JPH06114073A - Laser inciser - Google Patents

Abstract

PURPOSE:To achieve a laser incision accurately and safely with a simple operation by arranging outgoing ends at a plurality of fibers for introducing light in parallel while the reflected light of a laser light emitted is detected to control the emission and the stoppage thereof of the fibers for introducing light sequentially one at a time. CONSTITUTION:This apparatus is mainly made up of a laser probe 1 and a laser device 2. The laser probe 1 is made up of a plurality of fibers 3 for introducing light and outgoing ends 4 thereof are arranged in parallel to be held at the tip part 6 of a sheath 5 while the incoming ends 7 thereof are connected optically to a laser generation means 8 of the laser device 2. The reflected light of the fibers 3 for introducing light is detected by a detection means 15 while a power source 17 of the laser generation means 8 is controlled by a control means 16 based on the results of the detection. The control means 16 stops the fibers 3 for introducing light after the laser light is emitted one at a time sequentially in the order of the outgoing ends 4 arranged thereby achieving an incision of an organic tissue simply, accurately and in safety.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a laser incision device for incising an in vivo part with a laser.

[0002]

2. Description of the Related Art In recent years, percutaneous removal of the gallbladder using a trocar or a laparoscope has attracted attention because the burden on the patient is small. In this cholecystectomy operation, a laser probe is usually used to separate the adhesion between the gallbladder and the liver so that a clean cut is made with less bleeding.

The laser probe used for this technique has a tip having a thin tip. Then, the tip is brought into contact with the adhesion portion and irradiated with laser light, and moved like a scalpel to be separated (see Japanese Patent Application No. 4-23632).

[0004]

However, in this conventional laser probe, since the adhesion part of the gallbladder and the liver is cut off entirely, the laser probe must be moved along the adhesion part. . But,
It is difficult to perform a moving operation in the abdominal cavity using a trocar or a laparoscope, and a clean incision cannot be made due to camera shake or the like.
And this technique requires considerable skill, and it also took a lot of time to learn the technique.

Further, the contact type tip of the laser probe has a considerably sharp conical shape in order to enhance its cutting ability, and it is desired to cut this sharp tip during the procedure. There is a possibility that normal tissue may be damaged if it is touched by mistakenly other than the site.

The present invention has been made in view of the above problems, and an object of the present invention is to provide a laser cutting device capable of reliably and safely cutting with a simple operation.

[0007]

SUMMARY OF THE INVENTION According to the present invention, a plurality of light guiding fibers having emission ends arranged side by side, laser generating means optically connected to the incident ends of each light guiding fiber, and The detecting means detects the reflected light of the laser light emitted through the light guide fiber, and the control means that controls the emission of the laser light through each light guide fiber according to the detection signal of the detecting means. Judging from the step of emitting the laser light from the light guiding fiber 1 and the reduction of the reflected light of the laser light emitted from the light guiding fiber 1, emission of the laser light through the light guiding fiber 1 And the step of irradiating the laser light emission through the adjacent light guide fiber, and a plurality of light guide fibers whose emission ends are arranged side by side. A laser incision apparatus that performs control for incising sequentially carried by body tissue to emission of laser light by using the side-by-side order.

[0008]

1 and 2 show an embodiment of the present invention, and FIG. 1 shows a schematic construction of the laser cutting device. That is, this laser cutting device has a laser probe 1 and a laser device 2. The laser probe 1 is composed of a plurality of light guiding fibers 3, and the emitting ends 4 of the respective light guiding fibers 3 are held by a flat distal end portion 6 of a sheath 5 in a state of being arranged in close proximity to each other in a row.
An incident end 7 of each light guiding fiber 3 is optically connected to a laser generating means 8 of a laser device 2 which will be described later.

The laser generating means 8 outputs a semiconductor laser (LD) 11 corresponding to each incident end 7 of each of the light guiding fibers 3 and a laser beam emitted from each semiconductor laser 11. And a condenser lens 12 that guides light onto the corresponding incident optical axis without leakage. On the optical axis between the lens 12 and the entrance end 7 of the fiber 3, the laser light emitted from the semiconductor laser 11 is transmitted without leakage, while the corresponding exit end 4 of the fiber 3 is guided to the entrance end 7. Mirror 13 that reflects the returning reflected light to the outside of the optical path
The light reflected by the mirror 13 is received by the sensor 14 and detected.

When the sensor 14 receives the light, the signal is transmitted to the reflected light detecting means 15 to detect the reflection of the laser light and determine the degree thereof. The reflected light detection means 15 transmits the result to the control means 16, and thereby controls the power supply 17 of the laser generation means 8.

Next, the function and operation of the control means 16 will be described below. In advance, the laser probe 1 is percutaneously introduced into the abdominal cavity using a trocar or a laparoscope,
As shown in FIG. 2, the flat distal end portion 6 of the sheath 5 is brought into close contact with or in contact with the adhesion portion 23 of the gallbladder 21 and the liver 22.

First, the semiconductor laser 11 corresponding to the first light guiding fiber 3 located at the end of the laser probe 1 is driven by the power source 17 to emit light. The laser light emitted by the semiconductor laser 11 is condensed by the condenser lens 12, passes through the mirror 13, and enters the corresponding incident end 7 of the fiber 3. The exit end 4 of the fiber 3 faces or contacts the tissue as described above,
Therefore, a part of the laser light emitted from the emission end 4 returns as reflected light. This reflected light is guided to the incident end 7 through the light guiding fiber 3, emitted from this, sent to the sensor 14 via the mirror 13, and detected.
The reflected light detection means 15 detects the presence of the reflected light and the degree of the reflected light based on the received light signal. When the reflected light is above a certain level, the control means 16 continues to supply the driving power from the power supply 17 to the semiconductor laser 11.

After that, when the tissue portion is separated by the laser light, and as a result, the reflected light disappears and the light reception signal at the sensor 14 becomes below a certain level, the control means 16 stops the emission of the laser light and at the same time, The semiconductor laser 11 corresponding to the fiber 3 adjacent to this one is caused to emit light,
A laser is made to enter the adjacent fiber 3.

The above-described operation is sequentially repeated from the one end side to the other end side of the light guide fibers 3 having the emission ends 4 arranged in a line. That is, the laser light is sequentially incident on the fibers 3 arranged in a line to separate the living tissue. The laser light is incident on each of the fibers 3 by the reflected light from the fiber 3. When the living tissue part facing the fiber 3 is cut off, the laser is emitted from the adjacent fiber 3, so to speak, a laser. Sequential scanning is performed with the light separated.

Therefore, according to the above construction, the adhesion portion 23 can be separated without moving the laser probe 1. When the separation is completed, the emission of the laser light is automatically stopped. Therefore, even after the separation, the laser light does not continue to be emitted, so that damage to other organs can be minimized and safety can be improved.

The fibers 3 arranged in a line may be sequentially processed one by one, and a plurality of fibers may be processed without irradiating the single fiber 3 with laser light. Also,
When the fibers 3 are arranged in a plurality of rows, irradiation of laser light may be sequentially performed for each two fibers. Further, it is possible to perform overlapping irradiation operations to some extent, rather than moving to the next one after the irradiation of the laser beams one by one or two by two is completely completed.

Further, in the laser generating means 8 of the above-mentioned embodiment, the semiconductor laser 11, the condenser lens 12, which correspond to the incident end 7 of each of the light guiding fibers 3, respectively.
Although a set of laser generating units such as the mirror 13 and the sensor 14 is individually provided, one set is optically moved sequentially to the position of the incident end 7 of each light guiding fiber 3 and the set of the set is formed. It may be configured to share things. Further, the side of the fiber 3 on the incident end 7 side may be optically moved. Here, the term “optically moving” includes the case where the entrance end 7 of the fiber 3 and the laser generating unit are fixed and the optical path between them is switched.

FIG. 3 shows a modification of the laser probe 1. This is a flat tip portion 6 of a sheath 5 in which the exit ends 4 of the light guiding fibers are arranged in close proximity to each other in a line.
Is at least flexible and can be rolled freely. When the laser probe 1 is inserted into the outer tube 25 of the trocar, for example, as shown in FIG. 3A, the flattened tip 6 is rounded and inserted into the outer tube 25. You can When the tip 6 is pushed out into the body cavity, it automatically expands, and the tip 6 restores to a flatly spread state as shown in FIG.

According to this, the laser probe 1 is inserted into the outer tube 25 when it is inserted into the body, and the laser probe 1 is made to protrude from the tip opening of the outer tube 25 at the time of treatment inside the body so that the emission ends of the respective light guiding fibers 3 are emitted. 4 can be used in a single row in parallel. Then, the laser probe 1 can be easily inserted into the outer tube 25 or the like when it is inserted into the body.

[0020]

As described above, according to the present invention, it is possible to make a reliable and safe incision in a body part by a simple operation without requiring a difficult procedure.

[Brief description of drawings]

FIG. 1 is a schematic explanatory diagram of a configuration of a laser cutting device according to an embodiment of the present invention.

FIG. 2 is a perspective view showing a usage state of the laser probe.

FIG. 3 is a perspective view showing a modified example of the laser probe.

[Explanation of symbols]

1 ... Laser probe, 2 ... Laser device, 3 ... Light guide fiber, 4 ... Emitting end, 5 ... Sheath, 6 ... Tip part, 7
... incident end, 8 ... laser generating means, 11 ... semiconductor laser, 13 ... mirror, 14 ... sensor, 15 ... reflected light detecting means, 16 ... control means, 17 ... power supply.

Claims (1)

[Claims] 1. A plurality of light guiding fibers having emission ends arranged side by side, a laser generating means optically connected to the incident ends of the respective light guiding fibers, and a laser emitted through each light guiding fiber. The detecting means detects the reflected light of each light, and the control means for controlling the emission of the laser light through each light guide fiber by the detection signal of this detecting means. Judging by the step of emitting the laser light and the reduction of the reflected light of the laser light emitted from the one light guiding fiber, the emission of the laser light through the one light guiding fiber is stopped and the adjacent light guiding fiber is guided. Laser light is output through the light guide fiber, and a plurality of light guide fibers with their output ends arranged are used in the order in which they are arranged. A laser incision device, characterized in that the laser light is sequentially emitted to control incision of a living tissue.