JPS6357060B2 - - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION The present invention relates to an intrabody cavity ultrasound diagnostic apparatus.

As an intrabody cavity ultrasound diagnostic device that combines an optical viewing tube for observing the inside of a body cavity and an ultrasound probe for obtaining ultrasound signal images, those shown in FIGS. 1 and 2 have been proposed. . In these figures, reference numeral 1 denotes an ultrasonic probe head, which has an ultrasonic signal transmission/reception window 2 formed on its side, and a small diameter shaft 4 connected to its rear via a curved portion 3. 4 contains a cord for transmitting and receiving ultrasonic signals, a wire for driving a mirror in the ultrasonic probe head 1, etc. (not shown). This shaft body 4 passes through the channel of the insertion section 6 in which the optical viewing tube 5 is disposed, and its rear end is connected to the drive section 9 via the optical viewing tube proximal portion 7 and channel insertion port 8. There is. A light guide cable 10 and an eyepiece section 11 that is inclined with respect to the axial direction of the insertion section 6 are connected to the optical viewing tube proximal section 7 . Further, the drive section 9 is
A gripping handle 12 is connected to the lower part thereof, and a signal cable 13 is inserted therethrough, and a drive motor 14 is connected to the rear thereof.

In the above-mentioned ultrasound diagnostic apparatus, in order to obtain an ultrasound image, the insertion section 6 and the ultrasound probe head 1 are inserted into a body cavity, and a predetermined organ is captured within the field of view of the optical tube 5 in the insertion section 6. Ultrasonic probe head 1 at 15
The window 2 of the ultrasound probe head 1 is brought into contact with the organ 15 by bending the curved portion 3 as shown in FIG.

However, in the conventional apparatus described above, the ultrasound probe head 1 and the curved part 3 are located in front of the tip of the optical viewing tube 5.
Because the insertion part protrudes relatively long, the observation field of the optical viewing tube 5 is obstructed when inserting it into a body cavity or when bringing the ultrasound probe head 1 into close contact with an organ 15. 6 must be pushed down to bend the curved portion 3 and come into contact with it, which poses a problem in that it is difficult to operate and requires skill.

Furthermore, in the above configuration, the operator must hold the optical viewing tube proximal portion 7 with one hand and grip the gripping handle 12 of the drive portion 9 with the other hand during operation, and must perform other operations, such as There was an inconvenience in that it was not possible to guide the patient's posture or press the body wall.

Moreover, the grip handle 12 of the insertion section 6 is provided with a drive section 9 and a drive motor 14, which is heavy and difficult to operate when inserting the insertion section 6 into the body cavity and performing diagnostic operations. Not only is it difficult to use, but the volume on the proximal side increases, making it difficult to operate and observe the optical tube.

This invention has been made in view of the above-mentioned problems, and is provided in an intrabody cavity diagnostic apparatus that performs ultrasound diagnosis using a rotary ultrasound scanning method, in which a grasping grip and a drive device with a built-in rotation motor are configured separately. However, by connecting the two with a flexible drive cable, the grasping grip used for inserting the insertion part into the body cavity, bending it, and performing diagnostic operations in close contact with organs can be made lightweight and compact, and as a result, the above-mentioned operations can be performed easily. An object of the present invention is to provide an intrabody cavity ultrasound diagnostic device that can improve the operability of the body cavity.

The present invention will be specifically described below with reference to the drawings.

3 to 16 show an embodiment of the present invention.

In these figures, reference numeral 21 denotes an insertion section, and at the tip of this insertion section 21 there is an ultrasonic probe head 23 having windows 22 for transmitting and receiving ultrasonic waves sequentially from the front to the sides.
and a curved portion 24 are connected, and the insertion portion 21, the ultrasound probe head 23, and the curved portion 24 are configured to have approximately the same diameter. A cutout window 25 cut out in the visual field direction is formed on the outer periphery of the insertion portion 21 behind the curved portion 24, and an endoscope guide tube 26 is disposed from the cutout window 25 to the rear end of the insertion portion 21. A perspective-viewing endoscope 27 of the same diameter is inserted and removably inserted. In the case of the illustrated device for diagnosing internal organs in the abdominal cavity, a notch window 25 formed in the insertion portion 21 is located on the right side when viewed from the operator in normal use, and a perspective-view type internal portion is provided in this notch window. The distal end of the endoscope 27 is positioned so that the diagonally right front is within the field of view of the endoscope. The perspective-viewing endoscope 27 used has a viewing direction of approximately 45 degrees or more. Further, the angle of inclination of the viewing direction of the cutout window 25 formed in the insertion section 21 is formed in the range of 5 degrees to 25 degrees so that the field of view of the endoscope 27 is not obstructed by the outer periphery of the insertion section 21. has been done.

A hand portion main body 28 is connected to the rear end of the insertion portion 21, and a grasping grip 29 that is inclined approximately 60 degrees forward with respect to the axial direction is integrally attached to the upper outer periphery of the hand portion main body 28 in normal use. connected and configured to be grasped with one hand. This prevents the grip 29 from coming into contact with the body wall and getting in the way even if the insertion section 21 is tilted significantly, especially when the insertion section 21 is inserted into a body cavity to diagnose deep organs. This grip 2
The head of No. 9 has a substantially spherical bending operation part 30, and a bending operation lever 31 is protruded from this bending operation part 30, so that the grip 29 can be operated with the thumb of the hand holding the grip. There is.

A drive unit 32 containing an ultrasonic scanning motor is constructed separately from the grip 29, and the drive unit 32 and the grip 29 are connected by a flexible drive cable 33. Further, the drive unit 32 is connected to a display device 36 including a cathode ray tube 35 via a signal cable 34. Furthermore, a flexible light guide cable 38 is connected to the front of the eyepiece 37 of the oblique-viewing endoscope 27, and is connected to a light source device 39. The light guide cable 38 and the drive cable 33 are operable so as not to interfere with the insertion of the insertion section 21 into the body cavity, the operation of bringing the ultrasound probe head 23 into contact with a predetermined organ, and the operation of ultrasound diagnosis. For this purpose, the endoscope eyepiece 37 and the bending operation part 30 of the handle grip 29 are connected in the same lateral direction.

The ultrasound probe head 23 and the curved portion 24 are
It is configured as shown in the figure. That is, a medium chamber 40 is formed in the ultrasound probe head 23,
An ultrasonic transducer 41 and a mirror 4 are provided in this medium chamber 40.
2 are arranged facing each other. This vibrator 4
A signal cord 43 inserted from the drive device unit 32 through the insertion portion 21 is connected to the mirror 42, and a shaft portion 44 is formed on the mirror 42, and a flexible drive shaft 45 is connected to this shaft portion 44. has been done. On the other hand, the curved portion 24 is configured by pivotally supporting a plurality of joint members 46, and the joint members 46 are supported by a rubber jacket 47.
Further, an operation wire 48 inserted from the bending operation section 30 is fixed to the distal end joint member 46.

The bending direction of this bending portion 24 is set to the visual field direction of the endoscope 27 as shown in FIG. An ultrasonic wave transmitting/receiving window 22 is configured to fit within the field of view of the endoscope 27. In this way, in the case of the one for intra-abdominal organ diagnosis shown in the figure, the endoscope 27 inserted into the insertion section 21
The reason why the visual field direction and the curved direction of the curved portion 24 are set to the right when viewed from the operator is that when used for ultrasound diagnosis of the intra-abdominal organ 49, it is necessary to determine which part of the skin has many blood vessels and the organ. The position of the organ is determined naturally, and the insertion position and insertion direction are determined medically. Therefore, if the field of view is to the right in normal use and the field of view is curved in this direction, the organ can be seen. Observation, ultrasound probe head 2 to organs
This is because it is suitable for operation and observation within a body cavity due to the close contact of item 3. Therefore, it goes without saying that the field of view and the direction of curvature of the endoscope 27 used for ultrasonic diagnosis of organs other than those in the abdominal cavity do not have to be in the right direction. Furthermore, the ultrasound transmitting/receiving window 22 provided in the ultrasound probe head 23 is arranged in the viewing direction of the endoscope 27 so that when the bending part 24 is bent, it is possible to visually confirm which part the window 22 is in contact with. It is arranged at a position perpendicular to the direction of curvature.

Further, as shown in FIG. 7, the cutout window 25 formed in the insertion portion 21 is formed in a connecting member 51 that connects the tip of the outer tube 50 constituting the insertion portion 21 and the curved portion 24. The outer tube 50 side of the connecting member 51 is fitted and fixed inside the outer tube 50, while the curved portion 24 side of the connecting member 51 engages the joint member 46 inwardly, and the outer circumference of the outer connecting member 51. It is fixed by screwing in screws 52. With this configuration, the inner side of the connecting portion between the joint member 46 and the connecting member 51 containing the drive shaft 53, the signal cable 43, the operating wire 48, etc. can be made wide. Furthermore, as shown in FIG. 9, the insertion portion 2
In order to make the cutout window 25 formed in the endoscope 1 large, the mirror drive drive shaft 53 inserted into the insertion section mantle 50 is disposed on the opposite side to the viewing direction of the endoscope 27.

Further, the connection between the insertion portion 21 and the proximal body 28 is as shown in FIG. That is, the endoscope guide tube 26, the drive shaft tube 54, and the insertion section mantle tube 50.
A pipe holder 55 for holding and fixing the pipe holder 55 is inserted into the handle main body 28, a thread is formed on the outer periphery of the handle main body 28, and a cap 56 having a female thread is screwed from the outer circumferential direction. It is pressed and fixed to the hand portion main body 28. Further, the mirror drive shaft 53 is supported by a bearing in a pipe receiver 55, and the end position of the pipe receiver 55 is the end, and the end of the drive shaft 53 is inserted through the grip grip 29. Flexible drive shaft 45
are connected.

On the other hand, a fixing hole 57 communicating with the endoscope guide tube 26 is formed on the rear end side of the hand portion main body 28, and an O. A ring 58 is inserted into the fixing hole 57, and a spiral groove 59 is provided on the inner circumference of the hole 57.
The O-ring tightening body 61 with a protruding pin 60 that engages in is screwed in to press and deform the O-ring 58, and the deformed O-ring 58 tightens the endoscope 27 to fix the removal direction and rotation direction. At the same time,
Maintains airtightness. Further, the O-ring tightening body 61 is formed into a cylindrical shape so that the endoscope 27 can be inserted therethrough, and a lever 62 is provided protruding from the outer periphery of the rear part.

As shown in FIG. 13, a flexible drive shaft 45 disposed within the grip 29 is housed within a flexible tube 63 and inserted through the grip 29 in the axial direction. The upper end of the flexible drive shaft 45 is connected to a bearing 6 on the head side of the grip 29.
4 and 64, and a bevel gear 66 is pivotally attached to the upper end of this shaft 65. On the other hand, a connector 67 is formed in the lateral direction on the operation part 30 of the grip head, and this connector 63 has a male side electrical connection pin 6.
The bearing 7 is inserted into the insulating member 69 through which the bearing 8 is inserted.
A drive shaft joint 71 is provided which is bearing at 0.0, 70 and has a bevel gear 66, and a thread is formed on the outer periphery of a connector case 72. And the drive shaft joint 71 of the connector 67
and shaft 65 are connected at right angles through bevel gears 66, 66. An engagement recess 72 having a hexagonal cross section is formed on the connector side of the drive shaft joint 71.

Further, the drive cable 33 has a flexible jacket tube 73 as shown in FIGS. 14 and 15.
A flexible drive shaft 45 inserted into a flexible tube 74, an electric signal cord for the vibrator, and a rotation detection signal cord 7
5... are installed. As shown in FIG. 14, the connecting portion of the grip side connector 67 of the drive cable 33 has a case 76 fixed to the other side of the mantle tube 73, and the flexible tube 74 is connected to the case 76. , 77, and a cord 75 having a female electrical connection pin 79 is provided. This case 76 has a connector 6 of the grip 29.
A connector connecting screw 80 that is screwed into the connector 67 is rotatably provided, and engages the drive shaft engagement recess 72 of the connector 67 into the drive shaft recess joint 78 and connects the claw side electrical connection pins 79 . After the male side electrical connection pins 68 of the connector 67 are engaged and connected, they are screwed into the connector 67. moreover,
As shown in FIG. 15, the drive cable 33 on the drive device unit 32 side has a case 81 fixed to the jacket tube 73 and a flexible tube 74 attached to the case 81.
The drive shaft protrusion (hexagonal cross section) joint 8 is connected to the drive shaft and is supported by bearings 82, 82.
3 and male side electrical connection pins 85 connected to cords 84. This case 81 is provided with a rotatable connector connecting screw 87 that is screwed into a connector 86 of the drive device 32 shown in FIG. The connector 86 of the drive device unit 32 shown in FIG. 16 has a connector case 88 attached to the device housing 32, and is connected to a drive shaft 89 connected to a rotating motor via a speed reduction mechanism or the like to the case 88. A drive shaft recessed joint 91 bearing a bearing, and an electric signal cord 92...
Female side electrical connection pins 93 connected to the case 88 are disposed, and a thread is formed on the outer periphery of the case 88, so that the connector connection screw 87 of the drive cable 33 is screwed into the case 88.

In FIG. 13, reference numeral 94 is a bending operation unit, and 95 is a finger rest of the operation lever 31.

In such a configuration, as shown in FIG. 11, the operator grasps the grip 29 with one hand, and also places his or her thumb on the bending operation lever 31 of the approximately spherical bending operation part 30 formed on the head of the grip 29. The insertion section 21 is inserted into a body cavity, for example, the abdominal cavity, through a trocar (not shown) while the abdomen of the patient is being applied. While observing the insertion section 21 diagonally forward to the right, insert the ultrasound probe head 2.
3 to the organ 49. After confirming the organ 49, the user operates the bending operation lever 31 with the thumb, pulls the operation wire 48, and moves the bending part 24 in the viewing direction of the endoscope 27 for intraperitoneal diagnosis as shown in the figure. The ultrasound probe head 23 and the window 22 for ultrasound transmission and reception are brought into view by curving it to the right as seen from the surgeon, and the ultrasound transmission and reception is performed while visually checking the organ 49 as shown in FIG. 12. window 22
is brought into close contact with a predetermined part of the organ 49.

As described above, the endoscope 27 faces the cutout window 25 formed on the side of the insertion section 21 behind the curved section 24, and its tip is of a perspective type, so that the field of view is limited to the ultrasound probe head 21. The ultrasound probe can be inserted while visually checking the organ without being obstructed by the curved portion 24, and since the ultrasound probe head 23 can be curved in the direction of the field of view of the endoscope 27, close contact with the organ 49 can be performed without the organ 49 and the ultrasound probe being obstructed. This can be done while visually checking both parts of the head 23, and the diagnosis can be made accurately and easily.
Furthermore, it is also possible to check which position the ultrasonic wave transmitting/receiving window 22 is in contact with.

In this invention, in the above embodiment, the insertion portion 2
Although the endoscope 27 is configured to be inserted into and removed from the insertion section 21, an optical system may be built into the insertion section 21.

As described above, according to the present invention, the grasping grip and the drive device containing the rotation motor are configured separately, and the two are connected by a flexible drive cable, so that the head and curved part of the ultrasound probe can be easily moved. The grasping grip that performs operations such as inserting the insertion section located at the front into the body cavity, bending the curved part, and bringing the head of the ultrasound probe into close contact with the organ can be made lightweight and small, and as a result, the above operations are made easier. It is possible to improve operability.

Further, since the flexible drive cable has a built-in ultrasonic scanning rotation drive shaft connected to the rotation motor, the rotation of the rotation motor is transmitted to the gripping grip via the ultrasonic scanning rotation drive shaft. In fact, the rotational speed can be easily set by controlling the rotational speed of the above-mentioned rotation motor, and excellent effects such as high rotational accuracy can be achieved. be done.

[Brief explanation of drawings]

Figure 1 is a front view of a conventional ultrasound diagnostic device;
Fig. 2 is a usage state diagram of the same as above, Fig. 3 and the following show an embodiment of the present invention, Fig. 3 is a general schematic diagram of the ultrasonic diagnostic device, and Fig. 4 is a diagram showing how to remove the endoscope from the insertion section. 5 is a view taken in the direction of arrow A in FIG. 4, FIG. 6 is a sectional view showing the ultrasound probe head and curved portion, and FIG. 7 is a cutout window and curved portion of the insertion section. 8 is a sectional view taken along the line B-B in FIG. 7, FIG. 9 is a cross-sectional view of the insertion portion, and FIG. 10 is a cutaway of the main part showing the main body of the proximal portion. A sectional view, FIG. 11 is an explanatory diagram showing the state of use, FIG. 12 is an explanatory diagram showing the field of view of the endoscope in FIG. 11,
Fig. 13 is a sectional view showing the inside of the operating section, Fig. 14 is a sectional view showing the proximal side of the drive cable, Fig. 15 is a sectional view showing the drive cable on the drive unit side, and Fig. 16 is a sectional view of the drive unit. It is a sectional view showing a connection connector. 21... Insertion section, 23... Ultrasonic probe head, 27... Endoscope, 28... Hand operation unit, 29
...Gripping grip, 32...Driver unit,
33... Drive cable, 34... Signal cable,
41... vibrator, 42... mirror, 43... electrical signal cord, 45... flexible drive shaft, 68... electrical connection pin, 71... drive shaft joint.

Claims (1)

[Scope of Claims] 1. In a body cavity diagnostic device that performs ultrasonic diagnosis using a rotary ultrasonic scanning method, a grasping grip and a drive device with a built-in rotation motor are configured separately, and both are connected by a flexible drive cable. An intrabody cavity ultrasonic diagnostic apparatus characterized in that the flexible drive cable has a built-in rotary drive shaft for ultrasonic scanning connected to the rotary motor. 2. The intrabody cavity ultrasonic diagnostic apparatus according to claim 1, wherein the flexible drive cable has an electric signal cord built therein in addition to the rotational drive shaft for ultrasonic scanning. 3. Claims characterized in that the grasping grip has a rotary drive shaft for ultrasonic scanning built into a flexible drive cable, and a rotary drive shaft joint and an electrical connection pin that connect electrical signal cords in a detachable manner. The intrabody cavity ultrasound diagnostic device according to item 1. 4. Claims characterized in that the drive device has a rotary drive shaft for ultrasonic scanning built into a flexible drive cable, and a rotary drive shaft joint and an electrical connection pin that connect electrical signal cords in a detachable manner. The intrabody cavity ultrasound diagnostic device according to item 1.