Puncture needle device for endoscope

The present invention relates to an endoscopic puncture needle device that is inserted into an endoscopic treatment tool insertion channel, punctures a subject portion in a body cavity, and collects living tissue.

In recent years, pathological definitive diagnosis has been widely performed in the medical diagnosis field. This pathological definitive diagnosis is, for example, a diagnostic method performed by collecting a sample under an ultrasonic tomographic image observation using an ultrasonic diagnostic apparatus. In this diagnostic method, a long puncture needle is guided to the subject portion via an endoscopic treatment tool insertion channel and punctured by using an ultrasonic tomographic image as a guide, and a sample is collected.

In order to make such a definitive diagnosis of pathology, for example, as described in Japanese Patent Application Laid-Open No. 2001-37765 and Japanese Patent Application Laid-Open No. 8-150145, an endoscope that can be fixed to the entrance of a channel for inserting a treatment tool of an endoscope. Mirror puncture needle devices have been proposed.

Here, in general, the shape of the cutting edge of a conventional puncture needle used in the above-mentioned puncture needle device for an endoscope has a structure similar to the shape of the cutting edge of a normal injection needle as shown in FIGS. 24 (a) and 24 (b). It has become. That is, the conventional puncture needle 100 cuts the tip of the ultrafine tube, and at least one or more blade surfaces 100a are formed on the cut tip. Here, FIG. 24 (a) is a cross-sectional view showing the tip of the puncture needle 100 in a state where the inner needle (stylet) 101 is projected, and FIG. 24 (b) shows the tip of the conventional puncture needle 100. It is a perspective view which shows.

However, in general, an injection needle is originally intended to be inserted into a living tissue. The conventional puncture needle, which has a structure similar to the shape of the cutting edge of an injection needle as described above, has a structure in which the living tissue is actively taken into the inside because the cutting edge cuts through the living tissue and inserts the needle. Absent. Therefore, in the above-mentioned conventional puncture needle, when the state of the subject part, for example, the living tissue is hard, the sample may not be collected inside, or even if the sample is collected, only a very small amount is collected. There wasn't. In addition, when a suction biopsy is performed in which the inside of the needle is negatively pressured with a syringe or the like to suck the tissue, there is a disadvantage that the living tissue is collected separately.

As another conventional puncture needle device for an endoscope, for example, as described in Japanese Patent Application Laid-Open No. 10-216134, a notch portion is formed on a side portion of an inner needle that can be moved forward and backward by inserting the puncture needle. An apparatus having a configuration in which the above is formed has been proposed. In the endoscopic puncture needle device described in JP-A No. 10-216134, the puncture needle is advanced to insert the biological tissue of the subject portion into the notch, and then the puncture needle is advanced. By storing the inner needle, the living tissue is cut and a sample is collected.

However, the puncture needle device for an endoscope described in JP-A-10-216134 can collect a sample in an elongated shape, but in order to secure the mechanical strength of the notch, the notch is used. The depth is limited and it is not possible to collect a sample of sufficient thickness. Therefore, in the biopsy using the conventional endoscopic puncture needle device, if the amount of sample collected is insufficient for making a definitive diagnosis of pathology, it is repeated until a sufficient amount is collected. A biopsy had to be performed, which was complicated.

In general, there are two diagnostic methods for collected samples: cytology and histology. Cytology is a diagnosis by diagnosing each cell. Therefore, in cytodiagnosis, it is difficult to determine whether the sample is benign or malignant, and it is difficult to obtain information up to the definitive pathological diagnosis.

On the other hand, histological diagnosis is a method of diagnosing a single mass of living tissues by diagnosing it as a whole, so that information sufficient for making a definitive pathological diagnosis can be easily obtained. Therefore, when making a definitive pathological diagnosis, it is desirable to collect the sample as a tissue-like mass to a certain extent so that the tissue diagnosis can be performed.<patcit num="1"><text>Japanese Unexamined Patent Publication No. 2001-37765</text></patcit><patcit num="2"><text>Japanese Patent Application Laid-Open No. 8-150145</text></patcit><patcit num="3"><text>Japanese Unexamined Patent Publication No. 10-216134</text></patcit>

<p> The problem to be solved is that it is difficult to collect a sample amount large enough for making a definitive pathological diagnosis with a conventional puncture needle device for an endoscope.</p>

<p> The puncture needle device for an endoscope according to claim 1 of the present invention has a sheath that can be inserted into and detached from a channel for inserting a treatment tool of an endoscope, and a subject portion in a body cavity that can be inserted and removed through the sheath and can move forward and backward. A long tubular puncture needle for puncturing and collecting living tissue, an operation unit provided on the base end side of the sheath and operating the advance / retreat of the puncture needle, and an operation unit provided on the operation unit for the puncture. It is characterized in that it is provided with a protrusion mechanism for projecting the needle, and a slanted blade surface that becomes sharp toward the tip is formed on at least one of the outer peripheral surface and the inner peripheral surface of the tip portion of the puncture needle. There is. Further, the invention according to claim 2 of the present invention has an internal needle that can be inserted into the puncture needle and can move forward and backward in the puncture needle device for an endoscope according to claim 1. When the inner needle is projected from the tip of the puncture needle, at least one of the outer peripheral surface and the inner peripheral surface of the tip of the puncture needle has a blade surface formed in a slanted shape that becomes sharp toward the tip. It is characterized by forming an almost continuous inclination with the needle.</p>

<p> The endoscopic puncture needle device of the present invention has an advantage that a sufficient amount of sample for making a definitive diagnosis of pathology can be easily collected.</p>

Hereinafter, examples of the present invention will be described with reference to the drawings.

1 to 16 relate to the first embodiment of the present invention, and FIG. 1 is an explanatory view showing a state in which the puncture needle device for an endoscope of the first embodiment is attached to the treatment tool insertion port of the endoscope. , FIG. 2 is an external view of the puncture needle device for an endoscope of FIG. 1, FIG. 3 is a sectional view of the puncture needle device for an endoscope of FIG. 2, FIG. 4 is an external view showing a coil sheath of FIG. FIG. 3 is an explanatory view showing the puncture needle portion of FIG. 3, FIG. 6 is a cross-sectional explanatory view showing the switch portion of FIG. 3, FIG. 7 is an explanatory view showing the tip end side of the puncture needle of FIG. FIG. 7 (b) is an external view of the tip side of the needle, FIG. 7 (b) is a sectional view of FIG. 7 (a), FIG. 8 is an explanatory view showing the operation of the front half side of the puncture needle device for an endoscope, and FIG. 8 (a) is an explanatory view. A cross-sectional view showing the puncture ready state in which the tip of the puncture needle is housed in the coil sheath, FIG. 8 (b) shows the state in which the tip of the puncture needle protrudes from the tip of the coil sheath with the third slide portion advanced to the maximum. The cross-sectional view shown, FIG. 8 (c) is a cross-sectional view showing a state in which the inner needle is removed, FIG. 9 is an explanatory view showing the operation of the latter half side of the puncture needle device for an endoscope, and FIG. 9 (a) is an adjustment view. FIG. 9 (b) is a cross-sectional view showing a state in which the cylinder is rotated to set the protrusion length, and FIG. 9 (b) is a cross-sectional view showing a state in which the tip of the puncture needle is projected at a high speed by the set protrusion length. (c) is a cross-sectional view showing a state in which the third slide portion is pulled to the proximal end side as much as possible when the puncture needle device is removed from the instrument insertion channel of the endoscope, and FIG. 10 shows the puncture needle portion. Explanatory drawing showing the puncture ready state in which the tip is housed in the coil sheath, FIG. 11 is an explanatory view showing the state when the tip of the puncture needle portion is projected from the tip of the coil sheath and advanced to the front of the subject portion, FIG. Is an explanatory diagram showing the state when the tip of the puncture needle is inserted into the subject and guided into the target lesion. FIG. 13 shows the tip of the puncture needle reaching the target lesion and removing the inner needle. Explanatory drawing showing the state when the puncture needle part is operated, FIG. 14 is an explanatory view showing the state when the puncture needle part is deeply inserted into the target lesion part by operating the switch part, and FIG. 15 shows the sample taken in by the tip of the puncture needle part. An explanatory view showing a state when the puncture needle is removed from the target lesion in the as-is state, FIG. 16 is an explanatory view showing a modified example of the puncture needle, and FIG. 16 (a) is a cross section showing the puncture needle of the modified example. Figure, Figure 16 (b) is a cross-sectional view when the inner needle is inserted through the puncture needle of the figure (a).

As shown in FIG. 1, the endoscopic puncture needle device (hereinafter, simply referred to as a puncture needle device) 1 of the present embodiment is an ultrasonic endoscope or an endoscope 2 via a treatment tool insertion channel (not shown). It is designed to be guided into the body cavity. The endoscope 2 has an elongated insertion portion 3 inserted into the body cavity, an operation portion 4 provided at the rear end of the insertion portion 3, and an eyepiece portion 5 arranged at the rear end of the operation portion 4. And a universal cord 6 having a connector 7 connected to a light source device (not shown). Although the illustrated endoscope 2 is an optical endoscope, the endoscope optical image is photoelectrically converted and not shown by attaching a television camera head to the eyepiece 5 of the endoscope. It is also used to obtain endoscopic images by connecting to a camera control unit (hereinafter referred to as CCU). Further, as the endoscope used in this embodiment, as an electronic endoscope, an imaging optical system and an imaging device are built in the tip portion of the insertion portion, and a signal line extends from the operation portion at the end of the universal cord. Of course, the endoscope may be connected to the CCU via the provided connector to obtain an endoscope image.

A treatment tool insertion port 8 for inserting a treatment tool such as the puncture needle device 1 is provided on the front end side of the operation unit 4 of the endoscope. The treatment tool insertion port 8 communicates with a treatment tool insertion channel (not shown). The treatment tool insertion channel is arranged in the insertion portion 3 and opens to the treatment tool outlet 9a formed at the tip portion 3a of the insertion portion. Therefore, the puncture needle device 1 can project the puncture needle portion 11 on the distal end side from the treatment tool outlet 9a by inserting the puncture needle device 1 into the treatment tool insertion channel from the treatment tool insertion port 8. ing.

As shown in FIG. 2, in the puncture needle device 1, the puncture needle portion 11 (see FIG. 5) that punctures the subject portion in the body cavity and the puncture needle portion 11 are inserted to insert the treatment tool of the endoscope. The coil sheath 12 (see FIG. 4) to be inserted into the body cavity via a general channel and the puncture needle portion 11 inserted from the rear end side of the coil sheath 12 are inserted into the coil sheath 12 in a state where the coil sheath 12 is arranged inside. It is mainly composed of an auxiliary instrument main body 13 as an operation unit provided with a protrusion mechanism for projecting the puncture needle portion 11 toward the tip side.

The auxiliary device main body 13 has a hollow structure fixing cylinder 21 having a protruding mechanism for projecting the puncture needle portion 11 and having a removable fixing portion 21a at the treatment tool insertion port 8 of the endoscope 2. A first slide portion 22 having a hollow structure that is movably inserted inside the fixed cylinder 21 in the longitudinal direction, an adjusting cylinder 23 for adjusting the protrusion length by the protrusion mechanism of the puncture needle portion 11, and the first slide portion 23. A hollow structure second slide portion 25 (see FIG. 3) that is internally installed in the slide portion 22 and has a finger hook portion 24 on the rear end side, and a pipe that is inserted into the second slide portion 25 so as to be able to advance and retreat. It is mainly composed of a portion 26 and a third slide portion 28 having a hollow structure provided with a pipe base 27 fixed to the base end side of the pipe portion 26.

Next, the internal structure of the auxiliary device main body 13 will be described with reference to FIG. A groove 31 is provided on one side surface of the fixing cylinder 21 in the longitudinal direction, and a first fixing screw 32 is screwed through the groove 31 near the tip of the first slide portion 22. A male screw portion 33 is provided on the outer periphery of the first slide portion 22 on the base end side. The female screw of the adjusting cylinder 23 is screwed into the male screw portion 33. A switch portion 34 for projecting the puncture needle portion 11 is provided near the center of the first slide portion 22.

The adjustment cylinder 23 has a flat adjustment cylinder bottom portion 36 having a front end side that is screwably open with a male screw portion 33 and a hole on the rear end side through which a small diameter portion 35 constituting the second slide portion 25 penetrates. have. The adjusting cylinder 23 is provided with a coil spring 37 as an urging member for urging the second slide portion 25 toward the tip end side with respect to the first slide portion 22.

The adjusting cylinder 23 moves back and forth by rotating with respect to the first slide portion 22, and can be moved toward the base end side until the adjusting cylinder bottom portion 36 comes into contact with the damper 38 of the finger hook portion 24. Then, the adjusting cylinder 23 defines a protruding length (the length at which the puncture needle portion 11 protrudes due to the urging force of the coil spring 37) 39 by the protruding mechanism at the distance between the adjusting cylinder bottom portion 36 and the damper 38. ing. In the state of FIG. 8A, which will be described later, the adjusting cylinder 23 is located on the most advanced side, so that the protruding length 39 is the maximum protruding length 40.

The second slide portion 25 is composed of a large diameter portion 41, a small diameter portion 35, and a finger hook portion 24 in this order from the tip end side. The large diameter portion 41 and the small diameter portion 35 are inserted into the first slide portion 22. The large diameter portion 41 has an outer diameter slightly smaller than the inner diameter of the first slide portion 22. The small diameter portion 35 is a pipe-shaped member having an outer diameter smaller than the inner diameter of the coil spring 37, and the pipe portion 26 of the third slide portion 28 is inserted.

The coil spring 37 is inserted inside the first slide portion 22 on the outside of the small diameter portion 35 of the second slide portion 25. The base end side of the coil spring 37 is fixed to the base end side of the first slide portion 22, and the tip end side is fixed to the base end side of the large diameter portion 41 of the second slide portion 25. The coil spring 37 is a compression spring, and as described above, the second slide portion 25 is always urged toward the tip end side with respect to the first slide portion 22.

The finger hook portion 24 is provided with a disk-shaped damper fixing plate 42 on the tip end side and a disc-shaped finger hook plate 43 on the base end side. The second fixing screw 44 is screwed perpendicular to the longitudinal axis near the center of the finger hook portion 24. A ring-shaped damper 38 made of a shock-absorbing material such as rubber is fixed to the tip end side of the damper fixing plate 42. An annular groove 45 is formed in a part of the inner diameter of the finger hook portion 24, and an elastic ring 46 made of a material such as rubber is fitted. The inner diameter of the elastic ring 46 is slightly smaller than the outer diameter of the pipe portion 26 of the third slide portion 28.

A scale 47 (see FIG. 2) is formed on the outer periphery of the small diameter portion 35 of the second slide portion 25 so that the surface on the tip end side of the damper 38 is zero and toward the tip end side. The scale 47 shows the protrusion length 39 defined by between the damper 38 and the bottom 36 of the adjusting cylinder.

Two click grooves, which are annular grooves, are formed on the outer surface of the pipe portion 26, and the groove on the base end side is the first click groove 48 and the groove on the tip end side is the second click groove 49, respectively. ing. The first click groove 48 and the second click groove 49 are grooves that generate a light locking force when the elastic ring 46 is fitted and further make the operator feel a click feeling.

The second click groove 49 is formed on the tip end side of the first click groove 48. The distance between the first click groove 48 and the second click groove 49 is the maximum protrusion length of 40 or more. Further, the base end of the pipe base 27 of the third slide portion 28 is a male screw lure base 50.

A puncture needle retract index (not shown) composed of a colored ring can be provided on the surface of the pipe portion 26 of the third slide portion 28, and the third slide portion 28 is completely formed. It is provided at a position where it is pulled toward the base end side and can be visually recognized only when it is in a clicked state in the second click groove 49. (In FIG. 2, since the third slide portion is located closer to the tip side, it is located inside the second slide portion 25 and cannot be visually recognized.) The operation is performed by this puncture needle retract index. The person can indirectly recognize that the puncture needle portion 11 is housed in the coil sheath 12, and after confirming the puncture needle withdrawal index, the puncture needle portion 11 is removed from the endoscope 2 at the time of removal. It is possible to prevent the puncture needle portion 11 from puncturing the treatment tool insertion channel of the endoscope 2.

Next, the coil sheath 12 detachably fixed to the first slide portion 22 of the auxiliary instrument main body 13 will be described with reference to FIG. The coil sheath 12 is composed of a coil sheath insertion portion 51, a coil sheath base end portion 52, and a coil sheath base portion 53.

The coil sheath insertion portion 51 is made of a flexible metal coil having a length similar to that of the treatment tool insertion channel of the endoscope 2. The coil sheath insertion portion 51 has an inner diameter larger than the outer diameter of the puncture needle portion 11 and an outer diameter smaller than the treatment tool insertion channel of the endoscope 2, and the treatment tool of the endoscope 2 It can be freely inserted and removed from the insertion channel. The coil sheath insertion portion 51 penetrates the fixed cylinder 21 and projects toward the tip end side in a state of being attached to and combined with the coil sheath base portion 53.

The coil sheath base portion 53 is detachably screwed to the tip of the first slide portion 22 of the auxiliary tool main body 13. The coil sheath base end portion 52 is connected to the base end side of the coil sheath base portion 53. The coil sheath base end portion 52 is composed of the same coil as the coil sheath insertion portion 51, and is inserted halfway through the third slide portion 28 of the auxiliary instrument main body 13.

Next, the puncture needle portion 11 that punctures the subject portion in the body cavity will be described with reference to FIG. The puncture needle portion 11 is detachably attached to the lure base 50 provided on the pipe base 27 of the auxiliary device main body 13. The puncture needle portion 11 is inserted through the coil sheath 12 to puncture the subject portion in the body cavity so as to be able to move forward and backward, and a long tubular puncture needle (puncture needle for endoscopy) for collecting biological tissue. It is composed of 55 and a puncture needle base 56 fixed to the puncture needle 55.

The internal needle (stylet) 57 is inserted into the puncture needle 55 so as to be able to move forward and backward. An inner needle cap 58 is fixed to the inner needle 57. The puncture needle mouthpiece 56 and the inner needle mouthpiece 58 are detachably combined, and in a state where the inner needle 57 is inserted through the puncture needle 55, the tip of the inner needle 57 is the tip of the puncture needle 55. It is designed to protrude toward the tip side.

Next, the structure of the switch portion 34 provided on the first slide portion 22 of the auxiliary instrument main body 13 will be described with reference to FIG. As shown in FIG. 6, the switch seat 61 of the switch portion 34 is provided on the upper side of the notch portion 62 formed near the center of the first slide portion 22. In the switch unit 34, a safety ring 63 as a safety device and a button 64 as a switch mechanism are assembled to the switch seat 61.

The safety ring 63 is a ring-shaped member, and is rotatably assembled around the axis perpendicular to the longitudinal axis with respect to the switch seat 61. A lock index 65, which is a pin-shaped member, radially penetrates and is fixed to the cylindrical surface of the safety ring 63. The lock index 65 projects on the inner and outer surfaces of the safety ring 63.

The button 64 is incorporated inside the safety ring 63, and is composed of a button head 66, a shaft 67, and a pusher 68. The button head 66 is a tubular member having an inner diameter of the safety ring 63. The shaft 67 is a rod-shaped member coaxial with the button head 66, and freely penetrates the switch seat 61 in advancing and retreating. The pusher 68 is fixed to the other end of the shaft 67 and has a size that can be inserted into the notch 62.

A switch spring 69 is incorporated between the switch seat 61 of the shaft 67 and the button head 66. The button 64 is always urged upward in the figure by the switch spring 69. A switch groove 71 is formed on the lower surface of the button head 66 as a recess into which the lock index 65 can enter.

Unless the lock index 65 and the switch groove 71 are displaced by approximately 180 degrees and the safety ring 63 is rotated around the shaft 67 to match the lock index 65 with the switch groove 71. When the bottom of the button head 66 and the lock index 65 come into contact with each other, the button 64 cannot be pressed, which is a restricted state.

Then, when the safety ring 63 is rotated from this state until the lock index 65 is rotated to the same position as the switch groove 71, the switch unit 34 is connected to the lock index 65 and the switch groove 71. When the positions match, the button 64 can be pressed down. That is, the switch portion 34 can be in a deregulated state in which the puncture needle portion 11 can be projected.

The large diameter portion 41 of the second slide portion 25 is partially cut out, and a latch 72 as a locking mechanism for temporarily locking the urging force of the coil spring 37 is incorporated. A swing shaft 73 perpendicular to the longitudinal axis penetrates the base end side of the latch 72. The latch 72 is swingably supported around the swing shaft 73. Due to the swing of the swing shaft 73, the tip end side of the latch 72 takes a state of being housed in the outer diameter of the large diameter portion 41 of the second slide portion 25 and a state of protruding from the large diameter portion 41. I'm getting it. A leaf spring 74 is attached to the tip end side of the latch 72, and one end thereof is urged so that the tip end side of the latch 72 protrudes from the large diameter portion 41.

As shown in FIG. 6, the tip side of the latch 72 is locked to the cutout portion 62 of the first slide portion 22, and the second slide portion is urged to the tip side by the coil spring 37. Prevents 25 from moving forward. As described above, the switch portion 34 rotates the safety ring 63 around the shaft 67 to release the regulation, and pushes down the button head 66 so that the pusher 68 enters the notch portion 62. When the latch 72 that is locked to the notch 62 is pushed down, the locking between the notch 62 and the latch 72 is released. As a result, the switch portion 34 releases the urging force of the coil spring 37 that urges the second slide portion 25 toward the tip end side.

Then, the puncture needle portion 11 advances at a high speed by the protrusion length 39 set in advance by the second slide portion 25, so that the puncture needle portion 11 projects at a high speed by the length of the protrusion length 39 set as described later, and the target It is designed to puncture the lesion.

Here, the conventional puncture needle has a structure in which the cutting edge shape is similar to the cutting edge shape of a normal injection needle, and since this cutting edge pierces the living tissue while cutting it, the structure is such that the living tissue is actively taken into the inside. is not. Therefore, in the conventional puncture needle, the state of the subject portion, for example, when the living tissue is hard, the sample is not collected inside, or even if the sample is collected, the amount is extremely small.

Therefore, in the present embodiment, the puncture needle 55 is formed by forming a slanted blade surface that becomes sharp toward the tip on the outer peripheral surface of the tip. That is, as shown in FIGS. 7A and 7B, the puncture needle 55 cuts the tip of the ultrafine tube diagonally with respect to the longitudinal axis direction to form a tip portion, and the outer peripheral surface of the tip portion A slanted blade surface 81 that becomes sharp toward the tip is formed on the entire circumference. The puncture needle 55 shown in FIGS. 7A and 7B shows a state in which the inner needle 57 is projected from the tip end side.

The puncture needle 55 is formed so that when the inner needle 57 is projected from the tip end portion, the blade surface 81 forms an inclination substantially continuous with the inner needle 57. As a result, the puncture needle 55 can be manually and smoothly inserted deeply into the subject portion together with the inner needle 57 without any resistance even with the inner needle 57 inserted. For example, the puncture needle 55 can be inserted deep into the subject portion. It is possible to puncture an existing target lesion.

Further, the puncture needle 55 projects the puncture needle portion 11 by the above-mentioned operation after removing the inner needle 57, so that the target lesion portion is internally formed without taking in unnecessary biological tissue on the puncture route. It is possible to take in the sample as a tissue-like mass to some extent and cut it from the surrounding tissue.

The operation of the puncture needle device 1 configured in this way will be described with reference to FIGS. 8 to 15. First, the tip portion 3a of the endoscope insertion portion 3 is inserted and positioned near the target portion. Next, as shown in FIG. 10, with the tip of the puncture needle portion 11 housed in the coil sheath 12, the coil sheath 12 is inserted into the treatment tool insertion channel of the endoscope 2, and the fixing portion 21a is inserted into the treatment tool. Fixed to mouth 8. At this time, the tip of the puncture needle portion 11 is located slightly closer to the proximal end side than the tip of the coil sheath 12 inserted in the tip portion 3a of the endoscope insertion portion 3, and is housed in the coil sheath 12.

At this time, as shown in FIG. 8A, the first fixing screw 32 is in the tightened state, and as described above, the adjusting cylinder 23 is located on the most advanced side. Therefore, the protruding length 39 of the puncture needle portion 11 has a maximum protruding length of 40. Further, the first click groove 48 is in a state of being fitted in the elastic ring 46. The tip side of the latch 72 is locked to the notch 62 of the first slide part 22 to prevent the second slide part 25 urged to the tip side from advancing by the urging force of the coil spring 37. are doing.

Next, when the first fixing screw 32 is loosened and the first slide portion 22 is advanced toward the tip side, the first slide portion 22 is guided by the groove 31 of the fixing cylinder 21 and moves forward. Then, the tip of the coil sheath 12 is advanced to the vicinity of the subject portion 90 under the observation of the optical field of view or the ultrasonic image of the endoscope 2. Then, the first slide portion 22 is fixed by tightening the first fixing screw 32 again.

Next, the second fixing screw 44 is loosened so that the third slide portion 28 can move forward and backward with respect to the second slide portion 25. Then, the third slide portion 28 grips the pipe base 27 and is advanced. The third slide portion 28 is locked by the elastic ring 46 and the first click groove 48 with a light locking force, but the lock can be easily released manually and can be advanced.

Then, as shown in FIG. 8B, the puncture needle portion 11 advances, and the tip of the puncture needle portion 11 protrudes from the tip of the coil sheath 12. In addition, in FIG. 8B, the auxiliary instrument main body 13 shows a state in which the third slide portion 28 is advanced to the maximum. By this operation, under the observation of the ultrasonic image obtained by the ultrasonic observation device (not shown), the puncture needle portion 11 is advanced to the front of the subject portion 90 as shown in FIG. 11, and is covered as shown in FIG. It is inserted into the sample part 90 and guided into the target lesion part. At this time, the puncture needle portion 11 can be manually and smoothly deeply inserted into the subject portion by the puncture needle 55 together with the inner needle 57 without relatively resistance.

When the tip of the puncture needle portion 11 reaches the target lesion, the inner needle cap 58 is removed from the puncture needle cap 56 as shown in FIG. 8 (c), and the inner needle 57 is removed as shown in FIG. Next, the distance at which the sample is to be collected, that is, the distance to be projected by the coil spring 37 is measured. The operator sets the protrusion length 39 by rotating the adjustment cylinder 23 shown in FIG. 9A and moving it to a desired position while reading the scale 47 according to the measured distance.

Next, the second fixing screw 44 is tightened to make the third slide portion 28 immovable with respect to the second slide portion 25. This is to prevent the third slide portion 28 from retracting when the coil spring 37 protrudes. Next, the operator operates the switch portion 34 to automatically project the puncture needle portion 11 by the protrusion mechanism. Here, by further suctioning, the sample (tissue) is more easily taken up by the inside of the puncture needle 55. Therefore, a suction device (not shown) may be connected to the puncture needle base 56 to perform suction.

The switch unit 34 is rotated by rotating the safety ring 63 from the regulated state described with reference to FIG. 6 until the lock index 65 is at the same position as the switch groove 71. Since the lock index 65 also protrudes from the outer surface of the safety ring 63, the position of the lock index 65 can be visually and tactilely grasped by the operator. Then, when the positions of the lock index 65 and the switch groove 71 match, the button 64 can be pressed down.

Here, when the button head 66 of the switch portion 34 is pushed down, the lock between the notch portion 62 and the latch 72 is released. Then, as shown in FIG. 9B, the second slide portion 25 urged to the tip side by the urging force of the coil spring 37 advances at high speed by the protrusion length 39. At this time, the damper 38 absorbs the impact when the third slide portion 28 collides with the adjusting cylinder 23.

At this time, the third slide portion 28 is fixed to the second slide portion 25 by the second fixing screw 44, and the puncture needle portion 11 is further fixed to the third slide portion 28. Therefore, as the second slide portion 25 advances at high speed by the protrusion length 39 and the third slide portion 28 also advances at high speed by the protrusion length 39, the puncture needle portion 11 also advances at high speed at the same time. That is, by pressing the button head 66 of the button 64, the tip of the puncture needle portion 11 projects at high speed by the set protrusion length 39.

Then, the puncture needle portion 11 is deeply inserted into the target lesion portion as shown in FIG. Then, as described in FIGS. 7 (a) and 7 (b), the puncture needle 55 can take in the sample of the target lesion as a tissue-like mass to some extent inside and cut it from the surrounding tissue.

Then, the second fixing screw 44 is loosened, and the third slide portion 28 is pulled to the base end side to the maximum as shown in FIG. 9 (c). Then, as shown in FIG. 15, the tip of the puncture needle portion 11 is removed from the target lesion portion while the sample is still taken in. Then, the puncture needle portion 11 is housed in the coil sheath 12. Next, the fixing portion 21a is disengaged and the puncture needle device 1 is removed from the endoscopic treatment tool insertion channel. As a result, the puncture needle device 1 of the present embodiment can collect a sufficient amount of sample at one time for making a definitive diagnosis of pathology, and the operation time can be shortened.

The tip of the puncture needle may be formed as shown in FIGS. 16A and 16B. As shown in FIGS. 16A and 16B, the puncture needle 55B cuts the tip of the ultrafine tube perpendicularly to the longitudinal axis direction to form the tip, and forms the tip, and the entire circumference of the outer peripheral surface of the tip. A slanted blade surface 81b that becomes sharp toward the tip is formed.

As a result, the puncture needle 55B of this modified example obtains almost the same effect as that of the first embodiment, and the inclination formed together with the inner needle 57 is more continuous, so that the puncture needle 55B smoothly enters the target lesion. Can be inserted. Furthermore, since the tip of the puncture needle 55B of this modified example is vertical, the tissue does not escape and a larger amount of sample can be taken.

In the puncture needle of the present embodiment, a slanted blade surface that becomes sharp toward the tip is formed on the entire circumference of the tip, but it may be formed on substantially half the circumference of the tip. It may be formed intermittently along the circumference of the tip portion, or may be formed substantially on the entire circumference while leaving a part of the tip portion (this point is the second embodiment to be performed later). The same applies to the examples and each modification).

17 to 23 relate to the second embodiment of the present invention, FIG. 17 is a cross-sectional view showing the puncture needle of the second embodiment, and FIG. 18 shows a state when the puncture needle is guided to the front of the target lesion. Explanatory drawing, FIG. 19 is an explanatory view showing the state when the target lesion is pulled into the inside of the puncture needle by suction, and FIG. 20 is an explanatory view showing the state when the puncture needle is deeply inserted into the target lesion by operating the switch part. FIG. 21 is an explanatory view showing the state when the tip of the puncture needle is removed from the target lesion while the sample is still taken in, and FIG. 22 is an explanatory view showing a modified example of the puncture needle. 22 (a) is a cross-sectional view of the puncture needle of the first modified example, FIG. 22 (b) is a cross-sectional view of the puncture needle of the second modified example, and FIG. 22 (c) is a puncture of the third modified example. A cross-sectional view of the needle, FIG. 23 is an explanatory view showing a further modified example of the puncture needle, FIG. 23 (a) is a cross-sectional view of the puncture needle of the fourth modified example, and FIG. 23 (b) is a fifth modified example. It is sectional drawing of a puncture needle.

The first embodiment described above is configured by forming a slanted blade surface that becomes sharp toward the tip on the entire circumference of the outer peripheral surface with respect to the tip portion of the puncture needle, but the second embodiment is configured. A slanted blade surface that becomes sharp toward the tip is formed on the entire circumference of the inner peripheral surface with respect to the tip of the puncture needle. Since the other configurations are the same as those in the first embodiment, the description thereof will be omitted, and the same configurations will be described with the same reference numerals.

That is, as shown in FIG. 17, in the puncture needle device of the second embodiment, the tip of the ultrafine tube is cut perpendicularly to the longitudinal axis direction (may be cut diagonally as a modification) to cut the tip. A puncture needle 55C is provided on the entire inner peripheral surface of the tip portion, which is formed and has a slanted blade surface 81c that becomes sharp toward the tip.

With this configuration, when the puncture needle 55C is inserted into the subject portion 90, the sample of the target lesion portion can be cut out by the blade surface 81c and taken into the inside as a tissue-like mass to some extent. Since the other configurations are almost the same as those in the first embodiment, the description thereof will be omitted.

The operation of the puncture needle device of the second embodiment configured as described above will be described with reference to FIGS. 18 to 21. The puncture needle device of the second embodiment is used when the target lesion is present in the subject 90 near the body surface.

Therefore, the puncture needle device of the second embodiment does not require the inner needle 57 from the beginning, and in FIGS. 8 and 9 of the first embodiment, the inner needle cap 58 is removed from the puncture needle cap 56 and the inner needle is removed. Used with 57 removed. Other than that, the operation of the puncture needle device of the second embodiment is almost the same as that of FIGS. 8 and 9 of the first embodiment until the puncture needle portion 11 is guided to the front of the subject portion 90 as shown in FIG. The same applies (however, the inner needle cap 58 is removed from the puncture needle cap 56 and the inner needle 57 is removed), and the description thereof will be omitted. Next, the operator measures and sets a predetermined distance from which the sample is to be collected from the tip of the puncture needle portion 11. Then, the operator operates the switch portion 34 to automatically project the puncture needle portion 11 by the protrusion mechanism.

Here, by further suctioning, the sample (tissue) is more easily taken up inside the puncture needle 55C. Therefore, a suction device (not shown) is connected to the puncture needle base 56 to perform suction. As shown in FIG. 19, the puncture needle 55C of the puncture needle portion 11 pulls a part of the target lesion portion into the inside by the suction. Then, when the switch portion 34 is operated, the puncture needle portion 11 projects only the set protrusion length 39 at high speed. Then, the puncture needle 55C of the puncture needle portion 11 is deeply inserted into the target lesion portion as shown in FIG. 20, and the sample is taken into the inside as a tissue-like mass to some extent and cut out from the surrounding tissue.

Next, by pulling the third slide portion 28 to the proximal end side to the maximum extent, as shown in FIG. 21, the tip of the puncture needle 55C of the puncture needle portion 11 is removed from the target lesion while the sample is still taken in. And housed in the coil sheath 12. Then, the puncture needle device is removed from the endoscopic treatment tool insertion channel.

As a result, in the puncture needle device of the second embodiment, the blade surface 81c of the puncture needle 55C is formed on the inner peripheral surface of the tip portion, so that the sample (tissue) cut out by the puncture needle 55C is used. It is possible to obtain the effect that it becomes easier to be taken in more positively inside.

The puncture needle may be formed in a tip shape as shown in FIGS. 22 (a) to 22 (c). The puncture needle 55D shown in FIG. 22 (a) is configured by forming a step portion 81d for holding a tissue hook on the inner peripheral surface of the puncture needle 55C of the second embodiment. With this configuration, after the puncture needle 55D is inserted into the target site, the sample that has entered the inside is hooked by the stepped portion 81d and cut out, so that the sample (tissue) that has been cut out can be more easily cut from the surrounding tissue. Is hard to fall off. Therefore, the puncture needle 55D can further enhance the effect of cutting and collecting the sample taken in from the surrounding tissue, and the sample collection property is further improved.

Further, the puncture needle 55E shown in FIG. 22B is formed by displacing (shifting) the blade surface 81e with respect to the puncture needle 55C of the second embodiment. With this configuration, the puncture needle 55E can further enhance the effect of cutting from the surrounding tissue on the sample taken into the inside like the puncture needle 55D, and the sample collection property is further improved.

Further, the puncture needle 55F shown in FIG. 22 (c) is configured by forming a slanted blade surface 81b that becomes sharp toward the tip on both inner and outer peripheral surfaces of the tip portion. .. With this configuration, the puncture needle 55F can further enhance the effect of puncturing the subject portion, and the punctureability is improved.

Furthermore, the puncture needle may be formed in the shape of the tip portion as shown in FIGS. 23 (a) and 23 (b). The puncture needle 55G shown in FIG. 23 (a) is formed by cutting the tip of an ultrafine tube in a curved shape with respect to the longitudinal axis direction to form a tip, and the tip is formed on the entire circumference of the inner peripheral surface of the tip. A slope-shaped blade surface of 81 g that becomes sharp toward the surface is formed. With this configuration, the puncture needle 55G can be punched into a hole when the sample is relatively hard or fibrous to further enhance the effect of punching into the subject, and the puncture property can be further enhanced. Is improved.

Further, the puncture needle 55H shown in FIG. 23 (b) is configured by forming a slanted blade surface 81h in the vicinity of the central portion of the outer peripheral surface of the puncture needle 55G. With this configuration, the puncture needle 55H can further enhance the effect of puncturing the subject portion with respect to the puncture needle 55G, and the punctureability is improved.

The present invention is not limited to the examples described above, and various modifications can be made without departing from the gist of the invention.

[Additional Notes]

(Appendix 1) A sheath that can be inserted into and removed from the endoscopic treatment tool insertion channel and a tubular shape that can be inserted through the sheath and punctured into the subject area in the body cavity to collect living tissue. It is provided with a long puncture needle, an operation unit provided on the base end side of the sheath to operate the advance / retreat of the puncture needle, and a protrusion mechanism provided on the operation unit to project the puncture needle. A puncture needle device for an endoscope, characterized in that a puncture needle device for an endoscope is formed with a sloping blade surface that becomes sharp toward the tip on at least one of the outer peripheral surface and the inner peripheral surface of the tip end portion of the puncture needle.

(Appendix 2) The puncture needle is characterized in that a slanted blade surface that becomes sharp toward the tip is formed on at least one of the outer peripheral surface, the inner peripheral surface, and the inner and outer peripheral surfaces of the tip portion. The puncture needle device for an endoscope according to Appendix 1.

(Appendix 3) The puncture needle has an inner needle that can be inserted into the puncture needle and can move forward and backward, and the puncture needle is the outer periphery of the tip portion of the puncture needle when the inner needle is projected from the tip portion of the puncture needle. The item according to Appendix 1, wherein the blade surface formed in a slanted shape that becomes sharp toward the tip on at least one of the surface and the inner peripheral surface forms a substantially continuous inclination together with the inner needle. Puncture needle device for endoscopes.

(Appendix 4) The puncture needle has a slanted blade surface that becomes sharp toward the tip on at least one of the outer peripheral surface, the inner peripheral surface, and the inner and outer peripheral surfaces of the tip portion, and the entire circumference of the tip portion, substantially The puncture needle device for an endoscope according to Appendix 1, wherein the puncture needle device is formed intermittently along a half circumference, a circumference, or substantially the entire circumference except for a part.

(Appendix 5) In the puncture needle, the tip of the ultrafine tube is cut diagonally with respect to the longitudinal axis direction to form a tip, and the tip is formed on at least one of the outer peripheral surface, the inner peripheral surface, and the inner and outer peripheral surfaces of the tip. The puncture needle device for an endoscope according to Appendix 1, wherein a slanted blade surface that becomes sharp toward the tip is formed.

(Appendix 6) In the puncture needle, the tip of the ultrafine tube is cut perpendicularly to the longitudinal axis direction to form a tip, and the tip is formed on at least one of the outer peripheral surface, the inner peripheral surface, and the inner and outer peripheral surfaces of the tip. The puncture needle device for an endoscope according to Appendix 1, wherein a slope-shaped blade surface that becomes sharp toward the tip is formed.

(Appendix 7) In the puncture needle, the tip of an ultrafine tube is cut in a curved shape from the tip side in the longitudinal axis direction to form a tip, and the outer peripheral surface, inner peripheral surface, and inner and outer peripheral surfaces of the tip are formed. The puncture needle device for an endoscope according to Appendix 1, wherein a slope-shaped blade surface that becomes sharp toward the tip is formed on at least one of the two.

(Appendix 8) The puncture needle has an inclined (displaced) blade surface that becomes sharp toward the tip at least one of the outer peripheral surface, the inner peripheral surface, and the inner and outer peripheral surfaces of the tip of the puncture needle. The puncture needle device for an endoscope according to Appendix 1, wherein the puncture needle device is formed.

(Appendix 9) In the puncture needle, the tip of an ultrafine tube is cut in a curved shape from the tip side in the longitudinal axis direction to form a tip, and the outer peripheral surface, inner peripheral surface, and inner and outer peripheral surfaces of the tip are formed. The endoscope according to Appendix 1, wherein a slanted blade surface that becomes sharp toward the tip is formed on at least one of the blade surfaces, and the blade surface is further formed in the vicinity of the central portion of the curved portion. Puncture needle device.

(Appendix 10) The endoscopic puncture according to Appendix 1, wherein the puncture needle has a holding step portion formed on the inner peripheral surface for hooking and cutting off the living tissue that has entered the inside. Needle device.

(Appendix 11) A sheath that can be inserted into and removed from the endoscopic treatment tool insertion channel, a puncture needle that allows the sheath to be inserted and moved forward and backward, a puncture needle that can be inserted and removed, and an internal needle that can be moved forward and backward. In an endoscopic puncture needle device having an operation portion for operating the advance / retreat of the puncture needle and the inner needle, which is located on the base end side of the sheath, on the outer peripheral surface or the inner peripheral surface of the tip portion of the puncture needle. A puncture needle device for an endoscope, characterized in that a sloping blade surface is formed on substantially the entire circumference and a protrusion mechanism for the puncture needle is provided on the operation portion.

(Appendix 12) A long tubular shape that is formed into a tubular shape by inserting a removable sheath into the endoscopic treatment tool insertion channel and puncturing the subject part in the body cavity so that it can move forward and backward freely. A puncture needle for an endoscope, characterized in that a sloping blade surface that becomes sharp toward the tip is formed on at least one of the outer peripheral surface, the inner peripheral surface, and the inner and outer peripheral surfaces of the tip portion. Mirror puncture needle.

<figref num="1">It is explanatory drawing which shows the state which the puncture needle device for an endoscope of 1st Example is attached to the treatment tool insertion opening of an endoscope.</figref><figref num="2">It is an external view of the puncture needle device for an endoscope of FIG.</figref><figref num="3">It is sectional drawing of the puncture needle device for an endoscope of FIG.</figref><figref num="4">It is an external view which shows the coil sheath of FIG.</figref><figref num="5">It is explanatory drawing which shows the puncture needle part of FIG.</figref><figref num="6">It is explanatory drawing which shows the switch part of FIG.</figref><figref num="7">It is explanatory drawing which shows the tip side of the puncture needle of FIG.</figref><figref num="8">It is explanatory drawing which shows the operation of the front half side of the puncture needle device for an endoscope.</figref><figref num="9">It is explanatory drawing which shows the operation of the latter half side of the puncture needle device for an endoscope.</figref><figref num="10">It is explanatory drawing which shows the puncture preparation state which the tip of the puncture needle part is housed in a coil sheath.</figref><figref num="11">It is explanatory drawing which shows the state when the tip of the puncture needle part protrudes from the tip of a coil sheath and advances to the front of the subject part.</figref><figref num="12">It is explanatory drawing which shows the state when the tip of the puncture needle part is inserted into the subject part and is guided into the target lesion part.</figref><figref num="13">It is explanatory drawing which shows the state when the tip of the puncture needle part reaches the inside of a target lesion part, and the inner needle is removed.</figref><figref num="14">It is explanatory drawing which shows the state when the puncture needle part is deeply inserted into the target lesion part by operating a switch part.</figref><figref num="15">It is explanatory drawing which shows the state when the tip of the puncture needle part is removed from the target lesion part with the sample taken in.</figref><figref num="16">It is explanatory drawing which shows the modification of the puncture needle.</figref><figref num="17">It is sectional drawing which shows the puncture needle of the 2nd Example.</figref><figref num="18">It is explanatory drawing which shows the state when the puncture needle part is guided to the front of the target lesion part.</figref><figref num="19">It is explanatory drawing which shows the state when suction is performed and the target lesion part is pulled into the inside of a puncture needle.</figref><figref num="20">It is explanatory drawing which shows the state when the puncture needle part is deeply inserted into the target lesion part by operating a switch part.</figref><figref num="21">It is explanatory drawing which shows the state when the tip of the puncture needle part is removed from the target lesion part with the sample taken in.</figref><figref num="22">It is explanatory drawing which shows the modification of the puncture needle.</figref><figref num="23">It is explanatory drawing which shows the further modification of the puncture needle.</figref><figref num="24">It is explanatory drawing which shows the conventional puncture needle.</figref>

Code description

1 Puncture needle device (puncture needle device for endoscope) 2 Endoscope 3 Insertion part 8 Treatment tool insertion port (treatment tool insertion channel entrance) 9a Treatment tool outlet 11 Puncture needle part 12 Coil sheath 13 Auxiliary device body 21 Fixed Cylinder 21a Fixing part 22 1st slide part 23 Adjusting cylinder 25 2nd slide part 28 3rd slide part 32 1st fixing screw 34 Switch part 37 Coil spring 44 2nd fixing screw 55 Puncture needle (puncture needle for endoscope) 56 Puncture needle mouthpiece 57 Inner needle 58 Inner needle mouthpiece 81 Blade surface agent Attorney Susumu Ito