JP2015126885A - Medical instrument emitting near infrared fluorescence and medical instrument position confirmation system - Google Patents

Abstract

PROBLEM TO BE SOLVED: To confirm the position of a medical instrument such as a shunt tube without using an X-ray.SOLUTION: A medical instrument position confirmation system includes: a medical instrument 1 capable of emitting light in which a luminescent agent emitting fluorescence due to irradiation of near infrared light with a wavelength of 600-1400 nm is applied to the surface or kneaded; a light source 3 which emits the near infrared light 2 to the medical instrument 1; a camera 4 which receives the near infrared fluorescence emitted by the luminescent agent of the medical instrument 1; and a monitor 6 which displays an image 5 captured by the camera 4.

Description

  The present invention relates to a medical device that emits near-infrared fluorescence when irradiated with near-infrared light, and a medical device position confirmation that can receive the near-infrared fluorescence emitted from the medical device and confirm the position of the medical device. About the system.

  Medical professionals want to confirm the position of medical devices (stents, coil emboli, catheter tubes, injection needles, shunt tubes, drain tubes, implants, etc.) that are inserted into or placed in the patient's body. There is a request. For example, when an injection needle such as dialysis is inserted into a specific blood vessel, there is a demand for confirming during the operation whether or not the injection needle has surely entered the target blood vessel.

  Conventionally, the above-described position confirmation of a medical device is generally performed by irradiating a patient with X-rays and observing a fluoroscopic image thereof.

  Also, as a means for confirming the advancing direction and position of the catheter inserted into the patient, an optical fiber is attached to the catheter so that the catheter is configured as an optical waveguide type, and the distal end of the catheter is caused to emit light. Has been proposed. The near-infrared light is incident on the catheter, the near-infrared light emitted from the distal end is detected by a photodetector from outside the patient's body, and the position of the tip of the catheter is detected (see, for example, Patent Document 1). ).

Special table 2010-528818

  The method of using X-rays for confirming the position of a medical device has a problem that the operator and the patient continue to receive X-ray exposure during the operation. In addition, there is a problem that it is difficult to use for a medical device made of resin that transmits X-rays.

  In addition, the method using the optical waveguide catheter has a problem that only the point of the catheter such as the tip of the catheter can be detected, and it is difficult to detect the entire position, orientation, posture, etc. of the medical device.

  Therefore, an object of this invention is to provide the medical device which can eliminate the said malfunction, and the position detection system of this medical device.

  In order to solve the above problems, the present invention employs the following configuration.

  In order to facilitate understanding of the present invention, reference numerals in the drawings are given in parentheses, but the present invention is not limited thereto.

  That is, in the invention according to claim 1, the near-infrared light (2) having a wavelength of 600 nm to 1400 nm is irradiated with a near-infrared fluorescent light-emitting agent applied or kneaded on the surface. A medical device (1) that emits infrared fluorescence is employed.

  The medical device emitting near infrared fluorescence according to claim 1, wherein the main body of the medical device (1) is a shunt tube, and the luminescent agent is applied to the entire surface of the main body. Or kneaded into the entire body.

  Further, the invention according to claim 3 is a luminescence in which a light-emitting agent that emits near-infrared fluorescence when irradiated with near-infrared light (2) having a wavelength of 600 nm to 1400 nm is coated or kneaded on the surface. A possible medical device (1), a light source (3) that irradiates the near-infrared light (2) toward the medical device (1), and a near-infrared fluorescence emitted by the luminescent agent of the medical device (1) A medical device position confirmation system including a camera (4) that receives light and a monitor (6) that displays an image (5) taken by the camera (4) is employed.

  As described in claim 4, in the medical device position confirmation system according to claim 3, the main body of the medical device (1) is a shunt tube, and the luminescent agent is applied to the entire surface of the main body. Or can be kneaded into the entire body.

  According to the present invention, since the position of the medical device (1) can be detected easily and safely without using X-rays, radiation exposure of patients and medical workers can be avoided. In addition, the overall position, orientation, posture, etc. of the medical device (1) can be easily and accurately confirmed.

It is explanatory drawing of the medical device position confirmation system which concerns on this invention. It is explanatory drawing which shows the state which has confirmed the position of the shunt tube inserted in the patient's body. It is explanatory drawing which shows the state which has confirmed the position of the stent inserted in the blood vessel of a patient. It is explanatory drawing which shows the state which has confirmed the position of the injection needle inserted in the blood vessel of a patient. It is explanatory drawing which shows the state which has confirmed the position of the catheter inserted in the blood vessel of a patient.

  Hereinafter, embodiments for carrying out the invention will be described with reference to the drawings.

<Embodiment 1>
As shown in FIGS. 1 and 2, in this medical device position confirmation system, a medical device 1 that emits near-infrared fluorescence, a light source 3 that irradiates near-infrared light 2 toward the medical device 1, and the medical device described above. A camera 4 that receives fluorescence emitted by the luminescent agent of the tool 1 and a monitor 6 that displays an image 5 of the medical tool 1 taken by the camera 4 are used.

  The medical device 1 is specifically a shunt tube. The surface of the shunt tube is coated with a luminescent agent that emits near-infrared fluorescence when irradiated with near-infrared light 2 having a wavelength of 600 nm to 1400 nm. Alternatively, the light-emitting agent is kneaded in advance into a resin that forms a shunt tube that is the medical device 1.

  As the luminescent agent, for example, indocyanine green that emits light by irradiation with near infrared light can be used. Needless to say, the luminescent agent is a drug that can be used on the human body or animals.

  As the light source 3, an LED that emits near-infrared light 2 or the like is used. The near-infrared light 2 is relatively easy to transmit through the human body 7 and can transmit up to about 5 mm to 20 mm below the tissue surface of the human body 7. Moreover, the near-infrared light 2 is preferably in a wavelength range suitable for causing the luminescent agent to emit light, and can be used in a wavelength range of 600 nm to 1400 nm. When the luminescent agent is indocyanine green, the wavelength range is desirably 700 nm to 1100 nm.

  When the near-infrared light 2 is irradiated from the light source 3 toward the portion of the human body 7 where the medical device 1 is inserted at a depth of 5 mm to 20 mm below the tissue surface, the medical device 1 emits near-infrared fluorescence. To emit.

  The camera 4 can image the entire medical device 1 by receiving near-infrared fluorescence emitted from the light emitting agent of the medical device 1 with a light receiving element. That is, the near-infrared fluorescence emitted from the luminescent agent of the medical device 1 passes through the tissue of the human body 7, and the camera 4 receives the light and images the medical device 1. In addition, the contour of the human body 7 is photographed at the same time.

  The imaging by the camera 4 may be monochrome or color. The camera 4 may be one in which the light source 3 is provided in a ring around the lens. Thereby, it becomes possible to photograph the medical device 1 more appropriately.

  The monitor 6 projects the image 5 of the medical device 1 taken by the camera 4 on the projection screen in monochrome or color. A medical worker such as an operator can confirm the position, posture, orientation, etc. of the medical device 1 in the human body 1 by viewing the image 5 of the medical device 1 displayed on the monitor 6.

  Next, the operation of the medical device position confirmation system configured as described above will be described.

  (1) As shown in FIG.1 and FIG.2, the shunt tube which is the medical device 1 which emits near-infrared fluorescence is inserted in a patient's body by an operator.

  The shunt tube is used to drain cerebrospinal fluid through the patient's subcutaneous skin into the abdominal cavity in the treatment of hydrocephalus. The shunt tube passes from the patient's head 7a to the abdomen 7b at a depth of 5 to 20 mm. Is done.

  (2) While the shunt tube as the medical device 1 is passed through the patient's body, the near-infrared light 2 in the above wavelength range is irradiated from the light source 3 to the patient.

  When the near-infrared light 2 hits the patient's epidermis medical device 1 from the light source 3, the entire medical device 1 emits near-infrared fluorescence, and this near-infrared fluorescence is received by the camera 4, and the monitor 6 performs medical treatment. The entire image of the tool 1 is displayed. In addition, reflected light reflected from the surface of the human body 7 is received by the camera 4, so that an outline image of the human body 7 is also displayed on the monitor 6 together with the medical device 1.

  (3) A medical worker such as a surgeon looks at the images of the medical device 1 and the human body 7 displayed on the monitor 6, and the traveling direction of the tip of the medical device 1 and the overall position, posture, orientation, etc. of the medical device 1 Surgery, treatment, etc. are performed while confirming the above.

  Thereby, during treatment for a patient with hydrocephalus, route confirmation can be performed without using X-rays to determine where the shunt tube after treatment has been placed under the skin and into the abdominal cavity.

<Embodiment 2>
As shown in FIG. 3, the medical device 1 used in the second embodiment is a stent inserted into a blood vessel 8.

  In the second embodiment, during craniotomy for a cerebral aneurysm, a surgical approach is combined with a stent to which a luminescent agent is applied or kneaded as an intravascular approach, or during a thoracotomy, a surgical approach is performed. As an intravascular approach, a stent coated with a luminescent agent or kneaded is used in combination.

  During this surgical operation, near-infrared light 2 is irradiated from the outside of the body toward the affected area from the light source 3, whereby the fluorescence emitted from the medical device 1 in the affected area is received by the camera 4, and as a result, the entire image of the stent is monitored. 6 is displayed in real time.

  Thus, during a surgical operation, an operator or the like can perform an operation while easily confirming the position, posture, etc. of the stent as the medical device 1 from the blood vessel 8 or the organ surface without using X-rays.

<Embodiment 3>
As shown in FIG. 4, the medical device 1 that emits near-infrared fluorescence used in the third embodiment is an injection needle inserted into a blood vessel 8.

  In the third embodiment, the injection needle as the medical device 1 is punctured from above the skin 9 into the patient's vein. The luminescent agent is applied to the surface of the injection needle.

  During the medical practice with this injection needle, near-infrared light 2 is emitted from the light source 3 toward the affected area from above the skin 9, whereby the fluorescence emitted from the injection needle under the patient's skin is received by the camera 4, As a result, the entire image of the injection needle and the blood vessel 8 as a vein is displayed on the monitor 6 in real time. In this case, since reduced hemoglobin in venous blood absorbs a wavelength component of 600 nm to 800 nm in the near infrared light, the vein is projected in black on the monitor 6, and the injection needle as the medical device 1 is on the surface thereof. Since the near-infrared fluorescent color emitted from the light is transmitted outside the skin, the near-infrared fluorescent color is projected on the monitor 6.

  Thus, the operator can easily and accurately insert the injection needle into the vein while confirming the positional relationship between the blood vessel 8 and the injection needle from above the patient's skin 9 without using X-rays. .

  According to the test by the present inventors, it was possible to visually recognize the injection needle and the blood vessel even at a depth of about 2 cm subcutaneously.

<Embodiment 4>
As shown in FIG. 5, the medical device 1 that emits near-infrared fluorescence used in the fourth embodiment is a catheter inserted into a blood vessel 8.

  The light emitting agent is applied to the surface of the catheter or kneaded into the catheter material.

  During insertion of the catheter into the exposed blood vessel 8 during the thoracotomy, the near-infrared light 2 is emitted from the light source 3 toward the exposed blood vessel 8 and is emitted from the catheter in the patient's blood vessel 8. The fluorescence is received by the camera 4, and as a result, an entire image of the catheter and the blood vessel 8 is displayed on the monitor 6 in real time. In this case, since the near-infrared fluorescent color emitted from the surface of the catheter which is the medical device 1 is transmitted outside the blood vessel 8, it is projected on the monitor 6 in the near-infrared fluorescent color.

  In the fourth embodiment, the blood vessel 8 is an artery, and a catheter is being inserted from the aorta into the carotid artery. In this artery, reference numeral 8a indicates the descending aorta, and reference numeral 8b indicates the brachiocephalic artery.

  Thus, without using X-rays, the operator can easily and easily insert the catheter into the artery while confirming the distal end of the catheter in the blood vessel 8, the overall position, the traveling direction of the distal end, etc. from outside the patient's blood vessel 8. Can be inserted accurately.

  In addition, this invention is not limited to the said embodiment, It can apply also to the following forms.

  (1) For example, in the above-described embodiment, hydrocephalus, blood vessel treatment, shunt tube, and use of a stent have been described. However, the present invention can be applied to other treatments and medical devices. For example, the present invention can be applied to a coil embolus, a catheter tube, a drain tube, and an implant as a medical device.

  (2) In addition, when placing a stent in the bile duct or pancreatic duct during laparoscopic surgery, the position, posture, orientation, etc. of the stent can be confirmed from the blood vessel or organ surface without using X-rays. When a catheter is inserted into a vein, the position of the vein and the injection needle or catheter, which is a medical device, can be confirmed by irradiating infrared light with a wavelength suitable for the luminescent agent and a wavelength that can easily be absorbed by the vein. It is possible to confirm whether the injection needle and the catheter are accurately in the vein.

  (3) Also, when the cannula of the dialysis needle is removed, the tip of the cannula may be disconnected and left in the blood vessel. Even in such a case, if the cannula is coated with a fluorescent agent, the cannula is separated. It is possible to easily and accurately identify the position under the skin where the cut cannula tip remains, and noninvasive treatment can be performed.

  (4) It can be applied not only to human medical practice but also to animal medicine.

  (5) After placing a tube or the like in a patient's body, a tube or the like can be identified without using an X-ray, an electron beam, or the like by injecting and administering a fluorescent reagent as a luminescent agent into the tube or the like.

DESCRIPTION OF SYMBOLS 1 ... Medical device 2 ... Near-infrared light 3 ... Light source 4 ... Camera 5 ... Image 6 ... Monitor

That is, the invention according to claim 1 is capable of emitting near-infrared fluorescence at 5 mm to 20 mm below the tissue surface of a living body by being irradiated with near-infrared light (2) having a wavelength of 600 nm to 1400 nm from outside the body. The medical device (1) that emits near-infrared fluorescence is employed.

As described in claim 2, the medical device that emits near-infrared fluorescence according to claim 1 is applied to a shunt tube, a stent, a syringe needle, a coil embolus, a catheter tube, a drain tube, an implant, or a cannula. can do.

Moreover, the invention which concerns on Claim 3 can light-emit near-infrared fluorescence in 5-20 mm below the tissue surface of a biological body by irradiating near-infrared light (2) with a wavelength of 600 nm-1400 nm from the outside of the body. A medical device (1), a light source (3) for irradiating the near-infrared light (2) from outside the body toward the medical device (1) existing below the tissue surface of the living body, and the medical device (1) a camera (4) for the near-infrared fluorescence received in vitro, having a monitor (6) for projecting the image (5) of the camera (4) is taken, employing a medical instrument location system.

The medical device position confirmation system according to claim 3, wherein the medical device is a shunt tube, a stent, a syringe needle, a coil embolus, a catheter tube, a drain tube, an implant, or a cannula. Can be applied to.

Claims (4)

  A medical device that emits near-infrared fluorescence, characterized in that a light-emitting agent that emits near-infrared fluorescence when irradiated with near-infrared light having a wavelength of 600 nm to 1400 nm is coated or kneaded on the surface.   The medical device emitting near-infrared fluorescence according to claim 1, wherein the main body of the medical device is a shunt tube, and the luminescent agent is applied to the entire surface of the main body or kneaded into the entire main body. A medical device that emits near-infrared fluorescence.   A luminescent agent that emits near-infrared fluorescence when irradiated with near-infrared light having a wavelength of 600 nm to 1400 nm is applied to the surface or kneaded, and the luminosity-capable medical device, and toward the medical device, the above-mentioned A medical device position confirmation comprising: a light source that emits near-infrared light; a camera that receives near-infrared fluorescence emitted by the luminescent agent of the medical device; and a monitor that displays an image captured by the camera. system.   The medical device position confirmation system according to claim 3, wherein the main body of the medical device is a shunt tube, and the luminescent agent is applied to the entire surface of the main body or kneaded into the entire main body. A medical device location confirmation system.

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