JP5809939B2 - Ultrasound endoscope puncture needle - Google Patents

Description

  The present invention relates to a puncture needle for an ultrasonic endoscope that is used by being inserted into an internal conduit of a convex-type ultrasonic endoscope.

19 and 20 show a conventional convex ultrasonic endoscope 100, a sheath 105 that can be inserted into and removed from the internal conduit of the ultrasonic endoscope 100, and a puncture needle 106 that can be inserted into and removed from the sheath 105. , Shows.
The ultrasonic endoscope 100 includes an operation unit (not shown), a flexible insertion unit 101 extending forward from the operation unit, and an ultrasonic probe 102 provided at the distal end of the insertion unit 101. doing. The vicinity of the distal end of the insertion portion 101 is a bending portion (not shown) that bends up and down in response to an operation of a bending operation lever (not shown) provided in the operation portion, and the portion located immediately before the bending portion is The tip portion 103 is made of a hard material and cannot be deformed. An internal conduit 104 is provided inside the operation unit and insertion unit 101. A portion of the internal conduit 104 excluding the front end and the rear end extends along the axis of the insertion portion 101, and the rear end of the internal conduit 104 is open at the operation portion. The front portion of the internal conduit 104 is constituted by a hole formed in the distal end portion 103. As shown in the drawing, the vicinity of the front end of the internal conduit 104 is bent, and the front end portion (the portion located in front of the bent portion) of the internal conduit 104 is inclined with respect to the axis of the insertion portion 101 (tip portion 103). doing. The front end of the internal conduit 104 is opened at the surface of the insertion portion 101 (tip portion 103), and the front end opening is located immediately after the ultrasonic probe 102.

The sheath 105 (and the puncture needle 106) can be inserted into and removed from the internal duct 104 from the rear end opening formed in the operation section.
The sheath 105 is a cylindrical member made of a flexible material such as resin and having both ends open.
The puncture needle 106 is a flexible hollow metal member, and the distal end surface of the puncture needle 106 is an inclined surface that is inclined with respect to the axis of the puncture needle 106 in a side view.

  When the sheath 105 and the puncture needle 106 are inserted into the ultrasonic endoscope 100 (internal conduit 104), first, the puncture needle 106 is inserted into the sheath 105 in advance outside the ultrasonic endoscope 100 (internal conduit 104). The tip of the puncture needle 106 is placed in the sheath 105 after insertion. Then, the sheath 105 and the puncture needle 106 are inserted together into the inner duct 104 from the rear end opening, and the distal end of the sheath 105 is projected outward from the front end opening of the inner duct 104. If the distal end portion of the puncture needle 106 protrudes outside the sheath 105 by sliding the puncture needle 106 forward relative to the sheath 105, the body cavity wall can be treated with the puncture needle 106.

JP 2002-306606 A

  For example, as shown in FIG. 19, when the puncture needle 106 is inserted into the sheath 105 in a state where the front end portion of the distal end surface is positioned downward and the rear end portion of the distal end surface is positioned upward, the front portion of the puncture needle 106 is When an upward biasing force is applied to the bending portion (for example, when the bending portion is bent so that the distal end portion of the insertion portion 101 (the portion located in front of the bending portion) faces downward by operating the bending operation lever). When the puncture needle 106 is slid forward relative to the sheath 105 in the internal conduit 104, a large frictional force is generated between the rear end portion of the distal end surface of the puncture needle 106 and the inner surface (ceiling surface) of the sheath 105. May occur, and the puncture needle 106 (the tip thereof) may not be able to move smoothly through the sheath 105.

  On the other hand, as shown in FIG. 20, the puncture needle 106 is inserted into the sheath 105 in a state where the front end portion of the distal end surface is positioned upward and the rear end portion of the distal end surface is positioned downward, and the puncture is performed in the internal conduit 104. When the needle 106 is slid forward relative to the sheath 105, the front end portion of the distal end surface of the puncture needle 106 is caught immediately before the bent portion of the sheath 105, or the rear end portion of the distal end surface of the puncture needle 106 is the sheath 105. There is a possibility that the puncture needle 106 (the tip thereof) cannot smoothly pass through the bent portion of the sheath 105 due to being caught on the inner surface (bottom surface) of the bent portion.

  The present invention provides an ultrasonic endoscope capable of smoothly moving an internal conduit having a bent portion formed in a convex ultrasonic endoscope while having a shape in which a distal end surface is inclined when viewed from the side. An object of the present invention is to provide a puncture needle for use.

The puncture needle for an ultrasonic endoscope of the present invention is flexible with respect to an internal conduit formed in an insertion portion that extends from an operation portion of a convex ultrasonic endoscope and has an ultrasonic probe at a distal end portion. In a flexible puncture needle that can be inserted / removed in a state of being covered with a sheath having a sheath, the inner conduit bends the vicinity of the distal end to incline the axis of the distal end with respect to the axis of the insertion section And the tip is opened immediately after the ultrasonic probe, and the puncture needle is inclined with respect to its own axis when viewed from the side, and in the longitudinal direction of the tip surface. When viewed from the side, formed at the rear end chamfered portion that is inclined with respect to the front end surface and the axis when viewed from the side, and formed at the front end portion in the longitudinal direction of the front end surface. Chamfering the front end face and the front end face inclined with respect to the axis. It is characterized in that it comprises a part, a.

  Furthermore, the peripheral edge chamfered portion formed on the entire peripheral edge portion of the front end surface is inclined with respect to the front end surface and the axis when viewed from the side and includes the rear end chamfered portion and the front end chamfered portion. Good.

The puncture needle for an ultrasonic endoscope of the present invention has a rear end portion of a distal end surface that is inclined with respect to its own axis when viewed from the side, and the distal end surface and the axis when viewed from the side. A rear end chamfered portion that is inclined with respect to the front end portion is formed, and a front end chamfered portion that is inclined with respect to the front end surface and the axis when viewed from the side is formed at the front end portion of the front end surface .
Therefore, even if the rear end portion of the distal end surface of the ultrasonic endoscope puncture needle contacts the inner surface of the sheath, the frictional force between the rear end chamfered portion and the inner surface of the sheath does not increase. The puncture needle can move smoothly in the sheath.
In addition, the distal end portion of the ultrasonic endoscope puncture needle is the bent portion of the sheath while the front end portion of the distal end surface of the ultrasonic endoscope puncture needle is positioned upward and the rear end portion of the distal end surface is positioned downward. When trying to pass through, the tip of the puncture needle comes into contact with the portion located immediately before the bent portion of the sheath. However, at this time, the inclination direction of the portion located immediately before the bent portion of the sheath is substantially parallel to the inclination direction of the distal end surface of the puncture needle, and the front end chamfered portion is formed at the front end portion (upper end portion) of the distal end surface. Therefore, there is little risk that the tip of the puncture needle will be caught on the portion immediately before the bent portion of the sheath or the sheath may be damaged. In addition, since the rear end chamfered portion is formed at the rear end portion (lower end portion) of the distal end surface of the puncture needle, the rear end chamfered portion extends along the inner surface of the sheath when the portion attempts to pass through the bent portion of the sheath. Therefore, the puncture needle passes through the bent portion of the sheath while bending the distal end portion thereof. Therefore, the puncture needle can smoothly pass through the bent portion of the sheath without damaging the sheath.

It is a side view in the connection state of the ultrasonic endoscope of one Embodiment of this invention and the puncture needle apparatus in the shortest state. It is a side view of the puncture needle device in the shortest state. It is a perspective view of a nozzle | cap | die. It is a vertical side view of the puncture needle device in the expanded state. It is a vertical side view of a nozzle | cap | die and a cylindrical connection part when it begins to screw the 1st protrusion piece and 2nd protrusion piece of a nozzle | cap | die to a 1st thread groove and a 2nd thread groove. FIG. 6 is a longitudinal side view similar to FIG. 5 when the first and second protrusions of the base are screwed into the first and second screw grooves. It is an expansion perspective view of the front-end | tip part of a puncture needle. It is an enlarged side view of the front-end | tip part of a puncture needle. A portion of the puncture needle with the front end of the distal end face positioned upward and the rear end of the distal end face positioned downward is inserted to the point immediately after the bent portion of the internal conduit of the ultrasonic endoscope. FIG. 9 is a side view similar to FIG. 9 when a puncture needle with the front end portion of the distal end surface positioned upward and the rear end portion of the distal end surface positioned downward is inserted up to the bent portion of the internal duct of the ultrasonic endoscope. It is. 9 is a side view similar to FIG. 9 when the distal end portion of the puncture needle with the front end portion of the distal end surface positioned upward and the rear end portion of the distal end surface positioned downward is protruded from the distal end opening of the sheath and pierced into the body cavity wall. It is. The same as FIG. 9 when the puncture needle with the front end portion of the distal end surface positioned downward and the rear end portion of the distal end surface positioned upward is inserted up to immediately after the bent portion of the internal duct of the ultrasonic endoscope It is a side view. 9 is a side view similar to FIG. 9 when a puncture needle with the front end portion of the distal end surface positioned downward and the rear end portion of the distal end surface positioned upward is inserted up to the bent portion of the internal duct of the ultrasonic endoscope. It is. 11 is a side view similar to FIG. 11 when the distal end portion of the puncture needle with the front end portion of the distal end surface positioned downward and the rear end portion of the distal end surface positioned upward is projected from the distal end opening of the sheath and pierced into the body cavity wall. It is. It is an expansion perspective view of the front-end | tip part of the puncture needle of a modification. It is an enlarged side view of the front-end | tip part of the puncture needle of a modification. It is an expansion perspective view of the front-end | tip part of the puncture needle of another modification. It is an enlarged side view of the front-end | tip part of the puncture needle of another modification. It is a side view similar to FIG. 9 of a prior art example. It is a side view similar to FIG. 12 of a prior art example.

Hereinafter, an embodiment of the present invention will be described with reference to the accompanying drawings. In the following description, in the front-rear direction, the distal end side of the insertion portion 13 is defined as “front” and the operation portion 11 side is defined as “rear” for the ultrasonic endoscope 10, and the puncture needle device 30 is punctured. The front end side of the needle 55 is “front”, and the stylet support cap 58 side is “rear”. First, the structure of the ultrasonic endoscope 10 to which the puncture needle device 30 can be attached and detached will be described.
The ultrasonic endoscope 10 is a convex-type ultrasonic endoscope, and includes both an operation unit 11 and a flexible insertion unit 13 that extends forward from the operation unit 11 and includes an ultrasonic probe 12 at the tip. A light guide tube and an ultrasonic image transmission tube (both not shown) extending from the operation unit 11 to the opposite side of the insertion unit 13, and at the ends of the light guide tube and the ultrasonic image transmission tube A light source connector and an ultrasonic image connector are provided. The bending portion 14 in the vicinity of the distal end portion of the insertion portion 13 bends in the vertical direction according to the rotation operation of the bending operation lever 15 provided in the operation portion 11. A treatment instrument insertion protrusion 16 is provided on the operation section 11, and a base 17 having a substantially cylindrical shape and open at both ends protrudes in a fixed state on the rear end surface of the treatment instrument insertion protrusion 16. It is. As shown in FIG. 3, in the vicinity of the distal end portion of the outer peripheral surface of the base 17, the first 17 having a symmetrical shape is located at a position shifted by 180 ° in the circumferential direction when viewed in the direction of the axis AL1 of the base 17. The projecting piece 18A and the second projecting piece 18B are integrally projected. The overall shape of the first projecting piece 18A and the second projecting piece 18B is a shape obtained by cutting off both sides of a circle along a pair of arcs that are symmetric with respect to the center point of the circle. An annular flange 19 having a circular shape when viewed from the front is provided on the outer peripheral surface of the base 17 while shifting the positions of the first and second projecting pieces 18A and 18B in the direction of the axis AL1. Furthermore, inside the operation part 11 and the insertion part 13, an inner pipe line 20 (FIG. 1, the rear end is connected to the base 17 and the front end is connected to the treatment instrument opening 21 formed near the front end of the insertion part 13. 9 to 14) are provided. As shown in the figure, the treatment instrument opening 21 is located immediately after the ultrasonic probe 12. A portion excluding the rear end portion (a portion located in the operation portion 11) and the front end portion 20 b of the internal pipe line 20 extends along the axis of the insertion portion 13. However, the axis of the front end 20b positioned in front of the bent portion 20a (see FIGS. 9 to 14) formed in the vicinity of the front end of the internal conduit 20 is inclined with respect to the axis of the insertion portion 13. Further, the front end portion (portion located immediately before the bending portion) of the insertion portion 13 is made of hard resin, and the front portion (portion shown in FIGS. 9 to 14) of the internal conduit 20 is formed on the insertion portion 13. Since it is formed by the hole formed in the front end portion (hard resin portion), the front portion of the internal conduit 20 cannot be deformed.
Also, an arrow-shaped endoscope-side index 22 is formed on one side surface of the treatment instrument insertion protrusion 16 by printing (see FIG. 1).
The ultrasonic imaging connector is connected to an ultrasonic diagnostic apparatus (not shown), the ultrasonic diagnostic apparatus is connected to a CRT monitor, and the ultrasonic probe 12 is covered with a rubber balloon (not shown). When the ultrasonic image rendering switch of the ultrasonic diagnostic apparatus is pressed, an ultrasonic wave is transmitted from the surface of the ultrasonic probe 12 toward the test part, and the ultrasonic probe 12 receives the ultrasonic wave reflected by the test part. . An ultrasonic signal transmission cable (not shown) for connecting the ultrasonic probe 12 and the ultrasonic image connector is provided inside the insertion unit 13, the operation unit 11, and the ultrasonic signal transmission tube. The ultrasonic image received by 12 is electrically processed by the ultrasonic diagnostic apparatus and displayed on the CRT monitor.

Next, the structure of the puncture needle device 30 will be described.
The puncture needle device 30 has a substantially cylindrical tubular connecting portion 31 formed of a hard resin (PC (polycarbonate) or a resin material capable of EOG sterilization such as Noryl). A through hole communicating with the internal space of the cylindrical connection portion 31 is formed in the front portion of the cylindrical connection portion 31, and an annular recess 33 is formed in the peripheral edge portion of the front end of the through hole. Further, on the inner peripheral surface of the through hole, a first screw groove 32A and a second screw groove 32B having a spiral shape centering on the axis AL2 of the cylindrical connecting portion 31 extending rearward from the annular recess 33 are formed. It is. The phase of the first screw groove 32A and the second screw groove 32B (circumferential position around the axis line AL2 of the cylindrical connection portion 31) constituting the double thread is shifted by 180 °, and the first screw groove The phase of the inlet side end portion 32A1 of 32A and the inlet side end portion 32B1 of the second screw groove 32B are shifted by 180 °.
In addition, an arrow-shaped index 38 is formed on one side surface of the cylindrical connection portion 31 by printing (see FIGS. 1 and 2).
A first lock support member 34, which is a cylindrical member having a diameter larger than that of the cylindrical connection portion 31 and made of hard resin (PC or the like), is concentrically fixed to the rear end portion of the cylindrical connection portion 31. The first lock support member 34 is formed with a female screw hole 35 that penetrates the first lock support member 34 in the radial direction, and the screw portion 37 of the first lock member 36 is screwed into the female screw hole 35. .

  In the internal space of the cylindrical connection part 31 and the first lock support member 34, the outer diameter is smaller than the inner diameter of the cylindrical connection part 31 and is substantially the same as the inner diameter of the rear part of the first lock support member 34. A sheath support member 39, which is a tubular member molded from the same material as the connection portion 31, is inserted so as to be slidable in the axial direction of the tubular connection portion 31 and the sheath support member 39. The rear end of the sheath support member 39 is open, and a holder 40 is fixed to the front end portion inside the sheath support member 39. A rear end portion of a sheath 42, which is a cylindrical member made of a flexible material such as resin and is open at both ends, is fitted and fixed in a through support hole 41 that penetrates the holder 40 in the axial direction of the sheath support member 39. The front portion of the sheath 42 protrudes forward of the cylindrical connection portion 31 through the inner circumferential space of the first screw groove 32A and the second screw groove 32B. A first stopper member 44, which is a cylindrical member made of hard resin (PC or the like) having a diameter larger than that of the sheath support member 39, is concentrically fixed to the rear end portion of the sheath support member 39. Accordingly, the sheath support member 39 includes a maximum pushing position (the position in FIG. 4) where the first stopper member 44 abuts the rear end surface of the first lock support member 34, and the first stopper member 44 is disposed behind the first lock support member 34. Maximum pull-out position separated from the end face rearward (not shown; the front end portion of the sheath support member 39 is located in the cylindrical connection portion 31, and the holder 40 abuts on the inner peripheral end portion of the first lock support member 34. Is further slidable with respect to the cylindrical connecting portion 31, and the amount of protrusion of the sheath 42 relative to the cylindrical connecting portion 31 is adjusted by sliding the sheath support member 39. it can. Further, when the first lock member 36 is rotated with respect to the female screw hole 35 and the end surface of the screw portion 37 is pressed against the outer peripheral surface of the sheath support member 39, the relative position of the sheath support member 39 with respect to the tubular connection portion 31 is changed. It can be held in a desired position.

  In the inner space of the sheath support member 39 and the first stopper member 44, both outer diameters thereof are substantially the same as the inner diameter of the rear end portion of the first stopper member 44, and both ends are formed of the same material as the cylindrical connection portion 31. A slide member 50, which is a tubular member having an opening, is inserted so as to be slidable in the axial direction of the tubular connection portion 31 and the sheath support member 39. A stopper 51 located in the inner space of the sheath support member 39 is provided at the front end of the slide member 50. Furthermore, the center through-hole of the 2nd lock support member 45 which is a cylindrical member consisting of hard resin (PC etc.) is slidably fitted to the outer peripheral surface of the slide member 50. The second lock support member 45 is formed with a female screw hole 46 that penetrates the second lock support member 45 in the radial direction, and the screw portion 48 of the second lock member 47 is screwed into the female screw hole 46. Yes. Therefore, the position of the second lock support member 45 with respect to the slide member 50 is adjusted, and the end surface of the threaded portion 48 of the second lock member 47 is pressed against the outer peripheral surface of the slide member 50, and the second lock support member with respect to the slide member 50 If the position of 45 is fixed, the protrusion amount of the sheath 42 with respect to the cylindrical connection portion 31 when the front end surface of the second lock support member 45 abuts on the rear end surface of the first stopper member 44 can be adjusted.

In the slide member 50, the stopper 51 is positioned at the rear end of the inner space of the sheath support member 39, and the rear end surface of the stopper 51 is in contact with the inner surface 44a of the first stopper member 44 (the rear end surface of the sheath support member 39 is in contact with the slide member 50). 4 (see FIG. 4), the front end face of the second lock support member 45 contacts the rear end face of the first stopper member 44, and the rear end face of the stopper 51 is the first end face. A sheath support member 39 (and a cylindrical connection) is provided between a protruding position (a position shown in FIGS. 1 and 2) where a puncture needle 55 (described later) protrudes from the distal end of the sheath 42 and is spaced forward from the inner surface of the stopper member 44. Slidable relative to part 31). The “projection position” shown in FIGS. 1 and 2 is a “projection position” when the second lock support member 45 is positioned at the rear end of the slide member 50, and the position of the second lock support member 45 is The “protruding position” when positioned forward is the front end surface of the second lock support member 45 spaced forward from the rear end portion 50a of the slide member 50 is in contact with the rear end surface of the first stopper member 44, and This is a position where a puncture needle 55 described later protrudes from the distal end of the sheath 42.
Further, as shown in FIG. 4, when the second lock support member 45 is held at the front end position with respect to the slide member 50 by the second lock member 47 and the second lock support member 45 is brought into contact with the first stopper member 44. Even if an external force is applied forward to the slide member 50, the slide member 50 does not slide forward from the storage position.

A front portion of a puncture needle support member 53 made of hard resin (polypropylene or the like) is fitted and fixed in the internal space of the rear end portion 50a of the slide member 50. The support hole 54 formed in the front part of the puncture needle support member 53 is made of a hollow metal material having flexibility and has a rear end opened and an opening 55a (see FIG. 1) in the vicinity of the front end. The rear end is fitted and fixed. As shown in FIGS. 7 and 8, the distal end surface 55b of the puncture needle 55 is inclined with respect to its own axis when viewed from the side. Furthermore, a peripheral chamfered portion 55c that is inclined with respect to the axis of the distal end surface 55b and the puncture needle 55 when viewed from the side is formed on the entire peripheral portion of the distal end surface 55b. As shown in FIGS. 7 and 8, the rear end portion in the longitudinal direction of the peripheral chamfered portion 55c is a rear end chamfered portion 55d, and the front end portion in the longitudinal direction is a front end chamfered portion 55e.
The front portion of the puncture needle 55 is inserted into the sheath 42 through the inner space of the sheath support member 39 and the slide member 50. When the slide member 50 is positioned at the storage position, the tip of the puncture needle 55 is positioned inside the sheath 42. However, when the slide member 50 is moved to the protruding position, the tip of the puncture needle 55 protrudes from the tip of the sheath 42 ( (See FIGS. 1, 11, and 14). A rear space 56 communicating with the support hole 54 is formed at the rear part of the puncture needle support member 53, and a male screw 57 is formed on the outer peripheral surface of the rear part of the puncture needle support member 53.
A stylus support cap 58 made of hard resin (for example, POM) can be attached to and detached from the puncture needle support member 53. At the front portion of the stylet support cap 58, a fitting portion 59 that can be inserted into and removed from the rear space 56 of the puncture needle support member 53 and an outer cylindrical portion 60 located on the outer peripheral side of the fitting portion 59 are concentric. A female screw 61 is formed on the inner peripheral surface of the outer cylindrical portion 60. Furthermore, the rear end of the stylet 63, which is a flexible member, is fixed to the stylet support cap 58. Therefore, when the fitting portion 59 is fitted in the rear space 56 and the female screw 61 is screwed into the male screw 57, the tip of the stylet 63 is inserted into the inner space of the puncture needle 55 from the rear end opening of the puncture needle 55, The front end portion of the let 63 closes the opening 55 a of the puncture needle 55.

Next, a procedure for attaching and detaching the puncture needle device 30 to the base 17 of the ultrasonic endoscope 10 will be described.
In order to connect the puncture needle device 30 separated from the ultrasonic endoscope 10 to the base 17 of the ultrasonic endoscope 10, first, the slide member 50 is positioned at the storage position as shown in FIG. The end surface of the screw portion 37 of the lock member 36 is separated from the outer peripheral surface of the sheath support member 39, and the end surface of the screw portion 48 of the second lock member 47 is pressed against the outer peripheral surface of the slide member 50. Then, the axial end AL1 and the axial line AL2 are made coincident and the endoscope side index 22 and the index 38 are located at the same circumferential position, the front end of the cylindrical connecting portion 31 and the base 17 are opposed to each other, and the sheath 42 is connected to the base 42 17 and the internal pipe line 20 are inserted.

Next, the annular recess 33 is fitted to the first projecting piece 18A and the second projecting piece 18B while maintaining the relative circumferential position of the base 17 and the cylindrical connecting part 31, and the first thread groove 32A is fitted. The inlet side end portion 32A1 and the inlet side end portion 32B1 of the second screw groove 32B are screwed (inserted) into the first protruding piece 18A and the second protruding piece 18B, respectively (see FIG. 5). In this state, the cylindrical connecting portion 31 is rotated with respect to the base 17, and as shown in FIG. 6, the first projecting piece 18A and the second projecting piece 18B are connected to the terminal position 32A2 of the first screw groove 32A and the second end. When the annular flange 19 is fitted into the annular recess 33 before reaching the terminal position 32B2 of the thread groove 32B, the cylindrical connecting portion 31 cannot be rotated further. In the present embodiment, both the female thread groove (first thread groove 32A and second thread groove 32B) formed in the cylindrical connecting portion 31 and the first projecting piece 18A and the second projecting piece 18B formed in the base 17 are provided. Since there are two threads, the base 17 and the puncture needle device 30 can be connected with a small amount of rotation even when the first screw groove 32A and the second screw groove 32B are elongated in the direction of the axis AL2. As shown in FIG. 1, when the connection between the cap 17 and the puncture needle device 30 is completed, the first lock member 36 and the second lock member 47 are located on the side opposite to the operation unit 11. Further, when viewed from the side, the front end portion of the distal end surface 55b of the puncture needle 55 is positioned upward, and the rear end portion of the distal end surface 55b is positioned downward (see FIGS. 9 to 11).
When the connection between the base 17 and the cylindrical connection portion 31 is completed, the first stopper member 44 is slid with respect to the cylindrical connection portion 31 so that the distal end of the sheath 42 protrudes from the treatment instrument opening 21 by several millimeters. After adjusting to (refer FIG. 1), the 1st locking member 36 is tightened and the position of the 1st stopper member 44 is fixed.

  When the puncture needle device 30 is connected to the ultrasonic endoscope 10 (the base 17) in this way, the puncture needle device 30 is brought into a stationary state with respect to the base 17 (the ultrasonic endoscope 10). Therefore, if the insertion portion 13 is inserted into the body cavity of the subject and the ultrasonic probe 12 (balloon) is brought into contact with the body cavity wall A (see FIG. 11), the operator looks at the image displayed on the CRT monitor. The puncture needle device 30 connected to the ultrasonic endoscope 10 can be operated. For example, when the stylet support cap 58 is unscrewed from the puncture needle support member 53 and the stylet support cap 58 is moved rearward with respect to the puncture needle support member 53, the stylet 63 extends from the inside of the puncture needle 55. Can be pulled out. Further, the second lock member 47 is rotated so that the end surface of the screw portion 48 is separated from the outer peripheral surface of the slide member 50 (the lock by the second lock member 47 is released), and the slide member 50 is slid forward. Then, the puncture needle 55 moves to the distal end side with respect to the sheath 42, and the distal end of the puncture needle 55 projects from the distal end of the sheath 42 when the slide member 50 moves to the projecting position (see FIGS. 1 and 11). ). Therefore, the body cavity wall A can be treated with the tip of the puncture needle 55 protruding from the tip of the sheath 42 (see FIG. 11). Further, by adjusting the slide position of the second lock support member 45 with respect to the slide member 50, the puncture needle 55 protrudes from the distal end of the sheath 42 when the second lock support member 45 comes into contact with the first stopper member 44. The amount can be adjusted.

  For example, when a downward urging force is applied to the front portion of the puncture needle 55 (for example, by operating the bending operation lever, the distal end portion of the insertion portion 13 (the portion positioned in front of the bending portion 14) is moved upward. When the puncture needle 55 is slid relatively forward with respect to the sheath 42 when the bending portion 14 is bent so as to face the lower end of the peripheral chamfered portion 55c and the inner surface (bottom surface) of the sheath 42 as shown in FIG. A frictional force is generated between However, since the rear end chamfered portion 55d inclined with respect to the axis of the distal end surface 55b and the puncture needle 55 when viewed from the side is formed at the lower end portion of the peripheral chamfered portion 55c, the frictional force at this time is large. It ’s hard to be. Therefore, even if the lower end portion of the peripheral chamfered portion 55 c is in contact with the inner surface (bottom surface) of the sheath 42, the puncture needle 55 can move smoothly in the sheath 42. Similarly, when an upward biasing force is applied to the front portion of the puncture needle 55 (for example, when the bending portion 14 is bent so that the distal end portion of the insertion portion 13 faces downward by operating the bending operation lever). When the puncture needle 55 is slid forward relative to the sheath 42, a frictional force is generated between the upper end portion of the peripheral chamfered portion 55c and the inner surface (ceiling surface) of the sheath 42 (not shown). However, since the front end chamfered portion 55e that is inclined with respect to the axis of the distal end surface 55b and the puncture needle 55 when viewed from the side is formed at the upper end portion of the peripheral chamfered portion 55c, the frictional force at this time increases. Therefore, the puncture needle 55 can move smoothly in the sheath 42 in this case.

Further, as shown in FIG. 10, when the distal end portion of the puncture needle 55 passes through the bent portion of the sheath 42, the distal end surface 55 b of the puncture needle 55 contacts the inner surface of the portion located immediately before the bent portion of the sheath 42. However, the inclination direction of the portion of the sheath 42 (parallel to the front end portion 20b) and the inclination direction of the distal end surface 55b are substantially parallel, and the front end chamfered portion 55e is formed at the upper end portion (front end portion) of the distal end surface 55b. Therefore, at this time, there is little possibility that the distal end portion of the puncture needle 55 is caught on the portion immediately before the bent portion of the sheath 42 or the sheath 42 is damaged. In addition, the rear end chamfered portion 55d formed at the lower end portion (rear end portion) of the front end surface 55b moves forward (in the diagonally upward direction) along the inner surface (bottom surface) of the sheath 42. It passes smoothly through the bent portion of the sheath 42 while being bent (see FIG. 11). Therefore, the puncture needle 55 can smoothly pass through the bent portion of the sheath 42 without damaging the sheath 42.
Furthermore, as shown in FIG. 11, when the distal end of the puncture needle 55 is projected from the distal end of the sheath 42, the angle formed by the distal end surface 55b with respect to the body cavity wall A becomes an angle close to a right angle. It becomes easy to stab the body cavity wall A.

In addition, since the first lock member 36 and the second lock member 47 are positioned on the opposite side of the operation unit 11, the operator can easily perform the rotation operation of the first lock member 36 and the second lock member 47. Is possible.
If the inlet-side end 32A1 of the first screw groove 32A is screwed to the second projecting piece 18B, and the inlet-side end 32B1 of the second screw groove 32B is screwed to the first projecting piece 18A. Because the first lock member 36 and the second lock member 47 are located on the operation unit 11 side when the connection between the cylindrical connection unit 31 and the base 17 is completed (the angle formed between the axis AL2 and the AL3 axis of the operation unit 11). Is smaller than 90 °, and the distance between the first lock member 36 and the second lock member 47 and the operation portion 11 becomes narrow), and the rotation operation of the first lock member 36 and the second lock member 47 becomes difficult. However, when the entrance-side end 32A1 is screwed into the second projecting piece 18B and the entrance-side end 32B1 is screwed into the first projecting piece 18A, the operator has the same index 38 as the endoscope side index 22 By visually recognizing that it is not located on the side, it is possible to reliably recognize that the rotational direction positions of the base 17 and the cylindrical connecting portion 31 are not correct, so that there is little possibility of such a problem.

On the other hand, if the surgeon connects the front end portion of the cylindrical connecting portion 31 and the base 17 with the endoscope side index 22 and the index 38 positioned at opposite circumferential positions (first screw groove). When the inlet side end portion 32A1 of 32A is screwed into the second projecting piece 18B and the inlet side end portion 32B1 of the second screw groove 32B is screwed into the first projecting piece 18A), FIG. As shown, when viewed from the side, the front end portion of the distal end surface 55b of the puncture needle 55 is positioned below, and the rear end portion of the distal end surface 55b is positioned upward.
For example, when an upward biasing force is applied to the front portion of the puncture needle 55 (for example, when the bending portion 14 is bent so that the distal end portion of the insertion portion 13 faces downward by operating the bending operation lever). When the puncture needle 55 is slid forward relative to the sheath 42, a frictional force is generated between the upper end portion of the peripheral chamfered portion 55c and the inner surface (ceiling surface) of the sheath 42 as shown in FIG. However, since the front end surface 55b and the rear end chamfered portion 55d inclined with respect to the axis of the puncture needle 55 are formed at the upper end portion of the peripheral chamfered portion 55c when viewed from the side, the frictional force at this time is large. It ’s hard to be. Therefore, even if the upper end portion of the peripheral chamfered portion 55 c is in contact with the inner surface (ceiling surface) of the sheath 42, the puncture needle 55 can move smoothly in the sheath 42. Similarly, when a downward urging force is applied to the front portion of the puncture needle 55 (not shown. For example, by operating the bending operation lever, the bending portion 14 is moved so that the distal end portion of the insertion portion 13 faces upward. When the puncture needle 55 is relatively slid forward with respect to the sheath 42, a frictional force is generated between the lower end portion of the peripheral chamfered portion 55c and the inner surface (bottom surface) of the sheath 42 (not shown). However, since the front end chamfered portion 55e that is inclined with respect to the axis of the distal end surface 55b and the puncture needle 55 when viewed from the side is formed at the lower end portion of the peripheral chamfered portion 55c, the frictional force at this time increases. Therefore, the puncture needle 55 can move smoothly in the sheath 42 in this case.

  Further, when the distal end portion of the puncture needle 55 passes through the bent portion of the sheath 42 (the portion bent by the bent portion 20a), the lower end portion (front end portion) of the distal end surface 55b of the puncture needle 55 is the bent portion of the sheath 42. It contacts the inner surface of the part located immediately before the part (see FIG. 13). However, since the front end chamfered portion 55e substantially parallel to the inclination direction (parallel to the front end portion 20b) of the portion of the sheath 42 is formed at the lower end portion (front end portion) of the front end surface 55b, the lower end portion of the front end surface 55b Is unlikely to get caught or damaged by the sheath 42, and the puncture needle 55 smoothly passes through the bent portion of the sheath 42 while bending its distal end (see FIG. 14).

  When it is desired to remove the puncture needle device 30 from the ultrasonic endoscope 10, the first thread groove 32A and the second thread groove are rotated by rotating the cylindrical connecting portion 31 with respect to the base 17 in the direction opposite to that when the puncture needle device 30 is mounted. The screwing (connection) between 32B, the first projecting piece 18A, and the second projecting piece 18B is released. When the puncture needle device 30 is pulled rearward from the base 17 after the connection is released, the puncture needle device 30 is separated from the ultrasonic endoscope 10 and the sheath 42 passes through the inner conduit 20 of the ultrasonic endoscope 10. And is pulled out from the base 17.

As mentioned above, although this invention was demonstrated based on the said embodiment, this invention can be implemented, giving various changes.
For example, you may implement a puncture needle in the aspect of FIGS. The puncture needles 65 and 66 in FIGS. 15 to 18 are made of the same material as the puncture needle 55 and have the same structure as the puncture needle 55 except for the tip shape.
The distal end surface 65a of the puncture needle 65 in FIGS. 15 and 16 is a plane that is inclined with respect to its own axis when viewed from the side. Furthermore, a rear end chamfered portion 65b that is inclined with respect to the axis of the distal end surface 65a and the puncture needle 65 when viewed from the side is formed at the rear end portion in the longitudinal direction of the distal end surface 65a. A front end chamfered portion 65c that is inclined with respect to the axis of the distal end surface 65a and the puncture needle 65 when viewed from the side is formed at the front end portion in the longitudinal direction. Thus, since the puncture needle 65 has the rear end chamfered portion 65b and the front end chamfered portion 65c at the front end portion, substantially the same operational effects as the puncture needle 55 can be exhibited.
The tip surface 66a of the puncture needle 66 of FIGS. 17 and 18 is a flat surface that is inclined with respect to its own axis when viewed from the side, and the rear end portion in the longitudinal direction of the tip surface 66a is viewed from the side. A rear end chamfered portion 66b that is inclined with respect to the axis of the distal end surface 66a and the puncture needle 66 is formed.
Since the puncture needle 66 has the rear end chamfered portion 66b at the distal end portion, it is possible to exhibit substantially the same operational effects as those achieved by the rear end chamfered portion 55d among the operational effects exhibited by the puncture needle 55. . Furthermore, since the front end portion of the distal end surface 66a is not chamfered, there is an advantage that the distal end portion can be easily inserted into the body cavity wall A or the like rather than the puncture needles 55 and 65.

Furthermore, the shape of the first and second protrusions 18A and 18B formed on the base 17 may not be the above-described shape.
Further, the endoscope side index 22 may be formed on the peripheral surface of the base 17, or the shapes (designs) of the endoscope side index 22 and the index 38 may be changed to different ones.
Alternatively, the annular flange 19 may be a non-annular projecting member that projects from the outer periphery of the base 17 without being annular.

DESCRIPTION OF SYMBOLS 10 Ultrasound endoscope 11 Operation part 12 Ultrasound probe 13 Insertion part 14 Bending part 15 Bending operation lever 16 Protrusion 17 for treatment instrument insertion | insert 18A 1st protrusion 18B 2nd protrusion 19 Annular flange 20 Inner pipe Path 20a Bend 20b Front end 21 Treatment instrument opening 22 Endoscope side index 30 Puncture needle device 31 Cylindrical connecting part 32A First screw groove 32B Second screw groove 32A1 32B1 Inlet side end 32A2 32B2 End position 33 Annular recess 34 First lock support member 35 Female screw hole 36 First lock member 37 Screw part 38 Index 39 Sheath support member 40 Holder 41 Through support hole 42 Sheath 44 First stopper member 45 Second lock support member 46 Female screw hole 47 Second Lock member (adjustment knob member)
48 Screw portion 50 Slide member 51 Stopper 53 Puncture needle support member 54 Support hole 55 Puncture needle 55a Opening 55b Front end surface 55c Peripheral chamfer 55d Rear end chamfer 55e Front end chamfer 56 Rear space 57 Male screw 58 Stylet support cap 59 Fitting Part 60 outer cylindrical part 61 female thread 63 stylet 65 puncture needle 65a distal end face 65b rear end chamfered part 65c front end chamfered part 66 puncture needle 66a front end face 66b rear end chamfered part AL1 AL2 AL3 axis

Claims (2)

It can be inserted into and removed from an internal conduit that extends from the operation section of the convex-type ultrasonic endoscope and is formed in the insertion section having an ultrasonic probe at the distal end while being covered with a flexible sheath. In a puncture needle having flexibility,
The inner pipe is formed by inclining the axis of the tip with respect to the axis of the insertion part by bending the vicinity of the tip and opening the tip immediately after the ultrasonic probe,
The puncture needle is
A tip surface inclined with respect to its own axis when viewed from the side;
A rear end chamfered portion which is formed at the rear end portion in the longitudinal direction of the front end surface and which is inclined with respect to the front end surface and the axis when viewed from the side;
A front end chamfered portion that is formed at the front end portion in the longitudinal direction of the front end surface and is inclined with respect to the front end surface and the axis when viewed from the side;
A puncture needle for an ultrasonic endoscope, comprising: The puncture needle for an ultrasonic endoscope according to claim 1 ,
Ultrasound endoscopy provided with a peripheral chamfered portion formed on the entire peripheral portion of the front end surface, which is inclined with respect to the front end surface and the axis when viewed from the side and includes the rear end chamfered portion and the front end chamfered portion. Puncture needle for mirror.

Images