JPS59120147A - Medical laser apparatus - Google Patents

Abstract

(57) [Summary] This bulletin contains application data before electronic filing, so abstract data is not recorded.

Description

DETAILED DESCRIPTION OF THE INVENTION The present invention relates to a medical laser device, and in particular, a V-monme therapy laser device that can be used in narrow body cavities such as the esophagus, intestines, or bronchi. -JJ” -Soj
l! It concerns X.

As is well known, recently in the medical field "(,
Laser devices are being used for medical purposes to stop bleeding in an affected area, to remove or vaporize tissue in an affected area.

and 1, l O) l therapeutic therapist i':+'
However, the laser beam from the laser beam generator was not introduced into the body cavity. Self: The first optical transmission fiber and the outer circumference of the second optical transmission fiber. +l with two gaps! <It was constructed with an air supply Ef'' stage that utilizes the gap between the restored protection tube and the optical transmission fiber to supply air]/-
The endoscope is comprised of a beam irradiation unit, and an endoscope equipped with an insertion channel for guiding the insertion of the transmission fiber into the body together with a protective tube.

Togo 7th ＼As is well known, 7. j, +7 inside the body cavity of the endoscope +I +i person 81
; is the first t'+;AQ'i CJ from the i++ side, the observation window and - (- the end of the channel: l1ji side II
The hard end part with I, etc. is controlled by the hand operation, and the concave bend part at the hand [1!1 part is connected to the Φ connected to the production part There is. Therefore, an endoscope equipped with a body cavity insertion section having such a configuration has a hard distal end section 11 provided on the distal end side of the insertion channel in a wide space such as an exposed stomach. The curved rigid part can be freely directed in each direction by controlling the lA bending part l4.
1J function, with a base 1 installed on the hand control section.
1. Insert i1j na channel 1llf from 1, and align the end face of the optical transmission fiber to the desired l? 4 therapy department (
輯、Two-phase series-t! iMru. However, the way to 1,
11! Alternatively, it is impossible to direct the output end face of the optical transmission fiber to the desired treatment area by controlling the curvature of the curved part in a narrow body cavity such as a bronchus. However, this may not be an exaggeration.In view of this fact, recently, the output end face of an optical transmission solenoid is forced diagonally, and the output η, 1 laser beam is By bending or refracting the output 1'I of the optical transmission fiber.
The vicinity may be slightly bent, or a curved prism may be attached to the output end surface of the mouth 4j, i"A soiher.
AJ-4
It has been proposed to refract 1- in an oblique direction, or in a right-angled direction. however,
l, AJ - light is refracted in an oblique direction - (going up is
Because the emitted laser light spreads or is irradiated obliquely to the treatment area, it actually spreads wider and the light density per target area becomes lower, making it difficult to perform appropriate treatment. By increasing the irradiation area more than necessary, there is a risk that normal areas other than the desired treatment area will be irradiated, resulting in false injections.Furthermore, the output end face of the optical transmission fiber may Although there is no problem in joining and gluing rectangular prisms due to oblique irradiation, the work of joining or gluing them together is extremely difficult.

The current situation is as follows: The medical relay devices that have been proposed so far have shortcomings, and improvements are desired.

Therefore, the present invention provides a medical treatment system that can perform not only laser treatment in a narrow body cavity but also a wide body cavity with force. It provides equipment.

The above is a medical laser device based on this invention (-1).
A detailed description will be given based on an embodiment illustrated in the drawings.

FIG. 1 is an explanatory view of the main parts of an embodiment of the medical laser device according to the invention of FIG. In addition to the observation window and illumination window for endoscopic observation on the front end surface of the , there is an insertion hole for inserting and guiding forceps, etc., located between the proximal end 1j or at the proximal 1-1 working part. 3-L12 between the tips of Yannen 2
A is set up. Also, considering the same IG, 3 is,
The fiber for laser beam transmission is connected to the laser light transmission fiber 3, and the input end surface is connected to the laser beam (not shown) in one direction. Air is sent between the outer circumference” 11! The protective nause 4, which contains the gaps forming the channels, is coated. This protection tube 4 has a laser light transfer laser beam 3 emitting from the end thereof on the +'j'j side, 51. : Attach the center link protrusion 5a that fixes the H side to the center of the protective nayouf 4 (1:
：1 got [21 gold 5 or the same right sazai "ζ is there.

The above +ll) configuration is a 1-monme therapeutic device;
The characteristic parts are the right angle prism 6 and the Brisno holder 7 that holds the curved prism 6 fixed. 1. The Brisme retainer 1h body 7 is formed in a self-bottomed cylindrical shape, and the inner circumferential surface of the open I end portion is fitted with the above-mentioned [21 metal 5]. An engagement protrusion 7a is formed to elastically engage a circumferential engagement groove 5b formed on the outer periphery of the metal 5.

This prism holder 7 has, as described in -1- [the incident surface is perpendicular to the exit plane of the laser beam transmission fiber 3 when it is engaged and attached to the gold 5]. I.J.
S' A 6 is fixedly installed, and 11 old + 7b is installed in the part that corresponds to the output q of tooth angle Brism 6, and 1-1.
I'm getting fucked. It should be noted that the gap between the laser beam transmission fiber 3 and the fibers 3 and
1, ゛), 11K gold 5 has a thread that communicates with the outside; nJ hole 5c
It is provided along the axial direction and communicates with the communication hole 5b, and when the prism holder 7 is attached, the inner periphery of the holder 7! A groove 5b is provided which forms an air supply path from \y and G and moves rapidly from \y to 1.17b.

The medical laser device configured as described above is operated as described above each time the holder 7 is attached and used. It is refracted by the prism 6 in the angular force direction of ζ with respect to the direction of the insertion force. Therefore, the laser beam is irradiated from the front to the treatment site on the inner wall along the insertion direction of the endoscope in a narrow body cavity such as the esophagus, intestine, or bronchus. It is something that can be treated.

Further, this medical laser device can be used in the same manner as before when the prism holder 7 is not attached.

FIGS. 2 and 3 show other embodiments of the medical laser device according to the present invention, and 10 and 11 indicate the rigid tip portion and the curved portion that constitute the body cavity insertion portion of the endoscope. show. Above tip hardness) I: 7 part 1° has 1 or
The insert placed in the original operation part is 1j
: A laser beam transmission fiber 12 configured in the same manner as in Example 1 and a protective tube 71 coated on its outer periphery;
A channel forming hole I5 that forms the tip side I of the seed oil channel 14 through which the laser probe consisting of 3 is inserted.
is provided. In the channel forming hole 5,
A threaded groove 15a is formed in the inner circumferential portion of the "first side opening 1", so that the prism holder 16 can be screwed into the prism holder 16. The prism J3 holder 16 has a right-angled brism 17 fixed thereto so that its input surface faces the output surface of the optical transmission fiber 12 into which it is inserted when the prism J3 holder 16 is screwed together. In the channel forming hole 15, a communicating hole 15b communicating with the outside is provided at a position C opposite to the exit point of the right angle prism 17 mounted thereon.

The medical laser device configured as described above has a prism held (* l
By using the device 6, the result shown in FIG.
As shown in FIG.
- The light is refracted twice by the prism 17 with respect to the insertion force direction G4 of the endoscope. It is irradiated from the front onto the treatment area along the direction of the insertion force, and a laser beam is used to treat the treatment area.

Moreover, by removing and using the prism holder 16, the prism holder 16 can be used in the same manner as before, as shown in FIG.

FIG. 4 shows another embodiment of the medical laser device according to the present invention, and 20 and 21 are hard tips of Y, ′, and I that constitute the body cavity insertion portion of the endoscope. The curved part is shown. Further, 22 indicates a prism holder, and this prism holder 22 has a cylindrical shape with a bottom and is formed of a transparent material, and its opening (in other words, outside the hard tip portion 20). :11 and 7 circumferential engagement grooves 20a
An engaging protrusion 22a is provided that elastically engages with. Moreover, this prism holder 22 has a tip 61) in its component part! An angle-angle brism 24 with an entrance surface facing the opening 1-1 of the well-known insertion channel 23 formed on the O; . This prism 24 has an L horn in FIG. 4, that is, a direction in which the outgoing light traverses the observation field of view. It is arranged in L. the prism holder 224;
Furthermore, the beam ()'- is not emitted via the prism 24 to a portion corresponding to the observation field of view of the observation optical system.
An indicator 26 indicating the direction of light emission is also provided.

Historically, in this prism holder 22, a portion 22I) corresponding to the laser/light emission direction (1) is cut off.

The therapeutic racer device having the configuration 1- below is ijLMi+
The same effect as in the embodiment described above is obtained each time the Bliss J and the holder 22 are attached to an endoscope having an insertion channel.
i's presence 4. There is (4) where you can check the direction of laser beam irradiation from Z.

Fig. 5 7 False) (Fig. 8 shows another 'j5. embodiment of the medical Rayleigh device according to the invention of 2. 7. The parts are the same as the embodiment shown in Fig. 4. In this embodiment 4.'', a mirror 27 is provided in place of the t'Fi mark 20 at an angle of about 45° and an inclination of 1q.

According to the configuration described in 1-1, I and F are simply A, and the index 26 allows you to observe the direction (A) direction (different from A1) to see whether it is actually the laser beam or the part that is irradiated. .

Muo, a roof prism is used in place of the 1-mirror, both of which are [1] possible.

In addition, as shown in FIG. 6, each time a prism 25 with a convex exit surface is used instead of the right-angle prism 24 (the entrance surface may be convex or concave, or the exit surface may be concave), the laser I can do it. Therefore,)1. Q
I decided to change 14 Tachibana 11 between the shooting site and prism 25! ! ! 6) The area relationship between the irradiation spot and the irradiation area that can change the subometry diameter to I, J, 3,
Depending on the case, it is possible to perform the necessary racer light treatment.

Historically, as shown in FIG. concave lens 2
8 or a concave lens 29 as shown in FIG. 8, the same effect as the embodiment shown in FIG. 6 can be expected. Moreover, by employing the configurations shown in FIGS. 7 and 8 or a similar configuration on the exit surface side, it is possible to select the spot i flea.

9 to 11 show still other embodiments of the medical laser device according to the present invention. FIG. 9 is a perspective view of the rigid distal end portion 30 of the body cavity insertion portion of a so-called side-viewing endoscope;
As is well known, this hard tip portion 30 includes an observation window 31. Lighting window 32. Air/water supply jet 1133 and forceps 1'+
34 are arranged and there are -C. As is well known, the forceps 1134 contains a $II forceps as shown in FIGS. 7 and 8.
Ti! The 111 child who was l1lI oiled through fi channel 35 was woken up by Eisaku via T-Tweet! '
/: JJi movement control forceps-r front 36 is provided (
There is. In such a side-viewing endoscope, in the small 4" embodiment shown in FIG. 10, $11 decimal channel; 35
Opening 116. ．． 1. A curved prism 38 or a magnet 37 is attached to the surface of the forceps base A'L stand 36 between the rows. In the embodiment shown in FIG. 11, a prism holder 4 holding a curved prism 40 is
1 or the forceps IJ34 are inserted in a sealed manner.Of course, the right angle prism 4 is inserted into this prism holder 41.
A right-angle prism 40 is provided so that the incident surface of 0 faces the opening 1-1 of the forceps insertion channel 35, and its exit surface faces the 134 side. 41 includes a convex i7i4]a for the engaging member 11- which engages with a recess formed in the forceps D34, and a gas supplied through the gap between the racer light transmission Fine-No-12 and the protective tube 13, i+'. i-angle Bliss J-4
Air supply n4 formed so as to be blown onto the exit surface of 0
1b has also been made.

Therefore, when this medical laser device is applied to a side-viewing endoscope, one laser beam can be guided in the measurement direction with respect to the insertion direction of the endoscope that can perform observation + illumination. This is an i+J function in which laser beams are used to insert electric wires into narrow body cavities such as the esophagus, intestines, and branches. Moreover, the 10th
In the case of the configuration as shown in the figure, the C irradiation position can be changed at will by controlling the forceps stand 36 1-4-1 as is well known. Moreover, when configured as shown in FIG. 11, the laser beam transmission fiber 12 and the protective tip,
- It is possible to prevent the intrusion of body fluids, etc. by maintaining the air in the air supply section through the fiber 13, and to keep the output end face of the laser beam transmission fiber 12 and the entrance and exit faces of the right-angle prism 40 clean. It is something that can be protected.

In each of the above embodiments, a rectangular prism is mainly used, but a mirror or other shaped prism may be constructed by combining the configurations shown in each embodiment. .

As described in I- below, the medical treatment according to the present invention
According to "J-Installation", by detachably attaching a configuration including an 11\ angle prism to a medical laser device 61 known from J-III, it is possible to sufficiently operate within narrow body cavities such as the esophagus, intestines, and bronchi. It is possible to perform laser light therapy.

[Brief explanation of the drawing]

FIG. 1 is a cross-sectional view of essential parts of one embodiment of a medical laser device according to the present invention, and FIGS. 2 to 11 are explanatory diagrams showing other embodiments of the medical laser device according to the present invention. be. 1.10.20.30 ・-Hard tip portion 2 of body cavity insertion portion, 14. 23. 35 - Insertion channel 3.12 - Fiber for laser light transmission 4.13
Protective tip 1-F fi, 17.24.38.40 - Tooth angle brism 7
．． 16.22.41 Brism Holder. Applicant Fuji Photo Mitsutsuki Co., Ltd. Figure 1 Figure 2 OII Figure 3 Figure 295-Chrysanthemum 4I\] Figure 6 Nishiki in Figure 22 /IXI Procedure Masaru Sode Written by Commissioner of the Patent Office Mr. Kazuo Wakasugi 1 Case Indication 1988 Patent Application No. 228264 2. Name of the invention Medical laser device 3. Voluntary ministry to correct sleeves 6. Contents of amendment (1) “Intracavity” in the first line of page 3 of the specification is corrected to “intracavitary” . (2) In lines 2 and 3 of the same page, "curved hard part is a curved part" is amended to read "curved part".

Claims (2)

[Claims] (1) A medical ray man who inserts a laser beam transmission fiber into a body cavity and irradiates 116 laser beams for LH treatment.
A medical laser device characterized in that a reflecting member for reflecting and refracting light by the gravity of the emission end face of the laser beam transmission fiber is detachably installed. (2) Medical use according to claim 1, characterized in that the reflective portion is removably provided on the distal end side of the protective tube of the laser beam transmission fiber or the insertion guide channel. Laser device.