Surgery – Instruments – Light application
Patent
1997-12-18
2000-10-24
Dvorak, Linda C. M.
Surgery
Instruments
Light application
606 10, 606 12, A61B 1736
Patent
active
061359947
DESCRIPTION:
BRIEF SUMMARY
TECHNICAL FIELD AND INDUSTRIAL APPLICABILITY
This invention is disclosed in the context of cosmetic and reconstructive surgical procedures. However, it is believed to be useful in other applications as well.
BACKGROUND ART
Various techniques for facial cosmetic and reconstructive surgery are known. There are, for example, the techniques known as chemical peels and dermabrasion. More recently, laser cosmetic surgical techniques have become of interest. This recent interest parallels the development of small, highly maneuverable laser handpieces. Examples of these types of equipment are the SilkTouch.TM. model laser available from Sharplan Lasers, Inc., One Pearl Court, Allendale, N.J. 07401 and the UltraPulse.TM. model laser available from Coherent, Inc., 3270 West Bayshore Road, Palo Alto, Calif. 94303-4043.
Characterization of dermal structure by ultrasound is also known. There is, for example, Aging Skin Properties and Functional Changes, eds. Leveque, Jean-Luc and Pierre G. Agache. Chapter 7 of this reference describes high frequency ultrasound characterization of skin.
Computer imaging is presently in use in pre-operative surgical evaluations. There is, for example, the Mirror II aesthetic imaging system available from Mirror Image Technology, 4300 198th Street SW, Suite 200, Lynnwood, Wash. 98036. These systems can be thought of as dividing patient images digitized from color camera output into pixels and storing them as, for example, color and intensity information, pixel by pixel. Imaging of cosmetic and reconstructive surgical results can then be obtained by various types of averaging of stored intensity and color value data over numbers of adjacent pixels selected, for example, interactively by the physician and/or physician's assistant in consultation with the patient. This provides the patient with realistic expectations of various surgical outcomes prospectively, so that more informed elective decisions can be made.
DISCLOSURE OF INVENTION
According to the invention, a surgical method comprises orienting an ultrasound transmitter to transmit ultrasound from a first location on the skin surface, transmitting the ultrasound, generating a time base, receiving ultrasound echoes, and determining from the time between transmission and reception the depth beneath the skin of tissue to be treated. The ultrasound transmitter is then successively oriented to transmit ultrasound from multiple additional locations. At each of the multiple additional locations, the ultrasound is transmitted, a time base is generated, ultrasound echoes are received, and the depth beneath the skin of tissue to be treated is determined from the time between transmission and reception. The depths of the tissue at the first location and the multiple additional locations are stored in a memory associated with a process controller. A laser is targeted on the first location. The depth of the tissue to be treated beneath the first location is retrieved from the memory. A laser excitation power that will achieve treatment of the tissue at the retrieved depth is calculated from the retrieved depth of the tissue to be treated beneath the first location. The laser is excited at this power. The laser is successively targeted on each of the multiple additional locations, and at each of the multiple additional locations the depth of the tissue to be treated beneath that said location is retrieved from the memory. A laser excitation power that will achieve treatment of the tissue at the retrieved depth is calculated from the retrieved depth of the tissue to be treated beneath that said location. The laser is excited at each of these powers.
Illustratively according to the invention, the steps of determining from the time between transmission and reception the depth beneath the skin surface of tissue to be treated comprise the steps of determining from the time between transmission and reception the depth beneath the skin surface of the reticular dermis.
Alternatively, illustratively according to the invention, the steps of determinin
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patent: 4973848 (1990-11-01), Kolobanov et al.
patent: 5254112 (1993-10-01), Sinofsky et al.
patent: 5464013 (1995-11-01), Lemelson
"IEEE 1989 Ultrasonics Symposium Proceedings," sponsored by the Ultrasonics Ferroelectric and Frequency Control Society, Oct. 3-6, 1989, Le Grand Hotel, Montreal, Quebec, Canada; B. R. McAvoy, Editor.
Dvorak Linda C. M.
Harris-Ogugua Sonya
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