JP2005349121A - Puncture needle for endoscope - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To raise precision in tissue examination by preventing the mingling of the useless tissue of a part other than a target part when the target part is punctured to sample the tissue. <P>SOLUTION: An outer needle 22 internally stores a pipe shape inner needle 23 which is sharp at a distal end and a stylet 24 which is sharp at a distal end and arranged so as to be freely inserted/ejected to/from the inner needle 23. An inner needle entrance part 22c for allowing the outer and inner parts of the outer needle 22 to perform communication and allowing the inner needle 23 and the stylet 24 to move forwards and backwards is disposed on the base part side surface of the distal end part 22b of the outer needle 22 and clogged with a flexible membrane 25. Then the outer needle 22 with the distal end not opened therein is punctured to a part near the target part and the inner needle 23 is projected from the outer needle 22 at the position. The tissue of the target part is sucked/sampled, so as to prevent contamination and to raise precision in examination. <P>COPYRIGHT: (C)2006,JPO&NCIPI

Description

Translated fromJapanese

本発明は、経内視鏡的に目的部位に穿刺して生体組織を採取するための内視鏡用穿刺針に関する。  The present invention relates to an endoscope puncture needle for collecting a living tissue by puncturing a target site through a transendoscope.

近年、超音波内視鏡による超音波断層像観察下において、超音波断層像をガイドにして鉗子等の処置具を挿通する処置具用チャンネルを介して長尺の穿刺針を観察部位まで誘導して病変組織に突刺し、体組織を採取して病理確定診断を行う手技が行われている。  In recent years, a long puncture needle has been guided to an observation site through a treatment instrument channel through which a treatment instrument such as a forceps is inserted using an ultrasonic tomogram as a guide while observing an ultrasonic tomogram with an ultrasonic endoscope. A technique for puncturing a diseased tissue, collecting a body tissue, and performing a pathological diagnosis has been performed.

このような診断を行うための穿刺針は、例えば、特許文献１に開示されている。この穿刺針は、先端部が鋭利な形状に形成された細長の針管内に、先端が鋭利な形状のスタイレットを挿脱自在に配置したものであり、超音波画像の観察下において、針管が目的部位まで到達したとき、スタイレットを吸引口金から引き抜き、吸引口金にシリンジ等を接続して体腔内組織の吸引を行う。
特開２００３−１９０１７９号公報A puncture needle for performing such a diagnosis is disclosed inPatent Document 1, for example. In this puncture needle, a stylet with a sharp tip is removably disposed in an elongated needle tube having a sharp tip, and the needle tube is observed under observation of an ultrasonic image. When the target site is reached, the stylet is withdrawn from the suction cap, and a syringe or the like is connected to the suction cap to suck the tissue in the body cavity.
JP 2003-190179 A

特許文献１に開示されているように、従来の穿刺針では、針管が目的部位に到達するまでは、針管内にスタイレットを収納したまま穿刺している。しかしながら、針管とスタイレットとの間には、スタイレットを進退させるための僅かな空隙が存在し、特に、穿刺経路が長い深部の組織を採取するような場合には、針管内に目的部位以外の不要な組織が混入する虞があり、検査精度を向上する上での支障となる。  As disclosed inPatent Document 1, the conventional puncture needle is punctured with the stylet stored in the needle tube until the needle tube reaches the target site. However, there is a slight gap between the needle tube and the stylet to advance and retreat the stylet. Especially when a deep tissue with a long puncture path is collected, the needle tube has a region other than the target site. There is a possibility that unnecessary tissue may be mixed, which hinders improvement in inspection accuracy.

本発明は上記事情に鑑みてなされたもので、目的部位に穿刺して組織を採取する際に、目的部位以外の不要な組織が混入することを防止し、組織検査の精度を向上することのできる内視鏡用穿刺針を提供することを目的としている。  The present invention has been made in view of the above circumstances, and prevents an unnecessary tissue other than the target site from being mixed when the tissue is collected by puncturing the target site, thereby improving the accuracy of the tissue examination. An object of the present invention is to provide an endoscopic puncture needle.

上記目的を達成するため、本発明による内視鏡用穿刺針は、内視鏡の処置具用チャンネルに進退自在に挿通されるシースと、上記シース内に進退自在に挿通され、先端部周辺に外部に連通する連通口を設けると共に、この連通口を閉塞する可撓膜を配設した外針と、上記外針内に進退自在に挿通される中空状の内針と、上記内視鏡の処置具用チャンネル入口に着脱自在に固定される操作部本体と、上記外針を上記操作部本体に対して進退自在に保持する外針スライダと、上記内針を上記外針に対して進退自在に保持し、上記内針を上記外針の上記可撓膜から外部に突出させて目的部位の組織を採取可能とする内針スライダとを備えたことを特徴とする。  In order to achieve the above object, an puncture needle for an endoscope according to the present invention is inserted into a channel for a treatment instrument of an endoscope so as to be able to advance and retract, and is inserted so as to be able to advance and retract in the sheath so as to surround the distal end portion. An outer needle provided with a communication port communicating with the outside and provided with a flexible film that closes the communication port, a hollow inner needle inserted into the outer needle so as to freely advance and retreat, and the endoscope An operation portion main body that is detachably fixed to the treatment instrument channel inlet, an outer needle slider that holds the outer needle movably forward and backward with respect to the operation portion main body, and the inner needle can be moved forward and backward with respect to the outer needle. And an inner needle slider that allows the inner needle to protrude outward from the flexible film of the outer needle to collect tissue at a target site.

本発明による内視鏡用穿刺針は、目的部位に穿刺して組織を採取する際に、先端部周辺の外部に連通する連通口を可撓膜で閉塞した外針を目的部位近傍まで穿刺し、外針から内針を突出させて目的部位の組織を採取することが可能であるため、採取した組織に目的部位以外の不要な組織が混入することを防止することができ、組織検査の精度を向上することができる。  The puncture needle for an endoscope according to the present invention punctures an outer needle close to the target site by closing a communication port communicating with the outside around the distal end portion with a flexible film when collecting the tissue by puncturing the target site. Since it is possible to extract the tissue at the target site by projecting the inner needle from the outer needle, it is possible to prevent unnecessary tissue other than the target site from being mixed into the collected tissue, and the accuracy of the tissue examination Can be improved.

以下、図面を参照して本発明の実施の形態を説明する。図１〜図１６は本発明の実施の一形態に係り、図１は内視鏡装置の全体構成図、図２は外針及び内針を突出させた状態の内視鏡用穿刺針の外観図、図３はシース内に外針及び内針を収納した状態の内視鏡用穿刺針の外観図、図４は外針及び内針の構成を示す説明図、図５は外針及び内針の他の構成例を示す説明図、図６は外針及び内針の更に他の構成例を示す説明図、図７は操作部の構成を示す説明図、図８は図７のＡ部拡大図、図９は図７のＢ部拡大図、図１０は図７のＣ部拡大図、図１１は穿刺針の取付けを示す説明図であり、図１１（ａ）は穿刺針を処置具用チャンネル入口に固定した状態を示す図、図１１（ｂ）はシースを処置具用チャンネル出口から突出した状態を示す図、図１２は外針の操作状態を示す説明図であり、図１２（ａ）は外針を突出させたときの穿刺針を示す図、図１２（ｂ）はシースから外針を突出させた状態を示す図、図１３は内針の操作状態を示す説明図であり、図１３（ａ）は外針から内針を突出させたときの穿刺針を示す図、図１３（ｂ）は外針から内針を突出させた状態を示す図、図１４は穿刺針による吸引生検の開始を示す説明図であり、図１４（ａ）は穿刺針にシリンジを装着した状態を示す説明図、図１４（ｂ）は内針からスタイレットを抜き取った状態を示す説明図、図１５は吸引生検時の操作を示す説明図であり、図１５（ａ）は穿刺針のアジテーション操作を示す図、図１５（ｂ）は内針の動きを示す図、図１６は吸引生検終了後の状態を示す説明図であり、図１６（ａ）は穿刺針からシリンジを取り外した状態を示す図、図１６（ｂ）は内針を抜き取った後の外針を示す図である。  Embodiments of the present invention will be described below with reference to the drawings. 1 to 16 relate to an embodiment of the present invention, FIG. 1 is an overall configuration diagram of an endoscope apparatus, and FIG. 2 is an external view of an endoscope puncture needle with an outer needle and an inner needle protruding. 3 is an external view of the puncture needle for an endoscope in a state where the outer needle and the inner needle are housed in the sheath, FIG. 4 is an explanatory view showing the configuration of the outer needle and the inner needle, and FIG. 6 is an explanatory diagram showing another configuration example of the needle, FIG. 6 is an explanatory diagram showing still another configuration example of the outer needle and the inner needle, FIG. 7 is an explanatory diagram showing the configuration of the operation unit, and FIG. FIG. 9 is an enlarged view of part B of FIG. 7, FIG. 10 is an enlarged view of part C of FIG. 7, FIG. 11 is an explanatory view showing attachment of the puncture needle, and FIG. FIG. 11B is a diagram showing a state in which the sheath is protruded from the treatment instrument channel outlet, FIG. 12 is an explanatory diagram showing an operation state of the outer needle, and FIG. ) Is a view showing the puncture needle when the outer needle is protruded, FIG. 12B is a view showing a state where the outer needle is protruded from the sheath, and FIG. 13 is an explanatory view showing an operation state of the inner needle, 13A is a view showing the puncture needle when the inner needle is protruded from the outer needle, FIG. 13B is a view showing a state where the inner needle is protruded from the outer needle, and FIG. 14 is aspiration by the puncture needle. It is explanatory drawing which shows the start of a biopsy, Fig.14 (a) is explanatory drawing which shows the state which mounted | wore the puncture needle, FIG.14 (b) is explanatory drawing which shows the state which extracted the stylet from the inner needle, 15A and 15B are explanatory views showing operations during aspiration biopsy. FIG. 15A is a diagram showing the agitation operation of the puncture needle, FIG. 15B is a diagram showing the movement of the inner needle, and FIG. It is explanatory drawing which shows the state after completion | finish of a test | inspection, FIG.16 (a) is a figure which shows the state which removed the syringe from the puncture needle, FIG. (B) is a diagram showing an outer needle After removing the inner needle.

図１に示す内視鏡装置１は、本実施の形態においては、超音波を送受するための超音波振動子（例えばコンベックス型等の超音波振動子）３を先端部に備えた超音波内視鏡２と、超音波振動子３の駆動及び走査、エコー信号の処理等を行って超音波画像を生成する超音波観測装置１５とを基本構成として備えている。超音波内視鏡２には、超音波画像の観察下において、目的部位に突刺して体組織や体液を採取するための内視鏡用穿刺針（以下、単に「穿刺針」と記載する）２０を着脱自在に装着することができる。  In the present embodiment, anendoscope apparatus 1 shown in FIG. 1 includes an ultrasonic transducer (for example, an ultrasonic transducer such as a convex type) 3 for transmitting and receiving ultrasonic waves at its distal end. The basic configuration includes an endoscope 2 and anultrasonic observation device 15 that generates an ultrasonic image by driving and scanning theultrasonic transducer 3, processing an echo signal, and the like. The ultrasonic endoscope 2 has an endoscope puncture needle (hereinafter simply referred to as “puncture needle”) for puncturing a target site and collecting body tissue or fluid under observation of an ultrasound image. 20 can be detachably mounted.

超音波内視鏡２は、体腔内に挿入される細長の可撓性を有する挿入部４を有し、この挿入部４の先端側に超音波振動子３を備えると共に、後端側に操作部５及び接眼部６を備えている。操作部５の側部からは、ユニバーサルコード７が延出され、このユニバーサルコード７の末端に、超音波観測装置１５に接続される超音波コネクタ８が設けられている。また、ユニバーサルコード７の中途部からは、光源用ケーブル９が分岐され、この光源用ケーブル９の末端に、図示しない光源装置に接続される内視鏡コネクタ１０が設けられている。  The ultrasonic endoscope 2 has an elongatedflexible insertion portion 4 to be inserted into a body cavity. The ultrasonic endoscope 2 includes anultrasonic transducer 3 on the distal end side of theinsertion portion 4 and is operated on the rear end side. Apart 5 and aneyepiece part 6 are provided. Auniversal cord 7 is extended from the side of theoperation unit 5, and anultrasonic connector 8 connected to theultrasonic observation device 15 is provided at the end of theuniversal cord 7. A light source cable 9 is branched from the middle portion of theuniversal cord 7, and anendoscope connector 10 connected to a light source device (not shown) is provided at the end of the light source cable 9.

また、超音波内視鏡２の操作部５先端側には、鉗子等の処置具を挿通するための処置具用チャンネルの入口口金１１が設けられている。この処置具用チャンネルの入口口金１１には、穿刺針２０が着脱自在に螺合固定されるようになっており、以下に説明するように、超音波振動子３の超音波走査面内に突出させた外針２２から更に内針２３を突出させて目的部位に穿刺することにより、体組織や体液を採取することができる。  In addition, at the distal end side of theoperation section 5 of the ultrasonic endoscope 2, aninlet cap 11 for a treatment instrument channel for inserting a treatment instrument such as a forceps is provided. Thepuncture needle 20 is detachably screwed and fixed to theinlet base 11 of the treatment instrument channel, and protrudes into the ultrasonic scanning plane of theultrasonic transducer 3 as described below. By further projecting theinner needle 23 from theouter needle 22 that has been made to puncture the target site, body tissue or body fluid can be collected.

穿刺針２０は、図２に示すように、内視鏡の処置具用チャンネルに挿入される細長のパイプ状のシース２１と、このシース２１の基端部に配置された把持部を兼ねる操作部３５と、操作部３５を介してシース２１内に進退自在に挿通配置される外針２２と、外針２２内に進退自在に挿通配置され、外針２２から突出されて目的部位の体組織や体液を採取するための内針２３とを主として構成されている。  As shown in FIG. 2, thepuncture needle 20 includes an elongated pipe-shaped sheath 21 that is inserted into a treatment instrument channel of an endoscope, and an operation unit that also serves as a gripping part disposed at the proximal end of thesheath 21. 35, anouter needle 22 that is inserted and disposed in thesheath 21 through theoperation unit 35 so as to be movable forward and backward, and anouter needle 22 that is inserted and disposed in theouter needle 22 so as to be movable forward and backward. Aninner needle 23 for collecting body fluid is mainly configured.

尚、本形態においては、穿刺針２０は、使い捨てタイプとして構成され、シース２１は、コスト低減が可能な、ポリエーテルサルホンやテフロン（登録商標）等の樹脂部材で形成される。ポリエーテルサルホンやテフロン（登録商標）は、用途に応じて使い分けられる。  In this embodiment, thepuncture needle 20 is configured as a disposable type, and thesheath 21 is formed of a resin member such as polyethersulfone or Teflon (registered trademark) that can reduce the cost. Polyethersulfone and Teflon (registered trademark) are properly used depending on the application.

操作部３５は、シース２１の基端部が固設される操作部本体４０と、操作部本体４０に対して摺動自在に設けられ、外針２２を進退させる外針スライダ５０と、外針スライダ５０に対して摺動自在に設けられ、内針２３を進退させる内針スライダ６０とで主に構成されている。図３に示すように、穿刺針２０を使用しない状態では、外針スライダ５０は、操作部本体４０から離間する方向に引き延ばされた位置で固定（後述するストッパ用の固定ネジ５３により固定；図７参照）され、この状態では、外針２２の先端部はシース２１内に配置されている。  Theoperation unit 35 includes an operation unitmain body 40 to which the proximal end portion of thesheath 21 is fixed, anouter needle slider 50 that is slidable with respect to the operation unitmain body 40, and moves theouter needle 22 forward and backward. Theslider 50 is slidably provided, and mainly includes aninner needle slider 60 that moves theinner needle 23 forward and backward. As shown in FIG. 3, when thepuncture needle 20 is not used, theouter needle slider 50 is fixed at a position extended in a direction away from the operation section main body 40 (fixed by astopper fixing screw 53 described later). ; See FIG. 7), and in this state, the distal end portion of theouter needle 22 is disposed in thesheath 21.

シース２１内に配置される外針２２は、例えばステンレス等の金属材で形成され、図４に示すように、細長のパイプ状の針管部２２ａと、この針管部２２ａの先端を閉塞する鋭利な形状の先端部２２ｂとを備えた形状に形成されている。外針２２の内部には、同様にステンレス等の金属材で形成され、先端が鋭利な形状のパイプ状の内針２３と、内針２３内に挿脱自在に配置される先端が鋭利な形状のスタイレット２４とが収納されている。  Theouter needle 22 disposed in thesheath 21 is made of, for example, a metal material such as stainless steel. As shown in FIG. 4, theouter needle 22 has a slender pipe-shaped needle tube portion 22a and a sharp tip that closes the tip of the needle tube portion 22a. It is formed in a shape provided with a shape tip portion 22b. Theouter needle 22 is similarly formed of a metal material such as stainless steel, and has a pipe-shapedinner needle 23 having a sharp tip and a sharp tip that is removably disposed in theinner needle 23. Thestylet 24 is housed.

また、外針２２の先端部２２ｂの基部側面には、外針２２の外部と内部とを連通させて内針２３及びスタイレット２４を進退可能とするための内針出入口部２２ｃが設けられている。この内針出入口部２２ｃは、先端が閉塞された外針２２の内部と外部とを連通する連通口であり、針管部２２ａから先端部２２ｂにかけての内孔端部に形成された傾斜面２２ｄを案内として、内針２３及びスタイレット２４が側方に突出可能となっている。この内針出入口部２２ｃは、内針２３及びスタイレット２４を外部に突出させない状態では、開口周縁に接着や溶着等によって固着された可撓膜２５によって閉塞されている。  Further, an inner needle inlet / outlet portion 22c is provided on the base side surface of the distal end portion 22b of theouter needle 22 to allow theinner needle 23 and thestylet 24 to advance and retract by communicating the outside and the inside of theouter needle 22. Yes. The inner needle inlet / outlet portion 22c is a communication port that communicates the inside and the outside of theouter needle 22 with its tip closed, and has an inclined surface 22d formed at the inner hole end portion from the needle tube portion 22a to the tip portion 22b. As a guide, theinner needle 23 and thestylet 24 can protrude sideways. When theinner needle 23 and thestylet 24 are not projected to the outside, the inner needle inlet / outlet portion 22c is closed by aflexible film 25 fixed to the peripheral edge of the opening by adhesion or welding.

可撓膜２５は、医療用材料としての適性を有し、且つ可撓性を有する材料、例えば、ラテックスや高分子樹脂材料等によって形成され、内針２３及びスタイレット２４を可撓膜２５から突出可能とすると共に、吸引生検後に内針２３を外針２２内に収納したときの内針出入口部２２ｃの閉塞性を回復可能としている。  Theflexible film 25 has suitability as a medical material and is formed of a flexible material such as latex or a polymer resin material, and theinner needle 23 and thestylet 24 are separated from theflexible film 25. In addition to being able to protrude, it is possible to recover the closing property of the inner needle entrance / exit portion 22c when theinner needle 23 is housed in theouter needle 22 after the suction biopsy.

すなわち、所定の部位を観察し、更に、その奥の部位の組織を採取して検査を行う必要が生じた場合、先端が開口されていない外針２２を目的部位の近傍まで穿刺し、その位置で外針２２から内針２３を突出させて目的部位の組織を吸引・採取し、内針２３を外針２２内に収納したとき、可撓膜２５によって外針２２の開口が閉じられるため、目的部位以外の不要な組織の混入（以下、「コンタミネーション」と称する）を防止することができ、検査精度を向上することができる。  That is, when it is necessary to observe a predetermined part and further collect and examine the tissue in the back part, theouter needle 22 whose tip is not opened is punctured to the vicinity of the target part, and the position When theinner needle 23 protrudes from theouter needle 22 and the tissue of the target site is sucked and collected and theinner needle 23 is stored in theouter needle 22, the opening of theouter needle 22 is closed by theflexible film 25. It is possible to prevent unnecessary tissue other than the target site from being mixed (hereinafter referred to as “contamination”), and the inspection accuracy can be improved.

この場合、図４においては、可撓膜２５を外針２２の先端側部に部分的に設ける例を示しているが、図５に示すように、チューブ状の可撓膜２７を用いても良い。  In this case, FIG. 4 shows an example in which theflexible film 25 is partially provided on the distal end side portion of theouter needle 22. However, as shown in FIG. good.

図５の例では、外針２２を変更した外針２６を用いている。この外針２６は、外針２２と同様の形状、すなわち、パイプ状の針管部２６ａ、この針管部２６ａの先端を閉塞する鋭利な形状の先端部２６ｂ、内針２３（及びスタイレット２４）の外針２６からの出し入れための内針出入口部２６ｃ及び傾斜面２６ｄを備えており、更に、先端部２６ｂ基部外周に、凹部をなす段部２６ｅが全周に渡って形成されている。  In the example of FIG. 5, anouter needle 26 in which theouter needle 22 is changed is used. Theouter needle 26 has the same shape as theouter needle 22, that is, a pipe-shaped needle tube portion 26a, a sharp-shaped distal end portion 26b that closes the distal end of the needle tube portion 26a, and the inner needle 23 (and the stylet 24). An inner needle inlet /outlet portion 26c and an inclined surface 26d for taking in and out of theouter needle 26 are provided, and a step portion 26e forming a recess is formed on the outer periphery of the distal end portion 26b over the entire circumference.

チューブ状の可撓膜２７は、外針２６外周の段部２６ｅに取り付けられ、内針出入口部２６ｃを除く部分が接着や溶着等によって外針２６に固定される。これにより、組付け作業性が向上するばかりでなく、固着面積が拡大し、可撓膜２７をより強固に外針２６に固着することができる。  The tube-shapedflexible film 27 is attached to a step portion 26e on the outer periphery of theouter needle 26, and a portion other than the inner needle inlet /outlet portion 26c is fixed to theouter needle 26 by adhesion or welding. Thereby, not only the assembly workability is improved, but also the fixing area is enlarged, and theflexible film 27 can be fixed to theouter needle 26 more firmly.

また、外針２６は、外針２２に比較して針管部２６ａを短くし、針管部２６ａの末端に樹脂材等で形成される外針用シース２８を冠着・固定している。樹脂材料で形成した外針用シース２８内には、内針２３及びスタイレット２４が挿通配置されることから、必要な穿刺力を得る上での剛性を確保しつつ、コスト低減を図ることができる。  Further, theouter needle 26 has a needle tube portion 26a shorter than theouter needle 22, and asheath 28 for outer needle formed of a resin material or the like is crowned and fixed to the end of the needle tube portion 26a. Since theinner needle 23 and thestylet 24 are inserted and disposed in theouter needle sheath 28 formed of a resin material, it is possible to reduce costs while ensuring rigidity for obtaining a necessary puncture force. it can.

更に、図４及び図５は、内針２３を外針２２の側方に突出させる例を示しているが、図６に示すように、内針２３及びスタイレット２４を外針の長手軸方向前面に突出させるようにしても良い。すなわち、ステンレスパイプ等の部材を軸方向に対して斜めにカットして刃面を形成した外針２９を用い、刃面開口部を内針出入口部として、この内針出入口部を封止する可撓膜体３０を設ける。  4 and 5 show an example in which theinner needle 23 protrudes to the side of theouter needle 22, but as shown in FIG. 6, theinner needle 23 and thestylet 24 are arranged in the longitudinal direction of the outer needle. You may make it protrude on the front. That is, anouter needle 29 having a blade surface formed by cutting a member such as a stainless pipe obliquely with respect to the axial direction is used, and the inner needle inlet / outlet portion can be sealed using the blade surface opening as an inner needle inlet / outlet portion. Aflexure body 30 is provided.

可撓膜体３０は、外針２９の刃面形状に沿った可撓膜３０ａと、この可撓膜３０ａを端部に有する円筒状の装着部３０ｂとを備えた形状であり、外針２９の刃面開口から所定深さに設けた円筒状のざぐり部２９ａに、装着部３０ｂを接着或いは溶着する。この場合、可撓膜体３０は、成型によって製作することにより、製造コストを低減することが可能となるが、必ずしも全体を可撓性の材料で形成する必要はなく、外針２９の刃面開口を封止する可撓膜３０ａのみに可撓性を有する材料を用い、装着部３０ｂは硬質材料で形成しても良い。  Theflexible membrane body 30 has a shape including a flexible membrane 30 a that follows the shape of the blade surface of theouter needle 29, and a cylindrical mounting portion 30 b that has the flexible membrane 30 a at its end. The mounting portion 30b is bonded or welded to a cylindrical counterbore portion 29a provided at a predetermined depth from the blade surface opening. In this case, it is possible to reduce the manufacturing cost by manufacturing theflexible film body 30 by molding. However, theflexible film body 30 is not necessarily formed of a flexible material as a whole, and the blade surface of theouter needle 29 is not necessarily formed. A material having flexibility may be used only for the flexible film 30a that seals the opening, and the mounting portion 30b may be formed of a hard material.

また、外針２９は、外針２６と同様に短く形成し、外針用シース２８に固着・接続する。但し、外針２６とシース２８との接続が外針２６にシース２８を被せる形式であるのに対し、外針２９とシース２８との接続は、外針２９内にシース２８を嵌め込む接続形式とする。  Further, theouter needle 29 is formed short like theouter needle 26 and is fixedly connected to theouter needle sheath 28. However, the connection between theouter needle 26 and thesheath 28 is a type in which theouter needle 26 is covered with thesheath 28, whereas the connection between theouter needle 29 and thesheath 28 is a connection type in which thesheath 28 is fitted into theouter needle 29. And

また、本実施の形態においては、内針２３内にスタイレット２４を挿通・配置する例について説明しているが、外針２２の先端部を完全に閉塞して目的部位近傍まで穿刺し、その位置で内針２３を外針２２から突出させるため、スタイレット２４を省略することも可能である。  Further, in the present embodiment, an example in which thestylet 24 is inserted and arranged in theinner needle 23 is described. However, the distal end portion of theouter needle 22 is completely closed and punctured to the vicinity of the target site. Since theinner needle 23 protrudes from theouter needle 22 at the position, thestylet 24 can be omitted.

次に、以上の外針２２及び内針２３の進退操作を行うための操作部３５の構成例について、図７〜図１０を参照し、操作部本体４０、外針スライダ５０、内針スライダ６０の順に説明する。  Next, with reference to FIGS. 7 to 10, the configuration example of theoperation unit 35 for performing the above-described advance / retreat operation of theouter needle 22 and theinner needle 23 will be described with reference to FIGS. 7 to 10. Will be described in the order.

図７及び図８に示すように、操作部本体４０は、後述する外針スライダ５０の外針操作管５１が摺動自在に収納される細長のパイプ状のスライダ収納管４１を主として構成されている。スライダ収納管４１は、先端部の内径が外針操作管５１の外径よりも小径に形成され、超音波内視鏡２の処置具用チャンネルの入口口金１１に連結固定される２条ネジ（雌ネジ）を形成した接続ネジ４２とシース２１の基端部を固定するシース口金部材４３とが順に配設されている。また、スライダ収納管４１の後端部には、外針操作管５１の抜け止めとなるキャップ部材４４が螺合されている。  As shown in FIGS. 7 and 8, the operation sectionmain body 40 is mainly configured by an elongated pipe-shapedslider storage tube 41 in which an outerneedle operation tube 51 of anouter needle slider 50 described later is slidably stored. Yes. Theslider storage tube 41 is formed with a double thread (the inner diameter of the distal end portion is smaller than the outer diameter of the outer needle operation tube 51) and is connected and fixed to theinlet base 11 of the treatment instrument channel of the ultrasonic endoscope 2. Aconnection screw 42 in which a female screw) is formed and asheath base member 43 that fixes the proximal end portion of thesheath 21 are disposed in this order. In addition, acap member 44 that prevents the outerneedle operation tube 51 from coming off is screwed to the rear end portion of theslider storage tube 41.

接続ネジ４２は、スライダ収納管４１の先端部に螺合されて内設され、スライダ収納管４１の先端部に径方向に螺設された止めネジ４５によって固定されている。シース口金部材４３は、接続ネジ４２によって固定されるフランジ部４３ａの前後に、ボス部４３ｂを突出した形状に形成され、このボス部４３ｂの内周面と、スライダ収納管４１の先端部内に固設される管状部材４６の外周面との間に、シース２１を挟持して固定している。シース２１内の外針２２は、シース２１から手元側に延出されて管状部材４６内を挿通され、外針操作管５１の先端に固定されている。  Theconnection screw 42 is screwed into the distal end portion of theslider storage tube 41 and is fixed by a set screw 45 screwed in the radial direction at the distal end portion of theslider storage tube 41. Thesheath base member 43 is formed in a shape in which a boss portion 43 b protrudes before and after the flange portion 43 a fixed by theconnection screw 42, and is fixed to the inner peripheral surface of the boss portion 43 b and the distal end portion of theslider storage tube 41. Thesheath 21 is sandwiched and fixed between the outer peripheral surface of thetubular member 46 provided. Theouter needle 22 in thesheath 21 extends from thesheath 21 to the proximal side, is inserted through thetubular member 46, and is fixed to the distal end of the outerneedle operation tube 51.

外針スライダ５０は、図７及び図９に示すように、後述する内針スライダ６０の内針操作管６１が摺動自在に収納される細長のパイプ状の外針操作管５１を主として構成されている。外針操作管５１は、先端部の内径が内針操作管６１の外径よりも小径に形成され、この先端部に外針２２の末端が固設されると共に、径方向にピン５２が立設されてスライダ収納管４１に形成された案内溝４１ａから突出されている。  As shown in FIGS. 7 and 9, theouter needle slider 50 is mainly composed of an elongated pipe-shaped outerneedle operation tube 51 in which an innerneedle operation tube 61 of aninner needle slider 60 described later is slidably accommodated. ing. The outerneedle operating tube 51 is formed so that the inner diameter of the distal end portion is smaller than the outer diameter of the innerneedle operating tube 61, and the distal end of theouter needle 22 is fixed to the distal end portion, and thepin 52 stands in the radial direction. It is provided and protrudes from a guide groove 41 a formed in theslider storage tube 41.

この案内溝４１ａは、外針操作管５１を長手方向に摺動移動させる際の案内となるものであり、この案内溝４１ａから突出するピン５２の先端部に、外針操作管５１を所望の位置に固定するストッパ用としての固定ネジ５３が螺合されている。尚、案内溝４１ａは、外針２２のシース２１からの最大突出長さを規定するスライダ収納管４１の先端側の位置から、スライダ収納管４１の末端まで形成されている。  The guide groove 41a serves as a guide when the outerneedle operation tube 51 is slid and moved in the longitudinal direction. The outerneedle operation tube 51 is provided at a distal end portion of thepin 52 protruding from the guide groove 41a. A fixingscrew 53 as a stopper for fixing to a position is screwed. The guide groove 41 a is formed from the position on the distal end side of theslider storage tube 41 that defines the maximum protruding length of theouter needle 22 from thesheath 21 to the end of theslider storage tube 41.

製品の出荷時には、ピン５２を介して外針操作管５１がスライダ収納管４１の基端側（固定ネジ５３下部がキャップ部材４４に当接する位置）に配置され、固定ネジ５３が所定のトルクで締結されている。この状態では、固定ネジ５３及び外針操作管５１がスライダ収納管４１の側壁を押圧して外針操作管５１が固定され、この外針操作管５１に固設される外針２２の先端部がシース２１内にあって突出しない配置状態となる。  When the product is shipped, the outerneedle operation tube 51 is disposed on the proximal end side of the slider storage tube 41 (a position where the lower portion of the fixingscrew 53 abuts against the cap member 44) via thepin 52, and the fixingscrew 53 has a predetermined torque. It is concluded. In this state, the fixingscrew 53 and the outerneedle operation tube 51 press the side wall of theslider storage tube 41 to fix the outerneedle operation tube 51, and the distal end portion of theouter needle 22 fixed to the outerneedle operation tube 51 is fixed. Is in thesheath 21 and does not protrude.

また、外針操作管５１の後端部には、キャップ部材５５が螺合され、このキャップ部材５５の内周面と内針操作管６１の外周面との間に、Ｏリング５６が介装されている。このＯリング５６は、内針２３による吸引生検時に、外気が侵入することを防止するためのシールである。  Acap member 55 is screwed into the rear end portion of the outerneedle operation tube 51, and an O-ring 56 is interposed between the inner peripheral surface of thecap member 55 and the outer peripheral surface of the innerneedle operation tube 61. Has been. The O-ring 56 is a seal for preventing outside air from entering during suction biopsy using theinner needle 23.

次に、内針スライダ６０について説明する。内針スライダ６０は、図７及び図１０に示すように、内針２３（及びスタイレット２４）が摺動自在に挿通配置される内針操作管６１と、この内針操作管６１の後端に固設される連結部材６２に、着脱自在に螺合される吸引口金部材６３とを主として構成されている。  Next, theinner needle slider 60 will be described. As shown in FIGS. 7 and 10, theinner needle slider 60 includes an innerneedle operation tube 61 into which the inner needle 23 (and the stylet 24) is slidably inserted and a rear end of the innerneedle operation tube 61. Asuction base member 63 that is detachably screwed to a connectingmember 62 fixed to the main body is mainly configured.

吸引口金部材６３は、連結部材６２に螺合される雌ネジ部６３ａと、吸引生検時にシリンジ等を装着するための口金部６３ｂとを備え、雌ネジ部６３ａの内径側に、連結部材６２内に嵌挿されるボス部６３ｃが形成されている。このボス部６３ｃには、内針２３の末端が固設されており、この内針２３内に挿通されるスタイレット２４の末端が、口金部６３ｂに着脱自在に取り付けられるスタイレット口金部材６４に固設されている。  Thesuction cap member 63 includes a female screw portion 63a that is screwed to the connectingmember 62, and a cap portion 63b for mounting a syringe or the like at the time of a suction biopsy. Aboss portion 63c is formed to be fitted inside. The end of theinner needle 23 is fixed to theboss portion 63c, and the end of thestylet 24 inserted into theinner needle 23 is attached to astylet base member 64 that is detachably attached to the base portion 63b. It is fixed.

尚、内針操作管６１には、内針２３の外針２２からの突出方向を予め認知可能なように、外針操作管５１との合せマーク等を設けることが望ましい。この場合、操作部本体４０は、スライダ収納管４１を、接続ネジ４２及びシース口金部材４３による処置具用チャンネル入口への接続部分で分離し、相対回転可能な構成にしても良い。このような回転取付構造は、本出願人による特開２００１−２７５９４７号公報に、固定リングとシリンダとによる回転構造として開示されている。  The innerneedle operation tube 61 is preferably provided with an alignment mark with the outerneedle operation tube 51 so that the protruding direction of theinner needle 23 from theouter needle 22 can be recognized in advance. In this case, the operation unitmain body 40 may be configured such that theslider storage tube 41 is separated at the connection portion to the treatment instrument channel inlet by theconnection screw 42 and thesheath base member 43 and can be relatively rotated. Such a rotation mounting structure is disclosed in Japanese Patent Application Laid-Open No. 2001-275947 by the present applicant as a rotation structure including a fixing ring and a cylinder.

また、外針２２，内針２３の先端部の所定位置表面には、複数の円環状の溝を、例えば長手方向に設けることが望ましく、この円環状の溝により、超音波振動子３から出射された超音波の反射エコーを超音波振動子３により多く反射させて超音波画像を明瞭に描出可能とする共に、外針２２，内針２３と目的部位との位置関係及び距離を精度良く把握することが可能となる。  In addition, it is desirable to provide a plurality of annular grooves in the longitudinal direction, for example, in the longitudinal direction on the surfaces of the distal end portions of theouter needle 22 and theinner needle 23, and theultrasonic transducer 3 emits the annular grooves. The reflected ultrasonic echoes are reflected by theultrasonic transducer 3 so that an ultrasonic image can be clearly depicted, and the positional relationship and distance between theouter needle 22 and theinner needle 23 and the target portion are accurately grasped. It becomes possible to do.

次に、上述のように構成された穿刺針２０の使用法について、観察部位から更に深部にある目的部位の生検を行う場合を例に取り、図１１〜図１６を参照して説明する。  Next, a method of using thepuncture needle 20 configured as described above will be described with reference to FIGS. 11 to 16, taking as an example a case where a biopsy of a target site deeper than the observation site is performed.

先ず、超音波内視鏡２の挿入部４の先端を目的部位近傍に対向するように挿入配置し、この状態で、穿刺針２０のシース２１を操作部５に設けられた入口口金１１から処置具用チャンネル内に導入していく。そして、穿刺針２０の操作部本体４０を入口口金１１に螺合・固定する。  First, the distal end of theinsertion portion 4 of the ultrasonic endoscope 2 is inserted and disposed so as to face the vicinity of the target site, and in this state, thesheath 21 of thepuncture needle 20 is treated from theinlet base 11 provided in theoperation portion 5. It will be introduced into the equipment channel. Then, the operation portionmain body 40 of thepuncture needle 20 is screwed and fixed to theinlet base 11.

このとき、図１１（ａ）に示すように、穿刺針２０は、外針スライダ５０が操作部本体４０から長さＬ１だけ延出された略最後端の位置で固定ネジ５３により固定され、内針スライダ６０が外針スライダ５０から長さＬ２だけ延出された初期位置にあるため、図１１（ｂ）に示すように、シース２１が挿入部４先端の処置具用チャンネル出口より僅かに突出されている。従って、内針２３及びスタイレット２４は外針２２内に収納され、外針２２がシース２１内に収納された状態となっている。  At this time, as shown in FIG. 11A, thepuncture needle 20 is fixed by the fixingscrew 53 at the position of the most rear end where theouter needle slider 50 is extended from the operation portionmain body 40 by the length L1. Since theneedle slider 60 is in the initial position extended by the length L2 from theouter needle slider 50, thesheath 21 slightly protrudes from the treatment instrument channel outlet at the distal end of theinsertion portion 4 as shown in FIG. Has been. Therefore, theinner needle 23 and thestylet 24 are stored in theouter needle 22, and theouter needle 22 is stored in thesheath 21.

次に、挿入部４先端の超音波振動子３を体腔壁７０に当接しての超音波走査による超音波画像の観察下において、体腔壁７０に比較的近い観察部位７１及び観察部位７１の奥にある目的部位７２の位置を確認する。そして、図１２（ａ）に示すように、固定ネジ５３を緩めて外針スライダ５０を操作部本体４０側にスライドさせ、図１２（ｂ）に示すように、外針２２をシース２１から突出させて観察部位７１よりも深部の目的部位７２の近傍の部位まで穿刺する。  Next, under observation of an ultrasonic image by ultrasonic scanning with theultrasonic transducer 3 at the distal end of theinsertion portion 4 in contact with thebody cavity wall 70, anobservation site 71 that is relatively close to thebody cavity wall 70 and the back of theobservation site 71 The position of thetarget site 72 is confirmed. Then, as shown in FIG. 12A, the fixingscrew 53 is loosened and theouter needle slider 50 is slid toward the operation unitmain body 40, and theouter needle 22 protrudes from thesheath 21 as shown in FIG. 12B. Thus, puncture is performed up to a site near thetarget site 72 deeper than theobservation site 71.

このとき、内針スライダ６０を外針スライダ５０から長さＬ２だけ延出された初期位置に保持したまま、外針スライダ５０が操作部本体４０から長さＬ１’の位置に縮められ（Ｌ１’＜Ｌ１）、その位置で、固定ネジ５３を締め込んで外針２２の位置を強固に固定する。この状態では、外針２２の先端部は完全に閉塞されているため、検査対象でない不要な組織が外針２２内に入ることはない。  At this time, while holding theinner needle slider 60 at the initial position extended from theouter needle slider 50 by the length L2, theouter needle slider 50 is contracted from the operation portionmain body 40 to the position of the length L1 ′ (L1 ′). <L1) At that position, the fixingscrew 53 is tightened to firmly fix the position of theouter needle 22. In this state, the distal end portion of theouter needle 22 is completely occluded, so that unnecessary tissue that is not a subject of inspection does not enter theouter needle 22.

次に、超音波画像を観察しながら、図１３（ａ）に示すように、内針スライダ６０を外針スライダ５０側にスライドさせ、図１３（ｂ）に示すように、外針２２の可撓膜２５を破って内針２３及びスタイレット２４を突出させ、目的部位７２の内部まで内針２３及びスタイレット２４を穿刺する。この状態では、外針スライダ５０が操作部本体４０から長さＬ１’の位置に固定されたまま、内針スライダ６０が外針スライダ５０から長さＬ２’の位置に縮められる（Ｌ２’＜Ｌ２）。  Next, while observing the ultrasonic image, theinner needle slider 60 is slid toward theouter needle slider 50 as shown in FIG. 13A, and theouter needle 22 is allowed to move as shown in FIG. 13B. Theinner needle 23 and thestylet 24 are protruded by breaking theflexible film 25, and theinner needle 23 and thestylet 24 are punctured to the inside of thetarget site 72. In this state, theinner needle slider 60 is contracted from theouter needle slider 50 to the position of the length L2 ′ while theouter needle slider 50 is fixed to the position of the length L1 ′ from the operation portion main body 40 (L2 ′ <L2 ).

そして、内針２３が目的部位７２まで到達したことを確認したなら、内針スライダ６０の吸引口金部材６３からスタイレット口金部材６４を外してスタイレット２４を吸引口金部材６３から引き抜き、図１４（ａ）に示すように、吸引口金部材６３の口金部６３ｂにシリンジ６５を接続する。これにより、図１４（ｂ）に示すように、目的部位７２内で内針２３の先端が開口され、組織の吸引が可能となる。  When it is confirmed that theinner needle 23 has reached thetarget portion 72, thestylet base member 64 is removed from thesuction base member 63 of theinner needle slider 60, and thestylet 24 is pulled out from thesuction base member 63, and FIG. As shown to a), thesyringe 65 is connected to the cap part 63b of thesuction cap member 63. As a result, as shown in FIG. 14B, the distal end of theinner needle 23 is opened in thetarget site 72, and the tissue can be aspirated.

この目的部位７２の組織を吸引・採取する際には、図１５（ａ）に示すように、シリンジ６５を取り付けた状態で内針スライダ６０を所定量ΔＳだけ進退させる操作を繰返し、図１５（ｂ）に示すように、内針２３内からの吸引に加えて内針２３の機械的な押し出しによって組織を取り込む動作（アジテーション）を併用し、目的部位７２の組織を採取する。  When the tissue of thetarget site 72 is aspirated / collected, as shown in FIG. 15A, the operation of moving theinner needle slider 60 forward and backward by a predetermined amount ΔS with thesyringe 65 attached is repeated. As shown in b), in addition to the suction from theinner needle 23, the operation of taking in the tissue by mechanical push-out of the inner needle 23 (agitation) is used together to collect the tissue of thetarget site 72.

その後、図１６（ａ）に示すように、シリンジ６５及び吸引口金部材６３を内針スライダ６０の連結部材６２から外して内針２３を引き抜き、採取した組織の検査を行う。万一、組織の採取量が不十分であった場合には、図１６（ｂ）に示すように、外針２２は目的部位７２の近傍の位置に保持されているため、新しい内針を外針２２内に挿通することにより、目的部位７２の組織の採取を再度行うことができる。  Thereafter, as shown in FIG. 16A, thesyringe 65 and thesuction cap member 63 are detached from the connectingmember 62 of theinner needle slider 60, theinner needle 23 is pulled out, and the collected tissue is inspected. If the amount of collected tissue is insufficient, theouter needle 22 is held at a position near thetarget site 72 as shown in FIG. By inserting into theneedle 22, the tissue of thetarget site 72 can be collected again.

以上の操作によって内針２３内に採取された組織は、目的部位７２の近傍まで穿刺する外針２２を完全に閉塞して組織採取機能を与えていないことから、コンタミネーションの虞がなく、精度の高い検査が可能となる。  Since the tissue collected in theinner needle 23 by the above operation does not give the tissue collection function by completely closing theouter needle 22 that punctures to the vicinity of thetarget site 72, there is no risk of contamination and accuracy. High inspection is possible.

そして、組織の採取量が検査に十分な量であり、検査が終了した後は、外針２２をシース２１に収納して穿刺針２０を超音波内視鏡２の操作部５から取外し、穿刺針２０を廃棄する。この場合、操作部本体４０のキャップ部材４４をスライダ収納管４１から外すことにより、外針スライダ５０を操作部本体４０から分離することができ、また、スライダ収納管４１先端の接続ネジ４２，シース口金部材４３を緩めることにより、シース２１を操作部本体４０から取り外すことができることから、厳重な洗滌・滅菌の管理下において、操作部本体４０のみを再利用することも可能である。  The amount of tissue collected is sufficient for the examination, and after the examination is completed, theouter needle 22 is housed in thesheath 21 and thepuncture needle 20 is removed from theoperation section 5 of the ultrasonic endoscope 2 and puncture is performed. Theneedle 20 is discarded. In this case, theouter needle slider 50 can be separated from the operation unitmain body 40 by removing thecap member 44 of the operation unitmain body 40 from theslider storage tube 41, and the connectingscrew 42 and sheath at the tip of theslider storage tube 41 are provided. By loosening thecap member 43, thesheath 21 can be removed from the operation portionmain body 40. Therefore, only the operation portionmain body 40 can be reused under strict cleaning and sterilization management.

尚、以上の穿刺針２０の使用例は、観察部位７１より更に深部の目的部位７２の組織を採取する例であるが、体腔表面の組織を採取する際には、外針２２を体組織に穿刺することなく、外針２２から内針２３を突出させて体組織を吸引・採取するといったように、通常の外針のみの穿刺針と同様の使用法も可能である。これにより、通常の穿刺針と本実施形態の穿刺針２０とを交換・使い分けするといった煩雑さを解消することができる。  The use example of thepuncture needle 20 described above is an example in which the tissue of thetarget site 72 deeper than theobservation site 71 is sampled. However, when the tissue on the body cavity surface is sampled, theouter needle 22 is used as the body tissue. A method of use similar to a normal puncture needle with only an outer needle is also possible, such as causing theinner needle 23 to protrude from theouter needle 22 without puncturing and sucking and collecting body tissue. Thereby, it is possible to eliminate the trouble of exchanging and using the normal puncture needle and thepuncture needle 20 of the present embodiment.

本発明は、以上述べた実施形態のみに限定されるものではなく、発明の要旨を逸脱しない範囲で種々変形実施可能である。  The present invention is not limited to the embodiments described above, and various modifications can be made without departing from the spirit of the invention.

内視鏡装置の全体構成図Overall configuration diagram of endoscope apparatus外針及び内針を突出させた状態の内視鏡用穿刺針の外観図External view of puncture needle for endoscope with outer needle and inner needle protrudingシース内に外針及び内針を収納した状態の内視鏡用穿刺針の外観図External view of endoscope puncture needle with outer needle and inner needle housed in sheath外針及び内針の構成を示す説明図Explanatory drawing which shows the structure of an outer needle and an inner needle外針及び内針の他の構成例を示す説明図Explanatory drawing which shows the other structural example of an outer needle and an inner needle外針及び内針の更に他の構成例を示す説明図Explanatory drawing which shows the further another structural example of an outer needle and an inner needle.操作部の構成を示す説明図Explanatory drawing showing the configuration of the operation unit図７のＡ部拡大図Part A enlarged view of FIG.図７のＢ部拡大図Part B enlarged view of FIG.図７のＣ部拡大図Part C enlarged view of FIG.穿刺針の取付けを示す説明図Explanatory drawing showing attachment of puncture needle外針の操作状態を示す説明図Explanatory drawing showing the operating state of the outer needle内針の操作状態を示す説明図Explanatory drawing showing the operating state of the inner needle穿刺針による吸引生検の開始を示す説明図Explanatory drawing showing the start of aspiration biopsy with a puncture needle吸引生検における穿刺針の操作を示す説明図Explanatory drawing which shows operation of the puncture needle in aspiration biopsy吸引生検終了後の状態を示す説明図Explanatory drawing showing the state after the end of aspiration biopsy

符号の説明Explanation of symbols

２ 超音波内視鏡
１１ 入口口金
２０ 内視鏡用穿刺針
２１ シース
２２ 外針
２３ 内針
２５ 可撓膜
４０ 操作部本体
５０ 外針スライダ
６０ 内針スライダ
代理人 弁理士 伊 藤 進2Ultrasound Endoscope 11Entrance Cap 20Endoscope Puncture Needle 21Sheath 22Outer Needle 23Inner Needle 25Flexible Film 40 OperationUnit Main Body 50Outer Needle Slider 60 Inner Needle Slider
Agent Patent Attorney Susumu Ito

Claims (4)

Translated fromJapanese

内視鏡の処置具用チャンネルに進退自在に挿通されるシースと、
上記シース内に進退自在に挿通され、先端部周辺に外部に連通する連通口を設けると共に、この連通口を閉塞する可撓膜を配設した外針と、
上記外針内に進退自在に挿通される中空状の内針と、
上記内視鏡の処置具用チャンネル入口に着脱自在に固定される操作部本体と、
上記外針を上記操作部本体に対して進退自在に保持する外針スライダと、
上記内針を上記外針に対して進退自在に保持し、上記内針を上記外針の上記可撓膜から外部に突出させて目的部位の組織を採取可能とする内針スライダと、
を備えたことを特徴とする内視鏡用穿刺針。A sheath that is inserted into a treatment instrument channel of an endoscope so as to freely advance and retract;
An outer needle that is inserted into the sheath so as to be movable forward and backward, has a communication port that communicates with the outside around the tip, and is provided with a flexible film that closes the communication port;
A hollow inner needle that is inserted into the outer needle so as to freely advance and retract;
An operation unit main body detachably fixed to a treatment instrument channel inlet of the endoscope;
An outer needle slider for holding the outer needle movably forward and backward with respect to the operation unit body;
An inner needle slider that holds the inner needle so as to be movable back and forth with respect to the outer needle, and allows the inner needle to project outward from the flexible film of the outer needle so as to collect tissue at a target site;
A puncture needle for an endoscope, comprising: 上記外針の連通口を上記外針の先端部の側面に設け、上記可撓膜によって閉塞したことを特徴とする請求項１記載の内視鏡用穿刺針。  The puncture needle for an endoscope according to claim 1, wherein a communication port of the outer needle is provided on a side surface of a distal end portion of the outer needle and is closed by the flexible film. 上記外針の連通口を上記外針の先端部の前面に設け、上記可撓膜によって閉塞したことを特徴とする請求項１記載の内視鏡用穿刺針。  The puncture needle for an endoscope according to claim 1, wherein a communication port of the outer needle is provided on a front surface of a distal end portion of the outer needle and is closed by the flexible film. 上記内針スライダの後端に、上記内針の内部を吸気通路として吸引する吸引手段を着脱自在に接続可能な口金部を設けたことを特徴とする請求項１〜３の何れか一に記載の内視鏡用穿刺針。  The base part which can attach | detach the detachable connection of the suction means which attracts | sucks the inside of the said inner needle as an intake passage is provided in the rear end of the said inner needle slider. Endoscopic puncture needle.

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