WO2011038923A2 - Méthode de traitement médical de patients - Google Patents

Méthode de traitement médical de patients Download PDF

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Publication number
WO2011038923A2
WO2011038923A2 PCT/EP2010/005992 EP2010005992W WO2011038923A2 WO 2011038923 A2 WO2011038923 A2 WO 2011038923A2 EP 2010005992 W EP2010005992 W EP 2010005992W WO 2011038923 A2 WO2011038923 A2 WO 2011038923A2
Authority
WO
WIPO (PCT)
Prior art keywords
laser
pulses
tissue
patients
laser beam
Prior art date
Application number
PCT/EP2010/005992
Other languages
German (de)
English (en)
Other versions
WO2011038923A3 (fr
Inventor
Olaf Schäfer
Original Assignee
Schaefer Olaf
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by Schaefer Olaf filed Critical Schaefer Olaf
Publication of WO2011038923A2 publication Critical patent/WO2011038923A2/fr
Publication of WO2011038923A3 publication Critical patent/WO2011038923A3/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00—Radiation therapy
    • A61N5/06—Radiation therapy using light
    • A61N5/0613—Apparatus adapted for a specific treatment
    • A61N5/0616—Skin treatment other than tanning
    • 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
    • A61B18/203—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 applying laser energy to the outside of the body
    • 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
    • A61B2017/00137—Details of operation mode
    • A61B2017/00154—Details of operation mode pulsed
    • A61B2017/00172—Pulse trains, bursts, intermittent continuous operation
    • 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
    • A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00452—Skin

Definitions

  • the invention relates to a method for the medical treatment of patients with a laser beam from a semiconductor or diode laser, wherein the laser beam is applied in the form of pulses to the area to be treated.
  • Laser systems are today an indispensable tool in medicine. They enable precise, precise and non-contact work. For medical applications, there are a variety of laser systems. Of central importance here is for each laser, its active medium, which defines the emission wavelength and thus defines the application of the laser in medicine. The selection is essentially made by the wavelength-dependent absorption of the laser radiation in the tissue.
  • Various laser systems are used in human medicine, such as ophthalmology, dermatology, plastic surgery, gynecology, neurosurgery, urology and dentistry, as well as in veterinary medicine.
  • the laser is used for example for the treatment of periodontal disease and gum disease as well as a drill replacement.
  • the basis of the generation of laser radiation is always the stimulated emission.
  • excitation of the atoms or molecules in the laser-active medium takes place a higher energy levels, which are responsible for the laser transition. If the excitation is strong enough to generate an overpopulation of the upper laser level (pumping), it is called a population inversion.
  • a spontaneous emission transition to stimulated emission i. to an artificially generated depopulation of the upper laser level and to the emission of laser beams.
  • the process by which the laser medium is excited depends on the laser medium used. The three most important types of stimulation are
  • Diode lasers use semiconductor crystals as active media that emit coherent radiation in the visible and near-infrared spectral regions upon excitation.
  • the energy states of the electrons are not sharp, as with free atoms, but given by broad bands.
  • the ground state forms the valence band, the excited state the power band.
  • the excitation is usually carried out at the so-called pn junction after applying an external voltage.
  • the electrons are transported from the valence band into the power band, resulting in population inversion. In a subsequent stimulated emission, they return to the valence band and emit light.
  • the emission wavelength depends on the energetic distance between valence band and power band, the band gap resulting from the selection of suitable semiconductor compounds.
  • Diode lasers have been used in medicine since the mid-1990s. The main areas of application are coagulation (hemostasis), surgery (removal of soft tissue) and the elimination of pathogens. In addition, powerful diode lasers, as described, for example, in DE 10 2004 006 932, can also be used for hair removal (epilation).
  • Diode lasers are available in several discrete wavelengths. It is known e.g. Wavelengths of 635 nm (visible, red), 810 nm, 940 nm and 980 nm (all infrared, invisible) with sufficient power for the situations described. In addition, there are other wavelengths that have insufficient output power for the described applications.
  • diode lasers of 810 nm and 980 nm are used.
  • the principle of action of these diode lasers on the patient is the absorption of the laser light by biological tissue.
  • the absorption by water is insignificant in this wavelength range (0.01% to 0.1%).
  • the main mechanism of action is the absorption of laser light by melanin (skin) or hemoglobin (red blood pigment).
  • the surgical cutting with a diode laser thus requires a well-perfused tissue.
  • diode lasers can be switched on or off much like a light bulb. While a solid-state laser such as Nd: YAG can emit more than one joule of energy in a short time (typically a few ⁇ s), corresponding to a peak power of several 1000 watts, the diode laser can only operate at maximum power (typically 2 to 15 Watt) are turned on. If this occurs over a period of several times, as with the Nd: YAG laser, only energies of a few mJ are achieved. Diode lasers are therefore operated in the medical application mostly continuous (CW) or with relatively long quasi-pulses (a few ms).
  • CW continuous
  • quasi-pulses a few ms
  • the thermal load causes the tissue to burn. This is called carbonation and means charred tissue. As a result, the wound healing is disturbed, it comes to toxic by-products.
  • the thermal Effect of carbonization therefore limits the maximum usable laser power and thus the cutting speed.
  • Another aspect of the previously known diode lasers is the poor coupling of the laser radiation to the tissue.
  • the laser beam then often shows no or only a weak response to the irradiated tissue.
  • the object of the present invention is to further improve the method according to DE 10 2005 055 523 A1.
  • At least partially one or more intermediate pulses are applied between two pulses.
  • the tissue and, of course, the patient, too are virtually prepared for the actual pulses, so that the method according to the invention proceeds more gently and more tolerably. In practice, it has been found that this also speeds up the process. It leads faster to a desired positive result.
  • the intermediate pulses may preferably have a lower strength than the actual pulses and be shorter.
  • Figure 1 is a diagrammatic representation of a possible embodiment of the inventive method
  • Figure 2 is a diagrammatic representation of another possible embodiment of the inventive method
  • FIG. 3 shows a further diagrammatic representation of a possible embodiment of the method according to the invention.
  • the energy with which a diode laser according to the invention is operated in watts is shown over time. It can be seen that the laser beam is applied in the form of pulses 1 .1 or 1 .2. Between the pulses 1 .1 and 1 .2 there is a pulse-free space. During this time, no application of the laser beam to the area of the patient to be treated takes place.
  • the pulses 1.1 and 1 .2 are applied at about 30 watts, the duration of each pulse 1 .1 or 1 .2 amounts to about 16 [is and the time between the pulses 1.1 and 1 .2 to about 32 us ,
  • the pulses have a substantially rectangular shape.
  • the pulses 1 .3 and 1.4 should usually be output in a form of a Gaussian curve according to the inventive method. This is shown in FIG. The increase should in any case take place with more than 0.1 watts per ps, resulting in a relatively steep bell curve. The waste is similar.
  • FIG. 3 shows a particularly preferred embodiment of the method according to the invention. Here, the current or energy is always kept just below a threshold value 2, at which the laser would go into operation. As a result, the time until the application of the pulses 1.5 and 1.6 is significantly shortened, so that a steeper rise of the bell shape of the curve is possible, which almost approaches the rectangular shape.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Physics & Mathematics (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Optics & Photonics (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Pathology (AREA)
  • Radiology & Medical Imaging (AREA)
  • Electromagnetism (AREA)
  • Otolaryngology (AREA)
  • Biophysics (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Radiation-Therapy Devices (AREA)
  • Laser Surgery Devices (AREA)
  • Dental Tools And Instruments Or Auxiliary Dental Instruments (AREA)

Abstract

Méthode de traitement médical de patients au moyen d'un faisceau laser composé d'un laser à semiconducteur ou à diode, le faisceau laser étant appliqué sur la zone à traiter sous forme d'impulsions (1.1 à 1.6), une ou plusieurs impulsions intermédiaires étant au moins parfois appliquées entre deux impulsions (1.1 à 1.6).
PCT/EP2010/005992 2009-10-02 2010-10-01 Méthode de traitement médical de patients WO2011038923A2 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE102009048027.7 2009-10-02
DE200910048027 DE102009048027A1 (de) 2009-10-02 2009-10-02 Verfahren zur medizinischen Behandlung von Patienten

Publications (2)

Publication Number Publication Date
WO2011038923A2 true WO2011038923A2 (fr) 2011-04-07
WO2011038923A3 WO2011038923A3 (fr) 2012-02-23

Family

ID=43568098

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/EP2010/005992 WO2011038923A2 (fr) 2009-10-02 2010-10-01 Méthode de traitement médical de patients

Country Status (2)

Country Link
DE (1) DE102009048027A1 (fr)
WO (1) WO2011038923A2 (fr)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2020244751A1 (fr) * 2019-06-05 2020-12-10 Biofrontera Bioscience Gmbh Éclairage pour thérapie photodynamique
US11235169B1 (en) 2020-10-15 2022-02-01 Biofrontera Pharma Gmbh Illumination device for photodynamic therapy, method for treating a skin disease and method for operating an illumination device

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE102004006932B3 (de) 2004-01-30 2005-10-20 Dilas Diodenlaser Gmbh Hochleistungs-Diodenlaser mit einer Einrichtung zur Strahlformung
DE102005055523A1 (de) 2005-11-18 2007-05-31 Elexxion Gmbh Verfahren zur medizinischen Behandlung von Patienten

Family Cites Families (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5632739A (en) * 1994-10-13 1997-05-27 The General Hospital Corporation Two-pulse, lateral tissue illuminator
US6974224B2 (en) * 2003-07-30 2005-12-13 Tru-Light Corporation Modularized light processing of body components

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE102004006932B3 (de) 2004-01-30 2005-10-20 Dilas Diodenlaser Gmbh Hochleistungs-Diodenlaser mit einer Einrichtung zur Strahlformung
DE102005055523A1 (de) 2005-11-18 2007-05-31 Elexxion Gmbh Verfahren zur medizinischen Behandlung von Patienten

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2020244751A1 (fr) * 2019-06-05 2020-12-10 Biofrontera Bioscience Gmbh Éclairage pour thérapie photodynamique
US11219781B2 (en) 2019-06-05 2022-01-11 Biofrontera Pharma Gmbh Illumination for photodynamic therapy
US11235169B1 (en) 2020-10-15 2022-02-01 Biofrontera Pharma Gmbh Illumination device for photodynamic therapy, method for treating a skin disease and method for operating an illumination device

Also Published As

Publication number Publication date
WO2011038923A3 (fr) 2012-02-23
DE102009048027A1 (de) 2011-04-07

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