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

描述(由申请人提供)：本申请涉及广泛的挑战领域(06)使能技术和具体挑战主题，(06-DK-104)使能技术用于预防和治疗疾病。泌尿系疾病是一个令人衰弱的医学问题，对所有年龄和背景的人的生活都有不利影响。外科激光形成了前列腺、肾脏、输尿管、膀胱和尿路的许多治疗和内窥镜手术的标准护理。尽管如此，当前最先进的设备仍受到一些限制，包括切割和凝固参数的可调整性有限，以及复杂的光传输系统，这些系统不够灵活，产生的光束质量不够理想，无法进行精细加工。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Aculight公司为一种独特的光纤激光器设计开发了一种专有的灵活、低成本的架构，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。根据红外线组织消融的原理，拟议工作的目标是与范德比尔特大学和不列颠哥伦比亚大学的临床医生合作应用这项技术，以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为1.94？m，这被证明比目前可用的外科激光系统具有更好的消融和传输质量。在这项拟议的工作中，洛克希德·马丁Aculight公司将开发和测试一种能够支持两种不同脉冲模式的稀土光纤激光器，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殊外科应用的特定需求，从在照射区域外不起作用的立即汽化，到附带热损伤最小且没有出血的精确消融，再到具有良好止血控制的大量组织切除。在成功完成这些里程碑之后，激光系统将被进一步开发用于商业化，以满足广泛的外科应用。虽然我们在这里提出的大多数脉冲特征现在都可以用现有的激光光源来实现，但对于短脉冲和连续波，需要一个单独的光源。与目前只有一种操作模式的现有设备相比，拟议的设备将很容易生成各种格式，成本更低，便携性更强。该设备的新奇之处在于改进了的技术，允许设计出高性能、紧凑、低成本和可扩展的单一仪器。这种设备可以彻底改变这一领域，因为它提供了一个平台，可以完全满足医院和临床环境中泌尿外科的各种外科和门诊需求。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、整形外科、外科机器人、胃科外科和耳鼻喉科等领域，以克服现有限制，开创新技术，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工具，改善手术结果，提高手术速度，并降低执行这些程序的相关成本，从而使那些需要手术进行与泌尿外科相关的治疗的人受益。这项研究将专注于克服目前限制外科激光有效治疗各种泌尿外科程序的局限性，这将有助于改善患者的护理。

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.