A laser gun device for drilling and bending holes in biological bone tissue

Abstract

The application discloses a laser gun device for drilling and bending holes in biological bone tissue, which comprises switchable light sources, a detection real-time transmission feedback system connected with the switchable light sources, multifunctional integrated transmission optical fibers and a laser gun. The multifunctional integrated transmission optical fibers comprise flexible transmission optical fibers connected with the switchable light sources, main optical fibers arranged in the laser gun and pre-deformed elastic optical fiber bullets. After the pre-deformed elastic optical fiber bullets are chambered, the pre-deformed elastic optical fiber bullets are connected with the transmission mechanism in the laser gun and are shot out of the muzzle. The deformation recovery process of the optical fiber bullets is synchronous with the drilling and bending process of the laser on the biological bone tissue and the trajectories are the same, so that the operation of drilling and bending arc holes from outside to inside and then outside is realized on the biological bone tissue. The application has a clever structure design and can drill fine bent holes in different parts of the biological hard tissue, solves the problem that the drilling and bending process is limited to straight holes and there is no laser medical bent hole processing example.

Description

[0001] The present application relates to the field of laser medical technology, in particular to a laser gun device for drilling and bending holes in biological bone tissue.

[0002] As one of the greatest scientific inventions of the 20th century, laser technology is widely used in sensing, material processing, additive manufacturing, imaging, communication and other fields due to its high coherence, high brightness, high directionality and high monochromaticity. Among them, the laser scalpel, as a treatment method instead of traditional metal knives and high-frequency electric knives, has become the most safe, efficient and low-damage surgical method at present.

[0003] The laser scalpel mainly utilizes the characteristics that biological tissue has a specific absorption peak at a specific wavelength, and directly irradiates the human tissue with laser to achieve the effect of instantaneous heating. For soft tissue, the water in the cell rapidly vaporizes and breaks through the cell wall to achieve cutting effect; for soft tissue, the water in the cell slowly vaporizes and the cell shrinks to achieve hemostasis effect. For hard tissue, the "micro-explosion" principle is used to rapidly vaporize the soft tissue connected to the human hard tissue, and the pressure generated will break through the hard tissue in the form of explosion to achieve cutting effect. However, the existing laser surgery technology mainly acts on soft tissue. The utility model with the authorization announcement number CN201977930U introduces a visual laser minimally invasive surgical treatment system for respiratory system; the utility model with the authorization announcement number CN206214182U introduces a laparoscopic laser resection mirror system; the Chinese invention patent with the publication number CN108814658A introduces a craniotomy device and craniotomy method, and the cutting device moves along the running track to achieve the cutting of the scalp and / or skull. That is, the mainstream laser surgery system at present is still limited to and suitable for soft tissue cutting, and part of the hard tissue cutting cases are also limited to teeth or cadaver bones. There is a lack of clinical implementation cases for hard tissue cutting in vivo.

[0004] ​​Drilling is a common means of laser medical processing at present, and the use of laser collimation characteristics can achieve efficient, safe and low-damage straight hole processing. However, for the complex environment in the human body, in some scenarios, special bending hole processing is needed for the patient to achieve the purpose of treatment and repair. The suture anchor technology is the standard technology for tissue repair and suture in clinical practice. The conventional operation is to implant an anchor in the bone tissue first, and then to achieve anchoring in the bone tissue through threads, barbs or wing structures, and then to use the suture line pre-penetrated through the tail hole of the anchor for tissue repair and suture. However, no matter how the material is improved, the anchor is always a foreign body to the human body, and the anchor itself has a certain space-occupying effect, and there is a risk of surgical failure due to insufficient holding force of the anchor itself, even pulling out of the bone tissue, especially for elderly patients with osteoporosis. In a few emergency situations in clinical practice, the surgeon needs to perform tissue repair and suture in situ without preparing an anchor or because of cost and other reasons, the anchor cannot be used or the anchor suture fails, or the anchor is pulled out during the operation. The emergency treatment method is to drill a straight hole on the bone section, then pass the needle with the line through the hole, and use the bone beam between the holes to achieve anchoring, and then perform tissue suture repair. However, the bone often presents as an arc surface (bone end) or a columnar surface (bone shaft), so the hole and the bone surface form an acute angle, which will cause the so-called "turning killer" effect to cut the suture line. This is only a temporary replacement measure in clinical practice and cannot be used routinely for tissue repair and suture. If an arc-shaped curved hole can be drilled in the bone, and the hole wall is polished, and the suture line is passed into the hole, the suture line and the hole are not in an acute angle relationship, and the suture line will not be cut due to the "turning killer" effect, so as to replace the function of the anchor, and directly use the bone beam between the hole inlet and outlet to achieve anchoring, and then use the line to perform tissue suture repair.

[0005] The current mainstream medical drilling technology is mechanical drilling with medical electric drill. However, the drill bit of the existing medical electric drill can only drill straight holes, and cannot drill a fine and curved hole on the bone tissue. Even the medical soft drill only realizes bending in the operation part so that the drill bit reaches a specific operation area. For example, when the hip joint is replaced, the drill bit of the acetabular cup prosthesis is drilled by the soft drill, but the drilled hole is still a straight hole. Even if part of the technology can realize curved hole processing, the complexity of the equipment and the vibration, roughness of the machining surface, and invariability of the operation of the mechanical machining itself are also brought into the curved hole processing. The US patent US4265231A discloses an arc-shaped drill bit accessory for bone drilling, which is connected to a vertical straight sleeve through a rigid sleeve with a horizontal plane of 270-degree arc, and finally connected to a rotatable handle. Through the rotation of the handle, the curved hole processing can be realized. The US patent US6740090B1 discloses a method and device for forming a shaped axial hole through a vertebra, which realizes curved hole processing by extending from the front or rear target point along the curvature of the spine along one or more vertebral bodies in the head direction through the anterior or posterior axial instrument fusion line (AAIFL or PAIFL). The US patent US9364242B2 discloses a drilling device for forming a curved bone channel in a vertebral body, which realizes curved hole processing by embedding a curved guide pin in a straight sleeve.

[0006] However, in the above-mentioned patents, whether it is the pre-designed curved hole processing path, the rotatable drill bit in the front section of the processing part, or the soft drill, it is still in the mechanical machining category, and cannot overcome the problems of debris, roughness, vibration, and inconvenience of operation caused by mechanical machining. Moreover, due to the limitation of mechanical materials and process machining, the drilled curved hole is still greatly limited in key technical parameters such as hole diameter and turning radius, and cannot realize fine curved hole preparation on hard bone.

[0007] US20080108876A1 discloses a surgical instrument based on shape memory metal, which utilizes the principle of electric spark drilling to change between two shapes when one or both of heating and cooling are applied, ultimately achieving bend hole machining. Electric spark machining is a processing method that utilizes the principle of "electrical discharge corrosion". For electric spark machining of bend holes, the current solutions mainly utilize compression springs, shape memory alloys, etc. to control the electrode, or use methods such as wire frame electrodes to achieve curved motion of the discharge electrode. 1. Compression spring technology: the electrode head and the spindle head of the electric spark machine are connected by a spring, three steel wires are connected on the circumference of the free end of the spring, and the length of each steel wire is controlled to adjust the release amount of the spring during processing, thereby controlling the advancing posture and orientation of the free end of the spring (Annals of the CIRP, 1989, 38(1): 203-206). However, in actual operation, the vibration of the spring is difficult to control, and as the hole depth increases, the stability of the mechanism continuously decreases, resulting in low processing precision and efficiency, and there are great limitations on the shape and size of the processed hole, which can only process simple large-radius curved holes. 2. Shape memory alloy technology: EP0885093A1 discloses an electrical processing method based on memory metal. This processing method is similar to the spring, connecting the electrode head and the spindle head together, which inevitably causes the electrode head to lose stability during processing, and the processing efficiency, bend hole shape, precision and inner surface quality are not high. 3. In addition, there is a method of using a flexible electrode head for electrolytic processing. Before using this method, a small hole is first processed on the workpiece, and then the flexible electrode head is sent into the small hole for electrical processing. The ideal processing trajectory cannot be obtained due to the influence of many uncertain factors during processing, and a standard curved cylindrical surface with high precision and low roughness cannot be obtained. Electric spark machining has no comparability in terms of precision, efficiency, stability, surface quality, etc. compared with laser machining.

[0008] Existing laser medical drilling technology is still limited to straight hole machining, and there is no report on laser medical bend hole machining. CN109953826A provides a laser device and processing method for orthopedic drilling, which fixes the laser drilling, uses laser ranging to detect the drilling depth in real time, can automatically adjust the focal length on the processing plane, and stops working automatically until the predetermined depth value is reached. However, it is still limited to drilling straight holes, and can only be fixed for operation, which is not convenient to operate. CN105189023B provides a laser system for drilling holes in medical devices, which uses a low-power fiber seed laser to generate a modulated and amplified high-quality laser beam, and the high-quality laser beam has precise characteristics to produce precise drilling, but is limited to straight hole machining.

[0009] In addition, in the existing laser medical technology, the flexible transmission of laser still has problems. The Chinese invention patent with publication number CN109975921A introduces an air-core infrared energy transmission waveguide, but it does not have flexibility; the Chinese invention patent with publication number CN109307561A introduces a sapphire single crystal fiber that can be used for high-energy laser transmission and can withstand high temperature, but the fiber preparation process is complex and the cost is high; the American invention patent with publication number US5285518A introduces a ZBLAN fiber that can be used for 3-5 mu m laser transmission, but it is powerless for 9-12 mu m CO2 laser transmission; the American invention patent with publication number US5251062A introduces a tellurite fiber that can be used for 1-3 and 4-5.6 mu m laser transmission. The fiber has high nonlinearity, high stability and high transmittance, but the transmission range is limited, the loss is high, and the fiber cannot achieve light irradiation; the American invention patent with publication number US5491767A introduces a medical germanate fiber that can be used for 2.6-2.9 mu m laser transmission (solid-state laser), the fiber has high biocompatibility and high damage threshold, and the infrared transmittance is high, but it cannot be applied to 9-12 mu m CO2 laser transmission; the American invention patent with publication number US8681421B1 proposes an infrared energy transmission system based on quartz material, but the transmission range of the fiber is only up to 4 mu m. In summary, the existing laser flexible transmission technology shows that the flexible transmission technology in the near-infrared band of 0.78-6 mu m is relatively mature, but there is still a lack of a flexible transmission method for 9-12 mu m CO2 laser.

[0010] As can be seen from the prior art, the lack of bending hole machining method in the field of laser flexible drilling in medical treatment is limited to the flexible transmission of laser on the one hand, and the realization of bending method is difficult on the other hand.

SUMMARY

[0011] Therefore, in order to overcome the shortcomings of the prior art, the present application provides a laser gun device for drilling and bending holes in biological bone tissue. Through switchable laser light source, fiber transmission method and ingenious structure design, fine bending holes can be drilled in different parts of the biological bone tissue, a fine arc-shaped bending hole can be drilled on the bone, and the hole wall and hole mouth can be polished at the same time. The operation is convenient and controllable, the reliability is high, the suture can be inserted into the arc-shaped hole at the same time or immediately after, the bone beam between the inlet and outlet of the arc-shaped hole is used to replace the traditional anchor to achieve anchoring, and then the tissue suture repair operation is performed.

[0012] The problems of the existing medical mechanical drilling, such as material and process limitations, large turning radius, large hole diameter, generation of debris, roughness, vibration and inconvenience of operation, inability to prepare fine bending holes and suture cutting, and limitation of traditional methods to straight hole machining and lack of laser medical drilling and bending hole machining examples are solved.

[0013] To achieve the above object, the technical scheme of the present application is as follows:

[0014] A laser gun device for drilling and bending holes in biological bone tissue, comprising a switchable light source and a connected detection real-time transmission feedback system, a multifunctional integrated transmission optical fiber and a laser gun, the multifunctional integrated transmission optical fiber comprises a flexible transmission optical fiber and a main optical fiber and a pre-deformation elastic optical fiber bullet connected in the laser gun, the input end of the flexible transmission optical fiber is connected with the switchable light source, and the output end is connected with the main optical fiber, so as to complete the transmission or switching of the light source; the main optical fiber in the laser gun is in a telescopic and folded form.

[0015] The front end of the pre-deformation elastic optical fiber bullet is composed of an optical fiber inner core and a pre-bent arc-shaped memory metal outer shell, and has a suture on the side wall of the memory metal outer shell, the inside of the laser gun is connected with the pre-deformation elastic optical fiber bullet through a transmission mechanism, so as to shoot it out of the muzzle, by continuously extruding the pre-deformation elastic optical fiber bullet, the deformation and recovery process of the pre-deformation elastic optical fiber bullet in the process of traveling is synchronous with the process of drilling and bending holes by laser on the biological bone tissue and has the same trajectory, so as to realize the operation of arc drilling and bending from outside to inside and then to outside.

[0016] The light source is a switchable light source, and the wavelength range is 2-12 μm, which can be manually or automatically switched according to different cutting tissues, and the light source with appropriate wavelength, power and pulse width is selected according to the bone material, and the corresponding output end.

[0017] Optionally, the switchable light source comprises CO2 laser light source, water laser light source, Er laser, holmium laser, YSAG laser and other light sources with different wave bands covering different tissue absorption peaks, the average power can cover 10 mw-100 w, the peak power is 100 w-1000 w, and the type is a short pulse laser.

[0018] The detection real-time transmission feedback system can detect the incision depth, and automatically switch the power, pulse width and other parameters according to the cut tissue; the bone material information is fed back to the switchable light source to select the light source with appropriate wavelength, power and pulse width, so as to be suitable for drilling different bones.

[0019] Optionally, the detection real-time transmission feedback system is a plasma detection system or an infrared detection system, which can realize real-time detection of cutting depth and tissue temperature, and real-time feedback to the control system to realize "opening and closing at any time".

[0020] The multifunctional integrated transmission optical fiber is an integrated transmission optical fiber with functions of gas transmission, detection light transmission, and cutting laser transmission. Optionally, the multifunctional integrated transmission optical fiber comprises an outer cladding layer, a reflection layer, and an air core structure; the outer cladding layer is located at the outermost layer, and the outer cladding layer is a polymer outer cladding layer, and the reflection layer is an omnidirectional reflection layer.

[0021] Further, the outer cladding layer, the reflection layer, and the air core structure of the multifunctional integrated transmission optical fiber are concentric circles.

[0022] Specifically, the polymer outer cladding layer of the multifunctional integrated transmission optical fiber is a thermoplastic polymer or an ultraviolet curing resin, and the thickness of the polymer outer cladding layer is 50-1000 μm.

[0023] Specifically, the omnidirectional reflection layer of the multifunctional integrated transmission optical fiber is a multi-material medium reflection structure, the multi-material medium reflection structure is composed of at least two medium materials with different refractive indexes, and the thickness of the medium reflection structure is 10-100 μm. Preferably, the medium materials include a high-refractive-index material and a low-refractive-index material, the high-refractive-index material is a glass material, and the low-refractive-index material is a polymer material.

[0024] Specifically, the multi-material medium reflection structure of the multifunctional integrated transmission optical fiber is alternately composed of medium materials with different refractive indexes, the refractive index difference of the medium materials with different refractive indexes is 0.1-2.0, the thickness of a single layer of each medium material is 0.5-10 μm, and the number of alternating layers is 5-30 layers.

[0025] Specifically, one medium material of the multi-material medium reflection structure is the material constituting the polymer outer cladding layer, or one medium material of the multi-material medium reflection structure has similar thermodynamic properties with the material constituting the polymer outer cladding layer; each medium material of the multi-material medium reflection structure has similar thermodynamic properties. The similar thermodynamic properties refer to a glass transition temperature difference of 50℃, a temperature interval crossing within a 10 4 -10 8 poise viscosity interval, and a refractive index difference between materials of 0.1-2.0.

[0026] Specifically, the air core of the multifunctional integrated transmission optical fiber can realize gas or liquid transmission, achieve the functions of cleaning and cooling, and the transmission optical fiber can be an optical fiber bundle integrated by optical fibers of different wavebands, and can realize transmission of 2-12 μm waveband laser with a loss of <1 dB / m.

[0027] The multifunctional integrated transmission optical fiber uses laser to automatically complete polishing of the hole and the hole opening while preparing the hole: using the principle of laser polishing, the edges of the hole, the inlet hole and the outlet hole are polished and ground by low-power laser burning slowly, and the hole and the hole opening are polished at the same time of hole preparation, which can make the hole wall smooth, thereby avoiding the rough surface of the hole and the hole opening to form wear and cut on the suture, and effectively protecting the strength of the suture. Subsequently, the suture attached to the outer wall of the optical fiber bullet is taken out of the hole for subsequent suture repair of the tissue.

[0028] Further, the pre-deformed elastic optical fiber bullet includes an integrated optical fiber bullet front part, an optical fiber bullet middle part and an optical fiber bullet adapter part, the optical fiber bullet adapter part is connected to the base on the barrel of the laser gun, and the base can drive the optical fiber bullet adapter part to move forward and backward.

[0029] Preferably, the head side wall of the memory metal outer shell is provided with a barb structure for hanging the suture, which is taken out after the optical fiber bullet drills the hole; each time before drilling a curved hole, the suture is hung on the side wall of the pre-bent elastic optical fiber bullet head outer shell, and then the pre-bent elastic optical fiber bullet with the suture is chambered like a bullet, and the laser gun is loaded from the chamber.

[0030] The head side wall of the memory metal outer shell is pre-embedded with a steel wire loop structure for hanging the suture, which can be automatically ejected after drilling the hole. Then the steel wire loop is pulled out of the body by a probe or a wire grabber, and the suture is hung by the steel wire loop. When the optical fiber bullet exits the hole backward, the suture can be taken into the hole through the steel wire loop in the reverse direction, which can also be used for subsequent operation of tissue repair suture. This reverse line taking method brings the suture into the hole, which is an alternative to the barb which brings the suture into the hole in the forward direction.

[0031] When the optical fiber bullet drills a curved hole, the fiber bending or light path bending can be realized by rigid metal sleeve, end face processing and other methods, and the low-loss transmission of the fiber is realized by using the principle of photonic bandgap or total reflection. In addition, the flexibility of the fiber and the low-loss transmission of the fiber when the bending radius is >2 cm are ensured by using the specific polymer material as the main body material of the fiber.

[0032] Optionally, the bending processing of the multifunctional integrated transmission optical fiber can be realized by changing the direction of the fiber output laser. Specifically, the output fiber end is processed to form a refractive or reflective mirror, and the controllable angle output of the laser is realized by using the final lens collimation, thereby realizing the bending processing of the hole.

[0033] Further, the laser gun comprises a gun handle, a gun barrel and a gun barrel, the front end of the gun barrel is designed as a lower jaw and an upper jaw, the upper jaw is foldable, a through hole is arranged on the surface of the upper jaw, and the through hole is filled with a bullet piece which can elastically clamp the through hole, when the upper jaw is opened upward, the bullet piece is popped up at the same time to expose the through hole, and the subsequent suture is convenient to pass out.

[0034] Preferably, the base on the gun barrel is provided with a water inlet and a water outlet, water is injected to cool, cool and clean the optical fiber bullet adapter, so as to reduce the burning effect of the optical fiber bullet on the bone tissue when drilling.

[0035] The gun handle comprises a handle, a first trigger and a second trigger, a rotating mechanism is arranged in the handle, the first trigger is connected to the base of the gun barrel through the rotating mechanism and a bearing, and the first trigger drives the base to move forward and backward, thereby controlling the advance and retreat of the optical fiber bullet. A steel wire is arranged in the gun barrel, and the two ends of the steel wire are connected to the second trigger and the upper jaw of the gun barrel respectively, and the second trigger drives the upper jaw to open and close through the connected steel wire.

[0036] Further, the base is arranged in the chamber, and the base is connected to the optical fiber bullet adapter. The side of the chamber is provided with an openable chamber port, which is convenient for loading the optical fiber bullet. After the optical fiber bullet adapter is loaded, it is connected to the base to realize the communication between the optical fiber bullet and the main optical fiber.

[0037] Further, the main optical fiber, the pre-deformed elastic optical fiber bullet and the base in the laser gun can also be an integrated structure, and the front end of the optical fiber bullet is directly stretched out of the muzzle through the movement of the base.

[0038] Alternatively, the openable chamber port of the chamber can also be arranged on the upper part of the gun body, and the pre-bent elastic optical fiber bullet with a wire is placed at this position, and the communication is realized through the light conversion interface in the handle and the optical fiber at the tail end of the gun.

[0039] Preferably, the base of the chamber is movable forward and backward, and the base and the optical fiber bullet adapter can be driven to move forward or backward by pulling the first trigger, thereby controlling the stretching and retracting action of the optical fiber bullet after the chambered optical fiber bullet is stretched out of the front end of the laser gun, so as to realize the emission or retraction of the optical fiber bullet.

[0040] In particular, the opening and closing folding radius R of the upper jaw of the muzzle is equal to the pre-bending radius R of the pre-deformed elastic optical fiber bullet, so that when the upper jaw of the muzzle is opened to any angle, the direction of the deformation recovery of the pre-deformed elastic optical fiber bullet after the muzzle will always be aligned with the through hole of the upper jaw of the muzzle. By selecting the clamping position, direction and angle of the upper and lower jaws of the muzzle on the biological bone tissue, a controllable and suitable fine bending hole can be drilled at the required position, so as to realize the aiming function.

[0041] After the laser gun is inserted into the body, the upper and lower jaws of the gun barrel are opened and aimed at the specific position of the inlet and outlet holes of the fine bending hole to be prepared, the operator holds and stabilizes the handle, and then pulls the first trigger to start drilling. The fiber bullet drills a hole, and the suture is taken out of the hole at the same time. The through hole of the upper jaw of the gun barrel has a metal pellet, which is pushed open when the fiber bullet passes through the hole. When the fiber exits the hole, the metal pellet clamps the suture taken out, and the head of the suture is left outside the outlet of the hole. The suture is pulled out of the body by pulling the gun head or using a wire holder or a probe. Thus, the drilling and wire taking operations can be completed at one time, and then the suture is used for tissue suture repair operation.

[0042] The tail end of the gun body is connected with a multifunctional integrated transmission optical fiber and circuit. Laser is transmitted from the light source to the optical fiber and then to the output end. Feedback information and circuit control parts are integrated therein to implement laser control feedback.

[0043] The gun handle part is designed with a light conversion interface, and the gun barrel upper end is bored. A pre-bent elastic fiber bullet with a wire is placed in this position, and the light conversion interface in the gun handle and the optical fiber at the tail end of the gun are connected.

[0044] In the multifunctional integrated transmission optical fiber, the flexible transmission optical fiber is connected with the switchable light source through an input end coupling device and connected with the main optical fiber in the laser gun through an output end coupling device.

[0045] The main optical fiber in the laser gun is in a telescopic and foldable form, and can also be in a curved, coiled or wound form. When the base moves forward and backward, the main optical fiber in the laser gun can be telescoped and folded within a certain range without affecting the transmission of laser energy.

[0046] The working principle of the present application is as follows:

[0047] The application utilizes switchable light source to excite laser suitable for different bone tissues or other biological hard tissues, multifunctional integrated transmission optical fiber and automatic switching output end to complete the transmission of light source, through the up and down jaw aiming of the laser gun handle muzzle aiming at the import and export parts clamped in the need of preparing fine curved hole, the pre-bent elastic optical fiber bullet with the function of line is drilled quickly under the control of the handle, the transmission feedback system monitors the drilling situation in real time during the drilling, and controls and adjusts the light source and the output end, at the same time, the multifunctional integrated transmission optical fiber completes the cleaning and cooling function, the biological bone tissue is drilled a fine arc-shaped curved hole by using the deformation recovery of the pre-bent elastic optical fiber bullet itself or the inclined output light, end face processing and other means, the hole and the hole are polished at the same time of preparing the hole, so that the hole and the hole are smooth. After the optical fiber bullet drills the curved hole, the optical fiber bullet exits the hole and directly rushes to the through hole of the upper jaw of the muzzle, the bullet piece is pushed open at the through hole, and then the optical fiber bullet is withdrawn, and the bullet piece presses the suture to facilitate the subsequent suture repair of the tissue. The above steps are completed quickly and at one time in the highly integrated system.

[0048] The application has the advantages that through the switchable laser light source, optical fiber transmission mode and ingenious structure design, fine curved holes can be drilled in different parts of the biological hard tissue, the operation is convenient and controllable, the reliability is high, the problems that the current mechanical drilling is limited by materials and process, the turning radius is large, the hole diameter is large and fine curved holes cannot be prepared are solved, the problems of debris, roughness, vibration and inconvenient operation in mechanical processing are solved, the design of fine curved holes reduces the cutting of the suture, the entrance and the exit of the curved hole are polished by taking advantage of the slow ablation of low-power laser, the suture is further avoided from being cut off due to the rough interface, the strength of the suture is effectively protected, the operation efficiency and the durability of the suture are improved. Through the ingenious design of the gun head, the one-time drilling with the suture operation scheme is convenient to operate and saves the operation time. Further, the gun head can be directly inserted into the body to operate under the monitoring of the visible endoscope, the disadvantages of large open operation trauma and slow recovery are avoided. The suture is anchored by the bone beam between the entrance and the exit of the hole, and then the tissue is sutured and repaired, so that the current operation mode of implanting the anchor nail with the suture and then sutured and repaired is completely changed, the strength is better, the anchor nail is avoided from being pulled out and failed, the dissection repair is better realized, the physiological characteristics are better met, and the long-term retention of the anchor nail and other implants in the body is fundamentally avoided to interfere with the local human body. BRIEF DESCRIPTION OF DRAWINGS

[0049] In order to more clearly illustrate the technical solutions in the embodiments of the application or the prior art, the following will briefly introduce the drawings needed to be used in the embodiments or the prior art description. Obviously, the drawings in the following description only some embodiments of the application, and for those skilled in the art, other drawings can also be obtained without creative labor.

[0050] Figure 1 The system architecture of the present application.

[0051] Figure 2 The device structure of the present application applied to human bone tissue.

[0052] Figure 3 The structure of the laser gun.

[0053] Figure 4 The part of the state diagram of the optical fiber bullet after the bullet fragments are pushed open by the laser gun.

[0054] Figure 5 The structure of the optical fiber bullet.

[0055] Figure 6 The structure of the laser gun. Figure 5 The enlarged structure diagram of A in the middle.

[0056] Figure 7 The working mode diagram of the optical fiber bullet with steel wire loops in the front.

[0057] Figure 8 The original state diagram of the pre-deformed elastic optical fiber bullet.

[0058] Figure 9 The state diagram of the pre-deformed elastic optical fiber bullet placed in the gun barrel.

[0059] Figure 10 The state diagram of the pre-deformed elastic optical fiber bullet ejected from the muzzle.

[0060] Figure 11 The state diagram of the pre-deformed elastic optical fiber bullet ejected from the muzzle.

[0061] Figure 12 The state diagram of the pre-deformed elastic optical fiber bullet ejected from the muzzle.

[0062] In the figure, 01 is a switchable light source, 02 is a multifunctional integrated transmission optical fiber, 03 is a laser gun, 04 is a detection real-time transmission feedback system, 05 is a flexible transmission optical fiber, 06 is an input end coupling device, and 07 is an output end coupling device.

[0063] 1, the front of the optical fiber bullet, 2, muzzle lower jaw, 3, the middle of the optical fiber bullet, 4, muzzle upper jaw, 5, shrapnel, 6, optical fiber bullet adapter, 7, base water inlet, 8, base water outlet, 9, base, 10, main optical fiber, 11, rotating mechanism, 12, gun handle, 121, gun handle, 13, the first trigger, 14, the second trigger, 15, suture, 16, barb structure, 17, gun barrel, 18, gun barrel, 181, steel wire, 19, biological bone tissue. 20, steel wire loop, 21, pre-deformation elastic optical fiber bullet.

DETAILED DESCRIPTION

[0064] The technical solutions in the embodiments of the present application will be clearly and completely described below with reference to the drawings in the embodiments of the present application. Obviously, the described embodiments are only part of the embodiments of the present application, rather than all the embodiments. Based on the embodiments in the present application, all other embodiments obtained by those skilled in the art without creative work fall within the scope of protection of the present application.

[0065] Embodiment:

[0066] Referring to Figures 1 to 12 A laser gun device for drilling curved holes in biological bone tissue includes a switchable light source 01 and a connected detection real-time transmission feedback system 04, a multifunctional integrated transmission optical fiber 02 and a laser gun 03. The multifunctional integrated transmission optical fiber 02 includes a flexible transmission optical fiber 05, a main optical fiber 10 arranged in the laser gun 03, and a pre-deformation elastic optical fiber bullet 21 connected thereto. The flexible transmission optical fiber 05 is connected to the switchable light source 01 through an input end coupling device 06 and connected to the main optical fiber 10 through an output end coupling device 07, thereby completing the transmission or switching of the light source.

[0067] The main optical fiber 10 in the laser gun 03 is in a telescopic and folded form.

[0068] The detection real-time transmission feedback system 04 can detect the depth of the incision and automatically switch the power, pulse width and other parameters according to the cut tissue. The bone material information is fed back to the switchable light source 01 to select a light source with appropriate wavelength, power and pulse width.

[0069] The multifunctional integrated transmission optical fiber 02 is a transmission optical fiber integrating functions of gas transmission, detection light transmission and cutting laser transmission. The laser is used to prepare a hole at the same time, and automatically polish the hole and the hole opening, so as to make the hole and the hole opening smooth and reduce the adverse effects on the bone tissue. The multifunctional integrated transmission optical fiber 02 can switch the light source at the output end according to the information feedback of the detection real-time transmission feedback system 04, so as to be suitable for different bone drilling.

[0070] Referring to Figure 3And Figure 5 The pre-deformation elastic fiber bullet 21 includes the front part 1, the middle part 3 and the adapter 6 of the fiber bullet, the adapter 6 is connected to the base 9 on the barrel of the laser gun 03, and the base 9 can drive the adapter 6 to move forward and backward.

[0071] As Figure 6 shown, the front part 1 of the fiber bullet is composed of the fiber core and the pre-bent arc-shaped memory metal shell, the side wall of the memory metal shell is provided with the barb structure 16 for hanging the suture 15 which is taken out after the fiber bullet is drilled. The inside of the laser gun 03 is connected to the fiber bullet through the transmission mechanism, the fiber bullet is shot out of the muzzle, the pre-deformation elastic fiber bullet 21 is continuously extruded, the deformation recovery process of the pre-deformation elastic fiber bullet 21 in the running is synchronous with the process of drilling the hole on the biological bone tissue by the laser and the trajectories are the same, so that the arc-shaped drilling operation from outside to inside and then to outside is realized.

[0072] Referring to Figure 7 , the working mode diagram of the front part 1 of the photon bullet with the steel wire loop: the front end of the front part 1 of the fiber bullet is provided with the steel wire loop 20, after the steel wire loop 20 is taken out with the fiber bullet drilled, the suture is sleeved into the steel wire loop 20; when the fiber bullet is retracted, the steel wire loop 20 returns along the original route with the fiber bullet, so that the steel wire loop 20 takes the suture 15 into the hole in the reverse wire taking mode, which is another way to complete the suture drilling.

[0073] Referring to Figures 8 to 12 , Figure 8 It is a schematic diagram of the original state of the pre-deformation elastic fiber bullet 21, which is pre-bent, the pre-bent arc-shaped radius R is equivalent to the arc-shaped radius R of the folding movable upper jaw 4 on the muzzle, so as to ensure that the bullet directly hits the through hole of the upper jaw 4 after being shot out of the muzzle.

[0074] Figure 9 It represents the schematic diagram of the state of the pre-deformation elastic fiber bullet 21 placed in the barrel 18.

[0075] Figure 10 , Figure 11 , Figure 12 It represents the state change process of the pre-deformation fiber bullet 21 gradually turning after being shot out of the muzzle.

[0076] When the pre-deformation elastic fiber bullet 21 drills the hole, the fiber bending or the light path bending can be realized by additional memory metal, rigid metal sleeve, end face processing and other ways, the low-loss transmission of the fiber is realized by using the photonic bandgap effect or the total reflection principle, in addition, the flexibility of the fiber and the low-loss transmission of the fiber when the bending radius is greater than 2 cm are ensured by using the specific polymer material as the main body material of the fiber.

[0077] When preparing to drill a hole, first hang a suture on the side wall of the pre-deformed elastic optical fiber bullet 21 at the front end, and then load the suture 15 optical fiber bullet into the interior of the laser gun 03. After aiming at the drilling position, pull the first trigger 13 to start drilling. The pre-deformed elastic optical fiber bullet 21 drills a hole, and the suture 15 is simultaneously taken out of the hole, and the bullet 5 set on the gun muzzle upper jaw 4 clamps the line and takes it out of the body, completing a drilling and line operation.

[0078] Referring to Figure 2 With Figure 3 , the laser gun 03 includes a gun handle 12, a gun barrel 17, and a gun barrel 18, the front end of the gun barrel 18 is designed as a gun muzzle lower jaw 2 and a gun muzzle upper jaw 4; the gun muzzle upper jaw 4 can be folded, and a through hole is provided on the surface thereof, and the through hole is filled with a bullet 5, when the gun muzzle upper jaw 4 is opened upward, the bullet 5 is popped up at the same time to expose the through hole, and the suture 15 is conveniently taken out.

[0079] The gun handle 12 includes a gun handle 121, a first trigger 13, and a second trigger 14, the gun handle 121 is provided with a rotating wheel mechanism 11, the first trigger 13 is connected to the base 9 of the gun barrel 17 through the rotating wheel mechanism 11 and a bearing, pulling the first trigger 13 drives the base 9 to move forward and backward, thereby controlling the advance and retreat of the optical fiber bullet. The steel wire 181 is arranged in the gun barrel 18, and the two ends of the steel wire 181 are connected to the second trigger 14 and the gun muzzle upper jaw 4 respectively, and pulling the second trigger 14 controls the opening and closing of the gun muzzle upper jaw 4 through the connected steel wire 181.

[0080] Further, the switchable light source 01 includes CO2 laser light source, water laser light source, Er laser, holmium laser, YSAG laser and other different waveband light sources that can cover different tissue absorption peaks, which can be selected and changed, the average power can cover 10mw-100w, the peak power is 100w-1000w, and the type is a short pulse laser. The switchable light source can excite laser suitable for different bone tissues or other hard tissues.

[0081] The working principle of the present application is that: the handle of the laser gun 03 holds the entrance and exit parts of the fine bending hole to be prepared, the pre-deformation elastic optical fiber bullet 21 with integrated wire function drills the hole quickly under the control of the handle, and completes the cleaning and cooling function. During this period, the real-time monitoring drilling condition of the optical fiber detection real-time transmission feedback system 04, and the control and feedback of the light source and the output end, the biological bone tissue or other hard tissue is prepared by using memory metal, fiber self-bending, end face processing and other means to obtain the required fine bending hole. The pre-deformation elastic optical fiber bullet 21 automatically completes the polishing of the hole and the hole at the same time, so that the hole and the hole are smooth; when the optical fiber bullet is fired, the upper jaw 4 of the gun barrel is lifted, and after the optical fiber bullet drills the bending hole, according to the memory metal along the predetermined arc, the bullet 5 is pushed open through the through hole of the upper jaw 4 of the gun barrel, and then the optical fiber bullet is withdrawn, the bullet 5 presses the suture 15, so as to be used for subsequent suture repair of the tissue.

[0082] The biological bone tissue 19 can be the humeral tuberosity footprint area rotator cuff attachment, the glenoid labrum attachment of the glenoid rim, the attachment of various joint collateral ligaments or other parts of the body that need to be repaired and sutured. According to different parts, select appropriate laser light source, the basic principle is the same, first select appropriate light source, directly coupled into the designed fiber bundle, laser input and coupled output to the laser output end, finally emitted by the knife edge directly acting on the tissue, to achieve the purpose of drilling. When drilling, the probe light can also be transmitted through the designed fiber bundle, and after collecting the wound information, it is transmitted to the detection and analysis equipment through the multifunctional optical fiber, and the wavelength, power and pulse intensity of the laser are adjusted by analyzing the depth and size of the wound.

[0083] The advantages of the present application are as follows:

[0084] (1) The laser hard tissue drilling and wire system provided by the present application can prepare fine bending holes and polish. Compared with traditional mechanical drilling and bending holes, it can realize accurate machining of bending holes with smaller turning radius and hole diameter, avoid mechanical vibration, solve the problem that only mechanical machining method can be used to realize bending hole machining in traditional hard tissue surgery, overcome the shortcoming that traditional laser knife can only cut, fully utilize the advantages of flexible transmission of optical fiber while combining the advantages of high drilling precision, smoothness and good controllability of laser knife, so as to obtain ideal fine bending hole shape. Avoid cutting the suture and interference of anchor nail implantation on the local human body. The one-time drilling and wire operation scheme is convenient to operate and saves operation time. At the same time, the tissue repair and suture are in the footprint area, which better realizes anatomical repair and is more in line with the physiological characteristics compared with the anchor nail technology.

[0085] (2) The laser hard tissue drilling and suture system provided by the application can prepare fine curved holes and polishing, can realize the simultaneous cutting of different hard tissues and soft tissues, avoids the repeated switching of light sources, transmission media and cutting methods of traditional laser surgical knives when cutting different tissues, solves the problem that the existing switchable light source only provides switching of near-infrared waveband light sources and cannot involve mid-infrared waveband light sources such as CO2 lasers, solves the problem that the traditional switchable laser surgical knife head only works on the surface of the skin, and realizes the switching of the knife edge when cutting different tissues in the internal environment of the human body.

[0086] (3) The laser hard tissue drilling and suture system provided by the application can realize polishing and grinding at the pore, utilize the advantage of slow ablation of low-power laser, grind the entrance and exit of the curved hole, avoid the cutting of the suture line due to the rough interface, avoid the difficulty of grinding in the traditional surgical process and the inconvenience of switching the cutting equipment and the grinding equipment, and improve the surgical efficiency and the durability of the suture line.

[0087] The above only describes the preferred embodiments of the application and is not intended to limit the application. Any modification, equivalent replacement, improvement, etc. made within the spirit and principle of the application shall be included in the protection scope of the application.

Claims

1. A laser gun device for drilling a curved hole in a biological bone tissue, characterized in that, The application relates to a multifunctional integrated transmission optical fiber and laser gun comprising a switchable light source, a connected detection real-time transmission feedback system, a multifunctional integrated transmission optical fiber and the laser gun, wherein the multifunctional integrated transmission optical fiber comprises a flexible transmission optical fiber, a main optical fiber arranged in the laser gun and a pre-deformed elastic optical fiber bullet connected to the main optical fiber; the input end of the flexible transmission optical fiber is connected to the switchable light source, and the output end of the flexible transmission optical fiber is connected to the main optical fiber, so that the transmission or switching of the light source is completed; the main optical fiber in the laser gun is in a telescopic and foldable mode. The front end of the pre-deformed elastic optical fiber bullet is composed of an optical fiber inner core and a pre-bent arc-shaped memory metal outer shell, and a suture is arranged on the side wall of the memory metal outer shell; the inside of the laser gun is connected to the pre-deformed elastic optical fiber bullet through a transmission mechanism, so that the pre-deformed elastic optical fiber bullet is shot out of the muzzle; the process of continuously extruding the pre-deformed elastic optical fiber bullet and the process of deforming and recovering the pre-deformed elastic optical fiber bullet in the process of traveling are synchronous and have the same track as the process of drilling and bending holes on the biological bone tissue by laser, so that the operation of drilling and bending holes in an arc shape from outside to inside and then to outside is realized. The pre-deformed elastic optical fiber bullet comprises a front part of the optical fiber bullet, a middle part of the optical fiber bullet and an optical fiber bullet adapter which is connected to the front part of the optical fiber bullet and the middle part of the optical fiber bullet; the optical fiber bullet adapter is connected to the base on the barrel of the laser gun; the base can drive the optical fiber bullet adapter to move forward and backward. The head side wall of the memory metal outer shell is provided with a barb structure for suspending the suture, and the suture is taken out after drilling.

2. The laser gun device for drilling and bending holes in biological bone tissue according to claim 1, characterized in that, The head side wall of the memory metal outer shell is pre-buried with a steel wire knot structure for suspending the suture, so that the suture is taken into the hole in a reverse wire taking mode; the steel wire knot can be automatically ejected after drilling.

3. The laser gun device for drilling and bending holes in biological bone tissue according to claim 1, characterized in that, The laser gun comprises a gun handle, a barrel and a gun barrel; the front end of the gun barrel is designed as a lower jaw of the muzzle and an upper jaw of the muzzle; the upper jaw of the muzzle is foldable, and a through hole is arranged on the surface of the upper jaw of the muzzle; the through hole is filled with a spring piece which is elastically clamped to close the through hole.

4. The laser gun device for drilling and bending holes in biological bone tissue according to claim 3, characterized in that, The arc radius R of the foldable upper jaw of the muzzle is equal to the arc radius R of the pre-bent arc shape of the pre-deformed elastic optical fiber bullet.

5. The laser gun device for drilling and bending holes in biological bone tissue according to claim 3, characterized in that, The base on the barrel of the laser gun is provided with a water inlet and a water outlet.

6. The laser gun device for drilling and bending holes in biological bone tissue according to claim 3, characterized in that, The gun handle comprises a handle, a first trigger and a second trigger; a rotating wheel mechanism is arranged in the handle; the base of the barrel is connected to the first trigger through the rotating wheel mechanism and a bearing; the first trigger is pulled to drive the base to move forward and backward, so as to control the advance and retreat of the optical fiber bullet.

7. A laser gun device for drilling and bending holes in biological bone tissue according to claim 6, characterized in that, A steel wire is arranged in the gun barrel; the two ends of the steel wire are connected to the second trigger and the upper jaw of the muzzle respectively; the second trigger is pulled to control the opening and closing of the upper jaw of the muzzle through the connected steel wire.

8. The laser gun device for drilling and bending holes in biological bone tissue according to claim 1, characterized in that, The flexible transmission optical fiber is connected to the switchable light source through an input end coupling device and connected to the main optical fiber in the laser gun through an output end coupling device.

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