WO2021233873A1

WO2021233873A1 - Device for assisting with illumination and displaying anatomical boundaries during medical procedures

Info

Publication number: WO2021233873A1
Application number: PCT/EP2021/063074
Authority: WO
Inventors: Helmut Neumann; Oliver MUENSTERER; Sara MAHLER; Andreas Lindner
Original assignee: Universitätsmedizin Der Johannes Gutenberg-Universität Mainz
Priority date: 2020-05-19
Filing date: 2021-05-18
Publication date: 2021-11-25
Also published as: DE102020113465A1

Abstract

The invention relates to a device for assisting with illumination and displaying anatomical boundaries during medical procedures, in particular in the context of an endoscopy, laparoscopy and/or diaphanoscopy, comprising a hollow tube (1) having a proximal end (21) and a distal end (22) and a separate light cable (3), which is guided in a lumen (2) of the hollow tube (1) and is fitted, in its longitudinal extension, with one or more light sources (4) connected in series, the wavelength, frequency and/or intensity of which light sources can be controlled, individually or together, by a control unit (6), wherein the hollow tube (1) can be flexibly shaped and is designed to be light-permeable at least in the region of the light sources (4).

Description

Device to support the illumination and the anatomical representation of borders in medical interventions

Technical area

The present invention relates to a device for supporting the illumination and the anatomical border display in medical interventions, in particular in the context of endoscopy, laparoscopy and / or diaphanoscopy.

State of the art

Endoscopes and their wide range of applications have become indispensable in modern medicine. In the course of surgical interventions or therapies, it is possible to penetrate into the interior of people or animals. The light source required for an examination or inspection is usually realized via a connected light guide which transports light to the tip of the endoscope, for example via a glass fiber bundle. Such endoscopes or probes equipped with a light guide are described, for example, in WO 2019/185645 A1, DE 4340 997 A1 or WO 01/87416 A1. US Patent 5,588,952 describes a flexible probe equipped with a light source and a light guide. The disadvantage of such systems is that the illumination only takes place in the direction in which the imaging lens of the endoscope is also pointing.

In order to achieve a more comprehensive illumination of body regions, DE 10 2006 001 736 A1 proposes a device equipped with several light sources for applying monochromatic light in the wavelength range from 600 nm to 380 nm in body orifices. The device comprises a hollow cylinder, in the interior of which several light sources are arranged in such a way that they can emit their light to the outside and the top and bottom of which are hermetically sealed. The light sources can be fed with one or more batteries located in a shaft. The light sources are, for example, laser diodes. This enables other regions that are not directly illuminated by the imaging endoscope to be made visible.

But the existing light technology is not only used with endoscopes. US 2004/0093044 A1 describes a catheter system in which a light guide is provided in the catheter shaft in order to guide light from a light source to the proximal end of the catheter. The catheter is also equipped with a balloon adjacent to the lighting zone. EP 2 111 896 A1 describes a probe made of silicone or a silicone-like material which is transparent to light. A light guide is inserted into the probe, which emits light over a large part of its length. In a variant, the probe provides two channels (lumina), a light guide being inserted into one channel. Different wavelengths can be emitted. The lumen of the probe, which is not occupied by a light guide, can be used for the discharge or supply of fluid. Similar variants of such lighting devices are described in US 2007/177008 A1 or US 2005/099824 A1.

WO2017 / 011085 A1 describes a gastric tube equipped with a light source which comprises a gastric bougie and a catheter. The light source comprises an optical light string, but can also consist of individual light point sources.

US 2018/0049902 A1 describes a device for gastrectomy which comprises a hollow tube in which a number of LED light sources are arranged. These are used to illuminate the surgical site in the course of a stomach removal.

As before, with the known solutions, problem-free orientation or positioning of tools in the body in the context of endoscopy, laparoscopy and / or diaphanoscopy is not possible in an optimal manner. While a rough placement of an endoscope is just about possible, previous lighting systems quickly reach their limits when it comes to x-raying tissues or when fine details of tissue structures have to be identified.

Presentation of the invention

Against this background, it is the object of the present invention to provide an alternative device for supporting the illumination during medical interventions, in particular in the context of endoscopy, laparoscopy and / or diaphanoscopy, in order to improve the lighting situation in endoscopic applications or surgical measures.

This object is achieved by a device with the features of claim 1. Preferred design variants can be found in the subclaims. The device according to the invention enables anatomical target structures or objects to be illuminated with the aid of further light sources, which has many advantages in endoscopic or laparoscopic surgery. The device according to the invention enables the illumination of hollow organs, a transillumination of tissues, a better delimitation of anatomical boundaries or also an exact placement of surgical instruments or fluorescent markings. In the case of endoscopic interventions, the device according to the invention enables, for example, precise intraluminal positioning, while in the case of surgical preparations of hollow organs the anatomical boundaries can be identified better and more reliably. Methods such as diaphanoscopy, in which tissues are x-rayed to show vessels, hollow organs, tumors, etc., are made possible without the need for an endoscope. This allows hollow organs such as the stomach, intestines or urethra to be examined in a way that is gentle on the patient. Since up to now an endoscope always had to be used as a light source, diaphanoscopy was not easily possible with such organs. The same also applies to interventions as part of a percutaneous endoscopic gastrostomy (PEG).

In the device according to the invention, depending on the intended use, different wavelengths can be used for the individual light sources so that they illuminate the target area in different colors. By choosing the wavelength, fluorescent dyes can also be used, for example to mark tissue sections. In some variants of the invention, a suction and / or rinsing function is also integrated in the device, or also additional functional elements which give the device the function of a retractor or a preparation aid.

In its basic form, the device according to the invention comprises a hollow tube with a proximal end and a distal end. The proximal end denotes the part of the hollow tube that points towards the body of a patient (ie closer to the body), while the distal end is the opposite (ie more distant from the body) section of the hollow tube. The distal end of the hollow tube is used, for example, to supply energy to the light sources (electrical wiring), to supply or discharge fluids (e.g. via suction or rinsing lines) or to operate control elements (e.g. setting the wavelength or the intensity of the light sources). A lumen is formed in the interior of the hollow tube, ie a cavity in which a separate light cord is guided. The length of the light string is equipped with one or more light sources connected in series. The light cord is preferably flexible and its shape follows the shape of the hollow tube, but it can also be designed to be rigid if the Hollow hose should have a certain rigidity in a certain application, depending on the respective area of use.

Active or passive light sources are preferably used in the device according to the invention. Active light sources independently generate light to illuminate their surroundings. Passive light sources emit light by reflecting received light, i.e. they pass on light from another light source without emitting light energy themselves.

The active light sources are preferably luminescence diodes (LEDs), although other lighting means that are suitable for the purpose according to the invention can also be used. A plurality of LEDs are preferably arranged along the light string in order to obtain as large an area as possible, but at the same time also targeted illumination. The LEDs in the individual design variants are preferably designed in different colors and arranged at defined intervals on the light string.

In a preferred variant, the light sources can also be formed by the ends of different light guides which guide the light from the outside to the desired light source position. This has the advantage that no electrical connection lines have to be routed to the cranial section of the device. In one embodiment, one or more glass fibers or other light guides can be used as the light source.

Preferably, individual or all light sources of the light string can be regulated individually or collectively in terms of their wavelength, frequency and / or intensity via a control unit. According to the invention, the term “intensity” is understood to mean either the irradiance or the illuminance. The luminous intensity indicates the luminous flux related to the solid angle.

Preferably, light sources are used which emit in a wavelength range from approximately 380 nm to 780 nm. In the case of LEDs, the preferred wavelength is in the range from 400 nm to 700 nm, the red LEDs preferably in the range 700 to 630 nm, the orange LEDs preferably in the range 630 to 590 nm, the yellow LEDs preferably in the range 590 to 560 nm, the green LEDs preferably emit in the range 560 to 490 nm, the blue LEDs preferably emit in the range 490 to 450 nm and the violet LEDs preferably emit in the range 450 to 400 nm. In a preferred embodiment, the individual wavelength of a light source can be regulated via a control unit independently of the selected wavelength of the other light sources. In other embodiments, all the light sources of the light string can be regulated synchronously or individually in terms of their wavelength, frequency and / or intensity.

The central component of the device according to the invention is thus a flexible hollow tube which is transparent at least in the area of the light sources. For use in endoscopy, laparoscopy and / or diaphanoscopy, it is necessary according to the invention for the hollow tube to be flexibly malleable and to be transparent in the area of the light sources.

However, it is preferred that the entire hollow tube is translucent from the inside to the outside. The hollow tube is preferably a tube or a tube piece made of silicone, a silicone-like material or another biocompatible material. Of course, other synthetic polymers can also be used as the hollow tube, which are at least partially transparent to the required wavelength range. Preferred plastics for the hollow tube or its coating are, for example, cyclo-olefin copolymers, polycarbonates, polyethylene teraphthalates, perfluoroalkoxy polymers, polyvinylidene fluorides, polymethyl methacrylates, polymethyl methacrylimides, acrylstyrene-acrylonitrile copolymers, silicones, epoxy casting resins or epoxy adhesives , thermally or UV-crosslinking acrylate casting resins, polyurethane casting resins, polyester casting resins or mixtures and / or combinations thereof.

The medical lighting device according to the invention is made available in various alterations and modifications. In a first embodiment it is provided that the lumen of the hollow tube comprises its own channel for conveying fluids (e.g. liquids, gases or body secretions) which is separated from the lumen for guiding the light cord. The separation can take place, for example, via a partition. In an alternative variant, the lumen for the light cord and the channel for guiding fluids are formed by separate tubes which are inserted inside the hollow tube. These tubes can either be fixedly connected to the raw tube or, in another variant of the invention, can be displaced in the longitudinal direction within the hollow tube. By shifting or twisting the light cord or the tube with the light cord guided therein, it is possible to easily adjust the illumination of the target area from the distal end of the hollow tube by positioning the light sources.

The channel for fluid provided in the hollow tube is preferably used for sucking liquids from the body or for rinsing the examination region. For this purpose, the channel is preferably connected to a suction device and / or a pump. Depending on One or more intermediate containers are provided, for example collecting containers or containers for the provision of rinsing liquid or air.

In a preferred embodiment it is provided that the channel comprises one or more openings in its longitudinal extension for the entry or exit of fluids in order to achieve the suction or flushing effect. This opening is preferably located at the proximal end of the hollow tube, either on its end face or at a point on the radially extending hollow tube wall. A plurality of openings can either be arranged in the longitudinal extension of the hollow tube or can also be arranged radially circumferentially. The arrangement of the openings can either be uniform or staggered. A connection for the suction device or the pump is preferably provided at the opposite distal end. Alternatively, the connection can be equipped with a bladder syringe.

The LEDs of the light string should be electrically isolated. The energy supply takes place via a line which preferably leaves the hollow tube on the face of the distal end and is coupled to the control unit. Depending on the application, the control unit comprises several operating elements such as a control for adjusting the wavelength, frequency or intensity, a switch for switching the light sources on and off or dimming and, if necessary, display elements.

In a further embodiment, the medical device according to the invention comprises a further function, for example to mobilize tissue or organs for illumination. With the help of an arrangement of hemispheres, the hollow tube, which is flexible in itself, is transformed into a rigid retractor which, however, also illuminates the area of use due to the light cord that is also integrated. Particularly in the case of laparoscopic interventions, it is sometimes necessary to mobilize tissue or organs in such a way that the target region can be reached more easily or represented more optimally for the imaging process. For example, penetration into the patient via a trocar is possible. In this variant it is provided that in a section of the lumen of the hollow tube there are several hemispheres arranged in a row, which can be fixed in their position via a fixing element extending in the longitudinal direction of the hollow tube. The ball centers are connected via the fixing element (e.g. a fixing thread). The hemispheres preferably have a concave and a convex side, which preferably have a 3-D profile, for example in the form of a three-dimensional grain on their surface, so that the hollow tube can be held in a certain position when the fixing element is actuated.

In a further development of this embodiment, the hollow tube comprises additional control elements, which also extend in the longitudinal direction of the hollow tube and on the Front side of the proximal end of the hollow tube are connected to the hollow tube at anchor points. This enables the hollow tube to be positioned and fixed more precisely. These anchor points are preferably distributed evenly spaced at the proximal end of the hollow tube. In a preferred variant, four control elements are provided which, for example, are connected to the proximal end of the hollow tube at the 3, 6, 9 and 12 position as an anchor point. The individual control elements can be operated via the distal end of the hollow tube. The control elements are preferably control threads which run through the hemispheres and open into a control thread bundle at the distal end of the hollow tube. Due to this construction, it is possible to change the shape of the hollow tube, for example to prevent organs or tissue from shifting in front of the field of vision, while the position of the hollow tube is held by the control elements and the hemispheres connected in series.

In a further embodiment it is provided that an outwardly extending gripper is formed at the distal end of the hollow tube, which gripper can be operated through the hollow tube via a control element extending therein. This is preferably an atraumatic gripper with which it is possible, for example, to hold the gastric mucosa away from an endoscope, but at the same time also to build up a certain amount of tension on the tissue. This is particularly helpful during an endoscopic G-POEM operation. For this purpose, the device according to the invention is guided in addition to an endoscope via the patient's esophagus into the stomach. The desired point in the gastric mucosa is grasped with the gripper and then stiffened with the aid of the fixing element and the operating element provided for this purpose. By applying different wavelengths to the LEDs, the surgical site is illuminated with different colors, so that the surgeon has a better orientation while he is performing an intervention between the gastric mucosa and the surrounding muscle layer.

In a further embodiment, the hollow tube according to the invention additionally comprises a balloon, so that the device can be used as a catheter, for example as a urinary catheter. The balloon is expediently located in a proximal section, preferably at the proximal end of the hollow tube. The light cord is guided in a separate lumen of the hollow tube. A separate filling channel is provided for inflating or deflating the balloon, through which the filling fluid for filling the balloon is passed or through which the filling fluid can be discharged again when the balloon is deflated. At the distal end there is preferably a connection for the balloon fluid, a line guide for the light cord and a connection for a fluid, for example a connection for a urine bag or a Bladder syringe. With the help of the balloon formed on the hollow tube, lighting and thus a better demarcation from the urethra is possible. For this purpose, the device according to the invention is pushed through the urethra into the bladder and the balloon in the bladder is inflated in order to hold the catheter in the urethra.

In a further embodiment, the distal end of the hollow tube is closed and there is an opening at its proximal end, so that the esophagus can be illuminated, similar to a gastric tube, albeit illuminated. Depending on the variant, the hollow tube can also be open at the end, for example to suck off gastric juice into a secretion bag or a syringe.

In a further embodiment, a magnet or a magnetic element is located in the hollow tube so that the device can be brought to the desired position with a magnetic auxiliary tool. At the end of the operative, diagnostic or therapeutic intervention, the device can again be easily removed from the patient's body using the magnetic auxiliary tool. For example, a hollow tube can be used as an auxiliary tool, in which a magnet of opposite polarity, for example a bar magnet, is located. To position the magnet within the hollow tube of the auxiliary tool, a plastic rod (e.g. silicone rod) can be inserted into the hollow tube in order to increase or weaken the magnetic force at the proximal end of the hollow tube. The magnetic coupling makes it possible to position the lighting device according to the invention precisely or to get it out of the body.

For better illustration, the invention is explained in more detail in the following drawings. However, the concept of the invention is in no way restricted to these specific design variants.

Brief description of the drawings

Fig. 1 shows a variant embodiment of a lighting device according to the invention,

Fig. 2 shows a further development of the embodiment shown in Fig. 1,

Fig. 3 shows an alternative embodiment,

Fig. 4 shows an embodiment which is suitable for laparoscopic interventions, Fig. 5 shows a further development of the variant of Fig. 4,

6 shows an embodiment variant designed as a catheter,

Fig. 7 shows a variant which can be used as a gastric tube,

FIG. 8 shows a variant embodiment which enables positioning by means of one or more magnets.

Ways of Carrying Out the Invention

In Fig. 1, a first embodiment of the medical lighting device according to the invention is shown. This consists of a hollow tube made of silicone or a silicone-like material. For medical interventions in the context of endoscopy, laparoscopy and / or diaphanoscopy, tubes coated with PVC or Teflon are preferred in order to protect the working channel of the endoscope. The outside diameter is between 2.0 and 4.0 mm, preferably 2.8 mm. A luminous cord 3, which consists of several light sources 4 (LEDs) arranged in a row, is guided within the hollow tube 1. The LEDs are arranged at regular intervals of approx. 1 cm, starting from the proximal end 21 of the hollow tube 1. The distances between the LEDs vary depending on the intended use and are up to 40 cm for a gastric tube, up to 110 cm for a tube for a colonoscopy and up to 61 cm for a tube for a gastroscopy. The light cord 3 is connected via a line 5 for the energy supply. The hollow tube 1 is completely waterproof, flexible and translucent. The light sources 4 are regulated by a control unit 6 with which various parameters of the light sources 4, such as intensity or wavelength, can be set via a control 7. In the variant shown, LEDs with different colors or wavelengths are integrated as light sources 4 in the light string 3 and are arranged at regular intervals from one another. Due to this construction, an optimal illumination of the target area is made possible. On the control unit 6 there is also a switch 8 for switching the light sources 4 on and off and a switch 9 for switching to the flash mode (pulsing). The LEDs are preferably operated via a battery, the electrical wiring being carried out via an electrical line 5 which is inserted into the lumen 2 via the distal end 22 of the hollow tube 1. Depending on the embodiment variant, it is provided that the light cord 3 is either fixed or displaceable within the hollow tube 1 in the lumen 2. Depending on the intended use, certain guide aids are then required as auxiliary tools. With the device shown, operations are possible which must or must be carried out in a deep body region of a patient in which only a small access is available, so that a previously satisfactory illumination by conventional endoscopes or operating theater lighting devices is enormously improved and anatomical structures can be better delimited.

FIG. 2 shows a further development in which, in addition to the luminous cord 3, a channel 10 is also integrated in the lumen 2 of the hollow tube 1. The channel 10 can be used to suck in fluid (liquids or gases) from a region of the body or to flush fluid into the target region. For this purpose, at least one opening is provided on the end face of the proximal end 21 of the hollow tube 1. Body fluids or secretions, for example, can be transported via the channel 10 via a suction channel 17 into a collecting container 12 by means of a suction device 13. This can be regulated via a valve 11. Conversely, fluids, for example liquids, can be flushed into the relevant body region via a fluid container 15 by means of a pump 14 via a flushing channel 16 and the channel 10 located in the hollow tube 1. The whole thing is very gentle on the tissue and enables fluids to be removed or rinsed with saline solution during a surgical procedure.

In Fig. 3 a variant is shown in which a channel 10 is also provided in the lumen 2 of the hollow tube 1, which forms its own lumen and through which fluids such as liquids or gases can be passed, for example by pumping or suction. For this purpose, openings 20 are provided in the wall of the hollow tube 1, which open the channel 10 to the outside world and enable fluid to be transported. The distal end of the channel 10 can, for example, be provided with a connection for a suction device or a bladder syringe.

4 shows an embodiment which is particularly suitable for laparoscopic interventions, since it can be used to hold tissue or organs in a non-disruptive position for better accessibility or image display. For this purpose, the hollow tube 1 is introduced into the patient, for example via a trocar, and gently brought into the desired position. According to the invention, a light cord 3 with several light sources 4 arranged in series is located in the lumen 2 within the hollow tube 1 (FIG. 4B). In a region of the lumen 2 of the hollow tube 1, however, additional elements are provided in order to give the device the function of a retractor (FIG. 4A). For this purpose, there are several half-shells 30 arranged in a row in an upper region of the hollow tube 1, which have a concave and a convex side and are held together by a fixing element 31 which runs through the centers of the half-shells 30. The fixing element 31 can for example be a fixing thread. The proximal end of the fixing element 31 cooperates with control elements 33 (in the variant, three control elements 33.1, 33.2, 33.3 are shown, which are designed as control threads), the ends of which with anchor points 34 (in the variant there are three Anchor points 34.1, 34.2, 34.3 shown) are connected to the proximal end 21 of the hollow tube 1. The individual control elements 33 (here designed as control threads) can be steered centrally via a control thread bundle 32 at the distal end. The concave and convex sides of the half-shells 30 have a three-dimensional profile on their surface so that they can be fixed in a certain position by actuating the fixing element 31. Depending on the application, more than three, for example four or six control elements 33 or anchor points 34 can be implemented. The arrangement of the half-shells 30 gives the hollow tube 31 a rigidity, which, for example, makes it possible to retain tissues or organs at the surgical site. At the same time, the light cord 3 enables the OP area to be illuminated.

FIG. 5 shows a further development of the variant from FIG. 4. In the upper part of the hollow tube 1, the mentioned half-shells 30 with the control elements 33, which are fastened with the proximal end 21 to anchor points 34, can be seen (FIG. 5A). In the lower part of the hollow tube 1 in the lumen 2 there are the light cord 3 required for the illumination and an additional atraumatic gripper 40 which can be operated via a control element 41. Of course, a variant is also conceivable in which only the gripper 40 with the control element 41 is arranged in the lumen 2 of the hollow tube 1, that is to say a variant that manages without half-shells 30. The gripper 40 enables, for example, an endoscopic G-POEM operation (= gastric peroral myotomy). The gastric mucous membrane is pressed lightly in order to build up a certain amount of tension on the tissue. The hollow tube 1 is passed through the patient's esophagus together with an endoscope into the stomach. The desired point in the gastric mucosa is then grasped with the gripper 40 under an endoscopic view. By illuminating the luminous cord 3 by means of light sources 4, the surgeon has a much better orientation than would be the case with a conventional endoscope. He can even recognize subtle differences between the gastric mucosa and the muscle layer. In addition, it has a scaling through possible colored LEDs that are arranged at a defined distance.

6 shows a variant which is designed as a catheter, the hollow tube 1 comprising at least one inflatable balloon 51 which can be filled via a filling channel 50.

This variant is suitable, for example, as a urinary catheter for illuminating or displaying the urethra. For this purpose, the device is pushed through the urethra into the bladder and then the balloon 51 in the bladder is inflated by passing liquid or a gas mixture through the filling channel 50 into the balloon 51. The channel 10 ends at the proximal end 21 in an opening 52 in order to either suck in / drain off liquid or to flush it into the region to be treated. Various connections are provided at the distal end 22. So ends the channel 10 into a connection 53 for the fluid, for example a connection for a urine bag or a bladder syringe. The filling channel 50 opens into a connection 54 for the balloon fluid. The light sources (LEDs) 4 of the luminous cord 3 shine in the variant shown in different colors, which makes it possible to estimate the distance and to define anatomical boundaries. The control is preferably carried out outside the body. This is particularly useful for corrective operations on the genital area, such as flypospadia correction, and makes preparation easier.

In Fig. 7 a variant is shown which is suitable as a gastric tube. Here, too, the channel 10 comprises an opening 52, the distal end of the channel 10 opening into a connection 55 for a secretion bag.

8 shows a further embodiment variant in which the hollow tube 1 is positioned by means of one or more magnets 61. The magnet 61 enables the device to be positioned at the target location. In the variant shown, the energy store (battery 62) is also integrated in the hollow tube 1. The switching of the light sources 4 of the light cord 3 takes place via a switch 60. The positioning by means of magnets 61 takes place via an auxiliary tool which has a magnet of opposite polarity (not shown).

The invention is not restricted to the embodiment variants shown. It can be seen that the lighting device according to the invention provides an additional light source in endoscopy or laparoscopy, it being possible for additional different wavelengths to be applied in order to also enable fluorescence examinations, for example. In this way, fuzzy borders, but also very small, difficult-to-identify tissue structures can be recognized and prepared accordingly. The device enables such transitions to be made more easily recognizable for the surgeon, while at the same time the risk of injury to adjacent tissue structures is significantly reduced. The description shows the wide range of applications in different areas of medicine. List of reference symbols:

1 = hollow tube

2 = lumen

3 = light cord

4 = light source

5 = electrical line

6 = control device

7 = control for wavelength, frequency or intensity

8 = switch for light sources

9 = switch for pulse function

10 = channel

11 = valve

12 = collecting container

13 = suction device

14 = pump

15 = fluid container

16 = flushing channel

17 = suction channel

20 = opening for fluid

21 = proximal end

22 = distal end

30 = half-shells

31 = fixing element

32 = control thread bundle

33 = control element

34 = anchor point for control element

40 = gripper

41 = control element for gripper

50 = filling channel for balloon

51 = balloon

53 = connection for the fluid

54 = connection for the balloon fluid

55 = connection for secretion bag 60 = switch

61 = magnet

62 = energy storage (battery)

Claims

Patent claims:

1. Device for supporting the illumination during medical interventions, in particular in the context of endoscopy, laparoscopy and / or diaphanoscopy, comprising a hollow tube (1) with a proximal end (21) and a distal end (22) and one in a lumen (2 ) the hollow tube (1) guided separate light cord (3), which is equipped in its longitudinal extent with one or more light sources (4) connected in series, the wavelength, frequency and / or intensity of which can be regulated individually or jointly via a control unit (6) / are, wherein the hollow tube (1) can be shaped flexibly and is designed to be transparent at least in the area of the light sources (4).

2. Device according to claim 1, characterized in that the lumen (2) of the hollow tube (1) comprises a channel (10) for conducting fluids, the channel (10) being separated from the lumen (2) of the hollow tube (1) is.

3. Device according to claim 2, characterized in that the channel (10) is connected either directly or indirectly to a suction device (13) or a pump (14).

4. Apparatus according to claim 2 or claim 3, characterized in that the channel (10) comprises openings (4) for the entry or exit of fluids in its longitudinal extension.

5. The device according to claim 1, characterized in that the hollow tube (1) can be fixed in its position via at least one fixing element (31) extending in the longitudinal direction.

6. The device according to claim 5, characterized in that in a section of the lumen (2) of the hollow tube (1) a plurality of hemispheres (30) arranged in a row are provided, which over the in the hollow tube (1) extending in the longitudinal direction of the fixing element ( 31) can be fixed in their position.

7. The device according to claim 6, characterized in that the hemispheres (30) have a concave and a convex side with a 3D profile.

8. Apparatus according to claim 6 or claim 7, characterized in that at least two in the hollow tube (1) extending in the longitudinal direction control elements (33) are provided which with the proximal end of the hollow tube (1) at anchor points (34) are connected and cooperate with the fixing element (31) for positioning the hollow tube (1).

9. Device according to one of claims 1 to 8, characterized in that a gripper (40) is formed at the proximal end of the hollow tube (1), which via a control element (41) extending in the longitudinal direction in the retrieval tube (1) for the Gripper (40) can be operated in a distal section.

10. The device according to claim 2, characterized in that the hollow tube (1) comprises an inflatable balloon (51) in its proximal section and a filling channel (50) designed for filling the balloon (51) with balloon fluid in its lumen (2), a line guide (5) for the light cord (3), a connection (53) for the fluid and a connection (54) for the balloon fluid are provided on an opposite distal section of the hollow tube (1).

11. The device according to claim 2, characterized in that there is an opening (52) in the channel (10) and the distal end (22) of which is provided with a connection (53) for a secretion bag or a syringe.

12. The device according to claim 1, characterized in that one or more magnets (61) are arranged in the hollow tube (1) for positioning with an auxiliary tool.

13. Device according to one of the preceding claims 1 to 12, characterized in that there is an energy source (62) and / or a controller (60) for the light sources (4) in or on the hollow tube (1).

14. The device according to claim 2, characterized in that the separation of the channel (10) for guiding fluids and the lumen (2) for guiding the light cord (3) takes place via an intermediate wall.

15. The device according to claim 2, characterized in that the separation of the channel (10) for guiding fluids and the lumen (2) for guiding the light cord (3) takes place via separate tubes located inside the hollow tube (1).

16. The device according to claim 15, characterized in that the tubes are firmly connected to the hollow tube (1).

17. The device according to claim 15, characterized in that the tubes are displaceable in the longitudinal direction within the hollow tube (1).

18. The device according to claim 1, characterized in that the light sources (4) are either active or passive light sources.

19. The device according to claim 18, characterized in that the light sources (4) are the ends of different light guides which guide the light from the outside to the desired light source position.