WO2012057274A1 - Dispositif d'irradiation ultrasonore - Google Patents

Dispositif d'irradiation ultrasonore Download PDF

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Publication number
WO2012057274A1
WO2012057274A1 PCT/JP2011/074834 JP2011074834W WO2012057274A1 WO 2012057274 A1 WO2012057274 A1 WO 2012057274A1 JP 2011074834 W JP2011074834 W JP 2011074834W WO 2012057274 A1 WO2012057274 A1 WO 2012057274A1
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WO
WIPO (PCT)
Prior art keywords
ultrasonic
focused
irradiation device
cylinder member
ultrasonic irradiation
Prior art date
Application number
PCT/JP2011/074834
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English (en)
Japanese (ja)
Inventor
博士 鶴田
峰雪 村上
石橋　義治
Original Assignee
オリンパス株式会社
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Publication of WO2012057274A1 publication Critical patent/WO2012057274A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N7/00—Ultrasound therapy
    • A61N7/02—Localised ultrasound hyperthermia
    • A61N7/022—Localised ultrasound hyperthermia intracavitary
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N7/00—Ultrasound therapy
    • A61N2007/0043—Ultrasound therapy intra-cavitary
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N7/00—Ultrasound therapy
    • A61N2007/0056—Beam shaping elements
    • A61N2007/0065—Concave transducers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N7/00—Ultrasound therapy
    • A61N2007/0086—Beam steering
    • A61N2007/0091—Beam steering with moving parts, e.g. transducers, lenses, reflectors

Definitions

  • the present invention relates to an ultrasonic irradiation device for performing a treatment on a living tissue using a focused ultrasonic element.
  • Patent Document 1 describes a therapeutic device for high-frequency treatment that performs high-frequency treatment on a lesion.
  • a claw portion of an arm that clamps a living tissue is provided at the tip of the device, and a lesion portion that protrudes slightly from the living tissue near the surface layer and is close to the initial state is pinched by the claw portion of the arm at the tip of the device.
  • a high frequency current is applied to the arm at the tip of the device to remove the lesion.
  • An ultrasonic irradiation device is an ultrasonic irradiation device that is at least partially inserted into a body cavity and performs treatment by irradiating ultrasonic waves to a living tissue that forms the body cavity.
  • a focused ultrasonic element that emits a focused ultrasonic wave that is focused and is focused at a predetermined distance; and a focused ultrasonic wave that is focused from the focused ultrasonic element is disposed around the focused position.
  • FIG. 1 is a longitudinal sectional view showing a schematic configuration of the ultrasonic irradiation device according to the first embodiment of the present invention.
  • FIG. 2A is a front view of the ultrasonic irradiation device of the first embodiment.
  • 2B is a cross-sectional view taken along the line IIB-IIB shown in FIG.
  • FIG. 3 is a side view showing a schematic configuration of the entire system of laparoscopic surgery using the ultrasonic irradiation device of the first embodiment.
  • FIG. 4 is a longitudinal sectional view showing a state in which the tip of the device is pressed against the tissue surface when the ultrasonic irradiation device of the first embodiment is used, and the central portion of the tissue surface is raised.
  • FIG. 1 is a longitudinal sectional view showing a schematic configuration of the ultrasonic irradiation device according to the first embodiment of the present invention.
  • FIG. 2A is a front view of the ultrasonic irradiation device of the first embodiment.
  • FIG. 5 shows a state in which the root portion of the lesion on the tissue surface is sandwiched by the gripping portion when the ultrasonic irradiation device of the first embodiment is used, and the lesion is raised and called into the device to be fixed. It is a longitudinal cross-sectional view shown.
  • FIG. 6 is a front view of the ultrasonic irradiation device of FIG.
  • FIG. 7 is a longitudinal sectional view showing a treatment state of a lesioned part by the ultrasonic irradiation device of the first embodiment.
  • FIG. 8A is a longitudinal cross-sectional view of the main part showing Modification 1 of the ultrasonic irradiation device of the first embodiment.
  • FIG. 8B is a longitudinal sectional view of a main part showing a second modification of the ultrasonic irradiation device according to the first embodiment.
  • FIG. 9 is a longitudinal sectional view showing an ultrasonic irradiation device according to the second embodiment of the present invention.
  • FIG. 10 shows that when the ultrasonic irradiation device of the second embodiment is used, the device is pressed against the tissue surface so that the lesion enters the central hole of the balloon attached to the tip of the device and the central hole of the rubber ring. It is a longitudinal cross-sectional view which shows a state.
  • FIG. 11 is a longitudinal cross-sectional view showing a state where the distal end portion of the device is positioned by inflating the donut-shaped balloon of the ultrasonic irradiation device of the second embodiment and tightening the lesioned portion.
  • FIG. 12 is a longitudinal sectional view showing a treatment state of a lesioned part by the ultrasonic irradiation device of the second embodiment.
  • FIG. 13 is a longitudinal sectional view showing a state in which the position of the ultrasonic element holding member is changed when the lesioned part is irradiated by the ultrasonic irradiation device of the second embodiment.
  • FIG. 14 is a longitudinal sectional view showing a first modification of the ultrasonic irradiation device of the second embodiment.
  • FIG. 15 is a longitudinal sectional view showing a second modification of the ultrasonic irradiation device of the second embodiment.
  • the ultrasonic irradiation device 1 includes, for example, the abdominal wall portion of the patient H on the operation table 5 together with the ultrasonic endoscope 3 and the pneumoperitoneum device 4 under the laparoscopic surgery system shown in FIG. Used by being punctured.
  • the ultrasonic irradiation device 1 is connected to an ultrasonic irradiation device 6 via a cable 2.
  • the pneumoperitoneum device 4 is connected to the air supply device 7.
  • the air supplied from the air supply device 7 is supplied to the abdomen of the patient H through the insufflation device 4. Air is filled in the abdomen of the patient H to form a surgical space.
  • the ultrasonic endoscope 3 includes an insertion portion 3a to be inserted into a body cavity and a grip portion 3b for the operator to grip.
  • an illumination window (not shown), an observation portion (light observation portion, ultrasonic observation portion) and the like are disposed.
  • a light source device 9 is connected to the grip portion 3b via a universal cord 8. And the illumination light supplied from the light source device 9 is radiate
  • a light image in the body cavity that is incident on the light observation unit is formed by an optical system, and is imaged by an imaging unit such as a CCD (not shown), for example, and an observation image is formed by photoelectric conversion.
  • This observation image is sent to a monitor or the like (not shown) via a camera control unit (not shown) and displayed on a display screen.
  • the ultrasonic observation unit the reflected wave of the ultrasonic wave irradiated on the living body is received as an electric signal and imaged.
  • an irradiation device body 11 is disposed at the tip of the cable 2.
  • FIG. 1 shows a schematic configuration of an irradiation device body 11 of the ultrasonic irradiation device 1 of the present embodiment.
  • the distal end portion of the irradiation device main body 11 is provided with an outer cylinder member 12 (structure) and an inner cylinder member (gripping part operation member) 13 movable in the center line direction with respect to the outer cylinder member 12. ing.
  • a tapered surface 14 having a small outer diameter is formed on the peripheral wall surface of the distal end portion of the inner cylinder member 13 as it approaches the distal end side.
  • a grip portion (positioning means) 15 that grips (holds) the living tissue is provided at the distal end portion of the outer cylinder member 12.
  • the grip portion 15 is provided with two rigid arms 16a and 16b that grip (hold) the living tissue.
  • two rod-shaped support members 17a and 17b for supporting the two rigid arms 16a and 16b are provided at the distal end portion of the outer cylinder member 12.
  • the two support members 17 a and 17 b are disposed so as to face the inner side of the outer cylinder member 12.
  • the outer end portions of the support members 17 a and 17 b are fixed to the peripheral wall portion of the outer cylinder member 12.
  • Inner end portions of the support members 17 a and 17 b are extended toward the inner side of the outer cylinder member 12 along a direction orthogonal to the center line direction of the outer cylinder member 12. Furthermore, a large-diameter stopper 18 is formed at the inner end of each support member 17a, 17b.
  • the one rigid arm 16a is formed with an insertion hole 19a through which the one support member 17a is inserted.
  • an insertion hole 19b through which the other support member 17b is inserted is formed in the other rigid arm 16b.
  • the two rigid arms 16a and 16b are supported so as to be movable in the direction perpendicular to the center line direction of the outer cylinder member 12 along the support members 17a and 17b, respectively.
  • the two rigid arms 16a and 16b of the gripping portion 15 are in a fully open position where the ends of the two rigid arms 16a and 16b of the gripping portion 15 shown in FIGS. 1, 2A, and 2B are opened in a fully open state, It can move between the fully closed position where the tips of the two rigid arms 16a and 16b of the gripping portion 15 shown in FIG.
  • Arc-shaped sliding contact portions 20 that are in sliding contact with the tapered surface 14 of the inner cylindrical member 13 are provided at the base end portions of the two rigid arms 16a and 16b, respectively.
  • a claw portion 21 that is bent toward the inner side of the outer cylinder member 12 is provided at the distal end portion of each of the rigid arms 16a and 16b.
  • compression coil springs (elastic members) 22 are mounted on the two support members 17a and 17b.
  • the compression coil spring 22 biases the hard arms 16a and 16b so as to press the inner cylinder member 12 in the inner direction (closing direction).
  • the compression coil spring 22 is disposed between the outer cylinder member 12 and the rigid arms 16a and 16b.
  • the proximal end portion of the inner cylinder member 13 is connected to an opening / closing operation unit for opening / closing a gripping unit (not shown).
  • the opening / closing operation unit has a drive mechanism that drives the outer cylinder member 12 in a state in which the inner cylinder member 13 is advanced and retracted in the center line direction.
  • This drive mechanism may be, for example, a ball screw mechanism including an electromagnetic motor. Further, an ultrasonic motor capable of linear driving may be used.
  • the sliding contact portions 20 of the two rigid arms 16a and 16b slide and move along the tapered surface 14 as the inner cylinder member 13 moves forward. To do. At this time, the two rigid arms 16a and 16b move from the inner side to the outer side of the outer cylinder member 12 along the supporting members 17a and 17b, respectively, while compressing them against the spring force of the compression coil spring 22. .
  • the inner cylinder member 13 moves from the fully opened position in FIG. 1 toward the proximal end of the outer cylinder member 12 (leftward in FIG. 1). Pulled. At this time, the two hard arms 16 a and 16 b are pressed inward (closed direction) of the outer cylinder member 12 by the spring force of the compression coil spring 22.
  • the sliding contact portions 20 of the two hard arms 16a and 16b move to a position where they slide in contact with the most distal position of the tapered surface 14 of the inner cylinder member 13 as shown in FIG. As shown in FIG. 6, it is set to move to the fully closed position where the tips of the two rigid arms 16a and 16b of the gripping part 15 come into contact with each other. In this state, the living tissue is grasped (held) between the tips of the two rigid arms 16a and 16b.
  • a focused ultrasonic element 23 for irradiating focused ultrasonic waves is disposed inside the inner cylindrical member 13 of the irradiation device body 11.
  • the focused ultrasonic element 23 is, for example, a piezoelectric element.
  • a cMUT element capacitive Micro-machined Ultrasonic Transducers: capacitive ultrasonic transmission / reception device based on micromachine technology
  • capable of emitting focused ultrasound may be used.
  • the focused ultrasonic element 23 is held by a holding member 24.
  • the holding member 24 is mounted inside the inner cylinder member 13 so as to be movable in the direction of the center line of the outer cylinder member 12.
  • the holding member 24 is connected to moving means (not shown).
  • the moving means of the ultrasonic element holding member is composed of, for example, a ball screw mechanism equipped with an electromagnetic motor.
  • the moving means may be an ultrasonic motor capable of linear driving.
  • the distal end opening of the outer cylinder member 12 is closed by bringing the distal opening of the outer cylinder member 12 into contact with the surface H1 of the biological tissue to be treated.
  • an ultrasonic propagation space portion (closed space) serving as a propagation path of the focused ultrasonic wave is formed between the focused ultrasonic element 23 and the surface H1 of the living tissue.
  • the propagation path is a space from at least the focused ultrasonic element 23 to the focused position of the focused ultrasonic wave.
  • a plurality of liquid injection ports 25 for receiving the ultrasonic propagation medium from the outside of the outer cylinder member 12 to the inside of the outer cylinder member 12 are formed on the outer peripheral surface of the distal end portion of the outer cylinder member 12. Thereafter, the irradiation device body 11 is inserted into the body of the patient H, and a liquid ultrasonic propagation medium such as water flows into the outer cylinder member 12 from the liquid inlet 25. The ultrasonic propagation medium fills the ultrasonic propagation space of the focused ultrasonic element 23 inside the outer cylinder member 12.
  • the operation of the ultrasonic irradiation device of the present embodiment configured as described above will be described.
  • the inner cylinder member 13 is held in advance at the retracted position shown in FIG.
  • the slidable contact portions 20 of the two rigid arms 16a and 16b are in a state of being moved to a position where they are in slidable contact with the most distal position of the tapered surface 14 of the inner cylinder member 13.
  • the rigid arms 16 a and 16 b are held in a state where they are pressed inward (in the closing direction) of the outer cylinder member 12 by the spring force of the compression coil spring 22.
  • the position of a lesion H2 such as a tumor in the deep part of the living tissue is previously detected using the ultrasonic endoscope 3 (see FIG. 3), MRI, CT, or the like. To confirm.
  • the periphery of the living tissue where the lesioned part H2 is present is filled in advance with an ultrasonic propagation medium such as water.
  • the tip of the irradiation device main body 11 is placed near the surface H1 of the living tissue where the lesioned part H2 is located. Subsequently, an opening / closing operation means (not shown) is operated to move the inner cylinder member 13 in the outer cylinder member 12 linearly forward in the direction of the distal end portion of the outer cylinder member 12.
  • the tapered surface 14 of the inner cylinder member 13 comes into contact with the tapered sliding contact portions 20 of the two rigid arms 16a and 16b of the gripping portion 15, and the sliding contact portion of the gripping portion 15 is reached. It penetrates inside the 20 tapered section.
  • the two rigid arms 16 a and 16 b that have been closed by the spring force of the compression coil spring 22 open while pressing the compression coil spring 22.
  • the tip of the irradiation device body 11 of the ultrasonic irradiation device 1 is placed on the surface H1 of the biological tissue as shown in FIG.
  • the center portion of the surface H1 of the living tissue is raised by pressing.
  • the living tissue around the lesioned part H2 is drawn into the closed space inside the outer cylindrical member 12, and between the distal ends of the fully closed positions where the distal ends of the two rigid arms 16a and 16b come into contact with each other. Is gripped (held) and positioned with respect to the living tissue. In this state, the ultrasonic wave propagation space is filled with the ultrasonic wave propagation medium (water) (see FIG. 5).
  • the moving means (not shown) of the ultrasonic element holding member is operated to move the holding member 24 in the direction of the two rigid arms 16a and 16b.
  • the focusing position (focus) of the focusing ultrasonic element 23 is made to coincide with the lesioned part H2 such as a tumor deep in the living tissue.
  • the ultrasound output from the focused ultrasound element 23 is focused on a lesion H2 such as a tumor, and the lesion H2 such as a tumor is treated with ultrasound (see FIG. 7).
  • the moving means is repeatedly operated to change the position of the holding member 24 little by little, thereby changing the focus position of the ultrasonic wave output from the focused ultrasonic element 23 little by little to change the lesioned part such as a tumor. Treat the whole of H2.
  • the ultrasonic irradiation device 1 having the above-described configuration has the following effects.
  • the ultrasonic irradiation device 1 uses the focused ultrasonic element 23 as a sound source, and a focus position (focal point) of the ultrasonic wave irradiated from the sound source and a position of a lesioned part H2 such as a tumor formed in a deep part of a living tissue. Therefore, the focused ultrasound output from the focused ultrasound element 23 can be correctly irradiated to the lesioned part H2. Therefore, the lesioned part H2 formed in the deep part of the living tissue can be treated with minimal invasiveness without incision.
  • the irradiation device main body 11 raises and grasps the lesioned part H2 or the surface H1 of the living tissue by the two rigid arms 16a and 16b during ultrasonic irradiation, and draws it into the lesioned part, thereby setting the focal position of the ultrasonic wave to the lesioned part H2. It is aligned with. Therefore, even a subject that is easy to move, such as a living tissue in the body, can be fixed to the irradiation device main body 11 by being gripped by the grip portion 15. Therefore, it is possible to accurately align the focused position of the ultrasonic wave with respect to the lesioned part H2 located near the grasped surface. For this reason, an appropriate treatment can be performed without being influenced by the movement of the tissue surface.
  • the support structure of the focused ultrasonic element 23 can be simplified. Therefore, an extra member is not required for the support structure of the focused ultrasonic element 23, and it is possible to provide the minimally invasive ultrasonic irradiation device 1 with a reduced diameter.
  • an ultrasonic irradiation device capable of performing appropriate treatment not only on a lesion part formed near the surface layer of a biological tissue but also on a lesion part H2 such as a tumor grown in a deep part of the biological tissue. 1 can be provided.
  • a plate spring or the like may be used.
  • FIG. 8A shows Modification 1 of the ultrasonic irradiation device 1 of the first embodiment.
  • a plurality of liquid injection ports 25 are provided in the peripheral wall portion of the outer cylinder member 12 of the irradiation device body 11.
  • a liquid ultrasonic propagation medium (water or the like) that fills a space that is a propagation path of the focused ultrasonic wave formed inside the outer cylindrical member 12 from the liquid injection port 25 is supplied.
  • the liquid injection port 25 is not formed in the outer cylinder member 12, and the space is isolated from the outside.
  • a liquid supply path 31 for supplying a liquid ultrasonic propagation medium is provided.
  • the liquid supply path 31 is connected to a liquid supply unit (not shown) at the base end.
  • an ultrasonic propagation medium necessary for ultrasonic propagation flows out, and a biological tissue (tubular biological tissue such as an esophagus) that cannot be filled with the ultrasonic propagation medium is used.
  • a biological tissue tubular biological tissue such as an esophagus
  • Ultrasound irradiation is possible even in a lesion such as a developed tumor. Therefore, there is an effect that it becomes unnecessary to limit the living tissue to be treated.
  • FIG. 8B shows Modification 2 of the ultrasonic irradiation device 1 according to the first embodiment.
  • a hole corresponding to the liquid injection port 25 is formed in the peripheral wall portion of the outer cylinder member 12, and the ultrasonic propagation medium is formed inside the outer cylinder member 12.
  • a liquid supply path 31 for supplying a liquid is provided.
  • the liquid supply path 31 is connected to a liquid supply unit (not shown) at the base end.
  • the ultrasonic wave propagation medium can be supplied to the ultrasonic wave propagation space through the liquid supply path 31 by the irradiation device body 11 itself. Further, the ultrasonic propagation medium can be supplied to the outside of the outer cylinder member 12 from a hole provided in the peripheral wall portion of the outer cylinder member 12.
  • the periphery of the living tissue can be filled with the ultrasonic propagation medium by the ultrasonic irradiation device, and another ultrasonic propagation medium supply means is not required.
  • the treatment can be performed while the ultrasonic propagation medium is replenished.
  • FIG. 9 is a diagram showing a schematic configuration of the irradiation device body 41 of the ultrasonic irradiation device 1 of the present embodiment.
  • the outer cylinder member 42 is provided in the front-end
  • FIG. Inside the outer cylindrical member 42, a focused ultrasonic element 43 that irradiates focused ultrasonic waves, a holding member 44 that holds the focused ultrasonic element 43, and the holding member 44 with respect to the outer cylindrical member 42. And moving means 45 for moving back and forth in the direction of the center line.
  • the moving means 45 is constituted by, for example, a ball screw mechanism provided with an electromagnetic motor.
  • the moving member 45 moves the holding member 44 forward and backward in the center line direction with respect to the outer cylinder member 42, thereby changing the focus position of the ultrasonic wave output from the focus ultrasonic element 43.
  • a gripping mechanism 46 for gripping the living tissue is provided at the distal end portion of the outer cylinder member 42.
  • the gripping mechanism 46 includes a donut-shaped balloon 47 that is disposed along the inner peripheral surface of the distal end portion of the outer cylinder member 42, and a rubber ring 48 that is adjacent to the balloon 47.
  • the outer peripheral part of the balloon 47 is fixed to the inner peripheral surface of the distal end part of the outer cylinder member 42. Further, a fluid supply path 49 that supplies fluid to the inside of the donut-shaped balloon 47 is formed in the cylindrical wall portion of the outer cylindrical member 42. The base end portion of the fluid supply path 49 is connected to a fluid supply unit (not shown).
  • the rubber ring 48 is disposed at the distal end portion of the outer cylinder member 42 and adjacent to the proximal end side of the outer cylinder member 42 of the donut-shaped balloon 47.
  • the rubber ring 48 is attached to the inner peripheral surface of the outer cylinder member 42 so as to be replaceable according to the size of the tumor.
  • the rubber ring 48 regulates the shape of the balloon 47 so that the balloon 47 expands toward the center of the outer cylinder member 42 when a fluid is supplied into the donut-shaped balloon 47.
  • temporary fixing of a lesion H2 such as a tumor is performed.
  • the front side of the balloon 47 comes into contact with the surface H1 of the biological tissue to be treated, and the rear side of the balloon 47 comes into contact with the rubber ring 48.
  • the gripping mechanism 46 supplies a liquid that propagates ultrasonic waves, for example, as a fluid to the donut-shaped balloon 47, so that when the balloon 47 is inflated in the center direction of the outer cylinder member 42, the gripping mechanism 46 enters the center hole 47a of the balloon 47.
  • a lesion H2 such as a tumor is inserted.
  • the balloon 47 is inflated and the living tissue is tightened, thereby positioning the distal end portion of the irradiation device body 41 with respect to the lesioned part H2 such as a tumor.
  • a plurality of liquid injection ports 50 are formed on the outer peripheral surface of the distal end portion of the outer cylinder member 42. Then, an ultrasonic propagation medium such as water is caused to flow from the outside of the outer cylinder member 42 into the outer cylinder member 42 through the plurality of liquid inlets 50, so that the internal space portion of the outer cylinder member 42 is ultrasonic waves such as water. It is filled with a propagation medium.
  • the ultrasonic irradiation device 1 of the present embodiment When using the ultrasonic irradiation device 1 of the present embodiment, first, the position of the lesioned part H2 such as a raised tumor is specified using the ultrasonic endoscope 3 (see FIG. 3) or the like. The periphery of a living tissue where a lesioned part H2 such as a tumor is present is prefilled with a liquid ultrasonic propagation medium such as water.
  • the tip of the irradiation device main body 41 of the ultrasonic irradiation device 1 described above is arranged near the surface H1 of the living tissue where the lesioned part H2 is located. Subsequently, the irradiation device body 41 is pushed against the surface H1 of the living tissue so that a lesioned part H2 such as a tumor enters the center hole 47a of the balloon 47 attached to the tip of the irradiation device body 41 and the center hole of the rubber ring 48. Hit (see FIG. 10). At this time, the lesion part H2 such as a tumor can be temporarily fixed by the rubber ring 48.
  • the fluid supply path 49 enters the donut-shaped balloon 47 with, for example, water as a fluid.
  • the balloon 47 is inflated by supplying a liquid through which ultrasonic waves propagate.
  • the front surface side of the balloon 47 contacts the surface H1 of the biological tissue to be treated, and the rear surface side of the balloon 47 contacts the rubber ring 48. This restricts the movement of the balloon 47 in the front-rear direction, that is, the movement in the center line direction of the propagation path of the ultrasonic wave output from the focused ultrasonic element 43.
  • the shape of the balloon 47 can be regulated so that the balloon 47 inflates toward the center of the outer cylinder member 42.
  • the donut-shaped balloon 47 is inflated, and at the same time, the diameter of the central hole 47a is reduced while tightly contacting the living tissue around the lesion H2 such as a tumor and the tumor itself, and the tumor is tightened.
  • the distal end portion of the irradiation device body 41 is positioned with respect to the tumor (see FIG. 11).
  • the sound wave propagation space (closed space) is filled with water.
  • the ultrasonic element holding member moving means 45 is operated to move the ultrasonic element holding member 44 in the direction of the gripping mechanism 46.
  • the focused position (focal point) of the focused ultrasonic element 43 and the position of the lesioned part H2 such as a tumor are matched, and the lesioned part H2 such as a tumor is treated with ultrasound (see FIG. 12).
  • the position of the ultrasonic element holding member 44 is changed little by little by repeatedly operating the ultrasonic element holding member moving means 45 as indicated by an arrow in FIG. Because it changes little by little, the entire tumor can be treated.
  • the soft balloon 47 is used for the gripping mechanism 46, and the ring 48 for regulating the shape of the balloon 47 is also made of rubber.
  • the portion (inner diameter) into which can enter can be expanded and contracted.
  • the balloon 47 is in a deflated state even in a lesioned part H2 such as a tumor that has risen to the same size as the outer diameter of the outer cylindrical member 42 of the irradiation device body 41, the tumor is placed in the central hole of the balloon 47 and the rubber ring 48 A lesion H2 such as can be covered. Further, since the rubber ring 48 is also stretchable, the lesioned part H2 such as a tumor can be tightened by inflating the balloon 47 in that state, so the irradiation device body 41 of the irradiation device main body 41 can be tightened against the lesioned part H2 such as a tumor. The tip can be easily fixed.
  • the gripping mechanism 46 of the present embodiment requires fewer parts than the structure of the gripping portion 15 of the ultrasonic irradiation device 1 of the first embodiment.
  • the focused ultrasonic element 43 of this embodiment has shown the piezoelectric element similarly to 1st Embodiment, the cMUT element which can emit a focused ultrasonic wave may be sufficient.
  • the ultrasonic element holding member moving means 45 also shows a ball screw mechanism provided with an electromagnetic motor, but may be an ultrasonic motor capable of linear driving.
  • FIG. 14 shows a first modification of the ultrasonic irradiation device 1 of the second embodiment.
  • an ultrasonic propagation medium is provided in the cylindrical wall portion of the outer cylinder member 42 of the irradiation device main body 41 and inside the outer cylinder member 42.
  • a supply path 51 for supplying (liquid such as water) is provided.
  • a supply portion of an ultrasonic propagation medium (not shown) is connected to the base end portion of the supply path 51.
  • an ultrasonic propagation medium is supplied to the ultrasonic propagation space by the irradiation device body 41 itself.
  • the ultrasonic irradiation device 1 of the present modification is, for example, a lesion such as a tumor generated in a biological tissue (tubular biological tissue such as an esophagus) in which an ultrasonic propagation medium flows out in ultrasonic propagation. Ultrasonic irradiation is possible. Therefore, there is an effect that it is not necessary to limit the living tissue to be treated.
  • FIG. 15 shows a second modification of the ultrasonic irradiation device 1 of the second embodiment.
  • a protrusion such as a nail 61 is provided on the inner peripheral surface of a donut-shaped balloon 47 (a portion that contacts a lesioned part such as a tumor).
  • the protrusion such as the nail 61 bites into the living tissue, so that the positioning accuracy is further improved.
  • each embodiment of the present invention can perform an appropriate treatment not only on a lesion part formed in the vicinity of the surface layer of a biological tissue but also on a lesion part (tumor or the like) grown in a deep part of the biological tissue.
  • An ultrasonic irradiation device is provided.
  • the present invention is not limited to the above-described embodiment, and various modifications can be made without departing from the scope of the present invention.

Abstract

La présente invention concerne un dispositif d'irradiation ultrasonore qui effectue un traitement par irradiation d'ondes ultrasonores sur un organisme vivant, au moins une partie du dispositif étant insérée dans une cavité corporelle, et est équipé de : un composant ultrasonore focalisé (23) qui émet des ondes ultrasonores focalisées ; une unité de maintien (15) qui est placée de manière à entourer la position de focalisation vers laquelle les ondes ultrasonores focalisées convergent, et maintenant une partie de l'organisme vivant à irradier avec des ondes ultrasonores focalisées pour effectuer un positionnement ; et un composant cylindrique externe (12) qui définit un espace à utiliser en tant que chemin de propagation, tout en soutenant également l'unité de maintien (15).
PCT/JP2011/074834 2010-10-27 2011-10-27 Dispositif d'irradiation ultrasonore WO2012057274A1 (fr)

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JP2016021982A (ja) * 2014-07-16 2016-02-08 オリンパス株式会社 超音波治療装置

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JP2003190170A (ja) * 2001-12-21 2003-07-08 Aloka Co Ltd 超音波診断治療装置

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JPH10216146A (ja) * 1997-02-12 1998-08-18 Olympus Optical Co Ltd 超音波アダプタ
JPH11192231A (ja) * 1997-10-14 1999-07-21 Siemens Ag 女性胸部の超音波治療装置
JP2002186624A (ja) * 2000-12-20 2002-07-02 Asahi Optical Co Ltd 鉗 子
JP2003190170A (ja) * 2001-12-21 2003-07-08 Aloka Co Ltd 超音波診断治療装置

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