Light irradiation medical device

Abstract

The present application provides a kind of light irradiation medical device (1), it has: shaft (2), the shaft (2) has the 1st end and the 2nd end in the long axis direction (x), and have the inner cavity (5) extending along long axis direction (x);And light guide device (20), the light guide device (20) is configured to the inner cavity (5) of shaft (2), and can be moved along long axis direction (x), light guide device (20) extends along long axis direction (x), light guide device (20) has light diffusion part (21) in its distal part, shaft (2) has the 1st window (11) of the peripheral wall (6) being arranged in its distal part, and the 2nd window (12) being arranged in the distal end surface (7) of shaft (2), shaft (2) has reflective surface (8) on the distal side than the 1st window (11) and on the inner side of shaft (2), the reflective surface (8) is reflected to the light (50) that is emitted from light guide device (20).

Description

TECHNICAL FIELD

[0001] The present application relates to a light irradiation medical device for irradiating light to a tissue such as a cancer cell in a lumen in a blood vessel, a digestive tract, or the like in a living body. BACKGROUND

[0002] In photodynamic therapy (PDT), a photosensitizer is injected into a living body by intravenous injection or intraperitoneal administration, the photosensitizer is aggregated in a target tissue such as a cancer cell, and the photosensitizer is excited by irradiation of light of a specific wavelength. Energy conversion occurs when the excited photosensitizer returns to a ground state, thereby generating a reactive oxygen species. The target tissue is removed by attack of the reactive oxygen species. In ablation using a laser, a laser is irradiated to a target tissue, and cauterization is performed. A device for performing such light irradiation has been proposed.

[0003] In Patent Literature 1, an endoscope system having an insertion section, an illumination light irradiation section, a treatment light irradiation section, and a light receiving section is disclosed. The insertion section is formed in a cylindrical shape that can be inserted into a body lumen of an object. In the treatment light irradiation section, the treatment light is simultaneously irradiated to a substantially tubular region on the side or front of the distal end section.

[0004] In Patent Literature 2, a light probe having a probe outer cylinder, a light waveguide member, a first irradiation section, and a second irradiation section is disclosed. The light waveguide member waveguides a first light and a second light disposed in the axial direction of the probe outer cylinder to the inside space of the probe outer cylinder. When the first light and the second light are simultaneously emitted from the light waveguide member, the first irradiation section and the second irradiation section respectively irradiate the first light and the second light to different parts on an irradiation object.

[0005] Patent Literature 1: Japanese Patent Application Publication No. 2014-104138

[0006] Patent Literature 2: Japanese Patent Application Publication No. 2008-125939

[0007] As described in Patent Literatures 1 and 2, there are a side irradiation type and a front irradiation type of light irradiation devices, which are separately used depending on the site of tumor generation and the shape. However, in actual surgery, there are cases where the irradiation direction needs to be switched, such as after irradiation to the side, irradiation to the front. In a case where the irradiation direction is to be switched, the device must be replaced each time, and there is a concern that this causes elongation of surgery and a burden on the surgical operator or the patient. Therefore, an object of the present application is to provide a light irradiation medical device that contributes to the efficiency of surgery. SUMMARY

[0008] An embodiment of the light irradiation medical device of the present application capable of achieving the above object is characterized by comprising: a shaft having a first end and a second end in a longitudinal direction and having an inner cavity extending in the longitudinal direction; and a light guide device disposed in the inner cavity of the shaft and capable of moving in the longitudinal direction of the shaft, the light guide device extending in the longitudinal direction of the shaft, the light guide device having a light diffusion portion at a distal portion thereof, the shaft having a first window provided to a peripheral wall of the distal portion thereof and a second window provided to a distal end surface of the shaft, the shaft having a reflection surface on a distal side of the first window and on an inner side of the shaft, the reflection surface reflecting light emitted from the light guide device. According to the above light irradiation medical device, by moving the light guide device in the longitudinal direction of the shaft, it is possible to switch the direction of irradiation of light. Replacement of a device for switching the direction of irradiation is not necessary, and thus it is possible to contribute to the efficiency of surgery. For example, it is preferable that, if the light guide device is moved so that the light diffusion portion overlaps the first window, light emitted from the light guide device passes through the first window, and if the light guide device is moved so that the light diffusion portion overlaps the reflection surface, light emitted from the light guide device passes through the second window.

[0009] In the longitudinal direction of the shaft, the first window can also be longer than the light diffusion portion. The first window can also be disposed over the entire circumference of the shaft. In the first window, a transparent member through which light emitted from the light guide device passes can also be disposed.

[0010] In the longitudinal direction of the shaft, the reflection surface can also be disposed in a range longer than the light diffusion portion. The reflection surface can also be disposed over the entire circumference of the shaft. The shaft can also have a reduced diameter portion in which the inner diameter of the shaft is reduced toward the first window on the distal side of the first window, and the reflection surface can be disposed in the reduced diameter portion. The reflection surface can also be disposed in the entire range on the distal side of the proximal end of the reduced diameter portion in the shaft.

[0011] The shaft can also have a small diameter portion on the distal side of the first window, the small diameter portion being configured to have an inner diameter smaller than the smallest inner diameter of the shaft in the range having the first window and to be in contact with the light guide device in a state in which the light guide device is capable of moving in the longitudinal direction of the shaft.

[0012] A lens that converges light emitted from the light guide device can also be provided at the distal end portion of the inner cavity of the shaft. The light guide device can also have a position display portion that indicates the position of the light guide device with respect to the shaft at the proximal end portion thereof.

[0013] An expansion portion that expands toward the radial outer side of the shaft can also be provided at the distal portion of the shaft. The expansion portion can be a balloon, a basket provided with a plurality of elastic wires, or a self-expanding stent.

[0014] According to the above light irradiation medical device, by moving the light guide device in the longitudinal direction of the shaft, it is possible to switch the direction of irradiation of light. Replacement of a device for switching the direction of irradiation is not necessary, and thus it is possible to contribute to the efficiency of surgery. BRIEF DESCRIPTION OF DRAWINGS

[0015] Figure 1 is a side view of a light irradiation medical device according to an embodiment of the present application.

[0016] Figure 2 is a cross-sectional view of a distal side of the light irradiation medical device shown in Figure 1

[0017] is a III-III cross-sectional view of the light irradiation medical device shown in Figure 3 Figure 2 is a IV-IV cross-sectional view of the light irradiation medical device shown in

[0018] Figure 4 Figure 2 is a V-V cross-sectional view of the light irradiation medical device shown in

[0019] Figure 5 is a cross-sectional view of a distal side of the light irradiation medical device shown in Figure 2

[0020] Figure 6 is a cross-sectional view of a distal side of the light irradiation medical device shown in Figure 1

[0021] is a cross-sectional view of a modification of the light diffusion section shown in Figure 7 Figure 2 is a side view of a modification of the light irradiation medical device shown in

[0022] Figure 8 Figure 1 is a side view of a modification of the light irradiation medical device shown in

[0023] Figure 9 is a cross-sectional view of a modification of the shaft shown in Figure 2

[0024] is a cross-sectional view of a modification of the light irradiation medical device shown in Figure 10 Figure 2 is a front view of a valve shown in

[0025] Figure 11 Figure 10 is a cross-sectional view of a modification of the light irradiation medical device shown in

[0026] Figure 12 is a cross-sectional view of a modification of the light irradiation medical device shown in Figure 2

[0027] is a cross-sectional view (partial side view) of a modification of the light irradiation medical device shown in Figure 13 Figure 2 is a cross-sectional view (partial side view) of a modification of the light irradiation medical device shown in

[0028] Figure 14 Figure 2 ​​​​​​​​​A cross-sectional view of a modification of the light irradiation medical device shown. DETAILED DESCRIPTION

[0029] Hereinafter, the present application will be described more specifically based on the following embodiments, but the present application is of course not limited to the following embodiments, and can of course be appropriately changed to be implemented within a range that can conform to the gist described above and later, and these are included in the technical scope of the present application. Further, in each drawing, there are cases where hatching, component reference numerals, and the like are omitted for convenience, in which case, the description, other drawings are referred to. In addition, the dimensions of various components in the drawings are premised on facilitating the understanding of the features of the present application, and thus there are cases where the dimensions differ from actual dimensions.

[0030] One embodiment of the light irradiation medical device of the present application is characterized by comprising: a shaft having a first end and a second end in a long axis direction, and having an inner cavity extending in the long axis direction; and a light guide device disposed in the inner cavity of the shaft and movable in the long axis direction of the shaft, the light guide device extending in the long axis direction of the shaft, the light guide device having a light diffusion portion at a distal portion thereof, the shaft having a first window provided to a peripheral wall of the distal portion thereof, and a second window provided to a distal end surface of the shaft, the shaft having a reflection surface on the inner side thereof on the distal side from the first window, the reflection surface reflecting light emitted from the light guide device. According to the above-described light irradiation medical device, by moving the light guide device in the long axis direction of the shaft, it is possible to switch the irradiation direction of light. Replacement of the device for switching the irradiation direction is not necessary, and thus it is possible to contribute to the efficiency of surgery.

[0031] The light irradiation medical device is used for irradiating light of a specific wavelength to a treatment site of a target tissue such as a cancer cell in a blood vessel, a digestive tract, or the like in PDT, photodynamic therapy. The light irradiation medical device can be delivered to the treatment site alone, or can be used together with a catheter or an endoscope for delivery. In treatment using an endoscope, the light irradiation medical device is disposed in the body through a forceps channel of the endoscope, and is delivered to the treatment site.

[0032] REFERENCE Figures 1-6 The basic structure of the device will be described. Figure 1 is a side view of the light irradiation medical device of one embodiment of the present application. Figure 2 and Figure 6 is a cross-sectional view of the distal side of the light irradiation medical device shown in Figure 1 Figure 3 is a III-III cross-sectional view of the light irradiation medical device shown in Figure 2 Figure 4 is a IV-IV cross-sectional view of the light irradiation medical device shown in Figure 2 Figure 5 is a cross-sectional view of the distal side of the light irradiation medical device shown in Figure 2 ​​​A V-V sectional view of the light irradiation medical device is shown. Figure 2 A state in which the light guide device 20 is moved so that the light diffusion portion 21 of the light guide device 20 corresponds to the first window 11 is shown, Figure 6 A state in which the light guide device 20 is moved so that the light diffusion portion 21 is located at a position farther than the first window 11 is shown. The light irradiation medical device 1 is provided with a shaft 2 and the light guide device 20. Hereinafter, there are cases in which the light irradiation medical device 1 is simply referred to as the device 1.

[0033] In the present application, the distal side of the device 1 refers to the first end side of the long axis direction x of the shaft 2, that is, the side of the subject. The proximal side of the device 1 refers to the second end side of the long axis direction x of the shaft 2, that is, the side of the hand of the user. There are cases in which the proximal side of each component after being bisected in the long axis direction thereof is referred to as the proximal portion, and the distal side is referred to as the distal portion.

[0034] The shaft 2 has a long axis direction x, a radial direction y, and a circumferential direction p. The shaft 2 has a first end and a second end in the long axis direction x, and has an inner lumen 5 extending in the long axis direction x. The first end can correspond to the distal end of the shaft 2, and the second end can correspond to the proximal end of the shaft 2. In order to arrange the light guide device 20 in the inner lumen 5, the shaft 2 has a cylindrical shape. Since the shaft 2 is inserted into the body, it is preferable to have flexibility. Furthermore, in the radial direction y of the shaft 2, the inner side refers to the direction toward the long axis center of the shaft 2, and the outer side refers to the radial direction opposite to the inner side.

[0035] The shaft 2 is a hollow body formed by arranging one or a plurality of wires in a predetermined pattern, a component in which at least either the inner side surface or the outer side surface of the above-mentioned hollow body is coated with resin, a resin tube, or a component in which these are combined, and for example, a component in which these are connected in the long axis direction x can be cited. As the hollow body formed by arranging the wires in a predetermined pattern, a cylindrical body having a mesh structure by simply crossing or braiding the wires, a coil formed by winding the wires can be shown. The wire can be one or a plurality of single wires, or one or a plurality of stranded wires. The resin tube can be manufactured by, for example, extrusion molding. In the case where the shaft 2 is a resin tube, the shaft 2 can be composed of a single layer or a plurality of layers. The shaft 2 can also be configured so that a part of the long axis direction x or the circumferential direction p is composed of a single layer, and the other part is composed of a plurality of layers. For example, as shown in Figure 2 and Figure 5 As shown in Figure 1 As shown in

[0036] Shaft 2 can be made of synthetic resins such as polyolefin resins (e.g., polyethylene, polypropylene), polyamide resins (e.g., nylon), polyester resins (e.g., PET), aromatic polyetherketone resins (e.g., PEEK), polyether polyamide resins, polyurethane resins, polyimide resins, and fluoropolymers (e.g., PTFE, PFA, ETFE), or metals such as stainless steel, carbon steel, and nickel-titanium alloys. They can be used individually or in combination of two or more. The body 3 of shaft 2 is preferably made of any of the aforementioned synthetic resins.

[0037] like Figure 2 As shown, a first window 11 is provided on the peripheral wall 6 of the distal portion of shaft 2. Additionally, a second window 12 is provided on the distal end face 7 of shaft 2. Shaft 2 has a reflective surface 8 on its inner side, more distal than the first window 11, which reflects light emitted from the light guide device 20. According to device 1, the irradiation direction of light 50 can be switched by moving the light guide device 20 in the long axis direction x. Replacement of the device for switching the irradiation direction is not necessary, thus contributing to the efficiency of the surgery.

[0038] like Figure 2 As shown, if the light guide device 20 is moved so that the light diffuser 21 overlaps with the first window 11, the light 50 emitted from the light guide device 20 can also pass through the first window 11. Therefore, light 50 can be incident laterally through the first window 11. Figure 6 As shown, if the light guide device 20 is moved so that the light diffusion section 21 overlaps with the reflective surface 8, the light 50 emitted from the light guide device 20 can also pass through the second window 12. Thus, the light 50 can be irradiated forward, i.e., in a far-field direction, through the second window 12.

[0039] When irradiating to the side, it is preferable to move the light guide device 20 so that the light diffuser 21 overlaps with at least a portion of the first window 11 in the long axis direction x. When irradiating forward, it is preferable to move the light guide device 20 so that the distal end of the light diffuser 21 is located further away from the proximal end of the reflective surface 8, and more preferably, the light guide device 20 is moved so that the proximal end of the light diffuser 21 is located further away from the proximal end of the reflective surface 8.

[0040] The light guide device 20 is disposed within the cavity 5 of the shaft 2 and is movable along the long axis direction x. The light guide device 20 extends along the long axis direction x and has a light diffusion section 21 at its distal end. A connector 22 disposed at the proximal end of the light guide device 20 is connected to a light source such as a semiconductor laser.

[0041] The first therapeutic ray can be emitted from the light guide device 20. In addition to the first ray, a second ray for targeting can also be emitted.

[0042] The first light is preferably laser light of a wavelength suitable for light treatment such as PDT, PIT, which irradiates the tissue in the body. The wavelength of the first light can be, for example, 0.64 μm or more, 0.65 μm or more, or 0.66 μm or more, and can also be 0.72 μm or less, 0.71 μm or less, or 0.7 μm or less.

[0043] The second light is light emitted in order to grasp the treatment site before the first light is emitted, and is preferably lower in radiant energy than the first light. The second light is preferably higher in relative visibility than the first light, and the wavelength of the second light is preferably in the range of 0.55 μm to 0.56 μm, for example.

[0044] The first light and the second light can be emitted from one light source, or the first light and the second light can be emitted from different light sources.

[0045] In the Figure 2 , the light guide device 20 has an optical fiber 23 extending in the long axis direction x. The optical fiber 23 is a transmission path that transmits an optical signal to the subject tissue. In the Figure 2 , the optical fiber 23 has a core 24 and a cladding 25 that covers the radial outer side of the core 24, and has a cladding-removed portion 26 at a part of the distal end portion of the core 24. Hereinafter, there are cases where the cladding-removed portion 26 is simply referred to as the portion 26. The portion 26 is a portion where the cladding 25 is not present at least in a part of the circumferential direction of the core 24, but the cladding 25 can not be present in the entire circumferential direction of the core 24. In the Figure 2 , the portion 26 is a light emitting region and functions as a light diffusing portion 21. By providing the portion 26, it is possible to irradiate light to the side through the first window 11.

[0046] The material that constitutes the core 24 and the cladding 25 is not particularly limited, and plastic, quartz glass, fluoride glass, or the like can be used.

[0047] In the long axis direction x, the portion 26 is preferably provided at a part of the core 24 that includes the distal end 24a. Thereby, it is easy to form the portion 26, and it is also possible to improve the flexibility at the distal end portion of the light guide device 20.

[0048] As shown in Figure 2 , the position of the distal end 26a of the portion 26 is preferably coincident with the position of the distal end 24a of the core 24. Thereby, it is not necessary to form the portion 26 while leaving the cladding 25 at a part that includes the distal end of the optical fiber 23, which is a difficult process, and thus it is possible to make the process of forming the light emitting region of the optical fiber 23 easy.

[0049] The portion 26 can be formed by etching or polishing to peel the cladding layer 25. In order to improve light diffusivity, a concavo-convex can also be provided on the surface of the portion 26. The concavo-convex can be formed by roughening the surface of the portion 26 mechanically or chemically. As a method of roughening the surface, for example, a method using etching processing, sandblasting processing, a scribe needle, a wire brush, or sandpaper can be listed.

[0050] Figure 7 is a sectional view of a modification of the light guide device 20 shown in Figure 2 As shown in Figure 7 The light guide device 20 can also have an optical fiber 23, and a diffusion member 28 is attached to the front end surface of the optical fiber 23. The diffusion member 28 only needs to diffuse light emitted from the optical fiber 23 at least in the radial direction y of the shaft 2. The shape of the diffusion member 28 is not particularly limited, and for example, can be a columnar shape.

[0051] Although not shown, the diffusion member 28 can be arranged so as to cover the portion 26 in which the cladding layer is not present. In this case, the diffusion member 28 is preferably annular or coil-shaped.

[0052] As the diffusion member 28, for example, glass such as quartz glass, or resin can be used. The diffusion member 28 made of resin can be configured by dispersing a diffusion agent in a resin having light transmittance. As the resin having light transmittance, (meth)acrylic resin (for example, polymethyl methacrylate (PMMA)), polycarbonate resin (for example, polydiethylene glycol bisallyl carbonate (PC)), polystyrene resin (for example, methyl methacrylate-styrene copolymer resin (MS), acrylonitrile-styrene resin (SAN)), polyamide resin (for example, nylon), polyolefin resin can be listed. As the diffusion agent, inorganic particles such as titanium oxide, barium sulfate, calcium carbonate, organic particles such as crosslinked acrylic particles, crosslinked styrene particles can be listed.

[0053] In Figure 2 and Figure 7 , an example in which the light guide device 20 has one single-core fiber in which one core 24 is arranged in one cladding layer 25 is shown, but the light guide device 20 can have a plurality of single-core fibers. The light guide device 20 can have one or a plurality of multi-core fibers in which a plurality of cores 24 are arranged in one cladding layer.

[0054] The light guide device 20 is preferably not rotated around the long axis of the shaft 2 with respect to the shaft 2. Thereby, the light guide device 20 can not be rotated when adjusting the irradiation position of light, and thus damage to the light guide device 20 can be prevented.

[0055] As Figure 2As shown, when the light guide device 20 has an optical fiber 23, the light guide device 20 preferably has a protective sleeve 27 that covers the optical fiber 23 and is transparent. The protective sleeve 27 can strengthen the optical fiber 23, improve light diffusion, and reduce uneven illumination.

[0056] The protective sleeve 27 extends along the long axis of the optical fiber 23. The protective sleeve 27 preferably covers the entire long axis of the optical fiber 23. This allows for the suppression of damage, deformation, and breakage of the fiber core 24 throughout the optical fiber 23. For the same reason, the protective sleeve 27 preferably covers the entire circumferential direction of the optical fiber 23. The distal end 27a of the protective sleeve 27 is preferably located further distal than the distal end of the optical fiber 23, and more preferably further distal than the distal end 24a of the fiber core 24. A portion 26 is preferably covered by the protective sleeve 27, and more preferably, the entire portion 26 is covered by the protective sleeve 27.

[0057] The protective sleeve 27 only needs to be light-transmitting. The protective sleeve 27 is preferably made of resin. Examples of resins that can be used to constitute the protective sleeve 27 include polyamide resins, polyester resins, polyurethane resins, polyolefin resins, fluorinated resins, vinyl chloride resins, silicone resins, and natural rubber. Only one type may be used, or two or more types may be used in combination. Among these, polyamide resins, polyester resins, polyurethane resins, polyolefin resins, and fluorinated resins are preferred.

[0058] Light-diffusing materials such as inorganic particles like titanium dioxide, barium sulfate, and calcium carbonate, as well as organic particles like cross-linked acrylic particles and cross-linked styrene particles, can be added to the resin constituting the protective sleeve 27. This allows light from the light-diffusing section 21 to be further diffused.

[0059] Figure 8 It means Figure 1 A side view of a modified example of the light-irradiating medical device shown. (See attached image.) Figure 8 As shown, the light guide device 20 preferably has a position display section 29 at its proximal end, indicating the position of the light guide device 20 relative to the axis 2. The position of the light diffusion section 21 can be easily determined by the position display section 29, thus enabling reliable illumination of the treatment object such as a lesion.

[0060] The position display unit 29 can display scales, text, numbers, symbols, graphics, etc. The position display unit 29 can also be a protrusion or recess provided on the surface of the light guide device 20 or the handle 10. The scales can be a combination of at least one of the following: an axis extending along the long axis or circumferential direction of the light guide device 20, a straight line intersecting the axis, a curve, an oblique line, or a point. Only one position display unit 29 can be provided, or multiple units can be provided.

[0061] The position display portion 29 can be a colored portion in the outer surface of the light guide device 20, or a portion in which a coloring agent such as a pigment is mixed in the material that constitutes the light guide device 20.

[0062] One or more first windows 11 can be provided with respect to one axis 2. In order to easily adjust the irradiation position, it is preferable to provide only one first window 11 with respect to one axis 2.

[0063] The first window 11 is preferably disposed at a position closer to the proximal end 2a of the axis 2 than the distal end 2a. For example, the proximal end 11a of the first window 11 can be located within a range of 10 cm from the distal end 2a.

[0064] In the long axis direction x, the length of the first window 11 is not particularly limited, but the first window 11 is preferably longer than the light diffusion portion 21. Thereby, a large range in the long axis direction x can be irradiated at one time by the first window 11.

[0065] The first window 11 can be disposed only on a part of the circumferential direction p of the axis 2, but is preferably disposed over a range of more than half of the circumferential direction p, and more preferably disposed over the entire circumferential direction p. Since a large range of the circumferential direction p can be irradiated at one time, the operation time can be shortened.

[0066] In the circumferential direction p, the first window 11 is preferably longer than the light diffusion portion 21. Thereby, a large range of the circumferential direction p can be irradiated at one time by the first window 11. Further, in the circumferential direction p, the first window 11 is more preferably longer than the portion 26. That is, in the case where the light diffusion portion 21 is provided in a range of less than the entire circumferential direction p, the first window 11 is preferably provided to be longer than the length of the circumferential direction p of the light diffusion portion 21 or provided over the entire circumferential direction p.

[0067] The second window 12 can be provided at the distal end surface 7 of the axis 2. The second window 12 can also be referred to as an opening at the distal end 2a of the axis 2. The second window 12 is preferably extended in the radial direction y of the axis 2. The second window 12 is preferably not disposed on the peripheral wall 6. A plurality of second windows 12 can be provided with respect to one axis 2, or only one second window 12 can be provided.

[0068] The first window 11 and the second window 12 are preferably made of a material having a higher light transmittance than the portions of the axis 2 in which these windows are not provided. As such a configuration, for example, a manner in which the windows are opened, or a manner in which transparent members are disposed on the windows can be cited. Here, the manner in which the windows are opened means that no other members are disposed in the windows.

[0069] The first window 11 is opened, and thereby the inside and the outside of the axis 2 can be communicated through the first window 11. The light diffusion portion 21 can be exposed from the first window 11 when the light guide device 20 is moved, and thereby it is easy to directly irradiate light to the lesion portion.

[0070] The first window 11 is preferably provided with a transparent member (hereinafter, referred to as a first transparent member 13) through which light emitted from the light guide 20 is transmitted. By the first transparent member 13, the effect of preventing the liquid from being immersed into the shaft 2 can be improved. The material of the first transparent member 13 is adjusted, whereby light can be easily diffused appropriately. The first transparent member 13 is preferably provided in the entire first window 11.

[0071] In Figure 2 and Figure 4 , the first transparent member 13 extends in the direction of the surface of the peripheral wall 6. The first transparent member 13 can be a curved thin plate-shaped member, or can be a cylindrical member.

[0072] In Figures 1-2 , the first transparent member 13 is provided in the first window 11, and the second window 12 is open. Although not shown, a second transparent member through which light from the light guide 20 is transmitted can be provided in the second window 12. The second transparent member can be provided in the inner cavity 5 of the shaft 2. The second transparent member is preferably provided in the entire second window 12. As a result, the distal end 2a of the shaft 2 is preferably closed. Thereby, the effect of preventing the liquid from being immersed into the shaft 2 can be further improved.

[0073] The second transparent member preferably extends in the radial direction y of the shaft 2. The second transparent member can be, for example, a relatively thin flat plate. The distal end surface or the proximal end surface of the second transparent member can be flat, or can be curved.

[0074] As the material of the first transparent member 13 or the second transparent member, for example, a synthetic resin such as (meth)acrylic resin (for example, polymethyl methacrylate (PMMA)), polycarbonate resin (for example, polydiethylene glycol bisallyl carbonate (PC)), polystyrene resin (for example, methyl methacrylate-styrene copolymer resin (MS), acrylonitrile-styrene resin (SAN)), polyamide resin (for example, nylon), or polyolefin resin can be exemplified. They can be used alone by one kind, or can be used in combination of two or more kinds. The material of the first transparent member 13 and the second transparent member can be the same, or can be different from each other.

[0075] As shown in Figure 2 , the shaft 2 has a reflection surface 8. Light from the light diffusion portion 21 is reflected by the reflection surface 8, whereby irradiation to the front through the second window 12 can be performed efficiently. In Figure 2 and Figure 5 , an example in which the shaft 2 has a long cylindrical main body 3, that is, the main body 3 provided with the first window 11, and a cylindrical reflection member 4 provided on the inner side of the main body 3, and the inner surface of the reflection member 4 is the reflection surface 8 is shown.

[0076] The reflection surface 8 can also be the surface of a reflection layer laminated on the inner surface of the main body 3. The reflection layer can also be formed by, for example, applying a coating agent containing a reflection material to the inner surface of the main body 3. The reflection layer can also be formed by adhering a reflection material to the inner surface of the shaft 2 using a method such as evaporation, sputtering, plating, or chemical plating. The reflection layer can also be a metal thin film. As the reflection material, for example, aluminum, gold, silver, copper, tin, titanium dioxide, tantalum pentoxide, aluminum oxide, silicon dioxide, magnesium fluoride, or a combination thereof can be listed. The above-described reflection member 4 can also be composed of a material containing the reflection material.

[0077] As shown in FIG. 2, the reflection surface 8 is preferably disposed on the entire circumference p of the shaft 2. This easily reflects light from the light guide device 20 toward the front without leaking. Figure 5

[0078] As shown in FIG. 3, in the long axis direction x, the reflection surface 8 is preferably disposed in a range longer than the light diffusion portion 21. In the long axis direction x, the reflection surface 8 is more preferably disposed in a range longer than the portion 26. This easily reflects light from the light guide device 20 toward the front without leaking. In addition, in the long axis direction x, the reflection surface 8 can also be disposed in a range longer than the first window 11. Figure 6

[0079] At least a portion of the reflection surface 8 can also be inclined with respect to the optical axis of the optical fiber 23. The inclination angle of the reflection surface 8 with respect to the optical axis of the optical fiber 23 can be 3 degrees or more, 5 degrees or more, or 10 degrees or more, or can also be 30 degrees or less, 25 degrees or less, or 15 degrees or less. By thus setting the inclination angle, it is easy to reflect light toward the front using the reflection surface 8.

[0080] Figure 9 is a cross-sectional view of a modification example of the shaft 2 shown in FIG. 1. As shown in FIG. 2, it is preferable to provide a lens 30 that converges light emitted from the light guide device 20 at the distal end portion of the inner cavity 5 of the shaft 2. By providing such a lens 30, it is easy to emit light from the light guide device 20 toward the front. One or a plurality of lenses can also be provided. Figure 2 Figure 9 As the lens 30, a condensing lens such as a Gradient Index lens (GRIN lens) can be used. In addition, as the lens 30, an aberration correction lens can also be used. It is possible to correct aberration generated by reflection of emitted light by the reflection surface 8, and thus in the case where the emitted light is a light ray for observation, it is easy to image the emitted light, and thus it is easy to observe the front of the shaft 2. As the aberration correction lens, a doublet lens composed of a convex lens and a concave lens, an aspherical lens can be listed.

[0081] As the lens 30, a condensing lens such as a Gradient Index lens (GRIN lens) can be used. In addition, as the lens 30, an aberration correction lens can also be used. It is possible to correct aberration generated by reflection of emitted light by the reflection surface 8, and thus in the case where the emitted light is a light ray for observation, it is easy to image the emitted light, and thus it is easy to observe the front of the shaft 2. As the aberration correction lens, a doublet lens composed of a convex lens and a concave lens, an aspherical lens can be listed.

[0082] ​​​Lens 30 is preferably positioned further away from the first window 11, and more preferably positioned in the second window 12. In the long axis direction x, lens 30 can be positioned at the location having the reflecting surface 8, or it can be positioned further away from the reflecting surface 8.

[0083] like Figure 2 As shown, shaft 2 has a reduced diameter portion 14 on the side farther from the first window 11, where the inner diameter of shaft 2 decreases towards the first window 11. Preferably, a reflective surface 8 is disposed in the reduced diameter portion 14. Since at least a portion of the reflective surface 8 is inclined relative to the major axis direction x, the reflective surface 8 is easily oriented towards the second window 12. As a result, light from the light diffusion portion 21 can easily pass through the second window 12 and illuminate forward.

[0084] like Figure 2 As shown, in the reduced diameter section 14, the inner diameter of the shaft 2 can also taper towards the first window 11. In this case, it is preferable that the reflecting surface 8 is inclined relative to the extending direction of the light diffuser section 21. Alternatively, a stepped difference can be provided on the inner surface of the shaft 2, and the inner diameter of the shaft 2 can be progressively reduced towards the first window 11. Figure 9 As shown, in the reduced diameter section 14, the inner diameter of shaft 2 can also decrease exponentially. For example... Figure 9 As shown, by using a dome-shaped reflective component 4 at the proximal end, the inner diameter of shaft 2 can be reduced exponentially.

[0085] The reflective surface 8 is preferably disposed in the entire section of the near end 14b of the narrower diameter portion 14 in the shaft 2, near the far side. This arrangement of the reflective surface 8 facilitates the forward illumination of light from the light diffuser 21 through the second window 12.

[0086] Figure 10 It means Figure 2 A cross-sectional view of a modified example of device 1 shown. Figure 11 yes Figure 10 The front view of valve 16 is shown. Figure 10 As shown, axis 2 may also have a small-diameter portion 15 on a side farther from the first window 11. This small-diameter portion 15 is configured such that its inner diameter is smaller than the minimum inner diameter of axis 2 in the section containing the first window 11, and it contacts the light guide device 20 when the light guide device 20 can move along the long axis direction x. Since it is easy to trap light in the space farther from the small-diameter portion 15, the amount of light emitted from the second window 12 can be increased.

[0087] like Figure 2As shown, a small-diameter portion 15 can also be formed by protruding radially inward from the peripheral wall 6 of the shaft 2. Alternatively, a component for reducing the inner diameter of the shaft 2 can be provided in the inner cavity 5 of the shaft 2. The component forming the small-diameter portion 15 is preferably capable of elastic deformation. Even when the light guide device 20 is moved, the small-diameter portion 15 elastically deforms, thus maintaining a tight fit between the small-diameter portion 15 and the light guide device 20. Figure 10 In this case, a valve 16 is installed in the inner cavity 5 of shaft 2. For example... Figure 11 As shown, an opening 17 is provided in the center of the valve 16, through which the light guide device 20 can be inserted.

[0088] The method of forming the small-diameter portion 15 is not limited to the valve 16; a sealing component can also be provided in the inner cavity 5 of the shaft 2. This improves the sealing performance between the light guide device 20 and the shaft 2. The sealing component is preferably annular. The sealing component can be a circular or elliptical ring (in other words, an O-ring), a polygonal square ring, or a ring with a cross-section combining circular, elliptical, or polygonal shapes.

[0089] Alternatively, a nut portion can be provided on the side of axis 2 furthest from the first window 11, and a bolt portion that engages with the nut portion can be provided on the side of the light-diffusing portion 21 of the light guide device 20 near the nut portion. In this case, the nut portion functions as a small-diameter portion 15. Preferably, the outer diameter of the side of the light guide device 20 furthest from the bolt portion is smaller than that of the bolt portion. This makes it easier to insert the position furthest from the bolt portion into the interval furthest from the small-diameter portion 15.

[0090] The small-diameter portion 15 may also have a surface 18 facing the distal end 2a of the shaft 2, and a reflective member 4 or a reflective layer is disposed on the surface 18. This facilitates the forward illumination of light from the light diffuser 21 through the second window 12.

[0091] When the light guide device 20 is moved so that the light diffusion portion 21 overlaps with the first window 11, it is preferable that the small-diameter portion 15 contacts the light guide device 20. In this case, it is more preferable that the distal end of the light guide device 20 is positioned further away from the small-diameter portion 15. This allows the position of the light guide device 20 within the fixed shaft 2 to be maintained when irradiating laterally.

[0092] Figure 12 It means Figure 2 A cross-sectional view of a modified example of device 1 shown. Figure 13 It means Figure 2 A cross-sectional view (partial side view) of a modified example of device 1 shown. Figure 14 It means Figure 2 A cross-sectional view of a modified example of the device 1 shown. (e.g.) Figures 12-14 As shown, preferably, the distal portion of the shaft 2 has an expansion portion 40 that expands outward toward the radial direction y of the shaft 2. By expanding the expansion portion 40, the device 1 can be easily fixed inside the body.

[0093] The expansion portion 40 is preferably a balloon, a basket or a stent having a plurality of elastic wires, and more preferably a balloon 41 Figure 12 , a basket 43 Figure 13 having a plurality of elastic wires, or a self-expandable stent 46 Figure 14 . If the expansion portion 40 is the balloon 41, the outer surface of the balloon 41 comes into contact with the biological tube wall such as a blood vessel or a digestive tract when the balloon 41 is expanded, and thus the shaft 2 can be fixed in the body. If the expansion portion 40 is the basket or the stent, the wire constituting the basket or the stent easily penetrates into the biological tube wall, and thus the device 1 can be stably fixed in the body. In the stent, the self-expandable type can not be provided with a balloon inside, and thus the diameter in the reduced diameter state can be reduced as compared with the balloon expansion type. Further, in the self-expandable stent 46, the outer shape is schematically shown in Figure 14 .

[0094] The expansion portion 40 can be disposed on the distal side from the first window 11, or on the proximal side from the first window 11. The expansion portion 40 can be longer than the light diffusion portion 21 in the long axis direction x. Alternatively, the expansion portion 40 can be disposed so as to overlap the first window 11. In this case, the expansion portion 40 can be longer than the first window 11 in the long axis direction x.

[0095] In Figure 12 , the shaft 2 is composed of an inner tube 2A and an outer tube 2B. The reflection member 4 is provided inside the inner tube 2A. A fluid supply (not shown) is connected to the proximal portion of the shaft 2. The light guide device 20 is inserted into the lumen of the inner tube 2A. The space between the inner tube 2A and the outer tube 2B communicates with the inside of the balloon 41, and functions as a flow path for a pressure fluid.

[0096] The balloon 41 can be disposed so as to cover the first window 11. The first window 11 can be longer than the straight tube portion 42 of the balloon 41 in the long axis direction x. In the case where the balloon 41 covers the first window 11, a gas such as air, nitrogen, or carbon dioxide gas is preferably supplied into the balloon 41 from the viewpoint of light transmission. The balloon 41 preferably contains a light-transmissive material. The balloon 41 can contain a light-diffusing material.

[0097] In the basket 43, a plurality of elastic wires 44 are bundled on the distal side and the proximal side, respectively. In Figure 13 , the distal end portion and the proximal end portion of the elastic wire 44 are fixed to the shaft 2 by a cylindrical connecting member 45, respectively. The elastic wire 44 can be bent between the two bundle portions, or twisted in a spiral shape. The elastic wire 44 is preferably composed of a shape memory alloy or a shape memory resin. The elastic wire 44 can be a single wire or a twisted wire of a metal wire.

[0098] The stent is, for example, a structure capable of expansion composed of a mesh structure such as a mesh, and includes a plurality of struts. The stent can be formed, for example, of a pattern of structure elements that are connected to each other so as to be stretchable in the circumferential direction and the axial direction.

[0099] The proximal end portion of the stent 46 is preferably fixed to the distal end portion of the shaft 2. The device 1 can be fixed in the body in a state in which the stent does not obstruct the emission of light. In the case where the expansion portion 40 is the self-expanding stent 46 and the distal end portion is more expandable than the proximal end portion, the distal end portion is preferably not fixed to the distal end portion of the shaft 2. By bringing the distal end portion of the stent into contact with the biological tube wall, the shaft 2 can be fixed in the body. In the case where the expansion portion 40 is the basket, the distal end portion of the shaft 2 is preferably fixed to the distal end portion of the basket. By fixing the distal end portion of the shaft 2 to the distal end portion of the basket, the shaft 2 can be fixed in the body. Figure 14 In the embodiment shown in FIG. 1, the expansion portion 40 is the self-expanding stent 46, and the distal end portion of the stent 46 is fixed to the distal end portion of the shaft 2. In the embodiment shown in FIG. 2, the expansion portion 40 is the self-expanding stent 46, and the distal end portion of the stent 46 is not fixed to the distal end portion of the shaft 2. In the embodiment shown in FIG. 3, the expansion portion 40 is the basket 43, and the distal end portion of the shaft 2 is fixed to the distal end portion of the basket 43.

[0100] In the case where the expansion portion 40 is the basket or the stent, the device 1 preferably further has a third tubular member capable of housing the expansion portion 40 in the lumen. Thereby, until the device 1 is transported to the vicinity of the treatment portion, the basket or the stent can be prevented from expanding to damage the forceps port, the forceps channel, the tissue in the body, or the like.

[0101] This application claims the benefit of priority of Japanese Patent Application No. 2020-204324 filed on December 9, 2020. The entire contents of the specification of Japanese Patent Application No. 2020-204324 filed on December 9, 2020 are incorporated herein by reference.

[0102] Explanation of Reference Numerals

[0103] 1…light irradiation medical device; 2…shaft; 3…main body; 4…reflection member; 5…lumen; 6…peripheral wall; 7…distal end surface; 8…reflection surface; 10…handle; 11…first window; 12…second window; 13…first transparent member; 14…reduced diameter portion; 15…small diameter portion; 16…valve; 17…opening; 18…surface; 20…light guide device; 21…light diffusion portion; 22…connector; 23…optical fiber; 24…core; 25…cladding; 26…cladding non-existing portion; 27…protective tube; 28…diffusion member; 29…position display portion; 30…lens; 40…expansion portion; 41…balloon; 42…straight tube portion; 43…basket; 44…elastic wire; 45…connecting member; 46…self-expanding stent; 47…support portion; 50…light; x…longitudinal direction of the shaft; y…radial direction of the shaft; p…circumferential direction of the shaft.

Claims

1. A phototherapy medical device, characterized in that, have: A shaft having a first end and a second end in the long axis direction, and having an inner cavity extending along the long axis direction; and A light guide device is disposed within the inner cavity of the shaft and is movable along the long axis. The light guide device extends along the long axis, and the light guide device has a light diffusion portion at its distal end. The shaft has a first window disposed on the peripheral wall of its distal portion and a second window disposed on the distal end face of the shaft. The axis has a reflective surface on the side farther from the first window and inside the axis, and the reflective surface reflects the light emitted from the light guide device.

2. The light irradiation medical device according to claim 1, characterized in that, If the light guide device is moved so that the light diffuser overlaps with the first window, then the light emitted from the light guide device passes through the first window. If the light guide device is moved so that the light diffusion portion overlaps with the reflective surface, the light emitted from the light guide device passes through the second window.

3. The photo-irradiation medical device according to claim 1 or 2, characterized in that, In the long axis direction, the first window is longer than the light diffusion length.

4. The phototherapy medical device according to any one of claims 1 to 3, characterized in that, The first window is disposed circumferentially on the axis.

5. The phototherapy medical device according to any one of claims 1 to 4, characterized in that, The first window is provided with a transparent component through which light emitted from the light guide device can pass.

6. The phototherapy medical device according to any one of claims 1 to 5, characterized in that, In the long axis direction, the reflective surface is configured within a range longer than the light diffusion length.

7. The phototherapy medical device according to any one of claims 1 to 6, characterized in that, The reflective surface is disposed circumferentially on the axis.

8. The phototherapy medical device according to any one of claims 1 to 7, characterized in that, The shaft has a reduced diameter portion on the side farther from the first window, with the inner diameter of the shaft decreasing toward the first window side, and the reflective surface is disposed on the reduced diameter portion.

9. The photo-irradiation medical device according to claim 8, characterized in that, The reflective surface is disposed in the entire section of the shaft that is further away from the proximal end of the reduced diameter portion.

10. The phototherapy medical device according to any one of claims 1 to 9, characterized in that, The shaft has a small diameter portion on the side farther from the first window. The small diameter portion is configured such that its inner diameter is smaller than the minimum inner diameter of the shaft in the section containing the first window, and it contacts the light guide device when the light guide device is able to move along the long axis direction.

11. The phototherapy medical device according to any one of claims 1 to 10, characterized in that, A lens is provided at the distal end of the inner cavity of the shaft, the lens converging light emitted from the light guide device.

12. The phototherapy medical device according to any one of claims 1 to 11, characterized in that, The distal portion of the shaft has an expansion portion that expands radially outward toward the shaft.

13. The photo-irradiation medical device according to claim 12, characterized in that, The expansion portion is a balloon, a basket with multiple elastic lines, or a self-expanding stent.

14. The phototherapy medical device according to any one of claims 1 to 13, characterized in that, The light guide device has a position display section at its proximal end indicating the position of the light guide device relative to the axis.

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