JPH0568984B2 - - Google Patents

Description

[Detailed Description of the Invention] [Industrial Application Field] The present invention relates to an intrabody cavity ultrasound endoscope, which has an improved structure at the tip of an insertion section that is equipped with an ultrasound probe, an observation window, etc. It is.

[Conventional technology]

Various types of ultrasound endoscopes have been proposed so far, with an insertion section inserted into a body cavity and performing precise ultrasound diagnosis from inside the body cavity. For example, JP-A-61
-168337, a rotor is rotatably provided at the tip of the insertion section to mechanically radially scan the ultrasonic beam from an ultrasound probe in a direction perpendicular to the center axis of the insertion section. It has been proposed that the cap be covered with a tip cap having an ultrasonic transmitting/receiving window, and a side view type or front perspective type observation window is provided on the side surface of the rear end of the tip cap.

In addition, United States Patent No. 4327738 discloses that an electronic linear type ultrasound probe is provided at the tip of the insertion tube on the side parallel to the center axis of the insertion tube, and the rear side thereof has an observation window in front. A device equipped with an optical system has been proposed.

[Problem to be solved by the invention]

However, although the former of the above-mentioned conventional ultrasound endoscopes can obtain ultrasound tomographic images over a wide 360° range, when the insertion section is inserted into the body cavity, the field of view of the observation window is limited to the front. Since this was not ensured, there was a risk of damaging mucous membranes and lesions if there were protruding stenoses or bleeding-prone areas such as varicose veins. Furthermore, even when attempting to insert the insertion section deep into a luminal organ with many curved parts, such as the large intestine, it is difficult to smoothly insert the insertion section because it is difficult to know in which direction the tip of the insertion section should be directed.

On the other hand, with the latter type, it is easy to secure a front view when inserting the insertion part, but if the hard tip part is lengthened, it becomes difficult to insert it into a bent organ, so there are restrictions on the length. There is a situation in which the length of the ultrasonic probe installed here can only be about 3 cm at most. For this reason, there was a problem in that ultrasonic tomographic images could only be taken in a narrow width of about 3 cm. In addition, only ultrasonic tomographic images parallel to the central axis of the insertion tube can be obtained, and in order to thoroughly screen lesions in hollow organs, the tip of the insertion tube must be rotated through a 360° range while pushing forward. However, the diagnosis required a lot of time, which was very painful for the subject.

The present invention has been proposed to solve the above-mentioned problems, and allows for safe and reliable insertion into hollow organs, as well as the ability to obtain slice-shaped ultrasonic tomographic images covering almost the entire 360° circumference. The purpose of the present invention is to provide an intrabody cavity ultrasound endoscope that can perform the following functions.

[Means and actions for achieving the task]

In order to achieve the above object, the present invention provides a cylindrical ultrasonic transmitting/receiving window having an ultrasonic transmitting/receiving means at the distal end of the insertion section that emits and enters an ultrasonic beam around the entire circumference in a direction substantially orthogonal to the central axis of the insertion section. an intracorporeal ultrasound endoscope, wherein a substantially cylindrical member equipped with an observation optical system having at least a forward viewing direction is arranged in parallel with the cylindrical ultrasound transmitting/receiving window so as to be substantially parallel to the central axis of the insertion part; And so.

Further, the cylindrical ultrasonic transmitting/receiving window portion is a tip cap that covers the periphery of an ultrasonic transmitting/receiving means that rotatably supports a rotor equipped with an ultrasonic probe on the tip support portion of the endoscope. It was used as an intrabody ultrasound endoscope.

Further, the cylindrical ultrasonic transmitting/receiving window section was an intracorporeal ultrasonic endoscope, which is an acoustic lens of a cylindrical electronic scanning type ultrasonic probe.

Further, an intracorporeal ultrasonic endoscope is provided in which an opening for a liquid sending conduit is provided near the rear end of the cylindrical ultrasonic transmitting/receiving window.

Further, an intracorporeal ultrasonic endoscope is provided in which an ultrasonic sound absorbing member is provided in at least a range of the substantially cylindrical member that is hit by the ultrasonic beam.

Further, a suction or liquid sending pipe is arranged in parallel on the side of the cylindrical ultrasonic transmitting/receiving window, and at least a range of the suction or liquid sending pipe crossed by the ultrasonic beam is made of an ultrasonic beam transparent member. It was used as an intrabody ultrasound endoscope.

In addition, the tip member at the tip of the insertion section, which is not hit by the ultrasonic beam, is made into a substantially cylindrical shape with an outer circumferential diameter that is approximately the same as the outer circumferential diameter of the tip support provided on the rear end side of the cylindrical ultrasonic transmitting and receiving window. It was used as a sonic endoscope.

Moreover, the intrabody cavity ultrasound endoscope is provided with a removably attached balloon that seals between the distal end portion and the distal end support portion.

Since the present invention is configured as described above, insertion into a hollow organ can be performed safely and reliably, and a slice-shaped ultrasonic tomographic image covering almost the entire 360° circumference can be obtained.

〔Example〕

FIG. 1 shows a first embodiment of the present invention, and is a sectional view of the distal end of an insertion section of a mechanical radial scanning type intracorporeal ultrasound endoscope. A rotor 5 is rotatably supported by a ball bearing 3 and a spacer 4 on a tip support portion 2 of an insertion portion tip 1. A cylindrical tip cap 7 having an ultrasonic transmitting/receiving window 6 is provided on the lateral outer circumference of the rotor 5, and the inside thereof is filled with an ultrasonic medium liquid 8 which also acts as a lubricant. It is sealed with a seal member 9 and a sealing screw 10. An ultrasonic probe 11 with an ultrasonic input/output surface facing laterally is fixed to the rotor 5, and the rotor is connected to a motor (not shown) provided in the operating section.
A hollow flexible transmission shaft 12 that transmits the rotational driving force of
is connected to. A signal cable 13 from the ultrasonic probe 11 is guided to the operating section through the inside of the transmission shaft 12.

A cylindrical member 14 is provided substantially parallel to the distal end cap 7 and on the same distal end surface, and its rear end is fixed to the distal end support portion 2. Note that the tip support portion 2 has a substantially cylindrical shape that holds the tip cap 7, the cylindrical member 14, etc., and the cylindrical member 1
A tip member 15 having approximately the same diameter as the outer periphery of the tip support portion 2 is provided to cover the tip of the tip 4 and the tip of the tip cap 7. The cylindrical member 14 includes an observation optical system 18 consisting of an objective lens 16 having a field of view in the distal direction and an image guide fiber 17, an illumination optical system 21 consisting of an illumination lens 19 and a light guide fiber 20, and air and water supply pipes 22. has been established. Further, on the outer periphery of the metal pipe 24 constituting the cylindrical member 14, a portion of the outer periphery of the metal pipe 24 that is hit by the ultrasonic beam 23 emitted from the ultrasonic probe 11 is provided with an elastic rubber tube (urethane rubber, silicone rubber, etc.) 25 to prevent image deterioration due to diffuse reflection of the ultrasonic beam 23.

A suction conduit 2 that is substantially parallel to the tip cap 7 and the cylindrical member 14 and connected to the opening 27 of the tip member 15.
There are 6. At least the part of the suction conduit 26 that is hit by the ultrasound beam 23 is made of an elastic rubber tube (urethane rubber, neoprene rubber, silicone rubber, etc.) 28 with high ultrasound transparency, and
By filling the inside with a liquid such as water, the ultrasonic beam 23 is also transmitted to the back side of the suction pipe 26.

In addition, the tip support part 2 has an opening in the front surface, and a liquid supply pipe 29 for injecting degassed water, etc., which is a medium for ultrasonic diagnosis, is provided almost parallel to the suction pipe 26, etc. It is set up. In addition, at the rear of the insertion part tip 1, there is a curved part 30 and a flexible soft part (not shown).
are arranged in series to form an insertion section.

With this configuration, it is easy to insert the insertion section into a luminal organ such as a large intestine or an esophagus in a body cavity when performing an ultrasonic diagnosis. In other words, the insertion section can be safely and reliably inserted to the target site while checking the front with the objective lens 16 provided on the distal end surface of the insertion section. After inserting the insertion section to the target site in this way, deaerated water is injected into the hollow organ from the deaerated water injection line 29 and is slightly suctioned through the suction line 26 to deaerate the body. Fill with water. Next, the rotor 5 and the ultrasonic probe 11 are activated to emit and inject the ultrasonic beam all around in a direction substantially orthogonal to the insertion axis, thereby producing ultrasonic waves on the monitor of the observation device. Projects a tomographic image. In this case, although the part corresponding to the cylindrical member 14 is radially blackened, the other members do not block the transmission of the ultrasound beam 23, so a clear ultrasound tomographic image can be obtained over a range of approximately 300°. It will be. moreover,
An advantage of the first embodiment is that water can be easily held inside the ultrasonic transmitting/receiving window 6 since the distal end member 15 is provided on the distal end surface of the insertion portion. In addition, a circular tip member 1
5, the risk of damaging the inner wall of the body cavity when inserting and removing the insertion tube is reduced. In addition, the suction pipe 2
6 is constructed so as not to impede transmission of the ultrasound beam 23, and an opening is provided near the observation window on the distal end surface of the insertion section, so that the endoscopic treatment instrument can be used safely. In addition, because the endoscope uses a degassed water filling method that eliminates the need for space for a balloon attachment groove, the length of the rigid tip can be shortened and the ease of insertion into hollow organs can be improved. .

FIG. 2 shows a second embodiment of the present invention, and parts corresponding to those in the first embodiment are given the same reference numerals.
An air injection/exhaust port 32 is provided on the outer periphery of the tip member 15, and a cylindrical balloon 33 is attached to cover it. A cylindrical balloon 33 is attached to cover the area. A water inlet 35 for injecting deaerated water 34, which is an ultrasonic transmission medium, and a suction port 36 for sucking out unnecessary air and water are opened between the two balloons, and the two balloons and the inner wall 3 of the body cavity are opened.
The body cavity formed by 7 is filled with degassed water. Note that the injection/discharge port 32 communicates with an injection/discharge device such as a syringe provided in an operation section (not shown) through an injection/discharge conduit 38.

The ultrasonic probe 11 is connected to a rotating shaft 39,
It is rotated by the driving force of a small motor such as a ring-shaped ultrasonic motor 40 provided inside the tip support section 2 . The ultrasonic signal transmission member 41 and the rotational position detector 42 are
It controls signals to the ultrasonic probe 11. Note that 43 is a sealing member such as an O-ring or a variseal, which functions to seal the ultrasonic transmission medium liquid 8 within the tip cap 7.

Since this embodiment is configured in this way, in body cavities that are difficult to fill with deaerated water, such as the vicinity of the esophagus and large intestine cavity, air is first injected into the two balloons 33 located before and after the tip cap. , body cavity inner wall 3
Press 7 to make it stick. Next, degassed water 34 is injected from the injection port 35, and unnecessary air is sucked from the suction port 36, and the degassed water 34 is poured between the two balloons.
to fill up. In this way, ultrasound diagnosis can be performed without putting pressure on the inside of the body cavity. It goes without saying that the insertion tube can be inserted safely and reliably while checking the front. Furthermore, in this embodiment, since a motor and a rotational position detector are provided at the tip of the insertion portion, phase shifts caused by twisting of the transmission shaft are prevented, and stable rotation of the ultrasonic probe can be realized. In addition, the outer diameter of the insertion section on the rear side of the insertion section tip can be made thinner, making it possible to reduce the pain of the subject. FIG. 3 is a cross-sectional view of FIG.
The figure shows an ultrasonic tomographic image displayed on a monitor 60, in which 61 is a so-called cut (chip and black) part of the cylindrical member, and 62 is the esophageal wall.
3 indicates a lesion.

FIG. 5 shows a third embodiment of the present invention.
A sound absorbing material 44 made of silicone rubber that absorbs ultrasonic waves is interposed between the tip cap 7 and the cylindrical member 14, and the tip member 15 in the first embodiment is omitted. Therefore, it is possible to prevent dirt such as feces from getting stuck between the tip cap 7 and the cylindrical member 14, and due to the sound absorption effect, the back side of the cylindrical member 14 comes out more clearly, reducing disturbances in the ultrasound diagnostic image near the boundary. did it. Furthermore, since the tip member 15 is eliminated, the diameter of the tip portion can be reduced.

FIG. 6 shows a fourth embodiment of the present invention,
The observation optical system 18, illumination optical system 19, air supply and water supply pipes 22, which were provided in the cylindrical member 14 in the first embodiment, are provided substantially parallel to the side of the tip cap 7, and at least the ultrasonic beam 23 The portions that come into contact with the tubes are made of plastic, and the air and water supply pipes 22 are made of elastic rubber tubes to improve ultrasonic permeability. As a result, although there is a slight decrease in sensitivity, it is now possible to obtain ultrasonic diagnostic images covering the entire 360° circumference.

7A to 7C show a fifth embodiment of the present invention, in which instead of the tip cap 7 in the first embodiment, a microconvex or An electronic radial electronic scan type ultrasonic probe 48 is provided,
A balloon 33 is attached so as to cover the entire circumference, and the inside is filled with deaerated water 34, so that ultrasonic diagnosis can be performed using the balloon contact method. The ultrasonic probe 48 is composed of an ultrasonic transducer film 49 made of a composite material of polymer or polymer ceramics, a plurality of signal cables 50, an acoustic lens 51, and the like. This embodiment eliminates the need for a motor, rotational position detector, rotational drive transmission unit, etc., which reduces the occurrence of mechanical failures, eliminates the need for bearings, etc. related to the rotation mechanism, and allows the rigid tip portion to be shortened. Improves insertability.

〔Effect of the invention〕

As described above, according to the present invention, the insertion tube can be inserted safely and reliably while checking the front, and the ultrasound scans the entire circumference of the hollow organ almost 360 degrees to generate sliced ultrasound waves. We were able to provide an intracorporeal ultrasound endoscope that can obtain tomographic images.

[Brief explanation of the drawing]

FIG. 1 is a sectional view of the tip of the first embodiment of the present invention, of which FIG. 1A is a vertical sectional view of the main part, FIG. 1B is a front view, and FIG. 1C is a AA sectional view, FIG. 1 D is BB sectional view, FIG. 1 E is
C-C cross-sectional view, Figure 1 F is D-D cross-sectional view, Figure 1
Figure G is a cross-sectional view taken along line E-E, Figure 1 H is a cross-sectional view taken along line F-F, Figure 2 is a cross-sectional view of the tip section showing the second embodiment, and Figure 3 is a cross-sectional view taken along line G-G. FIG. 4 is an explanatory diagram showing an ultrasonic tomographic image, FIG. 5 is a sectional view showing the third embodiment, and FIG. 6 is a sectional view showing the fourth embodiment.
7A to 7C show the fifth embodiment, of which FIG. 7A is a perspective view, FIG. 7B is a side sectional view, and FIG.
Figure C is a sectional view taken along line H-H. DESCRIPTION OF SYMBOLS 1... Insertion part tip, 6... Ultrasonic transmission window, 14... Cylindrical member, 29... Liquid feeding pipe.

Claims (1)

[Scope of Claims] 1. A cylindrical ultrasonic transmitting/receiving window portion having an ultrasonic transmitting/receiving means for emitting and injecting an ultrasonic beam around the entire circumference in a direction substantially perpendicular to the central axis of the insertion portion is provided at the distal end of the insertion portion. , wherein a substantially cylindrical member equipped with an observation optical system having at least a forward viewing direction is arranged in parallel with the cylindrical ultrasound transmitting/receiving window so as to be substantially parallel to the central axis of the insertion section. Endoscope. 2. The cylindrical ultrasonic transmitting/receiving window is a distal end cap that covers the periphery of an ultrasonic transmitting/receiving means that rotatably supports a rotor equipped with an ultrasonic probe relative to the distal end support of the endoscope. Claim 1 characterized by
Intrabody ultrasound endoscope described. 3. The intrabody cavity ultrasound endoscope according to claim 1, wherein the cylindrical ultrasound transmission/reception window is an acoustic lens of a cylindrical electronic scanning ultrasound probe. 4. The intrabody cavity ultrasonic endoscope according to claim 1, further comprising an opening for a liquid sending conduit near the rear end of the cylindrical ultrasonic transmitting/receiving window. 5. The intrabody cavity ultrasonic endoscope according to claim 1, wherein an ultrasonic sound absorbing member is provided in at least a range of the substantially cylindrical member that is hit by the ultrasonic beam. 6. Suction or liquid sending pipes are arranged side by side on the side of the cylindrical ultrasonic transmitting/receiving window, and at least the range crossed by the ultrasonic beam of the suction or liquid sending pipe is made of an ultrasonic beam transparent member. The intrabody cavity ultrasound endoscope according to any one of claims 1 to 5, characterized in that: 7. The distal end member at the distal end of the insertion section, which is not hit by the ultrasonic beam, is made into a substantially cylindrical shape having an outer circumferential diameter that is approximately the same as the outer circumferential diameter of the distal end support provided on the rear end side of the cylindrical ultrasonic transmitting/receiving window. The intrabody cavity ultrasonic endoscope according to claims 1 to 6. 8. The intrabody cavity ultrasonic endoscope according to claim 7, further comprising a removably provided balloon that seals between the distal end portion and the distal end support portion.