JPH10211210A - Laser probe - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a laser probe which is hard to be broken and has high durability by arranging an optical transmission member whose tip part is positioned in an inner part than the tip opening of a tube member and which introduces a laser beam in the tube member having an opening in its tip and irradiating the laser beam of the optical transmission member on the tube member. SOLUTION: An optical fiber 2 is arranged inside an outer cylindrical tube 3 which is made of metal and has rigidity superior in heat insulating performance, the tip part of the outer cylindrical tube 3 is provided with a bent part 3a and a bent part 3b so as to be formed into a hooked state, and the tip face is made into an opening part. A fiber holding tool 4 is fixed to the inside of the outer cylindrical tube 3 and the optical fiber 2 is held and fixed to the internal diameter of the fiber holding tool 4. The tip face 2a of the optical fiber 2 is so arranged as to be positioned in a straight part in the front side than the bent part 3a of the outer cylindrical tube 3. The laser beam is guided and transmitted through the optical fiber 2 and emitted from the tip face 2a, irradiated on the internal face of the outer cylindrical tube 3, and then heats the outer cylindrical tube 3.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a laser probe for performing treatments such as incision, hemostasis, coagulation and transpiration of a living tissue by irradiating a laser beam.

[0002]

2. Description of the Related Art In a laser probe disclosed in Japanese Patent Application Laid-Open No. 5-95954, a tip portion of a tip is provided with a curved portion which is curved toward a hand side, and the curved portion is introduced into the tip. Provide a reflector that reflects the laser light to the near side so that the laser light is irradiated only to the affected tissue, which is the object to be irradiated, and the normal tissue located behind the affected tissue is not irradiated as much as possible. ing. In the laser probe described in Japanese Patent Publication No. 5-86225, a laser beam from a laser source is transmitted through an optical fiber and emitted from the front end of the optical fiber, and this laser beam is made of artificial sapphire or the like. The tissue is radiated through the member.

[0003]

Problems to be Solved by the Invention Japanese Patent Laid-Open No. 5-95954
In the laser probe described in the publication, the curved portion of the distal end tip is disposed between the affected part, which is the irradiated body located on the hand side, and a normal tissue part located behind the affected part, By irradiating light, it is possible to irradiate only the affected part, which is the irradiation target, and the laser light is not irradiated to the normal tissue site, but the curved part provided in the distal tip is easily damaged and lacks durability Shape. Sapphire tips are expensive, and laser probes that are easily damaged are highly undesirable. On the other hand, the laser probe described in Japanese Patent Publication No. 5-86225 is particularly advantageous for the hemostasis of the digestive tract, but it is required to act in a direction perpendicular to the longitudinal axis of the laser probe. Not suitable for neck incision. In addition, since the sapphire chip is expensive, a more durable configuration is preferable. The present invention has been made in view of such circumstances, and can provide a laser probe which is hard to be damaged and has high durability.

[0004]

According to the present invention, there is provided a laser probe having a tubular member having an opening at a distal end, and a laser disposed within the tubular member, the distal end of which is located deeper than the distal opening of the tubular member. A light transmission member for guiding light, and at least a part of the laser light emitted from the light transmission member is applied to the tubular member.

[0005]

Embodiments of the present invention will be described below with reference to the drawings. FIGS. 1 and 2 relate to a first embodiment of the present invention. FIG. 1 is a sectional view of a tip portion of a laser probe, and FIG. 2 is a front view of a fiber holder.

In the laser probe 1 shown in FIG. 1, laser light from a laser source (not shown) is transmitted through an optical fiber 2. The optical fiber 2 is disposed inside a heat-resistant rigid outer tube 3 made of metal such as stainless steel. The outer tube 3 has substantially the same diameter over its entire length, and its distal end has a curved portion 3a and a curved portion 3b, and is formed in a hook shape so that a living tissue or the like can be hooked. The tip surface is an opening. Therefore, the living tissue or the like can be hooked on the hook-shaped portion. A fiber holder 4 is fixed in the outer tube 3 by press fitting or bonding, and the optical fiber 2 is held and fixed in the inner diameter of the fiber holder 4 by pressing or bonding. The distal end surface 2a of the optical fiber 2 is
It is arranged so as to be located at a straight portion closer to the hand than a. Two grooves 4a are provided on the outer peripheral side of the fiber holder 4 as shown in FIG. One groove may be provided, or three or more grooves may be provided. Optical fiber 2
A space formed between the outer tube 3 and the inner diameter of the outer tube 3 and a continuous space formed by the groove 4a provided in the fiber holder form a fluid passage. The fluid passes through a path 5 indicated by a broken line.

Next, the operation of this embodiment will be described.
Laser light generated from a laser source (not shown) is guided through the optical fiber 2 and emitted from the distal end surface 2a.
The emitted laser light is applied to the inner surface of the outer tube 3 to heat the outer tube. Therefore, the living tissue can be heated / coagulated or cut off by emitting the laser light in a state where the living tissue is previously hooked on the hook-shaped portion of the laser probe. By flowing a cooling fluid such as water through the fluid passage 5, overheating and the like near the distal end of the optical fiber 2 and the curved portion of the outer tube 3 can be prevented.

According to this embodiment, the living tissue is coagulated and cut off by a rigid outer tube made of metal or the like heated by a laser beam, so that a conventional tip made of sapphire is not used. Without it, its durability is dramatically improved. In addition, the tip shape of the outer tube is not limited to a hook shape, and it is hardly damaged even when formed in various shapes, and sufficient durability can be secured. In addition, since it has a hook-like shape, it is possible to realize a laser probe that is optimal for tissue exfoliation and the like and has high durability.

In order to further increase the reflection of the laser beam on the inner surface of the outer tube 3, gold plating or the like may be applied. Conversely, when it is desired to increase the absorption to suppress the reflection and to reduce the heating other than the necessary parts as much as possible, a surface treatment such as black chrome plating may be performed.

Next, a second embodiment of the present invention will be described with reference to FIG. FIG. 3 shows the optical fiber 2 shown in FIG.
And the configuration in which the shape of the outer tube 3 is different.

In the laser probe 6 shown in FIG. 3, the optical fiber 7 has its tip surface 7a cut obliquely, and the cut surface functions as a reflection surface. Further, the outer tube 8 has only one curved portion 8a. The distal end surface 7a is arranged in a direction facing the curved portion 8a. The optical fiber 7 is held and fixed to the outer tube with the same configuration as in the first embodiment.

Next, the operation of this embodiment will be described.
A laser beam generated from a laser source (not shown) is transmitted through the optical fiber 7 and transmitted through the optical fiber 7 so as to be cut at an angle.
Is reflected by The reflected laser light is emitted from the side of the optical fiber 7. The emitted laser beam irradiates and heats only the vicinity of the inside of the curved portion 8a of the outer tube 8. The laser light is emitted while the living tissue is hooked on the hook-shaped portion of the laser probe in advance, so that only the living tissue located inside the curved portion of the hook-shaped portion is selectively heated / coagulated or cut off. Can be.

According to this embodiment, since the portion heated by the laser beam is only inside the curved portion of the hook-shaped portion, the living tissue in contact with the outside of the curved portion is not adversely affected by the heat. Therefore, only the living tissue hooked inside the curved portion of the hook-shaped portion of the laser probe can be coagulated or cut off safely.

Next, a third embodiment of the present invention will be described with reference to FIG. Note that the same components as those in the first embodiment are denoted by the same reference numerals, and description thereof will be omitted.

In the laser probe 11 shown in FIG. 4, laser light from a laser source (not shown) is transmitted through an optical fiber 12. The optical fiber 12 is disposed in an outer tube 13 made of metal such as stainless steel and having excellent heat resistance. The outer tube 13 has substantially the same diameter over its entire length, and its distal end is an opening. The distal end surface 12a of the optical fiber 12 is assembled so as to be located at a position deeper on the inner side than the opening of the outer tube 13. The method of holding and fixing the optical fiber 12 and the outer tube 13 is the same as in the first embodiment. At the incident end of the laser light (not shown) to the optical fiber 12, the laser light emitted from the distal end face 12a is formed into a donut shape by injecting the laser light at an angle with respect to the optical axis of the optical fiber 12. Of light. Optical fiber 12
A fluid passage 5 is formed by a gap formed between the outer tube 13 and the inner diameter of the outer tube 13 and a continuous space formed by a groove provided in a fiber holder (not shown) as in the first embodiment. .

Next, the operation of this embodiment will be described.
Laser light generated from a laser source (not shown) is guided and transmitted through the optical fiber 12, and is emitted as a donut-shaped light beam from the emission surface 12a at the tip. The emitted donut-shaped laser light is applied to the inner surface of the outer tube 13,
The outer tube 13 is heated. Therefore, by bringing the living tissue into contact with the outer tube 13 of the laser probe 11, the living tissue can be heated / coagulated or cut off. At this time, since the laser light is a donut-shaped light beam, there is no laser light directly emitted from the emission surface 12a of the optical fiber 12 and reaching the living tissue. In addition, by flowing a cooling fluid such as water through the fluid passage, overheating or the like near the distal end of the optical fiber 12 and the distal end of the outer tube 13 can be prevented.

According to the present embodiment, the laser beam is converted into a donut-shaped light beam to heat the outer tube 13, so that
Even if the outer tube 13 has a shape without a curved portion,
No laser light is directly emitted from the emission surface 12a of the optical fiber 12 to the living tissue. Therefore, safety is high,
Even if the structure of the curved part is required only for the purpose of not directly irradiating the laser beam, the necessity can be eliminated,
A straight-shaped laser probe that can be easily processed can be used.

Next, a fourth embodiment of the present invention will be described with reference to FIG. Note that the same components as those of the third embodiment are denoted by the same reference numerals, and description thereof will be omitted.

The fourth embodiment differs from the third embodiment shown in FIG. 4 only in the shape of the distal end of the outer tube 13.

In the laser probe 16 shown in FIG. 5, the outer tube 17 has substantially the same diameter up to the vicinity of the tip, and the tip 17a is tapered and narrowed. An opening is provided at the tip. The distal end surface 12a of the optical fiber 12 is located at a position deeper on the inner side than the opening of the outer tube 17 and
Are assembled so as to be located in a straight portion having substantially the same diameter. In addition, the method of holding and fixing the optical fiber 12 and the outer tube 17 and the formation of the fluid passage 5 are the same as in the third embodiment.

The operation of this embodiment is the same as that of the third embodiment.

According to the present embodiment, in addition to the effects of the third embodiment, by contacting the tip 17a, which is squeezed finely, with the living tissue, hemostasis, coagulation, etc. targeting only a finer portion are achieved. It can be performed.

Next, a configuration example of a laser probe suitable for operating in a direction perpendicular to the longitudinal axis direction of the laser probe will be described with reference to FIGS.

In the laser probe 21 shown in FIG. 6, laser light from a laser source (not shown) is transmitted through an optical fiber 22. The optical fiber 22 is made of a metal such as stainless steel and has a rigid and excellent heat resistance.
3. The distal end of the outer tube 23
Stepped portion 24a and saw-shaped portion 24b of fiber holder 24
The distal end of the optical fiber 22 is held and fixed in the inner diameter portion 24c of the fiber holder 24 by press-fitting or bonding or the like. The saw-like portion 24b has a groove 24 as shown in FIG.
d is formed. One or more grooves 24d may be provided. A male screw portion 24e is formed on the distal end side of the fiber holder 24. Holder 2 made of metal such as stainless steel
5 is provided with a female screw portion 25a at the inner diameter thereof, and has a configuration in which the male screw portion 24e of the fiber holder 24 is screwed and assembled. The holder 25 is provided with a hole 25b penetrating from the outer peripheral side to the inner peripheral side. The hole 25b is
One or more locations may be provided. A translucent member 26 made of quartz, artificial sapphire, or the like is attached to the step 25c on the distal end side of the holder 25 by caulking or the like. The incident surface 26a of the light transmitting member 26 is the emission surface 22a of the optical fiber 22.
The optical fiber 22 is assembled in the outer tube 23 so as to have an appropriate space between the light exit surface 22a and the light incident surface 26a of the light transmitting member 26.
In addition, the coating of the optical fiber is removed at the tip side from the position corresponding to the middle of the groove 24d. The gap between the optical fiber coating and the inner diameter of the outer tube, the groove 24d provided in the fiber holder, the gap between the inner diameter portion 24c of the fiber holder and the uncoated optical fiber, the inner diameter of the holder 25 The continuous space formed by the portion and the hole 25b provided in the holder 25 forms a fluid passage. The fluid passes through a path 27 indicated by a broken line. The light-transmitting member 26 is a cylindrical part 2
A reflection surface 26c for reflecting the laser light incident from the incident surface 26a is provided on the tip side of the laser beam 6b, and the laser light reflected by the reflection surface 26c is introduced to repeat the internal reflection on the inner surface. And a distal end portion 26d for emitting laser light from the distal end portion to the target tissue. The tip part 26d cuts the tip of the cylindrical member diagonally at two places,
The two cut surfaces 26e form a substantially double edged shape. The central axis 26f of the cylindrical tip 26d and the incident surface 2
The central axis 26g of the cylindrical portion 26b having one end 6a is formed so as to form a substantially right angle. The reflection surface 26c has an angle of about 45 degrees with respect to the respective central axes 26f and 26g. The outer diameter of the outer tube 23, the outer diameter of the fiber holder 24, and the outer diameter of the holder 25 are substantially the same.

Next, the operation of this configuration example will be described. Laser light generated from a laser source (not shown) is guided through the optical fiber 22 and emitted from the emission surface 22a at the tip. The emitted laser light is incident on the incident surface 26 of the light transmitting member 26.
After passing through the cylindrical portion 26b and passing through the cylindrical portion 26b, the light is reflected by the reflecting surface 26c in a substantially right-angle direction, and is repeatedly reflected on the inner surface by using the two surfaces 26e having a substantially double-edge shape in the cylindrical portion 26d as the reflecting surfaces. Are converged toward the tip of the tubular portion 26d. Therefore, for example, when incising the neck of the bladder, the double-edged surface 26
By emitting the laser light by bringing the tip of e into contact with the living tissue of the prostate neck, the bladder neck can be incised without bleeding due to the thermal action of the laser light and the mechanical action of the double-edged shape. By flowing a cooling fluid such as water through the fluid passage 27, overheating of the distal end of the optical fiber 22, the light transmitting member 26, and each member located in the path can be prevented. Since the optical fiber holder 24 and the holder 25 are connected by screws, the light transmitting member 2
In the event that 6 is damaged, it can be easily replaced.

According to the configuration examples shown in FIGS. 6 and 7, the laser beam can be made to act in a direction substantially perpendicular to the longitudinal axis of the laser probe, and the laser probe having an optimal shape for incising the bladder neck can be obtained. Can be provided. If the tip is broken, it can be easily replaced.

The configuration example of the laser probe shown in FIG. 8 is different from the configuration example shown in FIG. 6 only in the shape of the light transmitting member.

The light transmitting member 31 is provided with a reflecting surface 31c for reflecting the laser light incident from the incident surface 31a on the tip end side of the cylindrical portion 31b, and transmits the laser light reflected by the reflecting surface 31c. It has a distal end 31d that emits laser light from the distal end to the target tissue while introducing and repeating internal reflection on its inner surface. The tip of the tip portion 31d is
It is formed in a conical shape. The central axis of the cylindrical tip portion 31d and the central axis of the cylindrical portion 31b having the incident surface 31a at one end are formed so as to be substantially perpendicular to each other, and the reflecting surface 31c is approximately 45 ° away from each central axis. It is configured to be in degrees.

The operation of this configuration example is almost the same as the configuration examples of FIGS. After passing through the cylindrical portion 31b, the laser beam incident on the light transmitting member 31 is reflected in a substantially right angle direction on the reflecting surface 31c, and the inner surface of the conical portion in the cylindrical portion 31d is repeatedly reflected on the inner surface to form a conical portion. Is converged toward the tip of and emitted.

Since the tip of the probe is sharp, hemostasis and coagulation of a finer portion can be performed.

As described in detail above, according to the embodiment of the present invention, the following configuration can be obtained. [Appendix 1] A tubular member having an opening at a tip thereof, and an optical transmission member which is disposed within the tubular member and guides a laser beam whose tip is located deeper than the tip opening of the tubular member. A laser probe, wherein at least a part of laser light emitted from the light transmission member is irradiated on the tubular member. [Additional Item 2] The laser probe according to Additional Item 1, wherein the tubular member has heat resistance and rigidity and has substantially the same diameter over its entire length. [Additional Item 3] The laser probe according to Additional Item 1, wherein the tubular member has substantially the same diameter up to the vicinity of a distal end thereof, and the distal end has a tapered shape. [Additional Item 4] The additional item 1, wherein the laser beam is emitted from the optical transmission member in an oblique direction with respect to the longitudinal axis of the optical transmission member, and the laser light emitted from the optical transmission member is substantially donut-shaped. The laser probe as described. [Appendix 5] A tubular member having an opening at a distal end and having at least a distal end portion in a hook shape, and a laser beam which is disposed inside the tubular member and has a distal end located at a position deeper than the distal end opening of the tubular member. A laser probe comprising: a light transmission member that emits light. [Additional Item 6] The additional item, wherein the tubular member has a hook-shaped distal end portion and a linear proximal side portion, and the distal end of the optical transmission member is located at a linear portion of the tubular member. 6. The laser probe according to 5. [Additional Item 7] The tubular member has a hook-shaped tip and a straight hand side, and the tip of the light transmission member is positioned near a boundary between the straight portion and the hook-shaped portion of the tubular member. 6. The laser probe according to claim 5, wherein [Additional Item 8] The tip of the optical transmission member is formed obliquely with respect to the longitudinal axis thereof so as to be able to reflect laser light, and the laser light reflected by the reflective surface is used to identify the tubular member. 6. The laser probe according to claim 5, wherein the laser probe can be irradiated only to the portion. [Appendix 9] The tip of the optical transmission member is formed obliquely with respect to its longitudinal axis so as to be able to reflect laser light, and the laser light reflected by the surface capable of being reflected is hooked to the hook of the tubular member. 6. The laser probe according to claim 5, wherein an optical transmission member is arranged to be guided inside the shape portion. [Additional Item 10] The laser probe according to Additional Item 1 or Additional Item 5, wherein a fluid passage is provided between the tubular member and the optical transmission member. [Supplementary Note 11] A laser having an optical transmission member that guides laser light, an incident surface disposed opposite to a tip end surface of the optical transmission member from which the laser light is emitted, and a laser incident from the incident surface. A laser probe, comprising: a reflecting surface for reflecting light; and a laser light transmitting member having a tip shape for converging the laser light reflected by the reflecting surface by internal reflection. [Additional Item 12] The laser probe according to Additional Item 11, wherein the distal end shape of the laser light transmitting member is a double edged shape. [Additional Item 13] The laser probe according to Additional Item 11, wherein the tip of the laser beam transmitting member has a conical shape. [Additional Item 14] The laser probe according to Additional Item 11, wherein the laser beam transmitting member is made of artificial sapphire.

[0032]

As described above, according to the present invention, it is possible to provide a laser probe which is hardly damaged and has high durability.

[Brief description of the drawings]

FIG. 1 is a sectional view of a laser probe according to a first embodiment of the present invention.

FIG. 2 is a sectional view of a fiber holder of the laser probe according to the first embodiment of the present invention.

FIG. 3 is a sectional view of a laser probe according to a second embodiment of the present invention.

FIG. 4 is a sectional view of a laser probe according to a third embodiment of the present invention.

FIG. 5 is a sectional view of a laser probe according to a fourth embodiment of the present invention.

FIG. 6 is a cross-sectional view of a laser probe suitable for acting in a direction perpendicular to the longitudinal axis direction of the laser probe.

FIG. 7 is a sectional view of a fiber holder of the laser probe of FIG. 6;

FIG. 8 is a cross-sectional view of another laser probe suitable for acting in a direction perpendicular to the longitudinal axis direction of the laser probe.

[Explanation of symbols]

 1,6,11,16,21,31 Laser probe 2,7,12,22 Optical fiber 3,8,13,17,23 Outer tube 4,24 Fiber holder

 ──────────────────────────────────────────────────続 き Continuing on the front page (72) Inventor Hitoshi Ueno 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inside Olympus Optical Co., Ltd. (72) Inventor Nobuyuki 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd. (72) Inventor Mamoru Kaneko 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd.

Claims (1)

[Claims] 1. A tubular member having an opening at a distal end, and an optical transmission member disposed in the tubular member and guiding a laser beam whose distal end is located deeper than the distal end opening of the tubular member. A laser probe, wherein at least a part of laser light emitted from the light transmission member is irradiated on the tubular member.