Ultrasonic endoscope

Abstract

The present invention provides an ultrasonic endoscope capable of observing the base end side of a treatment instrument within the observation field of an observation window. The ultrasonic endoscope comprises: a front end hard portion (34) provided at the front end of an insertion portion (12); an ultrasonic transducer (50) provided at the front end hard portion (34); a treatment instrument outlet portion provided at the base end side of the ultrasonic transducer (50), comprising a stand accommodating portion (62) having an opening portion (58) with one side in a first direction as an opening direction, an opening forming surface (70) formed with the opening portion (58), and a treatment instrument stand (60) provided inside the stand accommodating portion (62) and changing the outlet direction of the treatment instrument; and an observation window (44) provided on an observation mechanism forming surface (72) provided at the base end side of the opening forming surface (70), wherein the position of the observation window (44) in the first direction is provided at a position closer to one side of the first direction than the position of one side opening of the opening portion (58).

Description

[0001] This application is a divisional application of the Chinese invention patent application with an application date of February 5, 2018, an invention name of “Ultrasonic Endoscope” and an application number of 201880022392.8 (PCT / JP2018 / 003868). Technical Field

[0002] The present invention relates to an ultrasonic endoscope, and more particularly to an ultrasonic endoscope including a treatment tool erecting stand for erecting a treatment tool led out from an opening provided in a distal end hard portion of an endoscope insertion portion. Background Art

[0003] At present, among ultrasonic endoscopes, the following type of ultrasonic endoscope is known: a vertical stand is provided at the front end of the insertion portion inserted into the body cavity, and a treatment instrument inserted through the treatment instrument insertion channel and led out from the treatment instrument lead-out portion at the front end is stood up by the vertical stand, and the vertical angle of the vertical stand can be changed to adjust the lead-out direction of the treatment instrument.

[0004] For example, the following patent document 1 describes an endoscope having an upright platform provided at a treatment instrument outlet, an upright rod connected to the upright platform via a rotating shaft, an operating wire connected to the upright rod, and the operating wire is designed to be pushed and pulled by operating an operating part connected to the base end of the insertion part.

[0005] Prior art literature

[0006] Patent Literature

[0007] Patent Document 1: Japanese Patent Application Publication No. 2005-287593 Summary of the invention

[0008] Technical issues to be solved by the invention

[0009] However, in the ultrasonic endoscope with the stand described in Patent Document 1, since the observation part is arranged on the side of the treatment instrument stand (treatment instrument outlet part), when the treatment instrument is led out, the treatment instrument enters the observation field of view from the peripheral part of the monitor screen. Therefore, the treatment instrument is less effective in penetrating the part where the puncture needle or stent is inserted. In addition, when the stent is indwelling, the base end (front side) of the stent needs to be exposed from the tissue, but when the ultrasonic transducer is in contact with the tissue surface, it is difficult to capture the insertion point in the optical field of view. Therefore, in order to observe, it is necessary to pull the insertion part to change the observation field of view.

[0010] The present invention has been made in view of such circumstances, and an object of the present invention is to provide an ultrasonic endoscope capable of observing the proximal end side of a treatment instrument within the observation field of an observation window.

[0011] Means for solving technical problems

[0012] In order to achieve the above-mentioned purpose, the present invention provides an ultrasonic endoscope, which comprises: a front end hard part, which is arranged at the front end of the endoscope insertion part; an ultrasonic transducer, which is arranged at the front end hard part; a treatment instrument outlet part, which is arranged at the base end side of the ultrasonic transducer, and comprises a stand accommodating part, an opening forming surface, a treatment instrument outlet, and a treatment instrument stand, wherein the stand accommodating part has an opening part with one side of a first direction perpendicular to the axial direction of the front end hard part as the opening direction, or with a direction with a component facing one side of the first direction and a component facing the front end side of the axial direction of the front end hard part as the opening direction, and the opening part is formed on the opening forming surface. And it has a normal component toward the opening direction, the disposal instrument outlet is connected to the interior of the vertical table accommodating part to export the disposal instrument, and the disposal instrument vertical table is arranged inside the vertical table accommodating part to change the export direction of the disposal instrument exported from the disposal instrument outlet; the observation window is arranged on the observation mechanism forming surface, the observation mechanism forming surface is arranged on the base end side of the opening forming surface, and has a normal component toward the front end side of the axial direction of the front end hard part, when the position of the end of the opening on the side closest to the first direction is set as the one side opening position, the position of the observation window in the first direction is arranged at a position on the side closer to the first direction than the one side opening position.

[0013] As before, when the opening is arranged on the base side of the observation window, only the portion of the treatment instrument that is led out and is closer to the front end side than the observation window enters the observation field of view of the observation window, and it cannot be confirmed through the observation window according to the treatment position of the treatment instrument. In the present invention, the opening for leading out the treatment instrument is arranged at a position closer to the front end side than the observation window. In addition, in the first direction, the position of the observation window is arranged at a position closer to one side of the first direction than the position of the opening on one side of the opening. Thus, the blind spot where the treatment instrument led out from the opening does not enter the observation field of view of the observation window can be reduced. Therefore, treatment can be performed while confirming through the observation window, and therefore, treatment can be reliably performed at the target position.

[0014] In another aspect of the present invention, the ultrasonic transducer preferably includes an ultrasonic wave transmitting and receiving surface formed in a curved shape along the axial direction of the distal end hard portion.

[0015] The present invention is applicable to a convex ultrasonic endoscope in which the ultrasonic wave transmitting and receiving surface of the ultrasonic transducer is formed in a curved shape along the axial direction of the distal end hard portion.

[0016] In another aspect of the present invention, it is preferred to have a top portion of an end portion located on the side closest to the first direction in the ultrasonic transmitting and receiving surface, and when the top position in the first direction is set as the top position and the position of the end portion of the opening portion on the other side closest to the first direction is set as the position of the opening portion on the other side, the top position is set at the same position as the position of the opening portion on the other side, or at a position closer to the first direction than the position of the opening portion on the other side.

[0017] This aspect specifies the positions of the opening and the ultrasonic transducer, and by setting the topmost position of the ultrasonic transceiver surface in the first direction to be the same as the position of the opening on the other side, or to a position closer to the first direction than the position of the opening on the other side, the treatment instrument led out from the opening can be brought close to the ultrasonic transducer. By bringing the treatment instrument close to the ultrasonic transducer, the position observed by ultrasonic observation can be treated with the treatment instrument.

[0018] In another aspect of the present invention, when the position of the treatment instrument outlet in the first direction is set as the outlet position, the topmost position is preferably set at the same position as the outlet position or at a position closer to the first direction than the outlet position.

[0019] This aspect specifies the position of the treatment instrument outlet and the ultrasonic transducer. The treatment instrument passes through the treatment instrument insertion channel provided in the endoscope insertion portion and is led out from the opening portion that opens on one side in the first direction. Therefore, by setting the topmost position of the ultrasonic transceiver surface in the first direction at the same position as the outlet position or at a position closer to the first direction than the outlet position, the treatment instrument can be guided to the vicinity of the ultrasonic transducer. Thus, treatment with the treatment instrument can be performed at the position observed by ultrasonic observation.

[0020] In another aspect of the present invention, it is preferred that there is a vertical wall portion rising from the opening portion around the opening portion, and when the position of the end portion of the upper edge portion of the vertical wall portion closest to the first direction is set as the upper end position of the side wall portion, the position of the observation window in the first direction is arranged at a position closer to the first direction than the upper end position of the side wall portion.

[0021] According to this aspect, by providing the vertical wall portion around the opening portion, the treatment instrument introduced from the opening portion can be prevented from swaying horizontally, and treatment can be reliably performed at the target position using the treatment instrument. In addition, by arranging the position of the observation window at a position closer to the first direction than the upper end position of the one side wall portion, treatment can be performed at the target position while confirming the treatment instrument introduced from the vertical wall portion through the observation window.

[0022] In another aspect of the present invention, it is preferable that the standing wall portion is provided only on the base end side of the opening portion.

[0023] According to this aspect, by setting the position of the vertical wall portion to the base end side of the opening portion, a space can be provided between the ultrasonic transducer and the vertical wall portion. Therefore, the body cavity wall (tissue) can be closely attached to the base end side of the transceiver surface of the ultrasonic transducer, so that the distance between the treatment instrument led out of the opening portion and the body cavity wall can be shortened, thereby making it easy to introduce the treatment instrument to the target position.

[0024] In another aspect of the present invention, the ultrasonic transducer preferably includes an ultrasonic wave transmitting and receiving surface formed in a curved shape along the axial direction of the distal end hard portion.

[0025] The present invention is applicable to an ultrasonic endoscope in which the ultrasonic wave transmitting and receiving surface of the ultrasonic transducer is formed into a convex shape curved along the axial direction of the distal end hard portion.

[0026] In another aspect of the present invention, it is preferred to have a top portion of an end portion located on the side closest to the first direction in the ultrasonic transmitting and receiving surface, and when the top position in the first direction is set as the top position and the position of the end portion of the upper end edge portion of the vertical wall portion closest to the other side of the first direction is set as the upper end position of the other side wall portion, the top position is set at the same position as the upper end position of the other side wall portion, or at a position closer to the first direction than the upper end position of the other side wall portion.

[0027] This aspect specifies the position of the upper edge of the vertical wall portion and the ultrasonic transducer when the vertical wall portion is provided, and by setting the topmost position of the ultrasonic transceiver surface in the first direction to be the same as the upper end position of the other side wall portion, or to a position closer to the first direction than the upper end position of the other side wall portion, the treatment instrument led out from the vertical wall portion can be brought close to the ultrasonic transducer. Therefore, treatment with the treatment instrument can be performed at the position observed by ultrasonic observation.

[0028] In another aspect of the present invention, it is preferred that the observation window is arranged offset from the treatment instrument standing table in a second direction perpendicular to the first direction.

[0029] According to this aspect, since the observation window is arranged offset from the treatment instrument erecting stand in the second direction, it is possible to prevent the observation field of the observation window from being blocked by the treatment instrument and the treatment instrument erecting stand when the treatment instrument erecting stand is erected.

[0030] In another aspect of the present invention, it is preferred that the treatment instrument standing platform is exposed from the opening forming surface.

[0031] According to this aspect, by exposing the treatment instrument erecting stand from the opening forming surface, the treatment instrument erecting stand exposed from the opening can be confirmed within the observation field of the observation window.

[0032] In another aspect of the present invention, it is preferable that the observation mechanism forming surface include a nozzle for spraying the cleaning liquid toward the observation window and a deflecting portion for redirecting the cleaning liquid having passed through the observation window toward the opening.

[0033] According to this aspect, cleaning liquid is sprayed from a nozzle arranged on the surface forming the observation mechanism component to clean the observation window, and a deflection portion is provided to change the direction of the cleaning liquid toward the opening. Thus, the cleaning liquid that has passed through the observation window can be directed toward the opening, so the opening can be cleaned with the cleaning liquid.

[0034] In another aspect of the present invention, the observation mechanism forming surface preferably has an illumination section, and the opening forming surface preferably has light guide avoidance walls at locations on both sides thereof for preventing illumination light from the illumination section from being blocked.

[0035] According to this aspect, by providing the light guide avoidance wall portions on both sides of the opening forming surface, it is possible to prevent uneven illumination from the illumination portion or a portion that becomes a shadow, so that treatment with the treatment instrument can be performed safely.

[0036] Effects of the Invention

[0037] According to the ultrasonic endoscope of the present invention, by providing an observation window at the base end side of the opening, and setting the position of the observation window in the first direction to be closer to the side of the opening than the position of the opening on one side of the opening, a blind area where the treatment instrument led out of the opening does not enter the observation field of the observation window can be reduced. Thus, the treatment instrument led out of the opening can be confirmed through the observation window, so that treatment can be reliably performed at the target position. BRIEF DESCRIPTION OF THE DRAWINGS

[0038] Figure 1 It is an overall view of the ultrasonic endoscope of the present invention.

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

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

[0041] Figure 4 It is a side cross-sectional view of the distal end hard portion of the first embodiment of the insertion portion.

[0042] Figure 5 It is a side sectional view showing a modified example of the upright stand of the front end hard portion.

[0043] Figure 6 This is a diagram for explaining a state where a stent is punctured into a body cavity wall.

[0044] Figure 7 This is a diagram showing an optical image of a puncture state captured through an observation window.

[0045] Figure 8It is a perspective view showing the appearance of the distal end rigid portion of the second embodiment of the insertion portion.

[0046] Fig. 9 It is a perspective view showing the appearance of the distal end hard portion of a modified example of the second embodiment of the insertion portion.

[0047] Fig.10 It is a side cross-sectional view of the distal end hard portion of a modified example of the second embodiment of the insertion portion.

[0048] Fig.11 It is a perspective view showing the appearance of the distal end rigid portion of the third embodiment of the insertion portion.

[0049] Fig.12 This is a diagram for explaining a state in which the distal end hard portion is brought into close contact with the body cavity wall.

[0050] Fig.13 It is a side sectional view of the distal end hard portion of the fourth embodiment of the insertion portion.

[0051] Fig.14 It is a side cross-sectional view of a distal end hard portion of a modified example of the fourth embodiment of the insertion portion. DETAILED DESCRIPTION

[0052] Hereinafter, the ultrasonic endoscope of the present invention will be described with reference to the drawings.

[0053] (Ultrasound Endoscope)

[0054] Figure 1 It is an overall view of an ultrasonic endoscope 1 to which the present invention is applied.

[0055] Figure 1 The ultrasonic endoscope 1 (hereinafter also simply referred to as "endoscope 1") in the figure is composed of an operation portion 10 that a practitioner holds and performs various operations, an insertion portion (endoscope insertion portion) 12 that is inserted into a body cavity of a patient, and a universal cord 14 for connecting the endoscope 1 to system components such as a processor device and a light source device (not shown) that constitute the endoscope system.

[0056] The operation portion 10 is provided with various operation components operated by the practitioner, for example, an angle button 16, a vertical operation lever 18, an air and water supply button 20, and a suction button 22, etc., whose functions will be described later as appropriate.

[0057] Furthermore, the operation portion 10 is provided with a treatment instrument introduction port 24 for inserting a treatment instrument into a treatment instrument insertion channel inserted into the insertion portion 12 .

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

[0059] The insertion portion 12 is composed of a flexible portion 30 , a bending portion 32 , and a distal hard portion 34 in this order from the proximal end side toward the distal end side.

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

[0061] The bending portion 32 is bent in the vertical direction and the horizontal direction by the rotation operation of the angle knob 16 of the operation portion 10 . By bending the bending portion 32 , the distal end hard portion 34 can be directed in a desired direction.

[0062] As described in detail later, the front end hard portion 34 includes an imaging unit and an illumination unit for photographing observation images in the body cavity, an ultrasonic transducer for acquiring ultrasonic images, and a treatment instrument lead-out unit for leading out the treatment instrument inserted from the treatment instrument introduction port 24. The treatment instrument lead-out unit is composed of a treatment instrument lead-out port 80, a stand accommodating unit, a stand, an opening, and an opening forming surface. In addition, in the following description, the stand accommodating unit 62 is sometimes used with the same meaning as the treatment instrument lead-out unit.

[0063] The universal cord 14 contains an electric cable, a light guide, and a fluid tube. A connector is provided at an end (not shown) of the universal cord 14. By connecting the connector to a predetermined system component device such as a processor device and a light source device that constitutes the endoscope system, power, control signals, illumination light, liquid and gas, etc. required for the operation of the endoscope 1 are supplied from the system component device to the endoscope 1, and data of an observation image obtained by the imaging unit or data of an ultrasonic image obtained by the ultrasonic transducer are transmitted from the endoscope 1 to the system component device. In addition, the observation image or ultrasonic image transmitted to the system component device is displayed on a monitor so that the practitioner or the like can observe it.

[0064] (Structure of the front hard part)

[0065] <<First Implementation Method>>

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

[0067] The distal end rigid portion 34 has a distal end rigid portion body (frame) 36 forming an outer wall or an inner partition wall thereof, and each component arranged in the distal end rigid portion 34 is accommodated and held in an accommodation portion (accommodation chamber) partitioned by the distal end rigid portion body 36 .

[0068] Although the details are omitted, the front end rigid portion main body 36 can be partially detached as a partition block, and each component can be assembled to a predetermined receiving portion in a state where the partition block is removed. After each component is assembled to the receiving portion, the partition block is mounted on the front end rigid portion main body 36, so that each component is received and held in the receiving portion and fixed to the front end rigid portion 34.

[0069] The distal rigid portion body 36 is formed of an insulating material having insulating properties, for example, a resin material such as methacrylic resin or plastic such as polycarbonate.

[0070] like Figures 2 to 4 As shown, the distal end rigid portion 34 is composed of a base portion 40 constituting the distal end rigid portion main body 36 and an extended portion 42 extending from the base portion 40 to the distal end side and holding the ultrasonic transducer 50 .

[0071] The extension portion 42 is provided with a convex ultrasonic transducer 50 having an ultrasonic wave transmitting and receiving surface 52 on the upper side. The ultrasonic wave transmitting and receiving surface 52 is formed by arranging ultrasonic transducers for transmitting and receiving ultrasonic waves in a curved shape along the axis 38 direction of the distal end rigid portion 34. The ultrasonic transducer 50 acquires data for generating an ultrasonic image of the in vivo tissue. Here, the axis 38 direction of the distal end rigid portion 34 refers to the direction of the axis 38 with respect to the internal organs. Figure 1 The direction is a line that is aligned with or parallel to the axis line in the longitudinal direction of the insertion portion 12. The number of ultrasonic transducers is not limited, and may be one or more than two ultrasonic transducers.

[0072] The base 40 is provided with an observation window 44 , lighting windows 46L and 46R, an air and water supply nozzle 48 , an opening 58 for leading out a treatment tool, and a standing wall 68 provided around the opening 58 .

[0073] The opening portion 58 is provided at the center of an opening forming surface 70 on the side of the extension portion 42 provided on the base 40, and the treatment instrument is guided 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 on the opening forming surface 70, and forms one side of the first direction perpendicular to the axis 38 of the front end hard portion 34 of the vertical stand accommodating portion 62 provided on the front end hard portion main body 36 as an opening direction. The opening portion 58 may also form a direction having a component on one side toward the first direction and a component on the front end side toward the axis 38 of the front end hard portion 34 as an opening direction. That is, the opening portion may also be formed so that the opening direction is toward the front end of the front end hard portion 34 and opens upward (on one side of the first direction). Here, the opening direction refers to the normal direction of the surface surrounded by the edge of the opening portion 58. In addition, in this specification, "one side of the first direction" refers to, for example, Figure 4As shown by the arrow A, it is a direction perpendicular to the axis 38 of the front end hard portion 34 and forming the opening 58 of the vertical stand accommodating portion 62. In addition, the "second direction" refers to the direction of the opening 58 of the vertical stand accommodating portion 62. Figure 2 As shown, the direction indicated by arrow B is perpendicular to the direction of the axis 38 of the distal end hard portion 34 and the first direction indicated by arrow A. In addition, in this specification, one side of the first direction is referred to as "upper" and "above", and the other side of the first direction is referred to as "lower" and "below".

[0074] The treatment instrument is inserted from the treatment instrument introduction port 24 of the operation portion 10. The opening forming surface 70 is formed by a surface having a normal component toward the opening direction. In the first embodiment, the opening direction is formed toward one side of the first direction, and the opening forming surface is arranged parallel to the axis 38 of the front end hard portion 34. In addition, it can also be inclined toward the front end side of the front end hard portion 34 and downward (the other side of the first direction). In addition, the opening portion 58 refers to the portion where the treatment instrument is led out from the stand accommodating portion 62 through the stand 60 described later.

[0075] By setting the opening 58 to the base end side of the ultrasonic transducer 50 and, as described later, to the front end side of the observation mechanism forming surface 72, the distance between the ultrasonic transducer 50 and the opening 58 can be shortened. Therefore, the distance from the position immediately after being led out from the opening 58 to the treatment position of the treatment instrument can be shortened, so that the lateral shaking of the treatment instrument can be reduced, and the treatment instrument can be punctured at the target position.

[0076] A vertical wall portion 68 is provided around the opening 58. The vertical wall portion 68 can prevent the treatment instrument led out from the opening 58 from lateral shaking, and the treatment of the target position can be stably performed by the treatment instrument. The vertical wall portion 68 only needs to prevent the lateral shaking of the treatment instrument, and it is not necessary to be provided around the entire opening 58. Specifically, it is preferably formed to stand upward from both sides of the direction of the treatment instrument led out of the opening 58. In addition, in the first embodiment, the vertical wall portion 68 is provided on the entire surface of the opening forming surface 70. In addition, the opening forming surface 70 and the vertical wall portion 68 can also be formed as a whole.

[0077] In addition, the front end hard portion body 36 is provided with light guide escape wall portions 76L and 76R formed by cutting away portions on both sides of the opening forming surface portion 74 forming the opening forming surface 70 obliquely downward. In this way, by forming the light guide escape wall portions 76L and 76R, it is possible to suppress the illumination light from the illumination windows 46L and 46R from being blocked, and it is possible to prevent the occurrence of uneven illumination or the occurrence of portions that become shadows. The light guide escape wall portions 76L and 76R are not limited to being cut away obliquely downward, and may also be cut away in the vertical direction or cut away obliquely forward.

[0078] The observation window 44 is arranged on the observation mechanism forming surface 72 provided on the base end side of the opening forming surface 70. Inside the observation mechanism forming surface 72, an imaging system unit in which an imaging optical system and a solid-state imaging element constituting a photographing section are integrally assembled is accommodated. Thus, light from a subject that becomes the field of view of the imaging section is taken in from the observation window 44, and a subject image is formed by the imaging optical system, and is photographed as an observation image by the solid-state imaging element. The observation mechanism forming surface 72 is composed of a surface having a normal component facing the front end side in the direction of the axis 38 of the front end rigid part 34. In the first embodiment, the observation mechanism forming surface 72 is formed as an inclined surface that faces the base end side of the front end rigid part main body 36 and is inclined upward. By setting the observation mechanism forming surface 72 as a surface having a normal component facing the front end side and providing the observation window 44, the treatment instrument led out from the opening can be confirmed through the observation window 44. In addition, the observation mechanism forming surface 72 can also be composed of a vertical surface perpendicular to the direction of the axis 38 of the front end rigid part 34.

[0079] The illumination windows 46L and 46R are provided on both sides of the observation mechanism forming surface 72 across the observation window 44. A light emitting portion constituting the illumination unit is accommodated inside the observation mechanism forming surface 72. Illumination light transmitted through a light guide from a light source device connected to the universal cord 14 is emitted from the light emitting portion so that the illumination light is irradiated to a subject within the field of view of the imaging unit through the illumination windows 46L and 46R.

[0080] The air and water supply nozzle 48 is arranged on the observation mechanism forming surface 72. By operating the air and water supply button 20 of the operating part 10, cleaning liquid, water or air, etc. (hereinafter also referred to as "cleaning liquid, etc.") is sprayed toward the observation window 44 from the air and water supply nozzle 48 to clean the observation window 44.

[0081] In addition, on the observation mechanism forming surface 72, a direction-changing portion 78 is provided at a position opposite to the air supply and water supply nozzle 48 across the observation window 44. The direction-changing portion 78 is configured to protrude toward the observation mechanism forming surface 72. The direction-changing portion 78 may be formed integrally with the observation mechanism forming surface 72, or may be fixed separately. The cleaning liquid or the like sprayed toward the observation window 44 from the air supply and water supply nozzle 48 collides with the direction-changing portion 78. The cleaning liquid or the like colliding with the direction-changing portion 78 changes direction toward the opening portion 58 and is supplied to the opening portion 58. Thus, the inside of the opening portion 58 is cleaned, etc.

[0082] The shape of the direction-changing portion 78 is not particularly limited, as long as it can direct the cleaning fluid or the like that has passed through the observation window 44 toward the opening 58. Figure 2 , 3 As shown, it can be composed of two surfaces 78A and 78B composed of mutually orthogonal planes, or it can be composed of a surface composed of a curved shape such as a circular arc, an elliptical arc, a parabola, etc.

[0083] A concave upright stand accommodating portion 62 is formed in the opening 58 and is connected to the opening 58 . A treatment instrument guide port 80 of a treatment instrument insertion channel 82 is arranged on the proximal end side of the upright stand accommodating portion 62 .

[0084] The treatment instrument outlet 80 is connected to a treatment instrument insertion passage 82 inserted into the insertion portion 12, and is connected from the treatment instrument introduction port 24 (see Figure 1 )The inserted treatment instrument is guided out from the treatment instrument guide port 80 to the vertical table accommodating portion 62.

[0085] An erection table (treatment instrument erection table) 60 is disposed at a position in front of the treatment instrument lead-out port 80 of the erection table accommodating portion 62 .

[0086] The stand 60 is formed of a metal material such as stainless steel, and has a concave guide surface 60a on the upper side that curves upward from the base end side toward the front end side of the front end rigid portion main body 36. The treatment instrument led out from the treatment instrument lead-out port 80 is bent upward along the guide surface 60a relative to the axis 38 direction of the front end rigid portion 34 (the long side direction of the insertion portion 12), and is led out from the opening portion 58 on the upper side of the stand accommodating portion 62 and the edge of the vertical wall portion 68 to the outside.

[0087] The erection stand 60 is erected by operating the erection operating lever 18 of the operating unit 10 , and the extraction direction (extraction angle) of the treatment instrument extracted from the opening 58 can be adjusted by erecting the erection stand 60 and adjusting the erection angle from the fallen state.

[0088] in addition, Figure 5 It is a side sectional view showing a modified example of the upright stand 61 of the front end hard portion. Figure 4 In the first embodiment shown in the figure, when the erection stand 60 is in the state of the fallen position (fully fallen state), the front end of the erection stand 60 protrudes from the front edge 68b of the standing wall 68, but Figure 5 When the erection stand 61 is in the fully collapsed state, the front end of the erection stand 61 does not protrude from the vertical wall portion 68, and the entire erection stand 61 is accommodated in the erection stand accommodation portion 62. In the fully collapsed state, by arranging the erection stand 61 to be accommodated in the erection stand accommodation portion 62, the insertion portion 12 can be smoothly inserted into the human body.

[0089] Furthermore, the treatment instrument insertion channel 82 is also connected to a suction channel (not shown), and body fluids and the like can be sucked from the opening 58 by operating the suction button 22 of the operation portion 10 .

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

[0091] In this embodiment, the first direction ( Figure 4 When the position of the end portion closest to one side of the upper edge portion 68a of the vertical wall portion 68 in the vertical direction (in the vertical direction) is set as the upper end position Q1 of the side wall portion, the observation window 44 is Figure 4 The position in the vertical direction of the vertical wall portion 68 is arranged at a position closer to the first direction than the upper end position Q1 of the side wall portion. That is, the axis 45 of the observation window extending from the center position of the observation window 44 in parallel with the axis 38 of the front end hard portion 34 is arranged above the position of the upper edge 68a. In the case of having a vertical wall portion 68, the disposal instrument is led out to the outside from the upper edge 68a or the front edge 68b of the vertical wall portion 68. In this way, by setting the upper edge 68a of the vertical wall portion 68 from the observation window 44 to the bottom, the disposal instrument led out from the vertical wall portion 68 can be reliably brought into the observation field of view of the observation window 44, so that the disposal instrument can be guided to the target position, which can improve the sniping performance.

[0092] In addition, Figure 4 In the first direction indicated by the arrow A of the front end hard portion body 36, the top position of the end portion of the ultrasonic transceiver surface 52 of the ultrasonic transducer 50 located on the side closest to the first direction is set as the top position P. In addition, when the position of the end portion closest to the other side of the upper edge portion 68a of the vertical wall portion 68 in the first direction is set as the other side wall portion upper end position Q2, in the first direction, the top position P is configured to be the same as the other side wall portion upper end position Q2, or to be closer to the first direction than the other side wall portion upper end position Q2. In addition, in Figure 4 In the embodiment, since the upper edge 68a is formed parallel to the axis 38 direction of the front end hard portion 34, the upper end position Q1 of one side wall portion and the upper end position Q2 of the other side wall portion are at the same position. In the case where the upper edge 68a is formed obliquely, the position of the lowest end of the upper edge 68a is set to the upper end position Q2 of the other side wall portion. By arranging the upper edge 68a of the vertical wall portion 68 and the ultrasonic transducer 50 in such a manner that the highest point position P is the same as the upper end position Q2 of the other side wall portion or is closer to one side of the first direction than the upper end position Q2 of the other side wall portion, when the treatment instrument passing through the treatment instrument insertion channel 82 is led out obliquely upward from the upper edge 68a or the front edge 68b of the vertical wall portion 68, the treatment instrument can be approached to the ultrasonic transducer 50 and led out. Therefore, the treatment instrument can be reliably punctured to the position where ultrasonic observation is being performed by the ultrasonic transducer 50.

[0093] In addition, Figure 4When the position of the treatment instrument outlet 80 is set to the outlet position R in the first direction indicated by the arrow A of the front end hard portion main body 36, the topmost position P is configured to be the same as the outlet position R or to be closer to the side (above) of the first direction than the outlet position R. The treatment instrument is guided obliquely upward from the opening 58 opening upward through the treatment instrument insertion channel 82. Therefore, by setting the treatment instrument 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. In addition, it is preferred that the outlet position R is set to the center position of the treatment instrument outlet 80 (refer to Figure 4 ), it is more preferable to satisfy the position of the end portion (upper end position) on one side of the first direction of the treatment instrument guide outlet 80.

[0094] In addition, if Figure 3 As shown, it is preferred that the observation window 44 is arranged offset from the vertical stand 60 in the second direction indicated by the arrow B. Here, the observation window 44 is arranged offset from the vertical stand 60 in the second direction, for example, as shown in FIG. Figure 3 As shown, in a top view, the center line 44A of the observation window 44 is offset relative to the center line 60A of the erection stand 60 in the second direction indicated by the arrow B. With such a structure, even when the erection stand 60 is erected and the treatment instrument is led out from the standing wall portion 68, the observation field of the observation window 44 can be prevented from being blocked by the treatment instrument and the erection stand 60, so that the treatment position can be confirmed through the observation window 44.

[0095] Next, as an example of treatment using the ultrasonic endoscope according to the present embodiment, an example of stent placement will be described. Figure 6 is a diagram for explaining a state where a stent is punctured into a body cavity wall. Figure 7 This is a diagram showing an optical image obtained by photographing the puncture state through the observation window.

[0096] According to this embodiment, Figure 6 and Figure 7 As shown in FIG. 1 , when the stent 90 is punctured into the body cavity wall 94, the insertion point 96 can be confirmed by the optical image of the observation window 44. Therefore, it is possible to easily confirm whether the base end side of the stent 90 is exposed from the insertion point 96, and by moving the insertion part 12 for confirmation as before, the process of changing the observation field of the observation window 44 can be reduced. Figure 7 In the figure, the ultrasonic wave transmitting and receiving surface 52 of the ultrasonic wave transducer 50 is not shown because it is blocked by the body cavity wall 94.

[0097] Second Implementation Method

[0098] Figure 81 is a perspective view showing the appearance of the front end hard portion 134 of the insertion portion of the ultrasonic endoscope of the second embodiment. The front end hard portion 134 of the second embodiment is different from the front end hard portion 34 of the first embodiment in that it does not have a vertical wall portion and a light guide escape wall portion. In addition, in the following embodiments, the same symbols are sometimes marked for the same structures as the first embodiment and their descriptions are omitted.

[0099] Even without the vertical wall portion, in terms of the positional relationship between the opening 158 for guiding the treatment tool to the outside and the observation window 44, the position of the opening 158 is closer to the front end side of the front end hard portion 134 than the observation window 44, and Figure 8 By setting the position of the end of the opening closest to the first direction in the first direction indicated by the middle arrow A, that is, the position of the one side opening, at a position lower than the axis 145 of the observation window 44, the treatment instrument led out from the opening 158 can also enter the observation field of the observation window 44. In addition, the axis 145 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 138 of the front end hard portion 134.

[0100] Preferably, when the treatment instrument is guided out of the front end hard portion body 136 from the opening 158, the erection stand 60 is exposed from the opening 158. By exposing the erection stand 60 from the opening 158, the erection stand 60 can be confirmed in the observation field of the observation window 44, and the treatment instrument can be guided to the target position by using the erection stand 60.

[0101] In addition, Figure 8 In the first direction indicated by the middle arrow A, the position of the end of the opening 158 closest to the other side in the first direction is set as the other side opening position, and the top position of the end of the ultrasonic transceiver surface 52 closest to the first side in the ultrasonic transducer 50 is set as the top position, and the top position is configured to be the same as the other side opening position, or to be closer to the first side (above) in the first direction than the other side opening position. By setting such a structure, as in the first embodiment, the treatment instrument can be led out close to the ultrasonic transducer 50.

[0102] [Modifications]

[0103] Fig. 9 1 is a perspective view showing the appearance of a distal end hard portion 135 of an insertion portion of an ultrasonic endoscope according to a modified example of the second embodiment. Fig.10 It is a side profile view.

[0104] Fig. 9 and Fig.10The front end rigid portion 135 shown in FIG. 1 has an opening portion 159 whose opening direction is a component facing one side of the first direction and a component facing the front end side of the axis 138 of the front end rigid portion 135. Figure 8 The distal end rigid portion 134 shown is different in that the opening forming surface 171 is formed by an inclined surface that is inclined toward one side (upward) in the first direction toward the proximal end side of the distal end rigid portion 135 .

[0105] Even when the opening forming surface 171 is formed by an inclined surface, the positional relationship between the opening 159 and the observation window 44 is such that the opening 159 is disposed closer to the front end side of the front end hard portion 135 than the observation window 44. Fig.10 In the first direction indicated by the middle arrow A, the end of the opening 159 closest to the first direction, i.e., the one side opening position U1, is arranged below the axis 145 of the observation window 44. Thus, the treatment instrument led out from the opening 159 can enter the observation field of the observation window 44.

[0106] In addition, Fig.10 In the first direction indicated by the middle arrow A, the position of the end of the opening 159 closest to the other side in the first direction is set as the other side opening position U2, and the top position of the end of the ultrasonic transceiver surface 52 of the ultrasonic transducer 50 closest to the one side in the first direction is set as the topmost position P. The topmost position P is configured to be the same as the other side opening position U2, or to be closer to the first side (above) in the first direction than the other side opening position U2. By setting such a structure, as in the first embodiment, the treatment instrument can be led out close to the ultrasonic transducer 50.

[0107] 《Third Implementation Mode》

[0108] Fig.11 2 is a perspective view showing the appearance of the distal end hard portion 234 of the insertion portion of the ultrasonic endoscope according to the third embodiment. Fig.12 This is a diagram for explaining a state in which the distal end hard portion 234 is brought into close contact with the body cavity wall 94 .

[0109] like Fig.11 As shown, the distal end hard portion 234 of the ultrasonic endoscope of the third embodiment is different from the distal end hard portion 34 of the first embodiment in that the formation position of the upright wall portion 268 is provided only on the proximal side of the opening portion 258. Even if the upright wall portion 268 is provided only on the proximal side of the opening portion 258, the effect of preventing lateral shaking can be achieved.

[0110] In the distal end hard portion 234 of the ultrasonic endoscope of the third embodiment, the upper end edge 268a of the vertical wall portion 268 is positioned closer to the distal end than the observation window 44, and Fig.11In the first direction indicated by the middle arrow A, the upper end of one side wall of the vertical wall portion 268 is arranged at a position lower than the axis 245 of the observation window 44, so that the treatment instrument led out from the vertical wall portion 268 provided on the front end hard portion body 236 can enter the observation field of the observation window 44. In addition, 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 hard portion 234.

[0111] In addition, if Fig.12 As shown, by providing the vertical wall portion 268 only on the proximal side of the opening portion 258, the body cavity wall (tissue) 94 can be brought into close contact with the proximal side of the ultrasonic wave transmitting and receiving surface 52 of the ultrasonic transducer 50. By bringing the body cavity wall 94 into close contact with the ultrasonic wave transmitting and receiving surface 52, the distance between the opening portion 258 and the body cavity wall 94 can be brought close, so that the position of the treatment instrument led out from the opening portion 258 can be prevented from being greatly deviated, so that treatment can be performed at the target position.

[0112] 《Fourth Implementation Mode》

[0113] Fig.13 It is a side cross-sectional view of the distal end hard portion 334 of the insertion portion of the ultrasonic endoscope according to the fourth embodiment.

[0114] like Fig.13 As shown, in the front end hard portion 334 of the ultrasonic endoscope of the fourth embodiment, Fig.13 The opening position U1 on one side of the opening 358 in the first direction indicated by the middle arrow A is set at a position closer to one side (above) in the first direction than the top position (topmost position P) of the end portion located on the first direction side of the ultrasonic transceiver surface 52 of the ultrasonic transducer 50. In addition, the outlet position R of the treatment instrument outlet 380 is formed at a position closer to one side (above) in the first direction than the opening position U1 on one side of the opening 358. Fig.13 In the positional relationship shown, by setting the positional relationship between the observation window 44 and the opening 358 so that the opening 358 is on the front end side of the observation window 44 and setting the position U1 of one side of the opening to be lower than the observation window 44, it is also possible to observe the treatment instrument guided out from the opening 58 within the observation field of the observation window 44 while performing treatment with the treatment instrument.

[0115] [Modifications]

[0116] Fig.14 It is a cross-sectional view of a modified example of the distal end hard portion 434 of the insertion portion of the ultrasonic endoscope according to the fourth embodiment.

[0117] Fig.14 The front end hard portion 434 is shown with Fig.13The difference of the front end hard portion 334 shown in the figure is that the other side opening position U2 of the opening 458 is set to the closest to the ultrasonic wave transmitting and receiving surface 52 of the ultrasonic transducer 50. Fig.14 The opening portion position U2 on the other side of the opening portion 458 may be the same as the top position (top position P) of the end portion on one side of the first direction indicated by the arrow A. The opening portion position U2 on the other side of the opening portion 458 may be the same as the top position P of the ultrasonic wave transmitting and receiving surface 52, or may be lower than the top position P. By making the opening portion position U2 on the other side of the opening portion 458 the same as the top position P of the ultrasonic wave transmitting and receiving surface 52, or lower than the top position P, the outer shape of the front end hard portion 434 can be reduced.

[0118] Explanation of symbols

[0119] 1 Ultrasonic endoscope

[0120] 10 Operation section

[0121] 12 Insertion

[0122] 14 Universal Cord

[0123] 16 Corner Button

[0124] 18 Vertical operating lever

[0125] 20 Gas and water supply buttons

[0126] 22 Attraction Button

[0127] 24 Disposal instrument introduction port

[0128] 30 Soft part

[0129] 32 Bend

[0130] 34, 134, 135, 234, 334, 434 Front hard part

[0131] 36, 136, 236 Front end hard part body (frame)

[0132] 38, 138, 238 Axis of the front hard part

[0133] 40 base

[0134] 42 Extension Department

[0135] 44 Observation window

[0136] 44A Centerline of viewing window

[0137] 45, 145, 245 Axis of observation window

[0138] 46L, 46R lighting window

[0139] 48 Air and water supply nozzles

[0140] 50 Ultrasonic transducer

[0141] 52 Ultrasonic transceiver surface

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

[0143] 60, 61 Vertical table (vertical table for handling equipment)

[0144] 60A Centerline of the vertical table

[0145] 60a Guide surface

[0146] 62 vertical platform accommodating part

[0147] 68, 268 vertical wall part

[0148] 68a, 268a Upper edge

[0149] 68b Front edge

[0150] 70, 171 opening forming surface

[0151] 72 Observation mechanism formation surface

[0152] 74 Opening to form face

[0153] 76L, 76R Light guide avoidance wall

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

[0155] 80, 380 Disposal equipment outlet

[0156] 82 Disposal equipment insertion channel

[0157] 90 Bracket

[0158] 94 Body cavity wall (tissue)

[0159] 96 thorn

Claims

1. An ultrasonic endoscope comprising: A front hard portion, which is provided at the front end of the endoscope insertion portion; An ultrasonic transducer, which is disposed on the front hard portion; a treatment instrument outlet portion, which is provided at the base end side of the ultrasonic transducer, and comprises: a stand accommodating portion, the stand accommodating portion having an opening portion, the opening portion having a first direction perpendicular to the axial direction of the front end hard portion as an opening direction, or having a component toward one side of the first direction and a component toward the front end side of the axial direction of the front end hard portion as an opening direction; an opening forming surface on which the opening is formed, the opening forming surface having a normal component facing the opening direction; a disposal instrument outlet, the disposal instrument outlet being connected to the interior of the vertical table accommodating portion to guide out the disposal instrument; and a treatment instrument erection stand, the treatment instrument erection stand being provided inside the erection stand accommodation portion and changing the lead-out direction of the treatment instrument led out from the treatment instrument lead-out port; and an observation window disposed on an observation mechanism forming surface, the observation mechanism forming surface being disposed on the base end side of the opening forming surface, the observation mechanism forming surface having a normal component facing the front end side in the axial direction of the front end hard portion, When the position of the end of the opening closest to one side in the first direction is defined as the one side opening position, The observation window is located at a position in the first direction closer to one side of the first direction than the one side opening. The ultrasonic transducer has an ultrasonic transmitting and receiving surface formed in a curved shape along the axial direction of the front end hard portion. The ultrasonic wave transmitting and receiving surface has a topmost portion located at the end portion closest to the first direction, and when the position of the topmost portion in the first direction is defined as the topmost position, The topmost position is located at a position closer to the other side of the first direction than the position of the one side opening. When the position of the treatment tool outlet in the first direction is set as the outlet position, The topmost position is set at the same position as the lead-out port position or at a position closer to the other side in the first direction than the lead-out port position.

2. The ultrasonic endoscope according to claim 1, wherein: When a standing wall portion is provided around the opening portion and stands up from the opening portion, and the position of the end of the upper edge of the standing wall portion closest to the first direction is set as the upper end position of one side wall portion, The position of the observation window in the first direction is arranged at a position closer to the one side in the first direction than the upper end position of the one side wall portion.

3. The ultrasonic endoscope according to claim 2, wherein: The standing wall portion is provided only on the base end side of the opening portion.

4. The ultrasonic endoscope according to any one of claims 1 to 3, wherein: The ultrasonic transducer has an ultrasonic wave transmitting and receiving surface formed in a curved shape along the axial direction of the distal end hard portion.

5. The ultrasonic endoscope according to any one of claims 1 to 3, wherein: The observation window is disposed so as to be offset from the treatment instrument standing platform in a second direction perpendicular to the first direction.

6. The ultrasonic endoscope according to any one of claims 1 to 3, wherein: The treatment tool standing stand is exposed from the opening forming surface.

7. The ultrasonic endoscope according to any one of claims 1 to 3, wherein: The observation mechanism forming surface includes: a nozzle that sprays 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.

8. The ultrasonic endoscope according to any one of claims 1 to 3, wherein: The observation mechanism forming surface has an illumination portion, The opening forming surface has light guide escape wall portions at both sides thereof, and the light guide escape wall portions prevent the illumination light from the illumination portion from being blocked.

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