KR101656494B1

KR101656494B1 - Rectal expansion apparatus for immobilization of prostate internal motion

Info

Publication number: KR101656494B1
Application number: KR1020150036766A
Authority: KR
Inventors: 금웅섭; 박효국
Original assignee: 연세대학교 산학협력단
Priority date: 2015-03-17
Filing date: 2015-03-17
Publication date: 2016-09-22

Abstract

A rectum expanding device for securing prostate motion is disclosed. A rectum expanding device for fixation of prostate motion of the present invention comprises: scanning means including a piston and a cylinder; An insertion member including a balloon through which fluid is injected or released by the syringe, and a tube connecting the cylinder with the balloon and through which the fluid moves; And a deformable member provided in the insertion member and deformed by movement of the piston in such a manner that the balloon is expanded or contracted by the fluid, wherein the deformable member prevents deformation of the balloon due to pressure inside the rectum when the balloon inflates . According to the present invention, it is possible to provide a rectal extension device for prostate-motion fixation which prevents the reduction of the elasticity of the balloon due to pressure in the rectum, and suppresses the shape deformation of the balloon caused by pressure in the rectum, .

Description

RECTAL EXPANSION APPARATUS FOR IMMOBILIZATION OF PROSTATE INTERNAL MOTION [0002]

More particularly, the present invention relates to a rectal expanding device for fixing a prostate, and more particularly, to a rectal expanding device for fixation of a prostate, And to suppress the deformation of the rectum.

The prostate is reported to vary in position by as much as two centimeters a day, depending on the amount of urine in the bladder, the amount of feces in the rectum, and other conditions such as abdominal pressure.

Therefore, it is necessary to accurately grasp the location of the prostate tumor every day for radiotherapy. However, since it is not easy to locate the prostate before 3D CRT, enlarging the treatment area was the only solution and therefore the dose could not be increased.

After the introduction of 3D CRT, various methods such as bladder distension, rectal balloon, fiducial marker insertion, BAT and cone beam CT have been developed to reduce the damage of surrounding tissues such as bladder and rectum as the radiation dose increases. Currently, most organs use one or more of these methods to treat prostate cancer after prostate location and location adjustment.

Among them, Korean Patent Registration No. 1345421 filed by the applicant of the present invention relates to a rectal balloon, and an extension device for a rectal prosthesis for fixing the movement of the prostate gland is disclosed in Patent Publication No. 1345421 The prostate is inserted into the rectum so as to inflate the rectum proximal to the prostate and fixes the position of the prostate when the cancer is treated by irradiating the cancer tissue of the prostate with one end of the prostate, A hollow tube having a ruler formed at its periphery; A balloon provided at the other end of the tube and configured to expand by operation of the air injection means; And a support catheter that is formed inside the tube such that one end thereof is located inside the balloon when the balloon is inserted into the rectum when the balloon is inserted into the rectum, .

In patent application No. 1345421, during the radiation treatment of prostate cancer, a balloon is inserted into the rectum very close to the prostate to expand the rectum and fix the prostate so that it does not move, thereby minimizing the radiation exposure area of rectal wall And the treatment dose of the tumor can be increased relatively, so that the treatment efficiency can be improved, and there is no movement of the prostate gland, so that irradiation with the radiation can be accurately performed.

However, since the conventional rectal extension device including the patent No. 1345421 is individually used for every 5 to 6 weeks of radiation treatment of prostate cancer, the elasticity of the balloon is increased by the pressure in the rectum as the number of times of use increases There was a problem that it gradually decreased.

In addition, the conventional rectal expanding device including the registered patent publication No. 1345421 may distort the shape of the balloon differently from the original shape due to the pressure in the rectum gas or the feces, and this may result in a decrease in the radiation therapy result for the prostate cancer There arises a problem that it acts as a factor of climbing.

In addition, the conventional rectal extension device including the No. 1345421 discloses that, when only the rear end of the balloon in the insertion direction of the balloon is engaged with the tube, the front end of the balloon due to rectal pressure and frictional force when the rectal balloon is inserted into the rectum It is not easy to determine the correct insertion position of the balloon in the rectum by pushing back and checking only the ruler formed on the tube. When the rectal balloon is inserted into the rectum, the frontal part of the balloon is pushed back, There was a problem that ruptured.

In addition, as described above, the conventional rectal expanding device including the balloon is combined with the tube only at the rear end of the balloon as described above, and once the balloon is inflated in the rectum, The pressure of the rectum and the frictional force are controlled by the balloon and the tube in the process of adjusting the insertion position of the balloon. And the balloon is ruptured at this portion.

(0001) Korean Patent Registration No. 1345421 (Registered on Dec. 19, 2013)

It is an object of the present invention to provide a rectal expanding device for prostate-motion fixation which prevents the reduction of the elasticity of the balloon due to pressure in the rectum even when repeatedly used and suppresses the shape deformation of the balloon due to pressure in the rectum, will be.

In addition, the position of the inflated balloon is accurately determined according to the insertion depth of the rectum, and the balloon is prevented from being damaged by friction with the inner wall of the rectum even when the inflated balloon is moved in the rectum. And to provide a rectal extension device.

The object is achieved according to the present invention by a scanning means comprising a piston and a cylinder; An insertion member including a balloon for injecting or discharging fluid by the syringe and a tube for connecting the balloon to the cylinder and a fluid through which the fluid moves; And a deformable member which is provided in the insertion member and deforms by the movement of the piston in such a manner that the balloon is inflated or contracted by the fluid, Thereby preventing deformation of the balloon.

And a support member for supporting the inner surface of the tube so that the shape of the tube is maintained inside the rectum. The front end of the support member is fixed to the insertion member so that the entire length of the insertion member is maintained even when the balloon is inflated or contracted. And may be coupled to the front end of the balloon.

A hemispherical head portion may be formed at the front end of the balloon to facilitate insertion into the rectum, and a front end of the support member may be coupled to the head portion.

Wherein the rear end portion is coupled to the piston and the front end portion is a moving member extending from the inside of the tube toward the balloon, wherein the front end portion is coupled to the front end portion of the support member and the rear end portion is interlocked with the moving member And a plurality of frames that are bent and deformed such that the balloon is expanded or contracted when the moving member is moved.

The frame may be configured to be formed radially about the support member and the moving member.

The deformable member includes a slider having a rear end coupled to the frame and slidable along the moving member, and the moving member is provided with a pair of latching portions for forming a reciprocating section of the slider .

The support member may be formed in the shape of a pipe so that the fluid moves through the inside of the support member, and a communication hole through which the fluid moves into the balloon may be formed.

The supporting member may be formed with a plurality of through holes through which the rear end of the frame passes.

According to the present invention, since the deformable member prevents the balloon from being deformed due to the pressure inside the rectum when the balloon is inflated, the elasticity of the balloon can be prevented from decreasing due to pressure in the rectum, It is possible to provide a rectal expansion device for fixing the prostate gland, which is configured to suppress the shape deformation of the balloon.

In addition, since the front end portion of the support member is engaged with the front end portion of the balloon inside the insertion member, the position of the balloon inflated inside the rectum is accurately determined according to the insertion length of the rectum and even if the inflated balloon is moved in the rectum, It is possible to provide a rectal extension device for fixing the prostate gland, which is configured to prevent breakage of the balloon due to friction with the inner wall.

BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is a perspective view of a rectal device for securing prostate movement according to an embodiment of the present invention; FIG.
FIG. 2 is a cross-sectional view showing a state in which a balloon of the rectum expansion device for fixing the prostate gland of FIG. 1 is contracted.
FIG. 3 is a sectional view showing a balloon of a rectum expanding device for fixing the prostate gland of FIG. 1 in an expanded state; FIG.

Hereinafter, preferred embodiments of the present invention will be described in detail with reference to the accompanying drawings. In the following description of the present invention, the well-known functions or constructions are not described in order to simplify the gist of the present invention.

The rectal motion expanding rectal apparatus for prostate motion fixation is prevented from reducing the elasticity of the balloon due to pressure in the rectum and suppressing the shape deformation of the balloon caused by the pressure in the rectum gas or the feces.

Further, according to the rectal motion expanding rectal device of the present invention, the position of the balloon inflated in the rectum is accurately determined according to the insertion length of the rectum, and even when the balloon in an inflated state is moved in the rectum, Thereby preventing breakage of the balloon caused by the balloon.

FIG. 1 is a perspective view of a rectal motion expanding device for prostate-motion fixation according to an embodiment of the present invention, FIG. 2 is a cross-sectional view showing a state in which a balloon of the rectal- FIG. 6 is a cross-sectional view illustrating the inflated state of the balloon of the rectal apparatus for fixing the prostate motion.

1 to 3, in the rectum expanding apparatus 1 for fixing the prostate gland according to the embodiment of the present invention, the decrease in elasticity of the balloon 21 due to pressure in the rectum is prevented even if it is used repeatedly The insertion member 20, the deformable member 30, the support member 40, and the movable member (not shown), which are formed in the balloon 21, 50).

1 to 3, the scanning means 10 includes a cylinder 11 and a piston 12 for injecting fluid into the balloon 21 or extracting fluid from the balloon 21, . The above-mentioned fluid means air, water or oil.

As shown in Figs. 1 and 2, a hole for communicating the outside and the inside is formed in the front end portion of the cylinder 11.

The piston (12) reciprocates inside the cylinder (11), and the fluid filled in the cylinder (11) is discharged to the outside or introduced into the inside through the hole.

1 to 3, the scanning means 10 may be formed in the form of a general syringe, and a pair of knobs (not shown) rotatably coupled to the cylinder 11 and the piston 12, (Not shown), and may be formed in the form of a pistol in which the cylinder 11 and the piston 12 move relative to each other by relative rotation between the grips. Of course, the scanning means 10 may be made such that the piston 12 is reciprocated by a mechanical force.

As shown in Figs. 1 to 3, the insertion member 20 is configured to be inserted into a rectum, and includes a balloon 21 and a tube 22. Fig.

As shown in Figs. 2 and 3, the balloon 21 is configured to expand and contract by the movement of a fluid, and is formed into a spherical or elliptical bag shape in which a fluid is filled.

The balloon 21 is formed of a fluid that is filled in the rubber, silicon, synthetic resin, or the like and a material whose shape easily changes due to an external pressure difference.

One side of the balloon 21 is formed with an opening through which a fluid flows or flows out, and the balloon 21 is inflated or contracted by a pressure difference between the inside and the outside. The balloon 21 is inflated in the rectum during radiation therapy for prostate cancer, thereby separating the rectal wall from the prostate gland or securing the prostate gland.

As shown in Figs. 1 to 3, a hemispherical head 21A is formed at the front end of the balloon 21.

As shown in FIGS. 2 and 3, the head portion 21A includes a hemispherical head HD which is inserted and fixed to the front end of the balloon 21 protruding hemispherically and the hemispherical front end.

The head HD is formed of plastic or hard rubber and is not significantly deformed by the pressure of the fluid injected into the balloon 21 and the internal pressure of the rectum. Thus, the front end of the balloon 21 protruding hemispherically forms a balloon 21) is maintained in a contracted state.

When the hemispherical head 21A is formed at the front end of the balloon 21, the balloon 21 smoothly expands the anus and rectum inner walls by the hemispherical surface of the head 21A when inserting the anus and moving inside the rectum It proceeds smoothly.

2 and 3, at the rear end of the head HD, an insertion groove HDa into which the front end portion of the support member 40 is inserted is formed. A projection HDb is formed at the center of the insertion groove HDa to define a boundary of a flow section of the engagement end 31A of the frame 31, which will be described later. The engaging end portion 31A is caught by the protruding portion HDb and is no longer inserted into the inside of the supporting member 40. [

As shown in Figs. 1 to 3, the tube 22 has a structure in which the balloon 21 and the cylinder 11 are connected and the fluid moves through the inside, and a passage through which the fluid moves in the longitudinal direction . The tube 22 is open at its both ends so that its front end is coupled to the opening of the balloon 21 and its rear end is coupled to the cylinder 11.

The tube 22 is inserted into the rectum via the anus with the balloon 21, and comes into direct contact with the rectal wall together with the balloon 21. The tube 22 is formed of soft rubber, silicone, and synthetic resin material to minimize frictional forces with the rectal wall during insertion through the anus.

1 to 3, the support member 40 is configured to support the inner surface of the tube 22 so that the shape of the tube 22 is maintained inside the rectum. Inside the insertion member 20, Respectively.

2 and 3, the front end portion of the support member 40 is inserted into the insertion hole HDa of the head HD, that is, the front end portion of the balloon 21 inside the insertion member 20, do. A portion other than the portion located inside the balloon 21 is inserted into the tube 22. [

The support member (40) is in close contact with the inner surface of the tube (22) at its outer circumferential surface from the inside of the tube (22). When the insertion member 20 is inserted into the rectum, the pressure of the rectal wall is applied to the balloon 21 and the tube 22. The balloon 21 and the tube 22 are deformed by the rigidity of the support member 40 Thereby maintaining the moving passage.

The support member 40 is formed in the shape of a pipe, and the fluid moves through the inside of the support member 40 inside the tube 22. [

The practitioner applies force to the rear end portion of the support member 40 through the outer surface of the tube 22 to move the insertion member 20 through the patient's anus into the rectum. The force of the operator is easily transmitted to the head portion 21A by the rigidity of the support member 40, so that the insertion member 20 can be easily inserted.

2 and 3, a latching hole H is formed at the front end of the support member 40, to which the latching end 31A of the frame 31 is inserted. The engagement holes (H) are formed in plural along the circumferential direction of the support member (40).

As shown in Figs. 2 and 3, a communication hole 40h1 through which the fluid moves inside the balloon 21 is formed in the support member 40. Fig.

2, the fluid discharged from the syringe at inflation of the balloon 21 moves through the tube 22 and the support member 40 and is injected into the balloon 21 through the communication hole 40h1. do. 3, the fluid filled in the balloon 21 at the time of contraction of the balloon 21 flows into the interior of the support member 40 through the communication hole 40h1, and the tube 22 and the support member 40 to the syringe side.

2 and 3, two communication holes 40h1 are formed, but it goes without saying that they may be formed in various numbers and shapes.

2 and 3, the deformable member 30 is configured to prevent deformation of the balloon 21 due to pressure inside the rectum when the balloon 21 expands. The deformable member 30 includes a frame 31 and a slider 32, .

As shown in Figs. 2 and 3, the frame 31 has a structure in which the balloon 21 is flexibly deformed by being inflated or contracted by the fluid, and a plurality of the balloon 21 are provided inside the insertion member 20.

The frame 31 is formed in the form of an elongated wire which is bent and deformed by the elastic force, and the front end portion is coupled to the front end portion of the support member 40 and the rear end portion is joined to the slider 32. A plurality of frames 31 are provided and are formed radially around the support member 40 and the movable member 50.

The plurality of frames 31 are disposed at equal angles to each other with the support member 40 as a center, so that the both ends of the frame 31 are moved closer or farther away when the slider 32 is moved. The frame 31 is made of elastically warped synthetic resin, carbon fiber, or metal.

It is preferable that the frame 31 is formed in a slightly curved shape at the time of manufacturing. If the frame 31 is formed in a curved state and the curved portion is radially disposed around the supporting member 40 and the moving member 50 so as to face the balloon 21, The bending deformation progresses in the direction of warping, that is, the direction in which the balloon 21 bulges.

As shown in Figs. 2 and 3, at both ends of the frame 31, a latching end 31A is formed which engages in the latching hole H.

The engaging end portion 31A is formed to be thicker than the engaging hole H in the circumferential direction and is not pulled out when the engaging end portion 31A is fitted in the one- The engaging end 31A is preferably formed in a spherical shape so as to minimize friction with the inner surface of the supporting member 40. [ Both ends of the frame 31 are freely rotated in accordance with the shape of the bending deformation when the frame 31 is inserted into the engagement hole H at the time of bending deformation of the frame 31. [

2 and 3, the slider 32 is configured such that the rear end of the frame 31 is engaged and slidable along the moving member 50, That is, in the form of a cylinder or a polygonal cylinder. The slider 32 is also provided with a plurality of latching holes H for latching the latching end 31A of the frame 31 along the circumferential direction.

2 and 3, the moving member 50 is configured to deform the deformable member 30 in conjunction with the reciprocal movement of the piston 12, the rear end portion of which is engaged with the piston 12, Extends inwardly of the tube 22 (more specifically inside the support member 40) toward the balloon 21.

The movable member 50 is formed in the form of a long and long rod, and the rear end thereof is engaged with the piston 12 to move together with the piston 12 when the piston 12 reciprocates.

2, the insertion member 20 is inserted into the rectum through the anus in a contracted state of the balloon 21, and inflates inside the rectum as shown in Fig. 3 to separate the rectal wall and the prostate gland Or to fix the prostate.

2 and 3, if the balloon 21 is fully inflated when the piston 12 is moved from the X1 position to the X2 position, at the same time, the frame 31 is also in contact with the balloon 21 It should be bent and deformed enough to come in contact with the inside of the balloon 21 so as to prevent deformation.

Since the size of the rectum varies depending on the age, weight and height of the patient, different volumes of balloons 21 must be used for each patient. To exactly match the amount of expansion of the balloon 21 and the deflection of the frame 31 The scanning means 10 having the capacity of the different cylinders 11 and the moving distances of the pistons 12 are required for the balloons 21 of different volumes.

2 and 3, the rectum expanding apparatus 1 for fixing the prostate gland according to an embodiment of the present invention includes a pair of a pair of movable members 50 forming a reciprocating section of the slider 32, And the moving distance of the piston 12 and the moving distance of the slider 32 are made different from each other so that one scanning means 10 can be used for different volume balloons 21 .

2 and 3, the first latching portion 50P1 is formed at the front end of the shifting member 50 and the second latching portion 50P2 is spaced rearward from the first latching portion 50P1 .

The first engaging portion 50P1 and the second engaging portion 50P2 are formed to protrude in the radial direction from the moving member 50 so that the slide is engaged with the first engaging portion 50P1 and the second engaging portion 50P2 The movement is limited and the movable member 50 moves along the longitudinal direction of the movable member 50 only between the first engaging portion 50P1 and the second engaging portion 50P2.

When the balloon 21 is fully inflated when the piston 12 moves from X1 to X2 and the frame 31 is flexibly deformed to sufficiently contact the inner surface of the balloon 21 when the slider moves from Y1 to Y2, The distance between the first engaging portion 50P1 and the second engaging portion 50P2 is set such that the difference between the moving distance of the piston 12 and the moving distance of the slider 32 The difference between the amount of expansion of the balloon 21 and the amount of flexural deformation of the frame 31 is corrected.

The latching parts 50P1 and 50P2 may be provided in various forms. Although not shown in detail, the engaging portions 50P1 and 50P2 are formed so as to be positionally adjustable along the longitudinal direction of the moving member 50. [

For example, a plurality of holes (not shown) may be formed along the longitudinal direction of the moving member 50 and a hole (not shown) may be formed in the engaging portions 50P1 and 50P2 to insert a small pin Can be fixed. Of course, the moving member 50 may be formed with a plurality of holes along the longitudinal direction, and the engaging portions 50P1 and 50P2 may be formed of small pins themselves and inserted into the holes.

2 and 3, the balloon 21 is retracted into the engagement hole H formed in the support member 40 and the slider 32, and when the frame 31 is extended, It is preferable that an inclined portion SL is formed in a direction in which the frame 31 rotates so that the frame 31 is not broken.

The front end portion of the frame 31 is coupled to the support member 40 and the rear end portion of the frame 31 is coupled to the slider 32 as described above. 2 and 3, the support member 40 is provided with a plurality of through holes 40h2 so that the rear end of the frame 31 can be engaged with the slider 32 located inside the support member 40 Is formed.

According to the present invention, since the deformable member 30 prevents the balloon 21 from being deformed due to the internal pressure of the rectenule when the balloon 21 is inflated, the elasticity of the balloon 21 due to rectal pressure It is possible to provide a rectal expanding device 1 for prostate-motion fixation, which is prevented from being deformed and deformed by the pressure of the gas or the feces in the rectum.

The front end portion of the support member 40 is engaged with the front end portion of the balloon 21 inside the insertion member 20 so that the position of the balloon 21 expanded in the rectum is accurately determined according to the rectum insertion depth, It is possible to provide a rectifier device 1 for rectal prostate motion fixation which is configured to prevent breakage of the balloon 21 due to friction with the inside wall of the rectum even if the balloon 21 in an expanded state is moved within the rectum.

While the present invention has been particularly shown and described with reference to exemplary embodiments thereof, it is to be understood that the invention is not limited to the disclosed embodiments, but, on the contrary, It is obvious to those who have. Accordingly, it should be understood that such modifications or alterations should not be understood individually from the technical spirit and viewpoint of the present invention, and that modified embodiments fall within the scope of the claims of the present invention.

1: rectum extension device 10: scanning means
20: insertion member 30: deformable member
40: support member 50: moving member
11: cylinder 31: frame
12: piston 31A: engaging end
21: balloon 32: slider
21A: head portion H: engagement hole
HD: Head SL:
HDa: insertion groove 50P:
HDb: protrusion 40h1: communication hole
22: tube 40h2: through hole

Claims

Scanning means including a piston and a cylinder;
An insertion member including a balloon for injecting or discharging fluid by the scanning means, and a tube for connecting the balloon and the cylinder and moving the fluid through the inside; And
And a deformable member provided in the insertion member and deformed by the movement of the piston in such a manner that the balloon is expanded or contracted by the fluid,
The deformable member prevents deformation of the balloon due to pressure inside the rectum when the balloon is inflated,
And a support member for supporting an inner surface of the tube so that the shape of the tube is maintained inside the rectum,
The front end portion of the support member is engaged with the front end portion of the balloon inside the insertion member so that the entire length of the insertion member is maintained even if the balloon is inflated or contracted,
A rear end portion coupled to the piston and a front end portion including a moving member extending from the inside of the tube toward the balloon,
Wherein the deformable member includes a plurality of frames in which a front end portion is coupled to a front end portion of the supporting member and a rear end portion is moved in association with the moving member and the balloon is deflected or contracted when the moving member is moved Wherein the prosthesis is fixed to the prosthesis.

delete

The method according to claim 1,
A hemispherical head is formed at the front end of the balloon to facilitate insertion into the rectum.
And a front end portion of the support member is coupled to the head portion.

delete

The method according to claim 1,
Wherein the frame is formed radially about the support member and the moving member.

The method according to claim 1,
Wherein the deformable member includes a slider to which a rear end of the frame is coupled and is slidably formed along the moving member,
Wherein the moving member is provided with a pair of latching portions for forming a reciprocating section of the slider.

The method according to claim 1,
Wherein the support member is formed in a pipe shape so that the fluid moves through the inside thereof, and a communication hole through which the fluid moves into the balloon is formed.

8. The method of claim 7,
And a plurality of through holes through which the rear end of the frame passes are formed in the support member.