JP2002113036A - Thermotherapeutic instrument - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a thermotherapeutic instrument capable of obtaining an excellent therapeutic effect by applying energy accurately toward an objective lesion part. SOLUTION: A control part 251a stops the output of a signal to the effect of outputting laser beams through a foot switch signal cable 291 in the case the temperature obtained from a detection signal of a mirror temperature sensor 111 for detecting the temperature of a laser emission part 122 installed at a laser irradiation device 1 becomes high temperature of specified value of more. The output of laser beams from a laser beam source 3 is thereby stopped. Or the control part can also make an adjustment by transmitting a signal for changing the laser output value of the laser beam source device 3 through a communication cable 293.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a method for inserting an insertion portion into a living body cavity or a lumen such as a blood vessel, urethra, or abdominal cavity, or pressing a portion against a living tissue by surgical operation, or applying the portion to the body surface. After pressing the pressed part, the body is irradiated with energy such as laser light, microwaves, radio waves, and ultrasonic waves from the emission part installed in the insertion part or the pressed part to the living tissue such as prostate tissue and heated. The present invention relates to a heat treatment apparatus for performing treatment.

[0002]

2. Description of the Related Art A long insertion portion which is inserted into a living body by utilizing a body cavity of the living body or making a small incision in the living body is used to apply laser light, microwaves, radio waves, There is known a heat treatment apparatus for heating and treating a lesion site by irradiating energy such as an ultrasonic wave to heat and degenerate, necrosis, coagulate, cauterize or evaporate the tissue at the lesion site to eliminate the tissue.

[0003] For example, Japanese Patent Application Laid-Open No. 11-333005 discloses that a laser beam supplied from a laser light source device is applied to a lesion site located at or near the surface layer of a living tissue, and the laser beam is installed near the distal end of an insertion portion. A side-injection type heat treatment apparatus configured to reflect and irradiate with a mirror which is a reflecting surface is shown.

[0004] Here, the setting of the treatment conditions in the heat treatment apparatus is generally determined by the operator himself based on his / her experience, and the treatment conditions such as the output of energy such as laser light and the irradiation time of energy are individually input. It is done by.

[0005] However, in the above-described heat treatment apparatus that irradiates a lesion site by reflecting the laser light with a mirror, it is impossible to know the state of the mirror, particularly the temperature, during the laser irradiation. If the surgeon selects a sufficiently large laser output value or a sufficiently long irradiation time, and if the cooling capacity of the coolant that cools the mirror periphery is relatively small as a condition combined with these, the temperature of the mirror may be reduced. Since the temperature of the mirror may increase, it is important to grasp the temperature of the mirror as a measured value.

That is, when the mirror is fixed to the base material of the base by bonding or the like,
The adhesive may be degraded by the thermal action, and the mirror itself may be lifted or peeled off. A similar possibility exists when the mirror and the base material are made of a combination of materials having greatly different coefficients of thermal expansion. Further, when the base material is made of a material having a particularly high thermal expansion property, the sliding resistance with the rail means for slidably guiding the mirror increases due to the thermal expansion of the base material, and the smoothness of the mirror is improved. Movement may be hindered.

[0007] Further, the above publication discloses that after inserting a long insertion portion into, for example, the urethra, the emission portion provided with a mirror that is a laser reflecting surface is reciprocated in the insertion portion in the longitudinal direction.
A technique has been proposed in which the laser light is focused on a target portion located deep within a living tissue by changing the emission angle of the laser light, that is, the angle of the mirror.
As a result, only the target site is heat-treated to a desired temperature, and sites other than the target site are kept at a low temperature. However, in the heat treatment apparatus described in the above publication, the emission operation itself of the laser beam by the emission part that moves continuously cannot be detected. For this reason, it has been difficult to directly confirm that the laser light is irradiated while appropriately moving the living tissue to be subjected to the heat treatment.

[0008]

SUMMARY OF THE INVENTION The present invention has been made in view of the above-mentioned problems of the prior art, and it is an object of the present invention to accurately transfer energy to a target lesion site. An object of the present invention is to provide a heat treatment apparatus capable of obtaining a favorable treatment effect by applying a voltage.

[0009]

The object of the present invention is achieved by the following means.

(1) A heat treatment apparatus for applying heat to living tissue to perform heat treatment, comprising: an energy supply means for supplying energy for treatment; and an energy supply means connected to the energy supply means. Energy reflecting means for reflecting the energy supplied from the device, energy output means, driving means for changing the position and angle of the energy reflecting means, and energy emitted by being reflected by the energy reflecting means. Detecting means for detecting information regarding the emission function, and energy control means for controlling an operation state of the energy supply means using a detection result of the detecting means,
A heat treatment apparatus comprising:

(2) The detecting means detects the temperature of the energy reflecting means.
The heat treatment apparatus according to claim 1.

(3) The heat treatment apparatus according to the above (2), wherein the detecting means is provided in an area of the energy reflecting means excluding a reflecting surface for receiving energy.

(4) The heat treatment apparatus according to the above (3), wherein the detection means is provided on a back surface of a reflection surface of the energy reflection means.

(5) There is further provided a monitoring means for monitoring an operation state of the driving means, and the energy control means further controls an operation state of the energy supply means using an output result from the monitoring means. The heat treatment apparatus according to any one of the above (1) to (4).

(6) The heat treatment apparatus according to (1), wherein the detecting means detects a reciprocating motion of the energy reflecting means.

(7) The detection means includes an energy detection section for detecting energy emitted from the energy reflection means when the energy reflection means is at a predetermined position, and sets a time interval for detection in the energy detection section. The heat treatment apparatus according to (6), wherein the reciprocating motion of the energy reflecting means is detected by the calculation.

(8) The detecting means includes a position detecting section for detecting that the energy reflecting means is at a predetermined position, and a reciprocating motion of the energy reflecting means is obtained by obtaining a time interval of detection in the position detecting section. The heat treatment apparatus according to the above (6), wherein the temperature is detected.

(9) The detecting means detects a position of the energy reflecting means at the first position, and emits light from the energy reflecting means when the energy reflecting means is at the second position. An energy detecting unit for detecting energy to be detected, and detecting a reciprocating motion of the energy reflecting means by obtaining a time interval of detection between the position detecting unit and the energy detecting unit. The heat treatment apparatus according to (1).

(10) The heat treatment apparatus according to the above (6), wherein the detection means further detects a surface temperature of the living tissue to be heat-treated.

(11) The detecting means includes one energy detecting section for detecting the energy emitted from the energy reflecting means when the energy reflecting means is at a predetermined position, and the detection time in the energy detecting section is provided. The heat treatment apparatus according to (10), wherein a reciprocating motion of the energy reflecting means is detected by obtaining an interval, and a surface temperature of the living tissue is detected by the energy detecting unit.

(12) The heating device according to the above (10), further comprising a diagnosis means for making a diagnosis on an emission function of the energy emitted from the energy reflection means using a detection result of the detection means. Treatment device.

(13) A wall member provided with a pair of grooves for slidably supporting protrusions provided on both sides of the energy reflecting means, wherein the wall member comprises:
The heat treatment apparatus according to any one of the above (6) to (12), further including a storage section in which the detection unit is installed.

(14) The above (6) to (6), wherein the detecting means comprises an optical sensor or a temperature sensor.
(13) The heat treatment apparatus according to any of (13).

(15) The energy supply means includes a first housing forming an outer frame, and the energy control means includes a first housing forming an outer frame separate from the first housing. The heat treatment apparatus further includes remote control means connected to the energy control means, and at least one signal transmission means connecting the energy supply means and the energy control means. The heat treatment apparatus according to any one of the above (1) to (14), characterized in that:

(16) The remote control means includes a foot switch means for outputting a signal prompting the operation of the energy supply means when the operator steps on the energy supply means, and the energy supply means in conjunction with a predetermined state of the heat treatment apparatus. The heat treatment apparatus according to (15), further comprising interlock switch means for outputting a signal for stopping the operation of the means.

(17) The heat treatment apparatus according to any one of (1) to (16), wherein the energy supply means supplies laser light as energy.

[0027]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Preferred embodiments of the present invention will be described below in detail with reference to the accompanying drawings.

FIG. 1 is a side view of a laser irradiation apparatus applied to a heat treatment apparatus according to a first embodiment of the present invention.
FIG. 3 is a sectional view of a tip portion of the laser irradiation device.

The heat treatment apparatus of this embodiment has a side-projection type laser irradiation device 1 for irradiating a living tissue with laser light. In this heat treatment apparatus, a long insertion portion 121 of the laser irradiation device 1 is inserted into a living body, and this insertion portion 121 is inserted.
The laser beam is emitted from the laser emitting section 122 installed in the laser beam toward the living tissue 1001 (see FIG. 6) to perform heat treatment. For example, treatment of tumors such as prostatic hyperplasia and various cancers is performed. Used for

As shown in FIGS. 1 and 2, the laser irradiation device 1 as an energy output means includes a long insertion portion 121 and a laser emission portion 12 for irradiating a laser beam.
2 and a housing 124 that contains the laser emitting section 122 and is connected to the distal end of the insertion section 121.

The laser emitting section 122 has one arm 1
28 are connected. The arm 128 is connected to the housing 1
24 supports the laser emission part 122. Arm 128
Is moved in the axial direction of the insertion section 121, so that the laser emitting section 122 is moved in the axial direction.

The laser emitting section 122 has a smooth laser reflecting surface (mirror) formed on one side and reflecting laser light.
123. The laser emitting section 122 is formed of, for example, resin, glass, metal, or a composite material thereof. Specifically, for example, a mirror-finished surface made of a metal as a base material, a thin film of a metal or the like formed of a resin or metal as a base material by vapor deposition or the like, and
One in which a reflecting material such as a mirror made of glass is adhered to a base material such as a resin or a metal, and the like. In the present embodiment, particularly, the mirror temperature sensor 111 for detecting the temperature of the laser emission unit 122
Is provided. As the mirror temperature sensor 111,
Examples include, but are not limited to, thermistors, thermocouples, platinum resistance temperature detectors, and the like.

This mirror temperature sensor 111 is preferably installed on the back surface of the laser reflecting surface 123. As a result, the mirror temperature sensor 111 is prevented from directly receiving the laser beam, so that the accuracy of detecting the temperature is kept good and the mirror temperature sensor 111 is protected from damage. Further, the light guide efficiency of the laser light is not reduced. The installation position of the mirror temperature sensor 111 is not limited to the back surface of the laser reflecting surface 123, but may be installed in any region of the laser emitting section 122 except for the laser reflecting surface 123.
The signal from the mirror temperature sensor 111 is sent on the mirror temperature sensor signal lead 112.

The housing 124 is formed of a hard tubular body such as stainless steel having a window 127 for irradiating a laser beam, and is covered by a cover member 125 that transmits laser light. The housing 124 has a pair of grooves 129 for engaging with protrusions 131 (see FIG. 3) protruding on both sides of the laser emission unit 122 in order to change the emission angle of the laser light emitted from the laser emission unit 122. It has an inner wall provided. The grooves 129 functioning as guides for the laser emitting section 122 are arranged on both sides of the laser emitting section 122 and are inclined with respect to the axial direction of the insertion section 121. The distal end of the housing 124 is sealed by a cap 126.

An optical fiber 101 for guiding a laser beam
Are arranged inside the insertion section 121. Note that a lens may be provided at the tip of the optical fiber 101. This lens is an optical element for reducing the irradiation angle of laser light. The optical fiber 101 transmits the laser light generated by the laser light source device 3. The buffer 132 accommodates the optical fiber forming the loop, and absorbs the movement of the optical fiber.

The laser irradiation device 1 is provided with an observation device 8 for observing a living tissue surface layer. This observation device 8
Is an endoscope 801 that is detachable from the laser irradiation device 1.
have. The endoscope 801 is inserted from the proximal end to the distal end of the laser irradiation device 1. Endoscope 80
A camera head 803 is attached to the base end side of the camera 1, and an image can be sent through a camera signal lead 804. In addition, a light guide 802 is connected to the base end side of the endoscope 801 to enable illumination of a surface layer irradiated with laser light. The camera head 803
Can be directly viewed through an eyepiece attached to the endoscope 801 without connecting the.

FIG. 3 is a perspective view for explaining the structure of the laser emitting section and the arm of the laser irradiation apparatus.

The arm 128 branches right and left in the housing 124 to support the laser emitting section 122,
It does not prevent the laser light from hitting the surface of the laser emitting section 122. The laser emitting unit 122 has one side,
The support part 130 is provided, and a pair of protrusions 131 is provided on the other side. The support unit 130 is rotatably attached to the arm 128, and can cope with a change in the irradiation angle of the laser emission unit 122. As described above, the protrusion 131 is provided in the groove 1 disposed on the inner wall of the housing 124.
29.

The arm 128 is connected to the drive unit 4 arranged at the base end of the laser irradiation device 1. Note that the drive unit 4 may be provided outside the laser irradiation device 1 and the arm 128 may be connected to the drive unit 4 via a drive shaft. In this case, a metal wire or the like can be used as the drive shaft.

The drive unit 4 has a motor 401 (see FIG. 13). As the motor 401, for example,
An induction motor, a servo motor, a stepping motor, or the like can be used. The drive unit 4 converts the rotational motion of the motor 401 into a reciprocating linear motion by a cam mechanism or a link mechanism (not shown) and transmits the reciprocal linear motion to the arm 128, thereby causing the laser emitting unit 122 to
21 is reciprocated in the axial direction. The tilt angle of the laser emitting unit 122 changes in accordance with the position in the axial direction based on the interlock between the arm 128 and the groove 129.

In the present embodiment, in particular, the driving unit 4
The laser irradiation device 1 is configured to be detachable. Specifically, for example, the motor 401
01 is connected to the driving force transmitting section 402 for transmitting the driving force of the laser irradiation device 1.
The driving force transmission unit 402 has a detachable driving force receiving unit 1.
35 is provided via a support 134 (FIG. 13).
reference). Note that the arm 128 is omitted and the optical fiber 10
The laser emitting portion 12 is fixed to a fixing member
2, the position and the angle of the laser emitting unit 122 can be changed by reciprocating the optical fiber 101 itself. In this case, the supporting portion 134 connected to the driving force receiving portion 135 is
It is connected to an optical fiber 101 that is reciprocated.

As described above, if the drive unit 4 and the laser irradiation device 1 are configured to be detachable from each other, the laser irradiation device 1 inserted into the living body can be discarded for each treatment, while the drive unit 4 and the laser irradiation device 1 can be discarded. Can be used repeatedly, thereby reducing running costs. Further, the drive unit 4 includes the drive unit 4.
For example, a micro switch 403 is provided as connection detection means for detecting that the is connected to the laser irradiation device 1.

FIG. 4 is a diagram for explaining the relationship between the movement of the laser emitting section and the direction of laser beam irradiation.

As shown in FIG. 4, the distance between the arm 128 and the non-parallel groove 129 at the position P2 is
Shorter than one. Therefore, when the support unit 130 of the laser emitting unit 122 moves from the position P1 to the position P2, the protrusion 131 of the laser emitting unit 122 slides along the groove 129, and the inclination angle of the laser emitting unit 122 is adjusted. Is done. That is, the insertion section 121 of the laser emission section 122
Becomes smaller with respect to the axis. Similarly, the support part 130 of the laser emitting part 122 is moved from the position P2 to the position P3.
When moving, the insertion portion 121 of the laser emission portion 122
Is further reduced with respect to the axis of the axis. On the other hand, at the positions P1 to P3, the laser light reflected by the laser emitting unit 122 concentrates on the lesion point, that is, the target point 1102 inside the target part 1101 which is the target heated part.

That is, the laser beam is continuously applied only to the target point 1102, and is applied intermittently to other living tissues such as the surface layer. Therefore, the target point 1102 is
Heated to reach desired temperature. On the other hand, other living tissues such as the surface layer have a small amount of heat and are hardly heated since the time for receiving the laser beam is short.

FIG. 5 is a sectional view taken along line AA of FIG.

As shown in FIG. 5, the insertion section 121 is provided with a working lumen 141 into which an arm 128 is slidably inserted. The working lumen 141 is formed parallel to the axis of the insertion section 121. The insertion section 121 further includes an optical fiber 101.
Lumen 142 for the endoscope 801 and the lumen 142 for the endoscope 801
3, a lumen 144 for injecting cooling water used as a cooling medium for cooling, and a lumen 145 for discharging the cooling water. In FIG. 5, the optical fiber 101 and the endoscope 801 are not shown. The cooling water suppresses heat generation in the housing 124 caused by the laser light,
Further, it is used to cool the surface of the living tissue in contact with the housing 124.

The lumens 144 and 145 are connected to a water supply tube 272 and a drainage tube 273 via a cooling water inlet connector 103 and a cooling water outlet connector 104, respectively (see FIG. 1). By circulating the cooling water, the cooling efficiency is improved. The temperature of the cooling water is not particularly limited as long as it can reduce the damage of the laser emitting portion 122 and the irradiation surface of the living tissue due to the irradiation of the laser beam, but is preferably 0 to 37 ° C., and more preferably less likely to cause frostbite,
The cooling effect is 8 to 25 ° C., which is high. In order to prevent the cooling water from flowing back, it is preferable to provide a check valve in each of the lumens 141 to 143. As a cooling medium, it is preferable to use a sterilized liquid, for example, purified water or physiological saline.

FIG. 6 is a sectional view for explaining an example of use of the laser irradiation apparatus.

The distal end of the insertion section 121 is inserted into the body cavity 1002, and the housing 124 in which the laser emitting section 122 is accommodated is placed on the lesion layer, that is, the surface layer near the target section 1101 which is the target heating section. Adhere. At this time, the housing 124 is moved by the endoscope 801.
It is desirable to directly confirm the position of. Note that the target point 110 in the longitudinal direction of the insertion portion 121 is
The position 2 is adjusted by moving the entire laser irradiation device 1 in the longitudinal direction of the insertion section 121. Also,
Target point 1 in the circumferential direction of insertion portion 121
The position of 102 is adjusted by rotating the entire laser irradiation device 1.

When irradiating the laser beam, the laser emitting section 122 is reciprocated in the axial direction while changing the irradiation angle at a period of 0.1 to 10 Hz, preferably 1 to 6 Hz. Thus, the optical path of the laser light is continuously changed, but all cross at the target point 1102.

Thus, the target point 1102 inside the living tissue 1001 and the vicinity thereof are heated by the irradiated laser beam to reach a desired temperature. Thus, it is possible to increase only the temperature in the desired target portion 1101 while suppressing the temperature rise in the surface layer portion.

The laser light applied to the living tissue 1001 may be divergent light, parallel light, or convergent light. In order to make the laser light convergent light, an optical system that makes the laser light convergent light is provided in the optical path of the laser light. Further, the laser light used is not particularly limited as long as it has a depth of a living body. However, the wavelength of the laser light is 750 to 1300 nm or 1600 to 180
About 0 nm is preferable because it has particularly excellent biological penetration properties. Examples of the laser light source device that generates laser light in the above wavelength range include a gas laser such as a He-Ne laser, a solid-state laser such as a Nd-YAG laser, and GaAl.
And a semiconductor laser such as an As laser.

Also, the diameter of the insertion portion of the laser irradiation device 1,
That is, the outer diameter of the insertion portion 121 is not particularly limited as long as it can be inserted into the body cavity 1002. However, the insertion portion 12
The outer diameter of 1 is preferably about 2 to 20 mm, more preferably about 3 to 8 mm.

FIG. 7 is a sectional view showing an example in which the heat treatment apparatus is used for treating a prostate. The insertion section 121 of the laser irradiation apparatus 1 is inserted into the urethra 1003, and the vicinity of the distal end of the insertion section 121 where the laser emission section is installed is the prostate 10
04 is brought into close contact with the surface layer. In the figure, reference numeral 1005 indicates a bladder. Urethral temperature sensors 113a and 113b for detecting the temperature of the urethral wall are disposed inside the vicinity of the distal end of the insertion section 121.

Further, the heat treatment apparatus of the present embodiment has a rectal probe 5. Rectal probe 5 contains anus 10
07, an insertion portion 501 inserted into the rectum 1006, and a grip 502 gripped by an operator. The insertion portion 501 of the rectal probe 5 is provided with a plurality of rectal temperature sensors 503a to 503e for detecting the temperature of the rectal wall, and the detected values are transmitted through the sensor signal leads 504. I have. As described above, the rectal temperature sensors 503a to 503e are arranged at a deep part of the prostate gland 1004 when viewed from the urethra 1003 without being inserted into a living tissue.

Therefore, the heat treatment apparatus can perform the heat treatment using the detection results of the urethral wall temperature and the rectal wall temperature. This makes it possible to prevent the urethra and rectum normal tissues existing in the vicinity of the prostate from being heated more than necessary. Here, examples of the temperature sensor used for the urethral temperature sensors 113a and 113b include a thermistor, a thermocouple, and a platinum resistance temperature detector.
Preferably, the thermocouple is small in size and has little effect on laser irradiation. In addition, rectal temperature sensors 503a to 503
Similarly, examples of the temperature sensor used for e include a thermistor, a thermocouple, a platinum resistance temperature detector, and the like, but an inexpensive thermistor is preferable.

FIG. 8 is a view showing the overall configuration of the heat treatment apparatus, FIG. 9 is a view showing the control body and the laser light source device, (A) is a front view, (B) is a side view, and (C) 9) is a rear view, and FIGS. 10 to 12 are cross-sectional views taken along line BB in FIG.

As shown in FIG. 8, the heat treatment apparatus according to the present embodiment includes a laser irradiation device 1, a control body 2, a laser light source device 3, a drive unit 4, a rectal probe 5, a foot switch 6, and an observation device 8. have. The laser irradiation device 1, the laser light source device 3, the drive unit 4, the rectal probe 5, and the foot switch 6 are connected to the control main body 2, respectively. The foot switch 6 outputs a signal for prompting the control main body 2 to irradiate laser light when the operator steps on the foot switch.

The observation device 8 includes a light source device 805 for supplying illumination light for endoscope observation, a television camera device 806 for capturing an image observed by the endoscope,
A television receiver 807 for displaying an image captured by the television camera device 806 and a cart 808 in which these are collectively installed and movable are provided. Light source device 805
Are connected to the light guide 802. The television camera device 806 is connected to the camera head 803 via a camera signal lead 804. Thereby, the endoscope 8
01 makes it possible to perform heat treatment while observing.

The control body 2 uses detection signals from various sensors and microswitches installed on the laser irradiation device 1, the drive unit 4, and the rectal probe 5, and the like.
The operation of the entire heat treatment apparatus is controlled.

As shown in FIG. 9, a main switch 201 for turning on the power, an abnormality notification indicator light 202 for lighting and notifying when a predetermined abnormality occurs, are provided on the front of the control main body 2.
An abnormality notification buzzer 20 for notifying by sound when a predetermined abnormality occurs
3. A media interface 204 for inputting information on an external storage medium is provided. In the present embodiment, the media interface 204 is a drive unit such as a flexible disk (FD) or a magneto-optical disk (MO) in which image information or the like obtained by diagnosing a patient is stored. A user interface 20 for displaying predetermined information to the user and receiving predetermined settings and operations is provided on the upper part of the control body 2.
5 are provided. The user interface 205
In the present embodiment, it is a touch-type operation panel including a display screen.

A drive unit connector 211 for connecting a signal lead extending from the drive unit 4 to the side surface of the control body 2, a sensor signal lead 102 extending from each sensor installed in the laser irradiation device 1, 11
2 and a rectal sensor connector 213 for connecting a sensor signal lead 504 extending from each sensor installed on the rectal probe 5.

A foot switch signal input connector 214 for connecting a signal lead wire extending from the foot switch 6 and a foot switch signal output connector 215 for connecting a foot switch signal cable 291 are provided on the back of the control main body 2. Are provided. The foot switch signal cable 291 transmits a foot switch signal from the foot switch 6 via the control main body 2. Further, an interlock switch signal input connector 217 for connecting a signal lead extending from the interlock switch 7 (see FIG. 13) and an interlock switch signal cable 292 for connecting the interlock switch signal cable 292 are provided on the rear surface of the control main body 2. A lock switch signal output connector 216 is provided. The interlock switch signal cable 292 transmits the interlock switch signal from the interlock switch 7 to the control unit 2.
Is transmitted via. Reference numeral 218 in the drawing indicates an inlet to which a power supply cable (not shown) is connected.

On the front of the laser light source device 3, a main switch 301 for turning on the power, and setting dials 302a to 302 for the operator to set the output conditions of the laser light.
c, and an emergency stop switch 303 for stopping the output of laser light in an emergency. With the setting dials 302a to 302c, output conditions such as a laser output value, a laser pulse time, a laser pulse interval, and a laser output time can be set. Then, the recommended value of the output condition of the laser beam planned by the control body 2 is displayed on the user interface 205.
The operator can arbitrarily set the output condition of the laser light with reference to the recommended value.

A laser output connector 304 for connecting the base end of the optical fiber 101 is provided on the side surface of the laser light source device 3. Further, the foot switch signal cable 2 described above is provided on the back of the laser light source device 3.
91 and interlock switch signal cable 292
, And a foot switch signal input connector 305 and an interlock switch signal input connector 306 are provided for connection of the respective switches. Note that reference numeral 30 in FIG.
Reference numeral 7 denotes an inlet to which a power supply cable (not shown) is connected.

As shown in FIG. 9, the laser light source device 3
The control body 2 is provided separately from the control main body 2 and includes housings that form different outer frames. The laser light source device 3 combined with the control main body 2 is not limited to a dedicated one, and if the specifications of the foot switch signal and the interlock switch signal are within the same range, different laser light source devices are appropriately combined with the control main body 2. Can be used. For example, a plurality of laser light source devices having different rated output values of laser light are prepared, and these can be used while appropriately replacing them. As a result, the systemicity of the entire heat treatment apparatus is improved, and the laser light source device can be easily removed, thereby improving the maintainability.

As shown in FIGS. 9 and 10 to 12,
A cooling unit is installed inside the control main body 2, and a cooling unit door 206 is attached to the front of the control main body 2 so as to be openable and closable. The cooling unit has a bag 271 that stores cooling water. A water supply tube 272 and a drainage tube 273 are connected to the bag 271. The water supply tube 272 and the drainage tube 273 are connected to the cooling water inlet connector 103 and the cooling water outlet connector 104 of the laser irradiation device 1 via the tube panel 207. The bag 271 has two parallel
It has two sides, each with a side wall 2
75 is affixed. The bag 271 is formed from, for example, a silicon rubber plate or sheet, and the bag side wall 275 is formed from, for example, an aluminum plate or sheet having a good heat transfer coefficient.

The cooling unit includes a first cooling element 252 a contacting one side of the bag 271 via the bag side wall 275 and the cooling surface 253, and a bag side wall 275.
And a second cooling element 252b provided so as to be able to contact and separate from the other side surface of the bag 271 via the cooling surface 253. As the cooling elements 252a and 252b, for example, those using a Peltier element can be used. The first cooling element 252a is connected to the fixed frame 2
76a, the second cooling element 252b
Is movable along the slide rail 279 together with the frame 276b.

When the cooling unit is used, the bag side wall 275 is used.
Is stored in a heat insulating housing 277 having heat insulating properties (FIG. 10). Then the second
The sliding element 252b is slid toward the first cooling element 252a (FIG. 11), and the hinge-type fixing member 280 is moved.
(FIG. 12). Thus, the bag 271
Are sandwiched and positioned by the first and second cooling elements themselves. And a heat insulating door 278 having heat insulating properties.
Is closed, the heat insulating housing 277 in which the bag 271 is stored is hermetically closed. Insulated door 278
A water temperature sensor 256 for detecting the temperature of the cooling water and a water level sensor 257 for detecting the level of the cooling water are attached, and the detection results thereof can be transmitted.

FIG. 13 is a block diagram of a control system centering on a control body of the heat treatment apparatus according to the first embodiment of the present invention, and FIG. 14 is a diagram for explaining details of the control unit shown in FIG. FIG. For the parts already mentioned,
The following description will be omitted with appropriate omission.

As shown in FIG. 13, the control main body 2 has a control section 251a. Then, as shown in FIG. 14, the control unit 251a includes a temperature measurement unit 233 and a light detection unit 23.
4. Mirror drive unit 235, connection detection unit 236, water temperature control unit 237, flow rate control unit 238, pressure detection unit 239, water level detection unit 240, laser light source device control unit 241, display / operation input unit 242, and data input / output A peripheral control unit such as a unit 243, a CPU 231 that performs overall control of each of the peripheral control units, and a memory 232 that stores predetermined programs and data are provided.

The urethral sensor connector 2 is connected to the temperature measuring section 233.
12, the detection signals from the mirror temperature sensor 111 and the urethral temperature sensors 113a and 113b, and the rectal temperature sensor 503a via the rectal sensor connector 213.
503e are input. Light detector 23
4, a detection signal from the optical sensor 114 is input via the urethral sensor connector 212. This optical sensor 11
Reference numeral 4 is installed in the laser irradiation device 1 and optically detects that the insertion section 121 of the laser irradiation device 1 is in contact with the laser light irradiation target. Thereby, the insertion portion 1
For example, it is possible to prevent a situation in which the laser light is irradiated when the device 21 is not inserted into a living body.

The mirror drive unit 235 is connected to the motor 401 of the drive unit 4 via the drive unit connector 211, and exchanges signals. That is, a drive signal is output from the mirror drive unit to the motor 401. Further, the motor 401 is provided with detection means (not shown) for detecting a rotation speed, a rotation angle position, and a rotation load, and a signal from these detection means is fed back to the mirror driving unit. The connection detection unit 236 includes
The drive unit 4 is connected via the drive unit connector 211.
The detection signal from the microswitch 403 for detecting that is connected to the laser irradiation device 1 is input.

The detection signal from the water temperature sensor 256 is input to the water temperature control section 237, and the water temperature control section 237 supplies electric power for cooling to the cooling element 252 according to the detection signal. Therefore, it is possible to control the temperature of the circulating cooling water in a range suitable for the treatment. Further, when detecting an excessively high temperature state of the cooling element 252 by the thermostat 254, the water temperature control unit 237 can stop the power supply to the cooling element. The detection signal from the water level sensor 257 is input to the water level detection unit 240, and it is possible to determine whether the required amount of cooling water is secured.

The flow control unit 238 is connected to the pump 258, and exchanges signals. That is, a drive signal is output from the flow control unit 238 to the pump 258, and a detection signal and the like regarding the flow are fed back from the pump 258 to the flow control unit 238. Thereby, the flow rate of the cooling water can be controlled. As the pump 258, for example, a roller pump, a diaphragm pump, a magnet pump, or the like can be used. The detection signal from the pressure sensor 259 which detects the water pressure in the water supply tube 272 is input to the pressure detection part 239. By monitoring the detection result of the pressure sensor 259, for example, the cooling water can be prevented from becoming excessively high pressure.

The laser light source device controller 241 receives a signal from the foot switch 6 via a foot switch signal input connector 214. The laser light source device control unit 241 outputs a signal to output laser light to the laser light source device 3 via the foot switch signal cable 291 as necessary. When a signal from the interlock switch 7 is input via the interlock switch signal input connector 217, the laser light source device control unit 241 sets the interlock switch signal cable 2
A signal for stopping the output of the laser light is output to the laser light source device 3 via 92. Interlock switch 7
Outputs a signal for stopping the operation of the laser light source device 3, for example, in conjunction with the opening of the laser management area door.

The display / operation input unit 242 turns on the abnormality notification indicator lamp 202 when a predetermined abnormal situation occurs,
A signal for operating the abnormality notification buzzer 203 is output. The display / operation input unit 242 is connected to the user interface 205, and exchanges signals. That is, predetermined information is output from the display / operation input unit 242 to the user interface 205, and a signal corresponding to, for example, predetermined setting or operation by the operator is output from the user interface 205 to the display / operation input unit 242. .

The data input / output unit 243 is connected to the media interface 204, and can input / output various information such as patient diagnostic information and heat treatment history via an external storage medium. I have. It is also possible to input and output information by directly connecting to an external storage device without media.

When using the heat treatment apparatus configured as described above, first, a lesion site of a patient is diagnosed in advance. Diagnosis of a lesion site includes, for example, an optical endoscope, an ultrasonic endoscope, X-ray contrast, magnetic resonance imaging (MR).
I; magnetic resonance imaging, computer-assisted tomography using X-ray or magnetic resonance (CT; comp)
uted tomography), positron emission tomography (PET; po)
sitron emission tomography, single photon emission computer-assisted tomography (SPECT; single photon emissi)
on computed tomography).

Then, for example, image information around the lesion site obtained by diagnosing the patient in advance is input from the media interface 204 via the FD or the like. The input image information around the lesion site is displayed on the user interface 205. The operator determines a target site that is a target heated site from the displayed lesion site, and inputs information about the target site through the user interface 205.

The control body 2 plans treatment conditions based on the target site determined by the operator, and displays recommended values of the treatment conditions on the user interface 205.
The operator sets the output condition of the laser beam as the treatment condition using the setting dials 302a to 302c of the laser light source device 3 with reference to the recommended value.

The output condition of the laser beam as the treatment condition is as follows.
For example, it is a laser output value, a laser output time, or the like. In addition,
Other treatment conditions, such as the temperature of the cooling water, the flow rate of the cooling water, and the moving speed of the laser emitting unit, are commonly used in the heat treatment, but can be set through the user interface 205 as necessary. It may be.

When the setting of the treatment condition is completed and the operator steps on the foot switch 6, a foot switch signal is input to the control section 251a of the control body 2. In the present embodiment, the laser light source device 3 is not operated just by stepping on the foot switch 6. That is, the control unit 251a grasps the state of each unit of the heat treatment apparatus, and when the condition that may output the laser light is satisfied, the control unit 251a transmits the laser light to the laser light source device 3 via the foot switch signal cable 291. A signal to output laser light is output.

More specifically, when the detection signal of the mirror temperature sensor 111 provided in the laser irradiation device 1 exceeds a preset value, the control unit 251a transmits the laser signal via the foot switch signal cable 291. The output of the signal to output light is stopped, and the operation of the laser light source device 3 is stopped.

In this way, when the operator selects a sufficiently large laser output value or a sufficiently long irradiation time, the cooling capacity of the refrigerant for cooling the periphery of the mirror is compared as a condition combined with these. In the case where the temperature is very small, even if the temperature of the mirror rises, the apparatus can be stopped with a sufficient margin before the following problem occurs. Therefore, it is possible to prevent wear of the device, especially around the mirror.

As an assumed trouble phenomenon, for example,
When the mirror is fixed to the base material of the base by bonding or the like, the adhesive degrades due to thermal action, and the mirror itself may float or peel off. is there. A similar possibility exists when the mirror and the base material are made of a combination of materials having greatly different coefficients of thermal expansion. Furthermore, when the substrate is made of a material having a particularly high thermal expansion property,
Due to the thermal expansion of the base material, the sliding resistance with the rail means (groove 129) for slidably guiding the mirror is increased, and the smooth movement of the mirror may be hindered.

Further, the control unit 251 a
When it is determined from the detection signal of the rotation speed, the rotation angle position, and the rotation load fed back from the motor 401 that the motor 401 is stopped or the deviation from the command value exceeds a predetermined allowable range, the laser light source device 3 is stopped. Further, the control unit 251a determines from the detection signal of the micro switch 403 of the drive unit 4
When it is determined that the drive unit 4 is not securely connected to the laser irradiation device 1, the operation of the laser light source device 3 is also stopped. In this manner, it is possible to irradiate the laser beam toward the lesion while reliably reciprocating the laser emitting unit 122 at a predetermined frequency.

If an abnormal condition occurs during the heat treatment, for example, when the door of the laser control area is opened,
When the interlock switch 7 operates, the control unit 251a
Stops the operation of the laser light source device 3. Control unit 251
a further includes other sensors in the heat treatment device,
A signal from a microswitch, a thermostat, and the like, and the operation state of each unit are monitored, and the operation of each unit in the heat treatment apparatus such as the laser light source device 3 is controlled as necessary.

FIG. 15 is a block diagram of a control system centering on the control main body of the heat treatment apparatus according to the second embodiment of the present invention, and FIG. 16 is a diagram for explaining details of the control unit shown in FIG. FIG. Hereinafter, the second embodiment will be described focusing on the differences from the above-described first embodiment.

As shown in FIGS. 15 and 16, in the second embodiment, the control section 251b of the control main body 2 includes a communication section, and the communication section includes a communication connector 294,
It is connected to the laser light source device 3 via the communication cable 293. In the above-described first embodiment, the output condition of the laser beam as the treatment condition is configured to be finally set by the operator through the setting dials 302a to 302c of the laser light source device 3. In the second embodiment, the configuration is such that the output condition of the laser beam as the treatment condition planned by the control unit 251b is automatically set by being transmitted to the laser light source device 3 via the communication cable 293. Have been.

FIG. 17 is a flowchart for explaining the operation for setting the laser output value, FIG. 18 is a flowchart for explaining the operation for setting the laser output time, and FIG.
5 is a flowchart for explaining an operation of monitoring the output state of laser light.

As shown in FIG. 17, the control unit 251b of the control main unit 2 plans a treatment condition based on the target site determined using the diagnostic information and the like, and sets a laser output value as the treatment condition ( (For example, 30 W) to the laser light source device 3 via the communication cable 293 (S1).
1). The laser light source device 3 checks the set value of the laser output value transmitted from the control unit 251b, and uses the control unit 251b via the communication cable 293 as the checked value of the laser output value.
Return to. The control unit 251b receives the confirmation value of the laser output value returned from the laser light source device 3 (S12).
YES), it is determined whether or not the set value of the laser output value matches the confirmation value (S13).

Then, when the set value of the laser output value matches the confirmation value (YE in S13),
S), the completion of the setting of the laser output value is displayed on the user interface 205 (S14), and the setting operation of the laser output value is terminated. Thus, the laser light output value is automatically and reliably set by using the communication cable 293. On the other hand, if the setting value of the laser output value does not match the confirmation value (NO in S13), it is displayed on the user interface 205 that there is an error in the setting of the laser output value (S15), and the operator Prompts the user to perform a predetermined process.

Further, as shown in FIG.
b is a setting operation of the laser output time as a treatment condition (S
21 to S25), but the content is the same as that of the above-described laser output value setting operation (S11 to S15), and the description thereof will be omitted. The laser output time as a treatment condition is set to, for example, 300 seconds.

Further, as shown in FIG. 19, assuming that the initial settings have been made in advance, when the operator steps on the foot switch 6, the control section 251b grasps the status of each section of the heat treatment apparatus. Then, when the condition for outputting the laser light is satisfied, a signal to output the laser light is output to the laser light source device 3. Thereby, the laser light source device 3 starts outputting the laser beam based on the set conditions (S31).

Here, every fixed time (for example, one second)
The current laser output value is transmitted from the laser light source device 3 to the control unit 251b via the communication cable 293. When no laser output value is transmitted from the laser light source device 3 (S
The control unit 251b displays on the user interface 205 that a communication error has occurred (S3).
5) The output of the laser beam is stopped (S37), and the operator is prompted to perform a predetermined process.

When the controller 251b receives the laser output value transmitted from the laser light source device 3 (YE in S32)
S), it is determined whether or not the actual laser output value is within an allowable range for the set value (for example, within ± 10% of the set value) (S33). If the laser output value is not within the allowable range with respect to the set value (NO in S33), control unit 251
b displays on the user interface 205 that an output error has occurred (S36), stops the output of the laser beam (S37), and prompts the operator to perform predetermined processing.

When the controller 251b determines that the laser output value is within the allowable range with respect to the set value (S3).
Even if (YES in 3), during the output of the laser beam, the status of each part of the heat treatment apparatus is always grasped to determine whether the output of the laser beam can be continued (S34). For example, the control unit 25
1b is a signal indicating that laser light is output via the foot switch signal cable 291 when the temperature obtained from the detection signal of the mirror temperature sensor 111 has reached a high temperature equal to or higher than a predetermined value (NO in S34). By stopping the output, the output of the laser beam is stopped. Alternatively, the control unit 25
1b is based on a detection signal of the mirror temperature sensor 111,
Adjustment such as transmitting a signal to change (increase or decrease) the laser output value of the laser light source device 3 via the communication cable 293 may be performed (S37). The control unit 251b monitors signals from other various sensors and the status of each unit of the heat treatment apparatus, and when it is determined that the output of the laser light should not be continued, the output of the laser light Is stopped or adjusted (S37).

As described above, according to the second embodiment, the same effects as those of the above-described first embodiment can be obtained, and the output condition of the laser beam as the treatment condition is automatically and reliably set. Operability and reliability are improved. Also, through the communication cable 293,
The output condition of the laser light by the laser light source device 3 can be automatically adjusted (for example, the laser output value is changed),
Various controls are possible, and the functionality is improved.

In the heat treatment apparatus according to the first and second embodiments, the mirror temperature sensor for detecting the temperature of the laser emitting section is used as the detecting means for detecting the information on the emitting function of the laser beam emitted from the laser emitting section. However, the present invention is not limited to this, and it is also possible to use, for example, one that detects the amount of distortion of the laser emitting unit.

FIG. 20 is a cross-sectional view of a tip portion of a laser irradiation device applied to the heat treatment apparatus according to the third embodiment of the present invention. FIG. 21 is a schematic diagram viewed from below FIG.
Is a cross-sectional view taken along line CC of FIG. 20, and FIG.
It is sectional drawing regarding line DD of 0. Hereinafter, the third embodiment will be described focusing on portions different from the above-described first embodiment, and description of common portions will be omitted as appropriate.

As shown in FIG. 20, the laser irradiation apparatus 1a according to the third embodiment includes an elongated inner pipe 151, an insertion section 150 inserted into a living body, and an insertion section 150.
And a laser emitting section 122 for emitting laser light. Also, the laser emitting unit 12
2 has a smooth laser reflecting surface (mirror) 123 for reflecting the laser light.

The inner pipe 151 of the insertion section 150 is formed of a hard tubular body such as stainless steel. A window 127 which is an opening for transmitting a laser beam is formed on the distal end side of the inner pipe 151. The entire inner pipe 151 including the window 127 is covered with an outer tube 152 having good laser transmittance.

At the tip of the inner pipe 151, a cap 1
53 is attached. The cap 153 has an insertion portion 1
A front observation window 154 for observing the front when inserting the 50 into the living body is provided. In the front observation window 154,
For example, a light transmitting plate 155 having good light transmittance is fitted and fixed. Also, inside the distal end portion of the insertion portion 150,
A wall member 156 that defines an internal space is provided. The wall member 156 has a pair of left and right plate-like portions.

An optical fiber 107 for transmitting a laser beam is disposed inside the insertion section 150. Optical fiber 1
07 is connected to the laser light source device 3 via an optical connector. The optical fiber 107 is covered with a protective pipe made of, for example, stainless steel so as not to be damaged or bent in the insertion portion 150 except for a tip portion. The laser emitting unit 122 is rotatably attached to a fixing member 157 fixed near the tip of the optical fiber 107. A pipe 159 is inserted into a through hole 158 formed in the fixing member 157. Thus, the fixing member 157 can stably slide along the pipe 159. Further, cleaning water can be supplied through the inside of the pipe 159. The washing water is bent toward the front observation window 154 by the channel 170 formed in the cap 153, and then flows so as to wash the outside of the light transmitting plate 155.

The projections 131 provided on both sides of the tip of the laser emitting portion 122 are slidably supported by a pair of grooves 129 formed in the wall member 156 and inclined with respect to the axial direction of the insertion portion 150. Is done. The optical fiber 107 is connected to the drive unit, and is capable of reciprocating in the axial direction of the insertion section 150. Therefore, when the optical fiber 107 itself is reciprocated, the tilt angle of the laser emitting unit 122 attached to the tip of the optical fiber 107 is changed by the action of the groove 129 while being reciprocated.

The cooling water circulates inside the insertion section 150 to cool the surface of the living tissue receiving the laser beam, the laser emission section 122 inside the insertion section 150, and the like. After the cooling water supplied through the water supply tube 272 flows into the lumen 160, the cooling water flows near the distal end of the insertion portion 150.
3 into the lumen 161 and drain tube 273
Is leaked through. The cooling water also flows into the lumen 162 through the hole 164 formed in the wall member 156.

The endoscope 8 is inserted inside the insertion section 150.
01 is arranged. The endoscope 801 is inserted from the base end side of the laser irradiation device 1a, and is movable in the axial direction inside the insertion section 150. The endoscope 801 has a field of view suitable for obtaining an observation field from both the window 127 and the front observation window 154. 22 to FIG.
In FIG. 4, the endoscope 801 is not shown.

In the third embodiment, in particular, the mirror 123
And a detection unit 165 for detecting the reciprocating movement of the laser emitting unit 122 having
The operation state of the laser light source device 3 is controlled using the detection result of No. 5. Note that such control may be performed independently, or may be performed in appropriate combination with the control in the above-described first and second embodiments.

The detection unit 165 is provided with the laser emitting section 12.
A reciprocating motion detection sensor 166 for detecting the reciprocating motion of
A urethral temperature sensor 167 for detecting the surface temperature of the living tissue to be subjected to the heat treatment, that is, the temperature of the urethral wall. The sensors 166 and 167 are installed in a housing formed in the wall member 156. As shown in FIG. 23, when installing the sensor, an adhesive 169 may be used. Sensors 166, 1
As the 67, a thermistor is used. However, other temperature measuring sensors such as thermocouples can be used.
Further, the sensor 166 may be a sensor capable of detecting laser light, such as a photoelectric element.

The reciprocating motion detecting sensor 166 is installed near the rear end position of the reciprocating motion of the laser emitting section 122, that is, near the rear end portion of the window 127. As a result, FIG.
As shown in FIG. 2, the laser emitting section 122 is located at the rear end position (FIG. 2).
0 at a position indicated by a solid line).
The laser light emitted from 22 can be detected.
The reciprocating motion of the laser emitting unit 122 is detected by obtaining the time interval of detection by the reciprocating motion detection sensor 166.

FIG. 25 is a diagram showing the detection values of the reciprocating motion detecting sensor. When the reciprocating motion detection sensor 166 receives the laser beam emitted from the laser emitting unit 122, it outputs a peak signal Ta that is instantaneously larger than the normal time, as shown in the figure. When the laser beam is not received, the reciprocating motion detection sensor 166 outputs a steady signal Tb lower than the peak signal Ta. FIG. 25 shows detection values when the laser emitting unit 122 reciprocates at a cycle of, for example, 5 Hz. It can be seen that the peak signal Ta appears every about 0.2 seconds. The interval of the peak signal Ta detected by such a reciprocating motion detection sensor 166, that is, the cycle C
The operation state of the laser emitting unit 122 with respect to the moving irradiation of the laser beam can be known by obtaining the above. Note that the reciprocating motion detection sensor 166 may be provided at, for example, a front end position and a rear end position of the reciprocating motion of the laser emitting unit 122. By doing so, the laser emitting unit 12 can be moved in a shorter time.
2 can be detected whether or not the operation is appropriate.
In addition, even when different moving speeds are set for the forward and return paths of the reciprocating motion, the laser emitting unit 1 may be set according to the respective paths.
22 can be detected.

On the other hand, the urethral temperature sensor 167
7 is installed near the center side. Thus, the irradiation of the living tissue with the laser light is prevented as much as possible, and the urethral wall temperature Tc
Can be detected more reliably.

As shown in FIG. 24, the detection unit 165 may be configured to have only one detection sensor 168 for detecting the reciprocating motion of the laser emitting unit 122 and the urethra temperature. The detection sensor 168 is installed near the center of the window 127 similarly to the urethral temperature sensor 167, but as shown in FIG. 24, preferably, it is shown in FIG. 23 so as to easily detect the laser beam. It is installed at a position slightly closer to the center of the window 127 than the urethral temperature sensor 167. In this case, as shown in FIG.
The urethral temperature can be known from the steady signal Tb corresponding to the signal obtained by cutting a.

Next, with reference to FIG. 26, a description will be given of a control procedure relating to the moving irradiation of the laser beam.

First, based on the signal from the reciprocating motion detecting sensor 166, the reciprocating motion of the laser emitting unit 122 is detected. Specifically, based on the detection value of the reciprocating motion detection sensor 166, a peak signal Ta, a period C between peaks (peak / peak), and the like are detected (S41).

The urethral surface temperature is detected based on the signal from the urethral temperature sensor 167 (S42).

Subsequently, using the detection results in steps S41 and S42, a diagnosis process relating to the laser beam moving irradiation is performed (S43). The diagnosis process is specifically performed based on the diagnosis table shown in FIG. The diagnosis table in FIG. 27 is an example, and is set in advance and stored in a storage unit (not shown), but can be changed as appropriate by, for example, an operator or an administrator of the apparatus.

According to FIG. 27, the peak / peak cycle C is constant (the fluctuation width with respect to the set cycle is equal to or less than a predetermined ratio), and the urethral surface temperature Tc is within the set range (for example, 20 to 45).
° C), it is diagnosed as normal, and it is assumed that moving irradiation of laser light is appropriate.

On the other hand, even if the urethral surface temperature Tc is within the set range, if the peak / peak period C is unstable, the drive state of the laser emitting unit is diagnosed as inappropriate, and it is assumed that there is uneven operation. . Possible causes include, for example, a failure in the drive system, a failure in the mirror operation, or a failure in the transmission system. In this case, the drive system failure includes an operation failure, the presence of play, a motor failure, and a power supply failure. The mirror operation failure includes the presence of play, an excessive load, and a transmission system failure. Includes overloading the probe. Also, even if the urethral surface temperature Tc is within the set range, if the peak / peak interval is small, the driving state of the laser emitting unit is diagnosed as inappropriate and the operation is assumed to be fast. As a cause of this, for example, it is assumed that a drive system is defective.
In this case, the drive system failure includes an operation failure, a motor failure, a power supply failure, and a component loss. In addition, even if the urethral surface temperature Tc is within the set range, if the peak / peak interval is large, the driving state of the laser emitting unit is diagnosed as inappropriate and the operation is assumed to be slow. As a cause of this, for example, it is assumed that a drive system is defective. In this case, the drive system failure includes an operation failure, play, a motor failure, and a power supply failure. The urethral surface temperature T
Even if c is within the set range, if there is no peak / peak signal, it is assumed that the driving state of the laser emitting unit or the reflection state of the laser light is diagnosed as inappropriate and the operation is stopped. Possible causes include, for example, a failure in the drive system, a failure in the mirror operation, or a failure in the transmission system.
In this case, the drive system failure includes an operation failure, presence of backlash,
A motor failure and a power supply failure include a mirror operation failure, and the presence of backlash and an overload include, and a transmission system failure includes an overload on a probe.

Further, when the peak / peak cycle C is constant but the peak signal Ta is lower than the set range and the urethral surface temperature Tc is within the set range, it is determined that the laser output is defective and the laser output value is small. Is done. As the cause, for example, a defect of the light source or a defect of the optical member is assumed. In this case, the defect of the light source includes a decrease in the laser output, and the defect of the optical member includes breakage of the optical fiber, poor polishing of the mirror, and burning of the mirror. When the peak / peak cycle C is constant but the peak signal Ta is higher than the set range and the urethral surface temperature Tc is within the set range, it is determined that the laser output is defective and the laser output value is large. As a cause of this, for example, a defect of the light source or a setting error is assumed. In this case, the defect of the light source includes an increase in the laser output, and the setting error includes an error in setting the laser output value by the operator.

If the urethral surface temperature Tc is lower than the set range even if the peak / peak cycle C is constant, it is diagnosed that the laser output is defective or the cooling is insufficient, and the laser output value is small. It is assumed to be supercooled. As the cause, for example, a defect of the light source, a defect of the optical member,
Alternatively, it is assumed that the cooling system is defective. In this case, the defect of the light source includes a decrease in the laser output, the defect of the optical member includes the breakage of the optical fiber, the poor polishing of the mirror, and the burn of the mirror, and the defect of the cooling system includes the cooling water. When the flow rate of the cooling water is excessive, the case where the temperature of the cooling water is low is included. Also, even if the peak / peak period C is constant,
When the urethral surface temperature Tc is higher than the set range, it is diagnosed that the laser output is defective or the cooling is insufficient, and it is assumed that the laser output value is large or the cooling is insufficient. Possible causes include, for example, a defect in the light source, a setting error, or a defect in the cooling system. In this case, a defect in the light source includes an increase in the laser output, a setting error includes an error in setting the laser output value by the operator, and a defect in the cooling system indicates an insufficient flow rate of the cooling water. Case, the case where the temperature of the cooling water is high is included.

Subsequently, in step S43, it is determined whether the moving irradiation of the laser beam has been diagnosed as appropriate (S43).
44).

If the moving irradiation of the laser beam is not diagnosed as appropriate (NO in S44), the control unit stops outputting the signal to output the laser beam and stops the operation of the laser light source device 3. Are performed (S45). In this case, it is possible to perform a procedure for notifying the operator of the diagnosis result regarding the moving irradiation of the laser beam obtained in step S43. Therefore, the operator can deal with the diagnosis result more appropriately.

As described above, according to the third embodiment, it is possible to directly monitor the moving irradiation of the laser beam, that is, the laser beam emitting operation itself by the continuously moving laser emitting unit. Therefore, it is possible to more quickly and reliably detect whether or not the living tissue to be subjected to the heat treatment is appropriately irradiated with the laser beam. This allows the laser light to
Appropriate application to the target lesion site can provide a good therapeutic effect.

FIGS. 28 to 30 are flowcharts showing a control procedure relating to moving irradiation of laser light in the heat treatment apparatus according to the fourth embodiment of the present invention. Hereinafter, the fourth embodiment will be described focusing on portions different from the above-described third embodiment, and description of common portions will be appropriately omitted.

In the fourth embodiment, an emitting unit position sensor (not shown), such as a photo interrupter, for detecting that the laser emitting unit 122 is at the rear end position (the position indicated by the solid line in FIG. 20) is provided. I have. This emission part position sensor is preferably installed at a position where the laser emission part 122 itself can be detected. However, the emitting unit position sensor can detect, for example, a fixing member 157 to which the laser emitting unit 122 on the distal end side of the protective pipe covering the optical fiber 107 is attached, or a position where the optical fiber 107 can detect the base fixed side of the protective pipe. May be installed. Other configurations of the heat treatment apparatus are the same as those of the third embodiment.

In the fourth embodiment, in particular, the mirror 123
The reciprocating motion of the laser emitting unit 122 having the above is detected, and the operation state of the laser light source device is controlled using the detection result of the reciprocating motion. Note that such control may be performed independently, or may be performed in appropriate combination with the control in the above-described first to third embodiments.

First, with reference to FIG. 28, a description will be given of a control procedure relating to moving irradiation of laser light at the start of laser output.

When the foot switch 6 is turned on (S51)
YES), the motor 401 of the drive unit 4 is rotated, and a confirmation sound indicating that the operation of the motor 401 is being confirmed is emitted (S52). Subsequently, it is determined whether a predetermined time (for example, 2 seconds) has elapsed since the foot switch 6 was turned on (S53). If the foot switch 6 is turned off before the predetermined time elapses from the turning on of the foot switch 6 (NO in S53) (YES in S54), the rotation of the motor 401 is stopped and the sounding of the confirmation sound is also stopped (S55). ).

Before the predetermined time has elapsed since the foot switch 6 was turned on (NO in S53), if the foot switch 6 is not turned off (NO in S54), the position of the laser emitting unit 122 is determined by the emitting unit position sensor. Detected (S5
6) It is determined whether or not the laser emitting unit 122 has reached the rear end position which is a predetermined reference position (S57). Then, a time interval at which the laser emitting unit 122 repeatedly arrives at the rear end position by reciprocating movement is measured. Here, the arrival at the rear end position of the laser emitting unit 122 indicates a change from a state where the laser emitting unit 122 is not at the rear end position to a state where the laser emitting unit 122 is at the rear end position. Also, it is possible to detect the case where the laser emitting unit 122 stops at the rear end position.

A new arrival at the rear end position of laser emitting section 122 is detected (YES in S57), and within 100 msec from the previous arrival (YES in S58), the moving speed of laser emitting section 122 is too fast. That is, it is determined that the cycle of the reciprocating motion is too short,
The confirmation sound is stopped and a predetermined error is displayed (S
60). On the other hand, when a new arrival at the rear end position of the laser emitting unit 122 is not detected (NO in S57), for example, when 340 msec has elapsed from the previous arrival (YE in S59).
S), it is determined that the moving speed of the laser emitting unit 122 is too slow, that is, the cycle of the reciprocating motion is too long,
Is stopped, the confirmation sound is stopped, and a predetermined error is displayed (S60). As a result, the time interval C at which the laser emitting unit 122 repeatedly arrives at the rear end position by reciprocating motion
If (msec) is, for example, 100 <C <340, it is determined that the reciprocating motion of the laser emitting unit 122 is appropriate.

The operation confirmation procedure shown in steps S54 to S60 is repeated for 2 seconds after the foot switch 6 is turned on. If the motor 401 and the confirmation sound are not stopped during this time (YES in S53), the motor 4
01 is detected by an encoder or the like (S6).
1). When the rotation speed of the motor 401 is within the predetermined setting range (YES in S62), laser output by the laser light source device 3 is started, and an output sound indicating that laser output is being performed is generated (S63).

Therefore, by confirming the reciprocating motion of the laser emitting unit 122 for a certain period of time before starting the laser output, it is possible to avoid a situation where the laser output is started in a state where the moving operation of the laser emitting unit 122 is not appropriate. Can be.

Further, only by operating the foot switch 6, the start of the reciprocating movement of the laser emitting section 122 and the start of the laser output can be sequentially performed. In addition, even if the foot switch 6 is turned on by mistake, the laser output is not started immediately, so that the output instruction can be canceled before the laser output starts.

Next, with reference to FIG. 29, a description will be given of a control procedure relating to moving irradiation of laser light during laser output.

During laser output, the position of the laser emitting section 122 is detected by the emitting section position sensor (S7).
1) It is determined whether or not the laser emitting unit 122 has reached a rear end position that is a predetermined reference position (S72). A new arrival at the rear end position of the laser emitting unit 122 is detected (S
YES at 72), for example, 100 msec from the previous arrival
If not (YES in S73), it is determined that the moving speed of the laser emitting unit 122 is too fast, and the laser output is stopped, the motor 401 is stopped, and a predetermined error display is performed (S81). On the other hand, when a new arrival at the rear end position of the laser emitting unit 122 is not detected (NO in S72), for example, 340 msec has elapsed from the previous arrival (Y in S74).
ES), it is determined that the moving speed of the laser emitting unit 122 is too slow, and the laser output is stopped, the motor 401 is stopped, and a predetermined error display is performed (S81).

The time interval C (msec) at which the laser emitting section 122 repeatedly arrives at the rear end position by reciprocating motion is:
For example, when 100 <C <340, the output value from the reciprocating motion detection sensor 166 is further detected (S75), and it is determined whether or not the peak signal Ta (see FIG. 25) is detected (S75). S76). Here, the reciprocating motion detection sensor 166 detects the laser light itself emitted from the laser emitting unit 122 when the laser emitting unit 122 is at the rear end position.

A new peak signal is detected by the reciprocating motion detection sensor 166 (YES in S76), for example, within 100 msec from the previous peak signal detection (S73).
YES), it is determined that the moving speed of the laser emitting unit 122 is too high, and the laser output is stopped, the motor 401 is stopped,
Then, a predetermined error display is performed (S81). on the other hand,
When a new peak signal is not detected by the reciprocating motion detection sensor 166 (NO in S76) and, for example, 340 msec has elapsed from the previous peak signal detection (YE in S78).
S), it is determined that the moving speed of the laser emitting unit 122 is too slow, and the laser output is stopped, the motor 401 is stopped, and a predetermined error display is performed (S81).

In step S79, the rotation speed of the motor 401 is detected by an encoder or the like (S79). When the rotation speed of the motor 401 is not within the predetermined setting range (S80)
NO), the laser output is stopped, the motor 401 is stopped, and a predetermined error display is performed (S81). During the laser output, the procedure shown in the flowchart of FIG. 29 is repeated.

Therefore, by constantly checking the reciprocating motion of the laser emitting unit 122 during laser output, it is possible to avoid a situation where the laser output is continued in a state where the movement of the laser emitting unit 122 is not appropriate. .
Further, by detecting the laser beam itself emitted from the laser emitting unit 122 with the reciprocating motion detection sensor 166, it is possible to confirm that the laser beam is emitted together.

Next, with reference to FIG. 30, a description will be given of a control procedure relating to the moving irradiation of the laser beam when the laser output is stopped.

During laser output, the foot switch 6
Is turned off, a laser output stop instruction is issued, insertion of the endoscope 801 to the distal end of the insertion section 150 is detected, or a temperature outside the set range is detected by the urethral temperature sensor 167, and cooling water is set. If an error has occurred based on the detection of an out-of-range temperature or the like (YES in S91),
The laser output is immediately stopped (S92).

Subsequently, the position of the laser emitting section 122 is detected by the emitting section position sensor (S93), and it is determined whether or not the laser emitting section 122 has reached the rear end position which is a predetermined reference position (S94). ). Then, the laser emitting section 12
When 2 arrives at the rear end position (YES in S94), the motor 401 is stopped (S97). That is, when the laser output is stopped, the positioning of the laser emitting unit 122 is stopped at the rear end position.

On the other hand, if 340 msec has elapsed (YES in S95) without the laser emitting section 122 arriving at the rear end position (YES in S95), a predetermined error display is performed (S96), and the motor 401 stops. Is performed (S97).

Therefore, when the laser output is stopped, it is confirmed that the laser emitting section 122 has been moved to the rear end position and stopped, so that the next operation is started while the moving operation of the laser emitting section 122 is not appropriate. Can be avoided.

When the laser emitting section 122 is stopped at the rear end position, the laser emitting section 122 is inclined to the horizontal direction in FIG.
Located at the top within 0. Therefore, when the laser output is stopped, the endoscope 801 can be moved to the distal end portion of the insertion section 150 without interfering with the laser emitting section 122, and the endoscope 801 can easily observe the front or side. It can be implemented.

As described above, according to the fourth embodiment, it is possible to directly monitor the reciprocating motion of the laser emitting unit that moves continuously. Therefore, it is possible to more quickly and surely detect a situation in which the moving irradiation of the laser beam becomes inappropriate based on the poor reciprocating motion of the laser emitting unit. Thereby, the laser beam can be applied appropriately to the target lesion site, and a good therapeutic effect can be obtained.

FIG. 31 is a cross-sectional view of a tip portion of a laser irradiation device applied to the heat treatment apparatus according to the fifth embodiment of the present invention, and FIG. 32 is a schematic diagram viewed from below in FIG. Hereinafter, the fifth embodiment will be described focusing on portions different from the above-described fourth embodiment, and descriptions of common portions will be omitted as appropriate.

The laser irradiation apparatus 1b according to the fifth embodiment is different from the laser irradiation apparatus 1b in that the reciprocating motion detecting sensor 166 of the detecting unit 165a is installed near the front end position of the laser emitting section 122 in the reciprocating motion, that is, near the front end portion of the window 127. , Is different from the fourth embodiment. As a result, as shown in FIG. 31, the laser beam emitted from the laser emitting unit 122 when the laser emitting unit 122 is at the tip position (the right side of the two positions indicated by the two-dot chain line in FIG. 31) Can be detected. Other configurations of the heat treatment apparatus are the same as those of the fourth embodiment. In the fifth embodiment, the reciprocating motion of the laser emitting unit 122 is detected by obtaining the time intervals of each detection by the reciprocating motion detection sensor 166 and the emitting unit position sensor.

FIGS. 33 and 34 are flow charts showing a control procedure for moving and irradiating the laser beam of the heat treatment apparatus according to the fifth embodiment of the present invention.

With reference to FIG. 33 and FIG. 34, a description will be given of a control procedure relating to moving irradiation of laser light during laser output. Note that the control regarding the moving irradiation of the laser beam at the time of starting the laser output and at the time of stopping the laser output is the same as in the fourth embodiment.

During the laser output, the position of the laser emitting section 122 is detected by the emitting section position sensor (S10).
1) It is determined whether or not the laser emitting unit 122 has reached a rear end position that is a predetermined reference position (S102). When a new arrival at the rear end position of the laser emitting unit 122 is detected (YES in S102), and within 50 msec from the previous peak signal detection by the reciprocating motion detection sensor 166 (YES in S103), the laser emitting unit 122 is detected. Is determined to be too fast, the laser output is stopped, the motor is stopped, and a predetermined error is displayed (S10).
9). On the other hand, no new arrival at the rear end position of the laser emitting unit 122 is detected (NO in S102), and for example, 1
When 70 msec has elapsed (YES in S104), it is determined that the moving speed of the laser emitting unit 122 is too slow, and the laser output is stopped, the motor is stopped, and a predetermined error display is performed (S109).

If NO is determined in the step S103, the output value from the reciprocating motion detecting sensor 166 is detected (S105), and the peak signal Ta (see FIG. 25).
It is determined whether or not is detected (S106). Here, the laser emitting unit 1 is detected by the reciprocating motion detection sensor 166.
When 22 is at the tip position, the laser light itself emitted from the laser emitting unit 122 is detected.

When a new peak signal is detected by the reciprocating motion detecting sensor 166 (YES in S106), and within 50 msec from the previous arrival at the rear end position detected by the emitting position sensor (YES in S107), laser emission is performed. It is determined that the moving speed of the unit 122 is too fast, and the laser output is stopped, the motor is stopped, and a predetermined error is displayed (S109). On the other hand, the reciprocating motion detection sensor 16
No new peak signal due to No. 6 is detected (N in S106).
O), for example, when 170 msec has elapsed since the last arrival at the rear end position detected by the emission unit position sensor (S1)
08 (YES), it is determined that the moving speed of the laser emitting unit 122 is too slow, and the laser output is stopped, the motor is stopped, and a predetermined error display is performed (S109).

Further, step S104 or step S104
If NO is determined in 108, the process shown in FIG. 34 is executed. However, step S11 in FIG.
The processing of steps S75 to S8 in FIG.
Since the processing is the same as the processing of step 1, the description is omitted. When the process shown in FIG. 34 is performed subsequent to the process in step S104 in FIG. 33, if YES is determined in step S116 in FIG. 34, the process proceeds to step S1 in FIG.
When the processing shown in FIG. 34 is performed following the processing in step S108 in FIG. 33 and YES is determined in step S116 in FIG.
Go to step S105. During laser output, the procedure shown in the flowcharts of FIGS. 33 and 34 is repeated.

As described above, according to the fifth embodiment, the same effects as those of the fourth embodiment can be obtained, and the installation position of the reciprocating motion detection sensor 166 can be changed without newly adding a sensor. Accordingly, even when different moving speeds are set for the forward path and the return path of the sensor reciprocating motion, the laser emitting unit 12
2 can be detected. Further, it is possible to detect whether or not the operation of the laser emitting unit 122 is appropriate in a shorter time.

The embodiments described above are not described to limit the present invention, and various modifications can be made by those skilled in the art within the technical concept of the present invention.

In the above-described embodiment, laser light is described as an example of the energy applied to the living tissue. However, the present invention is not limited to this. For example, microwaves, radio waves, ultrasonic waves, etc. May be applied.

[0161] Although the prostate has been described as an example of a living tissue to be subjected to heat treatment, the present invention is not limited to this, and the present invention is not limited thereto. And all living tissues that can be subjected to heat treatment by radiating energy from within the body or from the body surface.

[Supplementary Note] (Supplementary note 1) The energy output means has a shape capable of being inserted into the urethra, and is configured such that the energy output direction faces the prostate site when inserted into the urethra. The treatment device further includes a urethral temperature detecting unit installed on the energy output unit for detecting a temperature of a urethral wall, and a rectal temperature detecting unit for detecting a temperature of a rectum wall, and the energy control unit further includes the energy control unit. The heat treatment apparatus according to any one of claims 1 to 17, wherein an operation state of the energy supply unit is controlled using detection results of the urethral temperature detection unit and the rectal temperature detection unit.

(Supplementary Item 2) The energy control device may further include a light detection unit that is installed on the energy output unit and optically detects that the energy output unit is in contact with an energy output target. The means for controlling an operation state of the energy supply means further using a detection result of the detection means.
7. The heat treatment device according to any one of the additional items 1.

(Additional Item 3) A refrigerant container for accommodating the refrigerant, a refrigerant supply path and a refrigerant recovery path communicating between the refrigerant container and the energy output means, and sending the refrigerant toward the energy output means. And a cooling means for cooling the coolant, and a coolant control means for adjusting the flow rate and temperature of the coolant by controlling the operation state of the coolant sending means and the cooling means. The heat treatment apparatus according to any one of claims 1 to 17, and additional claims 1 and 2.

(Supplementary Item 4) The refrigerant container includes a first side surface and a second side surface parallel to the first side surface.
The cooling unit includes: a first cooling unit that contacts a first side surface of the refrigerant container; and a second cooling unit that is provided on the second side surface of the refrigerant container so as to be able to contact and separate therefrom. The heat treatment apparatus according to claim 3, characterized in that:

(Supplementary Note 5) A lumen for extending the inside of the energy output means along the longitudinal direction and observing a lumen open near the tip of the energy output means and a living body insertable into the lumen. And observation means, further comprising:
5. The heat treatment apparatus according to any one of 4.

[0167]

As described above, according to the heat treatment apparatus of the present invention, the information regarding the energy output function is detected, and the operation state of the energy supply means is controlled using the detection result. By properly applying the energy to the target lesion site, a favorable therapeutic effect can be obtained.

[Brief description of the drawings]

FIG. 1 is a side view of a laser irradiation apparatus applied to a heat treatment apparatus according to a first embodiment of the present invention.

FIG. 2 is a sectional view of a tip portion of the laser irradiation device.

FIG. 3 is a perspective view for explaining a structure of a laser emitting unit and an arm of the laser irradiation apparatus.

FIG. 4 is a diagram for explaining the relationship between the movement of a laser emitting unit and the irradiation direction of laser light.

FIG. 5 is a sectional view taken along line AA of FIG. 2;

FIG. 6 is a cross-sectional view illustrating an example of use of the laser irradiation device.

FIG. 7 is a sectional view showing an example in which the heat treatment apparatus is used for treating a prostate.

FIG. 8 is a diagram showing the overall configuration of the heat treatment apparatus.

9A and 9B are diagrams showing a control main body and a laser light source device, wherein FIG. 9A is a front view, FIG. 9B is a side view, and FIG. 9C is a rear view.

FIG. 10 is a sectional view taken along line BB in FIG. 9;

FIG. 11 is a cross-sectional view taken along line BB of FIG. 9;

FIG. 12 is a sectional view taken along line BB in FIG. 9;

FIG. 13 is a block diagram of a control system centering on a control main body of the heat treatment apparatus according to the first embodiment of the present invention.

FIG. 14 is a diagram illustrating details of a control unit shown in FIG. 13;

FIG. 15 is a block diagram of a control system centering on a control main body of the heat treatment apparatus according to the second embodiment of the present invention.

FIG. 16 is a diagram illustrating details of a control unit shown in FIG. 15;

FIG. 17 is a flowchart illustrating an operation of setting a laser output value.

FIG. 18 is a flowchart illustrating a setting operation of a laser output time.

FIG. 19 is a flowchart illustrating a monitoring operation of an output state of a laser beam.

FIG. 20 is a sectional view of a distal end portion of a laser irradiation device applied to the heat treatment apparatus according to the third embodiment of the present invention.

FIG. 21 is a schematic view seen from below in FIG. 20.

FIG. 22 is a sectional view taken along line CC in FIG. 20;

FIG. 23 is a sectional view taken along line DD in FIG. 20;

FIG. 24 is a line D in FIG. 20 showing a modification of the detection unit;
It is sectional drawing regarding -D.

FIG. 25 is a diagram showing detection values of a reciprocating motion detection sensor.

FIG. 26 is a flowchart showing a control procedure relating to moving irradiation of laser light in the heat treatment apparatus according to the third embodiment of the present invention.

FIG. 27 is a diagram showing a diagnosis table.

FIG. 28 is a flowchart showing a control procedure relating to moving irradiation of laser light at the start of laser output of the heat treatment apparatus according to the fourth embodiment of the present invention.

FIG. 29 is a flowchart showing a control procedure relating to moving irradiation of laser light during laser output of the heat treatment apparatus according to the fourth embodiment of the present invention.

FIG. 30 is a flowchart showing a control procedure relating to moving irradiation of laser light when the laser output of the heat treatment apparatus according to the fourth embodiment of the present invention is stopped.

FIG. 31 is a cross-sectional view of a tip portion of a laser irradiation device applied to a heat treatment apparatus according to a fifth embodiment of the present invention.

FIG. 32 is a schematic view as viewed from below in FIG. 31.

FIG. 33 is a flowchart showing a control procedure relating to moving irradiation of laser light in the heat treatment apparatus according to the fifth embodiment of the present invention.

FIG. 34 is a flowchart showing a control procedure relating to moving irradiation of laser light in the heat treatment apparatus according to the fifth embodiment of the present invention.

[Explanation of symbols]

 1, 1a: laser irradiation device (energy output means), 111: mirror temperature sensor (detection means), 122: laser emission part (energy reflection means), 123: laser reflection surface (reflection surface), 165: detection unit (detection) Means: 166: reciprocating motion detection sensor; 167: urethral temperature sensor; 2: control body; 251a, 251b: control unit (energy control means); 293: communication cable (signal transmission means); Supply means), 4 drive unit (drive means), 6 foot switch (remote control means), 7 interlock switch (remote control means), 1001 biological tissue.

──────────────────────────────────────────────────の Continued on the front page (51) Int.Cl. ⁷ Identification FI theme coat ゛ (Reference) A61N 5/06 A61B 17/36 350 (72) Inventor Norihiko Haruyama 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inside Olympus Optical Co., Ltd. (72) Takefumi Uesugi, Inventor 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inside Olympus Optical Co., Ltd. (72) Satoshi Mizukawa 2-43-2, Hatagaya, Shibuya-ku, Tokyo Inside Olympus Optical Co., Ltd. (72) Inventor Makoto Inaba 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inside Olympus Optical Co., Ltd. (72) Inventor Shigenobu Iwahashi 1500 Inoguchi, Nakai-cho, Ashigara-gun, Kanagawa Prefecture Terumo Corporation (72) Inventor Shigeki Ariura 1500 Inoguchi, Nakai-machi, Ashigara-gun, Kanagawa Terumo Corporation (72) Inventor Shin Makino 1500 1500 Inoguchi, Nakai-machi, Ashigara-Kami, Kanagawa Prefecture GG03 GG07 HH02 HH07 HH13 HH15 HH24 4C060 JJ29 KK22 KK23 MM24 MM25 4C082 AE01 AE05 AG02 AR02 MC01 MC03 ME01 ME21 MG01 MJ01 RL02 4C099 AA01 CA17 CA18 CA19 EA08 GA30 JA01 LA22

Claims (17)

[Claims] 1. A heat treatment apparatus for applying heat to living tissue to perform heat treatment, comprising: an energy supply means for supplying energy for treatment; and an energy supply means connected to the energy supply means. An energy output unit including an energy reflecting unit that reflects supplied energy; a driving unit that changes a position and an angle of the energy reflecting unit; and an emission of energy emitted by being reflected by the energy reflecting unit. A heat treatment apparatus comprising: detection means for detecting information on a function; and energy control means for controlling an operation state of the energy supply means using a detection result of the detection means. 2. The heat treatment apparatus according to claim 1, wherein the detecting means detects a temperature of the energy reflecting means. 3. The heat treatment apparatus according to claim 2, wherein the detection means is provided in an area of the energy reflection means other than a reflection surface that receives energy. 4. The heat treatment apparatus according to claim 3, wherein the detection unit is provided on a back surface of a reflection surface of the energy reflection unit. 5. An energy control device according to claim 5, further comprising a monitoring unit that monitors an operation state of the driving unit, wherein the energy control unit further controls an operation state of the energy supply unit using an output result from the monitoring unit. The heat treatment apparatus according to any one of claims 1 to 4, wherein: 6. The heat treatment apparatus according to claim 1, wherein the detecting means detects a reciprocating motion of the energy reflecting means. 7. The detection means includes an energy detection unit for detecting energy emitted from the energy reflection means when the energy reflection means is at a predetermined position, and obtains a time interval of detection by the energy detection unit. 7. The heat treatment apparatus according to claim 6, wherein the reciprocating motion of the energy reflecting means is detected by the detection. 8. The detecting means includes a position detecting unit for detecting that the energy reflecting means is at a predetermined position,
7. The heat treatment apparatus according to claim 6, wherein a reciprocating motion of the energy reflecting means is detected by obtaining a time interval of the detection in the position detecting section. 9. The energy detecting device according to claim 1, wherein said detecting means detects a position of said energy reflecting means at a first position, and said energy detecting means emits light from said energy reflecting means when said energy reflecting means is at a second position. 7. An energy detecting section for detecting energy of the energy reflecting means, wherein a reciprocating motion of the energy reflecting means is detected by obtaining a time interval of detection between the position detecting section and the energy detecting section. The heat treatment device according to claim 1. 10. The heat treatment apparatus according to claim 6, wherein the detection means further detects a surface temperature of the living tissue to be heat-treated. 11. The detection means includes one energy detection unit for detecting energy emitted from the energy reflection means when the energy reflection means is at a predetermined position, and a time interval of detection in the energy detection unit. 11. The heat treatment apparatus according to claim 10, wherein the reciprocating motion of the energy reflecting means is detected by calculating the energy, and the surface temperature of the living tissue is detected by the energy detecting unit. 12. The heat treatment apparatus according to claim 10, further comprising a diagnosis unit that performs a diagnosis on an emission function of energy emitted from the energy reflection unit using a detection result of the detection unit. . 13. A wall member having a pair of grooves for slidably supporting projections provided on both sides of the energy reflecting means, wherein the detecting means is provided on the wall member. The heat treatment apparatus according to any one of claims 6 to 12, further comprising a housing portion to be installed. 14. The heat treatment apparatus according to claim 6, wherein the detection unit includes an optical sensor or a temperature sensor. 15. The energy supply unit includes a first housing that forms an outer frame, and the energy control unit includes:
The heat treatment apparatus further includes a second housing that forms an outer frame that is separate from the first housing, wherein the heat treatment device is connected to the energy control unit, the remote control unit, the energy supply unit, And at least one signal transmission means for connecting the energy control means.
15. The heat treatment apparatus according to any one of 14. 16. The remote control means includes a foot switch means for outputting a signal for prompting an operation of the energy supply means by being stepped on by an operator, and the energy supply means in conjunction with a predetermined state of the heat treatment apparatus. The heat treatment apparatus according to claim 15, further comprising interlock switch means for outputting a signal for stopping the operation of the heat treatment apparatus. 17. The apparatus according to claim 1, wherein said energy supply means supplies laser light as energy.
A heat treatment apparatus according to any one of claims 1 to 16.