Apparatus for ablation of a selected mass
Abstract
(57) [Summary] The fusion treatment device includes a multiple antenna device. The multi-antenna device includes a primary antenna having a longitudinal axis, a central cavity and a distal end, and a secondary antenna having a distal end. The secondary antenna extends laterally from the central cavity of the primary antenna with respect to the longitudinal axis. The sensor is positioned at one or both of the distal ends of the primary or secondary antenna. A feedback controller is coupled to the energy source and sensor. The feedback control device imparts the supply and output of the fusion energy from the energy source to one or more antennas in response to the detection characteristic from the sensor.

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- 1【特許請求の範囲】 1.長手方向軸線と中央管腔と遠位端部とを有する一次アンテナと、遠位端部を 有して一次アンテナの中央管腔から長手方向軸線に対して横方向に展延される第 一の二次アンテナと、を含み、一次アンテナ又は第一の二次アンテナの一方がエ ネルギ源に電磁気的に結合された選択アンテナであり、他方が選択アンテナに電 磁気的に結合された非選択アンテナである、多重アンテナ装置と、 一次アンテナ又は第一の二次アンテナの遠位端部の一方に位置決めされたセ ンサと、 エネルギ源及びセンサに結合され、センサからの検出特性に応答して一本以 上のアンテナに対しエネルギ源からの融除エネルギの供給出力を付与する、フィ ードバック制御装置と、を含む、 ことを特徴とする融除処置装置。
- 2第一の二次アンテナが選択対象物に融除エネルギを供給し、第一のアンテナ がエネルギ源から受容した融除エネルギを、選択対象物に供給することなく、二 次アンテナに供給する、 ことを特徴とする請求の範囲第1項に記載の装置。
- 3一次アンテナが、エネルギ源から受容した融除エネルギを、選択対象物に供 給する、 ことを特徴とする請求の範囲第1項に記載の装置。
- 4一次アンテナが、融除エネルギ供給面を有する、 ことを特徴とする請求の範囲第1項に記載の装置。
- 5一次アンテナが、調節可能な融除エネルギ供給面を有する、 ことを特徴とする請求の範囲第1項に記載の装置。
- 6一次アンテナが、融除エネルギ供給面を有しない、 ことを特徴とする請求の範囲第1項に記載の装置。
- 7第一の二次アンテナが、調節可能な融除エネルギ供給面を有する、 ことを特徴とする請求の範囲第1項に記載の装置。
- 8一次アンテナ又は二次アンテナの一方の遠位端部に位置決めされた第二のセ ンサ、を更に含む、 ことを特徴とする請求の範囲第1項に記載の装置。
- 9二次センサが、フィードバック制御装置に結合されている、 ことを特徴とする請求の範囲第8項に記載の装置。
- 10一次アンテナの外側に該アンテナを取り囲むようにして位置決めされた絶縁 スリーブ、を更に含む、 ことを特徴とする請求の範囲第1項に記載の装置。
- 11絶縁スリーブが、一次アンテナの周囲で摺動可能に位置決めされる、 ことを特徴とする請求の範囲第1項に記載の装置。
- 12一次アンテナを取り囲む絶縁スリーブの遠位端部に位置決めされた第三のセ ンサ、を更に含む、 ことを特徴とする請求の範囲第10項に記載の装置。
- 13更に、 第一の二次アンテナの外側に該アンテナを取り囲むようにして位置決めされ た絶縁スリーブ、を備えた、 ことを特徴とする請求の範囲第1項に記載の装置。
- 14第一の二次アンテナの外側に該アンテナを取り囲むようにして位置決めされ た絶縁スリーブが、第一の二次アンテナの外側に摺動可能に位置決めされている 、 ことを特徴とする請求の範囲第13項に記載の装置。
- 15第一の二次アンテナの外側を取り囲む絶縁スリーブが、固定位置にある、 ことを特徴とする請求の範囲第13項に記載の装置。
- 16検出特性が、センサ位置のインピーダンスである、 ことを特徴とする請求の範囲第1項に記載の装置。
- 17検出特性が、センサ位置の温度である、 ことを特徴とする請求の範囲第1項に記載の装置。
- 18一次アンテナ及び二次アンテナが、高周波アンテナである、 ことを特徴とする請求の範囲第1項に記載の装置。
- 19一次及び二次アンテナが、マイクロ波アンテナである、 ことを特徴とする請求の範囲第1項に記載の装置。
- 20遠位端部に位置決めされた第四のセンサを有して一次アンテナの中央管腔か ら長手方向軸線に対し横方向に展延される第二の二次アンテナ、を更に含み、一 次アンテナが、融除エネルギ出力を受容すべくエネルギ源に結合され、第二の二 次アンテナが、一次アンテナから融除エネルギを受容すべく一次アンテナに結合 されている、 ことを特徴とする請求の範囲第1項に記載の装置。
- 21管腔と長手方向軸線とを有する一次アンテナと、一次アンテナを組織に挿入 する際に一次アンテナ内に位置決めされて選択組織対象物の位置で長手方向軸線 に対して横方向に一次アンテナから展延される二次アンテナと、を含み、二次ア ンテナの少なくとも遠位端部が一次アンテナよりも構造的に剛性が小さいように 構成され、一次アンテナが組織を通して導入されるのに十分な剛性を有するよう に構成された、多重アンテナ装置と、 エネルギ源と、 一次アンテナ又は二次アンテナの一方又は両方をエネルギ源に結合する少な くとも一本のケーブルと、 一次アンテナ又は二次アンテナの遠位端部の一方に位置決めされたセンサと、 エネルギ源及びセンサに結合され、センサからの検出特性に応答して一本以 上のアンテナに対しエネルギ源からの融除エネルギの供給出力を付与する、フィ ードバック制御装置と、を含む、 ことを特徴とする融除処置装置。
- 22一次アンテナが、二次アンテナの融除面の長さの少なくとも20%の長さの 融除面を有する、 ことを特徴とする請求の範囲第21項に記載の装置。
- 23一次アンテナが、二次アンテナの融除面の長さの少なくとも1/3の長さの 融除面を有する、 ことを特徴とする請求の範囲第21項に記載の装置。
- 24一次アンテナが、二次アンテナの融除面の長さの少なくとも1/2の長さの 融除面を有する、 ことを特徴とする請求の範囲21項に記載の装置。
- 25二本の二次電極が設けられて一次アンテナから横方向に展延し、一次アンテ ナ及び二次アンテナのそれぞれが、融除面の間に融除領域を形成するように融除 面を有する、 ことを特徴とする請求の範囲第21項に記載の装置。
- 26三本の二次電極が設けられて一次アンテナから横方向に展延し、一次アンテ ナ及び二次アンテナのそれぞれが、融除面の間に融除領域を形成するように融除 面を有する、 ことを特徴とする請求の範囲第21項に記載の装置。
- 27一次アンテナの外側の少なくとも一部に該部分を取り囲むようにして位置決 めされた絶縁スリーブ、を更に含む、 ことを特徴とする請求の範囲第21項に記載の装置。
- 28更に、接地パッド電極を備え、 一次及び二次アンテナがモノポーラモードで動作する、 ことを特徴とする請求の範囲第21項に記載の装置。
- 29一次アンテナ及び二次アンテナが、高周波アンテナである、 ことを特徴とする請求の範囲第21項に記載の装置。
- 30一次アンテナ及び二次アンテナが、マイクロ波アンテナである、 ことを特徴とする請求の範囲第4項に記載の装置。
- 31選択組織対象物内に融除領域を形成する方法であって、 一次アンテナと、一次アンテナ内に形成された一次アンテナ管腔内に収容さ れる一本以上の展延可能な二次アンテナと、アンテナに結合されて電磁エネルギ を供給するエネルギ源と、エネルギ源とアンテナに結合されるフィードバック制 御装置と、を有する融除装置を準備し、 選択組織対象物内に一次アンテナを挿入し、 少なくとも一本の二次アンテナを一次アンテナ管腔から一次アンテナの長手 方向軸線に対して横方向に選択組織対象物内に前進させ、 一次アンテナ融除面又は二次アンテナ融除面の一方又は両方から選択組織対 象物に電磁エネルギを供給し、 選択組織対象物にエネルギを供給する電極の温度を監視し、 選択組織対象物内に融除領域を生成する、 ことを特徴とする方法。
- 32それぞれ融除面を有する二本の二次アンテナを一次アンテナから前進させ、 二本の二次アンテナの融除面と一次アンテナ融除面との間に融除領域を形成する 、 ことを特徴とする請求の範囲第31項に記載の方法。
- 33一次アンテナの遠位端部から二本の二次アンテナを前進させる、 ことを特徴とする請求の範囲第32項に記載の方法。
- 34一次アンテナに形成された別々の開口部から二本の二次アンテナを前進させ る、 ことを特徴とする請求の範囲第32項に記載の方法。
- 35一次アンテナから二本の二次アンテナを前進させ、平面を構成する、 ことを特徴とする請求の範囲第32項に記載の方法。
- 36一次アンテナから三本の二次アンテナを前進させる、 ことを特徴とする請求の範囲第31項に記載の方法。
- 37三本の二次アンテナのそれぞれ及び一次アンテナが、融除面を有し、アンテ ナの融除面の間に融除領域を生成する、 ことを特徴とする請求の範囲第36項に記載の方法。
- 38一次アンテナが、二次アンテナの融除面の20%以上の融除面を有する、 ことを特徴とする請求の範囲第31項に記載の方法。
- 39一次アンテナが、二次アンテナの融除面の1/3以上の融除面を有する、 ことを特徴とする請求の範囲第31項に記載の方法。
- 40一次アンテナが、二次アンテナの融除面の1/2以上の融除面を有する、 ことを特徴とする請求の範囲第31項に記載の方法。
- 41一次アンテナ及び二次アンテナが、モノポーラモードで動作する、 ことを特徴とする請求の範囲第31項に記載の方法。
- 42融除装置が、バイポーラモードで動作する、 ことを特徴とする請求の範囲第31項に記載の方法。
- 43エネルギ源と、 管腔と長手方向軸線とを有する一次アンテナと、一次アンテナを組織に挿入 する際に一次アンテナ内に位置決めされて選択組織対象物の位置で長手方向軸線 に対して横方向に一次アンテナから展延される二次アンテナと、を含み、一次ア ンテナと二次アンテナとがそれぞれエネルギ源に電磁気的に結合された、モノポ ーラ型多重アンテナ装置と、 アンテナの一方又は両方をエネルギ源に結合する少なくとも一本のケーブル と、含む、 ことを特徴とする融除処置装置。
- 44二次アンテナの遠位端部の少なくとも一部が、一次アンテナより構造的に剛 性が小さいようにに構成され、一次アンテナが、組織を通して導入されるの十分 な剛性を有するように構成されている、 ことを特徴とする請求の範囲第43項に記載の装置。
- 45一次アンテナ又は二次アンテナの外側表面上に少なくとも部分的に位置決め されたセンサと、 エネルギ源とセンサとに結合され、センサからの検出特性に応答して一本以 上のアンテナに対しエネルギ源からの融除エネルギの供給出力を付与する、フィ ードバック装置と、を更に含む、 ことを特徴とする請求の範囲第43項に記載の装置。
- 46一次アンテナが、二次アンテナの融除面の長さの少なくとも20%の長さの 融除面を有する、 ことを特徴とする請求の範囲第43項に記載の装置。
- 47一次アンテナが、二次アンテナの融除面の長さの少なくとも1/3の長さの 融除面を有する、 ことを特徴とする請求の範囲第43項に記載の装置。
- 48一次アンテナが、二次アンテナの融除面の長さの少なくとも1/3の長さの 融除面を有する、 ことを特徴とする請求の範囲43項に記載の装置。
- 49二本の二次アンテナが設けられて一次アンテナから横方向に展延し、一次ア ンテナ及び二次アンテナがそれぞれ融除面を有して各融除面の間に融除領域を 生成する、 ことを特徴とする請求の範囲第43項に記載の装置。
- 50各二次アンテナが、温度を測定するためのセンサを含む、 ことを特徴とする請求の範囲第48項に記載の装置。
- 51一次アンテナ及び二次アンテナが、高周波アンテナである、 ことを特徴とする請求の範囲第43項に記載の装置。
- 52一次アンテナ及び二次アンテナが、マイクロ波アンテナである、 ことを特徴とする請求の範囲第43項に記載の装置。
- 53一次アンテナが、注入媒体を受け入れるように、中空であり、注入源に結合 されて、 ことを特徴とする請求の範囲第43項に記載の装置。
- 54選択組織対象物内に融除領域を生成する方法であって、 管腔を有する一次アンテナと、遠位端部を有する二次アンテナと、両方のア ンテナに電磁気的に結合されたエネルギと、を有するモノポーラ融除装置を準備 し、 接地パッド電極を準備し、 二次アンテナの遠位端部を一次アンテナの管腔内に位置決めした状態で、一 次アンテナを選択組織対象物内に挿入し、 二次アンテナの遠位端部を、一次アンテナの管腔から一次アンテナの長手方 向軸線に対して横方向に選択組織対象物内に前進させ、 一次アンテナ融除面又は二次アンテナ融除面の一方又は両方から選択組織対 象物に電磁エネルギを供給し、 選択組織対象物内に融除領域を生成する、 ことを特徴とする方法。
- 55融除面をそれぞれ有する二本の二次アンテナを、一次アンテナから前進させ 、二本の二次アンテナの融除面と一次アンテナの融除面との間に融除領域を形成 する、 ことを特徴とする請求の範囲第54項に記載の方法。
- 56二本の二次アンテナを、一次アンテナの遠位端部から前進させる、 ことを特徴とする請求の範囲第55項に記載の方法。
- 57二本の二次アンテナを、一次アンテナ内に形成した別々の開口部から前進さ せる、 ことを特徴とする請求の範囲第55項に記載の方法。
- 58エネルギ源と、 管腔と長手方向軸線とを有する一次アンテナと、管腔から長手方向軸線に対 して横方向に展延可能な二次アンテナと、を含み、一次又は二次アンテナのうち 選択された方のアンテナがエネルギ源に電磁気的に結合され、選択されない方の アンテナが選択アンテナに電磁気的に結合された、多重アンテナ装置と、 選択されたアンテナを選択されないアンテナに結合する少なくとも一本のケ ーブルと、を含む、 ことを特徴とする融除処置装置。
- 59選択されたアンテナが、一次アンテナである、 ことを特徴とする請求の範囲第58項に記載の装置。
- 60選択されたアンテナが、二次アンテナである、 ことを特徴とする請求の範囲第58項に記載の装置。
- 61一次アンテナが、二次アンテナの融除面の長さの少なくとも20%の長さの 融除面を有する、 ことを特徴とする請求の範囲58項に記載の装置。
- 62一次アンテナが、二次アンテナの融除面の長さの少なくとも1/3の長さの 融除面を有する、 ことを特徴とする請求の範囲第58項に記載の装置。
- 63一次アンテナが、二次アンテナの融除面の長さの少なくとも1/2の長さの 融除面を有する、 ことを特徴とする請求の範囲第58項に記載の装置。
- 64二本の二次アンテナが設けられて一次アンテナから横方向に展延し、一次ア ンテナ及び二次アンテナがそれぞれ融除面を有して各融除面の間に融除領域を形 成する、 ことを特徴とする請求の範囲第58項に記載の装置。
- 65三本の二次アンテナが設けられて一次アンテナから横方向に展延し、一次ア ンテナ及び二次アンテナがそれぞれ融除面を有して各融除面の間に融除領域を形 成する、 ことを特徴とする請求の範囲第58項に記載の装置。
- 66一次アンテナの外側の少なくとも一部に該部分を取り囲むようにして位置決 めされた絶縁スリーブ、を更に含む、 ことを特徴とする請求の範囲第58項に記載の装置。
- 67絶縁スリーブが、一次アンテナの外側に沿って調節可能に可動である、 ことを特徴とする請求の範囲第66項に記載の装置。
- 68二次アンテナの外側の少なくとも一部に該部分を取り囲むようにして位置決 めされた絶縁スリーブ、を更に含む、 ことを特徴とする請求の範囲第58項に記載の装置。
- 69絶縁スリーブが、二次アンテナの外側に沿って調節可能に可動である、 ことを特徴とする請求の範囲第68項に記載の装置。
- 70更に、接地パッド電極を備え、 一次及び二次アンテナがモノポーラモードで動作する、 ことを特徴とする請求の範囲第58項に記載の装置。
- 71一次及び二次アンテナが、高周波アンテナである、 ことを特徴とする請求の範囲第58項に記載の装置。
- 72一次及び二次アンテナが、マイクロ波アンテナである、 ことを特徴とする請求の範囲第58項に記載の装置。
- 73装置が、バイポーラ動作とモノポーラ動作の間で、切替え可能である、 ことを特徴とする請求の範囲第58項に記載の装置。
- 74一次アンテナが、注入媒体を受け入れるように、中空であり、注入媒体源に 結合されている、 ことを特徴とする請求の範囲第58項に記載の装置。
- 75選択組織対象物内に融除領域を生成する方法であって、 エネルギ源と、一次アンテナと、一次アンテナ内に形成された一次アンテナ 管腔内に収容される二次アンテナと、を含み、一次アンテナ又は二次アンテナ のうち選択された方のアンテナがエネルギ源に電磁気的に結合され、選択されな い方のアンテナが選択された方のアンテナに電磁気的に結合された、融除装置を 準備し、 二次アンテナを一次アンテナ管腔内に位置決めした状態で、一次アンテナを 選択組織対象物内に挿入し、 二次アンテナの遠位端部を、一次アンテナ管腔から一次アンテナの長手方向 軸線に対して横方向に選択組織対象物内に前進させ、 一次アンテナ融除面又は二次アンテナ融除面の一方又は両方から選択組織対 象物に電磁エネルギを供給し、 選択組織対象物内に融除領域を生成する、 ことを特徴とする方法。
- 76融除面をそれぞれ有する二本の二次アンテナを、一次アンテナから前進させ 、二本の二次アンテナの融除面と一次アンテナの融除面との間に融除領域を生成 する、 ことを特徴とする請求の範囲第75項に記載の方法。
- 77二本の二次アンテナを、一次アンテナの遠位端部から前進させる、 ことを特徴とする請求の範囲第76項に記載の方法。
- 78二本の二次アンテナを、一次アンテナに形成された別々の開口部から前進さ せる、 ことを特徴とする請求の範囲第76項に記載の方法。
- 79二本の二次アンテナを一次アンテナから前進させ、平面を構成する、 ことを特徴とする請求の範囲第76項に記載の方法。
- 80三本の二次アンテナを一次アンテナから前進させる、 ことを特徴とする請求の範囲第75項に記載の方法。
- 81三本の二次アンテナのそれぞれ及び一次アンテナが、融除面を有し、各アン テナの融除面の間に融除領域を生成する、 ことを特徴とする請求の範囲第80項に記載の方法。
- 82融除領域が、略球形の形状を有する、 ことを特徴とする請求の範囲第81項に記載の方法。
- 83一次アンテナが、二次アンテナの融除面の20%以上の融除面を有する、 ことを特徴とする請求の範囲第75項に記載の方法。
- 84一次アンテナが、二次アンテナの融除面の1/3以上の融除面を有する、 ことを特徴とする請求の範囲第75項に記載の方法。
- 85一次アンテナが、二次アンテナの融除面の1/2以上の融除面を有する、 ことを特徴とする請求の範囲第75項に記載の方法。
- 86一次アンテナ及び二次アンテナが、モノポーラモードで動作する、 ことを特徴とする請求の範囲第75項に記載の方法。
- 87融除装置が、バイポーラモードで動作する、 ことを特徴とする請求の範囲第75項に記載の方法。
Independent claims87
2 paragraphs, as filed
Description: TECHNICAL FIELD [Detailed description of the invention]
Methods and devices for melting selected objects About related applications By specifying the source, this application makes the disclosure content a part of the specification of the present application. Filed on August 15, 1995, entitled "Multiple Antenna Fusion Device" by Goff et al. It claims priority under US Patent Application No. 08/515379. Background of the invention Field of invention The present invention generally relates to an apparatus for treating and melting tissue objects such as tumors. The present invention relates to a device having a plurality of electrodes. Description of related technology Current thoracotomy procedures for the treatment of tumors are extremely destructive and often in healthy tissue Causes great damage. During surgery, doctors remove the tumor in the mother tissue that forms the tumor seed. Care must be taken to avoid accidental excision and metastasis. recent years Product development focuses on minimizing the traumatic nature of traditional surgical procedures .. Relatively significant progress has been made in the field of hyperthermia as an instrument for treating tumors. It is effective to raise the temperature of the tumor in the treatment and treatment of cancerous tissue. Are known. The mechanism of selective cancer cell eradication by hyperthermia is still completely Although unknown, the four cellular effects of hyperthermia on cancerous tissue, (i) cell membranes Or changes in the permeability or fluidity of the nuclear envelope, (ii) cytoplasmic litho that leads to the secretion of digestive enzymes Somatic degradation, (iii) thermal damage to proteins affecting cellular respiration and DNA or RNA synthesis, (iv) latent excitation of the immune system, has been proposed. Heat the tumor Treatment methods include direct contact high frequency supply device, microwave radiation, and electrically inductive connection. There are combined high frequency fields, ultrasound, and the use of various simple heat transfer techniques. One of the problems associated with all of these procedures is the lower centimeters of the skin surface. It means that it is necessary to generate extremely localized heat at the depth of the wheel. Place Microwave or ultrasonic radiation to focus energy at various depths of hope The technology used has been developed. However, the degree of localization is generally low and As a result, even healthy tissues can be harmed. Also, in the case of induction heating, the incident energy The degree of localization of Gi is low. Induction heating is performed by placing an antenna on the surface of body tissue. However, when driving the antenna using high-frequency current, the antenna is used. A surface eddy current is generated in the immediate vicinity, and a small amount of heat supplied to the underlying tissue causes Undesirable surface heating occurs. Thus, non-invasive procedures to supply heat to the internal tumor are substantially specific. It had drawbacks in performing selective treatment. High fever therapy, which can be generated from high frequency or microwave sources, adds heat to the tissue, but Normal cells survive because they do not exceed 45 degrees Celsius. In high fever therapy, Celsius Thermal energy of over 45 degrees is applied to damage and dry tissue structures, and proteins Causes metamorphism. Hyperthermia has recently been applied to the treatment of malignant tumors .. High fever therapy applies intra-tissue current while minimizing heat damage to healthy surrounding tissues. It is desirable that fever reveals a localized state of hyperthermia in a specific area. Tumors are often located subcutaneously, and surgery or internal surgery is required to locate the tumor. Either endoscopic treatment or external radiation is required. Current for absorption by healthy tissues Since the density is diminished, high fever therapy is performed externally in deep body tissue. That is difficult. In addition, some of the high frequency energy is counteracted at the muscle / fat-bone interface. Being fired, there is a problem when applying a given amount of energy directly to a small tumor Occurs. Attempts to use interstitial local hyperthermia result in non-uniform temperatures throughout the tumor It was hard to say that it was very successful. Tumor mass due to hyperthermia The decrease is believed to be related to heat irradiation. Heat irradiation dose is swollen during a certain period of time The minimum effective temperature applied to the entire ulcer tissue. Blood flow is heat loss for the tumor to be heated Effective cure as it is a major cause of loss and changes in blood flow throughout the tumor More uniform heating of the tumor tissue is required to ensure treatment. The same applies to the fusion of the tumor itself by the use of high frequency energy. .. Various methods have been used for high-frequency fusion of tissues such as tumors. Heat the tumor Ru Instead, the tumor is melted through the supply of energy. This method is (i) organization Positioning of high-frequency fusion electrodes for effective fusion of the entire tumor, (ii) Tumor site Introduction of high-frequency fusion electrode to (iii) fusion without damaging non-tumor tissue For various factors including control and monitoring of high frequency energy supply, etc. It was more difficult to implement. Many treatment methods and devices have been developed to treat tumors with minimal invasiveness. Has been done. An example is as disclosed in U.S. Pat. No. 4,920,978. , An endoscope that performs high-frequency hyperthermia in a tumor. In U.S. Pat. No. 4409903 Discloses a microwave endoscopy device. U.S. Pat. No. 4,920,978 Discloses an endoscope for radiofrequency hyperthermia. In U.S. Pat. No. 4,763,671 (Patent No. '671), intertissues within a tumor Using two catheters inserted from, the procedure is minimally invasive. To. The catheter includes a hard plastic support member. Around the support member , A conductor in the form of an open romesh is formed. Adhesive beads on the conductor make it perfect The edge layer is fixed. The insulating layer is non-adjustable except for preselected lengths. , Covers all of the conductors. The same electrode can treat tumors of different dimensions Can not. A tubular sleeve is inserted into the support to accommodate the radioactive seed. .. The device of patent No. '671 is used as a chemotherapeutic agent for tumors to improve treatment. The introduction of fluid media is not considered. Also, the size of the conductive surface of the electrode is not variable. I. In addition, the '671 patented device outputs the output independently of changes in voltage or current. The bell cannot be maintained at a given value. In U.S. Pat. No. 4,565,200 (Patent No. '200), electrodes are selected. Described an electrode device using a single inlet tube cannula for insertion into the site of interest doing. The device of No. 200 patent has a single inlet pipe, an introducer and a fluid injection device. Introducing and removing various inserts including, but not limited to, insulation sleeves, etc. Its use is limited in that it does not take into account the departure. In addition, the '200 patented design The device is configured to maintain the selective output independently of changes in current or voltage. Absent. Thus, multiple electrodes inserted into or near the tumor or other solid tissue. Equipment and methods are required in which the tumor or solid tissue is placed around the tumor or solid tissue. Outline of the invention Therefore, an object of the present invention includes multiple electrodes or multiple antennas that are introduced into the body. It is to provide a melting device. Another object of the present invention is to take a selected object that is introduced into the body and should be thawed. A melting device that includes multiple electrodes or multiple antennas that extend from the inserter so as to surround it. To provide. Yet another object of the present invention is a multiple spread electrode including a feedback control device, that is, a. It is to provide a melting device having an maintainer. Yet another object of the present invention is a multi-extended electrode or ante containing one or more thermal sensors. It is to provide a melting device having a function. Another object of the present invention is fusion having a multi-extended electrode or antenna including cooling means. To provide the device. Yet another object of the present invention is fusion with a multi-extended electrode or antenna that does not interfere. To provide the device. The above and other objectives are achieved in the fusion treatment device. With the longitudinal axis A primary antenna with a central canal and a distal end, and a secondary antenna with a distal end A multiple antenna device including the above is provided. The secondary antenna is in the primary antenna It extends laterally from the central lumen with respect to the longitudinal axis. Of the primary or secondary antenna The sensor is positioned on one or both of the distal ends. For energy sources and sensors , From the energy source for one or more antennas in response to the detection characteristics from the sensor A feedback control device that imparts a supply output of fusion energy is coupled. A brief description of the drawing Figure 1 shows electrodes with a lumen, cooling medium inflow conduit, cooling medium outflow conduit, and intraluminal. Cross section of the melting device of the present invention showing two probes extending from the side wall formed in It is a figure. FIG. 2a is a cross-sectional view of the distal end of the closed loop of the two cooling medium conduits of FIG. FIG. 2b is a perspective view of the conical fusion zone achieved with the device of FIG. Figure 2c shows one with a closed distal end and a cooling element positioned within the central canal. It is sectional drawing of the next antenna. Figure 2d has an open distal end and an elongated cooling element positioned within the central canal. It is sectional drawing of the primary antenna. FIG. 2e is a distal end view of the device of FIG. 2d. FIG. 2f is a cross-sectional view of the device of FIG. 2d along line 2f-2f. Figure 3a shows the main antenna with two secondary antennas spread within the selected tissue object. It is a perspective view of the Ming multiple antenna fusion apparatus. FIG. 3b is a cross-sectional view of another embodiment of the distal end of the closed loop of the two cooling medium conduits. is there. FIG. 4 is a cross-sectional view taken along line 4-4 of FIG. Figure 5 shows the first sensor positioned on the periphery of the fusion zone and the electrodes on the probe. Formed by a second sensor positioned at the midpoint between the probe and the distal end of the probe. In addition, it is a figure which showed the spherical fusion area of 4 cm. FIG. 6a shows the fusion of the present invention showing two probes extending from the distal end of the electrode. It is a perspective view of the device. FIG. 6b shows the multiplexing of the present invention showing two antennas with locking and gripping functions. It is a perspective view of the antenna melting device. FIG. 6c shows three secondary antennas with locking and gripping functions, according to the present invention. It is a perspective view of the multiple antenna fusion apparatus. FIG. 6d is a cross-sectional view of the device of FIG. 6c along line 6d-6d. FIG. 7 shows an electrode of the invention having a probe extending from the distal end of an insulating sleeve. It is a perspective view of the distal end of. FIG. 8 shows a perspective view of the melting device of the present invention, showing four probes extending from the electrodes. It is a figure. FIG. 9 shows the arrangement of the control device, energy source and other electronic components of the present invention. It is a block diagram. FIG. 10 shows electrodes with a cavity, a cooling medium inflow conduit, a cooling medium outflow conduit, and a lumen. Breaking of the melting device of the present invention, showing two probes extending from the sidewalls formed within It is a top view. FIG. 11 is a cross-sectional view of the distal end of the closed loop of the two cooling medium conduits of FIG. FIG. 12 is a cross-sectional view of another embodiment of a closed loop distal end of two cooling medium conduits. is there. FIG. 13 is a cross-sectional view taken along line 4-4 of FIG. FIG. 14 shows the first sensor positioned at the periphery of the fusion zone and the electricity on the probe. Generated by a second sensor positioned at the midpoint between the pole and the distal end of the probe It is the figure which showed the spherical fusion area of 4 cm. Figure 15 shows a feedback device that is effective in controlling the temperature of the energy supply electrode. It is a block diagram. FIG. 16 is a diagram showing a circuit effective for implementing the feedback device of FIG. .. Detailed explanation As shown in FIG. 1, the fusion treatment device 10 has multiple ante with adjustable lengths. Includes device 12. The multiple antenna device 12 has adjustable or non-adjustable energy. -A primary antenna 14 having a supply surface, that is, a supply length, and a small number in the primary antenna 14. One or more secondary antennas typically introduced from at least a partially formed lumen 1 6 and including. Each secondary antenna 16 also has an adjustable or non-adjustable energy supply surface. That is, it has a supply length. Adjustable length allows for melting objects of various geometries Can be The length of the primary antenna 14 and the secondary antenna 16 is adjustable , The primary antenna moves up, down, back and forth while rotating around its longitudinal axis. By cooperating with the sensor to define the peripheral edge or boundary of the object to be melted. It melts away various shapes that are not always symmetrical. The primary antenna or electrode 14 is guided percutaneously or using a laparoscope into the solid object. It is configured to be able to be entered. The primary antenna 14 can be introduced into a solid object. It can be provided with a pointed distal end 14'for ease. Each secondary antenna 16 , The rigidity is structurally smaller than that of the primary antenna 14. this is , (I) select different materials for antennas 14 and 16, (ii) same material To Use, but reduce the amount used for the secondary antenna 16, for example, the secondary antenna 1 Make the thickness of 6 smaller than the thickness of the primary antenna 14, or the antenna 14 or By containing another material in one of the 16 to make them different in structural rigidity. Will be achieved. For the purposes of this disclosure, the structural stiffness of the antenna is its longitudinal direction. It is defined as the amount of deviation with respect to the direction axis. A given antenna depends on its length It will be understood that they have different magnitudes of stiffness. Primary and secondary antennas Can be formed from a variety of conductive materials, including metallic and non-metallic. Suitable material As a charge, there is a 304 type stainless steel of subcutaneous injection quality. Of the primary antenna 14 The rigidity is greater than the rigidity of the secondary antenna 16. Secondary antenna 16 depending on the application The rigidity of the primary antenna 14 is about 10%, 25%, and 50% of the rigidity of the primary antenna 14. 75% and It can be 90%. The primary antenna 14 and the secondary antenna 16 are made of metal. And can be formed from a variety of conductive materials, including non-metals. Secondary electrode 16 depending on the application Is marketed by Raychem Corporation in Menlo Park, California. It may be formed from a shape memory metal such as NiTi. The primary antenna 14 or the secondary antenna 16 has different lengths. Suitable Appropriate lengths are 17.5 cm, 25.0 cm and 30.0 cm. Not limited. The actual length of the antenna is the actual length of the object to be melted. Placement, distance from the skin, accessibility, and whether the surgeon is laparoscopic or percutaneous. Is determined depending on which of the other treatments is selected. In addition, fusion treatment equipment Place 10, or more specifically, the multiple antenna device 12, via a guide, the desired It can be introduced up to the organizational location. Insulation pickpockets on the outside of one or both of the primary antenna 14 and the secondary antenna 16. The move 18 is positioned. Preferably, each insulating sleeve 18 has a fusion energy. Adjustably positioned so that the length of the antennas that make up the supply surface is variable To. Each insulating sleeve 18 surrounding the primary antenna 14 contains one or more openings. This allows it to pass through the primary antenna 14 and the insulation sleeve 18. The next antenna 16 can be inserted. The length of the distal end 16'is the secondary ante It is determined by the distance that the na 16 extends from the insulating sleeve. Inside or outside table of primary antenna 14, secondary antenna 16 or insulation sleeve 18 One or more sensors 24 may be positioned on the surface. Preferably, the sensor 24 Is a primary antenna distal end 14', a secondary antenna distal end 16', and an insulating pickpocket. -Positioned at the distal end 18'. The secondary antenna 16 is distal to the insulating sleeve. Can extend laterally from the end 18'to the primary antenna 14, sensor 2 4 can be positioned at the distal end of the insulating sleeve 18'. Preferably, The sensor 24 is at least partially positioned on the outer surface of the distal end 16'. To. L<sub>1</sub>Is the length of the electromagnetic energy supply surface of the primary antenna 14. L<sub>2</sub>Is a sensor One when 24 is at least partially positioned on the outer surface of the distal end 16' This is the distance from the next antenna 14 to the sensor 24. L<sub>2</sub>Is the primary antenna 14? Measured along the surface of the distal end 16'. In various embodiments, L<sub>2</sub>of The length is L<sub>1</sub>33.33% or more of, L<sub>1</sub>50, L<sub>1</sub>75% or more of, L<sub>1</sub>More than the length of Is. In one embodiment, the insulating sleeve can be formed from a polyamide material. Position the sensor on the polyamide insulator and 0.05mm (.0) 02 inch) shrink wrapping. The polyamide insulating layer is semi-rigid. The sensor is , Can be disposed over approximately the entire length of the polyamide. The present invention provides a multi-antenna fusion treatment device. The device is an electromagnetic energy source Trocar with a hollow cavity extending along its longitudinal axis and a distal end And a multiple antenna fusion device having three or more antennas. Trocar The antenna is initially positioned within the trocar lumen when the tissue is inserted into the tissue. .. At the selected tissue location, the antenna is from the trocar cavity to the longitudinal axis. It can be spread laterally. Each of the extended antennas is (i) extended. Create a volume fusion section between the antennas, (ii) 10-50 watts of electromagnetic energy Spread ante when the key is supplied from the electromagnetic energy supply source to the multiple antenna melting device Electricity large enough to generate a volume fusion section without interfering with any of the It has a magnetic energy supply surface. Multiple antenna fusion device has at least one cave It is connected to an electromagnetic energy source. As used herein, the term "obstruction" is used. As a result of the tissue site being sufficiently dried or carbonized, the dried or carbonized tissue site is high. Electricity It means that it interferes with the procedure that leads to resistance and causes coagulation lesions. The energy source 20 is a multiple antenna device 12 via one or more cables 22. Is connected with. The energy source 20 includes a radio frequency (RF) source, a microwave source, and a short energy source. Wave sources, coherent and incoherent or ultrasonic sources can be used. .. The multiple antenna device 12 includes a high frequency antenna, a microwave antenna, and the like. It can be composed of a primary antenna 14 and a secondary antenna 16 which are a combination of it can. In one embodiment, the energy source 20 combines a high frequency source with a microwave source. It is a combined box. Further, the laser optical fiber connected to the energy source 20 is It can be inserted through one or both of the primary antenna 14 and the secondary antenna 16. it can. In addition, one or more of the primary antenna 14 and the secondary antenna 16 are optical. It can also be used as an arm for inserting a river. Antennas 14 and 16 are electromagnetically coupled to energy source 20, respectively. .. Coupling may be done directly from the energy source 20 to each of the antennas 14 and 16. Alternatively, a collet, sleeve, etc. that couples the antennas 14 and 16 to the energy source 20. May be done indirectly using. Inside or outside table of primary antenna 14, secondary antenna 16 or insulation sleeve 18 One or more sensors 24 are positioned on the surface. Preferably, the sensor 24 , Primary antenna distal end 14', secondary antenna distal end 16', and isolated three Positioned at the distal end 18'. According to the sensor 24, (i) degree of fusion, ( ii) Amount to be melted, (iii) whether further melting is necessary, and (iv) the boundary of the object to be melted That is, it is possible to accurately measure the temperature at the tissue position in order to determine the peripheral portion. Further In addition, the sensor 24 prevents the non-target tissue from being destroyed or melted. The sensor 24 has a conventional structure and may be a thermistor, a thermocouple, a resistance wire, or the like. It is not limited to these. A suitable thermal sensor 24 is copper constant T-type thermocouple consisting of tongue, J-type, E-type, K-type thermocouple, optical fiber, resistance wire, There are thermocouple IR detectors, etc. It makes sense that the sensor 24 does not have to be a thermal sensor Let's understand. Sensor 24 measures temperature and / or impedance and destroys many tissues It allows monitoring and the desired level of fusion to be performed without the need for. This will , Damage to the tissue around the object to be melted is reduced. Species inside the selection Upon completion of tumor marginal determination and fusion by monitoring the temperature at each location Can make a decision. When the sensor 24 determines that the predetermined melting temperature has been exceeded , The appropriate feedback signal is received by the energy source 20 and the energy source 20 Adjusts the amount of energy supplied to the primary antenna 14 and / or the secondary antenna 16. To do. Thus, the shape of the melt is selectable and adjustable. Also, any number Only different fusion shapes can be obtained. This is the primary antenna 14 and the secondary antenna The length of the fusion surface of the enterner 16 is variable, and the sensor 24 is provided. Depends on. Preferably, the secondary antenna 16 has an opening 26 formed in the primary antenna 14. It can be spread laterally from. The opening 26 is typically the primary antenna 14. Positioned along the longitudinal axis. First, the primary antenna 14 is introduced into or near the actual object. next , The secondary antenna 16 is introduced into the solid body through the opening 26. Secondary antenna deviation The amount varies. For example, the secondary antenna 16 is the longitudinal axis of the primary antenna 14. It may be deviated several degrees from the line, or the secondary antenna 16 may be hooked to "7". It may be displaced as a geometric shape of any number including. In addition, the secondary antenna 16 Over a distance of a few millimeters or much larger than the primary antenna 14. Can be introduced. Is the fusion by the secondary antenna 16 the primary antenna 14? The secondary antenna 14 can be started a few millimeters away, Advance from the secondary antenna 14 over a greater distance and at that position the secondary antenna 16 It is also possible to start the initial melting by. As shown in FIG. 2 (a), first the primary antenna 14 is placed on the selected tissue target. It was inserted into an object or tumor 28. Then open the distal end 16'of the secondary antenna. Advance from section 26 into the selected tissue object. On the distal end 16', the sensor 24 Is positioned. Insulation sleeve 18 provided fixed or adjustable May be good. Energy such as high frequency, microwave, short wave, etc., primary antenna 14 and secondary Supply to antenna 16 or only one of them. Antennas 14 and 16 Either one can be active or passive. If the secondary antenna is active A sensor 24 is provided at the distal end 14'of the primary antenna. In this embodiment, L<sub>1</sub><sub></sub>Is the length of the electromagnetic energy supply surface of the distal end 16', L<sub>2</sub>Is the distal end 14 From the tip of , it is positioned in the primary antenna 14 and from there the secondary antenna 16 Is the distance to the laterally extending opening. Antennas 14 and 16 are monoports It is possible to operate in la mode (high frequency), but the multiple antenna device 12 is bipolar. It may be operated in a mode (high frequency). The multiple antenna device 12 is a monopolar Switchable between bipolar operation, but multiplex between antennas 14 and 16 Has a conversion function. The distal end 16'of the secondary antenna is housed within the primary antenna 14. Then rotate the primary antenna. Next, select the distal end 16'of the secondary antenna Introduce within organizational object 28. Select a secondary antenna when melting small parts It may be introduced within the Elective Object 28 by a small distance. Shape more fusion sites To achieve this, the secondary antenna can be further advanced any number of times. Again, the distal end 16'of the secondary antenna is stowed in the primary antenna 14. Further, as shown in FIG. 2 (a), the primary antenna 14 is the selected tissue object 28. It was inserted inside. Then, the distal end 16'of the secondary antenna is selected from the opening 26. Advance within the selected organization object. Sensor 24 is positioned on the distal end 16' It has been. The insulating sleeve 18 may be provided fixedly or adjustable. High lap Energy such as waves, microwaves, and short waves is applied to the primary antenna 14 and the secondary antenna 16. Alternatively, it is supplied to only one of them. Either antenna 14 or 16 It can be active or passive. If the secondary antenna is active, the primary antenna A sensor 24 is provided at the distal end 14'. In this embodiment, L<sub>1</sub>Is the distal end 16'is the length of the electromagnetic energy supply surface, L<sub>2</sub>From the tip of the distal end 14' , Positioned within the primary antenna 14 from which the secondary antenna 16 extends laterally The distance to the opening. Antennas 14 and 16 are in monopolar mode (high) It is possible to operate in (frequency), but the multiple antenna device 12 can be operated in bipolar mode (high frequency). It may be operated by waves). The multiple antenna device 12 has monopolar and bipolar motion. It is possible to switch between the works, but it has a multiplexing function between the antennas 14 and 16. To. The distal end 16'of the secondary antenna is housed within the primary antenna 14 and then the primary. Rotate the antenna. Next, select the distal end 16'of the secondary antenna. Tissue object 2 Within 8 Insert in. Select secondary antenna when melting small areas Tissue object 28 It may be introduced only a short distance inside. To form more fusion sites The secondary antenna can be further advanced any number of times. Again, secondary ante The distal end 16'is housed in the primary antenna 14. Two more in tumor 28 any number of times to form more fusion sites The next antenna can also be advanced. Again, the secondary antenna 16 is the primary antenna Stored in 14, and (i) rotate the primary antenna 14 again, (ii) of tumor 28 Secondary that was moved along the longitudinal axis and introduced and retracted with respect to the primary antenna 14. Antenna 16 initiates another series of fusions or (iii) withdraws from the tumor Can be done. Primary antenna 14 and secondary antenna with variable length fusion plane Includes a series of fusions with a number of parameters using the tenner 16 and sensor 24 Tumors with different characteristics and shapes, i.e. objects, can be melted. As shown in FIG. 2 (b), the primary antenna 14 has one or more cooling elements 27. Can include. One embodiment of a suitable cooling element 27 is to introduce a cooling element. It is an elongated closed structure 27'connected to the circulatory system. For antennas 14 or 16 Primary antenna 14 or secondary antenna 16 to transfer / send the cooling medium Can be provided with two lumens. In one embodiment, the dimensions of the lumen are external Outer diameter 2.97 mm (0.117 inch), inner diameter 2.24 mm in the lateral lumen Outer diameter 1.73 mm (0. 068 inches), inner diameter 1.52 mm (0.060 inches). cooling The medium enters the primary antenna 14 and is generated in the tissue surrounding the primary antenna 14. The heat is absorbed, and then the heated medium is discharged from the antenna 14. this is, Using two cavities, i.e. introducing a cooling medium in one cavities and heating in the other cavities It may be carried out so as to remove the cooled solution. Then heated medium Heat is removed from the antenna and recirculates in the antenna 14 as a cooling medium again. this is, It is a continuous procedure. Thus, the antenna 14 having the fusion energy supply surface A cooling function can be provided by simply positioning the cooling element 27 along the portion. it can. The insulating sleeve 18 is slidably adjusted along the length of the primary antenna 14. It may be possible, or it may be fixed and positioned. Insulation sleeve The outer part of the primary antenna 14 not covered by 18 is the fusion energy supply surface. To configure. Only this surface is heated by the electromagnetic energy supplied to the adjacent tissue Is carbonized. Therefore, it is only necessary to cool this surface of the antenna 14. The actual cooling by the cooling medium 17 can be limited to the fusion energy supply surface. To. As a cooling medium, ethyl alcohol, Freon, polydimethylsiloxane, etc. The refrigerant may be, but is not limited to these. Cooling is also Joule- It may be performed by gas expansion cooling by the Thomson effect. In another embodiment of cooling element 27, the distal end 14'is closed again and ante The cooling medium 27 flows through the central canal formed in the na 14. The cooling medium 27 is a pong It is connected to a good recirculation system with a heat exchanger with a device. Of the fluid passing through the primary antenna 14 The flow rate is variable based on a number of different parameters. In yet another embodiment, the cooling element 27 includes, but is limited to, a tubular member such as a cylinder. It is an elongated structure 27 that is not defined. The cooling medium flows through the elongated structure 27 (Fig. 2 (c)). The elongated structure 27 is located within the central canal of the primary antenna 14. It is placed and can extend to the distal end 14'. Distal end 14'is open It may be closed or closed. The cooling medium is confined within the elongated structure 27 . This As a result, other media can be introduced and distributed in the hollow cavity of the primary antenna 14. To. The secondary antenna 16 can be extended from the distal end 14 , but the ante It may be stretched along the side of the na 14 (Fig. 2 (d)). The cooling medium flowing through the cooling element 27 is introduced through the first opening and the second opening. It is discharged from the section (Fig. 2 (e)). Gas, cooling air, frozen air, compressed air, flare Various cooling media including on, water, alcohol, etc. can be used, but are limited to these. It is not fixed. In addition, the cooling element 27 is a wall that constitutes the primary antenna 14. It may be provided inside or may be positioned outside the primary antenna 14. This will , The desired cooling effect can be obtained without recirculating the cooling medium. Cooling equipment It can also be used. The combination of flow rate and temperature of the cooling medium is the desired level of cooling. It is important to achieve the rejection. As the amount of cooling increases, more high frequency energy effects will be produced in a wider area. It can be distributed over a region. Cooling is a set adjacent to antennas 14 and 16. Adjustably carried out until the end of the melting, which transitions to the melting of the weave. For the organization The high frequency radiation effect is regulated by the cooling conduction effect. The cooling element 27 is provided for the secondary antenna 1 as is provided for the primary antenna 14. It can also be provided for 6. By the electromagnetic energy supplied from the primary antenna 14 or the secondary antenna 16. The tissue adjacent to the antenna with the fusion energy supply surface is heated and the heat is dissipated. Return to Na 14 and 16. When more heat is applied, antennas 14 and 16 Carbonization also increases. As a result, the electromagnetic energy conductivity of the antenna is impaired. The arrangement of the cooling element 27 affects the effective supply of electromagnetic energy to the object. There is no. Cooling element 27 reduces heating of tissues adjacent to antennas 14 and 16. It is possible to melt the entire object while reducing or eliminating it. Cooling is Anne Required only if there are exposed surfaces of tena 14 and 16. As shown in FIG. 3A, the fusion treatment device is the longitudinal axis of the primary antenna 14. Can be spread laterally independently or subordinately along different positions along the line More than one secondary antenna 16 can be included. Each secondary antenna 16 is a primary antenna Advance through a separate opening 26 formed in the body of the entena 14. Multiple two The next antennas 16 are all along the same plane or along a plurality of planes, or Can be introduced along a plane that combines both. In FIG. 3 (b), the two secondary antennas 16 are each at the distal end 14'. It is spread from and introduced into the selected tissue object 28. The secondary antenna 16 is one A plane is formed, and a fusion zone is formed between the fusion planes of the primary antenna 14 and the secondary antenna 16. Is generated. The primary antenna 14 is adjacent and introduced into the selected tissue object 28. Can be This particular spread can occur if the selected tissue object 28 is small, or It is especially effective when it is not desirable to penetrate the selected tissue object. Secondary a With the antenna 16 housed in the central canal of the primary antenna 14, the primary antenna 14 Creates another fusion zone between the two secondary antennas 16 by rotating Can be In addition, the primary electrode 14 is adjacent to the selected tissue object 28 at its initial stage. After retracting from position and repositioning to another position adjacent to selected tissue object 28 , The secondary antenna 16 may be extended to initiate another fusion cycle. Different shape And Desired fusion for selected tissue objects of various sizes a variety of different form the shape for the Positioning is available. FIG. 4 shows the formation of a spherical melting section, and FIG. 5 shows the formation of a cylindrical melting section. It has been. In FIG. 6 (a), probes 24 and 26 are multiple antenna devices, respectively. It is spread from the distal end of 12 and inserted into the selected tissue object. Probe 24 and And 26 form one plane. Antenna 16 is a selected tissue object, as shown in FIGS. 6 (b) and 6 (c). It has another function of fixing the multiple antenna device 12 inside. In Fig. 6 (b), One or both antennas 16 fix the primary antenna or position trocar 14. Used for In addition, one or both antennas 16 melt the tissue. Also used for. In Fig. 6 (c), three antennas are extended and the primary antenna is extended. The entena, or trocar 14, is fixed. FIG. 6 (d) shows the injection function of the multiple antenna device 12. Inside the trocar 14 Three antennas 16 are positioned in the central lumen 14 . Antenna 16 One or more of them can have a central canal attached to the injection source. Central canal The cavity 14 is coupled to the injection source and various injection media are placed at selective positions inside and outside the object to be melted. Supply the body. Suitable injection media include therapeutic agents, conductivity-increasing media, contrast media, or There are dyes and the like, but they are not limited to these. An example of a therapeutic drug is chemotherapy It is a medicine. As shown in FIG. 7, the insulating sleeve 18 is the secondary probes 24, 26 and the absolute One cavity for accommodating another probe extending from the distal end of the rim sleeve 18 You can have more than one. FIG. 8 is derived from different side wall openings formed within the body of the multi-antenna device 12. The four probes inserted are shown. Some or all of the probes have a fixing function To do. Next, referring to FIG. 9, it is supplied through the primary antenna 14 and the secondary antenna 16. The generated current is measured by the current sensor 30. The voltage depends on the voltage sensor 32. Is measured. Next, impedance and power are the power and impedance calculation device. It is calculated in place. These numbers are for the user interface and display It is displayed on B36. The signal representing the power and impedance values is the controller 38. Received by. In one embodiment, the melting device is a handle, an electrode extending from the distal end of the handle, Includes probes, thermal sensors, and energy sources. The electrodes are at the distal end, in the lumen, Includes a cooling medium inflow conduit and a cooling medium outflow conduit. Two conduits connect the electrode lumen It extends through to the distal end of the electrode. The electrodes are cooling media that flow through the inflow and outflow conduits. A side wall opening isolated from the body is formed. The probe is at least part Positioned in the electrode lumen so as to move forward and backward through the side wall opening. It is configured. The thermal sensor is supported by a probe. The electrode is energy Combined with the source. As shown in FIG. 10, the melting device 10 includes a handle 11, an electrode 14, and a closed loop cooling device. Cooling medium inflow conduit 40 forming a rejection system, cooling medium outflow conduit 42, and tapered distal Includes a cap 44, which makes an end. Gas, cooling air, frozen air, compressed air, Various cooling media such as leon, water, alcohol, saline can be used, but this It is not limited to these. On the side wall of the antenna 14, the first side wall opening 46 Is formed. Further, the second side wall opening 48 may be provided. First and second side The wall opening is provided in the antenna 14 to form a physically weakened portion in the antenna 14. It can be a window. The first probe 24 is positioned within the electrode lumen and It can be moved forward and backward through the first side wall opening 46. Any second pro The move 26 is also positioned in the electrode lumen and is selected through the second side wall opening 48. It can be moved forward and backward with respect to the weaving part. Antenna 14 provides outer fusion energy to supply electromagnetic energy to the selective tissue fusion. It has a feeding surface and may have a tapered or pointed distal end. For tumor fusion In addition, the antenna 14 has an outer fusion of 6.35 mm (0.25 inch) or less. Has the length of the energy supply surface, about 1.83 mm (0.072 inches) or more It can have the outer diameter of the lower antenna 14. Each probe 24 and 26 is made of various materials including stainless steel, shape memory metal, etc. It can be formed from, but is not limited to. Probe 24 And 26 dimensions vary depending on the medical application. For the treatment of tumors, the probe 24 and 26 have a length extending into the tissue no more than 3 cm from the side wall opening. Have. The first sensor 50 is supported on the inner or outer surface by the probe 24. can do. The first sensor 50 is preferably the distal end of the probe 24. Positioned to. The second sensor 52 is on the probe 24 and outside the antenna 14. It may be positioned at any position between the lateral surface and the distal end of the probe 24. Preferably, the first sensor 50 can detect the temperature at the midpoint of the selective tissue melt. Positioned in position. The second sensor 52 is a blood vessel when the probe 24 is in the fusion procedure. It is useful for determining whether or not an obstacle such as is encountered. First sensor 50 If the second sensor 52 detects a higher temperature than the second sensor 52, this is because the second sensor 52 Indicates that it is close to the circulating blood vessels. When this occurs, the fusion energy is the blood It will be absorbed by the tube. Similarly, on the second probe 26, one or more sensors Can be provided. In addition, a third sensor 54 is mounted on the outer surface of the antenna 14. It may be positioned. According to sensors 50, 52 and 54, (i) degree of fusion, (ii) amount of fusion, (iii) ) Determine if further melting is required, and (iv) the boundary or periphery of the object to be melted. Therefore, it is possible to measure the degree accurately at the tissue site. In addition, sensor 50 , 52 and 54 prevent non-target tissues from being destroyed or melted. Sensors 50, 52, and 54 have conventional structures, such as thermistors, thermocouples, and sensors. It may be a counter line, etc., but it is not limited to these. Suitable thermal sensors 50, 52 And 54 are T-type thermocouples made of copper constantan, J-type, E-type, and K-type. There are thermocouples, optical fibers, resistance wires, thermocouple IR detectors, etc. Sensors 50, 52 , 54 do not necessarily have to be thermal sensors. Sensors 50, 52, 54 measure temperature and / or impedance, and many Allows monitoring and desired levels of fusion without destroying tissue .. This reduces damage to the tissue around the object to be melted. Choice pair Periphery of selected tissue object by monitoring temperature at various locations inside the elephant And the time of completion of the fusion can be determined. Explained in detail below As described above, when the sensors 50, 52, and 54 determine that the predetermined melting temperature has been exceeded, it is appropriate. Na The feedback signal is received by the energy source 20, which is the primary. Adjust the amount of energy supplied to the antenna 14 and / or the secondary antenna 14. The antenna 14 has electromagnetic energy due to electric wires, soldering, connection to a common coupler, and the like. Combined with Rugi source 20. The antenna 14 is connected to the probes 24 and 26. It can be independently coupled to the magnetic energy supply source 2. Antenna 14 and probe 2 4 and 26 are energy probes when energy is supplied to antenna 14. It may be multiplexed so that it is not supplied to 24 and 26. With electromagnetic energy output source There are high frequency sources, microwave sources, short wave sources and the like. Antenna 14 can be percutaneously or laparoscopically placed in tissue without the use of an inserter. Constructed sufficiently rigid so that it can be inserted. The actual length of antenna 14 is melted Choices to be made The location of the tissue object, the distance from the skin, the accessibility, and the surgeon's abdominal cavity Determined depending on whether to choose mirror treatment, percutaneous treatment, or other treatment Will be done. Suitable lengths are 17.5 cm, 25.0 cm and 30.0 cm , Not limited to these. The antenna 14 is selectively fused via a guide. It can be inserted up to the removal site. The insulating sleeve 18 is placed on the outer surface of the antenna 14 so as to surround the surface. And can be positioned. The insulating sleeve 18 has a variable length of fusion energy. Movable along the outer surface of the multiplex antenna device 12 to form the Rugi supply surface Noh. In one embodiment, the insulating sleeve 18 is made of a polyimide material. Can be done. The sensor may be positioned on the polyimide insulating sleeve 18. The polyimide insulating sleeve 18 is semi-rigid. The sensor is a polyimide insulation It can be arranged over substantially the entire length of the leave 18. Handle 11 is the function of the handle The length of the insulating sleeve 18 and the exposure of the multiple antenna device 12 Includes markings to indicate the length of the energy supply surface. Referring to FIG. 11, the cap 44 constitutes a closed-loop cooling medium flow path. It is shown as. Cap 44 is welded, soldered, coated with epoxy resin, etc. Distal ends of conduits 40 and 42 via various means including, but not limited to, It is fixed to the part. The antenna 14 is attached to the cap 44 by soldering, welding, and press-fitting. A step portion fixed to the distal end of the can be provided. Instead of cap 44 , A U'shaped joint is formed at the distal ends of the vessels 40 and 42, as shown in FIG. You may. Referring to FIG. 13, only a part of the electrodes interacts with the cooling medium inflow conduit 40. Has a face. However, of the cooling medium inflow conduit 40 and the antenna 14. The diameter prevents the transfer of energy through the selective tissue fusion site to the periphery of the site. Therefore, the tissue contact surface formed near the outer surface of the antenna 14 is sufficiently dried and charcoal. The dimensions are determined so that it does not become. FIG. 14 shows the formation of a spherical melting section with a diameter of 4 cm. Antenna 14 The 4 cm fusion energy supply surface is exposed. The electromagnetic energy supplied by the antenna 14 is applied to the fusion energy supply surface of the electrode. The electrode / tissue interface in the area is heated and the heat is sent back to the antenna 14. The greater the amount of heat that is heated and sent back, the greater the carbonization of the antenna 14. .. As a result, the electromagnetic energy conductivity through the selected tissue site is impaired. Antenna 1 The provision of a cooling structure in 4 effectively supplies electromagnetic energy to the selective tissue fusion site. It does not affect your salary. Cooling adds tissue to the electrode / tissue interface It is possible to melt the entire selective tissue fusion site while reducing or eliminating heat. Become. FIG. 15 shows the temperature that can be used to control the flow rate of the cooling medium through the antenna 14. It is a block diagram of a degree / impedance feedback device. Electromagnetic energy is After being supplied to the antenna 14 by the energy source 34, it is supplied to the tissue. monitor 60 measures the impedance of the tissue based on the energy supplied to the tissue and The measured impedance value is compared with the set value. The measured impedance value is the set value When it exceeds, the prohibition signal 62 is transmitted to the energy source 20 and further to the antenna 14. Stop supplying energy. If the measured impedance is within the allowable range, d Nergi continues to be supplied to the organization. Sensor 64 while supplying energy to the tissue Measures the temperature of the tissue and / or the antenna 14. Comparator 68 measures the measured temperature Receives a signal representing and compares its value to the value of a preset signal representing the desired temperature. To do. The comparator 68 tells the flow controller 70 that if the tissue temperature is too high, the cooling medium Send a signal to increase the flow rate, and if the temperature does not exceed the desired temperature, the flow rate Sends a signal to maintain. Next, referring to FIG. 16, the energy source 20 is coupled to the antenna 14 and the organism A statutoryly safe voltage is delivered to the selected tissue site. Electrodes 14 and 72 are both variable It is connected to the primary side of the pressure coil windings 74 and 76. Common primary windings 74 and 76 are strange It is electromagnetically coupled to the secondary windings 78 and 80 via the pressure core. First transformer t<sub>1</sub>The primary winding 74 applies the output voltage of the melting device 10 to the secondary winding 7. Combine with 8. Second transformer t<sub>2</sub>The primary winding 76 draws the output current of the melting device 10. , Combined with the secondary winding 80. The measuring circuit determines the magnitude of current and voltage, or root mean square current (RMS). With voltage These values expressed as are input to the division circuit D, and the effective voltage value is the effective current value. Geometric impedance of tissue site in sensor 68 by division To calculate. The output voltage of the division circuit D is input to the positive (+) input terminal of the comparator A. Voltage Source V<sub>0</sub>Is a variable resistor R<sub>v</sub>The voltage is supplied to the voltage input to the negative input section of the comparator A. The pressure can be adjusted manually. This voltage is the power supplied to the antenna 14. Represents the maximum impedance value. In particular, the tissue is greater than the maximum breaking impedance When heated to a temperature corresponding to the impedance value, the energy source 20 is ante Stop supplying energy to Na 14. The comparator A is the amplitude of the energy source 20, that is, Any commercially available type that can control pulse width modulation may be used. The flow rate of the cooling medium is based on the tissue impedance as shown in signal 82. Alternatively, it can be controlled based on the tissue temperature as indicated by signal 84. One embodiment In the state, the switch S is operated to set the impedance signal 82 to the positive of the comparator A. I am trying to input to the (+) input terminal. This signal is a negative (-) input terminal In cooperation with the reference voltage supplied to the comparator A, the comparator A generates an output signal. Selected organization When the fusion site is heated to a temperature that is biologically damaging, the tissue impedance becomes Do not use because it exceeds the selected impedance value input to the negative (-) input terminal. Generates signal 62 to disable energy source 20 and power antenna 14 To cancel. The output signal of the comparator A can be supplied to the pump 86. Selective tissue fusion department If the temperature is too high, the impedance will be within the permissible range. The pump 86 regulates the flow rate of the cooling medium supplied to the antenna 14, and the temperature of the antenna 14 is adjusted. Decrease the degree. The output signal of comparator A is the tissue temperature represented by its impedance. Depending on the degree, the energy output of the prohibited energy source 20 may be generated. Alternatively, it may generate energy output to the cooling antenna 14. Alternatively, both operations may be performed at the same time. The above description of preferred embodiments of the present invention are provided for purposes of illustration and explanation. Provided and is not intended to limit the invention to the exact form disclosed in a comprehensive manner. .. It will be obvious to those skilled in the art that many changes and variations can be made. Scope of the present invention Is defined by the following claims and their equivalents.
21 sheets
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| Document | Relation | Office | Cited during |
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| JP2004524865A | Cited by | Japan | Search report |
| US8216231B2 | Cited by | United States of America | Applicant |
| JP2005144159A | Cited by | Japan | Examiner |
| JP2009285463A | Cited by | Japan | Examiner |
| JP2009285463A | Cited by | Japan | Search report |
| US8348940B2 | Cited by | United States of America | Applicant |
181 members in 16 offices
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| 08515379 | United States of America | – | |
| 51537995 | United States of America | A | |
| 9613300 | United States of America | W |
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Numbers
- Publication
- 2000-500033
- Application
- 9509503
Titles2
- Japanese
- 選択対象物を融除するための方法及び装置
- English
- INDUSTRIAL APPLICABILITY: A method and an apparatus for melting a selected object.
Classification
- CPC, 45
- A61N1/403
- A61B18/1206
- A61B18/14
- A61B18/1402
- A61B18/1477
- A61B18/1482
- A61B18/1485
- A61B18/1492
- A61B18/18
- A61B18/1815
- A61B2017/00022
- A61B2017/00101
- A61B2018/00011
- A61B2018/00023
- A61B2018/00196
- A61B2018/00273
- A61B2018/00452
- A61B2018/00476
- A61B2018/00577
- A61B2018/00666
- A61B2018/00678
- A61B2018/00702
- A61B2018/00708
- A61B2018/00726
- A61B2018/00744
- A61B2018/00761
- A61B2018/00779
- A61B2018/00791
- A61B2018/00797
- A61B2018/00827
- A61B2018/00875
- A61B2018/00892
- A61B2018/124
- A61B2018/1253
- A61B2018/126
- A61B2018/1425
- A61B2018/143
- A61B2018/1432
- A61B2018/1435
- A61B2018/1472
- A61B2018/162
- A61B2218/002
- A61M25/007
- A61N1/06
- A61N5/04
- IPC, 14
- A61B17 22
- A61B17 00
- A61B17 34
- A61B18 00
- A61B18 04
- A61B18 12
- A61B18 14
- A61B18 16
- A61B18 18
- A61M3 02
- A61M25 00
- A61N1 06
- A61N1 40
- A61N5 04
Designated states5
- Regional, 5
- Sweden
- Togo
- Uganda
- Turkmenistan
- Viet Nam