JPH09103433A - Piercing needle operation auxiliary tool for endoscope - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a piercing needle operation auxiliary tool for an endoscope capable of being set at an appropriate position at the time of use even when the respective lengths of a channel for inserting a treatment tool, a piercing needle, a stiletto (core bar) and a jacket tube are varied and easily adjusting the projection amount of the piercing needle and the jacket tube matched with the needs of a user by one operator. SOLUTION: The fixing part 14 of a piercing operation part 9 is fixed to the forceps channel entrance 4 of a forceps channel 36 provided on an ultrasonic endoscope 41, a jacket tube slider 16 housing a fine adjustment pipe 18 connected to the jacket tube 19 is freely slidably housed inside the piercing operation part 9 and it can be fixed to the piercing operation part 9 by a sliding knob 15 engaged to a groove hole 8. The piercing needle 20 to which the stiletto (core bar) 21 is inserted is inserted inside the jacket tube 19 and the piercing needle 20 is fixed through a piercing needle jacket tube sliding part 10 and a piercing needle projection sliding part 11 by a piercing needle fixing part.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an endoscopic puncture needle operation assisting device for assisting puncture of an endoscopic puncture needle device inserted through a channel of an endoscope.

[0002]

2. Description of the Related Art In recent years, under observation of an ultrasonic tomographic image by an ultrasonic endoscope, a lesion biopsy needle inserted from a treatment instrument insertion channel of the ultrasonic endoscope punctures a diseased tissue and aspirates and collects the tissue. Then, the technique of making a pathological confirmation diagnosis came to be performed.

A puncture device for an endoscope used in such a procedure is constructed by inserting a puncture needle into a mantle tube so that the puncture needle can advance and retract, and by advancing and retracting a tube to which a puncture needle that assists puncture is fixed. , Puncturing.

As a conventional technique, Japanese Patent Application Laid-Open No. 7-17809
There is JP-A-8, and there is an outer tube fixing means that can be arbitrarily fixed to an inlet portion of a channel through which a treatment tool of an endoscope is inserted, and an endoscope puncture provided with an outer tube whose projecting length can be adjusted. We provide equipment.

[0005] In addition, in the independent plan G9409233.8,
By moving the hollow rod that fixed the puncture needle back and forth,
(EN) Provided is a puncture device for an endoscope, which can be inserted indirectly without operating the needle itself.

[0006]

[Patent Document 1] Japanese Patent Application Laid-Open No. 7-17809
The publication No. 8 has the following drawbacks. The adjustment mechanism for pressing the mantle tube protruding from the endoscopic treatment instrument insertion channel against the diseased tissue is performed intraoperatively, but the length of the mantle tube can be adjusted by the operator alone while holding the endoscope. It was difficult to carry out the operation of fixing the outer tube.

Since the length adjusting means of the mantle tube and the fixing means of the mantle tube are at different positions, when performing the adjustment during the operation,
It takes time to perform these operations and the pain to the patient is increased. Furthermore, since a thin puncture needle is directly pushed in, it is difficult to transmit a sufficient force to the tip portion, and it is difficult to perform a puncture operation.

[0008] Further, the self-proposed method G9409233.8 is such that the puncture needle is fixed to the hollow rod, and the hollow rod is moved forward and backward through a fixing means that can be arbitrarily fixed to the treatment instrument insertion channel of the endoscope, and indirectly. The puncture needle is moved forward and backward to perform puncture. However, due to the manufacturing process, the endoscopic treatment instrument insertion channel, the outer tube, the puncture needle, and the stylet (core bar) are inserted. Therefore, the respective tip positions cannot be adjusted, and the following occurs.

(A) When the mantle tube is shorter than the puncture needle, the channel is inserted with the puncture needle projecting from the tip of the mantle tube, so that there is a risk of making a hole in the channel with the puncture needle.

(B) Since the tip of the puncture needle does not always exist near the tip of the mantle tube, when the puncture needle is projected,
In the endoscope, the tip of the puncture needle sometimes sticks into the hollow inner wall of the tip of the curved outer tube.

(C) When the stylet (core bar) is retracted from the tip of the puncture needle, there is an increased possibility of sucking a tissue other than the target lesion tissue at the time of puncturing.

(D) Since there is no means for fixing the hollow rod after the needle has been inserted into the tissue when the needle is advanced and retracted using the hollow rod, it is possible to remove the tissue from the tissue inserted by the needle when performing tissue suction. There was a risk of falling out.

(E) Since the length of the mantle tube protruding from the treatment instrument insertion channel of the endoscope is fixed and there is no adjusting mechanism for pressing the mantle tube against the diseased tissue, the puncture needle is used for the lesion. When the tissue was inserted, the diseased tissue was moved by the pressed needle, making it difficult to surely insert the target site.

The present invention has been made in view of the above points, and the length of a channel for inserting a treatment tool of an endoscope, the length of a puncture needle, the length of a stylet (core bar), and the length of a mantle tube are manufactured. For endoscopes that can be set to an appropriate position during use even if there are variations within the tolerance, and the protrusion amount of the puncture needle and outer tube can be easily adjusted by a single operator to meet the needs of the user. An object is to provide a puncture needle operation assisting device.

[0015]

In order to achieve the above object, the puncture needle operation assisting device for an endoscope according to the present invention is used by being inserted into a treatment instrument insertion channel of an endoscope. The puncture needle for an endoscope in which the distal end of the puncture needle is moved in and out from the distal end of the mantle tube by operating the puncture needle, which is provided in the mantle tube, so as to be able to move forward and backward, toward and away from the puncture needle device. The operation assisting device has the following means,
The above-mentioned purpose is achieved.

1. It has a means for arbitrarily fixing and connecting to the treatment instrument insertion channel of the endoscope. 2. An outer tube distal end position adjusting means for aligning the outer tube distal end surface with the endoscope distal end portion is provided. 3. The operating portion including both the means for adjusting the length of the outer tube protruding from the distal end of the endoscope and the means for fixing the outer tube has means for advancing and retracting the outer tube and fixing the outer tube. 4. A puncture needle tip position adjusting means for aligning the tip of the puncture needle is provided inside the tip of the outer tube at the tip of the endoscope.

[0017]

BEST MODE FOR CARRYING OUT THE INVENTION Embodiments of the present invention will be specifically described below with reference to the drawings. (First Embodiment) In the first embodiment, an outer tube protruding length adjusting mechanism for pressing an outer tube protruding from a treatment instrument insertion channel of an endoscope against a diseased tissue, and an outer tube distal end portion A position adjusting mechanism that can position the tip of the puncture needle is provided in the vicinity, and it is an object to provide an endoscopic puncture needle operation assisting device that can be easily operated by the user. It has the following configuration.

FIG. 1 shows, for example, a convex type ultrasonic endoscope 41 as an endoscope in which the first embodiment is used. The convex type ultrasonic endoscope 41 has a bending operation knob 45 and the like. The operation portion 1 provided, the elongated insertion portion 2 continuously provided at the front end of the operation portion 1, the eyepiece portion 46 provided at the rear end of the operation portion 1 and having an eyepiece window, and the operation portion 1 of the operation portion 1. It is composed of a universal cord 47 extending from the side portion.

A treatment instrument channel inlet (referred to as a forceps channel inlet) 4 for inserting a treatment instrument such as forceps into the patient's body is provided at the front of the grip portion of the operation section 1. The forceps channel inlet 4 communicates with a treatment instrument channel (referred to as a forceps channel) 36 (see FIG. 9) for inserting a treatment instrument formed in the insertion portion 2, and the tip of the forceps channel 36 has a forceps channel outlet. It opens at 34 (see FIG. 2).

The elongated insertion portion 2 is a flexible long flexible tube portion 3, a bending portion 6 which can be bent up and down and left and right by remote control, and a convex type which electrically performs beam focusing at its tip. The tip rigid portion 5 made of a hard resin and provided with an ultrasonic transducer 7. The convex ultrasonic transducer 7 is connected to the cable inserted through the universal cord 47 through the insertion portion 2 and the operation portion 1, and the ultrasonic connector on the terminal side of the universal cord 47 is connected to an ultrasonic observation device (not shown). By connecting, the convex ultrasonic transducer 7 can be electronically driven to obtain an ultrasonic tomographic image.

FIG. 2 is a detailed view of the hard tip portion 5 of FIG. The forceps channel outlet 34 communicates with the forceps channel inlet 4 of the operating portion 1 through the forceps channel 36 (FIG. 9) provided in the insertion portion 2 in the longitudinal direction of the insertion portion 2.

In front of the forceps channel outlet 34, a forceps raising base 35 for raising a treatment tool such as forceps is attached to the distal end hard portion 5. A proximal end side of the forceps raising base 35 is attached to a shaft, and the forceps raising base 35 is rotatably supported by the shaft with respect to the distal end hard portion 5, and is protruded from the forceps channel outlet 34 by the forceps raising base 35. The direction of the treatment instrument can be variably controlled.

An illumination window 48 and an observation window 49 are provided in the distal end hard portion 5 and have the function of an endoscope.
That is, an illumination lens is attached to the illumination window 48, the illumination light supplied from an external light source device is transmitted to the tip surface by a light guide (not shown), and the illumination light is spread and emitted by the opposing illumination lens. Illuminate. The illuminated object is imaged on its focal plane by the objective lens attached to the observation window 49. The front end surface of the image guide is arranged on this focal plane, and the image is transmitted to the rear end surface of the image guide. Then, it is possible to perform magnified observation with the naked eye through an eyepiece lens attached to the eyepiece window so as to face the rear end surface.

A puncture needle operation assisting device for an endoscope (hereinafter simply referred to as a puncture needle operation assisting device) 5 of the first embodiment which can be fixed to the forceps channel inlet 4 of the ultrasonic endoscope 41.
0 is shown in FIG. 3A is a front view and FIG. 3B is a side view.

This puncture needle operation assisting device 50 is made of a heat-resistant and chemical-resistant member, and its tip is fixed to the forceps channel inlet 4, and the puncture needle device 51 shown in FIG. The puncture needle device 51 assists the puncture operation.

The puncture needle operation assisting device 50 has a hollow cylindrical puncture operation part 9 as an operation part provided with a fixing portion 14 for fixing (the puncture needle operation assisting device 50) to the forceps channel inlet 4. Puncture needle outer tube slide section 10 as an outer tube fixing operation section that interlocks with a slide knob 15 attached to a slot 8 partially opened on the puncture operating section 9 in parallel with its longitudinal axis, and as a puncture needle fixing advance / retreat section. The puncture needle protruding slide part 11 and the puncture needle fixing part 12 for fixing the puncture needle 20 are detachably connected and fixed to the forceps channel inlet 4 via a metal fixing part 14 having a so-called luer lock 13. .

The puncture operating portion 9 has a hollow cylindrical shape and has a slot 8 parallel to the longitudinal axis. Inside thereof, as shown in FIG. 4 (A), a slide knob 15 is provided through a screw 37 passing through the slot 8. The connected outer tube slider 16 is housed. The puncture needle outer tube slide section 10 and the outer tube slider 16 are rotatably coupled to the central axis of the operation section 9 in the longitudinal direction. That is, the front end of the puncture needle mantle tube slide portion 10 projects inward and is rotatably engaged and connected in the circumferential groove of the mantle tube slider 16. The puncture needle outer tube slide portion 10 has an outer diameter slidable inside the puncture operation portion 9.

A pin 17 is fixed to the outer tube slider 16 so as to project to the inner side of the fine adjustment pipe 18, and the pin 17 is long in the longitudinal direction of the fine adjustment pipe 18 as shown in FIG. 4 (B). It is engaged with the formed groove 44 and restricts the rotation of the fine adjustment pipe 18.

A threaded portion 18a is formed on the outer peripheral surface near the one end of the fine adjustment pipe 18, specifically, near the rear end. The threaded portion 18a meshes with the threaded portion of the puncture needle outer cannula slide 10. Are connected. Therefore, when the puncture needle mantle tube slide portion 10 is rotated with respect to the puncture operation portion 9, the fine adjustment pipe 18 is restricted in rotation, so that the fine adjustment pipe 1
8 moves in the longitudinal direction.

The other end of the fine adjustment pipe 18, that is, the front end is connected to the rear end of the outer tube 19 through which the puncture needle 20 (for performing puncture) is inserted by the screw fixing portion 24. Therefore, the outer tube 19 moves in the longitudinal direction together with the fine adjustment pipe 18. Therefore, as will be described later, by rotating the puncture needle outer tube slide portion 10, the tip position of the outer tube 19 can be finely adjusted, and a fine adjustment mechanism of the outer tube tip position is formed.

Further, by loosening the slide knob 15 for fixing the outer tube slider 16 while pressing the outer surface of the pricking operation portion 9 near the groove hole 8, the outer tube slider 16 side together with the slide knob 15 is formed into the groove hole. 8 can be moved in the longitudinal direction, and by this movement, the tip positions of the outer cannula slider 16 side (relative to the forceps channel 36), specifically, the outer cannula 19 and the puncture needle 20 can be adjusted.

FIG. 5 shows a mantle tube 19 made of a flexible metal.
Is shown. The outer tube 19 is hollow and has a long cylindrical shape, and has an inner diameter capable of inserting the puncture needle 20 inside the outer tube 19. Near the rear end of the outer tube 19, the front end of the fine adjustment pipe 18 of FIG. A screw fixing portion 24, which is fixed to the screw, is provided, and the rear end of the outer tube 19 is connected to the fine adjustment pipe 18. A hardened portion 40, which is hardened with solder or the like, is provided at the tip of the outer tube 19, and the tip of the outer tube 19 is hardened straight so as to regulate or guide the direction of the protruding puncture needle 20. ing. The outer appearance of the hardened portion 40 is smoothly finished so as not to damage the inner wall of the body cavity and the inner wall of the channel.

FIG. 6 shows a stylet (core bar) made of wire.
A puncture needle 2 for inserting and puncturing 21 which is inserted into the entire length so as to be able to move back and forth.
A puncture needle device 51 having 0 is shown, and a luer lock fixing portion 22 to which the rear end of the puncture needle 20 is joined by fixing or the like is provided on the proximal side of the puncture needle 20, and the rear end projects from the rear end of the puncture needle 20. A stylet operating portion 23 is provided in which the rear end of the stylet (core bar) 21 is joined by fixing or the like. The slender puncture needle 20 part is the outer tube 19, fine adjustment pipe 18, and puncture needle outer tube slide part 1 in the puncture needle operation assisting device 50.
0, a puncture needle insertion portion that is inserted through the puncture needle protruding slide portion 11 is formed, and the luer lock fixing portion 22 at the rear end of the puncture needle 20 has the puncture needle fixing portion 1 at the rear end of the puncture needle operation assisting device 50.
Fixed at 2.

The lure lock fixing portion 22 and the stylet operating portion 23 are provided with threaded portions which mesh with each other. Specifically, a male screw is formed on the rear end of the outer periphery of the luer lock fixing portion 22, and is connected with a female screw provided on the inner periphery of the stylet operating portion 23 by screwing.

A stylet adjusting mechanism capable of sliding the stylet (core bar) 21 with respect to the puncture needle 20 by rotating the stylet operating section 23 with respect to the luer lock fixing section 22. Is formed. Therefore, by this operation, it is possible to set the stylet (core bar) 21 to project from the tip side of the puncture needle 20. Insertion port 39 into which the stylet operating portion 23 of the lure lock fixing portion 22 is inserted
Has a syringe taper.

FIG. 7 shows a rear end portion of an endoscopic puncture device 52 (hereinafter simply referred to as puncture device) 52 in which a puncture needle device 51 is connected to a puncture needle operation assisting device 50. That is, the puncture needle outer tube slide portion 10 and the puncture needle protruding slide portion 11
FIG. 4 is a view in which the puncture needle fixing portion 12, the luer lock fixing portion 22, the stylet operating portion 23, and the puncture needle 20 are joined together. A spring 25 is provided inside the puncture needle outer tube slide portion 10.

At the rear end portion of the puncture needle outer tube slide portion 10 on the puncture needle protrusion slide portion 11 side, there are three locking members for locking the members of the puncture needle protrusion slide portion 11 (specifically, the first Lock member 26, second lock member 2
7, and a lock knob 30 provided with a third lock member 29)
Has been fixed.

The first lock member 26 and the second lock member 2
Numeral 7 exists on the same plane perpendicular to the central axis in the member longitudinal direction of the puncture needle mantle tube slide portion 10, and is engaged with the puncture needle protrusion slider 28 connected to the tip of the puncture needle protrusion slide portion 11. The third lock member 29 is provided in the recess of the lock knob 30.

The puncture needle protruding slider portion 11 is provided with a stopper 31 having an inner peripheral surface provided with a screw portion 31a meshing with a screw portion provided on the outer peripheral surface thereof. A stopper groove 38 that can be engaged with the third lock member 29 is formed on the outer peripheral surface of the stopper 31 over the entire circumference.

In the puncture needle fixing portion 12, a fine adjusting screw 32 screwed to the rear end portion of the puncture needle projecting slider portion 11 and a front end of the fine adjusting screw 32 are screwed to the puncture needle 2 at the rear end.
And a luer cap portion 33 connected to the 0 lure lock fixing portion 22. The threaded portion 32a of the fine adjustment screw 32 and the threaded portion of the luer mouthpiece portion 33 are screwed together to be engaged with each other (screwed).

A luer lock fixing portion 22 of the puncture needle 20 is connected to the luer mouth portion 33, and a stylet operating portion 23 is connected to the luer lock fixing portion 22 by screwing. The puncturing operating portion 9 and the puncture needle. The puncture needle 20 and the stylet (core metal) 21 are inserted into the outer tube slide portion 10 and the puncture needle protruding slide portion 11, respectively.

In FIG. 7, by rotating the luer cap portion 33 with respect to the fine adjustment screw 32, the luer cap portion 33 side can be moved and adjusted in the longitudinal direction of the puncture needle protruding slider portion 11. By this operation, as will be described later, the position of the distal end side of the puncture needle 20 with respect to the mantle tube 19 can be adjusted. That is, the tip position adjusting mechanism of the puncture needle 20 is formed.

When a force for moving the puncture needle protruding slide portion 11 to the front side is applied, the puncture needle protruding slider 28 is released from the first and second lock members 26, 27, and the inside of the puncture needle outer tube slide portion 10 is closed. To slide. By this operation, the outer tube 19 can be moved back and forth, and the outer tube 1
It can be made to project from the tip opening of 9. In this case, the amount of protrusion is set in the stopper groove 38 of the stopper 31 by the lock knob 3
It is up to the position where the third lock member 29 of 0 is engaged.

By this engagement, the puncture needle 20 can be locked in a state of protruding from the tip of the outer tube 19. Then, when a pulling force is applied to move the puncture needle protruding slide portion 11 to the rear side, the stopper groove 38
And the third lock member 29 are disengaged, and the elastic force of the spring 25 causes the puncture needle protruding slide portion 11 to move rearward (the puncture needle 20 can be retracted to the tip position of the outer tube 19). ).

Further, the stopper 31 attached to the puncture needle protruding slide portion 11 by screwing is rotated to adjust the position in the longitudinal direction on the puncture needle protruding slide portion 11, so that the puncture needle 20 protrudes. The stroke can be adjusted.

Next, according to the present embodiment, the outer tube 19 and the puncture needle 2 are arranged in the longitudinal direction of the forceps channel 36 in the present embodiment.
0, a feature is that a stylet (core bar) 21 in the puncture needle is provided with a length adjusting mechanism that can be moved back and forth, and by adjusting these adjusting mechanisms, it will be described below. Thus, even if the lengths of the channel 36, the puncture needle 20, the stylet (core bar) 21, and the outer tube 19 vary within the manufacturing tolerance, they can be set at appropriate positions during use, and the operator alone Puncture needle 20 and mantle tube 19
You can adjust the amount of protrusion. Next, the operation of the present embodiment will be described. (Operation 1) As shown in FIG. 8, puncture needle outer tube slide portion 1
When 0 is rotated with respect to the axial direction as indicated by arrow A, the fine adjustment pipe 18 whose rotation is blocked by the pin 17 is meshed with the puncture needle outer tube slide portion 10 and the screw portion 18a, and therefore is indicated by arrow B. Slide and move in the direction of the indicated axis. Since the screw fixing portion 24 connected to the outer tube 19 is fixed to the fine adjustment pipe 18 by screw fixing, the fine adjustment pipe 1
The outer tube 19 also slides together with 8.

FIG. 9 shows a part of the operating portion 1 and the insertion portion of the ultrasonic endoscope 41 in which the puncture operating portion 9 of the puncture needle operation assisting device 50 to which the puncture needle device 51 is connected is connected to the forceps channel inlet 4. It is a schematic diagram showing two forceps channels 36.

As described with reference to FIG. 8, by rotating the puncture needle mantle tube slide portion 10 in the direction of arrow A, the mantle tube 19 slides in the axial direction as indicated by arrow B, and the mantle tube 19 moves in the axial direction. By moving to the tip hard part 5
The tip portion of the mantle tube 19 near the forceps channel outlet 34 slides near the forceps raising base 35.

FIG. 10 shows a detailed view of the vicinity of the hard tip portion 5 at this time. FIG. 10A shows a state before the rotating operation, and FIG. 10B shows an example of the state of the outer tube 19 after the rotating operation. With this action, the puncture needle 20 and the stylet (core bar) 21 in the outer tube 19 do not slide.

Fine adjustment function of the tip of the mantle tube 19 (see FIG. 10).
Even if the lengths of the outer tube 19 and the forceps channel 36 have some variations (for example, the state shown in FIG. 10A), the distal end of the endoscope is provided as shown in FIG. 10B. It is possible to fit the tip of the outer tube 19 to the portion.

(Operation 2) Further, in FIG. 11, when the luer cap portion 33 is rotated with respect to the screw portion 32a of the fine adjustment screw 32, the fine adjustment screw 32 slides in the axial direction as indicated by arrow C.

FIG. 12 shows a state near the tip hard portion 5 at this time. FIG. 12A shows the state before the above operation and FIG.
2 (B) is an example showing the state after the above operation. When the fine adjustment screw 32 slides in this way, the tip positions of the puncture needle 20 and the stylet (core bar) 21 also slide. In this operation, the outer tube 19 does not slide, so that FIG.
As shown in (A) and FIG. 12 (B), the outer tube 19 maintains the same state.

Therefore, even if the lengths of the puncture needle 20 and the forceps channel 36 are deviated within the manufacturing tolerance as shown in FIG. 12 (A), for example, the internal operation is performed as shown in FIG. 12 (B) by the above operation. The tip of the puncture needle 20 can be set at the mirror tip position.

(Operation 3) Further, as shown in FIG. 13, when a force is applied to the puncture needle protruding slide portion 11 in the direction of arrow D, the puncture needle protruding slider 28 causes the puncture needle protruding slider 28 to move to the first and second locking members 26, 26.
It is released from 27, slides in the puncture needle outer tube slide part 10, and receives a reaction force in the direction of arrow E by the spring 25.

When a force is further applied in the direction of arrow D, the stopper 31 connected to the puncture needle protruding slide portion 11 is temporarily fixed by the tip of the third lock member 29 of the lock knob 30.

FIG. 14 shows a detailed cross-sectional view of the hard tip portion 5 before and after this operation. FIG. 14A shows a state before the operation, in which the puncture needle 20 and the stylet (core bar) 21 are positioned inside the distal end of the outer tube 19.

FIG. 14B shows the puncture needle 20 and the stylet (core bar) 21 after the operation. As shown in this figure, the puncture needle 20 and the stylet (core bar) 2
1 moves back and forth in the direction of arrow F.

As can be seen from the comparison between FIGS. 14A and 14B, the outer tube 19 is fixed in this operation. By this operation, the stroke length of the puncture needle 20 protruding from the mantle tube 19 can be set to an appropriate value. When the stopper 31 is released from the lock knob 30, the puncture needle protruding slide portion 1 in which the puncture needle is fixed by the elastic force of the spring 25.
1 is pulled back to the hand side.

(Operation 4) Further, as shown in FIG. 15, by rotating the stopper 31 meshing with the screw thread of the puncture needle projecting slide portion 11, the arrow G is formed in the length direction of the puncture needle projecting slide portion 11. It is possible to change the protruding stroke of the puncture needle protruding slide portion 11 by moving as described above.

(Operation 5) Further, in FIG. 16 similar to FIG. 9, when the screw 37 of the slide knob 15 is loosened and the slide knob 15 is slid as shown by an arrow H, the outer tube slider 16 connected to the screw 37. Is the slot 8 of the puncture operating portion 9.
Freely slide the range. After sliding, the outer tube slider 16 is fixed to the puncture operating portion 9 by tightening the slide knob 15.

At this time, the outer tube 19, the puncture needle protruding slide portion 11, which is connected to the outer tube slider 16, and the puncture needle fixing portion 1 which is connected to the puncture needle protruding slide portion 11.
2. The luer lock fixing part 22 and the stylet operating part 23, which are connected to the puncture needle fixing part 12, slide at the same time and move forward and backward on the forceps raising base 35 as shown by an arrow I in FIG.

The puncture needle 20 and the stylet (core metal) 21 in the outer tube 19 also slide in conjunction with the outer tube 19. FIG. 17 shows a detailed cross-sectional view of the hard tip portion 5 at this time. FIG. 17 (A) is before operation, FIG. 17 (B)
Is a diagram when this operation is performed.

(Operation 6) FIG. 18 shows a puncture needle device 51. In FIG. 18, the stylet operating portion 23 and the luer lock fixing portion 22 which are connected by a screw thread are rotated relative to the luer lock fixing portion 22 by rotating the stylet operating portion 23 in the axial direction. J
It changes like

At this time, at the tip of the puncture needle 20, the stylet (core metal) 21 advances and retreats with respect to the puncture needle 20 as indicated by arrow K. The stylet operating portion 23 connected to the stylet (core bar) 21 can be detachably attached to the luer lock fixing portion 22. The first embodiment has the following effects.

(1) By providing the function of finely adjusting the tip position of the outer tube (see FIG. 10) in the action 1, even if the lengths of the outer tube 19 and the forceps channel 36 are slightly varied, the tip of the endoscope is changed. It is possible to fit the tip of the outer tube to the part.

(2) By adjusting the position of the tip of the puncture needle in the action 2, it becomes possible to align the tip of the puncture needle with the tip of the outer tube of the puncture needle 20 as in the case of the effect (1). (3) Spring 25 when projecting the puncture needle 20 of action 3
The safety mechanism will prevent accidental application of excessive force.

It is possible to prevent the needle tip from vigorously protruding as soon as the lock is released. In addition, the puncture needle 20
By the lock mechanism for temporarily fixing the puncture needle 20 before protruding, the puncture needle 20 is erroneously inserted into the forceps channel 36 of the ultrasonic endoscope 41 when the puncture needle 20 and the mantle tube 19 are inserted into the ultrasonic endoscope 41. Does not stick out.

By simply releasing the lock mechanism,
Since it is possible to remove the puncture needle 20 from the tissue,
While puncturing the tissue with the puncture needle 20, the ultrasonic endoscope 4 is mistakenly inserted.
Never remove 1.

(4) By adjusting the amount of protrusion of the puncture needle 41 in the action 4, it is possible to prevent erroneous puncture during operation (that is, when piercing too deeply than necessary). In addition, by the temporary fixing means of the protruding amount of the puncture needle of the action 3,
It is possible to keep the puncture needle 20 pierced. This eliminates the risk of the puncture needle 20 accidentally coming off the diseased tissue due to the tissue suction operation after the insertion.

(5) A puncture corresponding to an operator's procedure, such as puncturing by sticking the mantle tube 19 to the diseased tissue of the patient, by the adjusting function interlocking the mantle tube 19 and the puncture needle 20 in the actions 5 and 6 Is possible. Also, the means for performing this adjusting function is one fixed knob (specifically, the slide knob 1
It becomes possible by operating 5), so the operation becomes easy.

(6) Like the effect (2), the stylet adjusting mechanism of the action 6 can surely cause the tip of the stylet (core bar) 21 to project to the tip of the puncture needle.
As a result, it is not necessary to suck tissue other than the diseased tissue into the inner diameter portion of the puncture needle 20.

(7) By the combination of the above effects (1), (2), and (6), the puncture needle 20 can be prevented from being stuck inside the mantle tube 19. (8) A syringe can be easily attached to and detached from the luer lock fixing portion 22. In addition, the operations 1 to 6 can be easily performed by one operator who performs the puncture treatment.

In the first embodiment, a similar effect is obtained even when an ultrasonic endoscope having a forceps channel 36 for inserting a treatment tool other than the convex type ultrasonic endoscope 41 is used. Is obtained.

(Second Embodiment) This embodiment is the first
In addition to the object of the above embodiment, an object thereof is to provide a puncture needle operation assisting tool having a function of reliably preventing the puncture needle from advancing and retracting during tissue suction after puncture. In order to achieve this purpose, it has the following configuration.

Puncture operation assisting device 50 of the second embodiment
FIG. 19 shows the configuration of the main part of the puncture device 52 including the puncture needle device 51 and the puncture needle device 51 imaged on the puncture operation assisting device 50. FIG. 19 is a cross-sectional view of the periphery of the puncture needle protruding slide portion 11 as in FIG. 15 of the first embodiment.

Puncture needle 20 and stylet (core bar) 21
Instead of the stopper 31 shown in FIG. 15, a threaded stopper 42 is connected to the puncture needle protruding slide portion 11 for protruding.

Further, the lock knob 41 fixed to the puncture needle outer tube slide portion 10 is provided with a screw portion 41a which is screwed to the thread of the stopper 42. Other configurations are first
This is the same as the embodiment. Next, the operation will be described.

The screw of the stopper 42 is screwed with the screw portion 41a of the lock knob 41 to be temporarily fixed. Other operations are the same as those of the first embodiment.

Puncture needle protruding slide portion 11 in the direction of arrow L
The stopper 42, which is connected to the puncture needle projecting slide portion 11 when the slide button is slid, is
Is temporarily fixed by.

According to this embodiment, there is no fear that the puncture needle 20 will be accidentally pulled out of the diseased tissue by a series of tissue suction operations after the puncture, due to the reliable fixing means of the protrusion amount of the puncture needle.
There is an effect that the state in which the puncture needle 20 is stuck can be maintained. Other effects are the same as those of the first embodiment.

(Third Embodiment) In addition to the object of the first embodiment, the following structure is provided for the purpose of providing a puncture needle operation assisting tool equipped with a puncture needle for facilitating puncture. I chose FIG. 20 shows a puncture needle device 51 according to the third embodiment.

In the puncture needle device 20 for puncturing tissue, the material of the puncture needle 20 and the tip end portion 43 of the stylet (core bar) 21 is made of a shape memory alloy. Other configurations are first
This is the same as the embodiment. Next, the operation will be described. Puncture needle 20 and stylet (core bar) made of shape memory alloy
Even if the tip 43 of 21 bends, it returns to the initial state.

The other operations are similar to those of the first embodiment. According to the present embodiment, since the puncture needle 20 and the tip end portion 43 of the stylet (core bar) 21 are made of a shape memory alloy, even if bent in a curved endoscope, the shape returns to a straight shape. The work of protruding from the endoscope and inserting into the diseased tissue is facilitated. Other effects are the same as those of the first embodiment.

[Additional Notes] 1. A puncture needle device for an endoscope, which is used by being inserted into a channel for inserting a treatment tool of an endoscope, and includes a puncture needle for inserting a puncture needle into a mantle tube and a wire rod inserted into the puncture needle. On the other hand, a mantle tube fixing in which a manipulating part having a fixing part that is arbitrarily fixed to the inlet part of the channel and a mantle tube that arbitrarily moves in the longitudinal axis direction of the puncture needle insertion part with respect to the manipulating part are fixed. An operating part and a puncture-needle fixing advancing / retreating part for fixing the puncture needle that moves back and forth arbitrarily in the longitudinal axis direction of the puncture-needle inserting part with respect to the mantle tube fixing operation part. An puncture needle operation assisting device for an endoscope, characterized in that adjustment means for adjusting the length in the longitudinal axis direction of the is provided.

2. The puncture operation assisting device for an endoscope according to appendix 1, further comprising means for advancing and retracting the mantle tube fixing operation part with respect to the operation part and fixing the operation tube fixation operation part with respect to the operation part. 3. 2. The puncture operation assisting device for an endoscope according to appendix 1, wherein the puncture needle fixing advance / retreat section is provided with means for restricting the advance / retreat. 4. The puncture operation assisting instrument for an endoscope according to appendix 1, wherein the material of the tip of the puncture needle is a shape memory alloy.

[0086]

As described above, according to the present invention, the outer tube adjusting mechanism for pressing the outer tube protruding from the treatment instrument insertion channel of the endoscope against the diseased tissue, and the outer tube adjusting mechanism in the vicinity of the tip of the outer tube. Since a position adjusting mechanism that can position the tip of the puncture needle is provided, 1. Since the mantle tube length adjusting means can press the mantle tube against the diseased tissue, the puncture position can be reliably determined.

2. Since the length adjusting means of the mantle tube and the position fixing means of the mantle tube are located at the same position, these operations can be performed easily with one hand, so that the puncture time can be shortened and the pain to the patient can be reduced.

3. Since there is a puncture needle tip position adjustment means,
It is possible to adjust the position of the puncture needle tip near the tip of the mantle tube, and when the puncture needle is projected, the tip of the puncture needle does not stick into the hollow inner wall of the tip of the mantle tube that is curved inside the endoscope. .

Therefore, even if the length of the treatment instrument insertion channel of the endoscope, the length of the puncture needle, the length of the stylet (core metal), and the length of the mantle tube finally vary within the manufacturing tolerance,
It can be set to an appropriate position during use, and the protrusion amount of the needle and the outer tube can be easily adjusted by a single operator according to the needs of the user.

[Brief description of the drawings]

FIG. 1 is an external view of a convex ultrasonic endoscope.

FIG. 2 is a detailed view of a hard tip portion of FIG.

FIG. 3 is a front view and a side view showing the puncture needle operation assisting device according to the first embodiment of the present invention.

FIG. 4 is a view showing a structure and a fine adjustment pipe near a slide knob of a puncture operation section.

FIG. 5 is a side view showing the outer tube with a part cut away.

FIG. 6 is a view showing a puncture needle.

FIG. 7 is a cross-sectional view showing a state where a puncture needle protruding slide portion, a puncture needle fixing portion, and the like are coupled to a puncture needle outer tube slide portion.

FIG. 8 is a view for explaining that the fine adjustment pipe side moves when the puncture needle outer tube slide part is rotated.

FIG. 9 is a schematic view showing the operation unit of the ultrasonic endoscope in which the puncture operation unit is connected to the forceps channel inlet, the channel in the insertion unit, and the like.

FIG. 10 is an explanatory view of the action of the distal end side of the outer tube on the channel outlet side before and after the operation of rotating the puncture needle outer tube slide section.

FIG. 11 is an explanatory diagram showing how the fine adjustment screw moves when the luer cap is rotated with respect to the fine adjustment screw.

FIG. 12 is an explanatory view of the operation of the puncture needle on the hard tip side before and after the operation of rotating the lure mouthpiece is performed.

FIG. 13 is an explanation of the action of pushing the puncture needle protruding slide portion forward to unlock the puncture needle protruding slider to move it forward and further to move it forward to lock the stopper to the lock knob. Fig.

FIG. 14 is an explanatory view of the operation of the puncture needle on the distal end hard portion side before and after the operation of moving the puncture needle protrusion slide portion forward by applying a force that pushes the puncture needle protrusion slide portion forward.

FIG. 15 is an explanatory diagram of an operation of varying the protrusion stroke of the puncture needle protrusion slide portion by rotating the stopper to move it in the length direction of the puncture needle protrusion slide portion.

FIG. 16 is an explanatory diagram of an operation when the slide knob is loosened and the fixed position is moved.

FIG. 17 is an explanatory view of the operation of the mantle tube, the puncture needle and the like on the distal end hard portion side before and after the operation of loosening the slide knob and moving the fixed position thereof.

FIG. 18 is an explanatory view of the stylet operation when the stylet operating part is rotated with respect to the luer lock fixing part 22 in the axial direction.

FIG. 19 is a cross-sectional view around a puncture needle protruding slide portion according to the second embodiment of the present invention.

FIG. 20 is a sectional view showing a puncture needle device according to a third embodiment of the present invention.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 ... Operation part 2 ... Insertion part 4 ... Forceps channel entrance 5 ... Tip hard part 7 ... Convex type ultrasonic transducer 8 ... Groove hole 9 ... Puncture operation part 10 ... Puncture needle outer tube slide part 11 ... Puncture needle protruding slide part 12 ... Puncture needle fixing part 13 ... Luer lock 14 ... Fixing part 15 ... Slide knob 16 ... Outer tube slider 17 ... Pin 18 ... Fine adjustment pipe 19 ... Outer tube 20 ... Puncturing needle 21 ... Stylet (core bar) 22 ... Luer lock Fixing part 23 ... Stylet operating part 24 ... Screw fixing part 25 ... Spring 26 ... First lock member 27 ... Second lock member 28 ... Puncture needle protruding slider 29 ... Third lock member 30 ... Lock knob 31 ... Stopper 32 ... Fine adjustment screw 33 ... Luer mouth part 34 ... Forceps channel outlet 35 ... Forceps raising base 36 ... Forceps channel 37 ... Screw 38 ... Stopper groove 39 ... Insertion port 40 ... Hardened part 41 ... Ultrasonic endoscope 44 ... Groove 50 ... Puncture needle operation assisting device 51 ... Puncture needle device 52 ... Puncture device

Claims (1)

[Claims] 1. An endoscope which is used by being inserted into a treatment instrument insertion channel of an endoscope, and which comprises a puncture needle for inserting and puncturing in a mantle tube and a wire inserted in the puncture needle. With respect to the puncture needle device for a mirror, an operating portion having a fixing portion fixed to the entrance portion of the channel, and an outer tube which is arbitrarily advanced and retracted in the longitudinal axis direction of the puncture needle insertion portion are fixed to the operating portion. The mantle tube fixing operation part, and the puncture needle fixing advancing / retreating part for fixing the puncture needle that advances and retracts arbitrarily in the longitudinal axis direction of the puncture needle insertion part with respect to the mantle tube fixing operation part. A puncture needle operation assisting device for an endoscope, comprising an adjusting means for adjusting the length of the wire in the longitudinal axis direction of the channel.