WO2018025605A1 - Puncture adapter for ultrasonically guided paracentesis and ultrasonic diagnosis device - Google Patents

Puncture adapter for ultrasonically guided paracentesis and ultrasonic diagnosis device Download PDF

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Publication number
WO2018025605A1
WO2018025605A1 PCT/JP2017/025458 JP2017025458W WO2018025605A1 WO 2018025605 A1 WO2018025605 A1 WO 2018025605A1 JP 2017025458 W JP2017025458 W JP 2017025458W WO 2018025605 A1 WO2018025605 A1 WO 2018025605A1
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WO
WIPO (PCT)
Prior art keywords
puncture
main piece
mirror surface
slit
surface portion
Prior art date
Application number
PCT/JP2017/025458
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French (fr)
Japanese (ja)
Inventor
浅尾　高行
Original Assignee
株式会社日本医療機器開発機構
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Publication date
Application filed by 株式会社日本医療機器開発機構 filed Critical 株式会社日本医療機器開発機構
Priority to JP2017551347A priority Critical patent/JP6239810B1/en
Publication of WO2018025605A1 publication Critical patent/WO2018025605A1/en

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves

Definitions

  • the present invention relates to a puncture adapter for ultrasonic guided puncture.
  • the puncture adapter of the present invention is used by being attached to an ultrasonic probe in order to guide a puncture needle such as an injection needle.
  • the present invention also relates to an ultrasonic diagnostic apparatus comprising the puncture adapter and an ultrasonic probe.
  • a puncture needle such as an injection needle is inserted into a living body, and examination such as collection of a tissue such as a tumor, local administration of a drug, or thermotherapy such as microwave or radio wave irradiation from a puncture needle
  • a puncture technique for performing such as is known.
  • Such puncture is performed with an ultrasonic tomographic image generated by an ultrasound diagnostic device for the purpose of avoiding blood vessels that may cause major bleeding due to damage, or for the purpose of reliably puncturing a tissue such as a tumor. It is common to refer to In this manner, puncture performed under the guidance of an ultrasonic diagnostic apparatus is referred to as ultrasonic guided puncture.
  • a puncture adapter for puncture is attached to an ultrasonic probe for diagnosis so that the puncture needle can be reliably inserted into a target position. Then, a method of inserting into the living body from the vicinity of the end of the contact surface (probe surface) of the ultrasonic probe with the living body while the puncture needle is guided by the puncturing adapter is used.
  • a puncture adapter having a guide hole into which the puncture needle can be inserted in order to guide the insertion direction of the puncture needle onto an ultrasonic scanning line by an ultrasonic probe (Patent Document 1). ).
  • Patent Document 1 a puncture adapter having a guide hole into which the puncture needle can be inserted in order to guide the insertion direction of the puncture needle onto an ultrasonic scanning line by an ultrasonic probe.
  • the conventional puncture adapter with a guide hole adheres to the patient's body fluid when the puncture needle is advanced or retracted along the guide hole. Or it is necessary to make the puncture adapter itself disposable, and there is a problem that it takes time and cost.
  • the conventional puncture adapter has a problem that when the puncture needle is inserted into the guide hole, the direction of insertion into the living body is limited and the degree of freedom of operation is lost, which makes it difficult to perform the operation. .
  • the ultrasonic probe and the puncture needle are connected via a puncture adapter, and it is difficult to operate the ultrasonic probe and the puncture needle independently of each other.
  • a puncture adapter it is difficult to operate the ultrasonic probe and the puncture needle independently of each other.
  • a deviation occurs in the insertion direction of the puncture needle according to the movement of the ultrasonic probe.
  • conventional puncture adapters have various problems such as easy losing sight of the needle tip of the puncture needle and time-consuming installation.
  • an object of the present invention is to provide a puncture adapter that can solve any one or more of the problems of the conventional puncture adapter described above. That is, the present invention provides a puncture adapter that can appropriately insert a puncture needle into a target position on a scanning line of an ultrasonic probe without relying on a guide hole.
  • the present invention basically connects a main piece having a mirror surface portion extending vertically and a sub-piece located on the front side of the main piece, and provides a slit in the sub-piece so that an operator can see the mirror surface portion. This is based on the knowledge that the virtual image can be visually recognized through the slit of the sub-piece.
  • the puncture adapter according to the present invention the operator who performs ultrasonic guided puncture operation himself / herself confirms that the viewing direction of the operator, the insertion position of the puncture needle, and the insertion angle are appropriate. Is possible. And according to this invention, even if it does not fix a puncture needle by a guide hole etc., it becomes easy to insert a puncture needle in the target position on the scanning line of an ultrasonic probe. More specifically, the present invention has the following configuration.
  • the 1st aspect of this invention is related with the puncture adapter 1 attached to an ultrasonic probe.
  • the puncture adapter includes a main piece 10 extending in the vertical direction and a subpiece 20 located on the front surface 10a side of the main piece, and the main piece 10 and the subpiece 20 are connected.
  • the main piece 10 has a mirror surface portion 11 extending in the vertical direction on the front surface 10 a below the connecting portion of the sub-piece 20.
  • the subpiece 20 has an inclined portion 21 inclined downward with respect to the front surface 10 a of the main piece, and a first slit 22 formed in the inclined portion 21.
  • the inclined portion 21 is inclined so as to intersect with the optical path from the time when the light constituting the image of the puncture needle 3 is reflected by the mirror surface portion 11 until reaching the user's viewpoint.
  • the puncture adapter is configured such that the mirror surface portion 11 can be visually recognized through the first slit 22.
  • the user When performing an ultrasound-guided puncture using the puncture adapter 1 of the present invention, first, the user (operator) can visually recognize the mirror surface portion 11 of the main piece 10 through the first slit 22 of the subpiece 20. Move your viewpoint position (head) to the position. As a result, the user can confirm that his / her head position and viewing direction are appropriate. Thereafter, the user carries a puncture needle such as an injection needle on the scanning line of the ultrasonic probe while maintaining a state where the mirror surface portion 11 of the main piece 10 can be visually recognized through the first slit 22 of the subpiece 20. At this time, the user confirms that the puncture needle is projected on the mirror surface portion 11 of the main piece 10.
  • a puncture needle such as an injection needle
  • the user determines the insertion angle of the puncture needle so that the angle of the puncture needle becomes an angle substantially parallel to the scanning line of the ultrasonic probe while moving the puncture needle left and right. That is, the user moves the left and right puncture needles so that the virtual image of the puncture needle projected on the mirror surface portion 11 of the main piece 10 is aligned with the mirror surface portion 11 of the main piece 10 and the first slit 22 of the subpiece 20. Determine the insertion angle while moving to. In this manner, the user visually recognizes the virtual image of the puncture needle reflected on the mirror surface portion 11 of the main piece 10 through the first slit 22 of the sub-piece 20, so that the insertion position and the insertion angle of the puncture needle are appropriate. Can be easily confirmed. Therefore, it is possible to appropriately guide the puncture needle to the target position on the scanning line of the ultrasonic probe without guiding the insertion direction of the puncture needle through the guide hole.
  • the mirror surface portion 11 includes a second slit 11a formed in the main piece 10 extending in the vertical direction, and a mirror member 11b disposed on the back surface 10b side of the main piece and visible through the second slit 11a. , Preferably. According to such a structure, it becomes easy for a user to visually confirm whether the puncture needle is projected on the mirror member 11b.
  • the puncture adapter of the present invention preferably further includes an attachment portion 40 for fixing the main piece 10 to the ultrasonic probe on the back surface 10b of the main piece.
  • the attachment portion 40 fixes the main piece 10 to the ultrasonic probe so that the mirror surface of the mirror surface portion 11 is substantially perpendicular to the probe surface.
  • the probe surface is a surface with which the end of the ultrasonic probe contacts.
  • substantially vertical means a range of 80 to 100 degrees.
  • the main piece 10 further has a non-mirror surface portion 12 on both the left and right sides of the mirror surface portion 11. If the entire front side of the main piece 10 is the mirror surface portion 11, it is difficult to align the first slit 22 of the subpiece 20 and the mirror surface portion 11. For this reason, it is preferable to provide a non-mirror surface portion 12 on the left and right sides of the mirror surface portion 11 on the front surface of the main piece 10 to distinguish between the mirror surface portion 11 and the non-mirror surface portion 12.
  • the subpiece 20 further includes a connecting portion 23 that connects the inclined portion 21 and the front surface 10a of the main piece with a gap.
  • the angle formed by the connecting portion 23 and the front surface 10a of the main piece is preferably substantially a right angle (85 to 95 degrees).
  • the subpiece 20 is provided with a certain gap between the inclined portion 21 and the front surface 10a of the main piece 10, so that the position of the user's own head and the viewing direction are appropriate. It will be possible to confirm more appropriately.
  • the puncture adapter of the present invention allows the mirror surface portion 11 to be seen straight through the first slit 22 of the subpiece 20, and the virtual image 3 ′ of the puncture needle 3 reflected on the mirror surface portion 11 is obtained.
  • the insertion position and the insertion angle of the puncture needle 3 are determined.
  • the width of the mirror surface portion 11 and the width of the first slit 22 are preferably wider than the outer diameter of the virtual image 3 ′ of the puncture needle 3.
  • the user can view the virtual image of the puncture needle 3 reflected on the mirror surface portion 11. It becomes easy to visually recognize 3 '.
  • the second aspect of the present invention relates to an ultrasonic apparatus including the puncture adapter 1 according to the first aspect described above and an ultrasonic probe 2 to which the puncture adapter 1 is attached.
  • the puncture adapter 1 may be detachably attached to the ultrasonic probe 2, or the puncture adapter 1 and the ultrasonic probe 2 are attached integrally (not detachable). It may be. That is, in the ultrasonic diagnostic apparatus of the present invention, the puncture adapter 1 and the ultrasonic probe 2 may be configured integrally.
  • the ultrasonic probe 2 a well-known thing can be used suitably.
  • a puncture adapter capable of appropriately inserting a puncture needle at a target position on the scanning line of an ultrasonic probe without depending on a guide hole.
  • FIG. 1 is a front perspective view showing an example of a puncture adapter according to the present invention.
  • FIG. 2 is a rear side view showing an example of the puncture adapter according to the present invention.
  • FIG. 3 is a schematic view showing a state where the puncture adapter is attached to the ultrasonic probe.
  • FIG. 4 schematically illustrates an operation for aligning the first slit and the mirror surface portion from the viewpoint position of the user.
  • FIG. 5 schematically illustrates an operation for determining the insertion position and insertion angle of the puncture needle from the viewpoint position of the user.
  • the term “front” means a surface facing the user's viewpoint when the puncture adapter is attached to the ultrasonic probe.
  • the term “rear surface” means a surface opposite to the front surface, that is, a surface that is not visually recognized by the user when the puncture adapter is used.
  • up and down means the up and down direction in a state where the puncture adapter is attached to the ultrasonic probe.
  • front and rear and “left and right” refer to the front and rear directions and the left and right directions based on the viewpoint of the user when the puncture adapter is used with the puncture adapter attached to the ultrasonic probe. Means the direction.
  • FIG. 1 is a front perspective view of the puncture adapter 1
  • FIG. 2 is a rear perspective view of the puncture adapter 1.
  • FIG. FIG. 3 shows an outline of an ultrasonic apparatus in which the puncture adapter 1 is attached to the ultrasonic probe 2.
  • the puncture adapter 1 is used by being attached to an ultrasonic probe 2.
  • the puncture adapter 1 guides the insertion direction of the puncture needle 3 such as an injection needle onto an ultrasonic scanning line (dotted line in FIG. 3) generated from the ultrasonic probe 2 in ultrasonic guided puncture. Used for.
  • the puncture needle 3 is placed on a target site (for example, a blood vessel) in the living body located on the scanning line of the ultrasonic probe 2. Can be inserted correctly.
  • a target site for example, a blood vessel
  • the puncture adapter 1 basically includes a main piece 10, a subpiece 20, a mirror member holding portion 30, and an attachment portion 40. As shown in FIG. 2, the puncture adapter 1 includes a plate-like mirror member 11 b that can be inserted between the main piece 10 and the mirror member holding portion 30.
  • the main piece 10 is a part extending in the vertical direction.
  • the subpiece 20 is provided on the front surface 10 a side of the upper end portion of the main piece 10, and the attachment portion 40 is provided on the back surface 10 b side of the lower end portion of the main piece 10.
  • the main piece 10 has a vertical direction and a horizontal direction, and is configured in a plate shape extending in the vertical direction.
  • the vertical length and the horizontal width of the main piece 10 can be appropriately designed.
  • the length of the main piece 10 may be 100 mm to 200 mm.
  • the width of the main piece 10 may be 10 mm to 90 mm.
  • the thickness of the main piece 10 is not particularly limited, but may be 5 to 15 mm.
  • the mirror surface portion 11 On the front surface 10a side of the main piece 10, a mirror surface portion 11 that extends linearly in the vertical direction is provided.
  • the mirror surface portion 11 is configured by a mirror that projects an object located on the front surface 10 a side of the main piece 10. That is, the mirror surface portion 11 has a mirror surface that reflects light (mainly visible light) at least on the front side.
  • the mirror surface portion 11 may be configured by a separately provided mirror member 11b, or may be realized by applying a mirror surface paint or attaching a seal having a mirror surface to the front surface 10a.
  • the mirror surface portion 11 has a width that can project at least the virtual image 3 ′ of the puncture needle 3 handled by the user.
  • the width of the mirror surface portion 11 is preferably wider than the outer diameter of the virtual image 3 ′ of the puncture needle 3 reflected on the mirror surface portion 11 when the puncture adapter 1 is in use.
  • the width of the mirror surface portion 11 may be, for example, 1 mm to 15 mm, and particularly preferably 2 mm to 10 mm.
  • the mirror surface part 11 has a length exceeding at least half of the total length of the main piece 10.
  • the mirror surface portion 11 is located at the center in the left-right direction on the front surface of the main piece 10. That is, the mirror surface portion 11 extends along the center line of the main piece 10. Further, non-mirror surface portions 12 are provided on both the left and right sides of the mirror surface portion 11.
  • the non-mirror surface portion 12 is a portion that cannot project an object, and the formation method is not particularly limited. By providing the non-mirror surface portions 12 on both the left and right sides of the mirror surface portion 11, the user can easily grasp the position of the mirror surface portion 11.
  • the mirror surface portion 11 is constituted by a second slit 11a and a mirror member 11b.
  • the second slit 11a is a hole penetrating from the front to the back of the main piece 10, and extends long in the vertical direction.
  • the second slit 11a is in a state where the lower end is open and the upper end is closed.
  • both the lower end and the upper end of the second slit 11a may be closed, or both the lower end and the upper end may be open.
  • the second slit 11a may be in a state where the lower end is closed and the upper end is opened.
  • the second slit 11 a is located at the center in the left-right direction on the front surface of the main piece 10.
  • the width of the second slit 11a matches the width of the mirror surface portion 11 described above, and may be 1 mm to 15 mm or 2 mm to 10 mm.
  • the mirror member 11 b is a member disposed on the back surface 10 b side of the main piece 10 and can be detached from the main piece 10.
  • the mirror member 11 b has at least one surface as a mirror surface, and is arranged so that the mirror surface is in contact with the back surface 10 b of the main piece 10. Thereby, the mirror surface of the mirror member 11 b is exposed to the front surface 10 a side of the main piece 10 through the second slit 11 a of the main piece 10.
  • the user can visually recognize the mirror surface of the mirror member 11 b from the front surface 10 a side of the main piece 10. As described above, by allowing the user to visually recognize the mirror surface through the second slit 11a, the user can easily grasp the position of the mirror surface visually.
  • the puncture adapter 1 may have a mirror member holding portion 30 on the back surface 10 b side of the main piece 10.
  • the mirror member holding unit 30 holds the mirror member 11b by sandwiching the mirror member 11b with the back surface 10b of the main piece 10. That is, the mirror member 11 b can be inserted between the main piece 10 and the mirror member holding portion 30. Further, the mirror member 11b can be freely attached and detached.
  • a subpiece 20 is connected to the front face 10 a side of the upper end of the main piece 10.
  • the subpiece 20 is basically molded integrally with the main piece 10.
  • the sub-piece 20 is preferably a plate having the same width and thickness as the main piece 10.
  • the subpiece 20 is attached to the upper end of the main piece 10, but the present invention is not limited to such a form.
  • the main piece 10 may have a portion extending upward from the subpiece 20.
  • the subpiece 20 is connected to the middle of the main piece 10 in the longitudinal direction. In the present invention, it is only necessary that the mirror surface portion 11 provided on the main piece 10 is positioned at least below the connecting portion of the subpiece 20.
  • the subpiece 20 has an inclined portion 21 inclined downward with respect to the front surface 10a of the main piece 10.
  • inclined downward means that the distal end 21 a of the inclined portion 21 farthest from the main piece 10 is located below the proximal end 21 b of the inclined portion 21 closest to the main piece 10.
  • the inclined portion 21 is inclined so as to intersect with an optical path until the light constituting the image of the puncture needle 3 reaches the user's viewpoint after being reflected by the mirror surface portion 11.
  • the angle formed by the inclined portion 21 and the main piece 10 is indicated by the symbol ⁇ .
  • the angle ⁇ formed is preferably 20 to 85 degrees, 30 to 80 degrees, or 45 to 60 degrees.
  • the inclined portion 21 extends in a direction away from the front surface 10 a of the main piece 10.
  • the length from the proximal end 21b to the distal end 21a of the inclined portion 21 may be 20 mm to 100 mm or 30 mm to 80 mm.
  • a first slit 22 is formed in the inclined portion 21 of the subpiece 20.
  • the first slit 22 is a hole that penetrates the inclined portion 21 and extends long along the extending direction of the inclined portion 21.
  • the first slit 22 is in a state where the lower end is open and the upper end is closed.
  • both the lower end and the upper end of the first slit 22 may be closed, or both the lower end and the upper end may be open.
  • the 1st slit 22 is located in the center of the left-right direction of the inclination part 21 of the subpiece 20 similarly to the mirror surface part 11 (2nd slit 11a). That is, the first slit 22 extends along the center line of the subpiece 20.
  • the first slit 22 and the mirror surface portion 11 are both formed along the center line of the puncture adapter 1.
  • variety of a 1st slit is substantially equal to the mirror surface part 11 (2nd slit 11a).
  • the width of the first slit is preferably a value in the range of 90% to 110% with respect to the width of the mirror surface portion 11.
  • variety of the 1st slit 22 is wider than the outer diameter of virtual image 3 'of the puncture needle 3 reflected on the mirror surface part 11 in the use condition of the puncture adapter 1.
  • the subpiece 20 may have a connecting portion 23 between the inclined portion 21 and the main piece 10.
  • the connecting portion 23 is a portion that connects the inclined portion 21 and the front surface 10a of the main piece with a gap.
  • the angle formed by the connecting portion 23 and the front surface 10a of the main piece is substantially a right angle (85 to 95 degrees).
  • the subpiece 20 is provided with a certain gap between the inclined portion 21 and the front surface 10a of the main piece 10, so that the position of the user's own head and the viewing direction are appropriate. It will be possible to confirm more appropriately.
  • the length of the connecting portion 23 (that is, the distance from the front face 10a of the main piece to the proximal end 21b of the inclined portion 21) may be, for example, 3 mm to 40 mm, or 10 mm to 30 mm.
  • the attachment part 40 has a structure for attaching the main body of the puncture adapter 1 to the ultrasonic probe 2.
  • the mounting portion 40 has two pairs of left and right (total four) arm portions 41.
  • the puncture adapter 1 can be fixed to the ultrasonic probe 2 by sandwiching the ultrasonic probe 2 between the left and right arm portions 41.
  • the ultrasonic probe 2 can be sandwiched and fixed between the left and right arm portions 41.
  • notches 42 are formed in one or a plurality of locations on both or one of the lower edge and the upper edge of each arm portion 41.
  • the rubber bands are wound around and fixed to the left and right arm portions 41, the rubber bands are engaged with the notches 42. Thereby, it is possible to stably wrap the rubber bands around the left and right arm portions 41.
  • the attachment portion 40 is provided at the lower end of the main piece 10, and extends from the lower end toward the back surface 10b.
  • the position where the attachment portion 40 is provided is not limited to the lower end of the main piece 10 and may be in the middle of the main piece 10.
  • FIG. 4 is a diagram for explaining an operation for determining the viewpoint position of the user.
  • FIG. 4 schematically shows the puncture adapter 1 and the ultrasonic probe 2 viewed from the user's viewpoint.
  • the subpiece 20 is located above the front side of the main piece 10.
  • the main piece 10 is partially hidden behind the subpiece 20.
  • the whole main piece 10 cannot be visually recognized from the viewpoint position of the user.
  • the first slit 22 of the subpiece 20 and the mirror surface portion 11 of the main piece 10 are not aligned. That is, the mirror surface portion 11 of the main piece 10 cannot be visually recognized through the first slit 22 of the subpiece 20.
  • This state can be said to be a state where the relative positional relationship between the user's viewpoint and the puncture adapter 1 is poor.
  • the ultrasonic probe 2 to which the puncture adapter 1 is attached by rotating the ultrasonic probe 2 to which the puncture adapter 1 is attached to the left or right, or by moving the position of the user's head, from the viewpoint of the user.
  • the mirror surface portion 11 of the main piece 10 is adjusted so that it can be seen straight through the first slit 22 of the subpiece 20. 4B, the first slit 22 of the subpiece 20 and the mirror surface portion 11 of the main piece 10 are completely aligned from the viewpoint of the user, and the mirror surface portion 11 is in a straight line through the first slit 22. It looks like In this state, it can be said that the relative positional relationship between the user's viewpoint and the puncture adapter 1 is appropriate.
  • FIG. 5 is a diagram for explaining an operation for determining the insertion position and the insertion angle of the puncture needle 3.
  • FIG. 5 schematically shows the puncture adapter 1 and the ultrasonic probe 2 viewed from the user's viewpoint, as in FIG.
  • the insertion position of the puncture needle 3 is determined without moving the viewpoint position of the user determined in FIG. 4B. That is, as shown in FIG. 5A, the state in which the first slit 22 of the subpiece 20 and the mirror surface portion 11 of the main piece 10 are aligned is maintained. In this state, the user looks into the mirror surface portion 11 of the main piece 10 from above through the first slit 22 of the subpiece 20. Then, the lower area of the puncture adapter 1 is displayed on the mirror surface portion 11.
  • a virtual image 3 ′ of the puncture needle 3 is projected onto the mirror surface portion 11 of the main piece 10.
  • the virtual image 3 'of the puncture needle 3 projected onto the mirror surface portion 11 is not aligned with the mirror surface portion 11 and the first slit 22 of the subpiece 20, It is in a tilted state. It can be said that such a state is a state where the insertion angle of the puncture needle 3 is bad from the viewpoint of the user.
  • the user rotates the puncture needle 3 that is operated at hand without moving the viewpoint, and moves the puncture needle 3 to the left and right to view the mirror surface portion 11 as viewed from the user's viewpoint.
  • the reflected virtual image 3 ′ of the puncture needle 3 is adjusted so as to be aligned with the mirror surface portion 11 and the first slit 22 of the subpiece 20. That is, as shown in FIG. 5B, when viewed from the user's point of view, the mirror surface portion 11 can be seen straight through the first slit 22 of the subpiece 20, and the puncture reflected on the mirror surface portion 11 can be seen.
  • the insertion angle of the puncture needle 3 is determined so that the virtual image 3 ′ of the needle 3 is aligned with the first slit 22 and the mirror surface portion 11.
  • the state shown in FIG. 5B can be said to be a state in which the viewpoint position of the user, the insertion position of the puncture needle 3, and the insertion angle of the puncture needle 3 are appropriately determined. Therefore, after confirming that the user has reached this state, the user enters the puncture needle 3 straight into the patient's skin or body. As a result, the puncture needle 3 can be reliably inserted into the target site on the scanning line under the guide of the ultrasonic probe 2.
  • the puncture adapter 1 according to the present invention when used, the user can use the guide hole on the scanning line of the ultrasonic probe 2 without using the guide hole to regulate the moving direction of the puncture needle.
  • the operation of inserting the puncture needle 3 can be appropriately assisted. Therefore, according to the puncture adapter 1 of the present invention, it is possible to solve the problem of the conventional adapter provided with the guide hole.
  • the puncture adapter 1 of the present invention can be mounted in a transparent sterilized probe cover and can be used repeatedly because the patient's bodily fluid basically does not adhere.
  • the puncture adapter 1 of the present invention does not physically restrict the insertion direction of the puncture needle 3, the degree of freedom of operation of the puncture needle 3 is increased, and the ultrasonic probe 2, the puncture needle 3, Can be operated independently. Furthermore, since the puncture adapter 1 of the present invention can be used with all the puncture needles 3 regardless of the thickness of the puncture needle 3, for example, it is possible to save the trouble of changing the adapter according to the thickness of the puncture needle 3. Can perform treatment quickly.
  • the ultrasonic probe when the probe surface of the ultrasonic probe is brought into contact with a rounded part such as a human arm, for example, the ultrasonic probe itself may tilt. In such a state where the ground contact surface is inclined, it has been difficult to accurately guide the puncture needle onto the scanning line of the ultrasonic probe using a conventional puncture adapter.
  • the puncture adapter 1 of the present invention the user himself / herself visually observes the mirror surface portion 11 of the main piece 10 and the first slit 22 of the subpiece 20 while finely adjusting the insertion position and the insertion angle of the puncture needle 3. Can be adjusted.
  • the puncture adapter 1 of the present invention is highly effective when operated on a tilted ground surface as compared with the conventional adapter.
  • the puncture adapter 1 of the present invention may be reusable or disposable. When the puncture adapter 1 is reused, it is preferable to remove the puncture adapter 1 from the ultrasonic probe 2 after use and disinfect by heating. When the puncture adapter 1 is a disposable type, the main body of the puncture adapter 1 is preferably made of inexpensive plastic.
  • the puncture adapter 1 configured to be detachable from the ultrasonic probe 2 has been mainly described.
  • the puncture adapter 1 and the ultrasonic probe 2 may be configured integrally in advance and cannot be separated from each other.
  • the configuration of the puncture adapter 1 is as described above.
  • the configuration of the ultrasonic probe 2 is not particularly limited, and a known configuration such as that disclosed in Patent Document 1 (Japanese Patent Laid-Open No. 2006-212165) can be appropriately employed. .
  • the puncture adapter can be used by using a visual sensor instead of visual observation.
  • the puncture adapter according to the present invention can also be used in surgery using a robot.
  • the present invention relates to a puncture adapter for ultrasonic guided puncture. Therefore, the present invention can be suitably used in the medical device manufacturing industry.

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Abstract

[Problem] To properly insert a puncture needle into a desired position on a scan line of an ultrasonic probe without requiring a guide hole. [Solution] A puncture adapter (1) attached to an ultrasonic probe includes a main piece (10) that extends in the vertical direction and a sub-piece (20) positioned on the front-surface (10a)-side of the main piece, the main piece and the sub-piece being connected. The main piece has, on the front surface below the site of connection with the sub-piece, a mirror surface part (11) that extends in the vertical direction. The sub-piece has an inclined part (21) that is inclined downward relative to the front surface of the main piece, and a first slit (22) formed in the inclined part. It is possible to visually recognize the mirror surface part through the first slit.

Description

超音波ガイド下穿刺術用の穿刺アダプター及び超音波診断装置Puncture adapter and ultrasonic diagnostic apparatus for ultrasonic guided puncture
　本発明は，超音波ガイド下穿刺術用の穿刺アダプターに関する。具体的に説明すると，本発明の穿刺アダプターは，注射針等の穿刺針をガイドするために超音波プローブに取り付けて使用されるものである。また，本発明は，前記の穿刺アダプターと超音波プローブとを備える超音波診断装置に関する。 The present invention relates to a puncture adapter for ultrasonic guided puncture. Specifically, the puncture adapter of the present invention is used by being attached to an ultrasonic probe in order to guide a puncture needle such as an injection needle. The present invention also relates to an ultrasonic diagnostic apparatus comprising the puncture adapter and an ultrasonic probe.
　従来から，注射針等の穿刺針を生体内に刺入して，腫瘍などの組織の採取等の検査や，薬剤の局所投与，あるいは穿刺針からのマイクロ波やラジオ波の照射等の温熱治療などを行う穿刺術が知られている。このような穿刺術は，損傷により大出血を起こす危険性のある血管などを避ける目的や，腫瘍などの組織に対して確実に穿刺する目的の下，超音波診断装置によって生成される超音波断層像を参照しながら行うことが一般的である。このように，超音波診断装置によるガイド下で行う穿刺術を，超音波ガイド下穿刺術という。 Conventionally, a puncture needle such as an injection needle is inserted into a living body, and examination such as collection of a tissue such as a tumor, local administration of a drug, or thermotherapy such as microwave or radio wave irradiation from a puncture needle A puncture technique for performing such as is known. Such puncture is performed with an ultrasonic tomographic image generated by an ultrasound diagnostic device for the purpose of avoiding blood vessels that may cause major bleeding due to damage, or for the purpose of reliably puncturing a tissue such as a tumor. It is common to refer to In this manner, puncture performed under the guidance of an ultrasonic diagnostic apparatus is referred to as ultrasonic guided puncture.
　例えば，超音波ガイド下穿刺術を施す場合には，穿刺針を目標とする位置に確実に刺入できるように，診断用の超音波プローブに穿刺用の穿刺アダプターを取り付けておく。そして，穿刺針をこの穿刺アダプターよってガイドしながら，超音波プローブの生体との接触面（プローブ面）の端部近傍から生体内に刺入する方法が取られる。 For example, when performing an ultrasound-guided puncture, a puncture adapter for puncture is attached to an ultrasonic probe for diagnosis so that the puncture needle can be reliably inserted into a target position. Then, a method of inserting into the living body from the vicinity of the end of the contact surface (probe surface) of the ultrasonic probe with the living body while the puncture needle is guided by the puncturing adapter is used.
　例えば，穿刺アダプターとしては，穿刺針の刺入方向を超音波プローブによる超音波の走査線上に案内するために，この穿刺針を挿入可能なガイド孔を有するものが知られている（特許文献１）。超音波ガイド下穿刺術を施す際には，超音波プローブで生体内の超音波断層像を撮影しながら，この穿刺アダプターのガイド孔に穿刺針を挿し込み，ガイド孔に沿って穿刺針を生体に刺入させることで，術者による手振れなどの影響を抑え，穿刺針を目標とする部位に案内することができる。 For example, as a puncture adapter, there is known a puncture adapter having a guide hole into which the puncture needle can be inserted in order to guide the insertion direction of the puncture needle onto an ultrasonic scanning line by an ultrasonic probe (Patent Document 1). ). When performing ultrasound-guided puncture, the puncture needle is inserted into the guide hole of the puncture adapter while taking an ultrasonic tomogram inside the living body with an ultrasonic probe, and the puncture needle is inserted into the living body along the guide hole. By inserting the needle into the needle, it is possible to suppress the influence of hand shake by the operator and guide the puncture needle to the target site.
特開２００６－２１２１６５号公報JP 2006-212165 A
　しかしながら，ガイド孔を有する従来の穿刺アダプターは，穿刺針をガイド孔に沿って進退させたときに患者の体液が付着するため，超音波ガイド下穿刺を行う度に穿刺アダプターを滅菌消毒したり，又は穿刺アダプター自体を使い捨てにする必要があり，手間とコストがかかるという問題がある。また，従来の穿刺アダプターは，ガイド孔に穿刺針が刺し込まれると，生体への刺入方向が制限されて操作の自由度が失われることとなるため，施術を行いにくくなるという問題がある。また，従来のアダプターは，穿刺針の太さに応じて，適切な口径のガイド孔を持つものを選択する必要があったり，穿刺針を変更したときには穿刺アダプター自体を取り替える必要があるなど，施術の遅延をもたらすおそれがある。さらに，ガイド孔に穿刺針を挿入した状態では，超音波プローブと穿刺針とが穿刺アダプターを介して連結した状態となるため，超音波プローブと穿刺針とをそれぞれ独立して操作することが難しくなる。例えば，穿刺針をガイド孔に沿って生体内に刺入した状態で超音波プローブを動かしてしまうと，超音波プローブの動きに応じて穿刺針の刺入方向にずれが生じることとなる。このため，超音波プローブのみを動かして撮影する位置を微調整するという操作に危険が伴うという問題がある。その他にも，従来の穿刺アダプターは，穿刺針の針先を見失いやすくなったり，装着に手間がかかるなど，種々の問題を内包するものであった。 However, the conventional puncture adapter with a guide hole adheres to the patient's body fluid when the puncture needle is advanced or retracted along the guide hole. Or it is necessary to make the puncture adapter itself disposable, and there is a problem that it takes time and cost. In addition, the conventional puncture adapter has a problem that when the puncture needle is inserted into the guide hole, the direction of insertion into the living body is limited and the degree of freedom of operation is lost, which makes it difficult to perform the operation. . In addition, it is necessary to select a conventional adapter that has a guide hole with an appropriate diameter according to the thickness of the puncture needle, or to change the puncture adapter itself when the puncture needle is changed. There is a risk of delay. Furthermore, when the puncture needle is inserted into the guide hole, the ultrasonic probe and the puncture needle are connected via a puncture adapter, and it is difficult to operate the ultrasonic probe and the puncture needle independently of each other. Become. For example, if the ultrasonic probe is moved in a state where the puncture needle is inserted into the living body along the guide hole, a deviation occurs in the insertion direction of the puncture needle according to the movement of the ultrasonic probe. For this reason, there is a problem that the operation of finely adjusting the imaging position by moving only the ultrasonic probe is dangerous. In addition, conventional puncture adapters have various problems such as easy losing sight of the needle tip of the puncture needle and time-consuming installation.
　そこで，本発明は，上記した従来の穿刺アダプターが抱える問題のいずれか１つ以上を解決できる穿刺アダプターを提供することを課題とする。すなわち，本発明は，ガイド孔に拠らなくても，超音波プローブの走査線上の目標とする位置へ穿刺針を適切に刺入させることのできる穿刺アダプターを提供する。 Therefore, an object of the present invention is to provide a puncture adapter that can solve any one or more of the problems of the conventional puncture adapter described above. That is, the present invention provides a puncture adapter that can appropriately insert a puncture needle into a target position on a scanning line of an ultrasonic probe without relying on a guide hole.
　本発明は，基本的に，上下に延びる鏡面部を有するメインピースと，その正面側に位置するサブピースとを前後に連結し，このサブピースにスリットを設けて，術者が鏡面部に映る穿刺針の虚像をサブピースのスリットを通じて視認できるようにするという知見に基づくものである。本発明に係る穿刺アダプターを利用すれば，術者の目視方向，穿刺針の刺入位置，及び刺入角度が適切であることを，超音波ガイド下穿刺術を行う術者自身に確認させることが可能となる。そして，本発明によれば，ガイド孔等によって穿刺針を固定しなくても，超音波プローブの走査線上の目標とする位置に穿刺針を刺入させやすくなる。具体的に説明すると，本発明は以下の構成を有する。 The present invention basically connects a main piece having a mirror surface portion extending vertically and a sub-piece located on the front side of the main piece, and provides a slit in the sub-piece so that an operator can see the mirror surface portion. This is based on the knowledge that the virtual image can be visually recognized through the slit of the sub-piece. When the puncture adapter according to the present invention is used, the operator who performs ultrasonic guided puncture operation himself / herself confirms that the viewing direction of the operator, the insertion position of the puncture needle, and the insertion angle are appropriate. Is possible. And according to this invention, even if it does not fix a puncture needle by a guide hole etc., it becomes easy to insert a puncture needle in the target position on the scanning line of an ultrasonic probe. More specifically, the present invention has the following configuration.
　本発明の第１の側面は，超音波プローブに取り付けられる穿刺アダプター１に関する。穿刺アダプターは，上下方向に延びるメインピース１０と，メインピースの正面１０ａ側に位置するサブピース２０とを備え，これらのメインピース１０とサブピース２０は連結している。メインピース１０は，サブピース２０の連結部位よりも下方の正面１０ａに，上下方向に延びる鏡面部１１を有する。サブピース２０は，メインピースの正面１０ａに対して下向きに傾斜した傾斜部２１と，この傾斜部２１に形成された第１スリット２２とを有する。つまり，傾斜部２１は，穿刺針３の像を構成する光が鏡面部１１で反射した後に使用者の視点に到達するまでの光路と交わるように，傾斜している。そして，穿刺アダプターは，第１スリット２２を通じて鏡面部１１を視認することができるように構成されている。 1st aspect of this invention is related with the puncture adapter 1 attached to an ultrasonic probe. The puncture adapter includes a main piece 10 extending in the vertical direction and a subpiece 20 located on the front surface 10a side of the main piece, and the main piece 10 and the subpiece 20 are connected. The main piece 10 has a mirror surface portion 11 extending in the vertical direction on the front surface 10 a below the connecting portion of the sub-piece 20. The subpiece 20 has an inclined portion 21 inclined downward with respect to the front surface 10 a of the main piece, and a first slit 22 formed in the inclined portion 21. That is, the inclined portion 21 is inclined so as to intersect with the optical path from the time when the light constituting the image of the puncture needle 3 is reflected by the mirror surface portion 11 until reaching the user's viewpoint. The puncture adapter is configured such that the mirror surface portion 11 can be visually recognized through the first slit 22.
　本発明の穿刺アダプター１を利用して超音波ガイド下穿刺術を行う際には，まず，使用者（術者）は，サブピース２０の第１スリット２２を通じてメインピース１０の鏡面部１１を視認できる位置に，自身の視点位置（頭部）を移動させる。これにより，使用者は自身の頭部の位置や目視方向が適切であることを確認できる。その後，使用者は，サブピース２０の第１スリット２２を通じてメインピース１０の鏡面部１１を視認できる状態を維持したまま，超音波プローブの走査線上に注射針などの穿刺針を運ぶ。このとき，使用者は，メインピース１０の鏡面部１１に穿刺針が映し出されていることを確認する。そして，使用者は，穿刺針を左右に動かしながら，この穿刺針の角度が超音波プローブの走査線と略平行な角度となるように，この穿刺針の刺入角度を決定する。すなわち，使用者は，メインピース１０の鏡面部１１に映し出された穿刺針の虚像が，メインピース１０の鏡面部１１とサブピース２０の第１スリット２２と一直線上に並ぶように，穿刺針を左右に動かしながら刺入角度を決定する。このように，使用者は，サブピース２０の第１スリット２２を通じてメインピース１０の鏡面部１１に映る穿刺針の虚像を視認することで，穿刺針の刺入位置及び刺入角度が適切であるかを簡単に確認することができる。従って，ガイド孔によって穿刺針の刺入方向を案内しなくても，超音波プローブの走査線上の目標とする位置に，穿刺針適切に導くことが可能となる。 When performing an ultrasound-guided puncture using the puncture adapter 1 of the present invention, first, the user (operator) can visually recognize the mirror surface portion 11 of the main piece 10 through the first slit 22 of the subpiece 20. Move your viewpoint position (head) to the position. As a result, the user can confirm that his / her head position and viewing direction are appropriate. Thereafter, the user carries a puncture needle such as an injection needle on the scanning line of the ultrasonic probe while maintaining a state where the mirror surface portion 11 of the main piece 10 can be visually recognized through the first slit 22 of the subpiece 20. At this time, the user confirms that the puncture needle is projected on the mirror surface portion 11 of the main piece 10. Then, the user determines the insertion angle of the puncture needle so that the angle of the puncture needle becomes an angle substantially parallel to the scanning line of the ultrasonic probe while moving the puncture needle left and right. That is, the user moves the left and right puncture needles so that the virtual image of the puncture needle projected on the mirror surface portion 11 of the main piece 10 is aligned with the mirror surface portion 11 of the main piece 10 and the first slit 22 of the subpiece 20. Determine the insertion angle while moving to. In this manner, the user visually recognizes the virtual image of the puncture needle reflected on the mirror surface portion 11 of the main piece 10 through the first slit 22 of the sub-piece 20, so that the insertion position and the insertion angle of the puncture needle are appropriate. Can be easily confirmed. Therefore, it is possible to appropriately guide the puncture needle to the target position on the scanning line of the ultrasonic probe without guiding the insertion direction of the puncture needle through the guide hole.
　本発明の穿刺アダプターにおいて，鏡面部１１は，メインピース１０に形成された上下方向に延びる第２スリット１１ａと，メインピースの背面１０ｂ側に配置され第２スリット１１ａを通じて視認可能な鏡部材１１ｂと，によって構成されていることが好ましい。このような構成によれば，使用者が鏡部材１１ｂに穿刺針が映し出されているかどうかを目視で確認しやすくなる。 In the puncture adapter of the present invention, the mirror surface portion 11 includes a second slit 11a formed in the main piece 10 extending in the vertical direction, and a mirror member 11b disposed on the back surface 10b side of the main piece and visible through the second slit 11a. , Preferably. According to such a structure, it becomes easy for a user to visually confirm whether the puncture needle is projected on the mirror member 11b.
　本発明の穿刺アダプターは，メインピースの背面１０ｂに，メインピース１０を超音波プローブに固定するための取付部４０を，さらに備えることが好ましい。このとき，取付部４０は，鏡面部１１の鏡面がプローブ面に対して略垂直になるように，メインピース１０を超音波プローブに固定する。なお，プローブ面とは，超音波プローブの端部が接する面である。また，略垂直とは，８０～１００度の範囲を意味する。このようにメインピースの背面１０ｂ側に取付部４０を設けることで，穿刺アダプターを超音波プローブに取り付けやすくなるとともに，超音波プローブを扱いやすくなる。 The puncture adapter of the present invention preferably further includes an attachment portion 40 for fixing the main piece 10 to the ultrasonic probe on the back surface 10b of the main piece. At this time, the attachment portion 40 fixes the main piece 10 to the ultrasonic probe so that the mirror surface of the mirror surface portion 11 is substantially perpendicular to the probe surface. The probe surface is a surface with which the end of the ultrasonic probe contacts. Further, “substantially vertical” means a range of 80 to 100 degrees. Thus, by providing the attachment part 40 on the back surface 10b side of the main piece, the puncture adapter can be easily attached to the ultrasonic probe and the ultrasonic probe can be easily handled.
　本発明の穿刺アダプターにおいて，メインピース１０は，鏡面部１１の左右両側に非鏡面部１２をさらに有することが好ましい。メインピース１０の正面側全体が鏡面部１１であると，サブピース２０の第１スリット２２と鏡面部１１との位置合わせが行いにくくなる。このため，メインピース１０の正面には，鏡面部１１の左右両側に非鏡面部１２を設けて，鏡面部１１と非鏡面部１２とを区別することが好ましい。 In the puncture adapter of the present invention, it is preferable that the main piece 10 further has a non-mirror surface portion 12 on both the left and right sides of the mirror surface portion 11. If the entire front side of the main piece 10 is the mirror surface portion 11, it is difficult to align the first slit 22 of the subpiece 20 and the mirror surface portion 11. For this reason, it is preferable to provide a non-mirror surface portion 12 on the left and right sides of the mirror surface portion 11 on the front surface of the main piece 10 to distinguish between the mirror surface portion 11 and the non-mirror surface portion 12.
　本発明の穿刺アダプターにおいて，サブピース２０は，傾斜部２１とメインピースの正面１０ａとを間隙を空けて連結する連結部２３をさらに有することが好ましい。特に，連結部２３とメインピースの正面１０ａのなす角は，ほぼ直角（８５～９５度）であることが好ましい。このように，サブピース２０は傾斜部２１とメインピース１０の正面１０ａとの間に一定の間隙が設けられていることで，使用者が自身の頭部の位置や目視方向が適切であることかどうかをより適切に確認できるようになる。 In the puncture adapter of the present invention, it is preferable that the subpiece 20 further includes a connecting portion 23 that connects the inclined portion 21 and the front surface 10a of the main piece with a gap. In particular, the angle formed by the connecting portion 23 and the front surface 10a of the main piece is preferably substantially a right angle (85 to 95 degrees). In this way, the subpiece 20 is provided with a certain gap between the inclined portion 21 and the front surface 10a of the main piece 10, so that the position of the user's own head and the viewing direction are appropriate. It will be possible to confirm more appropriately.
　本発明の穿刺アダプターは，使用者の視点から見たときに，サブピース２０の第１スリット２２を通じて鏡面部１１を真っ直ぐに視認でき，かつ，鏡面部１１に映った穿刺針３の虚像３´が第１スリット２２及び鏡面部１１と一直線上に並ぶようにすることで，穿刺針３の刺入位置及び刺入角度を決定する。このとき，鏡面部１１の幅，及び，第１スリット２２の幅は，穿刺針３の虚像３´の外径よりも広いことが好ましい。このように，鏡面部１１と第１スリット２２の幅を穿刺針３の虚像３´の外径よりも広く設定しておくことで，使用者は鏡面部１１に映り込んだ穿刺針３の虚像３´を視認しやすくなる。 When viewed from the user's viewpoint, the puncture adapter of the present invention allows the mirror surface portion 11 to be seen straight through the first slit 22 of the subpiece 20, and the virtual image 3 ′ of the puncture needle 3 reflected on the mirror surface portion 11 is obtained. By aligning the first slit 22 and the mirror surface portion 11 in a straight line, the insertion position and the insertion angle of the puncture needle 3 are determined. At this time, the width of the mirror surface portion 11 and the width of the first slit 22 are preferably wider than the outer diameter of the virtual image 3 ′ of the puncture needle 3. Thus, by setting the width of the mirror surface portion 11 and the first slit 22 wider than the outer diameter of the virtual image 3 ′ of the puncture needle 3, the user can view the virtual image of the puncture needle 3 reflected on the mirror surface portion 11. It becomes easy to visually recognize 3 '.
　本発明の第２の側面は，前述した第１の側面に係る穿刺アダプター１と，この穿刺アダプター１が取り付けられた超音波プローブ２と，を備える超音波装置に関する。本発明に係る超音波装置において，穿刺アダプター１は超音波プローブ２に対して着脱可能に取り付けられていてもよいし，穿刺アダプター１と超音波プローブ２は一体的に（着脱不能）に取り付けられていてもよい。つまり，本発明の超音波診断装置は，穿刺アダプター１と超音波プローブ２とが一体的に構成されていてもよい。なお，超音波プローブ２としては，適宜公知のものを用いることができる。 The second aspect of the present invention relates to an ultrasonic apparatus including the puncture adapter 1 according to the first aspect described above and an ultrasonic probe 2 to which the puncture adapter 1 is attached. In the ultrasonic apparatus according to the present invention, the puncture adapter 1 may be detachably attached to the ultrasonic probe 2, or the puncture adapter 1 and the ultrasonic probe 2 are attached integrally (not detachable). It may be. That is, in the ultrasonic diagnostic apparatus of the present invention, the puncture adapter 1 and the ultrasonic probe 2 may be configured integrally. In addition, as the ultrasonic probe 2, a well-known thing can be used suitably.
　本発明によれば，ガイド孔に拠らなくても，超音波プローブの走査線上の目標とする位置に穿刺針を適切に刺入させることのできる穿刺アダプターを提供することができる。 According to the present invention, it is possible to provide a puncture adapter capable of appropriately inserting a puncture needle at a target position on the scanning line of an ultrasonic probe without depending on a guide hole.
図１は，本発明に係る穿刺アダプターの一例を示した正面側斜視図である。FIG. 1 is a front perspective view showing an example of a puncture adapter according to the present invention. 図２は，本発明に係る穿刺アダプターの一例を示した背面側側面図である。FIG. 2 is a rear side view showing an example of the puncture adapter according to the present invention. 図３は，穿刺アダプターを超音波プローブに取り付けた状態を示した模式図である。FIG. 3 is a schematic view showing a state where the puncture adapter is attached to the ultrasonic probe. 図４は，第１スリットと鏡面部を合わせる操作を使用者の視点位置から模式的に描画している。FIG. 4 schematically illustrates an operation for aligning the first slit and the mirror surface portion from the viewpoint position of the user. 図５は，穿刺針の刺入位置及び刺入角度を決定する操作を使用者の視点位置から模式的に描画している。FIG. 5 schematically illustrates an operation for determining the insertion position and insertion angle of the puncture needle from the viewpoint position of the user.
　以下，図面を用いて本発明を実施するための形態について説明する。本発明は，以下に説明する形態に限定されるものではなく，以下の形態から当業者が自明な範囲で適宜変更したものも含む。 Hereinafter, embodiments for carrying out the present invention will be described with reference to the drawings. This invention is not limited to the form demonstrated below, The thing suitably changed in the range obvious to those skilled in the art from the following forms is also included.
　本願明細書において，「正面」というときは，穿刺アダプターを超音波プローブに取り付けて使用している状態において，使用者の視点と相対する面を意味する。また，本願明細書において，「背面」というときは，正面とは反対側の面，すなわち穿刺アダプターの使用状態においては使用者によっては視認されない面を意味する。また，本願明細書において，「上下」というときは，穿刺アダプターを超音波プローブに取り付けた状態における上下の方向を意味する。また，本願明細書において，「前後」及び「左右」というときは，穿刺アダプターを超音波プローブに取り付けて穿刺アダプターを使用している状態において，使用者の視点を基準とした前後の方向及び左右の方向を意味する。 In the present specification, the term “front” means a surface facing the user's viewpoint when the puncture adapter is attached to the ultrasonic probe. In the present specification, the term “rear surface” means a surface opposite to the front surface, that is, a surface that is not visually recognized by the user when the puncture adapter is used. Further, in this specification, “up and down” means the up and down direction in a state where the puncture adapter is attached to the ultrasonic probe. Also, in this specification, “front and rear” and “left and right” refer to the front and rear directions and the left and right directions based on the viewpoint of the user when the puncture adapter is used with the puncture adapter attached to the ultrasonic probe. Means the direction.
　図１は，穿刺アダプター１の正面側斜視図であり，図２は，穿刺アダプター１の背面側斜視図である。また，図３は，穿刺アダプター１が超音波プローブ２に取り付けられた超音波装置の概要を示している。図１から図３に示されるように，穿刺アダプター１は，超音波プローブ２に取り付けて使用される。穿刺アダプター１は，超音波ガイド下穿刺術において，注射針などの穿刺針３の刺入方向を，超音波プローブ２から発生された超音波の走査線（図３の一点鎖線）上に案内するために用いられる。穿刺アダプター１を正しく使用して，穿刺針３の刺入方向を決定することで，超音波プローブ２の走査線上に位置する生体内の目標とする部位（例えば血管など）に，この穿刺針３を正しく刺し込むことが可能となる。 1 is a front perspective view of the puncture adapter 1, and FIG. 2 is a rear perspective view of the puncture adapter 1. FIG. FIG. 3 shows an outline of an ultrasonic apparatus in which the puncture adapter 1 is attached to the ultrasonic probe 2. As shown in FIGS. 1 to 3, the puncture adapter 1 is used by being attached to an ultrasonic probe 2. The puncture adapter 1 guides the insertion direction of the puncture needle 3 such as an injection needle onto an ultrasonic scanning line (dotted line in FIG. 3) generated from the ultrasonic probe 2 in ultrasonic guided puncture. Used for. By correctly using the puncture adapter 1 and determining the insertion direction of the puncture needle 3, the puncture needle 3 is placed on a target site (for example, a blood vessel) in the living body located on the scanning line of the ultrasonic probe 2. Can be inserted correctly.
　図１及び図２に示した実施形態において，穿刺アダプター１は，基本的に，メインピース１０と，サブピース２０と，鏡部材保持部３０と，取付部４０とを備える。また，図２に示されるように，穿刺アダプター１は，メインピース１０と鏡部材保持部３０との間に挿入可能な板状の鏡部材１１ｂを備えている。 1 and 2, the puncture adapter 1 basically includes a main piece 10, a subpiece 20, a mirror member holding portion 30, and an attachment portion 40. As shown in FIG. 2, the puncture adapter 1 includes a plate-like mirror member 11 b that can be inserted between the main piece 10 and the mirror member holding portion 30.
　メインピース１０は，上下方向に延びる部位である。本実施形態においては，メインピース１０の上端部分の正面１０ａ側にサブピース２０が設けられ，メインピース１０の下端部分の背面１０ｂ側に取付部４０が設けられる。本実施形態において，メインピース１０は，上下方向と左右方向とを有し，上下方向の長く延びる板状に構成されている。メインピース１０の上下方向の長さと左右方向の幅は適宜設計可能である。例えば，メインピース１０の長さは，１００ｍｍ～２００ｍｍとすればよい。また，メインピース１０の幅は，１０ｍｍ～９０ｍｍとすればよい。メインピース１０の厚みは，特に限定されないが，５～１５ｍｍとすればよい。 The main piece 10 is a part extending in the vertical direction. In the present embodiment, the subpiece 20 is provided on the front surface 10 a side of the upper end portion of the main piece 10, and the attachment portion 40 is provided on the back surface 10 b side of the lower end portion of the main piece 10. In the present embodiment, the main piece 10 has a vertical direction and a horizontal direction, and is configured in a plate shape extending in the vertical direction. The vertical length and the horizontal width of the main piece 10 can be appropriately designed. For example, the length of the main piece 10 may be 100 mm to 200 mm. The width of the main piece 10 may be 10 mm to 90 mm. The thickness of the main piece 10 is not particularly limited, but may be 5 to 15 mm.
　メインピース１０の正面１０ａ側には，上下方向に直線状に延びる鏡面部１１が設けられている。鏡面部１１は，メインピース１０の正面１０ａ側に位置する物体を映し出す鏡で構成されている。つまり，鏡面部１１は，少なくとも正面側に光（主に可視光）を反射する鏡面を有する。鏡面部１１は，別途設けられた鏡部材１１ｂによって構成されていてもよいし，その他，正面１０ａに鏡面塗料を塗布したり鏡面を持つシールを貼付することによっても実現できる。鏡面部１１は，少なくとも使用者が扱う穿刺針３の虚像３´を映し出すことのできる幅を有する。つまり，鏡面部１１の幅は，穿刺アダプター１の使用状態において，この鏡面部１１に映り込んだ穿刺針３の虚像３´の外径よりも広いことが好ましい。鏡面部１１の幅は，例えば１ｍｍ～１５ｍｍとすればよく，特に２ｍｍ～１０ｍｍであることが好ましい。また，鏡面部１１は，少なくともメインピース１０の全長の半分を超える長さを有することが好ましい。 On the front surface 10a side of the main piece 10, a mirror surface portion 11 that extends linearly in the vertical direction is provided. The mirror surface portion 11 is configured by a mirror that projects an object located on the front surface 10 a side of the main piece 10. That is, the mirror surface portion 11 has a mirror surface that reflects light (mainly visible light) at least on the front side. The mirror surface portion 11 may be configured by a separately provided mirror member 11b, or may be realized by applying a mirror surface paint or attaching a seal having a mirror surface to the front surface 10a. The mirror surface portion 11 has a width that can project at least the virtual image 3 ′ of the puncture needle 3 handled by the user. That is, the width of the mirror surface portion 11 is preferably wider than the outer diameter of the virtual image 3 ′ of the puncture needle 3 reflected on the mirror surface portion 11 when the puncture adapter 1 is in use. The width of the mirror surface portion 11 may be, for example, 1 mm to 15 mm, and particularly preferably 2 mm to 10 mm. Moreover, it is preferable that the mirror surface part 11 has a length exceeding at least half of the total length of the main piece 10.
　鏡面部１１は，メインピース１０の正面の左右方向の中央に位置している。つまり，鏡面部１１は，メインピース１０の中心線に沿って延びたものである。また，鏡面部１１の左右両側には，非鏡面部１２が設けられている。非鏡面部１２は，物体を映し出すことができない部位であり，その形成方法は特に限定されない。鏡面部１１の左右両側に非鏡面部１２を設けることで，使用者が鏡面部１１の位置を把握しやすくなる。 The mirror surface portion 11 is located at the center in the left-right direction on the front surface of the main piece 10. That is, the mirror surface portion 11 extends along the center line of the main piece 10. Further, non-mirror surface portions 12 are provided on both the left and right sides of the mirror surface portion 11. The non-mirror surface portion 12 is a portion that cannot project an object, and the formation method is not particularly limited. By providing the non-mirror surface portions 12 on both the left and right sides of the mirror surface portion 11, the user can easily grasp the position of the mirror surface portion 11.
　図１及び図２に示されるように，本実施形態において，鏡面部１１は，第２スリット１１ａと鏡部材１１ｂとによって構成されている。第２スリット１１ａは，メインピース１０の正面から背面まで貫通する穴であり，上下方向に長く延びている。図１に示された例において，第２スリット１１ａは，下端が開き，上端が閉じた状態となっている。ただし，第２スリット１１ａは，下端と上端の両方が閉じられていてもよいし，下端と上端の両方が開いていてもよい。また，図の例とは反対に，第２スリット１１ａは，下端が閉じ，上端が開いた状態のものであってもよい。第２スリット１１ａは，メインピース１０の正面の左右方向の中央に位置している。第２スリット１１ａの幅は，前述した鏡面部１１の幅に一致するものであり，１ｍｍ～１５ｍｍ又は２ｍｍ～１０ｍｍとすればよい。鏡部材１１ｂは，メインピース１０の背面１０ｂ側に配置される部材であり，メインピース１０から取り外すことができる。鏡部材１１ｂは，少なくとも一面が鏡面となっており，その鏡面がメインピース１０の背面１０ｂに接するように配置される。これにより，メインピース１０の第２スリット１１ａを通じて，鏡部材１１ｂの鏡面が，メインピース１０の正面１０ａ側に露出する。従って，使用者は，メインピース１０の正面１０ａ側から，鏡部材１１ｂの鏡面を視認することができる。このように，使用者に対して第２スリット１１ａを通じて鏡面を視認させることで，使用者はその鏡面の位置を目視で把握しやすくなる。 As shown in FIGS. 1 and 2, in the present embodiment, the mirror surface portion 11 is constituted by a second slit 11a and a mirror member 11b. The second slit 11a is a hole penetrating from the front to the back of the main piece 10, and extends long in the vertical direction. In the example shown in FIG. 1, the second slit 11a is in a state where the lower end is open and the upper end is closed. However, both the lower end and the upper end of the second slit 11a may be closed, or both the lower end and the upper end may be open. Further, contrary to the example in the figure, the second slit 11a may be in a state where the lower end is closed and the upper end is opened. The second slit 11 a is located at the center in the left-right direction on the front surface of the main piece 10. The width of the second slit 11a matches the width of the mirror surface portion 11 described above, and may be 1 mm to 15 mm or 2 mm to 10 mm. The mirror member 11 b is a member disposed on the back surface 10 b side of the main piece 10 and can be detached from the main piece 10. The mirror member 11 b has at least one surface as a mirror surface, and is arranged so that the mirror surface is in contact with the back surface 10 b of the main piece 10. Thereby, the mirror surface of the mirror member 11 b is exposed to the front surface 10 a side of the main piece 10 through the second slit 11 a of the main piece 10. Therefore, the user can visually recognize the mirror surface of the mirror member 11 b from the front surface 10 a side of the main piece 10. As described above, by allowing the user to visually recognize the mirror surface through the second slit 11a, the user can easily grasp the position of the mirror surface visually.
　また，図２に示されるように，穿刺アダプター１は，メインピース１０の背面１０ｂ側に鏡部材保持部３０を有していてもよい。鏡部材保持部３０は，メインピース１０の背面１０ｂとの間で鏡部材１１ｂを挟み込むことにより，この鏡部材１１ｂを保持する。つまり，鏡部材１１ｂは，メインピース１０と鏡部材保持部３０との間に差し込むことができるようになっている。また，鏡部材１１ｂは自由に着脱することができる。 Further, as shown in FIG. 2, the puncture adapter 1 may have a mirror member holding portion 30 on the back surface 10 b side of the main piece 10. The mirror member holding unit 30 holds the mirror member 11b by sandwiching the mirror member 11b with the back surface 10b of the main piece 10. That is, the mirror member 11 b can be inserted between the main piece 10 and the mirror member holding portion 30. Further, the mirror member 11b can be freely attached and detached.
　図１及び図２に示されるように，メインピース１０の上端の正面１０ａ側には，サブピース２０が連結されている。サブピース２０は，基本的に，メインピース１０と一体的に成型されている。サブピース２０は，メインピース１０と同様の幅及び厚みを持つ板状とすることが好ましい。本実施形態において，サブピース２０は，メインピース１０の上端に取り付けられているが，本発明はこのような形態に限定されない。例えば，メインピース１０は，サブピース２０よりも上方に延出する部位を有するものであってもよい。この場合，サブピース２０は，メインピース１０の長手方向の中頃に連結されることとなる。本発明は，メインピース１０に設けられた鏡面部１１が，少なくとも，サブピース２０の連結部位よりも下方に位置していればよい。 As shown in FIGS. 1 and 2, a subpiece 20 is connected to the front face 10 a side of the upper end of the main piece 10. The subpiece 20 is basically molded integrally with the main piece 10. The sub-piece 20 is preferably a plate having the same width and thickness as the main piece 10. In the present embodiment, the subpiece 20 is attached to the upper end of the main piece 10, but the present invention is not limited to such a form. For example, the main piece 10 may have a portion extending upward from the subpiece 20. In this case, the subpiece 20 is connected to the middle of the main piece 10 in the longitudinal direction. In the present invention, it is only necessary that the mirror surface portion 11 provided on the main piece 10 is positioned at least below the connecting portion of the subpiece 20.
　サブピース２０は，メインピース１０の正面１０ａに対して下向きに傾斜した傾斜部２１を有している。ここにいう「下向きに傾斜」するとは，つまり，メインピース１０から最も遠い傾斜部２１の遠位端２１ａが，メインピース１０に最も近い傾斜部２１の近位端２１ｂよりも，下方に位置することを意味する。すなわち，傾斜部２１は，穿刺針３の像を構成する光が鏡面部１１で反射した後に使用者の視点に到達するまでの光路と交わるように，傾斜している。また，図２において，傾斜部２１とメインピース１０とのなす角が，符号θで示されている。例えば，なす角θは，２０度～８５度，３０度～８０度，又は４５～６０度であることが好ましい。傾斜部２１は，メインピース１０の正面１０ａから離れる方向に延在する。例えば，傾斜部２１の近位端２１ｂから遠位端２１ａまでの長さは，２０ｍｍ～１００ｍｍ又は３０ｍｍ～８０ｍｍとすればよい。 The subpiece 20 has an inclined portion 21 inclined downward with respect to the front surface 10a of the main piece 10. Here, “inclined downward” means that the distal end 21 a of the inclined portion 21 farthest from the main piece 10 is located below the proximal end 21 b of the inclined portion 21 closest to the main piece 10. Means that. That is, the inclined portion 21 is inclined so as to intersect with an optical path until the light constituting the image of the puncture needle 3 reaches the user's viewpoint after being reflected by the mirror surface portion 11. Further, in FIG. 2, the angle formed by the inclined portion 21 and the main piece 10 is indicated by the symbol θ. For example, the angle θ formed is preferably 20 to 85 degrees, 30 to 80 degrees, or 45 to 60 degrees. The inclined portion 21 extends in a direction away from the front surface 10 a of the main piece 10. For example, the length from the proximal end 21b to the distal end 21a of the inclined portion 21 may be 20 mm to 100 mm or 30 mm to 80 mm.
　サブピース２０の傾斜部２１には，第１スリット２２が形成されている。第１スリット２２は，傾斜部２１を貫通する穴であり，傾斜部２１の延在方向に沿って長く延びている。図１に示された例において，第１スリット２２は，下端が開き，上端が閉じた状態となっている。ただし，第１スリット２２は，下端と上端の両方が閉じられていてもよいし，下端と上端の両方が開いていてもよい。また，第１スリット２２は，鏡面部１１（第２スリット１１ａ）と同様に，サブピース２０の傾斜部２１の左右方向の中央に位置している。つまり，第１スリット２２は，サブピース２０の中心線に沿って延びたものである。このため，第１スリット２２と鏡面部１１（第２スリット１１ａ）とは，共に，穿刺アダプター１の中心線に沿って形成されたものとなる。これにより，使用者が穿刺アダプター１を正面側からみたときに，使用者の視点が穿刺アダプター１の中心線と一致している場合に，使用者は，第１スリット２２を通じて，鏡面部１１（第２スリット１１ａ）を視認することとなる。また，第１スリットの幅は，鏡面部１１（第２スリット１１ａ）と略等しいことが好ましい。具体的に，第１スリットの幅は，鏡面部１１の幅に対して，９０％～１１０％の範囲の値であることが好ましい。また，第１スリット２２の幅は，穿刺アダプター１の使用状態において，鏡面部１１に映り込んだ穿刺針３の虚像３´の外径よりも広いことが好ましい。 A first slit 22 is formed in the inclined portion 21 of the subpiece 20. The first slit 22 is a hole that penetrates the inclined portion 21 and extends long along the extending direction of the inclined portion 21. In the example shown in FIG. 1, the first slit 22 is in a state where the lower end is open and the upper end is closed. However, both the lower end and the upper end of the first slit 22 may be closed, or both the lower end and the upper end may be open. Moreover, the 1st slit 22 is located in the center of the left-right direction of the inclination part 21 of the subpiece 20 similarly to the mirror surface part 11 (2nd slit 11a). That is, the first slit 22 extends along the center line of the subpiece 20. For this reason, the first slit 22 and the mirror surface portion 11 (second slit 11a) are both formed along the center line of the puncture adapter 1. Thus, when the user views the puncture adapter 1 from the front side, when the user's viewpoint coincides with the center line of the puncture adapter 1, the user passes the first slit 22 through the mirror surface portion 11 ( The second slit 11a) will be visually recognized. Moreover, it is preferable that the width | variety of a 1st slit is substantially equal to the mirror surface part 11 (2nd slit 11a). Specifically, the width of the first slit is preferably a value in the range of 90% to 110% with respect to the width of the mirror surface portion 11. Moreover, it is preferable that the width | variety of the 1st slit 22 is wider than the outer diameter of virtual image 3 'of the puncture needle 3 reflected on the mirror surface part 11 in the use condition of the puncture adapter 1. FIG.
　また，サブピース２０は，傾斜部２１とメインピース１０と間に連結部２３を有していてもよい。連結部２３は，傾斜部２１とメインピースの正面１０ａとを間隙を空けて連結する部位である。このとき，連結部２３とメインピースの正面１０ａのなす角は，ほぼ直角（８５～９５度）であることが好ましい。このように，サブピース２０は傾斜部２１とメインピース１０の正面１０ａとの間に一定の間隙が設けられていることで，使用者が自身の頭部の位置や目視方向が適切であることかどうかをより適切に確認できるようになる。連結部２３の長さ（すなわち，メインピースの正面１０ａから傾斜部２１の近位端２１ｂまでの距離）は，例えば，３ｍｍ～４０ｍｍ，又は１０ｍｍ～３０ｍｍとすればよい。 Further, the subpiece 20 may have a connecting portion 23 between the inclined portion 21 and the main piece 10. The connecting portion 23 is a portion that connects the inclined portion 21 and the front surface 10a of the main piece with a gap. At this time, it is preferable that the angle formed by the connecting portion 23 and the front surface 10a of the main piece is substantially a right angle (85 to 95 degrees). In this way, the subpiece 20 is provided with a certain gap between the inclined portion 21 and the front surface 10a of the main piece 10, so that the position of the user's own head and the viewing direction are appropriate. It will be possible to confirm more appropriately. The length of the connecting portion 23 (that is, the distance from the front face 10a of the main piece to the proximal end 21b of the inclined portion 21) may be, for example, 3 mm to 40 mm, or 10 mm to 30 mm.
　取付部４０は，穿刺アダプター１の本体を超音波プローブ２に取り付けるための構造を有する。取付部４０を介して穿刺アダプター１の本体を超音波プローブ２に取り付けることで，鏡面部１１の鏡面がプローブ面に対して略垂直になる。図１から図３に示した例において，取付部４０は，左右二対（合計４本）のアーム部４１を有している。このため，左右のアーム部４１で超音波プローブ２を挟み込むことで，穿刺アダプター１を超音波プローブ２に固定することができる。例えば，左右のアーム部４１に輪ゴムを巻き付けることで，左右のアーム部４１で超音波プローブ２を挟み込んで固定することができる。また，各アーム部４１の下縁と上縁の両方又は一方には，一又は複数箇所に切欠き４２が形成されている。例えば，左右のアーム部４１に輪ゴムを巻き付けて固定する際に，切欠き４２に輪ゴムが係合するようになっている。これにより，左右のアーム部４１に安定的に輪ゴムを巻き付けることが可能となる。図１等に示した例において，取付部４０は，メインピース１０の下端に設けられており，この下端から背面１０ｂ側に向かって延在している。ただし，取付部４０を設ける位置は，メインピース１０の下端に限定されず，メインピース１０の中頃であってもよい。 The attachment part 40 has a structure for attaching the main body of the puncture adapter 1 to the ultrasonic probe 2. By attaching the main body of the puncture adapter 1 to the ultrasonic probe 2 via the attachment part 40, the mirror surface of the mirror surface part 11 becomes substantially perpendicular to the probe surface. In the example shown in FIG. 1 to FIG. 3, the mounting portion 40 has two pairs of left and right (total four) arm portions 41. For this reason, the puncture adapter 1 can be fixed to the ultrasonic probe 2 by sandwiching the ultrasonic probe 2 between the left and right arm portions 41. For example, by wrapping rubber bands around the left and right arm portions 41, the ultrasonic probe 2 can be sandwiched and fixed between the left and right arm portions 41. Further, notches 42 are formed in one or a plurality of locations on both or one of the lower edge and the upper edge of each arm portion 41. For example, when the rubber bands are wound around and fixed to the left and right arm portions 41, the rubber bands are engaged with the notches 42. Thereby, it is possible to stably wrap the rubber bands around the left and right arm portions 41. In the example shown in FIG. 1 and the like, the attachment portion 40 is provided at the lower end of the main piece 10, and extends from the lower end toward the back surface 10b. However, the position where the attachment portion 40 is provided is not limited to the lower end of the main piece 10 and may be in the middle of the main piece 10.
　続いて，本発明に係る穿刺アダプター１を利用して，注射針等の穿刺針３の刺入位置及び刺入角度を決定する方法について説明する。 Subsequently, a method for determining the insertion position and the insertion angle of the puncture needle 3 such as an injection needle using the puncture adapter 1 according to the present invention will be described.
　図４は，使用者の視点位置を決定する操作を説明するための図である。図４は，使用者の視点から見た穿刺アダプター１及び超音波プローブ２を模式的に示している。図４（ａ）に示されるように，メインピース１０の正面側の上方に，サブピース２０が位置している。超音波プローブ２に取り付けられた穿刺アダプター１を上側から覗き込むような体勢の場合，メインピース１０は，部分的に，サブピース２０の裏に隠れることとなる。このため，使用者の視点位置からは，メインピース１０の全体を視認することはできない。図４（ａ）に示した状態では，サブピース２０の第１スリット２２と，メインピース１０の鏡面部１１は揃っていない。つまり，サブピース２０の第１スリット２２を通じて，メインピース１０の鏡面部１１を一直線上に視認できない状態にある。この状態は，使用者の視点と穿刺アダプター１との相対的な位置関係が悪い状態であるといえる。 FIG. 4 is a diagram for explaining an operation for determining the viewpoint position of the user. FIG. 4 schematically shows the puncture adapter 1 and the ultrasonic probe 2 viewed from the user's viewpoint. As shown in FIG. 4A, the subpiece 20 is located above the front side of the main piece 10. When the posture is such that the puncture adapter 1 attached to the ultrasonic probe 2 is looked up from above, the main piece 10 is partially hidden behind the subpiece 20. For this reason, the whole main piece 10 cannot be visually recognized from the viewpoint position of the user. In the state shown in FIG. 4A, the first slit 22 of the subpiece 20 and the mirror surface portion 11 of the main piece 10 are not aligned. That is, the mirror surface portion 11 of the main piece 10 cannot be visually recognized through the first slit 22 of the subpiece 20. This state can be said to be a state where the relative positional relationship between the user's viewpoint and the puncture adapter 1 is poor.
　そこで，図４（ｂ）に示されるように，穿刺アダプター１が取り付けられた超音波プローブ２を左右に回転させるか，あるいは使用者の頭部の位置を移動させることによって，使用者の視点から，サブピース２０の第１スリット２２を通じて，メインピース１０の鏡面部１１を真っ直ぐに視認できるように調整する。図４（ｂ）の状態は，使用者の視点から見て，サブピース２０の第１スリット２２とメインピース１０の鏡面部１１が完全に揃っており，第１スリット２２を通じて鏡面部１１が一直線上に見えている。このような状態は，使用者の視点と穿刺アダプター１との相対的な位置関係が適切な状態であるといえる。 Therefore, as shown in FIG. 4B, by rotating the ultrasonic probe 2 to which the puncture adapter 1 is attached to the left or right, or by moving the position of the user's head, from the viewpoint of the user. The mirror surface portion 11 of the main piece 10 is adjusted so that it can be seen straight through the first slit 22 of the subpiece 20. 4B, the first slit 22 of the subpiece 20 and the mirror surface portion 11 of the main piece 10 are completely aligned from the viewpoint of the user, and the mirror surface portion 11 is in a straight line through the first slit 22. It looks like In this state, it can be said that the relative positional relationship between the user's viewpoint and the puncture adapter 1 is appropriate.
　次に，図５は，穿刺針３の刺入位置及び刺入角度を決定する操作を説明するための図である。図５は，図４と同様に，使用者の視点から見た穿刺アダプター１及び超音波プローブ２を模式的に示している。まずは，前述の図４（ｂ）で決定した使用者の視点位置を動かさないようにして，穿刺針３の刺入位置を決定する。つまり，図５（ａ）に示されるように，サブピース２０の第１スリット２２とメインピース１０の鏡面部１１が揃った状態を維持しておく。この状態で，使用者は，サブピース２０の第１スリット２２を通じて，メインピース１０の鏡面部１１を上から覗き込む。すると，鏡面部１１には，穿刺アダプター１の下側の領域が映し出される。使用者は手元で穿刺針３を操作しているため，メインピース１０の鏡面部１１には穿刺針３の虚像３´が投影される。ただし，図５（ａ）に示されるように，鏡面部１１に投影された穿刺針３の虚像３´は，この鏡面部１１及びサブピース２０の第１スリット２２と一直線上に並んでおらず，傾いた状態となっている。このような状態は，使用者の視点から見て，穿刺針３の刺入角度が悪い状態であるといえる。 Next, FIG. 5 is a diagram for explaining an operation for determining the insertion position and the insertion angle of the puncture needle 3. FIG. 5 schematically shows the puncture adapter 1 and the ultrasonic probe 2 viewed from the user's viewpoint, as in FIG. First, the insertion position of the puncture needle 3 is determined without moving the viewpoint position of the user determined in FIG. 4B. That is, as shown in FIG. 5A, the state in which the first slit 22 of the subpiece 20 and the mirror surface portion 11 of the main piece 10 are aligned is maintained. In this state, the user looks into the mirror surface portion 11 of the main piece 10 from above through the first slit 22 of the subpiece 20. Then, the lower area of the puncture adapter 1 is displayed on the mirror surface portion 11. Since the user operates the puncture needle 3 at hand, a virtual image 3 ′ of the puncture needle 3 is projected onto the mirror surface portion 11 of the main piece 10. However, as shown in FIG. 5 (a), the virtual image 3 'of the puncture needle 3 projected onto the mirror surface portion 11 is not aligned with the mirror surface portion 11 and the first slit 22 of the subpiece 20, It is in a tilted state. It can be said that such a state is a state where the insertion angle of the puncture needle 3 is bad from the viewpoint of the user.
　そこで，図５（ｂ）に示されるように，使用者は，視点を動かさずに，手元で操作する穿刺針３を左右に回転移動させて，使用者の視点から見て，鏡面部１１に映った穿刺針３の虚像３´が，この鏡面部１１及びサブピース２０の第１スリット２２と一直線上に並ぶように調整する。つまり，図５（ｂ）に示されるように，使用者の視点から見たときに，サブピース２０の第１スリット２２を通じて鏡面部１１を真っ直ぐに視認でき，かつ，この鏡面部１１に映った穿刺針３の虚像３´が第１スリット２２及び鏡面部１１と一直線上に並ぶように，穿刺針３の刺入角度を決定する。このような図５（ｂ）に示した状態が，使用者の視点位置，穿刺針３の刺入位置，及び穿刺針３の刺入角度が適切に決定された状態であるといえる。そこで，使用者は，この状態になったことを確認できた後に，穿刺針３を真っ直ぐに患者の皮膚や体内に進入させる。これにより，超音波プローブ２によるガイドの下，その走査線上の目標とする部位に穿刺針３を確実に刺入できるようになる。 Therefore, as shown in FIG. 5B, the user rotates the puncture needle 3 that is operated at hand without moving the viewpoint, and moves the puncture needle 3 to the left and right to view the mirror surface portion 11 as viewed from the user's viewpoint. The reflected virtual image 3 ′ of the puncture needle 3 is adjusted so as to be aligned with the mirror surface portion 11 and the first slit 22 of the subpiece 20. That is, as shown in FIG. 5B, when viewed from the user's point of view, the mirror surface portion 11 can be seen straight through the first slit 22 of the subpiece 20, and the puncture reflected on the mirror surface portion 11 can be seen. The insertion angle of the puncture needle 3 is determined so that the virtual image 3 ′ of the needle 3 is aligned with the first slit 22 and the mirror surface portion 11. The state shown in FIG. 5B can be said to be a state in which the viewpoint position of the user, the insertion position of the puncture needle 3, and the insertion angle of the puncture needle 3 are appropriately determined. Therefore, after confirming that the user has reached this state, the user enters the puncture needle 3 straight into the patient's skin or body. As a result, the puncture needle 3 can be reliably inserted into the target site on the scanning line under the guide of the ultrasonic probe 2.
　以上のとおり，本発明に係る穿刺アダプター１を利用すれば，従来のアダプターのようにガイド孔を利用して穿刺針の移動方向を規制しなくても，使用者が超音波プローブ２の走査線上に穿刺針３を刺入する操作を適切に補助することができる。従って，本発明の穿刺アダプター１によれば，ガイド孔が設けられた従来のアダプターが抱える問題を解消することができる。例えば，本発明の穿刺アダプター１は，透明な滅菌プローブカバーの中に装着することができ基本的に患者の体液が付着することがないため，繰り返し使用することが可能である。また，本発明の穿刺アダプター１は，穿刺針３の刺入方向を物理的に規制するものではないため，穿刺針３の操作の自由度が高くなるとともに，超音波プローブ２と穿刺針３とをそれぞれ独立して操作することが可能となる。さらに，本発明の穿刺アダプター１は，例えば穿刺針３の太さに関わらず，すべての穿刺針３で使用することができるため，穿刺針３の太さに応じてアダプターを付け替える手間を省くことができ，施術を迅速に遂行することができる。 As described above, when the puncture adapter 1 according to the present invention is used, the user can use the guide hole on the scanning line of the ultrasonic probe 2 without using the guide hole to regulate the moving direction of the puncture needle. The operation of inserting the puncture needle 3 can be appropriately assisted. Therefore, according to the puncture adapter 1 of the present invention, it is possible to solve the problem of the conventional adapter provided with the guide hole. For example, the puncture adapter 1 of the present invention can be mounted in a transparent sterilized probe cover and can be used repeatedly because the patient's bodily fluid basically does not adhere. In addition, since the puncture adapter 1 of the present invention does not physically restrict the insertion direction of the puncture needle 3, the degree of freedom of operation of the puncture needle 3 is increased, and the ultrasonic probe 2, the puncture needle 3, Can be operated independently. Furthermore, since the puncture adapter 1 of the present invention can be used with all the puncture needles 3 regardless of the thickness of the puncture needle 3, for example, it is possible to save the trouble of changing the adapter according to the thickness of the puncture needle 3. Can perform treatment quickly.
　さらに，例えば人体の腕部のように，丸みを帯びた部位に超音波プローブのプローブ面を接触させる場合，超音波プローブ自体が傾くことがある。このように接地面が傾いた状態では，従来の穿刺アダプターを利用して穿刺針を正確に超音波プローブの走査線上に導くことが難しいとされていた。これに対して，本発明の穿刺アダプター１は，使用者自身がメインピース１０の鏡面部１１とサブピース２０の第１スリット２２を目視しながら，穿刺針３の刺入位置と刺入角度を微調整することができる。このため，人体の腕部に超音波プローブ２を接触させる場合のように，超音波プローブ２の接地面が傾いた状態であっても，使用者の技術によって，穿刺針３の針先を超音波プローブ２の走査線上へと正確に導くことができる。このように，本発明の穿刺アダプター１は，従来のアダプターと比較して，傾いた接地面で運用する際の有効性が高いといえる。 Furthermore, when the probe surface of the ultrasonic probe is brought into contact with a rounded part such as a human arm, for example, the ultrasonic probe itself may tilt. In such a state where the ground contact surface is inclined, it has been difficult to accurately guide the puncture needle onto the scanning line of the ultrasonic probe using a conventional puncture adapter. In contrast, in the puncture adapter 1 of the present invention, the user himself / herself visually observes the mirror surface portion 11 of the main piece 10 and the first slit 22 of the subpiece 20 while finely adjusting the insertion position and the insertion angle of the puncture needle 3. Can be adjusted. For this reason, even when the ground contact surface of the ultrasonic probe 2 is tilted as in the case where the ultrasonic probe 2 is brought into contact with the human arm, the needle tip of the puncture needle 3 is superposed by the user's technique. The sound probe 2 can be accurately guided onto the scanning line. Thus, it can be said that the puncture adapter 1 of the present invention is highly effective when operated on a tilted ground surface as compared with the conventional adapter.
　また，本発明の穿刺アダプター１は，再利用可能なものであってもよいし，使い捨てのものであってもよい。穿刺アダプター１を再利用する場合には，その使用後に超音波プローブ２から穿刺アダプター１を取り外して，加熱消毒することが好ましい。また，穿刺アダプター１が使い捨てタイプである場合には，穿刺アダプター１の本体は安価なプラスチック製とすると良い。 The puncture adapter 1 of the present invention may be reusable or disposable. When the puncture adapter 1 is reused, it is preferable to remove the puncture adapter 1 from the ultrasonic probe 2 after use and disinfect by heating. When the puncture adapter 1 is a disposable type, the main body of the puncture adapter 1 is preferably made of inexpensive plastic.
　本願明細書では，主として，超音波プローブ２に対して着脱自在に構成された穿刺アダプター１について説明を行った。ただし，穿刺アダプター１と超音波プローブ２とは予め一体的に構成されており，互いに分離不能なものであってもよい。 In the present specification, the puncture adapter 1 configured to be detachable from the ultrasonic probe 2 has been mainly described. However, the puncture adapter 1 and the ultrasonic probe 2 may be configured integrally in advance and cannot be separated from each other.
　また，穿刺アダプター１の構成は上述したとおりである。他方で，超音波プローブ２の構成は，特に限定されるものではなく，例えば特許文献１（特開２００６－２１２１６５号公報）に開示されているものなど，適宜公知の構成を採用することができる。 The configuration of the puncture adapter 1 is as described above. On the other hand, the configuration of the ultrasonic probe 2 is not particularly limited, and a known configuration such as that disclosed in Patent Document 1 (Japanese Patent Laid-Open No. 2006-212165) can be appropriately employed. .
　また，本願明細書では，術者が目視で穿刺アダプターを使用する例を説明したが，目視の代わりに視覚センサを利用して穿刺アダプターを使用することもできる。このため，ロボットによる手術においても本発明に係る穿刺アダプターを利用することもできる。 Further, in this specification, an example in which the surgeon uses the puncture adapter by visual observation has been described, but the puncture adapter can be used by using a visual sensor instead of visual observation. For this reason, the puncture adapter according to the present invention can also be used in surgery using a robot.
　以上，本願明細書では，本発明の内容を表現するために，図面を参照しながら本発明の実施形態の説明を行った。ただし，本発明は，上記実施形態に限定されるものではなく，本願明細書に記載された事項に基づいて当業者が自明な変更形態や改良形態を包含するものである。 As mentioned above, in this specification, in order to express the content of the present invention, the embodiment of the present invention was described with reference to the drawings. However, the present invention is not limited to the above-described embodiments, but includes modifications and improvements obvious to those skilled in the art based on the matters described in the present specification.
　本発明は，超音波ガイド下穿刺術用の穿刺アダプターに関する。従って，本発明は，医療機器の製造業において好適に利用し得る。 The present invention relates to a puncture adapter for ultrasonic guided puncture. Therefore, the present invention can be suitably used in the medical device manufacturing industry.
１…穿刺アダプター　　　　　　２…超音波プローブ
３…穿刺針　　　　　　　　　　１０…メインピース
１０ａ…正面　　　　　　　　　１０ｂ…背面
１１…鏡面部　　　　　　　　　１１ａ…第２スリット
１１ｂ…鏡部材　　　　　　　　１２…非鏡面部
２０…サブピース　　　　　　　２１…傾斜部
２１ａ…遠位端　　　　　　　　２１ｂ…近位端
２２…第１スリット　　　　　　２３…連結部
４０…取付部　　　　　　　　　４１…アーム部
４２…切欠き DESCRIPTION OF SYMBOLS 1 ... Puncture adapter 2 ... Ultrasonic probe 3 ... Puncture needle 10 ... Main piece 10a ... Front surface 10b ... Back surface 11 ... Mirror surface part 11a ... Second slit 11b ... Mirror member 12 ... Non-mirror surface part 20 ... Subpiece 21 ... Inclined part 21a ... Distal end 21b ... proximal end 22 ... first slit 23 ... connecting portion 40 ... mounting portion 41 ... arm portion 42 ... notch

Claims (8)

  1. 　超音波プローブに取り付けられる穿刺アダプター（１）であって，
    　上下方向に延びるメインピース（１０）と，
    　前記メインピースの正面（１０ａ）側に位置するサブピース（２０）とを備え，
    　前記メインピース（１０）と前記サブピース（２０）は連結しており，
    　前記メインピース（１０）は，
    　　前記サブピース（２０）の連結部位よりも下方の前記正面（１０ａ）に上下方向に延びる鏡面部（１１）を有し，
    　前記サブピース（２０）は，
    　　前記メインピースの正面（１０ａ）に対して下向きに傾斜した傾斜部（２１）と，
    　　前記傾斜部（２１）に形成された第１スリット（２２）とを有し，
    　前記第１スリット（２２）を通じて前記鏡面部（１１）を視認することができる
    　穿刺アダプター。     A puncture adapter (1) attached to an ultrasonic probe,
    A main piece (10) extending vertically;
    A sub-piece (20) located on the front (10a) side of the main piece,
    The main piece (10) and the subpiece (20) are connected,
    The main piece (10)
    A mirror surface portion (11) extending in the vertical direction on the front surface (10a) below the connecting portion of the subpiece (20);
    The subpiece (20)
    An inclined portion (21) inclined downward with respect to the front surface (10a) of the main piece;
    A first slit (22) formed in the inclined portion (21),
    The puncture adapter which can visually recognize the mirror surface part (11) through the first slit (22).
  2. 　前記鏡面部（１１）は，
    　　前記メインピース（１０）に形成された上下方向に延びる第２スリット（１１ａ）と，
    　　前記メインピースの背面（１０ｂ）側に配置され，前記第２スリット（１１ａ）を通じて視認可能な鏡部材（１１ｂ）とによって構成されている
    　請求項１に記載の穿刺アダプター     The mirror surface portion (11)
    A second slit (11a) formed in the main piece (10) and extending in the vertical direction;
    The puncture adapter according to claim 1, comprising a mirror member (11b) disposed on the back surface (10b) side of the main piece and visible through the second slit (11a).
  3. 　前記メインピースの背面（１０ｂ）側に，前記メインピース（１０）を前記超音波プローブに固定するための取付部（４０）を，さらに備え，
    　前記取付部（４０）は，前記鏡面部（１１）の鏡面がプローブ面に対して略垂直になるように，前記メインピース（１０）を前記超音波プローブに固定する
    　請求項１に記載の穿刺アダプター。     A mounting portion (40) for fixing the main piece (10) to the ultrasonic probe is further provided on the back surface (10b) side of the main piece,
    The puncture according to claim 1, wherein the attachment portion (40) fixes the main piece (10) to the ultrasonic probe so that a mirror surface of the mirror surface portion (11) is substantially perpendicular to a probe surface. adapter.
  4. 　前記メインピース（１０）は，前記鏡面部（１１）の左右両側に非鏡面部（１２）をさらに有する
    　請求項１に記載の穿刺アダプター。     The puncture adapter according to claim 1, wherein the main piece (10) further includes a non-mirror surface portion (12) on both right and left sides of the mirror surface portion (11).
  5. 　前記サブピース（２０）は，前記傾斜部（２１）と前記メインピースの正面（１０ａ）とを間隙を空けて連結する連結部（２３）をさらに有する
    　請求項１に記載の穿刺アダプター。     The puncture adapter according to claim 1, wherein the sub-piece (20) further includes a connecting portion (23) for connecting the inclined portion (21) and the front surface (10a) of the main piece with a gap.
  6. 　前記傾斜部（２１）は，穿刺針（３）の像を構成する光が前記鏡面部（１１）で反射した後に使用者の視点に到達するまでの光路と交わるように，傾斜している
    　請求項１に記載の穿刺アダプター。     The inclined portion (21) is inclined so as to intersect with an optical path until light constituting the image of the puncture needle (3) is reflected by the mirror surface portion (11) and reaches the viewpoint of the user. Item 4. The puncture adapter according to item 1.
  7. 　使用者の視点から見たときに，前記サブピース（２０）の第１スリット（２２）を通じて鏡面部（１１）を真っ直ぐに視認でき，かつ，前記鏡面部（１１）に映った穿刺針（３）の虚像（３´）が前記第１スリット（２２）及び前記鏡面部（１１）と一直線上に並ぶように，穿刺針（３）の刺入位置及び刺入角度を決定するにあたり，
    　前記鏡面部（１１）の幅，及び，前記第１スリット（２２）の幅は，前記穿刺針（３）の虚像（３´）の外径よりも広い
    　請求項１に記載の穿刺アダプター。     When viewed from the user's viewpoint, the mirror surface portion (11) can be seen straight through the first slit (22) of the subpiece (20), and the puncture needle (3) reflected on the mirror surface portion (11) In determining the insertion position and the insertion angle of the puncture needle (3) so that the virtual image (3 ′) of the puncture needle (3 ′) is aligned with the first slit (22) and the mirror surface portion (11),
    The puncture adapter according to claim 1, wherein a width of the mirror surface portion (11) and a width of the first slit (22) are wider than an outer diameter of a virtual image (3 ') of the puncture needle (3).
  8. 　請求項１に記載の穿刺アダプター（１）と，
    　前記穿刺アダプター（１）が取り付けられた超音波プローブ（２）と，を備える
    　超音波診断装置。     The puncture adapter (1) according to claim 1,
    An ultrasonic diagnostic apparatus comprising: an ultrasonic probe (2) to which the puncture adapter (1) is attached.
PCT/JP2017/025458 2016-08-01 2017-07-12 Puncture adapter for ultrasonically guided paracentesis and ultrasonic diagnosis device WO2018025605A1 (en)

Priority Applications (1)

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JP2017551347A JP6239810B1 (en) 2016-08-01 2017-07-12 Puncture adapter and ultrasonic diagnostic apparatus for ultrasonic guided puncture

Applications Claiming Priority (2)

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JP2016-150944 2016-08-01
JP2016150944 2016-08-01

Publications (1)

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Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2010115246A (en) * 2008-11-11 2010-05-27 Hitachi Medical Corp Ultrasonic probe, and ultrasonic diagnostic apparatus using the ultrasonic probe
JP2012081134A (en) * 2010-10-13 2012-04-26 Fujifilm Corp Ultrasound diagnostic apparatus
JP3187732U (en) * 2013-09-30 2013-12-12 俊弘 安藤 Probe for ultrasonic diagnostic equipment
JP2016202645A (en) * 2015-04-23 2016-12-08 株式会社日本医療機器開発機構 Puncture adapter for puncture technique under ultrasonic guide and ultrasonic diagnostic device

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2010115246A (en) * 2008-11-11 2010-05-27 Hitachi Medical Corp Ultrasonic probe, and ultrasonic diagnostic apparatus using the ultrasonic probe
JP2012081134A (en) * 2010-10-13 2012-04-26 Fujifilm Corp Ultrasound diagnostic apparatus
JP3187732U (en) * 2013-09-30 2013-12-12 俊弘 安藤 Probe for ultrasonic diagnostic equipment
JP2016202645A (en) * 2015-04-23 2016-12-08 株式会社日本医療機器開発機構 Puncture adapter for puncture technique under ultrasonic guide and ultrasonic diagnostic device

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