技术领域Technical Field
本发明涉及医疗器具及治疗方法。The present invention relates to medical instruments and treatment methods.
背景技术Background technique
为了将治疗用光照射于异常组织而使用的光治疗装置是已知的。在专利文献1中公开了这种光治疗装置。A phototherapy device used to irradiate abnormal tissue with therapeutic light is known. Patent Document 1 discloses such a phototherapy device.
现有技术文献Prior art literature
专利文献Patent Literature
专利文献1：日本专利第4122323号公报Patent Document 1: Japanese Patent No. 4122323
发明内容Summary of the invention
发明所要解决的课题Problems to be solved by the invention
希望光治疗装置尽量不将光照射于正常组织。在从阴道内等体腔内向异常组织等对象部位照射光的光治疗中，在将体腔内插入装置插入于体腔内的状态下，难以从生物体外目视体腔内插入装置的光照射位置。因此，难以正确地掌握在体腔内的体腔内插入装置的光照射位置。It is desirable that the phototherapy device irradiates light to normal tissue as little as possible. In phototherapy in which light is irradiated to a target site such as abnormal tissue from a body cavity such as the vagina, it is difficult to visually observe the light irradiation position of the body cavity insertion device from outside the body when the body cavity insertion device is inserted into the body cavity. Therefore, it is difficult to accurately grasp the light irradiation position of the body cavity insertion device in the body cavity.
本发明的目的在于，提供一种能够从生物体外识别体腔内的体腔内插入装置的光照射位置的医疗器具以及治疗方法。An object of the present invention is to provide a medical device and a treatment method that can identify a light irradiation position of an intracavitary insertion device in a body cavity from outside the body.
用于解决课题的手段Means for solving problems
作为本发明的第1方式的医疗器具具备：体腔内插入装置，其在远位端部具备能插入体腔内的插入部；和保持装置，其能在比所述体腔内插入装置的所述插入部靠近位侧的位置保持所述体腔内插入装置，其中，所述体腔内插入装置的所述插入部在围绕所述体腔内插入装置的中心轴线的周向的一部分具备能从内部向外部照射光的光照射部，所述保持装置具备周向位置显示部，所述周向位置显示部伴随所述体腔内插入装置在所述周向上的回转而动作、并对所述光照射部在所述周向上的位置进行显示。The medical device as the first embodiment of the present invention comprises: an intra-body cavity insertion device, which has an insertion portion that can be inserted into the body cavity at a distal end; and a holding device that can hold the intra-body cavity insertion device at a position closer to the side than the insertion portion of the intra-body cavity insertion device, wherein the insertion portion of the intra-body cavity insertion device has a light irradiation portion that can irradiate light from the inside to the outside in a part of the circumference around the central axis of the intra-body cavity insertion device, and the holding device has a circumferential position display portion, which moves with the rotation of the intra-body cavity insertion device in the circumferential direction and displays the position of the light irradiation portion in the circumferential direction.
作为本发明的1个实施方式，所述光照射部是能够透过被插入于所述插入部的内部的发光体的光的光透过窗。According to one embodiment of the present invention, the light irradiation portion is a light-transmitting window capable of transmitting light from a light-emitting body inserted into the insertion portion.
作为本发明的1个实施方式，所述插入部具备能在所述体腔内扩张的球囊，所述光透过窗被设置于所述球囊。According to one embodiment of the present invention, the insertion portion includes a balloon expandable in the body cavity, and the light transmission window is provided in the balloon.
作为本发明的1个实施方式，在将所述周向位置显示部设为第1周向位置显示部的情况下，所述保持装置具备第2周向位置显示部，所述第2周向位置显示部能与所述体腔内插入装置在所述周向上的回转独立地动作、并能够对所述光照射部在所述周向上的位置的历史进行显示。As one embodiment of the present invention, when the circumferential position display portion is set as the first circumferential position display portion, the retaining device has a second circumferential position display portion, and the second circumferential position display portion can operate independently of the rotation of the intra-body cavity insertion device in the circumferential direction and can display the history of the position of the light irradiation portion in the circumferential direction.
作为本发明的1个实施方式，所述第2周向位置显示部能够在追随状态与独立状态之间进行状态变化，所述追随状态是伴随所述体腔内插入装置在所述周向上的回转而动作的状态，所述独立状态是与所述体腔内插入装置在所述周向上的回转独立地动作的状态。As one embodiment of the present invention, the second circumferential position display unit is capable of changing state between a following state and an independent state, wherein the following state is a state in which the movement occurs along with the rotation of the intra-body cavity insertion device in the circumferential direction, and the independent state is a state in which the movement occurs independently of the rotation of the intra-body cavity insertion device in the circumferential direction.
作为本发明的1个实施方式，所述保持装置在沿所述体腔内插入装置的所述中心轴线的轴向上以能相对移动的方式对所述体腔内插入装置进行保持，所述体腔内插入装置及所述保持装置中的至少一个装置具备轴向移动量显示部，所述轴向移动量显示部对与所述体腔内插入装置相对所述保持装置而言在所述轴向上的相对移动相伴的、所述光照射部在所述轴向上的移动量进行显示。As one embodiment of the present invention, the holding device holds the intracavitary insertion device in a relatively movable manner in the axial direction along the central axis of the intracavitary insertion device, and at least one of the intracavitary insertion device and the holding device has an axial movement amount display unit, which displays the axial movement amount of the light irradiation unit accompanying the relative movement of the intracavitary insertion device relative to the holding device in the axial direction.
作为本发明的1个实施方式，所述保持装置具备轴向位置显示部，所述轴向位置显示部能够与所述体腔内插入装置在所述轴向上的移动独立地动作、并能够对所述光照射部在所述轴向上的位置的历史进行显示。As one embodiment of the present invention, the holding device includes an axial position display unit that can operate independently of movement of the intracavitary insertion device in the axial direction and can display a history of the position of the light irradiation unit in the axial direction.
作为本发明的第2方式的治疗方法是使用医疗器具进行治疗的治疗方法，其中，所述医疗器具具备：体腔内插入装置，其在远位端部具备能插入体腔内的插入部；和保持装置，其能在比所述体腔内插入装置的所述插入部靠近位侧的位置保持所述体腔内插入装置，所述体腔内插入装置的所述插入部在围绕所述体腔内插入装置的中心轴线的周向的一部分具备能从内部向外部照射光的光照射部，所述治疗方法中，使所述体腔内插入装置在所述周向上回转，使用对所述光照射部在所述周向上的位置进行显示的、所述保持装置的周向位置显示部，将所述光照射部在所述周向上的位置对位于所述体腔内的光照射的对象部位。A second method of treatment according to the present invention is a method of treatment using a medical instrument, wherein the medical instrument comprises: an intra-body cavity insertion device having an insertion portion at a distal end thereof that can be inserted into a body cavity; and a holding device that can hold the intra-body cavity insertion device at a position closer to the side than the insertion portion of the intra-body cavity insertion device, wherein the insertion portion of the intra-body cavity insertion device has a light irradiation portion that can irradiate light from the inside to the outside at a portion in a circumferential direction around a central axis of the intra-body cavity insertion device, and in the method of treatment, the intra-body cavity insertion device is rotated in the circumferential direction, and a circumferential position display portion of the holding device that displays the circumferential position of the light irradiation portion is used to adjust the circumferential position of the light irradiation portion to an object part of the light irradiation located in the body cavity.
在作为本发明的1个实施方式的治疗方法中，在所述插入部的内侧插入发光体，穿过所述光照射部而利用所述发光体对所述对象部位进行光照射。In a treatment method according to one embodiment of the present invention, a light emitting body is inserted inside the insertion portion, and light is irradiated to the target site by the light emitting body through the light irradiation portion.
在作为本发明的1个实施方式的治疗方法中，在将所述周向位置显示部设为第1周向位置显示部的情况下，所述第1周向位置显示部伴随所述体腔内插入装置在所述周向上的回转而动作，所述保持装置具备第2周向位置显示部，所述第2周向位置显示部能够与所述体腔内插入装置在所述周向上的回转独立地动作，并能够对所述光照射部在所述周向上的位置的历史进行显示，在使所述体腔内插入装置在所述周向上回转、在所述周向上的不同位置将来自所述光照射部的光照射执行2次的情况下，将所述第2周向位置显示部配置在显示第1次照射位置的位置、作为过去的照射历史进行显示。In a treatment method as one embodiment of the present invention, when the circumferential position display unit is set as the first circumferential position display unit, the first circumferential position display unit moves along with the rotation of the intracavitary insertion device in the circumferential direction, and the holding device has a second circumferential position display unit, and the second circumferential position display unit can move independently of the rotation of the intracavitary insertion device in the circumferential direction and can display the history of the position of the light irradiation unit in the circumferential direction. When the intracavitary insertion device is rotated in the circumferential direction and light irradiation from the light irradiation unit is performed twice at different positions in the circumference, the second circumferential position display unit is configured to display the first irradiation position and display it as a past irradiation history.
在作为本发明的1个实施方式的治疗方法中，所述第2周向位置显示部能够在追随状态与独立状态之间进行状态变化，所述追随状态是伴随所述体腔内插入装置在所述周向上的回转而动作的状态，所述独立状态是与所述体腔内插入装置在所述周向上的回转独立地动作的状态，在使所述第2周向位置显示部保持为所述追随状态的状态下，使所述体腔内插入装置在所述周向上回转，将所述体腔内的所述光照射部在所述周向上的位置对位于所述第1次照射位置，在使所述第2周向位置显示部从所述追随状态进行状态变化为所述独立状态后，使所述体腔内插入装置在所述周向上回转，将所述体腔内的所述光照射部在所述周向上的位置对位于第2次照射位置。In a treatment method as one embodiment of the present invention, the second circumferential position display unit is capable of changing state between a following state and an independent state, the following state being a state in which the movement occurs along with the rotation of the intracavitary insertion device in the circumferential direction, and the independent state being a state in which the movement occurs independently of the rotation of the intracavitary insertion device in the circumferential direction, while the second circumferential position display unit is maintained in the following state, the intracavitary insertion device is rotated in the circumferential direction, and the position of the light irradiation unit in the body cavity in the circumferential direction is aligned to the first irradiation position, and after the second circumferential position display unit is changed from the following state to the independent state, the intracavitary insertion device is rotated in the circumferential direction, and the position of the light irradiation unit in the body cavity in the circumferential direction is aligned to the second irradiation position.
在作为本发明的1个实施方式的治疗方法中，所述保持装置在沿所述体腔内插入装置的所述中心轴线的轴向上以能相对移动的方式对所述体腔内插入装置进行保持，所述体腔内插入装置及所述保持装置中的至少一个装置具备轴向移动量显示部，所述轴向移动量显示部对与所述体腔内插入装置相对所述保持装置而言在所述轴向上的相对移动相伴的、所述光照射部在所述轴向上的移动量进行显示，使用所述轴向移动量显示部调整所述光照射部在所述体腔内的所述轴向的移动量。In a treatment method that is one embodiment of the present invention, the holding device holds the intracavitary insertion device in a relatively movable manner in the axial direction along the central axis of the intracavitary insertion device, and at least one of the intracavitary insertion device and the holding device includes an axial movement amount display unit, which displays the axial movement amount of the light irradiation unit associated with the relative movement of the intracavitary insertion device in the axial direction relative to the holding device, and the axial movement amount display unit is used to adjust the axial movement amount of the light irradiation unit in the body cavity.
在作为本发明的1个实施方式的治疗方法中，所述保持装置具备轴向位置显示部，所述轴向位置显示部能与所述体腔内插入装置在所述轴向上的移动独立地动作、并能对所述光照射部在所述轴向上的位置的历史进行显示，In a treatment method as one embodiment of the present invention, the holding device includes an axial position display unit that can operate independently of the movement of the intracavitary insertion device in the axial direction and can display the history of the position of the light irradiation unit in the axial direction.
在使所述体腔内插入装置在所述轴向上移动、在所述轴向上的不同位置将来自所述光照射部的光照射执行2次的情况下，将所述轴向位置显示部配置在显示第1次照射位置的位置、作为过去的照射历史进行显示。When the intracavitary insertion device is moved in the axial direction and light irradiation from the light irradiation unit is performed twice at different positions in the axial direction, the axial position display unit is configured to display the first irradiation position as a past irradiation history.
发明效果Effects of the Invention
根据本发明，能够提供能从生物体外识别体腔内的体腔内插入装置的光照射位置的医疗器具以及治疗方法。According to the present invention, it is possible to provide a medical device and a treatment method that can identify the light irradiation position of an intracavitary insertion device in a body cavity from outside the body.
附图说明BRIEF DESCRIPTION OF THE DRAWINGS
[图1]是示出作为本发明的一个实施方式的医疗器具的图。[ Fig. 1 ] is a diagram showing a medical device as one embodiment of the present invention.
[图2]是从图1所示的I的位置观察到的保持装置的俯视图。[ Fig. 2 ] is a plan view of the retaining device as viewed from position I shown in Fig. 1 .
[图3]是图1所示的II-II线的位置处的剖面图。[ Fig. 3 ] is a cross-sectional view taken along line II-II shown in Fig. 1 .
[图4A]是示出阴道内插入装置的插入部即将被插入阴道内之前的状态的图。[ Fig. 4A ] is a diagram showing a state immediately before the insertion portion of the intravaginal insertion device is inserted into the vagina.
[图4B]是示出阴道内插入装置的插入部被插入阴道内后的状态的图。[ Fig. 4B ] is a diagram showing a state where the insertion portion of the intravaginal insertion device is inserted into the vagina.
[图4C]是示出在阴道内将光照射部在周向上的位置对位于阴道内的光照射的对象部位的、对位工序的图。FIG. 4C is a diagram showing a step of aligning the circumferential position of the light irradiation section with the target site for light irradiation located in the vagina. FIG.
[图4D]是示出从阴道内插入装置的插入部的光照射部向对象部位照射光的光照射工序的图。[ Fig. 4D] is a diagram showing a light irradiation step of irradiating light from a light irradiation section of the insertion portion of the intravaginal insertion device to a target site.
[图5]是图1的III-III线的位置处的剖面图。[ Fig. 5 ] is a cross-sectional view taken along line III-III in Fig. 1 .
[图6A]是示出阴道内插入装置的插入部的一个变形例的图。[ Fig. 6A ] is a diagram showing a modified example of the insertion portion of the intravaginal insertion device.
[图6B]是示出使用了图6A所示的球囊的情况下的、周向位置显示部的一个变形例的图。[FIG. 6B] is a diagram showing a modified example of the circumferential position display unit when the balloon shown in FIG. 6A is used.
[图7]是示出使用了图6A所示的球囊的情况下的、操作杆的标记部的一个变形例的图。[ Fig. 7 ] is a diagram showing a modified example of the marking portion of the operating rod when the balloon shown in Fig. 6A is used.
[图8A]是示出保持装置具备第1周向位置显示部及第2周向位置显示部的例子的图，是示出第1周向位置显示部及第2周向位置显示部的规定的位置关系的图。8A] is a diagram showing an example in which a retaining device includes a first circumferential position indicating portion and a second circumferential position indicating portion, and is a diagram showing a predetermined positional relationship between the first circumferential position indicating portion and the second circumferential position indicating portion.
[图8B]是示出图8A所示的第1周向位置显示部及第2周向位置显示部的、与图8A不同的规定的位置关系的图。FIG. 8B is a diagram showing a predetermined positional relationship between the first circumferential position indicating portion and the second circumferential position indicating portion shown in FIG. 8A , which is different from that in FIG. 8A .
[图9A]是示出图8A、图8B所示的第2周向位置显示部能够在追随状态与独立状态之间进行状态变化的机构的一例的图。FIG. 9A is a diagram showing an example of a mechanism in which the second circumferential position display unit shown in FIGS. 8A and 8B can change state between a following state and an independent state.
[图9B]是示出将与图8A、图8B、图9A所示的第1周向位置显示部及第2周向位置显示部同样的构成应用于配置在保持装置的近位侧的、阴道内插入装置的标记部的位置的例子的图。[Fig. 9B] is a diagram showing an example of applying the same configuration as the first circumferential position display portion and the second circumferential position display portion shown in Figs. 8A, 8B, and 9A to the position of a marking portion of an intravaginal insertion device disposed on the proximal side of the retaining device.
[图10A]是示出图9A所示的第2周向位置显示部能够在追随状态与独立状态之间进行状态变化的机构的、与图9A不同的变形例的图。FIG. 10A ] is a diagram showing a modified example different from FIG. 9A , in which a mechanism is capable of changing the state of the second circumferential position display unit shown in FIG. 9A between a following state and an independent state.
[图10B]是图9B所示的周向位置显示部能够在追随状态与独立状态之间进行状态变化的机构的、与图9B不同的变形例的图。FIG. 10B is a diagram showing a modified example different from FIG. 9B of a mechanism in which the circumferential position display unit shown in FIG. 9B can change its state between a following state and an independent state.
[图11A]是示出代替图2所示的操作杆的标记部而在阴道内插入装置的轴(shaft)上设置标记部的例子的图。[ Fig. 11A] is a diagram showing an example in which a marking portion is provided on the shaft of the intravaginal insertion device instead of the marking portion of the operation rod shown in Fig. 2 .
[图11B]是图11A的IV-IV线的位置处的剖面图。[ Fig. 11B ] is a cross-sectional view taken along line IV-IV of Fig. 11A .
[图12]是示出取代设置在图2所示的保持装置上的轴向移动量显示部，而在阴道内插入装置上设置轴向移动量显示部的例子的图。[ Fig. 12] is a diagram showing an example in which an axial movement amount display portion is provided on the intravaginal insertion device instead of the axial movement amount display portion provided on the holding device shown in Fig. 2 .
[图13A]是示出保持装置具备操作杆的标记部、轴向移动量显示部及轴向位置显示部的例子的图，是示出标记部、轴向移动量显示部及轴向位置显示部的规定的位置关系的图。[Figure 13A] is a diagram showing an example in which a retaining device includes a marking portion of an operating rod, an axial movement amount display portion, and an axial position display portion, and is a diagram showing a predetermined positional relationship among the marking portion, the axial movement amount display portion, and the axial position display portion.
[图13B]是示出图13A所示的标记部、轴向移动量显示部及轴向位置显示部的、与图13A不同的规定的位置关系的图。FIG. 13B is a diagram showing a predetermined positional relationship of the marking portion, the axial movement amount display portion, and the axial position display portion shown in FIG. 13A , which is different from that in FIG. 13A .
[图14]是图13A的V-V线的位置处的剖面图。[Fig. 14] is a cross-sectional view taken along line V-V in Fig. 13A.
[图15]是示出图13A、图13B、图14所示的标记部的变形例的图。[Fig. 15] is a diagram showing a modified example of the marking portion shown in Figs. 13A, 13B, and 14.
具体实施方式Detailed ways
以下，参照附图对本发明所涉及的医疗器具以及治疗方法的实施方式进行例示说明。在各图中对共通的构成标注相同的附图标记。Hereinafter, embodiments of the medical device and the treatment method according to the present invention will be described with reference to the accompanying drawings. In each of the drawings, the same reference numerals are given to common components.
图1是示出作为本发明的医疗器具的一实施方式的医疗器具100的图。如图1所示，医疗器具100具备体腔内插入装置和保持装置2。在本说明书中，以下，为了便于说明，对作为体腔内插入装置的一例的阴道内插入装置1进行例示说明。但是，体腔内插入装置不限于阴道内插入装置1，也可以是能够插入阴道以外的其他体腔的装置。在图1中，示出在阴道内插入装置1内插入有作为发光体200的光纤200a的状态。医疗器具100能够用于例如基于光动力疗法(Photodynamic Therapy：PDT)的治疗、基于光免疫疗法(photoimmunotherapy：PIT)的治疗。FIG. 1 is a diagram showing a medical device 100 as one embodiment of the medical device of the present invention. As shown in FIG. 1 , the medical device 100 includes an intracavity insertion device and a retaining device 2. In this specification, for the sake of convenience, an intravaginal insertion device 1 as an example of an intracavity insertion device is exemplified below. However, the intracavity insertion device is not limited to the intravaginal insertion device 1, and may be a device that can be inserted into other body cavities other than the vagina. FIG. 1 shows a state in which an optical fiber 200a as a light emitting body 200 is inserted into the intravaginal insertion device 1. The medical device 100 can be used for treatment based on, for example, photodynamic therapy (PDT) or photoimmunotherapy (PIT).
如图1所示，阴道内插入装置1在远位端部具备能够插入于作为体腔内的阴道内的插入部11。以下，为了便于说明，将与阴道内插入装置1的中心轴线O平行的长度方向记载为“阴道内插入装置1的轴向A”或简称为“轴向A”。另外，将围绕阴道内插入装置1的中心轴线O的方向记载为“阴道内插入装置1的周向B”或简称为“周向B”。此外，将围绕阴道内插入装置1的中心轴线O的圆的半径方向记载为“阴道内插入装置1的径向C”或简称为“径向C”。As shown in FIG1 , the intravaginal insertion device 1 has an insertion portion 11 at the distal end portion that can be inserted into the vagina, which is a body cavity. Hereinafter, for the sake of convenience, the length direction parallel to the central axis O of the intravaginal insertion device 1 is recorded as "axial direction A of the intravaginal insertion device 1" or simply "axial direction A". In addition, the direction around the central axis O of the intravaginal insertion device 1 is recorded as "circumferential direction B of the intravaginal insertion device 1" or simply "circumferential direction B". In addition, the radial direction of the circle around the central axis O of the intravaginal insertion device 1 is recorded as "radial direction C of the intravaginal insertion device 1" or simply "radial direction C".
阴道内插入装置1的插入部11在阴道内插入装置1的周向B的一部分上具备可从内部向外部照射光的光照射部12。详情后述，本实施方式的光照射部12是能够使作为插入于插入部11的内部的发光体200的光纤200a的光透过的光透过窗12a。另外，详情后述，本实施方式的插入部11具备能够在阴道内扩张的球囊13。而且，作为本实施方式的光照射部12的光透过窗12a设置于球囊13。The insertion portion 11 of the intravaginal insertion device 1 is provided with a light irradiation portion 12 capable of irradiating light from the inside to the outside, on a portion of the circumferential direction B of the intravaginal insertion device 1. As will be described in detail later, the light irradiation portion 12 of the present embodiment is a light transmission window 12a capable of transmitting light of an optical fiber 200a as a light emitting body 200 inserted in the interior of the insertion portion 11. In addition, as will be described in detail later, the insertion portion 11 of the present embodiment is provided with a balloon 13 capable of expanding in the vagina. Moreover, the light transmission window 12a as the light irradiation portion 12 of the present embodiment is provided on the balloon 13.
如图1所示，保持装置2构成为能够在比阴道内插入装置1的插入部11靠近位侧的位置保持阴道内插入装置1。换言之，保持装置2能够保持阴道内插入装置1中的未被插入阴道内而延伸至体外的部分。在图1中，示出保持装置2在比插入部11靠近位侧的位置保持阴道内插入装置1的状态。As shown in FIG. 1 , the holding device 2 is configured to hold the intravaginal insertion device 1 at a position closer to the position side than the insertion portion 11 of the intravaginal insertion device 1. In other words, the holding device 2 can hold a portion of the intravaginal insertion device 1 that is not inserted into the vagina and extends outside the body. FIG. 1 shows a state in which the holding device 2 holds the intravaginal insertion device 1 at a position closer to the position side than the insertion portion 11.
保持装置2伴随阴道内插入装置1在周向B上的回转而动作，具备显示光照射部12在周向B上的位置的周向位置显示部31。图2是从图1所示的箭头I的位置观察到的保持装置2的俯视图。图3是在图1所示的II-II线的位置处的医疗器具100的剖面图。本实施方式的周向位置显示部31是伴随阴道内插入装置1在周向B上的回转而回转的回转标记，详情后述。作为周向位置显示部31的回转标记构成为能够以仅与阴道内插入装置1在周向B上的旋转角相等的角度回转。对于作为本实施方式的周向位置显示部31的回转标记而言，其通过包含第1齿轮32a及第2齿轮32b的齿轮组32而被传导阴道内插入装置1在周向B上的回转扭矩，详情后述。在图1～图3中，作为齿轮组32，示意性地示出了第1齿轮32a及第2齿轮32b，但实际的齿数、节圆直径等也可以适当地设计，以使作为周向位置显示部31的回转标记以仅与阴道内插入装置1在周向B上的旋转角相等的角度回转。The retaining device 2 moves along with the rotation of the intravaginal insertion device 1 in the circumferential direction B, and has a circumferential position display portion 31 that displays the position of the light irradiation portion 12 in the circumferential direction B. FIG. 2 is a top view of the retaining device 2 observed from the position of the arrow I shown in FIG. 1 . FIG. 3 is a cross-sectional view of the medical device 100 at the position of the II-II line shown in FIG. 1 . The circumferential position display portion 31 of the present embodiment is a rotation mark that rotates along with the rotation of the intravaginal insertion device 1 in the circumferential direction B, and the details will be described later. The rotation mark as the circumferential position display portion 31 is configured to be able to rotate at an angle equal to the rotation angle of the intravaginal insertion device 1 in the circumferential direction B. As for the rotation mark as the circumferential position display portion 31 of the present embodiment, the rotation torque of the intravaginal insertion device 1 in the circumferential direction B is transmitted through the gear group 32 including the first gear 32a and the second gear 32b, and the details will be described later. In Figures 1 to 3, the first gear 32a and the second gear 32b are schematically shown as the gear group 32, but the actual number of teeth, pitch circle diameter, etc. can also be appropriately designed so that the rotation mark serving as the circumferential position display portion 31 rotates at an angle equal to the rotation angle of the intravaginal insertion device 1 only in the circumferential direction B.
图4A～图4D是示出使用了医疗器具100的治疗方法的一例的图。4A to 4D are diagrams showing an example of a treatment method using the medical device 100 .
首先，对图4A～图4D所示的治疗方法的整体概要进行说明。在该治疗方法中，首先，向患者给予作为药剂的感光性物质，使感光性物质聚集在癌组织等光照射的对象部位X。然后，根据需要对患者实施局部麻醉或全身麻醉。然后，使用阴道镜70，从阴道口确认阴道400内的对象部位X的位置。之后，将医疗器具100的阴道内插入装置1的插入部11插入阴道400内(参见图4A)。如上所述，本实施方式的插入部11具备球囊13。在插入部11被插入于阴道400内时，球囊13处于收缩状态。插入部11被插入于阴道400内直至其远位端抵靠于子宫口300的周围的位置(参见图4B)。然后，根据需要，一边使用回波等图像诊断装置来确认阴道内插入装置1在阴道400内的位置，一边使阴道内插入装置1沿周向B回转。此时，使用保持装置2的周向位置显示部31来调整插入部11的光照射部12在周向B上的位置。由此，插入部11的光照射部12在周向B上的位置被对位于阴道400内的光照射的对象部位X(参见图4C)。然后，阴道镜70被拔去。然后，使插入部11的球囊13扩张，使其从收缩状态成为扩张状态(参见图4D)。但是，阴道镜70也可以在使插入部11的球囊13扩张后从阴道400内拔去。之后，从阴道内插入装置1的近位端侧向球囊13内插入作为发光体200的光纤200a(参见图4D)。然后，利用光纤200a，穿过设置于球囊13的作为光照射部12的光透过窗12a，对对象部位X进行光照射。例如，在对象部位X的范围宽的情况下，也可以使阴道内插入装置1移动或回转，对多个部位进行光照射。例如，也可以通过使阴道内插入装置1沿轴向A移动，在轴向A上分多次对对象部位X进行光照射。另外，也可以通过使阴道内插入装置1在周向B上回转，在周向B上分多次对对象部位X进行光照射。此外，可将阴道内插入装置1在轴向A上的移动和在周向B上的回转组合。对象部位X的光照射完成后，将阴道内插入装置1的插入部11拔出到阴道400外。First, the overall outline of the treatment method shown in Figures 4A to 4D is described. In this treatment method, first, a photosensitive substance as a drug is administered to the patient, and the photosensitive substance is accumulated in the target site X of light irradiation such as cancer tissue. Then, local anesthesia or general anesthesia is applied to the patient as needed. Then, the position of the target site X in the vagina 400 is confirmed from the vaginal opening using a colposcope 70. Thereafter, the insertion portion 11 of the intravaginal insertion device 1 of the medical device 100 is inserted into the vagina 400 (see Figure 4A). As described above, the insertion portion 11 of the present embodiment is provided with a balloon 13. When the insertion portion 11 is inserted into the vagina 400, the balloon 13 is in a contracted state. The insertion portion 11 is inserted into the vagina 400 until its distal end abuts against a position around the cervical 300 (see Figure 4B). Then, as needed, the position of the intravaginal insertion device 1 in the vagina 400 is confirmed using an image diagnostic device such as an echo while the intravaginal insertion device 1 is rotated in the circumferential direction B. At this time, the position of the light irradiation part 12 of the insertion part 11 in the circumferential direction B is adjusted using the circumferential position display part 31 of the holding device 2. Thus, the position of the light irradiation part 12 of the insertion part 11 in the circumferential direction B is aligned with the target part X of the light irradiation in the vagina 400 (see FIG. 4C). Then, the colposcope 70 is pulled out. Then, the balloon 13 of the insertion part 11 is expanded so that it changes from a contracted state to an expanded state (see FIG. 4D). However, the colposcope 70 may be pulled out from the vagina 400 after the balloon 13 of the insertion part 11 is expanded. Thereafter, the optical fiber 200a as the light emitting body 200 is inserted into the balloon 13 from the proximal end side of the intravaginal insertion device 1 (see FIG. 4D). Then, the optical fiber 200a is used to pass through the light transmission window 12a as the light irradiation part 12 provided in the balloon 13 to irradiate the target part X with light. For example, in the case where the range of the target part X is wide, the intravaginal insertion device 1 may be moved or rotated to irradiate multiple parts with light. For example, the intravaginal insertion device 1 may be moved along the axial direction A to irradiate the target part X with light in multiple times in the axial direction A. Alternatively, the intravaginal insertion device 1 may be rotated in the circumferential direction B to irradiate the target part X with light in multiple times in the circumferential direction B. Furthermore, the movement of the intravaginal insertion device 1 in the axial direction A and the rotation in the circumferential direction B may be combined. After the light irradiation of the target part X is completed, the insertion portion 11 of the intravaginal insertion device 1 is pulled out of the vagina 400.
图4A是示出在上述一系列的工序中医疗器具100的阴道内插入装置1的插入部11即将被插入于阴道400内之前的状态的图。图4B是示出在上述一系列的工序中医疗器具100的阴道内插入装置1的插入部11被插入于阴道400内后的状态的图。Fig. 4A is a diagram showing a state immediately before the insertion portion 11 of the intravaginal insertion device 1 of the medical device 100 is inserted into the vagina 400 in the above series of steps. Fig. 4B is a diagram showing a state after the insertion portion 11 of the intravaginal insertion device 1 of the medical device 100 is inserted into the vagina 400 in the above series of steps.
在图4B中，示出了收缩状态的球囊13被插入于阴道400内的例子，但也可以预先使球囊13从收缩状态成为扩张状态，使其保持扩张状态而被插入于阴道400内。FIG. 4B shows an example in which the balloon 13 in a deflated state is inserted into the vagina 400 . However, the balloon 13 may be expanded from the deflated state in advance and inserted into the vagina 400 while being kept in the expanded state.
图4C是示出在上述一系列的工序中在阴道400内将阴道内插入装置1沿周向B回转，将光照射部12在周向B上的位置对位于阴道400内的光照射的对象部位X的、对位工序的图。在该对位工序中，医务人员能够使用与阴道内插入装置1在周向B上的回转联动的、保持装置2的周向位置显示部31来识别光照射部12在周向B上的位置。即，能够从生物体外识别阴道400内的阴道内插入装置1的光照射位置。由此，容易调整阴道400内的光照射部12在周向B上的位置，其结果，容易将阴道400内的光照射部12在周向B上的位置对位于阴道400内的光照射的对象部位X。FIG. 4C is a diagram showing a positioning step of rotating the intravaginal insertion device 1 in the circumferential direction B in the vagina 400 and aligning the position of the light irradiation section 12 in the circumferential direction B with the target site X for light irradiation located in the vagina 400 in the above series of steps. In this positioning step, medical personnel can identify the position of the light irradiation section 12 in the circumferential direction B using the circumferential position display section 31 of the holding device 2 that is linked to the rotation of the intravaginal insertion device 1 in the circumferential direction B. That is, the light irradiation position of the intravaginal insertion device 1 in the vagina 400 can be identified from outside the body. As a result, it is easy to adjust the position of the light irradiation section 12 in the circumferential direction B in the vagina 400, and as a result, it is easy to align the position of the light irradiation section 12 in the circumferential direction B in the vagina 400 with the target site X for light irradiation located in the vagina 400.
图4D是示出在上述一系列的工序中，从阴道内插入装置1的插入部11的光照射部12向对象部位X照射光的光照射工序的图。聚集在癌组织等对象部位X的感光性物质能够引发光化学反应，使癌细胞变性或坏死。如图4D所示，通过将作为光照射部12的光透过窗12a设置于球囊13，能够使球囊13扩张，使作为光照射部12的光透过窗12a密合于对象部位X。因此，能够穿过作为光照射部12的光透过窗12a而利用光纤200a对对象部位X集中地进行光照射。FIG4D is a diagram showing a light irradiation process in which light is irradiated from the light irradiation section 12 of the insertion section 11 of the intravaginal insertion device 1 to the target part X in the above series of processes. The photosensitive substance gathered in the target part X such as cancer tissue can induce a photochemical reaction, causing cancer cells to denature or necrotize. As shown in FIG4D, by providing the light transmission window 12a as the light irradiation section 12 in the balloon 13, the balloon 13 can be expanded so that the light transmission window 12a as the light irradiation section 12 is closely attached to the target part X. Therefore, the target part X can be irradiated with light in a concentrated manner using the optical fiber 200a through the light transmission window 12a as the light irradiation section 12.
上述一系列的工序还可以包括发光体定位工序，其中，在将作为发光体200的光纤200a插入球囊13内时，通过使发光体200与后述的封闭部件23(参见图1)抵靠，从而进行发光体200在球囊13内的在轴向A上的定位。但是，该发光体定位工序不限于上述方法。发光体定位工序例如也可以通过以将设置于作为发光体200的光纤200a的基端侧的标记的位置配置为与设置于保持装置的标记的位置一致的方式来执行。The above series of steps may also include a light-emitting body positioning step, wherein, when the optical fiber 200a as the light-emitting body 200 is inserted into the balloon 13, the light-emitting body 200 is abutted against the sealing member 23 (see FIG. 1 ) described later, thereby positioning the light-emitting body 200 in the axial direction A in the balloon 13. However, the light-emitting body positioning step is not limited to the above method. The light-emitting body positioning step may also be performed, for example, by configuring the position of a mark provided on the base end side of the optical fiber 200a as the light-emitting body 200 to be consistent with the position of a mark provided on the holding device.
如上所述，在医疗器具100中，被插入于阴道内插入装置1的阴道400内的插入部11在周向B的一部分具备能够从内部向外部照射光的光照射部12。而且，在医疗器具100中，保持装置2具备伴随阴道内插入装置1在周向B上的回转而动作、对光照射部12在周向B上的位置进行显示的周向位置显示部31。因此，根据医疗器具100，通过使用保持装置2的周向位置显示部31，能够从生物体外识别阴道400内的阴道内插入装置1的光照射位置。由此，容易调整阴道400内的光照射部12在周向B上的位置。其结果，容易将阴道400内的光照射部12在周向B上的位置对位于阴道400内的光照射的对象部位X。As described above, in the medical device 100, the insertion portion 11 inserted into the vagina 400 of the intravaginal insertion device 1 is provided with the light irradiation portion 12 capable of irradiating light from the inside to the outside in a part of the circumferential direction B. Furthermore, in the medical device 100, the holding device 2 is provided with the circumferential position display portion 31 that operates with the rotation of the intravaginal insertion device 1 in the circumferential direction B and displays the position of the light irradiation portion 12 in the circumferential direction B. Therefore, according to the medical device 100, by using the circumferential position display portion 31 of the holding device 2, the light irradiation position of the intravaginal insertion device 1 in the vagina 400 can be recognized from outside the body. Thus, it is easy to adjust the position of the light irradiation portion 12 in the vagina 400 in the circumferential direction B. As a result, it is easy to adjust the position of the light irradiation portion 12 in the vagina 400 in the circumferential direction B to the target site X for light irradiation located in the vagina 400.
在此，阴道400内的光照射的对象部位X的位置使用阴道镜70(参见图4A等)在利用医疗器具100进行的治疗前预先通过目视来掌握。另外，阴道400内的光照射的对象部位X的位置例如也可以通过内窥镜、回波装置、CT、MRI等方法在利用医疗器具100的治疗前预先确定、或者从利用医疗器具100的治疗前起在治疗中持续确定。另外，根据对象部位X的位置，也可以在利用医疗器具100的治疗中也保持为将阴道镜70配置于阴道400内的状态。在上述情况下，也可以从利用医疗器具100的治疗前起在治疗中也持续使用阴道镜70来确认对象部位X的位置。Here, the position of the target site X for light irradiation in the vagina 400 is visually grasped in advance before the treatment using the medical device 100 using the colposcope 70 (see FIG. 4A , etc.). In addition, the position of the target site X for light irradiation in the vagina 400 may be determined in advance before the treatment using the medical device 100 using methods such as an endoscope, an echo device, CT, MRI, etc., or may be continuously determined during the treatment from before the treatment using the medical device 100. In addition, depending on the position of the target site X, the colposcope 70 may be kept in the state of being arranged in the vagina 400 during the treatment using the medical device 100. In the above case, the position of the target site X may be confirmed using the colposcope 70 from before the treatment using the medical device 100 and during the treatment.
另外，本实施方式的插入部11的光照射部12是能够使被插入于插入部11的内部的发光体200的光透过的光透过窗12a，但不限于该构成。光照射部12也可以是能够使被插入于插入部11的内部的发光体200的光通过的开口。而且，光照射部12例如也可以包括发光体本身。即，阴道内插入装置1也可以在插入部11的周向B的一部分具备能够朝向径向C的外侧进行光照射的、作为光照射部12的发光部。反过来而言，阴道内插入装置1也可以不具备发光体本身。如本实施方式那样，在阴道内插入装置1不具备发光体200的情况下，医疗器具100与被另行插入于阴道内插入装置1的插入部11的发光体200一同使用。In addition, the light irradiation portion 12 of the insertion portion 11 of the present embodiment is a light transmission window 12a that allows light from the light emitting body 200 inserted inside the insertion portion 11 to pass through, but is not limited to this structure. The light irradiation portion 12 may also be an opening that allows light from the light emitting body 200 inserted inside the insertion portion 11 to pass through. Moreover, the light irradiation portion 12 may also include the light emitting body itself, for example. That is, the intravaginal insertion device 1 may also include a light emitting portion that can irradiate light toward the outside in the radial direction C as a light irradiation portion 12 in a part of the circumferential direction B of the insertion portion 11. Conversely, the intravaginal insertion device 1 may not include the light emitting body itself. As in the present embodiment, when the intravaginal insertion device 1 does not include the light emitting body 200, the medical device 100 is used together with the light emitting body 200 that is separately inserted into the insertion portion 11 of the intravaginal insertion device 1.
此外，本实施方式的插入部11具备球囊13，但不限于该构成。插入部11也可以不具备球囊13。不具备球囊13的插入部11例如也可以是在内部划分出能够插入发光体200的中空部、并在侧壁的一部分设置有光照射部12的管体。像这样，插入部11也可以不是能够扩张及收缩的构成。但是，通过使得插入部11具备球囊13、光照射部12形成于球囊13，由此，容易使光照射部12密合于阴道400内的对象部位X(参见图4A～图4D)。由此，能够提高向对象部位X的光照射效率。In addition, the insertion portion 11 of the present embodiment is provided with a balloon 13, but is not limited to this structure. The insertion portion 11 may not be provided with the balloon 13. The insertion portion 11 without the balloon 13 may be, for example, a tube body having a hollow portion in which the light emitting body 200 can be inserted, and having a light irradiation portion 12 provided on a portion of the side wall. In this way, the insertion portion 11 may not be a structure capable of expansion and contraction. However, by providing the insertion portion 11 with the balloon 13 and forming the light irradiation portion 12 on the balloon 13, it is easy to make the light irradiation portion 12 fit closely to the target part X in the vagina 400 (see FIGS. 4A to 4D ). As a result, the efficiency of light irradiation to the target part X can be improved.
另外，如图1～图3所示，本实施方式的周向位置显示部31是经由齿轮组32而被传导阴道内插入装置1在周向B上的回转扭矩的构成，但不限于该构成。只要是伴随阴道内插入装置1在周向B上的回转而动作、对阴道内插入装置1的光照射部12在周向B上的位置进行显示的构成即可，周向位置显示部31例如也可以使用电能来控制位置。但是，周向位置显示部31优选如本实施方式那样以机械的方式控制位置。由此，容易通过简单的构成实现周向位置显示部31。In addition, as shown in FIGS. 1 to 3 , the circumferential position display unit 31 of the present embodiment is a structure in which the rotational torque of the intravaginal insertion device 1 in the circumferential direction B is transmitted via the gear set 32, but is not limited to this structure. As long as the structure is a structure that moves along with the rotation of the intravaginal insertion device 1 in the circumferential direction B and displays the position of the light irradiation unit 12 of the intravaginal insertion device 1 in the circumferential direction B, the circumferential position display unit 31 may also use electrical energy to control the position, for example. However, the circumferential position display unit 31 is preferably mechanically controlled as in the present embodiment. Thus, the circumferential position display unit 31 can be easily realized by a simple structure.
以下，对本实施方式的医疗器具100的进一步的详细内容进行说明。Hereinafter, the medical device 100 according to the present embodiment will be described in further detail.
本实施方式的阴道内插入装置1具备插入部11、和与该插入部11的近位侧相连并在插入部11被插入于阴道400(参见图4A～图4D)内的状态下向生物体外延伸的操作部14。保持装置2能够保持操作部14。The intravaginal insertion device 1 of this embodiment includes an insertion portion 11 and an operation portion 14 connected to the proximal side of the insertion portion 11 and extending outside the body when the insertion portion 11 is inserted into the vagina 400 (see FIGS. 4A to 4D ).
更具体而言，本实施方式的阴道内插入装置1具备球囊13和轴15。轴15从阴道内插入装置1的近位端延伸至远位端。球囊13被安装于轴15的远位端部。本实施方式的插入部11由球囊13、和轴15的远位端部构成。另外，本实施方式的操作部14由轴15中的、位于比球囊13靠近位侧的部分构成。在此，本实施方式的阴道内插入装置1的中心轴线O是轴15的中心轴线。即，本实施方式的阴道内插入装置1的轴向A与平行于轴15的中心轴线的方向相同。另外，本实施方式的阴道内插入装置1的周向B与围绕轴15的中心轴线的方向相同。此外，本实施方式的阴道内插入装置1的径向C与围绕轴15的中心轴线的圆的半径方向相同。More specifically, the intravaginal insertion device 1 of the present embodiment includes a balloon 13 and a shaft 15. The shaft 15 extends from the proximal end to the distal end of the intravaginal insertion device 1. The balloon 13 is mounted on the distal end of the shaft 15. The insertion portion 11 of the present embodiment is composed of the balloon 13 and the distal end of the shaft 15. In addition, the operating portion 14 of the present embodiment is composed of a portion of the shaft 15 that is located closer to the side than the balloon 13. Here, the central axis O of the intravaginal insertion device 1 of the present embodiment is the central axis of the shaft 15. That is, the axial direction A of the intravaginal insertion device 1 of the present embodiment is the same as the direction parallel to the central axis of the shaft 15. In addition, the circumferential direction B of the intravaginal insertion device 1 of the present embodiment is the same as the direction around the central axis of the shaft 15. In addition, the radial direction C of the intravaginal insertion device 1 of the present embodiment is the same as the radial direction of the circle around the central axis of the shaft 15.
更具体而言，轴15在内部划分有能够供作为发光体200的光纤200a插入的光纤管腔15a、和能够向球囊13内供给空气等流体的充胀管腔15b。本实施方式的轴15具备内管16和外管17。内管16及外管17配置成同心圆状。内管16与外管17相比向远位侧突出。光纤管腔15a被划分在内管16内。光纤管腔15a的远位端被封闭部件23封闭。充胀管腔15b被划分于外管17的内表面与内管16的外表面之间。More specifically, the shaft 15 is internally divided into an optical fiber lumen 15a into which an optical fiber 200a as a light emitting body 200 can be inserted, and an inflation lumen 15b into which a fluid such as air can be supplied to the balloon 13. The shaft 15 of this embodiment includes an inner tube 16 and an outer tube 17. The inner tube 16 and the outer tube 17 are arranged in a concentric circle. The inner tube 16 protrudes toward the distal side compared to the outer tube 17. The optical fiber lumen 15a is divided inside the inner tube 16. The distal end of the optical fiber lumen 15a is closed by a closing member 23. The inflation lumen 15b is divided between the inner surface of the outer tube 17 and the outer surface of the inner tube 16.
本实施方式的球囊13由安装于轴15的膜体形成。具体而言，形成球囊13的膜体是在轴15的远位端部的径向C上覆盖轴15的远位端部的周向B整个区域的环状的膜体。该膜体的远位端部在周向B的整个区域通过粘接等接合于内管16的远位端部。另外，该膜体的近位端部在周向B的整个区域通过粘接等接合于外管17的远位端部。而且，膜体的远位端部与近位端部之间未接合于轴15的内管16，在与内管16之间划分出能够收容流体的环状空间13a(参见图1)。被划分于内管16与外管17之间的充胀管腔15b的远位开口与该环状空间13a连通。流体通过充胀管腔15b而被供给至环状空间13a，由此形成球囊13的膜体向径向C的外侧扩张。相反，流体通过充胀管腔15b而被从环状空间13a排出，由此形成球囊13的膜体向径向C的内侧收缩。The balloon 13 of this embodiment is formed by a membrane body mounted on the shaft 15. Specifically, the membrane body forming the balloon 13 is an annular membrane body that covers the entire circumferential B area of the distal end of the shaft 15 in the radial direction C of the distal end of the shaft 15. The distal end of the membrane body is bonded to the distal end of the inner tube 16 by bonding or the like in the entire area of the circumferential B. In addition, the proximal end of the membrane body is bonded to the distal end of the outer tube 17 by bonding or the like in the entire area of the circumferential B. Moreover, the distal end and the proximal end of the membrane body are not bonded to the inner tube 16 of the shaft 15, and an annular space 13a (see Figure 1) that can accommodate fluid is divided between the distal end and the proximal end of the membrane body. The distal opening of the inflation lumen 15b divided between the inner tube 16 and the outer tube 17 is connected to the annular space 13a. The fluid is supplied to the annular space 13a through the inflation lumen 15b, thereby forming the membrane body of the balloon 13 to expand outward in the radial direction C. On the contrary, the fluid is discharged from the annular space 13 a through the inflation lumen 15 b , whereby the membrane forming the balloon 13 contracts inward in the radial direction C.
如上所述，在轴15的光纤管腔15a中插入作为发光体200的光纤200a。光纤200a被插入至球囊13内的位置。本实施方式的划分出光纤管腔15a的内管16例如由能够使光透过的透明的树脂材料形成即可。另外，也可以在内管16上形成例如能够使光通过的开口。As described above, the optical fiber 200a as the light emitting body 200 is inserted into the optical fiber lumen 15a of the shaft 15. The optical fiber 200a is inserted to a position in the balloon 13. The inner tube 16 that divides the optical fiber lumen 15a of the present embodiment can be formed of, for example, a transparent resin material that can transmit light. In addition, an opening that can allow light to pass can also be formed on the inner tube 16.
轴15的内管16及外管17的形成材料没有特别限定，例如可以是树脂材料。作为内管16及外管17的形成材料的树脂材料，例如可举出：聚乙烯、聚丙烯、乙烯-丙烯共聚物等聚烯烃；乙烯-乙酸乙烯酯共聚物(EVA)；聚氯乙烯；聚偏氯乙烯；聚苯乙烯；聚酰胺；聚酰亚胺；聚酰胺酰亚胺；聚碳酸酯；聚-(4-甲基戊烯-1)；离聚物；丙烯酸树脂；聚甲基丙烯酸甲酯；丙烯腈-丁二烯-苯乙烯共聚物(ABS树脂)；丙烯腈-苯乙烯共聚物(AS树脂)；丁二烯-苯乙烯共聚物；聚对苯二甲酸乙二醇酯(PET)、聚对苯二甲酸丁二醇酯(PBT)、聚对苯二甲酸环己烷二甲醇酯(PCT)等聚酯；聚醚；聚醚酮(PEK)；聚醚醚酮(PEEK)；聚醚酰亚胺；聚缩醛(POM)；聚苯醚；改性聚苯醚；聚砜；聚醚砜；聚苯硫醚；聚芳酯；芳香族聚酯(液晶聚合物)；聚四氟乙烯、聚偏氟乙烯、其他氟系树脂；等各种树脂材料。另外，也可以是包含这些中的1种以上的共混物。另外，外管17也可以是不锈钢、铁、镍钛合金、铝等金属。通过将外管17设为金属制，与设为树脂制的构成相比，能够期待小径化、刚性的提高带来的操作性的提高。The material forming the inner tube 16 and the outer tube 17 of the shaft 15 is not particularly limited, and may be, for example, a resin material. Examples of the resin material forming the inner tube 16 and the outer tube 17 include: polyolefins such as polyethylene, polypropylene, and ethylene-propylene copolymers; ethylene-vinyl acetate copolymers (EVA); polyvinyl chloride; polyvinylidene chloride; polystyrene; polyamide; polyimide; polyamideimide; polycarbonate; poly-(4-methylpentene-1); ionomer; acrylic resin; polymethyl methacrylate; acrylonitrile-butadiene-styrene copolymers (ABS resins); acrylonitrile-styrene copolymers (AS resins); Resins); butadiene-styrene copolymers; polyesters such as polyethylene terephthalate (PET), polybutylene terephthalate (PBT), and polycyclohexanedimethanol terephthalate (PCT); polyether; polyether ketone (PEK); polyetheretherketone (PEEK); polyetherimide; polyacetal (POM); polyphenylene ether; modified polyphenylene ether; polysulfone; polyethersulfone; polyphenylene sulfide; polyarylate; aromatic polyester (liquid crystal polymer); polytetrafluoroethylene, polyvinylidene fluoride, and other fluorine-based resins; and other various resin materials. In addition, it may also be a blend containing one or more of these. In addition, the outer tube 17 may also be a metal such as stainless steel, iron, nickel-titanium alloy, and aluminum. By making the outer tube 17 into a metal, compared with a structure made of a resin, it can be expected that the operability will be improved due to a smaller diameter and an increase in rigidity.
本实施方式的轴15是具备呈同心圆状配置的内管16及外管17的双重管结构，但不限于该构成。轴15例如也可以划分出在内部并列且呈直线状延伸的光纤管腔15a及充胀管腔15b。The shaft 15 of this embodiment has a double tube structure including an inner tube 16 and an outer tube 17 arranged concentrically, but is not limited to this structure. The shaft 15 may be divided into, for example, an optical fiber lumen 15a and an inflation lumen 15b extending linearly in parallel therein.
另外，本实施方式的轴15具备向径向C的外侧突出的2个环状凸部20a、20b。本实施方式的2个环状凸部20a、20b从轴15的外管17的外表面向径向C的外侧突出。另外，2个环状凸部20a、20b配置于在轴向A上分离的位置。在轴向A上的2个环状凸部20a、20b之间配置有保持装置2的后述的操作杆33。In addition, the shaft 15 of the present embodiment includes two annular protrusions 20a and 20b protruding outward in the radial direction C. The two annular protrusions 20a and 20b of the present embodiment protrude outward in the radial direction C from the outer surface of the outer tube 17 of the shaft 15. In addition, the two annular protrusions 20a and 20b are arranged at positions separated in the axial direction A. Between the two annular protrusions 20a and 20b in the axial direction A, an operating rod 33 of the retaining device 2 described later is arranged.
如图1所示，本实施方式的球囊13具备作为光照射部12的光透过窗12a。更具体而言，本实施方式的球囊13仅在周向B的一部分具备光透过窗12a。换言之，本实施方式的球囊13中的形成有光透过窗12a的周向B的一部分以外的部分是不使光透过而将其反射的光反射部24。因此，在球囊13内且在内管16内发光的光纤200a的光透过内管16，穿过仅形成于球囊13的周向B的一部分的光透过窗12a而朝向球囊13的径向C的外侧照射。相反，透过内管16而到达球囊13的光反射部24的光纤200a的光不透过而反射，在光反射部24的位置处几乎不朝向球囊13的径向C的外侧照射。像这样，本实施方式的插入部11具备具有能够仅在周向B的一部分朝向径向C的外侧照射光的指向性的光照射部12。As shown in FIG. 1 , the balloon 13 of the present embodiment includes a light transmission window 12a as a light irradiation section 12. More specifically, the balloon 13 of the present embodiment includes the light transmission window 12a only in a portion in the circumferential direction B. In other words, the portion of the balloon 13 of the present embodiment other than the portion in the circumferential direction B where the light transmission window 12a is formed is a light reflection section 24 that does not transmit light but reflects it. Therefore, the light of the optical fiber 200a that emits light in the balloon 13 and in the inner tube 16 transmits the inner tube 16, passes through the light transmission window 12a formed only in a portion in the circumferential direction B of the balloon 13, and is irradiated toward the outside of the radial direction C of the balloon 13. On the contrary, the light of the optical fiber 200a that transmits the inner tube 16 and reaches the light reflection section 24 of the balloon 13 is not transmitted but reflected, and is hardly irradiated toward the outside of the radial direction C of the balloon 13 at the position of the light reflection section 24. In this way, the insertion section 11 of the present embodiment includes a light irradiation section 12 having directivity that can irradiate light toward the outside of the radial direction C only in a portion in the circumferential direction B.
构成球囊13的膜体例如具备由光透过性材料形成的光透过层18a、和层叠于该光透过层18a的由光反射材料形成的光反射层18b。作为光透过性材料，例如可举出聚对苯二甲酸乙二醇酯、聚氨酯、尼龙等树脂材料。作为光反射材料，例如可举出氧化钛、硫酸钡、氧化锌等各种金属材料。由光反射材料形成的光反射层18b例如可以在上述光透过层18a的表面通过涂布而形成。涂布方法没有特别限定，例如可以使用浸渍法、喷涂法、辊涂法、丝网印刷法等。作为本实施方式的球囊13的光照射部12的光透过窗12a由在上述光透过层18a上未层叠有光反射层18b的部位构成。另外，本实施方式的球囊13的光反射部24由在上述光透过层18a上层叠有光反射层18b的部位构成。但是，球囊13的光透过窗12a及光反射部24的构成没有特别限定，不限于基于上述的光透过层18a及光反射层18b的构成。The membrane body constituting the balloon 13, for example, comprises a light-transmitting layer 18a formed of a light-transmitting material, and a light-reflecting layer 18b formed of a light-reflecting material laminated on the light-transmitting layer 18a. As the light-transmitting material, for example, resin materials such as polyethylene terephthalate, polyurethane, and nylon can be cited. As the light-reflecting material, for example, various metal materials such as titanium oxide, barium sulfate, and zinc oxide can be cited. The light-reflecting layer 18b formed of the light-reflecting material can be formed, for example, by coating on the surface of the light-transmitting layer 18a. The coating method is not particularly limited, and for example, a dipping method, a spraying method, a roller coating method, a screen printing method, etc. can be used. The light-transmitting window 12a of the light-irradiating portion 12 of the balloon 13 of this embodiment is composed of a portion on which the light-reflecting layer 18b is not laminated on the light-transmitting layer 18a. In addition, the light-reflecting portion 24 of the balloon 13 of this embodiment is composed of a portion on which the light-reflecting layer 18b is laminated on the light-transmitting layer 18a. However, the configurations of the light transmission window 12 a and the light reflection portion 24 of the balloon 13 are not particularly limited, and are not limited to the configurations based on the light transmission layer 18 a and the light reflection layer 18 b described above.
进一步地，如图1所示，本实施方式的球囊13具备大致圆筒状的筒壁部13b、与该筒壁部13b的远位侧相连的远位壁部13c、以及与筒壁部13b的近位侧相连的近位壁部13d。而且，作为本实施方式的光照射部12的光透过窗12a仅形成于筒壁部13b的周向B的一部分。即，在本实施方式的球囊13的远位壁部13c及近位壁部13d，未形成作为光照射部12的光透过窗12a。换言之，本实施方式的球囊13的远位壁部13c及近位壁部13d由光反射部24构成。像这样，球囊13的光照射部12可以仅形成于筒壁部13b的周向B的一部分。但是，球囊13的光照射部12的形成区域不限于上述区域。球囊13的光照射部12例如也可以仅在球囊13的周向B的一部分从筒壁部13b起至远位壁部13c为止的范围形成。这样的构成后面叙述(参见图6A)。Furthermore, as shown in FIG. 1 , the balloon 13 of the present embodiment includes a substantially cylindrical wall portion 13b, a distal wall portion 13c connected to the distal side of the wall portion 13b, and a proximal wall portion 13d connected to the proximal side of the wall portion 13b. Moreover, the light transmission window 12a as the light irradiation portion 12 of the present embodiment is formed only in a portion of the circumferential direction B of the wall portion 13b. That is, the light transmission window 12a as the light irradiation portion 12 is not formed in the distal wall portion 13c and the proximal wall portion 13d of the balloon 13 of the present embodiment. In other words, the distal wall portion 13c and the proximal wall portion 13d of the balloon 13 of the present embodiment are constituted by the light reflecting portion 24. In this way, the light irradiation portion 12 of the balloon 13 can be formed only in a portion of the circumferential direction B of the wall portion 13b. However, the formation area of the light irradiation portion 12 of the balloon 13 is not limited to the above-mentioned area. The light irradiation portion 12 of the balloon 13 may be formed, for example, only in a portion of the balloon 13 in the circumferential direction B, ranging from the tube wall portion 13b to the distal wall portion 13c. Such a configuration will be described later (see FIG. 6A ).
如图1所示，在本实施方式的轴15的外管17的近位端部安装有毂部19。毂部19具备能够连接流体供给件的端口部19a。利用与端口部19a连接的流体供给件，能够穿过充胀管腔15b而向球囊13的环状空间13a供给流体。另外，本实施方式的毂部19划分有供内管16插通的贯通孔19b。As shown in FIG1 , a hub 19 is installed at the proximal end of the outer tube 17 of the shaft 15 of the present embodiment. The hub 19 has a port 19a to which a fluid supply member can be connected. The fluid supply member connected to the port 19a can supply fluid to the annular space 13a of the balloon 13 through the inflation lumen 15b. In addition, the hub 19 of the present embodiment is divided into a through hole 19b for the inner tube 16 to pass through.
在此，如图1所示，本实施方式的阴道内插入装置1的操作部14具备示出插入部11的光照射部12在周向B上的位置的标记部14a。图5是在图1的III-III线的位置处的医疗器具100的剖面图。在周向B上，标记部14a配置在与插入部11的光照射部12相同的位置。因此，使用医疗器具100的医务人员通过在生物体外掌握操作部14的标记部14a在周向B上的位置，由此能够识别在阴道400(参见图4A～图4D)内的插入部11的光照射部12在周向B上的位置。本实施方式的标记部14a配置在保持装置2的近位侧。因此，在从近位侧观察保持装置2的同时调整阴道内插入装置1在周向B上的位置的情况下，标记部14a特别有用。Here, as shown in FIG. 1 , the operation portion 14 of the intravaginal insertion device 1 of the present embodiment is provided with a marking portion 14a indicating the position of the light irradiation portion 12 of the insertion portion 11 in the circumferential direction B. FIG. 5 is a cross-sectional view of the medical device 100 at the position of the III-III line of FIG. 1 . In the circumferential direction B, the marking portion 14a is arranged at the same position as the light irradiation portion 12 of the insertion portion 11. Therefore, a medical staff using the medical device 100 can recognize the position of the light irradiation portion 12 of the insertion portion 11 in the circumferential direction B in the vagina 400 (see FIGS. 4A to 4D ) by grasping the position of the marking portion 14a of the operation portion 14 in the circumferential direction B outside the body. The marking portion 14a of the present embodiment is arranged on the proximal side of the retaining device 2. Therefore, the marking portion 14a is particularly useful in the case of adjusting the position of the intravaginal insertion device 1 in the circumferential direction B while observing the retaining device 2 from the proximal side.
更具体而言，本实施方式的标记部14a由从构成操作部14的轴15向径向C的外侧突出的环状凸缘部中的、经颜色区分的周向B的一部分构成，但并不限定于该构成。标记部14a例如也可以是仅在与插入部11的光照射部12在周向B上的位置相同位置从轴15向径向C的外侧突出的突出部。另外，标记部14a也可以是从轴15向径向C的外侧突出的环状凸缘部的、形成于与插入部11的光照射部12在周向B上的位置相同位置的切口部。像这样，标记部14a只要能够识别插入部11的光照射部12在周向B上的位置即可，其构成没有特别限定。More specifically, the marking portion 14a of the present embodiment is composed of a portion of the annular flange portion protruding from the shaft 15 constituting the operating portion 14 to the outside of the radial direction C and differentiated by color, but is not limited to this configuration. The marking portion 14a may be, for example, a protruding portion protruding from the shaft 15 to the outside of the radial direction C only at the same position as the position of the light irradiation portion 12 of the insertion portion 11 in the circumferential direction B. In addition, the marking portion 14a may also be a cutout portion of the annular flange portion protruding from the shaft 15 to the outside of the radial direction C, formed at the same position as the position of the light irradiation portion 12 of the insertion portion 11 in the circumferential direction B. As such, the marking portion 14a may be configured without particular limitation as long as it can identify the position of the light irradiation portion 12 of the insertion portion 11 in the circumferential direction B.
如图1所示，本实施方式的保持装置2除了上述的周向位置显示部31以及齿轮组32之外，还具备操作杆33和壳体34。As shown in FIG. 1 , the holding device 2 of the present embodiment includes an operating lever 33 and a housing 34 in addition to the circumferential position display portion 31 and the gear train 32 described above.
如图1～图3所示，本实施方式的齿轮组32具备第1齿轮32a及第2齿轮32b。本实施方式的第1齿轮32a追随阴道内插入装置1的轴15在周向B上的回转而在周向B上回转。本实施方式的轴15以能够相对第1齿轮32a而言沿轴向A移动的方式被插通于第1齿轮32a的中央开口。另外，轴15具备向径向C的外侧突出并向第1齿轮32a传导周向B上的扭矩的、1个以上的突起21。但是，第1齿轮32a只要是容许轴15在轴向A上的移动并传导轴15的周向B上的转矩的构成即可，没有特别限定。As shown in FIGS. 1 to 3 , the gear set 32 of the present embodiment includes a first gear 32a and a second gear 32b. The first gear 32a of the present embodiment rotates in the circumferential direction B following the rotation of the shaft 15 of the intravaginal insertion device 1 in the circumferential direction B. The shaft 15 of the present embodiment is inserted into the central opening of the first gear 32a in a manner that allows it to move in the axial direction A relative to the first gear 32a. In addition, the shaft 15 includes one or more protrusions 21 that protrude outward in the radial direction C and transmit the torque in the circumferential direction B to the first gear 32a. However, the first gear 32a is not particularly limited as long as it allows the shaft 15 to move in the axial direction A and transmits the torque in the circumferential direction B of the shaft 15.
本实施方式的第2齿轮32b与第1齿轮32a卡合，追随第1齿轮32a的回转而回转。对于作为与本实施方式的第2齿轮32b的回转轴线正交的平面的回转平面而言，其与作为与第1齿轮32a的回转轴线正交的平面的回转平面正交。具体而言，本实施方式的第1齿轮32a的回转平面是与轴向A正交的平面，与此相对，本实施方式的第2齿轮32b的回转平面是与轴向A平行的平面。The second gear 32b of the present embodiment is engaged with the first gear 32a, and rotates following the rotation of the first gear 32a. The rotation plane, which is a plane orthogonal to the rotation axis of the second gear 32b of the present embodiment, is orthogonal to the rotation plane, which is a plane orthogonal to the rotation axis of the first gear 32a. Specifically, the rotation plane of the first gear 32a of the present embodiment is a plane orthogonal to the axial direction A, whereas the rotation plane of the second gear 32b of the present embodiment is a plane parallel to the axial direction A.
本实施方式的周向位置显示部31包括圆盘部31a。该圆盘部31a与第2齿轮32b呈同心圆状地连结。即，当第2齿轮32b绕中心轴线回转仅规定角度时，圆盘部31a也绕中心轴线仅回转相同的规定角度。The circumferential position display unit 31 of this embodiment includes a disk portion 31a. The disk portion 31a is concentrically connected to the second gear 32b. That is, when the second gear 32b rotates around the central axis by a predetermined angle, the disk portion 31a also rotates around the central axis by the same predetermined angle.
像这样，本实施方式的齿轮组32能够将阴道内插入装置1在周向B上的回转传导至周向位置显示部31。而且，对于作为本实施方式的周向位置显示部31的回转标记而言，其构成为在阴道内插入装置1向周向B回转仅规定角度的情况下，绕中心轴线仅回转相同的规定角度。In this way, the gear train 32 of the present embodiment can transmit the rotation of the intravaginal insertion device 1 in the circumferential direction B to the circumferential position display portion 31. Moreover, the rotation mark as the circumferential position display portion 31 of the present embodiment is configured to rotate only by the same predetermined angle around the central axis when the intravaginal insertion device 1 rotates only by a predetermined angle in the circumferential direction B.
更具体而言，本实施方式的周向位置显示部31具备显示插入部11的光照射部12在周向B上的位置的标记部31a1。更具体而言，本实施方式的标记部31a1由上述圆盘部31a中的经颜色区分的周向B的一部分构成。但是，标记部31a1并不限定于该构成。标记部31a1例如也可以是在围绕第2齿轮32b的周向上指示插入部11的光照射部12在周向B上的位置的棒状部。另外，标记部31a1也可以是在圆盘部31a的、显示插入部11的光照射部12在周向B上的位置的位置形成的切口部。像这样，标记部31a1只要能够识别插入部11的光照射部12在周向B上的位置即可，其构成没有特别限定。More specifically, the circumferential position display portion 31 of the present embodiment includes a marking portion 31a1 that displays the position of the light irradiation portion 12 of the insertion portion 11 in the circumferential direction B. More specifically, the marking portion 31a1 of the present embodiment is composed of a portion of the circumferential direction B that is differentiated by color in the above-mentioned disc portion 31a. However, the marking portion 31a1 is not limited to this structure. The marking portion 31a1 may, for example, be a rod-shaped portion that indicates the position of the light irradiation portion 12 of the insertion portion 11 in the circumferential direction B in the circumferential direction around the second gear 32b. In addition, the marking portion 31a1 may also be a cutout portion formed at a position of the disc portion 31a that displays the position of the light irradiation portion 12 of the insertion portion 11 in the circumferential direction B. As described above, the marking portion 31a1 is not particularly limited in structure as long as it can identify the position of the light irradiation portion 12 of the insertion portion 11 in the circumferential direction B.
标记部31a1所示的方向被与阴道400(参见图4A～图4D)内的光照射部12在周向B上的位置相对应。例如，在标记部31a1显示轴向A的远位侧的情况下，光照射部12可以以在阴道400内朝向腹侧的方式被对应。相反，在标记部31a1显示轴向A的近位侧的情况下，光照射部12可以以在阴道400内朝向脊背侧的方式被对应。但是，标记部31a1所显示的方向所对应的周向B上的位置并不限定于上述例示的关系。The direction indicated by the marking portion 31a1 corresponds to the position of the light irradiation portion 12 in the circumferential direction B in the vagina 400 (see FIGS. 4A to 4D ). For example, in a case where the marking portion 31a1 indicates the distal side of the axial direction A, the light irradiation portion 12 may be corresponded in a manner facing the ventral side in the vagina 400. Conversely, in a case where the marking portion 31a1 indicates the proximal side of the axial direction A, the light irradiation portion 12 may be corresponded in a manner facing the dorsal side in the vagina 400. However, the position in the circumferential direction B corresponding to the direction indicated by the marking portion 31a1 is not limited to the relationship exemplified above.
本实施方式的保持装置2在轴向A上将阴道内插入装置1以能够相对移动的方式保持。但是，本实施方式的保持装置2的操作杆33以能够与阴道内插入装置1一同沿轴向A移动的方式被安装于阴道内插入装置1。如图2所示，本实施方式的操作杆33具备在壳体34的外部露出的把持部33a、和位于壳体34的内部并与阴道内插入装置1卡合的卡合部33b。把持部33a及卡合部33b通过壳体34的后述槽34a相连。如图1所示，卡合部33b位于阴道内插入装置1的2个环状凸部20a、20b之间。操作杆33能够在沿轴向A延伸的壳体34的槽34a内相对壳体34移动。当操作杆33在壳体34的槽34a内向轴向A的远位侧移动时，卡合部33b对一方的环状凸部20a进行推压，阴道内插入装置1也相对壳体34而言向轴向A的远位侧移动。相反，当操作杆33在壳体34的槽34a内向轴向A的近位侧移动时，卡合部33b推压另一方的环状凸部20b，阴道内插入装置1也相对壳体34而言向轴向A的近位侧移动。即，本实施方式的操作杆33能够与阴道内插入装置1在轴向A上相追随地移动。另外，本实施方式的操作杆33不与阴道内插入装置1在周向B上的回转干涉。The retaining device 2 of the present embodiment retains the intravaginal insertion device 1 in a relatively movable manner in the axial direction A. However, the operating rod 33 of the retaining device 2 of the present embodiment is mounted on the intravaginal insertion device 1 in a manner that it can move along the axial direction A together with the intravaginal insertion device 1. As shown in FIG2 , the operating rod 33 of the present embodiment includes a gripping portion 33a exposed outside the housing 34, and an engaging portion 33b located inside the housing 34 and engaged with the intravaginal insertion device 1. The gripping portion 33a and the engaging portion 33b are connected via a groove 34a of the housing 34 described later. As shown in FIG1 , the engaging portion 33b is located between the two annular protrusions 20a and 20b of the intravaginal insertion device 1. The operating rod 33 can move relative to the housing 34 in the groove 34a of the housing 34 extending along the axial direction A. When the operating rod 33 moves toward the distal side of the axial direction A in the groove 34a of the housing 34, the engaging portion 33b pushes the annular convex portion 20a on one side, and the intravaginal insertion device 1 also moves toward the distal side of the axial direction A relative to the housing 34. On the contrary, when the operating rod 33 moves toward the proximal side of the axial direction A in the groove 34a of the housing 34, the engaging portion 33b pushes the annular convex portion 20b on the other side, and the intravaginal insertion device 1 also moves toward the proximal side of the axial direction A relative to the housing 34. That is, the operating rod 33 of the present embodiment can move in tracking with the intravaginal insertion device 1 in the axial direction A. In addition, the operating rod 33 of the present embodiment does not interfere with the rotation of the intravaginal insertion device 1 in the circumferential direction B.
如图2所示，操作杆33的把持部33a具备标记部33a1。该标记部33a1对插入部11的光照射部12在轴向A上的位置以及光照射部12在轴向A上的范围进行显示。其详细情况在后面叙述。2 , the grip portion 33a of the operating rod 33 includes a marking portion 33a1 that indicates the position of the light irradiation portion 12 of the insertion portion 11 in the axial direction A and the range of the light irradiation portion 12 in the axial direction A. The details will be described later.
本实施方式的壳体34安装有上述的周向位置显示部31、齿轮组32以及操作杆33。即，作为本实施方式的周向位置显示部31的回转标记以能够相对壳体34而回转的方式被保持。另外，本实施方式的齿轮组32以能够相对壳体34而回转的方式被保持。进一步地，本实施方式的操作杆33在插通于壳体34的槽34a的状态下，以能够相对壳体34而沿轴向A移动的方式被保持。The housing 34 of the present embodiment is mounted with the above-mentioned circumferential position display section 31, the gear group 32, and the operating rod 33. That is, the rotation mark as the circumferential position display section 31 of the present embodiment is held in a manner that allows rotation relative to the housing 34. In addition, the gear group 32 of the present embodiment is held in a manner that allows rotation relative to the housing 34. Furthermore, the operating rod 33 of the present embodiment is held in a manner that allows movement in the axial direction A relative to the housing 34 while being inserted into the groove 34a of the housing 34.
在此，本实施方式的壳体34具备对与阴道内插入装置1在轴向A上的相对移动相伴的、光照射部12在轴向A上的移动量进行显示的刻度部34b。如上所述，本实施方式的操作杆33能够与阴道内插入装置1一同沿轴向A移动。即，通过操作杆33沿轴向A移动，由此阴道内插入装置1的插入部11的光照射部12也沿轴向A移动。因此，通过利用刻度部34b对操作杆33的把持部33a在轴向A上的移动量进行确认，由此能够识别阴道内插入装置1的光照射部12在轴向A上的移动量。像这样，能够使用刻度部34b来调整阴道内的光照射部12在轴向A上的移动量。即，本实施方式的壳体34的刻度部34b构成轴向移动量显示部40，其对与阴道内插入装置1相对保持装置2而言在轴向A上的相对移动相伴的、光照射部12在轴向A上的移动量进行显示。Here, the housing 34 of the present embodiment is provided with a scale portion 34b for displaying the amount of movement of the light irradiation portion 12 in the axial direction A accompanying the relative movement of the intravaginal insertion device 1 in the axial direction A. As described above, the operating rod 33 of the present embodiment can move in the axial direction A together with the intravaginal insertion device 1. That is, by the movement of the operating rod 33 in the axial direction A, the light irradiation portion 12 of the insertion portion 11 of the intravaginal insertion device 1 also moves in the axial direction A. Therefore, by confirming the amount of movement of the grip portion 33a of the operating rod 33 in the axial direction A using the scale portion 34b, the amount of movement of the light irradiation portion 12 of the intravaginal insertion device 1 in the axial direction A can be recognized. In this way, the amount of movement of the light irradiation portion 12 in the vagina in the axial direction A can be adjusted using the scale portion 34b. That is, the scale portion 34b of the housing 34 of the present embodiment constitutes an axial movement amount display portion 40, which displays the amount of movement of the light irradiation portion 12 in the axial direction A accompanying the relative movement of the intravaginal insertion device 1 in the axial direction A relative to the holding device 2.
另外，如上所述，本实施方式的操作杆33的把持部33a具备标记部33a1。本实施方式的标记部33a1是在轴向A上为长尺寸的线状标记。在本实施方式中，标记部33a1在轴向A上的长度示出光照射部12在轴向A上的范围。由此，通过使用标记部33a1和作为轴向移动量显示部40的刻度部34b，能够一并识别光照射部12在轴向A上的位置以及在该位置处利用光照射部12而被光照射的在轴向A上的范围。因此，例如，在一边使阴道内插入装置1沿轴向A移动、一边分多次对阴道400(参见图4A～图4D)内的对象部位X进行光照射的情况下，通过使用标记部33a1和作为轴向移动量显示部40的刻度部34b，能够适当地调整各次的光照射位置以及各次的光照射区域。In addition, as described above, the grip portion 33a of the operating rod 33 of the present embodiment is provided with the marking portion 33a1. The marking portion 33a1 of the present embodiment is a linear mark having a long dimension in the axial direction A. In the present embodiment, the length of the marking portion 33a1 in the axial direction A indicates the range of the light irradiation portion 12 in the axial direction A. Thus, by using the marking portion 33a1 and the scale portion 34b as the axial movement amount display portion 40, the position of the light irradiation portion 12 in the axial direction A and the range in the axial direction A irradiated with light by the light irradiation portion 12 at the position can be recognized at the same time. Therefore, for example, when the target area X in the vagina 400 (see FIGS. 4A to 4D ) is irradiated with light in multiple times while the intravaginal insertion device 1 is moved in the axial direction A, the light irradiation position and the light irradiation area of each time can be appropriately adjusted by using the marking portion 33a1 and the scale portion 34b as the axial movement amount display portion 40.
另外，本实施方式的壳体34具备安装于患者的处置台的安装部34c。本实施方式的安装部34c具备沿轴向A延伸的轴部34c1。处置台例如将壳体34的安装部34c的轴部34c1以能够沿轴向A移动的方式支承。由此，能够在壳体34的安装部34c的轴部34c1被支承于处置台的状态下，使医疗器具100相对处置台而言沿轴向A移动。需要说明的是，壳体34的安装部34c的构成没有特别限定。In addition, the housing 34 of the present embodiment includes a mounting portion 34c mounted on a treatment table for a patient. The mounting portion 34c of the present embodiment includes a shaft portion 34c1 extending in the axial direction A. The treatment table supports the shaft portion 34c1 of the mounting portion 34c of the housing 34 in a manner that allows movement in the axial direction A, for example. Thus, the medical device 100 can be moved in the axial direction A relative to the treatment table in a state where the shaft portion 34c1 of the mounting portion 34c of the housing 34 is supported on the treatment table. It should be noted that the configuration of the mounting portion 34c of the housing 34 is not particularly limited.
以下，对本实施方式的医疗器具100的各部的各种变形例进行说明。Various modifications of the components of the medical device 100 according to the present embodiment will be described below.
图6A是示出阴道内插入装置1的插入部11的一个变形例的图。图6A所示的插入部11具备球囊13，该球囊13具备作为光照射部12的光透过窗12a。如图6A所示，球囊13的光照射部12也可以仅在球囊13的周向B的一部分在从筒壁部13b至远位壁部13c的范围形成。由此，在阴道400(参见图4A～图4D)内，不仅是阴道壁，对于位于子宫口300(参见图4A～图4D)的周围的对象部位X，也变得容易利用光照射部12进行光照射。Fig. 6A is a diagram showing a modified example of the insertion portion 11 of the intravaginal insertion device 1. The insertion portion 11 shown in Fig. 6A includes a balloon 13, and the balloon 13 includes a light transmission window 12a as a light irradiation portion 12. As shown in Fig. 6A, the light irradiation portion 12 of the balloon 13 may be formed only in a portion of the circumferential direction B of the balloon 13 in the range from the tube wall portion 13b to the distal wall portion 13c. Thus, in the vagina 400 (see Figs. 4A to 4D), it becomes easy to irradiate light using the light irradiation portion 12 not only to the vaginal wall but also to the target area X located around the cervical 300 (see Figs. 4A to 4D).
图6B是示出使用了图6A所示的球囊13的情况下的周向位置显示部31的一个变形例的图。图6B所示的周向位置显示部31具备：第1标记部42，其示出光照射部12中的设置于筒壁部13b的部分在周向B上的位置；和第2标记部43，其示出光照射部12中的设置于远位壁部13c的部分在周向B上的位置及其在远位壁部13c内所占的范围。图6B所示的第1标记部42以及第2标记部43构成为能够通过颜色区分、以及经颜色区分的区域来识别，但只要能够识别即可，其构成没有特别限定。FIG6B is a diagram showing a modified example of the circumferential position display section 31 when the balloon 13 shown in FIG6A is used. The circumferential position display section 31 shown in FIG6B includes: a first marking section 42, which shows the position of the portion of the light irradiation section 12 provided on the cylindrical wall portion 13b in the circumferential direction B; and a second marking section 43, which shows the position of the portion of the light irradiation section 12 provided on the distal wall portion 13c in the circumferential direction B and the range occupied by the portion in the distal wall portion 13c. The first marking section 42 and the second marking section 43 shown in FIG6B are configured to be identifiable by color distinction and color-differentiated areas, but their configuration is not particularly limited as long as they are identifiable.
另外，在图6B中，作为上述周向位置显示部31的变形例进行了说明，但例如也可以作为上述阴道内插入装置1的操作部14的标记部14a(参见图5)的变形例。6B , a modification of the circumferential position display portion 31 is described, but for example, it may be a modification of the marking portion 14a (see FIG. 5 ) of the operation portion 14 of the intravaginal insertion device 1 .
图7是示出使用了图6A所示的球囊13的情况下的、操作杆33的标记部33a1的一个变形例的图。图7所示的标记部33a1是在轴向A上为长尺寸的线状标记。图7所示的标记部33a1具备位于轴向A的远位侧的第1部分44、和位于轴向A的近位侧的第2部分45。标记部33a1的第1部分44示出图6A所示的球囊13的光照射部12中的设置于远位壁部13c的部分。更具体而言，标记部33a1的第1部分44在轴向A上的长度示出图6A所示的球囊13的光照射部12中的设置于远位壁部13c的部分在轴向A上的范围。另外，标记部33a1的第2部分45示出图6A所示的球囊13的光照射部12中的设置于筒壁部13b的部分。更具体而言，标记部33a1的第2部分45在轴向A上的长度示出图6A所示的球囊13的光照射部12中的设置于筒壁部13b的部分在轴向A上的范围。第1部分44及第2部分45例如可以构成为能够通过颜色区分来识别。但是，第1部分44及第2部分45只要能够相互识别，则也可以是例如使形状不同等其他构成。像这样，标记部33a1具备第1部分44及第2部分45，由此能够对球囊13的光照射部12中的设置于筒壁部13b的部分与球囊13的光照射部12中的设置于远位壁部13c的部分进行区分，从而适当地控制插入部11在轴向A上的位置。FIG7 is a diagram showing a modified example of the marking portion 33a1 of the operating rod 33 when the balloon 13 shown in FIG6A is used. The marking portion 33a1 shown in FIG7 is a linear marking having a long dimension in the axial direction A. The marking portion 33a1 shown in FIG7 includes a first portion 44 located on the distal side of the axial direction A, and a second portion 45 located on the proximal side of the axial direction A. The first portion 44 of the marking portion 33a1 indicates a portion of the light irradiation portion 12 of the balloon 13 shown in FIG6A that is disposed on the distal wall portion 13c. More specifically, the length of the first portion 44 of the marking portion 33a1 in the axial direction A indicates the range of the portion of the light irradiation portion 12 of the balloon 13 shown in FIG6A that is disposed on the distal wall portion 13c in the axial direction A. In addition, the second portion 45 of the marking portion 33a1 indicates a portion of the light irradiation portion 12 of the balloon 13 shown in FIG6A that is disposed on the barrel wall portion 13b. More specifically, the length of the second portion 45 of the marking portion 33a1 in the axial direction A shows the range of the portion of the light irradiation portion 12 of the balloon 13 shown in FIG. 6A that is provided on the barrel wall portion 13b in the axial direction A. The first portion 44 and the second portion 45 can be configured to be identifiable by color differentiation, for example. However, as long as the first portion 44 and the second portion 45 can be mutually identifiable, they can also be other configurations such as making the shapes different. In this way, the marking portion 33a1 includes the first portion 44 and the second portion 45, thereby being able to distinguish between the portion of the light irradiation portion 12 of the balloon 13 that is provided on the barrel wall portion 13b and the portion of the light irradiation portion 12 of the balloon 13 that is provided on the distal wall portion 13c, thereby appropriately controlling the position of the insertion portion 11 in the axial direction A.
图8A、图8B示出了保持装置2除了上述的周向位置显示部31之外还具备其他的周向位置显示部46的例子。图8A、图8B所示的周向位置显示部46与周向位置显示部31同样地是回转标记。在此，为了便于说明，将上述的周向位置显示部31记载为“第1周向位置显示部31”，将另一个周向位置显示部46记载为“第2周向位置显示部46”。如上所述，第1周向位置显示部31与阴道内插入装置1(参见图1)在周向B上的回转联动地动作。与此相对，第2周向位置显示部46能够与阴道内插入装置1在周向B上的回转独立地动作。由此，第2周向位置显示部46能够对光照射部12在周向B上的位置的历史进行显示。Fig. 8A and Fig. 8B show an example in which the retaining device 2 is provided with another circumferential position display part 46 in addition to the above-mentioned circumferential position display part 31. The circumferential position display part 46 shown in Fig. 8A and Fig. 8B is a rotation mark like the circumferential position display part 31. Here, for the convenience of explanation, the above-mentioned circumferential position display part 31 is recorded as "the first circumferential position display part 31", and the other circumferential position display part 46 is recorded as "the second circumferential position display part 46". As described above, the first circumferential position display part 31 operates in conjunction with the rotation of the intravaginal insertion device 1 (see Fig. 1) in the circumferential direction B. In contrast, the second circumferential position display part 46 can operate independently of the rotation of the intravaginal insertion device 1 in the circumferential direction B. Thus, the second circumferential position display part 46 can display the history of the position of the light irradiation part 12 in the circumferential direction B.
例如，设想在阴道400(参见图4A～图4D)内，通过使插入部11沿周向B回转而分2次执行光照射的情况。在该情况下，图8A示出进行第1次光照射时的第1周向位置显示部31及第2周向位置显示部46的位置关系。即，图8A所示的第1周向位置显示部31及第2周向位置显示部46均显示进行第1次光照射时的光照射部12在周向B上的位置(在图8A中为左侧)。For example, it is assumed that light irradiation is performed twice in the vagina 400 (see FIGS. 4A to 4D ) by rotating the insertion portion 11 along the circumferential direction B. In this case, FIG. 8A shows the positional relationship between the first circumferential position display portion 31 and the second circumferential position display portion 46 when the first light irradiation is performed. That is, the first circumferential position display portion 31 and the second circumferential position display portion 46 shown in FIG. 8A both show the position of the light irradiation portion 12 in the circumferential direction B when the first light irradiation is performed (on the left side in FIG. 8A ).
与此相对，图8B示出了进行第2次光照射时的第1周向位置显示部31及第2周向位置显示部46的位置关系。在结束了图8A所示的第1次光照射之后，使插入部11在周向B上回转，使光照射部12在周向B上的位置移动到进行第2次光照射的位置。在该移动时，第1周向位置显示部31与阴道内插入装置1(参见图1)在周向B上的回转联动地动作，向示出进行第2次光照射的、光照射部12在周向B上的位置的位置(在图8B中为上侧)移动。与此相对，第2周向位置显示部46不与阴道内插入装置1(参见图1)在周向B上的回转联动。即，如图8B所示，第2周向位置显示部46不从图8A的位置移动。像这样，能够利用第1周向位置显示部31示出第2次照射位置，并且利用第2周向位置显示部46将第1次的周向B上的照射位置作为过去的照射历史进行显示。像这样，在使阴道内插入装置1沿周向B回转，在不同的位置将来自光照射部12的光照射执行2次的情况下，通过将第2周向位置显示部46配置在示出第1次照射位置的位置，由此在调整第2次照射位置时，能够将第1次照射位置作为过去的照射历史进行显示。由此，容易适当地控制各次的光照射位置。In contrast, FIG8B shows the positional relationship between the first circumferential position display section 31 and the second circumferential position display section 46 when the second light irradiation is performed. After the first light irradiation shown in FIG8A is completed, the insertion section 11 is rotated in the circumferential direction B, and the position of the light irradiation section 12 in the circumferential direction B is moved to the position for the second light irradiation. During this movement, the first circumferential position display section 31 operates in conjunction with the rotation of the intravaginal insertion device 1 (see FIG1 ) in the circumferential direction B, and moves to the position (upper side in FIG8B ) indicating the position of the light irradiation section 12 in the circumferential direction B for the second light irradiation. In contrast, the second circumferential position display section 46 does not operate in conjunction with the rotation of the intravaginal insertion device 1 (see FIG1 ) in the circumferential direction B. That is, as shown in FIG8B , the second circumferential position display section 46 does not move from the position of FIG8A . In this way, the second irradiation position can be indicated by the first circumferential position display section 31, and the first irradiation position in the circumferential direction B can be indicated as the past irradiation history by the second circumferential position display section 46. In this way, when the intravaginal insertion device 1 is rotated in the circumferential direction B and the light irradiation from the light irradiation section 12 is performed twice at different positions, by arranging the second circumferential position display section 46 at the position indicating the first irradiation position, the first irradiation position can be indicated as the past irradiation history when the second irradiation position is adjusted. Thus, it is easy to appropriately control the light irradiation position at each time.
在图8A、图8B中，示出了保持装置2具备第1周向位置显示部31及第2周向位置显示部46这2个周向位置显示部的构成，但周向位置显示部的数量没有特别限定。保持装置2可以具备例如3个以上的周向位置显示部。由此，能够将周向B上的照射位置作为过去的多次照射历史进行显示。In FIG. 8A and FIG. 8B, the holding device 2 is shown to have two circumferential position display parts, namely the first circumferential position display part 31 and the second circumferential position display part 46, but the number of circumferential position display parts is not particularly limited. The holding device 2 may have, for example, three or more circumferential position display parts. Thus, the irradiation position in the circumferential direction B can be displayed as a plurality of irradiation histories in the past.
另外，图8A、图8B所示的第2周向位置显示部46可在追随状态和独立状态之间进行状态变化，其中，追随状态是伴随阴道内插入装置1在周向B上的回转而动作的状态，独立状态是与阴道内插入装置1在周向B上的回转独立地动作的状态。即，图8A、图8B所示的第2周向位置显示部46也可以在与第1周向位置显示部31一同在伴随阴道内插入装置1在周向B上的回转而动作的状态、和与第1周向位置显示部31不同地与阴道内插入装置1在周向B上的回转独立地动作的状态之间进行切换。在此，设想使阴道内插入装置1在周向B上回转、在周向B上的不同位置处将来自光照射部12的光照射执行2次的情况。在这样的情况下，在使第2周向位置显示部46保持为追随状态的状态下，使阴道内插入装置1在周向B上回转，使阴道内的光照射部12在周向B上的位置对位于第1次照射位置。接着，使第2周向位置显示部46从追随状态向独立状态进行状态变化。在该状态下，使阴道内插入装置1在周向B上回转，使阴道内的光照射部12在周向B上的位置对位于第2次照射位置。由此，能够将第2周向位置显示部46配置于示出第1次照射位置的位置。即，仅通过将第2周向位置显示部46从追随状态切换为独立状态的操作，就能够容易地将第2周向位置显示部46配置于示出第1次照射位置的位置。In addition, the second circumferential position display unit 46 shown in FIG. 8A and FIG. 8B can change between a following state and an independent state, wherein the following state is a state in which the intravaginal insertion device 1 is moved along with the rotation of the circumferential direction B, and the independent state is a state in which the intravaginal insertion device 1 is moved independently of the rotation of the circumferential direction B. That is, the second circumferential position display unit 46 shown in FIG. 8A and FIG. 8B can also switch between a state in which the intravaginal insertion device 1 is moved along with the rotation of the circumferential direction B together with the first circumferential position display unit 31, and a state in which the intravaginal insertion device 1 is moved independently of the rotation of the circumferential direction B unlike the first circumferential position display unit 31. Here, it is assumed that the intravaginal insertion device 1 is rotated in the circumferential direction B, and the light irradiation from the light irradiation unit 12 is performed twice at different positions in the circumferential direction B. In such a case, while the second circumferential position display section 46 is maintained in the following state, the intravaginal insertion device 1 is rotated in the circumferential direction B so that the position of the intravaginal light irradiation section 12 in the circumferential direction B is aligned with the first irradiation position. Next, the second circumferential position display section 46 is changed from the following state to the independent state. In this state, the intravaginal insertion device 1 is rotated in the circumferential direction B so that the position of the intravaginal light irradiation section 12 in the circumferential direction B is aligned with the second irradiation position. Thus, the second circumferential position display section 46 can be arranged at the position showing the first irradiation position. That is, the second circumferential position display section 46 can be easily arranged at the position showing the first irradiation position only by switching the second circumferential position display section 46 from the following state to the independent state.
图9A是示出图8A、图8B所示的第2周向位置显示部46能够在追随状态与独立状态之间进行状态变化的机构的一例的图。图9A的左侧的图是示出第2周向位置显示部46的追随状态的图，图9A的右侧的图是示出第2周向位置显示部46的独立状态的图。在图9A中，省略了内管16(参见图1)的图示。Fig. 9A is a diagram showing an example of a mechanism in which the second circumferential position display unit 46 shown in Fig. 8A and Fig. 8B can change state between a following state and an independent state. The left side of Fig. 9A shows the following state of the second circumferential position display unit 46, and the right side of Fig. 9A shows the independent state of the second circumferential position display unit 46. In Fig. 9A, the inner tube 16 (see Fig. 1) is omitted.
对于图9A所示的第1周向位置显示部31与阴道内插入装置1在周向B上的回转联动地动作的机构而言，其与使用齿轮组32的上述机构是同样的。与此相对，图9A所示的第2周向位置显示部46构成为能够利用另一齿轮组47与阴道内插入装置1在周向B上的回转联动地进行动作。齿轮组47具备第1齿轮47a和第2齿轮47b。此外，图9A所示的保持装置2包括：能够将阴道内插入装置1在周向B上的回转扭矩传导至齿轮组47的可动筒部48；以及从该可动筒部48突出并延伸至壳体34的外部的把持部49。可动筒部48以能够相对把持部49而言在周向B上独立地回转的方式被连结。由此，通过使把持部49沿轴向A移动，可动筒部48在被夹入阴道内插入装置1的轴15与齿轮组47的第1齿轮47a之间的状态(图9A的左侧的图)、和未被夹入阴道内插入装置1的轴15与齿轮组47的第1齿轮47a之间的状态(图9A的右侧的图)之间移动。The mechanism for the first circumferential position display portion 31 shown in FIG. 9A to move in conjunction with the rotation of the intravaginal insertion device 1 in the circumferential direction B is the same as the above-mentioned mechanism using the gear group 32. In contrast, the second circumferential position display portion 46 shown in FIG. 9A is configured to be able to move in conjunction with the rotation of the intravaginal insertion device 1 in the circumferential direction B using another gear group 47. The gear group 47 includes a first gear 47a and a second gear 47b. In addition, the retaining device 2 shown in FIG. 9A includes: a movable cylinder portion 48 capable of transmitting the rotation torque of the intravaginal insertion device 1 in the circumferential direction B to the gear group 47; and a gripping portion 49 protruding from the movable cylinder portion 48 and extending to the outside of the housing 34. The movable cylinder portion 48 is connected in a manner that it can rotate independently in the circumferential direction B relative to the gripping portion 49. Thus, by moving the holding portion 49 along the axial direction A, the movable tube portion 48 moves between a state in which it is clamped between the shaft 15 of the intravaginal insertion device 1 and the first gear 47a of the gear group 47 (the left side of FIG. 9A ), and a state in which it is not clamped between the shaft 15 of the intravaginal insertion device 1 and the first gear 47a of the gear group 47 (the right side of FIG. 9A ).
在可动筒部48被夹入阴道内插入装置1的轴15与齿轮组47的第1齿轮47a之间的状态(图9A的左侧的图)下，阴道内插入装置1在周向B上的回转扭矩经由可动筒部48被传导至第1齿轮47a。由此，在图9A的左侧所示的状态下，第2周向位置显示部46伴随阴道内插入装置1在周向B上的回转而动作。即，第2周向位置显示部46成为上述的追随状态。In the state where the movable cylinder 48 is sandwiched between the shaft 15 of the intravaginal insertion device 1 and the first gear 47a of the gear train 47 (the left side of FIG. 9A ), the rotational torque of the intravaginal insertion device 1 in the circumferential direction B is transmitted to the first gear 47a via the movable cylinder 48. Thus, in the state shown on the left side of FIG. 9A , the second circumferential position indicating portion 46 moves along with the rotation of the intravaginal insertion device 1 in the circumferential direction B. That is, the second circumferential position indicating portion 46 is in the above-mentioned following state.
与此相对，在可动筒部48未被夹入阴道内插入装置1的轴15与齿轮组47的第1齿轮47a之间的状态(图9A的右侧的图)下，阴道内插入装置1在周向B上的回转扭矩没有被传导至第1齿轮47a。因此，在图9A的右侧所示的状态下，第2周向位置显示部46不伴随阴道内插入装置1在周向B上的回转而动作。即，第2周向位置显示部46成为上述独立状态。On the other hand, in a state where the movable cylinder 48 is not sandwiched between the shaft 15 of the intravaginal insertion device 1 and the first gear 47a of the gear train 47 (the right side of FIG. 9A ), the rotational torque of the intravaginal insertion device 1 in the circumferential direction B is not transmitted to the first gear 47a. Therefore, in the state shown on the right side of FIG. 9A , the second circumferential position indicating portion 46 does not move with the rotation of the intravaginal insertion device 1 in the circumferential direction B. That is, the second circumferential position indicating portion 46 is in the above-mentioned independent state.
像这样，第2周向位置显示部46能够在上述的追随状态(图9A的左侧的图)与独立状态(图9A的右侧的图)之间进行状态变化。In this way, the second circumferential position indicator 46 can change its state between the above-mentioned following state (the left diagram of FIG. 9A ) and the independent state (the right diagram of FIG. 9A ).
另外，在图8A、图8B、图9A中，说明了保持装置2具备第1周向位置显示部31和第2周向位置显示部46的构成，但不限于该构成。图9B示出将与图8A、图8B、图9A所示的第1周向位置显示部31及第2周向位置显示部46同样的构成应用于医疗器具100的其他位置的例子。In addition, in Fig. 8A, Fig. 8B, and Fig. 9A, the structure in which the holding device 2 includes the first circumferential position display section 31 and the second circumferential position display section 46 is described, but the present invention is not limited to this structure. Fig. 9B shows an example in which the same structure as the first circumferential position display section 31 and the second circumferential position display section 46 shown in Fig. 8A, Fig. 8B, and Fig. 9A is applied to another position of the medical device 100.
具体而言，在图9B中，示出了阴道内插入装置1具备图5所示的标记部14a，保持装置2在与标记部14a相邻的位置具备周向位置显示部50的例子。周向位置显示部50与上述第1周向位置显示部31、第2周向位置显示部46同样地是回转标记。如上所述，阴道内插入装置1的标记部14a通过阴道内插入装置1在周向B上的回转而在周向B上回转。与此相对，保持装置2的周向位置显示部50能够在追随状态与独立状态之间进行状态变化。Specifically, FIG. 9B shows an example in which the intravaginal insertion device 1 includes the marking portion 14a shown in FIG. 5 and the holding device 2 includes a circumferential position display portion 50 at a position adjacent to the marking portion 14a. The circumferential position display portion 50 is a rotation mark similar to the first circumferential position display portion 31 and the second circumferential position display portion 46 described above. As described above, the marking portion 14a of the intravaginal insertion device 1 rotates in the circumferential direction B by the rotation of the intravaginal insertion device 1 in the circumferential direction B. In contrast, the circumferential position display portion 50 of the holding device 2 can change state between a following state and an independent state.
具体而言，图9B所示的保持装置2具备：能够将阴道内插入装置1在周向B上的回转扭矩传导至周向位置显示部50的可动筒部51；和从该可动筒部51突出并延伸至壳体34的外部的把持部52。可动筒部51以能够相对把持部52而言在周向B上独立地回转的方式被连结。由此，通过使把持部52沿轴向A移动，可动筒部51在被夹入阴道内插入装置1的轴15与周向位置显示部50之间的状态(图9B的左侧的图)、和未被夹入阴道内插入装置1的轴15与周向位置显示部50之间的状态(图9B的右侧的图)之间移动。Specifically, the retaining device 2 shown in FIG. 9B comprises: a movable tube 51 capable of transmitting the rotational torque of the intravaginal insertion device 1 in the circumferential direction B to the circumferential position display portion 50; and a gripping portion 52 protruding from the movable tube 51 and extending to the outside of the housing 34. The movable tube 51 is connected in a manner that it can rotate independently in the circumferential direction B relative to the gripping portion 52. Thus, by moving the gripping portion 52 along the axial direction A, the movable tube 51 moves between a state where it is sandwiched between the shaft 15 of the intravaginal insertion device 1 and the circumferential position display portion 50 (the figure on the left side of FIG. 9B ), and a state where it is not sandwiched between the shaft 15 of the intravaginal insertion device 1 and the circumferential position display portion 50 (the figure on the right side of FIG. 9B ).
在可动筒部51被夹入阴道内插入装置1的轴15与周向位置显示部50之间的状态(图9B的左侧的图)下，阴道内插入装置1在周向B上的回转扭矩经由可动筒部51而被传导至周向位置显示部50。由此，在图9B的左侧所示的状态下，周向位置显示部50伴随阴道内插入装置1在周向B上的回转而动作。即，周向位置显示部50成为上述的追随状态。In the state where the movable tube 51 is sandwiched between the shaft 15 of the intravaginal insertion device 1 and the circumferential position display portion 50 (the left side of FIG. 9B ), the rotational torque of the intravaginal insertion device 1 in the circumferential direction B is transmitted to the circumferential position display portion 50 via the movable tube 51. Thus, in the state shown on the left side of FIG. 9B , the circumferential position display portion 50 moves along with the rotation of the intravaginal insertion device 1 in the circumferential direction B. That is, the circumferential position display portion 50 is in the above-mentioned following state.
与此相对，在可动筒部51未被夹入阴道内插入装置1的轴15与周向位置显示部50之间的状态(图9B的右侧的图)下，阴道内插入装置1在周向B上的回转扭矩未被传导至周向位置显示部50。因此，在图9B的右侧所示的状态下，周向位置显示部50不伴随阴道内插入装置1在周向B上的回转而动作。即，周向位置显示部50成为上述独立状态。On the other hand, in a state where the movable cylindrical portion 51 is not sandwiched between the shaft 15 of the intravaginal insertion device 1 and the circumferential position display portion 50 (the right side of FIG. 9B ), the rotational torque of the intravaginal insertion device 1 in the circumferential direction B is not transmitted to the circumferential position display portion 50. Therefore, in the state shown on the right side of FIG. 9B , the circumferential position display portion 50 does not move with the rotation of the intravaginal insertion device 1 in the circumferential direction B. That is, the circumferential position display portion 50 is in the above-mentioned independent state.
像这样，在上述的追随状态(图9B的左侧的图)和独立状态(图9B的右侧的图)之间，状态可变的周向位置显示部50可以与设置在阴道内插入装置1上的标记部14a一同被使用。In this way, the state-variable circumferential position display portion 50 can be used together with the marking portion 14a provided on the intravaginal insertion device 1 between the above-mentioned following state (the left side diagram of FIG. 9B ) and the independent state (the right side diagram of FIG. 9B ).
图10A是示出第2周向位置显示部46能够在追随状态与独立状态之间进行状态变化的机构的、与图9A不同的变形例的图。在图10A所示的例子中，第2周向位置显示部46以相对壳体34而言能够沿径向C移动的方式被保持。而且，通过使第2周向位置显示部46沿径向C移动，第2周向位置显示部46能够在追随状态和独立状态之间进行状态变化，其中，该追随状态是从第1周向位置显示部31所具备的齿轮53被传导回转扭矩的状态(图10A的左侧的图)，该独立状态是从第1周向位置显示部31所具备的齿轮53不被传导回转扭矩的状态(图10A的右侧的图)。像这样，第2周向位置显示部46的追随状态与独立状态之间的状态变化能够通过各种机构来实现，其具体的构成没有特别限定。FIG. 10A is a diagram showing a modified example different from FIG. 9A of a mechanism in which the second circumferential position display unit 46 can change state between a following state and an independent state. In the example shown in FIG. 10A , the second circumferential position display unit 46 is held in a manner that can move in the radial direction C relative to the housing 34. Moreover, by moving the second circumferential position display unit 46 in the radial direction C, the second circumferential position display unit 46 can change state between a following state and an independent state, wherein the following state is a state in which a rotational torque is transmitted from the gear 53 provided by the first circumferential position display unit 31 (the figure on the left side of FIG. 10A ), and the independent state is a state in which a rotational torque is not transmitted from the gear 53 provided by the first circumferential position display unit 31 (the figure on the right side of FIG. 10A ). As such, the state change between the following state and the independent state of the second circumferential position display unit 46 can be realized by various mechanisms, and its specific configuration is not particularly limited.
图10B是示出周向位置显示部50能够在追随状态与独立状态之间进行状态变化的机构的、与图9B不同的变形例的图。在图10B所示的例子中，周向位置显示部50以相对壳体34而言能够沿轴向A移动的方式被保持。而且，通过使周向位置显示部50沿轴向A移动，周向位置显示部50能够在从标记部14a所具备的齿轮54被传导回转扭矩的状态(图10B的左侧的图)即追随状态、与从标记部14a所具备的齿轮54不被传导回转扭矩的状态(图10B的右侧的图)即独立状态之间进行状态变化。像这样，周向位置显示部50的追随状态与独立状态之间的状态变化能够通过各种机构来实现，其具体的构成没有特别限定。FIG. 10B is a diagram showing a modified example different from FIG. 9B of a mechanism in which the circumferential position display unit 50 can change state between a following state and an independent state. In the example shown in FIG. 10B , the circumferential position display unit 50 is held in a manner that can move along the axial direction A relative to the housing 34. Moreover, by moving the circumferential position display unit 50 along the axial direction A, the circumferential position display unit 50 can change state between a state in which a rotational torque is transmitted from the gear 54 provided by the marking portion 14a (the figure on the left side of FIG. 10B ), i.e., a following state, and a state in which a rotational torque is not transmitted from the gear 54 provided by the marking portion 14a (the figure on the right side of FIG. 10B ), i.e., an independent state. As such, the state change between the following state and the independent state of the circumferential position display unit 50 can be achieved by various mechanisms, and its specific configuration is not particularly limited.
图11A是示出代替图2所示的操作杆33的标记部33a1，而在阴道内插入装置1的轴15上设置有标记部55的例子的图。另外，图11B是在图11A的IV-IV线的位置处的医疗器具100的剖面图。如上所述，保持装置2的操作杆33与阴道内插入装置1一同沿轴向A移动。因此，如图11A、图11B所示，也可以在阴道内插入装置1的轴15上设置标记部55。需要说明的是，在图11A、图11B中，在壳体34上形成有视通开口34d，以使得能够从壳体34的外部视觉辨认内部的标记部55。视通开口34d是贯通壳体34的空隙，但例如也可以配置能够从外部对内部进行视通的透明部件，标记部55能够穿过该透明部件进行视通。FIG. 11A is a diagram showing an example in which a marking portion 55 is provided on the shaft 15 of the intravaginal insertion device 1 instead of the marking portion 33a1 of the operating rod 33 shown in FIG. 2 . In addition, FIG. 11B is a cross-sectional view of the medical device 100 at the position of the IV-IV line in FIG. 11A . As described above, the operating rod 33 of the retaining device 2 moves along the axial direction A together with the intravaginal insertion device 1. Therefore, as shown in FIG. 11A and FIG. 11B , a marking portion 55 may also be provided on the shaft 15 of the intravaginal insertion device 1. It should be noted that in FIG. 11A and FIG. 11B , a sight-through opening 34d is formed on the housing 34 so that the marking portion 55 inside can be visually recognized from the outside of the housing 34. The sight-through opening 34d is a gap that penetrates the housing 34, but, for example, a transparent member that allows the inside to be seen from the outside may also be provided, and the marking portion 55 can be seen through the transparent member.
图12是示出代替设置在图2所示的保持装置2上的作为轴向移动量显示部40的刻度部34b而在阴道内插入装置1设置作为轴向移动量显示部40的刻度部56的例子的图。当阴道内插入装置1相对保持装置2而言沿轴向A移动时，通过视觉辨认作为轴向移动量显示部40的刻度部56，能够掌握该轴向A上的相对移动量。像这样，轴向移动量显示部40不限于如图2所示那样设置于保持装置2的构成，也可以设置于阴道内插入装置1。Fig. 12 is a diagram showing an example in which a scale portion 56 as the axial movement amount display portion 40 is provided on the intravaginal insertion device 1 instead of the scale portion 34b as the axial movement amount display portion 40 provided on the holding device 2 shown in Fig. 2. When the intravaginal insertion device 1 moves in the axial direction A relative to the holding device 2, the relative movement amount in the axial direction A can be grasped by visually recognizing the scale portion 56 as the axial movement amount display portion 40. In this way, the axial movement amount display portion 40 is not limited to the configuration provided on the holding device 2 as shown in Fig. 2, and can also be provided on the intravaginal insertion device 1.
图13A、图13B是示出保持装置2具备能够与阴道内插入装置1在轴向A上的移动独立地动作、且能够对光照射部12在轴向A上的位置的历史进行显示的轴向位置显示部57的例子的图。图13A、图13B所示的轴向位置显示部57是直动标记。图13A、图13B所示的保持装置2除了具备操作杆33的标记部33a1以及作为轴向移动量显示部40的刻度部34b之外，还具备轴向位置显示部57。图13A、图13B所示的轴向位置显示部57能够在沿轴向A延伸的壳体34的槽34e内沿轴向A移动。Fig. 13A and Fig. 13B are diagrams showing an example in which the retaining device 2 is provided with an axial position display portion 57 that can operate independently of the movement of the intravaginal insertion device 1 in the axial direction A and can display the history of the position of the light irradiation portion 12 in the axial direction A. The axial position display portion 57 shown in Fig. 13A and Fig. 13B is a direct-acting mark. The retaining device 2 shown in Fig. 13A and Fig. 13B includes an axial position display portion 57 in addition to the marking portion 33a1 of the operating rod 33 and the scale portion 34b as the axial movement amount display portion 40. The axial position display portion 57 shown in Fig. 13A and Fig. 13B can move in the axial direction A in the groove 34e of the housing 34 extending in the axial direction A.
例如，设想在阴道400(参见图4A～图4D)内，通过使插入部11沿轴向A移动，由此分2次执行光照射的情况。在该情况下，图13A示出进行第1次光照射时的标记部33a1及轴向位置显示部57的位置关系。即，图13A所示的标记部33a1及轴向位置显示部57均显示进行第1次光照射时的光照射部12在轴向A上的位置。在图13A中，操作杆33的标记部33a1的远位端位于槽34a的远位端的位置。另外，轴向位置显示部57的远位端位于槽34e的远位端的位置。该状态例如可以是使插入部11的远位端抵靠于子宫口300(参见图4A～图4D)的周围的状态。在该状态下，通过光照射部12执行第1次光照射。For example, it is assumed that the light irradiation is performed twice by moving the insertion part 11 along the axial direction A in the vagina 400 (see FIGS. 4A to 4D ). In this case, FIG. 13A shows the positional relationship between the marking part 33a1 and the axial position display part 57 when the first light irradiation is performed. That is, the marking part 33a1 and the axial position display part 57 shown in FIG. 13A both show the position of the light irradiation part 12 in the axial direction A when the first light irradiation is performed. In FIG. 13A , the distal end of the marking part 33a1 of the operating rod 33 is located at the position of the distal end of the groove 34a. In addition, the distal end of the axial position display part 57 is located at the position of the distal end of the groove 34e. This state may be, for example, a state in which the distal end of the insertion part 11 is abutted against the periphery of the cervical 300 (see FIGS. 4A to 4D ). In this state, the first light irradiation is performed by the light irradiation part 12.
与此相对，图13B表示进行第2次光照射时的标记部33a1及轴向位置显示部57的位置关系。在结束了图13A所示的第1次光照射之后，使插入部11沿轴向A移动，使光照射部12在轴向A上的位置移动至进行第2次光照射的位置。在该移动时，操作杆33的标记部33a1与阴道内插入装置1在轴向A上的移动联动地动作，移动至示出进行第2次光照射的、光照射部12在轴向A上的位置的位置。与此相对，轴向位置显示部57不与阴道内插入装置1在轴向A上的移动联动。即，如图13B所示，轴向位置显示部57不从图13A的位置移动。由此，能够通过操作杆33的标记部33a1示出第2次照射位置，并且通过轴向位置显示部57将第1次的轴向A上的照射位置作为过去的照射历史进行显示。像这样，在使阴道内插入装置1沿轴向A移动，在轴向A的不同位置将来自光照射部12的光照射执行2次的情况下，通过将轴向位置显示部57配置在示出第1次照射位置的位置，在调整第2次照射位置时，能够将第1次照射位置作为过去的照射历史进行显示。由此，容易适当地控制各次的光照射位置。In contrast, FIG. 13B shows the positional relationship between the marking portion 33a1 and the axial position display portion 57 when the second light irradiation is performed. After the first light irradiation shown in FIG. 13A is completed, the insertion portion 11 is moved along the axial direction A, and the position of the light irradiation portion 12 in the axial direction A is moved to the position for performing the second light irradiation. During this movement, the marking portion 33a1 of the operating rod 33 operates in conjunction with the movement of the intravaginal insertion device 1 in the axial direction A, and moves to a position indicating the position of the light irradiation portion 12 in the axial direction A for performing the second light irradiation. In contrast, the axial position display portion 57 does not operate in conjunction with the movement of the intravaginal insertion device 1 in the axial direction A. That is, as shown in FIG. 13B, the axial position display portion 57 does not move from the position of FIG. 13A. Thus, the second irradiation position can be indicated by the marking portion 33a1 of the operating rod 33, and the first irradiation position in the axial direction A can be displayed as a past irradiation history by the axial position display portion 57. In this way, when the intravaginal insertion device 1 is moved along the axial direction A and light irradiation from the light irradiation section 12 is performed twice at different positions in the axial direction A, by arranging the axial position display section 57 at a position showing the first irradiation position, when adjusting the second irradiation position, the first irradiation position can be displayed as a past irradiation history. This makes it easy to appropriately control the light irradiation position at each time.
在图13A、图13B中，保持装置2仅具备1个轴向位置显示部57，但轴向位置显示部57的数量没有特别限定。保持装置2也可以具备例如3个以上的轴向位置显示部57。由此，能够将轴向A上的照射位置作为过去的多次照射历史进行显示。In FIG. 13A and FIG. 13B , the holding device 2 has only one axial position display unit 57, but the number of the axial position display units 57 is not particularly limited. The holding device 2 may also have, for example, three or more axial position display units 57. Thus, the irradiation position in the axial direction A can be displayed as a plurality of past irradiation histories.
另外，图13A、图13B所示的轴向位置显示部57是能够在槽34e内沿轴向A移动的直动标记，但也可以是固定于壳体34且相对壳体34而言不发生位置变动的固定标记。在该情况下，轴向位置显示部57可以用作示出初次光照射的轴向A上的位置以及初次光照射的轴向A上的范围的固定标记。但是，如图13A、图13B所示的轴向位置显示部57那样，优选为能够沿轴向A移动的构成。由此，能够根据例如患者的对象部位X(参见图4A～图4D)的位置等适当调整轴向位置显示部57在轴向A上的位置。In addition, the axial position display portion 57 shown in FIGS. 13A and 13B is a direct-acting mark that can move in the axial direction A within the groove 34e, but it can also be a fixed mark that is fixed to the housing 34 and does not change position relative to the housing 34. In this case, the axial position display portion 57 can be used as a fixed mark that shows the position on the axial direction A of the initial light irradiation and the range on the axial direction A of the initial light irradiation. However, it is preferably configured to be movable in the axial direction A, as in the axial position display portion 57 shown in FIGS. 13A and 13B. Thus, the position of the axial position display portion 57 in the axial direction A can be appropriately adjusted according to, for example, the position of the patient's target part X (see FIGS. 4A to 4D).
另外，图13A、图13B所示的轴向位置显示部57也可以是在伴随阴道内插入装置1在轴向A上的移动而动作的追随状态、和与阴道内插入装置1在轴向A上的移动独立地动作的独立状态之间能够进行状态变化。即，图13A、图13B所示的轴向位置显示部57也可以能够对与标记部33a1一同伴随阴道内插入装置1在轴向A上的移动而动作的状态、和与标记部33a1不同地与阴道内插入装置1在轴向A上的移动独立地动作的状态进行切换。In addition, the axial position display section 57 shown in Figs. 13A and 13B may be capable of changing its state between a following state in which it moves along with the movement of the intravaginal insertion device 1 in the axial direction A, and an independent state in which it moves independently of the movement of the intravaginal insertion device 1 in the axial direction A. That is, the axial position display section 57 shown in Figs. 13A and 13B may be capable of switching between a state in which it moves along with the movement of the intravaginal insertion device 1 in the axial direction A together with the marking section 33a1, and a state in which it moves independently of the movement of the intravaginal insertion device 1 in the axial direction A unlike the marking section 33a1.
图14是在图13A的V-V线的位置处的、医疗器具100的剖面图。图14是示出图13A、图13B所示的轴向位置显示部57能够在追随状态与独立状态之间进行状态变化的机构的一例的图。图14的左侧的图是示出轴向位置显示部57的追随状态的图，图14的右侧的图是示出轴向位置显示部57的独立状态的图。Fig. 14 is a cross-sectional view of the medical device 100 at the position of the V-V line of Fig. 13A. Fig. 14 is a diagram showing an example of a mechanism in which the axial position display unit 57 shown in Figs. 13A and 13B can change state between a following state and an independent state. The left side of Fig. 14 is a diagram showing the following state of the axial position display unit 57, and the right side of Fig. 14 is a diagram showing the independent state of the axial position display unit 57.
对于图14所示的标记部33a1与阴道内插入装置1在轴向A上的移动联动地动作的机构而言，其与使用环状凸部20a、20b(参见图1等)的上述机构是同样的。与此相对，图14所示的轴向位置显示部57以能够在径向C上移动的方式被保持于壳体34。在图14的左侧的图中，轴向位置显示部57的一部分以在轴向A上与操作杆33的卡合部33b重叠的方式配置。因此，若具备标记部33a1的操作杆33沿轴向A移动，则配置于在轴向A上与卡合部33b重叠的位置的、轴向位置显示部57的一部分被卡合部33b推压。由此，操作杆33及轴向位置显示部57能够在轴向A上一同移动。与此相对，在图14的右侧的图中，轴向位置显示部57成为在轴向A上不与操作杆33的卡合部33b重叠的状态。因此，即使具备标记部33a1的操作杆33沿轴向A移动，轴向位置显示部57也不会被操作杆33沿轴向A推压。即，操作杆33与轴向位置显示部57独立地沿轴向A移动。The mechanism in which the marking portion 33a1 shown in FIG. 14 and the movement of the intravaginal insertion device 1 in the axial direction A are linked to each other is the same as the above-mentioned mechanism using the annular protrusions 20a, 20b (see FIG. 1, etc.). In contrast, the axial position display portion 57 shown in FIG. 14 is held in the housing 34 in a manner that allows it to move in the radial direction C. In the figure on the left side of FIG. 14, a portion of the axial position display portion 57 is arranged in a manner that overlaps with the engaging portion 33b of the operating rod 33 in the axial direction A. Therefore, if the operating rod 33 having the marking portion 33a1 moves in the axial direction A, a portion of the axial position display portion 57 that is arranged at a position that overlaps with the engaging portion 33b in the axial direction A is pushed by the engaging portion 33b. Thus, the operating rod 33 and the axial position display portion 57 can move together in the axial direction A. In contrast, in the figure on the right side of FIG. 14, the axial position display portion 57 is in a state that does not overlap with the engaging portion 33b of the operating rod 33 in the axial direction A. Therefore, even if the operating rod 33 having the marking portion 33 a 1 moves in the axial direction A, the axial position indicator 57 is not pressed by the operating rod 33 in the axial direction A. That is, the operating rod 33 moves in the axial direction A independently of the axial position indicator 57 .
这样，在图14所示的例子中，通过使轴向位置显示部57在径向C上移动，由此轴向位置显示部57能够在追随状态(图14的左侧的图)和独立状态(图14的左侧的图)之间进行状态变化，其中，追随状态是在轴向A上与操作杆33重叠、在轴向A上与操作杆33一同移动的状态，独立状态是在轴向A上不与操作杆33重叠而在轴向A上不与操作杆33一同移动的状态。In this way, in the example shown in Figure 14, by moving the axial position display part 57 in the radial direction C, the axial position display part 57 can change its state between a following state (the figure on the left side of Figure 14) and an independent state (the figure on the left side of Figure 14), wherein the following state is a state in which the operating rod 33 overlaps with the axial direction A and moves together with the operating rod 33 in the axial direction A, and the independent state is a state in which the operating rod 33 does not overlap with the axial direction A and does not move together with the operating rod 33 in the axial direction A.
在图14中，可以通过使轴向位置显示部57沿径向C移动，由此例如使设置于操作杆33及轴向位置显示部57中的一方的凸部进入设置于另一方的沟槽部，实现上述的轴向位置显示部57的状态变化。但是，实现轴向位置显示部57的追随状态与独立状态之间的状态变化的构成不限于图14所示的构成，也可以是其他构成。In Fig. 14, the state change of the axial position display portion 57 can be achieved by moving the axial position display portion 57 in the radial direction C, thereby, for example, causing a convex portion provided on one of the operating rod 33 and the axial position display portion 57 to enter a groove portion provided on the other. However, the configuration for achieving the state change between the following state and the independent state of the axial position display portion 57 is not limited to the configuration shown in Fig. 14, and other configurations may also be used.
另外，如图7所示，轴向位置显示部57也可以具备位于轴向A的远位侧的第1部分61和位于轴向A的近位侧的第2部分62。轴向位置显示部57的第1部分61示出图6A所示的球囊13的光照射部12中的设置于远位壁部13c的部分。更具体而言，轴向位置显示部57的第1部分61在轴向A上的长度示出图6A所示的球囊13的光照射部12中的设置于远位壁部13c的部分在轴向A上的范围。另外，轴向位置显示部57的第2部分62示出图6A所示的球囊13的光照射部12中的设置于筒壁部13b的部分。更具体而言，轴向位置显示部57的第2部分62在轴向A上的长度示出图6A所示的球囊13的光照射部12中的设置于筒壁部13b的部分在轴向A上的范围。第1部分61及第2部分62例如可以构成为能够通过颜色区分来识别。但是，第1部分61及第2部分62只要能够相互识别，则也可以是例如使形状不同等其他构成。像这样，通过轴向位置显示部57具备第1部分61及第2部分62，能够对球囊13的光照射部12中的设置于筒壁部13b的部分和球囊13的光照射部12中的设置于远位壁部13c的部分进行区分，并显示过去的照射历史。In addition, as shown in FIG. 7 , the axial position display portion 57 may also include a first portion 61 located on the distal side of the axial direction A and a second portion 62 located on the proximal side of the axial direction A. The first portion 61 of the axial position display portion 57 shows the portion of the light irradiation portion 12 of the balloon 13 shown in FIG. 6A that is provided on the distal wall portion 13c. More specifically, the length of the first portion 61 of the axial position display portion 57 in the axial direction A shows the range of the portion of the light irradiation portion 12 of the balloon 13 shown in FIG. 6A that is provided on the distal wall portion 13c in the axial direction A. In addition, the second portion 62 of the axial position display portion 57 shows the portion of the light irradiation portion 12 of the balloon 13 shown in FIG. 6A that is provided on the barrel wall portion 13b. More specifically, the length of the second portion 62 of the axial position display portion 57 in the axial direction A shows the range of the portion of the light irradiation portion 12 of the balloon 13 shown in FIG. 6A that is provided on the barrel wall portion 13b in the axial direction A. The first portion 61 and the second portion 62 may be configured to be identifiable by color distinction, for example. However, as long as the first part 61 and the second part 62 can be identified from each other, they may also be other structures such as different shapes. In this way, by having the first part 61 and the second part 62 in the axial position display part 57, the part of the light irradiation part 12 of the balloon 13 disposed on the barrel wall part 13b and the part of the light irradiation part 12 of the balloon 13 disposed on the distal wall part 13c can be distinguished, and the past irradiation history can be displayed.
图15是示出图13A、图13B、图14所示的标记部33a1的变形例的图。图15所示的标记部33a1是在轴向A上为长尺寸的线状标记。图15所示的标记部33a1具备位于轴向A的近位侧的第1部分58和位于轴向A的远位侧的第2部分59。标记部33a1的第1部分58及第2部分59在轴向A上的合计长度示出光照射部12在轴向A上的范围。而且，第2部分59示出与显示上次的照射历史的轴向位置显示部57交错的区域。标记部33a1通过具备这样的第2部分59，由此在沿轴向A分多次进行光照射的情况下，能够确保与上次的光照射位置的、适当的交错区域。因此，能够抑制与上次的光照射区域的过度的重复、在与上次的光照射区域之间未执行光照射的区域的产生等。FIG. 15 is a diagram showing a modified example of the marking portion 33a1 shown in FIG. 13A , FIG. 13B , and FIG. 14 . The marking portion 33a1 shown in FIG. 15 is a linear mark having a long dimension in the axial direction A. The marking portion 33a1 shown in FIG. 15 includes a first portion 58 located on the proximal side of the axial direction A and a second portion 59 located on the distal side of the axial direction A. The total length of the first portion 58 and the second portion 59 of the marking portion 33a1 in the axial direction A indicates the range of the light irradiation portion 12 in the axial direction A. Moreover, the second portion 59 indicates an area intersecting with the axial position display portion 57 that displays the last irradiation history. By including such a second portion 59, the marking portion 33a1 can ensure an appropriate intersecting area with the last light irradiation position when light irradiation is performed multiple times along the axial direction A. Therefore, it is possible to suppress excessive duplication with the last light irradiation area, the generation of an area where light irradiation is not performed between the last light irradiation area, and the like.
第1部分58及第2部分59例如可以构成为能够通过颜色区分来识别。但是，第1部分58及第2部分59只要能够相互识别，则也可以是例如使形状不同等其他构成。The first portion 58 and the second portion 59 may be configured to be distinguishable by color, for example. However, the first portion 58 and the second portion 59 may be configured in other ways, for example, by making the shapes different, as long as they can be distinguished from each other.
本发明所涉及的医疗器具以及治疗方法不限于上述的实施方式以及各种变形例所示的具体的构成以及工序，在不脱离权利要求书的情况下能够进行各种变形、变更、组合。组合上述各种变形例彼此而构成的医疗器具也属于本发明的技术范围。The medical device and treatment method involved in the present invention are not limited to the specific configurations and processes shown in the above-mentioned embodiments and various modified examples, and various modifications, changes, and combinations can be made without departing from the claims. Medical devices composed of the above-mentioned various modified examples also belong to the technical scope of the present invention.
产业上的可利用性Industrial Applicability
本发明涉及医疗器具及治疗方法。The present invention relates to medical instruments and treatment methods.
附图标记说明Description of Reference Numerals
1：阴道内插入装置(体腔内插入装置的一例)1: Intravaginal insertion device (an example of an intracavitary insertion device)
2：保持装置2: Holding device
11：插入部11: Insertion
12：光照射部12: Light irradiation part
12a：光透过窗12a: Light through the window
13：球囊13: Balloon
13a：环状空间13a: Ring Space
13b：筒壁部13b: Cylinder wall
13c：远位壁部13c: Distal wall
13d：近位壁部13d: proximal wall
14：操作部14: Operation Department
14a：标记部14a: Marking section
15：轴15: Axis
15a：光纤管腔15a: Fiber optic lumen
15b：充胀管腔15b: Inflation Lumen
16：内管16: Inner tube
17：外管17: External pipe
18a：光透过层18a: Light transmission layer
18b：光反射层18b: Light reflection layer
19：毂部19: Hub
19a：端口部19a: Port
19b：贯通孔19b: Through hole
20a、20b：环状凸部20a, 20b: annular convex part
21：突起21: Protrusion
23：封闭部件23: Enclosed parts
24：光反射部24: Light reflection part
31：周向位置显示部(第1周向位置显示部的一例)31a：圆盘部31: Circumferential position display portion (an example of the first circumferential position display portion) 31a: Disk portion
31a1：标记部31a1: Marking
32：齿轮组32: Gear set
32a：第1齿轮32a: 1st gear
32b：第2齿轮32b: 2nd gear
33：操作杆33: Joystick
33a：把持部33a: Grip
33a1：标记部33a1: Marking
33b：卡合部33b: snap-fit portion
34：壳体34: Shell
34a：槽34a: Slot
34b：刻度部(保持装置的轴向移动量显示部的一例)34b: Scale portion (an example of a portion indicating the axial movement amount of the holding device)
34c：安装部34c: Installation
34c1：轴部34c1: shaft
34d：视通开口34d: Vision opening
34e：槽34e: Slot
40：轴向移动量显示部40: Axial movement display
42：第1标记部42: First marking part
43：第2标记部43: Second Marking Section
44：第1部分44: Part 1
45：第2部分45: Part 2
46：周向位置显示部(第2周向位置显示部的一例)46: Circumferential position display unit (an example of the second circumferential position display unit)
47：齿轮组47: Gear set
47a：第1齿轮47a: 1st gear
47b：第2齿轮47b: 2nd gear
48：可动筒部48: Movable barrel
49：把持部49: Grip
50：周向位置显示部50: Circumferential position display unit
51：可动筒部51: Movable barrel
52：把持部52: Grip
53：齿轮53: Gear
54：齿轮54: Gear
55：标记部55: Marking Department
56：刻度部(阴道内插入装置的轴向移动量显示部的一例)56: Scale portion (an example of a portion indicating the axial movement amount of the intravaginal insertion device)
57：轴向位置显示部57: Axial position display
58：第1部分58: Part 1
59：第2部分59: Part 2
61：第1部分61: Part 1
62：第2部分62: Part 2
70：阴道镜70: Colposcopy
100：医疗器具100: Medical devices
200：发光体200: Luminous body
200a：光纤200a: Fiber Optic
300：子宫口300: Uterine opening
400：阴道(体腔的一例)400: vagina (an example of a body cavity)
A：阴道内插入装置的轴向(体腔内插入装置的轴向的一例)A: Axial direction of the intravaginal insertion device (an example of the axial direction of the intracavitary insertion device)
B：阴道内插入装置的周向(体腔内插入装置的周向的一例)B: Circumferential direction of the intravaginal insertion device (an example of the circumferential direction of the intracavitary insertion device)
C：阴道内插入装置的径向(体腔内插入装置的径向的一例)C: Radial direction of the intravaginal insertion device (an example of radial direction of the intracavitary insertion device)
O：阴道内插入装置的中心轴线(体腔内插入装置的中心轴线的一例)O: Central axis of the intravaginal insertion device (an example of the central axis of the intracavitary insertion device)
X：对象部位X: Target part
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP2022051854 | 2022-03-28 | ||
| JP2022-051854 | 2022-03-28 | ||
| PCT/JP2023/008144WO2023189215A1 (en) | 2022-03-28 | 2023-03-03 | Medical instrument and therapeutic method |
| Publication Number | Publication Date |
|---|---|
| CN118354818Atrue CN118354818A (en) | 2024-07-16 |
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN202380014898.5APendingCN118354818A (en) | 2022-03-28 | 2023-03-03 | Medical device and method of treatment |
| Country | Link |
|---|---|
| JP (1) | JPWO2023189215A1 (en) |
| CN (1) | CN118354818A (en) |
| WO (1) | WO2023189215A1 (en) |
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| JP7326021B2 (en)* | 2019-05-16 | 2023-08-15 | 朝日インテック株式会社 | Light irradiation device and light irradiation system |
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| WO2023189215A1 (en) | 2023-10-05 |
| JPWO2023189215A1 (en) | 2023-10-05 |
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