Surgical Laser device development for precise or bulk ablation of urologic tissue

用于精确或批量消融泌尿系统组织的外科激光设备开发

• 批准号: 7838095
• 负责人: JONATHON D WELLS
• 金额: $ 50万
• 依托单位: LOCKHEED MARTIN ACULIGHT CORPORATION
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-05-24 至 2011-05-23
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7838095
• 关键词: Ablation; Address; Affect; Age; Ambulatory Care Facilities; Architecture; Area; Arts; Bladder; British Columbia; Calculi; Characteristics; Clinic; Clinical; Clinics and Hospitals; Coagulation Process; Collaborations; Communities; Complex; Dentistry; Device or Instrument Development; Devices; Disease; Drops; Evaluation; Excision; Exhibits; Family suidae; Fiber; Gastroenterology; Goals; Grant; Hemorrhage; Hemostatic Agents; Hospitals; In Vitro; Kidney; Kidney Calculi; Lasers; Lead; Life; Light; Lithotripsy; Marketing; Medical; Microsurgery; Modeling; Operative Surgical Procedures; Orthopedics; Otolaryngology; Outcome; Outpatients; Output; Patient Care; Performance; Physiologic pulse; Podiatry; Positioning Attribute; Prevention; Price; Procedures; Property; Prostate; Research; Research Personnel; Robotics; Sampling; Series; Source; Speed; Structure; Surgeon; System; Techniques; Technology; Testing; Thulium; Time; Tissue Model; Tissues; Universities; Ureter; Urethra; Urologic Diseases; Urology; Validation; Vision; Water; Work; absorption; arm; base; clinical application; commercialization; cost; design; flexibility; improved; in vivo; instrument; laptop; lysophosphatidic acid; meetings; neurosurgery; next generation; novel; operation; optical fiber; portability; product development; prototype; public health relevance; research study; soft tissue; standard of care; tool; touchscreen; urologic; validation studies; vaporization

DESCRIPTION (provided by applicant): This application addresses broad Challenge Area (06) Enabling Technologies and specific Challenge Topic, (06-DK-104) Enabling technology for the prevention and treatment of diseases. Urologic disease represents a debilitating medical problem that adversely affects the lives of people of all ages and backgrounds. Surgical lasers form the standard of care for many treatments and endoscopic procedures in the prostate, kidney, ureter, bladder, and urethra. Still, current state-of-the-art devices suffer from a number of limitations including limited adjustability of cutting and coagulating parameters and complex light delivery systems which are insufficiently flexible and yield a sub- optimal beam quality for fine work. These systems also tend to be large, inefficient, water-cooled, and expensive. Lockheed Martin Aculight has developed a proprietary flexible, low-cost architecture for a unique fiber laser design that represents a dramatic improvement over existing technologies in terms of performance, cost, size, and complexity. Based on the principles of infrared tissue ablation, the objective of the proposed work is to apply this technology in collaboration with Vanderbilt University and clinicians at the University of British Columbia to develop and test a highly efficient, compact ablative surgical tool. The device's output wavelength will be at 1.94¿m which is proven to exhibit superior ablative and delivery qualities over currently available surgical laser systems. In this proposed work, Lockheed Martin Aculight will develop and test a thulium fiber laser that is capable of two distinct pulse modes, including a novel short pulse mode for fast cutting and a continuous wave mode. This unit will address the specific needs of several particular surgical applications from immediate vaporization with no effect outside of the irradiated zone, to precise ablation with minimal collateral thermal damage and lack of bleeding, to mass tissue removal with fine hemostatic control. The laser system will be further developed for commercialization to address a wide array of surgical applications following successful completion of these milestones. While most of the pulse features we propose here can be achieved today with existing laser sources, a separate source is required for short pulses and another for CW. The proposed device will readily generate each format and will cost less and be far more portable than currently available units, which have only a single mode of operation. The novelty of this device is in the improved technology that allows design of a single instrument that is high-performance, compact, low-cost, and scalable. Such a device can completely revolutionize the field as it provides a platform that can completely address the wide variety of surgical and outpatient needs in urology in both hospital and clinic settings. This basic laser architecture and microsurgical ablative capability will ultimately be applied to fields such as neurosurgery, orthopedics, surgical robotics, gastrological surgery, and otolaryngology to overcome existing limitations, pioneer new techniques, and ultimately improve patient care. PUBLIC HEALTH RELEVANCE: This project is intended to benefit those that require surgery for urology related treatment by developing a tool that can improve surgical outcome, increase the speed of a procedure, and reduce the associated cost to perform these procedures. This research will focus on overcoming the limitations prohibiting current surgical lasers from effectively treating a wide variety of urologic procedures, which will allow improved patient care.

描述（由申请人提供）：本申请涉及广泛的挑战领域（06）使能技术和特定的挑战主题，（06-DK-104）使能技术用于预防和治疗疾病。泌尿系统疾病是一种使人衰弱的医学问题，对所有年龄和背景的人的生活产生不利影响。手术激光构成了前列腺、肾脏、输尿管、膀胱和尿道中许多治疗和内窥镜手术的护理标准。尽管如此，当前最先进的设备受到许多限制，包括切割和切割参数的有限可调性以及复杂的光递送系统，其不够灵活并且产生用于精细工作的次优光束质量。这些系统也往往是大型的、低效的、水冷的和昂贵的。洛克希德·马丁公司Aculight为独特的光纤激光器设计开发了一种专有的灵活、低成本架构，在性能、成本、尺寸和复杂性方面比现有技术有了显著的改进。基于红外组织消融的原理，本研究的目标是与范德比尔特大学和不列颠哥伦比亚省大学的临床医生合作，应用这项技术开发和测试一种高效、紧凑的消融手术工具。该设备的输出波长将在1.94 μ m，这被证明具有优于目前可用的外科激光系统的消融和输送质量。在这项拟议的工作中，洛克希德·马丁公司将开发和测试一种具有两种不同脉冲模式的铥光纤激光器，包括一种用于快速切割的新型短脉冲模式和一种连续波模式。该装置将满足几种特定手术应用的特定需求，从在辐照区域外无影响的立即汽化，到附带热损伤最小且无出血的精确消融，再到精细止血控制的大规模组织切除。在成功完成这些里程碑后，激光系统将进一步开发用于商业化，以解决广泛的外科应用。虽然我们在这里提出的大多数脉冲特征可以用现有的激光源实现，但短脉冲需要一个单独的源，CW需要另一个。拟议的设备将很容易生成每种格式，并且成本更低，而且比目前可用的只有单一操作模式的设备更便携。该设备的新奇在于改进的技术，该技术允许设计高性能、紧凑、低成本和可扩展的单个仪器。这种设备可以彻底改变该领域，因为它提供了一个平台，可以完全解决医院和诊所环境中泌尿外科手术和门诊病人的各种需求。这种基本的激光架构和显微外科消融能力最终将应用于神经外科、骨科、外科机器人、胃外科和耳鼻喉科等领域，以克服现有的局限性，开拓新技术，并最终改善患者护理。 公共卫生相关性：该项目旨在通过开发一种可以改善手术结果、提高手术速度并降低执行这些手术的相关成本的工具，使需要进行泌尿外科相关治疗的患者受益。这项研究将集中在克服限制目前的外科激光有效地治疗各种各样的泌尿外科手术，这将允许改善病人的护理。