JPH0698116B2 - Laser endoscope - Google Patents

Description

Description: TECHNICAL FIELD The present invention relates to a laser endoscope, and more particularly, a single optical fiber is used to transmit a laser light beam to an examination position in a body cavity for coherence. The present invention relates to a laser endoscope for transmitting a reflected image to a video screen or a monitor for observation by a multi-fiber optical cable.

Prior to the present invention, laser light beams have been used to both illuminate patients and treat illnesses. However, most of these instruments are not sized small enough to penetrate various body conduits and holes without causing discomfort to the patient, and in some cases, surgical instruments to guide the instrument to a desired location within the body cavity. Needs treatment. Can be inserted into a body cavity through a body conduit with minimal discomfort to the patient or introduced into the body cavity using a needle to eliminate the need for conventional surgical procedures No known device is available.

U.S. Pat. No. 3,858,577 to Bass et al. Discloses a substantially sized endoscope for performing laser surgery. The device uses conventional light through an optical fiber to illuminate the surgical location and laser light to perform the surgical procedure.

US Patent No. 4,013 to Epstein Outside
No. 1,403 discloses a fiber optic laser endoscope.
This device uses a laser beam as a light source and an optical fiber as an optical transmitter. The detection means comprises a television camera located at the inspection position and the laser beam produces three different wavelengths which produce white light. Ultraviolet or infrared light can also be used. The camera is separated from the optical fiber and the laser.

U.S. Pat.No. 4,313,431 to Frank discloses an endoscope equipped with a laser light source having a photoconductive fiber, which is used to irradiate a bladder tumor with a laser light beam. It

The present invention relates to a device for observing or treating the interior of a body cavity by non-surgical or microsurgical procedures. The device comprises a coherent multi-fiber optical cable having a planar distal end and a planar proximal end for insertion into a body cavity and provided within a small diameter optical cable. A single optical fiber is also provided having a far end adjacent the far end of the cable and a near end adjacent the near end of the cable. The laser light source can be aligned with the proximal end of the single line optical fiber to transmit light to the far end and illuminate the interior of the body cavity. Optical lens means provided at the far end of the optical cable focuses an image of a portion of the cavity at the far end of the optical cable for transmission within the cable. An optical focusing means can be connected to the proximal end of the optical cable to focus the image of the portion of the body cavity reflected through the cable, and the viewing means for displaying the image of the desired portion of the body cavity can be focused. Connected to the means.

More specifically, the laser endoscope includes a remote viewing unit that includes a television camera and an viewing monitor for displaying an image of a portion of the image viewed by the television camera, and an image from the optical cable for viewing the television camera. An optical cable interface including optical focusing means for focusing on the optical fiber, a laser diode for providing a light beam to the optical fiber, and a laser fiber interface for aligning the light beam from the laser diode with the optical fiber. In addition, the endoscope includes an optical cable assembly that includes a microdiameter coherent multi-fiber optical cable having a planar distal end and a planar proximal end for insertion into the body. Optical lens means are provided at the far end of the cable assembly for focusing and transmitting an image of a portion of the cavity at the far end of the optical cable and into the cable. Within the cable assembly is a single optical fiber having a distal end adjacent the far end of the fiber bundle and a proximal end adjacent the proximal end of the fiber bundle. Finally, the interface connector removably connects the remote viewing unit to match the multi-fiber optical cable to the optical cable interface and the single fiber optic to the laser fiber interface.

A fixed optical system can be provided in the remote unit, which optical system is aligned with the fiber optic bundle. Means may be provided for adjusting the focus of the camera with respect to the fixed optical system to project a correctly defined image on the viewing monitor.

Further, as a spare, a spare optical fiber having the same size and position as the single optical fiber can be provided. The interface connector is provided with a pair of spaced fiber optic pins that respectively match the ends of the single fiber optic and the spare fiber. Socket means are provided in the laser fiber interface for selectively receiving one of the fiber optic pins and aligning the pin with the light beam from the laser diode. Means are also provided for selectively moving the socket means for alignment with the desired one of the pins prior to insertion of the interface connector. The moving means takes the form of a slide member which supports the socket means and which receives the fiber optic pins and positions the socket means to align the single line optical fiber with the light beam from the laser diode from a first position. It is mounted for pivoting on the remote unit to a second position which receives the pin and positions the socket means to align the spare optical fiber with the light beam from the laser diode. The device can be actuated by suitable lever means connected to the slide.

If desired, the cable assembly provides fluid to temporarily remove blood or other bodily fluids at the viewing location within the body cavity, and multiple tubular passageways extending along the optical cable to facilitate viewing. Can have. Preferably, the passages are evenly spaced around the optical cable.

A suitable jacket is preferably provided around the optical cable and the single fiber. Further, a tubular tip can be provided having a central passageway through the center of the tip and with the distal end of the optical cable entering the interior of the tip.
Single and spare fibers can also pass through lateral passages offset from the center of the tip tube to the distal end of the tip. A lens system can be provided in the tubular tip between the distal end of the optical cable and the distal end of the tip. The tubular tip can taper towards its distal end to facilitate insertion into the body cavity.

These single-wire fibers can be formed from fibers that pass through the center of the optical cable rather than separate fibers that are spirally wound on the outside of the cable.

Another optical fiber is used to transmit light from different laser light sources, such as an argon laser or a YAG laser,
Laser surgery can destroy, for example, tissue erosion or tumors or unwanted body tissue growth, such as stones and gallstones. It can also be used to destroy placques in arteries, especially in arteries near the heart.

The advantages of the invention will become more apparent from the above description in connection with the following description of the drawings.

FIG. 1 shows an endoscope manufactured according to the present invention. This endoscope includes a remote control and viewing unit R,
A cable assembly C is detachably connected to this unit. The remote unit R includes a housing 10, which has a front panel 12 to which an observation monitor 14 is attached. On the left side of the viewing monitor are several knobs 16 for standard adjustments such as contrast, vertical hold and brightness adjustments. On the right side of the screen is the power on / off switch 18
And an on / off switch 20 for energizing the laser diode in the housing 10. Key lock 22
If the key lock 22 is not released, neither of the switches 18 and 20 can be activated and this is what initiates the laser delay.
A focusing knob 24 for focusing the image on the observation screen 14 is provided on the key lock 22, which will be described later in detail. A face plate 26 is provided at the right end of the front panel 12, and the face plate 26 is provided with an outlet 28 for interfacing between the remote unit R and the cable assembly C. The details will also be described later. An arcuate slot 30 is provided above the conset 28 in which the laser fiber can be selected to select the laser fiber through which the beam of laser light will pass. This feature will also be described in detail later.

Cable assembly C includes a cable 34, which is provided at a distal end for insertion into a body cavity.
36 and an interface connector 38 provided at the proximal end of the device so as to be plugged into the outlet 28 of the remote unit R.

Referring again to FIG. 1, the general operation of a laser endoscope can be understood. In this regard, a suitable key (not shown) in the key lock 22 may be used to depress the power button 18, which may turn on the observation monitor. An electrical interlock is provided to prevent energization of the laser until the interface connector 38 is inserted into the outlet 28. Pressing button 20 will activate the laser diode. Knob 32 is located at one of the ends along arcuate slot 30 for projecting the laser light beam along one of the two single wire fibers forming part of cable assembly 34, but also for this knob. It will be described in detail later. Once, with proper selection, the outlet 28 can be inserted into the interface connector 38, and not only the tip 36 can be introduced into the patient's body through either a conduit into the body leading to the examination area or a needle inserted into the body at an appropriate site. A portion of the cable assembly 34 can also be inserted. Tip 36 and cable assembly 32 can be inserted into the urethra, for example to examine a bladder or kidney. The small diameter of the cable assembly allows such insertion with little or no discomfort to the patient. The cable assembly can also be penetrated through the abdominal wall and inserted through a needle, but such insertion is possible using local anesthesia. By using this device,
Doctors can examine parts of the body that were previously inaccessible or were only accessible by amputation, which would cause significant trauma and discomfort to the patient. For example, the device
Can be inserted into the brain, spine, and joints. Most treatments contemplated by this invention can be performed outpatiently or in a very short hospital stay.

Once the tip 36 is in the inspection position, the laser button 20 can be pressed to energize the laser diode and project the laser light through the single wire fiber to the inspection position to illuminate the inspection position. The reflected light and image from the inspection location is returned through the cable assembly and can be viewed on screen 14. The knob 16 can be adjusted appropriately to provide the desired brightness, contrast and vertical hold. In addition, the knob 24 can be adjusted to bring the image into proper focus.
In addition, the device can be used to consult one or more physicians regarding internal conditions or to allow another physician to view the screen with one physician for use as a training tool for a student or other physician. TV for recording
A compatible output port (not shown) is provided.

2-9, the details of the cable assembly C can be understood. The cable 34 may be of any length, but is generally 1.0 to 1.5 m long. A coherent multi-fiber optical cable 40 is provided along the center of the cable 34, as best shown in FIG. 3, for transmitting an image from the examination location within the body cavity onto the viewing screen 14. This coherent multi-fiber optical cable can be co-extruded during manufacturing, but this manufacturing process attaches individual fibers together along their peripheral edges,
Cover with a silica coating and jacket 42. The jacket can be made of Teflon or PVC or other similar material. Coherent multi-fiber optical cable 40
Has a numerical aperture of 0.28 and a core diameter of about 4 microns 1
It can consist of 0,000 to 50,000 separate fibers and has a total diameter of about 0.5 to 2.5 mm with jacket 42 in it. A space is provided between the inner jacket 42 and the outer jacket 44, and the single-wire laser fiber 46 and the spare laser fiber 48 are located in the space from the interface connector 38 at the proximal end of the cable assembly C to the distance from the cable assembly C. Spirally extends to the tip 36 on the end.
The outer jacket 44 can also be constructed from fluorocarbon materials such as Teflon or PVC. Finally the outer jacket
An outer protective sheath 50 is provided along a portion of the length of 44, which may be made of a PVC cover braided with cloth or may be a flexible copper cover. Length extending beyond sheath 50 is 15 to 20 cm
You can At the end of the cable adjacent to the interface connector 38, a strain relaxation coil spring 52 having a length of 7 to 9 mm is provided. If desired, the tip 36 may be from a suitable source within or adjacent to the remote unit R so that a particular area of the examination location may be observed.
Another tubular passage 54 may be provided in the outer cover 44 for directing CO ₂ gas or other fluid through the body to a desired location within the body cavity to blow or flush body fluids such as blood. The outer jacket 44 has a total diameter of 1.5 to 3.5 mm
However, the outer diameter of the sheath 50 is 5 to 6 mm.
It becomes the size of. However, since the sheath portion is never inserted into the body cavity, larger dimensions are not impossible.

Preferably, there may be provided a third single line laser fiber used for laser treatment, for example fiber 53 shown in phantom in FIGS. 3 and 4. For example, a second laser such as an argon laser can be provided in the remote unit R, and this laser can be arbitrarily coupled with the fiber 53 to perform laser surgery at the inspection position. Laser light in the 500 nm range has been found to be satisfactory for this purpose.

As best shown in FIGS. 5 and 6, the tip 36, which can be constructed of stainless steel, has a central bore 56 and a tapered outer wall 58. The distal end of coherent multi-fiber optical cable 40 extends into bore 56 and terminates in a polished surface 59. The jackets 42 and 44 are shown in a more reduced scale than they actually are and have a groove 60 in the proximal end of the tip 36.
It is housed inside. The other portion of bore 56 is for positioning a lens system, shown as lens 62. Although only a pair of lenses is shown in the figure, the entire space from the far end of the optical fiber bundle 40 to the planar window 64 can be filled with lenses if necessary. It has been found that a lens that gives a wide magnification of 15 is suitable. These lenses are for focusing the image reflected from the body cavity so that the image reflected from the body cavity can be transmitted back to the remote unit R by the coherent multi-fiber optical cable 40. A lens can be placed instead of the planar window 64 and the window 64 can be omitted. groove
The jackets 42 and 44 are joined to the groove 60 by applying a suitable adhesive (shown) in the groove 60, and
Water can be prevented from entering the tip 36. Sixth
As best shown in the figures, jet openings 66 are located around the end of the tip 36 and communicate with the passages 54 in the outer jacket 44. This allows CO ₂ gas or other fluid to be exhaled through these openings to remove blood or other body fluids that interfere with the illumination of the area of the body cavity under observation and the reflection of the image in this area.

As mentioned above, the proximal end of cable 34 extends through interface connector 38. As best shown in FIG. 7, the coherent fiber bundle 40 is preferably a connector.
Completely penetrates 38 and has a polished end surface 67. This end face 67 abuts the end face 68 of the interface connector 38 as shown. Jackets 42 and 44 extend a short distance into groove 69 in connector 38 as shown. Preferably, strain relief spring 52 includes a flange 70, which is held in place via flange 70 by a lock nut 72 received on a threaded neck 74 on interface connector 38.

The passage 76 communicates with an upwardly extending passage 78 that extends along the upper edge of the neck, which passage 78 in turn connects with diverging passages 80 and 82, which passages 80 and 82 in turn are longitudinal passages. Connect with 84 and 86 respectively. Above the polished end 67 of the coherent fiber bundle 40 is a pair of laterally spaced optical fiber pins 88 and 90, respectively. Laser fibers 46 and 48 have been omitted from FIGS. 7 and 8 for clarity of illustration, but both fibers pass through passages 76 and 78, and laser fiber 46 also passes through diverging passage 80. It should be understood that it diverges and connects to the fiber optic pin 88 along the horizontal passage 84. Similarly, the spare fiber 48 passes through the passage 76 and then diverges through the diverging passage 82 and the longitudinal passage 8 to connect to the fiber optic pin 90.

The shape of the opening in outlet 28 preferably conforms to the shape of connector 38 to clearly and securely align interface connector 38 in outlet 28. The interface connector 38 includes a pair of locking grooves 92 and 94 on either side of the connector that releasably lock and hold the interface connector in the outlet 28. Also, the fiber optic pins 88 and 90 are exactly collinear with the respective laser fiber 46 and spare fiber 48 so that the beam transmits maximum power when projected through the pin. This increases the total amount of light provided at tip 36. Means (not shown) for controlling the power of the laser may also be provided.

Further details of the remote control unit R can be seen with reference next to FIGS. For example, locking grooves 92 and 94 cooperate with ball detents 96 and 98, respectively, which detents 96 and 98, respectively, are groove 104.
It is held in place by springs 100 and 102 mounted in and.

The slide member 108 includes an optical adapter 110 mounted laterally slidably within the face plate 26 and extending rearward, the adapter 110 containing the illumination fiber bundle 112 in the socket 113 and the laser diode 1.
Optically aligned with the 16 laser light beams 114. Lasers that emit light in the infrared and near infrared wavelengths illuminate the inspection location most. For example, from 790nm to 8
It has been found that light in the range up to 50 nm is satisfactory. The front end of optical adapter 110 is a socket 11 that selectively receives either fiber optic pin 88 or 90.
Having 7. As shown in FIG. 10, the pin 90 is shown to be located in the socket, which is the position when the locating knob is in the position shown in FIG. Dummy sockets 118 and 119 can be provided on both sides of the socket 117 to receive unused pins. Preferably, the lever arm 120 is connected to the knob 32 by a knob shaft 122 and is pivoted about a pivot pin mounted on the faceplate 26. The lower end of arm 120 diverges to form slot 126 shown in FIG.
A pin 128 connected to the slide 108 passes through this slot 128. As mentioned above, the lever arm 120 is the first
When in the position shown in FIG. 1, the socket 118 aligns with the fiber optic pin 90. However, when the lever arm is moved to the dotted position shown in FIG. 11, the socket 119 is aligned with the fiber optic pin 88. Therefore, either the single line laser fiber 46 or the spare optical fiber 48 can be selected to project the laser light beam. To maximize coupling and maintain laser beam coherency, the pin 117 must be accurately aligned with the laser beam 114. Such an arrangement maximizes the amount of light available at the inspection position. The purpose of making two fibers is
It is to provide redundancy when one or the other of the fibers breaks. Therefore, it does not matter what position the lever arm is in, unless the fibers that are installed to work in the system are in a broken condition that interferes with the operation of the device. If such a disconnection occurs, all that is required is to pull the interface connector 38 out of the outlet 28, move the lever 32 in the opposite direction, and position the socket 118 to receive the fiber optic pin for the other single wire laser fiber.

Fixed lens tube at the proximal end of the coherent fiber bundle 40 when the interface connector 38 is in place
130 line up on the same line. The tube can include one or more lenses, such as lenses 132 and 134,
The lens system serves to project the image transmitted through the coherent multi-fiber optical cable 40 onto the camera 136, which has a forward projecting focus adapter 138 slidably fitted to the end of the optical assembly 130. A dust and light shield 139 is provided at the end of the adapter 138. The camera 136 is preferably mounted for movement back and forth over spaced parallel support rods 140 and 142, which are mounted in a frame within the remote control unit R, respectively. Mounted longitudinally on the bottom of the camera is a rack 144, which is connected to a gear or pinion 146. The gear is then connected to the shaft 148, which can have a bevel gear 150 on the outer end of the shaft. This bevel gear 150 is a second bevel gear 150 on a shaft 154 connected to the focusing knob 24.
It meshes with the bevel gear 152. Therefore, the camera can be moved back and forth by rotating the focusing knob 24 one or the other until the image projected in the camera is properly focused and can be viewed on the screen 14.

Fig. 13 shows a block diagram of the remote control unit. FIG. 13 shows diagrammatically all the general arrangements of the electronic components that make up the remote control unit R, which are standard commercial items available to those skilled in the art for performing the above video image formats.

The advantages of the present invention will be readily apparent from the above description. Provided is a device having a microprobe that can be inserted into almost any part of the human body and can observe the state of the part. The installation of such devices can often be done through existing body conduits, but in other cases they can be inserted into a fine needle, but such insertion should only be done using local anesthesia. You can In addition, the remote control unit is provided with means for displaying on the monitor an image of any location within the body cavity for another physician or caregiver as well as the operating physician. A single laser beam of light, particularly a beam of light in the infrared or near infrared spectrum, can be used to illuminate any location within the body cavity. Such illumination is possible by ensuring that the laser light beam and the single-line laser fiber are exactly collinear to ensure maximum coupling and preserve laser beam coherency. Furthermore, the coherent multi-fiber optical cable forms a means for transmitting the reflected image from the inspection location to the camera. To improve this image projection, a lens system is provided at the inspection position side in the probe and at the other end of the optical cable in the remote control unit. The new interface transmits both the laser light and the reflected light image from the inspection location to the camera.
Means, such as passageways, may be provided for directing a jet of carbon dioxide gas or other fluid to remove blood or other body fluids from the examination area for better viewing. It is understood that additional laser light sources may be provided to provide sufficient energy laser light through one or more optical fibers in or along the coherent multi-fiber optical cable for actual surgical procedures as is well known to those skilled in the art. It Finally, the elements that the surgeon should extract,
For example, an endoscopic cable can be attached to one side of a gripper, eg, tweezers, so that one can look at the dust and grip it.

The term "micro" as used herein shall mean a cable assembly having a diameter not exceeding 3.5 mm.

While the present invention has been described in detail above with reference to preferred embodiments of the invention, it is understood that variations and modifications can be made within the spirit and scope of the invention.

[Brief description of drawings]

1 is a perspective view of a laser endoscope constructed according to the present invention, FIG. 2 is a partial side view of the optical cable assembly of FIG. 1, and FIG. 3 is a detailed view of the internal structure of the optical cable assembly of FIG. FIG. 4 is an enlarged vertical sectional view taken along line 3-3, FIG. 4 is a vertical sectional view taken along line 4-4 of FIG. 3, showing spiral wrapping of a single-wire optical fiber that carries laser light, and FIG. FIG. 6 is an enlarged longitudinal sectional view of the far end of the optical cable assembly shown in FIG. 6, FIG. 6 is an end view of the far end of the cable assembly shown in FIG. 5, and FIG. 7 is a partially cutaway view for clarity of illustration. 2 is an enlarged partial side view of the interface connector on the cable assembly of FIG. 2, FIG. 8 is a top view of the interface connector of FIG. 7, FIG. 9 is a left end view of the interface connector of FIG. 7, and FIG. Optical fiber FIG. 10 is an enlarged horizontal sectional view taken along line 10-10 in FIG. 1 showing an interface of a camera having a laser light source and a multi-fiber optical cable, and FIG. 11 is a partially cutaway view for clarity of illustration. 12 is a front view of the structure shown in FIG.
Fig. 13 is a top view of the structure shown in Fig. 13, and Fig. 13 is a block diagram of a circuit in the remote control unit. 14 ... Observation screen, 36 ... Tip, 38 ... Interface connector, 40 ... Coherent multi-fiber optical cable, 42, 44 ... Jacket, 46 ... Single line laser fiber, 48 ... Spare laser fiber.

 ─────────────────────────────────────────────────── ─── Continuation of front page (56) References JP-A-60-76713 (JP, A) JP-A-65-1207 (JP, A)

Claims (4)

[Claims] 1. A laser endoscope for observing and / or treating the inside of a body cavity by a non-surgical procedure or a fine surgical procedure, the laser endoscope comprising a remote observation unit and an endoscope. A cable assembly, wherein the remote viewing unit combines a TV camera, an viewing monitor for displaying a portion of the image viewed by the TV camera, and an image from an optical cable onto the TV camera. An optical cable interface including an optical focusing means for focusing, a laser diode for supplying a light beam to an optical fiber, and a laser fiber interface for aligning the light beam from the laser diode on the same line as the optical fiber, The endoscope cable assembly has a planar distal end and a planar proximal end for insertion into a body cavity. A coherent multi-fiber optical cable having a small diameter, and an optical lens means for focusing a part of an image of a cavity to transmit an image to the far end of the coherent multi-fiber optical cable. An optical lens means provided at the far end of the fiber optic cable, a single optical fiber having a far end adjacent to the far end of the coherent multi-fiber optical cable and a near end adjacent to the near end of the coherent multi-fiber optical cable. Detachably connectable to the remote observation unit, aligning the coherent multi-fiber optical cable with the optical cable interface and aligning the single fiber optic with the laser fiber interface. A fixed optical system provided in the remote observation unit, wherein the optical focusing means is a fixed optical system capable of being aligned on the same line; and the optical cable. And a means for movably adjusting the TV camera with respect to the fixed optical system so as to focus an image from the laser endoscope. 2. A spare optical fiber having a far end adjacent to the far end of the optical cable and a near end adjacent to the near end of the optical cable; and an end portion of the single optical fiber and the spare optical fiber, A pair of spaced apart optical fiber pins aligned on the same line, the pair of optical fiber pins provided in the interface connector, and provided in the laser fiber interface,
Socket means for selectively receiving one of the optical fiber pins at one end thereof and aligning it with the light beam from the laser diode; and selectively inserting the socket means before inserting the interface connector. 2. The laser endoscope according to claim 1, further comprising: a moving unit that moves the same to any one of the pins so as to be aligned with the one of the pins. 3. An illumination fiber bundle connected to the other end of the socket means for directing light from the laser diode to the proximal end of the single line optical fiber or the spare optical fiber. The laser endoscope according to claim 2. 4. The moving means is a sliding means that supports the socket means and is slidable on the remote observation unit, receives the optical fiber pin, and causes the single-wire optical fiber to move light from the laser diode. Receiving the spare fiber optic pin from a first position for locating the socket means to align the spare fiber optic with the beam of light from the laser diode so that it is aligned with the beam. A slide means that is movable to a second position for positioning the socket means, and is connected to the slide means, and selectively moves the slide means from the first position to the second position. The laser endoscope according to claim 2, wherein the laser endoscope is provided with a possible lever means.