JPH0889526A - Medical treatment instrument - Google Patents

Abstract

PURPOSE: To position a secondary bolus at a desired setting position regardlessly of a medical treating part by providing a medical treatment instrument equipped with an applicator and the secondary bolus with a deformation regulating means for regulating the deformation of the secondary bolus at the secondary bolus. CONSTITUTION: A secondary bolus 36 is mounted on the surface of a living body 33 on the target position of medical treatment, a band-shaped object 1 as the deformation regulating means is put onto the sagging part of a peripheral bottom part, and holes formed at both the ends are inserted to projections 2 formed on the side faces of a frame body 37, and set to the secondary bolus 36. Then, the band-shaped body 1 for a suitable length is set to the secondary bolus 36 corresponding to the target position of medical treatment and the inside of the secondary bolus 36 is sufficiently filled with water. Since the peripheral bottom part of the secondary bolus 36 is supported by the band-shaped body 1 and the band-shaped body 1 is not stretchable, the deformation of the secondary bolus 36 is regulated, the peripheral part is not sagged, no position deviation is generated, and it can be positioned at the desired position on the surface of the living body.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a therapeutic apparatus for irradiating a subject (living body) with ultrasonic waves or microwaves generated outside the body for the purpose of treatment, and more particularly to a therapeutic apparatus having a secondary bolus. It is a thing. Generally considered for this type of treatment device is the field of hyperthermia treatment devices. Hyperthermia treatment is based on the fact that cancer cells are highly sensitive to temperature and die when heated at 42.5 ° C. for about 30 minutes, but normal cells are not damaged much. As another field of application, application to a calculus crushing device for noninvasively treating calculi inside the body from outside the body is also considered.

[0002]

2. Description of the Related Art When irradiating ultrasonic waves (microwaves) inside a living body, when air exists between a portion (generally called an applicator) for generating ultrasonic waves (microwaves) outside the body and the living body. Since the acoustic impedance ρ (dielectric constant ε) of the two is very different, reflection occurs at the interface between the two (air and living body), and ultrasonic waves (microwaves) are not injected into the living body, or it is called a hot spot. There is a problem such as the occurrence of a part where the temperature becomes too high in the exposed part. The reflectance at the boundary surface is 99.9 when the acoustic impedances of the living body (muscle) and air are 1.07 and 0.00042 [kg / (m ² · sec)] when ultrasonic waves are applied.
%. Therefore, in this type of treatment device, in order to guide the ultrasonic waves (microwaves) generated by the applicator to the inside of the subject without loss, in the conventional device, as shown in FIG. 3, between the applicator 31 and the living body 33. A bag-like bolus made of a material such as silicon (hereinafter referred to as an applicator bolus) to hold a highly compatible liquid (usually degassed water, deionized water, etc.) whose acoustic characteristics are similar to those of a living body. 32 are provided. When the applicator bolus 32 that holds the matching liquid is interposed between the applicator 31 and the living body 33 in this way, the reflectance at the interface between the applicator bolus 32 and the living body 33 at this time is determined by the sound of water. Impedance 1.47 [kg
/ (M ² · sec)] is 6.5%, which means that the consistency is greatly improved compared to the case of air. In the case of the thermotherapy device, a mechanism for cooling and circulating the liquid in the applicator bolus 32 is provided in order to prevent the surface of the living body from being overheated, and the cooling water circulation provided in the applicator bolus 32 is provided in this circulation mechanism. The port 34 is connected to circulate the cooling water that has been cooled externally.

Further, in the electromagnetic wave thermotherapy apparatus, in addition to the bolus of the heating applicator, it is called an overlay bolus equipped with a cooling circulation mechanism in order to prevent hot spots due to the concentration of an electric field at the edge of the applicator. Things are being used. The conventional applicator bolus for this kind of device, or the overlay bolus, has a mechanism to circulate cooling water inside,
The applicator bolus 32 maintains its shape while the pressure inside and outside is balanced, and due to its elasticity, it becomes a hemispherical shape as shown in FIG. Since the surface of the living body (body surface) often has a convex shape and also has many fine uneven surfaces, the applicator bolus 32 thus inflated as shown in FIG. It is impossible to make close contact with, and a fine air layer 35 is formed. Air layer 35 like this
Occurs, the heating area becomes narrow and the applicator
The ultrasonic waves (microwaves) generated in 31 cannot be applied to the inside of the living body, and the ultrasonic waves applied to the applicator bolus 32 that is not in close contact with the living body 33 are the parts of the air layer as indicated by the arrows. Reflection is repeated at, and finally the part where the living body and the applicator bolus are in close contact is irradiated, and a hot spot occurs on the surface of the living body.

Further, when an acoustic lens and an applicator using the phased array system are used, phase synthesis as designed due to an air layer is not performed, and a desired temperature distribution cannot be obtained. In addition, if a pressure is forcibly applied to press the applicator bolus against the living body to bring it into close contact with the living body in order to prevent the formation of an air layer, the burden on the patient increases. For this reason, in order to bring the entire applicator into close contact with the surface of the living body, a bag-like bolus having an open upper part of the applicator to which the applicator bolus is attached, a so-called secondary bolus treatment device is proposed. There is. As shown in FIG. 5, the secondary bolus is composed of a bag body 36 made of a thin and soft material such as a silicone rubber sheet and having an open upper portion, and a ring-shaped frame body 37 for holding the bag body 37. It is made of a flexible material such as wire that can be freely changed in shape depending on the application site.

As described above, since the secondary bolus is a bag body having an open upper part and the bag body is a flexible thin film (sheet), when the secondary bolus is brought into contact with the body surface,
In combination with the fluidity of the matching liquid (deaerated water) 38 contained therein and its weight, the shape changes so as to follow the body surface shape even if there are convex surfaces or fine irregularities of the living body 33. Then, it adheres to the body surface without the air layer shown in FIG. The bolus 36 should be as thin as possible in order to reduce reflection and attenuation at the bag body 36 that constitutes the secondary bolus and improve adhesion. For this reason, the thickness of the bag body 36 forming the bolus is preferably set to a thickness which is generally said to be neglected of the reflection of ultrasonic waves in the layer, which is 1/10 or less of the wavelength. The secondary bolus is positioned on the body surface of the living body on the treatment target site and is held by the holding mechanism shown in FIG. 6 so that it can be easily brought into close contact with it.

As shown in FIG. 6, a holding body 39 vertically attached to a column 40 vertically attached to a truck 41 has a horizontal arm 37 'integrated with a frame body 37 for holding a secondary bolus. It is held slidably in the horizontal direction. As a result, the secondary bolus A is adjusted completely independently of the applicator 31 of the apparatus main body to the patient or the treatment target site, and its height (arrow A direction) and horizontal direction (arrow B direction).
It is possible to adjust and position the position of and to bring it into close contact with the surface of the living body. After positioning the applicator 31 in the degassed water 38 in the secondary bolus 36 as shown in FIG. 5, the applicator 31 is driven to match the ultrasonic waves or microwaves emitted from the applicator 31. The target treatment site in the living body 33 is irradiated through the liquid (deaerated water) 38 to perform thermotherapy and the like. At this time, since the applicator 31 is held by a support arm different from the holding mechanism of the secondary bolus A, only the weight of water in the secondary bolus A is added to the living body, and the applicator 31 having the applicator bolus 32 is added. I try not to add the weight of 31.

[0007]

The secondary bolus is a bag body having an open upper part, and its shape is freely deformable along the shape of the surface of the living body, so that it is effective for adhering to the surface of the living body. However, there are the following problems depending on the treatment site. That is, as shown in FIG. 7, when the convex portion of the living body is treated, or when the treatment site is located on the side of the body, if the secondary bolus is located on the convex portion of the living body or on the side of the body, It is difficult to position the secondary bolus at the desired position due to the weight of the liquid, which causes the secondary bolus to shift downwards and shift downwards. There was a problem that the effective position could not be achieved due to deviation from the set position.

In view of the above circumstances, it is an object of the present invention to provide a treatment device capable of positioning a secondary bolus at a desired setting position regardless of the treatment site.

[0009]

In order to achieve the above object, the therapeutic apparatus of the present invention is characterized in that the secondary bolus is provided with deformation restricting means for restricting its deformation. It is preferable that the deformation restricting means is made of a non-stretchable band-shaped member, is wound around the peripheral bottom portion of the bag body forming the secondary bolus, and has both ends fixed to the frame body holding the bag body. It is also possible to adjust the fixing positions of the strip-shaped bodies on both ends of the frame, that is, the length of the strip-shaped bodies.

[0010]

The operation of the present invention is as follows. That is, the deformation restricting means restricts the deformation of the bag body forming the secondary bolus. Therefore, even if the secondary bolus is located on the convex part of the living body or the body side part of the living body, the peripheral part of the bottom surface that does not contact the living body surface of the bag forming the secondary bolus is displaced downward due to the weight of the liquid in it. Without doing so, the secondary bolus can be set and positioned at a desired setting position. Further, if the deformation restricting means is a belt-shaped member and its length can be adjusted, the shape of the secondary bolus can be restricted to a shape that does not cause positional displacement from the treatment site, and the position can be set accurately, Effective treatment can be performed.

[0011]

An embodiment of the present invention will be described below with reference to the drawings. FIG. 1 is a schematic diagram showing a configuration of a main part of an embodiment of the present invention. Reference numeral 1 denotes a belt-like body (deformation regulation) that regulates deformation of the bag body 36 when water is injected into the bag body (secondary bolus) 36. Means) to wind the bottom of the bag 36, and both ends are fixed to both sides of the frame 37 to support the bottom of the bag 36. The strip-shaped body 1 has holes (see FIG. 2) formed at both ends thereof in the frame body 37.
It is fixed to the frame body 37 by engaging with the projection 2 provided on the.

Next, a procedure for heat treatment using the secondary bolus shown in FIG. 1 will be described. The secondary bolus 36 is placed on the body surface of the living body 33 on the target site for treatment. Specifically, after the secondary bolus 36 is moved to the vicinity of the living body 33 by the carriage 41, the height of the holding body 39 and the horizontal position of the frame body 37 are adjusted and positioned while confirming the position, and the secondary bolus. 36 is placed on the body surface of the living body 33 on the treatment target site. The secondary bolus 36 is set on the living body in a state where a small amount of liquid such as deaerated water is put in the secondary bolus 36.
When the secondary bolus 36 is on the convex portion of the living body 33 or on the side of the body, the peripheral bottom portion of the secondary bolus 36 is not in contact with the body surface, so water flows into that portion, and the peripheral bottom portion of the secondary bolus is shown in FIG. As a result, the position shifts.

The band-shaped body 1 is applied to the hanging portion of the peripheral bottom, and the holes formed at both ends of the band-shaped body 1 are inserted into the projections 2 provided on the side surfaces of the frame body 37, and the secondary bolus 36 is inserted.
Set to. At this time, the band-shaped body 1 having an appropriate length is set in the secondary bolus according to the treatment target site. Fill the secondary bolus 36 well with water. At this time, since the peripheral bottom portion of the secondary bolus 36 is supported by the band-shaped body 1 and the band-shaped body is non-stretchable, the deformation of the secondary bolus 36 is restricted, and the peripheral part that is not in contact with the living body surface may sag. Since there is no displacement, the secondary bolus 36 can be set and positioned at a desired position on the surface of the living body without causing positional displacement.

After the positioning, the ultrasonic applicator 31 integrally holding the applicator bolus 32 supported by the support arm 3 of the ultrasonic thermotherapy apparatus main body (not shown) is replaced with deaerated water in the secondary bolus 36. Immerse and position (FIG. 1 shows this positioned state), and then drive the ultrasonic applicator 31 to generate ultrasonic waves and
Heat treatment of the target treatment area in 33 is performed. In FIG. 1, the lengths of the strips 1 are adjusted by using the strips 1 having different lengths. However, as shown in FIG. 2, one end of the strip 1 is arranged along the length direction thereof. If a plurality of adjustment holes 4 are provided, the length of the strip-shaped body that supports the bottom portion of the secondary bolus can be adjusted by changing the adjustment hole 4 that engages with the protrusion 2 provided on the frame body 37. it can.

[0015]

[Modified Example]

1. In the embodiment, the flat plate-shaped band is used, but the support portion that contacts the secondary bolus bottom of the band may be formed in a bag shape. By doing so, slippage does not occur between the secondary bolus and the band-shaped body, so that the positioning becomes more reliable. 2. In the embodiment, the strip and the secondary bolus are separate bodies, but they may be fixed and integrated together, or the part of the secondary bolus supported by the strip may be thick or non-stretchable, and have an open end. The wall thickness or the non-stretchable member may be extended to be engaged or fixed to the frame body. By doing this, slippage does not occur as in the case of 1. 3. In the embodiment, the engagement between the belt-shaped body and the frame for holding the bag body is performed by the protrusion provided on the bag body and the hole formed in the belt-shaped body, but it is engaged by a hook, a velvet fastener or the like. You may do it. If the velvet fastener is used, the length of the belt-shaped body can be adjusted steplessly, and the length adjustment and the engaging operation are easy. 4. Although one strip is used in the embodiment, a plurality of strips may be used. In this way, a convex treatment site, a narrow neck treatment site, and the like have a portion that does not contact the biological surface in multiple directions of the bottom peripheral portion of the secondary bolus, and the displacement due to the inflow of water into this portion occurs. It is effective when it may occur.

[0016]

According to the present invention, since the deformation regulating means is provided in the secondary bolus, the displacement of the secondary bolus due to the sag of the secondary bolus due to the weight of water in the bolus does not occur. Positioning can be set to the position.

[Brief description of drawings]

FIG. 1 is a schematic diagram showing a configuration of a main part of an embodiment of the present invention.

FIG. 2 is a schematic diagram showing the configuration of another embodiment of the present invention.

FIG. 3 is a diagram showing a configuration of a conventional applicator.

FIG. 4 is a diagram showing a treatment state by the applicator of FIG.

FIG. 5 is a diagram showing a treatment state using a secondary bolus.

FIG. 6 is a diagram showing a configuration of a conventional auxiliary bolus holding mechanism.

FIG. 7 is a diagram illustrating a problem of a secondary bolus.

[Explanation of symbols]

1: Band (deformation control means) 2: Protrusion
4: Hole 31: Applicator 32: Applicator bolus 36: Bag (secondary bolus) 37: Frame

Claims (1)

[Claims] 1. A treatment device comprising an applicator for generating ultrasonic waves or microwaves, and a bag-shaped secondary bolus having an open upper part for containing a liquid in which the applicator is immersed, A treatment device characterized in that the secondary bolus is provided with a deformation regulating means for regulating the deformation thereof.