JP2006271691A - Laser-induced liquid jet generating device - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a laser-induced liquid jet generating device, safe for both patients and operators, capable of the irradiation of high-output laser beams for a long period of time without a catheter being thermally affected with laser beams. <P>SOLUTION: The laser-induced liquid jet generating device comprises a body 6 filled with a prescribed liquid W which absorbs laser beams, and a laser irradiation part 4 of an optical fiber 2 to which laser beams from a laser oscillator 1 are guided into the body 6. Laser beams are applied from the laser irradiation part 4 toward the liquid W to generate a jet stream J in the liquid W so that the jet is sprayed to the outside from the body 6. The laser-induced liquid jet generating device also comprises a catheter attaching part 12 to be integrally or detachably attached to a catheter member 13 into which the jet stream J is introduced, a jet generating tube part 10 in which the laser irradiation part 4 is stored for generating the jet stream J, and a heat-transfer preventive means 11 for preventing the thermal influence of the laser beams emitted from the laser irradiation part 4 from spreading to the outside via the jet generating tube part 10. <P>COPYRIGHT: (C)2007,JPO&INPIT

Description

  The present invention relates to a laser-induced liquid jet generating device that generates a jet flow by irradiating laser light toward a liquid.

  In recent years, as a means for treating thrombosis in which a human blood vessel is occluded, research on a treatment method in which a liquid jet flow is generated and physically disrupted has been advanced. This treatment method eliminates the need to administer a large amount of a thrombolytic agent with serious side effects such as bleeding, and enables blood resumption earlier than when using a thrombolytic agent alone. It is highly expected as a treatment method. In particular, when the ischemic state continues for 6 hours or more in the brain tissue, it is considered difficult to recover the associated neurological symptoms. However, if the blood flow can be resumed within a few hours after the onset, the therapeutic effect is extremely high.

  In the following Patent Documents 1 and 2 and Non-Patent Document 1, the optical fiber inserted into the catheter is pulse-guided with laser light from a laser oscillator, and the physiological saline filled in the catheter is rapidly ripened, A method of inducing a liquid jet flow and crushing and removing thrombus and the like by the force of the liquid jet flow is described.

  In this method, in order to reach the thrombus without reducing the force of the liquid jet flow and enhance the treatment effect, the catheter with the optical fiber inserted inside is guided close to the thrombus and the liquid jet flow is generated I am letting.

  However, the catheter to be inserted into the blood vessel is extremely thin, and the diameter of the optical fiber to be inserted into the catheter and used must be correspondingly small. In a small-diameter optical fiber, the intensity of laser light that can be guided is limited, and it is extremely difficult to guide high-power laser light. Therefore, in the above method, it is difficult to generate a strong liquid jet flow inside the catheter, and there is a possibility that crushing of a target such as a thrombus may be insufficient.

  In addition, as described in Patent Document 2 below, the conventional catheter is a long and thin tube molded from polypropylene, polyimide or the like as a material, so that it can be deformed along a tortuous blood vessel. Because it is flexible, it is susceptible to thermal effects when using powerful laser light.

  In particular, when an optical fiber having an outer diameter (core diameter) of about 0.4 mm is inserted into a small diameter catheter (usually about 0.9 mm), there is a very small gap between the inner surface of the catheter and the outer surface of the optical fiber. It becomes only. If strong laser light is irradiated in this state, the heat of the laser light is transmitted to the catheter, and the catheter may be melted and deformed. As a result, there is a possibility that the smooth liquid jet flow may be prevented from being ejected, and the life of the catheter itself may be shortened. In addition, heat that melts and deforms the resin or metal acts on the blood vessel wall and may have an adverse effect.

  For the above reasons, as a site for generating a powerful liquid jet flow by irradiating laser light, the outside of the catheter proximal end portion (hand portion) that does not enter the blood vessel than the inside of the catheter inserted into the blood vessel, That is, the outside of the catheter is desirable. However, in this case, since the distance from the laser irradiation part to the catheter tip is longer than that in the above method, in order to generate a liquid jet flow having the same intensity as that in the above method, laser irradiation at a higher output is required. Need to do. Along with this, the temperature around the laser irradiation part becomes considerably high. When the high temperature laser irradiation part directly contacts a patient or an operator, there is a risk of causing burns to the patient or the operator. In addition, the laser beam at high output and the high heat generated by the laser beam accelerate the deterioration of the material in the vicinity of the laser irradiation portion, and thus may cause damage or breakage of the device. Furthermore, when using a drug solution in which a drug such as a thrombolytic agent is dissolved as the liquid to be irradiated with a laser in order to generate a jet flow, the medicinal properties of the drug in the drug solution are reduced or eliminated by the high heat generated by the laser irradiation There is also a risk.

Therefore, when irradiating a laser outside the catheter, how to minimize the influence of the generated heat has been a problem.
JP 2003-111766 (paragraph numbers “0014” and “0015”, see FIG. 1) JP 2002-52084 A (paragraph numbers “0004”, “0010”, “0096”, see FIG. 27E) Japan-Japan Medical Journal Vol. 22 No. 3 (2001) (see page 217)

  The present invention has been made to solve the above-described problems, and the catheter can be irradiated with a laser beam at a high output for a long time without being thermally affected by the laser beam. It is an object of the present invention to provide a laser-induced liquid jet generating device that is safe for humans.

  The laser-induced liquid jet generating device of the present invention that achieves the above object has a main body filled with a predetermined liquid that absorbs laser light, and an optical fiber in which the laser light from a laser oscillator is guided in the main body. A laser-induced liquid jet generating device that includes a laser irradiation unit, irradiates a laser beam from the laser irradiation unit toward the liquid, generates a jet flow in the liquid, and ejects the liquid from the main body to the outside. A catheter mounting portion attached integrally or detachably to a catheter member into which a flow is introduced; a jet generating tube portion in which the laser irradiation portion is housed and generating the jet flow; and an irradiation from the laser irradiation portion To prevent the thermal effect of the laser beam from reaching the outside through the jet generating pipe section. And preventing means, and having a.

  The present invention does not irradiate a laser beam in a narrow and narrow catheter, but irradiates a laser beam in a jet generating tube provided at the base of the catheter, and the generated liquid jet flow from the tip of the jet generating tube to the catheter Therefore, a thin catheter can be used as much as it does not require a space for inserting an optical fiber into the catheter, and laser light irradiation at a higher output becomes possible.

  In addition, since heat transfer prevention means for preventing the thermal effect generated by the laser irradiation section is provided outside the jet generation tube section, the heat is not transmitted to the outside even when laser irradiation is performed at a high output. It will be safe for the person. In addition, the operability is improved, the destruction of blood clots and the like can be performed extremely powerfully and reliably, and the operation can be performed for a long time. Further, even when a chemical solution is used, if the vicinity of the laser irradiation portion of the jet generating tube portion is cooled, the temperature of the chemical solution existing in the vicinity thereof does not increase excessively, and the activity of the chemical solution is not impaired.

  Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings.

<First Embodiment>
FIG. 1 is a schematic cross-sectional view showing a first embodiment of the present invention, FIG. 2 is an enlarged cross-sectional view of the main part of FIG. 1 showing a modification of the jet generating pipe section, and FIG. 3 is another modification of the jet generating pipe section. The principal part expanded sectional view shown, FIGS. 4-9 is a schematic sectional drawing which shows the structural example of the front-end | tip part of a jet generating pipe part.

  The laser-induced liquid jet device of this embodiment generally includes a laser oscillator 1, an optical fiber 2 connected to the laser oscillator 1, a base 3 that inserts and holds the optical fiber 2, and a tip of the optical fiber 2 that extends from the base 3. Part, that is, the laser irradiation part 4 is composed of a main body 6 having an operating part 5 provided inside the jet generating pipe part 10.

  In the present embodiment, since it is preferable to use the long jet generation tube portion 10 in order to enable laser irradiation with high output, the base portion 3 and the operation portion 5 are separated.

  The laser oscillator 1 and the optical fiber 2 are well known and will not be described.

  Further details will be described. First, in the base 3 of the main body 6, a so-called Y connector 8 is screwed into the tip of a connecting member 7 connected to the laser oscillator 1, and a first valve 8 a of the Y connector 8 is elastically deformed in a valve body. 9 is provided so that the optical fiber 2 inserted therein by the connecting member 7 and the Y connector 8 being screwed can be elastically pressurized from the outer periphery to be in a fixed state or in an open state. . The second port 8b is provided with a liquid injection member P such as a syringe pump for injecting a predetermined liquid W (solid arrow) such as a chemical solution in which a drug such as physiological saline or a thrombolytic agent is dissolved.

  The actuating part 5 of the main body 6 is arranged in a substantially series from the base end side (the side near the laser oscillation source is referred to as the base end side, and the side jetting the jet stream J is referred to as the front end side). The heat transfer prevention means 11, the catheter attachment portion 12, and the catheter member 13 are configured.

  The jet generating tube portion 10 is a thin straight tube having a proximal end connected to the Y connector 8 of the base 3 and a distal end directed toward the inside of the catheter member 13. The optical fiber 2 is inserted into the jet generating tube portion 10. A jet stream J is generated. Therefore, since the jet generation pipe part 10 is exposed to high temperature, it is preferable to comprise the metal pipe (SUS etc.) which has a certain amount of heat resistance.

  However, it is difficult to completely suppress the deterioration and deterioration of the jet generation tube portion 10 due to laser irradiation. For example, a phenomenon such as SUS or the like in which the inner surface is discolored or deteriorated may occur. This is a phenomenon that occurs when a part of the laser beam is absorbed by the jet generation tube unit 10, and in order to suppress this phenomenon, a substance having an excellent reflectivity of the laser beam is applied to the inner surface of the jet generation tube unit 10, in particular. It is effective to provide in the vicinity of the tip of the optical fiber 2. In some cases, it is also effective to form only a substance having excellent reflectivity only in the vicinity of the laser irradiation section 4 of the jet generating tube section 10 and to bond SUS or the like before and after the substance. This reflection layer can be expected to suppress the absorption of laser light and the accompanying deterioration and deterioration of the jet generating tube section 10 and further increase the power of the liquid jet. Examples of the material suitable for the light reflecting layer include gold, platinum, silver, copper, and aluminum. In view of safety in the living body, it is desirable that gold or platinum is a main component. The thickness of the reflective layer is about several microns, so that the laser beam may be transmitted, the base material may deteriorate, and the reflective layer may be peeled off. It is desirable to do. Mirror finishing of the inner surface of the jet generating tube portion 10 including these reflective layers is also effective in improving the laser reflectivity.

  In particular, in the present embodiment, the jet generating pipe section 10 regulates the internal liquid W itself so as not to miss the reaction of the jet stream J, and the jet stream J is directed forward. , And a length Lo (see FIG. 1) of a portion where the optical fiber 2 and the jet generating tube portion 10 overlap (hereinafter, for the sake of simplicity) is determined. In this way, as the gap G is narrowed and the length Lo of the overlap portion is increased, the resistance to the reverse flow of the jet stream J toward the base increases, so that the stronger jet stream J Can be introduced into the catheter member 13. Moreover, the surgeon can control the strength of the jet stream J by adjusting the length Lo of the overlapping portion of the optical fiber 2 and the jet generating tube section 10.

  In the illustrated example, the main body 6 and the jet generating pipe section 10 are separated from each other. However, the present invention is not limited to this, and the main body is provided as long as it has pressure resistance enough to withstand high heat by laser irradiation. A part of the inside of 6 may be formed in a tubular shape to form the jet generating tube portion 10.

  The position of the laser irradiation unit 4 preferably has a predetermined distance L <b> 1 between the tip of the jet generating tube unit 10. In this way, the jet flow J generated in the jet generating pipe section 10 can be ejected powerfully toward the jet outlet of the main body 6 without unnecessarily diffusing and without substantially weakening. .

  As for the position of the optical fiber 2, the distal end portion of the optical fiber 2 should be arranged at the center of the lumen of the jet generating tube portion 10 as much as possible in order to obtain a stable liquid jet output while suppressing deterioration of the jet generating tube portion 10. . Specifically, a radial protrusion corresponding to less than ½ of the difference between the outer diameter of the optical fiber 2 and the inner diameter of the jet generating tube 10 is formed in a part of the lumen of the overlapping portion of the jet generating tube 10. (Not shown) is preferably provided. In this way, the laser irradiation unit 4 can be positioned at the center of the inner cavity of the jet generation tube unit 10 while maintaining the liquid supply of the predetermined liquid W, and laser irradiation at the eccentric position can be suppressed. In addition, it is preferable that the number of the radial protrusions is two or more, and each supports the optical fiber 2 evenly in the jet generating pipe portion 10. However, considering the liquid feeding resistance of the liquid W, the optimal number of radial protrusions is 2 to 4.

  The outer diameter of the optical fiber 2 and the inner diameter of the jet generating tube portion 10 are not particularly limited. However, when the jet stream J is generated in a low-viscosity liquid such as water or physiological saline, The inner diameter is preferably 1.05 to 1.50 times the outer diameter of the optical fiber 2, the length Lo of the overlapping portion is preferably 30 to 150 mm, the outer diameter of the optical fiber 2 is 600 to 800 μm, and the inner diameter of the jet generating tube section 10 Is preferably 700 to 1000 μm. However, in the case where the jet stream J is generated in a high-viscosity liquid such as a contrast agent, it is desirable to increase the gap width between the jet generating tube section 10 and the optical fiber 2 from the viewpoint of liquid feeding resistance. The distance L1 between the distal end of the jet generating tube section 10 and the distal end of the optical fiber 2 (laser irradiation section 4) is preferably 25 to 120 mm.

  The heat transfer preventing means 11 of this embodiment is such that the outer periphery in the vicinity of the laser irradiating unit 4 provided in the jet generating tube unit 10 is covered with a heat insulator 14 and is connected to the jet generating tube unit 10. However, the heat transfer prevention means 11 does not have to transmit the thermal influence of the jet generating pipe section 10 to the outside. For example, as shown by a one-dot chain line in FIG. 1, the exposed jet generating pipe section 10 is entirely covered. It may be provided as follows.

  As the heat insulator 14, for example, an internal fluid covered with a capsule-shaped sheathing material 15, a capsule-shaped sheathing material 15 whose inside is evacuated, or a heat-insulating material attached to the outer periphery of the jet generating pipe portion 10. Etc. can be used. That is, the heat insulator 14 in this specification does not mean only a material that prevents heat transfer, but should be understood in a broad sense including the heat transfer prevention structure exemplified above.

  Note that the capsule-shaped exterior material 15 is preferably made of a material having some heat resistance (such as SUS). When a heat-resistant material is used as the exterior material 15, the jet generating tube portion 10 is not formed separately from the heat transfer prevention means 11, but may be formed as a part of the heat transfer prevention means 11. Good.

  The catheter member 13 includes a catheter hub 16, a connecting pipe portion 17 provided on the proximal end side of the catheter hub 16, and an elongated tube 18 provided on the distal end side of the catheter hub 16. An anti-kink protector 19 is provided on the outer periphery between the two.

  The catheter member 13 and the sheathing material 15 are connected by a catheter mounting portion 12 that is detachably attached to each other, and the inner peripheral surface of the connecting tube portion 17 of the catheter member 13 is generally formed in a tapered shape. By pushing the portion 15a into the catheter member 13, both are fitted in a liquid-tight manner.

  The catheter mounting portion 12 is formed of a substantially cylindrical member, the distal end side is connected to the connecting tube portion 17 by a screw, and the inner protrusion 12a formed on the proximal end side is a part of the outer peripheral surface of the exterior member 15. Fits over the bulging part. Therefore, the catheter attachment portion 12 is temporarily held at the portion bulged by being inserted into the exterior member 15, and is fixedly connected by screwing at the screw portion. However, not only this but you may comprise integrally with the exterior | packing material 15 or the catheter member 13. FIG.

  In particular, in the catheter member 13, it is desirable that the jet flow J injected from the distal end portion of the jet generating tube portion 10 is introduced so as not to lose output. Therefore, in this embodiment, the jet flow inlet 20 of the catheter member 13 is used. Are arranged coaxially so that the tip of the jet generating tube portion 10 faces. As a result, the jet flow inlet 20 of the catheter member 13 and the tip of the jet generating tube portion 10 are connected in a substantially liquid-tight manner to such an extent that the jet flow J from the jet generating tube portion 10 does not lose output power. It is easy to introduce the force of the liquid jet flow generated by the irradiation into the catheter.

  The jet generating tube section 10 and the catheter member 13 are preferably brought into contact with each other, but may be slightly separated from each other to such an extent that the jet flow J does not substantially lose output.

  Further, the inner diameter d of the jet flow introduction port 20 in the catheter member 13 and the inner diameter D2 of the jet generating tube section 10 may be the same in order to prevent the jet flow J from being lost, but FIG. As shown in FIG. 6, if the relationship of D2> d is satisfied, the jet stream J flows from a wide area to a narrow area, so that a stronger jet stream J can be obtained, which is preferable.

  Further, as shown in FIG. 3, if the jet generating tube portion 10 is expanded to the end, the tip portion of the jet generating tube portion 10 is expanded in diameter, so that it closely contacts the inner surface of the connecting tube portion 17, The jet generating tube portion 10 is more surely sealed in the catheter member 13, which is preferable.

  4 to 9 are structural examples of the distal end portion of the jet generating tube portion 10. In order to suppress the loss of the output of the liquid jet 19 as much as possible, when the catheter member 13 and the heat insulator 14 are connected by the catheter mounting portion 12, the gap through which the liquid jet flow J escapes is not generated as much as possible, and the catheter is mounted. It is important to avoid complication of the shape of the portion 12.

  FIG. 4 shows an example of the structure of the tip of the jet generating tube portion when the jet generating tube portion 10 is brought into direct contact with the catheter hub 16. This structure example is simple in configuration and advantageous in cost. However, at the time of connection with the jet generating tube portion 10, there is a possibility that the lumen of the catheter hub 16 may be damaged at the distal end portion of the jet generating tube portion 10. For this reason, as shown in FIG. 5, a protective member 21 made of a flexible material may be provided at the tip of the jet generating tube portion 10.

  FIG. 6 shows an example of a structure in which a gap preventing member 22 made of a flexible material that closes the gap between the lumen of the catheter member 13 is provided at the tip of the jet generating tube section 10. For example, when the lumen of the catheter member 13 is larger than the outer diameter of the jet generating tube portion 10, providing the gap preventing member 22 at the tip of the jet generating tube portion 10 improves the adhesion with the lumen of the catheter member 13. In addition, damage to the catheter hub 16 can be suppressed.

  FIG. 7 shows an example of a structure in which the jet generating pipe 10 is covered with a covering 23 made of the same material (synthetic resin or the like) as the material forming the exterior material 15 in order to reinforce the jet generating pipe 10. is there. Also in this case, if the outer peripheral surface of the covering 23 is formed in a taper shape, the adhesion with the lumen of the catheter member 13 is improved.

  FIG. 8 shows an example of a structure in which the distal end portion of the jet generating tube portion 10 is close to or inserted into the lumen of the tube 18 without being in close contact with the catheter member 13. FIG. 9 is a structural example in which a stepped portion 24 is formed in the lumen of the catheter hub 16 and the distal end portion of the jet generating tube portion 10 is fitted. Even in this case, the jet flow J can be caused to flow into the tube 18.

  However, in the case of the example shown in FIGS. 8 and 9, if there is a large inner diameter difference between the distal end portion of the jet generating tube portion 10 and the lumen of the tube 18 or the catheter hub 16, output loss may occur. The inner diameter difference between the outer diameter of the distal end portion of the jet generating tube section 10 and the inner surface or lumen of the catheter hub 16 that is closest is preferably 100 μm or less.

  Next, the operation will be described.

  First, after priming the inside of the catheter member 13, a guide wire (not shown) is inserted into the catheter member 13, and the catheter member 13 is transported to the target site of the blood vessel while being guided by the guide wire. When the catheter member 13 reaches the target site, the guide wire is removed from the catheter member 13.

  On the other hand, when the liquid W is injected into the Y connector 8 via the second port 8 b of the Y connector 8, the liquid W passes through the second port 8 b of the Y connector 8 → the first port 8 a → the jet generation pipe portion 10. And flows out from the tip of the jet generating pipe section 10. As a result, it is understood that the liquid W is full, and the priming of the main body 6 is completed.

  Subsequently, the end portion 15 a of the sheathing member 15 is inserted into the catheter hub 16 of the catheter member 13, and the catheter member 13 and the sheathing member 15 are connected in a fluid-tight manner by the catheter attachment portion 12. Then, the liquid W is fed by the liquid injection member P, and the optical fiber 2 is inserted through the valve body 9 while flowing the liquid W into the catheter member 13 and the main body 6, and the distal end portion passes through the first port 8a. That is, when the laser irradiation unit 4 reaches the inside of the jet generating tube unit 10, it stops. The position of the laser irradiation unit 4 is set to a predetermined distance L1 from the tip of the jet generating tube unit 10. The heat transfer preventing means 11 is positioned on the outer peripheral surface of the jet generating tube portion 10 corresponding to the laser irradiation unit 4. At this stage, when the Y connector 8 is screwed into the connecting member 7, the valve body 9 is compressed and deformed, and the position of the optical fiber 2 in the jet generating tube portion 10 is fixed.

  However, in the embodiment, when the position of the optical fiber 2 is slid in the longitudinal direction in the jet generating pipe portion 10 by adjusting the position by tightening or loosening the valve body 9 with the Y connector 8, that is, If the length Lo of the overlapping portion of the optical fiber 2 is adjusted, the reverse flow of the jet stream J can be adjusted, and the output of the jet stream J from the tip of the device can be adjusted. The position in the jet generating pipe section 10 is determined.

  Then, when the liquid injection member P is operated to supply the liquid W to the tube 18 and the optical fiber 2 is connected to the laser oscillator 1 and the laser oscillator 1 is operated, the laser light is pulsed from the laser irradiation unit 4 to the liquid W. Is irradiated. Since this irradiation is performed not in the tube 18 of the catheter member 13 but in the jet generating tube portion 10, the liquid W is rapidly vaporized in the jet generating tube portion 10 to generate bubbles. The bubbles generated intermittently by the irradiation of the pulsed laser light abruptly pressurize and exclude the liquid W in the jet generating pipe section 10 to generate a liquid jet flow J.

  In the present embodiment, since the distal end of the jet generation tube portion 10 and the jet flow introduction port 20 of the catheter member 13 are at the opposing positions, the generated liquid jet flow J is quickly propagated to the liquid W in the tube 18, The liquid W in the tube 18 is ejected toward the front thrombus. Thereby, the thrombus in the blood vessel is crushed with the collision of the strong liquid jet stream J and the assistance of the thrombolytic agent, and blood reperfusion is started in the blood vessel. When it is confirmed that the thrombus has been crushed, the optical fiber 2 is removed from the tube 18 of the catheter member 13, and a suction device such as a syringe is attached to the second port 8 b of the Y connector 8. To the outside. Note that the clotted thrombus may be sucked through the lumen of a guide catheter (not shown) having a role of guiding the catheter member 13 together with the guide wire toward the target site of the blood vessel.

<Modification 1>
FIG. 10 is a schematic sectional view showing a first modification of the present embodiment. In addition, the same code | symbol is attached | subjected to the member which is common in the member shown to FIG.1, 2, and description is abbreviate | omitted.

  The heat transfer preventing means 11 of the above embodiment is a capsule having the heat insulator 14 covered with the exterior material 15, but the present invention is not limited to this and may flow a cooling fluid. As the cooling fluid, tap water or the like can be used, but it is preferable to use a predetermined liquid W for generating a liquid jet. The temperature of the cooling fluid is not particularly limited as long as it can sufficiently cool the jet generating pipe section 10, and is preferably room temperature (about 25 degrees) or lower.

  The heat transfer preventing means 11 of this modification is configured by a pipe line 30 that is provided so as to wrap the jet generating pipe part 10 over a wide range and in which a cooling fluid flows. The pipe line 30 includes an inlet 31 provided at a distal end portion into which a cooling fluid flows and an outlet 32 provided at a proximal end portion for discharging the cooling fluid. It is provided at a position corresponding to the laser irradiation unit 4 or in front thereof. Therefore, since the cooling fluid does not flow into the jet generation pipe section 10 and is used only for cooling the jet generation pipe section 10, tap water may be used.

  In this way, the cooling fluid flowing in from the inlet 31 first cools the laser irradiation section 4 and its vicinity that are highest in temperature among the jet generation pipe section 10, and the surroundings of the jet generation pipe section 10. Therefore, it can be efficiently cooled over a wide range. In addition, when the cooling fluid is continuously flown, the jet generating tube section 10 can be continuously cooled, so that it can be used for a long time, and the operator can operate with peace of mind without having to worry about anything, such as thrombus Destruction can be performed extremely powerfully and reliably.

<Second Embodiment>
FIG. 11 is a schematic sectional view showing a second embodiment of the present invention. In addition, the same code | symbol is used for the member which is common in the member shown in FIG. 1, etc., and description is abbreviate | omitted.

  In the above-described embodiment, the cooling liquid that cools the jet generating pipe section 10 and the liquid that guides the liquid that is guided into the jet generating pipe section 10 are used. However, in the present embodiment, the cooling liquid is used. Is used by guiding it to the jet generating pipe section 10.

  As shown in FIG. 11, the conduit 30 is provided with an inflow port 31 at a position corresponding to the laser irradiation unit 4, and an outflow port 32 opened upward on the proximal end side of the conduit 30. The liquid W that has flowed out through the conduit 33 connected to the outflow port 32 is guided into the jet generating pipe section 10.

  In this way, even if laser irradiation is performed in the jet generation pipe section 10, the cooling fluid flowing in from the inlet 31 immediately flows out from the outlet 32, and the flow rate of the cooling fluid in the pipe 30 increases. The cooling effect of the jet generating pipe part 10 is improved. In addition, since the cooling liquid is directly guided to the jet generating tube section 10 and used, the convenience for the operator is further improved and the apparatus can be used for a long time.

Also in the embodiment, when the Y connector 8 is tightened, the position of the optical fiber 2 in the jet generating tube portion 10 can be adjusted and fixed by the valve body 9, whereby the jet generating tube portion 10 and the optical fiber 2 overlap. By adjusting the length Lo of the portion, the output of the jet flow J from the tip of the device can be adjusted while adjusting the reverse flow of the jet flow J.
<Modification 1>
FIG. 12 is a schematic cross-sectional view showing a first modification of the second embodiment. In addition, the same code | symbol is used for the member which is common in the member shown in FIG.1 and FIG.11 etc., and description is abbreviate | omitted.

  This modification 1 is also used by guiding the cooling liquid to the jet generating pipe section 10, but in this pipeline 30, an inlet 31 and an outlet 32 are provided at positions corresponding to the laser irradiation section 4, A cooling fluid is introduced into the jet generating pipe section 10 through a conduit 33 from a second outlet 34 separately provided on the proximal end side of the pipe 30.

  In this way, even if laser irradiation is performed in the jet generation pipe section 10, the cooling fluid flowing in from the inlet 31 immediately flows out from the outlet 32, and the flow rate of the cooling fluid in the pipe 30 increases. The cooling effect of the jet generating pipe part 10 is improved. In addition, since the cooling liquid is guided to the jet generation tube section 10 and used, it is not necessary to inject the liquid W independently by a syringe pump or the like, and the convenience for the operator is further improved. Can be used. In addition, it is functionally similar to the above embodiment in that the destruction of the thrombus and the like can be performed extremely powerfully and reliably.

<Modification 2>
FIG. 13 is a schematic cross-sectional view showing a second modification of the present embodiment, and FIG. 14 is a schematic perspective view showing the main part of FIG. In addition, the same code | symbol is attached | subjected to the member which is common in the member shown to the said figure, and description is abbreviate | omitted.

  In the second embodiment, when the cooling liquid is guided to the jet generating pipe section 10 and used, the base 3 and the operating section 5 of the main body 6 are formed separately. 30 is directly connected to the connecting member 7, and the jet generating pipe portion 10 is completely accommodated in the pipe line 30.

  The pipe line 30 of this modification is one in which one end is connected to the catheter member 13 and the other end is connected to the connecting member 7, and the jet generating pipe part 10 is completely accommodated therein, and only the inlet 31 is irradiated with laser. The cooling liquid that is provided at a position corresponding to the section 4 or in front of the laser irradiation section 4 (at the front end side) and that flows in from the inlet 31 opens the proximal end of the jet generation pipe section 10 on the proximal end side of the conduit 30. It is made to flow into the jet generating pipe part 10 from the hole 10a.

  In this way, when laser irradiation is performed in the jet generation tube unit 10, the cooling fluid flowing in from the inlet 31 first cools the position corresponding to the laser irradiation unit 4 having the highest temperature in the jet generation tube unit 10. Then, it flows along the periphery of the jet generation pipe section 10 and flows into the jet generation pipe section 10 from the proximal end opening 10 b of the jet generation pipe section 10. Therefore, the outflow port 32 and the Y connector 8 are not required, the complicated liquid feeding path is simplified, and the configuration is extremely simple.

  Here, the proximal end side portion of the jet generating pipe section 10 may be simply opened in the pipe line 30, but since it is a free end, the supporting state becomes unstable and insertion of the optical fiber 2 is troublesome. There is a risk of becoming. Therefore, in this modification, as shown in FIGS. 13 and 14, a pipe support plate 35 formed in a tapered shape is provided at the end of the jet generating pipe part 10, and the large diameter part of the pipe support plate 35 is a pipe line. It is preferable that the jet generating tube portion 10 is supported in contact with the inner surface of 30. However, in such a tube support plate 35, since the liquid W does not flow into the jet generating tube section 10, it is preferable to provide a communication hole 36 through which the cooling fluid flows in the tube support plate 35.

  As a result, the base side of the jet generating pipe part 10 is fixedly supported in the pipe 30, and the cooling liquid flows through the communication hole 36, and the pipe support plate 35 expands in a tapered shape. Therefore, it becomes easier to insert the optical fiber 2 into the jet generating tube section 10 and workability is improved.

<Modification 3>
FIG. 15 is a schematic cross-sectional view showing a third modification of the second embodiment, and FIG. 16 is an enlarged cross-sectional view of the main part of FIG. In addition, the same code | symbol is attached | subjected to the member which is common in the member shown to the said figure, and description is abbreviate | omitted.

  In the modified example 2, since the pipe support plate 35 is provided on the base side of the jet generating pipe section 10, there is a possibility that the manufacture of the jet generating pipe section 10 is troublesome. For this reason, in this modification, the support body 37 separate from the jet generating pipe section 10 is fitted into the base side of the pipe line 30 and fixedly supported on the base side of the jet generating pipe section 10.

  The support body 37 has a liquid feeding lumen (communication hole 38) for flowing a cooling liquid, and can support the jet generating pipe section 10 with the inner peripheral surface of the pipe line 30. In this modification, as shown in FIG. 16, the tube has a short axial length and is around the axial center hole 39 through which the jet generating tube portion 10 is inserted. In addition, four communication holes 38 are opened in parallel to the axis. However, it is preferable that the shaft center hole 39 has a shape that expands in a tapered shape toward the base end side as illustrated in order to facilitate insertion of the optical fiber 2.

  In this way, since the base side of the jet generating tube portion 10 is fixedly supported by the shaft center hole 39 of the support body 40, the optical fiber 2 is inserted through the connecting member 7 and the valve body 9. Even if it exists, the insertion to the jet generation pipe part 10 becomes easy. In addition, the cooling fluid that has flowed in from the inflow port 31 can be U-turned through the communication hole 38 of the support 37 and flow into the jet generating pipe portion 10 through the axial center hole 39.

  17 to 19 are cross-sectional equivalent views taken along the line 17-17 in FIG. 16, and each show a modification of the support. In the example of FIG. 16, the support body 37 is provided with four communication holes 38 having the same diameter. However, the present invention is not limited to this, and as shown in FIG. A hole 38 may be provided, and as shown in FIG. 18, a rib 40 that connects the support 37 to the center boss portion 37a and the outer peripheral portion 37b is provided at a position of approximately 180 degrees. It may have two large communication holes 38. Further, as shown in FIG. 19, the conduit 30 and the support 37 may be integrally formed, and a communication hole 38 may be formed between the ribs 41 that connect both.

  Note that the support 37 may be provided not only at the base side end of the jet generating pipe part 10 but also at the intermediate part.

<Modification 4>
FIG. 20 is a schematic cross-sectional view showing Modification 4 of the second embodiment. In addition, the same code | symbol is attached | subjected to the member which is common in the member shown to the said figure, and description is abbreviate | omitted.

  In the modified example, since the pipe 30 that is closed at one end is used and the cooling liquid is caused to flow in the thin jet generating pipe portion 10, the cooling liquid W cannot be supplied in a large amount. In this modification, the pipe line 30 has a side port 42 through which the liquid W flows out so that a large amount of the cooling liquid W can flow.

  In this way, a part of the cooling liquid W that has flowed into the pipe line 30 from the inlet 31 is irradiated with the laser while flowing the cooling liquid into the jet generation pipe section 10, and the remaining cooling liquid W Since the liquid W can flow out from the side port 42, a large amount of cooling fluid can be flowed around the jet generating pipe section 10, and the cooling effect of the jet generating pipe section 10 is enhanced, and the operation can be performed for a long time. It becomes possible. In addition, after crushing the thrombus, etc., by jetting a more powerful jet stream J with high-power laser irradiation, a syringe or the like is connected to the side port 42, and the cooling liquid W is sucked to crush the thrombus. It is also possible to take out the outside in the same manner as described above.

  The present invention irradiates the liquid filled in the body with a laser beam having a wavelength that is easily absorbed from the tip of the optical fiber in a pulsed manner to rapidly ripen the liquid to generate bubbles, and the resulting liquid jet flow It can be used as a therapeutic tool for crushing thrombus.

It is a schematic sectional drawing which shows 1st Embodiment of this invention. It is sectional drawing which expanded the principal part of FIG. 1, which shows the modification of a jet generating pipe part. It is a principal part expanded sectional view which shows another modification of a jet generating pipe part. It is a schematic sectional drawing which shows the structural example of the front-end | tip part of a jet generating pipe part. It is a schematic sectional drawing which shows the structural example of the front-end | tip part of a jet generating pipe part. It is a schematic sectional drawing which shows the structural example of the front-end | tip part of a jet generating pipe part. It is a schematic sectional drawing which shows the structural example of the front-end | tip part of a jet generating pipe part. It is a schematic sectional drawing which shows the structural example of the front-end | tip part of a jet generating pipe part. It is a schematic sectional drawing which shows the structural example of the front-end | tip part of a jet generating pipe part. It is a schematic sectional drawing which shows the modification 1 of 1st Embodiment. It is a schematic sectional drawing which shows the 2nd Embodiment of this invention. It is a schematic sectional drawing which shows the modification 1 of 2nd Embodiment. It is a schematic sectional drawing which shows the modification 2 of 2nd Embodiment. It is a schematic perspective view which shows the principal part of FIG. It is a schematic sectional drawing which shows the modification 3 of 2nd Embodiment. It is a principal part expanded sectional view of FIG. It is sectional drawing which shows the modification of a support body. It is sectional drawing which shows the modification of a support body. It is sectional drawing which shows the modification of a support body. It is a schematic sectional drawing which shows the modification 4 of 2nd Embodiment.

Explanation of symbols

1 ... Laser oscillator,
2 ... Optical fiber,
4 ... Laser irradiation part,
6 ... body,
9 ... valve body (fixing means),
10 ... jet generating pipe part,
11 ... Heat transfer prevention means,
12 ... catheter attachment part,
13 ... catheter member,
14 ... thermal insulation,
20: Jet flow inlet,
30 ... pipeline,
31 ... Inlet,
32 ... Outlet,
33 ... conduit,
35 ... Tube support plate,
36, 38 ... communication hole,
40 ... support,
D1 ... the inner diameter of the part where the optical fiber is inserted,
D2: Inner diameter from laser irradiation part to tip part,
G ... Gap,
J ... Jet flow,
Lo ... the overlapping length,
L1 ... Distance between the laser irradiation part and the tip of the jet generating pipe part,
W ... Liquid.

Claims (16)

It has a main body filled with a predetermined liquid that absorbs laser light, and an optical fiber laser irradiation part that guides the laser light from the laser oscillator is provided in the main body, from the laser irradiation part toward the liquid In a laser-induced liquid jet generating device that irradiates a laser beam to generate a jet flow in the liquid and ejects the liquid from the main body,
The main body includes a catheter attachment portion that is integrally or detachably attached to a catheter member into which the jet flow is introduced, a jet generation tube portion that accommodates the laser irradiation portion and generates the jet flow, A laser-induced liquid jet generating device, comprising: heat transfer preventing means for preventing thermal influence of the laser light irradiated from the laser irradiating part from reaching the outside through the jet generating tube part.   2. The jet generating pipe section is configured to determine a gap between the optical fiber and a length overlapping with the optical fiber so that the liquid inside restricts reaction of the jet flow. A laser-induced liquid jet generating device described in 1.   3. The laser-induced liquid according to claim 1, wherein the jet generating tube portion is installed so that at least a tip portion of the jet generating tube portion and a jet flow inlet of the catheter member are coaxial. Jet generation device.   The said jet generation pipe part connected the front-end | tip part of the said jet generation pipe part, and the jet flow introduction port of the said catheter member substantially liquid-tightly, The Claim 1 characterized by the above-mentioned. Laser-induced liquid jet generation device.   5. The laser-induced liquid jet generation according to claim 1, wherein the optical fiber is accommodated so that the laser irradiation unit has a predetermined distance from a tip of the jet generation tube unit. device.   The laser-induced liquid jet generating device according to claim 1, wherein the main body includes a fixing unit that fixes a position of a distal end portion of the optical fiber in the jet generating pipe portion to a predetermined position.   The heat transfer prevention means is configured by a heat insulator provided so as to cover at least the periphery of the jet generating pipe part corresponding to the position of the laser irradiation part. The laser-induced liquid jet generating device as described.   The laser-induced liquid according to any one of claims 1 to 7, wherein the heat transfer preventing means is constituted by a pipe line arranged so that a cooling fluid flows around the jet generating pipe part. Jet generation device.   The pipe line is provided at or in front of a position corresponding to the laser irradiation unit, and has an inflow port through which the cooling fluid flows in and an outflow port through which the cooling fluid is discharged, and flows in from the inflow port. 9. The laser-induced liquid jet generating device according to claim 8, wherein the cooling fluid is configured to flow along the periphery of the jet generating pipe portion and to flow out from the outlet.   10. The laser-induced liquid jet generating device according to claim 8, wherein the pipe has a conduit for guiding the cooling fluid flowing out from the outlet into the jet generating pipe.   The said pipe line has the said inflow port provided in the position corresponding to the said laser irradiation part, The said fluid was made to flow in from the base end part side of the said jet generation pipe part. The laser-induced liquid jet generating device according to any one of the above.   The laser-induced liquid jet generating device according to any one of claims 8 to 11, wherein the pipe has the inlet and the outlet at a position corresponding to a tip of the jet generating pipe section.   Any of the paragraphs 8 to 12, wherein the pipe has a support body for supporting the jet generating pipe section therein, and a communication hole through which the cooling fluid flows is formed in the support body. A laser-induced liquid jet generating device according to claim 1.   The jet generation pipe part has a pipe support plate that contacts the inner surface of the pipe line on the base side to support the jet generation pipe part, and a communication hole through which the cooling fluid flows is formed in the pipe support plate. 14. The laser-induced liquid jet generating device according to any one of claims 8 to 13, wherein the device is a laser-induced liquid jet generating device.   15. The laser-induced liquid according to claim 1, wherein at least an inner wall near the tip of the optical fiber contains a substance that reflects laser light having a predetermined wavelength. Jet generation device.   The laser-induced laser according to any one of claims 1 to 15, wherein the jet generation tube portion has a radial protrusion that disposes at least a tip portion of an optical fiber at an axial center of a lumen of the jet generation tube portion. Liquid jet generating device.

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