JP2011078682A - Puncture needle - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a user-friendly puncture needle which can easily be switched between forward observation and rearward observation by a simple construction without increasing costs and without unnecessarily moving it in whole when it is inserted in a body. <P>SOLUTION: An insertion part 11 to be inserted into the body is provided with a shaft body 12 which linearly extends and is provided with an objective lens 12a at its end and an outer tube 20 which keeps the shaft body 12 fitted in so that it can move forward and backward in the axial direction and the end shaked into a needle. An opening 21 for observing the surrounding area from the objective lens 12a is formed at the end of the outer tube 20. A reflecting mirror 22 is arranged at the end in the opening 21. The objective lens 12a can perform at least two operations by forward and backward moving of the shaft body 12 with respect to the outer tube 20: forward observation with the objective lens 12a being in a position away from the reflecting mirror 22 and rearward observation with the objective lens 12a through the reflecting mirror 22 at a position near the reflecting mirror 22. <P>COPYRIGHT: (C)2011,JPO&INPIT

Description

  The present invention relates to a puncture needle formed in a needle shape so that the tip of an elongated insertion portion to be inserted into a body punctures a tissue, and particularly relates to a puncture needle used for gastrostomy.

  Conventionally, as this type of puncture needle, for example, as disclosed in Patent Document 1, a hollow outer needle having a blade formed at the opening edge of the distal end is provided, and the proximal end of the outer needle punctured into the body It is known that an insert such as a catheter or a guide wire is inserted from the side, and the insert is protruded from the distal end of the outer needle and introduced into the body.

  Such a puncture needle is used only for the purpose of puncturing a living tissue, and there is no one having an endoscopic role. Such a puncture needle and a conventional endoscope have structurally similar parts when viewed from the functional aspect of insertion into the body.

  The imaging part of the endoscope is composed of an objective lens in a fiberscope and a fiber bundle that transmits an image formed by the objective lens. In an electronic scope, the imaging part is electrically connected to the objective lens and the image formed by the objective lens. In a rigid mirror that is composed of one CCD element for converting a signal, a power line for driving the CCD, and a signal line for transmitting a video signal and is not rigid and generally bent, the image is formed by an objective lens and an objective lens. It consists of a plurality of relay lenses that transmit images.

  By the way, the insertion portion of the endoscope is configured in an elongated shape having a strength and a thickness that can withstand a moderate buckling load in the axial direction. The field of view at the distal end side of such an endoscope is limited to the forward view or the side view by adding a reflector or the like. It was necessary to tilt the rigid endoscope shaft itself. For this reason, there is a problem in that a blind spot is likely to occur in the observation range when there is a limit in the direction of travel or bending during insertion.

  As a conventional technique capable of solving such problems, for example, as disclosed in Patent Document 2, a cantilever having a shape memory material formed in a flat plate shape and a reflective surface, and heating for heating the cantilever There is already known an endoscope that further includes means and can observe not only the front side but also the side of the insertion direction by switching the angle of the reflecting surface by heating the cantilever with a heater.

  Furthermore, as disclosed in Patent Document 3, a light irradiation unit is provided behind the convex rotator mirror to irradiate the side of the imaging device, and a side image can be captured, and the convex rotation There is also an imaging device that can illuminate the front of the imaging device by providing a light irradiation unit in front of the body mirror and can capture a front image from a hole provided to include the rotation axis at the apex of the convex rotating mirror Already known.

JP 2006-320526 A JP-A-11-337843 JP 2002-233494 A

  When it is assumed that the function of the endoscope described in Patent Document 2 is combined with the puncture needle described in Patent Document 1 described above, a cantilever, a heater, or the like is required as means for switching the angle of the reflecting surface. There was a problem that the number of points increased and the cost increased. Also, since the field of view that can be observed is limited to the side (90 degrees side from the axis) other than the front, it is possible to observe the rear side opposite to the tip side again without moving during insertion into the body. There was a problem that it was difficult to use.

  Moreover, when it is assumed that the puncture needle described in Patent Document 1 described above is combined with the function of the endoscope described in Patent Document 3, it is possible to observe a wide field of view up to 360 ° around the imaging device at a time. Thus, the peripheral field of view in the direction of camera movement can be covered, but this has the problem that the observation range becomes wide and the diaphragm cannot be fully squeezed, and observation omissions are likely to occur. In addition, the peripheral part of the camera traveling direction can be covered in a wide range, but there is a problem that the rear side opposite to the traveling direction as described above is difficult to use again without moving. .

  The present invention has been made by paying attention to the above-described problems of the prior art, and presupposes that the puncture needle also has an endoscopic role, and causes a high cost with a simple configuration. Therefore, an object of the present invention is to provide a puncture needle that is easy to use and can be easily switched between anterior observation and backward observation without moving the entire body during insertion into the body.

The gist of the present invention for achieving the object described above resides in the inventions of the following items.
[1] In the puncture needle (10) formed in a needle shape so that the tip of the elongated insertion portion (11) to be inserted into the body punctures the tissue,
An optical system is built in the insertion portion (11), and an image inside the body is transmitted outside the body via a cable portion (13) connected to the insertion portion (11).
The insertion portion (11) is connected to the cable portion (13), extends linearly, and has a shaft main body (12) provided with an objective lens (12a) on the distal end side, and the shaft main body (12) extends along the axial direction. And an outer tube (20) that is fitted in such a manner that it can move back and forth, and has a needle-like tip.
A part of the outer periphery on the distal end side of the outer tube (20) is cut out in a range extending in a predetermined range in the axial direction and the circumferential direction, and the periphery is observed from the objective lens (12a) of the shaft body (12). Forming an opening (21);
A reflecting mirror (22) is provided on the distal end side in the opening (21) of the outer tube (20) to accommodate the rear in the axial direction in the field of view.
When the shaft main body (12) is moved back and forth with respect to the outer tube (20), the objective lens (12a) is forwardly observed at a position separated from the reflecting mirror (22), and the objective lens (12a) is reflected. A puncture needle (10) characterized in that it can be switched at least to a back observation through the reflecting mirror (22) at a position close to the mirror (22).

[2] In the puncture needle (10) formed in a needle shape so that the tip of the elongated insertion portion (11) to be inserted into the body punctures the tissue,
An optical system is built in the insertion portion (11), and an image inside the body is transmitted outside the body via a cable portion (13) connected to the insertion portion (11).
The insertion portion (11) is connected to the cable portion (13), extends linearly, and has a shaft main body (12) provided with an objective lens (12a) on the distal end side, and the shaft main body (12) extends along the axial direction. And an outer tube (20) that is fitted in such a manner that it can move back and forth, and has a needle-like tip.
The outer tube (20) is formed of a transparent material, and a reflecting mirror (22) that accommodates the rear in the axial direction in the field of view is provided on the distal end side of the outer tube (20).
When the shaft main body (12) is moved back and forth with respect to the outer tube (20), the objective lens (12a) is forwardly observed at a position separated from the reflecting mirror (22), and the objective lens (12a) is reflected. A puncture needle (10) characterized in that it can be switched at least to a back observation through the reflecting mirror (22) at a position close to the mirror (22).

[3] In the puncture needle (10) formed in a needle shape so that the tip of the elongated insertion portion (11) to be inserted into the body punctures the tissue,
An optical system is built in the insertion portion (11), and an image inside the body is transmitted outside the body via a cable portion (13) connected to the insertion portion (11).
The insertion portion (11) has a shaft main body (12) extending linearly connected to the cable portion (13), and is internally fitted so that the shaft main body (12) can move back and forth along the axial direction. An outer tube (20) formed in a shape,
A part of the outer periphery on the distal end side of the outer tube (20) is cut out in a range extending in a predetermined range in the axial direction and the circumferential direction to form an opening (21), and the distal end side in the opening (21) In addition, an objective lens (12a) for observing the surroundings facing the rear in the axial direction is provided,
A reflecting mirror (22) is provided on the distal end side of the shaft body (12) to accommodate the front in the axial direction in the field of view,
Backward observation at a position where the reflecting mirror (22) is separated from the objective lens (12a) by the back-and-forth movement of the shaft body (12) relative to the outer tube (20), and the reflecting mirror (22) is the objective. A puncture needle (10) characterized in that it can be switched at least to forward observation through the reflecting mirror (22) at a position close to the lens (12a).

[4] In the puncture needle (10) formed in a needle shape so that the tip of the elongated insertion portion (11) to be inserted into the body punctures the tissue,
An optical system is built in the insertion portion (11), and an image inside the body is transmitted outside the body via a cable portion (13) connected to the insertion portion (11).
The insertion portion (11) has a shaft main body (12) extending linearly connected to the cable portion (13), and is internally fitted so that the shaft main body (12) can move back and forth along the axial direction. An outer tube (20) formed in a shape,
The outer tube (20) is formed of a transparent material, and an objective lens (12a) for observing the periphery is provided on the distal end side of the outer tube (20).
A reflecting mirror (22) is provided on the distal end side of the shaft body (12) to accommodate the front in the axial direction in the field of view,
Backward observation at a position where the reflecting mirror (22) is separated from the objective lens (12a) by the back-and-forth movement of the shaft body (12) relative to the outer tube (20), and the reflecting mirror (22) is the objective. A puncture needle (10) characterized in that it can be switched at least to forward observation through the reflecting mirror (22) at a position close to the lens (12a).

  [5] The puncture needle (10) according to [1], [2], [3] or [4], wherein the distal end side of the outer tube (20) is made of a hard material suitable for insertion. .

  [6] The reflecting mirror (22) has a mirror surface having any one of a flat surface, a concave curved surface, a convex curved surface, or a conical shape with respect to the axial direction [1], The puncture needle (10) according to [2], [3], [4] or [5].

  [7] [1], [2], [3], wherein the reflecting mirror (22) is provided in a state inclined at a constant angle with respect to a reference plane perpendicular to the axial direction. The puncture needle (10) according to [4], [5] or [6].

  [8] [1], [2], [3], characterized in that a front observation light source (25) for irradiating the front in the axial direction is provided on the distal end side of the outer tube (20). The puncture needle (10) according to [4], [5], [6] or [7].

  [9] A rear observation light source (26) for irradiating the periphery of the position is provided in the middle of the outer tube (20). [1], [2], [3], [ The puncture needle (10) according to [4], [5], [6], [7] or [8].

  [10] Antireflection for preventing direct light irradiation from the rear observation light source (26) to the reflecting mirror (22) at the front position of the rear observation light source (26) of the outer tube (20). The puncture needle (10) according to [9], wherein a member (27) is provided.

The present invention operates as follows.
According to the puncture needle (10) described in [1], tissue can be punctured at the tip of the insertion portion (11), and the inside of the body can be observed by the optical system built in the insertion portion (11). It becomes possible, and the image inside the body can be transmitted outside the body via the cable portion (13) connected to the insertion portion (11).

  The insertion portion (11) has a shaft main body (12) provided with an objective lens (12a) on the distal end side, and the shaft main body (12) is fitted so as to be movable in the axial direction, and the distal end is formed in a needle shape. An outer tube (20) is provided, and the inside of the body can be observed through an opening (21) in which the outer periphery of the outer tube (20) is cut out from the objective lens (12a).

  By simply moving the shaft body (12) back and forth with respect to the outer tube (20), the visual field observed from the objective lens (12a) can be easily switched in the backward and forward direction without moving the outer tube (20). Can do.

  That is, when the shaft main body (12) is moved rearward with respect to the outer tube (20) and the objective lens (12a) is separated from the reflecting mirror (22) on the tip side in the opening (21), The forward observation can be performed as it is. On the other hand, when the shaft body (12) is moved forward relative to the outer tube (20) and the objective lens (12a) is brought close to the reflecting mirror (22), the rear observation is performed through the reflecting mirror (22). It can be performed. Of course, it is needless to say that observation between the front observation and the rear observation can be appropriately performed without any steps.

  For example, as described in [6] above, the reflecting mirror (22) may employ a mirror surface having any one of a flat surface, a concave curved surface, a convex curved surface, and a conical shape with respect to the rear in the axial direction. . Here, in the case of a concave curved surface, it becomes possible to observe a local area with a high magnification. Further, in the case of a convex curved surface or a conical shape, the rear side can be observed in a wider range including its periphery.

  In addition, as described in [2] above, the outer tube (20) is formed of a transparent material, and a reflecting mirror (22) that accommodates the rear side in the axial direction in the field of view is provided on the distal end side of the outer tube (20). You may comprise so that it may provide. In such a case, it is possible to visually recognize the outer tube (20) through the outer periphery without providing the opening (21), and the field of view can be expanded without being blocked by a part of the outer peripheral portion. it can.

  Thus, when the outer tube (20) is formed of a transparent material, the mechanical strength is weakened, and when bending or damage occurs during insertion, as described in [5], the outer tube (20) It is preferable that the front end side of the metal is made of a hard material having excellent strength such as metal.

  In the puncture needle (10) described in [1] above, the objective lens (12a) is provided on the shaft body (12) and the reflecting mirror (22) is provided on the outer tube (20). As with the puncture needle (10) described in [3] above, the shaft body (12) may be provided with a reflecting mirror (22) and the outer tube (20) may be provided with an objective lens (12a). .

  Similarly, in the puncture needle (10) described in [2] above, the shaft main body (12) is provided with the objective lens (12a), and the outer tube (20) is provided with the reflecting mirror (22). As in the puncture needle (10) described in [4] above, the shaft main body (12) may be provided with a reflecting mirror (22) and the outer tube (20) may be provided with an objective lens (12a). good.

  In addition, as described in [7] above, if the reflecting mirror (22) is provided at a certain angle with respect to a reference plane perpendicular to the axial direction, not only the rear but also the side. It is possible to fit in the field of view.

  Further, as described in [8] above, a front observation light source (25) for irradiating the front in the axial direction may be provided on the distal end side of the outer tube (20). This makes it possible to obtain a bright and clear image during normal forward observation.

  Further, as described in [9], a rear observation light source (26) for irradiating the periphery of the position may be provided in the middle of the outer tube (20). As a result, it is possible to obtain a bright and clear image even during rearward observation.

  Furthermore, as described in [10] above, the outer observation light source (26) is directly placed on the reflector (22) from the rear observation light source (26) at a position in front of the rear observation light source (26). It is preferable to provide an antireflection member (27) for preventing excessive light irradiation. Thereby, it becomes possible to obtain a clear image by preventing the reflection of light on the reflecting mirror (22).

  According to the puncture needle of the present invention, it is possible to puncture tissue at the distal end of the insertion portion, and to observe the inside of the body with the optical system built in the insertion portion. Since the relative positional relationship between the objective lens and the reflecting mirror changes due to movement, switching between forward and backward observation is possible, and the entire structure is moved freely during insertion into the body without incurring high costs with a simple configuration. Therefore, at least two of the front observation and the rear observation can be performed, and the usability in the treatment can be improved.

It is a side view which expands and shows the insertion part inserted in a body among the puncture needles concerning embodiment of this invention. It is a side view shown in the state where the shaft main part of the puncture needle concerning an embodiment of the invention was removed from the outer tube. It is a side view which shows the whole apparatus except an outer tube among the puncture needles which concern on embodiment of this invention. It is explanatory drawing which shows the state which observes ahead with the puncture needle which concerns on embodiment of this invention. It is explanatory drawing which shows the state observed back with the puncture needle which concerns on embodiment of this invention. It is explanatory drawing which shows typically the endoscopic gastrostomy construction using the puncture needle which concerns on embodiment of this invention. It is explanatory drawing which shows typically the endoscopic gastrostomy construction which is a continuation of FIG.

DESCRIPTION OF EMBODIMENTS Hereinafter, an embodiment that represents the present invention will be described based on the drawings.
1 to 7 show an embodiment of the present invention.
1 to 3 schematically show a schematic configuration of a puncture needle 10 according to the present embodiment, and FIG. 1 is an enlarged side view showing an elongated insertion portion 11 to be inserted into the body of the puncture needle 10. 2 is a side view showing the shaft main body 12 of the insertion portion 11 removed from the outer tube 20, and FIG. 3 is a side view showing the entire apparatus connected to the shaft main body 12.

  The puncture needle 10 is a device that incorporates an optical system in an elongated insertion portion 11 that is inserted into the body, and transmits an image inside the body to the outside via the cable portion 13 connected to the insertion portion 11. The insertion portion 11 is connected to a cable portion 13 made of a bundle of optical fibers, extends linearly, and has a shaft main body 12 provided with an objective lens 12a on the distal end side. The shaft main body 12 is fitted in such a manner that the shaft main body 12 can move back and forth in the axial direction. And an outer tube 20 to be provided. As will be described later, the distal end of the insertion portion 11 is formed in a needle shape so as to puncture the tissue.

  The cable portion 13 is flexible so that it can be bent flexibly. However, the shaft body 12 that is connected to the distal end side of the cable portion 13 has a rigidity that extends linearly and does not easily bend. The shaft body 12 may be configured by covering the tip side of the cable portion 13 with a thin tube made of stainless steel or synthetic resin over a predetermined length, for example. An objective lens 12 a made of a light transmissive material that transmits visible light is provided on the distal end side of the shaft body 12.

  An observation lens 14 that is visible in an enlarged state of an image transmitted by the internal optical fiber is connected to the base end of the cable portion 13. Further, instead of the observation lens 14, a monitor screen that displays an image may be connected. In addition, what is necessary is just to set the full length of the cable part 13 arbitrarily, but it is good to set the full length of the shaft main body 12 to 150 mm and an outer diameter to about 2.1 mm, for example.

  The outer tube 20 shown in FIG. 1 is configured by covering a thin metal tube 20a made of stainless steel or the like with a thin cover tube 20b made of a transparent resin. The outer tube 20 is formed into a thin tube using a transparent material such as a transparent resin. Also good. In any configuration, the shaft body 12 is a member that is fitted inside the shaft body 12 so as to be movable back and forth along the axial direction. As a specific material of the cover tube 20b, a transparent resin used as a medical device such as silicone rubber or soft polyvinyl chloride is suitable.

  On the distal end side of the outer tube 20, an opening 21 for observing the periphery from the objective lens 12 a of the shaft body 12 is formed by cutting out a part of the outer periphery in a range extending in a predetermined range in the axial direction and the circumferential direction. ing. A reflecting mirror 22 is provided on the distal end side in the opening 21 so that the rear side in the axial direction can be accommodated in the field of view. When the outer tube 20 is formed of a transparent material, the reflecting mirror 22 may be provided on the distal end side of the outer tube 20 without providing the opening 21 in particular.

  The opening 21 is cut out in a wide range, leaving a part of the outer periphery only in a straight line parallel to the axial direction, and a sufficiently wide field of view can be secured. The reflecting mirror 22 is disposed on the distal end side in the opening 21 with its central axis coinciding with the axial direction. Specifically, the reflecting mirror 22 is flat with respect to the rear in the axial direction. The mirror surface has a concave curved surface, a convex curved surface, or a conical shape. The mirror surface itself may be formed by vapor deposition or plating of a metal having a mirror effect, or the metal as a mirror material may be formed as it is in a predetermined surface shape.

  As shown in FIGS. 4 and 5, the puncture needle 10 includes a front observation at a rear position (see FIG. 4) where the objective lens 12 a is separated from the reflecting mirror 22 due to the back-and-forth movement of the shaft body 12 with respect to the outer tube 20. The objective lens 12a is configured to be switchable at least between backward observation through the reflecting mirror 22 at a front position (see FIG. 5) close to the reflecting mirror 22. Here, a latch joint portion 15 is provided on the proximal end side of the shaft body 12, while a latch portion 23 is provided on the proximal end side of the outer tube 20.

  The latch joint portion 15 and the latch portion 23 are combined with each other so that the shaft body 12 can be locked to the rear position (see FIG. 4) and the front position (see FIG. 5) with respect to the outer tube 20, respectively. is there. Specifically, for example, as in a well-known technique in a general ball-point pen knock mechanism, the latch joint portion 15 may be alternately protruded by pushing the latch joint portion 15 toward the outer tube 20 side with reference to the rear position (see FIG. 4). Any configuration that can perform an immersive operation is acceptable.

  The tip of the outer tube 20 is provided with a tip 25 formed in a needle shape so as to puncture the tissue. The pointed portion 25 is made of a transparent material such as a transparent resin, and is formed by radially molding a plurality of chip LEDs forward. That is, the tip 25 also serves as a front observation light source. For feeding power to the tip 25 (chip LED), a small battery that fits at the tip of the outer tube 20 may be attached, or an electric wire may be mixed in an optical fiber and connected.

  Furthermore, a rear observation light source 26 for irradiating the periphery of the position is provided at a position closer to the proximal end than the opening 21 of the outer tube 20. Here, if the total length of the shaft body 12 is, for example, 150 mm, the distance from the front end side of the front observation light source 25 to the base end of the rear observation light source 26 may be set to about 30 to 50 mm.

  Specifically, the rear observation light source 26 is configured by arranging a plurality of chip LEDs side by side in the entire circumferential direction on the outer periphery of the outer tube 20. The power supply to the front observation light source 25 may be connected by attaching a small battery that fits inside the outer tube 20 or by extending the electric wire by mixing it with an optical fiber.

  At the front position of the rear observation light source 26 in the outer tube 20, an antireflection member 27 for preventing direct light irradiation from the rear observation light source 26 to the reflecting mirror 22 is provided. The antireflection member 27 may be anything as long as it prevents light from the rear observation light source 26 from being reflected directly on the reflecting mirror 22, but as a specific material, for example, a part of the metal thin tube 20a is projected. As another configuration example, when the entire outer tube 20 is formed of only a transparent resin, the resin material may be mixed with a black pigment.

Next, the operation of the puncture needle 10 according to the present embodiment will be described.
As shown in FIG. 4, the elongated insertion portion 11 to be inserted into the body of the puncture needle 10 has a shaft main body 12 provided with an objective lens 12a on the distal end side, and the shaft main body 12 is internally fitted so as to be movable in the axial direction. The outer tube 20 having a needle-like pointed tip 25 at the tip is provided, and the inside of the body can be observed through an opening 21 in which the outer periphery of the outer tube 20 is cut out from the objective lens 12a.

  That is, according to the puncture needle 10, it is possible not only to puncture tissue from the tip 25 of the insertion portion 11 but also to observe the inside of the body with the puncture and the optical system built in the insertion portion 11. An image captured by the objective lens 12a through the opening 21 of the outer tube 20 is transmitted to the outside of the body through the cable unit 13 and can be observed through the observation lens 14 (see FIG. 3) at the base end of the cable unit 13. it can.

  During such observation, the field of view observed from the objective lens 12a can be easily switched in the front-rear direction without moving the outer tube 20 simply by moving the shaft body 12 back and forth with respect to the outer tube 20. In FIG. 4, when the objective lens 12 a is at a rear position separated from the reflecting mirror 22, it is possible to observe the front irradiated with light by the front observation light source 25.

  On the other hand, the locked state by the latch joint portion 15 and the latch portion 23 is released, and the shaft body 12 is moved forward with respect to the outer tube 20 as shown in FIG. When approaching the reflecting mirror 22 on the distal end side, the rear side irradiated with light by the rear observation light source 26 can be observed through the reflecting mirror 22. Here, the light traveling forward from the rear observation light source 26 is blocked by the antireflection member 27, so that the reflection of light on the reflecting mirror 22 can be prevented and a clear image can be obtained. Of course, it is needless to say that observation between the front observation and the rear observation can be appropriately performed without any steps.

  Further, when the outer tube 20 is formed of a transparent material, and the reflecting mirror 22 is provided on the distal end side of the outer tube 20 so that the rear side in the axial direction can be accommodated in the field of view, the opening 21 is not provided. Visual recognition through the outer periphery of the outer tube 20 is possible, and the field of view can be expanded without being blocked by a part of the outer peripheral portion.

  As the reflecting mirror 22, a mirror surface having any one of a flat surface, a concave curved surface, a convex curved surface, or a conical shape may be employed with respect to the rear in the axial direction. Here, in the case of a concave curved surface, it becomes possible to observe a local area with a high magnification. Further, in the case of a convex curved surface or a conical shape, the rear side can be observed in a wider range including its periphery. Further, a prism having the same function may be used instead of the reflecting mirror 22.

  Further, the reflecting mirror 22 may be provided in a state of being inclined at a certain angle with respect to a reference plane perpendicular to the axial direction. As a result, not only the rear but also the side can be accommodated in the field of view. For example, if the inclination is set at a maximum of 45 degrees, a lateral image can be seen. Note that the angle of the reflecting mirror 22 does not necessarily have to be constant, and may be freely variable by an operator from the outside. Here, as the variable means, it is conceivable to use, for example, pushing and pulling with a wire, inflation of a fine balloon, or the like.

  Specifically, such a puncture needle 10 can be used by puncturing the gastrostomy site at the time of gastrostomy. 6 and 7 schematically show a method of using the puncture needle 10 in an endoscopic gastrostomy performed for the purpose of supplementing nutrients, discharging body fluids, and the like. First, as shown in FIG. 6 (a), after the stomach is inflated in advance using a gas tube or a foaming agent, the stomach wall and the abdominal wall are brought into close contact with each other, and there is no inclusion such as a viscera at the gastrostomy puncture site Is confirmed using an ultrasonic diagnostic apparatus or the like.

  Next, as shown in FIG. 6B, the puncture needle 10 is punctured into the gastrostomy puncture site, the shaft body 12 is inserted, and the inside of the stomach can be observed. Subsequently, as shown in FIG. 6C, the stomach wall is fixed while observing the stomach. Next, as shown in FIG. 7D, a coaxial dilator A is inserted along the puncture needle 10 to expand the gastrostomy site.

  Then, as shown in FIGS. 7E and 7F, the catheter B is placed along the puncture needle 10 in the same manner as the dilator A, and the puncture needle 10 is observed after observing the catheter B placed in the stomach. Is removed. By performing such a procedure, it is possible to perform a bedside procedure with a smaller wound and lower cost than using a laparoscope.

  The embodiments of the present invention have been described above with reference to the drawings. However, the specific configuration is not limited to the above-described embodiments, and the present invention can be changed or added without departing from the scope of the present invention. Included in the invention. For example, in the above-described embodiment, the example in which the ear scope is improved as the puncture needle 10 has been described. However, the present invention is not limited to such a medical puncture needle, and includes pipes and various machines. It may be applied to internal inspection. Further, not only a fiberscope that projects an image with a bundle of optical fibers, but also an electronic scope in which a small electronic imaging device (CCD) such as a CCD or CMOS is arranged on the distal end side of the scope.

  Furthermore, as another embodiment, in the case where the above-described small electronic image pickup device (CCD) is used, the electronic image pickup device (CCD) and the objective lens 12a in the opening 21 cut out in the outer tube 20 are used. A reflecting mirror 22 that accommodates the front in the axial direction in the field of view may be provided on the distal end side of the shaft body 12 while being provided on the distal end side so as to face the rear in the axial direction.

  That is, in the puncture needle 10 described above, the objective lens 12a is provided on the shaft body 12, and the reflecting mirror 22 is provided on the outer tube 20, but as a reverse aspect, the reflecting mirror 22 is provided on the shaft body 12 and the outer tube 20 is provided. Are provided with an objective lens 12a and an electronic image pickup device (not shown). Here, when the outer tube 20 is formed of a transparent material, it is not necessary to provide the opening 21 in the outer tube 20 as described above, and the objective lens 12a and the electron facing the rear side in the axial direction as it is on the distal end side of the outer tube 20. An imaging element (CCD) may be provided.

  According to the configuration of such another embodiment, the back observation at the position where the reflecting mirror 22 is separated from the objective lens 12a by the longitudinal movement of the shaft body 12 with respect to the outer tube 20, and the reflecting mirror 22 is the objective lens 12a. It is possible to perform at least switching between forward observation through the reflecting mirror 22 at a position close to. Of course, observation at an intermediate position between the backward observation and the forward observation can be appropriately performed.

  The puncture needle according to the present invention is particularly excellent as one used for endoscopic gastrostomy.

DESCRIPTION OF SYMBOLS 10 ... Puncture needle 11 ... Insertion part 12 ... Shaft body 12a ... Objective lens 13 ... Cable part 14 ... Observation lens 15 ... Latch joint part 20 ... Outer tube 20a ... Metal thin tube 20b ... Cover tube 21 ... Opening part 22 ... Reflection mirror 23 ... Latch part 25 ... Pointed point (front observation light source)
26 ... Light source for rear observation 27 ... Antireflection member A ... Dilator B ... Catheter

Claims (10)

In the puncture needle formed in a needle shape so that the tip of the elongated insertion portion to be inserted into the body punctures the tissue,
An optical system is built in the insertion portion, and an image inside the body is transmitted outside the body via a cable portion connected to the insertion portion.
The insertion portion is connected to the cable portion, extends linearly, and has a shaft main body provided with an objective lens on the distal end side. An outer tube,
A part of the outer periphery on the distal end side of the outer tube is cut out in a range extending in a predetermined range in the axial direction and the circumferential direction, and an opening for observing the periphery from the objective lens of the shaft body is formed,
Provided on the distal end side in the opening of the outer tube, a reflecting mirror that accommodates the axial rear in the field of view,
By front-back movement of the shaft main body with respect to the outer tube, the objective lens is observed forward at a position separated from the reflecting mirror, and the objective lens is located behind the reflecting mirror at a position close to the reflecting mirror. A puncture needle characterized in that it can be switched at least for observation. In the puncture needle formed in a needle shape so that the tip of the elongated insertion portion to be inserted into the body punctures the tissue,
An optical system is built in the insertion part, and an image inside the body is transmitted outside the body via a cable part connected to the insertion part.
The insertion portion is connected to the cable portion, extends linearly, and has a shaft main body provided with an objective lens on the distal end side. An outer tube,
The outer tube is formed of a transparent material, and a reflecting mirror is provided on the distal end side of the outer tube to accommodate the rear in the axial direction in the field of view.
By front-back movement of the shaft main body with respect to the outer tube, the objective lens is observed forward at a position separated from the reflecting mirror, and the objective lens is located behind the reflecting mirror at a position close to the reflecting mirror. A puncture needle characterized in that it can be switched at least for observation. In the puncture needle formed in a needle shape so that the tip of the elongated insertion portion to be inserted into the body punctures the tissue,
An optical system is built in the insertion part, and an image inside the body is transmitted outside the body via a cable part connected to the insertion part.
The insertion portion includes a shaft main body extending linearly connected to the cable portion, an inner tube in which the shaft main body is movably moved back and forth along the axial direction, and an outer tube whose tip is formed in a needle shape,
A part of the outer periphery on the distal end side of the outer tube is cut out in a range extending in a predetermined range in the axial direction and in the circumferential direction, and an opening is formed. Provide an objective lens for observation,
Provided on the distal end side of the shaft body with a reflecting mirror that accommodates the front in the axial direction,
By the back-and-forth movement of the shaft main body with respect to the outer tube, the back observation at a position where the reflecting mirror is separated from the objective lens, and the front through the reflecting mirror at a position where the reflecting mirror is close to the objective lens A puncture needle characterized in that it can be switched at least for observation. In the puncture needle formed in a needle shape so that the tip of the elongated insertion portion to be inserted into the body punctures the tissue,
An optical system is built in the insertion part, and an image inside the body is transmitted outside the body via a cable part connected to the insertion part.
The insertion portion includes a shaft main body extending linearly connected to the cable portion, an inner tube in which the shaft main body is movably moved back and forth along the axial direction, and an outer tube whose tip is formed in a needle shape,
The outer tube is formed of a transparent material, and an objective lens is provided on the distal end side of the outer tube to observe the surroundings facing the rear in the axial direction.
Provided on the distal end side of the shaft body with a reflecting mirror that accommodates the front in the axial direction,
By the back-and-forth movement of the shaft main body with respect to the outer tube, the back observation at a position where the reflecting mirror is separated from the objective lens, and the front through the reflecting mirror at a position where the reflecting mirror is close to the objective lens A puncture needle characterized in that it can be switched at least for observation.   The puncture needle according to claim 1, 2, 3, or 4, wherein a distal end side of the outer tube is made of a hard material suitable for insertion.   The said reflecting mirror has a mirror surface in any one shape of a plane, a concave curved surface, a convex curved surface, or a cone shape with respect to the axial direction. 5. The puncture needle according to 5.   The puncture needle according to claim 1, 2, 3, 4, 5, or 6, wherein the reflecting mirror is provided in a state of being inclined at a constant angle with respect to a reference plane perpendicular to the axial direction. .   The puncture needle according to claim 1, 2, 3, 4, 5, 6 or 7, wherein a front observation light source for irradiating the front in the axial direction is provided on a distal end side of the outer tube.   The puncture needle according to claim 1, 2, 3, 4, 5, 6, 7 or 8, wherein a rear observation light source for irradiating the periphery of the position is provided in the middle of the outer tube. .   The antireflection member for preventing direct light irradiation to the reflecting mirror from the rear observation light source is provided at a front position of the rear observation light source of the outer tube. Puncture needle.

Images