JPS631054B2 - - Google Patents
Info
- Publication number
- JPS631054B2 JPS631054B2 JP54084480A JP8448079A JPS631054B2 JP S631054 B2 JPS631054 B2 JP S631054B2 JP 54084480 A JP54084480 A JP 54084480A JP 8448079 A JP8448079 A JP 8448079A JP S631054 B2 JPS631054 B2 JP S631054B2
- Authority
- JP
- Japan
- Prior art keywords
- detector
- laser
- tissue
- laser beam
- irradiation
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired
Links
- 238000009792 diffusion process Methods 0.000 claims description 11
- 230000003287 optical effect Effects 0.000 claims description 11
- 230000000694 effects Effects 0.000 claims description 9
- 238000013507 mapping Methods 0.000 claims description 4
- 230000006378 damage Effects 0.000 description 14
- 238000010586 diagram Methods 0.000 description 13
- 230000015271 coagulation Effects 0.000 description 8
- 238000005345 coagulation Methods 0.000 description 8
- 230000005855 radiation Effects 0.000 description 6
- 238000005259 measurement Methods 0.000 description 5
- 238000000034 method Methods 0.000 description 4
- 238000011156 evaluation Methods 0.000 description 3
- XKRFYHLGVUSROY-UHFFFAOYSA-N Argon Chemical compound [Ar] XKRFYHLGVUSROY-UHFFFAOYSA-N 0.000 description 2
- 206010017711 Gangrene Diseases 0.000 description 2
- 210000004027 cell Anatomy 0.000 description 2
- 238000002674 endoscopic surgery Methods 0.000 description 2
- 230000008020 evaporation Effects 0.000 description 2
- 238000001704 evaporation Methods 0.000 description 2
- 230000023597 hemostasis Effects 0.000 description 2
- 238000012544 monitoring process Methods 0.000 description 2
- 210000000056 organ Anatomy 0.000 description 2
- 230000035945 sensitivity Effects 0.000 description 2
- 206010047571 Visual impairment Diseases 0.000 description 1
- 238000010521 absorption reaction Methods 0.000 description 1
- 230000006978 adaptation Effects 0.000 description 1
- 229910052786 argon Inorganic materials 0.000 description 1
- 238000006243 chemical reaction Methods 0.000 description 1
- 238000002485 combustion reaction Methods 0.000 description 1
- 238000010276 construction Methods 0.000 description 1
- 238000010304 firing Methods 0.000 description 1
- 239000012530 fluid Substances 0.000 description 1
- 230000004907 flux Effects 0.000 description 1
- 238000002682 general surgery Methods 0.000 description 1
- 230000001678 irradiating effect Effects 0.000 description 1
- 238000012423 maintenance Methods 0.000 description 1
- 238000011017 operating method Methods 0.000 description 1
- 230000005693 optoelectronics Effects 0.000 description 1
- 239000011368 organic material Substances 0.000 description 1
- 230000035515 penetration Effects 0.000 description 1
- 230000001681 protective effect Effects 0.000 description 1
- 239000005336 safety glass Substances 0.000 description 1
- 210000002784 stomach Anatomy 0.000 description 1
- 238000001356 surgical procedure Methods 0.000 description 1
- 230000002123 temporal effect Effects 0.000 description 1
- 230000001225 therapeutic effect Effects 0.000 description 1
- 210000005167 vascular cell Anatomy 0.000 description 1
- 208000029257 vision disease Diseases 0.000 description 1
- 230000000007 visual effect Effects 0.000 description 1
- 230000004393 visual impairment Effects 0.000 description 1
- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Substances O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
- A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00017—Electrical control of surgical instruments
- A61B2017/00115—Electrical control of surgical instruments with audible or visual output
- A61B2017/00128—Electrical control of surgical instruments with audible or visual output related to intensity or progress of surgical action
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00636—Sensing and controlling the application of energy
Landscapes
- Health & Medical Sciences (AREA)
- Surgery (AREA)
- Physics & Mathematics (AREA)
- Life Sciences & Earth Sciences (AREA)
- Engineering & Computer Science (AREA)
- Medical Informatics (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Electromagnetism (AREA)
- Optics & Photonics (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Otolaryngology (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Laser Surgery Devices (AREA)
- Radiation Pyrometers (AREA)
Description
【発明の詳細な説明】
本発明は、生物の組織内におけるレーザ光線の
熱的作用を自動的に認知するための装置に関す
る。DETAILED DESCRIPTION OF THE INVENTION The present invention relates to a device for automatic recognition of the thermal effect of a laser beam in biological tissues.
ここ数年間、連続的に或いは長いパルスで働ら
く高出力のレーザが一般外科および内視鏡外科に
おいて、組織の切断および凝固並びに止血に使用
されることが多くなつて来た。この場合、照射時
間は１パルス当り0.1〜10秒であり、特別なアル
ゴン−レーザ、Nd：YAG−レーザおよびCO2−
レーザが使用されている。 In recent years, high power lasers working continuously or in long pulses have been increasingly used in general and endoscopic surgery for tissue cutting and coagulation and hemostasis. In this case, the irradiation time is 0.1-10 seconds per pulse, using special argon-laser, Nd:YAG-laser and CO2-
laser is used.
医学上のレーザの使用にあつては、所望のもく
しは必要とする治療作用以外に特に患者および手
術者の安全に関する問題が重要となる。この目的
のため、例えばレーザ保護めがねおよび保護フイ
ルターのような種々の安全処置が既に提案されて
いる。ドイツ公開特許公報2323137号により、レ
ーザ光線による外科的処置の際の安全向上に関し
て著しい進歩が見られるが、これによると特別に
形成された焦点調整手段は以下のように構成され
ている。即ち、この焦点調整手段が正確な一定の
間隔をもつて手術位置の直前に存在したとき始め
て作動レーザの照射部が接続され、焦点位置がこ
の手術位置から再び離れた際に自動的に再び遮断
されるように構成されている。これによつて、不
慮のレーザ照射が患者および手術台の傍らで一緒
に手術にたずさわつている人々に障害−特に視力
障害−を与えることが避けられる。 In the medical use of lasers, in addition to the desired therapeutic effect, concerns especially regarding patient and operator safety are important. Various safety measures have already been proposed for this purpose, such as, for example, laser safety glasses and protective filters. German Published Patent Application No. 2323137, which represents a significant step forward in improving safety during surgical procedures with laser beams, provides a specially designed focusing means as follows. That is, the irradiation part of the working laser is only connected when this focus adjustment means is located directly in front of the surgical position with an exact, constant distance, and is automatically switched off again when the focal position leaves this surgical position again. is configured to be This prevents accidental laser irradiation from causing damage to the patient and to those cooperating with him at the operating table, especially visual impairment.
ここで、作用するレーザ光線エネルギーの配量
および関係のない器官に対する放散された光線の
副作用に関しての患者の安全性と云う課題には余
りにも配慮がなされていないことが明瞭である。
これに対する判断規準は従来処置を行う医者が光
学的に見ることのできる組織の破壊、文献に記載
されている準拠値或いは既になされた経験から判
断される。 Here, it is clear that too little attention has been paid to the issue of patient safety with respect to the dosage of the laser beam energy applied and the side effects of the emitted radiation on extraneous organs.
Criteria for this determination are conventionally determined by the physician performing the procedure from optically visible tissue destruction, reference values described in the literature, or previous experience.
しかし、組織の種類種類によつて反応が極めて
異なり、したがつて患者にとつて必要な安全性で
作業を行うためには豊富な経験蓄積が必要であ
る。 However, reactions vary greatly depending on the type of tissue, and therefore extensive experience is required to perform the work with the necessary safety for the patient.
本発明の課題は、組織を凝固する際処理される
組織の破壊度の監視が直接示され、危険状態にあ
つてレーザが自動的に遮断されることを可能にす
る、医学的なレーザ凝固装置における生物の組織
内のレーザ光線の熱的作用を自動的に認知するた
めの装置を造ることである。即ち、測定技術的な
方法で組織変化の度合いを決定し、表示し、不所
望な障害が生じる前にレーザ照射を自動的に遮断
することを目的とする。 The object of the present invention is to provide a medical laser coagulation device which allows direct monitoring of the degree of destruction of the tissue being treated during coagulation, and in which the laser is automatically switched off in the event of a dangerous situation. The purpose of the present invention is to create a device for automatically recognizing the thermal effects of a laser beam in biological tissues. The aim is to determine and display the degree of tissue change using a measuring technique and to automatically switch off the laser irradiation before undesired damage occurs.
本発明による装置の特徴とするところは、赤外
線感受性検出器、サーミスタ或いはサーモパイル
がレーザの焦点調節手段内で光軸の近傍に設けら
れており、かつ側面フイルタを備えていることで
ある。 A feature of the device according to the invention is that the infrared-sensitive detector, thermistor or thermopile is arranged close to the optical axis in the focusing means of the laser and is provided with side filters.
この場合測定信号は一定の限界値に到達した際
音響的な表示を発し、この限界値を越えた場合作
業レーザのための遮断電子機器を制御する。 In this case, the measuring signal produces an acoustic indication when a certain limit value is reached and, if this limit value is exceeded, triggers the shut-off electronics for the working laser.
この構成によつて、どんな組織変化をも直ちに
自動的に表示され、一定の限界値を越えた場合自
動的にレーザ照射が遮断される。もちろん限界値
は不所望な組織破壊を招くような値以下である。 With this configuration, any tissue changes are immediately and automatically displayed, and laser irradiation is automatically shut off if certain limits are exceeded. Of course, the critical value is below a value that would lead to undesired tissue destruction.
以下に添付図面に図示した実施例につき本発明
を詳説する。 The invention will be explained in more detail below with reference to embodiments illustrated in the accompanying drawings.
本発明の課題は、上記のような装置によつて解
決され、この装置は切開による外科手術に適用で
きるが、この装置の操作の実際にあつては、レー
ザ照射された組織からの熱的戻り照射の変化を検
出器で記録し、評価−電子機器で温度値に変える
か、或いは照射された組織からの戻り拡散するレ
ーザ光線の変化をレーザ光線の衝突面の中央でこ
の衝突面の外部における面領域からの戻り拡散と
の−組織の熱的な破壊の直接的な尺度である内部
拡散に基づいて−比率で測定し、記録し、かつ評
価する操作方法様式が採られる。内視鏡による手
術の場合はこの装置は、上記操作方法様式の後者
に述べた操作様式が採られる。しかし、両者にあ
つては第５ａ，５ｂ図および第８図に示したよう
に測定信号は音響的な表示となる。これらの音響
的な信号は操作者に組織の熱的な破壊度の到達を
表示する。患者に障害が始まる一定の限界値を越
えた場合、本発明による装置の上記両操作方法に
あつて測定信号はレーザの自動的な遮断電子機器
の制御に役立つ。 The problem of the present invention is solved by a device as described above, which can be applied to incisional surgical operations, but in the actual operation of this device, the thermal return from the laser-irradiated tissue is Either the changes in the irradiation are recorded by a detector and converted into a temperature value by an evaluation electronic device, or the changes in the laser beam that diffuse back from the irradiated tissue are recorded in the center of the impact surface of the laser beam and outside this impact surface. A mode of operation is adopted in which the ratio of return diffusion from the surface area to internal diffusion, which is a direct measure of thermal destruction of the tissue, is measured, recorded and evaluated. In the case of endoscopic surgery, this device is operated in the latter manner of operation described above. However, in both cases, the measurement signal becomes an acoustic representation as shown in FIGS. 5a, 5b and 8. These acoustic signals indicate to the operator the extent to which the tissue has been thermally destroyed. In both of the above-mentioned operating methods of the device according to the invention, the measurement signal serves to control the electronics to automatically switch off the laser if a certain limit value is exceeded at which damage to the patient begins.
レーザを有機組織内で照射した場合に見られる
熱的な効果は、目のみによる観察によつては多く
の場合操作者にとつては認めにくい。 Thermal effects seen when a laser is irradiated into organic tissue are often difficult for the operator to notice when observed only with the eyes.
例えば切断工具、外科用メス等として使用され
るCO2−レーザの場合レーザ光線は殆んど完全に
組織の表面に吸収される。しかし、この場合熱的
な作用−光線衝突面における蒸発と燃焼−は目で
見ての観察で容易に調整できる。しかし、専ら組
織の凝固或いは止血に役立つ、例えばアルゴンレ
ーザおよびNd：Yagレーザにあつては組織の破
壊の度合いは目では認めにくい。なぜなら、この
使用の場合大きな浸入深さを必要とするからであ
る。即ち、レーザ光線が同時に著しく拡散した場
合吸収は僅かしか必要でない。この場合組織の著
しい容量が照射によつて捕捉され、殆んど一様に
加熱される。しかし、組織の破壊或いは凝固およ
び血管細胞の閉塞等が60℃の温度でもう行われ
る。これ以上のどんな度合までの温度上昇も医学
的に望ましくない。なぜなら60℃以上100℃以下
の温度では細胞液は蒸発してしまい、100℃では
激しく沸騰へと移行するからである。照射をそれ
以上持続すると有機物質は炭化、蒸発および燃焼
してしまう。 In the case of CO2 lasers used, for example, as cutting tools, scalpels, etc., the laser beam is almost completely absorbed by the tissue surface. However, in this case the thermal effects - evaporation and combustion at the beam impingement surface - can be easily adjusted by visual observation. However, in the case of, for example, argon laser and Nd: Yag laser, which serve exclusively for tissue coagulation or hemostasis, the degree of tissue destruction is difficult to visually discern. This is because this use requires a large penetration depth. That is, if the laser beam is highly diffused at the same time, only little absorption is required. In this case a significant volume of tissue is captured by the radiation and heated almost uniformly. However, tissue destruction or coagulation, vascular cell occlusion, etc. already occur at a temperature of 60°C. Any increase in temperature above this level is medically undesirable. This is because at temperatures above 60°C and below 100°C, cell fluid evaporates, and at 100°C it violently boils. If the irradiation continues longer than that, the organic material will carbonize, evaporate and burn.
大抵の医学的な処方では、約２−３mmの壊疸を
組織内で小さくするには60〜70℃の温度で十分で
ある。しかし、その場所にそれ以上照射した場合
には、特に胃壁および膀胱壁のような膜組織の場
合壊疸がこれらの壁を突き破り、これが組織の或
る程度の穿孔を招くと云う危険が生じる。 For most medical prescriptions, a temperature of 60-70°C is sufficient to reduce gangrene within the tissue by approximately 2-3 mm. However, if the site is irradiated further, there is a risk, especially in the case of membranous tissues such as the stomach and bladder walls, that gangrene will break through these walls and this will lead to some degree of perforation of the tissue.
他の危険は手術目的位置の後方に存在する器管
が損傷されることである。照射されている組織面
における凝固中のかつ70〜100℃の温度での変化
が目で認めることが難しいことから、本発明にあ
つては、電子光学的な手段によりどのようにして
レーザ照射の間の凝固度の変化を測定しかつ表示
するかの解決策が示されている（第１図〜第３図
参照）。 Another risk is damage to organs located behind the surgical target location. Since it is difficult to visually recognize changes in the irradiated tissue surface during coagulation and at a temperature of 70 to 100°C, the present invention proposes a method for controlling laser irradiation using electro-optical means. A solution for measuring and displaying the change in the degree of coagulation during the process is presented (see FIGS. 1-3).
第１図にはレーザ光線の衝突面の中央における
時間的なダイヤグラムで示されている。凝固の際
の医学的な適用は60℃〜70℃の温度範囲において
行われなければならないので、その際組織の破壊
および細胞水の蒸発を回避するため処置に関し
て、第１図のこの曲線は、65℃の時間範囲が比較
的幅が長く、これによつて急ぐことなく静かな処
置が可能であることを示している。 FIG. 1 shows a temporal diagram at the center of the impingement surface of the laser beam. Since medical applications during coagulation have to be carried out in a temperature range of 60° C. to 70° C., in order to avoid tissue destruction and evaporation of cell water, this curve in FIG. The time range at 65° C. is relatively wide, indicating that this allows a quiet and unhurried treatment.
第２図は一定の時間経過内でのレーザ光線の戻
り拡散の幾何学的な変化を示している。即ち、照
射の間組織内のレーザ光線の散乱庭の幾何学的形
状が変わり、全戻り照射のこの変化が測定されか
つ評価される。表面照射の延びは組織破壊の経過
にとつて明白な尺度である。散乱庭が僅かであれ
ばあるほど、組織の破壊はますます大きくなり、
かつレーザ光線のこの組織内への進入がますます
深くなる。 FIG. 2 shows the geometrical evolution of the return diffusion of the laser beam over a certain time course. That is, during irradiation the geometry of the scattering garden of the laser beam within the tissue changes and this change in total return irradiation is measured and evaluated. The length of surface irradiation is a clear measure of the course of tissue destruction. The smaller the scattering, the greater the tissue destruction;
And the laser beam penetrates deeper and deeper into this tissue.
第３図はレーザ光線のこの全戻り拡散のパラメ
ータをダイヤグラムで示した図である。この図か
ら、65℃の温度範囲において全戻り拡散が最も高
く、一定の照射時間内にあつて一定であることが
認められる。 FIG. 3 diagrammatically shows the parameters of this total return diffusion of the laser beam. From this figure, it can be seen that the total return diffusion is highest in the temperature range of 65°C and remains constant within a certain irradiation time.
本発明による装置にあつては、一方のやり方で
は温度の変化とこれに伴う熱的な戻り照射の変化
とが評価され、他方のやり方では組織内における
レーザ照射の散乱庭（Streuhot）の幾何形状の変
化が全戻り照射の変化の考慮の下で測定し、記録
しかつ評価される。 In the device according to the invention, on the one hand, changes in temperature and the associated changes in the thermal return radiation are evaluated, and on the other hand, the geometry of the scattering field of the laser radiation in the tissue is evaluated. The changes in the total return radiation are measured, recorded and evaluated under consideration of the changes in the total return radiation.
第４図は本発明による装置の１実施例を示した
ものである。レーザによつて照射される組織の熱
線の全光束密度Ｓは
Ｓ＝ε・σ・T4
である。式中
σはステフエン−ボルツマン−定数、
εは赤外線−領域において１に等しい組織の発
散率、
Ｔは組織の絶対温度
である。 FIG. 4 shows one embodiment of the device according to the invention. The total luminous flux density S of the heat rays of the tissue irradiated by the laser is S=ε·σ·T 4 . where σ is the Steffen-Boltzmann constant, ε is the tissue emittance rate equal to 1 in the infrared region, and T is the absolute temperature of the tissue.
この場合、赤外線感受性の検出器１２、サーミ
スタ或いは熱電対列が設けられている。これはレ
ーザの焦点調節手段１０内において光軸１１の近
傍に設けられている。検出器１２の前方には戻り
拡散するレーザ光線を抑制する働きをするいわゆ
るエツジフイルタ１３が設けられている。第４図
において、比較測定位置を符号１４で示した。焦
点調節手段１０の開口１７を囲繞している環状の
検出器１２或いはレーザ光線を透過し、熱源を反
射する90゜−ダイワロイツク転向鏡を内蔵するこ
とによつて達せられる射光軸と受光軸の同軸配設
のいずれかを２者択一的に使用することができ
る。 In this case, an infrared sensitive detector 12, thermistor or thermopile is provided. This is provided near the optical axis 11 within the laser focusing means 10. A so-called edge filter 13 is provided in front of the detector 12 and serves to suppress the laser beam returning and diffusing. In FIG. 4, the comparison measurement position is indicated by reference numeral 14. The coaxiality of the light emitting and receiving axes is achieved by incorporating an annular detector 12 surrounding the aperture 17 of the focusing means 10 or a 90° turning mirror that transmits the laser beam and reflects the heat source. Either arrangement can be used alternatively.
熱線が衝突した際の検出器１２の信号電圧は
VDet＝Mσ（TT 4−TR 4）・Ｒ
である。式中TTは加熱された場所における温度、
TRは照射開始前の組織の比較温度或いは−基準
温度、Ｒは検出器感度およびＭは装置の幾何学的
フアクタである。この場合
Ｍ＝１／π・ATAD／π2
である。式中ATは照射面の大きさ、ADは検出器
面の大きさ、およびｒは検出器の照射点からの距
離である。 The signal voltage of the detector 12 when the hot wire collides is V Det =Mσ(T T 4 −T R 4 )·R. In the formula, T T is the temperature at the heated place,
T R is the comparison or reference temperature of the tissue before the start of irradiation, R is the detector sensitivity and M is a geometric factor of the device. In this case, M=1/π・A T A D /π 2 . In the formula, A T is the size of the irradiation surface, A D is the size of the detector surface, and r is the distance from the irradiation point of the detector.
この光学的な配設は、作業間隔が変つても、即
ちレーザ照射点１９からの検出器１２の間隔が変
つてもＭの値いができる限り一定に留まるように
行われなければならない。図面において、組織は
符号１６で示した。この一定維持は検出器１２を
焦点調節手段１０の焦点１８のできる限り近傍に
設けることによつて達せられる。光線が焦点を調
節されていない場合検出器の位置は基準とならな
い。 This optical arrangement must be made in such a way that the value of M remains as constant as possible even if the working distance changes, ie the distance of the detector 12 from the laser irradiation point 19 changes. In the drawings, the tissue is designated by the reference numeral 16. This constant maintenance is achieved by placing the detector 12 as close as possible to the focal point 18 of the focusing means 10. If the beam is not focused, the detector position is not a reference.
測定信号を評価するため、第５ａ図および第５
ｂ図に示したような２つの回路が配設されてい
る。第５ａ図による配設ではT4に比例する検出
器電圧の変化が周波数で電圧制御される発振器の
制御に使用される。引続いてスピーカーで温度上
昇が聞取れるようになつている。外の障害要素と
電気的な構造要素の偏りに無関係に測定を行うよ
うにするため、温度値はレーザ照射の開始時に特
に直接レーザ光線１５の発射直前に記憶され、次
の温度値がこの初期の値いと評価−電子機器中で
除される。 5a and 5 to evaluate the measurement signal.
Two circuits as shown in Figure b are arranged. In the arrangement according to FIG. 5a, the variation of the detector voltage proportional to T 4 is used to control a frequency-voltage controlled oscillator. Subsequently, the temperature rise can be heard through the speakers. In order to carry out measurements independent of external disturbance elements and deviations of the electrical construction elements, the temperature value is stored at the start of the laser irradiation, in particular just before the firing of the direct laser beam 15, and the next temperature value is stored at this initial stage. Values and evaluations of - divided among electronic devices.
この表示と平行して図示の実施例では、レーザ
の自動的な遮断のための限界値切換増幅器が制御
可能である。 Parallel to this display, in the exemplary embodiment shown, a limit value switching amplifier for automatic switching off of the laser can be controlled.
第５ｂ図によるブロツク図は温度曲線の反曲点
のみが差動子（Drllerentiater）によつて音響的
に表示されるかもしくはレーザの遮断のために使
用されるように構成されている。 The block diagram according to FIG. 5b is constructed in such a way that only the inflection points of the temperature curve are acoustically indicated by a differential element or used for switching off the laser.
第２図に図示されているように、レーザ光線１
５の表面拡散の延びは組織破壊の経過のための敏
感な尺度である。この効果は光−電子的に表示に
使用される。このための構成は第７図および第８
図に略示されている。ここには、組織１６におけ
るレーザ光線１５の全拡散点１９がどのようにし
て２つに分岐された面検出器２０上に写像され、
しかもこの写像が全拡散点もしくは焦点１９の点
直径が作業距離に関係ないように行われる−これ
は写像レンズの焦点距離（焦点１８）の治療光線
の開き角に対する適当な適合によつて達せられる
−かが示されている。内視鏡の場合、このことは
発射されるレーザ光線の開散であり、焦点調節手
段１０では焦点レンズの焦点距離である。 As illustrated in FIG.
The surface diffusion extension of 5 is a sensitive measure for the course of tissue destruction. This effect is used in opto-electronic displays. The configuration for this is shown in Figures 7 and 8.
Schematically illustrated in the figure. It shows how the total diffusion point 19 of the laser beam 15 in the tissue 16 is mapped onto the bifurcated surface detector 20 and
Moreover, this mapping is carried out in such a way that the point diameter of the total diffusion point or focal point 19 is independent of the working distance - this is achieved by a suitable adaptation of the focal length of the mapping lens (focal point 18) to the aperture angle of the treatment beam. - is shown. In the case of an endoscope, this is the divergence of the emitted laser beam and, in the case of focusing means 10, the focal length of the focusing lens.
他の実施例にあつては拡散点の写像は、レーザ
光線１５の衝突点１９が内の検出器２０によつて
完全に、かつ外の拡散域が外の検出器２０によつ
て完全に或いは部分的に捉らえられるように構成
されている。受光光学系と照射光学系２４，２５
が同軸状に構成されている場合は検出器２０は環
状の内面と外方の環状面とから成る。内視鏡上の
器機の場合は、第７図に示したように、一般的な
観察路を本発明による安全装置と共に使用するの
が有利である。 In other embodiments, the mapping of the diffuse points is such that the point of impact 19 of the laser beam 15 is completely by the inner detector 20 and the outer diffuse area is completely by the outer detector 20, or It is designed to be partially captured. Light receiving optical system and irradiating optical system 24, 25
If the detectors 20 are constructed coaxially, the detector 20 consists of an annular inner surface and an outer annular surface. In the case of endoscopic instruments, it is advantageous to use a common viewing path with the safety device according to the invention, as shown in FIG.
観察光学系２３，２４−この場合符号２３で観
察路を、符号２４でこの観察路内における光学的
な部材を示した−とレーザ光学系２１，２２との
間の軸線の間隔により図示の膀胱鏡の視野内に平
行軸が生じる。即ち、レーザ点は膀胱鏡の組織壁
１９からの距離に応じて或る方向で視野にわたつ
て移動する。しかし、この移動は検出器には障害
となるような影響を何等与えない。なぜなら、感
受性の面が条件として形成されているからであ
る。 The distance between the axis lines between the observation optical systems 23, 24 - in this case reference numeral 23 indicates the observation path, and reference numeral 24 indicates the optical elements in this observation path - and the laser optical systems 21, 22 allows the bladder shown to be Parallel axes occur within the field of view of the mirror. That is, the laser point moves across the field of view in a certain direction depending on the distance from the tissue wall 19 of the cystoscope. However, this movement does not have any disturbing effect on the detector. This is because the aspect of sensitivity is formed as a condition.
戻り拡散するレーザ光線の全強度を変えること
による障害或るいは或る組織から他の組織への光
学的な特性の変化による障害を避けるため、検出
器電圧から電子的な加算と除算とにより値い
U1−U2／U1＋U2
（式中U1は内方の検出器における信号、U2は外
方の検出器における信号を意味する。）
が得られる。この値いは次いで先に記載したブロ
ツク図に相似して信号発生器もしくはレーザ回路
のための閾値増巾器の制御に利用される。これに
関する詳細なことは第８図および第９図から伺が
える。 In order to avoid disturbances due to changes in the total intensity of the returning laser beam or changes in optical properties from one tissue to another, values are calculated by electronic addition and division from the detector voltage. U 1 −U 2 /U 1 +U 2 (where U 1 means the signal at the inner detector and U 2 means the signal at the outer detector) is obtained. This value is then used analogous to the previously described block diagram to control a threshold amplifier for a signal generator or laser circuit. Details regarding this can be seen from FIGS. 8 and 9.
第１図はレーザ光線の衝突面の中央における時
間的な温度経過の図表、第２図はレーザ光線の戻
り拡散の幾何学的な変化の図、第３図はレーザ光
線の幾何学的な戻り拡散の図表、第４図は本発明
による装置の１実施例、第５ａ図は周波数で電圧
制御される発振器の制御回路図、第５ｂ図は温度
曲線の反曲点の音響的な表示のための回路図、第
６図は第５ｂ図による回路配設に関するパルスの
図表、第７図は監視検出器を備えたレーザ膀胱鏡
の概略図、第８図は測定値および評価値−電子機
器の回路図、第９図は第８図による回路配設のた
めのパルスの図表。
図中符号は、１０……焦点調節手段、１１……
光軸、１２……検出器、１３……エツジフイル
タ。
Figure 1 is a diagram of the temperature change over time at the center of the laser beam collision surface, Figure 2 is a diagram of the geometric changes in the return diffusion of the laser beam, and Figure 3 is a diagram of the geometric return of the laser beam. Diffusion diagram, FIG. 4 is an embodiment of the device according to the invention, FIG. 5a is a control circuit diagram of a frequency-voltage controlled oscillator, and FIG. 5b is for the acoustic representation of the reversal point of the temperature curve. 6 is a pulse diagram for the circuit arrangement according to FIG. 5b, FIG. 7 is a schematic diagram of a laser cystoscope with monitoring detector, and FIG. 8 is a diagram of the measured values and evaluation values of the electronic equipment. Circuit diagram, FIG. 9 is a diagram of pulses for the circuit arrangement according to FIG. The symbols in the figure are 10... focus adjustment means, 11...
Optical axis, 12...detector, 13...edge filter.
Claims (1)
動的に検出するための装置において、赤外線感受
性検出器１２、サーミスタ或いは熱電対列をレー
ザの焦点調節手段１０内において光軸１１の近傍
に設け、かつエツジフイルタ１３を設けたことを
特徴とする、上記生物組織内におけるレーザ光線
の熱作用を自動的に検出するための装置。 ２ 焦点調節手段１０の開口１７を環状に囲繞し
ている検出器１２が設けられている、特許請求の
範囲第１項に記載の装置。 ３ 検出器１２が焦点調節手段１０の焦点１８の
近傍に設けられている、特許請求の範囲第１項に
記載の装置。 ４ 組織１６におけるレーザ光線１５の拡散点１
９を写像するための２つに分割された面検出器２
０が設けられている、特許請求の範囲第１項から
第３項までのいずれか一つに記載の装置。 ５ 検出器２０が円環形の内面と外部の円環面と
の組合わせから成る、特許請求の範囲第４項に記
載の装置。Claims: 1. A device for automatically detecting the thermal effect of a laser beam in biological tissue, in which an infrared sensitive detector 12, a thermistor or a thermopile is placed within the focusing means 10 of the laser and aligned with the optical axis 11. 1. A device for automatically detecting the thermal effect of a laser beam in the biological tissue, characterized in that the edge filter 13 is provided in the vicinity of the biological tissue. 2. Device according to claim 1, characterized in that a detector 12 is provided which annularly surrounds the aperture 17 of the focusing means 10. 3. The device according to claim 1, wherein the detector 12 is arranged in the vicinity of the focal point 18 of the focusing means 10. 4 Diffusion point 1 of laser beam 15 in tissue 16
Surface detector 2 divided into two for mapping 9
4. Device according to any one of the claims 1 to 3, characterized in that 0 is provided. 5. The device according to claim 4, wherein the detector 20 comprises a combination of a toric inner surface and an outer toric surface.
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| DE19782829516 DE2829516A1 (en) | 1978-07-05 | 1978-07-05 | Monitor for medical laser coagulator - detects changes in thermal radiation from irradiated tissue for conversion to temperature values |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| JPS5510600A JPS5510600A (en) | 1980-01-25 |
| JPS631054B2 true JPS631054B2 (en) | 1988-01-11 |
Family
ID=6043599
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| JP8448079A Granted JPS5510600A (en) | 1978-07-05 | 1979-07-05 | Automatic detection of laser heat effect and device therefor |
Country Status (2)
| Country | Link |
|---|---|
| JP (1) | JPS5510600A (en) |
| DE (1) | DE2829516A1 (en) |
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US11605860B2 (en) | 2020-10-11 | 2023-03-14 | Advanced Powering Services, Inc. | Battery pack |
Families Citing this family (26)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US4316467A (en) * | 1980-06-23 | 1982-02-23 | Lorenzo P. Maun | Control for laser hemangioma treatment system |
| DE3024169C2 (en) * | 1980-06-27 | 1983-09-15 | Reginald Dipl.-Phys. Dr. 8028 Taufkirchen Birngruber | Method and device for operating a photocoagulator for biological tissue |
| JPS5778844A (en) * | 1980-11-04 | 1982-05-17 | Kogyo Gijutsuin | Lasre knife |
| JPS5777935A (en) * | 1980-11-04 | 1982-05-15 | Agency Of Ind Science & Technol | Safety device for photoconductive path |
| DE3245846C2 (en) * | 1981-12-28 | 1986-05-28 | Mitsubishi Denki K.K., Tokio/Tokyo | Safety device for a surgical laser beam device |
| DE3306981C2 (en) * | 1983-02-28 | 1987-11-12 | Wolfram 8048 Haimhausen Weinberg | Device for the photocoagulation of biological tissue |
| US4646737A (en) * | 1983-06-13 | 1987-03-03 | Laserscope, Inc. | Localized heat applying medical device |
| US4662368A (en) * | 1983-06-13 | 1987-05-05 | Trimedyne Laser Systems, Inc. | Localized heat applying medical device |
| JPS605172A (en) * | 1983-06-24 | 1985-01-11 | 松下電器産業株式会社 | Laser endoscope |
| US5002051A (en) * | 1983-10-06 | 1991-03-26 | Lasery Surgery Software, Inc. | Method for closing tissue wounds using radiative energy beams |
| HU191642B (en) * | 1984-03-21 | 1987-03-30 | Adam Kovacs | Method and instrument for discriminating from one another and separating by way of operation organic tissues |
| IL75998A0 (en) * | 1984-08-07 | 1985-12-31 | Medical Laser Research & Dev C | Laser system for providing target tissue specific energy deposition |
| DE3620123A1 (en) * | 1986-06-14 | 1987-12-17 | Strahlen Umweltforsch Gmbh | MEASURING AND RADIATION DEVICE FOR CAVITIES |
| US4938205A (en) * | 1988-05-27 | 1990-07-03 | The University Of Connecticut | Endoscope with traced raster and elemental photodetectors |
| DE3908928A1 (en) * | 1989-03-18 | 1990-09-20 | Messerschmitt Boelkow Blohm | Imaging method and device for the metered irradiation of biological tissues with laser beams in medical applications |
| DE3934640C1 (en) * | 1989-10-17 | 1991-02-28 | Messerschmitt Boelkow Blohm | Regulating temp. of laser radiation directed to biological tissue - measuring IR radiation emitted from latter exclusively in spectral range of atmospheric window |
| DE3936716C2 (en) * | 1989-11-03 | 1997-09-18 | Reginald Prof Dr Birngruber | Device for influencing material by pulsed light irradiation and use therefor |
| US5897551A (en) * | 1990-03-23 | 1999-04-27 | Myriadlase, Inc. | Medical device for applying high energy light and heat for gynecological sterilization procedures |
| US5147353A (en) * | 1990-03-23 | 1992-09-15 | Myriadlase, Inc. | Medical method for applying high energy light and heat for gynecological sterilization procedures |
| DE4017850C1 (en) * | 1990-06-02 | 1991-06-06 | Messerschmitt-Boelkow-Blohm Gmbh, 8012 Ottobrunn, De | Controlling laser beam radiation dose - using difference in properties of red, green and blue components of diffusely reflected light, as measure of radiation |
| FR2675371A1 (en) * | 1991-04-22 | 1992-10-23 | Technomed Int Sa | DEVICE FOR THERMAL TREATMENT OF FABRICS BY PULSE SEQUENCE GROUP. |
| DE9204621U1 (en) * | 1992-04-03 | 1992-07-30 | Oralia Dentalprodukte Gmbh, 7750 Konstanz | Device for applying with light |
| US5334191A (en) * | 1992-05-21 | 1994-08-02 | Dix Phillip Poppas | Laser tissue welding control system |
| DE4325724A1 (en) * | 1993-07-30 | 1995-02-02 | Paul Dr Debbage | Device and method for examining an object and for affecting the object |
| AU739166B2 (en) * | 1996-07-05 | 2001-10-04 | Unilever Plc | Process for obtaining oryzanol |
| US6659966B2 (en) * | 2001-11-15 | 2003-12-09 | Roche Diagnostics Corporation | Fluid sampling apparatus |
Family Cites Families (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| DE2321137C3 (en) * | 1973-04-26 | 1981-06-11 | Messerschmitt-Boelkow-Blohm Gmbh, 8000 Muenchen | Device for material processing by means of laser beams |
-
1978
- 1978-07-05 DE DE19782829516 patent/DE2829516A1/en active Granted
-
1979
- 1979-07-05 JP JP8448079A patent/JPS5510600A/en active Granted
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US11605860B2 (en) | 2020-10-11 | 2023-03-14 | Advanced Powering Services, Inc. | Battery pack |
Also Published As
| Publication number | Publication date |
|---|---|
| DE2829516C2 (en) | 1988-02-25 |
| DE2829516A1 (en) | 1980-01-17 |
| JPS5510600A (en) | 1980-01-25 |
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