WO2019187239A1

WO2019187239A1 - Ablation device

Info

Publication number: WO2019187239A1
Application number: PCT/JP2018/036228
Authority: WO
Inventors: 祐貴児玉
Original assignee: 日本ライフライン株式会社
Priority date: 2018-03-27
Filing date: 2018-09-28
Publication date: 2019-10-03
Also published as: TWI693920B; JP6871194B2; JP2019170465A; TW201941746A

Abstract

Provided is an ablation device which can improve convenience. An ablation device 1 comprises: an electrode needle 11 which percutaneously punctures an affected part 90 inside a body, and which is supplied with electric power Pout; an insulating tube 12 which exposes an electrode area (exposed area Ae) while covering the periphery of the electrode needle 11 along the axial direction (Z-axis direction) of the electrode needle 11; a flow path 110 which is formed inside the electrode needle 11 and through which a liquid L for cooling flows; and a handle 13 fitted to the base end side of the electrode needle 11. The handle 13 includes: a handle body 130; an operation part 131; a liquid storage section 133 which is disposed inside the handle body 130 and temporarily stores the liquid L for cooling; and a slide mechanism 132 which is disposed inside the handle body 130 in parallel to the liquid storage section 133 and which performs a slide operation along the axial direction in conjunction with a prescribed operation of the operation part 131, thereby causing a slide operation of the insulating tube 12 along the axial direction.

Description

Ablation device

The present invention relates to an ablation device provided with an electrode needle that is percutaneously punctured to an affected part in the body.

An ablation system that performs ablation (cauterization) on such an affected part has been proposed as one of medical devices for treating an affected part in a patient (for example, an affected part having a tumor such as cancer) (for example, Patent Document 1). This ablation system includes an ablation device having an electrode needle that is punctured percutaneously into an affected part in the body, and a power supply device that supplies electric power for performing the ablation on the affected part.

JP-T-2006-513830

By the way, the above-described ablation devices are generally required to improve convenience when used, for example. Therefore, it is desirable to provide an ablation device that can improve convenience.

An ablation device according to an embodiment of the present invention includes an electrode needle that is punctured percutaneously into an affected part of the body and that is supplied with electric power for ablation, and is positioned on the distal end side of the electrode needle. An insulating tube that covers the periphery of the electrode needle along the axial direction of the electrode needle while exposing the electrode region to be formed, a flow path that is formed inside the electrode needle and through which a cooling liquid flows, and an electrode needle And a handle attached to the base end side. The handle is disposed in the handle body as an exterior, an operation section for performing a predetermined operation for sliding the insulating tube along the axial direction, and temporarily supplying a cooling liquid. The insulating tube is placed in parallel with the liquid container in the handle body and in parallel with the liquid container in the handle body, and slides along the axial direction in conjunction with the predetermined operation on the operation unit. And a slide mechanism that slides along the axial direction.

In an ablation device according to an embodiment of the present invention, a liquid storage section that temporarily stores a cooling liquid and a slide that performs a predetermined operation for sliding the insulating tube along the axial direction. The mechanisms are arranged in parallel with each other in the handle body. This avoids a decrease in the adjustable range for the electrode region (exposed region from the insulating tube) where the tip of the electrode needle is located while reducing the size of the entire handle. That is, it is possible to achieve both the miniaturization of the entire handle and the widening of the adjustable range for the electrode region.

Note that the length of the handle along the axial direction is preferably 86 mm or less, for example. When the length along the axial direction of the handle is larger than 86 mm, for example, when performing a procedure in a state where a patient is in a circular CT (Computed Tomography) scanning apparatus, for example. This is because the handle and the CT scanning device may come into contact with each other.

The slide mechanism has a proximal end connected to the operation portion, and is linked to the handle body along the axial direction in the handle body in conjunction with the predetermined operation on the operation portion. A slide bar portion that slides in a moving manner, and a joint portion that joins the distal end side of the slide bar portion and the vicinity of the proximal end of the insulating tube, and the slide bar portion of the handle main body When positioned on the base end side, the liquid container may be extended so as to bypass the operation portion and the joint portion. In this case, when the predetermined operation is performed on the operation unit, interference between the slide bar unit and the liquid storage unit is prevented, and the entire handle can be easily downsized.

In the ablation device according to an embodiment of the present invention, the flow path includes a first flow path that is a flow path when the cooling liquid flows from the proximal end side to the distal end side of the electrode needle, and the cooling In the case where the liquid for use includes a second flow path that is a flow path when the liquid for use flows from the distal end side to the proximal end side of the electrode needle, the following may be performed. That is, the cooling liquid that has flowed into the handle body from the liquid feeding pipe is not directly stored in the liquid storage portion, but directly supplied into the first flow path, The cooling liquid supplied from above may be allowed to flow out of the handle body into the drain pipe after being temporarily stored in the liquid storage portion. In this case, the liquid warmed during the ablation and temporarily stored in the liquid storage portion (the liquid on the drain side supplied from the second flow path) and the first flow The liquid on the liquid feeding side supplied to the path is not mixed in the handle body. Therefore, a decrease in the cooling effect due to the cooling liquid due to the liquid on the liquid feeding side being warmed can be suppressed. As a result, the convenience when using the ablation device is further improved.

In this case, while further penetrating the liquid storage portion in the handle body, is further provided along the axial direction inside the electrode needle, further provided an inner tube constituting the first flow path inside the electrode needle, The cooling liquid may be directly supplied from the liquid feeding pipe into the inner pipe. In this case, the inner pipe constituting the first flow path penetrates the liquid storage portion in the handle main body, thereby further reducing the size of the entire handle. The adverse effect (reduction of cooling effect) on the liquid on the liquid feeding side due to the liquid (warmed liquid) is minimized. As a result, the convenience when using the ablation device is further improved.

According to the ablation device of an embodiment of the present invention, the liquid storage portion and the slide mechanism are arranged in parallel with each other in the handle body. The widening of the adjustable range can be achieved at the same time. Therefore, convenience when using the ablation device can be improved.

It is a block diagram showing typically the example of the whole composition of the ablation system provided with the ablation device concerning one embodiment of the present invention. It is a model side view showing the detailed structural example of the ablation device shown in FIG. FIG. 3 is a side view schematically illustrating a configuration example of a main part inside the handle illustrated in FIG. 2. FIG. 3 is a perspective view schematically illustrating a configuration example of a main part inside the handle illustrated in FIG. 2. FIG. 5 is a schematic cross-sectional view showing an example of an internal configuration in the vicinity of the liquid container shown in FIGS. 3 and 4 and on the tip side of the electrode needle shown in FIG. 2. It is a schematic diagram showing an example of the cauterization condition in the affected part by ablation. It is a model side view showing an example of the slide operation | movement in the ablation device shown in FIG.

Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings. The description will be given in the following order.
1. Embodiment (example in which a liquid container and a slide mechanism are arranged in parallel in the handle body)
2. Modified example

<1. Embodiment>
[Overall configuration of ablation system 5]
FIG. 1 schematically shows a block diagram of an overall configuration example of an ablation system 5 including an ablation device (ablation device 1) according to an embodiment of the present invention.

For example, as shown in FIG. 1, the ablation system 5 is a system used when treating an affected part 90 in the body of a patient 9, and performs predetermined ablation (cauterization) on the affected part 90. It has become.

The above-mentioned affected part 90 includes, for example, an affected part having a tumor such as cancer (liver cancer, lung cancer, breast cancer, kidney cancer, thyroid cancer, etc.).

The ablation system 5 includes an ablation device 1, a liquid supply device 2, and a power supply device 3 as shown in FIG. In the case of ablation using the ablation system 5, for example, the counter electrode plate 4 shown in FIG. 1 is also used as appropriate.

(Ablation device 1)
The ablation device 1 is a device used in the above-described ablation, and includes an electrode needle 11 and an insulating tube 12 as will be described in detail later.

The electrode needle 11 is a needle that is punctured percutaneously into the affected part 90 in the body of the patient 9, for example, as indicated by an arrow P1 in FIG. In addition, the liquid L supplied from the liquid supply apparatus 2 to be described later circulates in the electrode needle 11 (see FIG. 1).

The insulating tube 12 is a member that covers the periphery of the electrode needle 11 along the axial direction of the electrode needle 11 while exposing an electrode region (exposed region Ae described later) located on the distal end side of the electrode needle 11. .

A detailed configuration example of such an ablation device 1 will be described later (see FIGS. 2 and 3).

(Liquid supply device 2)
The liquid supply apparatus 2 is an apparatus that supplies the cooling liquid L to the ablation device 1 (inside the electrode needle 11), and has a liquid supply section 21, for example, as shown in FIG. Examples of the cooling liquid L include sterilized water and sterilized physiological saline.

The liquid supply unit 21 supplies the liquid L to the ablation device 1 as needed according to control by a control signal CTL2 described later. Specifically, for example, as shown in FIG. 1, the liquid supply unit 21 circulates the liquid L between the inside of the liquid supply device 2 and the inside of the electrode needle 11 (in a predetermined flow path 110 described later). In this way, the liquid L supply operation is performed. Further, according to the control by the control signal CTL2, the liquid L supply operation is executed or stopped. In addition, such a liquid supply part 21 is comprised including the liquid pump etc., for example.

(Power supply 3)
The power supply device 3 supplies power Pout (for example, power of radio frequency (RF)) for performing ablation between the electrode needle 11 and the counter electrode plate 4 and the liquid L in the liquid supply device 2 described above. It is a device for controlling the supply operation. As shown in FIG. 1, the power supply device 3 includes an input unit 31, a power supply unit 32, a control unit 33, and a display unit 34.

The input unit 31 is a part for inputting various set values and an instruction signal (operation signal Sm) for instructing a predetermined operation to be described later. Such an operation signal Sm is input from the input unit 31 in response to an operation by an operator (for example, an engineer) of the power supply device 3. However, these various setting values are not input in response to an operation by the operator, but may be set in the power supply device 3 in advance, for example, when the product is shipped. The set value input by the input unit 31 is supplied to the control unit 33 described later. Such an input unit 31 is configured using, for example, a predetermined dial, button, touch panel, or the like.

The power supply unit 32 is a part that supplies the power Pout described above between the electrode needle 11 and the counter electrode plate 4 in accordance with a control signal CTL1 described later. Such a power supply part 32 is comprised using the predetermined power supply circuit (for example, switching regulator etc.). When the power Pout is high frequency power, the frequency is, for example, about 450 kHz to 550 kHz (for example, 500 kHz).

The control unit 33 is a part that controls the entire power supply device 3 and performs predetermined arithmetic processing, and is configured using, for example, a microcomputer. Specifically, the control unit 33 first has a function (power supply control function) of controlling the supply operation of the power Pout in the power supply unit 32 using the control signal CTL1. In addition, the control unit 33 has a function (liquid supply control function) for controlling the supply operation of the liquid L in the liquid supply device 2 (liquid supply unit 21) using the control signal CTL2.

For example, as shown in FIG. 1, temperature information It measured in the ablation device 1 (a temperature sensor such as a thermocouple disposed inside the electrode needle 11) is supplied to the control unit 33 as needed. It has become so. For example, as shown in FIG. 1, the measurement value of the impedance value Zm is supplied to the control unit 33 from the power supply unit 32 as needed.

The display unit 34 is a part (monitor) that displays various types of information and outputs the information to the outside. Examples of information to be displayed include the above-described various set values input from the input unit 31, various parameters supplied from the control unit 33, temperature information It supplied from the ablation device 1, and the like. However, the information to be displayed is not limited to these information, and other information may be displayed instead of or in addition to other information. Such a display part 34 is comprised using the display (For example, a liquid crystal display, a CRT (Cathode * Ray * Tube) display, an organic EL (Electro * Luminescence) display, etc.) by various systems.

(Counter electrode 4)
For example, as shown in FIG. 1, the counter electrode plate 4 is used while being attached to the body surface of the patient 9 during ablation. Although details will be described later, during ablation, high-frequency energization is performed (electric power Pout is supplied) between the electrode needle 11 (the electrode region described above) and the counter electrode plate 4 in the ablation device 1. ing. Although details will be described later, during such ablation, as shown in FIG. 1, the impedance value Zm between the electrode needle 11 and the counter electrode plate 4 is measured as needed, and the measured impedance value Zm is In the power supply device 3, power is supplied from the power supply unit 32 to the control unit 33.

[Detailed configuration of ablation device 1]
Next, a detailed configuration example of the ablation device 1 described above will be described with reference to FIG. FIG. 2 schematically shows a detailed configuration example of the ablation device 1 shown in FIG. 1 in a side view (YZ side view). In FIG. 2, the portion indicated by the symbol P <b> 2 (partial region of the electrode needle 11 and the insulating tube 12) is enlarged and shown below in FIG. 2, as indicated by an arrow.

(Electrode needle 11)
The electrode needle 11 is provided along the Z-axis direction as shown in FIG. 2, and the length (axial length) along the Z-axis direction is, for example, about 30 mm to 350 mm. The electrode needle 11 has, along its axial direction (Z-axis direction), an exposed region Ae (electrode region that functions as an electrode during ablation) that is not covered with the insulating tube 12, and an insulating tube. 12 and the area | region (covering area | region of a base end side) covered with 12. As described above, the electric power Pout for ablation is supplied between the exposed area Ae of the electrode needle 11 and the counter electrode plate 4. In addition, such an electrode needle | hook 11 is comprised by metal materials, such as stainless steel, nickel titanium alloy, a titanium alloy, platinum, for example.

(Insulating tube 12)
As described above, the insulating tube 12 is a member that covers the periphery of the electrode needle 11 along the Z-axis direction while partially exposing the distal end side (exposed region Ae) of the electrode needle 11. The insulating tube 12 is attached to the electrode needle 11 along its axial direction (Z-axis direction), for example, as indicated by an arrow d2 in FIG. On the other hand, it is configured to be relatively slidable. Thereby, the length (axial direction length) along the Z-axis direction in the exposed region Ae of the electrode needle 11 can be adjusted.

In addition, the length (axial direction length) along the Z-axis direction in the exposed region Ae of the electrode needle 11 that can be adjusted by such an insulating tube 12 is, for example, about 3 mm to 50 mm. The insulating tube 12 is made of, for example, a synthetic resin such as PEEK (polyether ether ketone), PI (polyimide), fluorine resin, or polyether block amide.

(Handle 13)
The handle 13 is a portion that is gripped (gripped) by an operator (doctor) when the ablation device 1 is used. As shown in FIG. 2, the handle 13 mainly includes a handle main body 130 attached to the proximal end side of the electrode needle 11 and an operation portion (slide knob portion) 131.

The handle body 130 corresponds to a portion (gripping portion) that is actually gripped by the operator, and is a portion that also functions as an exterior of the handle 13. The handle body 130 is made of synthetic resin such as polycarbonate, acrylonitrile-butadiene-styrene copolymer (ABS), acrylic, polyolefin, polyoxymethylene, and the like.

The operation part 131 is a part where a predetermined operation (slide operation) for causing the insulating tube 12 to slide relative to the electrode needle 11 along its axial direction (Z-axis direction) is performed. It protrudes outside the handle body 130 (Y-axis direction). The operation unit 131 is made of, for example, the same material (synthetic resin or the like) as the handle body 130 described above. The operation unit 131 is configured to be slidable relative to the handle main body 130 along the axial direction (Z-axis direction) of the handle 13.

Although details will be described later, when such a slide operation is performed on the operation unit 131 (see, for example, the arrow d1 in FIG. 2), the insulating tube 12 moves along the Z-axis direction with respect to the electrode needle 11. The sliding movement is relatively performed (see, for example, the arrow d2 in FIG. 2). Thereby, the length (axial direction length) along the Z-axis direction in the exposed region Ae of the electrode needle 11 can be adjusted.

[Detailed configuration of handle 13]
Next, a detailed configuration example of the handle 13 will be described with reference to FIGS. FIG. 3 is a side view (YZ exploded side view) schematically showing an example of the configuration of the main part inside the handle 13 shown in FIG. FIG. 4 is a perspective view schematically showing a configuration example of a main part inside the handle 13. FIG. 5A is a schematic cross-sectional view (ZX cross-sectional view) showing an example of the internal configuration in the vicinity of the liquid storage portion (liquid storage portion 133 described later) shown in FIGS. is there. FIG. 5B is a schematic cross-sectional view (ZX cross-sectional view) showing an example of the internal configuration of the tip side of the electrode needle 11 shown in FIG.

3 and 4, for convenience of explanation, the handle main body 130 is illustrated with one side portion along the X-axis direction removed. In FIGS. 3 and 4, for convenience of explanation, the illustration of the configuration other than the main part inside the handle 13 is omitted as appropriate.

As shown in FIGS. 3, 4, and 5 (A), a slide mechanism 132 and a liquid storage portion 133 are provided inside the handle 13 (inside the handle main body 130).

(Slide mechanism 132)
Although details will be described later, the slide mechanism 132 slides along the Z-axis direction in conjunction with the above-described slide operation on the operation unit 131, thereby causing the insulating needle 12 to move along the Z-axis direction along the electrode needle 11. It is a mechanism which carries out a sliding operation relative to. As shown in FIG. 3, the slide mechanism 132 has a slide bar portion (parallel bar portion) 132a and a joint portion 132b.

As shown in FIG. 3, the joining portion 132 b is a portion that joins the distal end side of the slide bar portion 132 a described later and the vicinity of the proximal end of the insulating tube 12.

As shown in FIG. 3, the slide bar portion 132 a is disposed between the operation unit 131 described above and other internal components such as the liquid storage unit 133 in parallel mainly along the Z-axis direction. Yes. The slide bar portion 132a has a proximal end side connected to the operation portion 131 and a distal end side connected (joined) to the joint portion 132b. Such a slide bar portion 132a slides relative to the handle main body 130 along the Z-axis direction in the handle main body 130 in conjunction with the slide operation on the operation portion 131 described above. Yes.

Further, as shown in FIG. 3, when the operation unit 131 is located on the proximal end side of the handle body 130, the tip of the slide bar portion 132 a is compared with the tips of other internal parts such as the liquid storage unit 133. It is located on the tip side. In other words, when the slide bar portion 132a is positioned on the proximal end side of the handle main body 130, the slide bar portion 132a bypasses other internal components such as the liquid storage portion 133 between the operation portion 131 and the joint portion 132b. It extends. This prevents interference between the slide bar portion 132a and other internal components such as the liquid storage portion 133 during the slide operation on the operation portion 131, and facilitates downsizing of the handle 13 as a whole.

Note that the slide bar portion 132a and the joint portion 132b, and the operation portion 131 described above are each integrally formed, for example. However, the slide bar portion 132a, the joint portion 132b, and the operation portion 131 may be formed as separate bodies.

In this way, the slide mechanism 132 is arranged in parallel with the liquid storage portion 133 in the handle main body 130 as shown in FIGS. That is, in the handle main body 130, the slide mechanism 132 (slide bar portion 132a) and the liquid storage portion 133 are arranged in parallel (in this example, arranged in parallel along the Y-axis direction).

(Liquid storage part 133)
The liquid storage portion 133 is a member that temporarily stores the cooling liquid L in the handle main body 130 therein. For example, as shown in FIG. 4 and FIG. 5A, a liquid feed pipe for allowing the cooling liquid L to flow into the handle main body 130 (from the liquid supply part 21 described above) is provided in the liquid storage part 133. 81 and a drainage pipe 82 for discharging the cooling liquid L from the handle main body 130 (toward the liquid supply unit 21) are connected to each other. Further, a flow path through which the cooling liquid L reciprocates (circulates) is provided inside the handle main body 130 and the electrode needle 11 via the liquid supply pipe 81, the liquid storage portion 133, and the drainage pipe 82. Is formed.

(Channel 110)
Here, with reference to FIG. 5 (A) and FIG. 5 (B), the structure of the flow path 110 formed in the electrode needle 11 is demonstrated in detail.

First, as shown in FIG. 5B, the flow path 110 is formed along the axial direction (Z-axis direction) of the electrode needle 11 inside the electrode needle 11, and the cooling liquid L It is a flowing channel. Specifically, for example, as indicated by the broken-line arrows in FIGS. 5A and 5B, a flow path 110a (electrode) serving as a forward path for the cooling liquid L is provided in the flow path 110. A flow path when flowing from the proximal end side of the needle 11 to the distal end side) and a flow path 110b serving as a return path (flow path when flowing from the distal end side of the electrode needle 11 to the proximal end side) are provided. Yes.

It should be noted that such a flow path 110 corresponds to a specific example of “flow path” in the present invention. The flow path 110a corresponds to a specific example of “first flow path” in the present invention, and the flow path 110b corresponds to a specific example of “second flow path” in the present invention.

For example, as shown in FIGS. 5A and 5B, the handle main body 130 penetrates the liquid storage portion 133 along the Z-axis direction (in FIG. 5A). An inner tube 111 that constitutes the above-described flow path 110a (outward path) is provided inside the electrode needle 11 together with the reference P3). As shown in FIGS. 5A and 5B, the inner tube 111 is formed in the axial direction of the electrode needle 11 inside the handle main body 130, the electrode needle 11 (flow channel 110), and the liquid feeding tube 81. It is arranged along (Z-axis direction). As shown in FIG. 5A, the cooling liquid L is directly supplied from the liquid feeding pipe 81 into the inner pipe 111.

With such a configuration, the cooling liquid L that has flowed into the handle main body 130 from the liquid feeding pipe 81 is not temporarily stored in the liquid storage portion 133 (passes through the inner pipe 111). ) It is directly supplied into the forward flow path 110a (see FIG. 5A). In addition, the cooling liquid L supplied from the flow path 110b serving as the return path is temporarily stored in the liquid storage section 133 and then flows out from the handle body 130 into the drain pipe 82. (See FIG. 5A). With such a configuration, the liquid feeding pipe 81 for allowing the cooling liquid L to flow into the handle main body 130 and the drainage pipe 82 for discharging the cooling liquid L from the handle main body 130 are mutually connected. It can be provided by branching.

[Operation and action / effect]
(A. Basic operation)
In this ablation system 5, when treating the affected part 90 which has tumors, such as cancer, for example, predetermined ablation is performed with respect to such an affected part 90 (refer FIG. 1). In such ablation, first, for example, as indicated by an arrow P1 in FIG. 1, the electrode needle 11 in the ablation device 1 is moved from the distal end side (exposed region Ae side) to the affected part 90 in the body of the patient 9. Punctured percutaneously. Then, power Pout (for example, high frequency power) is supplied from the power supply device 3 (power supply unit 32) between the electrode needle 11 and the counter electrode plate 4, so that the affected part 90 is ablated by Joule heat generation. Is called.

Further, at the time of such ablation, the liquid supply device 2 is circulated so that the cooling liquid L circulates between the inside of the liquid supply device 2 and the inside of the electrode needle 11 (inside the flow path 110 described above). The liquid L is supplied from the (liquid supply part 21) to the electrode needle 11 (see FIG. 1). As a result, a cooling operation (cooling) is performed on the electrode needle 11 during ablation, and as a result, an excessive increase in the temperature (tissue temperature) of the affected area 90 is suppressed, and the impedance described above due to tissue carbonization. A sudden increase in the value Zm is prevented.

FIG. 6 schematically shows an example of the condition of cauterization in the affected area 90 due to such ablation. As shown in FIG. 6, when the above-described ablation is performed using the electrode needle 11 punctured in the affected area 90, for example, the initial rugby ball-shaped (elliptical spherical) thermal coagulation region Ah1 gradually expands. As a result, a substantially spherical thermocoagulation region Ah2 is obtained (see the broken arrow in FIG. 3). As a result, isotropic ablation of the entire affected area 90 is performed, and as a result, effective treatment of the affected area 90 is performed.

For example, as shown in FIGS. 2, 7 (A), and 7 (B), in the case of such ablation, the above-described slide operation on the operation unit 131 is performed on the handle 13 of the ablation device 1. Done in advance. Specifically, when a slide operation along the Z-axis direction is performed on the operation unit 131 (see, for example, the arrow d1 in FIGS. 2 and 7B), the operation unit 131 is interlocked with the slide operation. Thus, the slide mechanism 132 in the handle main body 130 performs a slide operation along the Z-axis direction (see arrow d0 in FIG. 7B). In conjunction with the slide operation of the slide mechanism 132, the insulating tube 12 also performs a slide operation along the Z-axis direction (see, for example, the arrow d2 in FIGS. 2 and 5B). As a result, for example, as shown in FIGS. 7A and 7B, the size (length along the Z-axis direction) of the exposed area Ae on the distal end side of the electrode needle 11 is arbitrarily adjusted, The ablation range at the time of ablation (the range corresponding to the exposure area Ae) is also arbitrarily adjusted.

Thereby, for example, when a small tumor is formed in a deep part of the liver, the exposed area Ae (ablation range) is set small, and the tip of the electrode needle 11 is inserted to the affected area 90 to perform ablation. By performing, only the affected part 90 can be cauterized selectively. That is, parts other than the affected part 90 are not cauterized, and the original function can be maintained. On the other hand, for example, when a large tumor is formed, by setting the exposed area Ae (ablation range) large, the large tumors can be cauterized together (collectively).

The slide operation on the operation unit 131 and the slide operation of the slide mechanism 132 and the insulating tube 12 in conjunction with the slide operation are stepwise along the axial direction (Z-axis direction) of the electrode needle 11. It may be adjustable (intermittently). In other words, the position when the operation unit 131, the slide mechanism 132, and the insulating tube 12 slide may be slightly fixed for each predetermined distance along the Z-axis direction.

(B. Comparative example)
Here, as the ablation device according to the comparative example, for example, the following configuration can be considered. That is, the ablation device of this comparative example is different from the ablation device 1 of the present embodiment shown in FIGS. 3 and 4 in that the slide mechanism 132 and the liquid storage portion 133 are arranged in series in the handle body. (Arranged side by side along the Z-axis direction, which is the axial direction of the electrode needle 11). However, such a comparative ablation device may cause the following problems.

That is, first, when performing ablation treatment for liver cancer in, for example, radiology, an ablation device is generally used under a CT scan. That is, the ablation device is used in a state where the patient is in the circular CT scanning apparatus. Therefore, since it is difficult to use a large ablation device, it is generally required to reduce the handle of the ablation device.

Therefore, in a general handle of an ablation device in which the slide mechanism 132 and the liquid storage portion 133 are arranged in series in the handle body, the handle is downsized as it is (the ablation device of the comparative example described above). Then, it becomes as follows. That is, in the ablation device of this comparative example, the entire handle can be reduced in size, but the electrode region (exposed region Ae from the insulating tube 12) located at the tip of the electrode needle 11 is axially (Z-axis direction). ), The adjustable range is reduced. Such an electrode region (exposed region Ae) corresponds to the ablation range at the time of ablation using the electrode needle 11 as described above (see FIGS. 7A and 7B). If the adjustment range for the ablation range is reduced, the convenience when using the ablation device may be impaired.

(C. This embodiment)
On the other hand, as shown in FIG. 3, the ablation device 1 of the present embodiment has the following configuration, unlike the ablation device of the comparative example. That is, the handle body 130 includes a liquid storage portion 133 that temporarily stores the cooling liquid L and a slide mechanism 132 that performs a predetermined operation for sliding the insulating tube 12 along the Z-axis direction. Are arranged in parallel with each other.

With this configuration, the ablation device 1 of the present embodiment is as follows, unlike the ablation device of the comparative example described above.

That is, first, the overall size of the handle 13 is reduced. Specifically, the size of the entire handle 13 (the axial length Lz shown in FIG. 3 (the length along the Z-axis direction)) can be set to 86 mm or less (Lz ≦ 86 mm), for example. On the other hand, for example, when the size of the entire handle 13 (the axial length Lz) is larger than 86 mm, as described above, when performing a procedure in a state where the patient is inside the circular CT scan apparatus, In addition, the handle 13 and the CT scanning device may come into contact with each other. Note that the lower limit value of the overall size of the handle 13 (axial length Lz) is, for example, 30 mm in consideration of securing the exposure area Ae (ablation range). That is, in this case, (30 mm ≦ Lz ≦ 86 mm) is satisfied. Further, in the ablation device 1, a decrease in the adjustable range for the electrode region (exposed region Ae from the insulating tube 12) where the tip of the electrode needle 11 is located is avoided (FIGS. 7A and 7). (See (B)). That is, in the ablation device 1, unlike the ablation device of the comparative example, both miniaturization of the handle 13 as a whole and widening of the adjustable range for the electrode region (ablation range described above) are realized. .

As described above, in the ablation device 1 according to the present embodiment, the liquid storage portion 133 and the slide mechanism 132 are arranged in parallel with each other in the handle main body 130, so that the overall size of the handle 13 and the ablation range can be reduced. It is possible to achieve both the widening of the adjustable range for. Therefore, in this ablation device 1, compared with the ablation device of the comparative example, for example, effective ablation can be performed. As a result, convenience in use can be improved.

Further, in the ablation device 1 of the present embodiment, the cooling liquid L that has flowed into the handle main body 130 from the liquid supply pipe 81 is not temporarily stored in the liquid storage portion 133, but becomes a forward flow. It is directly supplied into the passage 110a (inner pipe 111) (see FIG. 5A). In addition, the cooling liquid L supplied from the flow path 110b serving as the return path is temporarily stored in the liquid storage section 133 and then flows out from the handle main body 130 into the drainage pipe 82 (FIG. 5 (A)). As a result, as shown in FIG. 5A, the liquid L that is warmed during ablation and is temporarily stored in the liquid storage portion 133 (the liquid L on the drain side supplied from the flow path 110b). ) And the liquid L on the liquid feeding side supplied to the flow path 110a are not mixed in the handle main body 130. Therefore, a decrease in the cooling effect due to the cooling liquid L caused by the liquid L on the liquid feeding side being warmed can be suppressed. As a result, in this embodiment, the convenience when using the ablation device 1 can be further improved.

Furthermore, in the present embodiment, as shown in FIG. 5A, the liquid main body 133 is penetrated in the handle main body 130 and the flow path 110a (outward path) is formed inside the electrode needle 11. A tube 111 is provided. Then, the cooling liquid L is directly supplied from the liquid feeding pipe 81 into the inner pipe 111 (see FIG. 5A). As a result, the inner pipe 111 constituting the flow path 110a penetrates the liquid storage portion 133 in the handle main body 130, so that the size of the handle 13 as a whole can be further reduced. The adverse effect (decrease in cooling effect) on the liquid L on the liquid feeding side due to L (warmed liquid L) is minimized. As a result, in this embodiment, the convenience when using the ablation device 1 can be further improved.

<2. Modification>
While the present invention has been described with reference to the embodiment, the present invention is not limited to this embodiment, and various modifications can be made.

For example, the material of each member described in the above embodiment is not limited, and other materials may be used. In the above-described embodiment, the configuration of the ablation device or the like has been specifically described, but it is not always necessary to include all members, and other members may be further included. Furthermore, the values, ranges, magnitude relationships, and the like of the various parameters described in the above embodiments are not limited to those described in the above embodiments, and may be other values, ranges, magnitude relationships, and the like.

In the above embodiment, the configuration of the electrode needle, the insulating tube, the handle and the like in the ablation device has been specifically described. However, the configuration of each member is not described in the above embodiment. The configuration is not limited, and other configurations may be used. Specifically, for example, depending on the case, the electrode needle may be a bipolar type instead of the monopolar type described in the above embodiments and the like. For example, on the liquid feeding side described above, the cooling liquid may be temporarily stored in the liquid storage portion and then supplied into the flow path (first flow path). Further, for example, in some cases, the above-described inner tube (which constitutes the first flow path) may be configured not to penetrate the liquid storage part (a structure that bypasses the liquid storage part and reaches the flow path).

Furthermore, in the above-described embodiment, the block configurations of the liquid supply device 2 and the power supply device 3 are specifically described. However, it is not always necessary to include all the blocks described in the above-described embodiment. A block may be further provided. The ablation system 5 as a whole may further include other devices in addition to the devices described in the above embodiment.

Further, in the above-described embodiment and the like, the ablation device in which high-frequency conduction is performed between the electrode needle 11 and the counter electrode plate 4 at the time of ablation has been specifically described, but is not limited to the above-described embodiment and the like. Absent. Specifically, for example, an ablation device that performs ablation using other electromagnetic waves such as radio waves and microwaves may be used.

In addition, in the above embodiment, the control operation (ablation method) in the control unit 33 including the power supply control function and the liquid supply control function has been specifically described. However, the control method (ablation method) in these power supply control function and liquid supply control function is not limited to the method described in the above embodiment.

In addition, the series of processing described in the above embodiment may be performed by hardware (circuit) or software (program). When performed by software, the software is composed of a group of programs for causing each function to be executed by a computer. Each program may be used by being incorporated in advance in the computer, for example, or may be used by being installed in the computer from a network or a recording medium.

Furthermore, the various examples described so far may be applied in any combination.

Claims

An electrode needle that is punctured percutaneously into the affected part of the body and supplied with power for ablation;
An insulating tube covering the periphery of the electrode needle along the axial direction of the electrode needle while exposing an electrode region located on the tip side of the electrode needle;
Formed inside the electrode needle, and a flow path through which a cooling liquid flows;
A handle attached to the proximal end side of the electrode needle,
The handle is
A handle body as an exterior,
An operation unit for performing a predetermined operation for sliding the insulating tube along the axial direction;
A liquid storage portion disposed in the handle body and temporarily storing the cooling liquid;
In the handle body, the insulating tube is arranged along the axial direction by being arranged in parallel with the liquid storage portion and sliding along the axial direction in conjunction with the predetermined operation on the operating portion. An ablation device having a slide mechanism that slides.
The slide mechanism is
A slide bar that has a proximal end connected to the operation portion and slides relative to the handle body along the axial direction in the handle body in conjunction with the predetermined operation on the operation portion. And
A joining portion that joins the distal end side of the slide bar portion and the vicinity of the proximal end of the insulating tube;
The ablation device according to claim 1, wherein the slide bar portion extends so as to bypass the liquid storage portion between the operation portion and the joint portion when positioned on the proximal end side of the handle main body. .
The ablation device according to claim 1, wherein a length of the handle along the axial direction is 86 mm or less.
The flow path is
A first flow path that is a flow path when the cooling liquid flows from the proximal end side to the distal end side of the electrode needle;
A second flow path that is a flow path when the cooling liquid flows from the distal end side to the proximal end side of the electrode needle,
The cooling liquid that has flowed into the handle main body from the liquid supply pipe is not directly stored in the liquid storage portion, but directly supplied into the first flow path,
4. The cooling liquid supplied from the second flow path flows out of the handle body into the drain pipe after being temporarily stored in the liquid storage portion. 5. The ablation device according to any one of claims.
An inner tube that penetrates through the liquid container in the handle body, is disposed along the axial direction inside the electrode needle, and forms the first flow path inside the electrode needle;
The ablation device according to claim 4, wherein the cooling liquid is directly supplied from the liquid feeding pipe into the inner pipe.