JPH07178098A - Puncture needle device for endoscope - Google Patents

Abstract

(57) [Abstract] [Purpose] An endoscope capable of effectively collecting and retrieving cell tissue by positively advancing and retracting only the needle tip of a puncture needle that is projected from a treatment instrument insertion channel and stuck into a lesion. A puncture needle device for use is provided. A puncture needle device for an endoscope 1 used by being inserted into a treatment instrument insertion channel 55 of an endoscope, wherein an outer tube 2 is provided.
In the puncture needle device 1 for an endoscope, the tip of the puncture needle 3 is moved in and out from the tip of the mantle tube 2 by operating the puncture needle 3 that can be moved forward and backward in the proximal direction. An outer tube fixing means 30 for arbitrarily fixing the outer tube 2 to the inlet 56 portion of the treatment instrument insertion channel 55 is provided.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a puncture needle device for an endoscope which is inserted into a treatment instrument insertion channel of an endoscope and used for puncturing a body cavity.

[0002]

2. Description of the Related Art In recent years, a technique has been developed in which a suction biopsy needle is punctured in an affected area under observation of an ultrasonic tomographic image by an ultrasonic endoscope to collect cellular tissue of a lesion present in a deep area.

A puncture needle device for an endoscope used for such a procedure is constructed by inserting a puncture needle into a mantle tube so as to be able to move forward and backward, and punctures a lesion in order to effectively collect cell tissue. While advancing and retracting the needle tip, suction is performed from the needle tip.

[0004]

FIG. 8 shows a state in which the tip of the puncture needle 91 is stuck into the lesion 100 as described above.

The outer tube 94 protruding from the treatment instrument insertion channel 93 of the ultrasonic endoscope 92 is pressed against the inner wall 101 of the body cavity in order to maintain the positional relationship with the inner wall 101 of the body cavity.

However, in such a state, the puncture needle 9
When it is attempted to advance or retreat 1, the treatment instrument insertion channel 93
On the other hand, the outer tube 94 that can move back and forth often moves.

Then, for example, as shown in FIG. 9, the outer tube 94, the needle tip of the puncture needle 91 and the lesion 100 move together, and the needle tip of the puncture needle 91 moves relative to the lesion 100. There will be no. Such a phenomenon is
The quicker the forward / backward operation was, the more likely it was to occur.

[0008] Therefore, the present invention is for an endoscope capable of effectively advancing and retracting only the needle tip of a puncture needle that is projected from a treatment instrument insertion channel and punctured in a lesion to effectively collect a cell tissue. An object is to provide a puncture needle device.

[0009]

In order to achieve the above object, the puncture needle device for an endoscope of the present invention is used by being inserted into a treatment instrument insertion channel of an endoscope. A device for an endoscopic puncture needle device, wherein the distal end of the puncture needle is moved in and out from the distal end of the mantle tube by operating the puncture needle provided in the mantle tube so as to be able to move back and forth at the proximal side. An outer tube fixing means for arbitrarily fixing the outer tube to the inlet portion of the treatment instrument insertion channel is provided.

The outer tube fixing means adjusts the protruding length of the outer tube from the outlet of the treatment instrument insertion channel, and then fixes the outer tube to the inlet portion of the treatment instrument insertion channel. You can

[0011]

Embodiments will be described with reference to the drawings. FIG. 2 shows an ultrasonic endoscope, in which a distal end main body 51 is provided at the distal end of a flexible insertion portion 50 that is inserted into a body cavity of a patient.

The tip end main body 51 is provided with an objective optical system for obtaining an optical image of the surface of the subject and an ultrasonic probe for obtaining an ultrasonic tomographic image of the subject. Further, a bending portion 52 that is bendable by remote control is formed on the distal end side of the insertion portion 50.

An operation portion 60 is connected to the base end side of the insertion portion 50. The operation section 60 includes a bending operation knob 61 for remotely controlling the bending state of the bending section 52, an air / water supply switch 62 for performing an operation of ejecting air and water from an air supply nozzle and a water supply nozzle (not shown), and forceps. A suction switch 63 for performing suction operation via a channel or the like is provided.

Reference numeral 64 is a water injection port for feeding a liquid such as deaerated water into the balloon 53 when the balloon 53 is attached to the tip end main body 51. Reference numeral 65 is a suction conduit switching lever for switching the suction conduit to either a forceps channel or a drain conduit (not shown) from the balloon 53.

A treatment instrument insertion channel 55 for inserting a treatment instrument such as a puncture needle device for an endoscope is inserted and arranged over the entire length of the insertion portion 50. The inlet 56 opens obliquely upward in the vicinity of the connecting portion between the operating portion 60 and the insertion portion 50, and the outlet 57 is formed in the tip portion main body 51.
It is arranged so as to face the ultrasonic scanning direction from the side.

An eyepiece portion 68 having a built-in eyepiece lens is projectingly provided on the operation portion 60, and the base end side of the image guide fiber bundle inserted into the endoscope insertion portion 50 is arranged at the observation position. ing. Therefore, the optical image of the surface of the subject portion formed by the objective optical system can be observed through the eyepiece 68.

Reference numeral 70 is a connector for connecting the incident end of the light guide fiber bundle for illumination to the light source device, 71 is an air / water supply socket, 72 is a vent mouthpiece, 73 is a suction nipple, and 74 is a functional ground terminal. is there. Also, 81
Is a processing circuit that performs electrical processing on the ultrasonic probe. Reference numeral 82 is a C for displaying and observing an ultrasonic tomographic image.
It is an RT monitor.

In FIG. 3, the tip of the puncture needle device 1 for an endoscope inserted in the treatment instrument insertion channel 55 is projected from the outlet 57 of the treatment instrument insertion channel 55, and the outer tube 2 is placed on the inner wall 101 of the body cavity. The state is shown in which the needle tip of the puncture needle 3 is pressed and pierced into the deep lesion 100.

The tip portion of the mantle tube 2 is optically observed through the observation window 58, and the needle tip of the puncture needle 3 is a tomographic image by ultrasonic waves emitted and received from the ultrasonic probe 59, for example, shown in FIG. To be observed.

FIG. 5 is an enlarged view of the tip portion of the puncture needle device for an endoscope. The outer tube 2 that can be inserted into and removed from the treatment instrument insertion channel 55 is formed of a flexible tube such as a fluororesin tube. Then, the puncture needle 3 is inserted into the inside of the needle so that the needle can move back and forth over the entire length.
Is made of, for example, a thin stainless pipe, and a stylet (core bar) is removably inserted through the inside thereof.

FIG. 6 shows the hand operation section 5 of the puncture needle device for an endoscope. The hand operation part 5 is formed by connecting the first and second cylinders 6 and 7 with the connecting cylinder 8, and the first cylinder 6 and the connecting cylinder 8 are screwed together to form the second cylinder. Body 7 and connecting tube 8
Has been screwed.

The base end portion of the outer tube 2 is watertightly connected and fixed to the first tubular body 6, and the base end portion of the outer tube 2 is attached to the lower end portion of the first tubular body 6. A male screw 9 is screwed around to surround it.

Reference numeral 11 denotes a water injection port projecting from the first cylindrical body 6 so that cleaning water or the like for cleaning the inside of the mantle tube 2 can be injected, and 12 denotes the puncture needle 3 and the connecting cylinder 8. The O-ring is attached to the inner peripheral portion of the connecting cylinder 8 so as to seal the space.

The puncture needle 3 passes through the inside of the hand operation portion 5, and a needle base 14 capable of connecting an unillustrated syringe or the like is connected and fixed to the base end portion thereof. The stylet holding base 15 fixed to the base end of the stylet 4 is in contact with the end surface of the needle base 14.

Therefore, if the stylet 4 is pulled out from the puncture needle 3 by pulling the stylet holding mouthpiece 15 and the needle base 14 is connected to a syringe or the like to suck the needle, the tip of the puncture needle 3 can be sucked. it can.

The positioning member 17, which is fixed so as to project to the outer periphery in the middle of the puncture needle 3, can be inserted into the mouth of the second cylindrical body 7, and the outer peripheral surface of the positioning member 17 is circularly grooved. 18 is formed.

Then, the O-ring 20 fixed to the mouth portion of the second cylindrical body 7 by the pressing ring 19 is provided in the groove 1.
When the needle tip of the puncture needle 3 is engaged with the needle 8, the relative positional relationship between the two is fixed at the position where the needle tip of the puncture needle 3 is slightly retracted from the tip of the outer tube 2.

If the O-ring 20 and the groove 18 are disengaged and the needle base 14 is moved back and forth with respect to the hand operation section 5,
The needle tip of the puncture needle 3 can be inserted into and removed from the tip of the outer tube 2.

FIG. 7 shows the intermediate adjusting section 30 interposed between the channel inlet mouthpiece 56a projecting from the inlet 56 of the treatment instrument insertion channel 55 and the above-mentioned hand operation section 5.

On one end side of the intermediate adjusting portion 30, the front side connecting cylinder 3 which can be detachably attached to the channel inlet mouthpiece 56a by so-called luer lock engagement and can be watertightly fixed thereto.
1 is provided.

Further, on the other end side of the intermediate adjusting section 30, there is provided a source side connecting cylinder 33 in which a female thread 32 to be screwed with the male thread 9 of the hand operating section 5 is formed. Reference numeral 34 is a rubber ring for sealing with which the tip surface of the male screw 9 of the hand-side operation portion 5 is in pressure contact.

The connection adjusting tube 36 for connecting the front side connecting tube 31 and the source side connecting tube 33 includes a flexible tube 36a having one end fixed to the source side connecting tube 33, and the flexible tube 3 thereof.
It is formed by the metal pipe 36b fixed to the other end side of 6a.

The metal pipe 36b portion of the connection adjusting pipe 36 is fitted in the front connecting cylinder 31 so as to be able to move forward and backward, and in the screw hole formed in the front connecting cylinder 31 in the direction perpendicular to the axis. By screwing the fixing screw 38 from the outside, the metal pipe 36b is pressed and the connection adjusting pipe 36 is fixed to the front connecting cylinder 31.

Therefore, as shown by the arrow B, the fixing screw 38 is loosened to move the connection adjusting pipe 36 forward and backward in the direction of the arrow C, and then the fixing screw 38 is tightened.
The entire length of the intermediate adjustment unit 30 can be fixed while being arbitrarily adjusted. 39 is an O-ring for sealing.

FIG. 1 shows a hand portion in a state in which the puncture needle device for an endoscope is used. As the procedure of use, as shown in FIG. 1, first, the channel inlet cap 56a is used.
Remove the rubber stopper 56b from the channel inlet cap 5
The front connecting cylinder 33 of the intermediate adjusting unit 30 is attached to 6a.
The fixing screw 38 is tightened.

Next, with the O-ring 20 shown in FIG. 6 engaged with the groove and the needle tip of the puncture needle 3 retracted, the outer tube 2 is connected to the intermediate adjustment section 30 at the source side connecting tube. It is inserted from the 33 side, and further inserted into the treatment instrument insertion channel 55.

Then, the male screw 9 of the hand-operated portion 5 is firmly screwed into the female screw 32 of the intermediate adjusting portion 30 to connect the two, and then the fixing screw 38 is loosened so that the tip of the mantle tube 2 is shown in FIG.
Adjust the length of the connection adjusting tube 36 so that the connecting adjusting tube 36 is located at a proper position, and tighten the fixing screw 38.

By doing so, the outer tube 2 is fixed to the entrance 56 of the treatment instrument insertion channel 55 through some parts, and in this state, the puncture needle 3 is axially moved with respect to the hand operation section 5. When it is moved back and forth, the outer tube 2 does not move, and the tip of the puncture needle 3 reliably moves back and forth within the lesion 100.

Therefore, if the stylet 4 is removed in that state and suction is performed from the needle base 14, the cell tissue of the lesion 100 can be effectively collected. After using the puncture needle device for an endoscope, the tip side connecting tube 31 of the intermediate adjusting unit 30 is used.
By removing from the channel inlet mouthpiece 56a, all can be collectively removed from the treatment instrument insertion channel 55.

The present invention is not limited to the above-mentioned embodiment, and for example, the puncture needle device for an endoscope of the present invention may be used for an ordinary endoscope without an ultrasonic probe.

[0041]

According to the present invention, since the mantle tube can be arbitrarily fixed to the entrance portion of the treatment instrument insertion channel, only the needle tip of the puncture needle stuck in the lesion can be reliably advanced and retracted. The collection of cell tissues can be performed very effectively.

[Brief description of drawings]

FIG. 1 is a cross-sectional view of a hand portion in a use state of an embodiment.

FIG. 2 is a perspective view of an ultrasonic endoscope used in Examples.

FIG. 3 is a cross-sectional view of the tip portion in the use state of the embodiment.

FIG. 4 is a schematic view of an ultrasonic tomographic image of an example.

FIG. 5 is a cross-sectional view of the tip portion of the embodiment.

FIG. 6 is a cross-sectional view of a hand operation unit according to the embodiment.

FIG. 7 is a cross-sectional view of an intermediate adjusting unit according to the embodiment.

FIG. 8 is an explanatory diagram of a conventional example.

FIG. 9 is an explanatory diagram of a conventional example.

[Explanation of symbols]

 1 Endoscopic Puncture Needle Device 2 Outer Tube 3 Puncture Needle 30 Intermediate Adjusting Section 31 Tip Connection Tube 36 Connection Adjustment Tube 38 Fixing Screw 55 Treatment Tool Insertion Channel 56 Inlet

Claims (2)

[Claims] 1. A puncture needle device for an endoscope, which is used by being inserted into a treatment instrument insertion channel of an endoscope, wherein a puncture needle provided in an outer sheath tube so as to be movable back and forth is operated forward and backward. In the puncture needle device for an endoscope in which the distal end of the puncture needle is moved in and out from the distal end of the outer tube, an outer tube for arbitrarily fixing the outer tube to the inlet portion of the treatment instrument insertion channel. A puncture needle device for an endoscope, comprising a fixing means. 2. The outer tube fixing means adjusts the protruding length of the outer tube from the outlet of the treatment instrument insertion channel, and then fixes the outer tube to the inlet portion of the treatment instrument insertion channel. The puncture needle device for an endoscope according to claim 1, which is capable of