APPARATUS AND METHOD FOR REDUCING LASER BEAM ATTENTUATION IN A LIQUID MEDIUM

• US 20180206918A1
• Filed: 03/21/2018
• Published: 07/26/2018
• Est. Priority Date: 06/09/2016
• Status: Active Grant

• Current Assignee: Lumenis Limited (Boston Scientific Corporation)
• Original Assignee: Lumenis Limited (Boston Scientific Corporation)
• Inventors: Waisman, Tal, Khachaturov, Arkady, Preiss, Assaf
• Granted Patent: US 10,231,781 B2
• Time in Patent Office: Days
• CPC Class Codes: A61B 17/22 Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for dilators A61M29/00
• CPC Class Codes: A61B 17/22004 using mechanical vibrations, e.g. ultrasonic shock waves A61B17/225 takes precedence
• CPC Class Codes: A61B 18/20 using laser
• CPC Class Codes: A61B 18/22 the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
• CPC Class Codes: A61B 18/26 for producing a shock wave, e.g. laser lithotripsy
• CPC Class Codes: A61B 2017/00017 Electrical control of surgical instruments
• CPC Class Codes: A61B 2017/00176 Two pulses, e.g. second pulse having an effect different from the first one
• CPC Class Codes: A61B 2017/00482 with a code
• CPC Class Codes: A61B 2017/22007 Cavitation or pseudocavitation, i.e. creation of gas bubbles generating a secondary shock wave when collapsing
• CPC Class Codes: A61B 2018/00625 Vaporization
• CPC Class Codes: A61B 2018/00642 with feedback, i.e. closed loop control
• CPC Class Codes: A61B 2018/00684 using lookup tables
• CPC Class Codes: A61B 2018/00779 Power or energy
• CPC Class Codes: A61B 2018/20554 Arrangements for particular intensity distribution, e.g. tophat
• CPC Class Codes: A61B 2018/263 the conversion of laser energy into mechanical shockwaves taking place in a liquid

Abstract

A method of treating a mobile target tissue with a laser beam includes: providing a laser device for generating a laser beam and providing an optical fiber having a delivery end for guiding the laser beam to the target tissue; a controller causes the laser device to generate one or more laser pulses substantially along the same longitudinal axis. The controller causes the laser device to provide one or more laser pulses. The one or more pulses are selected to allow a vapor bubble formed by the one or more pulse to expand an amount sufficient to displace a substantial portion of the liquid medium from the space between the delivery end of the fiber and the target tissue. The one or more pulses are delivered to the target tissue through the vapor bubble after the vapor bubble has reached its maximum extent and has begun to collapse to reduce retropulsion of the mobile target tissue.

Claims

1. A medical laser system for treating a target tissue portion with a laser beam, said target tissue portion being mobile and immersed in a liquid medium formed primarily of water within a body lumen, said system comprising:

a laser device for generating an output laser beam;

an optical fiber for guiding the laser beam to the tissue portion, said fiber having a delivery end positioned close to but spaced from the target tissue portion to be treated; and

a controller for controlling the laser device and functioning to sequentially generate at least one series of first and second laser pulses, the first laser pulse and the second laser pulse being substantially along the same longitudinal axis, and wherein the first laser pulse has an energy sufficient to form a vapor bubble in the liquid medium at the delivery end of the fiber and wherein the second laser pulse is generated a predetermined time after the first laser pulse, said predetermined time being selected to allow the vapor bubble created by the first laser pulse to expand an amount sufficient to displace a substantial portion of the liquid medium from the space between the delivery end of the fiber and the target tissue portion, wherein the controller controls the initiation of said second laser pulse such that it is delivered to the tissue through the vapor bubble after the vapor bubble has reached its maximum extent and has begun to collapse whereby the collapsing bubble causes the tissue portion to remain substantially stationary when the second laser pulse is delivered, thus reducing retropulsion of the tissue portion.

2. A medical laser system for treating a target tissue portion with a laser beam, said tissue portion being immersed in a liquid medium within a body lumen, said system comprising:

a laser device for generating a laser beam;

an optical fiber having a delivery end for guiding the laser beam to the target tissue portion;

a controller for controlling the laser device to sequentially generate at least one first and one second laser pulse, wherein the first laser pulse and the second laser pulse are substantially along the same longitudinal axis, and wherein the first laser pulse has an energy sufficient to form a vapor bubble in the liquid medium at the delivery end of the fiber and wherein the second laser pulse is generated a time after the first laser pulse, said time being selected to allow the vapor bubble created by the first laser pulse to expand an amount sufficient to displace a substantial portion of the liquid medium from the space between the delivery end of the fiber and the target tissue portion, wherein the controller controls the initiation of the second laser pulse so that it is delivered to the tissue through the vapor bubble after the vapor bubble has reached its maximum extent and has begun to collapse, whereby the collapsing bubble causes the tissue portion to remain substantially stationary when the second laser pulse is delivered, thus reducing retropulsion of the tissue portion.

3. A method of treating a target tissue with a laser beam, said target tissue being mobile and immersed in a liquid medium within a body lumen, the method comprising:

providing a laser device for generating a laser beam;

providing an optical fiber having a delivery end for guiding the laser beam to the target tissue;

providing a controller for causing the laser device to generate one or more laser pulses substantially along the same longitudinal axis;

the controller causing the laser device to provide a first laser pulse, the first laser pulse having an energy sufficient to form a vapor bubble in the liquid medium at the delivery end of the fiber;

the controller next causing the laser device to provide a second laser pulse, the initiating time of the second laser pulse being selected to allow the vapor bubble created by the first laser pulse to expand an amount sufficient to displace a substantial portion of the liquid medium from the space between the delivery end of the fiber and the target tissue, the second pulse being delivered to the target tissue through the vapor bubble after the vapor bubble has reached its maximum extent and has begun to collapse; and

,

whereby the collapsing bubble causes the target tissue to remain substantially stationary when the second laser pulse is delivered, thus reducing retropulsion of the tissue portion.

4. A method of treating a target tissue with a laser beam, said target tissue being mobile and immersed in a liquid medium within a body lumen, the method comprising:

providing a laser device for generating a laser beam;

providing an optical fiber having a delivery end for guiding the laser beam to the target tissue;

providing a controller for causing the laser device to generate one or more laser pulses substantially along the same longitudinal axis;

the controller causing the laser device to provide one or more laser pulses, the one or more laser pulses being configured by the controller to have an energy sufficient to form a vapor bubble in the liquid medium at the delivery end of the fiber;

the one or more pulses being selected to allow the vapor bubble to expand an amount sufficient to displace a substantial portion of the liquid medium from the space between the delivery end of the fiber and the target tissue, the one or more pulses being delivered to the target tissue through the vapor bubble after the vapor bubble has reached its maximum extent and has begun to collapse; and

,

whereby the collapsing bubble causes the target tissue to remain substantially stationary as the one or more laser pulses are being delivered, thus reducing retropulsion of the target tissue.

5. The method of claim 4, wherein the one or more laser pulses is more than one train of pulses, further comprising the step of the controller of selecting a repetition rate for delivery of the more than one laser pulses.

6. The method of claim 4, further comprising:

selecting at least the following parameters through the controller;

selecting the total energy of one or more pulses to be delivered to the target tissue, and selecting the distance from the delivery end to the target tissue.

7. The method of claim 6, further comprising the steps of:

measuring actual energy irradiated by the laser device;

comparing the actual measured energy to a total energy selected by the controller; and

, if the comparison demonstrates variance of the actual measured energy from the selected total energy, the controller adjusting the energy for any following pulses to achieve the selected energy delivered to the target tissue.

8. The method of claim 4, wherein the target tissue is a tissue, an organ or a formed stone within a human body.

9. The method of claim 4, further comprising the step of selecting and mounting on the laser device an optical fiber type to be used in irradiating the target tissue.

10. The method of claim 9, wherein the type of optical fiber includes at least one of the parameters of:

fiber diameter, fiber material, fiber numerical aperture and shape of the distal delivery end.

11. The method of claim 6, wherein the step of selecting the distance from the delivery end to the target tissue includes the further step of measuring the distance and selecting the measured distance.

12. The method of claim 7, wherein the step of measuring the actual energy delivered by the laser is performed by a photodetector in the light path of the laser radiation.

13. The method of claim 7, wherein the step of the controller adjusting the energy is accomplished by a closed loop feedback circuit operatively connected to the controller.

14. The method of claim 9, wherein the controller intermittently recognizes parameters associated with the fiber type mounted on the laser device.

15. The method of claim 14, wherein the step of automatically recognizing is performed by a RFID identification tag mounted on the delivery device and on the waveguide or optical fiber.

16. The method of claim 9, wherein the controller indicates on a user interface associated with the controller if the optical fiber type is compatible with a treatment selected.