JPH07227394A - Ultrasonic diagnostic and curing system - Google Patents

Abstract

PURPOSE:To make high temp. curing over a wide range possible by a system wherein an ultrasonic curing means, an ultrasonic observation means, etc., are provided and a probe is inserted into an aimed position of a celom while optical observation is performed and texture changed by disease of an organ in a deep part can be cured by burning by means of ultrasonic wave. CONSTITUTION:On an ultrasonic probe 2A which can be inserted into a celom and has a capillary inserting part 7 provided with a flexible part 15, an ultrasonic curing means 17 for curing a living body by using an ultrasonic wave and an ultrasonic diagnostic means 18 for performing diagnosis of a living body by using the ultrasonic wave are provided. In addition, on the apex part 14 of this ultrasonic probe 2A, a forceps outlet 13 as a treating function guide part for performing treatment of a living body and an optical observation means 19 for observing optically the living body are formed successively from the apex side and a curved part 15 is formed back of the apex part 14. In addition, while an optical observation is performed by the optical observation means 19, the ultrasonic probe 2A is inserted into the aimed part of the celom and the apex part 14 is positionally adjusted at the optimum position for curing and diagnosis.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an ultrasonic diagnostic treatment system having an ultrasonic probe for performing ultrasonic diagnosis and ultrasonic treatment using focused ultrasonic waves in a body cavity.

[0002]

2. Description of the Related Art Generally, an ultrasonic transducer repeatedly transmits an ultrasonic pulse into a living tissue, and an echo of the ultrasonic pulse reflected from the living tissue is received by the same or a separate ultrasonic transducer. Then, various ultrasonic diagnostic apparatuses have been proposed in which information collected from a plurality of directions in the living body is displayed as an ultrasonic diagnostic image of a visible image by gradually shifting the direction in which the ultrasonic pulse is transmitted and received. .

[0003] These are generally those using an extracorporeal ultrasonic probe, but those used in combination with an endoscope, an ultrasonic probe having a small diameter, an intracorporeal ultrasonic probe to be inserted into a body cavity, and the like. Ultrasonic probes are also widely used.

On the other hand, various ultrasonic treatment devices such as a calculus crushing device and an ultrasonic thermotherapy device for performing various treatments with focused ultrasonic waves have been proposed. Among these ultrasonic treatment devices, there is an ultrasonic high-temperature treatment device that rapidly ablates and treats biological tissues such as cancer cells with focused high-intensity ultrasonic waves.

In order to obtain focused ultrasonic waves of high intensity, this ultrasonic high-temperature therapy apparatus focuses on an intended site from an extracorporeal applicator having an ultrasonic vibrator with a large opening, and is disclosed in, for example, PCT WO93 / 16641. As shown in (1), an intracavity probe that incorporates a relatively small ultrasonic transducer and is inserted into the rectum to treat an enlarged prostate is also known.

Further, the ultrasonic treatment apparatus disclosed in PCT WO93 / 16641 has a deep treatment site (focus).
An ultrasonic diagnostic apparatus for obtaining an ultrasonic tomographic image or the like is combined as a positioning means for performing the positioning. Therefore, various proposals have been made that the diagnostic ultrasonic transducer for focus positioning is built into the extracorporeal applicator or the probe inside the body cavity.

[0007]

[Problems to be Solved by the Invention] For example, PCT WO
In the conventional ultrasonic therapy device as shown in Japanese Patent Application No. 93/16641, especially in the case of inserting a probe in the body cavity into the rectum to treat the prostate, the probe is thick and rigid, and is used for diagnosis and treatment. Since the probe tip that emits ultrasonic waves cannot be freely bent, its application is extremely limited, and it is almost impossible to insert it into a lumen other than the rectum for treatment. Therefore, there is a problem in that the hyperthermia treatment by ultrasonic waves cannot be performed by inserting into the upper digestive tract, the lower digestive tract, the abdominal cavity or the like.

The present invention has been made in view of the above problems, and an object thereof is to insert a probe into a target site in a body cavity while performing optical observation to obtain an upper digestive tract, a lower digestive tract, and a thoracic cavity. Another object of the present invention is to provide an ultrasonic diagnostic treatment system having an ultrasonic probe that can be inserted into a body cavity such as an abdominal cavity or a ventricle to perform cauterization treatment of a diseased tissue of a deep organ with ultrasonic waves.

[0009]

According to the present invention, there is provided a thin tubular insertion portion that can be inserted into a body cavity, and at least at the tip end side of a bendable bending portion formed at the tip end side of the insertion portion, Ultrasonic treatment means for treating a living body using ultrasonic waves,
An ultrasonic observation means for diagnosing a living body using ultrasonic waves, a treatment function guide section for performing a treatment of the living body, and an ultrasonic probe provided with an optical observation means for optically observing the living body are provided, While performing optical observation by the optical observation means, insert the ultrasonic probe into the target site in the body cavity,
The position of the bending portion can be adjusted by a bending operation so that the distal end portion is located at a position suitable for treatment and diagnosis, and ultrasonic diagnosis for deep organs and high temperature treatment by ultrasonic waves can be performed.

In this case, since the ultrasonic wave observing means, the ultrasonic wave observing means, etc. are provided at the front end portion in front of the bending portion, the ultrasonic wave observing means and the ultrasonic wave observing means are made to be an organ by bending the bending portion. Ultrasonic diagnosis and high-temperature treatment by ultrasonic waves can be performed by contact, and ultrasonic diagnosis and high-temperature treatment by ultrasonic waves can be performed over a wider range (for example, upper digestive tract, lower digestive tract) than when no curved portion is provided. , Deep chest organs, can be inserted into the body cavity, such as the chest cavity, abdominal cavity and ventricles.
Further, in the state before the tip portion is brought into contact with the diseased tissue to be cauterized, the tip portion can be set in the vicinity of the target site by an optical observation means like an ordinary endoscope.

[0011]

Embodiments of the present invention will be described below with reference to the drawings. 1 to 8 relate to a first embodiment of the present invention, FIG. 1 shows the overall configuration of an ultrasonic diagnostic treatment system of the first embodiment, and FIG. 2 has an electronic endoscopic optical observation means. FIG. 3 shows the outer shape of the ultrasonic probe, FIG. 3 shows the outer shape of the ultrasonic probe having optical observation means like an optical endoscope, FIG. 4 shows the configuration on the tip side of the ultrasonic probe, and FIGS. 7 shows a modification of the tip portion of the ultrasonic probe, and FIG. 8 shows a usage example for explaining the operation of the first embodiment.

As shown in FIG. 1, an ultrasonic diagnostic treatment system 1 of the first embodiment illuminates an ultrasonic probe 2A having an electronic endoscope-like structure and an illumination light transmission means of the ultrasonic probe 2A. A light source device 3 for supplying light and a camera control unit (hereinafter abbreviated as CCU) for performing signal processing on an image pickup means built in the ultrasonic probe 2A.
4, an ultrasonic diagnostic treatment apparatus 5 having a signal processing system 5A for generating an ultrasonic image and a therapeutic signal generating system 5B for generating a drive signal for treatment, and a video signal of the CCU 4 and an ultrasonic signal processing system. It is composed of a color monitor 6 for displaying an endoscopic image and an ultrasonic image by a video signal.

The ultrasonic probe 2A is a thin tube (that is, a thin tube) -like insertion portion 7 that can be inserted into a body cavity.
And a wide operation portion 8 formed on the rear end of the insertion portion 7 for the operator to hold and perform insertion or bending operation, and the operation portion 8
The light source connector 10 at the end of the universal cable 9A can be detachably connected to the light source device 3.

A signal cable 1 is attached to the light source connector 10.
The signal connector 12a at one end of the signal cable 1 is connected to the other end of the signal cable 11. The CCU connector 12b is connected to the CCU 4 and the ultrasonic connector 12c is connected to the ultrasonic diagnostic treatment apparatus 5. .

The insertion portion 7 has a hard tip portion 14, a bendable bending portion 15, and a flexible flexible portion 16.
Are sequentially formed in the axial direction of the insertion portion 7 from the tip side.
Further, as shown in FIG. 4, an ultrasonic treatment means 17, an ultrasonic observation means 18, a forceps outlet 13 as a treatment function guide portion, and an optical observation means 19 are provided on the tip portion 14 from the tip side. It is characterized in that they are sequentially arranged in the axial direction of the insertion portion 7.

The ultrasonic treatment means 17 is composed of, for example, a concave ultrasonic transducer for treatment 20, and generates a drive voltage in the ultrasonic diagnostic treatment apparatus 5 via a signal line 21 inserted through the insertion portion 7 or the like. When the drive signal from the circuit 22 is applied, the ultrasonic waves emitted from the concave therapeutic ultrasonic transducer 20 travel with their wavefronts concave, and are emitted as shown by the dotted line in FIG. Convergence point 23
It travels as a therapeutic ultrasonic beam having a directivity that converges at a.

At the converging point 23a, the ultrasonic beam with a very high intensity, that is, the acoustically high energy density is obtained. Therefore, with a lesion tissue such as a tumor set near the converging point 23a, a drive signal having a large amplitude is applied to the concave therapeutic ultrasonic transducer 20 to generate a high-density acoustic wave based on the generated strong ultrasonic waves. Energy is used to cauterize the diseased tissue to allow therapeutic treatment.

The ultrasonic observation means 18 is formed of, for example, a convex array type ultrasonic transducer 24, and is connected to a transmission pulse generation circuit 26 and a reception processing circuit 27 which form a signal processing system 5A via a signal line 25. Has been done.

The transmission pulse from the transmission pulse generating circuit 26 is sequentially applied to each ultrasonic transducer constituting the convex array type ultrasonic transducer 24, and the ultrasonic pulse is substantially radial in the plane including the axial direction of the insertion portion 7. The ultrasonic waves are sequentially scanned into the sound wave observation region 28, transmitted to the target tissue side, and the ultrasonic waves reflected by the target tissue side are the ultrasonic transducers used for the transmission of the convex array ultrasonic transducer 24. After being sequentially received and converted into an electric signal, signal processing including amplification is performed in the reception processing circuit 27, and further converted into a standard video signal corresponding to an ultrasonic image through a DSC (not shown), It is input to the color monitor 6 via the superimposing circuit 29, and an ultrasonic tomographic image 30 is displayed as an ultrasonic observation image.

The drive frequency of the transmission pulse from the transmission pulse generation circuit 26 and the frequency (or frequency band) of the drive signal of the drive voltage generation circuit 22 do not overlap. Therefore, even if a therapeutic ultrasonic wave is emitted while the ultrasonic observation image is being observed by the ultrasonic observation means 18, the therapeutic ultrasonic wave does not become a noise and disturb the ultrasonic observation image. In this case, a filter for removing noise such as a trap circuit may be provided in the reception processing circuit 27. Further, a filter such as a trap circuit for removing the drive frequency component by the ultrasonic observation means 18 may be provided on the drive voltage generation circuit 22 side.

As shown in FIG. 1, the optical observing means 20 is an illuminating light emitting means (may be simply referred to as an illuminating optical system) for emitting illuminating light from an illuminating window through a light guide 31 and a lens. The image pickup means includes an objective lens 32 that forms an optical image of the target tissue illuminated by the illumination light and a CCD 33 that is arranged on the focal plane of the objective lens 32.

The light guide 31 is inserted through the insertion portion 7 or the like, and by connecting the light source connector 10 to the light source device 3, the illumination light generated by the lamp 34 and condensed by the lens is transmitted, and the tip end portion is transmitted. The light is emitted obliquely forward from the front end surface on the 14th side through the lens of the illumination window.

The range illuminated by the illumination light emitted obliquely forward substantially coincides with the observation range 35 of the objective lens 32. That is, the optical observation means 20 is composed of a front perspective type illumination and observation means. The objective lens 32 forms an optical image of the target tissue on the imaging surface of the CCD 33. The CCD 33 is connected to a video signal processing system (not shown) in the CCU 4 by a signal line 36, and the video signal processing system converts the video signal into a video signal.
It is possible to simultaneously display the endoscopic image 37 together with the ultrasonic tomographic image 30 on the color monitor 6 via 9.

In the bending portion 15 adjacent to the tip portion 14, a large number of bending pieces are rotatably connected to each other.
One end of the angle wire 39 is fixed to the angle knob 40 (FIG. 2) and the other end is connected to the pulley 38 in the operation portion 8.
(See), the pulley 38 is rotated to pull one of the angle wires 39 and loosen the other, so that the bending portion 1
The bending piece in 5 is bent in a desired direction so that the pulled side is the inside of the bending. By operating the angle knob 40, the bending angle of the bending portion 15 can be operated in the up / down direction, the left / right four directions, or the up / down or left / right two directions.

In the bending portion 15, the ultrasonic treatment means 17, the ultrasonic observation means 18, the treatment function guide portion, and the optical observation means 19 arranged in front of the bending portion 15 are freely bent in any direction. The bending portion 15 itself has the same structure as the bending portion used in a normal endoscope. An inlet 41 for introducing a treatment tool such as forceps is provided in the vicinity of the front end of the operation portion 8. The introduction opening 41 communicates with a treatment tool channel 42 provided in the insertion portion 7, and also in FIG. As shown in the drawing, the forceps outlet 13 has a function as a treatment function guide portion provided on the distal end portion 14, that is, a guide portion for performing a treatment function such as treatment with a treatment tool.

The forceps outlet 13 is provided at a position close to the optical observation means 19, and when a treatment tool (not shown) which is guided by the forceps outlet 13 and protrudes from the forceps outlet 13 is used to treat the living body, the treatment is performed. , So that it is possible to observe how the treatment tool is projected.

Further, as shown in FIG. 4, a nozzle 44 facing the observation window to wash and dry the outer surface of the observation window.
This nozzle 44 communicates with an air / water supply conduit (not shown) inserted through the insertion portion 7 or the like, and its rear end side is connected to a fluid control system in the light source device 3. Then, by operating the air / water supply button 45 (see FIG. 2) provided on the operation unit 8, air or water can be supplied. When the outer surface of the observation window becomes dirty, it can be washed by sending water, and then by sending air, the water droplets on the outer surface of the observation window can be dried or removed, and the observation field of view can always be set to a clean state. Is done.

The suction button 4 is provided adjacent to the air / water feeding button 45.
6 is provided, and by operating the suction button 46, unnecessary body fluid or the like can be sucked from the forceps outlet 13 at the tip of the treatment instrument channel 42 and discharged into the discharge container. For this reason,
The proximal side of the treatment instrument channel 42 also communicates with a suction channel (not shown) and is connected to a suction pump or the like of a fluid control system. That is, the treatment instrument channel 42 also has a function of a suction channel for sucking a fluid or the like, and the suction port in this case is the forceps outlet 13.

Further, image control buttons (or image control switches) 47 and 48 for performing freeze control of an endoscopic image, display switching control, and the like are provided near the rear end of the operation unit 8. The image control button 47, The signal from 48 is input to CCU 4 and controller 49.

The controller 49 is connected to the keyboard 50 and the foot switch 51, and can set the treatment time by the ultrasonic treatment means 17 and input the chart information of the patient from the keyboard 50.
The foot switch 51 is operated to start and stop the treatment by the ultrasonic treatment means 17.

The controller 49 is connected to the drive voltage generation circuit 22, the transmission pulse generation circuit 26, the reception processing circuit 27, and the superimpose circuit 29 in the ultrasonic diagnostic treatment apparatus 5, and is operated by an input operation from the keyboard 50. The ultrasonic treatment means 1 for setting the strength (or amplitude) of the driving voltage to the driving voltage generating circuit 22 via the controller 49.
7 to control the output conditions of strong ultrasonic waves, change the ultrasonic transmission conditions of the ultrasonic observation image, change the signal processing conditions for the received signal, and change the image displayed on the color monitor 6. It is possible to control.

The controller 49 is also connected to the CCU 4 so that the keyboard 50 can control the CCU 4 side, for example, to set a mode for displaying a still image. In FIG. 1, the ultrasonic diagnostic treatment apparatus 5 includes a signal processing system 5A for generating an ultrasonic image and a therapeutic signal generating system 5B for generating a therapeutic signal, but the signal processing system 5A and the medical treatment are used. The use signal generation system 5B may be provided separately.
Also, two color monitors for displaying the endoscopic image and two monitors for displaying the ultrasonic image may be arranged.

FIG. 2 shows the outer shape of the ultrasonic probe 2A.
This ultrasonic probe 2A adopts a structure of an electronic endoscope using an image pickup means for the optical observation means 19. In FIG. 1, the configuration of the electronic endoscope is adopted as the optical observation means 19 as the ultrasonic probe, but in the modified example in which the configuration of the fiberscope is adopted as the optical observation means 19 as shown in FIG. The ultrasonic probe 2B may be adopted.

The ultrasonic probe 2B shown in FIG. 3 is different from the ultrasonic probe 2A shown in FIG. 2 in that the image control buttons 47 and 48 are not provided at the rear end of the operating portion 8 and the eyepiece 52 is provided.
Are formed. Further, in FIG. 1, an image guide for transmitting an optical image is arranged instead of the CCD 33,
With this image guide, the optical image from the objective lens 32 can be transmitted to the end surface on the eyepiece 52 side, and enlarged observation can be performed from the eyepiece window at the rear end of the eyepiece 52.

A universal cable 9B having no signal line 36 extends from the operation section 8. Otherwise, the structure is the same as that of FIG. 2, and the same components are denoted by the same reference numerals and the description thereof is omitted. The ultrasonic probe 2B having an eyepiece 52 with a TV camera (not shown) may be used as the ultrasonic probe. In this case, connect the signal connector at the end of the signal line of the TV camera to CC of FIG.
When connected to U4, an ultrasonic diagnostic treatment system having almost the same function as in FIG. 1 can be constructed.

Further, an ultrasonic diagnostic treatment system of a modified example in which the ultrasonic probe 2B shown in FIG. 3 is adopted does not use the CCU 4 in FIG. In this case, only the ultrasonic tomographic image 30 is displayed on the color monitor 6 (that is, the superimposing circuit 29 outputs the video signal of the reception processing circuit 27 through, or the superimposing circuit 29 is omitted. May be). FIG. 4 corresponds to FIG. 2 or FIG.
The structure on the tip side of the ultrasonic probe 2A or 2B is shown in an enlarged manner.

As shown in FIG. 4, the ultrasonic treatment means 17
Is formed by a concave ultrasonic transducer 20 for medical treatment in which a rectangular oscillator plate is concaved in the longitudinal direction thereof. The emission range 23 of the therapeutic ultrasonic beam emitted in the upward direction (in FIG. 4) and sector-shaped ultrasonic waves facing the front strabismus by, for example, the convex array ultrasonic transducer 24 forming the ultrasonic observation means 18. An observation area (also referred to as an observation area) 28 and a conical observation area 35 formed by the optical observation means 19 are set to overlap each other.

More specifically, as shown in FIG. 4, the optical observation means 19 has a convergence point 23a within the observation range 35.
Is set so that the ultrasonic observation area 28 of the ultrasonic observation means 18 is also set to the ultrasonic observation area 28.
It is set so that the convergence point 23a is included therein. For example, the ultrasonic observation region 28 is a sectoral range extending from the diagonally rear side near the side to the diagonally front side, and the center of the ultrasonic observation region 28 is directed diagonally forward.

Since the optical visual field range and the acoustic observation region are set to overlap each other in the range including the convergence point 23a, the color monitor 6 is set in the state where the lesion tissue is set near the convergence point 23a. It is possible to set the state in which the lesioned tissue exists on the ultrasonic tomographic image 30 and the endoscopic image 37 displayed on the screen (However, when the lesioned tissue exists on the endoscopic image 37, the lesioned tissue exists inside the surface. Cannot directly visually recognize the diseased tissue, and can be confirmed on the ultrasonic tomographic image 30 even in this case).

Further, for example, the forceps outlet 13 is formed so that the axial direction of the forceps outlet 13 which determines the direction of the treatment tool projected from the forceps outlet 13 passes through the converging point 23a as shown by the alternate long and short dash line 13a. .

Therefore, for example, whether or not the lesion tissue is biopsied by a treatment tool before cauterizing the lesion tissue by the ultrasonic therapeutic means 17, or whether the tissue is cauterized sufficiently after the therapeutic treatment by the ultrasonic therapeutic means 17 is performed. When performing a biopsy for investigating, there is an advantage that the operation of positioning the distal end side of the treatment tool on the diseased tissue becomes easy.

The therapeutic ultrasonic transducer 20 constituting the ultrasonic therapeutic means 17 radiates a focused ultrasonic beam for high-intensity therapy (that is, a focused ultrasonic beam), and has a single unit. It may be an ultrasonic oscillator or may be composed of a plurality of ultrasonic oscillators.

Further, as described above, this ultrasonic transducer 20
Is not limited to a concave shape in the longitudinal direction, but may be a single or a plurality of concave shapes in the longitudinal direction and the width direction, or in the case of a flat plate ultrasonic transducer, the phase By using a phased array or the like arranged so as to be offset, a structure may be adopted in which the ultrasonic beam is radiated so as to converge.

Further, a structure in which a concave lens is attached to the ultrasonic wave emitting surface side of a flat plate type ultrasonic vibrator may be used to radiate the ultrasonic beam so as to converge it. In this way, as long as it has a structure suitable for radiating the ultrasonic beam so as to converge it and a driving means associated therewith,
It is not particularly limited. Further, the structure of the tip portion 14 is not limited to that shown in FIG. 4, but may be a modified structure shown in FIGS. 5 to 7.

In the tip end portion 14 shown in FIG. 4, the sector-shaped ultrasonic wave observation region 28 of the ultrasonic wave observation means 18 extends from a diagonal rear side close to the side to a diagonal front side, but FIG.
In the tip portion 14A of the first modification shown in (a),
The center axis of the observation range 35 of the optical observation means 19, that is, the observation center axis (or optical axis) 35a is set so as to pass through the converging point 23a, and the ultrasonic observation area 28 of the ultrasonic observation means 18 The central axis 28a is also set so as to pass through the convergence point 23a.

Further, as shown in FIG. 5 (b), a therapeutic ultrasonic transducer 20 in which a rectangular ultrasonic transducer plate is concave
Extends in the longitudinal direction (passes through the center of the width and is perpendicular to the paper surface)
The central cutting plane P1 is a convex array type ultrasonic transducer 2
A concave ultrasonic transducer 20, a convex array ultrasonic transducer 24, and an objective lens 32 are arranged at the tip 14 so as to pass through the center of 4 and further pass through the central axis (optical axis) of the objective lens 32. ing.

In FIG. 5B, the illumination windows are symmetrically arranged on both sides of the objective lens 32 (in FIG. 4, two illumination windows are arranged on one side of the objective lens 32.
Also in FIG. 4, illumination windows may be arranged on both sides of the objective lens 32 as in FIG. Further, in the case of FIG. 5, the forceps outlet 13 and the nozzle 44 are arranged at the position of the central cutting plane P1. In addition, the illumination lens shown in FIG. 1 is arranged inside the illumination window which is closed by a cover glass that functions as a protection member (not shown).

The observation window is also closed by a cover glass which functions as a protective member (not shown), and the objective lens 32 shown in FIG. 1 is arranged inside the cover glass which is protected by the cover glass. Of course, as shown in FIG.
You may make it attach 2 directly.

As can be seen from the arrangement of FIG. 5 (b), the ultrasonic observation region 28 by the convex array type ultrasonic transducer 24 is a sector-shaped region on the central cutting plane P1 and directed obliquely forward. The observation range 35 of the optical observation means 19 is a conical portion centered on the observation center axis 35a.

Also in FIG. 5A, the emitting range 23 of the therapeutic ultrasonic beam, the ultrasonic observation region 28, and the observation range 3
5 are overlapped with each other, and are set so that the convergence point 23a is located on the central axis 28a of the ultrasonic observation region 28 as described above, and the central axis 3 of the observation range 35 of the optical observation means 19 is set.
The convergence point 23a is located on the 5a so that the position setting (or the positioning) during the treatment can be easily performed.

The concave ultrasonic vibrator 20 is shown in FIG.
As shown in FIG. 5C showing the AA cross section in the plan view of FIG. 5B, it has an arcuate concave surface in the length direction. Electrodes are attached to both sides of the concave surface, and ultrasonic waves are emitted upward by applying a drive signal. A damping member or the like is attached to the back side.

FIG. 5 is a sectional view taken along line BB of FIG. 5 (b).
It may be flat as in (d) or may be concave in the width direction as shown in FIG. 5 (e). Figure 5
The radius of curvature of the concave surface in (c) and the radius of curvature of the concave surface in FIG. 5 (e) are set to be equal, so that the emitted ultrasonic waves converge at the same distance.

When the width is small, it may be flat as shown in FIG. 5D, and when it is large, it may be curved as shown in FIG. 5E so that it converges in the width direction. . The other configurations are the same as those in FIG. This first modification has substantially the same function as the case of the tip portion 14 of FIG. Further, in addition to the effects of the first embodiment, this modification is set so that the convergence point 23a is located on the central axis 28a of the ultrasonic observation region 28, so positioning during treatment is easier. It has the effect that In the case of the tip portion 14B of the second modification shown in FIG. 6, the ultrasonic observation means 18 is not the convex array ultrasonic transducer 24 of FIG. 4 or FIG.
It is composed of an electronic radial array type ultrasonic transducer 24A. That is, a large number of rectangular transducers are arranged along the surface of the cylindrical portion of the tip portion 14B (for example, a portion extending from the central axis of the cylindrical portion to an appropriate angle range), and ultrasonic waves are sequentially transmitted and received by each transducer. The ultrasonic observation region 28 is a sector-shaped range that extends to the angle range in a plane orthogonal to the axis of the tip portion 14B.

Further, the forceps outlet 13 is circular in FIGS. 4 and 5, but is rectangular in FIG. Further, in FIG. 6, the ultrasonic treatment means 17 has a therapeutic ultrasonic beam 23.
The ultrasonic therapeutic means 17 is arranged so as to be directed obliquely rearward, and the convergence point 23a of the therapeutic ultrasonic beam 23 is set to be located, for example, in the center of the plane including the ultrasonic observation region 28. The effect of this modification is similar to the first effect.

In the tip portion 14C of FIG. 7, the ultrasonic observation means 18 in FIG. 4 is constituted by a mechanical radial array type ultrasonic transducer 61a instead of the electronic radial array type ultrasonic transducer 24A. . This mechanical radial scan type ultrasonic transducer 61a has, for example, a plate-shaped ultrasonic transducer 6 at the tip of a flexible shaft 61b.
1a is attached, and the rear end side of the flexible shaft 61b is rotated or reciprocally rotated by a motor or the like not shown, so that the ultrasonic transducer 61a is also rotated or reciprocally rotated, and is orthogonal to the axis of the insertion portion 7. The ultrasonic waves are emitted in a fan shape in the plane.

The ultrasonic observation means 18 shown in FIGS.
However, the structure is not limited to that shown in (1), and another structure may be used as long as it is a structure for obtaining an ultrasonic diagnostic image. Optical observation means 19 in the present embodiment and modification
Shows the front perspective optical system as the most preferable example, but the present invention is not limited to this, and an optical system having another viewing direction may be used.

Next, the operation of the first embodiment will be described below with reference to the diagram of the usage example of FIG.

The ultrasonic probe 2A (or 2 having the above-mentioned configuration
8B, as shown in FIG. 8, is inserted into a luminal organ 63 such as the stomach, and while performing a bending operation, an optical image by the optical observation means 19 and an ultrasonic diagnostic image by the ultrasonic observation means 18. Based on the above, the tip portion 14 is brought into contact with the surface of the tube wall of the site to be diagnosed and treated.

As shown in FIG. 8, a balloon 64, in which an ultrasonic wave transmitting liquid for transmitting ultrasonic waves is enclosed, is attached to the outside of the ultrasonic treatment means 17 and the ultrasonic observation means 18 in the tip portion 14, and The ultrasonic wave for treatment and the ultrasonic wave for observation are transmitted and received through the ultrasonic wave transmitting liquid in the balloon 64.

The optical observation means 1 is inserted during the operation of inserting the ultrasonic probe 2A (or 2B) and contacting the tip portion 14.
9. Specifically, when the outer surface of the observation window to which the objective lens 32 is attached is contaminated with mucus or body fluid and the field of view cannot be secured, the observation window is washed by water supply or air supply from the nozzle 44. After drying and securing the field of view, the insertion operation is continued.

Further, body fluid or mucus can be sucked by an external suction source by operating the suction button 46 of the operating section 8 using the forceps outlet 13 as the treatment function guide section and its channel 42. . Therefore, the ultrasonic probe 2A can be inserted in the same manner as the insertion operation of a normal endoscope or an ultrasonic endoscope.
Each operation function (or 2B) operates. It is also possible to project a treatment tool (not shown) from the forceps outlet 13 and puncture the affected area with, for example, a biopsy needle to collect tissue for pathological diagnosis.

After the lesion 65 is captured and visualized in the ultrasonic observation region 28, the convergence point 23a in the focused ultrasonic beam for treatment emitted by the ultrasonic treatment means 17 is located at the lesion 6.
5, the position of the tip portion 14 of the ultrasonic probe 2A (or 2B) is set to the bending portion 15 by referring to the focus marker and the lesion ultrasonic image displayed on the ultrasonic diagnostic image (not shown). Set by That is, convergence point 2
The positioning of the focal point is set so that it is located in the lesioned part 65 in 3a.

After the positioning of the focal point is completed, the foot switch 51 is pushed to be turned on and a large driving voltage is applied from the driving voltage generating circuit 22 so that the focused ultrasonic waves for treatment having the intensity necessary for cauterization are ultrasonically treated. Irradiate from. This high-intensity therapeutic ultrasonic wave rapidly increases the temperature of the lesion area 65 at the focal point, and cauterizes the lesion tissue.

While observing the state of protein degeneration of the tissue due to this cauterization on the ultrasonic diagnostic image obtained by the ultrasonic observation means 18, high intensity until the protein degeneration necessary for necrosis of the diseased cells progresses. Irradiate therapeutic ultrasonic waves. After that, the irradiation of high-intensity therapeutic ultrasonic waves was stopped,
The degree of achievement of the treatment is confirmed on the ultrasonic diagnostic image, and if it is insufficient, additional irradiation is performed, and if irradiation to another portion is necessary, the treatment is continued in the same manner as above, and all treatments are terminated.

According to the first embodiment, the ultrasonic treatment means 17, the ultrasonic observation means 18, the treatment function guide portion and the optical observation means 19 are arranged in front of the bending portion 15 to perform optical observation and ultrasonic waves. The arrangement is extremely suitable for diagnosis and ultrasonic treatment.

Therefore, the tip portion 14 is inserted into the upper or lower digestive tract under observation of the optical image, and the digestive tract wall and deep organs deep inside the digestive tract wall are ultrasonically observed under observation of the ultrasonic diagnostic image. High temperature treatment (cauterization treatment) becomes possible. Therefore, the application of ultrasonic diagnostic treatment is dramatically expanded by the ultrasonic diagnostic treatment system 1.

That is, in the conventional ultrasonic probe having no curved portion, the direction in which the ultrasonic treatment means portion is brought into contact with the organ where the lesioned portion is extremely limited. That is, the probe can be inserted almost linearly, the side surface of the tip portion thereof can contact the organ, and the probe can be used only in a limited situation where the lesion portion exists on the deep side. Even in this case, it is necessary to form an insertion hole when inserting, and for example, when the vicinity of the heart becomes the insertion hole, it is extremely dangerous. In addition, it may be difficult to insert due to ribs and the like, and in practice, it can only be used in a limited manner.

On the other hand, in the first embodiment, the bending portion 1
Since 5 is provided, the side surface of the tip portion 14 can be brought into contact with the organ in which the lesioned portion exists by bending the bending portion 15.

Further, in the first embodiment, since the insertion portion 7 is flexible, it can be inserted into the body cavity from the oral cavity or the like, and can be inserted into the organ side in the body cavity without providing a hole for insertion in the abdomen or the like, and In that case, it can be introduced and set in the vicinity of the target organ under the observation by the optical observation means 19. That is, like the endoscope, under the observation of the optical observation means 19, the tip portion 14 can be set in the vicinity of the target organ, and thereafter, the side surface of the tip portion 14 is brought into contact with the organ and an ultrasonic observation image or It can be set to a state where a diagnostic image can be obtained, and after the lesion part is moved and adjusted to the position where it becomes the convergence point 23a, the ultrasonic treatment means 17 can perform cauterization treatment.

Therefore, according to the first embodiment, the ultrasonic probe can be used in a wider range than the ultrasonic probe without the bending portion 15. Further, since the predetermined position of the ultrasonic observation area 28 by the ultrasonic observation means 18 is set to be the convergence point 23a of the ultrasonic beam by the ultrasonic treatment means 17,
The ablation position can be easily determined on the ultrasonic observation image, and the ablation position can be confirmed. Therefore, the lesion area to be cauterized can be accurately set in the vicinity of the convergence point 23a to surely cauterize. Moreover, it is possible to prevent accidentally cauterizing a normal part.

When positioning is performed in this way, the ultrasonic observation means 18 and the ultrasonic treatment means 1 are attached to the hard tip portion 14.
7 is provided, the position of the converging point 23a hardly moves from the predetermined position of the ultrasonic observation region 28 by the ultrasonic observation means 18 even if the rear curved portion 15 is bent in an arbitrary direction. The lesion to be cauterized can be accurately set in the vicinity of the convergence point 23a, and cauterization treatment can be reliably performed.

Further, since the forceps outlet 13 is also provided at the tip portion 14, it is possible to collect diseased tissue or the like and perform diagnosis or treatment more reliably. In this case, if the guide direction of the forceps outlet 13 is set to the direction passing through the convergence point 23a, collection and the like will be easy.

In the first embodiment or its modification, the treatment function guide portion is omitted, or the optical observation means 1 is used.
The ultrasonic treatment means 17, the ultrasonic observation means 18, and the optical observation means 19 are formed in this order from the distal end side on the distal end portion 14 and the like, and are curved rearward adjacent to the distal end portion 14 and the like. A configuration in which the portion 15 is formed may be used.

Next, a second embodiment of the present invention will be described. First
In the embodiment and its modification, the ultrasonic probe 2A or 2B is used.
Ultrasonic treatment means 17, ultrasonic observation means 18, on the tip side of
The processing function guide portion and the optical observation means 19 are arranged in this order at the tip portion 1
The curved portion 15 is formed on the rear side adjacent to the tip portion 14 as shown in FIG. 9, but as shown in FIG. 9, the ultrasonic observation means 18, the ultrasonic treatment means 17, and the processing function guide portion are provided from the tip side. The forceps outlet 13 and the optical observation means 19 may be formed in this order on the tip portion 14D, and the curved portion 15 may be formed on the rear side adjacent to the tip portion 14D.

In the second embodiment, the ultrasonic observation means 18
Is formed of, for example, a convex array type ultrasonic transducer 24. Further, the optical observing means 19 has a configuration of a front perspective view with a diagonal front as a visual field. Also in this embodiment, the emitting range 23 of the therapeutic ultrasonic beam and the ultrasonic observation region 28 are provided.
The observation range 35 is set so as to overlap.

The treatment function guide portion is omitted or regarded as a function associated with the optical observation means 19, and the ultrasonic observation means 18, the ultrasonic treatment means 17, and the optical observation means 19 are arranged in this order from the distal end side. The tip 14D is formed on the tip 14D.
The curved portion 15 may be formed on the rear side adjacent to D.

As a modified example of the second embodiment, the structure shown in FIG. 10 may be used. In FIG. 10, the ultrasonic treatment means 17, the optical observation means 19, the treatment function guide portion, and the ultrasonic observation means 18 are formed in this order from the distal end side on the distal end portion 14E,
A curved portion 15 is formed on the rear side adjacent to the tip portion 14E.

Also in this modification, the ultrasonic observation means 18 is formed of, for example, a convex array ultrasonic transducer 24. Further, the optical observing means 19 has a side-view type configuration in which the side is a visual field. Also in this modification, the emission range 23 of the therapeutic ultrasonic beam, the ultrasonic observation region 28, and the observation region 35 are set to overlap.

Further, in FIG. 10, the treatment function guide portion is omitted or regarded as a function associated with the optical observation means 19, and the ultrasonic treatment means 17, the optical observation means 19, the ultrasonic observation means from the distal end side. It may be configured such that the front end portion 14E is formed in the order of 18 and the curved portion 15 is formed on the rear side adjacent to the front end portion 14E.

Further, the structure shown in FIG. 11 may be used.
In FIG. 11, the optical observation means 19, the treatment function guide portion, the ultrasonic treatment means 17, and the ultrasonic observation means 18 are formed in this order from the distal end side on the distal end portion 14F, and the curved portion 15 is formed rearward adjacent to the distal end portion 14F. Is formed.

Also in this modification, the ultrasonic observation means 18 is formed of, for example, a convex array ultrasonic transducer 24. Further, the optical observing means 19 has a rear perspective view with a diagonal rear view. Also in this modification, the emission range 23 of the therapeutic ultrasonic beam, the ultrasonic observation region 28,
The observation areas 35 are set to overlap.

In FIG. 11, the treatment function guide portion is omitted or regarded as a function associated with the optical observation means 19, and the optical observation means 19, the ultrasonic treatment means 17, the ultrasonic observation means are provided from the distal end side. It may be configured such that the front end portion 14F is formed in the order of 18 and the curved portion 15 is formed on the rear side adjacent to the front end portion 14F. The operation of the second embodiment and its modification is almost the same as that of the first embodiment. In addition to the effects of the second embodiment and its modification being similar to those of the previous embodiment and its modification, there is an advantage that the arrangement and configuration of each means that is easy to configure an ultrasonic probe can be achieved.

FIG. 12 shows the structure of the tip portion 14G of the ultrasonic probe 2A or 2B in the third embodiment of the present invention.
In the first and second embodiments (and their modifications), the ultrasonic treatment means 17 and the ultrasonic observation means 18 are formed at separate positions, but in this third embodiment they are integrated. It is configured as ultrasonic treatment / observation means 71.

In FIG. 12, the ultrasonic therapy / observation means 71, the treatment function guide portion, and the optical observation means 19 which are integrated from the distal end side are sequentially formed on the distal end portion 14G and are adjacent to the distal end portion 14G. The curved portion 15 is formed on the rear side.

The ultrasonic treatment / observation means 71 integrated with each other divides, for example, the concave ultrasonic transducer 20 shown in FIG. 4 at the center in the longitudinal direction, and, for example, a mechanical radial scan type transducer 61a at the center position. Are arranged, and the two concave ultrasonic transducers (72a, 72b) are divided on both sides in the length direction of the mechanical radial scan type transducer 61a.
And) are arranged.

The mechanical radial scan type transducer 61a at the center functions as an ultrasonic observation means in the ultrasonic treatment / observation means 71, and the two concave ultrasonic transducers 72a and 72b on both sides of the ultrasonic treatment. Functions as a therapeutic means. As described above, the mechanical radial scan oscillator 61a is connected to a flexible shaft (not shown in FIG. 12), and this shaft is rotationally driven by a motor, and a fan-shaped region is an ultrasonic observation region in a direction orthogonal to the axis of the insertion portion. 28.

In this embodiment, the optical observation means 19 has a front perspective type construction, and the therapeutic ultrasonic beam emitting range 23, the ultrasonic observation region 28, and the like as in the above-mentioned embodiments and the like.
The observation areas 35 are set to overlap.

Further, two concave ultrasonic transducers 72a and 72b are symmetrically arranged on both sides of the mechanical radial scan type transducer 61a, and as shown in FIG. The therapeutic ultrasonic beam emitted so as to be converged from 72b is the ultrasonic observation region 28.
For example, the mechanical radial scan type transducer 61a and the ultrasonic transducers 72a and 72b are arranged such that the convergence point 23a is located on the central axis 28a.

In FIG. 12, a concave ultrasonic transducer 72a,
Although a mechanical radial scan type transducer 61a is arranged as an ultrasonic observation means arranged between 72b, a tip end portion in which an electronic radial scan type ultrasonic transducer 24A is arranged as in the modification shown in FIG. It may be 14H. 12 and 13 have substantially the same operation and effect, except that the driving method for the ultrasonic observation means is different.

Further, as in the modification shown in FIG. 14, the tip portion 14 in which the electronic linear scan type ultrasonic transducer 73 is arranged
You can set it to I. In FIG. 14, for example, in FIG. 5B, the concave ultrasonic transducer 20 is cut along the cutting plane P1,
An electronic linear scan type ultrasonic transducer 73 is arranged along the cutting plane P1, and two concave ultrasonic transducers (74a, 74) are arranged on both sides (along the direction orthogonal to the longitudinal direction) of the ultrasonic transducer.
b)) is arranged.

Electronic linear scan type ultrasonic transducer 73
Has an ultrasonic observation region in a plane perpendicular to the paper surface including the array direction of the transducers (axial direction of the insertion portion). Then, for example, by performing phase control in which the timing of applying a transmission pulse to each transducer 73 is shifted by a delay element or the like to transmit and receive ultrasonic waves, a sector-shaped ultrasonic observation region in a plane including the axis of the insertion portion You can

Further, two concave ultrasonic transducers 74
The therapeutic ultrasonic beams a and 74b also exist in the plane including the ultrasonic observation region, and the convergence point is at a position on the central axis of the ultrasonic observation region, for example.

FIG. 15 shows an example of use for explaining the operation of the third embodiment. In FIG. 15, reference numeral 23 'indicates an emission range of the therapeutic ultrasonic beam in the width direction, which is also converged in the width direction and converges at a convergence point 23a in the length direction (for example, in FIG. 12, the ultrasonic transducer is used). 72a, 72
b has a concave surface in the longitudinal direction and the width direction). The third embodiment has the same effects as the first embodiment and its modification.

Further, in this embodiment, it is easy to set the focal point of the therapeutic focused ultrasonic wave on the central axis in the observation field of the ultrasonic wave, and when the focal position of the therapeutic focused ultrasonic wave is changed. However, this state can be maintained at all times.
In the first modified example of the first embodiment (see, for example, FIG. 5), the focus of therapeutic focused ultrasound can be set on the central axis in the observation field of view. When the focal point of is changed, the position of the focal point shifts from the center axis in the observation field of view.
Even if the focus of the therapeutic focused ultrasound is changed, the position of the focus moves on the central axis in the observation field of view. For this reason, it is very easy to carry out the treatment by the ultrasonic wave having the structure which can be easily positioned or set for the treatment by the ultrasonic wave, and there is also an effect that the efficiency of the ultrasonic diagnosis and the treatment is remarkably improved.

The above-mentioned therapeutic ultrasonic transducer is not limited to the one shown in FIGS. 12 to 14, but a single or a plurality of concave ultrasonic transducers are formed in the longitudinal direction as in the previous embodiment. , Or a phased array or the like, as long as it has a structure suitable for emitting focused ultrasonic waves and a driving means associated therewith, it is not limited. Also, as an ultrasonic transducer for observation, as shown in FIGS.
However, the structure is not limited to the one shown in FIG. 1, and any structure may be used as long as it can be integrally formed with the therapeutic ultrasonic transducer.

In the above-mentioned first to third embodiments and modifications, the ultrasonic treatment means 1 is provided on the distal end side of the bending portion 15.
7, ultrasonic observation means 18, treatment function guide portion, optical observation means 19, or ultrasonic treatment means 1 arranged in this order.
7 and the ultrasonic observation means 18 are interchanged in order, but the ultrasonic treatment means 17, the ultrasonic observation means 18, the treatment function guide section, and the optical observation means 19 may be arranged in the other order. good.

That is, at least the ultrasonic treatment means 17, the ultrasonic observation means 18, the treatment function guide portion, and the optical observation means 19 may be arranged on the distal end side of the bending portion 15.
Even if the treatment function guide portion is not provided, the bending portion 1
At least the ultrasonic treatment means 17, the ultrasonic observation means 18, and the optical observation means 19 may be arranged on the tip side of 5.

FIG. 16 shows an ultrasonic probe 80A according to the fourth embodiment of the present invention. This ultrasonic probe 80A has a thin tube (that is, a thin tube) -like insertion portion 8 so that it can be inserted into a body cavity.
1 and a wide operation portion 82 formed at the rear end of the insertion portion 81, and a universal cable 83 extended from the operation portion 82. The universal cable 83 is the ultrasonic observation device 5 (see FIG. 1). Connected).

The insertion portion 81 has a hard tip portion 84A,
A bendable bending portion 85 and a hard thin tube portion 86 are sequentially formed from the distal end side of the insertion portion 81. Further, the ultrasonic treatment means 87 and the ultrasonic observation means 88 are sequentially arranged in the axial direction of the insertion portion 81 from the distal end side at the distal end portion 84A, and the curved portion 85 is formed behind this. It is a feature. The ultrasonic treatment means 87 is composed of, for example, a concave ultrasonic transducer as in the first embodiment, and has an insertion portion 81.
A drive voltage is applied from the drive voltage generation circuit 22 in the ultrasonic diagnostic treatment apparatus 5 (see FIG. 1) through a signal line (not shown) inserted through the inside, and the like as shown by the dotted line in FIG. A therapeutic ultrasonic beam having directivity in the emission range 23 is converged at the converging point 23a.

The ultrasonic observing means 88 is formed of, for example, a convex array type ultrasonic transducer 24, and a transmission pulse generating circuit 26 and a reception processing circuit 27 (which form a signal processing system 5A via a signal line not shown). (See FIG. 1). Then, ultrasonic waves are scanned in the ultrasonic observation region 28 as shown by the thin line in FIG. Further, the operation portion 82 is provided with an angle knob 89 for performing an operation of controlling the bending direction of the bending portion 85.

The ultrasonic treatment means 87 has a structure suitable for emitting focused ultrasonic waves, such as a single or a plurality of concave or rectangular concave surfaces, or a phased array, as in the above-described embodiment. There is no limitation as long as it has a driving means associated therewith.

As an example of the ultrasonic observation means 88,
Although the convex array transducer 24 is shown in FIG. 16, it is not limited to this and may have any configuration as long as it is a configuration for obtaining an ultrasonic diagnostic image.

The ultrasonic probe 8 configured as described above
OA is a pneumoperitoneum 90 as shown in FIG.
The distal end 84A is contacted with the surface of the abdominal organ 92 to be treated through the balloon 64 while being inserted through the trocar 91 and performing a bending operation under optical observation with a rigid endoscope (not shown). . After that, ultrasonic diagnostic treatment is performed as in the previous embodiment.

According to this embodiment, an ultrasonic probe having a rigid insertion portion having an ultrasonic observation function, an ultrasonic treatment function, an insertion function, and a bending function is used to insert the ultrasonic probe into the thoracic cavity, the abdominal cavity, or the ventricle. Then, the ultrasonic high-temperature treatment can be performed under the ultrasonic diagnostic image of the deep organ, and further, the application of the ultrasonic diagnostic treatment from the inside of the body can be expanded.

FIG. 18 is a diagram showing the structure of the tip portion 84B of the ultrasonic probe 80B in the fifth embodiment of the present invention. In the present embodiment, the ultrasonic treatment means and the ultrasonic observation means are integrated to form an ultrasonic treatment / observation means 100. The tip portion 84B on which the ultrasonic treatment / observation means 100 is formed is connected to the bending portion 85.

That is, in this embodiment, in the ultrasonic diagnostic treatment system having the rigid thin tube having the curved portion 85 which can be inserted into the body cavity, the ultrasonic treatment / observation means 100 for treating and diagnosing the living body is the tip. The curved portion 85 is formed in the portion 84B and is adjacent to the tip portion 84B, and the curved portion 85 is formed in the rear portion.
The ultrasonic probe 80B is formed by being arranged in the first axial direction.

The ultrasonic treatment / observation means 100 is shown in FIG.
As shown in FIG. 8, between the two therapeutic ultrasonic transducers 72a and 72b divided as a therapeutic ultrasonic transducer (for example, similar to that shown in FIG. 14), an ultrasonic ultrasonic transducer for observation is provided. For example, electronic radial scan type ultrasonic transducer 2
4A is provided. A rigid thin tube portion 86 is formed behind the bending portion 85, and the configuration behind the bending portion 85 is shown in FIG.
Is similar in outline.

The ultrasonic transducer for treatment is not limited to the one shown in FIG. 18, but a single or a plurality of concave or rectangular concave shapes, or phased ones, as in the above-described embodiment. There is no limitation as long as it has a structure suitable for emitting focused ultrasonic waves and an associated driving means such as an array.

Further, FIG. 18 also shows a state of treatment. For example, as shown in FIG. 17, it is inserted into the abdominal cavity 90 via the trocar 91, and the tip portion 84B is brought into contact with the organ 92 in the abdominal cavity 90. Then, for example, an electronic radial scan ultrasonic transducer 24A as an ultrasonic transducer for observation is used.
The ultrasonic observation image in the ultrasonic observation region 95 is observed, and the lesion portion 65 is set on the central axis thereof.

Further, it is set from this ultrasonic observation image so that the image of the lesioned part 65 is located at the position corresponding to the focal position of the therapeutic ultrasonic transducers 72a and 72b on the central axis thereof, and the foot switch or the like is set. Turn on and use ultrasonic transducer 7
A therapeutic ultrasonic beam is emitted from 2a and 72b.

This therapeutic ultrasonic beam is emitted so as to converge at the converging point 96a within the emitting range 96 shown by the dotted line in FIG. Therefore, the lesion portion 65 may be set in the convergence point region 98 near the convergence point 96a.

The effect of this embodiment is the same as that of the first embodiment, and the focus of the therapeutic focused ultrasonic wave can be set on the central axis in the observation field of view by the ultrasonic wave. It also has the effect of dramatically improving the efficiency of ultrasonic diagnosis and treatment.

Further, as the observation ultrasonic transducer, a mechanical radial scan type transducer 61a as shown in FIG. 19 is arranged instead of the electronic radial array type transducer 24A as shown in FIG. The ultrasonic probe 80C having the observation means 100 may be used.

Further, as shown in FIG. 20, an electronic linear scan type ultrasonic transducer 73 is provided at the tip portion 84B in the same manner as in FIG.
Alternatively, the ultrasonic probe 80D may be the ultrasonic probe 80D having the ultrasonic treatment / observation means 100 in which the two concave ultrasonic transducers 74a and 74b are arranged on both sides along the width direction. Note that FIG. 20 shows the state in which the balloon 64 is attached.

The ultrasonic transducer for observation is shown in FIGS.
The present invention is not limited to the modification example, and may have any configuration as long as it can be integrally configured with the therapeutic ultrasonic transducer. The actions and effects of the modified examples of these configurations are the fifth.
It is similar to the embodiment.

The ultrasonic probes 80A to 80D of the fourth and fifth embodiments (including their modified examples) are not provided with optical observation means, but may be ultrasonic probes provided with optical observation means.

Although the ultrasonic probe for performing high temperature treatment (cauterization treatment) by ultrasonic waves has been shown in the first to fifth embodiments, the application of the ultrasonic probe is not limited to this, and the body cavity is not limited to this. It can be applied to all ultrasonic treatments using ultrasonic vibration, such as ultrasonic hyperthermia treatment from the inside, stone destruction by ultrasonic waves, and acceleration of the dissolution effect of the stone dissolving agent by ultrasonic waves.

FIG. 21 shows the overall configuration of an ultrasonic diagnostic treatment system 101 according to the sixth embodiment of the present invention. In addition to the configuration of the system 1 shown in FIG. 1, this embodiment includes an image filing device 102, an image processing device 103, and a face mount display (or head mout display, hereinafter referred to as HMD) 104. ing.

In this system 101, for example, an ultrasonic probe 2C having an optical observation means provided with two objective lenses and two CCDs is used, and two CCs are used.
The endoscopic image picked up by D can be output to the color monitor 6 side via a superimposing circuit or the like after being subjected to signal processing by the CCU 4 to be an image signal, and also input to the image processing device 103, The two image signals with parallax are processed and processed into a reproduced image of artificial reality.

This reproduced image of artificial reality is sent to the HMD 104 by a cable (not shown) via the image switching circuit, and the reproduced image 106 of artificial reality can be displayed on the two liquid crystal displays of the HMD 104. This HMD104
Also, the X-ray CT image 107, the X-ray image 108, and the ultrasonic observation image 109 acoustically picked up by the ultrasonic observation means 18 that are pre-filed in the image filing device 102 can be sent via the image switching circuit. I have to.

Further, an ultrasonic observation image which is picked up by the ultrasonic observation means 18 and processed by the ultrasonic wave is inputted to the image processing device 103, and the image is displayed, for example, in a reproduced image of artificial reality in an overlapped manner. It can be output to the HMD 104 via an image switching circuit by performing image processing on an image.

Further, the HMD 104 is provided with a sensor (not shown) for detecting, for example, the line-of-sight direction of the operator, and a detection signal for detecting the line-of-sight is sent to a controller for controlling display switching and the like. The controller switches the image to be output to the HMD 104 according to the detection signal. In addition, the liquid crystal display is set to a semi-transmissive state depending on the position of the line of sight so that the display image and the patient who has passed through the liquid crystal display can be seen.

According to this embodiment, the operator wearing the HMD 104 and using the ultrasonic diagnostic treatment system 101
Various images can be simultaneously or switched within the real visual field. Therefore, since the operator can see a plurality of images in the field of view, it is not necessary to see different images in the related art on separate monitors, and the efficiency of diagnostic treatment can be significantly improved.

Next, a seventh embodiment of the present invention will be described. The background of this embodiment will be described first. ◎ PCT WO93 / 1
The ultrasonic treatment apparatus disclosed in Japanese Patent No. 6641 is provided with an ultrasonic wave observation means, and the diagnosis of the lesion area and the setting of the treatment range are performed by the ultrasonic image obtained by the ultrasonic wave observation means. In such a case, only a limited range of diagnostic images can be obtained, and since the diagnosis is performed by a single means, it is not possible to perform multilateral diagnosis.

Therefore, in the seventh to ninth embodiments and their modifications, a diagnosis / treatment system in which an in-vitro image diagnostic apparatus and an ultrasonic diagnosis / treatment system are combined so as to enable multifaceted diagnosis is realized. It is a thing.

In these embodiments, in a diagnostic treatment system having a thin tube having a curved portion that can be inserted into a body cavity, image diagnosis or positioning of the thin tube is performed in combination with an extracorporeal image diagnostic device. The diagnostic treatment system will be described.

Also in this embodiment, as in the previous embodiment, as shown in FIG. 22 to FIG. 24, in addition to having a flexible insertion portion, as shown in FIG. 25 to FIG. In addition, it may have a hard insertion part. FIG. 22 shows a part of the diagnostic treatment system 110 in which the extracorporeal image diagnostic apparatus is an X-ray CT apparatus.

For example, the ultrasonic diagnostic treatment system 1 of FIG.
The X-ray C shown in FIG.
T111 (and X including the image processing apparatus thereof)
Line CT apparatus) to form the diagnostic treatment system 110 of the seventh embodiment. System body and X-ray CT
Although 111 are separate bodies, X-ray CT is used for diagnostic treatment
Both the diagnostic image and the ultrasonic diagnostic image by the ultrasonic probe 2A are referred to.

Alternatively, an image output device (not shown) of the X-ray CT apparatus and an image output (not shown) of the system body are connected to an image processing device such as CCU4 (or video processor) shown in FIG. The X-ray CT image corresponding to the in-vitro diagnostic device and the ultrasonic diagnostic image of the system main body are simultaneously or switched displayed on the color monitor 6 (see FIG. 1) connected to the output of the.

The diagnostic treatment system 110 having such a configuration is
Simultaneously with the normal X-ray CT examination, in the body cavity of the patient 114 lying on the bed 113 connected to the gadget 112, the luminal organ, the abdominal cavity, the thoracic cavity, the ventricle, etc., for example, the ultrasonic diagnostic probe 2A of FIG. Insert.

Next, an X-ray tomographic image of the lesion is acquired by the X-ray CT apparatus to diagnose the lesion and confirm the position of the tip of the ultrasonic probe 2A. further,
An ultrasonic diagnostic image is acquired by the ultrasonic probe 2A, and a lesion area is variously diagnosed based on the ultrasonic diagnostic image from the inside of the body cavity and the X-ray tomographic diagnostic image. Position the probe tip.

At this time, the diagnostic images obtained by different image diagnostic apparatuses (in this case, the X-ray CT111 and the ultrasonic probe 2A) may be observed on the display means included in each of them, but the configuration of this embodiment has been described. The image processing apparatus may display diagnostic images of different image diagnostic apparatuses on the same display unit for observation.

Alternatively, as shown in the sixth embodiment of FIG. 21, after the image processing apparatus 103 processes and processes it into an artificial reality reproduction image, the image output of this image processing apparatus 103 is output to the HMD 104. Then, various images are displayed at the same time or in a switched manner in the visual field of the operator wearing the same. After that, ultrasonic treatment is performed as in the previous embodiment.

Therefore, according to the present embodiment, by performing image diagnosis by different means other than the ultrasonic image diagnosis by the ultrasonic probe, especially X-ray CT diagnosis, the lesion area necessary for ultrasonic treatment is identified. Diagnosis, judgment / setting of treatment area,
There is an effect that the position confirmation and the positioning of the tip portion of the ultrasonic probe in the body cavity can be performed in a more diversified and accurate manner.

FIG. 23 shows a nuclear magnetic resonance diagnostic apparatus (abbreviated as MRI apparatus) 11 for the extracorporeal image diagnostic apparatus in the eighth embodiment.
6 shows an outline of a diagnostic treatment system 115 characterized in that the extracorporeal image diagnostic apparatus described in No. 6 is an MRI apparatus 116. The MRI apparatus 116 acquires MR signals under a strong static magnetic field generated by the magnet gantry 117 and images the MR signals.
Ultrasonic probe 118 used in combination with 16
Are configured for use in strong magnetic fields.

That is, the thin tube (corresponding to the ultrasonic probe) does not affect the imaging of the MRI apparatus 116.
The diagnostic / treatment system 115 is characterized by being constituted by a non-magnetic or weakly magnetic structure.

In the diagnostic / treatment system 115 having such a configuration, the magnet gantry 1 is used as in the case of a normal MRI examination.
The ultrasonic diagnostic probe 118 is inserted into the body cavity of the patient 114 lying on the bed 120 connected to the patient 17, into a luminal organ, an abdominal cavity, a chest cavity, a ventricle, or the like. The subsequent operation is almost the same as that shown in the seventh embodiment.

Therefore, according to the present embodiment, the image diagnosis by different means other than the ultrasonic image diagnosis by the ultrasonic probe, especially the MRI diagnosis is performed, thereby diagnosing the lesion portion necessary for the ultrasonic treatment, The treatment area can be determined and set, and the position and position of the tip of the ultrasonic probe in the body cavity can be confirmed and positioned more multilaterally and accurately.

Further, as shown in FIG.
The diagnostic / treatment system of the ninth embodiment may be configured by using the ultrasonic probe 118B having the high-frequency coil 119 for receiving the MR signal therein.

The ultrasonic probe 118B shown in FIG.
The ultrasonic probe 2B shown in FIG.
A high-frequency coil 119 formed of, for example, a loop antenna is built in the inside of the device, the inside of the ultrasonic observation device 18, or the inside of the optical observation device 19.

The output of the high frequency coil 119 is connected to the impedance matching circuit 120, the output of the impedance matching circuit 120 is connected to the cable 121, and the MR signal received by the high frequency coil 119 is transmitted to the ultrasonic probe 11.
8B, and is input to the signal input unit of the MRI apparatus 116.

Although FIG. 24 shows the ultrasonic probe 2B of FIG. 3 with the high frequency coil 119 built in the tip portion 14, the ultrasonic probe 2A of FIG. good. 25 to 27
Is an ultrasonic probe 118C in a modification of the ninth embodiment.
Through 118E.

The ultrasonic probe 118 shown in FIGS.
C to 118E are provided with a hard insertion portion 81. That is, the ultrasonic diagnostic treatment system is configured by incorporating the high-frequency coil 119 for receiving the MR signal in the distal end portion 84A or 84B of the thin tube formed by the rigid insertion portion 81.

FIG. 25 shows the ultrasonic probe 80A shown in FIG. 16 in which the high frequency coil 119 is built in the tip portion 84A, FIG. 26 shows the ultrasonic probe 80B shown in FIG. 18 in which the high frequency coil 119 is built in, and FIG. A high frequency coil 119 is built in the tip portion 84B of the ultrasonic probe 80C of FIG.

Also in the ultrasonic probes 118C to 118E, as in the ultrasonic probe 118B shown in FIG. 24, the ultrasonic treatment means 87 or the ultrasonic treatment / observation means 10 is used.
0 or the inside of the ultrasonic observation means 88 contains a high frequency coil 119 formed of, for example, a loop antenna, an impedance matching circuit 120, and a cable 1.
It is input to the signal input unit of the MRI apparatus via 21. M
The configuration relating to the display of the image obtained by the RI device and the image obtained by the ultrasonic probe is the same as the configuration described in the eighth embodiment.

Also in the diagnostic treatment system in the modified example, the ultrasonic diagnostic probes 118C to 118 are placed in the body cavity of the patient lying on the bed 120 connected to the magnet gantry 117, as in the case of the usual MRI examination.
Insert E into the abdominal cavity, chest cavity, ventricle, etc. The subsequent operation is similar to that of the ninth embodiment.

The ultrasonic probes 118C to 118C
The high-frequency coil 119 for MR signal reception built in the tip of 18E can be used to diagnose a lesion area by capturing a higher-definition intracorporeal MRI diagnostic image together with an MRI diagnostic image obtained by a normal extracorporeal high-frequency coil. it can.

Therefore, in addition to the effects of the ninth embodiment, it is possible to perform more accurate diagnosis of a lesion area and determination / setting of a treatment area by using an extremely high-definition MR diagnostic image. In addition,
In the seventh to ninth embodiments, the diagnostic treatment system in which the X-ray CT apparatus, the MRI apparatus, and the ultrasonic diagnostic treatment system are combined is shown as an example of the combination with the extracorporeal image diagnostic apparatus. Alternatively, for example, it may be combined with an external ultrasonic diagnostic apparatus.

That is, the extracorporeal image diagnostic apparatus is an ultrasonic diagnostic apparatus, which is a diagnostic treatment system, wherein the ultrasonic diagnostic apparatus has an extracorporeal ultrasonic diagnostic probe.

In such a configuration, the ultrasonic diagnosis of the lesion area from the inside of the body cavity by the ultrasonic probe inserted into the body cavity is supported by the ultrasonic diagnosis of the lesion area from outside the body. The display of ultrasonic diagnostic images from inside and outside the body is performed in the same manner as in the previous embodiment.

Therefore, in addition to the effects similar to those described in the previous embodiment, since the ultrasonic diagnostic apparatus which is an extracorporeal image diagnostic apparatus is small and can be easily used, the extracorporeal image diagnostic apparatus is extremely easy to support the diagnosis. It also has the effect that it can be realized.

By the way, when performing high temperature treatment with ultrasonic waves,
In order to obtain focused ultrasonic waves with high intensity, for example, PCT WO
In an ultrasonic probe incorporating a comparatively small therapeutic ultrasonic transducer, as disclosed in Japanese Patent Application No. 93/16641,
This small ultrasonic transducer is driven with high power.

The driving form is input (driving) due to both continuous (continuous wave) or intermittent (tone burst wave) and originally low conversion efficiency of the ultrasonic transducer. ) Most of the power is lost or heat. Therefore, there is a problem that the ultrasonic probe generates heat during ultrasonic treatment (during high-intensity focused ultrasonic wave irradiation). This problem may cause thermal damage to the living tissue that the ultrasonic probe contacts.

FIG. 28 shows an ultrasonic probe 1 according to the tenth embodiment which is provided with means for solving the above-mentioned problems.
25 is a sectional view showing the structure of the tip portion of 25. FIG. The present embodiment is characterized in that an ultrasonic diagnostic treatment system having a thin tube having a curved portion that can be inserted into a body cavity is provided with cooling means for the therapeutic ultrasonic transducer.

In this embodiment, as an example, the ultrasonic treatment / observation means 128 having the ultrasonic observation means 127 in the ultrasonic treatment means 126 is provided at the tip portion 129 to form the ultrasonic probe 125. However, the ultrasonic probe to which the present embodiment is applied is not limited to this.

A bendable bending portion 130 is provided on the rear side adjacent to the tip portion 129. Ultrasonic treatment means 126
The therapeutic ultrasonic transducer 133 is built in,
Inside the ultrasonic observation means 127, for example, a small-diameter ultrasonic probe 135 for obtaining an ultrasonic diagnostic image by mechanically scanning the ultrasonic ultrasonic transducer 134 at the tip.
It has a built-in tip.

Acoustic windows 136 for transmitting the applied ultrasonic waves are provided in the ultrasonic wave irradiation directions of the therapeutic ultrasonic wave oscillator 133 and the observation ultrasonic wave oscillator 134. The acoustic window 136 constitutes a part of the exterior of the ultrasonic probe 125. The acoustic window 13 inside the acoustic window 136
6 and the spaces 137, 13 formed between the ultrasonic transducer 133 for treatment and the tip of the ultrasonic probe 135 for observation.
Cooling water, which also serves as an acoustic transmission medium, is injected into the channels 8 and 139.

This cooling water is supplied from the cooling water supply means of the ultrasonic diagnostic treatment system body (not shown) to the cooling water supply line 1.
It is supplied to the space 137 via 40. The space 1
The cooling water of 37 flows into the space 138 in the ultrasonic observation means 127 through the flow port 141, and then the flow port 14 is also changed.
It flows into the space 139 via 2. The cooling water in the space 139 is passed through the cooling water recovery conduit 143 by the cooling water recovery means (not shown) of the ultrasonic diagnostic treatment system main body.
It is collected to the outside of the ultrasonic probe 125. That is, the cooling means is a cooling water circulating means for the radiation surface of the therapeutic ultrasonic transducer.

Next, the operation of the tenth embodiment will be described.
In such a configuration, the acoustic transmission medium that is in contact with the radiation surface of the therapeutic ultrasonic transducer 133 is cooling water, and the therapeutic ultrasonic transducer 133 is driven by the circulation generated by the supply and recovery of the cooling water during ultrasonic treatment. Heat generated by power loss,
It collects from the radiation surface of the therapeutic ultrasonic transducer 133 and prevents the therapeutic ultrasonic transducer 133 from becoming hot.

Therefore, according to this embodiment, the oscillator and the ultrasonic wave caused by the drive power loss, which occur when the small therapeutic ultrasonic oscillator is driven with a large electric power in order to obtain the high intensity focused ultrasonic wave. It is possible to prevent heat generation at the tip of the probe and ensure thermal safety of the living body.

In addition, the cooling water is the therapeutic ultrasonic transducer 13
Since it is in contact with only the radiation surface of No. 3, the vibrator can be cooled without increasing the impedance of the vibrator. This means that the oscillator load increases due to cooling water recirculation,
This has the effect of not increasing the drive voltage of the therapeutic ultrasonic transducer associated with this increase in load.

The ultrasonic probe 125B of the eleventh embodiment shown in FIG. 29 is the ultrasonic probe 1 shown in the tenth embodiment.
Based on the configuration of No. 25, the temperature of the therapeutic ultrasonic transducer 133 is observed. That is, the therapeutic ultrasonic transducer 133 is the therapeutic ultrasonic transducer 1
It is characterized by comprising temperature detecting means for monitoring the temperature of 33.

For example, temperature sensors 144 and 145 (joint portions in the case of a thermocouple) formed of, for example, thermocouples are provided on the back surface of the therapeutic ultrasonic transducer 133, that is, the surface not involved in ultrasonic radiation. ing. The thermocouple 144,
The lead wires 145 are arranged, for example, along the cooling water supply conduit 140 and the cooling water recovery conduit 143, respectively, and are connected to the temperature observing means of the ultrasonic diagnostic treatment system body (not shown), The observation means displays the measured temperature of the therapeutic ultrasonic transducer 133, issues a warning at a dangerous temperature, interrupts the treatment, and so on.

Therefore, according to the present embodiment, since the temperature of the therapeutic ultrasonic transducer 133 can be directly observed, it is judged based on this temperature whether cooling water recirculation is necessary or not, and the circulation velocity is determined. It becomes possible to control the ultrasonic therapy system itself. Therefore, the therapeutic ultrasonic transducer 133 can be cooled accurately.

In FIG. 30, the cooling means is an ultrasonic therapeutic means 126 in which the therapeutic ultrasonic vibrator 133 is incorporated.
The tip portion 1 of the ultrasonic probe 125C in the ultrasonic diagnostic treatment system according to the twelfth embodiment, which is constituted by a cooling water circulating means of an inflatable / contractible bag attached to the.
29 is shown.

The bag-shaped body is a balloon 150, and the balloon 150 is attached in close contact with the periphery of the ultrasonic therapeutic means 126. In this balloon 150, the fitting groove 1 provided on the exterior of the ultrasonic probe 125C is provided.
O-ring portions 151 and 152, which are fitted into the balloons 46 and 147 and keep the balloon inner space 153 watertight, are provided.
In addition, a suction pipe 155 is formed in the balloon 150. Since the suction pipe 155 is opened, the pipe is formed and at the same time, the pipe is supported to the tip of the balloon.
The support beam 158 is provided at the balloon tip and the suction conduit opening 154.
It is provided between and.

The suction pipe 155 of the balloon 150 is connected to the tube 157 at the pipe joint 156, and is collected to the outside of the ultrasonic probe 125C by the cooling water collecting means of the ultrasonic diagnostic treatment system body (not shown). It

Further, the ultrasonic probe 125C is provided with a cooling water supply pipe 148 which also serves as an acoustic transmission medium, and the supply pipe is opened to the internal space 153 of the balloon 150. This cooling water is supplied to the space 153 from a cooling water supply means (not shown) of the ultrasonic diagnostic treatment system main body via a cooling water supply pipe line 148.

On the other hand, the therapeutic ultrasonic transducer 133 and the observing ultrasonic probe 1 inside the ultrasonic probe 125C.
Spaces 137, 1 between the tip of 35 and the acoustic window 136
An acoustic transmission medium is previously enclosed in 38 and 139.

In such a structure, the cooling water is supplied from the cooling water supply means of the ultrasonic diagnostic treatment system main body to the inside of the balloon 150 via the cooling water supply pipe line to inflate the balloon 150. Then, when the balloon 150 is filled with cooling water and inflated to a desired size, the cooling recovery means of the ultrasonic diagnostic treatment system main body passes the suction conduit 155 and the tube 157 at the same flow rate as the supply flow rate. It is sucked and collected outside.

Therefore, the cooling water fills the inside of the balloon 150 and circulates in the balloon 150 while acting as an acoustic transmission medium for acoustically coupling with the living body. The cooling water recirculation in the balloon 150 may be performed under flow rate control. Further, like the ultrasonic probe 125D of the modified example of the twelfth embodiment shown in FIG. 31, a pressure sensor 158 is provided inside the balloon 150, and by the balloon internal pressure detection / control means of the ultrasonic diagnostic treatment system body (not shown), It may be refluxed under pressure control.

That is, the cooling water recirculation means for the bag-shaped body is characterized in that the bag-shaped body is equipped with a pressure sensor, and the pressure is controlled based on the detected pressure in the bag-shaped body. Can have the same effect.

Therefore, according to the present embodiment and its modification, the cooling water inside the balloon, which achieves the acoustic coupling between the ultrasonic probe 125C and the living body, is circulated at a constant flow rate or under a constant flow rate. The surface of the ultrasonic probe is cooled while performing the above, and the effect of preventing thermal damage to the living body is exhibited.

Particularly, in the case of constant pressure recirculation, there is an effect that the standoff when the ultrasonic probe 125D is brought into contact with the living body can be arbitrarily adjusted while realizing the cooling.

As another modification of the twelfth embodiment, the pressure sensor 158 is replaced with a temperature sensor, and the temperature sensor detects the temperature of the cooling water inside the balloon 150.
Perfusion control and treatment control may be performed as in the embodiment. The function and effect in that case are the same as those in the eleventh embodiment. Further, the pressure sensor 158 may be replaced with a temperature / pressure sensor so that the effects of this embodiment and the eleventh embodiment can be obtained at the same time.

Next, a thirteenth embodiment will be described. This embodiment is an ultrasonic probe having a retractor function, and is designed to facilitate treatment by avoiding an organ that is an obstacle to the target organ in the abdominal cavity or the like. 32 (a),
(B) is the top view and side view which show the external appearance of the abdominal cavity ultrasonic probe 220 in the ultrasonic diagnostic treatment system of 13th Example, respectively.

The ultrasonic probe 220 includes the elongated insertion portion 2
21 and an operation portion 222 provided at the rear end of the insertion portion 221.
And a signal cable 223 extending from the rear end of the operation unit 222. The insertion portion 221 has a structure in which a hard tip portion 224, a bendable bending portion 225, and a hard insertion tube portion 226 are sequentially formed from the tip end side,
The bending portion 225 can be bent by a bending operation knob 227 provided near the center of the operation portion 222.

The distal end portion 224 has a built-in ultrasonic transducer for observation and a concave focused ultrasonic transducer for treatment. Further, rod-shaped retract arms 228 made of an elastic body are provided on both side surfaces of the tip portion 224.

A first grip portion 230 formed on the front end side of the operation portion 222 and serving as a grip portion, a bending operation knob 227 formed near the center position, and a rear end portion of the operation portion 222. And a second grip portion 231 provided on the second grip portion 231. The second grip portion 231 is provided with an operation switch 232 for adjusting the opening degree of the retract arm 228.

Further, a balloon (not shown) for enclosing the ultrasonic transmission medium that performs acoustic coupling can be attached to the tip portion 224, and the ultrasonic transmission medium is provided at the rear end of the second grip portion 231. It is adapted to be supplied into the balloon from the injection port 233 via a conduit in the ultrasonic probe 220.

The tip portion 224 of this ultrasonic probe 220
Is, for example, the ultrasonic treatment shown in the fifth embodiment shown in FIG.
The observation means 100 has the same configuration as that of the observation means 100, and a description thereof will be omitted.

Ultrasonic probe 2 configured as described above
20 is inserted into a pneumoperitoneal cavity via a trocar to bring the tip 224 into contact with the surface of the tissue to be treated while performing a bending operation. Here, even if an attempt is made to bring the ultrasonic probe 220 into close contact with the surface of the tissue to be treated, other organs may be in the way and the close contact may not be achieved. Therefore, the operation switch 23 provided on the second grip portion 231
2 is slid forward and the retract arm 228 is opened, so that other organs are excluded and the ultrasonic probe 2
The 20 can be adhered to the tissue to be treated.

FIG. 33A shows a state before the retract arm 228 is opened, and FIG. 33B shows the opened state. When the treatment is completed, the operation switch 232 is slid backward to close the retract arm 228.

According to this embodiment, the retract arm 2
28 makes it possible to exclude organs that are obstructive to the treatment and allow the ultrasonic probe 220 to come into close contact with the tissue to be treated. In addition, since the airtightness is not provided between the ultrasonic probe 220 and the tissue due to the close contact, the ultrasonic energy can be efficiently transmitted to the affected area, and the treatment efficiency can be improved.

Next, the ultrasonic probe 220 of the first modified example.
A is shown in FIG. FIG. 34 (a) shows a state in which the plate-like retract arm 234 is in a state before being opened, and the sheath 23 having a notch on a side surface where ultrasonic waves are radiated from the transducer of the distal end portion 224.
5 is provided so as to be able to advance and retreat. Here, the retract arm 234 is a superelastic alloy in which Ni-Ti is an alloy or the like, and remembers an open shape which is a memory shape at body temperature or room temperature.

Then, when the sheath 235 is pulled, the retract arm 234 opens in a memory shape, as shown in FIG. 34 (b), and the disturbing organ can be excluded. The retract arm 234 is fixed to the tip portion 224 by a fixing portion 236. By sufficiently pulling the sheath 235, the bending portion 225 can be exposed and the bending operation can be freely performed. As an effect, since the organ can be excluded only by advancing and retracting the sheath 235, the structure is simple.

As still another modified example, FIG.
(C) shows an ultrasonic probe 220B provided with a clip arm 237. As shown in FIG. 35, a clip arm 237 having an arched tip is attached with its base end housed in a guide groove 238a of an arm fixing portion 238 between the tip portion 224 and the bending portion 225.

Normally, the clip arm 237 is biased toward the tip end by a spring member (not shown).
It is in the opened state as shown in (b). A pulling wire (not shown) is connected to the clip arm 237 and can be moved back and forth by the operation switch 232 (see FIG. 32) of the second grip portion 231.

Here, when the operation switch 232 is pulled to the front, the clip arm 237 is also pulled to the front, as shown in FIG.
The state is changed to the closed state as shown in FIG. After being inserted into the abdominal cavity in this state, the operation switch 232 is operated to open the affected part 239 to be treated and the distal end 224.
And the clip arm 237. After clipping, treatment is performed with a therapeutic ultrasonic transducer. The effect is that the distal end portion 224 and the affected area 239 can be surely brought into close contact with each other, and the balloon for enclosing the ultrasonic transmission medium is unnecessary.

According to the present embodiment and the modified example, in the ultrasonic diagnostic treatment system having the thin tube having the curved portion that can be inserted into the body cavity, the ultrasonic treatment means for treating the living body,
An ultrasonic diagnostic treatment system is formed which is provided with an ultrasonic observation means for diagnosing a living body and an adhesion means (arm member) for adhering at least one of the ultrasonic treatment means or the ultrasonic observation means to the living body. .

36 and 37 show a fourteenth embodiment of the present invention. In the operation under the observation of the endoscope to treat / operate the abdominal organs, when the ultrasonic probe is used together, the inside of the ultrasonic probe may not be airtight and is inserted into the abdominal cavity after the pneumoperitoneum. At times, there was the problem that pneumoperitoneum gas leaked from the abdominal cavity.

On the other hand, the convergence point of the therapeutic transducer provided on the ultrasonic probe is often fixed, and it is difficult to arbitrarily set the depth of the treatment site. The present embodiment is configured to include means for solving the above problems.

FIG. 36 shows a main part of an ultrasonic diagnostic treatment system 250 provided with a scope holding mechanism using a three-dimensional manipulator means. It shows a state in which a surgical site is being operated at the time of surgery under observation of a laparoscope. The abdominal cavity 252 inside the abdominal wall 251 is inflated by carbon dioxide gas fed by a pneumoperitoneum (not shown). 253 indicates the tissue to be treated.

A first trocar 254 and a second trocar 255 having an inner diameter of 10 mm, for example, are inserted into the abdominal wall 251, and an ultrasonic probe 256 and a scope (laparoscope or abdominal rigid endoscope) 257 are inserted in the holes. Is inserted.

This ultrasonic probe 256 and scope 2
57 is fixedly supported by a connection holding portion 258a formed of a plurality of rotation-controlled joints provided in the three-dimensional manipulator 258 (the three-dimensional manipulator is shown in Japanese Patent Application No. 4-144301). Further, rubber stoppers 259 are provided at the openings of the first trocar 254 and the second trocar 255, respectively.

In this embodiment, the ultrasonic probe 256 has a structure in which the ultrasonic treatment means 240 is detachable from the ultrasonic probe main body 241, as shown in FIG. The configuration is similar to the example.

As shown in FIG. 37 (a), the ultrasonic therapeutic means 240 has focal lengths of La, Lb, Lc (La
>Lb> Lc) therapeutic ultrasonic transducers 242a, 242
The housings b and 242c are prepared and can be detachably connected to the ultrasonic probe main body 241. Then, in FIG. 37B, for example, the focal length is Lb.
2 shows a state in which the ultrasonic treatment means 240 incorporating the therapeutic ultrasonic transducer 242b is connected.

Each ultrasonic treatment means 240 has a connector 243 at the base end. The connector 243 is provided with a terminal 244 for transmitting a signal for driving the therapeutic ultrasonic transducer 242i (i = a, b, c) and an O-ring 245 for maintaining airtightness.

On the other hand, the ultrasonic probe main body 241 is provided with an opening serving as a connector receiver 246 at the front end thereof, and the ultrasonic wave observation means 247 is provided at the rear side adjacent to the connector receiver 246.
Of the convex array transducer 247a
There is provided a tip portion 224 in which is formed. A curved portion 225 is formed behind the ultrasonic observation means 247, and a hard insertion tube portion 226 is formed behind this curved portion 225.

Next, the operation will be described. The pneumoperitoneum gas is prevented from leaking from the abdominal cavity 252 by inserting the ultrasonic probe 256 and the scope 257 into the trocars 254 and 255 having the rubber stopper 259, respectively. Further, the connector 243 of the ultrasonic treatment means 240 which is detachable is attached with an O
Since the ring 245 is provided, the ultrasonic probe 25
6 It is possible to prevent the pneumoperitoneum gas from leaking through the inside.

Further, by controlling the three-dimensional manipulator 258, the ultrasonic probe 256 can be remotely driven and controlled in a predetermined direction. The operation of the ultrasonic therapeutic means 240 is almost the same as that of the first embodiment.

The effects of this embodiment are as follows. The ultrasonic probe 256 alone can maintain airtightness and prevent leakage of pneumoperitoneum gas. Further, by providing the trocars 254 and 255 with the rubber stoppers 259, it is possible to prevent the gas of the insufflation from being doubled.

Further, since the ultrasonic treatment means 240 is detachable, the therapeutic transducer 242 having a different focal length is provided.
The treatment range in the depth direction can be expanded by arbitrarily combining a, 242b, and 242c.

Next, FIG. 38 shows a main part of an ultrasonic diagnostic treatment system 250A of a modified example of FIG. Only the different parts will be described below. A balloon 260 is provided in each of the insertion portions of the ultrasonic probe 262 and the scope 263, and the balloon 260 is detachable and its mounting position can be adjusted in the axial direction of the insertion portion. An ultrasonic treatment / observation means 264 is provided at the tip of the ultrasonic probe 262. Further, a tactile sensor 261 is provided on the surface. Two curved portions 225a and 225b are axially connected to the near side of the ultrasonic treatment / observation means 264.

The ultrasonic treatment / observation means 264 is, for example, the third
The structure is almost the same as that of the embodiment, and the probe main body 241A
The only difference is that it is removable. FIG. 39 shows the configuration of the tip side having this ultrasonic treatment / observation means 264.
It shows in (a). The ultrasonic wave treatment / observation means 2 is provided in the connector receiver 246 provided at the tip portion 224 of the probe body 241A.
64 connectors 243 (for example, see FIG. 33B) are connected.

Ultrasonic treatment / observation means 26 of FIG. 39 (a)
Instead of 4, the ultrasonic treatment / observation means 26 of FIG.
4A, or ultrasonic treatment / observation means 264 of FIG. 39 (c)
It is also possible to attach and use B. The ultrasonic treatment / observation means 264A of FIG. 33 (b) is the ultrasonic treatment transducer 7 used in the ultrasonic treatment / observation means 264 of FIG. 39 (a).
2a and 72b have different focal lengths (eg shorter)
Ultrasonic transducers 72a 'and 72b' for treatment of focal length are used.

The ultrasonic treatment / observation means 264C of FIG. 39 (c) corresponds to the ultrasonic treatment / observation means 26 of FIG. 39 (b).
4A for treatment ultrasonic transducers 72a ′, 72
therapeutic ultrasonic transducer 72 having a shorter focal length than b '
a "and 72b" are used.

The ultrasonic treatment / observation means 264A of FIG. 33 (b) corresponds to the ultrasonic treatment / observation means 26 of FIG. 39 (a).
For example, an observation ultrasonic transducer 61a ′ having a different observation range 28 (for example, wider) from the observation ultrasonic transducer 61a used in FIG. 4 is used. In addition, the ultrasonic treatment / observation means 264B of FIG. 33 (c) has a wider observation range 28 than the observation ultrasonic transducer 61a ′ used in the ultrasonic treatment / observation means 264A of FIG. 39 (b). The ultrasonic transducer 61a ″ is used. Further, as the ultrasonic transducer 61a for observation, those having different drive frequencies can be used.

Next, the operation will be described. After inserting the ultrasonic probe 262 and the scope 263, to which the balloon 260 is attached, into the trocars 254 and 255, respectively, the balloon 260 is inflated and brought into close contact with the distal end surfaces of the trocars 254 and 255 to prevent the abdominal cavity 252 from leaking the abdominal cavity gas. Can be prevented. On the other hand, ultrasonic treatment / observation means 2
The three-dimensional manipulator 258 and the curved portions 225a and 225b can be curved by the tactile sensor 261 provided on the surface 64 so that the ultrasonic observation and treatment unit 264 is always in close contact with the affected area.

Further, by making the ultrasonic observation / treatment means 264 detachable, the therapeutic transducer 72 having different focal lengths is provided.
a or the like, or the observation oscillator 61a or the like having a different drive frequency can be arbitrarily combined.

The effects of this modification are as follows. Since the airtightness can be maintained using the balloon 260, it is possible to use an existing trocar, probe, or scope. Further, by using the ultrasonic probe having a plurality of curved portions, the tip portion can be brought into close contact with the complicated shape of the affected area. Further, it becomes possible to bring an observation means or a treatment means to the curved portion, which leads to miniaturization of the probe. The observation means or the treatment means may be disposable (disposable).

Further, by making the ultrasonic observation / treatment means 264 detachable, not only the depth of the treatment region can be made variable, but also by changing the drive frequency of the observation means according to the depth, in the case of shallow depth. If the frequency is increased to improve the resolution and the depth is deep, the frequency can be decreased to appropriately combine them so that a tomographic image can be obtained over a long distance, and thus optimal diagnostic treatment can be performed.

36 and 38, the case of surgery in the abdominal cavity has been described, but the configuration of the ultrasonic probe 256A in the fifteenth embodiment of the present invention suitable for use in the upper or lower digestive tract or the like is shown. It shows in FIG.

The ultrasonic probe 256A of this embodiment is the tip portion 224 of the ultrasonic probe main body 241 in FIG.
In the ultrasonic probe main body 241A having a structure in which the optical observation means 248 is further formed, and instead of the rigid insertion tube portion 226 behind the bending portion 225, the flexible insertion tube portion 22 is provided.
6A, and in the mounted state, for example, the configuration is basically the same as that of the first embodiment.

As for the ultrasonic treatment means 240, the ultrasonic probe main body 241A is detachably attached to the ultrasonic probe main body 241A with the built-in therapeutic ultrasonic transducers 242a, 242b, 242c having different focal lengths La, Lb, Lc as in FIG. Since it is flexible and its configuration has been described above, its description is omitted.

This embodiment has the functions and effects of the first embodiment, and as explained in the fourteenth embodiment, the therapeutic ultrasonic transducer having the focal length at the depth of the treatment region according to the depth. It is possible to use the ultrasonic treatment means 240 having a built-in ultrasonic wave. Therefore, the treatment range in the depth direction can be expanded, and more appropriate treatment (for example, treatment in a short time or necrosis of tissues other than the lesion site can be minimized).

FIG. 41 shows the tip side of a modification of the fifteenth embodiment. This ultrasonic probe 256B is an ultrasonic probe main body 241B having a structure in which an optical observation means 248 is further formed at the tip end portion 224 of the ultrasonic probe main body 241A in FIG. 39, and the rigid insertion tube behind the bending portion 225a. A flexible insertion tube portion 226A is used instead of the portion 226, and when mounted, it basically has the same configuration as that of the first embodiment, for example. 41 shows the ultrasonic treatment / observation means 264 without the tactile sensor 261 provided on the surface thereof, the tactile sensor 261 may be provided.

This modification has the same operations and effects as the fifteenth embodiment. Further, when the tactile sensor 261 is provided, the effect of the modification of FIG. 39 is also obtained. The curved portion 22
Although the rear of 5a is described as the flexible insertion tube portion 226A, it may be a rigid insertion tube portion 226.

Next, a sixteenth embodiment of the present invention will be described. When the diagnostic probe 273 and the therapeutic probe 271 are separate bodies, there is a problem that the diagnostic probe 273 cannot accurately know where the treatment site by the therapeutic probe 271 is. Therefore, the present embodiment is provided with means for solving this problem. The same parts as in the 14th embodiment are omitted.

As shown in FIG. 42, the therapeutic probe 271 and the diagnostic probe 273 inserted into the abdominal cavity 252 have an ultrasonic therapeutic means 272 and an ultrasonic observing means 274.
It is connected and fixed and positioned in the position 2.

FIG. 43 shows the structure on the tip side provided with the positioning means. The ultrasonic observation means 18 is the electronic linear array type transducer 73 of FIG. 14, and the ultrasonic treatment means 17 is the one of FIG. 4 or FIG.
The basic configuration is the same as that of the concave ultrasonic transducer 20.
Rod-shaped permanent magnets 275 and 276 are provided on the respective side surfaces, and when they are brought close to each other in the abdominal cavity 252, they are attracted to each other by a magnetic force and fixed at a predetermined position. An electromagnet may be used instead of the permanent magnet.

Next, the operation will be described. The therapeutic probe 271 and the diagnostic probe 273, which are separate bodies, can be fixed at a predetermined relative position after being inserted into the abdominal cavity. The effects of this embodiment are as follows.

Treatment probe 271 and diagnostic probe 2
Since 73 can be fixed at a predetermined position, the position of the treatment site can be confirmed on the tomographic image obtained by the diagnostic probe 273, so that the affected area can be surely treated. It also improves safety and does not treat normal tissue.

When an electromagnet is used instead of a permanent magnet, the attachment / detachment can be performed electrically, so that the operability can be improved. Further, the suction force at the time of fixing can be set high. This is because the current only needs to be cut off when released.

FIG. 44 shows the structure of the distal end side in a modification of the 16th embodiment. A planar suction surface 282 is provided on one side surface of the tips of the therapeutic probe 280 and the diagnostic probe 285.
And 284 are provided respectively. The adsorption surface 2
A suction port 281 is provided at 82 (or 284), and the suction surfaces 282 and 284 are suction-fixed by suction through a pipe line (not shown).

Further, a three-dimensional magnetic sensor 283 capable of detecting a three-dimensional position is provided on a part of the tip portion 224 for the therapeutic probe and the diagnostic probe, respectively. Next, the operation will be described.

By providing the suction surfaces 282, 284 and the suction means on the respective probes 280, 285, it becomes possible to fix the respective probes 280, 285 at predetermined positions in the abdominal cavity.

Further, since the position of each probe 280, 285 can be known by providing the three-dimensional magnetic sensor, it is possible to position remotely and automatically by the three-dimensional manipulator shown in the fourteenth embodiment. it can. In other words, after the observation probe 285 is first positioned with respect to the affected area, the therapeutic probe 280 can be easily positioned on the observation probe 285 by remote control.

This modification has the following effects. Since the positioning is by suction, the structure is simple as long as there is an air conduit. Moreover, the positioning is easy by the magnetic sensor. Furthermore, the probes of each other can be automatically positioned.

Next, a seventeenth embodiment of the present invention will be described. For example, the larger the size of the therapeutic ultrasonic transducer 20 and the like in the first embodiment, the larger the strength of the generated ultrasonic waves. Therefore, it is desirable that the size is large, but there is a limit in incorporating it into a probe. Therefore, FIGS. 45 to 47 show the configurations of the ultrasonic probe 290 and its modification in the seventeenth embodiment capable of generating a stronger ultrasonic wave and increasing the therapeutic effect.

The construction of the ultrasonic probe 290 shown in FIG. 45 is basically similar to that of FIG.
7 is a cable-shaped capsule 2 that is separate from the probe body 291.
It is 92.

The structure of the capsule 292 is almost the same as that of the ultrasonic treatment means 17 of FIG. 4, and the same reference numerals are given and the description thereof is omitted. A different point is that a cable 293 extends to the rear end of the capsule 292, and a drive signal for the therapeutic ultrasonic transducer 20 is transmitted. A channel 294 is provided on the probe body 291 side, and a cable 293 is inserted into the channel 294.

Next, the operation will be described. First, the patient swallows the cord-shaped capsule 292,
Is sent to the affected area, for example. Then, connect the cable 293 of the capsule 292 to the channel 29 of the probe main body 291.
4, and the tip portion 14 of the probe main body 291 is brought closer to the capsule 281. After that, treatment is performed in the same manner as in the first embodiment.

The effects of this embodiment are as follows. By swallowing the capsule 292 in this way, the size of the therapeutic ultrasonic transducer 20 can be increased (the capsule 292 can be inserted into the body cavity even if the outer diameter thereof is slightly larger than that of the probe main body 291). it can.).

FIG. 46 shows the structure on the distal end side in a modification of the seventeenth embodiment. An ordinary endoscope 301 forming this modification has two channels 301 and 303, and has a capsule 292 for treatment and a probe 295 for diagnosis.
The ultrasonic probe 290A in the modified example is configured by using the above in combination.

At the tip of the diagnostic probe 295, for example, an electronic linear scan type oscillator is provided in the axial direction,
The oscillator is connected to the signal line in the probe.

The endoscope 301 has an observation window 30 at the tip 304.
5 and an illumination window 306 are provided, and a nozzle 44 is provided so as to face the observation window 305. A curved portion 15 is formed on the rear side adjacent to the distal end portion 304, and a flexible tube portion (not shown) is formed on the rear side thereof.

As an effect, the existing endoscope and probe for diagnosis can be used. The relative position between the observation means and the treatment means can be easily adjusted. Further, FIG. 47 shows the structure of the distal end side of the second modification of the seventeenth embodiment.

The Capsal 292A has a battery 297 inside.
And has projections 298 for gripping at both ends. Further, the capsule 292A has, for example, an electronic radial scan type oscillator 2 so as to have both functions for observation and treatment.
Ultrasonic treatment / observation means 71 in which treatment vibrators 72a and 72b are arranged on both sides of 4A is provided.

[0240] After the capsule 292A is swallowed by the patient, the endoscope 301A is inserted into the body cavity and the projection 2 is made by the grasping forceps 308 protruding from the outlet 313 of the channel.
98 is grasped and the capsule 292A is positioned. As an effect, since it is the cordless capsule 292A, the pain of the patient can be reduced. It is also possible to leave it indwelling for a long period of time, and it is also possible to treat it in several times.

The present invention is not limited to the above-mentioned ones, but also includes an embodiment or a modified example constituted by combining the above-mentioned embodiments and modified examples.

[Supplementary Note] (2) The ultrasonic treatment means comprises a single or a plurality of ultrasonic transducers for emitting focused ultrasonic waves of high intensity.
The ultrasonic diagnostic treatment system described. (3) The ultrasonic diagnostic treatment system according to claim 1, wherein the ultrasonic observation means comprises an ultrasonic transducer for obtaining an ultrasonic diagnostic image.

(4) The ultrasonic diagnostic treatment system according to claim 1, wherein the treatment function guide portion is a forceps port through which a separate treatment tool inserted through the insertion portion projects. (5) The ultrasonic diagnostic treatment system according to claim 1, wherein the optical observation means includes an illumination optical system that emits illumination light and an objective lens system that obtains an optical image.

(6) The ultrasonic diagnostic treatment system according to appendix 5, wherein the illumination optical system and the objective lens system have protective members for protecting them. The effect of Supplementary Note 6 is that the optical observation means can protect the body fluid, mucus and the like when inserting the ultrasonic probe into the body cavity.

(7) The ultrasonic diagnostic treatment system according to appendix 6, wherein the optical observation means has a water / air supply function for cleaning / drying the protective member. The effect of Appendix 7 is
When inserting the ultrasonic probe into the body cavity, it is possible to remove stains of the optical observation means due to body fluid, mucus or the like so as not to hinder the optical observation.

(8) With respect to the bending portion, it is possible to bend the distal end portion including the ultrasonic treatment means, the ultrasonic observation means, the treatment function guide portion and the optical observation means in any direction with respect to the insertion portion. The ultrasonic diagnostic treatment system according to claim 1. (9) The ultrasonic diagnostic treatment system according to claim 1, wherein the insertion portion is made of a flexible thin tube. The effect of Appendix 9 is to insert an ultrasonic probe into the lumen of the upper and lower digestive tracts,
It is possible to diagnose and treat the target site.

(10) The ultrasonic diagnostic treatment system according to claim 1, wherein the insertion portion is made of a rigid thin tube. The effect of Supplementary Note 10 is that the ultrasonic probe can be inserted into the body cavity such as the thoracic cavity, abdominal cavity or ventricle to diagnose and treat the target site.

[0248]

As described above, according to the present invention, at least the distal end side of the bendable bending portion having the thin tubular insertion portion that can be inserted into the body cavity and formed at the distal end side of the insertion portion. At a position, ultrasonic treatment means for treating a living body using ultrasonic waves, ultrasonic observation means for diagnosing a living body using ultrasonic waves,
Since a treatment function guide unit for performing treatment of the living body and an ultrasonic probe in which an optical observation means for optically observing the living body is arranged, an ultrasonic observation is performed by the optical observation means. Insert the sonic probe into the target site in the body cavity and adjust the position by bending the bending part so that the tip is in a position suitable for treatment and diagnosis. High temperature treatment with ultrasonic waves can be performed.

Further, since the ultrasonic wave observing means, the ultrasonic wave observing means, etc. are provided at the tip portion in front of the bending portion, the ultrasonic wave observing means and the ultrasonic wave observing means are brought into contact with the organ by bending the bending portion. It is possible to perform ultrasonic diagnosis and high-temperature treatment by ultrasonic waves, and the ultrasonic diagnosis and high-temperature treatment by ultrasonic waves can be performed over a wider range than when no curved portion is provided (for example, upper digestive tract, lower digestive tract, It can be inserted into a body cavity such as the thoracic cavity, abdominal cavity, or ventricles to deep organs).

[Brief description of drawings]

FIG. 1 is a configuration diagram showing a configuration of an ultrasonic diagnostic treatment system according to a first embodiment of the present invention.

FIG. 2 is a perspective view showing the outer shape of the ultrasonic probe according to the first embodiment.

FIG. 3 is a perspective view showing an outer shape of an ultrasonic probe according to a modification.

FIG. 4 is a perspective view showing the tip side of the ultrasonic probe.

FIG. 5 is a diagram showing a tip side of an ultrasonic probe according to a first modification.

FIG. 6 is a perspective view showing a tip side of an ultrasonic probe according to a second modification.

FIG. 7 is a perspective view showing a distal end side of an ultrasonic probe according to a third modified example.

FIG. 8 is an explanatory diagram showing a usage example for explaining the operation of the first embodiment.

FIG. 9 is a perspective view showing the distal end side of the ultrasonic probe according to the second embodiment of the present invention.

FIG. 10 is a perspective view showing a distal end side of an ultrasonic probe according to a first modification of the second embodiment.

FIG. 11 is a perspective view showing a distal end side of an ultrasonic probe according to a second modification of the second embodiment.

FIG. 12 is a perspective view showing a tip side of an ultrasonic probe according to a third embodiment of the invention.

FIG. 13 is a perspective view showing a distal end side of an ultrasonic probe according to a first modification of the third embodiment.

FIG. 14 is a perspective view showing a tip side of an ultrasonic probe according to a second modification of the third embodiment.

FIG. 15 is an explanatory diagram showing a usage example for explaining the operation of the third embodiment.

FIG. 16 is a schematic view showing an outer shape of an ultrasonic probe according to a fourth embodiment of the present invention.

FIG. 17 is an explanatory diagram showing a usage example for explaining the operation of the fourth embodiment.

FIG. 18 is a perspective view showing the distal end side of the ultrasonic probe according to the fifth embodiment of the present invention.

FIG. 19 is a perspective view showing a tip side of an ultrasonic probe according to a first modification of the fifth embodiment.

FIG. 20 is a plan view showing a distal end side of an ultrasonic probe according to a second modification of the fifth embodiment.

FIG. 21 is an explanatory diagram showing the overall configuration of an ultrasonic diagnostic treatment system according to a sixth embodiment of the present invention.

FIG. 22 is an explanatory diagram showing a main part of an ultrasonic diagnostic treatment system according to a seventh embodiment of the present invention.

FIG. 23 is an explanatory diagram showing the main parts of the diagnostic treatment system of the eighth embodiment of the present invention.

FIG. 24 is a perspective view showing the configuration of an ultrasonic probe according to a ninth embodiment of the present invention.

FIG. 25 is a side view showing the configuration of an ultrasonic probe according to a first modification of the ninth embodiment.

FIG. 26 is a perspective view showing the configuration on the distal end side of an ultrasonic probe according to a second modification of the ninth embodiment.

FIG. 27 is a perspective view showing the configuration on the distal end side of an ultrasonic probe according to a third modification of the ninth embodiment.

FIG. 28 is a cross-sectional view showing the configuration of the tip portion of the ultrasonic probe according to the tenth embodiment of the present invention.

FIG. 29 is a sectional view showing the configuration of the tip portion of the ultrasonic probe according to the eleventh embodiment of the present invention.

FIG. 30 is a sectional view showing the configuration of the tip portion of the ultrasonic probe according to the twelfth embodiment of the present invention.

FIG. 31 is a cross-sectional view showing the configuration of the distal end portion of an ultrasonic probe according to a modified example of the twelfth embodiment.

32A and 32B are a plan view and a side view showing the appearance of an intraperitoneal ultrasonic probe according to a thirteenth embodiment of the present invention.

FIG. 33 is an explanatory view of the operation of the thirteenth embodiment.

FIG. 34 is a perspective view showing a distal end side of an ultrasonic probe according to a first modification of the thirteenth embodiment.

FIG. 35 is a perspective view showing a distal end side of an ultrasonic probe according to a second modification of the thirteenth embodiment.

FIG. 36 is an explanatory diagram showing the configuration of the main part of the fourteenth embodiment of the present invention.

FIG. 37 is a perspective view showing the configuration on the tip side of an ultrasonic probe in the fourteenth embodiment.

FIG. 38 is an explanatory diagram showing the structure of the main part of a modification of the fourteenth embodiment.

FIG. 39 is a perspective view showing the configuration of the distal end side of an ultrasonic probe in a modified example.

FIG. 40 is a perspective view showing the configuration on the distal end side of an ultrasonic probe according to a fifteenth embodiment of the present invention.

FIG. 41 is a perspective view showing the configuration on the distal end side of an ultrasonic probe according to a modification of the fifteenth embodiment.

FIG. 42 is an explanatory view showing the constitution of the main part of the sixteenth embodiment of the present invention.

FIG. 43 is a plan view showing the configuration of the tip side of the ultrasonic probe in the sixteenth embodiment.

FIG. 44 is a plan view showing the distal end side of an ultrasonic probe according to a modification of the 16th embodiment.

FIG. 45 is a perspective view showing the configuration on the distal end side of an ultrasonic probe according to a seventeenth embodiment of the present invention.

FIG. 46 is a perspective view showing a distal end side of an ultrasonic probe according to a first modification of the 17th embodiment.

FIG. 47 is a perspective view showing a distal end side of an ultrasonic probe according to a second modification of the seventeenth embodiment.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 ... Ultrasonic diagnostic treatment system 2A, 2B ... Ultrasonic probe 3 ... Light source device 4 ... CCU 5 ... Ultrasound observation device 6 ... Color monitor 7 ... Insertion part 8 ... Operation part 9A, 9B ... Universal cable 10 ... Light source connector 11 ... signal cable 13 ... forceps outlet 14 ... tip part 15 ... bending part 16 ... flexible part 17 ... ultrasonic treatment means 18 ... ultrasonic observation means 19 ... optical observation means 20 ... therapeutic ultrasonic transducer 23 ... emission range 24 ... Convex array type ultrasonic transducer 26 ... Transmission pulse generating circuit 27 ... Reception processing circuit 28 ... Ultrasonic observation area 32 ... Objective lens 33 ... CCD 35 ... Observation range 41 ... Forceps inlet 42 ... Channel

 ─────────────────────────────────────────────────── ─── Continuation of the front page (72) Inventor Yasuhiro Ueda 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd. (72) Inventor Takashi Tsukaya 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd. (72) Inventor Seiji Kuramoto 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd. (72) Inventor Yoshinao Daimei 2-43-2, Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd.

Claims (1)

[Claims] 1. A thin tubular insertion portion that can be inserted into a body cavity, and ultrasonic waves are used to at least position the tip side of a bendable bending portion formed on the tip side of the insertion portion of the living body. An ultrasonic treatment means for treatment, an ultrasonic observation means for diagnosing a living body using ultrasonic waves, a treatment function guide section for performing treatment of the living body, an optical observation means for optically observing the living body, An ultrasonic diagnostic treatment system having an ultrasonic probe arranged.