Endoscopic submucosal dissection using carbon dioxide laser is a promising treatment of early digestive cancer because it can avoid the risk of perforation. Although a hollow optical fiber transmitting mid-infrared light has been used, it was observed that the irradiation effect was influenced by bending a gastrointestinal gastrointestinal endoscope due to the change in transmittance by the bending loss. Therefore, we quantitatively evaluated the change in the irradiation effect by bending the hollow optical fiber in the gastrointestinal endoscope and proposed a correction method to stabilize the irradiation effect. First, the relationship between the irradiated laser energy density and the incision depth for porcine stomach was measured by bending the head of the gastrointestinal endoscope. Next, the relationship between the bending angle of the head of the gastrointestinal endoscope and the temperature rise of the hollow optical fiber in the head of the gastrointestinal endoscope was measured during the laser irradiation. As a result, the laser energy density and the incision depth decreased as the bending angle increased, and linear correlation between the laser energy density and the incision depth was observed. It was found that the bending angle can be estimated by the ratio of the setting laser power to time derivative of the temporal profile of the temperature of the hollow optical fiber. In conclusion, it is suggested that the correction of the laser energy density and stabilization of the incision capability is possible by measuring the temporal profile of the temperature of the hollow optical fiber.
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