WO2013146503A1

WO2013146503A1 - Treatment instrument

Info

Publication number: WO2013146503A1
Application number: PCT/JP2013/057983
Authority: WO
Inventors: 狩野　渉; 裕一多田
Original assignee: テルモ株式会社
Priority date: 2012-03-28
Filing date: 2013-03-21
Publication date: 2013-10-03

Abstract

Provided is a treatment instrument configured so that the angle of protrusion of a treatment member can be easily adjusted. This tomographic image obtaining device (1) is provided with a body section (11), an insertion opening (14), a protrusion opening (15), and an angle adjustment mechanism (17). The body section (11) is formed in a tube-like shape. A treatment member (3) is inserted in the insertion opening (14). The treatment member (3) inserted in the body section (11) protrudes from the protrusion opening (15). The angle adjustment mechanism (17) comprises: an adjustment piece (21) which is provided in a pivotable manner at the protrusion opening (15), is in contact with the treatment member (3), and adjusts the angle at which the treatment member (3) protrudes; and a pressing member (22) which presses the adjustment piece (21) to cause the adjustment piece (21) to pivot.

Description

Treatment tool

The present invention relates to a treatment instrument that is inserted into a living body and performs a treatment on the living body.

Conventionally, as this type of treatment tool, one that projects a treatment member from a distal end portion inserted into a living body is known. For example, Patent Document 1 describes an ultrasonic endoscope. This ultrasonic endoscope has an insertion portion flexible tube that is used by being inserted into a lumen. The distal end portion of the insertion portion flexible tube is provided with a bending portion, and the distal end portion of the bending portion has a puncture needle projection port through which a puncture assembly (needle tube) for puncturing tissue in the lumen projects. Is provided.

A puncture needle raising piece for bending the needle tube and changing the direction of the tip of the needle tube is provided in the vicinity of the puncture needle protrusion. The puncture needle raising piece is rotatably supported by the bending portion. An operation wire is connected to the puncture needle raising piece. By operating this operating wire, the puncture needle raising piece rotates. The operation wire can be remotely operated by operating an operation lever that pulls the operation wire.

In the ultrasonic endoscope described in Patent Document 1 configured as described above, the needle tube protrudes by rotating the puncture needle raising piece while the end surface of the puncture needle raising piece is in contact with the needle tube. The direction is changed, and the direction of the tip of the needle tube is changed accordingly.

JP 2010-42139 A

However, in the technique disclosed in Patent Document 1, since the puncture needle raising piece is rotated by remotely operating the operation wire, a lumen through which the operation wire is inserted at a highly bent portion such as a bronchus to the upper lobe of the lung is temporarily provided. If the shape is deformed, friction may occur between the lumen and the operation wire.
Further, when the inner diameter of the lumen through which the operation wire is inserted is increased, the operation wire may be bent in the lumen.

When friction between the operation wire and the lumen or bending of the operation wire occurs, the force applied to the operation wire by the operator is not accurately transmitted to the puncture needle raising piece. For this reason, the puncture needle raising piece cannot be rotated accurately. Therefore, it is difficult to accurately adjust the angle at which the treatment member such as a needle tube protrudes from the treatment instrument (hereinafter referred to as “projection angle”).

An object of the present invention is to provide a treatment tool that can easily adjust the protrusion angle of a treatment member in consideration of the above-described problems.

In order to solve the above problems and achieve the object of the present invention, the treatment instrument of the present invention includes a main body, an insertion port, a projecting port, and an angle adjustment mechanism. The main body is formed in a tubular shape and is inserted into the living body. The insertion port is provided in the main body, and a treatment member that performs treatment of a living body is inserted therein. The protrusion is provided in the main body, and the treatment member inserted into the main body protrudes. The angle adjusting mechanism is provided at the protrusion and adjusts the angle at which the treatment member protrudes. In addition, the angle adjustment mechanism is rotatably provided at the projection port, contacts the treatment member, adjusts the angle at which the treatment member protrudes, an injection portion that injects liquid or gas into the main body, A pressing member that presses and rotates the adjustment piece by pressure fluctuation of the liquid or gas injected by the injection unit.

In the treatment instrument configured as described above, the pressing member of the angle adjustment mechanism presses and rotates the adjustment piece by the pressure variation of the liquid or gas injected by the injection unit, so that the protrusion angle of the treatment member can be easily adjusted. Can do.

Also, the treatment instrument of the present invention includes a main body portion, an insertion port, a projection port, and an angle adjustment mechanism. The main body is formed in a tubular shape and is inserted into the living body. The insertion port is provided in the main body, and a treatment member that performs treatment of a living body is inserted therein. The protrusion is provided in the main body, and the treatment member inserted into the main body protrudes. The angle adjusting mechanism is provided at the protrusion and adjusts the angle at which the treatment member protrudes. The angle adjustment mechanism is rotatably provided at the protrusion, and has an adjustment piece that abuts the treatment member and adjusts an angle at which the treatment member protrudes, and a coil and a magnet that are relatively movable. And an electric actuator for rotating the adjusting piece and a control unit for controlling the electric actuator.

In the treatment instrument configured as described above, since the electric actuator of the angle adjustment mechanism rotates the adjustment piece, the protrusion angle of the treatment member can be easily adjusted.

According to the tomographic image acquisition apparatus of the present invention, the protrusion angle of the treatment member can be easily adjusted.

It is a schematic block diagram which shows the 1st Embodiment of the treatment tool of this invention. It is sectional drawing which shows the principal part in 1st Embodiment of the treatment tool of this invention, A is a state in which a press member is located in an initial position, B is a state in which a press member is located in a movement control position, C is It is a C arrow directional view of A. It is a block diagram which shows the control system in the 1st Embodiment of the treatment tool of this invention. It is an explanatory view showing a use state in the first embodiment of the treatment tool of the present invention and showing a state where the treatment tool is inserted into the bronchus. It is explanatory drawing which shows the state which inserted the main-body part in the biological body in the 1st Example of the treatment tool of this invention. It is explanatory drawing which shows the example displayed on the image display part in the embodiment of the treatment tool of this invention. It is sectional drawing which shows the state which inserted the treatment member in the 1st Example of the treatment tool of this invention. It is sectional drawing which shows the principal part of the modification in the 1st Embodiment of the treatment tool of this invention. It is sectional drawing which shows the principal part in the 2nd Example of the treatment tool of this invention, A is a state in which a press member is located in an initial position, B is a state in which a press member is located in a movement control position, C is It is a C arrow directional view of A. It is sectional drawing which shows the principal part in the 3rd Embodiment of the treatment tool of this invention. It is sectional drawing which shows the principal part in the 4th Embodiment of the treatment tool of this invention, A is the state in which the adjustment piece is accommodated in the accommodation hole, B is sectional drawing which shows the state which the adjustment piece rotated. It is. It is a schematic block diagram which shows the 5th Embodiment of the treatment tool of this invention.

Hereinafter, embodiments of the treatment tool 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]
A configuration example of a first embodiment (hereinafter referred to as “this example”) of a tomographic image acquisition apparatus as a treatment instrument of the present invention will be described with reference to FIGS. 1 to 3. The tomographic image acquisition apparatus 1 is an apparatus from which a treatment tool for acquiring a tomographic image in a living body and performing a treatment on the living body protrudes.

As shown in FIGS. 1 and 2, the tomographic image acquisition apparatus 1 includes an ultrasonic probe 2 inserted into a living body, an image diagnostic unit 7, and a motor drive unit 8 indicating 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. A treatment member 3 for performing treatment on a living body is attached to the ultrasonic probe 2 so as to be movable back and forth. The diameter of the main body 11 is preferably 0.5 mm to 5 mm, particularly preferably 1 mm to 3 mm.

Examples of the treatment member 3 include a biopsy device that collects tissue at 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 do. 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 member 3 is inserted into the main body 11 from the insertion port 14. The treatment member 3 inserted into the insertion port 14 is inserted through the insertion hole 16. Further, the distal end portion of the treatment member 3 inserted through the insertion hole 16 protrudes from the opening of the protruding port 15 to the outside of the main body portion 11.

On the distal end side of the main body portion 11 in the projecting port 15, an inclined portion 18 that is inclined and extends into the main body portion 11 from the distal end edge of the opening of the projecting port 15 toward the proximal end side of the main body portion 11 is formed. Yes. The inclined portion 18 is formed with a substantially rectangular accommodation hole 19 when viewed from the protruding port 15 side. Further, a step portion 18 a is formed in the vicinity of one end portion of the accommodation hole 19 in the inclined portion 18 (end portion on the distal end side of the main body portion 11).

Hereinafter, the axial direction of the main body 11 will be referred to as the X direction, and the direction orthogonal to the X direction in the plane formed by the X direction and the direction in which the treatment member 3 projects will be described as the Y direction.

The main body 11 is provided with an angle adjusting mechanism 17 for adjusting the protrusion angle θ of the treatment member 3. The angle adjustment mechanism 17 includes an adjustment piece 21, a pressing member 22, an urging member 23, a cylinder 25, an indeflator (injection unit) 26 (see FIG. 1), an adjustment control unit (not shown), a rotary And an encoder (not shown).

The cylinder 25 is formed integrally with the main body 11 in the vicinity of the accommodation hole 19 in the main body 11. The cylinder 25 extends along the Y direction from the vicinity of the center in the X direction of the main body 11 to the opening side of the projecting port 15. The cylinder 25 defines an accommodation space 25a inside. The front end of the cylinder 25 is open, and the accommodation space 25a and the accommodation hole 19 communicate with each other. Further, a communication hole 25 b is formed on the base end side of the cylinder 25 to communicate the accommodation space 25 a and one end of a fluid path 27 described later.

On the distal end side and the proximal end side of the cylinder 25, projecting

portions

25c and 25d that project from the inner peripheral surface of the cylinder 25 into the accommodation space 25a and extend toward the central axis of the cylinder 25 are spaced apart from each other in the Y direction. Are formed in pairs. The

protrusions

25c and 25d are formed in a substantially ring plate shape when viewed in the Y direction.

As shown in FIG. 1, the indeflator 26 has a syringe 26a filled with physiological saline, a tube 26b, and a piston 26c. The proximal end portion of the tube 26b is connected to the syringe 26a. The piston 26c is connected to the adjustment control unit. The adjustment control unit has an operation mechanism (not shown) that performs an operation (injection operation) for pressing the piston 26c in a direction to push the piston 26c into the syringe 26a and an operation (a suction operation) for pulling the piston 26c in a direction to pull out the syringe 26a. . The piston 26c is injected by the adjustment control unit when injecting physiological saline in the syringe 26a, and is inhaled by the adjustment control unit when injecting physiological saline from the fluid path 27. In this example, a mode in which the syringe 26a is filled with physiological saline will be described. However, instead of the physiological saline, other liquids such as a contrast medium or gases such as compressed air may be used.

The tip of the tube 26 b is connected to the other end of the fluid path 27 of the main body 11. The fluid passage 27 is formed in the main body 11 and communicates the opening at the tip of the tube 26 b with the accommodation space 25 a of the cylinder 25. When the piston 26c is injected, physiological saline is injected from the syringe 26a into the tube 26b, and the physiological saline injected into the tube 26b flows into the fluid path 27. The physiological saline that has flowed into the fluid path 27 flows into the accommodation space 25a. Further, when the suction operation is performed by the piston 26c, the physiological saline in the accommodation space 25a, the fluid path 27, and the tube 26b is sucked into the syringe 26a.

The pressing member 22 is a member that presses and rotates the adjustment piece 21. The pressing member 22 is a substantially cylindrical molded product made of an elastic member such as rubber, and includes a first disc portion 22a, a connecting portion 22b, a second disc portion 22c, and a pressing portion 22d. Have.

The first disc portion 22a is formed in a substantially disc shape. The outer diameter of the first disc portion 22a is substantially the same as the inner diameter of the cylinder 25. The connecting portion 22b is formed in a substantially columnar shape extending in the central axis direction from a substantially central portion of the first disc portion 22a. The second disc portion 22c is formed in a substantially disc shape. The second disc portion 22c is provided at the tip of the connecting portion 22b and faces the first disc portion 22a. The outer diameter of the second disc portion 22c is substantially the same as the outer diameter of the first disc portion 22a. The pressing part 22d is formed in a substantially columnar shape extending in the central axis direction from a substantially central part of the second disc part 22c. The first disc portion 22a, the connecting portion 22b, the second disc portion 22c, and the pressing portion 22d are integrally formed on the same central axis.

The pressing member 22 is accommodated in the accommodating space 25a. The pressing member 22 is accommodated in the cylinder 25 so that the pressing portion 22d is disposed closer to the accommodating hole 19 than the first disc portion 22a. The tip of the pressing portion 22d is in contact with the adjustment piece 21. When the outer edges of the first disc portion 22 a and the second disc portion 22 c are in contact with the inner peripheral surface of the cylinder 25, the pressing member 22 closes the opening of the cylinder 25 in a liquid-tight manner. Therefore, the physiological saline that has flowed into the accommodation space 25a of the cylinder 25 does not flow into the living body via the opening at the tip of the cylinder 25, the accommodation hole 19, and the protruding port 15.

When the physiological saline flowing into the accommodation space 25a of the cylinder 25 is below a predetermined amount, that is, when the pressure applied to the pressing member 22 by the physiological saline is below a predetermined value, the pressing member 22 has the first disc portion 22a of the cylinder 25. It is located at the initial position where it comes into contact with the protrusion 25d. The protrusion 25d restricts the pressing member 22 at the initial position from moving in a direction away from the opening of the protrusion 15. When the physiological saline gradually flows into the accommodation space 25a, the physiological saline flowing into the accommodation space 25a exceeds a predetermined amount, and the pressure applied to the pressing member 22 exceeds a predetermined value, the pressing member 22 is exposed to the protrusion 15. The movement (sliding in the cylinder 25) is started in a direction approaching the opening.

When the pressing member 22 moves a predetermined distance in a direction approaching the opening of the protrusion port 15, the second disk portion 22 c is positioned at a movement restricting position where the second disk portion 22 c comes into contact with the protrusion 25 c of the cylinder 25. The protrusion 25 c restricts the movement of the pressing member 22 at the movement restriction position in a direction approaching the opening of the protrusion 15.

The adjusting piece 21 adjusts the protrusion angle of the treatment member 3 from the opening of the protrusion 15 by bending the tip of the treatment member 3 by contacting the treatment member 3. The adjustment piece 21 is formed in a substantially rectangular flat plate shape when viewed in the Y direction, and is disposed on the distal end side of the main body 11 in the protruding port 15. A support shaft 24 is attached to the base end side (one end side) of the main body 11 in the adjustment piece 21. The adjustment piece 21 is rotatably supported on the main body 11 by a support shaft 24. The length V1 (see FIG. 2C) of the side extending along the X direction of the adjustment piece 21 is preferably 0.1 mm to 1 mm. Further, the width of the adjusting piece 21, that is, the length W1 (see FIG. 2C) of the side extending along the direction orthogonal to the X direction and the Y direction is preferably 0.1 mm to 1 mm.

A biasing member 23 is attached to the other end of the adjusting piece 21. The urging member 23 is formed from a tension coil spring. One end portion of the urging member 23 is fixed to the other end portion of the adjustment piece 21, and the other end portion of the urging member 23 is fixed to the step portion 18 a of the main body portion 11. The urging member 23 always urges the adjusting piece 21 in a direction opposite to the direction in which the pressing member 22 presses the adjusting piece 21. That is, the urging member 23 always urges the other end portion of the adjustment piece 21 in a direction away from the opening of the protruding port 15. For this reason, the adjustment piece 21 is accommodated in the accommodation hole 19 when not being pressed by the pressing member 22.

When the pressing member 22 starts to move in a direction approaching the opening of the protruding port 15, the pressing member 21 presses the pressing surface 21 b of the adjusting piece 21 to rotate the adjusting piece 21. Thereby, the other end part of the adjustment piece 21 approaches the opening of the protrusion port 15.

When the treatment member 3 is inserted into the insertion port 14 (see FIG. 1) and is inserted through the insertion hole 16, the contact surface 21a on the opposite side of the pressing surface 21b of the adjustment piece 21 contacts the treatment member 3.

The rotary shaft 24 is connected to a rotary encoder. The rotary encoder sequentially calculates the inclination angle of the adjustment piece 21 (inclination angle with respect to the X direction on the contact surface 21a of the adjustment piece 21) based on the rotation angle of the support shaft 24, and the calculated angle information is an angle adjustment signal to be described later. The data is transmitted to the transmission / reception unit 33. Note that the rotary encoder is not always necessary. For example, the pressure information of the liquid or gas inside the indeflator 26 or the fluid passage 27 may be converted into angle information.

In the angle adjustment mechanism 17 configured as described above, when the adjustment controller injects the piston 26 c of the inflator 26, the amount of physiological saline in the accommodation space 25 a of the cylinder 25 increases and is added to the pressing member 22. The pressure fluctuates and the pressing member 22 moves in a direction approaching the opening of the protruding port 15. With the movement of the pressing member 22, the adjustment piece 21 is pressed, and the adjustment piece 21 is in a direction in which the other end of the adjustment piece 21 approaches the opening of the projection port 15 against the urging force of the urging member 23. To turn.

Further, when the adjustment control unit performs a suction operation on the piston 26c of the inflator 26, the amount of physiological saline in the accommodation space 25a of the cylinder 25 decreases, the pressure applied to the pressing member 22 fluctuates, and the pressing member 22 protrudes. It moves in a direction away from the opening of the mouth 15. With the movement of the pressing member 22, the adjustment piece 21 is released from the pressing, and the adjustment piece 21 is moved in a direction in which the other end portion of the adjustment piece 21 is separated from the opening of the projection port 15 by the urging force of the urging member 23. Rotate.

When the treatment member 3 inserted through the insertion hole 16 contacts the contact surface 21a of the adjustment piece 21, the treatment member 3 bends and deforms along the contact surface 21a. Therefore, by adjusting the rotation of the adjustment piece 21, the angle at which the treatment member 3 protrudes from the opening of the protrusion 15 (hereinafter referred to as “protrusion angle”) can be adjusted. The protrusion angle that can be adjusted by the angle adjusting mechanism 17 is preferably set at 1 to 45 degrees, and more preferably set at 1 to 30 degrees.

In addition, although the example which formed the adjustment piece 21 of the angle adjustment mechanism 17 in the substantially rectangular shape was demonstrated in this example, it is not limited to this. For example, the adjustment piece 21 may be formed in a tubular shape through which the treatment member 3 passes. 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 Y direction. 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. And the sensor part 12 rotates centering | focusing on a X direction. 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 X direction.

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 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 an angle adjustment signal (described later) calculated by the signal processing unit 36. Further, the angle adjustment signal transmission / reception unit 33 transmits the received angle adjustment signal to the angle adjustment mechanism 17. And the adjustment control part of the angle adjustment mechanism 17 adjusts the angle of the adjustment piece 21 (refer FIG. 2) based on the received angle adjustment signal.

Furthermore, the angle adjustment signal transmission / reception unit 33 receives angle information of the adjustment piece 21 (see FIG. 2) from the rotary encoder of the 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 inserting the ultrasound probe 2 into the bronchus N1 of the lung Q in the patient R will be described as an example of the operation of the tomographic image acquisition apparatus 1 of this example with reference to FIGS. In FIG. 4, the guide sheath 6 is omitted.

First, as shown in FIG. 4, the operator inserts the ultrasonic probe 2 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. Further, as shown in FIG. 2A, the pressing member 22 of the angle adjustment mechanism 17 is located at the initial position, and the adjustment piece 21 is accommodated in the accommodation hole 19.

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 X direction (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 X direction 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 provided in a position deviated from the axis of the main body 11 in the Y direction, that is, deviated in a direction away from the projecting opening 15 in the Y direction. Thereby, in the main-body part 11 whose cross section is substantially circular, the position of the projection port 15 from which the treatment member 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 Y direction.

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 member 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). The control unit 31 of the image diagnostic unit 7 measures the distance D in the Y direction from the outer wall of the side surface of the main body 11 to the center of the treatment target site M1 based on the input position information.

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. In addition, when the treatment target part M1 is designated, if the treatment target part M1 is not located in the plane A (see FIG. 6) formed in the X direction and the direction in which the treatment member 3 protrudes, the control unit 31 The image display unit 32 may display that the ultrasonic probe 2 needs to be rotated.

Further, the distance L in the X direction from the sensor unit 12 to the opening of the projection port 15 from which the treatment member 3 projects is set in the control unit 31 in advance as shown in FIG.

Then, the signal processing unit 36 of the control unit 31 calculates a projection angle θ for projecting the treatment member 3 from the distance D and the distance L. This protrusion angle θ can be calculated from the following equation 1, for example.
[Formula 1] tan θ = D / L

Next, the signal processing unit 36 of the control unit 31 generates an angle adjustment signal based on the calculated protrusion angle θ. The angle adjustment signal transmitting / receiving unit 33 of the control unit 31 receives the angle adjustment signal from the signal processing unit 36 and transmits the received angle adjustment signal to the angle adjustment mechanism 17. The angle adjustment signal is a signal for instructing the operation of the inflator 26 for rotating the adjustment piece 21 so that the treatment member 3 protrudes from the opening of the protrusion port 15 at the protrusion angle θ. The adjustment control unit of the angle adjustment mechanism 17 injects the piston 26c of the inflator 26 based on the received angle adjustment signal. Then, as shown in FIG. 2B, the adjusting piece 21 resists the urging force of the urging member 23 in the direction in which the other end of the adjusting piece 21 approaches the opening of the projection port 15 around the support shaft 24. Rotate. Thereby, the angle of the adjustment piece 21 is adjusted. When the control unit 31 determines that the inclination angle of the adjustment piece 21 has reached the protrusion angle θ based on the angle information of the adjustment piece 21 received from the rotary encoder of the angle adjustment mechanism 17, the control unit 31 transmits an angle adjustment signal. To stop.

In addition, 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 the treatment target site | part M1 was demonstrated in this example, it is not limited to this.

For example, as illustrated in FIG. 5, the control unit 31 includes a lower limit distance D1 in the Y direction from the outer wall of the side surface portion of the main body portion 11 to a lower limit position where treatment is possible in the treatment target site M1, and the side surface portion of the main body portion 11. The upper limit distance D2 in the Y direction from the outer wall to the upper limit position where treatment is possible in the treatment target part 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.

Next, the treatment member 3 is inserted into the insertion port 14 of the ultrasonic probe 2. When inserting the ultrasonic probe 2 into the bronchi N1 and the guide sheath 6, the treatment member 3 may be inserted through the insertion hole 16 of the ultrasonic probe 2.

And the treatment member 3 is bent and deformed 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 member 3 protrudes from the opening of the protrusion port 15 at a protrusion angle θ. Here, the protrusion angle θ of the treatment member 3 is set so that the treatment member 3 reliably reaches the treatment target site M1. Therefore, when the treatment member 3 is further inserted into the bronchi N1, the distal end portion of the treatment member 3 reaches the treatment target site M1 as shown in FIG. By confirming on the tomographic image that the treatment member 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 the present example, the pressing member 22 of the angle adjustment mechanism 17 presses and rotates the adjustment piece 21 due to pressure fluctuation caused by the liquid or gas injected by the indeflator 26. The protruding angle of the treatment member 3 can be easily adjusted even at a highly bent portion such as a bronchiole near the lobe.

The control unit 31 automatically calculates the protrusion angle θ of the treatment member 3 from the ultrasonic image acquired by the sensor unit 12. Therefore, the optimal protrusion angle θ of the treatment member 3 can be automatically set without being affected by the ability of the operator.

In addition, 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 protrusion angle θ of the treatment member 3 can be set more accurately. Thereby, it can control that the arrival part of treatment member 3 shifts from treatment object part M1.

Furthermore, the angle adjustment mechanism 17 is automatically operated based on the calculated protrusion angle θ. Thereby, the protrusion angle of the treatment member 3 can be changed without changing the position and posture of the distal end portion of the main body portion 11, and the work can be simplified.

In addition, in this example, the press member 22 of the angle adjustment mechanism 17 is located in an initial position, and the aspect which inserts the ultrasonic probe 2 in which the adjustment piece 21 is accommodated in the accommodation hole 19 in the patient R was demonstrated. However, instead of this, the ultrasonic probe 2 in a state where the pressing member 22 of the angle adjusting mechanism 17 is located at the upper limit position and the adjusting piece 21 is rotated may be inserted. In this case, the adjustment control unit of the angle adjustment mechanism 17 performs a suction operation on the piston c of the indeflator 26 based on the angle adjustment signal received from the control unit 31, and opens the other end of the adjustment piece 21 to the opening of the protrusion 15. Rotate in a direction away from

In the present embodiment, the indeflator 26 is provided outside the main body 11. However, an indeflator mechanism having the same function as that of the indeflator 26 may be provided near the cylinder 25 inside the main body 11. Good. In this case, since the cylinder 25 and the indeflator mechanism can be provided at a relatively close distance, the amount of physiological saline used can be reduced.

Alternatively, the adjustment piece 21 may be omitted, and the protrusion angle from the opening of the protrusion 15 of the treatment member 3 may be adjusted by bringing the pressing portion 22d of the pressing member 22 into contact with the treatment member 3. In this case, it is preferable that the treatment member 3 is inserted through the insertion hole of the ultrasonic probe 2 before the pressing member 22 is moved from the initial position in a direction approaching the opening of the projection port 15.

Further, as shown in FIG. 8, in addition to the urging member 23, the first disc portion 22 a of the pressing member 22 and the bottom of the cylinder 25 are urged in a direction away from the opening of the projection port 15. It may be connected by an urging member (elastic member) 28 such as a coil spring. In this case, installation of the urging member 23 may be omitted.

<2. Second Embodiment>
Next, a second embodiment of the treatment tool of the present invention will be described with reference to FIG.

The difference between the tomographic image acquisition apparatus 201 as the treatment tool according to the second embodiment and the tomographic image acquisition apparatus 1 according to the first embodiment is that the angle adjustment mechanism 217 in the ultrasonic probe 202 is different. It is a configuration. Specifically, the difference is that the adjustment piece 21 and the member corresponding to the pressing member 22 in the tomographic image acquisition apparatus 1 are integrally configured in the tomographic image acquisition apparatus 201.
Therefore, here, the configuration of the angle adjustment mechanism 217 will be mainly 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. 9, the angle adjustment mechanism 217 includes an adjustment piece 221, a pressing member 222, a biasing member 23, a cylinder 25, an indeflator (not shown), an adjustment control unit, and a rotary encoder. ing. Note that the cylinder 25, the indeflator, the adjustment control unit, and the rotary encoder are the same as the cylinder 25, the indeflator 26, the adjustment control unit, and the rotary encoder in the first embodiment. Is omitted.

The pressing member 222 is a member that rotates the adjustment piece 221. The pressing member 222 is a molded product made of an elastic member such as rubber, and includes a first disc portion 222a, a connecting portion 222b, a second disc portion 222c, and a pressing portion 222d. .

The first disc portion 222a is formed in a substantially disc shape. The outer diameter of the first disc portion 222 a is substantially the same as the inner diameter of the cylinder 25. The connecting portion 222b is formed in a substantially columnar shape extending in the central axis direction from a substantially central portion of the first disc portion 222a. The second disc portion 222c is formed in a substantially disc shape. The second disk part 222c is provided at the tip of the connecting part 222b and faces the first disk part 222a. The outer diameter of the second disc portion 222c is substantially the same as the outer diameter of the first disc portion 222a. The first disc portion 222a, the connecting portion 222b, and the second disc portion 222c are formed on the same central axis.

The pressing part 222d has a substantially cylindrical columnar part 222e extending in the direction of the central axis of the second disk part 222c from the surface opposite to the surface on which the coupling part 222b of the second disk part 222c is provided. Yes. The pressing portion 222d has a pair of arm portions 222f extending from both sides of the tip portion of the cylindrical portion 222e in a direction orthogonal to the extending direction of the cylindrical portion 222e. The first disc portion 222a, the connecting portion 222b, the second disc portion 222c, and the pressing portion 222d are integrally formed.

The pressing member 222 is accommodated in the accommodating space 25a. The pressing member 222 is accommodated in the cylinder 25 so that the pressing portion 222d is disposed closer to the accommodating hole 19 than the first disc portion 222a. The outer edges of the first disc portion 222a and the second disc portion 222c are in contact with the inner peripheral surface of the cylinder 25, and the pressing member 222 closes the opening of the cylinder 25 in a liquid-tight manner. Therefore, the physiological saline that has flowed into the accommodation space 25a of the cylinder 25 does not flow into the living body via the opening at the tip of the cylinder 25, the accommodation hole 19, and the protruding port 15.

When the physiological saline flowing into the accommodation space 25a of the cylinder 25 is below a predetermined amount, that is, when the pressure applied to the pressing member 222 by the physiological saline is below a predetermined value, the pressing member 222 is such that the first disc portion 222a is a cylinder. It is located at the initial position where it abuts on the 25 protruding portions 25d (see FIG. 9A). The protrusion 25d restricts the pressing member 222 at the initial position from moving in a direction away from the opening of the protrusion 15. When the physiological saline gradually flows into the accommodation space 25a, the physiological saline flowing into the accommodation space 25a exceeds a predetermined amount, and the pressure applied to the pressing member 222 exceeds a predetermined value, the pressing member 222 is protruded from the protrusion 15. The movement (sliding in the cylinder 25) is started in a direction approaching the opening.

When the pressing member 222 moves a predetermined distance in a direction approaching the opening of the protrusion port 15, the second disk portion 222 c is positioned at a movement restriction position where the second disk portion 222 c comes into contact with the protrusion 25 c of the cylinder 25. The protrusion 25c restricts the pressing member 222 at the movement restricting position from moving in a direction approaching the opening of the protrusion 15 (see FIG. 9B).

The adjusting piece 221 adjusts the protrusion angle of the treatment member 3 from the opening of the protrusion 15 by bending the distal end portion of the treatment member 3 by contacting the treatment member 3. The adjustment piece 221 is formed in a substantially rectangular flat plate shape when viewed in the Y direction, and is disposed on the distal end side of the main body portion 11 in the protruding port 15. A support shaft 24 is attached to the base end portion side of the main body 11 in the adjustment piece 221. The adjustment piece 221 is rotatably supported on the main body 11 by the support shaft 24. The length V2 (not shown) of the side extending along the X direction of the adjustment piece 221 is preferably 0.1 mm to 1 mm. The width of the adjusting piece 221, that is, the length W2 of the side extending along the direction orthogonal to the X direction and the Y direction (see FIG. 9C) is preferably 0.1 mm to 1 mm.

A pair of sliding groove forming portions 221c are formed at both ends of the adjusting piece 221 in the width direction. The sliding groove forming portion 221c has a sliding groove 221d extending from one end portion (end portion on the base end portion side of the main body portion 11) of the adjustment piece 221 to the other end portion (end portion on the front end portion side of the main body portion 11). Forming. The distal end portion of the arm portion 222f of the pressing member 222 is slidably engaged with the sliding groove 221d.

A biasing member 23 is attached to the other end of the adjustment piece 221. The urging member 23 is formed from a tension coil spring. One end of the urging member 23 is fixed to the other end of the adjustment piece 221, and the other end of the urging member 23 is fixed to the step portion 18 a of the main body 11. The urging member 23 always urges the other end portion of the adjustment piece 221 in a direction away from the opening of the protruding port 15. For this reason, the adjustment piece 221 is accommodated in the accommodation hole 19 when not being pressed by the pressing member 222.

When the pressing member 222 starts to move in a direction approaching the opening of the projection port 15, the arm portion 222f slides in the sliding groove 221d toward the distal end of the main body portion 11. Along with this, a force is applied to the adjustment piece 221 so as to turn the other end of the adjustment piece 221 closer to the opening of the projection port 15, so that the adjustment piece 221 rotates in the same direction.

When the treatment member 3 is inserted into the insertion port 14 and is inserted through the insertion hole 16, the contact surface 221 a of the adjustment piece 221 contacts the treatment member 3.

In the angle adjustment mechanism 217 configured as described above, when the adjustment controller injects the piston of the indeflator, the amount of physiological saline in the accommodation space 25a of the cylinder 25 increases, and the pressure applied to the pressing member 222 is increased. It fluctuates and the pressing member 222 moves in a direction approaching the opening of the protruding port 15. As the pressing member 222 moves, the arm portion 222f slides in the sliding groove 221d toward the distal end side of the main body portion 11, and the adjustment piece 221 resists the urging force of the urging member 23. The other end of the adjustment piece 221 rotates in a direction approaching the opening of the protruding port 15 (see FIG. 9B).

Further, when the adjustment control unit performs a suction operation on the piston 26c of the indeflator 26, the amount of physiological saline in the accommodation space 25a of the cylinder 25 decreases, the pressure applied to the pressing member 222 fluctuates, and the pressing member 222 protrudes. It moves in a direction away from the opening of the mouth 15. As the pressing member 222 moves, the arm portion 222f slides in the sliding groove 221d toward the proximal end portion of the main body portion 11. Along with this, a force is applied to the adjustment piece 221 so that the other end portion of the adjustment piece 221 rotates in a direction away from the opening of the projection port 15. Due to this force and the urging force of the urging member 23, the other end of the adjustment piece 221 rotates in a direction away from the opening of the protruding port 15 (see FIG. 9A).

When the treatment member 3 inserted into the insertion port 14 and inserted through the insertion hole 16 comes into contact with the contact surface 221a of the adjustment piece 221, the treatment member 3 is bent and deformed along the contact surface 221a. Therefore, the angle at which the treatment member 3 protrudes from the opening of the protrusion 15 is adjusted by rotating the adjustment piece 221. Note that the protrusion angle that can be adjusted by the angle adjusting mechanism 217 is preferably set at 1 to 45 degrees, and more preferably set at 1 to 30 degrees.

In the tomographic image acquisition apparatus 201 of this example, the pressing member 222 of the angle adjustment mechanism 217 rotates the adjustment piece 221 by pressure fluctuation due to the liquid or gas injected by the indeflator. For this reason, the protrusion angle of the treatment member 3 can be easily adjusted even at a highly bent portion such as a bronchiole near the upper lung.

Further, since the arm portion 222f and the sliding groove 221d are engaged, when the pressing member 222 moves in a direction away from the opening of the projection port 15, the arm portion 222f moves in the sliding groove 221d of the main body portion 11. Slide toward the base end. As a result, a force is applied to the adjustment piece 221 so that the other end portion of the adjustment piece 221 is moved away from the opening of the projection port 15, so that the adjustment piece 221 can be reliably rotated in the same direction.

In addition, in the tomographic image acquisition apparatus 201 of this example, installation of the urging member 23 may be omitted. Further, the base end portion of the pressing member 222 and the bottom portion of the cylinder 25 may be connected by an elastic member such as a coil spring that urges the pressing member in a direction away from the opening of the protruding port 15.

Further, an indeflator mechanism having the same function as that of the indeflator 26 may be provided in the vicinity of the cylinder 25 inside the main body 11 as in the first embodiment.
<3. Third Embodiment>
Next, a third embodiment of the treatment tool of the present invention will be described with reference to FIG.

The difference between the tomographic image acquisition apparatus 301 according to the third embodiment and the tomographic image acquisition apparatus 1 according to the first embodiment is the configuration of the angle adjustment mechanism 317 in the ultrasonic probe 302. Specifically, the members corresponding to the adjustment piece 21 and the pressing member 22 in the tomographic image acquisition apparatus 1 are integrated with the tomographic image acquisition apparatus 301 in the same manner as in the tomographic image acquisition apparatus 201 according to the second embodiment. This is a different point.
Therefore, here, the configuration of the angle adjustment mechanism 317 will be mainly described, and the same reference numerals are given to portions common to the tomographic image acquisition apparatus 1, and redundant description will be omitted.

As shown in FIG. 10, the angle adjustment mechanism 317 includes an adjustment unit (adjustment piece and pressing member) 321, an urging member 23, a cylinder 325, an indeflator (not shown), an adjustment control unit, and a rotary encoder. Have. Note that the biasing member 23, the indeflator, the adjustment control unit, and the rotary encoder are the same as the indeflator 26, the adjustment control unit, and the rotary encoder in the first embodiment, and thus description thereof is omitted. .

The cylinder 325 is integrally formed in the main body 11 near the accommodation hole 19 of the main body 11. The cylinder 325 extends in a curved manner from the vicinity of the central portion of the main body 11 in the Y direction toward the opening side of the protruding port 15. The cylinder 325 is formed so that the cross section thereof is a perfect circular arc centered on the central axis of the support shaft 24.

The cylinder 325 defines an accommodation space 325a inside. The front end of the cylinder 325 is open, and the accommodation space 325a and the accommodation hole 19 communicate with each other. In addition, a communication hole 325 b is formed on the base end side of the cylinder 325 so as to communicate the accommodation space 325 a and one end of the fluid path 27.

A protruding portion 325 c that protrudes from the inner peripheral surface of the cylinder 325 to the accommodation space 325 a and extends toward the central axis of the cylinder 325 is formed on the tip end side of the cylinder 325. The protruding portion 325c is formed in a substantially ring plate shape when viewed in the Y direction.

The adjustment part 321 adjusts the protrusion angle from the opening of the protrusion 15 in the treatment member 3 by bending the distal end portion of the treatment member 3 by contacting the treatment member 3. The adjustment part 321 has a flat plate part 321c and a bending part 321d.

The curved portion 321d is formed in a substantially cylindrical shape with an outer diameter smaller than the inner diameter of the cylinder 325. The curved portion 321d extends curvedly at the same angle as the cylinder 325. On one end side of the bending portion 321d, a ring plate-shaped locking portion 321e that protrudes from the outer peripheral surface of the bending portion 321d and extends in the circumferential direction is formed. The flat plate portion 321c is a flat plate-like member formed on the other end side of the curved portion 321d. The flat plate portion 321c and the curved portion 321d are integrally formed.

The curved portion 321d is accommodated in the accommodation space 325a. The outer edge of the locking portion 321e is in contact with the inner peripheral surface of the cylinder 325, and closes the opening of the cylinder 325 in a liquid-tight manner. Therefore, the physiological saline that has flowed into the accommodation space 325 a via the fluid path 27 does not flow into the living body via the opening at the tip of the cylinder 325, the accommodation hole 19, and the projection port 15.

A support shaft 24 is attached to one end of the flat plate portion 321c. The urging member 23 is attached to the other end of the flat plate portion 321c. The urging member 23 is formed from a tension coil spring. One end portion of the urging member 23 is fixed to the other end portion of the flat plate portion 321 c, and the other end portion of the urging member 23 is fixed to the front end portion side of the main body portion 11 that partitions the bottom portion of the accommodation hole 19. . The urging member 23 always urges the other end portion of the flat plate portion 321 c in a direction away from the opening of the protruding port 15. For this reason, in the adjustment part 321, the flat plate part 321 c is accommodated in the accommodation hole 19 when the amount of physiological saline in the cylinder 325 is equal to or less than a predetermined amount. Note that the length V3 (not shown) of the side extending along the X direction of the flat plate portion 321c is preferably 0.1 mm to 1 mm. The width of the flat plate portion 321c, that is, the length W3 (not shown) of the side extending along the direction orthogonal to the X direction and the Y direction is preferably 0.1 mm to 1 mm.

When the physiological saline flowing into the accommodation space 325a of the cylinder 325 is below a predetermined amount, that is, when the pressure applied to the curved portion 321d by the physiological saline is below a predetermined value, the adjusting portion 321 has the flat plate portion 321c in the accommodation hole 19. It is located in the initial position of the state accommodated in the. When the physiological saline gradually flows into the accommodation space 325a, the physiological saline flowing into the accommodation space 325a exceeds a predetermined amount, and the pressure applied to the bending portion 321d exceeds a predetermined value, the bending portion 321d has the protrusion 15 Rotation (sliding in the cylinder 325) is started in a direction approaching the opening. As a result, the adjustment portion 321 rotates in a direction in which the other end portion of the flat plate portion 321 c approaches the opening of the projection port 15.

When the adjusting portion 321 rotates a predetermined amount in the direction in which the other end portion of the flat plate portion 321c approaches the opening of the protruding port 15, the locking portion 321e is positioned at a movement restricting position where the engaging portion 321e contacts the protruding portion 325c of the cylinder 325. The protrusion 325 c restricts the movement restricting position adjustment part 321 from moving in the direction in which the other end of the flat plate part 321 c approaches the opening of the protrusion 15.

The treatment member 3 inserted through the insertion hole 16 bends and deforms along the contact surface 321a when it contacts the contact surface 321a of the adjusting portion 321. Therefore, the protrusion angle of the treatment member 3 can be adjusted by adjusting the rotation of the adjustment unit 321. Note that the protrusion angle adjustable by the angle adjusting mechanism 317 is preferably set at 1 to 45 degrees, and more preferably set at 1 to 30 degrees.

In the tomographic image acquisition apparatus 301 of the present example, the adjustment unit 321 of the angle adjustment mechanism 317 rotates due to pressure fluctuations caused by the liquid or gas injected by the indeflator, so that it is highly bent like a bronchiole near the upper lung. Even at the site, the protrusion angle of the treatment member 3 can be easily adjusted.

Further, in the tomographic image acquisition apparatus 301 of this example, since the adjustment unit 321 is configured with a single member, the configuration of the angle adjustment mechanism 317 can be simplified with a small number of parts.

In addition, in the tomographic image acquisition apparatus 301 of this example, installation of the urging member 23 may be omitted. Similarly to the first embodiment, a coil spring that biases one end portion of the bending portion 321d and the bottom portion of the cylinder 325 in a direction away from the opening of the projecting opening 15 of the bending portion 321d of the adjustment portion 321. You may connect with elastic members, such as.

Further, an indeflator mechanism having the same function as that of the indeflator 26 may be provided in the vicinity of the cylinder 325 inside the main body 11 as in the first embodiment.
<4. Fourth Embodiment>
Next, a fourth embodiment of the treatment tool of the present invention will be described with reference to FIG.

The difference between the tomographic image acquisition apparatus 401 as the treatment tool according to the fourth embodiment and the tomographic image acquisition apparatus 1 according to the first embodiment is that the angle adjustment mechanism 417 in the ultrasonic probe 402 is different. It is a configuration. Therefore, here, the configuration of the angle adjustment mechanism 417 will be mainly described, and the same reference numerals are given to the portions that are common to the tomographic image acquisition apparatus 1, and redundant descriptions are omitted.

As shown in FIG. 11, in this example, the main body 411 of the tomographic image acquisition apparatus 401 is provided with an accommodation space 425 a for accommodating an angle adjustment mechanism 417 and a coil 90 described later in the vicinity of the accommodation hole 19. The accommodation space 425a communicates with an accommodation space that accommodates an adjustment control unit (not shown). The accommodation hole 19 and the accommodation space 425a do not communicate with each other. The diameter of the main body 411 is preferably 0.5 mm to 5 mm, particularly preferably 1 mm to 3 mm. The other configuration of the main body unit 411 is the same as that of the main body unit 11 of the tomographic image acquisition apparatus 1, and thus the description thereof is omitted.

The angle adjustment mechanism 417 includes an adjustment piece 421, a coil 90, an urging member 423, an adjustment control unit (not shown), and a rotary encoder (not shown).

The coil 90 accommodated in the accommodation space 425a is wound around a central axis extending along the Y direction. The coil 90 is fixed in the accommodation space 425a by a fixing member (not shown). The coil 90 is connected to a power source (not shown) of the adjustment control unit. When a current flows through the coil 90, a magnetic field is generated around the coil 90. In this example, a magnetic field is generated in which the opening side of the projecting opening 15 in the coil 90 is the N pole and the opposite side is the S pole.

The adjustment piece 421 is formed in a substantially rectangular shape when viewed in the Y direction, and is disposed on the distal end side of the main body 411 in the protruding port 15. A support shaft 24 is attached to the base end side (one end side) of the main body 411 in the adjustment piece 421. The adjustment piece 421 is rotatably supported by the main body 411 by the support shaft 24. The surface on the opening side of the protrusion 15 of the adjustment piece 421 forms a contact surface 421a that contacts the treatment member 3 as will be described later. The length V4 (not shown) of the side extending along the X direction of the adjustment piece 421 is preferably 0.1 mm to 1 mm. The width of the adjustment piece 421, that is, the length W4 (not shown) of the side extending along the direction orthogonal to the X direction and the Y direction is preferably 0.1 mm to 1 mm.

A biasing member 423 is attached to the other end of the adjustment piece 421. The biasing member 423 is formed from a tension coil spring. One end portion of the urging member 423 is fixed to the other end portion of the adjustment piece 421, and the other end portion of the urging member 423 is fixed to the distal end side of the main body portion 411 that partitions the bottom portion of the accommodation hole 19. . The biasing member 423 moves the adjustment piece 421 toward a direction opposite to the direction in which the coil 90 of the angle adjustment mechanism 417, which will be described later, the magnet 100 embedded in the adjustment piece 421, and the adjustment control unit rotate the adjustment piece 421. Always energized. That is, the urging member 423 urges the other end portion of the adjustment piece 421 in a direction away from the opening of the protruding port 15. Therefore, when no current flows through the coil 90 and no magnetic field is generated around the coil 90, the adjustment piece 421 is accommodated in the accommodation hole 19.

A flat magnet 100 is embedded in the adjustment piece 421. When the adjustment piece 421 is accommodated in the accommodation hole 19, the magnet 100 is embedded such that the surface facing the main body 411 that defines the bottom of the accommodation hole 19 is an N-pole surface.

The adjustment control unit controls the turning of the adjustment piece 421 by switching on / off of the current flowing through the coil 90 and adjusting the amount of the current flowing based on the angle adjustment signal received from the control unit 31.

In the angle adjusting mechanism 417 configured as described above, a magnetic field is generated around the coil 90 when the adjustment control unit causes a current to flow through the coil 90. In this example, a magnetic field is generated in which the opening side of the projecting opening 15 in the coil 90 is the N pole and the opposite side is the S pole. Since the surface of the magnet 100 embedded in the adjustment piece 21 that faces the main body 411 that defines the bottom of the accommodation hole 19 is an N-pole surface, the N-pole surface of the magnet 100 and the projecting opening 15 of the coil 90 are provided. A repulsive force is generated between the opening and the end of the opening. Due to this repulsive force, the adjustment piece 421 rotates in a direction in which the other end portion of the adjustment piece 421 approaches the opening of the projection port 15 against the urging force of the urging member 423. The amount of rotation increases as the amount of current flowing through the coil 90 increases.

When the adjustment control unit reduces the amount of current flowing through the coil 90 or stops the current, the adjustment piece 421 is separated from the opening of the protrusion 15 by the urging force of the urging member 423. Rotate in the direction. As described above, the coil 90 of the angle adjustment mechanism 417, the magnet 100 embedded in the adjustment piece 421, and the adjustment control unit constitute an electric actuator that rotates the adjustment piece 421.

When the treatment member 3 inserted into the insertion port 14 and inserted through the insertion hole 16 contacts the contact surface 421a of the adjustment piece 421, the treatment member 3 bends and deforms along the contact surface 421a. Therefore, the protrusion angle of the treatment member 3 can be adjusted by adjusting the rotation of the adjustment piece 421. The protrusion angle that can be adjusted by the angle adjustment mechanism 417 is preferably set at 1 to 45 degrees, and more preferably set at 1 to 30 degrees.

In addition, about the other structure of the tomographic image acquisition apparatus 401, since it overlaps with the tomographic image acquisition apparatus 1, description is abbreviate | omitted.

In this example, when the ultrasonic probe 402 is inserted into the patient R, the adjustment control unit does not pass a current through the coil 90. Therefore, the adjustment piece 421 is accommodated in the accommodation hole 19, as shown in FIG. 11A. . Further, 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 angle adjustment mechanism 417. The angle adjustment signal of this example is a signal that indicates the amount of current that flows through the coil 90 for rotating the adjustment piece 421 so that the treatment member 3 protrudes from the opening of the protrusion port 15 at the protrusion angle θ. The adjustment control unit of the angle adjustment mechanism 417 applies a current to the coil 90 based on the received angle adjustment signal, and adjusts the amount of current to be supplied. 11B, the adjustment piece 421 rotates around the support shaft 24 in a direction in which the other end portion of the adjustment piece 421 approaches the opening of the projection port 15 against the urging force of the urging member 423. Move.

In this example, the adjustment piece 421 is rotated by the coil 90 of the angle adjustment mechanism 417, the magnet 100 embedded in the adjustment piece 421, and the electric actuator composed of the adjustment control unit. The protruding angle of the treatment member 3 can be easily adjusted even at the highly bent portion.

In this example, the mode in which the ultrasonic probe 402 in which the adjustment piece 421 is accommodated in the accommodation hole 19 is inserted into the patient R has been described. Instead, a maximum amount of current flows through the coil 90, And you may insert the ultrasonic probe 402 in the state rotated to the limit position which the adjustment piece 21 can rotate. In this case, the adjustment control unit of the angle adjustment mechanism 417 reduces the amount of current flowing through the coil 90 based on the angle adjustment signal received from the control unit 31 or stops the current, and the other end of the adjustment piece 21. Is rotated away from the opening of the protrusion 15.

Further, the direction of the magnetic field generated around the coil 90 may be the south pole on the opening side of the projection port 15 in the coil 90 and the north pole on the opposite side. In this case, when the adjustment piece 421 is accommodated in the accommodation hole 19, the magnet 100 is embedded so that the surface facing the main body 411 that defines the bottom of the accommodation hole 19 becomes the surface of the S pole.

Further, an iron core extending in the central axis direction of the coil 90 may be provided at the center of the coil 90.

Further, in this example, since the accommodation hole 19 and the accommodation space 425a are not communicated with each other, the possibility that the current flowing through the coil 90 contacts the body fluid in the living body can be extremely reduced.

Further, the storage space 425a may be omitted and the coil 90 may be embedded in the main body 411.

Further, a magnet may be provided on the main body 411 and a coil may be provided on the adjustment piece 421. In this case, the magnet divides the bottom portion of the accommodation hole 19 and is embedded in a portion facing the contact surface 421 a of the adjustment piece 421 when the adjustment piece 421 is accommodated in the accommodation hole 19.

Moreover, the installation of the biasing member 423 may be omitted. In this case, the adjustment control unit reverses the direction of the current flowing through the coil 90 to generate a reverse magnetic field around the coil 90, thereby generating an attractive force between the coil 90 and the adjustment piece 421. The other end portion of the adjustment piece 421 may be rotated in a direction away from the opening of the protruding port 15.

Further, instead of the coil 90 and the magnet 100, an electric motor having a coil and a magnet is directly or indirectly connected to the support shaft 24, and the adjustment control unit controls the driving of the electric motor, so that the adjustment piece 421 The rotation may be controlled.
<5. Fifth embodiment>
Next, a fifth embodiment of the treatment tool of the present invention will be described with reference to FIG.

The difference between the tomographic image acquisition apparatus 71 as the treatment tool according to the fifth embodiment and the tomographic image acquisition apparatus 1 according to the first embodiment is that the insertion is provided in the main body of the ultrasonic probe. The position of the mouth. 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. 12, 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 member 3 protrudes is formed. The diameter of the main body 81 is preferably 0.5 mm to 5 mm, and particularly preferably 1 mm to 3 mm.

Further, an insertion port 84 for inserting the treatment member 3 is provided in the vicinity of the protruding 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 fifth embodiment is set shorter than the insertion hole 16 of the ultrasonic probe 2 according to the first embodiment. Then, the treatment member 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 fifth embodiment, since the length of the insertion hole 86 through which the treatment member 3 is inserted can be shortened, the ultrasonic probe 72 is left with the treatment member 3 left. The extraction work can be easily performed. In addition, the length of the treatment member 3 used in the tomographic image acquisition apparatus 71 according to the fifth embodiment is smaller than that of the treatment member 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 fifth embodiment, it is preferable to insert the ultrasonic probe 72 into the living body after inserting the treatment member 3 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.

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. Then, an angle adjusting mechanism may be provided for all of the plurality of protruding openings, or an angle adjusting mechanism may be provided for at least one of the plurality of protruding openings.

DESCRIPTION OF SYMBOLS 1 ... Tomographic image acquisition apparatus (treatment tool), 2 ... Ultrasonic probe, 3 ... Treatment member, 6 ... Guide sheath, 6a ... Balloon, 7 ... Image diagnostic part, 8 ... Motor drive unit, 11 ... Main part, 12 ... Sensor Part, 13 ... drive shaft, 14 ... insertion port, 15 ... projection port, 16 ... insertion hole, 17 ... angle adjustment mechanism, 21 ... adjustment piece, 21a ... contact surface, 22 ... pressing member, 23 ... biasing member, 24 ... support shaft, 25 ... cylinder, 26 ... indeflator (injection part), 27 ... fluid path, 28 ... biasing member (elastic member), 31 ... control part, 32 ... image display part, 33 ... angle adjustment signal transmission / reception 34: Ultrasonic signal transmission / reception unit 35 ... Motor control circuit 36 ... Signal processing unit 41 ... Rotary joint 42 ... Rotation drive device 43 ... Dialkyl scanning motor, 44 ... encoder, 90 ... coil, 100 ... magnet, D ... distance, D1 ... lower limit distance, D2 ... upper distance, L ... distance, M1 ... treatment target portion, theta ... projecting angle

Claims

A tubular main body inserted into the living body;
An insertion port provided in the main body and into which a treatment member for treating the living body is inserted;
Protruding port provided in the main body part, from which the treatment member inserted into the main body part protrudes,
An angle adjustment mechanism that adjusts an angle at which the treatment member protrudes, provided at the protrusion, and
The angle adjustment mechanism includes:
An adjustment piece that is pivotally provided at the projecting port, abuts on the treatment member, and adjusts an angle at which the treatment member projects;
An injection part for injecting liquid or gas into the main body part;
And a pressing member that presses and rotates the adjustment piece by pressure fluctuation of the liquid or the gas injected by the injection unit.
The treatment tool according to claim 1, wherein the angle adjustment mechanism is provided with a biasing member that biases the adjustment piece in a direction opposite to a direction in which the pressing member presses the adjustment piece.
The treatment tool according to claim 1, further comprising a cylinder into which the liquid or the gas is injected and the pressing member is slidably disposed.
The treatment tool according to claim 1, further comprising an elastic member that urges the pressing member in a direction away from the opening of the protrusion.
The treatment tool according to claim 1, wherein the adjustment piece and the pressing member are integrally formed.
The treatment tool according to claim 1, wherein the injection part is formed integrally with the main body part.
A tubular main body inserted into the living body;
An insertion port provided in the main body and into which a treatment member for treating the living body is inserted;
Protruding port provided in the main body part, from which the treatment member inserted into the main body part protrudes,
An angle adjustment mechanism that adjusts an angle at which the treatment member protrudes, provided at the protrusion, and
The angle adjustment mechanism includes:
An adjustment piece that is pivotally provided at the projecting port, abuts on the treatment member, and adjusts an angle at which the treatment member projects;
An electric actuator having a relatively movable coil and magnet, and rotating the adjusting piece;
And a control unit that controls the electric actuator.
The treatment tool according to claim 7, wherein the angle adjustment mechanism is provided with a biasing member that biases the adjustment piece in a direction opposite to a direction in which the electric actuator rotates the adjustment piece. .
The magnet is provided on the adjustment piece,
The treatment tool according to claim 7, wherein the coil is provided at a position corresponding to the magnet in the main body.
The magnet is provided in the main body,
The treatment tool according to claim 7, wherein the coil is provided at a position corresponding to the magnet in the adjustment piece.