WO2020136936A1 - カテーテル、ガイドワイヤ、孔位置特定装置、孔位置特定方法、体内における物体存否判断支援装置、診断支援装置および治療支援装置 - Google Patents
カテーテル、ガイドワイヤ、孔位置特定装置、孔位置特定方法、体内における物体存否判断支援装置、診断支援装置および治療支援装置 Download PDFInfo
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- WO2020136936A1 WO2020136936A1 PCT/JP2019/019016 JP2019019016W WO2020136936A1 WO 2020136936 A1 WO2020136936 A1 WO 2020136936A1 JP 2019019016 W JP2019019016 W JP 2019019016W WO 2020136936 A1 WO2020136936 A1 WO 2020136936A1
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- Prior art keywords
- catheter
- hole
- light
- light source
- specifying
- Prior art date
Links
- 238000000034 method Methods 0.000 title abstract description 13
- 239000000126 substance Substances 0.000 claims abstract description 20
- 239000012530 fluid Substances 0.000 claims abstract description 17
- 230000010365 information processing Effects 0.000 claims description 25
- 210000004072 lung Anatomy 0.000 claims description 7
- 210000000056 organ Anatomy 0.000 claims description 7
- 210000001035 gastrointestinal tract Anatomy 0.000 claims description 5
- 210000000626 ureter Anatomy 0.000 claims description 4
- 238000003780 insertion Methods 0.000 abstract description 7
- 230000037431 insertion Effects 0.000 abstract description 7
- 210000002784 stomach Anatomy 0.000 description 9
- 238000010586 diagram Methods 0.000 description 8
- 230000001737 promoting effect Effects 0.000 description 6
- 239000007788 liquid Substances 0.000 description 4
- 238000003384 imaging method Methods 0.000 description 3
- 210000000936 intestine Anatomy 0.000 description 3
- 206010028980 Neoplasm Diseases 0.000 description 2
- 210000004204 blood vessel Anatomy 0.000 description 2
- 201000011510 cancer Diseases 0.000 description 2
- 210000002318 cardia Anatomy 0.000 description 2
- 239000004020 conductor Substances 0.000 description 2
- 238000003745 diagnosis Methods 0.000 description 2
- 210000001198 duodenum Anatomy 0.000 description 2
- 230000000694 effects Effects 0.000 description 2
- 210000002429 large intestine Anatomy 0.000 description 2
- 235000015097 nutrients Nutrition 0.000 description 2
- 210000000813 small intestine Anatomy 0.000 description 2
- 239000007787 solid Substances 0.000 description 2
- INGWEZCOABYORO-UHFFFAOYSA-N 2-(furan-2-yl)-7-methyl-1h-1,8-naphthyridin-4-one Chemical compound N=1C2=NC(C)=CC=C2C(O)=CC=1C1=CC=CO1 INGWEZCOABYORO-UHFFFAOYSA-N 0.000 description 1
- 240000007817 Olea europaea Species 0.000 description 1
- 108010064719 Oxyhemoglobins Proteins 0.000 description 1
- 206010035669 Pneumonia aspiration Diseases 0.000 description 1
- 210000000436 anus Anatomy 0.000 description 1
- 201000009807 aspiration pneumonia Diseases 0.000 description 1
- QVGXLLKOCUKJST-UHFFFAOYSA-N atomic oxygen Chemical compound [O] QVGXLLKOCUKJST-UHFFFAOYSA-N 0.000 description 1
- 230000002490 cerebral effect Effects 0.000 description 1
- 108010002255 deoxyhemoglobin Proteins 0.000 description 1
- 238000001514 detection method Methods 0.000 description 1
- 239000003814 drug Substances 0.000 description 1
- 229940079593 drug Drugs 0.000 description 1
- 230000005611 electricity Effects 0.000 description 1
- 210000004051 gastric juice Anatomy 0.000 description 1
- 238000007689 inspection Methods 0.000 description 1
- 239000000463 material Substances 0.000 description 1
- 239000000203 mixture Substances 0.000 description 1
- 239000013307 optical fiber Substances 0.000 description 1
- 229910052760 oxygen Inorganic materials 0.000 description 1
- 239000001301 oxygen Substances 0.000 description 1
- 230000009291 secondary effect Effects 0.000 description 1
- 210000001835 viscera Anatomy 0.000 description 1
Images
Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/0067—Catheters; Hollow probes characterised by the distal end, e.g. tips
- A61M25/0068—Static characteristics of the catheter tip, e.g. shape, atraumatic tip, curved tip or tip structure
- A61M25/007—Side holes, e.g. their profiles or arrangements; Provisions to keep side holes unblocked
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/06—Devices, other than using radiation, for detecting or locating foreign bodies ; determining position of probes within or on the body of the patient
- A61B5/061—Determining position of a probe within the body employing means separate from the probe, e.g. sensing internal probe position employing impedance electrodes on the surface of the body
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- A—HUMAN NECESSITIES
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
- A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
- A61B5/6847—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive mounted on an invasive device
- A61B5/6852—Catheters
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- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/0067—Catheters; Hollow probes characterised by the distal end, e.g. tips
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- A—HUMAN NECESSITIES
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- A61M25/00—Catheters; Hollow probes
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- A61M25/0105—Steering means as part of the catheter or advancing means; Markers for positioning
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- A—HUMAN NECESSITIES
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- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
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- A61M25/00—Catheters; Hollow probes
- A61M2025/0008—Catheters; Hollow probes having visible markings on its surface, i.e. visible to the naked eye, for any purpose, e.g. insertion depth markers, rotational markers or identification of type
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- A—HUMAN NECESSITIES
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- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/0067—Catheters; Hollow probes characterised by the distal end, e.g. tips
- A61M25/0074—Dynamic characteristics of the catheter tip, e.g. openable, closable, expandable or deformable
- A61M2025/0079—Separate user-activated means, e.g. guidewires, guide tubes, balloon catheters or sheaths, for sealing off an orifice, e.g. a lumen or side holes, of a catheter
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- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/0105—Steering means as part of the catheter or advancing means; Markers for positioning
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- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/09—Guide wires
- A61M2025/09175—Guide wires having specific characteristics at the distal tip
- A61M2025/09183—Guide wires having specific characteristics at the distal tip having tools at the distal tip
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- A61M2205/00—General characteristics of the apparatus
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- A61M2205/3306—Optical measuring means
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- A—HUMAN NECESSITIES
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- A61M2210/00—Anatomical parts of the body
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- A—HUMAN NECESSITIES
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- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2210/00—Anatomical parts of the body
- A61M2210/10—Trunk
- A61M2210/1078—Urinary tract
- A61M2210/1085—Bladder
Definitions
- the present invention relates to a catheter, a guide wire, a hole position specifying device, a hole position specifying method, an object presence/absence judgment supporting device, a diagnosis supporting device and a treatment supporting device.
- An object of the present invention is to provide a catheter, a guide wire, a hole position identifying device, a hole position identifying method, an object presence/absence determination assisting device, a diagnostic assisting device, and a treatment capable of easily identifying the position of a hole of a catheter in the body.
- a support device To provide a support device.
- the inventors of the present application have found an invention that can easily grasp the position of the hole of the catheter. Specifically, the inventors of the present application did not have the idea of specifying the position of the light source provided on the catheter in the body by the image capturing means such as a camera, but grasp the position of the light source by the image capturing means. It has been found that the position of the hole in the catheter can be identified through the position of the light source.
- the inventors of the present application have found that when light is introduced from a light source outside the body through a catheter or an optical fiber, the light loss is large, the light diffusing property is low, and the light amount is insufficient.
- One aspect of the guide wire of the present invention is a guide wire that is inserted into a catheter having a hole for introducing a fluid substance into the body or for sucking the fluid substance in the body, wherein One or a plurality of light sources for specifying the position may be provided.
- One aspect of the catheter of the present invention may be one in which the guide wire of the present invention is inserted.
- One embodiment of the catheter of the present invention is a catheter having a hole for introducing a fluid substance into the body or for sucking the fluid substance in the body, the light source for specifying the position of the hole of the catheter.
- One aspect of the catheter of the present invention can be such that when the end surface of the tip of the catheter is open, light is not emitted from the open end surface of the tip.
- One aspect of the hole locating device of the present invention can include the catheter of the present invention, and an imaging unit for imaging the light source of the catheter when the catheter is inside the body.
- One aspect of the hole position identifying device of the present invention may include a display device that displays information based on image information or video information captured by the capturing means.
- One aspect of the hole locating device of the present invention can include a light receiving unit that receives the light of the light source of the catheter when the catheter is inside the body.
- One aspect of the hole position identifying device of the present invention includes a first information processing unit, and the first information processing unit has a function of identifying whether or not a predetermined hole of the catheter is in a lung. You can
- One aspect of the hole position identifying device of the present invention includes a second information processing unit, and the second information processing unit can identify whether or not a predetermined hole of the catheter is below the diaphragm.
- One aspect of the hole locating device of the present invention includes a third information processing unit, and the third information processing unit determines whether a predetermined hole of the catheter is at a predetermined position or region of the digestive tract. It can have a specific function.
- One aspect of the hole locating device of the present invention includes a fourth information processing unit, wherein the fourth information processing unit has a predetermined hole or a predetermined position or region between the ureter and the bladder of the catheter. Can have the function of specifying whether or not.
- One aspect of the method for identifying the position of the hole of the catheter of the present invention is the step of inserting the catheter of the present invention into the body, the step of causing the light source of the catheter to emit light, and the light of the light source being photographed by a photographing means. Can be included.
- the step of inserting the catheter of the present invention into the body, the step of causing the light source of the catheter to emit light, and the light receiving section receiving the light of the light source can be included.
- the object presence/absence judgment support device of the present invention is for supporting judgment of whether or not an object exists at a predetermined site or organ in the body, and includes the hole position identifying device according to the present invention.
- the diagnostic support device includes the hole position specifying device according to the present invention.
- the treatment support device includes the hole position specifying device according to the present invention.
- fluid substance means a substance that has fluidity, and is a concept that includes a liquid and a mixture of a liquid and a solid.
- the body means the human or animal body.
- the absolute position of the hole of the catheter can be easily specified. It is important to be in place when expelling or aspirating fluent material from the catheter bore. If the hole of the catheter is not in an appropriate position and enters the lungs, for example, and nutrients or liquids flow into the lungs through the holes, a problem such as aspiration pneumonia may occur. According to this, such a problem can be solved.
- FIG. 2A is a diagram schematically showing an example of a catheter into which a guide wire is inserted.
- FIG. 2B is a diagram schematically showing a state when the guide wire is inserted into the catheter.
- FIG. 3A is a diagram schematically showing an example of a catheter.
- FIG. 3B is a diagram schematically showing a state when the guide wire is inserted into the catheter.
- 4A and 4B are schematic views showing an example of a catheter. It is a figure which shows the catheter which concerns on embodiment typically.
- FIG. 6A is a diagram schematically showing an example of mounting a light source on a catheter.
- FIG. 6B is a diagram schematically showing a cross section taken along line A1-A1 of FIG.
- FIG. 8A is a diagram schematically showing an example in which a light source is mounted on a guide wire insertion promoting member.
- FIG. 8B is a diagram schematically showing a cross section taken along line A2-A2 of FIG. It is a figure for demonstrating the light emission direction of a light source. It is a figure which shows typically the hole position identification device for pinpointing the position of the hole of a catheter. It is a figure which shows typically the picked-up image of a light source when the light source is image
- the guide wire 20 is inserted into the catheter 30, and is provided with a light source 10 as shown in FIG.
- the catheter 30 can be configured as shown in FIG. 2(A), FIG. 3(A) or FIG.
- the catheter 30 is provided with at least one hole 32 for admitting the fluid substance into the body or sucking the fluid substance in the body.
- Examples of fluid substances that can be put into the body include nutrients and drugs.
- Examples of fluid substances that are sucked from the body include gastric juice.
- the hole 32 of the catheter 30 may be provided on the side surface, or the tip may be provided with an open end.
- the number of light sources 10 provided on the guide wire 20 may be one or more.
- the light source 10 is provided so as to correspond to the position of the hole 32 when the guide wire 20 is inserted into the catheter 30. That is, the light source 10 is set on the guide wire 20 at a position where the light of the light source 10 is emitted to the outside through the hole 32.
- the guide wire 20 may be provided with wirings (conductors) 36 that are bundled. Electricity can be supplied to the light source 10 through the wiring 36.
- the catheter 30 shown in FIG. 2(A) is provided with an insertion promoting member (olive) 34 having a stopper function for the guide wire 20 at the tip.
- the insertion promoting member 34 may also be provided with the hole 32.
- the catheter 30 shown in FIG. 3(A) has a mode in which the insertion promoting member 34 of the guide wire 20 is not provided at the tip.
- FIG. 3(B) schematically shows a state in which the guide wire 20 is inserted into the catheter 30 of FIG. 3(A).
- the catheter 30 shown in FIG. 4(A) has a weight holding portion 38 that holds a weight on the distal end side. Note that, as shown in FIG. 4B, the number of holes 32 may be one.
- the light source 10 may be provided in the catheter 30 shown in FIGS.
- Catheter 30 has a hole 32 for introducing a fluid substance into the body or for sucking the fluid substance in the body.
- One or a plurality of light sources 10 for identifying the position of the hole 32 of the catheter 30 are provided.
- the light source 10 is provided at a position corresponding to the hole 32 of the catheter 30, as shown in FIG.
- the light sources 10 may be provided at positions adjacent to each other in the axial direction in relation to the hole 32, or may be provided at a portion of the catheter 30 located laterally of the hole 32 of the catheter 30.
- the catheter 30 is provided with wiring (conductor wire) 36, and the wiring 36 is electrically connected to the light source 10.
- Light Source 10 a known light source can be applied, and an LED light source such as an LED light bulb can be used.
- the light from the light source 10 is preferably light that easily passes through the body, and may be near infrared rays, for example.
- FIG. 5 the light source 10 is shown mounted on the catheter 30.
- FIG. 6 the light source 10 is shown embedded in the catheter 30.
- FIG. 6B is a schematic cross-sectional view taken along the line A1-A1 of FIG. As shown in FIG. 6(B), it may be a portion of the catheter 30 located in the lateral direction of the hole 32 of the catheter 30 and fitted into the catheter 30.
- a plurality of (eg, three or four) light sources 10 are provided around the catheters 30 that are axially adjacent to each other, not at the site of the catheter 30 that is located laterally of the hole 32 of the catheter 30. May be provided.
- the light source 10 may be provided on the insertion promoting member 34 of the guide wire 20.
- the first light source 10a may emit light laterally with respect to the axial direction of the catheter 30, for example.
- the second light source 10b may emit light in the axial direction of the catheter 30.
- the photographing means 42 can photograph the light of the light source 10 more reliably even if the body position or posture changes.
- the light source 10 can also be configured to include a plurality of light emitting elements.
- the light source 10 can include a light emitting element 10c that emits light in the axial direction and a light emitting element 10d that emits in a direction intersecting the axial direction (for example, a lateral direction).
- a plurality of light sources 10 that emit in the axial direction and light sources 10 that emit in the direction intersecting the axial direction may be provided. This allows the photographing means 42 to photograph the light of the light source more reliably even if the body position or posture changes.
- the catheter 30 has a plurality of holes 32 and the light source 10 is provided for each of the plurality of holes 32. In that case, it is possible to specify which hole 32 is located at which position by changing the wavelength of light between the light sources 10 having different holes 32 to be specified.
- the catheter 30 according to the embodiment may be applied to, for example, a tube from the mouth to the anus, a blood vessel including a cerebral blood vessel, a ureter and a bladder.
- a hole position specifying device 40 for specifying the position of the hole 32 of the catheter 30 has the catheter 30 according to the embodiment and the catheter 30 inside the body.
- a photographing means 42 for photographing the light source 10 of the catheter 30 can be included.
- the catheter 30 according to the embodiment includes one in which the guide wire 20 provided with the light source 10 is inserted into the catheter 30, and one in which the light source 10 is provided in the catheter 30.
- the photographing means 42 is not particularly limited as long as it can photograph the light of the light source 10, and for example, a camera such as a CCD camera or a camera for astronomical observation can be applied. If the light source 10 emits near-infrared rays, the photographing means 42 can be a camera (including a digital camera) from which a filter that blocks near-infrared rays is removed. When the image is taken by the image taking means 42, as shown in FIG. 11, a taken image or a taken image in which the portion of the light source 10 is illuminated can be obtained.
- the hole position identifying device 40 can include a display device that displays information based on image information or video information captured by the capturing means 42.
- the hole position identifying device 40 can include a light receiving unit 46 that receives the light of the light source 10 of the catheter 30 when the catheter 30 according to the embodiment is inside the body.
- the light receiving unit 46 is determined by the relationship with the light source 10, but when the light source 10 is an LED light source, it can be configured by, for example, a diode.
- the light receiving state of the light receiving unit 46 may be displayed on the display device.
- FIGS. 13 and 14 An example of the significance of specifying the positions of the plurality of holes 32 by the plurality of light sources 10 will be described with reference to FIGS. 13 and 14.
- the positions of the holes 32 sequentially go from top to bottom as going from the rear end side to the tip side.
- the hole 32 in the middle is in the stomach, even if the tip is above the cardia, or even if the two holes 32 are in the position in the stomach, the hole 32 between the two holes 32.
- it is above the cardia In such a case, by photographing the light source 10 with the photographing means 42 and specifying the position of the hole 32, it is possible to know how the catheter 30 is in the stomach.
- the display device is not particularly limited as long as it can display, and, for example, a known display can be applied.
- the positions of predetermined parts or organs such as the diaphragm or lungs may be displayed in the captured image or video displayed on the display device.
- the positions of the diaphragm and the lungs may be captured by the image capturing unit 42, or may be captured by another inspection device such as an X-ray device.
- the catheter 30 has a plurality of holes 32, the light source 10 is provided for each of the plurality of holes 32, and when the wavelengths of light of the light sources 10 having different holes 32 are changed, the photographing unit 42 or the light receiving unit 46 By grasping the wavelength of light, it is possible to specify which hole 32 is located at which position.
- the hole position identifying device 40 can include an information processing unit.
- the information processing unit can have, for example, the following first to fourth information processing units.
- the first information processing unit has a function of identifying whether or not the predetermined hole 32 of the catheter 30 is in the lung.
- the second information processing unit has a function of identifying whether or not the predetermined hole 32 of the catheter 30 is below the diaphragm.
- the third information processing unit has a function of identifying whether or not the predetermined hole 32 of the catheter 30 is at a predetermined position or area of the digestive tract.
- the predetermined position of the digestive tract include predetermined positions of the stomach, duodenum, large intestine, and small intestine.
- the predetermined region of the digestive tract include regions of organs such as stomach, duodenum, large intestine, and small intestine, or partial regions thereof.
- the fourth information processing unit has a function of identifying whether or not the predetermined hole 32 of the catheter 30 is at a predetermined position or area between the ureter and the bladder.
- the processing of the information processing unit can be performed by an electronic computer.
- the electronic computer and the photographing means 42 may be connected, the information processing section may process the photographing information photographed by the photographing means 42, and display the processed information on the display device.
- the step of inserting the catheter 30 according to the embodiment into the body, the step of causing the light source 10 of the catheter 30 to emit light, and the light of the light source 10 are performed. And a step of photographing the image with the photographing means 42.
- the step of inserting the catheter 30 according to the embodiment into the body the step of causing the light source 10 of the catheter 30 to emit light, and the light of the light source 10 Is received by the light receiving section 46.
- the first aspect and the second aspect may be combined.
- the light source 10 can be controlled by the control device 48.
- the control device 48 can be electrically connected to the light source 10 via the wiring 36.
- the hole position identifying device 40 is for judging whether a liquid substance or a solid substance is present in an organ where the catheter 30 is present, for example, a stomach or an intestine. It can be applied as an object existence determination support device.
- the contents existing in the body may be grasped by transmitting the wavelength of light.
- the hole locating device 40 is capable of diagnosing the state of an internal organ where the catheter 30 is present, for example, the surface of the stomach or the intestine or the part of the body between the surface and the skin. It can be used as a supporting device.
- the inside of the body where the catheter 30 exists because the light of the light source 10 in the body is photographed, and at least one of the hue, brightness, and saturation of the photographed image, the light amount of the light receiving unit 46, or the illuminance is different. It is possible to grasp the state of the organs such as the surface of the stomach and the intestines and the body part between the surface and the skin.
- the light source 10 emits near-infrared light
- oxyhemoglobin and deoxyhemoglobin are measured
- the near-infrared light passing through the body is detected by a detection device such as a light-receiving element, and the oxygen concentration is derived from the intensity of the transmitted wavelength. You may.
- the diagnostic support device can be applied to various diagnostic devices.
- the hole position identifying device 40 captures an image of the light source 10 of the catheter 30 (including the light source 10 of the guide wire 20) 10 in the body by the image capturing means 42, and the position of the hole 32 is determined by the light source 10. While recognizing, this light can be applied as a treatment support device for killing cancer cells or reducing the activity of cancer cells.
- the treatment support device can be applied to various treatment devices.
- the position of the hole 32 can be specified accurately. Further, the position of the hole 32 can be visually and easily grasped by displaying an image or a video obtained by photographing the light of the light source 10 on the display device.
- the present invention is applicable to catheters and various objects using catheters.
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Abstract
Description
本発明の孔位置特定装置の一態様は、第4の情報処理部を含み、前記第4の情報処理部は、前記カテーテルの所定の孔が尿管から膀胱までの間の所定の位置または領域にあるかどうかを特定する機能を有することができる。
カテーテルの孔から流動性物質を排出または吸引するに当たって、所定位置にあるかどうか重要である。カテーテルの孔が適切な位置になく、たとえば、肺に入ってしまい、栄養剤や液状物が孔を通じて肺に流れ込んでしまった場合には、誤嚥性肺炎などの問題も生じるところ、本発明によれば、そのような問題を解消することができる。
実施の形態に係るガイドワイヤ20は、カテーテル30に挿入されるものであり、図1に示すように、光源10が設けられている。
実施の形態に係るカテーテル30は、流動性物質を体内に入れるため、または、体内の流動性物質を吸引するための孔32を有する。カテーテル30の孔32の位置を特定するための光源10が一つ又は複数設けられている。具体的には、光源10は、図5に示すように、カテーテル30の孔32に対応する位置に設けられている。光源10は、孔32との関係において軸方向で隣り合う位置に設けられてもよいし、カテーテル30の孔32の横方向に位置するカテーテル30の部位に設けられてもよい。カテーテル30には配線(導線)36が設けられ、その配線36は光源10に電気的に接続されている。カテーテル30に配線36を設けることで、カテーテル30の弾力性を保ちつつ、折れにくくすることで、カテーテル30を所定の位置に挿入しやすくする、という副次的効果が得られる。
光源10は、公知のものを適用することができ、LED電球などのLED光源とすることができる。光源10の光は、体を容易に通過しやすい光であることが好ましく、たとえば、近赤外線とすることができる。
実施の形態に係るカテーテル30としては、たとえば、口から肛門までの管内、脳血管を含む血管内、尿管および膀胱への適用例が考えられる。
カテーテル30の孔32の位置を特定するための孔位置特定装置40は、図10に示すように、実施の形態に係るカテーテル30と、カテーテル30が体内にある場合に、カテーテル30の光源10を撮影するための撮影手段42とを含むことができる。ここで、実施の形態に係るカテーテル30とは、光源10が設けられたガイドワイヤ20をカテーテル30に挿入したもの、および、光源10がカテーテル30に設けられたものを含むものとする。
実施の形態に係る孔位置特定装置40は、カテーテル30が存在する器官、たとえば、胃や腸などに、液状物や固形物が存在しているかどうかを判断するための物体存否判断支援装置として適用することができる。体内にある光源10の光を撮影し、その撮影画像の色相、明度および彩度の少なくとも一種の違い、または受光部46の光量の違い、もしくは、照度の違いなどから、カテーテル30が存在する器官に物体が存在するかどうかを判断することができる。光の波長の透過により、体内に存在する内容物を把握してもよい。
実施の形態に係る孔位置特定装置40は、カテーテル30が存在する体内の器官、たとえば、胃や腸などの表面や、その表面と皮膚との間の体の部分の状態の診断を支援する装置として使用することができる。体内にある光源10の光を撮影し、その撮影画像の色相、明度および彩度の少なくとも一種の違い、または受光部46の光量の違い、もしくは、照度の違いなどから、カテーテル30が存在する体内の器官、たとえば、胃や腸などの表面や、その表面と皮膚との間の体の部分の状態を把握することができる。
実施の形態に係る孔位置特定装置40は、体内にあるカテーテル30の光源(ガイドワイヤ20の光源10を含む)10を撮影手段42で撮影し、その光源10により孔32の位置を認識しながら、この光を通じて、がん細胞を死滅またはがん細胞の活性を低減させるための治療支援装置として、適用することができる。
電極のインピーダンスでカテーテル30の位置を特定することが考えられるが、そのカテーテル30の位置は相対位置としてしか把握ができない。また、磁気センサーの場合には、磁気センサーがずれると、正確な位置を把握できない。
20 ガイドワイヤ
30 カテーテル
32 孔
34 挿入促進部材
36 配線
40 孔位置特定装置
42 撮影手段
44 表示装置
46 受光部
48 制御装置
Claims (16)
- 流動性物質を体内に入れるため、または、体内の流動性物質を吸引するための孔を有するカテーテルに挿入されるガイドワイヤであって、
前記カテーテルの孔の位置を特定するための光源が一つ又は複数設けられたガイドワイヤ。 - 請求項1に記載のガイドワイヤが挿入されたカテーテル。
- 流動性物質を体内に入れるため、または、体内の流動性物質を吸引するための孔を有するカテーテルであって、
前記カテーテルの孔の位置を特定するための光源が一つ又は複数設けられたカテーテル。 - 請求項2または3において、
前記カテーテルの先端の端面が開放されている場合に、
その開放された先端の端面から光を発しないカテーテル。 - 請求項2または3に記載のカテーテルと、
前記カテーテルが体内にある場合に、前記カテーテルの光源を撮影するための撮影手段とを含むカテーテルの孔の位置を特定するための孔位置特定装置。 - 請求項5において、
前記撮影手段が撮影した画像情報または映像情報に基づく情報を表示する表示装置を含む孔位置特定装置。 - 請求項5において、
前記カテーテルが体内にある場合に、前記カテーテルの光源の光を受光する受光部を含むカテーテルの孔の位置を特定するための孔位置特定装置。 - 請求項5において、
第1の情報処理部を含み、
前記第1の情報処理部は、前記カテーテルの所定の孔が肺に入っているかどうかを特定する機能を有する孔位置特定装置。 - 請求項5において、
第2の情報処理部を含み、
前記第2の情報処理部は、前記カテーテルの所定の孔が横隔膜より下にあるかどうか特定する機能を有する孔位置特定装置。 - 請求項5において、
第3の情報処理部を含み、
前記第3の情報処理部は、前記カテーテルの所定の孔が消化管の所定の位置または領域にあるかどうかを特定する機能を有する孔位置特定装置。 - 請求項5において、
第4の情報処理部を含み、
前記第4の情報処理部は、所定の孔が尿管から膀胱までの間の所定の位置または領域にあるかどうかを特定する機能を有する孔位置特定装置。 - 請求項2または3に記載のカテーテルを体内に挿入する工程と、
前記カテーテルの光源を発光させる工程と、
前記光源の光を撮影手段で撮影する工程とを含むカテーテルの孔の位置を特定する方法。 - 請求項2または3に記載のカテーテルを体内に挿入する工程と、
前記カテーテルの光源を発光させる工程と、
前記光源の光を受光部で受光する工程とを含むカテーテルの孔の位置を特定する方法。 - 請求項5に記載の孔位置特定装置を含む、体内の所定の部位または器官において物体が存在するかどうかの判断を支援する物体存否判断支援装置。
- 請求項5に記載の孔位置特定装置を含む、診断支援装置。
- 請求項5に記載の孔位置特定装置を含む、治療支援装置。
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CN202410226058.1A CN118105600A (zh) | 2018-12-27 | 2019-05-14 | 导管、导丝、孔位置确定装置、物体有无判断辅助装置、诊断辅助装置及治疗辅助装置 |
EP19903363.0A EP3903870A4 (en) | 2018-12-27 | 2019-05-14 | CATHETER, GUIDEWIRE, ORIFICE POSITION IDENTIFICATION DEVICE, ORIFICE POSITION IDENTIFICATION METHOD, INTERNAL OBJECT PRESENCE DETERMINATION ASSIST DEVICE, DIAGNOSTIC ASSIST DEVICE AND ASSIST DEVICE TO TREATMENT |
JP2020523828A JP6819981B2 (ja) | 2018-12-27 | 2019-05-14 | カテーテル、ガイドワイヤ、孔位置特定装置、孔位置特定方法、体内における物体存否判断支援装置、診断支援装置および治療支援装置 |
KR1020217023699A KR20210110640A (ko) | 2018-12-27 | 2019-05-14 | 카테터, 가이드 와이어, 구멍위치 특정장치, 구멍위치 특정방법, 체내 물체존부 판단지원장치, 진단지원장치 및 치료지원장치 |
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