JPH09131370A - Radiation exposing device by endoscope - Google Patents

Abstract

PROBLEM TO BE SOLVED: To improve the efficiency of the radiation therapeutic work by providing a radiation therapeutic applicator inserted into a body cavity through the channel of an endoscope and fitted with a radiation therapeutic radiation source, and properly fixing the applicator to the endoscope. SOLUTION: The insertion section 11 of an endoscope 7 is inserted into the body of a patient 3 for a radiation treatment. The insertion section 11 of the endoscope 7 is inserted to a position where a diseased section in the body can be observed, e.g. a position near the diseased section existing in an esophagus, while the observation image of the endoscope 7 is observed via a monitor 10. A small radiation source applicator 19 is inserted to the position corresponding to the diseased section through the channel of the endoscope 7. The lock mechanism sections of various moving sections of an endoscope support 14 are locked, the endoscope 7 is fixed not to be moved from its positioning position, and radioactive rays are irradiated to the diseased section from the small radiation source at the tip of the small radiation source applicator 19 via the operation of a controller 21 in a remote control room 20 for a radiation treatment.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an endoscopic radiation irradiation apparatus applied to a Braky therapy for directly carrying a radiation source to an affected area such as a tumor in a patient's body and irradiating the affected area with radiation for treatment. .

[0002]

2. Description of the Related Art In general, Brachytherapy, which carries a radiation source directly to an affected area such as a tumor in a patient's body and irradiates radiation from the vicinity of the affected area for treatment, has recently attracted attention as a new technique. Development of the device is also in progress. For example, refer to Shinya Ito, Vol. 49, No. 1, P24, Shinya Ito, et al., "Experience and Examination of Microselectron HDR System" (references).

Various types of brachytherapy applicators have also been proposed for carrying a brachytherapy source, which is a small radiation source for radiating radiation, to the affected area inside the patient's body. Here, in the Brachytherapy currently performed, the following various methods are adopted for positioning the brachytherapy applicator inserted into the patient's body to the affected part in the patient's body.

(1) A simulated ray source is inserted into the brachysource applicator, and the simulated ray source in the brachysource applicator is inserted into the patient's body under fluoroscopy. The brachysource applicator is inserted so that the source matches the location of the affected area within the patient.

(2) Connect the brachysource applicator and the endoscope to two
Each of these is inserted into the body cavity of the patient, and the position of the brachysource applicator is adjusted to the affected area with an endoscope. After positioning the brachytherapy applicator, only the endoscope is withdrawn out of the patient's body.

(3) The brachysource applicator is inserted into the channel of the endoscope inserted into the body cavity, and the position of the brachysource applicator is aligned with the affected area. After positioning the brachytherapy applicator, only the endoscope is withdrawn out of the patient's body.

[0007]

The above-mentioned conventional structure has the following problems. That is, in the case of positioning the brachysource applicator inserted into the patient's body under fluoroscopy (1), the detailed position and morphology of the affected area cannot be known. Therefore, there is a problem that the small-source applicator cannot be positioned with high accuracy.

In addition, the brachysource applicator and the endoscope 2
In the case of (2), where the booklet is inserted into the patient's body together, the brachysource applicator and the endoscope are inserted together into a narrow body cavity of the patient, so there is a spatial limitation. Easy to receive,
There is a problem that it is difficult to carry out the intended work.

Furthermore, in the case (3) of positioning the brachysource applicator by inserting the brachysource applicator into the patient's body by using the channel in the endoscope, It is difficult to remove only the endoscope from the patient's body without changing the insertion position, and the work is troublesome.
Further, there is a possibility that the position of the brachysource applicator may be displaced during the work of removing only the endoscope from the body of the patient.

The present invention has been made in view of the above problems, and an object thereof is to perform positioning of a radiation treatment applicator inserted into a patient's body with high accuracy and to improve work efficiency of radiation treatment. In addition, the applicator that is positioned and fixed in the state of being aligned with the affected area inside the patient's body can be prevented from moving before or during the treatment, and the operator can move from the endoscope. An object of the present invention is to provide a radiation irradiating device using an endoscope, which can observe the affected part in the patient's body and the state of the radiation treatment applicator even at a remote place.

[0011]

DISCLOSURE OF THE INVENTION The present invention provides an endoscope for insertion into a body cavity, and a radiation treatment application which is inserted into the body cavity through a channel of the endoscope and which penetrates a radiation source for radiation treatment. An endoscope support device that supports the endoscope and fixes the endoscope at an arbitrary observation position, a monitor that displays an observation image of the endoscope, and the radiation treatment applicator. And means for fixing to the endoscope.

Then, the position of the endoscope after being positioned on the affected area is fixed by an endoscope supporting device for supporting the endoscope, and the endoscope image is displayed on the monitor, so that the position away from the endoscope is obtained. While making it possible to confirm the endoscopic image with,
By fixing the applicator inserted into the body cavity through the channel of the endoscope to the endoscope by the applicator fixing means, the applicator positioned and fixed in the state of being aligned with the affected part in the body of the patient is treated before treatment, or It is designed to prevent movement during treatment.

[0013]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS A first embodiment of the present invention will be described below with reference to FIGS. FIG. 1 shows a schematic configuration of the entire radiation irradiating device 1 using an endoscope according to the present embodiment. 1 shows a scene in which the device 1 of this embodiment is actually used. In FIG.
Is a treatment room. The wall surface of this treatment room 2 is the radiation blocking wall 2
It is electromagnetically shielded by a.

Inside the treatment room 2, a bed 4 on which a patient 3 is placed, an endoscope device 5, and a brachytherapy device body 6 for radiation treatment are provided. Further, the endoscope device 5 is provided with an endoscope 7, a light source device 8, an endoscope image monitor signal conversion device 9, and a monitor 10.

Here, the endoscope 7 is provided with an insertion portion 11 to be inserted into the body of the patient 3 and a proximal operation portion 12 connected to the proximal end portion of the insertion portion 11. The operation unit 12 is provided with an eyepiece unit (not shown). Further, a treatment tool insertion portion 13 is provided on the proximal end side of the insertion portion 11 so as to project. The treatment instrument insertion portion 13 communicates with a treatment instrument insertion channel (not shown) provided inside the insertion portion 11.

The bed 4 is provided with an endoscope supporting device 14. The endoscope supporter 14 includes a fixed portion 14a fixed to the bed 4, a movable arm 15 of, for example, an articulated arm, and an endoscope holding portion 16 connected to the tip of the movable arm 15. It is provided. Then, with the operation portion 12 on the proximal end side of the endoscope 7 being held by the endoscope holding portion 16 of the endoscope support device 14, the insertion portion 1 of the endoscope 7 is
The tip side of 1 is inserted up to the periphery of the affected part in the body of the patient 3.

The link arms 15a of the movable arm 15 are connected by ball joints 15b. When each link arm 15a is manually moved to an arbitrary position, each link arm 15a is fixed by a frictional force at each moving position.

Further, the endoscope image monitor signal converting apparatus 9 is connected to, for example, a TV connected to the eyepiece of the operation section 12 of the endoscope 7.
Camera 17 and CCU connected to this TV camera 17
(Camera control unit) 18 is provided. The CCU 18 is connected to the monitor 10. Further, the light source device 8 is connected to the operation unit 12 of the endoscope 7. The observation image of the endoscope 7 is the TV camera 17
After the image pickup signal imaged by the TV camera 17 is input to the CCU 18, the CCU 1 is output.
The image is displayed on the monitor 10 based on the output signal from the monitor 8.

When the endoscope device 5 is an electronic scope, the endoscope 7 is connected to the monitor 10 via the video system main body (not shown), and is displayed on the monitor 10 based on the output signal from the video system main body. It is supposed to be.

The brachytherapy apparatus main body 6 is connected to a proximal end portion of a brachysource applicator (radiation therapy applicator) 19 to be inserted into the body of the patient 3. A small radiation source such as iridium (not shown), which is a radiation source, can be inserted from the small radiation source treatment apparatus main body 6 into the tip portion side of the small radiation source applicator 19. Then, the tip side of the brachysource applicator 19 is inserted from the treatment instrument insertion portion 13 of the endoscope 7 into a treatment instrument insertion channel inside the insertion portion 11, and further inserted into the body cavity of the patient 3 through this channel. It is supposed to be done.

Further, the radiation blocking wall 2 is provided for the treatment room 2.
A brachytherapy apparatus controller 21 is provided in the remote operation room 20 partitioned by a. The brachytherapy apparatus controller 21 is connected to the brachytherapy apparatus main body 6 via a connection cable 22. Then, the brachytherapy device controller 21 causes the brachytherapy device main body 6 to move a brachytherapy source such as iridium at the tip of the brachytherapy device applicator 19 from within the brachytherapy device body 6, for example, as shown in FIG.
The operation of transporting to the position corresponding to the affected part 24 existing in 3 is performed remotely.

Next, the operation of the above configuration will be described.
First, before the treatment by the device 1 of the present embodiment, the endoscope 7, the light source device 8, and the TV of the endoscope image monitor signal conversion device 9 are preliminarily set.
The camera 17, the CCU 18, and the monitor 10 are connected to each other and set up. Further, the brachytherapy device applicator 19 is connected to the brachytherapy apparatus main body 6. Further, the endoscope 7 is supported by the endoscope support device 14.

In this state, the patient 3 is brought to the treatment room 2. Then, the patient 3 is laid on the bed 4, and the insertion portion 11 of the endoscope 7 is inserted into the body of the patient 3. At this time, while observing the observation image of the endoscope 7 on the monitor 10, the insertion part 11 of the endoscope 7 can be observed at the affected part 24 inside the body of the patient 3, for example, the esophagus 23 of the patient 3 as shown in FIG. Is inserted up to a position near the affected part 24 existing in.

Subsequently, the brachysource applicator 19 is passed through the channel of the endoscope 7 and inserted to a position corresponding to the affected part 24. At this time, the accurate positioning work for aligning the tip of the brachysource applicator 19 with the position corresponding to the affected part 24 in the body of the patient 3 is performed while observing the monitor 10.

When the positioning work is completed, the lock mechanism (not shown) of each movable part of the endoscope supporter 14 is locked and the endoscope 7 is fixed so as not to move from the positioning position. Furthermore, after the fixation of the endoscope 7 is completed, the direction of the monitor 10 is changed and adjustment is performed so that the screen of the monitor 10 can be seen from the observation window of the remote control room 20 or the observation camera.

After that, the operator moves to the remote control room 20,
By operating the brachytherapy apparatus controller 21 in the remote control room 20, radiation therapy is performed by irradiating the affected part 24 in the body of the patient 3 with radiation from the brachysource at the tip of the brachysource applicator 19. . Monitor 1 during this radiotherapy
At 0, while observing the observation image of the endoscope 7 at any time, it is confirmed that the tip of the brachysource applicator 19 is not displaced from the position corresponding to the affected part 24 in the body of the patient 3.

Therefore, the above configuration has the following effects. That is, the position of the endoscope 7 after being positioned on the affected area 24 is fixed by the endoscope support device 14 that supports the endoscope 7, and the endoscope image is displayed on the monitor 10. As in the form, the operator moves into the remote control room 20, and an endoscopic image can be confirmed even at a position away from the endoscope 7. Therefore, even during irradiation of the small source, the monitor 10
Since the state of the brachysource applicator 19 can be observed with, the brachysource applicator 19 can be found during the radiation treatment or when the brachysource applicator 19 is displaced due to movement of the patient 3 before the treatment, etc. It is possible to prevent irradiation of the portion with radiation.

Furthermore, by fixing the brachysource applicator 19 inserted into the body cavity through the channel of the endoscope 7 to the endoscope 7, the positioning and fixing is performed in a state of being aligned with the affected part 24 in the body of the patient 3. Small source applicator 1
It is possible to prevent 9 from moving before or during treatment.

While observing the observation image of the endoscope 7 on the monitor 10, the tip portion of the brachysource applicator 19 is attached to the patient 3
Since the work of aligning with the affected part 24 in the body of the patient is performed, the positioning of the brachysource applicator 19 inserted into the body of the patient 3 can be performed with high accuracy. Furthermore, after positioning the brachysource applicator 19 inserted into the body of the patient 3, the troublesome work of removing only the endoscope 7 out of the body of the patient 3 becomes unnecessary, so that the work efficiency of radiation treatment is improved. Can be planned.

FIG. 3 shows a second embodiment of the present invention. In this embodiment, as shown in FIG. 3, the monitor 10 is arranged in the remote operation room 20. The other parts are almost the same as those in the first embodiment.

When the apparatus 1 of the present embodiment is used, the operator inserts the insertion portion 11 of the endoscope 7 into the body of the patient 3 in the treatment room 2 by the operator using the operation portion 12 of the endoscope 7. It is performed while observing through the eyepiece. At this time, the endoscope 7
Endoscope 7 while observing the observation image through the eyepiece of
The insertion part 11 is inserted to a position where the affected part 24 in the body of the patient 3 can be observed.

Subsequently, the brachysource applicator 19 is passed through the channel of the endoscope 7 and inserted to a position corresponding to the affected part 24. At this time, the accurate positioning work for aligning the tip portion of the brachysource applicator 19 with the position corresponding to the affected part 24 in the body of the patient 3 is performed while observing through the eyepiece of the endoscope 7.

When the positioning work is completed, the lock mechanism (not shown) of each movable part of the endoscope supporter 14 is locked to fix the endoscope 7 so as not to move from the positioning position.

After this, the operator moved to the remote control room 20,
By operating the brachytherapy apparatus controller 21 while observing the observation image of the endoscope 7 on the monitor 10 in the remote control room 20, the brachytherapy device inserted into the tip of the brachysource applicator 19 is operated. Radiation therapy for irradiating the affected area 24 inside the body of the patient 3 is performed. During the radiation treatment, the tip portion of the brachysource applicator 19 causes the affected portion 24 inside the body of the patient 3.
It is always confirmed from the observation image of the monitor 10 that the position does not deviate from the position corresponding to. Further, during irradiation of the small beam source, display means such as a lamp for indicating that the radiation is being irradiated is displayed on the monitor 1.
It is displayed on 0.

Therefore, the above configuration has the following effects. That is, since the monitor 10 is arranged in the remote operation room 20, even if the state of the treatment room 2 cannot be seen from the inside of the remote operation room 20, the operator in the remote operation room 20 is in the middle of irradiation of the brachytherapy source. By observing the observation image of the endoscope 7 displayed on the screen of the monitor 10, the state of the brachysource applicator 19 can be observed. Further, the irradiation timing can be confirmed by the display means during irradiation of radiation on the monitor 10. Therefore, when the brachysource applicator 19 is displaced from the position corresponding to the affected part 24 in the body of the patient 3 during the radiation treatment or due to the movement of the patient 3 before the treatment, this state can be easily found. Therefore, it is possible to prevent radiation from being applied to portions other than the affected area 24.

FIG. 4 shows a third embodiment of the present invention. In this embodiment, as shown in FIG.
Two monitors 10A and 10B are connected to the CU 18, one monitor 10A is provided in the treatment room 2, and the other monitor 10B is provided in the remote operation room 20. The other parts are almost the same as those in the first embodiment.

When the apparatus 1 of the present embodiment is used, the operator inserts the insertion portion 11 of the endoscope 7 into the body of the patient 3 in the treatment room 2 and the operator observes the endoscope 7 with the monitor 10A. It is done while observing the image. At this time, while observing the observation image of the endoscope 7 on the screen of the monitor 10A, the insertion part 11 of the endoscope 7 is inserted to a position where the affected part 24 in the body of the patient 3 can be observed.

Then, the brachysource applicator 19 is passed through the channel of the endoscope 7 and inserted to a position corresponding to the affected part 24. At this time, the accurate positioning work for aligning the tip portion of the brachysource applicator 19 with the position corresponding to the affected part 24 in the body of the patient 3 is performed while observing the observation image of the endoscope 7 on the screen of the monitor 10A.

When the positioning work is completed, the locking mechanism (not shown) of each movable part of the endoscope supporter 14 is locked and the endoscope 7 is fixed so as not to move from the positioning position.

After this, the operator moved to the remote control room 20,
By operating the brachytherapy apparatus controller 21 while observing the observation image of the endoscope 7 on the monitor 10B in the remote control room 20, the patient is irradiated with radiation from the brachysource at the tip of the brachysource applicator 19. The radiotherapy for irradiating the affected part 24 in the body 3 is performed. During this radiation treatment, it is confirmed from time to time that the tip of the brachysource applicator 19 is not displaced from the position corresponding to the affected part 24 in the body of the patient 3 by the observation image of the monitor 10B.

Therefore, in the above-mentioned structure, the monitor 10A is provided in the treatment room 2 and the remote operation room 2
Since the monitor 10B is provided in the display unit 0, the same effect as the second embodiment can be obtained by observing the observation image of the endoscope 7 displayed on the screen of the monitor 10B in the remote control room 20. In addition to the above, when the endoscope 7 is inserted into the treatment room 2, a plurality of operators can simultaneously observe the affected part 24 in the body of the patient 3 by the monitor 10A in the treatment room 2.

Further, when the position fixing work of the endoscope 7 is performed by the endoscope supporting device 14, it is not necessary to look through the eyepiece lens of the endoscope 7, so that the position fixing of the endoscope 7 can be performed in a comfortable posture. You can do the work.

Further, FIGS. 5 to 6B show the fourth embodiment of the present invention.
FIG. This embodiment is the first
The endoscope holding part 16 of the endoscope support device 14 of the embodiment is provided with the endoscope holding tool 31 shown in FIG.

The endoscope gripping tool 31 includes a gripping tool body 32.
And a rotating member 33 that is rotatably connected to the grasping tool body 32. Here, the rotating member 3
As shown in FIG. 6 (A), an insertion hole 34 through which the operation portion 12 of the endoscope 7 is inserted is formed in the axial center portion of the endoscope 3, and the treatment instrument insertion portion 13 of the endoscope 7 is inserted. Notch 3
5 is formed in a state of being connected to the insertion hole 34. Further, the grasping tool main body 32 has an insertion hole (not shown) through which the operation portion 12 of the endoscope 7 is inserted.

Further, a substantially L-shaped arm connecting portion 36 is provided on the outer peripheral surface of the gripping tool body 32 on the side opposite to the cutout portion 35 so as to project. The arm connecting portion 36 is connected to the tip end portion of the movable arm 15 of the endoscope supporting device 14.

Further, a pair of L-shaped bent portions 37 are provided on the outer peripheral surface of the grip body 32 so as to extend in a direction orthogonal to the direction connecting the notch 35 and the arm connecting portion 36. Has been done. A fixing screw 38 is screwed into each bent portion 37 from the outside. A pressure contact member 39 capable of contacting and separating from the rotating member 33 is connected to an inner end portion of the fixing screw 38.

Then, as shown in FIG. 6A, when the pressing member 39 is separated from the outer peripheral surface of the rotating member 33, the rotating member 33 is held rotatably with respect to the gripper main body 32. It has become. Further, when the fixing screw 38 is screwed in, as shown in FIG.
9 is pressed against the outer peripheral surface of the rotating member 33, and the rotating member 33 is fixed to the gripper main body 32 in a non-rotatable state.

Next, how to use the endoscope holding tool 31 of the present embodiment will be described. First, the arm connecting portion 36 of the endoscope grasping tool 31 is connected to the distal end portion of the movable arm 15 of the endoscope supporting device 14.

Then, the insertion portion 11 and the operation portion 12 of the endoscope 7 are inserted into the insertion hole 34 of the endoscope gripping tool 31 from the distal end side. At this time, the treatment instrument insertion portion 13 of the endoscope 7 is inserted into the cutout portion 35 of the rotating member 33.

Then, at a position where the operating portion 12 of the endoscope 7 cannot be inserted into the insertion hole 34 of the endoscope grasping tool 31 any more, the rotating member 33 is rotated with respect to the grasping tool main body 32, and the endoscope is viewed. The orientation of the mirror 7 in the circumferential direction is adjusted. Here, in a state where the circumferential direction of the endoscope 7 is determined, the fixing screw 38 is tightened and the press contact member 39 is pressed against the outer peripheral surface of the rotating member 33 as shown in FIG. The operation unit 12 of the endoscope 7 is fixed so as not to rotate in the circumferential direction.

Therefore, in the structure described above, the fixing screw 38 of the endoscope grasping tool 31 is rotated in the direction opposite to the tightening direction, and the pressure contact member 39 is separated from the outer peripheral surface of the rotating member 33, whereby the rotating member is rotated. Since 33 can be switched to a rotatable state with respect to the grasping tool main body 32, the position of the endoscope 7 in the circumferential direction can be easily adjusted. Then, while the position of the endoscope 7 in the circumferential direction is adjusted, the fixing screw 38 of the endoscope gripping tool 31 is tightened to press the press contact member 39 against the outer peripheral surface of the rotary member 33, Since the endoscope 7 can be fixed so as not to rotate in the circumferential direction, the work of aligning the insertion portion 11 of the endoscope 7 with the affected portion 24 in the body of the patient 3 can be easily performed.

Furthermore, since the endoscope 7 can be attached to and detached from the endoscope support device 14 without changing the circumferential direction of the endoscope 7, the endoscope after the position of the endoscope 7 is fixed. The re-observation of 7 can be facilitated.

Further, FIGS. 7 and 8 show a fifth embodiment of the present invention. This embodiment is provided with an endoscope fixing tool 41 for fixing the insertion portion 11 of the endoscope 7 of the first embodiment to the mouth portion 40 of the patient 3 as shown in FIG.

The endoscope fixture 41 has a substantially cylindrical fixture body 42, a pair of left and right strip-shaped projecting portions 43 projecting from the outer peripheral surface of the fixture body 42, and each projecting portion. A fixing cord 44, one end of which is fixed to the tip portion of 43, is provided.

Further, as shown in FIG. 7, the fixing device main body 42 has a notch 45 for notching a part of the cylinder. Further, a cutout portion 45 is formed on the outer peripheral surface of the fixture main body 42.
A plurality of engaging claw portions 46 are formed on one end face side of the. These engaging claws 46 are arranged side by side in the circumferential direction of the fixture main body 42. Further, on the other end surface side of the cutout portion 45 of the fixture main body 42, a hook portion 47 that can be selectively engaged and disengaged with any one of the engaging claw portions 46 is provided.

Next, how to use the endoscope fixing tool 41 of this embodiment will be described. First, the endoscope fixing tool 41 is placed in the mouth 40 of the patient 3, and the left and right fixing cords 44 of the endoscope fixing tool 41 are extended to the occipital region of the patient 3 so that they are tied up. The endoscope fixing tool 41 is attached to the patient 3.

Subsequently, the insertion portion 11 of the endoscope 7 is inserted into the body from the mouth portion 40 of the patient 3 via the inside of the cylinder of the fixture body 42 of the endoscope fixture 41. At this time, the insertion part 11 of the endoscope 7 is inserted to a position where the affected part 24 in the body of the patient 3 can be observed.

Furthermore, the affected part 24 of the insertion part 11 of the endoscope 7
After the positioning is completed, the hook portion 47 of the endoscope fixing tool 41 is pulled toward the engaging claw portion 46 side to be engaged with the engaging claw portion 46 at any position, whereby the fixing device main body 42
The fixture main body 42 in a state in which the interval between the notches 45 of the
Reduce the inner diameter of. At this time, the inner peripheral surface of the fixture body 42 is pressed against the insertion portion 11 of the endoscope 7, so that the insertion portion 11 of the endoscope 7 is fixed to the fixture body 42.

Therefore, in the case of the above-mentioned structure, the insertion part 11 of the endoscope 7 can be fixed to the mouth 40 of the patient 3 by the fixing body 42 of the endoscope fixing device 41.
It is possible to prevent the endoscope 7 from being displaced in the axial direction (insertion direction) during the radiation treatment or when the patient 3 moves before the treatment. Therefore, through the channel of the endoscope 7, the affected part 2
4 can prevent the brachysource applicator 19 positioned and fixed in the position corresponding to 4 from being displaced from the position corresponding to the affected part 24, thus preventing irradiation of a portion other than the affected part 24 with radiation. can do.

9 to 11 show a sixth embodiment of the present invention. This embodiment is provided with an endoscope fixing tool 51 for fixing the insertion portion 11 of the endoscope 7 of the first embodiment to the head 50 of the patient 3 as shown in FIG.

As shown in FIG. 9, the endoscope fixture 51 is provided with a fixture main body 52 and two fixing cords 53, one end of which is fixed to both ends of the fixture main body 52. There is.

Further, the fixture main body 52 is formed of a rubber band 54 as shown in FIG. The strip 54 is provided with a substantially straight narrow portion 54a having a narrow width and a substantially straight wide portion 54b having a width wider than the narrow portion 54a. Further, an elongated slit 54c is formed in the central portion of the wide portion 54b.

When the endoscope fixture 51 is used, as shown in FIG. 9, the narrow portion 54a of the fixture body 52 is crossed with the narrow portion 54a being inserted into the slit 54c of the wide portion 54b so as to be crossed. An endoscope insertion ring 55 is provided between both ends of 52.
Is formed. In this state, the insertion portion 11 of the endoscope 7 is inserted into the endoscope insertion ring 55 of the fixture body 52 for use.

Next, how to use the endoscope fixing tool 51 of the present embodiment will be described. First, with the endoscope fixing tool 51 set as shown in FIG.
The insertion portion 11 of the endoscope 7 is inserted into the endoscope insertion ring 55.

In this state, the insertion portion 11 of the endoscope 7 is inserted into the body through the mouth 40 of the patient 3. At this time, the endoscope 7
The insertion part 11 is inserted to a position where the affected part 24 in the body of the patient 3 can be observed.

Further, after the work of positioning the insertion part 11 of the endoscope 7 in accordance with the affected part 24 in the body of the patient 3 is completed, the endoscope fixing tool 51 is placed on the head 50 of the patient 3 and The endoscope fixing tool 51 is attached to the patient 3 by binding the left and right fixing strings 53 of the endoscope fixing tool 51 to the occipital region of the patient 3 in a tied state. At this time, the left and right fixing cords 53 are pulled and tied to the patient 3 to reduce the inner diameter of the endoscope insertion ring 55 of the fixture main body 52. As a result, the inner peripheral surface of the endoscope insertion ring 55 of the fixture body 52 is pressed against the insertion portion 11 of the endoscope 7, so that the insertion portion 11 of the endoscope 7 is fixed to the fixture body 52. . Therefore, the same effect as that of the fifth embodiment (see FIGS. 7 and 8) can be obtained even with the above-mentioned configuration.

FIG. 12 shows a seventh embodiment of the present invention. The present embodiment is a modification of the endoscope fixing tool 51 of the sixth embodiment (see FIGS. 9 to 11). That is, in this embodiment, the silicon tube 6
1 is a fixture main body 62 that can be used in the same manner as the endoscope fixture 51 of the sixth embodiment. Further, one fixing string 63 is inserted into the silicone tube 61 to form an endoscope fixing tool 64.

When the endoscope fixing tool 64 is used, as shown in FIG. 12, both ends of the silicon tube 61 of the fixing tool main body 62 are intersected with each other so that the endoscope insertion ring is inserted between both ends of the fixing tool main body 62. 65 is formed. In this state, the insertion portion 11 of the endoscope 7 is inserted into the endoscope insertion ring 65 of the fixture body 62 for use.

Therefore, even with the above-mentioned structure, the same effect as that of the sixth embodiment can be obtained. In addition, in this embodiment, the structure of the endoscope fixing tool 64 is particularly simple, so that the manufacturing is easy. Therefore, the inexpensive endoscope fixing tool 64 can be provided.

Further, FIG. 13 shows an eighth embodiment of the present invention. In this embodiment, the mouth 40 of the patient 3
An endoscope fixing tool 72 that is used by being inserted into a mouthpiece 71 that is attached to the above is provided.

The endoscope fixture 72 is provided with a hollow cone-shaped fixture main body 73. This fixture body 7
3 is formed with a notch portion 74 that vertically cuts a part of the conical weight.

Next, how to use the endoscope fixing tool 72 of the present embodiment will be described. First, the insertion portion 11 of the endoscope 7
Is inserted into the body of the patient 3 via the mouthpiece 71 while being passed through the hollow portion of the fixture body 73 of the endoscope fixture 72. At this time, the insertion part 11 of the endoscope 7 is inserted to a position where the affected part 24 in the body of the patient 3 can be observed.

Further, the affected part 24 of the insertion part 11 of the endoscope 7
After the positioning is completed, the endoscope fixing tool 72 is inserted into the mouthpiece 71. Here, since a tapered taper surface is formed on the outer peripheral surface of the endoscope fixing tool 72, the endoscope fixing tool 72 is gradually fixed as the endoscope fixing tool 72 is inserted into the mouthpiece 71. The diameter of the entire fixture main body 73 is reduced so that the diameter of the hollow portion of the fixture 72 becomes smaller. Therefore, the inner peripheral surface of the fixture main body 73 has the insertion portion 11 of the endoscope 7.
The insertion portion 11 of the endoscope 7 is fixed by the mouthpiece 71 and the endoscope fixing tool 72.

Therefore, even with the above-described structure, the same effect as that of the fifth embodiment (see FIGS. 7 and 8) can be obtained, and in this embodiment, the endoscope fixing tool 72 is particularly used for the patient 3.
Since it is not bound to the patient, there is an advantage that the patient 3 is not hurt.

Further, FIGS. 14A, 14B and 15
Shows a ninth embodiment of the present invention. In the present embodiment, the insertion portion 11 of the endoscope 7 of the first embodiment
As shown in FIG. 15, an endoscope fixing tool 81 for fixing to the opening 80 of the patient 3 is provided.

As shown in FIG. 14A, a balloon 82 having a substantially circular tube shape is provided in the endoscope fixture 81, and an air supply tube 83 having a proximal end portion communicating with one end portion of the balloon 82.
And the stopcock 8 attached to the tip of the air supply tube 83
4 are provided.

Further, the stopcock 84 has a stopper body 84a, and an opening / closing knob 84b rotatably mounted on the stopper body 84a.
Are provided. The open / close knob 84b is shown in FIG.
In the state of being held in the open position shown in (A), the air feeding tube 83 is held in a state capable of feeding air, and the open / close knob 84b is
14B is switched to the closed position shown in FIG. 14B so that the air supply from the air supply tube 83 is cut off.

Next, how to use the endoscope fixing tool 81 of the present embodiment will be described. When the endoscope fixing tool 81 is used, the endoscope fixing tool 81 is attached to the insertion section 11 of the endoscope 7 before inserting the insertion section 11 of the endoscope 7 into the patient 3. At this time, the opening / closing knob 84b of the stopcock 84 is previously shown in FIG.
The insertion portion 11 of the endoscope 7 is inserted into the tube of the balloon 82 while being held in the open position shown in (A). In this case, the balloon 82 is held so as to be axially movable along the insertion portion 11 of the endoscope 7.

In this state, the insertion portion 11 of the endoscope 7 is inserted into the body through the opening 80 of the patient 3. At this time, the insertion part 11 of the endoscope 7 is inserted to a position where the affected part 24 in the body of the patient 3 can be observed.

Further, after the work of positioning the insertion part 11 of the endoscope 7 in accordance with the affected part 24 in the body of the patient 3 is completed, the endoscope fixing tool 81 is placed in the opening part 80 of the patient 3. 14, air is injected into the balloon 82, and FIG.
The balloon 82 is inflated as shown in FIG. At this time, as the balloon 82 is inflated, the inner peripheral surface of the balloon 82 is pressed against the insertion portion 11 of the endoscope 7, and at the same time, the outer peripheral surface of the balloon 82 is pressed against the opening portion 80 of the patient 3 as shown in FIG. It As a result, the insertion portion 11 of the endoscope 7
Is fixed in the body cavity so that it cannot move in the axial direction (insertion direction). In this state, the open / close knob 84b of the stopcock 84 is rotated to the closed position. Therefore, the same effect as that of the fifth embodiment (see FIGS. 7 and 8) can be obtained even with the above-mentioned configuration.

16A and 16B show a tenth embodiment of the present invention. In this embodiment,
The insertion portion 11 of the endoscope 7 according to the first embodiment is shown in FIG.
As shown in (B), an endoscope fixing tool 91 for positioning and fixing is provided at a central position in the body cavity 90 of the patient 3.

As shown in FIG. 16 (A), the endoscope fixing tool 91 is provided with a tubular fixing tool body 92 made of a fluorinated compound resin and fitted on the insertion portion 11 of the endoscope 7. . The fixture main body 92 is arranged so as to cover almost the entire portion from the distal end portion of the insertion portion 11 of the endoscope 7 to the operation portion 12.

Further, four slits 93 extending in the axial direction are formed at the tip portion of the fixture main body 92 in the circumferential direction. Further, the fixture main body 92 is provided with a fixing portion 94 that is fixed to the tip end side of the slit 93 near the tip end portion of the insertion portion 11 of the endoscope 7.

Next, how to use the endoscope fixing tool 91 of the present embodiment will be described. First, the endoscope fixing tool 91 is previously prepared.
The insertion portion 11 of the endoscope 7 was inserted into the fixing body 92 of the endoscope from the distal end side, and the fixing portion 94 on the distal end side of the fixing body 92 was fixed near the distal end portion of the insertion portion 11 of the endoscope 7. Set to state.

In this state, the insertion portion 11 of the endoscope 7
Is inserted into the body cavity 90 of the patient 3 together with the endoscope fixing tool 91. At this time, the insertion part 11 of the endoscope 7 is inserted to a position where the affected part 24 in the body cavity 90 of the patient 3 can be observed.

Further, after the work of positioning the insertion part 11 of the endoscope 7 in accordance with the affected part 24 in the body cavity 90 of the patient 3 is completed, the proximal end of the endoscope fixing tool 91 is moved to the distal end side. Press operation. Due to this pressing force, the endoscope fixing tool 91 pushes the proximal end of the endoscope fixing tool 91 toward the distal end side, so that the entire portion of the fixing tool body 92 on the proximal side from each slit 93 is moved forward. Since it is extruded, the fixture main body 92
The tube wall portion 95 between the slits 93 on the tip side of FIG.
As shown in (B), it is expanded outward in a substantially arcuate shape. The top of the expanded portion is pressed against the inner wall surface of the body cavity 90 of the patient 3 so that the insertion portion 11 of the endoscope 7 is fixed so as not to move in the axial direction (insertion direction). At this time, the distal end portion of the insertion portion 11 of the endoscope 7 is fixed in a state of being arranged at the center position in the body cavity 90.

Therefore, in the case of the above-described structure, the endoscope fixture 91 prevents the insertion portion 11 of the endoscope 7 from moving axially (insertion direction) to the inner wall surface of the body cavity 90 of the patient 3. When fixed, the distal end portion of the insertion portion 11 of the endoscope 7 can be arranged at the center position in the body cavity 90.
The brachysource applicator 19 inserted into the treatment instrument insertion channel of the endoscope 7 can be reliably arranged at the center position in the body cavity 90. Therefore, the brachysource applicator 19
Radiation emitted from the patient can be evenly distributed in the body cavity 90 of the patient 3 in the circumferential direction, and the affected area in the body cavity 90 of the patient 3 can be subjected to radiation treatment in the circumferential direction in a uniform state.

17 and 18 show the first embodiment of the present invention.
1 shows one embodiment. The present embodiment is provided with an endoscope fixing tool 101 as a modified example of the endoscope fixing tool 91 of the tenth embodiment (see FIGS. 16 (A) and 16 (B)).

That is, the endoscope fixture 1 according to the present embodiment.
Reference numeral 01 denotes a tubular short fixture main body 102 made of a fluorinated resin, which is mounted only near the tip of the insertion portion 11 of the endoscope 7.
Is provided.

Further, the peripheral wall portion of the fixture main body 102 is provided with four slits 103 extending in the axial direction in the circumferential direction. Further, the slit 10 is formed in the fixture body 102.
A fixing portion 104 that is fixed to the insertion portion 11 of the endoscope 7 is provided on the rear end side with respect to 3.

The tip of the fixture operating rod 105 is attached to the tip of the fixture body 102. The proximal end portion of the fixture operation rod 105 is the insertion portion 1 of the endoscope 7.
No. 1 is extended to the operation unit 12 side.

Next, the endoscope fixing tool 101 of the present embodiment
Explain how to use. First, the endoscope fixing tool 1 in advance
The insertion portion 11 of the endoscope 7 is inserted into the fixture body 102 of 01 from the tip side, and the fixing portion 104 on the rear end side of the fixture body 102 is fixed to the insertion portion 11 of the endoscope 7. set.

In this state, the insertion portion 11 of the endoscope 7
Is inserted into the body cavity 90 of the patient 3 together with the endoscope fixing tool 101. At this time, the insertion part 11 of the endoscope 7 is inserted to a position where the affected part 24 in the body cavity 90 of the patient 3 can be observed.

Further, after the work of positioning the insertion part 11 of the endoscope 7 in accordance with the affected part 24 in the body cavity 90 of the patient 3 is completed, the fixture operating rod 10 of the endoscope fixture 101 is completed.
Pull the end on the proximal side of 5. Due to this pulling force, the endoscope fixing tool 101 pulls the proximal side end portion of the fixing tool operating rod 105 to operate the endoscope fixing tool 101.
Since the portion on the tip side of each slit 103 slides rearward, the tube wall portion 106 between each slit 103 of the fixture main body 102 is expanded outward in a substantially arcuate shape as shown in FIG. It The top of the expanded portion is pressed against the inner wall surface of the body cavity 90 of the patient 3 so that the insertion portion 11 of the endoscope 7 is fixed so as not to move in the axial direction (insertion direction). At this time, the distal end portion of the insertion portion 11 of the endoscope 7 is fixed in a state of being arranged at the center position in the body cavity 90.

Therefore, even in the case of the above structure, the endoscope fixture 101 prevents the insertion portion 11 of the endoscope 7 from moving axially (insertion direction) to the inner wall surface of the body cavity 90 of the patient 3. Since the distal end portion of the insertion portion 11 of the endoscope 7 can be arranged at the center position inside the body cavity 90 when fixed,
As in the tenth embodiment, the brachysource applicator 19 inserted in the treatment instrument insertion channel of the endoscope 7 can be reliably placed at the center position in the body cavity 90, and the tenth embodiment The same effect as is obtained.

FIG. 19 shows a twelfth embodiment of the present invention. In the present embodiment, a shaft portion 112 having a cross-sectional structure of a multi-lumen structure in which four lumens 111a to 111d extending in the axial direction are formed in the insertion portion 11 of the endoscope 7 is provided. 1
The insertion channel of the brachysource applicator 19 is formed by the lumen 111a arranged at 12 axial center positions.

Further, in the shaft portion 112, the other three lumens 111b, 1b are provided around the central lumen 111a.
11c and 111d are arranged. An objective lens 113 is arranged at the tip of the lumen 111b, a light guide 114 is arranged in the lumen 111c, and a suction port is formed by the lumen 111d.

Therefore, in the above-mentioned configuration, the brachysource applicator 19 is inserted into the lumen 111a of the shaft portion 112 during the radiation treatment so that the brachysource applicator 19 is always kept in the shaft portion of the endoscope 7. It can be arranged in the central part of 112. Therefore, it becomes easy to adjust the brachysource applicator 19 inserted in the lumen 111a of the shaft portion 112 of the endoscope 7 to the state of being arranged at the center position in the body cavity 90. The applied radiation can be evenly distributed in the body cavity 90 of the patient 3 in the circumferential direction, and the affected area in the body cavity 90 of the patient 3 can be subjected to radiation treatment in a uniform state in the circumferential direction.

20A to 20C show a twelfth embodiment of the present invention. In this embodiment,
As shown in FIG. 20 (A), the brachysource applicator 1 inserted in the insertion channel 121 of the insertion portion 11 of the endoscope 7.
A small wire for positioning and fixing the brachysource applicator 19 in a state of being arranged at the axial center position of the insertion portion 11 of the endoscope 7 when 9 is projected to the outside from the distal end opening portion of the insertion channel 121. A source applicator fixture 122 is provided.

As shown in FIG. 20 (B), the brachysource applicator fixture 122 is provided with a substantially bosh-shaped fixture body 123 made of transparent fluorinated compound resin. An endoscope connecting portion 124 that is connected to the distal end portion of the insertion portion 11 of the endoscope 7 is formed at one end of the fixture main body 123.
Further, a throttle portion 125 having an inner diameter smaller than that of the endoscope connecting portion 124 is formed at the other end of the fixture main body 123. The inner diameter of the narrowed portion 125 is set to be substantially the same as that of the small radiation source applicator 19, and the small radiation source applicator 1
9 can be inserted. The central axis of the throttle portion 125 of the fixture main body 123 is the endoscope connecting portion 12
It is arranged coaxially with the central axis of No. 4.

Next, how to use the brachysource applicator fixture 122 of this embodiment will be described. First, the fixture body 12 of the brachysource applicator fixture 122 is prepared in advance.
The endoscope connection part 124 of No. 3 is set in a state of being connected to the tip part of the insertion part 11 of the endoscope 7.

In this state, the insertion portion 11 of the endoscope 7
Is inserted into the body cavity 90 of the patient 3 together with the brachysource applicator fixture 122. At this time, the insertion portion 11 of the endoscope 7
Is inserted to a position where the affected part 24 in the body cavity 90 of the patient 3 can be observed.

Furthermore, after the work of positioning the insertion part 11 of the endoscope 7 in accordance with the affected part 24 in the body cavity 90 of the patient 3 is completed, the insertion channel 12 of the insertion part 11 of the endoscope 7 is completed.
The brachysource applicator 19 is inserted into the device 1. And
When the small-ray-source applicator 19 is projected outward from the distal end opening of the insertion channel 121, the distal end of the small-ray source applicator 19 has the small-ray source applicator fixture 1.
22 is in contact with the inner wall surface of the braid 22, and is guided by the inner wall surface of the brachysource applicator fixture 122.
To the outer side of the applicator fixture 122 through the opening of the throttle portion 125. At this time, the brachysource applicator 19 is positioned and fixed in a state where the tip portion of the brachysource applicator 19 is arranged at the axial center position of the insertion portion 11 of the endoscope 7.

Therefore, in the above-mentioned structure, when the tip portion of the brachysource applicator 19 is fixed by the brachysource applicator fixture 122, the brachysource applicator 19 is fixed.
Since the distal end portion of the insertion portion 11 can be arranged at the axial center position of the insertion portion 11 of the endoscope 7, the insertion channel 121 is moved from the axial center position of the insertion portion 11 of the endoscope 7 as shown in FIG. Even if it is detached, the tip of the brachysource applicator 19 extended to the outside of the applicator fixture 122 can be reliably arranged at the axial center position of the insertion portion 11 of the endoscope 7. it can. Therefore, the radiation emitted from the brachysource applicator 19 can be uniformly distributed in the body cavity 90 of the patient 3 in the circumferential direction, and the radiation can be evenly distributed in the circumferential direction to the affected part in the body cavity 90 of the patient 3. Can be treated.

Further, FIG. 21A shows a first modification of the brachysource applicator fixture 122 of the thirteenth embodiment. This is a brachysource applicator fixture 12
A plurality of elongated slits 126 extending in the axial direction are arranged side by side in the circumferential direction on the peripheral wall portion of the second fixture main body 123.

FIG. 21 (B) shows a second modification of the brachy-source applicator fixture 122 of the thirteenth embodiment. This is a brachysource applicator fixture 12
The second fixture main body 123 is formed by a transparent cylindrical columnar body 131 made of a fluorinated compound resin.

A concave portion 132 that forms the endoscope connecting portion 124 is formed at one end of the cylindrical body 131. Further, inside the cylindrical body 131, the brachysource applicator 19 is provided.
Guide holes 133 are formed. This guide hole 13
The opening on the base end side of 3 is communicated with the recess 132. Further, the opening 13 on the tip end side of the guide hole 133
3a is arranged at the center of the tip surface of the cylindrical body 131.

Then, the columnar body 131 is connected to the insertion section 11 of the endoscope 7 with the distal end portion of the insertion section 11 of the endoscope 7 being fitted in the recess 132 of the columnar body 131. Has become. Further, when the brachysource applicator 19 inserted into the insertion channel 121 of the insertion portion 11 of the endoscope 7 is projected to the outside from the tip opening of the insertion channel 121, the guide hole 133 of the cylindrical body 131. Through the opening 133a at the center of the front end surface of the cylindrical body 131, and is extended to the outside of the cylindrical body 131. Therefore, also in this case, the same effect as that of the brachysource applicator fixture 122 of the thirteenth embodiment can be obtained.

22A and 22B show a fourteenth embodiment of the present invention. In this embodiment,
As shown in FIG. 22 (B), a small ray source applicator-attaching type small ray source applicator fixture 141 for positioning and fixing the small ray source applicator 19 at a central position in the body cavity 90 is provided.

As shown in FIG. 22 (A), this brachysource applicator fixture 141 has a substantially tubular balloon 142.
And a balloon air supply tube 143 whose one end is connected to the balloon 142.

Next, how to use the brachysource applicator fixture 141 of this embodiment will be described. When the brachysource applicator fixture 141 is used, the brachysource applicator 19 is inserted into the insertion channel of the insertion part 11 of the endoscope 7 before the insertion part 11 of the endoscope 7 is inserted into the body cavity 90 of the patient 3. Insert inside. Then, the tip portion of the brachysource applicator 19 is made to project from the tip portion of the insertion portion 11 of the endoscope 7.

In this state, the brachysource applicator fixture 1
The tip portion of the brachysource applicator 19 is inserted into the balloon 142 of No. 41, and the balloon 142 is attached to the tip portion of the brachysource applicator 19 as shown in FIG.

In this state, the insertion portion 11 of the endoscope 7
Is inserted into the body cavity 90 of the patient 3 together with the brachysource applicator 19 and the brachysource applicator fixture 141. At this time, the insertion part 11 of the endoscope 7 is inserted to a position where the affected part 24 in the body cavity 90 of the patient 3 can be observed.

Here, it is assumed that the brachysource applicator fixture 1 is
When the brachysource applicator 19 can pass through the insertion channel of the insertion portion 11 of the endoscope 7 with the braid 41 mounted, the brachysource applicator fixture 141 is first attached to the brachysource applicator 19. After that, the brachysource applicator 19 is later inserted into the insertion channel of the insertion portion 11 of the endoscope 7 previously inserted into the body cavity 90 of the patient 3 together with the brachysource applicator fixture 141. May be.

After the work of positioning the insertion portion 11 of the endoscope 7 in accordance with the affected part 24 in the body cavity 90 of the patient 3 is completed, the positioning operation of the brachysource applicator 19 is performed. Then, when the positioning work of the brachysource applicator 19 is completed, air is injected into the balloon 142 by the balloon air supply tube 143, and the balloon 143 is inflated as shown in FIG. 22 (B). At this time, the outer peripheral surface of the balloon 143 is pressed against the wall surface inside the body cavity 90 of the patient 3 as the balloon 143 expands. As a result, the tip portion of the brachysource applicator 19 is fixed in the body cavity 90 in a state in which it cannot move in the axial direction (insertion direction). At this time, the tip of the brachysource applicator 19 is the balloon 1
It is positioned and fixed at a central position in the body cavity 90 by 43.

Therefore, in the case of the above structure, when the tip portion of the brachysource applicator 19 is fixed in the body cavity 90 by the brachysource applicator fixture 141 so that it cannot move in the axial direction (insertion direction). The brachysource applicator 19
Since the distal end portion of the braid can be arranged at the center position in the body cavity 90, the brachysource applicator 19 inserted in the insertion channel of the endoscope 7 can be reliably arranged at the center position in the body cavity 90. it can. Therefore, the radiation emitted from the brachysource applicator 19 can be uniformly distributed in the body cavity 90 of the patient 3 in the circumferential direction, and the radiation can be evenly distributed in the circumferential direction to the affected part in the body cavity 90 of the patient 3. Can be treated.

23 (A) to 23 (C) show a fifteenth embodiment of the present invention. In this embodiment,
A brachysource applicator fixture 151 having a structure different from that of the brachysource applicator fixture 141 of the fourteenth embodiment (see FIGS. 22A and 22B) is provided.

The braid source applicator fixture 151 is provided with a tubular fixture body 152 made of a fluorinated compound resin. Four slits 153 extending in the axial direction are formed at the rear end of the fixture main body 152 in the circumferential direction. Further, at the tip of the fixture body 152, a fixing portion 154 fixed near the tip of the brachysource applicator 19 is provided.
Is provided. Further, the rear end portion of the small-ray-source applicator fixture 151 is set so that the outer diameter dimension is larger than the insertion channel diameter of the insertion portion 11 of the endoscope 7.

Next, how to use the brachysource applicator fixture 151 of this embodiment will be described. When the brachysource applicator fixture 151 is used, the brachysource applicator 19 is inserted into the insertion channel of the endoscope 7 before the insertion portion 11 of the endoscope 7 is inserted into the body cavity 90 of the patient 3. Insert inside. Then, the tip portion of the brachysource applicator 19 is made to project from the tip portion of the insertion portion 11 of the endoscope 7.

In that state, the brachysource applicator fixture 1
The tip portion of the small ray source applicator 19 is inserted into the cylinder of 51, and the small ray source applicator fixture 151 is attached to the tip portion of the small ray source applicator 19 as shown in FIG.

In this state, the insertion portion 11 of the endoscope 7
Is inserted into the body cavity 90 of the patient 3 together with the brachysource applicator 19 and the brachysource applicator fixture 151. At this time, the insertion part 11 of the endoscope 7 is inserted to a position where the affected part 24 in the body cavity 90 of the patient 3 can be observed.

After the work of positioning the insertion portion 11 of the endoscope 7 in accordance with the affected part 24 in the body cavity 90 of the patient 3 is completed, the positioning operation of the brachysource applicator 19 is performed. Then, when the positioning work of the brachysource applicator 19 is completed, the brachysource applicator 19 is pulled to the hand side. Due to this pulling force, the brachysource applicator fixture 151 pulls the brachysource applicator 19 toward the operator's side, and the portion of the brachysource applicator fixture 151 on the tip side of each slit 153 is moved backward. Since it slides toward, the tube wall portion 155 between the slits 153 of the brachysource applicator fixture 151 is shown in FIG.
As shown in FIG. 3 (C), it is expanded outward in a substantially arcuate shape. Then, the top of the expanded portion is pressed against the inner wall surface of the body cavity 90 of the patient 3, whereby the tip of the brachysource applicator 19 is fixed in a state in which it cannot move in the axial direction (insertion direction). At this time, the tip portion of the brachysource applicator 19 is fixed in a state of being arranged at the center position in the body cavity 90.

Therefore, even with the above-mentioned structure, when the tip portion of the brachysource applicator 19 is fixed in the body cavity 90 by the brachysource applicator fixture 151 such that it cannot move in the axial direction (insertion direction). The brachysource applicator 19
Since the distal end portion of can be arranged at the center position in the body cavity 90, the same effect as that of the fourteenth embodiment can be obtained.

FIG. 24 shows a sixteenth embodiment of the present invention. In this embodiment, the brachysource applicator 19 is provided with a scale 161 for displaying the distance from the tip of the brachysource applicator 19.

Therefore, in the case of the above configuration, when performing the work of positioning the brachysource applicator 19 in accordance with the affected part 24 in the body cavity 90 of the patient 3 while observing with the endoscope 7, the brachysource is used. The position of the brachysource applicator 19 can be determined while measuring the distance to the affected part 24 and the size of the affected part 24 using the scale 161 of the applicator 19, and the radiation is emitted from the brachysource applicator 19. You can calculate the range to do. Therefore, the work of positioning the brachytherapy applicator 19 according to the affected part 24 becomes easy.

Furthermore, when the scale 161 is made of a material which is impermeable to X-rays such as a contrast agent, the brachysource applicator 19 can be easily positioned even under fluoroscopy. Further, the calculation of the range of radiation from the brachysource applicator 19 becomes easier.

FIG. 25 shows a seventeenth embodiment of the present invention. In the present embodiment, a brachysource applicator fixture 172 that can be attached to the channel insertion opening 171 of the treatment instrument insertion portion 13 of the insertion portion 11 of the endoscope 7 is provided.

This brachysource applicator fixture 172 is a hollow cone-shaped flexible fixture body 17 made of rubber.
3 are provided. The fixture main body 173 is formed with a cutout portion 174 which vertically cuts a part of the conical weight.

Next, how to use the brachysource applicator fixture 172 of this embodiment will be described. First, the brachysource applicator 19 is operated by the brachysource applicator fixture 172.
Inserted in the channel insertion port 171 of the treatment instrument insertion portion 13 while being passed through the hollow portion of the fixture main body 173. At this time, the insertion part 11 of the endoscope 7 is inserted to a position where the affected part 24 in the body of the patient 3 can be observed.

Then, after the operation of positioning the brachysource applicator 19 in accordance with the affected part 24 in the body cavity 90 of the patient 3 while observing with the endoscope 7, the brachysource applicator fixture 172 is channeled. It is inserted into the insertion port 171.
Here, since the tapered surface is formed on the outer peripheral surface of the brachysource applicator fixture 172, the brachysource applicator fixture 172 is gradually inserted as it is inserted into the channel insertion port 171. In the state where the diameter of the hollow portion of the brachysource applicator fixture 172 becomes small, the fixture body 1
The overall diameter of 73 is reduced. Therefore, the fixture body 173
Since the inner peripheral surface of is pressed against the brachysource applicator 19,
The brachysource applicator 19 is fixed to the channel insertion port 171 by a brachysource applicator fixture 172.

Therefore, in the above-mentioned structure, the brachysource applicator 19 is fixed to the endoscope 7,
During the radiation treatment by the brachysource applicator 19 or before the treatment, the brachysource applicator 19 is prevented from being displaced from the position corresponding to the affected part 24 in the body of the patient 3, and the part other than the affected part 24 is prevented. Can be prevented from being irradiated.

26A and 26B show the 18th embodiment of the present invention. In this embodiment,
Similarly to the brachysource applicator fixture 172 of the seventeenth embodiment (see FIG. 25), the brachysource application mounted on the channel insertion opening 171 of the treatment instrument insertion portion 13 of the insertion portion 11 of the endoscope 7. A fixing device 181 is provided.

The brachy-source applicator fixture 181 of this embodiment is provided with a base 182, a lid 183, a fixing O-ring 184, and a pressing member 185.

Here, the mouthpiece 182 is provided with a substantially cylindrical mouthpiece body 186. An insertion portion 187 having a substantially hollow circular cone shape to be inserted into the channel insertion opening 171 is formed on one end portion side of the mouthpiece main body 186, and a large diameter cylindrical portion 188 is formed on the other end portion side. Further, a flange portion 189 is provided so as to project from the open end of the large diameter tubular portion 188. A male screw portion 190 is formed on the outer peripheral surface of the flange portion 189. Even when the flange portion 189 is not provided, the male screw portion 190 may be formed on the outer peripheral surface of the large diameter tubular portion 188.

The lid body 183 is provided with a lid body 191 having a substantially bottomed cylindrical shape. A female screw portion 192 that meshes with the male screw portion 190 of the mouthpiece 182 is formed on the inner peripheral surface of the cylindrical portion of the lid body 191. Furthermore, this lid body 19
An insertion hole 193 is formed in the center of the bottom of the insertion hole 1 so that the small-beam source applicator 19 is inserted therethrough.

Further, the fixing O-ring 184 is the base 182.
Is disposed on the inner bottom portion of the large-diameter cylindrical portion 188. further,
The pressing member 185 is the fixing O-ring 1 in the large-diameter cylindrical portion 188.
It is arranged in a state of being placed on 84. Any number of O-rings 184 for fixing may overlap. O-ring 1
A flexible rubber tube may be used instead of 84.

Next, how to use the brachysource applicator fixture 181 of this embodiment will be described. The brachysource applicator fixture 181 of the present embodiment is the treatment instrument insertion portion 13
It is always attached to the channel insertion port 171 of the. When the brachysource applicator 19 is not attached to the endoscope 7, the lid 183 of the brachysource applicator fixture 181 moves away from the treatment instrument insertion portion 13 as shown in FIG. Is held in a state of being moved in the direction, and the pressing member 18
5 is held in a state where no pressing force is applied to the fixing O-ring 184.

In this state, the brachysource applicator 19 is inserted into the insertion hole 1 of the lid 183 of the brachysource applicator fixture 181.
From 93, it is inserted into the insertion channel of the endoscope 7 through the channel insertion opening 171 of the treatment instrument insertion portion 13. At this time, the insertion part 11 of the endoscope 7 is inserted to a position where the affected part 24 in the body of the patient 3 can be observed.

Then, after the operation of positioning the brachysource applicator 19 in accordance with the affected part 24 in the body cavity 90 of the patient 3 while observing with the endoscope 7, the braid of the brachysource applicator fixture 181 is closed. The female screw portion 192 of the body 183 is attached to the base 1
A screw tightening operation of screwing along the male screw portion 190 of 82 is performed. At this time, the lid 183 is the treatment instrument insertion portion 13
As the lid 183 is screwed, the pressing member 185 is pushed downward.
As shown in FIG. 26B, the fixing O-ring 184 is crushed. As described above, the crushing of the fixing O-ring 184 reduces the inner diameter of the fixing O-ring 184. Therefore, the brachysource applicator 19 is pressed by the inner peripheral surface of the fixing O-ring 184, and the brachysource applicator 19 is fixed in a state in which it cannot move in the axial direction (insertion direction).

Therefore, even if the above-mentioned structure is adopted,
The brachysource applicator 19 is fixed to the endoscope 7 in the same manner as in the first embodiment, so that the brachysource application is performed during the radiation treatment by the brachysource applicator 19 or when the patient 3 moves before the treatment. It is possible to prevent the data 19 from being displaced from the position corresponding to the affected part 24 in the body of the patient 3, and to prevent irradiation of a portion other than the affected part 24 with radiation. Further, in the present embodiment, the crushing amount of the fixing O-ring 184 can be adjusted according to the tightening amount of the lid 183 of the brachysource applicator fixture 181. The applicator 19 can be fixed.

FIG. 27 shows a nineteenth embodiment of the present invention. In the present embodiment, the angle operation section fixing tool 201 is provided on the endoscope supporting machine 14 that holds the operation section 12 of the endoscope 7.

The angle operation portion fixture 201 is provided with a rubber fixture body 202. One end of the fixture main body 202 is fixed to a fixture support portion 203 protruding from the endoscope support device 14. Further, at the other end of the fixture main body 202, an angle provided on the operation section 12 of the endoscope 7 in a state where the operation section 12 of the endoscope 7 is fixed to the endoscope support device 14. A locking portion 205 that is releasably locked to the operation portion 204 is provided. And
When the locking portion 205 of the fixture main body 202 is locked to the angle operating portion 204, the angle operating portion 204
Is fixed so that it cannot be rotated.

Next, how to use the angle operation section fixture 201 of this embodiment will be described. First, with the endoscope 7 attached to the endoscope support device 14, the insertion portion 11 of the endoscope 7 is inserted into the body of the patient 3, and then the brachysource applicator 19 of the endoscope 7 is inserted. The treatment tool insertion portion 13 is inserted into the insertion channel of the endoscope 7. At this time, the insertion part 11 of the endoscope 7 is inserted to a position where the affected part 24 in the body of the patient 3 can be observed.

Furthermore, the angle operation unit 204 of the endoscope 7
The insertion portion 11 of the endoscope 7 while adjusting the angle by
Is aligned with the affected part 24 in the body of the patient 3. After the positioning work is completed, as shown in FIG. 27, the locking portion 205 of the angle operation portion fixture 201 is pushed between the operation portion 12 (main body) of the endoscope 7 and the angle operation portion 204. As a result, the angle operation unit 204 is fixed by the frictional force of the angle operation unit fixture 201, and the angle of the endoscope 7 does not move.

Therefore, in the above-mentioned configuration, the endoscope positioned according to the affected part 24 in the body of the patient 3 by the patient 3 moving before or during the radiation treatment by the brachysource applicator 19 or the like. It is possible to prevent the tip portion of 7 from moving. Therefore, it is possible to prevent irradiation of a portion other than the affected area 24 or uneven irradiation of radiation.

28 to 30 show the twentieth embodiment of the present invention.
FIG. This embodiment is the first
The remote operation device 211 of the endoscope 7 is incorporated in the radiation irradiating device 1 by the endoscope of the embodiment (see FIGS. 1 and 2).

The remote control device 211 includes an angle knob operating device 212 shown in FIGS. 29 and 30 for operating the angle operating part 204 of the operating part 12 of the endoscope 7, and an angle controlling the angle knob operating device 212. Control device 21
3 and 3 are provided.

Further, as shown in FIG. 30, the angle knob operating device 212 includes an exterior cover 214 and a drive motor 21.
5 and a knob joint 216 are provided. Here, the exterior cover 214 is the endoscope grasping tool 31 of the endoscope supporting device 14.
Mounted on A drive motor 215 is attached to the inside of the exterior cover 214.

Further, the drive shaft on the one end side of the knob joint 216 is connected to the rotary shaft of the drive motor 215.
On the other end side of the knob joint 216, the angle operating portion 12
2 is engaged. Then, the drive motor 215 drives the angle operation portion 122 to rotate via the knob joint 216.

Also, the knob joint 216 and the outer cover 214
A seal 217 composed of an O-ring or the like is provided between and to make the space watertight. Incidentally, reference numeral 218
Is an engagement knob of the angle operation unit 204.

Further, one end of a holder cable 219 is connected to the angle knob operating device 212. The other end of the holder cable 219 is connected to the angle control device 2
13 is connected. Furthermore, the angle control device 21
Reference numeral 3 is connected to a remote control unit (not shown) in the remote control room 20.

Next, the operation of the above configuration will be described.
When the device 1 of the present embodiment is used, the second
The same operation as in the embodiment (see FIG. 3) is performed.
That is, in the treatment room 2, the insertion portion 11 of the endoscope 7 is inserted into the patient 3
The operation of inserting into the body of the operator is performed while the operator looks through the eyepiece lens of the operation unit 12 of the endoscope 7 and observes it. At this time,
The insertion part 11 of the endoscope 7 is inserted to a position where the affected part 24 in the body of the patient 3 can be observed while observing the observation image through the eyepiece of the endoscope 7.

Subsequently, the brachysource applicator 19 is passed through the channel of the endoscope 7 and inserted to a position corresponding to the affected part 24. At this time, the accurate positioning work for aligning the tip portion of the brachysource applicator 19 with the position corresponding to the affected part 24 in the body of the patient 3 is performed while observing through the eyepiece of the endoscope 7.

When the positioning work is completed, the lock mechanism part (not shown) of each movable part of the endoscope supporting device 14 is locked to fix the endoscope 7 so as not to move from the positioning position.

After this, the operator moved to the remote control room 20,
By operating the brachytherapy apparatus controller 21 while observing the observation image of the endoscope 7 on the monitor 10 in the remote control room 20, the patient is irradiated with radiation from the brachysource at the tip of the brachysource applicator 19. The radiotherapy for irradiating the affected part 24 in the body 3 is performed. During this radiation treatment, it is confirmed from time to time that the tip of the brachysource applicator 19 is not displaced from the position corresponding to the affected part 24 in the body of the patient 3 by the observation image of the monitor 10.

Further, while observing the observation image of the endoscope 7 on the monitor 10 in the remote control room 20, the tip of the brachysource applicator 19 is located at a position corresponding to the affected part 24 in the body of the patient 3. When the deviation is confirmed, a control signal is sent to the angle control device 213 by remote control from the remote control section of the remote control room 20. The drive motor 215 of the angle knob operating device 212 is rotationally driven by the control signal. Therefore, the drive motor 215 rotationally drives the angle operation portion 122 via the knob joint 216 to bend the distal end portion of the insertion portion 11 of the endoscope 7 to position the distal end portion of the brachysource applicator 19 at a desired position. Move to.

Therefore, the following effects can be obtained with the above structure. That is, before the radiotherapy by the brachysource applicator 19 or during the radiotherapy, the brachysource applicator 1
Even if the position of the tip portion of 9 is displaced, the position of the tip portion of the brachysource applicator 19 can be easily readjusted to the correct position by remote control from the remote operation room 20.
For example, during the radiation treatment, the troublesome work of interrupting the radiation irradiation and re-adjusting the position of the brachysource applicator 19 is not required. Therefore, the operation during radiation treatment becomes extremely simple, and the radiation treatment time can be shortened.

The present invention is not limited to the above-mentioned embodiments, and it goes without saying that various modifications can be made without departing from the gist of the present invention.

Next, other characteristic technical matters of the present application will be additionally described as follows.

(Additional Item 1) A brachysource applicator to be inserted into a body cavity, an endoscope capable of passing the brachysource applicator to be inserted into a body cavity through a channel, a light source device, and An endoscope supporting machine that can fix the endoscope to the affected area, a TV system and a monitor that displays an observation image of the endoscope, and a transendoscope that includes means for fixing the brachysource applicator to the endoscope. Radiation irradiation system.

(Purpose of Supplementary Note 1) It is possible to observe the state of the affected area and the brachytherapy applicator even if the operator does not have an endoscope, that is, even if the operator is far from the patient, and before or after treatment. The purpose is to prevent the brachysource applicator positioned in the affected area from moving during treatment.

(Operation of Supplementary Note 1) The endoscope after the positioning is fixed to the affected area by the endoscope supporting device for supporting the endoscope. Also, by displaying the endoscopic image on the monitor,
The endoscope image can be seen even when it is separated from the endoscope. further,
The brachysource applicator is fixed to the endoscope by the brachysource applicator fixing means.

(Effect of Supplementary Note 1) In the Braky therapy in which a brachytherapy is directly carried to an affected area such as a tumor and the affected area is irradiated, the present invention makes the treatment safer and improves the therapeutic effect. .

(Additional Item 2) In the additional item 1, a transendoscopic radiation irradiation system in which a monitor for monitoring an endoscopic image is installed in the remote operation room.

(Purpose of Supplementary Note 2) It is possible to observe the state of the affected area and the brachytherapy applicator in a remote control room or the like where the treatment room cannot be seen.

(Operation of Supplementary Note 2) An endoscopic image signal is carried to a monitor in a remote control room using a signal cable.

(Additional Item 3) In the additional item 1, a plurality of monitors for monitoring the observation image of the endoscope are installed, one for observation during insertion and one for observation during remote operation in the remote control room. Endoscopic irradiation system.

(Purpose of Supplementary Note 3) It is possible to observe the state of the affected part and the brachytherapy applicator both when the endoscope is inserted into the patient and when it is in the remote control room.

(Operation of Supplementary Note 3) An endoscopic image signal is carried to a monitor in a remote control room using a plurality of signal cables.

(Additional Item 4) In the additional item 1, the endoscope grasping machine provided with a means capable of detachably attaching the endoscope to the endoscope supporting device and rotating and fixing the endoscope in the circumferential direction. A transendoscopic radiation irradiation system provided between a mirror and an endoscope support device.

(Purpose of Supplementary Note 4) While facilitating the position fixing of the endoscope in the circumferential direction, the endoscope is inserted into a patient,
After the endoscope is positioned, it can be easily detached from the endoscope supporting device.

(Operation of Supplementary Note 4) An endoscopic image signal is carried to a plurality of monitors using a plurality of signal cables.

(Additional Item 5) A transendoscopic radiation irradiation system according to Additional Item 1, which is provided with means for fixing the endoscope to the endoscope insertion opening of the patient.

(Purpose of Additional Item 5) It is to prevent the endoscope positioned in the affected area from moving before or during the treatment.

(Operation of Supplementary Item 5) The endoscope is fixed to the endoscope insertion portion of the patient by the endoscope fixing means provided in the endoscope.

(Additional Item 6) In the additional item 1, a transendoscopic irradiation system in which an endoscope intraluminal fixing device for positioning the endoscope in the center of the cavity is attached to the tip of the endoscope.

(Operation of Additional Item 6) The endoscope fixing tool provided in the endoscope positions the endoscope in the center of the cavity.

(Additional Item 7) In the additional item 1, a transendoscopic radiation irradiation system using an endoscope in which a channel is located at the center.

(Operation of Supplementary Note 7) A channel hole is provided in the center of the endoscope.

(Additional Item 8) In the additional item 1, a brachysource applicator for positioning the brachysource applicator in the center of the cavity, a transendoscopic irradiation system in which an intracavitary fixture is attached to an endoscope. .

(Operation of Supplementary Note 8) The brachysource applicator fixture is provided at the distal end of the endoscope to position the brachysource applicator in the center of the cavity.

(Additional Item 9) In the additional item 1, a brachysource applicator for positioning the brachysource applicator in the center of the cavity is attached to the brachysource applicator. Irradiation system.

(Purpose of Additional Items 6 to 9) It is to facilitate positioning of the brachysource applicator inserted into the channel of the endoscope in the center of the cavity.

(Operation of Supplementary Note 9) The brachysource applicator is positioned in the center of the cavity by the brachysource fixture provided on the brachysource applicator.

(Additional Item 10) A transendoscopic radiation irradiation system according to Additional Item 1, wherein the brachysource applicator is graduated.

(Purpose of Supplementary Note 10) It is possible to measure the distance from the affected area, the size of the affected area, and the like in the endoscopic image.

(Operation of Supplementary Note 10) Using the scale displayed on the brachysource applicator, the distance such as the size of the affected area in the endoscopic image is measured.

(Additional Item 11) In the additional item 1, there is provided a transendoscopic radiation irradiation system provided with means for fixing the angle operation portion of the endoscope.

(Purpose of Supplementary Note 11) It is to prevent movement of the distal end portion of the endoscope positioned on the affected area before or during treatment.

(Operation of Supplementary Note 11) The angle fixing means fixes the endoscope angle operation portion so that it does not move.

(Additional Item 12) In the additional items 3 and 4, the transendoscopic radiation irradiation system is provided with a mechanism capable of remotely controlling the angle of the endoscope while watching the remote control monitor in the remote control room.

(Purpose of Supplementary Note 12) It is possible to change the angle position of the endoscope even in a remote operation room remote from the patient.

(Operation of Supplementary Note 12) An angle remote control device for remotely controlling the angle of the endoscope is used to remotely control the angle while watching the remote control monitor.

[0194]

According to the present invention, the radiation therapy applicator inserted into the patient's body can be positioned with high accuracy, and the work efficiency of radiation therapy can be improved. It is possible to prevent the applicator positioned and fixed in the state of being aligned with the affected part in the body from moving before or during the treatment, and even when the operator is away from the endoscope, The state of the radiation treatment applicator can be observed.

[Brief description of the drawings]

FIG. 1 is a schematic configuration diagram of an entire radiation irradiating device using an endoscope according to a first embodiment of the present invention.

FIG. 2 is a side view showing a usage state of the device according to the first embodiment.

FIG. 3 is a schematic configuration diagram of an entire radiation irradiating device using an endoscope according to a second embodiment of the present invention.

FIG. 4 is a schematic configuration diagram of an entire radiation irradiating device using an endoscope according to a third embodiment of the present invention.

FIG. 5 is a perspective view showing a configuration of a main part of a fourth embodiment of the present invention.

FIG. 6A is a plan view of a main part showing a state before the endoscope is attached to the endoscope gripping tool of the fourth embodiment; FIG.
[Fig. 3] is a plan view of a main part showing a state in which an endoscope is attached to the endoscope gripping tool of the embodiment.

FIG. 7 is a perspective view showing a configuration of main parts of a fifth embodiment of the present invention.

FIG. 8 is a perspective view showing a usage state of the endoscope fixing tool according to the fifth embodiment.

FIG. 9 is a perspective view showing a configuration of main parts of a sixth embodiment of the present invention.

FIG. 10 is a plan view of an endoscope fixing tool according to a sixth embodiment.

FIG. 11 is a perspective view showing a usage state of the endoscope fixing tool according to the sixth embodiment.

FIG. 12 is a perspective view showing a configuration of a main part of a seventh embodiment of the present invention.

FIG. 13 is a perspective view showing a configuration of a main part of an eighth embodiment of the present invention.

FIG. 14 shows a ninth embodiment of the present invention,
(A) is a perspective view showing a state where the balloon of the endoscope fixing tool is deflated, and (B) is a perspective view showing a state where the balloon of the endoscope fixing tool is inflated.

FIG. 15 is a side view showing a usage state of the endoscope fixing tool according to the ninth embodiment.

16A and 16B show a tenth embodiment of the present invention, wherein FIG. 16A is a side view of an endoscope, and FIG. 16B is a side view showing a usage state of an endoscope fixing tool.

FIG. 17 is a side view showing the configuration of the main parts of the eleventh embodiment of the present invention.

FIG. 18 is a side view showing a usage state of the endoscope fixing tool according to the eleventh embodiment.

FIG. 19 is a perspective view showing the main configuration of a twelfth embodiment of the present invention.

20A and 20B show a thirteenth embodiment of the present invention, wherein FIG. 20A is a perspective view of a main part showing a usage state of the applicator fixture, and FIG. 20B is a perspective view of the applicator fixture.
(C) is a perspective view of the tip part of an endoscope.

21A is a perspective view showing a first modification of the thirteenth embodiment, and FIG. 21B is a perspective view showing a second modification of the thirteenth embodiment.

22A and 22B show a fourteenth embodiment of the present invention, wherein FIG. 22A is a perspective view showing an attached state of the applicator fixture, and FIG. 22B is a perspective view showing a used state of the applicator fixture.

FIG. 23 shows a fifteenth embodiment of the present invention, wherein (A) is a perspective view showing a mounting state of an applicator fixture, and (B) is a side view showing a proximal end portion of an endoscope. ,
FIG. 6C is a perspective view showing a usage state of the applicator fixture.

FIG. 24 is a perspective view of essential parts showing a sixteenth embodiment of the present invention.

FIG. 25 is a perspective view of essential parts showing a seventeenth embodiment of the present invention.

26A and 26B show an eighteenth embodiment of the present invention, wherein FIG. 26A is a vertical sectional view showing a mounting state of the applicator fixing tool, and FIG. 26B is a vertical sectional view showing a using state of the applicator fixing tool. Fig.

FIG. 27 is a side view showing the configuration of the main parts of the nineteenth embodiment of the present invention.

FIG. 28 is a schematic configuration diagram of an entire radiation irradiating device using an endoscope according to a twentieth embodiment of the present invention.

FIG. 29 is a perspective view showing a supported state of the endoscope according to the twentieth embodiment.

FIG. 30 is a vertical sectional view of an angle knob operating device according to a twentieth embodiment.

[Explanation of symbols]

7 ... Endoscope, 19 ... Brachysource applicator (radiation treatment applicator), 14 ... Endoscope support machine, 10, 10A,
10B ... monitor.

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[Procedure amendment]

[Submission date] February 26, 1996

[Procedure amendment 1]

[Document name to be amended] Statement

[Correction target item name] 0134

[Correction method] Change

[Correction contents]

Here, the mouthpiece 182 is provided with a substantially cylindrical mouthpiece body 186. An insertion portion 187 having a substantially hollow circular cone shape to be inserted into the channel insertion opening 171 is formed on one end portion side of the mouthpiece main body 186, and a large diameter cylindrical portion 188 is formed on the other end portion side. Further, a flange portion 189 is provided so as to project from the open end of the large diameter tubular portion 188. A male screw portion 190 is formed on the outer peripheral surface of the flange portion 189. Even when the flange portion 189 is not, it is not externally threaded portion 190 is formed on an outer peripheral surface of the large diameter cylindrical portion 188
If it.

[Procedure amendment 2]

[Document name to be amended] Statement

[Correction target item name]

[Correction method] Change

[Correction contents]

(Operation of Supplementary Note 3) An endoscopic image signal is carried to a plurality of monitors using a plurality of signal cables.

[Procedure 3]

[Document name to be amended] Statement

[Correction target item name] 0172

[Correction method] Change

[Correction contents]

(Operation of Supplementary Note 4) The endoscope grasping machine facilitates attachment and detachment of the endoscope and the endoscope supporting machine.

Claims (1)

[Claims] 1. An endoscope to be inserted into a body cavity, and a radiotherapy applicator which is inserted into the body cavity through a channel of the endoscope and which penetrates a radiation source for radiotherapy.
An endoscope supporting device that supports the endoscope and fixes the endoscope at an arbitrary observation position, a monitor that displays an observation image of the endoscope, and the radiation treatment applicator are included in the endoscope. A radiation irradiating device using an endoscope, comprising: