JPH06169929A - Laser light irradiator for medical treatment - Google Patents

Abstract

PURPOSE:To provide a laser light irradiator for medical irradiation which enables the irradiation of a required part inside a blood vessel, a digestive apparatus or the like with a laser light (including general rays) to be transmitted with an optical fiber at an arbitrary angle of refraction. CONSTITUTION:In this laser light irradiator for medical treatment, a transparent ball 2 made of glass or a resin is welded at the tip of an optical fiber 1 and an opaque metal reflection film 3 is attached onto an outer surface of the transparent ball to form an integrating sphere 5 and the reflection film is removed at a position equivalent to an arbitrary angle alpha of refraction (0 deg.<alpha<180 deg.) to from an irradiation window 4. The fiber and the integrating sphere are housed in a sheath or a cannula 6 so as not to cover the irradiation window. This constitution allows the apparatus to be built in various catheters, balloons and the like to accomplish an accurate irradiation of a laser light from right near a lesion part in the treatment and diagnosis of a blood vessel, a digestive organ or the like thereby contributing to improvements in medical treatment.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a medical laser beam irradiating device, and more specifically, the present invention relates to a laser beam and other light beams in general in the vicinity of an irradiation target region as a medical treatment for blood vessels or digestive organs or as an endoscope. The present invention relates to a medical laser light irradiation device capable of refracting light at a required angle for irradiation. In addition, for convenience of description, the term "laser light" is used throughout the specification to broadly mean not only so-called laser light but also light rays in general.

[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 if 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", which includes a contact tip 3 in combination with a concave lens 28.
A device based on the idea of expanding the irradiation range by attaching a contact member consisting of 0 to the tip of the optical fiber 2 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 right angle. For example, even if the contact member as shown in this publication is attached to the tip of a catheter that is inserted almost parallel to the tissue M, the laser beam is directed at a right angle to the target region immediately next to the contact member. It is impossible to bend and irradiate. It is said that such right angle or near refraction of the laser beam is desirable for endovascular treatment, digestive organ 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 can be refracted at a required refraction angle in the vicinity of the tip of the fiber to accurately irradiate the target area. The object is to provide a laser irradiation device.

[0005]

Therefore, according to the present invention, a transparent sphere made of glass or plastic is welded to the tip irradiation part of a light guide part made of an optical fiber, and an opaque metal reflection film is formed on the entire outer peripheral surface of the transparent sphere. An integrating sphere is formed at the tip of the fiber by attaching it by a technique such as sputtering or vacuum deposition, and an arbitrary part of the opaque metal reflection film on the integrating sphere, that is, a refraction angle of laser light (0 ° or more) to be realized. (180 ° or less) is removed in a required size and shape to form a laser beam irradiation window, and an optical fiber and an integrating sphere are provided in a protective tube or a sleeve such as a stainless pipe so as not to cover the irradiation window. It is housed in and constitutes the basic part of the medical laser light irradiation device. As a result, the laser light uniformly reflected in the integrating sphere is concentratedly emitted from the irradiation window formed at a desired angle with respect to the optical axis to the target location. It is refracted and irradiated at an arbitrary required angle such as a right angle or more.

In the present invention, the transparent sphere may have a diameter approximately equal to the diameter of the optical fiber to approximately twice the diameter. Therefore, according to the present invention, it is possible to insert the optical fiber 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 refract and irradiate laser light 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 integrating sphere can be formed in various shapes, sizes and numbers. Eg 1 circular window, 2
Various irradiation windows can be realized according to the application, such as one or more circular windows, a slot-shaped oval window, or a strip-shaped window surrounding the entire circumference of the integrating sphere. The positions of these irradiation windows can be arbitrarily selected so as to achieve a desired refraction angle with respect to the optical axis. The refraction angle α with respect to the optical axis can be generally selected within the range of 0 ° <α <180 °,
The position of the irradiation window is determined on the integrating 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, a laser catheter for cauterization of lesions in blood vessels, a diagnostic catheter in combination with a gastrointestinal endoscope or a laparoscope, a laser balloon catheter, or an electrode catheter for treating arrhythmia,
An actual medical device can be realized by incorporating the laser light irradiation device of the present invention into the above. 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 cutaway 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 transparent end of the optical fiber 1 (right end in the figure) is transparent. A sphere 2, that is, a glass sphere or a plastic sphere 2 is welded, and an opaque metal reflection film 3 is formed on the surface of the transparent sphere 2 by spatter coating or vacuum deposition to form an integrating sphere 5.
Are configured. Preferably, the metal film 3 is preferably 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 integrating sphere 5. Since it is preferable that the films 3 and 3a are as thick as possible for the purpose of reinforcement, a relatively thick reinforcing film made of metal may be formed by sputtering and further plating.

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 enters the integrating sphere 5 from the tip of the fiber and is uniformly dispersed and reflected on the inner surface of the film 3. In other words, it is reflected so many times within a sphere that it flies, but it finds an exit in the window 4 and linearly emits in the direction of the line L from there (the line L is called the refraction irradiation direction). According to the present invention, the irradiation window 4 can be formed in an arbitrary position so as to realize a required refraction irradiation direction within the range of 0 ° <α <180 ° depending on the application of the laser light. Further, the number of irradiation windows is not limited to one, and a desired number can be provided and the shape can be changed as shown in FIG.
Although the example is circular when viewed from above, it can be formed in various other shapes. In the illustrated example, the axis of the optical fiber 1 and the center of the integrating sphere 5 are shown to be 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. it can.

The fiber 1 and the integrating sphere 5 are housed in a flexible jacket or sleeve 6 such as a stainless pipe so as not to cover the irradiation window 4, and the medical laser light irradiation of the present invention is performed. It constitutes the basic form of the device. In FIG. 1, the sleeve 6
The tip of the tube ends just near the irradiation window 4, but the sleeve 6 extends beyond the integrating sphere 5 (see FIG.
2), it is necessary to form 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 correspondingly, the welding portion of the glass sphere 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.

The optical fiber 1 used in the present invention has an extremely thin diameter of about 0.05 to 0.3 mm.
It is possible to use glass fibers or plastic fibers of various diameters up to a visible thickness.
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, and any light-impermeable 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, the irradiation window of the integrating sphere 5 has a strip shape 1 around the entire circumference of the sphere.
4 shows an example formed. 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 irradiation window 14 is formed on a surface that is substantially perpendicular to the incident axis of the laser light (L in FIG. 1), but the irradiation window can be formed 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 vascular treatment. . The optical fiber 1 and the integrating sphere 5 welded to the tip thereof are housed in a jacket or a sleeve 6 extending beyond the integrating sphere, and an opening is formed in a portion of the sleeve 6 corresponding to the irradiation window 4. Thin tip 6a of sleeve 6
A guide wire 7 made of a spring wire is attached to the. Such a catheter is guided in a blood vessel B by a guide wire, and when the built-in integrating sphere 5 reaches a lesion (atheroma layer) A, laser light is emitted in the direction almost perpendicular to the optical axis from the immediate vicinity thereof. Irradiation can be used to cauterize the lesion. Unlike conventional irradiation, which is almost parallel to the optical axis or slightly conical, the irradiation can be performed almost from the side of the lesion, so treatment can be performed accurately, in a short time, and with a minimum dose. There is an advantage that the treatment can be performed with laser irradiation. As a modification of the embodiment shown in FIG. 3, the guide wire 7 may be penetrated by the optical fiber 1 and the integrating sphere 5 may be projected 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 integrating sphere 5 and the optical fiber 1 are housed in the jacket 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 jacket. The mounting position of the tab 9 is not limited. The integrating sphere 5 of this example has the irradiation window 4 formed at a position of α≈135 °. No apparatus has hitherto been known that can irradiate a laser beam onto a region having a spread of about 45 ° with respect to the emitting tip, and no apparatus that can irradiate a laser beam locally at a desired angle has hitherto been known. 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 at an arbitrary position. Light guide 1 with integrating sphere 5 having 4
0, the image fiber 11 and the flash channel 12 and a part of the diagnostic catheter fixedly incorporated in the sleeve 13. (B) shows an apparatus in which the integrating sphere 5 fixed to the jacket 6 housed in the flash channel 15 so as to be able to be taken in and out is housed in the sleeve 13 together with the image fiber 11 and the light guide 10. 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.
FIG. 3 is a view of a diagnostic / treatment device in which a plurality of integrating spheres 5 fixed to a plurality of fibers are arranged around a channel 17 for inserting a guide wire or the like which is inserted through the inside of 6 at a substantially central portion, as seen from an end face. Irradiation window 4 formed at a required position on integrating sphere 5.
Thus, a clear and accurate diagnosis of a lesion can be performed by a plurality of laser beams emitted in a concentrated manner. (B) is a partial side view of the therapeutic laser instrument in which several integrating spheres 5 fixed to the tip of the excitation or fluorescence fiber 18 are housed in the outer cylinder 16. Of course, each integrating sphere 5 is provided with a laser beam irradiation window of a required shape at a required position, but it is omitted in the drawing.

FIG. 7 is similar to FIG. 6, but is an end view showing an example in which integrating spheres are arrayed in a multiple manner.
And a small number of integrating spheres 25 having a slightly smaller diameter are arranged between the inner tube 19 and the outer tube 20 around it. An irradiation window 24 is formed at a required position on each of the integrating spheres 25.

FIG. 8 is a schematic sectional view showing an example in which the laser light irradiation apparatus of the present invention is incorporated into a laser balloon catheter. An integrating sphere 5 is fixed to the tip of the transmission fiber 1 as having a band-shaped irradiation window 4. , Located within the balloon 26. 3a is a metal film for strengthening the adhesion between the integrating 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 integrating sphere 5, and a 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. The integrating sphere 5 fixed to the tip of the optical fiber 1 is irradiated in the same manner as the above-mentioned examples. It has a window 4 and is arranged almost in the middle between the tip electrode 28 and the front electrode 29 in the jacket 27. Conductive wire 30 leading to the tip electrode 28 and the electrode 2 in front
The conducting wire 31 leading to 9 is 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 integrating sphere 5 can be arranged so as to face the tip electrode 28.

Finally, FIG. 10 shows an example in which the integrating sphere also serves as one electrode in the electrode catheter as in the previous example. That is, the integrating sphere 35 having the irradiation window 34 fixed to the tip of the fiber 1 is projected from the jacket 27 and connected to the power source through the conductor 30. Front electrode 29
Is similar to the example of FIG.

[0022]

As described above, according to the present invention, an integrating sphere having an irradiation window formed at a position corresponding to an arbitrary refraction angle is welded to the tip of an optical fiber for transmitting laser light. Since the medical laser light irradiation device is configured by housing the flexible fiber in a flexible jacket or sleeve, when the optical fiber is tightly inserted into an extremely thin passage or conduit such as a blood vessel or digestive organ. Also, it becomes possible to accurately irradiate the laser beam at a right angle to the passage wall or the tube wall or at a desired specific angle. This is expected to have the effect of expanding the use of laser light in the medical field and opening up new ways of laser light treatment and diagnosis that have not been attempted in the past. In particular, in the case of laser light used in the medical field, it is necessary to accurately guide the laser light to the target area because the treatment and diagnosis such as coagulation and cauterization are performed by inserting an optical fiber into the human body. In this case, 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. Conventionally, a device that enables this easily While this has not been realized, the present invention certainly enables 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 shows a medical laser light irradiation apparatus of the present invention,
It is a schematic sectional drawing which shows the example implemented as a variable light type laser catheter with a guide wire.

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

FIG. 5 shows a medical laser light irradiation apparatus of the present invention,
An example implemented as an endoscopic and laparoscopic combination laser catheter for blood vessels, digestive organs, etc., (A) is a built-in integrating sphere type, (B) is a removable perspective view, respectively.

FIG. 6 shows a laser beam irradiation apparatus of the present invention for exciting and
It is an end view (A) and partial side view (B) which show two examples implemented as a laser catheter for the diagnosis and treatment of the hardening lesion by fluorescence.

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

FIG. 8 is a schematic sectional view showing an example in which the medical laser beam 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 integrating 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 ... Integrating sphere 6, 13, 16, 27 ... Envelope or sleeve 14 ... Other examples of irradiation window 26 ... Balloon 28, 29 ... Electrode 35 ... Electrode integrating sphere

Claims (10)

[Claims] 1. A transparent sphere is welded to the tip of a light guide portion made of an optical fiber, and an opaque metal reflection film is adhered to the entire outer peripheral surface of the transparent sphere to form an integrating sphere, which has an arbitrary refraction angle with respect to the optical axis. A part of the opaque metal reflection film on the integrating sphere corresponding to α is removed to form a laser light irradiation window, and the optical fiber and the integrating sphere are housed in the outer cover so as not to cover the irradiation window. A laser light irradiation device for medical use characterized in that a laser light traveling in an optical fiber is refracted and irradiated at an arbitrary angle. 2. The apparatus according to claim 1, wherein the irradiation window is a window formed by removing a part of the opaque metal reflection film into a single circle. 3. The apparatus according to claim 1, wherein the irradiation window is a window formed by removing a part of an opaque metal reflection film into two or more circular shapes. 4. The apparatus according to claim 5, wherein the irradiation window is a window formed by removing a part of the opaque metal reflection film in a strip shape. 5. The apparatus of claim 1, wherein the integrating sphere is mounted within a jacket with a guide wire. 6. The apparatus according to claim 1, wherein the integrating sphere is fixedly or movably housed in an outer casing together with a light guide, an image fiber, a flash channel and the like. 7. The apparatus according to claim 1, wherein a plurality of the integrating spheres are housed in an outer cover. 8. The device of claim 1, wherein the integrating sphere is contained within a balloon. 9. The apparatus of claim 1, wherein the integrating sphere is contained within an electrode catheter. 10. The device according to claim 1, wherein the integrating sphere also serves as one electrode of the electrode catheter.