JP6498028B2 - Endoscopic photodynamic therapy device - Google Patents

Description

  The present application relates to a photodynamic therapy device for an endoscope.

  In recent years, photodynamic therapy (hereinafter abbreviated as “PDT”) has attracted attention. PDT is a local treatment method using a photochemical reaction caused by laser light irradiation in a photosensitive substance that accumulates in a large amount in cancer cells. Typically, first, a photosensitive substance (for example, talaporfin sodium) is administered to a living body. Thereafter, the cancer cell in which the photosensitive substance is accumulated is irradiated with a laser beam having a predetermined output having an excitation wavelength unique to the photosensitive substance. Singlet oxygen is generated by the laser light irradiation, and cancer cells are destroyed. For example, Patent Documents 1 to 3 propose laser treatment apparatuses used for PDT and the like.

JP 2006-87646 A Japanese Patent Application Laid-Open No. 7-110088 Japanese Patent Laid-Open No. 2001-267681

  For example, when treating cancer that has occurred in the esophagus, digestive organs, etc. with PDT, it is conceivable to use a laser light source for PDT together with an endoscope. The present application provides a photodynamic therapy device for an endoscope.

  An endoscopic photodynamic therapy apparatus according to the present disclosure includes a light source and an optical fiber having one end connected to the light source, the optical fiber including a core made of quartz to which germanium is not added, and the core. A clad made of quartz covered with side surfaces and doped with fluorine, and a coat made of nylon covered the side surfaces of the clad.

  According to the present disclosure, there is provided a photodynamic therapy device that has excellent γ-ray resistance and can be used with an endoscope.

FIG. 1 is a perspective view showing an embodiment of a photodynamic therapy device for an endoscope. FIG. 2 is a schematic diagram showing a cross-sectional structure of an optical fiber of the endoscope photodynamic therapy apparatus shown in FIG. FIG. 3 is a perspective view showing the structure of the distal end portion of the probe of the endoscopic photodynamic therapy apparatus shown in FIG. FIG. 4 is a schematic diagram showing a configuration of an endoscope system used with the endoscopic photodynamic therapy apparatus shown in FIG. FIG. 5 is a schematic diagram showing a distal end partial structure in the endoscope of the endoscope system shown in FIG.

  When treating cancer that has occurred in the esophagus, digestive organs, etc. with PDT, an optical fiber is inserted from the mouth or the like to the affected area, and a PDT laser beam guided by the optical fiber is irradiated to the cancer cells. In order to irradiate the affected area including cancer with laser light, it is necessary to observe the esophagus and digestive organs. Therefore, it is conceivable to irradiate the laser light for PDT using an endoscope.

  Specifically, it is conceivable to use an endoscope having a forceps channel, insert an optical fiber for guiding the PDT laser light into the forceps channel, and irradiate the affected area with the laser light. In this case, the optical fiber of the photodynamic therapy device inserted into the forceps channel needs to be capable of γ-ray sterilization and to have flexibility and bending strength. In view of the above-described problems, the present application provides a photodynamic therapy device for an endoscope.

An overview of one aspect of the present disclosure is as follows.
[Item 1]
A light source; and an optical fiber having one end connected to the light source, the optical fiber including a core made of quartz not added with germanium, and a clad made of quartz covering a side surface of the core and adding fluorine. An endoscopic photodynamic therapy device that covers a side surface of the clad and has a coating made of nylon.
[Item 2]
Item 2. The endoscopic photodynamic therapy device according to Item 1, wherein the optical fiber is configured to be inserted into a forceps channel of an endoscope.
[Item 3]
Item 3. The endoscopic photodynamic therapy device according to Item 1 or 2, wherein the optical fiber is subjected to γ-ray sterilization.
[Item 4]
4. The endoscopic photodynamic therapy apparatus according to any one of items 1 to 3, wherein the light source generates laser light having a wavelength of 664 nm ± 2 nm.
[Item 5]
Item 5. The endoscopic photodynamic therapy device according to any one of Items 1 to 4, further comprising a ferrule connected to the other end of the optical fiber and having a lens.

  Hereinafter, an example of the photodynamic therapy device for an endoscope of the present disclosure will be described in detail with reference to the drawings. The drawings schematically show the size and shape of each part, and the actual size and shape of each part do not necessarily match those in the drawing.

  FIG. 1 shows an example of a photodynamic therapy device for an endoscope of the present disclosure. An endoscopic photodynamic therapy device 50 shown in FIG. 1 includes an optical fiber 2, a ferrule 100, and a light source 20. The optical fiber 2 and the ferrule 100 are collectively called a probe 10.

  The light source 20 generates laser light having a wavelength suitable for treatment by PDT. For example, the light source 20 generates laser light having a wavelength of 664 nm ± 2 nm.

  The optical fiber 2 has one end connected to the light source 20.

  FIG. 2 schematically shows a cross section of the optical fiber 2. The optical fiber 2 includes a core 3, a clad 4, and a coating 5. The core 3 is, for example, a fiber having a circular shape in a cross section perpendicular to the longitudinal direction. For example, the core 3 is preferably not added with an additive such as germanium. The core 3 is preferably made of pure quartz. Here, pure quartz means quartz that does not contain an intentionally added element. Since the core 3 is made of quartz containing no additive, the covalent bond between Si and O constituting the quartz is strong, and even when γ-rays are irradiated, the characteristics of the Si-O bond are cut off. Changes and changes in characteristics due to desorption of additives are less likely to occur. Therefore, the core 3 has a high resistance to γ rays, and even if the γ ray sterilization process is performed, the optical transmission characteristics of the optical fiber 2 are hardly deteriorated. The clad 4 is located so as to cover the side surface of the core 3, and the clad 4 has a refractive index smaller than that of the core 3. The clad 4 is made of, for example, quartz to which fluorine is added.

  The coating 5 is located on the side surface of the cladding 4 and covers the side surface. The covering 5 is made of nylon and protects the core wire composed of the core 3 and the clad 4. Nylon is excellent in radiation resistance, and even when γ-rays are irradiated, the mechanical strength is not easily lowered due to the polymer chain being broken. Further, since it has an appropriate bending strength, even when the optical fiber 2 is inserted into the esophagus or digestive organ, it is possible to bend the optical fiber with a small radius according to the shape of the organ and the intention of the operator. is there. Furthermore, since nylon generally has biocompatibility, the influence on the living body can be suppressed. The coating 5 can be made of various nylons collectively called polyamides such as nylon 6, nylon 11, nylon 12, nylon 66, and the like having a mechanical strength and the like according to the application.

  JP-A-11-343144 discloses an optical fiber for UV light transmission capable of γ-ray sterilization. In this optical fiber, hydrogen is added to the core and the clad in order to suppress the deterioration of the UV transmission characteristics due to the γ-ray irradiation, and the clad is coated with a metal in order to suppress the desorption of hydrogen. However, this optical fiber lacks flexibility and flexibility due to the metal coating. Moreover, the wavelength of the transmitted light is shorter than the wavelength of the laser light for PDT. For this reason, the optical fiber disclosed in this publication cannot be used for a photodynamic therapy device for an endoscope.

  The propagation of light in the optical fiber 2 may be a single mode or a multimode. In the case of multi-mode, it may be a step index or a graded index. There is no restriction | limiting in particular in the diameter of the core 3 of the optical fiber 2, For example, it is about 400 micrometers.

  Although not particularly shown in FIG. 1, an optical connector that can be attached to and detached from the light source 20 is connected to one end of the optical fiber 2, and one end of the optical fiber 2 is connected to the light source 20 through the optical connector.

  A ferrule 100 is connected to the other end of the optical fiber 2 as shown in FIG. The ferrule 100 has a through hole 100c, and the optical fiber 2 is fixed to the ferrule 100 so that light emitted from the other end of the optical fiber 2 is emitted to the outside from the through hole 100c. Ferrule 100 includes a lens 102 disposed in through hole 100c. The lens 102 adjusts the condensing state of light emitted from the other end of the optical fiber 2 to a desired shape. Thereby, the laser beam output from the optical fiber 2 is irradiated to the affected part in a desired condensed state.

  FIG. 4 schematically shows a configuration of an endoscope system 500 that is used together with the endoscopic photodynamic therapy apparatus of the present embodiment. The endoscope system 500 includes an endoscope 505, a processing device 550 connected to the endoscope 505, and a display 560 connected to the processing device 550. The endoscope 505 includes an insertion unit 510, an operation unit 520, and a cable 530.

  The insertion unit 510 is connected to the operation unit 520 and is inserted into the body cavity. The insertion portion 510 has an insertion port 517 a and has a forceps channel 517 provided in the insertion portion 510. The insertion portion 510 is a long (or tubular) member made of a flexible material. The distal end portion 510a of the insertion portion 510 is configured to be bendable by an operator's operation.

  The operation unit 520 includes various switches and buttons for operating the endoscope 505. The operation unit 520 includes, for example, a power switch, a button for switching illumination ON / OFF, an angle knob that changes the direction of the tip 510a, a button for ejecting air or water from the tip 510a, and an instruction to start / stop shooting. Including a release button.

  The cable 530 includes one end connected to the operation unit 520 and the other end detachable from the processing apparatus 550. The cable 530 includes an optical fiber and an electric signal line. A water supply / air supply pipe may be further included. The optical fiber extends to the insertion unit 510 via the operation unit 520.

  The processing device 550 includes an illumination light source 340. The illumination light source 340 generates illumination light for observing the inside of the body. The generated illumination light is guided to the insertion portion 510 of the endoscope 505 by the optical fiber of the cable 530 connected to the processing device 550.

  The processing device 550 further includes a signal processing device such as a CPU, an image processing circuit, a memory, and an input / output interface. As will be described later, an image signal provided from the imaging element provided at the distal end of the insertion portion 510 of the endoscope 505 is input to the processing device 550 through the electric signal line of the cable 530 and processed by the image processing circuit. The processed image signal is sent to the display 560. Further, the image signal may be stored in a memory or stored in an external storage device via an input / output interface. The signal processing device controls the operation of the entire endoscope system 500. The processing device 550 may be configured by a plurality of devices grouped by function, such as a video processor and a lighting device.

  FIG. 5 is a schematic perspective view of the distal end portion 510 a in the insertion portion 510 of the endoscope 505. The distal end portion 510a has an end surface 510e, and an illumination lens 511, an imaging element 512, a forceps opening 510c, and a nozzle opening 510b are provided on the end surface 510e.

  The illumination light generated by the illumination light source 340 is guided to the distal end portion 510a by the optical fiber of the cable 530, and is irradiated outside by an illumination lens 511 at an appropriate irradiation angle. Thereby, the target site | part in a biological body is irradiated with illumination light. The target part is imaged by the image sensor 512. Air or liquid is ejected from the nozzle opening 510b as necessary. The forceps opening 510 c is connected to a forceps channel 517 provided in the insertion portion 510. In the present embodiment, the probe 10 of the endoscopic photodynamic therapy device 50 is inserted into the forceps channel 517, and laser light having a wavelength suitable for treatment by PDT guided to the optical fiber 2 from the forceps opening 510c is emitted. To do.

  Hereinafter, with reference to FIG. 1 to FIG. 5, a method of using the endoscopic photodynamic therapy device 50 of the present embodiment and a photodynamic therapy will be described.

  First, it is confirmed in advance that the light source 20 of the endoscopic photodynamic therapy device 50 emits laser light having an intensity according to the specification. Further, according to a predetermined standard, the probe 10 is sterilized by γ rays. Since the optical fiber 2 of the probe 10 is covered with the nylon coating 5 having high γ resistance, the probe 10 can be sterilized without lowering the mechanical strength due to deterioration of the coating 5. A photosensitizer is administered to the patient a predetermined time prior to treatment.

  After a predetermined time, an endoscope is inserted into the patient, and the affected part where cancer has occurred, such as the esophagus and digestive organs, is confirmed by the endoscope 505. Subsequently, the probe 10 of the endoscopic photodynamic therapy device 50 is inserted into the forceps channel 517, and the angle knob of the operation unit 520 is set so that the end surface 510e of the distal end portion 510a of the endoscope 505 faces the affected area. Manipulate. As described above, the optical fiber 2 of the probe 10 is covered with the nylon coating 5 so as to have appropriate flexibility. Therefore, the probe 10 can be smoothly inserted into the forceps channel 517 in the distal end portion 510a of the endoscope 505 bent with a small radius. Further, by operating the angle knob of the operation unit 520, the end surface 510e of the insertion unit 510 into which the probe 10 is inserted can be directed to the affected part. Therefore, it is possible to irradiate the affected part with laser light for PDT treatment from the forceps opening 510c on the end surface 510e.

  Thereafter, the endoscopic photodynamic therapy device 50 generates laser light and irradiates the affected area with the laser light for a predetermined time. As a result, the photosensitizer accumulated in the cancer cells in the affected area is excited, and the generated singlet oxygen destroys the cancer cells.

  Thus, according to the endoscopic photodynamic therapy apparatus of this embodiment, since the optical fiber of the probe is provided with a nylon coating, it is possible to perform γ-ray sterilization treatment and to be flexible. A photodynamic therapeutic device for an endoscope that has sufficient flexibility and sufficient bending strength is realized.

  The endoscopic photodynamic therapy device of the present disclosure can be used for photodynamic therapy for cancer that has occurred in the esophagus and digestive organs, for example.

2 Optical fiber 3 Core 4 Clad 5 Coating 10 Probe 20 Light source 50 Endoscopic photodynamic therapy device 100 Ferrule 100c Through hole 102 Lens 340 Illumination light source 500 Endoscope system 505 Endoscope 510 Insertion part 510a Tip part 510b Nozzle Opening 510c Forceps opening 510e End surface 511 Illumination lens 512 Image sensor 517 Forceps channel 517a Insertion port 520 Operation unit 530 Cable 550 Processing device 560 Display

Claims (5)

A light source;
An optical fiber having one end connected to a light source and capable of γ-ray sterilization ;
With
The optical fiber has a core made of quartz to which germanium is not added, a cladding made of quartz that covers the side surface of the core and that is doped with fluorine, and a coating made of nylon that covers the side surface of the cladding and that is made of nylon. Endoscopic photodynamic therapy device.   The endoscopic photodynamic therapy apparatus according to claim 1, wherein the optical fiber is configured to be inserted into a forceps channel of an endoscope.   The endoscopic photodynamic therapy apparatus according to claim 1, wherein the optical fiber is subjected to γ-ray sterilization treatment.   The photodynamic therapy device for an endoscope according to any one of claims 1 to 3, wherein the light source generates laser light having a wavelength of 664 nm ± 2 nm.   The photodynamic therapy device for an endoscope according to any one of claims 1 to 4, further comprising a ferrule connected to the other end of the optical fiber and having a lens.

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