Medical Devices

Abstract

The present invention provides a medical device that can locally irradiate energy by approaching a treatment target part through an energy radiating part that can irradiate energy in a non-contact state with respect to a biological organ. A first part (115a) and a second part (115b) are formed at the front end of a shaft (110) of a guide part (100) provided in the medical device (10), the first part (115a) can abut against the inner wall of the biological organ, the second part (115b) is arranged at a position closer to the base end of the shaft than the first part, and can abut against the inner wall of the biological organ at a position different from the first part on the cross section of the inner wall of the biological organ, and the treatment part (200) can move in the inner cavity (113) of the shaft when at least a part of the first part and at least a part of the second part abut against the inner wall of the biological organ.

Description

Technical Field

[0001] The present invention relates to medical devices. Background Art

[0002] Medical devices are known that radiate energy into human organs to treat and improve various diseases. As an example of a treatment method using such medical devices, a surgery to cauterize nerves existing outside blood vessels is performed.

[0003] In the medical equipment used in the above-mentioned surgery, for example, as the type of energy, a high frequency (RF) in the radio band is sometimes selected. However, RF radiates energy in a state where the energy radiating part is in direct contact with the inner wall of the blood vessel to which the energy is applied, thereby directly heating the inner wall of the blood vessel using Joule heat, and indirectly raising the temperature of the nerves located outside the blood vessel through its heat propagation. Therefore, when RF is used, thermal damage to the directly heated blood vessel is bound to occur, so in order to avoid complications such as perforation of the blood vessel and stenosis of the blood vessel, the output needs to be suppressed to a low level. Therefore, in the surgery using RF, the cauterization depth has to be shallower, and it may not be possible to reliably remove the nerves. As a countermeasure to the above-mentioned problem, the surgeon removes the nerves located outside the blood vessel while applying energy to multiple locations in the circumferential direction and extension direction of the blood vessel to avoid applying energy locally concentrated on a part of the inner wall of the blood vessel.

[0004] As a medical device for easily performing the above-mentioned surgery, an RF catheter including a helical shaft and multipolar electrodes arranged on the surface of the shaft has been proposed (see Patent Document 1).

[0005] As a countermeasure different from using the RF catheter configured as described above, an energy radiating unit can be used that radiates energy such as microwaves and ultrasound waves in a non-contact state with respect to the inner wall of the blood vessel, and the nerves located outside the blood vessel can be removed by the energy. When such an energy radiating unit is used, it is not necessary to make the energy radiating unit directly contact the inner wall of the blood vessel, so that the nerves located deeper can be cauterized while protecting the inner wall of the blood vessel from excessive thermal damage.

[0006] However, since the energy radiating parts (e.g., antennas, elements) that radiate energy as described above are generally larger than RF electrodes, it is difficult to carry multiple of them in a thin-diameter catheter device or the like. Assuming that one energy radiating part is carried in a catheter device, in order to remove nerves located outside the blood vessel within a certain range, it is necessary to repeatedly perform the following operation before reaching the target ablation range: the energy radiating part is brought close to the cross-section of the blood vessel to radiate energy in a predetermined direction, and then the position of the energy radiating part is slightly moved to radiate. However, in order to perform such an operation under X-ray fluoroscopy, advanced catheter operation techniques are required, and the treatment success rate fluctuates depending on the operator.

[0007] In order to overcome the above-mentioned problems, a method has been attempted in which a catheter device equipped with one energy radiating unit is used to radiate energy at high output all around the blood vessel from the energy radiating unit disposed at the center of the cross section of the blood vessel (see Patent Document 2).

[0008] Prior Art Literature

[0009] Patent Literature

[0010] Patent Document 1: International Publication No. 2013-134541

[0011] Patent Document 2: Japanese Patent Application Publication No. 2017-196461 Summary of the invention

[0012] Summary of the Invention

[0013] Problems to be solved by the invention

[0014] However, when the catheter device of Patent Document 2 is used, it is necessary to radiate energy at a high output due to the distance between the energy radiating part and the inner wall of the blood vessel during treatment. In addition, when energy is radiated from the energy radiating part at a high output, the energy radiating part and the transmission path generate heat and become high temperature. Therefore, the operator needs to actively cool the energy radiating part during the operation by perfusion based on cooling water, etc. Moreover, the diameter of the target blood vessel varies according to each patient and each cauterization site, so the distance from the energy radiating part arranged in the center of the blood vessel to the inner wall of the blood vessel is different each time. Therefore, the operator needs to change the output according to the diameter of the blood vessel, etc. Therefore, in the catheter device of Patent Document 2, not only is the device structure complicated, but the workload of the operator required for the operation is also increased.

[0015] The present invention is based on the above-mentioned problems, and proposes that an energy radiating unit that can radiate energy in a non-contact state with respect to a biological organ can approach a treatment target part and locally radiate energy. Thus, while suppressing excessive increase of energy radiated from the energy radiating unit, nerves can be removed more reliably through simpler operation.

[0016] Solutions to Solve Problems

[0017] A medical device according to one embodiment of the present disclosure comprises: a guide portion, which has a shaft having an inner cavity formed therein and can be inserted into a living organ; and a treatment portion, which has an energy radiating portion, which, when arranged in the inner cavity of the shaft, can radiate energy that can reach peripheral nerves existing outside the living organ, and at the front end of the shaft are formed: a first portion, which can abut against the inner wall of the living organ; and a second portion, which is arranged at a position closer to the base end side of the shaft than the first portion and can abut against the inner wall of the living organ at a position different from the first portion on the cross section of the inner wall of the living organ, wherein the treatment portion can move in the inner cavity of the shaft in a state in which at least a portion of the first portion and at least a portion of the second portion abut against the inner wall of the living organ.

[0018] In a treatment method according to another embodiment of the present invention, a guide portion having an axis with an inner lumen is inserted into a living organ, a first portion formed at a front end portion of the axis is brought into contact with an inner wall of the living organ, and a second portion formed at a position closer to the base end of the axis than the first portion is brought into contact with a position different from the first portion in a cross-section of the inner wall of the living organ; in a state in which at least a portion of the first portion and at least a portion of the second portion are brought into contact with the inner wall of the living organ, a treatment portion having an energy radiating portion is moved a predetermined distance along the inner lumen of the axis; in a state in which the energy radiating portion is disposed in the inner lumen of the axis, energy is radiated from the energy radiating portion to apply the energy to peripheral nerves existing outside the living organ.

[0019] Effects of the Invention

[0020] According to the present disclosure, the first portion of the shaft of the guide portion and the second portion of the shaft of the guide portion are brought into contact with the inner wall of the biological organ, thereby enabling the shaft to be held relative to the biological organ. While holding the shaft relative to the biological organ, the operator moves the treatment portion along the inner cavity of the shaft and arranges the energy radiating portion of the treatment portion at a position close to the inner wall of the biological organ, thereby locally irradiating energy to a predetermined treatment target portion (for example, a peripheral nerve located outside a blood vessel). Therefore, the operator can suppress the energy radiated from the energy radiating portion to a low level, thereby enabling more reliable nerve removal while preventing burns and the like. BRIEF DESCRIPTION OF THE DRAWINGS

[0021] Figure 1 This is a diagram schematically showing the overall structure of a medical device according to an embodiment.

[0022] Figure 2 This is a perspective view showing an enlarged view of the front end portion of the shaft.

[0023] Figure 3 It is a cross-sectional view of the front end of the shaft.

[0024] Figure 4 This is a flowchart briefly showing the process of the treatment method of the embodiment.

[0025] Figure 5 This is a diagram schematically showing a blood vessel to which the treatment method is applied.

[0026] Figure 6 This is a cross-sectional view of a blood vessel schematically showing a situation when a treatment method using the medical device according to the embodiment is performed.

[0027] Figure 7 This is a cross-sectional view of a blood vessel schematically showing a situation when a treatment method using the medical device according to the embodiment is performed.

[0028] Figure 8 It is a perspective view schematically showing a situation when a treatment method using the medical device according to the embodiment is carried out.

[0029] Fig. 9 It is along Figure 7 A cross-sectional view (transverse cross-sectional view) of a blood vessel indicated by arrow 9A-9A.

[0030] Fig.10 This is a diagram schematically showing the overall structure of the medical device according to Modification 1.

[0031] Fig.11 This is a perspective view showing an enlarged front end portion of a shaft of a medical device according to Modification 2.

[0032] Fig.12This is a cross-sectional view of a blood vessel schematically showing an example of use of the medical device according to Modification 2.

[0033] Fig.13 It is along Fig.12 A cross-sectional view (transverse cross-sectional view) of a blood vessel indicated by arrow 13A-13A.

[0034] Fig.14 This is a perspective view showing an enlarged front end portion of a medical device according to a third modification.

[0035] Fig.15 This is a cross-sectional view of a blood vessel schematically showing an example of use of the medical device according to Modification 3.

[0036] Fig.16 It is along Fig.15 A cross-sectional view (transverse cross-sectional view) of a blood vessel indicated by arrow 16A-16A is shown.

[0037] Fig.17 This is a perspective view showing an enlarged front end portion of a medical device according to a fourth modification.

[0038] Fig.18 This is a cross-sectional view of a blood vessel schematically showing an example of use of the medical device according to Modification 4.

[0039] Fig.19 It is along Fig.18 A cross-sectional view (transverse cross-sectional view) of a blood vessel indicated by arrow 19A-19A.

[0040] Fig. 20 This is a cross-sectional view of a living organ schematically showing an example of use of the medical device according to Modification 5. DETAILED DESCRIPTION

[0041] Hereinafter, the embodiments of the present invention will be described with reference to the accompanying drawings. It should be noted that the following description does not limit the technical scope and meaning of the terms described in the technical solution. In addition, the dimensional ratios of the accompanying drawings are sometimes exaggerated for the sake of convenience of explanation and are different from the actual ratios. In addition, the range "X to Y" shown in this specification means "above X and below Y".

[0042] Figure 1 to Figure 3 It is a figure for demonstrating each part of the medical device 10 which concerns on embodiment. Figure 4 It is a flowchart showing an example of a procedure of a treatment method using the medical device 10 . Figure 5 This is a diagram for explaining a blood vessel V that is a target of a treatment method using the medical device 10 . Figure 6 to Figure 9 1 is a diagram for explaining an example of use of the medical device 10. It should be noted that Figure 8 2 is a perspective view schematically showing a state where the guide portion 100 and the treatment portion 200 are arranged in the blood vessel V. Fig. 9 It is along Figure 7 A transverse cross-sectional view of the blood vessel V in the direction indicated by arrow 9A-9A.

[0043] <Parts to be treated>

[0044] Reference Figure 5 to Figure 7 , the treatment target site S is described. Figure 5 The symbol VR represents the right renal artery, and the symbol VL represents the left renal artery. Figure 5 The symbol Va represents the superior mesenteric artery, the symbol Vb represents the celiac artery, the symbol Vc represents the inferior mesenteric artery, and the symbol Vd represents the aorta.

[0045] In the treatment method of this embodiment, a doctor or other person performing surgery (hereinafter referred to as "the person performing surgery") performs treatment to reduce the activity of the autonomic nerves in the blood vessels V having peripheral nerves (extravascular nerves) Na that innervate the patient's intestines, thereby increasing the peristaltic movement of the intestines. By performing such treatment, the person performing surgery can promote the alleviation of at least one symptom of abdominal distension, abdominal pain, discomfort in the perineum, and frequent bowel movements caused by the patient's constipation and / or abnormal peristaltic movement of the intestines (at least one of the symptoms caused by the patient's constipation and / or abnormal peristaltic movement of the intestines).

[0046] The blood vessel V to which the treatment method is applied is not particularly limited as long as it can cause the peristaltic movement of the intestinal tract of the patient (subject) to be increased by the treatment specified in the embodiment (for example, the application of energy based on microwaves described later). As an example, the blood vessel V can be appropriately selected from at least one of the superior mesenteric artery Va, the celiac artery Vb, and the inferior mesenteric artery Vc. In particular, from the viewpoint of further effectively increasing the peristaltic movement of the intestinal tract after the treatment, it is preferred to select the superior mesenteric artery Va as the blood vessel V.

[0047] As a treatment of the embodiment, the operator applies energy to one peripheral nerve Na or multiple peripheral nerves Na. As a result, the operator blocks the peripheral nerve Na, completely or partially cuts off the autonomic nerve transmission from the peripheral nerve Na to the digestive tract, thereby causing the peristaltic movement of the intestinal tract to be hyperactive. As a reason for activating the peristaltic movement of the intestinal tract by performing the treatment that reduces the activity of the autonomic nerves as described above in the blood vessel V, the following mechanism can be considered.

[0048] When the peripheral nerve Na is blocked by energy irradiated from the blood vessels V, and the autonomic nerve transmission from the peripheral nerve Na to the digestive tract is completely or partially blocked, the sympathetic nervous system is relatively weakened and the parasympathetic nervous system is dominant. In addition, by blocking the nerve transmission from the central nervous system, the intestinal nervous system that autonomously controls the movement of the intestinal tract at the end is dominant, and the peristaltic movement of the intestinal tract is activated. Moreover, when the peristaltic movement of the intestinal tract is activated, the colon transit time is promoted / normalized, thereby promoting the alleviation of at least one symptom of abdominal distension, abdominal pain, discomfort in the perineum, and frequent bowel movements caused by constipation and / or abnormal peristaltic movement of the intestinal tract.

[0049] In particular, the treatment method of this embodiment can effectively promote the alleviation of symptoms of delayed colon transit time type constipation, in which the stool transit time is delayed due to decreased intestinal peristalsis and constipation, among functional constipation without organic abnormalities in the colon.

[0050] Figure 6 The treatment target site (region containing one or more peripheral nerves Na) S shown is not particularly limited as long as it can cause the peristaltic movement of the intestine to be hyperactive. For example, within the blood vessel V, the treatment can be applied to any range (site) in the traveling direction (extension direction) of the blood vessel V, or to any range (site) in the circumferential direction (circumferential direction of the cross section) of the blood vessel V. In addition, the treatment can be applied multiple times to any multiple sites of the same blood vessel V, or to any multiple sites of different blood vessels V.

[0051] In this embodiment, if Figure 6 to Figure 9 As shown, the treatment method using the mesenteric artery Va as the target blood vessel V will be described.

[0052] The treatment method of this embodiment includes a case where treatment is performed around the origin of the superior mesenteric artery Va.

[0053] The treatment target site S preferably includes, for example, a range of 0 mm to 20 mm along the extension direction of the superior mesenteric artery Va based on the opening of the superior mesenteric artery Va. By applying energy within the above range of the superior mesenteric artery Va, it is possible to effectively suppress the transmission of energy to an organ (e.g., the pancreas or the duodenum) located on the distal side of the superior mesenteric artery Va.

[0054] To more reliably suppress energy transmission to organs located distal to the superior mesenteric artery Va, energy application from the superior mesenteric artery Va is preferably performed only within a range of 0 mm to 20 mm along the extension direction of the superior mesenteric artery Va.

[0055] When energy is applied to the treatment target site S from the superior mesenteric artery Va as in the treatment method of this embodiment, the treatment target site S may include a range of 0 mm to 100 mm along the extension direction of the aorta Vd based on the branch of the superior mesenteric artery Va.

[0056] The deep reaching length of the energy from the superior mesenteric artery Va side is preferably included in the range of 1mm to 6mm from the intima of the superior mesenteric artery Va. The peripheral nerves Na existing on the outside of the superior mesenteric artery Va exist at a relatively deep position around the starting part of the superior mesenteric artery Va. More specifically, the peripheral nerves Na exist in a bundle in the fat tissue outside the superior mesenteric artery Va in a state supported by the connecting tissue. Therefore, when energy is applied from the starting part of the superior mesenteric artery Va, the peripheral nerves Na of the superior mesenteric artery Va can be efficiently removed by making the energy reach the position of 1mm to 6mm of the intima of the superior mesenteric artery Va.

[0057] <Medical Equipment>

[0058] like Figure 1 , Figure 2 , Figure 3 As shown, the medical device 10 of the present embodiment includes a guide portion 100 and a treatment portion 200 .

[0059] like Figure 1 As shown, the guide portion 100 includes a shaft 110 and a hub 120 disposed at the base end of the shaft 110. Figure 3 As shown, the treatment portion 200 includes an energy radiating portion 210 , a main body portion 220 , and an auxiliary member 230 .

[0060] In this embodiment, if Figure 1 As shown, the medical device 10 can be configured as a catheter device in which the guide portion 100 and the treatment portion 200 are integrally assembled.

[0061] <Guide>

[0062] The guide portion 100 has an inner cavity 113 (see Fig. 9 ) shaft 110. The shaft 110 can be inserted into the blood vessel V.

[0063] Figure 2 1 shows the shaft 110 in a natural state without external force applied. At least a portion of the front end portion of the shaft 110 extends in a direction around the axial direction of the shaft 110 in a natural state. It should be noted that the front end portion of the shaft 110 is the end of the shaft 110 located on the insertion direction side into the living body.

[0064] like Figure 2 , Figure 8 , Fig. 9 As shown, a first portion 115 a and a second portion 115 b are formed at the front end portion of the shaft 110 .

[0065] like Figure 8 , Fig. 9 As shown, the first portion 115a can abut against the inner wall Vai of the blood vessel V.

[0066] The second portion 115 b is disposed closer to the proximal end of the shaft 110 than the first portion 115 a .

[0067] like Figure 8 , Fig. 9 As shown, the second portion 115 b can abut against the inner wall Vai of the blood vessel V at a position different from the first portion 115 a in the cross section of the inner wall Vai of the blood vessel V.

[0068] In the present embodiment, a spiral portion 115 in which a part of the shaft 110 extends spirally is formed at the front end portion of the shaft 110 .

[0069] The first portion 115a and the second portion 115b are respectively formed by a part of the spiral portion 115. In the shaft 110 formed with the spiral portion 115, the first portion 115a and the second portion 115b can be defined by any portion of the spiral portion 115 in the extending direction and the circumferential direction.

[0070] The spiral portion 115 may have a shape in the counterclockwise direction as indicated by an arrow R with respect to a predetermined reference axis A. The reference axis A may be defined by a straight line extending parallel to a linearly extending base-side region 118 of the shaft 110 , for example.

[0071] The specific shape of the spiral portion 115 (for example, the pitch of the spiral, the number of turns, the outer diameter of the spiral, the winding direction of the spiral, etc.) is not particularly limited as long as the first part 115a and the second part 115b can abut the inner wall Vai of the blood vessel V when the shaft 110 is arranged in the blood vessel V.

[0072] When the shaft 110 is inserted into the blood vessel V, Figure 8 As shown, the portion from the first site 115a to the second site 115b is brought into continuous contact with the inner wall Vai of the blood vessel V.

[0073] As described above, the first to second parts 115a and 115b are formed by a part of the spiral portion 115. When inserted into the blood vessel V, the spiral portion 115 extends spirally in the blood vessel V and abuts against the inner wall Vai of the blood vessel V in a predetermined range in a row.

[0074] The first portion 115a and the second portion 115b included in the spiral portion 115 abut against the inner wall Vai of the blood vessel V at different positions in the extending direction of the blood vessel V. In addition, the first portion 115a and the second portion 115b abut against the inner wall Vai of the blood vessel V at different positions in the circumferential direction of the blood vessel V. In this way, the shaft 110 can arrange the first portion 115a and the second portion 115b at positions close to the inner wall Vai of the blood vessel V.

[0075] With the first site 115 a and the second site 115 b disposed in the blood vessel V as described above, the operator can selectively dispose the energy radiating section 210 at any site of the spiral section 115 by moving the energy radiating section 210 along the spiral section 115 .

[0076] Then, the operator can locally apply energy to the peripheral nerve Na from a position close to the inner wall Vai of the blood vessel V by radiating energy from the energy radiating section 210 while the energy radiating section 210 is disposed at an arbitrary position of the spiral section 115 .

[0077] It should be noted that when the spiral portion 115 is formed on the shaft 110, a portion of the shaft 110 has a three-dimensional shape. Therefore, the shaft 110 can ensure a larger contact area with the inner wall Vai of the blood vessel V. As a result, the shaft 110 is held more stably with respect to the blood vessel V.

[0078] In addition, when the spiral portion 115 is formed on the shaft 110, the energy radiating portion 210 can be arranged at any position in the extension direction of the blood vessel V and the circumferential direction of the blood vessel V within the range where the spiral portion 115 is formed (the portion from the first portion 115a to the second portion 115b). Therefore, energy can be applied to the peripheral nerve Na from a position close to the inner wall Vai of the blood vessel V in a simple and efficient manner.

[0079] The shaft 110 is pre-shaped. Figure 2 The shape shown is formed with a spiral portion 115 .

[0080] It should be noted that the shaft 110 may be configured to be substantially straight as a whole when introduced into a living body, and to be deformed into a straight shape when delivered to the blood vessel V. Figure 2 When the shaft 110 is configured in this way, for example, the deformation of the shaft 110 can be configured so that a member such as a guide wire W having higher rigidity than the shaft 110 passes through the entire length of the shaft 110, and the shaft 110 can be reversibly deformed into a straight shape and a shape having a spiral portion 115 by applying and releasing an operating physical force. In addition, when the shaft 110 is configured in this way, the inner cavity of the shaft 110 through which the treatment portion 200 passes can be provided in a guide wire lumen formed over the entire length of the shaft 110.

[0081] Alternatively, the shaft 110 may be configured such that, for example, a portion of the shaft 110 is formed of a temperature-responsive material that deforms in response to temperature changes, and the spiral portion 115 is formed by adjusting the temperature.

[0082] like Figure 2 , Figure 6 As shown, the shaft 110 has a bent portion 116 located closer to the base end than the second portion 115 b.

[0083] The bending portion 116 is configured so that a portion located on the distal end side of the shaft 110 relative to the bending portion 116 can be deflected relative to a portion located on the proximal end side of the shaft 110 relative to the bending portion 116 .

[0084] In the present embodiment, the curved portion 116 is formed in a shape in which a portion of the shaft 110 is bent back toward the base portion 118. The direction of the bent portion 116 is determined by Figure 2 Indicated by arrow C. It should be noted that the position where the curved portion 116 is provided on the shaft 110 and the specific shape (curving direction, curvature, length, etc.) of the curved portion 116 are not particularly limited.

[0085] like Figure 6 , Figure 7 As shown, the superior mesenteric artery Va, after branching from the aorta Vd, bends sharply toward the lower limb and is substantially parallel to the aorta Vd. Therefore, when treatment is performed using the medical device 10 from the lower limb side, it is not easy to deliver the medical device 10 into the superior mesenteric artery Va.

[0086] In the present embodiment, the curved portion 116 is formed on the shaft 110 at a position closer to the proximal end than the second portion 115b, so that the portion located at the distal end side of the shaft 110 can be deflected relative to the portion located at a position closer to the proximal end side of the shaft 110 than the curved portion 116. Therefore, even when approaching from the lower limb side via the aorta Vd, the portion located at the distal end side of the shaft 110 can be easily introduced into the superior mesenteric artery Va.

[0087] When the operator delivers the medical device 10 to the superior mesenteric artery Va from the lower limb side, for example, the operator can insert the medical device 10 into the femoral artery from the patient's groin area and move it to the aorta Vd. By adopting this route, the insertion length of the medical device 10 in the living body is shortened. Therefore, the operator can operate the medical device 10 relatively easily in the living body. It should be noted that in the operation using the medical device 10, when accessing the superior mesenteric artery Va from the lower limb side, the curved portion 116 can abut against the inner wall Vai of the blood vessel V located at a position around the starting part of the superior mesenteric artery Va. As a result, the holding force of the shaft 110 relative to the inner wall Vai of the blood vessel V can be improved.

[0088] like Figure 1 , Figure 2 As shown, the shaft 110 includes a distal side portion 117 disposed on the distal side of the first portion 115 a and a proximal side portion 118 disposed on the proximal side of the curved portion 116 .

[0089] like Figure 1 As shown, the front end portion 117 extends in a direction away from the base portion 118 in a natural state without external force. For example, a front end tip can be attached to the front end of the front end portion 117. The front end tip can be made of a flexible resin material, for example.

[0090] The base side part 118 extends substantially linearly. A hub 120 is attached to the base end of the base side part 118 .

[0091] like Figure 1 As shown, the hub 120 has a main body 220 (see Figure 3 ) An operating portion 121 that slides relative to the shaft 110.

[0092] The operation part 121 is mechanically connected to the treatment part 200 inserted into the inner cavity 113 of the shaft 110. The operation part 121 can be configured, for example, Figure 1 The rotation operation in the direction of arrows r1 - r2 causes the treatment portion 200 to slide in the inner cavity 113 of the shaft 110 .

[0093] It should be noted that the operation portion 121 may be moved forward and backward, and the treatment portion 200 may be slid in conjunction with the forward and backward movement, or may have a locking mechanism that fixes the position of the treatment portion 200 before and after the movement.

[0094] like Figure 3As shown, a filling member 114 can be arranged at the front end of the inner cavity 113 of the shaft 110. A space portion 113a that allows movement of the treatment portion 200 can be provided at the base end side of the filling member 114. The filling member 114 divides the area in which the treatment portion 200 is accommodated in the inner cavity 113 and the area in which the guide wire lumen 114a is formed in the inner cavity.

[0095] A guide wire lumen 114a through which a guide wire W can pass can be formed inside the filling member 114. The guide wire lumen 114a connects an arbitrary position of the front end side portion 117 located on the front end side of the shaft 110 with the front end opening 110a of the shaft 110. That is, the medical device 10 is configured as a single-track catheter device in which the guide wire lumen 114a is formed only on the front end side of the shaft 110.

[0096] The shaft 110 may be formed of a member having flexibility. The material used for the shaft 110 is not particularly limited, but for example, the same material as the resin material used for a known catheter device may be used.

[0097] The shaft 110 may be composed of a single-layer or multi-layer resin pipe member, or may be embedded with a braided wire to enhance rigidity. In addition, the outer surface of the shaft 110 may be coated with a hydrophilic coating or the like. In addition, the outer diameter, inner diameter, axial length, cross-sectional shape, etc. of the shaft 110 are not particularly limited. In addition, there are no particular restrictions on the material of the filling member 114 filled in the shaft 110, the axial length of the space 113a filled with the filling member 114, the axial length of the space 113a, the position, etc.

[0098] <Disposal Department>

[0099] like Figure 3 , Fig. 9 As shown, the treatment portion 200 includes: an energy radiating portion 210 that is capable of radiating energy that can reach the peripheral nerves Na located outside the blood vessel V when configured in the inner cavity 113 of the shaft 110; and a main body portion 220 in which the energy radiating portion 210 is configured at the front end and inserted into the inner cavity 113 of the shaft 110.

[0100] like Figure 6 , Figure 7 , Figure 8 As shown, in a state where at least a portion of the first portion 115 a of the shaft 110 is in contact with the inner wall Vai of the blood vessel V, the treatment portion 200 can move in the lumen 113 of the shaft 110 .

[0101] Figure 2 , Figure 3 The arrow f indicates the direction in which the treatment portion 200 advances along the lumen 113 of the shaft 110 . The arrow b indicates the direction in which the treatment portion 200 retreats along the lumen 113 of the shaft 110 .

[0102] The energy radiating unit 210 can radiate, for example, microwaves or ultrasonic waves.

[0103] When the energy radiating portion 210 can radiate microwaves, the energy radiating portion 210 may be formed of, for example, an antenna unit.

[0104] When the energy radiating unit 210 is constituted by an antenna unit, the energy radiating unit 210 may set the center frequency of the antenna unit to any one of 915 MHz, 2.45 GHz, 5.8 GHz, and 24.125 GHz, for example.

[0105] When the energy radiating section 210 can radiate ultrasonic waves, the energy radiating section 210 may be formed of, for example, an ultrasonic element.

[0106] The energy radiating unit 210 is not particularly limited in its specific structure, type of radiated energy, maximum energy output, etc., as long as it can radiate energy from the inner cavity 113 of the shaft 110 so that the energy reaches the peripheral nerves Na existing outside the blood vessel V and removes the nerves. However, the energy radiating unit 210 is preferably configured to radiate microwaves or ultrasonic waves in a manner that can more reliably remove the peripheral nerves Na existing outside the blood vessel V even when energy is applied without direct contact with the inner wall Vai of the blood vessel V.

[0107] For example, when the energy radiation part 210 is composed of an antenna unit, the main body 220 of the treatment part 200 can be composed of a known coaxial cable that can supply current to the antenna unit. It should be noted that the main body 220 can move in the inner cavity 113 when inserted into the inner cavity 113 of the shaft 110, and the specific structure is not particularly limited. The main body 220 can be composed of any structure corresponding to the structure of the energy radiation part 210.

[0108] Only one energy radiating portion 210 may be provided in the treatment portion 200. By providing only one energy radiating portion 210 in the treatment portion 200, the diameter of the main body portion 220 can be reduced. Furthermore, by reducing the diameter of the main body portion 220, the diameter of the inner cavity 113 of the shaft 110 into which the main body portion 220 is inserted can be reduced. Thus, the outer diameter of the shaft 110 can be reduced.

[0109] like Figure 3 As shown, the treatment section 200 includes an auxiliary member 230 disposed on the front end side of the energy radiation section 210 .

[0110] When the energy radiating portion 210 moves in the inner cavity 113 of the shaft 110 , the auxiliary member 230 assists the movement of the energy radiating portion 210 by sliding relative to the shaft 110 .

[0111] The auxiliary member 230 assists the movement of the energy radiating part 210 at the front end side of the energy radiating part 210. Therefore, the operator can smoothly move the energy radiating part 210 along the first portion 115a given a spiral shape. The auxiliary member 230 can be made of a resin material, for example. Figure 3 In other drawings, illustration of the auxiliary member 230 is omitted.

[0112] The space portion 113 a of the inner cavity 113 formed on the front end side of the auxiliary member 230 defines the movement amount of the treatment portion 200 and the forward limit position of the treatment portion 200 .

[0113] The treatment section 200 can advance to a position where it contacts the base end of the filling member 114 disposed at the front end side of the space portion 113a. Therefore, it is possible to prevent the treatment section 200 from being moved unnecessarily toward the front end side of the shaft 110. Therefore, the operator can easily move the energy radiating section 210 within the range where the spiral portion 115 is formed.

[0114] The energy radiation by the energy radiation unit 210 can be transmitted through, for example, Figure 1 The energy radiating unit 210 is controlled by a predetermined controller (control device) 300 shown in the figure. The controller 300 can be connected to the energy radiating unit 210 via an energy transmission mechanism such as a signal line or an electric wire derived from the hub 120, for example.

[0115] As the controller 300 , for example, a known control device including a CPU and a storage unit can be used.

[0116] The storage unit includes a ROM for storing various programs and data, a RAM for temporarily storing programs and data as a work area, a hard disk capable of storing various programs and data, and the like.

[0117] The storage unit can store a series of programs necessary for controlling the operation of the treatment unit 200 .

[0118] Examples of the form of sending action instructions to the treatment unit 200 include a wired method via an electrical communication line, a wireless method not via an electrical communication line, a form of sending based on input from a person performing surgery or the like via an operating unit incorporated into a controller, a form of sending based on input from an external communication mechanism prepared as a device different from the controller, etc. However, the specific form is not particularly limited.

[0119] Treatment using the energy radiating unit 210 (radiation of energy from the energy radiating unit 210, movement of the treatment unit 200 in the inner cavity 113 of the shaft 110, etc.) can be performed, for example, by a medical device such as a treatment robot that replaces the work performed by a surgeon. In this case, the treatment can be performed by the surgeon controlling the treatment robot at a medical site such as an operating room or by remotely controlling the treatment robot.

[0120] Will Figure 1 The system in which the medical device 10 and the controller 300 are combined can be provided as a medical system for performing denervation.

[0121] <Disposal method>

[0122] Next, an example of a treatment method using the medical device 10 is described. Hereinafter, an example of using the medical device 10 for a surgery in which energy is applied to peripheral nerves Na running around a blood vessel V (superior mesenteric artery Va) to block the peripheral nerves Na and thereby increase peristalsis of the intestine.

[0123] It should be noted that the treatment process described in this specification is only an example, and for example, a part of the process, a process not specifically described, medical instruments other than the medical device 10 used in the operation, etc., techniques known in the medical field may be appropriately adopted.

[0124] The treatment method of this embodiment is briefly described as follows: Figure 4 As shown, the method includes the steps of delivering the guide portion 100 and the treatment portion 200 into the blood vessel V (S11), bringing the first portion 115a and the second portion 115b of the shaft 110 into contact with the inner wall Vai of the blood vessel V (S12), moving the treatment portion 200 along the inner cavity 113 of the shaft 110 (S13), and radiating energy from the energy radiating portion 210 disposed in the inner cavity 113 of the shaft 110 (S14).

[0125] like Figure 6 As shown, the operator delivers the shaft 110 into which the treatment portion 200 is inserted to the blood vessel V. The operator can use the guide wire W (see Figure 3 ) delivers the shaft 110 to the blood vessel V.

[0126] The operator makes the first portion 115a and the second portion 115b formed at the front end of the shaft 110 contact the inner wall Vai of the blood vessel V. The operator can hold the shaft 110 relative to the blood vessel V by making the first portion 115a and the second portion 115b contact the inner wall Vai of the blood vessel V. Figure 8 , Fig. 9As shown, the operator can place the energy radiating section 210 close to the inner wall Vai of the blood vessel V by placing the energy radiating section 210 in the spiral section 115 including the first section 115 a and the second section 115 b .

[0127] The operator radiates energy from the energy radiating unit 210 disposed in the lumen 113 of the shaft 110 while the first and second sites 115a and 115b are in contact with the inner wall Vai of the blood vessel V. The operator can locally apply energy to a predetermined treatment target site S.

[0128] The operator can apply energy to different sites in the extending direction of the blood vessel V and different sites in the circumferential direction of the blood vessel V by appropriately moving the treatment portion 200 along the spiral portion 115 during one operation.

[0129] The range (range of denervation) in which the operator applies energy to the periphery of the starting portion of the superior mesenteric artery Va can be set, for example, to be less than 50% in the peripheral direction of the superior mesenteric artery Va (less than 180° in the circumferential direction on the cross section of the blood vessel V). If the range of denervation is more than 50% in the peripheral direction of the superior mesenteric artery Va, hyperperistalsis after denervation may be excessively promoted. Therefore, it is preferable to denervate within the above range.

[0130] As described above, according to the medical device 10 and the treatment method of the present embodiment, the first portion 115a and the second portion 115b formed on the shaft 110 of the guide portion 100 are brought into contact with the inner wall Vai of the blood vessel V, thereby making it possible to hold the shaft 110 relative to the blood vessel V. While holding the shaft 110 relative to the blood vessel V, the operator moves the treatment portion 200 along the lumen 113 of the shaft 110 to dispose the energy radiating portion 210 of the treatment portion 200 at a position close to the inner wall Vai of the blood vessel V, thereby locally irradiating energy to the treatment target site S. Therefore, denervation can be performed more reliably while suppressing the energy radiated from the energy radiating portion 210 to a low level.

[0131] Next, a modification of the above-mentioned embodiment will be described. In the description of the modification, components, handling procedures, etc. that have already been described are appropriately omitted. In addition, the contents not particularly described in the modification are considered to be the same as those in the above-mentioned embodiment.

[0132] <Modification 1>

[0133] Fig.10 A medical device 10A according to Modification 1 is shown.

[0134] like Fig.10 As shown, the guide portion 100A and the treatment portion 200A of the medical device 10A are composed of separate catheter devices.

[0135] When performing treatment using the medical device 10A, the operator inserts the energy radiating portion 210 and the main body 220 of the treatment portion 200A into the inner cavity 113 of the shaft 110A. The operator radiates energy from the energy radiating portion 210 disposed in the inner cavity 113 of the shaft 110A, while the first portion 115a of the shaft 110 and the second portion 115b of the shaft 110A are in contact with the inner wall Vai of the blood vessel V, similarly to the process described in the aforementioned embodiment, thereby being able to locally apply energy to the treatment target site S.

[0136] It should be noted that the guide portion 100A and the treatment portion 200A described in this modification may each independently constitute a medical device used in an operation for removing the peripheral nerve Na existing outside the blood vessel V by radiating energy from the blood vessel V. That is, the guide portion 100A may be constituted as a guide device, and the treatment portion 200A may be constituted as a treatment device.

[0137] <Modification 2>

[0138] Fig.11 A medical device 10B according to a second modification is shown. Fig.12 and Fig.13 An example of a treatment method using the medical device 10B of Modification 2 is schematically shown. Fig.13 It is along Fig.12 A transverse cross-sectional view of the blood vessel V is shown along arrow 13A-13A.

[0139] The medical device 10 of the above-mentioned embodiment has a spiral portion 115 formed at the front end portion of the shaft 110 of the guide portion 100 (see Figure 2 ) On the other hand, the spiral portion 115 is not formed on the shaft 110B included in the guide portion 100B of the medical device 10B of the second modification.

[0140] like Fig.11 As shown, the front end portion of the shaft 110B in the second modification is given a shape bent in a direction intersecting the axial direction of the shaft 110B.

[0141] like Fig.12 As shown, the front end of the shaft 110B forms a first portion 115 a that can abut against the inner wall Vai of the blood vessel V.

[0142] The top of the curve disposed at a position closer to the proximal end side of the shaft 110B than the first portion 115 a forms a second portion 115 b that can come into contact with the inner wall Vai of the blood vessel V.

[0143] In treatment using the medical device 10B of Modification 2, as Fig.12As shown, the operator can arrange the first portion 115a and the second portion 115b so as to make point contact with the inner wall Vai of the blood vessel V.

[0144] The first portion 115 a and the second portion 115 b abut against the inner wall Vai of the blood vessel V at different positions in the extending direction of the blood vessel V.

[0145] like Fig.12 , Fig.13 As shown, an angle of 180° is provided between the first portion 115a and the second portion 115b along the circumferential direction of the blood vessel V. Therefore, the first portion 115a and the second portion 115b can be arranged at opposing positions sandwiching the center OA on the cross section of the blood vessel V therebetween.

[0146] It should be noted that the angle between the first portion 115a and the second portion 115b is not particularly limited as long as the first portion 115a and the second portion 115b can be arranged at different positions of the cross section of the blood vessel V. That is, the angle between the first portion 115a and the second portion 115b can be an angle other than 180°.

[0147] like Fig.11 , Fig.12 As shown, the surgeon can arrange the portion 119a formed between the first portion 115a and the second portion 115b on the shaft 110B and the portion 119b formed on the shaft 110B closer to the base end than the second portion 115b so as not to abut against the inner wall Vai of the blood vessel V.

[0148] The operator disposes the energy radiating section 210 at the first portion 115a abutting against the inner wall Vai of the blood vessel V, thereby making the energy radiating section 210 close to the inner wall Vai of the blood vessel V. The operator radiates energy from the energy radiating section 210 close to the inner wall Vai of the blood vessel V, thereby locally applying energy to the treatment target site S.

[0149] Furthermore, the operator can place the energy radiating section 210 close to the inner wall Vai of the blood vessel V by placing the energy radiating section 210 at the second site 115 b that contacts the inner wall Vai of the blood vessel V. As a result, the operator can place the energy radiating section 210 close to the inner wall Vai of the blood vessel V.

[0150] like Fig.12 and Fig.13As shown, the second part 115b is arranged at a position different from the first part 115a in the extension direction of the blood vessel V and the circumferential direction of the blood vessel V. Therefore, the operator can apply energy to a part different from the part where the first part 115a is arranged in the extension direction of the blood vessel V and the circumferential direction of the blood vessel V by radiating energy from the energy radiating part 210 arranged in the second part 115b. The operator can locally apply energy to the treatment target part S by radiating energy from the energy radiating part 210 arranged in the second part 115b, similarly to the case of radiating energy from the energy radiating part 210 arranged in the first part 115a.

[0151] In the medical device 10B of the second modification, the first portion 115a and the second portion 115b formed on the shaft 110B of the guide portion 100B are configured to make point contact with the inner wall Vai of the blood vessel V. Therefore, when the first portion 115a and the second portion 115b are brought into contact with the inner wall Vai of the blood vessel V, the burden on the blood vessel V can be reduced.

[0152] It should be noted that the curvature of the portion forming the first portion 115a and the second portion 115b on the shaft 110B, the axial distance between the first portion 115a and the second portion 115b, etc. are not particularly limited and may be arbitrarily changed.

[0153] <Variation 3>

[0154] Fig.14 A medical device 10C according to a third modification is shown. Fig.15 and Fig.16 An example of a treatment method using the medical device 10C of Modification 3 is schematically shown. Fig.16 It is along Fig.15 A transverse cross-sectional view of the blood vessel V is shown along arrows 16A-16A.

[0155] The medical device 10C of Modification 3 is similar to the medical device 10B of Modification 2, wherein the first portion 115a and the second portion 115b are configured to make point contact with the inner wall Vai of the blood vessel V. The medical device 10C also includes a third portion 115c formed closer to the proximal end of the shaft 110C than the second portion 115b.

[0156] The portions of the shaft 110C where the first portion 115a, the second portion 115b, and the third portion 115c are formed are bent relative to the axial direction of the shaft 110C. Therefore, the shaft 110C has a sawtooth shape that is bent multiple times relative to the axial direction of the shaft 110C.

[0157] like Fig.15 and Fig.16As shown, the operator can make the first portion 115a, the second portion 115b, and the third portion 115c respectively contact the inner wall Vai of the blood vessel V. The operator can make the energy radiating portion 210 close to the inner wall Vai of the blood vessel V by arranging the energy radiating portion 210 at the first portion 115a, the second portion 115b, and the third portion 115c.

[0158] The operator can arrange the portion 119c formed between the first portion 115a and the front end side portion 117, the portion 119d formed between the first portion 115a and the second portion 115b, the portion 119e formed between the second portion 115b and the third portion 115c, and the portion 119f formed between the third portion 115c and the base side portion 118 in a manner that does not abut against the inner wall Vai of the blood vessel V.

[0159] In the medical device 10C of the third modification, the first portion 115a, the second portion 115b, and the third portion 115c formed on the shaft 110C of the guide portion 100C are configured to make point contact with the inner wall Vai of the blood vessel V. Therefore, when the first portion 115a, the second portion 115b, and the third portion 115c are brought into contact with the inner wall Vai of the blood vessel V, the burden on the blood vessel V can be reduced.

[0160] It should be noted that the curvature of the parts forming the first part 115a, the second part 115b and the third part 115c on the shaft 110C, the axial distance between the parts 115a, 115b, 115c, the number of curved parts forming a sawtooth shape, etc. are not particularly limited and can be changed arbitrarily.

[0161] <Variation 4>

[0162] Fig.17 A medical device 10D according to a fourth modification is shown. Fig.18 and Fig.19 An example of a treatment method using the medical device 10D of Modification 4 is schematically shown. Fig.19 It is along Fig.18 A transverse cross-sectional view of the blood vessel V is shown along arrows 19A-19A.

[0163] A shaft 110D included in a guide portion 100D of a medical device 10D according to Modification 4 includes an intermediate portion 119 disposed between the first portion 115 a and the second portion 115 b .

[0164] The intermediate portion 119 is bent from the distal end side of the shaft 110D toward the proximal end side of the shaft 110D.

[0165] The portion of the shaft 110D where the first portion 115a is formed and its surrounding portion extend substantially linearly. Also, the portion of the shaft 110D where the second portion 115b is formed and its surrounding portion extend substantially linearly.

[0166] like Fig.18 and Fig.19 As shown, the operator can make the first portion 115a and the second portion 115b contact the inner wall Vai of the blood vessel V. The operator can make the energy radiating portion 210 close to the inner wall Vai of the blood vessel V by arranging the energy radiating portion 210 at the first portion 115a and the second portion 115b.

[0167] The operator can arrange the shaft 110D so that the intermediate portion 119 does not come into contact with the inner wall Vai of the blood vessel V.

[0168] In the medical device 10D of the modification example 4, the first part 115a and the second part 115b formed on the shaft 110D extend in a substantially straight line. Therefore, when the operator arranges the shaft 110D on the blood vessel V, the first part 115a and the second part 115b can be brought into contact with each other over a relatively long range along the extending direction of the blood vessel V. Thus, the operator can increase the holding force of the shaft 110D with respect to the inner wall Vai of the blood vessel V. In addition, the operator can locally apply energy to the treatment target site S by radiating energy from the energy radiating portion 210 arranged on the first part 115a and the second part 115b.

[0169] It should be noted that the axial length of the portion forming the first portion 115a and the second portion 115b on the shaft 110D, the curvature of the middle portion 119, etc. are not particularly limited and can be changed arbitrarily. In addition, the first portion 115a and the second portion 115b may not extend in a straight line. For example, the first portion 115a and the second portion 115b may not be arranged at positions opposite to each other.

[0170] <Variation 5>

[0171] Fig. 20 An example of a treatment method using the medical device 10E according to the fifth modification is shown.

[0172] In the aforementioned embodiment, a blood vessel V (superior mesenteric artery Va) is exemplified as a biological organ to be treated by the medical device 10. However, the biological organ to be treated by the medical device is not limited to a blood vessel, and may be a bile duct, a trachea, an esophagus, a urethra, an ear and nose cavity, etc. As an example, the medical device radiates energy from an energy radiating portion disposed in the renal artery, thereby being able to apply energy to the sympathetic nerves present in the adventitia of the patient's renal artery, thereby being configured as a device for lowering the patient's blood pressure. In addition, as another example, the medical device may also radiate energy from an energy radiating portion disposed in the bronchus, thereby being configured as a device for dilating the patient's bronchi.

[0173] Fig. 20 1 shows an example in which the medical device 10E is used for treatment of the pulmonary vein O. The first portion 115a and the second portion 115b of the shaft 110E provided in the guide portion 100E of the medical device 10E can contact the inner wall Oi of the pulmonary vein O. The operator can locally apply energy by radiating energy from the energy radiating portion 210 disposed on the first portion 115a and the second portion 115b of the shaft 110E. Thus, treatment and recovery of diseases such as atrial fibrillation can be achieved.

[0174] As mentioned above, the medical device and the treatment method of the present invention have been described by using the embodiments, but the present invention is not limited to the contents described in the specification, and appropriate changes can be made based on the description of the claims.

[0175] The medical device only needs to include a guide part and a treatment part, the guide part includes a shaft formed with a first part and a second part, and the treatment part can be inserted into the inner cavity of the guide part, and the specific structure is not limited. For example, the material, shape, size, arrangement, connection structure of each component of the guide part and the treatment part, etc. are not particularly limited as long as they can exert the effect of the present invention, and can be arbitrarily changed and replaced.

[0176] In addition, the medical device may appropriately add any components not specifically described in the specification, or appropriately omit any additional components described in the specification. In addition, the treatment method may appropriately add any process not specifically described in the specification, or appropriately omit any additional process described in the specification. In addition, the treatment method may appropriately change the order of the process as long as it can exert the effect of the invention.

[0177] Explanation of symbols:

[0178] 10, 10A, 10B, 10C, 10D, 10E medical equipment

[0179] 100, 100A, 100B, 100C, 100D, 100E guide part

[0180] 110, 110A, 110B, 110C, 110D, 110E shaft

[0181] 110a Front end opening of the shaft

[0182] 113 shaft inner cavity

[0183] 113a Space Department

[0184] 114 Filling components

[0185] 114a Guide wire lumen

[0186] 115 spiral part

[0187] 115a The first part

[0188] 115b Second part

[0189] 115c Third part

[0190] 116 bending part

[0191] 117 front end side

[0192] 118 base side part

[0193] 119 Middle

[0194] 120 Hub

[0195] 121 Operation Department

[0196] 200, 200A Disposal Department

[0197] 210 Energy Radiation Department

[0198] 220 Main body

[0199] 230 auxiliary components

[0200] 300 Controller

[0201] A reference axis

[0202] W Guide Wire

[0203] Na peripheral nerves (extravascular nerves)

[0204] S Treatment target area

[0205] V Blood vessel (biological lumen)

[0206] Va superior mesenteric artery

[0207] Vai inner wall

[0208] Vb celiac artery

[0209] Vc inferior mesenteric artery

[0210] Vd aorta

[0211] O Pulmonary vein

[0212] OiThe inner wall of the pulmonary vein

Claims

1. A medical device, wherein: The medical device has: A guide portion having a shaft having an inner lumen and capable of being inserted into a living body organ; as well as a treatment portion including an energy radiating portion which, when arranged in the inner cavity of the shaft, can radiate energy that can reach peripheral nerves existing outside the living organ, The front end of the shaft is formed with: A first portion capable of abutting against an inner wall of the biological organ; as well as a second portion disposed at a position closer to the base end of the shaft than the first portion and capable of contacting the inner wall of the living organ at a position different from that of the first portion in a cross section of the inner wall of the living organ, The first portion and the second portion are each formed by a portion of a spiral portion that spirally extends from a portion of the front end portion of the shaft. The treatment portion is movable in the inner cavity of the shaft in a state where at least a portion of the first portion and at least a portion of the second portion are in contact with the inner wall of the biological organ. The shaft has a curved portion located at a position closer to the base end than the spiral portion and outside the spiral portion, The bending portion is configured so that a portion located closer to the distal end of the shaft than the bending portion is deflected relative to a portion located closer to the proximal end of the shaft than the bending portion. The bent portion has a shape in which a portion of the shaft is bent so as to be folded back toward a portion on the base end side.

2. The medical device according to claim 1, wherein: The shaft is configured such that a portion from the first portion to the second portion is in continuous contact with an inner wall of the living organ.

3. The medical device according to claim 1, wherein: The shaft is configured so that the first portion and the second portion are in point contact with the inner wall of the biological organ, respectively.

4. The medical device according to claim 3, wherein: A sawtooth shape is formed at the front end portion of the shaft by the first portion and the second portion.

5. The medical device according to claim 1, wherein: The medical device includes an intermediate portion that is disposed between the first portion and the second portion and that curves from a distal end side of the shaft toward a proximal end side of the shaft.

6. The medical device according to any one of claims 1 to 5, wherein: The guide portion includes the shaft and a hub disposed at a base end portion of the shaft. The treatment portion includes the energy radiating portion and a main body portion, wherein the main body portion has the energy radiating portion disposed at a distal end portion and is inserted into the inner cavity of the shaft. The guide portion and the treatment portion constitute a catheter device in a state where they are integrally assembled.

7. The medical device according to any one of claims 1 to 5, wherein: The biological organ is at least one blood vessel selected from the group consisting of the superior mesenteric artery, the celiac artery, and the inferior mesenteric artery. The energy radiated from the energy radiating unit is applied to peripheral nerves innervating the intestine to reduce the activity of the autonomic nerves, thereby enhancing the peristaltic movement of the intestine, wherein the energy radiating unit is arranged in the inner cavity of the axis arranged in the blood vessel.

8. The medical device according to any one of claims 1 to 5, wherein: The energy radiating unit can radiate microwaves or ultrasonic waves.

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