JPH11104147A - Medical laser device and hand piece thereof - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a medical laser device which illuminates the surroundings of a region to which laser treatment is applied. SOLUTION: This hand piece 30 for this medical laser device comprises an optical fiber 122 and a casing 40 which retains the optical fiber 122 in such a way that its tip part protrudes by a specified length. In addition, the hand piece 30 has a lamp 110 which illuminates the tip part of the optical fiber 122 and its periphery and an illuminating light emission part 182 is provided in a spot way back from the tip of the optical fiber 122. An operator can visually examine the illumination state of a laser beam and the laser surgical treatment with the help of the illuminating light, and also can perform the surgical treatment correctly and precisely with the medical laser device.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a laser medical device for irradiating a laser beam emitted from a laser generator to a treatment section, and a handpiece for guiding the laser beam to the treatment section in the laser generator. Particularly, the present invention relates to a laser medical device and a handpiece suitable for a contact medical system in which a laser beam is emitted by bringing a laser beam emitting end of the handpiece into contact with an affected part.

[0002]

2. Description of the Related Art As a laser medical device for irradiating a treatment portion (for example, an incision portion or a dental treatment portion) with a laser beam emitted from a laser generator to cut or treat the treatment portion, a medical laser beam is guided. By guiding the visible guide light into the optical fiber for light emission and emitting the laser light with the illuminating part of the guide light aligned with the target laser irradiation position, the laser light can be reliably transmitted to the target portion. Irradiation is disclosed in JP-A-58-25152, Japanese Patent Publication No. 7-6 / 78.
No. 1337.

[0003]

However, in the laser medical device described in Japanese Patent Application Laid-Open No. 58-25152,
Laser light is used as guide light to illuminate the irradiation position of the laser light, but since the laser light has high directivity (low diffusion), it is necessary to illuminate only a limited part of the treatment part. Only. For this reason, particularly in dental treatment, in a place where external light is blocked by a dentition or the like, the situation around the laser light irradiation position cannot be seen, and it is difficult to perform treatment while moving the laser light left or right or up and down. Was.
In addition, since the laser light used as the guide light is red or orange visible light, there is a problem that it is difficult to confirm bleeding from the affected part. Furthermore, when the laser light is irradiated while the laser light emitting end of the optical fiber described in the above-mentioned publication is in contact with the affected part, the guide light is blocked by the affected part, so that the laser light is emitted from the optical fiber darkly. There is a drawback that the end cannot be seen and the surgical object cannot know where the laser light emitting end of the optical fiber is in contact with the affected part.

On the other hand, the laser medical device described in Japanese Patent Publication No. Hei 7-61337 emits laser light and guide light from one exit port provided in a handpiece, and the exit port is separated from a treatment section. Non-contact type used. However, the non-contact type handpiece has a problem that it is difficult for an operator to obtain an operation feeling and accurate treatment cannot be guaranteed.

[0005]

SUMMARY OF THE INVENTION Accordingly, the present invention provides a laser medical device capable of illuminating not only the laser beam irradiation position but also this irradiation position and the vicinity thereof. A main object of the present invention is to provide a laser treatment apparatus capable of illuminating the periphery of the treatment section even when the emission end is in contact with the treatment section, and a handpiece thereof.

To achieve the above object, a handpiece for a laser medical device according to a first embodiment comprises a first light transmitting means for transmitting a laser beam, and the first light transmitting means comprising the first light transmitting means. And a casing for holding the optical transmission means in such a state that the distal end thereof protrudes by a predetermined length. The handpiece also has illumination means for illuminating the outer periphery of the distal end of the first light transmission means and the periphery thereof, and the light emitting part of the illumination means faces the distal end of the first light transmission means. And provided on the casing.

In the handpiece according to the second aspect, the light emitting portion of the illuminating means is provided at a position retreated from the tip of the first light transmitting means.

A first aspect of the handpiece according to the second aspect has a second light transmission means for transmitting illumination light of the illumination means, and a tip light emitting portion of the second light transmission means. Is provided at a position retreated from the tip of the first optical transmission means.

In a second aspect of the handpiece according to the second aspect, the second optical transmission means comprises one or a plurality of optical fibers.

In a third aspect of the handpiece according to the second aspect, the second optical transmission means has a cylindrical member provided outside the first optical transmission body, and the cylindrical member is a cylindrical member. A plurality of optical fibers are arranged on a cylinder around the axis in parallel with the axis.

In a fourth aspect of the handpiece of the first and second embodiments, the first optical transmission means includes a primary optical transmission body and a secondary optical transmission body including the distal end. And the secondary side optical transmission body is detachable from the casing.

In a fifth aspect of the first and second aspects of the handpiece, the primary light transmitter is used as a light guide for illumination light, and the illumination transmitted by the primary light transmitter is used. Light is introduced into the second optical transmission means.

[0013] In a seventh aspect of the handpiece of the first and second aspects, the illumination light source of the illumination means is either an incandescent lamp or a light emitting diode.

In an eighth aspect of the handpiece of the first and second embodiments, the illumination light source of the illumination means is provided on the casing.

[0015] In a ninth aspect of the handpiece of the first and second aspects, the illumination light source of the illumination means is provided at a location remote from the handpiece.

A laser medical device according to the present invention has the laser medical device handpiece and a main unit having a laser generator, and transmits the laser light generated by the laser generator to the first optical transmission means. To be transmitted.

In the first aspect of the laser medical device, the illumination light source is provided in the main unit.

In a second aspect of the laser medical device, the laser medical device has a first switch for turning on and off the illumination light source, and a second switch for turning on and off the laser light from the laser generator. The second switch is turned on only when the first switch is turned on.

In the third aspect of the laser medical device, the on signal of the illumination light source is generated earlier than the on signal of the laser generator, and / or the off signal of the illumination light source is generated by the off signal of the laser generator. Generate later.

[0020] In the fourth aspect of the laser medical apparatus, the ON signal of the illumination light source is generated simultaneously with the ON signal of the laser irradiation preparation switch, and the OFF signal of the illumination light source outputs the OFF signal of the laser irradiation switch for a predetermined time. Occurs with a delay.

In a fifth aspect of the laser medical device, the laser medical device further comprises a foot controller having the first and second switches, and the foot controller is configured to release the first switch when the pedal is depressed to a first position. Is turned on, and then the pedal is depressed to the second position to turn on the second switch. Conversely, when the pedal is returned to the second position from the state where the second switch is turned on, the The second switch is turned off, and the first switch is turned off when the pedal is subsequently returned to the first position.

In a sixth aspect of the laser medical device, the laser medical device further comprises a guide light source for emitting guide light for illuminating a position to be irradiated with the laser light through the first optical transmission body. Are turned on at the same time.

In a seventh aspect of the laser medical device, the guide light has a different color from the illumination light.

[0024]

According to the laser medical device and the handpiece according to the present invention, for example, the laser light generated by the handpiece or a laser generator located at a position remote from the handpiece is transmitted by the first optical transmission means. It is transmitted and irradiated to a predetermined treatment section by operating the handpiece while grasping the casing. During the treatment, in the illumination means, the illumination light is emitted from the casing or a light emitting portion provided at a position retreated from the tip of the first light transmission means, and the outer periphery of the tip of the first light transmission means, that is, the emission end of the laser light. The outer periphery and its periphery are illuminated. Therefore, with the help of the illumination light, the surgeon can visually recognize the irradiation state and the treatment state of the laser light, and can perform a precise and precise treatment. Also, since the illumination light illuminates not only the laser beam irradiation area but also the surrounding area,
When treating while moving the handpiece, you can also check the state of the movement destination, it is easy to perform additional treatment and correction, there is no need to interrupt the irradiation of laser light for each confirmation,
Continuous treatment is possible.

In a handpiece in which the second optical transmission means is composed of one or more optical fibers, the illumination light of the illumination means is transmitted through these optical fibers and emitted from the tip. Further, the second optical transmission means has a cylindrical member provided outside the first optical transmission means, and the cylindrical member is provided with a plurality of optical fibers on a cylinder centered on the axis of the cylindrical member in parallel with the axis. Are arranged, the illuminating light of the illuminating means is reliably illuminated on the laser beam irradiation area and its surroundings.

[0026] The first optical transmission means includes a primary optical transmission body,
In the case where the secondary light transmitter is configured to be detachable from the casing, it is possible to remove the secondary light transmitter from the handpiece and perform autoclave sterilization. Can be done and sanitary.

The above-mentioned primary-side optical transmission body can be used as a light guide path for illumination light, and the illumination light transmitted by the primary-side optical transmission body can be introduced into the second optical transmission means, which is used for the illumination means. In the case where the illumination light source is provided in a place other than the handpiece, for example, in the main unit of the laser medical device, the laser light and the illumination light are transmitted by the primary optical transmitter, and thereafter, the laser light is transmitted by the secondary optical transmitter. While the illumination light is
To illuminate the outer periphery of the distal end portion of the secondary-side optical transmission body and its surroundings.

Various illumination devices can be used as the illumination light source of the illumination means. For example, a small incandescent light bulb or a light emitting diode can be incorporated in the handpiece. In addition, if the light transmitting portion is incorporated in the handpiece, the attenuation (loss) from the illumination light source to the light emitting portion is small, and the distal end portion of the first optical transmission means can be illuminated with appropriate brightness.

The illumination light source is located at a place away from the handpiece,
For example, it may be provided in the main unit of the laser medical device,
In this case, the handpiece can be reduced in size by the illumination light source.

The laser medical device is provided with a first switch for turning on / off the illumination light source and a second switch for turning on / off the laser generator. The second switch is turned on when the first switch is turned on. In the case where the laser light is turned on only when the laser light is radiated, the irradiation position is always illuminated by the illumination light, so that the tip of the first light transmission means is surely directed toward the target treatment position. Then, the laser light can be applied to the place.

In a laser medical device that generates the ON signal of the illumination light source earlier than the ON signal of the laser generator, and / or generates the OFF signal of the illumination light source later than the OFF signal of the laser generator, Since the laser light irradiation position is always illuminated while the laser light is emitted, the surgeon can easily visually recognize the laser light irradiation position in the treatment area, and reliably place the laser light in an appropriate place in the treatment. Can be irradiated.

A laser medical apparatus wherein the on signal of the illumination light source is generated simultaneously with the on signal of the laser irradiation preparation switch, and the off signal of the illumination light source is generated by delaying the off signal of the laser irradiation switch by a predetermined time. Then, the state of the treatment section can be confirmed before the laser beam irradiation, and appropriate laser medical treatment can be performed according to the state. In addition, the state after the treatment can be confirmed after the end of the laser beam irradiation.

First and second switches are provided on the foot controller. When the pedal is depressed to the first position, the first switch is turned on, and when the pedal is depressed to the second position, the second switch is turned on. Conversely, when the pedal is returned to the second position with the second switch turned on, the second switch is turned off, and then when the pedal is returned to the first position, the first switch is turned off. In the laser treatment device configured in the above, since illumination and irradiation of laser light can be controlled by pedal operation of the foot controller, the operator operates the handpiece at hand, while operating the pedal under the foot,
The operation can be performed easily.

In a laser medical apparatus in which a guide light source for emitting guide light for illuminating the irradiation position of laser light through the first optical transmission body is provided, and the illumination light and the guide light are turned on simultaneously, the laser light is illuminated by the illumination light. With the help of the guide light, the first light transmitting body and the laser light can be directed to the target treatment site in the treatment region.

When the guide light has a color different from that of the illumination light, the guide light can be surely visually recognized in the illumination light, so that the laser beam can be reliably irradiated to a target place.

[0036]

Preferred embodiments of the present invention will be described below with reference to the accompanying drawings. FIG. 1 shows the whole of a dental treatment laser medical device (10), which has a main body unit (12). The main unit (12) has a box-shaped housing (14), in which a control unit (16) for controlling the entire laser medical device (10) and a laser generator (18) are provided as shown in FIG. ),
Guide light source (20), illumination power supply (22), air supply source (2
4) A water supply (26) and a warning lamp power supply (28) are provided.

Returning to FIG. 1, the laser medical device (10) also uses a handpiece (30) for performing a treatment using a laser beam generated by a laser generator (18) and a handpiece (30). A foot controller (32) for an operator (not shown) to turn on / off the irradiation of the laser beam under the feet during the treatment. The main unit (12) and the handpiece (30) are composed of an optical fiber, an air supply pipe,
Water supply pipe, flexible tube containing electric wires (34)
The main unit (12) and the foot controller (32) are connected by a control line (36).

FIG. 3 shows a cross section of the tip portion of the handpiece (30). The handpiece (30) comprises a cylindrical (outer diameter of about 10 mm, length of about 15 cm) casing (40) (see FIG. 1) and a plurality of components [holder] attached to the distal end side of the casing (40). (42), fiber holding member (44), etc.].

One end of a flexible tube (34) is inserted and fixed to the rear end of the casing (40) (not shown). On the other hand, in FIGS. 3 and 4 [for the sake of clarity, in FIG. 4, the cross-sectional display of the holder (44) by oblique lines is omitted. ], An inner thread portion (46) is formed on the distal end side of the casing (40), and the holder (42) is fixed thereto.

As shown in FIG. 5, the holder (42) is formed of a cylindrical member, and has a through hole (48) formed along the central axis. A circumferentially continuous groove (50) is formed in the outer peripheral portion on the distal end side of the holder (42), and an O-ring (52) is mounted therein. An outer thread portion (54) is formed on the outer periphery of the rear end side of the holder (42), and the outer thread portion (54) is fitted to the inner thread portion (46) of the casing (40), whereby the casing ( The holder (42) can be detachably fixed to 40). Holder (4
A small diameter portion (56) is formed on the front end side of 2), and an external thread portion (58) is formed on the outer periphery of the rear end side of the small diameter portion (56). On the other hand, four conical holes (60) penetrating the small-diameter portion (56) are formed at the distal end side of the small-diameter portion (56) at an angle of 90 degrees in the circumferential direction. )
Each ball (62) having a diameter larger than the thickness of the ball is accommodated therein. In the small diameter portion (56), a part of the small diameter portion (56) is cut away rearward from the front end face to position the positioning groove (FIG. 6).
(64) is formed.

The through hole (48) comprises first to fourth through hole portions (66), (68), (70), (72),
The diameter of the first through-hole portion (66) on the rear end side is the smallest, and the diameter increases as it goes to the front end side. The rearmost first through-hole portion (66) is extended rearward by a cylindrical portion (74) projecting rearward from the rear end surface of the holder (42), and is provided inside the rear end portion of the cylindrical portion (74). An inner flange (76) continuous in the circumferential direction is formed on the peripheral surface. Also,
An inner threaded portion (7) is provided at the distal end side of the first through hole portion (66).
8) is formed.

The holder (42) also has three passages from the rear end face toward the front end side, namely, an air supply passage (80),
A water supply path (82) and a wiring path (84) are formed, and rear ends of the air supply path (80) and the water supply path (82) are enlarged to be connection parts (86) and (88). Connection (8
6) and (88) have connection pipes (90) and (92) respectively.
The connecting pipes (90) and (92) are connected to an air supply pipe (94) and a water supply pipe (96). The air supply path (80) has three branch paths (100), (102),
(104) is formed and the first branch (100) is
The second branch (102) communicates with the front end of the second through hole (68), and the third branch (104) communicates with the rear end of the through hole (68). 4 through holes (7
It communicates with 2). The water supply channel (82) communicates with the rear end of the third through-hole portion (70). Wiring path (84)
Communicates with a recess formed by cutting a part of the third through-hole portion (70) (that is, the lamp housing portion (106)). A wiring () having one end connected to the illumination power supply (22) is disposed in the wiring path (84), and the other end of the wiring () is connected to a small light emitting diode housed in the lamp housing (106). Alternatively, it is connected to a lamp (110) composed of an incandescent lamp.

The holder (42) is further provided with a first through-hole portion (6) from a substantially intermediate position of the second through-hole portion (68).
6) An exhaust path (112) is formed in the axial direction of the through hole (48) near the rear end.

The above-described air supply passage (80) and water supply passage (8)
2), wiring path (84), branch path (100), (10
2), (104), to form the exhaust passage (112), the holder (42) is divided into two parts by a plane including the center axis thereof, Roads and the like are formed. Further, the two divided parts are inseparably bonded in a combined state.

As shown in FIGS. 3 and 4, an optical fiber holder (116), a lens unit (118), and a fiber holding member (120) are arranged in the through hole (48) from the rear end side. The optical fiber holder (116) has a cylindrical shape, is disposed in the first through-hole (66), and its rearward movement is regulated by a rear end flange (76). Further, the optical fiber holder (116) is configured such that an output end (124) of the primary optical fiber (122) is cooled by an output end (124) to be described later. It is held so as to face the chamber (126). The rear end side (laser light incident end side) of the primary side optical fiber (122) is connected to a laser generator (18) (not shown), and emits laser light generated by the laser generator (18). The light exits from the section (124). In the inner peripheral portion of the optical fiber holder (116), an exhaust path (12
8) is formed, and exhaust from the exit end cooling chamber (126) is enabled.

The lens unit (118) includes the lens (1).
30) and first and second cylindrical lens holding members (132), (1) for holding the lens (130) on the central axis.
34), and are disposed in the second through-hole portion (68). The first lens holding member (132) has an externally threaded portion (136) on the rear end side thereof.
6) is replaced with the internal thread portion (7) on the tip side of the first through hole portion (66).
8) (See FIG. 5) An inner thread portion (138) is provided on the distal end side of the first lens holding member (132).
Is formed, and the second lens holding member (1) is correspondingly formed.
An outer thread portion (140) is formed on the outer periphery of the second lens holding member (140) with the lens (130) disposed inside the first lens holding member (132) as shown in the figure. The lens (130) is stably fixed by fitting the external thread (140) of the lens (134) into the internal thread (138) of the first lens holding member (132). An exit end cooling chamber (126) and an entrance end cooling chamber (142) are formed on the end side and the end side, respectively.

The first lens holding member (132) is provided with a passage (144) for connecting the inside and the outside, and the first lens holding member (144) is attached to a predetermined place and the passage (144) is formed. 144) is in communication with the first branch (100) of the holder (42). Therefore, the air supply pipe (8
The air (preferably dry air) supplied from the optical fiber holder (0) is supplied to the exit end cooling chamber (126) through the first branch (100) and the passage (144), and then the above-described optical fiber holder ( The air is exhausted to the internal space (146) of the handpiece (30) through the exhaust path (128) of (116). The handpiece (30) has an exhaust hole (not shown),
The air is discharged to the atmosphere from the internal space (146) of the handpiece (30) through the exhaust hole.

As shown in FIG. 4, the fiber holding member (1)
A hollow cylindrical member 20) has a distal end (150) having a diameter larger than that of the fourth through-hole portion (72) at its distal end, and a third end of the holder (42) at its rear end. Corresponding to the first through-hole portions (72), (70), and (68), there are a plurality of portions whose outer diameters are gradually reduced from the front end side to the rear end side, and the central axis is inside. Along the through hole (15
1) is formed, and the probe (1) is inserted into the through hole (151).
52) is inserted and fixed.

The probe (152) is a secondary optical fiber (154) whose periphery is protected by a stainless steel tube.
And an inner nozzle tube (156) and an outer nozzle tube (15) provided on the secondary side optical fiber (154).
2) comprising a water jet path (160) between the secondary optical fiber (154) and the inner nozzle tube (156);
An air injection path (162) is formed between the inner and outer nozzle tubes (156), (152).

At the distal end of the probe (152), as shown in FIG. 7, the distal ends of the inner nozzle tube (156) and the outer nozzle tube (152) are aligned with each other. Has a predetermined length projecting therefrom. In the present embodiment, an optical fiber composed of a core layer and a clad layer is used for the secondary side optical fiber (154). Each layer protrudes from the layer by a predetermined length. Further, the probe (152) projecting from the fiber holding member (120) and the secondary side optical fiber (15
The portion 4) is curved in a specific direction (downward in FIG. 7).

Returning to FIG. 4, the secondary optical fiber (15
4), inner and outer nozzle tubes (156), (15)
8) The rear end of the inner nozzle tube (156) is not at the same position, and the rear end of the inner nozzle tube (156) is moved forward by a predetermined distance from the rear end of the secondary optical fiber (154). 158) to the inner nozzle tube (15
6) The probe (152) has moved forward by a predetermined distance from the rear end, and the diameter of the probe (152) gradually decreases toward the rear end. Through-hole (151) of fiber holding member (120)
Corresponds to the step shape on the rear end side of the probe (152), and the inside diameter is gradually reduced from the front end side to the rear end side.
Thus, each part of the probe (152) is appropriately held in the through hole (151) of the fiber holding member (120). The rear end of the through hole (151) has an inner diameter that is enlarged to form an empty chamber (164) communicating with the incident end cooling chamber (142), and the secondary optical fiber ( 154) is projected at the incident end (166).

The portion of the fiber holding member (120) corresponding to the second through-hole portion (68) faces the second branch (102) (see FIGS. 3 and 5) of the holder (42). A passage (168) is formed. Also, a holder (42)
Another passage (170) is formed opposite the exhaust passage (112). Therefore, the air supplied from the air supply pipe (94) passes through the connection pipe (90), the air supply path (80), the second branch path (102), and the passage (168), and the entrance end cooling chamber (142). After being supplied to the internal space (14) of the passage (170), the exhaust passage (112), and the handpiece (30).
It is discharged to the atmosphere via 6).

Similarly, in a portion of the fiber holding member (120) corresponding to the third through-hole portion (70), a passage (172) facing the water supply passage (82) of the holder (42) is formed. I have. On the other hand, in the through hole (151) of the fiber holding member (120), the inner diameter of the portion facing the passage (172) is made larger than the outer diameter of the secondary optical fiber (154), so that the secondary optical fiber (154) is formed. A passage (174) is formed between the outer periphery of the water injection passage (174) and the passage (174). Therefore, the water pipe (9
6) The water sent through the connection pipe (92) and the water supply path (82) is supplied to the water injection path (160) through the passages (172) and (174).

A third branch path (1) is provided at a portion of the fiber holding member (120) corresponding to the third through-hole portion (70).
A passage (176) is formed opposite to the passage (04). On the other hand, the through hole (151) of the fiber holding member (120) has an inner diameter of a portion facing the passage (176) larger than the outer diameter of the inner nozzle tube (156), and is formed between the through hole (151) and the inner nozzle tube (156). A passage (178) is formed in
This passage (178) communicates with the air injection passage (162), and includes an air supply pipe (94), a connection pipe (90), and an air supply path (8).
0), the air sent through the third branch (104) is supplied to the air injection path (162) via the paths (176) and (178).

The fiber holding member (120) also has an optical path (180) leading from the lamp housing (106) to the distal end face for emitting the light of the lamp (110) from the distal end face.
Are formed. In addition, an optical fiber may be arranged in the optical path (180), and the light of the lamp (110) may be emitted through the optical fiber.

The light exit portion (182) of the optical path (180) is located at the distal end surface of the fiber holding member (120) in the direction in which the secondary optical fiber (154) is bent (downward in FIGS. 3 and 4). It is provided. Further, as shown in FIG. 7, the light emitted from the light emitting section (182) is transmitted to the secondary side optical fiber (15).
The optical path (180) is formed in a curved shape so as to illuminate the tip (155) of 4) and the surrounding area including the tip (155). In order to form such an optical path (180), in the present embodiment, the fiber holding member (120) is divided into two like the holder (42), and the optical path (18
0) is formed. Further, the two divided parts are inseparably bonded in a combined state.

The fiber holding member (120) has a pin (184) on the outer peripheral portion corresponding to the fourth through-hole portion (72).
Is fixed. Therefore, as shown in FIG. 6, the fiber holding member (120) is connected to the through hole (4) of the holder (42).
8) With the pin (184) inserted into the holder (4).
By engaging the positioning groove (64) provided on the distal end side of 2), the rotation of the fiber holding member (120) is prevented, and each part of the fiber holding member (120) is connected to the corresponding part of the holder (42). Can be matched.

A portion of the fiber holding member (120) corresponding to the fourth through-hole portion (72) is also provided with a holder (4).
Four depressions (186) corresponding to the conical holes (60) of 2)
Is formed, and as described later, the ball (62) accommodated in the conical hole (60) engages with the depression (186), thereby the fiber holding member (12) with respect to the holder (42).
0) can be prevented from falling off.

In addition, the second, third, and fourth through-hole portions (68), (7) are provided on the outer peripheral portion of the fiber holding member (120).
0) and (72), circumferentially continuous grooves (190), (192) and (194) are formed, and O grooves are formed in the respective grooves (190), (192) and (194).
The rings (196), (198), and (200) are mounted, thereby sealing between the fiber holding member (120) and the holder (42).

As shown in FIG. 3, the cap nut (202) has an inner thread portion (204) on the inner peripheral portion on the rear end side, and this inner thread portion (204) is attached to the outer peripheral portion on the distal end side of the holder (42). The cap nut (202) can be fixed to the holder (42) by being fitted into the external thread portion (58) formed in the portion. The cap nut (202) plays a role in positioning the fiber holding member (120) with respect to the holder (42). For this purpose, the inner diameter of the cap nut (202) on the distal end side is substantially equal to the outer diameter of the distal end side of the holder (42), and the rear end side of a portion corresponding to the conical hole (60) of the holder (42). A recess (206) is formed, and when the cap nut (202) is tightened with respect to the holder (42), the cap nut (20) is formed.
The inner surface of 2) comes into contact with and pushes the ball (62) housed in the conical hole (60) radially inward, and this ball (62) engages with the depression (186) of the fiber holding member (120). Together, the fiber holding member (120) is positioned. Conversely, when the cap nut (202) is loosened with respect to the holder (42) and the cap nut (202) is moved toward the distal end, the recess (206) of the cap nut (202) faces the ball (62). When the fiber holding member (120) is moved to the distal end side in this state, the ball (62) is pushed radially outward by the fiber holding member (120), and the fiber holding member (120) is moved to the holder (4).
Can be drawn from 2). The cap nut (20
2) When the holder is loosened and moved to the tip side, the holder (42)
Since the O-ring (52) attached to the tip of the holder slightly protrudes from the outer peripheral surface of the holder (42), the protrusion comes into contact with the cap nut (202) to prevent the cap nut (202) from falling off.

The handpiece (3
1), the laser light generated by the laser generator (18) is incident on the rear end side of the primary optical fiber (122) (see FIG. 1, 3, 4, 5, 7). )). The incident laser light is transmitted to the primary side optical fiber (12
It is guided to 2) and is emitted from the emission end (124) of the primary optical fiber (122) in the emission end cooling chamber (126) in the handpiece (30). The emitted laser light is condensed by the lens (130), and is incident on the entrance end cooling chamber (1).
After being incident on the incident end (166) of the secondary optical fiber (154) in (42), this secondary optical fiber (1)
It is guided to 54) and emitted from its tip (155).

The guide light (not shown) generated by the guide light source (20) is transmitted through the primary side optical fiber (122) and the secondary side optical fiber (154) in the same manner as the laser light. The irradiation position of the laser beam emitted from the tip (155) of the optical fiber (154) is indicated. As the guide light, a helium neon laser conventionally used,
A visible light laser such as a semiconductor laser having a wavelength in the range of 650-670 nanometers can be used.

The air sent from the air supply source (24)
The first to third branches (104) are entered via an air supply pipe (94), a connection pipe (90), and an air supply path (80). The air sent into the first branch (100) is supplied to the exit end cooling chamber (1).
26), where the exit end (124) of the primary side optical fiber (122) is cooled, and then the handpiece (3) is cooled.
0) is released to the atmosphere via the internal space (146).

The air sent into the second branch (102) is introduced into the entrance end cooling chamber (142), where it cools the entrance end (166) of the secondary optical fiber (154). It is released to the atmosphere via the internal space (146) of the handpiece (30).

The air sent into the third branch (104) is introduced into the air injection path (162) and discharged from the opening at the tip.

The water sent from the water supply source (26) is sent to a water injection path (160) via a water supply pipe (96), a connection pipe (92), and a water supply path (82), and this water injection path ( 1
Discharge from the opening at the tip of 60). The discharged water is finely dispersed in the form of a mist by the air discharged from the air injection path (162), and is sprayed on the irradiation part of the laser beam emitted from the secondary optical fiber (154).

On the other hand, the light generated by the lamp (110) enters the optical path (180) and exits from the light emitting section (182).
Here, the optical path (180) on the light emitting section (182) side is:
Since the secondary optical fiber (154) is inclined in the direction in which the secondary optical fiber (154) is bent with respect to the central axis of the handpiece (30) as shown in the figure, the emitted light is secondary light as shown in FIG. The outer periphery of the output end of the fiber (154) and its surrounding area are illuminated. For this reason, the operator, for example, in the oral cavity, not only treats the treatment site but also the secondary side optical fiber (154).
Can easily and visually confirm the condition of the peripheral region of the outer periphery of the tip portion.

The overall control of the laser medical device (10) will be described. Referring to FIG. 2, the main unit main switch (210), irradiation preparation switch (212), irradiation switch (214), and laser oscillation condition setting switch (216) are connected to the input unit of the control unit (16). . The main switch (210) of the main body (see FIG. 1) is the housing (14).
The laser medical device (10) can be set to the ON state only by inserting and rotating a suitable key by an operator using a key switch provided on one side of the laser medical device. The irradiation preparation switch (212) is a switch provided on the control panel (218) (see FIG. 1). When the irradiation preparation switch (212) is turned on, the guide light source (20) is turned on.
The guide light generated in the secondary side is emitted and the secondary side optical fiber (1
The light is emitted from the emission end of (54). Irradiation switch (21
4) is built in the foot controller (32),
The foot controller (32) is turned on by depressing the pedal (220) by a predetermined amount. The laser oscillation condition setting switch (216) is a switch provided on the control panel (218). By operating this switch, the oscillation condition of the laser beam can be set arbitrarily.

On the other hand, the output section of the control section (16) includes a laser generator (18), a guide light source (20), and an illumination power supply (2).
2), an air supply source (24), a water supply source (26), and a warning lamp power supply (28) are connected. The warning lamp power supply (28) is a power supply for supplying electricity to a warning lamp (110) provided in the main unit (12).

FIG. 8 shows a control example of the control circuit. According to this control example, the operator prepares the irradiation preparation switch (21) while the main body main switch (210) is turned on.
When 2) is turned on, the guide light source (20) and the illumination power supply (2)
2) turns on. As a result, the guide light is emitted from the distal end portion (155) of the secondary optical fiber (154), and the lamp (110) is turned on to turn on the secondary optical fiber (1).
The outer periphery of the tip portion and the periphery thereof are illuminated. In this state, the surgeon points the tip of the handpiece (30) toward the vicinity of the treatment site, visually recognizes the treatment site from the region illuminated by the illumination light, and accurately guides the guide light before the laser light irradiation. Can be placed in a therapeutic position.

It should be noted that the lamp (1) can be identified so that the guide light can be identified in the area illuminated by the lamp (110).
It is preferable that the light of 10) and the light of the guide light have different colors or that the intensity of the lamp light is weaker than the intensity of the guide light. Further, the guide light may be a laser light of a different color from the light of the lamp (110).

At the same time when the guide light source (20) and the illumination power supply (22) are turned on, the air supply source (24) is driven, and the air supplied from the source is cooled by the exit end cooling chamber (126) and the entrance end cooling chamber (142). ) And the probe (152)
It is injected from the tip side. This cools and cleans the exit end (124) of the primary optical fiber (122) and the entrance end (166) of the secondary optical fiber (154).

Next, referring to FIG. 1, the operator operates the foot controller (32) to switch the irradiation switch (214).
Is turned on, the laser generator (18) is activated to generate laser light. The generated laser light is emitted from the distal end (155) of the secondary optical fiber (154) as described above, and is emitted to the irradiation position of the guide light. At this time,
The irradiation state of the laser beam and the treatment state can be easily visually recognized with the help of the light of the lamp (110). In addition, since the illumination light illuminates not only the laser beam irradiation site but also the outer periphery of the tip of the secondary side optical fiber (155) and the periphery thereof, when the treatment is performed while moving the handpiece (30), the destination is the destination. Can be confirmed, and it is not necessary to interrupt the irradiation of the laser beam for each confirmation, and continuous treatment can be performed.

At the same time as the start of laser beam irradiation, the water supply source (2
6) is activated, whereby the water supplied from the water supply source (26) is discharged from the vicinity of the tip of the probe (152), and the discharged water is dispersed as mist by the jetted air, and the laser light is discharged. It is sprayed at the irradiation position.

At the same time as the start of laser beam irradiation, a warning lamp (110) is turned on. Therefore, the surgeon's assistant can know that the laser beam is being emitted.

When the irradiation of the laser beam is interrupted, the pedal (220) of the foot controller (32) is released and the irradiation switch (214) is turned off. Irradiation switch (2
When 14) is turned off, the laser generator (18) and the water supply source (26) are turned off, and irradiation of laser light and spraying of water are stopped.

Even if the irradiation switch (214) is turned off, as long as the irradiation preparation switch (212) is turned on, the guide light source (20), the illumination power supply (22) and the air supply source (24) are kept on. maintain. Therefore, although not shown in FIG. 8, when the irradiation switch (214) is turned on again while the irradiation preparation switch (212) is turned on, the laser beam irradiation and the water injection are performed almost simultaneously with the turning-on operation. Is resumed, and the laser treatment can be resumed. Therefore, when the treatment is continued while intermittently irradiating the laser light, the waiting time after turning on the irradiation switch (214) becomes unnecessary, and the treatment can be performed without delay.
In addition, it is possible to easily confirm the treatment result by the laser beam and use it for a subsequent treatment plan.

Thereafter, when the irradiation preparation switch (212) is turned off, the guide light source (20), the illumination power supply (22) and the air supply source (24) are turned off. However, it is not necessary to turn off the illumination power supply (22) at the same time as turning off the irradiation preparation switch (212), and the lamp (110) may be turned off after a predetermined time from turning off the irradiation switch (214).

The illumination light and the guide light are turned on at the same time when the irradiation preparation switch (212) is turned on. However, by providing a delay circuit (not shown), a predetermined time can be set after the irradiation preparation switch (212) is turned on. The illumination light and the guide light may be turned on with a time delay.

The guide light source (20) and the illumination power source (2)
2) and the air supply source (24) are connected to the irradiation preparation switch (21).
Although the switch is turned off at the same time as the switch 2), the switch may be turned off automatically a predetermined time after turning off the irradiation switch (214).

Further, as shown in FIG. 13, a foot controller (32) provided with a two-stage switch, that is, two switches (214A, 214B) sequentially turned on and off by a pedal (220) may be used.

Of the above two switches, the first switch (214A) is a switch for turning on / off the lighting of the illumination light and the guide light and the supply of air, and the second switch (214A).
14B) is a switch for turning on / off the irradiation of the laser beam and the injection of the water. When the foot (220) of the foot controller (32) is depressed, the first switch (214A) is first turned on at the first position P1, and when the pedal is further depressed, the second switch is turned on at the second position P2. (2
14B) turns on. On the other hand, the pedal (220) is returned from the fully depressed state, and after passing the second position P2, the second switch (214B) is turned off, and the depression is further returned shallowly to the first position. After P1, the first switch (214A) turns off.

FIG. 9 shows an example of control when the foot controller (32) as described above is used. According to this control example, when the pedal (220) is depressed to the first position P1, the first switch (214A) is turned on, whereby the lighting of the illumination light and the guide light and the supply of air are started. Then, when the pedal (220) is further depressed to the second position P2, the second switch (214B) is turned on, thereby starting irradiation of the laser beam and injection of water,
Conversely, when the pedal (220) is returned from the fully depressed state until it passes the second position P2, the second switch (2
14B) is turned off to stop laser beam irradiation and water injection, and when the pedal (220) is further returned until after passing the first position P1, the first switch (214A) is turned off to jet air and water. Is stopped, and after a predetermined time has elapsed, the illumination light is turned off. It goes without saying that the illumination light may be turned off simultaneously with the turning off of the first switch (214A).

With the above configuration, the illumination time L1 by the illumination light in the drawing is always longer than the laser illumination time L2, and the affected part can always be confirmed by the illumination light before and after the laser irradiation. In the above description, the first switch (214A) turns on / off the lighting of the illumination light and the irradiation of the guide light, on / off of the supply of air, and the second switch (214A).
B) is a configuration for turning on / off the irradiation of the laser beam and the injection of the water. At least the first switch (214A) is turned on / off only for turning on the irradiation light and the second switch (214A).
If B) turns on / off only the irradiation of laser light, on / off of irradiation of guide light, on / off of air supply, and on / off of water injection may be separately controlled. First switch (214A),
You may make it interlock with a 2nd switch (214B).

In the above embodiment, the hand piece (30)
Is provided with a lamp (110) to illuminate the laser beam irradiation position and its vicinity, but the present invention is not limited to this. For example, in another embodiment shown in FIGS. 10 to 12, a tube sheathed on the probe (230) is used.
(232) is constituted, for example, by arranging a large number of optical fibers on a cylindrical surface centered on the axis of the tube (232) without any gap in parallel with the axis, and the rear end is located at the emission end cooling chamber. (126).

In this embodiment, the illumination light source is provided in the main unit (14), and the illumination light generated there is introduced into the primary optical fiber (122) like the laser light, and the primary optical fiber (122). The light enters the optical fiber tube (232) for illumination from the exit end of (122) through the lens (130), and exits from the distal end of the optical fiber tube (232) as shown in FIG. At this time, as shown, the illumination light is not a laser light,
The emitted light spreads at a certain angle, and illuminates the irradiation position of the laser light and its periphery.

The optical fibers of the optical fiber tube (232) may be arranged in parallel with the axis thereof or in a spiral shape. Since the diffusion angle of light is widened, a wider range can be illuminated.

Further, the first and second optical transmission members for guiding the laser light are constituted by optical fibers, but any known light guiding members can be used as long as they can transmit the laser light.

Further, the embodiment in which the present invention is applied to a dental treatment apparatus has been described. However, the present invention can be applied to any medical apparatus using laser light.

Further, although the laser generator is provided in the main unit of the laser medical apparatus, it may be built in the handpiece depending on the form of the handpiece and the size of the laser generator.

In addition, in the above description, the probe (15
2) and (230) have been described with respect to the handpiece in which the tip side is bent to one side, but the probe tip side may protrude straight from the handpiece. In addition, although the optical fiber composed of the core and the clad is used as the secondary side optical fiber (154), the present invention is not limited to this, and the optical fiber composed of a single material such as quartz or sapphire or the cone is used. It may be a cylindrical or cylindrical member.

Finally, the type of laser light used in the laser medical device of the present invention is not limited. For example, when the laser medical device is used in the fields of dentistry, oral surgery, otolaryngology, etc. The wavelength of the laser light is 0.1.
It is desirable to use a laser of 5 to 5.5 μm. As such a laser, Er: YAG (erbium-yttrium-aluminum-garnet), Er: YSGG
(Erbium-yttrium-scandium-gallium-garnet), Ho: YAG (holmium-yttrium-aluminum-garnet), Th: YAG (thorium-yttrium-aluminum-garnet),
Co: VF (cobalt-panadium-fluoride),
Er: GLASS (erbium-glass), Nd: GL
ASS (neodymium-glass), Nd: YAG (neodymium-yttrium-aluminum-garnet), T
i: A solid-state laser such as Sa (titanium-sapphire) or a gas laser such as CO (carbon monoxide) can be used. However, since the solid-state laser light or the like is invisible light, as described above, as the guide light, a visible light laser such as a conventional helium neon laser or a semiconductor laser having a wavelength in the range of 400 to 800 nanometers is used. It is preferred to use.

[Brief description of the drawings]

FIG. 1 is an overall perspective view of a laser medical device according to the present invention.

FIG. 2 is a control circuit diagram of the laser medical device shown in FIG.

FIG. 3 is a partially enlarged longitudinal sectional view of a handpiece according to the present invention.

FIG. 4 is a partially enlarged longitudinal sectional view showing only a part of the handpiece partially enlarged longitudinal sectional view shown in FIG. 3;

FIG. 5 is a partially enlarged longitudinal sectional view showing another part of the handpiece partially enlarged longitudinal sectional view shown in FIG. 3;

FIG. 6 is a partial plan view of the handpiece according to the present invention.

FIG. 7 is a side view showing an illumination state of illumination light emitted from the tip of the handpiece.

FIG. 8 is a timing chart showing a control example of the laser medical device.

FIG. 9 is a timing chart showing another control example of the laser medical device.

FIG. 10 is a partially enlarged longitudinal sectional view showing another form of the handpiece.

11 is a side view showing an illumination area of illumination light emitted from the handpiece of FIG.

FIG. 12 is a cross-sectional view of a probe used in the handpiece of FIG.

FIG. 13 is a sectional view of a foot controller.

[Explanation of symbols]

DESCRIPTION OF SYMBOLS 10 ... Laser medical device, 12 ... Main unit, 16 ... Control part, 18 ... Laser generator, 20 ... Guide light source, 22 ...
Illumination power supply, 30 handpiece, 32 foot controller, 40 casing, 42 holder, 44 fiber holding member, 122 primary optical fiber, 154 secondary optical fiber, 155 secondary optical fiber tip , 110
... Lamp, 180 ... Optical path, 182 ... Light emitting part, 232 ... Optical fiber tube, 214 ... Irradiation switch, 214A ...
1st switch, 214B ... 2nd switch, 220 ... pedal.

Claims (19)

[Claims] 1. A laser medical device handpiece for guiding a laser beam to a treatment part, wherein the handpiece comprises:
(A) a first optical transmission means for transmitting a laser beam; and (b) a casing for holding the first optical transmission means in a state in which a tip of the first optical transmission means protrudes by a predetermined length. And (c) illuminating means for illuminating the outer periphery of the distal end of the first optical transmission means and its periphery, and (d)
A handpiece for a laser medical device, wherein the light emitting portion of the illumination means is provided on the casing toward a tip end of the first light transmission means. 2. A portion of the first light transmitting means protruding from the casing is bent in a specific direction, and the light emitting portion illuminates an outer periphery and a periphery of a tip end of the first light transmitting means. The laser medical device handpiece of claim 1, wherein the handpiece is oriented as follows. 3. A handpiece for a laser medical device for guiding a laser beam to a treatment part, wherein the handpiece comprises:
(A) a first optical transmission means for transmitting a laser beam; and (b) a casing for holding the first optical transmission means in a state in which a tip of the first optical transmission means protrudes by a predetermined length. And (c) illuminating means for illuminating the outer periphery of the distal end of the first optical transmission means and its periphery, and (d)
The handpiece for a laser medical device, wherein the light emitting part of the lighting means is provided at a position retreated from a tip part of the first light transmitting means. 4. A second light transmitting means for transmitting illumination light of said illuminating means, wherein a light emitting part at a tip of said second light transmitting means retreats from a tip of said first light transmitting means. 4. The handpiece for a laser medical device according to claim 3, wherein the handpiece is provided at a predetermined location. 5. The handpiece for a laser medical device according to claim 4, wherein said second optical transmission means is constituted by one or a plurality of optical fibers. 6. The second optical transmission means has a cylindrical member provided outside the first optical transmission means, and the cylindrical member is parallel to the axis on a cylinder centered on the axis of the cylindrical member. The handpiece for a laser medical device for a laser medical device according to claim 4, wherein a plurality of optical fibers are arranged. 7. The first optical transmission means has a primary-side optical transmission body and a secondary-side optical transmission body including the distal end, wherein the secondary-side optical transmission body is provided with respect to the casing. 7. The handpiece for a laser medical device according to claim 1, wherein the handpiece is detachable. 8. The primary light transmitter is used as a light guide for illumination light, and the illumination light transmitted by the primary light transmitter is introduced into the second light transmission means. The handpiece for a laser medical device according to claim 7, wherein: 9. The handpiece for a laser medical device according to claim 1, wherein an illuminating light source of said illuminating means is one of an incandescent lamp and a light emitting diode. 10. The handpiece for a laser medical device according to claim 9, wherein an illumination light source of said illumination means is provided on said casing. 11. The handpiece for a laser medical device according to claim 10, wherein an illumination light source of said illumination means is provided at a place remote from said handpiece. 12. A laser medical device handpiece according to any one of claims 1 to 11, and a main unit having a laser generator, wherein the laser light generated by the laser generator is converted to the first light. A laser medical device characterized by transmitting to a transmission means. 13. The laser medical device according to claim 12, wherein the illumination light source is provided in the main unit. 14. A first switch for turning on / off the illumination light source, and turning on / off a laser beam from the laser generator.
14. The laser medical device according to claim 12, further comprising: a second switch that is turned off, wherein the second switch is turned on only when the first switch is turned on. 15. The method according to claim 15, wherein the on signal of the illumination light source is generated earlier than the on signal of the laser generator, and / or the off signal of the illumination light source is generated later than the off signal of the laser generator. Claims 12 to 14
Any of the laser medical devices. 16. The method according to claim 16, wherein the ON signal of the illumination light source is generated simultaneously with the ON signal of the laser irradiation preparation switch, and the OFF signal of the illumination light source is generated by delaying the OFF signal of the laser irradiation switch by a predetermined time. 16. The laser medical device of claim 15, wherein 17. A foot controller comprising the first and second switches, wherein the foot controller turns on the first switch when the pedal is depressed to a first position, and then releases the pedal. When the pedal is depressed to the second position, the second switch is turned on. Conversely, when the pedal is returned to the second position from the state in which the second switch is turned on, the second switch is turned off. 16. The laser medical device according to claim 15, wherein the first switch is turned off when the pedal is returned to the first position. 18. A light source which emits guide light for illuminating a position to be irradiated with the laser light through the first optical transmission body, wherein the illumination light and the guide light are simultaneously turned on. The laser medical device according to any one of claims 12 to 17, wherein: 19. The laser medical device according to claim 18, wherein the guide light has a different color from the illumination light.