US20130041356A1 - Multi-spot laser surgical probe using faceted optical elements - Google Patents

Multi-spot laser surgical probe using faceted optical elements Download PDF

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Publication number
US20130041356A1
US20130041356A1 US13/565,041 US201213565041A US2013041356A1 US 20130041356 A1 US20130041356 A1 US 20130041356A1 US 201213565041 A US201213565041 A US 201213565041A US 2013041356 A1 US2013041356 A1 US 2013041356A1
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Prior art keywords
cannula
probe
handpiece
distal end
faceted
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Abandoned
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US13/565,041
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Ronald T. Smith
Michael Arthur Zica
Dustin Jacob Bouch
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Alcon Research LLC
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Alcon Research LLC
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Priority to US13/565,041 priority Critical patent/US20130041356A1/en
Assigned to ALCON RESEARCH, LTD. reassignment ALCON RESEARCH, LTD. ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: ZICA, MICHAEL ARTHUR, SMITH, RONALD T., BOUCH, Dustin Jacob
Publication of US20130041356A1 publication Critical patent/US20130041356A1/en
Priority to US14/560,645 priority patent/US9387040B2/en
Abandoned legal-status Critical Current

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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00064Constructional details of the endoscope body
    • A61B1/00066Proximal part of endoscope body, e.g. handles
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00064Constructional details of the endoscope body
    • A61B1/00071Insertion part of the endoscope body
    • A61B1/0008Insertion part of the endoscope body characterised by distal tip features
    • A61B1/00096Optical elements
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/06Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with illuminating arrangements
    • A61B1/07Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with illuminating arrangements using light-conductive means, e.g. optical fibres
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/12Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with cooling or rinsing arrangements
    • A61B1/128Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with cooling or rinsing arrangements provided with means for regulating temperature
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/20Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/20Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
    • A61B18/201Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser with beam delivery through a hollow tube, e.g. forming an articulated arm ; Hand-pieces therefor
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007Methods or devices for eye surgery
    • A61F9/008Methods or devices for eye surgery using laser
    • A61F9/00821Methods or devices for eye surgery using laser for coagulation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/0091Handpieces of the surgical instrument or device
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/20Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
    • A61B18/22Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
    • A61B2018/2255Optical elements at the distal end of probe tips
    • A61B2018/2272Optical elements at the distal end of probe tips with reflective or refractive surfaces for deflecting the beam
    • A61B2018/2277Optical elements at the distal end of probe tips with reflective or refractive surfaces for deflecting the beam with refractive surfaces
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007Methods or devices for eye surgery
    • A61F9/008Methods or devices for eye surgery using laser
    • A61F2009/00861Methods or devices for eye surgery using laser adapted for treatment at a particular location
    • A61F2009/00863Retina

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Physics & Mathematics (AREA)
  • Veterinary Medicine (AREA)
  • Optics & Photonics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Public Health (AREA)
  • General Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Pathology (AREA)
  • Radiology & Medical Imaging (AREA)
  • Biophysics (AREA)
  • Ophthalmology & Optometry (AREA)
  • Electromagnetism (AREA)
  • Otolaryngology (AREA)
  • Vascular Medicine (AREA)
  • Laser Surgery Devices (AREA)
  • Surgical Instruments (AREA)
  • Radiation-Therapy Devices (AREA)

Abstract

In particular embodiments of the present invention, an optical surgical probe includes a handpiece configured to optically couple to a light source and a cannula at a distal end of the handpiece. The probe further includes at least one light guide within the handpiece. The light guide is configured to carry a light beam from the light source to a distal end of the handpiece. The probe also includes a multi-spot generator in the cannula that includes a faceted optical adhesive with a faceted end surface spaced from a distal end of the light guide. The faceted end surface includes at least one facet oblique to a path of the light beam. In some embodiments, the probe also includes a high-conductivity ferrule at the distal end of the light guide. In other embodiments, the cannula is formed from a transparent material.

Description

    RELATED APPLICATIONS
  • This application claims priority to U.S. provisional application Ser. No. 61/521,447, filed on Aug. 9, 2011, the contents which are incorporated herein by reference. This application is related to co-pending U.S. patent application Ser. No. 12/959,533, filed on Dec. 3, 2010, and commonly assigned with the present Application.
  • FIELD OF THE INVENTION
  • This invention relates to optical surgical probes and, more particularly, to a multi-spot laser surgical probe using faceted optical elements.
  • BACKGROUND OF THE INVENTION
  • Optical surgical probes deliver light to a surgical field for a variety of applications. In some applications, it may be useful to deliver light to multiple spots in the surgical field. For example, in pan-retinal photocoagulation of retinal tissue, it may be desirable to deliver laser light to multiple spots so as to reduce the time of the pan-retinal photocoagulation procedure. Various techniques have been employed to produce multiple beams for a multi-spot pattern. For example, one approach uses a diffractive beam splitter element to divide an incoming beam into multiple spots that are coupled into multiple optical fibers that deliver the multiple spots to the retina. But it is also desirable to have a multi-spot generator that can be placed at a distal end of the optical surgical probe to more easily produce multiple spots from a single input beam, so that the multi-spot generator can more easily be used with existing laser sources without the need for additional components to align the laser surgical probe with the sources.
  • Difficulties can arise in the use of a diffractive beam splitter element at a distal end of the optical surgical probe. As one example, a diffractive beam splitter element produces a multitude of higher diffraction orders, and while these orders are relatively lower in light intensity as compared to the primary spot pattern, they may not always be negligible in terms of their effects. As another example, a diffractive element may not perform identically in different refractive media. For example, if the diffractive beam splitter element is placed into a medium other than air, such as saline solution or oil, the recessed portions of the microscopic surface relief structure of the diffractive beam splitter element can be filled with material having a different refractive index than air, which can ruin the spot pattern. As yet another example, the spacing between the spots can vary for different wavelengths, which can be problematic when an aiming beam is of a certain color while a treatment beam is of a different color. Lastly, diffractive elements are frequently expensive and difficult to produce, and this is particularly the case when the diffractive element must be constructed to fit into a small area, such as a distal tip of a surgical probe for surgical instruments that are 23-gauge or smaller. Thus, there remains a need for an optical surgical probe that can produce multiple spots at a target area using optical elements at a distal end of the surgical probe.
  • BRIEF SUMMARY OF THE INVENTION
  • Particular embodiments of the present invention provide a thermally robust optical surgical probe including a multi-spot generator with a faceted optical adhesive element. In particular embodiments of the present invention, an optical surgical probe is includes a handpiece configured to optically couple to a light source and a cannula at a distal end of the handpiece. The probe further includes at least one light guide within the handpiece. The light guide is configured to carry a light beam from the light source to a distal end of the handpiece. The probe also includes a multi-spot generator in the cannula that includes a faceted optical adhesive with a faceted end surface spaced from a distal end of the light guide. The faceted end surface includes at least one facet oblique to a path of the light beam. In some embodiments, the probe also includes a high-conductivity ferrule at the distal end of the light guide. In other embodiments, the cannula is formed from a transparent material.
  • Other objects, features and advantages of the present invention will become apparent with reference to the drawings, and the following description of the drawings and claims.
  • BRIEF DESCRIPTION OF THE DRAWINGS
  • FIG. 1 illustrates a multi-spot generator with a highly thermally conductive ferrule according to a particular embodiment of the present invention;
  • FIG. 2 illustrates a multi-spot generator with a transparent cannula according to a particular embodiment of the present invention; and
  • FIG. 3 illustrates a multi-spot generator with a transparent cannula according to an alternative embodiment of the present invention.
  • DETAILED DESCRIPTION OF THE PREFERRED EXEMPLARY EMBODIMENTS OF THE INVENTION
  • Co-pending U.S. application Ser. No. 12/959,533, filed on Dec. 3, 2010 and commonly assigned with the present Application, describes a multi-spot optical surgical probe using faceted optical adhesive. Various embodiments of the present invention provide additional features to facilitate the use of faceted optical adhesive in optical surgical probes. In particular, certain embodiments of the present invention provide a thermally robust optical surgical probe using faceted optical adhesive. As described in detail below, particular embodiments of the present invention incorporate o additional features to reduce the likelihood that “hot spots” will develop in the surgical probe that could cause the faceted optical adhesive or the adhesive joining the ferrule and the cannula to degrade and/or fail.
  • In certain embodiments of the present invention, a ferrule located within the distal end of the probe is modified to improve its ability to conduct heat away from the distal tip of the probe. The first modification is to change the material from the typically-used, low-thermal-conductivity stainless steel to a material with a much higher thermal conductivity such as copper or silver. The ferrule material need not necessarily be biocompatible since it is physically isolated from the outside of the probe. This permits the selection of a non-biocompatible material such as copper or silver that has much higher thermal conductivity than any available biocompatible materials. The higher thermal conductivity enables more efficient conduction of heat away from the distal end of the probe. The second modification is to add to the cylindrical ferrule a distal side-shield that prevents light reflected off of the adhesive facets from illuminating and being absorbed by the cannula. Instead, reflected light illuminates and is substantially absorbed by the high-thermal-conductivity ferrule that efficiently conducts the heat away from the distal end of the probe.
  • In an alternative embodiment of the present invention, the absorptive cannula is replaced with a transparent cannula that transmits reflected light from the adhesive facets into the ambient region outside of the cannula. This results in a significant reduction in the temperature of the distal end of the probe. Since high intensity transmitted light directed toward the surgeon may interfere with his view of the retina, various means are available to block or dissipate this light, including a reflective, diffusive or translucent layer on the outside of the transparent cannula and an opaque cylindrical cannula outside of the transparent cannula and physically separated from it by an insulating air gap. This opaque cannula need not necessarily be made from a highly thermally conductive material but it can be made from a stiff and strong material such as stainless steel which provides added structural strength to the distal end of the probe.
  • FIG. 1 illustrates a multi-spot generator 100 according to a particular embodiment of the present invention suitable for placement at a distal end of an optical surgical probe. In the depicted embodiment, a faceted optical adhesive 104 having a ball lens 106, such as a sapphire ball lens, is located within a cannula 108. Within the cannula 108 is a high-conductivity ferrule 110 holding an optical fiber 112. The optical fiber 112 delivers light, such as laser light, from an illumination source (not shown).
  • The high-thermal-conductivity ferrule 110 (hereinafter referred to as “high-conductivity ferrule”) is formed from a material with a thermal conductivity significantly higher than the stainless steel material ordinarily used in optical surgical probes, which is typically around 15 W/m-K. For purposes of this specification, “high-conductivity” will refer to materials having thermal conductivity in excess of 100 W/m-K. Suitable examples include copper (conductivity of 372 W/m-K), sterling silver (410 W/m-K), or pure silver (427 W/m-K). Because the high-conductivity ferrule 110 is encapsulated within the cannula 108 by the faceted optical adhesive 104, the high-conductivity ferrule 110 need not be made of a biocompatible material, which allows consideration of high-conductivity materials that are not ordinarily used in optical surgical probes.
  • The high-conductivity ferrule 110 includes a side-shield 114 extending distally past the optical fiber 112. The side-shield 114 is oriented to receive light reflected from facets of the faceted optical adhesive 104. While reflections from the faceted optical adhesive 104 are relatively low in energy compared to the incident beam (approximately 5% of incident energy), such reflections can nonetheless produce “hot spots” on the cannula 108. Given that the cannula 108 is ordinarily formed from stainless steel or other relatively poorly conducting material that is also not highly reflective, this can result in laser energy being absorbed, which in turn creates the potential for excess heat to accumulate near the faceted optical adhesive 104 or near the adhesive that bonds the ferrule 110 to the cannula 114 (not shown). This can degrade the performance of the optical surgical probe. The side-shield 114 intercepts the reflected beams to prevent them from reaching the cannula, and because the material of the ferrule 110 is highly conductive, any heat produced by absorption of the reflected beams in the ferrule 110 is rapidly dispersed, preventing the equilibrium temperature of the ferrule 110 from being significantly raised.
  • FIG. 2 illustrates an alternative embodiment of a thermally robust multi-spot generator according to the present invention. In the depicted embodiment, cannula 108 is formed of a transparent material. The material is preferably biocompatible, but if it is not, the outer surface cannula 108 may also be coated or treated to improve biocompatibility. The transparent cannula 108 allows the reflected light to pass through the cannula 108 to avoid forming hot spots. In particular embodiments, the cannula 108 is diffusive, so that the escaping light does not form visible light spots that could be distracting for a surgeon. For example, the surface of the cannula 108 could be formed from a translucent material, could be chemically or mechanically frosted (such as by scraping or acid etching), or could be coated with a diffusive coating. In alternative embodiments, the cannula 108 is transparent, but surrounded with a reflective coating, such as silver. The reflective coating prevents light from escaping into the surgeon's field of view while still reflecting the light away from the faceted optical adhesive 104, allowing the heat to be conducted away from the tip easily. The outer surface of the silver or reflective coating can be oxidized or coated to improve biocompatibility.
  • FIG. 3 illustrates an alternative embodiment of the transparent cannula 108. is In the depicted embodiment, an opaque outer cannula 120 surrounds the transparent cannula 108. The opaque outer cannula 120 may be formed from conventional biocompatible materials, and it is preferably relatively absorptive, although it need not be highly conductive. The outer cannula 120 and the transparent cannula 108 are separated by an air gap. The air gap provides thermal insulation between the transparent cannula 108, and the transparent cannula 108 may also be formed from an insulative material like glass. Whatever heat is produced in the outer cannula 120 may be conducted away into other parts of the probe or the biological material surrounding the outer cannula 120. The thermal insulation between the outer cannula 120 and the faceted optical adhesive 104 reduces the likelihood of excess heat from accumulating near the faceted optical adhesive 104.
  • The present invention is illustrated herein by example, and various modifications may be made by a person of ordinary skill in the art. Although the present invention is described in detail, it should be understood that various changes, substitutions and alterations can be made hereto without departing from the scope of the invention as claimed.

Claims (10)

1. An optical surgical probe comprising:
a handpiece, the handpiece configured to optically couple to a light source;
a cannula at a distal end of the handpiece;
at least one light guide within the handpiece; the at least one light guide configured to carry a light beam from the light source to a distal end of the handpiece;
a multi-spot generator in the cannula, the multi-spot generator including a faceted optical adhesive with a faceted end surface spaced from a distal end of the light guide, the faceted end surface including at least one facet oblique to a path of the light beam; and
a high-conductivity ferrule at the distal end of the light guide.
2. The probe of claim 1, wherein the high-conductivity ferrule is formed of silver.
3. The probe of claim 1, wherein the high-conductivity ferrule is formed of copper.
4. The probe of claim 1, wherein the high-conductivity ferrule comprises a side shield shielding the cannula from reflected light from the faceted optical adhesive.
5. The probe of claim 1, wherein the high-conductivity ferrule has a thermal conductivity of at least 372 W/m-K.
6. An optical surgical probe comprising:
a handpiece, the handpiece configured to optically couple to a light source;
a transparent cannula at a distal end of the handpiece;
at least one light guide within the handpiece; the at least one light guide configured to carry a light beam from the light source to a distal end of the handpiece;
a multi-spot generator in the cannula, the multi-spot generator including a faceted optical adhesive with a faceted end surface spaced from a distal end of the light guide, the faceted end surface including at least one facet oblique to a path of the light beam,
7. The probe of claim 6, wherein the transparent cannula is translucent.
8. The probe of claim 6, wherein the transparent cannula is frosted.
9. The probe of claim 6, wherein the transparent cannula further comprises a highly-reflective coating on an exterior of the cannula.
10. The probe of claim 6, wherein the transparent cannula is surrounded by an opaque outer cannula separated from the transparent cannula by an air gap.
US13/565,041 2011-08-09 2012-08-02 Multi-spot laser surgical probe using faceted optical elements Abandoned US20130041356A1 (en)

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US13/565,041 US20130041356A1 (en) 2011-08-09 2012-08-02 Multi-spot laser surgical probe using faceted optical elements
US14/560,645 US9387040B2 (en) 2011-08-09 2014-12-04 Multi-spot laser surgical probe using faceted optical elements

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US201161521447P 2011-08-09 2011-08-09
US13/565,041 US20130041356A1 (en) 2011-08-09 2012-08-02 Multi-spot laser surgical probe using faceted optical elements

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US20100042111A1 (en) * 2008-08-15 2010-02-18 Monteris Medical, Inc. Trajectory guide
US8571364B2 (en) 2011-11-09 2013-10-29 Alcon Research, Ltd. Multi-spot laser probe with faceted optical element
US8979871B2 (en) 2009-08-13 2015-03-17 Monteris Medical Corporation Image-guided therapy of a tissue
WO2015195225A3 (en) * 2014-06-19 2016-02-25 Novartis Ag Surgical probe with interlocking attachment
US9333038B2 (en) 2000-06-15 2016-05-10 Monteris Medical Corporation Hyperthermia treatment and probe therefore
US9433383B2 (en) 2014-03-18 2016-09-06 Monteris Medical Corporation Image-guided therapy of a tissue
US9504484B2 (en) 2014-03-18 2016-11-29 Monteris Medical Corporation Image-guided therapy of a tissue
US9849034B2 (en) 2011-11-07 2017-12-26 Alcon Research, Ltd. Retinal laser surgery
US10327830B2 (en) 2015-04-01 2019-06-25 Monteris Medical Corporation Cryotherapy, thermal therapy, temperature modulation therapy, and probe apparatus therefor
US10675113B2 (en) 2014-03-18 2020-06-09 Monteris Medical Corporation Automated therapy of a three-dimensional tissue region
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US11291470B2 (en) 2017-12-12 2022-04-05 Alcon Inc. Surgical probe with shape-memory material
JP2021505314A (en) 2017-12-12 2021-02-18 アルコン インコーポレイティド Multi-input coupled illuminated multi-spot laser probe
US11213426B2 (en) 2017-12-12 2022-01-04 Alcon Inc. Thermally robust multi-spot laser probe
US11135092B2 (en) 2017-12-12 2021-10-05 Alcon Inc. Multi-core fiber for a multi-spot laser probe

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