JPWO2016047202A1 - Endoscopic puncture needle - Google Patents

Abstract

A needle tube (3) that can be inserted into the channel; and a needle slider (23) that supports the needle tube (3) and moves the needle tube in the direction of the center line of the needle tube. The needle tube (3) When viewed from the center line direction, the insertion end (35) is located on the inner side of the outer peripheral surface of the needle tube (3) and can be inserted into the tissue, and the outer edge and insertion end (35 of the distal end surface of the needle tube (3) ) And the blade extending from the insertion end to the outer edge with the angle formed by the straight line connecting the center tube and the center line of the needle tube (3) inclined more than the inclination angle of the distal end portion of the angle tube with respect to the proximal end portion of the angle tube of the channel And surfaces (33, 34).

Description

The present invention relates to an endoscope puncture needle.
This application claims priority on September 26, 2014 based on Japanese Patent Application No. 2014-197106 for which it applied to Japan, and uses the content for it here.

  Conventionally, an inspection method called biopsy, in which a small amount of body tissue is collected and observed with a microscope, is known. When collecting deep tissue such as organs, it is difficult to observe with an optical endoscope, so an ultrasonic tomographic image of the organ is obtained with an ultrasonic endoscope, etc. A tissue may be collected by inserting a puncture needle.

  For example, Patent Literature 1 discloses a suction puncture needle that can be used for biopsy. Further, in Patent Document 2, in order to prevent the cutting edge from collapsing when the biopsy puncture needle comes into contact with a tissue such as a bone, the cutting edge of the puncture needle is made difficult to bend inside the puncture needle. It is disclosed to optimize the angle.

Japanese Unexamined Patent Publication No. 2005-31828 Japanese Unexamined Patent Publication No. 2001-292999

  When the puncture needle for endoscope is inserted through the channel of the endoscope, the puncture needle for endoscope is deformed into a curved shape following the shape of the channel. When the puncture needle for endoscope is moved to the tip side in the channel while the puncture needle for endoscope is deformed into a curved shape following the shape of the channel, it is plastic so that the cutting edge of the puncture needle for endoscope is turned up There is a possibility of deformation. When plastic deformation is performed so that the cutting edge of the endoscope puncture needle is turned over, the puncture performance of the cutting edge is lowered before the cutting edge of the puncture needle for endoscope is punctured into the tissue. In addition, when the puncture needle for endoscope is deformed into a curved shape following the shape of the channel, the cutting edge of the puncture needle for endoscope is likely to be pierced into the channel, and the endoscope may be damaged.

  The present invention has been made in view of the above-described circumstances, and an object thereof is to provide an endoscope puncture needle that is unlikely to cause damage to the endoscope or a decrease in puncture performance.

  A first aspect of the present invention is an endoscope puncture needle that is used by being attached to an endoscope having a bent channel, a needle tube that can be inserted into the channel, a needle tube that supports the needle tube, A needle slider that moves the needle tube in the direction of the center line, and the needle tube is located on the inner side of the outer peripheral surface of the needle tube when viewed from the center line direction of the needle tube and can be inserted into tissue. The angle formed by the straight line connecting the insertion end, the outer edge of the distal end surface of the needle tube, and the insertion end and the center line of the needle tube is always inclined with respect to the proximal end portion of the bending portion of the channel. A puncture needle for an endoscope having a blade surface extending from the insertion end to the outer edge in a state inclined more than an angle.

  According to a second aspect of the present invention, in the first aspect, the blade surface may have a conical surface shape whose diameter gradually decreases from the outer edge toward the insertion end side of the needle tube. .

  According to a third aspect of the present invention, in the first aspect, the blade surface is viewed from the first blade surface portion formed of a plane inclined with respect to the center line of the needle tube and the center line direction of the needle tube. A second blade surface portion having a piercing end on a line of intersection with the first blade surface portion, which is formed on a plane that faces the first blade surface portion and intersects the first blade surface portion. May be.

  According to the fourth aspect of the present invention, the puncture needle for an endoscope according to each of the aspects described above has a cylindrical shape in which the needle tube is inserted and has an outer diameter of 60% or more of the inner diameter of the channel. A sheath may be further provided.

  According to a fifth aspect of the present invention, in the fourth aspect, the outer diameter of the needle tube may be 60% or more of the inner diameter of the sheath.

  According to a sixth aspect of the present invention, in the fourth aspect, the sheath may be formed in a coil shape by winding a wire in a spiral shape.

  According to each aspect described above, it is possible to provide an endoscope puncture needle that is unlikely to cause damage to the endoscope or a decrease in puncture performance.

It is a figure showing a schematic structure of a biopsy system of this embodiment provided with a puncture needle for endoscopes and an ultrasonic endoscope of a 1st embodiment of the present invention. It is sectional drawing of the front-end | tip part of the ultrasonic endoscope which is an endoscope of the biopsy system. It is a fragmentary sectional view of the puncture needle for endoscopes. It is a top view which shows the front-end | tip part of the needle tube of the puncture needle for endoscopes. It is a front view which shows the front-end | tip part of the needle tube of the puncture needle for endoscopes. It is a side view which shows the front-end | tip part of the needle tube of the puncture needle for endoscopes. It is a bottom view which shows the front-end | tip part of the needle tube of the puncture needle for endoscopes. It is sectional drawing which shows the base end part of the operation part of the puncture needle for endoscopes. It is sectional drawing in the A1-A1 line | wire of FIG. It is sectional drawing in the B1-B1 line | wire of FIG. It is a top view of the operation part of the puncture needle for endoscopes. It is a perspective view showing the state where the puncture needle for the endoscope was attached to the endoscope. It is a figure for demonstrating an effect | action of the puncture needle for endoscopes. It is a figure for demonstrating an effect | action of the puncture needle for endoscopes. It is a figure for demonstrating an effect | action of the puncture needle for endoscopes. It is a figure for demonstrating an effect | action of the puncture needle for endoscopes. It is a figure for demonstrating an effect | action of the puncture needle for endoscopes. It is a figure for demonstrating an effect | action of the puncture needle for endoscopes. It is a figure for demonstrating an effect | action of the puncture needle for endoscopes. It is a top view of the front-end | tip part of the needle tube of the puncture needle for endoscopes of 2nd Embodiment of this invention. It is a front view of the front-end | tip part of the needle tube. It is a side view of the front-end | tip part of the needle tube. It is a bottom view of the tip part of the needle tube. It is a figure for demonstrating an effect | action of the puncture needle for endoscopes. It is a figure for demonstrating an effect | action of the puncture needle for endoscopes. It is a figure for demonstrating an effect | action of the puncture needle for endoscopes. It is a figure for demonstrating an effect | action of the puncture needle for endoscopes.

(First embodiment)
A first embodiment of the present invention will be described. FIG. 1 is a diagram showing a schematic configuration of a biopsy system of this embodiment provided with an endoscope puncture needle and an ultrasonic endoscope. FIG. 2 is a cross-sectional view of a distal end portion of an ultrasonic endoscope that is an endoscope of a biopsy system.
An endoscopic puncture needle 1 of the present embodiment shown in FIG. 1 (hereinafter simply referred to as “puncture needle 1”) is combined with an ultrasonic endoscope 100 as a part of a biopsy system 150 for biopsy. Is a biopsy needle used for

  First, an example of an endoscope used with the puncture needle 1 of this embodiment will be described. In addition, the structure of the endoscope which can be used with the puncture needle 1 of this embodiment is not specifically limited.

  An ultrasonic endoscope 100 exemplified in the present embodiment is a small-diameter endoscope that is assumed to be applied to perform diagnosis and treatment for a respiratory organ. The ultrasonic endoscope 100 includes an insertion portion 101 inserted into the body from the distal end, an operation portion 109 attached to the proximal end of the insertion portion 101, and a universal cord 112 having one end connected to a side portion of the operation portion 109. A light source device 113 connected to the other end of the universal cord 112 via a branch cable 112a, an optical observation unit 114 connected to the other end of the universal cord 112 via a branch cable 112b, and a universal cord 112 And an ultrasonic observation unit 115 connected to the other end via a branch cable 112c.

  The insertion portion 101 is provided with a hard portion 102, a bending portion 105, and a flexible tube portion 106 arranged in this order from the distal end side.

  The hard part 102 includes an optical imaging mechanism 103 for performing optical observation and an ultrasonic scanning mechanism 104 for performing ultrasonic observation.

  The optical imaging mechanism 103 controls an imaging optical system whose field of view is directed obliquely forward of the hard portion 102, an image sensor such as a CCD or CMOS that detects an image of a subject incident through the imaging optical system, and the operation of the image sensor. Various configurations (not shown) such as a CPU to perform are provided.

  The ultrasonic scanning mechanism (probe) 104 includes an ultrasonic transducer (not shown) that emits and receives ultrasonic waves. The ultrasonic scanning mechanism 104 receives the reflected wave reflected by the ultrasonic wave emitted from the ultrasonic vibrator when it hits the observation target, and observes the signal based on the ultrasonic wave received by the ultrasonic vibrator. Output to the unit 115. The ultrasonic scanning mechanism 104 of the present embodiment is used to acquire an ultrasonic image of a tissue that is a biopsy target, and to acquire an ultrasonic image of the needle tube 3 in the course of a biopsy procedure.

The bending portion 105 is formed in a cylindrical shape, and is pulled in a predetermined direction by pulling the angle wire (not shown) that is fixed to the distal end 105a (see FIG. 2) of the bending portion 105 and extends to the operation portion 109. It is an active bending part which curves to the side. The bending portion 105 of this embodiment can be bent in two directions along the ultrasonic scanning direction.
In the present embodiment, for example, an endoscope having a thin outer diameter that can be bent in two directions is used for respiratory treatment. However, for example, when performing digestive organ treatment, the outer diameter is used. However, an endoscope that can be bent in four directions with a high degree of freedom of operation may be used.

The flexible tube portion 106 is a cylindrical member that is formed flexibly so that the rigid portion 102 can be guided to a desired position in the lumen tissue or the body cavity.
Inside each of the bending portion 105 and the flexible tube portion 106, a channel 107 and a conduit (not shown) for performing air supply / water supply and suction are provided.

The channel 107 shown in FIGS. 1 and 2 is a cylindrical portion for inserting the puncture needle 1.
One end of the channel 107 is opened in the vicinity of the distal end portion of the hard portion 102, and the other end of the channel 107 is opened on the side surface on the distal end side of the operation portion 109. A base end cap 108 formed in a flange shape is fixed to the other end of the channel 107. The puncture needle 1 used together with the ultrasonic endoscope 100 can be fixed to the proximal end cap 108. The inner diameter of the channel 107 of this embodiment is 2.0 mm or more and 2.2 mm or less. This is smaller than the channel in a digestive endoscope.

  As shown in FIG. 2, the channel 107 has an axis C1 of the insertion portion 101 in the hard portion 102 (in this embodiment, as an example, the axis C1 of the insertion portion 101 coincides with the axis C3 of the channel tube 107c. ) Sloped slope portion 107a, a bent angle tube 107b connected to the base end of the slope portion 107a, and a channel tube 107c connected to the base end of the angle tube 107b.

  The slope portion 107a is provided in the hard portion 102 by forming a through hole in the hard portion 102 with a straight line inclined with respect to the axis C1 of the insertion portion 101 as a center line. The center line C2 of the through hole formed in the slope portion 107a is at a position included in the scanning surface (substantially the same as the curved surface described above) of the ultrasonic scanning mechanism 104. For this reason, when the puncture needle 1 is inserted into the slope portion 107a, the slope portion 107a guides the needle tube 3 of the puncture needle 1 to the above-described scanning plane and tilts with respect to the transducer of the ultrasonic scanning mechanism 104. Thus, the needle tube 3 can be protruded.

  The inclination angle of the center line C2 of the slope portion 107a with respect to the axis C1 of the insertion portion 101 may be set as appropriate corresponding to the site to be treated. In the present embodiment, the center line C2 of the slope portion 107a has an angle (for example, 23 ° or more and 28 ° or less) at which the needle tube 3 protrudes in a direction that can be acquired as an ultrasonic image with respect to the axis C1 of the insertion portion 101. Is inclined. The inclination angle of the center line C2 of the slope portion 107a with respect to the axis C1 of the insertion portion 101 is defined by the angle tube 107b. That is, in this embodiment, the inclination angle of the center line C2 of the slope portion 107a with respect to the axis C1 of the insertion portion 101 is set to the distal end side of the angle tube 107b with respect to the center line C3 of the channel tube 107c on the proximal end side of the angle tube 107b. The inclination angle θ1 of the center line C2 of a certain slope portion 107a.

  The angle tube 107b is bent at a predetermined angle in order to change the direction of the tip of the puncture needle 1 guided from the channel tube 107c to the slope portion 107a in a direction along the center line C2 of the slope portion 107a. It is a tube-like bent part. The angle tube 107b connects the slope portion 107a and the channel tube 107c. In the present embodiment, the angle tube 107b has an arc shape bent with a constant curvature.

The channel tube 107 c is a tube opened toward the distal end side of the insertion portion 101 in the vicinity of the proximal end of the hard portion 102. The opening on the distal end side of the channel tube 107c is fixed to the proximal end of the angle tube 107b.
The center line C3 of the channel tube 107c is substantially parallel to the center line C1 of the insertion portion 101. As an example, in the present embodiment, the center line C3 of the channel tube 107c coincides with the center line C1 of the insertion portion 101 as shown in FIG. The base end of the channel tube 107 c is fixed to the base end cap 108.

  The operation unit 109 shown in FIG. 1 has an outer surface formed so that an operator who uses the ultrasonic endoscope 100 can hold it in his / her hand, and pulls the angle wire to cause the bending unit 105 to bend. A bending operation mechanism 110 and a plurality of switches 111 for supplying air, supplying water, or sucking through a pipeline.

  The light source device 113 is a device for emitting illumination light for imaging by the optical imaging mechanism 103.

  The optical observation unit 114 is configured to display a video image captured by the image sensor of the optical imaging mechanism 103 on the monitor 116.

  The ultrasonic observation unit 115 receives a signal output from the ultrasonic scanning mechanism 104, generates an image based on the signal, and displays the image on the monitor 116.

  Next, the configuration of the puncture needle 1 will be described. FIG. 3 is a partial cross-sectional view of the puncture needle 1. FIG. 4 is a plan view showing the distal end portion of the needle tube of the puncture needle 1. FIG. 5 is a front view showing the distal end portion of the needle tube of the puncture needle 1. FIG. 6 is a side view showing the distal end portion of the needle tube of the puncture needle 1. FIG. 7 is a bottom view showing the distal end portion of the needle tube of the puncture needle 1. FIG. 8 is a cross-sectional view showing a proximal end portion of the operation portion of the puncture needle 1. 9 is a cross-sectional view taken along line A1-A1 of FIG. 10 is a cross-sectional view taken along line B1-B1 of FIG. FIG. 11 is a plan view of the operation unit of the puncture needle 1.

  As shown in FIG. 3, the puncture needle 1 includes an insert 2 that is inserted into the body, an operation unit (treatment instrument operation unit) 8 for operating the insert 2, and a stylet (core metal) 27. Prepare.

  The insert 2 is a long member that can be attached to the channel 107 so as to protrude from the distal end of the insertion portion 101 of the ultrasonic endoscope 100. The insert 2 includes a needle tube 3 and a cylindrical sheath 7 into which the needle tube 3 is inserted.

  As shown in FIGS. 3 to 7, the needle tube 3 includes a metal cylinder part 31 having a distal end and a base end, and a base member 36 fixed to the base end of the metal cylinder part 31. The needle tube 3 is advanced and retracted in the sheath 7 by the operation unit 8. The distal end of the needle tube 3 can project and retract from the opening of the distal end portion of the sheath 7. The outer diameter of the needle tube 3 is 60% or more of the inner diameter of the sheath 7.

  The metal cylinder portion 31 is a cylindrical member that has flexibility and elasticity that easily restores to a linear state even when bent by an external force. For example, an alloy material such as a stainless alloy, a nickel titanium alloy, or a cobalt chromium alloy can be employed as the material of the metal cylinder portion 31.

The distal end surface 32 of the metal cylinder portion 31 is sharpened to puncture the tissue with the needle tube 3 and is opened to suck the tissue into the needle tube 3.
In the present embodiment, the tip surface 32 of the metal cylinder part 31 includes a first blade surface 33 and a second blade surface 34 inclined obliquely with respect to the center line X1 of the metal cylinder part 31 itself, And a piercing end 35 configured on an intersection line X3 defined by the second blade surface 34.

  As shown in FIGS. 4 and 5, the first blade surface 33 is an annular surface that surrounds the opening at the tip of the metal cylinder portion 31 among the tip surfaces 32 of the metal cylinder portion 31. In the present embodiment, the first blade surface 33 is a plane that is inclined with respect to the center line X <b> 1 of the metal cylinder portion 31.

  As shown in FIGS. 5, 6, and 7, the second blade surface 34 is a surface formed at the tip portion of the metal cylinder portion 31 by backcut processing to a position facing the first blade surface 33. . The second blade surface 34 has two planes intersecting each other with a straight line inclined with respect to the center line X1 of the needle tube 3 as an intersection line X2 (right side surface 34a, left side surface 34b, “right” and “left” are notated. It is for convenience.)

The inclination angle of the distal end surface 32 is set based on the inclination angle θ1 (see FIG. 2) of the center line C2 of the slope portion 107a with respect to the axis C3 of the channel tube 107c located on the proximal end side of the angle tube 107b. That is, the inclination angle of the distal end surface 32 is set based on the shape of the angle tube 107b.
As the inclination angle of the distal end surface 32, the inclination angle θ2 of the first blade surface 33 with respect to the center line X1 of the needle tube 3 and the inclination angle of the second blade surface 34 with respect to the center line X1 of the needle tube 3 (right inclination angle θ3a, left inclination) There is an angle θ3b, where “right” and “left” are for convenience.
In the present embodiment, the right side surface 34a and the left side surface 34b are set on the basis of the inclination angle θ1, respectively, so that the intersection line X2 between the right side surface 34a and the left side surface 34b in the second blade surface 34 is obtained. Also, the inclination angle θ4 with respect to the center line X1 of the needle tube 3 is an angle based on the inclination angle θ1.

  The inclination angles θ2, θ3a, θ3b, and θ4 are all larger than the inclination angle θ1 of the center line C2 of the slope portion 107a with respect to the axis C3 of the channel tube 107c. For example, when the inclination angle θ1 of the center line C2 of the slope portion 107a with respect to the axis C1 of the insertion portion 101 is 23 ° and the channel tube 107c extends parallel to the insertion portion 101, the slope portion 107a with respect to the axis C3 of the channel tube 107c. Since the inclination angle θ1 of the center line C2 is 23 °, the inclination angles θ2, θ3a, θ3b, and θ4 with respect to the center line X1 of the needle tube 3 need only be larger than 23 °. When the inclination angle θ1 of the center line C2 of the slope portion 107a with respect to the axis C3 of the channel tube 107c is 23 °, the inclination angles θ2, θ3a, θ3b, and θ4 with respect to the center line X1 of the needle tube 3 are set to 25 °, for example. Can do. Although the inclination angles θ2, θ3a, θ3b, and θ4 may be equal to each other, the inclination angles θ2, θ3a, θ3b, and θ4 do not have to be equal to each other. The magnitudes of the inclination angles θ2, θ3a, θ3b, and θ4 take into consideration the puncture performance of the needle tube 3 to the tissue.

  As shown in FIGS. 4 to 7, in the present embodiment, the distal end surface 32 is composed of a plurality of planes inclined with respect to the center line X <b> 1 of the needle tube 3, but the outer edge 32 a of the distal end surface 32 of the needle tube 3 and The angle formed by the straight line connecting the insertion end 35 and the center line X1 of the needle tube 3 (for example, the inclination angles θ2, θ3a, θ3b, θ4) is any position on the outer edge 32a of the distal end surface 32. The inclination angle θ1 of the distal end portion of the angle tube 107b with respect to the proximal end portion of the angle tube 107b is always in a state of being largely inclined.

  As shown in FIGS. 8 to 10, the base member 36 is a substantially cylindrical member in which a through hole communicating with the inside of the metal tube portion 31 of the needle tube 3 is formed. A lock part 37 for fixing the syringe to the base member 36 is formed at the base end of the base member 36. A flange portion 38 is formed on the outer peripheral surface of the base member 36 so as to extend outward from the outer peripheral surface of the base member 36 in the radial direction of the needle tube 3. The flange portion 38 is fixed to a needle slider 23 of the operation unit 8 described later.

  The sheath 7 shown in FIG. 3 is a cylindrical member in which the needle tube 3 is inserted. The sheath 7 is made of resin, metal, or the like. The sheath 7 of the present embodiment is a coil sheath formed by winding a metal wire in a coil shape. The distal end of the sheath 7 is opened so that the needle tube 3 can protrude. The proximal end of the sheath 7 is fixed to the distal end portion of the operation unit 8. The outer diameter of the sheath 7 is 60% or more of the inner diameter of the channel 107.

  As shown in FIGS. 3 and 11, the operation unit 8 includes an operation main body 9, a sheath adjuster 18 provided on the distal end side of the operation main body 9, and a needle slider 23 provided on the proximal end side of the operation main body 9. Is provided.

  The operation body 9 is formed of, for example, ABS resin and has a lumen through which the needle tube 3 and the sheath 7 can be inserted. The distal end side of the operation body 9 is inserted into a sheath adjuster 18 formed in a tubular shape. The proximal end side of the operation body 9 is inserted into a needle slider 23 formed in a tubular shape. The operation main body 9 and the sheath adjuster 18, and the operation main body 9 and the needle slider 23 are engaged with each other by a groove or a projection (not shown) formed on the outer peripheral surface, so that relative rotation around the axis is suppressed, and the axial direction Is slidable.

  At the distal end of the sheath adjuster 18, a slide lock 51 that can be attached to and detached from the proximal end cap 108 of the ultrasonic endoscope 100 is provided. By sliding the slide lock 51 in a direction perpendicular to the axis of the operation unit 8 and engaging the base end base 108, the operation unit 8 can be fixed to the ultrasonic endoscope 100. A holder (fixed portion) 52 having a pair of wall portions 52 a and 52 b is provided on the distal end side of the slide lock 51. The holder 52 is fixed to the sheath adjuster 18. The pair of wall portions 52a and 52b of the holder 52 are substantially parallel, and the distance is set to a value that allows the distal end side of the operation unit 109 of the ultrasonic endoscope 100 to be accommodated without rattling.

  For example, a support pipe 53 made of stainless steel protrudes from the distal end portion of the sheath adjuster 18. The distal end portion of the support pipe 53 is inserted into the channel 107 when the puncture needle 1 is attached to the ultrasonic endoscope 100. The support pipe 53 is inserted into the operation body 9. The base end of the support pipe 53 is located closer to the base end side (for example, position P1 shown in FIG. 15) than the tip end of the needle slider 23 in a state where the needle slider 23 is most advanced with respect to the operation main body 9. The sheath 7 is inserted into the support pipe 53, and the base end portion protrudes from the base end of the support pipe 53 and is fixed to the operation body 9 by adhesion or the like.

  A fixing screw 54 is attached to the sheath adjuster 18. The fixing screw 54 passes through the sheath adjuster 18 and is fitted in a screw hole (not shown) provided in the operation main body 9. When the fixing screw 54 is tightened with respect to the operation main body 9, the sheath adjuster 18 is pressed against the operation main body 9, and the sheath adjuster 18 and the operation main body 9 can be fixed in a non-slidable manner. By changing the positional relationship between the sheath adjuster 18 and the operation main body 9, the protruding length of the sheath 7 from the channel 107 when the operation unit 8 is fixed to the ultrasonic endoscope 100 can be adjusted. The protrusion length can be fixed by the screw 54.

  As shown in FIG. 1, the axis of the fixing screw 54 is preferably arranged so as to be directed to the axis of the operation unit 109 housed in the holder 52. Thereby, since the fixing screw 54 is not biased left and right when the operation unit 8 is positioned in the front, it can be easily operated regardless of the operator's dominant hand. As long as the axis of the fixing screw 54 is directed toward the axis of the operation unit 109 accommodated in the holder 52, substantially the same effect can be obtained even if the fixing screw 54 is attached to the opposite side of FIG.

  The outer peripheral surface of the distal end portion of the sheath adjuster 18 is provided with irregularities so that the operator can easily grasp it.

As shown in FIG. 8, the needle slider 23 is a cylindrical member having a holding portion 24 for holding the cap member 36 of the needle tube 3 in a fixed state. The proximal end side of the needle tube 3 protrudes from the proximal end of the sheath 7 and extends to the inside of the needle slider 23. The needle slider 23 is connected to the operation main body 9 so as to be movable with respect to the operation main body 9.
The outer peripheral surface of the distal end portion of the needle slider 23 is provided with irregularities so that the operator can easily grasp it.
At the proximal end portion of the needle slider 23, the proximal end portion of the cap member 36 of the needle tube 3 protrudes outside the needle slider 23. The stylet 27 can be inserted from the opening on the base end side of the base member 36.

  The holding unit 24 restricts the rotation of the needle tube 3 relative to the needle slider 23 around the center line X1 of the needle tube 3 and restricts linear movement of the needle tube 3 relative to the needle slider 23 in the direction of the center line X1 of the needle tube 3. To do. In the present embodiment, the holding portion 24 has a pair of wall portions 25 (distal end wall portions 25a, 25a, 25a, 25b) spaced apart from the distal end side and the proximal end side of the flange portion 38 so as to sandwich the flange portion 38 of the base member 36. A proximal end wall portion 25b) and a rotation stop portion 26 that is disposed between the distal end wall portion 25a and the proximal end wall portion 25b and engages with the outer peripheral portion of the flange portion 38.

  As shown in FIGS. 3 and 11, a stopper 61 is movably attached to the operation body 9 on the distal end side of the needle slider 23. The stopper 61 has a fixing screw 62 and can be fixed to the operation body 9 by tightening the fixing screw 62. As shown in FIG. 1, the axis of the fixing screw 62 is preferably arranged so as to be directed to the axis of the operation unit 109 housed in the holder 52. Thereby, since the fixing screw 62 is not biased left and right when the operation unit 8 is positioned in the front, it can be easily operated regardless of the operator's dominant hand. As long as the axis of the fixing screw 62 is directed toward the axis of the operation unit 109 that is accommodated in the holder 52, substantially the same effect can be obtained even if the fixing screw 62 is attached facing the opposite side to FIG.

  The fixing screw 62 may be directed in the same direction as the fixing screw 54 described above, or may be directed in directions opposite to each other.

  Since the needle slider 23 can only move forward with respect to the operation main body 9 until it comes into contact with the stopper 61, the maximum protrusion length of the needle tube 3 from the sheath 7 is adjusted by adjusting the fixing position of the stopper 61 with respect to the operation main body 9. can do. In the present embodiment, as shown in FIG. 3, the operation stroke length (maximum movement amount) L <b> 2 of the needle tube 3 by the needle slider 23 is 5% or more of the total length of the sheath 7. In this embodiment, the operation stroke length L2 of the needle tube 3 by the needle slider 23 is preferably 40 mm or more, although it is also affected by the position of the treatment target site.

  The state in which the needle slider 23 is at the position where the needle slider 23 has moved to the limit on the proximal end side of the operation main body 9 is an initial state before the use of the puncture needle 1 is started. In the initial state, the tip of the needle tube 3 is in the sheath 7.

  The amount of movement of the needle slider 23 relative to the operation body 9 substantially corresponds to the amount of movement of the tip of the needle tube 3 relative to the sheath 7. That is, when the needle slider 23 moves the needle tube 3 relative to the sheath 7, the movement amount (relative stroke length L1) of the needle tube 3 with respect to the sheath 7 is changed to the actual movement amount (operation stroke length L2) of the needle slider 23. ) Plus the expansion or contraction of the needle tube 3. The expansion or contraction of the needle tube 3 includes the stretchability (elasticity) of the needle tube 3 itself, the stretchability (elasticity) of the sheath 7 itself, the magnitude of the frictional resistance between the needle tube 3 and the sheath 7, and the sheath 7 within the channel 107. It is influenced by the meandering state and the meandering state of the needle tube 3 in the sheath 7.

  When the needle slider 23 is at a position where the needle slider 23 has moved to the limit on the distal end side of the operation body 9, the distal end of the needle tube 3 protrudes from the distal end of the sheath 7. The protruding length of the needle tube 3 when the needle slider 23 is at the position where the needle slider 23 has moved to the limit on the distal end side of the operation body 9 is shorter than the operation stroke length L2 of the needle slider 23, but may be at least 40 mm. preferable.

  The stylet 27 shown in FIG. 3 is a wire-like member having a knob that can be attached to the lock portion 37 of the base member 36 and having a cross-sectional shape corresponding to the inner shape of the needle tube 3.

Operation during use of the puncture needle 1 having the above configuration will be described. FIG. 12 is a perspective view showing a state where the puncture needle 1 is attached to the ultrasonic endoscope 100. 13 to 19 are diagrams for explaining the operation of the puncture needle 1.
In the following, a biopsy procedure in which a needle tube 3 of the puncture needle 1 is inserted using a lesion located in the deep part of the lung as a target tissue and the cells of the lesion are collected through the needle tube 3 will be described as an example.

  First, the operator inserts the insertion portion 101 of the ultrasonic endoscope 100 shown in FIG. 1 into the body, observes with the optical imaging mechanism 103, and appropriately inserts the insertion portion 101 to the vicinity of the target tissue while curving the bending portion 105. Introduce the tip. After the introduction, the surgeon determines a site to perform a biopsy based on the observation results by the optical imaging mechanism 103 and the ultrasonic scanning mechanism 104.

  Next, the surgeon inserts the insertion body 2 of the puncture needle 1 from the distal end side into the channel 107 from the proximal end cap 108 provided in the operation unit 109 of the ultrasonic endoscope 100. Further, as shown in FIG. 12, the operator moves the distal end side of the operation unit 109 between the pair of wall portions 52 a and 52 b of the holder 52, and then slides provided on the operation unit 8 of the puncture needle 1. 51 is engaged with the base end cap 108. Thereby, the operation part 8 of the puncture needle 1 is fixed to the ultrasonic endoscope 100 so as not to rotate with respect to the operation part 109.

  Since the needle tube 3 of the puncture needle 1 shown in FIG. 3 is inserted into the channel 107 together with the sheath 7 (see the solid line portion in FIG. 3), relative movement of the needle tube 3 with respect to the sheath 7 Other than relative movement due to expansion and contraction hardly occurs. For this reason, even if the insertion portion 101 is curved, the insertion end 35 of the needle tube 3 does not pierce the inner surface of the sheath 7, and the insertion body 2 is guided to the distal end portion of the insertion portion 101.

In the process of inserting the insertion body 2 into the insertion portion 101, when the meandering is canceled after the meandering is accumulated in the region between the base end cap 108 and the angle tube 107b, the sheath 7 is moved against the needle tube 3. It will move to the tip side relatively. In the process of inserting the insert 2 into the channel 107, the meandering of the sheath 7 is repeatedly accumulated and eliminated, so how much meander is accumulated when the sheath 7 protrudes from the tip of the channel 107. It is not constant. Further, as one of the triggers for eliminating the meandering of the sheath 7, there is an advance / retreat movement of the needle tube 3 with respect to the sheath 7.
In this embodiment, since the needle tube 3 is subjected to backcut processing, the insertion end 35 is difficult to touch the inner surface of the sheath 7, and the needle tube 3 with respect to the sheath 7 in the process of inserting the insert 2 into the channel 107 is used. With slight movement, the needle tube 3 is unlikely to pierce the sheath 7.

  Next, as shown in FIG. 13, the operator loosens the fixing screw 54, and observes the sheath 7 and the body by the optical imaging mechanism 103 and the ultrasonic scanning mechanism 104 while relatively moving the sheath adjuster 18 and the operation body 9. The amount of protrusion of the sheath 7 from the distal end of the insertion portion 101 of the ultrasonic endoscope 100 is adjusted to an appropriate amount. After the adjustment, the operator tightens the fixing screw 54 to fix the protrusion amount.

  Next, based on the observation result by the ultrasonic scanning mechanism 104, the stopper 61 is moved in consideration of the distance to the target tissue T to be biopsied and fixed to the operation main body 9 at a desired position, and the maximum of the needle tube 3 is obtained. Adjust the protrusion length.

Next, the surgeon advances the needle slider 23 toward the distal end side of the operation unit 8. Then, the needle tube 3 moves in the sheath 7 toward the distal end side of the sheath 7 with respect to the sheath 7 (see the two-dot chain line portion in FIG. 3). In this embodiment, as shown in FIG. 14, when the insertion end 35 of the needle tube 3 passes through the angle tube 107 b, the outer peripheral surface in the vicinity of the insertion end 35 is in contact with the inner surface of the sheath 7, and the distal end portion of the needle tube 3. Receives a pressing force from the inner surface of the sheath 7.
As shown in FIGS. 14 to 17, in this embodiment, the tip surface of the needle tube 3 is in contact with the inner surface of the sheath 7 regardless of the direction in which the needle tube 3 enters the angle tube 107 b in the sheath 7. Among the outer surfaces of 32, it is an outer edge 32a portion.

  Since the tip surface 32 of the needle tube 3 has an inclination angle θ2, θ3a, θ3b, θ4 with respect to the center line X1 of the needle tube 3, all are larger than an inclination angle θ1 of the center line C2 of the slope portion 107a with respect to the axis C3 of the channel tube 107c. In the angle tube 107b, the needle tube 3 is inserted into the insertion end from the inner surface of the sheath 7 positioned along the inner surface of the angle tube 107b no matter where the needle tube 3 is rotated about the center line X1 of the needle tube 3. 35 is in a separated state.

  After the distal end portion of the needle tube 3 passes through the angle tube 107b without touching the inner surface of the sheath 7, the distal end portion of the needle tube 3 is advanced toward the distal end side along the slope of the slope portion 107a. Projecting from the opening of the channel 107 and projecting from the opening at the tip of the sheath 7 to the outside of the sheath 7.

  After the needle tube 3 protrudes from the opening at the distal end of the sheath 7 to the outside of the sheath 7, the operator further advances the needle slider 23 toward the distal end side of the operation portion 8, so that as shown in FIG. The insertion end 35 is punctured into the tissue and pushed forward to the target tissue T for biopsy. At this time, the needle tube 3 exposed to the outside from the surface of the tissue can be observed by the optical imaging mechanism 103, and the tip side portion of the needle tube 3 inserted into the tissue is observed by the ultrasonic scanning mechanism 104. Can do.

  The surgeon can observe an ultrasonic image based on the ultrasonic wave received by the ultrasonic scanning mechanism 104 with the ultrasonic observation unit 115 shown in FIG. With reference to the image of the needle tube 3 clearly displayed on the ultrasonic observation unit 115, as shown in FIG. 19, the operator causes the tip of the needle tube 3 to reach the target tissue T to be biopsied.

  Next, the surgeon pushes out the tissue that has entered the needle tube 3 and is not a biopsy target with the stylet 27 (see FIG. 1). Further, the operator pulls out the stylet 27 from the insert 2 and the operation unit 8. Thereby, a through hole extending from the distal end of the needle tube 3 to the proximal end of the needle slider 23 is generated. The surgeon connects a syringe or the like to the base member 36 disposed at the proximal end of the needle slider 23 to suck the inside of the needle tube 3 and suck the cells of the target tissue T to be biopsied from the tip of the needle tube 3. Collect.

  When a necessary amount of cells or the like can be collected, the needle slider 23 is retracted toward the proximal end side of the operation unit 8 and the distal end of the needle tube 3 is accommodated in the sheath 7. By accommodating the tip of the needle tube 3 in the sheath 7, the needle tube 3 comes out of the tissue. When the needle tube 3 is removed from the tissue, the slide lock 51 is removed from the proximal end cap 108 of the operation unit 109 of the ultrasonic endoscope 100, and the puncture needle 1 is removed from the channel 107. Finally, the ultrasonic endoscope 100 is removed from the patient, and the series of treatments is completed.

  As described above, in this embodiment, the state where the insertion end 35 of the needle tube 3 is separated from the inner surface of the sheath 7 within the angle tube 107b that is a bent portion of the channel 107 is maintained. In the process in which the distal end portion of the needle tube 3 passes, the insertion end 35 is retracted to a position where the insertion end 35 is most unlikely to penetrate the inner surface of the sheath 7. As a result, the possibility that the insertion end 35 of the needle tube 3 touches and deforms the inner surface of the sheath 7 can be kept low, and the puncture performance of the needle tube 3 into the tissue is unlikely to deteriorate. Further, the insertion end 35 of the needle tube 3 is prevented from breaking through the sheath 7 and further damaging the inner surface of the channel 107.

(Second Embodiment)
Next, a second embodiment of the present invention will be described. In this embodiment, the same components as those already described in the first embodiment are denoted by the same reference numerals as those in the first embodiment. FIG. 20 is a plan view of the distal end portion of the needle tube of the puncture needle for an endoscope according to the present embodiment. FIG. 21 is a front view of the distal end portion of the needle tube. FIG. 22 is a side view of the distal end portion of the needle tube. FIG. 23 is a bottom view of the distal end portion of the needle tube. FIGS. 24 to 27 are diagrams for explaining the operation of the puncture needle for an endoscope.

  The present embodiment differs from the first embodiment in that a Menghini needle 3A shown in FIGS. 20 to 23 is provided instead of the needle tube 3 described in the first embodiment.

  As shown in FIG. 22, the Menghini needle 3A of the present embodiment is inserted into the Menghini needle 3A from the outer edge 32aA of the Menghini needle 3A along a conical surface having a vertex Q at a position spaced from the center line X1A of the Menghini needle 3A. The blade surface 33A is curved in a conical surface with a diameter that gradually decreases toward the entry end 35 side. The inner peripheral portion of the distal end surface 32A of the Menghini needle 3A is a blade for cutting the tissue.

  The blade surface 33A formed on the distal end surface 32A of the Menghini needle 3A is at an angle greater than the inclination angle θ1 of the center line C2 of the slope portion 107a with respect to the axis C3 of the channel tube 107c with respect to the center line X1A of the Menghini needle 3A. Intersect.

  In the present embodiment, the conical surface that defines the blade surface 33A of the Menghini needle 3A has a center line X3 that is separated from the center line X1A of the Menghini needle 3A so as to be parallel to the center line X3. A conical surface having a straight line that intersects at an angle larger than the inclination angle θ1 of the center line C2 of the slope portion 107a with respect to the axis C3 of the channel tube 107c as a generating line.

As shown in FIGS. 24 to 27, also in this embodiment, the insertion end 35 of the Menghini needle 3A has a slope portion 107a from the channel tube 107c through the angle tube 107b regardless of the positional relationship in the sheath 7. In the process of moving to, it becomes a state separated from the inner surface of the sheath 7 as in the first embodiment. For this reason, the Menghini needle 3A of the present embodiment is also less likely to deform the insertion end 35 as in the first embodiment, and the puncture performance is unlikely to deteriorate.
Also in this embodiment, the Menghini needle 3A is unlikely to pierce the sheath 7 and damage the channel 107 as in the first embodiment.

  As described above, the embodiments of the present invention have been described in detail with reference to the drawings. As shown in each of the above embodiments, the needle tube of the puncture needle for an endoscope of the present invention includes a insertion end positioned at the distal end of the needle tube, The angle formed by the straight line connecting the outer edge of the distal end surface of the needle tube and the insertion end and the center line of the needle tube is always the bending of the channel. The sharp insertion end is prevented from touching the sheath by being defined as a state inclined more than the inclination angle of the distal end portion of the bent portion with respect to the proximal end portion of the portion (the angle tube 107b in the above embodiment). Yes. By satisfying such a positional relationship, the present invention is applied to a needle tube with a backcut described in the first embodiment and a needle tube having a needle tip shape other than the Menghini needle described in the second embodiment. Can do.

As mentioned above, although embodiment of this invention was explained in full detail with reference to drawings, the concrete structure is not restricted to this embodiment, The design change etc. of the range which does not deviate from the summary of this invention are included.
In addition, the constituent elements shown in the above-described embodiments can be combined as appropriate.

  According to each of the embodiments described above, it is possible to provide an endoscope puncture needle that is unlikely to cause damage to the endoscope or a decrease in puncture performance.

DESCRIPTION OF SYMBOLS 1 Endoscopic puncture needle 2 Insert 3 Needle tube 31 Metal cylinder part 32 Tip surface 32a Outer edge of tip face 33 First blade surface 34 Second blade surface 35 Insertion end 36 Base member 37 Lock part 38 Flange part 7 Sheath 8 Operation part 9 Operation body 18 Sheath adjuster 23 Needle slider 24 Holding part 25 Pair of wall parts 25a Tip wall part 25b Base end wall part 26 Anti-rotation part 27 Stylet 27a Knob 27b Core 51 Slide lock 52 Holder 52a, 52b Pair of walls Part 53 Support pipe 54 Fixing screw 61 Stopper 62 Fixing screw 100 Ultrasound endoscope 101 Insertion part 102 Hard part 103 Optical imaging mechanism 104 Ultrasonic scanning mechanism 105 Bending part 105a Tip 105b Base end 106 Flexible pipe part 107 Channel 107a Slope Part 107b Angle tube 107c H Down channel tube 108 proximal cap 109 operating portion 110 bending operation mechanism 111 a plurality of switches 112 universal cord 112a branch cable 112b branch cable 112c branch cable 113 light source apparatus 114 optical observation unit 115 ultrasonic observation unit 116 monitors

A first aspect of the present invention is an endoscope puncture needle that is used by being attached to an endoscope having a bent channel, a needle tube that can be inserted into the channel, a needle tube that supports the needle tube, A needle slider for moving the needle tube in the direction of the center line ; and provided on the distal end side of the needle tube and positioned inside the outer peripheral surface of the needle tube when viewed from the direction of the center line of the needle tube. A first end of a proximal end portion of the bent portion of the channel so as to be directed in a direction from the insertion end toward the center line as it goes to the distal end side along the center line . a first blade surface part to the greater inclination than the inclination angle of the second axis of the tip portion of the bent portion with respect to the axis, is that endoscopic needle having a.

According to a third aspect of the present invention, in embodiments the first, in terms you intersecting the first blade surface directed to said first blade surface and generally opposite when viewed from the direction of the center line becomes the angle between the line of intersection Yes to said center line the thorns Nyutan on the said first blade surface may have a second blade surface part is larger than the inclination angle.

According to a sixth aspect of the present invention, in the third aspect, the second blade surface portion is a right side formed by planes adjacent to each other with a straight line passing through the insertion point and inclined with respect to the center line as a boundary line. You may have a surface and a left side.
According to a seventh aspect of the present invention, in the sixth aspect, an angle formed between the second blade surface portion and the center line is larger than the inclination angle, and an angle formed between the boundary line and the center line. Is larger than the inclination angle, and the insertion end may always be away from the inner surface of the channel when the needle tube is rotated in the channel around the center line as a rotation center.

Claims (6)

An puncture needle for an endoscope used by being attached to an endoscope having a bent channel,
A needle tube that can be inserted into the channel;
A needle slider that supports the needle tube and moves the needle tube in the direction of the center line of the needle tube;
Have
The needle tube is
A piercing end that is located on the inner side of the outer peripheral surface of the needle tube and can be inserted into the tissue when viewed from the direction of the center line of the needle tube;
The angle formed by the straight line connecting the outer edge of the distal end surface of the needle tube and the insertion end and the center line of the needle tube is always larger than the inclination angle of the distal end portion of the bent portion with respect to the proximal end portion of the bent portion of the channel. A blade surface extending from the insertion end to the outer edge in an inclined state;
A puncture needle for an endoscope. The puncture needle for an endoscope according to claim 1,
The puncture needle for an endoscope, wherein the blade surface has a conical surface shape whose diameter gradually decreases from the outer edge toward the insertion end side of the needle tube. The puncture needle for an endoscope according to claim 1,
The blade surface is
A first blade surface portion comprising a plane inclined with respect to the center line of the needle tube;
When viewed from the direction of the center line of the needle tube, the first end surface is formed on a plane that is substantially opposite to the first blade surface portion and intersects the first blade surface portion, and has the insertion end on the intersection line with the first blade surface portion. A double-edged surface,
A puncture needle for an endoscope. The puncture needle for an endoscope according to claim 1,
An endoscope puncture needle further comprising a cylindrical sheath having the outer diameter of 60% or more of the inner diameter of the channel through which the needle tube is inserted. The puncture needle for an endoscope according to claim 4,
The puncture needle for an endoscope, wherein the outer diameter of the needle tube is 60% or more of the inner diameter of the sheath. The puncture needle for an endoscope according to claim 4 or 5,
The sheath is a puncture needle for an endoscope, in which an element wire is spirally wound to form a coil shape.

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