JP2004267655A - Apparatus and method of ultrasonic treatment - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an apparatus and a device of ultrasonic treatment, capable of correctly and safely irradiating an affected part with ultrasonic waves in the treatment with strong ultrasonic waves by fixing the tip of an ultrasonic applicator to the surface of the affected part. <P>SOLUTION: The ultrasonic applicator 32 has a water supply pipe 33 for exuding a coupling liquid 34 to the affected part from the tip of the ultrasonic applicator 32 for irradiation with the ultrasonic waves for medical treatment and a water suction pipe 36 for sucking the exuded coupling liquid 34 in the treatment of the affected part 152 with irradiation with ultrasonic waves for medical treatment. The water supply pipe 33 and the water suction pipe 36 are connected to a water supply tube pump 35 and a water suction tube pump 37 respectively. A system control part 41 sucks the surface of the affected part 152 by controlling the quantity of water fed by the water supply pipe 33 and sucked by the water suction pipe 36, so that the affected part 152 is fixed to the tip of the ultrasonic applicator 32. <P>COPYRIGHT: (C)2004,JPO&NCIPI

Description

[0001]
TECHNICAL FIELD OF THE INVENTION
The present invention relates to an ultrasonic treatment apparatus and an ultrasonic treatment method for performing treatment by irradiating ultrasonic waves to living tissue.
[0002]
[Prior art]
In recent years, a treatment called minimally invasive treatment has attracted attention, and aggressive attempts have been made in the field of treatment of malignant tumors for minimally invasive treatment. In the case of malignant tumors in particular, many treatments rely on surgery. However, in the case of conventional surgical treatment, that is, when performing extensive tissue resection, the original functions and appearance of the organ are considered. In many cases, the morphology is greatly impaired, and even if it survives, it imposes a great burden on the patient. For such conventional surgical treatments, there is a strong demand for the development of an ultrasonic treatment apparatus in consideration of quality-of-life (QOL). Research on ultrasonic therapy in which heat is applied by irradiating sound waves to cause thermal degeneration and necrosis has been advanced.
[0003]
The treatment method using high-intensity ultrasound is superior to the method using microwaves because it has better energy focusing and deeper penetration. It has a great advantage that a therapeutic treatment is possible.
[0004]
The treatment method using high-intensity ultrasonic waves irradiates a treatment site such as a tumor or a bleeding part of a blood vessel with an ultrasonic wave generated by supplying an electric drive signal to a piezoelectric vibrating element. By irradiating focused ultrasonic waves to the skin, local treatment is possible.
[0005]
As one of the treatment apparatuses using ultrasonic waves, a “harmonic scalpel (ultrasonic coagulation and incision apparatus)” for performing hemostasis on a bleeding site and crushing or excision of an affected part has been conventionally known. In this "harmonic scalpel", a horn fixed to a bolted Langevin type vibrator is provided with a saw-toothed rod at the tip, and this rod is attached to the affected part and ultrasonic waves are applied at a relatively low frequency of about several tens KHz. By vibrating, blood vessels or tissues are cut off.
[0006]
On the other hand, when ultrasound of a relatively high frequency of 1 MHz to 3 MHz is applied to a living tissue, the effect of the above-mentioned pulverization or excision is reduced and the effect of heat generation or hemostasis is enhanced. The intended ultrasonic treatment apparatus uses ultrasonic waves of the above-mentioned frequency.
[0007]
In a treatment using a combination of an ultrasonic treatment apparatus having such characteristics and a laparoscope, usually, a skin surface of a patient is incised by about 3 cm, and a trocar (with a check valve) having an inner diameter of about 2 cm is cut through the incision. ). Then, an ultrasonic irradiation unit (hereinafter, referred to as an ultrasonic applicator) of the ultrasonic treatment apparatus is inserted below the abdominal wall via the trocar.
[0008]
Inserting the ultrasonic applicator under the abdominal wall by the above method, when irradiating the therapeutic ultrasonic waves in a state where the tip thereof is in contact with the affected part, usually requires irradiation time of several tens of seconds to tens of minutes, During this irradiation period, the tip of the ultrasonic applicator must be stably fixed to the affected part. In response to such demands, the conventional ultrasonic therapy apparatus provides a tissue gripping part at a contact part of the ultrasonic applicator with the affected part, thereby displacing the ultrasonic applicator and the affected part during ultrasonic irradiation. A method for reducing the noise has been proposed (for example, see Patent Document 1).
[0009]
[Patent Document 1]
JP-A-10-216146 (page 5, FIG. 6)
[0010]
[Problems to be solved by the invention]
However, even when a tissue gripping portion as described in Patent Document 1 is provided on the ultrasonic applicator, the surface of the affected part is slippery because it is wet with body fluid, and because it has elasticity, It is extremely difficult to fix the tip of the ultrasonic applicator to the affected part for a long time. In particular, the need to position the distal end of the ultrasonic applicator through a small trocar hole in the patient's abdominal wall makes the long-term fixation more difficult. On the other hand, if the tip is provided with a mechanism like scissors to prevent slippage, there is a risk of damaging the affected part surface, which is not desirable.
[0011]
The present invention has been made in order to solve such a conventional problem, and an object thereof is to irradiate an ultrasonic wave to an affected part to perform treatment, and to perform treatment by applying a tip of an ultrasonic applicator during the treatment. It is an object of the present invention to provide an ultrasonic treatment apparatus and an ultrasonic treatment method capable of safely and easily performing treatment on an affected part by securely fixing the part to the affected part without causing damage.
[0012]
[Means for Solving the Problems]
In order to solve the above-mentioned problem, an ultrasonic therapy apparatus according to the present invention according to claim 1 includes an ultrasonic wave transmitting unit that irradiates a living body with therapeutic ultrasonic waves, and a driving unit that drives the ultrasonic wave transmitting unit. Driving means for supplying a signal, an ultrasonic applicator having the ultrasonic wave transmitting means at a distal end thereof, a suction pipe having one end opened at the distal end of the ultrasonic applicator, and the other of the suction pipe The suction means connected to the end of the ultrasonic applicator is formed by the living body and the distal end of the ultrasonic applicator when applying the therapeutic ultrasonic wave by bringing the distal end of the ultrasonic applicator into contact with the living body. Control means for controlling the suction means so that the pressure in the closed space becomes a predetermined negative pressure.
[0013]
According to a second aspect of the present invention, there is provided an ultrasonic treatment apparatus for irradiating a living body with therapeutic ultrasonic waves, and a driving means for supplying a drive signal to the ultrasonic transmission means. An ultrasonic applicator having the ultrasonic wave transmitting means at a distal end thereof, a water pipe having one end opened at the distal end of the ultrasonic applicator, and the other end of the water pipe being connected to the ultrasonic applicator. A water supply means for supplying a coupling liquid to the living body from an open end of the water supply pipe through the water supply pipe, and a water absorption pipe having one end opened at a tip end of the ultrasonic applicator. And the other end of the water absorption pipe is connected, the water absorption means for absorbing the coupling liquid sent to the living body from the open end of the water absorption pipe through the water absorption pipe, and Insert the tip of the ultrasonic applicator into the raw When irradiating therapeutic ultrasonic waves in contact with the living body, the water supply amount and the water absorption in the water supply means are adjusted so that the pressure in the closed space formed by the living body and the distal end portion of the ultrasonic applicator becomes a predetermined negative pressure. Control means for controlling the amount of water absorption in the means.
[0014]
On the other hand, an ultrasonic treatment method of the present invention according to claim 16 is an ultrasonic treatment method in which an ultrasonic applicator provided with an ultrasonic wave transmitting means at a distal end portion is brought into contact with a living body and irradiates the living body with an ultrasonic therapeutic wave. An ultrasonic treatment method, comprising: arranging a distal end portion of the ultrasonic applicator in the affected part of the living body; and controlling the amount of water supplied and the amount of water absorbed by the coupling liquid to the affected part to control the affected part of the living body by the ultrasonic application. And a step of irradiating the living body affected part with therapeutic ultrasonic waves.
[0015]
The ultrasonic treatment method according to the present invention according to claim 17 is an ultrasonic treatment method in which an ultrasonic applicator provided with an ultrasonic wave transmitting means at a distal end portion is brought into contact with a living body to irradiate a therapeutic ultrasonic wave to a diseased part of the living body. An ultrasonic treatment method, wherein the step of arranging the distal end of the ultrasonic applicator on the affected part of the living body, and fixing the living body affected part to the distal end of the ultrasonic applicator by controlling the suction amount with respect to the affected part And a step of irradiating the living body affected part with therapeutic ultrasonic waves.
[0016]
Therefore, according to the present invention, an ultrasonic treatment that can safely and easily perform treatment on an affected part by securely holding the ultrasonic irradiation surface of the ultrasonic applicator at the position of the affected part without damaging the organ An apparatus and an ultrasonic treatment method can be provided.
[0017]
BEST MODE FOR CARRYING OUT THE INVENTION
(First Embodiment)
The feature of the first embodiment of the present invention described below is that in a state in which the tip of the ultrasonic applicator is in contact with the affected part, water is supplied and absorbed from the tip to the affected part, The object of the present invention is to control the amount of water supplied and the amount of water absorbed at this time so that the affected part is adsorbed to the above-mentioned distal end and fixed.
[0018]
(Structure of the device)
The configuration of the ultrasonic therapy apparatus according to the first embodiment of the present invention will be described with reference to FIGS. FIG. 1 is a block diagram showing a schematic configuration of the entire ultrasonic therapy apparatus according to the first embodiment, and FIG. 2 is a diagram showing a configuration of an ultrasonic applicator of the ultrasonic therapy apparatus. FIG. 6 is a block diagram showing a configuration of an ultrasonic imaging apparatus provided in the ultrasonic treatment apparatus.
[0019]
In FIG. 1, an ultrasonic treatment apparatus 200 is inserted into a body surface 153 through an opening of a trocar 31 provided at an incision in the body surface 153 of a patient, and the ultrasonic treatment device 200 An ultrasonic applicator 32 for irradiating a sound wave, a tube pump 35 for supplying a coupling liquid 34 to the ultrasonic applicator 32 via a water supply pipe 33, and a water pump 36 from the ultrasonic applicator 32 A tube pump 37 which absorbs the coupling liquid 34 by water, a reservoir 38 in which the coupling liquid 34 for water supply is stored, and a storage tank 39 in which the absorbed coupling liquid 34 is stored. The water absorption pipe 36 between the ultrasonic applicator 32 and the tube pump 37 is provided with a pressure sensor 44 for measuring a negative pressure during water absorption.
[0020]
In addition, the ultrasonic therapy apparatus 200 includes an ultrasonic driving unit 40 that supplies a drive signal to the ultrasonic applicator 32 to irradiate the affected part 152 with ultrasonic waves, and the intensity and the intensity of the ultrasonic wave applied to the affected part 152. Starting from the irradiation time, a system control unit 41 that controls the entire apparatus in its entirety, an operation unit 42 to which various command signals are input by the operator, a tip of the ultrasonic applicator 32, and a surface of the affected area 152 And a vibrating section 43 for applying mechanical vibration to the ultrasonic applicator 32 to prevent adhesion of the ultrasonic applicator 32. Further, in the present embodiment, an ultrasonic imaging device 250 for confirming the treatment effect on the affected area 152 is provided.
[0021]
Next, the configuration of the ultrasonic applicator 32 will be described with reference to FIG. 2 (a) is a longitudinal sectional view of the ultrasonic applicator 32, and FIG. 2 (b) shows a transverse section of the ultrasonic applicator 32 in the AA section shown in FIG. 2 (a). ing.
[0022]
The ultrasonic applicator 32 has a circular plate-shaped ultrasonic wave transmitting unit that irradiates the affected part 152 with therapeutic ultrasonic waves in the vicinity of the distal end (the left end in FIG. 2A) of the cylindrical frame 46. 49 is provided, and the ultrasonic wave transmitting section 49 is connected to the ultrasonic driving section 40 of FIG. 1 via an Nx channel signal cable 50. Further, the ultrasonic wave emitting surface of the ultrasonic wave transmitting section 49 is covered with a water bag 48 made of a polymer material having excellent ultrasonic permeability, and the gap between the ultrasonic wave transmitting section 49 and the water bag 48 is made of deaerated water or the like. Is filled with an acoustic coupling liquid 54 using. Then, the acoustic coupling liquid 54 passes through a water bag water supply pipe 51 and a water bag water absorption pipe 52 whose one end is opened to the water bag 48 and the other end is connected to a circulating pump (not shown). Circulating. The water bag 48 and the acoustic coupling liquid 54 eliminate the air interposed between the ultrasonic wave transmitting unit 49 and the affected part 152 to improve the ultrasonic irradiation efficiency, and further circulate the acoustic coupling liquid 54. As a result, heat generated when driving the ultrasonic wave transmitting unit 49 is reduced.
[0023]
On the other hand, on the edge of the ultrasonic wave transmitting section 49, the open ends of a plurality of water pipes 33 for supplying a coupling liquid 34 composed of, for example, sterilized purified water to the surface of the affected area 152 are arranged. The surface of the open end is covered with a ring-shaped porous body 47 through which the coupling liquid 34 can pass. In addition, near the center of the water bag 48 and the ultrasonic wave transmitting unit 49, a water absorption pipe 36 having one end opened to the outside of the water bag 48 is provided. The other end of the water supply pipe 33 is connected to the tube pump 35 of FIG. 1, and the other end of the water absorption pipe 36 is connected to the tube pump 37 via the pressure sensor 44. That is, the coupling liquid 34 supplied by the tube pump 35 exudes from the porous body 47 to the affected part 152 via the water supply pipe 33, and the exuded coupling liquid 34 is provided at the center of the water bag 48. The water is discharged through the opening of the water absorption pipe 36.
[0024]
Further, a ring-shaped outer ring 53 for fixing the ultrasonic applicator 32 to the surface of the affected area 152 is provided at the tip of the cylindrical frame 46 of the ultrasonic applicator 32, and the outer ring 53 is formed of a water bag. 48 protrudes in the direction of the affected area 152 to approximately the same extent as the central part. The water bag water pipe 51, the water bag water pipe 52, the water pipe 33 and the water pipe 36 are arranged substantially parallel to the axis of the cylindrical frame 46 (the Z axis in FIG. 2A). .
[0025]
On the other hand, a small-diameter ultrasonic probe (hereinafter, referred to as a small-diameter probe) 101 of the ultrasonic imaging device 250 described later is provided at an outlet of the water absorption tube 36 in the ultrasonic applicator 32 (the details will be described with reference to FIG. 6). .) Is provided, and when the therapeutic effect on the affected area 152 is confirmed by an ultrasonic image, the small-diameter probe 101 inserted from the insertion hole 45 is used for the ultrasonic applicator 32. It is placed on the surface of the affected area 152 via the internal water absorption pipe 36. In addition, around the insertion hole 45, an unillustrated prevention valve for preventing the outflow of the coupling liquid 34 and the intrusion of air is provided, while the water supply pipe 33 has a plurality of small-diameter tubes as shown in FIG. A ring-shaped porous body 47 is attached to the open ends of a plurality of small-diameter tubes which are integrally formed.
[0026]
The porous body 47 is mainly made of alumina, silicon carbide, or the like in order to prevent the influence of ultrasonic waves emitted from the ultrasonic wave transmitting section 49, that is, to prevent deformation or clogging due to heat generation. It is desirable to use heat-resistant materials such as porous ceramics, but if the heat generation is within the allowable range, use a resin-made porous body using a sintered resin such as PVA sponge, urethane sponge, polyethylene, polypropylene, or fluorine. It is also possible. Specifically, there are a plastic sintered porous body of Someya Seisakusho, a continuous porous body of Muromachi Chemical Co., Ltd., and a porous metal plate of Global Electronics Industry Co., Ltd.
[0027]
Next, the structure of the ultrasonic wave transmitting unit 49 included in the ultrasonic applicator 32 will be described with reference to FIG.
[0028]
FIG. 4A is a diagram showing the arrangement of the piezoelectric vibrators 61 constituting the ultrasonic wave transmitting unit 49 from the front direction (the Z-axis direction in FIG. 2), and FIG. It is sectional drawing of the ultrasonic wave transmission part 49 in BB cross section shown to a). That is, the ultrasonic wave transmitting unit 49 includes Nx ring-shaped piezoelectric vibrators 61 which are concentrically arranged as shown in FIG. The piezoelectric vibrators 61 are arranged on the same plane. In addition, a circular space for arranging the water absorption pipe 36 is provided at the center of the ultrasonic wave transmitting unit 49.
[0029]
On the other hand, in FIG. 4B, an electrode 62a and an electrode 62b are mounted on a first surface (upper surface) and a second surface (lower surface) of the Nx piezoelectric vibrators 61, respectively. 63. The electrode 62b is provided with an acoustic matching layer 64 for efficiently irradiating therapeutic ultrasonic waves, and the surface thereof is covered with a protective film 65. The electrodes 62a respectively mounted on the piezoelectric vibrators 61 are connected to the ultrasonic driving section 40 of FIG. 1 by a signal cable 50 composed of an Nx channel, and the electrodes 62b are connected in common to ground (not shown) of the ultrasonic treatment apparatus 200. Connected to terminal.
[0030]
Next, the configurations of the ultrasonic drive unit 40 and the system control unit 41 will be described with reference to FIG. The ultrasonic drive unit 40 has a function of supplying a drive signal to the piezoelectric vibrator 61 of the ultrasonic applicator 32 to irradiate the affected part 152 with therapeutic ultrasonic waves. A CW generator 71 for generating a continuous wave having a frequency substantially equal to the resonance frequency, a delay circuit 72 for providing a predetermined delay phase to the continuous wave from the CW generator 71, and a continuous wave output from the delay circuit 72 And a matching circuit 74 that performs impedance matching in order to efficiently supply the output of the power amplifier 73 to the piezoelectric vibrator 61.
[0031]
The CW generator 71 includes a VCO (voltage control generator) and a D / A converter (not shown), and converts the frequency information supplied from the system control unit 41 into a voltage value by the D / A converter. Further, the output frequency of the VCO is set in accordance with this voltage value. That is, the frequency of the continuous wave output from the CW generator 71 is optimized according to the purpose of treatment (for example, hemostasis at a bleeding site or cauterization of a tumor) or the spread of the affected area 152.
[0032]
The delay circuit 72 converts the Nx channel continuous wave output from the CW generator 71 to focus and irradiate the therapeutic ultrasonic waves radiated by the piezoelectric vibrator 61 of the ultrasonic applicator 32 to the affected part 152. A predetermined delay phase is given to the signal. At this time, the delay phase given to each continuous wave is uniquely determined by the arrangement shape and the focusing distance of the piezoelectric vibrators 61. On the other hand, the amplification degree of the power amplifier 73 is controlled by the control signal of the system control unit 41, and the optimum amplification degree is set according to the purpose of treatment or the spread (depth) of the affected part 152.
[0033]
Next, the system control unit 41 of FIG. 5 includes a CPU (Central Processing Unit) 76 and a storage circuit 77, and controls the control of each unit and the control of the entire system according to a command signal input from the operation unit 42. Do. In the storage circuit 77 of the system control unit 41, optimal ultrasonic irradiation intensity, irradiation time, and the like set for each treatment organ, each ultrasonic applicator, each treatment purpose, and the like are stored in advance. Various command signals sent from the operator via the memory are also stored in the storage circuit 77. Further, in this storage circuit 77, the delay phase information in the delay circuit 72 of the ultrasonic drive unit 40 is stored for each piezoelectric vibration element 61 using the focal length of the ultrasonic beam as a parameter. On the other hand, the CPU 76 of the system control unit 41 sets the irradiation position, irradiation time, and the like for the ultrasonic drive unit 40 based on the treatment purpose and the affected part information input from the operation unit 42. Further, it receives the suction pressure information of the water suction pipe 36 measured by the pressure sensor 44 shown in FIG. 1, and controls the rotation speed of the tube pump 35 and the tube pump 37 so that the suction pressure falls within a predetermined range.
[0034]
Next, returning to FIG. 1, the tube pump 35 transmits the coupling liquid 34 to the water supply pipe 33 in order to exude the coupling liquid 34 from the porous body 47 at the distal end of the ultrasonic applicator 32 to the affected part 152. The water supply pump supplies the coupling liquid 34 by peristally moving a part of the water supply pipe 33 by a plurality of rotating rollers. On the other hand, the tube pump 37 is a water suction pump for sucking and discharging the coupling liquid 34 oozing into the affected part 152 from the opening of the water absorption pipe 36 provided at the center of the water bag 48 of the ultrasonic applicator 32. And has a configuration similar to that of the tube pump 35.
[0035]
The operation unit 42 includes a liquid crystal panel, a keyboard, a trackball, a mouse, various kinds of selection buttons, and the like on an operation panel. Information and further various commands are input.
[0036]
The vibrating section 43 is mounted on the outer frame of the ultrasonic applicator 32 and generates mechanical vibration. This mechanical vibration is transmitted to the water bag 48 of the ultrasonic applicator 32, and the vibration reduces adhesion between the water bag 48 and the surface of the affected area 152 caused by heat generation during ultrasonic irradiation. Note that the vibration unit 43 can use the same method as the vibrator mechanism generally used in a mobile phone.
[0037]
On the other hand, the pressure sensor 44 measures the suction pressure in the water suction pipe 36 when the coupling liquid 34 oozing into the affected area 152 is sucked by the tube pump 37. The system control unit 41 that has received the pressure information from the pressure sensor 44 controls the rotation of the tube pump 35 and the tube pump 37, and maintains the suction pressure within a predetermined range.
[0038]
Next, the configuration of the ultrasonic imaging apparatus 250 will be described with reference to FIG. The ultrasonic imaging apparatus 250 includes a small-diameter probe 101 that can be mounted on the affected part 152 via a small tube having an inner diameter of about 2 mm to 3 mm, and a drive signal connected to the small-diameter probe 101 and supplied to the small-diameter probe 101. An ultrasonic imaging apparatus main body 102 that generates ultrasonic image data in the affected area 152 based on a reception signal from the small diameter probe 101 is provided.
[0039]
The small-diameter probe 101 includes a flexible probe sheath 111 having a diameter of 2 mm to 3 mm, an ultrasonic vibrator 112 arranged near the distal end (the left end in FIG. 6) of the probe sheath 111, and an ultrasonic vibrator. A torque cable 113 for rotating the child 112 is provided.
[0040]
The probe sheath 111 of the small-diameter probe 101 is a thin cylindrical body that can be inserted into the water absorption tube 36 from the insertion hole 45 shown in FIG. 2, and a polymer material having excellent ultrasonic permeability is provided on the side surface of the distal end. The ultrasonic wave transmitting / receiving surface of the ultrasonic transducer 112 is disposed to face the acoustic window 114. Then, the ultrasonic transducer 112 converts the driving pulse supplied from the ultrasonic imaging apparatus main body 102 into an ultrasonic pulse (transmission ultrasonic wave), and the central axis of the probe sheath 111 (FIG. (In the Z-axis direction).
[0041]
On the other hand, the ultrasonic waves (received ultrasonic waves) reflected from the affected area 152 are received by the ultrasonic transducer 112 via the acoustic window 114 and are converted into electric signals (received signals). One end of a flexible torque cable 113 as a rotating shaft is connected to the ultrasonic transducer 112, and the torque cable 113 is rotatably supported by a bearing (not shown) of the probe sheath 111. A signal line (including a ground line) 115 is inserted into the torque cable 113. One end of the signal line 115 is connected to an electrode (not shown) of the ultrasonic transducer 112, and the other end is a rotary transformer. The transmission unit 121 and the reception unit 122 of the ultrasonic imaging apparatus main body 102 are connected via 116. The rotary transformer 116 enables communication between the rotor (rotation) side and the stator (fixed) side of the signal line 115 in a non-contact state.
[0042]
On the other hand, the ultrasonic imaging apparatus main body 102 includes a transmission unit 121 that supplies a driving signal to the ultrasonic transducer 112 of the small-diameter probe 101 and a reception unit that performs signal processing on a reception signal from the ultrasonic transducer 112. An image data generating unit 123 that generates ultrasonic image data based on an output signal of the receiving unit 122; and a display unit 124 that displays the image data. Further, the ultrasonic imaging apparatus main body 102 includes: a rotation mechanism section 125 having a rotation axis connected to the torque cable 113; a system control section 126 for integrally controlling each unit of the ultrasonic imaging apparatus main body 102; And an operation unit 127 to which various command signals are input.
[0043]
The transmission unit 121 is provided with a rate signal generator 131 that generates a reference clock signal for setting a drive timing for the ultrasonic transducer 112, and is energized by the reference clock signal from the rate signal generator 131, and receives the ultrasonic vibration. And a vibrator drive circuit 132 for generating a drive signal for the vibrator 112. An output terminal of the vibrator drive circuit 132 is connected to a signal line 115 from the stator side of the rotary transformer 116.
[0044]
On the other hand, the receiving unit 122 includes an amplifier 133 for amplifying a signal received from the ultrasonic transducer 112 to a predetermined size, a logarithmic amplifier 134 for logarithmically converting (compressing) the output amplitude of the amplifier 133, and an envelope detection. A detection circuit 135 is provided.
[0045]
Next, the output shaft (rotating shaft) of the motor 138 of the rotating mechanism unit 125 is connected to the torque cable 113, and rotates the rotating shaft in response to a rotation instruction signal from the system control unit 126. Then, the rotational force is transmitted to the ultrasonic transducer 112 via the torque cable 113, and the rotation angle of the motor 138 at this time is detected by the rotary encoder 139. Further, the counter 140 measures a pulse signal corresponding to the rotation angle supplied from the rotary encoder 139, and stores the measurement result as an address signal in the image data storage circuit 137 of the image data generator 123.
[0046]
On the other hand, the image data generation unit 123 converts the detection signal from the detection circuit 135 of the reception unit 122 into a digital signal into an A / D converter 136, and converts the digital signal converted by the A / D converter 136 into a rotation mechanism. And an image data storage circuit 137 for storing the image data at an address in the memory space designated by the address signal from the counter 140 of the unit. Further, the display unit 124 reads the ultrasonic image data stored in the image data storage circuit 137, performs a D / A conversion and a TV format conversion, and a monitor 142 that displays the converted ultrasonic image data. It has.
[0047]
(Ultrasonic treatment procedure and operation of the device)
Next, the procedure of the ultrasonic treatment according to the first embodiment will be described with reference to FIGS. FIG. 7 is a flowchart showing a treatment procedure.
[0048]
In FIG. 2, an operator (doctor) of the ultrasonic therapy apparatus 200 drives a circulating pump (not shown) prior to treatment, and the ultrasonic applicator 32 through a water bag water pipe 51 connected to the circulating pump. The acoustic coupling liquid 54 is supplied to the water bag 48 of FIG. Then, the acoustic coupling liquid 54 in the water bag 48 is returned to the circulation pump via the water bag water absorption pipe 52. That is, the acoustic coupling liquid 54 circulates between the circulation pump and the water bag 48 via the water bag water supply pipe 51 and the water bag water absorption pipe 52.
[0049]
Next, the operator incises at least two portions of the body surface 153 in order to perform detailed observation on the treatment site (affected portion) of the patient, and inserts, for example, a laparoscopic cannula through the first incision site. Then, the distal end of the cannula in which the imaging lens is arranged is brought close to the affected part 152, and the affected part 152 is observed to confirm the treatment method. Next, after mounting the trocar 31 on the second incision site, the water bag 48 is inserted through the ultrasonic applicator 32 filled with the acoustic coupling liquid 54, and the distal edge of the ultrasonic applicator 32 is inserted. The outer ring 53 provided on the part is arranged so as to be in close contact with the surface of the affected part 152 (step S1 in FIG. 7).
[0050]
When the distal end portion of the ultrasonic applicator 32 is arranged on the surface of the affected area 152, the operator uses the operation section 42 shown in FIG. 1 to obtain information on the patient, the organ to be treated, the purpose of treatment, and the ultrasonic applicator 32 to be used. Information, affected part information and the like are input, and further, a water supply / absorption command for the coupling liquid 34 is input (step S2 in FIG. 7). The CPU 76 of the system control unit 41 stores the input information in the storage circuit 77 and supplies a control signal to the tube pump 35 for water supply and the tube pump 37 for water absorption in accordance with the water supply / suction command signal. Then, the built-in roller is rotated at a predetermined speed. At this time, when the roller of the tube pump 35 first rotates, a part of the water supply pipe 33 sandwiched between the rollers is peristalticized, and the coupling liquid 34 stored in the reservoir 38 is superimposed via the water supply pipe 33. It is supplied to a porous body 47 provided on the front edge of the ultrasonic applicator 32. Then, the coupling liquid 34 oozes out from the porous body 47 to the surface of the affected part 152 and is stored in a closed space formed by the outer ring part 53 of the ultrasonic applicator 32, the water bag 48, and the surface of the affected part 152. .
[0051]
Next, by a control signal from the system control unit 41, a part of the water absorption pipe 36 sandwiched between the rollers of the tube pump 37 is peristaltic, and the coupling liquid 34 stored in the closed space of the ultrasonic applicator 32 is sucked. And discharged to the storage tank 39. In this case, for example, by controlling the rotation speed of the roller so that the amount of water absorbed by the tube pump 37 becomes larger than the amount of water supplied by the tube pump 35, the inside of the closed space becomes a negative pressure, and the surface of the affected part 152 becomes a Adsorb to. In other words, by controlling the rotation of the rollers of the tube pumps 35 and 37, the coupling liquid 34 in the closed space becomes negative pressure after most of the coupling liquid 34 is discharged through the water suction pipe 36. The air between the surface of the affected part 152 and the water bag 48 can be eliminated by the coupling liquid 34, so that efficient ultrasonic irradiation can be performed (FIG. Step S3).
[0052]
In addition, in order to control the negative pressure in the closed space to a desired value, as shown in FIG. 1, a pressure sensor 44 is provided on the water suction pipe 36 connecting the ultrasonic applicator 32 and the tube pump 37. The pressure value measured by the pressure sensor 44 is supplied to the system control unit 41, and the system control unit 41 controls the tube pump 37 and the tube pump 35 so that the pressure value is maintained at a preset value. Of the roller rotation speed is controlled. That is, since the pressure in the closed space can be controlled to a desired negative pressure by using the pressure sensor 44, the water bag 48 can be stably fixed to the surface of the affected area 152. The risk that the affected part 152 is damaged by the negative pressure can be avoided.
[0053]
As described above, when the installation of the ultrasonic applicator 32 on the surface of the diseased part 152 is completed, the operator inputs a command signal instructing the start of irradiation of the therapeutic ultrasonic wave through the operation unit 42 (see FIG. 7). Step S4).
[0054]
In FIG. 5, the CPU 76 of the system control unit 41 that has received the irradiation start command signal from the operation unit 42 transmits an ultrasonic wave based on the information of the ultrasonic applicator 32 and the diseased part information stored in the storage circuit 77. The delay phase information of the drive signal uniquely determined by the shape of the part 49 and the distance to the affected part 152 (that is, the focusing distance) is read from the storage circuit 77 of the system control unit 41, and the ultrasonic drive is performed based on the delay phase information. The delay phase in the delay circuit 72 of the section 40 is set. Next, the CPU 76 of the system control unit 41 sends a predetermined signal to the CW generator 71 of the ultrasonic drive unit 40 based on the target organ to be treated and the purpose of treatment already stored in the storage circuit 77, as well as the affected part information. A control signal for generating a continuous wave of a frequency (1 MHz to 3 MHz) is supplied.
[0055]
In this case, the D / A converter (not shown) of the CW generator 71 converts a digital signal corresponding to the therapeutic ultrasonic frequency from the CPU 76 of the system control unit 41 into a voltage, and outputs a VCO (not shown) of the CW generator 71 (not shown). The voltage control generator) generates a continuous wave having a frequency based on the voltage. That is, the frequency of the continuous wave output from the CW generator 71 is optimized according to the control signal from the CPU 76 depending on the organ to be treated, the purpose of the treatment, or the condition of the affected area 152.
[0056]
The continuous wave output from the CW generator 71 is given a delay time for focusing the therapeutic ultrasonic wave in a delay circuit 72 composed of an Nx channel, passes through a power amplifier 73 and a matching circuit 74, and It is supplied to the piezoelectric vibrator 61 in the ultrasonic wave transmitting section 49. The therapeutic ultrasonic wave emitted from the piezoelectric vibrator 61 by the driving of the continuous wave is focused at the diseased part 152, and performs hemostasis of blood vessels and cauterization of tumor tissue in the diseased part 152 (step S5 in FIG. 7).
[0057]
On the other hand, the heat generated in the ultrasonic wave transmitting unit 49 at the time of irradiation of the therapeutic ultrasonic wave circulates inside the water bag 48 via the water bag water pipe 51 and the water bag water absorption pipe 52. The heat is radiated by the acoustic coupling liquid 54. That is, the acoustic coupling liquid 54 filling the inside of the water bag 48 not only efficiently irradiates the affected part 152 with therapeutic ultrasonic waves from the ultrasonic wave transmitting part 49 by preventing air from intervening, but also It plays a role of cooling the acoustic wave transmitting unit 49.
[0058]
When the irradiation of the therapeutic ultrasonic wave to the affected part 152 is performed for a preset irradiation time, the system control unit 41 stops the generation of the continuous wave to the CW generator 71 of the ultrasonic drive unit 40, and The irradiation of the therapeutic ultrasonic waves to the target 152 is temporarily terminated. Next, the system control unit 41 stops the tube pump 37 after stopping the tube pump 37, or rotates the tube pump 37 in the reverse direction after stopping the tube pump 35, thereby moving the water bag 48 to the affected part 152. Release from the state of adsorption with the surface.
[0059]
The water bag 48 is generally made of a polymer material having an acoustic impedance similar to that of water or living tissue and having excellent ultrasonic permeability. The surface of the diseased part 152 adsorbed on the water bag 48 is used for treatment. When ultrasonic waves are applied, there is a possibility of adhesion due to heat generation. If the water bag 48 does not easily leave the surface of the affected part 152 at the end of the irradiation of the therapeutic ultrasonic wave for such a reason, the operator gives an instruction to start vibration to the system control part 41 from the operation part 42. Then, the system control unit 41 supplies a drive signal to the vibration unit 43. And the vibration part 43 peels the water bag 48 from the surface of the affected part 152 by giving a mechanical vibration to the ultrasonic applicator 32 (step S6 of FIG. 7).
[0060]
When the irradiation of the therapeutic ultrasonic wave to the diseased part 152 is completed, the therapeutic effect in the diseased part 152 is confirmed by the ultrasonic imaging device 250 having the small diameter probe 101 (step S7 in FIG. 7). The collection and display of ultrasonic image data by the ultrasonic imaging apparatus 250 will be described with reference to FIGS. FIG. 8 shows a method of installing the small-diameter probe 101 with respect to the diseased part 152. After the operator sets the ultrasonic imaging apparatus 250 to the operating state, the operator inserts the small-diameter probe 101 of the ultrasonic imaging apparatus 250 at the rear end of the ultrasonic applicator 32 as shown in FIG. The probe is inserted through the hole 45, and is inserted through the water absorption tube 36 until the front end of the small diameter probe 101 comes into contact with the surface of the affected part 152 after the treatment. However, the small-diameter probe 101 has flexibility, and when the small-diameter probe 101 is brought into contact with the surface of the affected part 152, the front end of the small-diameter probe 101 is bent as shown in FIG. The direction is matched with the affected area 152.
[0061]
An ultrasonic transducer 112 for transmitting and receiving ultrasonic waves to and from the affected part 152 is attached to the tip of a torque cable 113 provided on the central axis of the small-diameter probe 101. , And is transmitted by the drive signal supplied from the transmission unit 121 of the ultrasonic imaging apparatus main body 102 via the signal line 115 to emit a transmission ultrasonic wave to the diseased part 152. On the other hand, the received ultrasonic wave reflected from the affected area 152 is converted into a received signal by the same ultrasonic transducer 112, and the received signal is supplied to the receiving unit 122 of the ultrasonic imaging apparatus main body 102 via the signal line 115. . Then, after signal processing such as logarithmic conversion and envelope detection is performed in the receiving unit 122, the image data is generated in the image data generating unit 123 by A / D conversion and stored in the image data storage circuit 137 as ultrasonic image data.
[0062]
On the other hand, the ultrasonic transducer 112 is rotated by a motor 138 together with the torque cable 113 while transmitting and receiving ultrasonic waves, and the rotation angle is measured by an output pulse of a rotary encoder 139 attached to a rotation shaft of the motor 138. You. The output pulse is converted into a rotation angle by the counter 140 and stored in the image data storage circuit 137 as address data of the ultrasonic image data. The ultrasonic image data stored in the image data storage circuit 137 is displayed on the monitor 142 after D / A conversion and TV format conversion are performed in the conversion circuit 141 of the display unit 124. Note that when using the ultrasonic imaging apparatus 250 having the small-diameter probe 101 to check the therapeutic effect on the affected part 152 existing near the surface of the organ 151, the ultrasonic transducer 112 of the small-diameter probe 101 has a frequency of 15 MHz or more. It is desirable to use one having a resonance frequency of 20 MHz.
[0063]
The operator observes the therapeutic effect of the affected part 152 from the ultrasonic image displayed on the display unit 124 of the ultrasonic imaging apparatus 250, and when the therapeutic effect is insufficient, performs the same procedure as the procedure already described. The irradiation of the therapeutic ultrasonic wave and the confirmation of the therapeutic effect by the ultrasonic image are repeated (step S8 in FIG. 7). When a sufficient therapeutic effect has been confirmed, a series of therapeutic actions is terminated (step S9 in FIG. 7).
[0064]
(Modification)
Next, a modification of the first embodiment will be described with reference to FIGS. The feature of the first modification shown in FIG. 9 is that the openings of the water supply pipe 33 and the water absorption pipe 36 in the ultrasonic applicator 32 a are arranged concentrically at the center of the water bag 48. That is, the water supply pipe 33 and the water absorption pipe 36 are configured using a double-structured pipe. For example, as shown in FIG. 9B, the inner pipe is used as the water absorption pipe 36, and the outer pipe is used as the water transmission pipe 33. Used for One end of the water absorption pipe 36 directly opens at the center of the water bag 48, and one end of the water supply pipe 33 opens at the center of the water bag 48 via the porous body 47. On the other hand, the other end of the water absorption pipe 36 and the other end of the water supply pipe 33 are connected to the pressure sensor 44 and the tube pump 35 as in the first embodiment.
[0065]
On the other hand, the feature of the second modified example shown in FIG. 10 is that the respective openings of the water supply pipe 33 and the water absorption pipe 36 in the ultrasonic applicator 32b are arranged at the edge of the water bag 48. That is, FIG. 10A shows a case where one opening of the water supply pipe 33 and one opening of the water absorption pipe 36 are arranged at the edge of the water bag 48, and FIG. 9B shows a case where a plurality of openings are arranged respectively. is there.
[0066]
According to the present embodiment and its modifications described above, the surface of the affected part 152 is controlled by controlling the amount of water supplied by the tube pump 35 for water supply and the amount of water absorbed by the tube pump 37 for water absorption. Since it becomes possible to adsorb to the water bag 48 of the ultrasonic applicator 32, it becomes possible to irradiate the affected part 152 with the therapeutic ultrasonic wave accurately and easily. In addition, by using the pressure sensor 44, it is possible to control the surface of the diseased part 152 and the pressure in the space region surrounded by the water bag 48 and the outer ring part 53 to a desired negative pressure. , And the damage of the affected part 152 due to excessive negative pressure can be prevented. Further, since the air interposed between the surface of the affected area 152 and the water bag 48 is eliminated by the coupling liquid 34, efficient ultrasonic irradiation becomes possible.
[0067]
On the other hand, by using the small-diameter probe 101 via the water suction pipe 36, it is possible to confirm the therapeutic effect of the affected part 152 by an ultrasonic image. Further, the piezoelectric vibrators 61 of the ultrasonic wave transmitting unit 49 are arranged in an annular array, and by controlling the delay phase of the drive signal supplied to the piezoelectric vibrators 61, the focal point of the therapeutic ultrasonic wave is irradiated in the irradiation direction. It is possible to move to. For this reason, the ultrasonic treatment device 200 can be applied to treatment of a relatively large affected area 152.
[0068]
Further, according to the first modified example shown in FIG. 9, the water supply pipe 33 and the water suction pipe 36 can have a relatively simple structure, so that they can be easily replaced for each treatment. According to the second modification shown in FIG. 10, for example, as shown in FIG. 10A, the ultrasonic transducers 81 are arranged one-dimensionally or two-dimensionally at the center of the ultrasonic wave transmitter 49. By electronically controlling the direction of transmission and reception of ultrasonic waves by the ultrasonic transducer 81, it becomes possible to collect ultrasonic image data of the diseased part 152. Moreover, in this case, since the ultrasonic image data can be collected while the surface of the affected part 152 is adsorbed to the water bag 48, the irradiation of the therapeutic ultrasonic waves and the confirmation of the therapeutic effect can be efficiently repeated. It becomes. The method of acquiring the ultrasonic image data in this case is already widely known in the field of ultrasonic diagnosis, and thus the detailed description is omitted.
[0069]
In the first embodiment and its modification, the positions of the water supply pipe 33 and the water absorption pipe 36 may be reversed. Therefore, the insertion of the small-diameter probe 101 is performed via the water supply pipe 33. Is also good. Further, the opening positions of the water absorption pipe 36 of the first embodiment and the water absorption pipe 36 and the water supply pipe 33 in the modified example of FIG. 8 are not limited to the central part of the water bag 48. Further, it is desirable to mount a porous body 47 for oozing out the coupling liquid 34 at the opening of the water pipe 33, but the porous body 47 is not always necessary when the opening area of the water pipe 33 is small. .
[0070]
(Second embodiment)
Next, a second embodiment of the present embodiment will be described with reference to FIG. The feature of the second embodiment is that when the surface of the affected part 152 is adsorbed to the water bag 48 of the ultrasonic applicator 32, the suction is performed only by the suction pipe 36c opened to the water bag 48. That is, in the ultrasonic applicator 32c of the second embodiment shown in FIG. 11, the water supply pipe 33 and the porous body 47 are different from the ultrasonic applicator 32 of the first embodiment shown in FIG. Therefore, the tube pump 35 for water supply, the reservoir 38, the coupling liquid 34, and the like shown in FIG. 1 are not required.
[0071]
In irradiation of therapeutic ultrasonic waves performed using the ultrasonic applicator 32c having such a configuration, the operator drives a circulating pump (not shown) to move the inside of the water bag 48 of the ultrasonic applicator 32c into an acoustic cup. After being filled with the ring liquid 54, the body surface 153 of the patient is incised, and the trocar 31 is attached to the incision site. Then, the ultrasonic applicator 32 c is inserted through the opening of the trocar 31, and the outer ring 53 provided at the distal end of the ultrasonic applicator 32 c is arranged so as to be in close contact with the surface of the affected part 152.
[0072]
When the placement of the ultrasonic applicator 32c on the affected area 152 is completed, the operator inputs a suction command from the operation unit 42, and the system control unit 41 receives this command signal, and receives a suction tube pump. A control signal is supplied to 37 to rotate a built-in roller at a predetermined speed. Due to the rotation of the roller, a part of the suction tube 36c sandwiched between the rollers is peristaltic, and the air in the closed space formed by the water bag 48 at the distal end of the ultrasonic applicator 32c and the surface of the affected area 152 becomes a bodily fluid or The body fluid and blood sucked together with the blood and the like are discharged to the storage tank 39. At this time, the body fluid and blood on the surface of the affected part 152 serve as a coupling liquid, and the surface of the affected part 152 is adsorbed to the water bag 48. That is, the air in the closed space is exhausted to the outside by the suction of the tube pump 37 and becomes a negative pressure, so that the surface of the affected part 152 can be securely fixed to the water bag 48. Further, efficient ultrasonic irradiation can be performed via a body fluid or blood interposed between the surface of the affected area 152 and the water bag 48.
[0073]
As described above, when the attachment of the ultrasonic applicator 32c to the diseased part 152 is completed, the irradiation of the therapeutic ultrasonic waves and the confirmation of the therapeutic effect by the ultrasonic image are performed. These procedures are the same as those described above. The description is omitted because it is similar to that of the first embodiment.
[0074]
According to the second embodiment described above, the pressure in the surface area of the affected area 152 and the space region surrounded by the water bag 48 and the outer ring 53 can be controlled to a desired negative pressure by the tube pump 37 for suction. Therefore, the surface of the affected part 152 can be adsorbed to the water bag 48 of the ultrasonic applicator 32c. Therefore, it is possible to accurately and safely irradiate the therapeutic ultrasonic waves to the diseased part 152. In particular, in this embodiment, since the surface of the affected part 152 is adsorbed to the water bag 48 only by controlling the pressure of the suction pipe 36c, complicated control such as pressure difference control in water supply and water absorption is required. do not do. Further, there is an advantage that the operation is simplified because the coupling liquid 34 is not used.
[0075]
As described above, the embodiments of the present invention have been described, but the present invention is not limited to the above embodiments, and can be modified and implemented. For example, although a description has been given of hemostasis for a bleeding blood vessel and cauterization of a tumor as a treatment purpose in the above embodiment, the invention may be applied to other treatments.
[0076]
Although the case where the piezoelectric vibrators 61 of the ultrasonic wave transmitting unit 49 are arranged on the same plane has been described, the piezoelectric vibrators 61 may be arranged concavely in the direction of the affected part 152. The irradiation direction of the therapeutic ultrasonic wave may be controlled electronically by using a two-dimensional array.
[0077]
When the surface of the affected part 152 is positioned obliquely to the insertion direction of the ultrasonic applicator 32, it is difficult to form a closed space region surrounded by the surface of the affected part 152, the water bag 48, and the outer ring 53. Become. In such a case, a so-called angle mechanism that makes the angle of the tip portion of the ultrasonic applicator 32 variable is effective.
[0078]
FIG. 12 shows an angle mechanism for changing the direction of the distal end of the ultrasonic applicator 32d in the YZ plane. The angle lever 82 provided at the hand of the applicator 32 is connected with a wire 83a and a wire 83b, and the direction of the tip portion is changed by rotating the angle lever 82 by an operator. However, since the angle mechanism is a technique that has been widely used in an endoscope apparatus, a detailed description thereof will be omitted. With this angle mechanism, the tip of the ultrasonic applicator can always be set perpendicular to the surface of the affected area 152, so that the pressure in the closed space region can be reliably controlled to a desired negative pressure. Become.
[0079]
【The invention's effect】
As described above, according to the ultrasonic therapy apparatus of the present invention, the pressure in the closed space formed by the distal end portion of the ultrasonic applicator and the surface of the affected part is set to a negative pressure, so that the surface of the affected part is subjected to the ultrasonic applicator. Can be accurately and safely irradiated to the affected part with the therapeutic ultrasonic waves.
[Brief description of the drawings]
FIG. 1 is a block diagram showing a schematic configuration of an ultrasonic therapy apparatus according to a first embodiment of the present invention.
FIG. 2 is a diagram showing a configuration of an ultrasonic applicator according to the embodiment.
FIG. 3 is a diagram showing a specific example of a water pipe in the embodiment.
FIG. 4 is a diagram showing a structure of an ultrasonic wave transmitting unit in the embodiment.
FIG. 5 is a block diagram showing a configuration of an ultrasonic drive unit and a system control unit according to the embodiment;
FIG. 6 is a block diagram showing a configuration of the ultrasonic imaging apparatus according to the embodiment.
FIG. 7 is a flowchart showing a treatment procedure according to the embodiment;
FIG. 8 is a view showing a method for installing a small-diameter probe in the embodiment.
FIG. 9 is a view showing a modification of the embodiment.
FIG. 10 is a view showing another modification of the embodiment.
FIG. 11 is a diagram showing a configuration of an ultrasonic applicator according to a second embodiment of the present invention.
FIG. 12 is a diagram showing a configuration of an ultrasonic applicator provided with an angle mechanism according to the first embodiment and the second embodiment of the present invention.
[Explanation of symbols]
31 ... trocar
32 ... Ultrasonic applicator
33 ... water pipe
34 ... Coupling liquid
35 ... Tube pump
36 ... water absorption pipe
37 ... Tube pump
38 ... Reservoir
39 ... Storage tank
40 ... Ultrasonic drive
41 ... System control unit
42 ... Operation unit
43 ... vibrating part
44… Pressure sensor
45 ... insertion hole
46 ... cylindrical frame
47 ... porous body
48… Water bag
49 ... Ultrasonic transmitter
50 ... Signal cable
51 ... water pipe for water bag
52 ... water absorption tube for water bag
53 ... Outer ring
54… Acoustic coupling liquid
101 ... Small diameter probe
102: Ultrasonic imaging device main body
151 ... organ
152 ... affected area
153 ... body surface
200 ... Ultrasonic treatment device
250 ... Ultrasonic imaging device

Claims (18)

Ultrasonic wave transmitting means for irradiating the living body with therapeutic ultrasonic waves,
Driving means for supplying a driving signal to the ultrasonic wave transmitting means,
An ultrasonic applicator having the ultrasonic wave transmitting means at a distal end thereof,
A suction tube having one end opening at the tip of the ultrasonic applicator,
Suction means to which the other end of the suction tube is connected,
When the distal end of the ultrasonic applicator contacts the living body and irradiates therapeutic ultrasonic waves, the pressure in the closed space formed by the living body and the distal end of the ultrasonic applicator becomes a predetermined negative pressure. And a control means for controlling the suction means as described above. Ultrasonic wave transmitting means for irradiating the living body with therapeutic ultrasonic waves,
Driving means for supplying a driving signal to the ultrasonic wave transmitting means,
An ultrasonic applicator having the ultrasonic wave transmitting means at a distal end thereof,
A water pipe with one end opening at the tip of the ultrasonic applicator,
The other end of the water pipe is connected, water supply means for supplying a coupling liquid to the living body from the open end of the water pipe through the water pipe,
A water absorption tube having one end opening at the tip of the ultrasonic applicator,
The other end of the water absorption pipe is connected, and water absorption means for absorbing the coupling liquid sent to the living body from the open end of the water absorption pipe through the water absorption pipe,
When the distal end of the ultrasonic applicator contacts the living body and irradiates therapeutic ultrasonic waves, the pressure in the closed space formed by the living body and the distal end of the ultrasonic applicator becomes a predetermined negative pressure. As described above, the ultrasonic treatment apparatus is provided with control means for controlling the water supply amount in the water supply means and the water absorption amount in the water absorption means. Ultrasonic imaging means for displaying an image by ultrasonic waves is further provided, and using this ultrasonic imaging means, collection and display of image data of the living body irradiated with therapeutic ultrasonic waves by the ultrasonic wave transmitting means are performed. The ultrasonic treatment apparatus according to claim 1 or 2, wherein: The ultrasonic imaging means has a small-diameter probe, and an ultrasonic transmission / reception unit provided at a distal end of the small-diameter probe has a distal end of the ultrasonic applicator via one of the water supply pipe and the water absorption pipe. The ultrasonic treatment apparatus according to claim 3, wherein the ultrasonic treatment apparatus is inserted into a part. The water absorbing means has pressure measuring means for measuring the pressure of the water absorbing pipe, and the control means is configured to control the water feeding means and the water absorbing means such that the pressure measured by the pressure measuring means becomes a predetermined negative pressure. The ultrasonic irradiation device according to claim 2, wherein the ultrasonic irradiation device is controlled. The suction unit has a pressure measurement unit that measures the pressure of the suction pipe, and the control unit controls the suction unit so that the pressure measured by the pressure measurement unit becomes a predetermined negative pressure. The ultrasonic irradiation device according to claim 1 or 4, wherein: The ultrasonic irradiation according to claim 1, wherein the control unit controls the water suction unit or the suction unit so as to release the negative pressure in the closed space when the treatment is completed. apparatus. The ultrasonic applicator according to claim 1, wherein the ultrasonic applicator includes a holding unit on an edge of the distal end portion to fix the distal end portion to the living body. Sonic therapy equipment. 5. The ultrasonic applicator according to claim 1, wherein the ultrasonic applicator includes a vibration unit for releasing adhesion between the distal end of the ultrasonic applicator and the living body. 6. Sonic therapy equipment. The ultrasonic treatment according to claim 1, wherein the ultrasonic applicator includes an exuding unit for exuding the coupling liquid at an open end of the water pipe. apparatus. The ultrasonic treatment apparatus according to claim 9, wherein the exuding unit attaches a porous body to an open end of the water pipe. 5. The ultrasonic irradiation according to claim 1, wherein the ultrasonic applicator is provided with at least one open end of the water pipe at an edge of a distal end thereof. 6. apparatus. 5. The ultrasonic applicator according to claim 1, wherein at least one open end of the water suction pipe or the suction pipe is disposed substantially at a center of a tip portion thereof. 6. An ultrasonic therapy apparatus according to claim 1. 3. The ultrasonic applicator according to claim 1, wherein a water bag filled with an acoustic coupling liquid is provided at a distal end thereof, and the acoustic coupling liquid is circulated by circulation means. The ultrasonic therapy device according to claim 4. The ultrasonic treatment apparatus according to claim 1, wherein the ultrasonic applicator has an angle adjustment unit for setting a tip of the ultrasonic applicator in a desired direction. An ultrasonic treatment method in which an ultrasonic applicator provided with an ultrasonic wave transmitting means at a distal end portion is brought into contact with a living body and irradiates a therapeutic ultrasonic wave to a living body affected part,
Arranging the tip of the ultrasonic applicator on the diseased part of the living body,
Fixing the living body affected part to the distal end of the ultrasonic applicator by controlling the amount of water supplied and the amount of water absorbed by the coupling liquid to the affected part,
Irradiating a therapeutic ultrasonic wave to the affected part of the living body. An ultrasonic treatment method in which an ultrasonic applicator provided with an ultrasonic wave transmitting means at a distal end portion is brought into contact with a living body and irradiates a therapeutic ultrasonic wave to a living body affected part,
Arranging the tip of the ultrasonic applicator on the diseased part of the living body,
Fixing the living body affected part to the distal end of the ultrasonic applicator by controlling the suction amount for the affected part,
Irradiating a therapeutic ultrasonic wave to the affected part of the living body. 18. The method according to claim 16, further comprising a step of confirming a therapeutic effect on the living body affected part by an ultrasonic image when the irradiation of the therapeutic ultrasonic wave to the living body affected part is completed. Sonic treatment method.

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