U.S. patent application number 16/744320 was filed with the patent office on 2020-06-25 for surgical laser tool.
This patent application is currently assigned to Boston Scientific Scimed, Inc.. The applicant listed for this patent is Boston Scientific Scimed, Inc.. Invention is credited to Wen-Jui Ray CHIA, Hui Wang.
Application Number | 20200197093 16/744320 |
Document ID | / |
Family ID | 49627107 |
Filed Date | 2020-06-25 |
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United States Patent
Application |
20200197093 |
Kind Code |
A1 |
Wang; Hui ; et al. |
June 25, 2020 |
SURGICAL LASER TOOL
Abstract
A surgical laser tool for performing a laser procedure at a
treatment site is provided. The surgical laser tool includes a
laser source, a fiber catheter, and an analytical device. The laser
source is configured to generate laser energy. The fiber catheter
is configured to (i) acquire optical feedback from the treatment
site and (ii) deliver the laser energy to the treatment site. The
analytical device is configured to analyze reflected light from the
treatment site in order to allow a physician to perform a diagnosis
on the treatment site.
Inventors: |
Wang; Hui; (West Chester,
CA) ; CHIA; Wen-Jui Ray; (Sunnyvale, CA) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Boston Scientific Scimed, Inc. |
Maple Grove |
MN |
US |
|
|
Assignee: |
Boston Scientific Scimed,
Inc.
Maple Grove
MN
|
Family ID: |
49627107 |
Appl. No.: |
16/744320 |
Filed: |
January 16, 2020 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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14440204 |
May 1, 2015 |
10568692 |
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PCT/US2013/068878 |
Nov 7, 2013 |
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16744320 |
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61724349 |
Nov 9, 2012 |
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61B 5/0075 20130101;
A61B 5/0084 20130101; A61B 18/24 20130101; A61B 2017/00057
20130101 |
International
Class: |
A61B 18/24 20060101
A61B018/24; A61B 5/00 20060101 A61B005/00 |
Claims
1-21. (canceled)
22. A fiber catheter, comprising: a plurality of channels extending
between a proximal end of the fiber catheter and a distal end of
the fiber catheter; a first fiber disposed in a first channel of
the plurality of channels, wherein the first fiber is configured to
deliver a diagnostic light from a diagnostic light source to a
treatment site; and a second fiber disposed in a second channel of
the plurality of channels, wherein the second fiber is configured
to deliver a laser energy from a laser source to the treatment
site; and an actuator configured to vibrate a distal end of the
first fiber within the first channel.
23. The fiber catheter of claim 22, wherein the second fiber is
configured to discharge the laser energy substantially parallel to
a longitudinal axis of the second fiber or substantially
perpendicular to the longitudinal axis of the second fiber.
24. The fiber catheter of claim 22, wherein the first fiber is
further configured to receive optical feedback from the treatment
site.
25. The fiber catheter of claim 22, wherein the actuator includes a
magnet configured to move the distal end of the first fiber, or a
piezoelectric actuator.
26. The fiber catheter of claim 22, wherein the first fiber
includes a plurality of optical fibers.
27. The fiber catheter of claim 22, further comprising an optical
component at the proximal end of the fiber catheter, the optical
component being configured to couple the first fiber to the
diagnostic light source and the second fiber to the laser
source.
28. A tool comprising: a laser source configured to generate a
laser energy; a light source configured to generate a diagnostic
light; a fiber catheter comprising: a first fiber configured to
deliver the diagnostic light from the light source to a treatment
site, and a second fiber configured to deliver the laser energy
from the laser source to the treatment site; and an actuator
configured to vibrate a distal end of the first fiber independent
of a distal end of the second fiber.
29. The tool of claim 28, wherein the fiber catheter includes a
first channel and a second channel, and wherein the first fiber is
disposed in the first channel and the second fiber is disposed in
the second channel.
30. The tool of claim 28, wherein the first fiber is configured to
receive optical feedback from the treatment site based on the
diagnostic light, and wherein the tool further comprises an
analytical device configured to analyze the optical feedback.
31. The tool of claim 30, wherein the analytical device includes
one or more of a spectrometer, a photodetector, or a
photomultiplier tube.
32. The tool of claim 28, wherein the light source includes one or
more of a broadband light source, a white light source, a LED light
source, a pulsed laser source, or a laser source.
33. The tool of claim 28, wherein the first fiber includes a
plurality of optical fibers.
34. The tool of claim 28, further comprising an optical component
at a proximal end of the fiber catheter, the optical component
being configured to couple the first fiber to the diagnostic light
source and the second fiber to the laser source.
35. A method, comprising: positioning a distal end of a tool
adjacent a treatment site, the tool comprising: a laser source
configured to generate a laser energy, a light source configured to
generate a diagnostic light, a fiber catheter including a first
fiber configured to deliver the laser energy to the treatment site
and a second fiber configured to deliver the diagnostic light to
the treatment site, and an actuator configured to oscillate a
distal end of the second fiber independent of the first fiber;
oscillating the distal end of the second fiber relative to the
first fiber; discharging the diagnostic light from the light source
through the distal end of the second fiber onto the treatment site;
receiving an optical feedback from the treatment site; and
analyzing the optical feedback.
36. The method of claim 35, wherein the analyzing the optical
feedback includes using one or more of a spectrometer, a
photodetector, or a photomultiplier tube.
37. The method of claim 35, wherein the light source includes one
or more of a broadband light source, a white light source, a LED
light source, a pulsed laser source, or a laser source.
38. The method of claim 35, wherein the oscillating the distal end
of the second fiber is performed at a same time as the diagnostic
light is discharged from the second fiber.
39. The method of claim 35, wherein the diagnostic light is
discharged in a direction parallel to a longitudinal axis of the
fiber catheter.
40. The method of claim 35, further comprising delivering the laser
energy to the treatment site in a direction substantially parallel
to a longitudinal axis of the second fiber.
41. The method of claim 35, further comprising delivering the laser
energy to the treatment site in a direction substantially
perpendicular to a longitudinal axis of the second fiber.
Description
BACKGROUND
[0001] Laser surgery can be an alternative to traditional surgical
tools, as it can reduce bleeding, pain and infection. Patients
after laser surgery often have less hospitalization time. In
addition, a surgical laser delivered through a fiber can be easily
integrated with a compact and flexible endoscopy. However, laser
surgery relies on tissue vaporization or chip off. After surgery;
it is very difficult to collect enough tissue samples for further
histopathological analysis, which is currently considered as the
golden standard for final diagnosis of many diseases, for example,
cancer. Due to this reason, laser surgery is still not widely
employed in many clinics.
SUMMARY
[0002] Embodiments of the invention are directed to a surgical
laser tools for performing a laser procedure at a treatment site
and methods of diagnosing and treating a treatment site in a
patient using a surgical laser tool. Some embodiments of the
surgical laser tool include a laser source, a fiber catheter, and
an analytical device. The laser source is configured to generate
laser energy. The fiber catheter is configured to (i) acquire
optical feedback from the treatment site and (ii) deliver the laser
energy to the treatment site. The analytical device is configured
to analyze reflected light from the treatment site in order to
allow a physician to perform a diagnosis on the treatment site.
[0003] Other embodiments of the surgical laser tool include a
surgical laser, a fiber catheter, an imaging light source, an
optical device, and an analytical device. The surgical laser is
configured to generate laser energy. The fiber catheter includes a
fiber bundle configured to image the treatment site and discharge
the laser energy to the treatment site. The optical device couples
light generated by the imaging light source and laser energy
generated by the surgical laser to the fiber bundle. The analytical
device is configured to analyze reflected light from the treatment
site.
[0004] In accordance with some embodiments of the method, a
surgical laser tool is provided. In some embodiments the surgical
laser tool includes a laser source, a fiber catheter, a diagnostic
light source, or/and an analytical device. The laser source is
configured to generate laser energy. The fiber catheter is
configured to (i) acquire optical feedback from the treatment site
and (ii) deliver the laser energy to the treatment site. The
diagnostic light source is configured to deliver light to the fiber
catheter through an optical path. The analytical device is
configured to analyze reflected light from the treatment site in
order to allow a physician to perform a diagnosis on the treatment
site. Also in the method, light from the diagnostic light source is
discharged through a distal end of the fiber catheter onto the
treatment site. Collected light from the diagnostic light source
reflected off the treatment site is then delivered through the
fiber catheter to the analytical device for analysis. A surgical
laser treatment is then performed based on an analysis of the
collected light.
[0005] In some embodiments, the diagnostic light source is a white
light, an LED light, a pulsed laser, a continuous wave laser, or a
broad band light source.
BRIEF DESCRIPTION OF THE DRAWINGS
[0006] FIG. 1 is a simplified diagram of a distal end of an
endoscope and a fiber catheter in accordance with embodiments of
the invention.
[0007] FIGS. 2 and 3 are simplified diagrams of a surgical laser
tool in accordance with embodiments of the invention.
[0008] FIG. 4 is a simplified diagram of a fiber catheter in
accordance with embodiments of the invention.
[0009] FIGS. 5 and 6 are simplified cross-sectional views of a
fiber catheter in accordance with embodiments of the invention.
[0010] FIG. 7 is a simplified end view of a surgical laser tool in
accordance with embodiments of the invention.
DETAILED DESCRIPTION OF ILLUSTRATIVE EMBODIMENTS
[0011] Embodiments of the invention are described more fully
hereinafter with reference to the accompanying drawings. Elements
that are identified using the same or similar reference characters
refer to the same or similar elements. The various embodiments of
the invention may, however, be embodied in many different forms and
should not be construed as limited to the embodiments set forth
herein. Rather, these embodiments are provided so that this
disclosure will be thorough and complete, and will fully convey the
scope of the invention to those skilled in the art.
[0012] Specific details are given in the following description to
provide a thorough understanding of the embodiments. However, it is
understood by those of ordinary skill in the art that the
embodiments may be practiced without these specific details. For
example, circuits, systems, networks, processes; frames, supports,
connectors, motors, processors, and other components may not be
shown, or shown in block diagram form in order to not obscure the
embodiments in unnecessary detail.
[0013] The terminology used herein is for the purpose of describing
particular embodiments only and is not intended to be limiting of
the invention. As used herein, the singular forms "a", "an" and
"the" are intended to include the plural forms as well, unless the
context clearly indicates otherwise. It will be further understood
that the terms "comprises" and/or "comprising," when used in this
specification, specify the presence of stated features, integers,
steps, operations, elements, and/or components, but do not preclude
the presence or addition of one or more other features, integers,
steps, operations; elements, components, and/or groups thereof.
[0014] It will be understood that when an element is referred to as
being "connected" or "coupled" to another element, it can be
directly connected or coupled to the other element or intervening
elements may be present, in contrast, if an element is referred to
as being "directly connected" or "directly coupled" to another
element, there are no intervening elements present.
[0015] It will be understood that, although the terms first,
second; etc. may be used herein to describe various elements, these
elements should not be limited by these terms. These terms are only
used to distinguish one element from another. Thus, a first element
could be termed a second element without departing from the
teachings of the present invention.
[0016] Unless otherwise defined, all terms (including technical and
scientific terms) used herein have the same meaning as commonly
understood by one of ordinary skill in the art to which this
invention belongs. It will be further understood that terms, such
as those defined in commonly used dictionaries, should be
interpreted as having a meaning that is consistent with their
meaning in the context of the relevant art and will not be
interpreted in an idealized or overly formal sense unless expressly
so defined herein.
[0017] As will further be appreciated by one of skill in the art,
the present invention may be embodied as methods, systems, and/or
computer program products. Accordingly, the present invention may
take the form of an entirely hardware embodiment, an entirely
software embodiment or an embodiment combining software and
hardware aspects. Furthermore, the present invention may take the
form of a computer program product on a computer-usable storage
medium having computer-usable program code embodied in the medium.
Any suitable computer readable medium may be utilized including
hard disks, CD-ROMs, optical storage devices, or magnetic storage
devices. Such computer readable media and memory for computer
programs and software do not include transitory waves or
signals.
[0018] The computer-usable or computer-readable medium may be, for
example but not limited to, an electronic, magnetic, optical,
electromagnetic, infrared, or semiconductor system, apparatus,
device, or propagation medium. More specific examples (a
non-exhaustive list) of the computer-readable medium would include
the following: an electrical connection having one or more wires, a
portable computer diskette, a random access memory (RAM), a
read-only memory (ROM), an erasable programmable read-only memory
(EPROM or Flash memory), an optical fiber, and a portable compact
disc read-only memory (CD-ROM). Note that the computer-usable or
computer-readable medium could even be paper or another suitable
medium upon which the program is printed, as the program can be
electronically captured, via, for instance, optical scanning of the
paper or other medium, then compiled, interpreted, or otherwise
processed in a suitable manner, if necessary, and then stored in a
computer memory.
[0019] Embodiments of the invention may also be described using
flowchart illustrations and block diagrams. Although a flowchart
may describe the operations as a sequential process, many of the
operations can be performed in parallel or concurrently. In
addition, the order of the operations may be re-arranged. A process
is terminated when its operations are completed, but could have
additional steps not included in a figure or described herein.
[0020] It is understood that one or more of the blocks (of the
flowcharts and block diagrams) may be implemented by computer
program instructions. These program instructions may be provided to
a processor circuit, such as a microprocessor, microcontroller or
other processor, which executes the instructions to implement the
functions specified in the block or blocks through a series of
operational steps to be performed by the processor(s) and
corresponding hardware components.
[0021] Embodiments of the invention are directed to surgical laser
tools, systems and surgical laser treatments. In some embodiments,
the tools facilitate in vivo diagnosis through optical parameters
measurement or imaging during laser surgery. Surgeons can be
effectively guided to find out the resection margin and may not
need to spare tissue for further histopathological analysis. More
importantly, in vivo diagnostic feedbacks will enable complete and
fine surgery at once, which will significantly reduce the recurrent
diseases and avoid repeat surgeries.
[0022] FIG. 1 is a simplified diagram of a distal end of a
conventional endoscope 100. The endoscope 100 may include a working
channel or lumen 102, light outputs 106 through which light may be
discharged to illuminate a treatment site, and an imaging component
108 (e.g., a CCD camera) that may be used to capture images of the
treatment site.
[0023] FIG. 2 is a simplified diagram of a surgical laser tool 110
in accordance with embodiments of the invention. In one embodiment,
the tool 110 comprises a fiber catheter 112 (single mode or
multi-mode), which may be delivered to a targeted treatment site
through the working channel 102 of an endoscope or cystoscope, as
illustrated in FIG. 1. In some embodiments, the fiber catheter 112
includes at least one optical fiber that is configured to acquire
optical parameter feedbacks. In some embodiments the fiber catheter
112 is configured to deliver laser energy to the treatment site for
a surgical laser treatment (e.g., tissue cutting, ablating,
vaporization, etc.). The distal end 114 of the fiber catheter 112
may be configured to discharge laser energy along a central axis of
the catheter 112 (i.e., end-fire), laterally to the central axis
(i.e., side-fire), or in another conventional manner.
[0024] In some embodiments, the tool 110 includes one or more
optical components 116 (e.g., fiber coupler or a beam splitter cube
with free space coupling) at a proximal end 118 of the fiber
catheter 112 that are configured to optically couple the at least
one optical fiber of the fiber catheter 112 to multiple optical
paths (122, 126, 130), each of which may be coupled to a different
device.
[0025] In one embodiment, the tool 110 includes a surgical laser
120 configured to generate laser energy for use in a surgical laser
treatment. The surgical laser 120 may comprise a conventional laser
resonator or other device configured to generate laser energy used
in laser surgical procedures, such as tissue cutting, ablating,
coagulation or vaporizing procedures. The laser energy generated by
the surgical laser 120 is delivered to the fiber catheter 112
through an optical path 122 and the optical components 116. The
laser energy may be discharged through the distal end 114 of the
fiber catheter 112 to the targeted treatment site, as mentioned
above.
[0026] In one embodiment, the tool 110 includes a diagnostic light
source (DLS) 124, which is configured to deliver light to the fiber
catheter 112 through an optical path 126 and the optical components
116, as shown in FIG. 2. The DLS 124 can be, for example, white
light, LED, pulsed or continuous waver lasers, or a broad band
light source. The light from the DLS 124 can be discharged through
the distal end 114 of the fiber catheter 112. In some embodiments,
the DLS 124 generates broadband light using a white light, an LED,
a super-luminescent LED, a laser source, or other suitable source.
The DLS 124 may also include a filter to produce light having a
narrow wavelength band. In some embodiments, the surgical laser 120
can also be used as the diagnostic light source.
[0027] In one embodiment, the tool 110 includes an analytical
device (AD) 128, which is configured to analyze reflected light
from the treatment site for diagnostics. The AD 128 can be, for
example, a spectrometer, a photodetector, or a photomultiplier
tube. In one embodiment, AD 128 is optically coupled to the fiber
catheter 112 through an optical path 130 and the optical components
116, as shown in FIG. 2. Light, generated by the DLS 124 and
discharged through the fiber catheter 112 or light from the outputs
106, is reflected from tissue in the treatment site and delivered
to the AD 128 through the fiber catheter 112. In one embodiment,
the AD 128 includes a spectrometer. In one embodiment, the AD 128
includes a photodetector or photo multiplier tube, which could be
used, for example, for fluorescence and Raman detection.
[0028] FIG. 3 is a simplified diagram of a surgical laser tool 110
in accordance with embodiments of the invention. In one embodiment,
the tool 110 comprises a fiber catheter 112 comprising a fiber
bundle 140 that is configured for both imaging and surgery. In one
embodiment, the fiber bundle 140 is flexible and composed of a
plurality of thin optical fibers 140a. In one embodiment, a housing
141 surrounds the fiber bundle 140. In one embodiment, the tool 110
includes a surgical laser 120, such as that described above. In one
embodiment, the tool 110 includes an imaging or diagnostic light
source 142.
[0029] The light generated by the imaging or diagnostic light
source 142 and the laser energy generated by the surgical laser 120
are coupled to the fiber bundle 140 though a suitable optical
component or components 116, such as, for example, a beam combiner,
that is either polarization or non-polarization sensitive and which
may be supported by the housing 141 at the proximal end 118 of the
fiber bundle 140. In some embodiments, the laser energy 144
generated by the surgical laser 120 and/or the light 146 generated
by the light source 142 may be optically processed using one or
more lenses 148 or other optical components as necessary.
[0030] In one embodiment, the polarization states of the laser
energy 144 and the light 146 are manipulated through polarization
controllers to linear polarization states that are orthogonal to
each other. In this case, they can be combined through a
polarization sensitive beam splitter without light loss.
[0031] For imaging, the light 146 from the light source 142 is
focused onto the proximal end 118 of the fiber bundle 140 through a
scanner 150, which can provide X,Y scanning and be realized by
galvanometers or a piezoelectric actuator, in accordance with some
embodiments of the invention. In one embodiment, the scanning beam
190 is conducted through the fiber bundle 140 to the distal end 114
of the fiber bundle 140. The beam 190 can be further focused onto
the targeted treatment site 200 through a lens or other optical
component as necessary.
[0032] The reflected light 195 from the targeted treatment site 200
is collected by fiber bundle 140 and fed back through the fiber
bundle 140 to the AD 1128, such as, for example, a spectrometer, a
photodetector or photo multiplier tube, or other analytical device
for analysis. A beam splitter 116, which may be dichromatic,
polarization sensitive, or polarization non-sensitive, may be used
to direct the reflected light 195 to the AD 128, as shown in FIG.
3.
[0033] In one embodiment, the light 195 fed back through the fiber
bundle 140 can be further processed based on the signal from each
location during the scanning to form an image. During surgery,
surgeons can initiate laser surgery based on the acquired images.
Different imaging schemes could be employed here. For example, for
optical coherence tomography, the light source 142 could be a
broadband light source (i.e. superluminescent ILD or swept light
source); for nonlinear optical imaging (i.e. Raman, two photon),
the light source 142 could be a pulsed laser; for fluorescence
imaging, the light source could be a narrow band light from a laser
or filtered from a broad band light source, as mentioned above. The
fiber bundle 140 can be further simplified to a multimode or a
single mode fiber. However, the optical signal such as Raman
scattering and fluorescence can still be acquired.
[0034] FIG. 4 is a simplified illustration of a fiber catheter 112
in accordance with other embodiments of the invention that can be
used to simultaneously image, diagnose and perform laser surgery of
a target treatment site 200. In one embodiment, the fiber catheter
112 comprises two channels: an imaging channel 164 that receives an
imaging fiber 166, and a laser channel 168 that includes an optical
fiber or receives a laser fiber (not shown) for discharging
surgical laser energy to the target site. In one embodiment, the
fiber catheter 112 includes a magnetic force or a piezoelectric
actuator that moves or vibrates the distal end 170 of the imaging
fiber 166, as indicated by arrow 172, for scanning purposes. A lens
or other optical component 174 may be used to focus light 176 to,
or from, the imaging fiber 166. Exemplary imaging modalities that
could be realized in this scheme and others described herein
include optical coherence topography (OCT), two photon microscopy,
fluorescence lifetime imaging, fluorescence confocal imaging, Raman
scattering imaging, reflection confocal imaging, coherent
anti-stock imaging, and second harmonic imaging.
[0035] As mentioned above, the laser channel 168 is used to
accommodate a surgical laser fiber, which can discharge laser
energy from a laser source to perform a surgical laser treatment at
a treatment site 200, such as a tissue ablation treatment. In one
embodiment, the fiber catheter 112 is used with the surgical laser
tool 110 to perform the surgical laser treatment based on the
observation of the optical imaging feedback through the imaging
fiber 166, in accordance with embodiments described above.
[0036] In some embodiments, the fiber catheter 112 includes
additional Channels, as shown in the simplified cross-sectional
views of the fiber catheter 112 provided in FIGS. 5 and 6. In one
embodiment, the fiber catheter 112 includes one or more irrigant
channels 178 for providing or removing a flow of liquid (e.g.,
saline) or air for cooling or cleaning the target treatment
site.
[0037] In one embodiment, the surgical laser tool 110 may include a
modified endoscope or cystoscope 180, a simplified end view of
which is provided in FIG. 7. In one embodiment, a thin surgical
laser channel 168 having, for example, a diameter of 100 um to 1
mm, is formed in the endoscope 180 for accommodating a surgical
laser fiber. Also illustrated in FIG. 7 are a working channel 102
to receive, for example, a fiber or fiber catheter, light outputs
106, and an imaging component 108, which can be, for example, a CCD
camera.
[0038] The optical feedback signal can also be used as a control
signal to the laser, which can adjust laser parameters, such as
power level, pulse width, lasing duration etc.
[0039] Embodiments of the invention combine diagnosis and treatment
into a single tool. The tool may be used to eliminate lab
intensive, time-consuming and delayed histological analysis. It can
also be used to provide surgeons with an objective guidance for
finding resection margins. More importantly, it will enable laser
as a major tool for surgery, which will lead to low health cost for
both patients and hospitals.
[0040] Although the present invention has been described with
reference to preferred embodiments, workers skilled in the art will
recognize that changes may be made in form and detail without
departing from the spirit and scope of the invention.
* * * * *