JPH07328025A - Medical laser device - Google Patents

Abstract

PURPOSE:To provide a medical laser device having high light conductivity and good operability without being broken by a laser beam. CONSTITUTION:This medical laser device is constituted of a Q-switch ruby laser oscillator 101 oscillating a high-output laser beam, a fiber bundle 113 having an incidence end section integrated with multiple optical fibers by the fusion of clad and introducing the laser beam, and a hand piece 103 fitted at the outgoing end section of the fiber bundle 113 and radiating the laser beam to a treatment portion.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a medical laser device, and more particularly to improvement of a light guide path for guiding a laser beam to a handpiece.

[0002]

2. Description of the Related Art A medical laser is known as a device for treating a tissue (abnormal tissue) forming a skin disease such as a bruise.
This treatment involves irradiating a laser beam of a specific wavelength (eg, ruby laser) that is not much absorbed by normal tissue but is much absorbed by abnormal tissue to destroy normal tissue while suppressing damage to normal tissue. It is the basic principle. That is, the abnormal tissue is destroyed as follows.
When the laser beam is applied to the epidermis, a part of it is reflected by the surface and the rest penetrates into the skin. The laser beam is scattered and absorbed little by little in the skin, and the intensity of the laser beam is transmitted while it is weakened. When the laser beam reaches the abnormal tissue, most of it is absorbed and converted into heat, which destroys the abnormal tissue.

Further, this treatment has a greater effect on normal tissues as the treatment time increases, so it is desired to destroy abnormal tissues in the shortest possible time (desirably 40 nsec or less). In particular, when the treatment site is deep, the laser beam must be attenuated so much that it has a large peak output.

In response to this, a technique called a Q-switch method has been developed which is capable of oscillating a high-power laser beam (hereinafter referred to as a giant pulse) in a short time. However, although it became possible to oscillate a giant pulse by this Q-switch method, the conventional light guide path (optical fiber light guide method, mirror junction light guide method)
Then there are various problems.

The conventional optical fiber guiding system will be described below.

FIG. 5 is a schematic configuration diagram of an optical fiber.
As shown in FIG. 5, the optical fiber is a region 501 (hereinafter, referred to as a core) formed of a transparent body having a predetermined refractive index.
And a region 502 having a lower refractive index than the core 501 (hereinafter referred to as a clad).

When light is guided using an optical fiber as shown in FIG. 5, the laser beam oscillated by the laser oscillator is
The light is focused on the entrance end of the optical fiber by the lens. The condensed laser beam is guided by an optical fiber to a handpiece provided at the emission end of the optical fiber. The guided laser beam is applied to the treatment site via the handpiece. The light guide rate of the entire light guide path using the optical fiber is about 60%.

When irradiating a high-power laser beam using such an optical fiber, there are the following problems.

When light is guided by a single optical fiber as shown in FIG. 5a, since the area of the optical fiber end face is small, the fiber end face is irradiated with a laser beam having a remarkably large peak output. As a result, the end face of the fiber is broken above the breaking threshold. When a plurality of optical fibers are bundled as shown in FIG. 5b, the material for bundling the optical fibers is melted and the fiber end face is destroyed. Even if it is not destroyed, the light guide rate is lowered because the laser beam is applied to the parts other than the core and the clad.

On the other hand, as an alternative to the optical fiber light guide system, there is known a so-called mirror junction light guide system which is also compatible with the Q switch method.

The mirror-int light guide system will be described below.

FIG. 6 is an example of a schematic configuration diagram of the mirror joint light guide path 601. In FIG. 6, the mirror joint light guide 601 includes a multi-joint (for example, seven joints) tubular body portion in which a plurality of arm tubular bodies 602 are rotatably coupled to each other by a plurality of joints 603. And
Inside the John Into 603, a mirror 604 for bending the laser beam at a right angle is individually provided at 45 degrees with respect to the cylindrical body 602. Also, the mirror joint light guide path 6
A light transmission member 605 is provided on the input surface 01.
The mirror junction light guide 601 configured in this way
In, the giant pulse output from the laser oscillation unit is transmitted through the light transmission member 605, reflected by each mirror 604, and guided to the handpiece. Handpiece
The rotation of each joint of the mirror penetration light guide 601 is used to press the beam output surface thereof against the treatment surface. As described above, the mirror penetration light guide 601 can be guided to the handpiece without being destroyed by the laser beam. The light guide ratio of the mirror junction light guide 601 is 7
When using one sheet, it is about 90%.

However, this mirror-int light guide 601 has the following problems. Joint 603
Is a movable part (rotates), so that the mirror 604 provided inside the joint moves, and the optical axis easily shifts. Further, the optical axis adjustment is troublesome because a specialized engineer must be dispatched each time.

Further, in order to make the optical axes of the mirrors coincide with each other, the cylindrical body 602 needs to be a strong pipe, and a ball bearing or the like for smoothly rotating the John Into 603 is also required. As a result, the weight of the whole mirror light guide 601 becomes heavy and the operability deteriorates.

[0015]

As described above, when one optical fiber is used, the end face of the fiber is broken because the end face of the fiber is small. When a plurality of optical fibers are used, the material for bundling the optical fibers is melted and the end faces of the fibers are destroyed.

When the mirror-int light guide is used, since the joint 603 is a movable part, the optical axis is likely to shift, and a specialized engineer must be dispatched to adjust the optical axis. That is, the optical axis adjustment is troublesome. Then, a strong cylindrical body 602 and a joint 6 that make the optical axes of the mirrors coincide with each other.
Due to the ball bearing or the like that smoothly rotates 03, the weight of the entire mirror joint optical path 601 becomes heavy and the operability deteriorates.

Therefore, the present invention eliminates the above-mentioned drawbacks, and an object of the present invention is to provide a medical laser device having a light guide path having a high light guide ratio even in the case of a high output laser beam and having an excellent operability. It is what

[0018]

In order to achieve the above-mentioned object, the present invention has a laser beam oscillating means for oscillating a laser beam and an incident end portion in which a plurality of optical fibers are fused and integrated. A fiber bundle that guides the light, and is attached to the exit end of the fiber bundle,
And a handpiece for irradiating the treatment site with the laser beam.

[0019]

According to the present invention, by using a fiber bundle having an incident end portion in which a plurality of optical fibers are fused and integrated, a high light guide ratio and high operability can be obtained even in the case of a high output laser beam. It becomes possible to realize a medical laser device having a good light guide path.

[0020]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS A first embodiment according to the present invention will be described below with reference to the drawings.

FIG. 1 is a schematic configuration diagram of a medical laser device according to a first embodiment of the present invention. The apparatus of the embodiment shown in FIG. 1 includes a Q-switched ruby laser oscillator 101 that oscillates a laser beam, and a Q-switched ruby laser oscillator 10 of this embodiment.
Light guide path 102 for guiding the laser beam oscillated from 1
And a handpiece 103 for irradiating the laser beam guided by the light guide path 102 to the treatment site.

Next, a Q-switch ruby laser oscillator 101
The specific configuration of will be described.

The Q-switched ruby laser oscillator 101 shown in FIG. 1 oscillates a giant pulse having a remarkably large peak output in a short time (pulse width 30 nsec), and its constituent elements will be described below.

The flash lamp 104 emits light.

The ruby rod 105 is arranged so that light is emitted from the flash lamp 104 (for example, the flash lamp 104 is located at one focal point of the ellipse and the ruby rod 105 is located at the other focal point of the ellipse), and laser light is excited by this light. Is to be induced and released. Note that the flash lamp 10 is not irradiated with the laser beam that has been stimulatedly emitted to the ruby rod 105.
When only the light emitted from 4 is irradiated, the ruby rod 105 is in a population inversion state.

The mirrors 106 and 107 are the ruby rod 1
05, a polarizer 108 and a Q switch 109, which will be described later, are arranged in parallel with each other so as to sandwich them. Incidentally, the mirror 106
Is a total reflection mirror, and the mirror 107 transmits a part of light in order to extract a laser beam.

The polarizer 108 is the ruby rod 105.
The laser beam emitted from the ruby rod 105 is used as a unidirectional deflection component.

The Q switch 109 is provided on the laser oscillating surface side (mirror 107 side) of the polarizer 108, modulates the laser light when an electric field is applied so that the deflection direction of the laser light does not coincide with the deflection direction by the polarizer 108. To do.

It should be noted that the Q value of the Q switch 109 is set low and the Q value is switched to a high value immediately before the instability occurs.
By transitioning the energy of a large number of atoms kept in the excited state without stimulated emission, it is possible to oscillate a high-power giant pulse with a short irradiation time.

The energy meter 110 is provided on the laser beam output side of the mirror 107 and measures the peak output and irradiation time during giant pulse oscillation.

Next, a specific structure of the light guide path 102 will be described.

The light guide path 102 guides the giant pulse oscillated from the Q-switch ruby laser oscillator 101, and each constituent element will be described below.

The lens 111 collects the giant pulse oscillated from the Q-switch ruby laser oscillator 101.

The kaleidoscope 112 includes a lens 111.
The energy density of the giant pulse focused by is homogenized over a predetermined cross section. As the kaleidoscope 112, a hollow material (for example, stainless steel) whose inner surface is vapor-deposited with aluminum, quartz, or the like can be used.

The fiber bundle 113 has an entrance end and an exit end in which a plurality of optical fibers are bundled together by, for example, melting a clad, and a giant whose energy density is made uniform by the kaleidoscope 112. It guides the pulse. The optical fiber used in the fiber bundle 113 includes a silica glass fiber, a multi-component fiber, a plastic fiber, and the like. In order to guide a laser beam having a high output and a short irradiation time, for example, a giant pulse, the fiber end face is used. A quartz glass fiber having a large breaking threshold (end surface is less likely to be broken) is desirable. The fiber bundle 113 is coated with stainless steel or the like to protect the optical fiber. This coating fixes only the vicinity of the entrance and exit ends, and the rest is not fixed so that the fiber bundle 113 can be moved flexibly.

Here, the fiber bundle 113 will be described. FIG. 2 is an example of a cross-sectional view taken along the line AA of the fiber bundle 113 shown in FIG. Fiber bundle 11
The input / output end of 3 is a bundle of a plurality of optical fibers by melting the clad as shown in FIG. This melting reduces the gap between the clads (the gap when a plurality of optical fibers are formed) while the core remains in its original shape, and the gap can be eliminated altogether. Further, it is the core and the clad of the optical fiber that guide the laser beam, and since the gap is not guided, the guiding rate of the laser beam changes due to melting of the clad.

Further, in order to prevent the fiber bundle 113 from being broken, a predetermined number of optical fibers must be bundled so as not to exceed the predetermined fiber end face breaking threshold of the optical fibers.

Here, the fiber end face destruction threshold value 10 MW / m
The number of optical fibers required for the fiber bundle 113 will be described by taking as an example a quartz glass fiber having m ² , a clad outer diameter of 70 μm, and a core outer diameter of 63 μm.

The therapeutic energy density required to destroy deep-seated bruises is 6 J / cm ² (= 0.06 J / mm ² ).
It is known to be the above. In order to satisfy this condition, it is necessary to consider the loss until the giant pulse is applied to the bruise. That is, the loss of the kaleidoscope 112 is about 20%, the loss of the optical system (lens 111) for guiding light to the kaleidoscope 112 is about 2%, the loss of the fiber bundle 113 is about 15%, the handpiece 10
The loss of 3 is about 2%, and the total loss is about 39%.

Further, the number of optical fibers having a predetermined diameter and a fiber end face destruction threshold value to be bundled is determined by the irradiation area of the laser beam. In addition, Kaleidoscope 11
Since the energy density of the giant pulse is made uniform by 2, the laser output energy can be obtained by (treatment energy density × irradiation time) / (transmittance of light guide system).

As a result, the irradiation time (pulse width) of the giant pulse oscillated from the Q-switch ruby laser device 101 is 30 nsec (= 30 × 10 ⁻⁹ se).
c), assuming that the irradiation area is 4 mm × 4 mm = 16 mm ² and the light guide ratio of the light guide path 102 is 61%, the required laser output energy in the Q switch ruby laser device 101 is (0.06 J / mm ² ) × (16 mm ² ) /0.61=
1.57J or more is required. Therefore, the peak power output is (1.57J) / (30 × 10 ^-9 sec) = 52.3M
W is required.

The destruction threshold of the optical fiber is 10 MW / mm ²
In order to suppress the threshold value of the fiber end face to 10 MW / mm ² or less, assuming that the number of optical fibers is N, 52.3 MW / [N × {70 × 10 ⁻³ mm / 2)} ² ×
The relationship of [π] ≦ 10 MW / mm ² is established. If N is obtained from this, N ≧ 1
It becomes 358.9. Therefore, if 1359 or more optical fibers are bundled, the end face destruction threshold of 10 MW per optical fiber
/ Mm ² or less.

As described above, a predetermined number of optical fibers are bundled to form the fiber bundle 113. The number of optical fibers obtained here is calculated with the minimum output energy required to break deep-seated bruises, so it is desirable to change it as necessary.

On the contrary, for example, this optical fiber 151
Q-switched ruby laser oscillator 101
If the peak power of the laser beam oscillating from is within the range of 52.3 MW ≦ peak power ≦ 58.1 MW, the fiber bundle 113 is not destroyed.

The handpiece 103 is optically attached to the emitting end of the fiber bundle 113 and irradiates the treatment site with the giant pulse guided by the fiber bundle 113. This handpiece 103
Is a kaleidoscope, projection lens,
Equipped with irradiation window.

The kaleidoscope is a fiber bundle 1
The irradiation shape of the giant pulse guided by 13 to the treatment site is set.

The projection lens projects a giant pulse whose irradiation shape is set by the kaleidoscope.

The irradiation window indicates the irradiation area of the giant pulse which is brought into contact with the treatment site and projected by the projection lens.

The operation of the embodiment apparatus configured as described above will be described.

The operator presses the irradiation window (not shown) of the handpiece 103 against the treatment site on the one hand, and sets the peak output and the irradiation time according to the type and the depth of the treatment site on the other hand. . Light is emitted from the flash lamp 104 to oscillate a giant pulse. The light emitted from the flash lamp 104 illuminates the ruby rod 105. The ruby rod 105 is excited by the light emitted from the flash lamp 104 to stimulately emit laser light (here, in the direction of the mirror 106). The laser light thus stimulated and emitted is reflected by the mirror 106. The reflected laser light enters the polarizer 108 via the ruby rod 105. The polarizer 108 converts the incident laser light into a polarization component in one direction (transmits only the polarization component in one direction). The laser light converted into a polarized light component in one direction by the polarizer 108 enters a Q switch 109. At this time Q
The electric field is applied to the switch 109, and the laser light incident on the Q switch 109 is modulated and emitted to the mirror 107. The laser light that hits the mirror 107 is reflected by the mirror 1.
The light is reflected at 07, is modulated again by the Q switch 109, and enters the polarizer 109. This laser light has a polarization direction different from that of the laser light transmitted by the polarizer 108, and is blocked by the polarizer 108. As a result, only the light emitted from the flash lamp 104 is emitted to the ruby rod 105, and the ruby rod 105 continues to be excited in a population inversion state.

When the electric field applied to the Q switch 109 is cut off in this state, the Q value (stored energy / energy lost per second) suddenly increases from 0 and a giant pulse oscillates.

The giant pulse oscillated from the Q-switch ruby laser oscillator 101 as described above is generated by the lens 1
The light is focused on the kaleidoscope 112 by 11. The giant pulse focused on the kaleidoscope 112 is
The energy density is made uniform by repeating reflection on the inner surface of the kaleidoscope 112, and the energy is incident on the incident end of the fiber bundle 113.

The giant pulse incident on the incident end of the fiber bundle 113 is guided to the handpiece 103 via the fiber bundle 113. At this time, the giant pulse incident on the core is repeatedly reflected in the core and guided to the handpiece 103, and the giant pulse incident on the clad is guided to the handpiece 103 and is incident on the handpiece 103 similarly to the giant pulse incident on the core. Light is guided.

In this way, the irradiation shape of the giant pulse incident on the handpiece 103 is changed by the kaleidoscope 114 provided inside the handpiece. The giant pulse is projected onto the irradiation window by the projection lens and is irradiated from the irradiation window abutting on the treatment site.
The operator measures the peak output with the energy meter 112 when irradiating the treatment site with the giant pulse, and resets the peak output as necessary.

As described above, in this embodiment, the Q-switched ruby laser device 1 is used by using the fiber bundle 113 in which the clad is melted and a plurality of optical fibers are bundled together.
The giant pulse oscillated from 01 was guided to the handpiece 103. As a result, it becomes possible to guide light with a high light guiding rate even in the case of a high-power laser beam. Further, since the fiber bundle 113 that bundles the optical fibers having a small cladding outer diameter is used, the operability is improved.
In addition, the Giant Pulse directly into the fiber bundle 1
Since the incident end face of 13 is not irradiated and the energy density of the giant pulse is made uniform via the kaleidoscope 112, the life of the fiber bundle 113 is extended.

The second embodiment of the present invention will be described below with reference to the drawings.

The second embodiment is a modification of the fiber bundle 111 of the first embodiment.

FIG. 3 is a schematic configuration diagram of a medical laser device according to a second embodiment of the present invention. Note that the same parts as those in FIG. The apparatus of the embodiment shown in FIG. 3 includes a Q-switched ruby laser oscillator 301 that oscillates a laser beam and a Q-switched ruby laser oscillator 30.
1. A fiber bundle 302 that guides the laser beam oscillated from 1 and a handpiece 30 that irradiates the treatment site with the laser beam guided from the fiber bundle 302.
5, 306.

A specific configuration of the Q-switched ruby laser oscillator 301 in the thus constructed apparatus will be described.

The Q-switched ruby laser oscillator 301 shown in FIG. 3 oscillates a high-power laser beam in a short time. The Q-switched ruby laser oscillator 101 according to the first embodiment has a lens 310 and a lens moving part which will be described later. 311 is provided.

The lens 310 is provided on the laser oscillating surface side of the energy meter 110 and focuses (squeezes) the giant pulse transmitted through the mirror 107 on the incident end surface of the fiber bundle 302.

The lens moving unit 311 is connected to the lens 310, and in order to change the irradiation area of the giant pulse guided to the incident end surface of the fiber bundle 302, the lens 310 is moved in the horizontal direction with respect to the incident direction of the giant pulse on the incident end surface. To move to.

Next, the fiber bundle 302 will be described.

The fiber bundle 302 shown in FIG.
A giant pulse oscillated from the switch ruby laser oscillator 301 is generated by handpieces 305 and 306 described later.
It guides light to. The fiber bundle 303,
304 has the same incident end (incident end of the fiber bundle 302).

FIG. 4 shows the fiber bundle 30 shown in FIG.
2 is an example of a schematic cross-sectional view of FIG. 2, FIG. 4A is a line BB of the fiber bundle 302, and FIG.
C-C line, FIG. 4 c shows DD of fiber bundle 304
The cross section of the line is shown.

As shown in FIG. 4a, the fiber bundle 30
As in the first embodiment, the plurality of optical fibers are bundled together at the incident end portion 2 by melting the cladding.

On the other hand, as shown in FIG. 4bc, the exit end is
A plurality of optical fibers are bundled by adhering adjacent clads with, for example, resin. The emitting ends are bundled according to the light intensity. This is because the giant pulse incident on the incident end portion does not have a uniform energy density by the kaleidoscope as in the first embodiment, and the light intensity is near the center (the solid optical fiber in the figure) and the end (the figure). This is because the optical fiber indicated by the middle broken line is different, and the light that once enters the optical fiber is guided to the emission end without leaking. As a result, it becomes possible to divide the emission end portion according to the light intensity.

The handpieces 305 and 306 are optically attached to the output ends of the fiber bundles 302 (the output ends of the fiber bundles 303 and 304), respectively.
The giant pulse guided by the fiber bundle 302 is applied to the treatment site.

The handpieces 305 and 306 respectively include a kaleidoscope, a projection lens, and an irradiation window (not shown). Since these are the same as those in the first embodiment, the description thereof will be omitted.

The operation of the embodiment apparatus configured as described above will be described.

The operator, on the other hand, uses the hand pieces 305, 30
Each irradiation window (not shown) 6 is pressed against the treatment site, and on the other hand, the peak output and the irradiation time are set according to, for example, the type and deepness of the treatment site. When the treatment condition is set in this way, the energy meter 110 is set as in the first embodiment.
The giant pulse that has passed through is collected by the lens 310 at the incident end of the fiber bundle 302. At this time, the lens 310 changes the predetermined irradiation area of the giant pulse that is moved by the lens moving unit 311 and guided to the incident end of the fiber bundle 302. (Here, it is assumed that the entire incident end face is irradiated.) Fiber bundle 30
The giant pulse incident on the incident end of No. 2 passes through the optical fiber from the emitting end to the handpieces 305, 306.
Guided by the respective kaleidoscopes. At this time, the giant pulse guided to the handpiece 305 has a larger energy than the giant pulse guided to the handpiece 306. The giant pulse guided to the kaleidoscope of each of the handpieces 305 and 306 repeats reflection on the inner surface to make the energy density uniform. Then, the giant pulse is projected onto the irradiation window by the projection lens, and irradiates the treatment site with which the handpieces 305 and 306 are in contact with each other through the irradiation window.

In this embodiment, an incident end portion in which a plurality of optical fibers are bundled together by melting the clad,
A giant pulse is guided by a fiber bundle having a light emitting end portion in which a plurality of optical fibers are bundled according to light intensity by adhering a clad with a resin.

As a result, similar to the first embodiment, even if the peak output of the laser beam is large, the treatment site can be treated with high light guiding rate and operability.

Further, it is possible to simultaneously irradiate a plurality of treatment areas and treatment areas having different deepness, and if necessary, it is possible to irradiate only one treatment area.

Furthermore, since the clad at the emitting end is adhered with resin, a plurality of optical fibers can be easily integrated.

In this embodiment, the portions other than the incident end portion are divided into two fiber bundles according to the light intensity. However, if the plurality of optical fibers have an incident end portion that is bundled together by melting, it is not the incident end portion. May be divided into other than light intensity,
The number is not limited to two and may be divided into a plurality of fiber bundles.

The present invention is not limited to the embodiments described above, and various modifications are possible within the scope of the gist of the present invention.

For example, if the incident end portions are bundled together by melting, the emitting end portions may be either melted or resin, and may be bundled by various other methods.

As the optical fiber, various glass fibers having different outer diameters and threshold values may be used as long as the incident end is not destroyed by the laser beam, and the fiber bundle is coated with a degree of freedom required for the fiber bundle. As long as it can be held, various materials such as a coil may be used.

Further, various laser light sources such as normal oscillation may be used as long as the peak output required for breaking the bruise in a short time can be generated.

[0081]

As described in detail above, according to the present invention, it is possible to realize a medical laser device having a light guide path which has a high light guide ratio even in the case of a high power laser beam and has good operability. It will be possible.

[Brief description of drawings]

FIG. 1 is a schematic configuration diagram of a medical laser device according to a first embodiment of the invention.

FIG. 2 is a sectional view taken along line AA of FIG.

FIG. 3 is a schematic configuration diagram of a medical laser device according to a second embodiment of the invention.

4 is a sectional view of a fiber bundle according to a second embodiment of the present invention, (a) is a sectional view taken along line BB in FIG. 3, FIG.
3B is a sectional view taken along the line CC in FIG. 3, and FIG.
6 is a cross-sectional view taken along line D-D in FIG.

5A and 5B are schematic views of a conventional optical fiber light guide path.

FIG. 6 is a schematic view of a conventional mirror penetration light guide path.

[Explanation of symbols]

 101, 301 ... Q-switched ruby laser oscillator 102 ... Light guide 103, 305, 306 ... Handpiece 113, 302 ... Fiber bundle

Claims (12)

[Claims] 1. A laser beam generating means for oscillating a laser beam, and an incident end portion in which a plurality of optical fibers are fused and integrated,
A medical laser device comprising: a fiber bundle that guides the laser beam; and a handpiece that is attached to an emission end of the fiber bundle and irradiates a treatment site with the laser beam. 2. The medical laser device according to claim 1, wherein the laser beam generating means is a Q-switch laser oscillator. 3. The laser beam has a pulse width of 30 n.
3. The medical laser device according to claim 1, wherein the pulse has a peak power of 47 MW or more in sec or less. 4. The medical laser device according to claim 1, wherein the fiber bundle has a plurality of emitting ends. 5. The medical laser device according to claim 4, wherein the emission end portion is divided into a plurality of portions according to light intensity. 6. The medical device according to claim 1, wherein the fiber bundle includes a laser beam uniforming unit that homogenizes the energy density of the laser beam over a predetermined cross section. Laser device. 7. The medical laser device according to claim 6, wherein the laser beam uniforming means is a hollow material having an inner surface subjected to aluminum vapor deposition. 8. The medical laser device according to claim 6, wherein the laser beam uniforming means is provided in a horizontal direction with respect to a laser beam incident direction of the incident end portion. 9. The optical fiber comprises a core formed of a transparent body having a predetermined refractive index, and a clad formed around the core of a transparent body having a lower refractive index than the core. The medical laser device according to any one of claims 1 to 5, characterized in that: 10. The medical laser device according to claim 1, wherein the optical fiber is a quartz fiber formed of quartz. 11. The irradiation means is attached to the emission end, and is arranged on the output side of the laser beam uniformizing means for uniformizing the energy density of the laser beam over a predetermined cross section. A projection lens for projecting the laser beam whose energy density is made uniform by the laser beam homogenizing means, and a laser beam projected by the projection lens which is provided at a predetermined distance closer to the treatment site than the projection lens. The medical laser device according to claim 1, which is a handpiece including an irradiation window indicating an irradiation region. 12. A laser beam oscillating means for oscillating a laser beam, a light guide lens for squeezing the laser beam, an entrance end portion in which a plurality of optical fibers are fused and integrated, and an exit end portion divided into a plurality of parts. A fiber bundle that guides the laser beam narrowed down by the light guide lens, a lens moving unit that moves the light guide lens in a horizontal direction with respect to the laser beam incident direction of the incident end, and the emission. A laser beam homogenizing unit that is optically attached to the treatment site side of the end portion and that homogenizes the energy density of the laser beam over a predetermined cross section; A projection lens for projecting the laser beam having a uniform energy density by means, and disposed on the treatment site side of the projection lens, Serial medical laser device and a radiation window showing the irradiation area of the projected the laser beam by the projection lens.