Insert with light source

Abstract

The present invention relates to an insert inserted into a natural opening of a body such as a vagina or a rectum, in which, in a state in which the insert is inserted into the body, light is efficiently and safely incident to tissue within a body cavity from a distal end of the insert, and the light incident to the tissue within the body cavity from the distal end can be well observed from the abdominal cavity side. An insert (1A) inserted into a natural opening of a body has a light source (10) at a proximal end of a cylindrical body (2) formed from a light-guiding resin, and has a light-emitting part at a distal end. The light-emitting part at the distal end has a structure for emitting light incident at the proximal end from the light-emitting part at the distal end to the outside in the radial direction of the cylindrical body (2) with high intensity. As an example of the light-emitting part at the distal end, an annular convex part (20A) which protrudes outward in the radial direction of the cylindrical body (2) and has a curved surface (21) which is in close contact with tissue in a body cavity can be listed.

Description

Technical Field

[0001] The present invention relates to an insert with a light source used in laparoscopic hysterectomy surgery and the like. Background Art

[0002] Generally speaking, in a laparoscopic hysterectomy, the round ligament, infundibulopelvic ligament, uterosacral ligament (cephalic uterine band), uterine artery, ovarian artery, etc. are cut or the bladder is stripped. The end of the uterus enters the upper part of the vagina and is surrounded by the vaginal vault (the wing-shaped expansion at the upper end of the vagina). Under laparoscopic observation, the uterus is separated from the vaginal canal at the vaginal vault or its vicinity by a scalpel inserted into the abdominal cavity, taken out of the body, and the vaginal wound is closed by suturing. The excision line of the uterus at this time is called the "excision line". It is important to identify the excision line that can perform the complete excision of the uterus with minimal invasion. However, under observation from the abdominal cavity, the vaginal vault cannot be directly observed, making it difficult to determine the excision line.

[0003] Conventionally, the incision line is determined by inserting a finger or a rigid catheter described in Patent Document 1 (a commercially available product, such as the Vagi catheter manufactured by Yako Co., Ltd.) transvaginally into the body, pushing against the vaginal vault (the wing-shaped expansion at the upper end of the vagina surrounding the distal end of the uterus). The incision line is determined based on the movement of the vaginal vault observed using a laparoscope within the abdominal cavity while the rigid catheter is moved and pushed in. However, this method merely estimates the approximate location of the intended incision line.

[0004] As another method for determining the incision line, there is a method of observing the boundary between the uterus and the vagina by transmitting light from the vaginal side. For example, there is a method (Patent Document 2) in which an optical fiber connected to a light source outside the body is inserted into the body through the vagina through a tube, the end of the optical fiber at the distal end of the tube is moved along the vaginal vault, and the light passing through the vaginal vault is observed using a laparoscope in the abdominal cavity, thereby determining the incision line; and a method (Patent Document 3) in which an optical fiber is embedded in the wall of a catheter inserted into the vagina, light is incident from an external light source outside the body on the optical fiber and emitted from the end of the optical fiber at the distal end of the catheter, and the light passing through the vaginal vault is observed using a laparoscope in the abdominal cavity, thereby determining the incision line. Offline; a method (Patent Document 4) in which a resin ring embedded with a light-emitting diode (LED) is mounted on the distal end of a catheter inserted into the vagina, power is supplied to the LED from outside the body by wiring to cause the LED to emit light, and a laparoscope in the abdominal cavity is used to observe the light passing through the vaginal vault to determine the resection line; a method (Patent Document 5) in which the LED is arranged in a ring shape on the edge of a cervical canal cup inserted into the body through the vagina and pushed against the vaginal vault, and a laparoscope in the abdominal cavity is used to observe the light emitted by the LED to determine the resection line.

[0005] However, when light from an external light source is transmitted through an optical fiber from the vaginal side to illuminate the boundary between the uterus and the vagina, as described in Patent Documents 2 and 3, light transmission loss increases, making it difficult to determine the incision line. Furthermore, the optical fiber connecting the external light source to the intravaginal device often becomes an obstacle to surgical operation.

[0006] On the other hand, when LEDs are arranged inside the body as described in Patent Documents 4 and 5, the risk as a medical device is increased due to concerns about electric shock and temperature rise of the device inside the body. Prior art literature Patent Literature

[0007] Patent Document 1: Japanese Patent Application Laid-Open No. 2004-41395; Patent Document 2: Japanese Patent No. 4038590; Patent Document 3: Japanese Patent Application Laid-Open No. 11-336; Patent Document 4: Japanese Patent No. 6133423; Patent Document 5: Japanese Patent Application Laid-Open No. 2017-202317. Summary of the Invention Problems to be solved by the invention

[0008] Compared to the above-mentioned prior art, the subject of the present invention is to enable light to be efficiently and safely incident on tissues in the body cavity from the distal end of the insert that is inserted into a natural opening of the body, such as the vagina and rectum, while the insert is inserted into the body, and to enable light incident on tissues in the body cavity from the distal end to be well observed from the abdominal cavity side. Solutions to Problems

[0009] The present inventors have discovered the following circumstances and completed the present invention: (i) if the insert inserted into the natural opening of the body is a tubular body formed of a light-conducting resin, a light source is directly arranged at its proximal end and the distal end is a light-emitting end, the light emitted by the light source can be efficiently transmitted to the distal end; (ii) if the distal end is made into a specific shape, the distal end of the tubular body inserted into the natural opening is in close contact with the tissue in the body cavity, so that the light emitted from the distal end is efficiently incident on the tissue in the body cavity; and (iii) by making the distal end into a specific shape, the intensity of the light emitted from the distal end traveling radially outward from the tubular body becomes stronger, so that the luminescence of the tissue in the body cavity can be easily confirmed from the serous membrane side of the tissue in the body cavity.

[0010] That is, the present invention provides an insert with a light source, which is inserted into a natural opening of the body. A light source is provided at the proximal end of a cylindrical body formed of a light-conducting resin, and a light emitting unit is provided at the distal end. The light emitting unit has a structure that emits light incident at the proximal end toward the radially outer side of the cylindrical body at high intensity at the distal end. Effects of the Invention

[0011] According to the present invention, a cylindrical body inserted into a natural body opening, such as the vagina or rectum, is formed from a light-conducting resin. A light source is located at the proximal end of the body, and a light-emitting portion is located at the distal end. Consequently, light emitted by the light source enters the proximal end and is emitted from the annular protrusion at the distal end without any transmission loss due to optical fiber.

[0012] Furthermore, the light-emitting portion at the distal end is structured to emit light incident at the proximal end radially outward from the cylindrical body at high intensity. Therefore, when the proximal light source of the insert of the present invention is illuminated and inserted into a natural body opening such as the vagina or rectum, the light emitted by the light-emitting portion can be clearly observed from the serosal side of the tissue within the body cavity at the insertion site, making it easier to identify the incision line from the serosal side.

[0013] In addition, in this insert, the light source is provided at the proximal end of the cylindrical body, and thus the light source is located outside the body, thereby avoiding the risk of electric shock or temperature increase that would occur if the light source were provided inside the body. BRIEF DESCRIPTION OF THE DRAWINGS

[0014] Figure 1A This is a perspective view of the insert with a light source 1A of the embodiment with the cap opened, viewed from the distal end side. Figure 1B 1 is a perspective view of the insert with a light source 1A of the embodiment with the cap closed, viewed from the proximal end side. Figure 1C FIG. 1 is a side view of an insert with a light source 1A according to an embodiment with the cap opened. Figure 1D 1A is a cross-sectional view of an insert with a light source 1A with a cap opened, as viewed in the direction of arrows a and b. Figure 2 1A is a longitudinal sectional view of the annular convex portion 20A, showing the function of the annular convex portion 20A formed as the light emitting portion at the distal end of the light source insert 1A according to the embodiment. Figure 3A This is a perspective view of a normal vagina into which the light source insert 1A according to the embodiment is inserted, as viewed from the abdominal cavity side. Figure 3B This is an explanatory diagram of the position of the uterine incision line determined in a normal vagina after the light source insertion device 1A of the embodiment is inserted. Figure 4A This is a perspective view of a deep vagina into which the light source insert 1A according to the embodiment is inserted, as viewed from the abdominal cavity side. Figure 4BThis is an explanatory diagram of the position of the uterine incision line determined in the deep vagina after the light source insertion device 1A of the embodiment is inserted. Figure 5 1 is a longitudinal sectional view of the annular convex portion, which is formed as the light emitting portion 20B at the distal end of the insert with a light source according to the embodiment, and shows the function of the annular convex portion. Figure 6 1 is a longitudinal sectional view of the annular convex portion, which is formed as the light emitting portion 20C at the distal end of the insert with a light source according to the embodiment, and shows the function of the annular convex portion. Figure 7 1 is a longitudinal sectional view of the annular convex portion, which is formed as the light emitting portion 20D at the distal end of the insert with a light source according to the embodiment, and shows the function of the annular convex portion. Figure 8 This is a longitudinal sectional view of a blasted portion formed as the light emitting portion 20p at the distal end of the insert with a light source according to the embodiment, illustrating the function of the blasted portion. Figure 9 1 is a longitudinal sectional view of the light-containing diffusing agent portion, illustrating the function of the light-containing diffusing agent layer formed as the light-emitting portion 20q at the distal end of the insert with a light source according to the embodiment. Figure 10 This is a longitudinal sectional view of the light emitting portion 20Apq, which is formed as an annular convex portion at the distal end of the light source insert of the embodiment, and shows the function of an object having a blasted portion and containing a light diffusing agent. Figure 11 It is a longitudinal sectional view showing the function of the distal end of the insert with a light source according to the comparative example. Figure 12 It is a longitudinal sectional view showing the function of the distal end of the insert with a light source according to the comparative example. Figure 13A 1B is a side view of the insert 1B according to the embodiment. Figure 13B 1B is a cross-sectional view of an insert 1B according to the embodiment. Figure 14 It is a photograph of the luminescence test of the insert 1A of the embodiment covering the artificial skin sheet. Figure 15A This is a photo of a light-emitting test of an insert with R processing on the tip. Figure 15B This is a photograph of a light emission test of an insert without R processing on the distal end. DETAILED DESCRIPTION

[0015] The following describes in detail the light-emitting insert (hereinafter referred to as "the insert") of the present invention, using a vaginal insert used in laparoscopic hysterectomy surgery as an example, with reference to the accompanying drawings. In the various figures, the same reference numerals indicate the same or equivalent components.

[0016] Furthermore, the insert of the present invention is not limited to use in the vagina, and can also be configured as an insert to be inserted into a natural opening of the body such as the rectum.

[0017] (Overall structure) like Figure 1A 、 Figure 1B 、 Figure 1C as well as Figure 1D As shown, a vaginal light source insert 1A according to one embodiment of the present invention comprises a substantially cylindrical tubular body 2 for insertion into the vagina. The length of the tubular body 2, along the axis A, is determined so that the proximal end of the tubular body 2 is external to the body when inserted into the vagina, and is, for example, 180 mm or greater. Furthermore, the wall thickness d1 of the tubular body 2 is preferably approximately 2 to 4 mm.

[0018] The distal end of the tubular body 2 is open, and its opening surface 2a is inclined relative to the axis A of the tubular body 2 in response to the situation where the posterior vaginal fornix is ​​located deeper than the anterior vaginal fornix.

[0019] Near the proximal end of the cylindrical body 2, a handle 3 is attached as needed, into which a cap 4 is inserted. An opening 4a is formed in the center of the cap 4 for inserting surgical instruments. A plug 4b is integrally formed with the cap 4 and fits into the opening 4a, as indicated by the arrow. The handle 3 and cap 4 can be constructed similarly to the insert described in Patent Document 1.

[0020] On the other hand, the insert of the present invention is mainly composed of a light source mounted on the proximal end of a cylindrical body 2 formed of a light-conducting resin. This reduces light transmission loss when light incident from the proximal light source is guided to the distal end.

[0021] Here, as the light-conducting resin, for example, polymethyl methacrylate, polycarbonate, polystyrene, or the like can be used.

[0022] As a light source, the insert 1A of this embodiment is provided with a ring-shaped lighting member 10 in which a plurality of chip LEDs 11 are embedded. The light-emitting surfaces of the chip LEDs 11 of the ring-shaped lighting member 10 are directed toward the distal end of the cylindrical body 2 .

[0023] In addition, the insert of the present invention is also mainly composed of the following: a light-emitting portion is provided at the distal end of the cylindrical body 2, and the light-emitting portion has a structure that allows light incident at the proximal end to be emitted radially outward at the distal end of the cylindrical body with high intensity, that is, in the intensity distribution of light emitted from the distal end, the intensity of light emitted radially outward of the cylindrical body becomes stronger.

[0024] The distal end light-emitting portion can be configured in various ways, as long as it allows light incident at the proximal end to be emitted radially outward at high intensity at the distal end. For example, the light-emitting portion 20A of the distal end of the light-emitting insert 1A of this embodiment includes an annular projection that projects radially outward from the tubular body 2. This light-emitting portion (annular projection) 20A has a curved surface 21 that closely contacts the tissue within the body cavity when the insert 1A is inserted into the body cavity. The curved surface 21 that protrudes radially outward from the tubular body 2 allows light emitted by the light source 10 to be emitted radially outward from the light-emitting portion (annular projection) 20A with high intensity. Furthermore, when the insert 1A is inserted into the vagina, the tissue within the body cavity closely contacts the curved surface 21. Therefore, light emitted from the curved surface 21 enters the tissue within the body cavity without losing intensity in the gap between the curved surface 21 and the tissue, and passes through the tissue within the body cavity. Therefore, the light-emitting portion in the body cavity can be observed well through the laparoscope inserted into the body cavity on the serosal side of the tissue in the body cavity.

[0025] (light source) In the present invention, the light source 10 is mounted on the proximal end of the cylindrical body 2 without using an optical fiber. As the light source, an LED or the like is preferably used. In addition, the light source 10 is preferably used with the light emitting surface facing the end face of the proximal end of the cylindrical body 2. More specifically, for example, Figure 1D As shown, the light-emitting surfaces of the plurality of chip LEDs 11 are directed toward the end face of the proximal end of the cylindrical body 2, and the plurality of chip LEDs 11 are arranged in a ring along the end face. In this case, the chip LEDs 11 may be embedded in a ring-shaped component 12 formed of a resin having the same refractive index as that of the cylindrical body 2, with the light-emitting surfaces of the chip LEDs 11 directed toward the end face of the proximal end of the cylindrical body 2, and the ring-shaped component 12 may be bonded to the end face of the proximal end of the cylindrical body 2 using an adhesive having the same refractive index as that of the cylindrical body 2. Alternatively, the chip LEDs 11 may be directly bonded to the end face of the proximal end of the cylindrical body 2 using an adhesive having the same refractive index as that of the resin constituting the cylindrical body 2.

[0026] From the perspective of visibility of the light-emitting portion during laparoscope operation, the light source 10 preferably emits light with a wavelength ranging from visible light to near infrared light (approximately 400 to 1000 nm).

[0027] Furthermore, a battery box 13 housing batteries 14 serving as a power source for the chip LED 11 is preferably provided at the proximal end of the tubular body 2. In the insert 1A of the embodiment, the battery box 13 is provided in parallel with the ring-shaped member 12. This eliminates the situation where the wiring of the light source 10 interferes with the surgical procedure.

[0028] (Annular convex portion) Figure 2This is a longitudinal cross-sectional view (a cross-sectional view taken along the cylindrical body axis A) of the annular projection 20A of the insert 1A of the embodiment, with the insert 1A inserted into the vagina 100 and the annular projection 20A at the distal end of the insert 1A pressed against the vaginal vault 101. The annular projection 20A has a curved surface 21 that projects radially outward from the cylindrical body 2. As shown in the figure, the curved surface 21 is not formed radially inward of the cylindrical body 2 relative to the inner end point P1 of the arc forming the curved surface 21, but rather projects radially outward from the outer end point P2 of the arc forming the curved surface 21. In addition, the inner endpoint P1 of the curved surface 21, the point most protruding outward in the radial direction (outer protruding point) P3, and the outer endpoint P2 are smoothly continuous. Whether on the inner endpoint P1 side of the outer protruding point P3 or on the outer endpoint P2 side of the outer protruding point P3, the curved surface 21 becomes a shape that is closely attached to the tissue 120 in the body cavity.

[0029] More specifically, in Figure 2 In the cross-sectional view shown, the inner endpoint P1 of the arc of the curved surface 21 is located on the inner surface 2b of the tubular body 2, and the curved surface 21 is located radially outward of the tubular body 2 relative to the inner endpoint P1. Furthermore, the curved surface 21 forms an arc approximately three-quarters of a circle (θ1: 240 to 285°) formed within the wall thickness of the tubular body 2. The curved surface 21 extends proximally beyond the outer protruding point P3, which protrudes most radially outward, by approximately one-quarter of a circle (θ2: 60 to 105°). Therefore, when the tubular body 2 is pressed against the vaginal vault 101, substantially the entire surface of the curved surface 21 is in close contact with the tissue within the body cavity. While the entire surface of the curved surface 21 does not necessarily need to be in close contact with the tissue within the body cavity, it is preferably in close contact at the outer protruding point P3, as well as on the inner endpoint P1 and outer endpoint P2 sides (preferably, the protruding area in the center including the outer protruding point P3).

[0030] If Figure 2 The insert 1A shown, which has the annular protrusion 20A at the distal end, is pushed transvaginally to the vaginal fornix 101, and the light source 10 at the proximal end is turned on, so that light is emitted from the annular protrusion 20A at the distal end. As shown by the arrows in the figure, the light is diffused upward (in the direction of the axis A) and laterally, and particularly diagonally with strong light intensity. Figure 3A As shown, the light emitted from the annular convex portion 20A pressed against the vaginal fornix 101 can be observed from the abdominal cavity side as the light emitting portion B using an endoscope 200, as shown in FIG. Figure 3B As shown, the cutting line X can be appropriately determined.

[0031] The shape of the vagina and uterus viewed from the abdominal cavity is similar to Figure 3A and Figure 3B The same shape as shown Figure 4A and Figure 4BAs shown in FIG, there is a case where the vagina 100 is long and the vaginal fornix 101 is deep, but in this case, if the insert 1A of the embodiment is used, the light emitting portion B can be observed corresponding to the position of the vaginal fornix 101. Figure 4B As shown, the cutting line X can be appropriately determined.

[0032] In contrast, if Figure 11 If the distal end 2x of the cylindrical body 2 is a plane perpendicular to the axis A, as in the insert of the comparative example shown, the intensity of light incident from a light source at the proximal end of the cylindrical body 2 is strong at the distal end 2x along the axis A, while the intensity of light emitted laterally is weak. Furthermore, as shown in the enlarged view within the figure, the cylindrical body 2 is not in close contact with the intracavitary tissue 120 in the region 2r near the side end from the corner of the distal end 2x. The refractive index of the cylindrical body 2 (for example, 1.49 in the case of acrylic resin), the refractive index of the intracavitary tissue (the refractive index of biological tissue is approximately 1.55, and the refractive index of water contained therein is 1.33), and the refractive index of the gap between them (the refractive index of air is 1.00) are different. Therefore, reflection occurs at their interface, and the intensity of light passing through the intracavitary tissue from the distal end 2x to the side of the cylindrical body 2 becomes weaker. Therefore, it is difficult to observe the light emitted from the distal end 2x of the tubular body 2 as a light-emitting portion from the abdominal cavity side, and it is also difficult to determine the resection line X.

[0033] In addition, if Figure 12 The insert of the comparative example shown in FIG. 1 is a simple rounding of the distal end 2x of the cylindrical body 2. Figure 11 Compared to the case shown, the diffusion of light emitted from the distal end 2x becomes stronger, but the intensity of light emitted to the side of the tubular body 2 is weak. Therefore, simply rounding the corners of the distal end 2x of the tubular body 2 still makes it difficult to observe the light emitted from the distal end 2x as a light-emitting portion from the abdominal cavity side.

[0034] (Deformation of the light-emitting portion at the distal end) like Figure 3A or Figure 3B As shown, in order to clearly observe the emitted light from the annular convex portion of the light emitting portion provided at the distal end of the tubular body 2 from the abdominal cavity side, in the present invention, it is also possible to Figure 5 As shown in the annular projection 20B at the distal end of the tubular body 2, the radial thickness d2 of the outer protrusion point P3 of the annular projection 20B is greater than the wall thickness d1 of the tubular body 2. The difference d3 between the thickness d2 of the annular projection 20B and the wall thickness d1 of the tubular body 2 is preferably at least 1 / 4 of the wall thickness d1.

[0035] In addition, Figure 5The annular protrusion 20B of the illustrated insert also has a curved surface smoothly continuous with its inner end point P1, outer protrusion point P3, and outer end point P2 to improve adhesion between the annular protrusion 20B and the tissue within the body cavity. Furthermore, the curved surface 21 continues proximally beyond the outer protrusion point P3 by approximately one-sixth of a circle (θ2: 40 to 70°).

[0036] Figure 6 The annular protrusion 20C at the distal end of the cylindrical body 2 shown in FIG. Figure 2 The annular protrusion 20A shown is inclined in such a manner that the opening diameter of the inner surface 2b of the cylindrical body 2 becomes wider as it approaches the distal end of the cylindrical body 2. The inclination angle θ3 is preferably 35 to 60 degrees from the axis A. By forming this inclined surface 2y, the light incident on the proximal end of the cylindrical body 2 can be reflected outward in the radial direction of the cylindrical body 2 by the inclined surface 2y, and then emitted outward in the radial direction of the cylindrical body 2 from the curved surface 21. Therefore, the intensity of the light emitted outward in the radial direction becomes stronger. Therefore, if the light is reflected from the proximal end of the cylindrical body 2 Figure 6 The light emitting portion of the annular convex portion 20C shown in the figure emits light to the tissue in the body cavity, and the light emitting portion of the tissue in the body cavity can be well observed from the abdominal cavity side.

[0037] Figure 7 The annular protrusion 20D at the distal end of the cylindrical body 2 is shown in FIG. Figure 6 The annular projection 20C shown has a reflective film 22 formed on the inner surface 2b of the cylindrical body. Reflective film 22 can be formed from a metal film such as an aluminum vapor-deposited film, or a commercially available mirror-effect spray. The presence of reflective film 22 increases the intensity of light reflected radially outward from the inclined surface 2y. This allows the annular projection 20D to be more clearly observed as a light-emitting portion from the abdominal cavity side.

[0038] Figure 8 The light emitting portion 20p of the cylindrical body 2 shown has rounded corners at the distal end of the cylindrical body 2 and a roughened outer surface. The roughened surface is preferably formed by blasting. Blasting is a surface roughening technique that creates numerous tiny flaws on the surface and can be performed using a laser machine, sandblasting machine, or the like.

[0039] If the outer peripheral surface of the distal end of the cylindrical body 2 is formed as a rough surface 20p, light incident on the proximal end of the cylindrical body 2 is diffused from the rough surface 20p. Therefore, even if the rough surface 20p is formed on the distal end of the cylindrical body 2, the light emitted by the rough surface 20p can be observed from the abdominal cavity side.

[0040] Figure 9The light emitting portion 20q of the cylindrical body 2 shown has rounded corners at the distal end of the cylindrical body 2 and a light diffusing agent layer formed on the outer peripheral surface of the distal end. As the light diffusing agent contained in the light emitting portion 20q, a well-known light diffusing agent used in lighting fixtures can be used, for example, micron-sized silicone particles, polystyrene particles, etc.

[0041] If the light-containing diffusing agent layer 20q is provided on the outer peripheral surface of the distal end of the cylindrical body 2, light incident on the proximal end of the cylindrical body 2 is diffused by the light-containing diffusing agent layer 20q. Therefore, by forming the light-containing diffusing agent layer 20q on the outer peripheral surface of the distal end of the cylindrical body 2, the light emission of the light-containing diffusing agent layer 20q can be observed from the abdominal cavity side.

[0042] By combining the above-mentioned light emitting portion structure (annular convex portions 20A to 20D, rough surface 20p, light-containing diffusing agent layer 20q), light incident on the proximal end of the cylindrical body can also be emitted more strongly toward the radially outer side of the cylindrical body at the distal end. For example, Figure 10 The light emitting portion 20Apq shown in the figure is formed with a light diffusing agent layer on the outer peripheral surface of the distal end of the cylindrical body 2, and the distal end is formed into Figure 2 The annular convex portion 20A shown has its curved surface blasted.

[0043] (Luminous scale) The light source insert of the present invention preferably has a light emitting scale on the outer peripheral surface at a predetermined distance from the light emitting portion at the distal end of the cylindrical body, which emits light in the form of a scale. For example, Figure 1C 、 Figure 1D As in the insert 1A of the illustrated embodiment, an annular projection 30 can be provided as a luminous scale at a predetermined distance L1 from the luminous portion (annular projection) 20A at the distal end of the cylindrical body 2, extending along the entire circumference of the cylindrical body. A plurality of luminous scales (annular projections) 30 are formed, each spaced a predetermined distance L2 apart.

[0044] In this embodiment, each luminous scale 30 is formed in a plane perpendicular to the axis A of the cylindrical body 2. Furthermore, each luminous scale 30 protrudes in a semi-cylindrical (kamaboko-shaped) shape in the longitudinal section (a cross section taken along the axial direction) of the cylindrical body 2. The protruding length L3 of the luminous scale 30 from the outer surface 2c of the cylindrical body is preferably not less than 1 / 4 times and not more than 1 time the wall thickness d1 of the cylindrical body 2. Furthermore, the width L4 of the luminous scale in the direction of the axis A is preferably not less than 1 / 4 times and not more than 1 time the wall thickness d1.

[0045] The luminous scale 30 may be formed by bonding a ring made of hard rubber such as transparent silicone rubber to the cylindrical body 2 , or may be integrally molded with the cylindrical body 2 using the same resin as the cylindrical body 2 .

[0046] Alternatively, a roughened surface may be formed in a circumferential band on the outer surface of the cylindrical body as a luminous scale, or a light-containing diffusing agent layer may be provided. The roughened surface for the luminous scale can be formed by blasting, etc., similarly to the roughened surface 20p at the distal end, and the light-containing diffusing agent layer can be formed similarly to the light-containing diffusing agent layer 20q at the distal end.

[0047] These structures (annular protrusion 30, rough surface, and light-diffusing agent layer) may be appropriately combined. For example, the surface of the annular protrusion 30 may be blasted to form a luminous scale, or an article having the annular protrusion 30 formed on a light-diffusing agent layer may be used as a luminous scale.

[0048] By providing the luminous scale 30 on the tubular body 2, as shown in the embodiment described later, when light incident from the proximal end of the tubular body 2 is emitted from the luminous portion 20 at the distal end, light can also be emitted from the luminous scale 30 outward in the radial direction of the tubular body, and the luminous portion based on this can be observed as a scale from the abdominal cavity side. Therefore, the luminous portion based on the luminous scale 30 can be used as a scale mark when treating the vaginal or rectal wall from the serosal side at a desired position from the luminous portion (annular protrusion) 20 at the distal end.

[0049] Figure 13A 、 Figure 13B The insert 1B shown is Figure 1A 、 Figure 1B 、 Figure 1C 、 Figure 1D In the illustrated insert 1A, luminous scales (annular projections) 30 are arranged equidistantly from the distal luminous portion (annular projection) 20A throughout its entire circumference. Therefore, the surface surrounded by each luminous scale (annular projection) 30 is inclined relative to the axis A of the cylindrical body 2, similarly to the opening surface 2a of the cylindrical body 2. Furthermore, in the insert 1B, the distal luminous portion (annular projection) 20 and luminous scales (annular projections) 30 are integrally formed with the cylindrical body 2.

[0050] By providing the luminous scale 30 at equal distances from the distal end annular projection 20 throughout the entire circumference, the distance to the vaginal fornix can be easily determined.

[0051] In the insert of the present invention, the various modifications described above can be appropriately combined. Example

[0052] Luminescence test 1 The Vagi catheter (size M) manufactured by Yako Co., Ltd. (catheter outer diameter 35 mm, inner diameter 29 mm, catheter effective length 180 mm) was used for preparation. Figure 1A 、 Figure 1B 、 Figure 1C as well as Figure 1DThe insert 1A shown here consists of eight surface-mount chip LEDs (3 mm in diameter, emitting light at a wavelength of 850 nm (near infrared) or 624 nm (red)) arranged in a circle on the handle-side end face of the Vagi catheter (i.e., the proximal end of the tubular body 2) and secured with acrylic adhesive. Each chip LED 11 is connected to a battery 14 within a battery compartment 13. In addition, the annular convex portion 20 of the cylindrical body 2 is Figure 2 The cross-section shown is formed.

[0053] The manufactured insert 1A was covered with a 4 mm thick, light orange artificial skin sheet made of silicone resin. Each chip LED 11 was turned on, and the artificial skin sheet was photographed from obliquely above the cylindrical body in a dark room using a near-infrared observation camera.

[0054] As a result, whether the LED light emission wavelength is 850nm or 624nm, the light emission of the light emitting portion (annular convex portion) 20 at the distal end of the tubular body 2 and the light emission of the light emitting scale (annular convex portion) 30 can be clearly confirmed on the artificial skin sheet. Figure 14 The image at 850 nm is shown in FIG.

[0055] Luminescence Test 2 The insert made in the luminous test 1 does not have the luminous scale (annular convex part) 30, and the luminous part at the distal end of the cylindrical body 2 is processed into Figure 2 The cross section of the insert shown in FIG. 1 is shown (with distal end R processing). In addition, except that the distal end of the cylindrical body 2 is not processed at all, the distal end is Figure 11 Inserts other than the cross-section shown are manufactured in the same manner (without the R processing of the distal end).

[0056] An artificial skin sheet was placed on each of the inserts with and without distal end R processing as in the luminescence test 1, and the LED was turned on to photograph the artificial skin sheet in a dark room using a near-infrared observation camera. exist Figure 15A (with R processing at the end) and Figure 15B The results are shown in (without distal end R processing).

[0057] exist Figure 15A In contrast, the luminance of the luminous part (256 grayscales) exceeds 240. Figure 15B The luminance of the light-emitting portion is 195. For a photographic camera, a luminance exceeding 240 is out of range, so the actual luminance intensity ratio is considered to be 240 / 195 or more. From these results, it can be confirmed that the intensity of light observed through the artificial skin sheet is improved by performing the distal end R processing. Description of Reference Numerals

[0058] 1A, 1B with light source insert 2 cylindrical body 2a Opening surface of the cylindrical body 2b cylindrical inner surface 2c cylindrical outer surface 2r The area from the corner of the distal end to the side end 2x distal end of the barrel 2y inclined surface 3 handles 4 caps 4a Opening 4b bolt 10 Light source, ring lighting 11 Chip LED 12 ring parts 13 Battery Box 14 Batteries 20A, 20B, 20C, 20D light-emitting parts (ring-shaped convex parts) 20p Luminous part (rough surface) 20q Light-emitting part (including light-diffusing agent layer) 21 Surface 22 Reflective film 30 Luminous scale, luminous scale annular protrusion 100 Vagina 101 Vaginal Vault 110 Uterus 120 Tissues in the body cavity 200 Endoscope A axis of the cylindrical body B Luminous part L1: The distance between the annular convex portion and the annular convex portion for the luminous scale L2 Interval between the annular convex parts of the luminous scale L3: Protruding length of the annular convex portion for the luminous scale L4 Width of the annular convex portion for luminous scale in the direction of axis A Inside endpoint of the P1 surface Outer endpoint of the P2 surface Outer protrusion of the P3 surface X cut off line d1: wall thickness of the cylinder d2 Thickness of the annular convex part d3 is the difference between the thickness d2 of the annular projection and the wall thickness d1 of the cylindrical body.

Claims

1. An insert with a light source, which is inserted into a natural opening of the body, A light source is provided at the proximal end of a cylindrical body formed of a light-conducting resin, and a light emitting unit is provided at the distal end. The light emitting unit has a structure that emits light incident at the proximal end toward the radially outer side of the cylindrical body at high intensity at the distal end.

2. The insert according to claim 1, wherein The light emitting portion at the distal end is formed by an annular convex portion that protrudes radially outward from the cylindrical body and has a curved surface that closely contacts the tissue in the body cavity.

3. The insert according to claim 2, wherein In the longitudinal section of the cylindrical body, the curved surface of the annular convex portion is not formed radially inward of the cylindrical body relative to the inner end point of the arc of the curved surface, but protrudes radially outward of the cylindrical body relative to the outer end point of the arc of the curved surface.

4. The insert according to claim 1 or 3, wherein In the longitudinal section of the cylindrical body, the inner end point of the arc of the annular convex portion of the curved surface, the point where the curved surface most protrudes radially outward, and the outer end point of the arc of the curved surface are smoothly continuous.

5. The insert according to claim 1, wherein The light emitting portion at the distal end is a rough surface formed on the outer peripheral surface of the distal end.

6. The insert according to claim 1, wherein The light emitting portion at the distal end is a light-containing diffusing agent layer formed on the outer peripheral surface of the distal end.

7. The insert according to claim 1, wherein The cylindrical body has a light-emitting scale on its outer peripheral surface at a predetermined distance from the light-emitting portion at the distal end, which emits light incident at the proximal end in a scale-like manner.

8. The insert according to claim 7, wherein The luminous scale has an annular convex portion formed along the circumferential direction on the outer surface of the cylindrical body.

9. The insert according to claim 7, wherein The luminous scale has a rough surface formed in a band shape along the circumferential direction on the outer surface of the cylindrical body.

10. The insert according to claim 7, wherein The luminous scale has a light-containing diffusing agent portion formed in a band shape along the circumferential direction on the outer surface of the cylindrical body.

11. The insert according to claim 1, wherein The light emitting surface of the chip LED is connected to the proximal end of the cylindrical body.

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