JP2005287832A - Heat treatment apparatus - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a heat treatment apparatus allowing an operator to easily confirm the direction of an irradiation part by correlating the actual direction of the irradiation part with an image inside a living body observed with an endoscope. <P>SOLUTION: The heat treatment device comprises an applicator 1 for applying a laser beam to the living body, an angle sensor 2 for detecting the direction of application of the laser beam, an image take-in part 3 inserted into the applicator 1 for taking in the image of a treated region of the living body from the applicator 1, a control part 41 for correcting the direction of the image of the treated region based on the direction of application of the laser beam detected by the angle sensor 2, and a display part 42 for displaying the image of the treated region whose direction is corrected. <P>COPYRIGHT: (C)2006,JPO&NCIPI

Description

  In the present invention, an insertion portion is inserted into a living body lumen or lumen such as a blood vessel, urethra, and abdominal cavity, or a pressing portion is pressed against a living tissue or a pressing portion is pressed against a body surface. The present invention relates to a heat treatment apparatus that performs heat treatment by irradiating a lesion site of a living tissue with energy such as laser light, microwaves, radio waves, and ultrasonic waves from an irradiation unit installed in an insertion part or a pressing part.

  Using a long insertion part that is inserted into the living body by using a body cavity of the living body or by making a small incision in the living body, energy such as laser light, microwave, radio wave, or ultrasonic wave is applied to the lesion site of the living body. There is known a heat treatment apparatus that heats and treats a lesion site by irradiating and irradiating the lesion site by heating, degeneration, necrosis, coagulation, cauterization or evaporation. In general, this heat treatment apparatus directly irradiates energy to a lesion site located on or near the surface of a living tissue.

  In addition, a technique for irradiating energy to a deep part of a living tissue for the purpose of treating a lesion site located in the deep part of the living tissue such as a prostate is also known.

  This heat treatment apparatus is generally performed in the following procedure when, for example, prostate treatment is performed.

  First, an image diagnosis is performed on a tissue including a lesion to be heat-treated or a surrounding tissue. As a result, the shape of the tissue including the heat treatment target lesion, the positional relationship with the surrounding tissue, the shape of the lesion site, the degree of serious injury, and the like can be grasped. These diagnoses are performed by a separate image diagnostic apparatus not included in a heat treatment apparatus such as an MRI or an ultrasonic diagnostic apparatus or palpation from the rectum.

  Subsequently, the operator inserts the insertion portion into the urethra by his / her own operation, and observes the urethra with an endoscope, and causes the irradiation portion to reach the urethra near the prostate. Here, the operator temporarily stops observing the urethra with an endoscope, rotates the insertion portion around the urethra, aligns the direction of the irradiation portion with a desired energy irradiation direction, and irradiates energy.

  Thus, in view of the surgeon adjusting the direction of the irradiation unit during the operation, the following invention has been made to facilitate the alignment of the irradiation unit.

  (I) A heat treatment apparatus that detects and displays the direction of the irradiation unit (see, for example, Patent Document 1). According to this apparatus, since the irradiation unit is directed to which direction is displayed, the alignment of the irradiation unit is facilitated.

(Ii) A heat treatment apparatus that displays an irradiation range superimposed on a diagnostic image of a dedicated diagnostic imaging apparatus (see, for example, Patent Document 2). In this apparatus, the operator inputs an irradiation direction to the image while viewing the diagnostic image. Thus, the surgeon can determine in which direction the irradiation unit should be adjusted by referring to the diagnostic image during the operation.
JP 2001-46390 A JP 2002-17743 A

  However, in the conventional heat treatment apparatus (i) as described above, even if the operator confirms the direction of the detected irradiation unit, the direction of the irradiation unit is immediately determined by looking at the endoscope image. It ’s hard to understand. This is for the following reason.

  The positional relationship between the endoscope and the observation window opened toward the living body does not change. Therefore, the observation window is always at a fixed position on the image captured from the endoscope. For example, when the observation window is located at the lower part of the image, the observation window does not move from the lower part of the image no matter how much the endoscope is rotated. Since energy is normally irradiated from the observation window, the irradiation direction also appears constant if the position of the observation window on the image does not change.

  Even if only the direction of the irradiation unit is detected without considering this, the direction of the irradiation unit on the image is different from the direction of the detected irradiation unit. This requires the operator to pay attention to the confirmation of the irradiation direction, and easy confirmation cannot be achieved.

  Moreover, in the conventional heat treatment apparatus (ii) as described above, the direction of the irradiation unit is only displayed superimposed on the diagnostic image, and therefore, just by confirming this diagnostic image, the same as the heat treatment apparatus (i) described above. For the reason, it is difficult to immediately know which direction the irradiation unit is facing.

  As described above, the conventional heat treatment apparatus has a problem that it is difficult to confirm the direction of the irradiation unit because the actual direction of the irradiation unit and the direction of the image are different.

  The present invention has been made in view of the above problems, and the surgeon can easily determine the direction of the irradiation unit by associating the actual direction of the irradiation unit with the in-vivo image observed by the endoscope. It aims at providing the heat treatment apparatus which can be confirmed.

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

  (1) An energy irradiating unit that irradiates energy to a living body, an irradiation direction detecting unit that detects an irradiation direction of the energy, and an image that is inserted into the energy irradiating unit and captures an image of a treatment site from the energy irradiating unit Based on the energy irradiation direction detected by the capture means, the irradiation direction detection means, an image correction means for correcting the direction of the image of the treatment area, and an image of the treatment area whose direction has been corrected are displayed. An image display means for performing heat treatment.

  (2) An energy irradiating means for irradiating the living body with energy, an irradiation direction detecting means for detecting the irradiation direction of the energy, and an image inserted into the energy irradiating means and capturing an image of a treatment site from the energy irradiating means A capturing unit; an image correcting unit that corrects a direction of the image of the treatment site based on the irradiation direction of the energy detected by the irradiation direction detection unit; and a parameter image that visually indicates a parameter of the energy irradiation. A heating treatment apparatus comprising: parameter creation means to create, image synthesis means for synthesizing the corrected image of the treatment site with the parameter image, and image display means for displaying the synthesized image .

  (3) An energy irradiation unit that irradiates energy to the living body, an irradiation direction detection unit that detects the irradiation direction of the energy, and an image that is inserted into the energy irradiation unit and captures an image of a treatment site from the energy irradiation unit Based on the energy irradiation direction detected by the capture means, the irradiation direction detection means, an image correction means for correcting the direction of the image of the treatment area, and an image of the treatment area whose direction has been corrected are displayed. An image display means for performing heat treatment.

  (4) An energy irradiation means for irradiating energy to the living body, an irradiation direction detection means for detecting the irradiation direction of the energy, and an image that is inserted into the energy irradiation means and that captures an image of a treatment site from the energy irradiation means A capturing unit; an image correcting unit that corrects a direction of the image of the treatment site based on the irradiation direction of the energy detected by the irradiation direction detection unit; and a parameter image that visually indicates a parameter of the energy irradiation. A heating treatment apparatus comprising: parameter creation means to create, image synthesis means for synthesizing the corrected image of the treatment site with the parameter image, and image display means for displaying the synthesized image .

  According to the heat treatment apparatus of (1) above, the direction of energy irradiation is detected, and based on the direction, the direction of the image of the treatment site is corrected and displayed on the image display means. An image oriented in the same direction can be provided. Therefore, the surgeon can easily and intuitively grasp the energy irradiation direction by looking at the image on the image display means.

  According to the heat treatment apparatus of (2) above, the energy irradiation direction is detected, and based on the direction, the direction of the image of the treatment site is corrected and displayed on the image display means. An image oriented in the same direction can be provided. Therefore, the surgeon can easily and intuitively grasp the energy irradiation direction by looking at the image on the image display means. In addition, since the parameter image is synthesized with the image of the treatment site, the energy irradiation parameters can be easily confirmed by the image display means.

  According to the heat treatment apparatus of the above (3), the observation angle is detected, and based on the angle, the direction of the image of the living body being observed is corrected and displayed on the image display means. Can be provided in the same direction. Therefore, the surgeon can easily and intuitively grasp the energy irradiation direction by looking at the image on the image display means.

  According to the heat treatment apparatus of the above (4), the observation angle is detected, and based on the angle, the direction of the image of the living body being observed is corrected and displayed on the image display means. Can be provided in the same direction. Therefore, the surgeon can easily and intuitively grasp the energy irradiation direction by looking at the image on the image display means. In addition, since the parameter image is synthesized with the image of the treatment site, the energy irradiation parameters can be easily confirmed by the image display means.

  Hereinafter, embodiments of the present invention will be described with reference to the drawings.

(First embodiment)
FIG. 1 is a schematic diagram showing an overall configuration of a heat treatment apparatus to which the present invention is applied, FIG. 2 is a schematic diagram showing a mechanism of an insertion portion of an applicator, and FIG. 3 is a block diagram showing a schematic configuration of a main body.

  The heat treatment apparatus includes an applicator 1 that irradiates energy to a living body, an angle sensor 2 that detects a rotation angle of the applicator 1, an image capturing unit 3 that captures an in-vivo image, and a main body that controls the applicator 1. 4. Each part will be described.

(applicator)
The applicator 1 serves as an energy irradiation means. The applicator 1 includes an insertion part 11, an irradiation window 12, an optical fiber 13, a protective tube 14, a driving part 15, and a reflecting mirror 16.

  As shown in FIG. 1, the insertion portion 11 is formed in a long shape that can be inserted into a living body such as a urethra so that the optical fiber 13 and an endoscope (observation portion) to be described later can be disposed inside. It is formed hollow. The irradiation window 12 opens laterally with respect to the longitudinal direction of the insertion portion 11.

  The optical fiber 13 and the reflecting mirror 16 serve as an irradiation unit, and irradiate energy from the irradiation window 12 toward the living body on the side of the insertion unit 11.

  The optical fiber 13 is connected to the main body 4 and transmits energy generated in the main body 4. The energy is supplied to the living body as laser light. As the laser light, divergent light, parallel light, or convergent light can be used. The laser beam to be used is not particularly limited as long as it has a biological depth. The wavelength of the laser beam is preferably about 750 to 1300 nm or about 1600 to 1800 nm because it has particularly excellent living body penetration. Examples of the laser beam generating in such a range include a gas laser such as a He—Ne laser, a solid state laser such as an Nd—YAG laser, and a semiconductor laser such as a GaAlAs laser.

  The protective tube 14 is provided around the optical fiber 13 in the insertion portion 11 and protects the optical fiber 13 from refraction.

  The drive unit 15 holds the protective tube 14 so as to reciprocate the protective tube 14 in the longitudinal direction of the insertion unit 11. The drive unit 15 has, for example, a cam mechanism that converts the rotational motion of the motor into a reciprocating motion, and reciprocates the protective tube 14 by the rotation of the motor. The drive unit 15 is connected to the main body 4 and its drive is controlled.

  The reflecting mirror 16 has a smooth reflecting surface that reflects the laser light, and reflects the laser light from the optical fiber 13 to the side of the insertion portion 11. The reflecting mirror 16 has one end attached to the tip of the protective tube 14 and the other end attached to a groove on the inner surface of the insertion portion 11. When the drive unit 15 is driven, the other end of the reflecting mirror 16 slides in the groove on the inner surface of the insertion unit 11, and the inclination angle is changed as shown in FIG. For this reason, the reflection angle of the laser beam is changed, and as a result, the emission angle at which the laser beam is irradiated laterally from the insertion portion 11 is changed.

  Since the emission angle of the laser beam is changed, the laser beam is concentrated on the target lesion as shown in FIG. Thereby, a lesioned part is effectively treated. On the other hand, the surface layer between the lesioned part and the insertion part 11 is irradiated with laser light intermittently. Thereby, the irradiation time of the laser beam with respect to the biological tissue of a surface layer is short, and the biological tissue of a surface layer is preserve | saved almost without heating.

  The applicator 1 is rotatable with the central axis as a rotation axis.

(Angle sensor)
The angle sensor 2 is attached to the applicator 1 and detects the rotation angle of the applicator 1 based on gravity. As the angle sensor 2, for example, a biaxial tilt sensor is used.

  The angle sensor 2 is connected to the main body 4 via the cable 21 and transmits information on the detected angle to the main body 4.

(Image capture part)
The image capturing unit 3 includes an endoscope 31 that is an observation unit, a camera head 32, a processor 33, and a light source 34. In the following description, a case where a treatment site in a living body, in particular, a treatment site is observed with the endoscope 31 and irradiated with laser light will be mainly described. However, the endoscope 31 can also be used for observation in a living body other than the treatment site. Thereby, for example, the inside of a living body can be observed through the endoscope 31, and a treatment site can be specified.

  The endoscope 31 is, for example, a fiber scope. The endoscope 31 is inserted into the insertion portion 11 of the applicator 1, and the distal end of the insertion is located in the vicinity of the irradiation window 12. The endoscope 31 captures an image of the treatment site in the living body through the irradiation window 12 from the inside of the insertion portion 11. The proximal end of the endoscope 31 is in contact with the camera head 32.

  The camera head 32 captures an in-vivo image transmitted through the endoscope 31 at the proximal end of the endoscope 31. At the tip of the camera head 32, for example, a CCD camera or the like is provided, thereby converting the image of the endoscope 31 into an electrical signal. The image captured by the camera head 32 is transmitted to the processor 33 via the cable 35. When a video scope is used for the endoscope 31, the endoscope 31 is directly connected to the processor 33 without using the camera head 32.

  The processor 33 synthesizes the electrical signals sent from the camera head 32 and reconstructs them into an image that can be displayed on the display unit 42 described later. The reconstructed image is transmitted from the processor 33 to the main body 4 via the cable 36.

  The light source 34 is connected to the light guide 37. Although not shown in the insertion portion 11, the light guide 37 is guided along the endoscope 31 to the tip of the endoscope 31. The light guide 37 guides the light from the light source 34 to the tip of the endoscope 31 and irradiates it. Even if the applicator 1 is inserted into a living body, the inside of the living body can be illuminated, and the endoscope 31 can capture a bright image. The light source 34 starts to emit light when the operator turns on the power.

  The endoscope 31 is not formed integrally with the camera head 32. However, in the first embodiment, the endoscope 31 and the camera head 32 are fixed to each other by the fixing tool 38. The fixing tool 38 is further fixed to the applicator 1, and the applicator 1, the endoscope 31, and the camera head 32 are fixed integrally. Therefore, when the applicator 1 is rotated about the longitudinal axis, the endoscope 31 and the camera head 32 are also rotated.

  Note that, when the image is captured, the applicator 1 and the endoscope 31 rotate together, so that the position of the irradiation window 12 does not change in the field of view of the endoscope 31. That is, in the image captured from the endoscope 31, even if the applicator 1 is actually rotated, the position of the irradiation window 12 does not change. If the position of the irradiation window 12 does not change, it is difficult to perceive whether the applicator 1 is rotating. Therefore, as will be described later, in the present invention, the image captured from the endoscope 31 is corrected so that the position of the irradiation window 12 also rotates in accordance with the rotation of the applicator 1. Details will be described in the sections (main body) and (display section).

(Body)
As shown in FIG. 1, the main body 4 includes a control unit 41, a display unit 42 and a foot pedal 43 connected to the control unit 41.

  As shown in FIG. 3, the control unit 41 includes a laser oscillation unit 411. The laser oscillation unit 411 oscillates laser light and outputs it to the optical fiber 13. The laser beam generated here is irradiated to the treatment site via the optical fiber 13.

  A foot pedal 43 is connected to the laser oscillation unit 411. The foot pedal 43 is arranged at a position where the surgeon can step on during the operation. The depression of the foot pedal 43 is sent to the laser oscillating unit 411 as a cue of laser light oscillation.

  As shown in FIG. 3, the control unit 41 further includes an image input unit 412, an irradiation direction calculation unit 413, an image rotation unit 414, a setting unit 415, a setting image creation unit 416, and an image composition unit 417.

  The image input unit 412 is connected to the processor 33 of the image capturing unit 3, and the image for the display unit 42 converted by the processor 33 is input via the cable 36.

  The irradiation direction calculation unit 413 is connected to the angle sensor 2, and the detection result of the angle sensor 2 is input via the cable 21. The irradiation direction calculation unit 413 calculates the energy irradiation direction of the applicator 1 based on the detection result of the angle sensor 2, that is, the rotation angle of the applicator 1. The energy irradiation direction can be calculated according to the following logic.

  As described above, the applicator 1 includes the optical fiber 13 and the reflecting mirror 16 as an irradiation unit. The optical fiber 13 and the reflecting mirror 16 rotate according to the rotation of the applicator 1. Therefore, the laser beam is always emitted from the irradiation window 12. If the reference position of the applicator 1 and the position of the irradiation window 12 are associated with each other, the direction of the irradiation window 12 can be determined by detecting the rotation angle of the applicator 1 by the angle sensor 2, so the irradiation direction of the laser light is also unique. Can be guided.

  The image rotation unit 414 is connected to the image input unit 412 and the irradiation direction calculation unit 413. The image rotation unit 414 rotates and corrects the image of the treatment site from the image input unit 412 based on the information on the energy irradiation direction from the irradiation direction calculation unit 413.

  The setting unit 415 sets energy irradiation parameters. This setting is input in advance by the operator. The surgeon makes a diagnosis on the tissue including the lesion to be heat-treated or the surrounding tissue by using a separate image diagnostic apparatus or palpation from the rectum. As a result, the shape of the tissue including the heat treatment target lesion, the positional relationship with the surrounding tissue, the shape of the lesion site, the degree of serious injury, and the like are grasped. Then, the operator determines parameters for heat treatment and inputs them to the setting unit 415 of the main body 4. Here, the set parameters include at least one of treatment temperature, laser beam irradiation direction, laser beam irradiation intensity, laser beam irradiation time, and irradiation energy amount.

  The setting image creation unit 416 is connected to the setting unit 415 and creates a parameter image for visually indicating the energy irradiation parameters set by the setting unit 415.

  The image composition unit 417 is connected to the image rotation unit 414 and the setting image creation unit 416. The image synthesis unit 417 synthesizes the image of the treatment site and the parameter image and transmits the synthesized image to the display unit 42.

  The display unit 42 is connected to the image composition unit 417. The display unit 42 is a display device that visually shows an image of the treatment site synthesized by the image synthesis unit 417 to the operator. The display unit 42 is, for example, a CRT display device or a liquid crystal display device, and is a device that displays an image in the NTSC system, PAL system, or HDTV system, or a DTV system using a personal computer. Further, the aspect ratio of the screen of the display unit 42 is not limited to 3: 4, and may be 16: 8. Next, the display unit 42 will be described in more detail.

(Display section)
4 is a diagram showing a display unit, FIG. 5 is a diagram showing a state where an image of a treatment site is enlarged, FIG. 6 is a diagram showing a state where a parameter image is enlarged, and FIG. 7 is a display unit showing a next treatment site. FIG.

  As shown in FIG. 4, the display unit 42 is provided with a parameter display area 5 and a treatment site display area 6. A parameter image (left side in the figure), an image of a living body treatment site (right side in the figure), Is displayed.

  The parameter image indicates the irradiation direction of the laser light by arrows 51a to 51c. Arrows are displayed for the number of irradiated locations. In arrows 51a to 51c, an arrow 51a in a direction in which the laser beam is to be irradiated next is shown thick.

  In addition, the parameter image shows, as numerical values, irradiation parameters of laser light to be irradiated next, that is, laser light irradiated in the direction of the thick arrow 51a, below the arrow. For example, as shown in FIG. 4, the laser light irradiation direction, treatment temperature, and laser light irradiation time are shown in the numerical display areas 52 a to 52 c.

  Here, the numerical display area 52a indicates how much the irradiation direction of the laser beam is inclined with respect to the vertical direction. In FIG. 4, since the thick arrow 51a is inclined 135 degrees, the numerical value display area 52a indicates “angle R135 degrees”. In the drawing, although the thick arrow 51a is directed to the left side, the display includes “R” indicating the right because it is inclined to the right side when viewed from the patient side. For example, when tilted 45 degrees to the left as viewed from the patient side, “angle L45 degrees” is displayed in the display area 52a (see FIG. 7).

  The display unit 42 is a touch panel. When the operator touches the upper and lower buttons 53 on the right side of the display areas 52a to 52c, the parameter of the laser beam irradiation can be increased or decreased even during the operation.

  The image of the treatment site in the treatment site display area 6 is an image taken from the distal end of the endoscope 31. The distal end 110 of the insertion portion 11 and the irradiation window 12 enter the field of view of the endoscope 31. The endoscope is positioned slightly closer to the irradiation window 12 than the center of the insertion portion 11 so that the range in which the living body can be observed is widened.

  In the first embodiment, since the applicator 1 and the image capturing unit 3 are integrally fixed, even if the applicator 1 rotates in the living body, the positional relationship between the endoscope 31 and the irradiation window 12 is Always constant. Therefore, if the field of view of the endoscope 31 is directly displayed on the display unit 42, the position of the irradiation window 12 does not move on the screen. However, as described above, in the present invention, the control unit 41 calculates the direction in which the irradiation window 12 faces based on the rotation angle of the applicator 1, and corrects the direction of the image captured from the endoscope 31. To do. Therefore, as the applicator 1 rotates, the image of the treatment site display area 6 of the display unit 42 also rotates.

  In the display unit 42, the sizes of the parameter display area 5 and the treatment site display area 6 to be displayed can be changed. For example, when the treatment site display area 6 on the screen of the display unit 42 is touched, the parameter display area 5 is reduced and the treatment site display area 6 is enlarged as shown in FIG. Conversely, when the parameter display area 5 on the screen of the display unit 42 is touched, the parameter display area 5 is enlarged and the treatment site display area 6 is reduced as shown in FIG.

  When the laser light irradiation direction shown in the parameter image, in FIG. 4, in the direction indicated by the arrow 51a is finished, as shown in FIG. 7, the arrow 51b in the direction of the next laser light irradiation is shown. Is shown thick. On the contrary, the arrow 51a indicating the direction in which the irradiation of the laser light is finished is shown thinly.

  The heat treatment apparatus to which the present invention is applied is configured as described above.

(Function)
Next, how the heat treatment apparatus works during surgery will be described.

  First, the surgeon makes a diagnosis on a tissue including a lesion to be heat-treated or its surrounding tissue in advance using a separate image diagnostic apparatus or palpation. As a result, the shape of the tissue including the heat treatment target lesion, the positional relationship with the surrounding tissue, the shape of the lesion site, the degree of serious injury, and the like are grasped. Then, the operator determines parameters for heat treatment and inputs them to the setting unit 415 of the main body 4.

  Then, the parameters input to the setting unit 415 are automatically transmitted to the setting image creation unit 416. The setting image creation unit 416 creates a parameter image that visually indicates the parameter based on the received parameter. The parameter image is transmitted to the image composition unit 417. The parameter image is stored in the image composition unit 417.

  Next, the surgeon holds the applicator 1 and inserts the insertion portion 11 into the affected area of the patient. For example, when the affected part is the prostate, the applicator 1 is inserted into the urethra. The surgeon turns on the power of the processor 33 and the light source 34 and irradiates light from the light guide 37 at the tip of the applicator 1. As a result, an image of a living body illuminated brightly is captured from the endoscope 31.

  Images captured by the endoscope 31 are sequentially converted into electrical signals by the camera head 32, further converted into display data by the processor 33, and transmitted to the main body 4. In the main body 4, the transmitted image of the treatment site is input to the image input unit 412 and transmitted to the image rotation unit 414.

  Here, when the surgeon rotates the applicator 1, this rotation is detected by the angle sensor 2 and transmitted to the main body 4. The detection result of the angle sensor 2 is input to the irradiation direction calculation unit 413 in the main body 4. Based on the detection result of the angle sensor 2, the irradiation direction calculation unit 413 calculates which of the living body the irradiation window 12 of the applicator 1 is facing and transmits it to the image rotation unit 414.

  The image rotation unit 414 rotates the image of the treatment site transmitted from the image input unit 412 based on the information on the direction of the irradiation window 12 transmitted from the irradiation direction calculation unit 413. For example, when the irradiation direction is tilted 135 degrees to the left with respect to the vertical direction, the image of the treatment site is also corrected to tilt 135 degrees to the left with respect to the vertical direction. As a result, the direction in which the irradiation window 12 faces, that is, the direction in which the laser beam is irradiated is associated with the image of the treatment site.

  The image whose orientation is corrected is transmitted from the image rotation unit 414 to the image composition unit 417. In the image composition unit 417, the previously created parameter image and the image of the treatment site whose orientation has been corrected are synthesized and transmitted to the display unit 42.

  As a result, as shown in FIG. 4, the laser light irradiation parameters are displayed in the parameter display area 5 and the treatment site image whose direction is corrected is displayed in the treatment site display area 6.

  When the surgeon rotates the applicator 1, the image of the treatment site display area 6 is also rotated. The surgeon looks at the treatment site display area 6 while referring to the parameter image, and rotates the applicator 1 so that the irradiation window 12 faces the irradiation direction 51a of the first laser beam as shown in FIG. Align.

  Then, the surgeon steps on the foot pedal 43 to irradiate the living body with laser light for the irradiation time indicated in the parameter display area 5.

  Subsequently, the surgeon aligns the position of the irradiation window 12 with the position of the thick arrow 51b with reference to the parameter image in the parameter display area 5 shown in FIG. Similarly, laser light irradiation is performed.

  By repeating this, the rotational position of the applicator 1 is changed until the arrows 51a to 51c shown in the parameter image all become thin, that is, until the irradiation of the laser light in all the irradiation directions is completed, and the laser light irradiation is performed. I do.

  As described above, in the present invention, the rotation of the applicator 1 is detected, and the image captured from the endoscope 31 is also rotated so as to match the rotation of the applicator 1. Therefore, since the rotation operation of the applicator 1 and the display of the endoscopic image coincide with each other, the operator can easily and intuitively grasp the rotation position of the applicator 1. Thereby, it takes no time for the surgeon to grasp the rotational position of the applicator 1, and the rotational position is not mistaken.

  Furthermore, in the present invention, since the irradiation parameters including the direction of irradiating the laser beam and the image of the endoscope 31 are displayed on the single display unit 42, the irradiation is performed without the operator moving the line of sight almost. The applicator 1 can be positioned by comparing the parameter and the endoscopic image.

  Moreover, in the said embodiment, the touch panel system is employ | adopted for the display part 42, The size can be changed freely by touching the parameter display area 5 or the treatment site | part display area 6. FIG. Therefore, the operator can easily confirm the display unit 42. For example, the operator can confirm the living body seen from the irradiation window 12 in an easy-to-understand manner by enlarging the treatment site display area 6, and can perform an accurate diagnosis.

  In the first embodiment described above, the irradiation direction calculation unit 413 detects the direction of the irradiation window 12 and rotates the image according to the direction. However, other methods may be used. For example, even if the gravity direction detected by the angle sensor 2 is recognized as a reference and the applicator 1 is rotated, the image rotation unit 414 rotates the image so that the gravity direction is always the downward direction of the display image. can do. At this time, the parameter image displayed in the parameter display area 5 is displayed so that the rectal direction of the patient is downward.

(Second Embodiment)
In the first embodiment, in the treatment site display area 6, only the image captured from the endoscope 31 is shown while correcting the direction. On the other hand, in the second embodiment, in the treatment site display area 6, the information of the irradiation parameter of the laser beam is synthesized with the image 61 of the endoscope 31.

  Since the first embodiment and the second embodiment have the same configuration, description of the configuration is omitted. However, since the image composition method in the image composition unit 417 is different, this point will be described with reference to FIGS. 8 and 9.

  8 and 9 are views showing a state of the display unit according to the second embodiment.

  As shown in FIGS. 8 and 9, parameter information 54 a to 54 c and 55 a to 55 c are synthesized around the image 61 of the endoscope 31 in the treatment site display area 6 displayed on the display unit 42.

  The parameter information 54a to 54c and 55a to 55c are combined with the image 61 in association with the direction in which the laser beam should be irradiated. The parameter information 54a to 54c indicates, for example, the treatment temperature, the laser beam irradiation time, and the laser beam irradiation amount as numerical values.

  The parameter information 55a to 55c indicates the irradiation direction of the laser light, the irradiation order, and the completion or non-completion of the irradiation. For example, as shown in FIG. 8, when the direction in which the laser beam is first irradiated is the direction of the arrow 51a, the parameter information 55a in the corresponding direction blinks. The other parameter information 55b and 55c do not blink.

  When the irradiation of the laser light in the direction of the arrow 51a is completed, the blinking of the parameter information 55a stops, and the shape of the parameter information 55a changes from that before the laser irradiation. For example, as shown in FIG. Thereby, the surgeon can easily determine whether or not the irradiation of the laser beam is finished. The arrow 51a becomes thinner.

  Next, the arrow 51b in the direction of the next laser beam irradiation becomes thicker. At the same time, the parameter information 55b corresponding to the arrow 51b starts to blink. This is repeated until there is no more direction to irradiate the laser beam.

  As described above, in the second embodiment, since the parameter information 54a to 54c and 55a to 55c are synthesized around the endoscopic image 61, the parameter display area 5 of the display unit 42 is not looked at. If only the treatment site display area 6 is viewed, the parameters at the time of laser light irradiation can be easily understood, and the progress of treatment can be confirmed.

  In the second embodiment, the display unit 42 is provided with both the parameter display area 5 and the treatment site display area 6. However, as shown in FIGS. 10 and 11, the parameter display area 5 and the treatment site display area 6 can be separately displayed.

  FIG. 10 is a view showing an endoscope monitor provided separately, and FIG. 11 is a view showing a display section 42 having only the parameter display area 5.

  When the treatment site display area 6 is displayed separately, an endoscope monitor is provided separately. In the control unit 41, the parameter information set by the setting unit 415 is added to the image rotated by the image rotation unit 414, and the result is output to the endoscope monitor.

  Then, as shown in FIG. 10, an image of only the treatment site display area 6 is displayed on the endoscope monitor. Here, the image displayed on the endoscope monitor is the same as the treatment site display area 6 shown in FIG. If a high-quality endoscope monitor is prepared, a clearer image of the treatment site can be seen.

  In the display unit 42, the parameter display area 5 and the treatment site display area 6 can be displayed side by side as shown in FIG. 8, or only the parameter display area 5 is enlarged as shown in FIG. It can also be displayed.

(Third embodiment)
In the said 1st Embodiment and 2nd Embodiment, in the display part 42, the parameter display area 5 and the treatment site | part display area 6 are provided separately. However, the parameter display area 5 can be superimposed on the treatment site display area 6.

  FIG. 12 is a diagram showing a state in which the parameter display area 5 is superimposed on the treatment site display area 6.

  As shown in FIG. 12, arrows 51 a to 51 c indicating the irradiation direction of the laser light are superimposed on the endoscopic image 61 in the treatment site display area 6. In addition, as in the second embodiment, parameter information 54a to 54c is displayed around the endoscope image 61. The roles of the arrows 51a to 51c and the parameter information 54a to 54c are the same as those described in the first embodiment and the second embodiment.

  In the third embodiment, since the arrows 51 a to 51 c in the laser beam irradiation direction are superimposed on the endoscopic image 61, the operator needs to compare the parameter display area 5 and the treatment site display area 6. Absent. By rotating the applicator 1 and aligning the position of the irradiation window 12 displayed in the treatment site display area 6 with the direction of the arrows 51a to 51c, it is possible to irradiate laser light in an appropriate direction of the treatment site.

(Fourth embodiment)
In the first to third embodiments, the case where a biaxial tilt sensor is used as the angle sensor 2 has been described. However, the present invention is not limited to this. Different configurations can also be applied as angle sensors.

  FIG. 13 is a diagram illustrating a configuration of a heat treatment apparatus using different angle sensors. The same configurations as those in the first embodiment are denoted by the same reference numerals, and the description thereof is omitted.

  As shown in FIG. 13, in the third embodiment, the applicator 1 is fixed to the applicator support portion 71. The applicator support portion 71 is formed in an annular shape, and the insertion portion 11 of the applicator 1 is fitted and fixed. The insertion portion 11 is a base that is not inserted into the living body during the operation, and is supported by the applicator support portion 71.

  The applicator support 71 is rotatably held by an applicator stand 72. Therefore, when the applicator 1 is rotated, the applicator support 71 rotates together and the applicator stand 72 does not rotate.

  The applicator support 71 is provided with an angle sensor 25. The angle sensor 25 is, for example, a rotary encoder or a potentiometer. In the case of a rotary encoder, a rotation angle is detected by providing a slit disk in the applicator support 71 and applying light from the light emitting element to the slit disk to detect repeated light and dark.

  As described above, various types of angle sensors can be applied.

(Fifth embodiment)
FIG. 14 is a schematic diagram showing a heat treatment apparatus having a different configuration for angle detection. In addition, about the structure similar to 1st Embodiment, the same reference number is attached | subjected and the description is abbreviate | omitted.

  In the first to fourth embodiments, the endoscope 31 and the camera head 32 of the image capturing unit 3 are fixed to the applicator 1 by the fixing tool 38. On the other hand, in the fifth embodiment, as shown in FIG. 14, only the endoscope 31 is fixed to the applicator 1 by the fixture 39, and the camera head 32 is not fixed to the applicator 1.

  In the heat treatment apparatus of the fifth embodiment, the angle detection unit 26 is attached to the camera head 32. The angle detection unit 26 includes an angle sensor 27. The angle sensor 27 is a biaxial tilt sensor, for example, and detects the rotation angle of the camera head 32.

  The angle detection unit 26 is detachable from the camera head 32. The angle detection unit 26 is attached to a predetermined position of the camera head 32 so that the posture when attached to the camera head 32 does not vary.

  The angle detection unit 26 is connected to the main body 4 via the cable 28, and the detected angle of the camera head 32 is input to the irradiation direction calculation unit 413.

  In the fifth embodiment, the irradiation direction calculation unit 413 calculates the energy irradiation direction of the applicator 1 based on the detection angles of the angle sensor 2 and the angle sensor 27. At the time of calculation, the irradiation direction calculation unit 413 takes into account that the camera head 32 can also freely rotate and is shifted from the reference position. Specifically, the irradiation direction calculation unit 413 calculates the difference between the rotation angles of the camera head 32 and the applicator 1 and adds the rotation angle from the reference position of the camera head 32 to the difference. With this as the rotation angle of the applicator 1, thereafter, the energy irradiation direction is calculated as in the first embodiment.

  As described above, the fifth embodiment shows that the present invention can be applied even when the camera head 32 is not fixed to the endoscope 31.

  In the first to fifth embodiments, the energy irradiated toward the living tissue is not limited to the laser beam as in the above-described embodiment, and energy such as microwaves, radio waves, and ultrasonic waves is used. May be used.

  In addition, the case of the prostate as an example of the biological tissue to be heat-treated has been described, but the present invention is not limited to this, and the living body such as blood vessels, digestive tract (esophagus, intestinal tract, etc.), abdominal cavity, etc. Or all living tissues that can be heated and irradiated with energy from the body surface.

"Appendix"
(Additional item 1)
The heat treatment apparatus according to claim 2 or 5, wherein the image display means displays the image of the treatment site or the living body and the parameter image side by side.

(Appendix 2)
The heat treatment apparatus according to claim 2, wherein the image display unit displays an image in which the parameter image is superimposed on an image of the treatment site or the living body.

(Additional Item 3)
The parameter image includes an image showing the treatment temperature, energy irradiation time and energy irradiation amount in numerical form,
The heat treatment apparatus according to claim 2, wherein the image display means displays the digitized parameter image around the image of the treatment site.

(Appendix 4)
8. The heat treatment apparatus according to appendix 7, wherein the image display means displays the digitized parameter image at a position corresponding to an energy irradiation direction around the image of the treatment site.

(Appendix 5)
The parameter image includes an image of an arrow indicating a direction in which energy is to be irradiated,
6. The heat treatment apparatus according to claim 2, wherein the image display unit displays the image of the arrow so as to overlap the image of the treatment site.

1 is a schematic diagram showing an overall configuration of a heat treatment apparatus to which the present invention is applied. It is the schematic which shows the mechanism of the insertion part of an applicator. It is a block diagram which shows schematic structure of a main body. FIG. 5 is a diagram showing a state where an image of a treatment site is enlarged, FIG. 6 is a diagram showing a state where a parameter image is enlarged, and FIG. 7 is a diagram showing a display unit showing the next treatment site. It is. It is a figure which shows a display part. It is a figure which shows a mode that the image of the treatment site was expanded. It is a figure which shows the display part which shows the following treatment site | part. It is a figure which shows the mode of the display part which concerns on 2nd Embodiment. It is a figure which shows the mode of the display part which concerns on 2nd Embodiment. It is a figure which shows the monitor for endoscopes provided separately. It is a figure which shows the display part which has only a parameter display area. It is a figure which shows a mode that the parameter display area | region was superimposed on the treatment site | part display area | region. It is a figure which shows the structure of the heat treatment apparatus using a different angle sensor. It is the schematic which shows the heat treatment apparatus which has a different structure about an angle detection.

Explanation of symbols

1 ... applicator,
2, 25, 27 ... angle sensors,
3 ... Image capture unit,
4 ... body,
5 ... Parameter display area,
6 ... treatment site display area,
11 ... Insertion part,
12 ... Irradiation window,
13 ... Optical fiber,
14 ... protection tube,
15 ... Drive unit,
16 ... Reflector,
21, 35, 36 ... cable,
26: Angle detection unit,
31 ... Endoscope,
32 ... Camera head,
33 ... Processor,
34 ... Light source,
37 ... Light guide,
38, 39 ... Fixing tool,
41. Control unit,
42 ... display part,
43. Foot pedal,
51a-c ... arrow (irradiation direction),
52a-c ... Numerical value display area,
53 ... Up and down buttons,
54a-c, 55a-c ... parameter information,
61 ... Endoscopic image,
110 ... tip,
411 ... Laser oscillator,
412: Image input unit,
413 ... Irradiation direction calculation unit,
414 ... an image rotation unit,
415 ... Setting section,
416 ... Setting image creation unit,
417: Image composition unit.

Claims (9)

Energy irradiation means for irradiating the living body with energy;
An irradiation direction detecting means for detecting an irradiation direction of the energy;
An image capturing means that is inserted into the energy irradiation means and captures an image of a treatment site from within the energy irradiation means;
Image correcting means for correcting the direction of the image of the treatment site based on the irradiation direction of the energy detected by the irradiation direction detecting means;
Image display means for displaying an image of the treatment site whose direction is corrected;
The heat treatment apparatus characterized by having. Energy irradiation means for irradiating the living body with energy;
An irradiation direction detecting means for detecting an irradiation direction of the energy;
An image capturing means that is inserted into the energy irradiation means and captures an image of a treatment site from within the energy irradiation means;
Image correcting means for correcting the direction of the image of the treatment site based on the irradiation direction of the energy detected by the irradiation direction detecting means;
Parameter creation means for creating a parameter image that visually indicates the parameters of energy irradiation;
Image synthesizing means for synthesizing the corrected image of the treatment site with the parameter image;
Image display means for displaying the synthesized image;
The heat treatment apparatus characterized by having.   The heat treatment apparatus according to claim 1, wherein the image correction unit corrects the direction of the image of the treatment site so as to match the irradiation direction of the energy. Energy irradiation means for irradiating the living body with energy;
An image capturing unit that includes an observation unit that is inserted into the energy irradiation unit, and that captures an image of the living body from the energy irradiation unit;
An angle detection means for detecting an observation angle of the observation unit;
Image correcting means for correcting the direction of the image of the living body based on the observation angle detected by the angle detecting means;
Image display means for displaying an image of the living body whose direction is corrected;
The heat treatment apparatus characterized by having. Energy irradiation means for irradiating the living body with energy;
An image capturing means for capturing an image of the living body from the energy irradiation means, the observation unit inserted into the energy irradiation means;
An angle detection means for detecting an observation angle of the observation unit;
Image correcting means for correcting the direction of the image of the living body based on the observation angle detected by the angle detecting means;
Parameter creation means for creating a parameter image that visually indicates the parameters of energy irradiation;
Image combining means for combining the corrected biological image with the parameter image;
Image display means for displaying the synthesized image;
The heat treatment apparatus characterized by having.   The energy irradiation direction is calculated based on the observation angle detected by the angle detection unit, and the image correction unit corrects the direction of the image of the living body so as to match the calculated energy irradiation direction. The heat treatment apparatus according to claim 4 or 5.   The heating treatment apparatus according to claim 2 or 5, wherein the parameter image is created based on at least one parameter among treatment temperature, energy irradiation direction, energy irradiation intensity, energy irradiation time, and irradiation energy amount. The energy irradiation means includes
A long insertion part that can be inserted into a living body;
An irradiation window that opens laterally with respect to the longitudinal direction of the insertion portion;
An irradiation unit that is provided in the insertion unit and irradiates energy from the irradiation window toward the side of the insertion unit;
The heat treatment apparatus as described in any one of Claims 1-7 containing these.   The heat treatment apparatus according to claim 8, wherein the irradiation unit is movable in a longitudinal direction of the insertion unit and changes an emission angle of energy with the movement.

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