WO2008024022A1 - Dispositif laser - Google Patents

Dispositif laser Download PDF

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Publication number
WO2008024022A1
WO2008024022A1 PCT/RU2007/000409 RU2007000409W WO2008024022A1 WO 2008024022 A1 WO2008024022 A1 WO 2008024022A1 RU 2007000409 W RU2007000409 W RU 2007000409W WO 2008024022 A1 WO2008024022 A1 WO 2008024022A1
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Prior art keywords
laser
radiation
emitter
crystal
resonator
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PCT/RU2007/000409
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English (en)
Russian (ru)
Inventor
David Georgievich Kochiev
Anatoly Leonidovich Bondarenko
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Obschestvo S Ogranichennoi Otvetstvennostju 'lazernye Tehnologii V Meditsine ' (Ooo 'l.T.M.')
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Application filed by Obschestvo S Ogranichennoi Otvetstvennostju 'lazernye Tehnologii V Meditsine ' (Ooo 'l.T.M.') filed Critical Obschestvo S Ogranichennoi Otvetstvennostju 'lazernye Tehnologii V Meditsine ' (Ooo 'l.T.M.')
Publication of WO2008024022A1 publication Critical patent/WO2008024022A1/fr

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    • 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
    • A61B18/22—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 the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
    • A61B18/24—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 the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor with a catheter
    • H—ELECTRICITY
    • H01—ELECTRIC ELEMENTS
    • H01S—DEVICES USING THE PROCESS OF LIGHT AMPLIFICATION BY STIMULATED EMISSION OF RADIATION [LASER] TO AMPLIFY OR GENERATE LIGHT; DEVICES USING STIMULATED EMISSION OF ELECTROMAGNETIC RADIATION IN WAVE RANGES OTHER THAN OPTICAL
    • H01S3/00—Lasers, i.e. devices using stimulated emission of electromagnetic radiation in the infrared, visible or ultraviolet wave range
    • H01S3/23—Arrangements of two or more lasers not provided for in groups H01S3/02 - H01S3/22, e.g. tandem arrangements of separate active media

Definitions

  • the invention relates to medical equipment.
  • the first group is associated with the impact on the soft tissues of the body with the aim of dissection, vaporization or coagulation.
  • diseases in which such laser methods of exposure have been successfully and widely used include: benign prostatic hyperplasia (BPH), urethral stricture, bladder tumors, etc.
  • BPH benign prostatic hyperplasia
  • urethral stricture urethral stricture
  • bladder tumors etc.
  • the second group of interventions is associated with the need to destroy solid stones in the presence of ICD.
  • One of the main reasons limiting the spread of laser treatment methods in urology is the difficulty in operation and the high cost of the proposed surgical lasers.
  • US Pat. No. 5,593,404 (Castello et al) describes a device based on an Nd: YAG laser, with a radiation wavelength of 1.064 ⁇ m, operating in a continuous generation mode, with an output radiation power in the range from 40 W to 90 W.
  • the device is used when treatment of urethral strictures, bladder tumors, interstitial coagulation, treatment of genital warts.
  • the disadvantage of this device is that the effectiveness of its use in urology is limited to procedures that allow deep, up to several millimeters, penetration of radiation into biological tissues.
  • a device US 6,986,764 (Dvaprot et al) is also known based on an Nd: YAG laser operating in a quasi-continuous mode of generation, with the generation of second harmonic radiation, with a radiation power of up to 80 watts.
  • the proportion of tissue is greater than when exposed to 1.064 ⁇ m radiation, and the depth of the residual coagulated tissue does not exceed 1-2 mm.
  • the disadvantage of this device is that for given radiation parameters and the mechanism of interaction with TC Anyu application is limited only to the area of tasks associated with tissue ablation.In urology, the device is used in the treatment of BPH.
  • Ho: YAG laser radiation is well absorbed by the water contained in the tissues. Thankss to the small depth of radiation penetration and the independence of absorption from the type of tissue, contact dissection, vaporization and ablation of tissues using Ho: YAG lasers are effective procedures in the treatment of a number of diseases. The strong absorption of radiation by the substance of the stone and the water present in them allows the use of such lasers also in the fragmentation of stones in the ICD. However, the need to use high pulse energies of up to 2.5 J for pulse durations of up to several hundred microseconds and the thermal mechanism of stone destruction create a high risk of damage to the tissues surrounding the stone, and therefore the scope of such devices should be recognized as limited.
  • laser installations are more preferable, in which the acoustic mechanism of stone destruction is realized, not thermal, but.
  • the destruction of stones occurs due to the generation of shock waves propagating in the stone material after the cavitation bubble collapses on the surface of the stone (K. Ripk, G. Delacretaz, R. P. Slaté. lithotritors "Lasers and Surgery app Medical, v. 16, p. 2, pp. 134-146, 1995).
  • One of the first devices for laser lithotripsy were lamp-based dye laser-based installations. They had an optimal radiation pulse duration in the range of 1-3 ⁇ s, a radiation wavelength of 0.504 ⁇ m, with a local minimum absorption of oxyhemoglobin.
  • the disadvantage of such lasers is that not all types of stones can be fragmented, and the operation of such lasers in the clinic is expensive (M.A. Imagoglu, H. Bakirtas, O. Yigitbasi, N. Erso, N.
  • the radiation wavelength can lie in the range of 0.7-1.0 ⁇ m and falls into the region of minimal absorption by the surrounding tissue .
  • the second harmonic of radiation serves to initiate a laser spark on the surface of the stone.
  • the pulse duration of 1.1 ⁇ s is implemented in the device using fast feedback, which controls the transmission of the gate based on the Pockels cell.
  • the disadvantage of this device is the spike structure of the temporal profile of the pulse, with a modulation of the radiation intensity of up to 50%, which leads to damage to the fiber tool when the radiation is delivered to the stone.
  • the distal end of the fiber in contact with the tissue is destroyed due to inhomogeneities in the temporal profile of the radiation pulse.
  • a known Nd: YAG crystal laser (RU 93003708, GI Dyakonov et al., Publ. 05/20/1995), using a similar method to extend the duration of the radiation pulse generation and conversion to the second harmonic.
  • a shutter to control the rate of radiation output from the resonator a shutter with impaired total internal reflection (ATR shutter), synchronized with the pump lamp power supply, is used. Since the kinetics of the development of pump processes in an Nd: YAG crystal is approximately 30 times faster than the kinetics of the development of processes in an alexandrite crystal, controlling a resonator with an Nd: YAG crystal becomes even more difficult.
  • the disadvantage of this device is the complex control circuit, low reliability during operation.
  • a laser based on a ruby crystal is also known (RU 95105018, Berenberg V.A. et al., Published on 06/10/1997).
  • the radiation wavelength - 0.65 ⁇ m of such a laser - is safe for the surrounding tissue, the microsecond pulse duration is realized by increasing the cavity length due to organization of a multi-pass circuit between the mirror system.
  • the disadvantage of this device is the complexity of the design, the need for careful tuning and the complexity of operation.
  • a known laser based on an Nd: YAG crystal with a microsecond pulse duration and conversion of radiation to the second harmonic see US 5963575, Muller G. et al., Publ. 05.10.1999.
  • the duration of the lasing pulse is achieved, as in a ruby laser, by changing the length of the resonator by introducing an optical delay into it.
  • a fiber optic delay was used as a delay.
  • fiber optical delay as a resonator element for changing the temporal characteristics of laser radiation was used by E. M. Dianov et al. (See E. M. Dianov, C.K. Isaev, L.S. Kornienko, N.V. Kravtsov, V. In Firsov.
  • the disadvantage of this device is that not all types of stones are destroyed by exposure, and the destruction efficiency of stones of mixed composition from calcium oxalate monohydrate and dihydrate is 53.4%, struvite - 68.1%, calcium phosphate - 58% (see S. Lahme, E. ⁇ irrer, A. Stepzl.
  • YAG lasers of such power requires the combination of two or more resonators operating at low frequencies in order to obtain a high average radiation power and solve problems with cooling and thermal effects in active elements
  • the disadvantage of the device is, first of all, the high cost and the risk of thermal damage to surrounding tissues during lithotripsy.
  • the main objective of the present invention was to provide a device for affecting solid calculi during lithotripsy and soft tissues in operative urology, which would be free from most of the drawbacks of the above installations, both multifunctional and designed to solve any one of these problems.
  • the first laser emitter is configured to converting the radiation into the second harmonic and capable of generating radiation with a pulse duration value lying in the range 0.5 ⁇ 5.0 ms, and includes laser cavity-based crystal Nd: YAYU 3 Q-switched gate with frustrated total internal reflection, and optical fiber delay line, as well as a non-resonant converter of radiation into the second harmonic of radiation on a nonlinear crystal with a conversion efficiency of at least 25%
  • the second laser emitter is made with the ability to work in a pulse-periodic mode with a maximum average output power of up to 100 W, and includes a laser
  • the radiation to second harmonic converter is equipped with a thermal stabilization system, which includes a thermostat connected to the controller with a non-linear crystal installed in it.
  • the radiation to second harmonic converter is capable of realizing a 90 ° angle-critical phase angle synchronism with focusing of the radiation into said non-linear crystal.
  • a crystal can be used as a nonlinear crystal in the radiation converter into the second harmonic
  • KTiOPO 4 As the output mirror in the laser resonator of the first emitter, it is preferable to use the polished end face of the non-linear KTiOPO 4 crystal.
  • the duration of the opening of the shutter is more than 2 ⁇ s and the duration of the open state is more than 6 ⁇ s.
  • the fiber delay is set so that one of the ends of the fiber delay is located on the order of the diameter of the quartz fiber core from the reflective surface of the spherical mirror of the resonator, and the second end is aligned with the aperture of the active element of the resonator in the output aperture.
  • a polarization isolation based on a Fresnel rhombus and a polarizer is installed in the laser cavity of the first emitter between the active element and the fiber delay.
  • the laser installation can be configured to connect an end-video camera and further comprise a video signal processing unit from the end-video camera.
  • the laser installation can be configured to demonstrate the course of surgical intervention in real time on the screen of a touch monitor connected to the video processing unit, while simultaneously recording video information on an external mobile storage medium.
  • Nd YAUs for lithotripter
  • Nd YAG for a scalpel-coagulator
  • the indicated pulse duration of the radiation generated in the first emitter is optimal from the point of view of reliability and efficiency of the installation - with pulse durations less than 0.5 ⁇ s, the risk of damage to the fiber catheter significantly increases when the radiation is delivered to the surface of the calculus, and with durations of more than 5 ⁇ s, the energy input efficiency decreases in the generation of a shock wave and, as a result, the efficiency of calculus fragmentation decreases.
  • the capabilities of two lasers of different types, combined into a complex provide a solution to problems in the entire range of tasks related to both dissection and coagulation of tissues, and removal of solid calculi in the treatment of urolithiasis.
  • the specified arrangement provides the advantage of multifunctionality of use installation, which is achieved by the possibility of combining various operating modes and parameters of the output radiation that make up its lasers: a scalpel-coagulator and lithotripter.
  • FIG. 1 is a block diagram of an installation
  • FIG. 3 is a diagram of a node of a spherical mirror of a lithotripter
  • FIG. 4 temporal transmission profile of the gate ATR and the shape of the pulse generation.
  • the installation according to the invention consists of two laser emitters with active elements from crystals Nd: YAYU 3 1 and Nd: YAG 2.
  • the active elements 1 and 2 are pumped by a pump lamp power supply unit 5, controlled by controller 8. Modulation of the quality factor of the resonator in the first emitter
  • lithotripter (in the lithotripter) is carried out by a modulator 3 based on a gate with impaired total internal reflection (ATR shutter), the control unit of which is connected to controller 8.
  • ATR shutter the control unit of which is connected to controller 8.
  • the non-resonant conversion of the lithotripter radiation to the second harmonic is carried out by a nonlinear crystal located in thermostat 4.
  • the cooling system 6 with an air-water closed-circuit heat exchanger cools the active elements 1 and 2 and the pump lamps.
  • the touch monitor 9 serves as a control panel for controlling the installation operation by the user, and as a video monitor for displaying the end-video camera signal, the processing of which is carried out by the processing unit 10.
  • the video processing unit 10 can serve not only to display the progress of the intervention in real time on the monitor screen 9, but can also record video signal to an external mobile storage medium (for example, to a portable hard disk that is connected using the USB interface) for archiving or subsequent analysis.
  • analogue laser lithotripter
  • the resonator Q-factor is modulated using a passive shutter, which leads to the formation of a spike temporal structure of the generation pulse.
  • An increase in the energy of the generation pulse under such conditions leads to an increase in the modulation of the intensity of the temporal profile of the pulse and the risk of damage to the optical elements of the resonator and the fiber tool.
  • the low density of radiation intensity in a nonlinear KTP crystal due to the beam size and a pulse duration of 1 ⁇ s, with intracavity conversion of radiation to the second harmonic gives a low conversion efficiency.
  • the limitation of the total output pulse energy and the low conversion efficiency give a total pulse energy of 120 mJ at the output of the emitter, and a fraction of converted radiation of 20 mJ.
  • a laser resonator circuit in order to increase the output energy of the pulse and increase the conversion efficiency, a laser resonator circuit is implemented, which makes it possible to obtain a single generation pulse with a smooth temporal radiation profile.
  • active resonator Q-switching is implemented by the ATR shutter.
  • Angularly critical phase matching in a KTP crystal (KTiOPO 4 ) for 1.0796 ⁇ m radiation has an angular width sufficient for focusing, when the crystal is heated to a temperature of 54 ° C, the width of the phase matching angles becomes maximum and equal to 4 and 12 degrees for the phase matching angles ⁇ and ⁇ , respectively.
  • non-resonant conversion of radiation to the second harmonic with an angle-critical, 90 ° synchronism with focusing of radiation into a nonlinear KTP crystal was carried out.
  • FIG. 2 shows an optical diagram of a device.
  • the laser resonator of the first emitter (lithotripter) is assembled on the basis of an active element from an NdrY ⁇ 27 crystal.
  • the effective length of the resonator is changed by setting the optical fiber delay 21.
  • the radiation aperture at the output end of the optical delay fiber 21 is matched with the aperture of the active element 27 by the lens 22, focal whose distance in the described particular case was chosen equal to 18 mm.
  • the radiation returning from the opposite end of the optical delay 21 is carried out by a spherical mirror 20.
  • the radius R of the spherical surface of the mirror 20 is selected so that R »d, and the choice of a specific value of the radius R is determined by the design of the mirror mount.
  • part 20.1 of the fiber connector lies on the spherical surface of the mirror and has a diameter D.
  • the values of D and R define the gap ⁇ between the reflective surface of the mirror 20 and the fiber end.
  • the size the reflective coating on the mirror 20 should be less than D, the inner diameter of the part 20.1, to prevent contamination or damage during assembly of the node.
  • NA O, 16.
  • the bending radius of the fiber rolled into rings is 150 mm.
  • the spherical mirror assembly 20 can serve as a kind of angle selector due to an increase in losses for radiation having large values of the numerical aperture when it returns to the optical delay.
  • the rotary mirrors 26 and 28 serve to reduce the dimensions of the lithotripter resonator
  • the lens 29 (for example, with a focal length of 99 mm) is designed to focus radiation on the surface of the front end of the nonlinear crystal 31, for which a KTP crystal can be chosen ( KTiOPO 4 ).
  • the front end of the KTP 31 crystal is a polished surface, without coatings, and serves as the output mirror of the resonator, with a reflection coefficient of R ⁇ 7%.
  • the lens 29 constructs an image of the diaphragm 23 on the surface of the end face of the crystal with a reduction coefficient, for example, M ⁇ 3.5.
  • the radiation focusing angle does not exceed the width of the angles of uncritical synchronism in the crystal 31, and the peak values of the energy density on the surface of the crystal 31 do not exceed 18 J / cm 2 , which is lower than the threshold values of the surface damage of the KTP crystal (see Abrosimov CA, Grechin C.G., Kochiev D.G., Maklakova H.Yu., Semenenko V. “GBG in a KTP crystal of single pulses of microsecond duration)), Quantum Electronics, 31, Zh /, pp. 643-646, 2001).
  • the Q-factor of the resonator of the first emitter is modulated by an ATR shutter 30 located between the lens 29 and the crystal 31. It is preferable to select the parameters for controlling the ATR shutter and its characteristics in such a way that the open state of the shutter 30 is 10-15 times longer than the full passage of the resonator, and the time the opening of the shutter 30 was twice the duration of the generation pulse. In this particular case of execution, the duration of the open state of the ATR shutter was set to 30 t> 6 ⁇ s, and the opening duration C> 2 ⁇ s.
  • FIG. Figure 4 shows the characteristic shape of the ATR gate transmission curve and the temporal shape of the laser pulse.
  • a polarization isolation based on the Fresnel rhombus 24 and the polarizer 25 is installed between the active element 27 and the end of the optical delay fiber.
  • the polarization isolation is used to suppress generation that can occur in the cavity formed between the end of the nonlinear crystal 31 and the end of the optical delay fiber 21, preventing the formation of coupled resonators. Pulses of short duration 10-100 ns, in the case of generation in such a resonator, modulate the time profile of the intensity of the microsecond pulse, which as a result can lead to the destruction of the optical elements of the resonator.
  • the maximum laser pulse energy at its output was 186 mJ in the example under consideration, and the pulse width at half maximum was 0.92 ⁇ s.
  • the optimum temperature in thermostat 4 with a KTP 27 crystal for the realization of phase-matching uncritical in the angles was set to 54, O 0 C ⁇ 0, GC. With a crystal length of 24 mm the fraction of energy of the radiation converted to the second harmonic was 57 mJ ( ⁇ 31%).
  • the input system of two lenses 32 and 34 is intended to input radiation of two wavelengths into a fiber instrument (fiber catheter) 37 connected to the first emitter.
  • Part of the radiation by the plate 33 is allocated to control the output pulse energy to a group of components, where 34 and 36 are energy meters based on photodiodes, and 35 - a dichroic mirror.
  • Lenses 32 (with a focal length of 114 mm) and 34 (with a focal length of 18.4 mm) are optimized to minimize spherical and chromatic aberrations for two wavelengths: 1.0796 ⁇ m and 0.5398 ⁇ m.
  • the image of the laser beam spot in the plane of the output mirror of the resonator, at the end of the KTP 31 crystal, is built in the plane of the input end of the fiber tool 37, with a reduction coefficient of about 6.7.
  • the diameter of the laser spot at the input end of the fiber tool is 240 ⁇ m with a diameter of the quartz fiber core of 300 ⁇ m.
  • the efficiency of introducing radiation into the fiber is 91% for radiation with a wavelength of 1.0896 ⁇ m and 85% with a wavelength of 0.5396 ⁇ m. Further, as shown in Fig.
  • the second emitter (scalpel coagulator), designed for dissection and coagulation of tissues, includes a resonator based on an active element made of an Nd: YAG 42 crystal, ⁇ 6, ZxlOO mm in size.
  • a flat mirror 44 with a transmittance of radiation of ⁇ 50% serves as the output mirror of the resonator.
  • the flat mirror 43 is used as a swivel to reduce dimensions.
  • An enlightened plane-parallel plate 45 serves to divert part of the radiation to the energy meter 46, for monitoring output energy of a radiation pulse.
  • a two-component lens 47 serves to introduce radiation into a fiber catheter 48 connected to a second emitter.
  • Installation can be applied as follows.
  • the laser unit is switched to an operating mode in which only the first laser emitter (lithotripter) is involved.
  • a fiber catheter 37 is inserted into the working channel of a surgical endoscopic instrument (eg, ureteroscope).
  • a surgical endoscopic instrument eg, ureteroscope.
  • the contact effect of laser radiation on the stone surface is carried out.
  • the maximum output energy of the laser pulse at the distal end of fiber 37 of the first emitter with a quartz core diameter of 300 ⁇ m was 165 mJ, of which 49 mJ is the radiation energy in the pulse at a second harmonic wavelength.
  • the duration of the output pulse in this case is 0.92 ⁇ s.
  • an operating mode is established in which only the second emitter (scalpel-coagulator) is involved.
  • the radiation is delivered to the exposure zone by a fiber catheter 48, both during endoscopic interventions and during open operations.
  • the tissue is dissected due to photothermal exposure, with partial vaporization and coagulation of the tissue along the dissection zone.
  • the device according to the invention can be successfully used in surgical urology, in particular, in the treatment of benign prostatic hyperplasia (BPH) and in lithotripsy in the treatment of urolithiasis (ICD).
  • BPH benign prostatic hyperplasia
  • ICD urolithiasis

Abstract

L'invention concerne des équipements médicaux et peut notamment s'utiliser en urologie opératoire et en lythotripsie. L'installation laser comprend au moins un premier émetteur laser, destiné au fractionnement de calculs, et un deuxième émetteur laser servant à trancher et à coaguler les tissus. Le premier émetteur laser permet de convertir le rayonnement en une deuxième harmonique et possède une durée d'impulsions de 0,5 à 5,0 microsecondes. Il comprend un résonateur laser à base d'un cristal Nd:YAlO3 dans lequel la modulation de qualité se fait au moyen de la gâchette à réflectance interne perturbée et une ligne de retard à fibre optique ainsi qu'un convertisseur hors résonance du rayonnement en une deuxième harmonique sur un cristal non linéaire, avec une efficacité de conversion d'au moins 25%. Le deuxième émetteur laser permet le fonctionnement en mode à impulsions périodiques, avec une puissance de sortie moyenne jusqu'à 100 Wt et comprend un résonateur laser à base d'un cristal Nd:YAG.
PCT/RU2007/000409 2006-07-31 2007-07-30 Dispositif laser WO2008024022A1 (fr)

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Cited By (5)

* Cited by examiner, † Cited by third party
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WO2013159793A1 (fr) 2012-04-26 2013-10-31 Dornier Medtech Laser Gmbh Procédé de génération d'impulsions laser façonnées dans un lithotriteur et lithotriteur
CN103584916A (zh) * 2013-11-23 2014-02-19 中国地质大学（武汉） 一种提高红外脉冲激光消融效率的装置及方法
US10226297B2 (en) 2012-09-06 2019-03-12 Covidien Lp Medical devices and methods incorporating frustrated total internal reflection for energy-efficient sealing and cutting of tissue using light energy
CN109494562A (zh) * 2018-12-05 2019-03-19 武汉华锐超快光纤激光技术有限公司 一种双频双脉冲腔内激光碎石机
US10231782B2 (en) 2012-09-06 2019-03-19 Covidien Lp Medical devices and methods incorporating frustrated total internal reflection for energy-efficient sealing and cutting of tissue using light energy

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Cited By (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2013159793A1 (fr) 2012-04-26 2013-10-31 Dornier Medtech Laser Gmbh Procédé de génération d'impulsions laser façonnées dans un lithotriteur et lithotriteur
US10258410B2 (en) 2012-04-26 2019-04-16 Dornier Medtech Laser Gmbh Method for generating shaped laser pulses in a lithotripter and a lithotripter
US10226297B2 (en) 2012-09-06 2019-03-12 Covidien Lp Medical devices and methods incorporating frustrated total internal reflection for energy-efficient sealing and cutting of tissue using light energy
US10231782B2 (en) 2012-09-06 2019-03-19 Covidien Lp Medical devices and methods incorporating frustrated total internal reflection for energy-efficient sealing and cutting of tissue using light energy
US10893908B2 (en) 2012-09-06 2021-01-19 Covidien Lp Medical devices and methods incorporating frustrated total internal reflection for energy-efficient sealing and cutting of tissue using light energy
US10925670B2 (en) 2012-09-06 2021-02-23 Covidien Lp Medical devices and methods incorporating frustrated total internal reflection for energy-efficient sealing and cutting of tissue using light energy
US11786304B2 (en) 2012-09-06 2023-10-17 Covidien Lp Medical devices and methods incorporating frustrated total internal reflection for energy-efficient sealing and cutting of tissue using light energy
US11793569B2 (en) 2012-09-06 2023-10-24 Covidien Lp Medical devices and methods incorporating frustrated total internal reflection for energy-efficient sealing and cutting of tissue using light energy
CN103584916A (zh) * 2013-11-23 2014-02-19 中国地质大学（武汉） 一种提高红外脉冲激光消融效率的装置及方法
CN109494562A (zh) * 2018-12-05 2019-03-19 武汉华锐超快光纤激光技术有限公司 一种双频双脉冲腔内激光碎石机

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