FR2535614A1 - LASER IRRADIATION DEVICE - Google Patents

Abstract

THE DEVICE OF THE INVENTION INCLUDES A PLURALITY OF LASER SOURCES 2, 3 TO EXIT FROM A PLURALITY OF LASER BEAMS EACH HAVING A DIFFERENT WAVELENGTH; A GUIDING BEAM SOURCE 4, 5 TO EXIT A VISIBLE GUIDING BEAM; AND A MEANS OF MIXING 7, 6 FOR COAXIALLY MIXING ONE OR MORE OF THE LASER BEAMS WITH THE VISIBLE GUIDING BEAM; A LIGHT GUIDING MEANS 10 FOR GUIDING THE LASER BEAM AND THE VISIBLE GUIDED BEAM MIXED TOWARDS A TARGET; THE LASER SOURCES, THE GUIDE BEAM SOURCE, THE LIGHT GUIDANCE MEANS AND THE MIXTURE MEANS ALL FIXED ON THE SAME SUPPORT BASE 1 COMPRISING A SUPPORT PLATE 101, ONE OR MORE LASER SOURCES AND THE BEAM SOURCE GUIDE BEING FIXED ON THE SAME SURFACE OF THE SUPPORT PLATE IN A WAY TO ENSURE THAT ALL THE BEAMS IRRADATED BY THE SOURCES ARE DIRECTED IN THE SAME DIRECTION AND THAT THEIR OPTICAL AXES ARE KEPT PARALLEL TO THE OTHERS AND TO THE SAME DISTANCE FROM THE SUPPORT PLATE.

Description

The present invention relates to a device

  laser irradiation and, more particularly, a

  positive laser irradiation which is applicable to

  medical treatment under the most favorable conditions

  In other words, the present invention relates to an optical system of a laser irradiation device which precedes a simultaneous irradiation and / or, to the choï-x by

  a plurality of working laser beams, each beam

  with a wavelength different from that of

1 o others.

  We know that the interaction between an organism

  vant and a laser beam which irradiates this organism varies

  depending on the wavelength of the irradiated laser beam

  dié Simultaneous irradiation of an affected part of an or-

  living ganism by a plurality of laser beams having

  different wavelengths provides a result

  much better condition than in the case where irradiation is carried out

kills with a single laser beam.

  For example, the combination of the irradiation of a YAG laser beam (garnet -yttritum-aluminum) which is effective in the case of hemostasis and coagulation and of a Co 2 laser beam which is excellent for a surgical operation. effectively reduces bleeding during the operation We know

  that the Ar laser also has an efficiency identical to that

2.

the YAG laser.

  In the prior art, we have proposed

  tifs for simultaneous and / or optional irradiation by a plurality of working laser beams having different wavelengths For example, Japanese patent application N O 130145/81 describes a device which uses the

  C 02 laser and YAG laser and has two light guides

  mother. In the device of the prior art which has just been cited, one of the light guides is a guide with an articulated arm which simultaneously and / or selectively directs

  the laser beam C 02 and the laser beam YAG The other guide

  of laser is a fiber optic guide which only conducts the YAG laser beam The light guide is used with

an endoscope.

  Note that this art patent application

  previous describes only the broad outlines of such a provision

  sitive and no practical and specific provision con-

  identifying a plurality of working laser sources,

  sources of guide beams and various optical means

  that are necessary to form an irra-

  diation by operational and desirable laser We understand

  dra that the laser irradiation device of this type which comprises a plurality of working laser sources and performs irradiation with a laser beam at the same time as with a visible guide beam, requires various types of optical means and consequently , the

  : building such a device is complicated -By con-

  sequent, it is essential to have a reasonable arrangement of optical means to make a device

  which is operational and more efficient in its use

practical.

  The object of the present invention is to satisfy

  the conditions mentioned above.

  An object of the present invention is a provision

  laser irradiation device equipped with a plurality of sources

  these working laser beams, one or more

  light sources for guidance and one or more guides

  3. of light, in which the arrangement of these various

  optical means, as described below Jest ration-

  nalised, easy optical adjustment and stability

excellent optics.

  The present invention will be well understood when

  of the following description made in conjunction with the

  attached sins in which: Figure 1 is a view of an embodiment of the present invention;

  FIG. 2 is a view of a support base 1, shown

  felt in Figure 1; Figure 3 is a view of the arrangement of the beams whose irradiation is caused from said towards types of source fixed to the base 1; and FIG. 4 represents the case where a guide 1 l of

  light by fiber and the base 1 are connected to each other

  be. The present invention will now be described.

  in conjunction with the accompanying drawings.

  In the figure there is shown a device which comprises two types of working laser source, two types

  guide beam source and two light guides.

  As shown in the drawings, a support base 1 is mounted perpendicularly in a housing 12 in such a way that it projects in part on the upper plate of the housing. In addition, an energy source 13 is

  mounted inside the casing 12 to supply the sources

these laser beam.

  On the front surface of a support plate 101 are mounted a first source 2 of working laser

  and a second source 3 of working laser, the outputs of which

  ties are invisible laser beams, and a first source 4 of guide beam whose output is a guide beam On the rear side of the support plate 101, is fixed a second source 5 of guide beam whose output is another guide beam,

  Note that all sources are directed perpetually

  diculously and upward so the beams of

4 2535614

  outlet are directed perpendicular and upward.

  as the first source 2 of the working laser beam, a source having a high incision capacity is used, for example, a Co 2 laser whose output beam is represented by the reference 201 As the second source 3 of the working laser, uses a source with a high blood coagulation capacity, for example, a YAG laser source, the output beam of which is represented by the reference 301 On the other hand, as the first source 4 of the guide beam, uses a 1 e-Ne laser beam source, whose output beam

  401 is red As the second guide beam source 5

  dage, we use a halogen lamp whose beam

501 is white.

  On the front surface of the support plate

  101, a second mixing means 7 is fixed, which has the function of

  tion of coaxially mixing the second laser beam 301 and the first guide beam 401 The mixing means 7 consists of a reflecting mirror 701 which reflects

  the first guide beam 401, and a dichroli-

  that 702 which allows the second laser beam 301 to pass but reflects the first guide beam 401 Each of the

  mirrors 701 and 702 is fixed via a support

  port (not shown> to the support plate 101 In the

  mixing means 7, the two laser beams mentioned above

  top-are mixed coaxially to give a beam

output 402.

  In this particular case, the laser beam 301

  which is applied to the second mixing means 7 is collimated

  The reason is that, when the second laser source is the YAG laser, in particular when it is a YAG laser

  with multi-mode oscillations, a beam divergence.

  becomes 14 15 mrad and the beam diameter becomes excessively large Therefore it becomes

  difficult to use a light guide with articulated arm.

  Instead of the optical correction means 303, it is possible to use

  read an exit mirror having a certain curvature as se-

  source 3 of working laser, for corri-

  manage the divergence of the beam, The optical means of correcting

  tion 303 is also attached to, the support plate 101.

  In an identical manner, a first mixing means 6 is fixed to the front surface of the support plate 101 for coaxially mixing the first laser beam 201 and the beam 402 The mixing means 6 is

  made up of reflecting mirrors 601 and 602 which reflect

  the first laser beam 201 ,: from another reflecting mirror 1 î 604 which reflects the beam 402, and from a dichroic mirror 603 which allows the passage of the first laser beam 201 but reflects the beam 402 Each of the mirrors 601 to 604 is fixed, via a support (not shown), to the support plate 101 The is two beams which are adjusted coaxially by the mixing means 6 exit in the form of a beam 202 as

shown in the figure.

  As is clearly shown, the first irradiation means 6 is designed so that the beam 402 reflected by the mirror 604 and the first laser beam

  201 reflected by mirrors 601 and 602 are mixed-

  coaxially by the dichroic mirror 603 Thus, the

  beam 402 is only reflected twice for the melan

  ge, so that the loss of the second laser beam 301

  during transmission can be advantageously avoided.

  The position and angle of the beam 402 are

  adjusted by the reflecting mirror 604 and the mirror

  review 603, while the position and angle of the first

  laser beam 201 are adjusted by mirrors ref léchis-

sants 601 and 602.

  The beam 202 is introduced into a light guide with articulated arm which is mounted in the manner

  classic on the upper part of the support base l, and pro-

  yields to the required irradiation Light guide 10 is

  used for surgical operations The axis of the beam

  the light 202 is adjusted so as to coincide with that of the light guide 10 by adjusting the mirrors arranged at

  the interior of the first mixing means 6.

6. 2535614.

  A means 8 for changing the opti-

  that is arranged on the support plate 101 The means 8

  allows the optical path of beam 402 to be changed by

  placement of the reflective mirdir 801 which is fixed to a rotating solenoid (not shown) The arrangement is such that, when the mirror 801 is moved to a position

  withdrawal, the beam 402 passes directly into the first

  mier mixing means 6 When the mirror 801 is placed in an advanced position, the optical path of the beam

  402 is modified By changing the optical path, the irradia-

  tion due to the first source 4 of guide beam is suppressed by an appropriate means, and the second laser beam 301 is irradiated in the third mixing means 9, which

will be described later.

  On the rear side of the support plate 101 is fixed a reflecting mirror 901 (see FIG. 2) which reflects the second guide beam 501 On the front surface of the support plate 101 is fixed a dichroic mirror 902 which reflects the second beam

  laser 301 and allows the passage of the second guide beam

  ge 501 Mirrors 901 and 902 are fixed to the plate

  support 101 by means of supports (not shown

  A third mixing means 9 consists of

two mirrors 901 and 902.

  The second guide beam 501 is reflected

  by the mirror 901 and directed so as to cross an opening

  ture l Ola (see Figure 2) which is made in the support plate 101, then introduced into the dichroic mirror 902 The second laser beam 301 is also introduced into the mirror 902 and mixed coaxially with the second

  guide beam 501 The two adjusted beams coaxia-

  also exit in the form of a bundle 502, as shown

felt in the figure.

  The beam 502 is directed so as to be introduced into a fiber light guide 11 which is

  subject to support 1 by a means which will be described later

  Consequently, the beam 502 can carry out a

  irradiation of the required part through the guide

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  de ll The light guide ll is incorporated in a backing

  Mine cope to be used in a surgical operation

  gical in the form of a visual field, It will be understood that the device of the present invention is actuated in one of the modes of irradiation

which are described below.

  1) In the first mode, the means 8 of change-

  optical path ment is placed in its re- position

  line, and the first source 2 of laser beam of

  vail and the second source 3 of the working laser beam are in operation The first laser beam 201, the second laser beam 301, and the first guide beam 401 carry out coaxial irradiation via

  of the light guide 10 with an articulated arm.

  2) In the second mode, the means 8 for changing the optical path is placed in its withdrawn position and only the first source 2 of the working laser beam

  is in service The first laser beam 201 and the first

  mier guide beam 401 proceed to coaxial irradiation through the light guide 10 to

articulated arm -

  3) In the third mode, the means 8 of change-

  optical path ment is placed in its position of re-

  line, and only the second source 3 of working laser beam is in service The second laser beam 301 and

  the first guide beam 401 carry out an irradiation

  coaxial tion via the light guide 10 with articulated arm

  4) In the fourth mode, the means 8 of changing

  optical path element is placed in its advanced position and only the second source 3 of working laser beam is in use The second laser beam 301 and the second

  guide beam 501 proceed to coaxial irradiation

  it through the fiber optic light guide.

  On the other hand, in the present embodiment

  tion of the invention, the alignment of the optical axes at each

  that incident end of light guide 10 with rear arm

  and fiber light guide lb can be done

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  killed in the following manner For the alignment of the optical axis relative to the light guide l Q, the means 8 for changing the optical path is placed in its withdrawn position so

  irradiation by the first beam of mistletoe

  beam 401 As described above, the first guide beam 401 is reflected and directed towards the light guide 10 As the first guide beam 401 is adjusted coaxially both with the first beam la, ser 201 and with the second beam 301, alignment can

  be executed in such a way that while observing visual-

  ment the first guide beam 401, the beam is adjusted so as to coincide with the central part (optical axis of the light guide with articulated arm) of the end

light guide incident 10.

  On the other hand, for the alignment of the opti-

  as the light guide 11 made of fiber, the means 8 for changing

  the optical path ment is placed in its advanced position, and the first source 4 of the guide beam is in service The first guide beam 401 leaving the first source 4 of the guide beam propagates along the same optical path as the second laser beam

  301 and is directed towards the fiber light guide 11.

  Alignment can thus be performed in a ma-

  such that, while visually observing the first guide beam 401, the position of the light guide 11

  is adjusted as described above, so as to introduce

  re the beam in the incident end of this guide.

  However, the second guide beam 501

  coming out of the second source 5 is not a coherent light

  annuity, and the beam cannot be diaphragmed with an exact

  meticulous titude Thus, it cannot constitute a benchmark

  for positioning the light guide 11.

  In addition, according to the present invention, the second laser beam 301 and the first guide beam 401 are mixed after they are both removed once from their sources 3 and 4 Consequently, there is no risk that the divergence of the first guide beam is disturbed

9 2535614

  by optical correction means 303 Furthermore, as it

  this is not a classic type in which the first

  mier guide beam is induced in the totally reflecting side of the mirror of the second beam source 3, working laser beam, there is also no risk that

  the heated lens of a YAG laser rod causes the

  lation of the first guide beam 401 Consequently,

  the articulated arm light guide can be used as

- my classic light guide.

  An arrangement concerning the various optical means

  ques is shown in connection with Figures 2 to 4,

  Figure 2 is a view of the support base which is shown

  presented in figure 1 Support 1 is entirely manufactured

  by casting The support plate 101, located inside

  laughing base liest consists of a sheet and has a projecting part As indicated above, the projecting part of the plate 101 projects outwards from

  the upper plate of the casing It will be noted that the part

  plate 101 is mounted inside the car-

  ter Side plates 103, 104 and 105 have been provided to surround the support plate 101 The side plates are used on the other hand to prevent the plate from twisting and bending 101 On the side plate 105 is arranged a cylindrical body 102 which surrounds the protruding part of the plate 101 In the figure, the references 106 and 107 relate to reinforcement plates of the base 1 Two openings are made in the reinforcement plate 106 to allow the passage of the second laser beam 301

  and the first guide laser beam 401.

  As indicated above, the first source 2 of working laser beam, the second source 3 of working laser beam, the first source 4 of guide beam and the second source 5 of guide beam

  are arranged vertically on the support plate 101.

  It is important here that all the beams irradiated by the sources are directed in the same direction As

  the second source 5 of guide light is not available

  placed on the front surface of plate 101, it is not

2535614.

  not always necessary to place it in the same direction

  tion than the other beam sources, such an arrangement has the effect that the beams coming from the sources

  are all kept parallel to each other By con-

  sequent, the second working laser beam 301 and the

  first guide beam 401 are parallel to each other

  be and introduced into the second mixing means 7 In the first mixing means 6, the first working laser beam 201 and the beam 402 held in parallel

to each other are introduced there.

  The first-source 2 of working laser beam,

  the second source 3 of the working laser beam and the first

  source 4 of the guide beam are arranged on the support plate 101 in such a way that the axis of the irradiated beams 201, 301 and 401 of the sources 2, 3 and 4 is at the same distance from the surface of the plate 101 and directed parallel to this plate as shown in FIG. 3 Consequently, when the second working laser beam 301 and the first guide beam 401 are introduced into the second mixing means 7, the optical axes of the beams are kept parallel S to the

  support plate 101 and at the same distance from it.

  How the beam 402 is coaxial with the second laser beam

  working 301, when the beam 402 and the first beam

  working laser 201 are introduced into the first mixing means 6, the optical axes of each beam

  are kept parallel to plate 101 and at the same distance

  tance thereof Therefore, the operations of melan

  ge beams are executed in a plane which is my Cinte-

  bare parallel to the support plate 101 The distance between the surface of the support plate 101 and each of the axes

  beams can be adjusted, for example, by

rods 203 and 403.

  As shown in Figure 4, a cylindrical body

  that 108 (not shown in FIG. 2) is mounted so as to surround an opening l Ola which has been made in the support plate 101 An adjustment mechanism 14 is provided at the upper end of the body 108 and directed towards a

* 11 2535614

  other opening 121 which is formed in the casing 12, A connector 112, which is provided at the base end of the

  fiber light guide 11 is detachably connected

  ble to the adjustment mechanism 14 via the

  vertex 121 This is how the beam 502 which is obtained by mixing the second working laser beam 301 and the second guide beam 501 is introduced into the

  light guide 11, The reference 111 represents a con-

beam density 502.

  Consequently, to summarize the above, in the device of the present invention, all the optical means such as the first and second sources 2 and 3 of working laser beams, the first and second sources 4 and 5 of guide laser beams , the first, second and third mixing means 6, 7 and 9, the means 8 for changing the optical path and the

  first and second light guides 10 and there are installed

strips on the base 1.

  The incident end of the light guide 10 is adjusted in a plane which extends perpendicular to the axial direction of the beam 5020 The adjustment mechanism 14

* is arranged in such a way that a slider 142 is placed at.

  inside a housing 141, and that one side of this coulis-

  bucket is compressed by a spring 144 and the other c 8 tee

  in contact with a screw 143 It will be understood that the coulis-.

  bucket 142 can move along an axis X, shown in the figure, by loosening the screw 143, On the other hand,

  provided another screw and another spring in a posi-

  tion perpendicular to the spring 144 and the screw 143 (this screw and this spring not being shown) The

  slide 142 can move along the Y axis by loosening

  rage of the other screw With such an arrangement, the end

  incident light guide 11 can be easily

hindered on the axis of the beam 502 -

  As described above, the second beam

  working laser 301 and the first guide laser beam

  ge 401 are mixed before the first beam is mixed

  working laser 201 and the second working laser beam

12 2535614

  vail 301 Therefore, you can use the visible beam

  guide line 401 as a guide for aligning the light guide 1 i made of fiber and the light guide 10 with an articulated arm. In the embodiment described above, the second source 5 of the guide laser beam can be omitted. However, in this case, the third mixing means 9 is also omitted, and the first guide beam 401 is irradiated independently of the position of

  medium 8 In this case, instead of the third means of mixing

  age, you need a reflective mirror to direct the beam

  ceau 402 on the light guide 11 On the other hand, we

  tera that it is not essential that all the sources of beams and the mixing means are placed on the support plate 101 A part of them can be placed on the side plates which have been discussed previously However, in in this case, each of the axes of the irradiated beams must be at the same distance from the surface of the plate 101 On the other hand, in the present embodiment, the fiber light guide 11 can

  be omitted However, in this case, the means 8 of change-

  ment of optical path, the second source 5 of guide beam, and the third mixing means 9 are also omitted.

  As previously described, the irra-

  diation by laser of the present invention has the characteristics

  following: 1) All the optical means, such as the sources of working laser beams, the sources of guide beams, the mixing means, the optical path change devices and the light guides are mounted on

a single support base.

  2) The sources of working laser beams and the sources of guide beams mounted on the front surface of the support plate are arranged so that all the beams irradiated by the sources are

  headed in the same direction On the other hand, each source

  this is placed on the front surface of the plate so that the axes of the beams irradiated by the sources

  are at the same distance from the support plate and main-

held parallel to each other.

  3) The first guide beam which leaves the first source (visible laser source) is mixed with the second laser beam before being introduced into the

  optical path change means.

  4) The second laser beam coming out of the se-

  this laser beam source is mixed coaxially with the first guide beam which leaves the first guide beam source after projection of these beams from their respective sources, the laser irradiation device according to the present invention is arranged so that when it is subjected to vibrations or shocks and that the position of the support base has been changed, the optical system does not exhibit any anomaly This is due to the fact that almost

  all means, including means of production

  ceaux, the means of transmission of the beams, and others

  optical means, are arranged on the same support base.

  In the case where the base has undergone expansion and / or shrinkage as a result of heat or age, the optical means arranged on the single base are subjected to an almost identical effect, in other words, even if there are changes in the positions of

  optical means, the relative displacement of each of the

  means is very low Consequently, the device of the present invention has a high stability on the

  plan of optical effects, It is desirable that the support base

  port is monobloc (whether it is # for example, manufactured by

  pouring, etc.) Alternatively, it can be arranged inside

  the crankcase so as to be suspended by certain damping means in order to reduce the effects of

fibrations and / or shocks.

  Thus, according to the present invention, all the beams irradiated by the sources mounted on the front surface of the support plate are directed -in the

  same direction and kept parallel to each other.

13,

- 14 2535614

  In addition, these beams are located at the same distance from the support plate and parallel to this plate. Consequently, two beams parallel to each other and to the support plate and at the same distance from this plate.

  that are introduced into each mixing means Consequently, the preceding arrangement facilitates the mixing of the beams The arrangement is such that the number of mirrors

  needed to mix the beams can be reduced.

  The above advantage is essential in a device which includes a plurality of laser sources and an optical system of complicated structure if one wishes

  simplify and stabilize the optical system.

  On the other hand, according to the present invention, as described in connection with the third characteristic, the structure is designed so that the first guide beam and the second working laser beam are

  initially mixed so that the first beam of mistletoe

  dage can be used as a benchmark for the alignment of the optical axes of the incident ends of the two light guides Therefore, it is possible to easily perform the alignment of the optical axes of the guides and the manpower required for such optical adjustment can

be reduced.

  Although a detailed description has not been

  done, the first laser-working beam and the first guide beam are initially mixed, a system

  complicated optics must be incorporated to perform the ali-

  alignment of the optical axes of the light guides mentioned above

above.

  In addition, as described in connection with the fourth-

  As a feature of the present invention, the mixing of the second laser beam and the first guide beam is carried out after they have been projected from their sources. This is particularly advantageous in

  the case where a light guide with articulated arm is used

  as a light guide, as mentioned earlier

  rement. The third characteristic produces effects

2535614

  individuals whatever the first and second characteristics, and can be advantageously incorporated

  in a device equipped with two light guides.

  The present invention is not limited to the exemplary embodiments which have just been described, it

  is on the contrary susceptible to modifications and varian-

  your who will appear to the man of the Part,

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Claims (15)

  1 Laser irradiation device,   laughed in that it comprises: a plurality of laser sources for outputting a plurality of laser beams each having a different wavelength; a guide beam source for outputting a visible guide beam   mixing means for mixing coaxial-   one or more laser beams with the visible guide beam; light guiding means for guiding   the laser beam and the visible guide beam mix   toward a desired target; the laser sources, the guide beam source, the light guide means and the mixing means all being fixed on a single support base comprising a support plate; and   one or more of the laser sources and the source   this guide beam being fixed to the same surface of the support plate so as to have the assurance that all the beams irradiated by the sources will be directed in the same direction and that their optical axes will be kept at the same distance from the support plate and parallel to it,   2 Device according to claim 1, charac-   terized in that it further comprises another means of guiding   light beam and an optical path changing means for modifying one or more laser beams and directing the beam towards the other light guiding means, this   other light guiding means and changing means   optical path ment being fixed on the support base.   3 Device according to claim 2, character-   laughed at in that it further includes another source of do   guide ring on a back side of the super plate   port and another mixing means to mix coaxial-   one visible guide wire from the other   guide beam source with direct laser beam 17 2535614   managed by means of optical path change to   the other light guiding means, the other metering means   swaddle being fixed on the support base.   4 Device according to any one of the res-   dications 1 to 3, characterized in that the laser source and   the guide beam source are supported by the.   support plate with a spacer inserted between them   so as to maintain the distances between the axis of the beam   skin irradiated from each source and the support plate to the same value.   Device according to any one of claims 1 to 4, characterized in that the laser sources   include a first source to output a first do   laser skin mainly allowing the incision of an object   and a second laser source for outputting a second beam   laser skin mainly allowing the coagulation of the object and in that the light guide means is a first light guide intended mainly for surgical operation and the other light guide means is the second light guide intended mainly at be used in an endoscope.   6 Device according to any one of the res-   dications 1 to 5, characterized in that the support plate   port has a projecting part, and the support base is   placed perpendicular to the inside of a housing so that the working laser beam sources and the guide beam source are directed vertically upwards.   7 Device according to claim 61 character-   laughed in that it further comprises side plates fixed to the ends of the support plate, reinforcement plates which are arranged perpendicular to   the support plate and a cylindrical body which is mounted   tee so as to surround the projecting part from where it re-   after the first light guide is placed on the ex- '   upper end of the cylindrical body.   8 Device according to claim 7, character-   risé in that the support base is formed in one piece by casting. 18 2535614   9 Device according to any one of the res-   dications 4 to 8, characterized in that the second guide   light is a fiber light guide, which is available   dried on a cylindrical body placed on the support plate.   10 Device according to any one of claims 5 to 9, characterized in that the other source of   guide beam is a halogen lamp.   11 Laser irradiation device, character-   terized in that it comprises: a first laser source for outputting a first laser beam; a second laser source for outputting a second laser beam;   a first mixing means for mixing coa-   xially the first laser beam with the second laser beam ser;   a first light guide to guide the first   linking the laser beam and / or the second laser beam from the first mixing means to a desired target; An optical path changing means for modifying the optical path of the second laser beam;   a second light guide to guide the se-   cond laser beam whose optical path has been modified towards a desired target; and a guide beam source for outputting a laser beam serving as a visible guide beam, the second laser beam and the guide beam being mixed coaxially by the second mixing means before being introduced into the path changing means optical.   12 Device according to claim 11, charac-   terized in that the first laser source is a C 02 laser, the second laser source is a YAG laser, and the source of   guide beam is a He-Ne laser.   13 Device according to claim 11 or claim 12, characterized in that the first light guide is a light guide with articulated arm, and the beam Me guiding with the second laser beam are mixed coaxially by a dichroic mirror and a mirror   reflecting after projection from their sources.   14 _ Device according to claim 13, ca-   characterized in that it also includes an optical correction means for collimating the second laser beam.   Device according to any one of the re-   vendications 11 to 14, characterized in that the first mixing means comprises two reflecting mirrors for   reflect the first laser beam, another mirror reflected   chissant to reflect the second laser beam and make it   guide ring, and a dichrolic mirror to reflect the   second laser beam and the guide beam but leave   being able to penetrate the first laser beam. 19.