JPH07185019A - Thermotherapeutic device - Google Patents

Abstract

PURPOSE:To provide an easy-to-handle thermotherapeutic device with which an in vivo portion such as a rectal wall required to avoid heating as far as possible is not possible to be heated to a high temperature state even when a simple structure applicator is used. CONSTITUTION:During heating therapy, a high frequency wave radiated from a therapeutic applicator 1 in a rectum, for example, is received by a receiving probe 20. Based on received microwave power, in order to avoid a thermal damage of the rectum during the heating therapy, for example, an alarm is issued or the microwave power is controlled, or the alarm is issued for a state wherein an in vivo portion under therapy is overheated.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION The present invention relates to the oral cavity, nasal cavity,
It is equipped with a thermotherapy applicator that is used by inserting it into a body lumen such as an ear cavity, a rectal cavity, a urethra, or a cavity that is artificially opened in the living body. The present invention relates to a thermotherapy device that imparts a thermotherapy effect by emitting high-frequency radiation.

[0002]

2. Description of the Related Art Generally, it has been known that when a malignant tumor is heated, its affected tissue is reduced due to its hyperthermia treatment effect. However, by heating a benign tumor, benign prostatic hyperplasia. , It was discovered that the therapeutic effect appears. Further, in recent years, in this treatment method, a high temperature treatment method in which the heating temperature is further raised has been proposed.

[0003] Here, when this high temperature treatment method is applied to benign prostatic hyperplasia, the temperature inside the prostate is 45
It is heated to a temperature of -60 ° C or higher. In this case, in particular, it is necessary to provide cooling means for the applicator in order to prevent it from overheating. According to this, during the treatment of benign prostatic hyperplasia with high temperature, the applicator can be cooled and the surface of the urethral membrane can be protected from burns even in an environment where the inside of the prostate is heated to a high temperature state.

However, in a region where the cooling by the surface of the applicator is not effective, in some cases, the normal treatment may expose normal living tissues to a high temperature environment. For example, in a case where the prostate tissue and the rectal wall are very close to each other, the rectal wall, which is relatively poor in heat resistance, exists within the reach of electromagnetic waves,
The rectal wall, which has poor heat resistance, may be heated to a relatively high temperature.

Further, in a small applicator having a relatively small outer diameter of the applicator body and a size that can be inserted into the urethra, the electromagnetic wave radiation antenna formed therein is necessarily small. Becomes When such a small-sized antenna adopts a structure for giving directivity of electromagnetic wave radiation to the antenna itself, there is a problem that the structure of the antenna itself becomes complicated and the cost becomes high.

For this reason, in a small applicator which has been widely used in the past and can be inserted into the urethra, the radiation distribution of electromagnetic waves emitted from this applicator is concentric in the cross section of the applicator. And is omnidirectional. In addition, JP-A-4-2837
No. 7 publication discloses that a space for blocking electromagnetic waves is provided inside the applicator body, and normal living tissue other than the affected part (such as an enlarged prostate) unevenly distributed around the living body lumen when the electromagnetic wave is emitted from the applicator body. There is proposed an applicator having a structure capable of effectively heating and treating only the affected part by preventing the electromagnetic wave from being radiated to this part by the blocking space.

[0007]

By the way, in the applicator disclosed in Japanese Unexamined Patent Publication No. 4-28377 as described above, the orientation of the electromagnetic wave shielding space in the applicator body is determined during actual use. There is a problem that it is difficult to do. Therefore, a considerable amount of unnecessary labor and time is spent to confirm the directivity of the radiation distribution of the electromagnetic waves emitted from the applicator body during hyperthermia treatment.
The hyperthermia treatment using the applicator of that method has a problem that work efficiency is poor.

When the applicator body is mounted in the wrong direction, the directivity of the radiation distribution of the electromagnetic waves emitted from the applicator body is accurately directed toward the affected area which is unevenly distributed around the living body lumen. I can't. Moreover, the thermotherapy effect will be reduced. The present invention has been made in view of the above-mentioned problems, and the object is to use an applicator of any structure, and a living body part where it is desired to avoid heating of the rectal wall or the like is overheated. An object of the present invention is to provide a thermotherapy device which is easy to use without fear.

[0009]

The hyperthermia treatment device of the present invention is a hyperthermia treatment device for treating an affected part of a living body with high frequency waves radiated from an applicator inserted into a living body cavity and used. Emitted from
A receiving probe having a built-in antenna for receiving high-frequency power that passes through the affected area, and means for determining the high-frequency output of the applicator based on the received power by the probe, and by the receiving probe, for example, the received power The high frequency output of the thermotherapy applicator is controlled based on the above.

Then, for example, when the thermotherapy applicator is inserted from the urethral side and installed, and the receiving probe having the antenna built in is inserted and installed on the rectal side, high-frequency power that penetrates the affected area on the rectal side is applied. The high-frequency output of the thermotherapy applicator is adjusted to an appropriate output by receiving with an antenna. In this case, the area where heat resistance is weak and the normal area where heating is to be avoided as much as possible are not overheated.

[0011]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS A first embodiment of the present invention will be described below with reference to FIGS. FIG. 1 schematically shows the configuration of the thermotherapy device. In FIG. 1, reference numeral 1 denotes a thermotherapy applicator that is used by inserting it into a living body cavity, and a balloon 2 for indwelling fixation is provided at the tip of the insertion part of the applicator 1. In the tip portion of the applicator 1, a transmitting antenna that radiates a high frequency, for example, a microwave, which will be described later, is built in. Further, in the applicator 1, a cooling water circulation path for cooling a portion that generates heat is formed. Then, this reflux path is connected to the cooling water reflux device 6 through the reflux tubes 4 and 5.

The applicator 1 is connected to a microphone wave generator 12 via a microwave cable 11.
The microwave generator 12 is provided with a microwave oscillator 13 and a control unit 14 as means for controlling the oscillation output. Then, the microwave oscillated by the microwave generator 12 is transmitted to the transmitting antenna of the applicator 1, and the microwave is radiated toward the living body.

In FIG. 1, reference numeral 20 denotes a microwave receiving probe. The microwave receiving probe 20 has a receiving antenna 21 built-in in the tip thereof.
1 receives microwaves emitted from the thermotherapy applicator 1 and transmitted through the affected area. The received microwaves are sent to the microwave receiver 23 through the output cable 64, as will be described later.

The microwave receiving device 23 includes a receiving circuit 24 for receiving the microwave, a judging section 25 for judging the degree of microwave intensity based on the received output of the microwave,
A control signal output unit 26 that outputs a control signal based on the determination result, a dangerous value (threshold value) input unit 27 that is set according to the situation of use, and a warning circuit 28 are provided. The warning circuit 28 drives a warning output device 29 that notifies a surgeon of danger by using a lamp or a buzzer.

FIG. 2 shows a specific structure of the thermotherapy applicator 1. In FIG. 2, reference numeral 31 denotes the sheath body, and the inflatable balloon 2 is attached to the outer peripheral surface of the distal end portion of the sheath body 31. Inside the sheath body 31, a first lumen 34 having a sealed tip is provided.
And a second lumen 35 for setting a heating range, which extends in parallel with the first lumen 34.

The second lumen 35 may have a cross-sectional area of about 1/5 or less of that of the first lumen 34 so as not to impair the cooling mechanism of the first lumen 34. desirable. Air is enclosed in the second lumen 35, and this portion has a characteristic of reflecting radiation of electromagnetic waves. Specifically, the second lumen 35 is also a balloon air supply / exhaust tube. Further, it may be a drainage tube for sucking urine or the like, or a transportation path for a drug solution. Further, a plurality of second lumens 35 are formed, and the total cross-sectional area thereof is 1/5 of that of the first lumen 34.
The configuration may be set within the following range.

Further, the distal end of the second lumen 35 is formed on the outer peripheral surface of the distal end portion of the sheath body 31, and is connected to the opening portion 36 that opens inside the balloon 2. The base end portion of the second lumen 35 is connected to the openable / closable connector portion 37. An external air supply means such as a syringe is detachably connected to the connector portion 37.

An inner tube 39 is inserted inside the first lumen 34. The tip of the inner tube 39 extends to the vicinity of the tip sealing portion of the first lumen 34. In this case, a spiral tube 40 is wound around the outer peripheral surface of the inner tube 39. And
A first cooling liquid passage 41 through which a cooling liquid can flow is formed between the inner peripheral surface of the first lumen 34 and the outer peripheral surface of the inner tube 39.

At the tip of the inner tube 39, there is provided a communication hole (not shown) which communicates with the inside of the first cooling liquid passage 41 between the first lumen 34 and the inner tube 39, and through this communication hole. It communicates with the second coolant passage 45. Since the spiral tube 40 is wound around the inner tube 39, the inner tube 39
It is possible to flex the applicator 1 flexibly while holding the coaxial cable 42 in the center of the first lumen 34.

A coaxial cable 42 for transmitting electromagnetic waves is inserted into the inner tube 39. A microwave antenna (electromagnetic wave radiating portion) 43 for heating that radiates microwaves is formed at the tip of the coaxial cable 42. A connector portion 44 is provided at the base end portion of the coaxial cable 42. The connector portion 44 is connected to the external microwave generator 12. A second cooling liquid passage 45 is formed between the inner tube 39 and the coaxial cable 42 so that a cooling liquid can flow therethrough.

Further, the sheath body 31 and the inner tube 3
One end of the above-mentioned reflux tube 4 is hermetically connected to the base end of the first cooling liquid passage 41 between the inner tube 39 and the coaxial cable 42. One end of the other reflux tube 5 is hermetically connected to the liquid passage 45. Then, it is connected to an external reflux device 6 through these reflux tubes 4 and 5.

Inside the reflux device 6, a heat exchange part (not shown) for changing the temperature of the cooling liquid and a pump part (not shown) for changing the amount of the cooling liquid sent are arranged. And
When the reflux device 6 is driven, the cooling liquid discharged from the pump portion passes through one reflux tube 4 and the applicator 1
Is supplied to. Further, the cooling liquid supplied to the reflux passage of the applicator 1 is supplied from the first cooling liquid passage 41 between the sheath body 1 and the inner tube 39 to the second cooling liquid between the inner tube 39 and the coaxial cable 42. It flows into the passage 45. Then, it is recovered from the second cooling liquid passage 45 to the reflux device 6 through the other reflux tube 5.

Further, two sensor holes 52a and 52b are formed on the outer peripheral surface of the distal end portion of the sheath body 31 in a state of being separated by a predetermined distance in the axial direction of the sheath body 31.
A first temperature sensor 53 and a second temperature sensor 54 are inserted in the space between the sheath body 31 and the inner tube 39.

The sensitive portion at the tip of the first temperature sensor 53 on one side is connected to the sheath body 31 from the front sensor hole 52a.
, And is fixed to the outer peripheral surface of the sheath body 31 with an adhesive or the like. In this case, the first temperature sensor 53
The sensitive section is disposed near the antenna 3.

Similarly, the sensitive portion at the tip of the other second temperature sensor 54 is from the rear sensor hole 52b to the sheath body 31.
, And is fixed to the outer peripheral surface of the sheath body 31 with an adhesive or the like. In this case, the second temperature sensor 54
The sensitive portion of is arranged behind the sensitive portion of the first temperature sensor 53, for example, within a range of 20 to 30 mm.

The signal lines 55 of the first temperature sensor 53 and the second temperature sensor 54 extend to the proximal end side of the sheath body 31 and are connected to the connector portion 56. Further, the temperature sensor 5 is provided on the outer peripheral surface of the distal end portion of the sheath body 31.
A thin-walled cover member 57 (for example, wall thickness t: about 0.1 to 0.5 mm) that covers the outside of the sheath body 31 in a state of covering the sensitive portions of 3, 54 is attached.

After the first temperature sensor 53 and the second temperature sensor 54 are attached to the two sensor holes 52a and 52b on the outer peripheral surface of the distal end portion of the sheath body 31, a filler such as a silicone adhesive is used. It is filled, and the filling material is also applied to the sensitive portion. Further, by covering the upper part of the sensitive portion with the thin cover member 57, a double insulating structure is provided between the temperature sensors 53 and 54 and the living body without impairing the response speed of the temperature sensors 53 and 54. Reserved.

FIG. 4 shows the above-mentioned microwave receiving probe 20, which is inserted into the rectum and receives microwaves that pass through the urethra, prostate and rectal wall. More specifically, this rectal microwave receiving probe 20 has an exterior part including an insertion part 61 that is inserted into the rectum 58 and a support part 62 that supports the insertion part 61 when it is inserted into a living body cavity. is doing. The microwave receiving antenna 21 for receiving the microwave radiated from the thermotherapy applicator 1 and transmitted through the rectal wall 59 is built in the exterior portion. The exterior portion does not interfere with microwave propagation to the built-in receiving antenna 21,
For example, it is formed of a low dielectric constant material such as resin.

The receiving antenna 21 is, for example, as shown in FIG.
An antenna having an arbitrary shape for receiving microwaves is used, such as a loop antenna as shown in FIG. 5 or a coaxial antenna as shown in FIG. The receiving antenna 21 is grounded or integrated with an output cable 64. The output cable 64 is led out of the rectal microwave receiving probe 20, and is terminated at an external microwave receiving device 23. Connector 6 for connecting
5 are provided.

When this hyperthermia treatment apparatus is used by a patient with prostatic disease, the procedure is as follows. First, the insertion part of the applicator 1 is inserted through the urethra. After the tip of the applicator 1 reaches the inside of the bladder 61a, the connector 3
7, the balloon 2 is inflated by supplying air into the balloon 2 through the second lumen 35 by a syringe or the like. Then, the applicator 1 is pulled until a resistance is felt, and the pulling operation of the applicator 1 is stopped while the resistance is felt. Then, the sensitive portion at the tip of the first temperature sensor 53 of the applicator 1 is positioned in contact with the wall of the prostate tissue in the enlarged prostate region, and the sensitive portion at the tip of the second temperature sensor 54 is positioned in contact with the urethral sphincter. It FIG. 3 shows the indwelling state.

On the other hand, as shown in FIG. 3, the microwave receiving probe 20 is inserted into the rectum 58 so that the central portion of the receiving antenna 21 is located in the rectum 58 below the prostate 60. The cooling water recirculation device 6 and the microwave generator 12 are driven. In addition, the microwave generator 12
Oscillates. Then, the electromagnetic wave (microwave) transmitted from the microwave oscillator 13 through the coaxial cable 42 is radiated from the antenna 43 to the tissue of the living body prostate 60.

In this state, the heat treatment is performed, and the microwave transmitted through the rectal wall 59 and the prostate 60 is received by the microwave receiving probe 20 during the treatment, and the received output is large, and the heat treatment is performed during the heat treatment. In a situation where there is a risk of overheating the rectal wall 59 and causing thermal damage, the determination unit 2
5 judges it, and activates the warning output device 29 which notifies the operator. At the same time, the microwave generator 1
The oscillating operation of the second microwave oscillator 13 is cut off.

When the rectal wall 59 is likely to be overheated during thermal treatment to cause thermal damage, the control signal from the judging section 25 controls the output of the microwave oscillator 13 of the microwave generator 12. Then, the output of the microwave is shut off, or the received power in the rectum 58 is operated to be below the safety allowable value.

According to this embodiment, based on the microwave power received in the rectum, a warning or microwave output is controlled to prevent thermal damage to the rectum during warming treatment, so It is possible to safely perform hyperthermia without causing an increase in the temperature of the rectal wall.

FIG. 6 shows a second embodiment of the present invention. This shows a modification of the microwave reception probe 20. In the microwave receiving probe 20, a balloon 72 is coaxially provided at the distal end of an insertion portion 71 to be inserted into the rectum, and a support portion 74 to be held at the time of insertion is provided on the proximal side of the insertion portion 71. Is provided. A receiving antenna 75 for receiving the microwave radiated from the applicator 1 and transmitted through the rectal wall is built in the tip of the insertion portion 71 of the microwave receiving probe 20.

The receiving portion of the receiving antenna 75 bends the coaxial cable 42 inside the balloon 72 so as to be offset from the central axis of the microwave receiving probe 20 to one inner wall side of the balloon 72. In order to hold the receiving antenna 75, the receiving antenna 75 is composed of, for example, a semi-rigid coaxial cable or the like.

In addition to the structure of the previous embodiment, tubes 76 and 77 for circulating a fluid inside the probe 20 are connected to the support portion 74, which is the cooling device shown in FIG. It is connected to the liquid reflux device 78. The cooling liquid recirculation device 78 circulates a cooling liquid, such as a liquid having a large specific heat, into the probe 20 to cool the probe 20.

Microwave receiving probe 2 having such a configuration
In No. 0, after being inserted into the rectum, the balloon 72 is inflated by the injection of the cooling liquid and closely adheres to the rectal wall. Next, the thermotherapy is started, and the insertion portion 71 of the microwave reception probe 20 is rotated in the direction in which the microwave reception power in the rectum is maximized. Next, the cooling liquid in the balloon 72 is refluxed to cool the surface of the rectal wall.

If the received power is large and there is a risk that the rectal wall will be overheated during thermal treatment to cause thermal damage, the operator is warned and the output of the high frequency oscillator is output, as in the previous embodiment. Or shutting off the microwave output of the high frequency oscillator together with the notification by the warning means, or keeping the received power in the rectum below the safe allowable value.

Therefore, since the transmitted power is monitored in a direction closer to the rectal wall on the prostate side in the direction in which the microwave power is most strongly received, it is possible to more reliably prevent the thermal damage to the rectal wall during the heating treatment. Is. Further, the safety of treatment is further improved because the rectal wall is cooled by reflux. In addition, it is possible to eliminate errors due to individual differences in rectal diameter as much as possible.

FIG. 7 shows a third embodiment of the present invention. Microwave receiving probe 2 for rectum shown in FIG.
A modified example of 0 is shown. That is, a balloon 80 is provided on the outer periphery of the distal end portion of the insertion portion 61 of the microwave receiving probe 20, the inside of the balloon 80 and the inside of the insertion portion 81 are communicated with each other through a conduction port 82, and liquid is sent through the inside of the insertion portion 81. Balloon 8
Inflate 0. Further, since the cooling liquid flows back inside the expansion space of the balloon 80, tubes 76 and 77 similar to the above for supplying / collecting the refluxing liquid to the support portion 74 are provided.

The probe 20 for rectal microwave reception having the above-mentioned structure is inserted into the rectum, and then the balloon 80 is inflated by the injection of the cooling liquid, and the balloon 80 is brought into close contact with the rectal wall. next,
Hyperthermia treatment is started, and the cooling liquid in the balloon 80 is refluxed to cool the rectal wall surface. Therefore, as in the previous embodiment, the rectal wall is cooled by reflux, together with a warning for preventing overheating and control of microwave output based on the microwave received power in the rectum.

[0043]

As described above, according to the present invention, during treatment, for example, the radio frequency emitted from the thermotherapy applicator in the rectum is received by the receiving probe, and based on the received electric power, for example, It is possible to control the warning or microwave output so that the rectum does not get heat-damaged during the warming treatment, or to warn if the body part under treatment is overheated.

[Brief description of drawings]

FIG. 1 is an explanatory diagram of a schematic configuration of a thermotherapy apparatus according to a first embodiment of the present invention.

FIG. 2 is a diagram showing a thermotherapy applicator in the thermotherapy device according to the first embodiment of the present invention.

FIG. 3 is an explanatory diagram of a usage state of the thermotherapy device according to the first embodiment of the present invention.

FIG. 4 is an explanatory diagram of a microwave receiving applicator of the thermotherapy device according to the first embodiment of the present invention.

FIG. 5 is an explanatory diagram of a modification of the microwave receiving applicator according to the first embodiment of the present invention.

FIG. 6 is an explanatory diagram of a microwave receiving applicator according to a second embodiment of the present invention.

FIG. 7 is an explanatory view of an assembled state of the microwave receiving applicator.

FIG. 8 is an explanatory diagram of a microwave receiving applicator according to a third embodiment of the present invention.

[Explanation of symbols]

DESCRIPTION OF SYMBOLS 1 ... Thermotherapy applicator, 12 ... Microwave generator, 13 ... Microwave oscillator, 14 ... Control part, 20 ... Microwave receiving probe, 21 ... Receiving antenna, 23
... microwave receiving device, 24 ... receiving circuit, 25 ... judgment part, 26 ... control signal output part, 27 ... dangerous value (threshold value)
Input unit, 28 ... Warning circuit, 75 ... Receiving antenna 75.

Claims (1)

[Claims] 1. A hyperthermia treatment apparatus for treating a diseased part of a living body with a high frequency wave radiated from a heat treatment applicator which is inserted into a living body cavity, and a high frequency wave radiated from the heat treatment applicator and transmitted through the diseased part. A thermotherapy device comprising: a receiving probe having an antenna for receiving electric power; and means for discriminating a high frequency output of the applicator based on the electric power received by the probe.