JP2810684B2 - Laser probe - Google Patents

Description

Description: TECHNICAL FIELD The present invention relates to a laser probe that cauterizes and removes a lesion in a body cavity, for example, a thrombus formed in a blood vessel using a laser beam.

[Related Art] In recent years, an operation of cauterizing and removing a thrombus or the like formed in a blood vessel by laser light has been attempted. US Pat. No. 4,646,737 describes a contact member at the tip as a laser probe of this kind, and connects the contact member by contacting the laser light emitting end of a laser guide to the contact member, so that the contact member is heated by laser light. Things are shown.

Then, the laser probe is introduced into a blood vessel, and the contact member heated by the laser light is pressed against the thrombus, so that the heat causes the thrombus to be cauterized and removed. At this time, the thrombus completely closes or closes the blood vessel, but by advancing and retracting the contact member repeatedly in the blood vessel, cauterizing while expanding the thrombus by the shape of the contact member and its high heat. It is.

However, as described above, in order to cauterize a thrombus in a blood vessel, it is necessary to heat the contact member to a high temperature capable of cauterizing. In addition, the contact member repeatedly advances and retreats in the blood vessel in order to spread the thrombus. For this reason, the coating (usually made of resin) of the laser guide may be melted and the contact member may fall off from the laser guide. If the contact member falls off, a serious situation such as obstruction of a blood vessel may be caused. Met.

Therefore, US Pat. No. 4,760,845 describes a specification in which a heat conductive wire is wound around the neck of the contact member to enhance the heat radiation of the joint between the contact member and the laser guide to prevent the contact member from falling off. It is shown.

[Problems to be Solved by the Invention] However, even if a heat conductive wire is wound around the neck of the contact member, the joint between the contact member and the laser guide is not actively cooled. In other words, the natural heat radiation was performed efficiently, and the cooling effect was small. Therefore, it has not been possible to completely prevent the contact member from falling off due to burning of the laser guide.

Therefore, it is conceivable to flow a physiological saline solution toward the contact member and forcibly cool it, but this alone will cool the entire contact member, and the heating efficiency of the contact member by laser light will decrease. However, this results in an obstacle to the essential laser treatment.

The present invention has been made in view of the above circumstances, and an object thereof is to perform normal laser treatment without hindering heating of a contact portion of a contact member with a biological lesion, and furthermore, a contact member It is to provide a laser probe which can efficiently cool a joint portion between the contact member and the laser guide and prevent the contact member from falling off.

[Means for Solving the Problems] In order to solve the above problems, a laser probe of the present invention has a laser guide for guiding laser light, and is attached to a laser light emitting end of the laser guide by inserting the laser guide into the laser light emitting end. A contact member to be heated by the laser beam; and an exterior means for inserting the laser guide therein and forming a fluid passage between the laser guide and the exterior means, the vicinity of a joint between the laser guide and the contact member. And a fluid outlet is provided.

[Operation] In the laser probe having such a configuration, the fluid flowing through the fluid passage passes through the connecting portion of the contact member with the laser guide, flows out of the fluid outlet, and contacts the biological lesion of the contact member. And efficiently cooling only the connecting portion between the contact member and the laser guide without obstructing the heating of the contact portion.

[Embodiment] Hereinafter, a first embodiment of the present invention will be described with reference to FIG. 1 and FIG.

FIG. 1 shows a tip portion of a laser probe according to the present invention, and 1 is a laser guide. The laser guide 1 includes a core and a clad made of, for example, quartz glass, and its outer periphery is covered with a protective tube 2 made of a resin. At the tip of the laser guide 1, the protective tube 2 is removed to minimize thermal damage to the protective tube 2, and the portion of the laser guide 1 is directly exposed.

The exposed portion 3 of the laser guide 1 and the covering portion 4 behind the exposed portion 3 are inserted into holes 6 formed in the contact member 5. The contact member 5 is fixed to the laser guide 1 by means such as an adhesive or caulking. Also,
The contact member 5 has a front-end-side main portion 7 formed in a warhead shape larger than the outer diameter of the laser guide 1, and a rear-end-side portion formed in a thin pipe shape. The distal-side main portion 7 has a diameter necessary and sufficient for expanding the thrombus 9 in the blood vessel 8, and various systems are prepared according to the state of the blood vessel 8 and the thrombus 9. Is done. Further, the material of the contact member 5 is metal, ceramic, or the like.
In order to prevent the cauterized thrombus or the like from adhering, the outer surface thereof is subjected to Teflon processing or the like.

The outer periphery of the laser guide 1 is covered with a sheath 10. The sheath 10 is made of trade name, Teflon (polyfluorinated ethylene fiber) or the like.
It is externally connected to a fixing portion 12 formed on the rear end pipe portion 11. The rear end of the sheath 10 is fitted and held on a mounting portion 14 formed at the front end of the coupling member 13 as shown in FIG. A fluid passage 15 is formed in a gap between the sheath 10 and the laser guide 1.

A base 16 is provided on a side portion of the coupling member 13, and
An injection port 18 of a syringe 17 is detachably connected to the base 16. Further, a pushing member 20 in which an O-ring 19 is inserted is screwed to the rear end of the joining member 13, and the O-ring 19 is compressed in the axial direction by tightening the pushing member 20 to the joining member 13. The laser guide 1 is brought into close contact with the outer peripheral surface, thereby maintaining the water tightness in the coupling member 13. Further, the syringe 17 is filled with a fluid, for example, a physiological saline solution 21, and by pushing the piston 22 of the syringe 17, the physiological saline solution 21 flows into the fluid passage 15 in the sheath 10 through the coupling member 13. It is supposed to.

A fluid outlet 23 is formed near the joint between the contact member 5 and the laser guide 1 in the sheath 10, that is, outside the rear end pipe portion 11 of the contact member 5. The fluid outlet 23 communicates with the fluid passage 15 in the sheath 10.

Next, a method of using the laser probe thus configured will be described. FIG. 2 shows a state in which the contact member 5 is inserted into the blood vessel 8 and reaches the thrombus 9. The contact member 5 spreads the thrombus 9 and presses it. In this state, when a laser beam is introduced through the laser guide 1 and irradiates the contact member 5, the contact member 5 is heated. And
The contact member 5 is moved forward and backward with respect to the thrombus portion 9, and the thrombus portion 9 is spread and cauterized.

By the way, since the temperature of the contact member 5 becomes high during the treatment, there is a possibility that the laser guide 1, particularly the protective tube 2 is burned and the contact member 5 falls off from the laser guide 1.

Then, the piston 22 of the syringe 17 connected to the base 16 of the connecting member 13 is pushed in, and the physiological saline 21 inside is sheathed.
Into the fluid passage 15 in the inside. Then, the physiological saline 21 is guided to the front end side of the fluid passage 15, passes through the rear end pipe portion 11 of the contact member 5, cools it, and then flows out of the laser probe through the fluid outlet 23 of the sheath 10. I do.

In this way, the physiological saline 21 fed from the syringe 17
Of the contact member 5 passes through the rear end pipe portion 11 and flows out of the fluid outlet 23 to the outside.
In this case, only the contact portion between the contact member 5 and the laser guide 1 is efficiently cooled without hindering the contact portion between the contact member 5 and the heating portion, that is, the tip-side main portion 7. Therefore, the tip side main body portion 7
Is efficiently heated by the laser beam, so that ordinary laser treatment can be performed, and the contact member 5 can be prevented from falling off due to burning of the laser guide 1.

FIG. 3 shows a second embodiment of the present invention. In this embodiment, the sheath 10 and the contact member 5 are connected via a connecting member 31 made of metal, ceramics or the like.
That is, the distal end of the connecting member 31 is detachably screwed to a screw portion 32 formed on the rear end pipe portion 11 of the contact member 5, and the fitting portion 33 formed on the rear end of the connecting member 31 has a sheath 10. Are externally fitted together. A fluid outlet is provided near the joint between the contact member 5 and the laser guide 1 in the connection member 31, that is, outside the rear end pipe portion 11 of the contact member 5.
The fluid outlet 34 communicates with the fluid passage 15 in the sheath 10. Thus, the physiological saline solution 21 sent from the syringe 17 (see FIG. 2) flows through the rear end pipe portion 11 of the contact member 5 and flows out of the fluid outlet 34. Other basic configurations and operations are the same as those of the first embodiment.

According to the laser probe having such a configuration, in addition to the effects of the first embodiment, since the connecting member 31 is made of a material having excellent rigidity and heat resistance such as metal or ceramics, the sheath 10 made of Teflon or the like is used. It has higher durability compared to.

FIG. 4 shows a third embodiment of the present invention. This embodiment is different from the second embodiment in that a concavo-convex surface 41 such as a thread is formed on a portion where the contact member 5 is connected to the laser guide 1, that is, on the outer periphery of the rear end pipe portion 11 of the contact member 5. .

According to the laser probe having such a configuration, the fluid contact area of the rear end pipe portion 11 increases, and the cooling efficiency of the joint between the contact member 5 and the laser guide 1 is further improved. The falling off of the contact member 5 can be more effectively prevented.

[Effects of the Invention] As described above, according to the present invention, among the contact members, without hindering the heating of the contact portion with the living body lesion,
Since only the joint portion between the contact member and the laser guide is efficiently cooled, the contact portion of the contact member with the diseased part of the living body is efficiently heated by laser light, so that ordinary laser treatment can be performed. Thus, it is possible to prevent the contact member from falling off due to the burnout.

[Brief description of the drawings]

FIGS. 1 and 2 show a first embodiment of the present invention. FIG. 1 is an enlarged sectional view of a tip portion of a laser probe, FIG. FIG. 4 is an enlarged sectional view of a tip portion of a laser probe according to a second embodiment of the present invention, and FIG. 4 is an enlarged sectional view of a tip portion of the laser probe according to the third embodiment of the present invention. 1 ... laser guide, 5 ... contact member, 10 ... sheath,
11 ... rear end pipe part, 15 ... fluid passage, 23, 34 ... fluid outlet.

Claims (1)

(57) [Claims] 1. A laser guide for guiding a laser beam, a contact member which is attached to a laser beam emitting end of the laser guide by being inserted therein and which is heated by the laser beam; A laser probe, comprising: exterior means for forming a fluid passage between the guide and a guide, wherein the exterior means is provided with a fluid outlet located near a joint between the laser guide and the contact member.