JPS63230142A - Endoscope for hyperthermia - Google Patents

Abstract

(57) [Summary] This bulletin contains application data before electronic filing, so abstract data is not recorded.

Description

DETAILED DESCRIPTION OF THE INVENTION [Field of Industrial Application] The present invention relates to an endoscope for heating and treating an affected area within a body cavity.

[Conventional technology]

It is known that malignant tumors occurring within body cavities are sensitive to temperatures of around 42° C., and that thermotherapy is effective as a means of treating such affected areas.

As a conventional thermotherapy device, as described in Japanese Patent Publication No. 57-34867, a microwave oscillator is attached to the tip of the insertion section of an endoscope, and the affected area is treated with microwaves emitted from the microwave oscillator. As shown in JP-A No. 55-70248,
2. Description of the Related Art There is a known method in which a thermotherapy probe is inserted into an affected area using a forceps insertion channel of an endoscope, and the affected area is subjected to heat treatment using the probe.

However, the former requires a microwave oscillator to be attached to the tip of the endoscope's insertion section, and this structure increases the diameter of the end of the endoscope's insertion section, making it difficult to insert it into narrow body cavities. It becomes difficult.

In addition, with the latter, the tip of the endoscope must first be inserted close to the affected area, and the probe must be guided to the affected area using the endoscope's channel for passing the forceps. It is necessary to insert the probe following the insertion operation, and it takes time and effort to insert the probe into the body cavity.

Therefore, both of these methods have the disadvantage of causing pain to the patient during insertion.

For this reason, it is conceivable to add a thermotherapy function to the endoscope itself.

That is, a balloon is provided at the tip of the insertion section of the endoscope to inflate the body cavity and transfer heat to the affected area, and the balloon is inflated inside the endoscope and heat is transferred to the affected area through the balloon. It is conceivable to provide means for supplying a fluid for this purpose, and also to provide within the balloon a heating electrode for heating the fluid and a temperature measuring means for monitoring the temperature of the fluid.

With this configuration, the insertion section of the endoscope is inserted into the body cavity without inflating the balloon, and at this time, the endoscope's inherent monitoring means can be used to search for the affected area and insert the endoscope. At the same time, fluid can be supplied to the balloon near the affected area to inflate it.

[Problem that the invention seeks to solve]

However, the endoscope for thermotherapy as described above has a switch that perfuses pressurized fluid in the balloon, an electrode switch that operates the electricity supply to the heating electrode, and a temperature measurement device that opens and closes the electrical circuit of the temperature measurement means. A switch is required.

If such an operating section is configured separately from the endoscope's original operating section, there is a concern that the operating sections will become separate and independent, making it difficult to operate both.

The present invention aims to provide an endoscope for thermotherapy that facilitates the operation of the endoscope itself and the thermotherapy section.

[Means for solving problems]

The present invention is characterized in that a switch for fluid perfusion, a switch for controlling energization of the heating electrode, and a switch for temperature measurement are all provided in the operating section of the endoscope.

[Effect]

According to the present invention, the fluid perfusion switch, electrode switch, and temperature measurement switch are installed in the operation section of the endoscope, so the operation of the endoscope itself and the operation of the thermotherapy section can be concentrated in one place. This makes the operation easier.

〔Example〕

The present invention will be explained below based on a first embodiment shown in FIGS. 1 to 6.

In FIG. 1, the overall structure of an endoscope 1 is shown, and 2 is the endoscope main body. The endoscope main body 2 includes an insertion section 3 inserted into a living body cavity A, and an operating section 4 at hand.

The insertion section 3 has a distal end component 7 connected to the distal end of the flexible tube section 5 via a tubular curved section 6, and is formed into an airtight hollow cylindrical shape over its entire length.

The curved portion 6 may have a known structure, so its detailed structure will be omitted, but a plurality of ring-shaped curved portions are rotatably connected to each other in the axial direction to form a curved tube. By inserting a plurality of operating wires into the interior of the curved tube and operating the operating wires using an angle knob 8 provided on the operating section 4, the curved tube can be bent in any direction, up, down, left, or right. It has become.

As shown in FIGS. 2 and 3, the tip component 7 includes:
An observation window 9 is formed, and an objective lens 10 is mounted in the observation window 9.
The objective lens 10 and the eyepiece 11 provided on the operating section 4 are connected by a fiber cord 12 inserted through the insertion section 3.

Further, although not shown in the drawings, the tip end of the light cable is exposed to the tip structure section 7, and this light cable is inserted into the insertion section 3 and guided into the connection cable 13 led out from the operation section 4. ing.

The connection cable 13 is connected to the light source device 1 via the socket 14.
5. Although not shown, the light source device 15 is provided with a light source, a suction pump, and an air pump.

Note that a branch cable 16 is connected to the connection cable 13, and this branch cable 16 is connected to a heating control device 17. As shown in FIGS. 2 and 5, the heating control device 17 includes a high frequency power source 18. Fluid perfusion pump 19, temperature measuring device 20, and alarm device 21 (sixth
(as shown in the figure) is provided.

Further, as shown in FIG. 3, the distal end component 7 has a water supply passage 25 for cleaning the observation window. It is connected.

Furthermore, a suction passage 27 is formed in the distal end component 7, as shown in FIG. Note that the suction passage 27 is
Although not shown, it is known that the channel also serves as a channel for forceps insertion halfway through.

As shown in FIG. 2, a balloon 30 is provided on the curved portion 6 or the tip forming portion 7. As shown in FIG. This balloon 30
is made of an elastic tube made of rubber or the like, and is fixed to the curved portion 6 or the tip portion 7 in a fluid-tight manner. Therefore, when the pressure inside this balloon 30 is increased, the balloon 30
is starting to swell.

Around the curved portion 6 or the distal end portion 7, an intracorporeal high-frequency electrode 31 in the form of a coil, for example, is provided inside the balloon 30. Intrabody cavity high frequency electrode 3
1 is connected to a high frequency power source 18 of a heating control device 17 by a lead wire inserted through a branch cable 16 from the insertion section 3, the operation section 4, and the connection cable 13.

Furthermore, a temperature sensor 32 made of a thermal lightning pair or the like is attached to the inner surface or within the wall thickness of the balloon 30.

This temperature sensor 32 is also connected to the temperature measuring device 20 of the heating control device 17 by a lead wire inserted through the branch cable 1B from the insertion section 3, the operation section 4, and the connection cable 13.

Further, a pressure sensor 33 made of a semiconductor is provided on the curved portion 6 or the tip forming portion 7, and is located inside the balloon 30 and detects the pressure inside the balloon 30. This pressure sensor 33 is also connected to the alarm device 21 of the heating control device 17 in the same manner.

The curved portion 6 or the tip forming portion 7 has the balloon 3
As shown in FIG. , heating control device 1
7 is connected to a fluid perfusion pump 19.

This fluid perfusion pump 19 is connected to the first pump shown in FIG.
It is configured to be connected to either the balloon water injection passage 35 or the observation window cleaning water supply passage 25 via a switching valve 37 .

The curved portion 6 or the tip forming portion 7 has the balloon 3
As shown in FIG. It is introduced into the IG and connected to the suction pump of the light source device 15. In this case, the suction pump is connected to either the balloon drainage passage 30 or the suction passage 27 via a second switching valve 38 shown in FIG.

The operation unit 4 includes an air and water supply valve 40, a suction valve 41, a switch 42 for perfusing the pressurized fluid in the balloon 30, an electrode switch 43 for controlling energization of the intracorporeal high-frequency electrode 31, and a temperature measuring means. A temperature measuring switch 44 for opening and closing the electrical circuit is provided, and the first and second switching valves 37 and 38 are further provided.

The air and water supply valve 40 is provided in the balloon water injection passage 35 and the air supply passage 26, and as shown in FIG.
2 are slidably fitted together, and the control piston 52 is biased by a spring 53. An annular groove 54 is formed in the control piston 52, and a communication chamber 55 is formed between the control piston 52 and the bottom of the valve case 50.

The suction valve 41 is provided in the balloon drainage passage 3o, and as shown in FIG. The piston 62 is biased by a spring 63. An annular groove 64 is formed in the control piston 62, and a communication chamber 65 is formed between the control piston 62 and the bottom of the valve case 60.

The pressurized fluid perfusion switch 42 operates the fluid perfusion pump 19 provided in the heating control device 17, and the high frequency electrode switch 43 controls energization to the intracorporeal high frequency electrode 31 and measures the temperature. The switch 44 opens and closes the electric circuit of the temperature measuring means.

Note that 70 is an extracorporeal high-frequency electrode, which is connected to the high-frequency power source 18 of the heating control device 17.

Further, as shown in FIG. 6, the pressure sensor 33 described above is activated by the amplifier 75 when the set pressure inside the balloon 30 changes. The buzzer 77 and lamp 7
This activates the alarm display device No. 8.

The operation of the embodiment with such a configuration will be explained.

The insertion section 3 of the endoscope 1 is inserted into the body cavity A with the balloon 30 deflated.

In this case, the insertion section 3 is inserted into the body cavity A while emitting light from the light cable facing the tip of the insertion section to illuminate the body cavity A and searching for the affected area using the observation window 9. This operation is similar to that of a normal endoscope.

When the affected area B of the malignant tumor is found in the body cavity A, balloon 3
Operate the curved part B using the angle knob 8 so that the curved part B faces the affected part B.

The endoscope 1 is held still with the balloon 30 facing the affected area B, and fluid is injected into the balloon 30. For injection into the balloon 30, when the pressurized fluid perfusion switch 42 is operated, the fluid perfusion pump 19 provided in the heating control device 17 is activated. Then, the first switching valve 37 is operated to connect the balloon water injection passage 35 to the air/water supply valve 40, and the air/water supply valve 40 is pushed down. Then, the annular groove 54 of the control piston 52 opens the balloon water injection passage 35, so that
Fluid flows from the fluid perfusion pump 19 to the balloon water injection passage 35
Water is injected into the balloon 30 through this process.

This inflates the balloon 30, and the outer surface of the balloon 30 is pressed against the affected area B.

When the balloon 30 comes into close contact with the affected area B at an appropriate pressure, the air/water supply valve 40 is released from being pressed down, and the annular groove 54 of the control piston 52 closes the balloon water injection passage 35, thereby stopping water injection.

Next, when the high frequency electrode switch 43 is operated, a high frequency voltage is applied between the intracorporeal high frequency electrode 31 and the extracorporeal high frequency electrode 70, thereby heating the fluid within the balloon 30. .

When the temperature measurement switch 44 is pressed, the temperature sensor 32 is connected to the temperature measurement device 20, so that the temperature of the fluid can be known from the display of the temperature measurement device 20.

When the fluid in the balloon 30 reaches the optimal temperature for treating the affected area B, for example around 42°C, maintain this state,
Perform heat treatment.

Note that during such treatment, if the fluid pressure inside the balloon 30 changes due to the patient moving or the fluid perfusion pump 19 malfunctioning, the balloon 30 may move away from the affected area or become misaligned. However, when the fluid pressure inside the balloon 80 changes, the pressure sensor 33 detects this, and as shown in FIG. 6, the amplifier 75. A buzzer 77 and a lamp 78 are activated via the comparator 7B.

As a result, an alarm is displayed, and it is possible to know whether or not the affected area B is being treated appropriately.

Similarly, the fluid temperature during treatment can be detected by the temperature sensor 32 and displayed on the temperature measuring device 20, and it can be confirmed whether or not an appropriate temperature is being maintained.

When the treatment for a predetermined period of time is over, the high-frequency electrode switch 43 is turned off, and the application of voltage to the intracorporeal high-frequency electrode 31 and the extracorporeal high-frequency electrode 70 is stopped.

Next, the fluid in the balloon 30 is discharged. This emission is
The second switching valve 38 is operated to connect the balloon drainage passage 30 to the suction valve 41 side, and the suction valve 41 is pushed down. The annular groove 64 of the control piston 62 then opens the balloon drainage passage 30, so that the fluid within the balloon 30 is drawn into the suction pump and thus evacuated.

Therefore, the balloon 30 is deflated and becomes as thick as ζL with the insertion portion of the endoscope 1, so that it can be pulled out from the body cavity A.

Note that when inserting the endoscope insertion section 3, if the observation window 9 becomes dirty, operate the first switching valve 37 to connect the observation window cleaning water injection passage 25 to the air and water supply valve 40. When the air and water supply valve 40 is pressed down, the fluid perfusion pump 19
The fluid is sent from there to the observation window cleaning water injection passage 25 to wash away the surface of the observation window 9. After that, when the air and water supply valve 40 is released from the depression and the leak hole 51 is closed with a finger, air is sent from the air supply pump through the air supply passage 26 to the water injection passage 25 for cleaning the observation window, and the air is sent to the observation window cleaning water passage 25. Blow off the surface.

In addition, when removing body fluid etc. in the body cavity A, operate the second switching valve 38 to connect the suction passage 27 to the suction valve 41 side, and when the suction valve 41 is pushed down, the control piston 62 Since the annular groove 64 connects the suction passage 27 to the suction pump, the fluid in the body cavity A is discharged from the suction passage 27.

According to such an embodiment, since the balloon 30 is provided at the tip of the insertion portion of the endoscope 1, the original functions of the endoscope 1, that is, the ability to perform a bending operation within the body cavity A, and the observation window 9 can be improved.
The device can be inserted while searching for the affected area B, and therefore the insertion operation is easy and the operation time is short.

Furthermore, the balloon 30 is deflated at the time of insertion, and has the same thickness as the endoscope insertion portion 3, making it easy to insert.

For this reason, it is unlikely to cause pain to the patient during insertion.

In addition, the operating parts necessary for thermotherapy, namely, the air and water supply valve 40, the suction valve 41, the pressurized fluid perfusion switch 42, the intracorporeal high-frequency electrode switch 43, and the temperature measurement switch 44, as well as the first and Second switching valve 3
7.38 are all centrally installed in the operating section 4 of the endoscope 1, so the thermal treatment operation can be performed quickly and consecutively with the endoscope operation, thus saving a lot of time in the preparation stage of the treatment. Since there is no need to spend money, the pain caused to the patient is further reduced.

Note that the present invention is not limited to the first embodiment described above.

That is, in the case of the first embodiment, the curved portion 6 of the distal end insertion portion of the endoscope is bent by the operation wire inserted into the insertion portion 3 by operating the angle knob 8. A memory alloy may be used and the shape memory alloy may be caused to self-heat and deform by energizing it, and the bending portion 6 may be operated to bend by this deformation. Therefore, the operating section 4 may be equipped with a shape memory alloy energization switch 80, as shown in FIG. 7 as a second embodiment.

Further, in the case of the first embodiment, the intracorporeal high-frequency electrode 31 is arranged in a coil shape around the curved part 6 or the tip structure part 7, but if this is done, there is a concern that the diameter of the insertion part will increase. There is. In order to avoid this, a configuration may be adopted as shown in FIG. 8 as a third embodiment.

That is, in FIG. 8, the curved portion 6 is similar to the conventional one.
A plurality of ring-shaped curved portions 90 are rotatably connected to each other in the axial direction to form a curved tube 91, and the outer periphery of this curved tube 91 is made of wire mesh as in the past. It is covered by a cylindrical body 92. In this embodiment, the cylindrical body 92 made of wire mesh is used as an intracorporeal high-frequency electrode, and by doing so, the thickness of the insertion portion can be reduced. The wire mesh tube 92 serving as an intracorporeal high-frequency electrode is insulated from the curved tube 91 by an insulating rubber 93, and its outer periphery is covered with an insulating coating 94.

Furthermore, in the first embodiment, the balloon 30 is shaped like a tube that covers the curved portion 6 or the distal end portion 7. However, in the fourth embodiment shown in FIG. Furthermore, the balloon may be in the form of a bag that covers the distal end of the endoscope. When using such a bag-shaped balloon 130, the bag-shaped balloon 180 may be made of a transparent material so as not to obstruct observation through the observation window 9.

Further, the observation window of the endoscope 1 may be configured with a side view observation window 95 or a perspective observation window as shown in the fourth embodiment shown in FIG. In the case of a bag-shaped object 130 as shown in FIG.

In addition, as shown in the fifth embodiment shown in FIG. 11, a bag-shaped balloon 130 is attached to the distal end of the endoscope to cover it, and the balloon 130 is inserted using the water supply passage 25 for cleaning the observation window.
In addition to injecting water into the tank, water may also be drained through the suction passage 27. Channel 1 for forceps insertion
00 may be used to insert and remove the intracorporeal high-frequency electrode 110 and a temperature sensor (not shown) into and out of the balloon 130.

Furthermore, the temperature sensor 32 may be provided on the outer surface of the balloon 30.130.

Furthermore, although the use of the pressure sensor 33 is not limited, a polymer pressure sensor may be used instead of the semiconductor pressure sensor.

In addition, as a means for detecting whether the balloon 30 is in close contact with the body cavity A, light is passed through the fluid inside the balloon 30 from an endoscope, and the light is reflected by the inner surface of the balloon 30. It is also possible to determine the separated position of the balloon 30 based on the strength, or to determine the separated position of the balloon 30 by attaching an ultrasonic oscillator to the endoscope and emitting ultrasonic waves from the ultrasonic oscillator into the balloon 30. Means are possible.

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

〔Effect of the invention〕

As explained above, according to the present invention, the fluid perfusion switch, the switch for controlling energization to the heating electrode, and the switch for temperature measurement are all provided in the operation section of the endoscope, so that the endoscope itself The operations of the heat treatment section and the operation of the heat treatment section can be performed centrally in one place, making the operation easy. Therefore, in addition to making effective use of the endoscope's original functions and making it easier to insert the thermotherapy section, it also makes it easier to operate the endoscope itself and the thermotherapy section. can be inserted quickly, reducing the pain caused to the patient during insertion.

[Brief explanation of the drawing]

1 to 6 show a first embodiment of the present invention, FIG. 1 is a diagram showing the overall structure, FIG. 2 is a diagram illustrating the schematic configuration of the heat treatment section, Fig. 4 is a diagram explaining the fluid system of the insertion section, Fig. 5 is an explanatory diagram showing the overall connection state, Fig. 6 is a diagram showing the operating system of the pressure sensor, and Fig. 7 is a diagram showing the second embodiment of the present invention. FIG. 8 is a cross-sectional view of the distal end of an endoscope showing a third embodiment of the present invention; FIG.
The figure is a sectional view of the distal end of an endoscope showing a fourth embodiment of the present invention, FIG. 10 is an external view of an endoscope showing a fifth embodiment of the present invention, and FIG. FIG. 6 is a sectional view of the distal end portion of an endoscope showing an example of No. 6 in use. DESCRIPTION OF SYMBOLS 1... Endoscope, 2... Endoscope main body, 3... Insertion part, 4... Operation part, 5... Flexible tube part, 6... Curved part, 7...・Kubata component, 30.130...Balloon,
31.110... On-body high frequency electrode, 32... Temperature sensor, 33... Pressure sensor 37... First switching valve, 38... Second switching valve, 40... Currency water supply valve, 41... Suction valve, 42... Pressurized fluid irrigation switch, 43... High frequency electrode switch, 44... Warm face measurement switch. Applicant's Representative Patent Attorney Jun Tsuboi Figure 7 Figure 8, jt Figure 9 Figure 10 Figure 11 Procedural Amendments Showa Ch 2 and 7. -2nd Patent Office Commissioner Kunio Ogawa 1, Indication of the case, Patent Application No. 62-65003 2, Title of the invention: Endoscope for thermotherapy 3, Relationship with the amended person case Patent applicant (037) Olympus Optical Industry Co., Ltd. 4, Agent UBE Building 7, 3-7-2 Kasumigaseki, Chiyoda-ku, Tokyo;
Contents of amendment (1) In the specification, "42°C" is replaced with "43°C" in line 19 of page 1 and line C of page 13.
I am corrected. (2) In the specification, on page 3, line 10, the phrase "heating the fluid" is corrected to "heating the affected area." (3) In the specification, the phrase "air pump" on page 6, line 12 is corrected to "air/water pump." (4) In the specification, page 7, line 1, page 2, line 2,
Page 9, line 3, page 14, line 17, page 2, line 2,
The words "washing" in the 3rd line of page 15 and the 16th line of page 18 are corrected to "washing". (5) "Figure 3" on page 10, line 11 in the specification
The statement has been corrected to read "Figure 4." (6) In the specification, from page 12, line 20 to page 13, line 1, the phrase "the fluid in the balloon 30" is replaced with "
Affected area B,” he corrected. (7) In the specification, "Balloon drainage passage 30J" is corrected to "Balloon drainage passage 36" in lines 6 to 7 of page 14 and line 9 of the same page. (8) In the specification, on page 18, line 10, the phrase ``r-side view type'' is corrected to ``side view type.'' (9) In the specification box, page 18, line 11, the phrase "slanted type" is corrected to "slanted type." (1.) In the drawing, 3rd figure) To Bessaiyo ■ So correction 3. (
Book ÷ 1 thirst 1f inside book 11 history~shi. )

Claims (1)

[Claims] An endoscope for thermotherapy, wherein an inflatable balloon, a heating electrode, and a temperature measuring means are provided in the insertion portion of the endoscope, and a supply passage for supplying pressurized fluid to the balloon is provided inside the endoscope. In the endoscope, the operating section of the endoscope is provided with a switch for perfusing the pressurized fluid in the balloon, a switch for controlling energization of the heating electrode, and a switch for the temperature measuring means. Features of endoscope for thermotherapy.