Medical devices

Abstract

To provide a medical device capable of maintaining an appropriate irradiation state to an affected area.SOLUTION: A medical device 10 for applying excitation light to a photosensitive substance accumulated in a tumor to destroy the tumor cell, comprises a shaft part 30, the long tubular body having a distal end and a proximal end and including a window part 32 for transmitting light, a light emitting part 22 disposed inside the shaft part 30 and emitting the excitation light of the photosensitive substance toward the distal end direction at a prescribed divergence angle θ, a reflecting part 60 disposed on the distal end side of the light emitting part 22 inside the shaft part 30 and reflecting the excitation light emitted from the light emitting part 22 to a lateral side orthogonal to an axis X of the shaft part 30 at the divergence angle θ to transmit it through the window part 32, and an adjusting part 80, the adjusting part 80 configured to change a clearance between the light emitting part 22 and the reflecting part 60 along the axis X of the shaft part 30.SELECTED DRAWING: Figure 1

Description

Technical Field

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[0001] The present invention relates to a medical device used for treatment by irradiating a lesion with light.

Background Art

[0002] As local treatments for cancer, photodynamic therapy and photoimmunotherapy using photoreactive substances having tumor cell selectivity are known (see, for example, Patent Document 1). Among these, a treatment method using a photosensitive substance (hydrophilic phthalocyanine) can specifically destroy target cells without destroying non-target cells such as normal cells by irradiating the photosensitive substance accumulated in the tumor with excitation light (for example, near-infrared light), and is expected to obtain a high treatment effect while reducing side effects. (See Patent Document 2)

Prior Art Documents

Patent Documents

[0003]

Patent Document 1

Patent Document 2

Summary of the Invention

Problems to be Solved by the Invention

[0004] When irradiating a lesion with light during treatment, since the irradiation state of the light is closely related to the treatment range and treatment effect, it is necessary to maintain an appropriate light irradiation state in order to perform the treatment reliably. However, in actual treatment, it is assumed that it may be difficult to maintain the state where the excitation light is irradiated in an appropriate state for a certain period of time due to spatial constraints, constraints due to body posture, constraints on the irradiation range due to the light irradiation method, etc. For this reason, a technique or device capable of maintaining an appropriate light irradiation state is required.

[0005] The present invention was made to solve the above-mentioned problems, and aims to provide a medical device that can uniformly irradiate a lesion with excitation light and stably maintain the irradiation state to the lesion. [Means for solving the problem]

[0006] The medical device according to the present invention, which achieves the above objective, is a medical device that irradiates a photosensitive substance accumulated in a tumor with excitation light to destroy tumor cells, and comprises a long tube having a tip and a base, a shaft portion having a light-transmitting window, a light-emitting portion disposed inside the shaft portion and emitting excitation light for the photosensitive substance toward the tip at a predetermined divergence angle, a reflecting portion disposed inside the shaft portion toward the tip side of the light-emitting portion and reflecting the excitation light emitted from the light-emitting portion toward the side perpendicular to the axis of the shaft portion at a divergence angle to allow it to pass through the window, and an adjustment portion. A distance detection unit for detecting the distance to the object to be irradiated with the excitation light, and a drive unit for moving the light emission unit or the reflecting unit along the axis of the shaft, The adjustment unit has the ability to change the distance between the light-emitting part and the reflecting part along the axis of the shaft. Let It is configured to The control unit has a control unit that adjusts the separation distance between the light emitting unit and the reflecting unit based on the detection result of the distance detection unit. . [Effects of the Invention]

[0007] In the medical device configured as described above, the distance between the light-emitting and reflective sections can be changed within the shaft. Therefore, the distance required to spread the excitation light emitted from the light-emitting section, which has a predetermined divergence angle, to a desired range can be adjusted within the shaft. As a result, excitation light that has been diverged to a desired range can be irradiated onto a lesion adjacent to the medical device. Consequently, the excitation light can be uniformly irradiated onto the lesion, and the irradiation state to the lesion can be stably maintained.

[0008] The medical device has a distance detection unit that detects the distance to the object to be irradiated with the excitation light. do This allows the distance detection unit to measure the height of the raised lesion and determine whether or not it is treatable. Furthermore, it enables the determination of whether the appropriate distance between the window and the lesion is maintained during treatment.

[0009] The adjustment unit includes a control unit configured to change the distance between the light-emitting portion and the reflecting portion along the axis of the shaft portion. do This allows the medical device's control unit to automatically and appropriately adjust the distance between the light-emitting and reflective sections, thereby improving operability.

[0010] The medical device has a drive unit that moves the light emitting unit or the reflecting unit along the axis of the shaft, and the control unit adjusts the separation distance between the light emitting unit and the reflecting unit based on the detection result of the distance detection unit. do This allows the drive unit to automatically adjust so that the irradiation range of the excitation light on the target is appropriate according to the distance from the medical device to the target, thereby improving operability.

[0011] The medical device has an image detection unit that detects an image of the target to be irradiated, and the control unit may stop the emission of the excitation light based on the results of the image detection unit. This improves operability because it is possible to determine from the image that the treatment with excitation light is complete and to automatically stop the emission of the excitation light.

[0012] The control unit calculates the integrated energy of the excitation light irradiated onto the target based on the detection result of the image detection unit, The integrated energy of the excitation light irradiated onto the target object Based on the calculation results, the emission of the excitation light may be stopped. This allows for automatic detection of when sufficient excitation light irradiation has been performed and the irradiation to be stopped, improving operability.

[0013] The medical device has a notification unit capable of notifying information to the outside, and the control unit is The distance detection unit Based on the detection results, the notification unit may be instructed to broadcast information. The medical device has a notification unit capable of notifying information to the outside, and the control unit may cause the notification unit to notify information based on the detection result of the image detection unit. The medical device has a notification unit capable of notifying information to the outside, and the control unit may cause the notification unit to notify information based on the calculation result of the integrated energy of the excitation light irradiated onto the irradiation target. This allows the operator to recognize the detection results from the notification unit and perform treatment using excitation light appropriately.

[0014] The reflection part may be detachable from the shaft part. Thereby, according to the situation such as the size, shape, position, treatment method, etc. of the lesion part, a desirable reflection part can be selected and used.

[0015] The shaft part may have a cleaning lumen that opens near the window part and can supply liquid to the window part. Thereby, it is possible to suppress the window part from getting dirty and becoming unable to emit excitation light from the window part.

Brief Description of the Drawings

[0016] [Figure 1] It is a perspective view showing the medical device according to this embodiment. [Figure 2] It is a longitudinal sectional view near the light emitting part of the medical device, (A) shows the state where the light emitting part is arranged on the proximal end side, and (B) shows the state where the light emitting part is arranged on the distal end side. [Figure 3] It is a perspective view showing the reflection part of the medical device, (A) shows this embodiment, (B) shows the first modification example, and (C) shows the second modification example. [Figure 4] It is a longitudinal sectional view showing the third modification example of the medical device, (A) shows the state where the reflection part and the shaft detachment part are detached from the shaft main body, and (B) shows the state where the reflection part and the shaft detachment part are connected to the shaft main body. [Figure 5] It is a longitudinal sectional view showing the fourth modification example of the medical device. [Figure 6] It is a longitudinal sectional view showing the fifth modification example of the medical device. [Figure 7] It is a longitudinal sectional view showing the sixth modification example of the medical device. [Figure 8] It is a plan view of the lesion part for explaining the usage example of the sixth modification example. [Figure 9] It is a longitudinal sectional view showing the seventh modification example of the medical device.

Modes for Carrying Out the Invention

[0017] Embodiments of the present invention will be described below with reference to the drawings. Note that the dimensions in the drawings may be exaggerated for illustrative purposes and may differ from the actual dimensions. In addition, in this specification and drawings, components having substantially the same functional configuration are denoted by the same reference numerals to avoid redundant explanations. In this specification, the side of the device that comes into contact with the living body will be referred to as the "tip end," and the side that is operated will be referred to as the "proximal end."

[0018] The medical device 10 according to this embodiment is used for the treatment of tumors. The type of tumor is not particularly limited, but it can be applied to gynecological cancers such as endometrial cancer and ovarian cancer. The medical device 10 is used in photoimmunotherapy, which destroys target cells by irradiating a photosensitive substance accumulated in the tumor cells with near-infrared light, which is the excitation light for the photosensitive substance. Target cells are tumor cells such as cancer cells and cells of precancerous lesions. In this treatment method, an antibody that specifically binds only to a specific antigen on the surface of tumor cells and a photosensitive substance bound to that antibody are used as drugs. The antibody is not particularly limited, but examples include panitumubab, trastuzumab, HuJ591, pertuzumab, lapatinib, palbociclib, and olaparib. The photosensitive substance is, for example, a hydrophilic phthalocyanine, which is a substance that reacts to near-infrared light with a wavelength of approximately 700 nm (IR700), but is not limited to this. When IR700 is exposed to near-infrared light with a wavelength of approximately 660-740 nm, the ligand of the functional group that ensures its water solubility is cleaved, causing a structural change from water-soluble to hydrophobic. This structural change allows membrane proteins to be extracted, creating holes in the cell membrane and allowing water to enter the cell, thus rupturing and destroying tumor cells. In addition, IR700 is excited by near-infrared light and emits fluorescence at a wavelength different from the excitation wavelength. For example, when IR700 is excited by near-infrared light with a wavelength of 689 nm, it emits fluorescence at a wavelength of 704 nm. IR700 undergoes a structural change while emitting fluorescence through a photoreaction, and once it has destroyed tumor cells and fulfilled its role as a drug, it ceases to emit fluorescence.

[0019] The medical device 10 of this embodiment is configured to be suitable for treatments that approach tumor cells via open surgery or laparoscopy. As shown in Figures 1 and 2, the medical device 10 according to this embodiment includes a light irradiation unit 20 that irradiates the lesion with excitation light for a photosensitive substance, a housing 40 that is operated by the operator by hand, a shaft 30 extending from the housing 40 toward the tip, a reflecting unit 60 that reflects the excitation light emitted from the light emission unit 22, a distance detection unit 70 that detects the distance to the target of the excitation light irradiation, a tubular unit 50 that extends from the housing 40 toward the tip and covers the shaft 30, an adjustment unit 80, and a notification unit 90 that notifies the outside of information. The medical device 10 also includes a posture adjustment unit 11 that adjusts the posture of the light irradiation unit 20.

[0020] The shaft portion 30 is a long tube having a tip portion and a base portion, and has a lumen 31 in which the light irradiation portion 20 and the reflecting portion 60 are arranged. A light-transmitting window portion 32 is formed on a part of the outer circumferential surface of the tip portion of the shaft portion 30. The window portion 32 allows excitation light to pass through from the lumen 31 side to the side Y perpendicular to the axis X of the shaft portion 30. The window portion 32 is made of transparent resin or glass. The surface of the window portion 32 is preferably flat or thin so that the transmitted excitation light is not distorted. The window portion 32 may also be a through hole. The shaft portion 30 is preferably flexible and has a curved portion within a range that can be accommodated in the tubular portion 50.

[0021] As shown in Figure 1, the tubular portion 50 is a tube that covers a part of the shaft portion 30. A rotational operation portion 51, which is one of the posture adjustment portions 11, is provided at the base end of the tubular portion 50. By rotating the rotational operation portion 51, the operator can rotate the shaft portion 30 about the axis X.

[0022] As shown in Figures 1 and 2, the light irradiation unit 20 has a long irradiation optical waveguide 21 and a light emission unit 22 located at the tip of the irradiation optical waveguide 21. The irradiation optical waveguide 21 is a long wire that propagates light. The irradiation optical waveguide 21 is formed by, for example, a single optical fiber. However, the irradiation optical waveguide 21 may be formed by multiple optical fibers. The irradiation optical waveguide 21 is located inside the shaft body 34, and the base end of the irradiation optical waveguide 21 can be connected to an optical output device (not shown) that outputs light. The irradiation optical waveguide 21 can receive near-infrared light from the optical output device and propagate the near-infrared light to the light emission unit 22. However, the irradiation optical waveguide 21 may be formed by an optical waveguide other than an optical fiber.

[0023] The light-emitting section 22 emits excitation light that spreads toward the tip with a predetermined divergence angle θ relative to the tip. The light-emitting section 22 is, for example, a lens or diffuser connected to the cut end of an optical fiber. The light-emitting section 22 may also be an LED or the like that emits light when powered.

[0024] As shown in Figures 2-3, the reflecting section 60 is a mirror having a reflective surface 61 and is positioned towards the tip of the light-emitting section 22 of the lumen 31. The reflecting section 60 reflects the excitation light received from the light-emitting section 22, which is positioned at the base end, at an angle of approximately 90 degrees and emits it to the side Y. The reflective surface 61 of the reflecting section 60 is planar, and the divergence angle θ of the reflected excitation light is maintained almost without distortion. As shown in Figure 3(A), the reflecting section 60 is cylindrical in shape with a reflective surface 61 inclined at an angle of approximately 45 degrees towards the base end, but it may also be a rectangular prism as shown in Figure 3(B) or a polygonal prism as shown in Figure 4(C). The reflecting section 60 may also be a prism. If it is a prism, it is positioned in the opposite state to the mirror shown so that it reflects off the inner surface of the prism.

[0025] As shown in Figures 4(A) and 4(B), the reflective portion 60 may be detachable from the shaft body 34 on the proximal end side of the shaft attachment portion 33, together with the shaft attachment portion 33 located at the tip of the shaft portion 30. This allows the operator to select the shaft attachment portion 33 having an appropriate reflective portion 60 in accordance with the size, shape, location, treatment method, etc., of the lesion L, and change it to the desired form.

[0026] In this embodiment, the reflecting part 60 does not move within the lumen 31 of the shaft part 30, while the light emitting part 22 is movable. However, as shown in Figure 5, the reflecting part 60 may move within the shaft part 30 while the light emitting part 22 does not move. In this case, a drive shaft 35 is arranged within the lumen 31 to move the reflecting part 60 along the axis X. The drive shaft 35 is driven by a drive source, for example, located inside the housing 40. The window part 32 is formed to be long along the axis X so that the excitation light reflected from the reflecting part 60 can be emitted to the outside of the shaft part 30 even when the reflecting part 60 moves along the axis X. The reflecting part 60 may also be rotationally driven by the drive shaft 35 and be rotatable about the axis X. This allows the irradiation direction of the excitation light to be adjusted in the rotational direction. In this case, the window part 32 that transmits the excitation light is preferably formed over 360 degrees in the circumferential direction, and is preferably cylindrical or polygonal. Preferably, the drive source that drives the drive shaft 35 is controlled by the control unit 81, which will be described later.

[0027] As shown in Figures 1 and 2, the distance detection unit 70 is positioned near the window 32 so as to be able to detect the distance along the lateral Y from the window 32 to the target of irradiation (lesion L). For example, the distance detection unit 70 is positioned adjacent to the window 32 on the outer circumferential surface of the shaft 30. The distance detection unit 70 is a non-contact displacement sensor, such as a laser, LED, or ultrasonic type. Alternatively, as shown in Figure 6, the distance detection unit 70 may be a contact-type displacement sensor with a protruding contact element 71. Or, the distance detection unit 70 may be a proximity sensor that detects whether or not a predetermined distance is within it. Alternatively, the distance detection unit may be formed by a light emission unit 22 and a reflecting unit 60. For example, when the distance from the window 32 to the target of irradiation is appropriate, the light irradiated onto the target of irradiation will be focused, allowing the operator to recognize the distance from the window 32 to the target of irradiation by observing the surface of the target of irradiation visually or with an endoscope such as a laparoscope. The light irradiated at this time may be excitation light, but it does not have to be excitation light. Furthermore, when the distance from the window 32 to the irradiated object is appropriate, the edges of the light illuminating the object become clear, and the operator may recognize this visually or with an endoscope. Also, when the orientation (angle) of the irradiated object relative to the window 32 is appropriate (for example, parallel), the light illuminating the object changes from an ellipse to a perfect circle, and the operator may recognize this visually or with an endoscope. Note that the surface of the irradiated object may be observed using the image detection unit 100 described later.

[0028] The presence of the distance detection unit 70 allows the operator to measure the height of the elevated lesion L and determine whether or not treatment using excitation light is possible. Furthermore, during treatment, the operator can determine from the detection results of the distance detection unit 70 whether the distance between the window 32 and the lesion L is being appropriately maintained.

[0029] As shown in Figure 1, the housing 40 includes a housing body 55 on which a gripping portion 52 is provided for the operator to grasp, a forward and backward movement operation portion 53 on which the operator controls the protruding state of the shaft portion 30 from the tubular portion 50, and an irradiation operation portion 54 on which the operator controls the emission of excitation light from the light emission portion 22.

[0030] The reciprocating operation unit 53 is rotatably connected to the housing body 55. The reciprocating operation unit 53 is connected to the base end of the shaft portion 30 inside the housing body 55. The shaft portion 30 is rotatably connected to the reciprocating operation unit 53 so as not to be hindered from rotating about its axis X. When the operator moves the reciprocating operation unit 53 while gripping the gripping portion 52, the shaft portion 30 can move back and forth along its axis X. Therefore, the operator can extend and retract the shaft portion 30 from the tip of the tubular portion 50 by operating the reciprocating operation unit 53. In addition, the shaft portion 30 is rotatable by receiving rotational force from the rotation operation unit 51.

[0031] When the operator operates the irradiation control unit 54, excitation light is output from the optical output device (not shown) inside the housing 40 to the irradiation optical waveguide 21. The optical output device may be located outside the housing 40.

[0032] The shaft portion 30 protruding from the tubular portion 50 has a shape that is curved in one direction. This allows the light-emitting portion 22 to be directed in various directions by rotating the shaft portion 30 around the axis X. The shaft portion 30 is made of a deformable material and can take on a straight shape when housed in the tubular portion 50.

[0033] The adjustment unit 80 is configured to change the distance between the light-emitting unit 22 and the reflecting unit 60 along the axis X of the shaft unit 30. The adjustment unit 80 includes a control unit 81 and a drive unit 24. The control unit 81 is configured around a logic circuit, such as a microcontroller. The control unit 81 controls the drive unit 24, which moves the light-emitting unit 22 along the axis X. The control unit 81 is located inside the housing 40, but may be located in an external device that can be connected to the medical device 10.

[0034] The control unit 81 receives the detection result from the distance detection unit 70 and controls the drive unit 24 to move the light emission unit 22 along the axis X according to the distance from the window unit 32 to the target to be illuminated.

[0035] As shown in Figure 7, the medical device 10 may have an image detection unit 100 that images the target of excitation light irradiation (lesion L). The image detection unit 100 is positioned adjacent to the window 32 on the outer surface of the shaft 30. The image detection unit 100 is, for example, a CCD sensor or a CMOS sensor. The image detection unit 100 can transmit the detection result to the control unit 81.

[0036] The control unit 81 analyzes the image received from the image detection unit 100 and can determine whether or not excitation light is incident on the lesion L based on the state of light on the surface of the lesion L during excitation light irradiation. At this time, for example, as shown in Figure 8, if the operator has previously attached dye C or the like to multiple locations surrounding the lesion L on the biological surface, or to surround the lesion L in a ring shape, the control unit 81 can easily identify the dye C from the image. The control unit 81 then determines whether or not excitation light is irradiating the entire area where the dye C is attached based on the change in the color of the image at the location where the dye C is attached, and as a result can determine whether or not excitation light has been irradiated on the lesion L. The control unit 81 can notify the operator of the determination result from a notification unit 90 (see Figure 1), such as an image display device such as a monitor or a sound output device such as a speaker. The notification unit 90 may be located in the housing 40 or in an external device that can be connected to the medical device 10.

[0037] Furthermore, the control unit 81 can analyze the image received from the image detection unit 100 and determine from the state of light on the surface of the lesion L while the excitation light is being irradiated whether or not the necessary amount of excitation light has been irradiated to the lesion L. The control unit 81 calculates the energy of the excitation light irradiated to the lesion L from the state of light on the surface of the lesion L while the excitation light is being irradiated. The control unit 81 then continues to accumulate the energy of the excitation light input to the lesion L while the excitation light is being emitted, and when the accumulated energy reaches the threshold required for treatment, it may stop the emission of excitation light from the light emission unit 22 or notify the operator via the notification unit 90.

[0038] Furthermore, the notification unit 90 may be controlled by the control unit 81 to notify the distance detected by the distance detection unit 70 (see Figures 1, 2, and 6), whether or not the distance is appropriate, or to notify the detection results of the change in distance.

[0039] Furthermore, as shown in Figure 9, the shaft portion 30 may have a cleaning lumen 36 that opens near the window portion 32 and can supply liquid to the window portion 32. This allows liquid (e.g., water or saline solution) to be supplied from the cleaning lumen 36 to the window portion 32, making it possible to clean the window portion 32 to which bodily fluids or other substances may be attached.

[0040] The medical device 10 of this embodiment allows for excitation light irradiation by either keeping the light-emitting surface of the surface-emitting window 32 away from the living body or bringing it into contact with the living body. The medical device 10 is suitable for application to elevated or invasive lesions. Furthermore, even if bodily fluids adhere to the window 32 due to contact with the living body during device operation, the window 32 can be cleaned on the spot.

[0041] Next, a treatment method using the medical device 10 according to this embodiment will be described.

[0042] First, a photosensitive substance is administered into the body. The method of administering the photosensitive substance into the body is not particularly limited as long as the photosensitive substance can reach the tumor cells, but for example, it is administered intravascularly, and in this embodiment, it is administered intravenously. Approximately 12 to 36 hours after intravenous administration, the photoirradiation treatment is performed using the medical device 10 of this embodiment.

[0043] In this embodiment, the surgeon approaches the lesion L either through open surgery or laparoscopy, as described above. The surgeon approaches the lesion L using an endoscope such as a laparoscope. The surgeon inserts the tubular body containing the tip of the shaft 30 into the body, and when the tip reaches the vicinity of the lesion L, operates the advance / return movement operation unit 53 to make the portion including the window 32 and the distance detection unit 70 protrude from the tubular body 50. Then, the surgeon changes the orientation of the window 32 by operating the rotation operation unit 51, and directs the window 32 toward the lesion L, as shown in Figure 2. It is preferable that the window 32 be away from the lesion L, but it may be in contact with the lesion L.

[0044] The operator operates the irradiation control unit 54 of the housing 40. This causes the control unit 81 to receive detection results from the distance detection unit 70 and control the drive unit 24, which moves the light emission unit 22 along the axis X, according to the distance from the window unit 32 to the lesion L, which is the target of irradiation. When the distance from the window unit 32 to the lesion L is short, the control unit 81 moves the light emission unit 22 toward the proximal end, away from the reflecting unit 60, as shown in Figure 2(A). When the distance from the window unit 32 to the lesion L is long, the control unit 81 moves the light emission unit 22 toward the tip, closer to the reflecting unit 60. This allows the irradiation distance from the light emission unit 22 to the lesion L via the reflecting unit 60 to be appropriately maintained. Alternatively, the control unit 81 may adjust the irradiation range (the range of excitation light irradiated onto the target (lesion L)) according to the size of the lesion L, rather than controlling the distance from the light emission unit 22 to the lesion L via the reflecting unit 60 to a predetermined value. Therefore, the excitation light emitted from the light emission unit 22 at a predetermined divergence angle θ, after being reflected by the reflecting unit 60, continues to diverge and heads laterally Y, spreading to a desired range and reaching the target.

[0045] The control unit 81 adjusts the distance between the window 32 and the lesion L, and then controls the light output device to supply excitation light to the light emission unit 22. This allows the excitation light to be irradiated onto the lesion L from the light emission surface of the light emission unit 22.

[0046] When excitation light is irradiated, it reaches the photosensitive substances accumulated in the tumor. This causes a chemical change in the photosensitive substances excited by the excitation light, and further structural changes in the photosensitive substances create holes in the cell membrane. As a result, the tumor cells irradiated with excitation light are destroyed.

[0047] The control unit 81 can adjust the distance between the light emission unit 22 and the reflecting unit 60 so that the irradiation distance or irradiation range of the excitation light remains constant while the excitation light is being irradiated.

[0048] The operator irradiates the photosensitive substance excited by the excitation light from the light irradiation unit 20 and confirms the fluorescence emitted by the photosensitive substance. The irradiation state of the excitation light and the fluorescence can be confirmed via a light-transmitting unit and an irradiation optical waveguide 21. That is, the irradiation light-transmitting unit and the irradiation optical waveguide 21 can be used in combination for fluorescence detection, and the fluorescence detected via the irradiation optical waveguide 21 can be displayed on, for example, an external display device (not shown) to confirm the irradiation state of the excitation light and the fluorescence. In addition, other light detection units may be placed inside the light-transmitting unit or near the support unit for confirming the irradiation state of the excitation light and the fluorescence.

[0049] The surgeon determines that sufficient destruction of tumor cells has been achieved in the area irradiated with excitation light when the fluorescence disappears using a display device or when a predetermined time has elapsed. If other tumor cells are present, the surgeon brings the light-emitting surface into contact with the surrounding area of ​​other lesions L and irradiates them with excitation light.

[0050] As described above, the medical device 10 according to this embodiment is a medical device 10 that irradiates a photosensitive substance accumulated in a tumor with excitation light to destroy tumor cells, and is a long tube having a tip and a base, a shaft portion 30 having a light-transmitting window portion 32, a light-emitting portion 22 disposed inside the shaft portion 30 that emits excitation light for the photosensitive substance toward the tip at a predetermined divergence angle θ, a reflecting portion 60 disposed inside the shaft portion 30 toward the tip side of the light-emitting portion 22 and reflects the excitation light emitted from the light-emitting portion 22 toward the side Y perpendicular to the axis X of the shaft portion 30 at a divergence angle θ to transmit through the window portion 32, and an adjustment portion 80, wherein the adjustment portion 80 is configured to change the distance between the light-emitting portion 22 and the reflecting portion 60 along the axis X of the shaft portion 30.

[0051] As described above, the medical device 10 allows the separation distance between the light-emitting section 22 and the reflecting section 60 to be changed within the shaft section 30. Therefore, the distance required to spread the excitation light emitted from the light-emitting section 22, which has a predetermined divergence angle θ, to a desired range can be changed within the shaft section 30. As a result, excitation light that has been diverged to a desired range can be irradiated onto the lesion L adjacent to the medical device 10. Consequently, the excitation light can be uniformly irradiated onto the lesion L, and the irradiation state to the lesion L can be stably maintained.

[0052] The medical device 10 has a distance detection unit 70 that detects the distance to the target to which the excitation light is irradiated. This makes it possible to measure the height of the elevated lesion L using the distance detection unit 70 and determine whether or not it is treatable. It also makes it possible to determine whether the distance between the window 32 and the lesion L is appropriately maintained during treatment.

[0053] The adjustment unit 80 has a control unit 81 that changes the distance between the light-emitting unit 22 and the reflecting unit 60 along the axis X of the shaft unit 30. As a result, the medical device 10 can automatically and appropriately adjust the distance between the light-emitting unit 22 and the reflecting unit 60 by the control unit 81, thereby improving operability.

[0054] The medical device 10 has a drive unit 24 that moves the light emitting unit 22 or the reflecting unit 60 along the axis X of the shaft unit 30, and the control unit 81 may adjust the separation distance between the light emitting unit 22 and the reflecting unit 60 based on the detection result of the distance detection unit 70. This improves operability because the drive unit 24 can be automatically adjusted so that the irradiation range of the excitation light on the target is appropriate according to the distance from the medical device 10 to the target.

[0055] The medical device 10 has an image detection unit 100 that detects an image of the target to be irradiated, and the control unit 81 may stop the emission of excitation light based on the results of the image detection unit 100. This improves operability because it is possible to determine from the image that the treatment with excitation light is complete and to automatically stop the emission of excitation light.

[0056] The control unit 81 may calculate the integrated energy of the excitation light irradiated onto the target based on the detection result of the image detection unit 100, and stop the emission of the excitation light based on the calculation result. This allows the system to automatically determine when sufficient excitation light irradiation has been performed and stop the irradiation, improving operability.

[0057] The medical device 10 has a notification unit 90 that can transmit information to the outside, and the control unit 81 may cause the notification unit 90 to transmit information based on at least one detection result obtained. This allows the operator to recognize the detection result from the notification unit 90 and perform treatment using excitation light appropriately.

[0058] The reflective portion 60 may be detachable from the shaft portion 30. This allows for the selection and use of the most suitable reflective portion 60 depending on the size, shape, location, treatment method, and other conditions of the lesion L.

[0059] The shaft portion 30 may have a cleaning lumen 36 that opens near the window portion 32, allowing liquid to be supplied to the window portion 32. This prevents the window portion 32 from becoming dirty and unable to emit excitation light.

[0060] It should be noted that the present invention is not limited to the embodiments described above, and various modifications can be made by those skilled in the art within the technical framework of the present invention. For example, each of the configurations described herein may be combined as appropriate. Furthermore, the separation distance between the light emitting unit 22 and the reflecting unit 60 may be changed at the discretion of the operator rather than by the control unit 81. In this case, the operator can change the separation distance between the light emitting unit 22 and the reflecting unit 60 by operating a switch mechanism that can adjust the operation of the drive unit 24, or manually without using the drive unit 24. [Explanation of symbols]

[0061] 10 Medical Devices 11 Posture adjustment section 20 Light-irradiating section 21 Optical waveguide for irradiation 22 Light-emitting section 24 Drive unit 30 Shaft section 31 lumens 32 Window section 33 Shaft detachment section 34 Shaft body 35 Drive shaft 36 lumens for cleaning 40 cabinets 50 Tubular part 51 Rotary operation section 52 Gripping part 53 Forward / backward movement operation section 54 Irradiation operation section 55 Main unit 60 Reflector 61 Reflective surface 70 Distance detection unit 80 Adjustment part 81 Control Unit 90 Hochi Department 100 Image detection unit L lesion X-axis center Y side

Claims

1. A medical device that destroys tumor cells by irradiating photosensitive substances accumulated in tumors with excitation light, It is a long tube having a tip and a base, and a shaft portion having a light-transmitting window, A light emitting section is positioned inside the shaft portion and emits excitation light for the photosensitive material toward the tip at a predetermined divergence angle, A reflecting portion is located inside the shaft portion, towards the tip of the light-emitting portion, and reflects the excitation light emitted from the light-emitting portion with a divergence angle perpendicular to the axis of the shaft portion, thereby transmitting it through the window portion. Adjustment part, A distance detection unit for detecting the distance to the object to be irradiated with the excitation light, The system includes a drive unit that moves the light-emitting portion or the reflecting portion along the axis of the shaft portion, The adjustment unit has a control unit configured to change the distance between the light emitting unit and the reflecting unit along the axis of the shaft, The control unit adjusts the separation distance between the light emitting unit and the reflecting unit based on the detection result of the distance detection unit, in this medical device.

2. It has an image detection unit that detects the image of the target to be irradiated, The medical device according to claim 1, wherein the control unit stops the emission of the excitation light based on the detection result of the image detection unit.

3. The medical device according to claim 2, wherein the control unit calculates the integrated energy of the excitation light irradiated onto the target based on the detection result of the image detection unit, and stops the emission of the excitation light based on the calculation result of the integrated energy of the excitation light irradiated onto the target.

4. It has a notification unit that can transmit information to the outside, The medical device according to any one of claims 1 to 3, wherein the control unit causes the notification unit to notify information based on the detection result of the distance detection unit.

5. Having a notification unit capable of notifying information to the outside, The medical device according to claim 2, wherein the control unit causes the notification unit to notify the notification unit of information based on the detection result of the image detection unit.

6. Having a notification unit capable of notifying information to the outside, The medical device according to claim 3, wherein the control unit causes the notification unit to notify information based on the calculation result of the integrated energy of the excitation light irradiated onto the target of irradiation.

7. The medical device according to any one of claims 1 to 6, wherein the reflective portion is detachable from the shaft portion.

8. The medical device according to any one of claims 1 to 7, wherein the shaft portion has a cleaning lumen that opens near the window portion and allows liquid to be supplied to the window portion.

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