WO2023047709A1

WO2023047709A1 - Light irradiating medical device

Info

Publication number: WO2023047709A1
Application number: PCT/JP2022/022436
Authority: WO
Inventors: 弘規 ▲高▼田
Original assignee: 株式会社カネカ
Priority date: 2021-09-27
Filing date: 2022-06-02
Publication date: 2023-03-30

Abstract

The present invention relates to a light irradiating medical device (1) comprising: a shaft (10) having a distal end and a proximal end in the longitudinal direction (x), and having a lumen (11) extending in the longitudinal direction (x); an optical fiber member (20) disposed in the lumen (11) of the shaft (10); a first coil member (40) disposed in the lumen (11) of the shaft (10) and located further toward the distal end than the optical fiber member (20), the first coil member (40) including a helically wound wire (42). The first coil member (40) has a pitch (P1) longer than the wire diameter of the wire (42). The distal end of the optical fiber member (20) and the proximal end of the first coil member (40) are in abutment with each other but are not fixed to each other.

Description

Light irradiation medical device

The present invention relates to a light irradiation medical device for irradiating tissues such as cancer cells with light in body lumens such as blood vessels and gastrointestinal tracts.

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 using laser light, a target tissue is irradiated with laser light and cauterized. An apparatus for performing such light irradiation has been proposed.

Patent Document 1 discloses a main body having an elongated outer shape, a coil body provided on the tip side of the main body, and a light irradiation part provided inside the coil body for irradiating light toward the outside. is disclosed. Further, an aspect is shown in which an inner coil body and a core shaft are provided inside the coil body, and a part of the core shaft and a part of the inner coil body are joined via a joining portion.

Japanese Patent Application Laid-Open No. 2021-90503

In the light irradiation device described in Patent Document 1, the pitch of the inner coils is dense. For this reason, the inner coil cannot contract when a force directed from the distal direction to the proximal direction is applied. Further, since it is fixed by the joint, the inner coil cannot be stretched when a force directed from the distal direction to the proximal direction is applied. In this way, the lack of flexibility due to the tight pitch of the inner coil causes the light irradiation device disclosed in Patent Document 1 to increase the load on the optical fiber and other members, and is easily damaged. Met. In addition, it lacks flexibility and therefore lacks operability. Accordingly, an object of the present invention is to provide a light irradiation medical device that is excellent in breakage resistance and operability.

One embodiment of the photoirradiation medical device of the present invention that can achieve the above objects is as follows.
[1] a shaft having a longitudinally distal end and a proximal end and having a longitudinally extending lumen; an optical fiber member disposed in the lumen of the shaft; a first coil member having a lumen and disposed distal to the optical fiber member and having a wire wound in a helical shape, the first coil member being longer than the wire diameter of the wire. A light irradiation medical device having a pitch, wherein the distal end of the fiber optic member and the proximal end of the first coil member abut but are not fixed.
According to the above light irradiation medical device, the contact between the distal end portion of the optical fiber member and the proximal end portion of the first coil member causes a force directed from the distal side direction to the proximal side direction with respect to the shaft. That is, when a pushing force is applied to the shaft, the pitch of the first coil member shrinks to fulfill a cushioning function, so damage to the optical fiber member can be easily suppressed. In addition, since the distal end portion of the optical fiber member and the proximal end portion of the first coil member are not fixed, a force directed from the proximal direction to the distal direction with respect to the shaft, that is, the shaft with respect to the shaft When a force is applied in the direction in which the coil member extends, the first coil member and the optical fiber member can be separated from each other, so damage to the optical fiber can be easily suppressed. In addition, since the first coil member has the pitch as described above, flexibility can be imparted to the distal end portion of the light irradiation medical device, and operability can be improved.
[2] The light irradiation medical device according to [1], wherein the inner diameter of the proximal end of the first coil member is smaller than the outer diameter of the distal end of the optical fiber member.
[3] The light irradiation medical device according to [1] or [2], which is arranged in the lumen of the shaft and has a tubular member covering the first coil member.
[4] The light irradiation medical device according to [3], in which the distal end of the first coil member and the distal end of the cylindrical member are fixed.
[5] The optical fiber member has a light diffusing portion extending longitudinally in a predetermined section of its distal portion and emitting light radially outward of the shaft, and the proximal end of the tubular member is positioned closer to the proximal side than the distal end of the light diffusing section [3] or [4].
[6] The light irradiation medical device according to [5], in which the outer peripheral surface of the tubular member is in contact with the inner peripheral surface of the shaft, and the outer peripheral surface of the light diffusing portion and the inner peripheral surface of the shaft are arranged apart from each other.
[7] The distal end of the tubular member has a lid that has a larger area than the lumen of the distal end of the tubular member when the tubular member is viewed from the distal side [3]-[ 6], the light irradiation medical device according to any one of items.
[8] The light irradiation medical device according to any one of [3] to [7], wherein the cylindrical member is a second coil member in which a wire is helically wound.
[9] The light irradiation medical device according to [8], wherein the average pitch of the first coil members is larger than the average pitch of the second coil members.
[10] The light irradiation medical device according to [8] or [9], wherein the wire diameter of the wire of the first coil member is smaller than the wire diameter of the wire of the second coil member.
[11] The cross-sectional area of the wire in the direction perpendicular to the longitudinal direction and passing through the midpoint of the length in the longitudinal direction of the first coil member is the midpoint of the length in the longitudinal direction of the second coil member. The light irradiation medical device according to any one of [8] to [10], which is smaller than the cross-sectional area of the wire passing through.
[12] The light irradiation medical device according to any one of [8] to [11], wherein the winding direction of the first coil member and the winding direction of the second coil member are the same.
[13] The distal end portion of the second coil member has a lid portion whose area when the second coil member is viewed from the distal side is larger than the lumen of the distal end portion of the second coil member. The light irradiation medical device according to any one of [8] to [12].
[14] The light irradiation medical device according to any one of [1] to [13], wherein the optical fiber member has a reflector on its distal end surface.
[15] The light irradiation medical device according to any one of [1] to [14], wherein the first coil member has a pitch of 1.5 times or more the wire diameter of the wire.
[16] The distal end of the first coil member has a lid that has a larger area than the lumen of the distal end of the first coil member when the first coil member is viewed from the distal side. The light irradiation medical device according to any one of [1] to [15].

According to the above light irradiation medical device, the contact between the distal end portion of the optical fiber member and the proximal end portion of the first coil member causes a force directed from the distal side direction to the proximal side direction with respect to the shaft. That is, when a pushing force is applied to the shaft, the pitch of the first coil member shrinks to fulfill a cushioning function, so damage to the optical fiber member can be easily suppressed. In addition, since the distal end portion of the optical fiber member and the proximal end portion of the first coil member are not fixed, a force directed from the proximal direction to the distal direction with respect to the shaft, that is, the shaft with respect to the shaft When a force is applied in the direction in which the coil member extends, the first coil member and the optical fiber member can be separated from each other, so damage to the optical fiber can be easily suppressed. In addition, since the first coil member has the pitch as described above, flexibility can be imparted to the distal end portion of the light irradiation medical device, and operability can be improved.

1 is a cross-sectional view (partial side view) of a light irradiation medical device according to an embodiment of the present invention; FIG. FIG. 2 is a cross-sectional end view of the light irradiation medical device shown in FIG. 1 taken along line II-II. 2 is a cut end view of the first coil member shown in FIG. 1. FIG. 1. It is sectional drawing (partial side view) which shows the modification of the light irradiation medical device shown in FIG. 5 is a cut end view of the cylindrical member shown in FIG. 4. FIG. 1. It is sectional drawing (partial side view) which shows the modification of the light irradiation medical device shown in FIG. 7 is a cut end view of the second coil member shown in FIG. 6. FIG. 2 is an enlarged cross-sectional view of the distal side of the fiber optic member shown in FIG. 1; FIG. FIG. 7 is a cross-sectional view showing a modification of the optical fiber member shown in FIG. 6; FIG. 7 is a cross-sectional view showing another modification of the optical fiber member shown in FIG. 6; FIG. 7 is a cross-sectional view showing another modification of the optical fiber member shown in FIG. 6;

Hereinafter, the present invention will be described in detail with reference to the drawings, but the present invention is not limited to the illustrated examples, and can be implemented with appropriate modifications within the scope that can conform to the gist of the above and later descriptions. All of them are included in the technical scope of the present invention. In each drawing, hatching, symbols, etc. may be omitted for the sake of convenience. In such cases, the specification and other drawings shall be referred to. In addition, the dimensions of various parts in the drawings may differ from the actual dimensions, since priority is given to aid understanding of the features of the present invention.

One embodiment of the photomedical device of the present invention includes a shaft having longitudinally distal and proximal ends and having a longitudinally extending lumen; and a first coil member disposed in the lumen of the shaft and distally of the optical fiber member and having a wire wound in a spiral shape; The coil member has a pitch longer than the wire diameter of the wire, and the distal end of the optical fiber member and the proximal end of the first coil member are in contact, but are not fixed. . According to the above light irradiation medical device, the contact between the distal end portion of the optical fiber member and the proximal end portion of the first coil member causes a force directed from the distal side direction to the proximal side direction with respect to the shaft. That is, when a pushing force is applied to the shaft, the pitch of the first coil member shrinks to fulfill a cushioning function, so damage to the optical fiber member can be easily suppressed. In addition, since the distal end portion of the optical fiber member and the proximal end portion of the first coil member are not fixed, a force directed from the proximal direction to the distal direction with respect to the shaft, that is, the shaft with respect to the shaft When a force is applied in the direction in which the coil member extends, the first coil member and the optical fiber member can be separated from each other, so damage to the optical fiber can be easily suppressed. In addition, since the first coil member has the pitch as described above, flexibility can be imparted to the distal end portion of the light irradiation medical device, and operability can be improved.

A photoirradiation medical device is used in PDT and photoablation to irradiate light of a specific wavelength to the treatment area, which is the target tissue such as cancer cells, in a body lumen such as a blood vessel or digestive tract. The light irradiation medical device may be delivered to the treatment site alone, or may be used together with a delivery catheter or endoscope. In treatment using an endoscope, a light irradiation medical device is placed inside the body through a forceps channel of the endoscope and delivered to a treatment site.

The basic configuration of the device will be described with reference to FIGS. 1 to 11. FIG. FIG. 1 is a cross-sectional view (partial side view) of a light irradiation medical device according to one embodiment of the present invention. FIG. 2 is an end view of the light irradiation medical device shown in FIG. 1 taken along line II-II. 3 is a cut end view of the first coil member shown in FIG. 1. FIG. FIG. 4 is a cross-sectional view (partial side view) showing a modification of the light irradiation medical device shown in FIG. 5 is a cut end view of the cylindrical member shown in FIG. 4. FIG. FIG. 6 is a sectional view (partial side view) showing a modification of the light irradiation medical device shown in FIG. 7 is a cut end view of the second coil member shown in FIG. 6. FIG. 8 is an enlarged cross-sectional view of the distal side of the optical fiber member shown in FIG. 1. FIG. 9 to 11 are sectional views showing other modifications of the optical fiber member shown in FIG. The light irradiation medical device 1 has a shaft 10 , an optical fiber member 20 and a first coil member 40 . In the following, the light irradiation medical device may be simply referred to as the device. In order to facilitate understanding of the positional relationship between the optical fiber member 20 and the first coil member 40, the shaft 10 is omitted from FIGS.

In this specification, the distal side of the device 1 refers to the distal end side of the shaft 10 in the longitudinal direction x and the treatment target side. The proximal side of the device 1 refers to the proximal end side of the shaft 10 in the longitudinal direction x and the user's hand side. When each member is divided into two halves in the longitudinal direction x of the shaft 10, the proximal side may be called the proximal portion, and the distal side may be called the distal portion. In the radial direction of the device 1, the inner side refers to the direction toward the central axis c extending in the longitudinal direction x of the shaft 10, and the outer side refers to the radial direction opposite to the inner side.

The device 1 includes a shaft 10. The shaft 10 has a longitudinal direction x, a radial direction and a circumferential direction p. Shaft 10 has distal and proximal ends in longitudinal direction x and has a lumen 11 extending in longitudinal direction x. The shaft 10 may have only one lumen 11 or may have a plurality of them. Shaft 10 has a cylindrical shape for arranging optical fiber member 20 and first coil member 40 in lumen 11 thereof. Shaft 10 preferably has a cylindrical shape with only one lumen 11 . Since the shaft 10 is inserted into the body, it is preferably flexible. Shaft 10 has an inner peripheral surface 12 and an outer peripheral surface 13 .

The shaft 10 is a hollow body formed by arranging one or more wires in a predetermined pattern; a hollow body having at least one of its inner surface or outer surface coated with a resin; a resin tube; , such as those connected in the longitudinal direction. A hollow body in which wires are arranged in a predetermined pattern includes a cylindrical 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. When the shaft 10 is a resin tube, the shaft 10 can be composed of a single layer or multiple layers. A portion of the shaft 10 in the longitudinal direction x or the circumferential direction p may be composed of a single layer, and the other portion may be composed of a plurality of layers.

The shaft 10 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), polyether polyamide resin, polyurethane. It can be made of synthetic resin such as 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. It is preferable that at least a portion of the shaft 10 that overlaps with the light diffusion portion 21 described later is made of resin having light transmission properties. At least a portion of the shaft 10 that overlaps the light diffusing portion 21 may be made of a transparent resin.

A distal tip 15 may be attached to the distal end of the shaft 10 as shown in FIG. Damage to living tissue by the distal end of the shaft 10 can be avoided. Examples of the shape of the distal tip 15 include a cylindrical shape, an oval cylindrical shape, a hemispherical shape, an oval spherical shape, a truncated pyramid shape, a truncated cone shape, a long truncated cone shape, a rounded truncated pyramid shape, or a combination thereof. can be done.

A handle 70 is connected to the proximal portion of the shaft 10 in FIG. By holding the handle 70 by the operator, the device 1 can be easily operated. The handle 70 extends, for example, in the longitudinal direction x. Handle 70 may be constructed from one or more members. In FIG. 1, the handle 70 has a hollow portion extending in the longitudinal direction x. The handle 70 may have, for example, a cylindrical shape. In FIG. 1, the shaft 10 and the optical fiber member 20 are inserted through the hollow portion of the handle 70 .

Although the material of the handle 70 is not particularly limited, for example, polyolefin resins such as polypropylene (PP) and polyethylene (PE), polyester resins such as polyethylene terephthalate (PET), polycarbonate resins, ABS resins, and synthetic resins such as polyurethane resins are used. be able to.

The device 1 has an optical fiber member 20 arranged in the lumen 11 of the shaft 10 . The optical fiber member 20 is a member provided with an optical fiber, which is a transmission line for transmitting optical signals to the target tissue. As shown in FIG. 1, fiber optic member 20 is disposed within lumen 11 of shaft 10 . In FIG. 1, the proximal end of fiber optic member 20 extends proximally from handle 70 . The proximal end of fiber optic member 20 is connected to a light source such as a semiconductor laser.

The optical fiber member 20 preferably has a light diffusing portion 21 extending in the longitudinal direction x in a predetermined section of its distal portion and emitting light outward in the radial direction of the shaft 10 . Fiber optic member 20 has an outer peripheral surface 23 . The light diffusing portion 21 functions as a light emitting area capable of emitting light radially outward. The light diffusing portion 21 is arranged to extend in the longitudinal direction x and the circumferential direction p of the shaft 10 . The light diffusing portion 21 has an outer peripheral surface 23 . An outer peripheral surface 23 of the light diffusion portion 21 faces the inner peripheral surface 12 side of the shaft 10 .

The device 1 is inserted through the endoscope to the position where the target tissue is in the body cavity. At this time, the target tissue is positioned radially outward of the outer peripheral surface 13 of the shaft 10 . The light emitted from the light diffusing portion 21 passes through at least a portion of the shaft 10 that overlaps the light diffusing portion 21 , so that the light reaches the target tissue around the device 1 .

As described above, it is preferable that light is emitted from the light diffusion portion 21 at least outward in the radial direction of the shaft 10, and the light is emitted from the light diffusion portion 21 over the entire circumferential direction p of the shaft 10. It is preferable that the light is emitted outward in the radial direction of the shaft 10 . Light may be emitted further from the light diffusing portion 21 toward the distal direction of the shaft 10, that is, toward the front.

The light diffusing part 21 is not a diffusing member (for example, a diffuser plate or a prism) separate from the optical fiber of the optical fiber member 20, but a part forming part of the optical fiber. An optical fiber has a core and a cladding. The clad is arranged on the outer circumference of the core and covers a part of the radially outer side of the core. The light diffusion part 21 has (i) a mode in which only the core is arranged, (ii) a mode in which the core and the clad are arranged, or (iii) a part in which only the core is arranged and the other part in which the core and the clad are arranged. is preferably configured from any of the aspects in which is arranged. A covering material for protection may be arranged outside the clad in the radial direction, but it is preferable that the light diffusing portion 21 is not arranged with members other than the core and the clad.

The materials that make up the core and clad are not particularly limited, and glass such as plastic, quartz glass, and fluoride glass can be used.

At least in the portion of the shaft 10 that overlaps the light diffusing portion 21, the resin forming the shaft 10 contains inorganic particles such as titanium oxide, barium sulfate, and calcium carbonate, and organic particles such as crosslinked acrylic particles and crosslinked styrene particles. Light diffusing materials can be added. Light emitted from the light diffusing portion 21 is more easily diffused by the shaft 10 .

The light diffusion part 21 is preferably arranged on the most distal side of the optical fiber. The light diffusion part 21 may be arranged on the most distal side of the optical fiber member 20 . This facilitates the formation of the light diffusing portion 21 and increases the flexibility of the distal end portion of the optical fiber.

The length of the light diffusion portion 21 in the longitudinal direction x may be set to 1/50 or more, 1/45 or more, or 1/30 or more of the total length of the optical fiber member 20 . By setting such a length, it becomes easy to irradiate the entire target tissue with a single irradiation. In addition, the length of the light diffusion portion 21 in the longitudinal direction x may be set to 1/20 or less, 1/25 or less, or 1/30 or less of the total length of the optical fiber member 20 . By setting such a length, it is possible to prevent irradiation of non-target tissues.

The light diffusing portion 21 may be arranged only in a part of the shaft 10 in the circumferential direction p, but as shown in FIG. preferably. Since a wide range in the circumferential direction p can be irradiated at once, efficiency of the procedure can be improved.

The device 1 has a first coil member 40 disposed in the lumen 11 of the shaft 10 on the distal side of the optical fiber member 20 and around which a wire 42 is helically wound. The entire first coil member 40 in the longitudinal direction x is preferably arranged in the lumen 11 of the shaft 10 .

The wire rod 42 has a distal end and a proximal end in its longitudinal direction. The wire 42 may be composed of a single linear member from the distal end to the proximal end, or the wire 42 may be composed of a plurality of linear members connected to each other in the longitudinal direction thereof.

The cross-sectional shape of the wire rod 42 perpendicular to the longitudinal axis direction may be circular, oval, polygonal, or a combination thereof. The oval shape includes an elliptical shape, an egg shape, and a rounded rectangular shape. The same applies to other descriptions in this specification.

The wire diameter (thickness) of the wire 42 constituting the first coil member 40 and the number of turns of the wire 42 are not particularly limited. The axial length of the first coil member 40 may be larger or smaller than the maximum outer diameter of the first coil member 40 .

The first coil member 40 has a pitch P1 longer than the wire diameter of the wire rod 42 . The pitch P1 is the distance between the central axes of two adjacent wire rods 42 forming the first coil member 40 in the axial direction, as shown in FIG. The pitch P1 of the first coil members 40 may be constant in the axial direction, or may vary depending on the position in the axial direction. Of the plurality of pitches P1 of the first coil member 40, only a portion of the pitches P1 may be longer than the wire diameter of the wire 42, or the entire pitch P1 may be longer than the wire diameter of the wire 42. Due to the pitch P1 as described above, when a force directed from the distal direction to the proximal direction is applied to the shaft 10, i.e., a pushing force is applied to the shaft 10, the first coil member Since the contraction of the pitch P1 of 40 makes it easier to fulfill the cushioning function, it is possible to make it easier to suppress damage to the optical fiber member 20 . In addition, since the first coil member 40 has the pitch P1 as described above, the distal end portion of the device 1 can be made flexible, and the operability can be easily improved.

The first coil member 40 preferably has a pitch P1 that is 1.5 times or more the wire diameter of the wire 42, may have a pitch P1 that is 1.6 times or more, or is 1.7 times or more. may have a pitch P1 of Also, the first coil member 40 may have a pitch P1 of 3.0 times or less the wire diameter of the wire 42, or may have a pitch P1 of 2.5 times or less. All the pitches P1 present in the first coil member 40 may be within the above range, or a part of the pitches P1 may be within the above range. With the pitch as described above, when a force directed from the distal direction to the proximal direction is applied to the shaft 10 , that is, a pushing force is applied to the shaft 10 , the first coil member 40 Since the contraction of the pitch of the optical fiber member 20 facilitates the fulfillment of the cushioning function, it is possible to easily suppress the breakage of the optical fiber member 20 . In addition, since the first coil member 40 has the pitch as described above, the distal end portion of the device 1 can be made flexible, and the operability can be easily improved.

The outer diameter of the first coil member 40 may be constant in the longitudinal axis direction x of the shaft 10, or the outer diameter of the first coil member 40 may vary depending on the position in the longitudinal axis direction x. For example, when the first coil member 40 is divided into a distal portion and a proximal portion in the longitudinal direction x, the average outer diameter of the distal portion of the first coil member 40 is It may be larger than the average outer diameter of the site.

The inner diameter of the first coil member 40 may be constant in the longitudinal axis direction x of the shaft 10, or the inner diameter of the first coil member 40 may vary depending on the position in the longitudinal axis direction x. For example, when the first coil member 40 is divided into a distal portion and a proximal portion in the longitudinal direction x, the average inner diameter of the distal portion of the first coil member 40 is equal to the proximal portion of the first coil member 40. It may be larger than the average inner diameter of the portion.

The inner diameter of the proximal end of the first coil member 40 is preferably smaller than the outer diameter of the distal end of the optical fiber member 20 . As a result, the pitch of the first coil member 40 can be easily contracted when a force directed toward the proximal direction from the distal side to the shaft 10 , that is, a pushing force is applied to the shaft 10 . Therefore, the first coil member 40 can easily perform the cushion function. Therefore, damage to the optical fiber member 20 can be easily suppressed.

The first coil member 40 is preferably made of a material having a higher reflectance than the shaft 10. This configuration facilitates diffusion of the reflected light on the inner peripheral surface 43 of the first coil member 40 . Here, the reflectance refers to the reflectance of light emitted from the light diffusing portion 21, and the unit is %. The reflectance can be measured using a reflectance measurement system OP-RF-VIS-GT50 manufactured by Ocean Photonics.

The first coil member 40 is preferably made of metal, such as gold, silver, platinum, palladium, tungsten, tantalum, iridium, and alloys thereof. A superelastic alloy such as a Ti alloy may also be used.

A part of the first coil member 40 may be made of resin. The first coil member 40 may have a coil member main body and a reflective layer arranged on the inner surface of the coil member main body. The light from the light diffusing portion 21 can be reflected by the reflective layer regardless of the material of the coil member main body. For example, a coil body or a resin tube around which a resin wire is wound may be the coil member main body. The reflective layer may be provided by applying a coating agent containing a reflective material to the inner surface of the coil member body, and the reflective material is applied to the inner surface of the coil member body by a method such as vapor deposition, sputtering, electroplating, or chemical plating. It may be arranged by adhering. Note that the reflective layer may be a metal thin film. Reflective materials include, for example, aluminum, gold, silver, copper, tin, titanium dioxide, tantalum pentoxide, aluminum oxide, silicon dioxide, magnesium fluoride, or combinations thereof. When the first coil member 40 has a reflective layer, at least one of the materials exemplified as the constituent materials of the shaft 10 can be used for the coil member main body.

The distal end portion of the first coil member 40 has a lid portion 450 whose area when the first coil member 40 is viewed from the distal side is larger than the lumen of the distal end portion of the first coil member 40. preferably. The lid portion 450 can be formed, for example, by heating the distal end 401 side of the first coil member 40 to deform it. As a result, the first coil member 40 whose distal end 401 side is closed as shown in FIG. 3 can be obtained. Alternatively, a cylindrical coil having one lumen and a metal member separate from the cylindrical coil are prepared, and the metal member is heated and welded so as to close the opening on the distal side of the cylindrical coil. A portion 450 can also be formed. In this way, the first coil member 40 with the distal end 401 side closed can also be obtained.

The distal end of the optical fiber member 20 of the device 1 and the proximal end of the first coil member 40 are in contact, but are not fixed. Since the distal end of the optical fiber member 20 and the proximal end of the first coil member 40 are in contact with each other, a force directed from the distal direction to the proximal direction with respect to the shaft 10 , i.e., the force applied to the shaft 10 When a pushing force is applied, the pitch of the first coil member 40 shrinks to fulfill a cushioning function, so damage to the optical fiber member 20 can be easily suppressed. Further, since the distal end portion of the optical fiber member 20 and the proximal end portion of the first coil member 40 are not fixed, the force directed from the proximal direction to the distal direction with respect to the shaft 10, that is, the shaft 10 When a force is applied in the direction in which the shaft 10 extends, the first coil member 40 and the optical fiber member 20 can be separated from each other, so damage to the optical fiber member 20 can be easily suppressed.

As shown in FIG. 4 , the device 1 may have a tubular member 50 that is arranged in the lumen 11 of the shaft 10 and covers the first coil member 40 . The tubular member 50 is preferably formed to extend in the longitudinal direction x of the shaft 10 . A direction of the tubular member 50 that is parallel to the longitudinal axis direction x of the shaft 10 is referred to as an axial direction of the tubular member 50 . The entire first coil member 40 may be covered with the tubular member 50 , or only a part of the first coil member 40 may be covered with the tubular member 50 . As a result, it is possible to increase the rigidity of the distal end portion, thereby making it easier to improve the operability.

It is preferable that the tubular member 50 has one lumen. The shape of the cylindrical member 50 is not particularly limited, but may be cylindrical, elliptical, or polygonal. The axial length of the tubular member 50 may be larger or smaller than the maximum outer diameter of the tubular member 50 .

As shown in FIG. 4 , the proximal end 502 of the tubular member 50 may be positioned closer to the proximal side than the distal end of the light diffusion portion 21 . Moreover, it is preferable that the cylindrical member 50 covers a part of the distal portion of the light diffusing portion 21 . In this specification, the portion of the light diffusing portion 21 that is not covered with the cylindrical member 50 and is exposed to the shaft 10 side is referred to as an exposed portion 22 . As a result, it is possible to increase the rigidity of the distal end portion, thereby making it easier to improve the operability. In addition, in the portion of the light diffusing portion 21 covered with the cylindrical member 50, the light emitted from the light diffusing portion 21 is reflected by the inner peripheral surface 53 of the cylindrical member 50 shown in FIG. It becomes easy to diffuse in various directions from the exposed portion 22 that is the portion of the diffusion portion 21 that is not covered with the cylindrical member 50 . As a result, the emission intensity distribution of the exposed portion 22 is more likely to be uniform in the circumferential direction p of the shaft 10 . As a result, it is possible to reduce the number of times the target tissue such as a tumor is irradiated and the number of times the position of the exposed portion 22 is adjusted with respect to the target tissue, thereby improving the efficiency of the procedure. In addition, when the cylindrical member 50 covers the light diffusing portion 21 , it covers only a part of the light diffusing portion 21 , and preferably does not cover the entire light diffusing portion 21 . Thereby, the exposed portion 22 is formed in the light diffusion portion 21 . Note that the cylindrical member 50 does not have to partially cover the distal portion of the light diffusing portion 21 . In the radial direction of the shaft 10 , it is preferable that there be no separate member between the exposed portion 22 and the shaft 10 , but any member that does not block the light emitted from the exposed portion 22 may be provided.

As shown in FIG. 5, the distal end of the tubular member 50 has a cap 550 that has a larger area than the lumen of the distal end of the tubular member 50 when the tubular member 50 is viewed from the distal side. You may have In this way, the distal end 501 side of the cylindrical member 50 is closed and the proximal end 502 side is open, so that the light emitted from the light diffusing portion 21 is directed to the inner peripheral surface of the cylindrical member 50. 53 and the inner end surface 56 can be reflected. The inner peripheral surface 53 may be composed of only the curved surface portion, may be composed of only the flat surface portion, or may be composed of a combination of the curved surface portion and the flat surface portion. In order to facilitate diffusion of the light reflected by the inner peripheral surface 53 in multiple directions, the inner peripheral surface 53 preferably has a curved surface portion. Further, the inner end surface 56 may be composed of only the flat portion, may be composed of only the curved surface portion, or may be composed of a combination of the curved surface portion and the flat surface portion.

The distal end of the first coil member 40 and the distal end of the tubular member 50 may be fixed. The first coil member 40 may be directly fixed to the cylindrical member 50, or may be indirectly fixed via another member. The method of fixing the first coil member 40 and the cylindrical member 50 is not particularly limited, but for example, welding, welding, crimping such as caulking, bonding with an adhesive, engaging, connecting, binding, ligating, etc. physical fixing. or a combination thereof. Note that the distal end portion of the first coil member 40 and the distal end portion of the tubular member 50 do not have to be fixed.

As shown in FIG. 4 , the outer peripheral surface 54 of the tubular member 50 may be in contact with the inner peripheral surface 12 of the shaft 10 . With this configuration, the position of the cylindrical member 50 and the optical fiber member 20 relative to the shaft 10 is less likely to shift, and the position of the exposed portion 22 is fixed, so that the irradiation position can be stabilized. Note that the outer peripheral surface 54 of the cylindrical member 50 does not have to be in contact with the inner peripheral surface 12 of the shaft 10 .

The outer peripheral surface 23 of the light diffusion portion 21 and the inner peripheral surface 12 of the shaft 10 may be arranged apart from each other. More preferably, the outer peripheral surface 23 of the light diffusing portion 21 is arranged apart from the inner peripheral surface 12 of the shaft 10 in the exposed portion 22 . Further, it is more preferable that the outer peripheral surface 23 of the light diffusing portion 21 is separated from the inner peripheral surface 12 of the shaft 10 over the entire lengthwise direction x. By arranging the light diffusing portion 21 in the lumen 11 of the shaft 10 in this way, the flexibility of the shaft 10 can be maintained at the position where the light diffusing portion 21 exists, and the operability can be easily improved. can be done.

As shown in FIG. 6, the tubular member disposed in the lumen 11 of the shaft 10 and covering the first coil member 40 is the second coil member 60 having a wire rod 62 spirally wound thereon. may The description of the first coil member 40 can be referred to for the material forming the second coil member 60 .

The second coil member 60 preferably has a pitch P2 equal to or greater than the wire diameter of the wire rod 62, may have a pitch P2 that is 1.1 times or more, or has a pitch P2 that is 1.2 times or more. You may have Further, the second coil member 60 may have a pitch P2 of 3.0 times or less the wire diameter of the wire 62, or may have a pitch P2 of 2.5 times or less. The pitch P2 is the interval between the central axes of two adjacent wire rods 62 forming the second coil member 60 . All the pitches P2 present in the second coil member 60 may be within the above range, or a part of the pitches P2 may be within the above range. By having the pitch as described above, the distal end portion of the device 1 can be given flexibility and moderate rigidity, and operability can be easily improved.

As shown in FIGS. 6 and 7, the second coil member 60 may have the same pitch as the wire diameter of the wire rod 62 . Such coils are commonly referred to as tight wound coils. A tightly wound coil is preferable because there is no gap between two adjacent wire rods 62 and light is less likely to leak from the second coil member 60 . It is also preferable when using the second coil member 60 as a marker.

When the wire diameter of the wire rod 62 changes in its longitudinal axis direction (for example, when there is a large-diameter portion and a small-diameter portion with a smaller wire diameter than the large-diameter portion), the second coil member 60 is The pitch may be smaller than the wire diameter of the wire 62 .

The outer diameter of the second coil member 60 may be constant in the longitudinal axis direction x of the shaft 10, or the outer diameter of the second coil member 60 may vary depending on the position in the longitudinal axis direction x. For example, when the second coil member 60 is divided into a distal portion and a proximal portion in the longitudinal direction x, the average outer diameter of the distal portion of the second coil member 60 is It may be larger than the average outer diameter of the site.

The average pitch P1 of the first coil members 40 may be larger than the average pitch P2 of the second coil members 60 . Part of the pitch P1 of the first coil members 40 may be greater than the pitch P2 of the second coil members 60, but the entire pitch P1 of the first coil members 40 is greater than the pitch P2 of the second coil members 60. is preferred. As a result, flexibility can be easily imparted to the inner side of the device 1 in the radial direction, and operability can be easily improved.

The wire diameter of the wire 42 of the first coil member 40 may be smaller than the wire diameter of the wire 62 of the second coil member 60 . As a result, flexibility can be easily imparted to the inner side of the device 1 in the radial direction, and operability can be easily improved.

The cross-sectional area of the wire rod 42 in the direction perpendicular to the longitudinal axis direction x and passing through the midpoint of the length in the longitudinal axis direction of the first coil member 40 is the middle of the length in the longitudinal axis direction of the second coil member 60. It may be smaller than the cross-sectional area of wire rod 62 passing through the point. As a result, flexibility can be easily imparted to the inner side of the device 1 in the radial direction, and operability can be easily improved.

The winding direction of the first coil member 40 and the winding direction of the second coil member 60 are preferably the same. As a result, the slippage between the first coil member 40 and the second coil member 60 is improved, so that the first coil member 40 and the second coil member 60 can easily follow the shape change of the shaft 10, and the device 1 can be operated. It can make it easier to improve the quality. Although not shown, the winding direction of the first coil member and the winding direction of the second coil member may be different.

As shown in FIG. 7, the distal end portion of the second coil member 60 has an area larger than the lumen of the distal end portion of the second coil member 60 when the second coil member 60 is viewed from the distal side. It preferably has a large lid 650 . The lid portion 650 of the second coil member 60 can be formed by the same method as the lid portion 450 of the first coil member 40 . In this way, the distal end 601 side of the second coil member 60 is closed and the proximal end 602 side is open. can be reflected by the inner peripheral surface 63 and the inner end surface 66 of the .

As shown in FIG. 6 , the proximal end 602 of the second coil member 60 may be positioned closer to the proximal side than the distal end of the light diffusing portion 21 . Also, the second coil member 60 preferably covers a portion of the distal portion of the light diffusion section 21 . In this specification, the portion of the light diffusing portion 21 that is not covered with the second coil member 60 and is exposed to the shaft 10 side is referred to as an exposed portion 22 . Due to the presence of the second coil member 60, the rigidity of the distal end portion can be increased, so that the operability can be easily improved. In addition, in the portion of the light diffusing portion 21 covered with the second coil member 60, the light emitted from the light diffusing portion 21 is reflected by the inner peripheral surface 63 of the second coil member 60, so that the reflected light is diffused. It becomes easy to diffuse in various directions from the exposed portion 22 , which is the portion of the portion 21 that is not covered with the second coil member 60 . As a result, the emission intensity distribution of the exposed portion 22 is more likely to be uniform in the circumferential direction p of the shaft 10 . As a result, it is possible to reduce the number of times the target tissue such as a tumor is irradiated and the number of times the position of the exposed portion 22 is adjusted with respect to the target tissue, thereby improving the efficiency of the procedure. When the second coil member 60 covers the light diffusing section 21 , it covers only a part of the light diffusing section 21 , and preferably does not cover the entire light diffusing section 21 . Thereby, the exposed portion 22 is formed in the light diffusion portion 21 . In addition, the second coil member 60 may not partially cover the distal portion of the light diffusion section 21 . In the radial direction of the shaft 10 , it is preferable that there be no separate member between the exposed portion 22 and the shaft 10 , but any member that does not block the light emitted from the exposed portion 22 may be provided.

Next, a configuration example of the optical fiber member 20 will be described with reference to FIGS. 8 to 11. FIG. 8-11, the optical fiber member 20 has a core 25 extending in the longitudinal direction x, and the optical fiber member 20 has a first clad 26 disposed around the core 25. It has a first section 31 where In the first section 31, the light is likely to be totally reflected at the boundary between the core 25 and the first clad 26. Therefore, in the first section 31, the light is confined within the core 25 and propagated to the distal side of the optical fiber member 20. be.

It is preferable that one core 25 is arranged in one first clad 26 in the first section 31 . In the first section 31, the optical fiber can be rephrased as a single-core optical fiber.

In order to prevent the profile of the optical fiber member 20 from increasing, the first clad 26 may be positioned radially outwardly of the optical fiber member 20 in the first section 31 . That is, the first section 31 does not need to be provided with other members such as a covering material.

Although not shown, the first section 31 of the optical fiber member 20 may be provided with a coating material around the outer periphery of the first clad 26 . It is possible to protect the outside of the first section 31 , and it is also possible to suppress light leakage and emission to the outside in the first section 31 . The coating material may be a coating layer arranged on the outer peripheral surface of the first clad 26 or a sheath enclosing the first clad 26 . The covering material can be made of a resin such as an ultraviolet curable resin.

In FIG. 8, the optical fiber member 20 has a second clad 27 disposed on the outer periphery of the core 25 and having a larger surface roughness of the outer peripheral surface than the first clad 26 in the light diffusion part 21. 32. The second section 32 is positioned more distally than the first section 31 . By making the surface roughness of the cladding greater in the second section 32 than in the first section 31, part of the light is confined within the core 25 and propagated distally of the optical fiber member 20, and the remaining light is transmitted to the second section. It leaks out from the second clad 27 and is injected radially outward. It is preferable that the first section 31 does not emit light radially outward, or that the amount of light leakage is smaller than that of the second section 32 .

As in the first section 31 , in the second section 32 , one core 25 is preferably arranged in one second clad 27 . The first section 31 and the second section 32 may consist of one optical fiber. The first clad 26 of the first section 31 and the second clad 27 of the second section 32 may be integrally formed. As for the optical fiber, the optical fiber for the first section 31 and the optical fiber for the second section 32 may be spliced in the longitudinal axis direction x. The first clad 26 of the first section 31 and the second clad 27 of the second section 32 may be separately formed and then joined together.

In the second section 32, it is preferable that the second cladding 27 is located on the outermost side of the optical fiber member 20 in the radial direction. That is, in the second section 32, it is preferable that no member (for example, a covering material) other than the core 25 and the second clad 27 is arranged. With this configuration, light can be emitted outward in the radial direction of the shaft 10 from the second section 32 .

The surface roughness of the outer peripheral surface of the second clad 27 in the second section 32 is greater than the surface roughness of the outer peripheral surface of the first clad 26 in the first section 31 . Here, the surface roughness is the arithmetic mean roughness Ra between the reference lengths of the roughness curve in the longitudinal axis direction of the outer peripheral surface of the optical fiber member 20 . The reference length may be set according to the magnification of the laser microscope used, and is, for example, 200 μm. The above arithmetic mean roughness Ra corresponds to the arithmetic mean roughness Ra specified in JIS B 0601 (2001) and is measured according to JIS B 0633 (2001). For the measurement, a measuring machine specified in JIS B 0651 (2001) (for example, a laser microscope VK-X3000 manufactured by Keyence Corporation) is used.

The average value of the surface roughness of the outer peripheral surface of the second clad 27 in the second section 32 is preferably larger than the average value of the surface roughness of the outer peripheral surface of the first clad 26 in the first section 31 . In the first section 31 , light is likely to be confined within the core 25 , and in the second section 32 , light is likely to be emitted radially outward from the second clad 27 . As a result, the light emission intensity distribution of the light diffusing portion 21 is easily made uniform in the longitudinal direction x. The average value of the surface roughness is the average value of the surface roughness values of 10 or more measurement points set so as to be aligned in the longitudinal axis direction x in the section to be measured (for example, the first section 31). .

As shown in FIG. 8, when the second section 32 is divided into a distal portion 323 and a proximal portion 324 in the longitudinal direction x, the surface roughness of the outer peripheral surface of the second clad 27 in the proximal portion 324 is The average value is preferably smaller than the average surface roughness of the outer peripheral surface of the second clad 27 in the distal portion 323 . With this configuration, the proximal portion 324 enhances the effect of confining light within the core 25 more than the distal portion 323, while the distal portion 323 facilitates the radially outward emission of light from the second clad 27. Therefore, the emission intensity distribution of the second section 32 is easily uniformed in the longitudinal direction x.

The second section 32 is preferably shorter than the first section 31 in the longitudinal direction x. It becomes easier to form the light diffusing portion 21, and the flexibility of the distal end portion of the optical fiber 20 can also be increased. The length of the second section 32 in the longitudinal direction x can be set to 1/20 or less, 1/25 or less, or 1/30 or less of the length of the first section 31 . Also, the length of the second section 32 in the longitudinal axis direction x may be set to 1/50 or more, 1/45 or more, or 1/30 or more of the length of the first section 31. good.

As can be understood from FIG. 8, the average thickness of the second clad 27 in the second section 32 is preferably smaller than the average thickness of the first clad 26 in the first section 31. By adjusting the thickness of the clad in this way, light is more likely to be confined in the core 25 in the first section 31, and light is more likely to be emitted radially outward from the second clad 27 in the second section 32. . Here, the clad thickness can be measured using a laser microscope VK-X3000 manufactured by Keyence Corporation.

As shown in FIGS. 9 and 10 , when the optical fiber member 20 has the first section 31 , the optical fiber member 20 has no cladding in the light diffusing portion 21 and is located distally of the first section 31 . may have a third section 33 located at . Since there is no clad in the third section 33, the light from the core 25 is emitted radially outward.

In the third section 33, it is preferable that no clad exists in at least a part of the core 25 in the circumferential direction, and more preferably, no clad exists in the entire circumferential direction of the core 25.

In the third section 33, it is preferable that the core 25 is positioned radially outermost in the optical fiber member 20. However, it is preferable that at least part of the third section 33 is covered with the second coil member 60 . In other words, in the third section 33, it is preferable that not only the clad but also any members (for example, covering material) other than the core 25 and the second coil member 60 are arranged.

In the longitudinal direction x, the outer diameter of the core 25 in the third section 33 may be a constant value, or the outer diameter of the core 25 may be a different value depending on the position in the longitudinal direction x.

As shown in FIGS. 9 and 10, the distal end of the third section 33 is preferably at the same position as the distal end of the core 25 in the longitudinal direction x. The formation of the third section 33 is facilitated, and the flexibility at the distal end of the optical fiber member 20 can also be increased.

The surface roughness of the outer peripheral surface of the core 25 in the third section 33 is preferably larger than the surface roughness of the outer peripheral surface of the first clad 26 in the first section 31 . Light is likely to be confined within the core 25 in the first section 31 , and light is likely to be emitted radially outward from the core 25 in the third section 33 .

At least one of the second section 32 and the third section 33 is preferably arranged in the light diffusion section 21, and both the second section 32 and the third section 33 may be arranged. As shown in FIG. 9, it is preferable that the light diffusing portion 21 has a second section 32 and a third section 33 arranged in order from the proximal side to the distal side. With this configuration, the light emission intensity distribution of the light diffusing portion 21 can be easily uniformed in the longitudinal direction x. In order to enhance this effect, it is preferable that the first section 31, the second section 32, and the third section 33 are adjacent to each other in the longitudinal direction x. More specifically, the first section 31 and the second section 32 are adjacent to each other, and the second section 32 and the third section 33 are preferably adjacent to each other.

When the optical fiber member 20 has the second section 32 and the third section 33, it is preferable that the third section 33 is shorter than the second section 32 in the longitudinal axis direction x as shown in FIG. With this configuration, it becomes easier to uniform the emission intensity distribution of the entire exposed portion 22 in the longitudinal direction x. A mode in which the second section 32 is shorter than the third section 33 in the longitudinal direction x is also allowed.

The length of the third section 33 in the longitudinal direction x is preferably 20% or less of the total length of the second section 32 and the third section 33, and is preferably 18% or less. More preferably, the size is 15% or less. In addition, the length of the third section 33 in the longitudinal direction x may be 5% or more, 8% or more, or 10% or more of the total length of the second section 32 and the third section 33. . This configuration makes it easier to uniformize the emission intensity distribution of the exposed portion 22 in the longitudinal direction x.

The average value of the surface roughness of the outer peripheral surface of the second clad 27 in the second section 32 is preferably smaller than the average value of the surface roughness of the outer peripheral surface of the core 25 in the third section 33 . This configuration makes it easier to uniformize the emission intensity distribution in the longitudinal axis direction x in each of the second section 32 and the third section 33 .

As shown in FIG. 8, the optical fiber member 20 may have only the second section 32 in the light diffusing portion 21 . That is, the optical fiber member 20 does not have to have the third section 33 in the light diffusing portion 21 . Even with the configuration having only the second section 32, the emission intensity distribution of the exposed portion 22 in the longitudinal axis direction x can be made uniform. Since the core 25 is not exposed, it also has the effect of preventing damage to the optical fiber member 20 due to bending of the device 1 during the procedure.

If the optical fiber member 20 has only the second section 32 in the light diffusing portion 21, the distal end of the second section 32 may be at the same position as the distal end of the core 25 in the longitudinal direction x. preferable.

As shown in FIG. 10, the optical fiber member 20 may have only the third section 33 in the light diffusing portion 21 . That is, the optical fiber member 20 does not have to have the second section 32 in the light diffusing portion 21 . Even with the configuration having only the third section 33, the emission intensity distribution of the exposed portion 22 in the longitudinal axis direction x can be made uniform.

The second section 32 and the third section 33 can be formed by removing the clad by etching or polishing. In order to adjust the surface roughness of the second section 32 and the third section 33, the outer peripheral surface of the second clad 27 and the outer peripheral surface of the core 25 of the third section 33 may be uneven. The unevenness can be formed by mechanically or chemically roughening the surface of the core 25 of the second clad 27 or the third section 33 . Examples of methods for roughening the surface include etching, blasting, a method using a scribe, a wire brush, or sandpaper.

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. In addition to the first beam, a second targeting beam may be emitted. The second light beam is a light beam emitted to grasp the treatment site before the first light beam is emitted, and preferably has a lower radiant energy than the first light beam.

As shown in FIG. 11, the optical fiber member 20 preferably has a reflector 200 on its distal end face. The reflector 200 is, for example, a mirror arranged so that the reflecting surface faces the proximal side. With this configuration, light can be reflected not only by the inner peripheral surface of the second coil member 60 but also by the reflector 200, so that the reflected light can be easily diffused in various directions.

The surface of the reflector 200 is preferably made of aluminum, gold, silver, copper, tin, titanium dioxide, tantalum pentoxide, aluminum oxide, silicon dioxide, or magnesium fluoride.

Although the shape of the reflector 200 is not particularly limited, it can be shaped like a plate, a cylinder, or a polygonal column, for example.

This application claims the benefit of priority based on Japanese Patent Application No. 2021-156417 filed on September 27, 2021. The entire contents of the specification of Japanese Patent Application No. 2021-156417 filed on September 27, 2021 are incorporated herein by reference.

1: Light irradiation medical device 10: Shaft 11: Lumen 20: Optical fiber member 21: Light diffusion part 22: Exposed part 25: Core 26: First clad 27: Second clad 200: Reflective material 31: First section 32: Second section 323: Distal section 324: Proximal section 33: Third section 40: First coil member 42: Wire rod 50: Tubular member 60: Second coil member 62: Wire rod 70: Handle x: Longitudinal axis direction p: circumferential direction

Claims

a shaft having longitudinal distal and proximal ends and having a lumen extending longitudinally;
a fiber optic member disposed in the lumen of the shaft;
a first coil member disposed in the lumen of the shaft and distal to the optical fiber member, the first coil member being helically wound with a wire;
The first coil member has a pitch longer than the wire diameter of the wire,
A light irradiation medical device in which the distal end of the optical fiber member and the proximal end of the first coil member abut but are not fixed.
The light irradiation medical device according to claim 1, wherein the inner diameter of the proximal end of the first coil member is smaller than the outer diameter of the distal end of the optical fiber member.
The light irradiation medical device according to claim 1 or 2, further comprising a tubular member arranged in the lumen of the shaft and covering the first coil member.
The light irradiation medical device according to claim 3, wherein the distal end of the first coil member and the distal end of the cylindrical member are fixed.
The optical fiber member has a light diffusing portion extending in the longitudinal direction in a predetermined section of its distal portion and emitting light radially outward from the shaft,
4. The light irradiation medical device according to claim 3, wherein the proximal end of the cylindrical member is positioned closer to the proximal side than the distal end of the light diffusing portion.
The light irradiation medical device according to claim 5, wherein the outer peripheral surface of the tubular member is in contact with the inner peripheral surface of the shaft, and the outer peripheral surface of the light diffusing portion and the inner peripheral surface of the shaft are arranged apart from each other. .
4. The distal end portion of the tubular member has a lid portion having a larger area than the lumen of the distal end portion of the tubular member when the tubular member is viewed from the distal side. light irradiation medical device.
The light irradiation medical device according to claim 3, wherein the tubular member is a second coil member in which a wire is spirally wound.
The light irradiation medical device according to claim 8, wherein the average pitch of the first coil member is larger than the average pitch of the second coil member.
The light irradiation medical device according to claim 8, wherein the wire diameter of the wire material of the first coil member is smaller than the wire diameter of the wire material of the second coil member.
The cross-sectional area of the wire in the direction perpendicular to the longitudinal axis direction and passing through the midpoint of the length of the first coil member in the longitudinal axis direction is the length of the second coil member in the longitudinal axis direction. 9. The photoirradiation medical device according to claim 8, wherein the cross-sectional area of the wire passing through the midpoint of is smaller than that of the wire.
The light irradiation medical device according to claim 8, wherein the winding direction of the first coil member and the winding direction of the second coil member are the same.
The distal end portion of the second coil member has a lid portion whose area when the second coil member is viewed from the distal side is larger than the lumen of the distal end portion of the second coil member. The light irradiation medical device according to claim 8.
The light irradiation medical device according to claim 1, wherein the optical fiber member has a reflector on its distal end surface.
The light irradiation medical device according to claim 1, wherein the first coil member has a pitch of 1.5 times or more the wire diameter of the wire.
The distal end portion of the first coil member has a lid portion whose area when the first coil member is viewed from the distal side is larger than the lumen of the distal end portion of the first coil member. The photoirradiation medical device according to claim 1.