DE10219297A1 - Medical instrument for generation of scar tissue to stiffen soft tissue, combines an ultrasound generator with a laser so that electromagnetic and or ultrasound energy can be coupled into the tissue via an opto-acoustic coupler - Google Patents

Medical instrument for generation of scar tissue to stiffen soft tissue, combines an ultrasound generator with a laser so that electromagnetic and or ultrasound energy can be coupled into the tissue via an opto-acoustic coupler

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Publication number
DE10219297A1
DE10219297A1 DE2002119297 DE10219297A DE10219297A1 DE 10219297 A1 DE10219297 A1 DE 10219297A1 DE 2002119297 DE2002119297 DE 2002119297 DE 10219297 A DE10219297 A DE 10219297A DE 10219297 A1 DE10219297 A1 DE 10219297A1
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Prior art keywords
tissue
laser
method
characterized
generation
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DE2002119297
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German (de)
Inventor
Gerhard Mueller
Hans-Peter Berlien
Karsten Liebold
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LASER- und MEDIZIN-TECHNOLOGIE GGMBH BERLIN
Laser & Med Tech GmbH
Original Assignee
LASER- und MEDIZIN-TECHNOLOGIE GGMBH BERLIN
Laser & Med Tech GmbH
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N7/00Ultrasound therapy
    • A61N7/02Localised ultrasound hyperthermia
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/20Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
    • A61B18/22Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor

Abstract

Method and device for generation of scar tissue in biological soft tissue by use of electromagnetic energy, whereby said scar tissue is at least two-dimensional. The device used combines a laser, for generation of the electromagnetic energy, with an ultrasonic transducer for application of ultrasonic energy with backscatter ultrasound used for an A-scan evaluation. Accordingly the laser optical waveguide also forms a transfer path for the sound energy.

Description

    Aufgabenstellung task
  • In vielen Bereichen der Veterinär- und Humanmedizin ist es im Bereich rekonstruktiver bzw. plastischer und/oder kosmetischer chirurgischer Interventionen gewünscht, weichgewebliche Anteile in ihrer Flexibilität und Mobilität zu verändern. In many areas of veterinary and human medicine, it is desirable in the field of reconstructive or plastic and / or cosmetic surgical interventions to change weichgewebliche play in their flexibility and mobility. Daher ist es gewünscht, mit einem möglichst minimal belastenden Verfahren eben eine solche Versteifung herbeizuführen. Therefore, it is desired to provide to bring about a minimal possible polluting ones such stiffening.
  • Stand der Technik State of the art
  • Es ist beispielsweise bekannt, dass einige Hunderassen, wie Englische Bulldogge, Chow-Chow, etc. dazu neigen, im Schlaflaute Schnarchgeräusche von sich zu geben. For example it is known that some breeds, like English Bulldog, Chow Chow, etc. tend to be in sleep sounds snoring noises. Hier wäre es wünschenswert, mit einem möglichst wenig belastenden Eingriff die Schnarchneigung zu mindern, bzw. zu unterdrücken. It would be desirable to reduce a little as possible harmful interference snoring tendency or suppress. Zur Zeit erfolgt dies durch direkte chirurgische Maßnahmen, die in der Regel das Gaumensegel ganz oder teilweise entfernen und durch die anschließend entstehende Narbe eine Straffung herbeiführen. Currently, this is done by direct surgical measures that the soft palate completely or partially remove a rule and bring about by the then resulting scar tightening. Ähnliche Vorgehensweisen sind auch im Bereich der Humanmedizin zur chirurgischen Behandlung von Schnarchern bekannt. Similar procedures are also known in the field of human medicine for the surgical treatment of snoring. Es ist auch bekannt, derartige Resektionen des Gaumensegels, bzw. der Uvula lasertechnisch mit entweder CO 2 - oder Nd : YAG-Lasern vorzunehmen, oder aber direkt die Uvula und die seitlichen Segelfenster mittels Hochfrequenz-Applikation so weit thermisch zu veröden, dass es ebenfalls wieder zur Narbenbildung und damit Straffung kommt. It is also known, such resections of the soft palate or uvula, laser technology with either CO 2 -, or Nd: make YAG lasers, or directly to obliterate the uvula and the side sail window by means of high-frequency application as far thermally that it also returns to scarring and tightening. Eine ähnlich liegende Problemstellung liegt im Bereich der Entfernung, bzw. Reduktion von Falten in der Gesichtshaut vor. A similar problem addressed position is in the range of distance, and reduction of wrinkles in the face skin from. Hier wird entweder wiederum durch Lasertechnik und großflächige Bestrahlung versucht, subdermale Narbenplatten zu erzeugen, die zu einer Straffung und Immobilisierung des Gewebes führen. Here is either again tempted by laser technology and large-scale exposure to produce subdermal scar plates which lead to streamlining and immobilization of the tissue. Gleichermaßen wird versucht, durch Injektion nerventoxischer Gifte, wie beispielweise Botulinumextrakt, das Gewebe in eine Krampfstarre zu überführen. Similarly, it is attempted to convert by injection of toxic nerve poisons, such as Botulinumextrakt, the tissue in a varicose rigidity. Ebenfalls sind Techniken bekannt, die durch eine oberflächliche Abtragung des Gewebes eine Neubildung der oberen Hautschichten stimulieren und damit zumindest solche Faltenanteile, die sich ausschließlich in der Oberhaut ausgebildet haben, auch entfernen können. Techniques are also known to be stimulated by a superficial ablation of the tissue new formation of the upper layers of the skin and thus at least can also remove those wrinkles shares that have formed exclusively in the epidermis. Andere Anwendungsgebiete einer derartigen Technik liegen ggf. in der Versteifung des Halteapparates von venösen Herzklappen. Other fields of use of such a technique are necessary, in the stiffening of the attachment apparatus of venous valves.
  • Erfindungsgemäße Lösung inventive solution
  • Ein auch in den möglichen Anwendungen in der Veterinär- und Humanmedizin unterschiedlichen Einsatzgebieten gemeinsam ist der erfindungswesentliche und auch für den medizinischen Fachmann überraschende Befund, dass es anstatt großflächiger Induktion von Narbenplatten oder teilchirurgischer Gewebeentfernung mit anschließender großer Vernarbung völlig ausreicht, röhrenförmige Narbentunnel in dem Zielgewebe zu induzieren. A different also in the possible applications in the veterinary and human medicine fields of application have in common is essential to the invention and also for the medical professional on the surprising finding that it is fully sufficient rather than large-scale induction of scar plates or in part surgical tissue removal with subsequent large scarring, tubular scars tunnel in the target tissue to induce. Dabei wirken diese röhrenförmigen Narbentunnel, nachdem sich innerhalb der Röhre durch einsprossendes Granulationsgewebe eine strangförmige Narbe gebildet hat, wie die Stangen eines Gatters oder das Maschenwerk eines stabilen Netzes, das je nach Geometrie und Anlage völlig ausreicht, die weichgeweblichen Zielstrukturen gezielt zu versteifen. In this case these tubular scars tunnel effect after it has been formed within the tube through one pross granulation tissue, a string-shaped scar, such as to stiffen the bars of a gate or the mesh of a stable network that is fully sufficient, depending on the geometry and conditioning the weichgeweblichen target structures selectively.
  • Neben diesem verfahrenstechnischen Grundgedanken ist erfindungsgemäß auch die technische Lösung, um eben solche röhrenförmigen Primärstrukturen im Zielgewebe zu schaffen. In addition to this procedural principles according to the invention, the technical solution just to create such tubular primary structures in the target tissue. Hierzu werden erfindungswesentlich und vorzugsweise optische Lichtleitfasern verwendet, die gleichzeitig, wie - unsere eigene Patentschrift zur Simultanübertragung von Laser und Ultraschall zitierend - beschrieben, in der Lage sind, chirurgischen Ultraschall und Laserstrahlung simultan und/oder alternierend zu übertragen. To this end, optical fibers used in the present essential and preferably at the same time as - described surgical ultrasound and laser radiation are capable of simultaneously and / or alternately transmitted - our own patent for the simultaneous transmission of laser and ultrasound citing. Dabei kommt der Möglichkeit der alternierenden Applikation von chirurgischem Ultraschall und Laserlicht besondere Bedeutung zu, um in Abhängigkeit der biologischen Reaktion das Zielgewebe perforieren zu können, ohne dass die Faser vom vorher geplanten Weg auswandern kann, da insbesondere mit Ultraschallfrequenzen zwischen 20 und 50 kHz normales Weichgewebe oder Muskelzellen sehr gut perforiert werden können, hingegen collagen- und elastinhaltige Strukturen besonders gut mit gepulster Laserstrahlung, wahlweise eines Excimer-Lasers oder eines Erbium-dotierten Festkörper- Lasers Anwendung finden. In this case, the possibility of the alternating application of surgical ultrasound and laser light is particularly important in order to perforate the target tissue in response to the biological reaction without that the fiber can emigrate from the previously planned route, as particular at ultrasonic frequencies between 20 and 50 kHz normal soft tissue or muscle cells can be well perforated very, however, find collagen and elastinhaltige structures particularly well with pulsed laser radiation, optionally an excimer laser or an erbium doped solid state laser application. Prozesswesentlich ist dabei das Zusammenwirken aus ultrakurzer Pulsdauer und sehr hoher Absorption der Lichtstrahlung im Zielgewebe. process is essentially the interaction of ultra-short pulse duration and very high absorption of the light radiation in the target tissue. Typischerweise kommen Pulsbreiten von 300 Mikrosekunden und weniger in Betracht. Typically come pulse widths of 300 microseconds and less useful. In dem bevorzugten Ausführungsbeispiel typischerweise von ca. 200 Nanosekunden und weniger. In the preferred embodiment, typically of about 200 nanoseconds or less.
  • In Weiterführung des Erfindungsgedankens besteht das lichtleitende System dabei aus einer Hohlkapillare, vorzugsweise aus Saphir, welche bevorzugt die Ultraschallenergie appliziert, bei Bedarf jedoch auch als Wellenleiter für die in einem besonderen Ausführungsbeispiel bevorzugte Erbium : YAG- Laserstrahlung genutzt werden kann. In a further development of the inventive concept, the light-conducting system consists of a hollow capillary, preferably made of sapphire, but which is preferably applied ultrasonic energy, if necessary, also as a waveguide for the preferred in a particular embodiment, Erbium: YAG laser radiation can be used. Gleichzeitig kann das innere Lumen einer solchen Kapillare, die mechanisch außerordentlich stabil ist und zur Erhöhung der Stabilität noch mit einem biokompatiblen Metallüberzug, typischerweise Gold, beschichtet ist, einen Außendurchmesser von weniger als einem Millimeter und dem inneren Lumen kann das durch die Ultraschallschwingung, bzw. Laserstrahlung fragmentierte Gewebe abgesaugt werden. At the same time the inner lumen of such a capillary, which is mechanically extremely stable and is also coated to increase the stability with a biocompatible metal coating, typically gold, an outer diameter of less than one millimeter and the inner lumen can be obtained by the ultrasonic vibration, or laser radiation fragmented tissues are aspirated. Gleichzeitig kann aber auch das innere Lumen durch Einbringung einer weiteren Lichtleitfaser im Sinne eines Mandrins benutzt werden, um mit dieser inneren Faser beispielsweise ebenfalls wiederum Laserstrahlung zum Vorbohren des gewünschten Zielkanals übertragen werden oder aber höherfrequenter Ultraschall zur Erlangung eines A-Scan-Signals zur ständigen Messung der Restgewebedicke am Ende des Zielkanals, was insbesondere bei der Behandlung des Gaumensegels und der Uvola notwendig sein wird. At the same time but also the inner lumen of a stylet can be used by introducing a further optical fiber in the sense so as to also turn the laser radiation is transmitted to the pre-drilling of the desired target channel with this inner fiber, for example, or higher-frequency ultrasound to obtain an A-scan signal for continuous measurement the residual tissue thickness at the end of the target channel, which will be necessary in particular in the treatment of the soft palate and the Uvola.
  • In Weiterführung des Erfindungsgedankens kann das innere Lumen aber auch zur Injektion beispielsweise von Fibrinkleber oder anderer vernarbungsfördernder Substanzen genutzt werden. In continuation of the inventive concept, but the inner lumen can also be used for injection, for example, fibrin glue or other cicatrizing substances. Die erfindungsgemäßen Vorrichtungen sind in den Abb. 1 bis 2 näher erläutert: The devices of the invention are explained in more detail in Figures 1 to 2.:
  • Abb. 1 Fig. 1
  • Dargestellt ist das Prinzip einer möglichen technischen Ausführungsform der Erfindung. Shown is the principle of a possible technical embodiment of the invention. In einem Handstück ( 1 ) wird zur gewünschten Gewebeschädigung geeigneter Ultraschall und oder entsprechende Laserstrahlung in einen optoakustischen Applikator ( 2 ) eingekoppelt. In a handpiece (1) is coupled to the desired tissue damage and of suitable ultrasonic or laser radiation corresponding to an optoacoustic applicator (2). Der optoakustische Applikator ( 2 ) kann je nach Anforderung mehr oder weniger flexibel ausgelegt sein und wird in der gewünschten Position in das Weichgewebe ( 3 ) eingestochen, wobei durch die am distalen Ende des Applikators abgegebene Ultraschall- und oder Laserenergie die gewünschte röhrenförmige Gewebeschädigung erzeugt wird. Optoacoustic applicator (2) may according to requirements be more or less designed to be flexible and is inserted into the desired position in the soft tissue (3), whereby the desired tubular tissue damage is produced by the discharged at the distal end of the applicator ultrasonic and or laser energy , Zur Erzeugung der Laser- und Ultraschallenergie dient ein Ultraschallgenerator ( 4 ), der einen im Handstück ( 1 ) befindlichen Ultraschallwandler versorgt, sowie der Laser ( 5 ). An ultrasonic generator (4) which supplies a located in the handpiece (1) ultrasonic transducer, and the laser (5) is used to generate the laser and ultrasonic energy. Außerdem befinden sich am Handstück ( 1 ) die Anschlüsse für eine gegebenenfalls in den Applikator ( 2 ) integrierten Spülung ( 6 ) und Absaugung ( 7 ), die das Entfernen der erzeugten Gewebefragmente erlaubt. Also located on the handpiece (1), the connections for an optionally into the applicator (2) integrated purge (6) and suction means (7) which allows the removal of the tissue fragments generated.
  • Abb. 2 Fig. 2
  • Diese Abbildung zeigt das Prinzip einer möglichen technischen Ausführungsform des optoakustischen Applikators. This figure shows the principle of a possible technical embodiment of the opto-acoustic applicator. Dieser besteht aus einem Wellenleiter ( 8 ), zum Beispiel einer Saphir-Kapillare, deren proximales Ende in einer Ultraschallsonotrode ( 9 ) derart befestigt ist, das über die Mantelfläche tangential Ultraschallenergie eingekoppelt werden kann. This consists of a waveguide (8), for example a sapphire capillary whose proximal end is fixed in an ultrasonic sonotrode (9) in such a way that can be injected via the lateral surface tangentially ultrasonic energy. Diese regt den Wellenleiter ( 8 ) zu longitudinalen Schwingungen an. This stimulates the waveguide (8) to longitudinal vibrations. Über die vom Laser kommende akustische entkoppelte Glasfaser ( 10 ) wird die Laserstrahlung in die proximale Stirnfläche des Wellenleiters ( 8 ) eingekoppelt. The laser radiation is coupled into the proximal end face of the waveguide (8) coming from the laser acoustic decoupled optical fiber (10). Das Lumen ( 11 ) des Wellenleiters ( 8 ) kann bei entsprechender konstruktiver Gestaltung zur Absaugung, Spülung und oder als Arbeitskanal genutzt werden. The lumen (11) of the waveguide (8) can be used with appropriate structural design for the extraction, rinsing and or as a working channel. Bezugszeichenliste 1 Handstück LIST OF REFERENCES 1 handpiece
    2 optoakustischer Applikator 2 optoacoustic applicator
    3 Weichgewebe 3 soft tissue
    4 Ultraschallgenerator 4 ultrasonic generator
    5 Laser 5 laser
    6 Spülung 6 flushing
    7 Absaugung 7 suction
    8 Wellenleiter 8 waveguide
    9 Ultraschallsonotrode 9 ultrasonic sonotrode
    10 Glasfaser 10 optical
    11 Wellenleiterlumen 11 fiber lumens

Claims (8)

  1. 1. Verfahren und Vorrichtung zur Erzeugung von Narbenstrukturen im biologischen Weichgewebe mittels elektromagnetischer Energie, dadurch gekennzeichnet , dass diese Narbenstrukturen mindestens zweidimensional sind. 1. Method and apparatus for production of grain structures in biological soft tissue by means of electromagnetic energy, characterized in that these scars structures are at least two-dimensionally.
  2. 2. Vorrichtung nach 1, dadurch gekennzeichnet, dass ein Laser zur Erzeugung der elektromagnetischen Energie in Kombination mit der Übertragung von Ultraschallenergie eingesetzt wird. 2. A device according to 1, characterized in that a laser for generating the electromagnetic energy in combination with the transmission of ultrasonic energy is used.
  3. 3. Verfahren und Vorrichtung nach 1 und 2, dadurch gekennzeichnet, dass ein Laser mit Ultraschall über einen Wellenleiter geführt wird. 3. The method and apparatus of Figure 1 and 2, characterized in that a laser with ultrasound is passed through a waveguide.
  4. 4. Verfahren und Vorrichtung nach 1 bis 3, dadurch gekennzeichnet, dass als Wellenleiter optische Fasern genutzt werden. 4. The method and apparatus according to 1 to 3, characterized in that are used as optical waveguide fibers.
  5. 5. Verfahren und Vorrichtung nach 1 bis 3, dadurch gekennzeichnet, dass als Wellenleiter Kapillaren genutzt werden. 5. The method and apparatus according to 1 to 3, characterized in that are used as a waveguide capillaries.
  6. 6. Verfahren und Vorrichtung nach 1 bis 5, dadurch gekennzeichnet, dass zusätzlich zum Leistungsultraschall das rücklaufende Signal als A-Scan ausgewertet wird. 6. The method and apparatus according to 1 to 5, characterized in that in addition to the ultrasonic power, the returning signal is evaluated as A-scan.
  7. 7. Verfahren und Vorrichtung nach 1 bis 5, dadurch gekennzeichnet, dass der Wellenleiter als Übertragungsweg für ein A-Scan-Signal genutzt wird. 7. The method and apparatus according to 1 to 5, characterized in that the waveguide is used as a transmission path for an A-scan signal.
  8. 8. Verfahren und Vorrichtung nach 1 bis 7, dadurch gekennzeichnet, dass eine zusätzliche Injektion von vernarbungsfördernden Substanzen erfolgt. 8. The method and apparatus according to 1 to 7, characterized in that an additional injection of cicatrizing substances takes place.
DE2002119297 2002-04-25 2002-04-25 Medical instrument for generation of scar tissue to stiffen soft tissue, combines an ultrasound generator with a laser so that electromagnetic and or ultrasound energy can be coupled into the tissue via an opto-acoustic coupler Withdrawn DE10219297A1 (en)

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DE10347079A1 (en) * 2003-10-10 2005-05-19 Fraunhofer-Gesellschaft zur Förderung der angewandten Forschung e.V. Ultrasound coupler for ultrasonic device, e.g. for bone examination, has electroacoustic transducers coupled to side of elongate waveguide for generating and detecting ultrasound waves
WO2006042201A1 (en) 2004-10-06 2006-04-20 Guided Therapy Systems, L.L.C. Method and system for ultrasound tissue treatment
US8128618B2 (en) 2005-08-03 2012-03-06 Massachusetts Eye & Ear Infirmary Targeted muscle ablation for reducing signs of aging
US8282554B2 (en) 2004-10-06 2012-10-09 Guided Therapy Systems, Llc Methods for treatment of sweat glands
US8298144B2 (en) 2006-06-23 2012-10-30 Koninklijke Philips Electronics N.V. Timing controller for combined photoacoustic and ultrasound imager
US8409097B2 (en) 2000-12-28 2013-04-02 Ardent Sound, Inc Visual imaging system for ultrasonic probe
US8444562B2 (en) 2004-10-06 2013-05-21 Guided Therapy Systems, Llc System and method for treating muscle, tendon, ligament and cartilage tissue
US8460193B2 (en) 2004-10-06 2013-06-11 Guided Therapy Systems Llc System and method for ultra-high frequency ultrasound treatment
US8480585B2 (en) 1997-10-14 2013-07-09 Guided Therapy Systems, Llc Imaging, therapy and temperature monitoring ultrasonic system and method
US8636665B2 (en) 2004-10-06 2014-01-28 Guided Therapy Systems, Llc Method and system for ultrasound treatment of fat
US8663112B2 (en) 2004-10-06 2014-03-04 Guided Therapy Systems, Llc Methods and systems for fat reduction and/or cellulite treatment
US8690779B2 (en) 2004-10-06 2014-04-08 Guided Therapy Systems, Llc Noninvasive aesthetic treatment for tightening tissue
US8708935B2 (en) 2004-09-16 2014-04-29 Guided Therapy Systems, Llc System and method for variable depth ultrasound treatment
US8715186B2 (en) 2009-11-24 2014-05-06 Guided Therapy Systems, Llc Methods and systems for generating thermal bubbles for improved ultrasound imaging and therapy
US8764687B2 (en) 2007-05-07 2014-07-01 Guided Therapy Systems, Llc Methods and systems for coupling and focusing acoustic energy using a coupler member
US8858471B2 (en) 2011-07-10 2014-10-14 Guided Therapy Systems, Llc Methods and systems for ultrasound treatment
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US9320537B2 (en) 2004-10-06 2016-04-26 Guided Therapy Systems, Llc Methods for noninvasive skin tightening
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US9510802B2 (en) 2012-09-21 2016-12-06 Guided Therapy Systems, Llc Reflective ultrasound technology for dermatological treatments
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US8480585B2 (en) 1997-10-14 2013-07-09 Guided Therapy Systems, Llc Imaging, therapy and temperature monitoring ultrasonic system and method
US9272162B2 (en) 1997-10-14 2016-03-01 Guided Therapy Systems, Llc Imaging, therapy, and temperature monitoring ultrasonic method
US8409097B2 (en) 2000-12-28 2013-04-02 Ardent Sound, Inc Visual imaging system for ultrasonic probe
US9907535B2 (en) 2000-12-28 2018-03-06 Ardent Sound, Inc. Visual imaging system for ultrasonic probe
DE10347079A1 (en) * 2003-10-10 2005-05-19 Fraunhofer-Gesellschaft zur Förderung der angewandten Forschung e.V. Ultrasound coupler for ultrasonic device, e.g. for bone examination, has electroacoustic transducers coupled to side of elongate waveguide for generating and detecting ultrasound waves
DE10347079B4 (en) * 2003-10-10 2005-09-01 Fraunhofer-Gesellschaft zur Förderung der angewandten Forschung e.V. Coupler for an ultrasound machine and ultrasound procedures
US9011336B2 (en) 2004-09-16 2015-04-21 Guided Therapy Systems, Llc Method and system for combined energy therapy profile
US8708935B2 (en) 2004-09-16 2014-04-29 Guided Therapy Systems, Llc System and method for variable depth ultrasound treatment
US9114247B2 (en) 2004-09-16 2015-08-25 Guided Therapy Systems, Llc Method and system for ultrasound treatment with a multi-directional transducer
US9895560B2 (en) 2004-09-24 2018-02-20 Guided Therapy Systems, Llc Methods for rejuvenating skin by heating tissue for cosmetic treatment of the face and body
US9095697B2 (en) 2004-09-24 2015-08-04 Guided Therapy Systems, Llc Methods for preheating tissue for cosmetic treatment of the face and body
US8282554B2 (en) 2004-10-06 2012-10-09 Guided Therapy Systems, Llc Methods for treatment of sweat glands
US8444562B2 (en) 2004-10-06 2013-05-21 Guided Therapy Systems, Llc System and method for treating muscle, tendon, ligament and cartilage tissue
US8460193B2 (en) 2004-10-06 2013-06-11 Guided Therapy Systems Llc System and method for ultra-high frequency ultrasound treatment
US9533175B2 (en) 2004-10-06 2017-01-03 Guided Therapy Systems, Llc Energy based fat reduction
US8506486B2 (en) 2004-10-06 2013-08-13 Guided Therapy Systems, Llc Ultrasound treatment of sub-dermal tissue for cosmetic effects
US8523775B2 (en) 2004-10-06 2013-09-03 Guided Therapy Systems, Llc Energy based hyperhidrosis treatment
US8636665B2 (en) 2004-10-06 2014-01-28 Guided Therapy Systems, Llc Method and system for ultrasound treatment of fat
US8641622B2 (en) 2004-10-06 2014-02-04 Guided Therapy Systems, Llc Method and system for treating photoaged tissue
US8663112B2 (en) 2004-10-06 2014-03-04 Guided Therapy Systems, Llc Methods and systems for fat reduction and/or cellulite treatment
US8672848B2 (en) 2004-10-06 2014-03-18 Guided Therapy Systems, Llc Method and system for treating cellulite
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