JPH07116166A - Endoscope - Google Patents

Abstract

PURPOSE:To enable an endoscope to easily recognize the locational relation between the ultrasonic sectional image and the endoscope image gained through an ultrasonic probe inserted in the treating device channel by installing an standard point verifying device capable of moving flexibly from the top of the endoscope within the range of an ultrasonic beam as well as the endoscope's view. CONSTITUTION:A hard edge component is placed at an endoscope's edge 6. In said edge component, a hole is axially formed for a wire 33 serving as an ultrasonic reflecting material, i.e., a standard point verifying device, and a tube through which a wire is passed is placed via a connecting pipe installed at the rear edge. The wire 33 is passed through the tube, the connecting pipe and the said hole so as to be slidable due to a wire inserting mechanism. By protruding the wire 33 within the operating range of the ultrasonic beam as well as the view of the endoscope, the locational relation between the endoscope' s observation image and the ultrasonic sectional image is instantly perceived.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an endoscope which obtains an endoscopic image and an ultrasonic diagnostic image for diagnosis.

[0002]

2. Description of the Related Art Conventionally, by inserting an elongated insertion portion into a body cavity, an organ in the body cavity or the like can be observed, and if necessary, various treatment procedures can be performed by using a treatment instrument inserted in a treatment instrument channel. The endoscope that can be used is widely used. Also,
Not only for medical use but also for industrial use, observe objects inside boilers, machines, chemical plants, etc., or inside machines, etc.
An endoscope is used for the examination. Further, recently, an electronic endoscope using a solid-state image pickup device such as a CCD as an image pickup means at the tip of the insertion portion is used.

In an endoscope having the treatment instrument channel, an ultrasonic probe may be inserted into the treatment instrument channel to perform ultrasonic diagnosis. When performing ultrasonic diagnosis First, the ultrasonic probe was inserted into the treatment instrument channel, the ultrasonic probe was introduced to the target site, and the ultrasonic beam was oscillated from the ultrasonic probe to perform ultrasonic diagnosis.

An ultrasonic endoscope in which an ultrasonic probe is provided at the distal end portion of the endoscope is known as a similar structure in which an ultrasonic probe is inserted through a treatment instrument channel to perform ultrasonic diagnosis. Further, Japanese Patent Laid-Open No. 3-47243 discloses an intracorporeal ultrasonic diagnostic apparatus including a display control unit for displaying an ultrasonic tomographic image and superimposing an index indicating the visual field direction of an optical system on the ultrasonic tomographic image. Is proposed.

[0005]

However, in the endoscope in which the ultrasonic probe is inserted through the treatment instrument channel, the direction of the visual field of the endoscope optical system is changed in the ultrasonic tomographic image obtained by this ultrasonic probe. Since it is not displayed, it is difficult to observe the ultrasonic tomographic image and instantly grasp the positional relationship with the endoscopic image. In particular, when the ultrasonic probe is radially scanned, this ultrasonic tomographic image may be rotated on the monitor in order to obtain a standard ultrasonic tomographic image. It has become very difficult to recognize the position of the endoscope tip at. For this reason, the burden on the operator is increased and the inspection time is required.

The present invention has been made in view of the above circumstances, and it is possible to easily recognize the positional relationship between the ultrasonic tomographic image obtained by the ultrasonic probe inserted in the treatment instrument channel and the endoscopic image. The purpose is to provide an endoscope.

[0007]

An endoscope of the present invention is an endoscope having a treatment instrument channel into which an ultrasonic probe can be inserted, and an endoscope of an ultrasonic tomographic image obtained by the ultrasonic probe. Reference point confirmation means for informing a positional relationship corresponding to the mirror image is provided in the ultrasonic beam operation range and in the endoscope visual field range so as to be movable back and forth from the endoscope front end surface.

[0008]

With this configuration, when recognizing the positional relationship between the ultrasonic tomographic image and the endoscopic image, the reference point confirmation means is moved from the distal end surface of the endoscope within the ultrasonic beam operation range and the endoscope visual field range. Make it protrude inside. Then, a part of the ultrasonic beam oscillated from the ultrasonic probe is reflected by the reference point confirmation means and an ultrasonic image appears on the ultrasonic tomographic image, and at the same time, the reference point confirmation means is projected on the endoscopic image, and the ultrasonic wave is displayed. The positional relationship between the tomographic image and the endoscopic image is recognized. Then, after confirming the positional relationship between the ultrasonic tomographic image and the endoscopic image, the reference point confirmation means is retracted.

[0009]

Embodiments of the present invention will be described below with reference to the drawings. 1 to 13 relate to an embodiment of the present invention. FIG. 1 is a perspective view showing a schematic structure of an endoscope, FIG. 2 is a view showing a structure of a distal end portion of the endoscope, and FIG. 3 is shown in FIG. Sectional drawing of an endoscope front-end | tip part, FIG. 4 is sectional drawing which shows the state which penetrated the ultrasonic probe into the endoscope, FIG. 5 is a figure which shows a wire insertion / removal mechanism, FIG. 6 is sectional drawing of a wire insertion / removal mechanism, 7 is a diagram showing an endoscopic observation image, FIG. 8 is a diagram showing an endoscopic observation image when an ultrasonic probe is used, and FIG. 9 is a diagram showing an ultrasonic tomographic image of the ultrasonic probe. 10 is a cross-sectional view of the endoscope tip portion during use of the ultrasonic probe, FIG. 11 is a diagram showing endoscopic observation showing a state in which a wire is projected at the endoscope tip during use of the ultrasonic probe, and FIG. FIG. 13 is a diagram showing an ultrasonic tomographic image in a state where a wire is projected at the tip of the endoscope while the ultrasonic probe is being used.
FIG. 13 is a diagram showing an ultrasonic tomographic image when the ultrasonic tomographic image of FIG. 12 is rotated on a monitor.

As shown in FIG. 1, the endoscope 1 is composed of an elongated insertion portion 2 having flexibility and an operation portion 3 arranged on the proximal side of the insertion portion 2.

The insertion portion 2 has a flexible portion 4 having a base end integrally fixed to the operation portion 3 and having flexibility, and a bending portion 5 provided at a tip of the flexible portion 4. It is composed of a hard tip portion 6 provided at the tip of the curved portion 5.

The operation portion 3 is provided with bending operation knobs 7a and 7b for bending the bending portion 5, and a treatment instrument channel port 8 for inserting a treatment instrument into a channel formed in the endoscope insertion portion 2. An operation knob 9 for moving a wire, which will be described later, is provided. The universal cord 10 extends from the side of the operation unit.

Reference numeral 11 is an eyepiece. Further, a light guide or the like (not shown) is inserted into the inside of the universal cord, and by connecting the universal cord to the light source device via the connector 12, the illumination light is emitted to the observation site. .

As shown in FIG. 2, the endoscope distal end portion 6 is provided with a hard distal end forming portion 20. The tip forming portion 20 covers the tip portion with a tip cover 21, while providing two illumination windows 22, 22, an observation window 23, and an observation window cleaning nozzle 24.
And a treatment tool insertion channel 25 and a through hole 26 through which a reference point confirmation means described later is inserted.

As shown in FIG. 3, an objective optical system 31 is provided inside the observation window 23 provided in the tip forming member 20.
At the rear end side of the objective optical system 31, a front end surface of an image guide 32 made of a fiber bundle is arranged, and the rear end surface of the image guide 32 extends to the eyepiece section 11.

A light distribution lens and a light guide (not shown) are provided at the rear ends of the two illumination windows 22, and the rear ends of the light guides extend to the light source device.

A channel hole 25a forming a treatment instrument insertion channel 25 is axially formed in the distal end constituting member 20, and a channel is provided via a connecting pipe 26 provided at the rear end of the channel hole 25a. The tube 25b communicates with the treatment instrument channel port 8. Therefore, by inserting a treatment tool such as forceps or an ultrasonic probe through the treatment tool channel port 8, the treatment tool can be introduced from the tip opening (reference numeral 25) to a desired observation site.

In addition, in the tip forming member 20, a wire insertion through hole 26a for inserting a wire 33 formed of an ultrasonic wave reflecting substance, which is a reference point confirmation means, for example, made of metal.
Is formed in the axial direction, and the wire insertion tube 26b communicates with the connection tube 27 arranged at the rear end of the wire insertion through hole 26a. This wire insertion tube 2
A wire 33 is inserted through 6b, the connecting pipe 27, and the through hole 26a for inserting a wire, and can be moved back and forth by a wire inserting / removing mechanism described later.

As shown in FIG. 4, an ultrasonic probe 34 is inserted through the treatment instrument insertion channel 25. The ultrasonic probe 34 emits ultrasonic waves in a direction perpendicular to the axial direction and rotates to perform radial scanning. The ultrasonic probe 34 has a cylindrical probe outer cover 35, and the probe outer cover 35 is provided. An ultrasonic transducer 37 supported by a rotatable flexible shaft 36 is arranged inside the.

The wire insertion / removal mechanism will be described with reference to FIGS. 5 and 6. As shown in FIG. 5, the operation knob 9 is fixed to the operation lever 41 with a screw 42 so as to rotate about a central shaft 43. A center shaft of a bending operation knob (not shown) is fitted inside the center shaft 43, the first link 44 is screwed and fixed to the operation lever 41, and one end of the second link 45 is attached to the first link 44.
To pin 46. The other end of the second link 45 is connected to the wire coupling member 48 by a pin 47. The wire 33 is fixed to the wire coupling member 48, and the watertight O-ring 4 is also attached.
9 is inserted in the wire tube attachment member 50. The wire tube 26b described above is fixed to the wire tube attachment member 50, and the operation lever 41 is rotated by operating the knob 9, and along with this rotation, the second lever is connected via the first link 44. The link 45 is converted into a linear motion so that the wire 33 is axially advanced and retracted via the wire coupling member 48.

While observing an endoscopic image with the endoscope 1 configured as described above, the ultrasonic probe 34 is inserted through the treatment instrument insertion channel 25 and radial scanning is performed to observe an ultrasonic tomographic image. The state when doing is explained.

First, the affected area is found by looking through the eyepiece of the endoscope 1. (FIG. 7) Next, after diagnosing the affected area from the endoscopic image shown in FIG. 7,
As shown in FIG. 8, the ultrasonic probe 34 is moved closer to the affected area in order to perform ultrasonic diagnosis. Then, radial scanning is performed. Then, for example, an ultrasonic tomographic image as shown in FIG. 9 is displayed on the monitor 90.

In the ultrasonic tomographic image projected on the ultrasonic diagnostic monitor 90 shown in FIG. 9, the affected area is upward.
However, as shown in FIG. 8, the actual affected area is located at the lower left of the ultrasonic probe 34 when viewed from the operation section side on the endoscopic observation image. This is because the ultrasonic tomographic image is projected from the tip side of the ultrasonic probe, and the actual diseased part is that the lower right side is the normal position on the ultrasonic tomographic image.

That is, in the situation shown in FIGS. 8 and 9,
It is very difficult to instantly correspond the positional relationship between the endoscopic observation image and the ultrasonic tomographic image.

Here, as shown in FIG. 10, by operating the knob 9, the wire 33 is attached to the tip surface 20a of the tip forming portion 20.
Project from. The protrusion amount of the wire 33 at this time is within the ultrasonic beam operation range and within the visual field range of the endoscope. The endoscopic observation image at this time is shown in FIG.
The ultrasonic tomographic image is shown in FIG. The wire 33, the ultrasonic probe 34, and the affected area are shown in FIG. 11, and the ultrasonic image 33a of the round wire 33 and the affected area appear in FIG.

As shown in FIG. 2, since the through hole 26 is present right above the treatment instrument channel 25, the ultrasonic image 33a of the wire 33 is directly above the ultrasonic tomographic image shown in FIG. For example, the positional relationship between the endoscopic observation image and the ultrasonic tomographic image will match.

Therefore, the ultrasonic tomographic image is rotated on the monitor so that the ultrasonic image 33a of the wire 33 is turned up as shown in FIG. 13 so that the positional relationship between the endoscopic observation image and the ultrasonic tomographic image is the same. Can be made.

As described above, by projecting the ultrasonic reflecting member, which is the reference point confirming means, from the distal end surface of the endoscope within the ultrasonic beam operating range and the visual field range of the endoscope, It is possible to instantly determine the positional relationship between the observation image and the ultrasonic tomographic image. For this reason, accurate examination and diagnosis can be performed efficiently, so that the burden on the operator can be reduced and the patient's pain can be eased.

The wire is not limited to a stranded wire, but may be a single wire, as long as it is a material that reflects ultrasonic waves regardless of whether it is a metal or a non-metal.

FIG. 14 is a cross-sectional view of an operating portion according to an application example of the present invention. As shown in the figure, in the present embodiment, instead of using the wire inserting / removing mechanism, the wire base 41 is watertightly fixed to the outer plate 3a of the operation portion by the nut 42 through the O-ring 43, and the wire base 41 is attached to the wire. The pipe 44 is fitted and fixed, and the wire tube 26b is fixed to the wire pipe 44 so that the wire 33 can be inserted and removed from the wire base 41.

According to the present embodiment, since the wire 33 is simply inserted and removed from the outside without using the wire inserting and removing mechanism, the structure of the operating portion is extremely simplified and the malfunction is extremely reduced. .

Further, by connecting a syringe or a water injection pump (not shown) to the wire base 41 described above, it is possible to clean the stain on the affected area confirmed by the endoscopic observation image. Other configurations, operations, and effects are the same as those in the above-mentioned embodiment.

FIG. 15 is a sectional view of an operating portion according to another application of the present invention. As shown in the figure, the structure for fixing the wire base 41 and the like to the operation part outer plate 3a is the same as the application example of FIG. In this embodiment, the wire base 41
Connected to rubber 51, base 52, tube 53, syringe 54
And a liquid feeding tube 56 can be connected to the lure lock base 55.

According to this embodiment, using the syringe 54,
The fine particles 57 contained in the fluid are emitted from the ultrasonic probe by sending a harmless fluid to the human body mixed with the fine particles 57 through the liquid feeding tube 56 and ejecting the fluid from the tip. It becomes possible to reflect a sound wave and observe an ultrasonic tomographic image. Other configurations, operations, and effects are the same as those in the above-mentioned embodiment.

Examples of fluids include water, physiological saline, air, etc., which are harmless to the human body. Further, as an example of the fine particles 57, grain powder such as wheat flour and oil particles which are harmless to the human body can be considered. Other harmless to the human body,
Any substance that reflects ultrasonic waves may be used. In addition, if it is visualized as an ultrasonic tomographic image, the fine particles 5 in the fluid may be used.
It is not necessary to mix 7 and only the fluid may be used.

Although the above embodiment has been described with reference to an optical endoscope, it can also be applied to an electronic endoscope.
As an ultrasonic scanning method, an example of mechanical radial scanning has been shown, but it goes without saying that electronic radial scanning may be used.

By the way, when the ultrasonic probe is inserted into the treatment tool insertion channel of the endoscope and the endoscope is operated to bring the ultrasonic probe into contact with the affected part, the ultrasonic probe is used. There was a case where it was not possible to bring the ultrasonic probe into contact with the affected area as desired without following the movement of the. Therefore, the above problems can be solved by configuring the ultrasonic probe or the endoscope as follows.

As shown in FIG. 16, an inflatable and defensible balloon 63 is arranged on the outer peripheral portion of the probe outer skin 62 so that the ultrasonic probe 61 does not rotate with respect to the endoscope. That is, when the balloon 63 is deflated by an external device (not shown), the ultrasonic probe 61 is inserted into the treatment instrument insertion channel 65 of the endoscope 64. Then, the balloon 63 is inflated and the treatment instrument channel 65 is
The ultrasonic probe 61 is fixed inside.

As described above, by fixing the ultrasonic probe in the treatment instrument insertion channel with the balloon, the twisting motion of the endoscope is caused when the endoscope is twisted or brought into contact with the affected part. The ultrasonic probe follows well and the operability is improved.

17 and 18 show another example.

As shown in the figure, in order to prevent the ultrasonic probe from rotating with respect to the endoscope, a groove 74 is provided in the probe skin 73 of the ultrasonic probe 71, and the groove 74 is provided in the tip cover 75 of the endoscope 72. Is formed with a protrusion 76 that fits in the.

In this way, by fitting the projection provided on the endoscope side into the groove provided on the ultrasonic side, the same action and effect as in FIG. 16 can be obtained.

[0043]

As described above, the endoscope of the present invention can easily recognize the positional relationship between the ultrasonic tomographic image obtained by the ultrasonic probe inserted in the treatment instrument channel and the endoscopic image. You can

[Brief description of drawings]

1 to 13 relate to one embodiment of the present invention,
FIG. 1 is a perspective view showing a schematic configuration of an endoscope.

FIG. 2 is a diagram showing a configuration of a distal end portion of an endoscope.

FIG. 3 is a cross-sectional view of the endoscope distal end portion shown in FIG.

FIG. 4 is a sectional view showing a state in which an ultrasonic probe is inserted into an endoscope.

FIG. 5 is a diagram showing a wire insertion / removal mechanism.

FIG. 6 is a sectional view of a wire insertion / removal mechanism.

FIG. 7 is a diagram showing an endoscopic observation image.

FIG. 8 is a diagram showing an endoscopic observation image when an ultrasonic probe is used.

FIG. 9 is a diagram showing an ultrasonic tomographic image of an ultrasonic probe.

FIG. 10 is a cross-sectional view of the endoscope distal end portion during use of the ultrasonic probe.

FIG. 11 is a diagram showing an endoscopic observation image showing a state in which a wire is projected at the tip of the endoscope while using the ultrasonic probe.

FIG. 12 is a diagram showing an ultrasonic tomographic image in a state where a wire is projected at the tip of the endoscope while the ultrasonic probe is being used.

13 is a diagram showing an ultrasonic tomographic image when the ultrasonic tomographic image of FIG. 12 is rotated on a monitor.

FIG. 14 is a cross-sectional view of an operation unit according to an application example of the present invention.

FIG. 15 is a sectional view of an operating portion according to another application example of the present invention.

FIG. 16 is a cross-sectional view showing the rotation stop of the ultrasonic probe inserted through the endoscope.

17 and 18 relate to another embodiment of the rotation stop of the ultrasonic probe, and FIG. 17 is a perspective view showing the endoscope and the ultrasonic probe.

FIG. 18 is a sectional view showing an endoscope and an ultrasonic probe.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 ... Endoscope 26 ... Through hole 33 ... Wire (reference point confirmation means) 34 ... Ultrasonic probe

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[Procedure amendment]

[Submission date] January 21, 1994

[Procedure Amendment 1]

[Document name to be amended] Statement

[Correction target item name] 0008

[Correction method] Change

[Correction content]

[0008]

With this configuration, when recognizing the positional relationship between the ultrasonic tomographic image and the endoscopic image, the reference point confirmation means is moved from the distal end surface of the endoscope within the ultrasonic beam operation range and the endoscope visual field range. Within
Make it protrude . Then, a part of the ultrasonic beam oscillated from the ultrasonic probe is reflected by the reference point confirmation means and an ultrasonic image appears on the ultrasonic tomographic image, and at the same time, the reference point confirmation means is projected on the endoscopic image, and the ultrasonic wave is displayed. The positional relationship between the tomographic image and the endoscopic image is recognized. Then, after confirming the positional relationship between the ultrasonic tomographic image and the endoscopic image, the reference point confirmation means is retracted.

[Procedure Amendment 2]

[Document name to be amended] Statement

[Correction target item name] 0017

[Correction method] Change

[Correction content]

A channel hole 25a forming a treatment instrument insertion channel 25 is axially formed in the distal end forming member 20, and a channel is provided via a connecting pipe 28 arranged at the rear end of the channel hole 25a. The tube 25b communicates with the treatment instrument channel port 8. Therefore, by inserting a treatment tool such as forceps or an ultrasonic probe through the treatment tool channel port 8, the treatment tool can be introduced from the tip opening (reference numeral 25) to a desired observation site.

[Procedure 3]

[Document name to be amended] Statement

[Correction target item name] 0020

[Correction method] Change

[Correction content]

The wire insertion / removal mechanism will be described with reference to FIGS. 5 and 6. As shown in FIG. 5, the operation knob 9 is fixed to the operation lever 41 with a screw 42 so as to rotate about a central shaft 43. Inside the central shaft 43, the bending operation knob 7a shown in FIG.
The central axis of 7b is fitted, the first link 44 is screwed and fixed to the operation lever 41, and one end of the second link 45 is connected to the first link 44 by a pin 46. The other end of the second link 45 is connected to the wire coupling member 48 by a pin 47. The wire 33 is fixed to the wire coupling member 48, and the watertight O-ring 49 is inserted into the wire tube mounting member 50. The wire insertion tube 26b described above is fixed to the wire tube attachment member 50, and the operation lever 41 is operated by operating the knob 9.
Rotates, and with this rotation, the second link 45 is converted into a linear motion via the first link 44, and the wire 33 moves back and forth in the axial direction via the wire coupling member 48. .

[Procedure amendment 4]

[Document name to be amended] Statement

[Name of item to be corrected] 0029

[Correction method] Change

[Correction content]

The wire is not limited to a stranded wire, and may be a single wire, as long as it is a material that reflects ultrasonic waves regardless of whether it is metal or non-metal.

[Procedure Amendment 5]

[Document name to be amended] Statement

[Name of item to be corrected] 0030

[Correction method] Change

[Correction content]

FIG. 14 is a cross-sectional view of an operating portion according to an application example of the present invention. As shown in the figure, in the present embodiment, instead of using the wire inserting / removing mechanism, the wire base 141 is watertightly fixed to the outer plate 3a of the operating portion by the nut 142 through the O-ring 143, and the wire base 141 is attached to the wire. This wire pipe is used while fitting and fixing the pipe 144.
The wire insertion tube 26b is fixed to 144 so that the wire 33 can be inserted and removed from the wire base 141 .

[Procedure correction 6]

[Document name to be amended] Statement

[Name of item to be corrected] 0032

[Correction method] Change

[Correction content]

Further, by connecting a syringe or a water injection pump (not shown) to the wire base 141 described above, it is possible to clean the stain on the affected area confirmed by the endoscopic observation image. Other configurations, operations, and effects are the same as those in the above-mentioned embodiment.

[Procedure Amendment 7]

[Document name to be amended] Statement

[Correction target item name] 0033

[Correction method] Change

[Correction content]

FIG. 15 is a sectional view of an operating portion according to another application of the present invention. As shown in the drawing, the structure for fixing the wire base 141 and the like to the operation portion outer plate 3a is the same as the application example of FIG. In this embodiment, the wire base 1
41 to the connection rubber 51, the mouthpiece 52, tube 53, syringe 54 is capable of connecting the liquid supply tube 56 made of luer lock cap 55 connected.

[Procedure Amendment 8]

[Document name to be amended] Statement

[Name of item to be corrected] Figure 3

[Correction method] Change

[Correction content]

FIG. 3 is a cross - sectional view taken along the line AA of the distal end portion of the endoscope shown in FIG.

[Procedure Amendment 9]

[Document name to be corrected] Drawing

[Name of item to be corrected] Figure 3

[Correction method] Change

[Correction content]

[Figure 3]

[Procedure Amendment 10]

[Document name to be corrected] Drawing

[Name of item to be corrected] Fig. 4

[Correction method] Change

[Correction content]

[Figure 4]

[Procedure Amendment 11]

[Document name to be corrected] Drawing

[Name of item to be corrected] Fig. 10

[Correction method] Change

[Correction content]

[Figure 10]

[Procedure Amendment 12]

[Document name to be corrected] Drawing

[Name of item to be corrected] Fig. 14

[Correction method] Change

[Correction content]

FIG. 14

[Procedure Amendment 13]

[Document name to be corrected] Drawing

[Correction target item name] Figure 15

[Correction method] Change

[Correction content]

FIG. 15

Claims (1)

[Claims] 1. An endoscope having a treatment tool channel through which an ultrasonic probe can be inserted, reference point confirmation means for informing a positional relationship corresponding to an endoscopic image of an ultrasonic tomographic image obtained by the ultrasonic probe. An endoscope characterized by being provided so as to be capable of advancing and retracting from the front end surface of the endoscope within the ultrasonic beam operating range and within the endoscope visual field range.