JP3754562B2 - Energy irradiation device - Google Patents

Description

[0001]
BACKGROUND OF THE INVENTION
The present invention relates to a side-projection type energy irradiation apparatus that is inserted into a living body lumen such as a blood vessel, urethra, and abdominal cavity, and irradiates a living tissue with energy such as laser light and ultrasonic waves having deep living body properties.
[0002]
[Prior art]
By using a body cavity or making a small incision and inserting a long energy irradiation device into the living body lumen and irradiating the lesion with energy of various energy densities, degeneration, necrosis, coagulation, cauterization, Techniques for treating by incision or transpiration are known.
[0003]
In general, these techniques irradiate energy directly on the surface layer of a living tissue or a lesion located in the vicinity thereof, but the lesion is located for the purpose of treating a lesion (deep lesion) located deep in the living tissue. A technique for irradiating energy deeply is also known.
[0004]
However, in order to heat the deep part of the lesion to a sufficient temperature, it is necessary to irradiate relatively high output energy, which may damage the surface layer part.
[0005]
[Problems to be solved by the invention]
In order to solve the above-described problem, for example, it is conceivable to provide a plurality of emission units that emit energy so that the irradiation range of energy from each emission unit overlaps in the deep part of the lesion at the tip of the energy irradiation apparatus ( Multi-point focusing method). According to this method, energy from each emitting part provided at different positions is collected in the lesion deep part, so that it is possible to heat the lesion deep part to a sufficient temperature while reducing damage to the surface layer to some extent. is there.
[0006]
However, in the energy irradiation device having such a configuration, there is a limit in reducing surface layer damage. That is, in the conventional apparatus, the temperature in the vicinity of the condensing point is higher than the portion irradiated with the laser beam alone, because the amount of heat for a plurality of laser beams is added. However, since heating along the optical axis of each laser beam is also performed, a slight high temperature portion is also formed on each laser optical axis in the vicinity of the surface layer (not overlapping). This phenomenon is disadvantageous for surface preservation and becomes the limit of the multi-point focusing method.
[0007]
The present invention has been made in view of the above points, and its purpose is not complicated in structure, and it is easy and reliable while preventing damage to normal tissue (particularly normal tissue in the surface layer portion). An object of the present invention is to provide a side-projection type energy irradiation apparatus capable of effectively irradiating a target portion (particularly, an irradiation target portion located in a deep portion) with energy.
[0008]
[Means for Solving the Problems]
Such an object is achieved by the present inventions (1) to (15) below.
[0009]
(1) A side-projection type energy irradiation apparatus that irradiates living tissue with energy having a living body depth, and is provided with a long main body, and the energy installed on the main body is directed sideways or obliquely. An emission part for emitting, and a moving means for moving the position of the emission part in the axial direction of the main body,
An energy irradiation apparatus, further comprising a guide member that is slidably fitted to a part of the emitting portion and is not parallel to the axial direction of the main body.
[0010]
(2) The energy irradiating apparatus according to (1), wherein the moving unit is connected to an electric driving unit to repeatedly reciprocate the emitting unit in the axial direction.
[0011]
(3) The energy irradiation apparatus according to (1) or (2), wherein the guide member is movable in an axial direction.
[0012]
(4) The energy irradiation apparatus according to any one of (1) to (3), wherein the energy is laser light.
[0013]
(5) The energy irradiation device according to (4), further including a light guide member that guides the energy to the emission unit.
[0014]
(6) An optical element for converging the laser beam is provided between the tip of the light guide member and the emitting portion, and the optical element is for converging the laser beam into parallel light. The energy irradiation apparatus according to (5) above, which is characterized.
[0015]
(7) The energy irradiation apparatus according to any one of (4) to (6), wherein the emission unit includes a reflection surface that reflects the laser light.
[0016]
(8) The energy irradiation apparatus according to (2), wherein the moving unit is a single rod-like body, and further includes an adjusting unit that can adjust a moving amount of the reciprocating motion of the emitting unit.
[0017]
(9) The energy irradiation device according to (7), wherein the reflection surface is a concave surface.
[0018]
(10) The energy irradiation apparatus according to any one of (1) to (9), wherein the main body has a lumen into which an endoscope is inserted.
[0019]
(11) The energy irradiation apparatus according to any one of (1) to (10), wherein a balloon that expands and contracts is provided near the tip.
[0020]
(12) The laser irradiation apparatus according to (11), further including a flow path for supplying and discharging a working fluid for expanding the balloon.
[0021]
(13) The laser irradiation apparatus according to (12), wherein the working fluid is a coolant.
[0022]
(14) The energy irradiation apparatus according to any one of (1) to (13), wherein the main body has a surface layer containing a hydrophilic polymer material on a surface thereof.
[0023]
(15) The energy irradiation apparatus according to any one of (4) to (14), wherein the laser beam has a wavelength of 750 to 1300 nm or 1600 to 1800 nm.
[0024]
DETAILED DESCRIPTION OF THE INVENTION
Hereinafter, the energy irradiation apparatus of this invention is demonstrated in detail based on the preferred Example shown to an accompanying drawing.
[0025]
FIG. 1 is a cross-sectional view showing a side-irradiation type laser irradiation apparatus that irradiates a living tissue with a laser beam having a living body depth as a first embodiment of the energy irradiation apparatus of the present invention. In FIG. 1, a laser irradiation apparatus 1 has a long main body 2. A housing 4 containing a laser emitting portion 3 is connected to the distal end portion of the main body 2. A single arm 5 is connected to the emitting portion 3 as a moving means for supporting the emitting portion 3 in the housing 4 so as to be capable of reciprocating in the axial direction of the main body 2. Reference numeral 6 denotes a reflecting surface formed on one side of the emitting portion 3.
[0026]
The housing 4 is formed of a rigid tubular body having a window 7 for emitting laser light, and the surface thereof is covered with a light-transmitting cover member 8. The distal end portion of the housing 4 is sealed with a distal end cap 9.
[0027]
Reference numeral 10 denotes a slide groove that is non-parallel to the axial direction of the main body 2 as a guide member of the emitting portion 3. The slide groove 10 is fixed to the left and right of the emitting portion 3 in the housing 4.
[0028]
FIG. 2 is a perspective view for explaining the structure of the emitting portion 3 and the arm 5. The arm 5 branches to the left and right within the housing 4 to support the emission part 3 so as not to prevent the laser beam from hitting the surface of the emission part 3. The support part 31 of the emitting part 3 has a rotatable shape so as to correspond to a change in angle. A projection 32 is provided at the other end of the support portion 31 in the emission portion 3, and the projection 32 fits into the slide groove 10 that is a guide member.
[0029]
The arm 5 is connected to a drive unit 11 which is an electric drive unit on the base end side so as to reciprocate the emitting unit 3 in the body axis direction. The emission part 3 changes the inclination angle with the position in the axial direction by the arm 5 and the slide groove 10. FIG. 3 is a diagram for explaining how the emitting unit 3 changes the tilt angle. Compared with the position where the exit portion 3 is located at the position A, the slide groove 10 which is not parallel to the arm 5 is closer to the arm 5 when the exit portion 3 is located at the position B. It will be inclined. Similarly, the position C is further inclined than the position B. The laser beam reflected at each position is concentrated on the target site. Therefore, only the target site is always irradiated with the laser beam, and other biological tissues such as the surface layer portion are hardly heated, and the target site is not heated. It becomes possible to heat only.
[0030]
Further, even when the shape of the target portion is complicated, the relationship between the arm 5 parallel to the main body axis direction and the non-parallel slide groove 10 and the shape of the slide groove 10 (which can be curved) are appropriately designed. Therefore, it is possible to cope to some extent.
[0031]
In FIG. 1, reference numeral 12 denotes an optical fiber as energy guiding means (light guiding means) for guiding laser light. A lens 13 is an optical element for converging the laser light into parallel light at the tip of the optical fiber 12. Is provided. The optical fiber 12 extends to a laser terminal 14 provided in the drive unit 11, and is configured to be connectable with a laser light generator (not shown).
[0032]
An endoscope 15 is inserted into the lumen of the main body 2. The endoscope 15 is an oblique viewing type using an optical fiber that also serves as illumination light, and an imaging lens 16 is provided at the tip. The endoscope 15 is installed so as to be freely inserted and removed from the proximal end portion of the laser irradiation apparatus 1. The housing 4 can be positioned by endoscopic observation. Further, by providing the guide light function, the laser irradiation position can be visually confirmed. Further, since the irradiated surface can be observed continuously during laser irradiation, it is possible to optimize the irradiation conditions while observing the state.
[0033]
4 is a cross-sectional view taken along line AA of the main body 2 of FIG. In FIG. 4, 2a is a working lumen through which the arm 5 is inserted so as to be able to reciprocate. In this case, the working lumen 2 a is formed in parallel with the axis of the main body 2. 2b is a light guide lumen for the optical fiber 12, 2c is an endoscope lumen for the endoscope 15, and 2d and 2e respectively suppress the heat generation in the housing 4 by the laser, and the housing 4 is a cooling water inflow lumen and an outflow lumen for cooling the living tissue surface layer in contact with 4. These lumens 2d and 2e are connected to connecting portions 17a and 17b in FIG. 1, respectively, and are configured to be connected to a cooling water circulation device (not shown). At this time, it is desirable to prevent a reverse flow of the coolant to the drive unit side by providing a check valve (not shown) at the base end of each lumen 2a, 2b and 2c. The working lumens 2a and 2b can also be used for cooling water inflow and outflow.
[0034]
FIG. 5 is a diagram illustrating a mechanism of the drive unit 11 for causing the emitting unit 3 to reciprocate. A linearly driven follower type groove cam 18 is provided in the drive unit 11, and a rotating shaft 19 of the groove cam 18 is connected to a shaft of a motor 20 which is an electric drive means. The groove cam 18 is provided with an eccentric oval groove 18a. A cam follower 52 provided at the base end of the rod 51 connected to the base end of the arm 5 is slidably fitted in the groove 18a. It is.
[0035]
Due to the rotation of the motor 20, the groove cam 18 rotates around the rotation shaft 19. At that time, the cam follower 52 does not rotate but slides in the groove 18a. Since the rotating shaft 19 is eccentric with respect to the groove 18a, the rod 51 (and the arm 5) repeats linear motion (reciprocating motion) by rotation.
[0036]
Next, a specific use situation and operation of the laser irradiation apparatus 1 described above will be described.
[0037]
First, as shown in FIG. 6, the main body 2 is inserted into the body cavity 110 from the distal end portion, and the housing 4 provided at the distal end portion is positioned in the vicinity of the irradiation target portion 120 and is brought into close contact with the body cavity surface layer portion. At this time, it is desirable to confirm the position of the housing 4 directly with the endoscope 15. In adjusting the position of the target position 121 in the longitudinal direction of the main body 2, the entire laser irradiation apparatus 1 is moved in a predetermined direction (longitudinal direction of the main body 2). Further, in adjusting the position of the target position 121 in the circumferential direction of the main body 2, the entire laser irradiation apparatus 1 is manually rotated.
[0038]
Next, a laser beam generator (not shown) is operated, and at the same time, the motor 20 is driven to rotate, and the laser beam is emitted from the emission part 3 in the housing 4.
[0039]
The laser light incident from the laser terminal 14 of the drive unit 11 is guided from the base end part to the front end part by the optical fiber 12, converged into parallel light by the lens 13, and then reflected by the reflection surface 6 of the emission part 3. The reflected light is applied to the target position 121. At that time, since the emission unit 3 changes the emission angle while reciprocating in the axial direction, the laser light gathers (condenses) at the target position 121 while continuously changing the path.
[0040]
As a result, the target position 121 of the living tissue 100 and a portion (region) in the vicinity thereof are heated to a desired temperature by the irradiated laser light. On the other hand, since the irradiation time of the laser light is short (less) at the upper part (for example, the surface layer part of the biological tissue 100) and the lower part of the irradiation target part 120 in FIG. It is kept at a low temperature. (Parts other than the irradiation target part 120 can be preserved). Thereby, it is possible to prevent (reduce) damage to parts other than the irradiation target part 120. In particular, even when the irradiation target part 120 is located in a deep part, damage to the surface layer part can be prevented, so that it is safe for the patient. High nature.
[0041]
Next, the target position 121 is moved (the target position 121 is continuously changed), and the entire irradiation target unit 120 is heated to a desired temperature.
[0042]
Thus, in the laser irradiation apparatus 1 of the present embodiment, the target position 121 can be moved in any direction, and in particular, the target position 121 can be moved in a direction perpendicular to the axis of the main body 2. Therefore, the irradiation target part 120 as a whole is uniformly and uniformly heated to a desired temperature with respect to the irradiation target part 120 positioned at an arbitrary position and the irradiation target part 120 having an arbitrary shape and arbitrary size. (It is possible to prevent local overheating and underheating from occurring).
[0043]
In the present invention, the laser light emitted from the emitting unit 3 may be any of diverging light, parallel light, and focused light, and among these, convergent light such as parallel light or focused light is preferable.
[0044]
When the laser light emitted from the emitting unit 3 is parallel light or focused light, the laser light can be more concentrated at the target position 121, and the energy density of the laser light at the target position 121 and its vicinity can be further increased. Can do. In other words, in the case of convergent light, when the energy density of the laser light irradiated to the target position 121 is the same, the energy density of the laser light irradiated to the surface layer portion is made lower than in the case of divergent light. Therefore, damage to the surface layer portion can be prevented more reliably.
[0045]
Further, when the laser light emitted from the emitting unit 3 is focused light, the laser light is focused at the target position 121, that is, a position where the laser light is focused (a spot on a plane perpendicular to the optical axis of the laser light). It is preferable that the position where the light area is minimized and the target position 121 coincide with each other. By converging the laser light at the target position 121, the energy density of the laser light at the target position 121 and in the vicinity thereof can be further increased.
[0046]
In order to make the laser light emitted from the emission part 3 become convergent light, an optical system for converting the laser light into convergent light is provided in the middle of the optical path of the laser light. In this case, the optical system (lens 13) may be provided separately from the emitting portion 3, or the reflecting surface 6 may be a concave mirror to serve as the optical system.
[0047]
The laser light to be used is not particularly limited as long as it has a living body depth, but one having a wavelength of about 750 to 1300 nm or about 1600 nm to 1800 nm is preferable. Laser light having a wavelength of about 750 to 1300 nm and about 1600 nm to 1800 nm is particularly excellent in living body penetration. Therefore, when the living body tissue is irradiated with the laser light, absorption of energy at the surface layer is small, and therefore, more It is possible to effectively irradiate the irradiation target portion (lesioned portion) 120 positioned deep in the living tissue with laser light.
[0048]
Examples of the laser beam generator that generates the laser beam having the wavelength include a gas laser such as a He—Ne laser, a solid state laser such as an Nd—YAG laser, and a semiconductor laser such as a GaAlAs laser.
[0049]
The outer diameter (diameter) of the insertion portion of the laser irradiation apparatus 1, that is, the outer diameter of the main body 2 is not particularly limited as long as it can be inserted into the body cavity 110, but is preferably about 2 to 20 mm, for example, about 3 to 8 mm. Is more preferable.
[0050]
Examples of the constituent material of the main body 2 include polyolefins such as polyethylene and polypropylene, polyesters such as ethylene-vinyl acetate copolymer (EVA), polyvinyl chloride, polyethylene terephthalate, and polybutylene terephthalate, polyamide, polyurethane, polystyrene, Examples thereof include a polymer alloy containing one of these, such as a fluororesin, or a combination of two or more thereof.
[0051]
The surface of the main body 2 may be provided with a hydrophilic polymer material, or a lubricious coating such as silicon or fluororesin. Thereby, the friction on the surface of the main body can be reduced, and the insertion into the body cavity can be made smooth. Alternatively, a disposable sheath covering the main body may be prepared separately, and a lubricious coating may be applied to the surface of the sheath. By using a disposable sheath, it is possible to prevent the adverse effect that the lubricity is impaired due to the peeling of the coating after multiple uses.
[0052]
The hydrophilic polymer material used for the lubricating coating is preferably, for example, carboxymethyl cellulose, polysaccharides, polyvinyl alcohol, polyethylene oxide, sodium polyacrylate, methyl vinyl ether-maleic anhydride copolymer, water-soluble polyamide, etc. Of these, methyl vinyl ether-maleic anhydride copolymer is particularly preferable.
[0053]
When using a laser irradiation apparatus coated with a hydrophilic polymer material, for example, the surface layer of the laser irradiation apparatus 1 is immersed in physiological saline or the like. As a result, the surface layer is moistened, and the surface of the laser irradiation apparatus 1 is lubricated. Since this laser irradiation apparatus 1 has a surface layer containing a hydrophilic polymer material, friction of the laser irradiation apparatus 1 against a living tissue is reduced, thereby reducing the burden on the patient and safety. Will improve. For example, the laser irradiation device 1 can be smoothly inserted into the body cavity, pulled out from the body cavity, and moved and rotated within the body cavity.
[0054]
The housing 4 is preferably made of a material having excellent light transmission characteristics such as quartz glass, acrylic, polystyrene, polycarbonate, polyethylene, polypropylene, vinylidene chloride, Teflon, and polyester. Here, the entire housing 4 does not need to be made of these materials, and may be only the laser beam emission window. Further, the laser emission window may be a cut surface, and the above material may be used for the cover member 8. By using such a material, laser light can be efficiently irradiated.
[0055]
In the present invention, the light guide member is not limited to an optical fiber as long as it can guide laser light, and may be, for example, a rod lens.
[0056]
In the present invention, the emitting part is not limited to the above-described embodiment, but may be a prism, a wedge plate, or the like.
[0057]
Next, a second embodiment of the energy irradiation apparatus of the present invention will be described.
[0058]
FIG. 7 is a cross-sectional view of the tip portion showing the laser irradiation apparatus of the second embodiment of the present invention. The description of the points common to the first embodiment will be omitted, and the main differences will be described.
In FIG. 7, in this laser irradiation apparatus 1, a rail body 21 having a slide groove 10 as a guide member can be adjusted by a guide bar 22 in the direction of the main body axis. When the rail body 21 is moved in the base end direction (drive device side), the inclination angle of the emitting portion 3 approaches perpendicularly, and the concentrated position of the laser beam is Base Will move in the direction. Therefore, when the target site (lesion) is in a wide range in the axial direction, the target site in a wide range can be heated by moving the rail body 21 without moving the laser irradiation device 1. By this mechanism, scratches caused by movement of the laser irradiation apparatus 1 can be reduced.
[0060]
In this embodiment, the portion of the rail body 21 corresponding to the laser beam passage is cut out so as not to obstruct the passage of the laser beam. However, acrylic resin or quartz is used so that the laser beam is transmitted through the rail body 21. You may comprise by light transmissive materials, such as.
[0061]
FIG. 8 is a cross-sectional view taken along line AA of the main body 2 of FIG. Compared to FIG. 4 of the first embodiment, a guide bar lumen 2f for the guide bar 22 is added. Therefore, the arrangement of other lumens has been changed.
[0062]
FIG. 9 is a diagram showing an internal structure of the driving device 11 of the laser irradiation apparatus of the second embodiment. In FIG. 9, illustration of the lumen other than the working lumen 2 a, the guide rod, the optical fiber, the endoscope, the cooling fluid circulation mechanism, and the like is omitted for easy understanding of the driving function. In FIG. 9, the rotor 23 attached to the motor 20 is rotatably connected to a rod 51 via a screw fulcrum 53, and the rod 51 is rotatably connected to the arm 5 via a fulcrum 54. ing. The screw fulcrum 53 can be fixed at an arbitrary position in the groove 24 by loosening the screw. Since the turning radius is changed by changing the mounting position of the screw fulcrum 53, the reciprocating motion range of the emitting portion 3 can be adjusted.
[0063]
FIG. 10 is a diagram for explaining the rotation of the rotor 23 and the movement of the arm 5 associated therewith. Since the arm 5 is housed so as to be guided in the working lumen 2a of the long main body 2 and is pivotally connected to the rod 51 by a fulcrum 54, as shown in FIG. It moves only in the axial direction and does not move in the vertical direction in the figure. Therefore, the arm 5 and the emitting part 3 connected to the tip of the arm 5 repeat reciprocating motion between the position shown in FIG. 10 (1) and the position (3).
[0064]
Next, a specific use situation and operation of the laser irradiation apparatus 1 described above will be described.
[0065]
First, as in the first embodiment shown in FIG. 6, the main body 2 is inserted into the body cavity 110 from the distal end portion, and the housing 4 provided at the distal end portion is positioned in the vicinity of the irradiation target portion 120. At this time, it is desirable to confirm the position of the housing 4 directly with the endoscope 15.
[0066]
The position of the rail body 21 is adjusted (set) by the guide rod 22 so that the target position (condensing position) 121 is positioned at a desired position in the irradiation target portion 120. Further, the screw fulcrum 53 is fixed at a preferred position of the groove 24. These settings are preferably made in advance by confirming the target position with an ultrasound image or MRI image before insertion into the body cavity 110.
[0067]
Here, if the position of the rail body 21 is moved to the front end side, the target position 121 moves to the front end side.
When the screw fulcrum 53 is moved toward the center of the rotor 23, the reciprocating distance of the emitting portion 3 is shortened, so that the cooling efficiency of the surface layer portion is lowered. As a result, the target position 121 approaches the surface layer. It becomes.
[0069]
Conversely, when the position of the rail body 21 is moved to the base end side, the target position 121 moves to the base end side.
Further, when the screw fulcrum 53 is moved away from the center of the rotor 23, the reciprocating distance of the emitting portion 3 is increased, so that the cooling efficiency of the surface layer portion is improved. As a result, the target position 121 is in the tissue deep direction. Will be moved to.
[0071]
Further, in adjusting the target position 121 in the circumferential direction of the main body 2, the entire laser irradiation device 1 is manually rotated. Other operations are the same as those of the first embodiment described above.
[0072]
Next, a third embodiment of the energy irradiation apparatus of the present invention will be described.
[0073]
FIG. 11 is a sectional view showing a third embodiment of the laser irradiation apparatus of the present invention. The description of the common points with the first and second embodiments will be omitted, and the main differences will be described.
[0074]
As shown in the figure, the laser irradiation apparatus 1 has a laser beam guided from the optical fiber 12 because the emitting part 25 having a reflecting surface for reflecting laser light has a concave reflecting surface 26. Converge. Therefore, the lens provided in the first and second embodiments is not provided. Here, the optical fiber 12 and the arm 5 are fixed to each other by an integrated tube 120, and are configured to reciprocate together. As a result, the positional relationship between the tip of the optical fiber 12 (laser emission end) and the reflecting surface 26 is always kept at a constant distance, and the convergent light is also kept in a constant shape.
[0075]
A balloon 27 that expands and contracts is provided on the housing 4 at the tip of the main body 2. As a constituent material of the balloon 27, for example, a material excellent in laser light transmittance, such as polyolefin, polyester, polyamide, latex, and cellulose, is preferable. As a result, energy loss and heat generation due to absorption of laser light by the balloon 27 can be reduced.
[0076]
The working fluid for expanding the balloon 27 is supplied by the cooling water inflow / outflow lumens 2d and 2e (see FIG. 4) shown in the first embodiment. These inflow / outflow lumens 2d and 2e are opened to the working fluid supply portion 17a and the discharge portion 17b formed on the proximal end side of the drive portion 11, respectively, and into the balloon 27 in the vicinity of the distal ends thereof. It is configured to communicate.
[0077]
The working fluid is not particularly limited as long as it can expand and contract the balloon 27, but a coolant is preferable. By using a coolant as the working fluid, the surface layer portion of the living tissue can be cooled by the coolant when irradiating the laser, thereby preventing the surface layer portion from being damaged more reliably.
[0078]
For example, when the irradiation target part is the prostate, the temperature of the irradiation target part is about 48 to 55 ° C., and the temperature of the upper part and the lower part of the irradiation target part is 44 ° C. or less, respectively. Although it is preferable to irradiate the laser beam, the laser irradiation apparatus 1 can irradiate the laser beam as such.
[0079]
Although it will not specifically limit if the temperature of the said cooling fluid is a grade which can cool the surface layer part of a biological tissue, 37 degrees C or less is preferable, about 0-25 degreeC is more preferable, About 0-10 degreeC is further more preferable.
[0080]
Further, physiological saline is preferable as the working fluid. By using physiological saline as the working fluid, when the working fluid leaks into the body for some reason, the influence of the leakage can be reduced.
[0081]
Moreover, when using a cooling liquid as a working fluid, it is preferable to circulate a cooling liquid, and it is more preferable to circulate a cooling liquid from before laser irradiation until laser irradiation is complete | finished. The cooling efficiency can be improved by circulating the cooling liquid, and the surface layer portion can be further cooled by circulating the cooling liquid from before the laser irradiation until the laser irradiation is completed.
[0082]
Moreover, it is preferable to provide the discharge part 17b with the pressure valve which opens, for example, when a fixed pressure is exceeded. Thereby, the balloon 27 can be expanded with a constant pressure regardless of the flow rate of the coolant.
[0083]
Further, it is preferable to control the temperature of the coolant and the flow rate of the coolant in conjunction with laser irradiation. Thereby, excessive cooling and excessive heating of the surface layer portion can be prevented.
[0084]
Moreover, it is preferable to provide the balloon 27 with a temperature sensor for detecting the surface temperature of the living tissue. In this case, the surface temperature of the living tissue can be detected by the temperature sensor, and the information (detected value) can be used for cooling control. Thereby, it can cool efficiently and necessary and sufficiently.
[0085]
Moreover, the balloon 27 may be formed so as to surround the entire periphery of the housing 4 other than the laser light emission window portion, as shown in FIG. 12 which is a front view. In this case, since the laser beam emission window of the main body 2 is pressed against the body cavity wall by expanding the balloon 27, the distance between the irradiation target portion and the emission portion 25 is stabilized, and the stability during irradiation is good.
[0086]
Next, the operation of the laser irradiation apparatus 1 will be described.
[0087]
With the balloon 27 deflated, the laser irradiation device 1 is inserted into the body cavity from the distal end portion, and the distal end portion is positioned at the irradiation target portion.
[0088]
Then, the coolant (working fluid) is injected from the supply unit 17a by a pump or the like connected to the supply unit 17a, and the balloon 27 is expanded to a predetermined size.
[0089]
In this case, the cooling fluid flows from the supply portion 17a through the inflow lumen 2d into the hollow portion of the balloon 27, whereby the balloon 27 is expanded.
[0090]
By expanding the balloon 27, the position and orientation of the laser irradiation apparatus 1 are fixed. Thereby, a laser beam can be irradiated to an irradiation target part easily and reliably.
[0091]
In addition, the portion in contact with the balloon 27 and the vicinity thereof, that is, the surface layer portion of the living tissue is cooled by the coolant, thereby preventing damage to the surface layer portion more reliably.
[0092]
When the cooling liquid is circulated, the cooling liquid is discharged from the discharge part 17b while injecting the cooling liquid from the supply part 17a. In this case, the coolant flows into the balloon 27 from the supply unit 17a through the inflow lumen 2d. The coolant that has flowed into the balloon 27 makes at least a half turn (circulates) in the balloon 27, and then is discharged from the discharge portion 17b through the outflow lumen 2e.
[0093]
When the laser irradiation to the irradiation target section is completed and the laser irradiation apparatus 1 is pulled out from the body cavity, the cooling liquid is not injected from the supply section 17a but only the cooling liquid is discharged from the discharge section 17b. In this case, the cooling liquid in the balloon 27 is discharged from the discharge portion 17b through the outflow lumen 2e, whereby the balloon 27 is deflated. Then, with the balloon 27 deflated, the entire laser irradiation device 1 is pulled out from the body cavity.
[0094]
In the laser irradiation apparatus 1, as described above, the position and orientation of the laser irradiation apparatus 1 can be fixed easily and reliably by the balloon 27.
[0095]
In the laser irradiation apparatus 1, the surface layer portion of the living tissue can be cooled by the cooling liquid in the balloon 27.
[0096]
In the present invention, in the laser irradiation apparatus 1 of the above-described embodiment, a balloon 27 or the like may be provided on the main body 2 as in the laser irradiation apparatus 1 of the third embodiment.
[0097]
The surface of the balloon 27 may be provided with a lubricating coating similar to that described in the first embodiment.
[0098]
Next, a description will be given of a fourth embodiment of the energy irradiation apparatus of the present invention.
[0099]
FIG. 13 is a sectional view showing an ultrasonic irradiation apparatus as a fourth embodiment of the energy irradiation apparatus of the present invention. The description of the points common to the first to third embodiments will be omitted, and the main differences will be described.
[0100]
In FIG. 13, the ultrasonic irradiation device 61 includes a long main body 62, an ultrasonic emission part 63, an ultrasonic transducer 64 formed on the surface thereof, and an arm 65 that supports the ultrasonic emission part 63. And an ultrasonic endoscope 66.
[0101]
In this embodiment, the structure and operation of the rail body 21 which is a guide member movable in the main body axial direction and the guide rod 22 are the same as those in the second and third embodiments. A signal line 67 having two insulation coatings is wound around the arm 65, and a drive signal is transmitted to the ultrasonic transducer 64.
[0102]
The inside of the housing 4 is filled with an ultrasonic transmission material such as physiological saline, and can transmit ultrasonic waves emitted from the ultrasonic transducer 64 and ultrasonic waves of the ultrasonic endoscope 66.
[0103]
The ultrasound used by the ultrasound transducer 64 differs depending on the applied organ and its position (depth, range), and thus cannot be defined unconditionally. However, if it is a soft tissue of about 1 to 5 cm in the depth direction. Those having a frequency of about 1 to 50 MHz are preferable.
[0104]
The ultrasonic endoscope 66 is an oblique viewing type, and is configured to be able to observe the surface layer of the living body irradiated with ultrasonic waves before starting treatment. The ultrasonic endoscope 66 can be inserted and removed from the proximal end portion of the ultrasonic irradiation device 61, and observes the irradiation position, irradiation direction, irradiation surface state, and the like of energy (ultrasonic waves). With the ultrasonic endoscope 66, it is possible to accurately confirm the irradiation site, and to prevent the wrong site from being irradiated. Further, since the observation can be continuously performed during the energy irradiation, the irradiation condition can be changed by observing the state of the irradiated surface.
[0105]
The energy irradiation apparatus of the present invention is a medical energy irradiation apparatus, and is used for the treatment of, for example, prostatic hypertrophy and various tumors (for example, cancer).
[0106]
As mentioned above, although the energy irradiation apparatus of this invention was demonstrated based on each Example of illustration, this invention is not limited to these, The structure of each part is set to the thing of the arbitrary structures which have the same function. Can be replaced.
[0107]
In the present invention, the features of the embodiments described above may be combined as appropriate. For example, the ultrasonic transducer of the fourth embodiment can be applied to the first to third embodiments, and the balloon of the third embodiment can be applied to the first, second, and fourth embodiments.
[0108]
【The invention's effect】
As described above, according to the energy irradiation apparatus of the present invention, the energy from the continuously moving emission position concentrates only at the target position, so the temperature of the part (normal tissue) other than the irradiation target part is low. Holds temperature. Thereby, it is possible to prevent (reduce) damage to parts other than the irradiation target part, and in particular, it is possible to prevent damage to the surface layer part even when the irradiation target part is located in the deep part, so that safety to the patient is improved. high. In addition, since the emission position moves continuously, deep heating with superior surface preservation is possible compared to the multipoint condensing type in which the emission end is fixed. And since the energy from the emission position which moves continuously concentrates on the target position, the density of energy increases at the target position and its vicinity, and thereby the irradiation target part can be heated to a desired temperature.
[0109]
In particular, in the energy irradiation apparatus of the present invention, the fixed guide means and the moving means (arms) are paired to control the movement of the emitting portion, so that only one (single) moving means is used to control the emitting portion. Since it is possible to realize reciprocal movement and change in tilt angle, the structure of the apparatus is simple, manufacture is easy, and there is little risk of failure.
[0110]
In addition, the target position can be moved by adjusting the position of the guide member, the mounting position of the cam and rod, etc. with the adjusting means. The entire irradiation target part can be uniformly heated to a desired temperature while being kept at a low temperature. Therefore, the operation is easy and the burden on the patient can be reduced.
[Brief description of the drawings]
FIG. 1 is a cross-sectional view showing a first embodiment of an energy irradiation apparatus of the present invention.
FIG. 2 is a perspective view for explaining the structure of an emission part and an arm in the energy irradiation apparatus shown in FIG.
FIG. 3 is a schematic diagram for explaining the movement of the emission unit and the energy irradiation direction of the energy irradiation device shown in FIG. 1;
4 is a cross-sectional view taken along line AA of the main body 2 of the energy irradiation apparatus shown in FIG.
FIG. 5 is a perspective view illustrating the structure of a drive unit in the energy irradiation device according to the first embodiment of the present invention.
6 is a cross-sectional view showing an example of use of the energy irradiation device shown in FIG.
FIG. 7 is a cross-sectional view showing a tip portion of a second embodiment of the energy irradiation apparatus of the present invention.
8 is a cross-sectional view taken along line AA of the main body 2 of the energy irradiation device shown in FIG.
FIG. 9 is a diagram illustrating the structure of a drive unit of a second embodiment of the energy irradiation apparatus of the present invention.
FIG. 10 is a diagram for explaining the operation of the drive unit of the second embodiment of the energy irradiation apparatus of the present invention.
FIG. 11 is a sectional view showing a third embodiment of the energy irradiation apparatus of the present invention.
FIG. 12 is a front view showing a modification of the energy irradiation apparatus according to the third embodiment of the present invention.
FIG. 13 is a cross-sectional view of the distal end portion showing a fourth embodiment of the energy irradiation apparatus of the present invention.
[Explanation of symbols]
1 Laser irradiation device
2 body
3 Outgoing part
4 Housing
5 arm
6 Reflective surface
7 windows
8 Cover member
9 Tip cap
10 Slide groove
11 Drive unit
12 optical fiber
13 Lens
14 Laser terminal
15 Endoscope
16 Imaging lens
17a, 17b Cooling water connection
18 groove cam
20 Motor
21 Rail body
22 guide bar
27 Balloon
51 rod

Claims (10)

A side-fired energy irradiation device for irradiating a living tissue with energy having a living body depth, a long main body, and an emission that is installed in the main body and emits the energy sideways or obliquely a parts and, moving means for moving the position of the emitting portion in the axial direction of the body, the axial and non-parallel to the guide members of the body with a portion slidably fitted in the exit portion,
The said irradiation part changes the inclination-angle with the position of the said axial direction by the said guide member, The energy irradiation apparatus characterized by the above-mentioned .   The energy irradiation apparatus according to claim 1, wherein the moving unit is connected to an electric driving unit to repeatedly reciprocate the emitting unit in the axial direction.   The energy irradiation apparatus according to claim 1, wherein the guide member is movable in an axial direction.   The energy irradiation apparatus according to claim 1, wherein the energy is laser light.   The energy irradiation apparatus according to claim 4, further comprising a light guide member that guides the energy to the emission unit.   The energy irradiation apparatus according to claim 5, further comprising an optical element that converges the laser light between a distal end of the light guide member and the emitting portion.   The energy irradiation apparatus according to claim 4, wherein the emission unit has a reflection surface that reflects the laser beam.   The energy irradiation apparatus according to claim 2, wherein the moving unit is a single rod-shaped body, and further includes an adjusting unit capable of adjusting a moving amount of the reciprocating motion of the emitting unit.   The energy irradiation apparatus according to claim 1, wherein the energy emitted from the emission unit is concentrated at a target position at any emission position where the emission unit is moved.   The said output part is supported by the said moving means and the said guide member, The inclination angle of the said output part changes with the position of the said axial direction, The Claim 1 thru | or 9 characterized by the above-mentioned. Energy irradiation device.

Images