JPS5962063A - Laser treating 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 [Technical Field of the Invention] The present invention relates to a laser treatment device that detects positional information of a nevus and automatically performs laser treatment on the nevus.

[Technical background of the invention]

Currently, various medical devices using laser light have been proposed, and one example of one used in the field of plastic surgery is the laser treatment device ff, which removes and treats colored birthmarks such as birthmarks, age spots, and sock lesions. .

Many conventional methods are known for the treatment of birthmarks, such as cell destruction using dry ice, skin grafting, excision, thin scraping, and baking with electric drying.
All of these methods have disadvantages, such as their effectiveness being low compared to the size of the invasion, the treatment itself causing pain to the patient, the need for hospitalization, and the long treatment period. Improvements have been desired. Recently, with the development and improvement of laser devices, methods of burning affected areas using laser beams have been proposed and are being put into practice, and their therapeutic effects are also becoming recognized.

FIG. 1 is a structural diagram of the affected tissue of a pigmented nevus. In the figure, A is normal skin tissue, B is the affected nevus, 1 is the epidermis, and 2 is the dermis. 3 is a colored cell or colored substance.

The reason why the affected nevus is different in color from normal skin is because the core contains many colored cells caused by melanin within the dermal layer.

By the way, not all of the affected nevi B in Figure 1 are abnormal. A nevus is a condition in which colored cells are mixed in normal tissue, and the color varies from black to brown depending on how mixed they are.

FIGS. 2(a) and 2(b) are diagrams showing an example of wavelength-reflectance characteristics of the skin measured by a spectrometer. In the figure, the horizontal axis shows the wavelength [μ+111], and the vertical axis shows the reflectance. FIG. 2(a) shows the reflectance spectrum characteristics of the normal area, showing a generally high reflectance and drawing a curve sloping upward to the right. Also, as the wavelength becomes longer, the reflectance increases,
The reflectance is almost constant between 0.6 μm and 1.0 μm. It has a minimum value near 0.55 μm and exhibits absorption characteristics due to the absorption of hemoglobin in red blood cells.

Such reflectance spectrum characteristics are visually perceived as so-called skin color.

FIG. 2(b) is an example of a black nevus adjacent to the normal area targeted in FIG. 2(,), and shows an overall low reflectance. The characteristic curve that slopes gently upward to the right is the reflectance characteristic of melanin itself, and these reflectance spectral characteristics are visually recognized as brown or black.

Incidentally, colored abnormal cells such as red birthmarks generally have lower brightness than normal cells, and absorb visible light more strongly than normal cells with higher brightness. Therefore, when these abnormal cells are irradiated with a high-energy laser beam in the visible light range, the beam is selectively absorbed by the abnormal cells and converted into thermal energy.

As a result, abnormal cells are strongly burned and destroyed.

On the other hand, just cells generally have high brightness and therefore absorb little of the laser beam. Therefore, there is little damage to normal cells due to heat. Therefore, if a nevus is irradiated with such a laser beam, the abnormal cells will be selectively burnt and the nevus will disappear, but relatively bright normal cells, sweat glands, skin, etc. will hardly be exposed to the laser beam. Since it does not absorb, irreversible damage is avoided, and burns on normal cells and skin surfaces caused by the laser beam heal rapidly with the formation of minute scars.

FIG. 3 is a perspective view of a conventional laser treatment device. 2 in the diagram
Reference numeral 1 denotes the main body of the apparatus, in which a laser oscillator, a power source, and an operation panel are built into the same tube. Laser light from a laser oscillator is guided through optical fibers 23 through a connector 22, and is emitted to the outside from the tip of a knotted bead 24 provided at the tip side of the optical fiber 23.

There are currently three types of lasers used for nevus treatment: argon laser, ruby laser, and YAG laser, as they must be selectively absorbed by the nevus and provide high output energy. is considered valid.

However, the output of the argon laser that has been put into practical use is 4~
Since the power is about 100W, the beam diameter of the laser irradiated from the handpiece 24 is as small as about 2Φ.

In the conventional device having such a configuration, during treatment, the doctor holds the handpiece in his hand, sequentially moves the irradiation position to two throats at a time while checking the affected area with the naked eye, and performs the treatment by irradiating the laser.

However, it is quite difficult to uniformly arrange the two irradiation circles while visually checking them with the naked eye, or to keep the irradiation time of each beam constant. As a result, the arrangement of the irradiation circles is disordered and overlapping υ
If the collision becomes severe, the damage to the abnormal cells becomes significant, leaving scars.

On the other hand, if the interval between the irradiation circles is too wide, that portion will remain as an untreated portion without being erased. Furthermore, if the irradiation time cannot be maintained at a constant level, burn spots are likely to occur, and damage to the skin surface cannot be avoided, especially if the irradiation time is long.

Therefore, with conventional equipment that performs laser irradiation without visual confirmation, there is a lot of time loss, and it is difficult for doctors to perform treatment efficiently because it requires a lot of effort.

[Purpose of the invention]

The present invention was developed in view of the above circumstances, and by automatically irradiating the inside of a nevus at a constant speed and at a constant irradiation interval, it reduces the labor of the doctor, allows efficient treatment, and has a good therapeutic effect. The present invention provides a laser treatment device.

[Summary of the invention]

That is, in order to achieve the above-mentioned object, the present invention attaches a light guide irradiation member that guides a laser beam and irradiates it to an irradiated object to a scanner that scans and moves it over a predetermined area, and sets the scanning area of this scanner at the position of the affected area. At the same time, a photometric means for detecting the amount of reflected light is provided, and a means for comparing the detected amount of reflected light with a preset threshold is provided so that the affected area can be identified from the amount of reflected light, and the affected area and its vicinity are sequentially scanned. While moving, the amount of reflected light is measured by the photometry means, and compared with a threshold value based on the difference in amount of reflected light between the affected area and the normal area, the affected area is detected and the generation of laser light is controlled. By configuring the scanning position of the scanner to correspond to the scanning position of the scanner, it measures light while sequentially scanning the affected area, detects whether it is an affected area, and automatically generates a laser beam if it is an affected area. By making it possible to perform laser treatment on only the affected area, and by scanning and moving the light guide irradiation member using a scanner, it is possible to set it so that the scanning movement is performed without any gaps according to the spot diameter of the light guide, thereby reducing uneven printing. To obtain a laser treatment device that does not leave any unburned portions, does not cause burn spots, and does not require the labor of a doctor.

[Embodiments of the invention]

An embodiment of the present invention will be described below with reference to the drawings.

The present invention takes a photo of the affected area of a patient to be treated, moves the photo with a coordinate detector, measures the amount of reflection in the photo, and confirms the location of the nevus, while the handpiece pointing toward the affected area detects the coordinates. The device scans the nevus based on the position information, and the laser device irradiates laser light based on the nevus information confirmed by the reflection measuring device to perform treatment.

FIG. 4 shows a block diagram of the present invention. In the figure, a laser device 41 has a built-in oscillator and power supply, and emits laser light while receiving an irradiation signal from an irradiation indicator 42. This irradiation indicator 42 has a built-in level setting device, and if the input signal is less than the voltage set by the level setting device, it is determined that it is a nevus, and sends a signal to the radar device 41 to instruct radial irradiation. Reference numeral 43 denotes an optical fiber, which is highly flexible and transmits the laser beam emitted from the laser device 41 to the hand piece 8 attached to the tip thereof, which is used to irradiate the affected area with the laser beam. Reference numeral 44 denotes a known reflection amount measuring device, a conceptual diagram of which is shown in FIG.

In the figure, L is a lamp as a light emitting source, and R is a lens that efficiently focuses the output light of the lamp L onto the irradiation light guide LG. LG' is a reflection light guide that transmits the reflected light from the object T to a photoelectric converter that converts it into an output voltage according to the intensity of the light. Then, the output of the photoelectric converter is amplified and output.

That is, the light from the lamp L is applied to the measured object T through the irradiation light guide LG, and the reflected light is received by the reflection light guide LG' and guided to the photoelectric converter, where a signal corresponding to the amount of incident light is generated. After the signal is converted into ', it is amplified by an amplifier A to obtain a signal corresponding to the amount of reflected light from the object T to be measured.

Returning to Figure 4 again. 45 is a photo of the affected area.

A conceptual diagram of a known coordinate detector that can be moved while detecting the Y-axis position is shown in FIG. As shown in the figure, the coordinate detector 45 moves the T-shaped cursor body 61 onto the X-Y plane 6.
By moving the cursor 65, which is movable along the Y-axis of 2 and still holds the pedestal 64 on which the photograph 63 showing the affected area is placed, along the Y-axis on the cursor body 61. , the coordinate position is detected by rotating the X-axis encoder 66A and the Y-axis circumferential encoder 66B by an amount corresponding to the amount of movement.

That is, on the T-shaped cursor main body 61, an endless wire 62 is arranged along the Y-axis direction by being passed around a pulley, and an encoder 6 is placed on the pulley on the T-shaped cursor body 61.
6B is attached, and a cursor 65 is attached to the wire 67.
9 are attached. Further, an endless wire 68 is supported by pulleys and is stretched along the X-axis movement direction of the cursor body 61, and an encoder 6 is attached to one pulley.
6k is attached, and the cursor body 6 is engaged with the wire 68.

Further, although not shown in the drawings as it deviates from the essence of the invention, the encoders 661 and 66B are each connected with a motor, and each wire 67 and 66B rotates the motor.
By driving 8, the crane body 61 can be moved in the X-axis direction and the cursor 65 can be moved in the Y-axis direction, thereby creating a mechanism that can move the photo 63 in the X and Y-axis directions while detecting the coordinates. There is. This coordinate detector can be operated so as to start its operation from any position according to an external instruction, and of course has a long-life structure so that the speed and moving distance can be changed as desired. However, when the limit switch reaches a predetermined position, the operation is stopped.

FIG. 7 shows the positional relationship between the reflection amount measuring device 44 and the photograph 63. At a position facing the photograph 63 placed on the pedestal 64, and separated from the pedestal 64, are an irradiation light guide LG and a reflection light guide LG' of the ruminant measuring device 44.
is fixedly arranged, and the reflection amount measuring device 44 is configured to detect the amount of reflection that changes as the photograph 6B moves and convert it into a voltage.

Returning to Figure 4 again. Reference numeral 46 denotes a scanner controller, which receives the Y-axis and Y-axis position signals output from the coordinate detector 45 and operates to drive and control the subsequent scanner 47 that scans the scanner 48. At that time, coordinate detector 4
Needless to say, the structure is such that the amount of movement of the scanner 47 can be changed according to the scale of the photograph 63 from the position signal of 5, and this technique is a conventional technique widely used in profiling lathes and the like. Since this is not the essence of this invention, it will not be described in detail here.

The scanner 47 receives a position signal from the scanner controller 46 described above, and functions to cause a hand piece 48, which is used to irradiate a laser beam to the affected area, to scan in the X and Y axis directions. This scanner 47 is also a known technique, and a specific example is shown in FIG.

In the figure, reference numeral 81 denotes a pair of rails extending in the X-axis direction, which are fixed along the X-axis direction of the pace 82. A movable table 83 that can move on this rail is arranged on this rail 8, and a box 84 is provided on this movable table 83. A motor for driving the moving table is provided in the deck 84, and the moving table 83 can be moved on the rail 8 by an X-axis position signal given from the scanner controller 46. A pole 85 is installed on the movable base 83 along the Y-axis direction, and the sole 85 is provided with a movable support 86 that moves on the pole 85 in the axial direction. This movable support 86 is cylindrical and has a shaft 8 on its side in the z-axis direction.
7 is attached with one end supported, and a gear (not shown) is provided inside the movable support 86, and this gear is engaged with a gear 88 provided on the pole 85. , and by rotating the gear of the movable support body 86 with a motor 89 provided on the movable support body 86, the movable support body 8
6 can be moved along the pole 85.

The motor 89 is controlled by a Y-axis position signal given from the scanner controller 46, and this allows the shaft 87 to move in the x- and y-axis directions. A shaft 90 is fitted to the tip of the shirt so that the length of the arm can be made variable, and the distance between the tip of the shirt 90 and the affected area can be adjusted to enable efficient treatment. It is.

That is, since the hand heath 48 is fixed to the tip of the shaft 80 with its axes aligned, the distance between the hand heath 48 and the affected area can be adjusted by expanding and contracting the shaft, and the X of the shaft 87 can be adjusted.

By moving on the Y axis, the hand heath 48 scans the surface of the affected area.

The operation of the apparatus of the present invention will be explained as follows.

The doctor first takes a photograph 63 of the birthmark to be treated and places it on the pedestal 64 of the coordinate detector 45. Further, the moving distance in the Y-axis direction and the moving speed in the X-axis direction according to the color tone of the nevus are set in the coordinate detector 45 so that the intensity distribution of the laser beam that irradiates the nevus is uniform. Next, the scan range of the scanner 47 is aligned with the affected area so that the position of the nevus in the photograph 63 and the patient's nevus relatively match. If the patient moves during irradiation treatment, there is a risk that the irradiation position will be distorted and the normal area will be irradiated, but the actual irradiation time is approximately 10.1 seconds per scan speed, and the scan range is, for example, 5 seconds. Since it takes about 25 seconds even for ttn x 5 cm, there are many practical measures that can be taken to prevent the patient from moving during this time, so they will not be detailed here.

Thereafter, the scanning position of the irradiation light guide LG and the reflection light guide LG' of the reflection amount measuring device 44 in the photograph 63 of FIG. A laser beam is emitted from the hand piece 48 at the nevus position at No. 3 and is irradiated onto the ridge on the axis of the nod bead 48. In this way, the laser beam is controlled without scanning until it reaches a predetermined end point position away from the nevus, such as the position marked with a circle in FIG. 19, and the coordinate detector 45 It detects from the position signal that the position has been reached and stops the operation, thereby ending the treatment.

As described in detail above, the present invention is equipped with a scanner that scans the laser beam for X and Y scanning, scans photos of the affected area sequentially, learns the affected area from the reflected light, and works in conjunction with the detection of the affected area. The oscillation of the laser device is controlled by the laser device, and the scanning of the photograph and the scanning of the scanner are linked, so if the scanning range of the scanner is adjusted to the affected area, the scanning will be performed automatically at a constant speed and a constant pitch. The laser beam is scanned, and at the location of the nevus, a laser beam is emitted from the handpiece, allowing laser treatment to be performed selectively on the nevus. Laser treatment can be performed on a regular basis, so the normal tissue around the affected area can be protected, and since scanning can be performed at regular pitches and trajectories, there is no uneven burning, so there are no spots.
It is possible to provide a laser treatment device with good therapeutic effects.

It should be noted that the present invention is not limited to the embodiments described above and shown in the drawings, and can be implemented with appropriate modifications within the scope of the gist thereof. For example, FIG. 6 shows an example of moving a photograph. However, the photograph is fixed and the irradiation and reflection light guides LG and LG of the reflection amount measuring device 44 are placed on the cursor 65.
' may be connected to scan the photo 63.

The above method scans a photograph of the affected area and sequentially detects the amount of reflected light, detects the nevus in the image from this K and outputs it together with the coordinate position signal at that time, and generates laser light only when the nevus is detected. In addition, the position of the handpiece for irradiating the laser beam is controlled based on the continuous position signal, so that laser treatment can be automatically performed based on a photograph of the affected area.

However, in addition to this method, instead of using photographs, the detection section of a reflected light measuring device is installed on the no-dobe and the no-dobe is scanned to directly detect the amount of light reflected from the irradiated object at each scanning position. It is also possible to detect whether or not the location is a nevus, and if it is a nevus, generate a laser beam to perform treatment.

10 shows a block diagram of another embodiment of the invention according to FIG. 10; FIG. No. 4 is a laser device, which has a built-in laser oscillator and power supply, and emits laser light when an irradiation instruction signal is input from a controller 102, which will be described later. 48 is an optical fiber;
It is highly flexible and functions to transmit the laser beam emitted from the laser device 41 to the hand piece 103 connected to its tip and irradiating the laser beam to the affected area.

As shown in the conceptual diagram of FIG. 11, the handpiece 103 includes an optical fiber OFI for irradiating the affected area with laser light, and an irradiation light guide O that constitutes the reflection amount measuring device 101, which will be described later.
F2 and the reflection light guide OF3 are configured to be integrally connected.

Reference numeral 101 is a known reflection measuring device, a conceptual diagram of which is shown in FIG. In the figure, L1 is a rung of the light emitting source, R1 is a lens that efficiently focuses the output light of the lamp L1 onto the irradiation light guide OF2, and the light from the lamp is sent from the irradiation light guide OFI to the handpiece 48. and irradiates the affected area. OF3 is a reflection light guide that transmits the reflected light from the affected area to the photoelectric converter DJ, which converts it into an output voltage according to the intensity of the light, and the output of the photoelectric converter D is transmitted to the amplifier AI, where it is voltage amplified. , subsequent controller 10
It will be communicated to 2.

Reference numeral 102 denotes a controller, which has a built-in level setting device (not shown) for setting an appropriate threshold value based on the difference in the amount of reflected light between a normal area and an affected area, and the output voltage of the reflection amount measuring device 101 described above is set by this level setting device. If the voltage is lower than the voltage set on the level setting device, it is determined that it is a birthmark, and it functions to send an irradiation instruction signal to the laser device 41 to irradiate pulsed laser light. The voltage set on the level setting device is set in advance to a value that recognizes the birthmark T, as shown in the drawing showing the relationship between the scan position and the output voltage of the reflex convergence measuring device 101 shown in FIG. The controller 102 starts the irradiation after the laser device 4 finishes irradiating pulsed laser light (for example, after 0.1 seconds in the case of an Alkon laser device that uses a mechanical shutter to irradiate intermittent laser beams, or depending on the charging time of the capacitor). In the case of a ruby laser device whose interval is determined, the configuration is such that a signal instructing movement is given to the scanner controller 104 after 30 seconds. The scanner controller 104 has the function of controlling the scanner 47, and by predetermining the current flowing to the motor of the scanner 47, it can change the intermittent scanning speed and operate the limit switch of the scanner 47. After moving the scanner 47 in the bitch leg for a certain distance, a current is sent in the opposite direction to move the scanner 47 in the reverse direction. 47 is a scanner which receives a position signal from the aforementioned scanner controller 104 and operates to scan the hand piece 103;
This is the same configuration as shown in the figure.

Although it will not be described in detail since it is not the essence of this invention, the scanner 47 is provided with left and right and upper and lower limit switches in the X-axis direction and Y-axis direction, respectively, and is configured so that the scan range can be set in advance. The relationship between the limit switch and the scanner controller 104 is such that, for example, when scanning in the right direction on the X axis, when a signal is sent from the right limit switch to the scanner controller 104, the scanner controller 104 moves in the right direction. is stopped and pitched in the Y-axis direction by a distance set in advance in the scanner controller 104, and then moved in the opposite direction of the The amount of reflected light is detected here.The signal of this detection is given to the controller 102 and compared with the setting value of the level setting device in the controller 101.

As a result, if it is higher than the set value, controller 101
If the current scanning position is determined to be a normal area, the laser beam irradiation command is not generated, and after a certain period of time, a signal is sent to the scanner controller 104, and the scanner 47 is moved a certain distance in the X-axis direction. let Here, similar reflected light amount measurement is performed again, and if the output signal of the reflection amount measuring device 101 is less than the level setting device in the controller 102, the controller 102 determines that it is a birthmark and sends an irradiation command signal to the laser device 41. Irradiate the feed laser beam. Since the laser beam from the laser device 41 is guided to the hand piece 103 via the light guide 0FF (43), the laser beam is irradiated to the opposite epidermis of the hunt heath 103, that is, the point opposite to the birthmark, and is cauterized. In this way, the amount of reflected light is measured to detect whether it is a nevus, and if it is a nevus, the handpiece is irradiated with a laser beam and moved to the next position, and if it is not a nevus, it is irradiated with a laser beam. Move the handpiece to the next position without This operation is repeated in sequence, and when it reaches the end in the X-axis direction, it is moved by -pitch in the Y-axis direction. In this way,
The operation stops when the mark reaches the end point.

As a result, if you set the scanning range of the handpiece in advance, it will scan this preset range and identify birthmarks, and automatically irradiate laser light where birthmarks are present, automatically providing laser treatment. Since this can be done, it is possible to perform a good treatment with no burn marks and a good treatment effect without having to go through the hands of a doctor.

〔Effect of the invention〕

As described in detail above, the present invention includes attaching a light guiding irradiation member that guides a laser beam and irradiating it to an irradiated object to a scanner that scans and moves it over a predetermined area, sets the scanning area of this scanner at the position of the affected area, and sets the amount of reflected light. A photometric means for detecting the detected reflected light is provided, and means is provided to compare the detected reflected light amount with a preset threshold value, so that an affected area with a large amount of reflected light can be determined. Measurement is performed using a photometric means, the affected area is detected by comparing it with a threshold value based on the difference in the amount of reflected light between the affected area and the normal area, and the generation of laser light is controlled. Since the system is configured to support this, laser treatment of only the affected area is automatically achieved by sequentially scanning and moving the affected area, measuring the light, detecting whether or not it is an affected area, and generating laser light if it is an affected area. In addition, since the light guide irradiation member is scanned by a scanner, it can be set to scan and move at a constant speed without any gaps according to the spot diameter of the laser beam, so there will be no uneven printing or unburned areas. Therefore, it is possible to provide a laser treatment device that does not cause burn spots and does not require the effort of a doctor.

[Brief explanation of drawings]

Figure 1 is a cross-sectional view showing the composition of the normal area in the vicinity of the affected nevus, Figure 2 is a diagram showing its wavelength and reflectance characteristics, and Figure 3 is a diagram showing the configuration of five conventional laser treatment devices. 4 is a block diagram showing an embodiment of the present invention, FIG. 5 is a diagram showing the concept of the reflection amount measuring device, FIG. 6 is a diagram showing the concept of the coordinate detector, and FIG. FIG. 8 is a perspective view showing the structure of the scanner; FIG. 9 is a diagram showing the relationship between the photograph and its scanning trajectory; FIG. Block diagram showing another embodiment, No. 11
The figure is a diagram to explain the configuration of the reflection amount measuring instrument, laser device, and handpiece, Figure 12 is a diagram to explain the detection status of affected and normal parts of the reflection measuring instrument, and Figure 13 is a diagram of the handpiece. It is a figure which shows the locus of scanning of a piece. 41... Laser device, 42... Irradiation indicator, 43...
・Optical fiber, 44.101... Reflection measuring device, 45
...Coordinate detector, 46...Scanner controller, 47
, 104... Scanner, 48, 103... Hand piece. Figure 1 Figure 2 (a) (b) Light I! Figure 10 Figure 12 +1-1 Figure 13 ζ

Claims (2)

[Claims] (1) A laser device that generates laser light, a light guide irradiation member that guides the laser light and irradiates the object to be irradiated with the laser light, and a light guide irradiation member that holds the light guide irradiation member and spreads it over a predetermined area. A scanner that moves and scans, a reflected light amount measuring device that detects the amount of reflected light, and compares the detected amount of light with a preset threshold value, and according to the comparison result, outputs a laser light generation control output to the radar device to avoid any trouble. a coordinate detector to which a photo of the affected area is attached, and which scans the detection section side of the reflected light amount measuring device relatively over a predetermined area of the photo and sequentially outputs coordinate signals of the scanning position; 1. A laser treatment device comprising: a scanner controller that controls scanning by giving a control signal to the scanner to set a scanning position according to the scanning position. (2) A laser device that generates laser light, a light guide irradiation member that guides the laser light and irradiates the object to be irradiated with the laser light, and holds and moves this light guide irradiation member over a predetermined area. A scanner for scanning and a detection section side are provided on the laser beam output end side of the light guide irradiation member, and the reflected light from the irradiated object is obtained from the detection section side to detect the amount of reflected light, which is set in advance. a reflection amount measuring device that generates an output by comparing it with a threshold; a controller that provides a laser beam generation control output to the laser device according to the comparison output; and a controller that generates a scanning command at predetermined intervals; 1. A laser treatment device comprising: a scanner controller that advances scanning of the scanner by -pitch each time a laser beam is received.