WO2015141411A1

WO2015141411A1 - Puncture device

Info

Publication number: WO2015141411A1
Application number: PCT/JP2015/055323
Authority: WO
Inventors: 正典佐伯
Original assignee: 正典佐伯
Priority date: 2014-03-17
Filing date: 2015-02-25
Publication date: 2015-09-24

Abstract

A puncture device is provided with: a contact section (20) having a through-hole (28) formed therein and having a contact surface on the front surface side thereof, the contact surface coming into contact with a part to be punctured; a contact detection means (29) for detecting the state of contact between the contact surface and the part to be punctured; a drive means (40) for causing a puncture needle (10) to protrude from and retract into the contact surface through the through-hole (28); and a control means (100) for controlling the drive of the drive means (40). While the contact surface is in contact with the part to be punctured, the control means (100) causes, by means of the drive of the drive means (40), the puncture needle (10) to gradually protrude out of the contact surface, determines on the basis of the detection by the contact detection means (29) that the contact surface has left, due to an increase in the amount of protrusion of the puncture needle (10), the surface of the part to be punctured, and obtains maximum depth information from the amount of protrusion of the puncture needle (10) at this time.

Description

Puncture device

The present invention relates to a puncture device including a puncture needle that is punctured into a living body.

As a conventional puncture device, Patent Document 1 includes an electrode needle and a cooling member in which a through-hole through which the electrode needle can be inserted is formed, and an electrode while cooling the cooling part of the cooling member in close contact with the surface of the skin A configuration is disclosed in which a needle is punctured by protruding from a cooling unit, and sweat glands are heated and destroyed. Excessive sweat secretion from the apocrine and eccrine sweat glands is likely to cause vaginal odor and hyperhidrosis, so treatment with such a puncture device can suppress excessive sweating. .

Also, as a conventional puncture device, as disclosed in Patent Document 2, a chemical solution injection device that injects a chemical solution into a living body is known. This device includes a needle guide assembly and a needle assembly. The needle assembly is inserted into the needle guide assembly so that the tip portion protrudes, and an anesthetic solution or the like can be injected from the tip portion. The needle guide assembly has stepped portions at two different points in the longitudinal direction, and the protruding length of the needle assembly changes by selecting the stepped portion that abuts the end wall of the needle assembly by rotating the needle assembly. Thus, the puncture depth can be controlled.

International Publication No. 2013/164996 Pamphlet Japanese Patent Laid-Open No. 7-51366

The sweat glands to be destroyed by the puncture device disclosed in Patent Document 1 are present at various depth positions from the dermis to the subcutaneous tissue, but the thickness of the dermis and the subcutaneous tissue is not only different among individuals but also a part of the human body It depends on the situation. For this reason, in order to reliably destroy the sweat glands, it is necessary to heat the entire depth direction while gradually changing the puncture depth according to the thickness of the dermis or subcutaneous tissue.

However, since it is difficult to grasp in advance the depth region of the sweat gland at the puncture site, the thermal energy supplied from the electrode needle is suppressed during treatment in accordance with the thin part such as the subcutaneous tissue. It is necessary to adjust the puncture depth at fine intervals. For this reason, there is a possibility that it takes time to treat a portion where the subcutaneous tissue or the like is thick, and there is room for further improvement in that the treatment is performed efficiently.

Moreover, although the chemical injection device disclosed in Patent Document 2 can adjust the puncture depth of the needle assembly to a preset value, the required puncture depth varies due to individual differences or the like. There is a problem that it is difficult to puncture with an accurate puncture depth.

For example, when local anesthesia is performed from the dermis to the subcutaneous tissue, it is desired to uniformly inject an anesthetic solution into the entire target region by a necessary amount. However, while the thickness of the dermis and subcutaneous tissue varies not only among individuals but also depending on the part of the human body, it is difficult to grasp this thickness in advance. It was difficult to inject.

Therefore, an object of the present invention is to provide a puncture apparatus that can perform a desired puncture quickly and accurately.

The object of the present invention is to provide a puncture needle that is punctured into a puncture site of a living body, a contact portion that has a through-hole penetrating the front and back and has a contact surface with the puncture site on the surface side, Contact detection means for detecting the contact state between the contact surface and the puncture site, drive means for causing the puncture needle to protrude from the contact surface via the through hole, and control for controlling the drive of the drive means And the control means causes the puncture needle to gradually protrude from the contact surface by driving the drive means in a state where the contact surface is in contact with the puncture site. Based on the detection of the contact detection means, it is determined that the contact surface has moved away from the surface of the puncture site as the protrusion amount increases, and maximum depth information is acquired from the protrusion amount of the puncture needle at this time Achieved by a lancing device.

In this puncture device, it is preferable that a plurality of the contact detection means are arranged on the contact surface, and the control means receives a non-contact signal from all the contact detection means. It is preferable to determine that the contact surface is separated from the surface of the puncture site.

The contact portion is preferably a cooling member capable of cooling the puncture site.

The puncture needle may be an electrode needle that supplies thermal energy from the tip. In this configuration, it is preferable that the control unit sets a plurality of heating depth positions based on the acquired maximum depth information, and supplies thermal energy from the puncture needle at each of the heating depth positions.

Alternatively, the puncture needle is communicated with a casing in which a drug solution is sealed, and can be configured to discharge the drug solution from the tip. In this configuration, the control means sets a plurality of injection depth positions based on the acquired maximum depth information, and stops the driven puncture needles at the respective injection depth positions for drug solution discharge. It is preferable to make it.

According to the present invention, it is possible to provide a puncture device that can perform a desired puncture quickly and accurately.

It is a side view of the puncture apparatus which concerns on the 1st Embodiment of this invention. FIG. 2 is a cross-sectional view taken along the line AA of the puncture device shown in FIG. It is a bottom view which shows the modification of the puncture apparatus shown in FIG. It is sectional drawing for demonstrating the usage method of the puncture apparatus shown in FIG. (A) And (b) is sectional drawing for demonstrating the usage method of the puncture apparatus shown in FIG. It is a side view which shows the modification of the puncture apparatus shown in FIG. FIG. 7 is an EE cross-sectional view of the puncture device shown in FIG. 6. It is sectional drawing which shows the use condition of the puncture apparatus shown in FIG. It is a side view of the puncture apparatus which concerns on the 2nd Embodiment of this invention. FIG. 10 is a sectional view taken along line FF of the puncture device shown in FIG. It is a bottom view which shows the modification of the puncture apparatus shown in FIG. FIG. 10 is a cross-sectional view for explaining a method of using the puncture device shown in FIG. 9. (A) And (b) is sectional drawing for demonstrating the usage method of the puncture apparatus shown in FIG. (A) And (b) is sectional drawing for demonstrating the usage method of the puncture apparatus shown in FIG. It is a side view which shows the modification of the puncture apparatus shown in FIG. FIG. 16 is a KK sectional view of the puncture device shown in FIG. It is sectional drawing which shows the use condition of the puncture apparatus shown in FIG.

(First embodiment)
Hereinafter, embodiments of the present invention will be described with reference to the accompanying drawings. FIG. 1 is a side view of the puncture device according to the first embodiment of the present invention, and FIG. 2 is a cross-sectional view taken along the line AA of FIG. As shown in FIG. 1 and FIG. 2, the puncture device 1 includes a puncture needle 10 that is punctured into a puncture site of a living body, a contact portion 20 that abuts against the puncture site, and a drive device 40 that drives the puncture needle 10. And a control device 70 for controlling the drive of the drive device 40 as main components. The puncture device 1 of the present embodiment is used as a sweating suppression device that can destroy the sweat gland and suppress excessive sweating by puncturing the puncture needle 10 to the puncture site including the sweat gland and supplying thermal energy. It is done.

The puncture needle 10 is made of a conductive metal material such as stainless steel, and is tapered so that the distal end portion 10a can be punctured. A portion of the puncture needle 10 other than the distal end portion 10a is covered with an insulating film 10b made of an electrically insulating material. A plurality of puncture needles 10 are arranged in a matrix and are fixed to a rectangular plate holder 12. The number of puncture needles 10 is not particularly limited, and may be single. When a plurality of puncture needles 10 are arranged, for example, about 20 to 30 needles (or more) are preferably arranged, and the interval between adjacent puncture needles 10 is, for example, 0.5 to 3 mm (more preferably 1 to 3 mm). ) Is preferably set to a degree. The thickness of each puncture needle 10 is preferably about 0.1 to 0.3 mm, for example. The arrangement shape of the plurality of puncture needles 10 may be various shapes such as an annular shape and a polygonal shape in addition to the matrix shape. The holder 12 is made of a plastic material or the like, and has a recess 12a at the center. An engagement protrusion 12b that is elastically deformable is provided on the inner peripheral surface of the recess 12a. The distal end portion 10a of the puncture needle 10 is formed in a blunt needle shape that penetrates the skin and subcutaneous tissue but does not penetrate the membrane tissue portion between the subcutaneous tissue and the muscle layer. It is possible to safely puncture only a depth region having a characteristic.

The abutting portion 20 is made of a flat plate-like cooling member capable of cooling the puncture site, and includes a Peltier element 22, a cooling plate 24, and a heat dissipation block 26. The Peltier element 22 has a known configuration in which a p-type semiconductor and an n-type semiconductor are thermally arranged in parallel. A cooling plate 24 is provided on the heat absorption side of the Peltier element 22, and a heat dissipation block 26 is provided on the heat generation side of the Peltier element 22. Is provided. A plurality of Peltier elements 22 having an appropriate size are arranged in a matrix. The cooling plate 24 and the heat dissipation block 26 have a plurality of

openings

24 a and 26 a formed in gaps between the plurality of Peltier elements 22, and a plurality of

openings

24 a and 26 a facing each other pass through the front and back surfaces of the contact portion 20. A through hole 28 is formed.

The cooling plate 24 has a flat contact surface 24b on the surface side, and the contact surface 24b serving as a cooling part can be brought into close contact with the skin of the human body. The contact surface 24b can be formed in an arc shape or a wavy curved surface shape in addition to the planar shape. The contact portion 20 may have, for example, a configuration in which a cooling pipe through which a refrigerant passes is embedded other than the configuration in which the contact portion 20 is cooled by energization as described above. Further, the abutting portion 20 may be configured to cool by injecting a cooling gas onto the epidermis, for example, in addition to the configuration in which the abutting unit 20 is in close contact with the epidermis of the human body and cooled.

The through hole 28 may have various shapes such as a honeycomb shape, a mesh shape, and a slit shape. The through holes 28 formed in the contact portion 20 do not necessarily correspond to the plurality of puncture needles 10 individually, and may be configured such that the plurality of puncture needles 10 are inserted into one through hole 28. In this case, as shown in a bottom view in FIG. 3, the through hole 28 is formed in the contact portion 20 in the shape of a long hole, and the two puncture needles 10 pass through both end edges in the longitudinal direction of the through hole 28. Thus, each puncture needle 10 may be fixed to the holder 12. According to this configuration, since the inner peripheral surface of the through-hole 28 can guide the advancement and retraction of each puncture needle 10 while facilitating the insertion of each puncture needle 10 into the through-hole 28, the puncture of the surface of the epidermis is further improved. It can be done reliably. The contact part 20 does not necessarily have a cooling function of the puncture site, and may be a site that can simply contact the puncture site.

The contact surface 24b is provided with a contact detection sensor 29 for detecting the contact state between the puncture site such as the epidermis of the human body and the contact surface 24b on the surface avoiding the opening 24a in the vicinity of the center. The contact detection sensor 29 is a pressure sensor having a small thickness (for example, about 0.1 mm), and outputs a contact signal or a non-contact signal with the puncture site. The structure of the contact detection sensor 29 is not particularly limited as long as the contact state between the contact surface 24b and the puncture site can be reliably detected. , Proximity sensors, current sensors, and the like. The arrangement of the contact detection sensors 29 is not particularly limited, but it is preferable that a plurality of contact detection sensors 29 are arranged on the contact surface 24b, and are arranged at intervals in the vicinity of the center of the contact surface 24b. Is preferred.

The puncture needle 10 and the contact portion 20 are supported by the support 30. The support 30 includes a rectangular housing portion 32 having a rectangular shape when viewed from below in FIG. 2 and a cylindrical portion 34 connected so as to communicate with the center of the top plate of the housing portion 32. The puncture needle 10 is held inside the portion 32. The housing part 32 has a guide groove 32a formed in the vicinity of the opening of a pair of side walls facing each other. The contact portion 20 is supported by the support body 30 so that the heat dissipation block 26 can slide along the guide groove 32a, and the distal end portion of each puncture needle 10 at a closed position that covers the opening of the housing portion 32. 10 a faces the through hole 28, and the puncture needle 10 can be inserted into the through hole 28. The guide groove 32a is provided with a terminal portion 32b (see FIG. 4), and the Peltier element 22 can be energized when the abutting portion 20 is in the closed position. In order to improve the heat dissipation from the heat dissipation block 26, the housing portion 32 may be formed of a mesh plate, a porous plate, or the like, or may be formed by cutting out a part of the side wall.

The drive device 40 includes a drive motor 42 such as a servo motor, an encoder 44 that detects the rotation speed of the drive motor 42, and a rod 46 that moves forward and backward by the rotation of the drive motor 42. A shaft 43 is connected to the rotating shaft 42 a of the drive motor 42, and a screw portion 43 a is formed on the outer peripheral surface of the shaft 43. The rod 46 is formed in a hollow cylindrical shape and is slidably accommodated in the cylindrical portion 34 of the support 30. A nut 46 a that is screwed into the threaded portion 43 a of the shaft 43 is fixed to the inner peripheral surface of the rod 46. On the other hand, a protrusion 46 b is provided on the outer peripheral surface of the rod 46, and the protrusion 46 b engages with a groove 34 a formed on the inner peripheral surface of the cylindrical portion 34, thereby preventing the rod 46 from rotating. Yes. With the above configuration of the drive device 40, the rod 46 can advance in the direction of arrow B in FIG. 2 by the rotation of the drive motor 42, and the advance amount of the rod 46 can be controlled based on the detection of the encoder 44.

An engagement recess 46c is formed on the outer peripheral surface of the tip end side (the lower end side in FIG. 2) of the rod 46, and the rod 46 is fitted into the recess 12a of the holder 12 so that the engagement recess 46c becomes the engagement protrusion 12b. By engaging, the holder 12 can be detachably fixed to the rod 46. In this way, the holder 12 can be pressed by the drive device 40, and the forward and backward movement of the rod 46 can cause the distal end portion 10a of the puncture needle 10 to protrude and retract from the contact surface 24b as shown by a broken line in FIG. The amount of protrusion of the puncture needle 10 from the lowermost surface of the contact surface 24b is not particularly limited, but can be set to about 0.1 to 10 mm, for example. When a plurality of puncture needles 10 (for example, about 20 to 30 needles or more) are arranged, it is preferable that the protruding amounts of all the puncture needles 10 are within the above numerical range. Further, a terminal (not shown) for supplying power to each puncture needle 10 when the holder 12 is mounted is provided at the distal end of the rod 46, and each puncture is made to a high frequency oscillator (not shown) installed outside. The needle 10 is electrically connected. The puncture needle 10 can apply a high-frequency current to a surface electrode (not shown) separately disposed on the surface of the human body while puncturing the human body, thereby heating the living tissue in the vicinity of the puncture needle 10. can do. In the case where a plurality of puncture needles 10 are provided, a high-frequency current may be applied between two adjacent puncture needles 10 and 10. Energization of the puncture needle 10, the contact portion 20, and the driving device 40 can be performed by a switch operation of the operation portion 50 provided on the cylindrical portion 34 of the support 30.

The control device 70 can be composed of a personal computer or the like, and controls the drive of the drive device 40 based on the protruding amount of the puncture needle 10. The control device 70 can also be built in the operation unit 50, and can be configured to set the protruding amount of the puncture needle 10 by operating the operation unit 50. A detection signal of a contact state (contact or non-contact) by the contact detection sensor 29 is input to the control device 70.

Next, a method of using the puncture apparatus 1 having the above configuration will be described. First, the holder 12 including the puncture needle 10 is attached to the rod 46 of the driving device 40. As shown in FIG. 4, the holder 12 is inserted in the direction indicated by the arrow C in a state where the contact portion 20 is retracted from the support 30 and the opening of the housing portion 32 is opened, thereby engaging with the engagement protrusion 12b. The holder 12 can be fixed to the rod 46 by engaging the mating recess 46 c. In order to ensure safety when the holder 12 is mounted, a cover member 12c that covers the puncture needle 10 is attached in advance to the holder 12 as shown by a broken line, and the cover member 12c is removed after the holder 12 is mounted. Also good. Thereafter, the contact portion 20 is slid in the arrow D direction to the closed position, whereby the terminal portion 32b of the support 30 is engaged with a terminal portion (not shown) of the contact portion 20, and the contact portion 20 is engaged. Is energized, and the contact portion 20 is positioned. The holder 12 can be attached to the rod 46 by screwing or the like instead of being fitted as in the present embodiment.

Next, as shown in FIG. 5A, the contact surface 24b of the contact portion 20 is brought into close contact with the epidermis surface S of the puncture site including sweat glands. When the contact surface 24 b and the skin surface S come into close contact with each other, a contact signal is input from the contact detection sensor 29 to the control device 70. In this state, when the measurement mode is selected by operating the operation unit 50, the control device 70 rotates the drive motor 42 of the drive device 40. The rod 46 advances in accordance with the amount of rotation of the drive motor 42 because the protrusion 46b engages with the groove 34a and cannot rotate, and the nut 46a is screwed with the shaft 43. Gradually protrudes from the contact surface 24b.

As the protruding amount L of the puncture needle 10 from the abutment surface 24b increases, the tip of the puncture needle 10 enters the subcutaneous tissue from the epidermis through the dermis, but to the membrane existing between the subcutaneous tissue and the muscle layer. When it reaches, the puncture needle 10 cannot penetrate the membrane, and the puncture depth of the puncture needle 10 is maintained constant. In this way, when the protrusion amount L of the puncture needle 10 is further increased without increasing the puncture depth, the skin surface S is curved so as to protrude downward as shown in FIG. The contact detection sensor 29 is separated from the surface 24 b and detects this, and a non-contact signal is input to the control device 70. The control device 70 determines the contact state based on the detection signal from the contact detection sensor 29. When a plurality of the contact detection sensors 29 are arranged on the contact surface 24b, the control device 70 determines that the skin surface S is in contact with the contact surface 24b when non-contact signals are input from all the contact detection sensors 29. It is preferable to determine that the contact surface 24b is separated from the contact surface 24b even when it is difficult to closely contact the entire contact surface 24b due to the surface shape or the like of the puncture site. However, the control device 70 may be configured to determine that the skin surface S is separated from the contact surface 24b based on the detection of the single contact detection sensor 29.

When determining that the skin surface S has moved away from the contact surface 24b, the control device 70 stops the driving device 40, calculates the protrusion amount L of the puncture needle 10 at this time from the value of the encoder 44, and determines the maximum depth. It is stored in memory as information. Thereafter, the control device 70 rotates the drive motor 42 in the reverse direction to move the puncture needle 10 in the direction of withdrawing from the puncture site, and embeds the tip of the puncture needle 10 above the contact surface 24b. As a result, the contact surface 24b comes into close contact with the skin surface S again. The puncture needle 10 is preferably appropriately set in thickness and pressing force so that the distal end portion 10a does not reach the muscle layer and stays securely in the subcutaneous tissue.

The maximum depth information acquired in this way corresponds to a depth region where a sweat gland such as apocrine gland exists at the puncture site, and the user can operate the operation unit 50 by grasping this depth region in advance. When the automatic mode is selected, efficient treatment can be performed.

That is, when the automatic mode is set, the control device 70 first sets a plurality of heating depth positions based on the maximum depth information. The heating depth position can be obtained from, for example, a depth interval determined by comparing the maximum depth value with a predetermined reference value. As a specific example, when the maximum depth is 4 mm or less, the depth interval is set to 0.4 mm, and the heating depth position is set to 0.4 mm, 0.8 mm, 1.2 mm from the skin surface, When the maximum depth exceeds 4 mm, the depth interval is set to 0.6 mm, and the heating depth position is set to 0.6 mm, 1.2 mm from the surface of the skin. Each depth position of 1.8 mm,... Can be set. The reference value and depth interval of the maximum depth are not limited to the above values, and a plurality of each can be set. Further, the depth interval does not necessarily have to be constant, and may be set so as to gradually decrease (or increase) as the puncture depth increases. The maximum depth information and the heating depth position may be output to a monitor of the control device 70 so that the user can grasp it.

After determining the plurality of heating depth positions in this way, the control device 70 energizes the contact portion 20 to cool the epidermis surface S to which the contact surface 24b is in close contact, while the distal end portion 10a of the puncture needle 10 is heated. The driving of the driving device 40 is controlled so as to stop at the depth position, and thermal energy is sequentially supplied from the distal end portion 10a to the target tissue at each heating depth position. Thereby, uniform heating can be performed along the depth direction of the puncture site, and the entire sweat gland existing in this region can be destroyed efficiently and reliably. The thermal energy supplied from the puncture needle 10 may be changed according to the depth interval, and the larger the depth interval, the larger the thermal energy may be supplied. The supply of thermal energy can be performed using various things such as a high frequency, a radio wave, a microwave, and a laser. Since the periphery of the puncture site is cooled by the close contact of the contact surface 24b, the epidermis surface S can prevent burns and can improve analgesia at the time of puncture and supply of thermal energy. In addition, you may make it apply | coat an anesthetic cream previously to the skin surface S which contact | abuts the contact surface 24b. When the contact surface 24b is configured to inject cooling gas onto the skin surface S, a good burn prevention effect and analgesic effect can be obtained by starting the injection of the cooling gas immediately before the puncture needle 10 is punctured into the skin surface S. be able to.

After the thermal energy is supplied for a predetermined time, the puncture needle 10 is raised by the operation of the driving device 40 and is accommodated in the casing 32 again. Thus, the treatment of the target tissue as a target is completed. When the next treatment is subsequently performed, the treatment can be started after the contact portion 20 is retracted along the guide groove 32a and the holder 12 is replaced with a new one. In this way, by configuring the holder 12 to be removable and replaceable, sterilization processing of the puncture needle 10 is unnecessary, and rapid treatment can be performed. The abutting portion 20 can also be removed from the guide groove 32a and replaced with a new one.

The puncture apparatus 1 according to the present embodiment can acquire in advance a depth region in which a sweat gland may exist at the puncture site as maximum depth information, and therefore efficiently supply heat energy to the sweat gland. Therefore, treatment for suppressing excessive sweating can be performed quickly and reliably. In the present invention, the suppression of perspiration refers to the purpose of reducing the amount of perspiration itself (for example, hyperhidrosis treatment) and the purpose of reducing the odor associated with perspiration even if the amount of perspiration is very small (for example, odor odor) ) Treatment).

As mentioned above, although the 1st Embodiment of this invention was explained in full detail, the specific aspect of this invention is not limited to the said embodiment. For example, in the present embodiment, the maximum depth information is acquired by the measurement mode, and the treatment is performed by automatically setting the heating depth by the automatic mode based on the maximum depth information. However, it may be configured such that the user can manually set the heating depth as appropriate based on the acquired maximum depth information.

Further, as shown in FIGS. 6 and 7, the support 30 may be configured to include a mounting portion 36 and a cartridge 60 that can be attached to and detached from the mounting portion 36. 6 is a side view of a modification of the puncture apparatus 1 shown in FIG. 1, and FIG. 7 is a cross-sectional view taken along line EE of FIG. 6 and 7, the same reference numerals are given to the same components as those shown in FIGS. 1 and 2, and detailed description thereof is omitted.

The mounting portion 36 is formed in a casing shape, and a driving device 40 is provided at the upper portion, and an engagement rail 36 a that engages with the cartridge 60 is provided at the lower portion. A cylindrical portion 34 is provided inside the mounting portion 36, and the shaft 43 and the rod 46 of the driving device 40 are accommodated inside the cylindrical portion 34, similarly to the configuration shown in FIG. 2.

The cartridge 60 is formed with an engagement groove 62a that engages with the engagement rail 36a on the upper surface of the cartridge main body 62. Can be installed as possible. The cartridge 60 is fixed to the mounting portion 36 by fitting of fitting portions (not shown) provided in the engagement rail 36a and the engagement groove 62a.

The holder 12 that supports the plurality of puncture needles 10 is accommodated inside the cartridge body 62. The holder 12 is urged by a spring member 64 as urging means so as to retract the puncture needle 10 into the cartridge body 62. An insertion hole 62a through which the tip 46d of the rod 46 can pass is formed in the upper part of the cartridge body 62, and the tip 46d is configured to be able to press the holder 12 when the rod 46 advances. A through hole 62 b through which the puncture needle 10 passes is formed in the lower part of the cartridge main body 62.

The contact portion 20 is supported by the mounting portion 36 via the support arm 21, and the cartridge 60 is disposed between the mounting portion 36 and the contact portion 20. The support arm 21 has flexibility and can hold the cartridge 60 between the mounting portion 36 and the contact portion 20. The support arm 21 accommodates wiring, signal lines, and the like that connect the contact portion 20 and the operation portion 50. The through hole 28 of the contact portion 20 is formed so as to be aligned with the through hole 62 b of the cartridge 60. The shapes of the through hole 28 and the through hole 62b are not particularly limited.

In the puncture device 1 ′ having such a configuration, when the rod 46 advances by the operation of the driving device 40, the distal end portion 46 d of the rod 46 is against the urging force of the spring member 64 as shown in FIG. , And the distal end portion 10a of the puncture needle 10 passes through the through

holes

62b and 28 and protrudes from the contact portion 20. After the target tissue is treated, the holder 46 is moved again to the retracted position by the urging force accumulated in the spring member 64 by retracting the rod 46. The cartridge 60 can be quickly and easily treated by replacing the mounting portion 36 with a new one.

The abutment portion 20 is supported by the mounting portion 36 by the flexible support arm 21, so that the cartridge 60 can be sandwiched between the abutment portion 20 and the attachment portion 36. The alignment of the hole 62b can be easily performed. However, the contact portion 20 may be configured to be detachable from the cartridge 60.

In the puncture device 1 ′ shown in FIGS. 6 and 7, the control device 70 can obtain the maximum depth information by performing the same control as described above, and a plurality of pieces of information can be obtained based on the maximum depth information. The heating depth position can be set, and thermal energy can be supplied from the puncture needle 10 at each heating depth position.

(Second Embodiment)
FIG. 9 is a side view of the puncture device according to the second embodiment of the present invention, and FIG. 10 is a cross-sectional view taken along the line FF of FIG. As shown in FIGS. 9 and 10, the puncture device 101 according to the second embodiment is similar to the puncture device 1 according to the first embodiment, in which the puncture needle 110, the contact portion 20, the drive device 40, and the control are provided. The apparatus 70 is provided as a main component, and is used as a chemical solution injector that injects a chemical solution such as an anesthetic solution into a living body. 9 and 10, the same components as those in the first embodiment are denoted by the same reference numerals, and detailed description thereof is omitted.

As shown in FIG. 10, a plurality of puncture needles 110 are provided in a matrix on the bottom surface of puncture body 116 including casing 112 and pressing plate 114. The casing 112 has an opening at the top, and stores a chemical solution Lq such as an anesthetic solution. The pressing plate 114 is slidably provided along the inner surface of the casing 112. Each puncture needle 110 is formed hollow with a metal material such as stainless steel, and the liquid medicine Lq can be discharged from the distal end portion 110a by the lowering of the pressing plate 114. The number of puncture needles 110 is not particularly limited, and may be single. When a plurality of puncture needles 110 are arranged, for example, about 20 to 30 needles (or more) are preferably arranged, and the interval between adjacent puncture needles 110 is, for example, 0.5 to 3 mm (more preferably 1 to 3 mm). ) Is preferably set to a degree. The thickness of each puncture needle 110 is preferably about 0.1 to 0.3 mm, for example. The arrangement shape of the plurality of puncture needles 110 may be various shapes such as an annular shape and a polygonal shape in addition to the matrix shape. The distal end portion 110a of the puncture needle 110 is formed in a blunt needle shape that penetrates the skin and the subcutaneous tissue but does not penetrate the membrane tissue portion between the subcutaneous tissue and the muscle layer. Only can be punctured safely.

The puncture needle 110 and the contact portion 20 are supported by the support 130. The support 130 includes a rectangular housing part 32 having a rectangular shape in the lower part in FIG. 10, a cylindrical part 34 connected to communicate with the center of the top plate of the housing part 32, and the interior of the housing part 32. And a mounting portion 136 for holding the puncture body 116. The mounting portion 136 is made of a flexible lid made of a material such as resin or rubber, and the puncture body 116 is detachably held by an ear portion 136a provided to be engageable with the upper outer surface of the casing 112. be able to. In addition, the mounting portion 136 is provided with an O-ring 136b for maintaining airtightness at a location where it abuts on the casing 112, and a pipe 118 made of a flexible tube capable of introducing compressed air into the casing 112 from the outside. The pressure plate 114 can be pressed by supplying compressed air from a supply source (not shown), and the drug solution Lq can be discharged from each puncture needle 110. The supply and stop of the chemical liquid Lq and the adjustment of the supply speed of the chemical liquid Lq can be performed by the control device controlling the opening degree of the adjustment valve 118a provided in the pipe 118. The discharge means for the chemical liquid Lq is not particularly limited, and for example, a configuration in which the pressing plate 114 is raised and lowered by driving a cylinder may be used. Moreover, you may comprise so that injection | pouring of the chemical | medical solution Lq may be performed at an appropriate injection | pouring speed | velocity by pushing a piston etc. manually instead of performing automatically. The housing portion 32 accommodates the mounting portion 136 so as to be movable up and down so that the puncture needle 110 can be inserted into the through hole 28 in a state where the contact portion 20 is in the closed position.

The through hole 28 may have various shapes such as a honeycomb shape, a mesh shape, and a slit shape. The through holes 28 formed in the contact portion 20 do not necessarily correspond to the plurality of puncture needles 110 individually, and may be configured such that the plurality of puncture needles 110 are inserted into one through hole 28. In this case, as shown in a bottom view in FIG. 11, the through hole 28 is formed in a long hole shape in the contact portion 20, and the two puncture needles 110 pass through both end edges in the longitudinal direction of the through hole 28. As such, each puncture needle 110 may be arranged. According to this configuration, the inner peripheral surface of the through-hole 28 can guide the advancement / retraction of each puncture needle 110 while facilitating the insertion of each puncture needle 110 into the through-hole 28, thereby further puncturing the surface of the epidermis. It can be done reliably. The contact part 20 does not necessarily have a cooling function of the puncture site, and may be a site that can simply contact the puncture site.

The mounting portion 136 is fixed to the tip end (lower end in FIG. 10) of the rod 46 included in the driving device 40, and the puncture body 116 can be moved up and down by the forward and backward movement of the rod 46. The puncture needle 110 can project the tip portion 110a from the contact surface 24b as shown by a broken line in FIG. 9 by advancing in the direction indicated by the arrow G in FIG. The protruding amount of the puncture needle 110 from the lowermost surface of the contact surface 24b is not particularly limited, but can be set to about 0.1 to 10 mm, for example. When a plurality of puncture needles 110 (for example, about 20 to 30 needles or more) are arranged, it is preferable that the protruding amounts of all the puncture needles 110 are within the above numerical range.

The energization of the contact portion 20 and the drive device 40 can be performed by a switch operation of the operation portion 50 provided in the cylindrical portion 34 of the support 130, and the operation is controlled by the control device 70. A detection signal of a contact state (contact or non-contact) by the contact detection sensor 29 is input to the control device 70.

Next, an example of how to use the puncture apparatus 101 having the above configuration will be described. In the present embodiment, an anesthetic solution is injected into a living body as a pretreatment for performing a thermal destruction of sweat glands such as apocrine sweat glands and eccrine sweat glands that cause causal odor (abalone) and hyperhidrosis with an electrode needle. The method is shown. Sweat glands such as apocrine sweat glands and eccrine sweat glands exist at various depths from the dermis to the subcutaneous tissue, but the thickness of the dermis and subcutaneous tissue varies not only among individuals but also depending on the part of the human body. In order to ensure destruction, it is necessary to heat the entire depth direction while gradually changing the puncture depth according to the thickness of the dermis or subcutaneous tissue. Therefore, the injection of the anesthetic solution for performing the nerve block is required to be accurately performed in a necessary region in accordance with the size of the three-dimensional region where the electrode needle is punctured. In the following, a method of injecting an anesthetic solution uniformly into this region after measuring a region in the depth direction for injecting the anesthetic solution in advance will be described.

First, the puncture body 116 is attached to the attachment portion 136 of the puncture apparatus 101. As shown in FIG. 12, the puncture body 116 is inserted in the direction indicated by the arrow H in a state where the contact portion 20 is retracted from the support 130 and the opening of the housing portion 32 is opened. The formed engagement protrusion 112a is made into an engagement recess 136c formed in the ear portion 136a of the mounting portion 136, the upper end portion of the casing 112 is brought into close contact with the O-ring 136b, and the puncture body 116 is hermetically sealed to the mounting portion 136. Can be fixed to. In order to ensure safety when the puncture body 116 is attached, a cover member 117 that covers the puncture needle 110 is attached in advance to the puncture body 116 as shown by a broken line, and the cover member 117 is removed after the puncture body 116 is attached. You may do it. Thereafter, the contact portion 20 is slid in the direction of arrow I to the closed position, whereby the terminal portion 32b of the support 130 is engaged with a terminal portion (not shown) of the contact portion 20, and the contact portion 20 is engaged. The cooling member is energized for cooling, and the contact portion 20 is positioned.

Next, as shown in FIG. 13A, the contact surface 24b of the contact portion 20 is brought into close contact with the epidermis surface S of the puncture site. When the contact surface 24 b and the skin surface S come into close contact with each other, a contact signal is input from the contact detection sensor 29 to the control device 70. In this state, when the measurement mode is selected by operating the operation unit 50, the control device 70 rotates the drive motor 42 of the drive device 40. Since the protrusion 46b engages with the groove 34a and the nut 46a is screwed with the shaft 43, the rod 46 advances according to the amount of rotation of the drive motor 42, and each puncture needle 16 The tip portion 16a gradually protrudes from the contact surface 24b.

As the protruding amount L1 of the puncture needle 110 from the contact surface 24b increases, the tip of the puncture needle 110 enters the subcutaneous tissue from the epidermis through the dermis, but to the membrane existing between the subcutaneous tissue and the muscle layer. When it reaches, the puncture needle 110 cannot penetrate the membrane, and the puncture depth of the puncture needle 110 is kept constant. Thus, when the protrusion amount L1 of the puncture needle 110 is further increased without increasing the puncture depth, as shown in FIG. 13 (b), the skin surface S is curved and comes into contact so as to protrude downward. The contact detection sensor 29 is separated from the surface 24 b and detects this, and a non-contact signal is input to the control device 70.

The control device 70 determines the contact state based on the detection signal from the contact detection sensor 29. When a plurality of the contact detection sensors 29 are arranged on the contact surface 24b, the control device 70 determines that the skin surface S is in contact with the contact surface 24b when the contact signals are input from all the contact detection sensors 29. It is preferable to determine that the contact surface 24b is separated from the contact surface 24b even when it is difficult to closely contact the entire contact surface 24b due to the surface shape or the like of the puncture site. However, the control device 70 may be configured to determine that the skin surface S is separated from the contact surface 24b based on the detection of the single contact detection sensor 29.

When determining that the skin surface S has moved away from the contact surface 24b, the control device 70 stops the driving device 40, calculates the protrusion amount L1 of the puncture needle 110 at this time from the value of the encoder 44, and determines the maximum depth. It is stored in memory as information. Thereafter, the control device 70 rotates the drive motor 42 in the reverse direction to move the puncture needle 110 in the direction of withdrawing from the puncture site, thereby burying the distal end portion 110a of the puncture needle 110 above the contact surface 24b. As a result, the contact surface 24b comes into close contact with the skin surface S again. It is preferable that the puncture needle 16 is appropriately set in thickness and pressing force so that the distal end portion 16a does not reach the muscle layer and stays securely in the subcutaneous tissue.

The maximum depth information acquired in this way corresponds to the depth region where the anesthetic solution needs to be injected, and the user selects the automatic mode by operating the operation unit 50 by grasping the depth region in advance. When this is done, the anesthetic solution can be injected easily and accurately.

That is, when the automatic mode is set, the control device 70 first sets a plurality of injection depth positions based on the maximum depth information. The implantation depth position can be obtained, for example, from the depth interval determined by comparing the maximum depth value with a predetermined reference value. As a specific example, when the maximum depth is 4 mm or less, the depth interval is set to 0.4 mm, and the injection depth position is set to 0.4 mm, 0.8 mm, 1.2 mm from the surface of the skin, When the maximum depth exceeds 4 mm, the depth interval is set to 0.6 mm, and the injection depth position is set to 0.6 mm, 1.2 mm from the skin surface. Each depth position of 1.8 mm,... Can be set. The reference value and depth interval of the maximum depth are not limited to the above values, and a plurality of each can be set. Further, the depth interval does not necessarily have to be constant, and may be set so as to gradually decrease (or increase) as the puncture depth increases. The maximum depth information and the injection depth position may be output to a monitor of the control device 60 so that the user can grasp it.

After determining the plurality of injection depth positions in this manner, the control device 70 energizes the contact portion 20 and cools the skin surface S to which the contact surface 24b comes into close contact, as shown in FIG. The driving of the driving device 40 is controlled so that the distal end portion 110a of the puncture needle 110 stops at each injection depth position. Then, the control device 70 opens the control valve 118 a for a predetermined time while the puncture needle 110 is stopped, and supplies compressed air from the pipe 118 to the mounting portion 136 and the puncture body 116. As a result, the pressing plate 114 included in the puncture body 116 is lowered in the direction indicated by the arrow J, and the predetermined amount of the anesthetic liquid Lq enclosed in the puncture body 10 is reduced by the puncture needle 110 as shown in FIG. It is injected into the living body from the distal end portion 110a. Thus, the anesthetic liquid Lq can be effectively spread over the entire region where the anesthetic liquid Lq needs to be injected by injecting the anesthetic liquid Lq at each injection depth position. The injection amount of the anesthetic liquid Lq may be the same at each injection depth position, or may be set to an appropriate amount according to the injection depth position by changing the opening degree, opening time, etc. of the control valve 118a. Is also possible. For example, the injection amount of the anesthetic liquid Lq at each injection depth position may be set larger as the depth interval of the injection depth position set based on the maximum depth information is larger.

Since the periphery of the puncture site is cooled by the close contact of the contact surface 24b, the skin surface S can improve analgesia during puncture. In addition, you may make it apply | coat an anesthetic cream previously to the skin surface S which contact | abuts the contact surface 24b. In the case where the contact surface 24b is configured to inject cooling gas onto the skin surface S, a good analgesic effect can be obtained by starting the injection of cooling gas immediately before the puncture needle 110 is punctured into the skin surface S. However, the abutment surface 24b of the abutment portion 20 may be configured not to have a cooling function.

After injecting the anesthetic liquid Lq at each injection depth position, the puncture body 116 is raised by the operation of the driving device 40 and is accommodated in the housing portion 32 again. Thus, anesthesia of the target area is completed. The next anesthesia can be started by retreating the contact portion 20, removing the puncture body 116 from the mounting portion 136 and replacing it with a new one, and then closing the contact portion 20 again. In this way, by configuring the puncture body 116 to be removable and replaceable, the puncture needle 110 does not need to be sterilized, and rapid treatment can be performed. The abutting portion 20 can also be removed from the guide groove 32a and replaced with a new one.

The puncture apparatus 101 according to the present embodiment acquires a depth region that requires anesthesia, such as a depth region in which a sweat gland may exist at a puncture site, in advance as a maximum depth information. Local anesthesia can be performed quickly and accurately. Therefore, after that, heat energy can be efficiently supplied to the sweat glands using the electrode needle while reducing pain, and treatment for suppressing excessive sweating can be performed quickly and easily. The drug solution Lq supplied by the puncture device 101 may be a solution or suspension containing a drug. The drug is not necessarily limited to an anesthetic, and may be various other drugs such as an analgesic and a hormone.

As mentioned above, although the 2nd Embodiment of this invention was explained in full detail, the specific aspect of this invention is not limited to the said embodiment. For example, in the present embodiment, the maximum depth information is acquired by the measurement mode, and the treatment is performed by automatically setting the injection depth by the automatic mode based on the maximum depth information. However, based on the acquired maximum depth information, the user may be able to manually set the injection depth appropriately. Moreover, the puncture body 116 can be fixed to the mounting portion 136 instead of the cartridge type as in the present embodiment, and the drug solution Lq can be sucked from the distal end portion 110a of the puncture needle 110 and reused.

15 is a side view of a modification of the puncture apparatus 101 shown in FIG. 9, and FIG. 16 is a cross-sectional view taken along the line KK of the puncture apparatus 101 shown in FIG. In FIGS. 15 and 16, the same components as those shown in FIGS. 9 and 10 are denoted by the same reference numerals, and detailed description thereof is omitted.

Puncture device 101 ′ shown in FIGS. 15 and 16 has puncture needle 110, abutment portion 20, drive device 40, and control device 70 as main components, similarly to puncture device 101 shown in FIGS. I have. The puncture needle 110 is provided on the bottom surface of the puncture body 216. The puncture body 216 and the contact portion 20 are supported by the support body 230.

The support body 230 is formed in a casing shape, and the driving device 40 is provided on the upper part of the main body 232, and the mounting part 236 that engages with the puncture body 216 is provided on the lower part of the main body 232. A cylindrical portion 234 is provided in the main body 232, and the shaft 43 and the rod 46 of the driving device 40 are accommodated in the cylindrical portion 234 in the same manner as the cylindrical portion 34 shown in FIG. 10. The mounting portion 236 includes a pair of

guide rails

236a and 236a. On the other hand, the puncture body 216 has engaging

grooves

219a and 219a that engage with the pair of

guide rails

236a and 236a, respectively, on the upper part of the covering 219 that constitutes the outermost portion. By moving along the

rails

236a and 236a, the puncture body 216 can be detachably attached to the attachment portion 236. The puncture body 216 is fixed to the mounting portion 236 by fitting fitting portions (not shown) provided in the pair of

guide rails

236a and 236a and the engaging

grooves

219a and 219a, respectively.

The puncture body 216 contains a casing 212 that supports a plurality of puncture needles 110 at the bottom inside the cover 219. The casing 212 is urged upward by a spring member 219d as urging means so that the puncture needle 110 is retracted into the cover 219. An insertion hole 219b through which the tip 46d of the rod 46 can pass is formed in the upper part of the cover 219, and the tip 46d can press the casing 212 when the rod 46 advances. A through-hole 219c through which the puncture needle 110 passes is formed in the lower part of the cover 219. Compressed air can be supplied to the inside of the casing 212 from a pipe 218 introduced through an opening 219e formed in the covering 219, and the compressed air is introduced by the operation of the control valve 218a. The chemical liquid Lq can be discharged by pressing.

The contact portion 20 is supported by the main body 232 via the support arm 21, and the puncture body 216 is disposed between the main body 232 and the contact portion 20. The support arm 21 has flexibility, and the puncture body 216 can be sandwiched between the mounting portion 236 and the contact portion 20. The support arm 21 accommodates wiring, signal lines, and the like that connect the contact portion 20 and the operation portion 50. The through hole 28 of the contact portion 20 is formed so as to be aligned with the puncture needle 110 and the through hole 219c of the cover 219.

In the puncture device 101 ′ having such a configuration, when the rod 46 is advanced by the operation of the driving device 40, the distal end portion 46d of the rod 46 is against the urging force of the spring member 219d as shown in FIG. The distal end portion 110a of the puncture needle 110 passes through the through

holes

219c and 28 and protrudes from the contact portion 20. Then, after the injection of the chemical liquid Lq, the holder 46 is moved again to the retracted position by the urging force accumulated in the spring member 219d by retracting the rod 46. By exchanging the puncture body 110 with a new one, the next anesthesia can be performed quickly and easily.

The contact portion 20 is supported on the mounting portion 236 by the flexible support arm 21, whereby the puncture body 216 can be sandwiched between the contact portion 20 and the mounting portion 236, and the insertion hole 219 b and The alignment of the through hole 28 can be easily performed. However, the contact portion 20 can be configured to be detachable from the puncture body 216.

In the puncture apparatus 101 ′ shown in FIGS. 15 and 16, the control unit 70 can acquire the maximum depth information by performing the same control as described above, and a plurality of pieces of information can be obtained based on the maximum depth information. The injection depth position can be set, and the chemical solution can be injected into the living body at each injection depth position.

1,101

Puncturing device

10, 110

Puncturing needles

10a, 110a Tip portion 12 Holder 20 Contact portion 21 Support arm 24b Contact surface 28 Through hole 29 Contact detection sensor 40 Drive device 70 Control device

Claims

A puncture needle that is punctured into a puncture site of a living body;
A contact portion in which a through-hole penetrating the front and back is formed and has a contact surface with a puncture site on the surface side;
Contact detection means for detecting a contact state between the contact surface and the puncture site;
Drive means for causing the puncture needle to protrude and retract from the contact surface through the through hole;
Control means for controlling the drive of the drive means,
The control means causes the puncture needle to gradually protrude from the abutment surface by driving the driving means in a state where the abutment surface is in contact with the puncture site, thereby increasing the protrusion amount of the puncture needle. Accordingly, the puncture apparatus which determines that the contact surface is separated from the surface of the puncture site based on the detection of the contact detection means, and obtains the maximum depth information from the protruding amount of the puncture needle at this time.
A plurality of the contact detection means are arranged on the contact surface,
The puncture apparatus according to claim 1, wherein the control unit determines that the contact surface is separated from the surface of the puncture site when non-contact signals are input from all the contact detection units.
The puncture device according to claim 1, wherein the contact portion is a cooling member capable of cooling the puncture site.
The puncture device according to claim 1, wherein the puncture needle is an electrode needle that supplies thermal energy from a tip portion.
The puncture apparatus according to claim 4, wherein the control means sets a plurality of heating depth positions based on the acquired maximum depth information and supplies thermal energy from the puncture needle at each of the heating depth positions. .
The puncture device according to claim 1, wherein the puncture needle is communicated with a casing in which a chemical solution is enclosed, and the chemical solution is discharged from a tip portion.
The control means sets a plurality of injection depth positions based on the acquired maximum depth information, and stops the driven puncture needle at each of the injection depth positions for drug solution discharge. The puncture device according to 1.