JP4199537B2 - Forceps raising mechanism of ultrasonic endoscope - Google Patents

Description

[0001]
【Technical field】
The present invention relates to a forceps raising mechanism of an ultrasonic endoscope.
[0002]
[Prior art and its problems]
As an example of an ultrasonic endoscope, an operation part and a flexible insertion part are provided, and an ultrasonic wave is transmitted to the distal end of the insertion part toward the test part and reflected. And a forceps channel penetrating the operation portion and the insertion portion is formed inside the operation portion and the insertion portion. The forceps channel has an inlet end at the operation portion, and the forceps channel has an outlet end at the distal end of the insertion portion located immediately after the ultrasonic probe. Furthermore, a CRT monitor for displaying an ultrasonic tomographic image is connected to the ultrasonic endoscope.
[0003]
In such an ultrasonic endoscope, a finger-suck rubber balloon is attached to the ultrasonic probe, the insertion portion is inserted into the body cavity, and deaerated water is sent between the ultrasonic probe and the balloon. The balloon is inflated to bring the balloon into contact with the test portion in the body cavity. And an ultrasonic tomogram can be displayed on a CRT monitor by emitting an ultrasonic wave from an ultrasonic probe and receiving an ultrasonic wave reflected by a body part to be examined by the ultrasonic probe.
[0004]
A treatment tool can be inserted into the forceps channel, and if the distal end of the treatment tool protrudes from the outlet side end of the forceps channel, the treatment portion can be treated by the treatment tool.
[0005]
Further, a forceps raising mechanism that is rotatable in a direction approaching (sleeping) and a direction separating (raising) the bottom surface of the forceps channel is provided in the outlet side end portion of the forceps channel. When the treatment tool is placed on the distal end of the forceps raising mechanism, the distal end of the treatment tool protrudes outside the forceps channel, and when the forceps raising mechanism is laid in this state, the distal end of the treatment tool approaches the ultrasonic probe. When the forceps raising mechanism is raised, the distal end portion of the treatment tool is bent with respect to the base portion and away from the ultrasonic probe (for example, Patent Document 1).
[0006]
Since the axis near the outlet end of the forceps channel faces away from the ultrasonic probe, if the axis of the treatment tool is oriented in the same direction as the axis of the forceps channel, the distal end of the treatment tool breaks through the balloon. There is no contact with the ultrasonic probe.
However, since the cross-sectional diameter of a puncture needle, which is one of the treatment tools, is considerably smaller than the cross-sectional diameter of the forceps channel, the sheath is not only in the axial direction of the forceps channel but also in the axial direction inside the forceps channel. You can move with great freedom in the direction. For this reason, if the dimensions of the forceps lifting mechanism are set so that the distance between the tip of the forceps lifting mechanism and the bottom surface of the forceps channel is shortened when the forceps lifting mechanism is laid to the limit, the forceps lifting mechanism is set to the limit. When laid down, the needle may come into contact with the balloon. When the needle contacts the balloon, it is dangerous because the needle may break through the balloon and contact the ultrasonic probe.
[0007]
To solve this problem, set the dimensions of the forceps lifting mechanism so that the distance between the tip of the forceps lifting mechanism and the bottom surface of the forceps channel is longer when the forceps lifting mechanism is laid to the limit. do it.
However, such a dimension setting causes another problem when a treatment instrument having a large cross-sectional diameter such as a stent is inserted into the forceps channel. That is, in this case, when the forceps raising mechanism is laid down to the limit, the distal end of the stent is already bent in the direction away from the ultrasonic probe with respect to the base, so the forceps raising mechanism is slightly raised. Therefore, the bending angle of the distal end portion of the stent immediately reaches the limit, and thus the angle of the distal end portion of the stent with respect to the axis of the forceps channel cannot be changed greatly.
[0008]
[Patent Document 1]
Japanese Patent Laid-Open No. 9-122067
OBJECT OF THE INVENTION
The present invention provides a treatment instrument having a large cross-sectional diameter, even when the treatment tool has a small cross-sectional diameter, when the forceps raising mechanism is laid down to the limit, the tip portion thereof does not contact the ultrasonic probe. Another object of the present invention is to provide a forceps raising mechanism for an ultrasonic endoscope that can greatly change the bending angle of its tip by raising the forceps raising mechanism to the limit.
[0010]
SUMMARY OF THE INVENTION
The forceps raising mechanism of the ultrasonic endoscope of the present invention includes an ultrasonic endoscope having an opening of a forceps channel and an ultrasonic probe that emits ultrasonic waves located in front of the opening at the distal end of the insertion portion. In this embodiment, a holding base and a levitation base pivoted on an axis parallel to each other in the opening of the forceps channel; a treatment instrument insertion hole communicating with the forceps channel formed between the holding base and the levitation base; Urging means for urging and rotating the treatment instrument insertion hole in a direction in which the size of the treatment tool insertion hole is reduced; and one end portion is coupled to the free end portion side of the holding table, and the other end portion can be pulled by the operation portion side. An operation wire.
[0011]
The restraining base and the levitating base are pivoted coaxially, and the restraining base has a substantially U-shape having a pair of leg portions pivoted at one end and a connecting portion connecting the pair of leg portions. The levitation base is located between the pair of leg portions of the holding base, and it is practical to form a treatment instrument insertion hole between the levitation base and the connection portion.
[0012]
The biasing means may be a leaf spring fixed to the levitation base.
[0013]
The biasing means may be a compression coil spring provided between the opening of the forceps channel and the levitation base.
[0014]
Furthermore, it is preferable to form a V-shaped groove at a portion of the connecting portion facing the levitation base.
[0015]
DETAILED DESCRIPTION OF THE INVENTION
Hereinafter, an embodiment of the present invention will be described with reference to the accompanying drawings.
An ultrasonic endoscope 10 shown in FIG. 1 includes an operation unit 11 and an insertion unit 12, and a distal end portion 12 a of the insertion unit 12 is vertically and horizontally and according to an operation of a bending operation device 13 provided in the operation unit 11. It is curved in the direction.
The distal end portion 12a is provided with an observation window (object window) and an illumination optical system (not shown). An image obtained through the observation window can be observed from an eyepiece unit 14 provided in the vicinity of the operation unit 11.
[0016]
Furthermore, a fiber bundle (not shown) as a light guide member that penetrates the operation unit 11 and the insertion unit 12 is disposed inside the ultrasonic endoscope 10. The fiber bundle passes through the inside of the light guide flexible tube 15 connected to the operation unit 11 and is connected to the light source device 16, and an incident end face of the fiber bundle is a light source lamp disposed in the light source device 16. (Not shown). On the other hand, since the emission end face formed at the tip of the fiber bundle faces the illumination optical system inside the tip 12a of the insertion portion 12, illumination light from the light source device 16 is given to the illumination optical system. It is done.
[0017]
The operation unit 11 is connected to a water supply tank T that stores deaerated water via a water supply pipe (not shown) disposed inside the light guide flexible pipe 15. A water supply passage (not shown) is formed inside the operation portion 11 and the insertion portion 12, and an inlet side end portion of the water supply passage is connected to a water supply pipe, and an outlet side end of the water supply passage is provided. The part is a water supply port (not shown) that opens at the tip 12a. When a water supply button (not shown) provided on the operation unit 11 is pressed, deaerated water is discharged from the water supply port, and when a suction button (not shown) provided on the operation unit 11 is pressed, the water supply port is released. Can breathe air.
[0018]
Furthermore, as shown in FIG. 2, the distal end portion 12a of the insertion portion 12 is provided with an ultrasonic probe 17 having a substantially arc shape in a side view. The ultrasonic probe 17 is subjected to electrical processing by an ultrasonic diagnostic apparatus (not shown) connected to the ultrasonic connector C, and transmits ultrasonic waves from the surface thereof toward the test portion. The ultrasonic wave reflected by is received.
[0019]
As shown in FIG. 2, an inclined surface 12b is formed at a position located immediately after the ultrasonic probe 17 of the insertion portion 12, and a concave portion 18 is formed in the inclined surface 12b.
Furthermore, a forceps port 19 for inserting a treatment tool is provided at the end of the insertion unit 12 on the operation unit 11 side, and the forceps port 19 is on the inlet side of the forceps channel 20 that penetrates the insertion unit 12. It is an end. The outlet side end 21 of the forceps channel 20 communicates with the recess (opening) 18, and the axis A (see FIG. 2) in the vicinity of the outlet side end 21 of the forceps channel 20 is in a direction to avoid the ultrasonic probe 17. It is suitable.
[0020]
The recess 18 is provided with a forceps raising mechanism 22 having the following configuration.
A pair of mounting pieces 23 are provided on both side portions of the bottom surface 18a of the recess 18, and between both the mounting pieces 23, both in the direction D (see FIG. 2) orthogonal to the bottom surface 18a and the axis A. A rotating shaft 24 parallel to the direction perpendicular to the rotating shaft 24 is rotatably supported.
On both ends of the rotary shaft 24, a holding table 25 having a substantially inverted U shape when viewed from the front is attached so as to be relatively rotatable. The restraining base 25 includes a pair of leg portions 26 that form a substantially triangular shape in a side view that is attached to the rotary shaft 24 so as to be relatively rotatable, and a connection portion 27 that connects the tip portions of both leg portions 26. A V-shaped groove 27a is formed at a portion of the portion 27 facing the bottom surface 18a. The bottom of the restraining table 25 is always in contact with the bottom surface 18a.
Further, the distal end portion of the operation wire W is fixed to one leg portion 26, and the proximal end portion of the operation wire W is fixed to a forceps raising mechanism lever (not shown) provided in the operation portion 11. Has been. When the forceps raising mechanism lever is operated in one direction, the holding table 25 rotates in the direction in which the bottom part is separated from the bottom surface 18a, and when the operation is performed in the opposite direction, the holding table 25 has its bottom part approaching the bottom surface 18a. Rotate in the direction.
[0021]
At the central portion of the rotating shaft 24, the base end portion of the plate-like levitation base 29, whose width in the direction of the rotating shaft 24 is narrower than the interval between the both leg portions 26 and whose distal end portion is located between the both leg portions 26, is fixed. ing. A treatment instrument insertion hole 28 is formed between the connecting portion 27 and the levitation base 29, and further, between the both leg portions 26, the surface facing the bottom surface 18 a of the levitation base 29 is in contact with the levitation base 29. Is provided with a leaf spring (biasing means) 30 that constantly urges rotation in a direction approaching the V-shaped groove 27a.
[0022]
As a treatment tool that can be inserted into the forceps channel 20, there are a puncture needle U shown in FIGS. 2 and 5 to 7, and a stent S shown in FIGS.
The puncture needle U is inserted into a sheath 31 made of a resin or a spiral spring-shaped metal connected to the tip of a syringe (not shown) and the sheath 31 so as to be relatively movable. The needle 32 protrudes from the tip of 31. The cross-sectional diameter of the sheath 31 is about 1/3 of the inner diameter of the forceps channel 20.
The stent S is a tubular member made of plastic or metal, and its cross-sectional diameter is smaller than the inner diameter of the forceps channel 20 but larger than the cross-sectional diameter of the sheath 31.
[0023]
Next, how to use the ultrasonic endoscope 10 and the treatment tool will be described.
First, the tip portion 12a of the insertion portion 12 is covered with a finger-suck rubber balloon B, and the mouth of the balloon B is fitted into the annular groove portion 12c formed on the surface of the insertion portion 12 by the O-ring R, and the inner surface of the balloon B is fitted. It is made to adhere to tip part 12a. In this state, the insertion part 12 is inserted into the body cavity while looking into the eyepiece part 14, and the distal end part 12a is brought close to the test part.
[0024]
Next, the water supply button provided on the operation unit 11 is pressed, deaerated water is sent from the water supply port of the tip part 12a to the gap between the inner surface of the balloon B and the tip part 12a, and the balloon B is inflated and brought into contact with the test part. Furthermore, an ultrasonic wave is transmitted from the ultrasonic probe 17 to check the state of the test part.
[0025]
As a result, if it is necessary to inject a drug into the test part, the puncture needle U connected to the syringe is inserted into the forceps channel 20 from the forceps port 19, passed through the treatment tool insertion hole 28, and the distal end portion is exited It protrudes to the outside of the side end portion 25. Then, the needle 32 is pierced into the test part, and the medicine in the syringe is injected from the needle 32 into the test part.
[0026]
Since the sheath 31 of the puncture needle U has a cross-sectional diameter as small as about 1/3 of the inner diameter of the forceps channel 20, the forceps channel 20 can freely move not only in the direction of the axis A but also in the direction perpendicular to the axis A. The degree is also great. For this reason, conventionally, when the forceps raising mechanism is laid down (approached to the bottom surface 18 a side), the needle 32 is too close to the ultrasonic probe 17 and may break through the balloon B and come into contact with the ultrasonic probe 17.
However, in the present embodiment, the puncture needle U is held between the levitation base 29 that is always urged to rotate toward the connection portion 27 and the V-shaped groove 27a, and the needle 32 is moved away from the ultrasonic probe 17. 2, the needle 32 does not contact the ultrasonic probe 17 even if the holding table 25 is laid down to the limit position where it contacts the bottom surface 18a as shown in FIG. Further, since the puncture needle U is engaged with the V-shaped groove 27a, the puncture needle U does not rattle against the forceps raising mechanism 22.
2, since the tip of the needle 32 is already positioned in front of the apex 17a of the ultrasonic probe 17, even if the needle 32 is protruded further, the tip of the needle 32 remains at the ultrasonic probe. 17 is not touched.
[0027]
Further, when the forceps raising mechanism lever is operated in one direction, as shown in FIG. 7, the holding base 25 rotates in the direction of rising (away from the bottom surface 18 a), and the distal end portion of the sheath 31 is the outlet end portion. It bends about a contact part with 25, and the angle with respect to the axis A of the needle | hook 32 becomes large.
When the forceps raising mechanism lever is returned in the opposite direction, the holding table 25 rotates in the sleeping direction.
[0028]
On the other hand, if it is necessary to insert the stent S into the body cavity as a result of examining the state of the test portion, the stent S is inserted into the forceps channel 20 from the forceps port 19 and the tip portion thereof floats with the V-shaped groove 27a. The tip of the stent S is protruded from the outlet side end 21 into the body cavity by being held between the platforms 29. At this time, since the stent S engages with the V-shaped groove 27a, it does not rattle against the forceps raising mechanism 22.
[0029]
Since the cross-sectional diameter of the stent S is larger than the cross-sectional diameter of the sheath 31, when the stent S is inserted between the V-shaped groove 27a and the levitation base 29, the levitation base 29 resists the urging force of the leaf spring 30 and the sheath S Compared with the case where 31 is inserted, it falls down largely toward the bottom surface 18a side. Therefore, as shown in FIG. 8, when the restraining table 25 is laid down to the limit, the stent S approaches the ultrasonic probe 17 a side in a range not contacting the balloon B. On the other hand, when the forceps raising mechanism lever is operated to rotate the holding base 25 in the direction away from the bottom surface 18a, the distal end portion of the stent S bends around the contact portion with the outlet side end portion 21, and the distal end of the stent S The angle formed by the portion and the axis A increases. When the forceps raising mechanism lever is returned in the opposite direction, the holding table 25 rotates in the sleeping direction.
Thus, even when the stent S is used as a treatment tool, by rotating the restraining table 25 from the position where it is laid to the limit (state of FIG. 8) to the position where it is raised to the limit (state of FIG. 11), The inclination angle with respect to the axis A of the distal end portion of the stent S can be greatly changed.
[0030]
In this embodiment, the plate spring 30 is used as the means for rotating and biasing the levitation base 29 toward the connecting portion 27 side. However, as a compression coil spring (not shown) provided between the bottom surface 18 a and the levitation base 29. Also good.
Further, although the holding table 25 and the levitation table 29 are supported by the common rotating shaft 24, the holding table 25 and the levitation table 29 may be supported by separate rotating shafts that are parallel to each other.
[0031]
【The invention's effect】
According to the present invention, even with a treatment tool having a small cross-sectional diameter, when the forceps raising mechanism is laid down to the limit, the distal end portion thereof does not contact the ultrasonic probe, and the treatment tool has a large cross-sectional diameter. Even if it exists, the bending angle of the front-end | tip part can be greatly changed by raising the forceps raising mechanism to the limit.
[Brief description of the drawings]
FIG. 1 is an external view showing the overall structure of an embodiment of the present invention.
FIG. 2 is an enlarged side view in which a portion near the distal end portion of an insertion portion of an ultrasonic endoscope is broken when a puncture needle is inserted into a forceps channel.
FIG. 3 is an enlarged side view of a forceps raising mechanism.
FIG. 4 is an enlarged front view of a forceps raising mechanism.
FIG. 5 is an enlarged side view of a forceps raising mechanism and a puncture needle.
6 is a cross-sectional view taken along line VI-VI in FIG.
FIG. 7 is an enlarged side view in which a portion near the distal end portion of the insertion portion of the ultrasonic endoscope is broken when the forceps raising mechanism is raised to bend the distal end portion of the puncture needle.
FIG. 8 is an enlarged side view in which a portion near the distal end portion of the insertion portion of the ultrasonic endoscope is broken when the stent is inserted into the forceps channel.
FIG. 9 is an enlarged side view of a forceps raising mechanism and a puncture needle.
10 is a cross-sectional view taken along line XX of FIG.
FIG. 11 is an enlarged side view in which a portion near the distal end portion of the insertion portion of the ultrasonic endoscope is broken when the distal end portion of the stent is bent by raising the forceps raising mechanism.
[Explanation of symbols]
DESCRIPTION OF SYMBOLS 10 Ultrasonic endoscope 11 Operation part 12 Insertion part 12a Tip part 12b Inclined surface 12c Annular groove part 13 Bending operation apparatus 14 Eyepiece part 15 Light guide flexible tube 16 Light source apparatus 17 Ultrasonic probe 18 Recessed part (opening part)
18a bottom surface 19 forceps port 20 forceps channel 21 outlet side end portion 22 forceps raising mechanism 23 mounting piece 24 rotating shaft 25 restraining base 26 leg portion 27 connecting portion 27a V-shaped groove 28 treatment tool insertion hole 29 floating base 30 leaf spring (attached) Means)
31 Sheath 32 Needle A Axis B Balloon C Ultrasonic connector D Direction orthogonal to the bottom surface of the recess RO ring S Stent (treatment tool)
T Water supply tank U Puncture needle (treatment instrument)
W Operation wire

Claims (5)

In an ultrasonic endoscope having an opening of a forceps channel at the distal end of the insertion portion and an ultrasonic probe that emits an ultrasonic wave positioned in front of the opening,
A holding base and a levitating base pivoted on an axis parallel to each other in the opening of the forceps channel;
A treatment instrument insertion hole communicating with the forceps channel formed between the holding table and the levitation table;
An urging means for urging the levitation base in a direction in which the size of the treatment instrument insertion hole is reduced;
And an operation wire having one end coupled to the free end side of the holding table and capable of pulling the other end on the operation unit side;
A forceps raising mechanism for an ultrasonic endoscope, comprising: 2. The forceps raising mechanism of an ultrasonic endoscope according to claim 1, wherein the restraining base and the levitation base are coaxially pivoted, and the restraining base has a pair of leg portions pivoted at one end and the leg base, It has a substantially U-shape having a connecting portion for connecting a pair of legs, and the levitation base is located between the pair of legs of the holding base, and is a treatment instrument between the connecting portions. Forceps raising mechanism of an ultrasonic endoscope that forms an insertion hole. The forceps raising mechanism for an ultrasonic endoscope according to claim 1 or 2, wherein the biasing means is a leaf spring fixed to the levitation base. The forceps raising mechanism of the ultrasonic endoscope according to claim 1 or 2, wherein the biasing means is a compression coil spring provided between the opening of the forceps channel and the levitation base. Forceps raising mechanism. 5. The forceps raising mechanism for an ultrasonic endoscope according to any one of claims 2 to 4, wherein a V-shaped groove is formed in a portion of the connecting portion facing the levitation base. mechanism.

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