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DE2826383A1 - Probe for laser surgery - is tubular and placed against or inserted in tissue, with or without heated end - Google Patents

Probe for laser surgery - is tubular and placed against or inserted in tissue, with or without heated end

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Publication number
DE2826383A1
DE2826383A1 DE19782826383 DE2826383A DE2826383A1 DE 2826383 A1 DE2826383 A1 DE 2826383A1 DE 19782826383 DE19782826383 DE 19782826383 DE 2826383 A DE2826383 A DE 2826383A DE 2826383 A1 DE2826383 A1 DE 2826383A1
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Germany
Prior art keywords
tissue
probe
laser beam
end piece
tubular
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.)
Withdrawn
Application number
DE19782826383
Other languages
German (de)
Inventor
Juergen Prof Dr Eichler
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Individual
Original Assignee
Individual
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Publication date
Application filed by Individual filed Critical Individual
Priority to DE19782826383 priority Critical patent/DE2826383A1/en
Publication of DE2826383A1 publication Critical patent/DE2826383A1/en
Withdrawn legal-status Critical Current

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    • 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
    • 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
    • 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
    • A61B18/24—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 with a catheter
    • 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
    • A61B18/28—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 heating a thermal probe or absorber
    • 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636—Sensing and controlling the application of energy
    • 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
    • A61B2018/2238—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 with means for selectively laterally deflecting the tip of the fibre
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2218/00—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2218/001—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body having means for irrigation and/or aspiration of substances to and/or from the surgical site
    • A61B2218/007—Aspiration
    • A61B2218/008—Aspiration for smoke evacuation

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  • Physics & Mathematics (AREA)
  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Optics & Photonics (AREA)
  • Engineering & Computer Science (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Biomedical Technology (AREA)
  • Electromagnetism (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Otolaryngology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Thermal Sciences (AREA)
  • Plasma & Fusion (AREA)
  • Mechanical Engineering (AREA)
  • Laser Surgery Devices (AREA)

Abstract

The probe guides a laser beam during a surgical operation. It is tubular, being placed directly against or inserted in the tissue. There can be an end piece (40) with absorbent surface, heated by the beam and in contact with the tissue, or alternatively transparent and through which the beam passes. As a further alternative there can be a light-conductive fibre in direct contact with the tissue, a further part of the probe being preferably also in contact with the tissue simultaneously.

Description

Sonde für die Laser-Chirurgie Probe for laser surgery

Die Erfindung betrifft eine Sonde der im Oberbegriff des Patentanspruchs 1 als bekannt vorausgesetzten Art.The invention relates to a probe in the preamble of the claim 1 Art.

In der Laser-Chirurgie wird Gewebe mit Laserstrahlung bestrahlt, und eine Reihe von insbesondere thermochemischen Reaktionen, z.B.In laser surgery, tissue is irradiated with laser radiation, and a number of particularly thermochemical reactions, e.g.

Koagulation, Verkochung, wird medizinisch nutzbar gemacht. Um den Laserstrahl auf die gewünschte Gewebestelle zu richten, sind flexible oder starre Strahlführungssysteme erforderlich, die mit einem Endstück oder einer Sonde versehen sind. Diese Sonde, aus der der Laserstrahl aus tritt, wird von der Hand des Chirurgen geführt.Coagulation, boiling, is made medically useful. To the Aiming the laser beam at the desired tissue location are flexible or rigid Beam guidance systems are required, which are provided with an end piece or a probe are. This probe, from which the laser beam emerges, is held by the surgeon's hand guided.

Bisher wurde mit der Sonde das Gewebe in der Regel nicht berührt.So far, the tissue has not usually been touched with the probe.

Dabei besteht insbesondere in engen Körperhöhlen die Gefahr der Verschmutzung der optischen Austrittfläche für den Laserstrahl durch Gewebedampf oder Sekrete. Diese Verschmutzung führt zu einer starken Auffächerung des Laserstrahls durch Lichtstreuung, und durch Absorption zu einer Erwärmung und Zerstörung der optischen Austrittsfläche, da die entstehende Wärme schlecht abgeführt wird.There is a risk of contamination, especially in narrow body cavities the optical exit surface for the laser beam through tissue vapor or secretions. This pollution leads to a strong fanning out of the laser beam due to light scattering, and through absorption to a heating and destruction of the optical exit surface, because the heat generated is poorly dissipated.

Weiterhin besteht bei der Erzeugung kleiner Läsionen beim berührungslosen Vorgehen die Gefahr des Wackelns. Ein weiterer Nachteil des bisherigen laser-chirurgischen Verfahrens besteht darin, daß Läsionen nur an der Gewebeoberfläche erzeugt werden können.Furthermore, there is the non-contact method of generating small lesions Approach the risk of wobbling. Another disadvantage of previous laser surgery The method is that lesions are created only on the surface of the tissue can.

Der vorliegenden Erfindung liegt die Aufgabe zugrunde, eine Sonde derart auszugestalten, daß entweder eine Verschmutzung der optischen Austrittsfläche für den Laserstrahl nicht auftreten kann, oder daß beim Auftreten einer Verschmutzung der Energietransport vom Laserstrahl ins Gewebe nur unwesentlich beeinflußt wird. Beim Auftreten einer Verschmutzung besteht die Aufgabe, die an der optischen Austrittsfläche für den Laserstrahl entstehende Wärme abzuführen, um eine Zerstörung zu vermeiden. Weiterhin ist die Gefahr des Wackelns zu vermeiden, und eine laser-chirurgische Anwendung in tieferen Gewebsbereichen zu ermöglichen.The present invention is based on the object of a probe designed in such a way that either contamination of the optical exit surface for the laser beam can not occur, or that when contamination occurs the energy transport from the laser beam into the tissue is only insignificantly influenced. If soiling occurs, the task is to act on the optical exit surface to dissipate the heat generated by the laser beam in order to avoid destruction. Furthermore, the risk of wobbling is to be avoided and laser-surgical To enable application in deeper tissue areas.

Diese Aufgabe wird erfindungsgemäß durch eine Sonde der eingangs genannten Art gelöst, die rohrförmig ist und das Gewebe direkt berührt oder in das Gewebe eingestochen wird.According to the invention, this object is achieved by a probe of the type mentioned at the beginning Kind of dissolved, which is tubular and touches the tissue directly or into the tissue is stabbed.

Dadurch, daß erfindungsgemäß der Laserstrahl in der Sonde eine lichtundurchlässige Schicht bestrahlt, die direkt auf das Gewebe gedrückt wird, findet ein Transport von thermischer Energie in das Gewebe statt, wobei die optische Austrittsfläche für den Laserstrahl gegen Verschmutzung vollständig geschützt ist. In einer anderen Ausführungsform der Erfindung kann der Laserstrahl durch ein lichtdurchlässiges Medium, das die optische Austrittsfläche für den Laserstrahl darstellt und direkt das Gewebe berührt, auf das Gewebe gestrahlt werden. Selbst bei totaler Verschmutzung der optischen Austrittsfläche findet ein Transport von thermischer Energie in das Gewebe statt. Zur Behandlung tief liegender Gewebsbereiche kann die Sonde erfindungsgemäß in das Gewebe eingestochen werden, wobei der Sondendurchmesser sehr gering gehalten werden kann.Because, according to the invention, the laser beam in the probe is an opaque one Irradiated layer that is pressed directly onto the tissue finds a transport of thermal energy held in the tissue, the optical exit surface for the laser beam is completely protected against contamination. In another Embodiment of the invention, the laser beam can pass through a light Medium that represents the optical exit surface for the laser beam and directly touches the tissue, blasted onto the tissue. Even with total pollution thermal energy is transported into the optical exit surface Tissue instead. According to the invention, the probe can be used to treat deep-lying tissue areas are pierced into the tissue, the probe diameter being kept very small can be.

Die mit der Erfindung erzielten Vorteile liegen insbesondere darin, daß d ædasVerschmutzungsproblem der optischen Austrittsfläche gelöst ist, daß ein Wackeln bei der manuellen Führung der Sonder verhindert wird und daß tiefere Gewebeschichten und unzugängliche Körperhöhlen behandelt werden können.The advantages achieved with the invention are, in particular, that the problem of contamination of the optical exit surface is solved, that a Wiggling in the manual guidance of the special is prevented and that deeper tissue layers and inaccessible body cavities can be treated.

Im folgenden werden bevorzugte Ausführungsformen der Erfindung anhand von Zeichnungen zur Erläuterung weiterer Merkmale beschrieben.Preferred embodiments of the invention will now be described with reference to of drawings to explain further features.

Es zeigen: Fig. 1 eine vereinfachte Darstellung einer Sonde zum Aufsetzen auf das Gewebe gemäß einer Ausführungsform der Erfindung; Fig. 2, weitere vereinfachte Darstellungen einer Sonde zum Aufsetzen 3 und 4 auf das Gewebe gemäß anderen Ausführungsformen der Erfindunc; Fig. 5 eine vereinfachte Darstellung einer Sonde zum Einstechen ins Gewebe gemäß einer Ausführungsform der Erfindung; Fig. 6 die Anwendung einer Sonde gemäß Fig. 5 in einer Körperhöhle.The figures show: FIG. 1 a simplified representation of a probe for placement on the fabric according to one embodiment of the invention; Fig. 2, further simplified Representations of a probe for placement 3 and 4 on the tissue according to other embodiments the invention; 5 shows a simplified representation of a probe for piercing into Fabric according to one embodiment of the invention; 6 shows the use of a probe according to FIG. 5 in a body cavity.

In Fig. 1 ist eine Sonde zum Aufsetzen auf das Gewebe gemäß der Erfindung im Längsschnitt dargestellt. Die Laserstrahlung wird in einer ummantelten Lichtleitfaser 1 im Innern eines Rohres 2 geführt Die Laserstrahlung 3 tritt am Ende der Lichtleitfaser 1 aus und bestrahlt das Innere des Endstückes 40, das einen hohen Absorptionskoeffizienten für die Laserstrahlung 3 hat. Das Endstück 40 besteht vorzugsweise aus einem sehr dünnen Blech, und die durch Absorption entstehende Wärme wird an der Berührungsfläche in das Gewebe 5 abgeführt. Bei genügend starker Strahlungsenergie koaguliert das Gewebe, und es bildet sich eine Koagulationszone, deren Grenze mit 6 markiert ist. Die seitliche Energieabfuhr vom Endstück 40 in das Rohr 2 wird durch dünne Wandungen klein gehalten. Weiterhin ist für das Rohr 2 ein Material mit geringem Wärmeleitkoeffizienten vorteilhaft. Bei hohen Laserleistungen kann das Rohr 2 durch eine Flüssigkeit 8 oder einen Gasstrom gekühlt werden. Die Dichtung 7 sorgt dafür, daß eine Kühlung im Bereich des Endstückes 40 nicht stattfindet. Die Temperatur am Endstück 40 kann durch ein nicht gezeichnetes Thermoelement, das in das Rohr 2 eingebracht wird, kontrolliert werden. Gegenüber anderen chirurgischen Thermosonden zeichnet sich Fig. 1 dadurch aus, daß die Wärme wesentlich präziser nur am Endstück 40 erzeugt wird. Die Form des Endstückes 40 kann analog zu den unterschiedlichsten Arten bei kryo-chirurgischen Sonden ausgebildet werden. Das Rohr 2 kann einen Durchmesser von einigen 0,1 mm bis mehrere mm haben, wobei die Größe stark von den Dimensionen des Endstückes 4 abweichen kann. Das Rohr 2 kann auch biegsam sein, so daß die Sonde in Kanäle von flexiblen Endoskopen eingeschoben werden kann.In Fig. 1 is a probe for placement on the tissue according to the invention shown in longitudinal section. The laser radiation is in a sheathed optical fiber 1 guided inside a tube 2 The laser radiation 3 occurs at the end of the optical fiber 1 off and irradiates the inside of the end piece 40, which has a high Has absorption coefficients for the laser radiation 3. The end piece 40 is preferably made from a very thin sheet of metal, and the heat generated by absorption is turned on the contact surface is discharged into the tissue 5. If the radiation energy is sufficiently strong The tissue coagulates and a coagulation zone is formed, the border with 6 is highlighted. The lateral energy dissipation from the end piece 40 into the tube 2 is through thin walls kept small. Furthermore, the pipe 2 is a material with little Thermal conductivity coefficient advantageous. With high laser powers, the tube 2 can through a liquid 8 or a gas stream can be cooled. The seal 7 ensures that cooling in the region of the end piece 40 does not take place. The temperature at the end piece 40 can by a thermocouple, not shown, which is in the tube 2 is introduced, are checked. Compared to other surgical thermoprobes Fig. 1 is characterized in that the heat is much more precise only at the end piece 40 is generated. The shape of the end piece 40 can be analogous to the most varied Species to be trained in cryosurgical probes. The tube 2 can have a diameter from a few 0.1 mm to several mm, the size greatly depending on the dimensions of the end piece 4 may differ. The tube 2 can also be flexible, so that the probe can be inserted into channels of flexible endoscopes.

In Fig. 2 ist eine andere Ausführungsform einer Sonde zum Aufsetzen auf das Gewebe gemäß der Erfindung dargestellt. Das Endstück 41 besteht im Gegensatz zu Fig. 1 aus durchsichtigem Material, z.B. Quarz oder Kunststoff, deren äußere Fläche die optische Austrittsfläche 9 für den Laserstrahl bildet. Die optische Austrittsfläche 9 berührt das Gewebe, wodurch die Fläche sofort verschmutzt wird. Bei geringen Strahlenergien wird das optische Verhalten des Gewebes 5 an der Fläche 9 nicht verändert, und der Laserstrahl 3 dringt trotz der Verschmutzung ähnlich wie ein freier Laserstrahl in das Gewebe ein. Bei hohen Energien verändert sich das optische Verhalten des Gewebes, wobei es beispielsweise durch Verkohlung braun oder schwarz werden kann. In diesem Fall wird das Endstück 4: weitgehend undurchsichtig und dem Gewebe wird wie in Fig. 1 nur thermische Energie zugeführt. Dadurch, daß dies Endstück 41 und das anliegende Gewebe gekühlt wird, kann eine Zerstörung vermieden werden.In Fig. 2 is another embodiment of a probe for placement shown on the fabric according to the invention. The end piece 41 is in contrast 1 made of transparent material, e.g. quartz or plastic, the outer Surface forms the optical exit surface 9 for the laser beam. The optical exit surface 9 touches the fabric, causing the surface to be soiled immediately. With low radiation energies the optical behavior of the fabric 5 on the surface 9 is not changed, and the Despite the contamination, laser beam 3 penetrates similarly to a free laser beam into the tissue. At high energies, the optical behavior of the changes Tissue, whereby it can become brown or black, for example due to charring. In this case, the end piece 4: is largely opaque and the fabric becomes as in Fig. 1 only thermal energy supplied. By doing this End piece 41 and the adjacent tissue is cooled, destruction can be avoided will.

In Fig. 3 ist eine weitere Ausführungsform der Erfindung dargestellt. Die optische Austrittsfläche für den Laserstrahl 9 wird hier durch das Faserende gebildet, aus dem der Laserstrahl austritt, und das das Gewebe berührt. Zum Schutz vor mechanischer Beschädigung der Faser ist es vorteilhaft, das Rohr 2 in einer Ebene mit dem Faserende enden zu lassen. Das Rohr 2 kann je nach anatomischen Gegebenheiten Biegungen am Ende aufweisen. Der Biegeradius kann durch bekannte Vorrichtungen auch variabel ausgestaltet werden.In Fig. 3, a further embodiment of the invention is shown. The optical exit surface for the laser beam 9 is here through the fiber end from which the laser beam emerges and which touches the tissue. For protection before mechanical damage to the fiber, it is advantageous to the tube 2 in a Let the layer end with the fiber end. The tube 2 can depending on the anatomical conditions Have bends at the end. The bending radius can also be achieved by known devices can be designed variably.

In Fig. 4 ist eine weitere Ausführungsform der Erfindung dargestellt. Das Rohr 2 wird auf das Gewebe aufgesetzt und danach mit einer lichtdurchlässigen Flüssigkeit 8 gefüllt. Das Endstück 42 wird somit aus der Flüssigkeit 8 gebildet. Die optische Austrittsfläche für den Laserstrahl 9 wird durch die Flüssigkeitsgrenze zum Gewebe 5 gebildet.In Fig. 4, a further embodiment of the invention is shown. The tube 2 is placed on the fabric and then with a translucent Liquid 8 filled. The end piece 42 is thus formed from the liquid 8. The optical exit surface for the laser beam 9 is through the liquid boundary formed into fabric 5.

Die Lichtleitfaser in Fig. 1, 2 und 4 kann auch durch andere Führungssysteme für den Laserstrahl (z.B. Linsensystem) ersetzt werden.The optical fiber in FIGS. 1, 2 and 4 can also be guided by other guide systems for the laser beam (e.g. lens system).

In Fig. 5 ist eine Ausführungsform einer Sonde zum Einstechen in das Gewebe gemaß der Erfindung dargestellt. Das Rohr 2 ist als möglichst feine Kanüle mit einer scharfen Spitze ausgebildet. Als nicht gezeichnetes Endstück kommen alle in Fig. 1 bis 4 beschriebenen Möglichkeiten in Frage. Zum Entweichen des entstehenden Dampfes kann der freie Zwischenraum zwischen dem Rohr 2 und der Lichtleitfaser 1 dienen. Mit Hilfe dieser Sondenform ist die Erzeugung von kugelähnlichen Koagulationszonen im Innern von Gewebe möglich.In Fig. 5 is an embodiment of a probe for piercing the Fabric according to the invention shown. The tube 2 is as fine as possible cannula formed with a sharp point. All of them come as an end piece that is not shown in Fig. 1 to 4 described possibilities in question. To escape the emerging The free space between the tube 2 and the optical fiber 1 can generate steam to serve. With the help of this shape of the probe, spherical coagulation zones can be created possible inside fabric.

In Fig. 6 ist die Anwendung der Sonde 5 zur Behandlung von Körperhöhlen (z.B. Kieferhöhle) dargestellt. Dabei ist es manchmal zweckmäßig, daß die Faser 1 in Pfeilrichtung achsial bewegt werden kann. Im Fall von Fig. 6 ist ein direkter Gewebekontakt zwischen der nicht gezeichneten Endfläche und dem Gewebe 5 nicht immer zweckmäßig. Für eine gleichmäßige Bestrahlung der Körperhöhle kann das Ende der Faser aufgerauht oder es kann eine Streuscheibe vorhanden sein, damit eine möglichst kugelförmige Winkelverteilung der Strahlung entsteht. Weiterhin kann durch einen nicht gezeichneten Strahlablenker, z.B. ein Prisma, der Laserstrahl am Ende der Faser abgelenkt werden, so daß durch Rotation des Rohres 2 fast alle Stellen der Körperhöhle vom Laserstrahl erfaßt werden können.In Fig. 6 is the application of the probe 5 for the treatment of body cavities (e.g. maxillary sinus). It is sometimes useful that the fiber 1 can be moved axially in the direction of the arrow can. In the case of Fig. 6 is a direct tissue contact between the end face, not shown, and the Fabric 5 is not always useful. For even irradiation of the body cavity the end of the fiber can be roughened or there can be a diffuser, so that the angular distribution of the radiation is as spherical as possible. Farther can use a beam deflector not shown, e.g. a prism, the laser beam be deflected at the end of the fiber, so that by rotation of the tube 2 almost all Places of the body cavity can be detected by the laser beam.

Claims (6)

Patentansprüche Sonde zur Führung des Laserstrahls für laser-chirurgische Anwendungen, dadurch gekennzeichnet, daß die Sonde rohrförmig ist, daß die Sonde direkt auf das Gewebe aufgesetzt oder eingestochen wird. Claims probe for guiding the laser beam for laser surgical Applications, characterized in that the probe is tubular, that the probe is placed or pierced directly onto the tissue. 2. Sonde nach Anspruch 1, dadurch gekennzeichnet, daß ein Endstück 40 mit absorbierender Fläche vom Laserstrahl erwärmt wird, und daß dieses Endstück 40 in Kontakt mit dem zu behandelnden Gewebe steht. 2. Probe according to claim 1, characterized in that an end piece 40 is heated with absorbing surface by the laser beam, and that this end piece 40 is in contact with the tissue to be treated. 3. Sonde nach Anspruch 1, dadurch gekennzeichnet, daß der Laserstrahl durch ein Endstück 41 aus einem durchsichtigen Material trifft und dann auf das Gewebe trifft, und daß dieses Endstück 41 in Kontakt mit dem zu behandelnden Gewebe steht. 3. Probe according to claim 1, characterized in that the laser beam through an end piece 41 made of a transparent material and then on the Tissue hits, and that this end piece 41 is in contact with the tissue to be treated stands. 4. Sonde nach Anspruch 1, dadurch gekennzeichnet, daß am Sondenende eine Lichtleitfaser 1 zur Führung des Laserstrahls direkten Kontakt mit dem zu behandelnden Gewebe hat und daß vorzugsweise gleichzeitig mindestens ein weiteres Teil der Sonde das Gewebe berührt. 4. Probe according to claim 1, characterized in that the probe end an optical fiber 1 for guiding the laser beam in direct contact with the one to be treated Has tissue and that preferably at least one further part of the probe at the same time touches the tissue. 5. Sonde nach Anspruch 1, dadurch gekennzeichnet, daß das Rohr 2 der Sonde das Gewebe berührt, und daß eine Lichtleitfaser 1 innerhalb des Rohres einen Laserstrahl 3 auf das Gewebe richtet, ohne das Gewebe zu berühren. 5. Probe according to claim 1, characterized in that the tube 2 the probe touches the tissue, and that an optical fiber 1 inside the tube directs a laser beam 3 onto the tissue without touching the tissue. 6. Sonde nach Anspruch 1 und 5, dadurch gekennzeichnet, daß eine durchsichtige Flüssigkeit 8 mit vorzugsweise hohem Siedepunkt den Raum zwischen der Faser und dem Gewebe ausfüllt. 6. Probe according to claim 1 and 5, characterized in that a transparent liquid 8 with preferably high boiling point the space between the fiber and the fabric fills.
DE19782826383 1978-06-16 1978-06-16 Probe for laser surgery - is tubular and placed against or inserted in tissue, with or without heated end Withdrawn DE2826383A1 (en)

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DE2852653A1 (en) * 1978-12-06 1980-06-19 Messerschmitt Boelkow Blohm Endoscope laser treatment device for bladder tumours - has pivoted rigid end sleeve operated via actuating rod or cable
DE3119322A1 (en) * 1981-05-15 1983-01-27 Messerschmitt-Bölkow-Blohm GmbH, 8000 München Probe for varicosclerosation
FR2512346A1 (en) * 1981-09-07 1983-03-11 Seriel Etu Realisa Electro APPARATUS FOR THE APPLICATION OF THERAPEUTIC TREATMENTS OF THE ACUPUNCTURE TYPE
EP0145780A1 (en) * 1983-06-13 1985-06-26 Laserscope Inc Localized heat applying medical device.
US4564011A (en) * 1982-03-22 1986-01-14 Leon Goldman Laser optic device and method
EP0178464A2 (en) * 1984-09-17 1986-04-23 Xintec Corporation Laser revascularization device and method of operation therefor
JPS61502168A (en) * 1984-05-22 1986-10-02 サージカル　レーザー　テクノロジーズ　インコーポレイテッド Medical and surgical laser probes
US4662368A (en) * 1983-06-13 1987-05-05 Trimedyne Laser Systems, Inc. Localized heat applying medical device
WO1987004611A1 (en) * 1986-01-30 1987-08-13 The Beth Israel Hospital Association Optical fiber metallic tip intravascular laser coagulation
US4693244A (en) * 1984-05-22 1987-09-15 Surgical Laser Technologies, Inc. Medical and surgical laser probe I
US4718417A (en) * 1985-03-22 1988-01-12 Massachusetts Institute Of Technology Visible fluorescence spectral diagnostic for laser angiosurgery
US4736743A (en) * 1986-05-12 1988-04-12 Surgical Laser Technology, Inc. Vaporization contact laser probe
US4773413A (en) * 1983-06-13 1988-09-27 Trimedyne Laser Systems, Inc. Localized heat applying medical device
EP0293458A1 (en) * 1986-12-18 1988-12-07 Patricia E Bath Method and apparatus for ablating and removing cataract lenses.
US4790311A (en) * 1986-06-03 1988-12-13 Ruiz Oscar F Radio frequency angioplasty catheter system
US4796622A (en) * 1987-03-06 1989-01-10 The United States Of America As Represented By The Department Of Health And Human Services Catheter with oxyhydrogen catalytic thermal tip
US4834093A (en) * 1986-02-03 1989-05-30 Littleford Phillip O Dilation catheter and method
WO1989009569A1 (en) * 1988-04-11 1989-10-19 Hgm Medical Laser Systems Inc. Laser heated probe and control system
US4913142A (en) * 1985-03-22 1990-04-03 Massachusetts Institute Of Technology Catheter for laser angiosurgery
EP0367705A2 (en) * 1988-10-31 1990-05-09 International Business Machines Corporation Laser assisted ultrasonic bonding
EP0373345A1 (en) * 1988-12-13 1990-06-20 International Business Machines Corporation Laser assisted heater bar for multiple lead attachment
US4994060A (en) * 1984-09-17 1991-02-19 Xintec Corporation Laser heated cautery cap with transparent substrate
EP0416793A1 (en) * 1989-08-30 1991-03-13 Angeion Corporation Catheter
US5009655A (en) * 1989-05-24 1991-04-23 C. R. Bard, Inc. Hot tip device with optical diagnostic capability
WO1991006251A1 (en) * 1989-11-06 1991-05-16 Surgilase Inc. Optical fibre assembly for medical lasers
US5041109A (en) * 1986-10-27 1991-08-20 University Of Florida Laser apparatus for the recanalization of vessels and the treatment of other cardiac conditions
US5061265A (en) * 1989-06-20 1991-10-29 University Of Florida Laser treatment apparatus and method
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US5125404A (en) * 1985-03-22 1992-06-30 Massachusetts Institute Of Technology Apparatus and method for obtaining spectrally resolved spatial images of tissue
US5147353A (en) * 1990-03-23 1992-09-15 Myriadlase, Inc. Medical method for applying high energy light and heat for gynecological sterilization procedures
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US5199431A (en) * 1985-03-22 1993-04-06 Massachusetts Institute Of Technology Optical needle for spectroscopic diagnosis
US5203780A (en) * 1990-09-05 1993-04-20 Liebler William A Vented surgical probe and method of use
US5221279A (en) * 1990-10-12 1993-06-22 Surgical Laser Technologies, Inc. Adjustable touch control handpiece
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US5304167A (en) * 1988-11-10 1994-04-19 Premier Laser Systems, Inc. Multiwavelength medical laser method
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US5451221A (en) * 1993-12-27 1995-09-19 Cynosure, Inc. Endoscopic light delivery system
US5454807A (en) * 1993-05-14 1995-10-03 Boston Scientific Corporation Medical treatment of deeply seated tissue using optical radiation
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US5569240A (en) * 1990-06-08 1996-10-29 Kelsey, Inc. Apparatus for interstitial laser therapy
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US5707368A (en) * 1990-10-31 1998-01-13 Premier Laser Systems, Inc. Contact tip for laser surgery
US5833683A (en) * 1996-01-12 1998-11-10 Surgical Laser Technologies, Inc. Laterally-emitting laser medical device
US5897551A (en) * 1990-03-23 1999-04-27 Myriadlase, Inc. Medical device for applying high energy light and heat for gynecological sterilization procedures
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DE2852653A1 (en) * 1978-12-06 1980-06-19 Messerschmitt Boelkow Blohm Endoscope laser treatment device for bladder tumours - has pivoted rigid end sleeve operated via actuating rod or cable
DE3119322A1 (en) * 1981-05-15 1983-01-27 Messerschmitt-Bölkow-Blohm GmbH, 8000 München Probe for varicosclerosation
FR2512346A1 (en) * 1981-09-07 1983-03-11 Seriel Etu Realisa Electro APPARATUS FOR THE APPLICATION OF THERAPEUTIC TREATMENTS OF THE ACUPUNCTURE TYPE
EP0074914A1 (en) * 1981-09-07 1983-03-23 Société Coopérative Ouvrière de Prod. à Resp. Limitée: ERIEL - Soc. d'Engineering et de Réalisations Electroniques et Ind. Apparatus for the application of acupuncture-type therapeutical treatments
US4564011A (en) * 1982-03-22 1986-01-14 Leon Goldman Laser optic device and method
EP0145780A4 (en) * 1983-06-13 1987-01-20 Laserscope Inc Localized heat applying medical device.
EP0145780A1 (en) * 1983-06-13 1985-06-26 Laserscope Inc Localized heat applying medical device.
US4646737A (en) * 1983-06-13 1987-03-03 Laserscope, Inc. Localized heat applying medical device
US4662368A (en) * 1983-06-13 1987-05-05 Trimedyne Laser Systems, Inc. Localized heat applying medical device
US4773413A (en) * 1983-06-13 1988-09-27 Trimedyne Laser Systems, Inc. Localized heat applying medical device
JPS61502168A (en) * 1984-05-22 1986-10-02 サージカル　レーザー　テクノロジーズ　インコーポレイテッド Medical and surgical laser probes
US4693244A (en) * 1984-05-22 1987-09-15 Surgical Laser Technologies, Inc. Medical and surgical laser probe I
JPH0586225B2 (en) * 1984-05-22 1993-12-10 Saajikaru Reezaa Tekunorojiizu
EP0178464A3 (en) * 1984-09-17 1986-05-07 Xintec Corporation Laser revascularization device and method of operation therefor
EP0178464A2 (en) * 1984-09-17 1986-04-23 Xintec Corporation Laser revascularization device and method of operation therefor
US4994060A (en) * 1984-09-17 1991-02-19 Xintec Corporation Laser heated cautery cap with transparent substrate
US5496305A (en) * 1985-03-22 1996-03-05 Massachusetts Institue Of Technology Catheter for laser angiosurgery
US4718417A (en) * 1985-03-22 1988-01-12 Massachusetts Institute Of Technology Visible fluorescence spectral diagnostic for laser angiosurgery
US5318024A (en) * 1985-03-22 1994-06-07 Massachusetts Institute Of Technology Laser endoscope for spectroscopic imaging
US4913142A (en) * 1985-03-22 1990-04-03 Massachusetts Institute Of Technology Catheter for laser angiosurgery
US5304173A (en) * 1985-03-22 1994-04-19 Massachusetts Institute Of Technology Spectral diagonostic and treatment system
US5290275A (en) * 1985-03-22 1994-03-01 Massachusetts Institute Of Technology Catheter for laser angiosurgery
US5199431A (en) * 1985-03-22 1993-04-06 Massachusetts Institute Of Technology Optical needle for spectroscopic diagnosis
US5125404A (en) * 1985-03-22 1992-06-30 Massachusetts Institute Of Technology Apparatus and method for obtaining spectrally resolved spatial images of tissue
US4735201A (en) * 1986-01-30 1988-04-05 The Beth Israel Hospital Association Optical fiber with detachable metallic tip for intravascular laser coagulation of arteries, veins, aneurysms, vascular malformations and arteriovenous fistulas
WO1987004611A1 (en) * 1986-01-30 1987-08-13 The Beth Israel Hospital Association Optical fiber metallic tip intravascular laser coagulation
US4834093A (en) * 1986-02-03 1989-05-30 Littleford Phillip O Dilation catheter and method
US4736743A (en) * 1986-05-12 1988-04-12 Surgical Laser Technology, Inc. Vaporization contact laser probe
US4790311A (en) * 1986-06-03 1988-12-13 Ruiz Oscar F Radio frequency angioplasty catheter system
US5041109A (en) * 1986-10-27 1991-08-20 University Of Florida Laser apparatus for the recanalization of vessels and the treatment of other cardiac conditions
EP0293458A1 (en) * 1986-12-18 1988-12-07 Patricia E Bath Method and apparatus for ablating and removing cataract lenses.
EP0293458A4 (en) * 1986-12-18 1989-11-27 Patricia E Bath Method and apparatus for ablating and removing cataract lenses.
US4899741A (en) * 1987-01-14 1990-02-13 Hgm Medical Laser Systems, Inc. Laser heated probe and control system
US4796622A (en) * 1987-03-06 1989-01-10 The United States Of America As Represented By The Department Of Health And Human Services Catheter with oxyhydrogen catalytic thermal tip
WO1989009569A1 (en) * 1988-04-11 1989-10-19 Hgm Medical Laser Systems Inc. Laser heated probe and control system
US5649924A (en) * 1988-06-10 1997-07-22 Trimedyne, Inc. Medical device for irradiation of tissue
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US5540676A (en) * 1988-11-10 1996-07-30 Premier Laser Systems, Inc. Method of laser surgery using multiple wavelengths
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US5147353A (en) * 1990-03-23 1992-09-15 Myriadlase, Inc. Medical method for applying high energy light and heat for gynecological sterilization procedures
US5897551A (en) * 1990-03-23 1999-04-27 Myriadlase, Inc. Medical device for applying high energy light and heat for gynecological sterilization procedures
EP0458506A1 (en) * 1990-05-15 1991-11-27 Surgical Laser Technologies, Inc. Unitary scalpel for contact laser surgery
US5154708A (en) * 1990-05-15 1992-10-13 Surgical Laser Technologies, Inc. Unitary scalpel for contact laser surgery
US5569240A (en) * 1990-06-08 1996-10-29 Kelsey, Inc. Apparatus for interstitial laser therapy
US5203780A (en) * 1990-09-05 1993-04-20 Liebler William A Vented surgical probe and method of use
US5221279A (en) * 1990-10-12 1993-06-22 Surgical Laser Technologies, Inc. Adjustable touch control handpiece
US5707368A (en) * 1990-10-31 1998-01-13 Premier Laser Systems, Inc. Contact tip for laser surgery
US6110167A (en) * 1990-10-31 2000-08-29 Premier Laser Systems, Inc. Contact tip for laser surgery
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US5454807A (en) * 1993-05-14 1995-10-03 Boston Scientific Corporation Medical treatment of deeply seated tissue using optical radiation
US5451221A (en) * 1993-12-27 1995-09-19 Cynosure, Inc. Endoscopic light delivery system
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US5672171A (en) * 1994-06-30 1997-09-30 American Medical Systems, Inc. Apparatus and method for interstitial laser treatment
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US5591161A (en) * 1995-10-25 1997-01-07 Plc Medical Systems, Inc. Angled beam delivery handpiece for laser or other monochromatic light source
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