WO2022181133A1

WO2022181133A1 - Light irradiation device for endoscope

Info

Publication number: WO2022181133A1
Application number: PCT/JP2022/002011
Authority: WO
Inventors: 俊彦宇都; 圭介松下; 吉隆中原
Original assignee: 株式会社カネカ
Priority date: 2021-02-25
Filing date: 2022-01-20
Publication date: 2022-09-01

Abstract

A light irradiation device (1) for an endoscope is provided with: an outer shaft (2) having a distal end (2a) and a proximal end (2b) in the longitudinal direction (x) and having an inner cavity (2c) extending in the longitudinal direction (x); an inner shaft (5) disposed in the inner cavity (2c) of the outer shaft (2) and extending in the longitudinal direction (x); a needle (10) disposed at a distal portion of the inner shaft (5); and a light guide material (20) disposed within the needle (10) and having a light diffusion unit (21) at a distal portion. The needle (10) has: a cylindrical section (11) transparent to light from the light diffusion unit (21); and a reduced diameter section (12) positioned distal to the cylindrical section (11) and having a smaller outer diameter than the outer diameter of the cylindrical section (11). The light (50) from the light diffusion unit (21) is emitted to a side of the needle (10).

Description

Endoscope light irradiation device

The present invention relates to an apparatus for irradiating tissues such as cancer cells in body lumens such as blood vessels and digestive tracts with light in endoscopic surgery.

In photodynamic therapy (PDT), a photosensitizer is administered into the body by intravenous injection or intraperitoneal injection, and the photosensitizer is accumulated in target tissues such as cancer cells, and light of a specific wavelength is used. to excite the photosensitizer. An energy transfer occurs when the excited photosensitizer returns to the ground state, generating reactive oxygen species. Target tissue can be removed by attacking the target tissue with reactive oxygen species. In ablation (tissue cauterization) using a laser beam, a target tissue is irradiated with a laser beam and cauterized. Patent Documents 1 to 5 disclose examples of light irradiation devices.

JP 2018-171231 A JP 2015-208428 A WO2016/204084 Japanese Utility Model Laid-Open No. 05-84344 Japanese Utility Model Publication No. 03-25803

It would be beneficial to provide a light irradiation device that can irradiate a wide range of light at an accurate position even on an affected part of an organ that moves rapidly, such as the lungs, under endoscopic surgery. Accordingly, an object of the present invention is to provide an apparatus that can easily irradiate a wide range of an affected area with light at an accurate position.

One embodiment of the endoscopic light irradiation device of the present invention, which has achieved the above object, has a distal end and a proximal end in the longitudinal direction, and a lumen extending in the longitudinal direction. an inner shaft disposed in the lumen of the outer shaft and extending longitudinally; a needle disposed at a distal portion of the inner shaft; a needle disposed within the needle and distal to the a light guide member having a light diffusing part in a portion thereof, and the needle includes a tube part that transmits light from the light diffusing part, and the needle is positioned distally from the tube part and is located closer to the outer diameter of the tube part than the tube part. The gist is that the light from the light diffusing portion is irradiated to the side of the needle. According to the endoscope light irradiation device, the light from the light diffusing portion is irradiated to the side of the needle through the tube portion of the needle, so that the affected area can be irradiated with the light over a wide range. In addition, since the light diffusing portion is arranged in the needle, it becomes easy to determine the irradiation position by puncturing the affected part with the needle, and it becomes easy to irradiate the light to the correct position.

The light diffusion part may be arranged on the pipe part. A light diffusing portion may be arranged all around the needle.

The reduced-diameter portion is made of a light-transmitting resin, and the light from the light-diffusing portion may be irradiated laterally and forwardly of the needle. Also, the reduced diameter portion may be made of metal. The distal end of the light diffusing portion may be positioned proximally relative to the proximal end of the reduced diameter portion. The reduced diameter portion may be closed.

The light guide material may be fixed to the needle. The needle may be curved. The inner shaft may have a position indicator on its proximal portion to indicate the position of the needle relative to the outer shaft.

The endoscopic light irradiation device may further include a suction section connected to the proximal portion of the outer shaft and suctioning the fluid in the lumen of the outer shaft. The outer shaft may have a longitudinally extending internal passage therein through which a fluid for cooling the affected area is passed. The endoscopic light irradiation device may further include a forceps portion arranged at a distal portion of the outer shaft to hold the affected area.

The endoscopic light irradiation device has a handle connected to the proximal portion of the inner shaft, and even if the inner shaft and the needle move distally or proximally with respect to the outer shaft by operating the handle, good. The handle may have a resilient member that biases the needle to protrude distally.

According to the endoscopic light irradiation device, the light from the light diffusion portion is irradiated to the side of the needle through the tube portion of the needle, so that the affected area can be irradiated with light over a wide range. In addition, since the light diffusing portion is arranged in the needle, it becomes easy to determine the irradiation position by puncturing the affected part with the needle, and it becomes easy to irradiate the light to the correct position.

BRIEF DESCRIPTION OF THE DRAWINGS It is a side view (partial cross section view) of the light irradiation apparatus for endoscopes which concerns on one Embodiment of this invention. It is sectional drawing which expanded the distal side of the needle|needle based on the light irradiation apparatus for endoscopes shown in FIG. FIG. 3 is a cross-sectional view of the needle shown in FIG. 2 taken along line III-III; It is a side view (partial cross section view) which shows the modification of the light irradiation apparatus for endoscopes shown in FIG. FIG. 3 is a cross-sectional view showing a modification of the needle shown in FIG. 2; It is a side view (partial cross section view) which shows the modification of the light irradiation apparatus for endoscopes shown in FIG. It is a side view (partial cross section view) which shows the modification of the light irradiation apparatus for endoscopes shown in FIG. It is a side view (partial cross section view) which shows the modification of the light irradiation apparatus for endoscopes shown in FIG. 1. It is a top view (partial cross section view) which shows the modification of the light irradiation apparatus for endoscopes shown in FIG. FIG. 10 is a side view (partial cross-sectional view) of the endoscope light irradiation device shown in FIG. 9 ;

Hereinafter, the present invention will be described in more detail based on the following embodiments, but the present invention is not limited by the following embodiments, and can be modified appropriately within the scope of the above and later descriptions. It is of course possible to carry out in addition, and all of them are included in the technical scope of the present invention. In each drawing, for the sake of convenience, hatching, member numbers, etc. may be omitted. In such cases, the specification and other drawings shall be referred to. In addition, the dimensions of various members in the drawings may differ from the actual dimensions, since priority is given to helping to understand the features of the present invention.

One embodiment of the endoscopic light irradiation device of the present invention comprises an outer shaft having a distal end and a proximal end in the longitudinal direction and a lumen extending in the longitudinal direction; a longitudinally extending inner shaft disposed within the lumen of the shaft; a needle disposed distally of the inner shaft; and a light diffusing portion disposed within the needle distally. and a light guide member, wherein the needle includes a tube part that transmits light from the light diffusion part, and a reduced diameter that is positioned distally from the tube part and has an outer diameter smaller than the outer diameter of the tube part and a portion, and the light from the light diffusion portion is irradiated to the side of the needle. According to the endoscope light irradiation device, the light from the light diffusing portion is irradiated to the side of the needle through the tube portion of the needle, so that the affected area can be irradiated with the light over a wide range. In addition, since the light diffusing portion is arranged in the needle, it becomes easy to determine the irradiation position by puncturing the affected part with the needle, and it becomes easy to irradiate the light to the correct position.

The configuration of the endoscope light irradiation device will be described with reference to FIGS. 1 to 10. FIG. FIG. 1 is a side view (partial cross-sectional view) of an endoscope light irradiation device according to an embodiment of the present invention. FIG. 2 is an enlarged cross-sectional view of the distal side of the needle of the endoscope light irradiation device shown in FIG. FIG. 3 is a cross-sectional view of the needle shown in FIG. 2, taken along line III-III. FIG. 4 is a side view (partial cross-sectional view) showing a modification of the endoscope light irradiation device shown in FIG. 5 is a cross-sectional view showing a modification of the needle shown in FIG. 2. FIG. 6 to 8 are side views (partial cross-sectional views) showing modifications of the endoscope light irradiation device shown in FIG. FIG. 9 is a plan view (partial cross-sectional view) showing a modification of the endoscope light irradiation device shown in FIG. FIG. 10 is a side view (partial cross-sectional view) of the endoscope light irradiation device shown in FIG. The endoscope light irradiation device 1 includes an outer shaft 2 , an inner shaft 5 , a needle 10 and a light guide member 20 .

The distal side of the endoscopic light irradiation device 1 refers to the treatment target side on the distal end 2a side of the outer shaft 2 in the longitudinal axis direction x. The proximal side of the endoscope light irradiation device 1 refers to the proximal end 2b side of the outer shaft 2 in the longitudinal axis direction x and the hand side of the user. When each member is divided into two halves along its longitudinal axis, the proximal side may be called the proximal portion, and the distal side may be called the distal portion.

The outer shaft 2 is a long member having a longitudinal axis direction x. The outer shaft 2 has a distal end 2a and a proximal end 2b in the longitudinal direction x and has a lumen 2c extending in the longitudinal direction x. The outer shaft 2 has an opening 2f at its distal end and communicates with the outside through the opening 2f. When puncturing the affected area to be treated with the needle 10, the needle 10 is protruded from the opening 2f.

The inner shaft 5 is an elongated member arranged in the lumen 2c of the outer shaft 2 and extending in the longitudinal axis direction x of the outer shaft 2. The inner shaft 5 has a lumen 5c in which the needle 10 is arranged. In FIG. 1, the lumen 2c is narrowed at the distal end of the outer shaft 2. As shown in FIG. Even if the inner shaft 5 is slid to the most distal side with respect to the outer shaft 2 , the distal end of the inner shaft 5 hits the distal end of the outer shaft 2 . It does not protrude from the opening 2f of the end 2a.

The outer shaft 2 has, for example, a tubular shape in order to arrange the inner shaft 5 in the lumen 2c. Further, the inner shaft 5 has, for example, a tubular shape in order to arrange the needle 10 in the lumen 5c. The outer shaft 2 and the inner shaft 5 are flexible because they are inserted into the body.

The outer shaft 2 or the inner shaft 5 is a hollow body formed by arranging one or more wires in a predetermined pattern; at least one of the inner surface or the outer surface of the hollow body is coated with a resin; tubes; or combinations thereof, such as those connected longitudinally. A hollow body in which wires are arranged in a predetermined pattern includes a tubular body having a mesh structure formed by simply crossing or weaving wires, and a coil in which wires are wound. The wire may be one or more solid wires or one or more twisted wires. A resin tube can be manufactured, for example, by extrusion molding. The resin tube can consist of a single layer or multiple layers. A part of the resin tube in the longitudinal axis direction or the circumferential direction may be composed of a single layer, and the other part may be composed of multiple layers. Both the outer shaft 2 and the inner shaft 5 may be resin tubes.

The outer shaft 2 or the inner shaft 5 is made of, for example, polyolefin resin (eg, polyethylene or polypropylene), polyamide resin (eg, nylon), polyester resin (eg, PET), aromatic polyether ketone resin (eg, PEEK), poly It can be made of synthetic resin such as ether polyamide resin, polyurethane resin, polyimide resin, fluorine resin (for example, PTFE, PFA, ETFE), or metal such as stainless steel, carbon steel, nickel-titanium alloy. These may be used individually by 1 type, and may be used in combination of 2 or more types.

The needle 10 is to be punctured into the target tissue in the living body under endoscopic surgery, and is provided to determine the light irradiation position. Needle 10 is an elongated member with a sharp tip. A distal end 10a of the needle 10 faces the distal end 2a side of the outer shaft 2 in the longitudinal direction x. A needle 10 is arranged at least at the distal portion of the inner shaft 5 . The needle 10 may be arranged in the entire lumen 5c of the inner shaft 5 as shown in FIG. By moving the inner shaft 5 with respect to the outer shaft 2, the needle 10 protrudes from the opening 2f.

The light guide member 20 is arranged inside the needle 10 and has a light diffusing portion 21 at its distal portion. The needle 10 has a tube portion 11 that transmits light from the light diffusing portion 21, and a reduced diameter portion 12 that is located distal to the tube portion 11 and has an outer diameter smaller than the outer diameter of the tube portion 11. is doing. The tube portion 11 is provided to accommodate the light guide member 20 , particularly the light diffusion portion 21 . The reduced diameter portion 12 functions as a puncture portion for puncturing the living tissue with the needle 10 . The light 50 from the light diffusing portion 21 is irradiated to the side of the needle 10 . Specifically, by moving the inner shaft 5 relative to the outer shaft 2 so that the light diffusing portion 21 of the light guide member 20 is located farther than the opening 2f of the distal end 2a of the outer shaft 2, the light is The side of the needle 10 can be irradiated with the light 50 from the diffusing portion 21 . According to the endoscope light irradiation device 1, the light 50 from the light diffusing portion 21 is irradiated to the side of the needle 10 through the tube portion 11 of the needle 10, so that the affected area can be irradiated with the light 50 over a wide range. can be done. In addition, since the light diffusing portion 21 is arranged in the needle 10, the irradiation position can be easily determined by puncturing the affected part with the needle 10, and the irradiation can be performed at an accurate position. Therefore, it can be suitably used even for affected parts of organs such as lungs that move rapidly. It is also useful for cancers that are large in size compared to devices that can irradiate only in front of the needle 10, that is, only in the distal direction.

The light 50 from the light diffusion part 21 may be irradiated not only to the side of the needle 10 but also to the front. This makes it easier to irradiate a wide area of the affected area all at once. In order to make it easier to irradiate the light 50 from the light diffusing portion 21 forward of the needle 10, the portion of the needle 10 on the distal side of the light diffusing portion 21 may be made of a material that transmits the light 50. good.

The detailed configuration of the light guide member 20 will be described later, but the light guide member 20 extends in the longitudinal direction of the needle 10 . A connector 22 is provided at the proximal end of the light guide member 20, and the connector 22 is connected to a light source such as a semiconductor laser. The distal end 21 a of the light diffusing portion 21 may coincide with the distal end 20 a of the light guide member 20 or may be arranged closer to the proximal side than the distal end 20 a of the light guide member 20 . A distal end 20 a of light guide 20 is preferably disposed within needle 10 and a proximal end of light guide 20 is preferably connected to connector 22 . When the proximal end of the needle 10 is in the middle of the inner shaft 5 , the light guide member 20 is arranged in the lumen of the inner shaft 5 on the proximal side of the proximal end of the needle 10 . The light guide member 20 and the inner shaft 5 may be fixed.

The inner shaft 5 and the needle 10 may be composed of separate members, or the inner shaft 5 and the needle 10 may be integrally formed. Needle 10 may be longer or shorter than inner shaft 5 . The proximal end of needle 10 may be located halfway along inner shaft 5 . The needle 10 may be slidable relative to the inner shaft 5, but preferably the needle 10 is fixed relative to the inner shaft 5 so as not to move. In FIG. 1 , the tubular portion 11 of the needle 10 is arranged in the lumen 5c of the inner shaft 5 so that a gap is formed between the inner surface of the inner shaft 5 and the outer surface of the needle 10 . Alternatively, the inner shaft 5 and the needle 10 may be fixed so as to contact each other. In addition, it is preferable that the light diffusing portion 21 in the tube portion 11 is arranged on the distal side of the distal end 5 a of the inner shaft 5 .

In FIG. 1, the needle 10 has a linear shape. Needle 10 may be curved, as shown in FIG. 4, to allow application to target tissue having a variety of shapes. The tubular portion 11 and the reduced diameter portion 12 may be curved, or only the tubular portion 11 may be curved. Alternatively, the tubular portion 11 may not be curved, and the reduced diameter portion 12 may be curved.

The needle 10 has at least one lumen 11c in the tubular portion 11. In FIG. 1, the outer diameter of the needle 10 is constant in the tubular portion 11 . The inner diameter of the tube portion 11 may be constant in the longitudinal direction of the needle 10, or may decrease toward the distal end 10a of the needle 10. As shown in FIG. The lumen 11c of the tube portion 11 may be in a state where there is no gap between it and the light guide member 20, or there may be a gap. For the strength of the needle 10 and the fixation of the light guide member 20, it is preferable that there is no gap.

The tube portion 11 may be made of a material that transmits light, and may be made of, for example, a light-transmitting resin. Examples of light-transmitting resins include (meth) acrylic resins (e.g., polymethyl methacrylate (PMMA)), polycarbonate resins (e.g., polydiethylene glycol bisallyl carbonate (PC)), polystyrene resins (e.g., methyl methacrylate/styrene). copolymer resin (MS), acrylonitrile styrene resin (SAN)), polyamide resin (for example, nylon), polyolefin resin, and polyacetal resin. Note that the tube portion 11 may be made of a transparent resin.

The tube portion 11 may be configured by dispersing a diffusing agent in a light-transmitting resin. Examples of the diffusing agent include inorganic particles such as titanium oxide, barium sulfate, and calcium carbonate, and organic particles such as crosslinked acrylic particles and crosslinked styrene particles.

The distal end 12a of the reduced diameter portion 12 coincides with the distal end 10a of the needle 10 in FIG. Distal end 10a of needle 10 may be coincident with the longitudinal axis of needle 10 or offset. Distal end 10 a of needle 10 may be located on the circumference of needle 10 . As seen from the direction perpendicular to the longitudinal axis of the needle 10 as shown in FIG. may

As shown in FIG. 5, the reduced diameter portion 12 may have a lumen 12c. As a result, the light guide member 20 can be arranged in the lumen 12c of the reduced diameter portion 12 as well. The lumen 12c of the reduced diameter portion 12 is preferably arranged so as to communicate with the lumen 11c of the tubular portion 11 . A lumen 12 c of the reduced diameter portion 12 extends in the longitudinal direction of the needle 10 . The lumen 12c of the reduced diameter section 12 may extend to a position proximal to the distal end 12a of the reduced diameter section 12 . For example, when the reduced diameter portion 12 has a blade surface 12d in a cross section perpendicular to the longitudinal direction of the needle 10, the lumen 12c of the reduced diameter portion 12 preferably does not reach the blade surface 12d.

It is preferable that the reduced diameter portion 12 is closed as shown in FIG. It is also preferable that the reduced diameter portion 12 has a solid structure. As a result, contact between the light guide member 20 arranged in the needle 10 and the living tissue or body fluid can be avoided.

The reduced diameter portion 12 can be made of resin or metal. By forming the reduced-diameter portion 12 from resin, the light 50 from the light diffusion portion 21 can easily pass through the reduced-diameter portion 12 . Further, by forming the reduced-diameter portion 12 from metal, the sharpness of the needle 10 can be sharpened, and the needle 10 can be easily punctured into the living tissue. As the resin or metal forming the reduced diameter portion 12, the materials mentioned in the description of the outer shaft 2 or the inner shaft 5 can be used. The reduced-diameter portion 12 may be made of a light-transmissive resin. As the light-transmissive resin, those mentioned in the description of the tube portion 11 can be used. The reduced diameter portion 12 and the tubular portion 11 may be made of the same material, or may be made of different materials.

The light guide member 20 is preferably fixed to the needle 10. As a result, it is preferable that the light guide member 20 and the needle 10 do not move relative to each other. The light diffusing portion 21 can be moved along with the movement of the needle 10 . For example, a configuration in which the light guide member 20 is built in the needle 10 can be employed. In addition, the light guide member 20 may be movable with respect to the needle 10 .

As shown in FIG. 5, it is preferable that the reduced diameter portion 12 is made of a light-transmitting resin, and the light 50 from the light diffusion portion 21 is emitted laterally and forwardly of the needle 10 . The light 50 from the light diffusing portion 21 can easily pass through the reduced-diameter portion 12 by forming the reduced-diameter portion 12 from a light-transmissive resin. Moreover, by irradiating the light 50 from the light diffusing part 21 to the side and front of the needle 10, a wide range of the affected part can be treated all at once.

As shown in FIG. 2, the light diffusion portion 21 is preferably arranged on the pipe portion 11. This makes it easier for the light 50 emitted from the light diffusing portion 21 to pass through the tube portion 11 and makes it easier to irradiate the side of the needle 10 .

As shown in FIG. 2, the distal end 21a of the light diffusing portion 21 is preferably positioned closer to the proximal side than the proximal end 12b of the reduced diameter portion 12. That is, the light diffusing portion 21 does not have to be arranged in the reduced diameter portion 12 . Since the step of arranging the light guide member 20 in the reduced diameter portion 12 is not required when manufacturing the endoscope light irradiation device 1 , the light diffusing portion 21 can be easily arranged in the needle 10 . Further, it becomes easy to form the pipe portion 11 and the reduced diameter portion 12 from different materials, such as an example in which the pipe portion 11 is made of resin and the reduced diameter portion 12 is made of metal. Although not shown, the distal end 21 a of the light diffusing portion 21 may coincide with the proximal end 12 b of the reduced diameter portion 12 or the distal end 11 a of the tube portion 11 .

As shown in FIG. 5 , part of the light diffusing portion 21 may be arranged on the reduced diameter portion 12 of the needle 10 . That is, the distal end 21 a of the light diffusing portion 21 is positioned distally from the proximal end 12 b of the reduced diameter portion 12 , and the proximal end 21 b of the light diffusing portion 21 is proximal to the distal end 11 a of the tube portion 11 . may be located in In that case, it is preferable that the reduced-diameter portion 12 is made of a resin having optical transparency. The light 50 from the light diffusing portion 21 is more likely to be irradiated through the reduced diameter portion 12 .

Although the light diffusing part 21 may be arranged only partially in the circumferential direction of the needle 10, it is preferably arranged all around the needle 10 as shown in FIG. This makes it easier for the light 50 to be emitted from the entire circumferential direction of the needle 10, making it easier to irradiate a wide range of the affected area all at once.

The light diffusing portion 21 should emit the first light beam for treatment. The first light beam is preferably laser light with a wavelength suitable for phototherapy such as PDT and PIT for irradiating internal tissue. The wavelength of the first light beam may be, for example, 0.64 μm or greater, 0.65 μm or greater, or 0.66 μm or greater, and may be 0.72 μm or less, 0.71 μm or less, or 0.7 μm or less. be.

A second ray for targeting may be emitted from the light diffusing portion 21 in addition to the first ray. A second ray is emitted to capture the treatment site prior to emission of the first ray. Preferably, the second beam has a lower radiant energy than the first beam. The second light beam preferably has higher relative luminosity than the first light beam, and the wavelength of the second light beam is preferably in the range of, for example, 0.55 μm or more and 0.56 μm or less.

FIG. 2 shows an example in which the light guide material 20 is an optical fiber 23. The optical fiber 23 has a core 24 and a clad 25 covering the core 24 , and the optical fiber 23 has a clad-free portion 26 in a portion of the distal portion of the core 24 . Hereinafter, the non-cladding portion 26 may be simply referred to as the portion 26 . In the portion 26 , the clad 25 does not have to exist in at least a part of the core 24 in the circumferential direction, and the clad 25 does not have to exist in the entire circumferential direction of the core 24 . In FIG. 2 , the portion 26 functions as the light diffusion portion 21 .

The constituent material of the core 24 or the clad 25 includes plastic, quartz glass, glass such as fluoride glass.

The portion 26 can be formed by removing the clad 25 by etching or polishing. In order to improve light diffusion, the surface of the portion 26 may be provided with unevenness. Asperities can be formed by mechanically or chemically roughening the surface of the part. Methods for roughening the surface include, for example, etching, blasting, a method using a scribe, a wire brush, or sandpaper. The outer diameter of the core 24 of the portion 26 may decrease toward the distal end of the core 24 so that the photon flux density of the light emitted from the portion 26 is uniform along the longitudinal axis of the optical fiber 23 . That is, core 24 may have a tapered shape at portion 26 .

Although not shown, the light guide member 20 may have an optical fiber 23 and a diffusion member connected to the tip surface of the optical fiber 23. In this case, the diffusion member functions as the light diffusion section 21 . The diffusing member may diffuse the light emitted from the optical fiber 23 at least in the radial direction of the optical fiber 23 . The shape of the diffusing member may be, for example, spherical, oval, hemispherical, or columnar. As another aspect, a diffusion member may be arranged so as to cover the clad non-existing portion 26 shown in FIG. In that case, the diffusing member preferably has a ring shape or a coil shape.

As the diffusion member, for example, glass such as quartz glass or resin can be used. A diffusion member made of resin can be configured by dispersing a diffusion agent in a light-transmitting resin. As the light-transmitting resin and the diffusing agent, those mentioned in the description of the tube portion 11 can be used.

At least one of a mirror, a lens, and a prism may be arranged on the distal side of the light guide member 20 relative to the light diffusion section 21 in order to adjust the emission direction of the light 50 from the light diffusion section 21 .

As shown in FIG. 2, the light guide material 20 may have only one single-core fiber in which one core is arranged in one clad, or may have a plurality of such single-core fibers. good. Also, the light guide material 20 may have one or a plurality of multi-core fibers in which a plurality of cores are arranged within one clad.

FIG. 1 shows an example in which the endoscope light irradiation device 1 further includes a handle 30 connected to the proximal portion of the inner shaft 5 . Manipulation of handle 30 preferably moves inner shaft 5 and needle 10 distally or proximally relative to outer shaft 2 . The needle 10 can be protruded from the outer shaft 2 by operating the handle 30 .

　In Fig. 1, the handle 30, the inner shaft 5 and the needle 10 are fixed to each other so as not to move relative to each other. When the handle 30 is moved distally, the needle 10 can be moved distally with respect to the outer shaft 2 , and the distal end 10 a side of the needle 10 can be protruded from the outer shaft 2 . Proximal movement of the handle 30 can move the needle 10 proximally relative to the outer shaft 2 so that the distal end 10a of the needle 10 can be accommodated within the outer shaft 2 .

As shown in FIG. 6, the handle 30 may have a resilient member 32 that biases the needle 10 to protrude distally. It is possible to force the needle 10 to protrude from the outer shaft 2 .

In FIG. 6, the handle 30 has a handle body 31 and an elastic member 32 arranged inside the handle body 31 . The handle body 31 has a hollow portion 31c therein, and the proximal end portion of the inner shaft 5 is arranged in the hollow portion 31c. The elastic member 32 may be arranged so as to enclose the proximal end of the inner shaft 5 in the hollow portion 31c. The elastic member 32 may be a spring member. The inner shaft 5 is configured to be slidable with respect to the handle 30 . Moving the inner shaft 5 proximally with respect to the handle 30 compresses the elastic member 32 in the longitudinal direction x. A distal end 10 a of needle 10 is housed in outer shaft 2 . This operation can be performed, for example, by pinching a knob arranged on the outer surface of the inner shaft 5 and moving it to the proximal side with respect to the handle 30 . On the other hand, when the external force on the inner shaft 5 is released by, for example, releasing the knob, the elastic member 32 tries to return to its original shape, and the inner shaft 5 moves distally. As a result, the distal end 10a of the needle 10 can be vigorously protruded from the opening 2f of the distal end 2a of the outer shaft 2.

As shown in FIG. 7 , the inner shaft 5 may have a position indicator 6 at its proximal portion to indicate the position of the needle 10 with respect to the outer shaft 2 . Since the position of the needle 10 can be easily grasped using the position display section 6 as a clue, it becomes easier to puncture the affected area with the needle 10 .

The position display unit 6 includes scales, letters, numbers, symbols, graphics, and the like. The scale is an axis line extending in the longitudinal or circumferential direction of the inner shaft 5 on which the position display portion 6 is arranged, and at least one of straight lines, curved lines, oblique lines, and points intersecting the axis line. It may be a combination. The position display portion 6 may be a colored portion of the outer surface of the inner shaft 5, or may be a portion in which the resin forming the inner shaft 5 is mixed with a dye such as a pigment.

A radiopaque marker may be placed on the needle 10 so that the position of the tip of the needle 10 can be confirmed under X-ray fluoroscopy. It is preferable that the radiopaque marker be arranged distally of the light diffusing portion 21 . One or more markers can be placed on needle 10 .

As shown in FIG. 7 , the endoscopic light irradiation device 1 may further include a suction section 33 connected to the proximal portion of the outer shaft 2 to suction the fluid in the lumen 2 c of the outer shaft 2 . . In this case, for example, the opening 2f at the distal end 2a of the outer shaft 2 can function as a suction port. When the opening 2f is brought into contact with the affected area and the fluid is sucked by the suction portion 33, the inside of the outer shaft 2 becomes negative pressure, and the opening 2f is in close contact with the affected area. The contact state can prevent the needle 10 from coming off during irradiation. If a side hole is arranged at the distal end of the outer shaft 2, this side hole may be used as a suction port. Alternatively, in a state where the needle 10 is arranged in the outer shaft 2, the target tissue is brought into contact with the opening 2f and sucked by the suction part 33, thereby preventing the puncture position of the needle 10 from shifting.

As the suction unit 33, a suction pump such as a vacuum pump can be used. By using the suction part 33, the inside of the outer shaft 2 should be a space with a pressure lower than the normal atmospheric pressure. The suction portion 33 is connected to the outer shaft 2 directly or indirectly via another member. In FIG. 7 , the suction portion 33 is connected to the outer shaft 2 via the first connecting pipe 34 . The first connecting pipe 34 communicates with a side hole 2g provided at the proximal end of the outer shaft 2. As shown in FIG.

As shown in FIG. 8, the outer shaft 2 may have an internal flow path 4 extending in the longitudinal direction x and through which fluid for cooling the affected area passes. Although the affected area may be hot during or after light irradiation, the cooling fluid can reach the affected area through the internal flow path 4 . Fluids that cool the affected area include, for example, physiological saline. Note that the internal flow path 4 may be used to deliver the drug solution to the affected area. In this case, the chemical liquid can be discharged from the opening 2f.

Only one internal flow path 4 may be arranged inside the outer shaft 2, or a plurality of them may be arranged. If the outer shaft 2 has only one lumen 2c, the space between the outer shaft 2 and the inner shaft 5 can function as the internal flow path 4.

The outer shaft 2 has a first internal flow path through which a fluid for cooling the affected area flows toward the distal side of the outer shaft 2 and a second internal flow path through which body fluids flow toward the proximal side. may have

The inlet of the internal flow path 4 may be arranged at the proximal portion of the outer shaft 2 . An opening at the proximal end of the outer shaft 2 or a side hole arranged at the proximal end of the outer shaft 2 may be the inlet of the internal flow path 4 .

The outlet of the internal flow path 4 may be arranged at the distal portion of the outer shaft 2 . For example, the opening at the distal end of the outer shaft 2 can serve as an outlet for the internal channel 4 as well as a port for projecting the needle 10 . Also, a side hole arranged at the distal end of the outer shaft 2 may be the outlet of the internal flow path 4 . The outer shaft 2 may have a plurality of outlets of the internal channel 4 .

A fluid supply unit 35 is preferably connected to the inlet of the internal channel 4 . A syringe can be used as the fluid supply unit 35 . Fluid supply 35 may comprise a pump. As shown in FIG. 8 , the fluid supply section 35 may be connected to the internal flow path 4 via a second connection pipe 36 . The second connecting pipe 36 communicates with a side hole 2g provided at the proximal end of the outer shaft 2. As shown in FIG.

As shown in FIGS. 9 and 10, the endoscopic light irradiation device 1 may further include a forceps section 41 arranged at the distal portion of the outer shaft 2 to hold the affected area. With this configuration, the target tissue or its surrounding tissue can be held during irradiation, so that the needle 10 can be prevented from coming off during irradiation.

For example, in FIGS. 9-10, the outer shaft 2 has a first lumen 2d and a second lumen 2e. Arranged in the first lumen 2d is an inner shaft 5 with a needle 10 arranged at its distal end. A forceps member 40 having a forceps portion 41 at its distal end is arranged in the second lumen 2e. The forceps portion 41 has a pair of forceps pieces 42 that are rotatably held. Linear members 43 are connected to proximal portions of the pair of forceps pieces 42, respectively. Proximal portions of the plurality of linear members 43 are connected to operation wires 44 . The plurality of linear members 43 and the operation wire 44 are fixed by crimping a cylindrical connector 45 . The forceps portion 41 can be closed by pulling the operation wire 44 proximally. Further, the forceps portion 41 can be opened by pushing the operation wire 44 distally. In addition, the aspect of the forceps part 41 and the forceps member 40 is not limited to this aspect.

9 and 10, the reduced diameter portion 12 is formed so that the distal end 10a of the needle 10 is positioned on the longitudinal axis of the needle 10. In FIGS. Although not shown, the outer shaft 2 has a first lumen 2d and a second lumen 2e, the needle 10 is arranged in the first lumen 2d, and the forceps member 40 is arranged in the second lumen 2e. In this case, the needle 10 may be arranged in the first lumen 2d such that the distal end 10a of the needle 10 is located on the longitudinal axis side of the outer shaft 2. By setting the position of the distal end 10a of the needle 10 in this way, the distal end 10a of the needle 10 and the forceps portion 41 can be brought close to each other, thereby further preventing the needle 10 from coming off during irradiation. .

This application claims the benefit of priority based on Japanese Patent Application No. 2021-028499 filed on February 25, 2021. The entire contents of the specification of Japanese Patent Application No. 2021-028499 filed on February 25, 2021 are incorporated herein by reference.

1: Endoscope Light Irradiation Device 2: Outer Shaft 4: Internal Flow Path 5: Inner Shaft 6: Position Display Part 10: Needle 11: Tube Part 12: Diameter Reduction Part 20: Light Guide Material 21: Light Diffusion Part 30 : Handle 32: Elastic member 33: Suction part 41: Forceps part 50: Light

Claims

an outer shaft having a longitudinal distal end and a proximal end and a lumen extending longitudinally;
an inner shaft disposed in the lumen of the outer shaft and extending in the longitudinal direction;
a needle disposed distally of the inner shaft;
a light guide disposed within the needle and having a light diffuser at a distal portion;
The needle has a tube portion that transmits light from the light diffusing portion, and a reduced-diameter portion positioned distally of the tube portion and having an outer diameter smaller than the outer diameter of the tube portion,
A light irradiation device for an endoscope in which the light from the light diffusing portion is irradiated to the side of the needle.
The endoscope light irradiation device according to claim 1, wherein the light diffusing section is arranged on the tube section.
The endoscope light irradiation device according to claim 1 or 2, wherein the light diffusing portion is arranged all around the needle.
The endoscopic device according to any one of claims 1 to 3, wherein the reduced-diameter portion is made of a light-transmitting resin, and the light from the light diffusion portion is irradiated to the side and front of the needle. Mirror light irradiation device.
The endoscope light irradiation device according to any one of claims 1 to 3, wherein the reduced diameter portion is made of metal.
The endoscope light irradiation device according to any one of claims 1 to 5, wherein the light guide member is fixed to the needle.
The endoscope light irradiation device according to any one of claims 1 to 6, wherein the distal end of the light diffusing portion is located closer to the proximal side than the proximal end of the reduced diameter portion.
The endoscope light irradiation device according to any one of claims 1 to 7, wherein the reduced diameter portion is closed.
The endoscope light irradiation device according to any one of claims 1 to 8, wherein the needle is curved.
The endoscopic light irradiation device according to any one of claims 1 to 9, further comprising a suction part connected to the proximal part of the outer shaft and sucking fluid in the lumen of the outer shaft.
11. The endoscopic light irradiation device according to claim 1, wherein the outer shaft has therein an internal flow path extending in the longitudinal direction and through which a fluid for cooling the affected part passes. Device.
The endoscopic light irradiation device according to any one of claims 1 to 11, further comprising a forceps portion arranged at the distal portion of the outer shaft and holding the affected area.
further comprising a handle connected to the proximal portion of the inner shaft;
The endoscope light irradiation device according to any one of claims 1 to 12, wherein the inner shaft and the needle are moved distally or proximally with respect to the outer shaft by operating the handle.
The endoscope light irradiation device according to claim 13, wherein the handle has an elastic member that biases the needle to protrude distally.
The endoscopic light irradiation device according to any one of claims 1 to 14, wherein the inner shaft has a position display portion indicating the position of the needle with respect to the outer shaft at its proximal portion.