JPH067833B2 - Shock wave therapy device - Google Patents

Description

Description: [Object of the Invention] (Field of Industrial Application) The present invention relates to a shock wave treatment apparatus for crushing and treating, for example, kidney stones and gallstones in a living body with shock waves.

(Prior Art) There are roughly three types of shock wave treatment devices,
The apparatus shown in FIG. 4 is of a type in which a water tank 2 is provided below the bed 1 and a shock wave oscillator 3 is provided at the bottom of the water tank 2. In such a device, the patient 4 who is a living body is in the bed 1
The patient 4 and the water in the water tank 2 are prevented from contacting each other in a state of being laid on the upper side so that an air layer is not formed between the patient 4 and the shock wave oscillator 3. The reason why the air layer is eliminated is that the shock wave is attenuated by passing through the air layer. Further, such a device is provided with a probe 5 of an ultrasonic diagnostic device, and the probe 5 is brought into contact with the patient 4 through the water tank 2.
By this contact, the probe 5 ultrasonically scans the treatment target of the patient 4, for example, the kidney stone portion, and sends the diagnosis result to the display processing device 6, whereby the display processing device 6 displays the image of the treatment target portion. It is converted and projected. However, the doctor who is the operator adjusts the focus position of the shock wave oscillating unit 3 while looking at the image of the treatment target displayed on the display processing device 6 and positions it on the kidney stone 7 that is the treatment target as shown in FIG. . Then, when the focal position of the shock wave oscillator 3 is positioned on the kidney stone 7, the shock wave 8 is emitted from the shock wave oscillator 3 and the kidney stone 7 is crushed.

Next, the device shown in FIG. 6 is of another type, and is configured to move the shock wave oscillator 10 along the C-arm 11 in the direction of arrow (a). Here, the shock wave oscillator 10
Is provided with a water bag 12 made of rubber in the front, and a shock wave oscillator is provided inside the water bag 12. Therefore, by contacting the water bag 12 with the patient, an air layer is not formed between the patient and the shock wave oscillator. In addition, 13 is a bet. In such an apparatus, the probe is brought into contact with the patient and the treatment target is displayed on a display processing apparatus (not shown) as in the above apparatus. When the treatment target is found, the position of the shock wave oscillation unit 10 is adjusted so that the shock wave emitted from the shock wave oscillation unit 10 is applied to the position of the treatment target. In this case, the shock wave oscillator 10 is moved along the C-arm 11 so that the shock wave is not irradiated to the ribs other than the treatment target, and the irradiation direction is adjusted. However, after this adjustment, a shock wave is radiated from the shock wave oscillating section 10 and the treatment target is crushed.

Further, the device shown in FIG. 7 is of another type, and the focus positioning mechanism 20 is provided with a shock wave oscillator 21 having a shock wave oscillator and a probe inside a water bag. The shock wave oscillating unit 21 rotates about axes perpendicular to each other as shown by arrows (b) and (c), and moves in the XYZ axis directions by the focus positioning mechanism 20. Reference numeral 22 is a treatment table. Therefore, the shock wave oscillating unit 21 is brought into contact with the patient 4 in a state where the patient 4 lies on the treatment table 22, and in this state, the position of the treatment target is detected by the probe and the focal position of the shock wave is positioned. After that, a shock wave is radiated from the shock wave oscillating unit 10 and the treatment target is crushed.

However, the above-mentioned types of devices have the following problems. First, in the type shown in FIG. 4, since the water tank 2 and the shock wave oscillator 3 are provided in the bed 1 itself, the apparatus becomes large and dedicated to shock wave treatment. For this reason,
If this device is installed in the clinic, the efficiency of use of the clinic will be reduced.

Next, in the type shown in FIG. 6, although the device can be downsized, since the shock wave oscillator 10 is moved by the C arm 11,
When the irradiation direction of the shock wave is changed after the focal position of the shock wave is adjusted to the treatment target, the focal position of the shock wave may deviate from the treatment target because the position of the treatment target varies depending on the individual difference of the patient.

Further, in the type shown in FIG. 7, as in the case of the above type, when the irradiation position of the shock wave 21a is changed after the focus position P of the shock wave 21a is adjusted to the treatment target 7 as shown in FIG. 8, the focus position Q of the shock wave 21a is changed. As shown in FIG.
It may deviate. When the focus position P of the shock wave 21a is deviated in this way, the treatment target 7 may be removed from the detection area of the probe and the treatment target 7 may be lost because the probe is provided inside the water bag. However, since the position of the treatment target 7 is different depending on the individual difference of the patient,
It is very difficult to change the irradiation direction of the shock wave oscillator 10 according to this difference in position.

(Problems to be Solved by the Invention) As described above, there are three types of shock wave treatment devices, but the device itself is large, or the irradiation direction of the shock wave is changed after the focus position of the shock wave is adjusted to the treatment target. In this case, the focus position of the shock wave may deviate from the treatment target, and the treatment target may be lost.

Therefore, the present invention, even if the irradiation direction of the shock wave is changed after the focal position of the shock wave oscillating unit is adjusted to the treatment target without being affected by the difference in the position of the treatment target due to individual differences in the living body, the focal position is not treated. It is an object of the present invention to provide a shock wave treatment device that can be easily positioned without moving.

[Structure of the Invention] (Means for Solving the Problems) The present invention relates to an XY moving mechanism that moves in the XY directions, and the X-direction moving mechanism.
A Z-direction moving mechanism provided in the Y-moving mechanism, a first turning mechanism provided in a terminal end portion of the Z-direction moving mechanism and turning in a first direction, and provided in the first turning mechanism. Being first
A second rotation mechanism that rotates in a second direction that intersects with the direction, and a shock wave oscillator provided in the second rotation mechanism,
Driving the XY moving mechanism, the Y direction moving mechanism, the first rotating mechanism and the second rotating mechanism changes the irradiation direction of the shock wave without shifting the focus position of the shock wave oscillated from the shock wave oscillating unit from the treatment target. And a control processing unit for controlling the shock wave treatment apparatus.

(Operation) By providing such means, the shock wave oscillating unit
The XY moving mechanism and the Z direction moving mechanism move in the XY direction and the Z direction, and the first and second rotating mechanisms rotate in the first direction and the second direction. Then, in this case, the shock wave oscillating unit changes the irradiation direction of the shock wave without shifting the focal position of the shock wave oscillated by the control processing means from the treatment target.

(Example) Hereinafter, a first example of the present invention will be described with reference to the drawings.

FIG. 1 is a block diagram of a shock wave treatment device. In the figure, reference numeral 30 denotes an XY moving mechanism, and a Z direction moving mechanism 31 is provided on the XY moving mechanism 30. The Z-direction moving mechanism 31 is composed of a Z-direction column 32 installed on the XY moving mechanism 30 and a moving body 33 slidably provided on the Z-direction column 32. This mobile 3
3, a first arm 34 as a first rotating mechanism is provided rotatably in the α direction which is the first direction, and the other end of the first arm 34 has an L-shaped second arm. 35 are provided. The second arm 35 is provided with a second rotating mechanism, and the shock wave oscillating unit 36 is provided through the second rotating mechanism. Although the second rotating mechanism is not shown because it is hidden by the second arm 35, the second rotating mechanism rotates in the α direction which is the second direction orthogonal to the β direction. ing.

As shown in FIG. 2, the shock wave oscillating unit 36 has a structure in which a probe 37 of an ultrasonic diagnostic apparatus is built in. That is, the shock wave oscillator 3 is provided on one opening side of the bellows 38.
9 is provided and a rubber water bag 4 is provided on the other opening side.
0 is provided, these bellows 38, shock wave oscillator 39
Water 41 is enclosed in a closed chamber formed by the water bag 40. Then, the probe 37 is inserted into the closed chamber.

On the other hand, 42 is a control processing device, and the control processing device 42 includes the XY moving mechanism 30, the moving body 33, and the first arm 34.
And a function of sending a movement control signal to the second rotation mechanism to change the irradiation direction of the shock wave without shifting the focal position P of the shock wave oscillated from the shock wave oscillating unit 36 from the treatment target, and the probe. It has a function of receiving a detection signal from 37 and visualizing it on the display 43. Reference numeral 44 is an operation board.

Here, the respective movement amounts in the XYZ directions when the irradiation direction of the shock wave is changed without changing the focal position P of the shock wave oscillator 36 will be described. Such a device is composed of a total of five axes of freedom including linear motion degrees of freedom X, Y and Z and rotational degrees of freedom α and β. Therefore, the focus position P of the shock wave oscillating unit 36 can be obtained by solving a coordinate conversion matrix with the degrees of freedom X, Y, Z of linear motion and the degrees of freedom α, β of rotation, and the focus position P is XYZ.
When expressed by (Px, Py, Pz) using coordinates, it is expressed by the following equation.

Zf represents the distance from the center of rotation of the α axis to the focal position.

Here, the focus position in the state where the focus position P is adjusted to the treatment target by driving the axis of each degree of freedom is (P _x1 , P _y1 , P _z1 ) and the respective rotation directions are α ₁ and β _1, and this state If the focal position in the state where the irradiation direction of the shock wave is changed by rotating each axis from ( ₂ ) to (P _x2 , P _y2 , P _z2 ) and the respective rotation directions are α ₂ and β ₂ , the shock wave of the treatment target is centered. Changing the irradiation direction means that the focus position does not change even if each axis is driven, And the relationship of α ₁ ≠ α ₂ β ₁ ≠ β ₂ is established. Therefore, the movement amounts ΔX, ΔY, and ΔZ are obtained from this relationship and the equation (1).

ΔX = Zf (sinβ2cosα2-sinβ1cosα1) (2) ΔY = -Zf (sinα2-sinα1) (3) ΔZ = Zf (cosβ2cosα2-cosβ1cosα1) (4) These movement amounts ΔX, ΔY and ΔZ are ΔX = P _x2 −P _x1 ΔY = P _y2 −P _y1 ΔZ = P _z2 −P _z1 . Therefore, the control processing device 42 calculates and obtains the movement amounts ΔX, ΔY, and ΔZ from the equations (2) to (4), and according to the movement amounts ΔX, ΔY, and ΔZ, the XY mechanism 33, the moving body 33, Each movement control signal is sent to each of the first arm 34 and the second rotation mechanism. Although not shown, a diagnostic bed is arranged below the shock wave oscillator 36.

Next, the operation of the apparatus configured as described above will be described.

When the patient lies on the examination bed, the control processing device 42 sends a movement control signal to the Z movement mechanism 31 to lower the shock wave oscillating unit 36 to bring it into contact with the patient. When the shock wave oscillating unit 36 contacts the patient, the probe 37 is operated to receive the detection signal. The control processing device 42 receives the detection signal, performs an imaging process, and displays the image on the display 43. Further, in this state, the control processing device 42 sends a movement control signal to the XY moving mechanism 30 and the Z direction moving mechanism 31, respectively, to move the position of the shock wave oscillator 36 in the XYZ directions, and at this time, the detection signal from the probe 37. In response to the image processing, the image is displayed on the display 4
Project to 3. In this way, when the treatment target, for example, a kidney stone is displayed on the display 43, the focus position P of the shock wave oscillating unit 36 is adjusted to the position of the kidney stone. In this case, the directions α and β of the shock wave oscillating unit 36 are adjusted so that the shock wave emitted from the shock wave oscillating unit 36 does not affect the ribs other than the renal stone.

For example, as shown in FIG. 3, when the shock wave oscillating unit 36 shifts from the A posture in which the shock wave is emitted at the angle of α ₁ to the B posture in which the shock wave is emitted at the angle of α ₂ , the control processing device 42 sets the XY direction.
The movement control signals for the movement amounts ΔX and ΔY are sent to the movement mechanism 30, the movement control signals for the movement amount ΔZ are sent to the Z-direction movement mechanism 31, and Δα = α ₂ −α _{1 for} the _second rotation mechanism. Send a movement control signal. This allows the XY moving mechanism 3
0 moves the shock wave oscillator 36 in the XY directions, the Z-direction moving mechanism 31 moves the shock wave oscillator 36 in the Z direction, and the second rotating mechanism rotates the shock wave oscillator 36 in the α direction. The β direction is controlled similarly. As a result, the focal position P of the shock wave oscillating unit 32 does not shift from the treatment target, and the irradiation direction of the shock wave changes to a direction that does not affect the ribs or the like. The movement of the shock wave oscillator 32 does not cause the field of view of the probe 37 to deviate from the treatment target, and the probe 37 detects the treatment target during movement. After this,
The shock wave is emitted from the shock wave oscillating unit 32 to the treatment target, and the kidney stone of the treatment target is broken.

Thus, in the first embodiment, the XY moving mechanism 3
The shock wave oscillating section 36 is moved to the X and
The irradiation direction is changed without moving the focal point position P of the shock wave from the treatment target by moving in the Y direction and the Z direction, and rotating in the α and β directions by the first and second rotating mechanisms 34. Therefore, even if the shock wave oscillating unit 36 is moved to change the irradiation angle of the shock wave, the position of the shock wave oscillating unit 36 can be changed without shifting the focus position P of the shock wave from the treatment target. Therefore, even if the patient's body type is obese or lean and the position of the treatment target varies depending on the body type, the shock wave oscillating unit 36 can be reliably operated from a direction that does not affect the ribs or the like.
The focus position P of can be adjusted to the treatment target. or,
The movement of the shock wave oscillating unit 36 depends on the respective movement amounts ΔX, ΔY and ΔZ.
Therefore, the arithmetic processing is simple and can be performed at high speed. Then, the XY moving mechanism 30 and the Z direction moving machine 31
It can be made compact with a simple structure.

Next, a second embodiment of the present invention will be described.

In this embodiment, a case of controlling by a simple proportional calculation will be described. The shock wave oscillating unit 36 is moved by a very small amount. When the shock wave oscillating unit 36 moves by a small amount in the vicinity of a certain posture (α ₁ , β ₁ , Z ₁ ), that is, the shock wave oscillating unit 3
When 6 moves within the range represented by sin Δα = Δα, sin Δβ = Δβ cos Δα = 1, cos Δβ = 1, the above equations (2) to (2)
(4) to approximate the equation, ΔX = Z1 · Δβ · cosβ 1 cosα 1 -Z1 · Δα · sinα 1 sinβ 1 ... (5) ΔY = -Z1 · Δα · cosα 1 ... (6) ΔZ = Z1 · Δβ · sin β ₁ cos α ₁ −Z ₁ · Δα · sin α ₁ cos β ₁ (7) These expressions show that the relationship between ΔX, ΔY, ΔZ, Δα, and Δβ can be linearized if the value determined by a certain posture is considered as a proportional constant. However, if the proportional constants are A, B, C, D, and E, the above equations (5) to (7) are as follows.

ΔX = A · Δβ−B · Δα (8) ΔY = C · Δα (9) ΔZ = D · Δβ−E · Δα (10) As a result, the respective movement amounts ΔX, ΔY, and ΔZ are (8) ) Expression-No.
The amount of movement Δ
Each movement control signal corresponding to X, ΔY, ΔZ is X, Y, Z,
It is sent to the α and β axes.

As described above, in the second embodiment, since the control processing device 42 has a function of controlling by a simple proportional calculation by approximation of a trigonometric function, when the shock wave oscillating unit 36 moves a minute amount, each movement is performed by a simple process. The movement control signals can be sent by calculating the quantities ΔX, ΔY, ΔZ.

The present invention is not limited to the above-mentioned embodiments, and may be modified without departing from the spirit of the invention. For example L
The character arm 35 may be replaced with a curved arm. Furthermore, although ultrasonic waves are used as shock waves, the shock waves are not limited to this. There is also a method of using one joystick (two-axis type) as an operation for moving the shock wave oscillator 36. In this method, two movement amounts of Δα and Δβ are input to the control processing device 42 by the joystick, and in the control processing device 44, from the respective movement amounts of Δα and Δβ, the above equations (2) to (4) are expressed. To calculate the amount of movement ΔX, Δ
Y and ΔZ are obtained. Thereby, the irradiation direction of the shock wave can be easily changed by one joystick while the irradiation position of the shock wave is adjusted to the treatment target.

[Effects of the Invention] As described in detail above, according to the present invention, the irradiation direction of the shock wave is adjusted after the focal position of the shock wave oscillating unit is adjusted to the treatment target without being affected by the difference in the position of the treatment target due to the individual difference of the living body. It is possible to provide a shock wave therapy device that can be easily positioned without deviating from the treatment target even if the focus position is changed.

[Brief description of drawings]

1 to 3 are views for explaining an embodiment of a shock wave treatment device according to the present invention, and FIG. 1 is a configuration diagram,
FIG. 2 is a block diagram of the shock wave oscillator, FIG. 3 is a diagram for explaining the action of changing the irradiation direction, and FIGS. 4 to 9 are diagrams for explaining the prior art. 30 ... XY movement mechanism, 31 ... Z direction movement mechanism, 32 ... Z
Direction column, 33 ... Moving body, 34 ... First arm, 35 ... L-shaped arm, 36 ... Shock wave oscillator, 42 ... Control processing device, 4
3 ... Display.

Claims (1)

[Claims] 1. An XY moving mechanism which moves in the XY directions, a Z direction moving mechanism which is provided in the XY moving mechanism, and a first direction which is provided at a terminal end portion of the Z direction moving mechanism and rotates in a first direction. The first rotating mechanism, the second rotating mechanism provided in the first rotating mechanism and rotating in the second direction intersecting the first direction, and the second rotating mechanism. The shock wave oscillating unit provided, and the focus position of the shock wave oscillated from the shock wave oscillating unit by driving the XY moving mechanism, the Y direction moving mechanism, the first rotating mechanism and the second rotating mechanism. And a control processing means for varying the irradiation direction of the shock wave without shifting the treatment target from the treatment object.