JPH0798049B2 - Intracorporeal hyperthermia treatment device - Google Patents

Description

TECHNICAL FIELD The present invention relates to a device for heating and treating a diseased part in a living body cavity.

[Conventional technology]

Malignant tumors that have arisen in the body cavity are vulnerable to temperatures around 42 ° C,
It is known that hyperthermia treatment is effective as a means for treating such an affected area.

As a conventional hyperthermia treatment device, as described in JP-A-55-70248, the tip of the catheter, as described in JP-A-55-70248, is provided with a balloon for transmitting heat to the affected area, and the balloon is attached to the catheter. There is known a device in which a fluid supply passage for inflating and transmitting heat to a diseased part through a balloon is provided, and a heating electrode for heating the fluid is provided in the balloon.

This is because when a balloon is inserted into the body cavity and the fluid is supplied from the fluid supply passage, the balloon inflates and the balloon expands the body cavity and contacts the affected area, thus heating the fluid in the balloon. Since the affected area is heated by heating with the electrodes, it is possible to perform thermal treatment.

It has also been proposed to provide a temperature measuring means for monitoring the temperature of the fluid in the balloon and control the temperature of the fluid with this temperature measuring means.

However, the above-mentioned conventional device has no means for guiding the balloon to a position in the body cavity that correctly faces the affected area, and it is difficult to reliably bring the balloon into contact with the affected area.

An endoscope may be used to introduce the balloon to a position directly facing the affected area. That is, since the endoscope is equipped with an observation window, it is possible to find the position of the affected part in the body cavity, therefore, while searching for the position of the affected part with the endoscope, by guiding the balloon, The balloon can be brought into reliable and correct contact with the affected area.

[Problems to be solved by the invention]

However, in such a device in which the thermotherapy device is inserted up to the vicinity of the affected area together with the endoscope, if the endoscope is left inside the body cavity while the thermotherapy is performed by the balloon, the patient suffers a pain. There is a problem that gives.

An object of the present invention is to provide an intracorporeal hyperthermia treatment device that can search for an affected area using an endoscope and can leave only the hyperthermia treatment applicator inside the body cavity.

[Means for solving problems]

The present invention is a thermotherapy applicator provided with an inflatable balloon, a heating means, and a temperature measuring means so as to be in close contact with an affected area, an endoscope insertable into a body cavity, and the thermotherapy applicator. It is characterized in that it comprises an attachment means for detachably engaging with the endoscope, and that the thermotherapy applicator can be left in the affected area during treatment.

[Action]

According to the present invention, the thermotherapy applicator can be inserted into the body cavity together with the endoscope in a state of being attached to the endoscope, so that the balloon can be reliably guided to the affected area. Moreover, if the thermotherapy applicator is separated from the endoscope in the body cavity and the endoscope is pulled out from the body cavity, only the thermotherapy applicator can be left in the body cavity. Therefore, since the endoscope is not inserted into the body cavity during the hyperthermia treatment, the patient suffers less pain.

〔Example〕

The present invention will be described below based on the first embodiment shown in FIGS.

FIG. 1 shows the entire configuration, and 1 is an endoscope. Since the endoscope 1 may be a conventionally known one, a detailed description of its structure will be omitted.
And the operation unit 3 at hand. The insertion portion 2 has a distal end portion connected to the distal end via a curved portion. By operating an angle knob provided on the operation portion 3, the curved portion can be curved in any direction.

An observation window is formed in the tip portion, and the observation window is connected to the observation window 4 provided in the operation section 3 via a fiber cord. In addition, it is desirable that the observation window of the present embodiment is a side-view type.

The tip of the light cable is exposed to the tip forming portion, and the light cable is connected to the light source device 5 through the operation portion 3.

The light source device 5 is provided with a light source, a suction pump, and an air supply pump.

Further, as is well known, a water injection passage for washing the observation window, an air supply passage, a suction passage, a forceps channel (none of which is shown), and the like are provided inside the endoscope 1.

An applicator 10 for heat treatment is detachably attached to the tip of the insertion portion 2 of the endoscope 1.

Referring to the applicator 10, as shown in FIG. 2, the applicator 10 of this embodiment has a balloon 12 formed of an elastic body such as rubber at the tip of a probe 11 made of an elongated flexible material. I have it.

The balloon 12 has a double structure. That is, 13 is an inner balloon that can be closely attached to the outer circumference of the insertion portion 2 of the endoscope 1, and has an annular tube shape. An outer balloon 14 which can be closely attached to the inner surface of the body cavity A is formed into an annular tube shape and integrally joined to the outer circumference of the endoscope inner balloon 13 by means of heat fusion or the like. Therefore, the inner balloon 13 and the outer balloon 14 have fluid injection spaces independent of each other, and have a double structure in the radial direction.

The joint wall between the inner balloon 13 and the outer balloon 14 constitutes an annular partition portion 15, and an annular body cavity high-frequency electrode 16, for example, is embedded over the entire circumference of the partition portion 15. The ring-shaped intracavity high-frequency electrode 16 maintains the reference diameter of the entire balloon 12.

A temperature sensor 17 made of a thermocouple or the like is attached to the inner surface of the outer balloon 14 or the inner or outer surface of the outer balloon 14.

As shown in FIG. 3, inside the probe 11, an inner balloon water injection passage 18a and an inner balloon drainage passage 18b are provided so as to communicate with the inside of the inner balloon 13, and also communicate with the inside of the outer balloon 14. An outer balloon water injection passage 19a and an outer balloon drainage passage 19b are provided.

Further, in the probe 11, the lead wire 20 connected to the high frequency electrode 16 in the body cavity is inserted, and the lead wires 21, 21 connected to the temperature sensor 17 are also inserted.

Such a probe 11 has a heating control device 25 shown in FIG.
It is connected to the. The heating controller 25 has a high-frequency power source 2
6, a fluid perfusion pump 27 and a temperature measuring device 28 are provided.

Inner balloon water injection passage 18 formed in the probe 11
a, inner balloon drainage passage 18b, outer balloon water injection passage 19
The a and outer balloon drainage passages 19b are respectively connected to the fluid perfusion pump 27 via a switching valve (not shown).

In addition, the body cavity high frequency electrode lead wire 20 inserted through the inside of the probe 11 is connected to a high frequency power source 26,
The lead wires 21 and 21 connected to the temperature sensor 17 are the temperature measuring device 2
Connected to 8.

In FIG. 1, 29 is an extracorporeal high-frequency electrode, which is connected to the high-frequency power source 26 of the heating control device 25.

The operation of the first embodiment having such a configuration will be described with reference to FIGS. 4 to 7.

Both the inner balloon 13 and the outer balloon 14 are deflated in the state where the pressure fluid is sucked from the inner balloon 13 and the outer balloon 14 by the fluid perfusion pump 27. In this case, the reference diameter of the entire balloon 12 is maintained by the annular high-frequency electrode 16 in the body cavity, so that the inner diameter of the inner balloon 13 is enlarged and the outer diameter of the outer balloon 14 is reduced.

Therefore, in this state, the tip portion of the endoscope 1 is inserted into the inner balloon 13. Then, the pressure fluid is injected from the fluid perfusion pump 27 into the inner balloon 13. Then, the inner balloon 13 is inflated. However, since the outer peripheral wall of the inner balloon 13 is prevented from expanding by the annular high-frequency electrode 16 in the body cavity, the inner balloon 13 eventually expands so as to have a smaller inner diameter, as shown in FIG. Therefore, the inner balloon 13
Is in close contact with the outer peripheral surface of the tip of the endoscope 1, and therefore the entire balloon 12 is frictionally attached to the tip of the endoscope 1.

In this state, the insertion portion 2 of the endoscope 1 is inserted into the body cavity A.

In this case, light is emitted from the light cable facing the tip of the insertion part to illuminate the body cavity A, and the insertion part 2 is inserted into the body cavity A while searching for the affected part in the observation window. This operation is similar to that of a normal endoscope.

When the affected part B of the malignant tumor is found in the body cavity A, the balloon 12
Are operated so as to face the affected area B.

The endoscope 1 is stopped with the balloon 12 facing the affected area B, and the fluid is injected from the fluid perfusion pump 27 into the outer balloon 14. Then, the outer balloon 14 is inflated, so that the outer balloon 14 has an increased outer diameter and is brought into close contact with the affected area B, as shown in FIG.

When the outer balloon 14 comes into close contact with the affected area B at an appropriate pressure, the fluid perfusion pump 27 sucks out the pressure fluid in the inner balloon 13. Then, the inner balloon 13 is deflated, and as shown in FIG. 6, the inner diameter is enlarged, so that the frictional engagement with the endoscope 1 is released.

In this state, the endoscope 1 can be pulled out of the body cavity A.
Even when the endoscope 1 is pulled out, since the outer balloon 14 is in close contact with the affected area B with an appropriate pressure, the balloon 12 of the applicator 10 remains in contact with the affected area B as shown in FIG. It is left in A.

Next, a high frequency voltage is applied from the high frequency power supply 26 between the high frequency electrode 16 inside the body cavity and the high frequency electrode 29 outside the body. Then, the fluid injected into the outer balloon 14 is heated.

The temperature of the fluid is detected by the temperature sensor 17 by the temperature sensor 28.
You can know by the display of.

When the fluid inside the outer balloon 14 reaches the optimum temperature for treating the affected area B, for example, around 42 ° C, this state is maintained,
Heat treatment.

The fluid temperature during the treatment can also be controlled by the display of the temperature measuring device 28 by the detection of the temperature sensor 17.

When the treatment for a predetermined time is completed, the energization of the intracavitary high-frequency electrode 17 and the extracorporeal high-frequency electrode 29 is stopped, and the fluid perfusion pump 27 discharges the pressurized fluid in the outer balloon 14. Then, the outer balloon 14 is deflated and the outer diameter is reduced, so that the close contact with the body cavity A is released. Therefore, the body cavity A is passed through the probe 11.
Can be pulled out.

According to the first embodiment described above, when the balloon 12 of the applicator 10 is inserted into the body cavity A, the balloon 12 is locked to the tip of the insertion portion of the endoscope 1 and is inserted together with the insertion portion of the endoscope 1. ,
The original function of the endoscope 1, that is, the affected part B can be inserted into the body cavity A while searching for the affected part B through the observation window, and the distal end can be bent, so that the balloon 12 can be reliably positioned at a position facing the affected part B. It can be guided and thus the insertion operation is easy and the insertion time is short.

Moreover, since the balloon 12 is deflated at the time of insertion and can have a thickness almost equal to that of the endoscope insertion portion 2, insertion is easy.

Therefore, the patient is less likely to suffer pain during insertion.

Further, since the endoscope 1 is pulled out from the body cavity A during the treatment of the affected area B with the balloon 12, the endoscope 1 is inserted into the body cavity A and released during the thermotherapy which requires a relatively long time. And the patient's distress during treatment is reduced.

The present invention is not limited to the above-mentioned first embodiment.

That is, in the second embodiment shown in FIGS. 8 and 9, the balloon 12 of the applicator 10 similar to that of the first embodiment is used.
The sliding tube 30 is used together with the endoscope 1 when inserting into the body cavity A.

The sliding tube 30 is known as an auxiliary tool for inserting the endoscope 1 into the body cavity A. When the inner balloon 13 is deflated and the endoscope 1 is extracted from the body cavity A as shown in FIG. The sliding tube 30 is covered on the endoscope 1 as shown in FIG. 8, and the insertion tip of the sliding tube 30 is brought into contact with the balloon 12 as shown in FIG. When the endoscope 1 is pulled out of the body cavity A in this state, the balloon 12 is pressed by the insertion tip portion of the sliding tube 30, so that the balloon 12 does not move together with the endoscope 1.

Therefore, it is possible to keep the balloon 12 in proper contact with the affected area B.

During the thermal treatment, the sliding tube 30 is also pulled out of the body cavity A.

FIGS. 10 and 11 show a third embodiment of the present invention.

In the third embodiment, the inner balloon 13 for adhering the endoscope and the outer balloon 14 for adhering the inner surface of the body cavity are separately formed,
The inner balloon 13 is integrally fixed to the tip of the endoscope 1.

Even in such a configuration, when inserting into the body cavity A, as shown in FIG. 10, only the inner balloon 13 is inflated to fix the outer balloon 14, and inside the body cavity A, as shown in FIG. Thus, the outer balloon 14 is inflated and the inner balloon 13 is deflated.

Therefore, the inflated outer balloon 14 adheres to the inner surface of the body cavity A, and the deflated inner balloon 13 separates from the outer balloon 14. Therefore, the endoscope 1 is left with the outer balloon 14 left.
And the inner balloon 13 can be pulled out.

12 and 13 show a fourth embodiment of the present invention.

In the fourth embodiment, the balloon 12 has a single shape, and elastically expandable / contractible C-rings 41, 41 made of a shape memory alloy are embedded in the front and rear ends of the balloon 12.

This is a C-ring 41,4 made of these shape memory alloys.
The balloon 12 is moved to the endoscope 1 to the 12th position by the elastic action of 1.
Lock as shown.

When it is inserted into the body cavity A, hot water is injected into the balloon 12. Then, the balloon 12 is inflated by the injection of warm water and closely adheres to the body cavity A. At this time, the heat of this warm water causes the C rings 41, 41 made of the shape memory alloy to expand and deform as shown in FIG. As a result, the inner diameter of the balloon 12 is also expanded, and the balloon 12 is separated from the endoscope 1. Therefore, only the endoscope 1 can be pulled out.

14 and 15 show a fifth embodiment of the present invention.

The fifth embodiment is a further improvement of the fourth embodiment, in which the body cavity electrode 50 is formed of a coil or tubular body made of a shape memory alloy.

In this device, the balloon 12 is locked to the endoscope 1 by the elastic action of the body cavity electrode 50 made of a shape memory alloy, as shown in FIG.

When it is inserted into the body cavity A, hot water is injected into the balloon 12. Then, the balloon 12 is inflated by the injection of warm water and closely adheres to the body cavity A. At this time, the body cavity electrode 50 made of the shape memory alloy is expanded and deformed by the heat of the warm water, as shown in FIG. As a result, the inner diameter of the balloon 12 also expands, and the balloon 12 moves away from the endoscope 1. Therefore, only the endoscope 1 can be pulled out.

16 to 20 show a sixth embodiment of the present invention.

As shown in FIGS. 17 and 18, the applicator 10 according to the sixth embodiment attaches the balloon 12 to a base body 60 having a diameter substantially equal to or smaller than that of the distal end portion of the endoscope 1, and A probe 11 is derived from 60.

The base 60 and the distal end of the endoscope 1 are shown in FIG.
As shown in Fig. 18, the permanent magnets 61, 62 can be attracted to each other.
(Or it may be an electromagnet) is attached,
The base 60 is detachably locked to the endoscope 1 by the permanent magnets 61 and 62.

The probe 11 led out from the substrate 60 is connected to the heating control device 25 through the channel 9 of the endoscope 1.

Inside the probe 11, as shown in FIGS. 19 and 20,
Water injection passage 61 and drain passage communicating with the inside of the balloon 12
62 is provided, the lead wire 20 connected to the high frequency electrode 16 in the body cavity is inserted, and the temperature sensor
Lead wires 21, 21 connected to 17 are inserted.

Such a probe 11 has an applicator-side connector 63.
And the heating control device side connector 64 are connected to the heating control device 25.

The applicator side connector 63 and the heating control device side connector 64 are connected to terminals 66a, 66b, 66b and receivers 67a, 67, respectively.
Electrical connection is made at b and 67b, and connection ports 68a and 68b and receiving port 69
The water injection passage 61 and the drainage passage 62 are connected to a and 69b, respectively.

In this case, the outer diameter D of the applicator-side connector 63 is formed to be smaller than the channel 9 of the endoscope 1, so that the applicator-side connector 63 can be inserted into the channel 9 of the endoscope 1. It is configured.

In such a sixth embodiment, first, outside the body, the probe 11 of the applicator 10 with the balloon 12 deflated,
The endoscope 1 is pulled out to the rear end side through the channel 9 from the tip end portion of the endoscope 1, and the base body 60 of the applicator 10 is set to the permanent magnets 61, 6
It is locked to the tip of the endoscope 1 by 2.

In this state, the endoscope 1 is inserted into the body cavity A, and the balloon 12
To the affected part B.

Next, when a force that pushes the rear end of the probe 11 into the channel 9 is applied, the force of separating from the front end portion of the endoscope 1 is transmitted to the base body 60, so that the permanent magnets 61 and 62 come off. Therefore, when the endoscope 1 is pulled out from the body cavity A, the balloon 12 is left inside the body cavity A. When the endoscope 1 is pulled out from the body cavity A, the applicator-side connector 63 passes through the channel 9 of the endoscope 1, so that the endoscope 1 should be pulled out with the balloon 12 left inside the body cavity A. You can

Thereafter, the applicator-side connector 63 of the probe 11 is connected to the heating control device-side connector 64 to connect the balloon 12 to the heating control device 25.

Therefore, the thermal treatment can be performed in the same manner as in the first embodiment.

FIG. 21 shows a seventh embodiment of the present invention.

This embodiment is a modification of the sixth embodiment, in which the probe 11 is divided near the balloon 12. Permanent magnets 71a, 71b for connecting the split probes 11a and 11b
By using (or an electromagnet), these divided probes 11a and 11b can be kept from separating during treatment.

The connection by such a magnet can also be applied to the connection portion between the applicator-side connector 63 and the heating control device-side connector 64 in the sixth embodiment.

FIG. 22 shows an eighth embodiment of the present invention.

In this structure, a sleeve 80 made of an insulating synthetic resin or the like is integrally fixed to the inside of the balloon 12, and a locking flange 81 is formed at the tip of the sleeve 80.

The tip of the endoscope 1 can be inserted into the sleeve 80,
The tip portion of the endoscope 1 abuts on the locking flange 81.

Therefore, when the distal end of the endoscope 1 is covered with the sleeve 80 having the balloon 12 and the endoscope 1 is inserted into the body cavity (in the arrow direction), the distal end of the endoscope 1 is locked by the flange 81. The balloon 12 is pushed forward to hit.

Further, when the endoscope 1 is pulled out, the distal end portion of the endoscope 1 separates from the locking flange 81, and the endoscope 1 can be pulled out with the balloon 12 left inside the body cavity.

FIG. 23 shows a ninth embodiment of the present invention.

In this device, a hooking ring 90 is provided at the tip of the balloon 12, a forceps 91 is inserted through the channel 9 of the endoscope 1, and the hooking ring 90 is engaged by the forceps 91 led out from the tip of the endoscope 1. It is a detachable hook.

According to this, forceps led out from the tip of the endoscope 1.
By hooking the hooking ring 90 with 91, the balloon 12 can be introduced together when inserting the distal end portion of the endoscope 1 into the body cavity, and when the balloon 12 is inserted into a desired place, Open the forceps 91 by operating the
Remove from 90. With this configuration, the endoscope 1 can be pulled out with the balloon 12 left inside the body cavity.

FIG. 24 shows a tenth embodiment of the present invention.

This is because the balloon 12 of the applicator 10 is the probe 11
And a type of forceps 91 that is inserted into the hooking ring 90 provided on the balloon 12 and the channel 9 of the endoscope 1.
The same effect as in the ninth embodiment is obtained in that

The endoscope of the present invention is not limited to the flexible type visual type as shown in the embodiment, but may be a video monitor type or a rigid type.

As described above, according to the present invention, the thermotherapy applicator can be inserted into the body cavity together with the endoscope in a state where the applicator is attached to the endoscope. It can be guided and allows for rapid insertion into the body cavity. Moreover, if the thermotherapy applicator is separated from the endoscope in the body cavity and the endoscope is pulled out from the body cavity, only the thermotherapy applicator can be left in the body cavity. Patients are less distressed because the endoscope is not inserted into the body cavity during treatment.

[Brief description of drawings]

1 to 7 show a first embodiment of the present invention, FIG. 1 is a view showing the entire structure, FIG. 2 is a sectional view showing the constitution of the applicator tip portion, and FIG. 2 is a sectional view taken along the line III-III, FIGS. 4 to 7 are views for explaining the inserting action,
8 and 9 are explanatory views showing a second embodiment of the present invention, FIG. 10 and FIG. 11 are explanatory views showing a third embodiment of the present invention, and FIG. 12 and FIG. An explanatory view showing a fourth embodiment of the present invention, and FIGS. 14 and 15 are explanatory views showing a fifth embodiment of the present invention. 16 to 20 show a sixth embodiment of the present invention, and FIG. 16 is a diagram showing the whole structure,
17 is a perspective view showing the structure of the applicator tip portion, FIG. 18 is a sectional view thereof, FIG. 19 is a perspective view of a connector portion, and FIG. 20 is a sectional view thereof. FIG. 21 is an explanatory view showing a seventh embodiment of the present invention, FIG. 22 is an explanatory view showing an eighth embodiment of the present invention, and FIG. 23 is an explanatory view showing a ninth embodiment of the present invention. , 24th
The figure is an explanatory view showing a tenth embodiment of the present invention. 1 ... Endoscope, 2 ... Endoscope insertion section, 3 ... Operation section, 5
...... Light source device, 9 ...... Channel, 10 ...... Applicator, 11 ...... Probe, 12 ...... Balloon, 16 ...... Body cavity high frequency electrode, 17 ...... Temperature sensor, 18a, 19a ...... Water injection passage, 1
8b, 19b …… Drainage passage, 25 …… Heating control device, 26 …… Power supply, 27 …… Fluid perfusion pump, 28 …… Temperature measuring instrument, 29…
... Extracorporeal electrode.

 ─────────────────────────────────────────────────── ─── Continuation of front page (72) Masaaki Hayashi 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inside Olympus Optical Co., Ltd. (72) Hideo Ito 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd. (72) Inventor Nobuhiko Washizuka 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd. (72) Inventor Shinji Hatta 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd. (72) Inventor Tadashi Abe 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd. (56) Reference JP-A 63-43661 (JP, A)

Claims (1)

[Claims] 1. A thermotherapy applicator provided with an inflatable balloon for adhering to an affected area, a heating means, and a temperature measuring means, an endoscope insertable into a body cavity, and the thermotherapy applicator. And an attachment means for detachably engaging the endoscope with each other, wherein the thermotherapy applicator can be left in the affected area during treatment.