JP3462597B2 - Ultrasound endoscope tip - Google Patents

Description

Description: BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a method for superposing an object on a distal end side of an object block provided with an objective optical system for obtaining an optical image of the surface of the object. The present invention relates to a distal end portion of an ultrasonic endoscope to which an ultrasonic scanning unit block provided with an ultrasonic probe for obtaining an ultrasonic tomographic image is connected. 2. Description of the Related Art In an ultrasonic endoscope as well, a biopsy tissue can be collected and other endoscopic procedures can be performed in the same manner as a general endoscope. It is desirable to be able to use tools. In order to control the position of the distal end of the treatment instrument in the body cavity, a treatment instrument raising table for changing the protruding direction of the treatment instruments is arranged. In order to sufficiently change the direction of the distal end of the treatment tool, it is necessary to form the treatment tool raising base to a certain size or more. In addition, so that the treatment instrument raising table does not protrude from the surface of the endoscope tip and damage the mucous membrane of the body cavity wall,
It is necessary to arrange it in a state housed in the recess. [0004] However, at the distal end of an ultrasonic endoscope in which an ultrasonic scanning unit block is connected to the distal end side of an objective unit block, a signal cable connected to an ultrasonic probe is not provided. Since it is inserted into the lower half of the objective unit block, the space and the recess for accommodating the treatment instrument raising table are arranged in the upper half of the objective unit block in parallel with the observation window and the illumination window. [0005] Therefore, in order to configure the treatment instrument raising table which needs a certain size or more so as not to protrude from the concave portion, the outer diameter of the distal end of the ultrasonic endoscope must be increased, and the patient has to be thickened. There was a drawback that the pain given to the person increased. Accordingly, the present invention provides a distal end portion of an ultrasonic endoscope which does not have a large outer diameter and has good insertability, while having a treatment instrument raising base capable of sufficiently changing the direction of the distal end of the treatment instrument. The purpose is to do. [0007] In order to achieve the above object, the distal end of the ultrasonic endoscope of the present invention is provided with an objective optical system for obtaining an optical image of the surface of the subject. At the distal end of the objective section block, at the distal end of an ultrasonic endoscope connected to an ultrasonic scanning section block provided with an ultrasonic probe for obtaining an ultrasonic tomographic image of the subject, In one of the left and right halves, a first slope in which an observation window and an illumination window are arranged is formed, and in the other half,
A recess in which a treatment tool raising table for changing the direction in which the treatment tools protrude is rotatably housed is formed alongside the first slope, and a portion located outside the recess is the first recess. The second slope is formed so as to protrude forward from the first slope at an angle which is higher than the slope. An embodiment will be described with reference to the drawings. FIG. 11 shows an overall configuration of an ultrasonic endoscope, in which a distal end body 1 is connected to a distal end of a flexible endoscope insertion section 40 inserted into a body cavity of a patient. In addition, a bending portion 30 that is bendable by remote control is formed on the distal end side of the insertion portion 40. An operation section 41 is connected to the base end of the insertion section 40. The operating section 41 includes a bending operation knob 42 for remotely controlling the amount of bending of the bending section 30, a treatment tool raising operation lever 43 for performing a raising operation of a treatment tool raising table 14 described later, a treatment tool insertion channel. An insertion port 44 for inserting a treatment instrument, an air supply switch 45a for performing operations for ejecting air and water from the air supply nozzle 6 of the distal end body 1, a suction operation via a forceps channel, and the like. A suction switch 45b and the like are provided. Reference numeral 46 denotes a water injection port for sending deaerated water into the balloon when the balloon is attached to the distal end body 1. Reference numeral 47 denotes a suction line switching lever for switching the suction line between the forceps channel and the drainage line from the balloon. An eyepiece 48 having an eyepiece built therein is projected from the operation unit 41, and the base end side of the image guide fiber bundle is arranged at the observation position. Therefore, an optical image of the surface of the subject obtained in the distal end body 1 can be observed through the eyepiece 48. Reference numeral 50 denotes a light guide connector for connecting the incident end of the illumination light guide fiber bundle to the light source device; 51, an air / water supply socket; 52, a vent cap; 53, a suction nipple; Terminal. Reference numeral 60 denotes a processing circuit for performing electrical processing on the ultrasonic probe 3 described later. Reference numeral 61 denotes a CRT monitor for displaying and observing an ultrasonic tomographic image. FIGS. 1, 2 and 3 are a side view and a plan view, respectively, showing a part of the distal end body 1 cut away.
The distal end main body 1 is provided on the distal end side of an objective section block 1a provided with an objective optical system 2 for obtaining an optical image of the surface of the subject.
An ultrasonic scanning unit block 1b provided with an ultrasonic transmitter / receiver (hereinafter referred to as "ultrasonic probe") 3 for obtaining an ultrasonic tomographic image of a subject is detachably connected. Observation window 4, illumination window 5, and air / water nozzle 6
Is disposed on a first slope 7 formed obliquely forward on the left half of the upper surface side of the objective section block 1a. The first slope 7 is formed with a relatively gentle slope in order to obtain an area sufficient to arrange the observation window 4, the illumination window 5, and the air / water supply nozzle 6. As shown in FIG. 2, the objective optical system 2 is disposed in the observation window 4, and an image of a subject obliquely forward of the distal end main body 1 is formed on the incident end face of the image guide fiber bundle 9. And transmitted to the eyepiece 48. Note that a solid-state imaging device may be used instead of the image guide fiber bundle 9. The emission end of the light guide fiber bundle 10 is arranged in the illumination window 5. The air / water supply nozzle 6 opens toward the surface of the illumination window 5, and as shown in FIG. 3, an air / water supply tube 11 and a water / water supply tube 12 are united and connected. I have. Both tubes 11 and 12 are wound around the outer circumference with a coil for preventing breakage. In the right half on the upper surface side of the objective section block 1a, a treatment tool raising table 14 for changing the direction of projection of the treatment tools is rotated adjacent to the first slope 7 in the left half. A recess 15 is formed to be freely accommodated. The outlet of the treatment instrument insertion channel 13 is connected to the rear wall of the recess 15 so as to communicate therewith. The treatment instrument elevator 14 is supported in the recess 15 so as to be rotatable about a shaft 16. I have. A coil for preventing breakage is wound around the outer periphery of the treatment instrument insertion channel 13, and this channel 13 is also used as a suction channel for sucking and discharging dirty liquid and the like. Then, by operating the operation wire 17 remotely from the operation section 41, the treatment instrument raising table 14 is moved.
Rotates within the concave portion 15 as shown by the two-dot chain line in FIG. 1 and changes the protruding direction of the distal end of the treatment tool protruding through the treatment tool insertion channel 13 within the range indicated by A. be able to. As shown in FIG. 1, FIG. 2 and FIG. 5, the portion located outside the concave portion 15 has a second angle projecting forward from the first slope 7 at an angle rising from the first slope 7. Are formed on the inclined surface 18 of FIG. The base end of the second slope 18 is the first slope 7
The second slope 18 is formed so as to gradually protrude forward from the first slope 7 upward from there. As a result, the distal end portion of the treatment tool raising table 14 which does not protrude from the surface of the first slope 7 when it is inverted, but protrudes from the surface of the first slope 7 when rising,
Even at the time of raising, it does not protrude from the second slope 18 and there is no possibility of damaging the inner wall of the body cavity. Therefore, the treatment tool raising base 14 is formed to have a size necessary for sufficiently raising the treatment tools, and the outer diameter of the distal end main body 1 is not increased, and the treatment tool raising base is formed. The protrusions 14 can be configured so as not to damage the inner wall of the body cavity. The ultrasonic scanning unit block 1b is provided with an ultrasonic probe 3 formed in a convex shape, and a fan-shaped side of the distal end main body 1 in a plane including the central axis of the distal end main body 1. Scan. In this embodiment, an electronic scanning ultrasonic probe is used as the ultrasonic probe 3, but a mechanically scanning ultrasonic probe may be used. Reference numeral 21 denotes a water supply port for sending out degassed water for inflating the balloon when the balloon is expandable and contractable to the distal end main body 1. A drain port for discharging degassed water is formed. The objective block 1a of the distal end body 1 is formed of a metal member such as stainless steel.
The ultrasonic scanning unit block 1b is formed of a plastic material such as polycarbonate resin, which is softer than the objective unit block 1a, and the two are removably fitted and connected and fixed by screws. Therefore, when the ultrasonic scanning unit block 1b breaks down, only the ultrasonic scanning unit block 1b can be removed and replaced, and the ultrasonic scanning unit block 1b can be replaced by the objective unit block 1a. Since it is softer, in the case of breakage of the connecting portion, the ultrasonic scanning unit block 1b
Is easier to break, and only the ultrasonic scanning unit block 1b needs to be replaced. FIG. 5 shows a cross section (V-V cross section) of a connecting portion between the objective portion block 1a and the ultrasonic scanning portion block 1b. The connecting portion uses the lower half of the tip main body 1. It is sized. In the connecting portion, the ultrasonic scanning block 1
“b” is formed in such a shape that the top of a baseball home base-shaped pentagon is rounded to the lower side, and the side opposite to it is longer and the upper side is arranged. In the inside thereof, a hole 24 through which the signal cable 23 connected to the ultrasonic probe 3 passes is provided.
Are provided in the axial direction. A substantially pentagonal fitting hole 26 into which the outer surface of the ultrasonic scanning unit block 1b is almost exactly fitted is formed in one of the objective unit blocks 1a. The ultrasonic scanning unit block 1b is fitted. Therefore, the relative rotation between the objective unit block 1a and the ultrasonic scanning unit block 1b is prevented by this fitting state, particularly, by the long side portion. A flexible, for example, silicone rubber-based waterproof sealing material 27 is applied to the fitting surface without any gap so that water or the like does not enter the inside from the outside along the fitting surface. Since no seal member such as an O-ring is provided here, the length in the axial direction can be reduced. In addition, the waterproof sealing material 27 does not necessarily need to be soft. On the side of the ultrasonic scanning section block 1b of the fitting portion, a pair of metal plates 28 having female threads is formed.
28 are buried on the left and right. And fixing screw 29,
29 are metal plates 28, 28 from the side of the objective block 1a.
The ultrasonic scanning unit block 1b is fixed so as not to come out of the objective unit block 1a forward. The metal plates 28, 28 embedded in the ultrasonic scanning unit block 1b are formed in a non-circular shape so that the metal plates 28, 28 are not rotated by the force of tightening the fixing screws 29, 29. It should be noted that the metal plates 28, 28 may be simply formed with round holes, and the fixing screws 29, 29 may be screwed into the objective block 1a. In that case, the distal ends of the fixing screws 29, 29 are formed in a columnar shape to be fitted into the round holes. The distal end body 1 is connected to a distal end portion of a bending portion 30 which can be bent by remote control. As shown in FIG. 2, the connection is performed by fixing the node ring 31 at the forefront to the vicinity of the rear end of the objective unit block 1a with screws. As shown in FIG. 6, the bending portion 30 is formed by rotatably connecting a number of short tubular node rings 31 with rivets 32, and a rubber tube (not shown) is provided therearound. It is formed by coating. The rivets 32 are connected to the node rings 31 at 90 degrees from the adjacent rivets 32.
Are alternately rotated in the vertical and horizontal directions. Therefore, the bending portion 30 can be bent in any direction as a whole. Then, four bending operation wires 33 (33U...) Selectively towed from the operation section 41 are connected to each other as shown in FIG.
Are arranged along the inner periphery of the node rings 31 one at a time at 90 ° intervals in each of the up, down, left, and right directions. Therefore, by pulling any one of the bending operation wires 33U from the operation section 41, the bending section 30 bends accurately in the up, down, left, and right directions. FIG. 8 shows a cross section near the connecting portion between the distal end main body 1 and the curved portion 30. Inside the node ring 31, an air supply tube 11, a water supply tube 12, a treatment instrument insertion channel 13, a treatment Lifting table operation wire 17, image guide fiber bundle 9, light guide fiber bundle 1
0, internal components such as a tube 37 for feeding degassed water, a tube 38 for draining degassed water, and an ultrasonic probe signal cable 23 are inserted. Reference numeral 35 denotes a rubber tube that covers the bending portion 30. As shown in FIG. 8, in the distal end portion main body 1, there is no built-in object on the extension line of the bending operation wires 33U, 33L, 33R in the three directions of upward and left and right. On the extension of the downward bending operation wire 33D, the signal cable 23 arranged near the lower center passes. Therefore, if the signal cable 23 is straightly arranged rearward as it is, it interferes with the downward bending operation wire 33D. Accordingly, in this embodiment, as shown in FIG.
Before reaching the distal end fixing portion 34 of the downward bending operation wire 33D, the trajectory of the signal cable 23 is deformed so that the signal cable 23 does not interfere with the downward bending operation wire 33D. FIG. 10 is a schematic diagram showing a change of the trajectory of the signal cable 23 as viewed from the front. As shown by an arrow B, the trajectory of the signal cable 23 is changed to the side, and Of the bending operation wire 33D. Therefore, the downward bending operation wire 33
There is no need to shift the arrangement position of D left and right, and if the downward bending operation wire 33D is pulled, the bending section 30 bends accurately downward, and any of the other three bending operation wires 33U, If 33L and 33R are towed, it will bend correctly in either the upper direction or the left-right direction. According to the present invention, the part positioned outside the recess in which the treatment instrument raising table is rotatably accommodated is formed at an angle rising from the first slope on which the observation window and the like are formed. In this case, the size of the treatment tool table is made large enough to change the direction of the distal end of the treatment instrument, and the distal end portion of the ultrasonic endoscope is formed on the second slope projecting forward from the first slope. It is possible to obtain an excellent insertability with a small outer diameter without increasing the pain given to the patient.

BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is a side view showing a part of a distal end portion of an ultrasonic endoscope according to an embodiment. FIG. 2 is a side view showing a part of a distal end portion of the ultrasonic endoscope of the embodiment cut away. FIG. 3 is a plan view showing a part of a distal end portion of the ultrasonic endoscope of the embodiment, which is cut away. FIG. 4 is a partial perspective view of a distal end portion of the ultrasonic endoscope according to the embodiment. FIG. 5 is a sectional view taken along line VV of the embodiment. FIG. 6 is a side view showing a part of the curved portion of the embodiment cut away. FIG. 7 is a front sectional view of the bending portion mechanism of the embodiment. FIG. 8 is a sectional view taken along line VIII-VIII of the embodiment. FIG. 9 is a schematic plan cross-sectional view showing a trajectory change state of a signal cable in the vicinity of a connection portion between a distal end portion and a curved portion according to the embodiment. FIG. 10 is a schematic front view showing a trajectory change state of a signal cable in the vicinity of a connection portion between a distal end portion and a curved portion according to the embodiment. FIG. 11 is a perspective view showing the overall configuration of the ultrasonic endoscope according to the embodiment. [Description of Signs] 1 Tip main body 1a Object section block 1b Ultrasonic scanning section block 4 Observation window 5 Illumination window 7 First slope 14 Treatment tool elevator 15 Recess 18 Second slope

Continuation of the front page (56) References JP-A-56-156144 (JP, A) JP-A-1-284234 (JP, A) JP-A-6-63041 (JP, A) JP-A-58-171104 (JP) (U, U) 62-61104 (JP, U) (58) Fields investigated (Int. Cl. ⁷ , DB name) A61B 1/00 A61B 8/12

Claims (1)

(57) Claims 1. An ultrasonic tomographic image of a subject is provided on the distal end side of an objective section block provided with an objective optical system for obtaining an optical image of the subject surface. At the distal end of the ultrasonic endoscope connected to the ultrasonic scanning unit block provided with the ultrasonic probe, the objective unit block has an observation window and an illumination window in one of the left and right halves. Is formed, and a concave portion in which a treatment tool raising table for changing a protruding direction of the treatment tools is rotatably housed is formed in the other half portion with the first slope. The base portion is formed side by side, and the base portion is located on the outside of the concave portion with the base portion of the first slope.
As the distance from the base end increases, the first
Of the second slope projecting forward from the slope of the first slope.
A distal end portion of an ultrasonic endoscope, wherein the distal end portion is formed at an angle standing from a plane .