DE3143421A1 - "laser-skalpell" - Google Patents
"laser-skalpell"Info
- Publication number
- DE3143421A1 DE3143421A1 DE19813143421 DE3143421A DE3143421A1 DE 3143421 A1 DE3143421 A1 DE 3143421A1 DE 19813143421 DE19813143421 DE 19813143421 DE 3143421 A DE3143421 A DE 3143421A DE 3143421 A1 DE3143421 A1 DE 3143421A1
- Authority
- DE
- Germany
- Prior art keywords
- laser
- output power
- switch
- laser scalpel
- handpiece
- 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.)
- Granted
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
- A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
- A61B18/22—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
- A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00636—Sensing and controlling the application of energy
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00636—Sensing and controlling the application of energy
- A61B2018/00696—Controlled or regulated parameters
- A61B2018/00702—Power or energy
- A61B2018/00708—Power or energy switching the power on or off
Landscapes
- Health & Medical Sciences (AREA)
- Surgery (AREA)
- Physics & Mathematics (AREA)
- Life Sciences & Earth Sciences (AREA)
- Engineering & Computer Science (AREA)
- Medical Informatics (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Electromagnetism (AREA)
- Optics & Photonics (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Otolaryngology (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Laser Surgery Devices (AREA)
Description
- BESCHREIBUNG
- Die Erfindung bezieht sich auf ein Laser-Skalpell mit einem in bezug auf seine Ausgangsleistung veränderbaren Laser-Generator.
- Bei der Verwendung eines Laser-Skalpells bei einem chirurgischen Eingriff wird die Stärke oder Abgabeleistung des Laserstrahls je #nach Art des Eingriffs, der Tiefe des Operationsfeldes u. dgl.
- ausgewählt. Zu diesem Zweck wird üblicherweise vor dem Beginn einer Operation an einem Steuergerät die gewünschte Ausgangsleistung eines Laser-Oszillators bzw. Laser-Generators eingestellt.
- Häufig ergibt sich während einer Operation die Notwendigkeit, die eingestellte Ausgangsleistung zu ändern. In jedem dieser Fälle muß der operierende Arzt erst mittels eines Fuß schalters o. dgl. die Gerätestromversorgung unterbrechen und dann eigenhändig oder durch eine Hilfskraft am Steuergerät die notwendigen Neueinstellungen bzw. Anderungen vornehmen. Dieser Umstand des herkömmlichen Systems führt zu verlängerten Operationszeiten, denn jede Anderung der Laser-Ausgangsleistung ist mit einer Unterbrechung des Operationsvorgangs verbunden. Ein noch schwerwiegenderer weil mit Gefahren für den Patienten verbundener Nachteil des bekannten Systems besteht darin, daß die Laserstrahl-Abgabeleistung, die ein äußerst kritischer Wert sein kann und oft bis auf wenige % oder sogar Zehntel-% eingehalten werden muß, durch Unerfahrenheit des Operateurs oder der ausführenden Hilfskraft und/oder Zeitmangel falsch eingestellt wird. Derartige Fehler können schwerwiegende Folgen haben.
- Der Erfindung liegt die Aufgabe zugrunde, ein besseres Laser-Skalpell zu schaffen, mit dessen Verwendung die genannten Nachteile und Gefahren vermieden werden können.
- Die erfindungsgemäße Lösung der gestellten Aufgabe ist kurz gefaßt im Patentanspruch 1 angegeben.
- Vorteilhafte Weiterbildungen des Erfindungsgedankens enthalten der folgende Beschreibungsteil und die Unteransprüche.
- Der Grundgedanke der Erfindung geht dahin, not':ndige Änderungen der Laserstrahl-Abgabeleistung a) nur innerhalb für die Sicherheit unbedenklicher Grenzen relativ zu einem vorher eingestellten Soll-Leistungswert und b) mittels einer dem Operierenden jederzeit leicht zugänglichen Schalteinrichtung an einem in seiner Hand befindlichen Operations- und Bedienungsteil, aus dem der Laserstrahl auf das Operationsfeld abgegeben wird, durchzuführen.
- So können Laser-Leistungsändrungen durch Fingerdruck sicher und ohne Unterbrechung der Operation vorgenommen werden.
- Nachstehend werden einige bevorzugte Ausführungsbeispiele der Erfindung und vorteilhafte Einzelheiten unter Bezug auf eine Zeichnung näher erläutert. Es zeigen: Fig. 1 eine schematische Darstellung eines ersten Ausführungsbeispiels eines erfindungsgemäßen Laser-Skalpells, Fig. 2 ein schematisches Schaltbild zu der Ausführung von Fig. 1, und Fig. 3 die schematische Darstellung eines abgewandelten Ausführungsbeispiels der Erfindung.
- Hauptbaugruppen des in Fig. 1 dargestellten erfindungsgemäßen Laser-Skalpells sind ein Laser-Generator 1, dessen Laserstrahlauslaß mit einem Verschluß ia versehen ist, ein Steuergerät 2, durch das die Ausgangs- bzw. Abgabeleistung des Laser-Generators 1 veränderbar ist und der Verschluß la offen oder geschlossen gehalten wird, ein Operations- und Bedienungsteil 4, das nachstehend kurz Handstück 4" genannt wird, und eine das Handstück 4 mit dem Laser-Generator 1 verbindende Faseroptik 3.
- Das bei einem chirurgischen Eingriff in der hand des Operateure liegende Handstück 4 bildet das Skalpell-Führungsteil, überträgt den aus der Faseroptik 3 kommenden Laserstrahl auf die Operationsstelle und enthält in seinem Gehäuse eine Unterbrechertaste RS mit Schalter, eine Taste DW mit Schalter zur Strahlleistungsverringerung und eine Taste UP mit Schalter zur Strahlleistungserhöhung. Alle drei Schalter sind über das Steuergerät 2 elektrisch mit dem Laser-Generator 1 verbunden.
- Durch die Schalterzustände EIN oder AUS der Unterbrechertaste RS wird der Verschluß 1a offen- bzw. geschlossengehalten. Bei offenem Verschluß 1a wird ein Laserstrahl mit einer zuvor im Generator 1 eingestellten Soll- oder Vorgabe-Leistung durch das Handstück 4 abgestrahlt. Aus Gründen der Operationssicherheit ist der Laser-Generator 1 so konstruiert, daß er nur bei im AUS-Zustand befindlichem Unterbrecherschalter RS eingeschaltet werden kann.
- Es ist ein Merkmal der Erfindung, daß der Änderungsbereich, in dem die vorgegebene Soll-Ausgangsleistung des Laser-Generators 1 über die Taste UP erhöht und durch die Taste DW reduziert werden kann, nach Vorwahl fest auf z.B. +10% und -10% b#egrenzt ist.
- Durch diese Begrenzung bleibt die Operationssicherheit auch bei Bedienungsfehlern gewahrt. Allgemein wird der Betrag des Änderungsbereichs von der Größe der Soll-Ausgangsleistung abhängig sein. Da ein Änderungsbetrag um wenige Prozent bei relativ großer Soll-Ausgangsleistung schon in die -zig Watt gehen würde, muß in diesem Fall der Änderungsbereich noch schmaler gewählt werden. Andererseits kann bei sehr kleiner Soll-Ausgangsleistung der Änderungsbereich ohne Bedenken auf z.B. 50% oder sogar 1008 ausgedehnt werden. Der gewünschte Leistungs-Anderungsbereich wird auf der Frontseite des Steuergerätes 2 an einer z.B. in % und/oder in Watt unterteilten Feineinstellskala 2a eingestellt.
- Die drei Tasten RS, UP und DW sind mit der in Fig. 2 schematisch dargestellten Steuerschaltung verbunden, die jeweils durch ein hochliegendes Signal auf Signalleitungen a, b, c bzw. d einen entsprechenden Befehl Verschluß auf", "mehr Leistung", "weniger Leistung" bzw. "Soll-Leistung" an das Steuergerät 2 abgibt, um den Laser-Generator 1 durch das betreffende Signal entsprechend zu steuern. Ferner enthält die Steuerschaltung in Fig. 2 einen Schalter SW zum Ein- oder Ausschalten des Laser-Generators 1, Inverter 11 . Ig, UND-Glieder A1 ... A51 ein ODER-Glied OR und ein Excl.ODER-Glied EX. Das ODER-Glied OR gibt abgängig davon, ob an seinen beiden Eingängen Signale mit hochliegenden oder unterschiedlich hohen Pegeln anliegen, ein Ausgangssignal für niedrigere bzw. höhere Laser-Ausgangsleistung ab.
- Der Laser-Generator 1 kann nur aktiviert werden, wenn der Schalter SW bei Schalter RS "AUS" eingeschaltet wird, arbeitet aber bei späteren Umschaltungen des Schalters RS weiter. Mit Einschaltung von RS bei oszillierendem und arbeitendem Generator 1 wird durch entsprechende Signale auf den Signalleitungen a und d der Verschluß 1a offengehalten und ein Laserstrahl mit Soll-Leistung aus dem Handstück 4 des Laser-Skalpells abgegeben. Ein Druck auf die Taste UP - - hat ein hochliegendes Signal auf Leitung b und eine Signalabsenkung auf Signalleitung d zur Folge, so daß die Laserstrahl-Ausqangsleistung am Handstück 4 wie vorgewählt erhöht wird. Dagegen bewirkt ein Fingerdruck auf Taste DW durch Signalpegelanhebung auf Leitung c und -absenkung auf Leitung d die Abgabe eines gemäß der Einstellung an der Skala 2a in der Leistung reduzierten Laserstrahls aus dem Handstück 4. Falls versehentlich beide Tasten UP und DW gedrückt werden, dann liegen die Signalpegel auf Leitung b und c niedrig, auf Leitung d hoch, und folglich erfolgt die Laserstrahlabgabe aus dem Hand- stück 4 mit der vorgegebenen Soll-Ausgangsleistung.
- Der mit dem erfindungsgemäßen Laser-Skalpell arbeitende Chirurg kann jederzeit während der Operation und ohne fremde Hilfe an dem in seiner Hand liegenden Handstück 4 durch einfache Betätigung der Tasten DW und UP die Laserstrahl-Abgabeenergie verändern. Operationen können ununterbrochen und in kürzerer Zeit durchgeführt werden. Der Operateur kann zwar die Laserstrahlleistung nach seinem Willen ändern, aber nur im Rahmen der vorher festgelegten Änderungsgrenzen. Deshalb wird auch bei einer Verwechselung der Tasten wie UP statt DW die Operationssicherheit immer gewahrt bleiben und keine Gefahr für den Patienten entstehen.
- Das in Fig. 3 dargestellte Ausführungsbeispiel unterscheidet sich von dem zuvor erläuterten dadurch, daß die Unterbrechertaste RS fehlt und der zugehörige Unterbrecherschalter RS in einen durch den operierenden Arzt während der Operation betätigbaren Fußschalter 5 verlegt ist.
- Falls eine feiner dosierbare Leistungsänderung innerhalb der vorher festgelegten Grenzen erwünscht ist, beispielsweise in drei Stufen, dann kann die Steuerschaltung z.B. in Verbindung mit einer separaten Überwachungs-Leuchtanzeige o. dgl. so ausgelegt sein, daß sie auf mehrmalige Betätigung der Taste DW bzw. UP entsprechend abgestuft reagiert.
- Das im Sinne der Erfindung ausgebildete Laser-Skalpell ist besonders leicht und problemlos bedienbar, weil der damit arbeitende Chirurg über das in seiner Hand befindliche Handstück jederzeit selbst die Laser-Ausgangsleistung der Situation anpassen kann. Durch die fest vorgegebenen Grenzen, zwischen denen eine Leistungsänderung durch Tasten- bzw. Schalterbe-- tätigung nur möglich ist, wird jede Gefahr aufgrund von Schalterbedienungsfehlern ausgeschlossen, die Operationssicherheit bleibt immer gewährleistet.
- Da die gewünschte Anderung der Laserstrahl leistung nicht mit Strom- oder Gerätabschaltungen verbunden ist und statt dessen durch Tastendruck jederzeit nach Wunsch vorgenommen werden kann, sind Operationen jetzt nicht nur sicherer sondern auch schneller und problemloser ausführbar.
Claims (4)
- Laser-Skalpell PATENTANSPRUCHE Laser-Skalpell mit einem bezüglich seiner Ausgangsleistung veränderbaren Laser-Generator, dadurch gekennzeichnet, daß an einem in der Hand des Operateurs zu haltenden und zur Abgabe eines Laserstrahls auf ein Operationsfeld eingerichteten Operations- und Bedienungsteil (4) eine manuell bedienbare Schalteinrichtung (UP, DW) zum Verändern der Laser-Ausgangsleistung relativ zu einer vor-eingestellten Soll-Leistung und innerhalb für die Sicherheit unbedenklicher Grenzen angebracht ist.
- 2. Laser-Skalpell nach Anspruch 1, dadurch gekennzeichnet, daß die Schalteinrichtung je einen Schalter zum Anheben (UP) und zum Senken (DW) der Ausgangsleistung relativ zur Soll-Leistung umfaßt.
- 3. Laser-Skalpell nach-Anspruch 2, dadurch gekennzeichnet, daß jedem der Schalter (UP, DW) eine leicht bedienbare Taste zugeordnet ist.
- 4. Laser-Skalpell nach Anspruch 1, dadurch gekennzeichnet, daß der vorgesehene Änderungsbereich der Laser-Ausgangsleistung relativ zu der Soll-Leistung an einer Skala (2a) einstellbar ist.
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
JP55153736A JPS5778844A (en) | 1980-11-04 | 1980-11-04 | Lasre knife |
Publications (2)
Publication Number | Publication Date |
---|---|
DE3143421A1 true DE3143421A1 (de) | 1982-05-27 |
DE3143421C2 DE3143421C2 (de) | 1985-05-02 |
Family
ID=15568969
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
DE3143421A Expired DE3143421C2 (de) | 1980-11-04 | 1981-11-02 | Laser-Skalpell |
Country Status (5)
Country | Link |
---|---|
US (1) | US4470414A (de) |
JP (1) | JPS5778844A (de) |
DE (1) | DE3143421C2 (de) |
FR (1) | FR2494986B1 (de) |
IL (1) | IL64087A (de) |
Cited By (284)
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EP0069930A1 (de) * | 1981-07-02 | 1983-01-19 | Sumitomo Electric Industries Limited | Überwachungseinrichtung für Lasersysteme mit das Laserlicht transmittierenden optischen Fasern |
DE3545873A1 (de) * | 1984-12-24 | 1986-07-31 | Shibuya Kogyo Co., Ltd., Kanazawa, Ishikawa | Geraet zur behandlung mit laserstrahlung |
US4608980A (en) * | 1984-04-13 | 1986-09-02 | Osada Electric Co., Ltd. | Laser hand piece |
US4632109A (en) * | 1984-12-11 | 1986-12-30 | Valleylab, Inc. | Circuitry for processing requests made from the sterile field of a surgical procedure to change the output power level of an electrosurgical generator |
US5531738A (en) * | 1993-12-09 | 1996-07-02 | Deutsche Aerospace Ag | Process for operating a laser |
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Also Published As
Publication number | Publication date |
---|---|
IL64087A0 (en) | 1982-01-31 |
DE3143421C2 (de) | 1985-05-02 |
US4470414A (en) | 1984-09-11 |
FR2494986A1 (fr) | 1982-06-04 |
JPS5778844A (en) | 1982-05-17 |
FR2494986B1 (fr) | 1985-08-09 |
IL64087A (en) | 1984-10-31 |
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