JP5313523B2 - Calculus diagnosis and crushing device and calculus diagnosis and crushing method using infrared wavelength tunable laser - Google Patents

Description

  The present invention relates to a calculus diagnosis / crushing apparatus and method for diagnosing a component of a calculus in a living body such as a gallstone and efficiently crushing the calculus.

Stone disease such as gallstones and kidney stones is a disease whose number of patients is increasing against the background of westernization of eating habits. The treatment method is prepared for various pathological conditions such as surgical treatment by stone removal surgery using laparotomy or laparoscope, and medical treatment by oral administration of calculus dissolution agent.
In recent years, crushing therapy using ultrasonic waves and crushing therapy using lasers have attracted attention as minimally invasive treatments. In particular, crushing treatment using a laser under an endoscope is an effective treatment method for crushing stones directly and reliably. Endoscopic laser fragmentation treatment has been recognized as a relatively safe and minimally invasive treatment method due to the accumulation of cases and advances in various equipment. Attempts have also been made to treat pancreatic stones for which there was no effective treatment.
The laser beam used for laser crushing treatment can concentrate and crush the energy only on the calculus without causing any damage to human tissues, so it is expected to become a therapeutic method that will continue to develop. .

Japanese Patent No. 3072840 Japanese Patent Publication No. 05-25495

  The inventors have noticed that there are the following problems in laser crushing treatment in the prior art, and have been working on solving this problem.

The first problem is the diagnostic accuracy of the calculus main component before laser crushing treatment. Although laser crushing treatment has the merit that laser light energy can be crushed by concentrating only on the calculus, there are a wide variety of constituents of calculus, each having different properties, so how to select the wavelength of the laser beam It is a problem that is difficult. For example, there are various types such as cholesterol stones, bilirubin calcium stones, calcium carbonate stones, calcium phosphate stones, and fatty acid calcium stones, and they may be mixed.
In the current treatment, the diagnosis before laser crushing treatment includes abdominal ultrasonography (US), ultrasonic endoscopy (EUS), abdominal CT examination, endoscopic retrograde cholangiography (ERCP), nuclear magnetism There are cases where the presence of stones is confirmed by obtaining images taken by various methods such as resonance tomography (3D-MRC), and the main components of the stone are estimated from the location and shape in the living body. Many. In many cases, the principal component of the calculus can be estimated to some extent from this captured image, but it is often difficult to estimate, and diagnosis including appropriate selection of the laser light wavelength is difficult.

  The second problem is safe and reliable cutting and removal of stones during laser crushing treatment. Laser crushing treatment has the merit that laser light energy can be concentrated only on stones and crushing, but conventional laser crushing treatment may break so that it can be flipped, and damage to human tissue due to crushing fragments is also a concern Therefore, the removal by the safe cutting of the calculus has been a problem. In particular, when the bile duct is full of stones or is a huge stone, it may be difficult to crush or remove the stone. When large stones cracked vigorously, not only human tissue was damaged, but the stones scattered around and it took time to remove all the stone fragments. When fragmented stones remained, there was a risk of recurring stones after cutting and causing residual stones.

  In view of the above-mentioned problems, the present invention is a calculus capable of ensuring safe selection of a laser light wavelength suitable for accurate diagnosis and treatment of a calculus main component dynamically during laser crushing treatment and capable of safe cutting of the calculus. The object is to provide a diagnosis and crushing method using a diagnostic and crushing apparatus and an infrared wavelength tunable laser.

In order to achieve the above object, the first calculus diagnosis / crushing apparatus of the present invention comprises:
Infrared wavelength tunable laser that irradiates stones with stone light for crushing stones and crushes them,
A first optical fiber having a condensing lens at the tip, and guiding the lithotripsy laser light emitted from the infrared wavelength variable laser to the calculus in the living body;
A spectrum measuring apparatus that irradiates the calculus with irradiation light by the irradiating means, receives reflected light from the calculus by the light receiving means, and performs spectral spectroscopic analysis of the calculus;
A second optical fiber that guides the irradiation light for spectrum measurement irradiated from the irradiation means of the spectrum measuring apparatus to the calculus in the living body, and a second optical fiber that guides reflected light from the calculus to the light receiving means of the spectrum measuring apparatus. With 3 optical fibers,
The wavelength of the calculus breaking laser light irradiated with the infrared wavelength tunable laser so that the absorption light of the calculus becomes a laser light having a large absorption rate based on the spectral spectroscopic analysis result of the calculus in the living body by the spectrum measuring device. Is a stone diagnosis and crushing device that irradiates and crushes the stone.
With the above configuration, before irradiating the lithotripsy laser beam, the spectrum stone is irradiated with spectrum measurement irradiation light and the reflected light is analyzed to obtain a spectral spectroscopic analysis result. The optimum laser wavelength can be known for each calculus from the spectrum, and the calculus can be crushed by irradiating laser light of the optimum wavelength that is strongly absorbed by the calculus by the infrared wavelength tunable laser.

  Next, in the configuration of the first calculus diagnosis / crushing apparatus of the present invention, it is preferable to use both the laser irradiation means and the infrared wavelength variable laser irradiation means of the spectrum measuring apparatus in order to reduce the size of the apparatus and reduce the cost. . That is, the wavelength scanning laser for irradiating the spectrum measurement irradiation light from the infrared wavelength tunable laser, wherein the spectrum measurement irradiation light irradiation means used in the spectrum measuring apparatus is also used as the infrared wavelength variable laser. Of the laser light emitted from the infrared wavelength tunable laser, the light is guided to the second optical fiber when irradiating the scan laser light, and the laser light for calculus crushing is irradiated when the laser light is irradiated. It is preferable to guide to one optical fiber.

Next, in the configuration of the first calculus diagnosis / crushing apparatus of the present invention, the spectrum measurement irradiation light irradiated toward the calculus through the second optical fiber is reflected by the calculus and the reflected light is reflected. In order to make it easy to enter the third optical fiber, it is preferable that the second optical fiber and the third optical fiber have a structure having a total reflection prism on the surface facing the calculus.
With the above configuration, it is possible to efficiently reflect the spectrum measurement irradiation light on the surface of the calculus, and it becomes easy to obtain reflected light having a level sufficient for spectrum analysis.

Next, the second calculus diagnosis / crushing apparatus of the present invention is replaced with a configuration using three optical fibers in the first calculus diagnosis / crushing apparatus of the present invention, and two optical fibers out of the three optical fibers. In addition, the diameter of the endoscope is reduced.
That is, the second calculus diagnosis / crushing apparatus of the present invention has a configuration in which the second optical fiber and the third optical fiber are combined with one first combined optical fiber, and the first combined optical fiber is The total reflection prism is provided on the surface facing the calculus, and the spectrum measurement irradiation light is guided from the irradiation means to the path toward the calculus on the path from the facing surface to the spectrum measuring device and reflected from the calculus. A spectroscope that guides light to a path toward the light receiving means is provided.
With the above configuration, a single optical fiber through which the spectrum measurement irradiation light and reflected light pass can be formed, and the total number of optical fibers can be configured by two.

  Next, in the second stone diagnosing and crushing device, as a device for reducing the size of the device and reducing the cost, the means for irradiating the spectrum measuring irradiation light used in the spectrum measuring device is also used by the infrared wavelength variable laser. The wavelength measurement laser beam emitted from the infrared wavelength tunable laser is used as the spectrum measurement irradiation light, and the laser beam emitted from the infrared wavelength variable laser is irradiated with the scan laser light. Is preferably guided to the first dual-purpose optical fiber and guided to the first optical fiber when the calculus breaking laser beam is irradiated.

Next, the third calculus diagnosis / crushing apparatus of the present invention is replaced with the configuration using three optical fibers in the first calculus diagnosis / crushing apparatus of the present invention, and the three optical fibers are replaced by one optical fiber. This is also used to reduce the diameter of the endoscope.
That is, the third calculus diagnosis / crushing apparatus of the present invention has a configuration in which the first optical fiber, the second optical fiber, and the third optical fiber are combined with one second combined optical fiber,
The second dual-purpose optical fiber has a configuration in which the condensing lens and the total reflection prism can be switched on a surface facing the calculus, and the laser beam is on a path from the facing surface to the spectrum measuring device. And a spectroscope for guiding the spectrum measurement irradiation light to the path from the irradiation means to the stone and guiding the reflected light from the stone to the light reception means,
When irradiating the spectrum measurement irradiation light among the laser light irradiated from the infrared wavelength tunable laser, switch to the total reflection prism,
In the case of irradiating the calculus breaking laser beam among the laser beams irradiated from the infrared wavelength tunable laser, it is configured to switch to the condenser lens.
With the above configuration, a single optical fiber can be used in the apparatus.

In the first to third calculus diagnosis / crushing apparatuses, when the infrared wavelength tunable laser irradiates the calculus crushing laser beam, the pulse laser beam may be a pulse laser beam having a reduced pulse time width. preferable.
With the above configuration, the calculus can be crushed so as to gradually break the intermolecular bonds of the calculus component, and the calculus can be cut so that the calculus collapses, so that the risk of damaging human tissue is reduced. At the same time, there is no large fragment that would cause recurrence.

In the first to third stone diagnosing / crushing apparatuses, the infrared wavelength tunable laser is preferably capable of selectively irradiating laser light in a mid-infrared wavelength region of 5 to 10 μm.
The wavelength of strong absorption varies depending on the type and condition of the calculus, but if the infrared wavelength tunable laser can select the wavelength in the mid-infrared wavelength region of 5 to 10 μm, the optimum determined based on the results of spectral spectroscopy analysis Versatile laser crushing treatment can be performed to adjust to a suitable laser beam wavelength.

In the first to third calculus diagnosis / crushing apparatuses, it is preferable that the spectrum measurement irradiation light used in the spectrum measurement apparatus is white light.
If it is white light, it can be used as irradiation light for spectrum measurement in a wavelength region necessary for spectrum spectroscopic analysis.
In the first to third stone diagnosing and crushing apparatuses, it is preferable that the scan laser light emitted as the spectrum measurement irradiation light by the infrared wavelength variable laser is in the mid-infrared wavelength region of 2 to 15 μm. .
If spectral spectroscopic analysis can be performed in the mid-infrared wavelength region of 2 to 15 μm, data necessary for analysis of absorption spectra in most stones can be obtained.

Next, in the method for diagnosing and crushing stones using the infrared wavelength tunable laser of the present invention, the spectrum measurement device is used to irradiate the calculus with irradiation light for spectrum measurement, and the spectrum spectroscopy of the reflected light from the calculus. Do the analysis,
When irradiating the calculus with the tunable laser light using the infrared wavelength tunable laser and crushing the calculus, based on the result of spectral spectroscopy analysis of the calculus in the living body by the spectrum measuring device In this method, the wavelength of the calculus breaking laser beam of the infrared wavelength tunable laser is selected so that the absorption rate of the calculus is high.

  According to the calculus diagnosis / crushing apparatus according to the present invention, before irradiating the lithotripsy laser light, the spectrum measurement result is obtained by irradiating the calculus with the spectrum measurement irradiation light and analyzing the reflected light. By measuring the absorption spectrum of the calculus in question, it is possible to know the optimum laser wavelength for each calculus. Irradiation can crush stones.

  Hereinafter, the calculus diagnosis / crushing apparatus and the calculus diagnosis / crushing method of the present invention will be described in detail based on embodiments shown in the accompanying drawings. The present invention is not limited to these examples.

A calculus diagnosis / crushing apparatus 100 according to Embodiment 1 of the present invention will be described.
Fig.1 (a) is a figure which shows typically the structural example of the calculus diagnosis and crushing apparatus 100 which concerns on Example 1 of this invention. A calculus 200 in the living body is also shown. Although the endoscope apparatus is not shown, the optical fiber provided in the calculus diagnosis / crushing apparatus 100 is such that the distal end portion 40 is introduced to the calculus 200 by the guidance of the endoscope apparatus. FIG. 1B is a schematic enlarged view of the tip portion 40 and the components incorporated therein.

  As shown in FIG. 1A, a calculus diagnosis / crushing apparatus 100 according to the present invention includes an infrared wavelength tunable laser 10, a spectrum measuring apparatus 20, a first optical fiber 30, a second optical fiber 31, and a third optical fiber 32. The optical fiber tip 40 facing the calculus 200 is provided.

The infrared wavelength tunable laser 10 is a laser that irradiates and crushes the stone 200 with a calculus breaking laser beam, and is a wavelength tunable laser that can be irradiated by selecting a wavelength. For example, it is assumed that laser light can be selectively irradiated in a mid-infrared wavelength region of 5 to 10 μm. In addition to free electron lasers and quantum cascade lasers, mid-infrared wavelength tunable lasers can be used to convert wavelength of tunable lasers that oscillate in other wavelength regions such as near infrared using nonlinear optics such as difference frequency generation and optical parametric oscillation. There is something to do.
The laser beam used for calculus crushing is a laser beam in the mid-infrared wavelength region of 5 to 10 μm, and is adjusted so as to have a wavelength with a large absorption rate for the calculus as will be described later. As will be described later, since most of the wavelengths having a high absorption rate for stones are in the mid-infrared wavelength region of 5 to 10 μm, laser light can be variably and selectively irradiated in the mid-infrared wavelength region of 5 to 10 μm. Is preferred. Moreover, as will be described later, the calculus breaking laser is preferably pulsed laser light with a shortened pulse time width.
The infrared wavelength tunable laser 10 includes laser irradiation means, wavelength adjustment means, and the like (not shown).

Next, the spectrum measurement apparatus 20 is an apparatus that irradiates the calculus 200 with spectrum measurement irradiation light, receives the reflected light from the calculus 200, and performs a spectral spectroscopic analysis of the calculus 200. For example, a Fourier transform infrared spectrometer Can be used.
Here, for example, white light can be used as the irradiation light for spectrum measurement. Since white light includes light having a wide range of wavelengths, when white light is irradiated onto the calculus 200, the necessary spectral spectroscopic analysis can be performed by dispersing the reflection.

The first optical fiber 30 is a medium that provides an optical path for guiding the calculus breaking laser light emitted from the infrared wavelength tunable laser 10 to the in-vivo calculus 200 facing the optical fiber tip 40, and at the tip thereof. Is provided with a condenser lens 50 to be described later.
The second optical fiber 31 is a medium that provides an optical path for guiding the spectrum measurement irradiation light emitted from the spectrum measurement apparatus 20 to the calculus 200 in the living body, and a total reflection prism 60 described later is disposed at the tip thereof. ing.
The third optical fiber 32 is a medium that provides an optical path for guiding the reflected light from the calculus 200 to the light receiving means of the spectrum measuring apparatus 20, and a total reflection prism 60 described later is disposed at the tip thereof.

  The distal end portion 40 is a portion in which the distal ends of the respective optical fibers are gathered, and is disposed so as to face the calculus 200 by guidance of an endoscope apparatus operation (not shown).

  The condenser lens 50 is a lens that emits the calculus breaking laser light emitted from the infrared wavelength tunable laser 10 from the first optical fiber 30 and focuses it on the calculus 200.

  The total reflection prism 60 is arranged so that the spectrum measurement irradiation light irradiated toward the calculus 200 through the second optical fiber 31 is reflected by the calculus 200 and easily enters the third optical fiber 32 as reflected light. The prisms are arranged at the tips of the second optical fiber 31 and the third optical fiber 32. Since the spectrum measurement irradiation light does not need to be emitted from the tip of the optical fiber, it is preferable to totally reflect the irradiation light. In addition, in order to analyze the absorption spectrum of the calculus 200 with high accuracy, it is necessary to arrange the tip portion 40 so as to face the calculus 200 so that the total reflection prism 60 is in contact with the surface of the calculus 200.

  FIG. 1B is a diagram schematically showing the tip 40 and the internal components, and the optical path of the spectrum measurement irradiation light and the calculus breaking laser light. The calculus breaking laser light emitted from the infrared wavelength tunable laser 10 is emitted through the condenser lens 50 and focused on the calculus 200. As will be described later, the calculus 200 has an infrared wavelength laser beam having a large absorption rate, and the calculus 200 can efficiently give laser beam energy. Further, the spectrum measurement irradiation light passing through the second optical fiber 31 is totally reflected at the boundary surface where the calculus 200 and the total reflection prism are in contact, and the reflected light is incident on the third optical fiber 32 schematically. Has been.

  Here, it will be described that the calculus breaking laser beam is a pulsed laser beam with a short pulse time width. Since the pulsed laser beam has strong energy, when the calculus 200 is irradiated, when the continuous laser beam energy is applied, the calculus 200 surface may evaporate or physically break or bounce. With pulse laser light, laser light energy is given in a short period of time, so the stone can be crushed so as to gradually break the intermolecular bonds of the stone component on the focused surface part, and slowly It can be crushed to cut. The crushed powder becomes fine particles and the risk of damaging human tissue is reduced, and large crushed pieces that cause relapse do not remain.

Next, an example of the operation flow of the calculus diagnosis / crushing apparatus 100 according to the first embodiment of the present invention will be described in order.
First, the distal end portion 40 of the calculus diagnosis / crushing apparatus 100 is guided by the operation of the endoscope apparatus or the like until it contacts the calculus 200 in the living body (step 31 in FIG. 3). In order to accurately analyze the absorption spectrum of the calculus described later, it is preferable to arrange the total reflection prism 60 so as to contact the calculus.

  Next, the spectrum measurement apparatus 20 irradiates the stone 200 with the spectrum measurement irradiation light via the second optical fiber 31 (step 32 in FIG. 3). The spectrum measuring apparatus 20 receives the reflected light from the calculus 200 via the third optical fiber 32 and analyzes the spectral spectral waveform of the calculus 200 (step 33 in FIG. 3).

FIG. 2 is a diagram showing an example of the result of absorption spectrum spectroscopy of stones. A total of nine absorption spectrum spectroscopic results are shown for three stones belonging to three classifications. The horizontal axis represents wavelength, and the vertical axis represents absorption rate.
FIG. 2 (a) shows the absorption spectrum spectroscopic results of three stones belonging to cholesterol stone, FIG. 2 (b) shows the absorption spectroscopic results of three stones belonging to calcium carbonate stone, and FIG. The absorption spectrum spectroscopy result of three stones classified into stones is shown. Specifically, FIG. 2 (c) shows a case in which calcium phosphate is the main component (upper in the figure) and other components (in the figure and lower).
As can be seen from FIG. 2A to FIG. 2C, the absorption spectrum of the calculus has a characteristic pattern according to the type of its constituent components, and it can be seen that there is a peak with a large absorption rate.

For example, in the cholesterol stone shown in FIG. 2 (a), there is a large peak near 7 μm or 9.5 μm. By using an infrared laser of any of these wavelengths, the laser light energy is efficiently absorbed by the calculus 200, so that the calculus 200 can be efficiently crushed.
In addition, the calcium carbonate stone shown in FIG. 2B has a large peak in the vicinity of 6.5 to 7 μm. By using an infrared laser of this wavelength, laser light energy is efficiently absorbed by the calculus 200, so that the calculus 200 can be efficiently crushed.
In the calcium phosphate stone shown in FIG. 2 (c), there are large peaks in the vicinity of 6 to 6.5 μm and in the vicinity of 9 to 9.5 μm. By using an infrared laser of any of these wavelengths, the laser light energy is efficiently absorbed by the calculus 200, so that the calculus 200 can be efficiently crushed. Further, in the calculus of other components shown in FIG. 2C and below, there is a large peak in the vicinity of 6 to 6.5 μm. By using an infrared laser of this wavelength, laser light energy is efficiently absorbed by the calculus 200, so that the calculus 200 can be efficiently crushed.

  Next, the wavelength adjusting means of the infrared wavelength tunable laser 10 adjusts the wavelength of the lithotripsy laser light to be irradiated based on the spectral spectroscopic analysis result of the calculus 200 to a wavelength at which the absorption rate of the calculus 200 is large (step in FIG. 3). 34).

  Next, the infrared wavelength tunable laser 10 irradiates the calculus 200 with the calculus breaking laser beam through the first optical fiber 30 to crush the calculus (step 35 in FIG. 3).

  According to the calculus diagnosis / crushing apparatus of the present invention, it is possible to irradiate the calculus breaking laser light adjusted to the optimum wavelength for each calculus from the absorption spectrum of the calculus. On the other hand, in the conventional treatment method, the wavelength is determined by estimating the calculus component in advance from image information obtained by image diagnosis or the like, and therefore the optimum wavelength is not always selected. It will be understood that the excellent effect of the stone diagnosis and crushing apparatus of the present invention is achieved.

Next, a calculus diagnosis / crushing apparatus 100a according to Example 2 of the present invention will be described.
FIG. 4 is a diagram schematically illustrating a calculus diagnosis / crushing apparatus 100a according to the second embodiment of the present invention. The stone diagnosis / crushing apparatus 100a according to the second embodiment is designed to simplify the apparatus as a configuration in which the irradiation means of the spectrum measurement irradiation light used in the spectrum measurement apparatus 20a is shared by the laser irradiation means of the infrared wavelength variable laser 10a. It is a thing.

In the configuration example of FIG. 4, the spectrum measuring apparatus 20a is incorporated in the casing of the infrared wavelength variable laser 10a, and the irradiation means for the spectrum measurement irradiation light is the laser irradiation means of the infrared wavelength variable laser 10a. It becomes the structure which is shared by.
A mechanism (not shown) for switching the optical path of laser light emitted from the infrared wavelength tunable laser 10a is built in, and when the scan laser light is emitted from the infrared wavelength tunable laser 10a, the second optical fiber 31a is provided. It is structured to be switched so that it is guided to the first optical fiber 30a when it is irradiated with the calculus breaking laser beam.

The spectrum measurement irradiation light is white light in the configuration of the first embodiment, but in the second embodiment, an infrared wavelength tunable laser is used, so that the wavelength scan laser light is used. Since the laser light itself is a light beam having a uniform wavelength, in order to analyze the absorption spectrum of the calculus 200 in a predetermined wavelength region, a laser light group that can be scanned while changing the wavelength at a fine sampling interval by the wavelength adjusting means is necessary. It is. That is, in the present invention, the wavelength scanning laser light is a light group including various wavelengths at sampling intervals that are fine enough to reproduce the absorption spectrum waveform of the calculus 200 within the wavelength region to be scanned. This corresponds to a group of laser beams that are irradiated in order from the short wavelength in the wavelength region to the length corresponding to the sampling interval.
It is preferable that the scan laser light emitted as the spectrum measurement irradiation light by the infrared wavelength variable laser is in the mid-infrared wavelength region of 2 to 15 μm. If the absorptivity in this wavelength region is collected at a predetermined sampling interval, it can be used for the absorption spectrum analysis of the calculus 200.

When the scan laser light of the second embodiment is used as spectrum measurement light, the absorptance obtained directly from the reflected light is a discrete value plotted as each value of a predetermined sampling interval, but the sampling interval is sufficient. If it is fine (if it satisfies the sampling theorem), a waveform almost identical to the absorption spectrum waveform of the calculus 200 shown in FIG. 2 can be reproduced.
In the configuration of FIG. 4, other components other than the components related to the configuration in which the irradiation unit of the spectrum measurement irradiation light used in the spectrum measuring apparatus 20a is also used by the laser irradiation unit of the infrared wavelength variable laser 10a are implemented. Since this is the same as that described in Example 1, description thereof is omitted here.

FIG. 5 shows an example of the operation flow of the calculus diagnosis / crushing apparatus 100a according to the second embodiment.
First, the distal end portion 40a of the calculus diagnosis / crushing apparatus 100a is guided by the operation of the endoscope apparatus or the like until it comes into contact with the calculus 200 in the living body (step 51 in FIG. 5).

  Scanning laser light is emitted as irradiation light for spectrum measurement toward the calculus 200 by the infrared wavelength tunable laser 10a (step 52 in FIG. 5).

  The spectrum measuring apparatus 20a receives the reflected light from the calculus 200, reproduces the absorption spectrum waveform based on the discrete values obtained in the scan wavelength region, and performs spectral spectroscopic analysis of the calculus 200 (step 53 in FIG. 5).

  Next, the wavelength adjusting means of the infrared wavelength tunable laser 10a adjusts the wavelength of the lithotripsy laser light to be irradiated based on the spectral spectroscopic analysis result of the calculus 200 to a wavelength at which the absorption rate of the calculus 200 is large (step in FIG. 5). 54).

  Next, the infrared wavelength tunable laser 10a irradiates the calculus 200 with a calculus breaking laser beam to crush the calculus (step 55 in FIG. 5).

  As described above, according to the calculus diagnosis / crushing apparatus 100a of the second embodiment, the apparatus is simplified as a configuration in which the irradiation means of the spectrum measurement irradiation light used in the spectrum measurement apparatus 20a is also used as the laser irradiation means of the infrared wavelength variable laser 10a. Can be realized.

Next, a calculus diagnosis / crushing apparatus 100b according to Example 3 of the present invention will be described.
FIG. 6A is a diagram schematically showing a calculus diagnosis / crushing apparatus 100b according to Example 3 of the present invention. The calculus diagnosis / crushing apparatus 100b according to the third embodiment is a device that simplifies the apparatus by using a second optical fiber and a third optical fiber as a single first optical fiber 33b.
That is, the spectrum measurement irradiation light emitted from the spectrum measuring apparatus 20b is guided to the calculus 200 through the first dual-purpose optical fiber 33b, and the reflected light from the calculus 200 is again transmitted through the first dual-use optical fiber 33b. The structure returns to the light receiving means of the spectrum measuring apparatus 20. In FIG. 6A, the spectrum of the reflected light from the optical path of the irradiation light for spectrum measurement is performed inside the spectrum measurement apparatus 20b, and the spectrometer is not shown.

  FIG. 6B is a diagram schematically showing the configuration of the spectrometer. Since the single first optical fiber 33b is also used as an optical path for the spectrum measurement irradiation light and its reflected light, the spectrum measurement irradiation light is irradiated on the path from the tip 40b to the spectrum measurement device 20b. It is necessary to have a configuration including a spectroscope that guides the reflected light returning from the calculus 200 to the path toward the light receiving means 22 of the spectrum measuring device 20b while guiding the path from the calculus 200 to the calculus 200. The spectroscope may use optical means such as a beam splitter.

  FIG. 7 schematically shows the structure of the tip 40b in the configuration of the third embodiment. At the tip of the first dual-purpose optical fiber 33b, a total reflection prism 60b is provided on the surface facing the calculus 200. The spectrum measurement irradiation light is totally reflected at the boundary surface of the calculus 200 from the first dual-purpose optical fiber 33b by the total reflection prism 60b, and returns to the first dual-purpose optical fiber 33b again.

  As the total reflection prism 60b, a small total reflection prism 60b may be prepared as shown in FIG. 7A, and as shown in FIG. A coating with a specularity is applied, and the angle is adjusted so as to satisfy the total reflection even for light incident on the total reflection prism 60b at an angle that does not satisfy the total reflection condition, and a high reflectance is obtained. It is also possible to give a device to obtain.

  In the configuration of FIG. 6, the other components other than the configuration in which the second optical fiber and the third optical fiber are shared by the single first optical fiber 33b are the same as those described in the first embodiment. Therefore, explanation here is omitted.

FIG. 8 shows an example of the operation flow of the stone diagnosis / crushing apparatus 100b according to the third embodiment.
First, the distal end portion 40b of the calculus diagnosis / crushing apparatus 100b is guided until it comes into contact with the calculus 200 in the living body by operating the endoscope apparatus or the like (step 81 in FIG. 8).

  Next, the spectrum measurement device 20b irradiates the stone 200 with the spectrum measurement irradiation light via the first dual-purpose optical fiber 33b (step 82 in FIG. 8).

  The reflected light totally reflected at the boundary surface between the total reflection prism 60b and the calculus 200 returns to the spectrum measuring device 20b again via the first dual-purpose optical fiber 33b, and the spectrum measuring device 20b performs a spectral spectral waveform analysis of the calculus 200 (FIG. 8 step 83).

  Next, the wavelength adjusting means of the infrared wavelength tunable laser 10b adjusts the wavelength of the calculus breaking laser light to be irradiated on the basis of the spectral spectroscopic analysis result of the calculus 200 (step in FIG. 8). 84).

  Next, the infrared wavelength tunable laser 10b irradiates the calculus 200 through the first optical fiber 30b with the calculus crushing laser beam to crush the calculus (step 85 in FIG. 8).

  As described above, according to the calculus diagnosis / crushing apparatus of the third embodiment, the apparatus can be simplified by adopting a configuration in which the second optical fiber and the third optical fiber are shared by the single first optical fiber 33b.

  Next, a configuration example in which the configuration of the third embodiment and the configuration of the second embodiment are combined will be described. In other words, the configuration in which the second optical fiber and the third optical fiber are shared by the single first optical fiber 33c, and the irradiation means of the spectrum measurement irradiation light used in the spectrum measuring apparatus 20c is the laser of the infrared wavelength variable laser 10c. This is combined with a configuration that is also used by the irradiation means.

  FIG. 9 is a diagram schematically showing a calculus diagnosis / crushing apparatus 100c according to Example 4 of the present invention. The stone diagnosis / crushing apparatus 100c according to the third embodiment has a configuration in which the spectrum measuring apparatus 20c is incorporated in the casing of the infrared wavelength variable laser 10c, and the irradiation means for the irradiation light for spectrum measurement is variable in the infrared wavelength. The laser 10c is configured to be shared by the laser irradiation means. In addition, the first optical fiber 33c is used as the second optical fiber and the third optical fiber.

  In this configuration example, the scan laser light emitted from the infrared wavelength tunable laser 10c is guided to the calculus 200 through the first dual-purpose optical fiber 33c, and the reflected light from the calculus 200 is again the first dual-purpose optical fiber 33c. Until the reflected light returns to the spectrum measuring device 20c, the reflected light is split with the scan laser light and input to the light receiving means side of the spectrum measuring device 20c.

  In the configuration of FIG. 9, the configuration in which the second optical fiber and the third optical fiber are shared by the single first optical fiber 33c, and the irradiation means for the spectrum measurement irradiation light used in the spectrum measuring apparatus 20c are infrared. Since the other components other than the configuration shared by the laser irradiation means of the wavelength tunable laser 10c are the same as those described in the first embodiment, the description thereof is omitted here.

FIG. 10 shows an example of the operation flow of the calculus diagnosis / crushing apparatus 100c according to the fourth embodiment.
First, the distal end portion 40c of the calculus diagnosis / crushing apparatus 100c is guided by the operation of the endoscope apparatus or the like until it comes into contact with the calculus 200 in the living body (step 101 in FIG. 10).

  Next, the infrared wavelength variable laser 10c irradiates the calculus 200 with scan laser light through the first optical fiber 33c (step 102 in FIG. 10).

  The reflected light totally reflected at the boundary surface between the total reflection prism 60c and the calculus 200 returns to the spectrum measurement device 20c again via the first dual-purpose optical fiber 33c, and the spectrum measurement device 20c performs spectral spectral waveform analysis of the calculus 200 (FIG. 10 step 103).

  Next, the wavelength adjusting means of the infrared wavelength tunable laser 10c adjusts the wavelength of the lithotripsy laser light to be irradiated based on the spectral spectroscopic analysis result of the calculus 200 to a wavelength at which the absorption rate of the calculus 200 is large (step in FIG. 10). 104).

  Next, the infrared wavelength tunable laser 10c irradiates the calculus 200 with the calculus breaking laser beam through the first optical fiber 30c, and crushes the calculus (step 105 in FIG. 10).

  As described above, according to the calculus diagnosis / crushing apparatus 100c of the fourth embodiment, the configuration in which the second optical fiber and the third optical fiber are combined with the single first optical fiber 33c, and the spectrum measurement used in the spectrum measurement apparatus 20c. The apparatus can be simplified as a configuration in which the irradiation means of the irradiation light is shared by the laser irradiation means of the infrared wavelength variable laser 10c.

Next, a calculus diagnosis / crushing apparatus 100d according to Example 5 of the present invention will be described.
Fig.11 (a) is a figure which shows typically the calculus diagnosis and crushing apparatus 100d which concerns on Example 5 of this invention. The calculus diagnosis / crushing apparatus 100d according to the fifth embodiment has a configuration in which the first optical fiber, the second optical fiber, and the third optical fiber are combined with one second dual-purpose optical fiber 34d. Further, the apparatus is simplified as a structure in which the irradiation means of the spectrum measurement irradiation light used in the spectrum measurement apparatus 20d is also used as the laser irradiation means of the infrared wavelength variable laser 10d.

In the configuration of FIG. 11A, the infrared wavelength tunable laser 10d has a configuration in which a spectrum measuring device 20d is incorporated, and the irradiation means of the spectrum measurement irradiation light for examining the absorption spectrum of the calculus is an infrared wavelength tunable laser. The scanning laser beam from 10d is used.
In the fifth embodiment, the optical path of the spectrum measurement irradiation light, the reflected light, and the lithotripsy laser light are shared by the single second dual-purpose optical fiber 34d.

  First, since the optical path of the scanning laser light and the optical path of the reflected light that serve as the spectral measurement irradiation light are combined, in this example, the spectral measurement irradiation light is irradiated from the irradiation means to the calculus 200 in the infrared wavelength variable laser 10d. There is a built-in spectroscope that guides the reflected light from the calculus 200 to the path toward the light receiving means of the spectrum measuring device 20d.

  Next, since the optical path of the scanning laser light serving as the spectrum measurement irradiation light and the optical path of the calculus breaking laser light are shared by the single second dual-purpose optical fiber 34d, switching of the optical system elements at the tip 40d, that is, The condensing lens 50d and the total reflection prism 60d must be switched. FIG. 11B schematically shows the principle that the arrangement can be switched by rotating the condenser lens 50d and the total reflection prism 60d incorporated in the rotary top.

  On the left side of FIG. 11B, the total reflection prism 60d is selected by rotating the rotary frame 41d when irradiating the scan laser light which is the spectrum measurement irradiation light among the laser lights irradiated from the infrared wavelength variable laser 10d. It is a figure which shows typically a mode that was done.

  The right side of FIG. 11B shows a state where the condensing lens 50d is selected by rotating the rotary piece 41d when irradiating the calculus breaking laser light among the laser light emitted from the infrared wavelength tunable laser 10d. FIG.

  In the configuration of FIG. 11, the configuration in which the first optical fiber, the second optical fiber, and the third optical fiber are shared by one second dual-purpose optical fiber 34d, and the spectrum measurement irradiation light used in the spectrum measuring apparatus 20d are used. The other components other than the configuration in which the irradiating means is also used by the laser irradiating means of the infrared wavelength variable laser 10d are the same as those described in the first embodiment, and thus the description thereof is omitted here.

FIG. 12 shows an example of the operation flow of the calculus diagnosis / crushing apparatus 100d according to the fifth embodiment.
First, the distal end portion 40d of the calculus diagnosis / crushing apparatus 100d is guided until it comes into contact with the calculus 200 in the living body by operating the endoscope apparatus or the like (step 121 in FIG. 12).

  The rotary piece 41d is rotated and adjusted so that the total reflection prism 60d is positioned at the boundary surface between the tip of the second dual-purpose optical fiber 34d and the calculus 200 (step 122 in FIG. 12).

  Next, a scan laser beam is irradiated to the calculus 200 by the infrared wavelength variable laser 10d through the second dual-purpose optical fiber 34d (step 123 in FIG. 12).

  The reflected light totally reflected at the boundary surface between the total reflection prism 60d and the calculus 200 returns to the spectrum measurement device 20d again through the second dual-purpose optical fiber 34d, and the spectrum measurement device 20d performs a spectrum spectral waveform analysis of the calculus 200 (FIG. 12 step 124).

  Next, the rotary piece 41d is rotated and adjusted so that the condenser lens 50d is positioned at the boundary surface between the tip of the second combined optical fiber 34d and the calculus 200 (step 125 in FIG. 12).

  Next, the wavelength adjusting means of the infrared wavelength tunable laser 10d adjusts the wavelength of the lithotripsy laser light to be irradiated based on the spectral spectroscopic analysis result of the calculus 200 to a wavelength at which the absorption rate of the calculus 200 is large (step in FIG. 12). 126).

  Next, the infrared wavelength tunable laser 10d irradiates the calculus 200 through the second combined optical fiber 34d with the calculus crushing laser beam to crush the calculus (step 127 in FIG. 12).

  As described above, according to the calculus diagnosis / crushing apparatus 100d of the fifth embodiment, the configuration in which the first optical fiber, the second optical fiber, and the third optical fiber are combined with the single second optical fiber 34d, and the spectrum measuring apparatus. The apparatus can be simplified as a configuration in which the irradiation means of the spectrum measurement irradiation light used in 20d is also used as the laser irradiation means of the infrared wavelength variable laser 10d.

  As mentioned above, although the preferable Example in the structural example of the calculus diagnosis and crushing apparatus of this invention was illustrated and demonstrated, it is understood that various changes are possible without deviating from the technical scope of this invention. I will.

  The stone diagnosis / crushing device of the present invention can be widely applied to stone diagnosis devices and stone treatment devices such as gallstones, ureter stones and kidney stones generated in the living body.

The figure which shows typically the structural example of the calculus diagnosis and the crushing apparatus 100 which concerns on Example 1 of this invention. The figure which shows the absorption spectrum spectroscopy result of the calculus The figure which shows an example of the flow of operation | movement of the calculus diagnosis and crushing apparatus 100 which concerns on Example 1 of this invention. The figure which shows typically the structural example of the calculus diagnosis and crushing apparatus 100a which concerns on Example 2 of this invention. The figure which shows an example of the flow of operation | movement of the stone diagnosis / crushing apparatus 100a which concerns on Example 2 of this invention. The figure which shows typically the structural example of the calculus diagnosis and crushing apparatus 100b which concerns on Example 3 of this invention. The figure which shows typically the structure of the front-end | tip part 40b in the structure of the present Example 3. The figure which shows an example of the flow of operation | movement of the calculus diagnosis and crushing apparatus 100b which concerns on Example 3 of this invention. The figure which shows typically the structural example of the calculus diagnosis and crushing apparatus 100c which concerns on Example 4 of this invention. The figure which shows an example of the flow of operation | movement of the stone diagnosis / crushing apparatus 100c which concerns on Example 4 of this invention. The figure which shows typically the structural example of the calculus diagnosis and crushing apparatus 100d which concerns on Example 5 of this invention. The figure which shows an example of the flow of operation | movement of the calculus diagnosis and crushing apparatus 100d which concerns on Example 5 of this invention.

Explanation of symbols

DESCRIPTION OF SYMBOLS 10 Infrared wavelength tunable laser 20 Spectrum measuring device 30 1st optical fiber 31 2nd optical fiber 32 3rd optical fiber 33 1st combined optical fiber 34 2nd combined optical fiber 40 Tip part 41 Rotation piece 50 Condensing lens 60 Total reflection Prism 100 Calculus diagnosis and crushing device 200 Calculus

Claims (9)

Infrared wavelength tunable laser that irradiates stones with stone light for crushing stones and crushes them,
A first optical fiber having a condensing lens at the tip, and guiding the lithotripsy laser light emitted from the infrared wavelength variable laser to the calculus in the living body;
A spectrum measuring device that irradiates wavelength scanning laser light from the infrared wavelength tunable laser toward the stone as irradiation light for spectrum measurement, receives reflected light from the stone by a light receiving means, and performs spectral spectroscopy analysis of the stone;
A second optical fiber for guiding the spectral measurement irradiation light irradiated from the irradiation means of the spectral measurement device to the stones in the body,
Of the laser light emitted from the infrared wavelength tunable laser, when irradiating the scan laser light, it is guided to the second optical fiber, and when irradiating the calculus breaking laser light, the first optical fiber. Switching means leading to
A third optical fiber for guiding the reflected light from the calculus to the light receiving means of the spectrum measuring device;
The wavelength of the calculus breaking laser light irradiated with the infrared wavelength tunable laser so that the absorption light of the calculus becomes a laser light having a large absorption rate based on the spectral spectroscopic analysis result of the calculus in the living body by the spectrum measuring device. A stone diagnosis and crushing device that selects and crushes stones by irradiating them.   The second optical fiber so that the spectrum measurement irradiation light irradiated toward the stone through the second optical fiber is reflected on the stone and easily enters the third optical fiber as the reflected light. The calculus diagnosis / crushing apparatus according to claim 1, further comprising a total reflection prism on a surface of the third optical fiber facing the calculus. The second optical fiber and the third optical fiber are combined into a single first optical fiber,
The first dual-purpose optical fiber includes the total reflection prism on a surface facing the calculus, and directs the spectrum measurement irradiation light from the irradiation unit to the calculus on a path from the facing surface to the spectrum measuring device. The calculus diagnosis / crushing apparatus according to claim 2, further comprising a spectroscope that guides the reflected light from the calculus to the path toward the light receiving means while guiding the reflected light from the calculus to the path.   The wavelength scanning laser light for irradiating the spectrum measurement irradiation light from the infrared wavelength tunable laser, wherein the irradiation means of the spectrum measurement irradiation light used in the spectrum measuring apparatus is also used as the infrared wavelength variable laser. Of the laser light emitted from the infrared wavelength tunable laser, when irradiating the scan laser light, it is guided to the first combined optical fiber, and when irradiating the stone crushing laser light, the first The calculus diagnosis / crushing apparatus according to claim 3, wherein the calculus diagnosis / crushing apparatus is guided to one optical fiber. The first optical fiber, the second optical fiber, and the third optical fiber are combined with a single second optical fiber,
The second dual-purpose optical fiber has a configuration in which the condensing lens and the total reflection prism can be switched on a surface facing the calculus, and the laser beam is on a path from the facing surface to the spectrum measuring device. And a spectroscope for guiding the spectrum measurement irradiation light to the path from the irradiation means to the stone and guiding the reflected light from the stone to the light reception means,
When irradiating the spectrum measurement irradiation light among the laser light irradiated from the infrared wavelength tunable laser, switch to the total reflection prism,
The calculus diagnosis / crushing apparatus according to claim 2, wherein the calculus crushing laser light is irradiated with the calculus crushing laser light among the laser light emitted from the infrared wavelength tunable laser.   The calculus according to any one of claims 1 to 5, wherein the infrared wavelength tunable laser is a pulse laser beam with a short pulse time width when irradiating the calculus breaking laser beam. Diagnosis and crushing equipment.   The calculus diagnosis / crushing apparatus according to any one of claims 1 to 6, wherein the infrared wavelength tunable laser can selectively irradiate a laser beam in a mid-infrared wavelength region of 5 to 10 µm.   The calculus diagnosis / crushing apparatus according to claim 1, wherein the spectrum measurement irradiation light used in the spectrum measurement apparatus is white light.   2. The calculus diagnosis / crushing apparatus according to claim 1, wherein the scan laser beam irradiated by the infrared wavelength tunable laser as the spectrum measurement irradiation light is in the mid-infrared wavelength region of 2 to 15 μm.

Images