JPH11318925A - Medical probe - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a medical probe of simple structure heightening safety to a patient without the possibility of adverse effect on other medical instruments. SOLUTION: A diode chip 8 heated proportionally to the supply voltage quantity, and a piercing needle 7 formed of material that conducts heat of the diode chip 8, are disposed at the tip part of an insert part 2. A probe control device is provided with a temperature setting part for controlling supply voltage to the diode chip 8 to optionally set the temperature of the piercing needle 7.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a medical probe for performing a treatment for applying heat to a prostatic tissue of, for example, benign prostatic hyperplasia to perform resection.

[0002]

2. Description of the Related Art Generally, a puncture needle is pierced into a prostatic hyperplasia prostate tissue, for example, as a treatment device for prostatic hypertrophy, and then the puncture needle is energized to apply heat to the prostatic hyperplasia prostate tissue. There is known a configuration of giving and cutting.

[0003] As a prior art of this type of apparatus, there is, for example, USP 5,582,589. In this method, a probe (puncture needle) composed of a radio frequency electrode and an insulating sleeve surrounding the radio frequency electrode is pierced into the prostate, and high-frequency electricity is applied to the prostate to heat the prostate. Here, a temperature sensor is mounted on the insulating sleeve. During the high-frequency heating, the temperature sensor monitors the temperature near the urethral wall.

[0004]

In the above-mentioned prior art, a high frequency is applied between a counter electrode plate adhered to a patient and a radio frequency electrode, so that the probe is heated at a high frequency to generate heat. Therefore, the patient may be burned due to high-frequency leakage current, peeling of the return electrode plate, and the like, and high-frequency noise may adversely affect other medical devices.

Further, when using a high-frequency output, the temperature near the puncture portion of the probe is not known, so that a temperature sensor for measuring the temperature near the puncture portion of the probe is separately provided.
It is necessary to control the high-frequency output according to the temperature measured by the temperature sensor. Therefore, there is a problem that the configuration of the entire medical device becomes complicated.

[0006] The present invention has been made in view of the above circumstances, and its object is to improve the safety for patients, to not adversely affect other medical devices,
An object of the present invention is to provide a medical probe having a simple structure.

[0007]

SUMMARY OF THE INVENTION The present invention relates to a medical probe having an elongated insertion portion to be inserted into the body and an extracorporeally arranged element arranged outside the body, wherein the heating element generates heat in proportion to the supply voltage. And a puncture needle formed of a material that conducts heat of the heating element, disposed at the distal end of the insertion section, and controlling the supply voltage to the heating element to arbitrarily adjust the temperature of the puncture needle. A medical probe, wherein a temperature control unit to be set is provided in the extracorporeal arrangement element.

During the treatment, the heating element is energized and heated with the puncture needle punctured into the living tissue. At this time,
By controlling the voltage of the puncture needle by arbitrarily controlling the supply voltage to the heating element by the temperature control means of the extracorporeal element, it is possible to prevent burns due to high-frequency output and to measure the temperature near the puncture needle such as a temperature sensor. This is an unnecessary configuration.

[0009]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Hereinafter, a first embodiment of the present invention will be described with reference to FIGS. FIG. 1 shows a schematic configuration of the entire medical probe 1 of the present embodiment. The medical probe 1 of the present embodiment is provided with an elongated insertion section 2 inserted into the body of the patient H, and a probe control device (external arrangement element) 3 arranged outside the body of the patient H. Here, the proximal handle 4 of the operator is connected to the proximal end of the insertion section 2 of the probe 1. One end of a cable 5 is connected to the rear end of the handle 4. The other end of the cable 5 is connected to the probe control device 3.

A plurality of puncture needle storage holes 6 are formed at the tip of the insertion section 2 as shown in FIG. A puncture needle 7 is mounted in these puncture needle storage holes 6 so as to be able to protrude and retract. At the tip of each puncture needle 7, a sharp point 7a is formed.

Further, inside the puncture needle 7, a diode chip (heating element) 8 that generates heat in proportion to the amount of supplied voltage is incorporated. One end of a lead wire 9 is connected to the diode chip 8. The other end of the lead wire 9 is connected to the internal wiring of the cable 5. The puncture needle 7 is formed of a material that conducts heat of the diode chip 8.

The handle 4 of the probe 1 is provided with a slide switch 10 for operating the puncture needle 7 to protrude and retract, and an output switch 11 for turning on / off the voltage supply of the probe control device 3. Note that the slide switch 10
Is mechanically connected to the puncture needle 7 via a connecting means (not shown), such as an operation wire, which is disposed inside the insertion portion 2 so as to be movable in the axial direction.

The probe control device 3 is provided with an operation panel 12 shown in FIG. This operation panel 12
Are provided with a temperature setting section (temperature control means) 13 for setting the temperature of the diode chip 8, a power switch 14, and a connection section 15 of the cable 5. Further, the temperature setting unit 13 is provided with a temperature setting scale 13a, a pointer 13b that moves on the temperature setting scale 13a in the vertical direction in FIG. 3, and a temperature setting switch 13c that moves the pointer 13b. I have. The setting temperature of the diode chip 8 is set to the operator's desired temperature by moving the pointer 13b up and down on the temperature setting scale 13a in accordance with the operation of the temperature setting switch 13c. .

Next, the operation of the above configuration will be described.
When using the medical probe 1 of this embodiment has the insertion portion 2 of the probe 1 as shown in FIG. 1 is inserted into the urethra H ₁ of the patient H. In FIG. 1, the inner part of the urethra H ₁ of the patient H is prostate H ₂ hypertrophic prostatic hyperplasia. Then, the insertion portion 2 of the probe 1, after being inserted from the urethra H _1, is inserted to the position of the prostate H _2.

Further, the insertion portion 2 of the probe 1 is prostate H ₂
2, the slide switch 10 of the handle 4 is slid to cause the puncture needle 7 to protrude.
Puncturing the puncture needle 7 into the prostate H ₂ as shown in.

Thereafter, when the output switch 11 of the handle 4 is turned on, a voltage corresponding to a preset temperature set in advance by the probe control device 3 is supplied to the diode chip 8 of the puncture needle 7 so that the diode chip 8 Generates heat. At this time, the set temperature of the diode chip 8 is set to the operator's desired temperature by moving the pointer 13b up and down on the temperature setting scale 13a with the operation of the temperature setting switch 13c.

Further, the heat of the diode chip 8 which has generated heat is conducted to the tissue of the prostate H ₂ through the puncture needle 7.
And thereby the tissue prostate H ₂ is ablated is heated treated.

Therefore, the above configuration has the following effects. That is, in the present embodiment, the diode chip 8 that generates heat in proportion to the supply voltage amount, and the puncture needle 7 formed of a material that conducts heat of the diode chip 8 are disposed at the distal end of the insertion section 2. Therefore, the tip of the puncture needle 7 can be heated to the temperature set by the temperature setting unit 13 of the probe control device 3, and the temperature can be set freely. Therefore, compared with the case of using a high frequency as in the conventional on heating treatment of the puncture needle 7 by heating the thermal treatment of tissue prostate H _2, less risk of burns to the patient H,
The safety for the patient H can be improved.

In addition, since only a voltage is supplied to the diode chip 8 when the puncture needle 7 is heated, power consumption can be significantly reduced as compared with a high frequency output. Further, since the influence of noise on other medical devices is small, the possibility of adversely affecting other medical devices is small, and safety can be improved.

Since the temperature of the diode chip 8 of the puncture needle 7 changes in proportion to the amount of voltage, the temperature of the diode chip 8 is reduced by operating the temperature setting switch 13c in the temperature setting unit 13 of the probe control device 3. Directly,
An operation for setting the temperature desired by the operator can be performed. This eliminates the need for a temperature measuring unit such as a temperature sensor as in the related art, so that the overall configuration of the medical probe 1 is simplified and the cost is reduced.

FIG. 4 shows a second embodiment of the present invention. In this embodiment, the insertion portion 2 in the medical probe 1 of the first embodiment (see FIGS. 1 to 3) is used.
Is a modification of the configuration of the front end portion as follows.

That is, in the first embodiment, the puncture needle 7
Although the configuration in which the diode chip 8 is incorporated in the inside is shown, in the present embodiment, the diode chip 21 is incorporated in the tip of the insertion section 2 of the probe 1.

Further, on the side surface of the diode chip 21, a puncture fine needle 23 contained in a tube 22 for preventing burns is provided.
Is inserted. Here, the puncture fine needle 23 is formed of a material having good heat conductivity. And this puncture fine needle 2
3 is held in a state of being pressed against and in contact with the side surface of the diode chip 21.

An exposed treatment section 23a which is not covered with the tube 22 for preventing burns is formed at the leading end of the puncture fine needle 23. And this treatment part 2
The treatment of the living tissue is performed by 3a.

The other parts have the same configuration as the medical probe 1 of the first embodiment, and the same parts as those of the medical probe 1 of the first embodiment are denoted by the same reference numerals. The description is omitted here.

Next, the operation of the above configuration will be described.
Similarly in the present embodiment and the first embodiment, in a state where the insertion portion 2 of the probe 1 is inserted to the position of the prostate H _2, puncture fine slide the slide switch 10 of the handle 4 shown in FIG. 1 the needle 23 punctures the prostate H _2.

Thereafter, when the output switch 11 of the handle 4 is turned on, the cable 5 and the lead wire 9 in the insertion section 2 are turned on.
The voltage is supplied to the diode chip 21 through the diode chip 21 and the diode chip 21 generates heat. Thereby, the heat of the diode chip 21 is transferred to the fine needle 23 disposed on the side surface of the diode chip 21. At this time, since the portion of the puncture fine needle 23 other than the treatment section 23a at the forefront is covered with the tube 22 for preventing burns, the puncture fine needle 2
3 of the heat is not transferring heat to the mucosa of the inner wall surface of the urethra H _1, which heat is transferred only in prostate H _2.

Therefore, in the present embodiment, a diode chip 21 that generates heat in proportion to the supply voltage amount and a puncture fine needle 23 formed of a material having good heat conductivity are disposed at the distal end of the insertion section 2. The heat of the diode chip 21 can be transferred to the fine puncture needle 23 so that the tip of the fine puncture needle 23 can be heated to the temperature set by the temperature setting unit 13 of the probe control device 3, and the temperature can be set freely. Can be done. Therefore, in the present embodiment, the prostate H2
As compared with the case where a high frequency is used for the heating treatment of the tissue, the safety for the patient H can be improved, and the influence of noise on other medical devices is small.
There is little risk of adversely affecting other medical devices, improving safety and saving power.

Furthermore, in this embodiment, in particular, since the diode chip 21 is disposed in the insertion section 2 of the probe 1, the outer diameter of the puncture needle 7 of the medical probe 1 of the first embodiment is reduced. In comparison, the outer diameter of the puncture fine needle 23 of the present embodiment can be reduced. Therefore, the puncture hole of the living tissue by the puncture fine needle 23 of the present embodiment can be reduced, and the safety can be further enhanced.

Further, in this embodiment, since only one diode chip 21 is required, the number of lead wires 9 in the probe 1 can be reduced as compared with the medical probe 1 of the first embodiment. Electricity can also be achieved.

FIG. 5 shows the tip of the puncture electrode device 31. The body of the patient H, for example, a pair of puncture 33 at the distal end of an elongated insertion portion 32 to be inserted into the urethra H ₁ is provided in the piercing electrode device 31 in FIG. Each puncture part 3
3 is provided with a puncture needle 34 and an insulating shield 35. Here, a measurement electrode 36 is provided on the insulating shield 35 at a position 3 mm or more away from the tip thereof as shown in FIG.

Further, a handle (not shown) is connected to the base end of the insertion portion 32. The handle is provided with an operation unit (not shown) that slides the puncture needle 34 and the insulating shield 35 of each puncture unit 33 independently.

The handle (not shown) of the puncture electrode device 31 is connected to a high-frequency power supply HFU 37. The high-frequency power supply HFU 37 has an impedance display section 38.
, An output unit 39, an input unit 40, and a connection unit 41. The puncture needle 34 of the puncture electrode device 31 is connected to the output unit 39, and the measurement electrode 36 is connected to the measurement input unit 40.

Further, a return electrode 42 as a return electrode is affixed to the patient's body. This return electrode plate 42 is a high frequency power supply H
It is connected to the connection part 41 of the FU 37 (in the case of a monopolar puncture electrode).

Next, the operation of the above configuration will be described.
When using the lancing electrode device 31 having the above structure (for the treatment of prostate H ₂₎ is protruded a puncture 33 from the insertion portion 32,
The puncture 33 to puncture the prostate of H ₂ under the mucosa H _3. At this time, a weak measurement current flows between the measurement electrode 36 of the insulating shield 35 and the counter electrode plate 42 at predetermined time intervals,
During that time, the impedance of the living tissue is measured. The measurement result of the impedance is displayed on the display unit 38 of the high-frequency power supply HFU 37.

[0036] Here, the case in which the measuring electrode 36 is in the urethra H _1, the impedance is different when in the prostate H _2. Then, the piercing electrode device 31 having the above structure by using it, from the measurement results displayed on the display unit 38 the current position, for example, the measuring electrode 6 within the prostate of H ₂ measuring electrode 6, i.e. below the mucosa H ₃ You can easily confirm that.

[0037] Therefore, work to penetrate the mucosal H ₃ below prostate H ₂ in the puncture 33, the surgeon RF power HFU3
While looking at the measurement result displayed on the display unit 38 of No. 7,
The insulating shield 35 is advanced. Then, the measuring electrode 36 from the measurement results displayed on the display unit 38 within the prostate H _2,
That confirms that the underlying mucosa H _3. At this time,
Since the tip of the insulation shield 35 is spaced from the measuring electrode 36 3mm or more, the insulating shield 35 is seen to have been deeply punctured 3mm or more mucous membranes H _3.

Further, the tip of the insulating shield 35 is a mucous membrane H
After it was confirmed _{that 3} is deeper puncture 3mm or more with respect to a high frequency by energizing the puncture needle 34, to ablate the prostate H _2.

Therefore, the puncturing electrode device 31 having the above configuration has the following effects. That is, the puncturing unit 3 is inserted from the insertion unit 32.
3 is protruded to puncture the prostate H ₂ under the mucous membrane H ₃ , while the measurement electrode 36 of the insulating shield 35 and the return electrode 42
And a weak measurement current is passed at predetermined time intervals, and the impedance of the living tissue during that time is measured to display the measurement result on the display unit 38 of the high-frequency power supply HFU 37. it can be seen that has been precisely puncture the mucosal H ₃ below. Therefore, it is possible to accurately position the lancing depth of the insulation shield 35, damage to the mucous membrane H ₃ by puncturing the insulation shield 35 is too shallow, the puncture of the insulation shield 35 is too deep, it is cauterized range Can be prevented from becoming smaller, mucous membrane H
₃ , thermal damage can be prevented.

FIG. 7 shows a modification of the puncture electrode device 31 shown in FIGS. In this modified example, at least two measurement electrodes 36 are provided on the insulating shield 35.

Therefore, in the above configuration, the position of the insulating shield 35 can be detected by measuring the impedance between the measurement electrodes 36. Therefore, since the measurement distance is short, there is an effect that the impedance can be measured more accurately.

Further, the present invention is not limited to the above-described embodiment, and it goes without saying that various modifications can be made without departing from the spirit of the present invention. Next, other characteristic technical matters of the present application will be additionally described as follows. (Appendix 1) In the medical probe with a puncture needle, the probe including a heating element and a puncture needle at the tip of an elongated insertion portion, and a main body to which the probe is connected and supplies a voltage to the heat generation element, The needle is made of a material that conducts heat of the heating element, the main body is provided with a circuit for controlling voltage supply to the heating element, and the temperature of the puncture needle can be arbitrarily set in the main body. Medical probe with puncture needle.

(Appendix 2) The medical probe with a puncture needle according to appendix 1, wherein the puncture needle freely protrudes and retracts from the tip of the probe. (Additional Item 3) The medical probe with a puncture needle according to Additional Item 1, wherein the temperature of the heating element rises in response to a supply voltage from the main body.

(Additional Item 4) The medical probe with a puncture needle according to Additional Item 3, wherein the heating element is a diode chip. (Additional Item 5) The medical probe with a puncture needle according to additional item 1, wherein the main body is provided with an operation sheet for setting the temperature of the puncture needle.

The present invention relates to a treatment apparatus for applying heat to a punctured needle to apply heat to, for example, prostatic tissue of benign prostatic hyperplasia to remove the same.
A prior art is US Pat. No. 5,582,589, in which a prostate is pierced with a probe made of a radio frequency electrode and an insulating sleeve surrounding the radio frequency electrode, and high-frequency electricity is supplied to the prostate for heating. At this time, the insulating sleeve has a temperature sensor for monitoring the temperature near the urethral wall.

(Problems to be Solved by Additional Items 1 to 5)
In the related art, a high frequency is supplied between a radio frequency electrode and a return electrode attached to a patient in order to generate heat from a puncture needle (probe). Therefore, there is a possibility that the patient may be burned due to a high-frequency leakage current, peeling of the return electrode plate, and the like, and there is a possibility that high-frequency noise may adversely affect other medical devices.
In addition, since high-frequency output does not allow the temperature in the vicinity of the puncture part to be known, it is necessary to provide a temperature sensor and control the output in accordance with the measured temperature, and the configuration of the device becomes complicated.

(Objects of Supplementary Items 1 to 5) The present application pays attention to the above points, and is a highly safe and simple structure capable of controlling the temperature without using a high frequency output for generating heat of the puncture needle and without using a temperature sensor. And a medical probe with a puncture needle.

(Means for Solving the Problems of Supplementary Items 1 to 5) A heating element connected to the main body by a cable and generating heat in proportion to the voltage from the main body is provided near the puncture needle. By this means, the temperature of the puncture needle can be controlled only by the amount of voltage from the main body, so that it is not necessary to prevent burns due to high-frequency output and to use temperature measurement means near the puncture needle such as a temperature sensor.

(Effects of Additional Items 1 to 5) According to the present invention, even when a puncture needle is heated to perform thermal treatment, a patient can be safely treated with less risk of burn. Further, since the heating element used in the present application does not require a temperature measuring means, the structure of the main body can be simplified and the cost can be reduced. Even during use, only voltage is supplied to the heating element, so that power consumption is considerably reduced as compared with high-frequency output.

(Appendix 6) In a high-frequency treatment apparatus connected to a high-frequency power source, the puncture needle has an insulating shield and a puncture needle that can be protruded and retracted independently of the distal end of the elongated insertion portion. A high-frequency treatment apparatus comprising means for indicating the puncture depth.

(Additional Item 7) In the additional item 6, the means is a means for indicating that the insulating shield is punctured under the mucous membrane. (Supplementary note 8) In Supplementary note 7, wherein the means includes a measurement electrode provided on an insulating shield for measuring tissue impedance.

(Supplementary Note 9) In the supplementary note 8, the measurement electrode is provided at a position 3 to 10 mm away from the tip of the insulating shield. (Supplementary note 10) In Supplementary note 8 or 9, wherein the impedance is measured between a measurement electrode and a return electrode (counter electrode) attached to a patient's body.

(Additional Item 11) In the additional item 8 or 9, the measuring electrode may include at least two or more measuring electrodes including a first electrode and a second electrode, and the impedance may be equal to the first electrode and the second electrode. What is measured between the electrodes.

(Additional Item 12) In the additional items 8 to 11, the measuring electrode is connected to an impedance display section on a high-frequency power supply. The present application relates to an apparatus for treating a disease (for example, prostatic hypertrophy) in which a high-frequency current is applied to a puncture needle to apply heat to a tissue (for example, the prostate) to perform resection. As prior art, Patent Publication No. 26475
No. 57, U.S. Pat. No. 5,672,153, there is a device in which a needle is punctured into the prostate and a high-frequency current is applied. A temperature sensor is provided on the insulating shield. If the temperature of the tissue becomes too high at the time of the application, the current is stopped. It is described.

(Problems to be Solved by Supplementary Items 6 to 12) In the above-mentioned conventional technology, an insulating shield is provided to prevent damage due to energization of the mucous membrane, and attention is paid to a change in tissue temperature. The depth of puncture under the mucosa was determined by the experience of the surgeon. Therefore, when the puncture depth of the shield is not sufficient, there is a possibility that the mucous membrane may be thermally damaged. Also, if the puncture of the shield is too deep under the mucous membrane because of fear of damage, there is a problem that the cauterization range of the prostate is reduced and the therapeutic effect is reduced.

(Purpose of Supplementary Items 6 to 12) In view of the above points, the present application focuses on the above points, and in a high-frequency puncture needle having an insulating shield, a high-frequency puncture that can accurately determine the puncture depth of the insulating shield below the mucous membrane To provide needles.

(Means for Solving the Problems in Supplementary Items 6 to 12) A means (measurement electrode) is provided near the distal end of the insulating shield to notify that the insulating shield is punctured under the mucous membrane. By this means, it can be seen that the insulating shield has been accurately punctured under the mucous membrane, and thermal damage to the mucous membrane can be prevented.

(Effects of Additional Items 6 to 12)
The puncturing depth of the insulating shield 5 can be accurately determined. Accurate positioning can prevent damage to the mucous membrane due to too shallow puncture of the insulating shield and reduction of the ablation range due to too deep puncture.

[0059]

According to the present invention, a heating element that generates heat in proportion to the supply voltage and a puncture needle formed of a material that conducts heat of the heating element are disposed at the distal end of the insertion section. In addition, the temperature control means for arbitrarily setting the temperature of the puncture needle by controlling the supply voltage to the heating element is provided in the extracorporeally arranged element, so that even when performing heat treatment by heating the puncture needle, there is a danger of burns to the patient. And safe treatment can be performed. In addition, since only a voltage is supplied to the heating element when the puncture needle is heated, power consumption is significantly reduced as compared with high-frequency output, and there is no possibility that other medical devices will be adversely affected. Further, since the heating element does not require a temperature measuring means, the configuration can be simplified and the cost can be reduced.

[Brief description of the drawings]

FIG. 1 is a schematic configuration diagram of an entire medical probe according to a first embodiment of the present invention.

FIG. 2 is an enlarged longitudinal sectional view of a main part of a tip portion of a probe insertion portion according to the first embodiment;

FIG. 3 is a front view showing the proximal components of the probe according to the first embodiment.

FIG. 4 is a longitudinal sectional view showing a schematic configuration of a main part of a medical probe according to a second embodiment of the present invention.

FIG. 5 is an enlarged longitudinal sectional view of a main part showing a distal end portion of an insertion portion of the puncture electrode device.

FIG. 6 is a longitudinal sectional view of a main part showing a puncture part of the puncture electrode device.

FIG. 7 is a longitudinal sectional view of a main part showing a modification of the puncture electrode device.

[Explanation of symbols]

 2 insertion part 3 probe control device (external arrangement element) 7 puncture needle 8 diode chip (heating element) 13 temperature setting part (temperature control means)

 ──────────────────────────────────────────────────続 き Continuation of the front page (72) Inventor Takahiro Ogasaka 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inside Olympus Optical Industrial Co., Ltd. (72) Inventor Naoki Sekino 2-43-2 Hatagaya, Shibuya-ku, Tokyo Within Olympus Optical Co., Ltd. (72) Kazuya Hijii 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inside Olympus Optical Co., Ltd. Masahide Oyama 2-43-2, Hatagaya, Shibuya-ku, Tokyo No. Olympus Optical Co., Ltd. (72) Inventor Masatoshi Somura 2-43-2 Hatagaya, Shibuya-ku, Tokyo In-line Olympus Optical Co., Ltd. (72) Inventor Hideto Yoshimine 2-chome Hatagaya, Shibuya-ku, Tokyo 43-2 Olympus Optical Co., Ltd. (72) Inventor Takeaki Nakamura 2-43-2 Hatagaya, Shibuya-ku, Tokyo Ori Path Optical Industry Co., Ltd. in

Claims (1)

[Claims] 1. A medical probe having an elongated insertion portion inserted into a body and an extracorporeal arrangement element arranged outside a body, comprising: a heating element that generates heat in proportion to a supply voltage amount; A puncture needle formed of a material that conducts the heat is disposed at the distal end of the insertion section, and a temperature control unit that controls a supply voltage to the heating element and arbitrarily sets the temperature of the puncture needle is provided. A medical probe provided on an extracorporeal arrangement element.