JPH0256098B2 - - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION a. Technical Field The present invention relates to a method of irradiating a tip rod member that comes into contact with tissue for the purpose of coagulation and incision.

b. Prior art and its problems Surgical therapy in which the distal end of a transmission fiber and a transparent rod member are optically connected and the distal end of the rod member is brought into contact with the affected tissue to perform incision and coagulation has already been put to practical use. ing. In the conventional method of irradiation from the distal end of the rod member, the distal end of the rod member was brought into contact with the affected tissue, and the irradiation foot switch was turned on to irradiate the tissue.

Confirmation of whether the tip of the rod member has come into contact with the affected tissue is carried out both visually and intuitively, and after confirmation, a laser beam is irradiated and used for treatment. Ta.

However, especially in endoscopic treatment, it is extremely difficult to confirm contact between the affected area and the rod member, and even if the rod member temporarily contacts a pulsating area, the laser beam It was difficult to time the irradiation, and it was not possible to provide accurate treatment irradiation. In addition, if the tip of the rod member is sharp and it is in contact with the affected tissue, if it is misidentified and the contact operation is continued, the tip of the rod member may pierce the tissue, resulting in , there was always the risk of bleeding or perforation.

Furthermore, in the conventional device, when the switch for laser irradiation is turned on, laser irradiation is performed from the tip of the rod member even when it is not necessary, which is very dangerous.

c. Purpose of the Invention The present invention has been made to solve the above-mentioned problems, and by making it possible to irradiate laser light only when the rod member comes into contact with tissue, it is possible to irradiate the affected area with laser light. This laser scalpel device is designed to be able to irradiate the rod member accurately and efficiently, to prevent erroneous irradiation of the laser beam, and to eliminate the risk of the tip of the rod member penetrating the tissue. This is what we intend to provide.

In order to achieve the above object, the medical laser scalpel according to the present invention includes a device for introducing irradiation light and detection light into a transmission fiber while forming a coaxial optical axis, and an optical device at the tip of the fiber. a rod member coupled to the rod member, a device for detecting the reflected light of the detection light from the output end face of the rod member, and transmitting the illumination light only when the amount of the reflected light becomes less than a certain reference level. It consists of a switching device that is introduced into the fiber.

d Configuration of the example The present invention will be explained below based on the drawings.

FIG. 1 is an external view of the tip of a laser scalpel showing an embodiment of the present invention. A laser fiber 1 that transmits laser power light is inserted into a gripper 2 and fixed with a nut-shaped fixture 3. A similar nut-shaped fitting 4 is provided at the distal end of the gripping tool 2, and is used for fixing the rod member 5. The gripping tool 2 is provided with a switch 6 for irradiating laser power light. The rod member 5 is removable and has a conical shape in this embodiment, and serves as a scalpel that is brought into contact with the affected area 7, which is the area to be irradiated with the laser beam.

Next, the entire laser scalpel device will be explained based on FIG. A shutter 9 for cutting off the laser beam, a half mirror 10, a mirror 11 with a hole in the center, and a condensing lens 12 are provided on the optical axis of the laser beam emitted from the irradiation light source 8, such as a YAG laser. Laser power light is made incident on the incident end face. The half mirror 10 is provided at an angle of 45 degrees on the optical axis of the laser power light, and is arranged so that the light emitted from the detection light source 13 such as a semiconductor laser is overlapped on the same axis. ing. Similarly to the half mirror 10, the perforated mirror 11 is also provided with its reflective surface facing the shutter drive system at an angle of 45 degrees.

The shutter drive system includes an irradiation cut filter 14, a photodetector 15, an amplifier circuit 16, a relay circuit 17, and a shutter drive circuit 18, which are arranged to operate in conjunction with the shutter 9. Relay circuit 1
7 is a manual switch 6 or a foot switch 19 provided on the gripping tool 2 shown in FIG.
It is connected to a device equipped with one of the following.

e. Effect of the Embodiment With this configuration, since the shutter 12 is in the closed state, the light introduced into the laser fiber and guided to the rod member is only the semiconductor laser light emitted from the detection light source. At this time, since the output end face of the rod member is optically polished, a portion of the semiconductor laser light is reflected by the output end face of the rod member, returns through the laser fiber, and passes through the condenser lens. The light is partially reflected by a mirror, passes through a cut filter, and enters a photodetector. The photodetector detects a change in the amount of reflected light. For example, when the output end face of the rod member comes into contact with tissue to be incised or coagulated, the light intensity level at the photodetector may be set as follows to detect the difference in reflected light. This will be explained using the graph in FIG. In this graph, A indicates the setting level, B indicates the reflection characteristics when the emitting end surface of the rod member is not in contact with the tissue, that is, it is in the air, and C indicates the reflection characteristic when the tip of the rod member is in contact with the tissue. It shows the reflection characteristics of time. As can be seen from this graph, the amount of reflected light in case B is higher than that in case A. C indicates that the amount of reflected light is smaller than A.

Here, since the photodetector, amplifier circuit, switch, and relay circuit are configured as an And circuit,
The switch signal is negative, that is, the switch status is OFF.
At this time, even if the signal from the photodetector is introduced into the relay circuit in a positive state, the shutter drive circuit will not operate and the shutter will remain closed, and the laser beam from the irradiation light source will be directed to the tip of the rod member. It is not fired from. When the switch is turned on, that is, a positive signal is introduced into the relay circuit, if the tip of the rod member comes into contact with the affected area, the reflected light quantity characteristics will be in the state shown in graph C, and the signal will be sent to the relay circuit as a positive signal. Therefore, the signal from the relay circuit is also introduced as a positive signal into the shutter drive circuit, and the shutter is opened and the laser beam is irradiated onto the affected area from the tip of the rod member for treatment.

f Effects of the Invention The medical laser scalpel according to the present invention includes a device for introducing irradiation light and detection light into a transmission fiber while forming a coaxial optical axis, and a device optically coupled to the tip of the fiber. a rod member, a device for detecting the reflected light of the detection light from the output end face of the rod member, and introducing the illumination light into the transmission fiber only when the amount of the reflected light becomes less than a certain reference level. Since it is constructed with an opening/closing device that allows the rod member to emit a laser beam at the moment the tip of the rod comes into contact with the site, treatment can be performed more accurately with the same feel as a conventional surgical scalpel. In addition, when the purpose is to incise a particular site, deep incision can be made by further inserting the tip of the laser scalpel into the incision. Furthermore, it eliminates the danger of ambiguity in confirming the contact between the rod member and the affected area under the endoscope, and also prevents troubles caused by erroneous firing of laser light when unnecessary.
Safety can also be ensured.

Since the structure is extremely simple, there is no need to improve the conventional rod member gripping tool or the rod member at the tip of the fiber used under an endoscope. Since there is no need to change the structure, the manufacturing cost is also low, and its practicality is extremely high.

[Brief explanation of drawings]

Fig. 1 is an external view of the tip of a laser scalpel showing an embodiment of the present invention, Fig. 2 is a block diagram for explaining the laser scalpel device, and Fig. 3 is a graph showing the light intensity level at the photodetector. be. 1... Laser fiber, 5... Rod member, 6... Irradiation switch, 8... Irradiation light source,
9...Shutter, 10...Half mirror, 11
... Mirror with hole, 12 ... Condensing lens, 1
3...Light source for detection, 14...Cut filter for irradiation, 15...Photodetector, 16...Amplification circuit, 1
7... Relay circuit, 18... Shutter drive circuit.

Claims (1)

[Scope of Claims] 1. A device for introducing irradiation light and detection light into a transmission fiber while forming a coaxial optical axis, a rod member optically coupled to the tip of the fiber, and the rod member. a device for detecting the reflected light of the detection light from the emission end face of the device; and an opening/closing device for introducing the irradiated light into the transmission fiber only when the amount of the reflected light becomes less than a certain reference level. A medical laser scalpel device featuring: 2. Claim 1, characterized in that, with respect to an arbitrary reference level of the current of the reflected light, the switching device introduces the irradiated light into the transmission fiber only when the current level of the reflected light is lower than the reference level. Laser scalpel device as described. 3. The laser scalpel device according to claim 1, characterized in that a switch circuit is introduced into a relay circuit linked to the device for detecting the reflected light.