JPH0219174A - Internal applicator for thermotherapy - Google Patents

Abstract

PURPOSE:To execute the expansion and thermotherapy of a narrow part with one applicator by providing an element for heating in the head part of a shaft body for inserting, simultaneously, forming an expanding part, and further, removably mounting a mantle around the shaft body for inserting. CONSTITUTION:An internal applicator 1 to mount a compartively hard mantle 18 is introduced into a body cavity. When an expanding part 4 located in the head of the applicator 1 attains to the narrow part, it is strongly pressed in, and the narrow part is expanded by using an tapered part 5. Next, a high frequency voltage is impressed between an internal electrode 11 and the external electrode of an external applicator, and the thermotherapy is executed by the heating with a high frequency.

Description

DETAILED DESCRIPTION OF THE INVENTION [Industrial Field of Application] The present invention relates to an in-body applicator for thermotherapy that heats and treats an affected area within a living body.

[Prior art] It is known that cells of malignant tumors such as cancer that form in living bodies are killed by heating them at a temperature around 43'C for about one hour and repeating this heating at regular intervals. ing. Additionally, devices for performing this thermal treatment have also been developed.

For this thermal treatment, high-frequency energy is applied between an internal applicator inserted into the body, especially a hollow organ, and an external applicator facing it, to dielectrically heat the affected area using high-frequency waves. The affected area of the living body is heated to a predetermined temperature. As intracorporeal applicators for this purpose, there are those having structures shown in Japanese Patent Publication No. 60-30226 and Japanese Patent Publication No. 62-48505. This is equipped with an electrode at the tip of a tube member that is inserted into the body, and the area around the electrode is covered with a balloon.
The balloon is designed to circulate cooling water, and a balloon made of a conductive material is provided at the tip of the tube member.
Some use the balloon itself as an electrode. In any case, the structure is such that the periphery of the shaft, which has a relatively small diameter, is covered with a balloon.

[Problems to be solved by the invention] However, the main target site for using the above-mentioned in-body applicator is a luminal organ such as the esophagus, but if cancer or the like occurs in such a luminal region, The luminal portion is often narrowed. In such a case, even if an attempt is made to introduce the above-described intracorporeal applicator, the insertion portion of the intracorporeal applicator is a flexible shaft-like body, so it is difficult to push it through the stenosis. Therefore, conventionally, prior to thermotherapy, the lumen is expanded using a dilator such as a bougie to, for example, an inner diameter of about 18 MII, and then the applicator is reinserted into the body.

Furthermore, depending on the degree of stenosis, it may not be possible to dilate it all at once, so bougies of several different diameters are used to gradually increase the diameter.

Therefore, it takes a long time just to expand the diameter, and when the heating time is included, the pain and burden on the patient becomes considerably large. Moreover, the burden on the operator is large.

The present invention has been made in view of the above-mentioned problems, and its purpose is to reduce the burden on patients and surgeons by making it possible to dilate a stenotic area and perform thermal treatment with a single applicator. It is an object of the present invention to provide an applicator for thermotherapy that can efficiently perform thermotherapy and relieve the pain of a patient during thermotherapy.

[Means and effects for solving the problems] In order to solve the above problems, the in-body applicator for thermotherapy of the present invention has a heating element connected to an electric cable at the distal end of a relatively flexible insertion shaft. In addition, an expanded portion is formed at the distal end of the insertion shaft, and a relatively hard mantle is removably attached around the insertion shaft.

This intracorporeal applicator for thermotherapy uses the expansion part at its tip to dilate the stenotic area, and has a relatively hard mantle around the insertion shaft to ensure insertion force and easily and quickly insert it into the body cavity. can be introduced into the stenosis to dilate the stenosis. After the stenosis is dilated, the relatively hard mantle attached around the insertion shaft can be easily removed, so that thermal treatment can be performed immediately thereafter. In other words, dilation of the stenotic site and thermal treatment can be performed with a single intracorporeal applicator, which reduces the burden on the patient and operator and allows efficient thermal treatment. Furthermore, it can relieve patient pain during hyperthermia treatment.

[Embodiment] FIGS. 1 to 6 show a first embodiment of the present invention. The thermotherapy device in this embodiment is constructed as shown in FIG. That is, it includes an intracorporeal applicator 1 and an extracorporeal applicator 2. The intracorporeal applicator 1 is constructed as shown in FIG. 3 in Figure 1
is a porous tube (so-called multi-lumen tube) as an insertion shaft that is relatively small in diameter and made of an elastic material.
This distal end portion has an expanded portion 4 having a relatively large diameter.

Further, the most distal end portion of the extended portion 4 is formed as a tapered portion 5 with a narrow tip. The expanded portion 4 is formed by forming a rear portion of the tapered portion 5 with a narrower diameter to form a narrower diameter shaft portion 6 and a step portion 7 following this. The shaft portion 6 is formed integrally with the porous tube 3, and each hole therein is a cooling liquid feeding passage 7, a cooling liquid drainage passage 8, a cable insertion passage 9, and a guide passage 10. They are each used as Further, a coil-shaped internal electrode 11 as a heating element is wound around the outer periphery of the shaft portion 6 . The in-body electrode 11 is connected to an energizing cable 12 inserted through the cable passage 9.

Further, in this expanded portion 4, a recess 13 formed around the shaft portion 6 between the tapered portion 5 and the stepped portion 7 is covered with a balloon 14 made of an elastic polymer or the like. The inflow lower a of the liquid feeding passage 7 and the discharge port 8a of the liquid drainage passage 8 are opened in this recess 13. Then, the inflow lower a is the recess 1
The discharge portion 8a of the liquid drainage passage 8 opens toward the proximal side of the recess 13. Thus, the cooling liquid is supplied from the inflow lower a through the liquid feeding passage 7, and is also discharged from the discharge port 8a through the liquid drainage passage 8. The liquid sending passage 7 and the liquid draining passage 8 are connected to a liquid sending tube 15 and a liquid draining tube 16, respectively, on the proximal side of the porous tube 3. Then, the recess 13 is filled and supplied with the cooling liquid from the external constant temperature circulation device 1-7 through these, and while the balloon 14 is expanded, the cooling liquid is returned to the constant temperature circulation device 17 and circulated. There are 7.

Further, in the intracorporeal applicator 1, a cylindrical jacket 18 made of a relatively hard elastic member and having approximately the same outer diameter as the step 7 is inserted into and removed from the outer periphery of the porous tube 3 on the proximal side of the step 7. It is attached freely. As shown in FIG. 2, this mantle 18 has two notches 19.19 formed on the left and right along its entire length along the axial direction, so that it can be torn along the entire length along these notches 19.19. It has become. However, the proximal end is the 12th
It has been partially torn beforehand as shown in the figure.
As a result, a pair of left and right holding portions 20°20 are formed.

On the other hand, the extracorporeal applicator 2 is provided with a balloon 24 having an extracorporeal electrode (not shown) therein. A cooling liquid cavity (not shown) is formed inside the balloon 24, and a liquid sending tube 25 and a liquid draining tube 26 are connected to this cooling liquid cavity. Further, a current supply cable 27 is connected to the extracorporeal electrode.

The liquid feeding tube 25 and the liquid draining tube 26 are connected to a constant temperature circulation device 17 described in "2".

Further, each of the energizing cables 12, 27 is detachably connected to an external high-frequency power supply device 28.

Next, the operation of the above thermotherapy device will be explained. First, as shown in FIG. 3, an intracorporeal applicator equipped with a mantle 18 is orally introduced into a body cavity, for example, into the esophagus 30. At this time, a guide wire (not shown) may be inserted and introduced into the guide passage 10 of the porous tube 3. When the expansion part 4 at the tip of the intracorporeal applicator 1 reaches the stenosis caused by the tumor 33, it is pushed in more forcefully and the tapered part 5 is used to expand the stenosis. Thereafter, using an X-ray observation device (not shown) or the like, as shown in FIG. 4, it is confirmed that the in-body electrode 11 is located at a portion of the affected tumor 33.

Then, while being careful not to change the position of the intracorporeal electrode 11, it is removed from the porous tube 3 by tearing it along the cuts 19, 19 while pulling the mantle 18 using the holding part 20, 20. On the other hand, the extracorporeal applicator 2 is joined to the outer surface of the living body so as to face the intracorporeal applicator 1 with the tumor 33 in between.

In this state, the constant temperature circulation device 17 is operated to supply cooling liquid to the balloon 14 to inflate it, and to circulate the cooling liquid using the liquid feeding tube 15 and the liquid drainage tube 16. Therefore, the cooling effect around the internal electrode 11 starts, and the expanded balloon 14 comes into close contact with the tumor 33. In the state shown in FIG. 5, the high frequency power supply device 28 is operated to apply a high frequency voltage between the internal electrode 11 and the external electrode of the external applicator 2. Thereby, the tumor 33 located between the intracorporeal applicator 1 and the extracorporeal applicator 2 is heated by the high frequency.

This allows thermotherapy to be performed.

As described above, the intracorporeal applicator 1 has the expanded portion 4 at its tip, but since it is inserted with the relatively hard mantle 18 attached, the overall diameter is relatively large and hard. . Therefore, the insertion force can be efficiently transmitted to the expanded portion 4 at the distal end, and the narrowed portion can be expanded easily and reliably.

Moreover, thermotherapy can be started immediately after dilating the stenotic region.

Therefore, no great pain or burden is placed on the patient or operator. Further, since the relatively hard outer mantle 18 is removed after dilating the stenosis, the insertion part of the intracorporeal applicator 1 is flexible and has a small diameter. Therefore, in particular, the portion passing through the patient's larynx can be made thinner, so that the patient's pain during the heat treatment can be reduced.

FIG. 7 shows a second embodiment of the invention. This embodiment is a porous tube 3 in an intracorporeal applicator 1.
It is made relatively thin over its entire length, and is fitted by fitting the mantle 18 without providing the stepped portion 7 in the first embodiment. Furthermore, in addition to the most tapered part 5, a second tapered part 41 is formed on the outer periphery of the leading end of the mantle 18 to form the expanded part 4. The rest of the configuration is the same as the first embodiment.

In this embodiment, when the catheter is inserted into the body cavity, the stenotic part is dilated mainly by the second tapered part 41 following the most advanced tapered part 5.

In the configuration of this embodiment, since there is no step 7, the porous tube 3 of the intracorporeal applicator 1 can be inserted from the rear end side of the mantle 18. Therefore, assembly of this intracorporeal applicator 1 becomes easy.

Further, since the tapered portions 5 and 41 can be made longer as a whole, the expansion of the narrowed portion by the expansion portion 4 becomes easier.

FIG. 8 shows a third embodiment of the present invention. This embodiment is similar to the cut 1 of the mantle 18 in the second embodiment.
9 is formed into a single spiral shape. In this way, the mantle 18 can be cut off into a tape and removed. This makes it easier to remove the mantle 18.

Note that the notch 19 in this third embodiment may be formed in a spiral shape with two or more threads. Further, the present invention is not limited to the above embodiments. For example, the present invention can be applied to an in-body applicator for thermotherapy that uses microwaves or a heating element such as a thermistor instead of using high frequency as a heating method.

[Effects of the Invention] As explained above, the in-body applicator for thermotherapy of the present invention has an expanding part at its tip which expands a stenotic part, and
Since a relatively hard mantle is attached around the insertion shaft, the insertion force when inserted into a body cavity can be reliably transmitted to the tip. Therefore, it can be easily and quickly introduced into a body cavity to dilate the stenosis. After dilating this stenosis, the relatively hard mantle attached around the insertion shaft can be easily removed, so after its placement,
Heat treatment can be performed immediately.

In other words, dilation of the stenotic site and thermal treatment can be performed with a single intracorporeal applicator, which reduces the burden on the patient and operator and allows efficient thermal treatment. Furthermore, it can relieve patient pain during hyperthermia treatment.

[Brief explanation of the drawing]

FIG. 11 is a side sectional view of an intracorporeal applicator showing the first embodiment of the present invention, FIG. 2 is a sectional view taken along line A-A in the first embodiment, and FIGS. FIG. 6 is an explanatory diagram of the procedure for using the intracorporeal applicator according to the embodiment
FIG. 7 is a side sectional view of an in-body applicator showing a second embodiment of the present invention, and FIG. 8 is a diagram showing an in-body applicator in a third embodiment of the present invention. FIG. 1... In-body applicator, 3... Porous tube 5
．． 4... Expansion part, 5... Taper part, 6... Shaft part,
11... In-body electrode, 12... Cable for energizing, 18
... Mantle, 19 ... Notch, 41 ... Second taper part. Figure 3 Figure 4 Applicant's representative Patent attorney Jun Tsuboi Figure 5 Figure G Figure

Claims (1)

[Claims] A relatively flexible insertion shaft, a heating element provided at the distal end of the insertion shaft, an electric cable for energizing this element, and an extension formed at the distal end of the insertion shaft. and a relatively hard mantle removably attached around the insertion shaft.