JPH08126604A - Tip part of ultrasonic endoscope - Google Patents

Abstract

PURPOSE: To provide the tip part of an ultrasonic endoscope not becoming large in its outer diameter and having good insertion properties while having a treatment jig erecting stand capable of sufficiently changing the direction of the tip of a treatment jig. CONSTITUTION: An ultrasonic scanning part block 1b to which an ultrasonic probe 3 for obtaining the ultrasonic tomographic image of an examinee is provided is connected to the leading end of an object part block 1a to which an object optical system for obtaining the optical image of the surface of the examinee is provided and a first slope 7 having an observation window 4 and an illumination window arranged thereto is formed to one half part among both left and right half parts of the object part block 1a while a recessed part 15 in which a treatment jig erecting stand 14 for converting the protruding direction of treatment jigs is housed in a freely revolvable manner is formed to the other half part of them side by side with the first slope and the part positioned outside the recessed part 15 is formed as the second slope 18 protruding forwardly from the first slope 7 at the angle erected from the first slope 7.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an ultrasonic probe for obtaining an ultrasonic tomographic image of a subject on the tip side of an objective block provided with an objective optical system for obtaining an optical image of the subject surface. The present invention relates to a distal end portion of an ultrasonic endoscope in which ultrasonic scanning block blocks provided with are connected.

[0002]

2. Description of the Related Art In an ultrasonic endoscope, a treatment instrument is used through a treatment instrument insertion channel so that a biopsy tissue can be collected and other endoscopic treatment can be performed like a general endoscope. It is desirable to be able to. Then, in order to control the distal end position of the treatment instrument within the body cavity, a treatment instrument raising base for changing the protruding direction of the treatment instrument is arranged.

In order to sufficiently change the direction of the distal end of the treatment instrument, it is necessary to form the treatment instrument raising base to a certain size or more. In addition, the treatment instrument raising base does not bulge from the surface of the endoscope tip portion and damage the mucous membrane of the body cavity wall,
It is necessary to arrange it so that it is housed in the recess.

[0004]

However, at the tip of the ultrasonic endoscope in which the ultrasonic scanning block is connected to the tip side of the objective block, the signal cable connected to the ultrasonic probe is connected to the objective block. Since it is inserted into the lower half of the above, the recess for accommodating the treatment instrument raising base is arranged in the upper half of the objective block in parallel with the observation window and the illumination window.

Therefore, in order to prevent the treatment instrument raising base, which requires a certain size or more, from protruding from the concave portion, the outer diameter of the distal end portion of the ultrasonic endoscope must be increased and the patient must be thickened. There was a drawback that the pain given to him became great.

[0006] Therefore, the present invention provides a distal end portion of an ultrasonic endoscope which has a treatment instrument raising base capable of sufficiently changing the direction of the distal end of the treatment instrument, and which has a good outer diameter and good insertability. The purpose is to do.

[0007]

In order to achieve the above object, the distal end portion of the ultrasonic endoscope according to the present invention is an objective unit block provided with an objective optical system for obtaining an optical image of the surface of a subject. At the distal end side of the ultrasonic endoscope, which is connected to an ultrasonic scanning unit block provided with an ultrasonic probe for obtaining an ultrasonic tomographic image of the subject, the objective unit block is A first slope where the observation window and the illumination window are arranged is formed in one half of the half and the other half is
A recess in which a treatment tool raising base for changing the projecting direction of the treatment tools is rotatably accommodated is formed side by side with the first inclined surface, and a portion located outside the recess is formed into the first portion. It is characterized in that it is formed on the second slope that protrudes forward of the first slope at an angle that stands up from the slope.

[0008]

Embodiments will be described with reference to the drawings. FIG. 11 shows the overall configuration of the ultrasonic endoscope, and the distal end body 1 is connected to the distal end of a flexible endoscope insertion portion 40 that is inserted into the body cavity of a patient. Further, a bending portion 30 that is bendable by remote control is formed on the distal end side of the insertion portion 40.

An operation portion 41 is connected to the base end side of the insertion portion 40. The operation portion 41 includes a bending operation knob 42 for remotely controlling the bending amount of the bending portion 30, a treatment instrument raising operation lever 43 for performing an operation for raising the treatment instrument raising base 14, which will be described later, and a treatment instrument insertion channel. A suction operation is performed through an insertion port 44 for inserting a treatment tool, an air / water switch 45a for performing an operation for ejecting air and water from the air / water nozzle 6 of the distal end body 1 and a forceps channel. A suction switch 45b and the like are provided.

Reference numeral 46 is a water injection port for feeding deaerated water into the balloon when the balloon is attached to the tip end main body 1. Reference numeral 47 is a suction conduit switching lever for switching the suction conduit between the forceps channel and the drainage conduit from the balloon.

An eyepiece portion 48 having an eyepiece lens built therein is projected from the operation portion 41, and the base end side of the image guide fiber bundle is arranged at the observation position. Therefore, the optical image of the surface of the subject obtained at the tip body 1 can be observed through the eyepiece 48.

Reference numeral 50 is a light guide connector for connecting the incident end of the light guide fiber bundle for illumination to the light source device, 51 is an air / water supply socket, 52 is a vent mouth ring, 53 is a suction nipple, and 54 is a functional ground. It is a terminal. Further, reference numeral 60 is a processing circuit that performs electrical processing on the ultrasonic probe 3 described later. Reference numeral 61 denotes a CRT monitor for displaying and observing an ultrasonic tomographic image.

FIGS. 1, 2 and 3 are two side views and a plan view, respectively, showing a part of the tip portion main body 1 cut away.
The tip body 1 is provided on the tip side of the objective block 1a provided with an objective optical system 2 for obtaining an optical image of the surface of the subject.
An ultrasonic scanning unit block 1b provided with an ultrasonic wave transmitter / receiver (hereinafter referred to as "ultrasonic probe") 3 for obtaining an ultrasonic tomographic image of a subject is detachably connected.

Observation window 4, illumination window 5 and air / water nozzle 6
Is disposed on a first sloped surface 7 that is formed in the left half portion on the upper surface side of the objective unit block 1a so as to face obliquely forward. This first slope 7 is formed with a relatively gentle slope in order to obtain an area sufficient for arranging the observation window 4, the illumination window 5, and the air / water supply nozzle 6.

As shown in FIG. 2, the objective optical system 2 is arranged in the observation window 4, and an image of a subject obliquely in front of the tip end main body 1 is formed on the incident end face of the image guide fiber bundle 9. It is transmitted to the eyepiece unit 48. A solid-state image sensor may be used instead of the image guide fiber bundle 9. The exit end of the light guide fiber bundle 10 is arranged in the illumination window 5.

The air supply / water supply nozzle 6 is open toward the surface of the illumination window 5, and as shown in FIG. 3, the air supply tube 11 and the water supply tube 12 are integrally connected to each other. There is. A coil for bending prevention is wound around the outer circumference of both the tubes 11 and 12.

On the right half portion of the upper surface side of the objective block 1a, a treatment instrument raising base 14 for changing the projecting direction of the treatment instruments is rotated adjacent to the first slope 7 of the left half portion. A recessed portion 15 that is freely accommodated is formed.

The outlet of the treatment instrument insertion channel 13 is connected to the rear wall of the recess 15 so that the treatment instrument raising base 14 is supported in the recess 15 so as to be rotatable around a shaft 16. There is.

A coil for preventing bending is wound around the outer circumference of the treatment instrument insertion channel 13, and this channel 13 is also used as a suction channel for sucking and discharging dirty liquid and the like.

Then, by operating the operation wire 17 from the operation section 41 remotely, the treatment tool raising base 14 is moved.
Rotates in the recess 15 as indicated by the chain double-dashed line in FIG. 1 and converts the projecting direction of the tip of the treatment instrument projected through the treatment instrument insertion channel 13 within the range indicated by A. be able to.

As shown in FIG. 1, FIG. 2 and FIG. 5, the portion located outside the concave portion 15 is a second protrusion projecting forward from the first slope 7 at an angle higher than the first slope 7. Is formed on the slope 18.

The base end portion of the second slope 18 is the first slope 7
The second sloped surface 18 is formed so as to gradually extend upward from the base end portion of the first sloped surface 7.

As a result, the tip portion of the treatment instrument raising base 14 that does not project from the surface of the first slope 7 when inverted but projects from the surface of the first slope 7 when rising,
Even when the robot rises, it does not project from the second slope 18 and there is no risk of damaging the inner wall of the body cavity.

Therefore, the treatment instrument raising base 14 is formed in a size required to sufficiently raise the treatment implements, and the treatment instrument raising base is not formed with a large outer diameter of the tip portion main body 1. The protrusion of 14 can be configured so as not to damage the inner wall of the body cavity.

The ultrasonic scanning unit block 1b is provided with an ultrasonic probe 3 formed in a convex shape, and the side of the tip body 1 is fan-shaped in a plane including the central axis of the tip body 1. To scan. Although an electronic scanning type ultrasonic probe is used as the ultrasonic probe 3 in this embodiment, a mechanical scanning type ultrasonic probe may be used.

Reference numeral 21 denotes a water supply port for sending degassed water for inflating the balloon into the balloon when the inflatable and deflatable balloon is attached to the tip end main body 1. On the opposite side (not shown), A drain port is formed to discharge degassed water.

The objective block 1a of the tip body 1 is formed of a metal member such as stainless steel,
The ultrasonic scanning unit block 1b is made of a plastic material such as polycarbonate resin which is softer than the objective unit block 1a, and both are detachably fitted and connected and screwed and fixed.

Therefore, when the ultrasonic scanning unit block 1b fails, only the ultrasonic scanning unit block 1b can be removed and replaced, and the ultrasonic scanning unit block 1b is the objective unit block 1a. Since it is softer, the ultrasonic scanning unit block 1b is used in the case of breakage of the connecting portion.
Is more likely to be damaged, and only the ultrasonic scanning unit block 1b needs to be replaced.

FIG. 5 shows a cross section (VV cross section) of the connecting portion between the objective portion block 1a and the ultrasonic scanning portion block 1b, and the connecting portion uses just the lower half portion of the tip portion main body 1. It is sized.

At the connecting portion, the ultrasonic scanning unit block 1
The base b is formed in a shape in which the top of a pentagonal home-base-shaped baseball is rounded down and its opposite side is a long side and is placed on the upper side. A hole 24 through which the signal cable 23 connected to the ultrasonic probe 3 is inserted
Are provided in the axial direction.

On one side of the objective unit block 1a, there is formed a substantially pentagonal fitting hole 26 in which the outer surface of the ultrasonic scanning unit block 1b is fitted almost exactly. The ultrasonic scanning unit block 1b is fitted. Therefore, the relative rotation between the objective unit block 1a and the ultrasonic scanning unit block 1b is prevented by this fitted state, particularly by the long side portion.

In order to prevent water or the like from entering the inside from the outside through the fitting surface, a flexible waterproof sealing material 27 of, for example, silicon rubber is applied to the fitting surface without any gap.

Since no seal member such as an O-ring is provided there, the length in the axial direction can be shortened. The waterproof seal material 27 does not necessarily have to be soft.

On the ultrasonic scanning block 1b side of the fitting portion, a pair of metal plates 28 having internal threads are formed.
28 are buried on the left and right. Then, the fixing screws 29,
29 is a metal plate 28, 28 from the side of the objective unit block 1a.
The ultrasonic scanning unit block 1b is fixed so that the ultrasonic scanning unit block 1b does not come out forward from the objective unit block 1a.

The metal plates 28, 28 embedded in the ultrasonic scanning unit block 1b have a non-circular outer shape so as not to be rotated by the force for tightening the fixing screws 29, 29.

It should be noted that the metal plates 28, 28 may be provided with a simple round hole so that the fixing screws 29, 29 are screwed to the objective unit block 1a side. In that case, the tip portions of the fixing screws 29, 29 are formed in a cylindrical shape to be fitted into the round holes.

The tip portion main body 1 is connected to the tip portion of a bendable bending portion 30 by remote control. As shown in FIG. 2, the connection is made by screwing and fixing the frontmost node ring 31 near the rear end of the objective block 1a.

As shown in FIG. 6, the bending portion 30 is formed by connecting a large number of short tubular joint rings 31 rotatably with rivets 32 and a rubber tube (not shown) around the rivets 32. It is formed by coating.

The rivets 32 ... Are connected to the adjacent rivets 32 ...
... are alternately rotated in the vertical direction and the horizontal direction. Therefore, the bending portion 30 can be bent in any direction as a whole.

The four bending operation wires 33 (33U ...) Which are selectively pulled by the operation unit 41 are shown in FIG.
As shown in FIG. 1, one at a time is arranged along the inner circumference of the node ring 31 in the up, down, left, and right directions at 90-degree intervals, and the tips thereof are all connected to the most advanced node ring 31. Therefore, by pulling one of the bending operation wires 33U ... From the operating portion 41, the bending portion 30 is bent accurately in each of the up, down, left, and right directions.

FIG. 8 shows a cross section in the vicinity of the connecting portion between the distal end portion main body 1 and the bending portion 30. Inside the node ring 31, the air supply tube 11, the water supply tube 12, the treatment instrument insertion channel 13, and the treatment. Operation wire 17 for raising platform, image guide fiber bundle 9, light guide fiber bundle 1
0, degassed water feeding tube 37, degassed water drainage tube 38, ultrasonic probe signal cable 23, and the like are inserted therein. Reference numeral 35 is a rubber tube that covers the curved portion 30.

As shown in FIG. 8, in the tip portion main body 1 part, there is no built-in object on the extension lines of the bending operation wires 33U, 33L, 33R in the three directions of upward and leftward and rightward. The signal cable 23 arranged near the center of the lower portion extends on an extension of the downward bending operation wire 33D. Therefore, if the signal cable 23 is arranged so as to extend straight rearward as it is, it will interfere with the downward bending operation wire 33D.

Therefore, in this embodiment, as shown in FIG. 9, the signal cable 23 is provided in the most advanced node ring 31.
The path of the signal cable 23 is deformed before reaching the tip fixing portion 34 of the downward bending operation wire 33D so that the signal cable 23 does not interfere with the downward bending operation wire 33D.

FIG. 10 is a schematic view showing a changed state of the track of the signal cable 23 as viewed from the front, and as shown by an arrow B, the track of the signal cable 23 is changed to the side and the downward direction. It does not interfere with the bending operation wire 33D.

Therefore, the downward bending operation wire 33
It is not necessary to shift the arrangement position of D to the left and right, and if the downward bending operation wire 33D is pulled, the bending portion 30 is accurately bent downward, and any one of the other three bending operation wires 33U, When 33L and 33R are pulled, they are bent accurately in either the upward direction or the lateral direction.

[0046]

According to the present invention, the portion located outside the concave portion in which the treatment instrument raising base is rotatably accommodated is located at an angle which is higher than the first slope formed with the observation window and the like. Since it is formed on the second slope that protrudes forward from the slope, the size of the treatment instrument table should be large enough to change the direction of the tip of the treatment instrument, and the outer diameter of the tip of the ultrasonic endoscope should be large. It is possible to obtain excellent insertability with less pain and less pain to the patient.

[Brief description of drawings]

FIG. 1 is a side view showing a part of a distal end portion of an ultrasonic endoscope according to an embodiment by cutting away the end portion.

FIG. 2 is a side view showing a part of the distal end portion of the ultrasonic endoscope according to the embodiment by cutting out.

FIG. 3 is a plan view showing a part of the distal end portion of the ultrasonic endoscope according to the embodiment by cutting out.

FIG. 4 is a partial perspective view of the distal end portion of the ultrasonic endoscope of the embodiment.

FIG. 5 is a sectional view taken along line VV of the example.

FIG. 6 is a side view showing a curved portion of the embodiment by cutting off a part thereof.

FIG. 7 is a front sectional view of a bending portion mechanism of the embodiment.

FIG. 8 is a sectional view taken along the line VIII-VIII of the embodiment.

FIG. 9 is a schematic plan cross-sectional view showing the state in which the trajectory of the signal cable is changed in the vicinity of the connecting portion between the distal end portion and the bending portion of the embodiment.

FIG. 10 is a schematic front view showing a state in which the trajectory of the signal cable is changed in the vicinity of the connecting portion between the distal end portion and the bending portion of the embodiment.

FIG. 11 is a perspective view showing the overall configuration of the ultrasonic endoscope of the embodiment.

[Explanation of symbols]

 1 Tip Main Body 1a Objective Block 1b Ultrasonic Scanning Block 4 Observation Window 5 Illumination Window 7 First Slope 14 Treatment Tool Raising Stand 15 Recess 18 Second Slope

Claims (1)

[Claims] 1. An ultrasonic wave in which an ultrasonic probe for obtaining an ultrasonic tomographic image of a subject is provided on the tip side of an objective section block provided with an objective optical system for obtaining an optical image of the subject surface. At the tip of the ultrasonic endoscope connected to the scanning block, the objective block has a first inclined surface on which an observation window and an illumination window are arranged in one half of the left and right halves. In the other half, a recessed portion in which a treatment instrument raising base for changing the projecting direction of the treatment instrument is rotatably accommodated is formed in parallel with the first inclined surface, and the recessed portion of the recessed portion is formed. A distal end portion of an ultrasonic endoscope, characterized in that a portion located on the outer side is formed on a second inclined surface projecting forward from the first inclined surface at an angle that stands up from the first inclined surface.