JP3514854B2 - Ultrasound diagnostic treatment system - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION [0001] BACKGROUND OF THE INVENTION 1. Field of the Invention
Ultrasound probe for diagnosis and ultrasound treatment with focused ultrasound
The present invention relates to an ultrasonic diagnostic treatment system having a probe. [0002] 2. Description of the Related Art Generally, an ultrasonic transducer is introduced into a living tissue.
Transmits ultrasonic pulses repeatedly and is reflected from living tissue
Ultrasonic pulse echoes are provided in the same or separate
This ultrasonic pulse is transmitted and received by the ultrasonic vibrator.
By gradually shifting the direction of
Information collected from different directions is displayed as a visible ultrasonic tomographic image.
Various ultrasonic diagnostic apparatuses have been proposed. [0003] Such an ultrasonic diagnostic apparatus is of an extracorporeal type.
It is common to use a wave probe,
Combined or small-diameter ultrasonic probe inserted into body cavity
In-body ultrasonic probe such as an intracorporeal ultrasonic probe
Widely used. On the other hand, a calculus crushing device and an ultrasonic thermal treatment device
Ultrasound treatment that performs various treatments with focused ultrasound
Various devices have been proposed. These ultrasound treatments
Some devices, such as cancer cells, are focused by high-intensity ultrasound.
Hot tissue ablation of any living tissue lesions for treatment
There was an ultrasonic hyperthermia device. [0005] This ultrasonic high-temperature treatment apparatus has a high strength.
Ultrasonic transducer with a large aperture to obtain focused ultrasound
Focused from the extracorporeal applicator to the target site
Besides, for example, PCT WO93 / 16641
Built-in relatively small ultrasonic transducer as shown in
And insert it into the rectum to treat an enlarged prostate
Some with robes are also known. Also, PCT WO93 / 16641
The ultrasound treatment device shown in the report has a deep treatment site (treatment
Means for positioning the focal point of ultrasonic waves
As an example, an ultrasonic diagnostic apparatus or the like for obtaining an ultrasonic tomographic image
Are combined. Thus, for the ultrasonic treatment
For focus positioning on extracorporeal applicators and intracavity probes
By incorporating a diagnostic ultrasonic transducer, ultrasonic
Positioning of the treatment site can be easily performed using the layer image.
To ensure that ultrasound treatment is performed while performing ultrasound diagnosis.
It can be carried out. [0007] The conventional ultrasonic high-temperature treatment apparatus as described above,
In particular, insert a probe into the rectum to treat the prostate
In such cases, the probe must be large and rigid.
Yes, also emits diagnostic and therapeutic ultrasound
The probe tip cannot be bent freely
Therefore, its application is extremely limited, and it can be inserted into a lumen other than the rectum.
Can not be treated. Therefore,
With conventional equipment, the upper gastrointestinal tract, lower gastrointestinal tract,
High temperature by ultrasonic wave from inside body cavity by inserting ultrasonic probe
There was a problem that treatment could not be performed. [0008] As described above, as described above,
The device that performs ultrasonic diagnosis and ultrasonic treatment of
It has an ultrasonic transducer for emitting sound waves and therapeutic ultrasonic waves
The application site is extremely limited depending on the configuration of the ultrasonic probe
Of the upper gastrointestinal tract, lower gastrointestinal tract, thoracic cavity, peritoneal cavity and ventricles.
It can be inserted into the body cavity to perform high-temperature treatment with ultrasound.
There is an inability to emit the therapeutic ultrasound
Treatment for ultrasonic energy alone
There was a problem that the efficiency was not so good. Further, in the conventional apparatus, the ultrasonic probe
Since the body is inserted into the body cavity, the therapeutic ultrasound
Focusing position and various information near the treatment site in the body (such as the treatment site
Which body temperature, ultrasound intensity at the treatment site, etc.)
It is difficult to monitor and easily grasp the treatment status.
Could not give reliable treatment. The present invention has been made in view of these circumstances.
A tubule for diagnosis and treatment to a desired site in a body cavity
It can be inserted and used for ultrasound therapy and other procedures.
And more efficiently and reliably treat the affected area.
With the aim of providing a possible ultrasound diagnostic treatment system
are doing. [0011] SUMMARY OF THE INVENTION Ultrasound diagnosis according to the present invention
The treatment system is designed to emit ultrasonic waves for observation at the tip.
Emits high-intensity ultrasonic waves for treatment
Insertable into body cavity with therapeutic ultrasound transducerInsert
DepartmentUltrasound with ultrasound for observation and therapeutic treatment
Wave diagnostic treatment system, furthermore,
Having treatment means for performing other treatments,Insertion sectionTo
The treatment means is emitted from the therapeutic ultrasonic transducer
To reach near the focal point of therapeutic ultrasoundNeedle tubular
Been formedIt is provided with a treatment means guide. [0012] [0013] Embodiments of the present invention will be described below with reference to the drawings.
I do. 1 to 6 relate to a first embodiment of the present invention.
1 is a configuration description showing the overall configuration of an ultrasonic diagnostic treatment system
FIG. 2 is a diagram showing an ultrasonic wave for emitting diagnostic ultrasonic waves and therapeutic ultrasonic waves.
FIG. 3 is a perspective view showing the configuration of the tip side of the acoustic wave probe, and FIG.
The configuration of the tip side of the wave probe and the state at the time of diagnosis and treatment are shown.
FIG. 4 is a cross-sectional explanatory view, and FIG.
FIG. 5 is an explanatory view showing the structure of a needle, and FIG.
Microwave with microwave oscillation probe penetrating through
FIG. 6 is an explanatory view showing the configuration of the treatment apparatus, and FIG.
Penetrated the treatment site through a microwave oscillation probe
It is an operation explanatory view showing a state. This embodiment is intended for diagnosis and treatment into a body cavity.
Ultrasonic transducer for diagnosis and treatment as a capillary to be inserted
The configuration of the ultrasonic probe with
This is an example in which an apparatus is configured by applying the configuration of an endoscope. As shown in FIG. 1, the ultrasonic diagnosis of this embodiment
The treatment system 1 has, for example, an electronic endoscope-like configuration.
Ultrasonic probe 2A and illumination of ultrasonic probe 2A
Light source device 3 for supplying light and built-in ultrasonic probe 2A
Control for performing signal processing on the selected imaging means
Unit (hereinafter abbreviated as CCU) 4 and an ultrasonic image
Observation Signal Processing System 5A for Generating Ultrasonic Signals for Treatment
Diagnostic ultrasound with built-in therapeutic signal generation system 5B for generating
A treatment circuit 5 and a video signal and observation signal processor of the CCU 4
Endoscopic image and ultrasonic image by video signal of science 5A
And a color monitor 6 for displaying. The ultrasonic probe 2A is inserted into a body cavity.
Insertion section 7 formed into a thin tube (that is, a thin tube) so that it can be formed
Formed at the rear end of the insertion portion 7 so that the operator can grasp and insert
A wide-width operation unit 8 for performing a turning operation or a bending operation;
And a universal cable 9A extending from
Light source connector provided at the end of the universal cable 9A
Can be detachably connected to the light source device 3.
ing. The signal cable 1 is connected to the light source connector 10.
1 is connected to the signal connector 12a at one end.
The other end of the cable 11 is connected to the CCU
Nectar 12b and the ultra-sonic connected to the ultrasonic diagnostic treatment circuit 5
And a sound wave connector 12c.
Probe 2A and CCU 4 and ultrasonic diagnostic treatment
The medical treatment circuit 5 is connected. The insertion portion 7 has a hard tip 14 and a bay.
Flexible bending portion 15 and rigid or flexible insertion tube portion 1
6 are sequentially formed from the distal end side of the insertion portion 7, and are inserted into the insertion portion.
Is a channel that is a lumen through which a guide needle and the like described later are inserted.
13 are provided. In addition, the tip 14
The opening 13a of the channel 13 and the ultrasonic treatment means 17
, Ultrasonic observation means 18 and optical observation means 19
Is established. The ultrasonic treatment means 17 is, for example, concavely shaped.
It is provided with the formed therapeutic ultrasonic vibrators 20a and 20b.
The ultrasonic vibrators 20a and 20b have a curvature
(R) A pair of ultrasonic transducer arrays with different
And is inserted in the insertion portion 7 and the like.
Drive signal in the ultrasonic diagnostic treatment circuit 5 via the signal line 21
It is connected to the generation circuit 22. The therapeutic ultrasonic transducers 20a and 20b
Drive in the ultrasonic diagnostic treatment circuit 5 via the signal line 21
When the drive signal from the signal generation circuit 22 is applied,
Ultrasonic waves are emitted, and the emitted ultrasonic waves are vibrated.
Emission as shown by the broken line in FIG. 1 due to the concave shape of the child
Collected as a therapeutic ultrasonic beam with directivity in range 23
The light is focused at the bundle point 23a. At this focusing point 23a,
High intensity ultrasonic beams, that is, acoustically high energy density
It becomes degree. Therefore, a lesion group such as a tumor is located near the focus point 23a.
With the weave set, the therapeutic ultrasonic transducers 20a, 20a
b, by applying a drive signal to the
It is possible to cauterize the affected tissue with energy and perform therapeutic treatment.
I am able to do it. The ultrasonic observation means 18 is, for example, a sector scan.
The insertion section 7 is composed of a forearm observation ultrasonic transducer 24.
Observation signal processing system via signal line 25 inserted inside
Transmission pulse generation circuit 26 and reception processing circuit forming 5A
27. The observation ultrasonic vibrator 24 includes a transmission pallet.
1 by applying a transmission pulse from the source generation circuit 26.
In the radial ultrasonic observation area 28 indicated by a dashed line.
The sound waves are sequentially scanned and transmitted to the target tissue side. And
The ultrasonic wave reflected on the target tissue side is the ultrasonic transducer for observation 2
4 and converted into an electrical signal.
The co-signal is subjected to signal processing in the reception processing circuit 27,
Is converted to a video signal corresponding to the image, and then
It is input to the color monitor 6 via the pause circuit 29,
It is displayed as a wave tomographic image 30. The optical observation means 19 is a front oblique optical system.
Lighting window through light guide 31 and lighting lens
Illumination light emitting means for emitting illumination light from
An objective lens 32 for forming an optical image of the illuminated target tissue side;
CCD (electric charge) disposed on the focal plane of the objective lens 32
Image pickup means having a coupling element 33
I have. The light guide 31 is inserted through the insertion portion 7 or the like.
The light source connector 10 extends
By connecting the light source device 3 to the
The illumination light generated by the lens and collected by the lens is incident on the end face
It has become so. The illumination light from the light source device 3 is
1 and transmitted to the distal end portion 14 side of the light guide.
The light exits diagonally forward from the end face through the illumination window lens.
It is. The range illuminated by the illumination light emitted diagonally forward
The enclosure is defined by the objective lens 32 shown by a two-dot chain line in FIG.
It almost coincides with the observation range 35, and this objective lens 32
An optical image of the target tissue is formed on the imaging surface of the CCD 33.
The CCD 33 is connected to a signal line 36 to control the image in the CCU 4.
Connected to the signal processing system,
The signal is converted into a video signal by the video signal processing system.
Input to the color monitor 6 via the superimpose circuit 29
And an endoscopic image 37 together with the ultrasonic tomographic image 30.
Is displayed. In the bending portion 15, a large number of bending pieces are alternately provided.
They are rotatably connected. Insertion including bending part 15
A curved wire 39 is inserted through the portion 7, and one end is
The other end is fixed to the end portion 14 and the other end is connected to the pulley 38 in the operation portion 8.
It is connected. Used for such ordinary endoscopes
With the same configuration as the curved portion, it was connected to the pulley 38
The bending wire 39 is pulled by rotating the bending knob (not shown).
The bending piece in the bending portion 15 is rotated by pulling and relaxing.
The bending part 15 is moved in four directions,
The chair can be bent in two directions, left and right. this
Due to the bending operation of the bending portion 15, the tip portion 14 can be moved in any direction.
The ultrasonic treatment means 17 of the distal end portion 14
Sound wave observation means 18, optical observation means 19, and channel
The opening 13a can be oriented in a desired direction.
I have. In the vicinity of the base end of the insertion portion 7, a channel is provided.
An introduction port 41 communicating with the console 13 is provided.
A guide needle or the like to be described later
Channel opening 13 through channel 13
a. Cha
The channel 13 is inserted near the channel opening 13a.
To raise the tip of the guide needle, etc. in a predetermined direction
A table 42 is provided. An endoscope image is provided near the rear end of the operation unit 8.
Image control to control image freeze and display switching
Buttons (or image control switches) 45 and 46 are provided.
The image control buttons 45 and 46 are connected to the CCU 4 and the ultrasonic
Connected to controller 47 provided in diagnostic treatment circuit 5
And the instruction signal from the image control buttons 45 and 46 is C
Input to CU4 and controller 47
I have. The controller 47 includes a keyboard 48
And a foot switch 49, and a keyboard
From 48, setting the treatment time by the ultrasonic treatment means 17
Or enter patient's chart information,
The user operates the foot switch 49 to operate the ultrasonic treatment unit 1.
7 can give instructions to start and stop treatment
Swelling. The controller 47 is an ultrasonic diagnostic device.
It is connected to the transmission circuit 26 in the medical treatment circuit 5 and controls each unit.
Or change the ultrasonic transmission conditions of the ultrasonic observation image,
Change of signal processing condition for received signal, ultrasonic treatment
Output conditions can be changed.
You. The controller 47 is also connected to the CCU 4,
The CCU 4 side can also be controlled from the keyboard 48
It has become. FIG. 2 shows the tip of the insertion portion 7 of the ultrasonic probe 2A.
2 shows an external configuration of the unit side. The insertion portion 7 is a distal end portion from the distal end side.
14, a bending portion 15, and an insertion tube portion 16 are provided in series. Insertion
The distal end of the channel 13 in the entrance 7 is directed to the treatment target site.
Puncture and guide the treatment tool etc. inserted into the lumen to the treatment target site
The guide needle 51 is inserted, and an optical
The channel arranged near the observation window 32a of the observation means 19
The guide needle 51 projects from the opening 13a.
ing. FIG. 3 shows an ultrasonic wave in the body cavity near a treatment target site.
Insert the probe 2A and insert the guide needle 51 to cure
A cross section near the distal end portion 14 in a state where the target site is punctured is shown.
It was done. The ultrasonic probe 2A having the above-described configuration is used.
When performing diagnosis and treatment using the ultrasonic probe 2A
Insert the insertion part 7 into the body cavity, and
While observing the inside of the body cavity by the observation means 19, FIG.
As shown in FIG.
The observation surface 52 on which 20b and 24 are disposed is moved to the living tissue 53.
The ultrasonic observation hand including the ultrasonic transducer for observation 24
Step 18 observes and diagnoses the vicinity of the lesion site 54 such as cancer.
You. Then, while observing the vicinity of the lesion site 54,
Of the therapeutic ultrasonic beam from the ultrasonic transducers 20a and 20b
The focusing point 23a is positioned at the lesion site 54, and the therapeutic supersonic
The ultrasonic treatment means 17 including the wave oscillators 20a and 20b
So that the lesion site 54 is subjected to high-temperature cautery to perform a therapeutic treatment.
Has become. In this embodiment, the introduction of the ultrasonic probe 2A
The guide needle 51 is inserted through the
The guide needle 51 is connected via the flannel 13 to the lesion of the target site for treatment.
To the position 54 and through the lumen of the guide needle 51
Can be guided to the lesion site 54, and the guide needle and treatment
Along with the ultrasonic treatment, other treatment means including tools and the like
It is possible to perform treatment and treatment. Here, the ultrasonic probe is provided at the tip 14 of the ultrasonic probe.
The raised stand 42 has a slope portion having a predetermined angle, and
It is fixed near the tunnel opening 13a. For this reason,
When the id needle 51 is inserted, the raising table 42 serves as a treatment means guide.
The guide needle 51 raised by the raising table 42 is set in advance.
Projected at a fixed angle, and the direction of this projection is
Ultrasonic beam for treatment output from transducers 20a and 20b
To the focal point 23a of the camera. Therefore,
When the id needle 51 is inserted into the channel 13,
Raised at 42, projected in the direction of ultrasonic observation and treatment, raised
The treatment target located in the protruding direction regulated by the table 42
At the lesion site 54. The guide needle 51 is, as shown in FIG.
Guide probe 5 to be a hollow and flexible guide tube
5 and a connector 5 at the base end of the guide probe 55.
6 are continuously provided. Guide probe 55
Is composed of a tubular material, and inserts a treatment tool etc. into the lumen.
It can be guided to the tip and has a sharp point at the tip.
This allows the distal end portion 57 to puncture the living tissue.
ing. The base of the guide probe 55 of the guide needle 51
Insert the guide needle 51 into the outer surface on the end side
As an insertion amount setting means that enables confirmation and setting of the amount,
A scale 58 is provided. That is, the ultrasonic probe
The raising table 42 serving as a treatment means guide of the blade 2A has a predetermined angle.
Guide needle 51 fixed in
Guides into the channel 13 because the
When a predetermined amount is inserted while looking at the scale 58 of the needle 51, the guide
The position of the tip 57 of the probe 55 is the position of the scale 58
Will be determined uniquely. FIG. 5 shows a state in which the guide needle 51 is inserted through the guide needle 51.
Microwave oscillation probe used in combination with 51
(MW probe)
It is shown. In FIG. 5, (a) is the overall configuration.
FIG. 3B is a cross-sectional view of the vicinity of the probe tip. The microwave oscillation probe 60 has a rigid insertion
The distal end portion 62 is connected to the distal end side of the insertion portion 61, and the insertion portion 61
The gripping part 63 is connected to the base end side of.
At the tip 62 of the microwave oscillation probe 60,
A conical tip 63 is provided.
Microwave (MW electromagnetic wave) is emitted from the nearby tip 62
It is supposed to be. Microwave oscillation probe 60
Is connected via a connection cord 64 extending from an end of the grip 63.
And connected to the microwave oscillating device 65,
Microwaves are supplied from the vibration device 65
You. The microwave oscillating probe 60 has a structure shown in FIG.
(B) As shown in FIG.
The cable 66 is inserted up to the distal end portion 62,
62, near the end of the coaxial cable 66.
Microwave antenna part 67 formed by slit is integrated
Is provided. The tip of the microwave oscillation probe 60
The part 62 and the tip 63 block microwave radiation
Each is formed using low dielectric constant material so as not to
I have. In addition, the distal tip 63 punctures the tissue in the body cavity.
It is formed in a conical shape in order to facilitate the operation. Using the ultrasonic probe 2A of the present embodiment,
When diagnosing and treating intraluminal tissue, first use an ultrasound
The insertion section 7 of the probe 2A is inserted into the body cavity, and includes the CCD 33.
Optical observation means 19 and observation ultrasonic vibrator 24
With the ultrasonic observation means 18,
Obtain an optical observation image and an ultrasonic observation image and cut the ultrasonic wave on the monitor 6.
The layer image 30 and the endoscope image 37 are displayed, and the lesion site 54 is displayed.
Observe the neighborhood. At this time, the light beam obtained through the objective lens 32 is obtained.
The optical image in the body cavity is photoelectrically converted by the CCD 33 to obtain
The captured image signal is subjected to signal processing by the CCU 4 and the endoscope image is processed.
Generates video signal and displays endoscope image 37 on monitor 6
To observe the inside of the body cavity near the tip 14 of the ultrasonic probe.
You. The supersonic wave is generated by the observation ultrasonic vibrator 24.
Ultrasound observation near the lesion site 54 such as cancer by transmitting and receiving waves
To obtain an ultrasonic signal. And the received ultrasonic signal
The signal is processed by the observation signal processing system 5A and the ultrasonic tomographic image is
A video signal is generated, and an ultrasonic tomographic image 30 is displayed on the monitor 6.
Display and display the vicinity of the lesion site 54 such as cancer as the treatment target site.
Observe and diagnose. At this time, the bending of the ultrasonic probe 2A
While the part 15 is being bent, the tip part 14 is set at a desired angle.
The distal end 14 is bent to the living tissue 53 of the treatment target site.
The observation is performed by bringing the observation surface 52 into contact. Then, as described above, the ultrasonic observation means 18
While observing the vicinity of the lesion site 54,
From a pair of therapeutic ultrasonic transducers 20a or 20b
Focus point (focus) 23a of the output therapeutic ultrasonic beam
Is positioned at the lesion site 54, and the therapeutic ultrasonic transducer 20 is positioned.
a, a higher intensity therapeutic ultrasound beam is emitted than 20b
And the acoustic energy of the ultrasound, which has become dense at the focal point
Supersonic by cauterizing hot tissue by heating
Perform therapeutic treatment with waves. Next, referring to the diagnostic image on the monitor 6,
Guide needle in the channel 13 of the ultrasonic probe 2A.
Insert 51. Provided at the ultrasonic probe tip 14
The raising table 42 serving as a treatment means guide is a predetermined
The guide needle 51 is not inserted because it is fixed at an angle.
The tip side is in a certain direction from the channel opening 13a.
Protrude and check the scale 58 of the guide probe 55
Guide needle according to the position of scale 58
The position of the distal end portion 57 of 51 is uniquely determined. Therefore,
Treatment output from the treatment ultrasonic transducers 20a and 20b
At or near the focal point 23a of the ultrasonic beam for
Position the distal end 57 of the guide needle 51 at the lesion site 54
Can be Thus, the guide of the guide needle 51
The tip portion 57 of the probe 55 reaches the lesion site 54
You. Subsequently, as shown in FIG.
And a therapeutic probe from the connector 56 at the proximal end
And insert the microwave oscillation probe 60
The distal end portion 62 is projected from the distal end of the guide needle 51 so that
Puncture at position 54. Thus, according to the configuration of the present embodiment,
For example, the guide needle 51 and the microwave oscillation probe 60 are included.
Channel 13 of the ultrasonic probe 2A
And inserted into the body cavity through the guide needle 51 and the microphone
Bringing the wave oscillation probe 60 to the lesion site 54
Can be. Then, a microphone is supplied from the microwave oscillator 65.
Microphone which is a therapeutic energy to the wave oscillating probe 60
MW electromagnetic wave from the probe tip 62
By applying heat to heat, cauterize, and coagulate the
To perform a microwave treatment. Ultrasonic treatment by means of ultrasonic treatment
Is performed, for example, in the case of protein denaturation of tissue by cauterization.
On the ultrasonic diagnostic image obtained by the ultrasonic observation means
While observing, only the necessary amount of necrosis
Until protein denaturation progresses, high intensity therapeutic ultrasonic to the treatment site
Irradiate waves. At this time, the state of the treatment
Irradiation of therapeutic ultrasonic waves while confirming on the image
When the treatment of the position is completed, the irradiation is stopped. In this embodiment
Is performed by microwave in parallel with this ultrasonic treatment.
Therapeutic treatment can be performed, and the lesion site is efficiently
Can be treated. As described above, in this embodiment, the ultrasonic wave for observation is used.
Ultrasonic probe having oscillator and therapeutic ultrasonic oscillator
2A for upper digestive tract, lower digestive tract, thoracic cavity, abdominal cavity, ventricle, etc.
Can be inserted into a desired site in the body cavity,
Ultrasound diagnosis of the abnormal site
And the ultrasonic probe 2A has a treatment means gas.
An elevator 42 serving as a guide is provided.
Place the treatment means such as the microwave oscillation probe 60 at a predetermined position.
Ultrasound because it can guide and reach the lesion site
It is possible to use a combination of treatments other than treatment. this
As described above, ultrasonic energy and microwave energy
Treatment for the affected area.
The effect can be improved. In addition, the treatment means
The position of the tip of the guide needle inserted into the body cavity
The location of the lesion is easily determined because the
I can. In the above-described embodiment, the ultrasonic probe
Guide as an example of a treatment means to reach the lesion site via
Guide needle 51 using a needle and a microwave oscillation probe.
The microwave oscillation probe 60 is inserted through the
Although the configuration example for performing the treatment has been described, it is not limited to this.
As a therapeutic probe, for example, as shown in FIG.
Laser pro with sharp contact tip 68 at the tip
The probe 69 may be similarly applied. Laser probe 69
When using the
Laser light for treatment as energy for treatment
The laser probe 69 supplies
The laser ablation treatment is performed by outputting to the abnormal site. In addition,
Tumors are created by an ultrasonic aspirator, etc.
The same applies to a suction probe that suctions a tumor
be able to. As a therapeutic probe, a tip
Lesions such as tumors configured with heating means such as a mister
Heating probe with a heat probe for heating and cauterizing the part
May be applied. On the other hand, it has a cooling
Insulated pipes with nitrogen, etc.
Supply cooling medium to freeze the lesion around the punctured tip
A cryoprobe to be treated may be applied. Further, the oscillation probe shown in FIGS.
Probe 60 with an HF (High Frequency) probe (high-frequency current
Probe) to the high-frequency current supplied from the HF power supply.
To cause the lesion near the probe tip to coagulate and evaporate
The arrangement may be performed in combination with the ultrasonic treatment.
The HF probe at this time is a bipolar type, extracorporeal counter electrode.
Any of the monopolar methods used in combination with the plate
May be. The oscillation probe 60 is connected to an RF (rad)
io Frequency) Probe and combined with extracorporeal return electrode
Use and configure heating means, combined with ultrasound treatment
, Cauterization and coagulation treatment of lesion area by RF electromagnetic waves
May be performed. FIGS. 8 to 12 show a second embodiment of the present invention.
FIG. 8 shows a case where a diagnostic ultrasonic wave and a therapeutic ultrasonic wave are emitted.
Configuration explanatory view showing the configuration of the intraperitoneal ultrasonic probe, FIG.
Is a cross-sectional view showing the configuration of the tip of the ultrasonic probe shown in FIG.
Fig. 10 shows the ultrasonic probe inserted into the abdominal cavity.
FIG. 11 shows the operation of the ultrasonic probe at the distal end.
The treatment means reaches the treatment site by the treatment means guide provided.
FIG. 12 is an operation explanatory view showing a reached state, and FIG.
Output control means with a temperature detection probe
Configuration and insertion of the temperature detection probe into the lumen of the guide needle
It is an operation explanatory view showing a state of puncturing a treatment site. This embodiment is intended for diagnosis and treatment into a body cavity.
Ultrasonic transducer for diagnosis and treatment as a capillary to be inserted
The configuration of the ultrasonic probe having
Intraperitoneal ultrasound probe inserted into the abdominal cavity through a tube
This is an example of a configuration applied to a lobe. As shown in FIG. 8, the ultrasonic diagnosis of this embodiment
The ultrasonic probe 71 used in the treatment system is a thin tube.
The insertion portion 72 is formed at a rear end of the insertion portion 72.
A wide first gripping portion 73 gripped by a person,
It is formed on the rear end side of the holding portion 73 and performs insertion or bending operation.
An operating section 74 and a second end formed on the rear end side of the operating section 74
The second grip 75 and the second grip 75
Connection cable connected to an ultrasonic diagnostic treatment circuit (not shown)
Bull 76. It should be noted that the ultrasonic diagnostic treatment system
The same configuration as that of the first embodiment is used for the ultrasonic diagnostic treatment circuit and the like.
The description can be omitted here. Is the insertion section 72 of the ultrasonic probe
Hard tip 77, bendable bend 78, hard tube
And an insertion tube 79 made of a shaped member.
You. The tip portion 77 has a supersonic as described later.
A wave oscillator is built-in and
A rune 80 is provided so as to be attachable.
Of acoustic impedance between ultrasonic probe and living tissue
To provide the function of acoustic coupling for matching
The ultrasonic transmission medium for the purpose is enclosed. Super
A diagram communicating with the inside of the balloon 80 in the acoustic probe 71
An introduction conduit (not shown) is provided, and the second
An inlet 81 communicating with the base end of the introduction pipe is provided.
And the ultrasonic transmission medium is injected from the injection port 81.
It is supplied into the balloon 80 via the introduction pipe.
ing. Further, the tip of the ultrasonic probe tip 77
The fitting groove or insertion hole through which the guide needle, etc. can be inserted.
Treatment means for guiding a treatment tool or the like including a guide needle
A guide portion 82 is formed and provided. Treatment means
As shown in FIG. 9, a puncture probe is
Mating groove through which a guide needle or therapeutic probe fits
As a part, a predetermined angle to the longitudinal direction of the ultrasonic probe
The guide groove 83 having a degree is formed.
Ultrasonic observation of the treatment tool etc. in the direction of a predetermined angle by the groove 83
It can be guided into the area 28. Then, at the tip 77 of the ultrasonic probe
Is a linear array type ultrasonic transducer for ultrasonic observation inside
84 of the linear array type ultrasonic transducer 84
An acoustic matching layer 85 is provided on the ultrasonic vibration emission surface side.
Thus, an ultrasonic wave for observation can be emitted to the ultrasonic observation region 28.
It has become. Although not shown here, the supersonic
The ultrasonic probe for treatment is provided at the tip 77 of the wave probe.
Thus, it is possible to emit therapeutic ultrasonic waves in the same manner as in the first embodiment.
Swelling. Further, as shown in FIG.
A bending operation knob 86 for operating the bending operation of the bending portion 78 is provided.
And a curvature (not shown) having substantially the same configuration as that of the first embodiment.
It is connected to the mechanism. The intraperitoneal ultrasonic probe 71 of this embodiment is
When diagnosing and treating tissues in body cavities using
0, the first grip 73 or the second grip
Grip 75 and trigger on the affected part of the insufflated abdominal cavity.
Insert the distal end portion 77 side of the insertion portion 72 through the racal 87 or the like.
Enter. Then, the bending operation knob 86 of the operation section 74 is operated.
By performing the bending operation, the bending portion 78 is bent,
Of the linear array type ultrasonic vibrator 84 built in 7
The wave emission surface side is in contact with the surface of the organ to be treated.
You. In this state, ultrasonic waves for observation are transmitted and received
Obtain an ultrasonic observation image of the site and display an ultrasonic tomographic image on the monitor screen
An image is displayed, and the vicinity of the lesion site is observed and diagnosed. In addition, diagnosis and treatment of such an intraperitoneal organ
In the case of performing the
An optical observation tube is inserted into the abdominal cavity and optical observation is performed. Ultrasound Probe for Ultrasound Diagnostic Treatment
FIG. 11 shows the state near the tip. Ultrasound as described above
The probe tip 77 is brought into contact with the organ to be treated,
By transmitting ultrasonic waves to the wave observation area 28, the lesion site
An ultrasonic tomographic image around 54 is obtained. Although not shown,
While performing ultrasonic diagnosis, the same as in the first embodiment,
By emitting therapeutic ultrasound from the ultrasonic transducer
The ultrasonic treatment of the lesion site 54 can be performed.
You. Then, no ultrasonic diagnosis or optical observation is performed.
Then, the guide needle 51 is inserted into the guide groove of the treatment means guide portion 82.
83 and a guide needle
51 is made to reach the lesion site 54. Then, guide needle 5
A temperature sensor 89 such as a thermocouple shown in FIG.
Insert the temperature detection probe 90 with the probe tip
Is inserted into the lesion site 54. In this embodiment, the in-vivo information detection is performed as a treatment means.
The temperature of the treatment site is measured using the temperature detection probe
Monitoring the status of the curriculum and
Output of therapeutic energy such as sound waves, microwaves, and lasers
Control and enable. Monitoring the output of this therapeutic energy
The configuration and operation of the control means will be described with reference to FIG. The temperature detection probe 90 detects the temperature at the tip.
A temperature sensor 89 such as a thermocouple for detection is provided, and a guide is provided.
It can be inserted into the lumen of the needle 51,
It is led to a lesion site 54 which is a treatment site, and
The temperature of the treatment site is detected by puncturing.
A temperature monitor 91 is connected to the temperature detection probe 90,
A signal indicating the temperature value of the treatment site detected at the probe tip
The signal is output from the temperature monitor 91.
The temperature monitor 91 includes an output control unit 92 and a treatment energy.
Energy output units 93 for outputting energy
Output according to the detected temperature value of the output of the temperature monitor 91
Control signal from output control unit 92 to energy output unit 93
The ultrasonic wave is fed back from the energy output unit 93.
Oscillator, microwave oscillation probe, laser probe, etc.
The therapeutic energy output to the output element is output controlled.
It is supposed to be. In the case of treatment with ultrasonic waves or microwaves,
Depends on the amount of output from the treatment energy, such as ultrasound.
The temperature of the treatment site is different due to
It is possible to grasp the treatment status by detecting
You. The temperature sensor 89 of the temperature detection probe 90 is connected to the lesion site.
The temperature at the time of treatment is detected by puncturing the temperature monitor 54 and a temperature monitor 91 is detected.
The detected temperature value is sent to the output control unit 92 via the. this
Output ultrasonic waves, microwaves, lasers, etc.
Monitors the temperature when performing treatment by firing, and based on the detected temperature
The output control unit 92 outputs an output control signal to
Control the output unit 93; For example, the treatment site is
When the temperature becomes high, the super sound from the energy output unit 93
Output of therapeutic energy such as waves, microwaves, lasers, etc.
Lower. On the other hand, the temperature of the treatment site becomes lower than the predetermined value.
In such a case, the output of the energy output unit 93 is increased.
Control. As a means for monitoring the state of the treatment site,
Instead of being limited to the temperature detection probe 90,
Using a sound pressure detection probe 95 as shown in FIG.
You can also. By monitoring the sound pressure at the treatment site
Configuration of output monitoring control means for controlling output of therapeutic ultrasound
The operation will be described with reference to FIG. The sound pressure detection probe 95 has a sound pressure
A sound pressure sensor 96 for detecting is provided.
It can be inserted into the cavity, and can be inserted at the treatment site via the guide needle 51.
The patient is guided to a certain lesion site 54, and punctures the lesion site 54 to be cured.
It detects the sound pressure of ultrasonic waves at the treatment site
You. A sound pressure monitor 97 is connected to the sound pressure detection probe 95.
Shows the sound pressure value of the treatment site detected by the probe tip.
Signal is output from the sound pressure monitor 97.
You. The sound pressure monitor 97 has an output control unit 98, an ultrasonic output
Units 99 are connected in order, and the output of the sound pressure monitor 97 is
An output control signal corresponding to the detected sound pressure value is output from the output control unit 98.
It is fed back to the ultrasonic output unit 99, and the ultrasonic output unit
Ultrasound for treatment output from 99 to the ultrasonic transducer
The force is controlled. At the time of treatment with ultrasonic waves, the sound pressure detection probe
The sound pressure sensor 96 of the probe 95
And outputs a detected sound pressure value via the sound pressure monitor 97.
It is sent to the control unit 98. In this way, the sound pressure during treatment is detected
Monitor the irradiation output value of the ultrasonic wave and output from the output control unit 98.
The ultrasonic output unit 99 is controlled by outputting a force control signal. This
As a result, it is possible to understand the status of
To control the ultrasonic irradiation output. As described above, the temperature detection probe and the sound pressure detection
By guiding an intellectual probe to the treatment site,
The temperature and sound pressure of the unusual part are detected and the state of the treatment part is rearranged.
Can be monitored in real time, and
The output of the treatment means can be controlled according to
It can improve the certainty of medical treatment and the safety to the living body.
Wear. Here, the ultrasonic therapy treatment and that of other treatments
The relationship between the respective target areas will be described. FIG. 14 shows an ultrasonic diagnosis using an ultrasonic probe.
Guided focused ultrasound treatment and cure with other procedures
It shows the area of medical treatment. The distal end 77 of the ultrasonic probe is
It is placed on the body wall surface and emits ultrasonic waves from the therapeutic ultrasonic transducer.
The focused supersonic radiated from the tip portion 77 by radiating
The site of the focal point 23a is cauterized by the wave 23.
At the same time, the guide needle 51 or various treatment probes
The collection is performed via a treatment means guide portion 82 serving as a puncture guide.
The puncture reaches the site of the bundle point 23a. The treatment area by these various treatment probes
Represents the treatment area by the focused ultrasound as indicated by 88 in the figure.
The area (23a in the figure) is not limited to the area around the area.
Area. Therefore, other actions
Treatment in combination with limited-area ultrasound treatment
Thus, it works so that a wider range of treatment can be performed. As described above, the treatment area by the other treatment is focused.
FIG. 15 is not limited to the region coincident with the ultrasonic treatment region.
As shown in FIG.
The target is a wide area 88a in the vicinity including the treatment area 23a.
In some cases, the guide needle 51 or the like is
Reach the seed treatment probe and supplement with other treatments
Ultrasound treatment, such as performing treatment and detecting sound pressure and temperature
You can also help. For example, collecting the site of the diseased tissue
Strong cautery treatment with bundled ultrasound to remove suspicious surrounding tissue
Suitable for ablation treatment of a site with microwaves
Can be used. Further, as shown in FIG.
The inside of is treated by the focused ultrasonic wave 23,
Tissue surface in a portion shallower than ultrasonic treatment area 23a
Or a region near the treatment region 88b by another treatment.
It is also conceivable that the target is used. In this case,
The guide needle 51 or various treatment probes were punctured.
Or contacting various treatment probes to the tissue surface,
Other treatments for areas shallower than the ultrasound treatment area
And the like. For example, a deep part
Cauterization treatment by focused ultrasound, shallow site and tissue surface etc.
It can be applied to cautery treatment with laser, etc.
Wear. FIG. 17 shows an ultrasonic wave according to the third embodiment of the present invention.
As a treatment means to be inserted into a treatment site via a probe,
Configuration of a treatment probe including a guide needle and a syringe, and
Showing the condition of puncture of the probe for treatment and treatment into the treatment site
FIG. The present embodiment is directed to an ultrasonic diagnostic and treatment system.
The ultrasonic probe is used in combination with an ultrasonic probe.
To the treatment site by inserting it into the body cavity through the
This is a configuration example using a medicine injection means as a treatment means to be performed.
You. As in the first embodiment, a treatment means guide is provided.
Guide inserted into the body cavity through an ultrasonic probe
The needle 51 is attached to the connector 101 on the hand side by the syringe 101.
Can be attached and used as a needle for drug injection.
You. A drug solution 102 is put in a syringe 101,
The medicinal solution 10 through the guide needle 51 by the syringe 101
2 can be injected into the lesion site 54. As the drug solution 102, for example, an anticancer agent
Such as drugs, ultrasonic enhancers (eg, emulsion
Etc.) or a tumor accumulating substance (eg,
Such as fluorodeoxyglucose)
Is used. In this embodiment, as in the first embodiment, the supersonic
Observation of target site in body cavity by wave probe
Guide through an ultrasonic probe while observing acoustic waves
The needle 51 reaches the lesion site 54 and is inserted. And
Check the puncture from the observation image on the monitor, and touch the guide needle 51.
From the connected syringe 101, drugs such as anticancer drugs, ultrasonic energy
The tumor accumulation substance is connected to the enhancer or the ultrasonic enhancer.
Inject the drug solution 102 such as the combined solution into the lesion site 54
You. Then, the treatment ultrasonic transducer in the ultrasonic probe
Focused ultrasound for treatment at the lesion site 54
Perform therapeutic treatment with waves. Thus, in this embodiment, the guide needle and the
Drugs such as anticancer drugs and ultrasonic enhancers by syringe
Can be injected into the treatment area of the affected area,
Strengthen the administration of anticancer drugs, etc. and the therapeutic ultrasound at the treatment site
The ultrasonic sound from the ultrasonic vibrator
Improves the therapeutic effect on the affected area compared to the treatment with waves alone
Can be Further, the guide needle is used as a suction biopsy needle,
Biopsy can be performed under the guidance of ultrasound diagnosis with a probe
It is possible. Biopsy forceps such as aspiration biopsy needle
The configuration example using the tissue sampling means according to the fourth embodiment is as follows.
This is described below. FIG. 18 shows an ultrasonic wave according to the fourth embodiment of the present invention.
As a treatment means to be inserted into a treatment site via a probe,
Section showing the configuration of the treatment probe including the puncture needle for aspiration biopsy
FIG. The suction biopsy needle is placed inside the soft outer cylinder 121.
A hard hollow puncture needle 122 is accommodated therein.
I have. A grip A123 is provided at the rear end of the soft outer cylinder 121.
Is fixedly connected. The rear end of the puncture needle 122 is soft
Tube 124 is connected, and this tube 12
4 has a suction hole (suction port) 125 and a grip B at the rear end.
126 is connected. Tube 124 from suction port
It communicates with the tip of the puncture needle 122 through the lumen. Suction
The hole 125 is a dimension that can be connected to the tip of a syringe (not shown).
Law, structure. In the state before use,
Approximately 50 mm between the top A123 and the suction hole 125.
Are open. Supersonic using a suction biopsy needle having such a configuration.
A puncture biopsy under a wave guide proceeds as follows:
You. First, the part to be inspected is depicted as an ultrasonic image,
Insert the suction biopsy needle through the insertion port of the ultrasonic probe. Sucking
The biopsy needle passes through a channel in the ultrasound probe,
Protrudes from the channel opening provided at the probe tip
I do. As the aspiration biopsy needle is inserted into the channel,
The tip of the respiratory needle is the treatment means guide as in the previous embodiment.
Abuts on the surface of the lesion. In this state, do not hold the grip A123.
When the grip B126 is pushed down, the puncture needle 122 is
It protrudes from the tip of the cylinder 121 and is inserted into the lesion.
And that the tip of the puncture needle 122 has reached the target site
Is confirmed by an ultrasonic image. Next, a syringe (not shown) is inserted into the suction hole 125.
Piercing needle 1 by connecting the syringe and pulling the inner cylinder of the syringe.
The inside of 22 is sucked. At this time, the contents of the diseased tissue are
The needle is inserted through the puncture needle 122, the tube 124, and the suction hole 125.
Housed in a syringe. As described above, in this embodiment, the cure by the ultrasonic wave is performed.
Perform a biopsy of the lesion using an aspiration biopsy needle
Can examine the condition of the tissue before and after treatment
Is possible. Next, an ultrasonic program to which the configuration of the endoscope is applied.
Gamma ray detection method for detecting gamma rays from lesions
FIG. 19 shows a configuration example in which a step is provided. The ultrasonic probe of this embodiment is the same as that of the first embodiment.
In the same way, it is applied to the configuration of the insertion section of the endoscope.
The unit is provided with an ultrasonic vibrator. As shown in FIG.
As described above, the tip 111 of the ultrasonic probe 110 includes
An optical perspective view (not shown) of a front perspective type is provided inside the observation window 32a.
Observation means are provided, and a treatment tool or the like is protruded near the observation window 32a.
A channel opening 13a is provided for
Convex type supersonic for observation on the tip side of observation window 32a etc.
A wave oscillator 112 is provided. Also, the probe tip
The part 111 has a distal end side of the ultrasonic transducer 112 for observation.
A medical ultrasonic transducer 113 is provided inside. Further, inside the probe tip 111,
Γ-ray from a certain direction on the back side of the therapeutic ultrasonic transducer 113
A scintillator 114 that emits light by detecting
A pre-positioner arranged to abut this scintillator 114
And the light from the scintillator 114 is provided.
The optical fiber 116 for guiding the light toward the probe
It is arranged in. Although not shown, the optical fiber
Iva 116 is inserted up to the operation unit on the hand side, and the optical fiber
Light from the scintillator 114 facing the base end of the
Is provided with a photoelectric conversion unit for converting the light into an electric signal. A diagnosis is made using the ultrasonic probe 110 of this embodiment.
When performing treatment and treatment, first, gallium (G
a), Fluorine (F) and other substances that emit gamma rays
Drugs that bind tumor-accumulating substances such as deoxyglucose
Intravenously. Then, this drug is used for cancer in living tissue 53, etc.
Accumulates at the tumor site (lesion site 54) and emits gamma rays
You. Next, the ultrasonic probe 110 is inserted into the body cavity, and
By the microscopic observation means and the ultrasonic transducer 112 for observation.
Observe the vicinity of the lesion site 54 optically and ultrasonically.
You. At this time, γ-rays are emitted from the lesion site 54.
The tip 111 of the ultrasonic probe 110
Approaches the lesion site 54, the scintillator 114
And emits light. The light from the scintillator 114 is
Not shown via prism 115 and optical fiber 116
The light is received by the photoelectric conversion unit, photoelectrically converted, and the probe tip
A signal indicating that 111 has approached the lesion site 54 is obtained.
It is. The probe output signal from the photoelectric converter
Notifies that the tip 111 has approached the lesion site 54,
Let the surgeon know. The scintillator 114 is used for gamma ray detection.
Since it has directivity, it is detected by the scintillator 114.
Of the ultrasonic probe 110 based on the information
Ultrasound for treatment by directing the tip 111 to the lesion site 54
The emission direction of the therapeutic ultrasonic wave from the transducer 113 is changed to the lesion site.
Match with 54. Then, the ultrasonic transducer for treatment 113
Irradiates high-intensity ultrasonic waves to the lesion site 54 from
Perform a therapeutic treatment. In this manner, gamma rays from a lesion site are detected.
The ultrasonic wave provided with the ultrasonic vibrator by providing the means
Point the tip of the probe accurately to the lesion such as cancer
And improve the directivity to the treatment target site.
Can improve the efficiency of therapeutic treatment.
You. [Appendix] (1) Ultrasonic for observation that emits ultrasonic waves for observation at the tip
Therapeutic Ultrasound that emits high-intensity ultrasonic waves for wave transducers and therapeutics
Having a thin tube that can be inserted into a body cavity with a sound transducer,
Ultrasound diagnostic treatment system for observation and treatment by ultrasound
Stem, and other processing to the treatment target site.
Treatment means for performing the placement, and the treatment means is provided in the thin tube.
Of the therapeutic ultrasonic wave emitted from the therapeutic ultrasonic transducer
Ultrasound diagnosis with treatment means guide to reach the focal point
Treatment system. (2) Emission of ultrasonic waves for observation at the tip
Emits high-intensity ultrasonic waves for observation and ultrasonic transducers for observation
Insertable into body cavities with therapeutic ultrasound transducer
Ultrasound with tubules for ultrasonic observation and therapeutic treatment
Wave diagnostic treatment system, furthermore,
Puncture means for performing other treatment by puncture, the tubule,
The puncture means is emitted from the therapeutic ultrasonic transducer
Puncture guide to reach and reach the focal point of therapeutic ultrasound
Ultrasound diagnostic treatment system equipped with. (3) Ultrasound for observation is emitted to the tip
Emits high-intensity ultrasonic waves for observation and ultrasonic transducers for observation
Insertable into body cavities with therapeutic ultrasound transducer
Ultrasound with tubules for ultrasonic observation and therapeutic treatment
Wave diagnostic treatment system, furthermore,
Having a treatment means for performing another treatment by puncturing,
The treatment means is emitted from the therapeutic ultrasonic transducer
Treatment means for puncturing by reaching the focal point of therapeutic ultrasound
Ultrasound diagnostic treatment system with id. (4) The treatment means is an ultrasonic treatment.
Treatment means for performing other treatments in combination with the treatment
The ultrasonic diagnostic treatment system according to Supplementary Note (1). In this configuration, a tubule for diagnosis and treatment is inserted into a body cavity.
Ultrasound treatment and other treatments inserted into the desired site inside
Can be used in combination with
Provides an ultrasonic diagnostic treatment system that can be improved
Ultrasonic transducer for observation and treatment
Insert the thin tube provided with the ultrasonic transducer at the tip into the body cavity,
Perform ultrasound observation and therapeutic treatment, and install
Insert the therapeutic treatment means into the body cavity
The therapeutic supersonic which enters and is emitted from the therapeutic ultrasonic transducer
Reach the focal point of the sound wave,
Perform medical treatment. This allows treatment other than ultrasonic treatment
Can be used to improve the therapeutic effect on the affected area
You. (5) The treatment means is a hollow guide.
Guide needle having a tube and a therapeutic probe for performing a therapeutic treatment
The ultrasonic diagnostic treatment system according to supplementary note (4),
M (6) The treatment means includes various information in the body
(1) which is an in-vivo information detection means for detecting and monitoring
An ultrasonic diagnostic treatment system according to item 1. [0106] This configuration allows the body to be used during treatment with ultrasound.
Can detect and monitor various types of information at treatment sites, etc.
Perform reliable treatment while grasping the treatment status easily
To provide an ultrasound diagnostic treatment system capable of
Ultrasonic transducer for observation and ultrasonic vibration for treatment
Insert the tubule with the tip into the body cavity, and
For observation and therapeutic treatment, and a treatment
Insert the in-vivo information detecting means into the body cavity with the step guide
Of the therapeutic ultrasonic wave emitted from the therapeutic ultrasonic transducer
Reach the focal point to detect and monitor various information in the body
You. This makes it possible to monitor various information in the body,
It can improve the realism and safety for the living body
You. (7) The treatment means emits microwaves.
A microwave oscillating probe that performs therapeutic treatment by irradiating
The ultrasonic diagnostic treatment system according to (1). (8) The treatment means emits a laser.
As described in Appendix (1), which is a laser probe that performs therapeutic treatment
Ultrasound diagnostic treatment system. (9) The treatment means has a heat generating means.
And a heat probe for performing heat ablation treatment of living tissue.
The ultrasonic diagnostic treatment system according to Supplementary Note (1). (10) The treatment means has a cooling means.
Is a cryoprobe that performs cryotherapy of living tissue
The ultrasonic diagnostic treatment system according to supplementary note (1). (11) The treatment means converts the high-frequency current to
-Frequency current probe for cauterization and coagulation of living tissue
The ultrasonic diagnostic treatment system according to supplementary note (1), wherein (12) The treatment means converts the electromagnetic wave into an RF electromagnetic wave.
RF probe for thermal, cautery, and coagulation treatment of living tissue
The ultrasonic diagnostic treatment system according to supplementary note (1), wherein (13) The treatment means converts the MW electromagnetic wave into
MW probe for thermal, cautery and coagulation treatment of living tissue
The ultrasonic diagnostic treatment system according to supplementary note (1), wherein (14) The treatment means includes the steps of:
The ultrasonic wave according to Appendix (1), which is a needle for drug injection to be injected.
Diagnostic treatment system. In this configuration, the observation ultrasonic vibrator and the
Ultrasound observation with a capillary tube equipped with a medical ultrasonic transducer
Diagnosis and treatment, and at this time, the
Insert the drug injection needle into the body cavity by the step guide and
Focusing of therapeutic ultrasound emitted from the therapeutic ultrasound transducer
The point is reached, and the drug is injected near the treatment target site. This
As a result, compared to treatment using ultrasound alone,
The therapeutic effect can be improved. (15) The treatment means is a medical treatment
Note that it is a temperature detection probe that detects the temperature of the target part
The ultrasonic diagnostic treatment system according to (1). (16) The treatment means is a medical treatment
Note that it is a sound pressure detection probe that detects the sound pressure of a target part
The ultrasonic diagnostic treatment system according to (1). (17) The treatment means collects a living tissue.
The ultrasonic diagnostic treatment described in Appendix (1), which is a biopsy forceps to be taken
Treatment system. (18) The thin tube has a flexible tube.
The ultrasonic diagnostic treatment system according to Appendix (1), wherein
Tem. (19) The thin tube is a hard thin tube.
The ultrasonic diagnostic treatment system according to supplementary note (1). (20) The thin tube has a bendable portion that can be bent.
Diagnostic ultrasound treatment according to supplementary note (1), which is a thin tube having
system. (21) The treatment means guide is
A channel provided inside the tube and serving as a treatment means insertion passage;
The treatment means, which is disposed at the tip of the channel,
And an elevator that raises in the direction of degrees.
The ultrasonic diagnostic treatment system according to (1). (22) Guided by the treatment means guide
The treatment means to be inserted is inserted into the treatment means guide by a predetermined amount.
With insertion amount setting means for setting the insertion amount for
The ultrasonic diagnostic treatment system described in Supplementary Note (21)
M [0124] As described above, according to the present invention, the diagnosis
Insertion of a tubule for cutting and treatment into a desired site in a body cavity
Treatment with ultrasound and other treatments can be performed,
It is possible to treat the affected area efficiently and reliably
effective.

BRIEF DESCRIPTION OF THE DRAWINGS FIGS. 1 to 6 relate to a first embodiment of the present invention,
FIG. 1 is a configuration explanatory view showing an overall configuration of an ultrasonic diagnostic treatment system. FIG. 2 is a perspective view showing a distal end configuration of an ultrasonic probe that emits diagnostic ultrasonic waves and therapeutic ultrasonic waves. FIG. FIG. 4 is an explanatory cross-sectional view showing the configuration of the distal end side of the probe and the state at the time of diagnosis and treatment. FIG. 4 is an explanatory view showing the configuration of a guide needle inserted into the ultrasonic probe. FIG. 5 is a micrograph inserted into the lumen of the guide needle. FIG. 6 is an explanatory view showing a configuration of a microwave treatment apparatus having a microwave oscillation probe. FIG. 6 is an operation explanatory view showing a state in which a microwave oscillation probe is inserted into a lumen of a guide needle and punctured at a treatment site. FIG. FIG. 8 is an explanatory view showing a configuration of a distal end portion of a laser probe used as a treatment means by being inserted into a lumen of the present invention. FIGS. 8 to 12 relate to a second embodiment of the present invention, and FIG. Intra-abdominal ultrasound that emits therapeutic ultrasound FIG. 9 is a configuration explanatory view showing the configuration of the probe. FIG. 9 is a cross-sectional view showing the configuration of the distal end of the ultrasonic probe shown in FIG. 8. FIG. 10 is an operational explanatory view showing a state in which the ultrasonic probe is inserted into the abdominal cavity. 11 is an operation explanatory view showing a state in which the treatment means reaches the treatment site by the treatment means guide provided at the distal end of the ultrasonic probe. FIG. 12 is a temperature detection probe for monitoring the temperature as a means for monitoring the state of the treatment site. FIG. 13 is an operation explanatory view showing the configuration of the output control means provided with the device and a state in which the temperature detection probe is inserted into the lumen of the guide needle and punctured the treatment site. FIG. 13 monitors sound pressure as a means for monitoring the state of the treatment site. FIG. 14 is an operation explanatory view showing a configuration of an output control means having a sound pressure detecting probe to be inserted and a state in which the sound pressure detecting probe is inserted into a lumen of the guide needle and punctured a treatment site. FIG. 15 is an operation explanatory view showing a region of treatment by focused ultrasound and a treatment by another treatment under a wave diagnostic guide. FIG. 15 is an explanation showing an example of a relationship between respective target regions of a treatment by focused ultrasound and another treatment. FIG. 16 is an explanatory view showing another example of the relationship between the respective target areas of the treatment by the focused ultrasound and the other treatment. FIG. 17: Treatment via the ultrasonic probe according to the third embodiment of the present invention. FIG. 18 is a functional explanatory view showing a configuration of a treatment probe including a guide needle and a syringe as a treatment means to be inserted into a site, and a state in which the treatment probe is punctured into a treatment site. FIG. 19 is a cross-sectional view showing a configuration of a treatment probe including a puncture needle for aspiration biopsy as a treatment means to be inserted into a treatment site via an ultrasonic probe. FIG. 19 is provided with γ-ray detection means for detecting γ-rays from a lesion site. Ultrasonic Pro 2A: Ultrasonic probe 5: Ultrasonic diagnostic treatment circuit 7: Insertion section 14: Tip section 13: Channel 13a: Channel openings 20a, 20b: Treatment Ultrasonic transducer 24 for observation Ultrasonic transducer 33 for observation 33 CCD 42 Erecting table 51 Guide needle 54 Lesion site 58 Scale 60 Microwave oscillation probe

────────────────────────────────────────────────── ─── Continuing on the front page (72) Inventor Yasuhiro Ueda 2-43-2 Hatagaya, Shibuya-ku, Tokyo O-limpus Optical Industry Co., Ltd. (72) Inventor Takashi Tsukaya 2-43-2 Hatagaya, Shibuya-ku, Tokyo O-Limpus Optical Industrial Co., Ltd. (72) Inventor Seiji Kuramoto 2-43-2 Hatagaya, Shibuya-ku, Tokyo O-limpus Optical Industrial Co., Ltd. (72) Inventor Yoshinao Ohaki 2-43-2, Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd. (56) References JP-A-4-307054 (JP, A) JP-A-2-126841 (JP, A) (58) Fields investigated (Int. Cl. ⁷ , DB name) A61B 8/00-8/15 A61B 18/00 A61F 7/00

Claims (1)

(57) [Claims] (1) An observation ultrasonic vibrator for emitting ultrasonic waves for observation to the distal end portion, and a therapeutic ultrasonic vibrator for emitting high intensity ultrasonic waves for treatment. An ultrasonic diagnostic treatment system that has an insertion portion that can be inserted into a body cavity and that performs observation and therapeutic treatment by ultrasonic waves, and further performs another treatment on a treatment target site A treatment means guide provided in the insertion portion so as to reach the vicinity of the focal point of the treatment ultrasonic wave emitted from the treatment ultrasonic transducer in the insertion portion ; An ultrasonic diagnostic treatment system characterized by the following.