JPH048054B2 - - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION [Field of Industrial Application] The present invention relates to an ultrasonic diagnostic device that is used by being inserted into a living body.

[Prior Art] In order to accurately diagnose or treat lesions within a living body, attention has been paid to the combined use of transendoscopic optical observation images and ultrasonic tomographic images using an ultrasound probe. . In this case, it is conceivable to incorporate an ultrasound probe into the distal end component of a device that has an observation optical system and is inserted into a living body, such as an endoscope.

[Problems to be Solved by the Invention] However, since the ultrasonic probe is larger in shape than the various optical system members built into the tip component, it is difficult to use the ultrasonic probe as an optical system member or a puncture needle lead-out mechanism. If they were built together, it would be easy to increase the size of the tip component. Since this type of ultrasonic diagnostic device is inserted into a living body to perform medical treatment, it is desired that the tip component and the like be made as thin and compact as possible.

Therefore, an object of the present invention is to use an ultrasonic probe to ascertain the condition under the surface of a body cavity wall or an organ, and to accurately insert a puncture needle into a desired site under ultrasonic diagnosis. It is an object of the present invention to provide an ultrasonic diagnostic device that can perform safe puncture treatment and that can downsize its tip component.

[Means for Solving the Problems] In order to achieve the above object, the ultrasound diagnostic device invented by the present inventor has an ultrasound transmitting/receiving surface in the lateral direction on the distal end component of the elongated insertion section inserted into the living body. A puncture needle is inserted into the ultrasonic probe, which is placed on the same side as the ultrasonic transmitting and receiving surface of the probe, and which is placed on the insertion proximal side of the tip structure than the probe, in the direction to be examined by the probe. A puncture needle outlet that is led out in a reversible manner, and a position that is closer to the insertion proximal side than the probe and where the puncture needle led out from the puncture needle outlet is visible, and that is deviated laterally from the diagnostic center line of the probe. and a window for an observation optical system located at a certain position.

[Function] The ultrasonic diagnostic apparatus of the present invention having the above configuration is capable of obtaining an ultrasonic tomographic image using an ultrasonic probe while visually observing the body wall, etc. and the puncture needle through the window of the observation optical system, and at the same time obtaining a desired image using the puncture needle. Treatment can be carried out. In the device of the present invention, the ultrasonic probe, which occupies a relatively large volume within the tip component, is placed closer to the insertion tip than the observation optical system, puncture needle outlet, etc., and the window of the observation optical system is aligned with the diagnostic center line of the probe. Since the observation optical system member and the insertion path of the puncture needle, which are inserted through the thin tip structure, can be easily arranged in the tip structure so as not to interfere with the ultrasound probe.

[Embodiment] A first embodiment of the present invention will be described below based on FIGS. 1 to 3. The present embodiment is a so-called rigid scope type ultrasonic diagnostic device, in which 1 is an elongated rigid insertion section that is inserted into a body cavity, 2 is a tip component located at the tip of the insertion section 1, Reference numeral 3 indicates an operation unit on the hand side, and reference numeral 4 indicates a universal cord connected to a light source device (not shown). Further, an ultrasonic probe 5 is attached to the tip component 2, with an ultrasonic wave transmitting/receiving surface 5a facing in the side direction. 6 is a damper material. This ultrasonic probe 5
is an electronic scanning type ultrasound probe that scans within a scanning range S with the axial direction of the insertion section 1 being the scan direction, and this ultrasound probe 5 does not include a signal cable 7 that is inserted through the insertion section 1. Connected to an ultrasound transceiver. A display (not shown) that visually displays a tomographic image under the body cavity wall obtained by transmitting and receiving ultrasound is connected to this ultrasound transmitter/receiver.

Further, the tip component 2 includes an ultrasonic probe 5.
A window 8a of the observation optical system 8 having a field of view in the direction to be inspected, and an illumination optical system 9 that provides illumination light to the part to be observed.
and is provided. The window 8a of the observation optical system 8 is
The window 8a is located closer to the insertion proximal side of the tip component 2 than the ultrasound probe 5, and as shown in FIG. ing. Moreover, as shown in FIG. 1, the observation optical system 8 is located at a position where it can capture within its field of view a puncture needle 12 led out from an outlet 11, which will be described later. 10 is an air/water supply nozzle.

Furthermore, a puncture needle outlet 11 is provided in the tip component 2 in the axial direction of the tip component 2 with respect to the ultrasound probe 5 . This puncture needle outlet 11 is
The needle tip 12a of the flexible puncture needle 12 is led out obliquely in the direction to be examined by the ultrasonic probe 5, and the puncture needle outlet 11 is inserted into the guide hole 13 formed in the tip component 2. The guide hole 13 is connected to a guide pipe 14. The other end of the guide pipe 14 passes through the insertion section 1 and is guided toward the operation section 3 side, and opens at the insertion port 15. As shown in FIGS. 1 and 2, the puncture needle outlet 11 is located on the ultrasonic transmitting/receiving surface 5a of the probe 5.
It is arranged on the same side as and on the diagnostic center line C of the probe 5, and furthermore, it is located on the insertion proximal side of the tip component 2 than the probe 5. Reference numeral 16 denotes a syringe for feeding a medical solution or the like into the puncture needle 12.

The puncture needle 12 is configured such that the protruding angle of its needle tip 12a can be adjusted by a puncture needle guide mechanism 20. This puncture needle guide mechanism 20 is configured as follows. That is, inside the puncture needle outlet 11, a raising stand 21 is provided rotatably about a pivot 22 for adjusting the protruding angle of the needle tip 12a. The raising table 21 has a guide surface 21a that abuts the midway side surface of the puncture needle 12, and is configured to deflect the needle tip 12a by adjusting the angle of the guide surface 21a.
Reference numeral 23 denotes an operating wire for adjusting the rotation angle of the elevating table 21. The distal end of the operating wire 23 is fixed to the elevating table 21, and the proximal end of the operating wire 23 is inserted through the insertion section 1. Guided by the operation section 3,
It is wrapped around the pulley 24. Reference numeral 25 denotes an operation knob that rotates the pulley 24. By operating this operation knob 25 and pulling the wire 23, the lifting platform 21 is remotely controlled and rotated according to the amount of pulling. ing.

In the ultrasonic diagnostic apparatus configured as described above, the insertion section 1 is inserted into a body cavity, and the window 8a of the observation optical system 8 is opened.
While performing visual observation throughout the body cavity, the distal end component 2 is positioned at the target site within the body cavity, and the transmitting/receiving surface 5a of the ultrasound probe 5 is brought into close contact with the surface of the body cavity wall A to be inspected. When the ultrasonic transceiver is activated in this state and ultrasonic scanning is performed by the ultrasonic probe 5, an ultrasonic tomographic image within the scanning range S is displayed on a display (not shown) based on the received ultrasonic echoes. . When a puncture target site B is found in this tomographic image, the operating knob 25 is operated so that the puncture needle 12 can protrude at a protrusion angle θ corresponding to the depth of the puncture target site B. The rotation angle of the upper table 21 is adjusted. That is, when the puncture target site B is at a shallow position, the protrusion angle θ is adjusted to be small, and when the puncture target site B is at a deep position, the protrusion angle θ is adjusted to be large.

Then, the puncture needle 12 inserted into the guide pipe 14 from the insertion port 15 is further pushed in, so that the needle tip 12a protrudes obliquely from the puncture needle outlet 11, and is caused to pierce the body cavity wall A. Then, an ultrasonic echo is generated by the puncture needle 12, and the puncture needle 12 is confirmed in the ultrasound tomographic image on the display, so while observing the position of the echo of the puncture needle 12 in the tomographic image,
The amount of penetration of the puncture needle 12 is adjusted and guided to the target site B. Then, the syringe 16 is used to inject a medicinal solution or other desired fluid.

In this way, according to the device of this embodiment, by using ultrasound, it is possible not only to find the puncture target site B hidden under the surface of the body cavity wall, but also to accurately pierce the puncture needle 12 into this site B. This allows for accurate and safe treatment. Moreover, according to this embodiment, since the electronic scanning type ultrasound probe 5 is used, there is an advantage that ultrasound diagnosis and puncture can be carried out over a wide range while the position of the insertion section 1 with respect to the body cavity remains fixed.

Moreover, since the distal end component 2 is equipped with an observation optical system 8 that allows visual observation in the same direction as the diagnosis direction using ultrasound, the state of the body cavity wall surface can be observed simultaneously, making it possible to perform more accurate and rapid observation. It is capable of diagnosis and treatment.

It goes without saying that the present invention can also be applied to a so-called flexible endoscope type having a flexible insertion section 1, as shown in FIG. 4 as a second embodiment. Since the basic configuration and operation and effects of the second embodiment are the same as those of the first embodiment, corresponding parts are designated by the same reference numerals and a description thereof will be omitted.

[Effects of the Invention] According to the present invention, the ultrasonic probe, which occupies a relatively large volume within the tip component, can be easily and compactly housed so as not to interfere with observation optical system members, puncture needle insertion holes, etc. Therefore, even if it is equipped with an ultrasonic probe, an observation optical system, a puncture needle outlet, etc., it is possible to downsize the tip component.

[Brief explanation of drawings]

FIG. 1 is a side view of an ultrasonic diagnostic device showing a first embodiment of the present invention, FIG. 2 is a plan view of the tip of the diagnostic device, and FIG. 3 is a cross-sectional view taken along the - line in FIG. 2. , FIG. 4 is a side view of an ultrasonic diagnostic apparatus showing a second embodiment of the present invention. DESCRIPTION OF SYMBOLS 1... Insertion part, 2... Tip structure part, 3... Scanning part, 5... Ultrasonic probe, 5a... Ultrasonic transmission/reception surface, 8... Observation optical system, 8a... Window of observation optical system, 9...Illumination optical system, 11...Puncture needle outlet,
12...Puncture needle, 12a...Needle tip.

Claims (1)

[Claims] 1. An ultrasonic probe provided with the ultrasonic transmitting/receiving surface facing laterally at the distal end component of an elongated insertion section inserted into a living body, and an ultrasonic probe provided on the same side as the ultrasonic transmitting/receiving surface of this probe and from this probe. a puncture needle outlet that is disposed on the insertion proximal side of the tip component and allows the puncture needle to be guided out in a protrusive and retractable manner in the direction to be inspected by the probe; and a puncture needle outlet that is closer to the insertion proximal side than the probe and from the puncture needle outlet. An ultrasonic diagnostic apparatus characterized by comprising a window of an observation optical system located at a position where a guided puncture needle can be visually recognized, and at a position laterally shifted from the diagnostic center line of the probe.