JPH0956828A - Applicator for hyperthermia - Google Patents

Abstract

PROBLEM TO BE SOLVED: To enhance the insertability of the above applicator by simplifying the constitution of a treating means for thermotherapy and means for introducing a radiation source and the constitution of a cooling structure and particularly forming the insertion part to a small diameter although the applicator has these means. SOLUTION: The applicator 1 for hypothermia includes an outside sheath 2 for the insertion part closed at the front end, an inside sheath 3 which is disposed in this outside sheath 2 and is opened at the front end, the mans which is constituted by utilizing the internal cavity of the inside sheath and the region between the inside sheath 3 and the outside sheath 2 and transfuses a cooling medium, an electrode 9 for thermotherapy which is installed between the inside sheath 3 and the outside sheath 2 and a tube 19 which is inserted into the inside sheath 3 and introduces the radiation source.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a hyperthermia device which heats and treats an affected area in a living body, and more particularly to a hyperthermia applicator which is inserted and used in a living body cavity.

[0002]

2. Description of the Related Art DE 4209844A1 shows a radiation heat therapy applicator, which is provided with a plurality of disc electrodes with pinholes at the tip of the insertion portion of a probe, and a sealing cap provided in the pinholes. The activator (radiation source) can be arbitrarily inserted into the space, and the space formed around the pinhole and disk electrode is used as a coolant conduit to cool the activator. It is a thing.

In Japanese Utility Model Laid-Open No. 63-109152, a cooling liquid circulation passage formed by a separator is provided in the insertion portion, and the high frequency heating electrode portion is cooled by circulating the cooling liquid in the circulation passage. A high frequency hyperthermic therapeutic applicator is shown.

[0004]

By the way, DE420
In the configuration as shown in 9844A1, since a plurality of disc electrodes are stacked and a sealing cap is required in the pinhole, the structure of the probe insertion part is complicated and the outer diameter becomes large. However, the flexibility of the probe decreases and the insertability of the probe is impaired.

In the structure of the applicator for high-frequency thermotherapy as shown in Japanese Utility Model Laid-Open No. Sho 63-109152, a cooling liquid circulation function is required, so that the structure for forming the circulation passage of the cooling liquid becomes complicated, and the insertion is complicated. The degree of freedom of the shape of the part is reduced, and the flexibility is reduced.

Further, if there is a wide area near the treatment area where heating is not desired, the cooling mechanism built into the applicator may lack capacity, and additional cooling means may be required.

The present invention has been made in view of the above-mentioned problems, and an object thereof is to provide a means for treating heat and a means for introducing a radiation source, even though the means and the cooling structure are provided. An object of the present invention is to provide an applicator for a hyperthermia, which has a simplified structure, and in particular, the outer diameter of an insertion portion can be formed to be small and which has high insertability.

[0008]

DISCLOSURE OF THE INVENTION The present invention is an applicator for a hyperthermia which inserts an insertion part into a body cavity to treat an affected part in the body cavity, and an outer sheath for the insertion part having a closed tip and an outer sheath for the insertion part. An inner sheath provided with an open tip, and means for perfusing a cooling medium constituted by utilizing the inner cavity of the inner sheath and the region between the inner sheath and the outer sheath,
An applicator for hyperthermia, comprising: a heat treatment treatment unit installed between the inner sheath and the outer sheath; and a tube unit that is inserted into the inner sheath and introduces a radiation source.

[0009]

BEST MODE FOR CARRYING OUT THE INVENTION

<First Embodiment> A first embodiment of the present invention will be described with reference to FIG. (Structure) In FIG. 1, reference numeral 1 is an applicator 1 for hyperthermia, the insertion portion of which has a flexible outer sheath 2 whose tip is closed by a spherical tip wall, and the inner sheath of this outer sheath 2 A flexible inner sheath 3 having an open tip is concentrically arranged.

At the end of the outer sheath 2, a coolant discharge end 4 is provided.
An insertion port 5 for penetrating the inner sheath 3 in a liquid-tightly sealed state and a transmission line outlet 6 extending obliquely rearward from the outer peripheral surface of the outer sheath 2 are provided. Further, the end portion of the inner sheath 3 penetrates the insertion port 5 and projects to the outside, and a cooling liquid injection end 7 and a radiation source introduction tube insertion port 8 are provided at this protruding end part. further,
A coil-shaped high-frequency electrode 9 is attached to the outer periphery of the distal end portion of the inner sheath 3 as a heat treatment treatment means. This constitutes the heating section of the applicator 1. A temperature sensor 10 for contacting the affected area is attached to the outer circumference of the outer sheath 2 corresponding to the heating area.

A relay tube 11 is provided at the cooling liquid discharge end 4.
, And another relay tube 12 is connected to the cooling liquid injection end 7. These relay tubes 11, 1
The other end of 2 is connected to a cooling liquid recirculation device 13 having a cooling liquid tank and a pump. Then, the cooling liquid is poured from the cooling liquid injection end 7 into the inner sheath 3 through the relay tube 12, and the cooling liquid is discharged from the cooling liquid discharge end 4 communicating with the space region between the outer sheath 2 and the inner sheath 3 through the relay tube 11. It is returned to the cooling liquid reflux device 13.

Therefore, in the insertion portion of the applicator 1, the cooling liquid flows toward the distal end side through the inner cavity of the inner sheath 3 and is discharged into the distal end portion of the outer sheath 2, and then the outer sheath 2 is outside the inner sheath 3. Perfusion is performed by repeating the flow of the cooling liquid toward the proximal end side toward the cooling liquid discharge end 4 through the region between the inner sheath 3 and the inner sheath 3. That is, the cooling means for perfusing the cooling medium is configured by utilizing the inner cavity of the inner sheath 3 and the region between the outer sheath 2 and the inner sheath 3. In addition,
The same cooling medium may be circulated, or the perfused cooling medium may be sequentially discarded.

On the other hand, the high-frequency transmission line 14 drawn out from the end of the high-frequency electrode 9 arranged in the insertion part of the applicator 1 is guided to the base end side along the outer peripheral surface of the inner tube 3, It is drawn out through the transmission line outlet 6 and is connected to a high frequency oscillator 16 via a relay cable 15. An extracorporeal electrode 18 is connected to the high-frequency oscillator 16 via another relay cable 17.

The radiation source introducing tube insertion port 8 penetrates the radiation source introducing tube 19 in a liquid-tightly sealed state. The tube 19 is inserted into the inner sheath 3, but the distal end thereof is the inner sheath. It can reach the tip of 3 and is positioned and fixed by a fixing screw cap 20 at a desired position. That is, fixing the axial movement of the tube 19,
The tip position of the tube 19 can be selected. The tip of the tube 19 is usually positioned at a position just before the opening of the tip of the inner sheath 3 corresponding to the heating portion of the applicator 1.

Further, the distal end side of the radiation source introducing tube 19 is extended outward from the inner sheath 3, and a radiation treatment device 21 is provided.
It is connected to the. (Operation) The operation of the hyperthermia applicator 1 will be described. First, the insertion part of the applicator 1 is inserted into the body cavity 23 of the patient 22, and the heating part is positioned at a desired site. The insertion of the applicator 1 and the positioning of the applicator 1 at a desired site are performed while confirming the position of the applicator 1 under X-ray fluoroscopy or ultrasonic fluoroscopy, or the position of the affected area is diagnosed in advance with an endoscope or the like. The insertion length may be measured.

FIG. 1 shows a state in which a heating part is aligned with the affected part 24 in the body cavity 23 and positioned. In this state, the cooling liquid recirculation device 13 is activated, the cooling liquid is recirculated from the inner cavity of the inner sheath 3 to the inner cavity side of the outer sheath 2, and the high-frequency oscillator 16 is activated. A high frequency is applied between the attached high frequency electrode 9 and the extracorporeal electrode 18 mounted on the surface of the living body so as to face the high frequency electrode 9, and the affected part 24 is heated by the high frequency. At this time,
The temperature of the inner surface of the cavity is measured by the temperature sensor 10 provided on the surface of the outer sheath 2, and the high frequency oscillation output of the high frequency oscillation device 16 is controlled based on the measured value to heat the affected part 24 to a constant temperature. To do so.

Further, the radiation source (for example, Ir) is inserted from the radiation treatment device 21 into the radiation source introducing tube 19 through the inner sheath 3 and the affected area 24 is irradiated with radiation in parallel with the heating treatment. Alternatively, the radiation source introducing tube 19 may be inserted into the inner sheath 3 in advance, and irradiation may be performed before the heating treatment or after the heating treatment. (Effect) According to the applicator 1, the configuration of the duct or the like is simplified, and in particular, the outer shape of the insertion portion can be formed thin and flexible, so that the lumen squeezed by a tumor or the like, the bile duct, the urethra, It can easily fit into a flexible and complicated shape such as a thin curved lumen of the cervix or bronchus, and can be easily inserted. Further, since the cooling liquid can circulate reliably even in a narrow and narrow cavity, a sufficient cooling function can be secured and more reliable heating can be performed. A radiation source introducing tube 19 can be inserted into the cooling liquid return passage, here, the inner cavity of the inner sheath 3.
It has become possible to easily perform simultaneous thermal and radiation combined treatment for a narrow and narrow lumen. Further, since the outer sheath 2 and the inner sheath 3 can be separated by pulling out the inner sheath 3 from the outer sheath 2, only the outer sheath 2 which is easily damaged by the insertion / withdrawal operation into the cavity can be used disposable. <Second Embodiment> A second embodiment of the present invention will be described with reference to FIG. (Structure) In the second embodiment, the following elements are added to the structure of the first embodiment described above. First, the wall thickness at the distal end portion of the outer sheath 2 was partially increased, and a pipe line (through hole) 31 along the axial direction was formed in the wall thickness portion 30. The thick portion 30 is formed in a streak shape along the axial direction of the outer sheath 2.

In addition, a part of the constituent elements in the above-described first embodiment is replaced as follows.
That is, the high-frequency electrode 9, the high-frequency transmission line 14, and the high-frequency oscillator 29 in the first embodiment are divided into a plurality of laser emitting portions 32 and laser transmission lines (optical fibers).
33 and the laser generator 34 are replaced respectively. Others are the same as the constituent elements in the above-described first embodiment. (Operation) In this embodiment, when the applicator 1 is inserted into the living body cavity, in addition to the operation of the first embodiment, a guide means such as a guide wire (not shown) is inserted into the conduit 31 and inserted into the same. Can be inserted along the cavity. Also,
It is possible to insert the observation device such as an endoscope through the observation device while inserting it while observing the inside of the cavity, confirm the position of the affected part 24, and place the applicator 1 at a desired position accurately.

After inserting the applicator 1 and during or before and after treatment, the conduit 31 can be used as an airway hole. Further, instead of the heating action by the high frequency of the first embodiment, the laser generator 34 is activated, and the affected part 22 is irradiated with laser from the laser emitting part 32 to perform the heating treatment.
Other actions are similar to those of the first embodiment. (Effect) According to the configuration of this embodiment, the applicator 1
Since the diameter of the electrode part of the insertion part can be formed thin, the same effect as the first embodiment can be obtained. In addition, since the pipe line 31 is provided, a guide wire or an endoscope can be inserted through the pipe line 31 to perform a quick procedure and further improve the insertability and the reliability. Further, since the duct 31 can be used as an airway during treatment, breathing is easy even when the applicator 1 is placed in the trachea, and the burden on the patient is reduced.

In the first and second embodiments, examples of high-frequency dielectric heating and laser heating are shown as the heating means, but instead of these, microwave heating, ultrasonic heating, etc. May be adopted. <Third Embodiment> A third embodiment of the present invention will be described with reference to FIG. (Structure) This embodiment is an example of a rectal cooling balloon device which is a cavity insertion type cooling means used when using the above-mentioned hyperthermia applicator. The rectal balloon device 40 has an insertion portion shaft 41, and is mounted in a state in which a swellable bag-like body 42 is covered around the shaft 41. Both ends of the bag-like body 42 are adhesively fixed to the outer periphery of the shaft 41 by an adhesive 43 so as to keep watertightness. Further, a grip portion 45 is connected to the rear end (base end) portion of the shaft 41 via a fitting portion 44.

The shaft 41 is provided with a fluid conduit 46 communicating with the inside of the bag-like body 42.
6 is open at the rear end of the shaft 41. The grip 4
Similarly, from the front end of 5 to the side of the grip, the fluid line 4
7 is provided, and the fluid conduits 46 and 47 communicate with each other by fitting the shaft 41 and the grip portion 45,
The distal end communicates with the inside of the bag-shaped body 42, and the proximal end communicates with the conduit port 4
8 is connected.

One end of a tube 49 is connected to the conduit port 48, and the other end of the tube 49 is connected to a fluid supply means 52 such as a syringe via a valve 51 such as a stopcock. (Operation) The rectal balloon device 40 having the above-described configuration is inserted into the rectum of a patient who is subjected to prostatic hyperthermia treatment with a transurethral applicator for hyperthermia, in a state in which the bag-shaped body 42 is deflated and the shaft 41 is thinned. .

Fluid insertion means 5 after insertion into the patient's rectum
The fluid is injected into the bag-shaped body 42 from 2 through the valve 51, the tube 49, the conduit port 48, the fluid conduit 47, and the fluid conduit 46, and the bag-shaped body 42 is expanded. Bag 42
The valve 51 is sealed after the fluid has been injected to such an extent that it expands and comes into close contact with the rectal wall. A fluid having a large specific heat, such as water or gel, is suitable as the fluid to be injected and sealed inside the bag-shaped body 42.

Thereafter, the hyperthermia treatment applicator as described above is inserted transurethrally to start hyperthermia treatment to heat the enlarged prostate. When the hyperthermia treatment is continued and the prostate is heated, the temperature of the rectal wall gradually rises, but the temperature rises because the rectal balloon device 40 enclosing a fluid having a large specific heat is in contact with the rectal wall. Allow the rectal wall to cool. (Effect) According to such a configuration and operation, since the rectal wall is cooled by the rectal balloon device 40 during the hyperthermia treatment, the lack of cooling capacity can be compensated. Further, it becomes possible to perform proactive warming treatment of the prostate without worrying about heat damage to the rectal wall. Furthermore, the effect of rectal wall cooling can be obtained with an extremely simple and inexpensive structure. It is possible to provide an intracavity-insertion-type cooling means that is flexible and easily fits in a complicated shape.

FIG. 4 shows a modification of the rectal balloon device 40. This is because a temperature sensor 55 is provided on the surface of the shaft 41 inside the bag-shaped body 42, and a temperature detection signal of the temperature sensor 55 is provided inside the grip portion 45 via a signal line 56, which is not shown. Entered in. The measured temperature calculated by the temperature measuring circuit is displayed on the temperature display section 57 provided on the grip section 45.

According to this structure, the temperature of the fluid enclosed in the bag-shaped body 42 can be observed during the thermotherapy,
It is possible to read from the temperature display unit 57 how the fluid temperature rises due to the patient's body temperature and the cooling effect on the rectal wall decreases. In such a case, the fluid inside the rectal balloon device 40 can be replaced to restore the cooling effect of the rectal wall. Therefore, it is possible to maintain the effect of rectal cooling protection during hyperthermia treatment for a long time, and it is possible to more safely perform hyperthermia treatment.

The configuration of the rectal probe shown here is merely an example, and the shaft or the gripping portion may have any shape and material, and both may be integrated, as long as they can be easily inserted into the rectum. . Further, even if the fluid conduit is not provided inside the shaft, the tube may be directly connected to the bag-like body to simplify the configuration, and the simplification of the structure impairs the operation and effect of the present embodiment. It is self-evident that it can be achieved without being lost. [Supplementary Note] According to the above description, it is obvious that at least the following items can be obtained. (1) In an applicator for a hyperthermia for treating an affected part in a body cavity by inserting the insertion part into the body cavity, an outer sheath for an insertion part having a closed tip, and an inner sheath having an open tip disposed in the outer sheath A means for perfusing a cooling medium constituted by utilizing the inner cavity of the inner sheath and a region between the inner sheath and the outer sheath; and a heat treatment treatment means installed between the inner sheath and the outer sheath. And a tube means that is inserted into the inner sheath and introduces a radiation source.

(2) A large-diameter portion formed to be thicker than the outer diameter of the other insertion portion is provided at a part of the distal end portion of the outer sheath forming the insertion portion, and this large-diameter portion is moved forward and backward. The hyperthermia applicator according to item 1, wherein a pipe passage (through hole) is provided so as to penetrate therethrough. By inserting a guide wire or endoscope through the through hole, the insertability and safety were further improved, and the burden on the operator was reduced. Since the duct can be used as a vent hole, when the applicator is inserted into the trachea for use, the patient can easily breathe and the burden on the patient is reduced. (3) A hyperthermia treatment system characterized in that an intracavity insertion type cooling means enclosing a mass having a large specific heat is provided in the vicinity of a treatment part of a living body and is used in combination with the hyperthermia applicator. (4) The hyperthermia treatment system according to item 3, wherein the temperature measuring means is provided in the mass having a large specific heat.

[0029]

As described above, according to the present invention, although the heat treatment treatment means and the means for introducing the radiation source are provided, the configurations of these means and the cooling structure are simplified, and particularly, the application is performed. Since the diameter of the insertion portion of the blade can be made small, the insertability into a narrow cavity is improved. Further, when the applicator is inserted, it can be inserted without forcibly expanding the narrow lumen, so that the burden on the patient is reduced and the operation of the operator is easy.

[Brief description of drawings]

FIG. 1 is an explanatory diagram of a usage state of a hyperthermia applicator system according to a first embodiment.

FIG. 2A is an axial longitudinal cross section of an applicator of the second embodiment, and FIG. 2B is a cross sectional view taken along line AA indicated in FIG.

FIG. 3 is a cross-sectional view showing the configuration of a rectal balloon device for cooling the rectal wall used in combination with a thermotherapy device.

FIG. 4 is a cross-sectional view showing a modified example of a rectal balloon device.

[Explanation of symbols]

1 ... Applicator for hyperthermia, 2 ... Outer sheath,
3 ... Inner sheath, 4 ... Coolant discharge end, 5 ... Insertion port, 6 ... Transmission line outlet, 8 ... Radiation source introducing tube insertion port, 9 ...
High frequency electrode, 10 ... Temperature sensor, 11 ... Relay tube,
12 ... Relay tube, 13 ... Coolant recirculation device, 14 ... High frequency transmission line, 16 ... High frequency oscillator, 17 ... Relay cable, 18 ... Extracorporeal electrode, 19 ... Radiation source introducing tube,
20 ... Fixing screw cap, 21 ... Radiotherapy device, 22
... Patient, 23 ... Body cavity, 24 ... Affected part.

Claims (1)

[Claims] 1. A hyperthermia applicator for treating an affected area in a body cavity by inserting the insertion section into the body cavity, wherein an outer sheath for the insertion section having a closed tip and an inner sheath having an open tip disposed in the outer sheath. A sheath, a means for perfusing a cooling medium constituted by utilizing the inner cavity of the inner sheath and a region between the inner sheath and the outer sheath, and a heat treatment treatment provided between the inner sheath and the outer sheath. An applicator for hyperthermia, comprising: a means and a tube means that is inserted into the inner sheath to introduce a radiation source.