JPS59211437A - Medical laser apparatus - Google Patents

Abstract

(57) [Summary] This bulletin contains application data before electronic filing, so abstract data is not recorded.

Description

[Detailed Description of the Invention] This invention relates to a medical laser device,
In particular, the present invention provides a medical laser device that is easy to install and use in medical facilities such as hospitals.

2. Description of the Related Art Recently, in the medical field, medical laser devices have been proposed and put into practical use that utilize laser beam energy to perform hemostasis treatment for bleeding in an affected area, or treatment such as ablation or vaporization of affected tissue. This medical laser device basically uses argon or YAG.
It consists of a laser oscillator, such as a laser oscillator, and a bendable or bendable optical transmission means that guides the laser beam emitted from the laser oscillator to the desired affected area. It is also well known that it is used transendoscopically in cases of internal bleeding.

By the way, this type of medical laser device that has been proposed and put into practical use basically has the above-mentioned configuration, but in reality, the device itself includes all of the following components.

That is, in addition to the above-mentioned laser oscillator, the medical rap' unit 59 includes a power supply system section and a cooling system section necessary for the laser oscillator, as well as a laser beam output control operation section necessary for laser treatment, and a time irradiation section. Various operation sections such as a laser beam irradiation mode setting operation section such as continuous irradiation mode and intermittent irradiation mode and a laser beam irradiation time setting operation section are integrated and frozen.

However, in a medical laser device with such a configuration, the transformer in the power supply system or the pump in the cooling system are heavy, which inevitably increases the total weight of the device, making it difficult to move easily. In addition, to secure water supply and sewage water supply for cooling water, and to secure three-phase AC power for equipment that requires all three-phase AC power as a power source for the power supply system. In most cases, there are restrictions on the installation location within a medical facility, and furthermore, because the various operating parts mentioned above are provided on the device itself, the device must be installed on the patient's head and cannot be used at all. The reality is that it has its drawbacks and difficulties, such as interfering with treatment.

Therefore, this invention does not have the above-mentioned drawbacks or difficulties t1?
: We provide an improved medical laser device.

Embodiments of the medical laser device according to the present invention will be described in detail below with reference to accompanying drawings.

FIG. 1 is a perspective view showing an embodiment of a medical laser device according to the present invention, and this medical laser device includes a main unit (A) configured in the shape shown in FIG.
It consists of an operation unit B configured in a shape as shown in FIG. The connection between the main body unit A and the operation unit B shown in FIG. 1, and the separation shown in FIGS. 2 and 3 from the connected state shown in FIG. Engagement recesses 711 to 1a to 1d for positioning
It was installed at 1m section 2 below the operation unit B. , Part 7 2
They can be easily separated by fitting a to 2d into engagement (the connection is made from the opening), and by removing the engagement f4H% and lifting the mount B. In addition, the main body Cornit A2v sudden, front 9.ゎhand 3
love. E, 8 handles 4. f, , Main body unit (not shown)
(g) You can move it by unlocking the moving casters provided on the bottom of A and pushing (or pulling) 7. Further, the operation unit (B) can be moved by holding it by the handle 5 and other parts, and can be placed on a suitable base such as a table in a medical facility. The main unit A and the operation unit B can be connected and separated mechanically as mentioned above, but of course, as will be described later, the main unit A and the operation unit B can be connected and separated mechanically. are electrically connected.

Furthermore, the connection between the main unit A and the operation unit B
On the bottom surface 2 of the VC1 operating unit B, there is a downward spout (in Fig. 4) to ensure safety during separation.
A base detector 7 is provided which is urged to protrude by a pufferfish 6.

This base detector 7 is the operating unit of the main body unit A)
The normally open swing S
i''' (Z ON).
The interlock device that causes the oscillation is released when it is QN, and the interlock device is released when it is OFF.
It is designed to operate. Therefore, due to the impact of the above-mentioned structure, the interlock device is activated during the separation operation, and the separation operation can be carried out safely without ray +ll'- oscillation.

Next, the components built into each of the main unit 1) A and operation unit B will be explained.
In A, a laser oscillator part 8 containing a laser oscillator such as an Alcon or YAG laser is installed at the top stage, a power supply system part 9 at the middle stage, and a cooling system part 10 at the bottom stage in the construction 9 shown in FIG. l/)ru. Inside the laser oscillator section B, there is a laser oscillator for aiming, such as a well-known VCHe-Ne laser, and an Albon or YAG laser.
- A therapeutic laser oscillator such as a laser is installed, and the aiming laser beam and the therapeutic laser beam are coaxially directed to the laser beam exit (see FIG. 2) using a well-known optical system. The laser beam exit port 88 is protected by a dustproof cover 8b to prevent dust from entering from that part when not in use, and when in use, it is protected by a bendable optical fiber (it may be a bendable articulated manipulator). ) 11 to the laser beam exit port 83, it is exposed to the outside by opening the dustproof cover 8b.

The power supply system section 9 is configured to be supplied with power via a power cable 98 connected to a three-phase AC power supply distributed to the installation location. This power supply system section EIV-t,
A power supply system section for driving a pump for cooling water circulation provided in the cooling system section 1D, which will be described later, a power supply system section for laser oscillation, such as lighting an excitation lamp for oscillation of the laser oscillator, and a power supply system for driving circuits of various control circuits. It consists of several parts. The power supply system section 9 is provided with a display panel 13 protected by a cover 121C that can be opened and closed as shown in FIG. In addition to the main power switch 13a, the display panel 13 includes an ammeter 13b that displays the value of the current supplied to the excitation lamp of the laser oscillator, and a display section that is built into the main unit A and displays the operating status of various FC operating sections. 1
3e is provided.

The cooling system section 10 includes a cooling system section using tap water as a secondary cooler, and a cooling system section using cooling water such as ion exchange water as a secondary cooler. The above-mentioned secondary cooling system section is supplied with tap water from a water hose 10 connected to a water supply port piped at the installation location, cools the cooling water of the primary cooling system section (described later) with a heat exchanger, and then cools the cooling water of the primary cooling system section, which will be described later.
0b is discharged into the sewer. Of course, this tap water is required to have a water pressure and water volume above a predetermined value in order to improve cooling efficiency.It goes without saying that this tap water is required to have a water pressure and water volume above a predetermined value, and it is also measured by a water pressure and water volume sensor (not shown) installed in the secondary cooling system. and is configured to be displayed on the display section 13clC of the display panel 13. The primary cooling system section through which the cooling water cooled by the secondary cooling flows is circulated by the cooling water circulation pump, and this secondary cooling system section has a laser The laser is guided to the oscillator and circulated to cool the laser oscillator.

Next, to explain the configuration of the operation unit B, this operation unit B includes the optical fiber tip insertion port 14 and the output W4 adjustment knob 15 that constitute the output adjustment section, and the irradiation mode setting section. An irradiation mode setting operation section 16, a time setting dial 17, an emergency stop switch 18, and a panel 19 for various alarm and status displays are provided on the front VC, and in addition, a sheet outlet 20 of the data printing printer, A mounting section 23 is provided to removably attach a switching section 21 between air and nonflammable gas and a guide bar 22 that suspends and holds the optical fiber 11.

The output adjustment section includes the optical fiber tip insertion port 14.
A photoelectric conversion element 14a shown in FIG. 6 is arranged at the innermost part of the optical fiber 11 so as to face the tip of the optical fiber 11 inserted therein.

This photoelectric conversion element 14aFi receives the laser beam emitted from the excited YAG laser rod 25 such as a krypton lamp and transmitted through the optical fiber 11, and inputs it to the central processing circuit 27 via the A/D converter 26. Ru. Man'C above output adjustment knob 1
Reference numeral 6 is for changing the resistance value 4 of a variable resistor 29 provided in the power supply control circuit 28 of the excitation lamp 24, thereby controlling the entire current to the excitation lamp 24. In addition, in Fig. 6, the reference numeral 30
is a resistor that carries a current flowing through the excitation lamp 24, and this resistor 3-0 is connected to the input terminal of an amplifier f31 such as an isolation amplifier. Then, (7) the output f” of the amplifier 31, ζ-meta 32
The signal is input to the central processing circuit 27 via the central processing circuit 27.

Further, in FIG. 6, reference numeral 33 is a shutter provided in and out of the laser oscillator optical path, and this shutter 33 is moved out of the optical path by switching such as a well-known foot switch to enable laser oscillation. The device is configured to be operable only when all interlock devices provided at various locations throughout the device are released.

The output adjustment section configured and constructed as described above operates and operates as follows.

First, perform each operation to ensure that all the interlock devices are released (of course, the interlock device is used to confirm that the optical fiber 11 is connected to the exit port 8& and that the tip of the optical fiber 11 is inserted into the insertion port 14). (including release of the locking device), the shutter 33 is operated to enable laser oscillation. Thereafter, the output adjustment knob 15 is operated manually (or automatically by a motor) to continuously change the resistance value of the variable resistor 29, thereby changing the value of the current flowing through the excitation lamp 24. The amount of change in this current value is input as an excitation lamp current monitor signal to the central processing circuit 27 via the amplifier 31 and the A/D converter 32fc. Further, an optical conversion element 14
a is the laser beam output (i'!) corresponding to the change in the excitation lamp current value.It is input as a laser beam output monitor signal to the central processing circuit 2T through the A/D converter 26.The central processing circuit 27 is ,
Based on the direct input signals of the excitation run f current monitor signal and the laser beam output monitor signal, changes in the laser beam output value are stored in correspondence with changes in the excitation lamp current value, and are handled based on the excitation run f current monitor signal. Signal processing is performed so that the laser beam output value can be read out. Therefore, by adjusting such operations prior to actual treatment, during actual treatment, the output adjustment knob 15 can be rotated, By changing the excitation ramp' current monitor signal, the laser beam output value (unit: watt) is displayed on the display 34 disposed on a part of the display panel 19. Since the laser beam output value is displayed based on the above memory, the laser beam output value is displayed without operating the shutter 33 (without laser oscillation), so the laser beam output setting U1 can be safely adjusted. This is something that can be done by the central processing circuit 2 mentioned above.
7, the VC is configured to output a signal that activates an interlock device that stops laser oscillation when the laser beam output monitor signal relative to the excitation lamp current monitor signal exceeds a preset lower limit value. By adopting this configuration, it is necessary to check the deterioration of the excitation lamp and the condition of the attachment of the optical fiber 11 to the laser beam exit port 8a. This can be used as a warning.

Next, regarding the irradiation mode setting section, see Figures 3, 7, and 8.
This will be explained based on the diagram. This irradiation mode setting section is a part for setting three irradiation modes: time irradiation mode, continuous irradiation mode, and intermittent irradiation mode. These irradiation modes i"l: are set taking into consideration the size of the affected area and the absorption state of irradiation energy, etc., and the time irradiation mode is the irradiation mode that is irradiated within a preset time (approximately 0 to 10 seconds). The continuous irradiation mode enables irradiation for a longer time than the tie L irradiation mode mentioned above, and the intermittent irradiation mode allows for full repeatability, for example, by starting irradiation for 2 seconds and then stopping irradiation for 3 seconds. mode.And,
In the continuous irradiation mode and the intermittent irradiation mode, it is possible to irradiate the shutter 33 in the laser oscillator for an arbitrary time based on a switch f7 signal from a foot switch.

Each irradiation mode setting as described above is performed by the irradiation mode setting section 1.
This is done by means of an irradiation mode setting knob 16b provided at a secured portion of the openable/closeable safety cover 1εIL provided at 6. When the safety cover 168 is closed, a detection switch SW shown in FIG. 8, which detects its open/closed state, is configured to fully close. ,Also,
The irradiation mode setting knob 16b is the mode changeover switch SW shown in FIG. The time irradiation mode terminal a, the continuous irradiation mode terminal A, and the intermittent irradiation mode terminal cf are connected to ground during operation. -Hikidani irradiation mode terminals a, b and C are respectively connected to the power supply VC.
CK connection, and one input terminal of each of the OR circuit 35, the first AND circuit 36, and the second AND circuit 37.
The other input terminal of is connected to the safety switch SW1 which is connected to the ground and the power supply vCC, and the output terminal of the OR circuit 35 is connected to the input port 41 which is input to the 7'-p line 40. There is. Furthermore, the first
and the safety switch Sw and the power supply Vcc via the second inverters 38 and 39, respectively, and the output terminals of the AND circuits 36 and 37 are connected to the input port 41. Furthermore, the above OR circuit 35. The output terminals of the first and second AND circuits 36 and 37 are connected to first to third mode display light emitting diodes 42 to 44 that emit light to indicate that the mode is time irradiation mode, continuous irradiation mode, or intermittent irradiation mode. are connected to each other.

Furthermore, the time setting dial 11#'i that constitutes this irradiation mode setting section, the irradiation time in time irradiation mode (0
~10 seconds) and irradiation time in intermittent irradiation mode (0~10 seconds)
(configuration) such that the time during which irradiation is stopped is set in advance.

The irradiation mode setting section configured as described above can set the valley irradiation mode by operating as follows. That is, as shown in FIG.
Open a and turn the mode changeover switch SW as shown in FIG.

When the safety switch SW is in the time irradiation mode position, the safety switch SW is in an open state based on the opening of the safety cover 16a, and the time irradiation mode signal is output only from the OR circuit 35. Therefore, at this point, irradiation can be performed within the time set by the time setting dial 17Vc.

Next, when the mode changeover switch sw is connected to the terminal 1 in the continuous irradiation mode position, irradiation within the continuous irradiation mode time can be performed only from the AND circuit 36.

Furthermore, when the mode selector switch S W2 f is connected to terminal C, which is the intermittent irradiation mode position, the intermittent irradiation mode signal is output only from the second AND circuit 3γ, and therefore, in this case, the shutter 33 is in the open state. vCI within any given time! P! It is capable of repeated intermittent irradiation.

However, since the safety switch SWI is closed when the safety cover 16ai is closed, the OR circuit 3
Since only the time irradiation mode signal from 5 is output, irradiation can only be performed in the time irradiation mode. Therefore, as long as the safety cover 16al is closed, the irradiation '5 is performed only within the time set by the time setting dial 17.
'J ability, and the level of danger is extremely low.

Next, the switching section between air and nonflammable gas will be explained based on FIGS. 9 to 11. This switching section between air and nonflammable gas is designed to prevent wrinkles caused by dirt on the output end surface (
・In order to prevent damage caused by laser beam irradiation, and to effectively prevent normal tissue surrounding the affected area irradiated with the laser beam from being heated by thermal conduction and suffering thermal damage, or to burn the tissue in the area affected by laser beam irradiation. This system switches the cooling fluid (air and nonflammable gas such as CO or gas) that is sprayed onto the affected area or its surroundings in order to blow away the smoke so as to prevent it from becoming difficult to see the affected area due to the smoke generated. Switching between air and non-flammable gas is necessary because air is sufficient when treating areas such as the esophagus or stomach where there is no flammable gas during extracorporeal treatment and endoscopic internal treatment. This is necessary in order to deliver nonflammable gas when treating areas in the body where flammable gas exists, such as the large intestine.

For the above purpose, the operating unit (B) of an embodiment of the medical radar device according to the present invention includes an air supply cylinder f50 and an air supply cylinder connected to the air supply pump 50 via an air supply cylinder f51. A second inflow 1715 connected to the first inflow port 52a, CO, and the gas cylinder 53 via the gas pipe 154
2b and these first and second inlets 52a and 52
A well-known three-way solenoid valve 52 at the outlet 52c' selectively connected to the outlet 52C with respect to the outlet 52C, and a connection 1j55 VC connected to the outlet 52C and arranged on the side V of the operating unit B.
Connected flow K ``Ia'56 and this fluid・Yia5
A fluid pressure sensor 57 disposed in the middle of 5 is provided. The above air supply bong f50 and three-way solenoid valve 52 (shun,
It is connected to the source 58 through the changeover switch SWe'ff: which is arranged between the relay switch SW and iJ'sW+' and between the source 58 and the source 58.

The changeover switch SWn is configured to be linked to the opening and closing of a protective cover 59 that protects the portion from which the second inlet 52b of the three-way solenoid valve 52 exits, and is turned OFF when the protective cover 59 is opened. has been done. The fluid pressure sensor 57 is a well-known sensor that detects the entire lower limit of the pressure of the fluid flowing through the fluid/J' Eve 56, and when the fluid pressure falls below a predetermined pressure, that is, when air is supplied from the air pump or When the supply of CO2 gas runs out, an interlock is activated to stop the laser oscillation and prevent thermal damage to the irradiation end face of the optical fiber 11.

Further, the connection port 52e is connected to the guide tube 1 I bvc connected to the fiber body 11a'i of the optical fiber 11 through which the fiber body 11a'i is protected, and the communication port 11+= is connected to the air or Co2
Gas is sent to the laser beam irradiation section through the gap between the guide duplex 11b and the fiber body 11a. .

The air/COt gas switching section with the IC configuration as described above is
When the protective cover 59 is in the closed state shown in FIGS. 1 and 3, the changeover switch SW4 is in the ON state, so the air supply pump 50 is activated by the relay switch
The three-way solenoid valve 52 connects the first inlet 52a and the outlet 52C to communicate with each other.

Therefore, in such a state, the air sent out from the air supply bong f50 is transferred from the air supply pipe 51 to the three-way solenoid valve 52 to the fluid pipe 56 to the communication pipe 11c to the guide tube 11.
It passes through b and is sprayed onto the laser beam irradiation section. As for the housing, when the protective cover 59 is opened as shown in FIG. and the outflow port 52e are returned to a communicating state.

Therefore, in this case, by connecting the gas supply pipe 54 connected to the CO2 gas tank 53 to the second inlet port 52b of the three-way solenoid valve 52 and opening the cock of the CO2 gas pump 53, the CO2 gas is sent out from the CO2 gas tank. C
The 02 gas is blown onto the laser beam irradiation section through the gas supply tube 54 -> three-way electromagnetic valve 52 -> fluid line f56 - continuous nozzle pipe 11c -> guide tube 11bi.

In addition, in order to ensure safety, it is desirable to configure the switching state between air and CO2 gas so that each state and fluid pressure are displayed on a part of the display panel 19.

FIG. 12 shows another embodiment of the medical Leveux device according to the present invention. The operating unit B' has at least the same configuration as the operating unit B of the embodiment. The main unit I-A and the operating unit B' are connected by a multi-relay optical fiber F different from that of the previous embodiment. This relay optical fiber F is provided with a condensing lens L on the incident end side thereof to condense a laser beam onto the incident end face. This condensing lens L1 can be positioned with respect to the input end face of the optical fiber using a χ-y-z alignment mechanism. ]: It is placed in the sea urchin. Further, on the output end side of this relay optical fiber F, a collimating lens L2 and a condensing lens L3 are disposed with the same configuration. The relay optical fiber F configured in this manner has its input end side connected to the laser beam exit port 8a provided in the main unit AK, and its output end side connected to the operation unit B.
′. The operation unit B' has optical fibers 11 to 11, which are the same as those in the embodiment, at a position where the light is condensed by the condenser lens L on the output end side of the relay optical fiber F connected as described above. The input end portion is configured to be detachably connected.

The 7j medical river relay f device configured as described above can be used in the same manner as in the embodiment described above, and by using the relay optical fiber F-i, optical fibers can be connected to the operating unit placed at hand according to the purpose of use. The fiber 11 can be connected and exchanged. In addition, for the initial adjustment, the relay optical fiber F is used for l: relay laser beam exit port 8.
(Alignment with a) By doing this, it is possible to connect to a mechanical connection. This is the condensing lens L
Since the incidence of the laser beam on + is treated as the output density based on the oscillation output diameter of the laser beam, alignment at a place with low output density before condensation when connecting must be considered. be. Therefore, since alignment is possible in a place where the output density is low, damage to the optical system due to the laser beam can be avoided as much as possible.

In addition, by making the optical fiber F for relaying thicker, it is possible to transmit data with lower power density.In addition, it is possible to separate the main unit A and the operation unit B' and use them by hanging them together. It is necessary to take this into consideration and apply a sufficient protective coating in advance to prevent damage. Furthermore, by combining the relay optical fibers F into one fiber, it is easier to use.

As described above, in the medical laser device according to the present invention, the parts subject to installation location restrictions and the parts with a large view are taken as one main body unit, and the parts necessary for actual treatment are divided into this main body unit. It is very advantageous in terms of use because it is integrated into an operating unit and each unit can be separated.

[Brief explanation of drawings]

1 to 11 are explanatory diagrams showing one embodiment of a medical laser device according to the present invention, in which FIG. 1 is a perspective view showing the entire device, and FIGS. 2 and 3 are illustrations thereof. 4 is a sectional view of a main part showing a part of the main unit, FIG. 5 is a perspective view of a main part of the main unit, and FIG. 6 is an output An explanatory diagram for explaining the adjustment section, FIG. 7 is a perspective view showing the main parts of the operation unit, FIG. 8 is an explanatory diagram for explaining the entire irradiation mode setting section, and FIGS. 9 to 11 are FIG. 12 is an explanatory view for explaining the air/nonflammable gas switching section, and FIG. 12 is an explanatory view of the main parts of another embodiment. A...Main unit B, B'...Operation unit 11...Optical fiber F...Relay optical fiber C1+C2...Cable applicant Fuji Photo Hikari Co., Ltd.

Claims (1)

[Claims] (1) Operation that includes at least a main unit containing a laser oscillator, the power supply system and cooling system necessary for this laser oscillator, and at least all the operation settings for laser beam irradiation mode, irradiation time, etc. required for radar treatment. What is claimed is: 1. A medical laser device comprising a unit, and the operating unit can be separated from the main unit as necessary.