Apparatus and method for computer controlled laser surgery

• US 4,672,963 A
• Filed: 06/07/1985
• Issued: 06/16/1987
• Est. Priority Date: 06/07/1985
• Status: Expired due to Fees

• Current Assignee: Israel Barken
• Original Assignee: Israel Barken
• Inventors: Barken, Israel
• Primary Examiner(s): Howell, Kyle L.
• Assistant Examiner(s): Hindenburg, Max F.
• Application Number:
  US06/742,278
• Time in Patent Office: 739 Days
• Field of Search: 128/6, 128/24 A, 128/303.1, 128/395-398, 128/660, 219/121 LU, 219/121 LV
• US Class Current: 606/12
• CPC Class Codes: A61B 18/20 using laser
• CPC Class Codes: A61B 18/24 with a catheter A61B18/26, A61B18/28 take precedence
• CPC Class Codes: A61B 2017/00274 Prostate operation, e.g. prostatectomy, turp, bhp treatment
• CPC Class Codes: A61B 2018/00547 Prostate
• CPC Class Codes: A61B 2018/00636 Sensing and controlling the application of energy
• CPC Class Codes: A61B 8/12 in body cavities or body tracts, e.g. by using catheters catheters per se A61M25/00

Abstract

A surgical system for destroying unwanted internal structures including a laser device, an ultrasonic probe and a computer system is described. The ultrasonic probe provides data signals that are processed by the computer system to provide an image of the structures involved in the laser irradiation procedure. The laser device can be inserted in the body and activated by the computer system to provide radiation capable of destroying internal tissue. By calibrating the effects of the laser device as a function of power, the surgical procedure can be controlled by including overlaying images of the regions already affected by the surgical procedures on the images previously provided by the ultrasonic probe. This image reconstruction can be performed in real time providing immediate feedback to the attending physician. The computer system can also monitor system parameters such as laser power. This system has particular application to procedures involving the prostate gland where the laser light guide can be inserted intraurethrally and the ultrasonic probe can be inserted intraurethrally or transrectally.

Claims

1. Apparatus for destroying unwanted internal tissue comprising:

ultrasonic probing means for applying ultrasonic signals to an internal body region of a patient;

laser irradiation means for irradiating pre-determined areas of said internal body region of said patient;

ultrasonic receiving means for receiving said applied ultrasonic signals, said applied ultrasonic signals conveying information about tissue in said internal body region and information about the position of said laser irradiation means in said internal body region of the patient; and

computer means for receiving said conveyed tissue and laser irradiation means information, said computer means controlling both intensity and duration of energy emitted by said laser irradiating means based upon said conveyed information.

2. Apparatus for destroying unwanted internal tissue as claimed in claim 1 wherein said ultrasonic probing means and said ultrasonic receiving means are both located externally to the body of said patient.

3. Apparatus for destroying unwanted internal tissue as claimed in claim 1 further comprising:

display means for receiving a representation of an image of said internal body region generated by said computer means.

4. Apparatus for destroying unwanted internal tissue as claimed in claim 3 further comprising:

input means connected to said display means and said computer means for receiving input from an operator to delimit healthy internal tissues from unwanted internal tissues, wherein said computer means controlling both said intensity and said duration of said energy emitted by said laser irradiating means can modify said intensity and said duration because of said delimiting.

5. Apparatus for destroying unwanted internal tissue as claimed in claim 4 wherein said computer means further comprises disabling means for disabling said laser irradiating means when the position of said laser irradiating means is such as to irradiate health tissue.

6. Apparatus for destroying unwanted internal tissue as claimed in claim 5 wherein said ultrasonic probing means and said ultrasonic receiving means are both located internally to the body of said patient.

7. Apparatus for destroying unwanted internal tissue as claimed in claim 6 wherein

said unwanted tissue is a prostate gland;

said ultrasonic probing means and said ultrasonic receiving means are a single unit and designed to be inserted transrectally; and

said laser irradiating means is designed to be inserted intraurethrally.

8. A method for destroying unwanted internal tissue comprising the steps of:

inserting laser irradiation means through a bodily opening of a patient;

ultrasonically probing to determine the position of said laser irradiating means and the unwanted internal tissue within said bodily opening;

providing ultrasonic output from said probing step to computer means for controlling the energy output of said laser irradiating means and accepting input from an operator wherein said computer means further comprises a real time ultrasonic display of the internal tissue of the patient and delimiting input means for delimiting, on said ultrasonic display, the tissue area to be irradiated, said delimiting input means being electronically coupled to said ultrasonic display and said computer means;

delimiting, by said delimiting input means, the tissue area to be irradiated by said laser irradiating means;

10. The method of destroying unwanted internal tissue of claim 8 further comprising the steps of:

determining with said computer means if said power and duration of said energy applied to said laser irradiating means will harm healthy tissue;

disabling said power and duration of said energy applied to said laser irradiating means if said step of determining yields a possibility of harm to healthy tissue.

9. positioning said laser irradiating means such that laser energy emanating from said laser irradiating means will destroy only unwanted internal tissue delimited by said delimiting input means;

computing optimum power and duration of energy to be applied to said laser irradiating means, said step of computing being done by said computer means;

controlling the power and duration of the energy applied to said laser irradiating means with said computer means; and

irradiating said unwanted internal tissue with said laser energy.

11. A method for destroying an unhealthy prostate gland compris the steps of:

inserting a laser irradiating means intraurethrally into a patient;

inserting an ultrasonic probe means transrectally into said patient;

probing to determine the position of said laser irradiating means relative to the prostate gland within said patient.

providing output from said probing step to a computer means;

providing a display of said prostate gland, tissue surrounding said prostate gland, and said laser irradiating means within said patient;

accepting input delimiting healthy internal tissue from said prostate gland;

positioning said laser irradiating means such that laser energy emanating from said laser irradiating means will destroy said prostate gland;

computing optimum power and duration of energy to be applied to said laser irradiating means, said step of computing being done by said computer means;

controlling said power and duration of said energy applied to said laser irradiating means with said computer means;

determining with said computer means if said power and duration of said energy applied to said laser irradiating means will harm healthy tissue;

disabling said power and duration of said energy applied to said laser irradiating means if said step of determining yields a possibility of harm to healthy tissue;

radiating said prostate gland tissue with said laser energy; and

thereafter

providing a display of said prostate gland, said display showing results of said step of radiating.