JP6666010B2 - Approach device - Google Patents

Description

  The present invention relates to an approach device for approaching a specific area inside an object.

  In order to approach or reach a specific area inside an object without destroying the object, various devices are required. For example, Japanese Patent Application Publication No. 2010-540180 discloses a device for disposing an anchor in or around a lumen structure. It is described that the anchor may be pushed out by a spring, compressed air, or the like, automatically shot, and penetrated through the lumen. However, it is difficult to drive the anchor so that it can be placed at a desired position.

  On the other hand, when an approach to a specific area is performed manually, for example, when performing a perforation by hand or approaching by a puncture by a technician, a simple approach is used because it depends on the skill of the technician. Is required.

  An object of the present invention is to provide an approach apparatus that can easily approach a specific area inside an object in consideration of the above fact.

  An approach device according to a first aspect of the present invention is directed to a projecting member having a leading portion formed at a distal end, and a long guide portion disposed behind the leading portion, wherein the leading portion is a target object. Firing the fired member so as to penetrate from the outside of one side of the target object to the outside of the other side of the target object by passing through the target portion inside the other, and the other surface while passing through the target portion from one surface of the target object A launcher for bridging the guide portion to the target object; and an insertion member inserted into the target object along the guide portion.

  In the approach apparatus according to the first aspect of the present invention, the projecting member is caused by the launcher such that the leading portion passes through the target portion inside the target object and penetrates from one surface outside to the other surface outside of the target object. Fired. Since the object is penetrated in this way, the target can be easily passed through as compared with the case where the object is retained at a predetermined position inside the target object. Note that the target portion here may be the specific region itself inside the target object, or may be a position close to a specific region different from the specific region.

  The long guide portion disposed behind the leading portion is bridged from one surface of the target object to the other surface via the target portion. By inserting the insertion member into the target object along the bridged guide portion, the insertion member can be easily inserted into the position where the guide portion is arranged.

  The approach device according to a second aspect of the present invention further includes a receiving portion that is arranged on the other surface side of the target object and receives a leading portion of the fired member.

  In the approach device according to the second aspect of the present invention, since the receiving portion is arranged on the other end side of the target object, the leading portion of the fired member that has penetrated the target object can be received.

  The approach device according to a third aspect of the present invention is characterized in that the guide portion is in a thread shape.

  Since the guide portion penetrating the target portion and extending from one side of the target object to the other side is in a thread shape in this way, even if the target portion moves inside the target object, the guide portion moves. Can follow. Therefore, damage to the target unit due to relative movement between the target object and the guide unit can be suppressed.

  An approach apparatus according to a fourth aspect of the present invention is characterized in that the launcher has a launch path arranged along the launch direction of the fired member.

  According to the approach device of the fourth aspect of the present invention, the accuracy of the firing direction of the fired member can be improved.

  An approach device according to a fifth aspect of the present invention includes a first support member disposed outside the one surface of the target object and supporting a rear end side of the guide unit, and the first support member sandwiching the target unit. A second support member disposed outside the other surface opposite to the support member and supporting a front end side of the guide portion.

  In the approach device according to a fifth aspect of the present invention, the first support member supports the rear end side of the guide portion on one side of the target object, and the second support member supports the front end of the guide portion on the other side of the target object. Support side. Therefore, the guide member is supported between the first support member and the second support member, and the insertion member can be easily guided and inserted by applying tension or the like.

  The approach device according to a sixth aspect of the present invention is characterized in that the leading portion has a maximum length of a cross section orthogonal to a traveling direction of 3 mm or less.

  According to the approach device of the sixth aspect of the present invention, it is possible to reduce damage to the target object pierced by the leading portion.

  An approach device according to a seventh aspect of the present invention is characterized in that a cross section orthogonal to a traveling direction of the leading portion is circular.

  According to the approach device of the seventh aspect of the present invention, it is possible to smoothly advance the leading portion straight within the target object.

  An approach device according to an eighth aspect of the present invention is characterized in that the guide portion has a wire diameter of 2 mm or less.

  According to the approach device of the eighth aspect of the present invention, it is possible to reduce damage to the target object through which the guide portion penetrates.

  An approach apparatus according to a ninth aspect of the present invention is characterized in that the leading portion penetrates the target object in a linear trajectory.

  According to the approach device of the ninth aspect of the present invention, it is possible to easily make a trajectory plan when penetrating the target object.

  An approach device according to a tenth aspect of the present invention is characterized in that the insertion member has a long tubular shape.

  According to the approach device of the tenth aspect of the present invention, the insertion member can be easily inserted into the target object along the guide member.

  An approach device according to an eleventh aspect of the present invention is characterized in that the insertion member is inserted into the target object with the guide portion inserted therein.

  According to the approach device of the eleventh aspect of the present invention, the insertion member can be more easily inserted into the target object along the guide member.

  The approach apparatus according to a twelfth aspect of the present invention is characterized in that a fiber device is inserted into the insertion member.

  According to the approach apparatus of the twelfth aspect of the present invention, the fibrous device can be easily inserted into the target portion in the target object.

  The approach apparatus according to a thirteenth aspect of the present invention is characterized in that at least one of a liquid, a gas, and a solid is inserted or discharged through the insertion member.

  According to the approach device of the thirteenth aspect of the present invention, at least one of a liquid, a gas, and a solid can be easily inserted or discharged via the insertion member.

  An approach apparatus according to a fourteenth aspect of the present invention is characterized in that a surgical instrument is inserted into the insertion member.

  According to the approach device of the fourteenth aspect of the present invention, a surgical instrument can be easily inserted into the insertion member.

  The approach device according to a fifteenth aspect of the present invention is characterized in that the insertion member is a catheter.

  According to the approach device of the fifteenth aspect of the present invention, the catheter can be easily inserted into the target portion in the target object.

  As described above, according to the approach device of the present invention, it is possible to easily approach a specific area inside an object without destroying the object.

It is a schematic structure figure of an approach device concerning this embodiment. It is a schematic diagram of a launcher and a penetrator of the approach device according to the present embodiment. It is a figure showing the modification of the penetrator concerning this embodiment. It is a figure showing the modification of the penetrator concerning this embodiment. It is a figure showing the modification of the penetrator concerning this embodiment. FIG. 7 is an operation explanatory diagram when the approach device according to the embodiment is used. FIG. 7 is an operation explanatory diagram when the approach device according to the embodiment is used. FIG. 7 is an operation explanatory diagram when the approach device according to the embodiment is used. FIG. 7 is an operation explanatory diagram when the approach device according to the embodiment is used. FIG. 7 is an operation explanatory diagram when the approach device according to the embodiment is used. It is explanatory drawing of another example using the approach apparatus which concerns on this embodiment.

  Next, embodiments of the present invention will be described in detail with reference to the drawings.

  As shown in FIG. 1, the approach device 10 of the present embodiment includes a projectile 30, a penetrator 20 as a member to be fired, and an insertion member 40.

  The penetrator 20 as a member to be fired is fired from the emitter 30 toward the target object 12, and has a leading portion 22 and a guide portion 24. As shown in FIG. 2, the leading portion 22 has a bullet shape with a tapered tip and a circular cross section.

  Note that the leading portion may have another shape. For example, it may be a spherical leading portion 22A as shown in FIG. 3A, a conical leading portion 22B as shown in FIG. 3B, or a long needle-like leading portion as shown in FIG. 3C. It may be 22C. In addition, the leading portion 22 can be made of a material such as a metal, a resin, or the like, and a suitable material can be appropriately selected according to the target object 12.

  The diameter of the rear side of the section orthogonal to the traveling direction F (the firing direction F) of the leading portion 22 is R1. The diameter R1 is selected according to the target object 12. For example, when the target object 12 is a living body, the diameter R1 is preferably smaller than 3 mm in order to suppress damage to the living body. For example, in the case of a human body, if the hole diameter is 2 mm or less, the influence on the human body is small, and quick healing becomes possible. The smaller the diameter of the leading portion 22, the smaller the influence on the human body and the less the pain, so that it is possible to pierce a plurality of times. It is generally known that when a needle for acupuncture and moxibustion having a diameter of several hundred μm is stuck, the self-healing function hardly affects the human body except for a specific site such as a nerve or a retina. The same applies to other living bodies as long as the needle has a diameter of several hundred μm.

  A guide portion 24 is attached to the leading portion 22. The guide portion 24 is formed in a thread shape and is set to be longer than the distance between the one surface 12A and the other surface 12B of the target object 12 when penetrating the target object. The guide portion 24 can be made of a material such as a metal, a resin, a biopolymer, or the like, and specific examples include a wire and a single wire. It is preferable that the guide unit 24 be selected from those having a function of imaging (X-ray, infrared, ultrasonic, etc.) from the outside of the target object 12 and visualizing it.

In particular, when the target object 12 is a living body, the wire diameter of the guide portion 24 is preferably smaller than the cross-sectional diameter R1 of the penetrator 20 in order to suppress damage to the living body. The guide portion 24 may be made of a rigid material such as a wire. Further, the rear end of the needle formed integrally with the leading portion 22 may be formed to be long.

  The launcher 30 includes a launch path 32, a holding unit 34, and an operating unit 36. The firing path 32 is formed in a cylindrical shape, and the cylindrical axis is arranged along the firing direction F of the leading portion 22 (the penetrator 20). A space R having a diameter slightly larger than the outer diameter of the leading portion 22 is formed in the cylinder of the firing path 32. A distal end opening 32 </ b> A is formed at the distal end of the firing path 32.

  The holding portion 34 is arranged at the rear end of the firing path 32 in the firing direction, and is capable of holding the outer periphery of the leading portion 22. An operating unit 36 for firing the penetrator 20 held by the holding unit 34 toward the target object 12 is provided in the projectile 30. As the operating unit 36, various types of firing devices such as a system for extruding the leading unit 22 by compressed air, a water jet system for extruding by water pressure, a rail gun for shooting by electromagnetic induction, a gun using explosives, and a high-pressure gas may be used. it can.

  The launching of the penetrator 20 by the launcher 30 requires energy that can penetrate the target object 12 linearly. The initial firing speed required for the penetrator 20 depends on the material of the target object 12, the penetration distance, the shape, the cross-sectional area, and the mass of the penetrator 20.

Examples of the target object 12 include a living body such as a human body and other animals. In addition, products and structures using materials such as resin, unvulcanized rubber, vulcanized rubber and metal, and structures using concrete before and after curing are also included. Furthermore, plants (fruits, seeds, roots, leaves, and the like) are also examples of the target object 12.

  For example, a 5.56 mm rifle warhead is also used for armor-piercing ammunition that penetrates steel, and its initial velocity is about 800 m / s. In addition, it has been reported that a railgun (super-electromagnetic gun) can fire an object having a mass of 3 g at about 8000 m / s and can further increase the speed. As described above, since the initial velocity range of the penetrator 20 can be selected widely by using various firing means, the initial velocity of the penetrator 20 is appropriately set depending on the target object 12 and the specifications of the penetrator 20 to be applied. .

  Further, when the penetrator 20 collides with the target object 12, the initial speed of the penetrator 20 is set such that the strain rate of the collision surface of the target object 12 exceeds the elastic deformation rate, thereby preventing damage to the target object 12. Can be reduced. For example, the initial speed may be relatively low for rubber-based materials and the like (unvulcanized rubber, vulcanized rubber, uncured concrete, fruit) and the like that are easily elastically deformed and have a low elastic deformation speed. On the other hand, a relatively high initial velocity is selected for a resin-based material that is unlikely to be elastically deformed and that easily causes crack propagation. For a metal material that is not easily elastically deformed and does not easily crack, an initial velocity close to the penetrable energy can be set. For living bodies such as the human body and other animals, similar to the rubber-based material described above, it is easily deformed elastically and is a target object having the characteristic that the elastic deformation speed is slow, but in order to exhibit a non-invasive effect, It is preferable to set a higher initial speed than the optimal initial speed of the rubber-based material.

  The projectile 30 is provided with a first support member 38. The first support member 38 is arranged behind the projectile 30, and the rear end of the guide part 24 is fixed to the front side thereof. Further, a second support member 39 is disposed on the opposite side of the target object 12 from the first support member 38 in the firing direction (see FIG. 1). The second support member 39 includes a receiving portion 39A that receives the leading portion 22 that has passed through the target object 12 and penetrated from the other surface 12B, and that supports the front end side of the guide portion 24 including the leading portion 22. 39B.

  As shown in FIG. 1, the insertion member 40 has a long tubular shape. The inner diameter of the tube of the insertion member 40 is larger than the outer diameter of the guide portion 24. The insertion member 40 is extrapolated to the guide 24 and is inserted into the target object 12 along the guide 24.

  The approach device 10 of the present embodiment can be used for, for example, cancer treatment. Next, a description will be given of an example of use in the case of using for cancer treatment.

  As shown in FIG. 4A, it is assumed that a cancer C exists in the liver K of a living body B (including animals such as monkeys, dogs, horses, and humans) as the target object 12. In this case, the target part T is set in the liver K in the vicinity of the cancer C where the region does not overlap with the cancer C. The setting of the target portion T is set based on images obtained by X-ray CT, MRI, ultrasonic imaging, and the like, in consideration of accessibility from the body surface, positions of other organs, blood vessels, and the like.

  In addition, based on the change in the hardness of the living body in the portion where the penetrator 20 passes, the trajectory plan to the target part T in advance based on the angle of entry into the organ, etc., the launching direction of the penetrator 20 by the launcher 30, Preferably, the speed is determined. The trajectory planning can use a trajectory planning method used in existing radiotherapy from CT images taken in advance.

  Next, the penetrator 20 is set in the launcher 30 of the approach device 10. In this set, the outer periphery of the leading portion 22 is arranged at the rear end of the firing path 32 while being held by the holding portion 34, and the rear end of the guide portion 24 is fixed to the first support member 38. Then, the projectile 30 is arranged outside the one surface 12A of the living body B, and the second support member 39 is arranged outside the other surface 12B of the living body B with the target portion T interposed therebetween.

  Next, the distal end opening 32A of the launch path 32 of the launcher 30 is directed toward the target section T, and the operating section 36 is operated to fire the leading section 22. The emitted leading portion 22 enters the inside from one surface 12A of the living body B, passes through the target portion T in the liver K, and exits from the other surface 12B of the living body B, as shown in FIG. 4B. . Then, it is received by the receiving portion 39A of the second support member 39. The front side of the guide portion 24 is fixed to the support portion 39B of the second support member 39 together with the leading portion 22. Thus, the guide portion 24 attached to the leading portion 22 penetrates the liver K and the target portion T from one surface 12A of the living body B, and is bridged to the other surface 12B side of the living body B.

  Next, as shown in FIG. 4C, the insertion member 40 is extrapolated to the guide portion 24. Then, the insertion member 40 is inserted into the living body B from the one surface 12A side. As shown in FIG. 4D, the insertion member 40 is moved along the guide portion 24 already bridged inside the living body B, and is arranged in front of the target portion T. At this time, since the insertion member 40 moves while being guided by the guide part 24, it can be easily inserted toward the target part T. Note that a catheter can be used as the insertion member 40.

  Next, the optical fiber 44 is passed through the tube of the insertion member 40, and the tip of the optical fiber 44 is disposed on the target portion T (see FIG. 4E). At this position, the cancer C can be irradiated with the laser light L. A laser having high directivity can be suitably used.

  The insertion member 40 may be pulled out of the body after the optical fiber 44 is placed on the target portion T, or may be left in the body for the next treatment.

  According to the approach device 10 of the present embodiment, since the target object 12 is punched by the leading portion 22 fired from the projectile 30, the leading portion 22 easily moves straight. That is, even if the hardness difference and other conditions differ depending on the region inside the target object 12, straight traveling is hardly hindered. Therefore, the set target portion T can be easily punched out, and the guide portion 24 can be bridged so as to pass through the target portion T. Then, the insertion member 40 can be easily accessed to the target portion T along the bridged guide portion 24.

  For example, when a needle or the like is driven, an organ of a living body may be deformed or move in relation to surrounding organs or a skeleton. In this regard, conventionally, since the needle is stabbed relatively slowly, there has been a problem that the needle is bent or the organ moves. By firing at an initial velocity equal to or higher than a predetermined value as in the present embodiment, the penetrator 20 advances linearly without causing deformation or movement of the organ with respect to the material parameters of the skin or the organ, and the target section. T can pass. With a conventional automatic puncture device, it was difficult to puncture a predetermined position due to deformation and movement of an organ, but with the approach device 10 of the present embodiment, a predetermined position can be accessed relatively easily.

  In addition, since it is possible to pass through the target T in the target object 12 in this manner, it is also possible to puncture a part that could not be observed with an ultrasonic diagnostic apparatus due to anatomical restrictions. As a result, it is possible to easily access an affected area that can be dealt with only by surgical removal surgery at present, and it is expected to be applied to a less invasive alternative treatment as compared with existing surgical removal surgery.

  Further, unlike the case of the conventional puncture, it is not necessary to perform the operation while observing the needle position by a plurality of times of CT imaging, so that the amount of exposure by CT imaging can be reduced. Furthermore, the target T can be easily punched out by the leading portion 22 without depending on the puncture skill of the technician.

  In addition, when making a trajectory plan, it is easy to calculate a trajectory plan without calculating the bending of the needle or the displacement of the organ by simulation, acquiring material parameters such as organs for each patient, etc. Can stand.

  If the optical fiber 44 can be arranged on the target T, laser irradiation can be performed from a position close to the cancer C. Therefore, it is possible to irradiate the laser to the cancer C with high accuracy, and it is possible to suppress the tissue other than the cancer C from being cauterized by the laser. In addition, laser irradiation can be performed from a position close to the cancer C, and adjustment of laser intensity and the like can be easily performed.

  Further, in the present embodiment, since the guide portion 24 has a thread shape, even if the target portion T moves inside the target object 12, the guide portion 24 can move following the movement. Therefore, the guide portion 24 and the target portion T do not move relative to each other due to the movement of the target portion T inside the target object 12, and damage to the target portion T can be suppressed.

  Further, in the present embodiment, since the launcher 30 includes the launch path 32, the accuracy of the launch direction of the leading portion 22 can be improved.

  Further, in the present embodiment, the first support member 38 supports the rear end side of the guide portion 24 on one surface 12A side of the target object 12, and the second support member 39 guides the guide end 24 on the other surface 12B side of the target object 12. The front end side of the portion 24 is supported. As described above, since the guide portion 24 is supported between the first support member 38 and the second support member 39, tension can be easily applied to the guide portion 24, and the insertion member 40 can be easily guided. It can be inserted along the part 24.

  Furthermore, in the present embodiment, since the receiving portion 39A for receiving the leading portion 22 is provided on the other surface 12B side of the target object 12, it is possible to prevent the leading portion 22 from hitting other portions.

  In the above example of use, only one guide portion 24 of the approach device 10 is penetrated, but a plurality of guide portions 24 may be penetrated and used. In this case, as shown in FIG. 5, the target portions T1 to T3 are set at positions surrounding the cancer C. The target portions T1 to T3 are positions in the liver K that surround the cancer C in the vicinity of the cancer C where the region does not overlap with the cancer C.

  For each of the target portions T1 to T3, three penetrators 20 are separately fired from the launchers 30 of the approach device 10 and individually punched. Thereby, the guide portion 24 is arranged so as to surround the cancer C. In this state, the insertion member 40 is inserted into the living body B, and then the optical fiber 44 is passed through the tube of the insertion member 40. Then, the tip of the optical fiber 44 is arranged on each of the target portions T1 to T3. Then, a laser is irradiated from each optical fiber 44 to the cancer C.

  In this way, by setting the target portions T1 to T3 so as to surround the cancer C and arranging the optical fibers 44 using the plurality of penetrators 20 for each of the target portions T1 to T3, the cancer C can be relatively large. Even if there is, cancer C can be incinerated with high accuracy from a close position.

  In the above example, three guide portions 24 are set, but two guide portions 24 may be set, or four or more guide portions 24 may be set.

  In addition, if a laser having a high directivity is used and a technique of cauterizing with a directivity is applied, a plurality of lasers can be arranged around the tumor without directly piercing the tumor ("cancer C" in the above example). It becomes possible to cauterize the tumor from around the tumor. Considering the properties of the cancer cells, the present embodiment can be suitably used because cancer cells may spread to a normal site by piercing the tumor itself.

  Further, in the above-mentioned use example, the optical fiber 44 is inserted using the insertion member 40, but a device for another use may be inserted. For example, the target portion T may be set in the region to be inspected, and a tissue sampling tool may be inserted. Furthermore, you may set the target part T in the place which performs drainage.

  In the above description, an example in which the target object 12 is a living body has been described. However, other target objects, for example, a product or a structure using a material such as resin, unvulcanized rubber, vulcanized rubber, and metal, It can also be used for observing the internal state of structures using concrete after hardening, and also plants (fruits, seeds, roots, leaves, etc.). For example, it can be used when a temperature sensor is arranged at a specific part in an uncured state and a temperature is measured for that part in the process of manufacturing a resin product. In this case, a specific portion for which temperature measurement is to be performed is defined as a target portion T. Then, the target portion T may be punched by the penetrator 20 and the temperature sensor may be moved to the target portion T along the guide portion 24.

In the present embodiment, the guide portion 24 is formed of a thread. However, the guide portion 24 may be formed of a long needle-like member integrally formed with the leading portion 22.
Further, in the present embodiment, the configuration in which the optical fiber 44 is inserted into the insertion member 40 has been described, but the present invention is not limited to this. Other fibrous devices or other surgical instruments may be inserted. Further, a substance having a medicinal effect which is any of a liquid, a gas, and a solid may be inserted.
In addition, the present invention is not limited to the case where any of liquid, gas, or solid is inserted into the insertion member 40, and the present invention is applicable to a case where any of liquid, gas, or solid is discharged through the insertion member 40. Approach device can be applied.

  The disclosure of Japanese Patent Application No. 2015-065094 filed on March 26, 2015 is incorporated herein by reference in its entirety.

10 Approach device 20 Penetrator (member to be fired)
22 Leading part 24 Guide part 30 Launcher 32 Launch path 38 First support member 39 Second support member 39A Receiving part 40 Insertion member T Target part

Claims (15)

A fired member having a leading portion formed at the tip and a long guide portion disposed behind the leading portion,
The leading portion fires the fired member such that it passes through the target portion inside the target object and penetrates from the outside of one surface of the target object to the outside of the other surface, and from the one surface of the target object. A launcher that bridges the guide portion to the other surface via a target portion,
An insertion member that is inserted into the target object along the guide portion,
With an approach device.   The approach device according to claim 1, further comprising: a receiving portion disposed on the other surface side of the target object and receiving a leading portion of the fired member.   The approach device according to claim 1, wherein the guide portion is formed in a thread shape.   The approach device according to any one of claims 1 to 3, wherein the launcher has a firing path arranged along a firing direction of the fired member. A first support member disposed outside the one surface of the target object and supporting a rear end side of the guide portion;
2. A second support member disposed outside the other surface of the target member opposite to the first support member and supporting a front end side of the guide portion, further comprising: a second support member. Item 5. The approach device according to any one of Items 4.   The approach device according to any one of claims 1 to 5, wherein the leading part has a maximum length of a cross section orthogonal to a traveling direction of 3 mm or less.   The approach device according to any one of claims 1 to 6, wherein the leading portion has a circular cross section orthogonal to a traveling direction.   The approach device according to any one of claims 1 to 7, wherein the guide portion has a wire diameter of 2 mm or less.   The approach device according to any one of claims 1 to 8, wherein the leading portion penetrates the target object in a linear trajectory.   The approach device according to any one of claims 1 to 8, wherein the insertion member has a long tubular shape.   The approach device according to claim 10, wherein the insertion member is inserted into the target object with the guide portion inserted therein.   The approach device according to any one of claims 1 to 11, wherein a fiber device is inserted into the insertion member.   The approach device according to any one of claims 1 to 11, wherein at least one of a liquid, a gas, and a solid is inserted or discharged through the insertion member.   The approach device according to any one of claims 1 to 11, wherein a surgical instrument is inserted into the insertion member.   The approach device according to any one of claims 1 to 14, wherein the insertion member is a catheter.

Images