JP4619099B2 - Bronchial ultrasound endoscope - Google Patents

Description

  The present invention relates to an ultrasonic endoscope for bronchus that is inserted into a bronchus and used for performing a puncture treatment.

  Since ultrasonic waves are significantly less propagated in air than underwater, a balloon formed of a resilient material is generally placed around the ultrasonic probe at the distal end of the insertion portion of an ultrasonic endoscope. It is used in a state where a balloon inflated with degassed water or the like in the direction of transmitting and receiving ultrasonic waves is pressed against the mucosal surface (for example, Patent Document 1).

  When such an ultrasonic endoscope is used not only for tomographic image observation but also for medical treatment, a puncture needle is protruded from a treatment tool protrusion formed at the distal end of the insertion portion, and injected under the mucous membrane. A puncture procedure is often performed to perform a puncture or extract a tissue.

  At the distal end of the insertion part of such an ultrasonic endoscope, a treatment tool projection port for projecting the treatment tool is arranged on the side surface. When performing a puncture treatment by projecting a puncture needle therefrom, In the case where the puncture needle is hard, etc., even if the puncture needle is protruded, the distal end of the insertion portion is merely retracted by the reaction force received from the affected portion side, and the puncture needle may not pierce the affected portion.

Therefore, a projection member that can be protruded and retracted mechanically by remote control is provided on the back side of the curved portion adjacent to the distal end of the insertion portion so that the distal end of the insertion portion does not retract during the puncture treatment. There is (for example, Patent Document 2).
JP-A-8-257029 JP 2004-105289 A

  However, if a protrusion member that can be mechanically protruded and retracted by remote operation is provided near the distal end of the insertion portion as described in Patent Document 2, a general endoscope is provided due to the presence of an ultrasonic probe or a balloon. In comparison, the distal end of the insertion portion of the ultrasonic endoscope that is larger than the insertion portion and causes great pain to the patient at the time of insertion may be further enlarged, which may cause significant pain to the patient.

  In addition, even if a mechanical projection member is provided on the back side of the treatment instrument projection port, if the reaction force received by the puncture needle acts in an oblique direction, the distal end of the insertion portion is positioned with the projection member as a fulcrum. It will be overturned and cannot puncture the affected area.

  Therefore, it is most desirable if the distal end of the insertion portion can be fixed in the body cavity with a balloon as described in Patent Document 1. FIG. 7 schematically shows such a state, in which 91 is an ultrasonic probe provided at the distal end 90 of the insertion portion, 92 is a balloon, 93 is a puncture needle, and 100 is a trachea.

  However, as shown in FIG. 8 illustrating the arrow VIII in FIG. 7, if the trachea 100 is completely blocked by the balloon 92, the patient cannot breathe through the trachea 100, Since it becomes a big physical burden, it is not preferable.

  Therefore, the present invention enables the tip of the insertion portion to be securely fixed in the bronchus with a balloon in a state where the airway is secured in the trachea, and the puncture needle is securely punctured even on a hard affected area. An object is to provide an ultrasonic endoscope for bronchi that can be performed safely and smoothly.

  In order to achieve the above object, an ultrasonic endoscope for bronchi of the present invention surrounds an ultrasonic probe disposed at the distal end of an insertion portion, and is attached with an inflatable / deflatable balloon made of a resilient material. In a bronchial ultrasonic endoscope in which a treatment instrument projection for projecting a treatment instrument is arranged on the side surface of the distal end of the insertion portion, a ventilation path that opens on the front side and the rear side when the balloon is inflated Is attached to the balloon.

  The air passage may be a tubular member fixed to the outer surface or the inner surface of the balloon, and the air passage may be formed by integral molding with the balloon.

  According to the present invention, by inflating the balloon, it is possible to reliably fix the distal end of the insertion portion in the bronchus and to puncture the puncture needle even in a hard affected area, etc. Since the airway is always secured in the bronchus by the road, the patient's breathing can be secured and the puncture treatment can be performed safely and smoothly.

  Surrounding the ultrasonic probe placed at the distal end of the insertion section, an inflatable / deflatable balloon made of a resilient material is attached, and a treatment instrument projection for projecting the treatment instrument is located on the side of the distal end of the insertion section In the ultrasonic endoscope for bronchi thus formed, when the balloon is inflated, an air passage that opens on the front side and the rear side of the balloon is attached to the balloon.

Embodiments of the present invention will be described with reference to the drawings.
FIG. 1 schematically shows a distal end portion of a state in which an insertion portion 1 of an endoscopic endoscope for bronchi is inserted into a trachea 100, and a front half of a distal end portion main body 2 connected to the distal end of the insertion portion 1. A so-called convex-type ultrasonic probe 3 is arranged on the side surface of the unit so as to emit and receive an ultrasonic signal to the side of the tip body 2 and scan in a fan shape in the front-rear direction.

  Further, an observation window 4 for optical observation is formed on a slope formed obliquely forward on the side surface in the same direction as the ultrasonic probe 3 in the rear half (right half in FIG. 1) of the tip body 2. The illumination window 5 is arranged side by side, and the tip of the treatment instrument such as the puncture needle 50 is protruded into the ultrasonic scanning range (that is, the optical observation range from the observation window 4) by the ultrasonic probe 3. A treatment tool protrusion 6 is formed. Reference numeral 7 denotes a treatment instrument insertion channel that communicates with the treatment instrument protrusion 6 and is inserted into the insertion portion 1.

  Reference numeral 10 denotes a balloon made of an elastic material such as silicon rubber, and this state is shown in FIG. 2 (side half sectional view) and FIG. 3 (front view). The balloon 10 of the example is formed in a substantially cylindrical shape opened in a state where both end portions are slightly narrowed, and O-ring-shaped fastening rings 11 are formed at both end portions.

  Further, on the outer surface of the balloon 10, a tube-like member 12 made of, for example, a silicon rubber tube or a tetrafluoroethylene resin tube having both ends opened is arranged in the axial direction and bonded and fixed. The shaped member 12 forms an air passage that opens on the front side and the rear side when the balloon 10 is inflated.

  Returning to FIG. 1, the balloon 10 is formed by inserting a ring 11 into circumferential grooves respectively formed at both front and rear positions with the ultrasonic probe 3 on the outer peripheral portion of the distal end body 2 interposed therebetween. It is attached in a watertight manner to surround the acoustic probe 3 and is detachable from the tip body 2. The balloon 10 may be attached to the distal end portion body 2 with a surgical suture or the like.

  Deaerated water can be injected and discharged into the balloon 10 by remote control from an operation unit (not shown) connected to the proximal end side of the insertion unit 1. Elastically deforms and expands and contracts.

  When performing a puncture treatment in the trachea 100 using the bronchial ultrasonic endoscope of the embodiment configured as described above, the balloon 10 is placed at the target position of the trachea 100 as shown in FIG. Inflate so that it is in close contact with the entire inner wall.

  As a result, the distal end body 2 is stably fixed near the center of the trachea 100. Therefore, if the distal end of the puncture needle 50 is pushed out from the treatment instrument projection port 6, the affected area to be punctured is hard. In addition, the puncture treatment can be performed by reliably piercing the affected part with the puncture needle 50 without almost retracting the distal end main body 2.

  As shown in FIG. 4 illustrating the arrow IV in FIG. 1, the trachea 100 is closed by the balloon 10, but the front and rear of the balloon 10 are communicated by the tubular member 12. The patient's breathing is ensured via the tubular member 12, and the puncture treatment can be performed safely and smoothly.

FIG. 5 is a reference example in which the tubular member 12 is bonded and fixed to the inner surface side of the balloon 10, and FIG. 6 is a reference example in which a plurality of the tubular members 12 are provided , both of which are outside the scope of the present invention .

1 is a partial cross-sectional side view of a distal end of an insertion portion in a state in which a bronchial ultrasonic endoscope according to a first embodiment of the present invention is inserted into a trachea. It is a side half sectional view of the balloon simple substance of the ultrasonic endoscope for bronchi of the 1st example of the present invention. It is a front view of the balloon simple substance of the ultrasonic endoscope for bronchi of the 1st example of the present invention. FIG. 4 is an arrow IV diagram in FIG. 1 of the bronchial ultrasonic endoscope of the first embodiment of the present invention. It is a side half sectional view of the balloon simple substance of the endoscopic endoscope for bronchi of a reference example outside the range of the present invention. It is a front view of the balloon simple substance of the ultrasonic endoscope for bronchi of the reference example outside the range of the present invention. FIG. 10 is a partial side sectional view of a distal end of an insertion portion in a state where a conventional bronchoscopic ultrasonic endoscope is inserted into a trachea. It is the arrow VIII figure in FIG. 7 of the conventional ultrasound endoscope for bronchi.

Explanation of symbols

1 Insertion Section 2 Tip Body (Insertion Tip)
3 Ultrasonic probe 6 Treatment tool protrusion 10 Balloon 12 Tubular member (air passage)
50 Puncture needle (treatment tool)
100 trachea

Claims (1)

An inflatable / deflatable balloon made of a resilient material is attached to surround the ultrasonic probe arranged at the distal end of the insertion section, and a treatment instrument protrusion for projecting the treatment instrument is formed on the side surface of the insertion section distal end. In the placed bronchial ultrasound endoscope,
An air passage that opens on the front side and the rear side when the balloon is inflated is formed by a tubular member, and the tubular member is bonded and fixed to the outer surface of the balloon. Bronchial ultrasound endoscope.

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