Development of a Novel Laser Instrument for Advanced Medical Applications

描述（由申请人提供）：该项目的主要目标是开发一种全新类型的激光系统，这将为包括微创手术、手术和内窥镜检查在内的各种临床应用的重大进展铺平道路。目前，由于大多数商用激光系统缺乏灵活性和多功能性，医疗激光器的应用受到了明显的限制。这些系统通常以单一的固定波长发射光，这使得每个激光器适用于非常狭窄的应用范围。例如，通过烧蚀去除组织需要红外光谱区域的波长，通常在2000到3000纳米之间。对于给定的手术任务而言，最佳的确切波长取决于组织的结构特性和含水量，因此，能够在大光谱范围内调整波长以优化切口参数（即消融轮廓，附带细胞损伤等）将是非常有益的。此外，在任何手术过程中保持良好的视觉效果是手术效果和结果的关键。体内平衡和凝固的控制也可以通过激光来实现，但是，激光的波长范围与烧蚀不同。我们的仪器将同时提供双波长输出，同时允许组织切割和伤口出血的控制。本提案将重点介绍新型台式激光仪器的组装、测试和临床表征。由于其全固态结构，激光仪器将非常坚固、可靠、紧凑和便携。玻璃光纤将用于将能量输送到笔大小的手持部件，使激光输出能够以高精度和前所未有的控制灵活地输送到目标组织。或者，激光能量可以通过内窥镜（或腹腔镜）输送，以切割和控制狭窄空间的出血。我们的愿景是，目前以更传统的手术通道完成的手术，可能会转变为最小的通道。这是特别的情况下，广泛暴露主要是为了控制出血。这种新型激光工具的灵活性将减轻这种担忧。通过减少脑操作的发病率和并发症，最低限度的可及性改善了患者的预后。

DESCRIPTION (provided by applicant): The main objective of this project is to develop a completely new type of laser system, which will pave the way for significant advances in a variety of clinical applications that encompass minimally invasive procedures, surgeries and endoscopies. Currently, the application of medical lasers is starkly limited by the lack of flexibility and versatility of most commercial laser systems. These systems typically emit light at a single, fixed wavelength which renders each laser suitable for a very narrow range of applications. For example, the removal of tissue via ablation requires a wavelength in the infrared spectral region, typically between 2000 and 3000 nm. The exact wavelength that is optimal for a given surgical task depends on the structural properties and water content of the tissue, Thus, having the ability to tune the wavelength across a large spectral range to optimize the incision parameters (i.e. ablation profile, collateral cell damage etc.) would be highly beneficial. In addition, to maintain good visualization during any operation is key for the effectiveness and the outcome of the procedure. Control of homeostasis and coagulation can be achieved through laser light as well, however, in a different wavelength range than ablation. Our instrument will provide a simultaneous dual wavelengths output which allows tissue cutting and the control of wound bleeding at the same time. This proposal will focus on the assembly, testing and clinical characterization of the new table-top laser instrument. Due to its all-solid-state construction, the laser instrument will be very robust, reliable, compact and portable. Glass fiber optics will be used to deliver the power to a pen-size hand piece that enables flexible delivery of the laser output to the target tissue with high-precision and unprecedented control. Alternatively, the laser power can be delivered through an endoscope (or laparoscope) to both cut and control bleeding in confined spaces. It is our vision that procedures currently being done with more traditional surgical access, may be converted to minimal access. This is especially the case where wide exposure is retained principally for the control of hemorrhage. This concern would be alleviated by the flexibility of this new laser tool. Minimal access improves patient outcomes by reducing the morbidity and complications of brain manipulation.