CA2201836A1 - Method for laser surgery - Google Patents
Method for laser surgeryInfo
- Publication number
- CA2201836A1 CA2201836A1 CA002201836A CA2201836A CA2201836A1 CA 2201836 A1 CA2201836 A1 CA 2201836A1 CA 002201836 A CA002201836 A CA 002201836A CA 2201836 A CA2201836 A CA 2201836A CA 2201836 A1 CA2201836 A1 CA 2201836A1
- Authority
- CA
- Canada
- Prior art keywords
- coherent radiation
- skin tissue
- laser
- pulses
- per square
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Abandoned
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
- A61B18/20—Surgical 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
- A61B18/203—Surgical 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 applying laser energy to the outside of the body
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
- A61B18/20—Surgical 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
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00238—Type of minimally invasive operation
- A61B2017/00243—Type of minimally invasive operation cardiac
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00743—Type of operation; Specification of treatment sites
- A61B2017/00747—Dermatology
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
- A61B2018/00452—Skin
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
- A61B2018/00452—Skin
- A61B2018/0047—Upper parts of the skin, e.g. skin peeling or treatment of wrinkles
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
- A61B18/20—Surgical 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
- A61B2018/2015—Miscellaneous features
- A61B2018/2025—Miscellaneous features with a pilot laser
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
- A61B18/20—Surgical 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
- A61B2018/2065—Multiwave; Wavelength mixing, e.g. using four or more wavelengths
- A61B2018/207—Multiwave; Wavelength mixing, e.g. using four or more wavelengths mixing two wavelengths
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
- A61C1/00—Dental machines for boring or cutting ; General features of dental machines or apparatus, e.g. hand-piece design
- A61C1/0046—Dental lasers
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS 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
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/10—Hair or skin implants
Abstract
A method of laser surgery, comprising the steps of selecting lasers whose output radiation has appropriate extinction lengths in the tissue to be ablated, coagulated, and/or shrunk, and directing radiation from those lasers coaxially and substantially simultaneously at the tissue.
Description
3 ~
APPLICATION FOR PATENT
Inventor: Ziv Karni Title: METHOD FOR LASER SURGERY
FIELD AND BACKGROUND OF THE INVENTION
The present invention relates to a method for performing laser surgery and, more particularly, to a method for sirnultaneously ablating, coagulating, and/or shrinking biological tissue.
Directing coherent radiation from a laser at a target is a well known method for precisely cutting that target by ablating or vaporizing a portion 10 of it. When the target is living biological tissue, the dynamic nature of the target poses special problems. For example, fluids such as blood may flow into the area of the cut, obscuring that area and absorbing part of the energy that otherwise would go into ablating the target.
This problem can be mitig~tetl by directing beams of coherent 15 radiation of two or more wavelengths at the tissue, one beam to ablate the tissue and the other to perform some other action, such as coagulating small blood vessels to prevent inflow of blood. For exarnple, Freiberg, in U. S. Patent Number 5,139,494, which is incorporated by reference for our purposes as if fully set forth herein, advocates using radiation in a 20 range of wavelengths between about 0.1 and about 0.3 microns, and between about 2.0 and about 12.0 microns, for ablative cutting, and radiation in a range of wavelengths between about 0.3 microns and about 2.0 microns for coagulation. These bearns of coherent radiation are directed coaxially at the tissue to be cut. Suitable means for combining laser beams coaxially are well known in the art. One such means is disclosed by Nakajima in U. S. Patent Number 4,408,602. Another is 5 disclosed by Jako in U. S. Patent Number 4,503,854. Both of these patents are incorporated by reference for all purposes as if fully set forth herein.
Among the surgical procedures to which laser surgery may be applied are skin resurfacing and hair irnplantation. In skin resurfacing, the 10 upper layer of skin is ablated by a first laser bearn while the underlying collagen is coagulated and shrunk by a second laser beam. In hair implantation, the accuracy of the drilling of holes for the implantation of new hair using a first laser beam is enhanced by the use of a second laser beam to coagulate small blood vessels and prevent inflow of blood. Both 15 of these procedures are very delicate and require precise selection and control of the wavelengths, intensities and durations of the laser beams.
There is thus a widely recognized need for, and it would be highly advantageous to have, a more precise method for using lasers to perform delicate surgical procedures such as skin resurfacing and hair implantation.
- ~ 2 Q ~ 8 3 fi SUMMARY OF THE INVENTION
According to the present invention there is provided a method for surgical alteration of skin tissue by simlllt~neous ablation, coa~,ulation, and shrinkage, comprising the steps of: (a) selecting a first coherent radiation 5 source characterized by emitting a first coherent radiation having an extinction length in the skin tissue of between about 0.01 millimeters and about 0.001 millimeters; (b) selecting a second coherent radiation source characterized by emi~tin~ a second coherent radiation having an extinction length in the skin tissue of between about 0.1 millimeters and about 0.01 10 millimeters; (c) directing a first beam of the first coherent radiation at the skin tissue; and (d) directing a second beam of the second coherent radiation at the skin tissue, substantially coaxially and substantially simultaneously with the first beam.
According to the present invention there is provided a method for 15 surgical alteration of skin tissue by simlllt~neous ablation, coagulation, and shrinkage, comprising the steps of: (a) selecting a first coherent radiation source characterized by emitting a first coherent radiation having an extinction length in the skin tissue of between about 0.01 millimeters and about 0.001 millimeters; (b) selecting a second coherent radiation source 20 characterized by emitting a second coherent radiation having an extinction length in the skin tissue of between about one millimeter and about 0.1 millimeters; (c) directing a first beam of the first coherent radiation at the - 220~ 83~
skin tissue; and (d~ directing a second be~m of the second coherent radiation at the skin tissue, substantially coaxially and subst~nti~lly simultaneously with the first beam.
The criteria for selecting the parameters for delicate laser surgery 5 on skin tissue are the desired physical effects. The ablative laser beam should be strongly absorbed by the target tissue, so that the ablative effects of the laser beaIn are confined to the target tissue. Furthermore, the pulse duration should be shorter than the thermal relaxation time of the target tissue, to prevent thermal damage to adjacent tissue, while the pulse 10 intensity should be suf~lciently high to achieve the desired ablation. In skin resurfacing, the laser beam used to shrink the collagen should not be significantly absorbed in the overlying skin, but should be absorbed by the collagen. In hair implantation, the laser bearn used should be absorbed only to an extent suf~lcient to coagulate the capillaries that are cut by the 15 ablative laser beam.
The present invention successfully addresses the shortcomings of the presently known procedures for skin resurfacing and hair implantation by providing an appropliate range of wavelengths, pulse durations, and pulse intensities for the laser beams used therein.
5 - 2 ~ 3 ~
BRIEF DESCRIPTION OF THE DRAWINGS
The invention is herein described, by way of example only, with reference to the accompanying drawings, wherein:
FIG. 1 is a graph of the extinction length, in water, of light of 5 various wavelengths, vs. wavelength;
FIG. 2A shows the firing schedule of the lasers in one embodiment of the present invention;
FIG. 2B shows the combined laser output corresponding to figure 2A;
FIG. 2C shows the combined laser output corresponding to the firing schedule of a different embodiment of the present invention.
DESCRIPTION OF THE PREFERRED EMBODIMENTS
The present invention is of a method for delicate laser surgery.
Specifically, the present invention can be used for precision skin 15 resurfacing and hair irnplantation. Although these specific procedures most commonly are performed on hllm~n patients, it will be appreciated by those ordinarily skilled in the art that the method described herein is equally applicable to surgical procedures carried out on lower m~mm~
The principles of precision laser surgery according to the present 20 invention may be better understood with reference to the drawings and the accompanying description.
6 ~ 3 ~
Referring now to the drawings, Figure 1 is a graph of the extinction length in water of infrared radiation of various wavelengths. Because skin tissue is 77% water by weight, water can be used as a proxy for skin tissue in selecting wavelengths for surgery.
To minimi7e peripheral damage, the extinction length of coherent radiation used for ablative cutting should be as small as posslble.
According to Figure 1, this length is between 0.01 millimeters and 0.001 millimeters. Note that the corresponding range of wavelengths is between about 2.5 microns and about 3.2 microns. This range is substantially 10 narrower than the 2-12 micron range recommended by Freiberg for ablative cutting. The 2.94 micron radiation of an erbium YAG laser has an extinction length in this range. The thermal relaxation time of m~mm~ n skin tissue is approxirnately one millisecond. Thus, the laser pulse duration should be no longer than this, and preferably about 0.3 15 milliseconds. The energy density of each pulse preferably is between one Joule per square centimeter and 50 Joules per square centimeter.
The extinction length of coherent radiation used for coagulation of small blood vessels should be somewhat longer than the extinction length of coherent radiation used for ablation, to spread the heating effect of the 20 laser beam over a larger depth range than is used for ablation. The intent here is merely to coagulate the blood, not to vaporize it. Between 0.1 millimeters and 0.01 millimeters is an appropliate extinction length for 3 ~
coagulation. The 10.6 micron radiation of a carbon dioxide laser has an extinction length in this range.
The laser beam used for coagulation may be either continuous or pulsed, as long as the duration of the coagulation beam substantially S overlaps the duration of the ablation bearn, as shown in Figures 2A, 2B, and 2C. In the four plots shown in these Figures, time T is the abscissa and beam intensity E is the ordinate. Figure 2A shows separate firing schedules for an erbium YAG ablation laser and a carbon dioxide coagulation laser in a preferred embodirnent of the present invention in 10 which the carbon dioxide laser is a continuous wave laser. The erbium YAG laser emits periodic pulses. The carbon dioxide laser fires continuously. The total laser output is the superposition of these t~vo outputs, as shown in Figure 2B. Preferably, the power level of the carbon dioxide laser is sufficiently high to coagulate the blood vessels cut by the 15 erbium YAG laser in between pulses of the erbium YAG laser, but not sufficiently high to cause peripheral damage by unwanted ablation. The preferred power density for a continuous wave carbon dioxide laser is between one Watt per square centimeter and 10 Watts per square centimeter.
Figure 2C shows the combined output of the erbium YAG laser and the carbon dioxide laser in a preferred embodiment of the present invention in which both lasers are pulsed. Note that the duration of each 8 ~ 3 ~
carbon dioxide laser pulse overlaps, and extends substantially beyond, the duration of the corresponding erbillm YAG laser pulse. Again, the object here is to coagulate the blood vessels cut by the erbium YAG laser without causing peripheral damage by unwanted ablation. The preferred carbon 5 dioxide pulse duration is between one millisecond and 10 milliseconds, and the preferred power density is between one Watt per square centimeter and 100 Watts per square centimeter.
The extinction length of coherent radiation used to shrirlk collagen preferably should match the thickness of the target collagen layer, which 10 may be as thick as about one millimeter. Collagen thinner than about 0.1 millimeters is shrunk by a laser appropriate for coagulation, for example a carbon dioxide laser. Thicker collagen is shrunk by a laser whose radiation has an extinction length of between about one millimeter and 0.1 millimeters. The 2.12 micron radiation of a holmium YAG laser has an 15 extinction length in this range. The shrinkage laser beam may be continuous or pulsed. Preferred pulse durations for a holmium YAG laser used to shrink collagen are between 0.3 milliseconds and one millisecond, and the preferred pulse energy density is about one Joule per square centimeter.
The range of wavelengths useful for laser surgery, as shown in Figure 1, is in the invisible infrared. In preferred embodiments of the present invention, a third, low power beam of visible coherent radiation 9 ~ 3 ~
is directed coaxially with the other two beams, so that the surgeon can see where the beams strike the patient.
While the invention has been described with respect to a limite~l number of embodiments, it will be appreciated that many variations, S modifications and other applications of the invention may be made.
APPLICATION FOR PATENT
Inventor: Ziv Karni Title: METHOD FOR LASER SURGERY
FIELD AND BACKGROUND OF THE INVENTION
The present invention relates to a method for performing laser surgery and, more particularly, to a method for sirnultaneously ablating, coagulating, and/or shrinking biological tissue.
Directing coherent radiation from a laser at a target is a well known method for precisely cutting that target by ablating or vaporizing a portion 10 of it. When the target is living biological tissue, the dynamic nature of the target poses special problems. For example, fluids such as blood may flow into the area of the cut, obscuring that area and absorbing part of the energy that otherwise would go into ablating the target.
This problem can be mitig~tetl by directing beams of coherent 15 radiation of two or more wavelengths at the tissue, one beam to ablate the tissue and the other to perform some other action, such as coagulating small blood vessels to prevent inflow of blood. For exarnple, Freiberg, in U. S. Patent Number 5,139,494, which is incorporated by reference for our purposes as if fully set forth herein, advocates using radiation in a 20 range of wavelengths between about 0.1 and about 0.3 microns, and between about 2.0 and about 12.0 microns, for ablative cutting, and radiation in a range of wavelengths between about 0.3 microns and about 2.0 microns for coagulation. These bearns of coherent radiation are directed coaxially at the tissue to be cut. Suitable means for combining laser beams coaxially are well known in the art. One such means is disclosed by Nakajima in U. S. Patent Number 4,408,602. Another is 5 disclosed by Jako in U. S. Patent Number 4,503,854. Both of these patents are incorporated by reference for all purposes as if fully set forth herein.
Among the surgical procedures to which laser surgery may be applied are skin resurfacing and hair irnplantation. In skin resurfacing, the 10 upper layer of skin is ablated by a first laser bearn while the underlying collagen is coagulated and shrunk by a second laser beam. In hair implantation, the accuracy of the drilling of holes for the implantation of new hair using a first laser beam is enhanced by the use of a second laser beam to coagulate small blood vessels and prevent inflow of blood. Both 15 of these procedures are very delicate and require precise selection and control of the wavelengths, intensities and durations of the laser beams.
There is thus a widely recognized need for, and it would be highly advantageous to have, a more precise method for using lasers to perform delicate surgical procedures such as skin resurfacing and hair implantation.
- ~ 2 Q ~ 8 3 fi SUMMARY OF THE INVENTION
According to the present invention there is provided a method for surgical alteration of skin tissue by simlllt~neous ablation, coa~,ulation, and shrinkage, comprising the steps of: (a) selecting a first coherent radiation 5 source characterized by emitting a first coherent radiation having an extinction length in the skin tissue of between about 0.01 millimeters and about 0.001 millimeters; (b) selecting a second coherent radiation source characterized by emi~tin~ a second coherent radiation having an extinction length in the skin tissue of between about 0.1 millimeters and about 0.01 10 millimeters; (c) directing a first beam of the first coherent radiation at the skin tissue; and (d) directing a second beam of the second coherent radiation at the skin tissue, substantially coaxially and substantially simultaneously with the first beam.
According to the present invention there is provided a method for 15 surgical alteration of skin tissue by simlllt~neous ablation, coagulation, and shrinkage, comprising the steps of: (a) selecting a first coherent radiation source characterized by emitting a first coherent radiation having an extinction length in the skin tissue of between about 0.01 millimeters and about 0.001 millimeters; (b) selecting a second coherent radiation source 20 characterized by emitting a second coherent radiation having an extinction length in the skin tissue of between about one millimeter and about 0.1 millimeters; (c) directing a first beam of the first coherent radiation at the - 220~ 83~
skin tissue; and (d~ directing a second be~m of the second coherent radiation at the skin tissue, substantially coaxially and subst~nti~lly simultaneously with the first beam.
The criteria for selecting the parameters for delicate laser surgery 5 on skin tissue are the desired physical effects. The ablative laser beam should be strongly absorbed by the target tissue, so that the ablative effects of the laser beaIn are confined to the target tissue. Furthermore, the pulse duration should be shorter than the thermal relaxation time of the target tissue, to prevent thermal damage to adjacent tissue, while the pulse 10 intensity should be suf~lciently high to achieve the desired ablation. In skin resurfacing, the laser beam used to shrink the collagen should not be significantly absorbed in the overlying skin, but should be absorbed by the collagen. In hair implantation, the laser bearn used should be absorbed only to an extent suf~lcient to coagulate the capillaries that are cut by the 15 ablative laser beam.
The present invention successfully addresses the shortcomings of the presently known procedures for skin resurfacing and hair implantation by providing an appropliate range of wavelengths, pulse durations, and pulse intensities for the laser beams used therein.
5 - 2 ~ 3 ~
BRIEF DESCRIPTION OF THE DRAWINGS
The invention is herein described, by way of example only, with reference to the accompanying drawings, wherein:
FIG. 1 is a graph of the extinction length, in water, of light of 5 various wavelengths, vs. wavelength;
FIG. 2A shows the firing schedule of the lasers in one embodiment of the present invention;
FIG. 2B shows the combined laser output corresponding to figure 2A;
FIG. 2C shows the combined laser output corresponding to the firing schedule of a different embodiment of the present invention.
DESCRIPTION OF THE PREFERRED EMBODIMENTS
The present invention is of a method for delicate laser surgery.
Specifically, the present invention can be used for precision skin 15 resurfacing and hair irnplantation. Although these specific procedures most commonly are performed on hllm~n patients, it will be appreciated by those ordinarily skilled in the art that the method described herein is equally applicable to surgical procedures carried out on lower m~mm~
The principles of precision laser surgery according to the present 20 invention may be better understood with reference to the drawings and the accompanying description.
6 ~ 3 ~
Referring now to the drawings, Figure 1 is a graph of the extinction length in water of infrared radiation of various wavelengths. Because skin tissue is 77% water by weight, water can be used as a proxy for skin tissue in selecting wavelengths for surgery.
To minimi7e peripheral damage, the extinction length of coherent radiation used for ablative cutting should be as small as posslble.
According to Figure 1, this length is between 0.01 millimeters and 0.001 millimeters. Note that the corresponding range of wavelengths is between about 2.5 microns and about 3.2 microns. This range is substantially 10 narrower than the 2-12 micron range recommended by Freiberg for ablative cutting. The 2.94 micron radiation of an erbium YAG laser has an extinction length in this range. The thermal relaxation time of m~mm~ n skin tissue is approxirnately one millisecond. Thus, the laser pulse duration should be no longer than this, and preferably about 0.3 15 milliseconds. The energy density of each pulse preferably is between one Joule per square centimeter and 50 Joules per square centimeter.
The extinction length of coherent radiation used for coagulation of small blood vessels should be somewhat longer than the extinction length of coherent radiation used for ablation, to spread the heating effect of the 20 laser beam over a larger depth range than is used for ablation. The intent here is merely to coagulate the blood, not to vaporize it. Between 0.1 millimeters and 0.01 millimeters is an appropliate extinction length for 3 ~
coagulation. The 10.6 micron radiation of a carbon dioxide laser has an extinction length in this range.
The laser beam used for coagulation may be either continuous or pulsed, as long as the duration of the coagulation beam substantially S overlaps the duration of the ablation bearn, as shown in Figures 2A, 2B, and 2C. In the four plots shown in these Figures, time T is the abscissa and beam intensity E is the ordinate. Figure 2A shows separate firing schedules for an erbium YAG ablation laser and a carbon dioxide coagulation laser in a preferred embodirnent of the present invention in 10 which the carbon dioxide laser is a continuous wave laser. The erbium YAG laser emits periodic pulses. The carbon dioxide laser fires continuously. The total laser output is the superposition of these t~vo outputs, as shown in Figure 2B. Preferably, the power level of the carbon dioxide laser is sufficiently high to coagulate the blood vessels cut by the 15 erbium YAG laser in between pulses of the erbium YAG laser, but not sufficiently high to cause peripheral damage by unwanted ablation. The preferred power density for a continuous wave carbon dioxide laser is between one Watt per square centimeter and 10 Watts per square centimeter.
Figure 2C shows the combined output of the erbium YAG laser and the carbon dioxide laser in a preferred embodiment of the present invention in which both lasers are pulsed. Note that the duration of each 8 ~ 3 ~
carbon dioxide laser pulse overlaps, and extends substantially beyond, the duration of the corresponding erbillm YAG laser pulse. Again, the object here is to coagulate the blood vessels cut by the erbium YAG laser without causing peripheral damage by unwanted ablation. The preferred carbon 5 dioxide pulse duration is between one millisecond and 10 milliseconds, and the preferred power density is between one Watt per square centimeter and 100 Watts per square centimeter.
The extinction length of coherent radiation used to shrirlk collagen preferably should match the thickness of the target collagen layer, which 10 may be as thick as about one millimeter. Collagen thinner than about 0.1 millimeters is shrunk by a laser appropriate for coagulation, for example a carbon dioxide laser. Thicker collagen is shrunk by a laser whose radiation has an extinction length of between about one millimeter and 0.1 millimeters. The 2.12 micron radiation of a holmium YAG laser has an 15 extinction length in this range. The shrinkage laser beam may be continuous or pulsed. Preferred pulse durations for a holmium YAG laser used to shrink collagen are between 0.3 milliseconds and one millisecond, and the preferred pulse energy density is about one Joule per square centimeter.
The range of wavelengths useful for laser surgery, as shown in Figure 1, is in the invisible infrared. In preferred embodiments of the present invention, a third, low power beam of visible coherent radiation 9 ~ 3 ~
is directed coaxially with the other two beams, so that the surgeon can see where the beams strike the patient.
While the invention has been described with respect to a limite~l number of embodiments, it will be appreciated that many variations, S modifications and other applications of the invention may be made.
Claims (22)
1. A method for surgical alteration of skin tissue by simultaneous ablation and coagulation, comprising the steps of:
(a) selecting a first coherent radiation source characterized by emitting a first coherent radiation having an extinction length in the skin tissue of between about 0.01 millimeters and about 0.001 millimeters;
(b) selecting a second coherent radiation source characterized by emitting a second coherent radiation having an extinction length in the skin tissue of between about 0.1 millimeters and about 0.01 millimeters;
(c) ablating the skin tissue by directing a first beam of said first coherent radiation at the skin tissue; and (d) coagulating the skin tissue by directing a second beam of said second coherent radiation at the skin tissue, substantially coaxially and substantially simultaneously with said first beam.
(a) selecting a first coherent radiation source characterized by emitting a first coherent radiation having an extinction length in the skin tissue of between about 0.01 millimeters and about 0.001 millimeters;
(b) selecting a second coherent radiation source characterized by emitting a second coherent radiation having an extinction length in the skin tissue of between about 0.1 millimeters and about 0.01 millimeters;
(c) ablating the skin tissue by directing a first beam of said first coherent radiation at the skin tissue; and (d) coagulating the skin tissue by directing a second beam of said second coherent radiation at the skin tissue, substantially coaxially and substantially simultaneously with said first beam.
2. The method of claim 1, wherein said first coherent radiation source is a laser.
3. The method of claim 2, wherein said first coherent radiation source is an erbium YAG laser.
4. The method of claim 1, wherein said second coherent radiation source is a laser.
5. The method of claim 4, wherein said laser is a carbon dioxide laser.
6. The method of claim 1, wherein said first beam is pulsed.
7. The method of claim 6, wherein each of said pulses has a duration of about 0.3 milliseconds, and wherein each of said pulses has an energy density of between about one Joule per square centimeter and about 50 Joules per square centimeter.
8. The method of claim 6, wherein said second beam is continuous.
9. The method of claim 8, wherein said second beam has a power density of between about one Watt per square centimeter and about
10 Watts per square centimeter.
10. The method of claim 6, wherein said second beam is pulsed, said pulses of said second beam at least partially overlapping in time with said pulses of said first beam.
10. The method of claim 6, wherein said second beam is pulsed, said pulses of said second beam at least partially overlapping in time with said pulses of said first beam.
11. The method of claim 10, wherein each of said pulses of said second beam has a duration of between about one millisecond and about 10 milliseconds, and wherein each of said pulses of said second beam has a power density of between about one Watt per square centimeter and about 100 Watts per square centimeter.
12. The method of claim 1, further comprising the step of directing a third beam of visible coherent radiation at the skin tissue, substantially coaxially and substantially simultaneously with said first beam.
13. A method for surgical alteration of skin tissue by simultaneous ablation and shrinkage, comprising the steps of:
(a) selecting a first coherent radiation source characterized by emitting a first coherent radiation having an extinction length in the skin tissue of between about 0.01 millimeters and about 0.001 millimeters;
(b) selecting a second coherent radiation source characterized by emitting a second coherent radiation having an extinction length in the skin tissue of between about one millimeter and about 0.01 millimeters;
(c) ablating the skin tissue by directing a first beam of said first coherent radiation at the skin tissue; and (d) shrinking the skin tissue by directing a second beam of said second coherent radiation at the skin tissue, substantially coaxially and substantially simultaneously with said first beam.
(a) selecting a first coherent radiation source characterized by emitting a first coherent radiation having an extinction length in the skin tissue of between about 0.01 millimeters and about 0.001 millimeters;
(b) selecting a second coherent radiation source characterized by emitting a second coherent radiation having an extinction length in the skin tissue of between about one millimeter and about 0.01 millimeters;
(c) ablating the skin tissue by directing a first beam of said first coherent radiation at the skin tissue; and (d) shrinking the skin tissue by directing a second beam of said second coherent radiation at the skin tissue, substantially coaxially and substantially simultaneously with said first beam.
14. The method of claim 13, wherein said first coherent radiation source is a laser.
15. The method of claim 14, wherein said first coherent radiation source is an erbium YAG laser.
16. The method of claim 13, wherein said second coherent radiation source is a laser.
17. The method of claim 16, wherein said laser is a holmium YAG laser.
18. The method of claim 13, wherein said first beam is pulsed.
19. The method of claim 18, wherein each of said pulses has a duration of about 0.3 milliseconds, and wherein each of said pulses has an energy density of between about one Joule per square centimeter and about 50 Joules per square centimeter.
20. The method of claim 18, wherein said second beam is pulsed, said pulses of said second beam at least partially overlapping in time with said pulses of said first beam.
21. The method of claim 20, wherein each of said pulses of said second beam has a duration of between about 0.3 milliseconds and about one millisecond, and wherein each of said pulses of said second beam has an energy density of about one Joule per square centimeter.
22. The method of claim 13, further comprising the step of directing a third beam of visible coherent radiation at the skin tissue, substantially coaxially and substantially simultaneously with said first beam.
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US08/647,531 | 1996-05-15 | ||
| US08/647,531 US5655547A (en) | 1996-05-15 | 1996-05-15 | Method for laser surgery |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CA2201836A1 true CA2201836A1 (en) | 1997-11-15 |
Family
ID=24597335
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA002201836A Abandoned CA2201836A1 (en) | 1996-05-15 | 1997-04-04 | Method for laser surgery |
Country Status (7)
| Country | Link |
|---|---|
| US (1) | US5655547A (en) |
| EP (1) | EP0807418A3 (en) |
| JP (1) | JPH1043196A (en) |
| KR (1) | KR970073528A (en) |
| AU (1) | AU1995297A (en) |
| CA (1) | CA2201836A1 (en) |
| IL (1) | IL120528A0 (en) |
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1997
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- 1997-05-01 JP JP9113731A patent/JPH1043196A/en active Pending
- 1997-05-13 KR KR1019970018440A patent/KR970073528A/en not_active Application Discontinuation
- 1997-05-15 EP EP97107961A patent/EP0807418A3/en not_active Withdrawn
Also Published As
| Publication number | Publication date |
|---|---|
| EP0807418A2 (en) | 1997-11-19 |
| AU1995297A (en) | 1997-11-20 |
| IL120528A0 (en) | 1997-07-13 |
| EP0807418A3 (en) | 1998-01-07 |
| KR970073528A (en) | 1997-12-10 |
| JPH1043196A (en) | 1998-02-17 |
| US5655547A (en) | 1997-08-12 |
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