JP3999755B2 - Thermal therapy probe - Google Patents

Description

  The present invention relates to a thermal treatment probe used for cryotherapy of an affected area such as cancer cells.

  Cryotherapy (cryotherapy) is a method of treating a lesion by freezing a lesion such as a tumor tissue and necrotizing the tumor tissue. Conventionally, an apparatus using high-pressure argon gas has been used for this cryotherapy (Non-patent Document 1). In this device, a tubular probe with a sharp tip is inserted into the affected part of the body, high pressure argon gas is ejected from the nozzle part at the tip, and the lesion is cooled by the Joule-Thomson effect. . In this cryotherapy apparatus, the probe tip temperature is -150 ° C.

  By the way, in order for cancer cells to die, it is necessary to cool the cells to −20 ° C. or lower. If the affected area, ie, the area to be frozen is 10 to 20 mm in diameter, at least the probe tip temperature needs to be −50 ° C. or lower in order to make this frozen area −20 ° C. or lower. Further, the endothermic amount is required to be about 5 W in consideration of the inflow of heat from the body temperature, the heat amount for cooling the cancer cells, and the coagulation heat for freezing the cancer cells. Moreover, in order to freeze cancer cells in the body, it is necessary to stab the probe into the body, but in order to stab the body, the diameter of the probe is limited to 10 mm, and the probe diameter needs to be 10 mm or less. . In practice, it is preferably 4 mm or less in consideration of the influence on the human body.

  Moreover, although it is not cryotherapy, there exists a Peltier cautery apparatus as a cooling treatment apparatus using a Peltier device (patent document 1). Moreover, as a thermal treatment device using a heat pipe, there is one using a heat pipe for heat transfer during heating (Patent Document 2).

JP 2002-177296 A JP-A-8-299376 “Ayumi of Medicine” Vol. 201, no. 11, June 15, 2002, pages 856, 857

  However, the conventional cryotherapy device using the Joule-Thompson effect using high-pressure argon gas has a probe tip temperature of −150 ° C., which is sufficient as the freezing capacity, but the device cost is extremely high, and high-pressure gas is handled. Therefore, the operation is complicated and the running cost is high.

  In addition, a cautery device using a Peltier element described in Patent Document 1 is a device for bringing a probe into contact with the surface of the body and treating cancer of the skin or mucous membrane. And when this apparatus is used for cryotherapy, it is necessary to cool the heat sink side with dry ice, and the operation is complicated. Furthermore, the device described in Patent Document 2 is a thermotherapy device and cannot be used for cryotherapy.

  The present invention has been made in view of such problems, and has a sufficient freezing capacity, does not use high-pressure gas, has low apparatus cost and running cost, and does not use dry ice and liquid nitrogen. An object of the present invention is to provide a thermal therapy probe that is easy to operate.

A thermal treatment probe according to the present invention is disposed between a first temperature end and a second temperature end to generate a temperature difference between the first temperature end and the second temperature end, A reference temperature source that cools or heats the second temperature end, a drive unit that drives the Peltier element so that the direction of energization of the Peltier element can be switched between normal and reverse during treatment, and one end at the first temperature end possess a heat pipe and the other end is thermally connected is inserted into the affected part, wherein the heat pipe has been inserted into the outer tube, as between the outer tube and the heat pipe is evacuated, The heat pipe and the outer tube are sealed at both ends thereof, and the tip of the heat pipe is exposed from the outer tube and comes into direct contact with the affected area, and is used for cryotherapy. Features.

Further, when freezing treatment, for example, the reference temperature source to cool said second temperature end, the drive unit you drive the Peltier element so that the heat flows in the second temperature end from the first temperature end .

  According to the present invention, the tip of the heat pipe inserted into the body is cooled by the thermoelectric effect of the Peltier element and the heat transfer effect of the heat pipe, and the affected part is frozen. For this reason, it is possible to obtain a cooling effect equivalent to cooling by injection of high-pressure gas, and since high-pressure gas, dry ice, liquid nitrogen, etc. are not used, the apparatus cost and running cost are low, and the operation is easy. Play.

  Hereinafter, embodiments of the present invention will be specifically described with reference to the accompanying drawings. FIG. 1 is a diagram showing a first embodiment of the present invention, and FIG. 2 is a diagram showing a heat pipe portion. The heat pipe 3 is coaxially inserted into the outer tube 2, the distal end portion of the outer tube 2 is hermetically sealed by a seal 2 a, and the proximal end portion of the outer tube 2 is placed in a container 13 described later. The gap between the outer tube 2 and the heat pipe 3 is maintained in a vacuum by being inserted and evacuating the inside of the container 13. Thereby, the heat pipe 3 is thermally shielded from the outside. The tip 3 a of the heat pipe 3 is exposed to the outside from the outer tube 2, and this portion is inserted into the human body 1. A temperature sensor 4 is disposed in the vicinity of the tip 3 a of the heat pipe 3, and a signal line of the temperature sensor 4 is input to the control circuit 10 provided outside along the outer tube 2.

  The base end of the heat pipe 3 is fixed to the soaking plate 8 and is thermally connected. A substrate 6 constituting one temperature end of the Peltier module 5 is joined to the soaking plate 8, and a substrate 7 constituting the other temperature end is joined to the water cooling jacket 9. In the water cooling jacket 9, cooling water is circulated and supplied from a chiller cooling water supply device 12 via a pipe 11. The pipe 11 has a water cooling jacket 9 side portion inserted into the container 13.

3 and 4 are diagrams showing the configuration of the Peltier module 5. The Peltier module 5 is a multi-stage module. For example, as shown in FIG. 4, each Peltier element 21 is stacked in three stages, and as shown in FIG. 3, eight unit modules of Peltier elements having a three-stage configuration are arranged in parallel. Connected to. That is, one Peltier module 5 has a p-type element and an n-type element bonded to each electrode (not shown) on the substrate 7 at the lowest level, and each electrode (see FIG. The p-type element and the n-type element are alternately connected in series by bonding the p-type element and the n-type element on the adjacent electrodes on the substrate 7 by using the not shown. Similarly, in the middle stage, a plurality of p-type elements and n-type elements arranged between the substrate 22 and the substrate 23 are alternately connected in series by an electrode on the substrate 22 and an electrode on the lower surface of the substrate 23. In the upper stage, a plurality of p-type elements and n-type elements arranged between the substrate 23 and the substrate 6 are alternately connected in series by the electrodes on the substrate 23 and the electrodes on the lower surface of the substrate 6. Connected to and configured. In each unit Peltier module 5, the electrodes at both ends of the electrodes that connect the upper and middle tiers and the middle and lower peltier elements 21 in series are connected to each other, and therefore all the upper, middle and lower peltier elements are connected. 21 are connected in series so that p-type elements and n-type elements are alternated. The electrodes at both ends of the series connection body are connected to the control circuit 10 .

  A plurality of unit Peltier modules 5 configured as described above are arranged on the water cooling jacket 9, and the upper substrate 6 is commonly joined to the heat equalizing plate 8. In the Peltier module configured as described above, when current is supplied to each element 21 of each unit module 5 in an appropriate direction via both ends of the series connection body, heat is generated from the substrate 6 side toward the substrate 7 side. The heat on the soaking plate 8 side gathers in the water cooling jacket 9.

  The proximal end portion of the outer tube 2 and the proximal end portion of the heat pipe 3, the heat equalizing plate 8, the Peltier module 5, and the water cooling jacket 9 are arranged in the container 13 by holding the inside of the container 13 in a vacuum. , Kept in a vacuum atmosphere. The diameter of the heat pipe 3 is preferably 8 mm or less, and the diameter of the outer pipe of the outer pipe 2 is preferably 10 mm or less. More preferably, the diameter of the heat pipe 3 is 3 mm or less, and the diameter of the outer pipe of the outer pipe 2 is 4 mm or less. In particular, if the diameter of the outer tube is larger than 10 mm, it is difficult to insert the probe into the human body 1.

  Next, the operation of the thermal treatment probe configured as described above will be described. Cooling water is circulated and supplied from the chiller cooling water supply device 12 to the water cooling jacket 9 to cool the substrate 7 of each Peltier module 5 on the water cooling jacket 9. And the front-end | tip 3a of the heat pipe 3 is inserted in the human body 1, and the front-end | tip 3a is located in an affected part. Thereafter, the control device 10 supplies power to each Peltier module 5. Then, heat is drawn from the soaking plate 8 by the Peltier module 5 and flows toward the water cooling jacket 9, and heat is collected in the water cooling jacket 9. The heat of the water cooling jacket 9 is cooled by the chiller cooling water. No heat is accumulated in the water cooling jacket 9.

In this way, the soaking plate 8 is cooled. And the front-end | tip 3a of the heat pipe 3 is cooled with the heat pipe by which the vacuum pipe | tube heat | fever was interrupted | blocked from the external environment by the outer tube | pipe 2. The temperature of the affected part is measured by the temperature sensor 4, and the detection signal is input to the control circuit 10, and the current supplied to the Peltier module 5 is controlled so that the temperature detected by the temperature sensor 4 becomes a predetermined value. .

  In this case, for example, the size of the lower substrate 7 in FIG. 4 is 45 mm × 45 mm, the size of each Peltier element 21 is 1.5 mm × 1.5 mm in cross section, and the height is 2.0 mm. 297 pairs of Peltier elements 21 of p-type and n-type are provided, the size of the middle substrate 22 is 35 mm × 35 mm, and the size of each Peltier element 21 is 1.6 mm × 1.6 mm in cross section and height Is 2.0 mm, 111 pairs of Peltier elements 21 are provided as a pair of p-type and n-type, the size of the upper substrate 23 is 25 mm × 25 mm, and the size of each Peltier element 21 is 1. 7 mm × 1.7 mm and the height is 2.0 mm, 38 Peltier elements 21 are provided as p-type and n-type pairs, and eight of these Peltier modules 5 are arranged in parallel with the water cooling jacket 9 and the heat equalizing plate 8. High temperature (water-cooled jacket) Preparative 9) side is 20 ° C., becomes low temperature (soaking plate 8) side is -80 ° C. or less, the endothermic amount is 5W. At this time, if the heat resistance of the heat pipe 3 is 6 ° C./W, the temperature difference between the proximal end and the distal end of the heat pipe 3 is 6 × 5 = 30 ° C. For this reason, the tip 3a of the heat pipe 3 becomes −80 − (− 30) = − 50 ° C. or less, and a low temperature (−50 ° C. or less at the probe tip) necessary for killing cancer cells in a frozen region having a diameter of 20 mm. And an endothermic amount (5 W) is obtained.

Thereby, cancer cells can be frozen and cancer cells can be killed. In this case, since it reaches the freezing temperature of −20 ° C. or less in the region having a diameter of about 10 to 20 mm, normal cells are prevented from being killed. After the cancer cells are frozen and killed, the energization direction of the Peltier element 21 is reversed and the tip 3a of the heat pipe 3 is heated. This frozen region is rapidly thawed and the probe is extracted from the body. In some cases, thermotherapy can be performed by using the probe while the tip 3a of the heat pipe 3 is heated.

  Next, the type of thermal treatment probe will be described. FIG. 5 is a diagram showing a treatment state using a puncture needle type cryoprobe. As shown in FIG. 5, the heat pipe portion of the frozen probe of the present invention is inserted into a malignant or benign tumor generated in an organ such as the liver, kidney, spleen, pancreas, adrenal gland, brain, thyroid gland, soft tissue and lung. And freeze the affected area. For example, when the tip 3a of the heat pipe 3 is inserted into the affected part 31 of the liver tumor generated in the liver 30 and this portion is cooled, the vicinity of the tip 3a is frozen and a frozen region called an ice ball 32 is generated. The ice ball 32 treats cancer cells. When puncturing the probe, another puncture needle is first inserted into the human body 1, a route is formed in advance, a sheath is inserted into this route to secure the route, and then the probe is inserted into the sheath. By doing so, the probe can be inserted into the human body 1.

  6 and 7 show a catheter type probe. Treatment of neoplastic lesions (malignant and benign) by inserting a catheter made of the probe of the present invention having a Peltier element in the biliary tract, airways, urethra, bladder, blood vessels and other luminal organs, and repeating freezing and thawing To do. In addition, with respect to blood vessels, physiological changes such as promotion of proliferation and inhibition of proliferation of endothelial cells are caused by cooling and heat. As shown in FIG. 6, a catheter 39 having a Peltier element is inserted into the bile duct 33 with respect to the bile duct gun 34 formed in the bile duct 33, and the tip 3a of the heat pipe 3 is positioned at the bile duct gun 34 and cooled. Freeze. As a result, the cancer cells generated by the ice ball 35 are killed. In this case, the catheter 39 is guided to a relatively thin lumen structure with a guide wire or the like. When guiding the catheter 39, X-ray fluoroscopy or the like may be used in combination.

  Further, as shown in FIG. 7, a catheter 39 is inserted into a blood vessel 36 in the brain, and the heat pipe tip 3a exposed from the tip is positioned at the aneurysm 37 to cool or warm the blood vessel wall. In other words, it promotes or suppresses the proliferation of blood vessel endothelium.

  FIG. 8 shows cryotherapy using an endoscope 40 incorporating the probe of the present invention. The catheter probe is inserted into a relatively thin lumen, but the endoscope 40 is inserted into a relatively thick lumen. An endoscope 40 equipped with a Peltier element is inserted into the digestive tract such as the esophagus, the intestinal tract, and the trachea, and freeze and thaw is repeated to treat neoplastic lesions (malignant and benign). In FIG. 8, the endoscope 40 is inserted into the esophagus, and the ice ball 43 is formed by the tip 3a of the heat pipe exposed from the tip, thereby treating the tumor 42.

It is a figure which shows the heat treatment probe of embodiment of this invention. Similarly, it is a figure which shows the part of the heat pipe. Similarly, it is a figure which shows the Peltier module. Similarly, it is the figure which shows the unit Peltier module. It is a figure which shows the treatment method by a puncture needle type freezing probe. It is a figure which shows the treatment method by a catheter type freezing probe. Similarly, it is a figure which shows the treatment method by a catheter type freezing probe. It is a figure which shows the treatment method by an endoscope type frozen probe.

Explanation of symbols

  1: human body, 2: outer pipe, 3: heat pipe, 3a: tip of heat pipe, 4: temperature sensor, 5: thermoelectric module, 6, 7, 22, 23: substrate, 8: heat equalizing plate, 9: water cooling Jacket: 10: Control circuit, 12: Cooling device

Claims (2)

A Peltier element that is disposed between the first temperature end and the second temperature end to generate a temperature difference between the first temperature end and the second temperature end, and cools or heats the second temperature end. A reference temperature source, a drive unit that drives the Peltier element so that the energization direction of the Peltier element can be switched between normal and reverse during treatment, and one end is thermally connected to the first temperature end and the other end is possess a heat pipe is inserted into the affected part, wherein the heat pipe has been inserted into the outer tube, so that between the outer tube and the heat pipe is in a vacuum state, and the heat pipe and the outer tube thereof A heat treatment probe which is sealed at both ends, the tip of the heat pipe is exposed from the outer tube and is in direct contact with the affected part, and is used for cryotherapy . In the cryotherapy, the reference temperature source cools the second temperature end, and the driving unit drives the Peltier element so that heat flows from the first temperature end to the second temperature end. The thermal treatment probe according to claim 1.

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