CN217472073U - Laser ablation assembly and laser ablation system - Google Patents

Laser ablation assembly and laser ablation system Download PDF

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Publication number
CN217472073U
CN217472073U CN202123422382.1U CN202123422382U CN217472073U CN 217472073 U CN217472073 U CN 217472073U CN 202123422382 U CN202123422382 U CN 202123422382U CN 217472073 U CN217472073 U CN 217472073U
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light
ablation
laser
laser ablation
optical fiber
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刘文博
韩萌
黄祖炎
杨恬恬
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Sinovation Beijing Medical Technology Co ltd
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Sinovation Beijing Medical Technology Co ltd
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Abstract

The application provides a laser ablation assembly, which comprises an ablation optical fiber and a cooling sleeve; the ablation optical fiber comprises a light guide optical fiber and an ablation tip; the cooling sleeve comprises a base, an inner pipe and an outer pipe, and two communicating structures are arranged in the base; a first supporting structure is arranged between the outer pipe and the inner pipe, a second supporting structure is arranged on the inner side of the inner pipe, the far end of the outer pipe is a blind end, a first channel is formed in the space between the outer pipe and the inner pipe, a second channel is formed in the space between the inner pipe and the optical fiber, and the first channel and the second channel are in fluid communication at the far ends; the first channel is in fluid communication at a proximal end with one of the communication structures and the second channel is in fluid communication at a proximal end with the other communication structure.

Description

Laser ablation assembly and laser ablation system
Technical Field
The utility model belongs to the technical field of the medical equipment technique and specifically relates to a laser ablation subassembly and use laser ablation system of this laser ablation subassembly is related to.
Background
Laser ablation is a novel tumor treatment technology which guides light into a human body through optical fibers to enable local biological tissues to be condensed and necrotic after being heated, and can achieve the purpose of removing in-situ tumors or lesions through small invasion. Compared with the traditional surgical excision operation, the method has the characteristics of short operation time, small operation wound surface, less occurrence of massive hemorrhage, less pain on patients, good postoperative recovery effect and certain anti-inflammatory and bactericidal effects. Has good prospect in disease treatment, especially in the treatment research of tumors, and is currently used for treating many types of tumors, such as tumors in the liver, brain, mammary gland, retina and other parts. But there are still a number of problems at present:
first, laser heating tissue can cause local tissue to be overheated and carbonized, which prevents further treatment and reduces the treatment range, so the cooling of ablation optical fiber by cooling fluid with cooling sleeve is the existing solution adopted in the field. However, in the prior art, with the gas cooling solution, the cooling jacket is limited by the change of the coolant from liquid to gas, and has an excessively large diameter; in the scheme of liquid cooling, the tissue is extruded after being implanted into the tissue, and the inner wall and the ablation optical fiber are sometimes adhered together between the outer wall and the inner wall, so that the passing of cooling fluid is influenced, and the heat dissipation effect of the cooling fluid on the ablation optical fiber is seriously weakened.
Secondly, as part of tissues or the exterior of the tumor has a membrane structure with certain toughness, the ablation sleeve cannot penetrate through the membrane, so that the ablation optical fiber deviates from a preset path, and the ablation operation precision is reduced or the damage to normal tissues is increased.
Thirdly, when the ablation optical fiber with directional light emitting is used, the central axis is kept unchanged when the ablation optical fiber needs to rotate, otherwise, deviation between actual ablation and expected ablation is caused.
Fourthly, continuous and accurate temperature detection is lacked in the ablation process, a sensor which is arranged independently in the existing monitoring method needs to be additionally implanted, and the diameters of the ablation optical fiber and related structures are increased due to the temperature measurement structures which are arranged side by side, so that the implantation difficulty and the wound are increased.
Fifthly, the ablation optical fiber needs higher output power, has larger diameter, goes deep into the tissue, needs to be implanted and rotated in the using process, and if the optical fiber or the treatment end head is broken in the process, the laser is likely to be directly irradiated forwards along the optical fiber direction to damage healthy tissue; therefore, the problems of continuous detection and monitoring of the laser transmission fiber and the treatment tip in laser ablation, whether the treatment tip falls off or is burnt, and the like are not solved
To address at least one or all of the above issues, the present invention provides a laser ablation assembly for laser hyperthermia.
SUMMERY OF THE UTILITY MODEL
A first aspect of the present application provides a laser ablation assembly comprising an ablation optical fiber and a cooling jacket; the ablation optical fiber comprises a light guide optical fiber and an ablation tip; the cooling sleeve comprises a base, an inner pipe and an outer pipe, and two communicating structures are arranged in the base; a first support structure is arranged between the outer tube and the inner tube, a second support structure is arranged on the inner side of the inner tube, the far end of the outer tube is a blind end, a first channel is formed in the space between the outer tube and the inner tube, a second channel is formed in the space between the inner tube and the optical fiber, and the first channel and the second channel are in fluid communication at the far ends; the first channel is in fluid communication at a proximal end with one of the communication structures and the second channel is in fluid communication at a proximal end with the other communication structure.
Preferably, the axis of the ablation fiber coincides or approximately coincides with the axis of the inner tube.
Optionally, the light guide fiber of the ablation fiber is a double-clad fiber, which includes a fiber core, a first cladding, and a second cladding, wherein the refractive index of the first cladding is smaller than that of the fiber core, and the refractive index of the second cladding is smaller than that of the first cladding; the fiber core can transmit light for temperature monitoring, and the first cladding can transmit light for ablation;
further, the first cladding layer may also transmit monitoring light for monitoring for breakage.
Optionally, the first coating may also transmit an indicator light for emitting visible light before treatment, facilitating the user to quickly confirm the availability of the ablation fiber.
The optional ablation end head further comprises a light splitting film, the light splitting film has high transmittance for ablation light, and the light splitting film has high reflectivity for monitoring light for monitoring fracture;
the position of the light splitting film in the treatment end can be in various conditions, and the light splitting film is arranged on the light path of the treatment laser after the treatment laser is emitted from the light guide optical fiber. In some embodiments, the light splitting film is disposed at the proximal end of the treatment tip, i.e., adjacent to the light-conducting optical fiber; in other embodiments, the spectroscopic membrane is disposed distal to the treatment tip; in other embodiments, the light splitting film is disposed at the light emitting portion of the treatment tip, i.e., the position where the treatment light exits the treatment tip.
Optionally, the treatment end still is provided with the beam split membrane, and the beam split membrane has high reflectivity to monitoring cracked monitoring light, has high transmissivity to other light, can be used for monitoring cracked monitoring light through first cladding transmission to whether the monitoring takes place optic fibre fracture in the use.
The reference to the light-splitting film having high transmittance to light in this application means that the light passes through the light-splitting film at a rate of not less than 90%, preferably not less than 95%, more preferably not less than 98%, etc.
The monitoring light reflected by the light splitting film has a high reflectivity, and the monitoring light is obviously different from the monitoring light returned by other reflecting surfaces when reaching the monitoring light detector and can be identified by the detector; for example, the intensity of the monitoring light reflected by the spectroscopic film upon reaching the monitoring light detector is at least 50% higher, preferably more than 1 times higher, than the monitoring light returned to the detector by the other reflecting surface.
In the application, the treatment tip is used for transmitting light to a target position, and the emergent direction of the light or at least a part of the light can be changed; the treatment tip can be selected in various ways, and in some embodiments, the treatment tip comprises a reflecting end surface so that light rays are emitted directionally according to a preset direction; in other embodiments, the treatment tip comprises scattering particles that cause light to exit in a direction perpendicular to the long axis of the light delivery structure; in still other embodiments, the treatment tip can have both scattering particles and a reflective surface; in some embodiments, the treatment tip has scattering particles and a diffusive reflective surface. The light rays which can be emitted by the treatment end head not only comprise treatment light, but also comprise indicating light rays and the like. The therapeutic light may include laser light for ablation, but also light for other methods such as photodynamic therapy. Therefore, the ablation optical fiber can be used for laser thermotherapy and photodynamic therapy.
Optionally, the ablation optical fiber further comprises a temperature measuring element, the temperature measuring element can be an extrinsic Fabry-Perot cavity sensor or a temperature measuring grating, and when the temperature measuring element is the extrinsic Fabry-Perot cavity sensor, the extrinsic Fabry-Perot cavity sensor is arranged to be adjacent to the distal end of the light guide optical fiber and to be adjacent to the ablation tip; when the temperature measuring element is a temperature measuring grating, the temperature measuring grating is arranged at the far end of the fiber core and is adjacent to the ablation probe.
Further, the ablation of the application transmits the temperature measuring light through the fiber core, after the temperature measuring light reaches the temperature measuring grating through the fiber core, at least one part of the temperature measuring light returns, the returned temperature measuring light is measured, and the temperature reaching the position of the temperature measuring grating (namely the near end of the treatment end) can be obtained. Further, through measuring the temperature measurement light that returns, can also obtain the structure condition (whether damage such as fracture has taken place promptly) from the near-end of ablation optic fibre to between the temperature measurement grating, when breaking, the signal that obtains from the temperature measurement grating can take place abrupt change to can let the user in time know.
In the laser ablation assembly of the present application, the number of the first support structures may be 3 or more, such as 3, 4, 5, 6, 8, etc., and preferably the first support structures are symmetrically distributed around the central axis of the cooling jacket, i.e. equally spaced along the circumference of the outer tube in cross-section; the second support structure allows the ablation fiber to rotate therein, the number of the second support structures may be 3 or more, such as 3, 4, 5, 6, 8, etc., and preferably the second support structures are symmetrically distributed around the central axis of the cooling jacket, i.e. equally spaced along the circumference of the inner tube in cross-section.
The first and second support structures extend in an axial direction; optionally, the second support structure is located closer to the proximal end at the distal end than at the distal end of the inner tube; alternatively, the first and second support structures may be discontinuous in the axial direction.
In some embodiments, the first support structure of the cooling jacket of the laser ablation assembly of the present application and the outer tube are a unitary structure, i.e., the first support structure is disposed on an inner wall of the outer tube; further, the outer wall of the inner tube may be provided with a groove for matching with the first support structure; or the radian matched with the outer diameter of the inner pipe is arranged at one end, close to the central axis, of the first supporting structure on the cross section, namely the end, close to the central axis, of the first supporting structure on the cross section is a concave arc matched with the convex arc of the outer wall of the inner pipe.
In other embodiments, the first support structure and the inner tube of the cooling jacket of the laser ablation assembly of the present application are a unitary structure, i.e., the first support structure is disposed on the outer wall of the inner tube, when the first support structure, the inner tube, and the second support structure are a unitary structure; furthermore, the end of the first supporting structure, which is close to the outer pipe, on the cross section has a radian matched with the inner diameter of the outer pipe, namely, the end of the first supporting structure, which is close to the outer pipe, on the cross section is a convex arc matched with a concave arc of the inner wall of the outer pipe; or the inner side of the outer pipe is provided with a groove, and the groove arranged on the inner side of the outer pipe is matched with the first supporting structure arranged on the outer wall of the inner pipe.
In still other embodiments, portions of the first support structure and the outer tube of the cooling jacket of the laser ablation assembly of the present application are a unitary structure, and the remaining first support structures and the inner tube are a unitary structure, i.e., a portion of the first support structures are disposed on the inner wall of the outer tube and the remaining first support structures are disposed on the outer wall of the inner tube; furthermore, the first supporting structure arranged on the inner wall of the outer pipe and the first supporting structure arranged on the outer wall of the inner pipe are arranged at intervals.
In some embodiments, in the cooling jacket of the laser ablation assembly, the outer tube, the first support structure and the inner tube are integrated, that is, the outer tube, the first support structure, the inner tube and the second support structure are integrated, and the integrated structure is favorable for manufacturing and processing, omits an assembly process and is more convenient and faster to use. Further, in case the outer tube, the first support structure, the inner tube and the second support structure are of unitary construction, the inner tube may be connected at a distal end with the outer tube and provided with a communication hole at a distal end of the inner tube such that the first channel and the second channel are in fluid communication.
In the cooling sleeve of the laser ablation assembly, one end of the second supporting structure, which is close to the axis, is matched with the ablation optical fiber, and optionally, on the cross section, one end of the second supporting structure, which is close to the axis, is a concave surface and is matched with a convex surface of the outer diameter of the optical fiber; optionally, one end of the second supporting structure near the axis is a convex surface corresponding to the convex surface of the outer diameter of the optical fiber, and compared with the aforementioned concave surface structure, the contact area is smaller and the resistance to rotation of the optical fiber is small.
Two communicating structures are provided in the base, the two communicating channels each being provided with a port, one of the two communicating structures being in proximal fluid communication with the first channel through its port, the other of the two communicating structures being in proximal fluid communication with the second channel through its port.
In some embodiments, the cooling jacket of the present application includes a first communication structure having a first port in fluid communication with the first fluid, and a second communication structure having a second port in fluid communication with the second channel;
cooling fluid enters the first channel from the first port on the first communicating structure, flows from the near end to the far end of the first channel, absorbs heat after reaching the far end of the cooling sleeve, flows back to the near end of the second channel, and finally flows out from the second port on the second communicating structure, so that the temperature of the ablation optical fiber is reduced;
or the cooling fluid enters the second channel from the second port on the second communicating structure, flows from the near end to the far end of the second channel, absorbs heat after reaching the far end of the cooling sleeve, flows back to the near end of the first channel, and finally flows out from the first port on the first communicating structure, so that the temperature of the ablation optical fiber is reduced.
In other embodiments, the cooling jacket of the present application includes a first port disposed on the first communication structure, the first port being in fluid communication with the second channel, a second port disposed on the second communication structure, the second port being in fluid communication with the first fluid flow;
cooling fluid enters the first channel from the second port of the second communicating structure, flows from the near end to the far end of the first channel, absorbs heat after reaching the far end of the cooling sleeve, flows back to the near end of the second channel, and finally flows out from the first port on the first communicating structure, so that the temperature of the ablation optical fiber is reduced;
or the cooling fluid enters the second channel from the first port on the first communication structure, flows from the near end to the far end of the second channel, absorbs heat after reaching the far end of the cooling sleeve, then flows back to the near end of the first channel, and finally flows out from the second port arranged on the second communication structure, so that the temperature of the ablation optical fiber is reduced.
The cooling fluid may be any fluid suitable for cooling, preferably including double distilled water, medical saline, and the like.
In a second aspect, the present application provides a laser ablation system comprising: comprises a control center, at least one therapeutic light source module, a cooling circulation module and at least one laser ablation component. The control center includes a host computer, which can be loaded with software programs for implementing the treatment, and input/output devices for displaying and receiving instructions.
The therapeutic light source module comprises one or more therapeutic light generators capable of generating one or more light rays (therapeutic light) for therapy, such as general ablation laser light of 980nm, 1064nm and the like; the therapy light generator may for example comprise several groups of lasers and corresponding controllers.
In some embodiments, the laser ablation system further comprises a monitoring module and an ablation optical fiber with a light splitting film, wherein the monitoring module comprises at least one monitoring light generator, a wavelength beam combining module, a transceiving branching device and at least one photoelectric detector. The therapeutic light (namely, ablation laser) generated by the therapeutic light source module and the monitoring light generated by the monitoring light generator can enter the transmission optical fiber after being processed by the wavelength beam combining module. In the using process, monitoring light is generated by the monitoring light generator, the monitoring light and the treatment light are combined in the wavelength beam combining module after passing through the transceiving branching device, then the monitoring light enters the ablation optical fiber, part of the monitoring light returns after being reflected at the light splitting film, and finally reaches the photoelectric detector after reentering the transceiving branching device, the photoelectric detector ensures that the problems of optical fiber breakage and the like do not occur in the optical path by continuously monitoring the returned monitoring light, and whether the structure of the ablation optical fiber is intact is judged.
Preferably, the monitoring light generator is selected from: the laser comprises a red laser for generating laser light with any wavelength in a 630-660 nm waveband, a near infrared laser for generating laser light with any wavelength in a 1300-1320 nm waveband, and a near infrared laser for generating laser light with any wavelength in a 1520-1565 nm waveband.
Optionally, the laser ablation system may further include a beam splitter, where the beam splitter connects the transmission fiber and the ablation fibers, and the beam splitter receives the light transmitted by the transmission fiber and distributes the light to two or more ablation fibers, where the wavelengths of the monitoring light returned by the splitting films corresponding to each ablation fiber are different.
At least a portion of the monitoring light may be detected by a photodetector, which may employ a variety of technologies, such as Photodiodes (PDs), Avalanche Photodiodes (APDs), photomultiplier tubes, by reflection from the spectroscopic film.
In some implementations, the monitoring light can be used as the detection light and the indicating light at the same time, that is, by controlling the reflection ratio of the light splitting film and the intensity of the monitoring light, the monitoring light emitted through the light splitting film can be used as the indicating light; the indicating light module or the indicating light laser is not separately arranged. The monitoring light can use visible light wavelength, and the normal light path can be determined by directly observing the emergence of the monitoring light from the ablation optical fiber.
In this application, the light generator, including the therapeutic light generator and the monitoring light generator, may each comprise one or more light source modules and corresponding controllers that may control emission parameters of the light source modules, such as output power, output period, output time domain, etc.
The therapeutic light generator may generate light for therapy, i.e. therapeutic light. Further, two or more therapeutic light generators may be provided, or a therapeutic light generator may comprise two or more light source modules, such that the laser therapy system of the present application may output two or more different wavelengths of therapeutic light in a variety of temporal ways, e.g., in some embodiments, two therapeutic lights may be output simultaneously; in still other embodiments, the first therapeutic light may be output separately and the second therapeutic light may be output separately; in other embodiments, the two therapeutic lights may be alternately output at fixed time intervals.
The monitoring light generator can generate light for monitoring whether the ablation optical fiber is broken, namely monitoring light; two or more therapy light generators may be provided, or a monitoring light generator may contain two or more light source modules, such that the laser ablation systems of the present application may output monitoring light at two or more different wavelengths.
Preferably, the wavelength of the monitoring light is different from the wavelength of the therapeutic light, more preferably, the wavelength of the monitoring light is significantly different or readily distinguishable from the wavelength of the therapeutic light.
The cooling circulation module and the cooling sleeve are used in combination for cooling the ablation optical fiber. The cooling circulation module includes: a pumping device (e.g., a peristaltic pump) and a cooling medium, wherein the ablation fiber is disposed in the cooling sleeve, the peristaltic pump pumps the cooling medium into the cooling sleeve, and the cooling medium absorbs heat from the ablation fiber and flows out of the cooling sleeve, thereby reducing the temperature of the ablation fiber and the tissue adjacent thereto, and the cooling fluid is circulated as described above.
In some embodiments, the laser ablation system of the present application further comprises a thermometry module and an ablation fiber with thermometry structure, wherein the thermometry module comprises a thermometry light source and a demodulation module. The temperature measuring light source and the demodulation module can adopt a suitable combination device, for example, in some embodiments, the temperature measuring light source is a C-band tunable laser, and the demodulation module is a photoelectric detector; in other embodiments, the temperature measuring light source is a C-band ASE light source, and the demodulation module is a spectrum demodulation module. In still other embodiments, the temperature measuring light source is a tungsten halogen white light source, and the demodulation module is a white light interference demodulation module. The temperature measurement light source emits temperature measurement light, the temperature measurement light is transmitted to the temperature measurement grating or the temperature measurement Fabry-Perot cavity sensor through the fiber core and then returns, the demodulation module measures the returned temperature measurement light, and the temperature of the temperature measurement grating (such as a Bragg grating) or the temperature measurement Fabry-Perot cavity sensor is obtained.
The beam combiner integrates light rays generated by the treatment light source module and the temperature sensing module, then the light rays are output through the transmission optical fiber, the transmission optical fiber is connected with the ablation optical fiber through the coupler, and finally the light rays generated by the treatment light source module and the temperature sensing module reach a target position.
Optionally, the treatment light source module further comprises an indication light source, wherein the indication light source comprises a visible light laser for generating visible light for indication, and the indication light source can be arranged independently or in the treatment light source module, that is, the treatment light source module not only comprises a laser for emitting treatment light, but also comprises a laser for emitting indication light.
Optionally, the optical fiber ablation system further comprises a splitter, the splitter can divide received light into multiple paths for output, the therapeutic light source module and the temperature sensing module can be respectively connected with the n splitters (n is a natural number greater than or equal to 2), the n therapeutic lights output by the n splitters and the corresponding n temperature measuring lights are paired pairwise, and the n therapeutic lights and the corresponding n temperature measuring lights enter the n ablation fibers after the n combiners. Further, there may be two or more therapy modules, each therapy module being used with one of the ablation fibers of the present application.
In some embodiments, the host computer can load an ablation program, record the temperature in real time through the temperature measuring module, monitor and display the temperature, estimate and display the ablation condition on the three-dimensional model according to the temperature and the duration time, and control the output power of the laser generator through the temperature and the ablation condition feedback; when receiving the abnormal monitoring optical signal, the therapeutic light generator can be closed in emergency.
In some embodiments, the laser treatment system further comprises a thermometry module, a monitoring module, and an ablation fiber with both a light splitting film and a thermometry structure. The temperature measuring module can detect the temperature of the temperature measuring structure and the near end of the ablation tip, and can also detect the structural condition from the near end to the temperature measuring structure; the monitoring module can monitor the structural condition from the near end to the light splitting film and can comprise a light guide fiber and an ablation tip.
In some embodiments, the magnetic resonance interstitial based laser hyperthermia system of the present application comprises a workstation comprising a host and a human-computer interaction module, and the laser hyperthermia system of the present application; further, the system may further include a Magnetic Resonance (MRI) device; in the use state, the host computer is in communication connection with the magnetic resonance device, receives the information of the magnetic resonance module, and completes at least one of the following according to the digital image information of the patient: the patient is documented, 3D modeling is carried out according to preoperative medical image information, and an operation scheme is generated; the MRI temperature imaging technology generates a real-time temperature image according to magnetic resonance information, the temperature image and the 3D model are fused and displayed in a man-machine interaction module, the digital image information comprises but is not limited to a CT image and a magnetic resonance image, and the temperature calculation and the ablation evaluation based on the magnetic resonance are verified and corrected through the temperature measured by an ablation optical fiber.
The host computer is loaded with a temperature measurement program which can execute temperature correction, and the temperature measurement program can execute the following method:
the temperature of the proximal end of the treatment tip is continuously obtained by using the temperature sensing module as a reference temperature,
the temperature of the near end of the therapeutic end head obtained by the magnetic resonance temperature measurement method is used as the calculated temperature,
after the primary calculated temperature is obtained, comparing the reference temperature with the calculated temperature;
when the absolute value of the difference value between the reference temperature and the calculated temperature exceeds a threshold value, correcting the calculated temperature;
extracting the highest temperature in the corrected calculated temperature, comparing the highest temperature with the warning temperature, and if the highest temperature exceeds the warning temperature, sending an instruction for closing the treatment laser; if the temperature does not exceed the warning temperature, the next round of magnetic resonance temperature measurement and temperature comparison is continued until the execution of the preset program is finished.
In some embodiments, the threshold may be set as desired, e.g., 1 ℃, 1.2 ℃, 1.5 ℃, 2 ℃, 3 ℃, etc.
In some embodiments, the warning temperature may be set as desired, such as 85 ℃, 88 ℃, 90 ℃, etc.
The host is also loaded with a fracture detection program that can perform the following method:
when the monitoring module detects that the fracture occurs, the generation of the therapeutic light is stopped immediately, and accidental injury is prevented.
The host computer may also generate a surgical plan, wherein the surgical plan contains information corresponding to the laser ablation assembly, including but not limited to: planning an ablation area and/or an ablation volume, laser power used for achieving a preset ablation result, light emitting time, a light emitting mode, the number of required ablation channels, a coolant flowing rate and a fiber catheter insertion path;
real-time control, namely calculating the temperature based on the magnetic resonance image, correcting the temperature image by using the temperature measuring structure, regulating and controlling the working parameters of each ablation optical fiber component in a working state and the treatment light source module and the cooling circulation module in real time, and carrying out ablation monitoring in real time;
comparing and analyzing, namely comparing the information in the operation scheme corresponding to each laser device with the information of the laser device after operation, generating ablation result information according to the comparison result and displaying the ablation result information on the man-machine interaction module; wherein, the content of comparison includes the following: a planned ablation area or volume, and a post-operative actual ablation area or volume; the ablation result information includes at least but is not limited to: ablation area percentage, ablation volume percentage, and pre-and post-ablation contrast maps.
The laser ablation assembly of the present application has at least the following advantages:
1. a first supporting structure is arranged between an outer tube and an inner tube of the sleeve, and a second supporting structure is arranged between the inner tube and a medical device (such as an ablation optical fiber, a deep electrode and the like), so that the radial strength is enhanced, the space between the inner tube and the outer tube and the space between the medical device and the inner tube are prevented from being stuck and blocked by tissue extrusion after implantation, and the circulation of cooling fluid is ensured;
2. the axial structural strength of the cooling conduit is enhanced, the membrane structure can be penetrated more easily, the possibility of deviating from a preset path is reduced, the puncture precision is improved, and the damage to normal tissues is reduced;
3. due to the special design of the supporting structure, the medical device (such as an ablation optical fiber, a deep electrode and the like) can keep the central axis unchanged when needing to rotate, the rotation angle can be calculated more accurately, and the treatment effects of ablation and the like can be estimated.
4. The temperature measuring element can carry out real-time continuous temperature monitoring on the ablation end;
5. the light splitting film can be used for monitoring whether the optical path of the ablation optical fiber is broken or not;
6. the built-in temperature measurement structure of ablation optic fibre can also be used for the structural damage to detect, and unable detector can't receive the temperature measurement light signal that the temperature measurement structure returned, explains that the structure damage takes place from the near-end to the temperature measurement structure in the ablation optic fibre, and temperature measurement light is unable to pass through.
7. According to the laser thermotherapy system based on the magnetic resonance interstitium, the temperature of the near end of the treatment end can be detected in real time through the built-in temperature measurement structure of the ablation optical fiber, the temperature at the near end of the treatment end is used as the reference temperature, and the reference temperature is compared with the calculated temperature obtained according to the magnetic resonance scanning method, so that the error of temperature measurement of the magnetic resonance scanning method is corrected, and further auxiliary correction is carried out on ablation calculation.
In order to make the aforementioned objects, features and advantages of the present application comprehensible, preferred embodiments accompanied with figures are described in detail below.
Drawings
In order to more clearly illustrate the detailed description of the present application or the technical solutions in the prior art, the drawings used in the detailed description or the prior art description will be briefly described below, and it is obvious that the drawings in the following description are some embodiments of the present application, and other drawings can be obtained by those skilled in the art without creative efforts.
FIG. 1 is a schematic view of a laser ablation assembly of one embodiment of the present application, wherein A is an elevation view, B is a cross-sectional view of a portion of the structure, and C is a cross-sectional view of section line A-A';
FIG. 2 is a cross-sectional view of a laser ablation assembly according to further embodiments of the present application, where 2A-2D are cross-sectional views of the laser ablation assembly at locations A-A' of FIG. 1 in some examples;
FIG. 3 is a cross-sectional view of a laser ablation assembly in further examples, where 3A-3D are cross-sectional views of the laser ablation assembly at locations A-A' of FIG. 1 in some examples;
FIG. 4 is a cross-sectional view of a laser ablation assembly in further examples, where 4A-4B are cross-sectional views of the laser ablation assembly in some examples at locations A-A' of FIG. 1;
FIG. 5 is a schematic illustration of a laser ablation assembly in an example, wherein 5A-5B are a cross-sectional view and a cross-sectional view, respectively;
FIG. 6 is a cross-sectional view of a laser ablation assembly in an example of the present application;
FIG. 7 is a cross-sectional view of a laser ablation assembly in another example of the present application;
FIG. 8 is a schematic view of an ablation optical fiber according to an embodiment of the present application, showing a temperature sensing grating;
FIG. 9 is a schematic view of an ablation fiber according to an embodiment of the present application showing an extrinsic Fabry-Perot cavity sensor;
FIG. 10 is a schematic structural view of an ablation optical fiber according to some embodiments of the present application, wherein A, B, C shows different positions of a light splitting film therein;
FIG. 11 is a detailed view of the partial schematic of FIG. 10, wherein 11A is a detailed view of A in FIG. 10, 11B is a detailed view of B in FIG. 10, and 11C is a cross-sectional view at A-A in FIG. 10;
FIG. 12 is a schematic view of an ablation optical fiber according to an embodiment of the present application;
FIG. 13 is a schematic diagram of the components of a laser treatment system according to an embodiment of the present application;
FIG. 14 is a schematic view of the components of a laser treatment system according to an embodiment of the present application;
FIG. 15 is a schematic diagram of the components of a laser treatment system according to an embodiment of the present application;
FIG. 16 is a schematic diagram of the components of a laser treatment system according to an embodiment of the present application;
FIG. 17 is a schematic diagram of the components of a laser treatment system according to an embodiment of the present application;
FIG. 18 is a schematic diagram of the components of a laser treatment system according to an embodiment of the present application;
FIG. 19 is a schematic diagram of the components of a laser treatment system according to an embodiment of the present application;
an icon:
10-an outer tube; 101-first support structure, 1012-first support structure, 102-first channel, 103-clamping structure, 1031-flow hole, 104-cone, 20-inner tube; 201-a second support structure; 202-a second channel, 30-an ablation fiber, 301-an ablation tip, 40-a first communicating structure, 401-a first port, 50-a second communicating structure, 501-a second port, 60-a connecting tip;
1-a therapeutic light generator; 2-monitoring the light generator; 3-a wavelength beam combining module; 4-a transmit-receive shunt device; 5-photodetector/photodetector assembly; 6-a transmission fiber; 7-an ablation fiber; 9-a combiner; 11-a temperature measuring module; 70-a light-guiding optical fiber; 71-a light splitting film; 72-a treatment tip; 74-a directional light exit structure; 701-a fiber core; 702-a cladding layer; 703-a coating layer; 704-a core; 705 — first cladding layer; 706 — a second cladding layer; 707-temperature measurement structure; 721-a sleeve; 722-a treatment tip body; 723-welding or gluing; 801-therapeutic light; 803-monitor light; 808-monitor light.
Detailed Description
To make the objects, technical solutions and advantages of the embodiments of the present application clearer, the technical solutions of the present application will be clearly and completely described below with reference to the accompanying drawings, and it is obvious that the described embodiments are some, but not all embodiments of the present application. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present application.
Examples
Referring to fig. 1, which illustrates a schematic view of a cooling jacket in some embodiments of the present application, fig. 1A is a front view of a cooling jacket, where 10 denotes an outer tube, 20 an inner tube and 30 an ablation fiber located therein (not shown), a first communication structure 40 and a first port 401, a second communication structure 50 and a second port 501, a cooling fluid may enter from the first port, exit from the second port, or enter from the second port, exit from the first port; the first port is in fluid communication with the first channel, the second port is in fluid communication with the tube interior space of the inner tube or the first port is in fluid communication with the tube interior space of the inner tube, and the second port is in fluid communication with the first channel; some specific configurations of the first channel, the interior space of the inner tube, and the cooling device in fluid communication can be found in the applicant's prior patent application "a water-cooled configuration for a laser surgical instrument" (application No. 20181077693.8), the entire contents of which are incorporated herein by reference; fig. 1B is a cross-sectional view of the distal portion structure circled in fig. 1A, corresponding to the location of the indicated line B-B' in fig. 1C, showing the outer tube 10, the inner tube 20, the second support structure 201 disposed inside the inner tube, the ablation optical fiber 30, the space between the outer tube 10 and the inner tube 20 forming a first channel 102, the first channel 102 being in distal fluid communication with the inner space 202 of the inner tube 20, the first support structure 101 and the second support structure 201 being absent at the distal end, the distal end of the inner tube 20 being distally beyond the distal end of the second support structure 201, such that the ablation tip 301 of the ablation optical fiber 30 is unaffected by the second support structure 201, i.e. the ablation tip 301 has substantially the same transmissivity to the ablation laser light in a direction around the axial center for one revolution, the arrows indicating one example of the direction of the cooling fluid flow therethrough;
fig. 1C is an example of a cross-sectional view at the position of section line a-a' in fig. 1B, showing four first support structures 101 disposed inside the outer tube 10, the first support structures 101 dividing the first channel 102 into 4 sections, and four second support structures 201 disposed inside the inner tube 20.
The number m of the first supporting structures 101 and the number n of the second supporting structures 201 can be any natural number greater than 2, m and n can be the same or different and can be set according to requirements, for example, m and n can be 3 and 3 respectively; 4 and 4,8 and 4, etc.; fig. 4A and 4B show two cooling jacket examples with three first support structures 101 and three second support structures 201;
the shape of the support structure can be adjusted as desired, for example, it can be uniform in cross-section along the radial direction of the cooling jacket, or it can be graduated along the radial direction of the cooling jacket, for example, as shown in fig. 3A-3D, which illustrate various situations where at least a portion of the first support structure and the second support structure are graduated along the radial direction in cross-section;
the first support structure may be arranged at different positions:
in the case that the first supporting structure 101 is only disposed on the outer tube 10, see fig. 1C, fig. 2A-2B, and fig. 3A, further, a corresponding groove or slot, such as fig. 2A-2B, may be disposed on the inner tube 20, so as to facilitate assembly and limit the inner tube 20 from rotating around the long axis relative to the outer tube 10;
in the case where the first support structure 1012 is disposed only on the inner tube 20, see fig. 2C-2D, fig. 3C, the first support structure 1012, the second support structure 201, and the inner tube 20 are a unitary structure; at this time, a groove or a slot (fig. 2C-2D) may be further disposed on the inner wall of the outer tube 10 for facilitating installation and limiting the inner tube 20 from rotating around the long axis relative to the outer tube 10;
the first supporting structure can also be arranged on the outer wall of the inner tube 20 and the inner wall of the outer tube 10 at the same time, see fig. 3B, wherein the first supporting structure 101 arranged on the inner wall of the outer tube 10 and the first supporting structure 1012 arranged on the inner wall of the inner tube 20 are arranged, further, corresponding grooves or clamping grooves can be arranged on the outer wall of the inner tube and the inner wall of the outer tube respectively, and more first supporting structures further enhance the structural strength, and are more favorable for resisting deformation and enhancing the puncture strength.
The cooling jacket of the present application may have a groove on the outer wall of the inner tube to match with the first support structure 101 disposed on the inner wall of the outer tube 10, so that the inner tube 20 and the outer tube 10 are assembled by the first support structure 101, and the inner tube 20 is prevented from rotating around the long axis inside the outer tube 10. The recess may take many forms, such as a slot, see fig. 2A, where the end of the first support structure 101 near the center is similar to a rectangle in cross-section; the groove may also be an arc shape that is concave toward the center in cross section, and the end of the corresponding first supporting structure 101 near the center is a convex arc shape, see fig. 2B; further, one end of the second support structure 201 close to the center is also convex arc-shaped, so that the contact area between the ablation optical fiber and the second support structure 201 is minimal or not, and the resistance to the rotation of the ablation optical fiber is small, which is particularly suitable for the case where directional therapy is required, see fig. 2B.
The cooling jacket of the present application may also be provided with grooves on the inner wall of the outer tube for matching with the first support structure, see fig. 2C and 2D, wherein the first support structure 1012 is provided on the outer wall of the inner tube 20 and the second support structure 201 is provided on the inner wall of the inner tube 20, i.e. the first support structure 1012, the inner tube 20 and the second support structure 201 are an integral structure, the distribution of the support structures may be of various designs, preferably, an evenly distributed arrangement is used, e.g. in case of four support structures, each support structure is perpendicular to the adjacent support structure.
The cooling jacket of the present application may also be an integral one-piece structure, see fig. 3D, wherein the first support structure 1201 is connected to the inner wall of the outer tube 10, while being connected to the outer wall of the inner tube 20; the integrated structure is beneficial to manufacturing and processing, the assembly process is omitted, and the ablation optical fiber is placed in the integrated structure during use, so that the integrated structure is more convenient and faster.
The support structure of the cooling jacket may be discontinuous in the axial direction, for example fig. 5A shows a section of one example, the second support structure 201 shows a three-segment structure in the axial direction, in the section at the C-C' position (fig. 5B), the second support structure 201 is absent; in this case, the weight of the cooling jacket is further reduced, so that the fluid communication of the four second passages 202 is smoother.
Referring to fig. 6 and 7, a clamping structure is arranged at the distal end of the outer tube, the clamping structure 103 is cylindrical and is fixedly connected with the inner wall of the outer tube 10 (i.e., arranged at the inner side of the distal end of the outer tube 10), the inner diameter of the clamping structure 103 is equal to or larger than the outer diameter of the inner tube 201, so that in the cooling sleeve after installation or manufacture, the distal end of the inner tube 201 is positioned in the clamping structure 103, and further, a communication hole can be arranged so that cooling fluid can flow in the direction of an arrow;
it is understood that the outer diameter of the clamping structure 103 may be equal to or smaller than the inner diameter of the inner tube 201, so that in the cooling jacket after installation or manufacture, the distal end of the inner tube 201 surrounds the clamping structure 103, and further, communication holes may be provided so that the cooling fluid may flow in the direction of the arrows;
the arrangement of the communication holes can be selected in various ways:
only the through hole 1031 is provided on the latching structure 103, and the distal end of the inner tube 201 is disposed in the latching structure 103 but does not reach the through hole 1031 yet, i.e. does not block the through hole;
the far ends of the clamping structure 103 and the inner pipe 201 are both provided with communication holes,
so that the cooling fluid can flow through the flow opening 1031 in the direction of the arrow, or flow openings can be provided in both the snap-fit structure 103 and the inner tube 201, and the inner tube 201 can be fully abutted against the distal end of the outer tube.
Further enhancing the penetration ability of the cooling jacket as shown in fig. 7, the distal end of the outer tube 10 is provided with a conical structure 104, which provides more excellent structural strength and stronger penetration ability together with the support structure by geometric configuration.
Example 1
Referring to fig. 8, the ablation fiber 6 includes: a double-clad optical fiber 60 and a treatment tip 66, wherein: the double-clad optical fiber 60 includes a core 61, a first cladding 62, and a second cladding 63; the treatment tip 66 can be a treatment tip for laser thermotherapy or a treatment tip for photodynamic therapy; the fiber core 61 of the double-clad fiber is provided with a temperature measuring grating 67 at the far end, the far end of the double-clad fiber is adjacent to the near end of the treatment tip, and the temperature at the far end can be continuously measured through the temperature measuring grating. The structure is only exemplary, the axial length of the double-clad fiber is far longer than that of the treatment tip, and most of the homogeneous structure of the proximal end is omitted;
one example of a temperature grating is a bragg grating;
the core 61 of the double-clad fiber is a single-mode core, preferably a single-mode core with a diameter of 9 to 25 microns;
the refractive index of the first cladding 62 of the double-clad optical fiber is smaller than that of the fiber core 61, so that temperature measuring laser can be transmitted in the fiber core 61;
the refractive index of the second cladding 63 of the double-clad fiber is smaller than that of the first cladding 62, so that the therapeutic laser can be transmitted in the first cladding 62;
it will be appreciated by those skilled in the art that the second cladding outer side may also be provided with different coating layers 64 as generally desired;
the treatment tip 66 can redirect at least a portion of the light, using a variety of different configurations as desired, for example, in some instances the treatment tip 66 can be a scattering tip that scatters light to direct light in a direction perpendicular to the long axis of the light-transmitting structure; in other embodiments, the treatment tip 66 is based on the scattering tip, and a portion of the area along the long axis is covered by a reflective material to provide a directed exit of light; further details of the treatment tip 66 can be found in the company's prior patent applications: 201810633280.8, a device for laser ablation; 201911409241.0, a device for laser interstitial hyperthermia system, the entire content of which is incorporated herein by reference; in still other examples, the treatment tip 66 may have a refractive surface 661 to allow light to exit in a particular direction, see fig. 10C.
Example 2
Referring to fig. 9, in one embodiment of the present application, an ablation fiber comprises: light guide fiber, temperature measurement structure and treatment end, light guide fiber is double-clad fiber 60, wherein:
61: the fiber core of the double-clad optical fiber is preferably a 9-25 um single-mode fiber core;
62: the first cladding of the double-clad fiber has a refractive index smaller than that of the core.
63: the second cladding of the double-clad optical fiber has a refractive index smaller than that of the first cladding.
64: some double-clad fibers do not have a coating layer.
66: the treatment end is a component for converting laser emitted by the optical fiber body into a shape required by treatment, and can be a scattering end, a reflecting end and the like.
The treatment tip 66 can redirect at least a portion of the light, using a variety of different configurations as desired, for example, in some instances the treatment tip 66 can be a scattering tip that scatters light to direct light in a direction perpendicular to the long axis of the light-transmitting structure; in other embodiments, the treatment tip 66 is based on the scattering tip, and a portion of the area along the long axis is covered by a reflective material to achieve directional light extraction; further details of the treatment tip 66 can be found in the company's prior patent applications: 201810633280.8, a device for laser ablation; 201911409241.0, a device for laser interstitial hyperthermia system, the entire contents of which are incorporated herein by reference; in still other examples, the treatment tip 66 may have a refractive surface 661 to allow light to exit in a particular direction, see fig. 10C.
68, 69 and 70 constitute a temperature measuring structure (extrinsic Fabry-Perot cavity sensor), wherein 68 is a substrate of the sensor, 69 is a diaphragm of the sensor, and 70 is a Fabry-Perot cavity (Fabry-Perot cavity) formed by one coating surface of the substrate and one coating surface of the diaphragm, the cavity can modulate an incident spectrum, and the peak-to-peak distance and the phase of the modulated spectrum correspond to the length of the cavity in a one-to-one mode. When the temperature of the sensor changes, the cavity length of the sensor changes correspondingly. The temperature of the sensor can be measured by demodulating the cavity length of the sensor.
The treatment tip can be connected with the light guide fiber and the treatment tip in various ways, such as laser welding or glue adhesion.
Optionally, the treatment tip is further included in the case where the treatment tip 66 is formed by gel injection molding 65: the sleeve connecting the double-clad fiber body and the beam conversion tip can be made of quartz, sapphire, PC, PTFE and other materials which can penetrate through the treatment laser. After the cannula 65 is connected to the light-conducting fiber, a treatment tip 66 is manufactured.
Example 3
Referring to fig. 10A, a schematic view of a treatment optical fiber is shown, which is provided with a light guide optical fiber 70, a light splitting film 71 and a treatment tip main body 72 in sequence from a proximal end to a distal end.
FIG. 11A is a detailed partial view of the therapeutic optical fiber of the example of FIG. 10A, wherein the light guiding optical fiber 70 comprises a core 701, a cladding 702, and a coating 703. the therapeutic tip 72 comprises a sleeve 721 and a therapeutic tip body 722; the sleeve 721 is not required, only if the treatment tip body 722 is fabricated by injection molding. In the case of a sleeve 721, the sleeve 721 may be attached to the cladding 702 by welding or gluing, etc., as indicated at 723; the spectroscopic film 71 is disposed between the fiber core 701 and the treatment tip body 722.
Example 4
Referring to fig. 10B, there is shown a schematic view of another therapeutic optical fiber, which is sequentially provided with a light guide optical fiber 70, a therapeutic tip body 72, and a light splitting film 71 from the proximal end to the distal end.
FIG. 11B is a detailed partial view of the therapeutic optical fiber of FIG. 10B, wherein the light-conducting optical fiber 70 comprises a core 701, a cladding 702, and a coating 703; the sleeve 721 is not required and may be omitted in some cases. In the case of a sleeve 721, the sleeve 721 may be attached to the cladding 702 by welding or gluing, etc., as indicated at 723; the spectroscopic membrane 71 is disposed distally of the treatment tip body 722.
Example 5
Referring to fig. 10C, there is shown a schematic view of another therapeutic optical fiber, which is sequentially provided with a light guide fiber 70, a therapeutic tip main body 72, a directional light-emitting structure 74 of the therapeutic tip, and a light splitting film 71 from the proximal end to the distal end; wherein the therapeutic light irradiates the tissue to be treated after the direction of the therapeutic light is changed through the directional light-emitting structure 74, the light-splitting film 71 is positioned on the light path of the therapeutic light emergent treatment end body, preferably, the light-splitting film 71 covers at least a part of the emergent area of the therapeutic light, preferably all the emergent area.
In this application, the sleeve may be a sleeve made of a material that is transparent to therapeutic light, such as quartz, sapphire, PC, PTFE, and the like.
In embodiments 3 to 5, the light guide fiber is preferably a multimode fiber having a core diameter of 50um to 1200 um.
A laser ablation system, comprising: a therapeutic light generator 1, a monitoring light generator 2, a beam combining module 3, a transceiving branching device 4, a photoelectric detector 5 and a transmission optical fiber 6,ablation optical fiber7; the light generated by the therapeutic light generator 1 and the monitoring light generator 2 can be combined by the beam combining module 3 and then delivered through the transmission optical fiber 6; optionally, the transmission fiber 6 is connected with one or more ablation fibers 7 through a coupler; the therapeutic light generator 1 may generate therapeutic light of one or more different wavelengths, for example may comprise one or more light sources, and the monitoring light generator 2 may generate monitoring light of one or more different wavelengths.
In some examples, the therapeutic light generator is a semiconductor laser or a solid state laser;
the monitoring light generator can also be a laser, such as a red laser with a wavelength of 630-660 nm, a near infrared laser with a wavelength of 1300-1320 nm or 1520-1565 nm;
the transceiving branching device 4 has three ports, a first port monitors the optical generator 2, a second port is connected with the beam module 3, and a third port is connected with the optical detector 5. It may be any of the following: optical circulators, fiber couplers/splitters, isolators with escape windows, and beam splitting slabs.
The photodetector 5 is capable of receiving and detecting the monitor light reflected by the spectroscopic film 71, and may be selected from any one of: PIN photodiodes, Avalanche Photodiodes (APDs), and photomultiplier tubes.
The laser therapeutic apparatus also comprises a control center, and the control center can judge whether the transmission light path is normal or not according to the monitoring light condition reflected by the light splitting film 71 and detected by the photoelectric detection 5, namely whether the optical fiber is broken or not at any position in the light path or not; the control center can also be loaded with a treatment scheme, and sends control commands to the treatment light generator according to the treatment scheme to generate treatment light according to the preset power and time.
And the ablation laser generated by the ablation laser generator and the detection laser generated by the detection laser generator are processed by the wavelength beam combination module to enter the light guide optical fiber.
Examples 6 to 8: a one-to-one correspondence embodiment improved on the basis of embodiments 3 to 5, that is, embodiment 6 is an embodiment described on the basis of embodiment 3, embodiment 7 is an embodiment described on the basis of embodiment 4, and embodiment 8 is an embodiment described on the basis of embodiment 5, and these solutions are different from the corresponding basic solutions in that a temperature measuring structure is added to the light guide fiber part; the light guide fiber is a double-cladding fiber, the specific structure of the light guide fiber comprises a fiber core, a first cladding and a second cladding, a Bragg grating for temperature measurement is arranged at the far end of the fiber core, the refractive index of the first cladding is smaller than that of the fiber core, the refractive index of the second cladding is smaller than that of the first cladding, the fiber core can transmit light for temperature monitoring, and the first cladding can transmit therapeutic light and monitoring light.
Referring to fig. 12, the structure of example 7 will be described in detail, wherein only the schematic structure of the distal end of the ablation fiber is shown, and the light guide fiber 70 is shown to include the coating layer 703, the fiber core 704, the first cladding 705, the second cladding 706, the treatment tip 72 including the treatment tip main body 722, the sleeve 721 and the light splitting film 71; the temperature measurement light 802 is transmitted in the fiber core 704, returns after reaching the Bragg grating 707 and carries temperature information; the therapeutic light 801 and the monitoring light 803 are transmitted through the first cladding, and after reaching the light splitting layer 71, the monitoring light 808 is folded back to feed back the light path structure information.
Example 9
Referring to fig. 13, there is shown a schematic view of a laser treatment system of the present application, comprising: a therapeutic light generator 1, a monitoring light generator 2, a wavelength beam combining module 3, a transceiving branching device 4, a photoelectric detector 5, a coupler 6, an ablation optical fiber 7 described in embodiments 1-4, and a control center (not shown); the light generated by the therapeutic light generator 1 and the monitoring light generator 2 is combined by the wavelength beam combining module 3 and then delivered by the transmission optical fiber; the transmission fiber is connected with the ablation fiber 7 through a coupler 6. After reaching the receiving and transmitting branching device 4, the monitoring light generated by the monitoring light generator 2 reaches the ablation optical fiber 7 through the wavelength beam combining module, the transmission optical fiber and the coupler 6, is reflected by the light splitting film 71 in the ablation optical fiber 7, returns to the transmitting branching device 4 again according to the reverse path of the original transmission path, and then reaches the light receiving detector 5, and the light receiving detector 5 confirms whether the transmission light path is normal or not through continuously measuring the intensity of the received monitoring light, and communicates the result to the control center.
The therapeutic light generator 1 may comprise one or more sets of lasers, for example where three sets of lasers are comprised, a first set of lasers may be capable of producing a first therapeutic light (e.g. 980nm laser), a second set of lasers may be capable of producing a second therapeutic light (e.g. 1064nm laser), a third set of lasers may produce an indicator light; the first therapeutic light and the second therapeutic light may be combined at any time interval and light intensity. The 980nm laser is higher in tissue heating speed, needs short time but weak penetrating power, and has strong 1064nm penetrating power but low tissue heating speed and long time; the 980nm laser and the 1064nm laser can be combined by the controller with different time domain distributions: for example, in sequence, a 980nm laser is used for ablation for a period of time, and then a 1064nm laser is used for ablation for a period of time; for example, the mixed use is that 980nm and 1064nm lasers are used for ablation at the same time, then the 980nm laser is turned off, and then the 1064nm laser is used for ablation for a period of time; for example, alternatively, a 980nm laser and a 1064nm laser are ablated at specific time intervals.
The monitoring light generator 2 can also comprise one or more groups of lasers, and in the using process, the monitoring light and the treatment light are obviously different and do not interfere as much as possible; using a monitoring light with obvious wavelength difference from the therapeutic light each time; preferably, visible light can be used as monitoring light, and at the moment, the monitoring light can also be used as indicating light, so that simple system check before use is facilitated; that is, the reflection ratio of the spectroscopic film and the intensity of the monitor light are controlled so that the part of the monitor light transmitted through the spectroscopic film can be directly observed enough to confirm that the light path is normal.
The transceiving branching device 4 has three ports, a first port is connected with the monitoring light generator 2, a second port is connected with the wavelength beam combining module 3, and a third port is connected with the optical detector 5. It may be any of the following: optical circulators, fiber couplers/splitters, isolators with escape windows, and beam splitting slabs.
The Photodetector (PD) 5 is capable of receiving and detecting the monitor light reflected by the spectroscopic film 71, and may be selected from any one of the following: PIN photodiodes, Avalanche Photodiodes (APDs), and photomultiplier tubes.
The control center can judge whether the transmission light path is normal or not according to the monitoring light condition reflected by the light splitting film 71 and detected by the photoelectric detection 5, namely whether the problems of optical fiber breakage and the like occur at any position in the light path or not; the control center can also be loaded with a treatment scheme, and sends control commands to the treatment light generator according to the treatment scheme to generate treatment light according to the preset power, time and the like.
A cooling circulation device (not shown) comprising a peristaltic pump, a cooling fluid and a cooling jacket, used in combination with the cooling jacket, the cooling fluid may be any fluid suitable for cooling, preferably comprising double distilled water, medical saline, etc.; the cooling cycle device may also be provided with one or more monitoring sensors for measuring the pressure in the cooling jacket, the flow rate of the cooling fluid, etc., detecting whether a blockage has occurred, a cooling jacket rupture, etc.
The control center can be in communication connection with the therapeutic light generator 1, the monitoring light generator 2, the photoelectric detector 5 and the cooling circulation device so as to send commands and receive feedback information, and the operation of the system is controlled by adjusting the power of the therapeutic light and the flow of the cooling fluid.
Example 10
Referring to fig. 14, a description is made on the basis of embodiment 9, whose laser treatment system includes: 3 therapeutic light generators 1, 3 monitoring light generators 2, 3 wavelength beam combining modules 3, 3 transceiving branching devices 4, 3 photodetectors 5, 3 couplers 6, 3 ablation fibers 7 as described in embodiments 1 to 4, and a control center 0; the system comprises a therapeutic light generator 1, a monitoring light generator 2, a wavelength beam combining module 3, a transceiving branching device 4, a photoelectric detector 5, a coupler 6 and an ablation optical fiber 7, wherein the therapeutic light generator 1, the monitoring light generator 2, the wavelength beam combining module 3, the transceiving branching device 4, the photoelectric detector 5, the coupler 6 and the ablation optical fiber 7 form a subsystem, namely 3 subsystems are simultaneously connected with a control center 0, and in each subsystem, light generated by the therapeutic light generator 1 and the monitoring light generator 2 is combined through the wavelength beam combining module 3 and then delivered through a transmission optical fiber; the transmission fiber is connected with the ablation fiber 7 through a coupler 6. After reaching the receiving and transmitting branching device 4, the monitoring light generated by the monitoring light generator 2 reaches the ablation optical fiber 7 through the wavelength beam combining module, the transmission optical fiber and the coupler 6, is reflected by the light splitting film 71 in the ablation optical fiber 7, returns to the transmitting branching device 4 again according to the reverse path of the original transmission path, and then reaches the light receiving detector 5, and the light receiving detector 5 confirms whether the transmission light path is normal or not through continuously measuring the intensity of the received monitoring light, and communicates the result to the control center. The control center can control each subsystem respectively, namely the use of different subsystems is not interfered mutually.
The therapeutic light generator 1 may comprise one or more sets of lasers, for example where three sets of lasers are comprised, a first set of lasers may be capable of producing a first therapeutic light (e.g. 980nm laser), a second set of lasers may be capable of producing a second therapeutic light (e.g. 1064nm laser), a third set of lasers may produce an indicator light; the first therapeutic light and the second therapeutic light may be combined at any time interval and light intensity.
The monitoring light generator 2 may also comprise one or more sets of lasers.
The subsystem of the embodiment can be further provided with an indication optical module, the indication optical module can be fused in the therapeutic light source module or can be independently arranged, and when the indication optical module is independently arranged, the indication optical module enters the ablation optical fiber through the wavelength beam combination module.
It is understood that the first therapeutic light and the second therapeutic light may also use other wavelengths of laser light suitable for laser hyperthermia, and that such wavelength schemes are included within the scope of the present application; the indicator light is typically selected to be visible light.
It is understood that the number of subsystems may be any, such as 2, 4, 5, etc., and such ranges are included within the scope of the present application.
The embodiment also comprises 3 cooling circulation devices corresponding to the ablation optical fibers, namely each subsystem comprises one cooling circulation device, the cooling circulation device comprises a peristaltic pump and a cooling fluid which are used in combination with the cooling sleeve, each ablation optical fiber can be used together with the corresponding cooling sleeve, and the cooling fluid can be any fluid suitable for cooling, preferably comprising double distilled water, medical physiological saline and the like; the cooling cycle device may also be provided with one or more monitoring sensors for measuring the pressure in the cooling jacket, the flow rate of the cooling fluid, etc., detecting whether a blockage has occurred, a cooling jacket rupture, etc.
The control center simultaneously and respectively controls 3 laser thermal therapy subsystems. The control center may control each subsystem to use the same or different treatment protocols, e.g., 980nm wavelength in the first subsystem, 1064nm wavelength in the second subsystem, and 980nm and 1064nm wavelength in the third subsystem; for example, the three subsystems each use therapeutic light wavelengths that are 980nm in combination with 1064nm, but the ablation times and intervals are different; the treatment scheme comprises the wavelength, the laser output power, the light emitting time, the light emitting mode, the laser emitting angle, the cooling fluid flow and other parameters.
Example 11
Referring to fig. 15, the laser treatment system of this embodiment includes: a therapeutic light generator 1, a monitoring light generator 2, a wavelength beam combining module 3, a transceiving branching device 4, a photoelectric detector assembly 5, a coupler 6, 3 ablation optical fibers 7 described in embodiments 1-4, and a control center 0; the therapeutic light generator 1 comprises four groups of lasers and controllers, wherein the four groups of lasers are respectively a first group, a second group, a third group and a fourth group, the lasers from the first group to the third group can generate therapeutic light with different wavelengths, and can be used independently or in combination, the fourth group of lasers can generate indicating light for rapidly detecting whether a light path is normal or not, namely the indicating light is independently started before use, and whether the ablation optical fiber can emit the indicating light or not is observed; the monitoring light generator 2 comprises 3 lasers (LD 1-3), the photoelectric detector 5 comprises 3 photoelectric detectors (PD 1-3), the 3 lasers (LD 1-3) generate monitoring light with different wavelengths, the monitoring light can be reflected by the light splitting films of the three ablation optical fibers respectively, the wavelength of the detection light falls into the high reflection wavelength range of the light splitting films, and then the detection light returns from the light splitting films and can reach the 3 detectors of the photoelectric detector assembly 5 through the transceiving branching device 4 to be detected respectively; namely, the light splitting film of each ablation optical fiber can reflect the monitoring light with different wavelengths.
The therapeutic light generator 1 may comprise one or more sets of lasers, for example where three sets of lasers are comprised, a first set of lasers may be capable of producing a first therapeutic light (e.g. 980nm laser), a second set of lasers may be capable of producing a second therapeutic light (e.g. 1064nm laser), a third set of lasers may produce an indicator light; the first therapeutic light and the second therapeutic light may be combined at any time interval and light intensity.
The embodiment also comprises 3 cooling circulation devices corresponding to the ablation optical fibers, namely, each ablation optical fiber corresponds to one cooling circulation device, each cooling circulation device comprises a peristaltic pump and a cooling fluid which are combined with the cooling sleeve for use, each ablation optical fiber is used together with the corresponding cooling sleeve, and the cooling fluid can be any fluid suitable for cooling, preferably comprises double distilled water, medical physiological saline and the like; the cooling cycle device may also be provided with one or more monitoring sensors for measuring the pressure in the cooling jacket, the flow rate of the cooling fluid, etc., detecting whether a blockage has occurred, a cooling jacket rupture, etc. The control center can be connected with 3 cooling circulators in communication and independently controlled.
It is understood that based on the present embodiment, other numbers of ablation fibers may be included in the laser hyperthermia system of the present application, for example, 2, 4, 5, 6, etc.; the therapeutic light generated by the therapeutic light source module and the monitoring light generated by the monitoring module can be divided into corresponding parts, such as 2 parts, 4 parts, 5 parts, 6 parts and the like, through the beam splitter, and the schemes are also within the scope of the application.
Example 12
Referring to fig. 16, a description is made on the basis of the solution of embodiment 9, and the difference from embodiment 9 is that the temperature measurement device further includes a temperature measurement module 9, where the temperature measurement module includes a temperature measurement light source and a demodulation module; the ablation optical fiber is the ablation optical fiber described in examples 5-8. Temperature measurement light generated by the temperature measurement module 11 enters the ablation optical fiber 7 together with other light (treatment light and monitoring light) through the beam combiner 9, the temperature measurement light is transmitted through the fiber core of the ablation optical fiber, and the other light is transmitted through the first cladding.
Example 13
Referring to fig. 17, a description is made on the basis of the scheme of the embodiment 10, and the difference from the embodiment 10 is that each subsystem further includes a temperature measurement module 9, and the temperature measurement module includes a temperature measurement light source and a demodulation module; the ablation optical fiber is the ablation optical fiber described in examples 6-8. Temperature measuring light generated by the temperature measuring module 11 enters the ablation optical fiber 7 together with other light (therapeutic light and monitoring light) through the beam combiner 10, the temperature measuring light is transmitted through the fiber core of the ablation optical fiber, and the other light is transmitted through the first cladding.
Example 14
Referring to fig. 18, a description is made on the basis of the solution of embodiment 11, and the difference from embodiment 11 is that the temperature measurement device further includes a temperature measurement module, where the temperature measurement module includes a temperature measurement light source and a demodulation module; the ablation optical fiber is the ablation optical fiber described in examples 6-8. The temperature measurement light source emits temperature measurement light, the temperature measurement light is transmitted to the temperature measurement structure through the fiber core and then returns, the temperature measurement light enters the corresponding first to third ablation optical fibers through the corresponding first to third beam combiners, the treatment light and the monitoring light together, the temperature measurement light is transmitted through the fiber core of the ablation optical fiber, the treatment light and the monitoring light are transmitted through the first cladding, the temperature measurement optical fiber carries temperature information to return after reaching the temperature measurement module, and the demodulation module measures the returned temperature measurement light to obtain the temperature of the temperature measurement structure (such as a Bragg grating or an extrinsic Fabry-Perot cavity) corresponding to the ablation optical fiber.
The temperature measurement light source and the demodulation module can adopt proper combination equipment:
when the temperature measuring structure is a Bragg grating or an extrinsic primary cavity:
optionally, the temperature measuring light source is a C-band tunable laser, and the demodulation module is a photodetector;
optionally, the temperature measuring light source is a C-band ASE light source, and the demodulation module is a spectrum demodulation module.
When the temperature measuring structure is an extrinsic Fabry-Perot cavity:
a combination of devices may also be used: the temperature measuring light source is a halogen tungsten lamp white light source, and the demodulation module is a white light interference demodulation module.
The embodiment also comprises 3 cooling circulation devices corresponding to the ablation optical fibers, namely, each ablation optical fiber corresponds to one cooling circulation device, each cooling circulation device comprises a peristaltic pump and cooling fluid and is used in combination with the corresponding cooling sleeve, each ablation optical fiber is used together with the corresponding cooling sleeve, and the cooling fluid can be any fluid suitable for cooling, preferably comprises double distilled water, medical physiological saline and the like; the cooling cycle device may also be provided with one or more monitoring sensors for measuring the pressure in the cooling jacket, the flow rate of the cooling fluid, etc., detecting whether a blockage has occurred, a cooling jacket rupture, etc. The control center can be connected with 3 cooling circulators in communication and independently controlled.
It is understood that based on the present embodiment, other numbers of ablation fibers may be included in the laser hyperthermia system of the present application, for example, 2, 4, 5, 6, etc.; therapeutic light generated by the therapeutic light source module and monitoring light generated by the monitoring module can be divided into corresponding parts through the beam splitter, temperature measuring light is divided into corresponding parts through the beam splitter, such as 2 parts, 4 parts, 5 parts, 6 parts and the like, then passes through the corresponding number of beam combiners, and then respectively enters the ablation optical fibers in one-to-one correspondence, and the schemes are also in the scope of the application.
Example 15
Referring to fig. 19, a description is made on the basis of the scheme of embodiment 14, and the difference from embodiment 14 is that a system of this embodiment includes 3 temperature measurement modules, a beam splitter is not required, temperature measurement light generated by each temperature measurement module enters corresponding first to third ablation optical fibers together with therapy light and monitor light through corresponding first to third beam combiners, the temperature measurement light is transmitted through a fiber core of the ablation optical fiber, the therapy light and the monitor light are transmitted through a first cladding, the temperature measurement optical fiber returns with temperature information after reaching the temperature measurement module, and the demodulation module measures the returned temperature measurement light to obtain a temperature of a temperature measurement structure (e.g., a bragg grating or an extrinsic primary cavity) corresponding to the ablation optical fiber.
It will be appreciated that the embodiments of the laser hyperthermia system described above can be combined with each other, and that these solutions are also within the scope of the present application.
Example 15
A magnetic resonance guided laser hyperthermia system comprising an ablation optical fiber of one or more of embodiments 1 to 8, or comprising a laser hyperthermia system of one of embodiments 9 to 14; the laser thermotherapy system guided by magnetic resonance can perform laser ablation on target tissues in a magnetic resonance environment, and the ablation temperature and the ablation volume are monitored and calculated through the magnetic resonance. The basic structural components of a magnetic resonance guided laser hyperthermia system can be referred to the present company's prior application 201810459539.1.
The system of the present application includes:
a magnetic resonance apparatus, a workstation and a laser hyperthermia system as described hereinbefore;
the magnetic resonance equipment can acquire images before and during operation;
the workstation comprises a host and a human-computer interaction module (such as a touch screen), wherein the host is in communication connection with the magnetic resonance device and can receive preoperative and intraoperative medical image information of the magnetic resonance equipment and other imaging equipment (such as CT), receive the filing of a patient, perform 3D modeling according to the preoperative medical image information and generate an operation scheme; generating a real-time temperature image according to the magnetic resonance information, planning a treatment area, displaying intraoperative information, sending control information to the laser thermal therapy apparatus, calculating temperature and estimating ablation, fusing and displaying the temperature image and the 3D model in a human-computer interaction module, and the like;
the host computer is loaded with a temperature measurement program which can execute temperature correction, and the temperature measurement program can execute the following method:
continuously obtaining the temperature of the temperature measuring module by using the temperature sensing module as a reference temperature;
after one round of magnetic resonance scanning in the operation is finished, the temperature of the temperature measuring module is obtained through magnetic resonance image calculation and is used as the calculated temperature,
comparing the absolute value of the difference value between the reference temperature and the calculated temperature at the same moment with a preset threshold value after the actual temperature is obtained every time;
when the reference temperature exceeds the warning temperature, the treatment laser is immediately closed;
and when the reference temperature and the calculated temperature exceed the threshold value, correcting the calculated temperature and then continuing the next round of magnetic resonance temperature measurement.
The host computer receives the feedback information of the monitoring module, and immediately closes all lasers generating the therapeutic light when receiving the fracture signal, so as to prevent accidental damage.
The host computer may also generate a surgical plan, wherein the surgical plan contains information corresponding to the laser ablation assembly, including but not limited to: planning an ablation area and/or an ablation volume, laser power used for achieving a preset ablation result, light emitting time, a light emitting mode, the number of required ablation channels, a coolant flowing rate and a fiber catheter insertion path;
real-time control, namely calculating the temperature based on the magnetic resonance image, correcting the temperature image by using the temperature measuring structure, regulating and controlling the working parameters of each ablation optical fiber component in a working state and the treatment light source module and the cooling circulation module in real time, and carrying out ablation monitoring in real time;
comparing and analyzing, namely comparing the information in the operation scheme corresponding to each laser device with the information of the laser device after operation, generating ablation result information according to the comparison result and displaying the ablation result information on the man-machine interaction module; wherein, the content of comparison includes the following: a planned ablation area or volume, and a post-operative actual ablation area or volume; the ablation result information includes at least but is not limited to: ablation area percentage, ablation volume percentage, and pre-and post-ablation contrast maps.
It is clear to those skilled in the art that, for convenience and brevity of description, the specific working processes of the system and the apparatus described above may refer to the corresponding processes in the foregoing method embodiments, and are not described herein again.
In addition, in the description of the embodiments of the present application, unless otherwise explicitly specified or limited, the term "connected" is to be interpreted broadly, e.g., as being fixedly connected, detachably connected, or integrally connected; can be mechanically or electrically connected; they may be connected directly or indirectly through intervening media, or they may be interconnected between two elements. The specific meaning of the above terms in the present application can be understood in a specific case by those of ordinary skill in the art.
Finally, it should be noted that: the above-mentioned embodiments are only specific embodiments of the present application, and are used for illustrating the technical solutions of the present application, but not limiting the same, and the scope of the present application is not limited thereto, and although the present application is described in detail with reference to the foregoing embodiments, those skilled in the art should understand that: any person skilled in the art can modify or easily conceive the technical solutions described in the foregoing embodiments or equivalent substitutes for some technical features within the technical scope disclosed in the present application; such modifications, changes or substitutions do not depart from the spirit and scope of the exemplary embodiments of the present application, and are intended to be covered by the scope of the present application. Therefore, the protection scope of the present application shall be subject to the protection scope of the claims.

Claims (18)

1. A laser ablation assembly comprising an ablation optical fiber and a cooling jacket; the ablation optical fiber comprises a light guide optical fiber and an ablation tip; the cooling sleeve comprises a base, an inner pipe and an outer pipe, and two communicating structures are arranged in the base; a first supporting structure is arranged between the outer tube and the inner tube, a second supporting structure is arranged on the inner side of the inner tube, the far end of the outer tube is a blind end, a first channel is formed in the space between the outer tube and the inner tube, a second channel is formed in the space between the inner tube and the optical fiber, and the first channel and the second channel are in fluid communication at the far end; the first channel is in fluid communication at a proximal end with one of the communication structures and the second channel is in fluid communication at a proximal end with the other communication structure.
2. The laser ablation assembly of claim 1, wherein the light guide fiber of the ablation fiber is a double-clad fiber including a core, a first cladding, and a second cladding, the first cladding having a refractive index less than that of the core, the second cladding having a refractive index less than that of the first cladding, the core being capable of transmitting the temperature measuring laser, and the first cladding being capable of transmitting the ablation laser.
3. The laser ablation assembly of claim 2, wherein the ablation fiber further comprises a temperature sensing element.
4. The laser ablation assembly of claim 3, wherein the temperature measuring element is an extrinsic Fabry-Perot cavity sensor.
5. The laser ablation assembly of claim 3, wherein the temperature sensing element is a Bragg grating disposed distal to the core.
6. The laser ablation assembly of claim 2, wherein the ablation tip further comprises a light-splitting film that is highly transmissive to the ablation laser and highly reflective to monitoring light for monitoring fractures.
7. The laser ablation assembly of claim 1, wherein the first support structure and the outer tube are a unitary structure.
8. A laser ablation assembly according to claim 7, wherein the outer side of the inner tube is provided with a groove.
9. The laser ablation assembly of claim 8, wherein a groove disposed outside the inner tube mates with the first support structure.
10. The laser ablation assembly of claim 1, wherein the first support structure and the inner tube are a unitary structure.
11. The laser ablation assembly of claim 10, wherein the outer tube is provided with a groove on an inner side thereof, the groove provided on the inner side of the outer tube mating with the first support structure.
12. The laser ablation assembly of claim 1, wherein a portion of the first support structure and the outer tube are a unitary structure, and the remainder of the first support structure and the inner tube are a unitary structure.
13. The laser ablation assembly of claim 1, wherein the outer tube, the first support structure, and the inner tube are a unitary structure.
14. A laser ablation system comprising a control center, at least one therapeutic light source module, a cooling circulation module, at least one laser ablation assembly of any of claims 1-13.
15. The laser ablation system of claim 14, further comprising a monitoring module, wherein the monitoring module comprises at least one monitoring light generator, a wavelength beam combining module, a transceiver and splitter device, and at least one photodetector.
16. The laser ablation system of claim 15, wherein the therapeutic light generated by the therapeutic light source module and the monitoring light generated by the monitoring light generator are coupled into the ablation fiber after being combined by the wavelength combining module.
17. The laser ablation system of claim 14, further comprising a thermometry module comprising a thermometry light source and a demodulation module.
18. A magnetic resonance guided laser ablation system comprising a laser ablation system according to any of claims 14 to 17.
CN202123422382.1U 2021-12-31 2021-12-31 Laser ablation assembly and laser ablation system Active CN217472073U (en)

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