JP3462776B2 - The tip of the ultrasonic treatment endoscope - Google Patents

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a distal end portion of a treatment ultrasonic endoscope capable of performing a high level endoscopic treatment.

[0002]

2. Description of the Related Art An ultrasonic endoscope can be used not only as an inspection instrument but also as a therapeutic instrument because it can simultaneously obtain an optical observation of the mucosal surface in a body cavity and an ultrasonic tomographic image of the submucosa. It is useful for.

Therefore, a conventional ultrasonic endoscope is provided with a member for performing optical observation, a member for performing ultrasonic scanning, and a member for projecting a treatment tool such as an injection tool. ing.

[0004]

When performing treatment (endoscopic treatment) using an endoscope, it is necessary to determine whether or not two treatment tools can be projected from the endoscope at the same time. The types and scope of endoscopic procedures differ significantly. Therefore, it is desirable that an ultrasonic endoscope for performing an endoscopic treatment be provided with two sets of channels for projecting the treatment tool and projecting ports.

However, compared with a general endoscope, an ultrasonic endoscope in which members for ultrasonic scanning are additionally arranged is
Providing a member using a plurality of treatment tools in this way
This is difficult to achieve because the tip of the insertion part becomes extremely large and causes great pain to the patient.

Therefore, the present invention is directed to an ultrasonic endoscope for treatment in which two treatment tools can be projected at the same time to perform a high-level endoscopic treatment without the tip of the insertion portion becoming relatively large. It is intended to provide a tip.

[0007]

To achieve the above object, the distal end portion of the ultrasonic treatment endoscope according to the present invention has an annular ultrasonic transducer array for performing radial scanning at the distal end of the insertion portion. First and second treatment tool projecting ports, which are arranged around the axis and project the tip portions of the treatment tools passed through the first and second treatment tool insertion channels, respectively, are provided with the ultrasonic transducer array. It is characterized by being placed in front of and behind it.

Even if a treatment tool raising piece for adjusting the projecting direction of the treatment tool projecting from each of the treatment tool projecting openings by remote operation is arranged in at least one of the treatment tool projecting openings. Good.

Further, an optical observation window may be arranged side by side with one of the first and second treatment tool projecting ports, and a balloon which surrounds the ultrasonic transducer array portion and is inflated by liquid filling. May be attached.

Further, the ultrasonic transducer array may be arranged so as to perform radial scanning diagonally forward of the tip of the insertion portion.

[0011]

BEST MODE FOR CARRYING OUT THE INVENTION Embodiments of the present invention will be described with reference to the drawings. FIG. 3 is a plan view of the distal end portion of the ultrasonic endoscope according to the first embodiment of the present invention, FIG. 1 is its I-I sectional view, and FIG. 2 is II-II sectional view.

Tip body 2 connected to the tip of insertion section 1
An annular ultrasonic transducer array 5 for performing radial scanning is arranged in the middle part of the. The ultrasonic transducer array 5 is arranged so as to be tilted with respect to the axis 2a of the tip body 2. As a result, the ultrasonic scanning direction A is not perpendicular to the axis 2a of the tip body 2 but is oblique.

The ultrasonic transducer array 5 is provided so that a plurality of ultrasonic transducers arranged in a cylindrical shape are radially divided and the ultrasonic transducers sequentially transmit and receive ultrasonic waves, so-called radial scanning. Ultrasonic scanning is performed.

Since the surface of the ultrasonic transducer array 5 is slightly recessed from the surface of the tip end main body 2 due to its arrangement, the recessed portion is filled with, for example, polymethylpentene 6 which allows ultrasonic waves to pass therethrough. There is.

As shown in FIG. 3, the optical observation window 3 and the first treatment tool projecting port 4 are arranged on the rear side surface of the ultrasonic body array 5 of the tip end main body 2 with the axis line therebetween. The illumination window 23 and the second treatment tool projecting opening 24 are arranged side by side on the axis line on the side surface on the front side of the ultrasonic transducer array 5.

They are arranged at the front and rear positions of the ultrasonic transducer array 5 at a position where the ultrasonic scanning direction A faces obliquely forward. As shown in FIG. 2, the observation optical axis B is
It faces diagonally forward, which is similar to the ultrasonic scanning direction A. That is, the observation optical system is a front perspective type.

Inside the optical observation window 3, as shown in FIG. 2, an objective optical system 7 including a prism and a lens is combined.
Is arranged, and the image pickup surface of the solid-state image pickup device 8 is arranged at the image forming position of the object by the objective optical system 7. 9
Is a signal cable. An image guide fiber bundle may be used instead of the solid-state image sensor 8.

Inside the illumination window 23, the exit end of the light guide fiber bundle 29 for illuminating the subject is arranged. The observation window 3 and the illumination window 23 may be replaced with each other.

As shown in FIG. 1, in each of the treatment tool projecting ports 4 and 24, the treatment tool raising pieces 11 and 2 for adjusting the projecting direction of the distal end portion of the projecting treatment tools 100 and 200.
1 is arranged so as to be swingable around the support shafts 12 and 22, and the first and second treatment tool insertion channels 14 and 34, which are inserted and arranged in the insertion portion 1 over the entire length, are arranged in the rear thereof. The tip is connected.

Each of the treatment instrument raising pieces 11, 21 is swung by the operation wires 13, 33 which are operated by a remote operation from an operation section (not shown) connected to the proximal end of the insertion section 1. As a result, the protruding direction of the distal end portion of the treatment instrument 100, 200 inserted into each treatment instrument insertion channel 14, 34 changes.

The second treatment tool insertion channel 24,
The operation wire 33, the light guide fiber bundle 29, and the like are arranged so as to pass through the space inside the ultrasonic transducer array 5, and the tip end body is formed compact and small.

Using the ultrasonic treatment endoscope of the embodiment configured as described above, for example, as shown in FIG. The thread 300 that is ejected with the grasping forceps 200 protruding and piercing the damaged mucous membrane and using the puncture needle 100 as a guide.
5 is grasped by the grasping forceps 200 on the back side of the mucous membrane, and
By pulling back the puncture needle 100 and the grasping forceps 200 as shown in FIG. 5, a high level endoscopic treatment such as suturing a damaged mucous membrane can be performed.

[0023]

[0024]

[0025]

[0026]

According to the present invention, an annular ultrasonic transducer array for performing radial scanning is arranged around the axis of the tip of the insertion portion, and the treatment is passed through the first and second treatment instrument insertion channels. First and second for projecting the tip portion of the tool, respectively
By arranging the treatment tool projecting ports in front of and behind the ultrasonic transducer array, the tip of the insertion part does not become relatively large, and two treatment tools can be projected at the same time to achieve a high-level endoscopic effect. Treatment can be performed.

[Brief description of drawings]

FIG. 1 is a cross-sectional view of the distal end portion of the treatment ultrasonic endoscope according to the first embodiment of the present invention taken along the line I-I in FIG. 3.

FIG. 2 is a cross-sectional view taken along the line II-II in FIG. 3 of the distal end portion of the medical treatment endoscope according to the first embodiment of the present invention.

FIG. 3 is a plan view of the distal end portion of the medical treatment endoscope according to the first embodiment of the present invention.

FIG. 4 is a schematic view showing a state of endoscopic treatment using the ultrasonic treatment endoscope according to the first embodiment of the present invention.

FIG. 5 is a schematic diagram showing a state of endoscopic treatment using the ultrasonic treatment endoscope according to the first embodiment of the present invention.

[Explanation of symbols]

1 Insert 2 Tip body 3 Optical observation window 4,24 Treatment tool protruding port 5 Ultrasonic transducer array 11,21 Treatment tool raising piece 14,34 Treatment instrument insertion channel 100,200 treatment tool

─────────────────────────────────────────────────── ─── Continuation of the front page (56) Reference JP-A-63-130052 (JP, A) JP-A-1-300939 (JP, A) JP-A-1-300940 (JP, A) JP-A-2- 265534 (JP, A) JP 2-286143 (JP, A) JP 4-279141 (JP, A) JP 5-269133 (JP, A) JP 7-227394 (JP, A) JP-A-8-126644 (JP, A) JP-A-8-140976 (JP, A) JP-A-8-154940 (JP, A) JP-A-9-234182 (JP, A) Actual exploitation Sho-48-81689 (JP, U) Showa 48-96790 (JP, U) Special Table 5-505739 (JP, A) Special Table 7-505791 (JP, A) (58) Fields investigated (Int.Cl. ⁷⁾ , DB name) A61B 8/00

Claims (3)

(57) [Claims] 1. An annular ultrasonic transducer array for performing radial scanning is tilted with respect to the axial direction at an intermediate position of the tip of the insertion section having a straight axis so as not to project from the surface of the tip of the insertion section. Placed, and the above
Between the surface of the entry tip and the surface of the ultrasonic transducer array
First and second treatment tool projecting openings for filling the recesses formed in the upper part with an ultrasonic conductive agent and projecting the distal end portions of the treatment tools passed through the first and second treatment tool insertion channels, respectively. However, the ultrasonic endoscope for treatment is arranged in front of and behind the ultrasonic transducer array at a position where the ultrasonic scanning direction of the ultrasonic transducer array is directed obliquely forward. Tip of. 2. A treatment instrument raising piece for remotely adjusting the projecting direction of the treatment instrument projected from each of the treatment instrument projecting ports is arranged in at least one of the treatment instrument projecting ports. Item 2. A distal end portion of the ultrasonic treatment endoscope according to Item 1. 3. The distal end portion of the treatment ultrasonic endoscope according to claim 1, wherein an optical observation window is arranged side by side with one of the first and second treatment tool projecting ports.