Light applicator for transcutaneous photodynamic therapy (PDT)

Description

[0001] The present disclosure relates to a light applicator for performing transcutaneous photodynamic therapy (PDT).

[0002] PDT is a well-known medical therapy for a patient's pathological tissue. The patient is administered a photosensitizer or marker substance which selectively accumulates in the pathological tissue to be treated. During PDT, light is then applied directly onto or even into the pathological tissue using one or more light applicators in order to promote the light-induced formation of oxygen radicals using the locally accumulated photosensitizer or marker substance and thereby destroy the pathological tissue, such as a tumor. Typically, laser light is coupled into a light guide and guided to the tissue. If the pathological tissue is spread over an external surface of the body, e.g. the skin, or an internal surface, e.g.If the light source is positioned within a specific area of ​​the body, such as the inner surface of the esophagus or intestinal walls, the therapeutic light can be relatively easily decoupled and irradiated onto the pathological tissue surface. However, if the pathological tissue extends over a volume within an internal organ or organ segment, a tumor cannot always be effectively irradiated from the outside due to the limited penetration depth of the light into the tissue. In this case, PDT is particularly effective when the light is irradiated from within the pathological tissue volume. To do this, the light applicator(s) must be inserted into the pathological tissue. This is also referred to as interstitial (through internal surfaces) and / or transcutaneous (through the skin) PDT. US Pat. No. 6,048,359, for example, describes a system for performing transcutaneous PDT to irradiate an internal volume within a patient's body.A number of needle-like light applicators are inserted parallel through the skin into the body, with each light applicator having lateral light outputs distributed along its length in order to irradiate a volume in the body.

[0003] A disadvantage of the known solution is that the light applicators must be relatively thick and are relatively complex and expensive, meaning they cannot be implemented as disposable items for single use. Furthermore, the shape of the light applicators is not ergonomically adapted to manual handling, which therefore requires a high degree of practice, experience, and skill from the operator. WO 2021 / 083465 A1 describes a light applicator for PDD or PDT in moving organs. WO 2018 / 197651 A1 describes a device for the targeted illumination of an intraocular space of a human or animal eye. EP 3 777 974 A1 describes a light applicator for the examination and / or treatment of an organic body.

[0004] This gives rise to the task of providing a more cost-effective light applicator for performing transcutaneous PDT, which is easier to handle and safer and can, if necessary, be used closely together with other light applicators.

[0005] According to the present disclosure, to solve this problem, a light applicator is provided for performing transcutaneous photodynamic therapy, PDT, in tissue of an organic body, wherein the light applicator a needle section extending longitudinally along a puncture axis, at least one light-emitting element at the distal end of the needle section, an applicator tip extending at least partially distally from the at least one light-emitting element and at least partially light-transparent for puncturing the needle section into the tissue of the organic body along the puncture axis, and a handle element arranged proximally from the needle section for manually positioning the light applicator, wherein the handle element can be coupled to the needle section for positioning and / or puncturing and is designed to be removable from the needle section for carrying out the PDT.

[0006] The removable handle element allows ergonomic handling by an operator during positioning and / or insertion. Particularly during insertion, the operator may have to exert a relatively large manual force on the thinnest possible needle section. Because the handle element is designed to be removable, it can be made large enough to be easily grasped by the entire hand and several fingers. This allows multiple light applicators to be used together and inserted relatively close to one another without the handle elements blocking each other during PDT. In certain embodiments, it is even possible to use one handle element for positioning and / or inserting multiple light applicators.Furthermore, the relatively bulky handle element, once removed during PDT with the insertion axis not vertical, does not exert any lateral weight force on the needle section, which could result in a relatively large lateral force on the inserted applicator tip due to leverage. Such a lateral force on the inserted applicator tip should be avoided or minimized as much as possible to protect the patient's tissue and / or the applicator tip.

[0007] According to the invention, the light applicator further comprises a connecting cable for supplying the light applicator with light and / or power by means of a supply unit. The light-emitting element can be passively configured as a light guide output of a light guide that extends lengthwise through the needle section. The connecting cable can then comprise an optical fiber bundle, and the supply unit can couple laser light into the connected optical fiber bundle. Preferably, however, the light-emitting element is actively configured, for example as an LED, and actively converts electrical current into light at the distal end of the needle section. Compared to a light guide output, an active light-emitting element, e.g. an LED, at the distal end of the needle section has the great advantage that no expensive laser is required, the light of which must be coupled into the light guide by means of the supply unit.Since the supply unit only needs to supply the light applicators with power, it can be designed particularly simply and inexpensively. The actively light-emitting element preferably has a light spectrum tailored to the photosensitizer or marker substance. Alternatively or additionally, a light filter can be used.

[0008] Optionally, the connecting cable can have a proximal connector for connecting to a connector of a power supply unit. Preferably, the power supply unit has a plurality of connectors to simultaneously connect a plurality of light applicators and supply them with power and / or light.

[0009] Optionally, the connecting cable can have a distal-side connector, wherein the distal-side connector is designed to be removable from the needle section for positioning and / or insertion and connectable to a proximal-side connector of the needle section for performing PDT. This can be useful to keep the connecting cable for positioning and / or insertion completely separate from the needle section and only connect it to it via the distal-side connector once the needle section has been finally positioned and inserted, when it is needed for PDT.

[0010] Optionally, the proximal connection of the needle section can be protectively enclosed when the handle element is attached, and the distal connection of the connecting cable can only be connected to the proximal connection of the needle section when the handle element is removed. This protects the proximal connection of the needle section from damage and contamination until it is needed to connect the connecting cable.

[0011] As an alternative to a distal connection of the connecting cable and a corresponding proximal connection of the needle section, the connecting cable can be firmly connected to the needle section on the distal side. This has the significant advantage of reducing the weight and size of the proximal end of the needle section because an additional plug and socket for connecting the connecting cable and the needle section connection are no longer required. This minimizes the lateral weight forces acting with a leverage effect when the insertion axis is not vertical. It also saves the operator from having to make additional connections, which can significantly shorten the preparation time for PDT, especially when a large number of light applicators are to be used. Incorrect connection of the connecting cable to the needle section is also avoided.

[0012] Optionally, the handle element can have a first length along the puncture axis and the connecting cable a second length, with the second length being many times longer than the first length. A sufficiently long connecting cable is advantageous in order to allow as much freedom as possible when positioning the light applicator in relation to the power unit. On the other hand, long connecting cables can lead to cable clutter and / or confusion when many light applicators are used in parallel. In addition, a connecting cable that is too long can sag unhygienically onto the floor or come into contact with other non-sterile objects. Finally, the connecting cable can exert a lateral force on the needle section due to its own weight and / or tensile stress with a leverage effect, which must be minimized as much as possible.Therefore, a connecting cable that is firmly connected to the needle section is preferably arranged in or on the handle element in a bundle that is as light and orderly as possible.

[0013] According to the invention, the connecting cable for positioning and / or piercing is at least partially stowed in a hollow space in the handle element. Compared to a cable bundle arranged outside the handle element, a hollow space in the handle element for stowing the connecting cable has the advantage that the connecting cable is stored in a hygienically safe and protected manner and does not interfere with the operator's handling during positioning and / or piercing of the light applicator. The connecting cable is subject to fewer bends and kinks and can therefore be designed to be thinner and lighter if it does not "dangle" outside the handle element as a bundle of cables.

[0014] According to the invention, the handle element has at least one stowage element in the cavity, around which the connecting cable is wound in an orderly manner and / or arranged in a meandering pattern. The stowage element can, for example, be a spindle extending in the cavity of the handle element, preferably along the insertion axis, around which the connecting cable is wound, for example, helically. The cavity is also useful for keeping the weight of the handle element as low as possible. The stowage element, such as a spindle, can also be hollow if possible to reduce weight.

[0015] Optionally, the connecting cable can be coiled, i.e., thermally pretreated in such a way that it assumes a helical shape when relaxed, which it also returns to when it changes from the tensed to the relaxed state. This measure can prevent the connecting cable from resting on a potentially unhygienic surface when the distance between the patient and the supply unit is sufficiently short. Preferably, the coiled connecting cable can be wound helically around a storage element extending axially in a cavity of the handle element.

[0016] Optionally, the proximal connection of the connecting cable can be integrated into the handle element so that the handle element detached from the needle section serves as a plug element for inserting into the connection of the power unit for performing PDT. The proximal connection of the connecting cable is preferably integrated into the proximal side of the handle element so that the handle element can be inserted axially into the connection of the power unit for connecting the connecting cable. By detaching and removing the handle element from the needle section, the connecting cable stored in the cavity of the handle element can be unwound as far as required. The cavity preferably has an opening on the distal side which is closed by the proximal end of the needle section when the needle section is coupled in.After removing the handle element from the needle section, the connecting cable can be pulled out of the handle element through the now opened distal opening of the cavity.

[0017] Optionally, the light applicator can further comprise a guide element which is firmly connected to the needle section at a proximal end of the needle section or is integrated therein and is shaped to correspond to the handle element such that the guide element and the handle element can be resiliently inserted into one another. Such a coupling between the needle section and the handle element is, on the one hand, releasable and, on the other hand, strong enough to enable the needle section to be positioned and / or punctured with as little play as possible, even when relatively high manual force is applied to the handle element. Preferably, the coupling along the puncture axis is releasable by pulling the handle element proximally while the guide element is held firmly in place. For this purpose, closure elements can also be provided which can be brought into an open position, for example, by laterally pressing on the handle element in order to release the coupling.

[0018] Optionally, the needle section can have a first diameter perpendicular to the puncture axis, and the handle element can have a second diameter perpendicular to the puncture axis, with the second diameter being several times larger than the first diameter. Ergonomics for positioning and / or insertion are significantly improved when the handle element fits comfortably in the hand to optimally transfer manual force. For minimally invasive PDT, on the other hand, the needle section must be as thin and rigid as possible. For example, the first diameter of the needle section can be 1 mm or less. The second diameter of the handle element, however, can be 3 cm or more.

[0019] Optionally, the guide element can have a third diameter perpendicular to the insertion axis, wherein the third diameter is larger than the first diameter and smaller than the second diameter. This is useful to provide a secure positive fit for the releasable coupling between the guide element and the handle element, in which the handle element at least partially encompasses the guide element.

[0020] Optionally, the handle element can be made from at least two interconnected parts. Although the parts can be permanently connected to one another, this is particularly advantageous for manufacturing purposes in order to stow the connecting cable in a cavity of the handle element. A first part of the handle element can be in the form of a sleeve part, forming an outer wall around a cavity that is open on the distal side and initially also on the proximal side. The second part can be a proximal-side cover part with a spindle extending into the cavity, onto which the connecting cable is wound. The cover part can then be welded or glued to the sleeve part in such a way that the proximal-side opening of the cavity of the sleeve part is closed. The cover part preferably forms the proximal-side connection of the connecting cable for plugging into the supply unit.

[0021] Optionally, the light applicator can further comprise electronics for light applicator recognition, wherein the electronics for light applicator recognition are located in the handle element. This is particularly useful to ensure that the light applicator is automatically supplied correctly by the supply unit. The selection of possible operating parameters can be reduced or eliminated entirely if the supply unit recognizes the light applicator and accordingly reduces the selectable operating parameters or presets them without any options. This reduces the risk of incorrectly setting operating parameters. Especially if the light applicator is preferably designed as a disposable item for single use, the light applicator recognition can indicate whether the light applicator has already been used and can permit or deny operation accordingly. The use of unauthorized light applicators can also be denied.The handle element with integrated connection for the connecting cable offers enough volume to accommodate the electronics for light applicator recognition.

[0022] Optionally, the handle element can have a distally tapered portion. This is particularly useful when a plurality of light applicators must be positioned very closely parallel to one another and the ergonomically shaped handle element does not fit between the light applicators. For this purpose, the handle element can taper distally in a sleeve-like manner so that the distally tapered portion of the handle element can preferably encompass a proximal end of the needle section when the handle element is coupled to the needle section for positioning and / or insertion.

[0023] The system disclosed herein is explained in more detail below with reference to the accompanying figures. They show: Fig. 1 shows a schematic representation of a light applicator for performing percutaneous PDT; Fig. 2 shows a schematic representation of a light applicator being inserted into an organic body to perform percutaneous PDT; Fig. 3a, b shows schematic representations of the problem of a light applicator with an ergonomically shaped handle; Fig. 4a, b shows schematic representations of an example of an embodiment of a light applicator disclosed herein; Fig. 5a, b shows schematic representations of an example of a further embodiment of a light applicator disclosed herein; Fig. 6a, b shows schematic representations of an example of a further embodiment of a light applicator disclosed herein; Fig. 7a, b shows schematic representations of an example of a further embodiment of a light applicator disclosed herein; Fig. 8a, b shows schematic representations of an example of a further embodiment of a light applicator disclosed herein; Fig.8c-e show schematic representations of an example of a spiralized connecting cable with different stretching states; Fig. 9a,b show schematic representations of an example of a further embodiment of a light applicator disclosed herein; and Fig. 10a-c show schematic representations of an example of a further embodiment of a light applicator disclosed herein.

[0024] In Fig. 1 A needle-like light applicator 1 for performing transcutaneous photodynamic therapy (PDT) is shown, which can be inserted through a patient's skin, i.e. transcutaneously, into the patient's pathological tissue. The light applicator 1 is as rigid and thin as possible in order to cause as little damage as possible, i.e. minimally invasively, to the patient's healthy tissue during the puncture. An actively light-emitting element 7 in the form of an LED is arranged at the distal end 3 of a thin shaft-shaped needle section 5 of the light applicator 1. Distal to the LED 7, at the distal end 3 of the needle section 5 of the light applicator 1, a light-transparent and light-scattering applicator tip 9 is arranged. The light from the LED 7 is emitted by the applicator tip 9 as isotropically as possible into a solid angle of over 3π. The light emission from the applicator tip 9 is therefore approximately spherical.

[0025] The light applicator 1 can be connected to a power supply unit 13 via a connecting cable 11, which supplies the light applicator 1 with power, which drives the LED 7. The power supply unit 13 has a connection 15 for a proximal connection 17 of the connecting cable 11. The light applicator 1 has a handle element 19 at the proximal end of the needle section 5, with which an operator can manually grasp the light applicator 1, position it, and insert it into the patient. The light applicator 1 can be connected and supplied with power via the connecting cable 11 with the proximal connection plug 17, which fits into the connection 15 of the power supply unit 13. The needle section 5 of the light applicator 1 preferably has an electrically conductive core and an electrically conductive sheath electrically insulated from the core, so that the core and sheath can act as a forward and return conductor pair to supply the LED 7 with current.Alternatively or additionally, an extra current conductor can be provided in the needle section 5 of the light applicator 1.

[0026] Fig. 2 shows the light applicator 1 penetrating the skin 21 of a patient's body 23 with the aim of treating pathological tissue 25 in the patient with percutaneous PDT. To do so, an operator grasps the handle element 19 with their hand 27 and exerts a penetration force 29 directed distally along a penetration axis L on the needle section 5.

[0027] Fig. 3a shows a first problem of lateral forces acting on the light applicator 1 via leverage as soon as the light applicator 1 is finally positioned and inserted and released to perform PDT. The applicator tip 9 is inserted into the pathological tissue 25 in order to irradiate it with light from the inside. In this example, the insertion axis L runs at an angle γ to the vertical V, so that the weight force FH of the handle element 19 exerts a torque about a rotation axis D running parallel to the skin on the inserted needle section 5. This torque about the rotation axis D leads to an undesirable tissue-stressing lateral force on the inserted part of the needle section 5. This is not only harmful to the tissue, but in the worst case can lead to the applicator tip 9 breaking off.The leverage effect is greater the shorter the pierced part of the needle section 5 is compared to the part of the needle section 5 located outside the body 23. In addition to the weight force FH of the handle element 19, a weight force FK acts on the connecting cable 11 connected to the supply unit 13, unless it is placed unhygienically on a surface and is stretched through the air up to the supply unit 13, as shown. This force also amplifies the undesirable torque on the light applicator 1 about the rotational axis D with a relatively large leverage effect.

[0028] Fig. 3b shows a second problem when using multiple light applicators 1, preferably with a positioning template 31 in which the light applicators 1 are guided in a defined manner. If a close-meshed PDT with multiple light applicators 1 is to be performed for PDT in the, in this case, more voluminous pathological tissue 25, the laterally projecting handle elements 19 of the respective light applicators 1 can block each other.

[0029] In order to provide an ergonomically easy-to-use handle element on the one hand and to Fig. 3a , b In order to prevent the problems shown from occurring or to only do so to a limited extent, the handle element 19 is designed to be removable from the needle section 5 in the exemplary embodiments described below.

[0030] Fig. 4a shows a schematic longitudinal section of the light applicator 1, in which the handle element 19 is coupled onto the proximal end of the needle section 5. In this coupled configuration, the light applicator can be manually positioned and inserted as if the handle element 19 were firmly connected to the needle section 5. At the proximal end of the needle section 5, this is designed to be slightly thickened or equipped with a guide element 35 in the form of a guide sleeve. The guide element 35 is inserted in a form-fitting and / or force-fitting manner into a distal-side opening 37 of the handle element 19. In this exemplary embodiment, the proximal end of the needle section 5 has a proximal-side connection 39 for connecting a distal connection 41 (see Fig. 4b ) of the connecting cable 11. In the Fig. 4a In the coupled configuration shown, the handle element 19 protectively surrounds the proximal connection 39 of the needle section 5, so that the connecting cable 11 can only be connected when the handle element 19 has been removed from the needle section 5.

[0031] As soon as the light applicator 1 is positioned and / or inserted in a first step (indicated in the figures by a circled number), Fig. 4b In a second step, the handle element 19 is removed. A separate connecting cable 11 can then be used to connect the light applicator 1 to a power supply unit 13, which supplies the light applicator 1 with power via the connecting cable 11. For this purpose, the distal-side connector 41 of the connecting cable 11 is connected to the proximal-side connector 39 of the needle section 5, and the proximal-side connector 17 of the connecting cable 11 is connected to the connector 15 of the power supply unit 13.

[0032] Fig. 5a shows that in Fig. 4a shown principle in a more detailed embodiment. The handle element 19 has laterally arranged grip recesses 43 so that the handle element 19 can be better gripped and attached to or removed from the proximal end of the needle section 5. Accordingly, the guide element 35 also has a grip recess 45 in order to be able to hold it firmly when coupling and removing the handle element 19. The positive and non-positive connection for the coupling is achieved here by an external bead 47 on the guide element 35, which engages in a correspondingly shaped internal receiving groove 49 in the handle element 19. The handle element 19 is as in Fig. 5a The handle element 19, preferably made of plastic, is slit on the distal side in the cross-section shown below, whereby the handle element 19, preferably made of plastic, forms spring tongues 51 that yield radially outwardly. The spring tongues 51 can be pressed outward by the bead 47 against a spring force in order to briefly widen the inner diameter of the distal opening 37 of the handle element 19 in order to bring the bead 41 into and out of the receiving groove 49. Fig. 5b shows the connecting cable 11 connected after the handle element 19 has been removed, which cable partially rests on a base 53 if the distance between the patient and the light applicator 1 inserted into it on the one hand and the supply unit 13 on the other hand is correspondingly small.

[0033] In Fig. 6a , bAn embodiment is shown in which the connecting cable 11 is firmly connected to the needle section 5. Thus, there is no distal connection of the connecting cable 11 and no corresponding proximal connection on the needle section 5. The connecting cable 11 is bent outward by approximately 90° directly behind the needle section 11 and led out of the handle element 19. For this purpose, the handle element 19 has a cable recess 55 open on the distal side.

[0034] The connecting cable 11 is neatly bundled here as a cable bundle 57 so that it disturbs the operator as little as possible when positioning and / or inserting the light applicator 1. As in Fig. 6b As shown, the cable bundle 57 is unbundled after removal of the handle element 19 and the connecting cable 11 is connected with its proximal connection 17 to the connection 15 of the supply unit 13.

[0035] In Fig. 7a An embodiment is shown in which the cable bundle 57, including the proximal-side connector 17 of the connecting cable 11, is stored within a cavity 59 of the handle element 19. As a result, the cable bundle 57 does not interfere with the operator at all when positioning and / or inserting the light applicator 1. Furthermore, the connecting cable 11 is thus much better protected and subjected to less mechanical stress, so that it can be designed thinner and lighter. As shown in Fig. 7b As shown, after removing the handle element 19 from the needle section 5, the entire connecting cable 11 including the proximal-side connection 17 can be pulled out of the cavity 59 through the distal-side opening 37 of the handle element 19, whereby it is unbundled in order to be able to connect it to the supply unit 13.

[0036] Fig. 8a , b show that in Fig. 7a , b shown principle in a more detailed embodiment analogous to Fig.5a ,b. The coupling principle and the external shape of the handle element 19 and the guide element 35 are as in the embodiment according to Fig. 5a ,b. The handle element 19 is here formed from two parts 61, 63 that are firmly connected to one another. The first part 61 of the handle element 19 is a sleeve part 61 that forms an outer wall around the cavity 59, which is open on the distal side to the opening 37 and, before connecting to the second part 63, also on the proximal side. The second part 63 is here a proximal-side cover part 63 with a spindle 65 extending into the cavity 59 along the insertion axis L, which functions as a storage element on which the connecting cable 11 is wound in the coupled configuration of the handle element 19. The cover part 63 is then welded or glued to the sleeve part 61 in such a way that the proximal-side opening of the cavity 59 of the sleeve part 61 is closed. To reduce weight, the spindle 65 is hollow, allowing it to accommodate the proximal connection 17 of the connecting cable 11 in a space-saving manner.

[0037] In order to avoid that the connecting cable 11 is partially deposited on a possibly unhygienic surface 53, if the distance between the patient or his body 23 and the light applicator 1 inserted into it on the one hand and the supply unit 13 on the other hand is correspondingly small, as in Fig. 8b If this is the case, a connecting cable 11 can be used which is characterized by being spiralized in the relaxed state. This means that the connecting cable 11 assumes a helical shape when no force is exerted on the connecting cable 11, wherein the cable windings preferably lie directly against one another or touch one another and accordingly the axial extension of the spiral formed by the connecting cable 11 is maximally short (see Fig. 8c ). Preferably, in the state where the cable windings touch, as in Fig. 8c As shown, both the diameters and the lengths of the spiral formed by the connecting cable 11 on the one hand and the spindle 65 on the other hand are matched to one another, so that the spiralized connecting cable 11 can be easily applied to the spindle 65 and the spiral does not protrude axially.

[0038] Only by exerting and continuously increasing a force on the connecting cable 11 does the axial extension of the spiral increase and only then is the actual length of the connecting cable 11 increasingly used, which becomes necessary when the distance between the body 23 and the supply unit 13 is correspondingly large. Fig.8c and dshow, for different distances between the inserted light applicator 1 and the supply unit 13, how the spiral formed by the connecting cable 11 is stretched in the axial direction and thus the actual length of the connecting cable 11 is used in different ways depending on the situation, so that the connecting cable 11 never touches the substrate 53.

[0039] Such a spiralization of the connecting cable 11 can be achieved, for example, by thermally treating it in a corresponding manner in the wound state, whereby the helical shape is fixed, so that the connecting cable 11 maintains this shape in the relaxed state and then also assumes this shape again during the transition from the tensioned to the relaxed state, i.e. when no external force is exerted on the cable any longer.

[0040] The spiraling of the connecting cable 11 should be carried out in such a way that the force required to stretch the spiral in the axial direction is greater than the weight of the connecting cable 11, because otherwise the spiral in the present application would already be stretched by the dead weight of the connecting cable 11 and would not be able to maintain its advantageous short axial length at all.

[0041] As the length and thus the weight of the connecting cable 11 increases, the spiraling is preferably implemented in such a way that the force exerted on the cable spiral to stretch the cable spiral also increases. However, because this force is also transmitted to the light applicator 1 as a tensile force, this should not lead to its position in the body 23 no longer being maintained and possibly being unintentionally retracted or even completely pulled out of the body 23.

[0042] In the embodiment according to Fig. 9a ,b The proximal connection 17 of the connecting cable 11 is integrated into the handle element 19. The handle element 19 forms, on the one hand, the proximal connection 17 for plugging into the connection 15 of the supply unit 13 and, on the other hand, the cavity 59 in which the connecting cable 11 is neatly stowed as long as the handle element 19 is plugged onto the proximal end of the needle section 5. As shown in Fig. 9b As shown, the handle element 19 removed from the needle section 5 functions as a connector plug 17 for the connection 15 of the supply unit 13. Upon removal of the handle element 19 from the needle section 5, the cable bundle 57 unbundles in the cavity 59 and is pulled out of the distal opening 37 of the handle element 19 as far as required. If the entire length of the connecting cable 11 is not required, an unused remainder of the cable bundle 57 can remain bundled in the cavity 59, so that the connecting cable 11 does not settle on a possibly unhygienic surface 53 (as in Fig. 5b and 8b ). In addition, the cable order is higher, which is particularly advantageous when using several light applicators 1 simultaneously.

[0043] Analogous to Fig. 5a , b and 8a , b show Fig. 10a-c that in Fig. 9a , bshown principle in a more detailed embodiment. The coupling principle and the external shape of the handle element 19 and the guide element 35 are as in the embodiment according to Fig. 5a , b and Fig. 8a ,b. In addition, the connecting cable 11 is stored in a wound form on the spindle 65 in the cavity 59 of the handle element 19 as in the embodiment according to Fig. 8a ,b. The Fig. 10a-c The embodiment shown differs only in that it is from the embodiment according to Fig. 8a , b that the proximal connection 17 of the connecting cable 11 is integrated into the handle element 19, namely here in the cover part 63. As in Fig. 10b As shown, the handle element 19 removed from the needle section 5 functions as a connector plug 17 for the connection 15 of the supply unit 13. Upon removal of the handle element 19 from the needle section 5, the cable 11 wound onto the spindle 65 unwinds into the cavity 59 and is pulled out of the distal opening 37 of the handle element 19 only as far as required. If the entire length of the connecting cable 11 is not required, an unused remainder of the cable 11 can remain wound onto the spindle 65 and stored in the cavity 59, so that the connecting cable 11 does not settle on a possibly unhygienic surface 53 (as in Fig. 5b and 8b). Additionally, the connecting cable 11 can be spiralized, as described above. This has the advantage that, for example, even if the distance between the supply unit 13 and the body 23 into which the light applicator 1 is inserted is subsequently reduced, i.e., if, for example, the supply unit 13 is moved toward the body 23 in the already fully equipped state, the connecting cable 11 does not settle on the potentially unhygienic surface 53, but instead contracts into an axially shortened spiral.

[0044] In Fig. 10cThe handle element 19 has a protective cap 67 which protectively covers the integrated proximal connection 17 of the connecting cable 11 on the proximal side as long as the handle element 19 needs to be held for positioning and / or insertion. The protective cap 67 can then be removed to connect the proximal connection 17 of the connecting cable 11 to the connection 15 of the supply unit 13. The protective cap 67 protects both the proximal connection 17 of the connecting cable 11 from contamination and damage and the hand 27 of the operator from sharp-edged pins of the connection 17. Optionally, the cavity 69 formed by the hollow spindle 65 can accommodate electronic components 70, for example electronic components 70 for fiber optic detection. List of reference symbols:

[0045] 1Light applicator 3Distal end of the needle section 5Needle section 7Light-emitting element / LED 9Applicator tip 11Connecting cable 13Supply unit 15Connection of the supply unit 17Proximal connection of the connecting cable 19Handgrip element 21Skin 23Body 25Pathological tissue 27Hand of an operator 29Puncture force 31Positioning template 33Guides of the positioning template 35Guide element 37Distal opening of the handle element 39Proximal connection of the needle section 41Distal connection of the connecting cable 43Grip recesses 45Grip recess 47Bulb 49Receiving groove 51Spring tongues 53Subsurface 55Cable recess 57Cable bundle 59Cavity 61Sleeve part of the handle element 63Cover part of the Handle 65Storage element / spindle 67Protective cap 69Cavity 70Electronic components LInsertion axis VVertical γAngle

Claims

1. Light applicator (1) for the execution of a transcutaneous photodynamic therapy, PDT, in tissue (25) of an organic body (23), wherein the light applicator (1) has: - a needle section (5) extending longitudinally along an axis of penetration (L), - at least one light-emitting element (7) at the distal end (3) of the needle section (5), - an applicator tip (9) extending, at least partially, distally from the at least one light-emitting element (7), and, at least partially, transparent to light for the penetration of the needle section (5) into the tissue (25) of the organic body (23) along the axis of penetration (L), - a connection cable (11) for the supply of the light applicator (1) with light and / or power by means of a supply unit (13), and - a handgrip element (19), arranged in the proximal direction from the needle section (5), for the manual positioning of the light applicator (1), wherein the handgrip element (19) has a cavity (59), and wherein the handgrip element (19) can be coupled to the needle section (5) for the positioning and / or penetration, and for the execution of the PDT is designed to be removable from the needle section (5), wherein for the positioning and / or penetration, the connection cable (11) is, at least partially, stowable in the cavity (59) of the handgrip element (19), wherein the handgrip element (19) has at least one stowage element (65) in the cavity (59), around which the connection cable (11) can be stowed, wound in an orderly manner, and / or in a meandering arrangement.

2. Light applicator (1) in accordance with Claim 1, wherein the connection cable (11) has a connector (17) on the proximal side for purposes of connecting to a terminal (15) of the supply unit (13).

3. Light applicator (1) in accordance with Claim 1 or 2, wherein the connection cable (11) has a connector (41) on the distal side, wherein the distal-side connector (41) can be removed from the needle section (5) for the positioning and / or penetration, and can be connected to a proximal-side terminal (39) of the needle section (5) for purposes of performing the PDT.

4. Light applicator (1) in accordance with Claim 3, wherein the proximal-side terminal (39) of the needle section (5) is protectively enclosed by the handgrip element (19) when the latter is coupled, and the distal-side connector (41) of the connection cable (11) can only be connected to the proximal-side terminal (39) of the needle section (5) when the handgrip element (19) is removed.

5. Light applicator (1) in accordance with Claim 1 or 2, wherein on the distal side the connection cable (11) is fixedly connected to the needle section (5).

6. Light applicator (1) in accordance with one of the preceding claims, wherein the handgrip element (19) has a first length along the axis of penetration (L), and the connection cable (11) has a second length (L), wherein the second length is multiple times greater than the first length.

7. Light applicator (1) in accordance with one of the preceding claims, wherein in the relaxed state the connection cable (11) has the form of a spiral.

8. Light applicator (1) in accordance with preceding claims, wherein the connection cable (11) is wound helically onto the stowage element (65).

9. Light applicator (1) in accordance with one of the Claims 2 to 8, wherein the proximal-side connector (17) of the connection cable (11) is integrated into the handgrip element (19), such that the handgrip element (19), removed from the needle section (5), serves as a plug-in element for insertion into the terminal (15) of the supply unit (13) for the execution of the PDT.

10. Light applicator (1) in accordance with one of the preceding claims, further comprising a guide element (35), which is fixedly connected to the needle section (5) at a proximal end of the needle section (5), or is integrated therein, and is shaped to correspond to the handgrip element (19) such that the guide element (35) and the handgrip element (19) can be inserted into one another in a spring-loaded manner.

11. Light applicator (1) in accordance with one of the preceding claims, wherein the needle section (5) has a first diameter transverse to the axis of penetration (L), and the handgrip element (19) has a second diameter transverse to the axis of penetration (L), wherein the second diameter is multiple times greater than the first diameter.

12. Light applicator (1) in accordance with Claims 10 and 11, wherein the guide element (35) has a third diameter transverse to the axis of penetration (L), wherein the third diameter is greater than the first diameter, and less than the second diameter.

13. Light applicator (1) in accordance with one of the preceding claims, wherein the handgrip element (19) is fabricated from at least two interconnected parts (61, 63).

14. Light applicator (1) in accordance with one of the preceding claims, further comprising electronics for purposes of light applicator identification, wherein the electronics for purposes of light applicator identification are arranged in the handgrip element (19).

15. Light applicator (1) in accordance with one of the preceding claims, wherein the handgrip element (19) comprises a part that is tapered on the distal side.

16. Light applicator (1) in accordance with Claim 15, wherein the part of the handgrip element (19) that is tapered on the distal side is designed to grip around a proximal end of the needle section (5), when the handgrip element (19) is coupled to the needle section (5) for the positioning and / or penetration.