JP2007117188A - Medical device for interior of body - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a medical device for the interior of the body which can position a part to be diagnosed and treated relative to a functional element to perform diagnosis and treatment. <P>SOLUTION: The medical device for the interior of the body has the functional element 1 for the diagnosis and treatment and a fixing means 2 which is integrally formed with this functional element 1 and enables the functional element 1 to be mounted on a tissue by being fixed to the inside tissue from the body wall. The fixing means 2 has a suction section 7 which is fixed to the tissue by suction. <P>COPYRIGHT: (C)2007,JPO&INPIT

Description

  The present invention relates to an in-vivo medical device that diagnoses and treats tissue inside a body wall of a patient.

Conventionally, an endoscope is inserted into a body cavity to diagnose / treat (surgery) a tissue such as an organ. Endoscope treatment is performed by inserting an overtube in advance from outside the patient's body and inserting the endoscope insertion portion into the overtube. For example, a high-frequency knife or the like present at the distal end of the insertion portion. This is done by excising the lesioned part of the organ with an incision tool. Conventionally, at the time of this excision, since the lesioned part and its peripheral part are gripped by a clip having a sharp tip shape, there is a risk of unnecessary damage.
Therefore, for example, as disclosed in Patent Document 1, a holding member that holds a lesioned part by suction is proposed to prevent the lesioned part and its surroundings from being unnecessarily damaged when treating a lesioned part in a tissue in a patient. Has been.

Japanese Patent Laying-Open No. 2005-28006 (FIGS. 7 to 10)

However, when the target site to be excised is moving due to the movement of the organ, the relative position between the target site and the incision tool is not fixed, which makes the operation difficult. That is, the apparatus described in Patent Document 1 has a problem in that when the organ moves, the relative position between the target site to be excised and the incision tool is not fixed, and thus the operation becomes difficult.
In addition, not only in the case of the treatment by the endoscope but also in the case of the operation by laparotomy, the excision work becomes difficult because the relative position between the target site to be treated and the cutting tool is not fixed. . Furthermore, not only treatment but also a part of a moving organ is diagnosed using a sensor, if the relative position between the sensor and the target site is not determined, accurate diagnosis becomes difficult.

  Accordingly, the present invention has been made in view of the above problems, and an in-vivo medical device capable of determining the relative position between a site targeted for diagnosis / treatment and a functional element for performing diagnosis / treatment. The purpose is to provide.

In order to achieve the above object, an internal medical device according to the present invention includes a functional element for at least one of diagnosis and treatment, and is integrated with the functional element, and is fixed to the inner tissue from the body wall. And a fixing means for allowing the functional element to be attached to the tissue.
According to this medical device for internal use, the fixing element is fixed to the inner tissue from the body wall, so that the functional element integrated with the fixing means is fixed to the tissue. Therefore, the relative position between the functional element for diagnosis and treatment and the site to be diagnosed or treated for the tissue can be determined.

Moreover, the medical device for internal use of this invention is further provided with the movable means which makes it possible to change the position of the said functional element with respect to the said structure | tissue.
According to this, by changing the position of the functional element with respect to the tissue, diagnosis / treatment at a plurality of locations along the surface of the tissue can be performed.

  In this medical device for internal use, the movable means can be an actuator that changes a relative position between the fixing means and the functional element. Thereby, the position of the functional element can be changed with respect to the fixing means in a fixed state with respect to the tissue by the actuator.

  Alternatively, in the in-vivo medical device, the fixing means can release the fixation to the tissue to release the mounting of the functional element, and a plurality of the fixing means are provided. It can be set as the actuator which changes the relative position of fixing means. Thereby, the functional element can be moved by changing the relative position of the fixing means by operating the actuator in a state where the fixing to the tissue is released with respect to a part of the fixing means. .

Furthermore, it is preferable that these in-vivo medical devices further include a detecting means for detecting the position of the functional element on the tissue.
Thereby, even if the functional element moves in the body, the position of the functional element on the tissue can be detected by the detecting means. Further, in the case of a functional element having a function for diagnosis, if a diagnosis is performed using the functional element while moving, a diagnosis along the surface of the tissue can be performed and a planar diagnosis result (diagnosis map) can be obtained. .

Moreover, it is preferable that the medical device for internal use has a joint portion that generates a bending motion in order to change a relative angle between the functional element and the fixing means.
According to this, by causing a bending motion in the joint portion, it is possible to appropriately attach the functional element to the tissue even when the tissue is uneven.

In each of the in-vivo medical devices, it is preferable that the fixing means has a suction part that is fixed to the tissue by suction.
As a result, by fixing the suction portion of the fixing means to the tissue by suction, the functional element can be firmly attached to the tissue, and the fixing means can damage the tissue. Can be suppressed. Furthermore, if the suction at the suction part is released, the fixation is released, and the configuration of the fixing means is simplified.

The suction part includes a membrane member that is brought into contact with the tissue, and a main body part that forms a space part between the membrane member, and the suction part is configured to suck the space part and It is preferable to adsorb to the tissue via a membrane member.
In this case, the fixing means comes into contact with the tissue through the membrane member, and the space portion is sucked and absorbed by the tissue. Therefore, the fixing means can prevent the body fluid from the tissue side from being sucked by suction.

In addition, the medical device for internal use of the present invention preferably further includes an insertion assisting device in which the functional element and the fixing means are attached to the distal end and inserted into the body from outside the body. According to this, it is possible to insert the functional element and the fixing means which are integrated into the body.
In this case, it is preferable that the functional element and the fixing means are removable from the insertion assisting device. Thereby, a functional element and a fixing means can be left in the body.

  In the medical device for internal use, the functional element includes a sensor that diagnoses the state of the tissue. Furthermore, the functional element has a medical device for treating the tissue. Thereby, the functional element attached to the tissue can be diagnosed and treated.

  According to the internal medical device of the present invention, by fixing the fixing means to the inner tissue from the body wall, the functional element integrated with the fixing means is fixed to the tissue. Therefore, the relative position between the functional element and the site to be diagnosed or treated is determined, and the diagnosis or treatment in the body can be performed accurately.

Embodiments of the present invention will be described below with reference to the drawings.
FIG. 1 is a schematic view showing an embodiment of an in-vivo medical device of the present invention. In this medical device for internal use, the functional element 1 for at least one of diagnosis and treatment is attached to a living tissue inside the body wall such as in a chest cavity or abdominal cavity of a patient, and the function. Element 1 is made to function. For example, this in-vivo medical device can be diagnosed or treated for an organ by being attached to the outer surface or inner surface of the organ.

In FIG. 1, the medical device for internal use includes the functional element 1 and a fixing means 2 integrated with the functional element 1.
The functional element 1 can perform at least one of diagnosis and treatment on tissue inside the body wall of a patient, and can be, for example, a sensor for diagnosing the state of the tissue. More specifically, this sensor is a piezoresistive sensor for palpation and behavior diagnosis of tissue, an optical sensor for blood diagnosis, a temperature sensor for blood and tissue temperature diagnosis, and a tissue condition diagnosis. For example, a microwave sensor and an ultrasonic sensor for measuring the potential, and an electrode sensor for measuring a bioelectric potential.
Further, the functional element 1 can be a medical device (operator) that performs treatment on tissue. Specifically, a microwave probe for coagulation therapy, a nozzle or pump for drug solution administration or body fluid collection, a needle for tissue sampling, and an electrode for bioelectric stimulation are included. The functional element 1 may have the above-described sensor and medical device. Moreover, the case of having a plurality of types of these may be used.

The fixing means 2 can be fixed to the inner tissue from the body wall, and the functional element 1 can be attached to the tissue by this fixing. FIG. 2 is an explanatory view for explaining the fixing means, and FIG. 3 is a sectional view thereof.
2 and 3, the fixing means 2 has a suction part 7 that is fixed to the tissue by suction of gas (air). The suction part 7 is formed on the contact surface 2a which is a surface on the side in contact with the tissue. And this suction part 7 is connected with the one end part side of the piping 26, and the other end part side of this piping 26 is connected with the pump outside a figure. Thereby, by sucking air through the pipe 26, a negative pressure is generated in the space of the suction part 7 brought into contact with the tissue, and the fixing means 2 is adsorbed to the tissue. In this fixing means 2, the contact surface 2a with the tissue is circular, and one suction portion 7 is provided at the center of the contact surface 2a. The functional element 1 is omitted from the illustration.

  Moreover, the fixing means 2 of FIG. 1 is provided with a plurality (eight) suction portions 7 on the contact surface 2a at equal intervals in the circumferential direction. And the functional element 1 is provided in the center side of these suction parts 7 in the contact surface 2a. A plurality of suction portions 7 are provided on the contact surface 2a, and the fixing means 2 is made of a flexible material that can be elastically deformed, so that the target surface of the tissue has a complicated shape or there are irregularities in the tissue. However, the contact surface 2a of the fixing means 2 can be deformed following the unevenness, and is firmly fixed to the tissue by the plurality of suction portions 7. Further, even if the contact surface 2a is not sufficiently conformed to the unevenness, the fixing means 2 is elastically deformed, and some (at least one) of these suction portions 7 can be in close contact with the tissue, It can suppress that adsorption power is spoiled.

  FIG. 4 is a schematic view showing a modification of the fixing means 2. In this fixing means 2, the shape of the suction part 7 is different from that of FIGS. 1 to 3, and the suction part 7 is formed in an annular shape. In the embodiment shown in FIGS. 1 to 4, in the closed space formed between the surface of the tissue and the main body portion 22 of the fixing means 2, a negative pressure is obtained by removing the gas, thereby adsorbing the tissue. It is considered as a fixing mechanism. In addition, although not shown in the drawing, the mechanism is not a suction by a pump, but a mechanism that presses the main body portion 22 against the tissue side and elastically deforms the main body portion 22 to reduce the volume of the closed space and generate a negative pressure to be adsorbed. You can also.

  FIG. 5 shows a modification of the fixing means 2 shown in FIG. 3. The suction part 7 of the fixing means 2 forms a space 21 between the membrane member 20 brought into contact with the tissue 50 and the membrane member 20. Main body 22. That is, the contact surface 2 a is configured as the membrane member 20. The suction unit 7 can suck the gas in the space 21 by a pump or the like (not shown) and can adsorb it to the tissue 50 through the membrane member 20. In this case, the fixing means 2 comes into contact with the tissue 50 via the membrane member 20, and the space 21 is sucked to elastically deform the membrane member 20 and be adsorbed to the tissue 50. Inhalation of body fluid by suction can be prevented.

FIG. 6 is a schematic view showing still another modification of the fixing means 2. The contact with the tissue by the fixing means 2 is not due to adsorption as described above, and a large number of fine hairs (cilia) are formed on the contact surface 2a of the fixing means 2, and the function of the tissue is due to this function. The fixing means 2 is fixed. That is, the contact point between the tissues increases due to the fine hair, and the fixing means 2 is fixed to the tissue by the intermolecular force that attracts the molecules constituting the hair and the molecules constituting the tissue. be able to. As this fine hair, for example, there is a carbon nanotube, and this bundle is formed on the contact surface 2a. The carbon nanotubes are preferably branched from one to several hundreds of spatulas. According to this, a thing preferable also in intensity | strength is obtained. Further, in this case, the main body 22 and the hair are made of different materials, and the main body 22 is made of a flexible material, so that the main body 22 is made uneven even if there is unevenness on the surface of the tissue. The fixation means 2 can be brought into close contact with the surface of the tissue.
Although not shown, the contact surface 2a of the fixing means 2 may be formed as an adhesive protein surface, and the fixing means 2 may be fixed to the tissue by adhesion. Furthermore, an adhesive layer may be formed on the contact surface 2a, and the fixing means 2 may be fixed by adhesion. Further, the fixing means 2 may be fixed by a method combining a plurality of adsorption, adhesion and adhesion.

In each of the embodiments described above, the material of the fixing means 2 is formed of a flexible elastic material. For example, it can be a silicone rubber with good biocompatibility.
And the medical device for in-body in these embodiment is the structure by which the functional element 1 is taken in into the main-body part 22 of the fixing means 2, and the fixing means 2 and the functional element 1 are united.

  According to each fixing means 2 having the above configuration, it is possible to suppress the tissue from being damaged by the fixing. Further, by fixing the fixing means 2 to the tissue, the functional element 1 can be attached to the tissue, and the functional element 1 for diagnosis and treatment and the portion to be subjected to the diagnosis or treatment of the tissue The relative position between can be determined.

  FIG. 7 is a schematic diagram illustrating the function of the in-vivo medical device of the present invention. The fixing means 2 of this medical device for internal use is the same as that shown in FIG. In FIG. 7, the functional element 1 is a sensor of a contact type with respect to the tissue 50, for example, an ultrasonic sensor, a temperature sensor, a tactile sensor, or the like. A wiring 27 for outputting a signal from the functional element 1 is connected. This in-vivo medical device is provided in a state in which the detection part of the functional element 1 is exposed on the contact surface 2 a of the fixing means 2 and the functional element 1 is embedded in the main body part 22 of the fixing means 2. Although the result detected by the functional element 1 is transmitted to the outside by wire using the wiring 27, it may be transmitted to the outside by wireless by providing a wireless transmission means.

  And before the adsorption fixation to the structure | tissue shown to Fig.7 (a), the contact surface 2a of the fixing means 2 is made into the plane. As shown in FIG. 7B, when suction is performed by the suction unit 7, the fixing means 2 is fixed to the tissue 50 and the functional element 1 is attached to the tissue 50. The shape of the target portion of the tissue 50 shown in FIG. 7B is a curved surface that bulges outward, but a plurality of suction portions 7 are provided on the peripheral edge side of the circular contact surface 2a. Since the elastic material is flexible, the peripheral portion of the contact surface 2a of the fixing means 2 is in close contact with the tissue 50, and the entire fixing means 2 is elastically deformed so as to follow the shape of the tissue 50. Thus, the fixing means 2 is fixed. Since the fixing means 2 is elastically deformed, a force in the direction of pressing the surface of the tissue 50 acts at the central portion of the fixing means 2 due to the elastic restoring force. Therefore, the functional element 1 attached to the central part of the fixing means 2 is pressed toward the surface side of the tissue 50, and the functional element 1 can be brought into close contact with the tissue.

FIG. 8 is a schematic view for explaining another embodiment of the in-vivo medical device of the present invention. 7 is different from FIG. 7 in that a space portion 28 is provided in the main body portion 22 of the fixing means 2, and a second pipe for supplying gas to the space portion 28 is provided in the space portion 28. 29 is connected. A pipe connected to the suction unit 7 is a first pipe 26. The space portion 28 is formed in an outer portion of the functional element 1 in the main body portion 22 of the fixing means 2, that is, a portion on the opposite side of the contact surface with the tissue 50 in the functional element 1. An air supply source (not shown) is connected to the second pipe 29, gas is supplied to the space portion 28, and the space portion 28 can expand.
As a result, as shown in FIG. 8B, the fixing means 2 is adsorbed and fixed to the tissue 50 by the suction portion 7, and the functional element 1 is pressed toward the tissue 50 side by expanding the space portion 28. Can do. Therefore, even if the surface of the tissue 50 is uneven, or the surface of the tissue 50 is flat or recessed in a concave shape, the functional element 1 can be attached in close contact with the tissue. In particular, when the functional element 1 is a contact-type sensor, it is necessary to bring the sensor into close contact with the tissue 50, but this is possible by the function of the space portion 28. Furthermore, as shown in FIG. 8B, when the target site of the tissue 50 is a curved surface that swells outward, the elastic restoring force of the fixing means 2 further acts as in FIG. Can be attached in close contact with the tissue 50.

FIG. 9 is a schematic view for explaining another embodiment of the medical device for internal use of the present invention. In this medical device for internal use, the point different from FIG. 7 is that the functional element 1 is a contact-type medical device. Specifically, it is a nozzle (hollow needle) for injecting a chemical solution. In this case, a concave portion 31 that opens to the contact surface 2 a side is formed in the main body portion 22 of the fixing means 2, and the functional element 1 is attached to the concave portion 31. A liquid supply pipe 30 is connected to the functional element 1.
As shown in FIG. 9 (a), when the fixing means 2 is in a natural state, the tip of the needle of the functional element 1 is projected from the contact surface 2a, as shown in FIG. 9 (b). Further, the tip of the needle is inserted into the tissue 50 by causing the suction means 7 to adsorb the fixing means 2 to the tissue 50. Further, the distal end portion of the needle is more reliably inserted into the tissue by elastic deformation of the fixing means 2 by suction of the suction portion 7. The functional element 1 may be a needle for tissue sampling.

FIG. 10 is a schematic view for explaining still another embodiment of the medical device for internal use of the present invention. 9 is different from FIG. 9 in that a space portion 28 is provided in the main body portion 22 of the fixing means 2, and a second pipe for supplying gas to the space portion 28 in the space portion 28 is provided. 29 is connected. A pipe connected to the suction unit 7 is a first pipe 26. The space portion 28 is formed in an outer portion of the functional element 1 in the main body portion 22 of the fixing means 2, that is, a portion on the opposite side of the contact surface with the tissue 50 in the functional element 1. An air supply source (not shown) is connected to the second pipe 29, gas is supplied to the space portion 28, and the space portion 28 can expand.
As a result, as shown in FIG. 10B, the fixing means 2 is adsorbed and fixed to the tissue 50 by the suction portion 7, and the functional element 1 is pressed toward the tissue 50 side by expanding the space portion 28. The needle of the functional element 1 can be inserted into the tissue 50. Therefore, the needle can be inserted into the tissue 50 even if the surface of the tissue 50 is uneven, or the surface of the tissue 50 is flat or concave. That is, in this embodiment, the tip of the needle is retracted to the back side of the recess 31 with respect to the contact surface 2a, and the needle does not contact the tissue when the fixing means 2 is not fixed to the tissue 50. . However, when the fixing means 2 is fixed to the tissue 50 and the space 28 is expanded, the needle is inserted into the tissue 50. That is, by controlling the expansion operation in the space portion 28, the needle can be made to function or its function can be restricted.

  FIG. 11 is a perspective view showing another embodiment of the in-vivo medical device of the present invention. This in-vivo medical device is further provided with a movable means 3 that makes it possible to change the position of the functional element 1 with respect to the tissue. That is, this apparatus connects (attaches) the functional element 1 for at least one of diagnosis and treatment, a plurality of fixing means 2 integrated with the functional element 1, and the fixing means 2. And a movable means 3 for changing the relative positions of the plurality of fixing means 2. The plurality of fixing means 2 are provided apart from each other. In this embodiment, the configuration of the functional element 1 is the same as that described above, and the type thereof is appropriately selected. Furthermore, the configuration of each fixing means 2 can be the same as that described above, and a detailed description thereof will be omitted. The size of the in-vivo medical device shown in FIG. 11 is, for example, that the fixing means 2 has a suction cup structure with a diameter of about 5 mm, and the overall size is about 30 mm.

  The fixing means 2 can be fixed or released (released) with respect to the tissue, and the functional element 1 can be attached to or released from the tissue. More specifically, each of the plurality of fixing means 2 has the suction part 7 and is fixed to the tissue by suction in the suction part 7, and if the suction in the suction part 7 is released, the fixation to the tissue is released. Is done. According to the configuration of the suction portion 7 by suction, the configuration of the fixing means 2 that performs fixing or releasing of fixing can be simplified.

In FIG. 11, the fixing means 2 are provided at four positions apart from each other, and the fixing means 2 are disposed at respective positions corresponding to rectangular corners drawn by virtual lines (not shown). Yes. The pair of fixing means 2 are connected by the first connecting member 17a, and the remaining pair of fixing means 2 are connected by the second (other) connecting member 17b. These connecting members 17 a and 17 b are connected by the movable means 3.
In the in-vivo medical device in this embodiment, as shown in the above-described embodiment, the functional element 1 may be incorporated into the main body portion 22 (for example, see FIG. 1) of the fixing means 2 and integrated with each other.
Alternatively, the functional element 1 may be attached to the movable means 3 and the connecting members 17a and 17b. That is, in this case, the fixing means 2 and the functional element 1 are connected to each other via different members (the movable means 3 and the connecting members 17a and 17b), whereby the fixing means 2 and the functional element 1 are connected. It is united.

In FIG. 11, the movable means 3 is a telescopic actuator (air cylinder) 4. The relative position of the fixing means 2 can be changed by extending the telescopic actuator 4 in a state where a part of the plurality of fixing means 2 is released from the tissue. Thereby, the position of the functional element 1 can be changed.
When the telescopic actuator 4 is made of metal, it is preferable to coat the periphery with a material having good biocompatibility. Alternatively, the telescopic actuator 4 itself may be made of a resin having good biocompatibility.

  12A to 12D are explanatory views for sequentially explaining the movement operation of the in-vivo medical device by the telescopic actuator 4. In FIG. 12, the pair of fixing means 2 connected by the first connecting member 17a in FIG. 11 is a first portion 41, and the pair of fixing means 2 connected by the second connecting member 17b is a second portion 42. In the following description, it is assumed that the first portion 41 and the second portion 42 are connected by the telescopic actuator 4 as the movable means 3. In FIG. 12, the connecting members 17a and 17b are omitted. Furthermore, in each fixing means 2, those with hatches indicate a fixed state, and those without hatches indicate a state in which the fixing is released.

  In FIG. 12A, all the fixing means 2 are adsorbed and fixed to the tissue. In (b), the fixing of the first portion 41 is released, and the telescopic actuator 4 extends. In (c), the first portion 41 is fixed, the second portion 42 is fixed, and the telescopic actuator 4 is shortened. In (d), the second portion 42 is fixed. By performing the above-described operation for one cycle, the medical device for internal use has advanced by the dimension e with the first portion 41 in front. This dimension e is the amount of expansion / contraction of the expansion / contraction actuator 4. By repeating this cycle, the internal medical device can move, and the functional element 1 can move. Then, the functional element 1 is caused to function in a state in which all the fixing means 2 are fixed, and then the movement is performed. By repeating this operation, the tissue can be diagnosed and treated along the surface. Although not shown, a configuration in which the number of fixing means 2 is two in the front and rear and these are connected by the telescopic actuator 4 may be used.

FIG. 13 is a diagram for explaining another form of the movement operation of the medical device for internal use by the telescopic actuator 4. This in-vivo medical device includes four fixing means 2 and two telescopic actuators 4. The first fixing means 2a and the second fixing means 2b are connected by the first telescopic actuator 4a. The 3 fixing means 2c and the 4th fixing means 2d are connected by the 2nd expansion-contraction actuator 4b.
In FIG. 13A, all the fixing means 2 are adsorbed and fixed to the tissue. In (b), the fixing of the first fixing means 2a is released, and the first telescopic actuator 4a extends by the dimension f. In (c), it is fixed by the first fixing means 2a, the fixing is released by the third fixing means 2c, and the second telescopic actuator 4b is extended by the dimension f. In (d), the fixing of the second fixing means 2b is released, and the first telescopic actuator 2a is shortened by the dimension f. In (e), the second fixing means 2b is fixed, the fixing of the fourth fixing means 2d is released, and the second telescopic actuator 4b is shortened by the dimension f. In (f), the fourth fixing means 2d is fixed. By performing the above-described one-cycle operation, the in-vivo medical device advances by the dimension f before the first fixing means 2a and the third fixing means 2c. By repeating this cycle, the internal medical device can move, and the functional element 1 can move. Then, the functional element 1 is caused to function in a state in which all the fixing means 2 are fixed, and then the movement is performed. By repeating this operation, the tissue can be diagnosed and treated along the surface.

FIG. 14 and FIG. 15 show another in-vivo medical device of the present invention, and show a case where the moving direction of the moving function by the telescopic actuator 4 is two-dimensional (x-axis direction and y-axis direction). is there.
First, in FIG. 14, the medical device for internal use includes a main body 10, and the telescopic actuator 4 is attached so as to extend in four directions around the main body 10. Fixing means 2a, 2b, 2c, and 2d are attached to the tips of the telescopic actuators 4a, 4b, 4c, and 4d, respectively. That is, one main body 10 and each fixing means 2 are connected to each other by the telescopic actuator 4.

  In FIG. 14A, all the fixing means 2a, 2b, 2c, 2d are adsorbed and fixed to the tissue. In (b), the fixing of the second fixing means 2b is released, in (c) the second telescopic actuator 4b is extended by the dimension g, in (c) the second fixing means 2b is fixed, and in (d) the third fixing means 2b is fixed. The fixation of the fixing means 2c and the fourth fixing means 2d is released, and in (e), the first expansion / contraction actuator 4a expands by the dimension g and the second expansion / contraction actuator 4b shortens by the dimension g. Thereafter, when the third fixing means 2c and the fourth fixing means 2d are fixed (f), the fixing of the first fixing means 2a is released, and in (g), the first telescopic actuator 2a is shortened by the dimension g. By performing the above-described one-cycle operation, the in-vivo medical device advances by the dimension g in the positive direction along the y-axis with the second fixing means 2b in front. Note that the movement in the negative direction along the y-axis and the movement in the positive and negative directions along the x-axis are the same as described above, and thus the description thereof will be omitted. The medical device for internal use can move in four directions.

  FIG. 15 shows an embodiment in which the degree of freedom is further increased in the moving direction. FIG. 15A shows a telescopic actuator 4 provided radially in six directions and a fixing means 2 provided at the tip thereof. Furthermore, (b) is an embodiment in which the telescopic actuator 4 is provided radially in eight directions and the fixing means 2 is provided at the tip thereof. The movement operations for these are the same as those described above, and can be moved in each direction by switching between fixing and releasing, and expansion and contraction of the telescopic actuator 4.

Further, in the in-vivo medical device provided with these moving mechanisms, although not shown, detection for detecting the position of the functional element 1 by a receiver provided outside by transmitting a (wireless) signal to the outside. Means (not shown) are provided. That is, the detection means is a wireless transmitter, and is provided, for example, inside the main body 10 shown in FIG. And even if it is a case where this in-vivo medical device is left in the body by receiving the signal transmitted from this transmitter with the receiver provided outside the body, the functional element 1 of this in-vivo medical device The position can be detected externally.
Further, as another detection means for detecting the position of the functional element 1 outside the patient's body, a target member detected by MRI can be used. In this case, the patient diagnoses and treats with this in-vivo medical device while diagnosing with the MRI diagnostic machine. Thereby, the position of the internal medical device can be detected by the MRI diagnostic machine.
Moreover, the medical device for internal use of this invention is equipped with the communication means (not shown) for transmitting the information obtained when the functional element 1 functions to the receiver provided outside. This communication means is a wireless type or a wired type, and is provided, for example, inside the main body 10 shown in FIG. And even if this in-vivo medical device is left in the body by receiving a signal transmitted from this communication means by a communication device provided outside the body, diagnostic information and treatment information by this functional element 1 Can be detected externally, and treatment information for operating the functional element 1 by an operator on the external receiver side and movement instruction information for moving the functional element 1 are transmitted to the functional element 1 side. can do.

Thereby, even if the functional element 1 moves inside the body, the position of the functional element 1 can be detected outside the body by the detection means. The communication means enables various information to be communicated between an external operator (receiver) and the internal functional element 1.
If diagnosis / treatment is performed by the functional element 1 moving and functioning, diagnosis / treatment along the surface of the tissue can be performed. Further, the functional element 1 moving in the body acquires diagnosis information and treatment information of the tissue, and associates the information with the position of the functional element 1 when the information is obtained (in the functional element 1 or an external processing means). Thus, mapping can be performed to obtain planar diagnosis / treatment results, that is, diagnosis maps and treatment maps.

  In FIG. 16, the movable means 3 has a joint portion 6 in which a bending motion occurs. Specifically, the joint portion 6 is provided at the tip of the rod of the telescopic actuator 4, and the fixing means 2 is provided at the tip side. According to this, as shown in FIG. 16, in a portion where the fixing means 2 is connected to the main body 10, a bending motion is generated in the joint portion 6 that the movable means 3 has, Even if the tissue 50 is uneven or curved, the fixing means 2 can be fixed to the tissue 50, and the functional element 1 can be appropriately attached (contacted) to the tissue 50. By providing the joint portion 6, this in-vivo medical device can perform a three-dimensional operation.

  17 and 18 are diagrams for explaining the joint 6. The joint portion 6 is composed of two rubber layers 11 and 12, and has a thin and flexible structure as a whole. Specifically, the joint portion 6 is configured by laminating a first film body 11 and a second film body 12 made of a silicone rubber film. Between the 1st film body 11 and the 2nd film body 12, the space 13 which air is supplied partially and expand | swells is formed. Air is supplied to the space 13 from an air supply path 16 connected to the air supply source side. Of the joint 6, the portion where the space 13 is formed functions as balloon actuators 15a, 15b, and 15c.

The first film body 11 and the second film body 12 have different thicknesses. In the portion corresponding to the balloon actuator 15 (the portion where the space 13 is formed), the thickness of the second film body 12 is larger than the thickness of the first film body 11. The first film body 11 and the second film body 12 are both formed of the same material (for example, PDMS), but have different hardnesses. The first film body 11 is formed with a lower hardness than the second film body 12. That is, the first film body 11 is lower in rigidity than the second film body 12. Since both the first film body 11 and the second film body 12 are formed of a stretchable material, portions of the film bodies 11 and 12 that constitute the balloon actuators 15a, 15b, and 15c are in the space 13. By the pressure P of the supplied air, it can expand and expand while expanding its surface area like a balloon.
In the balloon actuators 15a, 15b, and 15c, the first film body 11 is thinner than the second film body 12 and is softer (less rigid). Therefore, the first film body 11 is more than the second film body 12 even under the same pressure. Can also expand greatly. In other words, since the second film body 12 is thicker (higher rigidity) than the first film body 11, it can only expand smaller than the first film body 11 under the same pressure.

FIG. 17 shows a state of expansion when the air pressure P is less than a predetermined pressure Psat. In this case, the first film body 11 and the second film body 12 constituting the balloon actuators 15a, 15b, and 15c are shown in FIG. Although both expand by the air pressure P, the thin and soft first film body 11 expands more greatly. When the film bodies 11 and 12 expand, tensile stresses (tension forces) Ft and Fb as shown in the figure are generated in the film bodies 11 and 12, respectively.
Paying attention to the second balloon actuator 5b, the tensile stresses Ft and Fb are forces in a direction to bring the base portions 14a and 14b on both sides of the balloon actuator 5b closer to each other. In the state of FIG. 17, the tensile stress generated in the first film body 11 is larger than the tensile stress generated in the second film body 12 (Ft> Fb). For this reason, the balloon actuator 15b performs a bending motion in which the base portion 14b moves upward with respect to the base portion 14a by a larger tensile stress Ft. That is, in the state of FIG. 17, a bending motion in the same direction as the expansion direction of the first film body 11 occurs.

FIG. 18 shows a state of expansion when the air pressure P becomes larger than the pressure Psat. In this case, the joint portion 6 performs a bending motion in the opposite direction (downward) to FIG. That is, when the air pressure P further increases, the first film body 11 and the second film body 12 constituting the balloon actuator 15b further expand and expand. Although the expansion (elongation) of the second film body 12 in FIG. 17 was slight, the second film body 12 is sufficiently high to generate a large tensile stress Fb even in the thick and hard second film body 12 by sufficiently high pressure. Expansion (elongation) occurs. Moreover, since the second film body 12 is thicker than the first film body 11, the tensile stress Fb in the second film body 12 once sufficient elongation occurs is greater than the tensile stress Ft generated in the first film body 11. Also grows. That is, in FIG. 17, Ft <Fb, and the balloon actuator 15b overcomes Ft by a larger tensile stress Fb and performs a bending motion in which the base portion 14b moves downward relative to the base portion 14a. That is, in the state of FIG. 18, a bending motion in the same direction as the expansion direction of the second film body 12 occurs.
Then, a bending motion similar to that of the second balloon actuator 15b occurs also for the other balloon actuators 15a and 15b, and the entire joint portion 6 performs a downward bending motion.

According to the balloon actuators 15a, 15b, and 15c described above, bending motions in two directions are possible. According to the balloon actuators 15a, 15b, and 15c, the bending motion direction can be changed by the air pressure P. Further, by adjusting the value of the air pressure P, the bending angle θ (FIG. 16) at the joint portion 6 can be changed. In addition, although the balloon actuator 15 was demonstrated as three, this number is changeable and can be made into 1 or 2 or more.
Further, when the fixing means 2 is formed by forming a large number of fine hairs (cilia) such as carbon nanotubes on the contact surface 2a of the fixing means 2 (see FIG. 6), the adhesion of one hair is When the contact surface 2a is peeled off from the end of the contact surface 2a because of its small size, the contact surface 2a having the hair is easily separated from the tissue. Therefore, the fixing means 2 is attached to the distal end portion of the balloon actuator 15, and the balloon actuator 15 is operated so that the contact surface 2a of the fixing means 2 is peeled in order from the end portion, thereby easily fixing from the tissue. The means 2 can be separated.

As described above, the embodiment in which the movable means 3 is an expansion / contraction actuator that changes the relative position of the fixing means 2 has been described. However, as another embodiment, the movable means 3 is configured by combining the fixing means 2 and the functional element 1. It can be set as the actuator which changes a relative position. Specifically, with reference to FIG. 1, the functional element 1 is attached to the central position of the main body 22 of the fixing means 2, and this functional element 1 is an actuator (not shown) provided in the main body 22. Z)). The functional element 1 is attached to the main body 22 so as to be movable. Thereby, the functional element 1 can move with respect to the fixing means 2 by operating the actuator.
Further, as another form, with reference to FIG. 14 (a), it is provided with a central main body 10 and a plurality of (four) fixing means 2 provided apart from each other on the outer side, and A functional element 1 is provided in the main body 10. The main body 10 can be moved by appropriately operating the actuator, and the relative position between the fixing means 2 and the functional element 1 can be changed.
According to these, the position of the functional element with respect to the tissue can be changed in a state where the in-vivo medical device is fixed to the tissue, and a plurality of diagnosis / treatments can be performed along the tissue surface.

  FIG. 19 is an overall view showing still another embodiment of the medical device for internal use of the present invention. This in-vivo medical device further includes an insertion assisting instrument 8 for inserting the device shown in each of the above embodiments into the body from outside the body. Specifically, an apparatus including the functional element 1 and the fixing means 2 that are integrated with each other is attached to the distal end portion 8 a of the insertion assisting device 8. According to this, the functional element 1 and the fixing means 2 can be inserted into the body as in the case of diagnosis / treatment using a conventional endoscope. The insertion assisting device 8 can be the same as that conventionally used for endoscopes or can be used.

Further, in the medical device for internal use provided with the insertion assisting device 8, the functional element 1 and the fixing means 2 which are integrated with each other can be detached from the distal end portion 8a. Thereby, functional element 1 grade | etc., Can be inserted in a body using the insertion auxiliary instrument 8, and functional element 1 grade | etc., Can be left in a body after that. By removing the functional element 1 and the fixing means 2 from the distal end portion 8a of the insertion assisting instrument 8, only the functional element 1 and the fixing means 2 which are small parts can be left in the body. Then, by removing the insertion assisting device 8 from the patient's body, the burden on the patient is eased, and the function / element 1 left in the body enables a long-term or long-term diagnosis / treatment.
Also, the functional element 1 left in the body can function and move by wired or wireless operation outside the body wall, and information from the functional element 1 (for example, the position of the functional element 1) is wired. Alternatively, it is transmitted to the outside of the body wall by radio.
Although not shown, the functional element 1 and the fixing means 2 that are integrated can be provided in a micro-internal robot for diagnosis and treatment.

According to the medical device for the body according to each embodiment as described above, the fixing element 2 is fixed to the inner tissue from the body wall, so that the functional element 1 integrated with the fixing means 2 is attached to the tissue. The position is fixed. Therefore, the relative position between the functional element 1 and the site to be diagnosed or treated can be determined, and the diagnosis or treatment can be performed accurately.
Further, fixing by the fixing means 2 is performed by suction of air, expansion of the space portion 28 for pressing the functional element 1 against the tissue is performed by supply of air, and the expansion / contraction actuator 4 and the joint section 6 of the movable means 3 are If the operation is based on the supply and discharge of air, all mechanisms can be configured to operate with air, so that control becomes easy and the use of air is safe.

In addition, the medical device for internal use of the present invention is not limited to the form shown in the drawings, but may be of other forms within the scope of the present invention, and the actuator as the movable means 3 has been described as a telescopic type. Other than this, for example, a motor, a pinion that rotates by this, and an arm having a rack portion that meshes with the motor can be provided, and the arm can be moved in the longitudinal direction by the rotation of the motor. Further, the movable means 3 may be configured by only the joint portion 6 shown in FIGS.
Further, in the case where the fixing means 2 has the suction part 7, as shown in FIG. 5, the suction part 7 has a space part 21 between the membrane member 20 brought into contact with the tissue and the membrane member 20. The space portion 21 is sucked and adsorbed to the tissue through the membrane member 20, but the configuration in which the membrane member 20 is interposed includes the fixing means 2 The present invention can be applied not only to the case of having one suction part 7 but also to the case of having a plurality of suction parts 7 shown in FIG. It can be configured.

It is the schematic which shows one Embodiment of the medical device for internal use of this invention. It is explanatory drawing explaining a fixing means. It is sectional drawing of the fixing means of FIG. It is the schematic which shows the modification of a fixing means. It is sectional drawing which shows the modification of a fixing means. It is the schematic which shows another modification of a fixing means. It is a schematic diagram explaining the function of the medical device for internal use of this invention. It is a schematic diagram explaining other embodiment of the medical device for internal use of this invention. It is a schematic diagram explaining another embodiment of the medical device for internal use of this invention. It is a schematic diagram explaining another embodiment of the medical device for internal use of this invention. It is a perspective view which shows embodiment of the medical device for internal use provided with the expansion-contraction actuator as a movable means. It is explanatory drawing explaining the operation | movement of the movement by the expansion-contraction actuator of the medical device for internal use of FIG. It is explanatory drawing explaining another form about the operation | movement of a telescopic actuator. It is explanatory drawing explaining other embodiment of the medical device for body provided with the expansion-contraction actuator. It is explanatory drawing explaining another embodiment of the medical device for the body provided with the expansion-contraction actuator. It is explanatory drawing explaining the function by a joint part. It is sectional drawing explaining the joint part which a movable means has. It is sectional drawing explaining operation | movement of the joint part of FIG. 1 is an overall view of an in-vivo medical device provided with an insertion assisting device.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Functional element 2 Fixing means 3 Movable means 4 Telescopic actuator 6 Joint part 7 Suction part 8 Insertion auxiliary instrument 8a Tip part 20 Membrane member 21 Space part 22 Main body part 50 Tissue

Claims (12)

Functional elements for at least one of diagnosis and treatment;
An in-vivo medical device comprising: a fixing unit that is integrated with the functional element and is fixed to an inner tissue from a body wall so that the functional element can be attached to the tissue.   The medical device for internal use according to claim 1, further comprising movable means that makes it possible to change the position of the functional element with respect to the tissue.   The medical device for internal use according to claim 2, wherein the movable means is an actuator that changes a relative position between the fixing means and the functional element. The fixing means is capable of releasing the fixation of the tissue by releasing the fixation to the tissue, and a plurality of the fixing means are provided,
The medical device for internal use according to claim 2, wherein the movable means is an actuator that changes a relative position of the fixing means.   The medical device for internal use as described in any one of Claims 2-4 further provided with the detection means for detecting the position on the said structure | tissue of the said functional element.   The medical device for internal use according to any one of claims 1 to 5, further comprising a joint portion that generates a bending motion in order to change a relative angle between the functional element and the fixing means.   The medical device for internal use according to any one of claims 1 to 6, wherein the fixing means includes a suction part that is fixed to the tissue by suction.   The suction portion includes a membrane member that is brought into contact with the tissue, and a main body portion that forms a space portion between the membrane member, and the suction portion is configured such that the space portion is sucked into the membrane member. The medical device for internal use of Claim 7 which adsorb | sucks to the said tissue via.   The medical device for internal use according to any one of claims 1 to 8, further comprising an insertion assisting instrument that is attached to a distal end portion of the functional element and the fixing means and is inserted into the body from outside the body.   The medical device for internal use according to claim 9, wherein the functional element and the fixing means are removable from the insertion assisting device. The medical device for internal use according to any one of claims 1 to 10, wherein the functional element includes a sensor that diagnoses a state of the tissue. The medical device for internal use according to any one of claims 1 to 11, wherein the functional element includes a medical device that performs treatment on the tissue.

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