JPH08140976A - Ultrasonic endoscope - Google Patents

Abstract

PURPOSE: To easily perform the ultrasonic observation of a necessary region within an endoscopic observation visual field under the observation due to an endoscopic observation mechanism by inclining an ultrasonic vibrator and the rotary axial line of the ultrasonic vibrator in the visual field direction of the endoscopic observation mechanism by a predetermined angle to allow an ultrasonic observation visual field to approach the endoscopic observation visual field. CONSTITUTION: A connection part 31b is provided to the leading end part of a leading end main body 31 provided with an endoscopic observation mechanism mounting part 31a in a protruding state and a leading end cap 40 is fitted to the connection part 31b and a support stand 41 is provided in the cap 40. An ultrasonic vibrator 42 is mounted on the support stand 41 and a rotary shaft 43 is connected to the support stand 41 and a flexible shaft 45 is connected to the rotary shaft 43. Herein, the ultrasonic vibrator 42 constituting an ultrasonic observation mechanism, the support stand 41 thereof, the rotary shaft 43 linked to the support stand 41 and the leading end cap 40 are provided so as to be inclined toward the endoscopic observation mechanism mounting part 31a by a predetermined angle with respect to the axial line of an insertion part 30.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an ultrasonic endoscope used for medical purposes.

[0002]

2. Description of the Related Art An ultrasonic endoscope has an endoscope observing mechanism and an ultrasonic observing mechanism provided at the tip of an insertion portion to be inserted into a body cavity. It is as shown in. In the figure, reference numeral 1 denotes an insertion portion, and an endoscope observation mechanism portion 2 is provided at a distal end body 1a of the insertion portion 1, and an ultrasonic observation mechanism portion is provided at a front portion of the endoscope observation mechanism 2. 3 is provided. The tip portion main body 1a is provided with an angle portion 1b and a flexible portion 1c, which are connected in sequence, and the flexible portion 1c is connected to the main body operating portion 4.

Next, FIGS. 13 and 14 show the distal end portion of the insertion portion 1. As is clear from these figures, the endoscope observation mechanism mounting portion 2 is flattened by chamfering a part of the side surface of the main body operating portion 1a.
It is formed by providing an illumination window 10 and an observation window 11. As is well known, an illumination lens for emitting illumination light supplied from a light source device via a light guide is attached to the illumination window 10, and an objective lens is attached to the observation window 11. At the image forming position of the objective lens, a solid-state image pickup device including an incident end of an image guide or a CCD camera is arranged. Further, in the endoscope observation mechanism mounting portion 2a, a treatment instrument lead-out portion 12 for leading out a forceps or other treatment instrument to a position in front of the observation window 11.
Is provided, and an air / water supply nozzle 13 for supplying a cleaning fluid toward the observation window 11 is opened at the stepped portion in the chamfered portion. The endoscopic observation mechanism portion 2 shown in the figure is of a side-view type in which the endoscopic observation visual field is in a direction orthogonal to the axis of the insertion portion 1, but the endoscopic observation mechanism mounting portion is inserted. By tilting at a predetermined angle with respect to the axis of the portion 1, it is possible to make the endoscope observation field of view obliquely directed forward (or backward).

The ultrasonic observation mechanism section 3 has a tip cap 20 provided so as to project from the tip surface of the tip body 1a, and an ultrasonic transducer 21 is provided in the tip cap 20.
It is provided installed on the support base 22. A flexible shaft 23 formed of a close contact coil is connected to the support base 22.
Is guided from the insertion section 1 into the main body operation section 4, and is rotated around the axis by the rotation driving means 24 (or manual operation etc.) such as a motor, whereby the ultrasonic transducer 21
Is designed to be rotated by remote control. A portion of the flexible shaft 23 extending from the tip body 1 a is inserted into the flexible tube 25.

The ultrasonic endoscope constructed as described above is
The insertion portion 1 is guided to a predetermined position in the body cavity, and the examination by the endoscope observation mechanism 2 is performed, and the ultrasonic transducer 21 in the ultrasonic observation mechanism 3 is detected in the affected area or other predetermined portion according to the result or the like. By rotationally driving, information about the internal tissue fault can be acquired. Then, the information on the internal tissue slice by the ultrasonic transducer 21 is displayed as an ultrasonic image on the monitor device after the reflected echo signal is subjected to predetermined signal processing.

[0006]

By the way, in the ultrasonic endoscope according to the prior art, the ultrasonic observation field of view by the ultrasonic observation mechanism 3 is in a direction orthogonal to the axis of the insertion section 1. Therefore, as shown below, the operability of the ultrasonic observation mechanism is not always good.

First, as shown in FIG. 15, in an ultrasonic endoscope for examining the upper digestive organs, for example, for the stomach, a state in which the field of view of the endoscope observation mechanism is directed to the gastric corner p ₁ In this case, an affected area is found at the corner p ₁ of the stomach, and when ultrasonic diagnosis is to be performed on this part, the ultrasonic observation field of view should be directed to the corner p ₁ of the stomach as it is. Cannot be performed, and the insertion section 1 must be moved. Here, since the inner wall of the stomach corner p ₁ has a concave curved shape, even if the ultrasound observation field of view is located at the stomach corner p ₁ , the ultrasound observation field of view is relative to the stomach corner p _1. Therefore, an ultrasonic tomographic image orthogonal to the inner wall of the body cavity cannot be obtained.

Further, since the esophagus is a thin body cavity tube, if the esophagus is to be placed within the field of view of the endoscope, as shown in FIG. 16, the angle portion 1b is operated to be bent to one of the body cavity tubes. By pressing, the observation window is made to have a predetermined distance from the inner wall p _{2 of} the body cavity to be inspected. Therefore, the axis of the tip body 1a is inclined at a predetermined angle with respect to the esophagus. Here, the hard portion at the tip of the insertion portion 1 is not limited to the tip portion main body 1a and the tip portion main body 1a.
Since the portion of the tip cap 20 that constitutes the ultrasonic observation mechanism 3 protruding from a is also a hard portion, the hard portion at this tip is oriented obliquely with respect to the axis of the body cavity tube. The acoustic field of view is not in the direction orthogonal to the inner wall p ₂ of the body cavity.

Further, in the duodenum, as shown in FIG. 17, a region p ₃ consisting of a pancreaticobiliary duct opening to the nipple is shown.
, Since it is inclined with respect to the duodenum, the add this site p ₃ in the ultrasonic field of view by the ultrasound observation mechanism, with curving larger angle portion 1b, it is necessary to move the insertion portion 1 Therefore, there is a problem that the operability becomes extremely poor.

In short, in the ultrasonic endoscope of the prior art, since the ultrasonic observation field of view is in the direction orthogonal to the axis of the insertion portion, it is not always rational for the operation of ultrasonic observation. It is not configured like this. The present invention has been made in view of the above-mentioned drawbacks of the prior art, and an object of the present invention is to bring an ultrasonic observation visual field close to an endoscope observation visual field and It is to make it possible to easily perform ultrasonic observation of a necessary portion with.

[0011]

In order to achieve the above-mentioned object, the present invention provides an ultrasonic transducer in an ultrasonic observation mechanism protruding from a tip end main body of an insertion portion and a rotation axis of the ultrasonic transducer. It is characterized in that it is provided so as to be inclined by a predetermined angle so as to be oriented substantially in the visual field direction of the endoscope observation mechanism with respect to the axis of the insertion section.

[0012]

[Operation] In the ultrasonic endoscope, since the ultrasonic observation mechanism is attached to a portion in front of the distal end body of the insertion portion, the endoscope observation field of view is in a direction orthogonal to the axis of the insertion portion. ,
That is, it is a side-viewing endoscope or a perspective-viewing endoscope having a predetermined angle with respect to a direction orthogonal to the axis of the endoscope.
By using a wide-angle lens, the endoscopic observation field of view is
Although a somewhat wide observation visual field can be obtained, the endoscope observation visual field and the ultrasonic observation visual field are separated from each other by a predetermined distance in the axial direction regardless of whether they are a side-view type or a perspective type.
The ultrasonic beam transmitted from the ultrasonic transducer to the inside of the body is narrowed down to have an extremely small beam diameter to improve directivity, and the ultrasonic observation field cuts the inside of the body at a certain plane. However, the cut surface in the body is determined by the angle with respect to the axis of the insertion portion of the ultrasonic transducer.

First, since the ultrasonic observation visual field is located in front of the center line of the endoscope observation visual field in the axial direction of the insertion portion, this ultrasonic observation visual field can be brought close to the endoscope observation visual field. , It is possible to scan on the ultrasonic tomographic plane including the substantially central portion of the endoscopic observation visual field. This is achieved by inclining the ultrasonic transducer and the rotation transmitting member that rotationally drives the ultrasonic transducer with respect to the axis of the insertion portion toward the visual field direction of the endoscope observation mechanism. Further, by tilting the direction of the ultrasonic transducer with respect to the axis of the insertion part, in order to obtain an endoscopic observation visual field in a narrow body cavity tube,
When the angle part is curved and the tip part main body is tilted with respect to the body cavity tube, the rotation axis of the ultrasonic transducer becomes substantially parallel to the body cavity tube, while obtaining an endoscope observation field of view. An ultrasonic tomographic image in a direction substantially orthogonal to the body cavity tube can be obtained. In addition, when performing an ultrasonic examination of a concave curved portion such as a gastric corner, the concave curved portion should be directed toward the center line direction of the observation visual field while keeping the concave curved portion in the visual field of the endoscope. Moreover, it is possible to obtain an ultrasonic tomographic image in a direction orthogonal to the inner wall of the body cavity. Furthermore, it becomes extremely easy to insert the insertion portion into the duodenum and bring the pancreaticobiliary duct that is inclined from the direction orthogonal to the insertion direction into the ultrasound observation field of view.

In summary, when examining the upper digestive organs, the ultrasonic observation visual field should be oriented at a predetermined angle with respect to the axis of the insertion section, and should be oriented in the direction of the center line of the endoscopic observation visual field. In order to install an ultrasonic observation mechanism,
There are many advantages. Moreover, since the ultrasonic observation mechanism is connected to the tip of the insertion part, the hard part at the tip part of the insertion part becomes long, but in the case of the upper digestive organ, the gastric corner and pylorus of the throat and stomach. There are parts such as parts that turn in a curved state. When inserting an insertion part having a long hard part at the tip into such a direction changing part, if the direction of inclination of the ultrasonic observation mechanism is directed toward the changing direction, the direction changing part will be smoothly moved. It can be passed, and at the same time, the patient's pain at that time can be reduced.

[0015]

Embodiments of the present invention will now be described in detail with reference to the drawings. First, FIG. 1 shows the external appearance of the distal end portion of the insertion portion of the ultrasonic endoscope, and FIG. 2 shows its XX cross section. In these drawings, reference numeral 30 denotes an insertion portion, and a tip end portion of the insertion portion 30 serves as a tip end portion main body 31, and an angle portion 32 is connected to the base end side of the tip end portion main body 31. The base end side of the angle portion 32 is a flexible portion, and the flexible portion is connected to the main body operating portion. However, since these structures are well known, their illustration and description are omitted. .

An endoscope observation mechanism mounting portion 31a is formed by chamfering the side surface of the tip portion main body 31, and the illumination window 33 and the observation window are formed in the endoscope observation mechanism mounting portion 31a. 34 are provided. Further, a treatment instrument lead-out portion 35 for leading out a treatment instrument such as forceps is provided at a position in front of the mounting portion of the observation window 34, and an observation window 3 is provided at a rear position.
An air / water supply nozzle 36 for cleaning the nozzle 4 is provided. These points are not different from those of the conventional art.

A connecting portion 31 is provided at the tip of the tip body 31.
b is projectingly provided, and the tip end cap 40 is fitted to the connecting portion 31b. The tip cap 40 is made of a resin material having good acoustic characteristics, and a support base 41 is provided in the tip cap 40.
The ultrasonic transducer 42 is attached to the above, and an acoustic medium such as liquid paraffin is enclosed. Here, the ultrasonic transducer 42 is for performing radial scanning, and for this purpose, the rotation shaft 43 is connected to the support base 41. The rotating shaft 43 is rotatably supported by a bearing 44 in the connecting portion 31b of the tip end body 31, and extends through the connecting portion 31b. The base end portion of the rotating shaft 43 has a rotation transmitting member. As a result, a flexible shaft 45 formed of a close contact coil is connected. The flexible shaft 45 passes through the insertion passage 37 formed inside the distal end portion main body 31 and is guided into the main body operation portion through the angle portion 32 and the flexible portion. A flexible tube 46 is inserted through the base end side portion, and the base end portion is connected to a rotation drive means such as a motor and is rotationally driven around the axis by the rotation drive means. It is like this.

Here, an ultrasonic transducer 42 constituting the ultrasonic observation mechanism and its supporting base 41, and further this supporting base 41.
Axis A _{1 of} the rotary shaft 43 and the tip cap 40 connected to
Is inclined by a predetermined angle θ with respect to the axis A ₂ of the insertion portion 30. The inclination direction is the direction toward the endoscope observation mechanism mounting portion 31a side provided on the distal end portion main body 31. As described above, in order to incline the ultrasonic observation mechanism, the insertion passage 37 provided in the tip end main body 31 is a linear passage portion 37a that is in a straight line state from the angle portion 32 side to a predetermined portion. The inclined passage portion 37b is inclined from the middle by the angle θ. The flexible shaft 45 extends from the linear passage portion 37a into the inclined passage portion 37b, and is connected to the rotary shaft 43 at a position inside the inclined passage portion 37b or at a position derived from the inclined passage portion 37b.

Here, in the tip portion main body 31, the portion where the illumination window 33 and the observation window 34 are provided has the highest filling rate, and each member is the endoscope observation mechanism mounting portion 31a.
It is located in a part that is offset to the side. By tilting the insertion passage 37 through which the flexible shaft 45 is inserted from the distal end side, the insertion passage 37 can be inserted into the distal end main body 3 as shown in FIG.
Therefore, it is possible to bypass the portion provided with the endoscope observation mechanism in 1 and to effectively utilize the space in the tip portion main body 31.

With the ultrasonic endoscope having the above-mentioned structure, the insertion section 30 can be inserted into a predetermined portion in the body cavity for endoscopic observation and ultrasonic observation. here,
The portion of the insertion portion 30 from the distal end body 30 to the distal end cap 40 is substantially a hard portion, and the hard portion has a considerable length. Therefore, when inserting the insertion portion 30 having such a long distal end hard portion into the body cavity, it is difficult to pass through a curved path such as a direction changing portion, and the patient suffers. It will also force you.

However, since the tip cap 40 is tilted by the angle θ with respect to the tip end main body 31, for example, when the tip cap 40 is passed through the throat, as shown in FIG. By orienting the insertion path in the curved direction, the insertion angle is provided at a predetermined value, so that the insertion path can be smoothly inserted into the curved path such as the throat. Also, the outer diameter of the tip cap 40 is smaller than the outer diameter of the tip body 31, and the tip cap 40 faces the endoscope observation mechanism mounting portion 31a from a position opposite to the endoscope observation mechanism mounting portion 31a. Since it is inclined, the tip cap 40 does not stick out of the outer diameter of the insertion portion 30 as shown in FIG. Therefore, when passing through the narrowed portion or the like, the narrowed portion will not be expanded more than necessary. Also, when inserting from the esophagus into the corner of the stomach and further leading to the duodenum via the pylorus of the stomach, the distal end cap 40 is directed in the same direction as the curved direction to allow smooth passage through these direction changing parts. You can

Therefore, when the esophagus is inspected, as shown in FIG. 6, the insertion portion 30 is inserted into the esophagus and the angle portion 32 is bent at a predetermined angle. The bending direction of the angle portion 32 is a direction in which the illumination window 33 and the observation window 34 are separated from the portion P ₁ of the esophagus to be inspected. As a result, the observation field of view through the observation window 34 is secured. And the tip body 31 with respect to the esophagus
When bent, the tip cap 40 containing the ultrasonic transducer 42 is straightened to the esophagus. Therefore,
The ultrasonic transducer 42 is rotationally driven, and ultrasonic pulses are transmitted at a predetermined angle during this period to receive reflected echoes from the inside of the body, whereby the ultrasonic observation field S in a direction substantially orthogonal to the inner wall of the esophagus You get ₁ .

Next, when the insertion portion 30 is positioned at the position shown in FIG. 7, the observation window 34 and the ultrasonic transducer 42 are placed in a substantially V-shaped positional relationship toward the corner P ₂ of the stomach. It will be held. Therefore, by rotating the ultrasonic transducer 42 while putting this gastric corner P ₂ into the observation visual field through the observation window 34, the ultrasonic observation visual field S ₂ in the direction orthogonal to this gastric corner P ₂ is obtained. You will be able to get it.

Then, as shown in FIG.
To the inside of the duodenum, and within this duodenum, the nipple P ₃
When is positioned at the center of the observation field of view by the observation window 34, the direction of the ultrasonic observation field of view by the ultrasonic transducer 42 is S ₃ . Since this direction is the direction of the pancreaticobiliary duct, while observing the site of the entrance of the nipple P ₃ through the observation window 34, the treatment instrument C such as a cannula is moved from the treatment instrument deriving section 35 to the inside of the pancreaticobiliary duct from the nipple P _3. By acquiring an ultrasonic tomographic image of the ultrasonic transducer 42 in this direction when guiding, it is possible to determine to which depth position the treatment instrument C has been inserted, and in which direction the pancreatic duct or the bile duct has been inserted. Confirmation can be done.

Further, in order to carry out ultrasonic observation at a portion shown by P ₄ which is a concave curved portion on the inner wall of the stomach as shown in FIG. The side provided with is made to face the part P ₄ so as to be in the endoscopic observation visual field, and thereafter,
The entire insertion portion 30 is rotated about the 180 ° axis. As a result, the tip cap 40 including the ultrasonic transducer 42 is built in.
Becomes almost parallel to the inner wall of the part P ₄ . Therefore, if the ultrasonic transducer 42 is rotationally driven in this state, the direction of the ultrasonic observation field of view becomes S ₄ , and an ultrasonic image in a direction substantially orthogonal to the body cavity wall can be obtained.

In this way, the entire insertion portion 30 is
In order to rotate about the 80 ° axis, the connecting portion between the insertion portion 30 and the main body operating portion may be provided with a rotation mechanism as shown in FIGS. 10 and 11. That is, the rotary cylinder 50 is connected to the insertion portion 30, and the rotary cylinder 50 is rotatably inserted into the holding cylinder 51 extending from the main body operation unit. An operation ring 52 is fixedly provided on the rotary cylinder 50, and the operation ring 52 is extended so as to cover the holding cylinder 51 with a predetermined gap. As a result, when the operation ring 52 is rotated, the rotary cylinder 50 and the insertion portion 30 follow the rotation and rotate around the axis. Here, if the rotation angle of the insertion portion 30 is not regulated, the insertion portion 30
Twisting will occur in the member inserted in the. In order to avoid such a situation, a pin 53 is attached to the holding cylinder 51, and the pin 53 is engaged with a groove 54 formed in the circumferential direction on the outer peripheral surface of the rotary cylinder 50. The groove 54 may be formed so as to form an angle of 180 °.

In the above-mentioned embodiment, the ultrasonic endoscope is mainly used for the examination of the upper digestive organs, but it goes without saying that it can be used for the examination of other parts. Yes. Further, the insertion passage through which the flexible shaft is inserted is divided into the straight passage portion and the inclined passage portion, but it may be constituted by only the inclined passage portion, and the whole passage is curved. May be Then, the rotary shaft connected to the ultrasonic transducer and the flexible shaft inserted in the insertion portion can be connected via a transmission means such as a gear. Furthermore, although the observation window in the endoscope observation mechanism is of a so-called side-view type in a direction orthogonal to the axis of the insertion portion, it may be a front or rear perspective type. Furthermore, it can also be applied to an ultrasonic endoscope in which a treatment instrument lead-out section or the like is not provided.

[0028]

As described above, according to the present invention, the ultrasonic transducer and the rotation axis of the ultrasonic transducer are oriented in the visual field direction of the endoscope observation mechanism with respect to the axis of the insertion portion. Since it is configured to be tilted by an angle, the ultrasonic observation field of view can be brought closer to the direction of the endoscope observation field of view, and the necessary site within this endoscope observation field of view can be easily observed under the observation of the endoscope observation mechanism. It has the effect of being able to observe ultrasonic waves.

[Brief description of drawings]

FIG. 1 is an external view of a distal end portion of an insertion portion of an ultrasonic endoscope showing an embodiment of the present invention.

FIG. 2 is a sectional view taken along line XX of FIG.

FIG. 3 is a sectional view taken along line YY of FIG. 1;

4 is an operation explanatory view showing a state in which the ultrasonic endoscope of FIG. 1 is inserted into a body cavity through a throat.

FIG. 5 is an external view of the insertion portion viewed from the distal end side.

6 is an operation explanatory view showing a state in which an examination of the esophagus is performed with the ultrasonic endoscope of FIG.

FIG. 7 is an operation explanatory view showing a state in which the inside of the stomach is inspected by the ultrasonic endoscope of FIG.

8 is an operation explanatory view showing a state in which the duodenum is inspected by the ultrasonic endoscope of FIG. 1. FIG.

9 is an operation explanatory view showing a state in which a region different from that in FIG. 7 in the stomach is inspected by the ultrasonic endoscope in FIG.

FIG. 10 is a half cross-sectional view showing the configuration of a rotation mechanism around the axis of the insertion portion.

11 is a sectional view taken along line ZZ of FIG.

FIG. 12 is a schematic configuration diagram of an ultrasonic endoscope.

FIG. 13 is an external view of the distal end portion of the insertion portion of the ultrasonic endoscope according to the related art.

14 is a sectional view taken along line NN of FIG.

FIG. 15 is an operation explanatory view showing a state in which the inside of the stomach is inspected by the ultrasonic endoscope according to the conventional technique.

FIG. 16 is an operation explanatory view showing a state in which an esophagus is inspected by a conventional ultrasonic endoscope.

FIG. 17 is an operation explanatory view showing a state in which a duodenum is inspected by an ultrasonic endoscope according to a conventional technique.

[Explanation of symbols]

 30 Insertion Part 31 Tip Part Main Body 31a Endoscope Observation Mechanism Mounting Part 33 Illumination Window 34 Observation Window 37 Insertion Passage 37a Straight Passage 37b Inclined Passage 40 Tip Cap 42 Ultrasonic Transducer 43 Rotation Shaft 45 Flexible Shaft

Claims (3)

[Claims] 1. A distal end body having an endoscope observation mechanism having an illumination window and an observation window is provided at the distal end of the insertion portion, and an ultrasonic transducer is rotatably mounted in the distal end cap. An ultrasonic observation mechanism that performs ultrasonic scanning with an ultrasonic transducer is provided so as to project from the tip end body, and the ultrasonic transducer and the rotation axis of the ultrasonic transducer are roughly aligned with the axis of the insertion portion. An ultrasonic endoscope characterized in that it is provided so as to be inclined by a predetermined angle so as to face the field of view of the endoscope observation mechanism. 2. The rotation transmitting member for rotationally driving the ultrasonic transducer is formed of a flexible shaft formed of a close contact coil, and a tip portion of the flexible shaft is bent. The ultrasonic endoscope according to 1. 3. The distal end portion main body is provided with an inclined passage that guides the flexible shaft in a predetermined angle direction with respect to the axis of the distal end portion main body. Ultrasound endoscope.