JPH119601A - Endoscope device and device for ultrasonic observation - Google Patents

Abstract

PROBLEM TO BE SOLVED: To eliminate a trouble at the time of the execution of endoscopic treatment by obtaining an excellent optically observed image and ultrasonic observed image without enlarging the hard part of an insertion part tip. SOLUTION: A balloon 11 in the state of being freely expanding and reducing in a radial direction is fixed to the neighborhood of the tip of an insertion part 1 coated by a flexible pipe and arranged with an observing window at its tip. A guide tube 12 communicate-connected to the balloon 11 is arranged along the outer surface of the insertion part 1. An ultrasonic catheter insertion port 15 for inserting an ultrasonic catheter 21 and a fluid pouring port 16 for pouring a fluid are provided at the hand side part of the guide tube 12.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an endoscopic apparatus for ultrasonic observation and a balloon apparatus for observing ultrasonic waves in a body using an endoscope.

[0002]

2. Description of the Related Art In the case of observing an ultrasonic wave in a body using an endoscope, generally, a so-called ultrasonic endoscope in which an observation optical system and an ultrasonic probe are built in a distal end of an insertion portion is generally used. In some cases, ultrasonic observation is performed by inserting an ultrasonic catheter into a treatment instrument insertion channel of a general endoscope.

[0003]

However, in the case of an ultrasonic endoscope, the internal structure of the insertion section becomes complicated, and both the thickness and the length of the hard section at the tip of the insertion section become extremely large. However, it cannot be used for ordinary endoscopy because it causes a great deal of pain to the patient and considerably sacrifices the optical observation performance.

When an ultrasonic catheter is inserted into a treatment instrument insertion channel of an endoscope, the treatment instrument insertion channel may be blocked by the ultrasonic catheter to perform various endoscopic procedures. Not only is it impossible, but also it is difficult to properly adhere the ultrasonic catheter to the mucosal surface endoscopically, so that a very complicated operation is required to obtain a clear ultrasonic observation image.

[0005] Therefore, the present invention is capable of obtaining an excellent optical observation image and ultrasonic observation image without enlarging the hard portion at the distal end of the insertion portion, and which does not hinder the execution of endoscopic procedures. It is an object to provide an endoscope device for sound wave observation and a balloon device.

[0006]

In order to achieve the above-mentioned object, an ultrasonic observation endoscope apparatus according to the present invention is provided in the vicinity of a distal end of an insertion portion which is covered with a flexible tube and has an observation window at the distal end. A balloon capable of radial expansion and contraction is attached to the guide tube, and a guide tube connected to the balloon is arranged along the outer surface of the insertion portion, and an ultrasonic wave for inserting an ultrasonic catheter into the guide tube is provided. A catheter insertion port and a fluid injection port for injecting a fluid are provided on the proximal side of the guide tube.

The ultrasonic catheter insertion port is provided straight on an extension of the axis of the proximal end of the guide tube, and the fluid inlet is provided on the side surface of the proximal end of the guide tube. You may.

[0008] Further, in the ultrasonic catheter insertion port,
When the ultrasonic catheter is not inserted there, it is elastically closed, and when the ultrasonic catheter is inserted there, it is pushed and opened in a state of sealing the outer peripheral surface of the ultrasonic catheter. A resilient plug may be provided, and the fluid inlet may be provided with a check valve that allows fluid to pass from the outside to the inside and prevents fluid from flowing in the opposite direction. A pinhole for passing the ultrasonic catheter may be formed.

The balloon device for ultrasonic observation according to the present invention further comprises a balloon which is attached to the distal end of the insertion portion of the endoscope so as to be expandable and contractable outward, and a distal end which is disposed along the outer surface of the insertion portion. Has a guide tube provided with a fluid injection port for injecting a fluid and an ultrasonic catheter insertion port for inserting an ultrasonic catheter in the proximal portion, which is connected to the balloon. .

[0010] The ultrasonic catheter insertion port is provided straight on an extension of the axis of the proximal end of the guide tube, and the fluid inlet is provided on a side surface of the proximal end of the guide tube. You may.

[0011] In the above-mentioned ultrasonic catheter insertion port,
When the ultrasonic catheter is not inserted therein, it is closed elastically, and when the ultrasonic catheter is inserted therein, it is pushed open while sealing the outer peripheral surface of the ultrasonic catheter. A resilient plug may be provided, and the fluid inlet may be provided with a check valve that allows fluid to pass from the outside to the inside and prevents fluid from flowing in the opposite direction. A pinhole for passing the ultrasonic catheter may be formed.

[0012]

Embodiments of the present invention will be described with reference to the drawings. FIG. 1 shows an overall configuration of an endoscope apparatus for ultrasonic observation according to the present invention, in which a distal end body in which an observation window, an illumination window, and the like are arranged at a distal end of an insertion section 1 covered with a flexible tube. 2 is connected, and an operation unit 3 is connected to the base of the insertion unit 1.

The operating section 3 includes a bending operation knob 4 for remotely bending a bending section formed at a distal end portion of the insertion section 1, an air / water supply operation button 5, a suction operation button 6, and the like. Have been. Reference numeral 7 denotes an eyepiece.

Numeral 8 denotes a treatment instrument insertion channel which is inserted through the entire length of the insertion section 1 and has an insertion port 8a.
By inserting various endoscope treatment tools from above, the distal end of the treatment tool can be projected forward from the distal end main body 2 to perform an endoscopic treatment.

A thin, highly elastic rubber balloon 11 is attached to the outer surface of a portion near the distal end of the insertion portion 1 (a portion substantially corresponding to a curved portion). Balloon 11
Are attached at both ends thereof in a state where they are tightly bound by a thread from the outer surface and are airtight between the outer peripheral surface of the insertion portion 1.

Reference numeral 12 denotes a flexible guide tube which is arranged along the outer peripheral surface of the insertion portion 1 and is attached to the outer surface of the insertion portion 1 at appropriate intervals by a fastening member 13 made of a thin tape or a band. It is tightened and fixed.

Therefore, the device of the present invention can be constituted by attaching a balloon 11 and a guide tube 12 to a commercially available ordinary endoscope, which is very economical.

The proximal portion of the guide tube 12 is separated from the insertion portion 1 near the connecting portion between the insertion portion 1 and the operation portion 3, and a proximal base 14 is attached to the proximal end of the guide tube 12. ing.

The guide tube 12 is attached to the proximal base 14.
An ultrasonic catheter insertion port 15 for inserting an ultrasonic catheter 21 into the apparatus, and a fluid injection port 16 for injecting a fluid from the injection cylinder 30 or the like to the proximal base 14 are formed.

FIG. 2 shows the proximal base 14, the ultrasonic catheter insertion port 15 is provided straight on an extension of the axis of the proximal end of the guide tube 12, and the fluid inlet 16 is connected to the proximal side. It is provided to protrude laterally from the side surface of the base 14.

Inside the ultrasonic catheter insertion port 15,
When the ultrasonic catheter 21 is not inserted, the ultrasonic catheter 21 is elastically closed, and the ultrasonic catheter 21 is inserted there.
Is inserted, a resilient plug 17 is provided which is pushed and opened to seal the space between the ultrasonic catheter 21 and the outer peripheral surface thereof.

The elastic plug 17 is a resilient rubber ring-shaped member having a pinhole 17a penetrated in the center thereof. By mounting, the hermetic sealing of the pinhole 17a is ensured. The ultrasonic catheter 21 pushes open the pinhole 17a and passes therethrough.

The cross-sectional shape of the half of the elastic plug 17 is
It may be circular as shown in FIG. 2, but may be non-circular as shown in FIG. Further, as shown in FIG. 4, the elastic plug 17 may be disposed in a crushed state between the detachable member 141 and the proximal base 14 at the portion of the ultrasonic catheter insertion port 15 of the proximal base 14. Good. Also, as shown in FIG. The detachable member 142 may be formed of an elastic member at the portion of the ultrasonic catheter insertion port 15 of the proximal base 14, and the elastic plug 17 may be formed as a part thereof.

Returning to FIG. 2, the fluid injection port 16 is formed in the shape of a so-called syringe barrel cap, and inside thereof,
The ball valve 18a is urged from the inside to the outside by the compression coil spring 18b and is arranged to be pressed against the back side of the fluid inlet 16 to allow the passage of the fluid from the fluid inlet 16 side into the proximal base 14. This constitutes a check valve for preventing the passage of fluid in the opposite direction.

An ultrasonic observation device 20 shown in FIG. 1 is provided at an end portion of an ultrasonic catheter 21 having an outer diameter dimension which can be inserted into and removed from the guide tube 12 as shown in FIG. Ultrasonic probe 212 for transmitting and receiving ultrasonic waves
Are arranged in the mantle tube 211, and the tip of the drive cable 213 arranged at the axial position of the mantle tube 211 is connected to the ultrasonic probe 212.

The drive cable 213 is connected to the ultrasonic probe 21
2 and a function of driving the ultrasonic probe 212 to rotate around the axis of the mantle tube 211. By rotating the ultrasonic probe 212, the mantle tube Ultrasonic waves are emitted and received and scanned over the entire circumference of 360 ° perpendicular to the axis of 211.

The base end of the drive cable 213 is connected to the scanning motor 22 shown in FIG. 1, and the signals input to and output from the ultrasonic probe 212 are processed by the control device 23, and the display screen 231 is displayed. , An ultrasonic tomographic image is displayed.

The ultrasonic observation endoscope apparatus thus configured can be easily used as a normal endoscope when ultrasonic observation is not performed. When performing ultrasonic observation, first, water (degassed water) is introduced into the balloon 11 from the fluid inlet 16 via the guide tube 12 to expand the balloon 11 in the radial direction.

Then, the ultrasonic catheter 21 is inserted into the guide tube 12 from the ultrasonic catheter insertion port 15 and the distal end portion of the ultrasonic catheter 21 is positioned in the balloon 11 as shown in FIG. Perform ultrasonic observation with.

As described above, the ultrasonic wave is transmitted and received from the distal end portion of the ultrasonic catheter 21 in a 360 ° circumferential direction around the axis, and as shown by an arrow A in FIG. By moving the distal end of the ultrasonic catheter 21 in the axial direction by the operation, it is possible to obtain an ultrasonic tomographic image of the entire affected part 100 located deeper than the body cavity wall.

The operation of guiding the balloon 11 to a position suitable for ultrasonic observation is performed by observing the inner wall of the body cavity illuminated by the illumination light emitted from the illumination window 2a arranged on the distal end main body 2. This is performed while optically observing through the window 2b.

When it is determined that the treatment is necessary based on the result of the ultrasonic observation, as shown in FIG. 8, a treatment tool such as the injection needle 50 is inserted into the treatment tool insertion channel of the endoscope, and the affected part is affected. 100 treatments can be administered.

Although not shown, air is fed into the balloon 11 as needed, and the balloon 11 is inflated without using the ultrasonic observation device 20, so that the distal end portion of the insertion portion 1 can be moved to the esophagus or the like. Pressing and fixing inside luminal organs,
It can be used effectively as an endoscope for treatment, for example, by sending cold water into the balloon 11 and pressing it against the affected part to stop bleeding.

[0034]

According to the present invention, by injecting a fluid into the balloon through the guide tube to inflate the balloon, and in that state, inserting the tip of the ultrasonic catheter into the balloon through the guide tube, Ultrasonic observation in the body cavity can be performed.

Therefore, it is not necessary to incorporate an ultrasonic observation device into the endoscope, so that an excellent optical observation image can be obtained without enlarging the rigid portion at the tip of the insertion portion of the endoscope, and at the same time, Ultrasound observation can be performed immediately according to the condition, and at this time, the treatment instrument insertion channel of the endoscope is not used. You can do it too.

[Brief description of the drawings]

FIG. 1 is an overall configuration diagram of an ultrasonic observation endoscope apparatus according to an embodiment of the present invention.

FIG. 2 is a side sectional view of a proximal base portion of the guide tube according to the embodiment of the present invention.

FIG. 3 is a side sectional view of a second example of the elastic plug according to the embodiment of the present invention.

FIG. 4 is a side sectional view of a third example of the ultrasonic catheter insertion port portion according to the embodiment of the present invention.

FIG. 5 is a side sectional view of a fourth example of the ultrasonic catheter insertion port portion according to the embodiment of the present invention.

FIG. 6 is a side sectional view of a distal end portion of the ultrasonic catheter according to the embodiment of the present invention.

FIG. 7 is a side cross-sectional view of a distal end portion of the endoscope apparatus for ultrasonic observation according to the embodiment of the present invention in use.

FIG. 8 is a side view of the distal end portion of the endoscope apparatus for ultrasonic observation according to the embodiment of the present invention in different use states.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 Insertion part 2 End part main body 8 Treatment tool insertion channel 11 Balloon 12 Guide tube 13 Clamping member 14 Hand base 15 Ultrasonic catheter insertion port 16 Fluid injection port 17 Elastic plug 18a, 18b Check valve 20 Ultrasonic observation device 21 Ultrasound catheter

Claims (8)

[Claims] 1. A balloon that can be radially inflated and contracted in the vicinity of the distal end of an insertion portion provided with a flexible tube and having an observation window disposed at the distal end, and a guide tube connected to the balloon is inserted into the balloon. It was arranged along the outer surface of the part, and an ultrasonic catheter insertion port for inserting an ultrasonic catheter into the guide tube and a fluid injection port for injecting fluid were provided on the proximal side of the guide tube. An endoscope apparatus for ultrasonic observation. 2. The ultrasonic catheter insertion port is provided straight on an extension of the axis of the proximal end of the guide tube, and the fluid inlet is provided on a side surface of the proximal end of the guide tube. The endoscope apparatus for ultrasonic observation according to claim 1. 3. The ultrasonic catheter insertion port is elastically closed when the ultrasonic catheter is not inserted therein, and when the ultrasonic catheter is inserted therein, the ultrasonic catheter is closed. A resilient plug which is pushed open in a state of sealing the outer peripheral surface of the catheter is provided. The endoscope apparatus for ultrasonic observation according to claim 1 or 2, further comprising: 4. The ultrasonic observation endoscope apparatus according to claim 3, wherein a pinhole for passing the ultrasonic catheter is formed in the elastic plug. 5. A balloon mounted in the vicinity of the distal end of the insertion portion of the endoscope so as to be expandable and contractible in the radial direction, and disposed along the outer surface of the insertion portion, and the distal end is connected to the balloon and connected to the proximal portion. A balloon apparatus for ultrasonic observation, comprising: a guide tube provided with a fluid injection port for injecting a fluid and an ultrasonic catheter insertion port for inserting an ultrasonic catheter. 6. The ultrasonic catheter insertion port is provided straight on an extension of the axis of the proximal end of the guide tube, and the fluid inlet is provided on a side surface of the proximal end of the guide tube. The balloon device for ultrasonic observation according to claim 5. 7. The ultrasonic catheter insertion port is closed elastically when the ultrasonic catheter is not inserted therein, and when the ultrasonic catheter is inserted therein, the ultrasonic catheter is inserted. A resilient plug which is pushed open in a state of sealing the outer peripheral surface of the fluid inlet is provided, and the fluid inlet has a check valve which allows fluid to pass from the outside to the inside and prevents fluid from flowing in the opposite direction. The ultrasonic observation balloon device according to claim 5 or 6, wherein the balloon device is provided. 8. The ultrasonic observation balloon apparatus according to claim 7, wherein a pinhole for passing the ultrasonic catheter is formed in the elastic plug.