System

Abstract

Provided is a system that improves the efficiency of examination and treatment using an endoscope.　A treatment system (20) comprises: a tubular member (31) that includes a hollow part (31S) therein and has, in a distal end part (31A) thereof, an ultrasonic transducer (32A) provided on the outer circumference of the hollow part (31S); and an operation handle (50) that includes a support member (55) for supporting a proximal end part (31B) of the tubular member (31) and a connection part (51) connectable to a treatment tool introduction port (112) of an endoscope (1) with the tubular member (31) inserted in the treatment tool introduction port (112) from the distal end part (31A) side. The tubular member (31) has a proximal end surface (311) and a distal end surface (312) in the axial direction, and has a proximal end opening (3(1)1A) continuous with the hollow part (31S) at least in the proximal end surface (311).

Description

system

[0001] The technology of the present disclosure relates to a system used in an endoscope.

[0002] Patent document 1 describes a transseptal insertion device that includes a sheath defining at least one hollow portion therein, one or more positioning balloons connected to the distal end of the sheath, and a piercing portion movably disposed within the hollow portion.

[0003] Patent document 2 describes a medical device for inducing controlled necrosis at a target location within the body, the medical device comprising an elongated member having a base end portion, a distal end portion, and at least one hollow portion therein that is fluidly connected to a cooling fluid, a plurality of ablation tips connected to the distal end of the elongated member and configured to contact and ablate tissue, and an ultrasonic probe for controlling the transmural depth of the plurality of ablation tips into the tissue.

[0004] US Patent No. 5,949,999 describes a system that includes a probe that deploys at least one needle into tissue.

[0005] US Patent No. 6,299,949 describes an imaging component that includes a shaft having a proximal end, a distal end, and a cavity, and an imaging transducer coupled to the distal end of the shaft.

[0006] Patent document 5 describes a treatment probe including a handle, a probe body, an imaging source coupled to the probe body, and an ablation element coupled to the probe body and configured to ablate target tissue.

[0007] Patent document 6 describes a system having an imaging component including an imaging handle segment, an imaging shaft having a proximal end and a distal end, and an imaging transducer at the distal end of the imaging shaft, and a needle component including a needle handle segment, a needle shaft having a distal end and a proximal end, and a needle structure reciprocally disposed on or within the needle shaft.

[0008] Japanese Patent Publication No. 2022-548739 Publication Japanese Patent No. 4653734 Publication Japanese Patent No. 6674432 Publication Japanese Special Publication Publication No. 2021-525124 Publication Japanese Special Publication Publication No. 2020-518385 Publication Japanese Patent No. 6243910

[0009] The present disclosure provides a technique that can improve the efficiency of examinations and treatments using endoscopes.

[0010] A system according to one aspect of the disclosed technology comprises a device including a tubular member having a hollow portion therein and having an ultrasonic vibrator attached to the outer periphery of the hollow portion at one end, a first support portion supporting the other end of the tubular member, and a connecting portion connectable to the treatment tool introduction port of an endoscope when the tubular member is inserted into the treatment tool introduction port from the one end side, wherein the tubular member has a first opening connected to the hollow portion in at least the first end face of the first end face on the other end side in the axial direction and a second end face on the one end side.

[0011] A treatment method according to one aspect of the technology of the present disclosure includes a first step of preparing a tubular member having a hollow portion therein, an ultrasonic vibrator being provided on the outer periphery of the hollow portion at one end thereof, and an opening on an end face on the other end side in the axial direction that is connected to the hollow portion; a second step of inserting a treatment tool into the hollow portion from the opening; a third step of inserting the tubular member with the treatment tool inserted into a subject and aligning the ultrasonic vibrator with a target site of the subject based on an output of the ultrasonic vibrator; a fourth step of holding the position of the treatment site while the target site, the ultrasonic vibrator, and a treatment portion of the treatment tool are aligned, and moving the tubular member toward the other end side to expose the treatment portion from the hollow portion; and a fifth step of, after the fourth step, driving the treatment portion to treat the target site.

[0012] According to the techniques of the present disclosure, it is possible to improve the efficiency of examinations and treatments using endoscopes.

[0013] FIG. 1 is a diagram showing a schematic configuration of an endoscopic device 100 according to one aspect of the disclosed technique. FIG. 2 is a cross-sectional schematic diagram showing a schematic configuration of a treatment system 20 that is used by inserting the treatment system 20 from the treatment tool introduction port 112 of the endoscope 1 shown in FIG. 1 into a treatment tool channel of the endoscope 1. FIG. 3 is an enlarged view of range X in FIG. 2. FIG. 4 is a cross-sectional view taken along arrows CC shown in FIG. 3. FIG. 5 is an enlarged view of range Y in FIG. 2. FIG. 6 is a diagram showing a state in which the gripping portion 33 has moved toward the proximal end of the tubular member 31 from the state shown in FIG. 3. FIG. 7 is a schematic diagram illustrating a modified example of the first restricting portion. FIG. 8 is a schematic diagram illustrating a state in which the ultrasound probe 30 and the treatment probe 40 are disposed at the endoscope distal end portion 10C. FIG. 9 is a schematic diagram illustrating a treatment method. FIG. 10 is a schematic diagram illustrating a treatment method. FIG. 11 is a diagram illustrating a first modified example of the treatment system 20, corresponding to FIG. 3. FIG. 12 is a diagram illustrating a second modified example of the treatment system 20, corresponding to FIG. 3. FIG. 13 is a schematic cross-sectional view taken along the line DD in FIG.

[0014] Fig. 1 is a diagram showing a schematic configuration of an endoscopic device 100 according to one aspect of the technology of the present disclosure. The endoscopic device 100 includes an endoscope 1, a main body 2 connected to the endoscope 1 and including a light source device 4 and a processor device 5, and a display device 7 that displays captured images and the like obtained by capturing images with the endoscope 1. In the example shown in Fig. 1, the endoscope 1 is a bronchoscope, but is not limited to this.

[0015] The endoscope 1 includes an insertion section 10, which is a long instrument extending in one direction and is inserted into a subject; an operation section 11 provided at the base end of the insertion section 10 and equipped with operation members for performing observation mode switching operations, image capture storage operations, forceps operations, suction operations, etc.; an angle lever 12 provided adjacent to the operation section 11; and a universal cord 13 including a connector section 13A that detachably connects the endoscope 1 to a connector connection section 4A of the light source device 4.

[0016] The operation unit 11 is provided with a treatment tool introduction port 112 through which a treatment tool for collecting biological tissue such as cells or polyps is introduced. Although not shown in FIG. 1 , various channels such as a treatment tool channel through which the treatment tool introduced from the treatment tool introduction port 112 is inserted and a suction channel are provided inside the operation unit 11 and the insertion unit 10. The operation unit 11 includes a suction button 11A and the like. A suction tube (not shown) is connected to the suction button 11A, and this suction tube is connected to a suction device. When the suction button 11A is operated, a fluid or the like is sucked into the suction tube from the tip of the endoscope 1 and collected by the suction device.

[0017] The insertion section 10 is composed of a flexible flexible section 10A, a bending section 10B provided at the tip of the flexible section 10A, and an endoscope tip section 10C that is harder than the flexible section 10A and provided at the tip of the bending section 10B. An imaging element and an imaging optical system are built into the endoscope tip section 10C.

[0018] The bending portion 10B is adapted to bend in the vertical direction (A2 direction) by rotating the angle lever 12 of the operating unit 11 in the A1 direction, and by bending the bending portion 10B, the endoscope tip portion 10C can be directed in the desired direction.

[0019] A light guide made up of a bundle of optical fibers is provided inside the endoscope 1, extending from the endoscope tip 10C of the insertion section 10 to the connector section 13A. Light generated by the light source device 4 is introduced into this light guide from the connector section 13A and travels to the endoscope tip 10C, where it is irradiated onto the subject through an illumination window provided in the endoscope tip 10C.

[0020] The configuration of the endoscope 1 is an example and is not limited to that shown in FIG.

[0021] Fig. 2 is a cross-sectional schematic diagram showing the general configuration of a treatment system 20 that is used by being inserted into a treatment tool channel of the endoscope 1 from the treatment tool introduction port 112 of the endoscope 1 shown in Fig. 1. Fig. 3 is an enlarged view of range X in Fig. 2. Fig. 4 is a cross-sectional view taken along arrows CC shown in Fig. 3. Fig. 5 is an enlarged view of range Y in Fig. 2.

[0022] The treatment system 20 comprises an ultrasonic probe 30, which is an elongated instrument that extends in one direction, a treatment probe 40, which is an elongated treatment tool that extends in one direction, and an operating handle 50 configured to support the ultrasonic probe 30 and the treatment probe 40.

[0023] The ultrasonic probe 30 includes a tubular member 31 made of resin, elastomer, or the like and having, for example, a cylindrical hollow portion 31S (see FIGS. 3 and 5 ). As shown in FIG. 3 , an ultrasonic transmitter / receiver 32 is provided on the outer periphery of the hollow portion 31S at a tip portion 31A, which is one end portion of the tubular member 31 in the axial direction. As shown in FIG. 4 , the ultrasonic transmitter / receiver 32 is preferably provided in an annular shape as viewed in the axial direction of the tubular member 31. The ultrasonic transmitter / receiver 32 does not have to be provided in an annular shape as viewed in the axial direction of the tubular member 31. For example, the ultrasonic transmitter / receiver 32 may be provided in an arc shape (e.g., a C-shape or semicircular shape) as viewed in the axial direction of the tubular member 31. By providing the ultrasonic transmitter / receiver 32 in an annular shape, ultrasonic images of the inside of the subject within a 360-degree range around the tip portion 31A can be easily obtained based on echoes received by the ultrasonic transmitter / receiver 32.

[0024] The ultrasonic transmitting / receiving unit 32 includes a plurality of ultrasonic transducers 32A (only some of which are shown in FIG. 4 ) arranged in a line along the circumferential direction of the tip end 31A of the tubular member 31, as well as an acoustic matching layer, an acoustic lens, and the like (not shown). The ultrasonic transducers 32A have, for example, a rectangular shape in a plan view in the vibration direction. The ultrasonic transducers 32A are provided at the tip end 31A with, for example, their longitudinal direction aligned with the axial direction of the tubular member 31.

[0025] A wiring group electrically connected to the ultrasonic transmitter / receiver unit 32 is provided in the wall of the tubular member 31. This wiring group extends to the vicinity of the base end 31B, which is the other end of the tubular member 31. As shown in Fig. 2, a substantially T-shaped gripping portion 33 is fixed to the portion of the tubular member 31 near the base end 31B, and the wiring group extends to the inside of this gripping portion 33. This wiring group is connected to an ultrasonic probe control device 300 that controls the ultrasonic transmitter / receiver unit 32 and generates and displays ultrasonic images.

[0026] As shown in Fig. 3, a distal end opening 312A connected to the hollow portion 31S is provided in a distal end surface 312, which is an end surface on one end side in the axial direction of the tubular member 31. As shown in Fig. 5, a proximal end opening 311A ​​connected to the hollow portion 31S is provided in a proximal end surface 311, which is an end surface on the other end side in the axial direction of the tubular member 31.

[0027] The treatment probe 40 has a treatment section 41 at its tip and is a treatment tool capable of freezing the tissue of a subject using the treatment section 41. The treatment probe 40 preferably has a treatment section 41 made of, for example, metal, which cools the treatment section 41 using the Joule-Thomson effect. The treatment probe 40 may be, for example, a CryoProbe (registered trademark).

[0028] The treatment probe 40 is used by being inserted through the proximal end opening 311A ​​into the hollow portion 31S of the ultrasonic probe 30. The treatment probe 40 is connected to a treatment probe control device 400 that performs various controls such as driving the treatment section 41 (injection of gas for cooling). The inner diameter of the tubular member 31 is preferably configured to be larger than the outer diameter of the treatment probe 40.

[0029] The operating handle 50 has an elongated cylindrical shape having an accommodation space capable of accommodating a part of the ultrasonic probe 30. The operating handle 50 has a cylindrical connecting portion 51 at its tip that can be connected by fitting or the like to a base 112A provided at the treatment tool introduction port 112 of the endoscope 1.

[0030] The operating handle 50 further has a cylindrical shaft member 52 that is supported by the connection portion 51 and extends to the side opposite the connection portion 51. The shaft member 52 has a flange portion 52a at the end on the connection portion 51 side and a flange portion 52b at the end opposite the connection portion 51 side. The flange portion 52a is inserted into the connection portion 51 and fixed thereto. A tubular member 31 is inserted throughout the shaft member 52. The part of the tubular member 31 that is distal to the flange portion 52a of the shaft member 52 passes through the inside of the connection portion 51 and is inserted into a base 112A that is connected to the connection portion 51.

[0031] When the treatment system 20 is in use, the ultrasonic probe 30, which has been led out of the connection part 51, is inserted from its tip end 31A through the mouthpiece 112A into the treatment tool channel 1A of the endoscope 1, and in this state, the connection part 51 is connected to the mouthpiece 112A. The connection part 51 is connectable to the treatment tool introduction port 112 in a state in which the tubular member 31 is inserted into the treatment tool introduction port 112 of the endoscope 1 from the tip end 31A side.

[0032] The operating handle 50 further includes a cylindrical slider 53 that is slidably connected to the outer peripheral surface of the shaft member 52 between the flange portions 52a and 52b so as to be axially movable along the shaft member 52. An opening is provided on the outer peripheral surface of the slider 53 at the end on the connection portion 51 side. A fixing member 57 such as a screw is inserted into this opening to fix (lock) the relative position of the slider 53 with respect to the shaft member 52. When the lock by the fixing member 57 is released, the slider 53 is configured to be movable within a range of a distance L1 between the position shown in FIG. 2 where its inner wall abuts against the flange portion 52b, and the position where its end face on the connection portion 51 side abuts against the connection portion 51.

[0033] The slider 53 has an opening 53K on its outer peripheral surface, closer to the base end than the position where the flange portion 52b is located when the end face on the connection portion 51 side is in contact with the flange portion 52a (the position of the shaft member 52 in this state is shown by the dashed line in the figure). The grip portion 33 is located at the position where this opening 53K is located. A portion of the grip portion 33 protrudes to the outside through the opening 53K. The grip portion 33 is fixed to the tubular member 31.

[0034] A cylindrical support member 55 is provided inside the slider 53 adjacent to the proximal end of the grip portion 33. The support member 55 supports the grip portion 33 or the proximal end 31B of the tubular member 31 fixed thereto, and is fixed to the grip portion 33 or the proximal end 31B by, for example, a magnet. The support member 55 has a flange portion 55a at its distal end. The internal space of the slider 53 proximal to the grip portion 33 narrows in two stages toward the proximal end, and the proximal end of the support member 55 is inserted into the narrowest portion. On the inner wall of the slider 53 proximal to the flange portion 55a, a step portion 53b and a step portion 53a are formed in this order from the distal end. A biasing portion 53c, such as a spring, is provided between the flange portion 55a and the step portion 53a of the support member 55 to bias the flange portion 55a toward the distal end. The support member 55 is configured to be movable from the initial position shown in Fig. 2 to a position where the flange portion 55a abuts the step portion 53b. For example, when an operator grasps the grip portion 33 and moves it to the right in Fig. 2, the tubular member 31 (i.e., the ultrasonic probe 30) fixed to the grip portion 33 and the support member 55 can be moved in the axial direction of the tubular member 31 by a distance L2.

[0035] A support member 56 that supports the treatment probe 40 is provided on the slider 53 closer to the proximal end than the support member 55. The support member 56 is made of a circular rubber or the like that fits into an opening provided in the proximal end surface of the slider 53, allowing the treatment probe 40 to be inserted therethrough. The support member 56 can be fixed to and support the inserted treatment probe 40 by tightening a screw or the like (not shown) to narrow the hollow portion. The treatment probe 40 inserted into the support member 56 is then inserted into the hollow portion 31S of the tubular member 31 via the support member 55 and is inserted all the way to the tip of the tubular member 31.

[0036] In the treatment system 20, it is preferable that the ultrasonic probe 30 and the grip portion 33 are detachably attached to the operating handle 50. When using the treatment system 20, first, an assembly including the ultrasonic probe 30 and the grip portion 33 fixed thereto is prepared, and this assembly is inserted into the slider 53 through the opening 53K. At this time, the ultrasonic probe 30 is inserted from its distal end through the slider 53, the shaft member 52, and the connecting portion 51 in that order, until most of the ultrasonic probe 30 is exposed to the outside through the connecting portion 51. Alternatively, the grip portion 33 or the base end 31B of the tubular member 31 may be fixed to the support member 55 by a magnet, adhesive, a locking structure, or the like. In the treatment system 20, the operating handle 50, the ultrasonic probe 30, and the grip portion 33 may be integrated, and only the treatment probe 40 may be detachably attached.

[0037] Next, the treatment probe 40 is inserted into the support member 56 from the treatment section 41 side, and the treatment probe 40 is inserted into the hollow section 31S of the tubular member 31 supported by the support member 55. Then, the tip of the treatment probe 40 is inserted all the way to the tip of the tubular member 31 so as to achieve the positional relationship shown in Fig. 3. In the example of Fig. 3, when viewed in the radial direction of the tubular member 31, the ultrasonic transmitter / receiver unit 32 and the treatment section 41 overlap, and the position of the ultrasonic transmitter / receiver unit 32 and the position of the treatment section 41 in the axial direction of the tubular member 31 are approximately the same.

[0038] 3, the treatment probe 40 is supported by the support member 56 with the treatment section 41 retracted from the distal end opening 312A into the hollow section 31S. The gripping section 33 and the support member 55, which are fixed to the ultrasonic probe 30, are movable in the axial direction within the slider 53. Therefore, when the gripping section 33 moves a distance L2 toward the base end from the position shown in FIG. 2, the ultrasonic probe 30 can be moved a distance L2 relative to the treatment probe 40.

[0039] Fig. 6 is a diagram showing a state in which the gripping portion 33 has moved from the state shown in Fig. 3 toward the proximal end of the tubular member 31. By moving the gripping portion 33 toward the proximal end by a distance L2 from the position shown in Fig. 2, the treatment portion 41 can be brought into a state in which it protrudes from the distal opening 312A to the outside of the hollow portion 31S, as shown in Fig. 6. In this way, the support members 55 and 56 support the tubular member 31 and the treatment probe 40 so that the relative positions of the treatment portion 41 of the treatment probe 40 and the distal end surface 312 of the tubular member 31 can be changed.

[0040] The support member 55 can only move between the initial position and the position where it abuts against the step portion 53 b. In other words, the amount of protrusion of the treatment section 41 from the hollow portion 31S is regulated by the support member 55, the biasing portion 53 c, ​​and the step portion 53 b. The support member 55, the biasing portion 53 c, ​​and the step portion 53 b constitute a first regulating portion.

[0041] The amount of protrusion of the treatment portion 41 from the hollow portion 31S can also be restricted by the tips of the ultrasonic probe 30 and the treatment probe 40, rather than by the operating handle 50. For example, as shown in Fig. 7, an annular protrusion 31T may be provided on the inner peripheral surface of the tip portion 31A of the tubular member 31, and a protrusion 40T that can abut against this protrusion 31T may be provided on the outer peripheral surface of the treatment probe 40 near the treatment portion 41. When the gripping portion 33 moves and the tubular member 31 moves rightward in Fig. 7, the protrusion 31T and the protrusion 40T abut against each other, maximizing the amount of protrusion of the treatment portion 41 from the hollow portion 31S, and thus restricting this protrusion amount. In the configuration shown in Fig. 7, the protrusion 31T and the protrusion 40T constitute a first restricting portion.

[0042] Furthermore, the operating handle 50 may be configured such that the position of the support member 55 (support position of the tubular member 31) is fixed and the position of the support member 56 (support position of the treatment probe 40) is movable, thereby making it possible to change the relative position between the treatment section 41 of the treatment probe 40 and the distal end surface 312 of the tubular member 31. The operating handle 50 may be configured such that the positions of the support members 55 and 56 are each movable, thereby making it possible to change the relative position between the treatment section 41 of the treatment probe 40 and the distal end surface 312 of the tubular member 31.

[0043] 3 (a state in which the ultrasonic transmitting / receiving unit 32 and the treatment unit 41 are aligned), the ultrasonic probe 30 with the treatment probe 40 inserted therethrough is inserted from its distal end into the treatment tool introduction port 112, and then the connecting portion 51 is connected to the treatment tool introduction port 112. In this state, as shown in FIG. 8, the ultrasonic probe 30 and the treatment probe 40 are retracted further inside the endoscope distal end portion 10C than the treatment tool outlet 10Ca formed on the end face of the endoscope distal end portion 10C.

[0044] 8 , when the slider 53 is moved along the shaft member 52, the position of the support member 55 on the slider 53 is fixed by the biasing force of the biasing unit 53c when the gripping portion 33 is not moved relative to the slider 53, so that the ultrasonic probe 30 and the treatment probe 40 can be moved simultaneously. As a result, the ultrasonic probe 30 and the treatment probe 40 can be protruded from the treatment instrument outlet 10Ca or retracted into the treatment instrument outlet 10Ca. In this way, the shaft member 52, the slider 53, the biasing unit 53c, the support member 55, and the support member 56 constitute a movement mechanism that moves the tubular member 31 and the treatment probe 40 in the axial direction of the tubular member 31 while maintaining the relative position between the distal end surface 312 and the treatment portion 41.

[0045] The slider 53 can only move between a position where it abuts against the connecting portion 51 and a position where it abuts against the flange portion 52b. Therefore, the amount of protrusion of the ultrasonic probe 30 and the treatment probe 40 from the treatment tool outlet 10Ca is regulated by the shaft member 52, the slider 53, and the connecting portion 51. The shaft member 52, the slider 53, and the connecting portion 51 constitute a second regulating portion.

[0046] An example of a treatment method using the endoscope 1 and treatment system 20 configured as described above will be described below. First, the surgeon inserts the insertion section 10 of the endoscope 1 into the bronchi of the subject and moves the endoscope tip section 10C to the desired site. Then, the surgeon inserts the ultrasound probe 30 and treatment probe 40 of the treatment system 20 prepared as described above into the treatment tool introduction port 112 and connects the connection section 51 to the treatment tool introduction port 112. Note that the treatment system 20 may be attached to the endoscope 1 before inserting the endoscope 1 into the subject.

[0047] Next, the operator slides the slider 53 to project the ultrasonic probe 30 and the treatment probe 40 from the treatment instrument outlet 10Ca and advances them inside the bronchus, and aligns the ultrasonic transmitter / receiver unit 32 with the target site P of the bronchus OS while checking the ultrasonic image generated based on the output of each ultrasonic vibrator 32A of the ultrasonic transmitter / receiver unit 32 (see FIG. 9). In the state shown in FIG. 9, the target site P, the ultrasonic vibrators 32A, and the treatment unit 41 are aligned.

[0048] Next, in the state shown in Figure 9, the surgeon slides the gripping portion 33 toward the base end, thereby moving the tubular member 31 toward the base end portion 31B while maintaining the position of the treatment portion 41, as shown in Figure 10, and exposing the treatment portion 41 from the hollow portion 31S.

[0049] Next, the surgeon drives the treatment unit 41 to treat the target site P. That is, the treatment unit 41 is cooled to freeze the target site P. Thereafter, while maintaining the positional relationship between the ultrasonic probe 30 and the treatment probe 40 shown in FIG. 10 , the surgeon removes the connection unit 51 from the treatment tool introduction port 112, pulls out the ultrasonic probe 30 and the treatment probe 40 from the treatment tool introduction port 112, and collects the frozen tissue.

[0050] In this way, with the treatment system 20, even in narrow areas such as the bronchi that cannot be observed with the endoscope 1, it is possible to search for the target site P with the ultrasonic probe 30 and treat the target site P (take tissue samples) with the treatment unit 41 without removing the ultrasonic probe 30 from the endoscope 1. For example, there is no need to insert an ultrasonic probe into the treatment instrument channel of the endoscope 1 to search for the target site P, then pull out the ultrasonic probe from the treatment instrument channel, insert a treatment probe into the treatment instrument channel, advance the treatment unit to the position of the target site P, and perform treatment in that state (interchanging the ultrasonic probe and treatment probe). This eliminates the need for a simple and efficient treatment.

[0051] Furthermore, since the ultrasonic transmission / reception unit 32 and the treatment unit 41 are arranged in approximately the same position, the target site P and the treatment unit 41 are aligned in the state shown in Fig. 10. This allows treatment to be performed accurately on the target site P confirmed in the ultrasonic image. Furthermore, compared to methods that use radiation to search for the target site, the use of ultrasonic waves eliminates the effect on the subject and reduces the cost of treatment.

[0052] Furthermore, according to the treatment system 20, the ultrasonic probe 30 and the treatment probe 40 can be inserted into the treatment instrument channel with the treatment unit 41 retracted into the hollow portion 31S, thereby protecting the treatment unit 41. In the example of Fig. 3, the entire treatment unit 41 is retracted into the hollow portion 31S from the distal end opening 312A, but the treatment probe 40 may be supported by the support member 56 with part of the treatment unit 41 outside the hollow portion 31S. Even in this case, most of the treatment unit 41 can be protected.

[0053] Furthermore, according to the treatment system 20, the treatment probe 40 can be inserted into and removed from the ultrasonic probe 30, so that a treatment probe already on the market can be used, thereby reducing the introduction cost of the system. In the treatment system 20, the operating handle 50 and the ultrasonic probe 30 may be washed and reused, while the treatment probe 40 may be a single-use product. Alternatively, the ultrasonic probe 30 may be washed and disinfected and reused, while the operating handle 50 and the treatment probe 40 may be a single-use product.

[0054] Fig. 11 is a diagram showing a first modified example of the treatment system 20, and corresponds to Fig. 3. In the modified example shown in Fig. 11, when the ultrasonic probe 30 and the treatment probe 40 are supported by the operating handle 50, the treatment section 41 protrudes from the distal end opening 312A to the outside of the hollow section 31S. Note that in this modified example, the support member 55 is modified to be immovable in the axial direction of the tubular member 31.

[0055] When using the treatment system 20 shown in Figure 11, after aligning the ultrasonic transmission / reception unit 32 with the target area P, the slider 53 is moved slightly toward the base end to move the treatment unit 41 to the position where the ultrasonic transmission / reception unit 32 was located, and in that state, the treatment unit 41 is driven to freeze the target area P.

[0056] In the modified example shown in Figure 11, by providing a mechanism that allows the slider 53 to be moved toward the base end by a distance equal to the distance between the treatment unit 41 and the ultrasonic transmission / reception unit 32 (for example, by adding a scale or the like to the slider 53), it is possible to perform more accurate treatment on the target area P.

[0057] The treatment probe 40 described above is not limited to one that can freeze and collect tissue, and other methods for collecting tissue can also be used. For example, the treatment portion 41 can be changed to a brush-shaped treatment portion. In this case, for example, by configuring the brush to be folded so that it can pass through the hollow portion 31S under normal conditions and to open up to a position where it can contact the target site P during treatment, it is possible to insert the treatment probe 40 into the ultrasound probe 30 and collect tissue at the same time.

[0058] Furthermore, the treatment section 41 may be a pair of forceps. In this case, for example, the forceps are normally folded to a degree that allows them to pass through the hollow section 31S, and during treatment, the forceps are opened to a position that allows them to come into contact with the target site P, thereby enabling both insertion of the treatment probe 40 into the ultrasonic probe 30 and tissue collection.

[0059] Fig. 12 is a diagram showing a second modified example of the treatment system 20, and corresponds to Fig. 3. Fig. 13 is a schematic cross-sectional view taken along the arrows D-D in Fig. 12. The modified example shown in Fig. 12 is the same as the configuration shown in Fig. 2 except that the hollow portion 31S of the tubular member 31 is closed at the distal end surface 312, a heat conduction member 34 is provided along the outer periphery adjacent to the ultrasound transmitting / receiving unit 32 at the distal end portion 31A of the tubular member 31 (in the example of Fig. 12, adjacent to the distal end surface 312), a treatment unit 41 is connected to the heat conduction member 34, and the support member 55 is modified to be immovable in the axial direction of the tubular member 31.

[0060] 13, the heat conducting member 34 is formed in an annular shape, and its outer surface is exposed. The treatment portion 41 is inserted into the hollow portion of the heat conducting member 34 and fixed to the heat conducting member 34 by fitting or adhesive.

[0061] 12, it is assumed that the treatment system 20 will be sold in an assembled state of the ultrasonic probe 30, the operating handle 50, and the treatment probe 40. However, the heat conductive member 34 and the portion of the tubular member 31 distal to it may be configured as independent parts, and after the treatment probe 40 is inserted into the ultrasonic probe 30 as shown in FIG. 11, these parts may be fitted into the treatment section 41, thereby obtaining the configuration of the modified example shown in FIG.

[0062] The method of using the treatment system 20 of the modified example shown in Fig. 12 is similar to that shown in Fig. 11. In the configuration shown in Fig. 12, when the treatment unit 41 is cooled, the cooling heat is transferred to the heat conduction member 34, and the tissue around the heat conduction member 34 is frozen. Therefore, similar to the configuration shown in Fig. 3 or Fig. 11, the tissue can be frozen and collected.

[0063] 12, it is also possible to configure the thermally conductive member 34 to be located adjacent to the proximal end of the ultrasonic transmitting / receiving unit 32, and to connect the treatment unit 41 to this thermally conductive member 34. As shown in Fig. 12, with the configuration in which the thermally conductive member 34 is provided between the distal end surface 312 and the ultrasonic transmitting / receiving unit 32, it is possible to accurately perform freezing treatment on the area being observed by the ultrasonic transmitting / receiving unit 32, even when the ultrasonic probe 30 and the treatment probe 40 are protruding to their maximum extent from the treatment tool outlet 10Ca.

[0064] As described above, this specification describes at least the following: Below, components corresponding to the above-described embodiment are shown in parentheses, but the present invention is not limited to these.

[0065] (1) A system (treatment system 20) comprising: a tubular member (tubular member 31) having a hollow portion (hollow portion 31S) therein and having an ultrasonic vibrator (ultrasonic vibrator 32A) provided on the outer periphery of the hollow portion at one end (tip end portion 31A); a first support portion (support member 55) supporting the other end (proximal end portion 31B) of the tubular member; and a connecting portion (connecting portion 51) connectable to a treatment tool introduction port (treatment tool introduction port 112) of an endoscope (endoscope 1) in a state in which the tubular member is inserted into the treatment tool introduction port from the one end side, wherein the tubular member has a first opening (proximal end opening 311A) connected to the hollow portion in at least the first end face out of a first end face (proximal end face 311) on the other end side in the axial direction and a second end face (tip end face 312) on the one end side.

[0066] (2) The system according to (1), wherein the second end surface of the tubular member is provided with a second opening (tip opening 312A) that is connected to the hollow portion.

[0067] (3) The system described in (2), wherein the device includes a second support portion (support member 56) that supports a treatment tool (treatment probe 40) inserted into the hollow portion, and the first support portion and the second support portion support the tubular member and the treatment tool so that the relative position between the treatment portion (treatment portion 41) of the treatment tool and the second end face of the tubular member can be changed.

[0068] (4) The system according to (3), wherein the relative position includes a state in which the treatment section protrudes from the second opening to the outside of the hollow section, and a state in which at least a part of the treatment section retracts from the second opening into the hollow section.

[0069] (5) The system according to (4), further comprising a first restricting portion that restricts the amount of protrusion of the treatment portion from the hollow portion.

[0070] (6) The system according to any one of (1) to (5), further comprising a treatment tool (treatment probe 40) inserted through the hollow portion, wherein the treatment tool is capable of freezing tissue.

[0071] (7) A system according to any one of (2) to (5), wherein the device includes a second support portion (support member 56) that supports a treatment tool (treatment probe 40) inserted into the hollow portion, and the second support portion supports the treatment tool in a state in which the treatment portion (treatment portion 41) of the treatment tool protrudes from the second opening to the outside of the hollow portion.

[0072] (8) A system according to any one of (3) to (5) and (7), wherein the device includes a moving mechanism that moves the tubular member and the treatment tool in the axial direction while the device is connected to the treatment tool introduction port and while the relative position between the second end face and the treatment section is maintained.

[0073] (9) The system according to (8), wherein the moving mechanism includes a second regulating section that regulates the amount of protrusion of the tubular member and the treatment tool from a treatment tool outlet (treatment tool outlet 10Ca) on the distal end surface of the endoscope.

[0074] (10) A system according to any one of (1) to (5), further comprising a treatment tool (treatment probe 40) inserted through the hollow portion, the treatment tool being capable of freezing tissue, a heat-conducting member (heat-conducting member 34) being provided along the outer periphery at one end of the tubular member, adjacent to the axial direction of the ultrasonic vibrator, and a treatment portion (treatment portion 41) of the treatment tool being connected to the heat-conducting member.

[0075] (11) The system according to (10), wherein the hollow portion of the tubular member is closed at the second end surface.

[0076] (12) The system according to (11), wherein the heat conduction member is provided between the ultrasonic vibrator and the second end surface.

[0077] (13) The system according to any one of (1) to (12), wherein a plurality of the ultrasonic transducers are arranged in a line along the circumferential direction of the one end on the outer periphery of the one end of the tubular member.

[0078] (14) A first step of preparing a tubular member (tubular member 31) having a hollow portion (hollow portion 31S) therein, in which an ultrasonic vibrator (ultrasonic vibrator 32A) is provided on the outer periphery of the hollow portion at one end (distal end 31A), and the tubular member (tubular member 31) has an opening (proximal end opening 311A) connected to the hollow portion on an end face on the other end (proximal end 31B) side in the axial direction; a second step of inserting a treatment tool (treatment probe 40) from the opening to the hollow portion; and a third step of inserting the tubular member into a subject with the ultrasonic vibrator and a treatment section (treatment section 41) of the treatment tool aligned, and aligning the ultrasonic vibrator with a target site (target site P) of the subject based on an output of the ultrasonic vibrator. a fourth step of maintaining the position of the treatment section while aligning the target area, the ultrasonic vibrator, and the treatment section (treatment section 41) and moving the tubular member toward the other end (base end 31B) to expose the treatment section from the hollow section; and a fifth step of, after the fourth step, driving the treatment section to treat the target area.

[0079] (15) The treatment method according to (14), wherein the treatment tool is capable of freezing tissue in the treatment section, and the treatment method includes a sixth step of, after the fifth step, moving the treatment tool and the tubular member to collect the frozen tissue.

[0080] Although various embodiments have been described above, it goes without saying that the present invention is not limited to such examples. It is clear that a person skilled in the art can conceive of various modifications or alterations within the scope of the claims, and it is understood that these also naturally fall within the technical scope of the present invention. Furthermore, the components of the above embodiments may be combined in any manner as long as they do not deviate from the spirit of the invention.

[0081] This application is based on a Japanese patent application (Patent Application No. 2023-169871) filed on September 29, 2023, the contents of which are incorporated herein by reference.

[0082] 1 Endoscope L1, L2 Distance 1A Treatment tool channel 2 Main body 4 Light source device 4A Connector connection portion 5 Processor device 7 Display device 10 Insertion portion 10A Flexible portion 10B Bending portion 10C Endoscope tip portion 10Ca Treatment tool outlet 11 Operation portion 11A Suction button 12 Angle lever 13 Universal cord 13A Connector portion 20 Treatment system 30 Ultrasonic probe 31 Tubular member 31A Tip portion 31B Base end portion 31S Hollow portion 31T, 40T Convex portion 32 Ultrasonic wave transmitting / receiving portion 32A Ultrasonic vibrator 33 Grip portion 34 Heat conductive member 40 Treatment probe 41 Treatment portion 50 Operation handle 51 Connection portion 52 Shaft member 52a, 52b, 55a Flange portion 53 Slider 53K Opening 53a, 53b Step portion 53c Urging portion 55, 56 Support member 57 Fixing member 100 Endoscope device 112 Treatment tool introduction port 112A Base 300 Ultrasonic probe control device 311 Base end surface 311A ​​Base end opening 312 Distal end surface 312A Distal end opening 400 Treatment probe control device

Claims

1. A system comprising: a tubular member having a hollow portion therein and having an ultrasonic transducer attached to the outer periphery of the hollow portion at one end; a first support portion supporting the other end of the tubular member; and a connection portion connectable to a treatment tool introduction port of an endoscope in a state in which the tubular member is inserted into the treatment tool introduction port from the one end side, wherein the tubular member has a first opening connected to the hollow portion in at least the first end face of a first end face on the other end side in the axial direction and a second end face on the one end side.

2. A system according to claim 1, wherein the second end face of the tubular member is provided with a second opening communicating with the hollow portion.

3. A system as described in claim 2, wherein the device includes a second support part that supports a treatment tool inserted into the hollow portion, and the first support part and the second support part support the tubular member and the treatment tool such that the relative position between the treatment part of the treatment tool and the second end face of the tubular member can be changed.

4. A system as described in claim 3, wherein the relative positions include a state in which the treatment portion protrudes from the second opening to outside the hollow portion, and a state in which at least a portion of the treatment portion retracts from the second opening into the hollow portion.

5. A system according to claim 4, comprising a first restricting portion that restricts the amount of protrusion of the treatment portion from the hollow portion.

6. A system according to any one of claims 1 to 5, further comprising a treatment tool inserted through said hollow portion, said treatment tool being capable of freezing tissue.

7. A system as described in claim 2, wherein the device includes a second support part that supports a treatment tool inserted into the hollow portion, and the second support part supports the treatment tool in a state in which the treatment part of the treatment tool protrudes outside the hollow portion from the second opening.

8. A system as claimed in any one of claims 3 to 5 and 7, wherein the device includes a moving mechanism that moves the tubular member and the treatment tool in the axial direction while the device is connected to the treatment tool introduction port and while the relative position between the second end face and the treatment section is maintained.

9. A system according to claim 8, wherein the movement mechanism includes a second regulating portion that regulates the amount of protrusion of the tubular member and the treatment tool from the treatment tool outlet port on the distal end surface of the endoscope.

10. A system as described in claim 1, further comprising a treatment tool inserted through the hollow portion, the treatment tool being capable of freezing tissue, a heat conductive member being provided along the outer periphery of one end of the tubular member adjacent to the axial direction of the ultrasonic transducer, and a treatment portion of the treatment tool being connected to the heat conductive member.

11. A system according to claim 10, wherein the hollow portion of the tubular member is closed at the second end surface.

12. The system according to claim 11, wherein the thermally conductive member is disposed between the ultrasonic transducer and the second end surface.

13. A system according to any one of claims 1 to 5 and 10 to 12, wherein a plurality of the ultrasonic transducers are arranged in a line along the circumferential direction of the one end on the outer periphery of the one end of the tubular member.

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