Diagnostic and Feedback Control System for Efficacy and Safety of Laser Application for Tissue Reshaping and Regeneration

Abstract

The efficacy and safety of laser medical treatments are ensured by performing a combination of measurement techniques to examine tissue properties in order to control characteristics of the laser treatments of cartilaginous tissues. In some aspects, a treatment tool is provided that is capable of taking and providing feedback relating to multiple measurements, including temperature measurements (in particular, radiometry), mechanical measurements, light scattering, speckle interferometry, optoacoustic measurements, and monitoring tissue electrical characteristics. The device is capable of providing feedback during the course of laser treatment of tissue to increase the safety and efficacy of treatment.

What is claimed is: 
     
         1 . A device for laser treatment of cartilaginous tissues, the device comprising:
 a handheld tool comprising
 a first subunit, including:
 a working optical fiber configured to transmit a first beam of laser light, the first beam of laser light producing a working radiation that provides a non-destructive irreversible modification of a cartilaginous tissue; and 
 a diagnostic optical fiber configured to transmit a second beam of laser light, the second beam of laser light producing a diagnostic radiation or receiving a diagnostic radiation from the cartilaginous tissue; 
 
 a second subunit including a fiber-optic irradiator configured to deliver one or both of the working radiation and the diagnostic radiation to the cartilaginous tissue; 
 a locking mechanism locking the second subunit to the first subunit; and 
 one or more sensors housed by the first subunit or the second subunit and configured for capturing data representing at least one of a physical and chemical characteristic of the cartilaginous tissue during application of the working radiation or the diagnostic radiation to the cartilaginous tissue; and 
   a feedback control system coupled to the one or more sensors and configured for processing the captured data to generate feedback regarding the physical or chemical characteristic of the cartilaginous tissue; and   a laser control unit configured to control the first and second beams of laser light, the laser control unit configured for modifying at least one of the first and second beams of laser light based on the feedback generated by the feedback control system.   
     
     
         2 . The device of  claim 1 , wherein the handheld tool further comprises:
 a cylinder having a lumen passing through the first subunit and the second subunit, the cylinder housing the working optical fiber and the diagnostic optical fiber.   
     
     
         3 . The device of  claim 2 , wherein the cylinder further comprises a plurality of coaxial layers. 
     
     
         4 . The device of  claim 3 , wherein one or a plurality of the coaxial layers has chamfered forms that are capable of being adjusted prior to inserting the device into a tissue. 
     
     
         5 . The device of  claim 3 , wherein the plurality of layers comprise an electrically conductive layer and an electrically insulating layer. 
     
     
         6 . The device of  claim 3 , wherein internal and external surfaces of the cylinder are isolated by a dielectric. 
     
     
         7 . The device of  claim 2 , wherein the distal end of the cylinder is sharpened to an acute angle. 
     
     
         8 . The device of  claim 2 , wherein the cylinder is configured to vibrate with fixed or alternating frequencies. 
     
     
         9 . The device of  claim 2 , further comprising a removable mandrel capable of being positioned within the lumen of the cylinder during insertion of the device into a tissue. 
     
     
         10 . The device of  claim 1 , wherein the handheld tool further comprises:
 an optical adapter interfacing the diagnostic optical fiber and the working optical fiber with the fiber-optic irradiator for delivery of the first and second beams of laser light to the cartilaginous tissue.   
     
     
         11 . The device of  claim 1 , wherein the locking mechanism comprises:
 at least one spring positioned in a slot in the first subunit;   at least one ball coupled to the second subunit, the ball configured to compress the spring into the slot to lock the second subunit to the first subunit.   
     
     
         12 . The device of  claim 1 , wherein the feedback control system is configured to process the captured data by:
 identifying threshold conditions that trigger a modification of treatment conditions; and   identifying modified treatment conditions responsive to a change in a characteristic of the cartilaginous tissue following treatment.   
     
     
         13 . The device of  claim 1 , wherein the device is configured to be controlled by a practitioner. 
     
     
         14 . The device of  claim 1 , wherein the device comprises a plurality of modular components. 
     
     
         15 . The device of  claim 14 , wherein the modular components comprise at least one of a tissue connector module, a fiber optic module, a sensor module, and a laser module. 
     
     
         16 . The device of  claim 1 , wherein the one or more sensors comprise at least one of a temperature sensor, an optical sensor, an optoacoustic sensor, an electrical sensor, and a mechanical sensor. 
     
     
         17 . The device of  claim 1 , wherein the physical or chemical characteristic is determined using a measurement selected from the group consisting of temperature measurements, light scattering measurements, speckle interferometry measurements, optoacoustic measurements, electrical measurements, and modulated differential scanning calorimetry measurements. 
     
     
         18 . The device of  claim 17 , wherein the temperature sensor comprises a thermocouple, radiometer, or photodiode. 
     
     
         19 . The device of  claim 17 , wherein the optical sensor is used for light scattering or interferometric measurements. 
     
     
         20 . The device of  claim 1 , wherein the device is configured to operate by contacting the one or more sensors with the tissue. 
     
     
         21 . The device of  claim 1 , wherein the device is configured to operate in the absence of contacting the at least one sensor with the tissue. 
     
     
         22 . The device of  claim 1 , further comprising a mass delivery structure, wherein the mass delivery structure is capable of delivering drugs to a tissue, evacuating liquids and tissues from the tissue, or for biopsy sampling. 
     
     
         23 . The device of  claim 1 , wherein the device is configured to provide optimal laser conditions prior to tissue treatment based on tissue characteristics. 
     
     
         24 . The device of  claim 1 , wherein the device is configured to select an optimal tissue treatment area based on tissue characteristics.