JPH0519079Y2 - - Google Patents

Description

[Detailed Description of the Invention] [Industrial Application Field] The present invention relates to a laser probe used for thermally treating an affected area within a body cavity.

[Conventional technology]

Cauterize malignant tumors that occur within body cavities, and
For medical treatment such as heating to a temperature of 43°C or removing blood clots in blood vessels, a laser is applied to the affected area or its vicinity as described in USP 4,316,467. A method of irradiating light is known.

In the case of this type of laser treatment, it is necessary to prevent the irradiated area that receives the laser beam from becoming too hot, and to prevent thermal damage to healthy tissue around the irradiated area that does not require laser irradiation. In order to maintain the temperature of the irradiated part or its surroundings at a constant temperature, a means is employed that measures the temperature near the part to which the laser beam is irradiated and controls the laser beam based on this monitoring. That is, if the temperature near the area where the laser beam is irradiated is too high, control is performed such as stopping the laser beam irradiation or reducing the laser beam output.

For this reason, conventional laser probes consist of a laser generator that generates laser light, a laser guide that is connected to the laser generator and guides the laser light to the irradiated area, and a laser that is installed at the tip of the laser guide. An irradiation chip, a temperature sensor such as a thermocouple that detects the temperature near the area to be irradiated with the laser beam, a temperature measuring device that measures the temperature detected by this temperature sensor, and a temperature sensor that measures the temperature detected by the temperature sensor. The temperature signal transmission means includes a lead wire or the like for transmitting the temperature signal to the temperature measuring device.

[The problem that the idea aims to solve]

However, in the past, the laser guide and thermocouple were separated from each other and each had to be inserted into the affected area in the body cavity separately, which required time and effort, especially when the lead connected to the thermocouple Since the wire is soft, it is difficult to guide it alone to the lesion within the body cavity, and there is a problem in that the workability is not good.

In addition, in order to maintain the temperature of the area to be irradiated with the laser beam or its surroundings at a constant temperature, it is not sufficient to simply stop the laser irradiation or control the laser beam output; Forced cooling is effective. For this reason, it is desirable to send the fluid to or around the irradiated area using a liquid sending means. However, in addition to the laser guide and the temperature signal transmission means, it is difficult to separately guide the liquid delivery means to the lesion within the body cavity.

The present invention was developed based on these circumstances, and it makes it easy to guide the laser guide, temperature signal transmission means, and liquid delivery means into the body cavity, and also maintains the temperature of the affected area constant and measures it accurately. The aim is to provide a laser probe that can.

[Means to solve the problem]

In order to achieve the above object, the present invention includes: a laser guide that guides a laser beam; a laser irradiation chip that irradiates an irradiated area with the laser beam guided by the laser guide; and a sheath through which the laser guide is inserted. A laser probe comprising: a holding means for holding the laser irradiation chip and the tip of the laser guide at the tip of the sheath; a temperature signal transmitting means guided to the outside from a tip of the temperature signal transmitting means; a temperature sensor provided at the tip of the temperature signal transmitting means to detect the temperature near a portion irradiated with the laser beam; and a temperature sensor provided on the proximal side of the sheath; connecting means each having an opening through which the laser guide is inserted and an opening through which the temperature signal transmitting means is inserted; and connecting means connected to the sheath and connected to the sheath through a conductive portion formed in the holding means. It is characterized by comprising: a liquid feeding means for causing the fluid to flow out from the tip.

[Effect]

According to the present invention, since the laser guide and the temperature signal transmission means are inserted into one sheath, the laser guide and the temperature signal transmission means can be simultaneously inserted into the body cavity through this sheath,
Insertion work becomes easier. Furthermore, since the fluid is sent through the interior of the sheath, there is no need to use any special liquid delivery means on the outside. The temperature signal transmitting means is guided to the outside from the distal end of the sheath through a conductive portion formed in the holding means for supporting the chip attached to the distal end of the sheath, so that the temperature signal transmitted at the distal end of the sheath is guided outside. The sensor can be brought into direct contact with or close to the affected area, and the temperature of the affected area can be measured with high precision. Furthermore, the fluid sent by the liquid sending means is supplied from the distal end of the sheath to the affected area through the inside of the sheath and through the conductive portion formed in the holding means provided for guiding the temperature signal transmitting means to the outside. Since the conducting portion also serves as a liquid feeding path, the structure of the liquid feeding path is simplified.

〔Example〕

The present invention will be explained below based on a first embodiment shown in FIGS. 1 to 6.

FIG. 1 shows the overall structure of a laser probe, in which 1 is a laser guide made of an optical fiber, and a laser probe connector 2 is connected to one end. Laser probe connector 2 is connected to laser generator 3 . The laser generator 3 has a laser generator 4 and a controller 5, and controls the laser output emitted from the laser generator 4 in response to commands from the controller 5.

The other end of the laser guide 1 is guided into a first sheath 8 by inserting a connecting tube 6 and a second sheath 7 corresponding to the connecting means of the present invention.
It is connected to a contact tip 9 made of sapphire or metal attached to the tip of the sheath 8.

The second sheath 7 and the first sheath 8 are
Each is formed from a flexible and insulating tube made of synthetic resin or the like.

At the distal end of the first sheath 8, a thermocouple 1 as a temperature sensor is located near the contact tip 9.
0, and this thermocouple 10 is connected to a pair of lead wires 11, 11 as temperature signal transmission means.

The lead wires 11, 11 are connected to the first sheath 8 and the second sheath 8.
The sheath 7 and connecting tube 6 are inserted into the connecting tube 6, and the connecting tube 6 is led out from the other end opening, and a thermocouple connector 12 is connected to the leading end.

Thermocouple connector 12 is detachably connected to temperature measuring device 13. The temperature measuring device 13 has a display unit 14 that displays the temperature detected by the thermocouple 10.
This temperature is sent to the control section 5 of the laser generator 3 as an electrical signal. The control unit 5 of the laser generator 3 is adapted to control the laser output of the laser generator 4 in response to a signal sent from the temperature measuring device 13.

The lead wires 11, 11 led out from the opening at the other end of the connection tube 6 are covered by a flexible insulation protection tube 15 made of synthetic resin or the like.

As shown in FIG. 2, the protection tube 15 has one end formed with a large diameter, and the end of the connection tube 6 made of the heat-shrinkable tube described above is placed over this large-diameter end and is heat-shrinked. It is joined by Further, the other end of the protective tube 15 is joined to the thermocouple connector 12 with an adhesive or the like.

Connection tube 6 consisting of the above heat-shrinkable tube
A laser guide introduction port 16 is opened in the middle in the axial direction, and the laser guide 1 is guided from this laser guide 16. Therefore, the lead wire 11,
11 and the laser guide 1 are guided by the connecting tube 6 and introduced into the sheath 7, and the branched portions of the lead wires 11, 11 and the laser guide 1 are held by the connecting tube 6.

Details of the laser probe connector 2 are shown in FIG.

That is, 20 is a connector outer cylinder, which is provided with a connection ring 21. A positioning cylinder 22 is attached inside the connector outer cylinder 20 with a plurality of screws 23, and a laser guide holding cylinder 24 is screwed into this positioning cylinder 22. The end of the laser guide 1 introduced into the end of the connector outer cylinder 20 is placed in the center of the laser guide holding cylinder 24 with adhesive 2.
Fixed via 5. Note that 26 is a rubber stopper that closes the open end of the connector outer cylinder 20.

As shown in FIG. 3, the position of the positioning cylinder 22 in the radial direction within the connector outer cylinder 20 is adjusted by a plurality of screws 23, thereby aligning the laser guide 1. .

In contrast to such a laser probe connector 2, the laser generator 3 is provided with a connector insertion tube 30 into which the tip of the connector outer tube 20 is inserted. The connecting ring 21 is screwed into the connector insertion tube 30 so that the connector outer tube 20 can be detachably connected thereto. A lens holding tube 31 is installed inside this connector insertion tube 30.
A lens 33 is fixed within this lens holding cylinder 31 via a lens holder 32. The tip surface of the lens holding cylinder 31 is a small diameter abutment surface 34,
This contact surface 34 is adapted to come into contact with the tip of the positioning cylinder 22.

When the connector outer tube 20 on the side of the laser probe connector 2 is connected to the connector insertion tube 30 on the side of the laser generator 3, the contact surface 34 of the lens holding tube 31 comes into contact with the tip of the positioning tube 22, and thereby the laser guide The input end 1a of the lens 1 and the condensing position of the lens 33 are aligned.

When a laser beam is emitted from the laser generating section 4 in this state, the laser beam enters the input end 1a of the laser guide 1 due to the focusing action of the lens 33.

The first sheath 8 and the second sheath 7 are connected via a connecting member 35 shown in Fig. 1. A water supply tube 36, which serves as a water supply means, is connected to the connecting member 35, and a water supply cylinder 37 is connected to the water supply tube 36. Water pressure-supplied by the water supply cylinder 37 can be supplied to the body cavity through the water supply tube 36 and the inside of the first sheath 8, as well as through a distal tip 50, which will be described later.

The details of the connecting member 35 are shown in FIG.
2 and 43, the first sheath 8 and the second sheath, respectively.
The sheath 7 and water supply tube 36 are connected.

The laser guide 1 and the lead plug 11 are connected to the first sheath 8, the connection ports 41 and 42, and the second
In this case, an O-ring 45 is installed in the connection port 42. This O-ring 45 is connected to the water supply tube 36.
It is sealed so that water sent from the to the first sheath 8 side does not flow into the second sheath 7 side. Note that instead of the O-ring 45, other sealing materials, adhesives, or the like may be used for sealing.

The distal end of the first sheath 8 is configured as shown in FIGS. 5 and 6.

That is, a distal end tip 50 is fixed to the distal end of the first sheath 8, and the distal end portion of the laser guide 1 that has been inserted through the first sheath 8 is held by this distal tip 50.

A fluid passage 51 communicating with the water supply tube 36 is provided between the inner surface of the first sheath 8 and the outer surface of the laser guide 1.

A plurality of grooves 52 corresponding to the conduction portion of the present invention are formed halfway in the axial direction in the tip 50, and these grooves 52 are connected to the fluid passage 51.
It also communicates with the front surface of the distal tip 50 through the gap between the distal tip 50 and the laser guide 1.

The lead wire 1 to which the thermocouple 10 is connected
1 and 11 are guided from the fluid passage 51 to one of the split grooves 52, and are led out from the distal edge of the first sheath 8.

A tip holder 53 is removably screwed into the distal tip 50. The aforementioned contact chip 9 is attached to this chip holder 53, and the rear surface of this contact chip 9 faces the output end 1b of the laser guide 1.

The chip holder 53 also has a groove 54 for fluid communication.
A plurality of grooves 54 are formed, and these grooves 54 correspond to the grooves 5 of the fluid passage 51 and the tip 50.
2..., and is adapted to lead out water sent from the water supply tube 36.
Therefore, the grooves 54 also constitute the conductive portion of the present invention.

The operation of the laser probe having such a configuration will be explained.

A laser probe is inserted into the body cavity, and its contact tip 9 is brought into contact with or faces the affected area. In this state, the laser generator 4 of the laser generator 3 generates a laser beam, and guides this laser beam to the laser guide 1. The laser guide 1 outputs the laser beam introduced at the input end 1a from the output end 1b toward the distal tip 9, so that the distal tip 9 irradiates the affected area, that is, the irradiated area with the laser beam. As a result, the temperature of the irradiated area rises, and thermal treatment is performed.

In this case, the thermocouple 10 detects the temperature near the irradiated part and transmits it to the temperature measuring device 13 through the lead wires 11, 11. The temperature measuring device 13 displays the temperature detected by the thermocouple 10 on the display section 14 and sends this temperature to the control section 5 of the laser generating device 3 as an electrical signal. In the laser generator 3, a control section 5 issues a command in response to a signal sent from the temperature measuring device 13, and controls the laser output generated by the laser generator 4.

Further, the water pumped by the water supply cylinder 37 is sent from the water supply tube 36 through the fluid passage 51 in the first sheath 8 and into the body cavity through the groove 52 of the distal tip 50 and the groove 54 of the tip holder 53. be able to. The supplied water can cool the affected area and its surrounding areas that have been heated by the laser beam irradiation.

According to the above configuration, since the laser guide 1 and the lead wires 11, 11 are inserted through the second sheath 7 and the first sheath 8, which are substantially connected together, the sheath By inserting the laser guide 1 and the thermocouple 10 into the body cavity, the laser guide 1 and the thermocouple 10 can be inserted to the affected area at the same time.
This makes the insertion work easier.

Moreover, the laser guide 1 and lead wires 11, 11 inserted into the first and second sheaths 8, 7,
They separate at the part that comes out from the second sheath 7, but since these branching points, that is, the roots, are covered with a connecting tube 6 made of a heat-shrinkable tube, these root parts, which are easily subjected to stress such as bending, are It becomes mechanically protected and can prevent damage.

Moreover, since the lead wires 11, 11 led out from the connection tube 6 are covered by the protection tube 15, the strength is improved in this part as well.
Therefore, damage to the lead wires 11, 11 is prevented.

The lead wires 11, 11, which serve as temperature signal transmission means, are guided from the fluid passage 51 to one of the grooves 52, and are led out from the distal end edge of the first sheath 8. Since a temperature sensor such as a thermocouple 10 is attached, the thermocouple 10 can be located outside the tip 50,
It can be placed directly or as close as possible to the part to be irradiated with the laser beam or its vicinity, and therefore the temperature of the part to be temperature detected can be detected with high precision.

Further, since the fluid passage 51 is formed inside the first and second sheaths 8 and 7 and serves as a liquid feeding passage, there is no need to provide a special liquid feeding means such as a tube on the outside, and cooling fluid is supply structure becomes easier. In addition, the cooling fluid can be sent out from the tip 50 by using the conduction path of the lead wires 11, 11 formed in the tip 50, that is, one of the split grooves 52 and the external split groove 54. This liquid feeding structure is simplified, and the cooling fluid can be reliably supplied to the affected area located in front of the distal tip 50 and its surroundings.

Because of this, it is possible to more accurately measure the temperature of the lesion heated by the laser beam, and it is also possible to keep the temperature of this lesion constant, and these functions are achieved with a simple structure. It can be made possible.

Note that the present invention is not limited to the above embodiments.

That is, in the case of the second embodiment shown in FIG.
A recess 9a is formed at the input end of the contact chip 9, and the output end 1b of the laser guide 1 is inserted into this recess 9a. In this way, the laser light emitted from the output end 1b of the laser guide 1 can be efficiently incident on the contact chip 9 without leaking.

Further, the thermocouple 10 is led out through a groove 54 for fluid communication formed in the chip holder 53.

In the case of the third embodiment shown in FIG. 8, a split groove 60 extending over the entire length in the axial direction is provided in the distal tip 50, and the lead wire 11 is guided into the split groove 60.
0 is used as a fluid passage.

In the case of the fourth embodiment shown in FIG. 9, two thermocouples 10a and 10b are used. 10b are respectively electrically connected.

In the case of the fifth embodiment shown in FIG.
In place of the split groove 60 shown in the figure, a tip 50
An insertion hole 65 is provided over the entire length in the axial direction, and the lead wire 11 is introduced into the insertion hole 65 and used as a fluid passage.

Furthermore, in the case of the sixth embodiment shown in FIG.
5b, and thermocouples 10a and 10b are electrically connected to these insertion holes 65a and 65b, respectively.

Furthermore, in the first embodiment described above, the laser guide inlet 1 is located midway in the axial direction as the connection tube 6.
A heat-shrinkable tube with an opening 71 is used, but this connecting tube 6 is composed of a bifurcated tube 70 made of resin or metal, as in the seventh embodiment shown in FIG. The laser guide 1 may be guided from the opening 72, and the lead wires 11, 11 may be guided from the other opening 72.

Furthermore, in the first embodiment described above, the thermocouple 10 is used as the temperature sensor, and the thermocouple 10 and the temperature measuring device 1 are used as the temperature signal transmission means.
In the eighth embodiment shown in FIG. 13, an infrared fiber 80 is used as a temperature sensor and a temperature signal transmission means. You may also do so. In this case, a fiber connector 81 is used as the connector, and an infrared detector 82 is used as the temperature measuring device.

In such a case, the irradiated part is heated by the laser light emitted from the laser guide 1 and emits infrared rays corresponding to the temperature. The infrared rays are detected and transmitted by the infrared fiber 80, guided to the infrared detector 82, and measured by the infrared detector 82.

In the case of such an embodiment, the temperature can be detected without contacting the irradiated portion with the tip of the infrared fiber 80, and the laser beam is transmitted through the infrared fiber 80.
There is no risk of heat damage as the tip will not hit the tip.

Even in such a case, the infrared detector 82
is led out from the tip of the sheath 8. Also in this case, the laser guide 1 and the lead-out portions of the infrared fiber 80 are held down by the connection tube 70, so damage to the root portions is prevented, and the infrared fiber 80 is covered by the protective tube 15, so damage to it is prevented. Prevented.

As described above, the infrared fiber 80 serves both as the temperature sensor and the temperature signal transmission means of the present invention.

[Effect of idea]

As explained above, according to the present invention, since the laser guide and the temperature signal transmission means are inserted into one sheath, the laser guide and the temperature signal transmission means can be simultaneously inserted into the body cavity through this sheath. Insertion work becomes easier. Furthermore, since the portion where the laser guide and the temperature signal transmission means are inserted into the sheath is held down by the connection means, damage to the laser guide and the temperature signal transmission means is prevented. Furthermore, since the fluid is sent to the affected area through the interior of the sheath, there is no need to provide a special liquid feeding means on the outside, and the structure of the liquid feeding means and the operation for inserting it into the body are simplified. The temperature signal transmitting means is guided to the outside from the distal end of the sheath via a conductive portion formed in the holding means for supporting the chip attached to the distal end of the sheath, so that the temperature signal is set at the distal end of the sheath. The sensor can be brought into direct contact with or close to the affected area, and the temperature of the affected area can be measured with high precision. Furthermore, the fluid sent by the liquid sending means is supplied from the distal end of the sheath to the affected area through the inside of the sheath and through the conducting section provided for guiding the temperature signal transmitting means to the outside. It can also be used as a liquid path, which also simplifies the structure of the liquid feeding path.

For this reason, it becomes easy to guide the laser guide, the temperature signal transmission means, and the liquid delivery means into the body cavity, and the temperature of the affected area can be kept constant and measured accurately.

[Brief explanation of the drawing]

1 to 6 show a first embodiment of the present invention, FIG. 1 is a configuration diagram of the entire laser prong, and FIG. 2 is a cross-sectional view of the latter half of the laser prong together with the laser prog connector and thermocouple connector. Figure 3 is a sectional view taken along the line - in Figure 2;
Figure 4 is a sectional view of the connection part of the water supply tube, Figure 5
The figure is a cross-sectional view of the tip of the laser probe, FIG. 6 is an exploded perspective view of the first sheath and the tip, and FIGS. 7 to 13 show the second to eighth embodiments of the present invention, respectively. FIG. DESCRIPTION OF SYMBOLS 1... Laser guide, 2... Laser probe connector, 3... Laser generator, 6... Connection tube (connection means), 7... Second sheath, 8...
First sheath, 9... Contact chip, 10... Thermocouple, 11... Lead wire, 12... Thermocouple connector, 13... Temperature measurement device, 15... Protection tube, 35... Connection member, 36 ... Water supply tube, 37 ... Water supply cylinder, 51 ... Water supply passage, 52, 54 ... Division groove, 80 ... Infrared fiber, 81 ... Fiber connector.

Claims (1)

[Scope of Claim for Utility Model Registration] A laser guide that guides a laser beam, a laser irradiation chip that irradiates an irradiated area with the laser beam guided by the laser guide, a sheath through which the laser guide is inserted, and the laser beam guided by the laser guide. A laser probe comprising an irradiation chip and a holding means for holding the tip of the laser guide at the tip of the sheath, the laser probe being inserted into the sheath and connected to the tip of the sheath through a conductive part formed in the holding means. a temperature signal transmission means led out to the outside; a temperature sensor provided at the tip of the temperature signal transmission means to detect the temperature near a portion irradiated with the laser beam; and a temperature sensor provided on the proximal side of the sheath and connected to the laser beam. connecting means each having an opening through which the guide is inserted and an opening through which the temperature signal transmitting means is inserted; and connecting means connected to the sheath and connected to the distal end of the sheath through the inside of the sheath and through a conductive portion formed in the holding means. A laser probe characterized by comprising: a liquid feeding means for causing a fluid to flow out to the outside;