JPH04357945A - Living body freezing treating needle - Google Patents

Abstract

PURPOSE:To provide the living body freezing treating needle which can be directly punctured into the affected part of the bioorgans from the outside of the body without incising the abdomen, freezes only the tip part to be brought into contact with the affected part without freezing the peripheral wall surface of the pipe punctured into the body and does not cause the unnecessary wounding and internal bleeding of the normal biotissue at the time of needling and removing. CONSTITUTION:This living body freezing treating needle 1 has a metallic tip material 2 formed to a sharply pointed projecting shape having about <=3.5mm outside diameter and a metallic outside pipe 3 successively provided with this tip member 2 at about the same diameter and maintains the spacing between this outside pipe 3 and a conduit existing on the inner peripheral side thereof via a spacing maintaining member 5a which can make substantial point contact therewith without coming into continuous contact in the axial direction therewith.

Description

[Detailed description of the invention]

0001

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a therapeutic needle for freezing a living body, and more particularly to a therapeutic needle for freezing a living body that is inserted into the body without making a laparotomy to cause cryo-necrosis of an affected part of an internal organ.

0002

BACKGROUND OF THE INVENTION Conventionally, surgery for cancer of internal organs, such as liver cancer, liver tumor, and pancreatic cancer, has been performed through laparotomy and removal. Doctors who perform surgery are required to have the skill to deal with the risks of the surgery and the complications of complications such as visceral adhesions after surgery, and patients undergoing surgery are required to have the ability to withstand the long duration of the surgery. Open surgery is difficult in all respects, as it requires physical strength from the patient and also takes into account the concerns and considerations of the patient's family, relatives, and friends. On the other hand, it has become possible to clearly resolve images of affected parts of the body using ultrasound diagnostic equipment, making it easier to detect early cancers. This also limited the frequency of open surgery. In addition, although there is a treatment method in which the abdomen is opened and the affected area is directly viewed and frozen and necrotized using a cryotip using liquid nitrogen evaporation and adiabatic expansion, it requires a laparotomy first, and furthermore, only the tip of the cryotip is needed. However, the temperature is not low enough to cause frost to form on the connecting flexible pipe from the liquid nitrogen container to the frozen chip, and on the frozen chip holding tube.
Due to the ice that had adhered to the holding tube, it was impossible to insert the needle into the body.

For example, in the surgical pump disclosed in Japanese Utility Model Publication No. 52-40618, liquid nitrogen is injected into the tip of the outer tube through a refrigerating fluid jetting pipe disposed inside the outer tube, which can create a vacuum inside. The tube is guided into the space inside the tip cap fixed to the tube, and the tip cap is cooled by evaporation and adiabatic expansion, and the cooled tip cap is brought into contact with the affected area and frozen. This surgical procedure has been used with good results in surgeries for basal ganglia, intracerebral tumors, pituitary glands, intracavity sarcomas, etc.

0004

However, when the above-mentioned prior art is examined in detail, it is found that the gas cylinder has a vaporized refrigerant discharge pipe inserted into the gas cylinder end cap in the center of the outer tube, and A refrigerating fluid ejection pipe is disposed below the discharge pipe, and is supported by a plurality of support rings so that the positional relationship between these two pipes within the outer tube is stabilized. The outer peripheral wall of the support ring has a diameter that closely contacts the inner peripheral wall of the outer tube, and the support ring faces the outer tube. That is,
Even if the inside of the outer tube is maintained in a vacuum and convective heat transfer is blocked, in addition to the cold radiation reaching the outer tube from the vaporized refrigerant discharge pipe and the frozen fluid jet pipe, the cold heat of both pipes is transmitted through the plurality of support rings. There is a possibility that frost and ice may be formed on the outer circumferential wall of the outer tube at least at the portion where the support ring is in contact with the outer tube. Furthermore, the end face shape of the probe tip cap is a spherical surface with a radius equal to the diameter of the outer tube;
The only way to reach the affected area is to make an incision in the epithelium or biological tissue of the affected area of the patient, or to insert the probe tip cap to the affected area from a pre-opened area such as the oral cavity or oral cavity through the insertion tube.

In view of the shortcomings of the prior art, the present invention has been developed to allow direct insertion into the affected area of a living organ from outside the body without having to open the abdomen, and to contact the affected area without causing ice to form on the outer circumferential wall of the tube inserted into the body. The purpose of the present invention is to provide a therapeutic needle for freezing a living body, which freezes only the tip thereof, and which does not unnecessarily damage normal living tissue and cause internal bleeding during insertion and withdrawal.

[0006]

[Means for Solving the Problems] In order to achieve the above technical problem, the present invention provides a metal tip member formed in the shape of a sharp protrusion with an outer diameter of approximately 3.5 mm or less, and a metal tip member having a diameter substantially the same as that of the tip member. and a metal outer tube connected in series with each other, the outer tube and the conduit located on the inner circumferential side of the outer tube do not have continuous contact in the axial direction, but maintain a gap so that they can substantially make point contact. We propose a therapeutic needle for freezing living bodies, which is characterized by maintaining a gap through a member.

[0007] It is preferable that the sharp protrusion of the tip member forms a sharp body having an oblique cross section on the outer tube, and that the edge is finished so as to form a cutting edge. Furthermore, it is more preferable that the outer tube is a rigid tube.

[0008]

[Operation] According to this technical means, by setting the outer diameter of both the tip member and the outer tube to 3.5 mm or less, even if bleeding occurs when inserted into an internal organ, the amount of bleeding will be 100 cc.
The symptoms are below, and the condition does not cause so-called internal bleeding, but rather recovers through natural healing.

[0009] Furthermore, by maintaining a gap between the outer tube and the middle tube located on the inner circumferential side thereof by a gap holding member that can substantially make point contact, cold heat conducted from the middle tube to the outer tube can be reduced. It is possible to keep the amount to a minimum. Further, a means for maintaining a vacuum in the space between the inner tube and the outer tube is provided, and an inner tube through which a freezing agent such as liquid nitrogen is introduced is arranged on the inner peripheral side of the inner tube,
If a triple-pipe structure is used in which the ring path between the middle tube and the inner tube is used as a discharge loop for nitrogen vaporized in the tip member, cold radiation from the inner tube to the outer tube is blocked by the middle tube, Also,
Convective heat transfer from the inner tube to the middle tube is relaxed by the vaporized nitrogen, and convective heat transfer from the middle tube to the outer tube is blocked by the vacuum space. Therefore, if the inner tube is extended to the distal end member, only the distal end member that comes into contact with the affected part of the body organ will be cooled by the freezing agent, and the outer circumferential wall of the outer tube in the middle will not be frozen, allowing normal living tissue to be preserved. It does not freeze and adhere to the outer wall of the outer tube.

[0010] Furthermore, since the sharp protrusion of the tip member constitutes a sharp body with an oblique cross section on the outer tube, and the edge is finished to form a cutting edge, it is possible to avoid freezing on the outer peripheral wall surface of the outer tube. By tilting it up, it becomes possible to easily insert it into the affected part of the body's internal organs. Furthermore, if the outer tube is a rigid tube, it can be inserted deep and accurately into the body without having to open the abdomen.

[0011]

DESCRIPTION OF THE PREFERRED EMBODIMENTS Preferred embodiments of the present invention will be described in detail below by way of example with reference to the drawings. However, unless otherwise specified, the dimensions, materials, shapes, and relative positions of the components described in this example are not intended to limit the scope of this invention, but are merely illustrative. Just an example.

1 to 4 show a therapeutic needle for freezing a living body according to an embodiment of the present invention, FIG. 1 is a front cutaway sectional view showing the overall configuration including related members, and FIG. 2 shows a needle for freezing a living body according to an embodiment of the present invention. FIG. 3 is a front sectional view of the tip of the needle, FIG. 3 is a front view showing a portion of the duct in the middle thereof, and FIG. 4 is a side view thereof. Reference numeral 1 designates a treatment needle for freezing living organisms, which consists of a concentric triple-tube needle body 1a consisting of an inner tube 3, a middle tube 4, and an outer tube 5, and a tip member 2 sealed to the tip of the needle body 1a.

[0013] At the tip of the needle body 1a, the tip of the middle tube 4 is expanded in diameter toward the inner wall of the outer tube 5 in a figure-eight shape and sealed by welding, and the joint part is fitted into the rear part of the tip member 2. The distal end nozzle portion 3a of the inner tube 3 is sealed and extends into a conical cavity 2a provided inside the rear end of the distal end member 2. The tip of the tip member 2 is cut obliquely with respect to the center of the outer tube, and the oval outer edge on the tip side is further polished to provide a cutting edge 2b, and the tip member 2 has approximately the same diameter as the outer diameter of the needle body 1a. Together with the needle body 1a, it is formed so that it can be inserted into the body without opening the abdomen. In addition, a fiber thread made of resin such as polyethylene or polyester is spirally wound around the outer periphery of the inner tube 4, and a gap maintaining member 5 is formed between the inner tube 4 and the outer tube 5.
The annular space 15 between the inner tube 4 and the outer tube 5 communicates with a large-diameter tube vacuum space 16, which will be described later, via a retaining ring 12A to provide vacuum suction.

A tapered part 6a is formed at the distal end of the large diameter tube 6, and a joint part 6b is formed at the rear end, and the outer tube 5 of the needle body 1a is inserted into the distal end of the tapered part 6a and sealed by welding. It has been stopped. The annular annular space 15 formed between the outer tube 5 and the middle tube 4 is the large diameter tube vacuum space 1 in the large diameter tube body 6.
6, and the large-diameter tube vacuum space 16 communicates with a vacuum exhaust pipe 8 and a vacuum flexible joint 7 provided at the rear of the large-diameter tube body 6 for vacuum suction. In addition, the middle pipe 4 has a retaining ring 12A.
The return gas ring passage 17 formed in the gap between the inner wall of the middle pipe 4 and the outer wall of the inner pipe 3 is held by the exhaust pipe 10 at the rear of the large diameter pipe 6 and sealed by welding. It opens into the exhaust pipe 10 and further communicates with the exhaust pipe 9. In addition, the inner tube 3 that has passed through the exhaust pipe 10 is held by a retaining ring 12B provided at the joint portion 6b, and is guided to a flexible pipe 11 having an inner diameter larger than that of the inner tube 3, and reaches the cryopot 18. . On the outer wall of the inner tube 3 that passes through the exhaust pipe 10 and reaches the cryopot 18, a tape-shaped heat insulating cloth 1 made of laminated aluminum foil and nylon threaded woven cloth is provided.
3 is wound. Furthermore, activated carbon 14 is contained in the large diameter tube vacuum space 16.

[0015] As described above, the therapeutic needle 1 for freezing a living body and the large diameter tube body 6
, and the flexible pipe 11 are configured,
An annular space 15 formed between the outer tube 5 and the middle tube 4, a large diameter tube vacuum space 16 formed between the large diameter tube body 6 and the middle tube 4, and an annular space between the flexible pipe 11 and the inner tube 3. 11b are in communication with each other, and if a vacuum pump (not shown) is connected to the vacuum universal joint 7 and the three spaces are suctioned through the vacuum exhaust pipe 8 and the vacuum flexible joint 7, the three spaces will have a vacuum degree of 10- A vacuum of 6 to 10-7 torr can be created. Compared to the annular space 15, the volumes of the remaining two spaces are formed to be extremely large, so that even if there is some vacuum leakage, the degree of vacuum will not drop easily, and the activity inside the large diameter tubular body 6 will be reduced. By adsorbing carbon-14 molecules, this degree of vacuum can be maintained for a long period of time.

Next, each tube of the concentric triple tube forming the needle body 1a will be explained in order.The inner tube 3 is a stainless steel thin tube with an outer diameter and an inner diameter of approximately 1.0 mm and 0.8 mm, respectively. The tip nozzle portion 3a extends into a conical cavity 2a provided inside the rear end of the tip member 2, and the liquid nitrogen 31 flowing inside the inner tube 3 is ejected from the nozzle portion 3a to the tip member 2. It is configured to collide with the inner wall surface and vaporize. The inner diameter of the middle pipe 4 is approximately 1.8 mm and 1.4 m, respectively.
The vaporized nitrogen is refluxed through a return gas ring 17 formed in the gap between the inner tube 3 and the middle tube 4 through a stainless steel thin tube of m. The outer tube 5 has an outer diameter and an inner diameter of approximately 3.0 mm and 2
．． The annular space 15 formed in the gap between the inner tube 3 and the outer tube 5 is communicated with a large diameter tube vacuum space 16 of the large diameter tube body 6, which is a 4 mm rigid stainless steel tube. Further, the length of the concentric triple tube is about 200 mm, and it is configured to be inserted into the body together with the tip member 2. The large diameter tube 6 is a stainless steel tube with an outer diameter of about 25 mm and a length of about 200 mm.

According to this therapeutic needle, when the exhaust pipe 9 is suctioned and depressurized by the exhaust pump 23, the liquid nitrogen 31 is introduced through the inner tube 3, and the liquid nitrogen 31 is discharged through the nozzle portion 3a.
is injected into the conical space 2a on the inner surface of the tip member 2, collides with the tip member 2 while expanding, and after the heat of evaporation acts as freezing heat, the heat-absorbing and vaporized gas reverses and hits the outer wall of the inner tube 3. It passes through the return gas ring path 17 in the inner gap of the middle pipe 4 and is discharged as return nitrogen gas 32 to the exhaust pipe 9 and the flexible exhaust pipe 2.
5 and is exhausted by the exhaust pump 23. At this time, since the liquid or gas flows through the return gas ring path 17 under a positive pressure state, there is no need to provide a holding member, and rather the presence of a holding member is not preferable because it creates resistance. Further, even if the inner tube 3 and the middle tube 4 come into contact with each other, the influence of heat loss is small because they are at low temperatures.

Since this point is already known, a detailed explanation of its structure will be omitted, and the resin yarn gap holding member 5a, which is the main part of the present invention, will be explained. As shown in FIG. 3, resin threads having a diameter a approximately 1/2 A are wound around the middle tube 4 in opposite directions or at different winding pitches so as to cross each other. The point where the two threads overlap at the intersection 5b is configured to serve as a holding fulcrum. That is, since the diameter a of the pair of gap holding members 5a is approximately 1/2A, FIG.
As shown in FIG. 4, the two pipes are not thermally connected to each other over the entire length of the annular space 15 other than the intersection 5b;
Point b serves as a support point that holds the middle tube 4 and the outer tube 5 concentrically.

FIG. 5 is a perspective view showing the configuration of a cryo-needle treatment apparatus including the treatment needle for freezing a living body according to an embodiment of the present invention, in which 18 is a cryopot which is a thermos flask filled with liquid nitrogen 31; 24 is a switch for operating the exhaust pump 23; 22 is a switch for operating the cryopot 18, the exhaust pump 23, and the switch 24; 24 is a switch for operating the exhaust pump 23; This is a wagon car equipped with the vehicle.

Flexible pipe 11 containing inner pipe 3
The distal end portion is the joint portion 6b on the rear end side of the large diameter tube body 6.
The rear end side of the flexible pipe 11 is welded to the outer diameter of the tip of the liquid feed pipe 19, and the flexible pipe 1
The inside of the annular space 11b formed between the inner tube 1 and the inner tube 3 is airtightly sealed and fixed while communicating with the large diameter tube vacuum space 16. The inner pipe 3 is connected to a liquid feed pipe 19 whose outer peripheral wall surface is insulated with a heat insulating material, and the liquid feed pipe 19 is connected to a siphon (not shown) that reaches approximately the bottom of the cryopot 18 via a universal joint 21. The liquid nitrogen 31 connected and filled in the cryopot 18 is configured to be supplied to the treatment needle 1 for freezing a living body.

The exhaust pump 23 is connected to the exhaust pipe 9 of the treatment needle 1 for freezing living organisms via a flexible exhaust pipe 25.

6 and 7 show a treatment method performed using a treatment needle for freezing living bodies according to an embodiment of the present invention, FIG. 6 is a front view showing the concept of the treatment method, and FIG. 7 is a CR used for treatment.
It is a front view of a T screen. 1 is the treatment needle for freezing a living body;
The ultrasonic sensor 41 inserted into the human body 44 via the holding/guide fitting 42 and held by the holding/guiding fitting 42 and placed in contact with the human body 44 emits a transmission wave 47 to the affected part 45 of the human body 44. Then, reflected waves 48 from human organs including the affected part 45 are received. 50 is a CRT screen;
The screen is configured to display a baseline image 51 of ultrasonic transmission and reception, an image 52 of the treatment needle, and an image 55 of the affected area.

To explain the operation of the cryo-needling treatment apparatus configured as described above, the treatment needle 1 for freezing a living body is inserted into the human body 44 while observing the baseline image 51 and the image 55 of the affected area on the CRT screen 50. Insert it toward the affected area 45. Since the image 52 of the therapeutic needle 1 is also displayed on the CRT screen 50, the holding/guide fitting 42 is operated until the baseline image 51 and the image 52 of the therapeutic needle match up to a matching point 53. Next, when the switch 24 is operated to drive the exhaust pump 23, the flexible exhaust pipe 25, exhaust pipes 9, 10
, and the gas in the return gas loop 17 is sucked in and exhausted,
The pressure within the conical cavity 2a of the tip member 2 becomes negative pressure. Therefore, the liquid nitrogen 31 in the cryopot 18 is
9, flows through the inner tube 3, is ejected in the form of a spray from the nozzle portion 3a, collides with the inner wall surface of the tip member 2 and vaporizes, and the sharp portion 2
is cooled to -130 degrees after approximately 1 minute, and an ice ball 46 is formed on the outer periphery of the sharpened portion 2, and the ice ball has a diameter of approximately 10 to 15 mm after approximately 1 minute, and approximately 10 to 15 mm in diameter after approximately 10 minutes. Grows to 20-30mm.

Ice ball image 5 on CRT screen 50
6 and when the desired size of the ice ball 46 is reached, operate the switch 24 to turn off the exhaust pump 23.
interrupts driving. The supply of liquid nitrogen 31 is stopped, the ice ball 46 formed on the tip member 2 is thawed by the body fluid, and the treatment needle 1 can be removed from the affected area 45. The treatment needle 1 is reinserted as necessary, and the above operation is repeated until the remaining living tissue in the affected area 45 is frozen and necrotized.

Furthermore, since the outer diameter of the tip member 2 and the needle body 1a is as small as about 3 mm, they can self-recover even if bleeding occurs.Moreover, since the needle body 1a is insulated by the annular space 15, the sharp point 2 When the treatment needle 1 for living body freezing is inserted and removed, organs on the way to the affected organ will not be damaged by freezing.

Note that the liquid nitrogen 31 flowing into the inner tube 3 is blocked from radiant heat radiation by the heat insulating cloth 13 and from convective heat radiation by the annular space 11b maintained in vacuum inside the flexible pipe 11. In the living body freezing treatment needle 1, a return gas ring path 1 is formed between the inner wall of the middle tube 4 and the inner wall of the inner tube 4.
7 is protected by low-temperature gaseous nitrogen refluxing, and the needle body 1
Inside a, it is insulated by the vacuum of the annular space 15 formed between the outer tube 5 and the inner tube 4, so the cold heat is dissipated to the outside air and no excess evaporation occurs. Nitrogen 31 can be supplied to the tip nozzle portion 3a without heat loss.

Furthermore, since the freezing needle device is entirely mounted on the wagon 22, the device can be placed close to the patient during treatment, and moreover, the freezing needle device can be placed close to the patient during treatment. The devices installed on the wagon 22 include a flexible pipe 11 and a flexible exhaust pipe 25.
Since the needles 1 and 2 are connected with each other, the treatment needle 1 for freezing a living body can be easily operated.

Conventionally, medical treatment has been performed while monitoring images of cell collection probes and injection needles using an ultrasonic diagnostic device, but the treatment method of the present application uses the therapeutic needle for freezing living bodies in combination with an ultrasonic diagnostic device. Not yet established. However, since the growth process of the ice ball can be clearly seen on ultrasound echo images, it has become possible to treat it without having to open the abdomen.

FIG. 8 is a front view showing a biological tissue freezing device according to another embodiment of the present invention. Reference numeral 1 denotes a treatment needle for freezing a biological body, which is welded and sealed to a large diameter tube body 6. As shown in FIG. The inside of the large-diameter tubular body 6 is connected to an ultra-vacuum pump (not shown) via a vacuum flexible joint and sucked therein, and is maintained in a vacuum. The exhaust nitrogen gas 32 vaporized by the treatment needle 1 is exhausted through the exhaust pipe 9 and the flexible exhaust pipe 25 by an exhaust pump (not shown). The therapeutic needle 1 is connected to the cryopot 18 via a joint nut 61 and an insulated straight pipe 62 provided at the rear end of the large diameter tube 6.

[0030] The biological tissue freezing device configured as described above has the following features:
When the lever 63 is pressed down to drive the exhaust pump and discharge the exhaust nitrogen gas 32, the liquid nitrogen 31 in the cryopot 18 is introduced into the tip of the treatment needle 1. In particular, the biological tissue freezing device can freeze and insert intracerebral tumors, pituitary glands, and other brain tissues, since the therapeutic needle 1 can be inserted through the skull.
It is applied in brain surgery to cause necrosis.

[0031]

[Effects of the Invention] As described above, according to the present invention, a vacuum space is formed on the inside of the outer tube through the gap retaining material that is substantially in point contact with the outer tube, and the outer tube is configured to be thermally insulated from the inside. In vivo freezing, which can be inserted directly into the affected part of a living organ from outside the human body without having to open the abdomen, and which freezes only the tip that contacts the affected part without freezing the outer peripheral wall of the outer tube inserted into the body. This makes it possible to provide medical treatment needles for patients. Also,
The outer diameter is made small, a cutting edge is provided on the sharp protrusion at the tip, and the inner side of the outer tube is thermally insulated to prevent ice from forming on the outer wall surface of the outer tube, so there is no need to open the abdomen. It is possible to provide a therapeutic needle for freezing a living body that does not unnecessarily damage normal living tissue and does not substantially cause internal bleeding when inserted and withdrawn. Furthermore, since the outer tube and the middle tube are formed into concentric double tubes, and the gap between the two tubes is maintained through a gap support member, and the outer tube is made into a rigid tube, there is no need to open the abdomen. It becomes possible to provide a therapeutic needle for freezing living organisms that can penetrate deep into the body. It has various effects such as

[Brief explanation of the drawing]

FIG. 1 is a front cross-sectional view showing the internal structure of a treatment needle for freezing a living body according to an embodiment of the present invention.

FIG. 2 is a front sectional view showing the main structure of the treatment needle for freezing living bodies according to the embodiment of the present invention.

FIG. 3 is a front view showing a portion of the midway pipe line of the treatment needle for freezing a living body according to the embodiment of the present invention;

FIG. 4 is a side view of FIG. 3;

FIG. 5 is a perspective view showing the configuration of a freezing needle treatment device including the treatment needle for freezing a living body according to an embodiment of the present invention.

FIG. 6 is a front view showing the concept of a treatment method performed using a treatment needle for freezing living organisms according to an embodiment of the present invention.

FIG. 7 is a front view of a CRT screen used for treatment using a treatment needle for freezing a living body according to an embodiment of the present invention.

FIG. 8 is a front view showing a biological tissue freezing device according to another embodiment of the present invention.

[Explanation of symbols]

1 Treatment needle for freezing living organisms 2 Tip member 2a Cutting blade part 3 Outer tube 4 Middle pipe 5a Gap retaining member

Claims (1)

[Claims] 1. A metal tip member formed in the shape of a sharp protrusion with an outer diameter of approximately 3.5 mm or less, and a metal outer tube connected with the tip member and having approximately the same diameter, the outer tube and the conduit located on the inner circumference side without continuous contact in the axial direction,
A therapeutic needle for freezing a living body, characterized in that a gap is maintained through a gap holding member that can be contacted by substantially point contact. [Claim 2]
The therapeutic needle for freezing a living body according to claim 1, wherein the sharp protrusion of the tip member constitutes a sharp body having an oblique cross section on the outer tube, and the edge is finished so as to form a cutting edge. The therapeutic needle for freezing a living body according to claim 1, wherein the outer tube is a rigid tube.