JPH0382482A - Laser treatment device - Google Patents

Abstract

PURPOSE:To perform prompt and proper medical treatment of the affected part by means of laser irradiation by controlling both a detecting means for decting the affected part by inputting a detecting signal by means of ultrasonic waves and a detecting signal by means of fluorescence, and a medical treatment means by means of laser through a signal from the detecting means. CONSTITUTION:It is so contrived that fluorescence is introduced from a fluorescence observing device 9 via an optical-part changeover part 8 for obtaining fluorescence from the inner wall of the body cavity, and that the light signal is input into a control unit 16. When an excitation light is irradiated on the neighborhood of the affected part, fluorescence is emitted only from the cancer part being the affected part. In this condition, irradiation is carried out by means of the control unit 16. As the control methods, there are such methods - when either of the detecting signal from a ultrasonic wave observing device 13 or the detecting signal from the fluorescence observing device 9 is input, emission of radiation of laser is carried out through a laser device 12; or when both of the signals are input, emission of radiation of laser is carried out. Thus, after the affected part has been detected, prompt and proper irradiation of laser can be carried out for treating the affected part.

Description

DETAILED DESCRIPTION OF THE INVENTION [Field of Industrial Application] The present invention relates to a laser treatment device, and is particularly used for treating an affected area within a body cavity.

[Conventional technology]

It is well known that laser treatments are used to remove abnormal formations in weak areas within body cavities that would be extremely dangerous to remove with a regular scalpel, and to destroy tissue around tumors. It is. To date, many cases of successful treatment of malignant tumors using lasers have been reported.

In this laser device, methods for detecting the affected area include, for example, a method using ultrasound and a method using fluorescence observation. In order to shorten the time from detection of the affected area to treatment, and to avoid misalignment of the treatment device with respect to the affected area and enable prompt and appropriate laser irradiation, the treatment device is controlled based on the detected information. , treatments have been proposed.

[Problem to be solved by the invention]

However, the conventional laser treatment apparatus described above has the following problems. In other words, if ultrasound is used at the stage of detecting the affected area, it is possible to determine the hardness inside the affected area, but
The surface condition cannot be properly grasped. On the other hand, fluorescence observation has the disadvantage that only the surface of the affected area can be seen.

Furthermore, after detecting the affected area, a laser treatment device is activated to perform treatment such as excision of the affected area, but there is a problem in that it is difficult to perform treatment quickly due to the timing deviation of laser irradiation. Furthermore, although it is sufficient to apply laser irradiation only to the affected area, there is a risk that unnecessary areas will be irradiated due to the operation of the laser treatment device.

The present invention is proposed to solve the above-mentioned problems.
The purpose of the present invention is to provide a laser treatment device that achieves safety and reliability of laser treatment.

[Means and effects for solving the problem] In order to achieve the above object, the present invention provides a laser treatment means having a detection means for detecting an affected area and a laser treatment means, in which an ultrasonic detection signal and a fluorescence detection signal are used. and a control means for controlling the laser treatment means based on the signal from the detection means.

In this way, by controlling the laser treatment means based on the ultrasonic detection signal and the fluorescence detection signal, treatment can be performed according to the condition of the affected area. Further, since the laser is emitted based on the signal from the detection means, the timing for laser emission is not lost, and the laser can be emitted appropriately only at the necessary locations.

〔Example〕

FIG. 1 shows a first embodiment of the present invention. This embodiment combines an endoscope with a laser treatment device, and the tip of the endoscope is as shown in FIG. An ultrasonic transducer 2 is provided at the tip of the curved part 1, and the ultrasonic transducer 2 rotates inside the storage part 3 so as to radiate ultrasonic waves from the scanning window 4 approximately 360 times over the entire circumference. It's Nishide. The ultrasonic waves emitted toward the inner wall of the body cavity propagate to the living body deep within the inner wall, and the ultrasonic waves reflected from there are received again by the ultrasonic transducer 2 and converted into electrical signals.

After this electrical signal is amplified and detected by an amplification/detection circuit, it is connected to the ultrasonic observation device 13 and displayed on a display device (monitor 14).
The ultrasonic tomographic image from the inner wall of the body cavity to the deep part of the inner wall is displayed, and if there is an affected area, its position and depth can be detected.

The light source device 15 is a device that supplies light for endoscopic observation.

An insertion channel 5 is formed in the body cavity insertion section including the tip of the endoscope and in the vicinity of the operator's hand, and an optical fiber 6 is inserted through the insertion channel 5. The optical fiber 6 extends in parallel with the ultrasound transducer rotating shaft 7 into which a signal cable is inserted, and its tip protrudes from the vicinity of the ultrasound transducer 2 to the outside of the endoscope tip. There is.

The optical fiber 6 is guided to a fluorescence observation device 9 via an optical path switching section 8. The fluorescence observation device 9 includes an excitation light source 1.
0 and a spectroscopic analyzer 11 are provided.

Furthermore, the optical fiber 8 is guided to a laser device 12 via an optical path switching section 8 . Therefore, excitation light for fluorescence observation and fluorescence can be guided through the optical fiber 6, and therapeutic laser light can also be guided.

Fluorescence observation device 9, laser device 12, ultrasonic observation device 13
are respectively connected to a control device 16 that controls them.

To perform treatment with the laser treatment device configured in this way, first insert the endoscope insertion section into the body cavity, and when it comes close to the treatment area, the operator can scan the endoscope at the end of the insertion section. A drive signal is sent to a certain ultrasonic transducer 2 to drive it. The ultrasonic transducer 2 rotates while emitting ultrasonic waves from the inner wall of the body cavity to the deep part, receives echo signals, performs necessary signal processing, and displays an ultrasonic tomographic image on a monitor 14 connected to an observation device 13. do. At the same time, a signal due to acoustic impedance is sent to the control device 16 via the ultrasonic observation device 13.
is input.

On the other hand, fluorescence is guided from the fluorescence observation device 9 via the optical path switching unit 8, and the fluorescence is obtained from the inner wall of the body cavity.
Make sure that the optical signal is input to the

Note that fluorescence is emitted only from the cancerous part, which is the affected part, when the vicinity of the affected part is irradiated with excitation light.

In this state, the control device 16 performs laser irradiation. As a control method, when there is a detection signal from the ultrasonic observation device 13 or a detection signal from the fluorescence observation device 9, the laser device 12 emits the laser, or both signals are emitted. There is a method in which the laser is emitted when .

After detecting the affected area in this way, the affected area can be treated quickly and appropriately by laser irradiation.

By the way, if there is a detection signal only from the fluorescence observation device 9, it means that the cancer is only on the surface of the affected area, so we emit a Co laser, which is a gas laser, and destroy the cancer cells.
If there is also a detection signal from the ultrasonic observation device 13, the cancer cells have progressed deep into the affected area, so YAG, which is a four-level infrared laser with good penetration ability, is emitted to destroy the cancer cells. All you need to do is get treatment.

Therefore, as in the second embodiment shown in FIG. 3, it is sufficient to configure the device so that two types of lasers can be emitted. That is, when the control device 16 irradiates the laser, if it is determined that there is cancer only on the surface of the affected area, the CO□ laser, which is absorbed only on the surface, is irradiated, and it is determined that there is cancer in the deep part of the affected area. In such cases, only YAG or YAG and Co, which has a deep penetration ability, is irradiated with a laser.

The other configurations are the same as those in the first embodiment.

Regarding the timing of laser emission, if the ultrasonic transducer rotates 5 times/see, the time required for one rotation is 0.2 sec.

Since laser emission must be controlled for each rotation, the emission time must be 0.2 seconds or less. If the ejection time per shot is 0.1 sec, then at 1 sec the maximum is 0.1 secX 5 times - Q, 5
sec laser will be emitted.

〔Effect of the invention〕

As described above, according to the present invention, the detection signal from the ultrasound observation device and the detection signal from the fluorescence observation device are used to detect the affected area ρ2
Since the laser beam is controlled to emit the laser by inputting the detection signal, the affected area can be treated quickly and appropriately by laser irradiation.

[Brief explanation of drawings]

FIG. 1 is a schematic diagram of an apparatus according to a first embodiment of the present invention, FIG. 2 is an enlarged view of the distal end of the endoscope, and FIG. 3 is a schematic diagram of an apparatus according to a second embodiment of the present invention. It is a schematic diagram. 610. Fiber 901. Fluorescence observation device 12, , ultrasonic observation device 16, , control device Fig. 1 Fig. 2 Fig. 3

Claims (1)

[Claims] 1. In a laser treatment device having a detection means for detecting an affected area and a laser treatment means, the affected area is detected by inputting an ultrasonic detection signal and a fluorescence detection signal. A laser treatment device comprising: a detection means; and a control means for controlling a laser treatment means based on a signal from the detection means.