JPH07100139A - Ultrasonic diagnostic apparatus for celom - Google Patents

Abstract

PURPOSE:To provide an ultrasonic diagnostic apparatus for colom capable of readily obtaining any tomographic diagnostic image covering a broad diagnostic field of view, shortening the time for diagnosis and improving the accuracy of diagnosis. CONSTITUTION:In this ultrasonic diagnostic apparatus for celom having an inserting part 14 extended from a grip part 13 and insertible into a celom, the inserting head 16 is mounted on the top of the inserting part 14 so as to rotate on the rotation axis 17, a drive control device 36 is provided so as to adjust and control the angle of rotation of the inserting head 16 from the grip part, and the inserting head 16 carries a vibrator group 31 comprising aligned vibrators 32 that generate ultrasonic waves.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a body cavity ultrasonic diagnostic apparatus, and more particularly to a body cavity ultrasonic diagnostic apparatus used as an ultrasonic laparoscope or the like.

[0002]

2. Description of the Related Art In recent years, a Laparosage (La
Paro Surgery) surgery is increasing for the purpose of improving the quality of life of patients. In Laparosurgery surgery,
As an observation means for observing the inside of a body cavity, a laparoscope (Laparo scop)
e) is inserted to diagnose the internal cavity of the body cavity. At that time, in order to obtain more information from the laparoscope that is inserted into the body cavity, an ultrasonic laparoscope that combines a vibrator that oscillates ultrasonic waves at the insertion tip has been developed as an intracorporeal ultrasound diagnostic device. There is.

A conventional intracavity ultrasonic diagnostic apparatus is constructed as shown in FIG. 15, and a laparoscope 2 having a small-diameter ultrasonic probe is connected to a monitor 1 for displaying an ultrasonic diagnostic image. The laparoscope 2 has an insertion portion 4 that extends from a grip portion 3 which is a hand operation portion and can be inserted into a body cavity, and a head portion 6 is provided at a distal end side of the insertion portion 4 via a bendable angle portion 5. It is provided. A vibrator 7 which is an ultrasonic element is arranged in the head portion 6 in the longitudinal direction, and ultrasonic waves are oscillated from the vibrator 7 to perform ultrasonic diagnosis inside the body cavity. At that time, the field of view for diagnosis is secured by operating and bending the angle portion 5. The angle mechanism for bending the angle portion 5 is disclosed in JP-A-4-40934 and JP-A-56-
There is one disclosed in Japanese Patent No. 89229.

[0004]

In the conventional intracorporeal ultrasonic diagnostic apparatus, the angle portion 5 is bent by an angle mechanism to secure a visual field for ultrasonic diagnosis. It requires a wide field of view like the diagnosis of the liver and the like.

However, in the conventional ultrasonic diagnostic apparatus for body cavity, since the bending angle (angle angle) of the angle portion 5 is regulated by the structure of the angle mechanism, the angle angle cannot be set to a large value, which results in a diagnosis. Therefore, there is a problem in that a wide field of view cannot be taken, and the resolution in the deep portion deteriorates.

Further, in the conventional ultrasonic diagnostic apparatus for body cavity, since the head section 6 at the tip of the insertion section is bent through the angle section 5, a transverse diagnostic image of the body cavity section which is important for diagnosis is obtained. It was not possible, and there was a problem in improving the diagnostic accuracy.

On the other hand, it is known that a relatively wide space can be secured under the abdominal cavity in the Laparosajuli surgery in the body cavity.

The present invention has been made in consideration of the above-mentioned circumstances, and a visual field for diagnosis can be taken in a wide range, an arbitrary tomographic image can be easily obtained to shorten the diagnostic time and improve the diagnostic accuracy. An object of the present invention is to provide an intracorporeal ultrasonic diagnostic apparatus capable of achieving the above.

Another object of the present invention is to provide an intracorporeal ultrasonic diagnostic apparatus in which the number of transducers, which are ultrasonic elements, is increased to improve the resolution and resolution of ultrasonic waves and the S / N ratio is improved. is there.

Still another object of the present invention is to provide an intracorporeal ultrasonic diagnostic apparatus capable of accurately puncturing or injecting a drug into a region to be diagnosed inside the body cavity.

[0011]

In order to solve the above-mentioned problems, the intracorporeal ultrasonic diagnostic apparatus according to the present invention can be extended from the grip portion and inserted into the body cavity as described in claim 1. In an intracorporeal ultrasonic diagnostic apparatus having an insertion portion, an insertion head is provided on the distal end side of the insertion portion so as to be rotatable around a rotation axis, and drive control means for adjusting and controlling the rotation angle of the insertion head from a grip portion is provided. On the other hand, the insertion head has a vibrator group in which vibrators for oscillating ultrasonic waves are arranged in a row.

In order to solve the above-mentioned problems, according to the intracorporeal ultrasonic diagnostic apparatus of the present invention, in addition to the contents described in claim 1, as described in claim 2, the distal end side of the insertion portion is And an insertion head is provided rotatably around the rotation axis of the tip of the angle portion. Further, as described in claim 3,
The insertion head is provided with a guide portion such as a notch for puncture guide.

Further, in order to solve the above-mentioned problems,
In the intracorporeal ultrasonic diagnostic apparatus according to the present invention, as described in claim 4 in addition to the contents described in claim 1, the drive control means includes the drive means provided in the grip portion, and the drive means of the drive means. It is provided with a power transmission means for transmitting a driving force to the insertion head to rotate the insertion head around the rotation axis, and a locking means for restricting the rotation of the insertion head.

[0014]

In the intracorporeal ultrasonic diagnostic apparatus of the present invention, the insertion head is provided on the distal end side of the insertion portion extending from the grip portion so as to be rotatable about the rotation axis, and the insertion head is provided with a vibrator which is an ultrasonic element. Since it has a group of transducers arranged in rows,
When inserting / withdrawing into / from the body cavity, the insertion / withdrawal resistance can be inserted and removed in a small form, and after insertion, the insertion head on the distal side of the insertion section can be rotated to effectively contact the insertion head with the site to be diagnosed such as the liver. Further, it is possible to easily obtain an arbitrary diagnostic image by making the diagnostic visual field of the diagnosed portion wide, and it is possible to shorten the diagnostic time and improve the diagnostic accuracy.

In this type of intracorporeal ultrasonic diagnostic apparatus, since a relatively large space can be provided within the body cavity, the length of the insertion head in the longitudinal direction can be increased, and therefore the number of transducers arranged in the insertion head can be increased. Can be increased in the longitudinal direction,
The resolution and resolution of ultrasonic waves can be improved, and S /
The N ratio is large and good.

Further, when the angled portion is formed on the tip side of the insertion portion and the insertion head is rotatably provided on the tip side of the angled portion, the insertion head is pressed against the site to be diagnosed in the body cavity such as the liver. At this time, it is possible to secure a diagnostic visual field in a state in which the angle portion is flexed so that the angle of view can be adjusted, and the resolution of the deep portion can be improved.

Further, when a guide portion such as a notch for puncture guide is formed on the insertion head, the puncture needle or the like is guided by the guide portion while confirming the site to be diagnosed in the body cavity by the transducer group of the insertion head. Therefore, the puncture and the injection of the medicine can be performed accurately.

[0018]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS An embodiment of an ultrasonic diagnostic apparatus for body cavity according to the present invention will be described below with reference to the accompanying drawings.

FIG. 1 is an overall schematic view showing an example of an ultrasonic diagnostic apparatus in a body cavity according to the present invention. In the figure, reference numeral 10 indicates a laparoscope as an ultrasonic scope equipped with a small-diameter ultrasonic probe. This laparoscope 10 is connected to a television monitor 12 provided on the ultrasonic diagnostic apparatus main body (not shown) through a universal cord 11 in which a power cord and a signal code are integrated so that an ultrasonic diagnostic image can be displayed by the laparoscope 10. Has become.

The laparoscope 10 has a grip portion 13 as a hand operation portion, and a flexible insertion portion 14 that extends from the grip portion 13 and can be inserted into a body cavity. Insertion part 14
An angle portion 15 is integrally provided on the tip side of the, and an insertion head 16 is provided at the tip of the angle portion 15, and the insertion head 16 is rotatable about a rotation axis (ear axis) 17 orthogonal to the longitudinal direction. Supported. The insertion head 16 is formed to have an outer diameter of 10 mmφ and an axial (longitudinal) length of about 30 to 60 mm, for example.

Laparoscope 10 as an intracorporeal ultrasonic diagnostic apparatus
As shown in FIGS. 2 (A) and 2 (B), the insertion portion 14 of FIG.
Is provided in a cantilever shape.

The angle mechanism 20 is formed into a tube shape or a sleeve shape by winding a coiled metal winding in a spiral shape with a spring force, and a bendable angle tube 21.
And a hand side connecting member 23 provided on one side of the angle tube 21 and fixed to the flexible guide tube 22, and a tip side connecting member 24 provided on the other side of the angle tube 21. Tip side connecting member 2
4 has a pair of ear pieces 25 extending toward the tip side.
The rotating shaft 17 is supported between the five. Angle tube 21
And the guide tube 22 is a flexible cover tube 2.
Covered with 6.

A driven pulley 28 as a rotary dial is mounted on the rotary shaft 17. This driven pulley 28
Is fixed to the base side of the insertion head 16, and the insertion head 16 is rotated as the driven pulley 28 rotates around the rotation axis. Since the insertion head 16 can be rotated, an arbitrary tomographic image can be easily obtained.

The insertion head 16 is configured by a rigid tube 30 to prevent head deformation and facilitate insertion, while the insertion head 16 has a transducer group 3 including ultrasonic elements.
1 is accommodated. The transducer group 31 is formed by arranging a number of ultrasonic transducers 32 in a row in the longitudinal direction. Insertion head 1
A puncture guide notch 33 is formed in a tapered shape on the side of 6 as a guide portion, and the puncture needle 34 described later is guided by this notch 33. Although various shapes of the notch 33 are possible, a guide hole may be formed instead of the notch. In order to easily find the notch 33 or the guide hole in the body cavity, the surface of the notch 33 or the guide hole portion may be formed of a light reflecting component, and other antireflection processing may be performed.

In addition, as shown in FIGS. 1 and 3, an angle operation knob 35 for driving the angle portion 15 and a head operation knob 36 for rotationally driving the insertion head 16 are provided in the grip portion 13 which is a hand operation portion of the laparoscope 10. Are provided on a common axis.

The head operating knob 36 constitutes a driving means for driving the insertion head 16, and is provided integrally with a drive pulley 38 housed in a grip casing 37 of the grip portion 13 as shown in FIG. . An operation cable 39 made of a belt, a wire, or the like is bridged between the drive pulley 38 and the driven pulley 28 of the insertion head 16 shown in FIGS. 2A and 2B to form power transmission means 40. The operation cable 39 has an insertion portion 14
The guide tube 22 and the angle tube 21 are inserted and guided. A tension roller for applying a required tension to the cable may be provided in the middle of the operation cable 39.

By rotating the head operating knob 36, the drive pulley 38 is rotated, and the operating head 16 is rotated about the rotary shaft 17 to hold an arbitrary rotational position.

The angle operation knob 35 also constitutes a drive means for the angle mechanism 20. Angle control knob 3
5 is rotationally operated independently of the head operation knob 36, and is also connected to the angle drive pulley 43 so as to rotate integrally therewith, and a swing cable 44 composed of a wire, a cable, or the like is hung on the angle drive pulley 43.

The swing cable 44 is inserted through the guide tube 22 and the angle tube 21 of the insertion section 14,
One end of the cable is a tip side connecting member 2 of the angle mechanism 20.
4 and the other end of the cable is connected to the other side of the connection member 24, respectively. In this way, the swing cable 44
Are connected to the tip side connecting member 24 at two positions which are diametrically opposed to each other. By rotating the angle operation knob 35,
The angle mechanism 20 is oscillated from side to side as shown in FIGS. Angle drive pulley 43
And the swing cable 44 constitutes the power transmission means 45 of the angle mechanism 20.

Further, as shown in FIG. 3, the head operating knob 36 and the angle operating knob 35 are restricted in rotation by a locking means 46 of a Pull to Lock type. The lock means 46 is provided with an operation button 47 provided on a shaft common to the head operation knob 36 and the angle operation knob 35, and a friction disc 49 fixed to a shaft 48 of the operation button 47 as a friction member for locking. By pulling, the friction disk 49 is moved to the drive pulley 38 side to press the head drive pulley 38.
The rotation of the head drive pulley 38 and the angle drive pulley 43 is restricted by the action of the frictional force due to the pressing of the friction disk 49, and the angle mechanism 20 and the insertion head 16 are locked and positioned at the swing position and the rotation position.

The lock position of the operation button 47 is released by its pressing action, and the head operation knob 36 and the angle operation knob 35 are rotated. Figure 3 shows Pull to Lo
An example of a ck type locking means is shown, but if the operation button 47 is installed on the opposite side of the grip casing 37, Push t
o Lock type locking means can be configured. Next, the operation of the ultrasonic diagnostic apparatus in the body cavity will be described.

As shown in FIG. 5, the laparoscope 10 as an intracorporeal ultrasonic diagnostic apparatus is inserted into the body cavity 51 of the subject 50 by using the trocar 53 attached to the abdominal wall 52 as shown in FIG. To be done. When the laparoscope 10 is inserted into the body cavity 51 or pulled out from the body cavity 51, the insertion head 16
Is axially aligned with the insertion portion 14 and is set so as to face the insertion portion 14 in the axial direction.

Therefore, the insertion portion 14 of the laparoscope 10 is inserted through the trocar 53, and after insertion, the head operating knob 36 is rotated to utilize the space in the body cavity 51 to rotate the operating head 16 to the rotating shaft 17. Rotate around. After that, the insertion portion 14 is further inserted to insert the insertion head 16 as shown in FIG.
Is brought into contact with the part to be diagnosed 54 such as an organ such as the liver to be diagnosed.

At that time, the insertion head 16 can be rotated so as to be perpendicular to the insertion portion 14, and the insertion head 16 can be effectively brought into contact with the organ to be diagnosed (diagnosis portion 54). At this time, by performing the angle operation of the angle mechanism 20 of the angle portion 15, the delicate contact property is improved and becomes favorable.

Further, the insertion head 16 provided on the distal end side of the insertion portion 14 can arrange a large number of ultrasonic transducers 32 in the longitudinal direction to lengthen the ultrasonic element portion. Can be increased, so that the S / N ratio can be improved and a wide field of view can be obtained, and the aperture can be expanded, so that the resolution in the deep portion can be improved. Therefore, at the time of ultrasonic diagnosis, a traverse diagnosis image can be easily obtained, so that the diagnosis time can be shortened and the accuracy of ultrasonic diagnosis is improved.

Further, since the insertion head 16 is provided with the notch 33 for puncture guide as a guide portion at a required position,
After confirming the diseased part of the part to be diagnosed with an ultrasonic image, while observing the notch 33 with an optical system such as a separately inserted endoscope, the puncture needle 34
It is possible to fit the notch 33 and guide the notch 33 while puncturing the target diseased part as shown in FIG. 7.
The puncture needle 34 is guided by the puncture guide notch 33 to perform accurate puncture, and a drug such as ethanol can be injected appropriately into a target diseased site.

In one embodiment of the ultrasonic diagnostic apparatus in the body cavity, an example in which the angle portion 15 formed on the distal end side of the insertion portion 14 is formed by using the spiral angle tube 21 and the operation cable 44 is capable of swinging freely is shown. As shown in FIG. 8, the angle portion is composed of a bendable guide tube 56 having elasticity, and an operation wire 59 is passed between fulcrums 57 and 58 on both sides of the guide tube 56, and the operation wire 59 is pulled. By doing so, the angle portion 15A may be swingable.

Further, as shown in FIG. 9, the angle portion 15
B may be configured by connecting a plurality of angle tops 60 in a bellows shape, and the operation cable 61 connected to the tip of the angle portion 15B may be pulled to swing freely.

Further, as shown in FIG.
The angle portion does not necessarily have to be provided on the tip side of the insertion portion 14 of A, and the insertion head 16 may be rotatably connected to the tip side of the operation portion 14 about the rotation shaft 17. in this case,
The power transmission means 63 of the drive control means for rotating the insertion head 16 may be a combination of a flexible screw shaft 64 and a drive and driven pinion 65. The screw shaft 64 may be a flexible torque transmission shaft that transmits rotational torque, and may have screw portions on both sides.

At this time, the power transmission means 63 of the drive control means
Instead of the head operating knob 36 provided on the grip portion 13, a driving motor (not shown) may be used to drive the driving force. The drive motor is housed in the grip portion 13 which is the operation portion at hand, and the motor drive is ON-OF.
The drive is controlled by the F button.

As another example of the intracavitary ultrasonic diagnostic apparatus, the rotation of the head drive pulley 38 of the drive control means may be restricted by the locking means 66 shown in FIGS. 11 and 12. The locking means 66 utilizes the cam action of the two cam disks 67 and 68 to press the friction disk 69 against the head drive pulley 38 and restrain the rotation of the head drive pulley 38.

The locking means 66 includes an operation disk 71 having an operation knob 70, a rotation-free drive side cam disk 67 provided on the operation disk 71, and the bearing 7.
2 has a driven side cam disk 67 that is slidable, and a friction disk 69 to which the axial displacement of the cam disk 67 is transmitted via a disk 73. As shown in FIG. 12, both cam disks 67 and 68 have inclined cam surfaces 67.
a and 68a are formed clockwise and counterclockwise, and the friction disc 69 is slidably moved in the axial direction of the bearing 72 by the cam action of the cam surfaces 67a and 68a.

By rotating the operating knob 70 counterclockwise from the unlocked position to the locked position, the cam surfaces 67a and 68a of both cam disks 67 and 68 act as cams to drive the friction disk 69 to the head drive. Pulley 38
Slide it to the side and press it to move the head drive pulley 38
Has restrained the rotation of.

The head drive pulley 38 is the bearing 7
It is rotatably supported by a rotary shaft 75 rotatably mounted on the shaft 2. The rotary shaft 75 is rotatably driven by operating an operation lever (operation knob) 76.

Furthermore, in one embodiment of the ultrasonic diagnostic apparatus in the body cavity, the insertion head 16 is attached to the distal end side of the insertion portion 14 in a cantilever shape, but the insertion head 16A is shown in FIG.
And as shown in FIG.
It may be rotatably supported around the tip auricle 17.

[0046]

As described above, in the intracorporeal ultrasonic diagnostic apparatus according to the present invention, the insertion head is provided on the distal end side of the insertion portion extending from the grip portion so as to be rotatable around the rotation axis, and the insertion head is provided. In addition, since it is equipped with a group of transducers in which ultrasonic transducers, which are ultrasonic elements, are arranged in a row, when inserting into and removing from the body cavity, the insertion / withdrawal resistance is taken in and out with a small shape.
Since the insertion head on the tip side of the insertion section can be rotated after insertion to effectively contact the insertion head with the liver,
It is possible to make effective contact with the part to be diagnosed of the part to be diagnosed, to easily obtain an arbitrary tomographic image by setting the diagnostic visual field of the part to be diagnosed to a wide range, and to shorten the diagnosis time and improve the diagnostic accuracy. Is improved.

In this intracavity ultrasonic diagnostic apparatus, since a relatively large space can be taken in the body cavity, the length of the insertion head in the longitudinal direction can be increased, and the number of transducers arranged in the insertion head can be changed in the longitudinal direction. It can be increased, the aperture is expanded, the resolution and resolution of ultrasonic waves can be improved, and the S / N ratio becomes large and good.

If an angled portion is formed on the distal end side of the insertion portion and the insertion head is rotatably provided on the distal end side of this angled portion, the insertion head is pressed against the body cavity to be diagnosed site such as the liver. At this time, it is possible to secure a diagnostic visual field in a state in which the angle portion is flexed so that the angle of view can be adjusted, and the resolution of the deep portion can be improved.

Further, when a guide portion such as a notch for puncture guide is formed in the insertion head, the puncture needle or the like is guided by the guide portion while confirming the site to be diagnosed in the body cavity with the transducer group of the insertion head. Therefore, the puncture and the injection of the medicine can be performed accurately.

[Brief description of drawings]

FIG. 1 is an overall external view showing an embodiment of an intracorporeal ultrasonic diagnostic apparatus according to the present invention.

2A and 2B are a side sectional view and a plan sectional view, respectively, showing a distal end side of an insertion portion of the intracorporeal ultrasonic diagnostic apparatus shown in FIG.

FIG. 3 is a schematic cross-sectional view showing drive control means provided on the grip portion side which is a hand operation portion of the intracavity ultrasonic diagnostic apparatus shown in FIG.

4A and 4B are views showing a bent state of an angle portion provided on the distal end side of the insertion portion of the intracavitary ultrasonic diagnostic apparatus shown in FIG. 1, respectively.

FIG. 5 is a view showing a state during insertion / withdrawal of the intracavity ultrasonic diagnostic apparatus shown in FIG.

FIG. 6 is a diagram showing a diagnostic state by the intracavity ultrasonic diagnostic apparatus shown in FIG. 1.

FIG. 7 is a diagram showing a medical process using the intracavity ultrasonic diagnostic apparatus shown in FIG. 1.

FIG. 8 is a diagram showing a first modification of the angle portion formed in the insertion portion of the intracavity ultrasonic diagnostic apparatus.

FIG. 9 is a diagram showing a second modification of the angle portion.

FIG. 10 is a diagram showing another embodiment of the intracavity ultrasonic diagnostic apparatus according to the present invention.

FIG. 11 is a cross-sectional view showing drive control means provided in a grip portion which is a hand operation portion of the intracavity ultrasonic diagnostic apparatus.

12 is an exploded perspective view showing a lock means of the drive control means shown in FIG.

FIG. 13 is a diagram showing another embodiment of the distal end side of the insertion portion of the intracorporeal ultrasonic diagnostic apparatus according to the present invention.

14 is a plan view showing a state in which the insertion head on the distal end side of the insertion section shown in FIG. 13 is rotated.

FIG. 15 is a schematic view showing a conventional intracavity ultrasonic diagnostic apparatus.

[Explanation of symbols]

 10 Laparoscope (Ultrasonic Scope) 11 Universal Code 12 Television Monitor 13 Grip Part 14 Insertion Part 15, 15A, 15B Angle Part 16 Insertion Head 17 Rotating Shaft (Ear Axis) 20 Angle Mechanism 21 Angle Tube 22 Guide Tube 23, 24 Connection Member 28 Driven pulley (rotary dial) 30 Head tube 31 Transducer group 32 Ultrasonic transducer 33 Notch (guide part) for puncture guide 34 Puncture needle 35 Angle operation knob (driving means) 36 Head operation knob (driving ground means) 37 Grip casing 38 Head drive pulley 39 Operation cable 40 Power transmission means 43 Angle drive pulley 44 Swing cable 45 Power transmission means 46 Locking means 47 Operation button 49 Friction disk 50 Subject 51 Body cavity 52 Abdominal wall 54 Diagnosis part 56 Guide tube 59 Operation wire 60 Angle top 61 Operation cable 63 Power transmission means 64 Screw shaft 65 Pinion 66 Locking means 67,68 Cam disk 69 Friction disk

Claims (4)

[Claims] 1. An intracorporeal ultrasonic diagnostic apparatus comprising an insertion portion extending from a grip portion and capable of being inserted into a body cavity, wherein an insertion head is provided on a distal end side of the insertion portion so as to be rotatable about a rotation axis, and the insertion is performed. Ultrasonic diagnosis in a body cavity, comprising drive control means for adjusting and controlling a rotation angle of the head from a grip part, and the insertion head has a transducer group in which transducers for oscillating ultrasonic waves are arranged in a row. apparatus. 2. The intracorporeal ultrasonic diagnosis according to claim 1, wherein an angled portion is provided on the distal end side of the insertion portion so as to be bendable, and the insertion head is rotatably provided around the distal end rotation axis of the angled portion. apparatus. 3. The intracorporeal ultrasonic diagnostic apparatus according to claim 1, wherein the insertion head is provided with a guide portion such as a notch for puncture guide. 4. The drive control means, a drive means provided in the grip portion, a power transmission means for transmitting a drive force of the drive means to the insertion head and rotating the insertion head around a rotation axis, and the insertion head. The intracorporeal ultrasonic diagnostic apparatus according to claim 1, further comprising locking means for restricting rotation of the body.