WO2013125493A1

WO2013125493A1 - Tomographic image acquisition device

Info

Publication number: WO2013125493A1
Application number: PCT/JP2013/053892
Authority: WO
Inventors: 狩野　渉; 裕一多田
Original assignee: テルモ株式会社
Priority date: 2012-02-24
Filing date: 2013-02-18
Publication date: 2013-08-29

Abstract

This tomographic image acquisition device (1) has a tubular main body (11), a sensor unit (12), an insertion hole (14), a protrusion hole (15), a protrusion-angle adjustment mechanism (17), and a control unit (31). The sensor unit (12) is provided at the tip of the main body (11), which is inserted into the subject, and transmits and receives signals into/from the subject's body. The protrusion-angle adjustment mechanism (17) is provided at the protrusion hole (15) and adjusts the angle (θ) at which a treatment tool (3) protrudes. The control unit (31) generates tomographic images on the basis of the signals received by the sensor unit (12) and operates the protrusion-angle adjustment mechanism (17) on the basis of said images.

Description

Tomographic image acquisition device

The present invention relates to a tomographic image acquisition apparatus that is inserted into a living body to acquire a tomographic image and from which a treatment tool that performs a treatment on the living body protrudes.

As this type of conventional tomographic image acquisition apparatus, there is an apparatus described in Patent Document 1, for example. This Patent Document 1 describes a technique for projecting a puncture needle that shows an example of a treatment instrument that performs a treatment on a living body from an ultrasonic probe that shows an example of a tomographic image acquisition apparatus.

In the technique described in Patent Document 1, first, an ultrasonic probe is inserted into a living body, and an image of a treatment target site to be treated is acquired. Then, the puncture needle is punctured at the treatment target site while observing the image acquired by the ultrasonic probe.

In addition, when there is a treatment target part to be treated at a position away from a wall surface such as a bronchus or a blood vessel into which the main body part of the tomographic image acquisition apparatus is inserted, the protrusion angle at which the treatment tool protrudes by tilting the tip of the main body part regulate.

JP 2003-164455 A

However, in the technique disclosed in Patent Document 1, the protrusion angle at which the treatment tool protrudes is constant. Therefore, when there is a treatment target part to be treated at a position away from the wall surface of the bronchus or blood vessel or the like into which the main body part of the tomographic image acquisition apparatus is inserted, the treatment tool is operated by operating the position and posture of the tip of the main body part. It was necessary to adjust the protruding angle to protrude, and the work was very troublesome.

In addition, while observing the tomographic image of the living body acquired by the surgeon, the projection angle was adjusted by operating the main body with a human hand, so that the surgeon can accurately reach the treatment target site. The ability of was greatly influenced.

SUMMARY OF THE INVENTION An object of the present invention is to provide a tomographic image acquisition apparatus that can simplify the work in consideration of the above-mentioned problems and can accurately reach the treatment tool to the treatment target site without being affected by the ability of the operator. It is to provide.

In order to solve the above problems and achieve the object of the present invention, a tomographic image acquisition apparatus of the present invention includes a tubular main body, a sensor unit, an insertion port, a projection port, a projection angle adjustment mechanism, and a control unit. And with.
The main body is inserted into the living body. A sensor part is provided in the front-end | tip part inserted in the biological body in a main-body part, and transmits / receives a signal to a biological body. The insertion port is provided in the main body, and a treatment tool for performing treatment on a treatment target site in a living body is inserted. The projecting port is provided in the main body, and projects the distal end of the treatment instrument inserted into the main body. The protrusion angle adjusting mechanism is provided in the protrusion and adjusts the protrusion angle of the treatment instrument. And a control part produces | generates a tomographic image based on the signal which the sensor part received, and operates a protrusion angle adjustment mechanism based on the produced | generated tomographic image.

According to the tomographic image acquisition apparatus of the present invention, the projecting angle of the treatment tool can be changed without changing the position and posture of the main body, so that the operation can be simplified. In addition, since the control unit automatically adjusts the protrusion angle of the treatment tool based on the tomographic image, the treatment tool can accurately reach the treatment target region without being affected by the ability of the operator. .

It is a schematic block diagram which shows the tomographic image acquisition apparatus concerning the 1st Example of this invention. It is sectional drawing which shows the principal part of the tomographic image acquisition apparatus concerning the 1st Embodiment of this invention. It is a block diagram which shows the control system of the tomographic image acquisition apparatus concerning the 1st Example of this invention. It is explanatory drawing which shows the use condition of the tomographic image acquisition apparatus concerning the 1st Example of this invention, and shows the state which inserted the tomographic image acquisition apparatus in the bronchus. It is explanatory drawing which shows the state which inserted the main-body part of the tomographic image acquisition apparatus concerning the 1st Example of this invention in the biological body. It is explanatory drawing which shows the example displayed on the image display part of the tomographic image acquisition apparatus concerning the 1st Example of this invention. It is sectional drawing which shows the state which changed the angle of the adjustment piece of the tomographic image acquisition apparatus concerning the 1st Example of this invention. It is sectional drawing which shows the principal part of the tomographic image acquisition apparatus concerning the 2nd Example of this invention. It is a schematic block diagram which shows the tomographic image acquisition apparatus concerning the 3rd Example of this invention. FIG. 10A shows a tomographic image acquisition apparatus according to a fourth embodiment of the present invention. FIG. 10A is a cross-sectional view showing a state in which the first sensor is inserted into the main body, and FIG. 10B shows that the second sensor is inserted into the main body. it is a sectional view showing a state. FIG. 11A is a sectional view and FIG. 11B is a front view showing a modification of the fixing mechanism of the tomographic image acquisition apparatus according to the fourth embodiment of the present invention.

Hereinafter, embodiments of the tomographic image acquisition apparatus of the present invention will be described with reference to FIGS. In addition, the same code | symbol is attached | subjected to the common member in each figure. The present invention is not limited to the following form.

<1. First Embodiment>
[Configuration example of tomographic image acquisition device]
Next, a configuration example of a first embodiment of the tomographic image acquisition apparatus of the present invention (hereinafter referred to as “this example”) will be described with reference to FIGS. 1 to 3.
FIG. 1 is a schematic configuration diagram showing a tomographic image acquisition apparatus of this example, and FIG. 2 is a cross-sectional view showing a main part of the tomographic image acquisition apparatus of this example.

A tomographic image acquisition apparatus 1 shown in FIG. 1 is an apparatus that acquires a tomographic image in a living body and projects a treatment tool that performs a treatment on the living body. The tomographic image acquisition apparatus 1 includes an ultrasonic probe 2 that is inserted into a living body, an image diagnosis unit 7, and a motor drive unit 8 that indicates a rotation drive unit.

[Ultrasonic probe]
The ultrasonic probe 2 has a main body portion 11 formed in a tubular shape, a sensor portion 12 built in the main body portion 11, and a drive shaft 13 (see FIG. 2). A treatment tool 3 for performing treatment on a living body is attached to the ultrasonic probe 2 so as to be movable back and forth.

Examples of the treatment tool 3 include a biopsy device that collects tissue of a treatment target site in a living body, a guide wire that marks the position of the treatment target site, and / or guides the biopsy device, a stylet, and the like. .

The main body 11 is formed in an elongated and substantially cylindrical shape, and both ends thereof are closed. Note that the shape of the main body 11 is not limited to a substantially cylindrical shape, and various other shapes such as a rectangular tube shape or an elliptical cross section cut in a direction orthogonal to the axial direction are applied. can. The front end of the main body 11 in the axial direction, that is, the side to be inserted into the living body is formed in a substantially hemispherical shape so as to be easily inserted into the lumen of the living body. Further, the main body 11 has flexibility in order to bend according to the bending of the lumen.

An insertion port 14 is formed on the base end side of the main body 11, and a projection port 15 is formed on the front end side of the main body 11. The insertion port 14 and the projection port 15 communicate with each other through the insertion hole 16. Then, the treatment instrument 3 is inserted into the main body 11 from the insertion port 14. The treatment tool 3 inserted into the insertion port 14 is inserted through the insertion hole 16. Further, the distal end portion of the treatment instrument 3 inserted through the insertion hole 16 protrudes from the protrusion port 15 to the outside of the main body portion 11.

Hereinafter, the axial direction of the main body 11 is defined as the first direction X, and the direction orthogonal to the first direction X in the plane formed by the first direction X and the direction in which the treatment instrument 3 protrudes is the second direction. described as Y.

As shown in FIG. 2, the main body 11 is provided with a protrusion angle adjusting mechanism 17 that adjusts the protrusion angle θ of the treatment instrument 3. The protrusion angle adjustment mechanism 17 includes an adjustment piece 21, an operation wire 22, an urging member 23, and an adjustment drive unit (not shown).

The adjusting piece 21 adjusts the protrusion angle of the treatment tool 3 from the protrusion 15 by bending the tip of the treatment tool 3 by contacting the treatment tool 3. The adjustment piece 21 is formed in the shape of a tongue piece, and is arranged on the distal end side of the main body portion 11 in the protruding port 15. A support shaft 24 is attached to one end of the adjustment piece 21 on the protruding port 15 side. Further, the adjustment piece 21 is rotatably supported by the main body 11 by the support shaft 24. Then, the adjustment piece 21 rotates along a plane formed by the first direction X and the second direction Y.

Also, the treatment instrument 3 comes into contact with the contact surface 21a on the opposite side of the tip of the main body 11 in the adjustment piece 21. In the initial state shown in FIG. 2, the contact surface 21 a of the adjustment piece 21 is erected along the second direction Y, and the direction in which the opening of the protrusion 15 and the insertion hole 16 extend (first It is orthogonal to the direction X).

A biasing member 23 is attached to the other end of the adjustment piece 21 opposite to the end where the support shaft 24 is provided. The urging member 23 is formed from a tension coil spring. The urging member 23 is fixed to the other end of the adjustment piece 21, and always urges the other end of the adjustment piece 21 toward the distal end side of the main body 11.

Further, an operation wire 22 is attached to the other end of the adjustment piece 21. The operation wire 22 is provided so as to be movable back and forth along the first direction X in which the main body 11 extends. The end of the operation wire 22 opposite to the adjustment piece 21 is connected to the adjustment drive unit.

When the adjustment drive unit is driven and the operation wire 22 is operated (pulled) toward the proximal end in the axial direction of the main body 11, the other end of the adjustment piece 21 protrudes against the urging force of the urging member 23. The adjustment piece 21 rotates in a direction approaching the mouth 15 (see FIG. 7). That is, the adjustment piece 21 is inclined with respect to the first direction X.

Further, when the drive of the adjustment drive unit is stopped and the pulling of the operation wire 22 is loosened, the adjustment piece 21 rotates in a direction in which the other end of the adjustment piece 21 is separated from the projecting port 15 by the urging force of the urging member 23. . Thus, by rotating the adjustment piece 21, the angle at which the treatment instrument 3 protrudes from the protrusion 15 (hereinafter referred to as “protrusion angle”) is adjusted.

In addition, although the example which formed the adjustment piece 21 of the protrusion angle adjustment mechanism 17 in the shape of a tongue piece was demonstrated in this example, it is not limited to this. For example, you may form the adjustment piece 21 in the tubular shape which the treatment tool 3 penetrates. When the adjustment piece 21 is formed in a tubular shape, it is preferable to arrange the adjustment piece 21 so that the cylindrical hole of the adjustment piece 21 communicates with the opening of the protruding port 15.

Also, a sensor unit 12 that transmits and receives signals is rotatably provided at the tip of the main body unit 11. The sensor unit 12 is disposed closer to the distal end side of the main body 11 than the protrusion 15 provided in the main body 11. The sensor unit 12 is provided so as to be biased in a direction away from the projecting port 15 with respect to the axis direction of the main body unit 11 in the second direction Y. The position where the sensor unit 12 is provided is not limited to the position deviated from the axis center. For example, the sensor unit 12 may be arranged at the axial center of the main body unit 11, and the position where the sensor unit 12 is provided is not particularly limited.

The sensor unit 12 includes a substantially cylindrical ultrasonic transducer that transmits ultrasonic waves to a living body, and a receiver that receives a reflected ultrasonic signal reflected from the living body. That is, the tomographic image acquisition apparatus 1 of this example is an apparatus that acquires a tomographic image in a living body as an ultrasound image. A drive shaft 13 is attached to the sensor unit 12.

The drive shaft 13 is inserted through the main body portion 11 from the distal end portion to the proximal end portion. The drive shaft 13 is connected to a motor drive unit 8 (see FIG. 3) provided at the proximal end portion of the main body portion 11 in the axial direction. When the motor drive unit 8 is driven, the rotational force is transmitted to the sensor unit 12 via the drive shaft 13. The sensor unit 12 rotates about the first direction X as a rotation center. Thereby, the tomographic image acquisition apparatus 1 of this example has a scanning range of 360 degrees around the side surface of the main body 11, that is, in a direction orthogonal to the first direction X.

In this example, the example in which the ultrasonic image is acquired in the range of 360 degrees by rotating the sensor unit 12 has been described, but the present invention is not limited to this. For example, the sensor unit 12 may not be rotated, or ultrasonic transducers may be arranged in an arc shape to acquire an ultrasonic image within a range of 360 degrees or less. That is, the present invention only needs to acquire an in-vivo tomographic image including the treatment target region M1.

[Guide sheath]
As shown in FIG. 1, the ultrasonic probe 2 is used while being inserted into a guide sheath 6. The guide sheath 6 is formed in a tube shape with both ends open and has flexibility. The guide sheath 6 is for guiding the ultrasonic probe 2 to the central part of the bronchus N1 and supporting the insertion of the ultrasonic probe 2.

A balloon 6 a that has elasticity and can be inflated and contracted is provided at the distal end of the guide sheath 6 in the axial direction. When the balloon 6a is inflated with the guide sheath 6 inserted into the lumen of the living body, the balloon 6a comes into close contact with the wall surface of the lumen (see FIG. 5).

In addition, although the example which provided the balloon 6a in the guide sheath 6 was demonstrated in this example, it is not limited to this, You may provide the balloon 6a in the front-end | tip part of the main-body part 11 in the ultrasonic probe 2. FIG. That is, the balloon 6 a may be provided on at least one of the ultrasonic probe 2 and the guide sheath 6.

Further, a balloon 6 a may be provided on the side surface of the main body 11 so as to surround the sensor unit 12. In this case, a liquid capable of transmitting ultrasonic vibration is injected into the balloon 6a.

[Control system of tomographic image acquisition device]
Next, a control system of the tomographic image acquisition apparatus 1 having the above-described configuration will be described with reference to FIG.
FIG. 3 is a block diagram showing a control system of the tomographic image acquisition apparatus 1.

As shown in FIG. 3, the image diagnosis unit 7 includes a control unit 31 and an image display unit 32. The control unit 31 includes an angle adjustment signal transmission / reception unit 33, an ultrasonic signal transmission / reception unit 34, a motor control circuit 35, and a signal processing unit 36.

The angle adjustment signal transmission / reception unit 33 is connected to the protrusion angle adjustment mechanism 17 in the ultrasonic probe 2. Further, the angle adjustment signal transmitting / receiving unit 33 is connected to the signal processing unit 36. The angle adjustment signal transmission / reception unit 33 receives the angle adjustment signal calculated by the signal processing unit 36. Further, the angle adjustment signal transmission / reception unit 33 transmits the received angle adjustment signal to the protrusion angle adjustment mechanism 17. And the protrusion angle adjustment mechanism 17 drives the adjustment drive part based on the received angle adjustment signal, and adjusts the angle of the adjustment piece 21 (refer FIG. 2).

Furthermore, the angle adjustment signal transmission / reception unit 33 receives angle information of the adjustment piece 21 (see FIG. 2) from the protrusion angle adjustment mechanism 17 and transmits it to the signal processing unit 36.

The ultrasonic signal transmission / reception unit 34 is connected to the sensor unit 12 and the signal processing unit 36 of the ultrasonic probe 2. The ultrasonic signal transmitting / receiving unit 34 is connected to the sensor unit 12 via the drive shaft 13 via a rotary joint 41 described later. The ultrasonic signal transmission / reception unit 34 receives an ultrasonic oscillation signal from the signal processing unit 36 and transmits the received ultrasonic oscillation signal to the sensor unit 12. The sensor unit 12 oscillates the ultrasonic transducer based on the ultrasonic oscillation signal from the ultrasonic signal transmission / reception unit 34.

Also, the reflected ultrasonic signal received by the receiver of the sensor unit 12 is sent from the sensor unit 12 to the ultrasonic signal transmitting / receiving unit 34. Then, the ultrasonic signal transmitting / receiving unit 34 transmits the received reflected ultrasonic signal to the signal processing unit 36. The signal processing unit 36 is connected to the image display unit 32.

Further, the signal processing unit 36 is connected to the motor drive unit 8 through the motor control circuit 35. The motor drive unit 8 includes a rotary joint 41 and a rotation drive device 42.

The rotation drive device 42 is connected to the drive shaft 13 of the ultrasonic probe 2 via the rotary joint 41. The rotation drive device 42 includes a radial scanning motor 43 and an encoder unit 44.

The radial scanning motor 43 is driven to rotate based on a rotation signal sent from the signal processing unit 36 via the motor control circuit 35. The rotational force of the radial scanning motor 43 is transmitted to the drive shaft 13 and the sensor unit 12 of the ultrasonic probe 2 via the rotary joint 41. Further, the rotation information of the radial scanning motor 43 is detected by the encoder unit 44. The encoder unit 44 transmits the detected rotation information of the radial scanning motor 43 to the signal processing unit 36 via the motor control circuit 35.

The signal processing unit 36 generates an ultrasonic tomographic image based on the reflected ultrasonic image signal received by the sensor unit 12 and the rotation information of the radial scanning motor 43 received from the encoder unit 44. The ultrasonic tomographic image generated by the signal processing unit 36 is displayed on the image display unit 32.

In addition, although the example which applied the ultrasonic probe which has an ultrasonic transducer | vibrator, what is called an ultrasonic endoscope apparatus was demonstrated as a tomographic image acquisition apparatus in this example, it is not limited to this. As the tomographic image acquisition apparatus, for example, an optical coherence tomography apparatus (provided with a light irradiating unit that irradiates light to a living body and a light receiving unit that receives light reflected from the living body and using light interference) Optical Coherent Tomography (OCT) may be applied. In other words, the tomographic image acquisition apparatus may be any apparatus that can acquire a tomographic image in a living body.

[Operation example of tomographic image acquisition device]
Next, an example of the operation of the tomographic image acquisition apparatus 1 of this example will be described with reference to FIGS.
FIG. 4 is an explanatory diagram showing a state in which the ultrasonic probe 2 is inserted into the living body. In FIG. 4, the guide sheath 6 is omitted. FIG. 5 is a side view showing a state in which the distal end portion of the ultrasonic probe 2 is inserted to the vicinity of the treatment target site. 6 is a diagram illustrating an example of a tomographic image displayed on the image display unit 32 of the image diagnostic unit 7, and FIG. 7 is a cross-sectional view illustrating a state where the treatment tool 3 is punctured into a treatment target site.

In this example, an example in which the ultrasound probe 2 is inserted into the bronchus N1 of the lung Q in the patient R will be described.

First, as shown in FIG. 4, the ultrasonic probe 2 is inserted from the oral cavity P of the patient R into the bronchus N1 of the lung Q showing an example of a living body. At this time, the ultrasonic probe 2 is inserted through the cylindrical hole of the guide sheath 6 as shown in FIGS.

Next, as shown in FIG. 5, the balloon 6a provided at the distal end of the guide sheath 6 is inflated, and the balloon 6a is brought into close contact with the wall surface of the bronchus N1. Thereby, the periphery of the bronchi N1 ahead of the balloon 6a is occluded. Next, a liquid that is an ultrasonic transmission medium is injected into the distal side of the bronchi N1 from the balloon 6a. Examples of the liquid to be injected include physiological saline.

The air layer that obstructs the propagation of ultrasonic waves can be removed by filling the peripheral side of the bronchi N1 with liquid. As a result, a clear ultrasonic image can be acquired by the ultrasonic probe 2.

Next, the ultrasonic probe 2 is inserted up to the treatment target site M1, that is, a location where a so-called nodule is found. In addition, although the example which inserted the ultrasonic probe 2 to the treatment target site | part M1 after inject | pouring the liquid was demonstrated, you may inject | pour a liquid after inserting the ultrasonic probe 2 to the treatment target site | part M1.

Next, the sensor unit 12 is driven to receive the reflected ultrasonic signal reflected from the bronchus N1. Then, the sensor unit 12 transmits the received reflected ultrasonic signal to the control unit 31 of the image diagnostic unit 7. At this time, when the motor drive unit 8 is driven, the sensor unit 12 and the drive shaft 13 rotate around the first direction X (see FIG. 7). The rotation information of the sensor unit 12 is sent from the encoder unit 44 to the control unit 31.

The control unit 31 generates an ultrasonic tomographic image from the reflected ultrasonic signal and the rotation information of the sensor unit 12. The generated ultrasonic tomographic image is displayed on the image display unit 32. Thereby, an ultrasonic image in a range of 360 degrees around the side surface of the main body 11, that is, in a direction orthogonal to the first direction X can be acquired.

Then, the position of the ultrasonic probe 2 is adjusted so that the treatment target site M1 is captured on the ultrasonic image obtained by the ultrasonic probe 2. When the treatment target region M1 is captured on the ultrasonic image, the image display unit 32 of the image diagnosis unit 7 displays a cross-sectional image of the main body 11 of the ultrasonic probe 2 and the bronchi N1 as shown in FIG. 6, for example. An ultrasonic image including a tomographic image is displayed.

Here, the sensor unit 12 is disposed at a position deviated from the axis of the main body unit 11 in the second direction Y, that is, away from the projecting port 15 in the second direction Y. Thereby, in the main-body part 11 whose cross section is substantially circular, the position of the projection port 15 from which the treatment tool 3 projects can be easily determined. Then, the surgeon rotates the ultrasonic probe 2 so that the protruding port 15 faces the treatment target site M1 side in the second direction Y.

Further, the image display unit 32 may display a mark P indicating the side of the main body 11 where the protrusion 15 is provided, that is, the position where the treatment instrument 3 protrudes. In this case, even if the sensor unit 12 is provided at the axial center of the main body unit 11, the position of the protruding port 15 can be easily determined.

Next, the surgeon designates a treatment target part M1 to be treated from the displayed ultrasonic image, and inputs position information of the treatment target part M1 to the image diagnosis unit 7 (see FIG. 3). Based on the input position information, the control unit 31 of the image diagnostic unit 7 measures the distance D in the second direction Y from the outer wall of the side surface of the main body 11 to the central part of the treatment target site M1.

In this example, the example in which the operator designates the treatment target part M1 has been described. However, the control unit 31 may automatically search the treatment target part M1 from the ultrasonic image and measure the distance D. good. Further, when the treatment target part M1 is designated, the control is performed when the treatment target part M1 is not located in the plane A (see FIG. 6) formed in the first direction X and the direction in which the treatment tool 3 protrudes. The unit 31 may display on the image display unit 32 that the ultrasonic probe 2 needs to be rotated.

Further, as shown in FIG. 5, the distance L in the first direction X from the sensor unit 12 to the projection port 15 from which the treatment instrument 3 projects is always constant. The information on the distance L is set in the control unit 31 in advance.

And the control part 31 calculates protrusion angle (theta) which makes the treatment tool 3 protrude from the distance D and the distance L. FIG. This protrusion angle θ can be calculated from the following equation 1, for example.
[Formula 1] tan θ = D / L

Next, the control unit 31 generates an angle adjustment signal based on the calculated protrusion angle θ, and transmits the generated angle adjustment signal to the protrusion angle adjustment mechanism 17. And as shown in FIG. 7, the protrusion angle adjustment mechanism 17 drives an adjustment drive part based on the received angle adjustment signal. When the adjustment drive unit is driven, the operation wire 22 is pulled by the adjustment drive unit. By pulling the operation wire 22, the adjustment piece 21 rotates around the support shaft 24 against the urging force of the urging member 23. Thereby, the angle of the adjustment piece 21 is adjusted.

In addition, when the inclination angle with respect to the 1st direction X in the contact surface 21a of the adjustment piece 21 is smaller than the calculated protrusion angle (theta), the force pulling the operation wire 22 is loosened. Then, due to the urging force of the urging member 23, the adjustment piece 21 rotates about the support shaft 24 in the direction opposite to the above-described direction. Thereby, the inclination angle with respect to the 1st direction X of the contact surface 21a of the adjustment piece 21 becomes large.

Moreover, although the example which measured the distance D from the outer wall of the side part of the main-body part 11 to the center part of treatment object part M1 was demonstrated, it is not limited to this.

For example, as illustrated in FIG. 5, the control unit 31 includes the lower limit distance D1 in the second direction Y from the outer wall of the side surface of the main body 11 to the lower limit position where treatment is possible in the treatment target site M1, and the The upper limit distance D2 in the second direction Y from the outer wall of the side surface portion to the upper limit position at which treatment is possible in the treatment target site M1 is measured. Then, the protrusion angle range θ1 to θ2 may be calculated from the measured lower limit distance D1 and upper limit distance D2 and the distance L. In this way, by providing a range for the protrusion angle θ, the accuracy of angle adjustment by the protrusion angle adjusting mechanism 17 can be set low.

Next, the treatment instrument 3 is inserted into the insertion port 14 of the ultrasonic probe 2. Note that when the ultrasonic probe 2 is inserted into the bronchi N1 and the guide sheath 6, the treatment tool 3 may be inserted through the insertion hole of the ultrasonic probe 2 in advance.

And the treatment tool 3 is bent by coming into contact with the contact surface 21a of the adjustment piece 21, and its traveling direction is adjusted. Therefore, the distal end portion of the treatment instrument 3 protrudes from the protrusion port 15 at a protrusion angle θ. Here, the protrusion angle θ of the treatment instrument 3 is set so that the treatment instrument 3 reliably reaches the treatment target site M1. Therefore, when the treatment tool 3 is further inserted into the bronchi N1, the distal end portion of the treatment tool 3 reaches the treatment target site M1. By confirming on the tomographic image that the treatment tool 3 has reached the treatment target site M1, the operation of the tomographic image acquisition apparatus 1 of this example is completed.

According to the tomographic image acquisition apparatus 1 of this example, the control unit 31 automatically calculates the protrusion angle θ of the treatment instrument 3 from the ultrasonic image acquired by the sensor unit 12. Therefore, the optimal protrusion angle θ of the treatment instrument 3 can be automatically set without being affected by the ability of the operator.

Further, since the accurate distance between the main body 11 and the treatment target site M1 is measured by the control unit 31 instead of the human eye, the projection angle θ of the treatment tool 3 can be set more accurately. Thereby, it can control that the arrival part of treatment implement 3 shifts from treatment object part M1.

Furthermore, the protrusion angle adjustment mechanism is automatically operated based on the calculated protrusion angle θ. Thereby, the protrusion angle of the treatment tool 3 can be changed without changing the position and posture of the distal end portion of the main body 11, and the work can be simplified.

<2. Second Embodiment>
Next, a tomographic image acquisition apparatus according to a second exemplary embodiment of the present invention will be described with reference to FIG.
FIG. 8 is a cross-sectional view showing the main part of the tomographic image acquisition apparatus according to the second embodiment.

The difference between the tomographic image acquisition apparatus 51 according to the second embodiment and the tomographic image acquisition apparatus 1 according to the first embodiment is the configuration of the protrusion angle adjustment mechanism in the ultrasonic probe. Therefore, here, the protrusion angle adjusting mechanism will be described, and the same reference numerals are given to the portions common to the tomographic image acquisition apparatus 1, and the redundant description will be omitted.

As shown in FIG. 8, the ultrasonic probe 52 in the tomographic image acquisition apparatus 51 is provided with a protrusion angle adjusting mechanism 57. The protrusion angle adjustment mechanism 57 includes an adjustment piece 61, a first operation wire 62, a second operation wire 63, a support shaft 64, and an adjustment drive unit (not shown).

The adjustment piece 61 is formed in the shape of a tongue piece, and is disposed on the distal end side of the main body 11 in the protruding port 15. A first operation wire 62 is attached to one end of the adjustment piece 61 on the protruding port 15 side. A second operation wire 63 is attached to the other end of the adjustment piece 61 opposite to the one end.

Further, a support shaft 64 is provided at an intermediate portion between one end and the other end of the adjustment piece 61. The adjustment piece 61 is rotatably supported on the main body 11 by a support shaft 64. Then, the adjustment piece 61 rotates along a plane that is locked in the first direction X and the second direction Y.

The first operation wire 62 and the second operation wire 63 are arranged to be movable back and forth along the first direction X in which the main body 11 extends. An adjustment drive unit is connected to the end of the first operation wire 62 and the second operation wire 63 opposite to the adjustment piece 61.

When the first operation wire 62 is pulled and the second operation wire 63 is loosened, the adjustment piece 61 rotates around the support shaft 64. In the second embodiment, the angle with the first direction X on the contact surface 61a of the adjustment piece 61 is increased. That is, the adjustment piece 61 rotates in a direction in which the contact surface 61 a is orthogonal to the first direction X.

Further, when the second operation wire 63 is pulled and the first operation wire 62 is loosened, the adjustment piece 61 rotates about the support shaft 64 in the direction opposite to the above-described direction. In the second embodiment, the angle of the contact surface 61a of the adjustment piece 61 with the first direction X is small. That is, the adjustment piece 61 rotates in a direction in which the contact surface 61 a is parallel to the first direction X.

Other configurations are the same as those of the tomographic image acquisition apparatus 1 according to the first embodiment described above, and thus the description thereof is omitted. Also by the tomographic image acquisition apparatus 51 having such a protrusion angle adjusting mechanism 57, the same operation and effect as the tomographic image acquisition apparatus 1 according to the first embodiment described above can be obtained.

<3. Third Embodiment>
Next, a tomographic image acquisition apparatus according to a third exemplary embodiment of the present invention will be described with reference to FIG.
FIG. 9 is a schematic configuration diagram of a tomographic image acquisition apparatus according to the third embodiment.

The difference between the tomographic image acquisition apparatus 71 according to the third embodiment and the tomographic image acquisition apparatus 1 according to the first embodiment is the position of the insertion port provided in the main body of the ultrasonic probe. is there. Therefore, here, the ultrasonic probe will be described, and the same reference numerals are given to portions common to the tomographic image acquisition apparatus 1, and duplicate description will be omitted.

As shown in FIG. 9, the ultrasonic probe 72 in the tomographic image acquisition apparatus 71 has a main body portion 81 and a sensor portion 12 built in the main body portion 81. In the vicinity of the sensor portion 12 at the distal end portion of the main body portion 81, a protruding port 85 from which the treatment instrument 3 protrudes is formed.

Also, an insertion port 84 for inserting the treatment instrument 3 is provided in the vicinity of the projection port 85 in the main body 81. The insertion port 84 is formed closer to the proximal end side in the axial direction of the main body 81 than the projection port 85. The insertion port 84 and the projection port 85 communicate with each other through the insertion hole 86. Further, the insertion hole 86 of the ultrasonic probe 72 according to the third embodiment is set shorter than the insertion hole 16 of the ultrasonic probe 2 according to the first embodiment. Then, the treatment tool 3 is inserted only into the distal end portion of the main body portion 81.

According to the tomographic image acquisition apparatus 71 according to the third embodiment, since the length of the insertion hole 86 through which the treatment tool 3 is inserted can be shortened, the ultrasonic probe 72 is left with the treatment tool 3 left. The extraction work can be easily performed. In addition, the length of the treatment tool 3 used in the tomographic image acquisition apparatus 71 according to the third embodiment is smaller than that of the treatment tool 3 used in the tomographic image acquisition apparatus 1 according to the first embodiment. Can be shortened.

In the tomographic image acquisition apparatus 71 according to the third embodiment, it is preferable that the ultrasonic probe 72 is inserted into the living body after the treatment instrument 3 is inserted into the ultrasonic probe 72.

Other configurations are the same as those of the tomographic image acquisition apparatus 1 according to the first embodiment described above, and thus the description thereof is omitted. Also by the tomographic image acquisition apparatus 71 having such an ultrasonic probe 72, the same operation and effect as the tomographic image acquisition apparatus 1 according to the first embodiment described above can be obtained.

<4. Fourth Embodiment>
Next, a tomographic image acquisition apparatus according to a fourth exemplary embodiment of the present invention will be described with reference to FIGS. 10A and 10B.
10A and 10B are cross-sectional views of a tomographic image acquisition apparatus according to the fourth embodiment.

The tomographic image acquisition apparatus 301 according to the fourth embodiment is different from the tomographic image acquisition apparatus 1 according to the first embodiment in that the sensor unit can be attached to and detached from the main body of the ultrasonic probe. such is the point. Therefore, here, the main body part and the sensor part of the ultrasonic probe will be described, the same reference numerals are given to the parts common to the tomographic image acquisition apparatus 1, and the duplicate description will be omitted.

As shown in FIGS. 10A and 10B, the main body portion 311 of the tomographic image acquisition apparatus 301 according to the fourth embodiment is provided with the protrusion angle adjusting mechanism 17 and the insertion hole 16 through which the treatment instrument 3 is inserted. In addition, an insertion hole 314 into which the first sensor portion 312 and the second sensor portion 313 are detachably inserted is formed. The insertion hole 314 penetrates the main body 311 along the axial direction. Therefore, an opening of the insertion hole 314 is formed at the tip of the main body portion 311 in the axial direction.

As shown in FIG. 10A, the first sensor unit 312 is a sensor that is made of, for example, a camera and can visually recognize the front of the main body unit 311 in the axial direction. The first sensor unit 312 is attached to the distal end of the bendable insertion member 312a in the axial direction.

As shown in FIG. 10B, the second sensor unit 313 includes an ultrasonic transducer that transmits an ultrasonic wave to a living body and a receiver that receives a reflected ultrasonic signal reflected from the living body. The second sensor unit 313 can acquire an in-vivo tomographic image as an ultrasonic image. Similarly to the first sensor portion 312, the second sensor portion 313 is attached to the distal end of the bendable insertion member 313a in the axial direction.

Furthermore, the main body 311 and the second sensor unit 313 are provided with a fixing mechanism 315 that fixes the second sensor unit 313 at a predetermined position of the insertion hole 314. The fixing mechanism 315 includes a main body side magnet 315 a provided in the insertion hole 314 of the main body portion 311 and a sensor side magnet 315 b provided in the second sensor portion 313. The main body side magnet 315a and the sensor side magnet 315b are attracted and fixed to a predetermined position of the insertion hole 314 by attracting each other by the magnetic force.

In addition, although the example which provided the magnet for both the main-body part 311 and the 2nd sensor part 313 was demonstrated as the fixing mechanism 315, it is not limited to this. For example, at least one of the main body portion 311 and the second sensor portion 313 may be provided with a magnet, and the other of the main body portion 311 and the second sensor portion 313 may be provided with a ferromagnetic material made of iron or the like.

Next, an operation example of the tomographic image acquisition apparatus 301 according to the fourth embodiment will be described.
First, as shown to FIG. 10A, it inserts in the insertion hole 314 of the main-body part 311 using the 1st sensor part 312 which is a sensor which can visually recognize the front. Next, the main body 311 is guided to a target site in the living body using image information from the first sensor unit 312.

After the main body 311 reaches the target site in the living body, the first sensor unit 312 is pulled out from the insertion hole 314. Next, the 2nd sensor part 313 which acquires a tomographic image in a living body is inserted in an insertion hole. Then, the main body side magnet 315a and the sensor side magnet 315b are attracted and fixed. Thus, the second sensor unit 313 can be fixed at a predetermined position in the insertion hole 314.

Since the other configuration is the same as that of the tomographic image acquisition apparatus 1 according to the first embodiment described above, description thereof is omitted. Also by the tomographic image acquisition apparatus 301 having such a main body 311, the same operations and effects as those of the tomographic image acquisition apparatus 1 according to the first embodiment described above can be obtained.

[Modification]
Next, a modified example of the fixing mechanism of the tomographic image acquisition apparatus 301 according to the fourth embodiment will be described with reference to FIGS. 11A and 11B. Here, the fixing mechanism will be described, and portions common to the tomographic image acquisition apparatus 301 according to the fourth embodiment are denoted by the same reference numerals, and redundant description is omitted.
FIG. 11A and FIG. 11B are diagrams showing a modification of the fixing mechanism of the tomographic image acquisition apparatus 301 according to the fourth embodiment.

As shown in FIGS. 11A and 11B, the fixing mechanism 315B includes an engaging protrusion 316 provided in the insertion hole 314B of the main body 311B, an engaging protrusion 316, and an engaging groove 317. The engagement groove 317 is provided in the second sensor unit 313B. The engagement protrusion 316 protrudes from the wall surface of the insertion hole 314B toward the radial center. When the engagement protrusion 316 and the engagement groove 317 are engaged, the second sensor portion 313B is fixed at a predetermined position in the insertion hole 314B.

In this modification, the engagement groove 317 is not provided in the first sensor unit. Therefore, the first sensor portion is not fixed at the position where the engagement protrusion 316 is provided in the insertion hole 314B. However, the engaging groove 317 may be provided in the first sensor unit and fixed at the same position as the second sensor unit 313B.

In addition, when the first sensor unit is inserted closer to the distal end side in the axial direction in the insertion hole 314B than the second sensor unit 313B, the diameter of the first sensor unit is sufficiently larger than the diameter of the second sensor unit 313B. You may make it small and set to the magnitude | size which does not interfere with the engagement protrusion 316. FIG.

In the fourth embodiment, the example in which the second sensor portions 313 and 313B are directly fixed to the insertion holes 314 and 314B has been described. However, the present invention is not limited to this. For example, a cylindrical member that accommodates the second sensor portion in the cylindrical hole may be provided, and a fixing mechanism may be provided on the cylindrical member. You may enable it to support the 2nd sensor part rotatably in the axial direction within the cylinder hole of this cylindrical member.

The present invention is not limited to the embodiment described above and shown in the drawings, and various modifications can be made without departing from the scope of the invention described in the claims. For example, in the above-described embodiment, the example in which the bronchus is applied as the living body into which the main body portion is inserted has been described. However, the living body into which the main body portion is inserted is not limited to the bronchi. For example, it can be applied to the treatment of living bodies in the digestive system such as the large intestine, the small intestine, the esophagus, the urinary system such as the urinary tract, and the other parts such as blood vessels.

Furthermore, although the example which provided only one protrusion port which a treatment tool protrudes in the main-body part was demonstrated, it is not limited to this, You may provide multiple protrusion ports in a main-body part. Thereby, a plurality of treatment tools can be used simultaneously under a tomographic image. And a protrusion angle adjustment mechanism may be provided in all of the plurality of protrusions, or a protrusion angle adjustment mechanism may be provided in at least one of the plurality of protrusions.

1, 51, 71, 301 ... Tomographic image acquisition device, 2, 52, 72 ... Ultrasonic probe, 3 ... Treatment instrument, 6 ... Guide sheath, 6a ... Balloon, 7 ... Image diagnostic unit, 8 ... Motor drive unit (Rotation drive) Unit), 11, 81, 311, 311B ... body part, 12 ... sensor part, 13 ... drive shaft, 14, 84 ... insertion port, 15, 85 ... projection port, 16, 86 ... insertion hole, 17, 57 ... projection Angle adjustment mechanism, 21, 61 ... adjustment piece, 21a, 61a ... abutment surface, 22 ... operation wire, 23 ... biasing member, 24, 64 ... spindle, 31 ... control part, 32 ... image display part, 33 ... Angle adjustment signal transmission / reception unit, 34 ... ultrasonic signal transmission / reception unit, 35 ... motor control circuit, 36 ... signal processing unit, 41 ... rotary joint, 42 ... rotation Moving device, 43 ... radial scanning motor, 44 ... encoder unit, 62 ... first operation wire, 63 ... second operation wire, 312 ... first sensor unit, 313, 313B ... second sensor unit, 315 315B: Fixing mechanism, D: Distance, D1: Lower limit distance, D2: Upper limit distance, L: Distance, M1: Treatment target site, θ: Projection angle

Claims

A tubular main body inserted into the living body;
A sensor unit that is provided at a distal end of the main body unit that is inserted into the living body, and that transmits and receives signals to and from the living body;
An insertion port provided in the main body, into which a treatment tool for performing treatment on a treatment target site in the living body is inserted;
A projecting port provided in the main body portion and projecting a distal end portion of the treatment instrument inserted into the main body portion;
A protrusion angle adjusting mechanism that is provided in the protrusion and adjusts the protrusion angle of the treatment instrument;
A control unit that generates a tomographic image based on a signal received by the sensor unit and operates the protrusion angle adjustment mechanism based on the generated tomographic image;
A tomographic image acquisition apparatus.
The controller is
Measure the distance between the main body and the treatment target site from the tomographic image,
The tomographic image acquisition apparatus according to claim 1, wherein the projection angle is calculated from the measured distance between the main body unit and the treatment target site and a preset distance between the sensor unit and the projection port.
The controller is
A lower limit distance from the main body part to a lower limit position at which treatment is possible at the treatment target site; and
Measuring the upper limit distance from the main body part to the upper limit position where treatment is possible in the treatment target site,
The tomographic image acquisition apparatus according to claim 1, wherein the range of the protrusion angle is calculated from the measured lower limit distance and the upper limit distance, and a preset distance between the sensor unit and the protrusion.
The protrusion angle adjusting mechanism is
An adjustment piece that is rotatably provided in the vicinity of the projecting opening in the main body, and the treatment tool abuts on.
The tomographic image acquisition apparatus according to claim 1, further comprising: an adjustment drive unit that rotates the adjustment piece according to a signal from the control unit.
The tomographic image acquisition apparatus according to claim 1, further comprising a rotation drive unit that rotates the sensor unit around an axial direction of the main body unit.
The tomographic image acquisition apparatus according to claim 1, wherein the sensor unit includes an ultrasonic transducer that transmits ultrasonic waves to the living body and a receiver that receives the ultrasonic waves reflected from the living body.
The tomographic image acquisition apparatus according to claim 1, wherein the sensor unit includes a light irradiation unit that irradiates light to the living body and a light receiving unit that receives the light reflected from the living body.
The tomographic image acquisition apparatus according to claim 1, wherein the treatment tool is a guide wire.
The tomographic image acquisition apparatus according to claim 1, wherein the main body has an insertion hole into which the sensor unit is detachably inserted.
The tomographic image acquisition apparatus according to claim 9, wherein the main body part and the sensor part are provided with a fixing mechanism that detachably fixes the sensor part at a predetermined position.