JPH02185269A - Photochemical treatment device - Google Patents

Abstract

PURPOSE:To stably, continuously, and surely illuminate the affected part of a tube cavity organ with a laser beam for a long time without putting an excessive burden on an operator to execute a photochemical treatment by equipping the subject device with a positioning manipulating mechanism to select the position of a semiconductor laser and a holding means to fix a sliding tube in a tube cavity. CONSTITUTION:The photochemical treatment device is positioned between balloons 13 and 13, and a semiconductor laser device 15 is provided on a part of the outer periphery of the device. For the sectional shape of a slit 14, recessed grooves 17 and 17 are carved and provided under a respective opposite state for right and left wall surface parts, and the respective right and left tip parts of a holding body 29 of the semiconductor laser device 15 to be mentioned after are respectively fitted in both of these grooves 17 and 17 and supported under a completely interposed state in the grooves 17 and 17. Consequently, this semiconductor laser device 15 can slide in the longitudinal direction of a sliding tube 10 along the slit 14. A fixing set screw 23 can fix a wire 20 by screwing and fastening the screw 23 itself. The holding means to fix the sliding tube 10 in the tube cavity is composed of the above-mentioned parts.

Description

DETAILED DESCRIPTION OF THE INVENTION [Industrial Application Field] The present invention relates to a photochemical treatment device used for, for example, irradiating cancer (malignant tumor) cells with laser light to destroy the malignant cells through a photochemical reaction.

[Prior Art] In recent years, photochemical therapy using drugs such as Hp D (hematoporphyrin derivative) has attracted attention in the treatment of cancer. This treatment method involves injecting tumor-loving substances such as H and D into the body and allowing them to be taken up only by cancer cells.
Laser light within the excitation spectrum of PD is irradiated to photochemically activate cancer cells, causing degeneration and destruction.

As such a photochemical treatment device, one constructed as shown in FIG. 13 is known. That is, Kr laser (
λ-410nm), or Ar laser (λ-514,5
An optical fiber 4 connected to a gas laser device 3 that excites A laser (λ-570 to 630 nm) or a dye laser device (not shown) that excites a laser A (λ-570 to 630 nm) is inserted into a channel of an endoscope 5 to expose the human body. 1 to the site of cancer cell 2.

[Problems to be Solved by the Invention] However, in this photochemical treatment method, it is necessary to continuously irradiate the cancer cells 2 with the laser light for several tens of minutes, so the operator must ensure that the laser light does not irradiate the cancer cell 2 during that time. In order to keep the endoscope 5 close to the cell 2, delicate angle manipulations must be continued. therefore,
The burden on the surgeon was extremely heavy.

In particular, positioning work for cancer cells 2 within a hollow organ requires not only angle manipulation but also delicate pushing and pulling manipulations in the forward and backward directions of the insertion section of the endoscope 5. Therefore, the burden on the operator was greater.

The present invention has been made in view of the above-mentioned problems, and its purpose is to treat the affected part of the hollow organ without placing an excessive burden on the operator who performs photochemical therapy on the affected part of the hollow organ. It is an object of the present invention to provide a photochemical treatment device that can stably and continuously illuminate a laser beam for a long period of time.

[Means for Solving the Problems and Their Effects] In order to solve the above problems, the present invention provides a photochemical therapy device that performs photochemical therapy on an affected area within a lumen of a living body, in which the insertion portion of an endoscope is inserted. A guiding sliding tube is provided, a semiconductor laser for irradiating a laser beam toward the affected area is provided in a part of the insertion assisting sliding tube in a position-selectable manner, and a positioning operation mechanism is provided for selecting the position of the semiconductor laser. and a holding means for fixing the sliding tube within the lumen.

According to this photochemical treatment device, the insertion section of the endoscope is guided to the affected area using a sliding tube,
The position of the sliding tube can be determined under observation with the endoscope. The sliding tube is then fixed in place by retaining means that secure it within the lumen. Furthermore, the semiconductor laser provided on a portion of the fixed sliding tube is accurately positioned toward the affected area by its positioning mechanism. Laser light is then irradiated from the semiconductor laser, which is precisely fixed in position, toward the affected area.

Therefore, the position of the semiconductor laser relative to the affected part of the hollow organ can be stably maintained for a long time.

[Embodiment] FIGS. 1 to 6 show a first embodiment of the present invention. As shown in FIG. 1, the photochemical treatment device 9 includes a sliding tube 10 made of a hollow flexible tube, a semiconductor laser power source 11 installed outside the body, and a balloon air pressure source 12. sliding tube 1
0 itself can be inserted into a hollow organ 28 of a living body, which will be described later, and can also be guided into the hollow organ 28 by passing through the insertion section of the oblique-viewing endoscope 5. The sliding tube 10 is provided with two balloons 13.13 provided as holding means at a distance in the front and back near its tip, and a semiconductor is located between the two balloons 13. A laser device 15 is provided. The configuration of this part will be explained in detail using FIGS. 2 to 4.

That is, first, as shown in FIG. 2, two balloons 1 are placed on the circumferential wall near the tip of a sliding tube 10 made of, for example, transparent resin, spaced a certain distance apart.
3.13, and a slit 14 is formed along the longitudinal axis of the sliding tube 10 between both balloons 13.13. As shown in FIG. 3, the slit 14 has a cross-sectional shape in which concave grooves 17 and 17 are carved facing each other on the left and right wall portions, respectively. ? 17. Semiconductor laser device 15 to be described later in 17
The left and right ends of the holding body 29 are respectively fitted and supported in a sandwiched manner.

Therefore, this semiconductor laser device 15 has a slit 14
The sliding tube 10 can be slid in the longitudinal direction along the slit 14, and will not fall out of the slit 14. Further, the front end of the holding body 29 of the semiconductor laser device 15 and the sliding tube 10 are connected by a tension spring 19 via a fixing member 18, respectively. Further, a wire 20 is connected to the rear end of the holding body 29 of the semiconductor laser device 15, and this wire 20 is connected to an insertion conduit 20 provided in the wall of the sliding tube 10.
The wire 20 is guided to the proximal side through an insertion conduit 21 that opens at the rearmost end surface of the sliding tube 10.
protrudes outward from the opening. Furthermore, as shown in FIG. 2, a screw hole 22 is bored at the rear end of the sliding tube 10 so as to intersect with the insertion conduit 21, and a fixing set screw 23 is screwed into this screw hole 22. There is.

The wire 20 can be fixed by screwing in and tightening the fixing set screw 23.

That is, these constitute a holding means for fixing the sliding tube 10 within the lumen.

Further, the two balloons 13 described above communicate with an air supply/exhaust pipe line 24 provided within the wall of the sliding tube 10. This supply/exhaust pipe 24 is the sliding tube 1
It is connected to an air supply/exhaust pipe 25 led out from the hand part of 0.

This supply/exhaust pipe 25 is connected to a balloon air pressure source 12 installed outside the body. Further, as shown in FIG. 1, an opening/closing valve 16 is provided in the middle of the supply/exhaust pipe 25.

Further, a lead wire 26 for power supply is connected to the semiconductor laser device 15. The lid wire 26 for power supply is led to the proximal portion of the sliding tube 10 through the conduit 21 like the wire 20 described above, and is connected to the semiconductor laser power source 11 by protruding outside through an opening 27 opened at the proximal portion. are doing.

Furthermore, the semiconductor laser device 15 is constructed as shown in FIG. That is, the holding body 29 has a recess 3.
0 is formed, and this recess 30 has a bottom part 32 for fixing a monitor photodiode 31, a side wall convex part 34 for fixing a semiconductor laser chip 33 that oscillates laser light, and an opening part for fixing a condenser lens 35. 36 are formed.

Further, the holding body 29 is made of a material with excellent heat conductivity such as aluminum, and therefore has the function of radiating the heat of the semiconductor laser chip 33.

The semiconductor laser chip 33 is a monitor photodiode 3
1 and the condenser lens 35, and radiates the laser beam to the outside from the opening 36 of the recess 30. Generally, the semiconductor laser chip 33 has a characteristic that its output changes due to heat generation. Therefore, the monitor photodiode 31 (; detects the change in the output of the laser beam, and according to the output change, the semiconductor laser chip 33 The current injected into the laser chip 33 is changed.The function of the monitoring photodiode 31 makes it possible to continuously obtain uniform laser light.

By the way, the semiconductor laser chip 33 is made of, for example, CaA,
It is a 1JAs-based (λ-780~830ni) double heterojunction laser, and the size of the chip itself is several 110.
The size is about 0n square, and the output per piece is as high as 1 to 5 W. On the other hand, in order to selectively destroy only cancer cells with a laser beam suitable for the excitation spectrum of HpD, approximately 1
Since an output of 00 mW is sufficient, it can be fully used in the semiconductor laser chip 33 of the present invention from an output point of view.

FIG. 5 is a graph showing the excitation spectrum of HpD,
FIG. 6 is a graph showing the absorption spectrum of hemoglobin in blood. HpD injected into the body has an excitation wavelength shown by line Ω1 in FIG. 5, and reaches a maximum around 400n1m. K: The excitation efficiency can be increased by using a laser, an Ar laser, or an Ar laser-excited dye laser, but 1
If the GaA IAs semiconductor laser chip 33 has an output of ~5 W class, the wavelength is 780 to 830 nm.
Sufficient excitation efficiency can be obtained even with a laser beam. Furthermore, as is clear from the hemoglobin absorption spectrum in blood shown by line g2 in FIG. 6, laser light with a wavelength in the range of 780 to 830 rv has superior transmission characteristics compared to conventional Kr lasers, etc. It is also useful in this respect because it can penetrate deep into cancerous tissues.

Next, the operation of the photochemical treatment device having the above configuration will be explained. Let us take as an example a case where the present invention is used for cancer cells 2 generated in a luminal organ 28 such as the esophagus.

In advance, HpD is injected into the body and incorporated into the cancer cells 2. Next, the sliding tube 10 is orally inserted to the target hollow organ 28. At this time,
This is done while confirming the position of the cancer cell 2 by inserting the endoscope 5 into the sliding tube 10 so that the cancer cell 2 is located between both balloons 13, 13. When the sliding tube 10 is located at the target position, the on-off valve 1
6 to open it, and compressed air is sent into both balloons 13 from the air pressure source 12.

Then, the balloon 13.13 expands until it presses against the inner wall surface of the hollow organ 28, and the sliding tube 10 is fixed to the hollow organ 28.

At this time, if the slit 14 is in a position where the cancer cells 2 are not directed, the sliding tube 10 is twisted on the proximal side to direct the slit 14 toward the cancer cells 2.

Next, the wire 20 is pushed and pulled on the proximal side so that the semiconductor laser device 15 is positioned directly below the cancer cell 2 . In other words, when the wire 20 is pulled, the semiconductor laser device 1
5 slides backward, and when the wire 20 is loosened,
It moves toward the tip side by the traction force of the tension spring 19. And the semiconductor laser device 15 is cancerous! After confirming with the endoscope 5 that the wire 20 is in a position facing the 411 cell 2, the wire 20 is tightened and fixed using the fixing set screw 23. Thereby, the semiconductor laser device 15 can be fixed at a correct position facing the cancer cells 2.

Next, the semiconductor laser power supply 11 is turned on, the semiconductor laser chip 33 is excited, and a uniform laser beam is sent to the condenser lens 35.
The cancer cells 2 are focused and irradiated through the beam. This allows only the cancer cells 2 to be destroyed by photochemical reaction.

In this photochemical treatment, it is necessary to continuously irradiate the cancer cells 2 with laser for several tens of minutes, but according to the above configuration,
Once the position of the semiconductor laser device 15 is determined, it can be fixed at that position for a long time. Therefore, since the focus of the laser beam does not shift during continuous irradiation, the burden on the operator is extremely lightened, and accurate treatment can be performed efficiently.

Further, since the position of the semiconductor laser device 15 can be slightly moved in the axial direction of the sliding tube 10, it is easy to focus on the cancer cells 2.

Furthermore, since the semiconductor laser device 15 is built into the sliding tube 10, there are no particular restrictions on the endoscope 5, and a general endoscope may be used.

Further, since the semiconductor laser device 15 is used, the entire device can be made smaller and simpler, and the production cost can be reduced.

7 and 8 show a second embodiment of the invention. In the first embodiment described above, the slit 14 and the semiconductor laser device 1 are provided at one location on the sliding tube 10.
However, in this second embodiment, a plurality of slits 14.5 are provided on the circumferential surface of the sliding tube 10, as shown in FIG. and each slit 14. . . . each includes a semiconductor laser device 15. ... has been established. Further, each semiconductor laser device 15, . . . has a slit 14 . The wires 20 . Conduit 2
1. Provide fixing screws 23, etc. Further, each lead wire 26°... is connected to each semiconductor laser device 15. It's attached to... Further, the rear end side portion of the sliding tube 10 is configured as 5 as shown in FIG. That is, this embodiment is particularly different from the first embodiment in that a plurality of semiconductor laser devices 15° are provided distributed on the circumferential surface of the sliding tube 10, and the other configuration is the same as that of the first embodiment. is substantially the same as that of

According to the configuration of this second embodiment, when cancer cells 2 are present in a certain luminal organ 28, they may not be located only at one location but may be scattered around several locations. In some cases they can be treated simultaneously.

That is, the sliding tube 10 is inserted into the hollow organ 28 in the same manner as in the first embodiment, and the cancer cells 2 are fixed so as to be located between the balloons 1, 3, and 13. At this time, there are multiple slits 14. Cancer cells 2°... should be located on some of them. Next, cancer cells 2. ... is located in the slit 14
．． The semiconductor lasers 15, . . . corresponding to the semiconductor lasers 15, . ...and wire 20. ... to be fixed. Subsequently, each of the cancer cells 2, .
Photochemical treatment is performed by selectively supplying power only to the semiconductor laser devices 15, . . . corresponding to the semiconductor laser devices 15, .

According to the configuration of this embodiment, one device can handle multiple cancer cells 2. ... can be treated at the same time, and this can be done easily, leading to a significant reduction in treatment time.

FIGS. 9 and 10 show a third embodiment of the present invention. In the first and second embodiments described above, it was possible to move the semiconductor laser device 15 only in the axial direction of the sliding tube jO, but in this third embodiment, the semiconductor laser device 15 could be moved only in the axial direction of the sliding tube jO.
The structure is such that it can also be moved in the circumferential direction.

That is, a cylindrical ultrasonic motor 38 is fitted into the outer peripheral surface of the sliding tube 10, and this ultrasonic motor 38 is composed of a stator 39 and a rotor 40. The rotor 40 rotates on the outer peripheral surface of the stator 39. A semiconductor laser device 15 is provided on a part of the outer periphery of the rotor 40. Further, the sliding tube 10 is provided on the peripheral surface of the sliding tube 10.
A plurality of slits 14 along the longitudinal axis direction. ..., and a fixing member 41 coupled to the stator 39 is slidably fitted into at least one slit 14 of the fixing member 41. This fixing member 40 has the above-mentioned first,
Similarly to the second embodiment, a tension spring 19 and a wire 20 are connected, and by operating the wire 20, the ultrasonic motor 3
8 can be moved in the axial direction. Further, the lead wire 42 of the ultrasonic motor 38 is connected to the sliding tube 1 of the ultrasonic motor 38.
It is connected to an external drive power source (not shown) through the inside of the wall.

Therefore, in this embodiment as well, the sliding tube 1o is fixed to the wall surface of the hollow organ 28 using both balloons 13 and 13 in the same manner as in the first and second embodiments described above.

Next, the wire 20 is operated to slide the ultrasonic motor 38 to a certain depth in the cancer cell 2 . Then, by rotating the ultrasonic motor 38, the semiconductor laser device 15
Move it to a position directly below and facing cancer cell 2. Thereafter, photochemical treatment similar to that described above is performed.

According to the configuration of this embodiment, the semiconductor laser device 15 can be moved not only in the axial direction of the sliding tube 10 but also in the circumferential direction, so that the cancer cells 2 can be more accurately irradiated with laser light. . Furthermore, cancer cells 2. ..., the semiconductor laser device 15 is sequentially moved to a position directly below the cancer cell 2 by operating the wire 20 and rotating the ultrasonic motor 38 without moving the sliding tube 10 many times. can be treated.

FIGS. 11 and 12 show a fourth embodiment of the present invention. This embodiment uses an electrostatic motor 43 in place of the ultrasonic motor 38 in the third embodiment. This electrostatic motor 43 is composed of a rotating ring 44 and a fixed ring 45, as shown in FIG. The fixing ring 45 is fixed to the sliding tube 10 in the same manner as the stator 39 of the ultrasonic motor 38. A plurality of electrodes 46a are provided at regular intervals on the outer peripheral surface of the fixed ring 45.
...is placed. One electrode 46b is also arranged on a part of the inner surface of the rotating ring 44.

Then, the electrode 46b on the rotating ring 44 side and the fixed ring 4
There is a gap between the electrodes 46a, . . . on the 5th side so that they do not come into contact with each other.

Therefore, as shown in FIG. 12, an electrode 46b on the rotating ring 44 side and an electrode 46a on the fixed ring 45 side.

When a voltage is sequentially applied to the electrodes 46a.

Electrostatic force acting between electrodes 46a and 46b.

46b are attracted and rotated. Other operations are the same as in the third embodiment.

According to the configuration of this embodiment, the ultrasonic motor 38 can be made thinner and more compact than the ultrasonic motor 38 described above.

Note that the present invention is not limited to the embodiments described above. For example, the tension spring can be replaced by any elastic member, and driving by a shape memory alloy or the like may also be considered.

[Effects of the Invention] As described above, according to the present invention, the position of the sliding tube can be determined under observation with an endoscope, and the sliding tube can be fixed within the lumen thereof. Furthermore, the semiconductor laser provided on a portion of the fixed sliding tube can be accurately positioned toward the affected area. Since the laser beam is directed toward the affected area from the semiconductor laser that is precisely fixed in this way, the tube can be easily controlled without placing an excessive burden on the operator performing photochemical treatment of the affected area in the hollow organ. Laser light can be irradiated stably and continuously for a long period of time to the affected area of a cavity organ to ensure reliable treatment.

[Brief explanation of the drawing]

1 to 6 show a first embodiment of the present invention, FIG. 1 is a perspective view of the treatment device, FIG. 2 is a side sectional view of the insertion side tip, and FIG. 3 is a slit and a 4 is a front sectional view of the semiconductor laser device section, FIG. 4 is a side sectional view of the semiconductor laser device section, and FIG. 5 is a graph showing the excitation spectrum of HpD.
FIG. 6 is a graph showing the absorption spectrum of hemoglobin in blood, FIGS. 7 and 8 show a second embodiment of the present invention, FIG. 7 is a perspective view of the treatment device in use, and FIG. The figure is a perspective view of the proximal portion of the treatment device, FIGS. 9 and 10 show a third embodiment of the present invention, FIG. 9 is a perspective view of the distal end of the treatment device, and FIG. Similarly, side sectional views of the distal end portion of the treatment device, FIGS. 11 and 12.
The figures show a fourth embodiment of the present invention, in which FIG. 11 is a side sectional view of the electrostatic motor portion of the treatment device, FIG. 12 is a front sectional view of the electrostatic motor portion of the treatment device, and FIG. The figure is an explanatory diagram of a conventional method. 2...Cancer cells, 9...Photochemical treatment device, 10...
Sliding tube, 13... Balloon, 14.
...Slit, 15...Semiconductor laser device, 20...
- Wire, 28... Luminal organ, 33... Semiconductor chip, 38... Ultrasonic motor, 43... Electrostatic motor. Applicant's agent Patent attorney Tsuboi 4 Figure 4 Figure 1 = Associate - L (λ)/nm Figure 5 Mei 2 v -; *L<λ)/nm Go to Figure 6 r Figure procedure 1j Indication of the case dated May 10, 1989 Patent Application No. 5 of 1998 2゜Name of the invention Photochemical treatment device 3゜Relationship with the person making the amendment 1■

Claims (1)

[Claims] In a photochemical treatment device that performs photochemical treatment on an affected area within a lumen of a living body, a sliding tube that guides the insertion of an insertion section of an endoscope, and a part of this sliding tube for assisting insertion are provided in a position selectable manner. Photochemical treatment characterized by comprising a semiconductor laser that irradiates laser light toward the affected area, a positioning operation mechanism that selects the position of the semiconductor laser, and a holding means that fixes the sliding tube within the lumen. Device.