JPH04285549A - Laser irradiating device - Google Patents

Abstract

PURPOSE:To precisely grasp the state of a testee body by laser irradiation and perform safe diagnosis and treatment. CONSTITUTION:Ultrasonic waves from two ultrasonic elements 11a, 11b provided in the axial direction of a slender inserting part 10 are transmitted and received to detect the tomographic image of a testee body. A laser emitting part 2 has a laser emitting hole 12 provided between two ultrasonic elements 11a, 11b, through which a laser beam 13 irradiates the observing area of the two ultrasonic elements 11a, 11b.

Description

[Detailed description of the invention]

0001

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a laser irradiation device for cauterizing an irradiated area by irradiating a laser beam.

0002

[Prior Art] Conventionally, using an endoscope and a laser device,
When performing therapeutic treatment within a body cavity, for example, to stop bleeding or cauterize malignant tissue such as cancer, we conduct animal experiments or desk experiments in advance to determine the treatment content and distance to the subject.
Laser output, laser irradiation time, etc. were ascertained, and based on these experimental results, laser output, laser irradiation time, etc. were set in clinical practice.

In the case of treatment inside a body cavity, the laser irradiation time is relatively short and the distance from the laser irradiation end to the subject is difficult to grasp under an endoscope. It is not possible to easily detect how deep the light is irradiated. For this reason, the reality is that treatment by laser irradiation is mostly performed based on the intuition and experience of the surgeon.

[0004] For this reason, there is a risk that the cauterization may be performed too deeply, causing bleeding or perforation, or that unnecessary areas may be burned. On the other hand, there is a risk that the area that should be cauterized may be left unburned, resulting in incomplete treatment.

As a means to solve these problems, as disclosed in Japanese Patent Publication No. 63-20547,
A laser irradiation device that uses a combination of ultrasonic observation means using an ultrasonic element has been proposed. This laser irradiation device displays a tomographic image of the subject using ultrasonic observation means,
Using this tomographic image, it is possible to detect the site to be irradiated with the laser and to understand the status of the ablation treatment, making it possible to safely perform treatment within the body cavity.

Furthermore, as disclosed in Japanese Unexamined Patent Publication No. 2-5936, a laser irradiation device using a combination of ultrasonic observation means using the ultrasonic element is used to remove atheroma formed in blood vessels. An application has been proposed.

[0007]

[Problems to be Solved by the Invention] The conventional laser irradiation device as described above transmits and receives ultrasound waves forward and observes a tomographic image of the subject, while irradiating a laser forward to perform treatment, etc. Since this is a direct-view type laser irradiation device, and the direction of ultrasonic wave transmission/reception and laser irradiation is only forward, it may be difficult to treat a desired area. Furthermore, in a device in which a laser emitting end is provided inside a cylindrical ultrasonic element, problems such as the laser emitting end generating heat due to laser irradiation and burning the ultrasonic element occur.

[0008] In order to solve this problem, a side-viewing side-emission type laser irradiation device can be considered, which performs treatment by emitting a laser beam to the side while transmitting and receiving ultrasonic waves to the side. In such a laser irradiation device, a catheter or the like equipped with a laser probe as a laser irradiation means and an ultrasound probe having an ultrasound element is inserted into the body cavity for diagnosis and treatment, or an ultrasound probe is inserted into the body cavity for diagnosis and treatment. A method is used in which the ultrasound probe is inserted into a body cavity, the treatment site is observed, the ultrasound probe is removed, and a laser probe is inserted to treat the treatment site.

However, when a laser probe and an ultrasound probe are inserted into a body cavity at the same time, the laser emitting end and the ultrasound element are located side by side with respect to the laser irradiation direction, making it difficult to diagnose using ultrasound. It is difficult to specify the positional relationship between the image and the laser irradiation position. For this reason,
It is difficult to confirm where the laser is irradiated in a diagnostic image obtained by ultrasound, and it is not possible to accurately grasp the condition of the subject due to laser irradiation. Similarly, when performing treatment by inserting a laser probe after observation with an ultrasound probe, the precise positional relationship between the ultrasound diagnostic image and the laser irradiation position cannot be determined, so incorrect irradiation may occur. It is dangerous as there is a risk of it getting damaged.

The present invention has been made in view of these circumstances, and provides a laser irradiation device that can accurately grasp the condition of a subject by laser irradiation and can perform safe diagnosis and treatment. It is intended to.

[0011]

[Means for Solving the Problems] A laser irradiation device according to claim 1 of the present invention has a plurality of ultrasonic elements in the axial direction of an elongated insertion section, and emits ultrasonic waves from these plurality of ultrasonic elements. The present invention comprises an ultrasonic observation means that transmits and receives waves to detect a tomographic image, and a laser irradiation means that has a laser emission section that irradiates laser light between the observation areas of the plurality of ultrasonic elements. A laser irradiation device according to a second aspect of the invention includes an ultrasonic element provided with a light-transmitting part through which a laser beam can pass, and an ultrasonic observation means for detecting a tomographic image by transmitting and receiving ultrasonic waves from the ultrasonic element. and a laser irradiation means having a laser emitting section that irradiates laser light through the transparent section.

0012

According to claim 1 of the present invention, the ultrasonic observation means detects a tomographic image by transmitting and receiving ultrasonic waves from a plurality of ultrasonic elements provided in the axial direction of the elongated insertion section. The laser irradiation means irradiates laser light between observation areas of the plurality of ultrasonic elements from a laser emission section.

In claim 2 of the present invention, the ultrasonic observation means detects a tomographic image by transmitting and receiving ultrasonic waves from an ultrasonic element provided with a light-transmitting portion through which laser light can pass. The laser irradiation means irradiates a laser beam from a laser emission section through the transparent section.

[0014]

Embodiments Hereinafter, embodiments of the present invention will be described with reference to the drawings. 1 and 2 relate to a first embodiment of the present invention; FIG. 1 is an explanatory diagram showing the configuration of the distal end of the insertion section of the laser irradiation device, and FIG. 2 is a block diagram showing the general configuration of the laser irradiation device. .

As shown in FIG. 2, the laser irradiation device includes:
A laser control circuit 1 for controlling laser light irradiation is provided, and a laser emitting section 2 for emitting laser light is connected to this laser control circuit 1. The laser light is emitted from the laser emitting section 2 to a subject 3. It is now irradiated. Further, an ultrasonic control circuit 4 for controlling transmission and reception of ultrasonic waves is provided, and an ultrasonic transmitting and receiving section 5 for transmitting and receiving ultrasonic waves is connected to this ultrasonic control circuit 4. Ultrasonic waves are transmitted to and received from the subject 3. The laser control circuit 1 and the ultrasound control circuit 4 are connected to a control device 6, and the control device 6 controls the subject 3.
The observation of tomographic images using ultrasonic waves and the laser irradiation state according to the tomographic images are controlled. Also,
A monitor 7 is connected to the control device 6, and this monitor 7
An ultrasonic tomographic image of the subject 3 is displayed. The laser control circuit 1 and the laser emitting section 2 constitute a laser irradiation means, and the ultrasonic control circuit 4,
The ultrasonic transmitting/receiving section 5 and the monitor 7 constitute an ultrasonic observation means.

As shown in FIG. 1, the ultrasonic transmitting/receiving section 5 includes two ultrasonic elements 11a and 11b provided on the side circumferential surface of an insertion section 10 formed of an elongated catheter or the like.
Ultrasonic waves are transmitted and received from these ultrasonic elements 11a and 11b laterally with respect to the insertion direction of the insertion section 10. Further, a laser emitting section 2 having a laser emitting port 12 is provided between the ultrasonic elements 11a and 11b, and a laser beam 13 is irradiated laterally from the laser emitting section 2.

Furthermore, the laser beam 13 has conventionally been a YAG laser beam.
Lasers, etc. have been used, but with such YAG lasers, thermally degenerated areas are formed around the areas that disappear due to the laser, making it difficult to diagnose, such as distinguishing between normal tissue and abnormal tissue using ultrasound. . Therefore, as the laser beam 13,
Lasers such as excimer laser, Ho:YAG laser, Er:YAG laser, etc., which create a parenchymal defect in the subject without causing coagulation, are used.

Next, the operation of this embodiment will be explained. The ultrasonic control circuit 4 controls the two ultrasonic elements 11a, 1
1b is driven to transmit ultrasonic waves to the subject 3, and the reflected waves from the subject 3 are reflected by the ultrasonic elements 11a and 11, respectively.
The wave is received at b. By rotating the insertion section 10 and scanning the ultrasonic elements 11a and 11b, the ultrasonic element 1
Tomographic images of the two subjects 3 are detected by 1a and 11b and displayed on the monitor 7. Then, a laser beam 13 is irradiated from the laser exit port 12 between the observation areas of the two ultrasonic elements 11a and 11b to perform a therapeutic treatment such as cauterization.

Here, since the laser beam 13 is irradiated between the front and rear tomographic images obtained by the ultrasonic elements 11a and 11b, the region irradiated with the laser beam 13 can be easily recognized. Then, the condition of the treatment area of the subject 3 is detected from the tomographic image, and the treatment is performed by controlling the laser output, laser irradiation time, etc. according to this tomogram, so that the treatment area of the subject 3 is as desired. Cauterized to the state. Further, it is also possible to perform laser irradiation by determining whether or not laser irradiation is necessary at the laser irradiation site based on the front and back tomographic images.

As described above, according to the present embodiment, since the laser beam 13 is irradiated between the tomographic images of the two subjects 3, it is possible to easily specify the laser irradiated area.
With the two tomographic images, it is possible to accurately grasp the treatment status of the subject by laser irradiation. Therefore, the state of laser irradiation can be appropriately controlled, and treatment by laser irradiation can be safely performed. In addition, since the laser beam is used to create a parenchymal defect in the subject without causing coagulation, no thermally degenerated area is formed around the laser irradiation area, and ultrasonic waves can be used to distinguish normal tissue from abnormal tissue. can be easily diagnosed.

3 and 4 relate to a second embodiment of the present invention, FIG. 3 is an explanatory diagram showing the configuration of the tip of the insertion section of the laser irradiation device, and FIG. 4 is the configuration of the output end of the laser probe in FIG. 3. FIG.

As shown in FIG. 3, in the second embodiment, two annular ultrasonic elements 21 are installed in the insertion section 10 of the laser irradiation device.
a and 21b are provided. A laser probe 22 is inserted inside the ultrasonic element 21a and transmits laser light and emits it from the output end. Further, between the ultrasonic elements 21a and 21b, there is a reflector 23 that reflects the laser beam and irradiates it laterally with respect to the insertion direction of the insertion section 10.
is located. It is currently difficult to realize a side-emitting type laser probe that can emit laser light to the sides, but by providing the reflector 23 in this way, it is possible to create a laser emitting section that can emit laser light to the sides. Can be configured. The ultrasonic elements 21a, 21b, the laser probe 22, and the reflector 23 are formed of a transparent thin-film outer cylinder 24 made of latex or the like so that the laser beam can pass therethrough.
covered with Further, a guide wire 25 that serves as a guide during insertion is inserted through the center of the insertion section 10 to the tip of the insertion section.

As shown in FIG. 4, the laser probe 22 is a multi-fiber tube-shaped structure made up of a plurality of laser guide fibers. This laser probe 22 either emits laser light from all the output ends 22a and irradiates the laser light in the entire circumferential direction using the reflector 23, or selects any output end 22a from among a plurality of laser guide fibers. It is designed to irradiate laser light in the desired direction.

Ultrasonic waves are transmitted and received from the two annular ultrasound elements 21a and 21b by electronic scanning, and a tomographic image of the subject is detected. Then, laser light 13 is irradiated between each detected tomographic image to perform treatment such as cauterization. Here, the treatment area is specified according to the state of each of the tomographic images, and the laser beam 13 is selected from among the plurality of laser guide fibers of the laser probe 22 and emitted so that the target treatment area is irradiated with the laser beam 13. Or, irradiate the entire circumference at once.

As described above, in the second embodiment, by selecting from a plurality of laser guide fibers and irradiating the laser in an arbitrary direction, or by irradiating the laser in the entire circumferential direction, the target treatment area can be appropriately targeted. Can irradiate laser light. In addition, by combining a side-viewing ultrasonic element for lateral observation and a direct-projection laser probe, we have developed a side-viewing system that allows you to easily identify the laser irradiation position and accurately grasp the treatment status. A type of laser irradiation device can be constructed.

Other configurations, functions, and effects are the same as in the first embodiment.

FIG. 5 is an explanatory diagram showing the configuration of the distal end of the insertion portion of the laser irradiation device according to the third embodiment of the present invention.

As shown in FIG. 5(a), an ultrasonic probe 32 consisting of a flexible shaft with an ultrasonic element 31 provided on the side surface of its tip is inserted into the insertion section 10 of the laser irradiation device. . A direct-emitting type laser probe 33 that emits a laser beam forward is inserted into the ultrasonic probe 32 . In front of the laser probe 33 is a side reflector 34 that reflects the laser beam from the laser probe 33 so that the laser beam 13 is radiated sideways.
is installed. The ultrasonic element 31 is shown in FIG. 5(b).
As shown in FIG. 2, a circular light-transmitting portion 35 is provided in the center so that the laser beam 13 can pass therethrough.

A tomographic image is detected by driving the ultrasonic element 31 to transmit and receive ultrasonic waves to and from the subject. Then, the laser beam 13 is emitted from the laser probe 33,
This laser beam 13 is reflected by the side reflector 34,
The light passes through the light transmitting portion 35 of the ultrasound element 31 and is irradiated onto the subject. Here, since the laser beam 13 is irradiated from the transparent part 35 provided at the center of the ultrasound element 31, the irradiation area of the laser beam 13 is within the tomographic image detected by the ultrasound, and the irradiation position is Accurately understood. Then, by rotating the ultrasonic probe 32 and controlling the emission of laser light in synchronization with this rotation, the laser light is irradiated in a targeted direction to perform therapeutic treatment such as cauterization.

[0030] In this way, by irradiating the laser beam within the observation area using ultrasound, the laser irradiation area can be easily detected, and the treatment status of the subject by laser irradiation can be accurately grasped. can.

[0031] Other configurations, operations, and effects are the same as those of the first embodiment.

FIG. 6 is an explanatory diagram showing the configuration of the distal end of the insertion portion of a laser irradiation device according to a fourth embodiment of the present invention.

As shown in FIG. 6(a), the fourth embodiment is a modification of the third embodiment, in which the insertion section 10 of the laser irradiation device is
On the side of the tip of the ultrasonic probe 32 inserted therein,
An ultrasonic element 41 having a laser light-transmitting portion is provided. This ultrasonic element 41 includes a light transmitting portion 45a formed in an elongated shape in the axial direction as shown in (b), or a light transmitting portion 45a formed in a long shape in the axial direction as shown in (c). Part 45
b is provided. A laser probe 43 having a reflective part 44 that reflects the laser beam laterally is inserted inside the ultrasound probe 32 so that the laser beam 13 passes through the transparent part 45 and is irradiated laterally. It has become.

Similar to the third embodiment, the laser beam 13 is emitted from the laser probe 43, passes through the light-transmitting portion 45 of the ultrasonic element 41, and is irradiated onto the subject. Here, the laser beam 13 is transmitted to a transparent section 45 provided at the center of the ultrasonic element 41.
Since the laser beam 13 is irradiated from the center, the irradiation site of the laser beam 13 is within the tomographic image detected by the ultrasound, and the irradiation position can be accurately grasped. Furthermore, since the light-transmitting portion 45 has a long slit shape, the laser probe 43 can be moved to displace the laser beam emission position within the range of the light-transmitting portion 45, thereby changing the laser irradiation position. can be done. Figure 6
When the ultrasonic element 41 is provided with a translucent portion 45a formed in the vertical direction as shown in (b), the laser probe 43 is moved forward and backward, and also in the rotational direction as shown in (c). When the formed transparent portion 45b is provided on the ultrasonic element 41, the laser probe 43 is rotated to change the laser irradiation position.

[0035] In this way, by irradiating the laser beam within the observation area using ultrasonic waves, the laser irradiation area can be easily detected, and the treatment status of the subject by laser irradiation can be accurately grasped. can. In addition, the transparent part 4
The laser beam emission position can be moved within a range of 5, making it possible to easily control the treatment area of the subject by laser irradiation.

Other structures, functions, and effects are the same as in the first embodiment.

[0037]

As explained above, according to the present invention, it is possible to accurately grasp the condition of a subject by laser irradiation, and it is possible to perform safe diagnosis and treatment.

[Brief explanation of the drawing]

FIG. 1 and FIG. 2 relate to a first embodiment of the present invention,
Figure 1 is an explanatory diagram showing the configuration of the tip of the insertion section of the laser irradiation device.

[Figure 2] Block diagram showing the general configuration of the laser irradiation device

FIG. 3 and FIG. 4 relate to a second embodiment of the present invention,
Figure 3 is an explanatory diagram showing the configuration of the tip of the insertion section of the laser irradiation device.

[Figure 4] An explanatory diagram showing the configuration of the output end of the laser probe in Figure 3.

FIG. 5 is an explanatory diagram showing the configuration of the distal end of the insertion section of the laser irradiation device according to the third embodiment of the present invention.

FIG. 6 is an explanatory diagram showing the configuration of the distal end of the insertion section of the laser irradiation device according to the fourth embodiment of the present invention.

[Explanation of symbols]

2...Laser emission part 5...Ultrasonic transmitter/receiver 6...Control device 7...Monitor 10...Insertion part 11a, 11b...Ultrasonic element 12...Laser exit aperture 13...Laser light

Claims (2)

[Claims] 1. Ultrasonic observation means having a plurality of ultrasonic elements in the axial direction of an elongated insertion section and detecting a tomographic image by transmitting and receiving ultrasonic waves from the plurality of ultrasonic elements; 1. A laser irradiation device comprising: a laser irradiation unit having a laser emission section that irradiates laser light between observation areas of an ultrasonic element. 2. Ultrasonic observation means having an ultrasonic element provided with a transparent part through which a laser beam can pass, and detecting a tomographic image by transmitting and receiving ultrasonic waves from the ultrasonic element; 1. A laser irradiation device comprising: a laser irradiation unit having a laser emission section that irradiates a laser beam through the laser beam.