JPH05220164A - Laser probe - Google Patents

Abstract

PURPOSE:To provide the laser probe which is safe without exerting a thermal influence on the normal tissue part around the stuck part of a living body in the case of peeling the stuck part and is easily usable. CONSTITUTION:A cap 4 for light shielding which covers one side of the front end tip 3 of the laser probe 1 is provided. The living body part existing on the side of the front end tip 3 is prevented from being irradiated with a laser beam by this cap 4 for light shielding.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a laser probe used for exfoliating an adhesion part of a living body in, for example, a cholecystectomy.

[0002]

2. Description of the Related Art Surgery to remove the gallbladder has been conventionally performed as a treatment method for cholelithiasis. There are two types of surgery to remove the gallbladder, one that is performed by opening the laparotomy and one that removes the gallbladder while using a laparoscope without opening the laparotomy. Cholecystectomy using a laparoscope, which has advantages such as rapid recovery, is drawing attention.

On the other hand, scissors and an electric scalpel have been used as instruments for peeling the adhesion part of the gallbladder in the cholecystectomy, but a method of incising with a laser beam using a laser probe is In recent years, it has attracted attention because of its incision ability and less bleeding. The method using a laser probe is also suitable for cholecystectomy using a laparoscope.

[0004]

When the adhesion portion of the gallbladder is peeled off by using the laser probe, the emitting end of the laser probe is brought into contact with the portion to be peeled off to emit laser light. In this method, the tissue is incised by the heat of the laser beam, so that it is inevitable that the surrounding tissue is thermally affected. When using this laser probe, it should be avoided as much as possible that the laser light hits normal tissue and exerts a great thermal influence.

The present invention has been made in view of the above-mentioned problems, and its purpose is to, when peeling off an adhesion part of a living body, not to exert a thermal effect on a normal tissue part around the adhesion part as much as possible. It is to provide a laser probe that is safe and easy to use.

[0006]

According to the present invention, in a laser probe which is connected to a laser device and guides a laser beam to a laser irradiation portion, a light-shielding cap is provided for covering one side of an emission end of the laser probe. Thus, the living body part located on one side of the emission end is not irradiated with the laser light.

[0007]

In the above structure, since one side portion of the emitting end of the laser probe is covered with the light-shielding cap, the normal tissue is irradiated with the laser beam or heat by arranging the light-shielding cap on the normal tissue side. It can be used safely by preventing transmission. Further, if the light-shielding cap is applied to the site of the living tissue, the emitting end can be correctly positioned and stabilized, which is easy to use.

[0008]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS A first embodiment of the present invention will be described with reference to FIGS. FIG. 1 shows the vicinity of the tip of a laser probe 1 according to the first embodiment. This laser probe 1 is constructed by attaching a contact type tip 3 to the tip of a light guide 2 made of an optical fiber or the like. The light guide 2 is configured as a long one by covering the outer circumference of a light guide element such as an optical fiber with a sheath. Further, it may be bendable or hard and not bendable. Although not shown, the proximal end of the laser probe 1 on the proximal side is provided with a connector for connecting to a laser device as a laser light source.

The contact-type tip 3 is formed of a transparent body in the shape of a conical column with a sharp tip. Then, the tip chip 3 makes the laser light guided by the light guide 2 incident from the incident end composed of the bottom face of the tip, guides the laser light to the tip while reflecting it at the conical peripheral surface portion, and in the process, Part of the laser light is emitted laterally from the peripheral surface of the cone.

A light-shielding cap 4 is attached to the tip of the light guide 2. As shown in FIG. 1, the light-shielding cap 4 is formed of a material having a low heat conductivity in a tubular shape, but has a shape in which one side portion is cut out, leaving the base end. The light-shielding cap 4 is attached by fitting and fixing the base end ring portion 5 on the outer periphery of the front end of the light guide 2. The remaining part of the one-sided part is cut out to form a light-shielding part 6 that surrounds the part of the tip chip 3 on one half side or less and surrounds it. The inner surface of the light shielding portion 6 is formed as a part of the cylindrical inner surface and is arranged coaxially with the central axis of the light guide 2. The tip portion 7 of the light shielding portion 6 is formed to be slightly longer than the tip of the tip chip 3, is rounded, extends toward the tip side of the tip chip 3, and surrounds one side of the tip of the tip chip 3. ..

Further, at least the inner surface of the light-shielding portion 6 of the light-shielding cap 4 is coated with a reflection film that reflects laser light. Therefore, the laser light emitted from the tip 3 toward the light-shielding cap 4 is reflected on the inner surface thereof.

FIG. 2 shows a state in which the gallbladder 8 is extracted using the laser probe 1. Adhesion site 10 with liver 9
The tip 3 having the light-shielding cap 4 is applied to.
At this time, the light shielding cap 4 is directed toward the normal living tissue portion on the liver 9 side, and the light shielding cap 4 is positioned between the living tissue portion and the tip 3. And the light guide 2
A laser beam is emitted from the tip chip 3 through and peeled off. The laser light directed from the tip 3 to the normal living tissue portion is reflected by the inner surface of the light-shielding cap 4 and is not applied to the normal living tissue portion. Also, the tip 3
Since the light-shielding cap 4 is separated from the heat shield, heat from the tip 3 is not transmitted to the normal living tissue part. In addition, 11 is a trocar.

Therefore, according to the laser probe 1, it is possible to prevent the normal tissue from being irradiated with the laser beam and the heat from being transmitted, and the laser probe 1 can be used safely. Further, since the light-shielding cap 4 can be applied to the site of the living tissue to correctly position and stabilize the tip chip 3, it is easy to use.

FIG. 3 shows a second embodiment of the present invention. In this embodiment, the emission end 13 is formed at the tip of the core of the optical fiber 12 constituting the light guide 2, and the emission end 13 is formed obliquely at an angle of 45 ° with respect to the center of the laser probe 1. is there. The laser light transmitted through the light guide 2 is reflected by the inner surface of the oblique emission end 13 and emitted at an angle of 90 ° with respect to the center of the laser probe 1. The light-shielding cap 4 is arranged on the opposite side of the direction in which the laser light is emitted. The other structure is the same as that of the first embodiment.

According to this laser probe 1, the laser light emitted from the emission end 13 of the laser probe 1 is emitted in the direction opposite to the light shielding cap 4 as much as possible, and the light shielding cap 4
The effect of not irradiating the living tissue located on the side with the laser light is enhanced.

FIG. 4 shows a third embodiment of the present invention. This embodiment shows a modification of the light shielding cap 4 in the structure of the first embodiment. In this, the base end side portion of the light shielding cap 4 is formed as a protective sheath 14 which is fitted on the outer periphery of the light guide 2.

FIG. 5 shows a sealing device 23 used for advancing and retracting the handpiece 22 of the laser probe 1 by engaging with the laparoscopic trocar 21 through which the laser probe 1 is inserted as described above. .. The sealing device 23 has a sealing bellows 24 which is loosely fitted to the outer periphery of the light guide 2 of the laser probe 1, and the base end of the bellows 24 is hermetically connected to the handpiece 22. At the tip of the bellows 24, as shown in FIG.
A seal member 25 that is airtightly and detachably attached to the base end of No. 1 is attached. (C) shows a state when the bellows 24 is extended, and (D) shows a state when the bellows 24 is contracted.

However, when the sealing device 23 is used, when the laser probe 1 is moved back and forth with respect to the trocar 21, the air in the expanded abdominal cavity does not leak from the outer end opening of the trocar 21. Therefore, the gas pressure in the abdominal cavity is kept constant to prevent contraction. The sealing device 23 of this type is not limited to the laser probe 1 and can be similarly used when an electric scalpel or a scope is used.

Each of FIG. 6 shows a modification of the laser probe 1. These laser probes 1 can be used by mounting the light shielding cap 4 as described above. These laser probes 1 have contact tip 3
The configuration is such that more laser light is emitted from the side peripheral surface of 0.

In FIG. 1A, the light emitting tip 32 of the laser optical fiber 32 inserted in the sheath 31 is formed obliquely with respect to the central axis of the fiber 32, and the luminous flux emitted from the light emitting tip 33. I tried to bend the direction. Therefore, the laser light obliquely enters the tip chip 30,
The incident angle becomes large, and more laser light leaks from the side peripheral surface of the tip 30 without being totally reflected. Therefore,
The incision ability on the side of the tip 30 can be improved.

In (B), a lens 35 is provided between the emitting tip surface 33 of the laser optical fiber 32 inserted in the sheath 31 and the tip 30, so that the lens 35 is obliquely incident on the tip 30. The amount of laser light leaking from the side peripheral surface of the tip 30 is increased. Therefore, also in this case, the incision ability on the side of the tip 30 can be improved.

In (C), a concave lens portion 36 consisting of a spherical concave portion is formed on the incident end surface of the tip 30 facing the emitting tip surface 33 of the laser optical fiber 32 inserted into the sheath 31. Therefore, the laser optical fiber 3
The direction of the laser light incident on the tip chip 30 from 2 spreads, and more laser light leaks from the side peripheral surface of the tip chip 30. Therefore, the incision ability on the side of the tip 30 can be improved.

FIG. 3D shows a concentrator 37 made of a conical solid transparent body between the emitting tip surface 33 of the laser optical fiber 32 inserted in the sheath 31 and the tip 30.
Is provided to change the traveling direction of the laser light obliquely so that the laser light is obliquely incident on the tip 30. For this reason, the amount of laser light leaking from the peripheral surface of the side portion of the distal tip 30 increases, and therefore, also in this case, the incision ability at the side of the distal tip 30 can be improved.

FIG. 7 shows a structure for emitting more laser light from the side peripheral surface of the contact type tip 30 as in the case of FIG. 6 described above. of course,
This laser probe 1 can also be used by mounting the light shielding cap 4 as described above. That is, the incident end face 40 of the laser optical fiber 32 inserted into the sheath 31
First and second lenses 41 and 42 for converging and entering laser light from a laser light source (not shown) are selectively retractable in the incident optical paths.

The first lens 41 and the second lens 42 have different focal lengths. The focal length of the first lens 41 is short. On the other hand, the focal length of the second lens 42 is long. Then, as shown in (A), if the first lens 41 having a short focal length is located in the incident optical path, it can be incident on the incident end face 40 of the laser optical fiber 32 at a large incident angle. In this case, the laser light is transmitted through the laser optical fiber 32, and the emission angle of the laser light emitted from the emission end increases and spreads, so that the laser light is obliquely incident on the tip chip 30. Then, the amount of laser light leaking from the side peripheral surface of the tip chip 30 increases, and therefore,
In this case, the incision ability on the side of the tip 30 can be improved.

On the other hand, if the second lens 42 having a long focal length is located in the incident optical path as shown in FIG. 6B, the light is incident on the incident end face 40 of the laser optical fiber 32 at a small incident angle. In this case, the laser light is transmitted through the laser optical fiber 32, and the emitting angle of the laser light emitted from the emitting end becomes smaller and narrower, so that the laser light leaking from the side peripheral surface of the tip chip 30 is reduced. .. That is, by selecting the lenses 41 and 42, the incision ability on the side of the distal tip 30 can be selectively switched.

FIG. 8 shows a means for changing the direction of the emission tip of the laser optical fiber 32 when the laser light is incident on the incident end of the tip 30 from the laser optical fiber 32. That is, the guide member 52 having the taper guide surface 51 at the side portion of the tip end portion of the laser optical fiber 32.
Further, a tip operating portion 54 of the sliding member 53 that moves back and forth is provided between the tapered guide surface 51 and the tip of the laser optical fiber 32. The sliding member 53 is operated to move back and forth by a knob 55 provided at the base end of the sheath 31.

When the sliding member 53 is moved back and forth by the knob 55, the tip operating portion 54 of the sliding member 53 moves back and forth between the tapered guide surface 51 of the guide member 52 and the tip of the laser optical fiber 32. The tip of the laser optical fiber 32 can be bent in accordance with the amount of advance / retreat to change the direction of the emission end.
By changing the direction of the emission end in this way, the angle of the laser light incident on the incident end of the tip chip 30 changes, and the amount of laser light leaked from the side peripheral surface of the tip chip 30 without being totally reflected. It can be adjusted. Therefore, the knob 55
The incision ability at the side of the distal tip 30 can be appropriately adjusted according to the front-back position of the. It should be noted that the present invention is not limited to the above-mentioned embodiments, and various modifications can be considered within the scope of the invention.

[0029]

As described above, according to the present invention, when the light-shielding cap that covers one side of the emission end of the laser probe is provided, the laser beam is applied to the living body part located on one side of the emission end by this light-shielding cap. Do not irradiate. For this reason,
By arranging the light-shielding cap on the normal tissue side, it is possible to prevent the normal tissue from being irradiated with laser light or to transmit heat, and can be used safely.
Further, if the light-shielding cap is applied to the site of the living tissue, the emitting end can be correctly positioned and stabilized, which is easy to use.

[Brief description of drawings]

FIG. 1 is a side view of the vicinity of a tip portion of a laser probe according to a first embodiment of the present invention.

FIG. 2 is an explanatory diagram showing a usage state of the laser probe according to the first embodiment of the present invention.

FIG. 3 is a side view of the vicinity of the tip of the laser probe according to the second embodiment of the present invention.

FIG. 4 is a side view of the vicinity of the tip of the laser probe according to the third embodiment of the present invention.

5A and 5B show a sealing device used in the laser probe of the present invention, FIG. 5A is a side view of the entire structure, and FIGS.
Is an explanatory view of a procedure of using the sealing device portion.

6 (A) to 6 (D) are cross-sectional views showing various modifications of the incident portion with respect to the tip of the laser probe of the present invention.

FIG. 7 is a cross-sectional view showing a modified example of the incident portion with respect to the light guide of the laser probe of the present invention, in which (A) and (B) are different states in which the lenses are switched.

FIG. 8 is a cross-sectional view showing another modified example of the incident portion with respect to the tip of the laser probe of the present invention.

[Explanation of symbols]

DESCRIPTION OF SYMBOLS 1 ... Laser probe, 2 ... Light guide, 3 ... Tip, 4 ... Shading cap, 6 ... Shading part, 8 ... Gallbladder, 9 ...
Liver, 30 ... Tip.

Front page continuation (72) Inventor Yasuhiko Omagari 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd. (72) Eiichi Fuse 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optics Industrial Co., Ltd. (72) Inventor, Tsukagoshi Iso 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd. (72) Inventor Tadao Hagino 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optics Industry Co., Ltd.

Claims (1)

[Claims] 1. A laser probe connected to a laser device for guiding a laser beam to a laser irradiating portion, wherein a light-shielding cap is provided to cover one side of an emission end of the laser probe, and the light-shielding cap is positioned on one side of the emission end. A laser probe characterized in that a living body part is not irradiated with laser light.