JP5517828B2 - Hollow waveguide and laser therapy device - Google Patents

Description

  The present invention relates to a laser treatment apparatus that performs laser treatment, for example, and a hollow waveguide used in the laser treatment apparatus.

  Conventionally, a treatment method using an endoscope has been implemented as a treatment method that can be treated with less burden on the patient. In the treatment using this endoscope, the endoscope tube is inserted into the body from the oral cavity or the like, and imaging and treatment are performed using the distal end configuration portion of the endoscope tube.

  The imaging is performed by irradiating illumination light from the tip component, receiving reflected light from the tissue in the body with a lens provided in the tip component, transmitting the light from the endoscope tube to the endoscope body device, This is executed by the endoscope main unit imaged and displayed on the display device.

  The treatment is performed by a forceps tip that is inserted from a forceps insertion opening called a channel and comes out from the forceps outlet of the tip constituting portion. As the forceps, various instruments such as a gripping forceps and a knife are used.

An instrument that uses a laser treatment apparatus has been proposed as an instrument that is inserted from the forceps insertion opening and used for treatment (see Patent Document 1). This Patent Document 1 describes the use of a CO ₂ laser in an endoscope.

  In addition, a bent fiber is used as a member for transmitting laser light (see Patent Document 2), the hollow waveguides are connected to each other to be elongated (see Patent Document 3), and the hollow waveguide and the hollow probe are connected. Thus, it has been proposed to increase the transmission efficiency to the tip (see Patent Document 4).

  Here, to suit the purpose of searching for and observing the affected area (affected area), the distal end portion of the endoscope is provided with a curved tube section that bends in various directions up, down, left, and right by the operator's operation. It has been. For this reason, in particular, a member that transmits laser light that is inserted into a portion that performs a bending operation of the distal end portion of the endoscope can be flexibly bent in accordance with the movement of the distal end portion of the endoscope within the bending tube portion. Desired. If it does so, the glass raw material etc. which will be broken if it will curve are not preferable, and the raw material which can endure the curve will be calculated | required.

  Further, the endoscope tube has a long insertion portion extending to the bending tube portion. For this reason, a member that transmits laser light is required to transmit the laser light while maintaining the required output intensity even at this long distance. If it does so, it is preferable to raise the transmission efficiency of a laser beam with materials with high surface smoothness, such as a glass material.

  However, the technologies of the above-mentioned patent documents cannot solve the two conflicting problems of improving the laser beam transmission efficiency and preventing damage to the bending.

Special table 2007-533374 JP-A 61-273517 JP-A-4-174804 Japanese Patent Laid-Open No. 10-221544

  In view of the above-described problems, an object of the present invention is to provide a hollow waveguide and a laser treatment apparatus that solve two conflicting problems of improving laser light transmission efficiency and preventing damage to bending.

  The present invention is formed by connecting a flexible hollow waveguide, which is formed in a long hollow shape inside and covered with a dielectric thin film to guide laser light in the axial direction, and is on the laser emission end side. The hollow waveguide is a hollow waveguide formed of a material that is more flexible than the hollow waveguide on the laser light source side.

The flexible material may be a bendable material such as polycarbonate, thermoplastic resin, or elastic metal. The elastic metal may be a superelastic alloy such as nickel titanium or a shape memory alloy.
The hollow waveguide on the laser light source side can be formed of a material having high surface smoothness and high transmission efficiency, such as glass.

  The dielectric thin film can be formed of an appropriate material that reflects laser light, such as COP (cyclic olefin polymer) or polyimide.

  According to the present invention, two conflicting problems of improving the transmission efficiency of laser light and preventing damage against bending can be solved. In other words, when a hollow waveguide is inserted into a forceps channel of an endoscope and used, a predetermined range near the distal end performs an extremely bending operation, but breakage occurs because a flexible material is located in this bending operation portion. Can be prevented. Further, even if the laser light source side is inflexible, the laser light can be transmitted using a material having a high transmission efficiency, so that the transmission efficiency can be improved.

  Furthermore, in order to ensure the highest possible transmission efficiency, the inner surface of the hollow waveguide on the emission end side, which is formed of a flexible material, is inserted into the bending operation part, as well as the inner surface of the hollow waveguide on the laser light source side. Since it is covered with a body thin film, it is possible to irradiate with sufficient laser light for work such as treatment.

As an aspect of the present invention, the outer diameter of the hollow waveguide can be formed smaller than the inner diameter of the forceps insertion path of the endoscope and longer than the entire length of the forceps insertion path.
As a result, the hollow waveguide can be used by being inserted into the forceps insertion path of the endoscope.

Further, as an aspect of the present invention, there can be provided connection means for detachably connecting the hollow waveguide on the laser emission end side and the hollow waveguide on the laser light source side.
The connecting means is contracted by being heated to a predetermined temperature, and after the contraction, a cylindrical fastening member that can be cut by a sharp member such as a blade, a male screw and a female screw, a convex portion and a concave portion, etc. It can be configured by connecting means.
According to the present invention, the hollow waveguide on the laser emission end side can be attached and detached. For example, it can be easily replaced and used for each treatment.

As an aspect of the present invention, the hollow waveguide on the laser emission end side can be configured to have an elastic force that restores the original state even if it is bent by an external force.
As a result, even if it is locally bent, it can be restored, and the laser beam can be transmitted without any problem.

As an aspect of the present invention, the hollow waveguide on the laser emission end side can be formed longer than the length of the bending operation portion provided at the distal end portion of the endoscope.
As a result, only the laser emission end side hollow waveguide exists in the bending operation portion of the endoscope, and the light source side hollow waveguide does not exist. Therefore, the bending operation portion of the endoscope is damaged by the bending operation. Can be reliably prevented.

As an aspect of the present invention, the hollow waveguide on the laser emission end side can be formed in a curved state in a natural state.
Accordingly, when the hollow waveguide is inserted from the forceps channel of the endoscope and the tip of the hollow waveguide on the laser emission end side protrudes from the forceps discharge port, the protruding portion is in a curved state. Accordingly, the treatment can be performed with the tip of the hollow waveguide on the laser emission end side being curved.

As an aspect of the present invention, a laser beam misirradiation preventing member can be provided at the tip of the hollow waveguide on the laser emission end side.
The misirradiation preventing member can be composed of a member that reflects light, such as a member that absorbs light, or a metal member.

  According to this aspect, laser light can be absorbed or reflected. Therefore, it is possible to perform treatment between the irradiation end of the laser beam and the misirradiation prevention member to prevent misirradiation of the other laser beam, or to change the irradiation direction by reflecting the laser beam. Therefore, it is possible to provide a hollow waveguide on the laser emission end side that is easy to work with. In particular, if a plurality of types of hollow waveguides on the laser emission end side provided with various misirradiation prevention members and laser waveguides on the laser emission end side not provided with the misirradiation prevention members are prepared, the state of the affected part can be obtained. Accordingly, appropriate treatment can be performed using a hollow waveguide on an appropriate laser emission end side.

  Further, the present invention can be a laser treatment apparatus including the above-described hollow waveguide and laser irradiation means for guiding laser light through the hollow waveguide and irradiating the treatment target site with the laser light.

The site to be treated can be an appropriate part of a living body including a human, such as the esophagus or stomach.
The laser irradiation means can be constituted by a laser irradiation means for irradiating an appropriate laser. As a laser to be irradiated, an appropriate laser such as a carbon dioxide laser, an Er: YAG laser, an Nd: YAG laser, a semiconductor laser such as a diode laser, or a pulsed die laser can be used.

  According to the present invention, the bending portion of the endoscope can be freely bent using a hollow waveguide that can freely bend, and the practitioner can perform laser treatment in a favorable working environment.

The present invention is also a flexible hollow waveguide formed in an elongated inner hollow shape and having an inner surface covered with a dielectric thin film to guide laser light, the hollow waveguide being an endoscope It is made of a material having flexibility that can respond to the bending even if it is bent in the bending operation part on the distal end side of the tube, and elasticity that can secure an internal hollow waveguide space even if the bending is performed. A hollow waveguide having an outer diameter that is thinner than the inner diameter of the forceps insertion path of the endoscope tube, that is longer than the bending operation portion and shorter than the entire length of the endoscope tube can be obtained.

  As a result, a hollow waveguide that can be used by being connected to the tip of the hollow waveguide on the laser light source side can be provided, and the hollow waveguide on the laser irradiation end side can be replaced and used for each treatment. .

  According to the present invention, it is possible to provide a hollow waveguide and a laser treatment apparatus that solve two conflicting problems of improving the transmission efficiency of laser light and preventing damage to bending.

The schematic block diagram of the treatment system by an endoscope apparatus and a laser treatment apparatus. The block diagram which shows the structure of an endoscope apparatus and a laser treatment apparatus. Explanatory drawing of a hollow waveguide. Explanatory drawing of the other example of a hollow waveguide. Explanatory drawing of the misirradiation prevention member with which a hollow waveguide is mounted | worn.

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

  FIG. 1 is a configuration diagram illustrating a schematic configuration of a treatment system 1 including an endoscope apparatus 10 and a laser treatment apparatus 50, and FIG. 2 illustrates a configuration of the endoscope apparatus 10 and the laser treatment apparatus 50. It is a block diagram.

  In the endoscope apparatus 10, as shown in FIG. 1, an operator operation unit 12 is connected to the apparatus main body by a connection cable 11.

The operator operation unit 12 mainly includes an operation unit 13 and an endoscope tube 21.
The operation unit 13 includes an eyepiece unit 15, a vertical angle knob 16, a left / right angle knob 17, an operation button 18, and a forceps insertion port 20.
The operation button 18 receives operation inputs such as air supply, water supply, suction, and zoom.

  The endoscope tube 21 is provided with a flexible tube portion 22, a curved tube portion 23, and a distal end configuration portion 30 in this order from the base portion toward the distal end. A forceps insertion path 19 that communicates from the forceps insertion opening 20 to the forceps outlet 36 of the distal end component 30 is provided inside the endoscope tube 21. The forceps insertion path 19 functions as a therapeutic device insertion path for inserting a therapeutic device such as a forceps or a hollow waveguide 60. In FIG. 1, the diameter is enlarged from the middle of the flexible tube portion 22 to the distal end of the bending tube portion 23, but this is for easy understanding of the configuration of the distal end configuration portion 30. Actually, it has a shape with a constant diameter that is suitable for insertion into the living body such as the esophagus, stomach, and intestines.

  The flexible tube portion 22 has a cylindrical shape that is appropriately curved, and can insert a therapeutic device such as an appropriate forceps inserted from the forceps insertion port 20 up to the distal end configuration portion 30. In this embodiment, the hollow waveguide 60 of the laser treatment apparatus 50 is inserted as a treatment device.

  The bending tube portion 23 is bent in the vertical direction by the operation of the vertical angle knob 16 and is bent in the horizontal direction by the left and right angle knob 17. More specifically, the bending tube portion 23 is connected to the vertical angle knob 16 and the horizontal angle knob 17 by wires (not shown) inserted through the endoscope tube 21. For this reason, the rotation operation of the up-down angle knob 16 and the left-right angle knob 17 is transmitted to the bending tube portion 23 by the wire, and the bending tube portion 23 bends up, down, left and right. Thereby, the bending tube part 23 can be bent at an arbitrary angle in an arbitrary direction, and the distal end component part 30 can be directed in an appropriate direction toward the treatment target site.

The distal end configuration unit 30 is provided with light guides 31 and 35, a sub-water supply port 32, a lens 33, a nozzle 34, and a forceps outlet 36.
The light guides 31 and 35 are illumination parts that irradiate light serving as illumination for imaging. This makes it possible to observe and perform treatment by illuminating the inside of the body where light does not reach.

The auxiliary water supply port 32 is a water supply port that discharges a liquid such as a staining solution.
The lens 33 is a lens for condensing light by illumination such as the light guides 31 and 35 and acquiring a captured image. A captured image can be obtained by appropriately processing the collected information, and the operator can check the state. The imaging element that converts light into an electrical signal may be provided in the vicinity of the distal end component 30 and connected to the endoscope apparatus 10 with a conductive wire, or provided in the endoscope apparatus 10 for illumination. May transmit light condensed by the lens by a light guide provided separately.

The nozzle 34 is a part that discharges a cleaning liquid or the like for cleaning the lens 33 toward the lens 33.
The forceps outlet 36 is an outlet of a treatment device such as the hollow waveguide 60 of the laser treatment apparatus 50.

  The hollow waveguide 60 has an inner hollow cylindrical inner surface covered with a dielectric thin film. The hollow waveguide 60 is formed longer than the forceps insertion path length L1, which is also the entire length of the endoscope tube 21. Details of the hollow waveguide 60 will be described later.

  As shown in FIG. 2, the laser treatment device 50 includes an operation unit / display unit 51, a power supply unit 52, a signal processing unit 53, a central control unit 54, a detection unit 55, a guide light emitting unit 56, a laser oscillation unit 57, and A gas injection unit 58 is provided.

The operation unit / display unit 51 receives an operation input such as a laser output setting or an operation mode change and transmits an input signal to the central control unit 54, and the laser output condition, the operation status of the apparatus, etc. from the central control unit 54 The display signal is received and appropriate information is displayed.
The power supply unit 52 supplies operating power to each unit such as the central control unit 54.

  The signal processing unit 53 processes the signal detected by the detection unit 55 and transmits it to the central control unit 54. In this embodiment, the signal processing unit 53 and the detection unit 55 constitute an OCT (Optical Coherence Tomography) apparatus. The detection unit 55 transmits, from the guide light emitting unit 56, the reflected guide light 55a (signal light) obtained by reflecting the low coherence guide light 56a irradiated from the guide light emitting unit 56 at the treatment target site. The received reference light is received to obtain interference light. The light received at this time is near infrared light in the vicinity of 800 nm to 1 μm. The detection unit 55 detects the light intensity of the beat signal generated by the interference between the reflection guide light 55a (signal light) and the reference light. The signal processing unit 53 performs heterodyne detection for obtaining the intensity of the signal light reflected from the predetermined surface of the treatment target site from the light intensity received from the detection unit 55, and acquires optical coherence tomographic information. By performing this while changing the treatment target site to be detected, optical coherence tomographic information of each treatment target site can be obtained. Thereby, optical coherence tomographic information including a tissue profile of a certain depth from the surface is obtained, and not only the surface mucosal layer but also the tissue profile to the submucosa and muscle layers are obtained. This optical coherence tomographic information is information before performing the imaging process. Then, the signal processing unit 53 transmits this optical coherence tomographic information to the central control unit 54.

The central control unit 54 performs various control operations on each unit. The central control unit 54 also includes a laser output control unit 54a and a storage unit 54b.
The laser output control unit 54 a controls the output value of the laser light 57 a from the laser oscillation unit 57 according to the output set by the operation unit / display unit 51 and the operation mode.
The storage unit 54b stores appropriate data in addition to control data such as output settings and operation mode settings.

As described above, the detection unit 55 receives the reflection guide light 55a (signal light) and the reference light, and detects the light intensity of the beat signal generated from the interference light.
The guide light emitting unit 56 emits near-infrared light having a low coherence with a wavelength of 800 nm to 1 μm. This guide light is for indicating the position where the therapeutic laser beam 57a is irradiated. Although near-infrared light is invisible, it can be detected and imaged by an imaging device, so that it is converted into an image signal by the imaging unit 45 of the endoscope apparatus 10 to be described later and displayed on the image display unit 48. The position where the therapeutic laser beam 57a is irradiated can be confirmed.

  The laser oscillation unit 57 oscillates a laser beam 57a used for the treatment. In this embodiment, a carbon dioxide laser is used as the laser beam 57a. Operations such as setting of the irradiation intensity of the carbon dioxide laser and starting and stopping of irradiation are performed by manual operation by the operation unit / display unit 51 and control output by the central control unit 54. Note that part or all of the manual operation can be replaced with a stepping operation using a foot controller (not shown) provided to be able to communicate and control the laser treatment apparatus 50.

  The gas injection unit 58 injects a gas 58a such as air. The injection of the gas 58a is used for confirming the degree of deformation of the treatment target region, thereby confirming whether or not the tissue is denatured, to what depth it is denatured, and the like. It is desirable that the pressure of the gas 58a injected by the gas injection unit 58 is grasped by an appropriate pressure acquisition unit.

  The guide light 56a irradiated by the guide light emitting unit 56, the laser light 57a oscillated by the laser oscillation unit 57, the gas 58a ejected by the gas ejection unit 58, and the reflected guide light 55a detected by the detection unit 55 are all present. It is transmitted by one hollow waveguide 60. Therefore, all of them are transmitted coaxially, and the part that acts on the treatment target and the part to be detected coincide with each other as the treatment target part.

The endoscope apparatus 10 includes an operation unit 41, a power supply unit 42, a central control unit 43, an illumination unit 44, an imaging unit 45, a water ejection unit 46, and an image display unit 48.
The operation unit 41 transmits an operation input by the operation unit 13 (see FIG. 1) to the central control unit 43. That is, the bending operation of the bending tube portion 23 by the operation of the vertical angle knob 16 and the left and right angle knob 17, the pressing operation by the operation button 18, and the like are transmitted. Alternatively, separately from the operation unit 12, for example, an operation unit is provided in a controller main body (not shown) of the endoscope apparatus, and operations such as illumination light quantity and still image shooting and storage are performed in the central control unit 43. introduce.

The power supply unit 42 supplies operating power to each unit such as the central control unit 43.
The central control unit 43 executes various control operations on each unit.
The illumination unit 44 performs illumination from the light guides 31 and 35 (see FIG. 1).

The imaging unit 45 captures an image transmitted from the lens 33 (see FIG. 1) and obtains a captured image necessary for the treatment. By continuously acquiring the captured images in real time, the surgeon can perform the treatment smoothly.
The water ejecting unit 46 ejects liquid from the auxiliary water supply port 32. In addition, liquid ejection from the nozzle 34 is also executed. As described above, the imaging unit 45 may be provided in the vicinity of the distal end configuration unit 30 or may be provided in a controller main body (not shown) of the endoscope apparatus 10.

The image display unit 48 displays an image according to a signal transmitted from the central control unit 43. This image includes a captured image acquired by the imaging unit 45. Therefore, the surgeon can perform the procedure while confirming the captured image displayed on the image display unit 48 in real time. In addition, the preoperative image is stored as a still image in, for example, the central control unit 43 or a communicable external storage device, and the preoperative image is recalled and displayed after the operation, before and after the operation. You can also compare images.

FIG. 3 is an explanatory diagram for explaining the structure of the hollow waveguide 60.
Figure 3 As shown in the enlarged view of (A), medium-Sorashirube waveguide 60 has a light source-side hollow waveguide 61 of the laser treatment apparatus 50 body side, the exit end side hollow waveguide 65 of the distal, the exit end The side hollow waveguide 65 and the light source side hollow waveguide 61 are configured by a connection member 69 that connects the side hollow waveguide 65 and the light source side hollow waveguide 61.

  As shown in FIG. 3C, the hollow waveguide outer diameter R <b> 1 that is the outer diameter of the hollow waveguide 60 is formed narrower than the forceps insertion path inner diameter R <b> 2 that is the inner diameter of the forceps insertion path 19. Note that the hollow waveguide outer diameter R <b> 1 in this example matches the outer diameter of the connection member 69 that is the maximum outer diameter of the hollow waveguide 60.

  As shown in the longitudinal sectional view of FIG. 3B and the transverse sectional view of FIG. 3C, the light source side hollow waveguide 61 has a dielectric around the entire inner surface of the cylindrical hollow cylindrical body 62. The thin film 63 is covered. The cylindrical body 62 is formed in a long shape from a material that has a smooth surface such as a glass tube and is suitable for efficient transmission of laser light. The dielectric thin film 63 may be formed of an appropriate material that reflects laser light, such as COP (cyclic olefin polymer) or polyimide.

  Further, as shown in the longitudinal sectional view of FIG. 3B and the transverse sectional view of FIG. 3D, the emitting end side hollow waveguide 65 is formed on the entire inner surface of the hollow cylindrical cylindrical body 66. Is covered with a dielectric thin film 67.

  The material forming the cylindrical body 66 of the emission end side hollow waveguide 65 is a material different from the cylindrical body 62 of the light source side hollow waveguide 61 and more flexible than the cylindrical body 62, It is preferable that the material be restored by its own elastic force even if it is bent. Specifically, the cylindrical body 66 is formed in an elongated shape from a bendable material such as polycarbonate, thermoplastic resin, or elastic metal. The cylindrical body 62 may be formed of a superelastic alloy such as nickel titanium or a shape memory alloy.

  The dielectric thin film 63 may be formed of an appropriate material that reflects and guides laser light, such as COP (cyclic olefin polymer) or polyimide. The dielectric thin film 63 may be formed of the same material as the dielectric thin film 63 of the light source side hollow waveguide 61.

  The light source side hollow waveguide 61 and the emission end side hollow waveguide 65 are formed to have the same or substantially the same outer diameter and inner diameter. In particular, it is preferable that the inner diameter be the same so that a step or a gap is not generated as much as possible at the boundary between the dielectric thin film 63 and the dielectric thin film 67. Thereby, it is possible to minimize the collision of the laser beam 57a, the guide beam 56a, and the reflected guide beam 55a with the connection portion. In addition, by making the outer diameters the same, it is possible to prevent the hollow waveguide 60 from being caught when the hollow waveguide 60 is inserted into / removed from the forceps insertion path 19.

  A cylindrical connection member 69 is provided on the outer periphery of the connection portion between the light source side hollow waveguide 61 and the emission end side hollow waveguide 65. For example, the connection member 69 is preferably formed of a material that shrinks when heated to a predetermined temperature. Furthermore, it is preferable that the material be cut by a sharp member such as a blade after shrinking. Thus, the connection portion 69 is covered with the connection member 69 in a state where the connection end surfaces 61a and 65a of the light source side hollow waveguide 61 and the emission end side hollow waveguide 65 are in contact with each other, and the connection member 69 is heated. The member 69 fastens the light source side hollow waveguide 61 and the emission end side hollow waveguide 65.

  The exit end side hollow waveguide length L3, which is the length of the exit end side hollow waveguide 65, is longer than the bending tube portion length L2, which is the length of the bending tube portion 23, as shown in FIG. It is formed shorter than L1, and is preferably formed to have a length substantially the same as or slightly longer than the total length of the bending tube portion 23 and the distal end constituting portion 30 of the endoscope tube 21. Specifically, if the total length of the bending tube portion 23 and the tip constituting portion 30 is 10 cm, for example, it can be about 15 cm.

  In this manner, the exit end side hollow waveguide 65 is formed from the forceps outlet 36 of the distal end configuration portion 30 by forming a length substantially the same as or slightly longer than the total length of the bending tube portion 23 and the distal end configuration portion 30. Even when the treatment is performed with the distal end of the end-side hollow waveguide 65 protruding, even if the bending tube portion 23 is bent to the maximum extent, the hollow waveguide 60 is not broken or broken. I have to. In other words, since the bendable exit end hollow waveguide 65 is always present in the curved tube portion 23 that is bent to the maximum extent, the exit end side hollow waveguide 65 is not cracked or broken. Can prevent damage.

  In addition, the light source side hollow waveguide 61 occupying most of the hollow waveguide 60 reduces the attenuation amount of the laser light 57a, and the laser light 57a efficiently inside the hollow waveguide 60 inserted into the endoscope tube 21. Can be transmitted. Therefore, the laser beam 57a having an output effective for the treatment can be emitted from the tip of the hollow waveguide 60.

With the above configuration and operation, two conflicting problems of improving the transmission efficiency of the laser light 57a and preventing damage to the bending can be solved.
That is, the emission end side hollow waveguide 65 has flexibility and can be freely bent. Since the light emitting side hollow waveguide 61 is always positioned without entering the light source side hollow waveguide 61 inside the total length portion of the bending tube portion 23 and the distal end constituting portion 30 in the endoscope tube 21, the bending is performed. The hollow waveguide 60 can be prevented from being damaged no matter how many times the tube portion 23 is bent.

  Further, the light source side hollow waveguide 61 that occupies most of the hollow waveguide 60 is less flexible than the emission end side hollow waveguide 65 in terms of flexibility, but the transmission efficiency of the laser light 57a is higher than that of the emission end side hollow waveguide 65. Therefore, the attenuation of the laser beam 57a can be suppressed as much as possible, and the laser beam 57a can be transmitted efficiently. Thereby, the laser beam 57a can be made to reach the treatment target site while maintaining the output necessary for the treatment.

  Further, since the light source side hollow waveguide 61 and the emission end side hollow waveguide 65 have the same outer diameter and inner diameter and are firmly connected by the connecting member 69, stable transmission of the laser light 57a is realized. can do.

  In addition, since the connection member 69 is a material that shrinks when heated to a predetermined temperature, the connection between the light source side hollow waveguide 61 and the emission end side hollow waveguide 65 can be easily performed only by heating to a predetermined temperature, It is possible to connect by reducing the maximum diameter of the connecting portion as much as possible.

  Further, since the connection member 69 is a material that can be easily cut by a sharp member such as a sharp member such as a blade, the emission end side hollow waveguide 65 can be easily replaced.

  In addition, the cylindrical body 66 of the emission end side hollow waveguide 65 is made of a material that can be restored by its own elastic force even if it is bent, so that it can be restored even if it is locally bent. 57a can be transmitted to the surgical site without problems.

  Further, the hollow waveguide 60 can transmit the laser beam 57A for treatment, and can transmit the guide light 56a and the reflected guide light 55a and the gas 58a coaxially.

The hollow waveguide 60 may have other configurations.
FIG. 4 is an explanatory diagram for explaining another embodiment.
As shown in the example of FIG. 4A, a reflecting member 68 that reflects light may be provided at the distal end portion of the emission end side hollow waveguide 65A that becomes the distal end of the hollow waveguide 60A. The reflecting member 68 has a shape in which a cylindrical shape is cut obliquely and is halved, and an inclined surface 68a serving as a reflecting surface is formed on the emission end side hollow waveguide 65A side.

  The tip end portion of the emission end side hollow waveguide 65A is provided with an inclined cut surface 66a which is cut at an angle. The reflecting member 68 is fixed to the projecting side of the inclined cut surface 66a.

  With this shape, the laser beam 57 a that travels from the base side toward the tip end inside the emission end side hollow waveguide 65 </ b> A can be reflected at a substantially right angle by the inclined surface 68 a of the reflecting member 68.

  Therefore, it is possible to provide the exit end side hollow waveguide 65A that is easy for the practitioner to work. In particular, if a plurality of types such as the emission end side hollow waveguide 65A provided with the reflection member 68 and the emission end side hollow waveguide 65 provided with no reflection member 68 are prepared, the emission end side hollow suitable for the state of the affected part is prepared. Proper treatment can be performed using the waveguides 65 and 65A.

  As for the reflecting member, in addition to the embodiment that reflects the laser beam 57a at a substantially right angle as shown in FIG. 4A, the reflection angle of the laser beam can be formed according to the ease of use. By changing the shape of the reflecting member and the design angle of the reflecting member, for example, a laser beam reflection angle of 45 degrees or other angles can be realized.

FIG. 4B is a longitudinal sectional view showing another example.
In this example, a male screw portion 61 b is formed on the connection side outer periphery of the light source side hollow waveguide 61 B, and a female screw portion 65 b is formed on the connection side inner periphery of the emission end side hollow waveguide 65. The light source side hollow waveguide 61B and the emission end side hollow waveguide 65B are connected and fixed by screwing the male screw portion 61b and the female screw portion 65b. In this case, the outer diameter and the inner diameter of the light source side hollow waveguide 61B and the emission end side hollow waveguide 65B are preferably the same. However, as shown in the figure, the inner diameter of the light source side hollow waveguide 61B is set to the emission end side hollow waveguide. You may comprise smaller than 65B. With this configuration, the male screw portion 61b and the female screw portion 65b can be easily screwed together, and the attenuation of the laser light 57a transmitted from the base side to the tip side can be prevented. Since the connection between the male screw portion 61b and the female screw portion 65b is by screwing, the emission end side hollow waveguide 65 can be easily replaced by loosening the screwing. In addition, a female thread portion may be formed on the connection side outer periphery of the light source side hollow waveguide 61B, and a male thread portion may be formed on the connection side inner periphery of the emission end side hollow waveguide 65.

FIG. 4C is a longitudinal sectional view showing another example.
In this example, a convex part 61c is formed on the connection side outer periphery of the light source side hollow waveguide 61C, and a concave part 65c is formed on the connection side inner periphery of the emission end side hollow waveguide 65C. And the convex part 61c and the recessed part 65c fit, and the convex part 61c is hold | maintained because the recessed part 65c formed in the radiation | emission end side hollow waveguide 65C comprised with the flexible material elastically deforms, and the light source side The hollow waveguide 61C and the emission end side hollow waveguide 65C are connected and fixed. In this case, the outer diameter and the inner diameter of the light source side hollow waveguide 61C and the emission end side hollow waveguide 65C are preferably the same, but the inner diameter of the light source side hollow waveguide 61C is set to the emission end side hollow waveguide as shown in the figure. You may comprise smaller than 65C. With this configuration, the male screw portion 61b and the female screw portion 65b can be easily screwed together, and the attenuation of the laser light 57a transmitted from the base side to the tip side can be prevented. In addition, since the connection of the convex part 61c and the recessed part 65c is by fitting, the radiation | emission end side hollow waveguide 65 can be easily replaced | exchanged by removing fitting. Further, a concave portion may be formed on the connection side outer periphery of the light source side hollow waveguide 61C, and a convex portion may be formed on the connection side inner periphery of the emission end side hollow waveguide 65C.

  In addition, the emission end side hollow waveguide 65 may be formed in a curved shape in a normal state. In this case, inside the endoscope tube 21, it follows the shape of the endoscope tube 21, and the emission end side hollow waveguide 65 protrudes from the forceps outlet 36 of the tip constituting portion 30, so that the emission end side hollow is increased. The waveguide 65 can be configured to protrude while being curved. Thereby, the part which protrudes from the forceps exit 36 in the output end side hollow waveguide 65 can be curved, and the treatment can be performed with the tip of the output end side hollow waveguide 65 being bent.

  Each of these hollow waveguides 61A, 61B, 61C can also obtain the same operational effects as the hollow waveguide 61 described above.

  FIG. 5 is an explanatory diagram for explaining the configuration of the erroneous irradiation preventing member 70 attached to the hollow waveguide. FIG. 5A shows a perspective view of the erroneous irradiation preventing member 70, and FIG. 5B shows a longitudinal sectional view of the erroneous irradiation preventing member 70.

  The misirradiation preventing member 70 includes a mounting portion 71 that is mounted on the tip of the emission end side hollow waveguide 65, an arm portion 72 that extends from the mounting portion 71 toward the tip, and a stopper portion 74 that stops the laser light 57a. The laser light absorbing member 73 is provided on the entire light source side surface of the stopper portion 74.

  The mounting portion 71 has an inner diameter that is the same as or slightly smaller than the outer shape of the emission end side hollow waveguide 65. Thereby, it can be fixedly connected to the tip of the emission end side hollow waveguide 65. The mounting portion 71 may be adhered to the tip of the emission end side hollow waveguide 65, or may be detachably connected by a method such as screwing or concavo-convex fitting.

The arm part 72 is an arm that extends in a straight line. As a result, a space A for sandwiching the treatment target site E such as a lesion is secured.
The absorbing member 73 is formed of a member that absorbs the laser light 57a. This prevents the laser beam 57a reaching the stopper 74 from being reflected and perforating an unintended living body part.
The stopper portion 74 is a disk-shaped portion disposed opposite to the emission end side hollow waveguide 65 with an outer diameter at least equal to or larger than the inner diameter of the emission end side hollow waveguide 65.

The misirradiation preventing member 70 composed of these parts is formed of a material capable of maintaining the shape such as a metal member. Thereby, deformation can be prevented and the laser beam 57a irradiated from the emitting end side hollow waveguide 65 can be received.
By using the erroneous irradiation preventing member 70, the range in which the laser light 57a acts on the living body can be limited to the space A, and erroneous irradiation can be prevented.

  In addition to the laser light absorbing member 73, a light scattering member that disperses the laser light and a reflective material that reflects the laser light in an appropriate direction are provided on the entire light source side surface of the stopper portion 74 to prevent erroneous irradiation. Also good. Any form that can prevent an unintended part from being erroneously irradiated, such as penetrating or deviating from the treatment target part, may be used.

  In addition, in the configuration of the hollow waveguides 60, 60A, 60B, and 60C, in addition to the above-described embodiments, a part of the outer peripheral surface of the hollow waveguide (the outer periphery of the emission end side hollow waveguides 65, 65A, 65B, and 65C) Surface) or the entire outer peripheral surface of the hollow waveguide (outer peripheral surfaces of the emission end side hollow waveguides 65, 65A to C and the light source side hollow waveguides 61, 61A, 61B, 61C) (not shown). Can be formed. As a method for forming the endoscope protection member, the emission end side hollow waveguides 65 and 65A to C or the light source side hollow waveguides 61 and 61A to C are inserted and fixed to an endoscope protection member formed into a hollow pipe. Possible methods.

  At this time, the material used for the endoscope protection member that covers the outer peripheral surfaces of the emission-end-side hollow waveguides 65 and 65A to C inserted into the bending tube portion 23 has a property that can endure at least a bending operation, and A material such as a nickel titanium superelastic alloy or a shape memory alloy that does not allow the laser beam 57a to pass therethrough is suitable. On the other hand, the material used for the endoscope protecting member that covers the outer peripheral surfaces of the light source side hollow waveguides 61, 61A to C may be any material that does not allow at least the laser light 57a to penetrate, but the emission end side hollow waveguides 65, 65A. It may be the same as the material covering the outer peripheral surface of ~ C.

  Generally, when the endoscope apparatus 10 is used, the endoscope tube 21 bends or curves, so that a load is applied to the therapeutic device inserted into the tube. In the embodiment of the present invention, a load is applied mainly to the hollow waveguides 60, 60A to 60C of the laser treatment apparatus 50 inserted into the endoscope tube 21, and in particular, bending is performed by bending up, down, left and right during the treatment. A large load is applied to the emission end side hollow waveguides 61, 61 </ b> A to 61 </ b> C inserted into the tube portion 23. Therefore, if the cylindrical body 66 is damaged by the bending operation or the like during the treatment, and the laser beam 57a transmitted through the hollow waveguide leaks from the hollow waveguide, the laser beam 57a is erroneously irradiated into the endoscope tube 21. As a result, there is a possibility that the endoscope apparatus 10 and further the laser treatment apparatus 50 as a treatment device may be damaged or malfunctioned.

  By providing the endoscope protection member, it is possible to prevent erroneous irradiation of the laser light 57a into the endoscope tube 21 even if the tubular body 66 is damaged, so that the endoscope apparatus 10 and laser treatment can be prevented. The effect which can prevent generation | occurrence | production of the damage and malfunction of the apparatus 50 is show | played.

  In addition, when providing an endoscope protective member in the outer peripheral surface whole region of the hollow waveguides 60 and 60A-C, it can be set as the structure of mis-irradiation prevention over a wider range.

In correspondence between the configuration of the present invention and the above-described embodiment,
The endoscope of the present invention corresponds to the endoscope apparatus 10 of the embodiment,
Similarly,
The bending operation portion corresponds to the bending tube portion 23,
The laser irradiation means corresponds to the laser oscillation unit 57,
The other part corresponds to the light source side hollow waveguide 61,
The tip side portion corresponds to the emission end side hollow waveguide 65 of the embodiment,
The connection means corresponds to the connection member 69, the male screw portion 61b and the female screw portion 65b, and the convex portion 61c and the concave portion 65c.
The total length of the forceps insertion path corresponds to the total length L1 of the forceps insertion path,
The length of the bending operation part corresponds to the bending tube part length L2,
The outer diameter of the hollow waveguide corresponds to the outer diameter R1 of the hollow waveguide,
The inner diameter of the forceps insertion path corresponds to the forceps insertion path inner diameter R2,
The flexible materials are polycarbonate, thermoplastic resin, elastic metal, shape memory alloy, super elastic alloy,
The present invention is not limited only to the configuration of the above-described embodiment, and many embodiments can be obtained.

  The present invention can be used in various devices that treat a living body using a laser. In particular, the present invention can be used for an apparatus such as an endoscope that transmits a laser beam in a limited space for treatment and treatment.

DESCRIPTION OF SYMBOLS 10 ... Endoscope apparatus, 19 ... Forceps insertion path, 23 ... Curved tube part, 50 ... Laser treatment apparatus, 57 ... Laser oscillation part, 57a ... Laser beam, 60, 60A, 60B, 60C ... Hollow waveguide, 61, 61A, 61B, 61C ... light source side hollow waveguide, 61b ... male screw part,
61c ... convex portion, 63, 67 ... dielectric thin film, 65, 65A, 65B, 65C ... emitting end side hollow waveguide, 65b ... female screw portion, 65c ... concave portion, 69 ... connecting member, 70 ... erroneous irradiation preventing member, L1 ... Length of forceps insertion path, L2 ... Length of curved tube section, L3 ... Length of emission end side hollow waveguide, R1 ... Hollow waveguide outer diameter, R2 ... Forceps insertion path inner diameter

Claims (8)

A hollow waveguide on the laser emission end side, which is formed by connecting a flexible hollow waveguide that is formed in a long hollow shape inside and covered with a dielectric thin film to guide laser light in the axial direction. A hollow waveguide characterized in that is formed of a material that is more flexible than the hollow waveguide on the laser light source side. 2. The hollow waveguide according to claim 1, wherein an outer diameter of the hollow waveguide is smaller than an inner diameter of a forceps insertion path of an endoscope and is longer than an entire length of the forceps insertion path. 3. The hollow waveguide according to claim 1, further comprising a connecting means for detachably connecting the hollow waveguide on the laser emission end side and the hollow waveguide on the laser light source side. The hollow waveguide according to claim 1, 2, or 3, wherein the hollow waveguide on the laser emission end side has an elastic force that restores to an original state even when it is bent by an external force. The hollow waveguide on the laser emission end side is:
The hollow waveguide according to any one of claims 2 to 4, wherein the hollow waveguide is formed longer than a length of a bending operation portion provided at a distal end portion of the endoscope. The hollow waveguide according to any one of claims 1 to 5, wherein the laser output end side hollow waveguide is formed in a curved state in a natural state. The hollow waveguide according to any one of claims 1 to 6, further comprising a laser beam misirradiation prevention member at a tip of the hollow waveguide on the laser emission end side. A hollow waveguide according to any one of claims 1 to 7,
A laser treatment apparatus comprising laser irradiation means for guiding laser light through the hollow waveguide and irradiating the treatment target site with the laser light.

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