JPH0620455B2 - Intracorporeal ultrasound diagnostic device - Google Patents

Description

Description: TECHNICAL FIELD The present invention relates to an intracorporeal ultrasonic diagnostic apparatus that inserts an ultrasonic scanner unit into a body cavity to perform ultrasonic diagnosis from the inside of the body cavity.

[Conventional technology]

There is a method of performing ultrasonic guided puncture of deep internal organs using an ultrasonic diagnostic device of the type of performing ultrasonic diagnosis by applying an ultrasonic scanner to the outer surface of the human body, but it is necessary to pierce the puncture needle deeper, In addition, the resolution of the ultrasonic tomographic image is poor, which is dangerous. Therefore, if the ultrasonic guided puncture needle is used from the inside of the body cavity using the ultrasonic endoscope, the puncture can be guided and operated by a high-resolution ultrasonic tomographic image. Furthermore, since the puncture depth is small, safe and reliable puncture can be performed.

Furthermore, conventionally, two endoscopes are simultaneously inserted into a patient and under ultrasound guidance, a puncture needle is projected from one endoscope and inserted into a guide port of the other endoscope to perform puncture. A device has been proposed. (Japanese Patent Laid-Open No. 60-75026) [Problems to be solved by the invention] However, in the case of the conventionally proposed one, since two endoscopes are inserted at the same time, the pain of the patient at the time of insertion is reduced. It is difficult, and it is very difficult to guide the puncture needle from the other endoscope to the guide port provided in the one endoscope.

The present invention has been made in view of such a problem, and provides an intracorporeal ultrasonic diagnostic apparatus that can be inserted without causing pain to a patient and that can easily guide a puncture needle to an ultrasonic scanning range. The purpose is to do.

[Means for solving problems]

This apparatus is provided with a means for determining the protruding direction of the puncture needle at the tip of the ultrasonic scanner or the puncture needle guide tube of the ultrasonic diagnostic apparatus in the body cavity.

[Action]

In this device, the puncture needle projecting from the puncture needle guide tube is projected in a predetermined direction by means for determining the projection direction of the puncture needle.

〔Example〕

1 to 4 show a first embodiment of the present invention.

The body cavity ultrasonic scanner 1 shown in FIG. 1 comprises an operating section 2 and an inserting section 3. Further, a universal cord 4 and an electric cable 5 are connected to the operating section 2, and the extension tip of the universal cord 4 is not shown. A connector 6 connected to an endoscope light source is provided, and the electric cable 5 is connected to an ultrasonic observation device (not shown). And the insertion part 3
Is formed by connecting a distal end hard portion 9 to the distal end of the flexible portion 7 on the base end side through a bending portion 8. The bending portion 8 is moved vertically and horizontally by operating a bending operation knob 10 provided in the operation portion 2. It can be bent remotely.

An insertion channel 12 for guiding the puncture needle guide tube 11 so as to advance and retreat is formed in the insertion portion 3 along the longitudinal direction thereof. One end of the insertion channel 12 is opened at the tip end opening 13 of the tip end hard portion 9, and the other end is opened at the operation portion 2. An ultrasonic probe 14 having a scanning range S is provided on the front surface of the hard tip portion 9. The signal line 15 connected to the ultrasonic probe 14 has the insertion portion 3
And, it is guided to the electric cable 5 through the inside of the operation unit 2 and connected to an ultrasonic observation device (not shown). Also,
A storage portion 16 for accommodating the distal end portion of the puncture needle guide tube 11 along the distal end portion is formed on the back surface portion of the distal end hard portion 9.
Further, the tip end opening 13 of the insertion channel 12 is stored in the storage section 1
It is opened toward 6. Furthermore, when the distal end portion of the puncture needle guide tube 11 is accommodated in the storage portion 16, the entire size thereof does not become larger than the insertion portion 3.

Further, in the puncture needle guide tube 11, an image guide and a ride guide are inserted into a flexible tube body 17, and a puncture needle guide channel 18 is formed.
The illumination optical system 19 of the light guide faces the tip surface of the puncture needle guide tube 11, and the tip of the puncture needle guide channel 18 is open. An objective optical system 20 is provided on the tip surface of the puncture needle guide tube 11, and an optical image of the observation field is formed on the tip surface of the image guide by the objective optical system 20. Then, this image is transmitted to the eyepiece unit 21 provided in the operation unit 2 via the image guide.

Further, the tip end portion of the tube body 17 of the puncture needle guide tube 11 is connected to the tip end of the distal end hard portion 9 of the intracavity ultrasonic scanner 1 via a bridge member 22 composed of a link mechanism. In other words, one end of the erection member 22 has one end hard portion 9
Is pivotally attached to the tip end of the tube body by a pin 23, and the other end is pivotally attached to the tip end of the tube body 17 by the pin 23 to form a rotating portion which can freely rotate.

The insertion channel 12 is provided in the middle of the proximal end of the tube body 17.
The slide operating portion 24 is formed by pulling the slide operating portion 24 from the outside to the outside, and the slide operating portion 24 can be held in the hand and the push-in / pull-out operation can be performed on the insertion channel 12.

The proximal end of the puncture needle guide channel 18 of the puncture needle guide tube 11 is connected to the insertion port 25 of the operation unit 2. Then, the puncture needle guiding channel 1 is introduced from the insertion opening 25.
A puncture tube 26 is inserted into the puncture tube 8.
A puncture needle 27 is attached to the tip of the puncture tube 26, and a syringe 28 used for injecting a drug solution or the like and sucking mucus or the like at the puncture target site is attached to the proximal end of the puncture tube 26. Be connected.

Further, a stopper portion 29 is provided at the distal end portions of the body cavity ultrasonic scanner 1 and the puncture needle guide tube 11. The stopper portion 29 is a stopper surface 29a at the tip of the body cavity ultrasonic scanner 1 with which the side surface of the erection member 22 abuts when the puncture needle guide tube 11 is pulled into the storage portion 16 (first position).
And a state in which the puncture needle guide tube 11 is pushed out (second position)
The body cavity ultrasonic scanner 1 on which the side surface of the erection member 22 abuts and the stopper surface 29b at the tip of the puncture needle guide tube 11 are formed. When the erection member 22 hits the stopper surface 29b at the second position, the puncture needle guide is provided at the most distal end portion of the intracavity ultrasonic scanner 1 on the central axis of the guide channel 18 of the puncture needle guide tube 11. A mouth 30 is provided.
The puncture needle guide port 30 opens in the direction of the super-inspection range S of the ultrasonic probe 14.

The body cavity ultrasonic scanner 1 is provided with a deaerated water injection conduit (not shown) so that deaerated water can be injected into the body cavity.

Next, the operation of the ultrasonic diagnostic apparatus in the body cavity will be described. First, when the insertion section 3 of the intracavity ultrasonic scanner 1 is inserted into the body cavity, the puncture needle guide tube 11 moves the tube body 17 in the slide operation section 24 as shown in FIG. 1 and FIG. By pulling, the tip portion is stored in the storage portion 16. That is, since the side surface of the erection member 22 is drawn into the tip opening 13 and is rotated until it abuts against the stopper surface 29a, the tip portion thereof does not come out in close contact with the bottom surface of the storage portion 16, that is, the back surface of the ultrasonic probe 14. It fits. The field of view of the puncture needle guide tube 11 faces the front of the insertion portion 3. Then, in this state, the insertion portion 3 is inserted into the body cavity.

Then, after inserting the insertion portion 3 into a wide space in the body cavity, for example, into the stomach, when performing ultrasonic diagnosis, the tube body 17 of the puncture needle guide tube 11 is pushed in by the slide operation portion 24 on the proximal side. As a result, the tip of the tube body 17 moves forward while pushing the erection member 22 and moves away from the storage portion 16. However, since the tip of the tube body 17 is connected to the erection member 22, it is fixed around the two rotation centers. Rotate while keeping the distance. The tip end side portion of the tube body 17 is pushed out from the tip end opening 13 of the insertion channel 12 to form a loop, and the side surface of the erection member 22 is the stopper surface 2.
Rotate until it hits 9b. Then, this tip is inverted and faces the region side of the scanning range S of the ultrasonic probe 14.

At this position, the central axes of the guide channel 18 of the puncture needle guide tube 11 and the puncture needle guide port 30 coincide with each other, and the puncture needle 27 only pushes the puncture tube 26 in the operating section 2 to project from the guide channel 18. Can be inserted into the puncture needle guide port 30. And if you push it in further, puncture needle 2
7 pierces the lesion portion in the scanning range S of the ultrasonic probe 14.

As described above, in the first embodiment, the stopper 29 is provided at the distal end portions of the body cavity ultrasonic scanner 1 and the puncture needle guide tube 11 so that the central axes of the guide channel 18 and the puncture needle guide port 30 coincide with each other. As a result, the puncture needle 27 can always project in a fixed direction and can be easily inserted into the puncture needle guide port 30. In addition, the puncture needle 27 is attached to the puncture needle guide port 30.
Even if an external force is applied in the state in which is inserted, there is no concern that the puncture needle 27 will shake and damage the inside of the body cavity.

FIG. 5 is a diagram showing a second embodiment of the present invention, in which the same parts as those in the first embodiment are designated by the same reference numerals, and detailed description thereof will be omitted.

In this embodiment, when the puncture needle guide tube 11 is pushed out and the central axes of the guide channel 18 and the puncture needle guide port 30 are aligned with each other, the stopper portion 31 is attached so as to abut against the distal end portion of the intracavity ultrasonic scanner 1. It is formed at the tip of the puncture needle guide tube 11.

Therefore, the puncture needle 27 can be easily inserted into the puncture needle guide port 30 with a simple configuration.

6 to 7 are views showing a third embodiment of the present invention.
A portion of the rigid tip portion 9 of the intracorporeal ultrasonic scanner 1 having the puncture needle guide port 30 and the stopper portion 32 is used as a separate puncture tip portion 33, and the puncture tip portion 33 is rotated by the rotating portion 34. 9 is rotatably connected. Then, a spring 35 biased in the direction of compression is provided on the housing portion 16 side of the distal end hard portion 9 and the puncture distal end portion 33 and the distal end hard portion 9 are provided.
It is provided between and. In addition, a slide rod 36 is inserted through the inside of the insertion portion 3, and the tip end is a puncture tip portion 33.
, And the base end is slidable back and forth in the operation unit 2.

Further, a erection member 37 integrally formed with the puncture needle guide tube 11 is rotatably connected to the puncture tip portion 33 by a pin 23, and the central axes of the guide channel 18 and the puncture needle guide port 30 coincide with each other. In this state, the stopper portion 32 is provided so that the erection member 37 abuts.

Even when the puncture needle 27 is inserted into the puncture needle guide port 30, if the slide rod 36 is pushed forward, the puncture angle can be easily changed to an arbitrary angle.

Further, as shown in FIG. 8 as the fourth embodiment, two puncture needle guide ports 38 may be provided. That is, by providing two puncture needle guide ports 38, the puncture needle can be inserted at different angles.

A light guide provided on the puncture needle guide tube 11,
The image guide, the illumination, and the objective optical system may be provided in the intracavity ultrasonic scanner 1.

〔The invention's effect〕

According to the present invention, the ultrasonic probe in the body cavity or the means for determining the protruding direction of the puncture needle is provided at the tip of the puncture needle guide tube, so that the puncture needle can always be easily projected in a fixed direction.

[Brief description of drawings]

FIG. 1 is an overall explanatory view showing a first embodiment of the present invention, FIG. 2 is a view showing a tip end portion of the same embodiment, and FIG. 3 is a view showing a tip end portion when the same embodiment is used, and FIG. FIG. 5 is a diagram showing a cross-section of the tip when the same embodiment is used, FIG. 5 is a diagram showing the tip part of the second embodiment,
FIG. 6 is a diagram showing the tip of the third embodiment, FIG. 7 is a diagram showing the tip of the same embodiment when in use, and FIG. 8 is a diagram showing the fourth embodiment. 1 ... Intracorporeal ultrasonic scanner, 11 ... Puncture needle guide tube, 22 ... Construction member, 26 ... Puncture tube, 27 ... Puncture needle, 29, 31, 32 ... Stopper part, 30, 38 ... … Puncture needle guide port

Claims (3)

[Claims] 1. A body cavity having an insertion portion and an operating portion, which has an insertion channel formed near both ends of the insertion portion and opened near the tip of the insertion portion, and has an ultrasonic probe provided near the tip of the insertion portion. An ultrasonic scanner, a puncture needle guide tube for guiding a flexible long puncture needle that is inserted into the insertion channel so as to be able to move forward and backward, and the tip of the puncture needle guide tube is rotatably connected to the tip of the insertion section. And a means for determining the protruding direction of the puncture needle so as to face the scanning range direction of the ultrasonic probe at the tip of at least one of the intracorporeal ultrasonic scanner or the puncture needle guide tube. A characteristic ultrasonic diagnostic device in a body cavity. 2. The means for determining the protruding direction of the puncture needle is a stopper portion provided at a position where the tip portion of the puncture needle guide tube or the side surface of the erection member abuts at a set angle. The intracorporeal ultrasonic diagnostic apparatus according to item 1. 3. The ultrasonic diagnosis in a body cavity according to claim 1, wherein the means for determining the protruding direction of the puncture needle is a puncture needle guide port provided at the tip of the ultrasonic scanner. apparatus.