WO2015086629A1 - Medical laser probe - Google Patents

Medical laser probe Download PDF

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Publication number
WO2015086629A1
WO2015086629A1 PCT/EP2014/077099 EP2014077099W WO2015086629A1 WO 2015086629 A1 WO2015086629 A1 WO 2015086629A1 EP 2014077099 W EP2014077099 W EP 2014077099W WO 2015086629 A1 WO2015086629 A1 WO 2015086629A1
Authority
WO
WIPO (PCT)
Prior art keywords
laser probe
characterized
according
laser
medical laser
Prior art date
Application number
PCT/EP2014/077099
Other languages
German (de)
French (fr)
Inventor
Sebastian WINKLER
Original Assignee
Leoni Kabel Holding Gmbh
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
Priority to DE102013225673 priority Critical
Priority to DE102013225673.6 priority
Application filed by Leoni Kabel Holding Gmbh filed Critical Leoni Kabel Holding Gmbh
Publication of WO2015086629A1 publication Critical patent/WO2015086629A1/en

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00Radiation therapy
    • A61N5/06Radiation therapy using light
    • A61N5/0601Apparatus for use inside the body
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Detecting, measuring or recording for diagnostic purposes; Identification of persons
    • A61B5/0059Detecting, measuring or recording for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence
    • A61B5/0082Detecting, measuring or recording for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence adapted for particular medical purposes
    • A61B5/0084Detecting, measuring or recording for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence adapted for particular medical purposes for introduction into the body, e.g. by catheters
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00315Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00345Vascular system
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2560/00Constructional details of operational features of apparatus; Accessories for medical measuring apparatus
    • A61B2560/04Constructional details of apparatus
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2562/00Details of sensors; Constructional details of sensor housings or probes; Accessories for sensors
    • A61B2562/22Arrangements of medical sensors with cables or leads; Connectors or couplings specifically adapted for medical sensors
    • A61B2562/221Arrangements of sensors with cables or leads, e.g. cable harnesses
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00Radiation therapy
    • A61N2005/002Cooling systems
    • A61N2005/005Cooling systems for cooling the radiator
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00Radiation therapy
    • A61N5/06Radiation therapy using light
    • A61N5/0601Apparatus for use inside the body
    • A61N2005/0602Apparatus for use inside the body for treatment of blood vessels

Abstract

Disclosed is a medical laser probe (2) for treating a patient, comprising a distal end (8) that has a laser light emergence window (28). In order to be able to make the laser probe (2) inexpensive in particular for single use of the entire laser probe (2), a laser which is designed as a laser diode (18) and is connected via a supply line (12) is arranged directly at the distal end (8). Since the laser diode (18) is integrated directly at the distal end (8), there is no need for a complex laser apparatus comprising a feeding device and an optical transmission path.

Description

 description

 Medical laser probe

The invention relates to a medical laser probe, as it is used in particular for the therapeutic treatment or for diagnostic purposes of patients.

For many medical treatments, the laser is used. Both for treatments inside the body as well as for external treatments and for dental medicine. In addition, lasers are also used for illumination purposes, for example as a support during therapy or for diagnostic purposes.

In the treatment or even diagnosis inside the body, a fiber optic is usually used and an optical fiber, for example, introduced through a catheter in the body to perform the treatment / diagnosis inside. The laser light is fed via a laser arranged outside the body in the optical fiber and passed through this to the diagnosis or treatment site. The laser light is designed depending on the application for treatment or lighting.

In such fiber-based probes very expensive lasers are required, the cost of which is in the range of several 10,000 EUR per device. This is then connected to a fiber-based laser probe, whose costs are typically in the range of several hundred EUR (150-500 EUR) and are also reusable (maximum 25 times). The high price for the laser results from the requirements of beam quality (to avoid dome losses in the fiber) as well as the reliability to compensate for the losses. In addition, a complex adjustment and maintenance is required for these complex and expensive lasers. There is also the risk of laser failure, which represents an economic risk for the user. Proceeding from this, the present invention seeks to improve a laser-based treatment or diagnosis of patients and in particular to design cheaper.

The object is achieved according to the invention by a medical laser probe, preferably for the therapeutic treatment of a patient having the features of claim 1. The laser probe in this case comprises a distal end, which is designed in particular for insertion into the body of a patient. In operation, a laser beam emerges from this distal end for treatment of the corresponding body region from an exit region designated as an exit window. An essential aspect is the fact that a laser is integrated directly at the distal end. The laser is designed as a semiconductor laser, a so-called diode laser, hereinafter also referred to as laser.

The particular advantage is the fact that only a small device-technical effort is required and is dispensed with external laser components. All that is required is an electrical supply for the laser integrated in the laser probe. For this purpose, an electrical supply line is led to the distal end for supplying the laser. This supply line comprises in particular a power supply line for the laser. In addition, a control line for controlling the laser for influencing its mode of operation is preferably integrated into the supply line.

The direct integration of the laser light source at the distal end of the laser probe, light losses during transport over an optical fiber, as is the case with conventional systems, avoided. These light losses occur, for example, when the laser light is coupled into the fiber but also due to fiber losses or bending losses.

Such a laser probe is designed in particular for intracorporeal medical treatment, ie it is designed such that it can be introduced, for example, into veins, etc. In principle, however, it is also possible to use such a laser probe for external applications. In an expedient embodiment of the laser is arranged in a housing. In this case, the term "enclosed" is understood in particular to mean that the laser in the housing is closed to the surroundings and, in particular, rests hermetically sealed. Hermetically sealed means that there is no mass transfer between the interior of the enclosure and the environment. This enclosure forms the distal end of the laser probe.

For the enclosure is preferably a capillary, so formed an elongated tube. In particular, a glass capillary is used. Such a can be produced easily and inexpensively. In this, the exit window is preferably integrated directly into the body of the capillary as part of the same. In particular, it is a capillary sealed to the distal end of the distal end, i. this is closed to the distal end side and toward the proximal end has an open end side, which is preferably closed by a closure element.

As an alternative to the glass capillary, the housing of the housing is made of plastic or metal. Again, the housing is preferably formed as a tube. In this case, a separate transparent element is preferably used to form the exit window. The exit window preferably closes the housing towards the distal end.

The exit window consists for example of glass or of an optically transparent plastic and is preferably pressed into the housing in a simple manner. Alternatively, the exit window is glued.

In principle, in all variants, further exit windows can be arranged, for example, in the radial direction.

The proximal end of the housing is preferably closed by an adhesive. Furthermore, this adhesive is preferably the at least one supplier transmission line. This hermetically sealed introduction of the supply line is achieved in a simple and cost-effective manner.

According to an expedient embodiment, at least one optical element which influences the radiated laser light, for example converges, diverges or also deflects, is integrated into the housing. For example, a diffuser, a lens, a lateral or even a radial deflection mirror are provided as optical elements. The optical element is alternatively or additionally formed by the exit window. In addition, however, an additional optical element is arranged.

Preferably, the housing has a diameter in the range of about 0.5 mm to 5 mm and is therefore suitable for insertion into the body.

Furthermore, the housing only has a length in the range of about 10 to 30 mm. It is therefore designed only as a very short piece and not as a long drawn hose. As a result, the body is charged only slightly. The enclosure is expediently formed as a stable, inherently rigid housing.

Conveniently, a coolant line is integrated in the supply line, via which a coolant for cooling the laser can be supplied and is supplied during operation. The coolant is either gaseous or liquid and, for example, water. Conveniently, the coolant line has a flow and return path. The coolant flows through, for example, a heat sink, which is attached to a circuit board thermally conductive, on which the laser diode is mounted.

The supply line is designed to be flexible overall, so that the entire laser probe can be used intracorporeally. At the same time, the supply line has a sufficiently high rigidity, so that the distal end can be displaced with the capillary via the supply line within the body, as is the case, for example, with so-called guide wires. The supply line is therefore sufficiently pressure-resistant to be able to propagate the containment in the body within veins / arteries. If necessary, the supply line is reinforced by a stiffening element, for example by a fiber, in particular glass fiber.

At the proximal end of the laser probe, that is at an end opposite the distal end, the laser probe preferably has a plug connector with which the laser probe can be connected to a supply station, for example a power supply unit for a power supply and / or a control unit. Alternatively or additionally, the connection to a coolant supply is likewise made possible via a plug connection. In addition to an electrical plug connection, the laser probe therefore also has a media connection for gas / liquid in this case.

Conveniently, the use of an additional catheter is dispensed with, that is, the laser probe is not guided inside a catheter. It consists in particular of the supply line, which has the plug at the proximal end and the housing at the distal end. Other components, the laser probe preferably does not have. Alternatively, however, it is also possible to guide the laser probe within a catheter.

As an alternative to an intracorporeal embodiment, the laser probe can also be used extracorporeally, eg for examinations of the skin, etc. In particular, for an extracorporeal application, a handle is provided in a preferred embodiment, which adjoins in particular directly to the housing and is attached to this or at least partially accommodates. The handle is preferably formed in several parts and consists for example of two half-shells. These are preferably attachable by the user, for example, in a simple manner clipped, so that the laser probe is prepared if necessary for extracorporeal use. In this case, the laser probe preferably consists only of the plug, the supply line, the housing and the handle part. The supply line is passed through the handle part. Other components, the laser probe preferably does not have. According to a preferred embodiment, the entire laser probe is designed in the manner of a disposable article for single use, so it is preferably formed only for a single use. The laser probe as a whole is sterilizable to allow medical use. By disposable article is meant in this case in particular that the laser probe as a whole is designed as simple as possible and preferably has no calibration option for the laser. After installation of the laser diode in the enclosure, this is therefore no longer configurable. It is preferably also no transmitter integrated. The cost of such a laser probe are compared to conventional fiber-based systems with an external laser source many times cheaper and, for example, in the range of only some 100 EUR.

The embodiment of the laser probe described here has the following advantages:

Light losses such as plug-in coupling, fiber losses and bending losses are avoided. The energy conversion of electrical energy through the laser into optical energy for distal end treatment is basically as efficient as with a laser that couples into a fiber, but there are no optical losses.

Depending on the application, the emission characteristic of the laser can be suitably selected or adjusted. Thus, the laser can radiate both over the long side of the capillary or forward. Due to the optional integration of optics, the emission characteristic is adjustable. Compared to conventional solutions, the overall structure is significantly less complex and therefore less expensive. Under adjustable here is a factory setting and configuration by the manufacturer of the intended for single use laser probe to understand. This concerns the choice of the laser probe as well as the structure of the enclosure and its exit window as well as the possibly present in the

Housing integrated optics. That is, for different applications, different types of laser probes are manufactured and maintained. In contrast to conventional fiber-based laser probes, the laser probe presented here is significantly cheaper and easier. This is achieved on the one hand by the direct integration into the distal end and on the other hand by the use of diode lasers, which can now be industrially manufactured in sufficiently small design and in large numbers, resulting in the cost savings. For example, up to 1 6,000 individual lasers can now be produced per wafer during semiconductor production, which leads to correspondingly low unit costs. Maintenance, repair and care is not required. Also, a calibration is not required.

In addition, the overall handling for the operator is comparatively easy. In particular, additional laser protection measures can be dispensed with in certain applications since the laser is used only on the patient.

A possible embodiment of such a laser probe is shown in the following figures. The figures show in simplified representations:

FIG. 1 shows, in the manner of a sectional view, an enlarged view of a distal end of a laser probe;

 Figure 2 is a cross-sectional view through an enclosure at the distal end with the integrated laser diode, as well

 Figure 3 is a side view of the laser probe with the housing at the distal

 End and a plug at the proximal end.

The laser probe 2 shown in the figures extends in a longitudinal direction 4 from a proximal end 6 to a distal end 8 (see Fig. 3). The proximal end 6 is formed by a plug 10 and connected via a supply line 12 with an enclosure 14, which forms the distal end 8. The configuration of the distal end 8 with the housing 14 is apparent in particular from FIGS. 1 and 2. The housing 14 encloses a cavity in which a mounted on a circuit board 1 6 laser diode 18 is arranged. In addition, viewed in the longitudinal direction 4 in front of the laser diode 18, an optical element 20 is further positioned, in the embodiment in the form of an optical lens.

The supply line 12 is led into the housing 14 and penetrates a rear end side of the housing 14 here. Via the supply line 12, an electrical supply line 12a and preferably also a coolant line 12b are provided in the exemplary embodiment. The coolant line 12b is used to supply an example gaseous or liquid cooling medium, which is used for cooling the laser diode 18. In the exemplary embodiment, the coolant line is connected to a heat sink 22. The coolant line 12b preferably has two partial strands for a flow and a return for the coolant.

Furthermore, the supply line 12 in the embodiment, a stiffening element 24. The stiffening element 24 is, in particular, an element extending over the entire length of the supply line 12, for example a wire or another pressure-resistant strand. The individual components are surrounded by a common outer shell. In addition to the components described here, the supply line 12 preferably has no further components.

In the exemplary embodiment, the housing 14 comprises a tube-shaped capillary, which is closed at its end face oriented towards the distal end 8 by a bottom. The capillary 26 is, in particular, a capillary 26 made of a transparent material and is preferably made of glass. The floor therefore forms an exit window 28, through which a laser light L generated by the laser diode 18 can emerge from the housing 14 in the longitudinal direction 4. Formed in an enclosure 14 made of transparent material virtually the entire enclosure 14 possible exit areas, so that a radial blasting is possible.

The capillary 26 is open towards the proximal end 6. This open end region is closed by a front wall for a hermetic seal of the housing 14, which is formed in the embodiment in particular by a plug of an adhesive 30. About this adhesive 30, the supply line 12 is glued and held on the one hand and at the same time hermetically sealed.

The entire laser probe 2 is used in particular for an intercorporeal examination or therapy of a patient. The laser probe 2 is thus introduced with the distal end 8 in advance in the body. To make this possible, on the one hand, the supply line 12 on a sufficient flexibility and on the other hand, however, also formed sufficiently rigid, so that the distal end 8 can be moved within the body in the longitudinal direction 4 via the supply line 12. For the lowest possible load on the body, the

Housing 14 a diameter d, which is in the range of 0.5 mm to a maximum of 5 mm and preferably up to 3 mm. At the same time, the housing has a length I in the range of about 10 mm to 30 mm. The total length of the laser probe 2 is usually a few meters, for example 2 - 4 m and in particular 3 m.

The power supply for the laser diode 18 is provided via the electrical supply line 12a. In addition, a signal line is expediently integrated, via which the laser diode 18 can be controlled. In a simplest embodiment, however, the control takes place only via the power supply line without further control lines. In addition, measuring leads, such as optical signals from the distal end 8, are again expediently transmitted in the direction of the proximal end 6, for example to an evaluation unit connected via the plug 10. These measurement signals are, for example, reflected or scattered light signals, either as optical signals be returned. Alternatively, these are detected via a semiconductor electronics integrated on the circuit board 1 6 and transmitted as electrical signals to the evaluation electronics connected to the proximal end 6. However, it is preferably a total of a simple structure, wherein the laser diode 18 is supplied exclusively with power / voltage and also controlled.

For an external laser treatment, for example of the skin, the laser probe 2 can in principle also be used. For this purpose, the laser probe 2 is preferably supplemented by a handle part 32, which is shown dotted in Fig. 3. This handle part is arranged directly on the housing 14 and takes this in particular partially, so that a stable, manageable head unit is formed at the distal end 8. The housing 14 is therefore at least partially embedded in the grip part 32. The user can therefore grasp the distal end 8 via the grip part 32 in this head region and thus manually irradiate the desired body parts.

Conveniently, the handle member 32 is fastened in a simple manner, so that it can be attached by the operator himself if necessary. For this purpose, it is in particular made of several parts, preferably two parts consisting of two half-shells, which are fastened to each other by preferably a simple latching or Aneinanderklipsen.

LIST OF REFERENCES Laser probe

 longitudinal direction

 6 proximal end

 distal end

 10 plugs

 12 supply line

 12a electrical supply line

 12b coolant line

 14 enclosure

 16 board

 18 laser diode

 20 optical element

 22 heat sink

 24 stiffening element

 26 capillaries

 28 exit window

 30 glue

 32 handle part

 L laser light

d diameter

 I length

Claims

claims
1 . A medical laser probe (2) for treating a patient comprising a distal end (8) having an exit window (28) for a laser beam,
 characterized,
 that at the distal end (8) a laser diode (18) is integrated, which is supplied via a supply line (12).
2. Medical laser probe (2) according to the preceding claim,
 characterized,
 in that the laser diode (18) is arranged in an enclosure (14).
Medical laser probe (2) according to the preceding claim,
 characterized,
 in that a capillary (26), in particular made of glass, is used for the housing (14).
Medical laser probe (2) according to one of the two preceding claims,
 characterized,
 the housing (14) has a separate transparent element as exit window (28) for the laser beam.
Medical laser probe (2) according to one of the preceding claims 2 to 4,
 characterized,
in that a proximal end of the housing (14) is closed by an adhesive (30) through which the supply line (12) is inserted.
6. Medical laser probe (2) according to one of claims 2 to 5,
 characterized,
 that in the housing (14) an optical element (20) is integrated, which is designed to influence the laser beam.
7. Medical laser probe (2) according to one of claims 2 to 8,
 characterized,
 in that the housing (14) has a diameter (d) in the range of 0.5 mm to 5 mm.
8. Medical laser probe (2) according to one of claims 2 to 9,
 characterized,
 in that the housing (14) has a length (I) in the range of approximately 10 to 30 mm.
9. Medical laser probe (2) according to one of claims 2 to 6,
 characterized,
 in that a coolant line (12b) for cooling the laser diode (18) is integrated into the supply line (12), in particular with a supply and return path.
10. Medical laser probe (2) according to one of the preceding claims, characterized
 that the supply line (12) is flexible but pressure-resistant with a sufficient inherent rigidity, such that the distal end (8) can be moved intracorporeally by means of the supply line (12).
1 1. Medical laser probe (2) according to one of the preceding claims, characterized
 the supply line (12) has a stiffening element (24).
12. Medical laser probe (2) according to one of the preceding claims, characterized
in that the supply line (12) has a plug (10) at the proximal end (6).
13. Medical laser probe (2) according to one of the preceding claims, characterized
 that it is designed for single use.
14. Medical laser probe (2) according to the preceding claim,
 characterized,
 that no possibility of calibration for the laser diode (18) is present.
15. Medical laser probe according to one of the preceding claims, characterized
 in that subsequently to the housing (14) a grip part (32) is arranged, which in particular is multi-part and can be clipped on.
PCT/EP2014/077099 2013-12-11 2014-12-10 Medical laser probe WO2015086629A1 (en)

Priority Applications (2)

Application Number Priority Date Filing Date Title
DE102013225673 2013-12-11
DE102013225673.6 2013-12-11

Publications (1)

Publication Number Publication Date
WO2015086629A1 true WO2015086629A1 (en) 2015-06-18

Family

ID=52134125

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/EP2014/077099 WO2015086629A1 (en) 2013-12-11 2014-12-10 Medical laser probe

Country Status (1)

Country Link
WO (1) WO2015086629A1 (en)

Citations (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH0592047A (en) * 1991-10-02 1993-04-16 Matsushita Electric Ind Co Ltd Probe of laser treating device
US5363135A (en) * 1992-04-21 1994-11-08 Inglese Jean Marc Endoscope having a semi-conductor element illumination arrangement
WO2002007629A1 (en) * 2000-07-06 2002-01-31 Ceramoptec Industries Active endoscopic photodynamic therapy devices; systems and method
WO2006089118A2 (en) * 2005-02-17 2006-08-24 Light Sciences Oncology, Inc. Photoreactive system and methods for prophylactic treatment of atherosclerosis
WO2010016859A1 (en) * 2008-08-07 2010-02-11 Remicalm Llc Oral cancer screening device
US20100324632A1 (en) * 2009-06-19 2010-12-23 Teng Lew Lim Method and portable system for non-invasive, In-vivo blood irradiation light therapy
WO2011037299A1 (en) * 2009-09-28 2011-03-31 Lg Electronics Inc. Capsule endoscope having biopsy function and method for controlling the same
WO2011094541A1 (en) * 2010-01-29 2011-08-04 Arista Therapeutics, Inc. Disposable led/laser catheter
US20130096438A1 (en) * 2010-06-23 2013-04-18 Siemens Aktiengesellschaft Method and device for detecting tumorous tissue in the gastrointestinal tract with the aid of an endocapsule

Patent Citations (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH0592047A (en) * 1991-10-02 1993-04-16 Matsushita Electric Ind Co Ltd Probe of laser treating device
US5363135A (en) * 1992-04-21 1994-11-08 Inglese Jean Marc Endoscope having a semi-conductor element illumination arrangement
WO2002007629A1 (en) * 2000-07-06 2002-01-31 Ceramoptec Industries Active endoscopic photodynamic therapy devices; systems and method
WO2006089118A2 (en) * 2005-02-17 2006-08-24 Light Sciences Oncology, Inc. Photoreactive system and methods for prophylactic treatment of atherosclerosis
WO2010016859A1 (en) * 2008-08-07 2010-02-11 Remicalm Llc Oral cancer screening device
US20100324632A1 (en) * 2009-06-19 2010-12-23 Teng Lew Lim Method and portable system for non-invasive, In-vivo blood irradiation light therapy
WO2011037299A1 (en) * 2009-09-28 2011-03-31 Lg Electronics Inc. Capsule endoscope having biopsy function and method for controlling the same
WO2011094541A1 (en) * 2010-01-29 2011-08-04 Arista Therapeutics, Inc. Disposable led/laser catheter
US20130096438A1 (en) * 2010-06-23 2013-04-18 Siemens Aktiengesellschaft Method and device for detecting tumorous tissue in the gastrointestinal tract with the aid of an endocapsule

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
None

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