DE102014101468B4 - Lighting unit for minimally invasive surgeries - Google Patents

Abstract

lighting unit (10) for minimally invasive operations,
having distal and proximal ends (12, 14), and
with a shaft (19) connecting the distal and proximal ends (12, 14) and comprising a receiving opening (20) for at least partially receiving a surgical instrument (50),
wherein at least one lighting element (16, 18) for emitting light (30, 32) for illuminating an operation area is arranged on the distal end (14),
a fastening unit (22) for detachably fastening the lighting unit (10) to a surgical instrument (50) being provided at the proximal end (12), and
wherein the fastening unit (22) is designed in the form of a clamping unit which can be clamped using a union nut.

Description

The invention relates to an illumination unit for minimally invasive operations, which has a distal end and a proximal end as well as a shaft connecting the distal end and the proximal end. Furthermore, the invention relates to an arrangement of a surgical instrument and such a lighting unit.

In the case of minimally invasive operations, it is common for an illumination unit to be integrated in the endoscope, which is used to view the operation site, so that the operation field is illuminated. This ensures that the objects in the field of view of the endoscope are sufficiently illuminated. However, the light source and the camera of the endoscope are arranged close to each other, so that the recorded image has relatively few shadows and is therefore low in contrast. This has the disadvantage that spatial orientation is made more difficult for the viewer due to the lack of shadows. However, it is important to clearly see the tip of surgical instruments in particular relative to surrounding organs in order to avoid accidental perforation of organs and vessels.

In order to achieve a higher contrast, another method uses a separate instrument for the illumination, so that the distance between the endoscope and the light source is increased and the shadows cast more clearly. However, this has the disadvantage that another instrument has to be introduced, which has to be handled in a correspondingly complicated and laborious manner.

From the document JP 2013-000 308 A discloses a lighting unit that can be slipped onto the shaft of a surgical instrument. The lighting unit includes a front lighting element and a side lighting element, which can be controlled via an external control unit.

Further lighting units for surgical instruments are from the documents JP 2000-245 689 A , JP H08-98 799 A , DE 43 06 553 A1 , US 2009/0 030 275 A1 and US 2009/0 281 478 A1 famous.

The document DE 20 2013 104 278 U1 describes an otoscope with an illuminant ring element. From the document EP 1 854 399 A1 an endoscopic or minimally invasive instrument with a laser-supported light pointer device is known.

It is the object of the invention to specify a lighting unit for microinvasive operations that is easy to handle and enables sufficient shadows to be cast in the operation area.

This object is achieved by a lighting unit having the features of claim 1. Advantageous developments of the invention are specified in the dependent claims.

According to the invention, the shank has a receiving opening which is designed in such a way that a surgical instrument can be at least partially received in it. At least one lighting element for emitting light to illuminate an operating area is provided at the distal end of the lighting unit.

The lighting unit can easily be slipped onto a surgical instrument through the receiving opening. This has the advantage that, on the one hand, it is arranged at a distance from the endoscope during the operation and thus ensures that a sufficient shadow is cast, but on the other hand it can be handled together with the surgical instrument and therefore does not have to be held separately. In this way, the advantages of being easy to handle and yet having sufficient shadow formation are combined with one another in a simple manner. By putting it on the surgical instrument, the advantage is also achieved that the area in which the surgical instrument is being worked is optimally illuminated at all times, and thus errors during the operation due to a lack of optical images are avoided.

The receiving opening is in particular designed in such a way that the lighting unit can be slipped over a shaft of a surgical instrument. For this purpose, the receiving opening is preferably designed as a through opening, which is shaped in such a way that when the lighting unit is placed over a surgical instrument, the distal end of the surgical instrument emerges from the distal end of the lighting unit and the proximal end of the surgical instrument emerges from the proximal end of the Lighting unit protrude. The result of this is that the lighting unit can be arranged in a simple manner on various surgical instruments and can therefore be used universally.

In this case, the tip of the surgical instrument in particular protrudes from the distal end of the lighting unit, so that the function of the surgical instrument during the operation is undisturbed by the protruding tip can be practiced. In particular, the handle of the surgical instrument protrudes from the proximal end of the lighting unit, so that the surgical instrument or the lighting unit arranged on it can be handled easily. The lighting unit is slipped onto the shaft of the surgical instrument, in particular from the distal end.

The shaft of the lighting unit is in particular cylindrical, preferably hollow-cylindrical. The result of this is that the lighting unit can easily be slipped onto all common minimally invasive surgical instruments, which always also have a long cylindrical shaft for minimally invasive operations. Thus, the lighting unit can be used universally.

In particular, a coupling element for coupling a light source is provided at the proximal end of the lighting unit, with a light guide for guiding the light from the proximal end, ie from the coupling unit, to the lighting element at the distal end being provided. In an advantageous embodiment of the invention, the lighting unit itself can also include the light source, so that then no coupling unit has to be provided for coupling an external light source. The light guide is designed in particular in the form of a glass fiber bundle and preferably runs within the wall of the shaft, so that the light guide is correspondingly protected by the wall.

Furthermore, it is advantageous if a plug connector for connecting an electrical energy source is provided at the proximal end, so that the lighting unit can be supplied with energy in a simple manner. Alternatively, the lighting unit can also have its own electrical energy source, for example in the form of an accumulator or a battery.

In a preferred embodiment, a plurality of lighting elements for emitting light for illuminating an operation area are arranged at the distal end of the lighting unit. The result of this is that the operation area can be optimally illuminated, for example by the light emitted by different illumination elements being shaped differently, having different wavelengths or being directed to different areas.

The lighting elements can be arranged at the tip of the lighting unit and/or on its radial circumference. The lighting elements can preferably be designed as exit pupils.

In particular, the lighting elements can be selectively activated or deactivated, with activation being possible in any desired combination, so that the best possible adaptability to the respective operating conditions is achieved.

Furthermore, an operating unit for controlling the lighting element or lighting elements can be provided at the proximal end of the lighting unit. In particular, the lighting elements can be selectively activated and deactivated via the operating unit of the lighting elements. Furthermore, for example, the illuminance can be adjusted via the operating unit. In addition or as an alternative, the lighting can also be modulated in terms of time and/or the intensity of the lighting can be modulated via the operating unit. The lighting can thus be precisely adapted to the individual situation, so that the operating area can be illuminated as precisely as possible. For example, patterns can also be projected onto organs in order to be able to orient oneself better relative to them.

The operating unit can include at least one button, at least one toggle switch and/or at least one switching element.

Furthermore, several light guides can be provided for guiding light from the proximal end, in particular from a coupling element for coupling a light source, to several light elements arranged at the distal end, with the operating unit being able to control into which light guide or light guides light is introduced . It can thus be set in a simple manner by introducing it into the corresponding light guide via which lighting elements light is emitted at the distal end, so that no additional switching elements have to be provided here.

Furthermore, it is advantageous if the lighting unit has a switching element for automatically activating the lighting unit when a surgical instrument is inserted into the receiving opening. In this case, this switching element is used in particular to detect when a surgical instrument is inserted, with the lighting unit being activated automatically when a corresponding detection is made. In this case, for example, a button can be provided which is actuated mechanically by the shaft of the surgical instrument when it is inserted into the receiving opening of the lighting unit.

According to the invention, a fastening unit for fastening the lighting unit to a surgical instrument in a detachable and recoverable manner is provided at the proximal end. The result of this is that the relative orientation between the lighting unit and the surgical instrument can be set in a fixed manner in a simple manner and the lighting unit therefore does not have to be held manually during the operation.

The attachment is designed in the form of a clamping unit that can be tightened using a union nut and thus clamped.

The invention also relates to an arrangement of a surgical instrument and a lighting unit as described above, the lighting unit being slipped over a shaft of the surgical instrument so that the shaft of the surgical instrument is accommodated in the receiving opening of the lighting unit.

Further features and advantages of the invention result from the following description, which explains the invention in more detail using exemplary embodiments together with the attached figures.

• 1 eine schematische, perspektivische Darstellung einer Beleuchtungseinheit;
• 2 eine schematische, perspektivische Darstellung eines Ausschnitts der Beleuchtungseinheit nach 1;
• 3 eine schematische, perspektivische Darstellung eines chirurgischen Instrumentes zur minimalinvasiven Operation;
• 4 eine Anordnung aus der Beleuchtungseinheit nach 1 und des chirurgischen Instrumentes nach 3;
• 5 eine schematische, perspektivische Darstellung eines Ausschnitts der Anordnung nach 4;
• 6 eine schematische, perspektivische Darstellung der Anordnung nach 4 in einem ersten Betriebszustand;
• 7 eine schematische, perspektivische Darstellung der Anordnung nach 4 in einem zweiten Betriebszustand;
• 8 eine schematische, perspektivische Darstellung der Anordnung nach 4 in einem dritten Betriebszustand;
• 9 eine schematische, perspektivische Darstellung der Anordnung nach 4 in einem vierten Betriebszustand;
• 10 eine schematische, perspektivische Darstellung der Anordnung nach 4 in einem fünften Betriebszustand;
• 11 eine Detailansicht der Anordnung nach 10.

Show it:

• 1 a schematic perspective view of a lighting unit;
• 2 a schematic perspective view of a section of the lighting unit 1 ;
• 3 a schematic perspective view of a surgical instrument for minimally invasive surgery;
• 4 an arrangement of the lighting unit 1 and the surgical instrument 3 ;
• 5 a schematic perspective view of a section of the arrangement 4 ;
• 6 a schematic perspective view of the arrangement 4 in a first operating condition;
• 7 a schematic perspective view of the arrangement 4 in a second operating condition;
• 8th a schematic perspective view of the arrangement 4 in a third operating condition;
• 9 a schematic perspective view of the arrangement 4 in a fourth operating condition;
• 10 a schematic perspective view of the arrangement 4 in a fifth operating condition;
• 11 a detailed view of the arrangement 10 .

In 1 a schematic, perspective view of a lighting unit 10 is shown. 2 12 shows an enlarged section of the proximal end 12 of the lighting unit 10. FIG 1 . A plurality of lighting elements are arranged at the distal end 14 of the lighting unit 10 for emitting light to illuminate an operating area, with some of these lighting elements being arranged on the front side and denoted by reference numeral 16 and another part of these lighting elements being arranged on the radial circumference and connected to the Reference numeral 18 is designated.

The lighting unit 10 has a shaft 19 which connects the proximal end 12 to the distal end 14 and which is in particular designed as a hollow cylinder, that is to say tubular. A receiving opening 20 in the form of a through-opening is formed by the hollow-cylindrical design. This receiving opening 20 is shaped in such a way that a shaft 52 of a surgical instrument 50 ( 3 ) can be accommodated in it, so that the lighting unit 10 can simply be slipped over this shaft 52 .

In 4 a schematic perspective view of the arrangement 100 is shown, which results when the lighting unit 10 is slipped over the shaft 52 of the surgical instrument 50 . In this case, the tip 54 of the surgical instrument 50 protrudes from the distal end 14 of the lighting unit 16 . Conversely, the handle 56 of the surgical instrument 50 protrudes from the proximal end 12, so that the lighting unit 10 is arranged exclusively in the area of the shaft 52 and does not interfere with the actual handling of the surgical instrument 50. In 5 An enlarged representation of a section of the arrangement 10 is shown, in which the handle 56 and part of the turned-on lighting unit 10 are shown.

At its proximal end 12, the lighting unit 10 has a fastening unit 22 designed as a clamping unit, which can be fixed and released by turning a union nut 24, so that the lighting unit 10 can thus be easily and detachably fastened to the surgical instrument 50.

In addition, the lighting unit 10 has a coupling element (not shown) on the proximal end 12 for coupling a light source a light guide, for example a glass fiber bundle, is arranged in the wall of the shaft 19, through which the light introduced at the proximal end 12 is guided to the lighting elements 16, 18 arranged at the distal end 14, so that it can be emitted by them.

In an alternative embodiment, a separate light source can also be provided in the lighting unit 10 .

In addition, a plug, also not visible in the figures, is provided at the proximal end 12 for connecting an electrical energy source. Alternatively or additionally, the lighting unit 10 can also have its own energy source, e.g. a battery or an accumulator.

The emission of light via the lighting elements 16 , 18 can be controlled via an operating unit 26 provided at the proximal end 12 . In particular, individual lighting elements 16, 18 can be activated and deactivated here, so that different forms of lighting can be set, as is the case in connection with the 6 until 11 is shown.

At the in 6 First operating state shown, lighting elements 18 arranged on the peripheral surface generate illumination 30 on the other side.

At the in 7 On the other hand, a conical illumination 32 directed forwards is achieved via illumination elements 16 arranged on the end face, by means of which an operation area in particular can be well illuminated.

At the in 8th The third operating state shown, the illumination is again generated by lighting elements 18 arranged on the peripheral surface, but, in contrast to the first operating state 6 , only in one segment, i.e. radiated in one direction.

In 9 a fourth operating state is shown, in which punctiform illumination is emitted forwards, by means of which something can be marked or indicated during an operation, for example.

At the in the 10 and 11 In the operating states shown, the light is emitted in the form of line lasers, so that corresponding patterns can be formed on organs.

In addition to activating and deactivating individual lighting elements 16, 18, the operating unit 26 can also be used, for example, to set the illuminance or the intensity of the lighting. Furthermore, the lighting can be modulated over time.

In addition, the lighting unit 10 can have a switching element (not visible in the figures) via which the insertion of the shaft 52 of the surgical instrument into the receiving opening 10 is detected, with the lighting being activated automatically if a corresponding detection is made.

The lighting unit 10 described above has the advantage that it does not have to be handled as a separate instrument during the operation, but can be handled together with the actual surgical instrument 50 . Thus, a particularly simple operation is possible. In particular, arranging the operating element 26 at the proximal end in the vicinity of the handle 56 allows easy adjustment of the individual operating states at any time.

In addition, arranging the lighting unit on the surgical instrument 50 has the advantage that there is as great a distance as possible between it and an endoscope, via which images are recorded during the operation, so that a sufficient shadow is cast and thus the relative position between the surgical instrument 50 and organs or vessels can be assessed.

In addition, the placement of the lighting elements 16, 18 in the vicinity of the tip 54 of the surgical instrument serves to ensure that the operating area is always well illuminated. Furthermore, patterns can be projected onto organs, which enable better recognition.

Furthermore, the lighting unit 10 has the advantage that it can easily be attached temporarily to different surgical instruments 50 so that it can be used universally.

• Zum einen kann der Chirurg durch das Beleuchten der Umgebung Strukturen deutlicher erkennen, so dass die Gefahr von Perforationen von Gefäßen oder Organen reduziert wird, da man den Abstand zu den umgebenden Organen bzw. Gefäßen besser abschätzen kann.

Furthermore, the following advantages are achieved by the lighting unit 10:

• On the one hand, the surgeon can see structures more clearly by illuminating the surroundings, so that the risk of perforations of vessels or organs is reduced, since the distance to the surrounding organs or vessels can be better estimated.

Furthermore, the surgeon can create shadows through additional lighting and thus generate more spatial information. So he is not only rely on the size of the instruments as an aid to estimating dimensions.

Furthermore, the lighting unit 10 enables the surgeon to contact z. B. with a light spot similar to a laser pointer to point to certain areas in order to be able to communicate better with his assistant. In particular, this prevents misunderstandings.

In addition, radiation that is not visible to the human eye can be emitted via the lighting unit 10, through which the contrast in the video image is significantly artificially increased by a sensitivity of the optical sensors in the spectral range on the screen that is invisible to the human eye.

The device can also be designed as a disposable product, so that no complex disinfection and cleaning measures are necessary and the greatest possible level of hygiene is achieved.

In particular, a sealing lip for sealing the area between the lighting unit 10 and the shaft 52 of the surgical instrument 50 is provided at the distal end of the lighting unit 10 . This ensures that no body fluid and/or dirt can impair the properties.

Reference List

10

lighting unit

12

proximal end

14

distal end

16, 18

lighting element

19

shaft

20

intake opening

22

fastening unit

24

union nut

26

operating unit

30, 32

lighting

50

surgical instrument

52

shaft

54

Top

56

Handle

100

arrangement

Claims (15)

lighting unit (10) for minimally invasive operations, having distal and proximal ends (12, 14), and with a shaft (19) connecting the distal and proximal ends (12, 14) and comprising a receiving opening (20) for at least partially receiving a surgical instrument (50), wherein at least one lighting element (16, 18) for emitting light (30, 32) for illuminating an operation area is arranged on the distal end (14), a fastening unit (22) for detachably fastening the lighting unit (10) to a surgical instrument (50) being provided at the proximal end (12), and wherein the fastening unit (22) is designed in the form of a clamping unit which can be clamped using a union nut. Lighting unit (10) after claim 1 , characterized in that the receiving opening (20) is designed such that the lighting unit can be slipped over a shaft (52) of a surgical instrument (50). Lighting unit (10) after claim 1 or 2 , characterized in that the receiving opening (20) is a through opening which is designed in such a way that when the lighting unit (16, 18) is placed over a surgical instrument (50), the distal end (54) of the surgical instrument (50 ) from the distal end (14) of the lighting unit (10) and the proximal end (56) of the surgical instrument (50) from the proximal end (14) of the lighting unit (10) protrude. Lighting unit (10) according to one of the preceding claims, characterized in that the shaft (19) is cylindrical, in particular hollow-cylindrical. Lighting unit (10) according to one of the preceding claims, characterized in that a coupling unit for coupling a light source is provided at the proximal end (12), and that a light guide for guiding the light from the proximal end (12) to the lighting element (16, 18) is provided. Lighting unit (10) after claim 5 , characterized in that the light guide runs within the wall of the shaft (19). Lighting unit (10) according to one of the preceding claims, characterized in that a plug connector for connecting an electrical voltage source is arranged at the proximal end (12). Lighting unit (10) according to one of the preceding claims, characterized in that a plurality of lighting elements (16, 18) for emitting light (30, 32) for illuminating an operation area are arranged at the distal end (14). Lighting unit (10) after claim 8 , characterized in that the lighting elements (16, 18) can be selectively activated and deactivated individually. Lighting unit (10) according to one of the preceding claims, characterized in that an operating unit (26) for controlling the lighting element or lighting elements (16, 18) is provided at the proximal end (12). Lighting unit (10) after claim 10 , characterized in that the lighting element or lighting elements (16, 18) can be activated and deactivated using the operating unit (26), the illuminance can be adjusted, the lighting can be modulated over time and/or the intensity of the lighting can be modulated. Lighting unit (10) after claim 11 , characterized in that the operating unit (26) comprises at least one button, a toggle switch and / or a switching element. Lighting unit (10) after claim 11 or 12 , characterized in that a plurality of light guides are provided for guiding light from the proximal end (12) to a plurality of lighting elements (16, 18) arranged at the distal end (14), and that the operating unit (26) can be used to control in which light guide or which light guide light is introduced. Lighting unit (10) according to one of the preceding claims, characterized in that a switching element is provided for automatically activating the lighting unit (10) when a surgical instrument is inserted into the receiving opening (20). Arrangement (100), with a minimally invasive surgical instrument (50), and with a lighting unit (10) according to one of Claims 1 until 14 , The lighting unit (10) being slipped over a shaft (52) of the surgical instrument (50), so that this shaft (52) is accommodated in the receiving opening (20).

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