JPH05344973A - Ultrasonic wave endoscope - Google Patents

Abstract

PURPOSE:To improve the insertion performance and sticking performance of an ultra sonic wave endoscope which can stick under an ultrasonic wave guide. CONSTITUTION:The center axis of an insertion part and the scan axis of an ultrasonic wave probe 26 whose transmission/receiving wave surface 27 is directed to the side surface direction are deflected by a prescribed quantity (x) in the radial direction, and the outside diameter of a supporting part 25 for supporting the probe made thinner than the outside diameter of the supporting part 33 of a clamp port for leading out a sticking needle in free appearance and disappearance in the scan sectional surface 28 of the ultrasonic wave probe. An observation optical system 36 is arranged on the side of the clamp port, and in the insertion part, a clap channel and a probe signal cable system can be inserted on one side, and the insertion member of the observation optical system can be inserted on the other side. The sticking under an ultrasonic wave guide is enabled, and the insertion performance is improved by reducing the outside diameter of the insertion part except for the necessary part, without increasing the length of the top edge hard part, and the pain of a patient can be reduced. With the constitution in which the projection direction of the needle is set within a favourable image range of the probe in the state where the erection board 31 close to the clamp port is perfectly turned up to a stopper, the excellent sticking is enabled.

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 which has a forceps port for ejecting a puncture needle or the like on the scanning surface of an ultrasonic probe so that the needle can be inserted and retracted into the living body. Regarding the endoscope.

[0002]

2. Description of the Related Art In an ultrasonic endoscope, Japanese Laid-Open Patent Publication No. 1-124444 (reference 1) discloses that an ultrasonic probe, a forceps port, and an observation optical system are laid out in this order from the tip. .. Further, in the one disclosed in JP-A-1-131243 (reference 2), the ultrasonic probe, the observation optical system, and the forceps port are arranged in a line in the same order from the tip to the hard tip portion. In both cases, the outer diameter (width) of the component supporting the ultrasonic probe and the component supporting the forceps port are the same, and the central axis of the insertion part and the scanning axis of the ultrasonic probe are the same. ing. Regarding the puncture procedure, the one described in Reference 2 does not have a function of adjusting the puncture angle of a treatment instrument such as a puncture needle at the forceps port, but the one disclosed in Reference 1 provides a raising table for adjusting the puncture angle. It has a protrusion angle of the needle that can be adjusted by adjusting the rising angle, and the position of the puncture needle can be ultrasonically observed.

[0003]

DISCLOSURE OF THE INVENTION Problems to be Solved by the Invention
As described above, in the ultrasonic endoscope, since the ultrasonic probe, the forceps mouth, and the observation optical system are arranged in a line from the tip, the tip hard length tends to be long, and the tip is continuous from the tip. Due to the same thickness, the subject suffers from pain when being inserted into the body cavity. The improvement of the insertability is useful for suppressing such a pain of the subject and shortening the examination time as a result, but there is a limit even if the miniaturization is advanced while keeping the configuration disclosed in the above document. ..

The applicant of the present invention has also proposed another ultrasonic endoscope in Japanese Patent Laid-Open Publication No. 1-173133, which has a center axis of the insertion portion and a rotation center of the rotor in the radial direction. By shifting the center of rotation and the center of curvature of the ultrasonic entrance / exit window to match, only a good image can be obtained in the entire circumferential direction, and the puncture needle can be freely retracted within the scanning cross section of the ultrasonic probe. It does not have a forceps port to lead it out.

Further, in the above-mentioned reference 1, although the raising table is provided, after the ultrasonic probe transmitting / receiving surface is brought into close contact with the inner wall surface of the body cavity, the protrusion angle of the needle ( θ) is adjusted, and the range of rising is wide, but it does not have a stopper function to regulate the rising angle. Since there is no stopper mechanism, the projection angle of the needle changes easily, it is often difficult to predict the projection direction and it is dangerous, and the operator will proceed with the procedure in order to avoid it, so it will take time for the examination. The burden on the patient also increases. In addition, when the ultrasonic probe transmitting / receiving surface is in close contact with the surface of the body cavity wall, a blind spot occurs where the needle cannot be seen in both the ultrasound image and the endoscope field of view, and depending on the situation, puncture under ultrasound guidance may be necessary. There are cases where it cannot be applied. Further, in the case of the reference 2, since the forceps mouth does not have a raising base and the needle is used exclusively by utilizing the slope of the outlet, the elevation angle (the slope angle of the outlet slope) must be reduced considerably. As a result, the needle is crossed near the surface of the ultrasonic wave transmitting / receiving surface to perform the puncture procedure. In other words, the puncture needle can be pierced only in the region near the wave transmission / reception surface, which makes it difficult to use, and
As mentioned above, since the raising angle is small, the needle does not fall within the range in which a good ultrasonic image can be obtained (usually, for example, about 10 mm or more from the surface of the transmitting / receiving surface), so there is also a problem that it is not possible to safely perform ultrasonic guided puncture. ..

The present invention is intended to realize an ultrasonic endoscope which is easy to use and has good operability, in which the disadvantages and inconveniences described above are eliminated, and the insertion property and the puncture property are improved. Is. More specifically, the tip of an ultrasonic endoscope capable of puncturing under ultrasonic guidance having a forceps port for projecting and retracting endoscopic treatment tools such as a puncture needle in the scanning cross section of the ultrasonic probe. An object of the present invention is to provide an ultrasonic endoscope which can have a short rigid length and can be obtained by making unnecessary portions thin so as to reduce the pain of a subject. Another object is to add a stopper function to the forceps port raising base to ensure that the treatment tools are within the good image range of the ultrasonic probe, and to easily and safely obtain good ultrasonic waves. An object of the present invention is to provide an ultrasonic endoscope capable of guided puncture.

[0007]

According to the present invention, the following ultrasonic endoscope is provided. An ultrasonic probe is provided so that the ultrasonic wave transmitting / receiving surface is directed to the lateral direction at the distal end configuration portion of the elongated insertion portion to be inserted into the living body, and the ultrasonic probe is on the same side as the ultrasonic wave transmitting / receiving surface of the ultrasonic probe. An ultrasonic endoscope in which a forceps port and an observation optical system for projecting and retracting endoscopic treatment tools such as a puncture needle in a scanning cross section of the ultrasonic probe is provided at a distal end portion closer to the hand than the ultrasonic probe. And
The central axis of the insertion part and the scanning axis of the ultrasonic probe are offset in the radial direction, and the outer diameter of the tip forming part supporting the ultrasonic probe is made smaller than the outer diameter of the tip forming part supporting the forceps port. An ultrasonic endoscope characterized by that, and an ultrasonic probe is provided in the distal end configuration portion of the elongated insertion portion, on the same side as the ultrasonic wave transmitting / receiving surface of the ultrasonic probe and on the nearer side than the ultrasonic probe. In the distal end configuration portion of the ultrasonic probe, a forceps port for retractably retracting endoscopic treatment tools such as a puncture needle and a raising base for adjusting the derivation angle of the treatment tools are provided in the scanning cross section of the ultrasonic probe. An ultrasonic endoscope, which is provided with a stopper mechanism that regulates the rising angle of the raising table, and is set so that the treatment tools fall within a good image range of the ultrasonic probe scanning range at the maximum raising time. It is an ultrasonic endoscope.

[0008]

According to the ultrasonic endoscope of the present invention, it is convenient to use and the operability can be improved. In the case of claim 1, the central axis of the insertion portion and the scanning axis of the ultrasonic probe with the ultrasonic transmission / reception surface oriented in the side direction are radially displaced, and the outer diameter of the portion supporting the ultrasonic probe is changed by the ultrasonic wave. By making the outer diameter of the forceps port that guides the puncture needle etc. into the scanning cross section of the probe slenderly smaller than the outer diameter of the part, the outer diameter of the insertion part can be made thin except for the necessary part without increasing the rigid length of the tip. Therefore, the insertability is improved. A puncture needle or the like can be led out from the forceps port into the scanning section, and the observation optical system can be arranged on the side of the forceps port by utilizing the above displacement. It is preferable to insert the forceps channel and the ultrasonic probe cable system into one of the insertion parts and the insertion member of the observation optical system into the other part.

According to a second aspect of the present invention, the stopper mechanism for regulating the raising angle of the raising table is set so that the puncture needle or the like is within the good image range of the ultrasonic probe scanning range at the time of maximum rise, so that the puncture procedure is performed. It suffices to raise the stand up to the state where it is regulated by the stopper mechanism and lead it out.In that state, the puncture needle, etc. will come out within the area of a good image, so that ultrasonically guided puncture can be performed safely and puncture performance is improved. improves. By the regulation by the stopper mechanism, the surgeon can easily predict the protruding direction of the puncture needle and the like, and also prevent unexpected changes in the protruding angle, and the tip is configured so that the puncture target site comes within a good image. By puncturing after moving the part, it is possible to make it difficult to use such that only the part near the transmitting / receiving surface is pierced, and it is possible to prevent blind spots.

[0010]

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

An operating section 2 is provided in succession to the inserting section 1, and the operating section 2 has a treatment tool, an insertion port 14 for deaerated water, an air / water feeding button 15, a suction button 16, and the bending section 12 described above. In addition to having an angle knob 17 for bending up and down and in four directions to the left and right, a raising operation knob 18 is further provided in the illustrated example. Raising control knob
As will be described later, 18 is used for operating a raising table whose raising angle is regulated by a stopper mechanism. Further, in the illustrated example, the operation unit 2 also includes an eyepiece unit for confirming the field of view of the endoscope.
The endoscope connector 4 connected to a light source device (not shown) via a universal cord 3 having a light guide, a suction tube, an air supply tube, a water supply tube and the like (not shown) is provided with the operation section 2 described above. Connected to. Further, the ultrasonic code 5 branches off in the middle of the universal code 3, which is connected to an ultrasonic diagnostic apparatus (not shown) through the ultrasonic connector 6 so that an ultrasonic tomographic image can be displayed on a monitor (not shown). ing. In the figure, reference numeral 20 denotes a sheath that will be touched in the description of later-described use, and 21 denotes an injection or suction syringe attached to the sheath end.

An ultrasonic probe is provided in the distal end constituting portion 11 which is a hard portion of the distal end of the insertion portion 4 into the body cavity, and the ultrasonic probe is provided on the same side as the ultrasonic transmission / reception surface of the ultrasonic probe. Also, a forceps port is provided at the distal end portion on the proximal side so that the treatment instrument for an endoscope such as a puncture needle can be pulled out in a scanning section of the ultrasonic probe. In particular,
The tip forming section 11 can be formed of an insulating member such as black plastic, and here, as shown in FIGS. 2 to 6, the tip supporting section 25 has a convex (convex) ultrasonic probe 26. Is slightly (for example 5-15
It is attached at an angle.

FIG. 2 is a plan view of the tip forming portion,
FIG. 3 is a view of the tip forming portion viewed from the tip side (left side in FIG. 2), and FIG. 4 is a side sectional view of the tip forming portion including the balloon portion (note that FIGS. Is shown with the balloon portion removed). 5 and 6 are diagrams for explaining the operation (the former shows the case when the raising table is inverted and the latter shows the case when the raising table is raised). The ultrasonic probe 26 shown in FIG.
4 to 4, the ultrasonic wave transmitting / receiving surface 27 is provided on the tip side support portion 25 in the side direction. As shown in FIG. 4, the support portion is divided into a front lid 25a and a main body 25b, which are connected by a fixing screw 25c and an adhesive 25d filling the inside. The tip side support portion 25 also has a scanning cross section 28 of the ultrasonic probe 26 at a rear position subsequent to the ultrasonic probe 26.
A forceps port 30 in which an endoscopic treatment tool 29 (Figs. 5 and 6) such as a puncture needle is arranged so as to be capable of projecting and retracting, and in the illustrated example, a raising operation of a hand-side operation unit 2 described later A raising base 31 is provided for adjusting the lead-out angle of the endoscopic treatment tools 29 by operating the knob 18 (FIG. 1). In order to be able to attach / detach the raising base 31 from the side, as shown in FIGS. 2 and 3, the tip forming portion 11 is provided with a lateral lid 32 on one side surface portion, and this is detachably attached. An example of the configuration related to the raising table 31 portion will be shown later.

An observation optical system can be provided on the other side portion facing the side lid 32 which is detachably attached. That is, in the present embodiment, as described above, the tip end main body 33 (FIGS. 2 and 3) of the forceps port 30 for ejecting the puncture needle or the like in the scanning section 28 of the ultrasonic probe 26 on the side opposite to the lateral lid 32 (FIGS. 2 and 3). )
Is an observation optical system consisting of an objective lens 34 and an illumination lens 35.
36, an air / water supply nozzle 37 for cleaning the objective lens 34 is mounted in the illustrated arrangement. Here, the visual field range 38 of the objective lens 34 of FIGS. 2 and 3 is oriented so as to supplement the blind spot of the scanning section 28 of the ultrasonic probe 26 and also overlap with the scanning section 28 (see FIG. 4). The forceps opening 30 and the observation optical system 36 are
As described above, instead of arranging them in the front-back direction (axial direction of the insertion part), the observation optical system 36, the air / water supply nozzle.
37 is disposed on the side of the forceps opening 30.

Further, in the present ultrasonic endoscope, the central axis of the insertion portion and the scanning axis of the ultrasonic probe are displaced in the radial direction, and the outer diameter of the tip forming portion supporting the ultrasonic probe is supported by the forceps port. Make it thinner than the outer diameter of the tip component. Specifically, FIG.
Further, as shown in FIG. 3, the central axis 39 of the insertion portion 1 including the forceps port support portion 33 and the scanning cross section 28 of the ultrasonic probe 26.
The (scanning axis) is set so that there is a displacement amount x in the radial direction of about 10 mm on the side of the horizontal lid 32. In addition, the tip side support portion 25
As shown in each of the figures, the outer diameter of the is slightly smaller than the outer diameter of the forceps port support portion 33 on the rear end side (width).

As shown in FIGS. 2 and 3, the forceps port 30 is arranged so as to be offset from the central axis 39 of the insertion portion by a radial displacement amount x, and the scanning axis of the ultrasonic probe 26 and the forceps port 30. Alignment with the axis of the puncture needle, therefore, it is possible to perform puncture under ultrasonic guidance even when using the puncture needle (29), and at the same time, avoid increasing the rigid length of the tip, and at the same time, the outer diameter of the insertion part 1 is not necessary. When making a thin wire, touch the forceps mouth 30
An observation optical system 36 and an air / water supply nozzle 37 can be arranged on the side of the
Moreover, in the insertion portion, the forceps channel and the signal cable of the ultrasonic probe 26 can be inserted into one side, and the observation optical system insertion member and the air / water supply tube can be inserted into the other side. The sectional configuration of FIG. 4 is a scanning section 28 of the ultrasonic probe 26.
Although a cross section along the (scanning axis) is shown, a plurality of signal cables 40 from the ultrasonic probe 26 pass under the forceps port 30 in the tip forming section 11 and the raising base 31 facing the port and pass from the operating section 2 over. It is connected to the ultrasonic connector 6 via the sound wave cord 5.

In addition to the forceps port 30 for ejecting the puncture needle in the scanning plane of the ultrasonic probe 26 so as to project into and retract from the tip forming portion 11, a raising base is also provided.
In the case where 31 is provided, in the present embodiment, a stopper mechanism that regulates the raising angle of the raising base 31 is provided, and the puncture needle is used as the ultrasonic probe when the robot is maximally raised (when the raising base is completely raised to the stopper). It is set so as to be within the good image range of the scanning range. Specifically, here, the puncture needle is positioned at the center position of the scanning range of the ultrasonic probe 26 when the ultrasonic probe 26 is raised to the maximum.
It is set so that the distance from the surface of is within the range of 25 mm ± 15 mm (Fig. 6).

7 and 8 show an example of details of the raising base 31 portion having the above-mentioned function. The raising base operating function has an operating wire 45 that raises (FIG. 6) and inverts (FIG. 5) the raising base 31, which includes a guide pipe 46 connected to the tip end body 33, and a guide tube 47 following the guide pipe.
(FIG. 8), and is connected to the raising operation knob 18 of FIG. Around the guide tube 47, a coil pipe 48 for preventing buckling of the tube is covered (FIG. 8). Raising stand
Although 31 is rotatably mounted on the tip end main body 33 about the rotation shaft 49, in the illustrated example, the stopper pin 50 is fixed to the raising base 31, while the raising base 31 is raised. A stopper surface 51 that regulates a 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 example, the rising angle is regulated by such a stopper mechanism. Then, the state in which the stopper pin 50 is in contact with the stopper surface 51 (FIG. 8), that is, the state in which the raising base 31 is completely raised to the position regulated by the stopper mechanism is the maximum raising time. As shown in FIG. 6, the puncture needle (29) is located at the center position of the scanning range from the surface of the ultrasonic wave transmitting / receiving surface 27 to the above-mentioned 25 mm ± 15 mm (hence, 10 mm minimum and 45 m maximum).
m) is set to fall within the good image range, so
This makes it possible to set the protruding direction of the puncture needle so as to fall within the good image range of the ultrasonic probe 26 during ultrasonic guided puncture.

In FIG. 4, the balloon portion is included as mentioned above, and as shown in the figure, the bag-like balloon 55 is detachably fixed around the ultrasonic probe 26 so as to cover it. The distal end side is fixed with a surgical cord 56 or the like so that the balloon 55 does not bulge toward the distal end side. Although not shown in the drawing, the balloon 55 has one inside the insertion part 1 in FIG. 1, and branches into two before the air / water supply button 15 and the suction button 16 in the operation part 2. Degassed water through the tube and operating these buttons 15 and 16
57 injection / drainage shall be performed. Moreover, FIGS.
In the figure, 61 indicates the inner wall of the body cavity, and 62 indicates the subject.

Ultrasonic diagnosis by the above-described ultrasonic endoscope, ultrasonic guided puncture, that is, an ultrasonic probe 26 is provided in the insertion portion 1 into the body cavity, and a scanning cross section 28 of the ultrasonic probe 26 is provided. The ultrasonic diagnosis or ultrasonic guided puncture of the object 62 to be inspected, which is provided with the forceps port 30 through which the puncture needle can be pulled out freely, can be performed as follows. At the time of 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 this ultrasonic endoscope, the insertion portion 1
The central axis 39 of the ultrasonic probe 26 and the scanning axis of the ultrasonic probe 26 with the ultrasonic transmission / reception surface 27 directed in the lateral direction are radially displaced (deviation amount x), and the distal end side supporting portion 25 as the ultrasonic probe 26 supporting portion is formed.
The outer diameter of is used as a support portion of the forceps port 30 for projecting and retracting the puncture needle into the scanning cross section 28 of the ultrasonic probe 26, and is made smaller than the outer diameter of the tip end main body 33. The pain is relieved. Compared with the case where the ultrasonic probe, forceps mouth, and observation optical system are arranged in a line from the distal end in the insertion direction, and the objective window and the illumination window in that case are scanned by the ultrasonic probe. Compared with the case where the forceps ports for ejecting the puncture needle so as to project and retract freely in the cross section are arranged on the left and right sides, in this configuration, the distal end hard length of the insertion part 1 can be made short and the distal end side The thickness of the support portion 25 is also the ultrasonic probe.
It can be made thin as much as possible while ensuring the puncture function capable of ultrasonically guided puncture with the axis of 26 and the axis of the forceps port 30 aligned, and the tip does not become thick. An observation optical system 36, an air / water feeding nozzle 37, etc. can be arranged on the side of the forceps port 30 as shown in FIGS. 2 and 3, and a forceps channel and a super-channel are provided on one side in the insertion portion 1 as shown in FIG. Since the signal cable 40 of the sonic probe 26 and the like for the observation optical system 36 and the air / water supply tube can be inserted into the other, the outer diameter of the insertion part 1 is not required without increasing the rigid length of the tip. By thinning the large portion, the insertability is improved, and the pain of the subject can be reduced accordingly. Improving the operability is advantageous in shortening the examination time, and also reduces the burden on the operator.

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

When a region to be treated is found on the basis of an ultrasonic tomographic image displayed on the monitor of the apparatus by such ultrasonic diagnosis, a treatment is carried out. In that case, even when a puncture treatment is performed, the ultrasonic endoscopy is performed. The mirror can safely perform good ultrasonic guided puncture. In this embodiment, the ultrasonic probe
The stopper 50 and the stopper surface 51 that regulate the rising angle of the raising base 31 that faces the forceps port 30 located in the above-described relationship with 26.
The stopper mechanism is provided so that the needle enters the good image range within the scanning range of the ultrasonic probe 26 when the robot is maximally raised, so that the stopper pin 50 of the raising base 31 strikes the stopper surface 51. The projection direction of the needle can be easily predicted just by raising the needle up, and the projection angle of the needle does not change easily, so it is possible to safely perform puncture under ultrasonic guidance, and the needle moves out within the area of a good image. If the distal end is moved by using a bending mechanism or the like so that the puncture target site is located in this area, and then puncture is performed, there is no blind spot and safe operation can be performed.

The specific procedure is as follows. First,
Perform the required movement of the tip component 11. That is, the subject 62 to be treated by collecting tissue by puncturing or locally injecting ethanol is placed in a good image range within the scanning section 28 (here, 10 mm or more from the surface of the ultrasonic wave transmitting / receiving surface 27). Then, the tip forming portion 11 is moved by operating the bending portion 12 or the like. here,
As shown in FIG. 6, when it is 5 mm or less, or when it is 45 mm or more, it is difficult to obtain a good ultrasonic image, and therefore, it is usually within the above range which is a range in which a good ultrasonic image can be obtained. Is good.

Next, the endoscopic treatment tools 29 such as a puncture needle,
Insert from the insertion opening 14 (FIG. 1) of the hand side operation unit 2. In this case, first, as shown in FIG. 5, the raising base 31 is inserted with the tilted state as shown in FIG. In the state in which the raising base 31 is inverted, the treatment tool 29 having a long hard portion can be inserted into the body cavity because the treatment tool 29 exits from the forceps port 30 almost forward. Then, when the treatment instrument 29 has reached the flexible portion, the raising base 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 raising base 31 contacts the stopper surface 51, the raising base 31 stops there. That is, the raising base 31 takes the position shown in FIG.

Regarding the angle in this case, as described above, in the present embodiment, the treatment instrument 29 is located at the center position of the scanning range (18) of the ultrasonic probe 26 from the surface of the ultrasonic 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 has only to perform an operation of raising to the maximum raising state regulated by the stopper mechanism. It will be. Thus, after the above-mentioned raising, the treatment instrument 29 is pushed toward the inner wall 61 of the body cavity by pushing the treatment tool 29 with the sheath 20 on the proximal side, and as shown in FIG. To reach. The above-mentioned state can be confirmed in the endoscope visual field by the objective lens visual field range 38 up to the inner wall 61 of the body cavity, and after that, it is displayed on the ultrasonic monitor and its entry is monitored within the area of a good image. it can. Then, after the tip reaches the object 62 to be inspected, the injection or suction syringe 21 may be attached to the end of the sheath 20 as shown in FIG. 1 to inject ethanol or perform a tissue biopsy.

As described above, according to the present ultrasonic endoscope, it is possible to prevent the protrusion angle from being changed unlike the case where the stopper mechanism is not provided, and it is possible to avoid the occurrence of a blind spot. Ultrasonic guided puncture can be performed safely and satisfactorily, since only the stopper mechanism needs to completely raise 31. In this embodiment, the stopper mechanism is composed of 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. The stopper mechanism may be configured to regulate the maximum rising state by contacting the surfaces of the side surface 60 of the raising base 31 and the bottom surface 61 of the forceps opening as shown in FIG. It may be provided not only in the vicinity of 31 but also in the operation portion 2. In any case, as in the case of the stopper pin 50 and the stopper surface 51, the puncture property is improved, and a simple and reliable method is provided to ensure good safety. Ultrasonic guided puncture can be realized.

The following is another embodiment of the present invention. The present embodiment, like the one according to the previous embodiment, is provided with an ultrasonic probe with the ultrasonic transmitting / receiving surface oriented in the lateral direction at the distal end constituent part of the elongated insertion part to be inserted into the living body. In the case of providing a forceps port and an observation optical system for ejecting the puncture needle in the scanning cross section of the ultrasonic probe at the tip side of the ultrasonic probe on the same side as the ultrasonic wave transmitting / receiving surface and on the side closer to this ultrasonic probe, A configuration in which the central axis of the insertion portion and the scanning axis of the ultrasonic probe are displaced in the radial direction, and the outer diameter of the tip forming portion supporting the ultrasonic probe is made smaller than the outer diameter of the tip forming portion supporting the forceps port. In addition to the ultrasonic endoscope, the ultrasonic probe is provided at the distal end portion of the elongated insertion portion, and the ultrasonic probe is provided at the distal end portion on the same side as the ultrasonic wave transmitting / receiving surface of this ultrasonic probe. Puncture needle in the scanning section of When installing a raising stand that adjusts the lead-out angle of the puncture needle by operating the forceps port that pulls out and retracts freely and the raising operation knob on the proximal side, a stopper mechanism that regulates the raising angle of the raising stand is provided. Any one of the ultrasonic endoscopes configured such that the puncture needle is set up so that the distance from the surface of the ultrasonic wave transmitting / receiving surface is within the range of 25 mm ± 15 mm at the center position of the scanning range of the ultrasonic probe when rising. Can also be applied.

FIG. 9 is a plan view of the tip forming portion of the ultrasonic endoscope according to the present embodiment, FIG. 10 is a view for explaining the main part in its section AA, and FIG. 11 is a view in the optical visual field. Other components shown and not shown may be the same as those in the above embodiment. In this embodiment, the objective lens 34 and the illumination lens 35 shown in FIGS. 2 and 3 of the above embodiment are arranged side by side on the side of the raising base 31 as shown in FIG. The direction 65 of the visual field is tilted toward the scanning section 28 side of the ultrasonic probe 26 (FIG. 10), and the distal end of the treatment instrument 29 such as a puncture needle as shown in FIG. It is arranged so that it is near the center of 66.

Also in this embodiment, an ultrasonic endoscope with a puncture function can be realized without increasing the length of the rigid tip and without thickening the tip portion, and also when introducing a puncture needle,
This can be done more safely and reliably. Figures 12 and 13
Is shown in comparison with the case of FIGS. 9 to 11, and the 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 the path on the plane including the broken line) as shown in FIG.
In that case, as shown in FIG. 13, the treatment instrument 29 is drawn around the optical visual field 66, which makes it difficult to visually recognize it. On the other hand, in this configuration, even in the case of the layout as shown in FIG.
The puncture needle, etc. can be well drawn in the ultrasonic image, and as shown in Fig. 11, it can be well drawn near the center of the optical field of view 66, thus improving safety and certainty, and with a simple structure. It is possible to safely and surely introduce endoscopic treatment tools such as.

The present invention is not limited to the above embodiments and modifications. For example, although the one according to FIG. 1 has an eyepiece, it may be eliminated and a solid-state image pickup device may be arranged at the tip so that an endoscopic image can be observed on the monitor like an ultrasonic image. Further, the ultrasonic probe may be a linear element / sector element or a combination thereof instead of the convex shape, or may be a mechanical element. In addition, various modifications and changes can be made within a range that does not deviate from the improvement of the insertability and the puncture property which are the aims of the present invention.

[0033]

According to the present invention, it is possible to shorten the rigid length of the tip of an ultrasonic endoscope capable of puncturing under ultrasonic guidance and to make unnecessary portions thinner to improve insertability. The pain can be reduced, the examination time can be shortened, and the burden on the operator can be reduced. In addition, the protruding direction of the treatment instrument such as the puncture needle can be included in the good image range of the ultrasonic probe simply by raising the raising table to a state where it is restricted by the stopper mechanism, improving the puncture property and making it easy and reliable. In addition, it is possible to safely perform good ultrasonic guided puncture.

[Brief description of drawings]

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

FIG. 2 is a plan view for explaining a tip forming portion of the same example.

FIG. 3 is a view seen from the tip side (left side in FIG. 2) of the tip forming portion.

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

FIG. 5 is a diagram (when the raising table is inverted) provided for explaining the operation when performing ultrasonic guided puncture.

[Fig. 6] Similarly, a diagram for explaining the operation (when the elevator is raised)
Is.

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

FIG. 8 is a diagram for explaining a regulation state of the raising angle of the raising base.

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

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

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

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

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

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 Insertion part 2 Operation part 11 Tip structure part 12 Bending part 13 Flexible part 18 Raising operation knob 19 Eyepiece part 25 Tip side support part 26 Ultrasonic probe 27 Ultrasonic wave transmission / reception surface 28 Scanning cross section (scanning axis) 29 Puncture needle etc. Endoscope treatment tools 30 Forceps port 31 Raising base 33 Forceps port support 34 Objective lens 35 Illumination lens 36 Observation optical system 38 Field of view 39 Center axis 45 Operating wire 50 Stopper pin 51 Stopper face 60 Side face of elevator 61 Bottom of forceps outlet 65 Field of view of objective lens 66 Optical field of view

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[Procedure amendment]

[Submission date] July 10, 1992

[Procedure Amendment 1]

[Document name to be amended] Statement

[Name of item to be corrected] Claim 1

[Correction method] Change

[Correction content]

[Procedure Amendment 2]

[Document name to be amended] Statement

[Correction target item name] 0006

[Correction method] Change

[Correction content]

The present invention is intended to realize an ultrasonic endoscope which is easy to use and has good operability, in which the disadvantages and inconveniences described above are eliminated, and the insertion property and the puncture property are improved. Is. More specifically, the tip of an ultrasonic endoscope capable of puncturing under ultrasonic guidance having a forceps port for projecting and retracting endoscopic treatment tools such as a puncture needle in the scanning cross section of the ultrasonic probe. An object of the present invention is to provide an ultrasonic endoscope which can have a short rigid length, can make unnecessary portions thin, and can reduce the pain of a subject. Another object is to add a stopper function to the forceps port raising base to ensure that the treatment tools are within the good image range of the ultrasonic probe, and to easily and safely obtain good ultrasonic waves. An object of the present invention is to provide an ultrasonic endoscope capable of guided puncture.

[Procedure 3]

[Document name to be amended] Statement

[Correction target item name] 0009

[Correction method] Change

[Correction content]

According to a second aspect of the present invention, the stopper mechanism for regulating the raising angle of the raising table is set so that the puncture needle or the like is within the good image range of the ultrasonic probe scanning range at the time of maximum rise, so that the puncture procedure is performed. It suffices to raise the stand up to the state where it is regulated by the stopper mechanism and lead it out.In that state, the puncture needle, etc. will come out within the area of a good image, so that ultrasonically guided puncture can be performed safely and puncture performance is improved. improves. By the regulation by the stopper mechanism, the surgeon can easily predict the protruding direction of the puncture needle and the like, and also prevent unexpected changes in the protruding angle, and the tip is configured so that the puncture target site comes within a good image. By puncturing after moving the part, it is possible to make it difficult to use, such as puncturing only a portion near the wave transmission / reception surface, and to prevent blind spots.

[Procedure amendment 4]

[Document name to be amended] Statement

[Name of item to be corrected] 0019

[Correction method] Change

[Correction content]

In this example, the rising angle is regulated by such a stopper mechanism. Then, the stopper pin 50 is the stopper surface.
The state in which it abuts against 51 (FIG. 8), that is, the state in which the raising base 31 is completely raised to the position regulated by the stopper mechanism is the maximum raising time, and the angle at this time is as shown in FIG. The puncture needle (29) is at the center position of the scanning range, and is 25 mm ± 15 mm from the surface of the ultrasonic wave transmitting / receiving surface 27 (hence, minimum 10 mm, maximum 45 mm).
Therefore, it is possible to set the protruding direction of the puncture needle so as to fall within the good image range of the ultrasonic probe 26 during puncture under ultrasonic guidance.

[Procedure Amendment 5]

[Document name to be amended] Statement

[Name of item to be corrected] 0022

[Correction method] Change

[Correction content]

In this case, in this ultrasonic endoscope, the insertion portion 1
The central axis 39 of the ultrasonic probe 26 and the scanning axis of the ultrasonic probe 26 with the ultrasonic transmission / reception surface 27 directed in the lateral direction are radially displaced (deviation amount x), and the distal end side supporting portion 25 as the ultrasonic probe 26 supporting portion is formed.
The outer diameter of is used as a support portion of the forceps port 30 for projecting and retracting the puncture needle into the scanning cross section 28 of the ultrasonic probe 26, and is made smaller than the outer diameter of the tip end main body 33. The pain is relieved. Compared with the case where the ultrasonic probe, forceps mouth, and observation optical system are arranged in a line from the distal end in the insertion direction, and the objective window and the illumination window in that case are scanned by the ultrasonic probe. Compared with the case where the forceps ports for ejecting the puncture needle so as to project and retract freely in the cross section are arranged on the left and right sides, in this configuration, the distal end hard length of the insertion part 1 can be made short and the distal end side The thickness of the support portion 25 is also the ultrasonic probe.
It can be made as thin as possible while ensuring the puncture function capable of ultrasonically guided puncture with the axis of 26 and the axis of forceps port 30 aligned, and the tip does not become thick. An observation optical system 36, an air / water feeding nozzle 37, etc. can be arranged on the side of the forceps port 30 as shown in FIGS. 2 and 3, and a forceps channel and a super-channel are provided on one side in the insertion portion 1 as shown in FIG. Since the signal cable 40 of the sonic probe 26 and the like for the observation optical system 36 and the air / water supply tube can be inserted into the other, the outer diameter of the insertion part 1 is not required without increasing the rigid length of the tip. By thinning the large portion, the insertability is improved, and the pain of the subject can be reduced accordingly. Improving the operability is advantageous in shortening the examination time, and also reduces the burden on the operator.

[Procedure Amendment 6]

[Document name to be amended] Statement

[Name of item to be corrected] 0030

[Correction method] Change

[Correction content]

FIG. 9 is a plan view of the tip forming portion of the ultrasonic endoscope according to the present embodiment, FIG. 10 is a view for explaining the main part in its section AA, and FIG. 11 is a view in the optical visual field. Other components shown and not shown may be the same as those in the above embodiment. In this embodiment, the objective lens 34 and the illumination lens 35 shown in FIGS. 2 and 3 of the above embodiment are arranged side by side on the side of the raising base 31 as shown in FIG. The direction 65 of the visual field is tilted toward the scanning section 28 side of the ultrasonic probe 26 (FIG. 10), and as shown in FIG. 11, the tip of the treatment instrument 29 such as a puncture needle is near the best focus and the optics of the eyepiece 19 (FIG. 1) It is arranged so as to be near the center of the visual field 66.

Claims (2)

[Claims] 1. An ultrasonic probe is provided on a distal end portion of an elongated insertion part to be inserted into a living body so that an ultrasonic wave transmitting / receiving surface is oriented in a lateral direction, and the ultrasonic probe has the same side as the ultrasonic wave transmitting / receiving surface. In addition, a forceps port and an observation optical system are provided at the distal end portion on the side closer to the ultrasonic probe than the ultrasonic probe so that the treatment tools for the endoscope such as a puncture needle can be projected and retracted in the scanning section of the ultrasonic probe. An ultrasonic endoscope, in which the central axis of the insertion portion and the scanning axis of the ultrasonic probe are offset in the radial direction, and the outer diameter of the tip forming portion that supports the ultrasonic probe is the tip that supports the forceps port. An ultrasonic endoscope characterized in that it is made thinner than the outer diameter of its constituent parts. 2. An ultrasonic probe is provided at the tip forming portion of the elongated insertion portion, and the ultrasonic probe is provided at the tip forming portion on the same side as the ultrasonic wave transmitting / receiving surface of the ultrasonic probe and closer to the hand than the ultrasonic probe. An ultrasonic endoscope in which a forceps port for retracting and retracting endoscopic treatment tools such as a puncture needle and a raising base for adjusting the derivation angle of the treatment tools is provided in the scanning cross section of the ultrasonic probe. A stopper mechanism that regulates the raising angle of the raising base,
An ultrasonic endoscope characterized in that the treatment tools are set so as to be within a good image range of the ultrasonic probe scanning range at the time of maximum rise.