JPH0591998A - Ultrasonic examination apparatus with puncture guide - Google Patents

Abstract

PURPOSE:To improve sniping characteristics to a lesion by constituting puncture position of an puncture needle so as to bring it within a field of observation of an endoscope when a guide hole the guided side of which is faced to the side where an endoscope observation mechanism is set, is pierced on the projected part provided on the apex hard part and projecting ahead, and a puncture needle is pierced into a living body through the guide hole. CONSTITUTION:A projected part 15 projecting ahead is formed on a position between an optical observation mechanism 13 and an ultrasonic observation mechanism 14 both provided on the apex hard part 12c of an inserting part 12. A guide hole 16 with an inner diameter being a little larger than the outer diameter of a puncture needle 2 is penetrated to guide the apex 2a of the puncture needle 2 in the thickness direction of the projected part 15. Then the optical observation mechanism 13 is positioned on the introducing side 16a of the puncture needle 2 of the guide hole 16 and the ultrasonic observation mechanism 14 is positioned on the guiding-out side 16b. In addition, the projected part 15 is inclined in such a way that the face of the introducing side 16a of the puncture needle 2 of the guide hole 16 is raised up toward the apex side and the introducing side 16a of the guide hole 16 is made within the view of optical observation in the view of the optical observation mechanism 13.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an ultrasonic inspection apparatus having an ultrasonic observation mechanism at the tip of an insertion portion, which is an ultrasonic inspection with a puncture guide for guiding a puncture needle such as an injection needle or a cytodiagnosis needle. It relates to the device.

[0002]

2. Description of the Related Art An ultrasonic inspection apparatus is capable of displaying an ultrasonic image on a display by injecting an ultrasonic pulse into the body, receiving a reflection echo thereof, processing the received ultrasonic signal. However, not only is it designed to allow ultrasonic pulses to enter the body from the outer skin, but it also has an insertion part that is inserted into the body cavity of a patient, and the tip of this insertion part is A body-insertion type ultrasonic examination apparatus in which an ultrasonic wave transducer is provided and an ultrasonic pulse is made incident from the inner wall of the body cavity is being used. Furthermore, in addition to the ultrasonic observation mechanism, Ultrasonic endoscopes having a mechanism for observing a visible image such as an internal object image (including not only an optical image but also an infrared image and the like) have become popular.

Thus, an ultrasonic probe that can be inserted into the body,
Ultrasound endoscopy is not only capable of examining internal tissues, but it is also more precise when the state of internal tissues is found, for example, when a tumor or other affected area or a suspected site is found. To collect cells for testing
It is also necessary to perform treatment such as injection on the affected area. In order to perform such treatment, a puncture needle such as an injection needle or a cytodiagnosis needle is used. Usually, the puncture needle has a flexible flexible tube with a needle tip made of a hard pipe with a sharp tip. There are soft puncture needles that are formed by connecting them to each other, and hard puncture needles that are entirely formed of a rigid tubular member.

Here, in order to surely guide the puncture needle to a predetermined site, the affected area is captured within the scanning range of the ultrasonic transducer, and the puncture needle is moved to the affected area while observing the ultrasonic image. You have to make it point toward you. A soft puncture needle having a needle tip at the tip of a flexible tube can be inserted into a treatment instrument insertion channel provided to insert forceps or other treatment instrument. The channel is guided into the body as a guide, and a predetermined amount is projected from the treatment tool insertion / extraction port provided at the tip of the insertion section under the supervision of the visible image observation mechanism to be captured within the scanning range of the ultrasonic transducer. It is possible.

[0005]

On the other hand, since the hard puncture needle cannot be inserted into the treatment instrument insertion channel, it is usually inserted directly from the epidermis of the body and guided to the affected area. However, it is considerably difficult to operate the puncture needle from outside the body and guide the tip of the needle into the scanning range of the ultrasonic transducer, and it is quite difficult to aim at the affected area, and in particular, the puncture needle is thin and Since its total length is relatively long, it bends due to resistance during insertion from the inner wall of the body cavity, so its stability cannot always be obtained,
There is a drawback that its operability is extremely poor.

The present invention has been made to solve the above-mentioned drawbacks and problems of the prior art. The object of the present invention is to insert a puncture needle through a route separate from the ultrasonic inspection apparatus. An object of the present invention is to provide an ultrasonic inspection apparatus with a puncture guide, which is designed to have a good aiming property on an affected part or the like when it is inserted.

[0007]

In order to achieve the above-mentioned object, the present invention provides an ultrasonic observation mechanism at the distal end portion of an insertion portion and a projection portion that protrudes forward from the ultrasonic observation mechanism. Then, a guide hole for guiding the puncture needle is formed in the protruding portion with the lead-out side facing the arrangement side of the ultrasonic observation mechanism, and the insertion position of the puncture needle is ultrasonically observed. The feature is that it is configured to fit within the field of view. Further, when configuring the ultrasonic inspection apparatus as an ultrasonic endoscope, at a position between the visible image observation mechanism and the ultrasonic observation mechanism,
Providing a projecting portion projecting forward, a guide hole for guiding the puncture needle to this projecting portion, with the introduction side facing the arrangement side of the visible image observation mechanism, and the arrangement side of the ultrasonic observation mechanism. By piercing so that the lead-out side faces, the insertion position of the puncture needle can be set within the ultrasonic observation field.

[0008]

With the above construction, by inserting the puncture needle into the guide hole, the portion protruding from the guide hole becomes relatively short and is regulated by the guide hole. Sufficient strength is maintained against resistance when piercing into, and the piercing property becomes good. Moreover, the entry of the puncture needle into the body is always kept within the visual field range of the ultrasonic observation mechanism, and the puncture needle can be operated under the monitoring by this ultrasonic observation mechanism. Is extremely good, and by operating while observing both the site to be treated such as the affected part and the puncture needle, the needle tip of the puncture needle can be reliably guided to the affected part, etc., and appropriate treatment is possible. Becomes In the case of configuring as an ultrasonic endoscope, since the visible image observation mechanism is provided on the introduction side of the guide hole, the introduction of the puncture needle into the guide hole can be monitored by this visible image observation mechanism. Therefore, the operability of the puncture needle is further improved.

[0009]

Embodiments of the present invention will now be described in detail with reference to the drawings. In the following description, an ultrasonic endoscope is used as the ultrasonic inspection apparatus, but it can be configured as an intracorporeal ultrasonic inspection apparatus having no visible image observation mechanism. Needless to say.

First, in FIG. 1, 1 is an ultrasonic endoscope as an ultrasonic examination apparatus, 2 is a puncture needle, and 3 is an ultrasonic endoscope 1 which is inserted into the body separately from the ultrasonic endoscope 1, and A rigid endoscope for tracking and confirming the insertion direction is shown.

The ultrasonic endoscope 1 comprises a main body operating portion 11 and an insertion portion 12 inserted into a body cavity, and the insertion portion 12 includes a flexible portion 12a, an angle portion 12b, and an angle portion 12b. 2 and 3, the visible image observation mechanism 13 and the ultrasonic observation mechanism 1 are provided at the distal end of the distal end hard portion 12c, as shown in FIGS.
And 4 are provided. As the visible image observation mechanism 13,
It has an illumination window 13a for illuminating the inside of the body cavity and an observation window 13b for optically observing the inside of the body cavity under illumination by the illumination window 13a.
An emission end of a light guide connected to a light source device faces 3a, and a solid-state image sensor such as a CCD is arranged at an image forming position of an objective lens provided in the observation window 13b, or an optical image is formed. The entrance end of the transmitting image guide is exposed. In addition, the ultrasonic observation mechanism 14
As shown in FIG. 4, a large number of ultrasonic transducers 14a are arranged in a convex curved line, and the ultrasonic transducers 14a are sequentially switched by an electronic changeover switch 14b to perform scanning. It is of the electronic scanning type. However, the scanning method of this ultrasonic observation mechanism may be other than the convex type.

The tip hard portion 12c is provided with the visible image observation mechanism 13 and the ultrasonic observation mechanism 14 as described above. The visible image observation mechanism 13 and the ultrasonic observation mechanism 14 are provided.
A projecting portion 15 projecting forward is formed in a region between and. The protrusion 15 has a puncture needle 2 in its thickness direction.
A guide hole 16 having an inner diameter slightly larger than the outer diameter of the puncture needle 2 is formed in order to guide the needle tip 2a. The visible image observation mechanism 13 is located on the introduction side 16a of the puncture needle 2 in the guide hole 16, and the ultrasonic observation mechanism 14 is located on the extraction side 16b. Also, the protrusion 1
5, the surface of the guide hole 16 on the introduction side 16a of the puncture needle 2 is inclined so as to rise toward the distal end side, so that the introduction side 16a of the guide hole 16 is in the visual field of the visible image observation mechanism 13. It can be placed in the observation field of view. Moreover, the guide hole 16 is an inclined hole that is inclined from the introduction side 16a toward the extraction side 16b,
With respect to the inclination direction, the lead-out side 16b is in the front direction, and therefore the puncture needle 2 inserted into the guide hole 16 is surely oriented in the direction in which the ultrasonic observation mechanism 14 enters the observation visual field.

As is apparent from FIG. 1, the ultrasonic endoscope 1 is designed to be inserted into the abdominal cavity by being guided by the trocar 4, and the visible image observing mechanism 13 observes the inner wall of the body cavity. In parallel with performing the above, the state of the tissue in the body cavity is observed by the ultrasonic observation mechanism 14. Then, when a tumor or other affected part or a suspected part of the affected part is found, treatment such as collecting tissue cells of this part or performing injection is performed. For this purpose, the puncture needle 2 is used. Here, the puncture needle 2 is made of a thin metal pipe and has a sharp tip 2a at its tip.
The syringe 21 and the like are connected to the base end.

Therefore, the affected area found by the ultrasonic observation mechanism 14 is held in the field of view, and in this state, the puncture needle 2 is inserted through the epidermis of the body and the distal end portion of the ultrasonic endoscope 1 is inserted. It is directed toward the guide hole 16 formed in the protruding portion 15. Then, in order to confirm the directing direction of the puncture needle 2, other observation means such as the rigid endoscope 3 in addition to the ultrasonic endoscope 1 is inserted into the body, and the puncture needle 2 is placed under its monitoring. As a result, the puncture needle 2 can be advanced toward the guide hole 16.

When the needle tip 2a of the puncture needle 2 enters near the tip of the insertion portion 12 of the ultrasonic endoscope 1, not only the above-mentioned monitoring by the rigid endoscope 3 but also a visible image of the ultrasonic endoscope 1 is performed. The guide hole 16 of the puncture needle 2 under observation by the observation mechanism 13
You can control the direction to
Moreover, the needle tip 2a of the puncture needle 2 can be reliably inserted into the guide hole 16. Here, since the hole diameter of the guide hole 16 is only slightly larger than the outer diameter of the puncture needle 2, it is necessary to perform fine alignment between the two, but, for example, by moving the outer skin of the patient, ultrasonic waves are generated. The puncture needle 2 can be adjusted to fit the position of the guide hole 16 while the endoscope 1 is fixed. In addition, the introduction side 16 of the guide hole 16
If a call-in part is provided in a, the guide hole 1 of the needle tip 2a
Insertion into 6 is even easier.

When the puncture needle 2 passes through the guide hole 16 and projects from the lead-out portion 16b, the puncture needle 2 is inserted into the wall of the body cavity. At this time, the needle tip 2a is in the ultrasonic observation mechanism 14. Will be within the observation field of view.
Therefore, by keeping the affected area in the observation visual field of the ultrasonic observation mechanism 14, the needle tip 2a can surely reach the affected area. Here, since the puncture needle 2 is inserted from the epidermis of the body, it has a considerable length, and since it has a very small diameter, it bends due to resistance when it is inserted into the body. Etc.
It cannot always maintain stability. However, by inserting a portion near the tip of the puncture needle 2 into the guide hole 16 and making the diameter difference between the guide hole 16 and the outer diameter of the puncture needle 2 small, the tip of the puncture needle 2 The site in the vicinity of the affected part is regulated, and the directivity to the affected part becomes extremely good. Then, when the needle tip 2a reaches the affected area, cells can be collected by applying suction force to the syringe 21, and when the syringe 21 is filled with a drug solution and the drug solution is pushed out, injection into the affected area is performed. It can be carried out.

[0017]

As described above, according to the present invention, the front hard portion is provided with the protruding portion, and the protruding portion is provided with the protruding portion.
A guide hole is formed on the installation side of the ultrasonic observation mechanism, the guide side of which is directed toward the extraction side. When the puncture needle is inserted into the body through this guide hole, the insertion position of the puncture needle is ultrasonic observation field of view. Since it is configured so that it can be housed inside, the directivity of the puncture needle with respect to the position to be treated such as the affected area is extremely good,
The operability of the puncture needle is significantly improved. Further, in the case of being configured as an ultrasonic endoscope including an ultrasonic observation mechanism and a visible image observation mechanism, by disposing the visible image observation mechanism on the introduction side of the guide hole, Since the insertion into the guide hole can be performed under the monitoring by the visible image observing mechanism, the operability of the puncture needle is further improved.

[Brief description of drawings]

FIG. 1 is an explanatory diagram showing a state in which a puncture needle is inserted into an affected area using an ultrasonic endoscope.

FIG. 2 is an external view showing a connected state of an ultrasonic endoscope and a puncture needle with a main part being a cross section.

FIG. 3 is an external view of a distal end portion of the ultrasonic endoscope.

FIG. 4 is an explanatory diagram of a configuration of an ultrasonic observation mechanism.

[Explanation of symbols]

 1 Ultrasonic Endoscope 2 Puncture Needle 2a Needle Point 12 Insertion Part 12c Tip Hard Part 13 Visible Image Observing Mechanism 14 Ultrasonic Observing Mechanism 15 Protruding Part 16 Guide Hole 16a Introducing Side 16b Deriving Side

Claims (2)

[Claims] 1. An ultrasonic observation mechanism is provided at a distal end portion of an insertion portion, and a protrusion protruding forward from the ultrasonic observation mechanism is provided, and a guide hole for guiding a puncture needle is provided in the protrusion. The insertion position of the puncture needle can be set within the ultrasonic observation field by piercing the ultrasonic observation mechanism so that the lead-out side faces the arrangement side. Ultrasonic examination device with puncture guide. 2. A visible image observing mechanism and an ultrasonic observing mechanism are provided at a distal end portion of the insertion portion, and a protrusion protruding forward is provided at a position between the visible image observing mechanism and the ultrasonic observing mechanism. A guide hole for guiding the puncture needle is provided on this protrusion so that the introduction side faces the installation side of the visible image observation mechanism and the extraction side faces the installation side of the ultrasonic observation mechanism. An ultrasonic inspection apparatus with a puncture guide characterized in that the insertion position of the puncture needle can be set within the ultrasonic observation visual field by being installed.