CA1332445C - Microsurgery using alternating laser beams of different wave lengths - Google Patents
Microsurgery using alternating laser beams of different wave lengthsInfo
- Publication number
- CA1332445C CA1332445C CA 558887 CA558887A CA1332445C CA 1332445 C CA1332445 C CA 1332445C CA 558887 CA558887 CA 558887 CA 558887 A CA558887 A CA 558887A CA 1332445 C CA1332445 C CA 1332445C
- Authority
- CA
- Canada
- Prior art keywords
- laser
- argon
- yag
- keys
- photodisruptive
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Fee Related
Links
Classifications
-
- B—PERFORMING OPERATIONS; TRANSPORTING
- B23—MACHINE TOOLS; METAL-WORKING NOT OTHERWISE PROVIDED FOR
- B23K—SOLDERING OR UNSOLDERING; WELDING; CLADDING OR PLATING BY SOLDERING OR WELDING; CUTTING BY APPLYING HEAT LOCALLY, e.g. FLAME CUTTING; WORKING BY LASER BEAM
- B23K26/00—Working by laser beam, e.g. welding, cutting or boring
- B23K26/02—Positioning or observing the workpiece, e.g. with respect to the point of impact; Aligning, aiming or focusing the laser beam
- B23K26/06—Shaping the laser beam, e.g. by masks or multi-focusing
- B23K26/0604—Shaping the laser beam, e.g. by masks or multi-focusing by a combination of beams
- B23K26/0613—Shaping the laser beam, e.g. by masks or multi-focusing by a combination of beams having a common axis
-
- 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
-
- B—PERFORMING OPERATIONS; TRANSPORTING
- B23—MACHINE TOOLS; METAL-WORKING NOT OTHERWISE PROVIDED FOR
- B23K—SOLDERING OR UNSOLDERING; WELDING; CLADDING OR PLATING BY SOLDERING OR WELDING; CUTTING BY APPLYING HEAT LOCALLY, e.g. FLAME CUTTING; WORKING BY LASER BEAM
- B23K26/00—Working by laser beam, e.g. welding, cutting or boring
- B23K26/02—Positioning or observing the workpiece, e.g. with respect to the point of impact; Aligning, aiming or focusing the laser beam
- B23K26/06—Shaping the laser beam, e.g. by masks or multi-focusing
- B23K26/062—Shaping the laser beam, e.g. by masks or multi-focusing by direct control of the laser beam
- B23K26/0622—Shaping the laser beam, e.g. by masks or multi-focusing by direct control of the laser beam by shaping pulses
-
- B—PERFORMING OPERATIONS; TRANSPORTING
- B23—MACHINE TOOLS; METAL-WORKING NOT OTHERWISE PROVIDED FOR
- B23K—SOLDERING OR UNSOLDERING; WELDING; CLADDING OR PLATING BY SOLDERING OR WELDING; CUTTING BY APPLYING HEAT LOCALLY, e.g. FLAME CUTTING; WORKING BY LASER BEAM
- B23K26/00—Working by laser beam, e.g. welding, cutting or boring
- B23K26/36—Removing material
- B23K26/362—Laser etching
- B23K26/364—Laser etching for making a groove or trench, e.g. for scribing a break initiation groove
-
- 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
- A61B18/26—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 for producing a shock wave, e.g. laser lithotripsy
-
- 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
- A61B2018/2065—Multiwave; Wavelength mixing, e.g. using four or more wavelengths
- A61B2018/207—Multiwave; Wavelength mixing, e.g. using four or more wavelengths mixing two wavelengths
Landscapes
- Physics & Mathematics (AREA)
- Optics & Photonics (AREA)
- Engineering & Computer Science (AREA)
- Plasma & Fusion (AREA)
- Mechanical Engineering (AREA)
- Health & Medical Sciences (AREA)
- Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Electromagnetism (AREA)
- Otolaryngology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Laser Surgery Devices (AREA)
- Lasers (AREA)
Abstract
Abstract of the Disclosure A method and an apparatus for conducting microsurgery on human or animal tissue which includes alternately providing an Argon laser beam pulse and a YAG laser beam pulse in a cycle which is equal to or less than one second. A robotic device including piston and cylinder arrangements is provided for activating the control keys on a control panel associated with the Argon and YAG lasers.
Description
~ 3 3 ~ 4 4~
The present invention relates to a method and apparatus for conducting microsurgery, and in particular, for incising human and animal tissue with a focused light beam.
In particular, because of sharp focusing and high power, laser beams are at present used to incise material. Thus, on the one hand, laser beams are used in the manufacture of components for electronics, and in particular, in the manufacture of integrated circuits. In medicine, and particularly in ophthalmology, they are used for heat coagulating the retina and disrupting a membrane of a cataract.
If lasers, with laser beams of long pulse duration, are used (e.g., thermal lasers), the energy converted at the target point as heat also has an effect in the adjacent areas whereby a desirable heat coagulation of the incision walls is achieved, but undesirable material changes can occur outside the incision.
If lasers with very high power laser beams are used (e.g., Q switched lasers), rapid incisions can be made. However, the incision walls can be very unstable, particularly in soft materials, since the incision walls have not undergone any stabilization by heat. ~:
In the case of materials containing much fluid, human or animal tissue, fluid, such as blood, ~f , etc., penetration into the incision is effected when ;;
incising by means of a high power laser beam which is ~ ;
not coagulatedj thus leading to problems, in particular, hindrances in the application of a laser. -When the tissues of the human eye or of the human or animal body are subjected to repeated appli-cations of a thermal tlong pulse duration) or a i ;~
photodisruptive type (short pulse duration) of laser, it becomes obvious that the same laser discharge on the same tissue achieves progressively diminished results. -'.,' ,'~','.'", ' '-", -~ 3 3 ~
In the case of the thermal (Ar) laser, it is due to an increased blanching of the tissue that the beam is reflected. In the case of the photodisruptive laser (YAG), it is the debris within the cut created by the laser and pressure from the adjacent tissue that prevents efficient tissue tunneling. Neither type of laser is able to achieve by itself efficient tunneling through solid tissue.
Surgical treatment requires the ability to create channels through solid tissue to form shunts and bypasses for the passage of body fluids or to penetrate through tissue to reach the object of surgery.
It is an object of the present invention to provide an apparatus for incising with a sharply focused laser beam, with which in particular blood fluid containing tissue can be cut with high efficiency.
A method in accordance with the present invention includes the steps of causing an incision in animal or human tissue comprising the steps of producing a first laser beam from a laser source consistiny of one of a photodisruptive laser and a thermal laser directing the first laser beam to the target area for a predetermined pulse duration and immediately successively producing a second laser beam from a second source consisting of the other photodisruptive laser and the thermal laser for a pulse of a predetermined duration to complete a cycle for a complete duration of one second or less, and repeating ! ' 301 the cycle.
In a more specific embodiment of the present method, the first and second laser beams are directed confocally onto the target area in alternating pulses.
An apparatus in accordance with the present invention comprises a housing, a first laser means producing a photodisruptive laser beam, a second laser means producing a thermal laser beam, means for .
13324~
directing the laser beams from the first and second laser means along a confocal path from the housing to a target, switching means for alternately directing the photodisruptive beam and the thermal beam in successive pulse durations for a complete cycle of a duration of one second or less.
In a more specific embodiment of the present invention, the thermal laser is an Argon laser while the photodisruptive laser is an Nd:YAG laser.
The alternative application of different types of lasers is of advantage. The energy of the laser beam of the thermal laser is converted in the tissue to heat.
It has been found that the alternating treatment of successive Argon laser beams and Nd:YAG
laser beams allows a deeper incision in the tissue. If an Nd:YAG laser discharge precedes an Argon laser application, the Nd:YAG laser cuts the tissue while the Argon laser coagulates the tissue. The cut of the Nd:YAG laser then penetrates the photocoagulated tissue at the target and reaches a deeper stratum which is not affected by the previous coagulation. The Argon laser beam passes through the incision and is efficiently absorbed, and the repeated alternating effect of the Argon-Nd:YAG laser discharges creates a cavity in the tissue with coagulated tissue walls.
The subsequent discharge of photodisruptive energy by the Nd:YAG laser of a second alternating cycle provides an implosive force within the same 30~ space. It disrupts the coagulated walls and expands the tunneling further. This action creates favourable conditions for another alternating laser cycle for further penetration.
The combined forces of the alternating beams is greater than each separate laser can provide alone.
The explosive pressure of the Argon laser depends on discharge in the narrow space provided by the Nd:YAG
.
,.:, 324~
laser's incision. The efficient transformation of these forces into mechanical energy prevents laser radiation overdosage.
It has been found that the alternating cycle of the laser beams must be accomplished within a time span of less than one second.
Having thus generally described the nature of the invention, reference will now be made to the accompanying drawings, showing by way of illustration, a preferred embodiment thereof, and in which:
Fig. 1 is a schematic diagram of a typical arrangement for producing two alternating laser beams of different wave lengths; and Fig. 2 is a schematic diagram of a typical robotic switching device which could be used with the apparatus illustrated schematically in Fig. 1.
Referring now to the drawings, there is shown a housing 10 within which is provided a typical Argon laser 12 and an Nd:YAG laser 14. A control panel 16 is arranged in the housing. The control panel includes manual command keys for the YAG laser (COHERENT System 9900). These command keys may include a STANDBY key 26 and a DISCHARGE key 28. A READY key 30 and an ARGON key 32 are also provided in line on the control panel. A robotic switching device 34, as shown in Fig. 2, would be located over the manual keys as shown in dotted lines in Fig. 1. The robotic device 34 would include piston and cylinder arrangements 36, 38, 40, and 42, which correspond to manual keys 26, 28, 30, 30~ and 32. The piston and cylinder arrangements, as is well known, may be pneumatic and may be electronically or electrically activated and may be controlled by a computer (not shown).
In order that the beams produced respectively from the Argon laser 12 and the YAG laser 14 be confocal, a series of mirrors 18, 20, 22, and 24, which are well known from the prior art, are located in ~" , ~"
~ 5 ~ 1332~
order to direct the laser beams as required. An on-off -trigger 44 activates the sequence, but a controllinq foot switch 46 may be provided in order to include a - :
double safety control ~ -The robotic device 34 is included in order :
to provide a cycle within one second which includes in one typical sequence the activation of the STANDBY key ~
26 by means of the corresponding piston 36 in the robot .
device 34 followed by the activation of the ARGON key 10 32 by the respective piston 42. This activation will ; ~:
provide the first laser discharge, and then the READY . .
key 28 must be activated by the respective piston 38 in ~.
order to discharge the YAG laser beam by means of the :: `i YAG key 30. The cycle is repeated by starting over: .
again with the STANDBY key 26. :
:,.~ ,. ': ' '"
,.
~ ,''. :"
The present invention relates to a method and apparatus for conducting microsurgery, and in particular, for incising human and animal tissue with a focused light beam.
In particular, because of sharp focusing and high power, laser beams are at present used to incise material. Thus, on the one hand, laser beams are used in the manufacture of components for electronics, and in particular, in the manufacture of integrated circuits. In medicine, and particularly in ophthalmology, they are used for heat coagulating the retina and disrupting a membrane of a cataract.
If lasers, with laser beams of long pulse duration, are used (e.g., thermal lasers), the energy converted at the target point as heat also has an effect in the adjacent areas whereby a desirable heat coagulation of the incision walls is achieved, but undesirable material changes can occur outside the incision.
If lasers with very high power laser beams are used (e.g., Q switched lasers), rapid incisions can be made. However, the incision walls can be very unstable, particularly in soft materials, since the incision walls have not undergone any stabilization by heat. ~:
In the case of materials containing much fluid, human or animal tissue, fluid, such as blood, ~f , etc., penetration into the incision is effected when ;;
incising by means of a high power laser beam which is ~ ;
not coagulatedj thus leading to problems, in particular, hindrances in the application of a laser. -When the tissues of the human eye or of the human or animal body are subjected to repeated appli-cations of a thermal tlong pulse duration) or a i ;~
photodisruptive type (short pulse duration) of laser, it becomes obvious that the same laser discharge on the same tissue achieves progressively diminished results. -'.,' ,'~','.'", ' '-", -~ 3 3 ~
In the case of the thermal (Ar) laser, it is due to an increased blanching of the tissue that the beam is reflected. In the case of the photodisruptive laser (YAG), it is the debris within the cut created by the laser and pressure from the adjacent tissue that prevents efficient tissue tunneling. Neither type of laser is able to achieve by itself efficient tunneling through solid tissue.
Surgical treatment requires the ability to create channels through solid tissue to form shunts and bypasses for the passage of body fluids or to penetrate through tissue to reach the object of surgery.
It is an object of the present invention to provide an apparatus for incising with a sharply focused laser beam, with which in particular blood fluid containing tissue can be cut with high efficiency.
A method in accordance with the present invention includes the steps of causing an incision in animal or human tissue comprising the steps of producing a first laser beam from a laser source consistiny of one of a photodisruptive laser and a thermal laser directing the first laser beam to the target area for a predetermined pulse duration and immediately successively producing a second laser beam from a second source consisting of the other photodisruptive laser and the thermal laser for a pulse of a predetermined duration to complete a cycle for a complete duration of one second or less, and repeating ! ' 301 the cycle.
In a more specific embodiment of the present method, the first and second laser beams are directed confocally onto the target area in alternating pulses.
An apparatus in accordance with the present invention comprises a housing, a first laser means producing a photodisruptive laser beam, a second laser means producing a thermal laser beam, means for .
13324~
directing the laser beams from the first and second laser means along a confocal path from the housing to a target, switching means for alternately directing the photodisruptive beam and the thermal beam in successive pulse durations for a complete cycle of a duration of one second or less.
In a more specific embodiment of the present invention, the thermal laser is an Argon laser while the photodisruptive laser is an Nd:YAG laser.
The alternative application of different types of lasers is of advantage. The energy of the laser beam of the thermal laser is converted in the tissue to heat.
It has been found that the alternating treatment of successive Argon laser beams and Nd:YAG
laser beams allows a deeper incision in the tissue. If an Nd:YAG laser discharge precedes an Argon laser application, the Nd:YAG laser cuts the tissue while the Argon laser coagulates the tissue. The cut of the Nd:YAG laser then penetrates the photocoagulated tissue at the target and reaches a deeper stratum which is not affected by the previous coagulation. The Argon laser beam passes through the incision and is efficiently absorbed, and the repeated alternating effect of the Argon-Nd:YAG laser discharges creates a cavity in the tissue with coagulated tissue walls.
The subsequent discharge of photodisruptive energy by the Nd:YAG laser of a second alternating cycle provides an implosive force within the same 30~ space. It disrupts the coagulated walls and expands the tunneling further. This action creates favourable conditions for another alternating laser cycle for further penetration.
The combined forces of the alternating beams is greater than each separate laser can provide alone.
The explosive pressure of the Argon laser depends on discharge in the narrow space provided by the Nd:YAG
.
,.:, 324~
laser's incision. The efficient transformation of these forces into mechanical energy prevents laser radiation overdosage.
It has been found that the alternating cycle of the laser beams must be accomplished within a time span of less than one second.
Having thus generally described the nature of the invention, reference will now be made to the accompanying drawings, showing by way of illustration, a preferred embodiment thereof, and in which:
Fig. 1 is a schematic diagram of a typical arrangement for producing two alternating laser beams of different wave lengths; and Fig. 2 is a schematic diagram of a typical robotic switching device which could be used with the apparatus illustrated schematically in Fig. 1.
Referring now to the drawings, there is shown a housing 10 within which is provided a typical Argon laser 12 and an Nd:YAG laser 14. A control panel 16 is arranged in the housing. The control panel includes manual command keys for the YAG laser (COHERENT System 9900). These command keys may include a STANDBY key 26 and a DISCHARGE key 28. A READY key 30 and an ARGON key 32 are also provided in line on the control panel. A robotic switching device 34, as shown in Fig. 2, would be located over the manual keys as shown in dotted lines in Fig. 1. The robotic device 34 would include piston and cylinder arrangements 36, 38, 40, and 42, which correspond to manual keys 26, 28, 30, 30~ and 32. The piston and cylinder arrangements, as is well known, may be pneumatic and may be electronically or electrically activated and may be controlled by a computer (not shown).
In order that the beams produced respectively from the Argon laser 12 and the YAG laser 14 be confocal, a series of mirrors 18, 20, 22, and 24, which are well known from the prior art, are located in ~" , ~"
~ 5 ~ 1332~
order to direct the laser beams as required. An on-off -trigger 44 activates the sequence, but a controllinq foot switch 46 may be provided in order to include a - :
double safety control ~ -The robotic device 34 is included in order :
to provide a cycle within one second which includes in one typical sequence the activation of the STANDBY key ~
26 by means of the corresponding piston 36 in the robot .
device 34 followed by the activation of the ARGON key 10 32 by the respective piston 42. This activation will ; ~:
provide the first laser discharge, and then the READY . .
key 28 must be activated by the respective piston 38 in ~.
order to discharge the YAG laser beam by means of the :: `i YAG key 30. The cycle is repeated by starting over: .
again with the STANDBY key 26. :
:,.~ ,. ': ' '"
,.
~ ,''. :"
Claims (3)
1. An apparatus for causing an incision on human or animal tissue, including a housing, a first laser means producing a Q-switched photodisruptive laser beam, a second laser means producing a continuous wave ion laser beam, means for directing the laser beams from the first and second laser means along a confocal path from the housing to a target, switching means for alternately directing the Q-switched photodisruptive beam and the continuous wave beam in successive pulse durations for a complete cycle of a duration of one second or less.
2. An apparatus as defined in claim 1, wherein the first laser means is an Nd:YAG laser and the second laser means is an Argon laser.
3. An apparatus as defined in claim 2, wherein the switching means includes a robotic device including a plurality of piston and cylinder arrangements and the housing includes a control panel with manual keys on the control panel representing the respective Argon and YAG lasers and separate pistons of the piston and cylinder arrangements are in line with the keys in order to activate the keys in response to a command received by the robotic device.
Priority Applications (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CA 558887 CA1332445C (en) | 1988-02-15 | 1988-02-15 | Microsurgery using alternating laser beams of different wave lengths |
| DE19893904287 DE3904287C2 (en) | 1988-02-15 | 1989-02-14 | Device for cutting with laser beams |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CA 558887 CA1332445C (en) | 1988-02-15 | 1988-02-15 | Microsurgery using alternating laser beams of different wave lengths |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CA1332445C true CA1332445C (en) | 1994-10-11 |
Family
ID=4137448
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA 558887 Expired - Fee Related CA1332445C (en) | 1988-02-15 | 1988-02-15 | Microsurgery using alternating laser beams of different wave lengths |
Country Status (2)
| Country | Link |
|---|---|
| CA (1) | CA1332445C (en) |
| DE (1) | DE3904287C2 (en) |
Families Citing this family (8)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US5769840A (en) * | 1988-04-19 | 1998-06-23 | Schirmer; Kurt E. | Microsurgery using alternating disruptive and thermal laser beam pulses |
| DE4033166A1 (en) * | 1990-10-19 | 1992-04-23 | Bergmann Hans Wilhelm | METHOD FOR COUPLING CW-CO (DOWN ARROW) 2 (DOWN ARROW) LASER BEAMS |
| CA2043072A1 (en) * | 1991-05-23 | 1992-11-24 | Kurt E. Schirmer | Device for making surgical incisions with combined thermal and ionizing laser beams |
| WO1993021843A1 (en) * | 1992-05-05 | 1993-11-11 | Coherent, Inc. | Device and method for variably blending multiple laser beams for medical purposes |
| US5375132A (en) * | 1993-05-05 | 1994-12-20 | Coherent, Inc. | Solid state laser with interleaved output |
| DE19521003C1 (en) * | 1995-06-08 | 1996-08-14 | Baasel Carl Lasertech | Pulsed light source for removing biological tissue |
| DE10006516C2 (en) * | 2000-02-15 | 2002-01-10 | Datacard Corp | Process for processing workpieces using multiple laser beams |
| DE10233662B4 (en) | 2002-07-24 | 2004-07-22 | Uhu Gmbh & Co. Kg | Filling system for a product made of viscous material |
Family Cites Families (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| GB2175737A (en) * | 1985-05-09 | 1986-12-03 | Control Laser Limited | Laser material processing |
| DE3714504A1 (en) * | 1987-04-30 | 1988-11-10 | Lambda Physik Gmbh | Method of working materials with laser beams |
-
1988
- 1988-02-15 CA CA 558887 patent/CA1332445C/en not_active Expired - Fee Related
-
1989
- 1989-02-14 DE DE19893904287 patent/DE3904287C2/en not_active Expired - Fee Related
Also Published As
| Publication number | Publication date |
|---|---|
| DE3904287A1 (en) | 1989-09-07 |
| DE3904287C2 (en) | 1996-08-14 |
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Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| MKLA | Lapsed |