JP3138024B2 - Stone crushing equipment - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a calculus breaking device.

[0002]

2. Description of the Related Art As a means for crushing a calculus formed inside a human body, there is a calculus crushing device disclosed in Japanese Patent Application Laid-Open No. 2-161937.

The structure of the calculus crushing apparatus disclosed in Japanese Patent Application Laid-Open No. 2-161937 is briefly described. The calculus crushing apparatus is excited by a flash lamp and emits a pulse laser beam having a wavelength of 504 nm and a laser pulse width of about 1 μsec. The apparatus includes a dye pulse laser device that can be generated, and an endoscope for guiding the pulse laser light generated by the dye pulse laser device to a calculus forming portion inside a human body.

The endoscope is provided with an observation optical fiber for observing the state of a calculus forming portion, and is configured so that perfusion water (physiological saline) can be jetted from a front end portion.

When calculus formed inside a human body is crushed by using the above-described calculus crushing apparatus, an endoscope is inserted into the human body so that the distal end of the endoscope faces the calculus, and a pigment is added. When pulsed laser light is generated by a pulsed laser device, the pulsed laser light is applied to a calculus via a fiberscope.

When the pulsed laser light is incident on a calculus,
Momentary thermal expansion occurs on the surface of the calculus, and under this influence, moisture between the tip of the irradiating optical fiber of the endoscope and the surface of the calculus is excited to be in a plasma state.

The plasma generates a shock wave on the calculus, which breaks the calculus.

[0008]

However, the calculus crushing device described above cannot easily crush calculus formed by cystine (C ₆ H ₁₂ N ₂ O ₄ S ₄ white crystalline amino acid). .

[0009]

[Knowledge from research results] In order to solve this problem, the present inventors focused on the wavelength and pulse width of pulsed laser light, and irradiated cystine with pulsed laser light of various wavelengths and pulse widths. It has been found that irradiating cystine with a pulse laser beam of about 100 nsec or less destroys cystine in a short time.

[0010]

SUMMARY OF THE INVENTION The object of the present invention is to solve the problems of the prior art based on the above-mentioned findings, and an object of the present invention is to crush stones formed by cystine inside a human body.

[0011]

A calculus crushing apparatus according to the present invention comprises a YAG laser oscillator which oscillates a pulse laser beam having a wavelength of 1064 nm and a pulse width of 100 nsec or less, and a YA capable of converting the wavelength of the pulse laser beam to 532 nm.
A pulse laser generator having a G laser second harmonic generator; a titanium sapphire laser rod excited by pulse laser light from the pulse laser generator;
A titanium sapphire laser generator that oscillates a pulse laser beam of 70 to 1100 nm, a pulse laser beam having a wavelength of 532 nm or 1064 nm from the pulse laser generator, and a wavelength 67 from the titanium sapphire laser generator.
An endoscope for irradiating pulse laser light of 0 to 1100 nm to a calculus formed inside a human body.

[0012]

In the calculus breaking device of the present invention, a pulse laser beam having a wavelength of 1064 nm obtained by a YAG laser oscillator, a pulse laser beam having a wavelength of 532 nm converted by a second harmonic generator, and a wavelength obtained by a titanium sapphire laser generator 67
The calculus formed inside the human body is irradiated with any one of the pulse laser light of 0 to 1100 nm through an endoscope to break the calculus.

[0013]

Embodiments of the present invention will be described below with reference to the drawings.

FIGS. 1 and 2 show an embodiment of the calculus crushing apparatus according to the present invention, in which 1 is a pulse laser generator, and the pulse laser generator 1 is a pulse laser generator for generating a pulse laser beam. It comprises a section 2 and a titanium sapphire laser generating section 3 which is excited by a laser beam generated by the pulse laser generating section 2 and generates pulsed laser light having a predetermined wavelength.

Reference numeral 4 denotes a half-wave plate and a polarizing prism for adjusting the output of the pulse laser light generated by the pulse laser generator 2 or the titanium sapphire laser generator 3.

Reference numeral 5 denotes an endoscope for guiding a pulse laser beam generated by the pulse laser generator 1 to a calculus forming portion formed inside a human body. The endoscope 5 is a light beam emitted by an illumination lamp 6. To the vicinity of the stone formation area
An illumination optical fiber 8 for illuminating the calculus, an observation optical fiber 9 for observing the state of the calculus 7 and the vicinity of the calculus formation point, and a pulse laser beam output from the pulse laser generator 1 to the calculus 7 Irradiation optical fiber 10 for irradiation, and perfusion water for supplying perfusion water (physiological saline) for cleaning to the distal end of the illumination optical fiber 8, the observation optical fiber 9, and the irradiation optical fiber 10. And a supply channel 11.

Reference numeral 12 denotes a color television camera for photographing the state of the calculus 7 and the vicinity of the calculus formation via the optical fiber 9 for observation, and 13 a monitor for displaying an image photographed by the color television camera 12.

Hereinafter, the configuration of the pulse laser generator 2 of the pulse laser generator 1 will be described.

Reference numeral 20 denotes a wavelength of 1064 nm and a pulse width of about 10
A pumping YAG laser oscillator that oscillates pulse laser light of nsec and a repetition rate of 20 Hz. Reference numeral 14 denotes 1 / λ ₂ = 1 / λ from a 1064 nm wavelength pulse laser light (YAG laser fundamental wave) oscillated by the YAG laser oscillator 20. ₁ + 1 / λ ₁ ... (1) YAG laser second harmonic generation that generates a pulse laser beam with a wavelength of 532 nm according to the relationship (second harmonic generation) (λ ₁ : fundamental wave, λ ₂ : second harmonic) A pulse laser beam having a wavelength of 532 nm generated by the second harmonic generator of the YAG laser and a pulse laser having a wavelength of 1064 nm remaining without being converted into the second harmonic by the second harmonic generator of the YAG laser; The dichroic mirror transmits a pulse laser beam having a wavelength of 1064 nm and reflects only a pulse laser beam having a wavelength of 532 nm.

A total reflection mirror 21 can be arranged between the YAG laser oscillator 20 and the YAG laser second harmonic device 14, and between the YAG laser second harmonic device 14 and the dichroic mirror 15. Can be provided with a dichroic mirror 27 that reflects a pulse laser beam having a wavelength of 532 nm and transmits a pulse laser beam having another wavelength.

Reference numeral 33 denotes a beam damper that absorbs a pulse laser beam having a wavelength of 1064 nm transmitted through the dichroic mirror 15.

Next, the configuration of the titanium sapphire laser generator 3 of the pulse laser generator 1 will be described.

Reference numeral 16 denotes a half mirror that transmits a part of the pulse laser light having a wavelength of 532 nm reflected by the dichroic mirror 15 and reflects the remaining part. Reference numeral 17 denotes a light source that converges the pulse laser light having a wavelength of 532 nm transmitted through the half mirror 16. A lens 18 is a total reflection mirror that reflects the 532 nm wavelength pulsed laser light transmitted by the half mirror 16, and 19 is a lens that converges the 532 nm wavelength pulsed laser light reflected by the total reflection mirror 18.

Reference numeral 22 denotes a dichroic mirror that reflects the 532 nm wavelength pulse laser beam converged by the lens 17 and transmits light of the titanium sapphire laser wavelength. 23 denotes a 532 nm pulse laser beam reflected by the dichroic mirror 22. A titanium sapphire laser rod for oscillation, which is excited by the above and generates pulsed laser light having a wavelength of 670 to 1100 nm, 24
Is a front mirror, and 25 is an end mirror. The front mirror 24 and the end mirror 25 constitute a resonator for resonating pulse laser light generated by the oscillation titanium sapphire laser rod 23.

Reference numeral 26 denotes a pulse laser beam having a wavelength of 670 to 1100 nm generated by the oscillation titanium sapphire laser rod 23, which allows only a specific wavelength of the pulse laser beam to be well transmitted and has other wavelength components. A wavelength tuning element (wavelength selection element) 29 such as a birefringent filter for blocking light is a telescope, and the wavelength tuning element 2 is controlled by the front mirror 24 and the end mirror 25.
Only the pulse laser light having a wavelength of 670 to 1100 nm that resonates via 6 is oscillated, and the beam diameter is enlarged by the telescope 29.

Reference numeral 28 denotes a pulse laser beam having a wavelength of 670 to 1100 nm whose beam diameter has been expanded by the telescope 29, and a wavelength 532n converged by the lens 19.
dichroic mirror that reflects m pulse laser light,
Reference numeral 30 denotes a wavelength 5 reflected by the dichroic mirror 28
A wavelength 670 to be excited by a 32 nm pulse laser beam and transmitted through the dichroic mirror 28 and incident.
A titanium sapphire laser rod for amplification for amplifying a pulse laser beam of 1100 nm, wherein a wavelength of 670 to 1 amplified by the titanium sapphire laser rod for amplification 30.
The 100 nm pulsed laser light is guided to the irradiation optical fiber 10 of the endoscope 5.

The above-described titanium sapphire laser oscillator 3
Then, the wavelength tuning element 26 is rotated so that the wavelength tuning element 2
The wavelength of the pulse laser beam oscillated from the titanium sapphire laser oscillator 3 is adjusted to 67 by adjusting the angle of 6.
It can be set to any wavelength in the wavelength range of 0 to 1100 nm.

In the figure, reference numeral 31 denotes a pair with the total reflection mirror 21. When the total reflection mirror 21 is disposed between the YAG laser oscillator 20 and the YAG laser second harmonic generator 14, Wavelength 1064 reflected by total reflection mirror 21
A total reflection mirror 32 for reflecting a pulse laser beam of nm is paired with the dichroic mirror 27, and the dichroic mirror 27 is disposed between the YAG laser second harmonic generator 14 and the dichroic mirror 15. The wavelength 532n reflected by the dichroic mirror 27
This is a total reflection mirror that reflects the m pulse laser light, and the pulse laser light reflected by the total reflection mirrors 31 and 32 is guided to the irradiation optical fiber 10 of the endoscope 5.

Hereinafter, an example of a procedure for crushing the calculus 7 formed in the human body using the above-described calculus crushing apparatus will be described.

When the calculus 7 formed inside the human body is crushed, the angle of the wavelength selection element 26 of the titanium sapphire laser generator 3 is changed by changing the pulse laser light having a wavelength of 790 nm to pass and the pulse laser light having another wavelength. The endoscope 5 is inserted into the human body such that the distal end of the endoscope 5 faces the calculus 7.

Next, the YAG laser oscillator 20
When a pulse laser beam having a wavelength of 1064 nm, a pulse width of about 10 nsec, and a repetition rate of 20 Hz is oscillated, the YAG laser second harmonic generator 14 generates a wavelength of 1064 nm.
532 nm wavelength and pulse width of about 10
Pulse laser light having a repetition rate of 20 Hz is generated for nsec, and the pulse laser light having a wavelength of 532 nm is incident on the half mirror 16.

The wavelength 532n incident on the half mirror 16
A part of the pulse laser beam of m is transmitted through the half mirror 16, converged by the lens 17, reflected by the dichroic mirror 22, incident on the titanium sapphire laser rod for oscillation 23 via the front mirror 24, and Excite 23.

The light having a wavelength of 670 to 1100 nm passes through a wavelength tuning element 26 by a front mirror 24 and an end mirror 25 and has a wavelength of 790 nm and a pulse width of about 10 ns.
c, Only the pulse laser beam having a repetition rate of 20 Hz is transmitted through the wavelength selection element 26,
The pulse laser beam having a wavelength of 790 nm is incident on the titanium sapphire laser rod 30 for amplification through the front mirror 24, the dichroic mirror 22, the telescope 29, and the dichroic mirror 28.

On the other hand, the rest of the pulsed laser beam having a wavelength of 532 nm incident on the half mirror 16 is reflected by the total reflection mirror 18, converged by the lens 19, and then reflected by the dichroic mirror 28 to be amplified by the titanium sapphire laser rod for amplification. It is incident on 30.

The wavelength 53 incident on the titanium sapphire laser rod 30 for amplification by the dichroic mirror 28
The 2 nm pulse laser beam excites the amplification titanium sapphire laser rod 30, and the pulse laser beam having a wavelength of 790 nm, a pulse width of about 10 nsec, and a repetition rate of 20 Hz incident on the amplification titanium sapphire laser rod 30 is amplified.

The laser light having a wavelength of 790 nm is １ ／
The light enters the irradiation optical fiber 10 of the endoscope 5 through the wave plate and the polarizing prism 4, is guided by the irradiation optical fiber 10, and is irradiated on the surface of the calculus 7 inside the human body.

A wavelength of 790 nm and a pulse width of about 10 ns
c, a pulse laser beam having a repetition rate of 20 Hz
Incident on the surface of the calculus 7 causes instantaneous thermal expansion,
Under the influence, the water between the tip of the irradiation optical fiber 10 and the surface of the calculus 7 is excited to be in a plasma state.

This plasma generates a shock wave on the calculus 7, and the calculus 7 is crushed by the shock wave.

At this time, in this embodiment, the calculus 7 is irradiated with a pulse laser beam having a pulse width of about 10 nsec, so that the calculus 7 can be crushed in a short time even if the calculus 7 is formed of cystine. Can be.

The reason is that if the pulse laser light (pulse width about 1 μsec) of the conventional calculus crushing apparatus and the pulse laser light (pulse width about 10 nsec) of this embodiment are equal in energy per pulse, the pulse laser light This is because the smaller the pulse width, the higher the peak value (peak power) per pulse, and the larger the shock wave acting on the calculus 7 by the plasma.

When the calculus 7 is crushed by a pulse laser beam having a wavelength of 1064 nm, the total reflection mirror 21 is moved to Y
The endoscope 5 is disposed between the AG laser oscillator 20 and the YAG laser second harmonic generator 14 and inserted into the human body such that the distal end of the endoscope 5 faces the calculus 7.

Next, the YAG laser oscillator 20
When a pulse laser beam having a wavelength of 1064 nm, a pulse width of about 10 nsec, and a repetition rate of 20 Hz is oscillated, the pulse laser beam is reflected by the total reflection mirrors 21 and 31, and the laser beam having a wavelength of 1064 nm passes through the polarizing filter 4 and is viewed endlessly. The light enters the irradiation optical fiber 10 of the mirror 5, is guided by the irradiation optical fiber 10, and is irradiated on the surface of the calculus 7 inside the human body.

Wavelength 1064 nm, pulse width about 10 ns
c, a pulse laser beam having a repetition rate of 20 Hz
Incident on the surface of the calculus 7 causes instantaneous thermal expansion,
Under the influence, the water between the tip of the irradiation optical fiber 10 and the surface of the calculus 7 is excited to be in a plasma state.

This plasma generates a shock wave on the calculus 7, and the calculus 7 is crushed by the shock wave.

At this time, even with the 1064 nm pulse laser beam, the peak value per pulse is high as in the case of the aforementioned 790 nm pulse laser beam, so that the calculus 7 formed by cystine is crushed in a short time. be able to.

When the calculus 7 is crushed by a pulsed laser beam having a wavelength of 532 nm, the dichroic mirror 2
7 is disposed between the YAG laser second harmonic oscillator 14 and the dichroic mirror 15, and the endoscope 5 is inserted into the human body such that the distal end of the endoscope 5 faces the calculus 7.

Next, the YAG laser oscillator 20
When a pulse laser beam having a wavelength of 1064 nm, a pulse width of about 10 nsec, and a repetition rate of 20 Hz is oscillated, the YAG laser second harmonic generator 14 generates a wavelength of 1064 nm.
532 nm wavelength and pulse width of about 10
Pulse laser light having a repetition rate of 20 Hz is generated for nsec. The pulse laser light having a wavelength of 532 nm is reflected by a dichroic mirror 27 and a total reflection mirror 32. The laser light having a wavelength of 532 nm is converted into a half-wave plate and a polarizing prism. The light enters the irradiation optical fiber 10 of the endoscope 5 through 4 and is guided by the irradiation optical fiber 10 to irradiate the surface of the calculus 7 inside the human body.

A wavelength of 532 nm and a pulse width of about 10 ns
c, a pulse laser beam having a repetition rate of 20 Hz
Incident on the surface of the calculus 7 causes instantaneous thermal expansion,
Under the influence, the water between the tip of the irradiation optical fiber 10 and the surface of the calculus 7 is excited to be in a plasma state.

This plasma generates a shock wave on the calculus 7, and the calculus 7 is crushed by the shock wave.

At this time, the pulse laser beam having the wavelength of 790 nm is also used by the pulse laser beam having the wavelength of 532 nm.
Since the peak value per pulse is high similarly to the pulse laser beam having a wavelength of 1064 nm, the calculus 7 formed by cystine can be crushed in a short time.

Table 1 below shows the calculus breaking effect of various components by the above-described pulsed laser light of each wavelength.

The components of each calculus are as follows: Calculus A is 95% calcium oxalate (CaC ₂ O ₄ ) + calcium phosphate (Ca)
₃ (PO ₄ ) ₂ ) 5%, stone B is 93% calcium phosphate
+ Calcium carbonate (CaCO ₃ ) 7%, calculus C is calcium oxalate 50% + calcium phosphate 50%, calculus D is
Calcium phosphate 59% + calcium oxalate 30% + calcium carbonate 11%, stones E is magnesium ammonium phosphate _{(Mg (NH 4) PO 4} ) 93% + calcium carbonate 7
%, Calculus F cystine _{(C 6 H 12 N 2 O} 4 S 4), calculus G uric acid _{(C 5 H 4 N 4 O} 3) is 98%.

Each pulse laser beam has a pulse width of about 10 nsec and a pulse energy of 10 mJ.

[0054]

[Table 1]

As described above, the calculus crushing apparatus of this embodiment can crush various calculi such as calculus formed by cystine, and can also use the YAG laser oscillator 20 and the titanium sapphire laser Since it is generated by a combination of the rods 23, 30, etc., operability and maintenance and inspection are easier than in a calculus crushing apparatus using a conventional dye pulse laser.

[0056] Incidentally, lithotriptor of the present invention is not limited to the embodiments described above, for example, pulse
Needless to say, the pulse width of the laser beam can be appropriately changed , and various changes can be made without departing from the scope of the present invention.

[0057]

As described above, according to the calculus crushing apparatus of the present invention, the following various excellent effects can be obtained.

(1) Since the pulse laser beam applied to the calculus is set to a pulse width of 100 nsec or less, the peak value (peak power) per pulse of the pulse laser beam is high, and the shock wave acting on the calculus by the plasma is large. And from the YAG laser oscillator and the second harmonic generator
Laser generator and titanium sapphire laser generation
The wavelength of the pulse laser beam is 1064 nm, 53
2 nm and 670 to 1100 nm can be set.
Effectively crush various stones including chin in a short time
Can be operated, the operability of the device is good,
Can also be done easily.

(2) When the pulse width of the pulse laser beam is 100
Since the peak value (peak power) per pulse of the pulsed laser light is increased to nsec or less, a crushing effect equal to or greater than that of the conventional device can be obtained for various calculi including cystine with a lower pulse energy than that of the conventional device. It is possible,
It is not necessary to increase the output of the pulse laser generator.

[Brief description of the drawings]

FIG. 1 is a conceptual diagram showing one embodiment of a calculus breaking device of the present invention.

FIG. 2 is a configuration diagram of a pulse laser generator of the calculus crushing apparatus shown in FIG.

[Description of Signs] Two- pulse laser generator 3 Titanium sapphire laser generator 5 Endoscope 7 Calculus 14 Second harmonic generator 20 YAG laser oscillator

──────────────────────────────────────────────────続 き Continuing on the front page (72) Inventor Keigo Takaoka 2-2-1 Otemachi, Chiyoda-ku, Tokyo Ishikawajima-Harima Heavy Industries, Ltd. Head Office (72) Inventor Daiji Nishizawa 3-1-1 Toyosu, Koto-ku, Tokyo 15 Ishikawa Shima-Harima Heavy Industries Co., Ltd., Toji Technical Center (72) Inventor Katsushi Inoue 3-1-1, Toyosu, Koto-ku, Tokyo Ishikawa Shima-Harima Heavy Industries Co., Ltd.Toji Technical Center (56) References JP-A-3-170146 (JP, A) JP-A-3-159661 (JP, A) JP-A-2-57245 (JP, A) JP-T-62-502871 (JP, A) International publication 90/12544 (WO, A1) (58) Fields surveyed (Int. Cl. ⁷ , DB name) A61B 17/22 A61B 18/00-18/28 A61N 5/06

Claims (1)

(57) [Claims] 1. A wavelength of 1064 nm and a pulse width of 100 ns.
a pulse laser generator having a YAG laser oscillator that oscillates a pulse laser beam of ec or less, a YAG laser second harmonic generator capable of converting the wavelength of the pulse laser beam to 532 nm, and a pulse from the pulse laser generator. a titanium sapphire laser generator for and oscillating a pulsed laser beam having a wavelength 670~1100nm have titanium sapphire laser rod excited by laser light, pulsed laser light having a wavelength of 532nm or wavelength 1064nm from the pulse laser generator, and titanium A calculus crushing device, comprising: an endoscope for irradiating a calculus formed inside a human body with pulsed laser light having a wavelength of 670 to 1100 nm from a sapphire laser generation unit.