JPS62246359A - 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] [Field of Industrial Application] This invention relates to a medical laser device,
In particular, the present invention relates to a medical laser device that can safely and accurately irradiate laser light even if the affected area to be irradiated with laser light moves due to breathing or the like.

[Conventional technology]

2. Description of the Related Art Recently, in the field of medicine, medical laser devices have come into practical use that utilize the energy of laser light to perform hemostasis treatment for bleeding in an affected area, or treatment such as excision or vaporization of affected tissue. The basic configuration of this medical laser device is a laser oscillator made of argon or YAG, etc., and a laser beam emitted from the laser oscillator that is guided to the desired affected area (light transmission means, a shutter that intermittents the laser beam, etc.). It is composed of
It is also well known that it is used directly when the affected area is outside the body, and via an endoscope when the affected area is inside the body cavity.

As modes for intermittent laser light, time irradiation mode, continuous irradiation mode, and intermittent irradiation mode are often used. These irradiation modes are set taking into account the size of the affected area and the absorption state of irradiation energy.
The above-mentioned continuous irradiation mode enables irradiation for a time longer than the above-mentioned time irradiation mode, and the above-mentioned intermittent irradiation mode allows, for example, irradiation for 2 seconds and then stops irradiation for 3 seconds. It is a mode that allows you to repeat the cycle of doing this.・ Also, the energy of the laser light used in medical laser equipment naturally has high energy,
If this laser beam is inadvertently applied to the human body, there is a high risk of burns, etc., and various safety devices are installed to prevent such a situation from occurring.

[Problem to be solved]

By the way, when irradiating the affected area with laser light in the above-mentioned intermittent irradiation mode, the length of the irradiation interval has traditionally been fixed in many cases.

On the other hand, there are many parts of the human body that move due to breathing or blood flow, and even if the laser beam is aimed accurately at the affected area, the focus of the laser beam may be lost due to the above-mentioned movement. This sometimes led to situations that were unfavorable from the standpoint of accuracy and safety.

For example, assume that laser light is normally irradiated when the affected area is close to the tip of the laser beam (referred to as a convex state), and that the laser light is focused in this convex state.

However, if the interval is fixed as described above, for example, if the laser beam is irradiated while the affected area is tilted away from the tip of the laser beam (referred to as the concave condition), the laser beam will not be focused. Laser light may be irradiated in a state where it is not present, making it impossible to perform the prescribed treatment, or in extreme cases, laser light may be irradiated on healthy areas that do not need to be irradiated, which is dangerous. there were.

[Means for solving problems]

In order to solve the above-mentioned problems, the present invention provides a medical laser device having at least a laser oscillator, a light transmission means for guiding the laser light emitted from the laser oscillator to a desired affected area, and a shutter for intermittent the laser light. 2 sensors that detect periodic movements of the human body;
and control means for intermittent operation of the shutter in synchronization with the output signal from the sensor.

[Effect]

By configuring the present invention as described above, periodic movements of the human body such as breathing are detected by a sensor, and the shutter is activated intermittently in synchronization with the output signal from this sensor, so that the affected area is in the convex state. The laser beam is irradiated only in certain cases, and the laser beam is not irradiated unless the convex state is present.

〔Example〕

The present invention will be explained below based on an illustrated embodiment.

FIG. 1 is a conceptual diagram showing an example of the case where the medical laser device of the present invention is applied to the human body.

As shown in FIG. 1, a patient 1 is lying on a bed 8, and a sensor 2 is attached to the patient's chest. The sensor 2 has a structure in which powdered carbon is sealed in a rubber tube, and when the patient's chest moves in response to breathing, the electrical resistance of the powdered carbon in the rubber tube changes, albeit slightly. This weak change in electrical resistance is extracted as a signal and sent to the amplifier 3.
The weak signal is thereby amplified and further sent to the laser device 4. Then, by performing the processing described below with this laser device 4, laser light is sent out to the light guide fiber 5 in synchronization with the signal taken out by the sensor 2. Further, the light guide fiber 5 is inserted in advance into the forceps channel of the endoscope 16 so that the laser output 7 can be seen from the tip of the insertion portion of the endoscope 6. The insertion portion of the endoscope 6 is then inserted into the body cavity of the patient l through the mouth, and a predetermined affected area is treated.

Here, the configuration of the laser device 4 will be explained based on FIG. 3.

As shown in FIG. 3, the output end of the sensor 2 consisting of a chest sensor etc. is connected to a central control unit (hereinafter referred to as CPU) consisting of a microcomputer, memory, etc.

) 21, and this CP
The output end of the foot switch 25 is connected to the second input end of U21. The first output terminal of the CPU 2t is a laser that controls laser oscillation. It is connected to the first input end of the liU control section 22, and the output end of this laser control section 22 is connected to a laser power supply section 23 that supplies power to the laser.
The output end of the laser oscillator 3 is connected to the first input end of the laser oscillation section 24 which is a laser oscillator made of argon or YAG, which constitutes the laser oscillation device 30 . A shutter portion 29 is inserted between the output end of the laser oscillation section 24 and the connector portion 20a of the light guide fiber 20 made of quartz or the like.

The tip of the light guide fiber 20 has a laser output (
(not shown) are connected.

Various interfaces are connected to the third input terminal of the CPU 21:
The output end of the control section 26 is connected to the interlock control section 26, and the various interlock control sections 26 supply cooling water, for example, and are part of the safety device. Further, an emergency switch 27 is connected to the fourth input terminal of the CPU 21, and this emergency switch 27 is activated in case, for example, a patient has a sudden seizure or the laser device shows an abnormality. By turning off the emergency switch 27, the practitioner controls the CPU 21 to prevent the laser oscillation unit 24 from emitting laser light.

Further, a second output end of the CPU 21 is connected to a laser shutter drive section 28 , and an output end of the laser shutter drive section 28 is connected to the shutter part 29 . That is, this shutter part 29 is configured to be driven by a rotary solenoid or the like as is well known, and is interposed between the laser oscillation part 24 and the connector part 20a, and cuts off and on the laser beam as appropriate. It looks like this.

An irradiation method setting section 31 is provided at the fifth input terminal of the CPU 21.
is connected. The irradiation method setting unit 31 is configured to set the time irradiation mode and continuous irradiation as described above.

Three irradiation modes can be set: irradiation mode and intermittent irradiation mode.

The third output terminal of the CPU 21 is connected to the first input terminal of the warning transmission control section 32.
The output end of No. 2 is connected to a buzzer 34 via a buzzer drive section 33. The second output end of the laser control section 22 is connected to the second input end of the warning transmission control section 32, and the first output end of the laser oscillation section 24 is connected to the second input end of the warning transmission control section 32. Connected to the second No. 18 terminal,
The output end of the shutter part 29 is connected to the third input end of the laser control section 22.

The operation of the medical laser device configured as described above will be explained in the first section. Third. This will be explained based on FIG.

In FIG. 1, it is assumed that the insertion portion of the endoscope 6 has been inserted into the body cavity of the patient 1, and the laser output 7 has been inserted to a position very close to the affected area of the patient 1.

In this state, as a matter of course, the laser device 4 is not operating and no treatment is being performed.

When a predetermined switch is turned on in this state, the sensor 2 captures the pitch of the patient's breathing, which is amplified by the amplifier 3 and pulses corresponding to the patient's breathing are sent to the laser device 4. Pulses in this state are sent to the laser device 4 as pulses with a constant period, such as pulses P, P2, . . . shown in FIG.

In this state, the practitioner observes the pulses using an appropriate means, and when he or she determines that the pulses are stable, turns on the foot switch 25. Then, as shown in FIG. 4, the foot switch 25 outputs H.
A level signal is sent to CPLt21.

On the other hand, at this time, periodic pulses from the sensor 2 are also being sent to the CPU 21, so as shown in FIG. 4, the laser power supply section 23 is turned on at the falling timing of the pulse P2, and the laser oscillate. However, even if the laser is oscillating, part 29 of the shutters emit laser light.

Since the optical path is blocked, the laser light does not exit the laser device.

Next, when the shutter of the shutter portion 29 is opened in synchronization with the pulse P at the rising edge of the pulse P from the sensor 2, the laser beam is converted into a pulsed laser beam B as shown in FIG. The radiation is then irradiated onto the affected area for a predetermined period of time. Furthermore, the shutter is opened also at the time of pulse P4 from sensor 2, and the laser beam is pulsed with code B.
2, the affected area is irradiated. Hereafter, in the same manner, the pulse of sensor 2 is PS+Pb, P? In response to each pulse of +..., the laser light is transmitted with the symbol B3. B4. BS...
The affected area is irradiated as shown in...

It should be noted that the affected area is approaching the laser beam 7 of the insertion part of the endoscope 6 inserted into the body cavity! In L1 (convex state), pulsed laser light is output in synchronization with the pulse from sensor 2, and conversely, when the affected area is away from laser emission 7 (concave state), laser light is output in synchronization with the pulse from sensor 2. Make sure that it does not appear.

By doing this, if the laser beam is focused when the affected area approaches the laser beam (in a convex state), the pulse P from the sensor 2 can be adjusted.
When P a, P s, ......, the affected area always approaches the tip of the laser output 7, and in this state, the laser beam from the laser output is focused on the affected area. The Rukoto. That is, in this way, unlike the case of the conventional intermittent irradiation mode which has fixed intervals, it is possible to irradiate the affected area with laser light according to the intervals specific to each patient.

Next, when the second foot switch 25 is turned on (see FIG. 4), the pulse P of the sensor 2 is generated in the same manner as described above. In response to this, the shutter of the shutter part 29 is opened, and the radar light is irradiated only during the period B. Suppose that a pulse P is received from the sensor 2, and when this pulse ends, the emergency switch 27 is activated due to some reason.
When the emergency switch 27 turns on, the CPU 21
An H level signal is sent to the CPU 21, and the CPU 21 immediately turns off the laser power supply 23 to stop laser oscillation. At the same time, a signal is sent to the shutter drive section 28 to keep the shutter part 29 closed.
The shutter of the shutter part 29 remains closed.

That is, when the emergency switch 27 is turned on, the laser light is not irradiated from the light guide fiber 20, so naturally the laser beam 7 inserted into the human body is
Also, the laser light is not irradiated, and the affected area of the patient 1 is not irradiated with the laser light either.

What has been described above is a chest sensor that is attached around the chest as a breathing pickup, but there is also a nostril type sensor as another breathing pickup. This nostril-shaped pink-up uses, for example, a thermistor to detect temperature changes when a person breathes, and when they exhale, this thermistor becomes warm, and conversely, when they breathe in, warm air is blown onto the thermistor. This takes advantage of the phenomenon that there is no such thing.

The above is the case for breathing pickups,
A pulse pink-up corresponding to heart pulsation can also be used.

This pulse pickup will be explained based on FIG. 2.

As shown in the figure, a sensor device 11 is disposed above the nail of the index finger 14, and a floodlight lamp 12 for projecting light is installed inside the sensor device 11. A narrow beam of light is projected onto the nail 14a of the index finger 14, and the light reflected by the nail 14a of the index finger 14 is received by the light receiving element 13 in the sensor device 11. Then, a predetermined process is performed in a control section (not shown) in the sensor device 11, and the output signal is sent to the laser device 4.

Even in this way, the pulse can be extracted as a pulse at a predetermined period, so that the pulses P, P2. from the sensor shown in FIG. . . . can be used as a pulse signal with a constant period.

〔effect〕

According to the present invention, even if the affected area moves in response to the human body's breathing, pulse, etc., the laser beam can be irradiated when the laser beam and the affected area are at a certain distance, allowing accurate and safe irradiation. Treatment with laser light can be performed.

[BRIEF DESCRIPTION OF THE DRAWINGS] FIG. 1 is a conceptual diagram showing an example of a case where the medical laser device of the present invention is applied to a human body, FIG. 2 is a schematic diagram showing an example of means for extracting pulses according to pulse rate, Figure 3 is the same as above.
FIG. 4 is a time chart showing the operation of the electric circuit block diagram shown in FIG. 3. FIG. DESCRIPTION OF SYMBOLS 1... Patient, 2... Sensor, 5.20... Light guide fiber, 7... Laser emission part 21... CPU. $ 1 Drawing 3 Selling Masaru Neichi (Voluntary) September 30, 1985 Commissioner of the Patent Office Kuro 1) Yu Akira Patent Application No. 89156 of 1989 2, Title of Invention Medical Laser Device 3, Amendment Patent applicant address: 1-324 Uetake-cho, Omiya-shi, Saitama Name:
Fuji Photo Kohki Co., Ltd. 4, Agent address: 10-5 Ginza 2-chome, Chuo-ku, Tokyo 104 Column 6 of the detailed description of the invention in the specification, Statement of contents of the amendment, page 3, bottom line, Page 4, line 3 and line 8, page 6, line 13, page 7, line 16 to 17
Toward the beginning of the line, 9N, line 18, page 11, line 16 and 19, page 12, line 2 and 6, and line 7, page 13, line 9, page 15. "Laser emission" written in the third line is corrected to "laser emission section."

Claims (1)

[Claims] 1. In a medical laser device having at least a laser oscillator, a light transmission means for guiding the laser light emitted from the laser oscillator to a desired affected area, and a shutter for intermittent the laser light, A medical laser device comprising: a sensor that detects physical movement; and a control means that intermittents the shutter in synchronization with an output signal from the sensor.