JP2004073284A - Medical instrument - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a medical instrument capable of discriminating the presence of the positional shift of an insertion part or preventing the positional shift of the insertion part. <P>SOLUTION: This medical instruement has a long applicator 100 capable of being inserted in a living body 700, a magnet 120 provided to a part of the applicator 100 to generate a magnetic field, a measuring part 200 for measuring the intensity of the magnetic field caused by the magnet 120 outside the living body 700, a memory part 300 for storing the intensity of the magnetic field, which is measured by the measuring part 200 when the applicator 100 is present at a reference position in the living body 700 as a reference value, and an output part 500 for outputting a predetermined signal on the basis of the change between the intensity of the magnetic field newly measured by the measuring part 200 and the reference value. Further, the magnet 120 is attracted to the living body 700 from the outside by an electromagnet to fix the applicator 100 in the inside of the living body 700. <P>COPYRIGHT: (C)2004,JPO

Description

[0001]
TECHNICAL FIELD OF THE INVENTION
The present invention relates to a medical device having an elongated insertion portion used for performing observation, treatment, surgery, or the like, when inserted into a living body, and particularly relates to a catheter, an endoscope, an ultrasonic probe, The present invention relates to a medical device having a puncture needle or an applicator as an insertion portion.
[0002]
[Prior art]
Conventionally, in order to treat a disease such as benign prostatic hyperplasia, a long applicator is inserted into a living body and is arranged at an optimal reference position, and then a laser beam or a microscopic light is irradiated from an irradiation unit provided on the applicator. 2. Description of the Related Art Medical devices that irradiate a wave to an affected area to perform heat treatment are known.
[0003]
However, the applicator located at the optimal reference position may subsequently be misaligned, hindering effective treatment. Therefore, the displacement of the applicator has been prevented by constantly checking the change in the position of the applicator using fluoroscopy or the like.
[0004]
[Problems to be solved by the invention]
However, when judging the presence or absence of the displacement of the applicator using X-ray fluoroscopy, a large-scale apparatus such as an X-ray fluoroscope is required, and the cost burden is increased. Furthermore, not only the operation of the applicator but also the operation of the X-ray fluoroscope is required, which increases the work load of the medical staff. There is also a demand to further reduce the amount of exposure due to X-ray fluoroscopy. These points are problems to be solved not only in medical devices for treating prostate, but also in all medical devices having an insertion portion that needs to be inserted into a living body and held for a relatively long time.
[0005]
Therefore, an object of the present invention is to provide a medical device that can determine the presence or absence of a positional shift of an insertion portion without using a large-scale device such as X-ray fluoroscopy. Another object of the present invention is to provide a medical device capable of preventing a displacement of an insertion portion in advance with a simple configuration.
[0006]
[Means for Solving the Problems]
The above object is solved by the following means.
(1) The medical device of the present invention has a long insertion portion that can be inserted into a living body, a generating portion that generates an electric field or a magnetic field, and measures the intensity of the electric field or the magnetic field caused by the generating portion outside the living body. And a storage unit that stores, as a reference value, the intensity of an electric field or a magnetic field measured by the measurement unit when the insertion unit is at a reference position inside the living body, and the generation unit or the measurement. One of the portions is provided in a part of the insertion portion, the other is fixable outside the living body, the change between the intensity of the electric field or magnetic field newly measured by the measurement unit and the reference value. And an output unit for outputting a predetermined signal based on the output signal.
(2) The generation unit is a magnetic body that generates a magnetic field, and the measurement unit includes a magnetic sensor that measures the intensity of the magnetic field.
(3) The medical device further includes a determining unit that determines whether there is a change in the position of the insertion unit based on a change between the electric field or magnetic field intensity newly measured by the measuring unit and the reference value. And the output section outputs the predetermined signal when it is determined that the position of the insertion section has changed from a reference position.
(4) The generating unit is provided in a part of the insertion unit, and the measurement unit includes a plurality of sensor arrays in which a plurality of magnetic sensors are annularly arranged outside the living body so as to surround the insertion unit. The storage unit stores the strength of each magnetic field measured by each of the plurality of magnetic sensors as a reference value when the insertion unit is present at a reference position inside the living body, and the determination unit includes Based on a change between the strength of the magnetic field newly measured by each of the plurality of magnetic sensors and the reference value, whether or not both the position change in the axial direction and the position change in the rotational direction of the insertion portion are present Judge.
(5) The insertion section includes an irradiation section that irradiates the living body with energy.
(6) The above energy is a laser beam.
(7) In the medical device of the present invention, the elongated insertion portion that can be inserted into the living body, a magnetic body provided in a part of the insertion portion, and a magnetic force from outside the living body. And a fixing portion for fixing the insertion portion to a reference position inside the living body by attracting the insertion portion.
(8) The fixing unit includes a plurality of electromagnets, and the medical device further includes a plurality of magnetic sensors configured to measure the strength of a magnetic field caused by the magnetic body outside a living body, and the plurality of magnets. An energization control unit that energizes the electromagnet under conditions where the magnetic forces acting between each electromagnet and the magnetic body balance with each other based on the measurement result by the sensor.
(9) The insertion section includes an irradiation section that irradiates energy toward the living body.
(10) The energization control unit controls energization of the electromagnet in conjunction with the state of energy irradiation by the irradiation unit.
(11) The above energy is a laser beam.
[0007]
BEST MODE FOR CARRYING OUT THE INVENTION
(First Embodiment)
Hereinafter, an example of the medical device of the present invention will be described in detail based on a preferred configuration example shown in the accompanying drawings. In the medical device according to the first embodiment, a magnet is attached to a part of a long insertion portion to be inserted into a living body, and a magnetic sensor fixed outside the living body generates a magnetic field caused by the magnet. Measure strength. Then, based on the change of the measured strength of the magnetic field with respect to the reference value, it is determined whether or not the position of the insertion portion has changed.
[0008]
FIG. 1 is a schematic configuration diagram illustrating the medical device according to the first embodiment. In the following embodiment, an explanation will be given by taking an example of an applicator as an insertion portion for heating and treating a prostate disease.
[0009]
The medical device according to the present embodiment includes an applicator 100, a measurement unit 200, a storage unit 300, a determination unit 400, an output unit 500, and a laser light source 600.
[0010]
The applicator 100 is a long-sized treatment device that can be inserted into a living body through the urethra. The applicator 100 is provided with an irradiation unit (irradiation window unit) 110 and a magnet 120, and an endoscope unit 130 is provided therein.
[0011]
FIG. 2 shows an example of the applicator 100. As shown in FIG. 2, an irradiating unit 110 for irradiating the living body tissue with the laser light is arranged near the distal end of the applicator 100. More specifically, the irradiating section 110 is a window section through which laser light irradiated to the living tissue passes. Further, a part of the applicator 100 is provided with a magnet (magnetic body) 120 for generating a magnetic field. More preferably, magnet 120 is provided near irradiation unit 110. In the example of the applicator illustrated in FIG. 2, the magnet 120 is provided at a predetermined position in the axial direction of the applicator 100 over the entire circumferential direction. However, the shape and arrangement of the provided magnets 120 are not limited to those shown in FIG.
[0012]
The measurement unit 200 shown in FIG. 1 measures the strength of a magnetic field caused by the magnet 120 provided on the applicator 100 outside a living body. The measurement unit 200 includes a magnetic sensor 210 that measures the strength of a magnetic field. As the magnetic sensor 210, various types such as a Hall element, an MR element, a GMR element, and a flux gate sensor can be used. Preferably, a small chip-type sensor is used as the magnetic sensor 210.
[0013]
Storage unit 300 is a memory such as a RAM (random access memory), for example. The storage unit 300 stores the strength of the magnetic field measured by the measurement unit 200. In particular, storage section 300 in the present embodiment stores the strength of the magnetic field measured by measurement section 200 as a reference value when applicator 100 is at a reference position inside the living body. Further, even after storing the reference value, storage section 300 sequentially stores the strength of the magnetic field newly measured by measurement section 200. In the present specification, the reference position means a position where the irradiation unit 110 can irradiate the affected part (in this case, the prostate) with laser light.
[0014]
The determination unit 400 is preferably configured by a control circuit such as a CPU. The determination unit 400 determines whether the strength of the magnetic field newly measured by the measurement unit 200 has changed with respect to the reference value stored in the storage unit 300. As a result, when the intensity of the newly measured magnetic field changes from the reference value, it is determined that the applicator 100 has moved from the reference position.
[0015]
The output unit 500 outputs a predetermined signal (alarm signal) based on a change between a newly measured magnetic field intensity and a reference value. More specifically, when the determining unit 400 determines that the position of the applicator 100 has changed from the reference position, the output unit 500 outputs a predetermined signal (alarm signal). As a result, the level of the sound output from the speaker 501 and the intermittent sound can be changed based on the predetermined signal to warn the medical worker of the displacement of the applicator 100. Alternatively, the position change of the applicator 100 may be displayed as a numerical value or an illustration on the display 502 to warn the medical staff of the displacement of the applicator 100. The output unit 500 includes a laser light source control unit 503, and the laser light source control unit 503 is desirably connected to the laser light source 600. The laser light source control unit 503 has a function of automatically stopping laser beam irradiation based on a predetermined signal when a position shift occurs.
[0016]
Next, a method of using the medical device shown in FIG. 1 will be described with reference to FIGS. FIG. 3 is a flowchart illustrating a method of using the medical device illustrated in FIG. 1 and its functions. FIG. 4 is an overall view showing an example of the arrangement of each unit in the medical device, and FIG. 5 is an enlarged view of a main part of FIG.
[0017]
First, in step S100 of FIG. 3, the measurement unit 200 is installed outside the living body 700 as shown in FIG. More specifically, the measurement unit 200 is fixed to the surface of the lower abdomen of the patient with a tape or a belt. The measurement section 200 is connected to the storage section 300, the determination section 400, and the output section 500.
[0018]
Next, in step S101, the measurement unit 200 starts measuring the intensity of the magnetic field caused by the magnet 120 provided in a part of the applicator 100. For example, when the applicator 100 inserted into the urethra moves along the axial direction and the distance between the magnet 120 and the measurement unit 200 increases, the strength of the magnetic field measured by the measurement unit 200 decreases. On the other hand, when the applicator 100 moves along the axial direction and the magnet 120 approaches the magnet 120, the strength of the magnetic field measured by the measuring unit 200 increases. Therefore, the measurement unit 200 can detect the distance (the degree of proximity) between the magnet 120 and the measurement unit 200.
[0019]
Specifically, in response to an instruction to start measurement by a medical worker using an operation unit (not shown), the magnetic sensor 210 provided in the measurement unit 200 starts measuring the strength of the magnetic field outside the living body. As a result, the intensity of the magnetic field measured by the magnetic sensor 210 can be stored in the storage unit 300, and the determination unit 400 and the output unit 500 can execute various processes.
[0020]
Next, in step S102, the medical worker inserts the applicator 100 along the urethra. Then, the applicator 100 is arranged at a reference position inside the living body 700, that is, a position where the irradiation unit 110 can irradiate the affected part (in this case, the prostate) with the laser beam. Specifically, as shown in FIG. 5, the medical worker places the applicator 100 at the reference position by observing the inside of the living body through the endoscope unit 130 provided on the applicator 100. For example, it is possible to observe a place called a condyle in a living body and to arrange the applicator 100 at an appropriate reference position based on the position of the condyle. However, unlike the present embodiment, the applicator 100 may be arranged at the reference position by a method other than the observation through the endoscope unit 130.
[0021]
When the applicator 100 is placed at the reference position, the medical worker instructs completion of the placement of the applicator 100 at the reference position using the operation unit. After waiting for an instruction to complete the arrangement at the reference position (step S103: YES), the process proceeds to step S104.
[0022]
Next, in step S104, the storage unit 300 stores the strength of the magnetic field measured by the measurement unit 200 as the reference value when the applicator 100 is at the reference position inside the living body.
[0023]
Then, in step S105, irradiation of laser light is started. First, the laser light source 600 generates laser light. The generated laser light is guided to the irradiation unit 110 through an optical fiber, and is irradiated from the irradiation unit 110 to the affected part. More specifically, as shown in FIG. 5, a reflecting mirror 112 that reflects a laser beam is mounted inside the applicator 100. The reflecting mirror 112 moves forward and backward in the axial direction of the applicator 100 along a rail (not shown) during laser irradiation. As the reflecting mirror 112 moves forward and backward, the angle of the reflecting mirror 112 changes. Therefore, the laser beam reflected by the reflecting mirror 112 is intensively applied to the affected part.
[0024]
In step S106, it is determined whether the laser irradiation has been completed. For example, the laser irradiation time can be set in advance. When the laser irradiation is completed (step S106: YES), the process ends. On the other hand, during laser irradiation (step S106: NO), the processing of step S107 is executed.
[0025]
In step S107, during the laser irradiation, the measurement unit 200 continues measuring the strength of the magnetic field caused by the magnet 120. That is, the measurement unit 200 continuously or at predetermined time intervals newly measures the strength of the magnetic field. The newly measured magnetic field strength is stored in the storage unit 300.
[0026]
Next, in step S108, the determination unit 400 determines whether the intensity of the magnetic field newly measured by the measurement unit 200 has changed from the above-described reference value. Specifically, in order to eliminate the influence of the fluctuation of the magnetic field strength due to the stability and noise of the magnetic field sensor 210, it is determined whether or not the magnetic field strength has changed beyond an allowable range with respect to the reference value. You. If the intensity of the measured magnetic field does not change with respect to the above-mentioned reference value (step S108: NO), it is determined that the applicator 100 has not moved from the reference position, and the process returns to step S106, where laser irradiation is continued To be continued. At this time, the fact that the applicator 100 has not moved from the reference position may be displayed on the display 502. On the other hand, if the measured magnetic field intensity has changed with respect to the reference value (step S108: YES), it is determined that the applicator 100 has moved from the reference position, and the process proceeds to step S109.
[0027]
In step S109, the output unit 500 outputs a predetermined signal (warning signal).
In step S110, based on a predetermined signal from the output unit 500, the speaker 501 changes the pitch of the sound or the intermittent sound to warn the medical staff of the displacement of the applicator 100. In addition, the display 502 warns a medical worker of a displacement of the applicator 100 by displaying a change in the position of the applicator 100 by numerical values or illustrations. Upon receiving these warnings, the medical worker can perform an operation of correcting the positional shift of the applicator 100. The medical worker may temporarily suspend the laser irradiation process.
[0028]
When it is determined that the position of the applicator 100 has changed from the reference position, a predetermined signal is output from the laser light source control unit 501 included in the output unit 500 to the laser light source 600, and the laser irradiation is automatically forcibly performed. Or the intensity of the laser beam may be weakened.
[0029]
As described above, according to the present embodiment, the strength of the magnetic field caused by the magnet 120 provided in a part of the applicator 100 as the insertion portion is measured outside the living body by the measurement unit 200, and the measured magnetic field Based on the change between the intensity and the reference value, a displacement of the applicator 100 can be detected and a warning can be given. Therefore, it is possible to determine the presence or absence of a position shift of the insertion portion such as the applicator and check the position shift without using a large-scale apparatus such as X-ray fluoroscopy.
[0030]
(First Modification)
Next, a first modified example will be described. In the above description, as shown in FIGS. 4 and 5, a case has been described in which one magnetic field sensor is used to detect a change in the position of the applicator in the axial direction. In this modification, a case will be described in which a plurality of magnetic field sensors are used to detect a change in the position of the applicator in the axial direction and a change in the position in the rotation direction. Here, the axial direction of the applicator means a direction along the axis of the applicator, and the rotating direction of the applicator means a direction rotating about the axis of the applicator 100 as a central axis.
[0031]
In this modification, a measuring unit including a plurality of magnetic sensors is provided to detect not only the position change of the applicator in the axial direction but also the position change of the applicator in the rotation direction. In addition, the shape and arrangement of the magnets provided on the applicator are such that the magnetic field due to the magnets is not omnidirectionally distributed in the radial direction around the axis of the applicator but is distributed with directivity. It is decided. For example, unlike the case shown in FIG. 2, the applicator is provided over a part of the circumferential direction at a predetermined position in the axial direction. FIG. 6 shows an example of the applicator of the present modification.
[0032]
Except for the configurations of the measuring unit and the applicator described above, the configuration of the medical device of this modification is substantially the same as the configuration shown in FIG. Hereinafter, the same members as those shown in FIG. 1 will be described using the same reference numerals.
[0033]
FIG. 7 is a diagram illustrating an example of the measurement unit 200 according to the present modification, and FIG. 8 is a diagram illustrating a state where the measurement unit 200 in FIG. In the case shown in FIG. 8, the measuring unit 200 is wound around the penis surface.
[0034]
The measurement unit 200 shown in FIG. 7 includes a mounting band 220 made of a flexible material, and a plurality of magnetic sensors 212a to 212d and 214a to 214d provided on the mounting band 220. More specifically, the plurality of magnetic sensors 212a to 212d constitute a first sensor row 212 arranged in an annular shape so as to surround the applicator 100, and the plurality of magnetic sensors 214a to 214d similarly have a second Of the sensor array 214 are configured. In other words, the measurement unit 200 includes a plurality of sensor rows in which a plurality of magnetic sensors are arranged in a ring so as to surround the applicator 100 at a predetermined position in the axial direction of the applicator 100 outside the living body 700. ing.
[0035]
Here, the attachment band 220 may have a hollow bag structure capable of feeding air into the inside thereof. In this case, since the attachment band 220 expands by sending air into the attachment band 220, the attachment band 220 can be firmly fixed according to the size of the living body 700 such as the penis.
[0036]
FIG. 9 is a diagram illustrating another example of the measuring unit 200 in the present modification. The measuring unit 200 shown in FIG. 9 includes a case 230 configured by a pair of case bodies 230a and 230b attached to be openable and closable via a hinge 240, and a plurality of magnetic sensors 212a to 212d provided in the case. 214a to 214d. Also in this case, when the pair of case bodies 230a and 230b are closed so as to sandwich the living body, a plurality of sensor rows in which a plurality of magnetic sensors are annularly arranged are formed.
[0037]
As described above, each of the magnetic sensors 212 a to 212 d and 214 a to 214 d provided in the measurement unit 200 is connected to the storage unit 300. Therefore, the storage unit 300 can individually store the strength of the magnetic field measured by each of the magnetic sensors 212a to 212d and 214a to 214d. In particular, the storage unit 300 stores, as a reference value, the strength of each magnetic field measured by each of the magnetic sensors 212a to 212d and 214a to 214d when the applicator 100 is at the reference position. Note that the reference position in the present modification includes an axial reference position that is an axial position at which the laser beam from the irradiation unit 110 can be irradiated onto the affected part, and a rotational position that allows the laser light to be irradiated onto the affected part (ie, (Direction) in the rotation direction.
[0038]
The determination unit 400 according to the present modification is configured to determine the direction of the applicator 100 in the axial direction based on a change between the strength of the magnetic field newly measured by each of the plurality of magnetic sensors 212a to 212d and 214a to 214d and the above-described reference value. It is determined whether there is a position change in the rotation direction and a position change in the rotation direction.
[0039]
FIG. 10 is a schematic diagram illustrating a relationship between the magnet 120 and a plurality of magnetic sensors according to the present modification.
[0040]
As shown in FIG. 10A, first, the measurement unit 200 is attached to the outside of the living body 700. In particular, as described above, the first sensor row 212 in which the plurality of magnetic sensors 212a to 212d are arranged in a ring shape so as to surround the applicator 100 outside the living body 700, and the plurality of magnetic sensors 214a to 214d are formed in a ring shape. And a second sensor array 214 arranged in the measuring section 200. Preferably, when the applicator 100 is arranged at the reference position, the magnet 120 is located between the first sensor row 212 and the second sensor row 214 along the axis of the applicator 100. As described above, the distance between the first sensor row 212 and the second sensor row 214 and the arrangement position of the magnet 120 are designed.
[0041]
Also, as shown in FIG. 10B, the magnetic field caused by the magnet 120 is distributed with directivity, not omnidirectionally in the radial direction around the axis of the applicator 100. The shape and arrangement position of the magnet 120 are designed. In the example shown in FIG. 10B, the magnetic field in the first direction connecting the magnetic sensor 212a and the magnetic sensor 212c is strong, and the magnetic field in the second direction connecting the magnetic sensor 212b and the magnetic sensor 212d is weak.
[0042]
Next, a method of determining whether or not the applicator 100 has moved from the reference position will be described with reference to FIG. Whether or not the applicator 100 has moved in the axial direction can be determined as follows. The presence or absence of the movement in the axial direction is mainly determined by comparing the strengths of the magnetic fields measured by the sensor rows 212 and 214 with each other.
[0043]
For example, in FIG. 10A, when the applicator 100 moves along the axis in a direction from the first sensor row 212 to the second sensor row 214, a new measurement is performed by the first sensor row 212. The strength of the magnetic field (for example, the sum or average value of the strengths of the magnetic fields measured by the magnetic sensors 212a to 212d forming the first sensor row) is weaker than the case of the reference value, and the second sensor row 214 causes a new strength. The intensity of the magnetic field measured at the time is increased as compared with the case of the reference value. On the other hand, when the applicator 100 moves along the axis in the direction from the second sensor row 214 to the first sensor row 212, the intensity of the magnetic field newly measured by the first sensor row 212 is equal to the reference value. The strength of the magnetic field newly measured by the second sensor row 214 is weakened as compared with the case of the reference value.
[0044]
As described above, as to whether or not the applicator 100 has moved in the axial direction, one of the strengths of the magnetic field measured by the first sensor row 212 and the second sensor row 214 increases and the other weakens. Therefore, it is possible to determine whether or not the applicator 100 has moved from the reference position in the axial direction by analyzing each change in the magnetic field strength measured by each of the sensor rows 212 and 214.
[0045]
On the other hand, whether or not the applicator 100 has moved in the rotation direction can be determined as follows. The presence or absence of the movement in the rotation direction is determined by comparing the respective changes in the strength of the magnetic field measured by the plurality of magnetic sensors 212a to 212d constituting one sensor row (for example, the first sensor row 212). be able to.
[0046]
For example, in the case shown in FIG. 10B, due to the directivity of the magnetic field caused by the magnet 120, the magnetic sensors 212a and 212c are positioned in the direction in which the magnetic field intensity is strong, and the magnetic sensors 212b and 212d are Are located in the direction where the strength is weak. In this case, when the applicator 100 moves in the rotational direction (changes in direction), the strength of the magnetic field newly measured by the magnetic sensors 212a and 212c is weakened as compared with the state of FIG. The strength of the magnetic field newly measured by 212b and 212d is stronger than in the state of FIG. In the above description, the change in the magnetic field strength measured by the first sensor row 212 has been described, but the same change in the magnetic field strength also occurs in the second sensor row 214.
As described above, whether or not the applicator 100 moves in the rotational direction is determined by analyzing each change in the magnetic field strength measured by the plurality of magnetic field sensors 212a to 212d forming one sensor row 212. can do.
[0047]
In the present modification, the method of using the medical device and the like are described in the flowchart of FIG. 3 except that the movement of the applicator 100 in the axial direction and the movement in the rotation direction can be determined. Is the same as Therefore, detailed description is omitted.
[0048]
As described above, according to the present modification, it is possible to determine not only whether the applicator 100 has moved in the axial direction but also whether there is movement in the rotation direction. In addition, the type of displacement (movement in the axial direction or movement in the rotation direction) can be notified to the medical staff. Therefore, the medical worker can return the position of the applicator 100 to the reference position.
[0049]
In the above description, the case where two sensor rows 212 and 214 are provided has been described, but the present invention is not limited to this case. That is, three or more sensor rows may be provided. In the above description, the case where four magnetic sensors 212a, 212b, 212c, and 212d arranged at an interval of about 90 degrees constitute one sensor row 212, but the present invention is limited to this case. I can't. That is, the number of magnetic sensors constituting one sensor row is not limited to four. When increasing the number of sensor rows, the measurement accuracy of the axial position change of the applicator 100 increases, and when increasing the number of magnetic sensors constituting one sensor row, the rotational direction of the applicator 100 increases. The measurement accuracy of the position change is increased.
[0050]
In the above description, the case where the magnet 120 (magnetic body) is provided in a part of the applicator 100 and the magnetic sensor 210 is provided outside the living body has been described, but the present invention is not limited to this case. Instead of the combination of the magnet 120 and the magnetic sensor 210, a combination of two microwave antennas may be used. In this case, a microwave antenna is provided in place of the magnetic sensor 210 in the measurement unit 200 disposed outside the living body 700. This microwave antenna is capable of transmitting and receiving microwaves. On the other hand, a small microwave reflecting antenna is provided in a part of the applicator 100 instead of the magnet 120. This microwave reflecting antenna transmits a reflected wave according to the intensity of the received microwave.
[0051]
According to this configuration, first, the microwave is output from the microwave antenna provided outside the living body. A reflected wave is transmitted from the microwave reflecting antenna that has received the microwave. Since the intensity of the microwave received by the reflecting antenna changes according to the distance from the microwave antenna, distance information can be obtained by knowing the intensity of the reflected wave. Therefore, the microwave intensity when the applicator 100 is at the reference position is stored as a reference value, and the displacement of the applicator 100 is determined based on a change in the newly measured microwave intensity with respect to the reference value. You can judge.
[0052]
In the above description, the case where the measurement unit 200 is disposed on the outer surface of the living body 700 (particularly, the penis) has been described. Indeed, in order to reduce the influence of noise and increase the S / N ratio, it is desirable to arrange the measuring unit 200 as close as possible to the magnet 120 and the like. However, depending on the measurement sensitivity of the measurement unit 200, the measurement unit 200 may be provided at a position away from the surface outside the living body. For example, the measurement unit 200 may be embedded in various facilities or devices such as an operating table.
[0053]
Further, the measurement unit 200, the storage unit 300, the determination unit 400, and the output unit 500 may be integrally formed. Further, the measurement unit 200 may be connected to the determination unit 400 or the output unit 500 by wireless or optical communication.
[0054]
The same effect can also be obtained by providing the measuring unit 200 in the applicator 100 and installing a magnetic material outside the belt.
[0055]
(Second embodiment)
In the above-described first embodiment and the first modification, the medical device that determines whether the applicator 100 has moved from the reference position has been described. In the present embodiment, a description will be given of a medical device that fixes the applicator 100 with a magnetic force in a state where the applicator 100 is at the reference position, and prevents positional displacement in advance. In the description of the present embodiment, the same members as those in the first embodiment will be described using the same reference numerals.
[0056]
FIG. 11 is a schematic configuration diagram illustrating a medical device according to the second embodiment, and FIG. 12 is a schematic diagram illustrating a configuration of a fixing unit illustrated in FIG. The medical device according to the present embodiment includes an applicator 100, a laser light source 600, a fixing unit 900, an energization control unit 950, and a plurality of magnetic sensors 212a to 212d, 214a to 214d, 216a to 216d (collectively referred to as magnetic sensors 210). Having. The applicator 100, the laser light source 600, and the plurality of magnetic sensors 210 are the same as those described in the first embodiment. Therefore, detailed description is omitted.
[0057]
The fixing unit 900 has a plurality of electromagnets 912a to 912d, 914a to 914d, and 916a to 916d (collectively referred to as electromagnets 910). The fixing unit 900 including the electromagnet 910 fixes the applicator 100 at a reference position inside the living body 700 by a magnetic force between the electromagnet 910 and the magnet 120 provided in a part of the applicator 100.
[0058]
The energization control unit 950 controls the current flowing to each electromagnet 910. As a result, the magnetic force generated by each electromagnet 910 can be controlled, and the applicator 100 can be fixed inside the living body 700 or can be released. In addition, as described later, the energization control unit 950 adjusts the current flowing to each electromagnet 910, so that when the energization is performed, the energization control unit 950 causes an imbalance between the respective magnetic forces acting between each electromagnet 910 and the magnet 120, thereby causing the application. The position of the data 100 is prevented from changing from the reference position. More specifically, the energization control unit 950 controls the current so as to control the balance of the respective magnetic forces acting between each electromagnet 910 and the magnet 120 based on the measurement result of the strength of the magnetic field caused by the magnet 120. Is adjusted, and each electromagnet is energized. As a result, the applicator 100 can be fixed inside the living body 700 while controlling the magnetic force balance acting between the plurality of electromagnets and the magnet 120.
[0059]
As shown in FIG. 12, the fixing part 900 is mounted outside the living body 700, particularly around the penis. The fixing portion 900 includes a mounting band 920 made of a flexible material, and a plurality of electromagnets 910 provided on the mounting band 920. Further, a plurality of magnetic sensors 210 are also provided integrally with the fixed part 900.
[0060]
In the present embodiment, the plurality of electromagnets 910 constitute a first electromagnet row 912, a second electromagnet row 914, and a third electromagnet row 916 arranged at equal intervals along the axial direction of the applicator 100. ing. For example, the first electromagnet row 912 is composed of a plurality of electromagnets 912a, 912b, 912c, and 912d arranged annularly so as to surround the applicator 100 outside the living body. Similarly to the first electromagnet row 912, the second electromagnet row 914 includes a plurality of electromagnets 914a to 914d, and the third electromagnet 916 includes a plurality of electromagnets 916a to 916d. In other words, the fixing unit 900 includes a plurality of electromagnet rows in which a plurality of electromagnets are annularly arranged so as to surround the applicator 100 at predetermined positions in the axial direction of the applicator 100.
[0061]
Further, in the present embodiment, a plurality of magnetic sensors 210 are attached to fixed portion 900. For example, each magnetic sensor 210 is arranged near each of the electromagnets 912a to 912d, 914a to 914d, and 916a to 916d.
[0062]
Here, the attachment band 920 may have a hollow bag structure through which air can be supplied. Further, similarly to the structure of the measuring section shown in FIG. 9, the fixing section 900 has a case 930 constituted by a pair of case bodies 930a and 930b attached by a hinge 940 so as to be openable and closable. And a plurality of electromagnets 910.
[0063]
Next, a method of using the medical device shown in FIG. 11 will be described with reference to FIG. FIG. 13 is a flowchart illustrating a method of using the medical device illustrated in FIG. 11 and its functions.
[0064]
In step S200, first, the fixing unit 900 is disposed outside the living body 700. Therefore, the magnetic sensor 210 attached to the fixing unit 900 is also arranged outside the living body 700.
[0065]
In step S201, the magnetic sensor 210 starts measuring the strength of the magnetic field caused by the magnet 120 provided in a part of the applicator 100. The processing in step S201 may be executed after step S202 or step S203 described later.
[0066]
In step S202, the medical worker inserts the applicator 100 into the urethra, and arranges the reference position inside the living body 700, that is, a position where the laser beam from the irradiation unit 110 can irradiate the affected part. Then, after waiting for an instruction to complete the arrangement of the applicator 100 at the reference position (step S203: YES), the process proceeds to the next step S204.
[0067]
In step S204, a condition in which the magnetic forces acting between each electromagnet 910 and the magnet 120 balance each other is calculated based on the measurement result of the magnetic field intensity by the magnetic sensor 210. For example, the strength of the magnetic field at the position of each electromagnet 910 is determined from the measurement result of the strength of the magnetic field. Based on the strength of the obtained magnetic field and the performance of the electromagnet 910 measured in advance, when it is assumed that a specific current has flowed through the electromagnet 910, each of the magnets 910 and the respective magnets 120 acting between the magnets 120 A magnetic force (magnetic force vector) is predicted. Then, based on the prediction result, the current value to be passed through each electromagnet 910 is determined when the respective magnetic force vectors are added and becomes zero when the respective magnetic force vectors are added and the forces are balanced.
[0068]
In step S205, the current having the value determined in step S204 is supplied to each electromagnet 910. That is, the electromagnets are energized under conditions where the magnetic forces acting between each electromagnet 910 and the magnet 120 balance each other. As a result, the electromagnet 910 attracts the magnet 120 by the magnetic force between the electromagnet 910 and the electromagnet 910 to fix the applicator 100 at the reference position inside the living body 700. The applicator 100 moves from the reference position before and after energization due to the imbalance of the magnetic force because the respective magnets acting between each electromagnet 910 and the magnetic body are energized under the condition that the respective magnetic forces balance each other. Can be prevented.
[0069]
In step S206, irradiation of laser light is started in a state where the applicator 100 is fixed inside the living body 700. Thereafter, after the laser irradiation for a predetermined time is completed (step S207: YES), the process of step S208 is executed. In step S208, the fixing of the applicator 100 is released by stopping the energization of the electromagnet 910. After the fixing of the applicator 100 is released, the medical worker pulls out the applicator 100 from the inside of the living body.
[0070]
Note that the present embodiment is not limited to this case. For example, when the applicator 100 is inserted along a relatively narrow tube such as the urethra, displacement of the applicator 100 in the axial direction is particularly problematic. Therefore, a condition may be calculated so that only the magnetic force vector component in the axial direction of the applicator 100 is balanced, and the applicator 100 by the electromagnet 910 may be fixed under this condition. In this case, since the force in the direction perpendicular to the axis is not offset, the applicator 100 can be fixed inside the living body 700 with a relatively strong force.
[0071]
Further, the electromagnet 910 in a non-energized state can be used as a magnetic sensor. When the electromagnet 910 is also used as a magnetic sensor, it is not necessary to separately provide the magnetic sensor 210.
[0072]
As described above, according to the present embodiment, the magnet 120 provided on a part of the applicator 100, which is the insertion portion, is attracted by the electromagnet 910 outside the living body 700, so that the applicator 100 is positioned inside the living body 700. Since the applicator 100 is fixed at the position, displacement of the applicator 100 can be prevented, and only the affected part to be treated is irradiated with laser light, so that effective heat treatment can be performed.
[0073]
As described above, the preferred embodiments of the present invention have been described, but the present invention should not be limited by these embodiments, and various modifications can be made within the scope of the technical idea.
[0074]
For example, in the above description, the case where laser light is irradiated from the irradiation unit has been described, but the present embodiment is not limited to this case. For example, energy such as microwaves may be irradiated from the irradiation unit toward the living body. In this case, a mechanism for irradiating microwaves is provided in the insertion section instead of the mechanism for irradiating laser light.
[0075]
In the above description, an applicator for treating prostate disease has been described as an example. However, the present invention is not limited to this case, and a long-shaped insertion device that needs to be held inside a living body for a relatively long time is used. The present invention can be applied to any medical device as long as it is a medical device having a section. Specifically, the present invention can be widely applied to medical devices having a catheter, an endoscope, an ultrasonic probe, a puncture needle, or the like as an insertion portion instead of the above-described applicator. Taking a catheter as an example, as in the first embodiment, a magnet is provided in a part of the catheter, the strength of a magnetic field caused by the magnet is measured outside the living body, and the catheter is located at a reference position. By comparing the reference value, which is the strength of the magnetic field measured at the time of the measurement, with the strength of the newly measured magnetic field, the displacement of the catheter can be determined, and various warnings can be given to the medical staff. . Further, similarly to the case of the second embodiment, the catheter can be fixed by a magnetic force between a magnet provided in a part of the catheter and a fixing portion provided outside the living body.
[0076]
[Appendix]
(Additional Item 1) The generation unit is a microwave reflection antenna that generates microwaves,
The medical device according to claim 1, wherein the measurement unit is a microwave antenna for measuring the intensity of the microwave outside a living body.
[0077]
(Additional Item 2) The predetermined signal output from the output unit is a signal for controlling a speaker that outputs a warning sound indicating that the position of the insertion unit has changed. Medical device as described.
[0078]
(Additional Item 3) The medical device according to claim 1, wherein the predetermined signal output from the output unit is a signal for controlling a display indicating that the position of the insertion unit has changed.
[0079]
(Additional Item 4) The medical device according to claim 5, wherein the predetermined signal output from the output unit is a signal for stopping irradiation of energy.
[0080]
(Appendix 5) The medical device according to claim 1, wherein the measurement unit is disposed in contact with an external surface of the living body.
[0081]
(Supplementary note 6) The medical device according to claim 1, wherein the measurement unit is arranged away from an external surface of the living body.
[0082]
(Supplementary note 7) The medical device according to claim 4, wherein the measurement unit includes a flexible band and the magnetic sensor attached to the band.
[0083]
(Supplementary note 8) The measurement unit according to claim 4, wherein the measurement unit includes a case configured by freely opening and closing a pair of case bodies via a hinge, and a magnetic sensor provided in the case. Medical device as described.
[0084]
(Appendix 9) The medical device according to claim 5 or 6, wherein the medical device is a heat treatment device.
[0085]
(Supplementary note 10) The medical device according to claim 5 or 6, wherein the medical device is a prostate heat treatment device.
[0086]
(Supplementary note 11) The fixing unit according to claim 7, wherein the fixing unit includes a plurality of electromagnet rows in which a plurality of electromagnets are annularly arranged outside the living body so as to surround the insertion section. Medical equipment.
[0087]
(Additional Item 12) The energization control unit energizes the electromagnet under conditions where the axial components of the magnetic force acting between each electromagnet and the magnetic body are balanced with each other. 9. The medical device according to 8.
[0088]
(Additional Item 13) The current supply controller adjusts a current value flowing through each electromagnet such that respective magnetic forces acting between each electromagnet and the magnetic body are balanced with each other. Medical equipment.
[0089]
(Supplementary Note 14) The medical device according to claim 10, wherein the energization control unit suspends energization to the electromagnet when the irradiation of the energy by the irradiation unit is completed.
[0090]
(Appendix 15) The medical device according to any one of claims 9 to 11, wherein the medical device is a heat treatment device.
[0091]
(Appendix 16) The medical device according to any one of claims 9 to 11, wherein the medical device is a prostate heat treatment device.
[0092]
【The invention's effect】
As described above, according to one aspect of the present invention, a generation unit that generates an electric field or a magnetic field, a measurement unit that measures the intensity of the electric or magnetic field caused by the generation unit, and an insertion unit that is positioned at a reference position inside a living body A storage unit that stores the intensity of the electric field or magnetic field measured by the measurement unit as a reference value when present, and a change between the intensity of the electric field or magnetic field newly measured by the measurement unit and the reference value. Output unit that outputs a predetermined signal based on the information, so that a medical worker can be notified of the displacement of the insertion unit in a living body without using a large-scale device, and immediately correct the position of the insertion unit. can do. In addition, the work load for checking the presence / absence of the displacement is reduced for the medical staff, so that it is possible to concentrate on the operation of the insertion section. Further, unlike the case where the displacement of the insertion portion is confirmed by X-ray fluoroscopy, the exposure dose is reduced.
[0093]
In particular, by using a magnetic substance that generates a magnetic field as the above-mentioned generating unit and using a measuring unit equipped with a magnetic sensor, it is possible to easily determine the presence or absence of displacement of the insertion unit using a magnetic field that has little effect on the living body. can do.
[0094]
In addition, by using a measurement unit including a plurality of sensor arrays in which a plurality of magnetic sensors are annularly arranged so as to surround the insertion unit outside the living body, the position change in the axial direction of the insertion unit and the rotation in the rotation direction can be achieved. The presence or absence of both of the position changes can be determined. Therefore, the type of displacement of the insertion portion can also be notified to the medical staff.
[0095]
Further, according to another aspect of the present invention, a magnetic member provided in a part of the insertion portion, and a fixing portion for fixing the insertion portion to a reference position inside the living body by a magnetic force between the magnetic material and Therefore, with a simple configuration, the insertion portion can be fixed at the reference position, and the displacement of the insertion portion can be prevented in advance.
[0096]
Also, a plurality of magnetic sensors that measure the strength of the magnetic field caused by the magnetic material outside the living body, and the respective magnetic forces acting between each electromagnet and the magnetic material are balanced with each other based on the measurement results by the plurality of magnetic sensors. When there is an energization control unit that energizes the electromagnet under conditions, it is possible to prevent the insertion unit from moving from the reference position due to imbalance in magnetic force.
[0097]
In addition, when the insertion unit includes an irradiation unit that irradiates energy toward the living body, it is possible to irradiate the living body with energy such as a laser beam in a state where the insertion portion is prevented from being displaced, and to specify the inside of the living body. Heat treatment that concentrates energy only on the affected area is possible.
[Brief description of the drawings]
FIG. 1 is a schematic configuration diagram illustrating a medical device according to a first embodiment.
FIG. 2 is a diagram showing an example of the applicator shown in FIG.
FIG. 3 is a flowchart showing a method of using and functions of the medical device of FIG. 1;
FIG. 4 is a diagram illustrating an example of an arrangement of each unit in the medical device in FIG. 1;
FIG. 5 is an enlarged view of a main part of FIG. 4;
FIG. 6 is a diagram illustrating an example of an applicator according to a first modification.
FIG. 7 is a diagram illustrating an example of a measurement unit according to a first modification.
8 is a diagram showing a state in which the measurement unit shown in FIG. 7 is attached to the outside of a living body.
FIG. 9 is a diagram illustrating another example of the measurement unit in the first modification.
FIG. 10 is a diagram showing a relationship between a magnet and a magnetic sensor according to a first modification.
FIG. 11 is a schematic configuration diagram illustrating a medical device according to a second embodiment.
FIG. 12 is a schematic diagram illustrating a configuration of a fixing unit illustrated in FIG. 11;
FIG. 13 is a flowchart showing a method of using and functions of the medical device shown in FIG. 11;
[Explanation of symbols]
100 ... applicator (insertion part),
110 irradiation part,
120: magnet (generation unit),
200: measuring unit,
210 ... magnetic sensor,
212, 214 ... sensor row
300: storage unit,
400 ... decision section,
500 output unit,
503: laser light source control unit,
600 laser light source
900 ... fixed part,
910 ... electromagnet,
950 ... energization control unit.

Claims (11)

A long insertion portion that can be inserted into a living body,
A generator for generating an electric or magnetic field;
A measuring unit for measuring the intensity of an electric field or a magnetic field caused by the generating unit outside the living body, and a reference value indicating the intensity of the electric field or the magnetic field measured by the measuring unit when the insertion unit is present at a reference position inside the living body. And a storage unit for storing as
Either the generation unit or the measurement unit is provided in a part of the insertion unit, and the other can be fixed outside the living body,
A medical device comprising: an output unit that outputs a predetermined signal based on a change between the intensity of an electric field or a magnetic field newly measured by the measurement unit and the reference value. The generating unit is a magnetic body that generates a magnetic field,
The medical device according to claim 1, wherein the measurement unit includes a magnetic sensor that measures a magnetic field intensity. Further, a determination unit that determines the presence or absence of a change in the position of the insertion unit based on a change between the intensity of the electric field or magnetic field newly measured by the measurement unit and the reference value, the output unit includes: The medical device according to claim 1, wherein the predetermined signal is output when it is determined that the position of the insertion portion has changed from a reference position. The generating unit is provided in a part of the insertion unit,
The measurement unit includes a plurality of sensor rows in which a plurality of magnetic sensors are arranged annularly so as to surround the insertion unit outside the living body,
The storage unit stores the strength of each magnetic field measured by each of the plurality of magnetic sensors as a reference value when the insertion unit is present at a reference position inside the living body,
The determining unit is configured to change a position of the insertion unit in an axial direction and a position of the insertion unit in a rotation direction based on a change between a magnetic field intensity newly measured by each of the plurality of magnetic sensors and the reference value. 4. The medical device according to claim 3, wherein the presence or absence of both changes is determined. The medical device according to claim 1, wherein the insertion unit includes an irradiation unit that irradiates energy toward a living body. The medical device according to claim 5, wherein the energy is a laser beam. A long insertion portion that can be inserted into a living body,
A magnetic body provided in a part of the insertion portion,
A medical device comprising: a fixing portion that fixes the insertion portion to a reference position inside the living body by attracting the magnetic body by a magnetic force from outside the living body. The fixing unit includes a plurality of electromagnets,
Further, a plurality of magnetic sensors for measuring the strength of the magnetic field due to the magnetic material outside the living body, and based on the measurement results by the plurality of magnetic sensors, respective magnetic forces acting between each electromagnet and the magnetic material are The medical device according to claim 7, further comprising: an energization control unit configured to energize the electromagnet under mutually balanced conditions. The medical device according to claim 7, wherein the insertion unit includes an irradiation unit that irradiates the living body with energy. The medical device according to claim 9, wherein the energization control unit controls energization of the electromagnet in conjunction with an irradiation state of energy by the irradiation unit. The medical device according to claim 9, wherein the energy is a laser beam.

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