JP3406335B2 - Medical laser light irradiation device - Google Patents

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a laser light irradiation device for medical use , and more specifically, it is required for laser light irradiation near a region to be irradiated with laser light for treatment of blood vessels or digestive organs , or for diagnosis of endoscopes . TECHNICAL FIELD The present invention relates to a medical laser light irradiation device capable of refracting at an angle and performing irradiation.

[0002]

BACKGROUND OF THE INVENTION Laser light is used in the medical field for treatment and diagnosis such as coagulation, cauterization, evaporation and excision of an affected area. In these applications, laser light is generally transmitted by an optical fiber, but when the irradiation target is not on the extension line of the optical axis, the laser light must be bent. However, in general, laser light cannot be refracted at an arbitrary angle with respect to the optical axis unless the optical fiber is bent.

For example, Japanese Patent Laid-Open No. 61-50216
No. 8 shows a "medical and surgical laser probe" in which a contact member consisting of a contact tip 30 in combination with a concave lens 28 is attached to the tip of the optical fiber 2 so as to increase the irradiation range. A device based on the idea of expanding is disclosed. As a result, it is said that this contact member can sufficiently cover an area that could not be covered by irradiation of several times in the past with this contact member.
However, even with this contact member, the intended effect cannot be obtained unless the optical axis of the laser light is brought into contact with the irradiation target (tissue M) at a substantially right angle. For example, even if a contact member as shown in this publication is attached to the tip of a catheter that is inserted substantially parallel to the tissue M, the laser beam is bent at a substantially right angle to the target region immediately next to the contact member. Irradiation is impossible. It is said that such right angle or near refraction of the laser beam is desirable for endovascular treatment, digestive system treatment and diagnosis, but no medical laser irradiation device satisfying such demand has been obtained so far. It was

[0004]

SUMMARY OF THE INVENTION Therefore, according to the present invention, a laser beam transmitted by an optical fiber is refracted at a required refraction angle in the vicinity of the tip of the fiber so that the target region can be accurately irradiated. SUMMARY OF THE INVENTION It is an object of the invention to provide a laser irradiation device for use.

[0005]

Therefore, the present invention provides a body
A medical light laser light irradiation device to be inserted inside,
Optical fiber that guides laser light and coating of the optical fiber
And a reflective film sphere that is a sphere fused to the tip of the optical fiber and has an opaque metal reflective film adhered to the outer peripheral surface of the sphere.
By removing a part of the opaque metal reflective film
To form a light irradiation window, so that the optical fiber
As the guided laser light is emitted from the light irradiation window
Medical laser light irradiation device characterized by being configured
Is provided. Thus, the sphere is glass
Or a light beam plan consisting of plastic and optical fiber
It is welded to the inner tip, and an opaque metal reflection film is attached to the entire outer peripheral surface of this sphere by a technique such as sputtering or vacuum deposition to form a reflection film sphere at the fiber tip.
Any part of the opaque metal reflective film on the reflective film sphere , i.e. a predetermined angle with respect to the optical axis of the optical fiber
A laser beam irradiation window is formed by deleting the laser beam with a required size and shape at a position (0 ° or more and 180 ° or less), and the optical fiber and the reflective film sphere are made of stainless pipe or the like so as not to cover the irradiation window. It is housed in a protective tube or sleeve and constitutes the basic part of a medical laser light irradiation device. As a result, the laser light that is uniformly reflected in the reflecting film sphere is emitted intensively from the irradiation window formed at the desired angle with respect to the optical axis to the target location. Alternatively, the light is refracted and irradiated at any required angle such as a right angle or more.

In the present invention, a transparent sphere having a diameter approximately equal to the diameter of the optical fiber to approximately twice the diameter can be used. Therefore, according to the present invention, the optical fiber can be inserted into a thin tube or a gap having a diameter about twice the diameter of the optical fiber, that is, into a blood vessel or a digestive organ, and the laser beam can be refracted and irradiated at the insertion tip. By arranging the laser beam irradiation device of the present invention inside a catheter that is usually used for medical purposes, it is possible to diagnose or treat a lesion immediately beside the catheter tip (a point bent at a right angle). Therefore, unlike the conventional irradiation from a long distance, the accuracy can be remarkably improved.

The irradiation window on the reflective film sphere can be formed in various shapes, sizes and numbers. For example, one circular window, two or more circular windows, a slot-shaped oval window, or a strip-shaped window surrounding the entire circumference of the reflective film sphere , etc.
Various irradiation windows can be realized according to the application. The positions of these irradiation windows can be arbitrarily selected so as to achieve a desired refraction angle with respect to the optical axis. Refraction angle α with respect to the optical axis
Can be generally selected within the range of 0 ° <α <180 °, and the position of the irradiation window is determined on the reflective film sphere according to the selected refraction angle.

The laser beam irradiation apparatus of the present invention can be implemented in combination with various medical devices. For example,
Laser catheter for cauterization of lesions in blood vessels, diagnostic catheter in combination with gastrointestinal endoscope and laparoscope, laser balloon catheter, or electrode catheter for treating arrhythmia, etc. The medical device can be realized. Depending on the specific medical device type, a laser beam or other general light beam will be used for that particular device.

[0009]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS An embodiment of a medical laser light irradiation apparatus of the present invention will be described with reference to the drawings. FIG. 1 is a partially cut side view showing a basic form of a medical laser light irradiation apparatus of the present invention. Reference numeral 1 is an appropriate optical fiber for transmitting and guiding laser light, and a tip of the optical fiber 1 (right end in the figure). transparent balls 2, or glass spheres or plastic spheres 2 is welded, the transparent bulb 2 of the surface is opaque metal reflection film 3 is formed by such sputter coating or vacuum vapor deposition reflective film spheres
It constitutes the body 5. It is preferable that the metal film 3 is continuously coated up to the vicinity of the tip of the optical fiber 1 as shown by 3a in FIG. This is to reinforce the welded portion of the optical fiber 1 and the reflective film sphere 5. Membranes 3, 3 for the purpose of reinforcement
Since it is preferable that “a” be as thick as possible, a relatively thick reinforcing film of metal may be formed by sputtering on top of sputtering.

An irradiation window 4 is formed in the opaque metal film 3. In the example of FIG. 1, the window 4 is positioned so as to coincide with the direction of the refraction angle α = 90 ° with respect to the straight optical axis (broken line L) of the laser light. For example, by removing the metal film 3 as a circular window, Has been formed. Laser light from a laser light source or a general light source (not shown) arranged near the base end (left end in the figure) of the optical fiber 1 is reflected from the tip of the fiber to a reflective film sphere.
The light enters the body 5, is uniformly dispersed and reflected on the inner surface of the film 3, and is reflected innumerably many times in a sphere, so to speak, and flies away, but an exit is found in the window 4 and linearly emitted in the direction of the line L from there. (The line L is referred to as the refraction irradiation direction). According to the invention, the irradiation window 4 is 0 ° <α <180 with respect to the optical axis in the optical fiber .
It can be formed at an arbitrary position so as to realize a required refraction irradiation direction depending on the application of laser light within the range of °. Further, the number of irradiation windows is not limited to one, and a necessary number can be provided, and the shape is circular in a plan view in the example of FIG. 1, but other various shapes can be formed. In the illustrated example, the axis of the optical fiber 1 and the center of the reflective film sphere 5 are shown as substantially coincident with each other, but the invention is not limited to this, and the fiber axis and the center of the glass sphere may be offset and welded. You can also

The fiber 1 and the reflecting film sphere 5 are provided with an irradiation window 4
It is housed in a flexible jacket or sleeve 6 such as a stainless pipe so as not to cover the above, and constitutes the basic form of the medical laser light irradiation apparatus of the present invention. In FIG. 1, the tip of the sleeve 6 ends just near the irradiation window 4,
When the sleeve 6 extends beyond the reflective film sphere 5 (see the example of FIG. 3 described later), it is necessary to make an opening in the portion of the sleeve 6 corresponding to the irradiation window 4. Although not shown in FIG. 1, it is preferable that the tip of the fiber has a convex shape and the welding portion of the glass ball 2 has a concave shape. Such a complementary uneven shape is necessary for accurately and firmly welding, but in the present invention, the uneven shape is applied by applying the fine processing technology disclosed in Japanese Patent Application No. 1-126599 owned by the present inventor. It can be easily processed.

As the optical fiber 1 used in the present invention, a glass fiber or a plastic fiber having various diameters ranging from an extremely thin diameter of 0.05 to 0.3 mm to a visible thickness is used. You can The transparent sphere 2 is required to be an optically true sphere, and its material is preferably an inorganic material oxide glass, particularly high-purity glass, but in reality, it is a transparent material such as plastic. It is preferable to manufacture it. The metal material used for the opaque metal reflective film 3 is not particularly limited, and is suitable for sputtering, vacuum deposition, or further CVD,
Any light opaque material can be used. Further, the reflective film 3 can be formed not only by a single layer of metal, but also by stacking different kinds of metal on two or three layers.

FIG. 2 shows another embodiment of the laser light irradiation apparatus of the present invention, that is, an example in which the irradiation window of the reflective film sphere 5 is formed in a band shape 14 around the entire circumference of the sphere. This example is used when it is necessary to irradiate the entire circumference at the same time in the vicinity of the tip of a catheter inserted into the digestive system or blood vessel. Depending on the case, the number of the band-shaped irradiation windows 14 is not limited to one, and it is possible to form two or more. It is also possible to use a band-shaped irradiation window in combination with a circular or other locally shaped window. Further, in the illustrated example, the incident axis of the laser light (see FIG.
Although the irradiation window 14 is formed on a surface that is substantially perpendicular to L), it is also possible to form the irradiation window on an inclined surface.

FIG. 3 is a schematic cross-sectional view showing an embodiment in which the basic laser light irradiation apparatus of the present invention as exemplified above is incorporated in an actual variable light type laser catheter with a guide wire for blood vessel treatment. . The optical fiber 1 and the reflective film sphere 5 welded to the tip thereof are housed in a jacket or sleeve 6 extending beyond the reflective film sphere , and an opening is formed in a portion of the sleeve 6 corresponding to the irradiation window 4. ing. A guide wire 7 made of a spring wire is attached to the narrow tip 6a of the sleeve 6. Such a catheter is guided in the blood vessel B by a guide wire, and when the built-in reflecting film sphere 5 reaches a lesion (atheroma layer) A, laser light is emitted from the immediate vicinity thereof in a direction substantially perpendicular to the optical axis. The lesion can then be cauterized. Unlike conventional irradiation that is almost parallel to the optical axis or has a slight conical spread, irradiation can be performed almost from the side of the lesion, so the treatment is accurate, and the amount of laser irradiation is minimal in a short time. There is an advantage that the treatment can be carried out with. As a modification of the embodiment shown in FIG. 3, the optical fiber 1 penetrates the guide wire 7,
It is also possible to form the reflecting film sphere 5 at the tip of the wire.

FIG. 4 is a schematic sectional view showing an example of a laser light treatment instrument having a simpler structure. The reflective film sphere 5 and the optical fiber 1 are housed in the outer cover 6 as in the previous example, and a slide tab 9 for slidably holding the guide wire 8 is provided on the side of the outer cover. The mounting position of the tab 9 is not limited. In the reflective film sphere 5 of this example, the irradiation window 4 is formed at a position of α≈135 °. About 45 ° to the emission tip
A device capable of irradiating a laser beam to a region having a wide angle has not been known so far, and there is no device capable of irradiating a laser beam in a localized manner at a desired angle. Thereby, the therapeutic effect such as cauterization of the atheroma layer A in the blood vessel wall B can be significantly improved.

FIG. 5 shows an example in which the laser light irradiation apparatus of the present invention is implemented as an endoscopic or laparoscopic combination laser catheter for blood vessels, digestive organs, etc. (A) shows an irradiation window 4 at an arbitrary position. The figure shows a part of a diagnostic catheter in which a reflective film sphere 5 having a light guide 10, an image fiber 11 and a flash channel 12 is fixedly incorporated in a sleeve 13. (B) shows the image fiber 11 and the light guide 10 together with the anti- fixing member fixed to the outer cover 6 housed in the flash channel 15 so that it can be taken in and out.
The device in which the spray sphere 5 is housed in the sleeve 13 is shown. Also in this example, the position (angle) of the irradiation window 4 can be variably formed as required.

FIG. 6 shows an example in which the laser light irradiation apparatus of the present invention is incorporated into a laser catheter for diagnosis and treatment of hardening lesions by excitation / fluorescence.
6 is a view of a diagnostic / treatment device in which a plurality of reflective film spheres 5 fixed to a plurality of fibers are arranged around a channel 17 for insertion of a guide wire or the like that is inserted through almost the center of 6 as seen from the end face. FIG. A clear and accurate diagnosis of a lesion can be performed by a plurality of laser beams intensively emitted by the irradiation window 4 formed at a required position of the reflective film sphere 5. (B) shows a few fibers fixed to the tip of the excitation or fluorescence fiber 18.
FIG. 7 is a partial side view of a therapeutic laser device in which a reflective film sphere 5 is housed in an outer cylinder 16. Of course, each reflection film sphere 5 has a laser beam irradiation window of a required shape formed at a required position.
It is omitted in the figure.

FIG. 7 is similar to FIG. 6, but is an end view showing an example in which the reflective film spheres are multiply arranged, and a plurality of reflective film spheres 5 are provided around the central insertion channel 17. Each of them is arranged as having a refraction irradiation window 4, and a large number of slightly smaller-diameter reflective film spheres 25 are arranged between the inner tube 19 and the outer tube 20 around it. The reflection film sphere 25 has an irradiation window 2
4 is formed at a required position.

FIG. 8 is a schematic sectional view showing an example in which the laser light irradiation device of the present invention is incorporated in a laser balloon catheter, and a reflective film sphere 5 is fixed to the tip of the transmission fiber 1 as having a band-shaped irradiation window 4. And is positioned within the balloon 26. Reference numeral 3a is a metal film that strengthens the adhesion between the reflective film sphere 5 and the transmission fiber 1, and the fiber tip and the transparent sphere are optically continuous. Reference numeral 3b is a base portion for fixing the extension shaft 1'to the outer wall of the reflective film sphere 5, and the guide wire 7 is supported at the tip of the extension shaft. The transmission fiber 1 is appropriately connected to a light source through a thin tube 27 at the rear end of the balloon.

FIG. 9 is a partial side view showing an example in which the laser light irradiation apparatus of the present invention is applied to a laser electrode catheter for treating arrhythmia, and a reflection film ball fixed to the tip of the optical fiber 1.
The body 5 has the irradiation window 4 as in the above-mentioned examples, and is arranged substantially in the middle between the tip electrode 28 in the outer cover 27 and the front electrode 29. A lead wire 30 leading to the tip electrode 28 and a lead wire 31 leading to the front electrode 29 are inserted into the jacket 27.
As shown in the figure, the portion of the outer cover 27 corresponding to the irradiation window 4 is an opening. Although not shown, the reflective film sphere 5
Can be arranged so as to face the tip electrode 28.

Finally, FIG. 10 shows an example in which the reflecting film sphere also serves as one of the electrodes in the electrode catheter as in the previous example. That is, the reflective film sphere 35 having the irradiation window 34 fixed to the tip of the fiber 1 is projected from the outer cover 27 and connected to the power source through the conducting wire 30. The electrode 29 on the front side is similar to the example in FIG.

[0022]

As described above, according to the present invention, the optical axis of the transmitted light is provided at the tip of the optical fiber for transmitting the laser light.
On the other hand, a reflection film sphere having an irradiation window formed at a position corresponding to an arbitrary refraction angle is welded, and this is housed in a flexible jacket or sleeve to construct a medical laser light irradiation device. Therefore, even when the optical fiber is tightly inserted into an extremely thin passage or duct such as a blood vessel or digestive organ, the laser beam can be applied at a right angle to the passage wall or the duct wall or at a desired specific angle. It is possible to accurately irradiate. This will expand the use of laser light in the medical field,
It is expected to have the effect of opening the way for laser light therapy and diagnosis that have not been attempted in the past. In particular, in the case of laser light used in the medical field, an optical fiber is inserted into the human body to perform treatment and diagnosis such as coagulation and cauterization, so it is necessary to accurately guide the laser light to the target area, In many cases, the target area is located laterally with respect to the laser optical axis guided by the catheter, so it was necessary to accurately guide the laser light to the lateral target area, but this is easily possible in the past. Whereas no device has been realized, the present invention certainly allows this.

[Brief description of drawings]

FIG. 1 is a partially cut side view showing a basic form of a medical laser light irradiation apparatus according to the present invention.

FIG. 2 is a partial side view showing another embodiment of the medical laser light irradiation apparatus of the present invention.

FIG. 3 is a schematic cross-sectional view showing an example in which the medical laser light irradiation apparatus of the present invention is implemented as a variable light type laser catheter with a guide wire.

FIG. 4 is a schematic cross-sectional view showing one embodiment of a laser light treatment / diagnosis device having a simpler configuration, to which the laser light irradiation device of the present invention is applied.

FIG. 5 shows an example in which the medical laser light irradiation apparatus of the present invention is implemented as a combined endoscopic and laparoscopic laser catheter for blood vessels and digestive organs, and (A) is a reflective sphere . FIG. 3 is a partial perspective view showing a storage type and a type (B) showing a retractable type.

FIG. 6 is an end view (A) and a partial side view (B) showing two examples in which the laser light irradiation apparatus of the present invention is used as a laser catheter for diagnosis and treatment of hardening lesions by excitation / fluorescence. .

FIG. 7 is an end view showing a laser catheter in which reflective film spheres according to the present invention are multiply arranged.

FIG. 8 is a schematic cross-sectional view showing an example in which the medical laser light irradiation apparatus of the present invention is applied to a laser balloon catheter.

FIG. 9 is a partial side view showing an example in which the laser light irradiation apparatus of the present invention is applied to a laser electrode catheter for treating arrhythmia.

FIG. 10 is a partial side view showing an example in which the reflective film sphere of the present invention is also used as one electrode of an electrode catheter.

[Explanation of symbols]

DESCRIPTION OF SYMBOLS 1 ... Optical fiber 2 ... Transparent sphere 3 ... Opaque metal reflective film 4 ... Irradiation window 5 ... Reflective film sphere 6, 13, 16, 27 ... Jacket or sleeve 14 ... Other embodiment 26 of irradiation window ... Balloon 28, 29 ... Electrode 35 ... Example of this device provided with electrode

─────────────────────────────────────────────────── ─── Continuation of the front page (56) References JP-A-4-28358 (JP, A) Actually open 3-116820 (JP, U) Special table Sho 61-502169 (JP, A) (58) Survey Field (Int.Cl. ⁷ , DB name) A61B 18/20

Claims (7)

(57) [Claims] 1. A medical optical laser illuminating device to be inserted into the body.
An irradiation device, which is an optical fiber for guiding laser light, an outer cover for coating the optical fiber, and a sphere welded to the tip of the optical fiber,
Reflective film sphere with opaque metal reflective film attached to the outer peripheral surface of the sphere
And a part of the opaque metal reflective film in the reflective film sphere.
A light irradiation window is formed by being removed.
The laser light guided by the optical fiber is the light irradiation window.
For medical use characterized by being configured to irradiate from
Laser light irradiation device. 2. The light irradiation window is an optical axis of the optical fiber.
A contract that is a circular window located at a certain angle to the line
The medical laser light irradiation apparatus according to claim 1. 3. The predetermined angle is 90 degrees.
2. The medical laser beam irradiation device according to 2. 4. The light irradiation window is a band surrounding the sphere.
The laser light irradiation device for medical use according to claim 1, which is a window.
Place 5. A guide wire is attached to the outer cover, and the reflective film sphere is guided into the body by the guide wire.
The medical laser according to claim 1, which is configured to
Light irradiation device . 6. A medical laser light illuminating device to be inserted into the body
An optical fiber for guiding laser light and a tip of the optical fiber
Of the opaque metal reflective film that is welded to the
A reflective film sphere with a light irradiation window that is partially removed,
From a medical laser light irradiating means composed of the above, and an outer casing accommodating the medical laser light irradiating means,
The outer surface of the outer cover is provided with two parts before and after the storage position of the reflective film sphere.
Two electrodes are arranged, and the two electrodes are provided inside the outer cover.
Two conductors leading to the optical fiber are inserted through the optical fiber.
So that the guided laser light is emitted from the light irradiation window.
Medical laser irradiation instrumentation characterized that it has been configured to
Place 7. A medical optical laser light illuminating device to be inserted into the body
A plurality of optical fibers for guiding laser light and respective optical fibers.
Opaque gold that is welded to the tip of the iva and attached to its outer surface
Reflection film with a light irradiation window formed by removing a part of the metal reflection film
A plurality of medical laser light irradiation hands composed of a sphere and
A step and an outer cover for housing the plurality of medical laser light irradiation means.
And the laser light guided by the plurality of optical fibers is
Note that it was configured to illuminate from multiple light irradiation windows.
A characteristic medical laser light irradiation device.