JP2008245954A - Cryogenic medical instrument - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a medical instrument that effectively freezes or thaws an affected area. <P>SOLUTION: This cryogenic medical instrument supplies a freezing gas and a thawing gas alternately to a probe 1 pierced into an affected area and is used in cryotherapy for necrotizing the affected area through repeated freezing and thawing. The cryogenic medical instrument has a heat transmission means 3 that expands by hydroscopic pressure, and carries out cryotherapy of the affected area by circulating the freezing gas and the thawing gas alternately through the heat transmission means 3. Because a volume and heat transmission area of the distal end of the probe 1 increases remarkably due the heat transmission means 3, the affected area is frozen and thawed effectively by the freezing gas and the thawing gas. With such a configuration, the affected area is necrotized in a short time, so that treatment time of the cryotherapy is greatly reduced together with burden imposed on a patient alleviated. <P>COPYRIGHT: (C)2009,JPO&INPIT

Description

  The present invention relates to a cryomedical device (cryoprobe) for performing cryogenic treatment.

In recent years, cryotherapy for treating an affected area of a patient using an ultra-low temperature fluid such as argon gas has been performed.
For example, when treating cancer by this cryotherapy, a probe, which is a medical instrument, is punctured into the patient's body so that the tip reaches the cancer tissue, and in this state, a cryogenic freezing gas such as argon gas is first supplied to the probe. Treatment of cancer by necrotizing the cancer tissue by the Joule-Thompson effect by alternately repeating the operation of freezing the cancer tissue and then supplying the thawing gas such as helium gas to the probe to defrost the frozen cancer tissue This cryotherapy is disclosed in Non-Patent Document 1, and a medical instrument or the like used for cryotherapy is disclosed in Non-Patent Document 2.

In Non-Patent Document 2, a double tube (coaxial needle) with a sharp tip is applied to the patient's body surface as “Practice of puncture method and cryotherapy” from the right column of page 10 to page 11. In this state, a long and thin guide needle is inserted along the central axis of the double tube, and the guide needle is punctured to the affected area.
Thereafter, the double tube is advanced along the guide needle to the affected part and further penetrated into the tumor. Then, the guide needle is removed, and a freezing terminal (probe) is inserted and loaded along the hollow shaft in the double tube instead.
A cryotherapy is described in which high pressure argon gas as a freezing gas and high pressure helium gas as a thawing gas are alternately supplied to a freezing terminal, and the affected area is necrotized by repeating freezing and thawing in a short time. .

The magazine “Ayumi of Medicine” (Vol. 206 No. 3, 2003. 7.19). Kawamura et al., “Freeze-thaw necrosis therapy for lung cancer” (P229-P231). Magazine "Cryogenic Medicine" (30, 2004). Nakatsuka, Kawamura et al., “Percutaneous cryotherapy for lung malignant tumor using CT fluoroscopy” (P9-P15).

A medical instrument used in conventional cryotherapy has a structure in which a frozen gas and a thaw gas are alternately sent into a probe made of a metal tube such as stainless steel so that an affected part is necrotized.
However, in the medical instrument described in Patent Document 2, the tip of the probe is formed into a sharp cone, and the volume and surface area (heat transfer area) of the tip are extremely small, so the affected part is frozen or thawed. In this case, the thermal efficiency is poor, and as a result, the Joule-Thompson effect cannot be sufficiently exhibited.
The present invention has been made to ameliorate such a problem, and provides a cryomedical device capable of efficiently freezing and thawing the affected area, thereby shortening the treatment time in cryotherapy and reducing the burden on the patient. The purpose is to reduce.

  The cryomedical device of the present invention is a cryomedical device used for cryotherapy in which the affected part is necrotized by supplying frozen gas and thawing gas alternately to the probe punctured in the affected part and repeating the freezing and thawing of the affected part. In addition, a heat transfer means that expands due to fluid pressure is provided on the distal end side of the probe, and frozen treatment and thawing gas are alternately circulated through the heat transfer means to perform freezing treatment of the affected area.

With the above-described configuration, the volume and heat transfer area of the probe tip are greatly increased by the heat transfer means that expands due to fluid pressure, so that the affected area can be efficiently frozen and thawed by the freezing gas and the thawing gas. Since necrosis can be achieved in a short time, the treatment time in cryotherapy can be greatly shortened and the burden on the patient can be reduced.
Also, if the same amount of time as before is spent for freezing and thawing, it becomes possible to treat a larger affected area, so the number of probe punctures used to treat a larger affected area can be reduced, which allows patients to be treated. Can reduce the burden of

  In the cryomedical device of the present invention, the probe is formed of a probe main body, a puncture portion, and an outer tube fitted to the probe main body so as to be insertable / removable, and heat transfer means is provided between the tip of the probe main body and the puncture portion. The inflatable body is formed in a contracted state, covered with the outer tube, and the outer tube is removed from the probe body that has been punctured from the puncture portion to the affected area, and frozen gas and thawing gas are applied to the inflatable body. By alternately supplying and expanding, the affected area is repeatedly frozen and thawed.

  With this configuration, when the probe is punctured into the affected area of the patient, the outer tube covers the expanded body housed in a contracted state, so that the puncture operation to the affected area can be performed easily and accurately, and during treatment. Since the heat transfer area to the affected area is greatly increased by extracting the mantle tube and expanding the expansion body, the affected area can be frozen and thawed much more efficiently than when only the probe is used.

  Before the cryotherapy medical device of the present invention alternately supplies the freezing gas and the thawing gas to the probe and starts the freezing treatment of the affected part, the test solution is pressurized and supplied to the probe to expand the heat transfer means, Control means for detecting leakage of the heat transfer means from the difference between the return amount of the inspection liquid returned from the heat transfer means and the supply amount of the inspection liquid supplied to the heat transfer means is provided.

  With the above configuration, since defects such as leakage of the heat transfer means can be detected in advance, cryotherapy can be performed safely, and by performing an inspection using distilled water, physiological saline or the like as an inspection liquid, Even when there is a leak in the heat transfer means and the test liquid leaks into the body, adverse effects on the human body can be prevented.

  In the cryomedical device of the present invention, the expanded body is formed of a thin film having high thermal conductivity, and a string-like or net-like reinforcing member is provided in a layer shape on the thin film to define the expanded shape of the expanded body. It is reinforced.

  With the above configuration, the expansion body can be contracted in a compact manner, so that the expansion body can be easily accommodated in the distal end portion of the probe having a small diameter, and the expansion body is reinforced by the reinforcing member. Accidents such as rupture can be prevented.

  In the cryomedical device of the present invention, the gas forward path provided in the probe main body protrudes from the probe main body, and the puncture portion is connected to the distal end portion of the gas forward path. Gas ejection holes for ejecting the thawing gas are provided.

  With the above configuration, the expansion body can be easily accommodated in the gap formed in the tube between the probe main body and the puncture portion, and the expansion is performed by the gas ejected from the gas ejection hole of the gas forward path located at the center of the expansion body. The body can be inflated almost evenly.

  In the cryomedical device of the present invention, the center of the expansion body is decentered with respect to the center of the gas outward path, thereby increasing the heat transfer area in the eccentric direction of the expansion body, thereby imparting heat directivity to the expansion body. Is.

  With the above configuration, when the probe is punctured into the affected area, the probe is rotated so that the heat directivity direction of the expandable body is directed to the local direction of the affected area, and in this state, frozen gas and thawing gas are alternately supplied to the expandable body to expand By conducting heat intensively from the body to the local area, the local area can be frozen and thawed more efficiently, so even if the affected area is large and the entire affected area cannot be treated at once, a specific part of the affected area can be concentrated. By treating and repeating this operation, the entire affected area can be treated.

  According to the cryomedical device of the present invention, the volume of the probe tip and the heat transfer area are remarkably increased by the heat transfer means, so that the affected part can be efficiently frozen and thawed by the freezing gas and the thawing gas. Can be necrotized in a short time, greatly reducing the treatment time in cryotherapy and reducing the burden on the patient.If the same amount of time as before is used for freezing and thawing, Treatment for this is possible with a smaller number of probes.

Embodiments of the present invention will be described in detail with reference to the drawings.
1 is an overall schematic configuration diagram of a cryomedical device, FIG. 2 is a perspective view of a probe that is a cryomedical instrument, FIG. 3 is a block diagram of a control system, and FIG. 4 is an enlarged cross-sectional view of the probe and the outer tube tip. FIG. 5 to FIG. 7 are explanatory diagrams of actions during treatment.
The cryomedical apparatus shown in FIG. 1 supplies a probe 1 and a switching means 8 for alternately supplying a freezing gas and a thawing gas to the probe 1 at the time of treatment and supplying a test liquid to the probe 1 at the time of a leak test. The control means 10 for controlling the above, the freezing gas supply source 12, the thawing gas supply source 13, and the inspection liquid supply source 14 connected to the switching means 8.

As shown in FIG. 3, the probe 1 which is a frozen medical instrument includes a probe main body 1 a, an outer tube 2 fitted to the probe main body 1 a, and a puncture portion 1 b that forms the tip of the probe 1.
The probe main body 1a of the probe 1 is formed of a stainless tube having an outer diameter of, for example, 2 mm to 3 mm, and the puncture portion 1b that forms the distal end portion of the probe 1 is formed in a sharp conical shape with the same metal, and the rear end surface Is connected to the distal end portion of the gas forward path 1c formed of, for example, a stainless thin tube having an outer diameter of about 0.6 mm, and the proximal end side of the gas forward path 1c is formed at the central portion of the probe main body 1a. It passes through the gas return path 1d and reaches the connector 5 provided at the rear end of the probe main body 1a.
The gas return path 1d formed over the entire length of the probe main body 1a has a larger diameter than the outer diameter of the gas forward path 1c, and gas flows between the inner peripheral surface of the gas return path 1d and the outer peripheral surface of the gas forward path 1c. The probe main body 1a and the gas forward path 1c are integrated by fixing the outer peripheral face of the gas forward path 1c to a rib (not shown) protruding from the inner peripheral face of the gas return path 1d. ing.

Further, a gap 1e is provided between the distal end portion of the probe main body 1a and the puncture portion 1b, and the heat transfer means 3 is provided in the gap 1e, and the outer peripheral surface of the gas forward path 1c exposed to the gap 1e portion. The gas ejection holes 1f made up of a large number of small holes are provided, and gas is supplied from the gas ejection holes 1f to the expansion body 3a forming the heat transfer means 3.
The heat transfer means 3 increases the volume and surface area of the tip of the probe 1 to efficiently transfer the heat of the freezing gas and the thaw gas supplied to the tip of the probe 1 to the affected part. When the affected area is frozen and thawed in a short time and the same treatment time as before is spent, the larger affected area can be treated. For example, the expanding body 3a that expands in a cylindrical shape and the expanding body 3a At the same time it is inflated to a predetermined shape, it comprises a reinforcing member 3b that reinforces the entire expansion body 3a.

The inflatable body 3a is made of a tube-shaped balloon made of, for example, a metal thin film or a plastic thin film having a high thermal conductivity that has sufficient durability to withstand the heat and pressure (up to 150 kg / cm ²⁾ of the freezing gas and the thawing gas. It is formed, and one end side is airtightly fixed to the connecting part between the puncture portion 1b and the gas forward path 1c, and the other end side protrudes so as to surround the gas return path 1d opened at the distal end surface of the probe body 1a. It is airtightly fixed to the part 1g.
The expansion body 3a has a tube diameter set in advance so that the outer diameter of the expansion body 3a is sufficiently larger than the outer diameter of the probe main body 1a when expanded by a gas. A plurality of reinforcing members 3b are embedded in layers in substantially equal intervals in the direction.

The reinforcing member 3b is formed of a string-like material made of high-strength synthetic resin fiber, such as nylon (registered trademark) fiber or carbon fiber, and is provided so as to be substantially parallel to the gas forward path 1c. Is fixed integrally with the one end of the expansion body 3a, and the other end is fixed integrally with the other end of the expansion body 3a.
When gas is supplied into the gas outlet 1f of the gas forward path 1c, the gas is expanded into a substantially cylindrical shape having a sufficiently larger diameter than the outer diameter of the probe main body 1a as shown in FIG. Since the reinforcing member 3 bites into the outer peripheral surface, the outer periphery of the expansion body 3b is expanded substantially in a parachute shape as shown in FIG.

The outer tube 2 forming the outer shell of the probe 1 is formed of, for example, a stainless steel tube similar to the probe main body 1a, and the inner diameter is slightly larger than the outer diameter of the probe main body 1a.
The distal end portion of the outer tube 2 is fitted to the probe main body 1a so as to contact the rear end surface of the puncture portion 1b of the probe 1, and after the probe 1 is punctured into the affected portion, it is removed from the rear end side of the probe main body 1a. Whereas the probe 1 is used repeatedly, the outer tube 2 is disposable so that it can be discarded once used, like an injection needle.

A connector 5 made of a material having low temperature resistance and electrical insulation is provided at the rear end of the probe 1, and one end side of the gas supply / exhaust pipe 6 is detachably connected to the connector 5. The other end side of the gas supply / exhaust pipe 6 is connected to the switching means 8.
The gas supply / exhaust pipe 6 is formed by a gas supply pipe 6a and a gas exhaust pipe 6b made of a soft flexible tube such as a tube so as not to hinder the work of puncturing the probe 1 into the affected area. One end of the pipe 6a is connected to the gas forward path 1c of the probe main body 1a via the connector 5, and one end of the gas discharge pipe 6b is connected to the gas return path 1d of the probe main body 1a via the connector 5 to supply gas. The other ends of the pipe 6 a and the gas discharge pipe 6 b are connected to the freezing gas supply source 11, the thawing gas supply source 12, and the inspection liquid supply source 13 through the switching means 8.

As shown in FIGS. 1 and 2, the switching means 8 includes a switching valve 8a connected to the gas supply / exhaust pipe 6, an on-off valve 8b provided between the switching valve 8a and the frozen gas supply source 12, and a switching valve. And an on-off valve 8c provided between the defrosting gas supply source 13 and an on-off valve 8d provided between the switching valve 8a and the inspection liquid supply source 14. The switching valve 8a and each on-off valve 8b, 8c, and 8d use solenoid valves or the like and are electrically connected to the control means 10, and are controlled to be opened and closed by the control means 10 including the arithmetic processing means 10a and the input / output means 10b. ing.
The frozen gas supply source 12 is a gas cylinder such as high pressure argon gas, the thawing gas supply source 13 is a gas cylinder such as high pressure helium gas, and the inspection liquid supply source 14 is pressurized distilled water, physiological saline, or the like. The liquid cylinder filled with the inspection liquid is used, and the pressure of the gas or liquid supplied from the freezing gas supply source 12, the thawing gas supply source 13, and the inspection liquid supply source 14 to the switching valve 8a is as follows. The amount of gas or test solution supplied from the switching valve 8a, detected by the pressure detection means 15, 16, 17 provided before and after the on-off valves 8b, 8c, 8d and sent to the control means 10, and the switching valve The return amount of the gas or the inspection liquid returning to 8a is detected by the flow rate detection means 18 provided at the connection portion between the switching valve 8a and the gas supply / exhaust pipe 6 and sent to the control means 10. It has become way.

  Next, the operation of the cryomedical device constructed as described above will be described. When a cryomedical device is used to treat cancer, for example, the probe 1 is inserted into the outer tube 2 and the tip of the probe 1 is a cancer tissue. When the probe 1 is punctured into the patient's body so that the distal end of the probe 1 penetrates the cancer tissue, the outer tube 2 is pulled backward from the probe 1, and as shown in FIG. The expansion body 3a of the heat transfer means 3 housed in a contracted state in the gap 1e between 1 is exposed in the affected area.

Next, before starting the treatment of the affected area, the heat transfer means 3 provided at the tip of the probe 1 is inspected for leaks.
This test is indispensable, and in order to be safe even if there is a leak in the heat transfer means 3, use a test solution such as distilled water or physiological saline that does not harm if leaked into the patient's body. .
In the inspection, when the gas supply / exhaust pipe 6 is connected to the connector 5 provided at the base of the lobe body 1a and the control means 10 is in the inspection mode in this state and the inspection is carried out, the control means 10 makes the on-off valve 8d. After the command is sent to the opening / closing valve 8d, the switching valve 8a is switched to the inspection liquid supply source 14 side.
This test solution supply source 14 a pressure approximately equal to the freezing gas and thawing scan of pressure from, for example, up to 150 Kg / test fluid pressurized in cm ² is inspected for liquid supply source 14 through the gas supply and exhaust pipe 6 The expansion body 3a of the heat transfer means 3 is expanded.
The inspection liquid obtained by expanding the expansion body 3a of the heat transfer means 3 returns to the switching valve 8a through the gas return path 1d and the gas discharge pipe 9, so that the connection portion between the switching valve 8a and the gas supply / exhaust pipe 6 The flow rate detection means 18 provided in FIG. 5 detects the supply amount and return amount of the test liquid, and the control means 10 calculates the difference between the supply amount and the return amount.
And it is test | inspected whether the expansion body 3a of the heat-transfer means 3 has a leak from the difference of the supply amount and return amount of a test | inspection liquid.

When the above leak inspection is completed, the control means 10 is switched to the cryotherapy mode and the cryotherapy is started. After the on / off valve 8d is closed and the on / off valves 8b and 8c are opened by the command from the control means 10, the switching is performed. The valve 8 a is switched to the freezing gas supply source 12 side, and first, the freezing gas is supplied from the freezing gas supply source 12 side to the probe 1 through the gas supply / exhaust pipe 6.
The frozen gas supplied to the probe 1 reaches the heat transfer means 3 through the gas forward path 1c, and for example, the frozen gas pressurized to 150 kg / cm ² at the maximum is ejected into the expansion body 3a from the gas ejection hole 1f. Therefore, the expansion body 3a stored in the contracted state in the gap 1e is expanded to the state shown in FIGS.
As a result, the volume of the tip of the probe 1 is increased by several tens of times, and the heat transfer area of the surface is increased by several tens of times to several hundreds of times. When the time is frozen and the same amount of time as before is used for freezing, the larger affected area can be frozen.

When the preset freezing time has elapsed, the control means 10 switches the switching valve 8a to the thawing gas supply source 13 side, so that the thawing gas is supplied from the thawing gas supply source 13 side to the probe 1 through the gas supply pipe 7. .
The thawing gas supplied to the probe 1 reaches the expansion body 3b of the heat transfer means 3 from the gas forward path 1c in the probe main body 1a, and is ejected into the expansion body 3a from the gas ejection hole 1f. Since the frozen gas filled in 3a is pushed out to the gas return path 1d, the frozen gas in the expansion body 3a is replaced with the thawing gas.
As a result, thawing of the affected area is started by the thawing gas in the expansion body 3a, but the entire surface of the expansion body 3a becomes a heat transfer area even during thawing, and the cancer tissue of the affected area is generated by the thawing gas circulating in the expansion body 3a. Therefore, the cancer tissue can be thawed in a short time compared to the case where only the tip of the conventional probe 1 is cooled. While the affected part can be thawed, the frozen gas discharged from the expansion body 3a to the gas return path 1d is returned to the switching means 8 through the gas discharge pipe 9 and collected in a collection tank (not shown).
Thereafter, the supply of the freezing gas and the thawing gas is alternately repeated, and the freezing and thawing of the affected part are repeated. As a result, the cancer tissue of the affected part is necrotized by the Joule-Thompson effect, and the therapeutic effect by the cryotherapy can be obtained.

The above is a case where the outer peripheral surface of the expansion body 3a is concentrically expanded with respect to the center of the probe 1 to freeze and thaw the cancer tissue as the affected part. However, as in the modification shown in FIG. On the other hand, the expansion body 3a may be formed in advance so that the outer peripheral surface of the expansion body 3a is ε-eccentric and expands, thereby obtaining the following operational effects.
That is, in cryotherapy, when a diseased part to be treated is large, it is often performed by using a plurality of probes 1.
Also, when freezing or thawing the affected area, the blood flowing in the blood vessels (arteries) near the affected area may be frozen or thawed to destroy blood components. There is a case.
In such a case, the probe 1 is punctured into the blood vessel in the vicinity of the affected area, the inert gas is supplied to the heat transfer means 3 at the tip, and the blood is closed by the expanded body 3a, so that the blood flowing through the blood vessel is Temporary hemostasis can be performed, thereby preventing the destruction of blood components flowing through the blood vessels in the vicinity of the affected area during cryotherapy.

Further, as in the modification shown in FIG. 8, the thermal directivity A may be imparted in the eccentric direction by using the expansion body 3a in which the outer peripheral surface is eccentric and expands with respect to the center of the probe main body 1a.
That is, the heat transmitted to the affected area from the outer peripheral surface of the expansion body 3a expanded so as to be concentric with the center of the gas forward path 1c is substantially uniform in the embodiment.
However, if the affected area is large, it may be effective to apply heat intensively to the affected area to freeze the area and to thaw to treat the area.
In such a case, treatment may be performed using the probe 1 in which the center of the expansion body 3b is decentered by ε with respect to the center of the gas forward path 1c as in the modification shown in FIG.
The method of using the probe 1 is the same as in the above embodiment, but when the probe 1 is punctured into the affected area, the probe 1 is rotated so that the eccentric direction (thermal directivity direction A) of the expansion body 3a is directed to the local direction of the affected area. And the volume and heat-transfer area of the expansion body 3a with respect to a local increase.
And in this state, by supplying frozen gas and thawing gas alternately to the gas forward path 1c and conducting heat intensively to the local area from the expansion body 3, the local area can be frozen and thawed more efficiently, Even when the affected area is large and the entire affected area cannot be treated at once, a specific portion of the affected area is intensively treated, and the entire affected area can be treated by repeating this operation.

In the above embodiment, the example in which the reinforcing members 3b made of string-like objects are radially provided on the outer peripheral surface of the expansion body 3a of the heat transfer means 3 has been described. However, the reinforcing members 3b formed in a net shape are provided on the outer periphery of the expansion body 3a. It may be provided on the surface to regulate the expansion amount of the expansion body 3a or to reinforce the expansion body 3a.
In the cryotherapy, the probe 1 is directly punctured into the affected area of the patient. However, the guide needle is punctured in advance to the affected area, and then the probe 1 is punctured into the affected area using the guide needle as a guide. Good.
Furthermore, although the example which applied the probe 1 to the cryotherapy of cancer was demonstrated, it can apply to the whole cryomedical apparatus used for the disease for which cryotherapy is effective.

BRIEF DESCRIPTION OF THE DRAWINGS It is a whole schematic block diagram of the cryomedical apparatus provided with the cryomedical apparatus which becomes embodiment of this invention. 1 is a perspective view of a cryomedical device according to an embodiment of the present invention. It is a block diagram of the control system used for the cryomedical device which becomes embodiment of this invention. It is an expanded sectional view of the probe and outer tube tip of the cryomedical device according to the embodiment of the present invention. It is operation | movement explanatory drawing of the freezing medical instrument which becomes embodiment of this invention. It is operation | movement explanatory drawing of the freezing medical instrument which becomes embodiment of this invention. It is operation | movement explanatory drawing of the freezing medical instrument which becomes embodiment of this invention. It is explanatory drawing which shows the modification of the frozen medical instrument which becomes embodiment of this invention.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Probe 1a Probe main body 1b Puncture part 1c Gas forward path 1d Gas return path 1f Gas ejection hole 2 Outer tube 3 Heat transfer means 3a Expansion body 3b Reinforcement member 6 Gas supply / exhaust pipe 8 Switching means 10 Control means 12 Freezing gas supply source 13 Thaw gas Supply source 14 Inspection liquid supply source

Claims (6)

  A cryomedical instrument used for cryotherapy in which the affected part is necrotized by alternately supplying a freezing gas and a thawing gas to a probe punctured in the affected part, and repeating the freezing and thawing of the affected part, wherein the tip of the probe A cryomedical device characterized in that heat transfer means that expands by fluid pressure is provided on the side, and the frozen gas and thawing gas are alternately passed through the heat transfer means to perform cryotherapy of the affected area.   The probe is formed of a probe main body, a puncture portion, and a mantle tube fitted to the probe main body so as to be insertable / removable, and the heat transfer means is formed between the tip of the probe main body and the puncture portion. The expanded body is stored in a contracted state, and the expanded body is covered by the outer tube, and the outer tube is extracted from the probe main body that has been punctured from the puncture portion to the affected area. The cryomedical device according to claim 1, wherein the affected part is repeatedly frozen and thawed by alternately supplying thawing gas and expanding.   Before supplying frozen gas and thawing gas alternately to the probe to start freezing treatment of the affected area, a pressurized test solution is supplied to the probe to expand the heat transfer means, and the heat transfer means 3. A control means for detecting leakage of the heat transfer means from the difference between the return amount of the test liquid returned from and the supply amount of the test liquid supplied to the heat transfer means. The cryomedical device described.   The expansion body is formed of a thin film having high thermal conductivity, and a string-like or net-like reinforcing member is provided in a layer on the thin film to define the expansion shape of the expansion body, and the expansion body is reinforced. The cryomedical device according to any one of claims 1 to 3.   A gas forward path provided in the probe main body is projected from the probe main body, and the puncture portion is connected to a distal end portion of the gas forward path, and a frozen gas and a thawing gas are introduced into the expansion body at the distal end side of the gas forward path. The cryomedical device according to any one of claims 1 to 4, wherein a gas ejection hole for ejecting gas is provided.   The center of the expansion body is decentered with respect to the center of the gas outward path to increase the heat transfer area in the eccentric direction of the expansion body, thereby imparting heat directivity to the expansion body. A cryomedical device according to any one of the above.

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