CN1165485A - Phototherapeutic apparatus - Google Patents

Phototherapeutic apparatus Download PDF

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Publication number
CN1165485A
CN1165485A CN95195954A CN95195954A CN1165485A CN 1165485 A CN1165485 A CN 1165485A CN 95195954 A CN95195954 A CN 95195954A CN 95195954 A CN95195954 A CN 95195954A CN 1165485 A CN1165485 A CN 1165485A
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CN
China
Prior art keywords
scattering
shell
cloth
width
optical fiber
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Granted
Application number
CN95195954A
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Chinese (zh)
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CN1072971C (en
Inventor
E·L·辛诺夫斯基
L·S·巴斯特
N·法尔
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Rare Earth Medical Inc
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Rare Earth Medical Inc
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Priority claimed from US08/471,744 external-priority patent/US5637877A/en
Priority claimed from US08/468,568 external-priority patent/US5643253A/en
Priority claimed from US08/467,414 external-priority patent/US5632767A/en
Application filed by Rare Earth Medical Inc filed Critical Rare Earth Medical Inc
Publication of CN1165485A publication Critical patent/CN1165485A/en
Application granted granted Critical
Publication of CN1072971C publication Critical patent/CN1072971C/en
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00—Radiation therapy
    • A61N5/06—Radiation therapy using light
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00—Radiation therapy
    • A61N5/06—Radiation therapy using light
    • A61N5/0601—Apparatus for use inside the body
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L2/00—Methods or apparatus for disinfecting or sterilising materials or objects other than foodstuffs or contact lenses; Accessories therefor
    • A61L2/02—Methods or apparatus for disinfecting or sterilising materials or objects other than foodstuffs or contact lenses; Accessories therefor using physical phenomena
    • A61L2/08—Radiation
    • A61L2/10—Ultra-violet radiation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L29/00—Materials for catheters, medical tubing, cannulae, or endoscopes or for coating catheters
    • A61L29/08—Materials for coatings
    • A61L29/085—Macromolecular materials
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
    • A61B18/22—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
    • A61B2018/2255—Optical elements at the distal end of probe tips
    • A61B2018/2261—Optical elements at the distal end of probe tips with scattering, diffusion or dispersion of light

Abstract

Optically transmissive fiber tip assemblies having radiation-scattering particles incorporated therein are disclosed in the present invention for use in phototherapy. In one embodiment, diffusers with reflective end caps are disclosed. As radiation propagates through the fiber tip, a portion of the radiation is scattered in a cylindrical (or partially cylindrical) pattern along the length of the fiber tip. Radiation which is not scattered during this initial pass through the tip can be reflected by at least one surface of the assembly and returned through the tip. During this second pass, the remaining radiation (or at least a major portion of this returning radiation) again encounters the scatterers which provide further radial diffusion of the radiation. The scattering medium and the reflective end cap can interact to provide a substantially uniform (or other predefined) axial distribution of laser radiation over the length of the tip apparatus. In another embodiment, diffusive loop assemblies are disclosed for diffusing radiation from an optical fiber. Disposed sheaths are also disclosed, as are integral stopper devices which limit the penetration of the apparatus. The devices of the invention are useful for various medical purposes as well as the sterilization of medical instruments.

Description

Phototherapy device
Background of invention
The present invention relates to the phototherapy technical field, more specifically, relate to and use optical fiber or other flexible fiber waveguide the width of cloth to be penetrated the method and apparatus that is transported to institute's homing position.
Fiberoptic phototherapy just day by day all increases in diagnosis that is used for various diseases and treatment.For example, at surgical field, the iraser width of cloth is penetrated usually and is transferred to surgery location by the hand-held apparatus that optical delivery fiber is housed, so that solidificating blood or cut and organize.Similarly the fibre optics transmission system also is used for endoscope or based on the apparatus of conduit, introduces in the body cavity so that a width of cloth that is used for the treatment of penetrated.U.S. Pat-4,336,809 (Clark) and the U.S. heavily issue patent RE-34, and 544 (Spears) disclose hemoporphyrin dyestuff and analog selectively accumulation in cancerous tissue, and this accumulation can detect by characteristic fluorescence under the blue light width of cloth be penetrated.These patents are further instructed, and the cancerous tissue of absorbing dye can preferably destroy by penetrate (high-intensity typically HONGGUANG) by the width of cloth of dye molecule absorption during phototherapy.
Other people also propose to penetrate with the fiber-optic transfer width of cloth, so that treatment arthrosclerosis disease.For example, U.S. Pat-4,878,492 (Sinofsky etc.).Disclose with infrared radiation and when balloon angioplasty, heated blood vessel, so that melt blood vessel endothelium lining and sealing surfaces.The another kind that the optical fiber transmission width of cloth is penetrated is applied in U.S. Pat-5,053, open among 033 (Clark), its instruction is to be right after the restenosis of angioplasty can suppress by the UV width of cloth is penetrated to be applied on the angioplasty position, so that kill smooth muscle cell, otherwise described cellular response angioplasty causes damage to blood vessel wall.
However, there are many problems to limit the development of fibre optics phototherapy technology.Typically, optical fiber can only be from their end faces emissions light, and thus, the light of being launched often is focused, and perhaps disperses by conical figure only at most, and is therefore only very little regional illuminated in optical fiber far-end front.Little exposed region has limited the spendable energy of phototherapy, because must prevent the overheated of destination organization.
Although propose " side emission " optical fiber, so that bigger adaptability is arranged when phototherapy, this approach still can not make the large-scale even tissue ground width of cloth penetrate, and is requiring the inhomogeneity situation in border also to be not suitable for using.Because the zone that side emission optical fiber exposure is limited, they are very little to the effect that relaxes " focus " problem, and this problem has limited by fiber-optic transfer and penetrated intensity to the width of cloth of therapentic part.
The somebody proposes to be used for the end of dispersing of optical fiber, so that increase the scope of being penetrated by the width of cloth, and/or reduces the undue probability that exposes.Yet, disperse end and can not satisfy for many therapeutic purposes complicated because their are made, and/or because the width of cloth penetrate can not be fully evenly scattering to reduce " focus " problem.The dispersing end and can not transmit the high-octane width of cloth and penetrate of prior art.For example, at 10 watts or the higher order of magnitude, so that promote light to coagulate or other.
This just exists the device that need better be used for the fibre optics phototherapy.More specifically, the optical fiber end device of dispersing should satisfy the needs in the long-term expectation of this technical field, described device can with respect to fiber axis diametrically (for example, side direction) exposure region of periphery (or wide-angle) is provided, and do not have focus.In addition, penetrating means for diverging less than the irradiation of 360 ° horizontal angle or the width of cloth, should to meet at the needs aspect the minimum side reaction of phototherapy surgery are particular importances.Similarly, provide gradually exposure figure that change or wide propagation, or the means for diverging of other predetermined light distribution pattern also should meet special needs.Also have, can increase vertical width of cloth amount of penetrating during use and provide the bigger adaptive optical fiber end fitting of dispersing also can meet needs aspect phototherapy.
In other application facet, the phototherapy apparatus can be used for the treatment of electric arrhythmia.Under this operating position, the conduit with fibre optics parts is sent into the intracardiac of patient by aorta.When intracardiac, conduit is read electric pulse by the electric contact on its shell or other duct element, so that arrhythmia source, location.In case the location, the phototherapy assembly starts, so that the intracardiac wall of " melting " part.By solidifying near the tissue that is positioned at the arrhythmia source, therefore, the heart that reduces patient is continued to stand ARR probability again.
On other is used, the laser width of cloth penetrate can with connect use at the intracardiac catheter apparatus of patient so that increase the blood flow in myocardial ischemia zone.In this operating process, the laser width of cloth is penetrated and be used for forming many apertures on cardiac muscle, and thus, anoxybiotic tissue is used from the blood of ventricular chamber and breathed.
In all these are used, all exist patient's inner tissue, the probability of heart damage particularly is if radiative optical fiber inserts tissue of patient too far.More specifically, for cardiac muscle, the heart wall perforation has breakneck consequence.
Therefore, just there is the device that need better be used for the fibre optics phototherapy in this.More specifically, can " stop " optical fiber has particular importance in the phototherapy surgical field of minimum side reaction to the device of tissue of patient perforation needs.And the device that for example can assist to stablize the phototherapy apparatus during operation in the chamber of the heart of beating fast is also particularly useful.
In other application facet, phototherapy device can be used for the sterilizing cavity of medical equipment, for example, endoscope apparatus is a kind of complexity and expensive medical apparatus and instruments, and it makes the physician can observe interior tissue and structure, and these apparatuses are reusable typically, therefore, must be each with the back sterilization.In addition, because many endoscopies will repeatedly use every day, so the sterilization of apparatus must be finished in busy clinic apace.
Traditionally, endoscope sterilizes with the mode of chemical bath, its inner chamber or be immersed in the disinfectant solution, or wash with disinfectant solution.
Lamentedly, effect is low sometimes for routine techniques.Disinfectant solution can not permeate whole inner chamber, perhaps is not enough to reach the intensity of desired sterilization effect.In addition, the cavity of endoscope has the residue of being made up of cell of accumulation, and they can not rinse out simply, and these residues may hide microorganism, and they are not damaged in cleaning process.
Therefore, this just exists needs better inner chamber disinfectant method and device to endoscopic instrument.Can guarantee requirement more effective sterilization functions and/or can will satisfy the long-term serious hope of this technical field faster to apparatus cavity disinfectant method and device.
Summary of the invention
The invention discloses and be used to disperse the method and apparatus of penetrating from the width of cloth of optical fiber, so that provide bigger exposure area for phototherapy.Described method and apparatus is particularly suitable for as the part based on fiberoptic medical laser system.The present invention is uniformly or other predetermined Energy distribution figure for the major part of exposure area provides basically further.The present invention propagates extensively constituting and realizing being used for fibre-optic circumference, change gradually and/or side emission end assembly particularly useful so that laser is penetrated with respect to axle width of cloth on one or more radially outer figures of optical fiber.Use term " optical fiber " to comprise the optical delivery waveguide of different shape and size at this.
According to one aspect of the present invention, disclosed optical delivery fiber end construction has the width of cloth and penetrates scattering particles (particle) and a transmitting terminal.Penetrate when propagating by optical fiber end when the width of cloth, the width of cloth is penetrated and is scattered.The width of cloth is penetrated when running into scattering particles at every turn and all will be offset, and penetrates above the critical angle of internal reflection and the optical fiber end of overflowing up to some width of cloth.First during through optical fiber end not the width of cloth of outgoing penetrate by at least one end surfaces reflection and through optical fiber end and return.For the second time by the time, the remaining width of cloth is penetrated (major part that the width of cloth that perhaps returns is specifically penetrated) and is run into once more and provide further radially the width of cloth to penetrate the scatterer of scattering.
In one embodiment, a kind of scattering end fitting that scattering is penetrated from the width of cloth of optical fiber that is used for is disclosed, this device comprise one can be aligned with the optical fiber far-end, and be suitable for admitting the optical fiber far-end, the optical transmission tubular shell device that plays the waveguide effect when being used for by spread fiber light also comprises a reflection end cap and dress light scattering medium within it, like this, light by said spread fiber runs into scattering medium, and a part of light passes through described shell to external leakage, and another part light is by scattering medium and by the end cap reflection, so that can transmit by said scattering medium again.
The reflecting surface of device also can improve, so that produce non-cylindrical or aspheric exposure figure.Disclosed catoptric arrangement is controlled the horizontal development of the light that is sent by the scattering end.The angle of these technology and the exposure of structure permission level for example, is 270 °, 180 °, even littler angle.Use term " wide-angle exposure " at this, so that explanation has the exposing patterns greater than the part cylindrical (or part sphere) of 90 ° horizontal angle.
According to another aspect of the present invention, the quantity of dress scatterer and/or the length of scattering end can be controlled, and like this, scattering width of cloth beam initial and reflection path is complementary.By correctly selecting these parameters, can become even along the cumulative energy density or the flow of at least a portion optical fiber end length.Thus, the invention provides the mechanism that a kind of even cylindrical width of cloth that is used for biological structure and similar structures is penetrated.
In another embodiment of the present invention, the quantity that scatterer is housed can change, so that produce the exposure figure that changes gradually or change in addition.For example, a plurality of scatterers can be contained in the disperser distal portions, so that produce the exposure figure that increases progressively.As a kind of conversion, transparent Te Fulong (teflon) bar can be transferred to the reflecting mirror of far-end, so that produce the intensity that increases away from the optical fiber place.
Of the present invention aspect another, disclose and be used to expand the axial range that the diffusion width of cloth is penetrated, and/or be used to allow fiber or fiber subclass to select bunchy technology and the structure that triggers, so that near optical fiber end, realize the phototherapy of the ad-hoc location of tissue of patient zone or section.The system of this bunchy also can be used for the width of cloth of two or more different wave lengths penetrated and is sent to treatment position, thus, provides synergism by a plurality of treatment wavelength, perhaps makes the diagnosis of different wave length and the treatment width of cloth penetrate and can finish with a single process.
In another aspect of the present invention, the novel materials and the structure that are used for the emission end device are disclosed, so that the probability of the bonding contact between the tissue segments of mitigation or reduction end and vicinity.This aspect of the present invention with endoscope and/or particularly useful based on combining of the phototherapy of conduit so that guarantee that emission end can unexpectedly not be bonded on body cavity or the blood vessel at therapeutic process.In a preferred embodiment, disclose fluorinated polymer material outward,, contacted with bonding between biological tissue so that in therapeutic process, suppress end fitting as the Taflon material etc. as the preferred material that is used for end seal and/or coats or apply.More preferably, Teflon  material is Teflon  FEP material (a kind of poly-perfluoro ethylene-propylene copolymer).Other Teflon  material also is useful in certain application as Teflon  PFA (polymer of a kind of politef and perfluoro alkoxy side chain) and Teflon  PTFE (politef).
In the scatterer structure that discloses a kind of novelty aspect another of the present invention, this structure makes the structure of the scattering ratio prior art that ultraviolet (UV) and infrared (IR) width of cloth penetrate have higher efficient.The scatterer device of disclosed fill liquid more specifically, uses the structure of deuterium oxide and other heavy aqueous solution to transmit IR light with lower loss and minimum end-heating.The distilled water suspension of the scatterer that is used for the UV optical transmission is also disclosed.
In another aspect of the present invention, the new therapeutic scheme of the phototherapy surgery that is used for minimumization side reaction is disclosed.For example, disclose and be used for the treatment of the carcinoma of prostate and the similar scheme of disease, in this scheme, the scattering end fitting places near cancerous tissue or the organization of human body, with the scattered light heating with optionally destroy cancerous issue or dysplastic tissue.In addition, the present invention can also be used for the sealing of human body pipe (leading), and/or the reconstruction of the connector between incomplete or destructive pipe (leading) and the valve.And, medicament, implant infrastructure, or the photoactivation of suture material can be acted on valuably by scattering device of the present invention.According to another purposes of the present invention, can be used to the medical apparatus and instruments of sterilizing at this disclosed phototherapy device.
Aspect another, a plurality of end fittings that can play the optical delivery fiber of scatterer effect are disclosed of the present invention.Two or more optical fiber end devices are by formation of knots, and this circle produces wide propagation illumination pattern uniformly.Use " one-tenth round " or " folding " optical fiber, a plurality of optical fiber can dispose by mode connected to one another, have how much exposure figures that strengthen energy density and prevented " focus " so that produce one.
The scatterer of this round can be contained in interior specula tool or the conduit.Originally dispersing element presses contraction state (most of in implement body) configuration, reconfigures by deployed configuration with control line or analog then.Thus, two or more circles that are in deployed configuration can produce the scattering device of " being similar to sphere ", and perhaps, if further launch, circle can form " heart " structure.Thus, the present invention can amplify to throw a wide exposure range relatively little apparatus.
Each one circle comprises the tubular shell of an optical transmission, and this housing is aimed at the far-end of optical fiber and is suitable for admitting this far-end, and plays the effect of waveguide by spread fiber for light.In one embodiment, tubular housing is a hollow pipe with the scattering medium filling, and optical fiber connects on their each ends.Enter the opposite end of shell by the light of spread fiber, and before arriving the other end, be scattered.In another embodiment, device can connect simple optical fiber, and further comprises an end cap and cased light scattering medium, and like this, the light by spread fiber enters scattering medium, the light of part by shell to external leakage.In an embodiment of device with cover, end cap is a simple limiter, and all basically light finally all was scattered before arriving limiter.At another embodiment, end cap comprises a reflecting surface, and this just makes, when light passes through spread fiber, its part is originally by scattering medium scattering and outgoing radially, and another part is through scattering medium and by the end cap reflection, so that transmit by scattering medium once more.
Of the present invention aspect another, can control the quantity of scatterer of installation and/or the length of scattering circle, this just makes that the scattering that the width of cloth initial and the reflex circuit mark is penetrated is complementary.Can become even by correct selection parameter along the flow or the cumulative energy density of at least a portion optical fiber end length.
, disclose and be used in the disposable shell that is connected with scattering device aspect another of the present invention, outer field shell is around whole optical transmission apparatus, and guarantees to produce the element that the width of cloth penetrates and can not directly contact with patient anatomies.This just allows apparatus energy reuse.Have only around the shell of device need at every turn with after abandon.
The invention also discloses the phototherapy apparatus of the limiter with one, this device limit fibre end is passed.In a preferred embodiment, the shell of a band groove is around inner optical fiber configuration, and the shell of band groove is so to constitute, and when thrusting tissue, folding becomes expansion shape.When pressurization of shell back and expansion, optical transmission apparatus has bigger sectional area, prevents from like this to thrust apparatus outside predetermined desired distance.
The present invention is particularly useful thrusting of restriction optical delivery fiber, therefore, reduces the probability of thrusting body cavity or tissue.The present invention is useful especially in the ventricle of " (ablative) that burning is touched " laser width of cloth injection device being inserted the heart, when realizing that revising ARR laser ablation performs the operation, maybe when through skin the heart being carried out the revascularization art.In the operation of these types, the surgeon manages partly to puncture cardiac muscle, and the heart wall that can entirely not puncture.Limiter means of the present invention limits paracentesis depth and makes the optical delivery end stable when phototherapy.
Structure disclosed in this invention is represented the treatment width of cloth is penetrated the actual step of carrying towards therapentic part at a distance.The structure of scattering device of the present invention allow to carry 10 watts of levels or more the width of cloth of high-energy level penetrate.In fact, the scattering end fitting has successfully constituted the energy that surpasses 100 watts has been transported to the structure of therapentic part with scattering pattern, and doctor can be fast, equably the large tracts of land tissue is treated.
The invention also discloses the inner chamber disinfectant method and the device that are used for internal specula tool.Use the inner surface in the ultraviolet radiation disinfecting apparatus chamber of scattering.Ultraviolet radiation can transmit by one or more optical fiber with the light scattering device that has been coupled.Apparatus is by penetrating the operation that is transferred to surface of internal cavity to the virose width of cloth of pair cell, so that the biological agent that sterilization may exist at the apparatus intracavity.
Disclose the inner chamber decontaminating apparatus in this aspect of the invention, this device has the optical transmission fiber that can transmit ultraviolet radiation.This device also comprises a scatterer device that is coupled on the optical fiber, so that scattering is from the ultraviolet radiation of optical fiber.Enough little of said optical fiber and scatterer is so that be contained in the intracavity of endoscope to them.Device also comprises width of cloth injection device, is used to produce ultraviolet radiation and the width of cloth penetrated be coupled to optical fiber.
The wavelength of disinfectant ultraviolet radiation preferable range is between about 400 to 200 nanometers, and is preferred between 300 to 200 nanometers, most preferred between 280 to 240 nanometers.This width of cloth is penetrated can be provided by lasing light emitter, as argon ion laser or excimer laser (as helium chlorine excimer laser).As a kind of conversion, solid-state laser also can be connected use with the frequency modulation(PFM) element.For example, the infrared radiation source can be used for being connected with two frequency-doubling crystals, and their co-operate are so that produce the width of cloth beam of quadruple in the ultraviolet spectrum region.In the embodiment of another conversion, simple UV flash lamps also can be used as light source and uses with the optical fiber coupling.
Optical fiber can be the light transmission component of any prior art, comprises, for example, quartz glass.Use term " optical fiber " to comprise the optical delivery waveguide of difformity and size at this.
In one embodiment, the scattering end can be used for being connected with optical fiber, is transferred to inner chamber so that the virose width of cloth of the pair cell of scattering penetrated.The structure of scattering fiber end can be penetrated scattering particles by the width of cloth that carries and be constituted in suitable transmission medium.As a kind of conversion, the scattering end can be made of the tube-like piece of the medium charge of any suitable scattered light, and need not special scatterer.For example, the longer pipe of filling water and acetic acid also can play the effect of scattering medium.In this embodiment, do not need mobile scattering end.And device can be used for the major part or the whole length of cavity are sterilized together.
Aspect another, disclose the new material and the new construction that are used for the scattering end fitting of the present invention, described scattering end device further relaxes and reduces the probability that bonding contacts between end and near chamber wall.This aspect of the present invention can unexpectedly not be bonded on the apparatus inner chamber in assurance scattering end or be useful especially on the intravital residue in chamber.In one embodiment, disclose fluoropolymer material, for example Teflon  etc. is used for the shell of end as a kind of preferable material, and this is because they have low bonding contact performance, high ultraviolet transfer rate and low refractive index.
Aspect another, disclosed disposable shell is used for being connected use with ultraviolet disinfection optical fiber with the scatterer device of the present invention.Shell is around whole optical transmission apparatus, and guarantees to produce parts that the width of cloth penetrates and can directly not contact with the residue that the cavity of apparatus maybe may be present in intracavity.This just not only makes the doctor can repeatedly use endoscope, but and makes the disinfecting apparatus reuse.Only need abandon the shell that encases decontaminating apparatus in each back of using.As a kind of conversion, disposable shell/scatterer can be connected use with reusable optical fiber.Thus, can install on reusable optical fiber with the disposable shell of light scattering medium filling, and be used for finishing sterilization of instruments.After this program was finished, therefore, the scattering medium of shell and Qi Nei can abandon.
Aspect another, the scheme that is used to realize sterilization of instruments is disclosed of the present invention.These methods typically comprise the ultraviolet radiation device are contained in the cavity of apparatus, promote decontaminating apparatus then by cavity, and this just makes total inner surface use the virose width of cloth of antibacterial has been penetrated light bath.This method also comprises uses disposable shell, comes around disinfecting apparatus, and promotes it by inner chamber, abandons after disinfectant program finishes then.
Use term " interior specula tool " and " endoscope " at this, described is a kind of total apparatus classification, be used to observe the body inner structure or undergo surgery in vivo, it comprises cystoscope, bronchoscope, back arched roof mirror (Culpascepes), rectoscope, laryngoscope, conduit, arthroscope and other endoscope etc.
Below in conjunction with some preferred embodiments the present invention is described.Yet, should be understood that for the professional and technical personnel and can make various conversion and improvement, but these all do not break away from the spirit and scope of the present invention.
The accompanying drawing summary
The present invention will be from can more fully understanding below in conjunction with the accompanying drawing illustration, and accompanying drawing has:
Fig. 1 is the profile that comprises the phototherapy device of optical fiber and scattering end fitting according to the present invention;
Fig. 2 is another profile that comprises the phototherapy device of a plurality of optical fiber and scattering end fitting according to the present invention;
Fig. 2 A is the profile along the fibre scattering end fitting among Fig. 2 of the A-A hatching of Fig. 2;
Fig. 3 is another profile that comprises the phototherapy device of a plurality of optical fiber and scattering end fitting according to the present invention, and wherein optical fiber has different end points in described device;
Fig. 3 A is the perspective view of the optical fiber end of Fig. 3;
Fig. 4 is another profile that comprises the phototherapy device of the stacked scatterer pipe fitting of multilamellar according to the present invention;
Fig. 5 comprises vertical reflecting mirror according to the present invention, so that optionally another profile of phototherapy device of level is provided in the scattering end fitting;
Fig. 5 A is the profile along the fibre scattering end fitting of Fig. 5 of the A-A hatching of Fig. 5;
Fig. 6 A is the profile according to the another kind of mirror structure of using in the scattering end fitting of the present invention;
Fig. 6 B is the profile according to another mirror structure of using in the scattering end fitting of the present invention;
Fig. 7 A, 7B and 7C are graphic extensions for the relation between the axial distance of the relative density of different scatterer load concentration and fiber end face;
Fig. 8 is according to the graph of a relation of the present invention for axial location that is configured in the reflecting mirror of diverse location in the scattering end fitting and intensity;
Fig. 9 is according to the axial location of the scattering end fitting of a reality of the present invention and the graph of a relation of intensity;
Figure 10 is the horizontal intensity chart according to two scattering end fittings of the present invention, and one of them provides columniform exposure figure, and another provides half-cylindrical figure;
Figure 11 is the transmitting pin spectrogram of Teflon  FEP, in order to the relation of explanation transfer rate and wavelength;
Figure 12 is the profile according to another phototherapy device of the present invention, and this device has the chamber of the different scattering mediums of two fillings, so that realize the scatter graph of growth;
Figure 13 is the perspective illustration according to cast scatterer of the present invention;
Figure 14 A is the side view of cast scatterer when being in the complete contraction state of dispersing element;
Figure 14 B is the side view that is similar to Figure 14 A, and wherein the element of cast scatterer is in the part deployed condition;
Figure 14 C is another side view of apparatus, and wherein cast scatterer element is in complete deployed condition;
Figure 14 D is another side view of apparatus, and wherein the cast scatterer element of deployed condition partly is shrunk to " heart " scatterer with control line fully;
Figure 15 A is the cutaway view for the fibre scattering end fitting of the device usefulness of Figure 13;
Figure 15 B is the intensity of cast scatterer of Figure 15 A and the graph of a relation of axial distance;
Figure 16 is the cutaway view for the another kind of fibre scattering end fitting of device usefulness shown in Figure 13;
Figure 17 is the sketch map when the present invention is used as the part of endoscopic system;
Figure 18 is that it has also used disposable shell according to another cutaway view of optical fiber of the present invention and scattering end fitting;
Figure 19 is the perspective illustration according to the limiter means of the far-end of phototherapy device of the present invention and one;
Figure 20 is the cutaway view of the phototherapy device of explanation Figure 19;
Figure 21 is the sketch map of the present invention as the part of conduit or endoscope system;
Figure 22 A explanation with before human organ or body cavity surface contact at the unfolded phototherapy device of the present invention of initial position;
Figure 22 B is the device of Figure 22 A after beginning to thrust tissue furtherly;
Thrusting of the phototherapy device of the key diagram 22A that Figure 22 C further illustrates, wherein limiters mechanisms part use;
Figure 22 D is the device that further specifies Figure 22 A, and wherein limiter means is used fully;
Figure 23 is the sketch map according to the phototherapy device of the medical apparatus and instruments that is used to sterilize of the present invention;
Figure 24 is the cutaway view for the fibre scattering end fitting of the decontaminating apparatus use of Figure 23;
Figure 25 is the cutaway view according to optical fiber of the present invention and scattering end fitting, has wherein also used disposable shell.
Describe in detail
Fibre scattering end fitting 10 shown in Figure 1 comprise have optical transmission core 14, the optical fiber 12 of clad 16 and outer cushion 18.The end face of fiber cores 14 inserts in the shell 20, and described shell comprises the scattering medium 22 with special scattering particles 24.Medium 22 preferably has the refractive index greater than shell 20.At the far-end of shell 20, the end plug 26 of a band specular reflector 28 is housed.
In scattering medium 22 and along the length of device 10, press columniform figure scattering by the light transmission that fiber cores 14 is propagated.When light ran into scattering particles at every turn, it was all with deviation, and on some position, and clean deviation surpasses the critical angle of the internal reflection on the interface of 22 in shell 20 and medium, and when this happens, light is with outgoing.Light can not outgoing when the first pass end part then return by reflecting mirror 28 reflections and through end fitting.For the second time by the time, the remaining width of cloth is penetrated (perhaps being the major part that the width of cloth that returns is penetrated at least) and is run into scatterer 22 again, this scatterer make again light to around scattering.
Shown in Fig. 2 and Fig. 2 A is another scattering end fitting 40, and it has and essentially identical element shown in Figure 1, except being configured to of fibre bundle 12A-12E.Each fiber cores is exposed and optical transmission is arrived in the scattering medium 22.
Fig. 2 A is the cutaway view of the device of Fig. 2, and it shows fibre bundle 12A-12E, shell 20, the configuration of scattering medium 22 and reflecting mirror 28.
Fig. 3 and Fig. 3 A show another scattering end fitting 40, and it has and essentially identical element shown in Figure 1, except being configured to of fibre bundle 12A-12E.Each fiber cores all is exposed in the scatterer medium 22 and light transmission and arrives in it, but each optical fiber distribution frame with outside plant thus, forms the axial scattering of expansion on the diverse location of shell 20.
Fig. 3 A is the perspective view of the fibre bundle of Fig. 3, and fibre bundle 12A-12E position in the enclosure is described.
Shown in Figure 4 is another kind of scatterer end fitting 50, wherein, uses a kind of multiwalled laminated piece as scattering organ pipe 20, thus, innermost layer 22 parcel scatterer media 22, that center on innermost layer 20A is intermediate layer 20B, the 3rd layer of 20C forms around preceding two-layer 20A and 20B.This structure permission uses different polymer to become tube material, and/or allows to introduce a part painted or corrosive structure energy conduct pipe 20.
Shown in Figure 5 is another embodiment of scattering end fitting 60, and it is made up of reflector bar 62 longitudinally.Further specify as the profile of Fig. 5 A, vertically reflector 62 can be in laminated construction, for example between layer 20 and the layer 30, forms as layer or the paper tinsel element of part.Vertical reflector 62 and scatterer medium co-operation shown in Fig. 5 and Fig. 5 A, be approximately 180 ° horizontal exposure figure so that produce, yet, should see that other exposure angle can be expanded realization by widening (or narrowing down) mirror elements 62 simply towards periphery.Can constitute the mirror structure of different conversion.For example, reflecting mirror can be contained in the outside of shell, perhaps can be used as coating rather than paper tinsel element and forms.And vertically reflecting mirror can need not to reflect end face 28 uses, if do not need to strengthen axial uniformity.
It shown in Fig. 6 A another structure that is used for the end reflections mirror.As shown in the figure, end reflections mirror 28A has one scattering medium is the surface of convex, has changed exposure figure thus.Fig. 6 B also shows the structure that another kind is used for the end reflections mirror, and wherein reflecting surface is far-end rather than its proximal end face that is positioned at plug 26.In this embodiment, plug 26 is optical delivery parts, and reflecting surface 28B is a concave surface.In this embodiment, filling piece 29 also can be positioned at the end of pipe 20.
Fig. 7 A-Fig. 7 C illustrates the influence of different scatterer concentration to the scatter graph of end fitting.Yes changes with the diameter of pipe, length, wavelength and the other factors of pipe for the optium concentration of scatterer particle of scatterer medium of packing into.Yet best concentration can be tested definite soon.Fig. 7 A explanation loads the situation of too much scatterer (particle), and most light is scattered immediately entering the scattering organ pipe.Fig. 7 B explanation scatterer medium situation very little, bright spot appears near the reflecting mirror.Be the preferred embodiments of the present invention shown in Fig. 7 C, wherein, the concentration of scatterer and the position of reflecting mirror are chosen such that promptly only scattering on basic axial patterns uniformly.
The length (that is the distance between fiber end face and reflecting mirror) that should be understood that the scattering organ pipe also influences the uniformity that the width of cloth of scattering is penetrated.Shown in Figure 8 is diameter at given light source, pipe, and under the situation of scatterer concentration, the position of reflecting mirror is how to change exposure figure.When the distance between pipe elongation and optical fiber and the reflecting mirror increases, can see the decline on uniformity.Optimum size for concrete application can be determined by sample plot.
Fig. 9 is the intensity map of a preferred embodiment of the present invention, be similar to optical fiber end device shown in Figure 1 and have one with silicone and titanium dioxide scattering mixture filling and the Teflon  FEP tubular shell (external diameter is approximately 0.5mm, and internal diameter is approximately 0.25mm) of the lid of an aluminized reflecting mirror is arranged.Scattering medium is by the silicone (Mastersil of 20 parts of cleanings TMPrescription 151-cleaning is provided by the Masterbond company of New Jersey Hackensack) (press Mastersil with the titanium dioxide of a filling silicone TM151-is white for prescription, is also provided by Masterbond) mixed preparing.Consequently form a scattering end fitting that on the length of whole 25mm, transmits 633 nano red lights equably.
Figure 10 explanation is used for the horizontal exposure figure of two embodiment of the present invention.The pictorial representation of being made up of square is by the light intensity that is similar to the outside scattering of optical fiber end device shown in Figure 1.This horizontal exposing patterns is anisotropic substantially.By the pictorial representation light intensity that is similar to the outside scattering of optical fiber end device shown in Figure 5 that diamond is formed, this horizontal exposure figure is actually semi-cylindrical.
Be suitable for scattering device is connected to and have external diameter and be approximately typical manufacturing process on the optical fiber of 500 microns to 1000 microns cladding of glass or polymer by peelling off cushion from optical fiber end, that is, expose the optical fiber inner core of about 2-3mm and its covering (not needing to peel off covering) from fibre core.Before peelling off, fiber end face preferably should be prepared and grinding with method well-known in the art, to reduce border or interface loss.The transparent tubular structure that is configured for the shell of scatterer medium slides on prepared optical fiber end then, preferably slips over optical fiber end.For example, if require the end fitting of 20mm, pipe range is about 100mm, and described device can slip over the about 75mm of optical fiber, stays the cavity of about 25mm before fiber end face.In a preferred embodiment, shell is a Teflon  FEP pipe, is for example provided by Zeus Industries (Raritan of New Jersey).
Shown in Figure 11 is the transmission spectrum of Teflon  FEP, illustrates that this material is very suitable for providing the material of the parcel scatterer of the entire spectrum from infrared to ultraviolet to use.
Inject the material silicone of undertaking scatterer then in the device, as silicone, epoxy resin or other polymeric material (if requiring solid scattering thing) or the suitable scatterer particle liquid that contains colloid such as silicon, aluminium oxide or titanium dioxide, as water or heavy aqueous solution (liquid-scattering device if desired.As mentioned above, a kind of typical scatterer medium is by the silicone Mastersil of 70 parts of cleanings TMPrescription 151-cleaning is provided by the Masterbond company of New Jersey Hackensack) and the titanium dioxide (Mastersil of 1 part of filling silicone TMThe prescription 151-white, also provide by Masterbond) and the routine silicone solidify or the sclerosing agent mixed preparing.Tube chamber should be used silicone, epoxy resin or other carrier mixture filling fully, to prevent to enter bubble.The far-end of reflecting mirror (for example, aluminum, the reflector plug of gold or other coating) insertion tube.Reflector at scatterer tube far-end can depositing metal or insulating coating.Use the room temperature vulcanizing agent in a preferred embodiment, and the scatterer device can overnightly solidify simply.
Selectively, as last step, outer Teflon  sleeve can be around the device configuration, so that parcel and protection comprise the whole end fitting of inscattering organ pipe and optical fiber end.Outer sleeve is particularly useful when constituting the structure of big horizontal angle, non-cylindrical scatterer.In these were used, structure inscattering device along the axial arrangement reflection bar of device, so that stop light in the scattering of shell with the position of mirror over, and had defined the exposure figure of a non-cylindrical then thus.To determine horizontal exposure figure by accumulative degree around the reflecting mirror.Use outer sleeve also to make the selection of miscellaneous pipe can be used for the inner part of scatterer shell.Thus, any material transparent may be used to inner tube, and outer Teflon  sleeve will still guarantee to contact the adhesion problem minimum.
Should be understood that above-mentioned manufacture process only is explanation, other diverse ways also can be implemented to constitute optical fiber end device of the present invention.For example, automatically extruding formation method and/or injection molding may be used to the scattering end fitting of mass production optical fiber and one.
The quantity of the scatterer of composition scattering end fitting is with carrier and desired length variations, and therefore, it can be regulated by the special applications that runs into.Different scatterers can be useful in special applications more or less.The related characteristics of following three kinds of different scatterer compositions of table 1 explanation:
Table 1 scatterer characteristic
Scatterer composition density transmission frequency spectra
G/c.c (wavelength: micron)
TiO 2 4.0 .45-11
SiO 2 2.1 .2-7
Al 2O 3 3.6 .2-9
In some applications, two or more scatterer compositions can be mixed, so that obtain blended characteristic.
Can use liquid-scattering device composition, so that phototherapy is extended to ultraviolet (UV) and infrared (IR) spectrum district of frequency spectrum.More specifically, the structure of using deuterium oxide or other heavy aqueous solution is to transmission IR light and reduce the wastage and minimum end-heating is useful.Distilled water suspension scatterer can be used for the ultraviolet light transmission.
Above-mentioned manufacturing technology is used to produce and is connected to the scatterer end of diameter at the optical fiber of 100 to 600 micrometer ranges.When fibre bundle being connected on the scatterer end, each optical fiber even can be littler, for example: diameter is 25 microns.Columniform light scattering device produces and is grown to the axial exposure figure of 2cm to 4cm.Horizontal explosure angle is 360 ° for the device of similar Fig. 1, and the device of similar Fig. 5 is 180 °.The periphery that other horizontal exposure figure can pass through vertical reflecting optics 62 of change Fig. 5 extends acquisition.Solid tube is transparent Teflon , and is the titanium dioxide mixed injection molding shaping with above-mentioned silicone and fine particle.The pipe of perfusion fluid has similar structure, but contains the water or the D of useful colloidal aluminium oxide or cilicon oxide filler 2O solution.A kind of colloidal alumina composition of typical scatterer is with 12733 supplies of filling a prescription by Johnson Matthey company (Seabrook NewHampshire).During use, preferably with 100: 1 water dilution, pH neutralized with acetic acid.
Shown in Figure 12 is according to another kind of phototherapy device 80 of the present invention, and it has the chamber that two different scattering mediums of usefulness are filled, so that produce a kind of scatter graph of increase.Device 80 comprises the optical fiber 12 with optical transmission core 14.The end face of fiber cores 14 inserts in the shell 20, and described shell comprises first chamber with first scattering medium 21 and special scattering particles 22A.Shell also comprises one second chamber, and this chamber has by the transparent core 23 that annular space centered on of second medium charge (being FEP bar or pearl), and described second medium has the scattering 22B of different loading densities or composition.The end plug 26 of band reflecting mirror 28 is housed at the far-end of shell 20.
The optical transmission of propagating by fiber cores 14 arrives scattering medium 22A, and is scattering into cylindrical figure along the length of device 10.Each light runs into scattering particles, and it is with regard to deviation, and on certain position, clean deviation surpasses the critical angle in the internal reflection at the interface on the boundary of shell 20 and medium 21, and when this situation occurs, light will penetrate.Similarly, the light transmission by first chamber runs into scatterer 22 to second chamber 23 at this chamber, makes more light by deviation.The first pass end not light of outgoing is returned by reflecting mirror 28 reflections and by end fitting.For the second time by the time, the remaining width of cloth is penetrated (or the width of cloth that returns at least penetrate major part) and is run into scatterer 22A and 22B again, they provide scattering towards periphery to light once more.
Figure 13 shows another phototherapy device 100, and it comprises that has a plurality of light scattering circle 114A, the sleeve pipe 112 of 114B, and said circle can stretch out from apparatus overcoat 112 or withdraws by control line 116.As shown in the figure, device 100 comprises that also radio is intransitable regional 118, and this zone helps locating with the ray localization device.Although only show two circles among the figure, in some application scenario, it can have more (or still less) number of turns.
Figure 14 A-14D schematically shows the operating position of Figure 114 A and 114B.Be fully interior compressed mode shown in Figure 114 A, in this pattern, the major part of circle is recovered in the shell 112.At Figure 14 B, control line 116 partly moves forward, scattering circle 114A, and the major part of 114B is outwards protruded from shell 112.At Figure 14 C, control line further skids off forward from shell 112, circle 114A, and 114B now approaches to launch fully.At Figure 14 D, control line 116 partly shrinks again at expanded position, to form " heart " scatterer.
At Figure 15 A, be depicted as intercepted (truncated) profile of circle 114, it connects two optical fiber, and every optical fiber has optical transmission core 120A, 120B, and coating/cushion 129.Every fiber cores 120A, the end face of 120B inserts in the shell 128, and shell contains scattering medium 124 and selectable special scattering particles 125.Medium 124 preferably has the refractive index higher than shell 128.
Figure 15 B is the intensity of two optical fiber shown in Figure 15 A and the graph of a relation of radial distance.The relation that the width of cloth that is scattered of first optical fiber of curve 121A explanation is penetrated intensity and axial length, and curve 121B represents the similar intensity distributions by unfolded second optical fiber of opposite configuration.The integrated intensity of these two optical fiber distributes by curve 123 expressions.Because used a pair of optical fiber that connects by rightabout, people can realize approaching the equally distributed scattering width of cloth thus and penetrate.
The similar width of cloth is penetrated distribution pattern and also can be realized by use the reflection end cap at individual circle, as shown in figure 16.In the figure, show the intercepted profile of scattering circle 114, it has the optical fiber with optical transmission core 120 and coating/cushion 129.The end face of optical fiber inserts in the shell 128, and described shell contains scattering medium 124 and optional special scattering particles 125.Medium 124 preferably has the refractive index that is higher than shell 128.Far-end at shell 128 is equipped with end plug 126.End plug selectively is equipped with reflecting mirror 140, so that produce the distribution pattern that is similar to Figure 15 B.
The optical transmission of propagating by fiber cores 120 in scattering medium, and along the length of device 14 by cylindrical figure scattering.When light ran into scattering particles at every turn, it was deviation, and on certain position, and clean deviation surpasses between shell 128 and medium 124 interior refractive critical angle at the interface, and when this situation occurring, light is with outgoing.The length that shell can be done enough is so that guarantee that in fact all light that incide in the shell can be scattered and spread in single-pathway.Perhaps, as mentioned above, can reflecting mirror be installed at the far-end of scattering device.When using reflecting mirror, the light arrival reflecting mirror of propagating by medium 124 140 will be scattered before at least in part.The first pass end not light of outgoing will and be passed end fitting and return by reflecting mirror 140 reflections.For the second time by the time, the remaining width of cloth is penetrated (or the width of cloth that returns of major part is penetrated at least) and is run into scatterer again, this scatterer provides peripherad scattering to light once more.
Figure 17 schematically shows the circle scattering device 100 of the present invention under the user mode, and this device is coupled to a phototherapy width of cloth to be penetrated on the source 136 (for example, laser) and be positioned at the patient body, so that carry out phototherapy.As shown in figure 17, scattering device can be designed to be contained in the instrument channel of endoscope 132.Endoscope may further include a finder 134 and/or also has an additional channels 138 that is used to introduce the solution of saliniferous flushing liquor or treatment at least.As a kind of conversion, scattering device of the present invention can combine with the apparatus of conduit type, and said apparatus need not the assistance of endoscope path way and introduces in the patient body.
Figure 18 shows around the outer sleeve (for example: Teflon  material) of device configuration, is used to encase optical fiber 112 and cast scattering device 114.Shell is around whole optical transmission apparatus and guarantees that the width of cloth penetrates production part and can directly not contact with patient's health that thus, apparatus can reuse.Have only shell 150 to abandon with the back.
Device of the present invention can be used for different therapeutic purposes.A kind of application is photokinesis treatment (Photodynamic therapy PDT), a kind of form of photoactivation chemotherapy.In such a way, light-sensitive coloring agent makes like this that by injection or the transmission of other carrier dyestuff preferably is accumulated in cancerous cell.When the suitable wavelengths of the cell of absorbing dye (for example: use HONGGUANG) irradiation, photochemical reaction takes place, generation can be killed the group (singlet oxygen normally) of cell.Thus, the present invention also comprises and uses the width of cloth be scattered to penetrate, so that the activation light-sensitive coloring agent.An advantage of the invention is that it allows by conduit, trocar, on the entry needle of hollow or other the hand-held apparatus treatment position a long way off with the mode PDT of minimum side reaction, because the optical fiber end device of scattering can constitute with the external diameter that has only a hundreds of micron dimension now.
The present invention is included in also that light coagulates and/or the treatment of the hemoporphyrin of cancer and hyperplasia phenomenon (hyperplasia) the aspect use scattering width of cloth are penetrated.For example, aforesaid phototherapy device can be used for liver, pancreas or carcinoma of prostate, or benign prostatic hyperplasia.The scattering width of cloth that is used to heat prostata tissue is penetrated to be used in and is substituted prostate transurethral resection, prostate balloon expansion art or ultrasonic ablation (hyperthemria).More specifically, aforesaid directed probe is improving aspect the more prostate treatment result of short time direct heating and is being useful at the bigger prostata tissue region allocation width of cloth aspect penetrating especially, improved the heats of thermotherapy thus, and reduced around organizational structure, as sphincteral danger of crossing the hot injury.The present invention also makes hepatocarcinoma and pancreas (head) cancer energy calking (interstitial) laser photocoagulation.Desired effect is percutaneously to insert in the cancer piece by the scattering optical fiber end that hypodermic needle or similar apparatus carry to penetrate the realization of heat damage cancerous tissue by the laser width of cloth of depositing.These steps each, treatment can be finished, and patient regains consciousness, and has prevented usually as operating on the anesthesia of operation.
In the phototherapy technology based on heat, scattering optical fiber end fitting of the present invention can be used for the structure of distribution thermal source big in destination organization.The present invention has changed the speed of heat storage in tissue significantly, particularly in the scope of optical fiber end, and overheated and/or carbonization restriction effectiveness and effectively heat conversion of restriction in this scope inner tissue.Because it is to be distributed on the bigger scope of organization by scattering device that the width of cloth penetrates, more organize by direct heating, and seldom need to rely on thermal convection current by the tissue that is close to and conduction of heat transfer heat to tumor around.
And, disclosed hereinly be used for scattering end and telescopic material and further improved therapeutic effect owing to allow high-amplitude to penetrate transmission and low the absorption, guaranteed that thus end fitting itself can be in use not overheated.In addition, use Teflon  pipe and/or coat owing to prevented from the end melting between end fitting and biological tissue in use and bondd to contact further to have improved operation sequence.Have found that Teflon  FEP material (polyfluorinated ethylene-acrylic polymers) is preferred for most application, because if the words that they are corroded before with the scattering medium filling, can variable color, and Teflon  PFA material (polytetrafluoroethylene polymer and perfluoro alkoxy side chain) and Teflon  PTFE (politef) and other fluoropolymer also can use.
The big horizontal angle scatterer of non-cylindrical of the present invention is also useful in the treatment application facet especially.Because the directed scattering width of cloth is penetrated, can provide the treatment width of cloth to penetrate to large-area tissue at this disclosed device, and also protect responsive tissue and biological structure.For example; in prostate treatment, scatterer semi-cylindrical or other big horizontal angle can place in the urethra and rotate in place, like this; prostate stands phototherapy, and patient's sphincter and/or other tissue regions are subjected to protecting significantly and the injury that not penetrated by the width of cloth.In addition, the scattering end fitting of non-cylindrical can be used for being transferred to tissue penetrating than heavy dose of width of cloth and rotating, (or partly) destination organization scanning around realizing with higher intensity level in use if desired.
Scattering end fitting of the present invention can be used in other the medical application, and for example, heat is coagulated graft, the activation of photoreaction suture material, the thermosetting of prosthetic device, the binder activating that is used to implant etc.
Shown in Figure 19 is that it has the optical delivery fiber 214 of a tubular housing 212 and an inside according to another phototherapy device 200 of the present invention.The far-end of shell 212 is band grooves, and like this, the axial compression shell will cause the strut in band grooved area 216 to stretch.
Figure 20 illustrates in greater detail the cutaway view of far-end of the device of Figure 19.Shown optical delivery element have a clad and cushion around the optical fiber 220 of optical transmission core 222.The end face of fiber cores 222 inserts in the shell 228 that contains scattering medium 224 and selectable special scatterer particle 225, and medium 224 preferably has the refractive index that is higher than shell 228.Far-end at shell 228 is equipped with end cap 226, and selectively, end cap also can be equipped with reflecting mirror 240.End cap 226 can further be ground to a point 230, so that help the tissue that punctures.
The light of propagating by fiber cores 222 is transfused to the scatterer medium, and presses cylindrical figure scattering along the length of device 214.Afterwards, light runs into the scatterer particle at every turn, and all with deviation, and on certain position, clean deviation surpasses the critical angle in the internal reflection at the interface of 224 in shell 228 and medium, and when this situation occurred, light was with outgoing.Shell can do long enough enter and can in single path, be scattered so that guarantee in fact all light, perhaps as mentioned above, can install to reflecting mirror the far-end of each scatterer device.When using reflecting mirror, the light of propagating by medium 224 will be scattered before arriving reflecting mirror 240 at least in part.The light of outgoing will not return by reflecting mirror 240 reflections and by end fitting when the first pass end.For the second time by the time, the remaining width of cloth is penetrated (or being the major part that the width of cloth that returns is penetrated at least) and is run into scatterer once more, this scatterer to light provide to around scattering.
Figure 21 schematically shows the phototherapy device of the present invention 200 under user mode.Scattering device with band indentation limiters is connected to the phototherapy width of cloth and penetrates on the source 236 (for example, laser) and be contained in patient's the human body, so that treatment is provided.As shown in figure 21, scattering device can design or be contained in the conduit 232.Conduit 232 may further include an electrical sensor apparatus 234, and/or at least one is used to introduce the additional channel of the solution of saliniferous or treatment.
Figure 22 A schematically shows the use of phototherapy device of the present invention.As shown in the figure, at first apparatus is navigated on the section that requires the human body that the puncture and the width of cloth penetrate.As shown in the figure, device comprises a shell 212 and the optical delivery fiber element 214 with end 226 with band grooved area 216.A preferred embodiment, optical fiber 214 and shell 212 constitute with enough intervals, so that liquid saliniferous or treatment can be discharged.More specifically, saliniferous liquid wash optical fiber end 214 can be near the position of treatment the cools tissue surface.
Shown in Figure 22 B the first puncture of device 200, in the figure, punctured patient's tissue of optical transmission fiber, but contact tissue surface not, the end 217 of shell 212.
At Figure 22 C, optical fiber 214 further thrusts patient's tissue, and shell 212 has just been shifted the position near tissue of patient onto.When apparatus is pushed ahead again, the zone 216 of band groove is supported 218 radially extrapolated from device main body because the power that applies during puncture begins to stretch.
At Figure 22 D, shown device is in complete unfolded position, and the optical fiber 214 of predetermined length has now thrust the tissue of human body, and the support 218 of circumferentially extending entirely has been compressed to maximum position, has produced the obstruction of a big cross section for further puncturing.
Different materials can be used to make shell, comprises, for example Teflon  and other fluorocarbon polymer.Supporting 218 can be made up of axial thin slice on the diverse location of shell.For example constitute one four limiter means that supports, four longitudinal cuts are inserted in the shell with 90 ° interval each other.The length of otch is decided by the degree of limiter circumferentially extending.In one embodiment, also can be with the polymer of the impervious material of radio (as barium or bismuth) filling shell, so that can when angiography, can observe.
In Figure 23, shown phototherapy device 300 also is applicable to the inner chamber of the medical interior specula tool 332 of sterilization, and shown phototherapy device comprises 336, the optical fiber 312 in a ultraviolet radiation source and a scattering end fitting 314.
During use, device 300 be used to sterilize or clean in the inner chamber of specula tool 332.Optical fiber 312 with light scattering far end device 314 inserts and requires the disinfectant intracavity.According to a kind of method, optical fiber end is inserted by whole apparatus, then at leisure to retraction.The starting width of cloth is penetrated the source, so that make light pass to scattering end fitting 314 by optical fiber 312.When device during by endoscope chamber 338 retraction, the deleterious width of cloth of antibacterial is penetrated all parts that are transferred to internal chamber wall, similarly be subjected to the width of cloth at any residue of internal chamber wall and deposit and penetrate, so that kill the antibacterial of in these deposits, hiding.
Figure 24 illustrates in greater detail scattering end fitting 314, shows the optical fiber 312 with optical transmission core 320 and cushion or clad 321.The end face of fiber cores 320 inserts in the shell 328 that scattering medium 324 and optional special scattering particles 325 are housed.Embodiment as the aforementioned, medium 324 still has the refractive index that is higher than shell 328.The end plug 326 of a band reflecting mirror 340 is housed at the far-end of shell 328.
Press cylindrical figure scattering by the optical transmission that fiber cores 320 is propagated to scattering medium 324 and along the length of device 314.Light runs into scattering particles at every turn.All with deviation, and on certain position, clean deviation surpasses the critical angle of the internal reflection at the interface of 324 in shell 328 and medium, and when this situation occurring, light is with outgoing.The first pass end not light of outgoing is reflected by reflecting mirror 328, and returns by end fitting.When for the second time by the time, the remaining width of cloth is penetrated (or being the major part that the width of cloth that returns is penetrated at least) and is run into scatterer 325 once more, it for ultraviolet light provide again to around scattering.
Certainly, the optium concentration of the scattering particles of composition scattering medium is with diameter, the length of pipe, wavelength, the other factors variation equally in addition of pipe.However, optium concentration can be easy to experiment for the ultraviolet radiation of 400-200 micromillimetre to be determined, is the aluminium oxide of the colloidal that suspends in acetic acid for a preferred embodiment of scattering medium.The length (being the distance between optical fiber end and the reflecting mirror) that should be understood that the scattering organ pipe also influences the uniformity that the scattering width of cloth is penetrated.
As shown in figure 25, outer Teflon  sleeve 350 is selectively installed around device as final step, so that encase and protect the whole end fitting that comprises inscattering organ pipe 314 and optical fiber end 312.
During use, device inserts endoscope's intracavity and is connected on the UV light source.The starting light source, the UV width of cloth is penetrated and is transferred to the scattering end, at the be projected as columniform exposure figure of this scatterer to the chamber wall.Then, device can go up slide at fore-and-aft direction (or at both direction), so that penetrate with the disinfectant width of cloth light bath is carried out in whole chamber.

Claims (58)

1. scattering end fitting of using for optical fiber, so that the width of cloth by said spread fiber is penetrated scattering, said end fitting comprises a shell with optical transmission scatterer of first end that is suitable for receiving optical delivery fiber, in said shell, light scattering medium is housed, like this, in the time of on being connected to said device, the width of cloth by spread fiber injects scattering medium, and the width of cloth of a part is penetrated by the outside scattering of said shell.
2. according to the said device of claim 1, wherein said medium has the refractive index that is higher than shell, will produce scattering when light runs into scattering particles in medium, and the certain amount of deviation, thus, deflection angle surpasses between medium and shell the critical angle of internal reflection at the interface.
3. according to the said device of claim 1, wherein device also comprises having the optical transmission shell that is suitable for receiving first end of optical delivery fiber and has second end of reflecting surface, in said shell, light scattering medium is housed, like this, in the time of on being connected to said device, the width of cloth by spread fiber injects scattering medium, and a part of width of cloth is penetrated by said shell by outwards scattering, remaining is used for by said scattering medium transmission by scattering medium and by the reflecting surface reflection.
4. according to the said device of claim 3, the wherein interaction on scattering medium and reflection end surface is so that provide the uniformly axial basically width of cloth to penetrate distribution on the whole length of end fitting.
5. according to the said device of claim 1, wherein shell comprises the chamber of the scattering medium filling that two usefulness is different at least, so that realize improving scatter graph.
6. according to the said device of claim 1, wherein scattering medium further comprises the polymeric material with composition light scattering particles within it.
7. according to the said device of claim 5, wherein particle is evenly dispersed in whole polymeric materials substantially.
8. according to the said device of claim 6, wherein polymeric material is to select from the group of silica gel and epoxide resin polymer.
9. according to the said device of claim 6, wherein polymeric material is solidified into solid.
10. according to the said device of claim 6, wherein scattering particles is from aluminium oxide, chooses in the group that the chemical compound of silicon dioxide and titanium dioxide and their mixture are formed.
11. according to the said device of claim 1, wherein scattering medium is the liquid with composition light scattering particles within it.
12. according to the said device of claim 11, wherein liquid is to choose from the group that comprises water, heavy water and composition thereof, and selectively wherein liquid be that pH-is equilibrated.
13. according to the said device of claim 11, wherein scattering particles is chosen from the group that comprises aluminium oxide, silicon oxide and titanium oxide compound and composition thereof.
14. according to the said device of claim 1, wherein shell comprises that further the width of cloth penetrates the transmission fluorocarbon polymer.
15. according to the said device of claim 14, wherein the width of cloth penetrate the transmission fluorocarbon polymer be the Teflon polymer.
16. according to the said device of claim 14, wherein fluorocarbon polymer is polyfluorinated ethylene-propylene copolymer.
17., wherein reflect the reflecting mirror of at least one coating surface of end cap according to the said device of claim 3.
18. according to the said device of claim 17, wherein the reflecting mirror of coating surface is that the reflecting material of choosing in the group by gold, aluminum and insulating compound applies.
19. according to the said device of claim 1, wherein shell comprises the concentric layer of the tubular of the polymeric material that two transmission width of cloth are penetrated at least.
20. according to the said device of claim 1, wherein device further comprises a vertically reflection unit of configuration, is used to produce the exposure figure that has less than 360 ° horizontal angle.
21. according to the said device of claim 20, wherein device comprises a cylindrical case, device also comprises vertical mirror elements that a protection component environment avoids the width of cloth to penetrate.
22. according to the said device of claim 21, wherein mirror elements is a reflector sheet that places the elongated bending between said shell two-layer.
23. according to the said device of claim 1, wherein device comprises that further at least one optical fiber is connected on the said shell.
24. according to the said device of claim 23, wherein device further comprises a plurality of optical fiber of arranging by bundle, and their distal end is connected on the interior different axial locations of said shell, so that elongated distribution pattern is provided.
25. according to the said device of claim 1, wherein shell is by crooked structure configuration, so that form the cast scatterer.
26. according to the said device of claim 25, wherein shell is further to be suitable at one end admitting first optical fiber, receives second optical fiber in second termination.
27. according to the said device of claim 25, wherein device comprises that also one centers on the sleeve of a plurality of cast scatterers and makes the cast scatterer by shrinking and launching two states and launch.
28. according to the said device of claim 27, wherein device also comprises and is used to control device that said cast scatterer is moved to deployed condition by contraction state.
29., wherein in the scatterer shell scattering medium is housed according to the said device of claim 25.
30. according to the said device of claim 29, wherein scattering medium also comprises the polymeric material that is studded with light scattering particles in it.
31. according to the said device of claim 30, wherein scattering particles is chosen from the group that comprises aluminium oxide, silicon oxide and titanium oxide compound and composition thereof.
32. according to the said device of claim 30, wherein the scattering shell comprises that also the width of cloth penetrates the transmission fluorocarbon polymer.
33. according to the said device of claim 25, wherein the bubbler shell also comprises the end cap of a reflection.
34. according to the said device of claim 25, wherein device also comprises a tubular sleeve with the optical fiber that is coupled to each end.
35. according to the said device of claim 1, also comprise a shell that centers on said end fitting and have a trough of belt zone, this shell can be expanded when device penetrates into biological tissue.
36. according to the said device of claim 35, wherein end fitting has the far-end of a point.
37. according to the said device of claim 35, wherein the scattering end fitting also comprises and is suitable for the optical transmission shell that is connected with the optical fiber far-end, and light scattering medium is housed in the shell.
38. according to the said device of claim 37, wherein shell also comprises an end cap with reflecting surface, like this, the light width of cloth by the spread fiber that connects injects scattering medium, the width of cloth of part is penetrated by the outside outgoing of said shell, and other parts are by end reflections, so that transmit and outwards outgoing again by said scattering medium again.
39. according to the said device of claim 37, wherein scattering medium also comprises the medium with distribution light scattering particles within it.
40. according to the said device of claim 39, wherein scattering particles is to choose from the group that the chemical compound that comprises aluminium oxide, silicon oxide, titanium oxide and their mixture are formed.
41. according to the said device of claim 35, wherein limiter is to make with the intransitable material of radio.
42. according to the said device of claim 37, wherein shell is to make with polymeric material.
43. according to the said device of claim 37, wherein the polymeric material of shell is a fluorocarbon polymer.
44. according to the said device of claim 35, wherein end fitting and the shell that centers on are to have enough intervals to constitute between them, are used for a treatment liquid transfer is penetrated the position to the width of cloth.
45. according to the said device of claim 1, wherein device also comprises the optical transmission fiber of the interior intracavity of specula tool in that can transmit ultraviolet radiation and enough little can being contained in; And
Be coupled to said end fitting, be used for the width of cloth is penetrated the inner wall surface of the inner chamber that is scattered in interior specula tool.
46. according to the said device of claim 45, wherein optical transmission fiber is a kind of silicon dioxide fibre of melting.
47. according to the said device of claim 45, wherein the scatterer device also comprises a fluoropolymer polymer shell that scattering medium is housed.
48. according to the said device of claim 45, wherein device also comprises width of cloth injection device, the UV width of cloth that it also is included in the 400-200 nanometer range is penetrated the source.
49. according to the said device of claim 48, wherein width of cloth injection device is a laser instrument.
50. according to the said device of claim 49, wherein laser instrument is an argon ion laser.
51. according to the said device of claim 49, wherein laser instrument is an excimer laser.
52. according to the said device of claim 49, wherein laser instrument is gas, liquid or the fixed laser of frequency multiplication.
53. according to the said device of claim 48, wherein width of cloth injection device is a UV flash lamps.
54. according to the said device of claim 1, wherein device also comprises the disposable shell that is suitable for encasing end scatterer device.
55. one kind be used to sterilize in the method for inner chamber of specula tool, comprising:
Introducing can be transmitted optical transmission fiber and scattering end fitting that is used for the width of cloth is penetrated the interior intracavity that scatters to interior specula tool that the UV width of cloth is penetrated;
Said optical fiber is coupled on the ultraviolet radiation source;
Activate the said width of cloth and penetrate the source, so as the width of cloth penetrate be transferred to by said optical fiber and said scattering end fitting on the inner wall surface of specula tool inner chamber; With
Withdrawal optical fiber and scattering end fitting under the situation that the continuation width of cloth is penetrated are so that make the physical length energy ultraviolet radiation of surface of internal cavity.
56. according to the said method of claim 55, wherein this method also comprises by said optical fiber and scattering end fitting the deleterious ultraviolet radiation of antibacterial is transported on the inner surface of apparatus inner chamber.
57. according to the said method of claim 56, wherein this method also comprises the ultraviolet radiation of use wavelength in the 400-200 nanometer range.
58. according to the said method of claim 55, wherein this method also comprises before the inner chamber of specula tool in the said device introducing, encases said optical fiber and scattering end fitting with disposable shell.
CN95195954A 1994-09-09 1995-09-08 Phototherapeutic apparatus Expired - Fee Related CN1072971C (en)

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US30360594A 1994-09-09 1994-09-09
US08/303,605 1994-09-09
US08/471,744 US5637877A (en) 1995-06-06 1995-06-06 Ultraviolet sterilization of instrument lumens
US08/468,568 1995-06-06
US08/468,568 US5643253A (en) 1995-06-06 1995-06-06 Phototherapy apparatus with integral stopper device
US08/467,414 1995-06-06
US08/467,414 US5632767A (en) 1994-09-09 1995-06-06 Loop diffusers for diffusion of optical radiation
US08/471,744 1995-06-06

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CN1072971C CN1072971C (en) 2001-10-17

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WO1996007451A3 (en) 1996-05-23
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WO1996007451A2 (en) 1996-03-14
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AU3626995A (en) 1996-03-27
CA2199384A1 (en) 1996-03-14

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