JP2012187257A - Ablation device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an ablation device that can move a focus and irradiate target tissue with a high-intensity focused ultrasound (HIFU) while an irradiation part is positioned and fixed at the target tissue.SOLUTION: The ablation device 1 for cauterizing living tissue by a high-intensity focused ultrasound includes: a housing 21 having an opening; an irradiation part 11 having a HIFU transducer 22 disposed in the housing, and for emitting a high-intensity focused ultrasound through the opening; a suction part 12 for fixing the housing to the living tissue; and a focus control part for moving a focal position of the high-intensity focused ultrasound in the depth direction of the living tissue.

Description

  The present invention relates to an ablation device used when cauterizing a target tissue.

  Conventionally, high-density focused ultrasound therapy that ablates the target tissue by irradiating high-intensity focused ultrasound (HIFU) from outside the body for the purpose of cancer treatment of organs with little movement. Are known. (For example, refer to Patent Document 1.)

  On the other hand, as a method for treating arrhythmias such as atrial fibrillation, catheter ablation is performed by cauterizing and ablating some abnormally excited tissue using a catheter delivered to the heart. The use of is being considered.

Since the heart is constantly moving due to pulsation, breathing, etc., the target tissue to be cauterized is also constantly moving. It is difficult to ablate.
In order to solve this problem, Patent Document 2 describes a technique for positioning an ablation device with respect to a tissue using a balloon.

Japanese Patent No. 4292326 JP 2006-518648 A

However, in the technique described in Patent Document 2, although the position of the target tissue can be determined, the focus position of the HIFU in that state is fixed, so that the focus position is always in focus. Not necessarily. When the focus is shifted, the target position can be cauterized by increasing the output of the HIFU, but the surrounding tissue that should not be cauterized is cauterized.
If a tissue that is not supposed to be cauterized is cauterized, the post-procedural cardiac function is excessively lowered, which may adversely affect the prognosis of the patient.

  The present invention has been made in view of the circumstances as described above, and provides an ablation device that can irradiate the HIFU by moving the focal point in a state where the irradiation unit is positioned with respect to the target tissue. With the goal.

  The present invention relates to an ablation device for cauterizing a living tissue with high-density focused ultrasound, a housing having an opening, and a HIFU vibration disposed in the housing and radiating the high-density focused ultrasound from the opening. An irradiation unit having a child, a fixing unit that fixes the housing to the living tissue, and a focus adjustment unit that moves a focal position of the high-density focused ultrasound in the depth direction of the living tissue. Features.

  The fixing portion may include a contact member that forms a sealed space with the living tissue and contacts the living tissue, and a negative pressure mechanism that creates a negative pressure in the sealed space, You may have a deflatable balloon.

  The focus adjustment unit may include a drive shaft whose one end is fixed to the HIFU vibrator, and a drive unit that advances and retracts the drive shaft with respect to the housing.

  In the irradiation unit, the opening may be formed in a plane parallel to the longitudinal direction of the housing, and a reflection member that changes the irradiation direction of the high-density focused ultrasound may be disposed on the inner tip side of the housing. .

  The ablation device of the present invention may further include a long insertion portion, and the irradiation portion and the fixing portion may be provided on the distal end side of the insertion portion.

  According to the ablation device of the present invention, the HIFU can be irradiated by moving the focal point in the depth direction of the target tissue while the irradiation unit is positioned with respect to the target tissue.

It is a figure which shows schematic structure of the ablation device of 1st embodiment of this invention. It is a figure which shows the insertion part front end side of the ablation device in a partial cross section. It is a figure which shows the operation | movement at the time of use of the ablation device. It is a figure showing operation at the time of use in the modification of the ablation device. It is an enlarged view which shows the front end side of the ablation device which concerns on 2nd embodiment of this invention. It is sectional drawing in the AA of FIG. It is an enlarged view which shows the front end side of the ablation device which concerns on 3rd embodiment of this invention.

A first embodiment of the present invention will be described with reference to FIGS.
FIG. 1 is a diagram showing a schematic configuration of an ablation device 1 of the present embodiment. The ablation device 1 cauterizes a target biological tissue with HIFU. As shown in FIG. 1, a long insertion unit 10 having an irradiation unit (described later) for irradiating HIFU, and a drive for driving the irradiation unit. The unit 30 includes an ultrasonic transmission / reception circuit 31 and a high-frequency power source 32 connected to the irradiation unit, a computer (control unit) 40 for controlling the entire apparatus, and an operation unit 50 operated by an operator.

  The insertion portion 10 has flexibility, and can be deformed and displaced following the heart beat during cauterization described later. As a specific configuration of the insertion portion 10, a configuration similar to that of a known ablation catheter can be employed.

  FIG. 2 is a partial cross-sectional view of the distal end side of the insertion portion 10. At the distal end portion of the insertion unit 10, an irradiation unit 11 that irradiates HIFU and a suction unit (fixing unit) 12 for fixing the irradiation unit 11 to the heart are provided. The irradiation unit 11 includes a housing 21 having an opening on the distal end side, a HIFU vibrator (hereinafter simply referred to as “vibrator”) 22 disposed in the housing 21, and a drive shaft 23 that moves the HIFU vibrator 22. And.

  The housing 21 is formed in a substantially cylindrical shape with a distal end side opened by metal or the like, and is attached to the insertion portion 10 so that the distal end opening is flush with (including substantially flush with) the distal end of the insertion portion 10. . A supply conduit 24 and a recovery conduit 25 that supply and recover the acoustic medium to and from the inner cavity of the housing 21 are opened on the bottom surface 21 </ b> A on the proximal end side of the housing 21. The supply conduit 24 and the recovery conduit 25 extend through the insertion portion 10 to the proximal end side of the insertion portion 10.

  The vibrator 22 is disposed in the inner cavity of the housing 21 while being accommodated in the casing 26. The transducer 22 has a spherical acoustic radiation surface 22A, and can irradiate the irradiated ultrasonic waves such as HIFU so as to converge to a predetermined focal point. A matching layer (not shown) is formed in the shape of the acoustic radiation surface 22A, and a backing layer (not shown) is provided on the rear surface on the base end side. As long as the vibrator can converge and irradiate HIFU to a predetermined focal point, there is no particular limitation on the specific configuration thereof. For example, a known acoustic lens is provided, and ultrasonic waves are converged by the acoustic lens. A configuration may be taken.

The drive shaft 23 is connected to the casing 26 through the bottom surface 21A of the housing. Therefore, by moving the drive shaft 23 back and forth in the axial direction, the casing 26 and the vibrator 22 accommodated in the casing 26 can be moved in the housing 21 in the axial direction of the insertion portion 10. An O-ring (not shown) or the like is attached to a hole in the bottom surface 21A through which the drive shaft 23 is inserted, and the space between the drive shaft 23 and the housing 21 is kept watertight. A wiring (not shown) extends in the drive shaft 23, and the vibrator 22 and a switch described later are connected by the wiring.
The drive shaft 23 is provided with a displacement detection means such as an encoder (not shown), and the advance / retreat amount of the drive shaft 23 is transmitted to the computer 40 as needed.

  The suction part 12 includes a suction pad (contact member) 13 provided on the distal end side of the insertion part 10 and a suction conduit 14 connected to the suction pad 13. The suction pad 13 is formed in a substantially donut shape from rubber, elastomer, or the like, and is disposed so as to surround the distal end side of the housing 21 when the insertion portion 10 is viewed from the distal end side. The suction pad 13 is provided with a suction groove 13 </ b> A having an annular shape and a bowl-shaped cross-section on the front surface side.

  The suction conduit 14 communicates with the proximal end opening of the through hole 13B that penetrates the suction pad 13 in the thickness direction, and extends through the insertion portion 10 to the proximal end side. The opening on the tip side of the through hole 13B is formed in the suction groove 13A, and the suction groove 13A and the through hole 13B communicate with each other.

The drive unit 30 has a known mechanism such as a motor, and is provided on the proximal end side of the insertion unit 10 as shown in FIG. The drive unit 30 and the drive shaft 23 constitute a focus adjustment unit that moves the focal position of the HIFU.
The ultrasonic transmission / reception circuit 31 transmits / receives ultrasonic waves for examination for estimating ultrasonic attenuation, which will be described later, and the high frequency power supply 32 generates HIFU for tissue ablation. The ultrasonic transmission / reception circuit 31 and the high frequency power supply 32 are connected to the vibrator 22 by a wiring 34 via a switch 33. Accordingly, it is possible to selectively switch the ultrasonic wave transmitted to the transducer 22 by operating the switch 33.

  The suction line 14, the supply line 24, and the recovery line 25 are independently connected to the pump 35 by piping or the like. An acoustic medium supply source (not shown) is connected to the pump 35, and suction, fluid supply, and recovery can be independently performed on the suction line 14, the supply line 24, and the recovery line 25. . The suction line 14 and the pump 35 form a negative pressure mechanism that creates a negative pressure in the suction groove 13A.

The computer 40 is connected to the drive unit 30, the ultrasonic transmission / reception circuit 31, the high frequency power supply 32, the switch 33, and the pump 35. The computer 40 controls the operation of each connected mechanism based on an operation of the operator via the operation unit 50 or a predetermined program. The computer 40 is connected to a monitor 41 and can display information on each part of the ablation device 1 and various information acquired by the irradiation unit 11 on the monitor 41.
The operation unit 50 includes, for example, a pedal 51 and a keyboard 52, and can send commands to the computer 40 by operating them. The operation unit 50 may be provided with other known various interfaces.

The operation at the time of use of the ablation device 1 of the present embodiment configured as described above will be described by taking as an example a case of performing ablation of myocardial tissue.
First, the surgeon makes a hole in the chest wall of the patient and inserts an introduction device such as a trocar or a guiding catheter to establish an access path to the chest cavity. Next, the ablation device 1 is inserted into the introduction instrument from the distal end side of the insertion portion 10. Then, the distal end of the insertion portion 10 is advanced to the vicinity of the target site to be cauterized while observing the distal end of the insertion portion 10 with observation means such as a thoracoscope separately inserted into the chest cavity. The target region is specified by known heart mapping or the like.

  When the distal end of the insertion portion 10 reaches the target site, the surgeon presses the distal end surface of the insertion portion 10 against the pericardial membrane covering the target site to bring the suction pad 13 into close contact with the pericardial membrane. Thereby, the suction groove 13A located between the pericardial membrane and the suction pad 13 becomes a sealed space. When the operation part 50 is operated in this state and the suction line 14 is sucked by the pump 35, the inside of the suction groove 13A becomes negative pressure, and the distal end of the insertion part 10 is held in close contact with the pericardial membrane. Thereby, the housing 21 is fixed with respect to the heart, and the irradiation part 11 is positioned with respect to the heart.

  Subsequently, the surgeon supplies the acoustic medium Am from the supply conduit 24 and fills the lumen of the housing 21 as shown in FIG. As the acoustic medium Am, a fluid such as physiological saline (saline) can be suitably used. Since the distal end of the insertion portion 10 is in close contact with the pericardial membrane by the suction portion 12, the acoustic medium Am does not leak from the distal end opening of the housing 21. In order to smoothly fill the acoustic medium Am, air or the like in the housing 21 may be sucked and discharged from the collection pipe 25 as appropriate. When the inner cavity of the housing 21 is almost filled with the acoustic medium Am, the vibrator 22 can be suitably irradiated with ultrasonic waves.

  Next, the surgeon performs tissue evaluation in the depth direction of the target region. The switch 33 is operated to connect the ultrasonic transmission / reception circuit 31 and the vibrator 22, and the target part is irradiated with relatively weak ultrasonic waves for observation from the vibrator 22, and the reflected wave is received by the vibrator 22. . When irradiating ultrasonic waves for observation, the driving unit 30 is operated to advance the irradiation unit 11, and irradiation is performed while gradually moving the focal point toward the deep part of the target region. At the position of the epicardium and endocardium in the pericardium, there is a large difference in acoustic impedance before and after that, so the echo signal becomes large, so by capturing the points where the output changes greatly, The position of the endocardium can be confirmed. When the irradiation unit 11 is advanced and retracted, the acoustic medium Am in the housing 21 is recovered from the recovery conduit 25 and the acoustic medium Am is supplied from the supply conduit 24 into the housing 21 so that it can be smoothly advanced and retracted. .

  When a tissue having a substantially homogeneous structure in the thickness direction, such as a myocardial tissue, is assumed to have a substantially uniform acoustic impedance in the thickness direction (that is, the ultrasonic intensity at the focal position of the transducer 22 is If there is no attenuation in the tissue, it is assumed to be constant.) By this, it is possible to easily estimate the ultrasonic attenuation amount in the tissue. That is, the ultrasonic attenuation amount in the myocardium can be estimated by acquiring at least two focal position ultrasonic wave reception signal strengths separated in the depth direction in which the ultrasonic wave travels within the myocardium. Here, it should be noted that the attenuation obtained based on the received signal is the sum of the attenuation at the time of transmission and at the time of reception.

  After obtaining the estimated value of the ultrasonic attenuation amount in the myocardial tissue, the focal position signal intensity at each position in the depth direction of the target region is set, and based on this, the HIFU supplied to the transducer 22 at each position in the depth direction Is calculated and determined. In the present embodiment, the energy intensity of the HIFU supplied to the transducer 22 at each position in the depth direction is determined so that the focal position signal intensity is constant over the depth direction. This calculation and determination may be performed by the computer 40 based on a predetermined program.

  Once the energy intensity of the HIFU is determined, the operator operates the drive shaft 23 to advance the irradiation unit 11 relative to the insertion unit 10 and move the focal point of the irradiation unit 11 to a position deeper than the depth of cauterization. , Move the focus gradually to the near side. When the focal point comes to the ablation position, the surgeon operates the switch 33 to connect the high-frequency power source 32 and the irradiation unit 11 and perform a predetermined operation such as operating the pedal 51, so that the transducer 22 shifts to the focal point. HIFU is irradiated so as to converge, and the myocardial tissue at the ablation position is cauterized.

  During the cauterization, the heart is beating, but the tip of the insertion portion 10 irradiated with HIFU is fixed to the heart by the suction portion 12, so that the position of the irradiation portion 11 relative to the cauterization site is not shaken by the pulsation. The HIFU is irradiated with the focus of the vibrator 22 positioned with high accuracy. By cauterizing while the irradiation unit 11 is retracted, the irradiated HIFU does not pass through the tissue whose physical properties have changed due to the cauterization, and the tissue cauterization can be performed by always irradiating the HIFU close to the set energy amount. .

  When the tissue to be cauterized extends over a predetermined range in the depth direction of the myocardium, the drive shaft 23 is driven while irradiating the HIFU. Thereby, cauterization can be performed in a desired pattern, such as cauterizing the myocardial tissue to transmurality, or cauterizing a plurality of parts separated in the depth direction.

  According to the ablation device 1 of this embodiment, since the suction unit 12 that fixes the housing 21 of the irradiation unit 11 to the heart is provided, even when the tissue such as the heart is constantly moving, the vibrator 22 The focal point is highly positioned in the target tissue. Furthermore, by providing the focus adjustment unit, the focal position of the HIFU can be moved in the depth direction of the target tissue, and the targeted site can be cauterized more accurately. Therefore, it is possible to prevent cauterization of tissues that should not be cauterized around the site to be cauterized, suppress a situation such as excessive reduction in cardiac function after cauterization treatment, and improve the patient's QOL.

  Further, since the switch 33 and the ultrasonic transmission / reception circuit 31 are provided, the HIFU can be irradiated so as to obtain a more appropriate energy amount by estimating the ultrasonic attenuation before the HIFU is irradiated.

In the present embodiment, the example in which the irradiation unit is positioned on the target tissue by the suction unit having the suction pad and the suction conduit has been described, but the configuration of the fixing unit is not limited thereto.
In the ablation device 1A of the modification shown in FIG. 4, a contact pad 15 having substantially the same material and shape as the suction pad 13 is attached to the distal end of the insertion portion 10, but there is no suction conduit. In the ablation device 1A, the distal end of the insertion portion 10 is pressed against the heart Ht, and then the housing 21 is filled with the acoustic medium Am. Thereafter, when the pump 35 is operated to suck the acoustic medium Am from the supply line 24A and the recovery line 25, the inside of the housing 21 becomes negative pressure and is fixed to the heart Ht.

  In this modified example, the housing 21, the supply conduit 24A, and the recovery conduit 25, which are a part of the irradiation unit 11, also serve as a fixed portion, so that the structure can be further simplified. In addition, when taking such a structure, if one of the supply pipe line and the recovery pipe line is communicated with the vicinity of the front end opening of the housing 21, the above-described suction fixation can be effectively performed. In FIG. 4, the supply conduit 24 </ b> A communicates with the vicinity of the front end opening of the housing 21, but instead, the recovery conduit may communicate with the vicinity of the front end opening. The contact pad 15 is provided to keep the periphery of the tip opening of the housing 21 watertight. However, the contact pad 15 may not be provided as long as the tip opening is kept watertight.

  Next, a second embodiment of the present invention will be described with reference to FIGS. The difference between the ablation device 51 of the present embodiment and the ablation device 1 described above is the structure of the irradiation part and the fixing part. In the following description, components that are the same as those already described are assigned the same reference numerals and redundant description is omitted.

  5 is a cross-sectional view showing the distal end side of the ablation device 61, and FIG. 6 is a cross-sectional view taken along the line AA in FIG. As shown in FIGS. 5 and 6, the housing 63 of the irradiation unit 62 has a substantially semicircular cross section orthogonal to the longitudinal direction, and has a curved first outer peripheral surface 63 </ b> A and a planar second outer peripheral surface. 63B. There is no opening at the tip of the housing 62, and an opening 63C is formed in a part of the second outer peripheral surface 63B. An acoustic window membrane 64 is attached to the opening 63C and is sealed so that the acoustic medium Am supplied into the housing 63 does not leak out of the housing from the opening. The acoustic window film 64 can be formed using a polymer material such as polyether block amide or silicone, and is formed to be thin enough to transmit ultrasonic waves emitted from the vibrator 22.

  A mirror (reflecting member) 65 that changes the direction of the ultrasonic wave emitted from the vibrator 22 is disposed on the distal end side in the housing 63. The ultrasonic wave irradiated from the vibrator 22 is reflected by the mirror 65 and is emitted from the opening 63 </ b> C and converges to a predetermined focal point F. The mirror 65 has an angle adjustment mechanism (not shown), and by operating the angle adjustment mechanism via the operation unit 50, the direction of the ultrasonic wave emitted from the opening can be adjusted within a certain range.

  A balloon 66 is attached to the first outer peripheral surface 63 </ b> A of the housing 63. Connected to the balloon 66 is a tube 67 for supplying and collecting fluid in the balloon 66. The tube 67 extends to the proximal end side along the insertion portion 10 and is connected to a pump and a fluid supply source (both not shown).

  The ablation device 61 of this embodiment can be suitably used when it is difficult to approach perpendicularly to the surface of the ablation site due to space or the like. Hereinafter, the operation when the ablation device 61 is used will be described by taking as an example a case where the heart is approached from below the xiphoid process and the insertion portion 10 is advanced into the pericardial membrane to cauterize the myocardial tissue.

  The surgeon establishes an access path to the chest cavity in the chest wall near the xiphoid process by the same operation as in the first embodiment. The pericardium is incised while observing with a thoracoscope or the like, and the insertion site of the ablation device 61 is formed. Thereafter, the ablation device 61 is inserted into the thoracic cavity through the introducer, and the irradiation unit 62 at the distal end of the insertion unit 10 is inserted into the pericardial membrane and advanced to the vicinity of the ablation site.

When the irradiation unit 62 reaches the vicinity of the ablation site, the operator holds the insertion unit 10 with the opening 63C facing the myocardial tissue and operates the pump 35 to send a fluid into the balloon 66 and inflate it. As shown in FIG. 5, the balloon 66 is inflated toward the pericardium Pc on the side opposite to the opening 63C, and as a result, the opening 63C is pressed against the myocardial tissue Mt to be in close contact therewith, and the irradiation unit 62 is positioned. Thereafter, cauterization of the ablation site is performed in the same procedure as in the first embodiment. You may adjust the angle of the mirror 65 as needed.
When the cauterization is completed, the operator operates the pump 35 to collect and contract the fluid in the balloon 66 from the tube 67, remove the ablation device 61 from the pericardium, and suture the incision site.

Also in the ablation device 61 of the present embodiment, cauterization can be performed while moving the focal position of the HIFU in a state where the focal point of the transducer 22 is highly positioned in the target tissue, as in the first embodiment.
Further, since the balloon 66 and the tube 67 functioning as a fixing part are provided, and the irradiation part 63 has the housing 63 and the mirror 65 having the opening 63C on the side, the ablation site of the ablation site is formed as in the pericardial membrane. Even if there is not enough space in the depth direction, the irradiation section can be suitably positioned and the procedure can be performed.

  Furthermore, since the flexible acoustic window membrane 64 is attached to the opening 63C, it deforms following the surface shape of the target tissue such as the myocardial tissue Mt, thereby improving the adhesion between the irradiation unit 63 and the target tissue. it can.

  Next, a third embodiment of the present invention will be described with reference to FIG. The difference between the ablation device 71 of the present embodiment and the ablation device of each of the embodiments described above is the configuration of the irradiation unit.

  FIG. 7 is a cross-sectional view showing the distal end side of the ablation device 71. The housing 73 of the irradiation unit 72 has an opening 73 </ b> C on the side as in the second embodiment. A fixing portion 75 is provided around the opening 73C. The fixing portion 75 includes a suction pad 76 and a suction conduit 77, and has a structure that is substantially the same as that of the suction portion of the first embodiment.

As shown in FIG. 7, the vibrator 78 in the ablation device 71 has an array structure in which a plurality of plate-like vibration elements 78 </ b> A are aligned in the longitudinal direction of the housing 73. Each vibration element 78A is connected to the switch 33, and can transmit and receive ultrasonic waves independently. Wirings connecting each vibration element 78A and the switch are combined as a cable 79 and extend to the proximal end side.
The irradiation unit 72 does not include a drive shaft, and the ablation device 71 does not include a drive unit. Therefore, the vibrator 78 does not move in the housing 73. In addition, the housing 73 does not have the recovery conduit 25, and is instead formed with a discharge port 73A through which excess acoustic medium Am is discharged.

An operation at the time of use of the ablation device 71 configured as described above will be described.
The operation until the irradiation unit 72 is positioned and fixed so that the opening 73C of the housing 73 is in close contact with the heart Ht using the fixing unit 75 is substantially the same as in the first embodiment.
When irradiating ultrasonic waves from the transducer 22, the focal position can be moved in the depth direction of the heart Ht by changing the phase of the drive voltage applied to each vibration element 78A. Further, it is possible to move the focal position within a certain range in the alignment direction of the vibration elements 78A (same as the longitudinal direction of the housing) while maintaining the depth direction. As described above, in the present embodiment, the vibrator 78 itself exhibits a function of the focus adjustment unit.

  Also in the ablation device 71 of the present embodiment, ablation can be performed by moving the focal position of the HIFU in the depth direction of the target tissue while the focus of the transducer 22 is highly positioned on the target tissue.

  Further, since the irradiation unit 72 includes the vibrator 78 having the array structure, the focal position can be moved without moving the vibrator 78 itself. For this reason, there is no need for a mechanism for moving the vibrator, and the configuration can be simplified and the diameter of the insertion portion can be reduced.

  However, when the focal position of the transducer 78 is moved, unlike the first and second embodiments in which the transducer itself is advanced and retracted, the distance between the transducer and the focal position changes. Note that the magnitude of the energy itself changes as the focal position moves. Therefore, when setting the magnitude of the drive voltage to be applied to each transducer based on the estimated value of ultrasonic attenuation, a table showing the relationship between the distance between the transducer and the focal position and the magnitude of the converged ultrasonic energy It is preferable to perform calculation so that the setting reflecting this is performed, for example, by being stored in the computer 40.

  In the present embodiment, the shape and arrangement of the vibration elements in the vibrator can be variously changed. For example, a plurality of ring-shaped vibration elements having different diameters may be arranged concentrically, or a plurality of vibration elements may be arranged in a lattice shape when viewed from the opening side of the housing. By setting the shape and arrangement mode of each vibration element in various ways, the adjustable direction and adjustable range of the focal position can be set in various ways.

  The embodiments of the present invention have been described above. However, the technical scope of the present invention is not limited to the above-described embodiments, and the combinations of the components or the components may be changed without departing from the spirit of the present invention. It is possible to make various changes to or delete them.

  For example, the acoustic window membrane of the second embodiment may be attached to the opening of the housing in the first embodiment or the third embodiment, or instead of the balloon and the tube in the second embodiment, the suction of the first embodiment A fixing part having the same structure as the part may be provided.

  In addition, the target tissue of the ablation device of the present invention is not limited to one that moves constantly like the heart. Therefore, it is possible to perform tissue ablation more pinpointed by controlling the focal point of the irradiation unit in the thickness direction for tissues and organs where conventional cancer treatment using HIFU is performed. This can be expected to improve the patient's QOL and life prognosis.

1, 1A, 51, 71 Ablation device 10 Insertion unit 11 Irradiation unit 12 Suction unit (fixing unit)
13 Suction pad (contact member)
21, 63, 73 Housing 22, 78 HIFU vibrator 23 Drive shaft 30 Drive unit 63C, 73C Opening 65 Mirror (reflective member)
66 Balloon

Claims (6)

An ablation device that cauterizes living tissue by high-density focused ultrasound,
An irradiation unit including a housing having an opening, and a HIFU vibrator disposed in the housing and configured to irradiate the high-density focused ultrasonic wave from the opening;
A fixing portion for fixing the housing to the living tissue;
A focus adjustment unit that moves the focal position of the high-density focal ultrasound in the depth direction of the biological tissue;
An ablation device comprising:   The said fixing | fixed part has a contact member which forms a sealed space between the said biological tissues and contacts the said biological tissue, and a negative pressure mechanism which makes the said sealed space a negative pressure. The ablation device described in.   The ablation device according to claim 1, wherein the fixing portion includes a balloon that can be inflated and deflated.   The focus adjusting unit includes a drive shaft having one end fixed to the HIFU vibrator, and a drive unit that moves the drive shaft back and forth with respect to the housing. 4. The ablation device according to 3. In the irradiation unit,
The opening is formed in a plane parallel to the longitudinal direction of the housing;
2. The ablation device according to claim 1, wherein a reflection member that changes an irradiation direction of the high-intensity focused ultrasound is disposed on an inner tip side of the housing. It further includes a long insertion part,
The ablation device according to claim 1, wherein the irradiation unit and the fixing unit are provided on a distal end side of the insertion unit.

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