Ultrasonic endoscope

Abstract

Provided is an ultrasonic endoscope capable of observing a proximal end portion side of a treatment instrument within an observation field of view of an observation window. The ultrasonic endoscope includes: a distal rigid portion (34) provided at a distal end of an insertion portion (12); an ultrasonic transducer (50) provided to the distal rigid portion (34); a treatment instrument guide portion provided at a proximal end side of the ultrasonic transducer (50), including a standing platform housing portion (62) having an opening portion (58) with one side in a first direction as an opening direction, an opening formation surface (70) formed with the opening portion (58), and a treatment instrument standing platform (60) provided inside the standing platform housing portion (62) and changing a guide direction of the treatment instrument; and an observation window (44) provided to an observation mechanism formation surface (72) provided at a proximal end side of the opening formation surface (70), the observation window (44) being provided at a position in the first direction that is on one side of a position of the one side opening portion of the opening portion (58).

Description

[0001] This application is a divisional application of the PCT / JP2018 / 003868 Chinese Invention Patent Application with the application date of February 5, 2018, the title of "Ultrasonic Endoscope", and the application number of 201880022392.8. TECHNICAL FIELD

[0002] The present application relates to an ultrasonic endoscope, and particularly relates to an ultrasonic endoscope provided with a treatment instrument erecting stage that erects a treatment instrument led out from an opening part of a hard part provided at a front end of an insertion part of the endoscope. BACKGROUND

[0003] At present, in an ultrasonic endoscope, there is known an ultrasonic endoscope provided with an erecting stage at a front end part of an insertion part inserted into a body cavity, a treatment instrument is erected by the erecting stage, the treatment instrument is led out from a treatment instrument leading-out part of the front end part through a treatment instrument insertion passage, and the leading-out direction of the treatment instrument can be adjusted by changing the erecting angle of the erecting stage.

[0004] For example, in the following Patent Literature 1, there is described an endoscope provided with an erecting stage at a treatment instrument leading-out part, an erecting rod is connected to the erecting stage via a rotation shaft, and an operation wire is connected to the erecting rod, the operation wire is designed to be pushed and pulled by the operation of an operation part provided at a proximal end part of the insertion part.

[0005] PRIOR ART DOCUMENTS

[0006] PATENT LITERATURE

[0007] Patent Literature 1: Japanese Patent Application Publication No. 2005-287593 SUMMARY

[0008] TECHNICAL PROBLEM TO BE SOLVED BY THE INVENTION

[0009] However, in the ultrasonic endoscope provided with the erecting stage described in Patent Literature 1, since the observation part is provided at the side of the treatment instrument erecting stage (treatment instrument leading-out part), when the treatment instrument is led out, the treatment instrument enters the observation visual field from the peripheral part of the monitor screen. Therefore, the sniping property of the treatment instrument to the part where the puncture needle or stent is inserted is reduced. In addition, when the stent is left, the proximal end part (front side) of the stent needs to be exposed from the tissue, but in the state where the ultrasonic transducer is in contact with the tissue surface, it is difficult to capture the puncture point in the optical visual field, and therefore, in order to perform observation, the insertion part needs to be pulled to change the observation visual field.

[0010] The present application is completed in view of this situation, and aims to provide an ultrasonic endoscope capable of observing the proximal end part side of the treatment instrument in the observation visual field of the observation window.

[0011] MEANS FOR SOLVING THE TECHNICAL PROBLEM

[0012] To achieve the above object, the present application provides an ultrasonic endoscope, which comprises: a front-end rigid portion provided at a front end of an endoscope insertion portion; an ultrasonic transducer provided in the front-end rigid portion; a treatment instrument guide portion provided at a proximal end side of the ultrasonic transducer, which has a standing stage housing portion, an opening formation surface, a treatment instrument guide outlet, and a treatment instrument standing stage, the standing stage housing portion has an opening portion which has one side in a first direction perpendicular to an axis direction of the front-end rigid portion as an opening direction, or has a direction which has a component toward the one side in the first direction and a component toward a front end side of the axis direction of the front-end rigid portion as an opening direction, the opening formation surface has the opening portion formed thereon and has a normal component toward the opening direction, the treatment instrument guide outlet communicates with an inside of the standing stage housing portion to guide a treatment instrument, and the treatment instrument standing stage is provided in the inside of the standing stage housing portion to change a guide direction of the treatment instrument guided from the treatment instrument guide outlet; and an observation window provided on an observation mechanism formation surface provided at a proximal end side of the opening formation surface and having a normal component toward a front end side of the axis direction of the front-end rigid portion, wherein, when a position of an end portion of the opening portion on the one side in the first direction is set as a one-side opening portion position, a position of the observation window in the first direction is arranged at a position on the one side in the first direction than the one-side opening portion position.

[0013] As in the past, when the opening portion is provided on the proximal end side of the observation window, only a portion of the treatment instrument guided on the distal end side of the observation window enters an observation field of view of the observation window, and depending on a treatment position of the treatment instrument, the treatment instrument cannot be confirmed through the observation window. In the present application, the opening portion of the treatment instrument is arranged at a position on the distal end side of the observation window. In addition, in the first direction, the position of the observation window is set at a position on the one side in the first direction than the one-side opening portion position of the opening portion. Thus, a blind area in which the treatment instrument guided from the opening portion does not enter the observation field of view of the observation window can be reduced. Therefore, treatment can be performed while being confirmed through the observation window, and thus, treatment can be reliably performed at a target position.

[0014] In another aspect of the present application, it is preferable that the ultrasonic transducer has an ultrasonic transmitting / receiving surface formed in a curved shape along the axis direction of the front-end rigid portion.

[0015] The present application can be applied to a convex ultrasonic endoscope in which an ultrasonic transmitting / receiving surface of an ultrasonic transducer is formed in a curved shape along an axis direction of a front-end rigid portion.

[0016] In another aspect of the present application, preferably, the topmost portion is provided with an end portion located on the side of the ultrasonic wave transmitting / receiving face closest to the first direction, and when a position of the other side opening portion is set as the other side opening portion position, the topmost portion position is set at a position identical to the other side opening portion position or on the side of the first direction from the other side opening portion position.

[0017] This aspect specifies the positions of the opening portion and the ultrasonic wave transducer, and by setting the topmost portion position of the ultrasonic wave transmitting / receiving face on the first direction at a position identical to the other side opening portion position or on the side of the first direction from the other side opening portion position, the treatment instrument guided from the opening portion is brought close to the ultrasonic wave transducer. By bringing the treatment instrument close to the ultrasonic wave transducer as well, the treatment with the treatment instrument can be performed at the position observed by the ultrasonic observation.

[0018] In another aspect of the present application, preferably, when a position of the treatment instrument guide outlet on the first direction is set as the guide outlet position, the topmost portion position is set at a position identical to the guide outlet position or on the side of the first direction from the guide outlet position.

[0019] This aspect specifies the positions of the treatment instrument guide outlet and the ultrasonic wave transducer. The treatment instrument is guided from the opening portion opened on the side of the first direction through the treatment instrument insertion passage provided in the endoscope insertion portion. Therefore, by setting the topmost portion position of the ultrasonic wave transmitting / receiving face on the first direction at a position identical to the guide outlet position or on the side of the first direction from the guide outlet position, the treatment instrument can be guided to the vicinity of the ultrasonic wave transducer. Thus, the treatment with the treatment instrument can be performed at the position observed by the ultrasonic observation.

[0020] In another aspect of the present application, preferably, when the opening portion is provided with a standing wall portion standing from the opening portion around the opening portion, and a position of an end portion of the upper end edge portion of the standing wall portion on the side closest to the first direction is set as the one side wall portion upper end position, the position of the observation window on the first direction is set at a position on the side of the first direction from the one side wall portion upper end position.

[0021] According to this aspect, by providing the standing wall portion around the opening portion, the lateral shaking of the treatment instrument guided from the opening portion can be prevented, and the treatment can be reliably performed at the target position by the treatment instrument. In addition, by setting the position of the observation window at a position on the side of the first direction from the one side wall portion upper end position, the treatment can be performed at the target position while confirming the treatment instrument guided from the standing wall portion through the observation window.

[0022] In another aspect of the present application, preferably, the standing wall portion is provided only on the proximal end side of the opening portion.

[0023] According to this aspect, by setting the position of the standing wall portion to the base end side of the opening portion, a space can be provided between the ultrasonic transducer and the standing wall portion. Thus, the body cavity wall (tissue) can be made to adhere to the base end side of the transceiving surface of the ultrasonic transducer, so the distance from the treatment instrument guided from the opening portion to the body cavity wall can be shortened, and thus the treatment instrument can be easily guided to the target position.

[0024] In another aspect of the present application, it is preferable that the ultrasonic transducer have an ultrasonic transceiving surface formed in a curved shape along the axis direction of the front end rigid portion.

[0025] The present application can be applied to an ultrasonic endoscope having a convex ultrasonic transducer whose ultrasonic transceiving surface is formed in a curved shape along the axis direction of the front end rigid portion.

[0026] In another aspect of the present application, it is preferable that the topmost portion having an end portion on the side of the ultrasonic transceiving surface closest to the first direction be set to a topmost position, and the position of an end portion on the other side of the upper end edge portion of the standing wall portion closest to the first direction be set to an other-side wall portion upper end position, and the topmost position be set to a position identical to the other-side wall portion upper end position or on the side of the first direction from the other-side wall portion upper end position.

[0027] This aspect specifies the position of the upper end edge portion of the standing wall portion and the ultrasonic transducer when the standing wall portion is present, and by setting the topmost position of the ultrasonic transceiving surface in the first direction to a position identical to the other-side wall portion upper end position or on the side of the first direction from the other-side wall portion upper end position, the treatment instrument guided from the standing wall portion can be brought close to the ultrasonic transducer. Thus, treatment with the treatment instrument can be performed at a position observed by ultrasonic observation.

[0028] In another aspect of the present application, it is preferable that the observation window be disposed offset from the treatment instrument standing stage in a second direction perpendicular to the first direction.

[0029] According to this aspect, because the observation window is disposed offset from the treatment instrument standing stage in the second direction, the observation field of view of the observation window can be prevented from being obstructed by the treatment instrument and the treatment instrument standing stage when the treatment instrument standing stage is standing.

[0030] In another aspect of the present application, it is preferable that the treatment instrument standing stage be exposed from the opening formation surface.

[0031] According to this aspect, by causing the treatment instrument standing stage to be exposed from the opening formation surface, the treatment instrument standing stage exposed from the opening portion can be confirmed within the observation field of view of the observation window.

[0032] In another aspect of the present application, it is preferable that the observation mechanism formation surface be provided with a nozzle that ejects a cleaning liquid toward the observation window and a direction changing portion that changes the direction of the cleaning liquid that has passed through the observation window toward the opening portion.

[0033] According to this aspect, the cleaning of the observation window is performed by ejecting the cleaning liquid from the nozzle provided on the observation mechanism surface forming surface, and the direction of the cleaning liquid is changed toward the opening portion by the direction changing portion, whereby the cleaning liquid that has passed through the observation window is directed toward the opening portion, so the opening portion can be cleaned with the cleaning liquid.

[0034] In another aspect of the present application, it is preferable that the observation mechanism surface forming surface has an illumination portion, and the portions on both sides of the opening forming surface have light guide avoiding wall portions that inhibit the illumination light from the illumination portion from being blocked.

[0035] According to this aspect, by providing the light guide avoiding wall portions on both sides of the opening forming surface, the portions that generate illumination unevenness or become shadows from the illumination portion can be prevented, and thus the treatment with the treatment instrument can be performed safely.

[0036] Effects of the Invention

[0037] According to the ultrasonic endoscope of the present application, by providing the observation window on the proximal end side of the opening portion, and setting the position of the observation window in the first direction to the side of the opening portion position in the first direction, the blind area in which the treatment instrument guided from the opening portion does not enter the observation field of view of the observation window can be reduced. Thus, the treatment instrument guided from the opening portion can be confirmed through the observation window, and thus the treatment can be reliably performed at the target position. BRIEF DESCRIPTION OF DRAWINGS

[0038] Figure 1 is a whole view of the ultrasonic endoscope of the present application.

[0039] Figure 2 is a perspective view showing the appearance of the front end rigid portion of the first embodiment of the insertion portion.

[0040] Figure 3 is a plan view (top view) showing the appearance of the front end rigid portion of the first embodiment of the insertion portion.

[0041] Figure 4 is a side sectional view of the front end rigid portion of the first embodiment of the insertion portion.

[0042] Figure 5 is a side sectional view showing a modification of the standing stage of the front end rigid portion.

[0043] Figure 6 is a view showing the state in which the support is punctured in the wall of the body cavity.

[0044] Figure 7 is a view showing an optical image showing the state in which the puncture is photographed through the observation window.

[0045] Figure 8is a perspective view showing the appearance of the front end hard portion of the second embodiment of the insertion portion.

[0046] Figure 9 is a perspective view showing the appearance of the front end hard portion of the second embodiment of the insertion portion.

[0047] Figure 10 is a side sectional view of the front end hard portion of the second embodiment of the insertion portion.

[0048] Figure 11 is a perspective view showing the appearance of the front end hard portion of the third embodiment of the insertion portion.

[0049] Figure 12 is a view showing the state in which the front end hard portion is in close contact with the wall of the body cavity.

[0050] Figure 13 is a side sectional view of the front end hard portion of the fourth embodiment of the insertion portion.

[0051] Figure 14 is a side sectional view of the front end hard portion of the fourth embodiment of the insertion portion. DETAILED DESCRIPTION

[0052] Hereinafter, an ultrasonic endoscope according to the present application will be described with reference to the drawings.

[0053] (Ultrasonic endoscope)

[0054] Figure 1 is a perspective view showing the entire configuration of the ultrasonic endoscope 1 according to the present application.

[0055] Figure 1 The ultrasonic endoscope 1 (hereinafter, also simply referred to as "endoscope 1") in FIG. 1 is configured by an operation portion 10 which is held by a practitioner and in which various operations are performed, an insertion portion (endoscope insertion portion) 12 which is inserted into a body cavity of a patient, and a general-purpose cord 14 for connecting the endoscope 1 with system configuration devices such as a processor device and a light source device which constitute an endoscope system, which are not shown.

[0056] In the operation portion 10, various operation members which are operated by the practitioner are provided, and for example, a bend angle knob 16, an erecting operation lever 18, a gas / water supply button 20, a suction knob 22, and the like, the functions of which will be appropriately described later, are provided.

[0057] Further, in the operation portion 10, a treatment instrument guide inlet 24 for inserting a treatment instrument into a treatment instrument insertion passage which is inserted into the insertion portion 12 is provided.

[0058] The insertion portion 12 extends from the front end of the operation portion 10, and is formed in a long shape with a thin diameter as a whole.

[0059] Further, the insertion section 12 is composed of the soft section 30, the curved section 32, and the front-end hard section 34 in this order from the proximal end side toward the front end side.

[0060] The soft section 30 occupies most of the insertion section 12 from the proximal end side, and has flexibility to bend in any direction. When the insertion section 12 is inserted into the body cavity, the soft section 30 bends along the insertion path into the body cavity.

[0061] The curved section 32 is bent in the up-down direction and the left-right direction by a rotation operation of the bend knob 16 of the operation section 10, and by causing the curved section 32 to perform the bending operation, it is possible to cause the front-end hard section 34 to face a desired direction.

[0062] The front-end hard section 34, as will be described later, has an imaging section and an illumination section for photographing an observation image inside the body cavity, an ultrasonic transducer for acquiring an ultrasonic image, a treatment instrument lead-out section, and the like. The treatment instrument lead-out section is composed of a treatment instrument lead-out port 80, an erected table accommodating section, an erected table, an opening section, an opening forming surface, and the like. Further, in the following description, the erected table accommodating section 62 is sometimes used in the same meaning as the treatment instrument lead-out section.

[0063] The universal cord 14 internally houses a cable, a light guide, and a fluid tube. A connector is provided at a not-illustrated end portion of the universal cord 14, and by connecting the connector to a processor device, a light source device, and the like that constitute a prescribed system configuration device of an endoscope system, the system configuration device supplies power, control signals, illumination light, liquid and gas, and the like necessary for the use of the endoscope 1 from the system configuration device to the endoscope 1, and in addition, data of an observation image acquired by the imaging section or data of an ultrasonic image acquired by the ultrasonic transducer is transmitted from the endoscope 1 to the system configuration device. Further, the observation image or the ultrasonic image transmitted to the system configuration device is displayed on a monitor so as to be observable by a practitioner or the like.

[0064] (Structure of the front-end hard section)

[0065] First Embodiment

[0066] Next, the structure of the front-end hard section 34 of the insertion section 12 will be described. Figure 2 is a perspective view showing the appearance of the front-end hard section 34, Figure 3 is a plan view (top view), and Figure 4 is a side sectional view.

[0067] The front-end hard section 34 has a front-end hard section main body (frame) 36 that forms an outer wall or a partition wall inside, and accommodates and holds each of the constituent parts arranged in the front-end hard section 34 in an accommodating section (accommodating chamber) divided by the front-end hard section main body 36.

[0068] Although the detailed content is omitted, the front-end rigid portion main body 36 can detachably detach a part thereof as a partition block, and can assemble the respective constituent parts to the prescribed accommodation portion in a state where the partition block is detached. After the respective constituent parts are assembled to the accommodation portion, the respective constituent parts are accommodated and held in the accommodation portion and fixed to the front-end rigid portion 34 by installing the partition block to the front-end rigid portion main body 36.

[0069] The front-end rigid portion main body 36 is formed of an insulating material having insulating property, such as a plastic resin material such as a methyl methacrylate resin, a polycarbonate, or the like.

[0070] As shown in FIG. 1, the front-end rigid portion 34 is constituted of a base portion 40 constituting the front-end rigid portion main body 36, and an extension portion 42 extending from the base portion 40 to the front-end side and holding the ultrasonic transducer 50. Figures 2 to 4

[0071] The ultrasonic transducer 50 having a convex shape with an ultrasonic wave transmitting / receiving surface 52 on the upper side is disposed in the extension portion 42, and the ultrasonic wave transmitting / receiving surface 52 is formed by arranging ultrasonic wave vibrators transmitting / receiving ultrasonic waves in a curved shape in the axis 38 direction of the front-end rigid portion 34. Data for generating an ultrasonic image of a body tissue is obtained by the ultrasonic transducer 50. Here, the axis 38 direction of the front-end rigid portion 34 refers to the direction of a line coinciding with or parallel to the axis of the long side direction of the insertion portion 12. Further, the number of the ultrasonic wave vibrators is not limited, and can be one or a plurality of two or more. Figure 1

[0072] The observation window 44, the illumination windows 46L, 46R, the gas / water supply nozzle 48, the opening portion 58 through which the treatment instrument is led out, and the standing wall portion 68 provided around the opening portion 58 are provided in the base portion 40.

[0073] The opening portion 58 is provided in the center of the opening formation surface 70 provided on the extension portion 42 side of the base portion 40, and the treatment instrument is led out from the opening portion 58 to the scanning range of the ultrasonic wave of the ultrasonic transducer 50. The opening portion 58 is provided in the opening formation surface 70, and the side in the first direction perpendicular to the axis 38 of the front-end rigid portion 34 of the standing table accommodation portion 62 provided in the front-end rigid portion main body 36 is formed as an opening direction. The opening portion 58 can also form the direction having a component toward the side in the first direction and a component toward the front-end side in the axis 38 direction of the front-end rigid portion 34 as the opening direction. That is, the opening portion can also be formed so as to open the opening direction toward the front end of the front-end rigid portion 34 and upward (the side in the first direction). Here, the opening direction refers to the normal line direction of the face surrounded by the rim of the opening portion 58. Further, in the present specification, the "side in the first direction" refers to the side in the direction in which the front-end rigid portion 34 is inserted into the insertion portion 12. Figure 4 ​​direction perpendicular to the axis 38 direction of the distal hard portion 34 and the direction of the opening portion 58 in which the standing platform accommodating portion 62 is formed, indicated by an arrow A. Further, the "second direction" refers to a direction indicated by an arrow B, which is perpendicular to the axis 38 direction of the distal hard portion 34 and the first direction indicated by the arrow A. Figure 2

[0074] The treatment instrument is inserted from the treatment instrument guide inlet 24 of the operation portion 10. The opening formation surface 70 is formed by a surface having a normal component in the opening direction. In the first embodiment, the opening direction is formed toward one side of the first direction, and the opening formation surface is disposed in parallel with the axis 38 of the distal hard portion 34. Further, it can also be disposed inclined toward the distal end side of the distal hard portion 34 and downward (the other side of the first direction). Furthermore, the opening portion 58 refers to a portion through which the treatment instrument is guided from the standing platform 60, described later, to the standing platform accommodating portion 62.

[0075] By setting the position of the opening portion 58 to the proximal end side of the ultrasonic wave transducer 50, and as described later, to the distal end side of the observation mechanism formation surface 72, the distance of the ultrasonic wave transducer 50 from the opening portion 58 can be made close. Therefore, the distance from the position immediately after being guided from the opening portion 58 to the treatment position of the treatment instrument can be shortened, and thus, the lateral shaking of the treatment instrument can be reduced, and the treatment instrument can be punctured at the target position.

[0076] The standing wall portion 68 is provided around the opening portion 58. By the standing wall portion 68, the lateral shaking of the treatment instrument guided from the opening portion 58 can be prevented, and the treatment of the target position can be stably performed by the treatment instrument. The standing wall portion 68 only needs to be able to prevent the lateral shaking of the treatment instrument, and it is not necessary to be provided around the entire opening portion 58, and specifically, it is preferable to be formed to stand upward from both sides of the direction of the treatment instrument guided from the opening portion 58. Furthermore, in the first embodiment, the standing wall portion 68 is provided on the entire surface of the opening formation surface 70. Further, the opening formation surface 70 and the standing wall portion 68 can be formed in one body.

[0077] Further, the light guide avoiding wall portions 76L, 76R are provided on the distal hard portion main body 36, which are formed by cutting the portions on both sides of the opening formation surface portion 74 forming the opening formation surface 70 obliquely downward. In this way, by forming the light guide avoiding wall portions 76L, 76R, the illumination light from the illumination windows 46L, 46R can be prevented from being blocked, and the generation of illumination unevenness or a portion that becomes a shadow can be prevented. The light guide avoiding wall portions 76L, 76R are not limited to being cut obliquely downward, and can be a structure of being cut in the vertical direction or obliquely forward.

[0078] ​The observation window 44 is provided on an observation mechanism formation surface 72 provided on the proximal end side of the opening formation surface 70. Inside the observation mechanism formation surface 72, a camera system unit in which an imaging optical system and a solid-state imaging element that constitute a photographing section are assembled integrally is accommodated. Thus, light from an object in the field of view of the photographing section is taken in from the observation window 44, and an object image is formed by the imaging optical system, and the object image is imaged as an observation image by the solid-state imaging element. The observation mechanism formation surface 72 is constituted by a surface having a normal component toward the distal end side of the axis 38 of the distal end rigid section 34. In the first embodiment, the observation mechanism formation surface 72 is formed as an inclined surface inclined toward the proximal end side of the distal end rigid section body 36 and upward. By providing the observation mechanism formation surface 72 as a surface having a normal component toward the distal end side, and by providing the observation window 44, the treatment instrument guided from the opening section can be confirmed through the observation window 44. Further, the observation mechanism formation surface 72 can also be constituted by a vertical surface perpendicular to the axis 38 direction of the distal end rigid section 34.

[0079] The illumination windows 46L, 46R are provided on both sides of the observation window 44 on the observation mechanism formation surface 72. Inside the observation mechanism formation surface 72, a light exit section constituting an illuminating section is accommodated. Illumination light transmitted from a light source device connected to the general-purpose plug cord 14 through a light guide is emitted from the light exit section so that the illumination light is irradiated to an object in the field of view of the photographing section via the illumination windows 46L, 46R.

[0080] The gas / water supply nozzle 48 is provided on the observation mechanism formation surface 72, and by operation of the gas / water supply button 20 of the operation section 10, a cleaning liquid, water, or air, or the like (hereinafter also referred to as "cleaning liquid or the like") is sprayed from the gas / water supply nozzle 48 toward the observation window 44, and cleaning or the like of the observation window 44 is performed.

[0081] Further, on the observation mechanism formation surface 72, a change direction section 78 is provided at a position opposite the gas / water supply nozzle 48 with the observation window 44 interposed. The change direction section 78 is provided in a protruding manner toward the observation mechanism formation surface 72. The change direction section 78 can be formed integrally with the observation mechanism formation surface 72, or can be fixed separately. The cleaning liquid or the like sprayed from the gas / water supply nozzle 48 toward the observation window 44 collides with the change direction section 78. The cleaning liquid or the like that collides with the change direction section 78 changes direction toward the opening section 58, and is supplied to the opening section 58. Thus, cleaning or the like inside the opening section 58 is performed.

[0082] The shape of the change direction section 78 is not particularly limited, and only needs to be able to change the direction of the cleaning liquid or the like that has passed through the observation window 44 toward the opening section 58. As shown in FIG. 8, the change direction section 78 can be constituted by two surfaces 78A, 78B constituted by mutually orthogonal planes, or can be constituted by a surface constituted by a curved shape such as a circular arc shape, an elliptical arc shape, a parabolic shape, or the like. Figure 2 、 3 ​

[0083] In the opening portion 58, a recessed standing table accommodating portion 62 is formed which is provided in communication with the opening portion 58, and a treatment tool guide outlet 80 of a treatment tool insertion passage 82 is provided on the proximal end side thereof.

[0084] The treatment tool guide outlet 80 communicates with the treatment tool insertion passage 82 which is inserted into the insertion portion 12, and a treatment tool which is inserted from the treatment tool guide inlet 24 (refer to Figure 1 ) of the operation portion 10 is guided from this treatment tool guide outlet 80 to the standing table accommodating portion 62.

[0085] In a position of the standing table accommodating portion 62 which is in front of the treatment tool guide outlet 80, a standing table (treatment tool standing table) 60 is provided.

[0086] The standing table 60 is formed of a metal material such as stainless steel, and has a recessed guide surface 60a on the upper side which is curved upward from the proximal end side of the front end rigid portion main body 36 toward the front end side. The treatment tool which is guided from the treatment tool guide outlet 80 is curved upward along this guide surface 60a with respect to the axis 38 direction (longitudinal direction of the insertion portion 12) of the front end rigid portion 34, and is guided to the outside from the opening portion 58 and the edge portion of the standing wall portion 68 on the upper side of the standing table accommodating portion 62.

[0087] In addition, the standing table 60 performs a standing action by operation of the standing operation lever 18 of the operation portion 10, and by causing the standing table 60 to perform the standing action and adjusting the standing angle from the lying state, it is possible to adjust the guide direction (guide angle) of the treatment tool which is guided from the opening portion 58.

[0088] In addition, Figure 5 is a side sectional view showing a modification example of the standing table 61 of the front end rigid portion. Figure 4 The standing table 60 of the first embodiment shown is such that in a state in which the standing table 60 is in a lying position (fully lying state), the front end portion of the standing table 60 protrudes from the front edge portion 68b of the standing wall portion 68, but Figure 5 The standing table 61 shown is such that in the fully lying state, the front end portion of the standing table 61 does not protrude from the standing wall portion 68, and the entire standing table 61 is accommodated in the standing table accommodating portion 62. In the fully lying state, by being configured such that the standing table 61 is accommodated in the standing table accommodating portion 62, it is possible to smoothly perform insertion of the insertion portion 12 into the human body.

[0089] Further, the treatment tool insertion passage 82 is also connected to a suction passage which is not shown, and by operating the suction button 22 of the operation portion 10, it is also possible to suction a body fluid or the like from the opening portion 58.

[0090] Next, the positional relationship of the opening portion 58 of the front end rigid portion main body 36, the upper end edge portion 68a of the standing wall portion 68, the observation window 44, and the ultrasonic wave transducer 50 will be described.

[0091] In this embodiment, on the front rigid body 36, the first direction indicated by arrow A ( Figure 4 When the position of the upper edge 68a of the vertical wall portion 68 in the vertical direction is set to the upper end position Q1 of the side wall portion, the observation window 44 in the first direction ( Figure 4 The position (vertical direction) is positioned closer to the side in the first direction than the upper end position Q1 of one side wall. That is, the axis 45 of the observation window, which extends parallel to the axis 38 of the front rigid part 34 from the center position of the observation window 44, is positioned above the position of the upper edge 68a. In the case of the upright wall part 68, the treatment device is extended to the outside from the upper edge 68a or the front edge 68b of the upright wall part 68. In this way, by setting the upper edge 68a of the upright wall part 68 downward from the observation window 44, the treatment device extended from the upright wall part 68 can be reliably brought into the observation field of the observation window 44, thereby guiding the treatment device to the target position and improving sniping effectiveness.

[0092] In addition, Figure 4 In the first direction indicated by arrow A of the front rigid body 36, the topmost position of the end of the ultrasonic transceiver surface 52 of the ultrasonic transducer 50 located on the side closest to the first direction is set as the topmost position P. Furthermore, when the position of the end closest to the other side of the upper edge 68a of the vertical wall portion 68 in the first direction is set as the upper end position Q2 of the other side wall portion, the topmost position P in the first direction is configured to be the same as, or closer to, the side in the first direction than, the upper end position Q2 of the other side wall portion. Moreover, in Figure 4 In this configuration, because the upper edge 68a is formed parallel to the axis 38 of the front hard portion 34, the upper position Q1 of one side wall and the upper position Q2 of the other side wall are at the same position. When the upper edge 68a is formed at an angle, the lowermost position of the upper edge 68a is set as the upper position Q2 of the other side wall. By arranging the upper edge 68a of the vertical wall portion 68 and the ultrasonic transducer 50 such that the topmost position P is the same as or closer to the side in the first direction than the upper position Q2 of the other side wall, when a treatment device is extended obliquely upwards from the upper edge 68a or the front edge 68b of the vertical wall portion 68 through the treatment device insertion channel 82, the treatment device can be brought close to the ultrasonic transducer 50 and extended. Therefore, the treatment device can be reliably punctured to the position where ultrasonic observation is being performed using the ultrasonic transducer 50.

[0093] In addition, Figure 4When the position of the treatment instrument guide outlet 80 is set to the guide outlet position R in the first direction indicated by the arrow A of the front hard portion main body 36, the uppermost position P is arranged to be the same as the guide outlet position R or closer to the first direction side (upper side) than the guide outlet position R. The treatment instrument is guided from the opening portion 58 that opens upward to the obliquely upward direction through the treatment instrument insertion passage 82. Therefore, by setting the treatment instrument guide outlet 80 at a position lower than the ultrasonic transducer 50, the treatment instrument can be guided to the vicinity of the ultrasonic transducer 50. Further, it is preferable that the guide outlet position R be set to the center position of the treatment instrument guide outlet 80 (see Figure 4 ), and it is more preferable that the position of the end portion on the first direction side of the treatment instrument guide outlet 80 (upper end position) be satisfied.

[0094] Further, as shown in Figure 3 , it is preferable that the observation window 44 be arranged offset from the standing table 60 in the second direction indicated by the arrow B. Here, by the observation window 44 being arranged offset from the standing table 60 in the second direction, it means, for example, as shown in Figure 3 , that the center line 44A of the observation window 44 is offset from the center line 60A of the standing table 60 in the second direction indicated by the arrow B in plan view. By being configured in this way, in a state in which the standing table 60 is standing and the treatment instrument is being guided from the standing wall portion 68, it is possible to prevent the observation field of view of the observation window 44 from being obstructed by the treatment instrument and the standing table 60, and thus it is possible to confirm the treatment position through the observation window 44.

[0095] Next, as an example of treatment using the ultrasonic endoscope of the present embodiment, an example of indwelling a stent will be described. Figure 6 is a view that shows a state in which a stent is punctured into a body lumen wall, Figure 7 is a view that shows an optical image obtained by photographing the state of the puncture through the observation window.

[0096] According to the present embodiment, as shown in Figure 6 and Figure 7 , in a state in which the stent 90 is punctured into the body lumen wall 94, the puncture point 96 can be confirmed through the optical image of the observation window 44. Therefore, it is possible to easily confirm whether or not the proximal end side of the stent 90 is exposed from the insertion point 96, and by moving the insertion portion 12 in order to confirm as before, it is possible to reduce the process of changing the observation field of view of the observation window 44. Further, in Figure 7 , the ultrasonic transducer 50 is not shown because the ultrasonic transceiver surface 52 of the ultrasonic transducer 50 is obstructed by the body lumen wall 94.

[0097] <Second Embodiment>

[0098] Figure 8is a perspective view showing the appearance of the distal rigid portion 134 of the insertion portion of the ultrasonic endoscope according to the second embodiment. The distal rigid portion 134 of the second embodiment differs from the distal rigid portion 34 of the first embodiment in that it does not have a standing wall portion and a light guide avoiding wall portion. In the following embodiments, the same reference numerals are sometimes used for the same structures as those of the first embodiment, and the descriptions thereof are omitted.

[0099] Even without the standing wall portion, in the positional relationship between the opening portion 158 through which the treatment instrument is guided to the outside and the observation window 44, by making the position of the opening portion 158 more proximal to the distal end side of the distal rigid portion 134 than the observation window 44 and by making the position of the distal end of the treatment instrument guided out of the opening portion 158 more proximal to the distal end side of the distal rigid portion 134 than the distal end of the treatment instrument guided out of the observation window 44, the treatment instrument guided out of the opening portion 158 can be made to enter the observation field of view of the observation window 44. Figure 8 In the first direction indicated by arrow A in FIG. 15, the position of the end portion of the opening portion on the side most proximal to the first direction, that is, the one-side opening portion position, is set to a position lower than the axis 145 of the observation window 44. Also, the axis 145 of the observation window 44 is a line extending from the center position of the observation window 44 to the distal end side, and is a line parallel to the axis 138 of the distal rigid portion 134.

[0100] It is preferable that the standing platform 60 be exposed from the opening portion 158 when the treatment instrument is guided out of the opening portion 158 to the outside of the distal rigid portion main body 136. By making the standing platform 60 exposed from the opening portion 158, the standing platform 60 can be confirmed in the observation field of view of the observation window 44, and by using the standing platform 60 as a guide, the treatment instrument can be guided to the target position.

[0101] In addition, in the second embodiment, the distal end of the treatment instrument guided out of the opening portion 158 is made to be positioned more proximal to the distal end side of the distal rigid portion 134 than the distal end of the treatment instrument guided out of the observation window 44. Figure 8 In the first direction indicated by arrow A in FIG. 15, the position of the end portion of the opening portion on the side most proximal to the first direction, that is, the one-side opening portion position, is set to a position lower than the axis 145 of the observation window 44. Also, the axis 145 of the observation window 44 is a line extending from the center position of the observation window 44 to the distal end side, and is a line parallel to the axis 138 of the distal rigid portion 134.

[0102] [Modified Example]

[0103] Figure 9 is a perspective view showing the appearance of the distal rigid portion 135 of the insertion portion of the ultrasonic endoscope according to the modified example of the second embodiment, Figure 10 is a side cross-sectional view.

[0104] Figure 9 and Figure 10The front-end rigid portion 135 shown has an opening portion 159 whose direction is set as the opening direction for the component of the opening direction toward the first direction side and the component of the front-end side toward the axis 138 direction of the front-end rigid portion 135. Also, the opening portion 159 is provided on the side of the front-end rigid portion 135 on which the observation window 44 is provided. Figure 8 The front-end rigid portion 134 shown differs in that the opening formation surface 171 is formed by an inclined surface inclined toward the first direction side (upper side) of the base-end side of the front-end rigid portion 135.

[0105] Even in the case where the opening formation surface 171 is formed by an inclined surface, the position of the opening portion 159 is arranged at a position on the front-end side of the front-end rigid portion 135 than the observation window 44 in the positional relationship of the opening portion 159 and the observation window 44. Also, in the case where the opening formation surface 171 is formed by an inclined surface, the position of the opening portion 159 is arranged at a position on the front-end side of the front-end rigid portion 135 than the observation window 44 in the positional relationship of the opening portion 159 and the observation window 44. Figure 10 In the first direction indicated by the arrow A, the position of the end portion on the side farthest from the first direction of the opening portion 159, that is, the one-side opening portion position U1 is arranged at a position lower than the axis 145 of the observation window 44. Thereby, it is possible to cause the treatment instrument guided from the opening portion 159 to enter the observation field of view of the observation window 44.

[0106] Also, in the third embodiment, Figure 10 In the first direction indicated by the arrow A, the position of the end portion on the side farthest from the first direction of the opening portion 159, that is, the one-side opening portion position U1 is arranged at a position lower than the axis 145 of the observation window 44. Thereby, it is possible to cause the treatment instrument guided from the opening portion 159 to enter the observation field of view of the observation window 44.

[0107] Third Embodiment

[0108] Figure 11 is a perspective view showing the appearance of a front-end rigid portion 234 of an insertion portion of an ultrasonic endoscope according to the third embodiment, Figure 12 is a view illustrating a state in which the front-end rigid portion 234 is in close contact with a body lumen wall 94.

[0109] As shown in Figure 11 the front-end rigid portion 234 of the ultrasonic endoscope according to the third embodiment differs from the front-end rigid portion 34 of the first embodiment in that the formation position of the standing wall portion 268 is provided only on the base-end side of the opening portion 258. Even if the standing wall portion 268 is provided only on the base-end side of the opening portion 258, the effect of preventing lateral shaking can be achieved.

[0110] In the front-end rigid portion 234 of the ultrasonic endoscope according to the third embodiment, by making the upper end edge portion 268a of the standing wall portion 268 on the front-end side than the observation window 44, and in Figure 11In the first direction indicated by the arrow A, the upper end position of the side wall portion of the standing wall portion 268 is set to a position lower than the axis 245 of the observation window 44, and it is also possible to make the treatment instrument led out from the standing wall portion 268 provided to the front-end rigid portion main body 236 enter the observation field of view of the observation window 44. Further, the axis 245 of the observation window 44 is a line extending from the center position of the observation window 44 to the front-end side, and is a line parallel to the axis 238 of the front-end rigid portion 234.

[0111] Further, as Figure 12 indicated, by providing the standing wall portion 268 only to the base-end side of the opening portion 258, it is possible to make the body cavity wall (tissue) 94 abut against the base-end side of the ultrasonic transceiving surface 52 of the ultrasonic transducer 50. By making the body cavity wall 94 abut against the ultrasonic transceiving surface 52, it is possible to make the distance between the opening portion 258 and the body cavity wall 94 close, and thus, it is possible to prevent the position of the treatment instrument led out from the opening portion 258 from greatly deviating, and thus, it is possible to perform treatment at the target position.

[0112] Fourth Embodiment

[0113] Figure 13 is a side cross-sectional view of a front-end rigid portion 334 of an insertion portion of an ultrasonic endoscope according to the fourth embodiment.

[0114] As Figure 13 indicated, in the front-end rigid portion 334 of the ultrasonic endoscope according to the fourth embodiment, Figure 13 the one-side opening portion position U1 of the opening portion 358 in the first direction indicated by the arrow A is set to a position on the first direction (upper side) of the topmost position (topmost position P) of the end portion located on the most first direction side in the ultrasonic transceiving surface 52 of the ultrasonic transducer 50. In addition, the lead-out portion position R of the treatment instrument lead-out port 380 is formed at a position on the first direction (upper side) of the one-side opening portion position U1 of the opening portion 358. In Figure 13 the positional relationship indicated, by setting the positional relationship of the observation window 44 and the opening portion 358 such that the opening portion 358 is on the front-end side of the observation window 44 and the one-side opening portion position U1 is set to a position lower than the observation window 44, it is also possible to observe the treatment instrument led out from the opening portion 58 in the observation field of view of the observation window 44 and perform treatment with the treatment instrument.

[0115] [Modified Example]

[0116] Figure 14 is a cross-sectional view of a modified example of a front-end rigid portion 434 of an insertion portion of an ultrasonic endoscope according to the fourth embodiment.

[0117] Figure 14 The front-end rigid portion 434 indicated is different from Figure 13The front-end rigid portion 334 shown differs in that the other-side opening portion position U2 of the opening portion 458 is set at a position lower than the position of the most top portion of the ultrasonic wave transceiving face 52 of the ultrasonic wave transducer 50. Figure 14 The most top portion position (most top portion position P) of the end portion on the side of the first direction indicated by the arrow A is the same position. The other-side opening portion position U2 of the opening portion 458 can be the same as the most top portion position P of the ultrasonic wave transceiving face 52, or lower than the most top portion position P. By making the other-side opening portion position U2 of the opening portion 458 the same as the most top portion position P of the ultrasonic wave transceiving face 52, or lower, the outer shape of the front-end rigid portion 434 can be reduced.

[0118] Symbol explanation

[0119] 1 ultrasonic endoscope

[0120] 10 operation portion

[0121] 12 insertion portion

[0122] 14 general plug cord

[0123] 16 elbow knob

[0124] 18 vertical operation lever

[0125] 20 air / water supply button

[0126] 22 suction knob

[0127] 24 treatment instrument guide inlet

[0128] 30 soft portion

[0129] 32 bending portion

[0130] 34, 134, 135, 234, 334, 434 front-end rigid portion

[0131] 36, 136, 236 front-end rigid portion main body (frame body)

[0132] 38, 138, 238 axis of the front-end rigid portion

[0133] 40 base portion

[0134] 42 extension portion

[0135] 44 observation window

[0136] 44A center line of the observation window

[0137] 45, 145, 245 axis of the observation window

[0138] 46L, 46R illumination window

[0139] 48 air / water supply nozzle

[0140] 50 ultrasonic transducer

[0141] 52 ultrasonic transceiver surface

[0142] 58, 158, 159, 258, 358, 458 opening portion

[0143] 60, 61 stand (treatment instrument stand)

[0144] 60A center line of stand

[0145] 60a guide surface

[0146] 62 stand housing portion

[0147] 68, 268 standing wall portion

[0148] 68a, 268a upper end edge portion

[0149] 68b front edge portion

[0150] 70, 171 opening forming surface

[0151] 72 observation mechanism forming surface

[0152] 74 opening forming surface portion

[0153] 76L, 76R light guide avoiding wall portion

[0154] 78, 78A, 78B direction changing portion

[0155] 80, 380 treatment instrument guide outlet

[0156] 82 treatment instrument insertion passage

[0157] 90 bracket

[0158] 94 body cavity wall (tissue)

[0159] 96 spike

Claims

1. An ultrasonic endoscope comprising: a distal rigid portion provided at a distal end of an endoscope insertion portion; an ultrasonic transducer disposed in the distal rigid portion; an opening formation surface on which the opening portion is formed, the opening formation surface having a normal component toward the opening direction; a treatment instrument guide outlet that communicates with an inside of the standing platform housing portion to guide a treatment instrument; and a treatment instrument standing platform provided in the inside of the standing platform housing portion to change a guide direction of the treatment instrument guided from the treatment instrument guide outlet; an observation window disposed on an observation mechanism formation surface provided on a proximal end side of the opening formation surface, the observation mechanism formation surface having a normal component toward a distal end side of an axial direction of the distal rigid portion; and a standing wall portion that stands from the opening portion to one side of the first direction around the opening portion, wherein, when a position of an end portion of the upper end edge portion of the standing wall portion on the one side of the first direction is set as a one side wall portion upper end position, a position of the observation window in the first direction is disposed at a position on the one side of the first direction further than the one side wall portion upper end position.

2. The ultrasonic endoscope according to claim 1, wherein the ultrasonic transducer has an ultrasonic transceiving surface formed in a curved shape along the axial direction of the distal rigid portion.

3. The ultrasonic endoscope according to claim 2, wherein the ultrasonic transceiving surface has a topmost portion at an end portion on the one side of the first direction, and when a position of the topmost portion in the first direction is set as a topmost portion position and a position of an end portion of the opening portion on the other side of the first direction is set as an other side opening portion position, the topmost portion position is set at a position on the one side of the first direction that is the same as or further than the other side opening portion position. The treatment instrument guide portion is provided at the proximal end side of the ultrasonic transducer, and includes a stand housing portion having an opening portion that opens in a first direction perpendicular to the axis direction of the front end rigid portion or in a direction having a component toward the first direction and a component toward the front end side of the axis direction of the front end rigid portion.

4. The ultrasonic endoscope according to claim 3, wherein when a position of the treatment instrument guide outlet in the first direction is set as a guide outlet position, the topmost portion position is set at a position on the one side of the first direction that is the same as or further than the guide outlet position.

5. The ultrasonic endoscope according to claim 1, wherein the standing wall portion is provided only on the proximal end side of the opening portion.

6. The ultrasonic endoscope according to claim 2, wherein the ultrasonic transceiving surface has a topmost portion at an end portion on the one side of the first direction, and when a position of the topmost portion in the first direction is set as a topmost portion position and a position of an end portion of the upper end edge portion of the standing wall portion on the other side of the first direction is set as an other side wall portion upper end position, the topmost portion position is set at a position on the one side of the first direction that is the same as or further than the other side wall portion upper end position.

7. The ultrasonic endoscope according to any one of claims 1 to 3, wherein ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ The observation window is arranged offset from the treatment instrument stand in a second direction perpendicular to the first direction.

8. The ultrasonic endoscope according to any one of claims 1 to 3, wherein The treatment instrument stand is exposed from the opening formation surface.

9. The ultrasonic endoscope according to any one of claims 1 to 3, wherein The observation mechanism formation surface has a nozzle that sprays cleaning liquid toward the observation window and a direction changing portion that changes the direction of the cleaning liquid that has passed through the observation window toward the opening portion.

10. The ultrasonic endoscope according to any one of claims 1 to 3, wherein The observation mechanism formation surface has an illumination portion, The portions on both sides of the opening formation surface have light guide avoiding wall portions that inhibit the illumination light from the illumination portion from being blocked.

Images