WO2022153798A1 - 超音波内視鏡及びその先端ユニット - Google Patents
超音波内視鏡及びその先端ユニット Download PDFInfo
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- WO2022153798A1 WO2022153798A1 PCT/JP2021/047234 JP2021047234W WO2022153798A1 WO 2022153798 A1 WO2022153798 A1 WO 2022153798A1 JP 2021047234 W JP2021047234 W JP 2021047234W WO 2022153798 A1 WO2022153798 A1 WO 2022153798A1
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- tip
- ultrasonic
- end side
- ultrasonic transducer
- longitudinal axis
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- 230000037431 insertion Effects 0.000 claims abstract description 42
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/12—Diagnosis using ultrasonic, sonic or infrasonic waves in body cavities or body tracts, e.g. by using catheters
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/06—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with illuminating arrangements
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/267—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for the respiratory tract, e.g. laryngoscopes, bronchoscopes
- A61B1/2676—Bronchoscopes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/44—Constructional features of the ultrasonic, sonic or infrasonic diagnostic device
- A61B8/4444—Constructional features of the ultrasonic, sonic or infrasonic diagnostic device related to the probe
- A61B8/445—Details of catheter construction
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/04—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances
- A61B1/05—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances characterised by the image sensor, e.g. camera, being in the distal end portion
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/06—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with illuminating arrangements
- A61B1/07—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with illuminating arrangements using light-conductive means, e.g. optical fibres
Definitions
- the present invention relates to an ultrasonic endoscope and its tip unit.
- an electronic scanning type ultrasonic transducer (also referred to as an ultrasonic transducer array or an ultrasonic unit) is provided on a tip rigid portion (tip unit) constituting the tip of the insertion portion of the endoscope. Things are known. Then, while acquiring an ultrasonic image of the lesion (observation site, examination site, examination site is also possible) using the ultrasonic transducer, the puncture needle derived from the treatment tool outlet of the tip rigid part through the treatment tool channel is inserted. Treatments such as puncturing the lesion and collecting the cell tissue of the lesion are performed. For example, when collecting the cell tissue of the lymph node of the bronchus, a procedure of piercing the lymph node with a puncture needle is performed while acquiring an ultrasonic image of the lymph node by endoscopic ultrasonography.
- Patent Document 1 describes the center line of the ultrasonic scanning range (effective angle) and the long axis (longitudinal axis) of the tip rigid portion so that ultrasonic scanning can be performed on both lymph nodes located near and far from the bronchial wall surface.
- An ultrasonic endoscope that defines the angle of the above is disclosed.
- Patent Document 2 for the same purpose as the invention described in Patent Document 1, a outlet for a treatment tool (puncture needle or the like) is formed at the tip of the tip rigid portion to which the ultrasonic transducer is attached.
- An ultrasonic endoscope that is tilted forward (tilted) to the side opposite to the side is disclosed.
- the tip portion of the tip rigid portion is tilted forward as in the invention described in Patent Document 2 in order to improve the insertability or reduce the insertion force of the puncture needle. Endoscopic ultrasound is disclosed.
- the diameter of the insertion part of the ultrasonic endoscope and its tip rigid part has been further reduced in order to reduce the burden on the patient and improve the insertability.
- the ultrasonic image is drawn by the base end of the ultrasonic transducer, that is, the end closer to the outlet from which the puncture needle (treatment tool) is derived. It is important for endoscopic procedures. In this case, it is necessary to increase the contact area of the proximal end portion of the ultrasonic transducer with respect to the bronchial wall surface, but the above-mentioned patent documents do not disclose or suggest this point at all.
- the tip portion of the tip rigid portion protrudes outward from the outer circumference of the base end portion, which affects operability such as insertability of the insertion portion. Furthermore, it is necessary to secure an area for electrical wiring of the ultrasonic transducer.
- the present invention has been made in view of such circumstances, and an object of the present invention is to provide an ultrasonic endoscope and a tip unit thereof capable of reliably drawing an ultrasonic image at the proximal end portion of an ultrasonic transducer. do.
- An ultrasonic endoscope for achieving the object of the present invention includes an ultrasonic transducer provided on the tip side of the insertion portion and an ultrasonic transducer provided on the tip side of the tip body.
- the outer peripheral surface of the tip body is provided on the proximal end side of the ultrasonic transducer, and is provided on the first surface along the longitudinal axis of the insertion portion and on the proximal end side of the first surface, and is provided on the longitudinal axis.
- the second direction is the direction perpendicular to both the longitudinal axis and the first direction, including the stepped surface that connects the two, and the ultrasonic waves emitted from the ultrasonic transducer when the tip body is viewed from the second direction side.
- the first intersection is when the angle indicating the irradiation range is the effective angle and the intersection of the tangent line that is in contact with the ultrasonic transducer and in the most unidirectional position with respect to the stepped surface and the ultrasonic transducer is the first intersection. Is included within the range of 1/3 of the base end side of the effective angle. It is more preferable that the first intersection is included in the range of 1/4 of the effective angle on the proximal end side.
- the contact area of the base end portion of the ultrasonic transducer with respect to the wall surface can be increased, so that the ultrasonic image can be reliably drawn at this base end portion.
- the outlet is provided on the outer peripheral surface of the tip body and opens in one direction and the treatment tool is led out, and the lead port is provided in the tip body. It is provided with a conduit that is connected and through which a treatment tool is inserted, and an observation window of an observation optical system provided on a stepped surface, and is connected to an outlet when the tip body is viewed from the second direction side.
- the second intersection which is the intersection of the center line of the tip of the conduit and the tangent line, is located closer to the base end of the tip body than the first intersection.
- the second intersection is located between the ultrasonic transducer and the stepped surface.
- the outlet is provided on the outer peripheral surface of the tip body and opens in one direction and the treatment tool is led out, and the lead port is provided in the tip body. It is provided with a conduit that is connected and through which a treatment tool is inserted, and the angle between the longitudinal axis and the tip of the conduit is 20 ° to 35 ° when the tip body is viewed from the second direction side. Is.
- operability such as insertability of the ultrasonic endoscope can be ensured, and an increase in the load applied to the conduit from the treatment tool can be prevented.
- the tip of the conduit is a first tip connected to the outlet and a second tip provided on the base end side of the first tip.
- the first angle formed by the longitudinal axis and the first tip is 20 ° to 35 °
- the longitudinal axis and the second tip The second angle formed is 5 ° to 20 ° and is smaller than the first angle.
- the angle formed by the center line of the effective angle and the tip of the conduit is 15 ° to 60. °.
- the treatment tool can be inserted at an appropriate angle with respect to the drawing surface of the ultrasonic transducer.
- the observation window of the observation optical system is provided on the stepped surface, and the ultrasonic transducer is included in the field range of the observation optical system. Thereby, the contact of the ultrasonic transducer with respect to the wall surface can be observed by the observation optical system.
- the center point of the observation window is located on the one-way side of the ultrasonic transducer when the tip body is viewed from the second direction side. Thereby, the contact of the ultrasonic transducer with respect to the wall surface can be observed by the observation optical system.
- an observation window of an observation optical system and an illumination window of an illumination optical system are provided on a stepped surface.
- the ultrasonic endoscope according to another aspect of the present invention includes a lead-out port that opens on a first surface and a treatment tool is led out, and an observation window of an observation optical system provided on a stepped surface. As a result, the treatment tool derived from the outlet can be observed with the observation optical system.
- the tip main body is provided on the base end side of the ultrasonic mounting portion to which the ultrasonic transducer is mounted and the ultrasonic mounting portion, and has a first surface.
- the main body portion provided on the base end side of the first surface forming portion and having the second surface, and at least the ultrasonic mounting portion, which is opposite to the one-way side of the main body portion. It is provided with a protruding portion protruding in the direction side.
- the ultrasonic transducer can be tilted forward with respect to the longitudinal axis without tilting the tip or the entire tip of the tip body forward with respect to the longitudinal axis, so that the tip body (insertion portion) can be inserted. Sex can be ensured.
- the outlet from which the treatment tool is derived is opened on the first surface and the protruding portion is the tip portion main body viewed from the second direction side. , It is formed from the opening region of the outlet to the tip side of the ultrasonic mounting portion.
- the protrusion when the tip body is viewed from the second direction side, the protrusion is inclined with respect to the longitudinal axis from the base end side of the protrusion toward the tip side. It has two or more steps of inclined surfaces having different angles, and the inclined surface of the inclined surface gradually becomes smaller toward the tip end side of the protruding portion. As a result, the burden on the patient can be reduced.
- the outlet from which the transducer is derived is open on the first surface, and when the tip body is viewed from the second direction side, the outlet of the outlet The position in the first direction and the position of the apex in the first direction of the ultrasonic transducer are aligned. Clearance is ensured between the tip of the treatment tool led out from the outlet and the ultrasonic transducer.
- the tip main body is provided on the ultrasonic mounting portion to which the ultrasonic transducer is mounted and on the proximal end side of the ultrasonic mounting portion, and the first surface and the first surface are provided.
- the tip main body is provided with a first surface forming portion having a treatment tool outlet formed on one surface and a main body portion provided on the base end side of the first surface forming portion and having a second surface.
- the width of the ultrasonic mounting portion in the second direction is formed to be smaller than the width of the first surface forming portion in the second direction.
- the ultrasonic endoscope according to another aspect of the present invention has a connecting inclined surface that connects the base end side of the ultrasonic mounting portion and the tip end side of the first surface forming portion.
- the tip unit for achieving the object of the present invention includes a tip body provided on the tip side of the insertion portion of the ultrasonic endoscope and an ultrasonic transducer provided on the tip side of the tip body.
- the outer peripheral surface of the tip body is provided on the base end side of the ultrasonic transducer, and is provided on the first surface along the longitudinal axis of the insertion portion and on the base end side of the first surface.
- Ultrasonic waves when the tip body is viewed from the second direction side including the stepped surface connecting the tip side of the second surface and the direction perpendicular to both the longitudinal axis and the first direction as the second direction.
- the effective angle is the angle indicating the irradiation range of the ultrasonic waves emitted from the transducer, and the intersection of the tangent line that is in contact with the ultrasonic transducer and in the most unidirectional position with respect to the stepped surface and the ultrasonic transducer is the first intersection. If so, the first intersection is included within the range of 1/3 of the base end side of the effective angle.
- the present invention can reliably depict an ultrasonic image at the proximal end of an ultrasonic transducer.
- an ultrasonic endoscope endoscope
- FIG. 1 is an overall view of the ultrasonic endoscope 1.
- the ultrasonic endoscope 1 (hereinafter, simply abbreviated as "endoscope 1") is used for collecting cell tissues of lesions (observation sites, examination sites, and examination sites are also possible). Be done.
- a bronchial lymph node will be taken as an example as a lesion.
- the endoscope 1 is composed of an operation unit 10 that the practitioner grasps and performs various operations, an insertion unit 12 that is inserted into the patient's body, and a universal cord 14.
- the endoscope 1 is connected to a system configuration device such as a processor device (not shown) and a light source device that constitute the endoscope system via a universal cord 14.
- the operation unit 10 is provided with various operation members operated by the practitioner, for example, an angle lever 16 and a suction button 22 whose actions will be described later as appropriate.
- the operation unit 10 is provided with a treatment tool introduction port 24 for inserting the treatment tool into the treatment tool insertion channel 23 (see FIG. 4) that inserts the inside of the insertion unit 12.
- the insertion portion 12 extends from the tip of the operation portion 10, and is formed in a long shape with a small diameter as a whole.
- the insertion portion 12 is composed of a soft portion 30, a curved portion 32, and a tip rigid portion 34 (corresponding to the tip body and tip unit of the present invention) in this order from the proximal end side to the distal end side. ..
- the soft portion 30 occupies most of the insertion portion 12 from the proximal end side, and has flexibility that curves in any direction. When the insertion portion 12 is inserted into the body cavity, the soft portion 30 is curved along the insertion path into the body cavity.
- the curved portion 32 is configured to bend in the vertical direction (A2 direction) by rotating the angle lever 16 of the operating portion 10 in the A1 direction, and the curved portion 32 is bent in the vertical direction (A2 direction) to bend the tip rigid portion 34. Can be oriented in the desired direction.
- the tip rigid portion 34 will be described in detail with reference to FIGS. 2 to 4 described later, but the observation optical system 40 and the illumination optical system 44 for taking an observation image in the body and an ultrasonic image for acquiring an ultrasonic image are obtained.
- the ultrasonic transducer 50 and the outlet 52 for drawing out the treatment tool inserted from the treatment tool introduction port 24 are provided.
- the universal cord 14 includes the signal cable 54, the signal cable 56, and the light guide 58 shown in FIGS. 3 and 4 to be described in detail.
- a connector is provided at an end of the universal cord 14 (not shown).
- This connector is connected to a predetermined system configuration device that constitutes an endoscopic system such as a processor device and a light source device.
- the system configuration device supplies the endoscope 1 with electric power, control signals, illumination light, and the like necessary for operating the endoscope 1.
- the observation image data acquired by the observation optical system 40 and the ultrasonic image data acquired by the ultrasonic transducer 50 are transmitted from the endoscope 1 to the system configuration device.
- the observation image and the ultrasonic image transmitted to the system configuration device are displayed on the monitor and can be observed by the practitioner or the like.
- the configuration of the operation unit 10 is not limited to the mode shown in FIG.
- a pair of angle knobs may be provided instead of the angle lever 16, and the curved portion 32 may be curved in the vertical direction and the horizontal direction by rotating the pair of angle knobs.
- the operation unit 10 may be provided with an air supply / water supply button, and the air supply / water supply button may be operated to supply a gas such as air or a cleaning liquid to the tip rigid portion 34.
- FIG. 2 is a perspective view of the tip rigid portion 34 of the first embodiment.
- FIG. 3 is an exploded perspective view of the tip rigid portion 34 of the first embodiment.
- FIG. 4 is a cross-sectional view of the tip rigid portion 34 of the first embodiment.
- the Z direction in the figure is a direction parallel to the longitudinal axis 38 of the tip rigid portion 34 (insertion portion 12).
- the Z (+) direction side in the Z direction is the tip end side of the tip rigid portion 34
- the Z ( ⁇ ) direction side is the base end side of the tip rigid portion 34.
- the Y direction in the figure corresponds to the first direction of the present invention perpendicular to the Z direction, and in the present embodiment, it is the vertical direction in each figure.
- the Y (+) direction side, which is one direction side in the Y direction is the upper direction in the figure
- the Y (-) direction side which is the other direction side opposite to the one direction side in the Y direction
- the X direction in the figure corresponds to the second direction of the present invention which is perpendicular to both the Z direction and the Y direction.
- the tip rigid portion 34 is configured by combining an ultrasonic block component 60, a channel block component 70, and an optical system block component 80 (particularly, see FIG. 3).
- the tip rigid portion 34 has an ultrasonic mounting portion 34a and a lead-out port forming portion 34b (first surface of the present invention) from the tip side to the proximal end side of the tip rigid portion 34. (Corresponding to the forming portion) and the main body portion 34c (see FIGS. 2 and 4).
- the ultrasonic block component 60 is formed of an insulating material having an insulating property, for example, a resin material such as plastic such as polysulfone and polyetherimide.
- the ultrasonic block component 60 includes an ultrasonic mounting portion 34a and an optical system block component mounting portion 62 from the tip end side to the base end side (see FIG. 3).
- the ultrasonic mounting portion 34a and the optical system block component mounting portion 62 are integrally formed.
- the ultrasonic transducer 50 is on the Y ( ⁇ ) direction side with respect to the longitudinal axis 38. It is installed in a forward leaning (tilted) posture.
- the ultrasonic transducer 50 is a convex type having an ultrasonic transmitting / receiving surface in which ultrasonic vibrators for transmitting / receiving ultrasonic waves are arranged in a curved shape along the direction of the longitudinal axis 38.
- the ultrasonic transducer 50 acquires data for generating an ultrasonic image of lymph nodes.
- the number of ultrasonic transducers constituting the ultrasonic transducer 50 is not limited.
- the region of the proximal end portion of the ultrasonic mounting portion 34a on the Y ( ⁇ ) direction side is directed toward the proximal end side [Z ( ⁇ ) direction side].
- the optical system block component mounting portion 62 extends.
- a locking portion 64 for locking the locked portion 73 of the channel block component 70 described later is formed ( (See FIG. 4).
- the locking portion 64 has, for example, a locking claw that constitutes a snap fit.
- the optical system block component mounting portion 62 is a divided portion on the Y (-) direction side of the two divided portions (upper and lower divided into two) in which the outlet forming portion 34b and the main body portion 34c are divided into two in the Y direction, that is, the lower portion. It has a substantially semi-cylindrical shape corresponding to the divided portion on the half side (see FIG. 3). Therefore, the optical system block component mounting portion 62 has a mounting portion opening 65 that opens in the Y (+) direction side.
- the mounting portion opening 65 is formed parallel to the XZ plane and along the Z direction.
- a signal cable 54 for connecting the ultrasonic transducer 50 and the system configuration device described above is arranged inside the mounting portion opening 65 of the optical system block component mounting portion 62.
- the optical system block component mounting portion 62 is formed with a pair of guide portions 66 forming a mounting portion opening 65 and a pair of guide portions 66 extending in the Z ( ⁇ ) direction along the mounting portion opening 65. Has been done.
- An optical system block component 80 which will be described later, is attached to the pair of guide portions 66 while sliding in the Z direction. As a result, the optical system block component 80 is attached to the optical system block component attachment portion 62, that is, the ultrasonic block component 60 via the pair of guide portions 66.
- the channel block component 70 constitutes the outlet forming portion 34b together with the optical system block component 80 described later, and is made of a known metal material.
- the channel block component 70 is parallel to the outlet 52 of the treatment tool opened in the Y (+) direction and the XZ plane in which the outlet 52 is open and in the Z direction (including the longitudinal axis 38, the same applies hereinafter). ), With a substantially rectangular opening forming surface 71.
- the puncture needle 100 used for collecting lymph node tissue will be described as an example of a treatment tool.
- a pair of flange surfaces 72 parallel to the XZ surface are formed along the Z direction at both ends of the opening forming surface 71 in the X direction (see FIG. 3).
- the pair of flange surfaces 72 are used for attaching the channel block component 70 to the optical system block component 80, and extend outward (X direction) from both ends of the opening forming surface 71 in the X direction.
- a locked portion 73 that engages with the locking portion 64 of the ultrasonic mounting portion 34a is formed on the tip end side of the channel block component 70 (see FIGS. 3 and 4).
- the locked portion 73 has, for example, an engaging hole with which the locking claw of the locking portion 64 is engaged.
- a pipeline 74 inside the block is formed inside the channel block component 70.
- the inner block line 74 constitutes the line of the present invention together with the treatment tool insertion channel 23.
- the tip end side of the block inner conduit 74 is connected to the outlet 52, and the proximal end side of the block inner conduit 74 is connected to the treatment tool insertion channel 23 inserted through the insertion portion 12.
- the tip of the puncture needle 100 inserted from the treatment tool introduction port 24 is guided to the outlet 52 via the treatment tool insertion channel 23 and the inner tube line 74 of the block, and is led out from the outlet 52.
- the optical block component 80 is made of a resin material like the ultrasonic block component 60.
- the optical system block component 80 is a divided portion on the Y (+) direction side of the two divided portions in which the outlet forming portion 34b and the main body portion 34c are divided into two in the Y direction (upper and lower two divisions), that is, the upper half side. It has a shape corresponding to the divided part of.
- the optical system block component 80 includes a pair of channel block component mounting portions 81 provided at intervals in the X direction from the tip end side to the base end side, and an optical system accommodating portion 82 (FIG. 6). 3).
- the pair of channel block component mounting portions 81 and the optical system accommodating portion 82 are integrally formed.
- the pair of channel block component mounting portions 81 are located at a position one step lower than the apex on the Y (+) direction side of the optical system accommodating portion 82, that is, with respect to the apex when the optical system block component 80 is viewed from the X direction side. It extends from the position on the Y ( ⁇ ) direction side to the tip side [Z (+) direction side] of the optical system accommodating portion 82.
- a space for mounting the channel block component 70 is secured between the pair of channel block component mounting portions 81.
- a pair of flat surfaces 81a and a pair of support surfaces 81b are formed at the ends of the pair of channel block component mounting portions 81 on the Y (+) direction side (see FIG. 3).
- the pair of planes 81a have a shape parallel to the XZ plane and along the Z direction.
- the pair of support surfaces 81b are surfaces parallel to the pair of planes 81a.
- the pair of support surfaces 81b are located at positions shifted from each of the pair of planes 81a to the above-mentioned space side, and Y (-) by the thickness of the pair of flange surfaces 72 in the Y direction with respect to the pair of planes 81a. It is formed at a low position on the directional side.
- the pair of support surfaces 81b support the pair of flange surfaces 72 from both side sides in the X direction. Therefore, the channel block component 70 is slidably supported in the Z direction between the pair of channel block component mounting portions 81 via the pair of flange surfaces 72 and the pair of support surfaces 81b. As a result, the channel block component 70 can be attached to the optical system block component 80 while sliding in the Z direction. Then, the channel block component 70 is adhesively fixed to the optical system block component 80.
- the opening forming surface 71 and the pair of planes 81a form a continuous plane 90 (corresponding to the first surface of the present invention) (see FIG. 2).
- the continuous plane 90 is a plane parallel to the XZ plane and along the Z direction, and constitutes a part of the outer peripheral surface of the tip rigid portion 34.
- the outlet 52 is opened in the flat continuous flat surface 90, but is opened in a surface (first surface) having various shapes such as a curved surface, an inclined surface, or an uneven surface. May be good.
- the optical system storage unit 82 has a substantially semi-cylindrical shape, and has a convex surface 84 and a stepped surface 85.
- the convex surface 84 corresponds to the second surface of the present invention, and constitutes a part of the outer peripheral surface of the tip rigid portion 34 (optical system accommodating portion 82).
- the convex surface 84 is located on the Y (+) direction side of the continuous plane 90 and has a shape along the Z direction.
- the convex surface 84 may also be formed in various shapes such as a curved surface, an inclined surface, or an uneven surface.
- the stepped surface 85 is a slope connecting the base end side of the continuous plane 90 and the tip end side of the convex surface 84, and constitutes a part of the outer peripheral surface of the tip rigid portion 34.
- the slope referred to here also includes a vertical plane having an inclination angle of 90 ° with respect to the Z direction.
- the step surface 85 is provided with an observation window 40a of the observation optical system 40 and an illumination window 44a of the pair of illumination optical systems 44.
- the observation optical system 40 includes an observation window 40a provided on the stepped surface 85, a lens system 40b provided in the optical system storage portion 82, and an image pickup element 40c.
- the image sensor 40c is a CCD (Charge Coupled Device) type or CMOS (Complementary Metal Oxide Semiconductor) type image sensor, and images an observation image captured from the observation window 40a via the lens system 40b. Then, the image pickup device 40c outputs the image pickup signal of the observation image to the system configuration device via the signal cable 56 inserted into the insertion section 12.
- the illumination optical system 44 is provided on both sides of the observation optical system 40 in the X direction, and includes an illumination window 44a provided on the stepped surface 85 and a light guide 58 inserted into the insertion portion 12. An exit end of the light guide 58 is arranged behind each illumination window 44a. As a result, the illumination light supplied from the system configuration device to each light guide 58 is emitted from each illumination window 44a.
- the optical system block component 80 is attached to the optical system block component 60 with the channel block component 70 attached, while sliding in the Z direction with respect to the optical system block component attachment portion 62 of the ultrasonic block component 60 via a pair of guide portions 66. Be done. At this time, the locking portion 64 of the ultrasonic mounting portion 34a locks the locked portion 73 of the channel block component 70. As a result, the movement of the channel block component 70 and the optical system block component 80 in the Z direction with respect to the ultrasonic block component 60 is restricted, and the channel block component 70 is assembled to the ultrasonic block component 60.
- the tip end portion of the curved portion 32 is externally fitted and fixed to the base end portions of both the optical system storage portion 82 and the optical system block component mounting portion 62 (see FIG. 4).
- the optical system accommodating portion 82 and the optical system block component mounting portion 62 are held inseparably in the Y direction by the curved portion 32.
- the optical system block component 80 is assembled to the ultrasonic block component 60.
- the ultrasonic block component 60, the channel block component 70, and the optical system block component 80 are combined to form the tip rigid portion 34.
- the ultrasonic transducer 50, the outlet 52, and the stepped surface 85 (observation window 40a) are arranged in order from the tip side to the base end side. That is, the outlet 52 is arranged between the ultrasonic transducer 50 and the observation window 40a. Therefore, the puncture of the lymph node from the bronchial wall surface by the puncture needle 100 can be observed by the observation optical system 40.
- the tip rigid portion 34 of the present embodiment is the proximal end portion of the ultrasonic transducer 50 on the Z ( ⁇ ) direction side with respect to the bronchial wall surface, that is, the puncture needle when the ultrasonic image of the lymph node is acquired by the endoscope 1. It has a shape that can increase the contact area of the base end portion on the side of the outlet 52 from which 100 is derived. Hereinafter, this shape will be specifically described.
- FIG. 5 is a perspective view of the tip rigid portion 34 including the tangent line LT.
- FIG. 6 is a side view of the tip rigid portion 34 including the tangent LT.
- the shape of the tip rigid portion 34 capable of increasing the contact region of the proximal end portion of the ultrasonic transducer 50 with respect to the bronchial wall surface is effectively formed by the tangent LT and the ultrasonic transducer 50. It is defined using the angle ⁇ 1.
- the tangent line LT is a line that is in contact with the ultrasonic transducer 50 and at the position (vertex) on the most Y (+) direction side with respect to the stepped surface 85.
- the point where the tangent line LT contacts the ultrasonic transducer 50 is defined as the contact point P1 (corresponding to the first intersection of the present invention)
- the point where the tangent line LT contacts the stepped surface 85 is defined as the contact point P2.
- the tip rigid portion 34 When the tip rigid portion 34 is viewed from the X direction side as shown in FIG. 6, when the tip rigid portion 34 is brought into contact with the bronchial wall surface, the contacts P1 and the contact P2 come into contact with the bronchial wall surface as shown by the tangent line LT. In this case, the region between the contact point P1 and the contact point P2 in the tip rigid portion 34 becomes a region where it is difficult to contact the bronchial wall surface, and conversely, the region on the tip end side of the contact point P1 with respect to the bronchial wall surface. It is an area that is easy to contact.
- the region closer to the distal end side than the contact point P1 is likely to come into contact with the bronchial wall surface, and conversely, the region closer to the proximal end side than the contact point P1 is less likely to come into contact with the bronchial wall surface. ..
- the shape of the tip rigid portion 34 is adjusted so that the contact P1 is included in the range of 1/3 of the base end side of the effective angle ⁇ 1 (the range of the angle ⁇ 2 in the figure).
- the adjustment of the shape of the tip rigid portion 34 includes the adjustment of the shape, mounting position, and posture of the ultrasonic transducer 50, and the adjustment of the shape, formation position, and inclination angle of the stepped surface 85. It is more preferable that the contact P1 is included in the range of 1/4 of the effective angle ⁇ 1 on the proximal end side.
- an ultrasonic transducer is used.
- the region between the alternate long and short dash line R1a and the contact point P1 in the proximal end portion of 50 can be reliably brought into contact with the bronchial wall surface (see FIG. 6). That is, a part of the base end portion of the ultrasonic transducer 50 can be surely brought into contact with the bronchial wall surface. As a result, the contact area of the proximal end portion of the ultrasonic transducer 50 with respect to the bronchial wall surface can be increased.
- the contact region of the proximal end portion of the ultrasonic transducer 50 with respect to the bronchial wall surface can be increased more.
- the contact P1 is included in the range of 1/3 of the proximal end side of the effective angle ⁇ 1 of the ultrasonic transducer 50.
- the tip rigid portion 34 of the second embodiment secures operability such as insertability of the endoscope 1 by shortening the length of the tip rigid portion 34 by adjusting the shape (angle) of the inner tube line 74 in the block. , The insertion force of the puncture needle 100 is reduced, and the load applied from the puncture needle 100 to the channel block component 70 is prevented from increasing. Since the tip-hardened portion 34 of the second embodiment has basically the same configuration as the tip-hardened portion 34 of the first embodiment, the same reference numerals are given to those having the same function or configuration as those of the first embodiment. The description thereof will be omitted, and the description of the same effect as that of the first embodiment will be omitted.
- FIG. 7 is a cross-sectional view of the tip rigid portion 34 of the endoscope 1 of the second embodiment.
- the inner block line 74 has a shape in which the tip rigid portion 34 is bent in two steps when viewed from the X direction side.
- the inner block line 74 is composed of a first line 74a and a second line 74b.
- the first pipeline 74a corresponds to the tip end portion and the first tip end portion of the pipeline of the present invention, and is connected to the outlet 52 in the channel block component 70.
- the second pipeline 74b corresponds to the second tip portion of the present invention, and is provided on the proximal end side of the first pipeline 74a.
- the tip of the treatment tool insertion channel 23 is connected to the second conduit 74b.
- the angle ⁇ 3 (corresponding to the first angle of the present invention) formed by the center line L2A of the first pipeline 74a and the longitudinal axis 38 is set from 20 ° to 35 °.
- the angle ⁇ 3 is reduced, the length of the inner pipe line 74 in the block from the tip of the treatment tool insertion channel 23 to the outlet 52 becomes longer, so that the tip rigid portion 34 becomes longer and the endoscope 1 becomes longer. It may affect operability such as insertability.
- the angle ⁇ 3 becomes larger, the load applied to the channel block component 70 from the puncture needle 100 inserted in the inner block passage 74 increases. Therefore, in the second embodiment, the angle ⁇ 3 is set from 20 ° to 35 °.
- the angle ⁇ 4 (corresponding to the second angle of the present invention) formed by the center line L2B of the second pipeline 74b and the longitudinal axis 38 is set to be 5 ° to 20 ° and smaller than the angle ⁇ 3. .. If the angle ⁇ 4 of the second pipeline 74b is made the same as the angle ⁇ 3 of the first pipeline 74a, the width of the inner pipeline 74 in the block increases in the Y direction, that is, the thickness of the tip rigid portion 34 in the Y direction. May increase and the tip diameter becomes thicker, which may affect operability such as insertability of the endoscope 1. Therefore, by making the angle ⁇ 4 of the second pipeline 74b smaller than the angle ⁇ 3 of the first pipeline 74a, an increase in the thickness of the tip rigid portion 34 in the Y direction can be suppressed.
- the operability such as the insertability of the endoscope 1 is ensured by shortening the length of the tip rigid portion 34. It is possible to prevent an increase in the load applied from the puncture needle 100 to the channel block component 70. Further, by setting the angle ⁇ 4 to an angle of 5 ° to 20 ° and smaller than the angle ⁇ 3, operability such as insertability of the endoscope 1 is ensured. Further, by bending the inner block line 74 in two steps, the insertion force of the puncture needle 100 can be reduced as compared with the case where the inner block line 74 is bent in one step.
- the tip rigid portion 34 of the endoscope 1 according to the third embodiment of the present invention will be described.
- the ultrasonic transducer 50, the outlet 52, and the stepped surface 85 are arranged from the tip side to the proximal end side, so that the bronchus by the puncture needle 100 is provided.
- the puncture of the lymph node from the wall surface can be observed by the observation optical system 40.
- the tip rigid portion 34 of the third embodiment specifically defines the conditions for surely observing the above-mentioned lymph node puncture with the observation optical system 40. Since the tip-hardened portion 34 of the third embodiment has basically the same configuration as the tip-hardened portion 34 of each of the above-described embodiments, the same reference numerals are given to those having the same function or configuration as each of the above-described embodiments. Therefore, the description thereof will be omitted, and the description of the same effect as that of each of the above embodiments will be omitted.
- FIG. 8 is a cross-sectional view of the tip rigid portion 34 of the endoscope 1 of the third embodiment.
- the intersection P3 (corresponding to the second intersection of the present invention) between the tangent line LT and the center line L2A of the first pipeline 74a is a contact point. It is located within a range W indicating a position on the proximal end side of the tip rigid portion 34 with respect to P1, more preferably between the ultrasonic transducer 50 and the observation window 40a.
- the intersection P3 is closer to the base end side of the tip rigid portion 34 than the contact point P1. To position.
- intersection P3 corresponds to the position where the puncture needle 100 led out from the outlet 52 starts puncturing the lymph node from the bronchial wall surface in a state where the ultrasonic transducer 50 is in contact with the bronchial wall surface. Then, by locating the intersection P3 within the range W, that is, in front of the observation window 40a, the puncture of the lymph node from the bronchial wall surface by the puncture needle 100 can be reliably observed by the observation optical system 40.
- the tip rigid portion 34 of the endoscope 1 according to the fourth embodiment of the present invention makes it possible for the observation optical system 40 to observe the contact of the ultrasonic transducer 50 with respect to the bronchial wall surface. Since the tip-hardened portion 34 of the fourth embodiment has basically the same configuration as the tip-hardened portion 34 of each of the above-described embodiments, the same reference numerals are given to those having the same function or configuration as each of the above-described embodiments. Therefore, the description thereof will be omitted, and the description of the same effect as that of each of the above embodiments will be omitted.
- FIG. 9 is a cross-sectional view of the tip rigid portion 34 of the endoscope 1 of the fourth embodiment.
- the ultrasonic transducer 50 when viewed from the X direction side, is within the visual field range of the observation optical system 40 indicated by the symbol VA. It is included. Thereby, the contact of the ultrasonic transducer 50 with respect to the bronchial wall surface, particularly the proximal end portion thereof, can be observed by the observation optical system 40.
- the center point C of the observation window 40a is Y more than the ultrasonic transducer 50. It is located on the (+) direction side.
- the ultrasonic transducer 50 can be included in the field range of the observation optical system 40, so that the contact of the ultrasonic transducer 50 with respect to the bronchial wall surface can be observed.
- the tip rigid portion 34 of the endoscope 1 according to the fifth embodiment of the present invention allows the puncture needle 100 to be inserted at an appropriate angle with respect to the drawing surface (lymph node 200) of the ultrasonic transducer 50. Since the tip-hardened portion 34 of the fifth embodiment has basically the same configuration as the tip-hardened portion 34 of each of the above-described embodiments, the same reference numerals are given to those having the same function or configuration as each of the above-described embodiments. Therefore, the description thereof will be omitted, and the description of the same effect as that of each of the above embodiments will be omitted.
- FIG. 10 is a cross-sectional view of the tip rigid portion 34 of the endoscope 1 of the fifth embodiment.
- FIG. 11 is a diagram simply showing the puncture of the lymph node 200 by the puncture needle 100.
- reference numeral DA indicates the diameter of the lymph node 200, and here, for example, ⁇ 20 mm.
- reference numeral d indicates the distance in the Z direction between the base end of the ultrasonic transducer 50 and the puncture needle 100 (the center of the outlet 52), and is set to, for example, 5 mm here.
- the effective angle ⁇ 1 is set to, for example, 90 °.
- the tip rigid portion 34 of the fifth embodiment has the center line L4 of the effective angle ⁇ 1 of the ultrasonic transducer 50 and the center of the first conduit 74a when viewed from the X direction side.
- the position and orientation of the ultrasonic transducer 50 and the angle ⁇ 3 (see FIG. 7) of the first conduit 74a are adjusted.
- the insertion angle of the puncture needle 100 with respect to the drawing surface (lymph node 200) of the ultrasonic transducer 50 can be adjusted to ⁇ 5, so that the insertion angle of the puncture needle 100 with respect to the drawing surface becomes a steep angle or a shallow angle. It is prevented that it becomes too much. As a result, the puncture needle 100 can be inserted at an appropriate angle with respect to the drawing surface of the ultrasonic transducer 50.
- the tip-hardened portion 34 of the sixth embodiment is intended to ensure the insertability of the tip-hardened portion 34 and reduce the burden on the patient. Since the tip-hardened portion 34 of the sixth embodiment has basically the same configuration as the tip-hardened portion 34 of each of the above-described embodiments, the same reference numerals are given to those having the same function or configuration as each of the above-described embodiments. Therefore, the description thereof will be omitted, and the description of the same effect as that of each of the above embodiments will be omitted.
- FIG. 12 is a cross-sectional view of the tip rigid portion 34 of the endoscope 1 of the sixth embodiment.
- the tip rigid portion 34 of the sixth embodiment is formed with a protruding portion 63 protruding in the Y ( ⁇ ) direction side of the main body portion 34c when viewed from the X direction side.
- the protruding portion 63 extends from the opening region of the outlet 52 in the outlet forming portion 34b of the tip rigid portion 34, for example, from the center of the outlet 52 indicated by the center line L5 to the tip side of the ultrasonic mounting portion 34a. It is formed.
- the protrusion 63 may be formed from an arbitrary position in the opening region of the outlet 52 to the tip end side of the ultrasonic mounting portion 34a. Further, the protruding portion 63 may be formed only on the ultrasonic mounting portion 34a. That is, the protruding portion 63 may be formed at least on the ultrasonic mounting portion 34a.
- the height ⁇ h of the protruding portion 63 is set to, for example, 2.7 mm.
- the insertability of the tip rigid portion 34 (insertion portion 12) deteriorates, but in the sixth embodiment, only the ultrasonic transducer 50 is tilted forward. Therefore, insertability is improved. As a result, the insertability of the tip rigid portion 34 (insertion portion 12) into the patient's body is improved.
- the protrusion 63 has a two-stage inclined surface 63a, which has a different inclination angle with respect to the longitudinal axis 38 from the base end side to the tip side of the protruding portion 63. It has 63b.
- the inclined angle of the inclined surface 63a on the distal end side is smaller than the inclined angle of the inclined surface 63b on the proximal end side.
- the inclined surfaces 63a and 63b which are flat portions on the protruding portion 63 By forming the inclined surfaces 63a and 63b which are flat portions on the protruding portion 63 in this way, the contact area between the protruding portion 63 and the internal wall surface such as the bronchial wall surface is increased, and the contact pressure of the protruding portion 63 with respect to the internal wall surface is increased. Can be reduced. Further, in the sixth embodiment, since the inclined surface 63a on the distal end side is formed substantially parallel to the longitudinal axis 38, the contact pressure of the protruding portion 63 with respect to the internal wall surface can be further reduced. As a result, the burden on the patient can be further reduced.
- the protruding portion 63 is formed with two steps of inclined surfaces 63a and 63b, but three or more steps of inclined surfaces may be formed. Also in this case, the inclination angle of each inclined surface gradually decreases toward the tip end side of the protruding portion 63. Further, it is preferable that the inclined surface on the most tip side is formed substantially parallel to the longitudinal axis 38.
- FIG. 13 is a top view of the tip rigid portion 34 of the endoscope 1 of the first to sixth embodiments.
- FIG. 14 is a top view showing a modified example of the tip rigid portion 34 of the endoscope 1 of the sixth embodiment.
- the tip rigid portion 34 of each of the above embodiments is an ultrasonic mounting portion 34a and an outlet forming portion 34b when viewed from the Y (+) direction side (corresponding to the first direction side of the present invention).
- the widths in the X direction are substantially the same.
- the width WX1 (for example, 5) of the ultrasonic mounting portion 34a in the X direction when viewed from the Y (+) direction side. .7 mm) is formed smaller than the width WX2 (for example, 6.4 mm) of the outlet forming portion 34b in the X direction.
- the tip rigid portion 34 has an inclined surface 34d (in the present invention) connecting the base end side of the ultrasonic mounting portion 34a and the tip end side of the outlet port forming portion 34b (in the present invention). (Corresponding to the connecting inclined surface) is formed.
- the ultrasonic mounting portion 34a By narrowing the width WX1 of the ultrasonic mounting portion 34a in this way, only the ultrasonic mounting portion 34a can be miniaturized and inserted into the peripheral bronchus. Further, by forming the inclined surface 34d between the ultrasonic mounting portion 34a and the outlet forming portion 34b, the insertability can be ensured even when only the ultrasonic mounting portion 34a is miniaturized.
- the tip rigid portion 34 of the endoscope 1 according to the seventh embodiment of the present invention will be described.
- the balloon and the protrusions, grooves, and conduits for attaching the balloon are not provided on the tip rigid portion 34, the diameter of the tip rigid portion 34 can be reduced and the length in the Z direction can be shortened. It can be planned.
- the insertability of the insertion portion 12 is improved, the burden on the patient is reduced, and the sterility is guaranteed by a sterilizer that performs cleaning and disinfection.
- the puncture needle 100 led out from the outlet 52 may come close to the ultrasonic transducer 50.
- the tip rigid portion 34 of the seventh embodiment has a shape capable of ensuring a clearance between the puncture needle 100 led out from the outlet 52 and the ultrasonic transducer 50. Since the tip-hardened portion 34 of the seventh embodiment has basically the same configuration as the tip-hardened portion 34 of each of the above-described embodiments, the same reference numerals are given to those having the same function or configuration as each of the above-described embodiments. Therefore, the description thereof will be omitted, and the description of the same effect as that of each of the above embodiments will be omitted.
- FIG. 15 is a cross-sectional view of the tip rigid portion 34 of the endoscope 1 of the seventh embodiment.
- the tip rigid portion 34 of the seventh embodiment has the Y-direction position of the outlet 52 and the ultrasonic transducer as shown by the alternate long and short dash line L6 in the figure when viewed from the X direction side.
- the positions of the vertices P4 on the Y (+) direction side of 50 are aligned.
- the tip of the puncture needle 100 led out from the outlet 52 passes through a position on the Y (+) direction side of the apex P4 of the ultrasonic transducer 50, so that the tip of the puncture needle 100 and the ultrasonic transducer 50 Clearance is ensured between them.
- the tip rigid portion 34 is configured by combining the ultrasonic block component 60, the channel block component 70, and the optical system block component 80, but may be composed of four or more block components. .. Further, a plurality or all of the block parts may be integrally formed. Therefore, the present invention can be applied to various tip rigid portions 34 having an ultrasonic mounting portion 34a, an outlet forming portion 34b, and a main body portion 34c.
- the outlet 52 is provided between the ultrasonic transducer 50 and the stepped surface 85 (observation window 40a), but the stepped surface 85
- the outlet 52 may be provided on the proximal end side of the (observation window 40a).
- the endoscope 1 (ultrasonic bronchoscope) for examining the lymph nodes of the bronchus has been described as an example, but the endoscope 1 of the present invention is not limited to the ultrasonic bronchoscope. It is also applicable to ultrasonic gastroscopes. That is, the present invention is also applicable to various ultrasonic endoscopes and the tip rigid portion 34 (tip unit) provided on the tip side of the insertion portion 12 thereof. Further, the type of treatment tool used in the ultrasonic endoscope is not limited to the puncture needle 100, and various known treatment tools can be used. Further, the present invention can be applied to an ultrasonic endoscope not provided with an observation optical system 40 and an illumination optical system 44 and a rigid portion at the tip thereof.
- Ultrasonic endoscope (endoscope) 10 Operation part 12 Insertion part 14 Universal cord 16 Angle lever 22 Suction button 23 Treatment tool insertion channel 24 Treatment tool introduction port 30 Flexible part 32 Curved part 34 Tip rigid part 34a Ultrasonic mounting part 34b Outlet port forming part 34c Main body part 34d Inclined Surface 38 Longitudinal axis 40 Observation optical system 40a Observation window 40b Lens system 40c Imaging element 44 Illumination optical system 44a Illumination window 50 Ultrasonic transducer 52 Outlet port 54 Signal cable 56 Signal cable 58 Light guide 60 Ultrasonic block component 62 Optical system block component Mounting part 63 Protruding part 63a Inclined surface 63b Inclined surface 64 Locking part 65 Mounting part Opening 66 Guide part 70 Channel block part 71 Opening forming surface 72 Flange surface 73 Locked part 74 Block inner pipeline 74a First pipeline 74b 2 Pipeline 80 Optical system block part 81 Channel block part mounting part 81a Flat surface 81b Support surface 82
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Abstract
Description
図1は、超音波内視鏡1の全体図である。図1に示すように、超音波内視鏡1(以下、単に「内視鏡1」と略す)は、病変部(観察部位、検査部位、診察部位でも可)の細胞組織の採取などに用いられる。なお、本実施形態では病変部として気管支のリンパ節を例に挙げて説明を行う。
図2は、第1実施形態の先端硬性部34の斜視図である。図3は、第1実施形態の先端硬性部34の分解斜視図である。図4は、第1実施形態の先端硬性部34の断面図である。
次に、本発明の第2実施形態の内視鏡1の先端硬性部34について説明を行う。この第2実施形態の先端硬性部34は、ブロック内管路74の形状(角度)を調整することで、先端硬性部34の長さ短縮化による内視鏡1の挿入性など操作性の確保、穿刺針100の挿通力の低減、及び穿刺針100からチャンネルブロック部品70に加えられる荷重の増加防止を実現している。なお、第2実施形態の先端硬性部34は、第1実施形態の先端硬性部34と基本的に同じ構成であるので、上記第1実施形態と機能又は構成上同一のものについては同一符号を付してその説明は省略し、上記第1実施形態と同一の効果についても説明は省略する。
次に、本発明の第3実施形態の内視鏡1の先端硬性部34について説明を行う。上記各実施形態の先端硬性部34では、その先端側から基端側に向かって超音波トランスデューサ50、導出口52、及び段差面85(観察窓40a)を配置することで、穿刺針100による気管支壁面からのリンパ節の穿刺を観察光学系40で観察可能にしている。
次に、本発明の第4実施形態の内視鏡1の先端硬性部34について説明を行う。この第4実施形態の先端硬性部34は、気管支壁面に対する超音波トランスデューサ50の接触を観察光学系40で観察可能にしている。なお、第4実施形態の先端硬性部34は、上記各実施形態の先端硬性部34と基本的に同じ構成であるので、上記各実施形態と機能又は構成上同一のものについては同一符号を付してその説明は省略し、上記各実施形態と同一の効果についても説明は省略する。
次に、本発明の第5実施形態の内視鏡1の先端硬性部34について説明を行う。この第5実施形態の先端硬性部34は、超音波トランスデューサ50の描出面(リンパ節200)に対して穿刺針100を適切な角度で挿入可能にしている。なお、第5実施形態の先端硬性部34は、上記各実施形態の先端硬性部34と基本的に同じ構成であるので、上記各実施形態と機能又は構成上同一のものについては同一符号を付してその説明は省略し、上記各実施形態と同一の効果についても説明は省略する。
次に、本発明の第6実施形態の内視鏡1の先端硬性部34について説明を行う。この第6実施形態の先端硬性部34は、先端硬性部34の挿入性確保と患者の負担低減とを図っている。なお、第6実施形態の先端硬性部34は、上記各実施形態の先端硬性部34と基本的に同じ構成であるので、上記各実施形態と機能又は構成上同一のものについては同一符号を付してその説明は省略し、上記各実施形態と同一の効果についても説明は省略する。
次に、本発明の第7実施形態の内視鏡1の先端硬性部34について説明を行う。上記各実施形態では、先端硬性部34にバルーンと、その取り付け用の突起、溝、及び管路とが設けられていないので、先端硬性部34の小径化及びZ方向の長さの短縮化が図れる。その結果、上記各実施形態では、挿入部12の挿入性向上、患者負担軽減、及び洗浄消毒を行う滅菌機での滅菌性の保証が実現される。しかしながら、この場合には、導出口52から導出された穿刺針100が超音波トランスデューサ50に近接するおそれがある。
上記各実施形態では、先端硬性部34にバルーン管路を備えない内視鏡1を例に挙げて説明したが、先端硬性部34にバルーン管路を備える内視鏡1にも本発明を適用可能ある。
10 操作部
12 挿入部
14 ユニバーサルコード
16 アングルレバー
22 吸引ボタン
23 処置具挿通チャンネル
24 処置具導入口
30 軟性部
32 湾曲部
34 先端硬性部
34a 超音波取付部
34b 導出口形成部
34c 本体部
34d 傾斜面
38 長手軸
40 観察光学系
40a 観察窓
40b レンズ系
40c 撮像素子
44 照明光学系
44a 照明窓
50 超音波トランスデューサ
52 導出口
54 信号ケーブル
56 信号ケーブル
58 ライトガイド
60 超音波ブロック部品
62 光学系ブロック部品取付部
63 突出部
63a 傾斜面
63b 傾斜面
64 係止部
65 取付部開口
66 ガイド部
70 チャンネルブロック部品
71 開口形成面
72 フランジ面
73 被係止部
74 ブロック内管路
74a 第1管路
74b 第2管路
80 光学系ブロック部品
81 チャンネルブロック部品取付部
81a 平面
81b 支持面
82 光学系収納部
84 凸面
85 段差面
90 連続平面
100 穿刺針
200 リンパ節
C 中心点
DA 直径
d 間隔
L2A 中心線
L2B 中心線
L4 中心線
L5 中心線
L6 一点鎖線
LT 接線
P1 接点
P2 接点
P3 交点
P4 頂点
R1 照射範囲
W 範囲
WX1,WX2 幅
Δh 高さ
θ1 有効角度
θ2 角度
θ3 角度
θ4 角度
θ5 角度
θ6 角度
Claims (17)
- 挿入部の先端側に設けられた先端部本体と、前記先端部本体の先端側に設けられた超音波トランスデューサと、を備える超音波内視鏡において、
前記先端部本体の外周面が、
前記超音波トランスデューサの基端側に設けられ、前記挿入部の長手軸に沿った第1面と、
前記第1面の基端側に設けられ、前記長手軸に沿った第2面であって且つ前記第1面に対して前記長手軸に垂直な第1方向の一方向側に位置する第2面と、
前記第1面の基端側と前記第2面の先端側とを接続する段差面と、
を含み、
前記長手軸及び前記第1方向の双方に垂直な方向を第2方向とし、前記先端部本体を前記第2方向側から見た場合の前記超音波トランスデューサから発せられる超音波の照射範囲を示す角度を有効角度とし、前記超音波トランスデューサに接し且つ前記段差面に対して最も前記一方向側の位置で接する接線と、前記超音波トランスデューサとの交点を第1交点とした場合に、前記第1交点が前記有効角度の基端側1/3の範囲内に含まれる超音波内視鏡。 - 前記先端部本体の外周面に設けられ、前記一方向側に開口し且つ処置具が導出される導出口と、
前記先端部本体内で前記導出口に接続されており、前記処置具が挿通される管路と、
前記段差面に設けられた観察光学系の観察窓と、
を備え、
前記先端部本体を前記第2方向側から見た場合において、前記導出口に接続されている前記管路の先端部の中心線と、前記接線との交点である第2交点が、前記第1交点よりも前記先端部本体の基端側に位置する請求項1に記載の超音波内視鏡。 - 前記第2交点が、前記超音波トランスデューサと前記段差面との間に位置する請求項2に記載の超音波内視鏡。
- 前記先端部本体の外周面に設けられ、前記一方向側に開口し且つ処置具が導出される導出口と、
前記先端部本体内で前記導出口に接続されており、前記処置具が挿通される管路と、
を備え、
前記先端部本体を前記第2方向側から見た場合に、前記長手軸と前記管路の先端部とのなす角度が20°から35°である請求項1から3のいずれか1項に記載の超音波内視鏡。 - 前記管路の先端部が、前記導出口に接続される第1先端部と、前記第1先端部の基端側に設けられた第2先端部とを有し、
前記先端部本体を前記第2方向側から見た場合に、前記長手軸と前記第1先端部とのなす第1角度が20°から35°であり、前記長手軸と前記第2先端部とのなす第2角度が5°から20°であり且つ前記第1角度よりも小さい角度である請求項2から4のいずれか1項に記載の超音波内視鏡。 - 前記先端部本体を前記第2方向側から見た場合に、前記有効角度の中心線と、前記管路の先端部とのなす角度が15°~60°である請求項2から5のいずれか1項に記載の超音波内視鏡。
- 前記段差面に観察光学系の観察窓が設けられており、
前記観察光学系の視野範囲内に前記超音波トランスデューサが含まれる請求項1から6のいずれか1項に記載の超音波内視鏡。 - 前記先端部本体を前記第2方向側から見た場合に、前記観察窓の中心点が、前記超音波トランスデューサよりも前記一方向側に位置している請求項7に記載の超音波内視鏡。
- 前記段差面に、観察光学系の観察窓及び照明光学系の照明窓が設けられている請求項1から8のいずれか1項に記載の超音波内視鏡。
- 前記第1面に開口し且つ処置具が導出される導出口と、
前記段差面に設けられた観察光学系の観察窓と、
を備える請求項1から9のいずれか1項に記載の超音波内視鏡。 - 前記先端部本体が、
前記超音波トランスデューサが取り付けられた超音波取付部と、
前記超音波取付部の基端側に設けられ、前記第1面を有する第1面形成部と、
前記第1面形成部の基端側に設けられ、前記第2面を有する本体部と、
少なくとも前記超音波取付部に設けられ、前記本体部よりも前記一方向側とは反対の他方向側に突出した突出部と、
を備える請求項1から10のいずれか1項に記載の超音波内視鏡。 - 処置具が導出される導出口が前記第1面に開口しており、
前記突出部が、前記先端部本体を前記第2方向側から見た場合に、前記導出口の開口領域から前記超音波取付部の先端側に亘って形成されている請求項11に記載の超音波内視鏡。 - 前記先端部本体を前記第2方向側から見た場合に、前記突出部が、前記突出部の基端側から先端側に向かって、前記長手軸に対する傾斜角度が異なる2段以上の傾斜面を有し、
前記傾斜面の傾斜角度が、前記突出部の先端側に向かうのに従って次第に小さくなる請求項11又は12に記載の超音波内視鏡。 - 処置具が導出される導出口が前記第1面に開口しており、
前記先端部本体を前記第2方向側から見た場合に、前記導出口の前記第1方向の位置と、前記超音波トランスデューサの前記第1方向の頂点の位置と、が揃っている請求項1から13のいずれか1項に記載の超音波内視鏡。 - 前記先端部本体が、
前記超音波トランスデューサが取り付けられた超音波取付部と、
前記超音波取付部の基端側に設けられ、前記第1面と前記第1面に形成された処置具の導出口とを有する第1面形成部と、
前記第1面形成部の基端側に設けられ、前記第2面を有する本体部と、
を備え、
前記先端部本体を前記第1方向側から見た場合に、前記超音波取付部の前記第2方向の幅が前記第1面形成部の前記第2方向の幅よりも小さく形成されている請求項1から14のいずれか1項に記載の超音波内視鏡。 - 前記超音波取付部の基端側と前記第1面形成部の先端側とを接続する接続傾斜面を有する請求項15に記載の超音波内視鏡。
- 超音波内視鏡の挿入部の先端側に設けられた先端部本体と、前記先端部本体の先端側に設けられた超音波トランスデューサと、を備える超音波内視鏡の先端ユニットにおいて、
前記先端部本体の外周面が、
前記超音波トランスデューサの基端側に設けられ、前記挿入部の長手軸に沿った第1面と、
前記第1面の基端側に設けられ、前記長手軸に沿った第2面であって、且つ前記第1面に対して前記長手軸に垂直な第1方向の一方向側に位置する第2面と、
前記第1面の基端側と前記第2面の先端側とを接続する段差面と、
を含み、
前記長手軸及び前記第1方向の双方に垂直な方向を第2方向とし、前記先端部本体を前記第2方向側から見た場合の前記超音波トランスデューサから発せられる超音波の照射範囲を示す角度を有効角度とし、前記超音波トランスデューサに接し且つ前記段差面に対して最も前記一方向側の位置で接する接線と、前記超音波トランスデューサとの交点を第1交点とした場合に、前記第1交点が前記有効角度の基端側1/3の範囲内に含まれる超音波内視鏡の先端ユニット。
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