JP2010274012A - Intracorporeal medical treatment device - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an intracorporeal medical treatment device for use in medical treatment given through a blood vessel or the like, performing effective heating treatment with heating part of the device approaching close to a diseased part. <P>SOLUTION: This device includes a catheter 11 and lead wires 12 capable of moving the catheter 11. A spherical DSM (Degradable Starch Microspheres) 13 made of starch and a coil chip 14 are disposed at the tip of each lead wire 12. The catheter 11 is inserted through a blood vessel communicating to the diseased part, and the lead wires 12 are guided one by one into the blood vessel through the catheter 11. In this case, the DSM 13 can move to the peripheral blood vessel with a bloodstream to block up the blood vessel. Thus, the coil chip 14 can be integrally moved to the peripheral blood vessel, and disposed in or near the diseased part. The heat can be efficiently given to the diseased part by the coil chip 14 in or near the diseased part. <P>COPYRIGHT: (C)2011,JPO&INPIT

Description

  The present invention relates to an in-vivo treatment device used for treatment performed through a flow path (for example, a blood vessel, a digestive tract, a digestive gland, a trachea, etc.) formed in the body and through which a fluid flows.

  In Japan in recent years, the most common cause of death is due to malignant neoplasms. Therefore, development of an effective treatment method is desired. Various therapies such as drug therapy and radiation therapy are used for malignant neoplasms. One of the therapies is hyperthermia.

  In recent years, percutaneous RFA (Radiofrequency Ablation), which is a kind of hyperthermia and particularly effective in the treatment of hepatocellular carcinoma, has been developed. In this percutaneous RFA, an electrode for converting electric power into radio waves is inserted up to the affected area, and the affected area is irradiated with radio waves. At this time, cancer cells that are the affected area can become resistance, and Joule heat is generated in the affected area. That is, in percutaneous RFA, electric power is converted into heat via radio waves, and the affected part is cauterized by the heat.

  However, since the target of treatment with this percutaneous RFA is limited to hepatocellular carcinoma having a diameter of 3 cm or less, the application range is relatively narrow. In addition, when the electrode is inserted and removed, the tissue is damaged, and a large amount of blood bleeds, so that damage to the patient is great. As such, there are problems to be improved.

  In order to solve such a problem, for example, a cancer treatment device described below has been devised and described in the following literature. This device includes a microcatheter, a wire slidably provided in the microcatheter, and a coil electrically connected to the wire.

  The microcatheter is introduced into a blood vessel leading to the tumor mass, so that the coil is disposed at a predetermined position in the blood vessel. The coil generates heat by being energized through the wire. With the generated heat, the blood in the vicinity of the predetermined position is heated. Thereby, since the heated blood flows toward the tumor mass, the tumor mass can be heated.

  However, since the blood is mediated during the heating of the tumor mass, which is the affected area, the effect of treatment by heating is not sufficient. This is due to the fact that the heat source (coil in the above apparatus) is relatively far from the affected area. Thus, in the in-vivo treatment apparatus used for the treatment performed through the flow path that is formed in the body and through which the fluid flows, those that exhibit the following effects are preferable. That is, it is preferable that a functional part such as a heating element can be closer to the affected part in order to effectively treat this type of in-vivo treatment apparatus.

Japanese Patent No. 3131386

  In this type of in-vivo treatment device, it has been desired to develop a device capable of performing effective treatment by being able to approach the affected area. Accordingly, an object of the present invention is to provide an in-body treatment apparatus that can be used for treatment performed through a flow path that is formed in the body and through which a fluid circulates, so that effective treatment can be performed.

  The in-vivo treatment device according to the present invention is characterized by a flexible elongated body and a downstream of the flow in accordance with the flow of the fluid that is disposed in the elongated body and flows through the flow path formed in the body. And a moving body that moves along the flow path.

  Here, the “long body having flexibility” is a catheter, a wire, a lead wire, and the like, but is not limited thereto. Further, the “flow path formed in the body” is a flow path in a blood vessel, a digestive tract, a digestive gland, a trachea, and the like, and is not limited thereto. In addition, “fluid” is a liquid and / or a gas.

  According to the above configuration, the moving body can spontaneously move in the flow path, and the long body can move integrally with the moving body. For this reason, by adjusting the size of the moving body according to the flow path, the moving body and the long body can be easily introduced into the flow path even in a thin flow path. Therefore, for example, even when the flow path in the vicinity of the affected area is thin (that is, for example, when the flow path is a peripheral blood vessel), the movable body and the long body (part of them) can approach the vicinity of the affected area. . In addition, the moving body and the long body (a part thereof) can also enter the affected area. As a result, treatment can be effectively performed by causing the moving body and / or the long body (part) to function for the treatment of the affected area in the vicinity of the affected area.

  Here, when the moving body is made to function for the treatment of the affected area, for example, it is preferable to make it function so as to close the flow path in the vicinity of the affected area. Thereby, when inject | pouring a chemical | medical solution into a flow path, the density | concentration of a chemical | medical solution may become larger in the obstruction | occlusion site | part in a flow path, ie, the affected part vicinity. In addition, when the blood in the blood vessel is heated using (a part of) the elongated body, the temperature can be higher at the occluded site in the flow path, that is, near the affected area.

  In the internal treatment apparatus according to the present invention, the lead is provided with a catheter, the long body is movable in the longitudinal direction within the lumen of the catheter, and is provided with at least one conducting wire along the longitudinal direction. A power supply mechanism that supplies power to the lead wire included in the lead wire, and at least a part of the electrothermal conversion mechanism is disposed on the lead wire and is electrically connected to the lead wire. And an electrothermal conversion mechanism that converts the power supplied by the device into heat, and the moving body is disposed on the lead wire and accompanying the flow of the liquid flowing inside the blood vessel, digestive tract, or digestive gland Preferably, it is configured to move within the blood vessel, digestive tract, or digestive gland towards the downstream in the flow.

  Here, the “electrothermal conversion mechanism” may be one that directly converts electric power to heat, or one that indirectly converts electric power to heat via electromagnetic waves. That is, the electrothermal conversion mechanism is, for example, an electrical resistor, an electrode, a coil, or the like, but is not limited thereto.

  According to the said structure, a moving body and an elongate body can be moved in the pipe | tube via a catheter by inserting a catheter in a blood vessel, a digestive tract, or a part of digestive gland. The moving body can spontaneously move in a flow path such as in a blood vessel. Therefore, even when the blood vessel, digestive tract, or digestive gland near the affected area is thin, the electrothermal conversion mechanism arranged on the lead wire can approach the affected area. As a result, heating of the affected area as a treatment can be effectively performed.

  In addition, when the lead wire as a long body is moved to the distal end portion of the catheter (lumen), injection of physiological saline may be used. That is, a mechanism for injecting physiological saline from the rear end of the catheter (the lumen) may be provided. As the mechanism, for example, a syringe pump whose discharge port is connected to the rear end of the catheter can be used. As a result, the moving body and the long body can move toward the distal end of the lumen along with the flow in the lumen of the physiological saline.

  Further, for example, the lead wire as a long body is configured to include two conductive wires, the power supply mechanism is configured to supply power to each conductive wire included in the lead wire, and the electrothermal conversion mechanism is The entire electrothermal conversion mechanism may be disposed on the lead wire and electrically connected to the two conductive wires.

  In addition, for example, the lead wire as a long body is configured to include one lead wire, and the electrothermal conversion mechanism is an external electrode that is an electrode located outside the blood vessel, digestive tract, and digestive gland, and the external electrode An external electrode lead wire that is electrically connected to the lead wire as a part of the electrothermal conversion mechanism, and an internal electrode located inside the blood vessel, digestive tract, or digestive gland, It is configured to convert the power supplied by the power supply mechanism through the external electrode and the internal electrode into heat, and the power supply mechanism supplies power to the external electrode conductor in addition to the conductor provided in the lead wire. It may be configured to.

  In this case, for example, the lead wire is composed of a metal wire and a covering portion whose side surface is covered with an insulating material, the conductive wire is integrally formed with the metal wire, and the internal electrode is exposed from the covering portion. You may comprise so that it may become a part of said metal wire. That is, a part of the lead wire and the internal electrode are integrally formed. As a result, the diameter of the lead wire (including the mechanism disposed on the lead wire) can be made smaller than when the lead wire, the conductive wire, and the internal electrode are configured separately. .

  In the in-vivo treatment device according to the present invention, it is preferable that the moving body is made of a material soluble in a liquid.

  As the moving body moves along the flow path, it can be blocked at a site having a very small opening area. It is not preferable that the period in which the flow path is closed continues for a long time. For example, if the occlusion of the blood vessel by the moving body continues for a long time, necrosis may occur in cells downstream from the occlusion site. Therefore, in the moving body, it is preferable that the blockage of the flow path can be released by dissolving in the liquid. The said structure is based on this knowledge. According to the said structure, while a flow path is once obstruct | occluded with a moving body, obstruction | occlusion of a flow path can be cancelled | released after that.

  In addition, when the material of the moving body that is soluble in the liquid is configured such that the higher the temperature, the higher the dissolution rate, and the electrothermal conversion mechanism and the power supply mechanism are provided, as follows. You may control melt | dissolution of a moving body. That is, after the flow path is once blocked by the moving body, the moving body can be actively dissolved by the heat generated from the electrothermal conversion mechanism. Therefore, after the flow path is once blocked by the moving body, the time required to release the blockage can be controlled by adjusting the heat generation by controlling the power supply mechanism. In other words, it is possible to make the time required for the release coincide with the time desired by the operator.

  In the internal treatment device according to the present invention, the power supply mechanism is configured to supply power so that radio waves are generated by the electrothermal conversion mechanism, and the electrothermal conversion mechanism supplies power supplied by the power supply mechanism. It is configured to convert to heat via radio waves, and the moving body moves in the blood vessel toward the downstream in the flow as the blood flows in the blood vessel, and is soluble in blood It is preferable that the material is starch.

  According to this, hepatocellular carcinoma as an affected part can be effectively treated. That is, when the catheter is introduced into the vascular system leading to the tumor mass of the liver, the moving body and the lead wire can move to the peripheral blood vessels communicating with the tumor mass. The electrothermal conversion mechanism can also move integrally with the moving body. Thereby, the electrothermal conversion mechanism can be disposed in the vicinity of the tumor mass. Therefore, the tumor mass can be efficiently heated.

  On the other hand, since the moving body can be occluded by the blood vessels in the vicinity of the tumor mass of the liver, as described above, an increase in the chemical concentration and an increase in the heating temperature can be achieved. In addition, even when the occlusion of the blood vessel by the moving body occurs, the moving body can be gradually dissolved after the occlusion, so that the occurrence of necrosis in the cells downstream from the occluded site can be suppressed.

  In the in-vivo treatment apparatus according to the present invention, a plurality of lead wires are provided, and the power supply mechanism is configured to supply power to the lead wires respectively provided in the plurality of lead wires, and the electrothermal conversion mechanism and the moving body are provided. It is preferable that each of the plurality of lead wires is arranged.

  According to this, a plurality of electrothermal conversion mechanisms can be arranged in the vicinity of the affected area. Therefore, the affected part can be effectively heated at a higher temperature. Therefore, the affected area can be more effectively treated.

  In this case, for example, the first moving body, which is one moving body arranged on the first lead wire that is one of the plurality of lead wires, can move along with the flow. Only one lead wire is moved toward the downstream in the flow, and is a lead wire different from the first lead wire at a time later than the time when the movement associated with the flow of the first moving body starts. A plurality of second moving bodies, which are one moving body disposed on the second lead wire, are moved toward the downstream in the flow so that the second moving body can move along with the flow. It is more preferable to provide a control mechanism for controlling the movement of the lead wire.

  According to this, for example, in a branched flow path, the first moving body can block one of the flow paths. That is, the flow of the liquid can be continued in the channels other than the blocked channel. For this reason, the second moving body can move preferentially to a flow path other than the flow path blocked by the first moving body. From the above, the electrothermal conversion mechanisms respectively disposed on the plurality of lead wires can be disposed evenly in the vicinity of the affected area (see FIGS. 4 and 5 described later). As a result, the affected area can be more effectively treated.

  Furthermore, in this case, the moving body is made of a material soluble in the liquid, and the control mechanism directs only the first lead wire downstream in the flow so that the first moving body can move along with the flow. The second moving body flows at a time after the time when the movement accompanying the flow of the first moving body starts and before the time when the dissolution of the first moving body is completed. More preferably, the movement of the plurality of lead wires is controlled so that only the second lead wire is moved downstream in the flow so that the second lead wire can be moved along with the movement.

After the dissolution of the first moving body is completed, the flow is started again in the flow path blocked by the first moving body. For this reason, if the second moving body is allowed to move after the dissolution of the first moving body is completed, the second moving body moves to the same channel as the channel blocked by the first moving body. There is a risk. Therefore, in order to reliably arrange the plurality of electrothermal conversion mechanisms in the vicinity of the affected area, it is preferable that the second moving body is movable before the dissolution of the first moving body is completed. The said structure is based on this knowledge. According to the above configuration, the electrothermal conversion mechanism can be surely arranged in the vicinity of the affected part evenly.

  Further, the following control method may be employed in the in-vivo treatment device according to the present invention. That is, the first lead wire so that the first moving body, which is one moving body disposed on the first lead wire that is one of the plurality of lead wires, can move along with the flow. A first step of controlling the in-vivo treatment device so that only the fluid moves toward the downstream in the flow, and the first lead wire at a time after the start of the movement associated with the flow of the first mobile body Only the second lead wire is directed downstream in the flow so that the second moving member, which is one moving member disposed on the second lead wire, which is another lead wire, can move along with the flow. And a second step of controlling the intracorporeal treatment apparatus so as to be moved.

  Furthermore, in this case, the moving body is made of a material soluble in the liquid, and the second step is a time point after the time point when the movement associated with the flow of the first moving body starts, and the first moving body The internal treatment device is controlled so that only the second lead wire is moved downstream in the flow so that the second moving body can move along with the flow at a time prior to the completion of the dissolution of It is preferable to be configured to do so.

It is a figure which shows schematic structure of the in-vivo treatment apparatus concerning 1st Embodiment of this invention. FIG. 2 is a detailed view of one of the lead wires shown in FIG. 1. It is the flowchart which showed the action | operation of the in-body treatment apparatus shown in FIG. It is a figure which shows the action | operation of the in-vivo treatment apparatus in the case where the in-vivo treatment apparatus shown in FIG. 1 is applied to the vascular system leading to the liver (hepatocellular carcinoma). It is a schematic diagram when the in-vivo treatment apparatus shown in FIG. 1 is applied when an affected part is hepatocellular carcinoma. It is a figure which shows schematic structure of the in-vivo treatment apparatus concerning 2nd Embodiment of this invention. FIG. 7 is a detailed view of one of the lead wires shown in FIG. 6.

10 Intracorporeal treatment device 11 Catheter 12 Lead wire (long body)
12c Conductor 13 DSM (Moving object)
14 Coil chip (Power conversion mechanism)
15 Power supply for heating (power supply mechanism)
16 Lead wire introduction mechanism 17 Syringe pump (part of control mechanism)
18 Controller (part of control mechanism)
19a Internal electrode (part of electrothermal conversion mechanism)
19b External electrode (part of electrothermal conversion mechanism)
19c Lead wire for external electrode

  Embodiments of an in-vivo treatment device according to the present invention will be described below with reference to the drawings.

(First embodiment)
FIG. 1 is a diagram showing a schematic configuration of an in-vivo treatment device 10 according to the first embodiment of the present invention. This in-vivo treatment device 10 includes a catheter 11, three lead wires 12, a DSM (Degradable Star Microspheres) 13, a coil chip 14, a heating power source 15, a lead wire introduction mechanism 16, and a saline solution. A syringe pump 17 and a controller 18 are provided.

  The catheter 11 has a cylindrical shape. As the in-tube passage, a lumen 11a having a circular opening cross section is provided. Each lead wire 12 is made of a steel material, and its side surface is covered with an insulating material. Each lead wire 12 has flexibility, and can slide in the lumen 11a in the longitudinal direction.

  The DSM 13 is a fine particle made of spherical “starch”, and is provided at the tip of each lead wire 12. The coil chip 14 is provided at the distal end portion of each lead wire 12 and at the rear end side of each DSM 13. That is, the coil chip 14 corresponds to the electrothermal conversion mechanism, and the entire electrothermal conversion mechanism is disposed on the lead wire 12.

  The heating power supply 15 is electrically connected to each lead wire 12 at the rear end. The lead wire introduction mechanism 16 is connected to the catheter 11 at the rear end.

  The lead wire introduction mechanism 16 includes a passage 16a and a passage 16b therein. The open end 16a1 on one side of the passage 16a is connected to the tip end portion (discharge port 17a) of the syringe pump 17. The opening end 16a2 on the other side of the passage 16a is connected to the rear end of the lumen 11a. Thereby, the physiological saline in the syringe pump 17 can flow in toward the front-end | tip part of the lumen | rumen 11a via the channel | path 16a.

  The open end 16b1 on one side of the passage 16b is configured such that each lead wire 12 can be inserted from the tip thereof, and liquid does not leak out of the lead wire introduction mechanism 16 from the open end 16b1. The opening end 16b2 on the other side of the passage 16b is integrally formed with the opening end 16a2 and is connected to the rear end of the lumen 11a. Thereby, when the tip part (namely, DSM13) of each lead wire 12 is inserted in passage 16b, each lead wire 12 is lumen 11a via passage 16b with the flow of the above-mentioned physiological saline. Can be introduced respectively. The state shown in FIG. 1 is a state in which all three lead wires 12 are introduced into the lumen 11a.

  The syringe pump 17 is configured to be equipped with a hollow cylinder, a liquid discharge port 17a that is provided at the tip of the hollow cylinder and communicates with the space, and can be fitted in the space and can be moved relative to the hollow cylinder in the axial direction of the cylinder. This is a well-known liquid feed pump including a piston and an actuator 17b that moves the piston relative to the hollow cylinder. Saline can be enclosed in the cylinder of the syringe pump 17. As described above, the discharge port 17a of the syringe pump 17 communicates with the open end 16a1 on one side of the passage 16a. For this reason, the enclosed physiological saline can be pumped from the syringe pump 17 toward the distal end portion of the lumen 11a.

  The controller 18 is electrically connected to the heating power supply 15 and the actuator 17 b of the syringe pump 17. The controller 18 instructs the heating power supply 15 and the actuator 17b of the syringe pump 17 to operate based on an operation signal from an operation command unit (not shown) including a switch or the like. The relative movement distance and relative movement speed of the piston of the syringe pump 17 are adjusted by the operation instruction from the controller 18. In other words, the pressure, flow rate, etc. in the press-fitting of physiological saline can be adjusted. The syringe pump 17 and the controller 18 correspond to a control mechanism.

  FIG. 2 is a detailed view of one of the lead wires 12 shown in FIG. The leading end portion 12a of the lead wire 12 has a tapered shape. A DSM 13 having a radius R is disposed coaxially with the lead wire 12 at the distal end portion 12a. As a result, a recess 12b is formed between the lead wire 12 and the DSM 13 in the radial direction. For this reason, the surface of the hemispherical portion 13a on the rear end side of the lead wire 12 of the DSM 13 is greatly exposed. Therefore, the hemispherical portion 13a is easy to receive a flow of fluid flowing from the rear end to the front end, and the kinetic energy of the fluid can be efficiently converted into the kinetic energy of the DSM 13.

  In addition, a coil chip 14 having a radius r is disposed on a part of the lead wire 12 on the rear end side of the position where the DSM 13 is disposed. Here, each radius of the DSM 13 and the coil chip 14 satisfies the relationship of “R> r”. The coil chip 14 is configured to generate an electromagnetic wave in a radio wave region when a current passes therethrough. Inside the lead wire 12, two conductive wires 12 c having electrical conductivity are provided along the longitudinal direction of the lead wire 12. One end of each conducting wire 12c is electrically connected to the end portion 14a of the coil chip 14, and the other end of each conducting wire 12c is electrically connected to the heating power source 15, respectively. In addition, the side surface of the conducting wire 12c and the side surface of the element wire of the coil chip 14 are covered with an insulating material. Thereby, even when the coil chip 14 is located in an electrolyte such as blood, electromagnetic waves can be efficiently generated without causing a short circuit, and damage to a living tissue can be suppressed. Also, the lead wires 12 can be electrically insulated from each other.

  In the in-body treatment apparatus 10 configured as described above, the power from the heating power supply 15 can be supplied to the coil chip 14 via the two conductive wires 12c. Thereby, conversion of power into heat via radio waves can be achieved. The power can be adjusted by the controller 18 connected to the heating power supply 15. Accordingly, the intensity of the radio wave (ie, the amount of heat to be converted) can also be adjusted by the controller 18.

(Actual operation)
Hereinafter, the actual operation of the in-body treatment apparatus 10 configured as described above will be described with reference to the flowchart of FIG. 3 and FIG.

  FIG. 3 is a flowchart showing the operation of the in-body treatment apparatus 10. FIG. 4 shows an intracorporeal treatment apparatus 10 when the intracorporeal treatment apparatus 10 according to this embodiment is applied to a blood vessel (in this example, a blood vessel system leading to a liver (hepatocellular carcinoma)) as a flow path formed in the body. FIG. In this example, as an example of the operation, the in-vivo treatment device 10 is applied to heating hepatocellular carcinoma.

  When the operation of the internal treatment device 10 is executed, the operation is started from step 300 in the flowchart of FIG. 3, and the catheter 11 is inserted in the subsequent step 305. That is, only the catheter 11 in the in-body treatment apparatus 10 is inserted from the outside of the body toward the hepatic artery 20 (see FIG. 4).

  Next, at step 310, one lead wire 12 is set in the lead wire introduction mechanism 16. More specifically, one lead wire 12 is inserted so that the tip end portion (DSM 13) is located at an integral part of the passage 16a and the passage 16b.

  Next, in step 315, injection of physiological saline in the syringe pump 17 is started. More specifically, a press-fitting instruction starts to be sent from the controller 18 to the actuator 17b so that the moving speed and moving amount of the syringe coincide with preset command values.

  With the injection of physiological saline, as shown in FIG. 4A, the DSM 13 and the lead wire 12 move in the lumen 11a toward the tip. The DSM 13 that moves by press-fitting is exposed from the lumen 11a to the outside. Thereafter, the DSM 13 is spontaneously moved to the first peripheral blood vessel 21 having a diameter smaller than that of the hepatic artery 20 along with the blood flow in the blood vessel.

  Subsequently, in step 320, a timer (not shown) built in the controller 18 is started.

  On the other hand, immediately after the timer is started in step 320, it is determined in step 325 whether or not a predetermined time has elapsed since the timer was started. Hereinafter, the “predetermined time” will be described. The “predetermined time” is a time determined from parameters that control the flow rate of the DSM 13 in the blood vessel, such as separately measured blood pressure, the mass of the DSM 13, and the particle size of the DSM 13, and the distance to move the DSM 13. Specifically, a table defining the relationship between the parameter, the distance, and the time required to move the distance is created in advance through experiments, and the parameter and the distance are used as arguments. The predetermined time is determined by use.

  For example, the distance is a distance corresponding to the flow path leading from the tip of the DSM 13 to the blood vessel site to be occluded by the DSM 13 when the lead wire 12 is set in the lead wire introduction mechanism 16 in step 310. be able to. Thereby, the predetermined time can be a time corresponding to a period from the start of the injection of physiological saline to the time when the DSM 13 closes the blood vessel. More specifically, the predetermined period is set to 5.0 seconds. The predetermined time is preferably set to this time when reaching the nutrient blood vessel of liver cancer.

  Thus, in determining whether or not the DSM 13 has occluded the blood vessel, in this example, the occlusion of the blood vessel is estimated by calculating a predetermined time. Instead, the occlusion of the blood vessel may be confirmed by the visual recognition of the operator. Specifically, each time the lead wire 12 is introduced, it is preferable to inject the blood vessel contrast agent into the blood vessel to be occluded. According to this, simultaneously with the start of the occlusion of the blood vessel, the blood vessel downstream from the occlusion site is not imaged. Therefore, it can be visually recognized by the DSM 13 when the occlusion of the blood vessel is performed and in which part of the blood vessel. Such a confirmation method can also determine whether or not a blood vessel is occluded.

  If “No” is determined in Step 325, it is determined whether or not a predetermined time has elapsed. If “Yes” is determined, the process proceeds to Step 330 and the number of lead wires 12 introduced is “3”. Whether or not there is is determined. By setting the predetermined time as described above, the time point determined as “Yes” in step 325 can coincide with the time point when the DSM 13 of the lead 12 introduced first occludes the peripheral blood vessel 21. In other words, when “Yes” is determined in step 325, the first DSM 13 starts to block the peripheral blood vessel 21.

  At present, the number of lead wires 12 introduced is “1”. Accordingly, “No” is determined in step 330, and the process proceeds to step 310 where the second lead wire 12 is set in the lead wire introduction mechanism 16. Next, as in the case of the first lead wire 12, in step 315, injection of physiological saline in the syringe pump 17 is started.

  By the injection of the physiological saline, the DSM 13 and the lead wire 12 move in the lumen 11a toward the tip as shown in FIG. 4B. The moving DSM 13 is exposed to the outside from the lumen 11a. At this time, the peripheral blood vessel 21 is occluded by the first DSM 13. Therefore, the second DSM 13 is accompanied by the blood flow in the blood vessel and spontaneously moves to the second peripheral blood vessel 22 different from the first peripheral blood vessel 21.

  Subsequently, in step 320, the timer is restarted, and in step 325, it is determined again whether a predetermined time has elapsed since the timer start. If “Yes” is determined in step 325, the process proceeds to step 330 and it is determined again whether or not the number of lead wires 12 introduced is “3”. Further, when it is determined as “Yes” in Step 325, the second DSM 13 starts to block the peripheral blood vessel 22.

  At present, the number of lead wires 12 introduced is “2”. Therefore, it is determined again as “No” in Step 330, and the process proceeds to Step 310 where the third lead wire 12 is set in the lead wire introduction mechanism 16. Next, in the same manner as the first and second lead wires 12, in step 315, injection of physiological saline in the syringe pump 17 is started.

  Due to the injection of the physiological saline, the DSM 13 and the lead wire 12 move in the lumen 11a toward the tip as shown in FIG. 4C. The moving DSM 13 is exposed to the outside from the lumen 11a. At this time, the peripheral blood vessel 21 and the peripheral blood vessel 22 are respectively occluded by the first and second DSMs 13. Therefore, the third DSM 13 is accompanied by the blood flow in the blood vessel and spontaneously moves to the third peripheral blood vessel 23 different from the first and second peripheral blood vessels 21 and 22.

  Subsequently, the processing of step 320 and step 325 is executed in order, and the determination of step 330 is performed. When it is determined “Yes” in step 325, the third DSM 13 starts to block the peripheral blood vessel 23.

  On the other hand, as shown in FIG. 4D, after a certain period of time has elapsed since the start of occlusion of the peripheral blood vessel 23 by the third DSM 13, the first DSM 13 that occluded the peripheral blood vessel 21 is blood. Dissolves in and disappears. After that, the second and third DSMs 13 dissolve in order and disappear. Thus, the DSM 13 is adjusted as follows so that the DSM 13 dissolves and disappears in order. That is, until the last introduced DSM 13 (third in this embodiment) starts to be blocked, all other (first and second in this embodiment) DSM 13 do not disappear. The particle size of DSM13 is designed and adjusted.

  Further, the DSM 13 is designed to disappear in about 30 minutes from the time when the peripheral blood vessel is occluded. Since the peripheral blood vessel is once occluded, blood flow is permitted again, so that it is possible to suppress the necrosis of cells downstream from the occlusion site.

  At present, the number of lead wires 12 introduced is “3”. Therefore, it is determined as “Yes” in Step 330, and in the subsequent Step 335, the affected area is heated. More specifically, the controller 18 sends an instruction to the heating power supply 15 to supply power for the set power and period. That is, power is supplied to the three coil chips 14 from the heating power supply 15 through the conductive wires 12 c built in the three lead wires 12. A radio wave is generated from each of the three coil chips 14.

  At this time, each coil chip 14 is held and arranged in each of the peripheral blood vessels 21, 22, and 23. Therefore, a radio wave is generated from each coil chip 14 disposed around the affected area, and the radio wave is directed toward the affected area and irradiated. Therefore, the affected part can become a resistance in radio wave irradiation, and the radio wave is converted into heat. As a result, the affected part can be efficiently heated.

  Further, by this heating, the residual DSM 13 can be completely dissolved and disappeared. Therefore, blood flow after the occlusion can be surely permitted. As a result, the occurrence of necrosis can be suppressed at a site downstream of the occluded site in the blood vessel. As a heating mode, in order to achieve reliable heating of the affected part, the heating time and the heating degree may be adjusted according to the size of the affected part. On the other hand, in order to achieve complete dissolution of DSM 13, The heating time and the degree of heating may be adjusted according to the blockage time and the size of the DSM 13. Specifically, when it is desired to shorten the time from the start of occlusion until the DSM 13 dissolves and disappears, it is preferable to increase the heating time and / or the heating degree longer and larger. By adjusting in this way, the blocking time by the DSM 13 can be controlled, and a desired blocking time can be obtained.

  FIG. 5 is a schematic diagram when the in-vivo treatment device 10 of the present embodiment is applied when the affected part is hepatocellular carcinoma. By operating as described above, the three DSMs 13 can move one by one to a plurality of peripheral blood vessels near the hepatocellular carcinoma via the hepatic artery. As the three DSMs 13 move, the three lead wires 12 and the coil chip 14 can also move for each peripheral blood vessel. That is, the coil chip 14 can be disposed evenly around the hepatocellular carcinoma. Accordingly, radio waves are irradiated from the three coil chips 14 toward the hepatocellular carcinoma, and the hepatocellular carcinoma can be heated locally and efficiently.

  In addition, it is more effective if a reservoir for enclosing an anticancer agent is provided and the operation using the in-vivo treatment apparatus 10 and the injection of hepatocellular carcinoma into a nutritional blood vessel are used in combination. Specifically, it is preferable that a lumen other than the lumen 11a is provided in the catheter 11, and the lumen is configured to communicate with a reservoir enclosing an anticancer agent. According to this, the effect | action by heating and the effect | action by an anticancer agent can be used together effectively, and the sensitivity of the anticancer agent in an affected part can be enlarged. As a result, treatment can be performed more effectively.

  Further, the lead wire 12 and the coil chip 14 may be always held near the affected area. According to this, an affected part can be heated continuously for a long period. Therefore, hepatocellular carcinoma can be heated more reliably.

  As described above, according to the first embodiment of the in-vivo treatment apparatus of the present invention, the DSM 13 can move spontaneously in the blood vessel along with the blood flow, and the lead wire 12 and the coil chip 14 are also connected to the DSM 13. And move together. The size of the DSM 13 is adjusted according to the blood vessel. Therefore, even for thin blood vessels such as the peripheral blood vessels 21, 22, and 23, the DSM 13 and the coil chip 14 can be easily introduced into the peripheral blood vessels. Therefore, the DSM 13 and the coil chip 14 can approach the vicinity of the affected hepatocellular carcinoma. As a result, since the radio wave irradiation from the coil chip 14 to the vicinity of the hepatocellular carcinoma is performed in the vicinity of the affected part, the treatment can be effectively performed.

  Three lead wires 12 are introduced one by one with a time difference. Thereby, in the branched blood vessel near the affected part, the first DSM 13 can block one of the blood vessels. That is, blood flow can be continued in a flow path other than the blocked blood vessel. Therefore, the second DSM 13 can move preferentially to a blood vessel other than the blood vessel occluded by the first DSM 13 and can occlude the blood vessel. The third DSM 13 can move preferentially to blood vessels other than the blood vessels occluded by the first and second DSMs 13, and can occlude the blood vessels. From the above, the coil chips 14 respectively disposed on the three lead wires 12 can be disposed evenly in the vicinity of the affected area (see FIGS. 4 and 5). As a result, heating to hepatocellular carcinoma which is an affected part locally and effectively can be performed. In addition, even if the occlusion of the blood vessel due to the DSM 13 occurs, the DSM 13 can be gradually dissolved after the occlusion, so that the occurrence of necrosis in the cells downstream from the occlusion site can be suppressed.

(Second Embodiment)
Next, a second embodiment of the internal treatment device according to the present invention will be described. The second embodiment differs from the first embodiment only in the following points. First, the lead wire 12 provided in the second embodiment functions as a conducting wire and an electrode. That is, the lead wire 12 is integrally provided with one conductive wire. Moreover, it replaces with the coil chip | tip 14 with which the said 1st Embodiment is provided, and the lead wire 12 with which 2nd Embodiment is provided is provided with the internal electrode 19a integrally. Secondly, a patch-like external electrode 19b and an external electrode conductor 19c that electrically connects the external electrode 19b and the heating power source 15 are newly provided.

  FIG. 6 is a diagram showing a schematic configuration of the in-vivo treatment device 10 according to the second embodiment of the present invention. FIG. 6 corresponds to FIG. FIG. 7 is a detailed view of one of the lead wires 12 and corresponds to FIG. Hereinafter, only differences of the second embodiment from the first embodiment will be described with reference to FIGS. 6 and 7.

  As shown in FIG. 6, the internal electrode 19 a is provided at the tip end portion of each lead wire 12 and at the rear end side of each DSM 13. The internal electrode 19a is a part of the lead wire 12. Further, the lead wire 12 functions as a conducting wire. That is, since the internal electrode 19 a is a part of the lead wire 12, it is electrically connected to the heating power supply 15. On the other hand, the external electrode 19b has a patch portion 19b1 and is electrically connected to a heating power source through an external electrode conductor 19c having electrical conductivity. When the electric power from the heating power supply 15 is supplied to the internal electrode 19a and the external electrode 19b, the affected part can be heated via the electrode.

  More specifically, as shown in FIG. 7, each lead wire 12 is configured such that the side surface is exposed in the range of 2 to 3 cm in the longitudinal direction from a part of the covering portion that insulates the lead wire 12. ing. This exposed portion functions as the internal electrode 19a. Moreover, the steel material part which is the back end side rather than the internal electrode 19a and is coat | covered functions as a conducting wire. The exposed portion (that is, the surface area of the internal electrode 19a) is sufficiently smaller than the area of the patch portion 19b1 of the external electrode 19b.

  Next, the operation of the second embodiment will be described. In the second embodiment, the external electrode 19b is an epidermis outside the body and disposed at a site relatively close to the affected part. And the lead wire 12 is introduce | transduced one by one toward the affected part similarly to the action | operation in the said 1st Embodiment. That is, when the intracorporeal treatment apparatus 10 according to the second embodiment is applied to the treatment of hepatocellular carcinoma, the internal electrode 19a moves integrally with the DSM 13 to the vicinity of the affected area through the blood vessel, like the coil chip 14 in the first embodiment. Can do.

  After it is determined that the three internal electrodes 19a are arranged around the affected part (for example, hepatocellular carcinoma), power is supplied to both the electrodes 19a and 19b. Here, the surface area of the internal electrode 19a is sufficiently smaller than the patch portion of the external electrode 19b. That is, depending on the area difference, the heating wire density of the internal electrode 19a can be larger. For this reason, the affected part can be heated by the Joule heat from the internal electrode 19a. Therefore, the treatment can be effectively performed by this as well as the effect exhibited by the first embodiment. Moreover, since the internal electrode 19a and the conducting wire are formed integrally with the lead wire 12, the diameter of the lead wire 12 as a whole can be reduced. As a result, the DSM 13 can be moved more smoothly to the peripheral blood vessel.

  The present invention is not limited to the above embodiment, and various modifications can be employed within the scope of the present invention. For example, in each of the above embodiments, the in-vivo treatment device 10 is applied to the treatment of hepatocellular carcinoma, but may be applied to the treatment of a tumor formed in another organ instead. That is, instead of being inserted into the blood vessel leading to the liver, the catheter 11 may be inserted into, for example, a blood vessel, a digestive tract, a digestive gland, or a trachea leading to an affected area other than the liver.

  In each of the above embodiments, three lead wires 12 are provided. Alternatively, the number of lead wires 12 may be “2”, or may be “4” or more. Good. For example, it is preferable that the number of the lead wires 12 is increased as the size of the affected area (for example, the size of the tumor diameter) is increased.

  Further, in each of the above embodiments, physiological saline press-fitting is used when the lead wire 12 moves in the lumen 11a. Alternatively, the lead wire 12 may be sent out by an actuator. Good. Specifically, the lead wire introduction mechanism 16 may incorporate an actuator made of a rotating body or the like that moves the lead wire 12 in the longitudinal direction.

  In addition, in each of the embodiments described above, the DSM 13 is used as the moving body, but instead of this, a SAP (Super Absorption Polymer) may be used. In this case, the SAP is preferably formed in a spherical shape.

Claims (9)

A long body having flexibility;
A movable body that is disposed in the elongated body and moves in the flow path toward the downstream in the flow along with the flow of the fluid flowing in the flow path formed in the body;
An intracorporeal treatment device comprising: The intracorporeal treatment device according to claim 1,
With a catheter,
The elongated body is
A lead wire movable in the longitudinal direction within the lumen of the catheter and provided with at least one conducting wire along the longitudinal direction;
An electric power supply mechanism for supplying electric power to the conductive wire included in the lead wire;
At least a part of the mechanism is disposed on the lead wire and is electrically connected to the conductive wire, and an electrothermal conversion mechanism that converts the power supplied by the power supply mechanism into heat,
With
The moving body is
Along with the flow of the liquid flowing in the blood vessel, the digestive tract, or the digestive gland while being disposed on the lead wire, the blood vessel, the digestive tract, or the interior of the digestive gland toward the downstream in the flow. An internal treatment device configured to move. The intracorporeal treatment device according to claim 2,
The lead wire as the elongated body is
It is comprised so that two said conducting wires may be provided,
The power supply mechanism is
It is configured to supply power to each of the conducting wires included in the lead wire,
The electrothermal conversion mechanism is
An intracorporeal treatment device configured such that all of the electrothermal conversion mechanism is disposed on the lead wire and is electrically connected to the two lead wires. The intracorporeal treatment device according to claim 2,
The lead wire as the elongated body is
It is comprised so that one said conducting wire may be provided,
The electrothermal conversion mechanism is
An external electrode that is an electrode located outside the blood vessel, the digestive tract, and the digestive gland;
An external electrode conductor that is a conductor electrically connected to the external electrode;
As disposed as part of the electrothermal conversion mechanism on the lead wire, the blood vessel, the digestive tract, or an internal electrode located inside the digestive gland,
Configured to convert the power supplied by the power supply mechanism through the external electrode and the internal electrode into heat,
The power supply mechanism is
An internal treatment apparatus configured to supply power to the external electrode conductor in addition to the conductor provided in the lead wire. The intracorporeal treatment device according to any one of claims 1 to 4,
The moving body is
An intracorporeal treatment device composed of a material soluble in a liquid. The in-body treatment device according to any one of claims 2 to 4,
The power supply mechanism is
It is configured to supply power so that radio waves are generated in the electrothermal conversion mechanism,
The electrothermal conversion mechanism is
The power supplied by the power supply mechanism is configured to convert the heat via the radio wave,
The moving body is
An intracorporeal treatment device configured with starch that is a material soluble in blood while moving in the blood vessel toward the downstream in the flow in accordance with the flow of blood flowing in the blood vessel. The intracorporeal treatment device according to any one of claims 2 to 6,
A plurality of the lead wires;
The power supply mechanism is
Each of the plurality of lead wires is configured to supply power to each of the conducting wires, and
The electrothermal conversion mechanism and the moving body are:
An in-body treatment device configured to be disposed on each of the plurality of lead wires. The intracorporeal treatment device according to claim 7,
The first moving body, which is one of the moving bodies disposed on the first lead wire that is one of the plurality of lead wires, can be moved along with the flow. Moving only one lead wire downstream in the flow,
One of the second lead wires, which is one lead wire different from the first lead wire, at a time point later than the time point when the movement of the first moving body starts with the flow. The movement of the plurality of lead wires is controlled so that only the second lead wire is moved downstream in the flow so that the second moving body, which is the moving body, can move with the flow. An in-vivo treatment device provided with a control mechanism. The intracorporeal treatment device according to claim 8,
The moving body is
Consists of materials that are soluble in liquid,
The control mechanism is
Only the first lead wire is moved toward the downstream in the flow so that the first moving body can move with the flow, and
At a time point after the time point when the movement of the first moving body starts with the flow and before the time point when the dissolution of the first moving body is completed, the second moving body is An intracorporeal treatment device configured to control movement of the plurality of lead wires so that only the second lead wire is moved downstream in the flow so as to be movable along with the flow.

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