| CPC A61N 5/0616 (2013.01) [A61N 5/0625 (2013.01); A61B 2017/00061 (2013.01); A61B 2017/0019 (2013.01); A61B 2018/00791 (2013.01); A61B 2018/202 (2013.01); A61B 2018/20359 (2017.05); A61N 2005/007 (2013.01); A61N 2005/0628 (2013.01); A61N 5/067 (2021.08)] | 12 Claims |
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1. A method for treating the skin of a patient with one or more therapeutic laser pulses, the method comprising:
a) using a laser source for generating therapeutic laser pulses for application to a plurality of target skin areas as a laser therapy;
b) using a handpiece optically coupled to the laser source to receive the therapeutic laser pulses from the laser source and direct each therapeutic laser pulse to one of the plurality of target skin areas along a first optical path, wherein at least a portion of the first optical path is different for each target skin area of the plurality of target skin areas, the handpiece comprising:
1) a first optical element comprising a reflective element and having a reflective portion and a first open area comprising one of an aperture and a slot, wherein the first open area is located in the first optical path for each target skin area of the plurality of target skin areas;
2) at least a second optical element comprising a movable mirror that is movable to a plurality of different mirror positions, wherein the movable mirror is located in the first optical path for each target skin area of the plurality of target skin areas;
3) a contact cooling unit comprising a cooling window adapted to contact and cool a first skin area of the patient, wherein the cooling window comprises a thermally conductive material that is located in the first optical path for each target skin area of the plurality of target skin areas and is transmissive to infrared energy and the therapeutic laser pulses, and wherein each target skin area of the plurality of target skin areas comprises a different fraction of the first skin area cooled by the contact cooling window; and
4) a temperature sensing element for sensing, at each of the plurality of different mirror positions, infrared energy radiated from substantially only a selected one of the plurality of target skin areas through the cooling window along a second optical path that is generally counterdirectional to, and shares a common optical axis with, the first optical path for the selected one of the plurality of target skin areas, wherein
A) at least a portion of the second optical path for each target skin area of the plurality of target skin areas is different from every other second optical path;
B) the movable mirror and the reflective portion of the first optical element are located in the second optical path for each target skin area of the plurality of target skin areas;
C) the movable mirror is positioned within the handpiece to, at each of the plurality of different positions, direct one or more laser pulses to the selected one of the plurality of target skin areas along the first optical path, receive infrared energy radiated along the second optical path from substantially only the selected one of the plurality of target skin areas through the cooling window, and direct at least a portion of the received infrared energy to the reflective portion of the first optical element;
D) the reflective portion of the first optical element is positioned to receive the at least a portion of the infrared energy from the movable mirror and to reflect the infrared energy received from the movable mirror to the temperature sensing element; and
E) the temperature sensing element is adapted to generate a first signal indicative of the infrared energy received from the first optical element;
c) using a temperature determination unit adapted to determine a surface temperature of the selected one of the plurality of target skin areas based on the infrared energy received from the first optical element, the temperature determination unit comprising a controller comprising at least one processor adapted to process the first signal to determine the surface temperature of the selected one of the plurality of target skin areas at one or more timepoints before, during, or after the application of one or more of the therapeutic laser pulses to the selected one of the plurality of target skin areas;
d) contacting the first skin area with the cooling window;
e) cooling the first skin area from a first temperature to a second temperature using the cooling window;
f) generating at least one first therapeutic laser pulse using the laser source;
g) receiving the at least one first therapeutic laser pulse from the laser source with the handpiece;
h) applying the at least one first therapeutic laser pulse to a selected one of the plurality of target skin areas, the at least one first therapeutic laser pulse passing through the first open area, engaging the at least a second optical element, and passing through the cooling window along the first optical path for the selected one of the plurality of target skin areas;
i) determining the surface temperature of the selected one of the plurality of target skin areas one or more times before, during or after the application of the at least one first therapeutic laser pulse using the temperature determination unit;
j) performing at least one responsive action in response to determining the surface temperature of the selected one of the plurality of target skin areas, selected from
1) terminating the application of the at least one first therapeutic laser pulse to the selected one of the plurality of target skin areas based on the determined surface temperature;
2) indicating the instantaneous surface temperature of the selected one of the plurality of target skin areas;
3) indicating a maximum surface temperature of the target skin area;
4) changing at least one parameter of the laser therapy; and
5) indicating when the surface temperature of the selected one of the plurality of target skin areas returns to a desired temperature following delivery of the at least one therapeutic laser pulse.
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