JP2001037770A - Ultrasonic treatment implement - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an ultrasonic treatment implement capable of easily performing solidification and adhesion by ultrasonic energy in the state of clamping and holding both ends of a luminal organ by a clamping part and easily and surely performing anastomosis work. SOLUTION: In this ultrasonic treatment implement provided with the clamping part capable of clamping viable tissues, an operation part 8 for opening and closing the clamping part, an ultrasonic vibrator 2 for generating ultrasonic vibration, a horn 3 connected to the ultrasonic vibrator 2 and an ultrasonic probe 4 connected to the horn 3 whose tip part is led to the clamping part, a first clamping part 5 provided with a luminal shape and first and second probe circular arc parts 6 and 18 for which the tip part of the ultrasonic probe 4 connected to the first clamping part 5 is provided with a shape almost matched with the luminal shape of the first clamping part 5 are provided.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to, for example, an ultrasonic treatment device for performing an anastomosis by coagulating and adhering a luminal organ by using ultrasonic waves while holding a cut luminal organ.

[0002]

2. Description of the Related Art In a surgical operation for excision of a tumor site generated in a luminal organ such as the intestinal tract or esophagus of a living body, an anastomosis of the luminal organ is performed for the purpose of ensuring the function of the luminal organ after the excision.
In recent years, various improvements have been made to surgical instruments in order to perform more reliable anastomosis.

For example, JP-A-9-289991 discloses a so-called intestinal esophagus anastomosis device in which a conical anvil head is inserted into one hollow organ to be anastomosed, and the opposing staple head is inserted into the other staple head. After inserting into the luminal organ, reducing the distance between both heads and bringing them into close contact, multiple staples are punched out in a cylindrical shape, and the luminal organs are joined, and at the same time, the extra tissue remaining inside the staple row that was punched out is anviled The anastomosis of the luminal organs is completed by cutting with the cylindrical blade inside the staple row provided on the head.

Japanese Patent Application Laid-Open No. 8-89518 discloses that a pair of connectable metal tubular members are attached to both ends of a luminal organ to be anastomosed, and the tubular members are connected to each other. A method is disclosed that allows for anastomosis.

Japanese Patent Publication No. 7-57225 discloses that one end of a tubular member made of a bioabsorbable material is inserted into one of the luminal organs to be anastomosed, and the other end is inserted into the other luminal organ. Auxiliary tool that enables more reliable conventional hand-sewn operation, such as sewing the outer periphery of a luminal organ with a suture while leaving the tubular member in the luminal organ, is disclosed. Have been.

In Japanese Patent Application No. 9-355390, a grip is provided for gripping and releasing tissue in the body, and an ultrasonic vibrator is connected to the grip so that ultrasonic vibration can be transmitted to the grip. , Only by grasping the living tissue with the grasping portion,
A so-called ultrasonic treatment device that enables incision and coagulation adhesion of tissue by frictional heat due to heat energy due to the ultrasonic vibration is disclosed.

[0007]

However, in a so-called intestinal esophagus anastomosis apparatus as disclosed in Japanese Patent Application Laid-Open No. 9-289991, an anvil head is sandwiched between the anvil head and a staple head for driving staples for performing anastomosis is used. It is necessary to insert from the other end of a hollow organ that has not been inserted, for example, from the mouth in the esophagus, or from the anus in the intestinal tract, and when the surgical site is deep in the body, considerable insertion is required. Also, when removing the staple head and anvil head from inside the luminal organ after staple driving, extreme care must be taken so that both heads do not injure the luminal organ by mistake. Was giving mental fatigue.

In Japanese Patent Application Laid-Open No. HEI 8-89518, tubular members attached to both ends of a luminal organ remain in the body as foreign matter after surgery, and the outer shape of the esophagus or the like to be surgically operated is particularly close to the body surface. In addition to protruding from the skin as projections, it gives the patient a sense of incongruity when touching the body surface, so that there is a problem that there are limitations on the usable surgical target sites.

Furthermore, Japanese Patent Application Laid-Open No. 7-57225 discloses a method of forming a tubular member to be inserted into a luminal organ with a bioabsorbable material in order to solve the problem of the above-mentioned Japanese Patent Application Laid-Open No. 8-89518. However, the tubular member still protrudes from the skin until the tubular member is completely absorbed by the living body. In addition, since the operation of the operator itself requires a conventional hand-sewn operation, it is undeniable that a considerable amount of anastomosis operation time is required as compared with other methods.

[0010] The ultrasonic treatment device disclosed in Japanese Patent Application No. 9-355390 has a coagulation effect due to heat energy accompanying ultrasonic energy. By grasping with the grasping portion and applying a low level of ultrasonic energy, coagulation and adhesion can be measured, and hand sewing with a conventional suture can be easily performed in one action. However, it is difficult to grasp the luminal organs without causing deviation of the ends, and there is a problem that the grasping operation gives fatigue to the operator. Also, if the esophagus or intestinal tract is displaced and anastomosis is performed, the peristaltic movement may be impaired.

The present invention has been made in view of the above circumstances, and has an object to reduce the accuracy in anastomosis of a luminal organ, particularly in an anastomosis operation of a digestive tract such as an esophagus and an intestinal tract. An object of the present invention is to provide an ultrasonic treatment instrument which can shorten an anastomosis operation time, improve operation efficiency, and further reduce operator fatigue.

[0012]

In order to achieve the above object, the present invention provides a gripper capable of gripping a living tissue, an operation unit for opening and closing the gripper, and an ultrasonic vibrator near the operation unit. An ultrasonic transducer that generates an ultrasonic wave, a vibration transmitting member connected to the ultrasonic vibrator, and an ultrasonic probe connected to the vibration transmitting member and having a tip portion guided to the grip portion. In the ultrasonic treatment instrument, the grip portion has a lumen shape, and a distal end portion of the ultrasonic probe connected to the grip portion has a shape substantially matching the lumen shape of the grip portion. I do.

According to the above configuration, when performing an anastomosis of the luminal organ, the operator holds the luminal organ while holding the luminal shape of the luminal organ with the grip portion, and the ultrasonic wave attached to the grip portion. By applying ultrasonic vibration to the probe, both ends of the hollow organ are anastomosed by coagulation and adhesion.

[0014]

Embodiments of the present invention will be described below with reference to the drawings.

1 to 3 show a first embodiment, and FIG.
Is a longitudinal sectional side view schematically showing the overall shape of the ultrasonic treatment instrument, FIG. 2 is a longitudinal sectional side view showing a state in which a grip portion is closed at a distal end portion in FIG. 1, and FIG. 3 is along the line AA in FIG. It is sectional drawing and shows the state which grasped the luminal organ to be anastomosed, for example, the intestinal tract.

Referring to FIGS. 1 and 2, the overall configuration of the ultrasonic treatment tool according to the present embodiment will be described. An ultrasonic transducer 2 is provided on the proximal end side of the ultrasonic treatment instrument main body 1. The ultrasonic transducer 2 is electrically connected to the ultrasonic transducer 2, and the ultrasonic probe 4 A horn 3, which is a transmission member for transmitting the sonic vibration, is provided.

A first grip 5 is provided on the distal end side of the ultrasonic treatment instrument main body 1, and has a substantially semicircular lumen shape. A first probe arc 6 having substantially the same shape as the first grip 5 is provided at the tip of the ultrasonic probe 4.

At the proximal end of the ultrasonic treatment instrument main body 1, a holding portion 7 is provided integrally therewith. At a position opposed to the holding portion 7, an operation is performed so as to be movable in the direction of arrow 10 around a fulcrum 9 at the center. A section 8 is provided, and a link member 11 is integrally provided at one end of the operation section 8.

Further, a link arm 12 is provided on the link member 11, and a link member 14 provided on one end of a second holding portion 15 which forms a holding portion 16 together with the first holding portion 5 on the link arm 12. Are connected, and the link member 14 is rotatably supported by the fulcrum 13.

The link member 11 and the link arm 1
2, by the link member 14 and the fulcrum 9, 14,
A link mechanism that transmits the rotation of the operation unit 8 in the direction of the arrow 10 as the movement of the second gripper 15 in the direction of the arrow 17 is configured. A second probe arc 18 having substantially the same shape as the lumen of the second grip 15 and made of the same material as the ultrasonic probe 4 is provided inside the second grip 15. ing.

The second probe arc 18 is used to move the ultrasonic probe 4 when the second grip 15 moves in the direction of arrow 17 and forms a lumen with the first grip 5. At the position where one end 20 contacts one end 19, the second gripper 1
5 is attached to the inner circumference.

Reference numeral 21 denotes a generator for supplying electric energy to the ultrasonic vibrator 2, and reference numeral 22 denotes an input switch for driving the generator.

FIG. 3 shows a state in which a luminal organ to be anastomosed, for example, an intestinal tract is grasped.
The inner wall of one intestinal tract 23 to be anastomosed is provided on the inner surfaces of the gripper 5 and the second gripper 15, and the first gripper 5 and the second
This is a needle portion for fixing a part of the intestinal tract 23 when gripped by the grip portion 15 of FIG. Similarly, the other side, ie, intestinal tract 2
The first gripping portion 5 and the second gripping portion 15
Needles 27 and 28 for fixing the intestinal tract 24 are provided on the inner surface.

Next, the operation of the present embodiment will be described.

First, the surgeon holds the holding portion 7 of the ultrasonic treatment instrument main body 1 with one hand. In this state, the intestinal tract 2 to be anastomosed
The ends of 3 and 24 are respectively fitted to the lumen shape of the first grip 5. At this time, the intestinal tracts 23 and 24 are connected to the needle portions 25, 27 provided on the inner surface of the first grip portion 5.
In FIG. 3, the lower half region is temporarily fixed in a state where the ends are aligned.

Next, the operator rotates the operation unit 8 around the fulcrum 9 in the direction of the arrow 10 so that the link member 11,
The link mechanism constituted by the link arm 12 and the link member 14 causes the second gripping portion 15 to rotate in the direction of the arrow 17 to be in the state shown in FIGS. At this time, the needle part 2
3, the upper halves of the intestinal tracts 23 and 24 in FIG. 3 are also temporarily fixed with their ends also aligned.

Next, the surgeon operates the input switch 22 to drive the generator 21. Electric energy generated by the generator 21 is transmitted to the ultrasonic vibrator 2,
The vibration energy is converted into vibration energy, and the vibration energy is transmitted to the ultrasonic probe 4 by the horn 3. And
The light is transmitted to the first probe arc 6 at the tip. Further, by contact between the end 19 of the ultrasonic probe 4 and the end 20 of the second probe arc 18, vibration energy is transmitted to the second probe arc 18 as well. Then, the intestinal tracts 23 and 24 are generated by frictional heat caused by vibration energy.
Is coagulated and fused at its ends.

According to the present embodiment, the grasping portion of the living tissue at the distal end portion of the ultrasonic treatment instrument is configured to be openable and closable, and an ultrasonic probe on the inner periphery thereof is provided. Conventional luminal organs can be easily anastomosed. Furthermore, since the temporary fixation when grasping the luminal organ is made possible, it is possible to prevent the luminal organs from being erroneously shifted from each other, and to achieve more reliable anastomosis of the luminal organ with the ultrasonic treatment tool.

FIGS. 4 and 5 show the second embodiment. The same components as those in the first embodiment are denoted by the same reference numerals and description thereof is omitted. FIG. 4 is a longitudinal sectional side view showing the configuration of the operation unit side of the ultrasonic transducer, and FIG. 5 is a view showing a transmission state of ultrasonic vibration at the tip of the ultrasonic probe.

Referring to FIG. 4, the configuration of the ultrasonic transducer according to the present embodiment will be described.

On the proximal end side of the ultrasonic treatment instrument main body 1, there is provided an ultrasonic vibrator unit 30 composed of ultrasonic vibrators 31, 32, 33 having different oscillation frequencies. The ultrasonic transducer unit 30 is substantially integrally formed, and is connected to the ultrasonic probe 4 via a horn 3 as a transmission member.

Next, the operation of the present embodiment will be described.

As in the first embodiment, after the intestinal tracts 23 and 24 to be anastomosed by the operator are gripped by the first grip 5 and the second grip 15, the input switch 22 is operated.
The generator 21 is driven. Electric energy generated by the generator 21 is transmitted to the ultrasonic vibrators 31, 32, and 33 constituting the ultrasonic vibrator unit 30, respectively, and is converted into three types of vibration energy having different oscillation frequencies. Each vibration energy is transmitted to the ultrasonic probe 4 by the horn 3.

That is, the first probe arc portion 6 and the second probe arc portion 18 which are attached to the first grip portion 5 and the second grip portion 15 and are the tip portions of the ultrasonic probe. As shown in FIG.
As the amplitude 34 by the ultrasonic vibrator 32
As 5, the vibration energy is transmitted to the probe arc portions 6 and 18 as the amplitude 36 by the ultrasonic vibrator 33. And the intestinal tract 2
3, 24 are coagulated and fused at their ends.

According to the present embodiment, since the ultrasonic vibrators having different frequencies are used and the vibration energy of several different frequencies is transmitted to the tip of the ultrasonic probe, reliable coagulation and adhesion can be performed over a wide range. This makes it possible to apply to a hollow organ having a large diameter.

Although three types of ultrasonic transducers are used in the present embodiment, it goes without saying that a wider range of coagulation and adhesion can be achieved by using additional types of ultrasonic transducers.

FIGS. 6 and 7 show the third embodiment. The same components as those in the first embodiment are denoted by the same reference numerals and description thereof is omitted. FIG. 6 is a vertical sectional side view showing the configuration of the distal end portion side of the ultrasonic transducer, and FIG. 7 is a cross-sectional view showing details of a connection portion of the ultrasonic treatment instrument.

Referring to FIGS. 6 and 7, the configuration of the distal end portion of the ultrasonic treatment instrument 1 according to the present embodiment will be described. 40
Is a main body having the ultrasonic vibrator 2, the horn 3, and the like. Reference numeral 41 denotes a gripping unit having the first gripping portion 5 and the second gripping portion 15 having a substantially lumen shape, and is detachably attached to the main body portion 40 and the connection portion 42. The main body 40 is provided with an ultrasonic probe 43 connected to the horn 3.

A first probe arc portion 44 and a second probe arc portion 45 having substantially the same lumen shape are provided on the inner surfaces of the lumens of the first grip portion 5 and the second grip portion 15, respectively. At 47, it is arranged and fixed so as to be able to contact the ultrasonic probe 43. Reference numeral 48 denotes a first link arm connected to the link member 11 constituting a part of the operation unit 8, and reference numeral 49 denotes a link member connected to the link member 14 provided at one end of the second grip 15. Second
The link arms 48 and 49 are detachably connected by magnets 50 and 51 provided at opposing positions.

Next, the configuration of the connection section 42 will be described with reference to FIG. Reference numeral 52 denotes a ball member inserted into the hole 53 of the main body 40, which is held by the claws 54, the spring 55, and the cap 56 so as to be able to advance and retreat in the direction of the arrow 57. On the other hand, 58 is the grip unit 41
The groove is provided in the grip unit 41 so as to be disposed at substantially the same position as the ball member 52 when inserted into the gripping unit 41.

Next, the operation of the present embodiment will be described.

The operator operates the operation unit 4 in the same manner as in the first embodiment, and holds the intestinal tracts 23 and 24 with the first holding unit 5 and the second holding unit 15. At this time, the ultrasonic probe 43 is connected to the first probe arc portion 44 and the second probe arc portion 45 by the connection portions 46 and 47. Then, the input switch 22 is operated to drive the generator 21,
The vibration energy is transmitted to the first probe arc 44 and the second probe arc 45 via the ultrasonic probe 43. Therefore, the intestinal tracts 23 and 24 are coagulated and adhered at their ends by frictional heat due to vibration energy.

Next, when an anastomosis of luminal organs having different outer diameters is performed, the operator pulls the grip unit 41 in the direction of arrow 59 with respect to the main body 40. At this time, the ball member 52 is pushed up in the direction of the arrow 57 by the groove 58 of the grip unit 41. Further, the second link arm 49 is also separated from the first link arm 48 in the direction of arrow 59. Therefore, the grip unit 41 is detached from the main body 40. Next, a gripping unit (not shown) having a radius of curvature different from the tubular shape of the gripping unit 41 and the first and second gripping portions 5 and 15 is attached to the main body 40 in a manner reverse to that described above. Accordingly, the ball member 52, the groove 58, the magnet 5
According to 0 and 51, the gripping unit (not shown)
And an anastomosis of a luminal organ having an outer diameter different from that of the intestinal tracts 23 and 24 is enabled.

According to the present embodiment, the gripping units having different radii of curvature can be exchanged according to the various outer diameters of the luminal organ to be anastomosed. And more reliable anastomosis is possible.

The connection structure of the main body 40, the grip unit 41, and both link arms 48, 49 in the connection portion 42 may be any structure as long as it can be repeatedly attached and detached, such as screw fixing. Needless to say, the effect can be obtained.

FIGS. 8 to 11 show a fourth embodiment, in which the same components as those in the first embodiment are denoted by the same reference numerals and description thereof is omitted. 8 is a longitudinal side view showing the configuration of the tip side of the ultrasonic transducer, FIG. 9 is a top view in FIG. 8, FIG. 10 is a left side view in FIG. 8, and FIG. 11 is a perspective view in FIG.

The ultrasonic probe 70 is connected to the first horns 71 and 72 attached to the side surfaces of the first grip 73 and the second grip 74 connected to the horn 3. A guide shaft 75 serving as a rotation fulcrum of the link member 14 is provided integrally with the second holding portion 74, and a second holding ring 76 is provided at a tip on the opposite side thereof in the same manner as the second holding portion 74. It is mounted so as to be rotatable around the central axis of the shaft 75.

A first holding ring 78 is attached to a shaft 77 integrally attached to the main body 40 at a position opposed to the second holding ring 76. , And the second holding ring 76 are held by a rotation restricting means such as a key and a key groove (not shown) provided on the shaft 77 and the guide shaft 75 so as to be movable in parallel without rotating in the arrow 79 direction.

The probe arcs 71 and 72 are each provided with a plurality of substantially conical protrusions 80 along the circumferential direction, while the first and second holding rings 78 and 76 are opposed to each other. A concave portion 81 is provided at a position coinciding with the protrusion 80 when the parallel movement is performed in the direction of arrow 79 toward the side. Similarly, a projection 82 is also provided on both holding rings 78 and 76, and a hole 83 is provided at a position opposing the projection 82 in both probe arcs 71 and 72.

Next, the operation of the present embodiment will be described.

First, the surgeon operates the operating section 4 to sandwich the luminal organ to be anastomosed between the two holding sections 73 and 74 and the first and second holding rings 78 and 76. Next, the end face of the luminal organ is turned up, and the probe arc portions 71,
It hooks on the protrusion 80 provided on the 72 surface. Similarly, the end face of the opposite luminal organ is turned up and hooked on the projection 82 provided on both the retaining rings 78 and 76. In this state, the retaining rings 78 and 76 are slid along the shaft 77 and the guide shaft 75 in the direction of arrow 79 until the anastomotic lumen tissue is temporarily fixed.

Next, the surgeon operates the input switch 22 to drive the generator 21 in the same manner as in the first to third embodiments. However, the vibration energy is
The hollow organs are coagulated and adhered by frictional heat generated between the probe arc portions 71 and 72 and the two holding rings 78 and 76 through the frictional heat.

According to the present embodiment, it is possible to pull up the luminal organ and temporarily fix it to the projections 80 and 82 on the probe surface, which is the surface to be coagulated and adhered. Can be minimized.

According to the above embodiments, the following configuration is obtained.

(Supplementary Note 1) A gripper capable of gripping a living tissue, an operation unit for opening and closing the gripper, an ultrasonic vibrator for generating ultrasonic vibration, and a vibration connected to the ultrasonic vibrator An ultrasonic treatment instrument having a transmission member and an ultrasonic probe connected to the vibration transmission member and having a distal end portion guided to the grip portion, wherein the grip portion has a lumen shape and the grip portion An ultrasonic treatment instrument, wherein a distal end portion of the ultrasonic probe connected to the probe has a shape substantially matching a lumen shape of the grip portion.

(Supplementary note 2) The ultrasonic treatment instrument according to supplementary note 1, wherein the ultrasonic probe is composed of a plurality of bodies.

(Supplementary Note 3) The ultrasonic treatment tool according to Supplementary Note 1, wherein the ultrasonic vibrator comprises an aggregate of a plurality of ultrasonic vibrators having different frequencies. The ultrasonic treatment device according to claim 1, wherein the ultrasonic treatment device is detachably attached to a main body that holds the vibrator.

(Supplementary note 5) The supplementary note 1, wherein the holding portion is detachably attached to a main body portion having an ultrasonic vibrator, and the ultrasonic probe comprises a plurality of detachable bodies. Ultrasonic treatment tool.

(Supplementary note 6) The ultrasonic treatment instrument according to Supplementary note 1, further comprising a fixing portion for temporarily fixing a luminal organ to be anastomosed at a distal end portion of the ultrasonic probe.

[0060]

As described above, according to the present invention, coagulation and adhesion can be easily performed by ultrasonic energy in a state where both ends of the luminal organ are sandwiched and held by the gripping portions, and the anastomosis operation can be performed easily and reliably. Can be done. In addition, since the grasping part and the ultrasonic probe have a luminal shape that almost matches the outer diameter of the luminal organ, coagulation and adhesion can be performed in one action, shortening the operation time, and fatigue of the operator if forced. It can greatly contribute to reduction. In addition, since coagulation from several directions is not required for anastomosis of a single luminal organ (since it can be coagulated all around at one time), it is possible to minimize distortion of the luminal organ after anastomosis. Can greatly contribute to the improvement of surgical results.

[Brief description of the drawings]

FIG. 1 is an overall longitudinal side view of an ultrasonic treatment device according to a first embodiment of the present invention.

FIG. 2 is a longitudinal sectional side view showing a state in which a grip portion is closed at a distal end portion in FIG.

3 is a sectional view taken along line AA in FIG. 2,
The figure which shows the state which grasped the hollow organ to be anastomosed, for example, the intestinal tract.

FIG. 4 is a longitudinal sectional side view of an operation unit side of an ultrasonic transducer according to a second embodiment of the present invention.

FIG. 5 is a diagram showing a state of transmission of ultrasonic vibration at the tip of the ultrasonic probe according to the embodiment.

FIG. 6 is a vertical cross-sectional side view of a tip end side of an ultrasonic transducer according to a third embodiment of the present invention.

FIG. 7 is an exemplary sectional view showing details of a connection portion of the ultrasonic treatment device according to the embodiment;

FIG. 8 is a vertical side view of a tip end side of an ultrasonic transducer according to a fourth embodiment of the present invention.

FIG. 9 is a top view in FIG. 8;

FIG. 10 is a left side view in FIG. 8;

FIG. 11 is a perspective view of FIG.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 ... Ultrasonic treatment tool main body 2 ... Ultrasonic transducer 4 ... Ultrasonic probe 5 ... First grip part 6 ... First probe arc part 8 ... Operation part 18 ... Second probe arc part

 ────────────────────────────────────────────────── ─── Continued on the front page (72) Inventor Akira Shiga 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inside Olympus Optical Industrial Co., Ltd. (72) Inventor Tomohisa Sakurai 2-43-2 Hatagaya, Shibuya-ku, Tokyo No. Within Olympus Optical Co., Ltd. (72) Yoshiyoshi Shibata, Inventor 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inside Olympus Optical Co., Ltd. (72) Kenichi Kimura 2-43-2, Hatagaya, Shibuya-ku, Tokyo No. Olympus Optical Co., Ltd. (72) Takahiro Ogasaka, the inventor 2-43-2 Hatagaya, Shibuya-ku, Tokyo (72) Inventor Hiroshi Okabe 2-43-2, Hatagaya, Shibuya-ku, Tokyo No. Olympus Optical Co., Ltd. (72) Inventor Takeaki Nakamura 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olimpa Optical Industry Co., Ltd. in the F-term (reference) 4C060 CC02 CC33 CC36 JJ22 MM26

Claims (1)

[Claims] 1. A gripper capable of gripping a living tissue, an operation unit for opening and closing the gripper, an ultrasonic vibrator for generating ultrasonic vibration, and a vibration transmitting member connected to the ultrasonic vibrator And an ultrasonic treatment tool having an ultrasonic probe connected to the vibration transmitting member and having a distal end portion guided to the grip portion, wherein the grip portion has a lumen shape and is connected to the grip portion. The distal end of the ultrasonic probe to be used has a shape substantially matching the lumen shape of the grip portion.