Medical laser system

Abstract

To prevent a damage of an endoscope.SOLUTION: A medical laser system includes: an endoscope 1100 including a work channel; a laser configured to emit medical laser; and a laser fiber 22 movably arranged inside a lumen of the work channel 36 of the endoscope 1100, the laser fiber 22 having a distal end portion and a proximal end portion connected to the laser and being configured to transmit the medical laser to a target. The lumen of the work channel 36 has an inner surface at least partially processed with protection coating that prevents or reduces a damage of the endoscope 1100 caused by irradiation of the medical laser from the inside of the work channel 36 when the distal end portion of the laser fiber 22 exists inside the work channel 36.SELECTED DRAWING: Figure 11

Description

Technical Field

[0001] (Claim of Priority) This application claims the benefit of priority under 35 U.S.C. § 119(e) to U.S. Provisional Patent Application No. 62 / 882,837, filed Aug. 5, 2019; U.S. Provisional Patent Application No. 62 / 893,913, filed Aug. 30, 2019; and U.S. Provisional Patent Application No. 63 / 027,079, filed May 19, 2020, the entire contents of each of which are hereby incorporated by reference.

[0002] This document generally relates to surgical lasers and, in particular, to systems and methods for determining the advancement of a surgical laser fiber within an endoscope and providing coordinated feedback to the surgical laser.

Background Art

[0003] Laser or plasma systems have been used to deliver surgical laser energy to various target treatment areas such as soft or hard tissue. Examples of laser treatments include ablation, coagulation, vaporization, fragmentation, etc. In lithotripsy applications, lasers are used to break up stone structures in the kidneys, gallbladder, ureters, and other stone-forming areas, or to ablate large stones into smaller fragments.

[0004] Endoscopes are typically used to provide access to internal locations of a subject and provide visual access to a physician. An endoscope is typically inserted into a patient's body, delivers light to a target (e.g., a target anatomical structure or object) to be examined, and collects light reflected from the object. The reflected light carries information about the object being examined and can be used to create an image of the object. Some endoscopes include a working channel through which an operator can perform suction, pass instruments such as brushes, biopsy needles, or forceps, or perform minimally invasive surgery to remove unwanted tissue or foreign bodies from the patient's body.

Summary of the Invention

Means for Solving the Problems

[0005] According to one aspect of the present invention, a medical laser system includes an endoscope including a working channel, a laser device configured to irradiate a medical laser, and a laser fiber movably disposed within the lumen of the working channel of the endoscope, the laser fiber having (i) a distal end and (ii) a proximal end operably connected to the laser device, the laser fiber transmitting a medical laser to the distal end and thus to an anatomical target, and the lumen of the working channel has an inner surface at least partially treated with a protective coating that prevents or reduces damage to the endoscope by irradiation with a medical laser from within the working channel when the distal end of the laser fiber is present within the working channel. characterized by.

[0006] This summary is an overview of some of the disclosure of this application and is not intended to be an exclusive or exhaustive treatment of the subject matter. Further details regarding the subject matter are set forth in the detailed description and the appended claims. Another aspect of the present disclosure will be apparent to those skilled in the art upon reading the following detailed description and viewing the drawings that form a part thereof, each of which should not be construed in a limiting sense. The scope of the present disclosure is defined by the appended claims and their legal equivalents.

[0007] Various embodiments are shown, by way of example, in the figures of the accompanying drawings. Such embodiments are illustrative and are not intended to be comprehensive or exclusive embodiments of the subject matter.

Brief Description of the Drawings

[0008]

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Figure 11

DETAILED DESCRIPTION OF THE INVENTION

[0009] Damage to the endoscope during a surgical procedure can result in costly repairs to the endoscope, delays in the surgical procedure, and / or damage to other equipment. Currently, in laser endoscopy, there is no way to protect the inside workings of the endoscope from accidental laser irradiation while the laser fiber is inside the working channel of the scope. Accidental laser irradiation can cause back reflections that may damage the laser system or physical damage to the endoscope, thereby interfering with the performance of the equipment that the user can navigate or interfering with the visualization of the target area of the patient.

[0010] The ability to detect when a laser fiber has advanced outside of the endoscope can help prevent damage to the device and surgical delays to the patient. This detection can be achieved using a device used to perform an endoscopic examination configured as described herein.

[0011] The embodiments described herein address the problem of accidental firing of a surgical laser system inside an endoscope and use that method to identify when a surgical laser fiber migrates from inside the working channel of the endoscope to the outside of the endoscope. In this method, a light source(s) associated with the endoscopic instrument and a surgical laser fiber used for treating the patient are used. An optical feedback system is incorporated into the surgical laser system to limit laser irradiation through the laser fiber while the laser fiber is still inside the endoscope. This interlocking function of the system can function with a wide range of endoscopes and laser fiber sizes.

[0012] The embodiments described herein also protect from a fiber that breaks inside the endoscope. The surgical laser fiber exits the endoscope, but even if the fiber breaks inside the endoscope, the system detects the break as a new “tip” of the surgical laser fiber and recognizes that the new tip (now the end) is still inside the endoscope and prevents further laser irradiation inside the endoscope.

[0013] The method can be performed by measuring the optically detected reflectance that returns through the surgical laser fiber. The reflected light is generated from a light source used in the endoscopic examination. The light source can be selected from a wide variety of light sources. The absence of optical detection (or optical detection below a predetermined value) of the reflected signal returning through the surgical laser fiber results in the determination that the surgical laser fiber is within the working channel of the endoscope. Optical detection of the reflected signal above a predetermined value returning through the surgical laser fiber results in the determination that the surgical laser fiber has advanced sufficiently through the working channel and exited the endoscope. In this way, the position of the distal end of the surgical laser fiber can be confirmed before releasing laser energy.

[0014] Referring to FIG. 1, a system that uses an endoscope and a surgical laser for use in surgical endoscopy is generally designated by 10 and hereinafter referred to as "System 10". System 10 includes an endoscope 20 operably coupled to a laser 40 and a feedback analyzer 50. The endoscope 20 includes a surgical laser fiber 22, at least one light source 24, and a photodetector 30 (which may include a camera). The surgical laser fiber 22, the light source 24, and the photodetector 30 are disposed within a sheath 34 (shown in FIG. 2). The laser 40 is operably coupled to the surgical laser fiber 22 and the feedback analyzer 50, and both may be remote from the endoscope 20. The laser 40 may include a laser interlock 42. The feedback analyzer 50 is operably coupled to the laser interlock 42 and may include a processor 54 and a memory 56 having program code associated therewith. In some embodiments, System 10 can provide input data to another system, such as an image processor 44, whereby a monitor or another type of display displays information to the user, and the displayed information is related to the irradiation capabilities of the laser 40.

[0015] Referring to FIG. 2, the sheath 34 is tubular and has a generally circular cross-section that defines a working channel 36. The surgical laser fiber 22, the light sources 24 (two are shown), and the photodetector 30 are appropriately disposed within the working channel 36. Although these components are shown spaced apart from each other, it should be understood that such components can be appropriately packed tightly within the working channel 36, in contact with each other, or with a minimal space therebetween.

[0016] Regarding the laser 40, such a fiber-integrated laser system can be used for endoscopy due to its performance, passing laser energy through a flexible endoscope to effectively treat hard and soft tissues. These laser systems generate laser output beams in a wide wavelength range from ultraviolet (UV) to infrared (IR) (from 200 nanometers (nm) to 10,000 nm). Some fiber-integrated lasers generate output in wavelength ranges highly absorbed by soft or hard tissues, for example, 1900 nm to 3000 nm for water absorption, and 400 nm to 520 nm for oxyhemoglobin and / or deoxyhemoglobin absorption. Table 1 below is a summary of a list of IR lasers emitting in the high water absorption range (1900 nm to 3000 nm).

Table 1

[0017] Some fiber-integrated laser systems generate laser light output in a wavelength range minimally absorbed by the target soft or hard tissue. This type of laser provides effective tissue coagulation due to an invasion depth similar to the diameter of a fine tube, for example, about 5 micrometers (μm) to about 10 μm. Exemplary laser sources for lasers applicable to this embodiment include, but are not limited to, a) UV-VIS emitting InXGa1-XN semiconductor lasers (e.g., GaN with emission at 515 nm to 520 nm, and InXGa1-XN with emission at 370 nm to 493 nm), b) GaXAl1-XAs with emission at 750 nm to 850 nm, and c) InXGa1-XA with emission at 904 nm to 1065 nm.

[0018] An endoscope light source (such as light source 24) for use in endoscopic examinations can be used in conjunction with a surgical laser system (such as laser 40) and a fiber (such as surgical laser fiber 22) to provide a laser interlock 42 to system 10. The endoscope light source can be any light source that can provide appropriate illumination and be compatible with an appropriate endoscope. FIG. 3 shows, at 300, the spectra of three different light sources, namely a UV-VIS light source 310, an endoscope light source 320, and a VIS light source 330, any of which can be used as light source 24 and can be used to collect preliminary data with various endoscopes. Such a light source 24 is typically shown as white light for treatment and can also extend into the UV and IR spectra. This extended wavelength range of light source 24 can be particularly useful for the feedback analyzer 50 of system 10.

[0019] The light sources shown in Table 2 are additional light sources and wavelengths that can be used in an endoscope light source to promote accurate reflectance within an optimal range.

Table 2

[0020] Referring back to FIGS. 1 and 2, in one exemplary embodiment of system 10, light from light source 24 can be transmitted from endoscope 20 (or any applicable endoscope), and endoscope 20 can be used to treat a patient as long as it is capable of directing the light from light source 24 towards the target area. Endoscope 20 can be rigid, semi-rigid, or flexible. Endoscopes 20 that can be used in laser surgical procedures include ureteroscopes, cystoscopes, nephroscopes, and resection scopes. The system 10 described herein is intended to be used with any combination of endoscope type and flexibility, as well as any other endoscope designed to accept a surgical laser fiber for patient care, although not mentioned.

[0021] The surgical procedure performed by system 10 is carried out via a surgical laser fiber 22. The surgical laser fiber 22 can have a core diameter in the range of about 50 μm to about 1000 μm. The material from which the surgical laser fiber 22 is constructed is compatible with the wavelength used to transmit laser energy, but the transmission of the wavelength of the object incident from the light source 24 and reflected from the target area should also be taken into account.

[0022] The photodetector 30 reads the reflected light that travels through the surgical laser fiber 22 to the target area. The light source signals from the light source 24 and reflected from the target area to the photodetector 30 are also collected and transmitted to the feedback analyzer 50 together with the reflected light from the surgical laser fiber 22.

[0023] The photodetector 30 can be a dedicated photodetector tuned to the wavelength of interest of the system 10, or it can be a spectroscopic system incorporated into the system 10. Spectroscopy / spectrometry techniques are used in physics and chemistry to identify various materials through the spectra reflected, transmitted, emitted, or absorbed by such materials and may be used in system 10. Optical spectroscopy is a powerful method used for the concise and rapid analysis of organic and inorganic materials and has the following advantages: a) easy integration with a fiber laser delivery system, b) a non-destructive method for analyzing the chemical composition of materials, c) enabling the detection of material composition in real time, and d) applicability to the analysis of various types of materials (e.g., hard and soft tissues, stones, etc.). There may be other advantages.

[0024] The following spectroscopy techniques can be used alone or in combination to analyze the chemical composition of tissue and create spectroscopic feedback.

[0025] UV-VIS reflection spectroscopy. This method collects information from the light reflected by an object, which is similar to the information obtained from a color image created by the eye or a high-resolution camera, but is more quantitative and objective. Reflection spectroscopy provides information about the material because the reflection and absorption of light depend on its chemical composition and surface properties. Using this technique, it is also possible to obtain unique information regarding both the surface properties and volumetric properties of a sample. Reflection spectroscopy is a valuable technique for recognizing the composition of hard or soft tissues.

[0026] Fluorescence spectroscopy. This is a type of electromagnetic spectroscopy that analyzes fluorescence from a sample. It involves using light, usually UV, to excite a material compound and cause it to emit light, usually in the visible or IR region. This method can be applied to the analysis of some organic components, such as hard and soft tissues.

[0027] Fourier transform infrared spectroscopy (FTIR). This is a method used for easy and rapid material analysis. This technique has relatively good spatial resolution and provides information about the chemical composition of the material.

[0028] Raman spectroscopy. Raman chemical analysis shows good accuracy in identifying hard and soft tissue components. As a high-spatial-resolution technique, it is also useful for determining the distribution of components within a target.

[0029] In some embodiments, one or more types of spectroscopy can be used within the endoscope 20 to identify the presence of reflected light. The endoscope light source signal reflected from the target is rapidly detected via a surgical laser fiber and transmitted to a spectrometer. Alternatively, the detector can be a simple optical module dedicated to detecting the endoscope wavelengths of interest.

[0030] Still referring to FIGS. 1 and 2, feedback analyzer 50 uses the light returned through surgical laser fiber 22 as feedback to determine whether the distal end of surgical laser fiber 22 has advanced beyond the distal end of working channel 36 of endoscope 20. In some embodiments, feedback analyzer 50 may determine that surgical laser fiber 22 is fully disposed within working channel 36 and may display it to the user, for example, via red light (or a similar signal). Based on the feedback, feedback analyzer 50 may interface with laser interlock 42 to prevent laser 40 from being fired even when in the irradiation mode and the user attempts to intentionally fire the laser. Laser interlock 42 may also prevent unintentional firing of laser 40. Until surgical laser fiber 22 protrudes from sheath 34 and away from endoscope 20, laser 40 remains restricted from firing based on the reflectivity of light source 24 returned through surgical laser fiber 22.

[0031] Laser irradiation can be highly absorbed by soft tissue or hard tissue, stones, etc. Referring now to FIG. 4, the light absorption spectra measured in different media over a wavelength range are generally indicated at 400. Illustrated therein are the spectra of water 410A - 410C (75%, 100%, and 4% concentrations respectively), hemoglobin (Hb) 420, oxyhemoglobin (HbO2) 430, and melanin 440A - 440D (melanosome volume fractions are 2%, 13%, 30%, and 100% respectively). The water absorption wavelength ranges from 1900 nm to 3000 nm. The wavelength of oxyhemoglobin and / or oxyhemoglobin ranges from 400 nm to 520 nm.

[0032] Figures 1, 4, 5, and 6 illustrate a method of using the endoscope 20 with the system 10. Figure 4 shows the absorption of laser technology in different media. Many surgical lasers are highly absorbed by water or hemoglobin, but inside the scope, the media that absorb water are limited, which may cause the inside of the endoscope to be damaged by laser energy. Figure 1 shows the basic setup of the system 10 and detects the reflectivity from the light source 24. Figure 5 shows the spectral output 510 of the reflected light from the light source 24 at 500, which is detected through the surgical laser fiber 22 when the surgical laser fiber 22 travels (advances or retreats) through the working channel 36 of the endoscope 20. Figure 6 shows the basic setup when the surgical laser fiber 22 passes through the working channel 36 and leaves the distal end of the endoscope 20.

[0033] Referring now to Figure 7, feasibility data for identifying when the surgical laser fiber 22 exits the working channel 36 is generally indicated at 700. The data was collected by advancing a surgical laser fiber 22 having a 200μm core into a flexible ureteroscope equipped with a compatible light source 24 that functions as an optical signal source. This feasibility data 700 shows a significant increase 710 in the detected signal 720 when the surgical laser fiber 22 moves to the end of the working channel 36, making it possible to distinguish between the surgical laser fiber 22 being retracted into the working channel 36 and advancing beyond the working channel 36. Using this detection technique, the data from the photodetector 30 is processed by the feedback analyzer 50 to prevent accidental laser irradiation.

[0034] Figures 8A and 8B show a simulation setup 800 in which light from the surgical laser fiber 22 is deflected into a container containing phosphate buffered saline and calcium oxalate hydrate powder, simulating compositions that may be encountered during a clinical procedure. Figure 8A shows a test setup in which light is deflected into a phosphate buffered solution 810 (PBS 810), and Figure 8B shows a test setup in which light is deflected into PBS containing a calcium oxalate hydrate solution 820. The setup of Figure 8B comprises a cloudy white calcium oxalate hydrate solution 820 (shown in shadow), in contrast to the clear and transparent phosphate buffered solution 810. The calcium oxalate hydrate solution 820 may promote additional reflection and light scattering.

[0035] Referring to Figure 9, at 900, the data points shown represent the reflectance when light from the endoscope 20 is deflected into PBS (white circles) and PBS calcium oxalate solution (PBS containing COM, black circles). At 910, while this data indicates a higher detection of the light source optical signal, the surgical laser fiber 22 is within the working channel 36 of the endoscope 20 and the data trend is the same as when tested in air. The algorithm implemented in the feedback analyzer 50 can account for the trend in the data and determine when the surgical laser fiber 22 protrudes from the distal end of the endoscope 20.

[0036] Damage to the endoscope associated with accidental laser emission from within the working channel 36 can be due to the transparent working channel liner of the endoscope 20. Figure 10 is a diagram 1000 showing the transparent liner 1010 on the lumen of the working channel 36. During a surgical procedure, accidental laser irradiation when the laser fiber 22 is inside the working channel 36 may result in the laser energy 1001 being dispersed from the side of the transparent liner 1010, which can damage internal components of the endoscope 20, such as those adjacent to the transparent liner 1010 and those adjacent to the distal end of the endoscope 20.

[0037] This document discusses solutions for preventing or reducing damage due to accidental laser emission from within the working channel 36, according to various examples. FIG. 11 shows an example of an endoscope 1100 that includes a reflective coating 1020 on the transparent liner 1010 of the working channel 36. The reflective coating 1020 may include a reflective material, such as aluminum, silver, gold, or copper, in the wavelength range of laser irradiation. In some examples, the reflective surface may include a reflective coating, and the reflective coating may consist of one or more of barium sulfate, magnesium oxide, polytetrafluoroethylene (PTFE), dielectric high reflection (HR) coating, dichroic mirror, or a reflective photonic structure. The reflective coating 1002 may be applied using, among other techniques, vacuum metallization / deposition, spray coating, vapor deposition, conductive painting, or flame spraying.

[0038] As shown in FIG. 11, the laser energy 1002 emitted from the laser fiber 22 can be substantially reflected by the reflective coating 1020 when the laser fiber 22 is inside the working channel 36. The laser energy 1002 bounces along the wall of the liner 1010, proceeds to the distal end of the working channel 36, and then out from the distal end. In this way, the amount of damage to various components of the endoscope caused by laser dispersion can be substantially reduced. An endoscope with a reflective coating on the working channel liner described herein advantageously minimizes accidental damage to the scope during treatment, reduces the treatment and repair costs of reusable scopes, and can reduce the time that the reusable scope is out of use. In some examples, the reflective coating is applied to the liner of a disposable scope, thereby minimizing the accidental damage that can occur to multiple scopes in one treatment.

[0039] Further descriptions of various non-limiting exemplary embodiments are provided below. The exemplary embodiments described below may be implemented in conjunction with one or more other aspects or exemplary embodiments. That is, the exemplary embodiments of the present invention, such as those described below, may be implemented, practiced, or utilized in any combination (e.g., any combination that is suitable, feasible, and / or practicable), and is not limited to only the combinations described herein and / or included in the appended claims.

[0040] Example 1 is a method for feedback control of a surgical laser system. The method includes directing light from a distal end of an endoscope towards a target, optically detecting an amount of light reflected from the target, transmitting the optically detected amount of light through a laser fiber extending through a working channel of the endoscope, determining a position of a distal end of the laser fiber relative to the distal end of the endoscope based on the optically detected amount of light, and generating a control signal to the surgical laser system to adjust laser irradiation through the laser fiber.

[0041] In Example 2, the subject matter of Example 1 optionally includes determining a position of a distal end of the laser fiber relative to the distal end of the endoscope. When the optically detected amount of light is greater than a predetermined value, it is determined that the distal end of the laser fiber extends beyond the distal end of the endoscope. When the optically detected amount of light is less than the predetermined value, it is determined that the distal end of the laser fiber does not extend beyond the distal end of the endoscope, and generating a control signal to prevent the laser from emitting laser energy through the laser fiber.

[0042] In Example 3, the subject matter of Example 2 optionally includes providing a user with a first indicator of a distal end of the laser fiber that extends beyond the distal end of the endoscope and a second indicator of a distal end of the laser fiber that does not extend beyond the distal end of the endoscope.

[0043] In Example 4, one or more of the themes of Examples 1 to 3 optionally include determining the position of the distal end of the laser fiber relative to the distal end of the endoscope based on an increase in the amount of light detected over time or the rate of increase.

[0044] In Example 5, one or more of the themes of Examples 1 to 4 optionally include generating a control signal to a surgical laser system such that when the optically detected amount of light is greater than a predetermined value, the control signal is generated so that the surgical laser system can emit laser energy via the laser fiber, and when the optically detected amount of light is less than the predetermined value, the control signal is generated to prevent the surgical laser system from emitting laser energy via the laser fiber.

[0045] In Example 6, the theme of Example 5 optionally includes using a photodetector to detect the wavelength of the directed light, and generating a control signal to the surgical laser system to emit laser energy is further based on the detected wavelength of the directed light.

[0046] In Example 7, the theme of Example 6 optionally includes using a feedback analyzer to identify a target as one of a plurality of target types based on light reflected from the target, and generating a control signal to the surgical laser system to adjust the laser irradiation is further based on the identification of the target.

[0047] In Example 8, the theme of Example 7 optionally includes determining one or more spectral characteristics of the light reflected from the target using a spectroscopy system and identifying the target based on the one or more spectral characteristics.

[0048] In Example 9, the theme of Example 8 optionally includes determining one or more spectral characteristics including using at least one of UV-VIS reflectance spectroscopy, fluorescence spectroscopy, Fourier transform infrared spectroscopy, or Raman spectroscopy.

[0049] Example 10 is a laser feedback control system, which is an endoscope including an endoscope having a photodetector configured to detect the amount of light reflected from a target in response to illumination of the target from the distal end of the endoscope, a laser fiber extending through the working channel of the endoscope and configured to transmit the detected amount of light reflected from the target, and a controller configured to determine the position of the distal end of the laser fiber relative to the distal end of the endoscope based on the optically detected amount of light and generate a control signal to the surgical laser system to adjust the laser irradiation through the laser fiber.

[0050] In Example 11, the subject matter of Example 10 optionally includes that the controller is configured to determine the position of the distal end of the laser fiber, which includes determining that when the optically detected amount of light is greater than a predetermined value, the distal end of the laser fiber extends beyond the distal end of the endoscope, and determining that when the optically detected amount of light is less than the predetermined value, the distal end of the laser fiber does not extend beyond the distal end of the endoscope.

[0051] In Example 12, the subject matter of any one or more of Examples 10 - 11 optionally includes a laser interlock coupled to the surgical laser system, which is configured to allow the surgical laser system to emit laser energy through the laser fiber when the optically detected amount of light is greater than a predetermined value according to the control signal, and to prevent the surgical laser system from emitting laser energy through the laser fiber when the optically detected amount of light is less than the predetermined value.

[0052] In Example 13, any one or more of the themes of Examples 10 to 12 optionally include a spectroscopic system configured to determine one or more spectroscopic characteristics from light reflected from a target, and a feedback analyzer configured to identify the target as one of a plurality of target types based on the one or more spectroscopic characteristics, wherein the controller generates a control signal to the surgical laser system and adjusts the laser irradiation further based on the identification of the target.

[0053] In Example 14, the theme of Example 13 optionally includes that the controller is configured to determine the position of the distal end of the laser fiber relative to the distal end of the endoscope based on an increase or rate of increase in the amount of light detected over time.

[0054] Example 15 is an apparatus including at least one processor and at least one non-transitory memory including computer program code, the at least one non-transitory memory and the computer program code being configured, using the at least one processor, to cause the apparatus to at least direct light from the distal end of an endoscope towards a target, optically detect the amount of directional light reflected from the target, transmit the optically detected amount of light through a laser fiber extending through a working channel of the endoscope, determine the position of the distal end of the laser fiber relative to the distal end of the endoscope based on the optically detected amount of light, generate a control signal to a surgical laser system, and adjust the laser irradiation through the laser fiber.

[0055] In Example 16, the subject matter of Example 15 optionally includes that at least one non-transitory memory and computer program code are configured, using at least one processor, to cause the apparatus to determine that when the amount of optically detected light is greater than a predetermined value, the distal end of the laser fiber extends beyond the distal end of the endoscope, and when the amount of optically detected light is less than the predetermined value, the distal end of the laser fiber does not extend beyond the distal end of the endoscope, and to generate a control signal to prevent the surgical laser system from emitting laser energy via the laser fiber.

[0056] In Example 17, the subject matter of any one or more of Examples 15 to 16 optionally includes that at least one non-transitory memory and computer program code are configured, using at least one processor, to cause the apparatus to determine the position of the distal end of the laser fiber relative to the distal end of the endoscope based on an increase or rate of increase in the amount of detected light over time.

[0057] In Example 18, the subject matter of any one or more of Examples 15 to 17 optionally includes that at least one non-transitory memory and computer program code are configured, using at least one processor, to cause the apparatus to generate a control signal such that when the amount of optically detected light is greater than a predetermined value, the surgical laser system can emit laser energy via the laser fiber, and when the amount of optically detected light is less than the predetermined value, to generate a control signal to prevent the surgical laser system from emitting laser energy via the laser fiber.

[0058] In Example 19, the subject matter of Example 18 optionally includes that at least one non-transitory memory and computer program code are configured to cause an apparatus, using at least one processor, to at least identify a target as one of a plurality of target types based on light reflected from the target and generate a control signal to a surgical laser system to adjust laser irradiation based on the identification of the target.

[0059] In Example 20, the subject matter of Example 19 optionally includes that at least one non-transitory memory and computer program code are configured to cause an apparatus, using at least one processor, to at least determine one or more spectral characteristics of light reflected from a target and identify the target as one of a plurality of target types based on the one or more spectral characteristics.

[0060] Appendix The foregoing detailed description includes references to the accompanying drawings, which form a part of the detailed description. The drawings illustrate, by way of example, specific embodiments in which the invention may be practiced. These embodiments are also referred to herein as "examples." Such examples may include elements in addition to those shown or described. However, the inventor also contemplates examples in which only those elements shown or described are provided. Further, the inventor also contemplates examples in which any combination or substitution of those elements (or one or more aspects thereof) shown or described is used with respect to either a particular example (or one or more aspects thereof) or another example (or one or more aspects thereof) shown or described herein.

[0061] In this document, the terms "a" or "an" are used to include one or more, as is common in patent documents, regardless of any other instance, or use of "at least one" or "one or more". In this document, the term "or" is used to mean inclusive, or, unless otherwise indicated, "A or B" includes "A but not B", "B but not A", and "A and B". In this document, the terms "including" and "in which" are used as plain English synonyms for the respective terms "comprising" and "wherein". Also, in the following claims, the terms "including" and "comprising" are open-ended, i.e., a system, device, article, composition, formulation, or process that includes elements in addition to those recited after such terms within the scope of the claim is still considered to be within the scope of the claim. Further, in the following claims, terms such as "first", "second", and "third" are used merely as labels and are not intended to impose numerical requirements on their objects.

[0062] The above description is intended to be exemplary and not restrictive. For example, the foregoing examples (or one or more aspects thereof) may be used in combination with each other. Other embodiments may be used, such as by those skilled in the art when considering the above description. The abstract is provided in accordance with 37 C.F.R 1.72(b) to enable the reader to quickly ascertain the essence of the technical disclosure. The abstract is presented with the understanding that it is not to be used to interpret or limit the scope or meaning of the claims. Also, in the forms for carrying out the above invention, various features may be grouped to streamline the present disclosure. This should not be regarded as intending that the disclosed features not claimed are essential to any of the claims. Rather, the subject matter of the invention may lie in less than all the features of a particular disclosed embodiment. Accordingly, the following claims are hereby incorporated by reference into the forms for carrying out the invention as examples or embodiments, with each claim standing on its own as a separate embodiment, and such embodiments are contemplated to be combinable with each other in various combinations and permutations. The scope of the present invention should be determined with reference to the appended claims, along with the full scope of equivalents to which such claims are entitled.

[0063] [Appendix] The following embodiments may also be used. [1] A method for operating a laser feedback control system executed by a controller, wherein the controller illuminates a target with light generated from a light source of an endoscope, the controller transmits the reflected light of the light reflected by the target through a laser fiber passing through a working channel of the endoscope, the controller determines the position of the distal end of the laser fiber relative to the distal end of the endoscope based on the reflectance of the light, When the reflectance of the light is greater than a predetermined value, the controller determines that the distal end of the laser fiber extends beyond the distal end of the endoscope and generates a control signal that enables the surgical laser system to emit laser energy through the laser fiber, thereby enabling the surgical laser system to emit laser energy through the laser fiber. When the reflectance of the light is less than a predetermined value, the controller determines that the distal end of the laser fiber does not extend beyond the distal end of the endoscope and generates a control signal that prevents the surgical laser system from emitting laser energy through the laser fiber, thereby preventing the surgical laser system from emitting laser energy through the laser fiber. A method for operating a laser feedback control system, characterized by the above. [2] The controller provides a first indicator of the distal end of the laser fiber that extends beyond the distal end of the endoscope and a second indicator of the distal end of the laser fiber that does not extend beyond the distal end of the endoscope, according to the method for operating a laser feedback control system described in [1]. [3] The controller determines the position of the distal end of the laser fiber relative to the distal end of the endoscope based on an increase or rate of increase in the reflectance of the light detected over time, according to the method for operating a laser feedback control system described in [1] or [2]. [4] The controller uses one or more spectral characteristics based on the reflected light reflected from the target, with the target being one of a plurality of target types, to identify the target. Based on the identification of the target, a control signal is generated for the surgical laser system to adjust the laser irradiation. A method for operating a laser feedback control system according to [1], characterized by the above. [5] The method of operating the laser feedback control system according to [4], wherein the controller determines one or more spectral characteristics of the reflected light reflected from the target using a spectroscopic system and identifies the target based on the one or more spectral characteristics. [6] The controller UV-VIS reflection spectroscopy, fluorescence spectroscopy, Fourier transform infrared spectroscopy, or Raman spectroscopy, The method of operating the laser feedback control system according to [5], wherein at least one of them is used to determine one or more spectral characteristics. [7] A laser feedback control system, An endoscope including a light source that generates light for illuminating a target, A laser fiber extending through the working channel of the endoscope and configured to transmit the reflected light of the light reflected by the target, A controller, A feedback analyzer that determines the position of the distal end of the laser fiber relative to the distal end of the endoscope based on the reflectance of the light, A controller including a laser interlock coupled to the feedback analyzer to prevent the surgical laser system from emitting laser energy through the laser fiber, The feedback analyzer When the reflectance of the light is greater than a predetermined value, it is determined that the distal end of the laser fiber extends beyond the distal end of the endoscope, and a control signal is generated to enable the surgical laser system to emit laser energy through the laser fiber and output to the laser interlock, When the reflectance of the reflected light is less than a predetermined value, it is determined that the distal end of the laser fiber does not extend beyond the distal end of the endoscope, and a control signal is generated to prevent the surgical laser system from emitting laser energy through the laser fiber and output to the laser interlock. The laser interlock When the control signal from the feedback analyzer is a control signal that enables the emission of laser energy, the surgical laser system is enabled to emit laser energy through the laser fiber. When the control signal that enables the emission of laser energy is a control signal that prevents the emission of laser energy, the surgical laser system prevents the emission of laser energy through the laser fiber. The laser feedback control system according to the description, characterized by the above. [8] The feedback analyzer includes a spectroscopic system configured to determine one or more spectroscopic characteristics from the reflected light reflected by the target, and is configured to identify the target as one of a plurality of target types based on the one or more spectroscopic characteristics, and generates a laser irradiation control signal for adjusting the laser irradiation of the surgical laser system based on the identification of the target. The surgical laser system adjusts the laser irradiation based on the laser irradiation control signal. The laser feedback control system according to [7], characterized by the above. [9] The laser feedback control system according to [7], wherein the feedback analyzer is configured to determine the position of the distal end of the laser fiber relative to the distal end of the endoscope based on an increase or rate of increase in the reflectance of the light detected over time.

[10] An apparatus, At least one processor, At least one non - transitory memory including computer program code, wherein the at least one non - transitory memory and the computer program code use the at least one processor to cause the apparatus to at least illuminate a target with light generated from a light source of an endoscope, transmit the reflected light of the light reflected by the target through a laser fiber extending through a working channel of the endoscope, determine a position of a distal end of the laser fiber relative to a distal end of the endoscope based on a reflectance of the light, when the reflectance of the light is greater than a predetermined value, determine that the distal end of the laser fiber extends beyond the distal end of the endoscope and generate a control signal that enables a surgical laser system to emit laser energy through the laser fiber, enabling the surgical laser system to emit laser energy through the laser fiber, when the reflectance of the light is less than the predetermined value, determine that the distal end of the laser fiber does not extend beyond the distal end of the endoscope and generate a control signal that prevents the surgical laser system from emitting laser energy through the laser fiber, preventing the surgical laser system from emitting laser energy through the laser fiber, an apparatus configured as such.

[11] The at least one non - transitory memory and the computer program code use the at least one processor to cause the apparatus to determine the position of the distal end of the laser fiber relative to the distal end of the endoscope based on an increase or rate of increase of the reflectance of the light detected over time, the apparatus according to

[10] .

[12] The at least one non - transitory memory and the computer program code use the at least one processor to cause the apparatus to at least identify the target as one of a plurality of target types based on the reflected light reflected from the target, The apparatus according to

[10] , configured to generate a control signal to the surgical laser system to adjust laser irradiation based on the identification of the target.

[13] The at least one non-transitory memory and the computer program code, using the at least one processor, cause the apparatus to at least determine one or more spectral characteristics of the reflected light reflected from the target, The apparatus according to

[12] , configured to identify the target as one of the plurality of target types based on the one or more spectral characteristics.

[0064] [Appendix 2] Also, the following embodiments may be used. [1] A surgical laser system, comprising: a laser device that emits a surgical laser; an endoscope including a working channel and having a light source that generates illumination light for illuminating a target; a laser fiber extending within the working channel of the endoscope, the laser fiber transmitting the surgical laser emitted from the laser device and the reflected light of the illumination light reflected from the target; a photodetector that detects the reflected light reflected by the target and returning through the laser fiber; a controller configured to compare the reflectance of the reflected light with respect to the illumination light directed from the light source to the target with a threshold value indicating whether the distal end portion of the laser fiber extends beyond the distal end portion of the endoscope, and generate a control signal to prevent irradiation of the surgical laser through the laser fiber and output the control signal to the laser device when it is determined that the distal end portion of the laser fiber does not extend beyond the distal end portion of the endoscope; A surgical laser system characterized by the above. [2] The surgical laser system according to [1], wherein The controller compares the reflectance with the threshold value indicating whether the distal end of the laser fiber extends beyond the distal end of the endoscope, and when it is determined that the distal end of the laser fiber extends beyond the distal end of the endoscope, generates a control signal that enables the surgical laser to be irradiated to the target through the laser fiber and outputs the control signal to the laser device. A surgical laser system characterized by the above. [3] The surgical laser system according to [1], when the controller determines that the distal end of the laser fiber does not extend beyond the distal end of the endoscope, provides an indicator to the user indicating that the distal end of the laser fiber does not extend beyond the distal end of the endoscope. A surgical laser system characterized by the above. [4] The surgical laser system according to [1], the laser device includes a laser interlock to which a control signal from the controller is input, the laser interlock is configured to prohibit irradiation of the surgical laser when a control signal for preventing irradiation of the surgical laser through the laser fiber is input. A surgical laser system characterized by the above. [5] The surgical laser system according to [1], the controller is configured to generate the control signal for adjusting irradiation of the surgical laser based on an increase or rate of increase of the reflectance over time. A surgical laser system characterized by the above. [6] The surgical laser system according to [1], the photodetector is configured to detect the wavelength of the reflected light reflected from the target, the controller is configured to generate the control signal for adjusting irradiation of the surgical laser based on the detected wavelength of the reflected light. A surgical laser system characterized by [7] The surgical laser system according to [1], wherein the controller includes a feedback analyzer configured to identify the target as one of a plurality of target types using one or more spectral characteristics based on the reflected light reflected from the target, generating the control signal for adjusting the irradiation of the surgical laser based on the identification of the target by the feedback analyzer, A surgical laser system characterized by [8] The surgical laser system according to [1], comprising a spectroscopic system configured to determine one or more spectral characteristics from the reflected light reflected from the target, and a feedback analyzer configured to identify the target as one of a plurality of target types based on the one or more spectral characteristics, the controller is configured to generate the control signal for adjusting the irradiation of the surgical laser based on the identification of the target by the feedback analyzer, A surgical laser system characterized by [9] The surgical laser system according to [1], wherein the working channel of the endoscope includes an outer surface portion at least partially covered by a reflective coating, the reflective coating includes a reflective material that reflects the irradiation of the surgical laser in the working channel when the distal end of the laser fiber is within the working channel of the endoscope, A surgical laser system characterized by

[10] The surgical laser system according to [9], wherein the working channel includes a transparent liner between the outer surface portion and the reflective coating, A surgical laser system characterized by

[11] The surgical laser system according to [9], wherein the reflective coating is made of aluminum, silver, gold, or copper, A surgical laser system characterized by

[12] The surgical laser system according to [9], wherein the reflective material includes at least one of barium sulfate, magnesium oxide, polytetrafluoroethylene (PTFE), a dielectric high-reflection coating, a dichroic material, or a reflective photonic material, A surgical laser system characterized by

[13] A method of operating a surgical laser system executed by a controller, wherein the controller illuminates a target with illumination light generated from a light source provided in an endoscope including a working channel, the controller detects, using a photodetector, reflected light of the illumination light that is reflected from the target and returns through a laser fiber extending within the working channel of the endoscope, the controller, compares a reflectance of the reflected light with respect to the illumination light directed from the light source to the target to a threshold value indicating whether a distal end portion of the laser fiber extends beyond a distal end portion of the endoscope, and when it is determined that the distal end portion of the laser fiber does not extend beyond the distal end portion of the endoscope, generates a control signal for preventing irradiation of a surgical laser through the laser fiber and outputs the control signal to a laser device, A method of operating a surgical laser system including

[14] The method of operating a surgical laser system according to

[13] , The controller compares the reflectance with the threshold value indicating whether the distal end of the laser fiber extends beyond the distal end of the endoscope, and when it is determined that the distal end of the laser fiber extends beyond the distal end of the endoscope, generates a control signal that enables the surgical laser to be irradiated to the target via the laser fiber and outputs the control signal to the laser device. A method of operating a surgical laser system, characterized by the above.

[15] A method of operating a surgical laser system according to

[13] , wherein when the controller determines that the distal end of the laser fiber does not extend beyond the distal end of the endoscope, it provides an indicator to the user indicating that the distal end of the laser fiber does not extend beyond the distal end of the endoscope. A method of operating a surgical laser system, characterized by the above.

[16] A method of operating a surgical laser system according to

[13] , wherein the laser device includes a laser interlock that prohibits irradiation of the surgical laser, and when the controller determines that the distal end of the laser fiber does not extend beyond the distal end of the endoscope, it prevents irradiation of the surgical laser by the laser interlock. A method of operating a surgical laser system, characterized by the above.

[17] A method of operating a surgical laser system according to

[13] , wherein the controller adjusts irradiation of the surgical laser based on an increase or rate of increase of the reflectance over time. A method of operating a surgical laser system, characterized by the above.

[18] A method of operating a surgical laser system according to

[13] , wherein the controller uses the photodetector to detect the wavelength of the reflected light reflected from the target, and adjusts irradiation of the surgical laser based on the detected wavelength of the reflected light. A method for operating a surgical laser system, characterized thereby.

[19] A method for operating a surgical laser system according to

[13] , wherein the controller uses a feedback analyzer to identify the target as one of a plurality of target types based on the reflected light reflected from the target, and adjusts the irradiation of the surgical laser based on the identification of the target. A method for operating a surgical laser system, characterized thereby.

Claims

1. A medical laser system, comprising: An endoscope including a working channel; A laser device configured to irradiate a medical laser; A laser fiber movably disposed within the lumen of the working channel of the endoscope, having (i) a distal end and (ii) a proximal end operably connected to the laser device, the laser fiber transmitting a medical laser to the distal end and thus to an anatomical target; The lumen of the working channel having an inner surface at least partially treated with a protective coating that prevents or reduces damage to the endoscope by irradiation with a medical laser from within the working channel when the distal end of the laser fiber is present within the working channel; A medical laser system, characterized by the above.

2. The medical laser system according to Claim 1, wherein: The inner surface of the lumen treated with the protective coating includes a surface portion at the distal portion of the working channel; A medical laser system, characterized by the above.

3. The medical laser system according to Claim 1, wherein: The protective coating includes a reflective material that reflects the medical laser from within the working channel; A medical laser system, characterized by the above.

4. The medical laser system according to Claim 3, wherein: The reflective material is reflective in the wavelength range of the medical laser; A medical laser system, characterized by the above.

5. The medical laser system according to Claim 3, wherein: The reflective material includes at least one of aluminum, silver, gold, and copper; A medical laser system, characterized by the above.

6. The medical laser system according to Claim 3, wherein: The reflective material includes at least one of barium sulfate, magnesium oxide, and polytetrafluoroethylene; A medical laser system, characterized by the above.

7. The medical laser system according to Claim 1, wherein: The protective coating includes a dielectric high-reflection coating; A medical laser system, characterized by the above.

8. The medical laser system according to Claim 1, wherein: The protective coating includes a dichroic mirror; A medical laser system, characterized by the above.

9. The medical laser system according to Claim 1, wherein: The protective coating includes a reflective photonic structure; A medical laser system characterized by

10. The medical laser system according to claim 1, wherein the inner surface is at least partially treated with the protective coating using at least one of vacuum metallization / deposition, spray coating, vapor deposition, conductive coating, and flame spraying; A medical laser system characterized by

11. The medical laser system according to claim 1, wherein the protective coating is at least partially applied on the transparent liner of the working channel; A medical laser system characterized by

12. The medical laser system according to claim 1, further comprising a controller circuit, wherein the controller circuit is configured to generate a control signal for preventing irradiation of the medical laser from within the working channel when the distal end of the laser fiber is present within the working channel, and output the generated control signal to the laser device; A medical laser system characterized by

13. The medical laser system according to claim 12, wherein the controller circuit is configured to detect a reflectance of an optical signal reflected from the anatomical target in response to illumination of the anatomical target and returned to the laser fiber, and determine whether the distal end of the laser fiber is present inside or outside the working channel based on the detected reflectance; A medical laser system characterized by

14. The medical laser system according to claim 12, further comprising a laser interlock device, wherein the laser interlock device is configured to stop irradiation of the laser by the laser device in response to the control signal for preventing irradiation of the medical laser; A medical laser system characterized by

15. The medical laser system according to claim 12, wherein the controller circuit is configured to generate a control signal for resuming irradiation of the medical laser when the distal end of the laser fiber is present outside the working channel, and output the generated control signal to the laser device; A medical laser system characterized by

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