JP2000300666A - Heating device of perfusion within peritoneal cavity - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a heating device of a perfusion within a peritoneal cavity capable of simply and stably hating hot water within the peritoneal cavity by circulating perfusate with in the peritoneal cavity without a laparotomy. SOLUTION: This device is provided with a pump 10 for the perfusion of a fluid within a peritoneal cavity H through a water feeding tube 2 and a water absorbing tube 3, and is provided with a control part 13 for controlling a first shunt device 7a, a second shunt device 7b and valves 11a to 11c for controlling the flow rate of a perfusate fluid by means of this pump 10 based on the measuring result of the temperature of the perfusate fluid within the cavity H measured by a temperature sensor 5.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an intraperitoneal perfusion heating apparatus for heating a perfusate circulated in a patient's peritoneal cavity.

[0002]

2. Description of the Related Art In general, a therapy for circulating a perfusate in the abdominal cavity of a patient is described in the following document:
y And Cytoreductive Surgery (The Ludann Compan
y Grand Rapids. Michigan: Oct. 1995) ”. Among them, `` III.HeatedIntraoperative Intraper
"Itoneal Chemotherapy" discloses a therapy in which a perfusate is circulated intraperitoneally under laparotomy. Here, the operator manually agitates the perfusate to warm it evenly.

[0003]

The above-mentioned prior art has a problem that the burden on the patient is very large because the treatment is performed under laparotomy. In addition, there is also a problem that the treatment is complicated such that the operator manually agitates the perfusate circulated in the abdominal cavity, and it is difficult to perform a stable treatment.

The present invention has been made in view of the above circumstances, and has as its object to circulate a perfusate in the abdominal cavity without opening the abdomen, and to easily and stably heat the intraperitoneal warm water. It is to provide a heating device.

[0005]

According to the first aspect of the present invention, there is provided a fluid supply line for supplying a fluid into the abdominal cavity, a fluid collecting line for collecting the fluid in the abdominal cavity, Pump means for perfusing the fluid through the fluid supply line and the fluid recovery line, temperature measuring means for measuring the temperature of the perfused fluid in the peritoneal cavity, and the flow rate of the fluid perfused by the pump means , And control means for controlling the flow rate adjusting means based on the measurement result measured by the temperature measuring means. According to the first aspect of the present invention, the fluid is supplied to the abdominal cavity by the fluid supply line along with the driving of the pump means during the fluid perfusion in which the fluid is perfused into the abdominal cavity, and the fluid in the abdominal cavity is collected by the fluid collecting line. By doing so, the fluid is perfused into the abdominal cavity via the fluid supply line and the fluid recovery line. At this time, the temperature of the perfused fluid in the abdominal cavity is measured by the temperature measuring means, and the flow rate adjusting means is controlled by the control means based on the measurement result measured by the temperature measuring means, and the amount of the fluid perfused by the pump means is measured. By controlling the flow rate, uniform heating can be performed safely and safely under the abdominal cavity.

According to a second aspect of the present invention, at least one of the fluid supply pipe and the fluid recovery pipe is provided with flow branch means for branching into a plurality of flow paths. The intraperitoneal perfusion heating apparatus according to claim 1, wherein the flow rate of each of the flow paths is adjusted.
According to the second aspect of the present invention, when the fluid is perfused into the abdominal cavity via the fluid supply line and the fluid recovery line, the flow rate of each of the plurality of branched flow paths is adjusted. By doing so, the flow rate of the perfused fluid is controlled.

The invention according to claim 3 is a fluid supply line for supplying a fluid into the abdominal cavity, a fluid recovery line for collecting the fluid in the abdominal cavity, and the fluid supply line inside the abdominal cavity. Pump means for perfusing fluid through the fluid collection line, temperature measuring means for measuring the temperature of the perfused fluid in the peritoneal cavity, and a flow rate for controlling the flow rate of the fluid perfused by the pump means An intraperitoneal perfusion warming device, comprising: an adjusting unit; and a control unit that controls the temperature of the perfused fluid based on a measurement result measured by the temperature measuring unit. According to the third aspect of the present invention, the temperature of the fluid to be perfused is controlled by the control means based on the measurement result measured by the temperature measuring means, so that uniform heating can be performed safely and safely under the abdominal cavity. It was made.

[0008]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS A first embodiment of the present invention will be described below with reference to FIGS. 1 to 4 of the present intraperitoneal perfusion heating apparatus. FIG. 1 shows a schematic configuration of the whole system of the intraperitoneal perfusion heating apparatus of the present embodiment.

The intraperitoneal perfusion heating apparatus of the present embodiment is provided with an apparatus body 1 of the intraperitoneal perfusion heating apparatus. The apparatus main body 1 has a water supply tube (fluid supply line) for perfusate.
2 and one end of a water absorption tube (fluid recovery pipe) 3 are connected. The water supply tube 2 and the water absorption tube 3 are inserted into the abdominal cavity H through two trocars 4 previously punctured in the abdominal wall of the patient.

The water supply tube 2 and the water absorption tube 3 are provided with two pipes 2a, 2b, 3a, 3b, respectively. And the tip side of each tube 2, 3 is 2
It is also divided. Further, a temperature sensor (temperature measuring means) 5 is disposed at the tip of each of the two conduits 2a, 2b, 3a, 3b of each tube 2, 3. Each temperature sensor 5 is connected to the intraperitoneal perfusion heating device main body 1 via a temperature sensor cable 6.

FIG. 2 is a block diagram of the inside of the main body 1 of the intraperitoneal perfusion heating apparatus. An internal conduit 7 is provided inside the apparatus main body 1. One end of the internal conduit 7 is connected to a first flow divider (flow control means) 7a, and the other end is connected to a second flow divider (flow control means) 7b.
Furthermore, two pipe lines 2a and 2b of the water supply tube 2 are connected to the first flow divider 7a, respectively. Similarly, the second flow divider 7b has two pipes 3a, 3a,
3b are connected to each other.

Here, the flow divider 7a is provided with flow rate adjusting means for adjusting the flow rate ratio between the two pipe lines 2a and 2b in the water supply tube 2. Further, the current divider 7b is also provided in the current divider 7b.
A flow rate adjusting means for adjusting the flow rate ratio between the two pipe lines 3a and 3b in the water absorption tube 3 is provided similarly to the case of FIG.

In the middle of the internal conduit 7, there is provided a parallel conduit in which a perfusate tank 9 and a pump (pump means) 10 for perfusing the perfusate are connected in parallel. . The tank 9 is previously filled with a new perfusion solution. The tank 9 may be provided with a heating means for preheating the perfusate. Further, the internal pipe 7 has three valves (flow rate adjusting means) 11a to 11 for changing the flow paths of the parallel pipes.
c is interposed. Here, the first valve 11a is disposed between the first flow divider 7a and the parallel pipe. Further, the second valve 11b and the third valve 11c are arranged at both ends of the pipe on the tank 9 side in the parallel pipe. By the operation of these valves 11a to 11c, the flow path of the parallel pipeline can be switched between a state in which a flow path passing through the tank 9 is formed and a state in which a flow path passing through the pump 10 is formed. I can do it.

A heater 8 for heating the perfusate is interposed between the pump 10 and the first flow divider 7a in the internal conduit 7. The heater 8 has a function of keeping the temperature at a set temperature. When the pump 10 is driven, the perfusate discharged from the pump 10 is heated by the heater 8 and supplied to the water supply tube 2 through the flow divider 7a. Further, the perfusate collected from the water absorption tube 3 is sent to the pump 10 through the flow divider 7b.

A control section (control means) 13 is provided inside the apparatus main body 1. The pressure gauge 12 for measuring the pressure in the internal conduit 7 of the apparatus main body 1 is connected to the control unit 13. Further, the control unit 13 includes a first current divider 7a, a second current divider 7b, a heater 8, a pump 10,
A temperature measuring unit 14 connected to each of the valves 11 a to 11 c and measuring the temperature of each temperature sensor 5.
And the setting / display unit 15 are connected to each other. Here, the setting / display unit 15 is provided with a perfusion solution filling button, a start switch, a stop switch, a perfusion solution collection button, a reset switch, and the like (not shown).

Further, four temperature sensors 5 are connected to the temperature measuring section 14 via temperature sensor cables 6, respectively. Then, the control unit 13 uses the first shunt 7 based on the measurement result measured by the temperature sensor 5.
a, the second flow divider 7b and the flow rate adjusting means such as the valves 11a to 11c are controlled.

Next, the operation of the above configuration will be described.
When the intraperitoneal perfusion heating device of the present embodiment is used, when the power of the intraperitoneal perfusion heating device main body 1 is turned on, the heater 8 is heated at the temperature set in the setting / display section 15 in advance.

As shown in FIG. 1, two trocars 4 are respectively punctured into the abdominal wall of the patient and inserted into the abdominal cavity H. Further, the abdominal cavity H is passed through each trocar 4 in which the water supply tube 2 and the water absorption tube 3 for the perfusate penetrate the abdominal wall.
Is inserted into. Thereby, the setting is performed as shown in FIG.

In this state, when a perfusion liquid filling button (not shown) of the setting / display unit 15 is pressed, the first valve 11a and the third valve 11c are switched to the open state and the second valve 11b is switched to the closed state. In this state, the pump 10 is driven. Therefore, in this case, the perfusate in the tank 9 is sucked to the pump 10 side by the driving of the pump 10 and the perfusate discharged from the pump 10 is pressure-fed to the first flow divider 7a side to supply water. Water is supplied from the tube 2 into the abdominal cavity H.

When the peritoneal cavity H is filled with the perfusate to start heating, a start switch (not shown) of the setting / display unit 15 is pressed. During this operation, the first valve 1
1a is open, the second valve 11b, the third valve 11
c is respectively switched to the closed state. Therefore, in this case, this pump 10
Is discharged from the water supply tube 2 into the abdominal cavity H, and the perfusate in the abdominal cavity H is sucked into the device body 1 via the water absorption tube 3. Is done. Thereby, the perfusate circulates in the abdominal cavity H.

When the start switch is operated, the pressure in the internal conduit 7 of the apparatus main body 1 is measured by the pressure gauge 12 and the temperature of the perfusate in the abdominal cavity H is measured by each temperature sensor 5. The circulating operation of the perfusate is controlled by the control unit 13 in accordance with the flowcharts of FIGS. 3 and 4 as follows.

Here, two pipes 2 in the water supply tube 2
a and 2b are FLout1 and FLout2, and the flow rates of the two pipe lines 3a and 3b in the water absorption tube 3 are FLin.
1, FLin2, (FLout 1 + FLout
2) = (FLin1 + FLin2) = flow rate F of pump 10
L.

Also, one pipe 2a in the water supply tube 2
The temperature of the temperature sensor 5 at the tip of (flow rate FLout 1) is Tout 1, the temperature of the temperature sensor 5 at the tip of the other pipeline 2b (flow rate FLout 2) is Tout 2, and the water absorption tube 3
The temperature of the temperature sensor 5 at the tip of one of the pipes 3a (flow rate FLin1) is set to Tin1, and the other pipe 3b (flow rate FLin).
The temperature of the temperature sensor 5 at the tip of 2) is defined as Tin2.

When the start switch is operated,
As shown in the flowchart of FIG. 3, first, the temperature of the perfusate in the abdominal cavity H is measured by each temperature sensor 5 in step S1. Subsequently, an average value Tave of all temperatures is obtained (step S2).

Next, the temperatures on the water supply side (Tout 1, Tout
2) The average value Tout A and the temperature on the water absorption side (Tin1, Ti)
n2) and the difference Td between these two averages.
Find if (step S3).

Further, in the next step S4, the pressure gauge 12
To measure the pressure P in the internal conduit 7 of the device main body 1,
It is determined whether or not the pressure P is larger than a preset pressure allowable value Plim (step S5). Here, if it is determined that the measured pressure P is larger than the allowable pressure value Plim, the process proceeds to the next step S6, where the second valve 11b is opened for a short time Δt, and the flow rate of the pump 10 is reduced (step S7). ). Thereafter, the process proceeds to the next step, step 10 in the flowchart of FIG.

If it is determined in step S5 that the measured pressure P is smaller than the allowable pressure value Plim, the flow advances to step S8 to determine whether the average difference Tdif is larger than a preset temperature difference allowable value Tdlim. Judge. Here, when it is determined that the difference Tdif between the average values is larger than the temperature difference allowable value Tdlim, it is determined that the irrigation flow rate is insufficient, and the flow rate of the pump 10 is increased (step S9). afterwards,
Proceed to the next step 10.

In step S8, the difference Tdif between the average values is determined.
Is determined to be equal to or less than the temperature difference allowable value Tdlim, the flow proceeds to the next step 10 as it is. As a result, a perfusion solution having an irrigation flow rate sufficient for heating within a safe pressure range can flow into the abdominal cavity H.

In step S10, it is determined whether or not the average temperature Tave is higher than a preset temperature Tset. Here, when it is determined that the average value Tave of the temperature is higher than the set temperature Tset, the temperature of the heater 8 is lowered (step S11). Thereafter, the process proceeds to the next step S14.

In step S10, the average value Tave
Is not higher than the set temperature Tset, the process proceeds to the next step S12. Here, conversely, the average temperature T
It is determined whether or not ave is lower than the set temperature Tset. Here, when it is determined that the average value Tave of the temperature is lower than the set temperature Tset, the heater temperature is increased (step S5).
13). Thereafter, the process proceeds to the next step S14. In step S12, the average temperature Tave is equal to the set temperature Tset.
If it is not determined that it is lower, the process proceeds to the next step S14. Thereby, the temperature in the abdominal cavity H is adjusted so as to be maintained at the set temperature Tset.

Next, in step Sl4, the water supply tube 2
The temperatures (Tout 1 and Tout 2) of the temperature sensors 5 at the tips of the two pipelines 2a and 2b are compared, and the temperature Tout
It is determined whether 1 is higher than the temperature Tout2. If it is determined that the temperature Tout1 is higher than the temperature Tout2, the process proceeds to the next step S15, in which the flow rate FLout1 of one of the pipes 2a in the water supply tube 2 is reduced by dL, and the other is decreased. The flow rate FLout2 of the pipeline 2b is increased by dL. Thereafter, the process proceeds to the next step S18.

In step Sl4, the temperature Tout 1
If it is not determined that the temperature is higher than the temperature Tout2, the process proceeds to the next step S16. Here, conversely, the temperature T
It is determined whether out2 is higher than temperature Tout1. Here, if it is determined that the temperature Tout2 is higher than the temperature Tout1, the process proceeds to the next step S17, where the flow rate FLout2 is reduced by dL, and the flow rate FLout1 is changed to dL.
increase. Thereafter, the process proceeds to the next step S18. In step S16, the temperature Tout2 is smaller than the temperature Tout.
If it is not determined that it is higher than 1, the process proceeds to the next step S18. That is, of the flow rates of the perfusate in the two conduits 2a and 2b in the water supply tube 2, the flow rate of the lower temperature is increased so that the abdominal cavity H of the patient is heated more uniformly. .

Next, at step S18, the temperatures (Tin1, Tin2) of the temperature sensors 5 at the tips of the two pipes 3a, 3b of the water absorption tube 3 are compared, and whether or not the temperature Tin1 is higher than the temperature Tin2. Judge. Here, the temperature Tin
If it is determined that 1 is higher than the temperature Tin2, the process proceeds to the next step S19, in which the flow rate FLin1 is decreased by dL and the flow rate FLin2 is increased by dL. Then, step S
Returned to 1.

If it is not determined in step S18 that the temperature Tin1 is higher than the temperature Tin2, the process proceeds to the next step S20. Here, it is determined whether the temperature Tin2 is higher than the temperature Tin1. Here, the temperature Tin
If it is determined that the temperature 2 is higher than the temperature Tin1, the process proceeds to the next step S21, in which the flow rate FLin2 is decreased by dL and the flow rate FLin1 is increased by dL. Step S2
If it is not 0 and it is not determined that the temperature Tin2 is higher than the temperature Tin1, the process returns to step S1. In other words, in this water absorption tube 3 as well as in the water supply tube 2 side, of the flow rates of the perfusate in the two conduits 3a and 3b in the water absorption tube 3, the flow rate of the lower temperature is increased, and the water is more uniformly heated. To be adjusted.

When the series of steps S1 to S21 is completed, the process returns to step S1 to repeat the same steps. Then, at the end of the circulation operation of the perfusate, a stop switch (not shown) of the setting / display unit 15 is pressed. When the stop switch is pressed, the heater 8 is turned off, and the heating ends. At this time, the pump 10 continues to rotate.

Further, when the perfusion solution collection button (not shown) of the setting / display unit 15 is pressed after the completion of the heating, the first valve 1
1a, third valve 11c closed, second valve 11
b is switched to the open state. Therefore, in this case, the perfusate in the abdominal cavity H is sucked toward the apparatus main body 1 via the water absorption tube 3 and is collected in the tank 9 by the operation of the pump 10.

Therefore, the above configuration has the following effects. That is, in the present embodiment, the perfusate is supplied into the abdominal cavity H through the two conduits 3a and 3b in the water absorption tube 3 with the driving of the pump 10 during the fluid perfusion in which the perfusate is perfused into the peritoneal cavity H. The perfusate in the peritoneal cavity H is perfused into the peritoneal cavity H by collecting the perfusate in the peritoneal cavity H through the two conduits 3a and 3b in the water absorption tube 3. At this time, each pipe 2 of the water supply tube 2 and the water absorption tube 3
a, 2b, 3a, and 3b, the temperature of the perfusate in the abdominal cavity H is measured by the temperature sensor 5 at each tip, and three valves are controlled by the control unit 13 based on the measurement result measured by the temperature sensor 5. 11a to 11c,
By controlling the first flow divider 7a and the second flow divider 7b and controlling the flow rate of the perfusate perfused by the pump 10, the uniform and constant temperature warm water in the abdominal cavity H can be easily performed. Therefore, there is an effect that the perfusate is circulated in the abdominal cavity H without opening the abdomen, and the warm water in the abdominal cavity H can be more easily and stably heated.

FIGS. 5 to 7 show a second embodiment of the present invention. This embodiment relates to a first embodiment of the intraperitoneal perfusion heating apparatus of the first embodiment (see FIGS. 1 to 4).
Instead of the flow divider 7a and the second flow divider 7b, the first flow meter 16a is connected to the connection portion with the water supply tube 2 and the second flow meter 16 is connected to the connection portion with the water absorption tube 3 in the apparatus main body 1.
b. The other parts have the same configuration as that of the intraperitoneal perfusion heating device of the first embodiment, and the same reference numerals are used for the same portions as those of the intraperitoneal perfusion heating device of the first embodiment. The description is omitted here.

When the intraperitoneal perfusion warming apparatus of the present embodiment is used, two trocars 4 are respectively punctured into the abdominal wall of the patient as shown in FIG. Is inserted into. Further, the water supply tube 2 and the water absorption tube 3 for the perfusate are inserted into the abdominal cavity H through each trocar 4 penetrating the abdominal wall.

The method of filling and perfusing the perfusate in the present embodiment is the same as in the first embodiment. And
In the present embodiment, the control unit 13 monitors the pressure and the flow rate during the perfusion of the perfusate according to the flowchart of FIG. 7 and detects a water leak and a perfusion abnormality as follows.

First, in step S30, the pressure P in the internal conduit 7 of the apparatus main body 1 is measured by the pressure gauge 12, and it is determined whether or not this pressure P exceeds a preset allowable pressure value Plim. (Step S31). Here, when it is determined that the measured pressure P exceeds the allowable pressure value Plim, the process proceeds to the next step S32, and the second valve 11b is opened for a short time Δt. Thereafter, the process returns to step S30.

If it is not determined in step S31 that the measured pressure P exceeds the allowable pressure value Plim (if the pressure P is equal to or less than the allowable value Plim), the process proceeds to step S3.
Proceed to 3 to measure the flow rates of the flow meters 16a and 16b.

Subsequently, in the next step S34, it is determined whether or not the flow rate difference between the two flow meters 16a and 16b exceeds an allowable value. Here, when it is determined that the flow rate difference does not exceed the allowable value, the process returns to step S30.

In step S34, two flow meters 1
If it is determined that the flow rate difference between 6a and 16b exceeds the allowable value, an error is displayed in the next step S35. The method of displaying the error may be both the LED and the speaker, or one of them.

Further, in the next step S36, the setting and
It is determined whether or not a reset switch (not shown) on the display unit 15 has been pressed to reset an error. Here, if it is determined that the error has been reset, the next step S
At 37, the error display is erased and the process ends.

If it is determined in step S36 that the reset has not been performed, the process proceeds to the next step S38. Here, it is determined whether or not a predetermined time has elapsed. Here, when it is determined that a certain time has elapsed (when an error is not reset within a certain time)
Then, the process proceeds to the next step S39, in which the perfusate is automatically collected, and the process ends. The operation for collecting the perfusate is the same as in the first embodiment. Further, step S3
If it is determined in step 8 that the predetermined time has not elapsed, the process returns to step S36.

Therefore, the above configuration has the following effects. That is, in the present embodiment, the first flow meter 16 is connected to the connection portion of the apparatus main body 1 with the water supply tube 2.
a. Since the second flow meters 16b are respectively provided at the connection portions with the water absorption tubes 3, the flow difference between the two flow meters 16a and 16b is monitored to detect and notify abnormal perfusion due to water leakage or the like. it can. In addition, if the response is delayed, the perfusion solution is automatically collected, which is safer.

FIGS. 8 and 9 show a third embodiment of the present invention. In the present embodiment, the configuration of the intraperitoneal perfusion heating apparatus of the second embodiment (see FIGS. 5 to 7) is changed as follows.

That is, in the present embodiment, the optical sensor 17 for monitoring the color of the perfusate is provided downstream of the second flow meter 16b at the connection portion of the device main body 1 of the intraperitoneal perfusion heating device with the water absorption tube 3. It is provided. The other parts have the same configuration as the intraperitoneal perfusion heating device of the second embodiment, and the same reference numerals are used for the same portions as the intraperitoneal perfusion heating device of the second embodiment. The description is omitted here.

The method of filling and perfusing the perfusate in the intraperitoneal perfusion heating apparatus of the present embodiment is the same as that of the first embodiment. In this embodiment, the control unit 13 monitors the pressure, the flow rate, and the color of the perfusate during perfusion of the perfusate according to the flowchart of FIG. 9 and detects water leakage, perfusion abnormality, and bleeding as follows. It is.

First, in step S40, the pressure P in the internal pipe 7 of the apparatus main body 1 is measured by the pressure gauge 12. Subsequently, in the next step S41, it is determined whether or not the pressure P exceeds a preset allowable value Plim. Here, when it is determined that the measured pressure P exceeds the allowable pressure value Plim, the process proceeds to the next step S42, and the second valve 11b is opened for a short time Δt. Thereafter, the process returns to step S40.

If it is determined in step S41 that the measured pressure P is equal to or less than the allowable value Plim, the process proceeds to step S4.
Proceed to 3 to measure the flow rates of the flow meters 16a and 16b.

Subsequently, in the next step S44, it is determined whether or not the flow rate difference between the two flow meters 16a and 16b exceeds an allowable value. Here, when it is determined that the flow rate difference exceeds the allowable value, the process proceeds to step S47, and an error is displayed.

In step S44, two flow meters 1
If it is determined that the flow rate difference between 6a and 16b is equal to or smaller than the allowable value, the optical sensor 17 is checked in the next step S45. Subsequently, in the next step S46, it is determined whether or not there is a color change in the perfusate. If it is determined that there is a color change in the perfusate, the process proceeds to step S47, and an error is displayed. If it is determined in step S46 that there is no color change in the perfusate, the process returns to step S40.

The method of displaying the error in step S47 may be both the LED and the speaker, or one of them. Then, after an error is displayed in step S47, in the next step S48, it is determined whether or not a reset switch (not shown) in the setting / display unit 15 is pressed to reset the error. Here, if it is determined that the error has been reset, the error display is erased in the next step S49, and the process ends.

If it is determined in step S48 that the reset has not been performed, the process proceeds to the next step S50. Here, it is determined whether or not a predetermined time has elapsed. Here, when it is determined that a certain time has elapsed (when an error is not reset within a certain time)
Then, the process proceeds to the next step S51, in which the perfusate is automatically collected, and the process ends. The operation for collecting the perfusate is the same as in the first embodiment. Further, step S5
If it is determined that the predetermined time has not elapsed, the process returns to step S48.

Therefore, the above configuration has the following effects. That is, in the present embodiment, the second flow meter 16b at the connection portion of the apparatus main body 1 with the water absorption tube 3 is provided.
The optical sensor 17 for monitoring the color of the perfusate is provided on the downstream side of the above. In addition to the effect of the second embodiment, the presence or absence of bleeding is detected by monitoring the color change of the perfusate using the optical sensor 17. There is an effect that can be announced.

FIGS. 10A, 10B, and 16 show a fourth embodiment of the present invention. In the present embodiment, a living body access unit 21 is provided instead of the water supply tube 2 and the water absorption tube 3 of the intraperitoneal perfusion heating device of the first embodiment (see FIGS. 1 to 4).

The living body access part 21 is provided with a substantially tubular shaft 22 as shown in FIG. A grip 23 is provided at a base end of the shaft 22. A luer base 24 that communicates with the inner cavity 22 a of the shaft 22 protrudes from the base end of the grip 23.

A valve 25 capable of opening and closing the inner cavity 22a of the shaft 22 is mounted on the grip 23, and one end of a sensor lead 26 is connected thereto. A sensor connector 27 is connected to the other end of the sensor lead 26 as shown in FIG.

At the tip of the grip 23, two fitting claws 28 for connection are projected. The fitting claw 28 is adapted to be removably fitted to a mantle tube 30 of a trocar 29 (shown in FIGS. 14 to 16) which will be described later and used in combination with the living body access unit 21.

Further, on the outer peripheral surface of the grip 23, an open button 31 interlocked with the fitting claw 28 is provided. When the release button 31 is operated, the fitting claw 28 is moved in the direction of releasing the engagement of the trocar 29 with the outer tube 30.

FIG. 13 shows the tip of the shaft 22.
As shown in (A) and (B), for example, a temperature sensor 32 such as a thermocouple, a thermistor, or an optical fiber, and a pressure sensor 33 are provided. Output signal lines of each of the temperature sensor 32 and the pressure sensor 33 are connected to the sensor lead 26 described above.

FIG. 14 shows a representative example of a trocar 29 used in combination with the living body access section 21 of the present embodiment. The trocar 29 has been conventionally and generally used for laparoscopic surgery, and is used in combination with an inner needle 34 shown in FIG. 15 and an outer tube 30 shown in FIG.

Here, an elongated shaft 35 is attached to the inner needle 34.
Is provided with a sharp puncturing portion 36 at the tip end. Further, a grip portion 37 is provided at a base end of the shaft 35. The grip unit 37 includes the living body access unit 21.
Are provided with two fitting claws 38 and a release button 39 having substantially the same configuration as the two fitting claws 28 of the grip 23 and the release button 31 thereof.

The outer tube 30 has a tubular shaft portion 4.
0, and a large-diameter connecting cylinder 41 connected to the base end of the shaft 40. Inside the mantle tube 30, the inner needle 34 or the living body access unit 21 of the present embodiment is provided.
Of the shaft 22 is removably inserted. Then, with the inner needle 34 inserted into the outer tube 30 to a predetermined set position, the two fitting claws 38 of the inner needle 34 can be engaged with and disengaged from an engagement groove (not shown) of the connecting tubular portion 41. , The outer tube 30 and the inner needle 34 are integrally assembled. The mantle tube 30
Similarly, when the shaft 22 of the living body access unit 21 is inserted into the inside, the grip 23 of the living body access unit 21 is kept in a state where the shaft 22 is inserted to a predetermined set position.
The two fitting claws 28 are removably fitted into an engaging groove (not shown) of the connecting cylinder portion 41, so that the mantle tube 30 and the living body access portion 21 are integrally assembled. I have. In a state where the mantle tube 30 and the living body access unit 21 are integrally assembled, the distal end of the shaft 22 of the living body access unit 21 is disposed forward of the position of the front end of the shaft portion 40 of the mantle tube 30. It is desirable to be designed to

Next, the operation of the above configuration will be described.
FIG. 10A shows an actual use mode of the intraperitoneal perfusion heating apparatus of the present embodiment. When using the intraperitoneal perfusion heating device of the present embodiment, the trocar 2 shown in FIG.
9 is punctured into the peritoneum of the living body P. At this time, the trocar 29 is used in a state where the outer tube 30 and the inner needle 34 are integrally assembled. Then, the puncture portion 36 of the inner needle 34 is pierced into the peritoneum of the living body P and penetrates the peritoneum, and the shaft portion 40 of the mantle tube 30 is inserted into the abdominal cavity H together with the inner needle 34.

Further, after the shaft portion 40 of the mantle tube 30 is inserted into the abdominal cavity H, the inner needle 34 is removed from the mantle tube 30, and a laparoscope or forceps is usually inserted into the mantle tube 30. Observe and treat living tissues.

The living body access unit 21 according to the present embodiment
Is combined with the mantle tube 30 that has penetrated the peritoneum as described above. At this time, the living body access unit 21 is placed in the mantle tube 30.
Of the living body access portion 21 in a state where the shaft 22 is inserted and the shaft 22 is inserted to a predetermined set position.
By fitting the two fitting claws 28 of the grip 23 into an engaging groove (not shown) of the connecting tubular portion 41 so as to be detachable, the outer tube 30 and the living body access portion 21 are integrally assembled.

FIG. 10A shows a state where a plurality of living body access sections 21 are used in combination with the mantle tube 30. Here, each living body access unit 21
One end of a perfusion tube 42 is connected to the luer base 24. The other ends of these perfusion tubes 42 are connected to the apparatus main body 1 of the intraperitoneal perfusion heating apparatus of the first embodiment. Further, the sensor lead 2 of each living body access unit 21
Similarly, the sensor connector 27 of No. 6 is connected to the device main body 1 of the intraperitoneal perfusion heating device.

Here, the plurality of living body access parts 21 are arbitrarily selected so as to be an inlet and an outlet for perfusion arbitrarily, and hot water from the apparatus main body 1 of the intraperitoneal perfusion heating apparatus is introduced into the abdominal cavity.
It is possible to discharge.

The detection signals of the temperature sensor 32 and the pressure sensor 33 installed in each living body access unit 21 are fed back to the apparatus main body 1 of the intraperitoneal perfusion heating apparatus, and the temperature and flow rate of the perfused hot water are measured. You only have to control it.

Further, in the first embodiment, a configuration is shown in which the pressure of the hot water of the perfusion water is detected inside the apparatus main body 1 of the intraperitoneal perfusion heating apparatus. As described above, the direct detection of the pressure in the abdominal cavity is more effective in terms of treatment safety, and it is a matter of course that this configuration may be added to or replaced by the first embodiment.

FIG. 10B shows another usage state of the living body access unit 21 of the present embodiment. Here, it is also possible to puncture the mantle tube 30 of the trocar 29 into a portion near the four corners of the abdominal cavity H to perform a hot water perfusion treatment. The puncture site of the mantle tube 30 of the trocar 29,
Alternatively, the required number of puncturing points is arbitrarily selected by the operator, and is of course not limited to the number shown in FIGS.

Therefore, the above configuration has the following effects. That is, according to the present embodiment, the connection and operability of the living body access unit 21 at the time of the intraperitoneal hot water perfusion treatment become very easy, and the invasion degree of the conventional trocar 2 is reduced.
9 is the same as when using No. 9, so that the burden on the patient can be reduced.

FIGS. 17 to 21 show a fifth embodiment of the present invention. In the present embodiment, the configuration of the living body access unit 21 of the fourth embodiment (see FIGS. 10A, 10B and 16) is changed as follows.

FIG. 18 shows a living body access unit 5 according to this embodiment.
1 shows a schematic configuration. The living body access section 51 of the present embodiment is provided with a substantially tubular shaft 52 and a cover 53 slidable along the axial direction of the shaft 52.

Further, a grip 54 is provided at the base end of the shaft 52. The grip 54 has an elongated hole 55 for a slide guide of the cover 53.
An insertion portion 53a is formed on the base end side of the cover 53 so as to be removably inserted into the grip 54 of the shaft 52. A cover knob 56 is provided at an edge of the insertion portion 53a. The cover knob 56 is inserted into an elongated hole 55 of the grip 54. By sliding the cover knob 56 in the axial direction of the shaft 52 along the elongated hole 55 of the grip 54, the cover 53 can be slid in the axial direction of the shaft 52.

As shown in FIG. 20, a plurality of, in this embodiment, four tubes 57 are inserted into the shaft 52. Further, the proximal end of each tube 57 extends from the proximal end of the grip 54. A luer base 58 communicating with each tube 57 is connected to an extension of each tube 57, and a valve 59 capable of opening and closing the inner cavity of each tube 57 is provided.

Further, a temperature sensor 32 and a pressure sensor 33 (see FIGS. 13A and 13B) similar to those of the fourth embodiment are provided at the distal end of each tube 57.
Further, one end of a sensor lead 60 connected to the temperature sensor 32 and the pressure sensor 33 of each tube 57 is connected to the base end of the grip 54. The sensor connector 27 (see FIG. 12) similar to that of the fourth embodiment is connected to the other end of the sensor lead 60.

Further, two fitting claws 61 for connection protrude from the distal end of the grip 54 in the same manner as in the fourth embodiment. The fitting claw 61 is used in combination with the trocar 29 (shown in FIGS. 14 to 16).
The outer tube 30 is detachably fitted to the outer tube 30. Further, on the outer peripheral surface of the grip 54, an open button 62 interlocked with the fitting claw 61 is provided.

FIG. 21 shows the distal end of each tube 57.
As shown in FIG. 7, a bending habit portion 63 which is bent in a substantially L-shape is provided in advance. Note that a metal braided structure or the like may be provided on the wall of each tube 57 as necessary. further,
In the present embodiment, an example in which four tubes 57 are arranged is shown, but the number may be increased or decreased as necessary.

Next, the operation of the above configuration will be described.
FIG. 17 shows the actual use of the intraperitoneal perfusion heating apparatus of the present embodiment. In the case where the living body access unit 51 of the present embodiment is installed on the living body P, the trocar 29 of FIG. 14 is previously set in the central part of the peritoneum of the patient as shown in FIG. At a point, the peritoneum of the living body P is punctured. Thereafter, the inner needle 34 of the trocar 29 is pulled out, and the outer tube 30 of the trocar 29 and the living body access unit 51 are combined. At this time, the living body access unit 51
The cover 53 is slid in advance to a protruding position where it protrudes forward of the shaft 52 as shown in FIGS. Therefore, in this state, the bending habit 63 at the distal end of each tube 57 is held in a state housed in the cover 53.

Further, after combining the mantle tube 30 of the trocar 29 and the living body access section 51, the cover knob 5
6 is operated to slide the cover 53 backward on the shaft 52. As the cover 53 slides, the distal end of each tube 57 is exposed to the outside. Then, the insertion portion 53a of the cover 53 is
Of the tube 6 at the distal end of each tube 57.
When the whole 3 is exposed to the outside, as shown in FIG. 21, the bending habit portion 63 at the distal end of each tube 57 is automatically developed into the original bending habit shape in which the tube is bent substantially in an L-shape.

As shown in FIG. 17, a suitable holding arm 64 is provided near the bed on which the patient is placed. By attaching the grip 54 of the living body access unit 51 to the distal end of the holding arm 64 via the suspension means 65, a load on the patient can be avoided.

The luer base 5 of each living body access unit 51
8 is connected to one end of a perfusion tube 42 as in the fourth embodiment. The other ends of these perfusion tubes 42 are connected to the apparatus main body 1 of the intraperitoneal perfusion heating apparatus of the first embodiment. Further, the sensor connector 27 of the sensor lead 60 of each living body access unit 51 is similarly connected to the device main body 1 of the intraperitoneal perfusion heating device. Here, the plurality of tubes 57 disposed inside the living body access unit 51 may be individually selected as an inlet and an outlet for the perfusate, and if necessary, another living body access unit 71 may be used.
It may be the perfusion inlet or outlet.

Therefore, the above configuration has the following effects. That is, according to the present embodiment, a plurality of, in this embodiment, four tubes 57 are inserted into the shaft 52 of one living body access portion 51, and each tube 57 is individually connected to the inlet and outlet of the perfusate. The number of insertion holes (access ports) of the living body access portion 51 formed in the living body P of the patient can be reduced, and the burden on the patient can be further reduced. Can be.

FIGS. 22 to 24 show a sixth embodiment of the present invention. In this embodiment, FIG.
A liquid reflux catheter 81 shown in (A) and (B) is provided.

The liquid reflux catheter 81 of the present embodiment.
Is provided with an elongated insertion portion 82 to be inserted into the abdominal cavity of the patient as shown in FIG. This insertion portion 82
The gripping part 83 is connected to the base end of.

The insertion section 82 is provided with a soft intra-abdominal tube 84 and a hard outer tube 85 which is larger in diameter and shorter in length than the intra-abdominal tube 84. The intraperitoneal tube 84 and the mantle tube 85 are arranged coaxially.

Further, a hollow distal capsule 86 is provided at the distal end of the intraperitoneal tube 84. As shown in FIG. 23 (B), an insertion hole 86a for the intraperitoneal tube 84 is formed at one end of the tip capsule 86.
The distal end of the intraperitoneal tube 84 is inserted into the insertion hole 86.
a and inserted into the inside of the distal capsule 86, and in this state, the distal capsule 86 and the distal end of the intraperitoneal tube 84 are fixed in a watertight manner.

Further, a liquid injection hole 87 as a plurality of small holes is provided on the side surface of the tip capsule 86. And
The liquid Q injected from the intraperitoneal tube 84 is injected into the abdominal cavity through the liquid injection hole 87.

An injection part temperature sensor 88 is provided at a position close to the liquid injection hole 87. One end of a temperature sensor cable 89 is connected to the temperature sensor 88.

Further, a plurality of small holes, ie, liquid recovery holes 90, are provided on the side surface of the mantle tube 85. The liquid Q in the abdominal cavity flows into the outer tube 85 through the liquid recovery hole 90.

At a position close to the liquid collecting hole 90, a collecting section temperature sensor 91 is provided. One end of a temperature sensor cable 89 is connected to the temperature sensor 91.

Further, a water injection cap 92 and a collection cap 93 are provided in the grip portion 83. And the water inlet 92
, A liquid injection tube 94 and a recovery base 93 are mounted with a liquid recovery tube 95, respectively.

Further, two flow paths 96,
97 are pierced. Here, the distal end of one of the first flow paths 96 is connected to the proximal end of the intraperitoneal tube 84, and the proximal end is connected to the water inlet 92. Also, the other second
Is connected to a space between the base end of the mantle tube 85 and the base end of the intraperitoneal tube 84, and the base end is connected to the collection base 93.

Then, the liquid Q injected from the water inlet 92 is supplied from the first flow path 96 of the grip 83 to the intraperitoneal tube 8.
4, and flows out from the liquid injection hole 87 of the distal capsule 86 through the intraperitoneal tube 84. Further, the liquid Q taken into the mantle tube 85 from the liquid collection hole 90 of the mantle tube 85 flows into the collection base 93 through the second flow path 97 of the grip portion 83, and further flows from the collection base 93 to the liquid collection tube. 95 to be discharged.

FIG. 22 shows the use state of the liquid reflux catheter 81 of this embodiment. Although two or more liquid reflux catheters 81 of the present embodiment are used at the same time, in the present embodiment, three liquid reflux catheters 81A, 81 are used.
The case where B and 81C are used will be described.

Here, the three liquid reflux catheters 81A, 81B and 81C of the present embodiment are respectively inserted into the abdominal cavity H via the trocar 98 previously punctured into the abdominal wall of the patient as shown in FIG. It has become so. Further, the liquid injection tube 94 and the liquid recovery tube 9 connected to the liquid reflux catheter 81 of the present embodiment.
5 and the other end of the temperature sensor cable 89 are connected to a control unit (apparatus main body) 99 of the intraperitoneal perfusion heating apparatus.

As shown in FIG. 24, the control unit 99 has an internal conduit 10 in which a liquid recovery pump 100, a liquid tank 101, and a liquid injection pump 102 are connected in series.
3 are provided. Further, a liquid heating unit 104 is connected to the internal conduit 103 downstream of the liquid injection pump 102. The liquid heating unit 104 is configured to heat the liquid Q passing through the tube by absorbing heat by passing through a coiled tube placed in a hot water tank (not shown). The temperature in the hot water tank is controlled to be maintained at a preset temperature.

Further, a collection catheter selection valve unit 10 is provided at one end (liquid collection end) side of the internal conduit 103.
5. An infusion catheter selection valve unit 106 is connected to the other end (liquid injection end) side. Here, the collection catheter selection valve unit 105 is provided with a plurality of, in this embodiment, three, collection catheter selection valves 105a to 105c. Further, the infusion catheter selection valve unit 106 similarly includes a plurality of, in this embodiment, three infusion catheter selection valves 106.
a to 106c are provided. The three collection catheter selection valves 105a to 105c of the collection catheter selection valve unit 105 have the liquid collection tubes 95 of the three liquid reflux catheters 81A, 81B, and 81C.
Are connected to each other. Similarly, the three infusion catheter selection valves 106a to 106c of the infusion catheter selection valve unit 106 are connected to the liquid infusion tubes 94 of the three liquid reflux catheters 81A, 81B, and 81C, respectively.

The liquid reflux catheters 81A, 81A
After passing through the collection catheter selection valve unit 105, the flow path of the liquid Q collected from the liquid collection tubes 95 from the first and second liquid passages 1B and 81C merges into one flow path.
03 and sucked into the liquid recovery pump 100,
The liquid Q discharged from the liquid recovery pump 100 is sent to and stored in a liquid tank 101.

Further, the liquid in the liquid tank 101 is pumped up again by the liquid injection pump 102 and relayed to the liquid heating section 104. The liquid injection path from the liquid heating unit 104 is divided into a plurality of liquids, and after flowing into the three injection catheter selection valves 106a to 106c of the injection catheter selection valve unit 106, the three liquid reflux catheters 81A, 81B, 8
The liquid is supplied to a liquid injection tube 94 of 1C. Note that the same discharge amount is used for the liquid injection pump 102 and the liquid recovery pump 100.

The proximal end of the temperature sensor cable 89 is connected to the intraperitoneal temperature measuring section 107 of the control unit 99. Further, the central control unit 1 is provided in the control unit 99.
08 is provided. The central control unit 108 includes an intraperitoneal temperature measuring unit 107, an infusion catheter selection valve unit 106, and a collection catheter selection valve unit 105.
Are connected respectively. And the intraperitoneal temperature measuring unit 1
Based on the measurement data from 07, the centralized control unit 108 controls the infusion catheter selection valve unit 106 and the collection catheter selection valve unit 105 as follows.

That is, when the liquid reflux catheters 81A, 81B, 81C of the present embodiment are used, the tip capsule 86 of the liquid reflux catheters 81A, 81B, 81C is used.
The temperature TaIN of each injection part temperature sensor 88 provided in
TbIN and TcIN are measured by the intraperitoneal temperature measuring unit 107 and sent to the central control unit 108. This central control unit 10
In step 8, a comparison operation is performed between TaIN, TbIN, and TcIN, and the liquid reflux catheter 8 at which the lowest temperature TxIN is measured.
Specify 1x.

The infusion catheter selection valve 10 connected to the flow path to the designated liquid reflux catheter 81x.
Control the infusion catheter selection valves 106a-106c to open only 6x and close the remaining valves.

Similarly, the liquid reflux catheter 81
The temperatures Taout, Tbout, and Tcout of the recovery unit temperature sensors 91 provided in the outer tubes 85 of A, 81B, and 81C.
Is measured by the intraperitoneal temperature measurement unit 107 and sent to the central control unit 108. In this centralized control unit 108, Taout
, Tbout and Tcout are compared, and the liquid reflux catheter 81x at which the lowest temperature Txout is measured is designated.

The recovery catheter selection valve 10 connected to the flow path to the designated liquid reflux catheter 81x.
The collection catheter selection valves 105a to 105c are controlled so that only 5x is opened and the remaining valves are closed.

Next, the operation of the above configuration will be described.
The liquid reflux catheters 81A, 81B of the present embodiment,
When using 81C, three liquid recirculation catheters 81 are passed through a trocar 98 previously punctured into the abdominal wall of the patient.
A, 81B and 81C are inserted into the abdominal cavity H of the patient, respectively. Here, each of the liquid reflux catheters 81A, 81B,
In 81C, the liquid injection hole 87 is disposed on the distal end side and the liquid recovery hole 90 is disposed on the proximal side, so that the liquid injection hole 87 is naturally located in the deep part of the abdominal cavity H and the liquid recovery hole 90 is located in the shallow part. I do.

After that, the liquid injection pump 102 is operated. At this time, the liquid Q pumped from the liquid tank 101 is heated to a certain temperature that passes through the liquid heating unit 104, and the liquid reflux catheters 81A, 81B, 81
C is injected into the abdominal cavity H of the patient. Then, the inside of the abdominal cavity H of the patient is filled with the heated liquid Q, and the abdominal cavity wall and the organ surface are heated to a preset temperature.

Further, after the liquid Q is filled in the abdominal cavity H,
At the same time as the operation of the liquid recovery pump 100, the control of the central control unit 108 is started as described above. That is, 3
In each of the injection part temperature sensors 88 of the two liquid reflux catheters 81A, 81B, 81C, at the lowest temperature site,
The heated liquid Q is injected.

Furthermore, three liquid reflux catheters 81
The liquid Q is collected from the part with the lowest temperature among the collecting section temperature sensors 91 of A, 81B, and 81C. At this time, since the discharge amounts of the liquid injection pump 102 and the liquid recovery pump 100 are the same, the liquid amount in the abdominal cavity H is kept constant.

Thus, the above configuration has the following effects. That is, according to the present embodiment, since the liquid injection holes 87 are arranged on the distal end side of each of the liquid reflux catheters 81A, 81B, 81C and the liquid recovery holes 90 are arranged on the hand side, the liquid reflux catheter 81A, 81B, 81
When C is inserted into the abdominal cavity H of the patient, the liquid injection hole 87 can be naturally located at the deep part of the abdominal cavity H, and the liquid recovery hole 90 can be naturally located at the shallow part. Therefore, the heated liquid can be injected from the deep part of the abdominal cavity H and recovered from the shallow part, so that the temperature gradient in the vertical direction generated by the convection of the liquid is reduced, and the entire inside of the abdominal cavity H is kept at a uniform temperature. Has the effect of approaching.

In the present embodiment, since the liquid is collected from the part having the lowest temperature among the collecting sections of the three liquid reflux catheters 81A, 81B and 81C, the cooled liquid is efficiently collected and the abdominal cavity H It has the effect of always keeping the inside at a constant temperature. Furthermore, in the present embodiment, the heated liquid is injected into the portion having the lowest temperature among the injection sections of the three liquid reflux catheters 81A, 81B, and 81C.
The effect of keeping the temperature in the abdominal cavity H more constant can be expected.
Therefore, the liquid filled in the abdominal cavity H is kept at a constant temperature and the temperature is kept uniform, so that efficient thermal treatment can be performed.

FIG. 25 shows a seventh embodiment of the present invention. In the present embodiment, an intraperitoneal hot water perfusion system 112 incorporated in an MRI apparatus 111 is provided as shown in FIG. Here, M of the present embodiment
The RI device 111 is provided with a country 113 and an MRI device main body 114.

Further, a hot water perfusion apparatus 116 is connected to the MRI apparatus main body 114 via an interface apparatus 115 in the intraperitoneal hot water perfusion system 112 of the present embodiment. The country 113 and the MRI apparatus main body 1
14, the signal control lines 117, 1 between the MRI apparatus main body 114 and the interface apparatus 115, and between the interface apparatus 115 and the hot water perfusion apparatus 116, respectively.
18 and 119 are connected.

Further, one end of a perfusion tube 120 is connected to the hot water perfusion device 116. The other end of the perfusion tube 120 is provided in the fourth embodiment (FIG. 10).
(A), (B) to FIG. 16) (see FIG. 16)
The living body access unit 121 having the same configuration as that of is connected.

Next, the operation of the above configuration will be described.
In the present embodiment, it is possible to obtain temperature information in an arbitrary section or space of the living body P by MRI observation of the MRI apparatus 111. MR of general MRI apparatus 111
The temperature information obtained from the I device main body 114 can be used for controlling the hot water perfusion device 116 via the interface device 115.

At this time, it is natural that the living body access section 121 is made of a material having MRI compatibility. Further, detection information from a temperature sensor installed in the living body access unit 121 or installed in the living body P may be used as the absolute reference temperature information.

Therefore, the above configuration has the following effects. That is, in the present embodiment, the reliability of temperature management in the abdominal cavity H is improved by increasing the information amount, and control for further reducing the temperature unevenness of the hot water in the abdominal cavity H becomes possible.

Further, the present invention is not limited to the above-described embodiment, and it goes without saying that various modifications can be made without departing from the spirit of the present invention. Next, other characteristic technical matters of the present application will be additionally described as follows. (Appendix 1) Fluid perfusion means for supplying and recovering fluid into the abdominal cavity, fluid perfusion adjusting means for controlling at least one of temperature, flow rate, and flow distribution of the fluid, and temperature for measuring the temperature in the abdominal cavity An intraperitoneal perfusion warming device comprising a measuring means and a control means for controlling the fluid perfusion adjusting means based on a signal from the temperature measuring means.

(Additional Item 2) At least one temperature sensor arranged near the outlet and the inlet of the plurality of fluids, a fluid perfusion adjusting means for adjusting the temperature, the total flow rate, and the flow rate distribution of the fluid; Control means for controlling the fluid perfusion adjusting means based on the intraperitoneal perfusion heating apparatus.

(Appendix 3) An intraperitoneal perfusion warming apparatus having means for measuring the flow rate of water fed into the abdominal cavity and the flow rate recovered from the abdominal cavity, and control means for performing perfusion control based on the flow rate difference.

(Appendix 4) Intraperitoneal perfusion heating having fluid change detecting means for detecting a change in the state of the fluid collected from the abdominal cavity and control means for performing perfusion control based on a signal from the fluid change detecting means apparatus.

(Appendix 5) An intraperitoneal perfusion warming apparatus in which the living body access unit includes a shaft, a lumen extending inside the shaft, and a means for attaching and detaching the trocar.

(Appendix 6) The apparatus according to Appendix 5, wherein the living body insertion section of the living body access section has a temperature detecting means.

(Additional Item 7) The apparatus according to additional items 5 and 6, wherein the living body insertion section of the living body access section has a pressure detecting means.

(Additional Item 8) A plurality of tube means provided in the shaft, a cover means movable on the shaft, and a means for expanding the tube means outside the outer diameter of the shaft when the cover means moves. 8. The apparatus according to any one of additional items 5 to 7 having.

(Additional Item 9) The device according to additional items 5 to 8, further comprising means for suspending the living body access unit.

(Supplementary Note 10) A liquid infusion pump, a liquid recovery pump, a liquid heating section, and an intraperitoneal hot water introduction catheter, wherein the intraperitoneal hot water introduction catheter has a double-pipe structure. An intraperitoneal perfusion heater.

(Additional Item 11) An additional item 1 characterized in that a plurality of the intraperitoneal hot water introduction catheters are provided.
0 device.

(Supplementary Item 12) A temperature measuring means provided on the intraperitoneal hot water introducing catheter, an introducing path selecting means for introducing a liquid into at least one of the plurality of intraperitoneal hot water introducing catheters, and the temperature measuring means 13. The apparatus according to claim 10, further comprising control means for controlling the introduction path selecting means based on a signal from the control unit.

(Appendix 13) The apparatus according to Appendix 12, wherein the introduction path selecting means is controlled so as to introduce the liquid into the catheter having the lowest temperature.

(Supplementary Note 14) An intraperitoneal perfusion heating system comprising an MRI observation device, a hot water perfusion device, an interface device for transmitting detection information of the MRI observation device to the hot water perfusion device, and a living body access section.

(Additional Item 15) The system according to Additional Item 14, which has a living body access unit made of a nonmagnetic material.

(Additional Item 16) The system according to additional items 14 and 15, wherein the detection information of the MRI observation apparatus is temperature information.

(Additional Item 17) A supply pipe having a flow path for supplying a fluid into the abdominal cavity, a recovery pipe having a flow path for collecting the fluid supplied into the abdominal cavity, and the supply pipe Pump means for perfusing the fluid through a pipe and the recovery pipe, temperature measuring means for measuring the temperature of the fluid, and fluid perfusion adjusting means for controlling the flow rate of the fluid perfused by the pump means And a control means for controlling the fluid perfusion adjusting means based on the measurement result measured by the temperature measuring means.

(Additional Item 18) A flow branching means for branching at least one of the supply pipe and the recovery pipe into a plurality of flow paths, and the fluid perfusion adjusting means adjusts a flow rate of each of the flow paths. Item 18. The intraperitoneal perfusion warming device according to Item 17, wherein:

(Supplementary Item 19) A supply pipe having a flow path for supplying a fluid into the abdominal cavity, a recovery pipe having a flow path for collecting the fluid supplied into the abdominal cavity, Pump means for perfusing the fluid through a pipe and the recovery pipe, temperature measuring means for measuring the temperature of the fluid, and fluid perfusion adjusting means for controlling the flow rate of the fluid perfused by the pump means And a control means for controlling the temperature of the perfused fluid based on the measurement result measured by the temperature measuring means.

(Prior Art in Supplementary Note 1) As a prior art relating to the present invention, a document “Intraperitoneal Chemoth”
erapy And Cytoreductive Surgery (The Ludann Co
mpany Grand Rapids. Michigan: Oct. 1995). Among them, `` III.Heated Intraoperative Intraperiton
"Eal Chemotherapy" discloses a treatment method in which a perfusate is circulated intraperitoneally under laparotomy. In addition, the operator manually agitates the perfusate in order to heat uniformly.

(Problem to be Solved by Supplementary Item 1) In the above-mentioned prior art, since the treatment is performed under laparotomy, the burden on the patient is very large. In addition, the treatment is complicated, such as the operator's agitation by hand, and it is difficult to perform a stable treatment.

(Object of Supplementary Item 1) An object of the present invention is to provide a device capable of heating the intraperitoneal warm water more easily and stably without laparotomy.

(Means for Solving the Problem in Additional Item 1)
It has means for circulating the perfusate in the abdominal cavity and a temperature sensor arranged in the abdominal cavity, and controls the temperature, perfusion flow rate, and flow path of the perfusate based on a signal from the temperature sensor.

(Function of Supplementary Item 1) The function according to the present invention is that uniform heating can be performed safely and safely under the abdominal cavity.

(Effect of Supplementary Item 1) According to the configuration described in Supplementary Item 1, not only the problem of the prior art that the burden on the patient is large and it is difficult to stably heat the heat is solved, but also
The unique effect that uniform heating can be performed automatically at a constant temperature is obtained.

[0147]

According to the present invention, the perfusate can be circulated in the abdominal cavity without opening the abdomen, and the intraperitoneal warm water can be more easily and stably heated.
In addition to stable heating, a unique effect of automatically and uniformly heating at a constant temperature can be obtained.

[Brief description of the drawings]

FIG. 1 is a schematic configuration diagram of an entire system showing a use state of an intraperitoneal perfusion heating device according to a first embodiment of the present invention.

FIG. 2 is a block diagram showing a schematic configuration inside a main body of the intraperitoneal perfusion heating apparatus according to the first embodiment.

FIG. 3 is a first flowchart for explaining the operation of the intraperitoneal perfusion heating apparatus according to the first embodiment.

FIG. 4 is a second flowchart for explaining the operation of the intraperitoneal perfusion heating apparatus according to the first embodiment.

FIG. 5 is a schematic configuration diagram showing a use state of the intraperitoneal perfusion heating device according to the second embodiment of the present invention.

FIG. 6 is a block diagram showing a schematic configuration inside a main body of the intraperitoneal perfusion heating apparatus according to the second embodiment.

FIG. 7 is a flowchart for explaining the operation of the intraperitoneal perfusion heating apparatus according to the second embodiment.

FIG. 8 is a block diagram showing a schematic configuration inside a main body of an intraperitoneal perfusion heating apparatus according to a third embodiment of the present invention.

FIG. 9 is a flowchart for explaining the operation of the intraperitoneal perfusion heating apparatus according to the third embodiment.

FIG. 10 shows a usage pattern of the living body access unit according to the fourth embodiment of the present invention, in which (A) is a longitudinal sectional view of a main part showing a state where a trocar is inserted into the abdominal cavity of a patient,
(B) is a plan view of (A).

FIG. 11 is a plan view showing a living body access unit according to a fourth embodiment.

FIG. 12 is a side view showing a living body access unit according to a fourth embodiment.

13A is a cross-sectional view taken along line AA of FIG. 12, FIG.
Is a longitudinal sectional view of the tip of the shaft.

FIG. 14 is a side view showing a trocar according to the fourth embodiment.

FIG. 15 is a side view showing the inner needle of the trocar according to the fourth embodiment.

FIG. 16 is a side view showing an outer tube of a trocar according to the fourth embodiment.

FIG. 17 is a longitudinal sectional view of a main part showing a use state of a living body access unit according to a fifth embodiment of the present invention.

FIG. 18 is a side view showing a living body access unit according to the fifth embodiment.

FIG. 19 is a sectional view taken along line AA of FIG. 18;

FIG. 20 is a longitudinal sectional view showing a state where a trocar is punctured by a living body access unit according to the fifth embodiment.

FIG. 21 is a longitudinal sectional view showing an expanded state of a tube by a living body access unit according to a fifth embodiment.

FIG. 22 is a longitudinal sectional view of a main part showing a use state of the intraperitoneal perfusion heating apparatus according to the sixth embodiment of the present invention.

23A and 23B show a catheter for liquid perfusion of the intraperitoneal perfusion heating device according to the sixth embodiment, wherein FIG. 23A is a side view of the catheter, and FIG. 23B is a longitudinal sectional view of the catheter.

FIG. 24 is a block diagram showing a schematic configuration of an entire system of an intraperitoneal perfusion heating apparatus according to a sixth embodiment.

FIG. 25 is a schematic configuration diagram of an entire intraperitoneal perfusion heating apparatus according to a seventh embodiment of the present invention.

[Explanation of symbols]

 2 water supply tube (fluid supply line) 3 water absorption tube (fluid recovery line) 5 temperature sensor (temperature measuring means) 7a first flow divider (flow rate adjusting means) 7b second flow divider (flow rate adjusting means) 10 pump (Pump means) 11a to 11c Valve (flow rate adjusting means) 13 Control unit (control means)

 ────────────────────────────────────────────────── ─── Continuing on the front page (72) Inventor Takefumi Uesugi F-term (reference) 4C066 AA01 BB02 CC01 DD11 FF01 JJ10 LL02 LL05 QQ27 QQ35 QQ52 2-43-2 Hatagaya, Shibuya-ku, Tokyo

Claims (3)

[Claims] A fluid supply line for supplying a fluid into the abdominal cavity; a fluid recovery line for collecting the fluid in the abdominal cavity; and a fluid supply line and the fluid recovery line in the abdominal cavity. Pump means for perfusing the fluid through the apparatus, temperature measuring means for measuring the temperature of the perfused fluid in the abdominal cavity, flow rate adjusting means for controlling the flow rate of the fluid perfused by the pump means, the temperature Control means for controlling the flow rate adjusting means based on the measurement result measured by the measuring means; and an intraperitoneal perfusion warming apparatus. 2. A method according to claim 1, wherein at least one of said fluid supply pipe and said fluid recovery pipe is provided with a flow path branching means for branching into a plurality of flow paths, and said flow rate adjusting means is provided for each of said plurality of branched flow paths. The intraperitoneal perfusion warming device according to claim 1, wherein the flow rate of the blood is adjusted. 3. A fluid supply line for supplying a fluid into the abdominal cavity, a fluid collection line for collecting the fluid in the abdominal cavity, and a fluid supply line and the fluid collection line in the abdominal cavity. Pump means for perfusing the fluid through the apparatus, temperature measuring means for measuring the temperature of the perfused fluid in the abdominal cavity, flow rate adjusting means for controlling the flow rate of the fluid perfused by the pump means, the temperature Control means for controlling the temperature of the fluid to be perfused based on the measurement result measured by the measuring means; and an intraperitoneal perfusion heating apparatus.