JP4484044B2 - Ultrasound endoscope - Google Patents

Description

  The present invention provides an endoscope observation means having an observation visual field in front of the distal end hard portion at the distal end hard portion of the insertion portion, and a circumferential or arcuate ultrasonic scanning surface orthogonal to the axis of the distal end hard portion. The present invention relates to an ultrasonic endoscope provided with an electronic scanning ultrasonic observation means having

  The ultrasonic endoscope is configured to attach an endoscope observation means and an ultrasonic observation means to a distal end hard part of an insertion part into a body cavity or the like, and as a scanning mode by this ultrasonic observation means, A so-called electronic scanning type in which a large number of ultrasonic transducers are arranged in a predetermined direction and these ultrasonic transducers are sequentially driven has been widely used. An observation field of view in the endoscope observation means is a direct-view endoscope having a visual field in front of the distal end hard portion of the insertion portion, and the ultrasonic scanning surface by the ultrasonic observation means is in a radial direction, that is, in a circumferential shape. Or what was made into the circular arc shape made into the predetermined angle range is described in patent document 1, for example.

The ultrasonic endoscope disclosed in Patent Document 1 is inserted into a body cavity such as an upper digestive tract such as the esophagus and the duodenum and a lower digestive tract such as the large intestine, and the front of the insertion direction is observed by an endoscope observation means. As a result, when a region of interest such as a lesioned part is detected, the ultrasound observation means is positioned so as to face this region of interest, and information relating to the in-vivo tissue of the part can be acquired.
JP 2001-314403 A

  By the way, in the ultrasonic endoscope of the type described above, the number of ultrasonic transducers constituting the ultrasonic transducer array is several tens or more in terms of resolution. A cable is connected to each of the electrodes of each of the ultrasonic transducers. The connection of the cable is usually configured to be performed through a flexible substrate made of a resin film. And in patent document 1 mentioned above, it is set as the structure which divides | segments a flexible substrate into several sheets, extends each flexible substrate to the middle position of an insertion part, and connects with a cable. Here, the insertion portion has a structure in which the angle portion and the flexible portion are sequentially connected to the distal end hard portion equipped with the endoscope observation means and the ultrasonic observation means, and the connection between the flexible substrate and the cable is the angle portion. It is set as the position which passed through and entered the soft part. And the base end side edge part of the flexible substrate to which this cable is connected is in a free state.

  In this configuration, when the ultrasonic observation means is incorporated into the insertion portion, the ultrasonic transducer is inserted into the insertion portion in a state where the cable is connected to the flexible substrate in advance. The base end portion of the cable is inserted so as to be pulled from the base end side of the insertion portion until the array is disposed at the distal end of the insertion portion. And to ensure the stability of the cable connection to the flexible board, it is necessary to give the flexible board a certain amount of waist, so the edge part of the flexible board is inserted into the insertion part while being caught by another member. As a result, the insertion operability becomes poor, and if the cable is operated so as to be pulled in too strongly, there is a risk of disconnection of the cable.

  In addition, since the ultrasonic observation means and the endoscope observation means are incorporated in the insertion portion, the inside of the insertion portion has a high filling rate. And since the angle part is bent sharply by the bending operation, the end part is in a free state, and the flexible substrate with the waist is forcibly bent when the angle part is bent, and the end part is another member, For example, there is a risk of being pressed against the light guide that constitutes the endoscopic observation means, causing the edge to break the light guide made of ultrafine optical fiber or the cable connected to the solid-state imaging device, and further, the treatment instrument insertion tube and air / water supply Problems such as the possibility of buckling or damaging the tube occur.

  In short, when a flexible substrate is used to connect cables to a large number of ultrasonic transducers, if a part of the flexible substrate is left in a free state, not only when the insertion portion is incorporated, but also the ultrasonic endoscope is used. Even when operating as a mirror, the edges and corners of the flexible substrate that is in this free state may interfere with other members, which may press or damage these other members. .

  The present invention has been made in view of the above points, and an object of the present invention is to secure the fixation and stability of a cable connected to an ultrasonic transducer array and to insert ultrasonic observation means. The purpose is to make it easy to incorporate it into the department.

  In order to achieve the above-mentioned object, the present invention attaches an endoscope observation means having at least an illumination part and an observation part to the distal end surface of the hard tip part of the insertion part, and this endoscope observation means An ultrasonic endoscope in which an electronic scanning ultrasonic observation means is attached to the outer peripheral portion of the attachment part, and the ultrasonic observation means is an ultrasonic endoscope in which a plurality of ultrasonic transducers are arranged in a cylindrical shape or an arc shape. An ultrasonic transducer array and a backing layer formed in a cylindrical shape on the inner surface side thereof are provided, and each electrode of each ultrasonic transducer is provided between each ultrasonic transducer array and the backing layer. A flexible board having a plurality of one side terminals to be connected, the other side terminal to which each cable is connected, and a wiring pattern formed between the two terminals is disposed, and the flexible board is disposed on the one side terminal. A large diameter part formed with None the stepped structure having a small diameter portion to which the other terminal is formed, in which as its characterized in that a configuration in which the support portion of the annular inside the small-diameter portion.

  A large number of ultrasonic transducers constituting the ultrasonic transducer array and each cable are electrically connected via a flexible substrate, and this flexible substrate is attached to a support member. By attaching the flexible substrate to the support member in this way, the entire flexible substrate is fixed, and the edges and corners do not protrude. However, if the connecting portion between the flexible substrate and the ultrasonic vibrator is extended straight as it is and connected to the cable, the outer diameter of the connecting portion of the cable becomes large. Therefore, the flexible substrate has a step structure, the large diameter portion is connected to the ultrasonic transducer, and the cable is connected to the small diameter portion, so that the diameter of the connection portion between the flexible substrate and the cable is increased. Can be suppressed.

  A backing layer is provided on the inner surface side of the ultrasonic transducer array, and it is desirable that the thickness dimension of the backing layer is as thick as possible. The support member that supports the small-diameter portion of the flexible substrate may be an independent member, but the backing layer itself can also function as a support member. In this case, the backing layer is configured so as to project a predetermined length from the end of the ultrasonic transducer array toward the proximal end of the distal hard portion, and the outer peripheral surface of the projecting portion is By reducing the diameter, a step structure is formed, and a reduced diameter portion due to the step is used as a support portion.

  If the flexible substrate is configured as described above, the flexible substrate has a stepped structure. Therefore, there are bent portions at two locations, a transition portion from the large diameter portion to the step portion and a transition portion from the step portion to the small diameter portion. Arise. Although the flexible substrate can be formed in a stepped cylindrical shape in advance, it becomes difficult to form terminal portions and wirings formed on the flexible substrate by a printing unit. Thus, it is advantageous to form a pattern by printing by forming the flexible substrate with a single flat resin film.

  When the flexible substrate is formed of a flat resin film, it is necessary to bend at two places, and the bending angle is normally 90 °. The large-diameter portion of the flexible substrate has a cylindrical shape as a whole, and thus is composed of a continuous portion. However, at least a predetermined pitch interval is not provided between the transition portion to the step portion and the end portion of the small-diameter portion. Don't be. However, if only the cut is made, the flexible substrate partially overlaps at the small diameter portion. Therefore, the flexible substrate is divided into a plurality of strips so as to have the circumferential length of the small diameter portion. Here, the strip-shaped divided portions are formed at regular pitch intervals and extend to the position of the transition portion from the continuous portion to the stepped portion, but the width dimension of each divided portion is uniform. Moreover, it can also be set as the shape expanded to the position of the transition part from a front end side to a small diameter part as needed.

  The above-mentioned divided portion is bent at two places, but this bending is a right angle, and it is necessary to form a sharp bent shape that does not cause wrinkles or irregularities in whole or in part. If the bent part is partially lifted from the backing layer, not only does the strength of fixing the flexible substrate to the backing layer decrease, but the connection to the ultrasonic transducer may be poor, or the ultrasonic transducer may It causes inconvenience such as damage caused by excessive external force. Therefore, a configuration in which, for example, a plurality of minute holes and cuts are formed in the divided portion of the flexible substrate along the fold line at the transition portion from the large diameter portion to the step portion and the transition portion from the step portion to the small diameter portion. If so, a sharp bent state can be obtained.

  By adopting the above configuration, since the cable is fixed to the flexible substrate fixed to the support member, the cable can be easily connected, and can be firmly fixed, and stability is also ensured. In other words, the operation of incorporating the ultrasonic observation means into the insertion portion can be performed smoothly and easily, and there is an effect that other members are not compressed or damaged during operation.

  Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings. First, as shown in FIG. 1, the ultrasonic endoscope is roughly composed of a main body operation unit 1, an insertion unit 2, and a universal cord 3. The ultrasonic endoscope is connected to a light source device, a video signal processing device, and an ultrasonic observation device to constitute a system as a whole. The universal cord 3 is pulled out from the main body operation unit 1 and branches in the middle of the universal cord 3, a connection connector 3 a that is detachably connected to the light source device, a connection connector 3 b that is detachably connected to the video signal processing device, and an ultrasonic wave. A connection connector 3c is detachably connected to the observation apparatus.

  The main body operation unit 1 can be held by an operator with one hand, is provided with an angle operation means 4 and a treatment instrument introduction unit 5, and is equipped with operation buttons such as an air / water supply button 6 and a suction button 7 In addition, various switches 8 are also provided.

  The insertion portion 2 is a cord-like member having a predetermined length provided by being connected to the main body operation portion 1 and is inserted into the body of the subject. The insertion portion 2 is a flexible portion 2a that bends along the insertion path in a body cavity or the like for most of the length from the connecting portion to the main body operation portion 1, and an angle portion is provided at the tip of the flexible portion 2a. 2b is connected, and the distal end hard portion 2c is connected to the angle portion 2b. The angle portion 2b can be bent up and down and left and right by remote operation in order to point the distal end hard portion 2c in a desired direction. For this purpose, the main body operation unit 1 is provided with an angle operation means 4 and is controlled so that the angle portion 2b is bent by an operator's operation and the distal end hard portion 2c is directed in a desired direction.

  FIG. 2 shows the distal end portion of the insertion portion 2, and FIG. 3 shows the configuration of the distal end surface of the distal end hard portion 2 c in the insertion portion 2. As is clear from these drawings, the distal end hard portion 2c has an endoscope observation means having a predetermined viewing angle V with the direction of extension of the axis thereof, that is, the front of the distal end hard portion 2c as a visual field. Electronic radial scanning ultrasonic observation means having a circular or arcuate ultrasonic scanning surface W at a position on the base end side from the field of view of the mirror observation means is provided.

  FIG. 4 shows a cross section of the distal end portion of the insertion portion 2. As apparent from FIG. 3 and FIG. 3, the endoscope observation means includes an illumination unit 10 and an observation unit 11, and the illumination unit 10 is disposed on both sides of the observation unit 11. The illumination unit 10 includes an illumination lens 10a facing the distal end surface of the distal end hard portion 2c, and a light guide 10b (see FIGS. 5 to 8). The light guide 10b is made of a bundle of a large number of extremely thin optical fibers, extends from the connection connector 3a of the universal cord 3 to the distal end hard portion 2c of the insertion portion 2, and the illumination light output end thereof is an illumination lens 10a. It faces the position facing. On the other hand, the observation unit 11 includes an objective lens 11 a and a prism 11 b that bends the optical path from the objective lens 11 a by 90 °. The objective lens 11 a is provided in the lens barrel 12, and the prism 11 b is fixed to the lens barrel 12. Provided. A solid-state image sensor 13 is bonded to the prism 11b, and a predetermined number of signal lines are connected to the substrate 13a of the solid-state image sensor 13. The signal lines are bundled and extended as one video cable 14 to the connection connector 3b of the universal cord 3.

  The distal end surface of the distal end hard portion 2c of the insertion portion 2 is further provided with a treatment instrument derivation opening 15 for deriving forceps and other treatment instruments. A connection pipe 16 to which a treatment instrument insertion tube from the treatment instrument introduction portion 5 provided in the apparatus is connected is attached. Further, the treatment instrument insertion tube is configured to join the suction passage inside the main body operation unit 1. Furthermore, a nozzle 17 is mounted on the distal end hard portion 2c for cleaning when the distal end surface of the objective lens 12 in the observation unit 11 is soiled with body fluid or the like. The nozzle 17 is connected to a cleaning fluid supply tube 9 (see FIGS. 5 to 8) operated by the air / water supply button 6.

  The endoscope observation means is configured as described above, but the distal end portion of each member constituting the endoscope observation means is fixedly held by the endoscope mounting member 18. The endoscope mounting member 18 is made of a metal material such as stainless steel having a plurality of through holes through which the respective members constituting the endoscope observation means described above are inserted, and the endoscope mounting member 18 has a distal end cap 19. It is mated. The distal end cap 19 prevents the endoscope mounting member 18 made of a metal material from being exposed to the outside, and the endoscope mounting member 18 and the distal end cap 19 constitute a distal end block. As shown in FIG. 5, the tip cap 19 is formed with two screw holes 19a in the thickness direction, and set screws 20 are screwed into these screw holes 19a. The distal end of the set screw 20 is brought into pressure contact with the endoscope mounting member 18 and the abutment surface between the endoscope mounting member 18 and the distal end cap 19 is bonded to thereby constitute the endoscope mounting member 18 and the distal end cap 19. The tip block is integrated.

  Ultrasonic observation means having a radial scanning surface is attached to the proximal end side position of the distal end cap 19 in the distal end rigid portion 2c. As is apparent from FIG. 6, this ultrasonic observation means comprises an ultrasonic transducer array in which a large number of ultrasonic transducers 21 are arranged in the circumferential direction, and the ultrasonic transducer 21 is circumferential or arcuate ( For example, it is arranged so as to perform electronic scanning. A backing layer 22 is mounted on the inner peripheral side of the ultrasonic transducers 21 arranged in this manner, and an acoustic lens 23 is mounted on the outer peripheral side. These ultrasonic transducers 21, the backing layer 22, and the acoustic lenses are mounted. The ultrasonic transmission / reception unit 24 is configured by 23.

  Each ultrasonic transducer 21 has two electrodes 25 and 26, respectively, and one electrode 25 is a common electrode common to all (or every predetermined number) ultrasonic transducers 21 and the other. The electrode 26 is individually provided for each ultrasonic transducer 21. The individual electrodes 26 of the ultrasonic transducers 21 are electrically connected to a wiring pattern formed on the flexible substrate 28 as will be described later. Further, as shown in FIG. 7, a predetermined number of cables 27 are electrically connected to the individual electrodes 26 via flexible substrates 28. On the other hand, the connection between the flexible substrate 28 and the cable from the common electrode 25 may be one in principle, and although not shown in the figure, the connection of the cable is performed at the distal end side of the ultrasonic transducer 21. I have to.

  As described above, the ultrasonic transmission / reception unit 24 has a substantially cylindrical shape, and its inner peripheral surface is a tunnel-shaped passage. Each member constituting the endoscope observation means is inserted into the tunnel-shaped passage by the ultrasonic transmission / reception unit 24, is located on the distal end side from the ultrasonic transmission / reception unit 24, and is covered by the distal end cap 19. It is fixed to the endoscope mounting member 18. The distal end portion of the ultrasonic transmission / reception unit 24 is in contact with the end surface of the distal end cap 19, and the proximal end side is in contact with the end surface of the connecting member 30. The connecting member 30 constitutes a connecting portion to the angle portion 2b in the distal end hard portion 2c.

  Further, a bridging member 31 is provided inside the coupling member 30, and the most advanced ring 32 in the angle ring constituting the structure of the angle portion 2 b is coupled to the coupling member 30 and the bridging member 31. ing. Therefore, as is apparent from FIG. 8, the connecting member 30 and the bridging member 31 are connected by a plurality of screws 33, and the most advanced ring 32 is connected by a plurality of screws 34.

  The bridging member 31 is connected to the distal end ring 32 that constitutes the most distal position of the angle portion 2b together with the connecting member 30 that is arranged on the most proximal side of the distal end hard portion 2c, and the ultrasonic transmission / reception unit 24. The function of restricting the position in the direction perpendicular to the axis of the distal end hard portion 2c and the function of connecting the endoscope mounting portion 18 and the distal end cap 19 to the combined body are exhibited. Therefore, the bridging member 31 needs to have a high strength and is a member that is not exposed to the outside, and thus is formed of a metal such as stainless steel. As shown in FIG. 9, the bridging member 31 is connected to the connecting member 30 and the most distal ring 32 of the angle portion 2 b by screws 33 and 34. A plurality (three in the present embodiment) of connecting arms 31b extend toward the distal end side of the shape portion 31a.

  And the ultrasonic transmission / reception unit 24 is positioned in the direction orthogonal to the axis line by fitting with the connecting arm 31b. Further, the distal end portion of each connecting arm 31 b and the endoscope mounting member 18 are connected by a screw 35. A step 31c is formed on the outer peripheral surface of the cylindrical portion 31a of the bridging member 31, and the base end side is larger in diameter than the step 31c. Further, a step 30a is also formed on the inner peripheral surface of the connecting member 30, and the diameter of the inner peripheral surface on the base end side is larger than the step 30a. The ultrasonic transmission / reception unit 24 is sandwiched between the tip cap 19 and the connecting member 30 by joining the steps 31c and 30a. Then, the ultrasonic transmission / reception unit 24 is positioned in the axial direction and stopped by adhering the both end surfaces of the ultrasonic transmission / reception unit 24 to the proximal end surface of the distal end cap 19 and the distal end surface of the connecting member 30. The sound wave transmitting / receiving unit 24 is fixedly held at a predetermined position. The outer skin layer 36 of the angle portion 2b extends to the outer peripheral surface portion on the proximal end side of the connecting member 30, and the distal end portion of the outer skin layer 36 is fixed to the distal end hard portion by a fixing mechanism 37 made of a thread winding and an adhesive. It is fixed to the connecting member 30 of 2c.

  As described above, a large number of ultrasonic transducers 21 and cables 27 are electrically connected via the flexible substrate 28. For this purpose, the flexible substrate 28 is interposed so as to be sandwiched between the ultrasonic transducer 21 and the cable 27. The flexible substrate 28 has a required wiring pattern formed by means such as printing as shown in FIG. As the wiring pattern, a first terminal portion 29a electrically connected to the individual electrode 26 of the ultrasonic transducer 21 and a second terminal electrically connected to the cable 27 by means such as soldering. A portion 29b and a wiring 29c for connecting the first and second terminal portions 29a and 29b. The flexible substrate 28 is incorporated in the hard tip portion 2c so as to have a cylindrical shape as a whole, but as shown in FIG. 11, the ultrasonic vibrations constituting the ultrasonic transducer array arranged in an annular shape. The large diameter portion 28a is the joining portion side (that is, the first terminal portion 29a forming side) to the child 21 and the backing layer 22, and the side to which the cable 27 is connected (that is, the forming side of the second terminal portion 29b). The small-diameter portion 28b is a vertical portion 28c formed by a step between the small-diameter portions 28b.

  Thus, the flexible substrate 28 has a stepped cylindrical shape, and the flexible substrate 28 is attached to the backing layer 22. Here, the ultrasonic transducers 21 are arranged in an annular shape on the outer peripheral surface of the backing layer 22, and the first terminal portions 29 a of the flexible substrate 28 are connected to the electrodes 26 formed on these ultrasonic transducers 21. It will be electrically connected. Accordingly, the large-diameter portion 28a of the flexible substrate 28 has a substantially cylindrical shape similar to that of the backing layer 22, and the large-diameter portion 28a is sandwiched between the electrode 26 of the ultrasonic transducer 21 and the backing layer 22. It is installed.

  Here, as is apparent from FIG. 4, the inner peripheral surface of the ultrasonic transducer 21 is located outside the outer peripheral surface of the connecting member 30. Therefore, when the flexible substrate 28 is directly extended to the proximal end side. Interfering with the connecting member 30. This is why the small-diameter portion 28b is provided on the base end side of the cylindrical flexible substrate 28. The small-diameter portion 28b is formed with a second terminal portion 29b, and a cable 27 is electrically connected to each of the second terminal portions 29b by means such as soldering. And this small diameter part 28b is not made into a free state, but the inner surface is made to contact | abut to a support member, and is fixed to the outer surface of this support member by means, such as adhesion | attachment. The support member is formed by a small diameter portion 22 a that is integrally provided with the backing layer 22 and has a reduced diameter on the outer peripheral surface of the backing layer 22.

  Here, as the support member, the backing layer 22 is configured as a separate member, and it may be inserted into the tunnel-shaped passage having the inner diameter of the backing layer 22, but then the thickness of the backing layer 22 is reduced, In addition, an ultrasonic reflection effect is generated from the difference in acoustic impedance between the backing layer 22 and the support member. Therefore, in order to increase the thickness of the backing layer 22, the special backing function is not exhibited, but the backing layer 22 is used as a base member in order to function as a support member that supports the small-diameter portion 28 b of the flexible substrate 28. The extended portion is reduced in diameter to form a small-diameter portion 22a, and the small-diameter portion 28b of the flexible substrate 28 is fixed to the small-diameter portion 22a by adhesion. Further, the stepped wall of the backing layer 22 and the vertical portion 28c which is a transition portion from the large diameter portion 28a to the small diameter portion 28 of the flexible substrate 28 are also fixedly held by adhesion.

  As described above, many cables 27 connected to the flexible substrate 28 are located on the outer peripheral side of the small diameter portion 22 a of the backing layer 22, and these cables 27 are located on the outer peripheral side from the position where the bridging member 31 is disposed. 28 and the cable 27 is pulled out. On the other hand, at the position of FIG. 8, that is, the position of the connecting portion between the distal end hard portion 2 c and the angle portion 2 b, the cable 27 is inserted through the bridging member 31. Therefore, the cable 27 is drawn out so as to penetrate in the thickness direction of the bridging member 31. Here, an interval portion formed by dividing the connecting arm 31b in the bridging member 31 is allowed to pass. A plurality of cables 27 are divided into a plurality of, for example, about four cables and bundled, and the cable bundle 27B bundled in this way has a deformable shape, from the angle portion 2b to the flexible portion 2a. It is supposed to be inserted through.

  Moreover, each member which comprises an endoscope observation means is penetrated by the inner peripheral part of the ultrasonic transmission / reception unit 24 used as the tunnel-shaped channel | path. Among these, the light guide 10b and the video cable 14 bundled in two can be deformed so that the cross-sectional shape is arbitrary. As other insertion members, there are a connection pipe 16 and a cleaning fluid supply tube 9 constituting a treatment instrument insertion passage, and a tube 43 for supplying an ultrasonic transmission medium into a balloon 41 described later. The connecting pipe 16 constituting the treatment instrument insertion path is connected to a flexible tube on the proximal end side from the position shown in FIG. 8 or in the vicinity of the position shown in FIG. Further, as described above, the cables 27 connected to the ultrasonic transducers 21 are divided and bundled by a predetermined number, but the cable bundle 27B also passes through the tunnel-shaped passage and extends to the angle portion 2b side. I try to let it exist.

  The ultrasonic transducers 21 constituting the ultrasonic transmission / reception unit 24 transmit ultrasonic waves toward the inside of the body and receive reflected echoes from the tissue tomographic section in the body. In order to suppress attenuation, annular concave grooves 40, 40 are provided at positions before and after the mounting portion of the ultrasonic transmission / reception unit 24, that is, at the outer peripheral surface of the tip cap 19 and the connecting member 30, As is apparent from FIG. 2, a balloon 41 that bulges when an ultrasonic transmission medium is sealed is mounted between the two annular grooves 40 and 40. The balloon 41 is composed of a flexible film 41a having a cylindrical shape, and fastening rings 41b that are fastened to the annular groove 40 are provided at both ends of the flexible film 41a. Fastening is performed so that a tightening force acts on the annular groove 40. The connecting member 30 is provided with a supply / discharge passage 42 for supplying and discharging the ultrasonic transmission medium inside the balloon 41, and a tube 43 is connected to the supply / discharge passage 42.

  By configuring in this way, the insertion unit 2 is inserted into the body cavity of the subject, and illumination light is irradiated into the body cavity from the illumination unit 10 that constitutes the endoscope observation means, and the objective mounted on the observation unit 11 An image in the body cavity is formed on the solid-state imaging device 13 by the lens 12, and a video signal in the body cavity is acquired by the solid-state imaging device 13 and transmitted to the video signal processing device. In this video signal processing device, By performing predetermined signal processing, the image in the body cavity is displayed on the endoscope image display monitor. Therefore, by visually observing this monitor, it is possible to perform an endoscopy regarding the state in the body cavity.

  If there is a region of interest such as a lesion as a result of this endoscopy, the ultrasonic transmission / reception unit 24 constituting the ultrasonic observation means is moved to a position facing this region of interest. That is, by moving the insertion portion 2 forward by a predetermined distance, the ultrasonic transmission / reception unit 24 is disposed at a position facing the region of interest. Then, an ultrasonic transmission medium is supplied into the balloon 41, and the flexible film 41a is swelled to adhere to the inner wall of the body cavity. In this state, the ultrasonic transducers 21 arranged in the circumferential direction constituting the ultrasonic transmission / reception unit 24 are sequentially operated to transmit ultrasonic pulses toward the inside of the body and receive the reflected echoes. Here, the ultrasonic transducers 21 can be sequentially operated one by one, but by operating the plurality of ultrasonic transducers 21 with a predetermined time delay, for example, electronic focusing can be applied. . Since a method for electronically scanning a large number of ultrasonic transducers 21 arranged is well known in the art, description thereof is omitted here.

  As described above, the reflected echo signals acquired by the respective ultrasonic transducers 21 constituting the ultrasonic transmission / reception unit 24 are transmitted to the ultrasonic observation apparatus, and signal processing is performed by the ultrasonic observation apparatus. The tomographic information regarding the state of the body tissue including the region is acquired. The ultrasonic tomographic image is displayed on a monitor attached to the ultrasonic observation apparatus. This makes it possible to diagnose whether or not a lesion is included in the tissue.

  By the way, each member constituting the endoscope observation means, that is, the light guide 10b, the video cable 14, the connection pipe 16 constituting the treatment instrument insertion path and the cleaning fluid supply tube 9, and the ultrasonic wave constituting the ultrasonic observation means. The cable bundle 27 </ b> B drawn from the transmission / reception unit 24 and the tube 43 for supplying the ultrasonic transmission medium into the balloon 41 are assembled so as to be inserted into the main body operation unit 1 from at least the insertion unit 2.

  In this assembly, with the insertion portion 2 separated from the main body operation portion 1, first, at the tip of the angle portion 2b, the tube 43 connected to the connecting member 30 and the ultrasonic transmission / reception unit 24 are connected. The cable bundle 27B is inserted from the front end opening side of the angle portion 2b, and the angle portion 2b is inserted into the soft portion 2a. Here, the tube 43 has flexibility, and the cables 27 are bundled for every predetermined number. The cable bundle 27B bundled in this way is easily the base end of the flexible portion 2a of the insertion portion 2. Can be pulled out to the side. Moreover, since the cable bundle 27B has flexibility in the bending direction and can be deformed in the bundled state, the cable bundle 27B can be inserted into the insertion portion 2 very easily and constitutes the angle portion 2b. It can be smoothly inserted without being caught by the angle ring and other members.

  Next, the members constituting the endoscope observation means are assembled to the endoscope mounting member 18, and the endoscope mounting member 18 is connected to the distal end cap 19 with the screw 20 to form an integral distal end block. Thus, the light guide 10b, the video cable 14, the connection pipe 16 and the cleaning fluid supply tube 9 are sequentially inserted into the angle portion 2b and the flexible portion 2a from the tunnel-shaped passage formed by the ultrasonic transmission / reception unit 24. . At this time, the bridging member 31 is connected to the endoscope mounting member 18 in advance and fixed in a connected state by the screw 35.

  As described above, when the bridging member 31 connected to the tip block is inserted into the tunnel-shaped passage, both ends of the ultrasonic transmission / reception unit 24 are bonded to the connecting member 30 and the tip cap 19 constituting the tip block, respectively. Then, the connecting member 30 and the bridging member 31 are connected and fixed by the screw 33. Further, the bridging member 31 to which the connecting member 30 is connected and fixed is fixed to the most advanced ring 32 in the angle portion 2 b by the screw 34. Thereby, each part which comprises an ultrasonic observation means is assembled | attached to the insertion part 2. FIG.

  The insertion portion 2 is assembled as described above. When the insertion portion 2 of the ultrasonic endoscope is inserted into a body cavity or the like and the operation is performed, if the angle portion 2b is curved, Although the insertion member tries to move, all of the insertion members in the angle portion 2b are flexible in the bending direction, and the light guide 10b and the video signal cable 14 are bundled and divided into a plurality. Since the cross-sectional shape of the bundled cable bundle 27B is freely deformable, disconnection, buckling, damage, etc. occur even if each of the above-described members is pressed against other members during the bending operation of the angle portion 2b. There is no fear.

  Thus, the flexible substrate 28 may be formed in advance so as to have a stepped cylindrical shape, but the flexible substrate 28 has patterns such as terminal portions 29a and 29b and wirings 29c on the surface thereof. It is formed. These patterns are preferably performed by printing means. Therefore, in order to form a pattern on the stepped cylindrical flexible substrate 28 by printing means, as shown in FIG. 12A, a long resin film 50 is used. In this resin film 50, A pattern composed of the terminal portions 29a and 29b and the wiring 29c can be printed in a flat plate state.

  Here, since the stepped cylindrical shape is formed, the resin film 50 is formed with a notch 51 having a predetermined width at a predetermined depth from one end side thereof, thereby forming a continuous pitch 50 and a constant pitch interval. The divided portion 50b is formed. And as shown in FIG.12 (b), it is set as a ring shape by joining the both ends of the continuous part 50a of this resin film 50. As shown in FIG. Thus, the ring-shaped portion forms the large-diameter portion 28a of the flexible substrate 28. Then, as indicated by the phantom line in FIG. 12B, the transition portion from the continuous portion 50a to the dividing portion 50b is bent 90 ° inward, and the intermediate position of the dividing portion 50b is turned 90 ° to As shown in FIG. 12C, a large diameter portion 28b, a small diameter portion 28b, and a vertical portion 28c as a transition portion therebetween are formed in the flexible substrate 28. And the small diameter part 28b can be made into the substantially continuous cylindrical shape by setting the width | variety and the number of the notch parts 51 suitably.

  By the way, the two bent portions described above must be bent not in a straight line but in an arc. For this reason, if it is simply bent, stress may be applied to the bent portion to cause partial wrinkles or unevenness. In order to bend the bent part sharply by 90 ° without such a situation, as shown in FIG. 13, a predetermined number of micro holes 52 are formed along the bending line, and the split part 50b What is necessary is just to form the notch 53 in both ends. And these microhole 52 and the notch | incision 53 will exhibit the stress release function at the time of bend | folding in circular arc shape, and it can finish a bend line sharply. As a result, when the flexible substrate 28 is affixed to the backing layer 22, the strength is improved, and stress can be prevented from acting on the ultrasonic transducer 21 to which the flexible substrate 28 is connected.

1 is an overall configuration diagram of an ultrasonic endoscope showing an embodiment of the present invention. It is an external view of the front-end | tip part of an insertion part. It is a figure which shows the front end surface of a front-end | tip hard part. It is a longitudinal cross-sectional view of the front-end | tip part of an insertion part. It is AA sectional drawing of FIG. It is BB sectional drawing of FIG. It is CC sectional drawing of FIG. It is DD sectional drawing of FIG. It is an external appearance perspective view of a bridge member. It is a principal part expanded view of a flexible substrate. It is an expanded sectional view which shows the connection part of an ultrasonic transducer | vibrator and a backing layer, and a flexible substrate. It is explanatory drawing which shows the process for forming a stepped cylindrical flexible substrate from a flat resin film. It is an enlarged front view which shows the structure of the bending in the division part of a resin film.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Main body operation part 2 Insertion part 2a Soft part 2b Angle part 2c Hard tip hard part 10 Illumination part 10a Illumination lens 10b Light guide 11 Observation part 11a Objective lens 11b Prism 12 Lens tube 13 Solid-state image sensor 13a Substrate 18 Endoscope mounting member 19 tip cap 21 ultrasonic transducer 22 backing layer 23 acoustic lens 24 ultrasonic transmission / reception unit 27 cable 27B cable bundle 28 flexible board 28a large diameter portion 28b small diameter portion 28c vertical portion 29a, 29b terminal portion 29c wiring 30 connecting member 31 bridging member 31a Cylindrical part 31b Connecting arm 50 Resin film 50a Continuous part 50b Dividing part 51 Notch part 52 Micro hole 52 53 Cutting

Claims (4)

An endoscope observation means having at least an illumination part and an observation part on the distal end surface thereof is attached to the distal end hard part of the insertion part, and an electronic scanning ultrasonic wave is applied to the outer periphery of the attachment part of the endoscope observation means. In an ultrasonic endoscope equipped with observation means,
The ultrasonic observation means is provided with an ultrasonic transducer array in which a plurality of ultrasonic transducers are arranged in a cylindrical shape or an arc shape, and a backing layer formed in a cylindrical shape on the inner surface side thereof,
Between each of the ultrasonic transducer arrays and the backing layer, a plurality of one-side terminals connected to the electrodes of the ultrasonic transducers, an other-side terminal to which a cable is connected, and both ends thereof Arrange a flexible board formed with a wiring pattern formed between the children,
Each of the flexible substrates has a step structure having a large-diameter portion where the one-side terminal is formed on the outer surface side and a small-diameter portion where the other-side terminal is formed, and an annular shape is formed on the inner surface side of the small-diameter portion. An ultrasonic endoscope characterized in that a support portion is provided. The backing layer has a predetermined length extending from the end portion of the ultrasonic transducer array toward the proximal end side of the distal end hard portion, and the outer peripheral surface of the protruding portion is reduced in diameter. The ultrasonic endoscope according to claim 1, wherein the support has a reduced diameter portion due to the step as a structure. The flexible substrate has a long portion that covers substantially the entire length of the large diameter portion in the circumferential direction, and a length that substantially matches the length of the small diameter portion in the circumferential direction, and includes a plurality of strip-shaped divided portions. 2. The ultrasonic endoscope according to claim 1, wherein the divided portion has a length from a transition portion from the long portion to the stepped portion to an end portion of the support portion. Each of the divided portions of the flexible substrate includes at least a plurality of minute holes or notches along a fold line along a transition portion from the large diameter portion to the step portion and a transition portion from the step portion to the small diameter portion. 4. The ultrasonic endoscope according to claim 3, wherein any one of them is formed.

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