JP2002017773A - Thermotherapeutic device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a thermotherapeutic device adaptable for front and rear observation using an endoscope. SOLUTION: The thermotherapeutic device having a long insertion portion 100 insertable into a living body for giving energy irradiation from an emitting portion 110 installed in the insertion portion 100 to the tissue of the living body comprises the endoscope 15 inserted in the insertion portion 100 for observing an interior of the living body and front and rear observation windows 155, 104 for allowing the observation of the front and rear parts of the insertion portion 100, respectively, with the endoscope 15.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a laser beam, a microwave, a radio wave, an ultrasound The present invention relates to a heat treatment apparatus that performs heat treatment by irradiating living tissue with such energy.

[0002]

2. Description of the Related Art A heat treatment apparatus inserts a long insertion portion through a small incision made in a body cavity or a living body, and selectively irradiates a lesion site of the living body with energy such as laser light.
It is known that the tissue at the lesion site disappears and heals by heating, degenerating, necrotic, coagulating, cauterizing or evaporating. Such a heat treatment apparatus is generally configured to irradiate a laser beam to a lesion site located at or near a surface layer of a living tissue.

[0003] Further, there is also known a technique of irradiating a deep part of a living tissue with a laser beam for the purpose of treating a lesion located deep in the living tissue, that is, a deep lesion, such as heat treatment for prostatic hypertrophy. Have been.

[0004] The prostate is located at the bottom of the bladder of a man and surrounds the posterior urethra.
Transurethral techniques are often used. In the transurethral method, the insertion part of the heat treatment apparatus is inserted into the urethra, and energy irradiation is performed on a biological lesion. The heat treatment apparatus has an endoscope in order to confirm a lesion site in a living body and perform energy irradiation.

[0005] In the insertion section 90 of the conventional heat treatment apparatus, as shown in FIG. 8, an emission section 92 and the like are provided in front of the endoscope 91, and a forward view cannot be secured. Using a mold, a living body lesion site is confirmed from the side of the insertion portion 90 through the window 94 of the housing 93 and the light-transmitting cover member 95. For this reason, the conventional heat treatment apparatus cannot observe the front. Since it is impossible to observe the living body lesion site while looking in the forward direction, there is a problem that it takes time to position the insertion position of the insertion section 90 and the energy irradiation position.

[0006]

SUMMARY OF THE INVENTION The present invention has been made in view of such a conventional problem, and provides a heat treatment apparatus capable of performing forward observation and side observation using an endoscope. The purpose is to do.

[0007]

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

(1) The heat treatment apparatus according to the present invention includes a long insertion portion that can be inserted into a living body, and radiates energy toward living tissue from an emission portion provided in the insertion portion. In the heat treatment apparatus, an endoscope that is inserted into the insertion section and observes a living tissue, and a front observation window and side observation that allow the endoscope to observe the front and side of the insertion section, respectively. And a window.

(2) There is moving means for moving the position of the light emitting portion along the longitudinal direction of the insertion portion, and the light emitting angle of the light emitting portion changes with the movement of the light emitting portion along the longitudinal direction. Let it.

(3) An endoscope guide lumen for movably supporting the endoscope from the proximal end side of the insertion portion to the vicinity of the front observation window is further provided.

(4) There is further provided a restricting means for restricting contact of the endoscope with the front observation window.

(5) The restricting means is a tapered structure formed toward the front observation window, and a diameter of the tapered structure on the distal end side is smaller than a diameter of the endoscope.

(6) The front observation window is formed in a tip cap provided at the tip of the insertion portion, and the tip cap has a rounded and smooth shape.

(7) The tip cap includes a perfusion solution outlet for discharging a perfusion solution for cleaning the outer periphery of the front observation window, and the insertion portion guides the perfusion solution to the perfusion solution outlet. A perfusate passage is provided.

(8) The insertion section includes a cooling liquid passage for guiding a cooling liquid for cooling the emission section and the surface of the insertion section, and the perfusion liquid passage and the cooling liquid passage are independent of each other in the insertion section. It is formed.

(9) The tip cap is integrally formed with the front observation window.

(10) The cap is formed of a member that blocks laser light in a portion of the tip cap other than the vicinity of the front observation window.

(11) The front observation window is perpendicular to the optical axis of the endoscope or inclined from the vertical within a range smaller than a predetermined angle.

(12) The energy is a laser beam.

(13) The endoscope has a filter for blocking passage of the laser light.

[0021]

Embodiments of the present invention will be described below with reference to the drawings.

(First Embodiment) FIG. 1 is a perspective view of a laser irradiation apparatus 1 (heat treatment apparatus), and FIG. 2 is a view for explaining the internal structure of an insertion section 100 of the laser irradiation apparatus 1. is there. FIG. 3 is a sectional view taken along line AA of FIG.

The laser irradiation device 1 has an elongated main body 20.
, Drive device 30, cam box 40, shock absorber 5
0 and an endoscope 15.

An insertion portion 100 to be inserted into a living body is formed at the tip of the main body 20. The insertion portion 100 includes a housing 101, a cover member 102, and a tip cap 150.
And The housing 101 is formed of a rigid tubular body having a side window 104 for emitting laser light and for side observation,
It is covered with a cover member 102 having good laser light transmittance. Further, a pair of wall members 103 are fixedly arranged inside the housing 101 and define an internal space of the housing 101. In order to make the inside of the housing 101 a closed system, the housing 101
Close contact with 0. The distal end cap 150 is
Is provided with a front observation window 155 for confirming the front of the vehicle.

An optical fiber 16 for transmitting laser light is disposed inside the main body 20 and the housing 101. The proximal end of the optical fiber 16 is connected to a laser light generator (not shown) via an optical connector.

An emission section 110 for irradiating the laser beam to the side of the insertion section 100 is included in the housing 101. One end of an arm 120 is connected to the emission unit 110. The connection point between the emission unit 110 and the arm 120 is
Form a hinge mechanism. The other end of the arm 120 is connected to a cam mechanism in the cam box 40. The cam mechanism converts the rotational motion of the driving device 30 into a reciprocating motion of the main body 20 in the longitudinal direction. Therefore, the arm 120 reciprocates by the driving of the driving device 30, and interlocks with the emission unit 11.
0 also reciprocates. The driving device 30 is connected to the cable 3
Power is supplied from a power supply device (not shown) through the power supply 1.

The emission section 110 has a pair of projections 112 formed on both side surfaces. The protrusion 112 is provided in the housing 1
01, a pair of rail grooves 105 provided in the wall member 103
Is slidably fitted to The rail groove 105 is
0 is not parallel to the reciprocating direction. Therefore, arm 12
0 and the rail groove 105,
Is changed in inclination angle.

The emission section 110 has a smooth reflection surface 111 for reflecting laser light on one side. Laser light is emitted from the optical fiber 16 toward the reflection surface 111, and the reflected laser light passes through the side window 104 and irradiates the lesion site.

The optical fiber 16 has its distal end connected to the arm 120 by a connecting member 115. Therefore, while the optical fiber 16 and the arm 120 reciprocate integrally, the relative positional relationship between the reflecting surface 111 and the tip of the optical fiber 16 is kept substantially constant.

The shock absorber 50 accommodates the optical fiber 16 in a loop and fixes the base. Therefore, the reciprocating motion of the optical fiber 16 in the housing 101 and the main body 20 is converted into the contraction and expansion motion of the loop inside the shock absorber 50. That is, the optical fiber 16
Movement and load of the optical fiber 16 are absorbed.
Does not move outside the laser irradiation device 1.

The endoscope 15 is fixed in a straight line shape by being covered with a stainless steel protection pipe except for a distal end portion located in the internal space of the housing 101, and is prevented from being damaged and bent. The endoscope 15
The endoscope guide lumen 2 is passed through the endoscope introduction tube 17.
1 (21a, 21b). Here, the endoscope guide lumen 21 includes an endoscope guide lumen 21a formed on the main body 20 side and an endoscope guide lumen 21b formed on the distal end cap 150 side. This is a passage for guiding to the vicinity of the front observation window 155 and the side observation window 104.

The endoscope 15 is movable in the longitudinal direction of the main body 20. Since the endoscope 15 moves in a straight line shape without being curved, the endoscope guide lumen 21 is moved.
Even when the internal space of the housing 101 is interposed between the guide lumen 21 and the guide lumen 21, the guide lumen 21 is not separated.

The endoscope 15 has a field of view suitable for observing the inside of a living body from the side window 104 and the front observation window 155. Therefore, if the endoscope 15 is arranged near the side window 104, the side of the insertion section 100 can be observed, and if it is arranged near the front observation window 155, the front can be observed. Therefore, it is possible to easily observe the living tissue surface layer, position the housing 101 based on the observation, and visually confirm the laser beam irradiation position.

The endoscope 15 has a filter function for cutting a wavelength range of the laser light irradiated by the optical fiber 16. This filter function is provided between the endoscope 15 and a monitor that displays an image of the endoscope 15 or on the endoscope 15. Therefore, it is possible to prevent the laser light from entering the eyes when observing the living body with the endoscope.

Next, the specific structure of the tip cap 150 will be described.

FIG. 4A is a cross-sectional view around the tip cap 150, and FIG. 4B is a cross-sectional view showing a modification of the tip cap 150. In FIGS. 4A and 4B, the perfusate flush lumen 22 does not appear in an actual cross section, but is indicated by a broken line to facilitate understanding.

The tip cap 150 has a smooth substantially hemispherical portion 151 so as to be easily inserted into a living body, and has a shape that does not cause a step with the housing 101. Further, the housing 101 is covered with a cover member 102.

The front end cap 150 includes a front observation window 155 that allows the endoscope 15 to perform front observation.
The front observation window 155 is arranged in a notch 152 formed in a part of the substantially hemispherical portion 151 of the tip cap 150. The notch 152 is formed so as to expand from the front observation window 155 to the outside of the tip cap 150 so as not to obstruct the field of view of the endoscope 15 through the front observation window 155. In addition, since the tip cap 150 and the front observation window 155 are integrally formed with a transparent material that does not hinder the field of view of the endoscope 15, the number of components can be reduced. However, the tip cap 150 and the front observation window 155 may be formed separately and fixed. In this case, only the front observation window 155 can be made of a transparent substance that does not obstruct the visual field.

Further, the tip cap 150 is provided with a perfusate flush port 153 for removing blood, biological tissue fluid, air bubbles, etc. attached to the outside of the front observation window 155. The perfusate flush port 153 is connected to the front observation window 155.
It is formed so as to directly discharge the perfusate into the front observation window 155 and the surrounding environment can be efficiently cleaned. Therefore, dirt on the front observation window 155 can be removed, and observation with the endoscope 15 can be performed well.

As shown in FIG. 4A, the perfusate flush port 153 is connected to the perfusate flush lumen 22 positioned parallel to the longitudinal direction of the insertion section 100.
The perfusate flush lumen 22, as shown in FIG.
It is formed in the wall member 103 of the housing 101. The perfusate is injected from the perfusate inlet 23 shown in FIG. The perfusate is desirably colorless and transparent, such as purified water or physiological saline, and does not harm the living body.

The end cap 150 has an endoscope guide lumen 21b. The endoscope guide lumen 21b is a path for guiding the endoscope 15 to the vicinity of the front observation window 155. Endoscope guide lumen 21b
Simply guides the endoscope 15 to the front observation window 155, there is no problem if the endoscope 15 is shorter than the main body 20, but if the endoscope 15 is longer, the front observation window 155 may be damaged. As a structure for preventing this damage, the endoscope guide lumen 21 is provided.
b is the front observation window 15 near the front observation window 155.
It is tapered so that the diameter decreases toward 5.

Due to the taper, the diameter of the endoscope guide lumen 21 b is changed in the vicinity of the endoscope 15 by the endoscope 1.
5 smaller than the diameter. Therefore, the endoscope 15 hits the inner wall of the endoscope guide lumen 21b and stops before hitting the front observation window 155. As described above, the endoscope guide lumen 21b has a structure (tapered structure) for preventing the front observation window 155 from being damaged by the endoscope 15 abutting. The range to be tapered is not particularly limited as long as it is inside the tip cap 150. In addition, the inclination of the taper is such that the endoscope 15 has the front observation window 155.
There is no particular limitation as long as it does not hit the surface.

The front observation window 155 is formed by a uniform and transparent plane. The front observation window 155 is provided with an endoscope 15 to prevent halation caused by the endoscope guide light.
And an angle perpendicular to or nearly perpendicular to the optical axis. The angle close to the vertical is indicated by θ in FIG. 4B and is an angle at which the front observation window 155 is inclined toward the main body 20 with respect to a perpendicular to the optical axis of the endoscope 15. The angle θ is equal to the endoscope 1
5 is 60 °, the material of the front observation window is acrylic, and when the cooling liquid is water, it is preferably 0 ° to 27 °, more preferably 10 ° to 15 °. Even when the viewing angle, the material, and the coolant are other, the anti-halation angle θ is similarly set appropriately.
Since the angle of the front observation window 155 is set as described above, halation of the endoscope 15 can be prevented, and the field of view of the endoscope 15 can be kept good.

Next, the sectional structure of the main body 20 will be described with reference to FIG.

FIG. 5 is a sectional view taken along the line BB of FIG. Note that in FIG.
The housing 101 and the cover member 102 are omitted and not shown.

Inside the main body 20, an arm lumen 2 is provided.
4. Lumen 25 for optical fiber, lumen 2 for cooling liquid inflow
6. Coolant outflow lumen 27, endoscope guide lumen 2
1a and a perfusate flush lumen 22 are formed. The arm lumen 24 is parallel to the axis of the main body 20, and the arm 120 is inserted so as to be able to reciprocate. The optical fiber lumen 25 is parallel to the axis of the main body 20 and is covered with the optical fiber 16 covered by the protective pipe.
Are inserted so as to be able to reciprocate.

The coolant inflow lumen 26 and the coolant outflow lumen 27 are for inflow and outflow of the coolant.
The coolant inflow lumen 26 is connected via a tube 28 shown in FIG. 1 and the coolant outflow lumen 27 is connected via a tube 29 to a coolant circulation device (not shown). The coolant inflow lumen 26 and the coolant outflow lumen 27
It communicates with the internal space (see FIG. 2) of the housing 101 in which the emission unit 110 is arranged. Therefore, the cooling liquid sent from the cooling liquid circulation device is introduced into the internal space of the housing 101 via the tube 28 and the cooling liquid inflow lumen 26, and the surface of the living tissue to be irradiated with the laser light, the emission unit 110 and the laser The device parts such as the cover member 102 through which light is transmitted are cooled. Thereafter, the coolant is returned to the coolant circulation device via the coolant outflow lumen 27 and the tube 29.

The endoscope guide lumen 21a is connected to the endoscope 1
5 is reciprocally inserted.

The perfusate flush lumen 22 carries the perfusate injected from the perfusate inlet 23 shown in FIG. The perfusate flush lumen 22 is communicated from inside the main body 20 into the wall member 103 of the housing 101.
The perfusate flush lumen 22 is not opened in the internal space of the housing 101, and the tip cap 1
It is opened only at 50 perfusate flush ports 153. Therefore, the perfusate flush lumen 22 and the coolant inflow lumen 26 and the coolant outflow lumen 27 are completely independent. As a result, the perfusion liquid and the cooling liquid can be separately guided.

The respective lumens 21a, 24 and 25
It is desirable to provide a check valve (not shown) to prevent the coolant from flowing back to the cam box 40 side.

Next, a specific use situation and operation of the laser irradiation apparatus 1 will be described with reference to FIG.

FIG. 6 is a schematic diagram for explaining the use state of the laser irradiation device 1.

First, the insertion section 100 of the main body 20 of the laser irradiation device 1 is inserted into the body cavity 200. At this time, the endoscope 15 is arranged near the front observation window 155, and the approximate position of the lesion is searched for while observing the front. Then, the housing 101 in which the emission unit 110 is housed is brought into close contact with a lesion site, that is, a surface layer near a target site 201 which is a target heating site.

Then, the endoscope 15 is appropriately moved along the endoscope guide lumen 21 to perform forward observation from the front observation window 155 or side observation from the side window 104,
The target part 201 is accurately specified while directly confirming the vicinity of the target part 201. Target site 20
When the position of the housing 101 is adjusted with respect to the longitudinal direction of the body cavity 200 at the time of specifying 1, the entire laser irradiation device 1 is moved in the longitudinal direction of the main body 20. When adjusting the position of the housing 101 in the circumferential direction of the body cavity 200, the entire laser irradiation device 1 is rotated.

When heating treatment for the target site 201 is started, a tube 2 is supplied from a cooling liquid circulation device (not shown).
The cooling liquid whose temperature has been adjusted in advance is supplied to the laser irradiation device 1 via 8, and the laser light generating device is further operated. The generated laser light is introduced into the laser irradiation device 1 via a connector (not shown).

The laser light is further guided through the optical fiber 16 to the insertion portion of the laser irradiation device 1,
The light is reflected by the reflection surface 111 of the emission unit 110 in the light source 01, passes through the side window 104, passes through the cover member 102, and is irradiated on the target part 201. At this time, the emission unit 110
Changes the irradiation angle while reciprocating in the axial direction at a cycle of 1 to 6 Hz. The optical path of the laser light is continuously changed, but all intersect at the target portion 201.

As a result, the target portion 201 inside the living tissue 202 and its vicinity generate a large amount of heat due to the continuously irradiated laser light. Therefore, the target portion 201 reaches a desired temperature.

On the other hand, the irradiation of the laser beam on the region above the target portion 201, for example, the surface layer 203 of the living tissue 202 is intermittent and generates a small amount of heat. Similarly, the irradiation of the laser beam to the region below the target portion 201 is intermittent, and the amount of generated heat is small.
That is, the surrounding parts (normal parts) other than the target part 201 are maintained at a relatively low temperature. In particular, even when the target portion 201 is present at a deep position in the living tissue, the target portion 201 can be effectively heated while preventing or reducing damage to portions other than the target portion 201. Therefore, the safety for the patient is high.
In addition, a desired region is heated by changing the position of the target portion 201 and irradiating the target with the laser beam.

The laser beam to be 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 18
It is preferably about 00 nm. The diameter of the insertion portion of the laser irradiation device 1, that is, the outer diameter of the main body 20, is not particularly limited as long as it can be inserted into the body cavity 200. However, the outer diameter of the main body 20 is preferably about 2 to 20 mm, more preferably about 3 to 8 mm.

As described above, according to the heat treatment apparatus 1 of the present invention, the lesion site can be observed from the front observation window 155 and the side window 104, and the positioning of the housing 101 can be performed easily and quickly. Can be.

Further, since the endoscope guide lumen 21b is tapered, the endoscope 15 is connected to the front observation window 1b.
Never hit 55.

Further, the heat treatment apparatus 1 according to the present invention
For example, even if there is normal tissue such as urethra or rectum near the prostate, as in the case of prostatic diseases such as prostatic hyperplasia and prostate cancer, only the inside of the prostate can be heated and treated.

(Second Embodiment) FIG. 7 is a view showing a tip cap 750 of a laser irradiation apparatus 1 according to a second embodiment.

Since only the tip cap 750 is different from the above-described first embodiment, the difference between the tip cap 750 will be described below with reference to FIG. The same components as those in the first embodiment are denoted by the same reference numerals, and description thereof is omitted.

In FIG. 7, the tip cap 750 is formed of a substance that blocks the laser light supplied from the optical fiber 16. The distal end cap 750 has a smooth substantially hemispherical body 751 so as to be easily inserted into a living body, and has a shape in which a step with the housing 101 does not occur. The tip cap 750 includes a front observation window 755.

The front observation window 755 is made of a transparent material that does not hinder the field of view of the endoscope 15. The front observation window 755 is disposed in a notch 752 formed in a part of the substantially hemisphere 751 of the tip cap 750. The notch 752 is formed so as to expand from the front observation window 755 to the outside of the tip cap 750 so as not to obstruct the field of view of the endoscope 15 through the front observation window 755.

As described above, since the tip cap 750 is formed of a substance that blocks laser light, the light emitting section 110 is damaged, and even when the laser light goes straight without being reflected, the laser light is not reflected. It does not leak out of the tip cap 750.

The first and second 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. .

Further, as the energy applied to the living tissue, a laser beam has been described as an example.
The present invention is not limited to this. The energy may be, for example, a microwave, a radio wave, an ultrasonic wave, or the like.

[0070]

According to the first aspect of the present invention, since the front and side of the insertion portion can be observed, the positioning of the insertion portion in the living body can be performed quickly and accurately.

According to the second aspect of the present invention, the energy irradiation angle can be changed depending on the position to which the light emitting unit has moved, so that the energy can be concentrated only on a specific target portion, and the normal state other than the specific target portion can be concentrated. A site such as a tissue can be kept at a low temperature. This can prevent or reduce damage to parts other than the target part,
In particular, since the damage to the surface layer can be prevented even when the target portion is located at a deep portion, the safety for the patient is high.

According to the third aspect of the present invention, since the endoscope is movably supported, it is possible to observe the inside of a living body in a wide range.

According to the fourth and fifth aspects of the invention, it is possible to prevent the front observation window from being damaged by the endoscope coming into contact with the front observation window.

According to the sixth aspect of the present invention, since the distal end cap has a rounded and smooth shape, it is easy to insert the insertion portion into the living body.

According to the seventh aspect of the present invention, it is possible to remove dirt from the front observation window and to perform observation with an endoscope satisfactorily.

According to the eighth aspect of the present invention, the cooling liquid and the perfusion liquid can be separately guided.

According to the ninth aspect, the number of parts can be reduced.

According to the tenth aspect of the present invention, laser light does not leak from the tip cap.

According to the eleventh aspect, halation of the endoscope can be prevented, and the field of view of the endoscope can be kept good.

According to the twelfth aspect of the present invention, appropriate treatment can be performed by laser light.

According to the thirteenth aspect, the laser light is not output to the outside of the endoscope.

[Brief description of the drawings]

FIG. 1 is a perspective view of a laser irradiation device.

FIG. 2 is a diagram illustrating an internal structure of an insertion portion of the laser irradiation device.

FIG. 3 is a sectional view taken along line AA of FIG. 2;

FIG. 4A is a cross-sectional view around a tip cap 150, and FIG. 4B is a cross-sectional view showing a modification of the tip cap 150.

FIG. 5 is a sectional view taken along line BB of FIG. 2;

FIG. 6 is a schematic diagram illustrating a use state of the laser irradiation apparatus 1.

FIG. 7 is a view showing a tip cap of the laser irradiation device.

FIG. 8 is a view showing a conventional laser irradiation apparatus.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 ... Laser irradiation apparatus, 15 ... Endoscope, 16 ... Optical fiber, 21a, 21b ... Endoscope guide lumen, 22 ... Perfusion fluid flush lumen, 26 ... Coolant inflow lumen, 27 ... Coolant outflow lumen, 100 ... Insertion section, 101: housing, 110: emission section, 153: perfusate flush port, 150, 750: tip cap, 155, 755: front observation window.

Continued on the front page (51) Int.Cl. ⁷ Identification symbol FI Theme coat II (Reference) A61B 18/18 A61N 5/06 E A61N 5/02 Z 5/06 A61B 17/36 330 340 (72) Inventor Shin Makino 1500 Inoguchi, Nakai-machi, Ashigae-gun, Kanagawa Prefecture, Terumo Corporation (72) Inventor Satoshi Sakaguchi 1500, Inoguchi, Nakai-machi, Ashigara-gun, Kanagawa Prefecture, Terumo Corporation (72) Inventor Tohru Nagase 2-43-2 Hatagaya, Shibuya-ku, Tokyo Within the Limpus Optical Co., Ltd. (72) Norihiko Haruyama, Inventor 2-43-2, Hatagaya, Shibuya-ku, Tokyo O Within the Limpus Optical Co., Ltd. (72) Takefumi Uesugi, 2-43-2, Hatagaya, Shibuya-ku, Tokyo O Inside the Limpus Optical Industry Co., Ltd. (72) Inventor Satoshi Mizukawa 2-43-2, Hatagaya, Shibuya-ku, Tokyo O Inside the Limpus Optical Industry Co., Ltd. (72) Makoto Inaba 2-43-2, Hatagaya, Shibuya-ku, Tokyo O Limpus Optical Co., Ltd. Companies in the F-term (reference) 4C060 EE30 JJ12 JJ15 KK06 MM25 MM26 MM27 4C061 BB02 BB03 BB04 FF37 FF39 FF43 JJ11 4C082 MA02 MC01 ME01 PA06 PC10 PJ30 PL02 PL03 PL04 RA02 RE24 RE53 RG03 RL02 4C099 AA01 CA13 CA18 JA11 JA13

Claims (13)

[Claims] 1. A heat treatment apparatus comprising a long insertion portion insertable into a living body, and irradiating energy to living tissue from an emission portion provided in the insertion portion, wherein the insertion portion is inserted into the insertion portion. And an endoscope for observing a living tissue, and a front observation window and a side observation window that enable the front and side of the insertion portion to be observed by the endoscope, respectively. Heat treatment device. 2. A moving means for moving the position of the light emitting portion along the longitudinal direction of the insertion portion, and changing the light emitting angle of the light emitting portion with the movement of the light emitting portion along the longitudinal direction. The heat treatment apparatus according to claim 1, wherein: 3. The heat treatment according to claim 1, further comprising an endoscope guide lumen for movably supporting the endoscope from a proximal end side of the insertion portion to a position near the front observation window. apparatus. 4. The heat treatment apparatus according to claim 1, further comprising a regulation unit that regulates contact of the endoscope with the front observation window. 5. The restriction means has a tapered structure formed toward the front observation window, and a diameter of the tapered structure on the distal end side is smaller than a diameter of the endoscope. The heat treatment apparatus according to claim 1. 6. The front observation window according to claim 1, wherein the front observation window is formed in a front end cap provided at the front end of the insertion portion, and the front end cap has a rounded and smooth shape. The heat treatment apparatus according to claim 1. 7. The irrigation apparatus according to claim 7, wherein the tip cap includes an irrigation liquid outlet for discharging an irrigation liquid for cleaning an outer periphery of the front observation window, and the insertion unit guides the irrigation liquid to the irrigation liquid outlet. The heat treatment apparatus according to claim 6, further comprising a liquid passage. 8. The insertion part includes a cooling liquid passage for guiding a cooling liquid for cooling the emission part and the surface of the insertion part. The perfusion liquid passage and the cooling liquid passage are independently provided in the insertion part. The heat treatment apparatus according to claim 7, wherein the heat treatment apparatus is formed. 9. The heat treatment apparatus according to claim 6, wherein the tip cap is formed integrally with the front observation window. 10. The apparatus according to claim 6, wherein the cap is formed of a member that shields a laser beam in a portion of the tip cap other than a portion near the front observation window.
10. The heat treatment apparatus according to claim 9. 11. The heat treatment according to claim 1, wherein the front observation window is perpendicular to the optical axis of the endoscope or inclined from a vertical angle within a range smaller than a predetermined angle. apparatus. 12. The heat treatment apparatus according to claim 1, wherein the energy is a laser beam. 13. The endoscope according to claim 12, wherein the endoscope includes a filter for blocking passage of the laser light.
The heat treatment apparatus according to claim 1.