WO2015012116A1 - 医療用具及び医療用具用の光放射プローブ取付キット - Google Patents

医療用具及び医療用具用の光放射プローブ取付キット Download PDF

Info

Publication number
WO2015012116A1
WO2015012116A1 PCT/JP2014/068410 JP2014068410W WO2015012116A1 WO 2015012116 A1 WO2015012116 A1 WO 2015012116A1 JP 2014068410 W JP2014068410 W JP 2014068410W WO 2015012116 A1 WO2015012116 A1 WO 2015012116A1
Authority
WO
WIPO (PCT)
Prior art keywords
light emitting
emitting probe
catheter
tube
medical device
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/JP2014/068410
Other languages
English (en)
French (fr)
Japanese (ja)
Inventor
荒井　恒憲
亜莉沙 伊藤
恵美悠 小川
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
ARAI MEDPHOTON RESEARCH LABORATORIES Corp
Original Assignee
ARAI MEDPHOTON RESEARCH LABORATORIES Corp
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by ARAI MEDPHOTON RESEARCH LABORATORIES Corp filed Critical ARAI MEDPHOTON RESEARCH LABORATORIES Corp
Priority to US14/907,609 priority Critical patent/US20160157697A1/en
Priority to EP14829043.0A priority patent/EP3025751A4/en
Publication of WO2015012116A1 publication Critical patent/WO2015012116A1/ja
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Images

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00131—Accessories for endoscopes
    • A61B1/0014—Fastening element for attaching accessories to the outside of an endoscope, e.g. clips, clamps or bands
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00131—Accessories for endoscopes
    • A61B1/00135—Oversleeves mounted on the endoscope prior to insertion
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/06—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with illuminating arrangements
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/06—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with illuminating arrangements
    • A61B1/0661—Endoscope light sources
    • A61B1/0669—Endoscope light sources at proximal end of an endoscope
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
    • A61B18/22—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
    • A61B18/24—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor with a catheter
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/0059—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence
    • A61B5/0082—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence adapted for particular medical purposes
    • A61B5/0084—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence adapted for particular medical purposes for introduction into the body, e.g. by catheters
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/42—Detecting, measuring or recording for evaluating the gastrointestinal, the endocrine or the exocrine systems
    • A61B5/4222—Evaluating particular parts, e.g. particular organs
    • A61B5/425—Evaluating particular parts, e.g. particular organs pancreas
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00—Radiation therapy
    • A61N5/06—Radiation therapy using light
    • A61N5/0601—Apparatus for use inside the body
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00—Radiation therapy
    • A61N5/06—Radiation therapy using light
    • A61N5/0613—Apparatus adapted for a specific treatment
    • A61N5/062—Photodynamic therapy, i.e. excitation of an agent
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00—Radiation therapy
    • A61N5/06—Radiation therapy using light
    • A61N5/067—Radiation therapy using light using laser light
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00529—Liver
    • A61B2018/00535—Biliary tract
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00982—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
    • A61B18/22—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
    • A61B2018/2238—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor with means for selectively laterally deflecting the tip of the fibre
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
    • A61B18/22—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
    • A61B2018/2255—Optical elements at the distal end of probe tips
    • A61B2018/2261—Optical elements at the distal end of probe tips with scattering, diffusion or dispersion of light
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2560/00—Constructional details of operational features of apparatus; Accessories for medical measuring apparatus
    • A61B2560/04—Constructional details of apparatus
    • A61B2560/0443—Modular apparatus
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2562/00—Details of sensors; Constructional details of sensor housings or probes; Accessories for sensors
    • A61B2562/22—Arrangements of medical sensors with cables or leads; Connectors or couplings specifically adapted for medical sensors
    • A61B2562/225—Connectors or couplings
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/25—Bioelectric electrodes therefor
    • A61B5/279—Bioelectric electrodes therefor specially adapted for particular uses
    • A61B5/28—Bioelectric electrodes therefor specially adapted for particular uses for electrocardiography [ECG]
    • A61B5/283—Invasive
    • A61B5/287—Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]

Definitions

  • the present invention relates to a medical device having a light emitting probe attached to the outside and a light emitting probe mounting kit for the medical device.
  • High-frequency catheter ablation is a method of treating drug-resistant tachyarrhythmia and extrasystole by applying thermal energy from high-frequency waves from the catheter tip to the origin of arrhythmia and the reentry circuit.
  • the operator checks the electric block with the electrode catheter and cuts off the electric conduction with a catheter different from the electrode block.
  • high-frequency catheter ablation since it is difficult to identify the lesion, it is necessary to set a line for blocking abnormal electrical signals. The results are good when the two pulmonary veins are isolated together.
  • high-frequency catheter ablation is energization point by point, and it is necessary to connect points in order to obtain a linear treatment area all at once, and it is difficult to obtain a continuous treatment area.
  • Photodynamic therapy is a method in which a photosensitive substance is administered by a method such as intravenous injection, and the photosensitive substance is distributed to the target tissue and irradiated with a light beam such as a laser beam. This is a method of treating by causing a photosensitization reaction due to and causing necrosis of cells of a target tissue by this photosensitization reaction. 2.
  • a laser treatment system for performing photodynamic treatment a laser treatment system including a laser catheter and a PDT device main body that emits laser light to the laser catheter and detects return light from the laser catheter is known (for example, Patent Document 1). ).
  • the laser catheter of Patent Document 1 includes an optical fiber built in the extension direction of the catheter tube, an optical window provided optically continuously with the distal end of the optical fiber at the outermost portion of the distal end portion of the catheter tube, It is equipped with.
  • the optical window transmits the irradiation light emitted from the tip of the optical fiber, and condenses the fluorescence emitted by the photosensitive drug on the tip of the optical fiber. Since the laser catheter of Patent Document 1 is configured as described above, the tip of the laser catheter can be brought into contact with the tissue to be treated to perform photodynamic therapy.
  • the laser catheter of Patent Document 1 is configured to irradiate a laser beam from the distal end of the catheter tube, similarly to the catheter for high-frequency ablation. Therefore, when treating arrhythmia using the laser catheter of Patent Document 1, as in the case of high-frequency catheter ablation, irradiation is performed point by point, and in order to set a line for blocking abnormal electrical signals, It is necessary to connect points.
  • the laser catheter of Patent Document 1 has a limited range in which laser irradiation can be performed, and in order to create an abnormal electric conduction cutoff line, it is necessary to sequentially shift the irradiation range to obtain a linear treatment area.
  • the present invention has been made in view of the above problems, and an object of the present invention is to attach a light emitting probe on the outside, which can collectively create a linear abnormal electric conduction interruption line in the treatment of arrhythmia. Another object of the present invention is to provide a medical tool and a light emitting probe mounting kit for the medical tool. Another object of the present invention is to provide a light emitting probe mounting kit that can be easily externally combined with a medical device selected by the operator. Still another object of the present invention is to easily convert an existing medical device into a medical device having a light emitting probe attached to the outside, and a medical device having the light emitting probe attached to the outside and the medical device thereof. An object of the present invention is to provide a light emitting probe mounting kit used for a tool.
  • the problem is that the light transmission means for transmitting light from the light source and the light transmitted by the light transmission means are coupled to the light transmission means. This is solved by providing a light emitting probe for radiating and an external means for attaching the light emitting probe outside the medical device used by being inserted into a living body.
  • the subject is a light transmission means for transmitting light from a light source, a light emitting probe connected to the light transmission means and emitting light transmitted by the light transmission means,
  • the surgeon can easily produce a medical device with a light emitting probe by externally attaching the light emitting probe to the medical device selected by the operator.
  • high-frequency ablation catheters have been improved for a long time, and have enhanced operability, adhesion to tissues, additional functions such as 3D navigation and contact sensors. Therefore, if a light emitting probe is attached to the outside of any catheter such as an electrode catheter or an ablation catheter, a sheath, an endoscope, etc., light can be emitted while taking advantage of the functionality (operability, etc.) of these medical devices.
  • a catheter can be achieved.
  • the probe externally attached to the medical device is a light emitting probe using light
  • the radiation pattern is not limited to a point, and the radiation pattern is made linear to achieve a continuous treatment area.
  • an external means for externally attaching the light emitting probe is provided outside the medical tool used by being inserted into the living body, the operator can easily attach the light emitting probe to the medical tool. Can do. If a plurality of types of light emitting probes are prepared, a great number of types of medical tools with a light emitting probe can be realized along with options for medical tools. Further, the mounting position and mounting direction of the light emitting probe can be set arbitrarily.
  • the light emitting surface of the light emitting probe may be provided on a side surface of the light emitting probe and continuously extend along the extending direction of the light emitting probe. Since it comprises in this way, a radiation pattern can be made linear and a continuous treatment area can be achieved. In addition, the radiation pattern can be appropriately changed to a linear shape, a curved shape, or the like by appropriately selecting a catheter to be attached, such as a linear shape or a curved shape.
  • the external means may be a heat shrinkable tube having a space in which the medical device can be inserted before heat shrinkage, and the heat shrinkable tube may be fixed to the light emitting probe.
  • a medical device with a light emitting probe can be produced simply by inserting and heating the medical device into the space of the heat-shrinkable tube. Medical devices can be made.
  • the external attachment means may be capable of externally attaching a plurality of the light emitting probes to a single medical device. Since it comprises in this way, a light emission probe can be externally attached to several places of a medical device outer surface, and light emission is possible from the light radiation probe which reached
  • the external attachment means may include an opening for exposing an electrode formed on the outer surface of the medical device. Since it is configured in this manner, even when an electrophysiological examination or the like is performed using a medical device having an electrode provided on the outer surface, the potential can be measured through the opening, and the function of the electrode can be utilized. .
  • the external attachment means includes a covering portion that covers the surface of the medical device, and the covering portion has conductivity in the thickness direction and is insulative in a direction different from the thickness direction. It may consist of an anisotropic conductor provided with.
  • the anisotropic conductor of the covering portion that covers the surface of the medical device, Since conductivity is provided only in the thickness direction, potential measurement can be performed by this conductivity, and the function of the electrode can be utilized.
  • the medical device may be a medical device selected from the group including a catheter, a sheath, and an endoscope.
  • an operator can easily produce a medical device with a light emitting probe by attaching the light emitting probe to a medical device selected by the operator.
  • a medical device selected by the operator For example, high-frequency ablation catheters have been improved for a long time, and have enhanced operability, adhesion to tissues, additional functions such as 3D navigation and contact sensors. Therefore, if a light emitting probe is attached to the outside of any catheter such as an electrode catheter or an ablation catheter, a sheath, an endoscope, etc., light can be emitted while taking advantage of the functionality (operability, etc.) of these medical devices.
  • a catheter can be achieved.
  • the probe externally attached to the medical device is a light emitting probe using light
  • the radiation pattern is not limited to a point, and the radiation pattern is made linear to achieve a continuous treatment area.
  • an external means for externally attaching the light emitting probe is provided outside the medical tool used by being inserted into the living body, the operator can easily attach the light emitting probe to the medical tool. Can do. If a plurality of types of light emitting probes are prepared, a great number of types of medical tools with a light emitting probe can be realized along with options for medical tools. Further, the mounting position and mounting direction of the light emitting probe can be set arbitrarily.
  • FIG. 10 is a cross-sectional explanatory view showing the structure of an anisotropic conductor used for a cover in a modification of the laser catheter with a light emitting probe according to the fourth embodiment of the present invention. It is a partial external view of the optical radiation probe for endoscopes and endoscopes concerning other embodiments of the present invention.
  • the laser catheter light emitting probes P1 to P5 and the laser catheter light emitting probes according to the first, third, fifth, seventh, and ninth embodiments of the present invention are provided with the second, fourth, sixth, and eighth embodiments.
  • 10 and the laser catheters 1 to 5 as medical devices and the endoscope radiation probe P6 according to the eleventh embodiment will be described with reference to FIGS.
  • a laser catheter and an endoscope will be described as medical devices, but the present invention is not limited to this, and the medical device is introduced to a treatment target tissue in a living body such as a sheath and other medical tubes. Any medical device can be used.
  • a medical device to which a light emitting probe is attached is used for arrhythmia treatment in which an abnormal electrical conduction interruption line is created by photodynamic treatment
  • a biliary endoscope (external) Example of use for endoscopic photodynamic therapy for cancer in the pancreas and biliary tract using ultra-thin endoscope such as 1 to 3 mm in diameter and pancreas endoscope (outer diameter 1 to 2.5 mm)
  • the present invention is not limited to this.
  • the medical device of the present invention can be used as long as it is a pathological condition that can use a medical device equipped with a light emitting probe typified by a laser catheter.
  • photodynamic therapy such as cancer, infection, arteriosclerosis, etc. It can be used for the treatment of thrombosis using a laser catheter. Further, it can be used in all cases where laser irradiation and laser measurement are performed.
  • a heat-shrinkable tube or the like is used as the attachment means in the claims.
  • the present invention is not limited to this, and a clip, a ring, or the like may be used.
  • the light emitting probe P1 for a catheter of this embodiment includes a light emitting probe member 20, a ring tube 31 into which the light emitting probe member 20 is inserted, and a peeling tube 32. It is provided as a production kit for the laser catheter 1 with a light emitting probe. That is, after inserting the catheter 10 into the ring tube 31 and the peeling tube 32 of the light emitting probe P1 for the catheter, the ring tube 31 and the peeling tube 32 are contracted by applying heat to peel the peeling tube 32 as shown in FIG. A laser catheter 1 with a light emitting probe can be produced.
  • the light emitting probe member 20 is preferably a substantially cylindrical body having a diameter larger than the minimum diameter of a general optical fiber and smaller than the diameter of the catheter, and having a diameter of 0.125 to 2.5 mm, preferably 0.25 to 1 mm. .
  • the light emitting probe member 20 includes an optical fiber cable 22 and a laser probe 21 provided continuously at the tip of the optical fiber cable 22.
  • the optical fiber cable 22 is configured by sequentially covering a long core 23 with a clad 24 and a coating 25.
  • the optical fiber cable 22 has a core 23 made of polymethyl methacrylate, polystyrene, polycarbonate, or the like, and a clad 24 made of a plastic optical fiber made of a fluorinated polymer or the like. It is preferable to use a plastic optical fiber that is resistant to bending, but a glass optical fiber may also be used. Since the light emitting probe member 20 is fixed to the catheter 10, the operability of the catheter 10 is used, and the light radiating probe member 20 itself does not require operability. However, operability may be imparted to the light emitting probe member 20, or the light emitting probe member 20 may be formed from a shape memory material.
  • the laser probe 21 includes a light diffuser 28 in which the cladding 24 and the coating 25 are removed from the optical fiber cable 22, and the core 23 is exposed over a predetermined length from the distal end portion 26.
  • the resin layer 27 covers the outer periphery of the body 28.
  • the light diffuser 28 is formed integrally with the core 23, and is formed by sandblasting the core 23. The light emitted to the side having an angle with respect to the length direction of the light diffuser 28 is made uniform. Yes.
  • the light diffuser 28 is not limited to this, and the light diffuser 28 has a hollow portion in the center and a light reflecting mirror is provided on the inner surface, or a notch is provided on the inner surface. May be made uniform.
  • the resin layer 27 is formed by, for example, applying it to an acrylic ultraviolet curable resin in which quartz fine powder is dispersed and curing it with ultraviolet light.
  • a connector (not shown) is fixed to the end of the optical fiber cable 22 on the opposite side of the laser probe 21 and can be connected to a laser generator (not shown) incorporating a laser source (not shown) by this connector. Has been.
  • the light diffuser 28 is not limited to the one shown in FIG. 3, and other light diffusers may be used.
  • the light diffusing body 28 can be roughly divided into a case where the light diffusing body 28 is formed by extending the core 23 of the optical fiber cable 22 and a case where a light diffusing body 28 separate from the core 23 is provided. And can be used as the light diffuser 28 of the present embodiment.
  • the core 23 may or may not constitute the diffusing material itself.
  • the transmission light leakage method (a method in which a part of the core 23 is exposed by finely scratching the clad 24, a method in which leakage is formed by bending, etc.) and a method using a diffusing substance are roughly classified.
  • Examples of the transmission light leakage method include scratch processing (sand blasting, stamping, solvent processing, etc.), fiber Bragg grating (FBG), and microbending.
  • a method using a diffusing material there are a method of putting a diffusing material in the core 23 / cladding 24, a method of exposing the core 23 and putting a diffusing material in the coating 25, and the like.
  • Sand blasting is a method of spraying fine particles, and therefore applies to a method using this diffusing substance.
  • the latter case where the light diffuser 28 separate from the core 23 is provided is a case where an optical element different from the core 23 is used as the light diffuser 28.
  • an optical element such as a polyhedral prism, a SELFOC (registered trademark) lens (refractive index distribution type lens) or the like is used.
  • the ring tube 31 is formed by cutting a medical heat-shrinkable tube made of a transparent fluoropolymer or the like into a ring shape.
  • the ring tube 31 is made of a soft material that does not lose the original functions of the catheter 10 and the light emitting probe member 20.
  • the peeling tube 32 is a medical heat-shrinkable tube made of a transparent fluoropolymer or the like, and as shown in FIG. 1, a linear thin portion 32p is provided over the entire length in the length direction. . Since the thin portion 32p is thinner and more fragile than the other portions of the peeling tube 32, the peeling tube 32 can be torn in the length direction.
  • the thickness of the ring tube 31 is about 2/3 mm or less, preferably about 1/3 mm or less.
  • the inner diameter of the peeling tube 32 before heat shrinkage is configured to be slightly larger than the outer diameter of the ring tube 31 before heat shrinkage.
  • the outer surface of the ring tube 31 is weakly fixed to the inner surface of the peeling tube 32 partially by an adhesive. This fixation is strong enough to allow the peeling tube 32 and the ring tube 31 to be separated by hand when the peeling tube 32 is torn at the thin portion 32p.
  • the peeling tube 32 is composed of a seamless tubular body without a break, but is not limited to this, and a single strip-shaped long body made of a heat-shrinkable resin, You may comprise as a sushi roll-shaped cylindrical body by adhere
  • the catheter light emitting probe P ⁇ b> 1 includes a cylindrical space S in a region surrounded by the ring tube 31 and the peeling tube 32 and in a region adjacent to the light emitting probe member 20. .
  • This space S is used as a space for inserting the catheter 10 selected by the operator who is the user of the light emitting probe for catheter P1.
  • the peeling tube 32 is made of a color that allows the catheter 10 inserted into the space S to be visually recognized from the outside, for example, colorless and transparent or colored and transparent.
  • the ring tube 31 is inserted when the catheter 10 is inserted into the space S as shown in FIG. Can be used as a mark for arranging so as not to overlap the ring-shaped electrode 11 and the tip electrode 12 of the catheter 10.
  • the ring tube 31 and the peeling tube 32 may be formed of an antibacterial material.
  • the catheter light emitting probe P1 of the present embodiment is manufactured by the following process. First, a plurality of ring tubes 31 are manufactured by forming a colored heat-shrinkable tube from a heat-shrinkable material by a known method and cutting along a line perpendicular to the longitudinal direction of the tube. Next, a long shaft having a slightly smaller diameter than the mandrel is disposed on the exit side of the extruding machine for the peeling tube 32 having a mandrel and an extrusion head. A plurality of ring tubes 31 are inserted through the long shaft at predetermined intervals.
  • a peeling tube 32 made of a transparent heat shrinkable tube is formed using a known extruder, and peeling is performed so that the long shaft and the plurality of ring tubes 31 are inserted into the peeling tube 32.
  • the tube 32 is pushed out.
  • the ring tube 31 and the peeling tube 32 are overlapped with each other so that the ring tube 31 and the peeling tube 32 do not contract so that the laser is irradiated from the outside of the peeling tube 32 and the ring tube 31 and the peeling tube 32 are welded. Fix it.
  • a transparent adhesive is applied to a position corresponding to the ring tube 31 on the distal end side of the light emitting probe member 20, the light emitting probe member 20 is inserted into the ring tube 31 and the peeling tube 32, and the light emitting probe is inserted.
  • the member 20 is fixed to the ring tube 31.
  • the catheter light emitting probe P1 is completed.
  • the light emitting probe P1 for a catheter is provided in the state shown in FIG.
  • An operator who is a user of the catheter light emitting probe P1 selects the catheter 10 to be used in combination with the light emitting probe member 20 in accordance with a treatment method and a target site.
  • the selected catheter 10 is inserted into the space S of FIG. 1 so that the tip is located on the tip side of the light emitting probe member 20, and is arranged as shown in FIG.
  • the catheter 10 is an electrode catheter, the ring electrode 11 and the tip electrode 12 are arranged so as not to face the ring tube 31.
  • the ring tube 31 and the peeling tube 32 are heated and contracted, and the catheter 10 and the light emitting probe member 20 are fixed to each other in a direction perpendicular to the length direction. Thereafter, while taking care not to remove the ring tube 31 together with the peeling tube 32, the peeling tube 32 is removed by tearing at the thin-walled portion 32p to complete the laser catheter 1 with the light emitting probe of FIG.
  • a catheter 10 and a light emitting probe member 20 are fixed by a ring tube 31.
  • the electrode of the catheter is exposed at about 300 ° of the entire circumference, there is no problem in potential measurement. Therefore, in the laser catheter 1 with the light emitting probe of FIG.
  • the light emitting probe P1 for a catheter is provided with one light emitting probe member 20 may be provided.
  • the external means for attaching the light emitting probe member 20 to the outside of the catheter 10 and the two layers in which the peeling tube 32 is bonded to the outside of the ring tube 31.
  • the heat shrinkable tube 32 ′ having a single layer structure in which the external means can be peeled off by the thin portion 32p ′ so as to leave the ring tube 31 ′. You may comprise.
  • the thin-walled portion 32p ′ is a portion that is thinner and more fragile than the other portions of the heat-shrinkable tube 32 ′, and forms a ring-shaped ring tube 31 ′ that is perpendicular to the length direction of the heat-shrinkable tube 32 ′.
  • a pair of circles and straight lines connecting the ring tubes 31 ′ adjacent in the length direction are alternately formed over the entire length of the heat shrink tube 32 ′ in the length direction.
  • the light emitting probe P1 ′ for a catheter is provided in the state shown in FIG. 6, and an operator who is a user inserts the catheter 10 into the space S so that the distal end is positioned on the distal end side of the light emitting probe member 20. After the heat-shrinkable tube 32 'is heated and shrunk, the heat-shrinkable tube 32' is torn at the thin-walled portion 32p 'and parts other than the ring tube 31' are removed, thereby providing the light emitting probe shown in FIG. The laser catheter 1 is completed.
  • the other configuration of the catheter light emitting probe P1 ′ is the same as that of the catheter light emitting probe P1, and thus the description thereof is omitted.
  • the pattern of the thin portion 32p ′ may be formed so that the distance between the ring tubes 31 ′ adjacent in the length direction is substantially the same as the interval between the ring electrodes 11 of the catheter 10 assumed to be used. However, the interval between the ring electrodes 11 may be the same interval or may be random.
  • the pattern of the ring tube 31 ′ left after peeling at the thin wall portion 32 p ′ is formed in a direction perpendicular to the length direction of the catheter 10, but oblique to the length direction of the catheter 10. You may form in.
  • the portion to be removed is formed in an X-type lattice shape so as to form a rhombus with respect to the length direction of the catheter 10, the portion remaining after removing the rhombus portion becomes an oblique lattice shape. There is no need to consider.
  • Embodiment 2 Laser catheter 1 with light emitting probe >>
  • a surgeon who is a user combines the light emitting probe P1 for a catheter and the catheter 10 selected by himself to produce the laser catheter 1 with a light emitting probe shown in FIGS.
  • the laser catheter 1 with a light emitting probe is formed by fixing a known catheter 10 formed of a hollow soft tubular body and a light emitting probe member 20 by a ring tube 31.
  • the catheter 10 of the present embodiment is a known electrode catheter configured such that the distal end can be bent and bent in a J shape, and the distal end is fixed to the distal end. And a plurality of ring-shaped electrodes 11 fixed to the outer peripheral surface on the distal end side with a predetermined interval.
  • the catheter 10 has a lead wire connected to each of the tip electrode 12 and the ring electrode 11 in addition to a tension wire and a flexible structure (not shown) for bending and bending the tip side. Yes.
  • a control handle (not shown) for controlling the catheter 10 by controlling a pulling wire and a flexible structure (not shown) is connected to the end of the catheter 10 opposite to the distal end.
  • Other configurations of the present embodiment are the same as the respective configurations of the catheter light emitting probe P1 of the first embodiment, and thus description thereof is omitted.
  • the light-emitting probe P2 for a catheter of the present embodiment includes a light-emitting probe member 20 and a double tube 33 having a shape of a cross section 8 into which the light-emitting probe member 20 is inserted. It is provided as a preparation kit of the laser catheter 2 with the light emitting probe of FIG.
  • the double tube 33 includes a first tube 34 into which the light emitting probe member 20 is inserted and fixed, and a second tube 35 that forms a space S for inserting the catheter 10. In the connecting portion 35c, the outer portions are welded to each other.
  • the first tube 34 is made of a medical heat shrinkable tube made of a transparent fluoropolymer or the like, and is heated and contracted in a state where the light emitting probe member 20 is inserted therein, and the light emitting probe member 20 is It is fixed inside.
  • the second tube 35 is a medical heat-shrinkable tube made of a transparent fluoropolymer or the like, has not been heated, and is in an unshrinked state.
  • the first tube 34 and the second tube 35 are made of a soft material that does not lose the original functions of the catheter 10 and the light emitting probe member 20. As shown by the dotted line in FIG. 7, the second tube 35 is formed with a linear thin portion 35 p that is thinner and weaker than the other portions.
  • the thin-walled portion 35p is formed on the side surface of the second tube 35 with a peeling portion 35a surrounded by a plurality of rectangular patterns arranged in a row at regular intervals in the length direction of the second tube 35, and the other portions. It is formed so as to partition the region. As shown in FIG. 7, the region other than the peeling portion 35 a is formed in a ring shape perpendicular to the length direction of the second tube 35, and a plurality of ring portions 35 b having a predetermined interval in the length direction. And a connecting portion 35c that extends linearly along the length direction of the second tube 35 and connects the plurality of ring portions 35b in the length direction of the second tube 35. .
  • the connecting portion 35 c serves as a glue for connecting the first tube 34 to the second tube 35.
  • the 2nd tube 35 is equipped with the thin part 35p which draws a rectangular pattern, after inserting the catheter 10 into the 2nd tube 35 and making it shrink by heating, all the thin parts 35p When the second tube 35 is torn along the second tube 35, the peeled portion 35a surrounded by the rectangular pattern is peeled from the second tube 35, and only the plurality of ring portions 35b and the connecting portions 35c are separated from the first tube. 34 can remain connected.
  • the pattern drawn by the thin portion 35p is not limited to a rectangular shape as long as at least a part of the ring-shaped electrode 11 and the distal electrode 12 of the catheter 10 can be exposed, and may have any shape.
  • the light emitting probe for catheter P2 of this embodiment is manufactured by the following process. First, the first tube 34 and the second tube 35 are formed from a heat-shrinkable material by a known method. Then, the thin part 35p is formed in the 2nd tube 35 by a well-known method. The thin portion 35p may be formed at the same time as the second tube 35 is formed. Next, after the light emitting probe member 20 is inserted into the first tube 34, only the first tube 34 is heated and contracted, and the light emitting probe member 20 is fixed in the first tube 34. Thereafter, the side surface of the first tube 34 is brought into contact with the connecting portion 35c of the second tube 35, and the contacted portion is laser-welded so that the first tube 34 and the second tube 35 have a cross section. It is set as the double tube 33 joined by the side surface so that it may become 8 character. Thus, the catheter light emitting probe P2 is completed.
  • the second tube 35 has a single-layer structure that can be peeled off by the thin-walled portion 35p so as to leave the ring portion 35b and the connecting portion 35c.
  • the second tube 35 similarly to FIG. 1, has a two-layer structure. May be.
  • a two-layer structure in which a cylindrical peeling tube (not shown) is bonded to the outside of a ring tube (not shown) having the same shape as the ring portion 35b with a strength that can be separated by hand is preferable. .
  • the peeling tube (not shown) includes a pair of linear thin portions extending in the longitudinal direction at both ends of the connecting portion 35c, and the connecting portion 35c is formed by tearing the peeling tube (not shown) at the thin portion. It is preferable that the other part can be peeled while leaving the same shape part.
  • the light emitting probe P2 for catheter is provided in the state shown in FIG. An operator who is a user of the catheter light emitting probe P2 arranges the selected catheter 10 in the space S of FIG. 7 as shown in FIG. Next, the second tube 35 is heated and contracted, the catheter 10 is fixed in the second tube 35, the second tube 35 is torn by the thin-walled portion 35p, the peeling portion 35a is removed, and the ring portion
  • the laser catheter 2 with the light emitting probe of FIG. 8 is completed with the 35b and the connecting portion 35c remaining.
  • Embodiment 4 Laser catheter 2 with light emitting probe >>
  • the surgeon who is a user combines the light emitting probe for catheter P2 and the catheter 10 selected by himself to produce the laser catheter 2 with the light emitting probe of FIG.
  • the present invention is not limited to this, and may be provided in the form of the laser catheter 2 with the light emitting probe of FIG.
  • the laser catheter 2 with a light emitting probe is formed by fixing a known catheter 10 and a light emitting probe member 20 by a double tube 33.
  • the other configurations of the present embodiment are the same as the configurations of the catheter light emitting probes P1 and P2 of the first and third embodiments, and thus the description thereof is omitted.
  • FIG. 9 shows a light emitting probe P2 ′ for a catheter provided with three light emitting probe members 20.
  • the catheter light emitting probe P ⁇ b> 2 ′ has three first tubes 34 ′ fixed to the side surface of the second tube 35 at equal intervals in the circumferential direction. The light emitting probe member 20 is inserted and fixed in each of the first tubes 34 '.
  • a linear thin portion 35p ′ is formed in the second tube 35 ′.
  • the thin portion 35p ′ is formed by drawing a plurality of rectangular patterns arranged in three rows at predetermined intervals on the side surface of the second tube 35 ′ in the length direction of the second tube 35 ′. It is formed so as to partition the peeled portion 35a 'surrounded by and the other region.
  • the regions other than the peeling portion 35 a ′ are formed in a ring shape perpendicular to the length direction of the second tube 35 ′, and a plurality of them are spaced apart from each other in the length direction.
  • three connecting portions 35c ′ are provided at equal intervals in the circumferential direction of the second tube 35 ′, and the peeling portion 35a ′ is divided into three in the circumferential direction. Accordingly, the ring portion 35b ′ and the connecting portion 35c ′ form a lattice pattern on the side surface of the second tube 35 ′.
  • a first tube 34 ' is welded and fixed to each of the three connecting portions 35c'.
  • the number of the connecting portions 35c ′ and the second tubes 35 ′ is not limited to three, and may be two or four or more, but the functions of the ring electrode 11 and the tip electrode 12 of the catheter 10 In order to maintain the thickness, about 2 to 3 are preferable.
  • a plurality of connecting portions 35c ′ and second tubes 35 ′ in this way, a plurality of light emitting probe members 20 can be externally attached to the catheter 10, and the presence or absence of twisting of the catheter 10 inside the living body or the angle Regardless of this, it is possible to easily irradiate the desired part with light. It is also possible to control so that light is emitted only from the light emitting probe member 20 arranged at an appropriate position and light is not emitted from the other light probe members 20.
  • the second tube 35 ′ has a single layer structure that can be peeled off by the thin portion 35p ′ so as to leave the ring portion 35b ′ and the connecting portion 35c ′.
  • You may comprise from a layer structure.
  • a two-layer structure in which a cylindrical peeling tube (not shown) is bonded to the outside of a ring tube (not shown) having the same shape as the ring portion 35b 'with a strength that can be separated by hand is used. Good.
  • the peeling tube (not shown) is provided with a pair of linear thin portions extending in the longitudinal direction on both side ends of the connecting portion 35c ', and the connecting portion is formed by tearing the peeling tube (not shown) at the thin portion. It is preferable to leave the part having the same shape as that of 35c 'and make it possible to peel the other part.
  • the light emitting probe for catheter P3 of the present embodiment includes a light emitting probe member 20 and a mesh tube 36 into which the light emitting probe member 20 is inserted, and includes the light emitting probe of FIG. It is provided as a production kit for the laser catheter 3.
  • the mesh tube 36 is made of a transparent fluoropolymer or the like, and is formed of a heat-shrink type net-like tube that heat-shrinks when heated.
  • the mesh tube 36 is made of a soft material that does not lose the original functions of the catheter 10 and the light emitting probe member 20.
  • the thickness of the mesh tube 36 is about 2/3 mm or less, preferably about 1/3 mm or less.
  • the mesh tube 36 has a mesh roughness that does not interfere with potential measurement of the distal electrode 12 and the ring electrode 11 of the catheter 10 after heat shrinkage, for example, an aperture ratio of about 30 to 90%. Use.
  • the catheter light emitting probe P3 includes a cylindrical space S in a region adjacent to the light emitting probe member 20 in a portion surrounded by the mesh tube 36. An operator who is a user of the catheter light emitting probe P3 is used as a space for inserting the catheter 10 selected by the operator.
  • the light emitting probe for catheter P3 of this embodiment is manufactured by the following process. First, the mesh tube 36 is formed from a heat-shrinkable material by a known method. Next, after the light emitting probe member 20 is inserted into the mesh tube 36, the mesh tube 36 and the light emitting probe member 20 are laser-welded to complete the catheter light emitting probe P3.
  • the light emitting probe P3 for catheter is provided in the state shown in FIG. An operator who is a user of the light emitting probe for catheter P3 places the selected catheter 10 in the space S of FIG. Next, the mesh tube 36 is heated and contracted, and the catheter 10 is fixed in the mesh tube 36 to complete the laser catheter 3 with the light emitting probe of FIG.
  • the present invention is not limited to this, and may be provided in the form of the laser catheter 3 with the light emitting probe of FIG.
  • the laser catheter 3 with a light emitting probe is formed by fixing a known catheter 10 and a light emitting probe member 20 with a mesh tube 36. Since the other structure of this embodiment is the same as that of each structure of the light emitting probes P1 and P3 for catheters of Embodiments 1 and 5, description thereof is omitted.
  • Embodiment 7 Light emitting probe P4 for catheter >> Still another example of the light emitting probe for catheter according to the present invention will be described with reference to FIGS. As shown in FIG. 12, the light emitting probe for catheter P4 of the present embodiment includes a light emitting probe member 20 and a cover 37 into which the light emitting probe member 20 is inserted. A kit for producing the catheter 4 is provided.
  • the cover 37 includes a transparent tube 38 formed in a bag shape with the end of the cylindrical body closed, and an outer ring-shaped electrode 39 attached at predetermined intervals in the longitudinal direction outside the transparent tube 38 with a predetermined interval. And an outer tip electrode 40 attached to the tip of the outer side of the transparent tube 38, and a marker 45 provided at one place in the circumferential direction of the outer periphery of the cover 37.
  • the transparent tube 38 is made of a known medical tube made of silicone or the like, and has a thickness capable of being stored by bringing the light emitting probe member 20 and the catheter 10 into contact with the inner periphery.
  • the transparent tube 38 is made of a soft material that does not lose the original functions of the catheter 10 and the light emitting probe member 20.
  • the thickness of the transparent tube 38 is about 2/3 mm or less, preferably about 1/3 mm or less.
  • the outer ring-shaped electrode 39 is formed in a ring shape having a diameter slightly larger than the diameter of the transparent tube 38, and is composed of a ring-shaped electrode formed from a known material such as a platinum alloy. As shown in FIG. 14, projections 41 projecting inward are formed at a plurality of locations on the inner surface of the outer ring-shaped electrode 39.
  • the protrusion 41 includes a leg portion 41a that protrudes toward the inside of the outer ring-shaped electrode 39, and a head portion 41b that is formed wider than the leg portion 41a in a direction perpendicular to the protruding direction of the leg portion 41a. Yes.
  • the protrusion 41 penetrates the transparent tube 38 by being pushed into the hole 42 formed in the transparent tube 38 from the outside of the transparent tube 38.
  • the head 41b protrudes into the transparent tube 38, and the end of the hole 42 is sandwiched between the head 41b and the outer ring electrode 39, thereby fixing the outer ring electrode 39 to the outer surface of the transparent tube 38.
  • the outer ring-shaped electrode 39 is configured to be connectable to the ring-shaped electrode 11 of the catheter 10.
  • the outer tip electrode 40 has a container shape with the tip of the cylindrical body closed, is formed in the same shape as the tip of the transparent tube 38, and is made of an electrode made of a known material such as a platinum alloy.
  • the outer tip electrode 40 also has projections 41 as shown in FIG. 14 formed at a plurality of locations on the inner surface, and the projections 41 fix the outer tip electrode 40 to the tip of the transparent tube 38. Further, the outer tip electrode 40 is configured to be connectable to the tip electrode 12 of the catheter 10 by the projection 41.
  • the marker 45 is made of a known radiopaque marker, and is used for confirming whether the direction in which the light emitting probe member 20 is located coincides with the bending direction of the catheter 10 in fluoroscopy. When the direction of the light emitting probe member 20 and the bending direction of the catheter 10 are different, the adjustment is performed by rotating the catheter 10.
  • the light emitting probe P4 for catheter is provided in the state shown in FIG.
  • the surgeon who is a user of the catheter light emitting probe P4 places the selected catheter 10 in the space S of FIG. 12 as shown in FIG. 13 and fits the laser catheter 4 with the light emitting probe of FIG. Complete.
  • the outer ring-shaped electrode 39 and the outer tip electrode 40 may be provided in a state where they are not attached to the transparent tube 38.
  • the operator himself opens a hole 42 at the position of the transparent tube 38 in accordance with the tip electrode 12 and the ring electrode 11 of the catheter 10 selected by himself, and the protrusion 41 is engaged with the hole 42. Accordingly, the outer ring-shaped electrode 39 and the outer tip electrode 40 may be attached.
  • Embodiment 8 Laser catheter 4 with light emitting probe >>
  • a surgeon who is a user combines the light emitting probe for catheter P4 and the catheter 10 selected by himself to produce the laser catheter 4 with the light emitting probe of FIG.
  • the present invention is not limited to this, and may be provided in the form of the laser catheter 4 with the light emitting probe of FIG.
  • the laser catheter 4 with a light emitting probe is formed by fixing a known catheter 10 and a light emitting probe member 20 with a cover 37.
  • Other configurations of the present embodiment are the same as the configurations of the catheter light emitting probes P1 and P4 of the first and seventh embodiments, and thus the description thereof is omitted.
  • the light emitting probe P5 for a catheter of this embodiment includes a light emitting probe member 20, a heat shrinkable tube 43 in which the upper end of the light emitting probe member 20 is welded to the inner surface, and light on the inner surface.
  • the radiation probe member 20 includes an inner tube 44i for inserting a position near the boundary between the laser probe 21 and the optical fiber cable 22, and an outer tube 44o in which the inner tube 44i is welded to the inner surface.
  • a kit for producing a laser catheter 5 with a light emitting probe is provided as a kit for producing a laser catheter 5 with a light emitting probe.
  • the inner tube 44i is a medical tube having a slightly larger diameter than the light emitting probe member 20.
  • the heat-shrinkable tube 43 and the outer tube 44o are made of a medical heat-shrinkable tube made of a transparent fluoropolymer or the like that has been cut to a length approximately equal to the diameter of the catheter 10 after heat-shrinking. Since the outer tube 44o and the inner tube 44i are fixed to each other by welding, and the inner tube 44i and the light emitting probe member 20 are not fixed to each other, the inner tube 44i and the outer tube 44o are integrated, The light emitting probe member 20 is movable in the direction of the arrow in FIGS.
  • a space S for inserting the catheter 10 is provided adjacent to the light emitting probe member 20 or the inner tube 44i.
  • the light emitting probe 20 is bent and used as shown in FIG. 17 when inserted into the living body, so that the curved shape can be seen under the fluoroscopy by the fluoroscope.
  • An impermeable marker (not shown) may be provided.
  • the impermeable marker is formed from a known medical instrument material such as platinum, gold, iridium, and stainless steel, and may have any shape such as a ring shape or a coil shape. It is preferable that a plurality of opaque markers are provided at a distance so that a curved shape when the light emitting probe 20 is used can be recognized by arranging a plurality of opaque markers arranged at a predetermined distance.
  • the light emitting probe for catheter P5 is provided in the state shown in FIG.
  • An operator who is a user of the light emitting probe for catheter P5 places the selected catheter 10 in the space S of FIG. 15 as shown in FIG. Further, the heat shrinkable tube 43 is disposed at a position avoiding the distal electrode 12 and the ring electrode 11 of the catheter 10. Next, the heat-shrinkable tube 43 and the outer tube 44o are heated and contracted, and the catheter 10 is fixed in the heat-shrinkable tube 43 and the outer tube 44o, thereby completing the laser catheter 5 with the light emitting probe of FIG.
  • the inner tube 44i and the light emitting probe member 20 are not fixed to each other. Therefore, when the operator operates a control handle (not shown) at hand, the catheter 10 and the light emitting probe are connected.
  • the light emitting probe member 20 can be switched between the arrangement of FIG. 17 which is shaped like a bowstring. Therefore, when the laser catheter 5 with the light emitting probe is advanced in the blood vessel, the arrangement shown in FIG. 16 is adopted.
  • the arrangement shown in FIG. 17 is arranged and the catheter light emitting probe P5 is pressed against the target tissue. This makes it easy to bring the laser probe 21 into close contact with the target tissue.
  • the light emitting probe P5 for catheter of this embodiment is provided with the two-layer structure of the inner tube 44i and the outer tube 44o, it is not limited to this,
  • tip of the light emitting probe member 20 and the catheter 10 are not limited to this.
  • the light emitting probe member 20 and the catheter 10 may be bundled so as to be movable in the length direction at a position near the boundary between the laser probe 21 and the optical fiber cable 22.
  • the light emitting probe member 20 and the catheter 10 may be bundled by a single-layer tube that is not fixed to each other.
  • This tube is composed of a tube other than the heat-shrinkable tube, and the light emitting probe member 20 is fixed to the inner surface at a position near the boundary between the laser probe 21 and the optical fiber cable 22 and the catheter 10 is not fixed. It should be inserted.
  • Embodiment 10 Laser catheter 5 with light emitting probe
  • an operator who is a user combines the light emitting probe for catheter P5 and the catheter 10 selected by himself to produce the laser catheter 5 with the light emitting probe of FIGS. 16 and 17.
  • the present invention is not limited to this, and may be provided in the form of the laser catheter 5 with the light emitting probe of FIGS.
  • Other configurations of the present embodiment are the same as the configurations of the catheter light emission probes P1 and P5 of the first and ninth embodiments, and thus the description thereof is omitted.
  • the distal end side of the catheter 10 can be curved as shown in FIG. 1, but the distal end of the catheter 10 approaches another portion of the catheter 10 as shown in FIG. Then, a ring-shaped member may be used so as to face or abut against each other.
  • the second and second embodiments shown in FIGS. 5, 8, 11, 13, 16, and 17 are used.
  • the present invention is not limited to this, and the functions of the ring electrode 11 and the tip electrode 12 may be maintained by other methods.
  • the entire surface of the cover 37 has conductivity in the thickness direction of the cover 37 and is in a direction different from the thickness direction.
  • the anisotropic conductor includes an insulating film 46 having electrical insulating characteristics and conductive bumps 48 filled in a plurality of fine through holes 47 formed in the insulating film 46. It is prepared for.
  • the insulating film 46 is made of a thermosetting resin or a thermoplastic resin that is suitably used for medical purposes, and the conductive bumps 48 are various metals such as gold, silver, tin, or various alloys containing various metals as components. Consists of Further, instead of the mesh tube 36 shown in FIGS. 10 and 11, a heat-shrinkable tube made of an anisotropic conductor having conductivity in the thickness direction and having insulation in a direction different from the thickness direction. May be used.
  • Embodiment 11 Optical Radiation Probe for Endoscope
  • the light emitting probes P1 to P5 of each of the above embodiments can be applied to an endoscope instead of the catheter 10 to be an endoscope light emitting probe.
  • the endoscopic light emitting probe of the present embodiment uses, for example, an extremely thin endoscope such as a biliary endoscope (outer diameter 1 to 3 mm) and a pancreatic endoscope (1 to 2.5 mm). It can be suitably used for endoscopic photodynamic therapy for pancreatic cancer, biliary tract cancer, and the like.
  • pancreatic cancer and biliary tract cancer are present at the end of thin ducts such as the pancreatic duct and biliary tract, a normal-sized endoscope having a sufficient treatment tool or the like mounted therein cannot reach the lesioned part.
  • the light emitting probe 20 can be externally attached to the ultra-thin biliary endoscope 13 as in the present embodiment, the overall thickness of the obtained endoscope with the light emitting probe is still kept thin. Therefore, the biliary endoscope 13 is advanced to the lesion, and photodynamic therapy can be performed using the light emitting probe 20.
  • Endoscopes used in this embodiment are pancreatoscopes, biliary endoscopes (outer diameter 1 to 3 mm), pancreatic endoscopes (1 to 2.5 mm), nasal endoscopes (outer diameter 5 mm), etc.
  • a small-diameter endoscope is preferable.
  • the biliary endoscope for example, a child scope of a parent-child scope in which a child scope is stored in the parent scope may be used.
  • the parent-child scope for example, the parent-child scope is orally advanced to the duodenum, the papillary mouth and bile duct mouth are incised with the parent scope (duodenoscope) from the duodenal papilla, and the child scope (biliary tract) protrudes outside the parent scope Advance the endoscope to the bile duct and observe.
  • the nipple and pancreatic duct opening are incised (endoscopic papillary incision) with the parent scope, and the pancreatoscope (child scope) is inserted into the pancreatic duct to observe the intraductal papillary tumor and pancreatic cancer .
  • the endoscope light-emitting probe P6 of the present embodiment includes a light-emitting probe member 20 and a heat-shrinkable tube 32 ′ into which the light-emitting probe member 20 is inserted. It is provided as a preparation kit for the attached endoscope 6.
  • a thin portion 32p ′ having the same pattern as the light emitting probe P1 ′ for catheter is formed on the side surface of the heat shrinkable tube 32 ′, and the light emitting probe member 20 is fixed to the inner surface along the length direction. ing.
  • the biliary endoscope 13 used in the present embodiment is an ultra-thin general thin endoscope having an outer diameter of 5.9 mm or less, for example, 1 to 3 mm, which can be inserted into the pancreatic duct and biliary tract.
  • the objective optical system 14 for observing the predetermined range and the illumination optical system 15 capable of irradiating the predetermined range that can be observed by the objective optical system are provided.
  • the biliary endoscope 13 of the present embodiment may include an ultrafine treatment instrument inside or an electrode on the outer surface.
  • the endoscope light emitting probe P6 includes a space S at a position adjacent to the light emitting probe member 20 in the heat shrinkable tube 32 ′.
  • the surgeon who is the user inserts the biliary endoscope 13 into the space S as shown in FIG. 20, heats and contracts the heat-shrinkable tube 32 ′, and moves the heat-shrinkable tube 32 ′ at the thin-walled portion 32p ′.
  • an endoscope with a light emitting probe (not shown) can be produced.
  • the light emitting probes P1 to P5 of the above-described embodiments may be externally attached to an endoscope instead of the catheter 10.
  • the other configurations of the endoscope with the light emitting probe produced by the endoscope light emitting probe P6 and the endoscope light emitting probe P6 and the biliary endoscope 13 are the same as those in FIGS. The description is omitted.
  • the catheter 10 is used only once, whereas the biliary endoscope 13 is not discarded after use but is used repeatedly. Therefore, the ring tube 31 ′ has a biliary endoscope after use. 13 is easily thicker than the thin-walled portion 32p ′, but it is easy to tear from a thin-walled portion (not shown) formed weaker than the other portions of the ring tube 31 ′ or from the end portion. It may be provided with a notch or an opening. 6 is not limited to the biliary endoscope 13, and may be applied to other endoscopes or other medical devices such as a sheath. .
  • the present invention can be realized by the following configurations in addition to the configurations described in the claims. That is, the heat-shrinkable tube is removed after heat-shrinking on a plurality of annular heat-shrinkable tubes arranged at a plurality of positions in the lengthwise direction of the light emitting probe and on the outer surface of the plurality of annular heat-shrinkable tubes. And a peelable tube that is fixedly attached.
  • the heat shrinkable tube may be composed of a single layer, and a part of the heat shrinkable tube may be partially removable after heat shrinkage. Since it comprises in this way, even if it is a case where a medical device is equipped with an electrode on the outer periphery, an electrode is exposed to the outer side of a heat contraction tube, and does not produce a trouble in electric potential measurement.
  • a light emitting probe tube extending along the extending direction of the heat shrinkable tube is fixed to a side surface of the heat shrinkable tube, and the light emitting probe is fixed inside the light emitting probe tube. It may be.
  • the heat-shrinkable tube may have a net shape. Since it comprises in this way, it can take an electric potential from between the mesh
  • the external means comprises a bag-like body having a bag-like space capable of storing the tip of the light emitting probe and storing the tip of the medical device, and the bag-like body has an outer electrode on the outer surface.
  • the outer electrode may have a connection portion that penetrates the bag-like body in the thickness direction and can be connected to the electrode of the medical device stored in the bag-like body.
  • An outer electrode is provided on the outer surface, and the outer electrode has a connecting portion that penetrates the bag-like body in the thickness direction and can be connected to the electrode of the medical device stored in the bag-like body. Therefore, an electric potential can be taken outside the bag-like body, and it can be suitably used for a medical device equipped with an electrode such as an electrode catheter.
  • the optical radiation probe is held so as to be movable in the length direction with respect to the other heat shrinkable tube, and the one heat shrinkable tube can be externally attached to the distal end side of the medical device,
  • the other heat-shrinkable tube may be externally attached at a position that is longer than the length from the distal end side of the medical device to the end portion side opposite to the distal end.
  • the one heat shrinkable tube can be externally attached to the distal end side of the medical device, and the other heat shrinkable tube is disposed on the end portion side opposite to the distal end from the distal end side of the medical device. Since it can be externally attached at a position that is longer than the length up to, the medical tool with a light emitting probe passes along the medical tool and the light emitting probe along a thin region such as a blood vessel, When reaching the tissue to be treated, pulling the light emitting probe with the control handle at hand, the medical device bends like a bow, the light emitting probe becomes like a string, and the light emitting probe is irradiated to the tissue to be treated. It becomes easier to press the probe.
  • the medical device and the light emitting probe are connected by a tube or a cover made of resin or the like.
  • the present invention is not limited to this, and is made of, for example, a shape memory alloy. You may connect with a coil or a C ring. At this time, the coil and the C-ring may be provided so as to be discontinuous in the length direction of the medical device and overlap around the electrode of the medical device.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • General Health & Medical Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Physics & Mathematics (AREA)
  • Pathology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Biophysics (AREA)
  • Radiology & Medical Imaging (AREA)
  • Optics & Photonics (AREA)
  • Gastroenterology & Hepatology (AREA)
  • Endocrinology (AREA)
  • Physiology (AREA)
  • Electromagnetism (AREA)
  • Otolaryngology (AREA)
  • Media Introduction/Drainage Providing Device (AREA)
  • Laser Surgery Devices (AREA)
  • Radiation-Therapy Devices (AREA)
PCT/JP2014/068410 2013-07-26 2014-07-10 医療用具及び医療用具用の光放射プローブ取付キット Ceased WO2015012116A1 (ja)

Priority Applications (2)

Application Number Priority Date Filing Date Title
US14/907,609 US20160157697A1 (en) 2013-07-26 2014-07-10 Medical device and light-emitting probe mounting kit for medical device
EP14829043.0A EP3025751A4 (en) 2013-07-26 2014-07-10 MEDICAL DEVICE AND KIT FOR MOUNTING A LIGHT EMITTING PROBE TO THE MEDICAL DEVICE

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
JP2013155867A JP2015024030A (ja) 2013-07-26 2013-07-26 医療用具及び医療用具用の光放射プローブ取付キット
JP2013-155867 2013-07-26

Publications (1)

Publication Number Publication Date
WO2015012116A1 true WO2015012116A1 (ja) 2015-01-29

Family

ID=52393162

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/JP2014/068410 Ceased WO2015012116A1 (ja) 2013-07-26 2014-07-10 医療用具及び医療用具用の光放射プローブ取付キット

Country Status (4)

Country Link
US (1) US20160157697A1 (enExample)
EP (1) EP3025751A4 (enExample)
JP (1) JP2015024030A (enExample)
WO (1) WO2015012116A1 (enExample)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP6020870B1 (ja) * 2016-02-16 2016-11-02 株式会社エム・ピー・アイ 超極細撮像ユニット、ビデオスコープ
US20220409858A1 (en) * 2019-11-26 2022-12-29 Philips Image Guided Therapy Corporation Electromagnetic-radiation-cured radiopaque marker and associated devices, systems, and methods

Families Citing this family (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CA3132699C (en) * 2016-06-09 2024-05-28 Conmed Corporation Uterine manipulator
US20210228062A1 (en) * 2020-01-28 2021-07-29 Gyrus Acmi, Inc. D/B/A Olympus Surgical Technologies America Endoscope and endoscope attachments
US11992256B2 (en) 2020-02-28 2024-05-28 Gyrus Acmi, Inc. Electrosurgical attachment device
DE102020111886A1 (de) 2020-04-30 2021-11-04 Ambu A/S Spitze für ein Einwegendoskop, insbesondere für ein Einwegduodenoskop
US12268368B2 (en) 2020-04-30 2025-04-08 Ambu A/S Medical visualisation device
WO2024062901A1 (ja) * 2022-09-21 2024-03-28 古河電気工業株式会社 光ファイバプローブ

Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20060167532A1 (en) * 2005-01-26 2006-07-27 Parker Jeffery R Phototherapy treatment devices for applying area lighting to a wound
JP2006334398A (ja) * 2005-05-13 2006-12-14 Ethicon Endo Surgery Inc 内視鏡用の医療器具
US20070297190A1 (en) * 2006-06-22 2007-12-27 Kee Yean Ng Solid state light source adapted for remote illumination
JP2012147937A (ja) 2011-01-19 2012-08-09 Sony Corp レーザ治療装置、レーザ治療システム及び判別方法
JP2012161454A (ja) * 2011-02-07 2012-08-30 Hoya Corp 内視鏡の外付けチャンネル
JP2012228512A (ja) * 2011-04-22 2012-11-22 National Cheng Kung Univ 総胆管照明排液装置
JP2013521960A (ja) * 2010-03-24 2013-06-13 ユニベルシテ ピエール エ マリー キュリー（パリ シズエム） 方向付け可能端を有する柔軟な細長い構造体の製造方法

Family Cites Families (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5370649A (en) * 1991-08-16 1994-12-06 Myriadlase, Inc. Laterally reflecting tip for laser transmitting fiber
WO2005004704A2 (en) * 2003-07-08 2005-01-20 Light Sciences Corporation Light generating device that self centers within a lumen to render photodynamic therapy
JP5384808B2 (ja) * 2007-07-02 2014-01-08 オリンパス株式会社 内視鏡
GB2493606B (en) * 2008-03-07 2013-03-27 Milwaukee Electric Tool Corp Visual inspection device

Patent Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20060167532A1 (en) * 2005-01-26 2006-07-27 Parker Jeffery R Phototherapy treatment devices for applying area lighting to a wound
JP2006334398A (ja) * 2005-05-13 2006-12-14 Ethicon Endo Surgery Inc 内視鏡用の医療器具
US20070297190A1 (en) * 2006-06-22 2007-12-27 Kee Yean Ng Solid state light source adapted for remote illumination
JP2013521960A (ja) * 2010-03-24 2013-06-13 ユニベルシテ ピエール エ マリー キュリー（パリ シズエム） 方向付け可能端を有する柔軟な細長い構造体の製造方法
JP2012147937A (ja) 2011-01-19 2012-08-09 Sony Corp レーザ治療装置、レーザ治療システム及び判別方法
JP2012161454A (ja) * 2011-02-07 2012-08-30 Hoya Corp 内視鏡の外付けチャンネル
JP2012228512A (ja) * 2011-04-22 2012-11-22 National Cheng Kung Univ 総胆管照明排液装置

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
See also references of EP3025751A4

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP6020870B1 (ja) * 2016-02-16 2016-11-02 株式会社エム・ピー・アイ 超極細撮像ユニット、ビデオスコープ
TWI609668B (zh) * 2016-02-16 2018-01-01 Mpi股份有限公司 超極細攝像單元、視頻內視鏡
US20220409858A1 (en) * 2019-11-26 2022-12-29 Philips Image Guided Therapy Corporation Electromagnetic-radiation-cured radiopaque marker and associated devices, systems, and methods

Also Published As

Publication number Publication date
EP3025751A4 (en) 2016-08-03
EP3025751A1 (en) 2016-06-01
US20160157697A1 (en) 2016-06-09
JP2015024030A (ja) 2015-02-05

Similar Documents

Publication Publication Date Title
WO2015012116A1 (ja) 医療用具及び医療用具用の光放射プローブ取付キット
JP3615547B2 (ja) ゼブラ交換ガイドワイヤ
CN107567301B (zh) 具有电外科手术用工具的可操纵微型内窥镜和拉链式导管
US8696654B2 (en) Apparatus, method and computer program for applying energy to an object
JP5113400B2 (ja) 光ファイバ、光ファイバ装置及びバンドルファイバ
JP7384814B2 (ja) 光照射医療装置
JP7302816B2 (ja) 挿入性の良いファイバースコープ
EP3970781B1 (en) Light irradiation system
JP2004057815A (ja) 内視鏡用処置具装置
KR102276076B1 (ko) 레이저 치료기
WO2021019981A1 (ja) カテーテル、及び、光照射システム
JP6498028B2 (ja) 内視鏡用光線力学的治療装置
JP7546258B2 (ja) 挿入性の良いファイバースコープ
JP7718934B2 (ja) 光照射医療装置
WO2018008622A1 (ja) 光照射プローブ及びその製造方法
JP7687889B2 (ja) 光照射医療装置
WO2023281918A1 (ja) 光照射医療装置
WO2023281917A1 (ja) 光照射医療装置
WO2021079633A1 (ja) カテーテル
JP2023009439A (ja) 光照射医療装置
JP2021083661A (ja) 光照射デバイス
JP2019187935A (ja) チューブ及び医療ライトガイド
JPS62145205A (ja) レ−ザビ−ム伝送用フアイバ
JPS63147452A (ja) フアイバ−治療器具
ITTO20010608A1 (it) Dispositivo di visualizzazione e di trattamento di pareti cardiache.

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 14829043

Country of ref document: EP

Kind code of ref document: A1

NENP Non-entry into the national phase

Ref country code: DE

WWE Wipo information: entry into national phase

Ref document number: 14907609

Country of ref document: US

REEP Request for entry into the european phase

Ref document number: 2014829043

Country of ref document: EP

WWE Wipo information: entry into national phase

Ref document number: 2014829043

Country of ref document: EP