JP4481600B2 - Energy therapy device - Google Patents

Description

[0001]
BACKGROUND OF THE INVENTION
  The present invention is, for example, inserted into a biological lumen or lumen such as a digestive tract such as a blood vessel, an esophagus or a rectum, a urethra, an abdominal cavity, or a thoracic cavity, or surgically pressed against a living tissue or pressed against a body surface BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an energy therapy apparatus for irradiating a living tissue with energy such as ultrasonic waves and laser light to treat a tumor such as cancer or a prostatic hypertrophy at a high temperature.
[0002]
[Prior art]
  Utilizing the body cavity of the living body or making a small incision in the living body and inserting a long insertion part into the living body, irradiating the living tissue including the lesion with ultrasonic waves, laser light, etc. energy from this insertion part, Heat treatment techniques (hyperthermia, high-temperature treatment, ablation, and transpiration) are known in which the tissue at the lesion site or the surrounding tissue including the lesion site is eliminated by degeneration, necrosis, coagulation, cauterization, or transpiration.
[0003]
  In general, these techniques treat energy by directly irradiating a lesion site located on or near the surface of a living tissue. For example, heating of a lesion site located deep in a living tissue such as the prostate. It is also used for treatment.
[0004]
  Patent Document 1 discloses an example of a medical energy irradiation apparatus applied to such heat treatment. Patent Document 2 discloses a treatment apparatus applied to high intensity focused ultrasound (HIFU) therapy.
This medical energy irradiation apparatus is generally performed in the following procedure, for example, when treating prostate. In other words, a doctor who treats the prostate inserts the insertion part of the medical energy irradiation device into the rectum, causes the position of the emission part to reach the prostate, aligns the position of the emission part with the target site direction, and irradiates energy To do. This series of operations is generally performed by a doctor while observing with ultrasonic image diagnosis.
[0005]
  FIG. 21 is a graph showing the relationship between temperature and time for damaging (necrosis) biological tissue. The tissue becomes necrotic in a short time as the temperature increases. For example, necrotic tissue takes 3 minutes at a temperature of 55 ° C. and 50 hours at a temperature of 45 ° C. (Non-patent Document 1).
[Patent Document 1]
JP 2000-319 A
[Patent Document 2]
US Pat. No. 5,743,863
[Non-Patent Document 1]
Lasers in Surgery and Medicine 18: 22-33 (1996).
[0006]
[Problems to be solved by the invention]
  The above-described conventional energy irradiation apparatus for heat therapy is configured to concentrate and irradiate, for example, energy such as a laser beam emitted from an emission unit on a target site. In order to treat the target site while maintaining the warmed state as described above at the time of laser irradiation, it is necessary to increase the efficiency of energy use. In order to increase the efficiency of energy use, the output of the emission is increased, and there is a possibility of damaging normal tissues other than the target site.
[0007]
  In view of the above-described points, the present invention provides an energy treatment device that increases the efficiency of use of energy emitted from an emission unit and increases energy accumulation with respect to a target site while suppressing emission output.
[0008]
[Means for Solving the Problems]
  An energy treatment apparatus according to the present invention is an energy treatment apparatus that irradiates a living tissue with energy, and includes a first energy emission unit and a second energy emission unit that emit two types of energy having different frequencies, Reflecting means for reflecting the energy emitted from the second energy emitting unit to the target siteAnd the first and second energy emitting portions are disposed on one side, and the reflecting means is disposed at a position facing the first and second energy emitting portions across the target portion. Furthermore, the main body including the first and second energy emitting portions and the reflecting means are held, and the relative positions of the first and second energy emitting portions and the reflecting means can be adjusted. An arrangement device is provided that can change the direction of the energy emitting unit. And this invention,A standing wave having a first frequency is formed between the first energy emitting unit and the reflecting unit, and a second frequency different from the first frequency is defined between the second energy emitting unit and the reflecting unit. A standing wave of the first frequency and a standing wave of the second frequency overlap each other at the target site and strengthen each other most strongly.
[0009]
  An energy treatment apparatus according to the present invention is an energy treatment apparatus that irradiates a living tissue with energy, and includes a first energy emission unit and a second energy emission unit that emit two types of energy having different frequencies, A first energy emitting part integrally including the reflecting means, and a second energy emitting part integrally including the reflecting means, the reflecting means reflecting the energy emitted from the second energy emitting part to the target site. However, they are arranged at positions facing each other across the target site. Furthermore, the main body including the first energy emitting portion integrally including the reflecting means and the main body including the second energy emitting portion integrally including the reflecting means are held, and the first and second energy emitting portions and the reflection are retained. An arrangement device is provided that enables adjustment of the relative position with respect to the means and allows the orientations of the first and second energy emitting portions to be changed. In the present invention, a standing wave having the first frequency is formed between the first energy emitting unit and the reflecting unit, and the first frequency is different between the second energy emitting unit and the reflecting unit. A standing wave of the second frequency is formed, and the standing wave of the first frequency and the standing wave of the second frequency are overlapped at the target site so as to strengthen each other most.
[0010]
  In the energy treatment device according to the present invention, the first and second energy emitting units for emitting two energies having different frequencies, and the reflection means installed at positions facing the first and second energy emitting units. Since it comprises, the energy from the 1st and 2nd energy emission part and the energy reflected by the reflection means can be utilized. In addition, the target site is irradiated with energy having different frequencies from the first and second energy emitting units, and the energy transmitted from the target site and reflected by the reflecting means and the energy from the energy emitting unit are first and second. It is possible to irradiate the target site in a concentrated manner by superimposing the standing waves of the plurality of first and second energy having different frequencies. It is possible to increase the energy accumulation density and weaken the energy accumulation density to other living tissues.
[0014]
  The arrangement device includes an arrangement control means for setting a distance between the first and second energy emitting sections and the reflecting means, an orientation of the energy emitting section, a standing wave of the first frequency, and a second frequency An irradiation pattern having an energy intensity distribution such that standing waves of frequencies overlap each other at the target site and strengthen the intensity most, an output control means for controlling the irradiation output, and irradiation time;,Reflection control means for controlling the reflection means, cooling liquid control means for supplying and discharging the cooling liquid to the main body and the reflecting means, or to the two main bodies, and for detecting the intensity of the emitted energy from the energy emitting portion Energy detection meansIt is preferable.
[0015]
  The reflecting means preferably has a fixed reflecting surface or a variable reflecting surface.
[0016]
  Preferably, the reflecting means has a variable curvature of the reflecting surface, and the curvature radius is variable so as to reflect energy efficiently.
[0017]
  The reflecting means preferably has air venting means.
[0018]
  It is preferable that this energy treatment apparatus has a cooling unit that cools one or more of the energy emitting unit and the living tissue contacting the main body including the energy emitting unit.
[0019]
  The energy treatment apparatus preferably includes a cooling unit that cools at least one of the reflecting unit and the living tissue that contacts the reflecting unit.
[0020]
  It is preferable that this energy treatment apparatus has a means for converging, paralleling or expanding the spread angle of the output energy in the main body including the energy output unit.
[0021]
  It is preferable to have a balloon that expands and contracts on the surface of the main body including the energy emitting portion, the reflecting means, or both the main body and the reflecting means.
[0022]
  It is preferable to have a surface layer containing a hydrophilic polymer material on the surface of the main body including the energy emitting portion, the reflecting means, or both the main body and the reflecting means.
[0023]
DETAILED DESCRIPTION OF THE INVENTION
  Embodiments of the present invention will be described below with reference to the drawings.
[0024]
  FIG. 1 shows a basic configuration of an embodiment of an energy treatment apparatus according to the present invention. The energy treatment apparatus 1 according to the present embodiment includes an applicator 2 that is a long insertion portion, an energy output unit 3 that is installed in the applicator and irradiates energy to a living tissue, and an output unit 3. Reflecting means 4 that reflects the energy emitted from the emitting unit 3 that is installed relative to the emitting unit 3, a control unit that instructs an irradiation pattern for concentrating the energy on the target site of the living tissue, that is, the treatment site 80, and other controls. And a control device 5 having a section. The reflecting means 4 includes a reflector 6 that forms a plane or a concave surface that substantially reflects energy, and an operating rod 7 for inserting the reflector 6. That is, the reflector 6 is integrally provided at the tip of the operation rod 7.
[0025]
  As the emission energy, ultrasonic waves, laser light, directional electromagnetic waves, or the like can be used. The energy treatment apparatus 1 of the present example is applied to an ultrasonic treatment apparatus that uses ultrasonic waves with high deepness as energy. For this reason, an ultrasonic transducer serving as the emitting portion 3 is installed on the distal end side in the applicator 2. Ultrasonic waves are emitted from the ultrasonic transducer 3. As the ultrasonic vibrator, for example, an element whose shape changes when a voltage is applied, such as piezoelectric ceramics (PZT, barium titanate, etc.), piezoelectric polymer (PVDF, P (VDF-TrFE), etc.) can be used.
[0026]
  The irradiation pattern instructed from the control device 5 is the intensity of the ultrasonic wave at the treatment site 80 by the cooperation of the ultrasonic wave emitted from the ultrasonic transducer 3 and the reflected ultrasonic wave reflected by the reflector 6. The pattern is set so that the intensity of the ultrasonic wave becomes high and the intensity of the ultrasonic wave becomes low in other parts. In the present embodiment, the ultrasonic wave is irradiated from the ultrasonic transducer 3 toward the treatment site 80, the ultrasonic wave partially transmitted through the treatment site 80 is reflected by the reflector 6, and the reflected ultrasonic wave is again transmitted to the treatment site. 80 is irradiated.
[0027]
  As will be described later, the applicator 2 and the reflection means 4 are arranged so as to be movable so that the distance between them can be controlled. can do. Details of the constituent material of the applicator 2 will be described later.
[0028]
  Next, a principle usage example of the energy therapy apparatus 1 according to the present embodiment, that is, the ultrasound therapy apparatus will be described. In this example, the case of applying to the treatment of prostate cancer and prostatic hypertrophy will be described.
[0029]
  As shown in FIGS. 1, 2 </ b> A, and 2 </ b> B, the applicator 2 is inserted into the urethra 81, and the reflector 6 is inserted into the rectum 82 through the operation rod 7 at a position corresponding to the applicator 2. The applicator 2 is inserted so that the ultrasonic transducer 3 on the distal end side is located at a position corresponding to the treatment site 80 of the prostate 83. In this case, for example, by observing the urethra with an endoscope provided in the applicator 2, a characteristic shape of the prostate urethra can be found, and the front and back positions of the treatment site 80 can be determined. In this state, the ultrasonic wave 85 is emitted from the ultrasonic transducer 3 toward the treatment site 80. The emitted ultrasonic wave 85 is irradiated to the treatment site 80 and a part of the ultrasonic wave 85 is reflected by the reflector 6 inserted through the treatment site 80 and inserted into the rectum 82, and the reflected ultrasonic wave 85 ′ from the reflector 6 is reflected. The treatment site 80 is irradiated again. In the treatment site 80, the ultrasonic wave 85 directly from the ultrasonic transducer 3 and the reflected ultrasonic wave 85 ′ from the reflector 6 are irradiated, and the ultrasonic waves 85 and 85 ′ are superposed to superimpose the ultrasonic energy. Strength increases. Accordingly, the prostate can be selectively treated by modifying the tissue cells of the treatment site 80, for example, malignant tumors of prostate cancer or benign tumors of prostatic hypertrophy.
[0030]
  In the present embodiment, the temperature at the treatment site 80 can be treated at a high temperature and does not evaporate, preferably 55 ° C to 100 ° C, more preferably a temperature range around 70 ° C to 90 ° C. As described above, the ultrasonic energy is accumulated at the treatment site 80.
[0031]
  As shown in FIG. 2A, the applicator 2 and the reflecting means 4 are fixed to the holding portion 14 and the distance L between them is set to a required distance.
[0032]
  The above is the basic configuration of the energy treatment apparatus of the present invention. The present invention uses this basic configuration to increase the concentration of energy on the treatment site.
[0033]
  The energy treatment device according to the embodiment of the present invention includes a plurality of energy emitting units that emit energy having different frequencies, and each energy emitted from the energy emitting unit arranged at a position opposite to the energy emitting unit as a target site. A reflecting means for reflecting, and an arrangement device for arranging the energy emitting part and the reflecting means so that the energy different in frequency between the energy emitting part and the reflecting means forms a standing wave, respectively, By superimposing, it is configured to irradiate energy intensively to the target site of the living tissue.
The combined energy obtained by superimposing the plurality of standing waves has an energy intensity distribution in which the energy intensity is the highest at the target site and the energy intensity decreases as the distance from the target site increases.
[0034]
  According to the energy treatment device according to the embodiment of the present invention, the combined energy of the standing waves of the plurality of energies having the plurality of energy emitting units and the reflection means and having the different frequencies emitted from the plurality of energy emitting units. Is irradiated to the treatment site, and the intensity of the synthetic energy is maximized at the treatment site, so that energy can be intensively applied to the treatment site without heating the living tissue other than the treatment site. It becomes possible to heat to the temperature of the optimal high temperature treatment, and enables high temperature treatment for a short time.
[0035]
  Next, an embodiment of the energy treatment apparatus of the present invention will be described with reference to FIG.
The energy treatment apparatus 201 according to the present embodiment is similar to the applicator 2 that is a long insertion portion, and the energy emitting unit 3 and the emitting unit 3 installed in the applicator 2 as described above. A reflection device 4 including a reflector 6 and an operating rod 7 that are installed and reflects energy emitted from the emission unit 3, and a control device 5 are configured. The applicator 2 and the operating rod 7 of the reflecting means 4 are held by the placement device 14 outside the living body.
[0036]
  The control device 5 includes a control unit 91 configured by a CPU such as a microprocessor, and a database 92 that stores programs executed by the control unit 91 and various data. In the control unit 91, the cooling liquid is supplied to the emission unit 3 (3 a, 3 b), for example, the emission control means 93 for setting the transmission output for driving the ultrasonic transducer and the setting of the irradiation pattern, the applicator 2 and the reflector 6. Coolant control means 94 for supplying and discharging, arrangement control means 95 for setting the distance and direction between the applicator 2 and the reflection means 4, and reflection control for controlling, for example, the radius of curvature of the reflector of the reflection means The energy detecting means 97 for detecting the energy intensity emitted from the means 96 and the energy emitting unit 3, for example, the ultrasonic intensity is connected. Further, a monitor 98 such as a cathode ray tube or a liquid crystal is provided as a display means for displaying the calculation result of the input information.
  As the coolant control means 94, in order not to heat the surface layer of the living tissue that is not the treatment site by the ultrasonic wave emitted from the ultrasonic transducer 3, that is, the surface layer that contacts the applicator 2 and the reflector 6. The coolant is injected and discharged in a circulating manner.
[0037]
  In the present embodiment, in particular, the energy emitting unit 3 includes a plurality of energy emitting units that emit standing wave energy having different frequencies, in this example, two ultrasonic transducers 3a and 3b, and a reflector. 6, a common reflector 6 that reflects the ultrasonic waves from the two ultrasonic transducers 3a and 3b is arranged. As for the wavelength of each energy irradiated from the two ultrasonic transducers 3a and 3b, an integral multiple of half of the wavelength of each of the standing waves 851 and 852 is the distance l between the emitting portion 33 and the reflector 6. By setting as described above, standing waves 851 and 852 can be created (see FIG. 4).
[0038]
  As an irradiation pattern instructed from the control device 5, as shown in FIG. 4, ultrasonic waves 85 a and 85 b from the ultrasonic transducer 3 (3 a and 3 b) are irradiated to the treatment site 80, and a partial treatment site 80 is applied. A first standing wave 851 and a second standing wave 852 are created by superimposing the ultrasonic waves 85a ′ and 85b ′ transmitted through and reflected by the reflector 6. Further, the irradiation pattern is such that the first standing wave 851 and the second standing wave 852 overlap each other at the treatment site 80 by superimposition. Here, since the frequencies of the first standing wave 851 and the second standing wave 852 are different, two standing waves 851 and 852 are formed in the region between the ultrasonic transducer 3 and the reflector 6. Are combined into a third standing wave, which is an irradiation pattern having an energy intensity distribution that strengthens at the treatment site 80 and maximizes the energy intensity and cancels away as the distance from the treatment site 80 decreases.
[0039]
  FIG. 4 illustrates an example of this standing wave irradiation pattern. In this example, standing waves 851 and 852 are generated by superimposing ultrasonic waves 85a ′ and 85b ′ reflected by the reflector 6 by oscillating ultrasonic waves 85a and 85b having different frequencies from the ultrasonic transducer 3 (3a and 3b). Is generated. By appropriately selecting the wavelengths of the standing waves 851 and 852, the ultrasonic waves are overlapped at the treatment site 80 to strengthen the ultrasonic intensity.
[0040]
  FIG. 5 is a graph showing the relationship between the distance l and the second frequency when the first frequency is 3.8 MHz. In order to achieve the highest ultrasonic intensity at the center of the distance l, it is only necessary to satisfy l = 1/2 × | 1 / λ851-1 / λ852 |. For example, if the first frequency is 3.8 MHz when the distance is 1 = 50 mm, the second frequency may be set to 3.815 MHz.
[0041]
  The frequency λ851 of the standing wave 851 and the frequency λ852 of the standing wave 852 are determined by the following equations. The frequencies λ851 and λ852 are selected so that l = n × λ851 / 2 and l = m × λ852 / 2 are satisfied when the distance between the emitting portion and the reflector 6 is l. Here, n and m are integers. Alternatively, when the frequency is fixed, the positioning device 14 controls the distance l between the main body including the emitting portion and the reflecting means so that l satisfies the above expression, thereby standing waves 851 and standing waves 852. Can be made.
[0042]
  When the treatment site 80 is at a different position in the depth direction, it is synthesized from the first and second standing waves 851 and 852 by controlling the frequency of the ultrasonic waves from the ultrasonic transducers 3a and 3b. In addition, the maximum distribution of the energy intensity of the third standing wave 85 can be matched to the treatment site 80.
[0043]
  FIG. 6 schematically illustrates the irradiation state using the reflector 6 and the emitting portions 3a and 3b of FIG. 7A.
  The energy treatment apparatus includes ultrasonic transducers 3a and 3b arranged in parallel in the longitudinal direction of the applicator 2 so as to be emitted from the applicator 2 in the same circumferential direction, and the applicator 2 including the ultrasonic transducers 3a and 3b. Reflecting means 4 is provided at a position opposite to. The first ultrasonic wave 85a irradiated from the ultrasonic transducer 3a is overlapped with the ultrasonic wave 85a ′ that is transmitted through the treatment site and reflected by the reflecting means to generate a first standing wave 851. Similarly, the second ultrasonic wave 85b irradiated from the ultrasonic transducer 3b overlaps with the reflected ultrasonic wave 85b ′ to generate a second standing wave 852. By setting an appropriate different frequency and the distance l between the applicator 2 and the reflecting means 4 as described above, the strength of the treatment site 80 is highest due to further overlap of the standing wave 851 and the standing wave 852. Intensive energy treatment can be performed.
[0044]
  FIG. 7B is a perspective view of the emitting unit 3 showing another example including two ultrasonic transducers 3c and 3d. A ring-shaped ultrasonic transducer 3c and a circular ultrasonic transducer 3d having the same center as that of the ring-shaped ultrasonic transducer 3c are provided at the emission portion. The two ultrasonic transducers 3c and 3d can oscillate ultrasonic waves that are standing waves having different frequencies, and the above-described emission unit in FIG. 6A is replaced with the ultrasonic transducers 3c and 3d. Energy therapy can be performed.
[0045]
  FIG. 8 is an explanatory view showing an irradiation state showing other embodiments in which the emitting section and the reflecting means as shown in FIG. 9 are integrated and arranged at positions facing each other with the treatment site interposed therebetween.
  In order to create the first standing wave 851 integrated with the tip of the main body, the ultrasonic vibrator 3e and the reflector 6b that reflects the ultrasonic waves around the ultrasonic vibrator 3e are provided, and are positioned at positions facing the main body. The reflector 6c of the installed reflection means and the ultrasonic vibrator 3f for creating the second standing wave 852 are provided on the reflector 6c.
  The ultrasonic wave which is the first standing wave 851 made by the ultrasonic vibrator 3e and the ultrasonic wave which is the second standing wave 852 made by the ultrasonic vibrator 3f are combined to treat the treatment site 80. The energy treatment is performed intensively and intensively.
[0046]
  FIG. 10 shows an overall configuration diagram of another embodiment of the energy treatment device in which the emitting portion and the reflecting means of FIG. 9 are integrated.
  Even in the case of the configuration in which the emitting portion and the reflecting means are integrated, the energy treatment device 301 of the present embodiment is installed in the applicator 2 that is a long insertion portion and the applicator 2 as described above. The reflecting unit 4 having the emitting unit 3e and the reflector 6b, the emitting unit 3f and the reflector 6c opposite to the emitting unit 3e and the reflector 6b, and the control device 5 are configured. The applicator 2 and the operating rod 7 of the reflecting means 4 are held by the placement device 14 outside the living body. The reflector 6b reflects the energy from the emitting part 3f, and the reflector 6C reflects the energy from the emitting part 3e.
[0047]
  The control device 5 includes a control unit 91 configured by a CPU such as a microprocessor, and a database 92 that stores programs executed by the control unit 91 and various data. The control unit 91 supplies cooling liquid to the output units 3e and 3f, for example, the output control means 93 for setting the transmission output for driving the ultrasonic transducer and the setting of the irradiation pattern, the applicator 2, and the reflectors 6b and 6c. Cooling liquid control means 94 for supplying and discharging, arrangement control means 95 for setting the distance and direction between the applicator 2 and the reflecting means 4, and reflection control means for controlling, for example, the radius of curvature of the reflector of the reflecting means 96 and energy detecting means 97 for detecting energy intensity emitted from the energy emitting units 3e and 3f, for example, ultrasonic intensity, are connected. Further, a monitor 98 such as a cathode ray tube or a liquid crystal is provided as a display means for displaying the calculation result of the input information.
  The coolant control means 94 does not heat the surface layer of the biological tissue that is not the treatment site by the ultrasonic waves emitted from the ultrasonic transducers 3e and 3f, that is, the surface layer that contacts the applicator 2, the reflectors 6b and 6c. In order to prevent this, the coolant is injected and discharged cyclically.
[0048]
  When an ultrasonic transducer is used as the emitting unit 3, it is desirable to converge the ultrasonic wave and irradiate the treatment site 80. FIG. 11 shows a configuration for converging ultrasonic waves. In the example shown in FIG. 11A, the ultrasonic transducer 3 is combined with a half-wave plate 22 and an acoustic lens 23 is attached. The ultrasonic wave generated by the ultrasonic transducer 3 passes through the half-wave plate 22, is converged by the acoustic lens 23, and is irradiated to the treatment site 80. Moreover, when irradiating an ultrasonic wave in parallel, it can irradiate to the treatment site | part 80 by changing the acoustic lens 23 into a parallel ultrasonic wave. In the example of FIG. 11B, a concave reflector 26 is arranged instead of the acoustic lens. By using the concave reflector 26, the ultrasonic wave can be converged. Although not shown in the figure, the treatment site 80 can be irradiated with an enlarged acoustic lens.
[0049]
  Next, each embodiment of the reflecting means 4 will be described.
  The reflecting means 41 according to the present embodiment shown in FIG. 12 has one strip-like reflector 6 that reflects the irradiated ultrasonic wave, and both ends of the reflector 6 are arranged at a predetermined interval. The pair of support bases 30 and 31 are fixed so as to be curved, and the tip of the operating rod 7 is fixed to the other support base 31 movably disposed in the axial direction. The operating rod 7 is fixed to the other support base 31 by being inserted through a through hole 30 a provided in one support base 30 so as to be movable in the axial direction. In this reflecting means 41, the curvature of the reflecting surface 6a of the strip-shaped reflector 6 is variable by moving the operating rod 7. That is, by pulling the operating rod 7 forward, the support base 31 moves to the position of the broken line, the curvature of the reflector 6 increases, and the radius of curvature of the reflecting surface 6a decreases. Conversely, if the operating rod 7 is pushed, the radius of curvature of the reflector 6 increases. Therefore, for example, when it is desired to accurately reflect the irradiated ultrasonic wave toward the site to be treated, the curvature of the reflector 6 is changed by pulling or pushing the operation rod 7, and the reflected ultrasonic wave is treated. The part 80 is irradiated.
[0050]
  The reflecting means 42 of the present embodiment shown in FIGS. 13A and 13B has a reflector 6 formed by a plurality of reflecting element bodies 33 having a wide central width and gradually narrowing toward both ends and having both sides arcuate. Is configured. The plurality of reflecting element bodies 33 are arranged so as to be bundled in a hemispherical shape, and both ends thereof are supported so as to be inserted into the support bases 30 and 31 through an integral shaft 34. Other configurations are the same as those in FIG. The reflecting means 42 can change the curvature of the reflecting surface 6 a of the reflector 6 by operating the operating rod 7. That is, when the operating rod 7 is pressed, the distance between the support bases 30 and 31 is increased, and the entire width of the reflector 6 is changed so that the radius of curvature of the reflecting surface 6a is increased. On the contrary, by pulling the operating rod 7, the distance between the support bases 30 and 31 is shortened, and the entire width of the reflector 6 is changed so that the radius of curvature of the reflecting surface 6a is reduced.
[0051]
  14A and 14B is configured by forming a spoon-shaped reflector 6 at the tip of the operation rod 7. In the reflecting means 43, for example, an ultrasonic sensor 35 for detecting the ultrasonic wave irradiated from the emitting portion 3 is provided at the center of the reflector 6, and air for discharging the spoon-shaped internal air to the other portion. An ultrasonic jelly injection hole 37 for injecting the hole 36 and the ultrasonic jelly is formed. In this case, the ultrasonic jelly injection hole 37 is formed so as to communicate with the spoon-shaped reflecting surface through the operation rod 7. When this reflecting means 43 is used, for example, when an ultrasonic wave is emitted from the emitting unit 3, the output intensity of the ultrasonic wave is detected by the ultrasonic sensor 35 provided on the reflecting means 43. By feeding back the output from the ultrasonic sensor 35 to the control unit 91, the ultrasonic output of the emitting unit 3 can be controlled. Further, by injecting the ultrasonic jelly into the spoon-shaped reflector 6 through the ultrasonic jelly injection hole 37, the air between the reflective surface 6 a and the living body wall escapes from the air hole 36. In the presence of air, the propagation of ultrasonic waves is hindered. Since the air is eliminated by the injection of the ultrasonic jelly, the ultrasonic waves from the emission part 3 reach the reflecting surface in a good manner.
[0052]
  15A to 15C show still other embodiments of the reflecting means 4, respectively. In this example, a cooling liquid, for example, cooling water, is injected into the reflector 6 so as to relieve the warming of the portion that is not the treatment site, that is, the surface layer portion of the living tissue that contacts the reflection means 4.
[0053]
  The reflection means 44 shown in FIG. 15A includes an outer operation rod 7A having a cylindrical operation rod 7 and a pipe-shaped inner operation rod 7B arranged in the outer operation rod 7A so as to be movable in the axial direction. A reflector 6 composed of a plurality of reflector bodies 33 similar to that shown in FIG. 13 is disposed in the dish-like portion 7C on the tip side of the flange 7A. One end of the reflector 6 is fixed to the dish-like portion 7C, the other end is fixed to the tip of the inner operation rod 7B, and is fixed to the support base 30 that is arranged to be movable in the axial direction together with the inner operation rod 7B. . In the reflecting means 44, the curvature of the reflector 6 can be changed as described in FIG. 13 by moving the inner operation rod 7B forward and backward. On the other hand, the periphery of the dish-like portion 7C where the reflector 6 is disposed is covered with a soft film 38, and the inside of the dish-like portion 7C is sealed in a liquid-tight manner. The flexible film 38 is formed of a material that does not inhibit ultrasonic waves, such as silicon rubber or latex. In the reflecting means 44, a cooling liquid (for example, cooling water) 181 is injected from the pipe-shaped inner operation rod 7B into the reflector 6 (arrow a), and the reflector 6 cools the area where it is disposed, and then is cylindrical. The cooling means is configured to discharge the cooling liquid 181 to the outside through the external operation rod 7A (arrow b). This cooling liquid 181 can be circulated and used, for example. The entire reflector 6 is cooled by the circulation of the cooling liquid 181, and for example, the heat in the vicinity of the reflector 6 generated when the ultrasonic wave irradiated from the emitting unit 3 is reflected by the reflector 6 can be removed. Yes, the treatment site can be intensively treated.
[0054]
  The reflection means 45 shown in FIG. 15B is inserted through the through hole of the movable support base 30, and a pipe-shaped inner operation rod 7B is fixed, and a wire 182 that can move forward and backward in the inner operation rod 7B is disposed. The tip of the wire 182 is fixed to the center of the reflector 6. Since other configurations are the same as those in FIG. 15A, the corresponding parts are denoted by the same reference numerals, and redundant description is omitted. In the reflecting means 45, the central portion of the reflector 6 moves up and down in the drawing by moving the wire 182 backward and forward, so that the support base 30 moves forward and backward to change the curvature of the reflector 6. Can do. The vicinity of the reflector 6 can be cooled in the same manner as in FIG. 15A.
  The reflecting means 46 shown in FIG. 15C is configured by forming the reflector 6 from a bimetal material and installing a heater 40 below the reflector 6. Since other configurations are the same as those in FIG. 15A, the corresponding portions are denoted by the same reference numerals, and redundant description is omitted. In the reflecting means 46, the curvature of the reflector 6 can be changed by being bent by heating by the heater 40. The vicinity of the reflector 6 can be cooled as in FIG. 15A.
[0055]
  FIG. 16 shows still another embodiment of the reflecting means 4. In this example, the reflector is narrowed during insertion to facilitate insertion, and the reflector is expanded to a required size after insertion. The reflecting means 47 according to the present embodiment includes the reflector 6 including a plurality of reflecting element bodies 51, 52, and 53 having a reflecting surface having a required curvature. It is formed so as to be a reflector having a required size when overlapped and spread. That is, the first reflective element body 51 having a reflection surface with a required curvature folded in two so as to be connected in the middle and the two folded members of the first reflective element body 51 are arranged to overlap each other. In addition, second and third reflector bodies 52 and 53 having a reflecting surface having a required curvature are provided.
[0056]
  One end of the second reflecting element body 52 is rotatably attached to a shaft 54 integrated with the two-folded connecting portion 51A of the first reflecting element body 51, and the other end is disposed on the same axis as the shaft 54. Further, it is formed to be attached to the shaft of the first rotation gear 55. The third reflector 53 is rotatably attached to an integral shaft 56 at one end of the connecting portion 51A of the first reflector 51 that is folded in half, and the other end is disposed coaxially with the shaft 56. It is formed so as to be attached to the shaft of the second rotation gear 57. The first rotary gear 55 is pivotally supported between the end of the first reflector element 51 and the base on the side of the operating rod 7, and the second rotating gear 57 is connected to a rotary shaft 58 disposed through the operating rod 7. The rotary gears 55 and 57 are configured to mesh with each other. An operation lever 59 that is manually operated, for example, is attached to the rotary shaft 58. The housing 60 provided in the operation rod 7 is provided with a guide groove 61 of the operation lever 59, and the operation lever 59 is rotated along the guide groove 61. Further, a flexible film 38 that covers the entire reflector 6 is formed as in the above-mentioned patent, and an injection tube 63 that injects the cooling liquid into the reflector 6 through the housing 60 and a discharge tube 64 that discharges the cooling liquid are disposed. The part of the reflection means 47 and the operating rod 7 are connected by a connecting means 65.
[0057]
  When the reflector 6 is inserted into the living body lumen, as shown in FIG. 17A, the reflector 6 is thinly folded so that the three reflector elements 51, 52 and 53 are folded. When the operation lever 59 is rotated to rotate the rotating shaft 58 at the time when it is inserted into a predetermined position in the living body lumen, the second rotating gear 57 rotates and the first rotating gear 55 rotates in the reverse direction. Then, the second reflecting element body 52 and the third reflecting element body 53 attached to the rotary gears 55 and 57, respectively, are opened left and right around the first reflecting element body 51, as shown in FIG. 17B. Thus, a reflector 6 having a desired size is obtained.
[0058]
  FIG. 18 shows an embodiment of the overall configuration of the energy treatment apparatus according to the present invention. This example is applied to prostate treatment. The energy treatment device 1 according to the present embodiment is an arrangement device that arranges the applicator 2 and the reflection means 4 including the ultrasonic transducer 3 that is an energy emitting unit, that is, an arrangement that holds the applicator 2 and the reflection means 4. The apparatus 14 includes a control device 5 that controls the ultrasonic transducer 3 and the reflection means 4, and a monitor 98.
[0059]
  The placement device 14 is supported by a first holding unit 102 that holds the reflecting means 4 on the main surface of the base 101 and a support column 103 that extends from one side of the base 101, and faces the first holding unit 102. The second holding unit 104 that holds the applicator 2 and a position adjusting mechanism that adjusts the positions of the ultrasonic transducer 3 and the reflecting means 4 are provided. The 1st holding | maintenance part 102 is comprised so that the position and direction of the spoon-shaped reflector 6 can be adjusted arbitrarily holding the reflection means 4. FIG. In FIG. 18, the operating rod 7 of the reflector 4 is moved within the area indicated by oblique lines in the first holding unit 102 and is held at an arbitrary position and a rotational position.
[0060]
  Similarly to the first holding unit 102, the second holding unit 104 is divided into a cover unit 104A and a fixed unit 104B so as to hold the applicator 2 having a circular cross section. The second holding portion 104 is supported by a support body 108 that can move up and down along the support column 103, and is moved up and down via the support body 108. For example, the vertical movement can be controlled by a magnetic scale using a magnetic sensor (not shown). With this configuration, the position of the second holding unit 104, and thus the distance between the reflecting means 4 and the ultrasonic transducer 3, is operated via a transfer shaft (not shown) having a feed screw by operating the handle 110. The support 108 can be moved and set by a magnetic scale. The position adjustment mechanism includes vertical movement of the second holding unit 104, axial movement of the applicator 2 in the second holding unit 104 and rotation of the applicator 2 around the axis, and reflection means in the first holding unit 102. 4, and a means for rotating the reflector around the axis of the operating rod 7 and moving the operating rod 7 within the area indicated by the oblique lines.
[0061]
  The applicator 2 including the ultrasonic transducer 3 is connected to the control device 5 through the cable 112. The cable 112 includes electrical wiring and a cooling liquid feed / discharge tube for injecting and discharging the cooling liquid to and from the region where the ultrasonic transducer 3 in the applicator 2 is disposed. The reflection means 4 is connected to the control device 5 by a signal line of an output detection sensor for the cooling liquid feeding / discharging tube 113 for injecting and discharging the cooling liquid. The control device 5 includes a key operation unit, the control unit 91 and the database 92 described above, and further includes a cooling liquid tank and the like, controls the output of ultrasonic waves emitted from the ultrasonic transducer 3, controls the flow rate of the cooling liquid, When the detection signal processing from the ultrasonic sensor 35 of the reflector 6 and other functions to be described later are provided, the function is controlled. A foot switch 114 can also be provided.
[0062]
  On the other hand, observation means for observing a living tissue, for example, an endoscope, a CCD camera, an ultrasonic diagnostic imaging apparatus, and the like can be installed in the tip of the applicator 2. This endoscope will be described.
  The endoscope uses an optical fiber also serving as illumination light, and an imaging lens is provided at the tip. The endoscope is installed so as to be freely inserted and removed from the proximal end portion of the energy irradiation device. Positioning of the ultrasonic wave emitting portion 3 can be performed by endoscopic observation. In addition, by providing the guide light function, the ultrasonic irradiation position can be visually confirmed. Furthermore, since the irradiated surface can be observed continuously during ultrasonic irradiation, it is possible to optimize the irradiation conditions while observing the state.
[0063]
  Since the applicator 2 and the reflection means 4 are arranged so as to be movable so that the distance between them can be controlled by the arrangement device 14, it is preferable that the applicator 2 and the reflecting means 4 are made of a material having relatively high hardness, for example, stainless steel. can do. Details of the constituent material of the applicator 2 will be described later. The applicator 2 has a window (not shown) for irradiating the energy from the emitting part 3, and this window can also be used for observation means to be described later, in this example, an endoscope. As the material of the window, it is desirable to use a material having excellent transmission characteristics such as polyethylene terephthalate, acrylic, polystyrene, polycarbonate, polyethylene, polypropylene, vinylidene chloride, Teflon (registered trademark), and polyester.
[0064]
  In addition, a balloon that expands and contracts to fix the position after insertion can be provided in the portion of the applicator 2 that is inserted into the body cavity. As the constituent material of the balloon, for example, a material excellent in ultrasonic transmission properties such as polyolefin, polyester, polyamide, latex, cellulose and the like is preferable. Thereby, energy loss and heat generation due to absorption of ultrasonic waves by the balloon can be reduced.
[0065]
  Air or coolant can be used as the working fluid for expanding the balloon. The working fluid is not particularly limited as long as it can expand and contract the balloon, but a coolant is preferable. By using a coolant as the working fluid, the surface layer of the living tissue can be cooled by the coolant when irradiating with ultrasonic waves, thereby preventing damage to the surface layer more reliably.
[0066]
  The temperature of the coolant is not particularly limited as long as it can cool the surface layer portion of the living tissue, but is preferably 0 ° C. to 37 ° C., more preferably about 0 ° C. to 25 ° C.
[0067]
  The working fluid is preferably physiological saline or Ringer's solution. By using them as the working fluid, when the working fluid leaks into the body for some reason, the influence of the leakage can be reduced.
[0068]
  When a coolant is used as the working fluid, it is preferable to circulate the coolant, and it is more preferable to circulate the coolant until the ultrasonic irradiation is completed and the treatment is completed before the ultrasonic irradiation. By circulating the cooling liquid, the cooling efficiency can be improved, and by circulating the cooling liquid from before the ultrasonic irradiation until the ultrasonic irradiation is completed, the surface layer portion can be further cooled.
[0069]
  For example, a pressure valve that opens when the pressure exceeds a certain pressure is preferably provided in the discharge portion. Thereby, the balloon can be expanded with a constant pressure regardless of the flow rate of the coolant.
[0070]
  It is preferable to control the temperature of the coolant and the flow rate of the coolant in conjunction with ultrasonic irradiation. Thereby, excessive cooling and excessive heating of the surface layer portion can be prevented.
[0071]
  It is preferable to provide a temperature sensor for detecting the surface temperature of the living tissue on the balloon. In this case, the surface temperature of the living tissue can be detected by the temperature sensor, and the information (detected value) can be used for cooling control. Thereby, it can cool efficiently and necessary and sufficiently.
[0072]
  The balloon may be formed so as to surround the entire circumference other than the ultrasonic wave emitting portion of the housing. In this case, since the ultrasound emitting part of the main body is pressed against the body cavity wall by expanding the balloon, the distance between the irradiation target part and the emitting part is stabilized, and the stability during irradiation is good.
[0073]
  Moreover, as a constituent material of the applicator 2, for example, a hard pipe made of a metal such as stainless steel is preferable. Other constituent materials include, for example, polyolefins such as polyethylene and polypropylene, ethylene-vinyl acetate copolymer (EVA), polyvinyl chloride, polyethylene terephthalate, polyesters such as polybutylene terephthalate, polyamide, polyurethane, polystyrene, polycarbonate, Examples thereof include a polymer alloy containing one of these, such as a fluororesin, or a combination of two or more of these.
[0074]
  The surface of the main body may be provided with a hydrophilic polymer material, or a lubricious coating such as silicon or fluororesin. Thereby, the friction on the surface of the main body can be reduced, and the insertion into the body cavity can be made smooth.
[0075]
  As the hydrophilic polymer material used for the lubricating coating, for example, carboxymethyl cellulose, polysaccharides, polyvinyl alcohol, polyethylene oxide, sodium polyacrylate, methyl vinyl ether-maleic anhydride copolymer, water-soluble polyamide and the like are preferable. Of these, methyl vinyl ether-maleic anhydride copolymer is particularly preferable.
[0076]
  When using an energy treatment device coated with a hydrophilic polymer material, for example, the surface layer of the energy treatment device is immersed in physiological saline or the like. This wets the surface layer and creates lubricity on the surface of the energy treatment device. Since this energy treatment device has a surface layer containing a hydrophilic polymer material, friction of the energy treatment device against living tissue is reduced, thereby reducing the burden on the patient and improving safety. To do. For example, the energy treatment apparatus can be smoothly inserted into the body cavity, pulled out from the body cavity, and moved and rotated within the body cavity.
[0077]
  FIG. 19 is a flowchart showing treatment using the energy treatment device 1 according to the present embodiment shown in FIG.
  First, in step S1, the patient is anesthetized. Anesthesia may be general anesthesia or local anesthesia. In step S2, the applicator 2 is inserted into the urethra. In step S3, the reflecting means 4 is inserted into the rectum. In step S4, the applicator 2 and the reflecting means 4 are fixed to the placement device 14. In step S5, the irradiation position of the treatment site is determined, and the positions of the applicator 2 and the reflection means 4 are adjusted. In step S <b> 6, ultrasonic irradiation conditions are input to the control device 5. In step S7, the foot switch 114 is pressed to start treatment. In step S8, when the treatment of the treatment site is completed, the process proceeds to the end of the treatment in step S9. If there is a next treatment site, the process returns to step S5, and steps S5 to S8 are repeated until there is no treatment site.
[0078]
  FIG. 20 shows a flowchart for adjusting the position of the treatment site.
  In step S <b> 10, the rotation angle about the axis of the applicator 2 is determined, and the irradiation direction of the emitting unit (ultrasonic transducer) 3 is determined. In step S11, ultrasonic waves are weakly or irradiated for a short time. In step S <b> 12, the reflector 6 is fixed at a position that is received by the receiver attached to the reflector 6, in this example, the ultrasonic sensor 35 and receives the ultrasonic wave most strongly. In step S13, the adjustment ends.
[0079]
  In the energy treatment device of the present embodiment described above, it has been explained that energy is strengthened by two standing waves irradiated from two ultrasonic wave emitting units. Even if it exists, energy accumulation with respect to the target site | part can be improved more. The wavelength of each standing wave is set to an integral multiple of half of the wavelength of each standing wave when the distance L between the emitting portion and the reflector is set.
[0080]
  According to the energy treatment apparatus 1 according to the present embodiment described above, the ultrasonic wave having different frequencies from the plurality of ultrasonic transducers 3 and the respective ultrasonic waves reflected from the reflector 6 are treated with respect to the treatment site 80. By irradiating so as to overlap at the site, a plurality of standing waves having different frequencies are created and synthesized, thereby improving the use efficiency of the ultrasound and the efficiency of collecting the ultrasound into the treatment site 80. It is possible to warm up to the optimal high temperature treatment temperature.
[0081]
  By using ultrasonic waves having deep reachability as irradiation energy, it is possible to perform high temperature treatment on a site in the deep part.
[0082]
  Since the applicator 2 and the reflection means 4 can be moved in the major axis direction of the applicator 2 or / and the direction perpendicular to the major axis direction according to the treatment site by the arrangement device 14, the applicator 2 and the reflection means 4 are irradiated from the ultrasonic transducer 3. The set ultrasonic wave can be set at an optimum position with respect to the treatment site 80. It is also possible to position while observing.
[0083]
  The control device 5 can perform treatment more efficiently and in a short time by controlling the energy emitting unit 3 and the reflecting means 4.
[0084]
  Since the arrangement device 5 can arrange the energy emitting unit 3 and the reflection means 4, the position with the target site can be more stable, and the energy can be accurately irradiated to the target site even during energy irradiation. Energy can be concentrated.
[0085]
  Since the applicator 2 is provided with a cooling means, the surface layer portion of the living tissue can be cooled by the cooling liquid, and damage to the surface layer portion can be more reliably prevented.
[0086]
  By providing an acoustic lens 23 for converging, paralleling or magnifying ultrasonic waves on the ultrasonic wave output surface of the ultrasonic transducer 3, depending on the condition of the treatment site, the ultrasonic waves can be irradiated in a wide area or a narrow area, It can be irradiated intensively.
[0087]
  Since the reflecting means 4 is provided with a cooling means, the surface layer portion of the living tissue can be cooled by the cooling liquid, and damage to the surface layer portion can be more reliably prevented.
[0088]
  By providing the reflecting means 4 with a fixed reflecting surface or a variable reflecting surface, an optimum reflecting surface can be used depending on the treatment range of the target site, and more efficient treatment can be performed.
[0089]
  The placement device 14 has a change function for changing the irradiation direction of the ultrasonic wave from the ultrasonic transducer 3, so that the ultrasonic transducer 3 can be changed to an appropriate position with respect to the treatment site, and the set time. Can be shortened.
[0090]
  By making the curvature of the reflecting surface of the reflector 6 variable, the irradiation range can be varied according to the position and area in the depth direction at the treatment site.
[0091]
  By providing the ultrasonic sensor 35 on the reflector 6, it is possible to detect the output intensity of the ultrasonic wave, and to control the ultrasonic output emitted from the ultrasonic vibrator 3, review the setting of conditions, and the like. .
[0092]
  According to the energy treatment device according to the present embodiment, when the air vent hole 36 and the ultrasonic jelly injection hole 37 are provided in the reflector 6, the ultrasonic jelly is injected into the reflector 6, thereby reflecting the body cavity wall. The body 6 can be brought into close contact, and the ultrasonic waves can be accurately reflected to the treatment site 80 without being irregularly reflected.
[0093]
  By having the arrangement device 14 for holding the main body and the reflector 6, the main body and the reflector 6 can be fixed at an optimum position, and energy irradiation can be performed stably.
[0094]
  The control device 5 can perform an efficient treatment depending on the target site by instructing an irradiation pattern for concentrating energy on the target site.
[0095]
  Since the control device 5 controls the cooling means of the main body and the cooling means of the reflecting means, the surface layer portion of the living tissue can always be cooled by the cooling liquid, and damage to the surface layer portion can be more reliably prevented. Therefore, an efficient treatment can be performed in a short time.
[0096]
  Since the control device 5 controls the reflecting means, that is, when the curvature of the fixed reflecting surface or the variable reflecting surface is varied, the control device 5 can adjust the irradiation range according to the position and area in the depth direction of the target portion. Timely and efficient treatment can be performed.
[0097]
  When placing an endoscope or CCD camera on the applicator 2, it is possible to observe the state of the epidermis near the treatment site, or when placing an ultrasonic diagnostic imaging device, the state of the treatment site before and after treatment, It is possible to optimize the irradiation conditions while observing the state.
[0098]
  When the applicator 2 is provided with a balloon that expands and contracts, the applicator 2 can be pressed against the body cavity wall in the vicinity of the treatment site, the distance between the treatment site 80 and the ultrasonic transducer 3 is stabilized, and Ultrasonic irradiation can be stabilized.
[0099]
  When a surface layer containing a hydrophilic polymer material is formed on the surface of the applicator 2, friction on the surface of the applicator 2 is reduced, and insertion, extraction, movement, and rotation into the body cavity are made smooth. I can do it.
[0100]
  Although it has been described that the cooling means is provided in each of the main body, the reflection means, and the balloon, the cooling means for the main body, the reflection means, and the balloon can be provided in any combination depending on the cooling conditions.
[0101]
  In the upper example of this embodiment, the ultrasonic wave has been described as an example of the energy irradiated toward the living tissue. However, the present invention is not limited to this, for example, laser light, directional electromagnetic waves, and the like. For example, energy irradiation such as the above may be performed. In this case, if necessary, a window is provided in a portion corresponding to the emission portion of the applicator so as not to inhibit energy irradiation.
[0102]
  In the above example, as the present embodiment, the case of the prostate as an example of the living tissue to be subjected to the high temperature treatment has been described as an example. However, the present invention is not limited to this, and blood vessels and digestive tracts (esophagus) , Intestinal tract, etc.), all living tissues capable of performing high-temperature treatment by irradiating energy from inside the body such as the abdominal cavity or from the body surface.
[0103]
  The embodiments described above are not described to limit the present invention, and various modifications can be made by those skilled in the art within the technical idea of the present invention.
[0104]
【The invention's effect】
  According to the energy treatment device of the present invention, the frequencies are different.TwoThe energy ofFirst and secondWith different energy output and reflection meansFirst and secondSuperimpose standing wavesStrengthened the mostBy irradiating the target site with energy, the energy utilization efficiency is improved, and the energy accumulation to the target site, and hence the intensity of the energy, can be increased while suppressing the output power. Therefore, it is possible to warm to the temperature of the high temperature treatment, and an efficient high temperature treatment with low output is enabled.
[0105]
  Efficient energy accumulation at the target site by providing an energy intensity distribution that increases the energy intensity at the target site to the energy obtained by superimposing the standing wave by controlling the energy output pattern and the distance between the output unit and the reflection unit be able to.
[0106]
  Energy that is transmitted through a part of the target and reflected by the reflecting means and energy from the energy output part overlap to create a standing wave, and irradiation with standing waves of different wavelengths is further overlapped. Accumulation increases and the target site can be heated to an optimum temperature.
[0107]
  First and secondDifferent frequency from the energy output partFirst and secondBy irradiating with standing wave energy, it is possible to overlap under the optimum conditions according to the target part with different depth, and the accumulation of energy increases and the target part can be heated to the optimal temperature. .
[0108]
  According to the energy treatment device of the present invention,First and secondThe energy emitting part is placed on one side and the reflecting means sandwiches the target partFirst and secondTherefore, the energy utilization efficiency is improved, and the energy accumulation to the target site, and hence the intensity of the energy, can be increased while suppressing the output power. Therefore, it is possible to warm to the temperature of the high temperature treatment, and an efficient high temperature treatment with low output is enabled.
[0109]
  According to the energy treatment device of the present invention, the reflecting means is integrally provided.First and secondSince the energy emitting portions are respectively disposed at positions facing each other with the target portion interposed therebetween, energy use efficiency is improved, and energy accumulation to the target portion, and hence the strength of the energy can be increased while suppressing the output power. Therefore, it is possible to warm to the temperature of the high temperature treatment, and an efficient high temperature treatment with low output is enabled.
[0110]
  Since the main body including the energy emitting portion and the reflecting means, or the first and second main bodies including the energy emitting portion integrally including the reflecting means are provided, the arrangement device for holding and arranging is provided.The position with respect to the target site can be more stabilized, and the energy can be accurately irradiated to the target site even during energy irradiation.
[0111]
  The placement device is a relative position of the energy emitting part and the reflecting means.ofAdjustmentEnableAs a result, the energy emitting part and the reflecting means can be fixed at an optimal position, and energy irradiation can be performed stably.
[0112]
  Since the arrangement device can change the direction of the energy emitting unit, the position of the emitting unit can be changed to an appropriate direction with respect to the target site, and the setting time can be shortened.
[0113]
  Since the arrangement control means sets the interval between the energy emitting part and the reflecting means, the direction of the energy emitting part,Energy irradiation can be efficiently performed with an optimal arrangement.
[0114]
  The emission control means isHas an energy intensity distribution that overlaps at the target site and strengthens the intensity most.Since the irradiation pattern, irradiation output, and irradiation time are controlled, it is possible to treat the target site optimally, efficiently, and in a short time.
[0115]
  Since the reflection control means for controlling the reflection means is provided, an efficient treatment can be performed in a short time.
[0116]
  Since it has a coolant control means, it can prevent the temperature rise to the body tissue including the energy emitting part, the reflecting means, or the living tissue around the body including the energy emitting part having the reflecting means, and the treatment of the target site is efficient. Good and stable.
[0117]
  Because it has energy detection meansThe emission energy can be detected, the output of the emission energy can be controlled, the irradiation condition setting can be reviewed, and the like.
[0118]
  By providing the reflecting means with a fixed reflecting surface or a variable reflecting surface, an optimum reflecting surface can be used depending on the range of treatment of the target site, and more efficient treatment can be performed.
[0119]
  When the reflecting means is formed such that the radius of curvature of the reflecting surface can be varied, the irradiation range can be varied according to the position and area of the target portion in the depth direction.
[0120]
  By having the air vent hole groove in the reflector, the air can be extracted and the reflector can be closely attached to the wall of the body cavity, and the energy irradiated from the emitting part can be reflected accurately to the target site without irregular reflection. Can do.
[0121]
  By providing the cooling means in the energy emitting portion and the main body including the energy emitting portion, the surface layer portion of the living tissue can be cooled by the cooling liquid, and damage to the surface layer portion can be prevented more reliably.
[0122]
  By providing the cooling means in the reflecting means, it is possible to prevent a temperature rise in the living tissue around the reflecting means, and the target site can be treated efficiently and stably.
[0123]
  By providing the main body including the energy output part with means to converge, parallel or expand the spread angle of the output energy, depending on the state of the target site, the energy can be irradiated over a wide area or a narrow area, or ultrasonic waves can be concentrated. Can be irradiated.
[0124]
When the main body or reflecting means including the energy emitting part or a balloon that expands and contracts on the surface of both the main body and the reflecting means, the main body and the reflecting means can be pressed against the body cavity wall in the vicinity of the target part. The distance between the light emitting portion and the emitting portion is stabilized, and energy irradiation and energy reflection with respect to the target portion can be stabilized.
[0125]
  When the main body or the reflecting means including the energy emitting portion or the surface layer including the hydrophilic polymer material is provided on both the main body and the reflecting means, the friction of the surface of the main body or the reflecting means is reduced and the body is inserted into the body cavity. Pull out, move and rotate smoothly.
[0126]
It is possible to selectively irradiate the site in the deep part by making the energy irradiated from the emitting part into an ultrasonic wave.
[Brief description of the drawings]
FIG. 1 is a configuration diagram showing a basic configuration of an embodiment of an energy treatment apparatus according to the present invention.
FIG. 2A is a side view of the main part of the energy treatment device of FIG.
B is a cross-sectional view taken along line AA in FIG. 2A.
FIG. 3 is a configuration diagram showing an embodiment of an energy treatment device according to the present invention.
FIG. 4 is an explanatory view schematically showing an energy (ultrasonic wave) progress state which is a standing wave of an energy irradiation pattern of the energy treatment device according to the present invention.
FIG. 5 is a graph showing the relationship between the distance and the second frequency of the energy treatment device according to the present invention.
FIG. 6A is an explanatory diagram showing an example of an energy irradiation pattern of the energy treatment device according to the present invention.
B is an explanatory diagram of the energy irradiation pattern of FIG. 6A.
FIG. 7A is an explanatory diagram of an example of an emission unit of the energy treatment device according to the present invention.
B is explanatory drawing of the other example of the output part of the energy treatment apparatus which concerns on this invention.
FIG. 8 is a cross-sectional view for explaining another example of the energy irradiation pattern of the energy treatment device according to the present invention.
FIG. 9 is an explanatory diagram of another example of the energy irradiation pattern of the energy treatment device according to the present invention.
FIG. 10 is a block diagram showing another embodiment of the energy treatment device according to the present invention.
FIG. 11A is a configuration diagram showing an embodiment of an ultrasonic focusing element applied to the energy treatment device according to the present invention.
It is a block diagram which shows other embodiment of the ultrasonic converging element applied to the energy treatment apparatus which concerns on B this invention.
FIG. 12 is a perspective view showing an embodiment of the reflecting means of the energy treatment apparatus according to the present invention.
FIG. 13A is a perspective view showing another embodiment of the reflecting means of the energy treatment apparatus according to the present invention.
B is a cross-sectional view taken along line BB in FIG. 13A.
FIG. 14A is a perspective view showing another embodiment of the reflecting means of the energy treatment device according to the present invention.
B is a cross-sectional view taken along line CC of FIG. 14A.
FIG. 15A is a cross-sectional view showing another embodiment of the reflecting means of the energy treatment device according to the present invention.
B is a cross-sectional view showing another embodiment of the reflecting means of the energy treatment device according to the present invention.
C is a cross-sectional view showing another embodiment of the reflecting means of the energy treatment device according to the present invention.
FIG. 16A is a cross-sectional view showing another embodiment of the reflecting means of the energy treatment device according to the present invention.
B is a side view of the reflecting means of FIG. 16A.
17A and 17B are operation diagrams of the reflecting means of FIG.
FIG. 18 is an overall configuration diagram showing an embodiment of an energy treatment device according to the present invention.
FIG. 19 is a flowchart showing an embodiment of treatment by the energy treatment device according to the present invention.
FIG. 20 is a flowchart showing an embodiment of reflector position adjustment of the energy treatment apparatus according to the present invention.
FIG. 21 is a graph relating to temperature and time required for energy treatment.
[Explanation of symbols]
  1, 201, 301 ··· Energy treatment device, ··· Applicator, ··· Emitter, 3a, 3b, 3c, 3d, 3e, 3f ·· Ultrasonic transducer, 4, 41, 42, 43, 44 , 45, 47 ··· Reflecting means, 5 · · Control device, 6, 6b, 6c, 26 · · Reflector, 6a · · Reflecting surface, 7 · · Operating rod, 7A · · Outside operating rod, 7B · · Inside Operating rod, 7C ... Plate-like part, 14 ... Arrangement device, 22 ... 1/2 wave plate, 23 ... Acoustic lens, 30, 31 ... Support base, 30a ... Through hole, 33, 51, 52 , 53-Reflective element, 35-Ultrasonic sensor, 36-Air hole, 37-Ultrasonic jelly injection hole, 38-Soft film, 40-Heater, 51A-Connection part, 55 1 rotation gear, 56 .. integral shaft, 57 .. second rotation gear, 58 .. rotation shaft, 59 .. operation lever ..60..Housing, 63..Infusion tube, 64..Drain tube, 65..Connection means, 80..Treatment site, 81..urethra, 82..rectum, 83..Prostate, 84..Treatment site Other parts, 85 ··· Ultrasound, 85 '·· Reflected ultrasound, 91 ·· Control unit, 92 ·· Database, 93 ·· Ejection control means, 94 ·· Coolant control means, 95 ·· Placement control means , 96 .. Reflection control means, 97 .. Energy detection means, 98 .. Monitor, 101 .. Base, 102 .. First holding part, 102 A .. Cover part, 102 B .. Fixing part, 103. ····························· Second holding part; 105 ··· Movable block; 106 ··· Transfer shaft; 107 · 110 ·· Handle; 114 foot switch 181 .. Coolant, 182 .. Wire, 851 .. Ultrasound as first standing wave, 852 .. Ultrasound as second standing wave, 85 a .. First vibrator Ultrasonic wave reflected by the first vibrator, ultrasonic wave reflected by the first vibrator, ultrasonic wave caused by the second vibrator, ultrasonic wave reflected by the second vibrator, 85b '.

Claims (11)

An energy treatment device for irradiating living tissue with energy,
A first energy emitting unit and a second energy emitting unit for emitting two energies with different frequencies;
Reflecting means for reflecting the energy emitted from the first and second energy emitting portions to a target site ;
The first and second energy emitting units are arranged on one side, and the reflecting means is arranged at a position facing the first and second energy emitting units across the target site,
The main body including the first and second energy emitting portions and the reflecting means are held, and the relative positions of the first and second energy emitting portions and the reflecting means can be adjusted, and the first And an arrangement device capable of changing the direction of the second energy emitting unit,
A standing wave of a first frequency is formed between the first energy emitting unit and the reflecting means,
A standing wave having a second frequency different from the first frequency is formed between the second energy emitting unit and the reflecting means,
The energy therapy device, wherein the standing wave of the first frequency and the standing wave of the second frequency overlap each other at the target site and strengthen each other most. An energy treatment device for irradiating living tissue with energy,
A first energy emitting unit and a second energy emitting unit for emitting two energies with different frequencies;
Reflecting means for reflecting the energy emitted from the first and second energy emitting portions to a target site ;
The first energy emitting portion integrally including the reflecting means and the second energy emitting portion integrally including the reflecting means are respectively disposed at positions facing each other with the target portion interposed therebetween,
Holding a main body including a first energy output portion integrally including the reflecting means, and a main body including a second energy output portion integrally including the reflecting means, the first and second energy output portions; It is possible to adjust the relative position with respect to the reflecting means, and includes an arrangement device that can change the orientation of the first and second energy emitting units,
A standing wave of a first frequency is formed between the first energy emitting unit and the reflecting means,
A standing wave having a second frequency different from the first frequency is formed between the second energy emitting unit and the reflecting means,
The energy treatment device according to claim 1, wherein the standing wave of the first frequency and the standing wave of the second frequency overlap each other at the target site and strengthen each other most. The placement device comprises:
A distance between the first and second energy emitting portions and the reflecting means, an arrangement control means for setting the direction of the energy emitting portions;
An irradiation pattern having an energy intensity distribution such that the standing wave of the first frequency and the standing wave of the second frequency overlap each other at the target portion and strengthen the intensity most, an irradiation output, and an irradiation time. Emission control means for controlling,
Reflection control means for controlling the reflection means;
A coolant control means for supplying and discharging coolant to the body and the reflecting means or to the two bodies;
The energy treatment device according to claim 1, further comprising: an energy detection unit configured to detect an intensity of emitted energy from the energy emitting unit. It said reflecting means, the energy treatment device according to claim 1, wherein it has a fixed reflection surface or variable reflecting surface. The energy treatment device according to claim 1 or 2 , wherein the reflection means is configured such that the curvature of the reflection surface is variable. Energy treatment device according to claim 1 or 2, wherein the having the air vent means to said reflecting means. The energy according to any one of claims 1 to 6 , further comprising a cooling unit that cools at least one of the energy emitting unit and a living tissue that contacts the body including the energy emitting unit. Therapeutic device. The energy treatment apparatus according to any one of claims 1 to 7 , further comprising a cooling unit that cools at least one of the reflecting unit and the living tissue that contacts the reflecting unit. Wherein the body including the energy emitting portion, converges the spread angle of the outgoing energy, the energy treatment device according to claim 1, wherein further comprising means for parallel or larger. Energy treatment device body or said reflecting means, or extended to both surfaces of said body and said reflecting means, according to claim 1 or 2 further comprising a balloon to contract, including the energy emitting portion. 3. The energy treatment device according to claim 1, further comprising: a main body including the energy emitting unit, a reflecting unit, or a surface layer including a hydrophilic polymer material on both surfaces of the main body and the reflecting unit. .

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