JP3333019B2 - Thermal treatment equipment - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention comprises an applicator which is used by inserting it into a living body lumen such as an oral cavity, a nasal cavity, an ear cavity, a rectal cavity, a urethra, or a cavity artificially opened in a living body. The present invention relates to a thermal treatment device that gives a thermal effect to tissue from inside a living body.

[0002]

2. Description of the Related Art In general, it has been known that when a malignant tumor is heated, the affected tissue shrinks due to a thermal effect. However, by heating a benign tumor, benign prostatic hyperplasia, a therapeutic effect is obtained. It was discovered to appear. In recent years, a high temperature treatment in which the heating temperature is further increased has been proposed in this treatment method.

[0003] When high temperature treatment is performed for prostatic hypertrophy, the temperature inside the prostate is 45 to 60 ° C.
Alternatively, it is heated to a higher temperature. In this case, the applicator is provided with a cooling mechanism. The cooling mechanism of the applicator can protect the surface of the urethral membrane even in an environment where the inside of the prostate is heated to a high temperature state during high temperature treatment for prostatic hypertrophy.

In a small applicator whose outer diameter is relatively small and can be inserted into the urethra, an electromagnetic radiation antenna formed inside the applicator is necessarily small. Becomes If such a small antenna adopts a structure in which the antenna itself has directivity of electromagnetic wave radiation, the structure of the antenna itself becomes complicated, and there is a problem that the cost increases. Therefore, in a small applicator that is large enough to be inserted into the urethra, which has been widely used in the past, the radiation distribution of the electromagnetic waves emitted from this applicator is concentric in the cross section of the applicator, and is omnidirectional. It is of sexual nature.

[0005] For example, in Japanese Patent Application Laid-Open No. 4-28377, a space for shielding electromagnetic waves is provided inside the applicator main body, and when the electromagnetic waves are radiated from the applicator main body, the affected part (hypertrophy) is unevenly distributed around the body lumen. An applicator having a structure in which electromagnetic waves are not radiated to a portion of normal living tissue other than the prostate gland and the like, which is prevented by the shielding space, and only the affected part can be effectively heated and treated.

[0006]

In the above-mentioned conventional structure, there is disclosed an applicator having a structure in which electromagnetic waves radiated from an antenna are blocked by a space so that only an affected part can be effectively heated and treated. .

[0007] However, when the applicator is inserted and placed in the body cavity, the space of the sheath of the applicator may be deformed or crushed by the pressure from the body cavity, thereby impairing the function of blocking electromagnetic waves by the space. There is no consideration for this.

SUMMARY OF THE INVENTION The present invention has been made in view of the above circumstances. It is an object of the present invention to provide a thermotherapy apparatus having a directivity in radiation distribution of electromagnetic waves, wherein a space for blocking electromagnetic waves radiated from an antenna is provided from a body cavity. An object of the present invention is to provide a configuration in which deformation can be prevented by pressure so that only an affected part can be effectively heated and treated.

[0009]

The invention according to claim 1 is
A flexible sheath main body that can be inserted into a body cavity, an antenna provided inside the sheath main body, and capable of irradiating an electromagnetic wave for heating the inside of the body cavity, and for reflecting the electromagnetic wave from the antenna A space formed at a predetermined side portion in the sheath body so as to be able to inject the gas, and a reinforcing member provided inside the space and capable of suppressing deformation of an outer peripheral side wall surface of the space. It is a thermotherapy device characterized by comprising.

The invention according to claim 2 is the thermal treatment apparatus according to claim 1, wherein the reinforcing member has a spiral shape.

[0011] The invention according to claim 3 is the thermal treatment apparatus according to claim 1, wherein the reinforcing member is a plurality of beads.

[0012]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS First, a technique which is a premise of an embodiment of the present invention will be described with reference to FIGS. FIG. 1 shows an applicator 1 of a thermal treatment apparatus, and 2 is a sheath body. An inflatable balloon 3 is mounted on the outer peripheral surface of the distal end portion of the sheath body 2. Further, inside the sheath main body 2, as shown in FIG. 2A, a first lumen 4 whose tip is sealed, and a heating range changing parallel extending with the first lumen 4. A second lumen 5 is provided.

It is desirable that the second lumen 5 has a sectional area of about one fifth or less of the first lumen 4 so as not to impair the cooling mechanism of the first lumen 4. The second lumen 5 is filled with air and has a characteristic of reflecting electromagnetic wave radiation. Specifically, the second lumen 5 may be a balloon air supply / exhaust tube, a drainage tube for sucking urine or the like, or a drug solution transport path. Alternatively, a configuration may be employed in which a plurality of second lumens 5 are formed, and the total cross-sectional area is set to a range of one fifth or less of the first lumen 4.

Further, the distal end of the second lumen 5 is formed on the outer peripheral surface of the distal end of the sheath body 2 and is connected to an opening 5 a that opens inside the balloon 3. The base end of the second lumen 5 is connected to an openable / closable connector portion 5b. An external air supply means such as a syringe is detachably connected to the connector portion 5b.

An inner tube 9 is inserted inside the first lumen 4. The distal opening of the inner tube 9 extends to the vicinity of the distal sealing portion of the first lumen 4. In this case, a spiral tube 10 is wound around the outer peripheral surface of the inner tube 9. And
A first coolant passage 11 a through which coolant or the like can flow between the inner peripheral surface of the first lumen 4 and the outer peripheral surface of the inner tube 9.
Are formed. In addition, a communication hole (not shown) communicating with the first coolant passage 11 a between the first lumen 4 and the internal tube 9 is provided at a distal end portion of the internal tube 9.

Further, a coaxial cable 6 for transmitting electromagnetic waves is inserted into the inner tube 9. At the distal end of the coaxial cable 6, a heating microwave antenna (electromagnetic radiation section) 7 for radiating microwaves is formed. At the proximal end of the coaxial cable 6, a connector section 8 is provided. An external high-frequency oscillator (not shown) is connected to the connector section 8. The inner tube 9
A second space through which a coolant or the like can flow between the
Is formed.

Further, one end of an external liquid supply tube (not shown) is hermetically connected to the base end of the first cooling liquid passage 11a between the sheath main body 2 and the inner tube 9. One end of an external collection tube (not shown) is hermetically connected to the second coolant passage 11b between the coaxial cable 6 and the second coolant passage 11b. The other end portions of the liquid sending tube and the collection tube are connected to an external reflux device (not shown).

A heat exchange unit (not shown) for changing the temperature of the coolant and a pump unit (not shown) for changing the amount of the coolant are disposed inside the reflux device. When the reflux device is driven, the cooling liquid discharged from the pump unit is supplied to the applicator 1 through the liquid feeding tube. Further, the coolant supplied to the applicator 1 is supplied to the first coolant passage 1 between the sheath body 2 and the inner tube 9.
1a to the second between the inner tube 9 and the coaxial cable 6
Into the cooling liquid passage 11b. Then, the coolant is recovered from the second coolant passage 11b through the recovery tube to the reflux device side, thereby forming a coolant reflux passage.

The outer peripheral surface of the distal end of the sheath body 2 is
The two sensor holes 12a and 12b are formed so as to be separated by a predetermined distance in the axial direction of the sheath main body 2. Here, the space 11a between the sheath body 2 and the inner tube 9
Inside the first temperature sensor 13 and the second temperature sensor 1
4 has been inserted.

The sensing part at the tip of one of the first temperature sensors 13 is drawn out of the sheath body 2 from the front sensor hole 12a and is fixed to the outer peripheral surface of the sheath body 2 with an adhesive or the like. In this case, the sensitive part of the first temperature sensor 13 is arranged near the antenna 7.

Similarly, the sensitive portion at the tip of the other second temperature sensor 14 is drawn out of the sheath body 2 from the rear sensor hole 12b and is fixed to the outer peripheral surface of the sheath body 2 with an adhesive or the like. . In this case, the sensitive portion of the second temperature sensor 14 is located behind the sensitive portion of the first
It is arranged in the range of 0 to 30 mm.

The signal lines 15 of the first temperature sensor 13 and the second temperature sensor 14 extend to the proximal end of the sheath body 2 and are connected to a connector 16. Further, a temperature sensor 13,
14 (thickness t: 0. 1) such as a silicon tube that covers the outside of the sheath body 2 in a state of covering the 14 sensitive portions.
(About 1 to 0.5 mm).

The outer peripheral surface of the distal end of the sheath body 2 is
The first temperature sensor 13 is provided in the two sensor holes 12a and 12b.
After the second temperature sensor 14 is attached, the second temperature sensor 14 is filled with a filler such as a silicone-based adhesive, and the sensitive part is also coated with the filler. Further, since the thin cover member 17 covers the upper part of the sensitive part, the response speed of the temperature sensors 13 and 14 is not impaired.
A double insulating structure is secured between the third and the 14th and the living body H.

On the outer peripheral surface of the sheath body 2, there is provided a substantially linear mark (display member) 18 for displaying a biased state of the heating distribution due to the electromagnetic waves radiated from the microwave antenna 7. The mark 18 is arranged along the second lumen 5 inside the sheath body 2.

Next, the operation of the above configuration will be described.
First, the applicator 1 is inserted through the urethra of a patient with benign prostatic hyperplasia. After the distal end portion of the applicator 1 reaches the bladder, air is supplied to the balloon 3 from the connector portion 5b through the second lumen 5 using a syringe or the like, and the balloon 3 is inflated. Thereafter, the applicator 1 is pulled until a sense of resistance is felt, and the pulling operation of the applicator 1 is stopped in a state where the sense of resistance is felt.

At this time, the sensitive part at the tip of the first temperature sensor 13 of the applicator 1 contacts the inner wall of the prostatic tissue J of the prostatic enlargement as shown in FIG. The sensitive part at the tip is positioned in contact with the urethral sphincter. FIG. 2C shows a state in which the applicator 1 is inserted into the urethra of the living body H of the patient, where K is a rectal cavity, L is a rectal wall, and Q is a microwave radiated from the applicator 1. FIG.

Subsequently, in this state, the external high-frequency oscillator and the reflux device are driven. Then, an electromagnetic wave supplied from the high-frequency oscillator via the coaxial cable 6 is radiated from the antenna 7 to the prostate tissue J of the living body H.

Further, the coolant is circulated into the coolant circulating passage in the applicator 1 by driving the circulating device. That is, when the reflux device is driven, the cooling liquid discharged from the pump unit is supplied to the applicator 1 through the liquid feeding tube. Further, the cooling liquid supplied to the applicator 1 is guided to the distal end side of the sheath main body 2 through the first cooling liquid passage 11 a between the sheath main body 2 and the inner tube 9, and then is supplied to the distal end of the inner tube 9. The coolant flows into the second coolant passage 11b between the inner tube 9 and the coaxial cable 6 through a communication hole (not shown) provided. Then, the liquid is recovered from the second coolant passage 11b to the reflux device through a recovery tube.

Further, since the spiral tube 10 is wound around the inner tube 9, the applicator 1 can be flexibly bent while the inner tube 9 and the coaxial cable 6 are held at the center of the first lumen 4. It is possible.

FIG. 2B shows a state of a heating distribution Q by an electromagnetic wave radiated from the antenna 7 of the applicator 1. That is, as is clear from this figure, the heating distribution Q reflects electromagnetic radiation at the portion corresponding to the second lumen 5 in which air is sealed, due to the air in the second lumen 5 being reflected. The range is kept narrow.

The portion of the heating distribution Q where the heating range is narrow can be easily determined by visually checking the mark 18 on the outer peripheral surface of the sheath body 2. Therefore, by adjusting the mark 18 on the outer peripheral surface of the sheath body 2 to the direction of the unheated portion, for example, the direction of the rectal wall L having poor heat resistance, the portion having a wide heating range is, for example, generally ubiquitous from the center of the urethra. Since the prostate tissue J can be directed to the placed prostate tissue J, the prostate hyperplasia prostate tissue J can be effectively subjected to thermal treatment. Therefore, for example, even in a case where the rectal wall L with poor heat resistance is very close to the urethra or the like, by adjusting the direction of the mark 18 to a portion not heated, for example, the direction of the rectal wall L with poor heat resistance. The heating distribution Q of the applicator 1 can be arranged in an appropriate state as shown in FIG. 2 (C), so that the working efficiency of the thermal treatment can be increased and the thermal treatment effect can be enhanced. In particular, even when performing the high-temperature treatment proposed in recent years, the control of the heating distribution Q can be easily realized.

Therefore, in the above configuration, during the thermal treatment, by observing the mark 18 displayed on the outer surface of the applicator 1, the biased state of the heating distribution Q due to the electromagnetic wave radiated from the microwave antenna 7 can be determined. Since the determination can be easily made, the heating treatment or the high temperature treatment of the prostatic hyperplasia prostate tissue J can be safely realized without damaging the normal tissue of the living body H.

FIGS. 3A and 3B show an embodiment of the present invention. This is obtained by inserting a spiral tube 21 shown in FIG. 3 (B) into the second lumen 5 of the applicator 1 having the above configuration.

Therefore, in the configuration of the present embodiment, the strength of the sheath body 2 of the applicator 1 can be increased by the spiral tube 21 in the second lumen 5. Therefore, even when the applicator 1 receives a high pressure from the living body lumen when the applicator 1 is inserted, the spiral tube 21 allows the second lumen 5 to be inserted.
Can be reinforced. Therefore, the second lumen 5
Can be prevented from being crushed, so that even under severe conditions, the second lumen 5 can be held and the bias of the heating distribution of the applicator 1 can be secured.

FIGS. 4A and 4B show another configuration. This is obtained by inserting a large number of beads 31 shown in FIG. 4B into the second lumen 5 of the applicator 1 in the first example.

Therefore, in the above configuration, the strength of the sheath body 2 of the applicator 1 can be increased by the large number of beads 31 in the second lumen 5. Therefore, even when the applicator 1 receives a high pressure from the living body lumen when the applicator 1 is inserted, the second lumen 5 can be reinforced by the large number of beads 31. Therefore, since the second lumen 5 can be prevented from being crushed, it is possible to hold the second lumen 5 even under severe conditions and secure the bias of the heating distribution of the applicator 1. it can.

FIG. 5 shows another configuration. This forms a concave portion 41 extending in parallel with the first lumen 4 on the outer peripheral surface of the sheath main body 2 of the applicator 1 in the first example, and the concave portion 41 forms a second portion for changing the heating range. It forms a lumen.

Therefore, in the above configuration, since the concave portion 41 on the outer peripheral surface of the sheath body 2 is opened on the outer surface of the applicator 1, even if the applicator 1 is inserted into the body lumen, The opening does not close. for that reason,
The bias of the heating distribution of the applicator 1 can be reliably ensured with a simple structure by the air layer in the concave portion 41.

FIG. 6 shows an applicator 51 of still another configuration. In FIG. 6, reference numeral 52 denotes a sheath body of the applicator 51. Inside the sheath body 52, a first lumen 53 having a tip sealed at an axial center portion is provided.
A coaxial cable 54 for transmitting electromagnetic waves is inserted into the first lumen 53. At the end of the coaxial cable 54, a heating microwave antenna (electromagnetic wave radiating unit) for radiating microwaves is formed.

Further, the peripheral wall portion 55 of the first lumen 53
A second lumen 56 extending in parallel with the first lumen 55 for changing the heating range, and two lumens 57 and 58 having a substantially arc-shaped cross section.

Here, two lumens 5 having a substantially arc-shaped cross section are used.
7 and 58 are both used as coolant inflow passages flowing in the direction of the tip of the applicator 51. The coolant flowing in the distal direction through the two lumens 57 and 58 is introduced into the first lumen 53 inside the peripheral wall 55 through a communication hole (not shown) at the distal end of the applicator 51. The liquid is guided to the base end side through the coolant passage between the first lumen 53 and the coaxial cable 54, and is discharged out of the applicator 51.

At this time, deionized water flows into one lumen 57, and physiological saline flows into the other lumen 58. In such a situation, the electromagnetic wave is more attenuated than the physiological saline, so that the bias of the heating distribution can be secured as a result.

If a saline solution having a higher concentration is used in place of the physiological saline solution, the bias of the heating can be further emphasized. In addition, the lumen 57 and the lumen 5
It is also possible to control the heating distribution by changing the sectional area ratio of FIG.

Therefore, according to the present embodiment, the applicator 52
Of the heating distribution Q can be set freely, so that an appropriate deviation of the heating distribution Q can be set according to the shape and structure of the affected tissue. Therefore, the working efficiency of the thermal treatment can be improved, and the thermal treatment effect can be enhanced.

FIGS. 7A and 7B show still another example of the structure. In this case, a mark 61 indicating a weak heating distribution position is provided on the surface of the applicator 1 of the first example under the positional relationship between the first lumen 4 and the second lumen 5 shown in FIG. 7B. It was done. Since this mark 61 is used as a display on the surface of the applicator 1 to indicate a position where the heating distribution is weak, it is possible to confirm at a glance the direction in which the heating distribution is weak at the time of thermal treatment by visually observing the mark 61. it can.

Therefore, according to the present embodiment, by visually checking the mark 61 on the surface of the applicator 1, it is possible to confirm at a glance the direction in which the heating distribution is weak at the time of thermal treatment. The deviation of the temperature distribution can be easily confirmed.

FIGS. 8A and 8B show still another configuration example. This is used on the surface of the applicator 1 of the first example as a display indicating a position having a strong heating distribution under the positional relationship between the first lumen 4 and the second lumen shown in FIG. 8B. A mark 62 is provided.

Therefore, according to the present embodiment, by visually checking the mark 62 on the surface of the applicator 1, it is possible to confirm at a glance the direction in which the heating distribution is strong at the time of thermal treatment. The deviation of the temperature distribution can be easily confirmed.

FIGS. 9A and 9B show another example of the structure. This means that marks 63 and 64 indicating the strength of the heating distribution are formed on the surface of the first example of the applicator 1 under the positional relationship between the first lumen 4 shown in FIG. 9B and the second lumen. It was installed. Here, one mark 63 indicates a position where the heating distribution is strong, and the other mark 64 indicates a position where the heating distribution is weak.

Therefore, according to the present embodiment, by visually checking the marks 63 and 64 on the surface of the applicator 1, it is possible to confirm at a glance the strength of the heating distribution during the hyperthermia treatment. The deviation of the heating distribution can be easily confirmed.

FIGS. 10A and 10B show still another example. This is such that the sheath body 2 of the applicator 1 of the first example is made of a transparent member so that the first lumen 4 and the second lumen 5 can be seen from outside the applicator 1. is there.

Therefore, according to the present embodiment, the first lumen 4 and the second lumen 5 can be seen through the sheath body 2 of the applicator 1 from the outside of the applicator 1, so that the hyperthermia treatment can be performed. Sometimes the deviation of the heating distribution can be easily checked. Furthermore, in this case, in particular, the mark 18
Is unnecessary, so that the configuration of the applicator 1 can be further simplified.

FIGS. 11A and 11B show still another example. This is because the first lumen 4 shown in FIG. 11B is provided on the surface of the applicator 1 of the first example.
And a plurality of marks 65... Indicating the axial strength of the applicator 1 in the heating distribution under the positional relationship of the second lumen. Here, mark 6
Reference numeral 5a denotes a heating center, and marks 65b... Indicating that the heating distribution gradually weakens are arranged side by side on both sides of the mark 65a.

Therefore, according to the present embodiment, by visually checking the marks 65 on the surface of the applicator 1, the strength of the heating distribution can be confirmed at a glance at the time of thermal treatment. The deviation of the heating distribution can be easily confirmed.

FIGS. 12A and 12B and FIG.
Shows still another example. This is based on the positional relationship between the first lumen 4 shown in FIG. 12B and the second lumen on the surface of the applicator 1 of the first example, and the strength of the heating distribution over the entire surface of the applicator 1. A plurality of marks 66... For displaying a state are provided. Here, the mark 66a indicates the center of heating, and the mark 65a
, Marks 66b, 66c, 66d,... Indicating that the heating distribution gradually weakens.

Therefore, according to the present embodiment, by visually observing the marks 66 on the surface of the applicator 1, the strength of the heating distribution at the time of thermal treatment can be seen at a glance in the entire circumferential and axial directions of the applicator 1. Thus, the deviation of the heating distribution of the applicator 1 can be easily confirmed. The marks 66 may be provided not only on the surface of the sheath body 2 as shown, but also on the surface of a grip (grip) disposed behind the sheath body 2.

Incidentally, for example, in the above example (FIG. 7A,
(B) to marks 61 and 6 shown in FIGS. 9A and 9B).
The markers 2 and 63 may be composed of markers for X-ray, MRI, optical CT, ultrasonic, and the like. Also in this case, the direction of the applicator 1, that is, the direction of the bias of the heating distribution can be confirmed while the applicator 1 is actually inserted into the body cavity. Therefore, after the applicator 1 is inserted into the body cavity, it is possible to confirm the bias of the heating distribution of the applicator 1, and the safety of treatment is further improved. Further, the cross-sectional shape of the sheath body 2 of the applicator 1 in the vicinity of the mounting portion of the microwave antenna 7 may be formed to be flat or elliptical. In this case, the ease of insertion into the urethral stenosis can be enhanced. Further, an operation switch for a patient may be connected to the thermal treatment apparatus, and a warning mechanism may be provided for operating the patient operation switch to notify the operator when the patient feels hot during the thermal treatment. Naturally, the present invention can be variously modified and implemented without departing from the gist thereof.

[0058]

According to the present invention, during hyperthermia treatment,
The function of blocking electromagnetic waves can be ensured by the space.

[Brief description of the drawings]

FIG. 1 is a longitudinal sectional view showing an applicator of a thermal treatment apparatus according to an embodiment of the present invention.

2A is a cross-sectional view of an applicator, FIG. 2B is a cross-sectional view showing a heating distribution state by an electromagnetic wave radiated from the applicator, and FIG. 2C is a state in which the applicator has been inserted into a living body. FIG.

3A and 3B show one embodiment of the present invention, wherein FIG. 3A is a cross-sectional view of an applicator, and FIG. 3B is a perspective view showing a spiral tube.

4A and 4B show another example, in which FIG. 4A is a cross-sectional view of an applicator, and FIG. 4B is a perspective view showing beads placed inside a second lumen.

FIG. 5 is a cross-sectional view of an applicator showing still another example.

FIG. 6 is a cross-sectional view of an applicator showing still another example.

[7] and further showing another example, (A) is a side view showing a display member on the surface of the applicator, (B) is an arrow view from arrow Y ₁ direction (A).

[8] but showing still another example, (A) is a side view showing a display member on the surface of the applicator, (B) is an arrow view from arrow Y ₂ direction (A).

[9] and further showing another example, (A) is a side view showing a display member on the surface of the applicator, (B) is an arrow view from arrow Y ₃ direction (A).

10A and 10B show still another example, wherein FIG. 10A is a side view showing a display member on the surface of an applicator, and FIG.
Arrow view from arrow Y ₄ direction.

11A and 11B show still another example, in which FIG. 11A is a side view showing a display member on the surface of an applicator, and FIG.
Arrow view from arrow Y ₅ direction.

12A and 12B show still another example, in which FIG. 12A is a side view showing a display member on the surface of an applicator, and FIG.
Arrow view from arrow Y ₆ direction.

FIG. 13 is a side view showing a display member on the surface of an applicator of still another example.

[Explanation of symbols]

DESCRIPTION OF SYMBOLS 1 ... Applicator, 4 ... 1st lumen, 5 ... 2nd lumen, 7 ... Microwave antenna, 21 ... Spiral tube.

──────────────────────────────────────────────────続 き Continued on the front page (58) Fields surveyed (Int.Cl. ⁷ , DB name) A61N 5/02 A61F 7/12

Claims (3)

(57) [Claims] A flexible sheath main body that can be inserted into a body cavity; an antenna provided inside the sheath main body and capable of irradiating an electromagnetic wave for heating the inside of the body cavity; A space formed at a predetermined side portion in the sheath body so as to be capable of injecting a gas for reflecting an electromagnetic wave; and a space provided inside the space to suppress deformation of an outer peripheral side wall surface of the space. A thermotherapy device, comprising: a reinforcing member; 2. The thermal treatment apparatus according to claim 1, wherein the reinforcing member has a spiral shape. 3. The heat treatment apparatus according to claim 1, wherein the reinforcing member is a plurality of beads.