Probe device, examination device, method and controller for operating an examination device

Abstract

The present invention relates to a probe device (105) for selectively removing and / or modifying intestinal mucosa. The probe device (105) has a tubular housing (120) with a treatment probe (125) which extends in particular as far as an end of the housing (120), a radiation conductor (130) and a positioning element (200). The radiation conductor (130) is designed to emit electromagnetic radiation (115) guided in the radiation conductor (130) via an outlet (240) in the treatment probe (125) to surroundings of the probe device (105). The positioning element (200) is designed to fix the treatment probe (125) and / or the outlet (240) in a section of the intestine.

Description

[0001] Description

[0002] title

[0003] Probe device, examination device, method and control unit for operating an examination device

[0004] The presented approach relates to a probe device, an examination device, a method and a control unit for operating an examination device according to the main claim.

[0005] The removal of intestinal segments through bariatric surgery has been modified by treatments described in patents such as US 10,765,424; US 10,959,774; US 10,980,590; and US 10,987,149, which promote the selective modification or removal of mucosa in the duodenum through intensive hydrothermal ablation. This means that very hot water is used in the treatment to denature the intestinal mucosa during the procedure. Hot water is either introduced through the device and then removed, or a heat source heats the water in the distal portion of the probe just before the water comes into contact with the mucosa. Electrical or radiofrequency sources can be used to heat the water and mucosa at the treatment sites or in the external reservoir.

[0006] The approach presented here aims to create an improved probe device, an improved examination device, an improved method, and an improved control unit for operating an examination device according to the main claims. Advantageous embodiments and further developments are described in the dependent claims and the following description.

[0007] According to the approach presented here, this problem is solved by a probe device, an examination device, a method, and a control unit for operating an examination device with the features of the main claim. Advantageous embodiments and further developments of the presented approach are described in the description and the following dependent claims. To solve the aforementioned problem, the approach proposed here provides a probe device for the selective removal and / or modification of intestinal mucosa. The probe device comprises a tubular housing with a treatment probe, which extends in particular to one end of the housing, a radiation guide, and a positioning element. Alternatively or additionally, the tubular housing can also be provided with a treatment probe at one end of the housing.The radiation guide is designed to emit electromagnetic radiation guided in the radiation guide via an outlet in the treatment probe to an environment of the probe device. The positioning element is designed to fix the treatment probe and / or the outlet in a section of the intestine.

[0008] In a preferred first embodiment, the radiation guide is arranged to be axially and / or rotationally movable within the treatment probe in order to sequentially irradiate different areas of the intestinal mucosa while the positioning element is fixed. In a further preferred second embodiment, the radiation guide within the treatment probe is configured to emit electromagnetic radiation over a predetermined axial length and essentially circumferentially (360 degrees) in order to simultaneously treat a cylindrical area of ​​the intestinal mucosa. A particularly advantageous feature of the second embodiment is a radiation guide in the form of an optical fiber that has an emission region extending axially along a longitudinal axis of the optical fiber.

[0009] For the selective ablation and / or modification of intestinal mucosa, emitted electromagnetic radiation should act on a circumference and length of the intestinal mucosa. This can be achieved by axially and / or radially interrupted or continuous electromagnetic radiation. To irradiate different areas of the intestinal mucosa sequentially, one method can be used: either by axial and / or rotational movement of a radiation guide within a treatment probe with a fixed positioning element, or by a treatment probe designed to emit electromagnetic radiation over a predetermined axial length and essentially circumferentially (360 degrees) to simultaneously treat a cylindrical area of ​​the intestinal mucosa.

[0010] Modern lifestyles can lead to excessive nutrient intake and absorption, which, combined with a relative lack of exercise, can result in a significantly elevated body mass index, non-alcoholic fatty liver disease, diabetes, and other medical problems in both humans and animals. Dietary programs, exercise, and physical activity may offer only limited success in addressing this issue. Surgical interventions such as bypass surgery can be risky. The approach presented here may provide a less invasive yet effective alternative.

[0011] The approach presented here can create a device and a method for treating the intestinal mucosa, among other things, as a means of minimizing the increased incidence of obesity, non-alcoholic fatty liver disease, diabetes, and other medical problems in humans and animals. A reduction in type 2 diabetes mellitus can be observed in patients whose duodenal mucosa has been treated to remove / modify the mucosa within it.

[0012] The approach presented here enables the ablation and / or modification of a contiguous cylindrical area, segments within a cylindrical area, or selective segments of the intestinal mucosa by irradiating this mucosa with suitable laser radiation, with or without the use of photosensitizers. The aim of this approach is to provide a fiber-optic system that allows for the ablation and / or modification of the intestinal mucosa within a contiguous cylindrical area, segments within a cylindrical area, or selectively, without the need for heated water and / or solutions. The term "intestinal mucosa" can be used here to refer to the lining tissue layer of the intestine, encompassing the duodenum, jejunum, and ileum—these three constitute the small intestine—and the large intestine (intestinum crassum).In a preferred embodiment, the selective removal and / or modification of the lining tissue layer of the small intestine is involved. In a particularly preferred embodiment, the removal and / or modification of the lining tissue layer of the duodenum is involved.

[0013] Another objective of the approach presented here is to provide a visualization device that can be integrated into the probe device, which can also be referred to as a fiber optic system. A further objective of the approach presented here is to have a means of positioning the distal end of the probe device within the intestine and at a distance from the mucosa. If an expandable bladder is used to center the distal end, D₂O or another liquid that does not absorb significant energy at the radiation wavelengths used in the device can be employed. This means can be the positioning element.

[0014] The approach presented here can represent a probe device that can be fluid-free during radiation treatment and generally includes a visualization device and a means for measuring / monitoring the temperature at its distal end. This probe device can selectively ablate and / or modify the intestinal mucosa in the treatment of numerous diseases, such as type 2 diabetes mellitus, non-alcoholic fatty liver disease, excessive body mass index, and other such conditions. Light-activated techniques, such as photodynamic therapy with selected photosensitizers or photosensitizer precursors, or local denaturation of the mucosa, can be employed to increase the selectivity of mucosal ablation and / or modification. In a preferred embodiment, the photosensitizer temoporfin (m-THPC) can be used.These light-activated fiber optic systems can enable simpler and more selective treatments.

[0015] The positioning element can be designed as a cage or a balloon. This allows the probe device to be positioned reliably and very precisely within the intestine and at a distance from the mucosa.

[0016] The positioning element can include an activation line to introduce and / or remove fluid from the balloon. Additionally or alternatively, the activation line can include a traction device to change the shape of the cage. This embodiment also enables reliable and accurate positioning of the probe device.

[0017] The balloon-shaped positioning element can have a sheath that may be transparent to electromagnetic radiation. This allows circumferential radiation to be generated on the intestinal mucosa. In one embodiment, extending to the end of the housing, one end of the treatment probe can be at least partially conical. This embodiment also allows circumferential radiation to be generated on the intestinal mucosa.

[0018] The probe device can include a radiation guide housing in which the radiation guide can be movably arranged, in particular axially and / or rotationally movable. Additionally or alternatively, the radiation guide can be configured to guide infrared radiation, radiation in the wavelength range of 420 to 460 nanometers, and / or in the range of 1900 to 2000 nanometers. Additionally or alternatively, the radiation guide can be configured to guide an electromagnetic wavelength corresponding to an activation wavelength of Temoporfm, m-THPC. In other words, the approach presented here can provide a fiber optic system, a photosensitizer or a photosensitizer precursor, and a light source whose irradiation spectrum can correspond to the absorption spectrum or activation wavelengths of the photosensitizer or the photosensitizer resulting from the precursor.Thus, photodynamic therapy can be used to alter or remove the intestinal mucosa using synthetically produced photoensitizers, for example Temoporfm - m-THPC -, or chromophores naturally occurring in foods and spices as photosensitizers.

[0019] The probe device may include a temperature sensor configured to detect a temperature in the area of ​​the treatment probe. For example, the temperature may be detected in the area of ​​the positioning element or on a surface of the positioning element. In other words, the probe device may include a means for measuring and / or monitoring the local temperature at the distal end. This means for measuring and / or monitoring may be a temperature sensor.

[0020] The probe device can include a camera element arranged in the treatment probe, wherein the camera element can be configured to optically capture the area surrounding the treatment probe, in particular wherein the camera element can be movably arranged in a camera housing. This allows different segments of the intestinal mucosa to be viewed.

[0021] The radiation guide can have at least one termination element in the region of the outlet to substantially reflect and / or emit the electromagnetic radiation received by the radiation guide. Additionally or alternatively, the outlet can be configured to emit the electromagnetic radiation radially to the axial extent of the radiation guide at an angle of up to 360 degrees, in particular a maximum of 180 degrees, preferably a maximum of 90 degrees, and / or, for example, continuously over 360 degrees. An optical fiber can be selected as the radiation guide from among many possible optical fibers, including fibers that emit electromagnetic radiation over one or more radial sections and / or over one or more axial sections. The radiation can be emitted axially and / or radially interrupted, for example, axially by a two-ring radial fiber, and / or continuously, e.g., radially continuous around the perimeter.A radial fiber that segments or continuously emits electromagnetic radiation over 360 degrees is axially shifted during treatment to treat a sector of the intestinal mucosa extending in the direction of the radiation conductor.

[0022] In addition to a single-ring radial fiber that emits electromagnetic radiation in a 360-degree radius, and a multi-ring radial fiber, particularly a two-ring radial fiber that emits electromagnetic radiation from two rings, each with a 360-degree radius, so-called side fibers can be used in the probe device. These fibers emit electromagnetic radiation laterally over a limited angular range, for example, 30 degrees, or diffuser fibers. A side fiber that emits electromagnetic radiation over a smaller angular range, e.g., 30 degrees, is rotated and / or axially shifted during treatment to treat a sector of the intestinal mucosa.

[0023] A diffuser fiber is an optical fiber that has an emission region. This emission region extends axially along a longitudinal axis of the optical fiber and is arranged to emit radiation in a lateral direction with respect to the longitudinal axis. Within the emission region, the core section is provided with a plurality of scattering points, each formed by a local change in the refractive index within the core section. Such a diffuser fiber distributes the electromagnetic radiation over an axial region in such a way that no or only a minimal displacement of the radiation guide is necessary for processing, compared, for example, to a single-ring radial fiber.

[0024] The probe device may include a flushing device designed to drain ablated tissue into the area surrounding the treatment probe and / or to aerate an area surrounding the treatment probe. In other words, the probe device may be designed to remove and / or modify the surface of the intestinal mucosa to facilitate treatments of conditions such as type 2 diabetes mellitus, non-alcoholic fatty liver disease, excessive body mass index, and other such conditions.

[0025] An investigation device comprises an embodiment of a probe device mentioned herein and a radiation source for emitting electromagnetic radiation into the radiation conductor. In other words, the investigation device can have an irradiation source with a suitable wavelength, which can be coupled to the probe device.

[0026] The probe device may include the activation line, and the investigation device may further include an activation device which may be configured to convey a fluid transparent to electromagnetic radiation into the activation line.

[0027] The aforementioned advantages can also be realized according to one embodiment by means of a method for operating an embodiment of an investigation device mentioned herein, wherein the method includes a step of activating a light source to introduce light into the probe device.

[0028] This method can be implemented, for example, in software or hardware, or in a hybrid form of both, such as in a control unit. A method for the selective removal and / or modification of the intestinal mucosa using a fiber optic system can also be provided. Furthermore, the approach presented here creates a control unit configured to perform, control, and implement the steps of a variant of the method presented here in appropriate devices. This embodiment of the invention, in the form of a control unit, also allows the underlying problem to be solved quickly and efficiently.

[0029] For this purpose, the control unit can have at least one processing unit for processing signals or data, at least one storage unit for storing signals or data, at least one interface to a sensor or actuator for reading sensor signals from the sensor or for outputting control signals to the actuator, and / or at least one communication interface for reading or outputting data embedded in a communication protocol. The processing unit can be, for example, a signal processor, a microcontroller, or the like, while the storage unit can be flash memory or a magnetic storage device.The communication interface can be configured to read or output data wirelessly and / or via wired connections, whereby a communication interface that can read or output wired data can, for example, read this data electrically or optically from or output it into a corresponding data transmission line.

[0030] In this context, a control unit can be understood as an electrical device that processes sensor signals and outputs control and / or data signals accordingly. The control unit can have an interface, which can be implemented in hardware and / or software. In the case of a hardware-based interface, the interfaces can, for example, be part of a so-called system ASIC, which incorporates various functions of the control unit. However, it is also possible that the interfaces are separate integrated circuits or at least partially comprised of discrete components. In the case of a software-based interface, the interfaces can be software modules, which, for example, are located on a microcontroller alongside other software modules.

[0031] It is also advantageous to have a computer program product or computer program with program code that can be stored on a machine-readable carrier or storage medium such as a semiconductor memory, a hard disk memory or an optical memory and is used to carry out, implement and / or control the step of the method according to an embodiment described above, in particular if the program product or program is executed on a computer, a control unit or a device.

[0032] Examples of the presented approach are shown schematically in the drawings and are described in more detail below. It shows

[0033] Figure 1 shows a schematic representation of an embodiment of an examination device;

[0034] Figure 2 shows a schematic representation of an embodiment of a

[0035] Probe device;

[0036] Figure 3a shows a schematic representation of a positioning element to illustrate an embodiment of a probe device;

[0037] Figure 3b shows a schematic representation of a positioning element to illustrate an embodiment of a probe device;

[0038] Figure 4 shows a flowchart of an embodiment of a method for operating an inspection device; and

[0039] Figure 5 shows a block diagram of an exemplary embodiment of a control unit for operating an examination device.

[0040] The same or similar reference symbols are used in the following description for identical or similar elements, and for the sake of clarity, a repeated explanation of the function of these elements is omitted.

[0041] Figure 1 shows a schematic representation of an embodiment of an examination device 100. The examination device 100 comprises a probe device 105 and a radiation source 110. The radiation source 110 is configured to emit electromagnetic radiation 115 into the probe device 105.

[0042] to radiate. The probe device 105 is designed to selectively ablate and / or modify intestinal mucosa. For this purpose, the probe device 105 has a tubular housing 120 with a treatment probe 125, a radiation guide 130 and a positioning element.

[0043] According to the embodiment shown here, electromagnetic radiation 115 is emitted from the radiation source 110 into the radiation conductor 130. The testing device 100 also includes an activation device 135, which is configured to pump a fluid transparent to the electromagnetic radiation 115 into an activation line of the probe device 105. Figure 2 describes and illustrates the probe device 105 in more detail.

[0044] Figure 2 shows a schematic representation of an embodiment of a probe device 105. The probe device 105 is similar to or corresponds to the probe device from Figure 1. The probe device 105 is designed to selectively remove and / or modify intestinal mucosa.

[0045] For this purpose, the probe device 105 has the tubular housing 120 with the treatment probe 125, the radiation guide 130 and the positioning element 200.

[0046] Optionally, the probe device 105 includes a radiation guide housing 205, a temperature sensor 210, a camera element 215 and / or a flushing device 220.

[0047] The housing 120, which can also be described as a transparent inflatable balloon, has an inlet 225 and an end 230 opposite the inlet 225, with the treatment probe 125 extending to the end 230 of the housing 120. The treatment probe 125 is shown with a conical shape for illustrative purposes only. The inlet 225 is designed, for example, to emit the electromagnetic radiation 115 from the radiation source 110 shown in Fig. 1 into the radiation guide housing 205. An arrow represents, for illustrative purposes only, the direction of radiation of the electromagnetic radiation 115.

[0048] According to one embodiment, the radiation guide 130 is arranged to be axially and / or rotationally movable within the radiation guide housing 205. The radiation guide 130 is designed to emit the electromagnetic radiation 115 via an outlet 240 in the treatment probe 125 to the surroundings of the probe device 105. For this purpose, the radiation guide 130 has, for example, a termination element 245 in the region of the outlet 240 to substantially reflect and / or emit the electromagnetic radiation 115 received by the radiation guide 130. The termination element 245 can also be described as a radial fiber with a cap for total internal reflection. Additionally or alternatively, the outlet 240 is designed to emit the electromagnetic radiation 115 at an angle of up to 180 degrees, in particular up to 90 degrees.According to one embodiment, the radiation conductor 130 is configured to guide infrared radiation, radiation in the wavelength range of 420 to 460 nanometers, and / or radiation in the range of 1900 to 2000 nanometers. Additionally or alternatively, the radiation conductor 130 is configured to guide an electromagnetic wavelength corresponding to an activation wavelength of μm (m-THPC). The radiation conductor 130, which can also be described as an axially and / or rotationally movable fiber, enables the irradiation of a specific segment of the intestine without the need to inflate and deflate the balloon to move it. For this purpose, the treatment probe 125 extends over the entire axial length of the balloon to allow for the greatest possible axial displacement during treatment.

[0049] The positioning element 200 is designed to fix the treatment probe 125 and / or the outlet 240 in a section of the intestine. For this purpose, the positioning element 200 is, by way of example, arranged at the end 230 of the housing 120 and is designed as a balloon. The positioning element 200 has, for example, an activation line 250, which is arranged in the housing 120, for example, parallel to the radiation guide housing 205. The activation line 250 is designed to direct a fluid into and / or out of the balloon in order to fix the treatment probe 125 and / or the outlet 240 in the section of the intestine. The fluid is conveyed, for example, from the activation device shown in Fig. 1 into the activation line 250 to the positioning element 200, which is designed as a balloon. The balloon has, for example, a shell that is transparent to the electromagnetic radiation 115.

[0050] The camera element 215 is designed, for example, to optically capture the area around the treatment probe 125. For this purpose, the camera element 215 is movably arranged within a camera housing 255 (only as an example). The camera element 215 can also be referred to as a side-view camera, with the camera housing 255 being movably arranged within a second pipe channel. Different segments are visible by rotating the housing. According to one embodiment, the camera housing 225 is arranged adjacent to the radiation guide housing 205. According to the embodiment shown here, the activation line 250 is arranged between the radiation guide housing 205 and the camera housing 225 or the camera element 215.

[0051] The temperature sensor 210 is designed, for example, to detect a temperature in the area of ​​the treatment probe 125, for example in the area of ​​the positioning element 200. The rinsing device 220 is designed, for example, to discharge ablated tissue into the vicinity of the treatment probe 125 and / or to ventilate an area in the vicinity of the treatment probe 125.

[0052] The approach presented here is explained in other words below: The described examples do not claim to be exhaustive, but show how the method and the devices are used, for example, in the treatment of the duodenal mucosa to achieve results such as the treatment of type 2 diabetes mellitus with an elevated body mass index and related diseases.

[0053] According to a first embodiment, for uniform treatment of the intestinal mucosa, it is crucial that the end of the probe device 125, which can also be referred to as the distal tip, is conically shaped so that the radiation exits the end in a circumferential direction, and that the end of the probe device 125 is centered, for example, within the duodenal canal if treatment is to be performed there, so that the end of the probe device 125 is uniformly spaced from the intestinal walls where the mucosa is located. The use of a video endoscope for inserting the probe device 125 allows for real-time monitoring of the position of the distal tip.The methods for centering the distal end of the probe device 125 generally employ either the fluid activation of a compressed balloon or the mechanical expansion of a collapsed cage at the distal tip, i.e., the fluid activation of the positioning element 200 or the mechanical expansion of the positioning element 200. The latter is illustrated in Figure 3a and / or Figure 3b. Figure 2 therefore shows a fluid-activated balloon for centering the distal end of the probe device 125 in the duodenal tract, which is to be treated according to the approach presented here.

[0054] In the cage method, i.e., when the positioning element 200 is designed as a cage, the distal tip sits exactly in the middle of the intestinal canal, without any material between the probe tip and the mucosa-covered intestinal wall, see Figure 3a and / or Figure 3b.

[0055] In the balloon method shown here, where the positioning element 200 is configured as a balloon, a fluid is introduced to center the balloon in the canal for treatment. Withdrawing the fluid after treatment causes the balloon to automatically collapse back to its original state, generally simplifying the centering process in the canal. The fluid most commonly used here is water. However, if a procedure uses laser wavelengths that are absorbed by this medium, it is possible to replace the medium with D₂O, as is done in systems / devices used as arrhythmia lasers. The absorption of D₂O molecules is shifted relative to that of H₂O molecules, so there is only minimal absorption / heating in the balloon fluid. The key is to minimize the denaturation of the ablation.The modification is to be generated in the mucosa itself and not in the intestinal walls of residual fluid in the duodenal canal. This is supported by the use of shortened photon pulses during the procedure.

[0056] The photosensitizer temoporfin (m-THPC) generates singlet oxygen and other compounds that damage cells when irradiated with light corresponding to its absorption wavelengths. This has been used in the past, for example, to treat esophageal mucosa in Barrett's esophagus. Typically, this involves the use of green laser light and systemic drug infusion (532 ± 10 nanometers of light). Formulations of m-THPC that are taken orally and absorbed by the intestinal mucosa, as well as irradiation with blue photons, can be combined to enable even more selective and less systemic treatment. Extracts from natural foods, such as curcumin, can also be formulated and used as light-activated photosensitizers for such a treatment system and procedure.An inflatable balloon can be inserted via a (video) endoscope to selectively irradiate the desired segments. The balloon is filled with liquid, such as deuterated water or saline solution, because blue light is transmitted well in aqueous solutions.

[0057] According to a second embodiment, a 445-nanometer laser diode coupled to cylindrically diffusing fibers provides the illumination. Only non-thermal radiation intensity is used to protect the underlying structures important for intestinal function, as the penetration depth is shallow and, in the event of local absorption of the photosensitizer or its precursor, this provides a second selectivity level.

[0058] According to a third embodiment, selective heating or ablation of the intestinal mucosa in the absence of fluid during irradiation is achieved by using radially emitting optical fibers that enable circumferential irradiation, in combination with suitably configured spacers. These spacers are, for example, positioning elements such as balloons or cages. Suitable wavelengths for treatment are in the UV range, for example with excimer lasers, or at a blue wavelength or in the infrared range, for example at 1940 ± 10 nanometers.The irradiation is performed, for example, in pulsed or scanning motions to further locate and limit the damaged area within a mucosal segment, particularly in the absence of superheated water or other fluids during irradiation, thus protecting the underlying tissue essential for bowel function. Video endoscopes are used, for example, for the insertion and placement of the devices.

[0059] According to a fourth embodiment, irradiating the mucosa with laser light in the NIR range, at a wavelength of 1200 ± 100 nanometers, preferably 1267 ± 10 nanometers, converts triplet oxygen into singlet oxygen, thus enabling drug-free PDT treatment. This method is used, for example, for the treatment of squamous cell carcinomas and basal cell carcinomas. Here, too, the laser treatment is ideally performed with video endoscopes, which are additionally equipped with a ventilation tube to improve oxygen supply to the treatment area. To minimize thermal effects, the treatment is carried out with several successive irradiation phases of low light dose, interrupted by short breaks, thus ensuring a purely local treatment in this example as well.

[0060] According to a fifth embodiment, as in the PDT treatment (see second embodiment), suitable staining of the mucosa is combined with the process steps (see third embodiment). Staining agents can be dyes or microparticles that interact with the selected radiation wavelength. These and other conceivable variants are used, for example, to influence the intestinal mucosa in order to enable localized, effective treatment of type 2 diabetes mellitus, non-alcoholic fatty liver disease, problems with an elevated body mass index, and other related medical conditions, while remaining within the scope of the approach presented here.

[0061] Where applicable, all individual features shown in the exemplary embodiments are combined and / or exchanged without leaving the scope of the approach presented here.

[0062] In summary, the approach presented here concerns a device and a method for treating the intestinal mucosa. A fiber optic system is presented, comprising a visualization device and a means for measuring / monitoring the temperature at its distal end, which selectively ablates and / or modifies the intestinal mucosa for the treatment of numerous diseases such as type 2 diabetes mellitus, non-alcoholic fatty liver disease, excessive body mass index, and other conditions.Light-activated methods such as photodynamic therapy with selected photosensitizers or photosensitizer precursors, or drug-free photodynamic therapy using a NIR laser with the additional use of a ventilation unit, or local thermal heating directly in an area / volume of the mucosa to be treated using laser wavelengths without water contact with the mucosa during treatment at the distal end of the device during the actual irradiation, are employed to achieve increased selectivity in the ablation / denaturation of the mucosa. A preferred photosensitizer is temoporfin (m-THPC). These light-based fiber-optic systems enable simpler and more selective treatments.

[0063] In other words, the approach presented here comprises the probe device 105, which can also be described as a fiber-optic system for the selective ablation and / or modification of the intestinal mucosa, with a laser source and the treatment probe 125, which can also be referred to as a probe, for distributing the radiation at a distal location in a preselected pattern. The probe device 105 further comprises a visualization means. The probe device 105 also includes an irradiation source with a suitable wavelength, which can be coupled to the probe device 105. This is, for example, the radiation source shown and described in Figure 1. The suitable wavelength is, for example, a non-thermal wavelength, preferably 445 ± 10 nanometers or 1940 ± 10 nanometers, wherein the suitable wavelength is a NIR wavelength in the range of 1200 ± 100 nanometers, preferably 1267 ± 10 nanometers.

[0064] Furthermore, the probe device 105 includes the positioning element 200, which can also be described as a means for positioning a distal end of the system within the intestine and at a distance from the mucosa. Additionally, the probe device 105 includes the temperature sensor 210, which can also be described as a temperature measuring device and / or a monitoring device.

[0065] The probe device 105 has the treatment probe 125, which can also be called an optical fiber, the distal end of which is conically shaped and sealed in a transparent housing 120 to generate circumferential radiation onto the intestinal mucosa.

[0066] A channel through the probe device 105 and the distal area is designed for rinsing the denatured mucosa after irradiation, but remains empty during the actual irradiation. The irrigation device 220, for example, is arranged in this channel.

[0067] A further channel through the probe device 105 and the distal region is designed for ventilating and / or oxygenating the treatment region during irradiation at 1267 nanometers. The probe device 105 includes, for example, a photosensitizer or photosensitizer precursor and a light source whose irradiation spectrum corresponds to the absorption spectrum or the wavelengths of the activation spectrum of the photosensitizer or the photosensitizer resulting from the precursor. For example, temoporfin, m-THPC, is the selected photosensitizer.

[0068] For example, a procedure is provided for the selective ablation / denaturation and / or modification of intestinal mucosa using a fiber optic system comprising a laser source and a fiber optic transmission line terminating in a distal end probe to irradiate selected sections of a patient's duodenal mucosa. Mucosal treatment is used, for example, to treat one of the following conditions: type 2 diabetes mellitus, non-alcoholic fatty liver disease, and excessive body mass index. In this procedure, the wavelength used in the system is selected to generate highly localized, intense heat directly and only in the area / volume of the intestinal mucosa where treatment is desired.

[0069] Figure 3a shows a schematic representation of a positioning element 200 to illustrate an embodiment of a probe device. The positioning element 200 is similar to or corresponds to the positioning element from Figure 2, except that the positioning element 200 is designed as a cage. For this purpose, the activation line 250 includes a pulling device 300 to change the shape of the cage.

[0070] In other words, Figure 3a shows a mechanically activated cage for centering the distal end of the probe device, for example, during treatment of the duodenal mucosa. For instance, the mechanically activated cage is positioned at the treatment site in the duodenum, and then the collapsed cage is released to center the distal probe tip at the treatment site. Figure 3a shows, for example, a collapsed cage, while Figure 3b shows a mechanically activated cage.

[0071] Figure 3b shows a schematic representation of a positioning element 200 to illustrate an embodiment of a probe device. The positioning element 200 is similar to or corresponds to the positioning element in Figure 3a, except that the positioning element 200 is shown in an activated state. This means that the cage is deployed by actuating the pull device 300. This is achieved, for example, by a relative movement 305 on the activation line 250 and / or the pull device 300. The relative movement 305 is shown by arrows only as an example.

[0072] Figure 4 shows a flowchart of an embodiment of method 400 for operating an inspection device. The inspection device is similar to or corresponds to the inspection device shown in Figure 1. Method 400 comprises a step 405 of activating a light source to introduce light into the probe device.

[0073] Figure 5 shows a block diagram of an embodiment of a control unit 500 for operating an examination device. The control unit 500 is configured to control and / or execute the method from Figure 4 or a similar method.

[0074] For this purpose, the control unit 500 has an activation unit 505, which is designed to activate a light source in order to introduce light into the probe device.

Claims

Claims 1. Probe device (105) for selectively removing and / or modifying intestinal mucosa, wherein the probe device (105) has the following features: a tubular housing (120) with a treatment probe (125) which extends in particular to one end (230) of the housing (120); a radiation conductor (130) configured to emit electromagnetic radiation (115) guided in the radiation conductor (130) via an outlet (240) in the treatment probe (125) to an environment of the probe device (105); and a positioning element (200) designed to fix the treatment probe (125) and / or the outlet (240) in a section of the intestine.

2. Probe device (105) according to claim 1, wherein the positioning element (200) is designed as a cage or as a balloon.

3. Probe device (105) according to one of the preceding claims, wherein the positioning element (200) has an activation line (250) to guide a fluid into and / or out of the balloon and / or wherein the activation line (250) comprises a pulling device (300) to change the shape of the cage.

4. Probe device (105) according to one of the preceding claims, wherein the balloon has a shell which is transparent to the electromagnetic radiation (115).

5. Probe device (105) according to one of the preceding claims, wherein one end of the treatment probe (125) is at least partially conical in shape.

6. Probe device (105) according to one of the preceding claims, comprising a radiation guide housing (120) in which the radiation guide (130) is movably arranged and / or wherein the radiation guide (130) is configured to guide infrared radiation, radiation in the wavelength range of 420 to 460 nanometers and / or in the range of 1900 to 2000 nanometers and / or wherein the radiation guide (130) is configured to guide an electromagnetic wavelength corresponding to an activation wavelength of μ-THPC.

7. Probe device (105) according to one of the preceding claims, comprising a temperature sensor (210) configured to detect a temperature in the area of ​​the treatment probe (125).

8. Probe device (105) according to one of the preceding claims, comprising a camera element (215) arranged in the treatment probe (125) which is configured to optically detect the environment of the treatment probe (125), in particular wherein the camera element (215) is movably arranged in a camera housing (255).

9. Probe device (105) according to one of the preceding claims, wherein the radiation conductor (130) has a termination element (245) in the region of the outlet (240) to substantially reflect and / or emit the electromagnetic radiation (115) received by the radiation conductor (130), and / or wherein the outlet (240) is configured to emit the electromagnetic radiation (115) at an angle of at most 180 degrees, in particular at at most 90 degrees.

10. Probe device (105) according to one of the preceding claims, comprising a flushing device (220) configured to discharge removed tissue into an environment of the treatment probe (125) and / or to aerate an area of ​​the environment of the treatment probe (125).

11. Investigation device (100) with a probe device (105) according to one of the preceding claims 1 to 10 and with a radiation source (110) for emitting electromagnetic radiation (115) into the radiation conductor (130).

12. Investigation device (100) according to claim 11, wherein the probe device (105) has the activation line (250), wherein the investigation device (100) further comprises an activation device (135) configured to convey a fluid transparent to electromagnetic radiation (115) into the activation line (250).

13. Method (400) for operating an examination device (100) according to one of claims 11 to 12, wherein the method (400) comprises a step (405) of activating a light source to introduce light into the probe device (105).

14. Control unit (500) configured to control and / or execute step (405) of the method (400) according to claim 13 in a corresponding unit (505).

15. Computer program with program code for executing the method (400) according to claim 13, when the computer program is executed on a computer unit.

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