阅读说明：本技术 内窥镜 (Endoscope with a detachable handle ) 是由 福泽常夫 森本康彦 于 2019-08-26 设计创作，主要内容包括：本发明提供一种内窥镜,其能够适当地照明插入部的插入方向侧和处置器具及其处置对象部位,并且能够减小插入部的前端部的直径。本发明的内窥镜具备：处置器具导出口,形成于前端部主体,并使处置器具导出；立起台,控制从处置器具导出口导出的处置器具的导出方向；观察窗,在将与纵轴和处置器具导出口的开口面的法线方向两者垂直的方向设为处置器具导出口的宽度方向的情况下,在前端部主体上设置于比处置器具导出口更靠近宽度方向的一方向侧的位置；及第1照明窗,在前端部主体上设置于比处置器具导出口更靠近与一方向侧相反的另一方向侧的位置,从宽度方向侧观察时,将观察窗的观察轴相对于与纵轴平行的基准轴的倾斜角度设为观察轴角度,当从宽度方向侧观察时,将第1照明窗的第1照明轴相对于基准轴的倾斜角度设为第1照明轴角度的情况下,第1照明轴角度小于观察轴角度。(The invention provides an endoscope which can properly illuminate an insertion direction side of an insertion part, a treatment tool and a treatment target part thereof, and can reduce the diameter of a front end part of the insertion part. An endoscope of the present invention includes: a treatment instrument lead-out port formed in the distal end portion main body and used for leading out a treatment instrument; a standing stand for controlling a direction of the treatment instrument led out from the treatment instrument outlet; an observation window provided on the distal end portion body at a position on one side in the width direction with respect to the treatment instrument lead-out port, the observation window being defined by a direction perpendicular to both the longitudinal axis and a normal direction of an opening surface of the treatment instrument lead-out port as the width direction of the treatment instrument lead-out port; and a1 st illumination window provided on the distal end portion body at a position closer to the other direction side opposite to the one direction side than the treatment instrument lead-out port, wherein when viewed from the width direction side, an inclination angle of an observation axis of the observation window with respect to a reference axis parallel to the vertical axis is set as an observation axis angle, and when viewed from the width direction side, an inclination angle of a1 st illumination axis of the 1 st illumination window with respect to the reference axis is set as a1 st illumination axis angle, the 1 st illumination axis angle is smaller than the observation axis angle.)

1. An endoscope, comprising:

a distal end body provided on a distal end side of the insertion portion and having a distal end, a proximal end, and a longitudinal axis;

a treatment instrument outlet port formed in the distal end portion body and configured to lead out a treatment instrument inserted into the insertion portion;

a standing stand which is rotatably supported in the treatment instrument outlet port of the distal end portion body and controls a direction of leading out the treatment instrument from the treatment instrument outlet port;

an observation window provided on the distal end portion body at a position closer to one side in the width direction than the treatment instrument outlet port, when a direction perpendicular to both the longitudinal axis and a normal direction of an opening surface of the treatment instrument outlet port is set to the width direction of the treatment instrument outlet port; and

a1 st illumination window provided in the distal end portion body at a position closer to the other direction side opposite to the one direction side than the treatment instrument lead-out port,

when the observation window is viewed from the width direction side, an inclination angle of an observation axis of the observation window with respect to a reference axis parallel to the longitudinal axis is set as an observation axis angle, and when the observation window is viewed from the width direction side, an inclination angle of a1 st illumination axis of the 1 st illumination window with respect to the reference axis is set as a1 st illumination axis angle, the 1 st illumination axis angle is smaller than the observation axis angle.

2. The endoscope of claim 1,

the observation axis and the 1 st illumination axis are both inclined toward the distal end side of the distal end portion body from an attitude perpendicular to both the width direction and the longitudinal axis.

3. The endoscope of claim 1 or 2,

the tip end body has: the 1 st inclined plane takes the observation shaft as a normal line and is provided with the observation window; and a2 nd inclined surface which is provided with the 1 st illumination window with the 1 st illumination axis as a normal line.

4. The endoscope of any one of claims 1 to 3,

the 1 st illumination range of the illumination light emitted from the 1 st illumination window includes an observation range of the observation window.

5. The endoscope of any one of claims 1 to 4,

the observation window and the 1 st illumination window are provided on the distal end portion body at a position closer to a proximal end side of the distal end portion body than the treatment instrument lead-out port.

6. The endoscope according to any one of claims 1 to 5, comprising a2 nd illumination window provided on the distal end portion body at a position closer to the one direction side than the treatment instrument lead-out port,

a2 nd illumination axis of the 2 nd illumination window is inclined toward a tip side of the tip main body from a posture perpendicular to both the width direction and the longitudinal axis,

when the 2 nd illumination axis is inclined at the 2 nd illumination axis angle with respect to the reference axis when viewed from the width direction side, the 2 nd illumination axis angle is equal to the observation axis angle.

7. The endoscope of claim 6,

the 2 nd illumination window is provided on the distal end portion body at a position closer to a proximal end side of the distal end portion body than the treatment instrument introduction port.

8. The endoscope of claim 6 or 7,

the tip end body has a1 st inclined surface, the 1 st inclined surface being provided with the observation window with the observation axis as a normal line,

the 2 nd illumination window is provided on the 1 st inclined surface.

9. The endoscope of any one of claims 6 to 8,

the 2 nd illumination range of the illumination light emitted from the 2 nd illumination window includes the observation range of the observation window.

10. The endoscope of any one of claims 1 to 9,

an upright table support member rotatably supporting the upright table is provided in the front end portion body at a position on the other direction side of the upright table,

a light guide for emitting illumination light through the 1 st illumination window is inserted into the insertion portion,

the rising table support member holds a light guide tip portion of the light guide on the 1 st illumination window side.

11. The endoscope of any one of claims 1-10,

the treatment instrument is provided with an ultrasonic transducer that is provided on the distal end portion body and is positioned on the distal end side of the distal end portion body with respect to the treatment instrument outlet.

Technical Field

The present invention relates to an endoscope including a treatment instrument introduction port and an erecting base on a distal end side of an insertion portion.

Background

As an ultrasonic endoscope, there is known an endoscope in which an electronic scanning type ultrasonic transducer is provided at a distal end portion of an insertion portion of the endoscope, and a treatment instrument introduction port is disposed at a proximal end side of the ultrasonic transducer at the distal end portion. In an endoscopic examination using this ultrasonic endoscope, for example, a puncture treatment instrument that is passed through a treatment instrument insertion channel and a treatment instrument exit port and is guided into the body is inserted into a treatment target site to collect cells while an ultrasonic image of the treatment target site (including a site to be observed, an examination site, and the like) is acquired by an ultrasonic transducer. Then, in order to treat a desired position with such a treatment instrument, it is necessary to change the direction of the treatment instrument to be led out from the treatment instrument outlet formed at the distal end portion of the insertion portion. Therefore, a treatment instrument raising mechanism is provided inside the treatment instrument outlet at the distal end of the insertion portion (see patent documents 1 to 5).

The treatment instrument erecting mechanism includes an erecting base accommodating chamber, an erecting base rotating mechanism, and the like. The stand accommodating chamber is provided in a treatment instrument lead-out opening at the distal end of the insertion portion. The stand is rotatably supported about a rotation axis in the stand housing chamber. The stand rotating mechanism rotates the stand in accordance with a stand rotating operation performed by an operation portion of the ultrasonic endoscope.

An illumination window for emitting illumination light to a treatment target site or the like is provided on the outer surface of the distal end portion of the insertion portion, in addition to an observation window for observing the treatment instrument lead-out port and the treatment target site. A light guide (optical fiber cable) for guiding illumination light from the light source device to the illumination window is inserted into the insertion portion.

In the ultrasonic endoscopes described in patent documents 1 to 3, the illumination window is provided on the outer surface of the distal end portion of the insertion portion and at a position closer to the distal end side of the distal end portion than the treatment instrument lead-out port. In the ultrasonic endoscopes described in patent documents 4 and 5, when a direction parallel to the rotation axis of the standing table is set to the width direction of the treatment instrument lead-out port, the illumination window is provided on the outer surface of the distal end portion of the insertion portion and at a position on one side in the width direction with respect to the treatment instrument lead-out port.

In the endoscope described in patent document 6, the illumination window is provided on the outer surface of the distal end portion of the insertion portion and at a position closer to the insertion direction side (distal end side) than the observation window. In the ultrasonic endoscope described in patent document 7, two illumination windows are provided on the outer surface of the distal end portion of the insertion portion and at positions closer to the proximal end side of the distal end portion than the treatment instrument lead-out port.

Prior art documents

Patent document

Patent document 1: japanese patent laid-open publication No. 2005-287593

Patent document 2: japanese patent laid-open publication No. 2005-261746

Patent document 3: japanese patent laid-open publication No. 2005-287526

Patent document 4: japanese patent laid-open publication No. 8-126643

Patent document 5: japanese patent laid-open publication No. 8-126604

Patent document 6: japanese patent laid-open No. Sho 58-168711

Patent document 7: japanese patent laid-open No. 2007-252457

Disclosure of Invention

Technical problem to be solved by the invention

In the distal end portion of the insertion portion of the ultrasonic endoscope described in patent documents 1 to 3, the illumination window is disposed at a position closer to the distal end side of the distal end portion than the treatment instrument lead-out port, and therefore there is a possibility that the illumination light does not illuminate the treatment instrument led out from the treatment instrument lead-out port and the treatment target site thereof. Further, when the treatment instrument is displaced as the stand table rotates, the illumination mode of the illumination light with respect to the treatment instrument is changed, and thus, there is a possibility that the endoscope image is difficult to be observed, or the treatment instrument and the treatment target region thereof are out of the illumination range of the illumination light.

In the distal end portion of the insertion portion of the ultrasonic endoscope described in patent document 4 and patent document 5, the illumination window is disposed at a position on one side in the width direction with respect to the treatment instrument lead-out port, and therefore, compared to the ultrasonic endoscopes described in patent documents 1 to 3, the possibility that the treatment instrument and the treatment target site thereof enter within the illumination range of the illumination light is improved. However, in the ultrasonic endoscopes described in patent documents 4 and 5, the amount of illumination light emitted from the illumination window toward the insertion direction side of the insertion portion decreases, and the visibility (forward visibility) of the inner wall of the lumen located on the insertion direction side may decrease.

In the ultrasonic endoscopes described in patent documents 4 and 5, for example, when the inner wall surface of a lumen that is narrow such as a duodenum is illuminated, the distance between the illumination window and the inner wall surface of the lumen is excessively close, and therefore the amount of illumination light that is irradiated from the illumination window to the inner wall surface of the lumen may become excessively large. In this case, a halo is caused to be generated in the endoscopic image.

Patent document 6 does not describe any contents of illuminating the treatment instrument and the treatment target site with the illumination light emitted from the illumination window.

In the distal end portion of the insertion portion of the ultrasonic endoscope described in patent document 7, the illumination window is disposed at a position closer to the proximal end side of the distal end portion than the treatment instrument lead-out port, so that the possibility that the treatment instrument and the treatment target site thereof enter the illumination range of the illumination light is improved as compared with the ultrasonic endoscopes described in patent documents 1 to 5. However, in the ultrasonic endoscope described in patent document 7, the amount of illumination light emitted from the illumination window toward the insertion direction side of the insertion portion is also reduced, and the front visibility may be reduced.

The illumination axis of the illumination window described in each of the above patent documents is inclined with respect to a reference axis parallel to the longitudinal axis of the distal end portion of the insertion portion. Therefore, as the inclination angle of the illumination axis of the illumination window is larger, it is necessary to increase the inclination angle of the tip portion of the light guide (light guide tip portion) arranged in the tip portion with respect to the reference axis (see fig. 16 described later). In this case, if the diameter of the distal end portion of the insertion portion is not increased, the space for disposing the distal end portion of the light guide in the distal end portion cannot be secured.

The present invention has been made in view of such circumstances, and an object thereof is to provide an endoscope capable of appropriately illuminating the insertion direction side of an insertion portion, a treatment instrument, and a treatment target site thereof, and reducing the diameter of a distal end portion of the insertion portion.

Means for solving the technical problem

An endoscope for achieving the object of the present invention includes: a distal end body provided on a distal end side of the insertion portion and having a distal end, a proximal end, and a longitudinal axis; a treatment instrument outlet port formed in the distal end portion body and configured to lead out a treatment instrument inserted into the insertion portion; a standing stand which is rotatably supported in the treatment instrument outlet of the distal end portion body and controls a direction of the treatment instrument led out from the treatment instrument outlet; an observation window provided on the distal end portion body at a position on one side in the width direction with respect to the treatment instrument lead-out port, the observation window being defined by a direction perpendicular to both the longitudinal axis and a normal direction of an opening surface of the treatment instrument lead-out port as the width direction of the treatment instrument lead-out port; and a1 st illumination window provided on the distal end portion body at a position closer to the other direction side opposite to the one direction side than the treatment instrument lead-out port, wherein when viewed from the width direction side, an inclination angle of an observation axis of the observation window with respect to a reference axis parallel to the vertical axis is set as an observation axis angle, and when viewed from the width direction side, an inclination angle of a1 st illumination axis of the 1 st illumination window with respect to the reference axis is set as a1 st illumination axis angle, the 1 st illumination axis angle is smaller than the observation axis angle.

According to this endoscope, the illumination light quantity on the insertion direction side of the illumination insertion portion can be increased, and the illumination light quantity of the illumination light applied to the inner wall surface of the lumen can be reduced. Further, the inclination angle of the light guide tip of the light guide corresponding to the 1 st illumination window can be reduced.

In the endoscope according to the other aspect of the present invention, both the observation axis and the 1 st illumination axis are inclined toward the distal end side of the distal end portion main body from a posture perpendicular to both the width direction and the longitudinal axis.

In an endoscope according to another aspect of the present invention, a distal end portion main body includes: the 1 st inclined plane, regard observation axis as the normal and have observation windows; and a2 nd inclined surface having a1 st illumination axis as a normal line and a1 st illumination window.

In an endoscope according to another aspect of the present invention, the 1 st illumination range of the illumination light emitted from the 1 st illumination window includes an observation range of the observation window. This can improve the visibility of the observation range of the observation window.

In an endoscope according to another aspect of the present invention, the observation window and the 1 st illumination window are provided on the distal end portion body at positions closer to the proximal end side of the distal end portion body than the treatment instrument lead-out port. Accordingly, regardless of the rotational position of the standing table, the treatment instrument and the treatment target site thereof can be reliably illuminated with the illumination light from the 1 st illumination window, and observation can be performed through the observation window.

In the endoscope according to the other aspect of the present invention, the 2 nd illumination window is provided at the distal end portion body at a position closer to the one direction side than the treatment instrument lead-out port, the 2 nd illumination axis of the 2 nd illumination window is inclined toward the distal end side of the distal end portion body from an attitude perpendicular to both the width direction and the longitudinal axis, and when an inclination angle of the 2 nd illumination axis with respect to the reference axis is set to the 2 nd illumination axis angle when viewed from the width direction side, the 2 nd illumination axis angle is equal to the observation axis angle. Thus, the treatment instrument and the treatment target site can be reliably illuminated with the illumination light from the 2 nd illumination window.

In an endoscope according to another aspect of the present invention, the 2 nd illumination window is provided on the distal end portion body at a position closer to the proximal end side of the distal end portion body than the treatment instrument lead-out port. Thus, the treatment instrument and the treatment target site can be reliably illuminated with the illumination light from the 2 nd illumination window.

In an endoscope according to another aspect of the present invention, the distal end portion body has a1 st inclined surface in which an observation window is provided with an observation axis as a normal line, and the 2 nd illumination window is provided in the 1 st inclined surface.

In the endoscope according to the other aspect of the present invention, the 2 nd illumination range of the illumination light emitted from the 2 nd illumination window includes the observation range of the observation window. This can improve the visibility of the observation range of the observation window.

In an endoscope according to another aspect of the present invention, an upright-table support member that rotatably supports the upright table is provided in the distal-end-portion body at a position on the other side of the upright table in the other direction, a light guide that emits illumination light through the 1 st illumination window is inserted into the insertion portion, and the upright-table support member holds the light guide distal end portion on the 1 st illumination window side of the light guide. Since the inclination angle of the light guide tip portion of the light guide corresponding to the 1 st illumination window can be reduced, the diameter of the tip portion of the insertion portion can be reduced.

An endoscope according to another aspect of the present invention includes an ultrasonic transducer provided at the distal end portion body and located on a distal end side of the distal end portion body with respect to the treatment instrument introduction port.

Effects of the invention

The invention can properly illuminate the insertion direction side of the insertion part, the treatment tool and the treatment target part thereof, and can reduce the diameter of the front end part of the insertion part.

Drawings

Fig. 1 is a schematic diagram of an ultrasonic inspection system to which an endoscope of the present invention is applied.

Fig. 2 is a schematic diagram showing a piping structure of the ultrasonic endoscope.

Fig. 3 is an external perspective view of the distal end portion of the insertion portion.

Fig. 4 is a right side view of the insertion portion.

Fig. 5 is an exploded perspective view of the distal end portion of the insertion portion.

Fig. 6 is a perspective view of the vertical type housing.

Fig. 7 is a front view of the exterior case when the exterior case is viewed from the front end side.

Fig. 8 is a perspective view of an upright housing holding a light guide.

Fig. 9 is a schematic diagram showing an example of the raising table operating mechanism.

Fig. 10 is an explanatory diagram for explaining the rotation of the rising base in response to the operation of the operation lever.

Fig. 11 is a plan view of the exterior case.

Fig. 12 is an enlarged plan view of a part of the 1 st inclined surface as viewed from the normal direction side thereof.

Fig. 13 is a sectional view taken along line 13-13 of fig. 12.

Fig. 14 is an explanatory view for explaining an observation axis and an observation range of the observation window, a1 st illumination axis and a1 st illumination range of the 1 st illumination window, and a2 nd illumination axis and a2 nd illumination range of the 2 nd illumination window.

Fig. 15 is a side view of the distal end portion of the insertion portion inserted into the lumen.

Fig. 16 is an explanatory view for explaining the reduction in diameter of the distal end portion of the insertion portion.

Fig. 17 is a plan view of an exterior case according to another embodiment.

Detailed Description

[ Structure of ultrasonic inspection System and ultrasonic endoscope ]

Fig. 1 is a schematic diagram of an ultrasonic inspection system 2 to which an endoscope of the present invention is applied. As shown in fig. 1, the ultrasonic inspection system 2 includes: an ultrasonic endoscope 10 that photographs the inside of a lumen 154 (also referred to as a body cavity, see fig. 15) of a subject; an ultrasonic processor device 12 for generating an ultrasonic image; an endoscope processor device 14 for generating an endoscope image; a light source device 16 that supplies illumination light for illuminating the inside of the lumen 154 to the ultrasonic endoscope 10; and a monitor 18 for displaying the ultrasonic image and the endoscopic image.

The ultrasonic endoscope 1() corresponds to the endoscope of the present invention, and includes an insertion section 20, an operation section 22, and a universal cord 24.

The insertion portion 20 is inserted into various lumens 154 (refer to fig. 15). The operation section 22 is provided continuously to the proximal end side of the insertion section 20 and receives an operation by the doctor.

An operation unit 22 is connected to one end of the universal cord 24. An ultrasound connector 27 connected to the ultrasound processor device 12, an endoscope connector 28 connected to the endoscope processor device 14, and a light source connector 30 connected to the light source device 16 are provided on the other end side of the universal cord 24. The light source connector 30 is connected to a water supply tank 118 via an air/water supply pipe 32, and to a suction pump 124 via a suction pipe 34.

The ultrasonic processor device 12 generates an ultrasonic image from an ultrasonic detection signal output from the ultrasonic endoscope 10. The processor device 14 for endoscope generates an endoscope image from the image pickup signal output from the ultrasonic endoscope 10.

The light source device 16 is connected to an incident end of a light guide 128 (see fig. 2) inserted through the insertion portion 20, the operation portion 22, the universal cord 24, and the light source connector 30. The light source device 16 supplies illumination light to the incident end of the light guide 128. The illumination light is irradiated from the light guide 128 to the treatment target region through the illumination windows 90A and 90B (see fig. 3) described later.

The monitor 18 is connected to both the ultrasonic processor device 12 and the endoscope processor device 14, and displays an ultrasonic image generated by the ultrasonic processor device 12 and an endoscope image generated by the endoscope processor device 14. In the display of the ultrasonic image and the endoscopic image, only one of them or both of them can be selectively displayed.

The operation unit 22 is provided with an air/water feeding button 36 and a suction button 38 in parallel, and a pair of corner buttons 42, an operation lever 43, a treatment instrument insertion port 44, and the like.

The insertion portion 20 has a distal end, a proximal end, and a longitudinal axis, and includes a distal end portion 50, a bent portion 52, and a soft portion 54 in this order from the distal end side toward the proximal end side. The distal end portion 50 is formed of a hard member, and is also referred to as a distal end hard portion. An ultrasonic transducer 62 is provided at the distal end portion 50, and a balloon 64 covering the ultrasonic transducer 62 is detachably attached.

The bending portion 52 has one end connected to the proximal end side of the distal end portion 50 and the other end connected to the distal end side of the soft portion 54. The bending portion 52 is configured to be bendable and is remotely bent by rotating the pair of corner knobs 42. This enables the distal end portion 50 to be oriented in a desired direction.

The flexible portion 54 has a small diameter and a long length, and is flexible, and connects the bending portion 52 and the operation portion 22.

Fig. 2 is a schematic diagram showing a piping structure of the ultrasonic endoscope 10. As shown in fig. 2, a treatment instrument insertion channel 100, an air/water supply channel 102, and a balloon channel 104 having one end communicating with the internal space of the balloon 64 are provided in the insertion portion 20 and the operation portion 22.

One end side of the treatment instrument insertion channel 100 is connected to a vertical housing 200 (see fig. 3) described later, and the other end side of the treatment instrument insertion channel 100 is connected to a treatment instrument insertion port 44 in the operation unit 22. Thereby, the treatment instrument insertion port 44 and a treatment instrument outlet port 94 (see fig. 3) described later communicate with each other through the treatment instrument insertion channel 100. A suction line 106 branches from the treatment instrument insertion channel 100, and the suction line 106 is connected to the suction button 38.

One end side of the air/water supply line 102 is connected to an air/water supply nozzle 92 (see fig. 3) described later, and the other end side of the air/water supply line 102 is branched into an air supply line 108 and a water supply line 110. The air supply pipe 108 and the water supply pipe 110 are connected to the air supply/water supply button 36, respectively.

One end side of the balloon conduit 104 is connected to a supply/discharge port 70 that opens at a position inside the balloon 64 in the outer peripheral surface of the distal end portion 50, and the other end side of the balloon conduit 104 is branched into a balloon water supply conduit 112 and a balloon water discharge conduit 114. The balloon water supply line 112 is connected to the air and water supply button 36, and the balloon water discharge line 114 is connected to the suction button 38.

The air/water supply button 36 is connected to one end of an air supply line 116 connected to an air supply pump 129 and one end of a water supply line 120 connected to a water supply tank 118, in addition to the air supply line 108, the water supply line 110, and the balloon water supply line 112. The air feed pump 129 is operated at all times during the ultrasonic observation.

A branch line 122 branches from the air supply line 116, and the branch line 122 is connected to an inlet (above the liquid surface) of the water supply tank 118. The other end of the water supply line 120 is inserted into the water supply tank 118 (below the liquid surface). Then, when the internal pressure of the water supply tank 118 rises due to the supply of air from the air supply pump 129 via the branch pipe 122, the water in the water supply tank 118 is supplied to the water supply source pipe 120.

The air/water feeding button 36 is a known two-stage switching button. The air/water supply button 36 switches between leakage of air supplied from the air supply line 116, ejection of air from the air/water supply nozzle 92, ejection of water from the air/water supply nozzle 92, and supply of water into the balloon 64 in response to an operation by the doctor. Since a specific switching method is a known technique, a description thereof will be omitted.

The suction button 38 is connected to one end side of a suction source pipe 126 in addition to the suction pipe 106 and the balloon drainage pipe 114. A suction pump 124 is connected to the other end side of the suction source line 126. The suction pump 124 is also operated at all times during the ultrasonic observation. The suction button 38 is a two-stage switching type button, similar to the air/water feeding button 36.

The suction button 38 switches the connection of the suction source line 126 to the outside (atmosphere), the suction of various aspirant from the treatment instrument outlet port 94 (see fig. 3), and the drainage of water into the balloon 64 in accordance with the operation by the doctor. Since a specific switching method is a known technique, a description thereof will be omitted.

Returning to fig. 1, the operation lever 43 of the operation unit 22 is used to change the direction of the treatment instrument (not shown, and the same applies hereinafter) guided from the treatment instrument guide outlet 94 (see fig. 3), as will be described in detail later.

[ Structure of distal end portion of insertion portion ]

Fig. 3 is an external perspective view of the distal end portion 50 of the insertion portion 20. Fig. 4 is a right side view of the insertion portion 20. Fig. 5 is an exploded perspective view of the distal end portion 50 of the insertion portion 20. In fig. 3 and 5, the balloon 64 is not shown. In fig. 5, the light guide 128 is not shown.

As shown in fig. 3 to 5, the distal end portion 50 includes an outer case 72 (also referred to as a case) corresponding to the distal end portion body of the present invention. The outer case 72 has a distal end constituting the distal end of the insertion portion 20, a proximal end connected to the bending portion 52, and a longitudinal axis LA. Hereinafter, the distal end side of the outer case 72 is referred to as "outer case distal end side", and the proximal end side of the outer case 72 is referred to as "outer case proximal end side".

The external case 72 is provided with an ultrasonic observation unit 60 for acquiring an ultrasonic detection signal, a treatment instrument lead-out port 94 of a treatment instrument, a1 st inclined surface 86A and a2 nd inclined surface 86B, and an endoscopic observation unit 80 for acquiring an imaging signal, from the distal end side of the external case toward the proximal end side of the external case. Further, inside the outer case 72, an upright stand accommodating chamber 94a and an upright stand 96 which are located inside the treatment instrument outlet 94, and a metal upright case 200 (also referred to as an upright stand assembly) which rotatably supports the upright stand 96 are provided. The outer case 72 is provided with a lever housing cover 76.

The treatment instrument outlet 94 is opened at a position between the ultrasonic observation unit 60 and the endoscope observation unit 80 (the 1 st inclined surface 86A) on the outer surface of the outer case 72. The treatment instrument inserted into the treatment instrument insertion channel 100 of the insertion section 20 is led out from the treatment instrument outlet 94. Hereinafter, as shown in fig. 3, a direction perpendicular to both the vertical axis LA and the normal direction NV of the opening surface of the treatment instrument lead-out opening 94 is defined as the width direction WD of the treatment instrument lead-out opening 94, one direction side of the width direction WD is defined as the L direction side, and the other direction side opposite to the one direction side of the width direction WD is defined as the R direction side.

The 1 st inclined surface 86A and the 2 nd inclined surface 86B are inclined surfaces inclined toward the outer case proximal end side from an attitude parallel to the width direction WD and perpendicular to the longitudinal axis LA. As will be described in detail later, the inclination angle of the 1 st inclined surface 86A is different from the inclination angle of the 2 nd inclined surface 86B. Further, the 1 st inclined surface 86A is provided with an observation window area 86A1, a nozzle area 86A2, and an illumination window area 86A 3.

The 1 st inclined surface 86A is formed on the outer surface of the outer case 72 at a position closer to the proximal end side of the outer case than the treatment instrument lead-out port 94 in the direction along the longitudinal axis LA except for the illumination window region 86A 3. The 1 st inclined surface 86A is formed on the outer surface of the outer case 72 from the formation region of the treatment instrument lead-out opening 94 to the region on the L direction side thereof in the width direction WD. The 1 st inclined surface 86A is provided with an observation window 88 of the endoscope observation portion 80, a2 nd illumination window 90B, and an air/water feeding nozzle 92.

The 2 nd inclined surface 86B is formed on the outer surface of the outer case 72 on the side closer to the outer case distal end than the observation window region 86A1 of the 1 st inclined surface 86A in the direction along the longitudinal axis LA, and is formed on the side closer to the R direction than the region where the treatment instrument outlet 94 is formed in the width direction WD. A1 st illumination window 90A is provided on the 2 nd inclined surface 86B. Further, 2 nd inclined surface 86B may be formed at the same position as observation window region 86a1, at a position closer to the outer case proximal end side than observation window region 86a1, or at a position closer to the outer case distal end side than illumination window region 86A3 in the direction along longitudinal axis LA.

The ultrasonic observation unit 60 is provided on the outer case 72 at a position closer to the distal end side of the outer case than the treatment instrument outlet 94. The ultrasonic observation unit 60 includes an ultrasonic transducer 62 including a plurality of ultrasonic transducers. The ultrasonic transducers of the ultrasonic transducer 62 are sequentially driven in accordance with a drive signal input from the ultrasonic processor device 12. Thus, each ultrasonic transducer sequentially generates an ultrasonic wave to the treatment target site and receives an ultrasonic echo (echo signal) reflected at the treatment target site. Then, each ultrasonic transducer outputs an ultrasonic detection signal (electric signal) corresponding to the received ultrasonic echo to the ultrasonic processor device 12 via a signal cable (not shown) inserted into the insertion portion 20, the universal cord 24, and the like. As a result, an ultrasonic image is generated in the ultrasonic processor device 12.

The balloon 64 is attached to the outer case 72 on the distal end side of the outer case with respect to the treatment instrument lead-out port 94, and is formed in a bag shape covering the ultrasonic transducer 62, thereby preventing attenuation of ultrasonic waves and ultrasonic echoes. The balloon 64 is formed of an elastic material having elasticity such as latex rubber, and a retractable locking ring 66 is provided at an opening end on the proximal end side of the outer casing. Between the ultrasonic observation unit 60 and the treatment instrument outlet 94 in the outer case 72, the locking groove 68 is provided over the entire circumference of the outer case 72 in the circumferential direction. Then, the balloon 64 is detachably attached to the outer case 72 by fitting the locking ring 66 into the locking groove 68.

The endoscope observation portion 80 has an observation window 88 provided on the 1 st inclined surface 86A. Although not shown, an observation optical system (such as an objective lens) and a CCD (Charge Coupled Device) type or CMOS (Complementary Metal Oxide Semiconductor) type imaging element or the like constituting the endoscope observation unit 80 are disposed in the exterior case 72 and behind the observation window 88. The imaging element captures an observation image introduced through the observation window 88. The imaging element then outputs an image pickup signal of an observation image to the processor device 14 for an endoscope via a signal cable, not shown, inserted into the insertion portion 20, the universal cord 24, and the like. As a result, an endoscopic image is generated in the processor device for endoscope 14.

As will be described in detail later, the 1 st illumination window 90A and the 2 nd illumination window 90B emit illumination light forward of each other. An ejection end of the light guide 128 is disposed behind the illumination windows 90A and 90B in the outer case 72. Accordingly, as shown in fig. 2, by connecting the light source connector 30 to the light source device 16, the illumination light emitted from the light source device 16 is guided to the illumination windows 90A and 90B via the light guide 128, and the illumination light is emitted from the illumination windows 90A and 90B.

The air/water supply nozzle 92 is connected to one end side of the air/water supply line 102 shown in fig. 2, and discharges a fluid such as water or air to the observation window 88 in order to clean foreign matter and the like adhering to the surface of the observation window 88.

The exterior case 72 accommodates the respective parts of the ultrasonic observation unit 60 and the endoscope observation unit 80, and a standing stand 96 and a vertical case 200, which will be described later. In the outer case 72, a portion closer to the outer case proximal end side than the ultrasonic observation unit 60 is divided into two portions in the vertical direction in the drawing with a plane parallel to both the vertical axis LA and the width direction WD as a boundary. Therefore, the outer case 72 is composed of an outer case main body 72a located on the lower side in the figure and an outer case lid 72b located on the upper side in the figure.

The outer case main body 72a accommodates the ultrasound observation unit 60 at a distal end portion closer to the outer case distal end side than the treatment instrument lead-out port 94, and has a locking groove 68. The outer case body 72a has an opening 71 provided in a portion closer to the outer case proximal end side than the locking groove 68, and has an opening 71 covered with an outer case cover 72b (see fig. 5). The exterior case main body 72a accommodates a part of each of the standing stand 96 and the upright case 200 in the opening 71.

A groove portion 74 (see fig. 4) formed along the longitudinal axis LA and the supply/discharge port 70 opened at the end portion of the groove portion 74 on the housing base end side are formed on the side surface on the L direction side of the distal end portion of the housing main body 72 a. This allows water to be supplied to the interior of the balloon 64 through the supply/discharge port 70 or water in the interior of the balloon 64 to be discharged.

The exterior case cover 72b is detachably attached to the opening 71 of the exterior case body 72 a. The treatment instrument lead-out opening 94, the 1 st inclined surface 86A, and the 2 nd inclined surface 86B are formed in the outer case cover 72B from the outer case distal end side toward the outer case proximal end side. The exterior case cover 72B covers the endoscope observation portion 80 and the two light guides 128 that guide illumination light to the illumination windows 90A and 90B.

When the outer case cover 72b is attached to the opening 71 of the outer case body 72a, a standing table housing chamber 94a, which is a housing space for the standing table 96, is formed inside the treatment instrument outlet 94. Partition wall 73 (see fig. 5) forming the L-direction side surface of raised platform accommodating chamber 94a is formed across both outer case main body 72a and outer case cover 72 b.

A fitting hole 75 (see fig. 5) for fitting the lever housing cover 76 is formed in the side surface of the outer housing main body 72a and the outer housing cover 72b on the R direction side so as to extend across the outer housing main body 72a and the outer housing cover 72b at a position facing a lever housing chamber 212 (see fig. 5) of the stand-up housing 200, which will be described later.

The standing stand accommodating chamber 94a communicates with the treatment instrument insertion port 44 via the treatment instrument insertion passage 100 (see fig. 2) and the like. Therefore, the treatment instrument inserted into the treatment instrument insertion port 44 is introduced from the treatment instrument outlet port 94 into the lumen 154 (see fig. 15) via the treatment instrument insertion passage 100, the standing stand accommodating chamber 94a, and the like.

The standing stand 96 is rotatably supported (axially supported) by the vertical housing 200 via a rotating shaft 216 (see fig. 6) in the standing stand accommodating chamber 94 a. The rising stand 96 has an arc-shaped guide surface 96a, and the arc-shaped guide surface 96a guides the treatment instrument guided into the rising stand accommodating chamber 94a to the treatment instrument outlet 94. Thus, the raising table 96 switches the direction of the treatment instrument guided from the treatment instrument insertion path 100 into the raising table housing chamber 94a, and leads the treatment instrument out of the treatment instrument lead-out port 94. As will be described in detail later, the raising table 96 rotates about the rotation shaft 216 in the raising table housing chamber 94a in response to the operation of the operating lever 43, thereby changing the direction of the treatment instrument introduced from the treatment instrument outlet port 94 into the lumen 154 (see fig. 15). Accordingly, the raising table 96 controls the direction of the treatment instrument led out from the treatment instrument lead-out port 94.

The lever accommodation cover 76 is fitted into a fitting hole 75 in the outer surface of the outer case 72. The rod housing cover 76 is detachably mounted to the vertical housing 200 by a bolt 77 penetrating the rod housing cover 76 in a state of being fitted to the fitting hole 75 (see fig. 5).

[ Structure of vertical housing ]

Fig. 6 is a perspective view of the stand type casing 200, and fig. 7 is a front view of the stand type casing 200 when the stand type casing 200 is viewed from the outer casing front end side. Fig. 8 is a perspective view of the vertical housing 200 holding the light guide 128. As shown in fig. 6 to 8 and fig. 5, the vertical housing 200 corresponds to the rising stand supporting member of the present invention, and is formed of, for example, a metal material having corrosion resistance. The vertical housing 200 has a base 202 and a partition wall 204 extending from the base 202 toward the front end of the housing.

The distal end surface of the base 202 on the distal end side of the outer case constitutes a side surface of the outer case proximal end side of the standing stand accommodating chamber 94 a. Further, a through hole 202a parallel to the longitudinal axis LA is formed in the base 202, and a through hole 202a communicating with the standing table accommodating chamber 94a and the treatment instrument insertion passage 100 is formed. Thus, the treatment instrument insertion passage 100 and the raising table housing chamber 94a communicate with each other through the through-hole 202 a.

An optical guide holding groove 203 is formed in the upper surface (surface on the side of the treatment instrument in the direction of the lead-out direction) of the outer wall surface of the base 202. Here, the 1 st illumination window 90A is disposed on the upper side (the side perpendicular to both the vertical axis LA and the width direction WD) of the vertical housing 200, and the light guide 128 corresponding to the 1 st illumination window 90A is disposed along the upper surface of the base 202. Therefore, the light guide holding groove 203 holds the emission end of the light guide 128 corresponding to the 1 st illumination window 90A at a position facing the 1 st illumination window 90A. The light guide 128 corresponding to the 1 st illumination window 90A corresponds to the light guide of the present invention. Further, by holding the light guide 128 on the upper surface side of the base 202 by the light guide holding groove 203, the light guide 128 can be prevented from interfering with the operation wire 222 described later.

The light guide 128 corresponding to the 1 st illumination window 90A has a light guide distal end portion 141 which is a distal end portion on the side facing the 1 st illumination window 90A. The tip portion of the light guide tip portion 141 on the emission end side is inclined at a later-described 1 st illumination axis angle θ 1 (see fig. 14) corresponding to the base end portion of the light guide tip portion 141 parallel to the longitudinal axis LA. The proximal end portion of the light guide distal end portion 141 is held by the light guide holding groove 203.

As described above, the light guide 128 corresponding to the 2 nd illumination window 90B is accommodated in the exterior case cover 72B and is located at a position shifted to the L direction side from the base 202. A tip portion (emission end) of a tip portion 141 (not shown) of the light guide 128 facing the 2 nd illumination window 90B is inclined at a2 nd illumination axis angle θ 2 (see fig. 14) described later, corresponding to a base end portion of the tip portion 141 parallel to the longitudinal axis LA.

The partition 204 is provided between the rising stand 96 (rising stand accommodating chamber 94a) and a rising stand upright 210 (rod accommodating chamber 212) described later. The partition 204 has a side wall surface 206 which is a side surface on the R direction side, and a facing wall surface 208 which is a side surface on the L direction side and faces the rising base 96.

A rod accommodating chamber 212 for accommodating the standing stand rod 210 is formed in the side wall surface 206. A holding hole 214 (see fig. 6) that penetrates the partition wall 204 in the width direction WD (the axial direction of the rotary shaft 216) is formed in the bottom surface of the rod accommodating chamber 212 on the rising base 96 side. The holding hole 214 communicates the rod accommodating chamber 212 and the rising table accommodating chamber 94 a. The holding hole 214 also rotatably supports the rotary shaft 216. Further, since the rising stand vertical rod 210 in the rod housing chamber 212 rotates (swings) about the rotation shaft 216, the rod housing chamber 212 is formed in a fan shape about the rotation shaft 216.

A wire insertion hole 224 through which the operation wire 222 is inserted is formed in a side wall surface of the lever housing chamber 212 on the proximal end side of the outer case.

In the side wall surface 206, a bolt hole 220 into which the bolt 77 is screwed is formed in a region that is in the periphery of the rod accommodating chamber 212 and is covered with the rod accommodating cover 76. The number of bolts 77 and bolt holes 220 is not particularly limited.

The opposing wall surface 208 constitutes a side surface of the standing stand accommodating chamber 94a on the R direction side. The opposing wall surface 208 is provided with a holding hole 214. A notch 208a (see fig. 7) into which a part of the rising base 96 enters is formed in the opposing wall surface 208.

The raising table vertical rod 210 rotates the raising table 96 about the rotation shaft 216 in response to the operation of the operation lever 43. One of the rotating shafts 216 having a two-part structure is provided at one end of the standing stand upright 210, and an operation wire 222 is connected to the other end of the standing stand upright 210.

As described above, one of the rotation shafts 216 of the two-part structure is provided at one end of the standing stand upright 210, and the other is provided at one end of the standing stand 96. The raising stand upright 210 and the raising stand 96 are coupled to each other via a rotating shaft 216 having a two-part structure. For example, in the present embodiment, one and the other of the rotating shafts 216 of the two-division structure are coupled to each other by using a bolt 211 penetrating one end side of the standing stand upright 210, whereby the standing stand upright 210 and the standing stand 96 are coupled to each other via the rotating shaft 216 (see fig. 6). Thereby, the raising platform vertical rod 210 rotates (swings) integrally with the raising platform 96 around the rotation shaft 216.

The operation wire 222 has a distal-side coupling portion 222a at one end thereof, which is coupled to the upright stand 210 in the rod housing 212. The other end of the operation wire 222 is inserted into the insertion portion 20 from a wire insertion hole 224 of the lever housing chamber 212, and is connected to a raising table operation mechanism 226 (see fig. 9) in the operation portion 22.

Fig. 9 is a schematic diagram showing an example of the raising table operation mechanism 226. As shown in fig. 9, the operating wire 222 has a base end side connecting portion 222b connected to the raising table operating mechanism 226 on the base end side thereof. The raising table operation mechanism 226 includes an operation lever 43, a rotary drum 226A connected to the operation lever 43 and rotatable within a predetermined angular range, a crank member 226B connected to the rotary drum 226A, and a slider 226C connected to the crank member 226B. The base end side coupling portion 222b is coupled to the slider 226C.

When the operating lever 43 is operated to rotate the rotary drum 226A, the operating wire 222 is pushed and pulled via the crank member 226R and the slider 226C, whereby the raising stand upright 210 swings, and the raising stand 96 rotates (swings) about the rotary shaft 216 in accordance with the swinging of the raising stand upright 210.

Fig. 10 is an explanatory diagram for explaining the rotation of the rising base 96 corresponding to the operation of the operation lever 43. As shown by symbol XA in fig. 10, when the operation lever 43 is operated to rotate the rotary roller 226A in one direction, the operation wire 222 is pushed, and the raising stand upright 210 rotates in the direction SW1 around the rotary shaft 216. Thereby, the raising table 96 rotates to the falling position in accordance with the rotation.

As shown by reference numeral XB in fig. 10, when the operating lever 43 is operated to rotate the rotary roller 226A in the reverse direction, the operating wire 222 is pulled, and the raising stand upright 210 rotates in the SW2 direction opposite to the SW1 direction about the rotary shaft 216. Thereby, the raising table 96 rotates to the raising position in accordance with the rotation. In this way, the rotation shaft 216 is rotated by the operation of the operation lever 43 via the operation wire 222 and the raising table vertical rod 210, and the raising table 96 can be displaced (raised and lowered).

[ inclined surface, illumination windows, and observation window of No. 1 ]

Fig. 11 is a plan view of the outer case 72. As shown in fig. 11, the 1 st illumination window 90A is provided on the 2 nd inclined surface 86B of the outer case 72. As will be described in detail later, the emission direction of the illumination light in the 1 st illumination window 90A is different from that in the 2 nd illumination window 90B.

The observation window 88, the air/water feeding nozzle 92, and the 2 nd illumination window 90B are provided on the 1 st inclined surface 86A of the outer case 72. The 1 st inclined face 86A has the observation window area 86A1, the nozzle area 86A2, and the illumination window area 86A3, which are parallel to each other. In fig. 11 and fig. 12 described later, the observation window area 86a1, the nozzle area 86a2, and the illumination window area 86A3 are displayed by dot display. Hereinafter, the side opposite to the normal direction of the 1 st inclined surface 86A is referred to as a normal opposite direction.

Fig. 12 is an enlarged plan view of a part of the 1 st inclined surface 86A as viewed from the normal direction side thereof. Fig. 13 is a sectional view taken along line 13-13 of fig. 12.

As shown in fig. 12, 13 and 11, the observation window region 86A1 is formed on the 1 st inclined surface 86A at a position closer to the proximal end side of the outer sheath than the treatment instrument outlet port 94 in the direction along the longitudinal axis LA, and at a position closer to the L direction side than the treatment instrument outlet port 94 in the width direction WD. The observation window 88 is provided in the observation window region 86a 1.

The observation window 88 is provided in the observation window region 86a1, and is therefore positioned closer to the outer case proximal end side than the treatment instrument lead-out port 94 in the outer case 72. Thus, regardless of the rotational position of the stand 96, the treatment instrument and the treatment target site derived from the treatment instrument derivation 94 can be observed through the observation window 88. As a result, the visibility of the treatment instrument and the treatment target portion is improved.

The nozzle region 86A2 is formed on the 1 st inclined surface 86A at a position closer to the normal direction side than the observation window region 86A1, and is formed at a position closer to the L direction side with respect to the observation window region 86A1 in the width direction WD. The nozzle region 86A2 is displaced on the 1 st inclined surface 86A in the direction closest to the normal reverse direction. The air/water feeding nozzle 92 is provided in the nozzle region 86a 2.

The air/water feeding nozzle 92 is provided in the nozzle region 86a2, and is therefore positioned on the L direction side with respect to the observation window 88. As described above, the air/water supply nozzle 92 discharges a fluid such as water or air to the observation window 88 to clean the observation window 88.

An inclined surface 87 (slope) connecting the observation window region 86a1 and the nozzle region 86a2 is formed therebetween. Thereby, the fluid ejected from the air/water supply nozzle 92 toward the observation window 88 is diffused by the inclined surface 87. As a result, a wide area including the observation window 88 and its periphery can be cleaned.

The illumination window area 86A3 is formed on the 1 st inclined surface 86A at a position closer to the normal direction side of the 1 st inclined surface 86A than the top of the air/water feeding nozzle 92, and is formed at a position closer to the L direction side than the treatment instrument outlet 94 in the width direction WD. The illumination window area 86A3 is displaced on the 1 st inclined surface 86A closest to the normal direction side of the 1 st inclined surface 86A. The 2 nd illumination window 90B is provided in the illumination window area 86a 3.

In the observation window region 86A1, the nozzle region 86A2, and the illumination window region 86A3, the nozzle region 86A2 is displaced to the side closest to the normal reverse direction, and therefore the air/water supply nozzle 92 is provided in a recessed region (nozzle region 86A2) in the 1 st inclined surface 86A. As a result, the air/water feeding nozzle 92 provided in the nozzle region 86a2 can be reliably prevented from coming into contact with the inner wall of the lumen 154 (see fig. 15).

Further, by displacing the illumination window region 86A3 closer to the normal direction side of the 1 st inclined surface 86A than the top of the air/water feeding nozzle 92, even when the 2 nd illumination window 90B and the air/water feeding nozzle 92 are brought close to each other, it is possible to prevent the illumination light emitted from the 2 nd illumination window 90B from being blocked by the air/water feeding nozzle 92.

Further, by displacing the illumination window region 86A3 closer to the normal direction side of the 1 st inclined surface 86A than the observation window region 86A1 (observation window 88), even if a water droplet or the like adheres to the surface of the 2 nd illumination window 90B and the illumination light emitted from the 2 nd illumination window 90B is refracted by the water droplet or the like, the illumination light can be prevented from directly entering the observation window 88. This can prevent the occurrence of unexpected flare in the endoscopic image.

Fig. 14 is an explanatory diagram for explaining the observation axis 150A and the observation range 150B of the observation window 88, the 1 st illumination axis 151A and the 1 st illumination range 151B of the 1 st illumination window 90A, and the 2 nd illumination axis 152A and the 2 nd illumination range 152B of the 2 nd illumination window 90B. In fig. 14 (and also in fig. 15 described later), in order to prevent complication of the drawing, the axes and the ranges will be described assuming that the observation window 88 and the illumination windows 90A and 90B are located at the same position.

As shown in fig. 14, the observation axis 150A is an axis extending from the observation window 88 in the normal direction thereof, the 1 st illumination axis 151A is an axis extending from the 1 st illumination window 90A in the normal direction thereof, and the 2 nd illumination axis 152A is an axis extending from the 2 nd illumination window 90B in the normal direction thereof. The observation axis 150A, the 1 st illumination axis 151A, and the 2 nd illumination axis 152A are inclined axes inclined toward the front end side of the exterior case from postures perpendicular to both the width direction WD and the vertical axis LA. The observation axis 150A and the 2 nd illumination axis 152A are parallel to the normal line of the 1 st inclined surface 86A (the observation window region 86A1, the nozzle region 86A2, and the illumination window region 86A3), and the 1 st illumination axis 151A is parallel to the normal line of the 2 nd inclined surface 86B.

The observation axis angle θ 0 is an inclination angle of the observation axis 150A with respect to the reference axis LB parallel to the vertical axis LA when viewed from the width direction WD side (the paper surface vertical direction side). The 1 st illumination axis angle θ 1 is an inclination angle of the 1 st illumination axis 151A with respect to the reference axis LB when viewed from the width direction WD side. The 2 nd illumination axis angle θ 2 is an inclination angle of the 2 nd illumination axis 152A with respect to the reference axis LB when viewed from the width direction WD side. The reference axis LB is an axis intersecting the observation axis 150A when the observation axis angle is θ 0, an axis intersecting the 1 st illumination axis 151A when the 1 st illumination axis angle is θ 1, and an axis intersecting the 2 nd illumination axis 152A when the 2 nd illumination axis angle is θ 2.

When viewed from the width direction WD side, the observation axis angle θ 0 and the observation range 150B are set to values in which the angle range from one to the other of the treatment instrument and the treatment target site thereof led out from the treatment instrument outlet port 94 and the distal end side of the outer case [ the insertion direction side (advancing direction side) of the insertion portion 20 ] of the outer case 72 and the treatment instrument can be observed through the observation window 88. The observation axis angle θ 0 and the observation range 150B are preferably values that enable observation of the treatment instrument and the treatment target site derived from the treatment instrument lead-out port 94 in a state where the raising table 96 is rotated to the raising position.

The 1 st illumination axis angle θ 1 is smaller than the observation axis angle θ 0 (the 2 nd illumination axis angle θ 2), and therefore the 1 st illumination axis 151A is inclined closer to the outer case distal end side than the observation axis 150A. In other words, 2 nd inclined surface 86B is inclined at an angle closer to perpendicular with respect to reference axis LB than 1 st inclined surface 86A (observation window region 86A 1).

The 1 st illumination range 151B preferably includes at least the observation range 150B when viewed from the width direction WD side. Thereby, the 1 st illumination window 90A can illuminate the above-described angle range (observation range 150B) with illumination light. Thus, the treatment instrument and the treatment target site thereof derived from the treatment instrument lead-out opening 94 on the insertion direction side of the insertion portion 20 can be illuminated with the illumination light emitted from the 1 st illumination window 90A.

The 2 nd illumination axis angle θ 2 is equal to (including substantially equal to) the viewing axis angle θ 0, and thus the 2 nd illumination axis 152A is parallel to (including substantially parallel to) the viewing axis 150A. Moreover, when viewed from the width direction WD side, the 2 nd illumination range 152B preferably includes at least the observation range 150B. Thereby, the 2 nd illumination window 90B can also illuminate the above-described angle range (observation range 150B) with illumination light.

When the difference between the 1 st illumination axis angle θ 1 and the observation axis angle θ 0 (2 nd illumination axis angle θ 2) is Δ θ, the 1 st illumination range 151B is inclined by the difference Δ θ toward the outer case distal end side with respect to the 2 nd illumination range 152B. Thus, the 1 st illumination range 151B partially overlaps the 2 nd illumination range 152B. The difference Δ θ is set to a value that includes the observation range 150B in the 1 st illumination range 151B, that is, a value that allows the treatment instrument and the treatment target site thereof to be illuminated with the illumination light emitted from the 1 st illumination window 90A. For example, when the irradiation angle of the 1 st illumination window 90A corresponding to the 1 st illumination range 151B is θ L and the angle of view of the observation window 88 corresponding to the observation range 150B is θ C, the difference Δ θ satisfies Δ θ < θ L/2 — θ C/2.

Fig. 15 is a side view of the distal end portion 50 of the insertion portion 20 inserted into the lumen 154. As shown in fig. 15 and 14, by tilting the 1 st illumination window 90A (the 1 st illumination axis 151A) by the difference Δ θ closer to the outer case distal end side than the observation window 88 (the observation axis 150A) and the 2 nd illumination window 90B (the 2 nd illumination axis 152A), the 1 st illumination window 90A can increase the illumination light amount of the illumination light illuminating the insertion direction side of the insertion portion 20. As a result, for example, when the insertion portion 20 is inserted into the narrow lumen 154, the visibility (forward visibility) of the inner wall of the lumen 154 located on the insertion direction side of the insertion portion 20 is improved.

Further, by inclining only the difference Δ θ so that the 1 st illumination window 90A is closer to the outer case distal end side than the 2 nd illumination window 90B, for example, in the case of illuminating the inner wall surface of the lumen 154 which is narrow like a duodenum, the illumination light amount of the illumination light irradiated from the 1 st illumination window 90A to the inner wall surface can be reduced as compared with the illumination light amount of the illumination light irradiated from the 2 nd illumination window 90B to the inner wall surface. Thus, the illumination light amount of the illumination light applied to the inner wall surface of the lumen 154 can be reduced as compared with the case where the 1 st illumination axis angle θ 1 is set to be the same size as the 2 nd illumination axis angle θ 2. As a result, it is possible to prevent the occurrence of halation in the endoscope image due to an excessive amount of illumination light applied to the inner wall surface of the lumen 154. Further, if necessary, the illumination may be selectively performed only through the 1 st illumination window 90A.

By tilting the 2 nd illumination window 90B (the 2 nd illumination axis 152A and the 2 nd illumination range 152B) by the difference Δ θ closer to the outer case proximal end side than the 1 st illumination window 90A (the 1 st illumination axis 151A and the 1 st illumination range 151B), the 2 nd illumination window 90B can increase the illumination light amount of the illumination light illuminating the treatment instrument and the treatment target site derived from the treatment instrument lead-out opening 94. As a result, the treatment instrument and the treatment target site can be reliably illuminated with the illumination light, and thus the visibility of the treatment instrument and the treatment target site can be improved.

In this way, by combining the 1 st illumination window 90A and the 2 nd illumination window 90B, the front visibility of the insertion portion 20 and the visibility of the treatment instrument and the treatment target site can be improved.

Fig. 16 is an explanatory diagram for explaining the reduction in diameter of the distal end portion 50 of the insertion portion 20. In the drawing, reference numeral 141X denotes a light guide tip portion of the light guide 128 corresponding to a conventional 1 st illumination window (not shown) having a1 st illumination axis 151AX parallel to the observation axis 150A (2 nd illumination axis 152A).

Since the light guide tip portion 141 of the light guide 128 corresponding to the 1 st illumination window 90A is held in the light guide holding groove 203 formed in the upper surface of the base 202, the light guide tip portion 141 is disposed in a narrow space between the upper surface of the base 202 and the inner surface of the outer case cover 72 b. Therefore, the larger the inclination angle of light guide distal end portion 141 corresponding to illumination window 1a, the wider the arrangement space of light guide distal end portion 141 needs to be secured between the upper surface of base 202 and the inner surface of exterior case cover 72 b. As a result, the diameter of the distal end portion 50 increases, and therefore the inclination angle of the light guide distal end portion 141 corresponding to the 1 st illumination window 90A affects the diameter of the distal end portion 50 to increase.

On the other hand, the light guide tip portion 141 of the light guide 128 corresponding to the 2 nd illumination window 90B is disposed in a wide disposition space on the L direction side of the base 202 inside the exterior case cover 72B. Therefore, even if the inclination angle of the light guide distal end portion 141 corresponding to the 2 nd lighting window 90B is increased, the light guide distal end portion 141 can be arranged in the arrangement space with a margin. Therefore, the inclination angle of the light guide distal end portion 141 corresponding to the 2 nd illumination window 90B does not particularly affect the increase in diameter of the distal end portion 50.

Therefore, as shown in fig. 16, in the present embodiment, by tilting the 1 st illumination axis 151A of the 1 st illumination window 90A by the difference Δ θ closer to the outer case distal end side than the 1 st illumination axis 151AX (observation axis 150A), the arrangement space of the light guide distal end portion 141 corresponding to the 1 st illumination window 90A can be reduced by Δ h in the figure in the radial direction of the distal end portion 50. As a result, the diameter of the distal end portion 50 of the insertion portion 20 can be reduced.

[ Effect of the present embodiment ]

As described above, in the present embodiment, since the 1 st illumination axis angle θ 1 is made smaller than the observation axis angle θ 0, the illumination light amount on the insertion direction side of the illumination insertion portion 20 can be increased, and the illumination light amount of the illumination light irradiated to the inner wall surface of the lumen 154 can be reduced. This improves the visibility of the insertion portion 20 forward in the insertion direction, and prevents the illumination light from excessively illuminating the inner wall surface of the lumen 154. As a result, the insertion direction side of the insertion portion 20, the treatment instrument, and the treatment target site thereof can be appropriately illuminated. In addition, in the exterior case 72, since the inclination angle of the light guide distal end portion 141 corresponding to the 1 st illumination window 90A is reduced, the diameter of the distal end portion 50 of the insertion portion 20 can be reduced.

In the present embodiment, by making the 2 nd illumination axis angle θ 2 larger than the 1 st illumination axis angle θ 1, the 2 nd illumination window 90B can increase the illumination light amount of the illumination light illuminating the treatment instrument and the treatment target site derived from the treatment instrument lead-out opening 94. As a result, the treatment instrument and the treatment target site can be reliably illuminated with the illumination light from the 2 nd illumination window 90B.

[ others ]

Fig. 17 is a plan view of an exterior case 72 according to another embodiment. In the above-described embodiment (for example, see fig. 11), the illumination windows 90A and 90B are formed on the outer surface of the outer case 72 at positions closer to the outer case distal end side than the outer case proximal end side opening edge of the treatment instrument lead-out port 94. In contrast, as shown in fig. 17, for example, illumination windows 90A and 90B may be formed on the outer surface of the outer case 72 at positions closer to the outer case proximal end side than the treatment instrument lead-out port 94. Thus, the treatment instrument and the treatment target site led out from the treatment instrument lead-out opening 94 can be reliably illuminated by the illumination light emitted from the illumination windows 90A and 90B. As a result, the visibility of the treatment instrument and the treatment target site through the observation window 88 can be improved.

In the above embodiment, the 2 nd illumination axis angle θ 2 of the 2 nd illumination axis 152A of the 2 nd illumination window 90B is smaller than 90 °, but the 2 nd illumination axis angle θ 2 may be 90 ° (slightly 90 °) depending on the size of the 2 nd illumination range 152B. That is, at least the illumination window area 86A3 of the 1 st inclined surface 86A may be a surface parallel to the longitudinal axis LA.

In the above embodiment, the observation window 88 is provided on the outer surface of the outer case 72 at a position closer to the outer case proximal end side than the treatment instrument lead-out port 94, but the observation window 88 may be formed at a position shifted from the position on the outer case proximal end side toward the outer case distal end side and at a position on the L direction side of the treatment instrument lead-out port 94. However, in order to always observe the treatment instrument and the treatment target site thereof led out from the treatment instrument lead-out port 94, the observation window 88 is preferably formed at a position closer to the outer sheath proximal end side than the treatment instrument lead-out port 94.

In the above embodiment, the 2 nd illumination window 90B is formed in the illumination window area 86A3 of the 1 st inclined surface 86A, but the formation position of the 2 nd illumination window 90B is not particularly limited. In the above embodiment, the 2 nd illumination axis angle θ 2 is made larger than the 1 st illumination axis angle θ 1, but the 2 nd illumination axis angle θ 2 may be made smaller than the 1 st illumination axis angle θ 1, or both may be made equal. In addition, if the forward visibility and the visibility of the treatment instrument and the treatment target site can be ensured only by the 1 st illumination window 90A, the 2 nd illumination window 90B may be omitted.

In the above embodiment, the viewing axis 150A is parallel to the 2 nd illumination axis 152A, but the two may not be parallel. For example, the viewing axis angle θ 0 may be an angle between the 1 st illumination axis angle θ 1 and the 2 nd illumination axis angle θ 2.

In the above embodiment, the example in which the raising table 96 is rotated via the operation wire 222 and the raising table vertical rod 210 has been described, but the method of rotating the raising table 96 is not particularly limited, and a known method may be employed.

In the above embodiment, the observation window region 86A1, the nozzle region 86A2, and the illumination window region 86A3 which are different from each other are formed in the 1 st inclined surface 86A, but the observation window region 86A1, the nozzle region 86A2, and the illumination window region 86A3 may be formed on the same horizontal plane without a step.

In the above embodiment, the light guide distal end portion 141 corresponding to the 1 st illumination window 90A is held by the light guide holding groove 203 formed on the upper surface of the vertical housing 200, but the holding structure of the light guide distal end portion 141 by the vertical housing 200 is not particularly limited. For example, a through hole may be provided in the base 202 of the vertical housing 200 so that the light guide distal end portion 141 is inserted and held in the through hole.

Although 1 st illumination window 90A is parallel to 2 nd inclined surface 86B in the above embodiment, 1 st illumination window 90A may be provided so as not to be parallel to 2 nd inclined surface 86B. Similarly, observation window 88 and 2 nd illumination window 90B may be provided so as not to be parallel to 1 st inclined surface 86A.

In the above-described embodiment, the ultrasonic endoscope 10 including the ultrasonic observation unit 60 (the ultrasonic transducer 62) has been described as an example, but the present invention can also be applied to an endoscope including the standing table 96 for guiding a treatment instrument, for example, a side-view endoscope such as a duodenoscope.

Description of the symbols

2-ultrasonic examination system, 10-ultrasonic endoscope, 12-processor device for ultrasonic wave, 14-processor device for endoscope, 16-light source device, 18-monitor, 20-insertion portion, 22-operation portion, 24-universal cord, 27-connector for ultrasonic wave, 28-connector for endoscope, 30-connector for light source, 32-tube, 34-tube, 36-air-water feeding button, 38-suction button, 42-angle button, 43-operation rod, 44-insertion port for treatment instrument, 50-tip portion, 52-bending portion, 54-soft portion, 60-ultrasonic observation portion, 62-ultrasonic transducer, 64-balloon, 66-snap ring, 68-snap groove, 70-supply/discharge port, 71-opening portion, 72-exterior case, 72 a-exterior case body, 72B-exterior case cover, 73-partition wall, 74-groove portion, 75-fitting hole, 76-rod housing cover, 77-bolt, 80-endoscope observation portion, 86A-first inclined surface, 86A 1-observation window area, 86A 2-nozzle area, 86A 3-illumination window area, 86B-second inclined surface, 87-inclined surface, 88-observation window, 90A-first illumination window, 90B-second illumination window, 92-air/water supply nozzle, 94-treatment instrument outlet port, 94 a-standing table housing chamber, 96-standing table, 96A-guide surface, 100-treatment instrument insertion channel, 102-air/water supply channel, 104-balloon line, 106-suction line, 108-air supply line, 110-water supply line, 112-balloon water supply line, 114-balloon water discharge line, 116-air supply line, 118-water supply tank, 120-water supply line, 122-branch line, 124-suction pump, 126-suction source line, 128-light guide, 129-air supply pump, 141-light guide tip, 150A-observation axis, 150B-observation range, 151A-1 st illumination axis, 151 AX-1 st illumination axis, 151B-1 st illumination range, 152A-2 nd illumination axis, 152B-2 nd illumination range, 154-lumen, 200-vertical housing, 202-base, 202A-through hole, 203-light guide holding groove, 204-partition wall, 206-side wall, 208-opposing wall, 208 a-notch, 210-standing stand upright, 211-bolt, 212-rod housing, 214-holding hole, 216-rotation axis, 220-bolt hole, 222-operation line, 222 a-tip side connection portion, 222B-base side connection portion, 224-line insertion hole, 226-standing stand operation mechanism, 226A-rotation roller, 226B-crank member, 226C-slider, LA-vertical axis, LB-reference axis, NV-normal direction, WD-width direction, Δ θ -difference, θ 0-observation axis angle, θ 1-1 st illumination axis angle, θ 2-2 nd illumination axis angle.