Endoscopic ultrasound

Abstract

To provide an ultrasonic endoscope that allows the position of a supply port for supplying an ultrasonic transmission medium into a balloon to be easily grasped.SOLUTION: An ultrasonic endoscope comprises: a long insertion part 26 having a longitudinal axis A and provided with a tip hard part 52 on its tip side; an ultrasonic transducer 50 provided in the tip hard part 52 for transmitting / receiving ultrasonic waves; and a supply port 106 provided in the tip hard part 52 for supplying water into a balloon 100 surrounding the ultrasonic transducer 50. An index 120 for indicating the position of the supply port 106 in a circumferential direction around the longitudinal axis A is provided closer to the side of a base end than the tip hard part 52 of the insertion part 26.SELECTED DRAWING: Figure 5

Description

[Technical Field]

[0001] The present invention relates to an ultrasonic endoscope, and more particularly to an ultrasonic endoscope having an ultrasonic transducer at the tip of an insertion section. [Background technology]

[0002] In recent years, ultrasonic endoscopes have come into use in medical settings. Ultrasound endoscopes are equipped with an ultrasonic transducer that irradiates ultrasonic waves into the body of a subject and receives and visualizes the reflected waves.

[0003] The ultrasonic endoscope disclosed in Patent Document 1 has a tip component at the tip of the insertion section, and an ultrasonic transmission / reception unit (corresponding to an ultrasonic transducer) is provided on the tip side of the tip component. In this ultrasonic endoscope, a balloon is attached to the tip component so as to cover the ultrasonic transmission / reception unit. An ultrasonic transmission medium such as water is supplied into the balloon to inflate it, and the inflated balloon is brought into close contact with the area to be observed to obtain the ultrasonic images required for observation.

[0004] The ultrasonic endoscope also has an index indicating the position of an opening for discharging the ultrasound transmission medium from the balloon in order to remove air bubbles from the balloon. This index is formed as a marker hole on the distal end side of the tip component, closer to the base end than the balloon mounting groove in which the proximal end of the balloon is mounted. With this ultrasonic endoscope, air bubbles are collected by positioning the ultrasonic transducer vertically below the tip component, aligned with the marker hole, and then the suction button is operated to suck the ultrasound transmission medium from the balloon, thereby removing the air bubbles from the balloon. The opening also functions as a supply port for supplying the ultrasound transmission medium into the balloon. [Prior art documents] [Patent documents]

[0005] [Patent Document 1] Japanese Patent Application Laid-Open No. 2001-112761 Summary of the Invention [Problem to be solved by the invention]

[0006] However, the ultrasonic endoscope of Patent Document 1 has a problem in that, for example, when an operator tries to see the marker hole from the proximal end side of the insertion section, the marker hole may be hidden by a surface of the outer surface of the tip component that is closer to the proximal end than the surface on which the marker hole is formed, making it difficult to see the marker hole. As a result, it is difficult to grasp the position of the opening (supply port).

[0007] The present invention has been made in consideration of the above circumstances, and its object is to provide an ultrasonic endoscope that makes it easy to grasp the position of a supply port for supplying an ultrasonic transmission medium into a balloon. [Means for solving the problem]

[0008] In order to achieve the above-mentioned object, the ultrasonic endoscope of the present invention comprises an elongated insertion section having a longitudinal axis and a rigid tip section provided on the distal end side, an ultrasonic transducer provided in the rigid tip section for transmitting and receiving ultrasonic waves, and a supply port provided in the rigid tip section for supplying an ultrasonic transmission medium into a balloon surrounding the ultrasonic transducer, and an indicator indicating the circumferential position of the supply port around the longitudinal axis is provided on the proximal side of the rigid tip section of the insertion section.

[0009] According to one aspect of the present invention, the insertion section has a bending section connected to the base end side of the tip rigid section and a flexible section connected to the base end side of the bending section, and it is preferable that the indicator is provided on the flexible section.

[0010] According to one aspect of the present invention, the flexible section has a curved section adhesive connection section to which the curved section is adhesively connected, and the indicator is preferably provided at a position different from the curved section adhesive connection section.

[0011] According to one aspect of the present invention, the indicator is preferably provided in a range toward the tip side from a middle position in the longitudinal axis direction of the flexible section.

[0012] According to one aspect of the present invention, the indicator is preferably provided within a range of 200 mm from the distal end position of the distal end hard portion of the flexible portion.

[0013] According to one embodiment of the present invention, the flexible section is formed with a plurality of scales indicating the insertion length of the insertion section at positions corresponding to the respective insertion lengths, and it is preferable that the indicator is provided between the position where the most distal scale of the plurality of scales is formed and the distal position of the flexible section.

[0014] According to one aspect of the present invention, the indicator preferably has a shape different from that of the scale.

[0015] According to one aspect of the present invention, the indicator is preferably a different color from the scale.

[0016] According to one aspect of the present invention, the indicator is preferably provided at a position based on an imaginary extension line extending from the supply port in parallel to the longitudinal axis.

[0017] According to one aspect of the present invention, the indicator is preferably an indicator mark provided on an imaginary extension line.

[0018] According to one aspect of the present invention, the indicators are preferably a pair of indicator marks provided at positions facing each other across an imaginary extension line.

[0019] According to one aspect of the present invention, the indicator is preferably a printed mark formed by printing with paint.

[0020] According to one aspect of the present invention, the ultrasonic endoscope is a direct-view endoscope having an observation window on the distal end surface of the rigid distal end portion, and the ultrasonic transducer is preferably a radial ultrasonic transducer in which multiple ultrasonic vibrators are arranged circumferentially around the longitudinal axis. [Effects of the Invention]

[0021] According to the present invention, the position of the supply port for supplying the ultrasound transmission medium into the balloon can be easily grasped. [Brief explanation of the drawings]

[0022] [Figure 1] 1 is a schematic configuration diagram showing an example of an ultrasonic inspection system using an ultrasonic endoscope. [Figure 2] 2 is an enlarged perspective view of the distal end of the insertion part shown in FIG. 1. FIG. [Figure 3] 3 is a cross-sectional view of the distal end of the insertion part shown in FIG. 2. [Figure 4] FIG. 1 is a cross-sectional view of a balloon attached to a hard tip portion. [Figure 5] 10 is an explanatory diagram showing an example of an indicator provided on the insertion section. FIG. [Figure 6] FIG. 2 is a diagram showing the configuration of the ducts of the ultrasonic endoscope shown in FIG. [Figure 7] FIG. 10 is an explanatory diagram showing an indicator of a first modified example. [Figure 8] FIG. 10 is an explanatory diagram showing an index of a second modified example. DETAILED DESCRIPTION OF THE INVENTION

[0023] Hereinafter, preferred embodiments of an ultrasonic endoscope according to the present invention will be described with reference to the accompanying drawings.

[0024] FIG. 1 is a schematic diagram showing an example of an ultrasonic inspection system 10 that uses an ultrasonic endoscope 12 according to an embodiment.

[0025] 1, the ultrasound examination system 10 includes an ultrasound endoscope 12, an ultrasound processor 14, an endoscope processor 16, a light source 18, and a monitor 20. The ultrasound examination system 10 also includes a water tank 22 for storing cleaning water and the like, and a suction pump 24 for sucking up material from within the body cavity.

[0026] The ultrasonic endoscope 12 has an insertion section 26 that is inserted into a body cavity of a subject, an operation section 28 that is connected to the proximal end of the insertion section 26 and that allows the surgeon to perform operations, and a universal cord 30 that has one end connected to the operation section 28. The insertion section 26 is an example of the insertion section of the present invention.

[0027] The operation unit 28 is provided with an air / water supply button 32 for opening and closing an air / water supply line (not shown) from the water supply tank 22, and a suction button 34 for opening and closing a suction line (not shown) from the suction pump 24. The operation unit 28 is also provided with a pair of angle knobs 36, 36 and a treatment tool insertion port 37.

[0028] The other end of the universal cord 30 is provided with a connector 38 connected to the ultrasonic processor 14, a connector 40 connected to the endoscope processor 16, and a connector 42 connected to the light source device 18. The ultrasonic endoscope 12 is detachably connected to the ultrasonic processor 14, the endoscope processor 16, and the light source device 18 via these connectors 38, 40, and 42. The connector 42 also has an air / water supply tube 44 connected to the water tank 22 and a suction tube 46 connected to the suction pump 24.

[0029] The insertion section 26 has, in order from the distal end, a distal rigid section 52 having an endoscopic observation section 48 and an ultrasonic transducer 50, a bending section 54 connected to the proximal end side of the distal rigid section 52, and a flexible section 56 connecting the proximal end side of the bending section 54 to the distal end side of the operation section 28. The distal rigid section 52, bending section 54, and flexible section 56 are arranged along the longitudinal axis A of the elongated insertion section 26. The bending section 54 is made up of multiple bending pieces connected together and is configured to be freely bendable. The flexible section 56 is slender, long, and flexible.

[0030] The bending portion 54 is remotely bent by rotating a pair of angle knobs 36, 36 provided on the operation portion 28. This allows the distal rigid portion 52 to be oriented in a desired direction. Note that FIG. 3, which will be described later, shows a plurality of bending pieces 58 that constitute the bending portion 54 and a plurality of bending operation wires 60, 60 (two in FIG. 3). The distal end sides of these bending operation wires 60, 60 are connected to the bending pieces 58, and the proximal end sides are connected to the pair of angle knobs 36, 36 (see FIG. 1).

[0031] Returning to FIG. 1, the ultrasonic processor device 14 generates and supplies ultrasonic signals for generating ultrasonic waves to a plurality of ultrasonic vibrators 62 (see FIG. 2) that make up the ultrasonic transducer 50. The ultrasonic waves are emitted from the plurality of ultrasonic vibrators 62 toward the observation target area. The ultrasonic processor device 14 receives and acquires echo signals (reflected waves) reflected from the observation target area with the ultrasonic vibrators 62, and performs various signal processing on the acquired echo signals to generate an ultrasonic image. The generated ultrasonic image is displayed on the monitor 20.

[0032] The observation target area is illuminated by illumination light from the light source device 18 in the endoscopic observation section 48. The endoscope processor device 16 receives and acquires image signals acquired from the observation target area, and performs various signal processing and image processing on the acquired image signals to generate an endoscopic image. The generated endoscopic image is displayed on the monitor 20.

[0033] The monitor 20 displays an ultrasound image and an endoscopic image in response to the video signals generated by the ultrasound processor 14 and the endoscopic processor 16. The monitor 20 can be switched to display only one of the ultrasound images and the endoscopic image, or both images can be displayed simultaneously.

[0034] Next, the configuration of the tip portion of the insertion portion 26 will be described with reference to Figures 2 and 3. Figure 2 is an enlarged perspective view of the tip portion of the insertion portion 26 shown in Figure 1. Figure 3 is a cross-sectional view of the tip portion of the insertion portion 26 shown in Figure 2.

[0035] 2, the distal end rigid portion 52 is provided with an endoscopic observation unit 48 for acquiring endoscopic images at its distal end, and an ultrasonic transducer 50 for acquiring ultrasonic images at its proximal end. The ultrasonic transducer 50 is an example of the ultrasonic transducer of the present invention.

[0036] 2 and 3, the distal rigid portion 52 has a distal cap 64 disposed on the distal side of the ultrasonic transducer 50, and a proximal ring 66 disposed on the proximal side of the ultrasonic transducer 50. The distal cap 64 and the proximal ring 66 are made of an insulating material such as a hard resin and serve as exterior members.

[0037] 3, a shield ring 68 is connected to the base end side of the distal cap 64. An observation system unit 70, a shielded cable 72, a forceps channel 74, and the like, which will be described later, are arranged inside the shield ring 68, and the ultrasonic transducer 50 is arranged outside the shield ring 68.

[0038] 2, the ultrasonic transducer 50 is configured by arranging a plurality of ultrasonic vibrators 62 that transmit and receive ultrasonic waves in the circumferential direction of the outer peripheral wall of a shield ring 68 (see FIG. 3). That is, the ultrasonic transducer 50 of this example is a radial type ultrasonic transducer in which a plurality of ultrasonic vibrators 62 are arranged along the circumferential direction around the longitudinal axis A.

[0039] The multiple ultrasonic transducers 62 are connected to multiple cables (not shown), respectively. The multiple cables are housed in, for example, an ultrasonic shielded cable and are inserted from the bending portion 54 shown in FIG. 1 through the flexible portion 56 into the operation unit 28. The multiple cables are then inserted from the operation unit 28 into the universal cord 30 and connected to the ultrasonic connector 38. This connector 38 is connected to the ultrasonic processor device 14. Ultrasonic signals generated by the ultrasonic processor device 14 are supplied to the multiple ultrasonic transducers 62 via the multiple cables.

[0040] As shown in FIG. 2, a balloon 100 (see FIG. 4) surrounding the ultrasonic transducer 50 is detachably attached to the tip rigid portion 52. An ultrasonic wave transmission medium (e.g., water, oil, etc.; in this example, water will be used) is supplied into the balloon 100. Here, ultrasonic waves and echo signals are attenuated in air. Therefore, water is supplied into the balloon 100 to inflate it, and the inflated balloon 100 is brought into contact with the area to be observed, thereby removing air from between the ultrasonic transducer 50 and the area to be observed. This makes it possible to suppress the attenuation of ultrasonic waves and echo signals, thereby enabling the acquisition of good ultrasonic images. The balloon 100 will be described later.

[0041] 2, the endoscopic observation section 48 has a treatment tool outlet 78, an observation window 80, an illumination window 82, a nozzle 84, and the like, which are opened in the distal end surface 76 of the distal cap 64. That is, the ultrasonic endoscope 12 of this example is a direct-viewing type ultrasonic endoscope that has an observation window 80 in the distal end surface 76 of the rigid distal end portion 52. A pair of illumination windows 82 are provided, one on either side of the observation window 80.

[0042] 3, a forceps conduit 74 is connected to the treatment instrument outlet 78. The forceps conduit 74 has a forceps pipe 96 whose distal end is connected to the treatment instrument outlet 78, and a forceps tube 98 whose distal end is connected to the proximal end of the forceps pipe 96. The forceps tube 98 extends from the inside of the bending section 54 to the proximal end of the flexible section 56 (see FIG. 1), and the proximal end of the forceps tube 98 is connected to the treatment instrument insertion port 37 of the operation section 28 (see FIG. 1). A treatment instrument such as forceps is inserted into the forceps tube 98 from the treatment instrument insertion port 37 and is led out of the treatment instrument outlet 78 via the forceps pipe 96.

[0043] 3, the observation system unit 70 is disposed behind (on the proximal end side of) the observation window 80. The observation system unit 70 includes an objective lens 86, a prism 88, an imaging element 90, a substrate 92, a signal cable 94, and the like.

[0044] Light reflected from the observation target site entering through the observation window 80 is captured by the objective lens 86. The optical path of the captured reflected light is bent at a right angle by the prism 88, and an image is formed on the imaging surface of the imaging element 90. The imaging element 90 photoelectrically converts the reflected light from the observation target site imaged on the imaging surface, and outputs an image signal. Examples of the imaging element 90 include a CCD (Charge Coupled Device) and a CMOS (Complementary Metal Oxide Semiconductor).

[0045] The imaging element 90 is mounted on a substrate 92. A circuit pattern (not shown) electrically connected to the imaging element 90 is formed on the substrate 92. The circuit pattern has a plurality of electrodes, and a plurality of signal cables 94 are connected to these electrodes, respectively. The plurality of signal cables 94 are inserted into the operation unit 28 via the bending section 54 and the flexible section 56 shown in FIG. 1 in the form of a shielded cable 72 including the plurality of signal cables 94. The plurality of signal cables 94 are then inserted from the operation unit 28 into the universal cord 30 and connected to the connector 40 for the endoscope. This connector 40 is connected to the endoscope processor unit 16.

[0046] The emission ends of light guides (not shown) are connected to the illumination windows 82, 82 shown in Fig. 2. The light guides extend from the insertion section 26 shown in Fig. 1 to the operation section 28, and are inserted from the operation section 28 into the universal cord 30, with the incidence ends of the light guides connected to the connector 42 for the light source. This connector 42 is connected to the light source device 18. Illumination light emitted by the light source device 18 propagates through the light guide and is irradiated from the illumination windows 82, 82 shown in Fig. 2.

[0047] The nozzle 84 shown in FIG. 2 is connected to the distal end of an air and water supply conduit (not shown). This air and water supply conduit extends from the insertion section 26 shown in FIG. 1 to the operating section 28 and is inserted from the operating section 28 into the universal cord 30, with the proximal end of the air and water supply conduit connected to the light source connector 42. This connects the proximal end of the air and water supply conduit to the water tank 22 via the connector 42 and the air and water supply tube 44. Water in the water tank 22 is supplied from the air and water supply tube 44 via the connector 42 to the air and water supply conduit and is sprayed from the nozzle 84 toward the observation window 80 and the illumination window 82. Air sent from an air pump (not shown) is supplied to the air and water supply conduit, and this air is sprayed from the nozzle 84 toward the observation window 80 and the illumination window 82 via the air and water supply conduit.

[0048] Next, the balloon 100 shown in Fig. 4 will be described. Fig. 4 is a cross-sectional view of the balloon 100 attached to the rigid tip portion 52.

[0049] 4, an attachment groove 102 for attaching the base end side of the balloon 100 and an attachment groove 104 for attaching the tip end side of the balloon 100 are formed on the outer peripheral surface of the tip rigid portion 52. These attachment grooves 102, 104 are formed on the outer surface of the tip rigid portion 52 along the circumferential direction around the longitudinal axis A.

[0050] A supply port 106 for supplying water into the balloon 100 and discharging water from the balloon 100 is formed on the outer surface of the tip rigid portion 52 between the mounting grooves 102 and 104. The supply port 106 is formed between the mounting groove 102 and the ultrasonic transducer 50. The supply port 106 is further connected to the tip side of a balloon conduit 108 (see FIG. 6), which will be described later. The supply port 106 is an example of a supply port of the present invention.

[0051] The balloon 100 is made of an elastic material such as rubber. The balloon 100 has a ring-shaped band portion 110 at one end and a ring-shaped band portion 112 at the other end. In the balloon 100, the band portion 110 is elastically attached to the attachment groove 102 of the tip rigid portion 52, and the band portion 112 is elastically attached to the attachment groove 104.

[0052] Here, the ultrasonic endoscope 12 of the embodiment is provided with an index that indicates the circumferential position of the supply port 106 around the longitudinal axis A so that the position of the supply port 106 can be grasped from the outside. The ultrasonic endoscope 12 of the embodiment uses the above index to remove air bubbles from inside the balloon 100. An example of the index will be described below.

[0053] 5 is an explanatory diagram showing an example of the index 120. This index 120 is provided on the insertion section 26. The index 120 is an example of the index of the present invention.

[0054] 5, the indicator 120 in this example indicates the circumferential position of the supply port 106 around the longitudinal axis A as described above, and is provided on the base end side of the rigid distal end portion 52 of the insertion section 26. By providing the indicator 120 in this position, when the surgeon tries to see the indicator 120 from the base end side of the insertion section 26, the surgeon can see the indicator 120 without it being hidden by the balloon 100 (see FIG. 4).

[0055] 5, the indicator 120 is provided on the flexible section 56. The flexible section 56 has a bending section adhesive connection section 122 to which the bending section 54 is adhesively connected. The bending section adhesive connection section 122 is provided on the distal end side of the flexible section 56 along the circumferential direction around the longitudinal axis A. The indicator 120 is provided at a different position on the flexible section 56 from the bending section adhesive connection section 122, i.e., at a position closer to the proximal end than the bending section adhesive connection section 122.

[0056] The position of the indicator 120 is not limited to the different positions described above, and it may be provided on the bending portion adhesive connection portion 122. However, since the bending portion adhesive connection portion 122 is generally formed of a hardened adhesive, its outer surface is not smooth. For this reason, it is difficult to provide the indicator 120 on the bending portion adhesive connection portion 122, especially when the indicator 120 is provided by printing, for example. From this perspective, it is preferable to provide the indicator 120 on the outer surface of the flexible portion 56 at a position different from the bending portion adhesive connection portion 122, i.e., at a position where the outer surface is configured as a smooth surface (i.e., a position closer to the proximal end than the bending portion adhesive connection portion 122). The indicator 120 may also be provided on the bending portion 54, which is located closer to the proximal end than the distal rigid portion 52. However, by providing the indicator 120 on the flexible portion 56, the indicator 120 can be more easily seen by the surgeon when viewing the indicator 120 from the proximal end side of the insertion section 26, without being hidden by the balloon 100 (see FIG. 4 ) and the bending portion 54.

[0057] In addition, the indicator 120 in this example is provided in a range toward the tip side of the middle position in the longitudinal axis A direction of the flexible portion 56, specifically, in a range of 200 mm from the tip position of the distal end hard portion 52 of the flexible portion 56.

[0058] Furthermore, the flexible section 56 is formed with a plurality of scales 124 (only one scale 124 is shown in FIG. 5 ) indicating the insertion length of the insertion section 26 at positions corresponding to the insertion length. The scale 124 includes graduations B and numerical values ​​C, and is formed by printing or drawing that is visible from the outside. Furthermore, the plurality of scales 124 are formed at pitch intervals of 200 mm from the distal end position of the distal end hard section 52 of the insertion section 26, as an example. In such a flexible section 56, the index 120 of this example is provided between the position where the most distal scale 124 of the plurality of scales 124 is formed (a position 200 mm away from the distal end position of the distal end hard section 52) and the distal end position 56A of the flexible section 56.

[0059] Furthermore, it is preferable that the indicator 120 has a different shape from the scale 124. The specific shape of the indicator 120 will be described later.

[0060] Furthermore, it is preferable that the indicator 120 has a color different from that of the scale 124. To explain the specific color of the indicator 120, for example, if the color of the flexible portion 56 is black or a gray color close to black and the color of the scale 124 is white, the color of the indicator 120 is yellow, for example, in consideration of contrast. Note that the color of the indicator 120 is not limited to yellow, but it is preferable that the color of the indicator 120 is a color (for example, yellow-green) that can provide a contrast with the colors of the flexible portion 56 and the scale 124.

[0061] Furthermore, it is preferable that the indicator 120 be provided at a position based on an imaginary extension line D extending from the supply port 106 in a direction parallel to the longitudinal axis A. As an example, the indicator 120 in this example is provided on the imaginary extension line D. Note that, as long as the surgeon can determine the position of the supply port 106 from the position of the indicator 120, the position of the indicator 120 does not necessarily have to be provided on the imaginary extension line D. That is, the indicator 120 may be provided at a position shifted from the imaginary extension line D in the circumferential direction about the longitudinal axis A (for example, a position shifted 180 degrees from the imaginary extension line D in the circumferential direction about the longitudinal axis A). However, by providing the indicator 120 on the imaginary extension line D, the surgeon can easily determine that the supply port 106 is located on the imaginary extension line D of the indicator 120.

[0062] Furthermore, it is preferable that the indicator 120 is an index mark 126 provided on the imaginary extension line D. To explain a specific index mark 126 of the indicator 120 (corresponding to the shape of the indicator 120 described above), the index mark 126 in this example is formed in the shape of a substantially isosceles triangle, and is provided on the flexible portion 56 so that an apex angle 126A of the substantially isosceles triangle is located on the imaginary extension line D and a base 126B is perpendicular to the imaginary extension line D. When an operator sees this index mark 126, he or she can ascertain that the supply port 106 is located in the direction in which the apex angle 126A points (the direction along the imaginary extension line D).

[0063] Furthermore, the indicator 120 is preferably a printed mark formed by printing using paint. Examples of the paint include urethane-based, epoxy-based, and fluorine-based paints. The printed mark can be formed by ink pad printing, silk printing, or the like. Note that the indicator 120 is not limited to being printed using paint (ink), and can also be formed by laser processing (laser marking).

[0064] Next, an example of a bubble removal operation using the indicator 120 of this example will be described while explaining the conduit configuration of the ultrasonic endoscope 12 shown in Fig. 6. Note that the conduit configuration shown in Fig. 6 is an example, and the present invention is not limited to this conduit configuration.

[0065] As shown in Fig. 6, the operation unit 28 is provided with a cylinder 130 to which the air and water supply button 32 (see Fig. 1) is attached, and air and water are supplied via the cylinder 130 by operating the air and water supply button 32. An air supply conduit 132, a water supply conduit 134, and a balloon and water supply conduit 136 each extend from the cylinder 130 toward the insertion section 26. Of these conduits, the air supply conduit 132 and the water supply conduit 134 merge into a single air and water supply conduit 138, the distal end of which is connected to the nozzle 84 of the distal end rigid portion 52. An air supply conduit 140 and a water supply conduit 142 each extend from the cylinder 130 toward the universal cord 30 and are each connected to the connector 42.

[0066] The operation unit 28 is also provided with a cylinder 144 to which the suction button 34 (see FIG. 1) is attached, and suction is performed via the cylinder 144 by operating the suction button 34. A forceps conduit 74 and a balloon suction conduit 146 each extend from the cylinder 144 toward the insertion unit 26. The distal end of the forceps conduit 74 is connected to a treatment tool outlet port 78. The forceps conduit 74 branches midway and is connected to a treatment tool insertion port 37 (see FIG. 1). The balloon suction conduit 146 and the balloon water supply conduit 136 merge into a single balloon conduit 108, and the distal end of this balloon conduit 108 is connected to the supply port 106 (see FIG. 4) of the tip rigid portion 52. The suction conduit 148 extends from the cylinder 144 toward the universal cord 30 and is connected to the connector 42.

[0067] According to the ultrasonic endoscope 12 having the duct configuration configured as described above, air sent from an air pump (not shown) is sent from the connector 42 through the air supply duct 140 to the cylinder 130. Then, after air is sent to the air supply duct 132 by selectively operating the air / water supply button 32 (see FIG. 1), it is sprayed from the nozzle 84 through the air / water supply duct 138. Also, water (ultrasound transmission medium) sent from the water supply tank 22 (see FIG. 1) is sent from the connector 42 through the water supply duct 142 to the cylinder 130. Then, after water is sent to the water supply duct 134 by selectively operating the air / water supply button 32 (see FIG. 1), it is sprayed from the nozzle 84 through the air / water supply duct 138. Furthermore, the water supplied to the cylinder 130 is supplied from the balloon water supply conduit 136 to the balloon conduit 108 by selectively operating the air / water supply button 32 (see FIG. 1), and is then supplied into the balloon 100 from the supply port 106 of the tip rigid portion 52. As a result, the balloon 100 is inflated with water.

[0068] Meanwhile, water in the balloon 100 is sucked from the supply port 106 by selectively operating the suction button 34 (see FIG. 1). This water is sucked from the balloon conduit 108 into the balloon suction conduit 146, and then drained from the cylinder 144 through the suction conduit 148 and other channels into a suction tank (not shown).

[0069] When the balloon 100 is inflated with water, the water supply conduit 142, the cylinder 130, the balloon water supply conduit 136, and the balloon conduit 108 are filled with water, but air bubbles may get inside the balloon 100. In this case, the air bubbles may affect the quality of an ultrasound image, making it difficult to obtain a good ultrasound image. Therefore, in order to obtain a good ultrasound image, it is necessary to remove the air bubbles from inside the balloon 100 beforehand. An example of the air bubble removal process will be described below.

[0070] First, the surgeon grasps the flexible portion 56 and positions the insertion section 26 so that the rigid tip portion 52 faces vertically downward relative to the curved portion 54. This causes the water in the balloon 100 to descend vertically downward due to gravity, and the air bubbles in the balloon 100 to rise vertically upward. Then, for example, after positioning the insertion section 26 so that the rigid tip portion 52 faces diagonally downward relative to the curved portion 54, the surgeon rotates the insertion section 26 in the circumferential direction about the longitudinal axis A to orient the indicator 120 on the flexible portion 56 upward. Since the indicator 120 is located on the flexible portion 56, the surgeon can view the indicator 120 from the proximal end side of the insertion section 26 without it being hidden by the balloon 100. Furthermore, the rotation causes air bubbles to gather on an extension (on an imaginary extension line D) from the indicator 120 toward the rigid tip portion 52. As a result, air bubbles gather near the supply port 106.

[0071] Next, the suction button 34 (see FIG. 1) is operated to suck the water from inside the balloon 100. Then, air bubbles are sucked together with the water from the supply port 106. Then, before all the water from inside the balloon 100 is sucked, these air bubbles are sucked from the supply port 106 into the balloon conduit 108.

[0072] After that, when all the water inside the balloon 100 has been sucked out, the air bubbles are exhausted from the suction pump 24 to the outside via the balloon conduit 108, the balloon suction conduit 146, the cylinder 144, the suction conduit 148, etc. At this time, the balloon conduit 108, the balloon water supply conduit 136, the cylinder 130, and the water supply conduit 142 are filled with water. In this state, water is again supplied into the balloon 100 by operating the air / water supply button 32 (see FIG. 1), and the balloon 100 is inflated with water. This fills the balloon 100 with only water. As a result, ultrasonic diagnosis is possible without any air bubbles, and good ultrasonic images can be obtained.

[0073] As described above, the ultrasonic endoscope 12 of the embodiment employs a configuration in which the indicator 120, which indicates the circumferential position of the supply port 106 around the longitudinal axis A, is provided closer to the base end than the rigid distal end portion 52 of the insertion section 26. Therefore, when the surgeon attempts to view the indicator 120 from the base end side of the insertion section 26, the surgeon can see the indicator 120 without it being hidden by the balloon 100. As a result, the surgeon can easily grasp the position of the supply port 106.

[0074] In particular, the ultrasonic endoscope 12 of the embodiment employs a configuration in which the indicator 120 is provided on the flexible section 56, allowing the surgeon to see the indicator 120 without it being hidden by the balloon 100 and the bending section 54. Furthermore, the ultrasonic endoscope 12 of the embodiment preferably employs a configuration in which the indicator 120 is provided at a position on the flexible section 56 different from the bending section adhesive connection section 122 (i.e., closer to the base end than the bending section adhesive connection section 122). The outer surface of the flexible section 56 at a position closer to the base end than the bending section adhesive connection section 122 is configured as a smooth surface, and providing the indicator 120 at such a position allows the indicator 120 to be clearly displayed.

[0075] Furthermore, the ultrasonic endoscope 12 of the embodiment employs a configuration in which the indicator 120 is provided in a range toward the tip side from the middle position in the direction of the longitudinal axis A of the flexible section 56, so that the indicator 120 can be brought closer to the supply port 106. This makes it easier for the surgeon to grasp the position of the supply port 106. In particular, in the above configuration, it is preferable to configure the indicator 120 to be provided within a range of 200 mm from the tip position of the distal end rigid section 52 of the flexible section 56, making it even easier to grasp the position of the supply port 106.

[0076] Furthermore, the ultrasonic endoscope 12 of the embodiment employs a configuration in which the index 120 is provided between the position where the most distal scale 124 of the multiple scales 124 (only one scale 124 is shown in FIG. 5) is formed and the distal end position 56A (see FIG. 5) of the flexible section 56, so that the index 120 can be provided without mixing with the multiple scales 124. This makes it easier to find the index 120, and the surgeon can easily grasp the position of the supply port 106.

[0077] Furthermore, the ultrasonic endoscope 12 of the embodiment employs a configuration in which the index 120 has a different shape from the scale 124, so that the index 120 can be visually distinguished from the scale 124. This makes it easier to find the index 120, and the surgeon can easily grasp the position of the supply port 106.

[0078] Furthermore, the ultrasonic endoscope 12 of the embodiment employs a configuration in which the indicator 120 is a different color from the scale 124, so that the indicator 120 can be visually distinguished from the scale 124. This makes it easier to find the indicator 120, and the surgeon can easily grasp the position of the supply port 106.

[0079] Furthermore, the ultrasonic endoscope 12 of the embodiment employs a configuration in which the indicator 120 is provided at a position based on an imaginary extension line D that extends from the supply port 106 parallel to the longitudinal axis A, so that the surgeon can grasp the position of the supply port 106 based on the imaginary extension line D. In particular, in the above configuration, it is preferable to provide the indicator 120 on the imaginary extension line D, so that the surgeon can easily grasp the position of the supply port 106.

[0080] Furthermore, the ultrasonic endoscope 12 of the embodiment employs a configuration in which the indicator 120 is an index mark 126 provided on the virtual extension line D, making it easier to find the indicator 120, and thereby enabling the surgeon to easily grasp the position of the supply port 106.

[0081] Furthermore, the ultrasonic endoscope 12 of the embodiment employs a configuration in which the indicator 120 is a printed mark formed by printing with paint, making it easier to find the indicator 120, and thereby enabling the surgeon to easily grasp the position of the supply port 106.

[0082] Below, several variations regarding the index will be described.

[0083] Fig. 7 shows an index 150 of a first modified example. The index 150 shown in Fig. 7 is provided on the flexible portion 56, similar to the index 120 shown in Fig. 5, and has a pair of index marks 152, 152 provided at positions facing each other with the imaginary extension line D in between.

[0084] As an example, the index marks 152, 152 are formed in the shape of a substantially isosceles triangle, with apex angles 152A, 152A of the substantially isosceles triangle facing each other across imaginary extension line D, and with bases 152B, 152B formed parallel to imaginary extension line D. Looking at these index marks 152, 152, the surgeon can determine that supply port 106 is located in a direction (along imaginary extension line D) starting from the position where apex angles 152A and 152A face each other toward tip rigid portion 52. As a result, the surgeon can easily determine the position of supply port 106.

[0085] Fig. 8 shows an index 160 of a second modified example. The index 160 shown in Fig. 8 is provided on the flexible portion 56, similar to the index 120 shown in Fig. 5, and has an index mark 162 along the imaginary extension line D.

[0086] The index mark 162 is a linear mark having a base end 162A and a tip end 162B on the flexible portion 56. When the surgeon sees this index mark 162, he or she can determine that the supply port 106 is located in the direction along the index mark 162 (the direction along the imaginary extension line D). As a result, the surgeon can easily determine the position of the supply port 106.

[0087] 〔others〕 In the above embodiment, the ultrasonic endoscope 12 is described as a direct-viewing type having a radial ultrasonic transducer 50, but the present invention is not limited to this. For example, the present invention can also be applied to an oblique-viewing type ultrasonic endoscope having a radial ultrasonic transducer, and an oblique-viewing type ultrasonic endoscope having a convex ultrasonic transducer.

[0088] Although the ultrasonic endoscope according to the embodiment has been described above, the present invention may be improved or modified in several ways without departing from the gist of the present invention. [Explanation of symbols]

[0089] 10 Ultrasonic Inspection System 12 Endoscopic Ultrasound 14 Ultrasonic processor 16. Endoscope processor unit 18 Light source device 20 monitors 22 Water tank 24 Suction pump 26 Insertion section 28 Control section 30 Universal Code 32 Air / water supply button 34 Suction button 36 Angle knob 37 Treatment tool insertion port 38 Connectors 40 connectors 42 connectors 44 Air and water supply tube 46 Suction tube 48 Endoscopic observation section 50 Ultrasonic Transducer 52 Hard tip 54 Curved section 56 Soft part 58 Curved piece 60 Curved operation wire 62 Ultrasonic vibrator 64 Tip cap 66 Proximal ring 68 Shield Ring 70 Observation Unit 72 Shielded Cable 74 Forceps conduit 76 Tip surface 78 Treatment tool outlet 80 Observation window 82 Lighting window 84 nozzles 86 Objective Lens 88 Prism 90 Image sensor 92 PCB 94 Signal Cable 96 Forceps Pipe 98 Forceps Tube 100 balloons 102 Mounting groove 104 Mounting groove 106 Supply port 108 Balloon Pipeline 110 Band Club 112 Band Club 120 indicators 122 Curved adhesive joint 124 Scale 124 126 Indicator Mark 126A vertical angle 126B bottom 130 cylinders 132 Air line 134 Water pipeline 136 Balloon water supply pipeline 138 Air and water pipeline 140 Air line 142 Water pipeline 144 cylinders 146 Balloon suction line 150 indicators 152 Indicator Mark 152A Vertical angle 152B bottom 160 indicators 162 Indicator Mark 162A proximal end 162B Tip A Longitudinal axis B Scale C Number D Virtual extension line

Claims

1. an elongated insertion portion having a longitudinal axis and a hard tip portion provided on the distal end side; an ultrasonic transducer provided in the tip rigid portion for transmitting and receiving ultrasonic waves; a supply port provided in the distal end rigid portion for supplying an ultrasonic transmission medium into a balloon surrounding the ultrasonic transducer; Equipped with the insertion section has a bending section connected to a base end side of the distal end hard section, and a flexible section connected to the base end side of the bending section, an indicator that indicates a circumferential position of the supply port around the longitudinal axis is provided on the flexible portion; Ultrasound endoscope.

2. the flexible portion has a curved portion adhesive connection portion to which the curved portion is adhesively connected, The indicator is provided at a position different from the curved portion adhesive connection portion. The ultrasonic endoscope according to claim 1 .

3. The indicator is provided in a range toward the distal end of the flexible portion relative to a middle position in the longitudinal axis direction.

3. The ultrasonic endoscope according to claim 1.

4. The indicator is provided in the flexible portion within a range of 200 mm from the tip position of the distal end hard portion. The ultrasonic endoscope according to claim 3 .

5. a plurality of scales indicating the insertion lengths of the insertion portion are formed on the flexible portion at positions corresponding to the respective insertion lengths; the indicator is provided between a position where the most distal scale among the plurality of scales is formed and a distal end position of the flexible section; The ultrasonic endoscope according to claim 1 .

6. The indicator has a shape different from the scale. The ultrasonic endoscope according to claim 5 .

7. The indicator is a different color from the scale.

7. The ultrasonic endoscope according to claim 5 or 6.

8. The indicator is provided at a position based on an imaginary extension line extending from the supply port in parallel to the longitudinal axis. The ultrasonic endoscope according to claim 1 .

9. The indicator is an indicator mark provided on the virtual extension line. The ultrasonic endoscope according to claim 8.

10. The indicators are a pair of indicator marks provided at positions facing each other across the imaginary extension line. The ultrasonic endoscope according to claim 8.

11. The indicator is a printed mark formed by printing with paint. The ultrasonic endoscope according to claim 1 .

12. the ultrasonic endoscope is a direct-view microscope having an observation window on a distal end surface of the distal end hard portion, The ultrasonic transducer is a radial ultrasonic transducer in which a plurality of ultrasonic vibrators are arranged along a circumferential direction around the longitudinal axis. The ultrasonic endoscope according to claim 1 .

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