JP2002017747A - Thermotherapeutic device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a thermotherapeutic device in which a long-sized body part used in an organism, and a drive unit for driving a laser emission part, are separable while constantly ensuring function and performance. SOLUTION: A laser emission device 1 and a drive unit 4 for driving a laser emission mirror provided inside the laser emission device 1 to change the direction of laser emission, are made detachable. A microswitch 403 is provided at a connection part between the laser emission device 1 and the drive unit 4 to always monitor the connected state, and laser irradiation is stopped in the case the laser emission device 1 and the drive unit are disconnected.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a method for inserting an insertion part into a living body cavity or a lumen such as a blood vessel, urethra, or abdominal cavity, or pressing a part against a living tissue by a surgical operation, or applying it to a body surface. After pressing the pressed part, laser beam, microwave, radio wave, ultrasonic wave or other energy is applied to the affected part of the living tissue from the emission part installed in the insertion part or the pressed part to perform heat treatment. The present invention relates to a heat treatment device to be performed.

[0002]

2. Description of the Related Art Laser light, microwaves, and the like are applied to a lesion site in a living body using a long insertion portion that is inserted into the living body by utilizing a body cavity of the living body or making a small incision in the living body.
There is known a heat treatment apparatus that irradiates energy such as radio waves and ultrasonic waves to heat and denature, necrotic, coagulate, cauterize or evaporate the affected tissue so that the affected area disappears, thereby heating the affected area. .

For example, in the treatment of benign prostatic hyperplasia, since the prostate is located at the bottom of the bladder at the position surrounding the posterior urethra, a heat treatment apparatus for transurethral treatment using laser light or the like is used. I have.

In such a device for treating benign prostatic hyperplasia, for example, after inserting a long main body into the urethra, the laser emitting section is reciprocated in the main body in the longitudinal direction.
A technique has been proposed in which the laser light is focused on a target portion located deep within a living tissue by changing the emission angle of the laser light. As a result, only the target site is heat-treated to a desired temperature, and sites other than the target site are kept at a low temperature.

[0005]

However, for example, the above-described conventional heat treatment apparatus has a long body inserted into a living body and a motor for reciprocating a laser emitting unit in the body. And a relatively large-scale device configuration in which a drive unit accommodating is stored. For this reason, the long main body once used for treatment is repeatedly used after washing and sterilization.

[0006] Therefore, there is a problem that the apparatus may be worn or worn over time due to repeated use. In addition, since the long main body and the drive unit are integrated, it takes time to clean and sterilize the shape, so it is easy to wash and sterilize, or it can be disposable. Is required.

SUMMARY OF THE INVENTION The present invention has been made to solve the above-mentioned problems of the prior art, and an object of the present invention is to drive a long main body portion used in a living body and a laser emitting section. It is an object of the present invention to provide a heat treatment apparatus that can separate the drive unit of the laser irradiation apparatus and can surely drive the laser emitting unit during the heat treatment.

[0008]

The object of the present invention is achieved by the following means.

(1) A heat treatment apparatus for applying heat to living tissue to perform heat treatment, comprising: an energy supply means for supplying energy for treatment; and an energy supply means connected to the energy supply means. Energy output means having energy reflection means for reflecting energy supplied from the power supply means, a drive means detachably connected to the energy output means, and changing the position and angle of the energy reflection means, and the energy output means Connection detection means for detecting a connection state with the driving means, and according to the connection state detected by the connection detection means,
An energy control unit for controlling the energy supply unit.

(2) The detecting means is a micro switch.

(3) The energy supply means supplies a laser beam as energy.

[0012]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Preferred embodiments of the present invention will be described below in detail with reference to the accompanying drawings.

FIG. 1 is a side view of a laser irradiation apparatus applied to a heat treatment apparatus according to an embodiment of the present invention, and FIG. 2 is a cross-sectional view of a tip of the laser irradiation apparatus.

The heat treatment apparatus according to the present embodiment has a side-projection type laser irradiation apparatus 1 for irradiating a living tissue with laser light. In this heat treatment apparatus, a long insertion portion 121 of the laser irradiation device 1 is inserted into a living body, and this insertion portion 121 is inserted.
The laser beam is emitted from the laser emitting unit 122 installed in the body to the living tissue 1001 (see FIG. 6) to perform heat treatment. For example, treatment of tumors such as prostatic hyperplasia and various cancers is performed. Used for

As shown in FIGS. 1 and 2, a laser irradiation device 1 as an energy output means includes a long insertion portion 121 and a laser emission portion 12 for irradiating a laser beam.
2 and a housing 124 that contains the laser emitting section 122 and is connected to the distal end of the insertion section 121.

The laser emitting section 122 has one arm 1
28 are connected. The arm 128 is connected to the housing 1
24 supports the laser emission part 122. Arm 128
Is moved in the axial direction of the insertion section 121, so that the laser emitting section 122 is moved in the axial direction.

The laser emitting section 122 has a smooth laser reflecting surface (mirror) formed on one side and reflecting laser light.
123. The laser emitting section 122 is formed of, for example, resin, glass, metal, or a composite material thereof. Specifically, for example, a mirror-polished surface made of a metal as a base material, a mirror-finished surface formed by depositing a thin film of a metal or the like with a resin or metal as a base material, or a mirror made of a glass mirror or the like What adhere | attached the material to the base material of resin or metal, etc. are mentioned. In this embodiment,
A mirror temperature sensor 111 for detecting the temperature of the laser emitting unit 122 is provided. Examples of the mirror temperature sensor 111 include, but are not limited to, a thermistor, a thermocouple, and a platinum resistance temperature detector.

This mirror temperature sensor 111 is preferably installed on the back surface of the laser reflecting surface 123. As a result, the mirror temperature sensor 111 is prevented from directly receiving the laser beam, so that the accuracy of detecting the temperature is kept good and the mirror temperature sensor 111 is protected from damage. The installation position of the mirror temperature sensor 111 is not limited to the back surface of the laser reflecting surface 123, but may be installed in any region of the laser emitting section 122 except for the laser reflecting surface 123. The signal from the mirror temperature sensor 111 is sent on the mirror temperature sensor signal lead 112.

The housing 124 is made of a hard tubular body such as stainless steel having a window 127 for irradiating a laser beam, and is covered by a cover member 125 that transmits laser light. The housing 124 has an inner wall provided with a pair of grooves 129 for engaging with projections 131 (see FIG. 3) protruding on both sides of the laser emitting unit 122 in order to change the irradiation angle of the laser emitting unit 122. . The grooves 129 functioning as guides for the laser emitting section 122 are arranged on both sides of the laser emitting section 122 and are inclined with respect to the axial direction of the insertion section 121. The distal end of the housing 124 is sealed by a cap 126.

An optical fiber 101 for guiding a laser beam
Are arranged inside the insertion section 121. Note that a lens may be provided at the tip of the optical fiber 101. This lens is an optical element for reducing the irradiation angle of laser light. The optical fiber 101 transmits the laser light generated by the laser light source device 3. The buffer device 132 accommodates the optical fiber forming the loop and absorbs the movement of the optical fiber.

The laser irradiation device 1 includes a laser emitting section 12
A drive unit 4 serving as a drive unit for moving an arm 128 for changing the irradiation angle of No. 2 is detachably attached to the laser irradiation device 1.

Further, the laser irradiation device 1 is provided with an observation device 8 (see FIG. 8) for observing the surface layer of the living tissue. The observation device 8 has an endoscope 801 that is detachable from the laser irradiation device 1. The endoscope 801 is inserted from the proximal end to the distal end of the laser irradiation device 1. A camera head 80 is provided at the base end side of the endoscope 801.
3 can be attached and images can be sent through the camera signal lead 804. The camera head 80
From 3, it is also possible to directly see through an eyepiece attached to the endoscope 801. The optical fiber of the endoscope 801 that irradiates the illumination light also has a function of irradiating the guide light sent through the light guide 802.
Therefore, the observation of the surface layer irradiated with the laser light, the positioning of the housing 124 based on the endoscope observation, and the irradiation position of the laser light can be visually confirmed.

FIG. 3 is a perspective view for explaining the structure of the laser emitting section and the arm of the laser irradiation apparatus.

The arm 128 branches right and left in the housing 124 to support the laser emitting section 122,
It does not prevent the laser light from hitting the surface of the laser emitting section 122. The laser emitting unit 122 has one side,
The support part 130 is provided, and a pair of protrusions 131 is provided on the other side. The support unit 130 is rotatably attached to the arm 128, and can cope with a change in the irradiation angle of the laser emission unit 122. As described above, the protrusion 131 is provided in the groove 1 disposed on the inner wall of the housing 124.
29.

The arm 128 is connected to the drive unit 4 arranged at the base end of the laser irradiation device 1. Note that the drive unit 4 may be provided outside the laser irradiation device 1 and the arm 128 may be connected to the drive unit 4 via a drive shaft. In this case, a metal wire or the like can be used as the drive shaft.

The drive unit 4 has a motor 401 (see FIG. 13). As the motor 401, for example,
An induction motor, a servo motor, a stepping motor, or the like can be used. The drive unit 4
By converting the rotational motion of the motor 401 into a reciprocating linear motion by a cam mechanism or a link mechanism (not shown) and transmitting the reciprocating linear motion to the arm 128, the laser emitting unit 122 reciprocates in the axial direction of the insertion unit 121. The tilt angle of the laser emitting unit 122 changes in accordance with the position in the axial direction based on the interlock between the arm 128 and the groove 129.

The drive unit 4 is configured to be detachable from the laser irradiation device 1 as described above. Specifically, for example, a driving force transmitting unit 402 for transmitting the driving force of the motor 401 is connected to the motor 401, while the driving force transmitting unit 402 is connected to the arm 128 of the laser irradiation device 1. A detachable driving force receiving portion 135 is provided via a support portion 134 (see FIG. 13). Note that the arm 128 is omitted, the laser emitting unit 122 is rotatably attached to a fixing member fixed to the vicinity of the tip of the optical fiber 101, and the position and position of the laser emitting unit 122 are adjusted by reciprocating the optical fiber 101 itself. The angle may be changed. In this case, the supporting portion 134 connected to the driving force receiving portion 135 is connected to the optical fiber 101 that is reciprocated.

As described above, if the drive unit 4 and the laser irradiation device 1 are configured to be detachable from each other, the laser irradiation device 1 inserted into the living body can be discarded for each single treatment, while , The drive unit 4 can be used repeatedly. Therefore, cleaning, sterilization, and the like need only be performed on the drive unit 4 part, and since the shape is simple, the processing can be easily performed in each stage.

The drive unit 4 and the laser irradiation device 1
As connection detection means for detecting that the drive unit 4 is securely connected to the laser irradiation device 1,
For example, a micro switch 403 is provided. Therefore, the connection state between the drive unit 4 and the laser irradiation device 1 can be detected based on the signal from the microswitch 403.

In the present embodiment, the control main body 2 detects the signal from the micro switch 403, and if the drive unit 4 and the laser irradiation device 1 come off during the heat treatment, the control unit 2 uses the laser supply means. The output of laser light from a certain laser light source device 3 is stopped.

FIG. 4 is a diagram for explaining the relationship between the movement of the laser emitting section and the direction of laser beam irradiation.

As shown in FIG. 4, the distance between the arm 128 and the non-parallel groove 129 at the position P2 is
Shorter than one. Therefore, when the support unit 130 of the laser emitting unit 122 moves from the position P1 to the position P2, the protrusion 131 of the laser emitting unit 122 slides along the groove 129, and the inclination angle of the laser emitting unit 122 is adjusted. Is done. That is, the insertion section 121 of the laser emission section 122
Becomes smaller with respect to the axis. Similarly, the support part 130 of the laser emitting part 122 is moved from the position P2 to the position P3.
When moving, the insertion portion 121 of the laser emission portion 122
Is further reduced with respect to the axis of the axis. On the other hand, at the positions P1 to P3, the laser light reflected by the laser emitting unit 122 concentrates on the lesion point, that is, the target point 1102 inside the target part 1101 which is the target heated part.

That is, the laser beam is continuously applied only to the target point 1102, and the other living tissue such as the surface layer is applied intermittently. Therefore, the target point 1102 is heated by the irradiated laser light to reach a desired temperature. On the other hand, other living tissues such as the surface layer have a small amount of heat and are hardly heated because the time for receiving the laser beam is short.

FIG. 5 is a sectional view taken along line AA of FIG.

As shown in FIG. 5, the insertion section 121 is provided with a working lumen 141 into which an arm 128 is slidably inserted. The working lumen 141 is formed parallel to the axis of the insertion section 121. The insertion section 121 further includes an optical fiber 101.
Lumen 142 for the endoscope 801 and the lumen 142 for the endoscope 801
3, a lumen 144 for injecting cooling water used as a cooling medium for cooling, and a lumen 145 for discharging the cooling water. In FIG. 5, the optical fiber 101 and the endoscope 801 are not shown. The cooling water suppresses heat generation in the housing 124 caused by the laser light,
Further, it is used to cool the surface of the living tissue in contact with the housing 124.

The lumens 144 and 145 are connected to a water supply tube 272 and a drainage tube 273 via a cooling water inlet connector 103 and a cooling water outlet connector 104, respectively (see FIG. 1). By circulating the cooling water, the cooling efficiency is improved. The temperature of the cooling water is not particularly limited as long as it can reduce the damage of the laser emitting portion 122 and the irradiation surface of the living tissue due to the irradiation of the laser beam, but is preferably 0 to 37 ° C., and more preferably less likely to cause frostbite,
The cooling effect is 8 to 25 ° C., which is high. To prevent the cooling water from flowing back to the proximal end, the lumen 141
It is preferable to provide a check valve in each of the to 143. As a cooling medium, it is preferable to use a sterilized liquid, for example, purified water or physiological saline.

FIG. 6 is a sectional view for explaining an example of use of the laser irradiation apparatus.

The distal end of the insertion portion 121 is inserted into the body cavity 1002, and the housing 124 in which the laser emitting portion 122 is housed is brought into close contact with a lesion site, that is, a surface layer near a target site 1101, which is a target heating site. Let it. At this time, the housing 124 is moved by the endoscope 801.
It is desirable to directly confirm the position of. In addition, the insertion part 1
21 with respect to the longitudinal direction of the target point 1102
Is adjusted by moving the entire laser irradiation apparatus 1 in the longitudinal direction of the insertion section 121. The target point 11 in the circumferential direction of the insertion portion 121 is
The position 02 is adjusted by rotating the entire laser irradiation device 1.

When irradiating the laser beam, the laser emitting section 122 is reciprocated in the axial direction while changing the irradiation angle at a cycle of 0.1 to 10 Hz, preferably 1 to 6 Hz. In this way, the optical path of the laser light is continuously changed, but all cross at the target point 1102.

As a result, the target point 1102 inside the living tissue 1001 and the vicinity thereof are heated by the irradiated laser beam to reach a desired temperature. In this way, it is possible to increase only the temperature in the desired target portion 1101 while suppressing the temperature rise in the surface layer portion.

The laser light applied to the living tissue 1001 may be divergent light, parallel light, or convergent light. In order to make the laser light convergent light, an optical system that makes the laser light convergent light is provided in the optical path of the laser light. Further, the laser light used is not particularly limited as long as it has a depth of a living body. However, the wavelength of the laser light is 750 to 1300 nm or 1600 to 180
About 0 nm is preferable because it has particularly excellent biological penetration properties. Examples of the laser light source device that generates laser light in the above wavelength range include a gas laser such as a He-Ne laser, a solid-state laser such as an Nd-YAG laser, and a Ga laser.
Examples include a semiconductor laser such as an AlAs laser.

Further, the diameter of the insertion portion of the laser irradiation device 1,
That is, the outer diameter of the insertion portion 121 is not particularly limited as long as it can be inserted into the body cavity 1002. However, the insertion portion 12
The outer diameter of 1 is preferably about 2 to 20 mm, more preferably about 3 to 8 mm.

FIG. 7 is a sectional view showing an example in which the heat treatment apparatus is used for treating a prostate. The insertion section 121 of the laser irradiation apparatus 1 is inserted into the urethra 1003, and the vicinity of the distal end of the insertion section 121 where the laser emission section is installed is the prostate 10
04 is brought into close contact with the surface layer. In the figure, reference numeral 1005 indicates a bladder. Although not shown in FIG. 7, urethral temperature sensors 113a and 113b for detecting the temperature of the urethral wall
It is disposed inside the vicinity of the distal end of the insertion section 121 (FIG. 1).
And FIG. 13).

The heat treatment apparatus of this embodiment has a rectal probe 5. Rectal probe 5 contains anus 10
An insertion section 501 is inserted into the rectum 1006 from 07 and a grip 502 gripped by an operator. The insertion portion 501 of the rectal probe 5 is provided with a plurality of rectal temperature sensors 503a to 503e for detecting the temperature of the rectal wall, and the detected values are transmitted through the sensor signal leads 504. I have. As described above, the rectal temperature sensors 503a to 503e are arranged at a deep part of the prostate gland 1004 when viewed from the urethra 1003 without being inserted into a living tissue.

Therefore, the heat treatment apparatus can perform the heat treatment using the detection results of the urethral wall temperature and the rectal wall temperature. This makes it possible to prevent the urethra and rectum normal tissues existing in the vicinity of the prostate from being heated more than necessary. Here, examples of the temperature sensor used for the urethral temperature sensors 113a and 113b include a thermistor, a thermocouple, and a platinum resistance temperature detector.
Preferably, the thermocouple is small in size and has little effect on laser irradiation. In addition, rectal temperature sensors 503a to 503
Similarly, examples of the temperature sensor used for e include a thermistor, a thermocouple, a platinum resistance temperature detector, and the like, but an inexpensive thermistor is preferable.

FIG. 8 is a diagram showing the overall configuration of the heat treatment apparatus, FIG. 9 is a diagram showing the control main body and the laser light source device, (A) is a front view, (B) is a side view, and (C) 9) is a rear view, and FIGS. 10 to 12 are cross-sectional views taken along line BB in FIG.

As shown in FIG. 8, the heat treatment apparatus according to the present embodiment includes a laser irradiation device 1, a control body 2, a laser light source device 3, a drive unit 4, a rectal probe 5, a foot switch 6, and an observation device 8. have. The laser irradiation device 1, the laser light source device 3, the drive unit 4, the rectal probe 5, and the foot switch 6 are connected to the control main body 2, respectively. The foot switch 6 outputs a signal for prompting the control main body 2 to irradiate laser light when the operator steps on the foot switch.

The observation device 8 includes a light source device 805 for supplying light for illumination for endoscopic observation, a television camera device 806 for capturing an image observed by the endoscope,
A television receiver 807 for displaying an image captured by the television camera device 806 and a cart 808 in which these are collectively installed and movable are provided. Light source device 805
Are connected to the light guide 802. The television camera device 806 is connected to the camera head 803 via a camera signal lead 804. Thereby, the endoscope 8
01 makes it possible to perform heat treatment while observing.

The control body 2 controls the operation of the entire heat treatment apparatus by using detection signals from various sensors and microswitches installed on the laser irradiation device 1, the drive unit 4, and the rectal probe 5.

As shown in FIG. 9, a main switch 201 for turning on the power, an abnormality notification indicator light 202 for lighting and notifying when a predetermined abnormality occurs, are provided on the front of the control main body 2.
An abnormality notification buzzer 20 for notifying by sound when a predetermined abnormality occurs
3. A media interface 204 for inputting information on an external storage medium is provided. In the present embodiment, the media interface 204 is a drive unit such as a floppy (registered trademark) disk (FD) or a magneto-optical disk (MO) in which image information or the like obtained by diagnosing a patient is stored. In addition, a user interface 205 that displays predetermined information to a user and receives predetermined settings and operations is provided at an upper portion of the control main body 2. In this embodiment, the user interface 205 is a touch-type operation panel including a display screen.

A drive unit connector 211 for connecting a signal lead extending from the drive unit 4 to a side surface of the control body 2, a sensor signal lead 102 extending from each sensor installed in the laser irradiation device 1, 11
2 and a rectal sensor connector 213 for connecting a sensor signal lead 504 extending from each sensor installed on the rectal probe 5.

A foot switch signal input connector 214 for connecting a signal lead extending from the foot switch 6 and a foot switch signal output connector 215 for connecting a foot switch signal cable 291 are provided on the back of the control main body 2. Are provided. The foot switch signal cable 291 transmits a foot switch signal from the foot switch 6 via the control main body 2. Further, on the back of the control main body 2, an interlock switch signal input connector 217 for connecting a signal lead extending from the interlock switch 7 (see FIG. 13), and an interlock switch signal cable 2
An interlock switch signal output connector 216 for connecting the N.92 is provided. The interlock switch signal cable 292 transmits an interlock switch signal from the interlock switch 7 via the control main body 2. It should be noted that reference numeral 21 in FIG.
Reference numeral 8 denotes an inlet to which a power supply cable (not shown) is connected.

On the front surface of the laser light source device 3, a main switch 301 for turning on power, setting dials 302a to 302c for an operator to set output conditions of laser light,
And an emergency stop switch 303 for stopping the output of the laser light in an emergency. Setting dial 30
In 2a to 302c, output conditions such as a laser output value, a laser pulse time, a laser pulse interval, and a laser output time can be set. Then, the recommended value of the output condition of the laser beam planned by the control body 2 is displayed on the user interface 205. The surgeon can arbitrarily set the output condition of the laser light with reference to the recommended value.

A laser output connector 304 for connecting the base end of the optical fiber 101 is provided on the side surface of the laser light source device 3. Further, the foot switch signal cable 2 described above is provided on the back of the laser light source device 3.
91 and interlock switch signal cable 292
Are provided with a foot switch signal input connector 305 and an interlock switch signal input connector 306 for connecting the respective switches. Note that reference numeral 307 in FIG.
Indicates an inlet to which a power supply cable (not shown) is connected.

As shown in FIG. 9, the laser light source device 3
The control body 2 is provided separately from the control main body 2 and includes housings that form different outer frames. The laser light source device 3 combined with the control main body 2 is not limited to a dedicated one, and if the specifications of the foot switch signal and the interlock switch signal are within the same range, different laser light source devices are appropriately combined with the control main body 2. Can be used. For example, a plurality of laser light source devices having different rated output values of laser light are prepared, and these can be used while appropriately replacing them. As a result, the systemicity of the entire heat treatment apparatus is improved, and the laser light source device can be easily removed, thereby improving the maintainability.

As shown in FIGS. 9 and 10 to 12,
A cooling unit is installed inside the control main body 2, and a cooling unit door 206 is attached to the front of the control main body 2 so as to be openable and closable. The cooling unit has a bag 271 that stores cooling water. A water supply tube 272 and a drainage tube 273 are connected to the bag 271. The water supply tube 272 and the drainage tube 273 are connected to the cooling water inlet connector 103 and the cooling water outlet connector 104 of the laser irradiation device 1 via the tube panel 207. The bag 271 has two parallel
It has two sides, each with a side wall 2
75 is affixed. The bag 271 is formed of, for example, a silicon rubber plate or sheet, and the bag side wall 275 is formed of, for example, an aluminum plate or sheet having a good heat transfer coefficient.

The cooling unit includes a first cooling element 252 a contacting one side of the bag 271 via the bag side wall 275 and the cooling surface 253, and a bag side wall 275.
And a second cooling element 252b provided so as to be able to contact and separate from the other side surface of the bag 271 via the cooling surface 253. As the cooling elements 252a and 252b, for example, those using a Peltier element can be used. The first cooling element 252a is connected to the fixed frame 2
76a, the second cooling element 252b
Is movable along the slide rail 279 together with the frame 276b.

When the cooling unit is used, the bag side wall 275 is used.
Is stored in a heat insulating housing 277 having heat insulating properties (FIG. 10). Then the second
The sliding element 252b is slid toward the first cooling element 252a (FIG. 11), and the hinge-type fixing member 280 is moved.
(FIG. 12). Thus, the bag 271
Are sandwiched and positioned by the first and second cooling elements themselves. And a heat insulating door 278 having heat insulating properties.
Is closed, the heat insulating housing 277 in which the bag 271 is stored is hermetically closed. Insulated door 278
A water temperature sensor 256 for detecting the temperature of the cooling water and a water level sensor 257 for detecting the level of the cooling water are attached, and the detection results thereof can be transmitted.

FIG. 13 is a block diagram of a control system centering on a control main body of the heat treatment apparatus according to the embodiment of the present invention, and FIG. 14 is a diagram for explaining details of the control unit shown in FIG. is there. The parts already described will be omitted as appropriate, and the following description will be made.

As shown in FIG. 13, the control main body 2 has a control unit 251a functioning as energy control means. Then, as shown in FIG. 14, the control unit 251a includes a temperature measuring unit 233, a light detecting unit 234, and a mirror driving unit 23.
5. Connection detection unit 236, water temperature control unit 237, flow rate control unit 238, pressure detection unit 239, water level detection unit 240, laser light source device control unit 241, display / operation input unit 242, data input / output unit 243, etc. A control unit, a CPU 231 that performs overall control of each of these peripheral control units,
A memory 232 for storing predetermined programs and data.

The urethral sensor connector 2
12, the detection signals from the mirror temperature sensor 111 and the urethral temperature sensors 113a and 113b, and the rectal temperature sensor 503a via the rectal sensor connector 213.
503e are input. Light detector 23
4, a detection signal from the optical sensor 114 is input via the urethral sensor connector 212. This optical sensor 11
Reference numeral 4 is installed in the laser irradiation device 1 and optically detects that the insertion section 121 of the laser irradiation device 1 is in contact with the laser light irradiation target. Thereby, the insertion portion 1
For example, it is possible to prevent a situation in which the laser light is irradiated when the device 21 is not inserted into a living body.

The mirror drive unit 235 is connected to the motor 401 of the drive unit 4 via the drive unit connector 211, and exchanges signals. That is, a drive signal is output from the mirror drive unit to the motor 401. Further, the motor 401 is provided with detection means (not shown) for detecting a rotation speed, a rotation angle position, and a rotation load, and a signal from these detection means is fed back to the mirror driving unit.

The connection detector 236 receives, via the drive unit connector 211, a detection signal from the micro switch 403 for detecting that the drive unit 4 is connected to the laser irradiation device 1. And CP
When U231 detects from the signal of the microswitch 403 that the drive unit 4 has come off the laser irradiation device 1, it instructs the laser light source device control unit 241 to stop outputting laser light. The laser light source device control unit 241 outputs a signal for stopping the output of laser light to the laser light source device 3 via the interlock switch signal cable 292 in response to a command from the CPU 231. In this manner, it is possible to irradiate the laser beam toward the lesion while reliably reciprocating the laser emitting unit 122 at a predetermined frequency.

The CPU 231 simultaneously outputs the user interface 205 via the display / operation input unit 242.
Then, a display is issued to warn that the drive unit 4 has come off the laser irradiation device 1 and that the output of the laser beam has stopped.

A detection signal from the water temperature sensor 256 is input to the water temperature control section 237, and the water temperature control section 237 supplies electric power for cooling to the cooling element 252 according to the detection signal. Therefore, it is possible to control the temperature of the circulated cooling water in a range suitable for treatment. Water temperature control unit 2
When the thermostat 254 detects an excessively high temperature state of the cooling element 252, the power supply to the cooling element can be stopped.

The water level detector 240 includes a water level sensor 257
, And it is possible to determine whether the required amount of cooling water is secured.

The flow control unit 238 is connected to the pump 258, and exchanges signals. That is, a drive signal is output from the flow control unit 238 to the pump 258, and a detection signal related to the flow rate is fed back from the pump 258 to the flow control unit 238. Thereby, the flow rate of the cooling water can be controlled. As the pump 258, for example, a roller pump, a diaphragm pump, a magnet pump, or the like can be used.

The pressure detecting section 239 includes the water supply tube 27.
The detection signal from the pressure sensor 259 which detects the water pressure in 2 is input. By monitoring the detection result of the pressure sensor 259, for example, the cooling water can be prevented from becoming excessively high pressure.

The laser light source device controller 241 receives a signal from the foot switch 6 via a foot switch signal input connector 214. The laser light source device control unit 241 outputs a signal to output laser light to the laser light source device 3 via the foot switch signal cable 291 as necessary.

Further, the laser light source device control section 241 controls whether the signal from the interlock switch 7 is input via the interlock switch signal input connector 217 or, as described above, the laser light from the CPU 231. When an instruction to stop the output of the light is received, a signal for stopping the output of the laser light to the laser light source device 3 via the interlock switch signal cable 292 in order to stop the output of the laser light immediately. Is output. The interlock switch 7 outputs a signal for stopping the operation of the laser light source device 3, for example, in conjunction with the opening of the laser light management area door.

The display / operation input unit 242 turns on the abnormality notification indicator lamp 202 when a predetermined abnormal situation occurs,
A signal for operating the abnormality notification buzzer 203 is output. The display / operation input unit 242 is connected to the user interface 205, and exchanges signals. That is, predetermined information is output from the display / operation input unit 242 to the user interface 205, and a signal corresponding to, for example, predetermined setting or operation by the operator is output from the user interface 205 to the display / operation input unit 242. .

The data input / output unit 243 is connected to the media interface 204, and can input / output various information such as patient diagnostic information and heat treatment history via an external storage medium. . It is also possible to input and output information by directly connecting to an external storage device without media.

In using the heat treatment apparatus configured as described above, first, a lesion site of a patient is diagnosed in advance. Diagnosis of a lesion site includes, for example, an optical endoscope, an ultrasonic endoscope, X-ray contrast, magnetic resonance imaging (MR).
I; magnetic resonance imaging, computer-assisted tomography using X-ray or magnetic resonance (CT; comp)
uted tomography), positron emission tomography (PET; po)
sitron emission tomography, single photon emission computer-assisted tomography (SPECT; single photon emissi)
on computed tomography).

Then, for example, image information around the lesion site obtained by diagnosing the patient in advance is input from the media interface 204 via the FD or the like. The input image information around the lesion site is displayed on the user interface 205. The operator determines a target site that is a target heating site from the displayed lesion site, and inputs information about the target site through the user interface 205.

The control body 2 plans treatment conditions based on the target site determined by the operator, and displays recommended values of the treatment conditions on the user interface 205. The operator refers to the recommended value and sets the output condition of the laser beam as the treatment condition to the setting dial 30 of the laser light source device 3.
Set using 2a to 302c.

The output condition of the laser beam as the treatment condition is as follows.
For example, a laser output value, a laser output time, and the like. Note that other treatment conditions such as the temperature of the cooling water, the flow rate of the cooling water, and the moving speed of the laser emitting unit are set to general values in the heating treatment, but are set through the user interface 205 as necessary. You may be able to.

When the setting of the treatment condition is completed and the operator steps on the foot switch 6, a foot switch signal is input to the control section 251a of the control main body 2. In the present embodiment, the laser light source device 3 is not operated just by stepping on the foot switch 6. That is, the control unit 251a grasps the state of each unit of the heat treatment apparatus, and when the condition that may output the laser light is satisfied, the control unit 251a transmits the laser light to the laser light source device 3 via the foot switch signal cable 291. A signal to output laser light is output.

More specifically, when the detection signal of the mirror temperature sensor 111 installed in the laser irradiation device 1 exceeds a preset value, the control unit 251a transmits the laser light via the foot switch signal cable 291. Is stopped, and the operation of the laser light source device 3 is stopped.

In this way, when the operator selects a sufficiently large laser output value or a sufficiently long irradiation time, the cooling capacity of the refrigerant for cooling the periphery of the mirror is compared as a condition to be combined with them. In the case where the temperature is extremely small, even if the temperature of the mirror rises, the apparatus can be stopped with a sufficient margin before the following problem occurs. For this reason, it is possible to prevent the wear of the device, especially the periphery of the mirror.

As a conceivable defect phenomenon, for example, when the mirror is fixed to the base material of the base by bonding or the like, the adhesive degrades due to heat and the mirror itself rises. Or the possibility of peeling off. Further, the same possibility exists when the mirror and the base material are made of a combination of materials having greatly different coefficients of thermal expansion. Furthermore, when the base material is made of a material having a particularly high thermal expansion property, the sliding resistance with the rail means is reduced due to the thermal expansion of the equipment,
There is a possibility that smooth movement of the mirror may be hindered.

Further, the control unit 251 a
When it is determined from the detection signals of the rotation speed, the rotation angle position, and the rotation load that are fed back from the motor 401 that the motor 401 is stopped, or that the deviation from the command value exceeds a predetermined allowable range, the laser light source device 3 is stopped.

Further, the control unit 251a monitors signals from the micro switch 403, the interlock switch 7, and the like, and when the laser irradiation device 1 and the drive unit 4 come off during the heat treatment, for example, or when the laser management area When the door is opened, the operation of the laser light source device 3 is stopped. The control unit 251a further monitors the operation state of each unit from signals from other sensors and thermostats in the heat treatment apparatus, and, if necessary,
The operation of each part in the heat treatment device such as the laser light source device 3 is controlled.

As described above, in the present embodiment, the drive unit for moving the laser emitting section for changing the laser emitting direction is made detachable with respect to the laser irradiation apparatus.
While the laser irradiation device inserted into the living body can be discarded after each treatment, the drive unit can be used repeatedly, and the micro unit can be used between the laser irradiation device and the drive unit. A switch is provided so that these connection states can be constantly detected, and in the unlikely event that the laser irradiation device and the drive unit come off, the laser beam is stopped, so that the laser beam continues in one direction during the heat treatment. Irradiation can be prevented.

The embodiments described above are not described to limit the present invention, and various modifications can be made by those skilled in the art within the technical concept of the present invention.

For example, as the energy applied to the living tissue, a laser beam has been described as an example in the above-described embodiment. However, the present invention is not limited to this. For example, a microwave, a radio wave, an ultrasonic wave, or the like may be used. Irradiation of such energy may be performed.

Although the prostate has been described as an example of the living tissue to be subjected to the heat treatment, the present invention is not limited to this, and the present invention is not limited thereto. And all living tissues that can be subjected to heat treatment by radiating energy from within the body or from the body surface.

[Appendix] (Appendix 1) The energy output means has a shape insertable into the urethra, and is configured such that the energy output direction faces the prostate site when inserted into the urethra. The treatment device further includes a urethral temperature detecting unit installed on the energy output unit for detecting a temperature of a urethral wall, and a rectal temperature detecting unit for detecting a temperature of a rectum wall, and the energy control unit further includes the energy control unit. 2. The operation state of the energy supply unit is controlled using detection results of a urethral temperature detection unit and a rectal temperature detection unit.
The heat treatment apparatus according to any one of Items 1 to 3.

(Supplementary note 2) The energy control device further includes a light detection unit that is installed on the energy output unit and optically detects that the energy output unit is in contact with an energy output target. The means for controlling an operation state of the energy supply means further using a detection result of the detection means.
2. The heat treatment apparatus according to any one of the additional items 1 to 3.

(Additional Item 3) A refrigerant container for storing a refrigerant,
A refrigerant supply path and a refrigerant recovery path communicating between the refrigerant container and the energy output means, a refrigerant delivery means for delivering a refrigerant toward the energy output means, a cooling means for cooling the refrigerant, 4. The apparatus according to claim 1, further comprising: refrigerant control means for adjusting a flow rate and a temperature of the refrigerant by controlling an operation state of the refrigerant delivery means and the cooling means. A heat treatment apparatus according to any one of the preceding claims.

(Supplementary Item 4) The refrigerant container has a first side surface and a second side surface parallel to the first side surface, and the cooling means is provided on the first side surface of the refrigerant container. The cooling device according to claim 1, further comprising a first cooling unit that is in contact with the first cooling unit, and a second cooling unit that is provided on the second side surface of the refrigerant container so as to be able to contact and separate therefrom. The heat treatment apparatus according to any one of the above.

(Supplementary Note 5) A lumen for extending the inside of the energy output means in the longitudinal direction and opening near the tip of the energy output means, and a living body which can be inserted into the lumen for observation. The heat treatment apparatus according to any one of claims 1 to 3, further comprising an observation unit.

[0092]

As described above, according to the heat treatment apparatus of the present invention, the energy output means and the drive means for driving the energy reflection means provided in the energy output means are detachable. The connection state is detected by the connection detection unit, and the energy control unit controls the supply of energy based on the detection result, so that the energy output unit used in the living body can be separated. It is also possible to disposable the energy output means, which is a part used in the living body, while the energy output means and the drive means can be separated, so that during the treatment, the energy output means When the driving means comes off, the energy control means detects this by the connection detecting means and stops the irradiation of energy. Doing, it is possible to drive means to prevent energy irradiation in a state not connected.

[Brief description of the drawings]

FIG. 1 is a perspective view of a laser irradiation apparatus applied to a heat treatment apparatus according to an embodiment of the present invention.

FIG. 2 is a sectional view of a tip portion of the laser irradiation device.

FIG. 3 is a perspective view for explaining a structure of a laser emitting unit and an arm of the laser irradiation apparatus.

FIG. 4 is a diagram for explaining the relationship between the movement of a laser emitting unit and the irradiation direction of laser light.

FIG. 5 is a sectional view taken along line AA of FIG. 3;

FIG. 6 is a cross-sectional view illustrating an example of use of the laser irradiation device.

FIG. 7 is a sectional view showing an example in which the heat treatment apparatus is used for treating a prostate.

FIG. 8 is a diagram showing the overall configuration of the heat treatment apparatus.

9A and 9B are diagrams showing a control main body and a laser light source device, wherein FIG. 9A is a front view, FIG. 9B is a side view, and FIG. 9C is a rear view.

FIG. 10 is a sectional view taken along line BB in FIG. 9;

FIG. 11 is a cross-sectional view taken along line BB of FIG. 9;

FIG. 12 is a sectional view taken along line BB in FIG. 9;

FIG. 13 is a block diagram of a control system centering on a control main body of the heat treatment apparatus according to the first embodiment of the present invention.

FIG. 14 is a diagram illustrating details of a control unit shown in FIG. 13;

[Explanation of symbols]

 REFERENCE SIGNS LIST 1 laser irradiation device 2 control body 251 a control unit 403 microswitch 3 laser light source device 4 drive unit

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[Procedure amendment]

[Submission date] August 30, 2000 (2008.3.
0)

[Procedure amendment 1]

[Document name to be amended] Statement

[Correction target item name] 0091

[Correction method] Change

[Correction contents]

(Supplementary Note 5) In order to observe the lumen extending from the base end of the energy output means and extending inside the energy output means in the longitudinal direction, and a living body insertable into the lumen. The heat treatment apparatus according to any one of claims 1 to 3, further comprising:

Continued on the front page (51) Int.Cl. ⁷ Identification symbol FI Theme coat II (reference) A61F 7/12 A61N 5/01 A 5F072 A61N 1/02 5/06 E 1/40 H01S 3/00 A 5/01 A61B 17/36 350 5/06 H01S 3/00 330 340 (72) Inventor Norihiko Haruyama 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inside Olympus Optical Industrial Co., Ltd. (72) Takefumi Uesugi Hatagaya, Shibuya-ku, Tokyo 2-43-2, Olympus Optical Kogyo Co., Ltd. (72) Inventor Satoshi Mizukawa 2-43-2, Olympus Optical Kogyo Co., Ltd. (72) Inventor Makoto Inaba Hatagaya, Shibuya-ku, Tokyo 2-43-2 Olympus Optical Co., Ltd. (72) Inventor Shigenobu Iwahashi 1500 Inoguchi, Nakai-machi, Ashigara-gun, Kanagawa Prefecture Terumo Corporation (72) Inventor Shin Makino 1500 1500 Inoguchi, Nakai-machi, Ashigara-gun, Kanagawa Prefecture Terumo Corporation (72) Inventor Satoshi Sakaguchi Kanagawa 1500 Inoguchi, Nakai-machi, Ashigara-gun Terumo Co., Ltd. JJ11 JJ20 KK30 RR01 RR03 YY01

Claims (3)

[Claims] 1. A heat treatment apparatus for applying heat to living tissue to perform heat treatment, comprising: an energy supply means for supplying energy for treatment; and an energy supply means connected to the energy supply means. An energy output unit including an energy reflection unit that reflects supplied energy; a driving unit that is detachably connected to the energy output unit, and that changes a position and an angle of the energy reflection unit; A heat treatment apparatus comprising: connection detection means for detecting a connection state with a driving means; and energy control means for controlling the energy supply means in accordance with the connection state detected by the connection detection means. 2. The heat treatment apparatus according to claim 1, wherein said detection means is a micro switch. 3. The heat treatment apparatus according to claim 1, wherein the energy supply unit supplies a laser beam as energy.