CN101849868B - Self-control laser surgical equipment - Google Patents
Self-control laser surgical equipment Download PDFInfo
- Publication number
- CN101849868B CN101849868B CN2009103128468A CN200910312846A CN101849868B CN 101849868 B CN101849868 B CN 101849868B CN 2009103128468 A CN2009103128468 A CN 2009103128468A CN 200910312846 A CN200910312846 A CN 200910312846A CN 101849868 B CN101849868 B CN 101849868B
- Authority
- CN
- China
- Prior art keywords
- laser
- master controller
- laser instrument
- lesion tissue
- port
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Active
Links
Images
Abstract
The invention relates to self-control laser surgical equipment, which consists of a main controller, a display, a charge-coupled device (CCD) camera, a laser, light source equipment, a main bracket, a cantilever arm, a suspension surgical treatment head, a microscopic observation system and a microscopic surgical adapter. The main controller recognizes and processes images and light spectrums of focal tissues and normal tissues acquired by the CCD camera and correspondingly send a command to control the operation of the laser so as to prevent faulty operation of a laser surgery from damaging the normal tissues and making a surgery mistake; the main controller sends a command to control the startup and shutdown of the laser and modify laser output; an optical lens group forms a light path; and the microscopic observation system, a microscopic observation mirror, the CCD camera and the microscopic surgical adapter are integrated with one another through the optical lens group. The equipment has the advantages of simple structure, reasonable design, simple and easily-grasped operation, capability of eliminating the focal tissues without damaging the normal tissues in a surgery process, various control modes, adjustable parameter, wide application and capability of accurately controlling the number of surgeries and improving treating effect.
Description
The present invention is " automatic control laser operation equipment " application number: 200810154587.6, and the applying date: the dividing an application of December in 2008 26 days.
Technical field
The present invention relates to a kind of laser surgery medical apparatus and instruments, relate in particular to a kind of automatic control laser operation equipment.
Background technology
Adopt laser capture microdissection to undergo surgery and be widely used, be not only surgery, internal medicine, department of eye and ophthalmology and all use widely, aspect the treatment glaucoma, adopting the laser capture microdissection operation is the main means of treatment.Traditional filtering surgery mainly contains trabeculectomy, sclera is stung and cut art, but traditional filtering surgery post-operative complication is more, as early stage postoperative shallow of anterior chamber and do not have anterior chamber, eyelash pulse disappeared suddenly, ciliary block glaucoma, hemorrhage and filter bubble and do not form etc.; The filtration mouth in late period stops up, paralysed trace forms, the capsule sample becomes, filter follicular rupture, cataract and infection etc.Existing laser capture microdissection surgery systems mainly is by the situation of change of laser irradiation biological tissue by the microscopic system Real Time Observation, required according to operation, manually control the laser irradiation amount in the operation process, eliminating the same of lesion tissue often with complication, influence therapeutic effect, so, these therapeutic equipments and Therapeutic Method must be observed surgery situation on one side, manually control the laser irradiation amount in the whole surgery process on one side, more loaded down with trivial details, most operative doctors are to rely on the experience of operation to carry out laser surgery, are difficult to control well operation, also exist problems to need to be resolved hurrily.
Summary of the invention
Main purpose of the present invention is to solve the problem in above-mentioned laser surgery medical apparatus and instruments and the laser surgery, provide a kind of can control not damage normal structure when eliminating lesion tissue in the operation process, have multiple control modes, parameter is adjustable, be widely used, accurately control amount for surgical, improve the automatic control laser operation equipment of therapeutic effect.
The technical solution adopted for the present invention to solve the technical problems is:
Form by master controller, display, CCD photographic head, laser instrument, light source, main support, cantilever, suspension operative treatment head, microexamination system and microsurgery adapter.
The present invention is mainly by interface circuit, the pulse CO of master controller, display, CCD photographic head, laser instrument, light source, main support, cantilever, suspension operative treatment head, microexamination system, microsurgery adapter, image pick-up card, laser instrument and microcomputer
2Several parts such as laser instrument, pilot light laser instrument, microcomputer and software system are formed.The present invention treats the ophthalmic diseasess such as glaucoma, presbyopia and myopia of ophthalmology, and diseases such as nasal polyp and laryngeal carcinoma.
The shooting outfan of CCD photographic head is connected with master controller by circuit, the laser controlling connectivity port of laser instrument is connected with master controller by circuit, the laser output mouth of laser instrument is connected with the adapter input port of microsurgery adapter by optical fibers, the image of CCD camera collection lesion tissue and normal structure and spectrum and by the shooting outfan be transferred to master controller.
Master controller, display, CCD photographic head, laser instrument and microsurgery adapter are by the system that connects and composes surgical apparatus of circuit.Master controller, display, CCD photographic head, laser instrument and microsurgery adapter play the effect of parts separately in this system, the CCD photographic head detects operative site light intensity and change in color in real time, write down operation process simultaneously, and give master controller the image of lesion tissue and normal structure and spectral transmissions, image and spectrum are handled by the master controller monitoring, accurately control operation process, and can opening and shutting off by I/O interface control laser instrument.It is input with the video signal of CCD camera head directly that the present invention adopts image pick-up card, need not Signal Pretreatment; Analogue signal after A/D conversion directly through pci bus and master controller communication; Software system control CCD camera head obtains the image and the spectrum of required perioperatively operative site, and image document and SPECTRAL DATA are stored, change, analyzed.Master controller can adopt the PC computer.
Master controller identification and handle the lesion tissue of CCD camera collection and the image and the spectrum of normal structure, and correspondingly send the operation of instruction control laser instrument avoids the maloperation damage normal structure of laser surgery to cause the error of performing the operation.
Master controller of the present invention is discerned and is handled the lesion tissue of CCD camera collection and the image and the spectrum of normal structure, area array CCD is monitored the luminous reflectance intensity and the change in color of laser boring position tissue in real time when the treatment glaucoma, cutting when the hole must be with the sudden change of light intensity and color when wearing, at any time detect this sudden change and in time control laser shutdown, this process can be controlled in the limit of a laser pulse, thereby can prevent the excessive injury of laser effectively, reliably.When the treatment presbyopia, monitor the radian (diopter) of plane of crystal and the change of ante-chamber distance in real time, in time control laser energy, spot size and sclerectomy figure, improve presbyopic therapeutic effect.
Display is connected with the display connection port of master controller, adopt display screen or touch screen display as master controller, the lesion tissue that display instant playback CCD photographic head is gathered and the image and the spectrum of normal structure show surgical parameters on the display simultaneously.
Display of the present invention can adopt display screen or touch screen, adopts touch screen can simplify computer, directly operates corrected parameter on touch screen; Display shows the image and the spectrum of CCD camera collection in real time, shows the operational order that surgical parameters and master controller send simultaneously, is convenient to the doctor and observes and treat.Fully demonstrate energy, surgical parameters, the size of hot spot and the figure of lesion tissue excision of the image of lesion tissue and normal structure and spectrum, laser output light on the display.
The laser output mouth of laser instrument is connected with the adapter input port of microsurgery adapter by optical fibers or light-conducting arm, transmission treatment laser, gas laser or solid state laser or the semiconductor laser or the optical fiber laser of pulse operation mode adopted in treatment with laser instrument, pulse width: 250 μ s～100ms, energy density: 5～20J/cm
2, pulse frequency:＜200Hz.
The selection of laser parameter has direct influence to the effect of operation, the present invention makes a general reference all laser parameters that can impact operation, comprise optical maser wavelength, the way of output (pulse, pulse energy density, pulse width, pulse frequency, laser controlling mode (Artificial Control, feedback control) etc. continuously).
In from outside laser sclerectomy, the selection of laser parameter should be followed three principles: hot injury and mechanical damage minimum; Can accurately control amount for surgical; Excision efficient height, operating time are few.Obtaining minimum hot injury is vital principle, because no matter from the infringement to adjacent tissue, all is very crucial to postoperative wound healing and minimizing cicatrix still.Putting before this, should accurately control amount for surgical, avoiding the injury of crossing deep tissue.Only satisfying under above-mentioned two situation, could consider to improve excision efficient, reducing operating time.
Advantages such as the mid and far infrared laser of short pulse output is shallow with its heat effect effect table, damage is little, operative hemorrhage is few are applicable to glaucoma filtration surgery.CO wherein
2Laser has very strong hemostatic function when resection organization, and when excision is very little to the surrounding tissue damage, is suitable for doing from outside laser ablation operation.CW CO
2The effect of laser and pulse and ocular tissue's effect is different, and using short-pulse laser restriction thermal diffusion is a kind of method that reduces the hot injury.
The laser controlling connectivity port of laser instrument is connected with the control laser instrument connectivity port of master controller by circuit, and master controller sends start, the shutdown of instruction control laser instrument and revises the laser output.
The present invention comprises continuous wave, pulse, multiple-pulse, composite pulse etc. by the way of output of main controller controls laser instrument; Master controller can preestablish also can follow in operation according to needs changes surgical parameters at any time, and surgical parameters comprises: power, the irradiation time of continuous wave output, impulse wave output energy, pulsewidth and frequency etc.The present invention utilizes the high-speed i/o interface circuit, master controller is coupled together with laser instrument, use D/A to convert parameter and the function of controlling laser switch are set, the A/D conversion can be monitored the state of laser instrument, the time of total number of writing laser actual pulse and total contribution in real time.
The top of main support is provided with cantilever, and an end of cantilever is provided with and hangs the operative treatment head, and the operative treatment head is hung in main support and cantilever support suspention, and suspension operative treatment head keeps therapeutic state in the end of cantilever or moves freely.
Hang the operative treatment cephalic suspension on the cantilever of main support, main support and cantilever not only keep hanging and supported and suspended operative treatment head is in the optimal treatment position, can also in operation, move freely by up, down, left, right, before and after, make that hanging the operative treatment head is in the optimal treatment state all the time.
The top that hangs the operative treatment head is provided with microexamination system and microexamination mirror, a side that hangs the operative treatment head is provided with the CCD photographic head, the shooting outfan of CCD photographic head is connected with the data message interface of master controller by circuit, gives master controller image that captures and spectral transmissions immediately.
The bottom that hangs the operative treatment head is provided with the microsurgery adapter, the adapter input port of microsurgery adapter is connected with laser instrument, a side that hangs the operative treatment head is provided with light source interface, and the light source outfan of light source is connected the light illumination operative site by light source interface.
Place microexamination system, microexamination mirror, microsurgery adapter and CCD photographic head on the operative treatment head hanging, laser instrument, light source and master controller all by circuit respectively to connection, hang the center that the operative treatment head becomes treatment.
In hanging the operative treatment head optical glass group is set, the optical glass group forms light path, by the optical glass group microexamination system, microexamination mirror, CCD photographic head and microsurgery adapter is constituted an integral body.
Be arranged on the microexamination system, microexamination mirror, CCD photographic head and the microsurgery adapter that hang on the operative treatment head and organically be linked to be an integral body by the optical glass group, each corresponding position of comfortable optical glass group of microexamination system, microexamination mirror, CCD photographic head and microsurgery adapter.
Foot switch is connected with master controller, the keying foot switch is manually controlled the startup of laser instrument by master controller and is closed, the accident that occurs happening suddenly in operation is closed foot switch and is closed laser instrument at once, and the burst accident finishes to open foot switch, the state of resuming work.
The operation of foot switch is manually operated, is to look surgery situation by the doctor, turn-offs laser instrument after making subjective judgment, when needs continue operation, opens the foot switch state of resuming work.In addition, turn-off laser instrument and also have dual mode, a kind of is " operation finishes " button on the master controller, is by operator's control, is the precautionary measures that increase in order to meet emergencies the protection personal safety; Another kind is according to the image of lesion tissue and normal structure and spectrum--threshold value control, belongs to auto-control mode.Any 1 all can be turn-offed laser instrument when working in this three measures, and this three measures do not conflict mutually, thereby has increased the safety of total system.
Form by master controller, display, image collecting joint, laser instrument, light source and endoscope, display is connected with the display connection port of master controller, adopt universal display device or touch-screen display display as master controller, the lesion tissue that display instant playback CCD photographic head is gathered and the image and the spectrum of normal structure show surgical parameters on the display simultaneously.
The present invention mainly is made up of several parts such as interface circuit, pulse laser, pilot light laser instrument, microcomputer and software system of master controller, display, CCD photographic head, laser instrument, light source, main support, cantilever, suspension operative treatment head, microexamination system, microsurgery adapter, image pick-up card, laser instrument and microcomputer.Display shows the image and the spectrum of CCD camera collection in real time, shows the operational order that surgical parameters and master controller send simultaneously, is convenient to the doctor and observes and treat.Fully demonstrate energy, surgical parameters, the size of hot spot and the figure of lesion tissue excision of the image of lesion tissue and normal structure and spectrum, laser output light on the display.The present invention treats the disease of esophageal carcinoma, gastric cancer and rectal polyp.
The top of endoscope is provided with the biopsy mouth, pore, the water hole, light source interface and endoscope's FPDP, the biopsy mouth, pore, water hole and light source interface are connected to observation treatment end by the top of endoscope, constitute biopsy mouth port in observation treatment end, the pore port, water hole port and light source head, discharged by pore by the pore port by the waste gas that produces behind the surgical lesion tissue vaporization, organize liquid and the moisture that are produced by operative site in the operation process are discharged by the water hole by the water hole port, the light source output port of light source is transferred to the light source head of observation treatment port by fibre bundle by the light source interface of endoscope, on the observation treatment port 3 light source heads are set at least, the position of light source head illumination operation.
The figure collection head of CCD photographic head is set in the observation treatment end of endoscope, endoscope's FPDP that endoscope top is provided with is connected with the data message interface of master controller by circuit and is connected with the image card of master controller, the figure collection head of CCD photographic head is gathered the image and the spectrum of lesion tissue and normal structure, the lesion tissue of master controller identification and processing CCD camera collection and the image and the spectrum of normal structure, and the operation of correspondingly sending instruction control laser instrument, avoid the maloperation damage normal structure of laser surgery to cause the error of performing the operation.
The laser output mouth of laser instrument connects optical fibers, the biopsy mouth of optical fibers from endoscope inserted, fibre-optic end is until the biopsy mouth port of observation treatment port, transmission treatment laser, gas laser or solid state laser or the semiconductor laser or the optical fiber laser of pulse operation mode adopted in treatment with laser instrument, pulse width: 250 μ s～100ms, energy density: 5～20J/cm
2, pulse frequency:＜200Hz.
The laser controlling connectivity port of laser instrument is connected with the control laser instrument connectivity port of master controller by circuit, and master controller sends start, the shutdown of instruction control laser instrument and revises the laser output.
Foot switch is connected with master controller, the keying foot switch is manually controlled the startup of laser instrument by master controller and is closed, the accident that occurs happening suddenly in operation is closed foot switch and is closed laser instrument at once, and the burst accident finishes to open foot switch, the state of resuming work.
After preparing before the art, open master controller, display, CCD photographic head and light source, adjust the cantilever on the main support and hang the operative treatment head, the treatment end enters operative region, the microsurgery adaptor alignment operative site that hangs on the operative treatment head.
The present invention mainly is made up of several parts such as interface circuit, pulse laser, pilot light laser instrument, microcomputer and software system of master controller, display, CCD photographic head, laser instrument, light source, main support, cantilever, suspension operative treatment head, microexamination system, microsurgery adapter, image pick-up card, laser instrument and microcomputer.Adopt Visual C to programme, systems soft ware can be divided into three parts-CCD control and image processing part, laser controlling part and case management data base by function.The present invention treats the ophthalmic diseasess such as glaucoma, presbyopia and myopia of ophthalmology.
Image and spectrum by microexamination system on the suspension operative treatment head and display demonstration, observe the lesion tissue and the normal structure of operative site, the image and the spectrum of master controller identification, affirmation lesion tissue and normal structure are with microsurgery adapter locking lesion tissue position.
In the laser surgery, the control of amount for surgical is generally the Artificial Control mode, by doctor's Real Time Observation laser ablation degree of depth, the control mode influence is bigger, amount for surgical is difficult to accurate control, from outside laser sclerectomy associating iridectomy is had higher requirement to the control of amount for surgical, and feedback controling mode--area array CCD is monitored the luminous reflectance intensity and the change in color of laser boring position tissue in real time in employing, the system that have multiple control modes, parameter is adjustable, is used to perform the operation.
Open laser instrument, the surgical parameters of master controller correction laser instrument, the output of adjustment laser instrument, laser instrument are prepared the start bright dipping.
When the present invention starts working, click " beginning operation " button, automatically eject message box on the display and " please select operative site ", with the pilot light laser point in the click image, this point is draw the automatically square frame of a 52 * 52pixel of center, expression will be got the data of the interior pixel of this square frame as threshold decision, by behind " determining " button, wait for the signal of doctor's start.
The locking lesion tissue, master controller is sent out " start " and is gone out operational order, laser instrument start bright dipping, laser instrument output treatment laser, the lesion tissue of the treatment cut of laser instrument or vaporization operative site, treatment laser adopts gas laser or solid state laser or the semiconductor laser or the optical fiber laser of pulse operation mode, pulse width: 250 μ s～100ms, energy density: 5～20J/cm
2, pulse frequency:＜200Hz.
The CCD photographic head feeds back to master controller to image that captures and spectrum all the time; display shows image and the spectrum that the CCD photographic head captures all the time; master controller is monitored image and the spectrographic variation that captures at any time; and in time laser instrument is sent operational order, the output of shutdown or start or correction laser.
The selection of laser parameter has direct influence to the effect of operation, and in from outside laser sclerectomy, the selection of laser parameter should be followed three principles: hot injury and mechanical damage minimum; Can accurately control amount for surgical; Excision efficient height, operating time are few.Advantages such as the mid and far infrared laser of short pulse output is shallow with its heat effect effect table, damage is little, operative hemorrhage is few are applicable to glaucoma filtration surgery.Wherein laser has very strong hemostatic function when resection organization, and when excision is very little to the surrounding tissue damage, is suitable for doing from outside laser ablation operation.The effect of continuous wave laser and pulse and ocular tissue's effect is different, and using short-pulse laser restriction thermal diffusion is a kind of method that reduces the hot injury.
Foot switch is connected with master controller, opens and closes the startup and shutdown of foot switch by the main controller controls laser instrument.
The operation of foot switch is manually operated, is to look surgery situation by the doctor, turn-offs laser instrument after making subjective judgment, when needs continue operation, opens the foot switch state of resuming work.
Image and spectrum one disappearance when lesion tissue; image and spectrum that the CCD photographic head will capture normal structure feed back to master controller; image and spectrum that master controller monitors normal structure occur; immediately laser instrument is sent the instruction of " shutdown " operation; laser instrument is received " shutdown " operational order; before sending next pulse laser, stop to export laser, do not damage normal structure.
Master controller of the present invention can preestablish also can follow in operation according to needs changes surgical parameters at any time, and surgical parameters comprises: power, the irradiation time of continuous wave output, impulse wave output energy, pulsewidth and frequency etc.The present invention can monitor the state of laser instrument in real time, the time of total number of writing laser actual pulse and total contribution.
Adjust the cantilever on the main support and hang the operative treatment head, seek the lesion tissue of operative site, the lesion tissue that hangs the microsurgery adaptor alignment operative site on the operative treatment head, the image and the spectrum of master controller identification, affirmation lesion tissue and normal structure, the locking lesion tissue, master controller sends operational order, laser instrument start bright dipping, laser instrument output treatment laser, the lesion tissue of the treatment cut of laser instrument or vaporization operative site, reciprocation cycle is until the lesion tissue of eliminating operative site fully.
When the lesion tissue of operative site has been eliminated a part, continue the treatment lesion tissue of part in addition again, adjust the treatment position that hangs the operative treatment head, treatment is continued in the locking back, eliminates fully up to lesion tissue, and operation finishes.
When the lesion tissue of eliminating operative site fully, close laser instrument and stop output treatment laser; By hanging the normal structure and the lesion tissue of the image viewing operative site that microexamination system on the operative treatment head and display show, after master controller confirms that operative site is eliminated lesion tissue fully, cantilever on the mobile main support and suspension operative treatment head are removed the microsurgery adapter that hangs on the operative treatment head from operative site.
Close master controller, display, CCD photographic head and light source, operation finishes.
Foot switch is connected with master controller, occurs the burst accident in operation, closes foot switch, and foot switch is closed laser instrument by master controller, and laser instrument is shut down at once, stops output treatment laser;
When the burst accident finishes, open foot switch, the laser instrument state of resuming work.
In case the burst accident occurs, master controller does not send the operational order of cutting out laser instrument, operation does not finish as yet, the doctor can adopt foot switch, the operation of foot switch is manually operated, is to look surgery situation by the doctor, turn-offs laser instrument after making subjective judgment; When the burst accident eliminate to need continues operation, open the foot switch state of resuming work.
After preparing before the art, open master controller, display, light source and CCD photographic head, open the position of the light source head illumination operation of light source observation treatment port, the observation treatment end of endoscope enters operative region, aims at operative site.
The present invention mainly is made up of master controller, laser instrument, display, endoscope illuminator, endoscope and foot switch, laser instrument is to be connected with data wire by the A/D card with the connection of master controller, master controller is to connect by the display adapter holding wire with the connection of display, master controller is to connect by one group of data wire with the connection of endoscope, and light source is to be connected by the light source interface of circuit with endoscope with the connection of endoscope.The present invention treats the disease of nasal polyp, laryngeal carcinoma, esophageal carcinoma, gastric cancer and rectal polyp.
The laser output mouth of laser instrument connects optical fibers, and the biopsy mouth of optical fibers from endoscope inserted, and fibre-optic end is until the biopsy mouth port of observation treatment port, in observation treatment port bright dipping treatment focus.
The observation treatment port of endoscope is aimed at operative site, by the image and the spectrum of display demonstration operative site, the lesion tissue and the normal structure of observing operative site, the image and the spectrum of lesion tissue and normal structure is discerned, confirmed to master controller.
By master controller revisional operation parameter, adjust the output of laser instrument, laser instrument is prepared the start bright dipping.
The locking lesion tissue, master controller sends operational order, laser instrument start bright dipping, laser instrument output treatment laser, the lesion tissue of the treatment cut of laser instrument or vaporization operative site, treatment is adopted gas laser or solid state laser or the semiconductor laser or the optical fiber laser of pulse operation mode, pulse width: 250 μ s～100ms, energy density: 5～20J/cm with laser instrument
2, pulse frequency:＜200Hz.
The CCD photographic head feeds back to master controller to image that captures and spectrum all the time; display shows image and the spectrum that the CCD photographic head captures all the time; master controller is monitored image and the spectrographic variation that captures at any time; and in time laser instrument is sent operational order, the output of shutdown or start or correction laser.
The waste gas that the lesion tissue vaporization back of being performed the operation in operation process produces is discharged by pore by the pore port, and organize liquid and moisture that the position of being performed the operation in the operation process produces are discharged by the water hole by the water hole port.
Image and spectrum one disappearance when lesion tissue; image and spectrum that the CCD photographic head will capture normal structure feed back to master controller; image and spectrum that master controller monitors normal structure occur; immediately laser instrument is sent the instruction of " shutdown " operation; laser instrument is received " shutdown " operational order; before sending next pulse laser, stop to export laser, do not damage normal structure.
Adjust the observation treatment port of endoscope, seek the lesion tissue of operative site, with the lesion tissue that the observation treatment port of endoscope is aimed at operative site, the image and the spectrum of master controller identification, affirmation lesion tissue and normal structure, locking lesion tissue, master controller sends operational order, laser instrument start bright dipping, laser instrument output treatment laser, the lesion tissue of the treatment cut of laser instrument or vaporization operative site, reciprocation cycle is until the lesion tissue of eliminating operative site fully.
When the lesion tissue of eliminating operative site fully, close laser instrument and stop output treatment laser.
The normal structure and the lesion tissue of the image viewing operative site that shows by display, after master controller confirms that operative site is eliminated lesion tissue fully, the observation treatment port of endoscope withdraws from operative site, closes master controller, display, CCD photographic head and light source, and operation finishes.
Foot switch is connected with master controller, occurs the burst accident in operation, closes foot switch, and foot switch is closed laser instrument by master controller, and laser instrument is shut down at once, stops output treatment laser.
When the burst accident finishes, open foot switch, the laser instrument state of resuming work.
The present invention is for inquiring into the feasibility and the effect of laser surgery, and with traditional trabeculectomy contrast, implemented zoopery.
Experiment material
1, animal: 30 of the healthy adult white rabbits of the Japan large ear rabbit kind that is provided by Medical University Of Tianjin's Experimental Animal Center, body weight is 1.8～2.9 kilograms.Male and female half and half divide cage to feed.
2, laser instrument: laser surgery instrument
3, tonometer: Perkins applanation tonometer
4, Ophthalimic microsurgery magnifier and operating theater instruments
Experimental technique
1,30 white rabbits are divided into two groups by right and left eyes, right eye is an experimental group, uses CO
2Laser surgery system carries out laser sclerectomy associating iridectomy; Left eye is a matched group, carries out traditional trabeculectomy.Do the measurement of the preceding intraocular pressure of eyes art before this, learned the no significant difference of check by statistics.
2, three days 0.25% chloromycetin eyedropses of postoperative and 0.5% cortisone medicament for the eyes water spot eyes, 3 times/day.Before collecting the record art, the 1st, 2,3,7,14,28 days intraocular pressure of postoperative, filter bubble, cornea, anterior chamber, iris and crystalline situation.
Experimental result
1, anterior ocular segment inspection:
The anterior chamber response of experimental group is slight, and postoperative anterior chamber response complete obiteration in 3 days, and matched group recovers fully through 28 talentes, illustrate traditional operation to anterior chamber's influence much larger than the influence of laser surgery to the anterior chamber, and the anterior chamber recovers slow.
2, filter bubble analysis
The eye number distribution situation of experimental group and matched group postoperative filtration bubbles at different levels is done rank test, postoperative 3 days and 28 days comparative result of postoperative, P＜0.01, difference has statistical significance, and experimental group obviously is better than matched group; 7 days comparative result of postoperative, P＜0.05, difference has statistical significance, and experimental group is better than matched group; 14 days comparative result of postoperative, P＞0.05 does not have significant difference on the statistics.This filtration bubble function that shows experimental group and matched group has significant difference in the most of the time, experimental group is better than matched group.
3, the variation of intraocular pressure
Two groups of results relatively of 1 day, 2 days, 3 days, 7 days of postoperative, there is significant difference P＜0.01.During this period, matched group intraocular pressure meansigma methods is less than experimental group.14 days comparative result of postoperative, P＞0.05, no significant difference.And by the 28th day, the intraocular pressure meansigma methods of experimental group was less than matched group (P＜0.01).That is to say that the intraocular pressure meansigma methods of matched group is less than experimental group in the short after surgery time, then two groups of intraocular pressure meansigma methodss are tending towards identical, and experimental group intraocular pressure meansigma methods is less than matched group during by 28 days.
Experimental result shows, compares with traditional mechanicalness trabeculectomy, and laser sclerectomy associating iridectomy has remarkable advantages: operation method is simple, be easy to the control operation, and operating time is short; Accurately the control amount for surgical satisfies the requirement of operation; Anterior chamber response is light, and it is hemorrhage not have 1 example; Form functional preferably filtration bubble; Intraocular pressure smooth decreasing, lasting; The lining of duct rule, epithelial tissue is complete, the duct healing better; Scorching reaction of hole surrounding tissue and fibrosis are lighter.
The present invention is an automatic control laser operation equipment.Simple in structure, reasonable in design, make simply, operate simple and easy easy grasp, do not damage normal structure when eliminating lesion tissue in the operation process, have multiple control modes, parameter is adjustable, be widely used, and accurately controls amount for surgical, improves therapeutic effect, can be widely used in the treatment of surgery, internal medicine, department of eye and ophthalmic diseases, but the real time monitoring operation process, parameter is adjustable, can accurately control amount for surgical and reduce damage, the surgical effect ideal the hole surrounding tissue.
The multiple way of output be can select, continuous wave, pulse, multiple-pulse, composite pulse etc. comprised.Power, the irradiation time of continuous wave output, parameters such as impulse wave output energy, pulsewidth and frequency all can preestablish and change at any time on demand; CW Laser time or pulse laser pulse sum both can also can automatic feedback control by Artificial Control, and can be after operation finishes display result immediately; Each parameter that the adjusting knob of being made by software is regulated laser instrument by interface circuit is compared with analog regulation, have easy to adjust, directly perceived, adjustment amount is accurate, advantage such as reliable; Use camera head real time monitoring operation process, can in time detect and filter the hole and cut and wear, the feedback control laser shutdown prevents the injury of crossing of laser effectively; Can the real time record operation process, be convenient to patient data is managed.The medical record management Database Systems not only can also can be searched for doctor and patient at any time with on record with the image document record of postoperative before the art; According to the characteristics of laser ablation filtering operation, penetrate back laser continuation to the particularly injury of deep tissue on every side for avoiding filtering the hole, adopt two kinds of control modes.The one, ACTIVE CONTROL mode, the 2nd, feedback controling mode.The former is by to desiring the analysis of resection organization's characteristic, through experiment repeatedly in a large number, sums up best control parameter, by predefined program, realizes control automatically.A kind of mode in back adopts camera head to detect in real time and cuts brightness of position, hole and change in color.Experiment discovery hole is cut and is worn normal sudden change with light intensity and color, detects this sudden change and feedback control laser shutdown in time, can prevent the injury of crossing of laser effectively; The red laser of visible light wave range makes to guide light, and need exploration hole to cut light intensity or change in color when wearing in the feedback control, for avoiding the red interference of light of guiding to detecting, adopted two kinds of methods: the one, select for use the laser except that redness to make to guide light, the 2nd, close guide light automatically with main controller controls in good time.
Description of drawings
Below in conjunction with drawings and Examples to the detailed description of the invention.
The sketch map of Fig. 1 automatic control laser operation equipment
The partial schematic sectional view of Fig. 2 automatic control laser operation equipment
The sketch map of Fig. 3 automatic control laser operation equipment
The sketch map of endoscope of Fig. 4 automatic control laser operation equipment (A) and observation treatment end (B)
The schematic process flow diagram of the Therapeutic Method of Fig. 5 automatic control laser operation equipment
1 main support, 2 cantilevers, 3 hang the operative treatment head, 4 microexamination systems, 5 microexamination mirrors, 6 microsurgery adapters, 7 light source interface, 8CCD photographic head, 9 laser instrument, 10 master controllers, 11 display, 12 foot switchs, 13 shooting output ports, 14 adapter input ports, 15 optical glass groups, 16 endoscopies, 17 laser output mouths, 18 laser controlling connectivity ports, 19 biopsy mouths, 20 pores, 21 mouths of a river, 22 observation treatment ends, 23 endoscope's FPDPs, 24 light source heads, 25 image collecting joints, 26 pore ports, 27 water hole ports, 28 biopsy mouth ports, 29 light sources, 30 light source output ports, 31 control laser instrument connectivity ports, 32 data message interfaces, 33 display connection ports
The specific embodiment
Form by master controller (10), display (11), CCD photographic head (8), laser instrument (9), light source (29), main support (1), cantilever (2), suspension operative treatment head (3), microexamination system (4) and microsurgery adapter (6).
The shooting outfan (13) of CCD photographic head (8) is connected with master controller (10) by circuit, the laser controlling connectivity port (18) of laser instrument (9) is connected with master controller (10) by circuit, the laser output mouth (17) of laser instrument (9) is connected with the adapter input port (14) of microsurgery adapter (6) by the optical fibers lead, and image and spectrum that CCD photographic head (8) is gathered lesion tissue and normal structure also are transferred to master controller (10) by shooting outfan (13).
Master controller (10) identification and handle lesion tissue that CCD photographic head (8) gathers and the image and the spectrum of normal structure, and the operation of correspondingly sending instruction control laser instrument (9) avoid the maloperation damage normal structure of laser surgery to cause the error of performing the operation.
Display (11) is connected with the display connection port (33) of master controller (10), adopt display screen or touch screen display (11) as master controller (10), display (11) instant playback CCD photographic head (8) lesion tissue of being gathered and the image of normal structure and spectrum, display (11) is gone up and is shown surgical parameters simultaneously.
The laser output mouth (17) of laser instrument (9) is connected with the adapter input port (14) of microsurgery adapter (6) by optical fibers or light-conducting arm, transmission treatment laser, gas laser or solid state laser or the semiconductor laser or the optical fiber laser of pulse operation mode adopted in treatment with laser instrument (9), pulse width: 250 μ s～100ms, energy density: 5～20J/cm
2, pulse frequency:＜200Hz.
The laser controlling connectivity port (18) of laser instrument (9) is connected with the control laser instrument connectivity port (31) of master controller (10) by circuit, and master controller (10) sends start, the shutdown of instruction control laser instrument (9) and revises the laser output.
The top of main support (1) is provided with cantilever (2), one end of cantilever (2) is provided with and hangs operative treatment head (3), main support (1) and cantilever (2) support suspention and hang operative treatment head (3), and suspension operative treatment head (3) keeps therapeutic state in the end of cantilever (2) or moves freely.
The top that hangs operative treatment head (3) is provided with microexamination system (4) and microexamination mirror (5), a side that hangs operative treatment head (3) is provided with CCD photographic head (8), the shooting outfan (13) of CCD photographic head (8) is connected with the data message interface (32) of master controller (10) by circuit, gives master controller (10) image that captures and spectral transmissions immediately.
The bottom that hangs operative treatment head (3) is provided with microsurgery adapter (6), the adapter input port (14) of microsurgery adapter (6) is connected with laser instrument (9), a side that hangs operative treatment head (3) is provided with light source interface (7), and the light source outfan (30) of light source (29) is connected the light illumination operative site by light source interface (7).
In hanging operative treatment head (3), optical glass group (15) is set, optical glass group (15) forms light path, by optical glass group (15) microexamination system (4), microexamination mirror (5), CCD photographic head (8) and microsurgery adapter (6) is constituted an integral body.
Foot switch (12) is connected with master controller (10), keying foot switch (12) is manually controlled the startup of laser instrument (9) by master controller (10) and is closed, the accident that occurs happening suddenly in operation is closed foot switch (12) and is closed laser instrument (9) at once, the burst accident finishes to open foot switch (12), the state of resuming work, as shown in Figure 1 and Figure 2.
Form by master controller (10), display (11), image collecting joint (25), laser instrument (9), light source (29) and endoscope (16), display (11) is connected with the display connection port (33) of master controller (10), adopt universal display device or touch-screen display display (11) as master controller (10), display (11) instant playback CCD photographic head (8) lesion tissue of being gathered and the image of normal structure and spectrum, display (11) is gone up and is shown surgical parameters simultaneously.
The top of endoscope (16) is provided with biopsy mouth (19), pore (20), water hole (21), light source interface (7) and endoscope's FPDP (23), biopsy mouth (19), pore (20), water hole (21) and light source interface (7) are connected to observation treatment end (22) by the top of endoscope (16), constitute biopsy mouth port (28) in observation treatment end (22), pore port (26), water hole port (27) and light source head (24), discharged by pore (20) by pore port (26) by the waste gas that produces behind the surgical lesion tissue vaporization, organize liquid and the moisture that are produced by operative site in the operation process are discharged by water hole (21) by water hole port (27), the light source output port (30) of light source (29) is transferred to the light source head (24) of observation treatment port (22) by fibre bundle by the light source interface (7) of endoscope (16), on the observation treatment port (22) 3 light source heads (24) are set at least, the position of light source head (24) illumination operation.
The figure collection head (25) of CCD photographic head (8) is set in the observation treatment end (22) of endoscope (16), endoscope's FPDP (23) that endoscope (16) top is provided with is connected with the data message interface (32) of master controller (10) by circuit and is connected with the image card of master controller (1), the figure collection head (25) of CCD photographic head (8) is gathered the image and the spectrum of lesion tissue and normal structure, the lesion tissue that master controller (10) identification and processing CCD photographic head (8) are gathered and the image and the spectrum of normal structure, and the operation of correspondingly sending instruction control laser instrument (9), avoid the maloperation damage normal structure of laser surgery to cause the error of performing the operation.
The laser output mouth (17) of laser instrument (9) connects optical fibers, the biopsy mouth (19) of optical fibers from endoscope (16) inserted, the biopsy mouth port (28) that fibre-optic end is located until observation treatment port (22), transmission treatment laser, gas laser or solid state laser or the semiconductor laser or the optical fiber laser of pulse operation mode adopted in treatment with laser instrument, pulse width: 250 μ s～100ms, energy density: 5～20J/cm
2, pulse frequency:＜200Hz.
The laser controlling connectivity port (18) of laser instrument (9) is connected with the control laser instrument connectivity port (31) of master controller (10) by circuit, and master controller (10) sends start, the shutdown of instruction control laser instrument (9) and revises the laser output.
Foot switch (12) is connected with master controller (10), keying foot switch (12) is manually controlled the startup of laser instrument (9) by master controller (10) and is closed, the accident that occurs happening suddenly in operation is closed foot switch (12) and is closed laser instrument (9) at once, the burst accident finishes to open foot switch (12), the state of resuming work, as shown in Figure 3, Figure 4.
After preparing before the art, open master controller (10), display (11), CCD photographic head (8) and light source (29), adjust the cantilever (2) on the main support (1) and hang operative treatment head (3), the treatment end enters operative region, and the microsurgery adapter (6) that hangs on the operative treatment head (3) is aimed at operative site.
Image and spectrum by microexamination system (4) on the suspension operative treatment head (3) and display (11) demonstration, observe the lesion tissue and the normal structure of operative site, the image and the spectrum of master controller (10) identification, affirmation lesion tissue and normal structure are with microsurgery adapter (6) locking lesion tissue position.
Open laser instrument (9), master controller (10) is revised the surgical parameters of laser instrument (9), adjusts the output of laser instrument (9), and laser instrument (9) is prepared the start bright dipping.
The locking lesion tissue, master controller is sent out " start " and is gone out operational order, laser instrument (9) start bright dipping, laser instrument (9) output treatment laser, the lesion tissue of the treatment cut of laser instrument (9) or vaporization operative site, treatment laser adopts gas laser or solid state laser or the semiconductor laser or the optical fiber laser of pulse operation mode, pulse width: 250 μ s～100ms, energy density: 5～20J/cm
2, pulse frequency:＜200Hz.
CCD photographic head (8) feeds back to master controller (10) to image that captures and spectrum all the time; display (11) shows image and the spectrum that CCD photographic head (8) captures all the time; master controller (10) is monitored image and the spectrographic variation that captures at any time; and in time laser instrument (9) is sent operational order, the output of shutdown or start or correction laser.
Foot switch (12) is connected with master controller (10), opens and closes the startup and shutdown of foot switch (12) by master controller (10) control laser instrument (9).
Image and spectrum one disappearance when lesion tissue; image and spectrum that CCD photographic head (8) will capture normal structure feed back to master controller (10); image and spectrum that master controller (10) monitors normal structure occur; immediately laser instrument (9) is sent the instruction of " shutdown " operation; laser instrument (9) is received " shutdown " operational order; before sending next pulse laser, stop to export laser, do not damage normal structure.
Adjust the cantilever (2) on the main support (1) and hang operative treatment head (3), seek the lesion tissue of operative site, the lesion tissue that hangs microsurgery adapter (6) the aligning operative site on the operative treatment head (3), master controller (10) identification, confirm the image and the spectrum of lesion tissue and normal structure, the locking lesion tissue, master controller sends operational order, laser instrument (9) start bright dipping, laser instrument (9) output treatment laser, the lesion tissue of the treatment cut of laser instrument (9) or vaporization operative site, reciprocation cycle is until the lesion tissue of eliminating operative site fully.
When the lesion tissue of eliminating operative site fully, close laser instrument (9) and stop output treatment laser; The normal structure and the lesion tissue of the image viewing operative site by hanging microexamination system (4) on the operative treatment head (3) and display (11) demonstration, after master controller (10) confirms that operative site is eliminated lesion tissue fully, cantilever (2) on the mobile main support (1) and suspension operative treatment head (3) are removed the microsurgery adapter (6) that hangs on the operative treatment head (3) from operative site.
Close master controller (10), display (11), CCD photographic head (8) and light source, operation finishes, as Fig. 1, Fig. 2, shown in Figure 5.
Foot switch (12) is connected with master controller (10), occurs the burst accident in operation, closes foot switch (12), and foot switch (12) is closed laser instrument (9) by master controller (10), and laser instrument (9) is shut down at once, stops output treatment laser;
When the burst accident finishes, open foot switch (12), laser instrument (9) state of resuming work is as Fig. 1, shown in Figure 5.
After preparing before the art, open master controller (10), display (11), light source (29) and CCD photographic head (8), open the position of 3 light source heads (24) illumination operation of light source (29) observation treatment port (22), the observation treatment end (22) of endoscope (16) enters operative region, aims at operative site.
The laser output mouth (17) of laser instrument (9) connects optical fibers, the biopsy mouth (19) of optical fibers from endoscope (16) inserted, the biopsy mouth port (28) that fibre-optic end is located until observation treatment port (22) is located bright dipping treatment focus at observation treatment port (22).
The observation treatment port (22) of endoscope (16) is aimed at operative site, the image and the spectrum that show operative site by display (11), observe the lesion tissue and the normal structure of operative site, the image and the spectrum of master controller (10) identification, affirmation lesion tissue and normal structure.
By master controller (10) revisional operation parameter, adjust the output of laser instrument (9), laser instrument (9) is prepared the start bright dipping.
The locking lesion tissue, master controller sends operational order, laser instrument (9) start bright dipping, laser instrument (9) output treatment laser, the lesion tissue of the treatment cut of laser instrument (9) or vaporization operative site, treatment is adopted gas laser or solid state laser or the semiconductor laser or the optical fiber laser of pulse operation mode, pulse width: 250 μ s～100ms, energy density: 5～20J/cm with laser
2, pulse frequency:＜200Hz.
CCD photographic head (8) feeds back to master controller (10) to image that captures and spectrum all the time; display (11) shows image and the spectrum that CCD photographic head (8) captures all the time; master controller (10) is monitored image and the spectrographic variation that captures at any time; and in time laser instrument (9) is sent operational order, the output of shutdown or start or correction laser.
The waste gas that the lesion tissue vaporization back of being performed the operation in operation process produces is discharged by pore (20) by pore port (26), and organize liquid and moisture that the position of being performed the operation in the operation process produces are discharged by water hole (21) by water hole port (27).
Image and spectrum one disappearance when lesion tissue; image and spectrum that CCD photographic head (8) will capture normal structure feed back to master controller (10); image and spectrum that master controller (10) monitors normal structure occur; immediately laser instrument (9) is sent the instruction of " shutdown " operation; laser instrument (9) is received " shutdown " operational order; before sending next pulse laser, stop to export laser, do not damage normal structure.
Adjust the observation treatment port (22) of endoscope (16), seek the lesion tissue of operative site, the observation treatment port (22) of endoscope (16) is aimed at the lesion tissue of operative site, the image and the spectrum of master controller (10) identification, affirmation lesion tissue and normal structure, the locking lesion tissue, master controller sends operational order, laser instrument (9) start bright dipping, laser instrument (9) output treatment laser, the lesion tissue of the treatment cut of laser instrument (9) or vaporization operative site, reciprocation cycle is until the lesion tissue of eliminating operative site fully.
When the lesion tissue of eliminating operative site fully, close laser instrument (9) and stop output treatment laser.
The normal structure and the lesion tissue of the image viewing operative site that shows by display (11), after master controller (10) confirms that operative site is eliminated lesion tissue fully, the observation treatment port (22) of endoscope (16) withdraws from operative site, close master controller (10), display (11), CCD photographic head (8) and light source (29), operation finishes, as Fig. 3, Fig. 4, shown in Figure 5.
Foot switch (12) is connected with master controller (10), occurs the burst accident in operation, closes foot switch (12), and foot switch (12) is closed laser instrument (9) by master controller (10), and laser instrument (9) is shut down at once, stops output treatment laser.
When the burst accident finishes, open foot switch (12), laser instrument (9) state of resuming work is as Fig. 3, shown in Figure 5.
After preparing before the art, start, the observation treatment port (22) of endoscope (16) enters nasal cavity, aim at operative site--nasal polyp, CCD photographic head (8) is caught the image and the spectrum of the lesion tissue and the normal structure of operative site immediately, the image and the spectrum of master controller (10) identification, affirmation lesion tissue and normal structure, master controller (10) is revised the surgical parameters of laser instrument (9), and laser instrument (9) is prepared bright dipping; Lock polypous lesion tissue, master controller (10) sends operational order, laser instrument (9) bright dipping, master controller (10) is monitored image and the spectrum that CCD photographic head (13) is caught the lesion tissue and the normal structure of operative site at any time, the image of lesion tissue and spectrum one disappear, and master controller (10) instructs laser instrument (9) to shut down at once; Seek polypous lesion tissue at the operative site of nasal cavity, find polypous lesion tissue at the nasal cavity operative site, the observation treatment port (22) of endoscope (16) is aimed at the lesion tissue of operative site, master controller (10) identification, confirm the image and the spectrum of lesion tissue and normal structure, the locking lesion tissue, master controller sends operational order, laser instrument (9) start bright dipping, laser instrument (9) output treatment laser, the lesion tissue of the treatment cut of laser instrument (9) or vaporization operative site, reciprocation cycle is until the lesion tissue of eliminating operative site fully.
When the lesion tissue of eliminating operative site fully, close laser instrument (9) and stop output treatment laser.The normal structure and the lesion tissue of the image viewing operative site that shows by display (11), after master controller (10) confirms that operative site is eliminated polypous lesion tissue fully, the observation treatment port (22) of endoscope (16) withdraws from nasal cavity, close master controller (10), display (11), CCD photographic head (8) and light source (29), operation finishes, as Fig. 3, Fig. 4, shown in Figure 5.
After preparing before the art, start, the observation treatment port (22) of endoscope (16) enters the oral cavity, aim at operative site-laryngeal carcinoma, CCD photographic head (8) is caught the image and the spectrum of the lesion tissue and the normal structure of operative site immediately, the image and the spectrum of master controller (10) identification, affirmation lesion tissue and normal structure, master controller (10) is revised the surgical parameters of laser instrument (9), and laser instrument (9) is prepared bright dipping; The lesion tissue of locking laryngeal carcinoma, master controller (10) sends operational order, laser instrument (9) bright dipping, master controller (10) is monitored image and the spectrum that CCD photographic head (13) is caught the lesion tissue and the normal structure of operative site at any time, the image of lesion tissue and spectrum one disappear, and master controller (10) instructs laser instrument (9) to shut down at once; Seek the lesion tissue of laryngeal carcinoma at intraoral operative site, operative site is found the lesion tissue of laryngeal carcinoma in the oral cavity, the observation treatment port (22) of endoscope (16) is aimed at the lesion tissue of operative site, master controller (10) identification, confirm the image and the spectrum of lesion tissue and normal structure, the lesion tissue of locking laryngeal carcinoma, master controller sends operational order, laser instrument (9) start bright dipping, laser instrument (9) output treatment laser, the lesion tissue of the treatment cut of laser instrument (9) or vaporization operative site, reciprocation cycle is until the laryngeal carcinoma lesion tissue of eliminating operative site fully.
When the lesion tissue of eliminating operative site fully, close laser instrument (9) and stop output treatment laser.The normal structure and the lesion tissue of the image viewing operative site that shows by display (11), after master controller (10) confirms that operative site is eliminated the lesion tissue of laryngeal carcinoma fully, the observation treatment port (22) of endoscope (16) withdraws from the oral cavity, close master controller (10), display (11), CCD photographic head (8) and light source (29), operation finishes, as Fig. 3, Fig. 4, shown in Figure 5.
After preparing before the art, start, the observation treatment port (22) of endoscope (16) enters esophagus from the oral cavity, aim at operative site-esophageal carcinoma, CCD photographic head (8) is caught the image and the spectrum of the lesion tissue and the normal structure of operative site immediately, the image and the spectrum of master controller (10) identification, affirmation lesion tissue and normal structure, master controller (10) is revised the surgical parameters of laser instrument (9), and laser instrument (9) is prepared bright dipping; The lesion tissue of locking esophageal carcinoma, master controller (10) sends operational order, laser instrument (9) bright dipping, master controller (10) is monitored image and the spectrum that CCD photographic head (13) is caught the lesion tissue and the normal structure of operative site at any time, the image of lesion tissue and spectrum one disappear, and master controller (10) instructs laser instrument (9) to shut down at once; Seek the lesion tissue of esophageal carcinoma at intraesophageal operative site, operative site is found the lesion tissue of esophageal carcinoma in esophagus, the observation treatment port (22) of endoscope (16) is aimed at the lesion tissue of operative site, master controller (10) identification, confirm the image and the spectrum of lesion tissue and normal structure, the lesion tissue of locking esophageal carcinoma, master controller sends operational order, laser instrument (9) start bright dipping, laser instrument (9) output treatment laser, the lesion tissue of the treatment cut of laser instrument (9) or vaporization operative site, reciprocation cycle is until the esophageal carcinoma lesion tissue of eliminating operative site fully.
When the lesion tissue of eliminating operative site fully, close laser instrument (9) and stop output treatment laser.The normal structure and the lesion tissue of the image viewing operative site that shows by display (11), after master controller (10) confirms that operative site is eliminated the lesion tissue of esophageal carcinoma fully, the observation treatment port (22) of endoscope (16) withdraws from the oral cavity, close master controller (10), display (11), CCD photographic head (8) and light source (29), operation finishes, as Fig. 3, Fig. 4, shown in Figure 5.
After preparing before the art, start, the observation treatment port (22) of endoscope (16) enters stomach from the oral cavity by esophagus, aim at operative site-gastric cancer, CCD photographic head (8) is caught the image and the spectrum of the lesion tissue and the normal structure of operative site immediately, the image and the spectrum of master controller (10) identification, affirmation lesion tissue and normal structure, master controller (10) is revised the surgical parameters of laser instrument (9), and laser instrument (9) is prepared bright dipping; The lesion tissue of locking gastric cancer, master controller (10) sends operational order, laser instrument (9) bright dipping, master controller (10) is monitored image and the spectrum that CCD photographic head (13) is caught the lesion tissue and the normal structure of operative site at any time, the image of lesion tissue and spectrum one disappear, and master controller (10) instructs laser instrument (9) to shut down at once; Seek the lesion tissue of gastric cancer at the operative site of gastric, find the lesion tissue of gastric cancer at the gastric operative site, the observation treatment port (22) of endoscope (16) is aimed at the lesion tissue of operative site, master controller (10) identification, confirm the image and the spectrum of lesion tissue and normal structure, the lesion tissue of locking gastric cancer, master controller sends operational order, laser instrument (9) start bright dipping, laser instrument (9) output treatment laser, the lesion tissue of the treatment cut of laser instrument (9) or vaporization operative site, reciprocation cycle is until the gastric cancer lesion tissue of eliminating operative site fully.
When the lesion tissue of eliminating operative site fully, close laser instrument (9) and stop output treatment laser.The normal structure and the lesion tissue of the image viewing operative site that shows by display (11), after master controller (10) confirms that operative site is eliminated the lesion tissue of gastric cancer fully, the observation treatment port (22) of endoscope (16) withdraws from the oral cavity, close master controller (10), display (11), CCD photographic head (8) and light source (29), operation finishes, as Fig. 3, Fig. 4, shown in Figure 5.
After preparing before the art, start, the observation treatment port (22) of endoscope (16) enters rectum from anus, aim at operative site-rectal polyp, CCD photographic head (8) is caught the image and the spectrum of the lesion tissue and the normal structure of operative site immediately, the image and the spectrum of master controller (10) identification, affirmation lesion tissue and normal structure, master controller (10) is revised the surgical parameters of laser instrument (9), and laser instrument (9) is prepared bright dipping; The lesion tissue of locking rectal polyp, master controller (10) sends operational order, laser instrument (9) bright dipping, master controller (10) is monitored image and the spectrum that CCD photographic head (13) is caught the lesion tissue and the normal structure of operative site at any time, the image of lesion tissue and spectrum one disappear, and master controller (10) instructs laser instrument (9) to shut down at once; Seek the lesion tissue of rectal polyp at intrarectal operative site, find the lesion tissue of rectal polyp cancer at the internal rectum operative site, the observation treatment port (22) of endoscope (16) is aimed at the lesion tissue of operative site, master controller (10) identification, confirm the image and the spectrum of lesion tissue and normal structure, the lesion tissue of locking rectal polyp, master controller sends operational order, laser instrument (9) start bright dipping, laser instrument (9) output treatment laser, the lesion tissue of the treatment cut of laser instrument (9) or vaporization operative site, reciprocation cycle is until the rectal polyp lesion tissue of eliminating operative site fully.
When the lesion tissue of eliminating operative site fully, close laser instrument (9) and stop output treatment laser.The normal structure and the lesion tissue of the image viewing operative site that shows by display (11), after master controller (10) confirms that operative site is eliminated the lesion tissue of rectal polyp fully, the observation treatment port (22) of endoscope (16) withdraws from anus, close master controller (10), display (11), CCD photographic head (8) and light source (29), operation finishes, as Fig. 3, Fig. 4, shown in Figure 5.
Claims (1)
1. automatic control laser operation equipment, it is characterized in that forming by master controller (10), display (11), image collecting joint (25), laser instrument (9), light source (29) and endoscope (16), display (11) is connected with the display connection port (33) of master controller (10), adopt display screen or touch screen display (11) as master controller (10), display (11) instant playback CCD photographic head (8) lesion tissue of being gathered and the image of normal structure and spectrum, display (11) is gone up and is shown surgical parameters simultaneously; The top of endoscope (16) is provided with biopsy mouth (19), pore (20), water hole (21), light source interface (7) and endoscope's FPDP (23), biopsy mouth (19), pore (20), water hole (21) and light source interface (7) are connected to observation treatment end (22) by the top of endoscope (16), constitute biopsy mouth port (28) in observation treatment end (22), pore port (26), water hole port (27) and light source head (24), discharged by pore (20) by pore port (26) by the waste gas that produces behind the surgical lesion tissue vaporization, organize liquid and the moisture that are produced by operative site in the operation process are discharged by water hole (21) by water hole port (27), the light source output port (30) of light source (29) is transferred to the light source head (24) of observation treatment port (22) by fibre bundle by the light source interface (7) of endoscope (16), on the observation treatment port (22) 3 light source heads (24) are set at least, the position of light source head (24) illumination operation; The figure collection head (25) of CCD photographic head (8) is set in the observation treatment end (22) of endoscope (16), endoscope's FPDP (23) that endoscope (16) top is provided with is connected with the data message interface (32) of master controller (10) by circuit and is connected with the image card of master controller (1), the figure collection head of CCD photographic head (8) is gathered the image and the spectrum of lesion tissue and normal structure, the lesion tissue that master controller (10) identification and processing CCD photographic head (8) are gathered and the image and the spectrum of normal structure, and the operation of correspondingly sending instruction control laser instrument (9), avoid the maloperation damage normal structure of laser surgery to cause the error of performing the operation; The laser output mouth (17) of laser instrument (9) connects optical fibers, the biopsy mouth (19) of optical fibers from endoscope (16) inserted, the biopsy mouth port (28) that fibre-optic end is located until observation treatment port (22), transmission treatment laser, treatment is adopted gas laser or solid state laser or the semiconductor laser or the optical fiber laser of pulse operation mode, pulse CO with laser instrument
2Laser, pulse width: 250 μ s～100ms, energy density: 5～20J/cm
2, pulse frequency:＜200Hz; The laser controlling connectivity port (18) of laser instrument (9) is connected with the control laser instrument connectivity port (31) of master controller (10) by circuit, and master controller (10) sends start, the shutdown of instruction control laser instrument (9) and revises the laser output; Foot switch (12) is connected with master controller (10), keying foot switch (12) is manually controlled the startup of laser instrument (9) by master controller (10) and is closed, the accident that occurs happening suddenly in operation is closed foot switch (12) and is closed laser instrument (9) at once, the burst accident finishes to open foot switch (12), the state of resuming work.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN2009103128468A CN101849868B (en) | 2008-12-26 | 2008-12-26 | Self-control laser surgical equipment |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN2009103128468A CN101849868B (en) | 2008-12-26 | 2008-12-26 | Self-control laser surgical equipment |
Related Parent Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN200810154587A Division CN100594009C (en) | 2008-12-26 | 2008-12-26 | Self-controlled laser surgery equipment |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN101849868A CN101849868A (en) | 2010-10-06 |
| CN101849868B true CN101849868B (en) | 2011-11-23 |
Family
ID=42801675
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN2009103128468A Active CN101849868B (en) | 2008-12-26 | 2008-12-26 | Self-control laser surgical equipment |
Country Status (1)
| Country | Link |
|---|---|
| CN (1) | CN101849868B (en) |
Families Citing this family (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN103431941B (en) * | 2013-05-27 | 2015-02-04 | 宋艳萍 | Macular sparing control method and control system for ophthalmic laser treatment equipment |
| CN115381506A (en) | 2014-08-23 | 2022-11-25 | 直观外科手术操作公司 | System and method for dynamic trajectory control |
| CN104161590A (en) * | 2014-09-10 | 2014-11-26 | 山东省药物研究院 | Multi-wavelength laser endoscope device |
| CN104814828B (en) * | 2015-05-21 | 2017-05-31 | 中国科学院光电研究院 | Determine the fs-laser system and method for laser focal position in cornea tissue |
| CN106175942A (en) * | 2016-07-30 | 2016-12-07 | 杨超坤 | Automatic control laser operation equipment |
Citations (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO1997017903A1 (en) * | 1995-11-13 | 1997-05-22 | Gabriel Simon | Laser beam ophthalmological surgery method and apparatus |
| CN1579351A (en) * | 2003-08-07 | 2005-02-16 | 天津医科大学 | Automatic-controlled laser operation machine for glaucoma filtration operation |
| CN101125232A (en) * | 2006-08-17 | 2008-02-20 | 深圳市雷迈科技有限公司 | Semiconductor laser power therapeutic device |
| WO2008087483A1 (en) * | 2007-01-19 | 2008-07-24 | Technolas Perfect Vision Gmbh | System and method for precise beam positioning in ocular surgery |
-
2008
- 2008-12-26 CN CN2009103128468A patent/CN101849868B/en active Active
Patent Citations (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO1997017903A1 (en) * | 1995-11-13 | 1997-05-22 | Gabriel Simon | Laser beam ophthalmological surgery method and apparatus |
| CN1579351A (en) * | 2003-08-07 | 2005-02-16 | 天津医科大学 | Automatic-controlled laser operation machine for glaucoma filtration operation |
| CN101125232A (en) * | 2006-08-17 | 2008-02-20 | 深圳市雷迈科技有限公司 | Semiconductor laser power therapeutic device |
| WO2008087483A1 (en) * | 2007-01-19 | 2008-07-24 | Technolas Perfect Vision Gmbh | System and method for precise beam positioning in ocular surgery |
Also Published As
| Publication number | Publication date |
|---|---|
| CN101849868A (en) | 2010-10-06 |
Similar Documents
| Publication | Publication Date | Title |
|---|---|---|
| CN100594009C (en) | Self-controlled laser surgery equipment | |
| US20210298955A1 (en) | Compact reconfigurable integrated laser-phaco systems and methods of use | |
| US20100134759A1 (en) | Digital imaging system for eye procedures | |
| CN101849868B (en) | Self-control laser surgical equipment | |
| WO2019135130A1 (en) | Multiple illumination transmission through optical fiber | |
| JP2014523301A (en) | Apparatus and method for eye surgery | |
| AU2010259247A1 (en) | Ophthalmic endoillumination using low-power laser light | |
| EP3962423A1 (en) | Medical ophthalmic device | |
| JP2009297073A (en) | Surgical microscope | |
| CN201320219Y (en) | Self-controlling laser surgical equipment | |
| WO2020227210A1 (en) | Near-infrared illumination for surgical procedure | |
| McIntyre | Phototoxicity: The Eclipse Fitter | |
| TWI834039B (en) | Patient interface devices, methods, and systems for combined sonic and laser applications for the eye | |
| KR102146087B1 (en) | digital microscope of contact type for ophthalmology | |
| Sheindlin et al. | Ophthalmic endoscopy: applications in intraocular surgery | |
| US20230346600A1 (en) | Hybrid 2-port vitrectomy and combined treatment and infusion probe | |
| CN220360492U (en) | Temperature monitoring system for ophthalmic surgery | |
| US20230165715A1 (en) | Intraocular cyclophotocoagulation device and methods of use | |
| Rao et al. | Indirect micro-ophthalmoscopy: intraoperative binocular indirect ophthalmoscopy with the operating microscope | |
| TW202344232A (en) | Methods and systems for combined sonic and laser applications for the eye | |
| TW202227026A (en) | Methods and systems for combined sonic and laser applications for the eye | |
| Prasad et al. | Microsurgical Techniques in Ophthalmology–Current Procedures and Future Directions | |
| JPS6324926A (en) | Optical fiber type endoscope |
Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| C06 | Publication | ||
| PB01 | Publication | ||
| C10 | Entry into substantive examination | ||
| SE01 | Entry into force of request for substantive examination | ||
| C14 | Grant of patent or utility model | ||
| GR01 | Patent grant | ||
| ASS | Succession or assignment of patent right |
Owner name: CHINA MEDICAL (TIANJIN) MEDICAL SCIENCE + TECHNOLO Free format text: FORMER OWNER: TIANJIN MEDICAL UNIVERSITY Effective date: 20150119 |
|
| C41 | Transfer of patent application or patent right or utility model | ||
| COR | Change of bibliographic data |
Free format text: CORRECT: ADDRESS; FROM: 300070 TO: 300300 |
|
| TR01 | Transfer of patent right |
Effective date of registration: 20150119 Address after: 300300 Tianjin City five Dongli Development Zone Dongli Road No. 8 Patentee after: Chinese medicine branch (Tianjin) Medical Technology Group Limited Address before: 300070 Heping District, Tianjin Meteorological Observatory Road No. 22 Patentee before: Tianjin Medical University |