JPH07184904A - Diagnostic treatment system - Google Patents

Abstract

PURPOSE:To enable the high-temperature cautery treatment of deep internal organs by performing the high-temperature cautery treatment by sticking a cautery probe through a sticking guide mechanism into the organic tissue of a diseased part in the state of facing a top end part to the diseased part while controlling the bent part of an intracelom inserting probe. CONSTITUTION:The side of a top end part 12 of an inserting part 11 of an intracelom ultrasonic probe 10 is inserted to a relevant part inside the belly. The bending of a bent part 13 is controlled by operating an operating knob 22 of an operating part 21, ultrasonic diagnosis is performed while touching the surface of treatment object internal organs with the ultrasonic raditing face side of the top end part 12, and the image of the diseased part is plotted on a screen. Continuously, a sticking type microwave cautery probe 40 is inserted through a sticking guide mechanism 12b and stuck while confirming the conditions for the top end chip to reach the diseased part under the ultrasonic image, a microwave antenna part is positioned inside the diseased part, and proteinic degeneration sufficient for speedily heating, cauterizing and breaking the adjacent organic tissue is generated by irradiating it with microwaves.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a diagnostic treatment system, and more particularly to a diagnostic treatment system for performing ultrasonic diagnosis of deep organs and high temperature ablation treatment in a body cavity.

[0002]

2. Description of the Related Art Conventionally, an ultrasonic wave in which an ultrasonic pulse generated by an ultrasonic transducer is repeatedly transmitted into a living tissue and an echo of the ultrasonic pulse reflected from the living tissue is provided in the same or a different body. Received by the oscillator,
Various ultrasonic diagnostic apparatuses have been proposed which gradually change the transmitting and receiving directions of the ultrasonic pulse to display information collected from a plurality of directions in the living body as an ultrasonic tomographic image of a visible image. .

As each of these proposed ultrasonic diagnostic apparatuses, it is general to use an ultrasonic probe of an extracorporeal system, but in addition, an ultrasonic probe combined with an endoscope or an ultrasonic wave of a small diameter is used. In-body ultrasonic probes such as a probe and an intracorporeal ultrasonic probe to be inserted into a body cavity are also widely used.

On the other hand, among the means for treating lesions such as cancer cells, there is a high-temperature cautery treatment in which the lesions are cauterized at high temperature to cause protein degeneration in the relevant portions to cause necrosis. As one of the devices for performing the high-temperature ablation treatment, there is an ultrasonic high-temperature ablation treatment means for irradiating a focused high-intensity ultrasonic wave for treatment.

In the ultrasonic high-temperature cautery treatment means, in order to obtain focused ultrasonic waves with high intensity, an extracorporeal applicator equipped with an ultrasonic vibrator having a relatively large opening is used.
In addition to focusing the high-intensity ultrasonic waves on the lesion site to be treated, a relatively small ultrasonic transducer is built-in,
For example, a body cavity insertion probe adapted to be inserted into the rectum to treat an enlarged prostate is well known.
Further, these high-temperature ablation treatment means, as a positioning means for positioning the treatment site (focus) in the deep organ concerned, for example, is combined with an ultrasonic diagnostic apparatus for obtaining the ultrasonic tomographic image, For this reason, it is also found that a diagnostic ultrasonic transducer capable of performing focus positioning with respect to the extracorporeal applicator or the intracavity probe is built in.

[0006]

However, in each of the conventional high temperature treatment devices as described above, particularly in the device for treating the prostate by inserting the ultrasonic probe in the body cavity into the rectum, Since the ultrasonic probe itself is relatively thick and relatively rigid, its application range is extremely limited, and it is usually impossible to perform treatment by inserting it into a lumen other than the rectum. Therefore, for example, high-temperature ablation treatment for deep organs, which is performed by inserting it into a body cavity such as upper digestive tract, lower digestive tract, or abdominal cavity, cannot be performed.

The present invention has been made to solve the above-mentioned conventional problems, and the purpose thereof is to:
Insert into the body cavity such as upper digestive tract, lower digestive tract, abdominal cavity,
It is an object of the present invention to provide a diagnostic treatment system capable of performing high-temperature ablation treatment of deep internal organs under observation of ultrasonic images.

[0008]

In order to achieve the above object, the present invention provides a diagnostic treatment system for performing ultrasonic image diagnosis and high temperature ablation treatment of a deep organ in a body cavity.
A body cavity having a distal end portion in which an ultrasonic transducer for ultrasonic diagnostic imaging is built-in, a curved portion for bending the distal end portion, and a puncture guide mechanism for guiding puncture into living tissue at the distal end portion. A body cavity insertable probe that can be inserted into the body, an ultrasonic image diagnostic apparatus that makes a diagnosis by the ultrasonic image observation, and an ablation probe that is guided by the puncture guide mechanism and punctured in the living tissue of the affected area, An ablation device for supplying ablation energy to the ablation probe.

[0009]

Therefore, in the present invention, the curved portion of the probe for insertion into the body cavity is bent under the ultrasonic image observation by the ultrasonic image diagnostic apparatus in a state where the probe for insertion into the body cavity is inserted into the corresponding body cavity. The tip of the lesion is controlled to be exposed, the cauterization probe is pierced into the living tissue of the lesion through the puncture guide mechanism, and the corresponding living tissue is subjected to high temperature ablation treatment by the cauterizing energy supplied from the ablation device.

[0010]

DESCRIPTION OF THE PREFERRED EMBODIMENTS Hereinafter, different embodiments of the diagnostic treatment system according to the present invention will be described in detail with reference to FIGS.

FIGS. 1 (a) and 1 (b) are plan views showing the appearance of an ultrasonic probe for intra-abdominal cavity using a linear array type ultrasonic transducer applied to the diagnostic treatment system according to the first embodiment of the present invention. FIG. 2, a side view, and FIG. 2 are vertical cross-sectional views showing an enlarged schematic configuration of a tip portion of the ultrasonic probe of the first embodiment. 3 is a side view showing an external appearance of an ultrasonic probe for intra-abdominal cavity similarly using a linear array type ultrasonic transducer according to the second embodiment of the present invention, and FIG. FIG. 13 is a side view showing an appearance form of an intraperitoneal ultrasonic probe using a mechanical radial scan type ultrasonic transducer according to three examples.

That is, in each of the configurations of the first, second and third embodiments shown in these drawings, the ultrasonic probe 10 for intra-abdominal cavity has the insertion portion 11 inserted into the abdominal cavity and the bending operation knob 22. And the operation unit 21 in which is arranged. The insertion portion 11 includes the linear array ultrasonic transducer 31 in the former first and second embodiments, and the mechanical radial scan ultrasonic transducer 31 in the latter third embodiment. Each has a rigid tip portion 12 containing 51, a bending portion 13 for bending the tip portion 12 side by operating the bending operation knob 22, and an insertion tube 14 connected to the bending portion 13, respectively. The part 21 is a first part that holds the insertion part 11.
The gripping portion 23 and the second gripping portion 24 are respectively provided.

On the other hand, as shown in FIG. 2, a puncture guide 12a for guiding a puncture operation is formed at the exterior tip of the tip portion 12 of the intraperitoneal ultrasonic probe 10, and the puncture guide 12a is formed. As will be described later, a puncture probe, that is, in this case, an ablation guide groove 12b having a predetermined puncture angle for guiding the puncture ablation probe 40 is formed for 12a. A linear array ultrasonic transducer 31 is built in the tip portion 12, and an acoustic matching layer 32 is provided on the ultrasonic vibration emission surface side of the linear array ultrasonic transducer 31.

Further, in the case of the first embodiment, the tip portion 12
A balloon 33 that encloses an ultrasonic transmission medium that plays a role of acoustic coupling can be attached to the balloon 33, and the ultrasonic transmission medium is supplied from the injection port 25 to the inside of the balloon 33 through a conduit in the probe. To be supplied to. In the case of the third embodiment, by rotating the vibrator 51 in the radial direction via a flexible shaft (not shown) connected to the mechanical radial scan ultrasonic vibrator 51, the ultrasonic radial Directional scanning is enabled.

Here, FIGS. 5 (a) and 5 (b) are a side view showing an appearance of the puncture type microwave ablation probe and an enlarged sectional view showing a schematic configuration of the tip portion.

That is, in the configuration of FIG. 5, the puncture type microwave ablation probe 40 is connected to the microwave oscillating device (not shown) via the connecting cord 42.
1, a hard insertion portion 43 connected to the grip portion 41, a tip portion 44 connected to the insertion portion 43, and a tip tip 45 of the tip portion 44. Inside it,
A coaxial cable 46 for transmitting microwaves is inserted, and a microwave antenna portion 47 formed of a slit is integrally provided near the tip of the coaxial cable 46. Here, the tip portion 44 and the tip tip 45 are each formed of a low dielectric constant material so as not to interfere with microwave radiation, and the tip tip 45 is formed.
Is shaped into, for example, a conical shape in order to facilitate puncturing into the body cavity.

Thus, as shown in FIG. 6, the ultrasonic probe 10 for intra-abdominal cavity having the above-mentioned configuration is inserted into the abdominal cavity of the abdominal cavity through the trocar to insert the insertion portion 11 into the corresponding portion. Insert the tip 12 side. And the operation unit 2
By operating the curving operation knob 22 of No. 1, the curving unit 1
A state in which the ultrasonic wave emitting surface side of the linear array type ultrasonic transducer 31 or the mechanical radial scan type ultrasonic transducer 51 built in the tip portion 12 is brought into contact with the surface of the treatment target organ In addition, ultrasonic diagnosis is performed in this state, and an image of the lesion is displayed on the screen. Here, FIG. 7 shows an ultrasonic diagnostic image 71 to be drawn as an example of this case.
For example, a linear puncture index 72 is displayed in advance as a puncture path based on the puncture angle of the puncture guide groove 12b, and the relevant lesioned part 70 of the treatment target organ is displayed on the puncture index 72. Ultrasonic probe 10, so as to be positioned,
As a result, the tip 12 side is bent.

Subsequently, as shown in FIG. 8, the puncture-type microwave ablation probe 40 is attached to the puncture guide groove 12.
While being inserted through b, the patient is punctured while confirming how the distal tip 45 reaches the lesioned portion 70 through the abdominal wall along the puncturing direction 73 indicated by an arrow under the ultrasonic image. The microwave antenna part 47 is located in the lesion part 70. After that, while continuing to observe the ultrasonic diagnostic image, the microwave oscillating device oscillates a microwave, whereby the microwave antenna unit 47
It was confirmed that the irradiation of the microwave from the above rapidly heated and cauterized the relevant living tissue in the vicinity to cause the protein degeneration sufficient for necrosis of the lesion 70, and then the irradiation of the microwave was stopped. Terminate treatment. As a result, the high temperature treatment by cauterizing the deep organ to be treated can be accurately and accurately executed.

In the above description, the microwave ablation probe 40 is used as an example of the ablation probe. However, the ablation probe is not necessarily limited to this. For example, a contact tip may be attached to the tip. In addition to cauterization using the puncture-type rigid laser probe and the laser oscillator, heating probe, or the like, it is also possible to perform suction of a tumor by an ultrasonic aspirator or the like using an ultrafine probe.

Next, FIG. 9 is an explanatory view showing a usage state of an intraabdominal ultrasonic probe using the ultrasonic transducer of the fourth embodiment applied to the diagnostic treatment system of the present invention.

In FIG. 9, an ultrasonic probe 10a for intra-abdominal cavity has a hard insertion tube 62, a curved tube 63, a front oblique optical system 65 and a convex type ultrasonic vibration, as in the case of each of the above embodiments. The ultrasonic endoscope 61 includes a distal end portion 64 on which a child 66 is arranged.
1 is a combination of a soft puncture type cautery probe 68 that is pierced through the inside of 1 by forceps raising 67 to a lesion 70 to be treated at a desired angle, and here, similarly, the ultrasonic endoscope 61 is also used. Under the observation of the ultrasonic diagnostic image by
As can be seen in FIG. 2, high-temperature ablation treatment by the soft puncture type ablation probe 68 can be performed.

[0022]

As described above in detail with reference to the embodiments, according to the present invention, an ultrasonic image diagnosis is performed in a diagnostic treatment system for performing ultrasonic image diagnosis of a deep organ in a body cavity and high temperature ablation treatment. A probe for insertion into a body cavity having a distal end with an ultrasonic transducer built-in, a curved portion for bending the distal end, and a puncture guide mechanism for guiding puncture into living tissue. , An ultrasonic image diagnostic apparatus for performing a diagnosis by ultrasonic image observation, an ablation probe that is guided by a puncture guide mechanism and punctured into living tissue of a relevant lesion site, and an ablation device that supplies ablation energy to the ablation probe. With this configuration, the curved portion of the intracavity insertion probe is curved under the ultrasonic image observation by the ultrasonic imaging apparatus with the intracavity insertion probe inserted into the corresponding body cavity. Then, the ablation probe is pierced into the living tissue of the lesion through the puncture guide mechanism with the tip facing the affected area, and the ablation energy supplied from the ablation device treats the ablated tissue at a high temperature. It is possible to perform high temperature treatment by cauterization of deep organs accurately and accurately, and the applicable range can be expanded to all lesion sites accessible from the abdominal wall as well as the abdominal organ, and as a result, It has an excellent feature that a simple and practical diagnostic and treatment device that integrates ultrasonic diagnosis and high-temperature ablation treatment can be easily realized.

[Brief description of drawings]

1 (a) and 1 (b) are plan views showing the appearance of an intraperitoneal ultrasonic probe using a linear array ultrasonic transducer applied to the diagnostic treatment system according to the first embodiment of the present invention. ，
FIG.

FIG. 2 is an enlarged vertical cross-sectional view showing a schematic configuration of a tip portion of the ultrasonic probe of the first embodiment.

FIG. 3 is a side view showing the external appearance of an intra-abdominal ultrasonic probe similarly using a linear array ultrasonic transducer according to the second embodiment of the present invention.

FIG. 4 is a side view showing an external appearance of an ultrasonic probe for intraperitoneal cavity using a mechanical radial scan type ultrasonic transducer according to a third embodiment of the present invention.

5 (a) and 5 (b) are side views showing the external appearance of the puncture-type microwave ablation probe applied to each of the first to third embodiments, and an enlarged view showing the schematic configuration of the tip. FIG.

FIG. 6 is a perspective explanatory view showing a usage state of the intra-abdominal ultrasonic probe according to each of the first to third embodiments.

FIG. 7 is an explanatory diagram showing an example of an ultrasonic diagnostic image in the same use state.

FIG. 8 is a perspective explanatory view showing a mode of high-temperature ablation treatment using an intra-abdominal ultrasonic probe and a puncture-type microwave ablation probe in the same use state.

FIG. 9 is a perspective explanatory view showing a mode of high-temperature ablation treatment using an ultrasonic endoscope and a puncture-type ablation probe according to a fourth embodiment of the present invention.

[Explanation of symbols]

 10, 10a Ultrasonic probe for intraperitoneal cavity 11 Insertion part 12 Tip part 12a Puncture guide 12b Cautery guide groove 13 Curved part 14 Insertion tube 21 Operation part 22 Curved operation knob 23 First grip part 24 Second grip part 25 Injection port 26 26 31 Linear array type ultrasonic transducer 32 Acoustic matching layer 33 Balloon 40 Puncture type microwave ablation probe 41 Gripping portion 42 Connection cord 43 Insertion portion 44 Tip portion 45 Tip tip 46 Coaxial cable 47 Microwave antenna portion 51 Mechanical radial scan -Type ultrasonic transducer 61 Puncture cautery probe 62 Insertion tube 63 Curved portion 64 Tip portion 65 Anterior oblique optical system 66 Convex ultrasonic transducer 67 Forceps raising 68 Soft puncture cautery probe 70 Lesion site 71 Diagnostic image 72 Puncture index 73 Puncture direction

Claims (1)

[Claims] 1. A diagnostic treatment system for performing ultrasonic image diagnosis and high-temperature ablation treatment of a deep organ in a body cavity, wherein a distal end portion in which an ultrasonic transducer for the ultrasonic image diagnosis is disposed, and the distal end portion. A body cavity insertion probe that can be inserted into a body cavity by having a curved portion that bends the body and a puncture guide mechanism that guides puncture into living tissue at the tip portion, and an ultrasonic image diagnosis that performs the ultrasonic image diagnosis A diagnostic treatment system comprising: an apparatus, an ablation probe guided by the puncture guide mechanism to puncture a living tissue of a relevant lesion site, and an ablation apparatus for supplying an ablation energy to the ablation probe.