JPWO2016153008A1 - Approach device - Google Patents

Abstract

An approach device capable of easily approaching a specific area inside an object is provided. The approach device comprises a launcher (30) and a penetrator (20). The penetrator (20) has a leading portion (22) formed at the tip, and a long guide portion (24) is attached to the rear of the leading portion (22). The penetrator (20) is launched into the target object by the launcher (30), passes through the target portion T inside the target object, and penetrates to the outside of the other surface of the target object. The guide unit is bridged from the one side of the target object to the other side via the target unit. The insertion member is inserted into the target object along the guide portion.

Description

  The present invention relates to an approach device for approaching a specific area inside an object.

  Various approaches are required to approach or reach a specific area inside the object without destroying the object. For example, Japanese Patent Application Publication No. 2010-540180 discloses an apparatus for arranging an anchor in or around a lumen structure. It is described that the anchor may be pushed out automatically by a spring, compressed air, or the like and automatically fired to penetrate the lumen. However, it is difficult to drive the anchor so that it can be placed at a desired position.

  On the other hand, when approaching a specific area manually, for example, when approaching by drilling by hand or approaching by puncture by an engineer, it depends on the skill of the engineer. Is required.

  In view of the above facts, an object of the present invention is to provide an approach device that can easily approach a specific area inside an object.

  An approach device according to a first aspect of the present invention includes a member to be fired having a leading portion formed at a tip, and a long guide portion disposed behind the leading portion, and the leading portion is a target object. The target member is fired so that it passes through the target portion inside the target object and penetrates from the outer side of the one side of the target object to the outer side of the other side of the target object, and the other side while passing through the target unit from the one side of the target object A launcher that bridges the guide section, and an insertion member that is inserted into the target object along the guide section.

  In the approach device according to the first aspect of the present invention, the member to be fired is caused by the launcher so that the leading portion passes through the target portion inside the target object and penetrates from the outer side to the other side of the target object. Fired. Thus, since the object is penetrated, the target portion can be easily passed as compared with the case where the object is kept at a predetermined position inside the target object. Note that the target portion here may be the specific area itself inside the target object, or may be a position close to a specific area different from the specific area.

  The long guide portion disposed behind the leading portion is bridged from one surface of the target object to the other surface via the target portion. By inserting the insertion member into the target object along the spanned guide portion, the insertion member can be easily inserted into the position where the guide portion is disposed.

  The approach device according to the second aspect of the present invention further includes a receiving portion that is disposed on the other surface side of the target object and that receives the leading portion of the member to be fired.

  In the approach device according to the second aspect of the present invention, since the receiving portion is arranged on the other end side of the target object, the leading portion of the member to be fired that penetrates the target object can be received.

  The approach device according to the third aspect of the present invention is characterized in that the guide portion is thread-like.

  The guide part that passes through the target part and spans from one side of the target object to the other side is thread-like in this way, so even if the target part moves inside the target object, the guide part moves. You can move following. Therefore, damage to the target part due to relative movement between the target object and the guide part can be suppressed.

  The approach device according to a fourth aspect of the present invention is characterized in that the projecting device has a firing path arranged along the firing direction of the member to be fired.

  According to the approach device of the fourth aspect of the present invention, the accuracy of the firing direction of the member to be fired can be increased.

  In the approach device according to the fifth aspect of the present invention, the first support member that is disposed outside the one surface of the target object and supports the rear end side of the guide portion, and the first target member sandwich the target portion. A second support member disposed outside the other surface opposite to the support member and supporting the front end side of the guide portion.

  In the approach device according to the fifth aspect of the present invention, the first support member supports the rear end side of the guide part on one side of the target object, and the second support member is the front end of the guide part on the other side of the target object. Support the side. Accordingly, the insertion member can be inserted while being easily guided by supporting the guide portion between the first support member and the second support member and applying tension.

  The approach device according to a sixth aspect of the present invention is characterized in that the leading portion has a maximum length of a cross section perpendicular to the traveling direction of 3 mm or less.

  According to the approach device of the sixth aspect of the present invention, it is possible to reduce damage to the target object drilled by the leading portion.

  The approach device according to the seventh aspect of the present invention is characterized in that a cross section perpendicular to the traveling direction of the leading portion is circular.

  According to the approach device of the seventh aspect of the present invention, it is possible to smoothly advance the leading portion straight within the target object.

  The approach device according to an eighth aspect of the present invention is characterized in that a wire diameter of the guide portion is 2 mm or less.

  According to the approach device of the eighth aspect of the present invention, it is possible to reduce damage to the target object that the guide portion penetrates.

  The approach device according to a ninth aspect of the present invention is characterized in that the leading portion penetrates the target object in a linear trajectory.

  According to the approach device of the ninth aspect of the present invention, a trajectory plan for penetrating a target object can be easily established.

  The approach device according to a tenth aspect of the present invention is characterized in that the insertion member is a long tubular shape.

  According to the approach device of the tenth aspect of the present invention, the insertion member can be easily inserted into the target object along the guide member.

  The approach device according to an eleventh aspect of the present invention is characterized in that the insertion member is inserted into the target object with the guide portion inserted therein.

  According to the approach device of the eleventh aspect of the present invention, the insertion member can be more easily inserted into the target object along the guide member.

  The approach device according to a twelfth aspect of the present invention is characterized in that a fiber-like device is inserted into the insertion member.

  According to the approach device of the twelfth aspect of the present invention, the fiber device can be easily inserted into the target portion in the target object.

  The approach device according to the thirteenth aspect of the present invention is characterized in that at least one of a liquid, a gas, and a solid is inserted or discharged through the insertion member.

  According to the approach device of the thirteenth aspect of the present invention, at least one of a liquid, a gas, and a solid can be easily inserted or discharged through the insertion member.

  The approach device according to the fourteenth aspect of the present invention is characterized in that a surgical instrument is inserted into the insertion member.

  According to the approach device of the fourteenth aspect of the present invention, a surgical instrument can be easily inserted into the insertion member.

  The approach device according to a fifteenth aspect of the present invention is characterized in that the insertion member is a catheter.

  According to the approach device of the fifteenth aspect of the present invention, the catheter can be easily inserted into the target portion in the target object.

  As described above, according to the approach device of the present invention, it is possible to easily approach a specific area inside the object without destroying the object.

It is a schematic block diagram of the approach apparatus which concerns on this embodiment. It is the schematic of the launcher and penetrator of the approach apparatus which concerns on this embodiment. It is a figure which shows the modification of the penetrator which concerns on this embodiment. It is a figure which shows the modification of the penetrator which concerns on this embodiment. It is a figure which shows the modification of the penetrator which concerns on this embodiment. It is operation | movement explanatory drawing at the time of using the approach apparatus which concerns on this embodiment. It is operation | movement explanatory drawing at the time of using the approach apparatus which concerns on this embodiment. It is operation | movement explanatory drawing at the time of using the approach apparatus which concerns on this embodiment. It is operation | movement explanatory drawing at the time of using the approach apparatus which concerns on this embodiment. It is operation | movement explanatory drawing at the time of using the approach apparatus which concerns on this embodiment. It is explanatory drawing of the other example using the approach apparatus which concerns on this embodiment.

  Next, embodiments of the present invention will be described in detail with reference to the drawings.

  As shown in FIG. 1, the approach device 10 of the present embodiment includes a launcher 30, a penetrator 20 as a member to be fired, and an insertion member 40.

  The penetrator 20 as a member to be fired is fired from the launcher 30 toward the target object 12 and has a leading portion 22 and a guide portion 24. As shown in FIG. 2, the leading portion 22 has a bullet shape with a tapered tip and a circular cross section.

  The leading portion may have another shape. For example, it may be a spherical lead 22A as shown in FIG. 3A, a conical lead 22B as shown in FIG. 3B, or a long needle-like lead as shown in FIG. 3C. 22C may be used. In addition, the leading portion 22 can be made of a material such as metal or resin, and a suitable one can be appropriately selected according to the object 12.

  The diameter of the rear side of the cross section orthogonal to the traveling direction F (launching direction F) of the leading portion 22 is R1. The diameter R1 is selected according to the target object 12. For example, when the target object 12 is a living body, the diameter R1 is preferably smaller than 3 mm in order to suppress damage to the living body. For example, in the case of a human body, if the hole diameter is 2 mm or less, the influence on the human body is small and rapid healing is possible. The smaller the diameter of the leading portion 22, the less influence on the human body and the less pain, so it is possible to stab multiple times. It is generally known that when a needle with a diameter of several hundred μm for acupuncture is stabbed, it has little influence on the human body due to the self-repair function except for a specific part such as a nerve or retina. The same applies to other living bodies as long as the needle has a diameter of several hundred μm.

  A guide portion 24 is attached to the leading portion 22. The guide portion 24 has a thread shape and is set to be longer than the distance between the one surface 12A and the other surface 12B of the target object 12 when it is penetrated through the target object. The guide portion 24 can be made of a material such as a metal, a resin, or a biopolymer, and specifically includes a wire or a single wire. The guide unit 24 is preferably selected to have a function that can be visualized by imaging (X-ray, infrared, ultrasonic, etc.) from the outside of the target object 12.

In particular, when the target object 12 is a living body, the wire diameter of the guide portion 24 is preferably smaller than the cross-sectional diameter R1 of the penetrator 20 in order to suppress damage to the living body. In addition, the guide part 24 may be comprised with the material which has rigidity, such as a wire. Alternatively, the rear end of the needle formed integrally with the leading portion 22 may be formed long.

  The launcher 30 includes a launch path 32, a holding unit 34, and an operation unit 36. The launch path 32 has a cylindrical shape, and the cylinder axis is arranged along the launch direction F of the leading portion 22 (the penetrator 20). A space R having a slightly larger diameter than the outer diameter of the leading portion 22 is formed in the tube of the launch path 32. A tip opening 32 </ b> A is formed at the tip of the firing path 32.

  The holding part 34 is arranged at the rear end in the firing direction of the launch path 32 and can hold the outer periphery of the leading part 22. In the launcher 30, an operation unit 36 for firing the penetrator 20 held by the holding unit 34 toward the target object 12 is provided. As the actuating part 36, it is possible to use various launching devices such as a system that pushes the leading part 22 by compressed air, a water jet system that pushes by water pressure, a rail gun that fires by electromagnetic induction, a gun that uses gunpowder, and a high-pressure gas. it can.

  In order for the penetrator 20 to be fired by the launcher 30, energy that can penetrate the target object 12 linearly is required. The initial firing speed required for the penetrator 20 depends on the material of the target object 12, the penetration distance, the shape, cross-sectional area, and mass of the penetrator 20.

Examples of the target object 12 include living bodies such as human bodies and other animals. In addition, products and structures using materials such as resin, unvulcanized rubber, vulcanized rubber and metal, and structures using concrete before and after curing are also included. Further, plants (fruits, seeds, roots, leaves, etc.) are also exemplified as the target object 12.

  For example, the 5.56 mm warhead for rifles is also used for armor-piercing bullets that penetrate steel, and the initial velocity is about 800 m / s. In addition, it has been reported that a railgun (super-electromagnetic gun) can fire an object with a mass of 3 g at about 8000 m / s, and further increase the speed. Thus, since the initial speed range of the penetrator 20 can be widely selected by using various launching means, the initial speed of the penetrator 20 is appropriately set according to the specifications of the target object 12 and the applied penetrator 20. .

  Further, when the penetrator 20 collides with the target object 12, the initial speed of the penetrator 20 is set so that the strain speed of the collision surface of the target object 12 exceeds the elastic deformation speed, thereby damaging the target object 12. Can be reduced. For example, the initial speed may be relatively low for rubber-based materials that are easily elastically deformed and have a slow elastic deformation rate (unvulcanized rubber, vulcanized rubber, uncured concrete, fruit), and the like. On the other hand, a relatively high initial velocity is selected for a resin-based material that is not easily elastically deformed and is prone to crack propagation. For a metal material that is less likely to be elastically deformed and less likely to crack, an initial velocity close to the energy that can be penetrated can be set. For living bodies such as human bodies and other animals, similar to the rubber-based material described above, it is a target object that is easily elastically deformed and has a characteristic that the elastic deformation speed is slow. It is preferable to set a higher initial speed than the optimum initial speed of the rubber-based material.

  The launcher 30 is provided with a first support member 38. The first support member 38 is disposed behind the launcher 30, and the rear end of the guide portion 24 is fixed to the front side thereof. A second support member 39 is disposed on the opposite side of the firing direction from the first support member 38 with the target object 12 interposed therebetween (see FIG. 1). The second support member 39 includes a receiving portion 39A that receives the leading portion 22 that passes through the target object 12 and penetrates from the other surface 12B, and supports the front end side of the guide portion 24 including the leading portion 22. 39B.

  As shown in FIG. 1, the insertion member 40 has a long tubular shape. The inner diameter of the tube of the insertion member 40 is larger than the outer diameter of the guide portion 24. The insertion member 40 is extrapolated to the guide part 24 and inserted into the target object 12 along the guide part 24.

  The approach device 10 of this embodiment can be used for cancer treatment, for example. Next, an example of use when used for cancer treatment will be described.

  As shown in FIG. 4A, it is assumed that there is cancer C in the liver K of the living body B (including animals such as monkeys, dogs, and horses, and humans) as the target object 12. In this case, the target portion T is set in the vicinity of the cancer C where the region does not overlap with the cancer C in the liver K. The target portion T is set based on X-ray CT, MRI, an image obtained by ultrasonic imaging, and the like, taking into consideration the ease of access from the body surface, other organs, blood vessel positions, and the like.

  The trajectory plan to the target part T is made in advance based on the change in the hardness of the living body in the part through which the penetrator 20 passes, the angle of entry into the organ, etc., and the direction of launch of the penetrator 20 by the launcher 30; It is preferred to determine the speed. For trajectory planning, a trajectory planning method used in existing radiotherapy can be used from CT images taken in advance.

  Next, the penetrator 20 is set in the launcher 30 of the approach device 10. The set is arranged at the rear end of the launch path 32 while holding the outer periphery of the leading portion 22 with the holding portion 34, and the rear end of the guide portion 24 is fixed to the first support member 38. Then, the launcher 30 is disposed outside the one surface 12A of the living body B, and the second support member 39 is disposed outside the other surface 12B of the living body B with the target portion T interposed therebetween.

  Next, the tip opening 32A of the launch path 32 of the launcher 30 is directed toward the target portion T, the actuating portion 36 is actuated, and the leading portion 22 is fired. As shown in FIG. 4B, the fired leading portion 22 enters the inside from the one surface 12A of the living body B, passes through the target portion T in the liver K, and exits from the other surface 12B of the living body B. . Then, it is received by the receiving portion 39 </ b> A of the second support member 39. Together with the leading portion 22, the front side of the guide portion 24 is fixed to the support portion 39 </ b> B of the second support member 39. Thereby, the guide part 24 attached to the leading part 22 is bridged from the one surface 12A of the living body B to the other surface 12B side of the living body B through the liver K and the target portion T.

  Next, as illustrated in FIG. 4C, the insertion member 40 is extrapolated to the guide portion 24. Then, the insertion member 40 is inserted into the living body B from the one surface 12A side. As shown in FIG. 4D, the insertion member 40 is moved along the guide part 24 already spanned in the living body B and disposed in front of the target part T. At this time, since the insertion member 40 moves while being guided by the guide portion 24, it can be easily inserted toward the target portion T. As the insertion member 40, a catheter can be used.

  Next, the optical fiber 44 is passed through the tube of the insertion member 40, and the tip of the optical fiber 44 is disposed on the target portion T (see FIG. 4E). At this position, the laser beam L can be irradiated to the cancer C. A laser having high directivity can be preferably used.

  The insertion member 40 may be pulled out of the body after the optical fiber 44 is placed on the target portion T, or may be left in the body for the next treatment.

  According to the approach device 10 of the present embodiment, since the target object 12 is punched by the leading portion 22 launched from the launcher 30, the leading portion 22 is likely to advance straight. That is, even if the hardness difference and other conditions vary depending on the area inside the target object 12, straight travel is unlikely to be hindered. Therefore, the set target portion T can be easily punched out, and the guide portion 24 can be bridged so as to pass through the target portion T. And the insertion member 40 can be easily accessed to the target part T along the guide part 24 spanned.

  For example, when a needle or the like is driven, a living organ may be deformed or moved in relation to a surrounding organ or skeleton. In this regard, conventionally, since the needle has been stabbed relatively slowly, there has been a problem that the needle is bent and the organ moves. As in this embodiment, by launching at an initial velocity of a predetermined value or more, the penetrator 20 advances linearly without causing deformation or movement of the organ with respect to the skin or organ material parameters, and the target unit Can pass through T. In the conventional automatic puncture apparatus, it was difficult to puncture to a predetermined position due to deformation and movement of the organ, but the approach apparatus 10 of the present embodiment can access the predetermined position relatively easily.

  In addition, since it is possible to pass through the target T in the target object 12 in this way, it is possible to puncture a site that could not be observed with an ultrasonic diagnostic apparatus due to anatomical restrictions. As a result, it is possible to easily access an affected area that can be dealt with only by the surgical extraction operation at present, and it is expected to be applied to a less invasive alternative treatment as compared with the existing surgical extraction operation.

  Further, unlike the case of conventional puncture, it is not necessary to perform the observation while observing the needle position by a plurality of CT scans, so that the amount of exposure by CT scans can be reduced. Furthermore, the target T can be easily punched by the leading portion 22 without depending on the puncture skill of the engineer.

  In addition, when creating a trajectory plan, calculation of needle bending and organ displacement by simulation, acquisition of material parameters such as organs for each patient, etc. does not involve calculation costs, and trajectory planning is simple. Can stand.

  If the optical fiber 44 can be arranged on the target T, laser irradiation can be performed from a position close to the cancer C. Therefore, it is possible to irradiate the cancer C with a laser with high accuracy, and it is possible to suppress tissue other than the cancer C from being cauterized by the laser. Further, the laser can be irradiated from a position close to the cancer C, and the adjustment of the laser intensity and the like can be easily performed.

  In the present embodiment, since the guide portion 24 is thread-like, even if the target portion T moves inside the target object 12, the guide portion 24 can move following the movement. Therefore, the guide portion 24 and the target portion T do not move relative to each other due to the movement of the target portion T inside the target object 12, and damage to the target portion T can be suppressed.

  Moreover, in this embodiment, since the launcher 30 is provided with the launch path 32, the precision of the launch direction of the guide part 22 can be improved.

  In the present embodiment, the first support member 38 supports the rear end side of the guide portion 24 on the one surface 12A side of the target object 12, and the second support member 39 guides on the other surface 12B side of the target object 12. The front end side of the part 24 is supported. Thus, since the guide part 24 is supported between the 1st support member 38 and the 2nd support member 39, tension | tensile_strength can be easily given to the guide part 24 and the insertion member 40 is guided easily. It can be inserted along the portion 24.

  Furthermore, in this embodiment, since the receiving portion 39A that receives the leading portion 22 is provided on the other surface 12B side of the target object 12, it is possible to prevent the leading portion 22 from hitting other portions.

  In the above use example, only one guide portion 24 of the approach device 10 is penetrated, but a plurality of guide portions 24 may be penetrated and used. In this case, as shown in FIG. 5, the target portions T1 to T3 are set at positions surrounding the cancer C. The target portions T1 to T3 are positions in the liver K that surround the cancer C in the vicinity of the cancer C where the region does not overlap with the cancer C.

  For each of the target portions T1 to T3, the three penetrators 20 are fired separately from the launcher 30 of the approach device 10 and punched individually. Thereby, the guide part 24 is arrange | positioned so that the cancer C may be enclosed. In this state, the insertion member 40 is inserted into the living body B, and then the optical fiber 44 is passed through the tube of the insertion member 40. Then, the front-end | tip of the optical fiber 44 is each arrange | positioned to target part T1-T3. Then, each of the optical fibers 44 irradiates the cancer C with a laser.

  In this manner, the target portions T1 to T3 are set so as to surround the cancer C, and the optical fiber 44 is disposed on each of the target portions T1 to T3 using the plurality of penetrators 20, so that the cancer C is in a relatively large region. Even if it exists, cancer C can be incinerated with high precision from a close position.

  In the above example, three guide portions 24 are set. However, two guide portions 24 may be set, or four or more guide portions 24 may be set.

  If a laser with high directivity is used and a technique for cauterization with directivity is applied, a plurality of lasers are arranged around the tumor without directly piercing the tumor ("cancer C" in the above example). It becomes possible to cauterize the tumor from around the tumor. Considering the nature of cancer cells, there is a risk that cancer cells may diffuse to a normal site by piercing the tumor itself, and therefore this embodiment can be suitably used.

  In the above use example, the optical fiber 44 is inserted using the insertion member 40, but an instrument for other purposes may be inserted. For example, the target unit T may be set as a region to be inspected and a tissue collection tool may be inserted. Furthermore, you may set the target part T in the place which drains.

  Further, in the above description, an example in which the target object 12 is a living body has been described. However, other target objects, for example, products and structures using materials such as resin, unvulcanized rubber, vulcanized rubber, and metal, before curing, It can also be used for observing the internal state of a structure (such as fruit, seeds, roots, leaves, etc.) using a concrete after hardening. For example, in the manufacturing process of a resin product, it can be used when a temperature sensor is arranged at a specific part in an uncured state and the temperature of that part is measured. In this case, a specific portion where temperature measurement is desired is set as the target portion T. Then, the target portion T may be punched with the penetrator 20, and the temperature sensor may be moved to the target portion T along the guide portion 24.

In the present embodiment, the guide portion 24 is constituted by a thread-like member, but may be constituted by a long needle-like member formed integrally with the leading portion 22.
In the present embodiment, the configuration in which the optical fiber 44 is inserted into the insertion member 40 has been described, but the present invention is not limited to this. Other fiber-like devices may be used, and other surgical instruments may be inserted. Furthermore, a substance having a medicinal effect, which is liquid, gas, or solid, may be inserted.
In addition, the present invention is not limited to the case where any of liquid, gas, or solid is inserted into the insertion member 40, and the present invention is also applicable to the case where any of liquid, gas, or solid is discharged via the insertion member 40. The approach device can be applied.

  The disclosure of Japanese Patent Application No. 2015-065094 filed on March 26, 2015 is incorporated herein by reference in its entirety.

10 Approach device 20 Penetrator (member to be fired)
22 Leading portion 24 Guide portion 30 Launcher 32 Launch path 38 First support member 39 Second support member 39A Receiving portion 40 Inserting member T Target portion

Claims (15)

A to-be-fired member having a leading portion formed at the tip and a long guide portion disposed behind the leading portion;
Firing the member to be fired so that the leading portion passes through the target portion inside the target object and penetrates from the outer side of the one side of the target object to the outer side of the other side of the target object, and from the one side of the target object, A launcher that bridges the guide part to the other surface via the target part;
An insertion member inserted into the target object along the guide portion;
An approach device with   The approach device according to claim 1, further comprising a receiving portion that is disposed on the other surface side of the target object and receives a leading portion of the member to be fired.   The approach device according to claim 1, wherein the guide portion has a thread shape.   The approach device according to any one of claims 1 to 3, wherein the launcher includes a launch path disposed along a firing direction of the member to be fired. A first support member disposed outside the one surface of the target object and supporting a rear end side of the guide portion;
The second support member that is disposed outside the other surface on the opposite side of the first support member across the target portion and further supports the front end side of the guide portion. Item 5. The approach device according to any one of Items4.   The approach device according to any one of claims 1 to 5, wherein the leading portion has a maximum length of a cross section orthogonal to the traveling direction of 3 mm or less.   The approach device according to claim 1, wherein the leading portion has a circular cross section perpendicular to the traveling direction.   The approach device according to claim 1, wherein the guide portion has a wire diameter of 2 mm or less.   The approach device according to claim 1, wherein the leading portion penetrates the target object in a straight path.   The approach device according to any one of claims 1 to 8, wherein the insertion member has a long tubular shape.   The approach device according to claim 10, wherein the insertion member is inserted into the target object with the guide portion inserted therein.   The approach device according to claim 1, wherein a fiber-like device is inserted into the insertion member.   The approach device according to any one of claims 1 to 11, wherein at least one of a liquid, a gas, and a solid is inserted or discharged through the insertion member.   The approach apparatus according to any one of claims 1 to 11, wherein a surgical instrument is inserted into the insertion member.   The approach device according to any one of claims 1 to 14, wherein the insertion member is a catheter.

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