JP6842399B2 - Laser chips, laser treatment tools, laser treatment equipment, and laser treatment systems - Google Patents

Description

The present invention relates to, for example, a laser chip mounted on the tip of a laser transmission line, a laser treatment tool equipped with the laser tip, a laser treatment device, and a laser treatment system.

In recent years, in fields such as laparotomy and dental treatment, treatment may be performed using an electric knife or a laser treatment device using laser light, and the development of minimally invasive medical treatment using these laser treatment devices has progressed. There is. For example, surgical or medical treatment using an endoscope is performed as minimally invasive medical treatment. In particular, endoscopic submucosal dissection (Endoscopic Submucosal Dissection, abbreviated as ESD) for early gastrointestinal cancer is attracting attention as an effective treatment method with less burden on patients.

In the above ESD, the area around the affected area to be treated is first marked, and the mucosal layer is incised using this as a mark. The submucosal tissue is then stripped and all tissue in the tumor area is removed. High-frequency electric scalpels are generally used as treatment tools for these marking, submucosal incision, and submucosal dissection procedures, but blood vessels are also present in the submucosal layer, which may cause bleeding during the procedure.

Various laser treatment devices have been proposed for the purpose of stopping bleeding at such a bleeding site. For example, Patent Document 1 describes a metal that is an impermeable material for laser light and absorbs a part of the laser light. A laser treatment apparatus equipped with a heated laser tip is disclosed.

It is said that the laser chip can incise the treatment target portion with the laser chip heated by absorbing a part of the laser light, and can stop bleeding at the bleeding portion by irradiating the bleeding portion with a part of the laser beam that is not absorbed. ing.

However, there is a space between the laser chip and the exit end of the laser transmission path, and if a liquid such as blood or washing water intervenes in this space, the laser light is absorbed by the liquid and is sufficient for the laser chip. Not reachable. Therefore, the coagulation efficiency of blood is lowered, and there is a risk that hemostasis cannot be reliably performed at the bleeding site.

Japanese Unexamined Patent Publication No. 6-20578

Therefore, in view of the above problems, an object of the present invention is to provide a laser chip, a laser treatment device, and a laser treatment system capable of reliably stopping bleeding in laser medical treatment.

The present invention, irradiation and laser which emits the laser beam, a laser transmission path for guiding the laser beam oscillated from the laser oscillator to the practitioner target site, provided we are on the tip of the laser transmission path, the laser beam a laser chip mounted on the laser irradiation port provided we are to the laser transmission channel, as well as to conduct said laser light and gas, emitted from the laser irradiation port, the laser chip, the laser with an opening A mounting portion detachably configured on the irradiation port, a tubular cover portion extending from the mounting portion to the tip side along the irradiation direction of the laser beam, and a tubular cover portion provided on the tip side of the cover portion. It is composed of a bottomed tip and an irradiation space to be irradiated with the laser beam inside, and the bottom of the tip is not transmitted by the irradiated laser beam and is at least of the laser beam. This is a laser treatment device provided with a through hole in the cover portion that absorbs and heats a part of the laser portion, penetrates in an intersecting direction intersecting the irradiation direction, and allows gas to flow out through the laser transmission path .
The present invention is also characterized in that it is a laser treatment system composed of the above-mentioned laser treatment device and an endoscope capable of inserting the laser transmission path.

Further, the present invention is a laser chip provided at the tip of a laser transmission path, which is mounted on a laser irradiation port for irradiating a laser beam, and has a mounting portion which is open and detachably configured on the laser irradiation port. It is composed of a tubular cover portion extending from the mounting portion to the tip side along the irradiation direction of the laser beam and a bottomed tip bottom portion provided on the tip side of the cover portion. An irradiation space to be irradiated with the laser beam is formed, and the bottom of the tip is heated by absorbing at least a part of the laser beam without transmitting the irradiated laser beam to the cover portion. It is characterized in that a through hole is provided which penetrates in an intersecting direction intersecting the irradiation direction, conducts the laser transmission path together with the laser beam, and allows the gas emitted from the laser irradiation port to flow out.
The present invention is a laser treatment apparatus provided with a laser oscillator that oscillates a carbon dioxide laser beam, a laser transmission path that guides the laser beam oscillated from the laser oscillator to a site to be treated, and the above-mentioned laser chip. It is characterized by.

The above-mentioned irradiated laser light is not transmitted when at least the tip bottom portion is composed of a laser light non-transmissive member that absorbs the laser light without transmitting the laser light, or the tip bottom portion. This includes the case where a non-transmissive member that absorbs the laser light without transmitting it is attached to the mounting portion side and coated or attached.

According to the present invention, hemostasis can be reliably performed in laser medical treatment.
More specifically, since the irradiation space is formed inside the laser chip, an object that absorbs the laser light is not interposed between the laser chip and the bottom of the tip, and the laser light is attached to the bottom of the tip. It is directly irradiated to the part side. As a result, the laser beam is absorbed without being transmitted, and the bottom of the tip can be efficiently heated. Since the bottom of the tip that has been efficiently heated can be brought into contact with the bleeding site, the blood at the bleeding site can be reliably coagulated to stop bleeding.

Further, since the cover portion is formed in a tubular shape from the mounting portion to the tip end side, it is possible to prevent foreign substances such as blood from entering the irradiation space, for example. Therefore, the laser beam conducting through the irradiation space is not absorbed by the foreign matter, and the bottom of the tip can be efficiently heated.

As an aspect of the present invention, the cover portion may be provided with a through hole that penetrates in an intersecting direction intersecting the irradiation direction and allows a gas that conducts the laser transmission path to flow out.
According to the present invention, since the gas can flow out from the through hole, it is possible to prevent foreign matter from entering the inside of the laser transmission path through the through hole. Further, for example, when a gas such as air is allowed to flow into the laser transmission line, the pressure in the irradiation space increases, and it is possible to more reliably prevent foreign matter from entering the inside of the laser transmission line.

Furthermore, when the irradiation of the laser beam is stopped, the temperature of the tip bottom portion where the gas is heated is promoted, and the gas is released from the through hole, so that the tip bottom portion can be cooled immediately. .. This makes it possible to prevent damage to the living body due to unintended contact with the tip bottom because the temperature is not high when the laser beam is stopped even when the tip bottom is unnecessarily contacted with the living tissue.

Further, since the laser tip is cooled immediately when the irradiation of the laser beam is stopped, the inner wall of the endoscope scope is pulled out from the endoscope scope in which the laser treatment tool having the laser tip mounted on the tip is inserted. There is no risk of damage or injury to the operator when replacing the laser tip.

Further, as an aspect of the present invention, the bottom portion of the tip may be tapered toward the tip.
According to the present invention, since the surface area of the tip bottom can be reduced, the tip bottom can be heated more efficiently by irradiating the laser beam, and the bleeding site can be more reliably stopped from bleeding.

The above-mentioned tapering of the tip bottom portion toward the tip refers to a case where the tip end side of the tip bottom portion is configured to be thinner than the base end side, the cover portion, and the mounting portion, for example, the tip of the tip bottom portion. It refers to the case where the side is formed in a cone shape, a hemisphere, a semi-elliptical spherical shape, a cone trapezoidal shape, or a part of a spheroid shape.

Further, as an aspect of the present invention, a reflection recess that tapers toward the tip and reflects a part of the laser beam may be provided on the base end side of the tip bottom portion.
The reflective recess includes a case where the base end side of the tip bottom portion is formed in a cone shape or a cone trapezoidal shape, or a recess such as a hemispherical shape or a part of a spheroid.

Further, the reflection recess has a structure in which the mounting portion side of the tip bottom portion formed of a member that reflects a part of the laser beam such as metal is recessed, or is recessed so as to taper toward the tip. It also includes a configuration in which a reflecting member that reflects a part of the laser beam is attached to the mounting portion side of the tip bottom portion.

According to the present invention, since the volume of the tip bottom can be reduced, the tip bottom can be heated more efficiently by irradiation with the laser beam. Further, since the laser beam reflected without being absorbed by the tip bottom portion is irradiated to other places, the tip bottom portion can be heated more efficiently.

Further, as an aspect of the present invention, a contact surface formed of a curved surface having a radius of curvature of 10 mm or more or a flat surface may be provided in front of the bottom portion of the tip.
Specifically, the above-mentioned curved surface refers to a convex curved surface protruding toward the tip side or a concave curved surface toward the laser irradiation port side.

According to the present invention, hemostasis can be reliably performed without expanding the damaged area.
More specifically, for example, when the radius of curvature of the contact surface is +10 mm or more, or when the contact surface is flat, that is, when the contact surface is formed by a convex curved surface, or when the contact surface is formed. When the surface is flat, the contact surface can be directly pressed against the damaged portion to irradiate the bottom of the tip where the contact surface is provided with laser light. As a result, the blood in and around the damaged portion to which the contact surface heated by absorbing the energy of the laser beam is abutted can be coagulated, and the damaged portion can be reliably stopped from bleeding.

On the other hand, when the radius of curvature of the contact portion is −10 mm or more, that is, when the contact portion is formed of a concave curved surface, the contact portion is pressed against the damaged portion to be removed from the damaged portion. The discharged blood can be collected in the recess. Since the amount of blood collected in the recess is very small, the blood collected in the recess can be sufficiently coagulated at the abutting portion heated by irradiating the laser beam to stop bleeding at the damaged portion.
In this way, hemostasis using the contact portion having a different radius of curvature has a different hemostasis effect, so that the contact portion having a curved or flat surface having a different radius of curvature is used properly depending on the site of the bleeding site and the bleeding condition. be able to.

Further, as an aspect of the present invention, the tip bottom portion may be made of a metal material or a heat-resistant ceramic material.
According to the present invention, since the absorbed laser light is converted into heat at the tip bottom portion, the tip bottom portion can be reliably heated. Therefore, the blood at the bleeding site can be reliably coagulated and the bleeding site can be stopped.

Furthermore, as an aspect of the present invention, the tip bottom portion may be made of quartz glass.
The quartz glass is opaque only to laser light oscillating in the wavelength band of the infrared region such as a carbon dioxide gas laser, and has a configuration capable of transmitting in the visible wavelength band.

According to the present invention, the bottom of the tip can absorb the laser light in the infrared region and transmit the visible light, so that the tip side of the bottom of the tip is touched while visually observing the bleeding portion illuminated by the visible light. It can be contacted and bleeding can be stopped reliably.

Further, as an aspect of the present invention, a coating for reducing the reflection of the laser beam may be applied to the base end side of the tip bottom portion.
According to the present invention, the energy of the laser beam absorbed by the abutting portion can be increased, so that the abutting portion can be efficiently heated. As a result, bleeding can be reliably stopped when the contact portion is brought into contact with a bleeding damaged portion in the living tissue.

Further, as an aspect of the present invention, a sticking prevention coating for preventing sticking to a living tissue may be applied to the tip side of the tip bottom portion.
The anti-adhesion coating may be any coating as long as it does not adhere to living tissue, for example, titanium carbide (TiC), titanium nitride (TiN), silicon carbide (SiC), silicon nitride, or nitride. Contains boron (BN) and the like.

INDUSTRIAL APPLICABILITY According to the present invention, it is possible to prevent the abutting portion that has been brought into contact with the living tissue from sticking to the living tissue. Damage can be prevented.

INDUSTRIAL APPLICABILITY According to the present invention, it is possible to provide a laser chip, a laser treatment device, and a laser treatment system capable of efficiently stopping bleeding in laser medicine.

Schematic configuration diagram of a treatment system using an endoscope device and a laser treatment device. The block diagram which shows the structure of the endoscope apparatus and the laser treatment apparatus. The schematic perspective view of the laser chip attached to the tip of a laser transmission line. Schematic exploded perspective view of the tip of the laser transmission line and the laser chip. Explanatory drawing of a laser transmission line and a laser chip. Explanatory drawing of the laser chip used for the treatment system. Explanatory drawing of the laser chip of another embodiment. Explanatory drawing of the laser chip of another embodiment. Explanatory drawing of the laser chip of another embodiment. Explanatory drawing of the laser chip of another embodiment. Explanatory drawing of the laser chip of another embodiment.

An embodiment of the present invention will be described below with reference to the drawings.
FIG. 1 is a block diagram showing a schematic configuration of a laser treatment system 1 composed of an endoscope device 10 and a laser treatment device 50, and FIG. 2 is a configuration diagram showing a configuration of the endoscope device 10 and the laser treatment device 50. It is a block diagram which shows.

As shown in FIG. 1, the endoscope device 10 has an endoscope scope 12 connected to a device main body by a connection cable 11.
The endoscope scope 12 is mainly composed of an operation unit 13 and a flexible endoscope tube 21.

The operation unit 13 is provided with an eyepiece portion 15, an up / down angle knob 16, a left / right angle knob 17, an operation button 18, a device insertion port 20, and the like.
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 from the base to the tip, a curved tube portion 23 that can be flexibly bent, and a tip component portion 30 in this order. Further, inside the endoscope tube 21, a device insertion path 19 that communicates from the device insertion port 20 to the device outlet 36 of the tip component 30 is provided. The device insertion path 19 functions as a therapeutic device insertion path for inserting a therapeutic device such as forceps or a laser transmission path 60.

Note that FIG. 1 shows that the diameter is increased from the middle of the flexible tube portion 22 to the tip of the curved tube portion 23, but this is for drawing the configuration of the tip constituent portion 30 in an easy-to-understand manner. Actually, it has a shape with a constant diameter suitable for insertion into a living body such as the esophagus, stomach, and intestine.

The flexible tube portion 22 has a cylindrical shape that is appropriately curved, and a therapeutic device such as an appropriate forceps can be inserted from the device insertion port 20 to the tip component portion 30. In this embodiment, a laser transmission line 60 connected to the laser treatment device 50 is inserted as a treatment device. A laser chip 70 is attached to the tip of the laser transmission line 60.
The curved pipe portion 23 is curved in the vertical direction by the operation of the vertical angle knob 16, and is curved in the horizontal direction by the left and right angle knobs 17.

The tip component 30 is provided with light guides 31, 35, an auxiliary water supply port 32, a lens 33, a nozzle 34, and a device outlet 36.
The light guides 31 and 35 are illumination portions that irradiate light that serves as illumination for imaging. This makes it possible to illuminate the inside of the body, which is out of reach of light, for observation and treatment.

The sub water supply port 32 is a water supply port that discharges a liquid such as a dyeing liquid.
The lens 33 is a lens for collecting light from illumination such as light guides 31 and 35 and acquiring an image to be captured, and an image sensor arranged behind the lens.

The nozzle 34 is a portion that discharges a cleaning liquid or the like for cleaning the lens 33 toward the lens 33.
The device outlet 36 is an outlet of a therapeutic device such as a laser transmission line 60 of the laser treatment device 50. The laser transmission path 60 is formed to be longer than the device insertion path length, which is also the total length of the endoscope tube 21. The details of the laser transmission line 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 central control unit 54, a guide light emitting unit 56, a laser oscillation unit 57, and a gas emission unit 58.
The operation unit / display unit 51 receives operation inputs such as laser output settings and operation mode changes and transmits an input signal to the central control unit 54, and the central control unit 54 determines the laser output conditions and the operation status of the device. Receives the display signal of and displays appropriate information.
The power supply unit 52 supplies operating power to each unit such as the central control unit 54.

The central control unit 54 executes various control operations for each unit. The central control unit 54 also has a laser output control unit 54a, a storage unit 54b, and a gas control unit 54c.
The laser output control unit 54a controls the output value of the laser light 57a by the laser oscillation unit 57 according to the output and the operation mode set by the operation unit / display unit 51. The storage unit 54b stores appropriate data in addition to control data such as output settings and operation mode settings. The gas control unit 54c controls the output value of the released gas 58a according to the output and the operation mode set by the operation unit / display unit 51.

The guide light emitting unit 56 emits a guide light 56a for indicating a position where the therapeutic laser light 57a is irradiated. The guide light 56a can confirm the position where the therapeutic laser light 57a is irradiated.

The laser oscillating unit 57 oscillates the therapeutic laser beam 57a used in the treatment. In this embodiment, a carbon dioxide gas laser is used as the laser beam 57a. Operations such as setting the irradiation intensity of the carbon dioxide laser and starting and stopping the irradiation are performed by manual operation by the operation unit / display unit 51 and control output by the central control unit 54. It should be noted that a part or all of the manual operation can be replaced with a stepping operation using a foot controller (not shown) provided so as to be able to communicate and control the laser treatment device 50.
The guide light 56a emitted by the guide light emitting unit 56 and the laser light 57a oscillated by the laser oscillating unit 57 are all transmitted by one laser transmitter 63. The laser transmission body 63 is composed of a hollow waveguide.

The gas discharge unit 58 executes the discharge of the discharged gas 58a to be inserted into the laser transmission line 60. In this embodiment, air is used as the released gas 58a. The amount of air released is manually operated by the operation unit / display unit 51 and controlled by the central control unit 54, and the air pressure is changed according to the set value to supply a desired amount of air to the incident side of the laser transmission body 63. Insert it from inside. As described above, in the present embodiment, since the hollow waveguide is used as the laser transmission body 63, air can flow into the same space as the propagation region of the laser light.
The emitted gas 58a can keep the internal space of the laser chip 70, which will be described later, at a positive pressure, and can cool the laser chip 70 without irradiating the laser beam 57a.

The endoscope device 10 is provided with an operation unit 41, a power supply unit 42, a central control unit 43, an illumination unit 44, an image pickup unit 45, a water injection unit 46, and an image display unit 47.
The operation unit 41 transmits the operation input from the operation unit 13 (see FIG. 1) to the central control unit 43. That is, the bending operation of the curved pipe 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 that of the endoscope scope 12, for example, an operation unit is provided in the controller main body (not shown) of the endoscope device, and operations such as the amount of light of illumination and the shooting memory of a still image are performed by the central control unit. Communicate to 43.

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

The image pickup unit 45 captures an image transmitted from the lens 33 and an image pickup element (see FIG. 1) arranged behind the lens 33, obtains an image captured image necessary for the treatment, and performs image processing. By continuously acquiring the captured images in real time, the surgeon can perform the treatment smoothly.

The water injection unit 46 executes the injection of the liquid from the sub water supply port 32. It also executes injection of liquid from the nozzle 34. As described above, the imaging unit 45 may be provided in the vicinity of the tip component 30 or in the controller main body (not shown) of the endoscope device 10.

The image display unit 47 displays an image according to a signal transmitted from the central control unit 43. This image also includes a captured image acquired by the imaging unit 45. Therefore, the surgeon can perform the treatment while checking the captured image displayed in real time on the image display unit 47.

Next, the structure of the laser transmission line 60 and the laser treatment tool 80 in which the laser chip 70 is mounted at the tip of the laser transmission line 60 will be described with reference to FIGS. 3 to 5.
FIG. 3 shows an enlarged perspective view of the tip of the laser treatment tool 80, more specifically, shows a schematic perspective view of a laser transmission line 60 having a laser chip 70 mounted on the tip, and FIG. 4 shows a schematic perspective view of the tip of the laser transmission line 60. A schematic exploded perspective view of a state in which the laser chip 70 mounted on the laser tip 70 is removed is shown, and FIG. 5 shows an explanatory view of a tip portion of the laser treatment tool 80. In addition, in FIGS. 3 and 4, a part of the exterior tube 61 constituting the laser transmission line 60 is shown by a dotted line to indicate a transmission state.

More specifically, FIG. 5 (a) shows a side view of the laser treatment tool 80, FIG. 5 (b) shows a plan view of the laser treatment tool 80, and FIG. 5 (c) shows FIG. 5 (b). A cross-sectional view of AA is shown. In other words, FIG. 5C shows a vertical cross-sectional view of the laser transmission line 60 in a state where the laser chip 70 attached to the tip thereof is removed.

As shown in FIGS. 3 and 4, the laser transmission path 60 includes an outer tube 61, a laser chip side mounting portion 62 provided at the tip of the outer tube 61, and a laser transmission body inserted inside the outer tube 61. It is composed of 63 and is formed longer than the endoscope tube 21 as described above.

The outer tube 61 is a hollow and flexible resin tube having an insertion space 611 (see FIG. 5C) through which the laser transmission body 63 is inserted, and as shown in FIGS. 3 and 4, the outer tube 61 is a hollow and flexible resin tube. On the outer peripheral surface, a plurality of outer peripheral convex portions 612 having an outer diameter slightly smaller than the inner diameter of the device insertion path 19 of the endoscope tube 21 and adjacent outer peripheral convex portions 612 are concave from the outer peripheral convex portion 612. A certain outer peripheral recess 613 is arranged in parallel in the circumferential direction, and is formed in a substantially gear shape in a cross section viewed from the optical axis direction D corresponding to the irradiation direction of the laser beam 57a (not shown).

In the exterior tube 61 configured in this way, when the outer tube 61 is inserted into the device insertion path 19, the outer peripheral convex portion 612 comes into contact with the device insertion path 19 and is firmly fixed, and in response to the bending of the endoscope tube 21. Can be bent flexibly.

As shown in FIGS. 4 and 5 (c), the laser chip side mounting portion 62 has a configuration in which the transmission path side mounting portion 621, the tube connecting portion 622, and the laser chip mounting portion 623 are arranged side by side from the rear.
As shown in FIG. 5C, the transmission path side mounting portion 621 has an outer diameter substantially the same as the inner diameter of the outer tube 61, and is one size larger than the outer diameter of the laser transmitter 63 made of the hollow waveguide described later. It is formed of a tubular body having a large inner diameter, and the laser transmission body 63 can be inserted, and the laser chip side mounting portion 62 can be fitted to the outer tube 61 by inserting the transmission path side mounting portion 621 into the insertion space 611. ..

The tube connecting portion 622 is a tubular body provided at the tip of the transmission path side mounting portion 621, has an outer diameter slightly smaller than the inner diameter of the device insertion path 19, and is substantially the same as the outer diameter of the laser transmission body 63. It has an inner diameter, and when the laser chip side mounting portion 62 is mounted on the outer tube 61, the outer peripheral surfaces of the outer tube 61 and the laser chip side mounting portion 62 are flush with each other, and the laser irradiation port described later 631 can be fixed to the central portion of the cross section of the exterior tube 61.

The laser chip mounting portion 623 is a tubular body extending from the tip end portion of the tube connecting portion 622 and having an outer diameter substantially the same as that of the transmission path side mounting portion 621, and the outer peripheral surface on the proximal end side is along the optical axis direction D. A transmission path side threaded portion 624 is provided.

The laser transmission body 63 inserted into the insertion space 611 is a hollow waveguide, and has a cylindrical body in which the entire inner surface of the hollow cylindrical tubular body is covered with a dielectric thin film (not shown) at the tip. A laser irradiation port 631 for irradiating the laser beam 57a is provided.

The laser transmission body 63 constituting this hollow waveguide is a tubular body, has a smooth surface such as a glass tube, and is formed in a long shape by a material suitable for forming a reflective film such as silver and a dielectric thin film, and is dielectric. The body thin film is formed of an appropriate material such as COP (cyclic olefin polymer) or polyimide that efficiently reflects and transmits laser light.
In this way, since the inner peripheral surface of the laser transmission body 63 is coated with a reflective film such as silver and a dielectric thin film, the laser light 57a in the infrared region such as a carbon dioxide gas laser conducting inside the laser transmission body 63 is emitted. It can conduct with high transmission efficiency.

The laser chip 70, which can be attached to the tip of the laser transmission line 60, is an infrared laser light opaque, which is composed of a bottomed substantially cylindrical body in which the base end side on the incident side of the laser light is open and the tip side is closed. It is a metal laser chip made of stainless steel, and as shown in FIGS. 3 to 5, a laser transmission line 60, a detachable mounting portion 71, and a cover portion 72 extending from the mounting portion 71 to the tip side. , It is integrally formed with a bottomed tip bottom portion 73 provided on the tip end side of the cover portion 72.

The mounting portion 71 corresponding to the mounting portion is formed of a tubular body having substantially the same outer diameter as the outer diameter of the tube connecting portion 622 and having substantially the same inner diameter as the outer diameter of the laser chip mounting portion 623. On the inner peripheral surface on the rear end side of the mounting portion 71, a tip-side screw portion 711 that can be screwed with the transmission path-side screw portion 624 is formed (see FIG. 5C).

As shown in FIGS. 3 and 5, the cover portion 72 extending from the tip of the mounting portion 71 is a cylindrical body having the same outer diameter as the outer diameter of the mounting portion 71, and has an outer diameter of the laser chip mounting portion 623. The base end side cylindrical portion 721 having the same inner diameter as the above, and the tip end side cylindrical portion 722 provided on the tip end side of the base end side cylindrical portion 721 are integrally formed.

The base end side cylindrical portion 721 is a cylindrical body having the same outer diameter as the outer diameter of the mounting portion 71 and the same inner diameter as the outer diameter of the laser chip mounting portion 623. Three circular through holes 74 penetrating the plate thickness of the laser chip 70 are provided at equal intervals along the circumferential direction. The diameter of the through hole 74 is set so small that it is difficult for blood to enter the inside due to surface tension.

The distal end-side cylindrical portion 722 is a cylindrical body having the same outer diameter as the outer diameter of the proximal end-side cylindrical portion 721 and whose inner diameter is one size smaller than the inner diameter of the proximal end-side cylindrical portion 721. The inner surface of the distal end side cylindrical portion 722 and the inner surface of the proximal end side cylindrical portion 721 are connected via a stepped portion 723.

As shown in FIG. 5, the tip bottom portion 73 is formed in a truncated cone shape on the tip side of the tip side cylindrical portion 722. Specifically, the tip bottom portion 73 has a circle having the same outer diameter as the outer diameter of the tip side cylindrical portion 722 as the bottom surface, and a circle having a diameter of about one-third of the outer diameter of the tip side cylindrical portion 722 as the upper surface. It is formed in a conical trapezoidal shape, and a contact surface 731 that comes into contact with the bleeding site is provided at the tip of the tip bottom portion 73.

Further, as shown in FIG. 5C, the base end of the tip bottom portion 73 is provided with a concave recess 732 having a conical recess with a circle having the same diameter as the inner diameter of the tip side cylindrical portion 722 as the bottom surface. .. As shown in FIG. 5C, the recess 732 is configured such that the angle formed by the generatrix in cross-sectional view is 90 degrees, and the depth L2 of the recess 732 is about one-fourth of the height L1 of the cover portion 72. It is composed of the length of.
The recess 732 may be coated with a coating member that reduces the reflection of the laser beam 57a.

The contact surface 731 is formed of a circular plane along a cross section orthogonal to the optical axis direction D. Further, the surface thereof is coated with titanium carbide (TiC) in order to prevent adhesion to living tissues.

In this embodiment, titanium carbide (TiC) is used as the anti-adhesion coating, but the present invention is not limited to this, and any coating may be used as long as it does not adhere to the living tissue. .. Specifically, it may be coated with titanium nitride (TiN), silicon carbide (SiC), silicon nitride, boron nitride (BN) or the like.

Inside the laser chip 70 configured in this way, an irradiation space S in which the laser beam 57a and the emitted gas 58a are conducted is formed. Further, the laser chip 70 can absorb a part of the laser light 57a conducting the irradiation space S in the recess 732 and reflect the unabsorbed laser light 57a. In other words, it is configured so that the laser beam 57a is not emitted from the contact surface 731.

The laser chip 70 can be mounted on the tip portion of the laser transmission line 60 by screwing the mounting portion 71 into the laser chip mounting portion 623. In this state, by operating the laser treatment device 50 and oscillating the laser beam 57a, the laser beam 57a can be irradiated to the tip bottom portion 73.

Hereinafter, a case where the laser beam 57a is irradiated in the laser transmission line 60 with the laser chip 70 mounted will be described with reference to FIG.
Here, FIG. 6A shows the vicinity of the tip of the laser transmission line 60 in a state where the laser chip 70 is mounted on the laser transmission line 60, and the laser beam 57a propagated through the laser transmission body 63 and irradiated. A side sectional view showing the route is shown, and FIG. 6B shows a side sectional view showing the route of the emitted gas 58a in the laser transmission path 60 with the laser chip 70 attached.

As shown in FIG. 6A, the laser beam 57a emitted from the laser irradiation port 631 in the laser transmission path 60 with the laser chip 70 attached is irradiated to the base end side of the tip bottom portion 73, so that the tip end It is absorbed by the bottom 73. As a result, the tip bottom portion 73 (laser chip 70) is heated.

Further, of the laser light 57a emitted from the laser irradiation port 631, a part of the laser light 57a deviated from the center of the tip bottom portion 73 in the irradiation direction is reflected by the recess 732 toward the facing recess 732, and is reflected toward the recess 732 facing the recess 732. It is absorbed by the recess 732 facing the reflective surface in the above. As described above, a part of the laser beam 57a reflected without being absorbed is further absorbed by the recess 732, so that the tip bottom portion 73 is efficiently heated. Therefore, by abutting the heated contact surface 731 against the bleeding site by absorbing the laser beam 57a, the blood can be coagulated and the bleeding site can be stopped.

On the other hand, as shown in FIG. 6B, the released gas 58a discharged from the laser irradiation port 631 into the irradiation space S flows out to the outside through the through hole 74 provided in the base end side cylindrical portion 721. .. At this time, the released gas 58a is the air that is pressurized and passes through the inside of the laser transmission body 63, and the inside of the laser chip 70 becomes a positive pressure. Further, the released gas 58a is released to the outside through the through hole 74.

In this way, the released gas 58a is released from the through hole 74, and the diameter of the through hole 74 is so small that it is difficult for blood to enter the inside due to the surface tension of the blood. Even if blood or the like adheres to the vicinity of 74, it is possible to prevent blood from entering the internal space of the laser chip 70 through the through hole 74.

In the above description, the laser tip 70 has a tip bottom portion 73 that tapers toward the tip provided at the tip of the cylindrical cover portion 72, and a concave portion that is recessed in a conical shape on the inner surface of the tip bottom portion 73 on the base end side. Although the 732 is provided, as shown in FIGS. 7 and 8, a laser chip 70 having another shape may be used.

Here, FIGS. 7 and 8 show cross-sectional views corresponding to the AA cross-sectional views of the laser chip 70 in the laser chips 70a, 70b, 70c, 70d, and 70e, which are other embodiments.
Of the configurations of the laser chips 70a, 70b, 70c, 70d, and 70e shown in FIGS. 7 and 8, the same configurations as those of the laser chip 70 are designated by the same reference numerals, and the description thereof will be omitted.

For example, in the laser chip 70a shown in FIG. 7A, the tip bottom portion 73a provided on the tip side of the cover portion 72 is a cylindrical body having the same outer diameter as the cover portion 72, and is located on the base end side of the tip bottom portion 73a. Is formed with a conical recess 732 that tapers toward the tip side. The contact surface 731a of the laser chip 70a formed in this way has a larger area than the contact surface 731.

Further, as in the laser chip 70b shown in FIG. 7B, the cover portion 72b and the tip bottom portion 73b may be formed in a shape that tapers from the base end side.
Specifically, the laser chip 70b is integrally composed of a mounting portion 71, a cover portion 72b corresponding to the cover portion 72, and a tip bottom portion 73b corresponding to the tip bottom portion 73.

The cover portion 72b is formed by a truncated cylinder having the same outer diameter as the outer diameter of the mounting portion 71 and a truncated cone provided on the distal end side of the cylinder, and the distal end side cylindrical portion 721b and the distal end side cylindrical portion 721b. The tip side cylindrical portion 722b, which is a truncated cone extending from the tip, is formed, and the tip bottom portion 73b is integrally formed in a truncated cone shape that tapers toward the tip.

In addition, instead of forming a recess 732 on the base end surface of the tip bottom portion 73b, a hemispherical spherical protrusion 733 having the same diameter as the inner diameter of the cover portion 72 protruding toward the base end side is integrally configured. Has been done.

Like the laser chip 70, the protrusion 733 is made of stainless steel, and the laser transmission path 60 is a part of the laser light 57a when the laser chip 70 is attached to the tip thereof and irradiated with the laser light 57a. Can be absorbed to heat the tip bottom portion 73b, and the unabsorbed laser beam 57a can be reflected toward the cover portion 72b to heat the cover portion 72b.

Further, the cover portion 72b does not necessarily have to have a frustum shape, and is formed by an arc whose outer shape in the cross section of the laser chip 70c tapers toward the tip in the optical axis direction D, for example, as shown in FIG. 7C. It may have been done. In FIG. 7C, a protrusion 733 is formed on the base end side of the tip bottom portion 73c, but a recess 732 may be formed as in the case of the laser chip 70 or the like.

Furthermore, as shown in the laser chips 70d and 70e shown in FIGS. 8 (a) and 8 (b), the stairs of the cover portions 72d and 72e toward the inner diameter side toward the tip end side in the optical axis direction D in the cross-sectional view. It may be composed of a shape.

More specifically, the laser chips 70d and 70e shown in FIGS. 8 (a) and 8 (b) have a mounting portion 71, a cover portion 72d and 72e corresponding to the cover portion 72, and a tip bottom portion corresponding to the tip bottom portion 73. It is composed of 73d and 73e.

The cover portions 72d and 72e extending from the mounting portion 71 toward the tip are the base end side cylindrical portions 721d and 721e, which are cylindrical bodies having a stepped shape in which the diameter is reduced toward the inner diameter side in the central portion in the longitudinal direction. It is integrally composed of the distal end side cylindrical portions 722d and 722e, which are cylindrical bodies whose diameters are smaller than the distal end side outer diameters of the proximal end side cylindrical portions 721d and 721e.

The base end side cylindrical portions 721d and 721e have the same outer diameter as the outer diameter of the mounting portion 71 on the base end side, and are formed in a stepped shape having a diameter smaller than the outer diameter of the mounting portion 71 at the central portion. .. Further, the inner diameters of the base end side cylindrical portions 721d and 721e are configured to be the same as the outer diameter of the laser chip mounting portion 623. It should be noted that three through holes 74 penetrating outward in the radial direction are provided in the central portion of the base end side cylindrical portions 721d and 721e in the optical axis direction D.

The length of the optical axis direction D in the tip side cylindrical portions 722d and 722e is formed longer than that of the tip side cylindrical portion 722 in the cover portion 72, and the tip bottom portions 73d and 73e have a truncated cone shape at the tip. Is provided. The length of the tip bottom portions 73d and 73e in the optical axis direction D is formed to be about half the length of the tip bottom portion 73 of the laser chip 70.

As shown in FIG. 8A, the tip bottom portion 73d is formed with a concave portion 732 recessed in a conical shape on the proximal end side. On the other hand, as shown in FIG. 8B, no recess is formed on the base end side of the tip bottom portion 73e, and the tip bottom portion 73e is formed in a flat shape.

Further, the length L3 of the tip bottom portion 73d along the optical axis direction D is configured to be about 1.5 times the depth L4 of the recess 732. That is, the laser chip 70d is formed so that the distance between the tip of the recess 732 and the contact surface 731d of the tip bottom 73d is shorter than that of the laser chip 70.

Since the laser chips 70d and 70e configured in this way have a smaller volume than the laser chip 70, they can be heated more efficiently. Further, since the distance between the contact surfaces 731d and e and the base end side of the tip bottom portion 73 is formed to be short, the tip bottom portions 73d and 73e can be heated more efficiently. In particular, in the laser chip 70d, since the distance between the contact surface 731d and the tip of the recess 732d is shorter, the tip bottom 73d can be heated more efficiently.

The configuration of the laser chip 70 shown in FIGS. 5, 7 and 8 is not limited to this configuration, and the combination can be changed as appropriate. That is, the base end side of the tip bottom portion 73c of the laser chip 70c can be made flat like the laser chip 70e, or the protrusion 733 can be provided on the base end side of the tip bottom portion 73d of the laser chip 70d. Further, the length of the tip bottom portion 73 of the laser chip 70 in the optical axis direction D can be shortened.

The laser chip 70 (referred to as a laser chip 70 including the laser chips 70a, 70b, 70c, 70d, and 70e) configured in this way has a laser beam 57a provided at the tip of the laser transmission path 60. A laser chip to be mounted on the laser transmitting body 63 to be irradiated, and mounting portions 71 (mounting portions 71a, 71b, 71c, 71d, 71e) which are detachably configured to be attached to and detachable from the laser transmitting body 63 while opening the incident side of the laser beam. Including, it is described as the mounting portion 71) and the tubular cover portion 72 (cover portions 72a, 72b, 72c, which extends from the mounting portion 71 to the tip side along the optical axis direction D of the laser beam 57a. 72d, 72e are included as the cover portion 72), and the bottomed tip bottom portion 73 (tip bottom portions 73a, 73b, 73c, 73d, 73e) provided on the tip end side of the cover portion 72 is included. It is described as the tip bottom 73) to form an irradiation space S in which the laser beam 57a is irradiated, and the tip bottom 73 does not allow the irradiated laser beam 57a to pass through, and at least the laser. By absorbing a part of the light 57a and heating it, bleeding can be reliably stopped in laser medical treatment.

More specifically, since the irradiation space S is formed inside the laser chip 70, there is nothing that absorbs the laser beam 57a up to the tip bottom 73. Therefore, the laser beam 57a is directly irradiated to the tip bottom portion 73, and the tip bottom portion 73 is absorbed without transmitting the laser beam 57a, so that the tip bottom portion 73 is efficiently heated. Since the tip bottom 73 efficiently heated in this way can be brought into contact with the bleeding site, the bleeding site can be reliably stopped from bleeding.

Further, since the cover portion 72 is formed in a tubular shape from the mounting portion 71 to the tip end side, it is possible to prevent foreign matter such as blood from entering the inside of the laser chip 70. Therefore, the laser beam 57a conducting through the irradiation space S is not absorbed by the foreign matter, and the tip bottom portion 73 can be efficiently heated.

Further, the cover portion 72 is provided with a through hole 74 that penetrates in the intersecting direction intersecting the optical axis direction D and allows the emitted gas 58a that conducts the laser transmission path 60 to flow out, so that the emitted gas 58a is provided from the through hole 74. It can flow out and prevent foreign matter from entering the inside of the laser transmission line 60 through the through hole 74 (see FIG. 6B). In particular, in the present embodiment, a hollow waveguide is used as the laser transmission body 63, and if foreign matter invades the inside of the waveguide and becomes contaminated, the laser transmission efficiency is significantly lowered. Further, since the emitted gas 58a is a gas that flows in from the incident side of the laser transmission body 63, it is possible to more reliably prevent foreign matter from entering the inside of the laser transmission body 63.

Furthermore, by providing the through hole 74, when the irradiation of the laser beam 57a is stopped, the temperature of the tip bottom 73 where the gas is heated is promoted, and the gas is discharged from the through hole 74, so that the laser As soon as the irradiation of the light 57a is stopped, the tip bottom portion 73 can be cooled. As a result, even when the tip bottom 73 is unnecessarily in contact with the living tissue, the tip bottom 73 is not at a high temperature when the laser beam is stopped, so that damage to the living body due to unintended contact with the tip bottom 73 can be prevented.

Further, since the laser chip 70 is cooled as soon as the irradiation of the laser beam 57a is stopped, the inner wall of the endoscope scope 12 may be damaged when it is pulled out from the endoscope scope 12 in which the laser transmission path 60 is inserted, for example. There is no risk of the practitioner being injured when replacing the laser chip 70.

Further, since the tip bottom portions 73, 73b, 73c, 73d, 73e are tapered toward the tip, the surface area of the tip bottom portions 73, 73b, 73c, 73d, 73e can be reduced, so that the laser beam 57a is irradiated. As a result, the bottom of the tip 73 can be heated more efficiently, and the bleeding site can be stopped more reliably.

Furthermore, the base end side of the tip bottom portions 73, 73a, 73d is provided with a recess 732 that tapers toward the tip in the laser irradiation direction and reflects a part of the laser beam 57a. The volume of the tip bottom 73 can be reduced. Therefore, the tip bottom portion 73 can be heated more efficiently by irradiating the laser beam 57a.

Further, as shown in FIG. 6A, the laser light 57a reflected without being absorbed by the recess 732 is irradiated to a surface different from the surface of the recess 732 irradiated with the laser light 57a, and is absorbed by the tip bottom portion 73. Therefore, the tip bottom portion 73 can be heated more efficiently.

Furthermore, the damaged area is widened by providing contact surfaces 731, 731a, 731b, 731c, 731d, 731e formed of flat surfaces in front of the tip bottom portions 73, 73a, 73b, 73c, 73d, 73e. Hemostasis can be reliably performed without any problems.

More specifically, the laser beam 57a is applied to the tip bottoms 73, 73a, 73b, 73c, 73d, 73e to directly press the heated contact surfaces 731, 731a, 731b, 731c, 731d, 731e against the damaged part. As a result, blood in and around the injured site can be coagulated to ensure hemostasis at the injured site.

Further, in the present embodiment, the contact surface 731 or the like is a flat surface, but it is not necessary to limit the contact surface 731 or the like to a flat surface. For example, as shown in FIGS. 9 and 10, contact surfaces 731x and 731y formed by a curved surface having a radius of curvature of 10 mm or more may be provided.

Hereinafter, the laser chip 70x having a gentle convex surface and the laser chip 70y having a gentle concave surface will be described with reference to FIGS. 9 and 10. Of the configurations of the laser chips 70x and 70y described below, the same configurations as those of the laser chip 70 are designated by the same reference numerals, and the description thereof will be omitted.

FIG. 9 shows an explanatory view when the contact surface is a gently convex surface, and FIG. 10 shows an explanatory view when the contact surface is a gentle concave surface. Specifically, FIG. 9A shows a cross-sectional view of the laser tip 70x having a gently convex contact surface, and FIG. 9B shows a schematic cross-sectional view of a bleeding site E hemostasis method using the laser tip 70x. Shown. Further, FIG. 10A shows a cross-sectional view of the laser tip 70y having a gently convex contact surface, and FIG. 10B shows a schematic cross-sectional view of a hemostasis method of the bleeding site E using the laser tip 70y. .. The bleeding site E is a blood vessel running in the submucosal layer L2 between the mucosal layer L1 and the muscular layer L3.

As shown in FIG. 9A, the laser chip 70x has a contact surface formed in front of the laser chip 70x, which is composed of a gently curved contact surface 731x having a radius of curvature of 15 mm protruding forward. There is.

Therefore, when the contact surface 731x is brought into contact with the bleeding site E, the living tissue is deformed along the curved surface, and the amount of blood intervening between the bleeding site E and the contact surface 73x can be further reduced. , Blood B can be reliably coagulated to stop bleeding from the bleeding site E (see FIG. 9B).
Further, unlike the laser chip 70, since the laser chip 70x does not have a corner formed at the end of the contact surface 731x, it is possible to prevent the corner from damaging the living tissue in the vicinity of the bleeding site E.

On the other hand, in the laser chip 70y, as shown in FIG. 10A, the contact surface formed in front of the laser chip 70y is composed of a gently curved contact surface 731y recessed in the rear and having a radius of curvature of 15 mm. Has been done.

Therefore, when the contact concave surface 73y is brought into contact with the bleeding site E, blood B can be collected between the contact surface 731y and the bleeding site E. Since the accumulated blood B is a minute amount, it can be sufficiently coagulated by abutting the heated contact concave surface 73y to reliably stop bleeding at the bleeding site E (see FIG. 10B).

As described above, when the radius of curvature of the contact surface 731 is +10 mm or more (see FIG. 9A), that is, when the contact surface 731x is formed by a convex curved surface, the contact surface 731x is damaged. Since it can be directly pressed against the injured site (see FIG. 9B), the heated contact surface 731x can coagulate the blood in and around the injured site, and the injured site can be reliably stopped from bleeding.

On the other hand, when the radius of curvature of the contact surface 731 is -10 mm or more, that is, when the contact surface 731y is formed by a concave curved surface (see FIG. 10A), the contact surface 731y is used as the damaged portion. By pressing, blood discharged from the injured site can be collected in the recess (see FIG. 10 (b)). By irradiating the laser beam 57a, the blood accumulated in the recess can be coagulated on the heated contact surface 731y to stop bleeding at the damaged site.
In this way, hemostasis using contact surfaces 731 with different radii of curvature has different hemostasis effects, so the contact surfaces 731 on curved or flat surfaces with different radii of curvature are used properly depending on the site of bleeding and the bleeding condition. be able to.

Further, since the laser chip 70 including the tip bottom 73 is made of a metal material that does not transmit the laser light, the absorbed laser light 57a can be converted into heat at the tip bottom 73 to heat the tip bottom 73. Therefore, the tip bottom portion 73 can be reliably heated. Therefore, the blood from the bleeding site E can be surely coagulated and the bleeding site can be stopped.
The laser chip 70 including the tip bottom portion 73 has the same effect even if it is made of a heat-resistant ceramic material that is opaque to laser light, instead of a metal material.

In the present embodiment, the laser chip 70 is made of stainless steel. For example, the laser chip 70 may be made of quartz glass that is opaque to infrared laser light but transparent to visible light. In this case, since the tip bottom 73 can absorb the laser beam 57a, which is an infrared laser, and transmit visible light as guide light, the tip is visually observed by illuminating the bleeding site with the guide light. The tip side of the bottom portion 73 can be accurately contacted. Therefore, the bleeding site can be stopped more reliably.

Further, since the base end side of the tip bottom portion 73 is coated with a coating that reduces the reflection of the laser beam 57a, the energy of the laser beam 57a absorbed by the contact portion can be increased, so that the contact portion Can be heated efficiently. As a result, bleeding can be reliably stopped when the contact portion is brought into contact with the bleeding damaged portion in the living tissue.

Furthermore, since the tip side of the tip bottom portion 73 is provided with a sticking prevention coating that prevents sticking to the living tissue, the contact portion that has come into contact with the living tissue is stuck to the living tissue. Therefore, it is possible to prevent damage to the damaged part when the contact portion is separated from the damaged part where bleeding is stopped.

In correspondence between the configuration of the present invention and the above-described embodiment, the reflective recess of the present invention corresponds to the recess 732.
Similarly, the laser oscillator corresponds to the laser oscillator unit 57.
The endoscope corresponds to the endoscope device 10, but
The irradiation direction corresponds to the optical axis direction D,
The present invention is not limited to the configuration of the above-described embodiment, and many embodiments can be obtained.

For example, in the present embodiment, the laser chip 70 including the tip bottom 73 is made of stainless steel that absorbs the laser beam 57a, but the present invention is not limited to this, for example, it may be made of a titanium alloy having good compatibility with a living body, or the tip may be made of a titanium alloy. A laser light non-transmissive member that converts heat without transmitting the laser light 57a may be attached to the contact surface 731 of the bottom portion 73.

Further, in the present embodiment, the contact surface 731 has a shape in which the base end side of the tip bottom portion 73 is recessed in a conical shape, but may be, for example, a cone trapezoidal shape or a spherically recessed shape, and further. , As shown in FIG. 11A, it may be a cone-shaped depression that is rotationally asymmetrical along the optical axis direction D. By forming the cone shape asymmetrically in rotation in this way, it is possible to prevent the laser beam 57a irradiated on the contact surface 731 from being reflected toward the laser transmission body 63 side.

Further, in the present embodiment, the angle formed by the busbars of the recesses 321 is 90 degrees, but the angle is not limited to this angle, and may be 90 degrees or less or 90 degrees or more. However, when the angle formed by the bus lines is 90 degrees or less, the laser beam 57a can be reflected on the surface facing the recess 321 irradiated with the laser beam, so that the reflected laser beam 57a causes the tip bottom portion 73. Can be heated efficiently.

Furthermore, in the present embodiment, the through hole 74 is provided in the central portion of the base end side cylindrical portion 721, but it does not necessarily have to be in this position, and may be provided in, for example, the tip end side cylindrical portion 722, and further. It may be provided in the mounting portion 71. Further, as shown in FIG. 11B, the laser irradiation port 631 may be projected toward the tip end side, and the through hole 74 may be provided on the proximal end side of the laser irradiation port 631.

Furthermore, in the present embodiment, the through hole 74 is formed along the radial direction of the cover portion 72 of the cylindrical body, but it does not necessarily have to be provided along this direction, and is shown in FIG. 11 (c), for example. As described above, the cover portion 72 may be formed from the radial direction toward the proximal end side. As a result, the length of the through hole 74 can be increased, and the released gas 58a emitted from the laser irradiation port 631 can be sent to the tip side without being directly discharged to the outside from the through hole 74. Therefore, it is possible to prevent external blood or the like from entering the inside of the laser chip 70 through the through hole 74, and it is possible to efficiently cool the tip bottom portion 73 when the laser beam 57a is stopped.
Further, the through hole 74 may be formed so that the diameter is reduced toward the outer side in the radial direction.

The configuration of the laser chip 70 shown in FIG. 11 is not limited to this configuration, and for example, the combination may be appropriately changed with respect to the laser chip 70 shown in FIGS. 5, 7, and 8. Absent. That is, the combination of each configuration of the embodiments described in the present specification can be appropriately changed as long as there is no contradiction.

1 Treatment system 10 Endoscope device 50 Laser treatment device 57 Laser oscillation unit 57a Laser light 60 Laser transmission path 631 Laser irradiation ports 70, 70a, 70b, 70c, 70d, 70e, 70x, 70y Laser chips 71, 71a, 71b, 71c, 71d, 71e Mounting parts 72, 72a, 72b, 72c, 72d, 72e Cover parts 73, 73a, 73b, 73c, 73d, 73e, 73x, 73y Tip bottom 732 recesses 731, 731a, 731b, 731c, 731d, 731e , 731x, 731y Contact surface 74 Through hole 80 Laser treatment tool D Irradiation direction S Irradiation space

Claims (12)

A laser oscillator that oscillates laser light and
A laser transmission line that guides the laser beam oscillated from the laser oscillator to the treatment target site,
The provided et is the tip of the laser transmission path, and the laser chip is provided we are to be mounted on the laser irradiation port irradiating the laser beam,
The laser transmission path conducts the laser light and the gas and emits the laser light from the laser irradiation port.
The laser chip is
A mounting portion that opens and is detachably attached to the laser irradiation port,
A tubular cover portion extending from the mounting portion to the tip side along the irradiation direction of the laser beam, and a tubular cover portion.
It is composed of a bottomed tip bottom provided on the tip side of the cover portion.
An irradiation space to be irradiated with the laser beam is formed inside, and the bottom of the tip is heated by absorbing at least a part of the laser beam without transmitting the irradiated laser beam .
On the cover
A laser treatment apparatus provided with a through hole that penetrates in an intersecting direction that intersects with the irradiation direction and allows a gas that conducts the laser transmission path to flow out. The bottom of the tip is recessed so as to taper toward the tip.
The laser treatment apparatus according to claim 1 . A reflection recess that tapers toward the tip and reflects a part of the laser beam is provided on the base end side of the tip bottom portion.
The laser treatment apparatus according to claim 1 or 2 . In front of the bottom of the tip, a contact surface formed of a curved surface having a radius of curvature of 10 mm or more or a flat surface is provided.
The laser treatment apparatus according to any one of claims 1 to 3 . The bottom of the tip is made of a metal material or a heat-resistant ceramic material.
The laser treatment apparatus according to any one of claims 1 to 4 . The bottom of the tip is made of quartz glass
The laser treatment apparatus according to any one of claims 1 to 4 . A coating that reduces the reflection of the laser beam is applied to the base end side of the tip bottom portion.
The laser treatment apparatus according to any one of claims 1 to 6 . A sticking prevention coating was applied to the tip side of the bottom of the tip to prevent sticking to living tissue.
The laser treatment apparatus according to any one of claims 1 to 7 . The laser treatment apparatus according to any one of claims 1 to 8, wherein the laser oscillator oscillates a carbon dioxide laser beam. The laser treatment apparatus according to any one of claims 1 to 9.
A laser treatment system composed of an endoscope that allows the laser transmission path to be inserted. A laser chip attached to a laser irradiation port for irradiating laser light, which is provided at the tip of a laser transmission line.
A mounting portion that opens and is detachably attached to the laser irradiation port,
A tubular cover portion extending from the mounting portion to the tip side along the irradiation direction of the laser beam, and a tubular cover portion.
It is composed of a bottomed tip bottom provided on the tip side of the cover portion.
An irradiation space to be irradiated with the laser beam is formed inside, and the bottom of the tip is heated by absorbing at least a part of the laser beam without transmitting the irradiated laser beam .
On the cover
Penetrate in the crossing direction that intersects the irradiation direction,
A laser chip provided with a through hole that conducts the laser transmission path together with the laser beam and allows the gas emitted from the laser irradiation port to flow out. A laser transmission line that guides the laser light to the treatment target site,
A laser treatment tool including the laser chip according to claim 11.

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