DE3143421C2 - Laser-Skalpell - Google Patents
Laser-SkalpellInfo
- Publication number
- DE3143421C2 DE3143421C2 DE3143421A DE3143421A DE3143421C2 DE 3143421 C2 DE3143421 C2 DE 3143421C2 DE 3143421 A DE3143421 A DE 3143421A DE 3143421 A DE3143421 A DE 3143421A DE 3143421 C2 DE3143421 C2 DE 3143421C2
- Authority
- DE
- Germany
- Prior art keywords
- laser
- output power
- scalpel
- handpiece
- switch
- 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.)
- Expired
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)
Abstract
Bei einem Laser-Skalpell (Fig.1) für chirurgische Zwecke kann mittels an einem bei chirurgischen Eingriffen in der Hand des Operateurs liegenden Handstück (4) angeordneter Drucktasten (DW, UP) die Energie eines aus dem Handstück (4) auf ein Operationsfeld abgegebenen Laserstrahls innerhalb die Sicherheit gewährleistender Grenzen verändert werden. Jede gewünschte Leistungsänderung kann risikofrei und einfach durch Fingerdruck vom Operateur selbst vorgenommen werden, der Operationsablauf wird dadurch nicht unterbrochen.
Description
— der Laser- Generator (1) einen Strahlenauslaß-Verschluß {ta) besitzt,daß
— der Strahlenauslaß-Verschluß (ta) von der Einstelleinrichtung
(RS) aus, unabhängig von der Laser-Ausgangsleistung betätigbar ist, daß
— der Laser- Generator nur bei geschlossenem Strahleöäuslaß-Verschluß (ta) in Betrieb genommen
werden kann, daß
— die Laser-Ausgangsleistung nur innerhalb eines eine voreingestellte Ausgangsleistung einschließenden
Sicherheitsbereiches veränderbar ist, und daß
— die prozentuale Abweichung der Bereichsgrenzen von der voreingestellten Ausgangsleistung
bei größerer Ausgangsleistung kleiner ist.
2. Laser-Skalpell nach Anspruch 1, dadurch gekennzeichnet daß die Einstelleinrichtung je einen
Schalter zum Betätigen des Strahlenauslaß-Verschlusses
(RS), zum Anheben (UP) und zum Absenken (DW) der Ausgangsleistung besitzt.
3. Laser-Skalpell nach Anspruch 2, dadurch gekennzeichnet, daß der Laser-Generator (1) bei
gleichzeitiger Betätigung der Schalter zum Anheben (UP) und zum Absenken (DW) die voreingestellte
Ausgangsleistung abgibt.
Die Erfindung betrifft ein Laser-Skalpell mit einem Laser-Generator, der mittels einer, an einem in der
Hand des Operateurs zu haltenden und zur Abgabe eines Laserstrahls auf ein Operationsfeld eingerichteten
Operations- und Bedienungsteil angebrachten, manuell bedienbaren Eintstelleinrichtung bezüglich seiner Ausgangsleistung
kontinuierlich veränderbar ist.
Bei der Verwendung eines Laser-Skalpells bei einem chirurgischen Eingriff wird die Stärke oder Abgabeleistung
des Laserstrahls je nach Art des Eingriffes, der Tiefe des Operationsfeldes und dergleichen 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.
Bei einem aus der DE-OS 21 45 921 bekannten Laser-Skalpell ist zu diesem Zweck eine Stellvorrichtung
zur Intensitätssteuerung vorgesehen, die durch einen verschiebbaren Knopf beeinflußbar ist, der sich am
Griffende des Operations- und Bedienungsteils befindet. Die Laserstrahl-Ausgangsleistung ist allerdings ein äußerst
kritischer Wert, der oft bis auf wenige Prozent oder sogar Zehntel-Prozent eingehalten werden muß,
so daß die bei dem bekannten Skalpell vorhandene Möglichkeit der Fehleinstellung unter Umständen zu
schwerwiegenden Folgen führen kann. Darüberhinaus können sich unerwünschte Folgen dadurch ergeben, daß
mit dem Einschalten des Laser-Generators sofort ein Laserstrahl abgegeben wird, ohne da-3 der Operationsund
Bedienungsteil schon unter einem geeigneten Abstand auf die Operationsstelle gerichtet ist, ein. Umstand,
der auch dann zu Handhabungsschwierigkeites. führt, wenn mit einer Intensitätssteuerung wie bei dem bekannten
Laser-Skalpell die Anfangsintensität praktisch auf Null eingestellt ist Diese Null-Einstellung erfolgt im
Rahmen der kontinuierlichen Veränderung der Laserstrahl-Ausgangsleistung. Eine davon unabhängige und
jederzeit vornehmbare Strahlunterbrechung ist bei dem Laser-Skalpell nach der DE-OS 21 45 921 nicht vorgesehen.
Bei einem anderen aus der DE-OS 28 29 516 bekannten Laser-Skalpell werden durch die Handhabung bedingte
Dosierungsfehler dadurch vermieden, daß Änderungen der thermischen Rückstrahlung an der laserbestrahlten
Operationsstelle oder Änderungen des dort rückgestellten Laserlichts gemessen, registriert und ausgewertet
werden, um bei Überschreitung festgelegter Grenzwerte eine Ausschalteelektronik für den Arbeitslaser
anzusteuern. Es fehlt hier dann allerdings die, wie erwähnt erwünschte Vlöglichkeit der Veränderung der
Ausgangsleistung während der Operation durch den Operateur. Außerdem ist hier ebenfalls nicht vermieden,
daß die Laserstrahlung sofort beim Einschalten des Laser-Generators, unter Umständen in unbeabsichtiger
Intensität und Zielrichtung abgegeben wird, wenn das Laser-Skalpell versehentlich unter einem Abstand zu
einem Objekt liegt der kleiner als ein Grenzabstand ist, bei dem das Laser-Skalpell automatisch eingeschaltet
wird.
Der Erfindung liegt die Aufgabe zugrunde, ein Laser-Skalpell mit kontinuierlich veränderbarer Ausgangsleistung
der eingangs genannten Art v» weiterzubilden, daß aufgrund von Fehlbedienungen beim Einschalten
des Laser-Generators und Verändern seiner Ausgangsleitung keine Gefährdung von Patient bzv/. Bedienungspersonal
auftritt.
Diese Aufgabe wird bei einem Laser-Skalpell der eingangs genannten Art erfindungsgemäß durch die kennzeichnenden
Merkmale im Patentanspruch 1 gelöst.
Vorteilhafte Weiterbildungen der Erfindung sind in den Unteransprüchen angegeben.
Nachstehend werden bevorzugte Ausführungsbeispiele der Erfindung und vorteilhafte Einzelheiten unter
Bezug auf eine Zeichnung näher erläutert. Es zeigt
F i g. 1 eine schematische Darstellung eines ersten Ausführungsbeispiels eines erfindungsgemäßen Laser-Skalpells,
F i g. 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 Laser-Skalpells
sind ein Laser-Generator 1, dessen Lascrstrahl-Auslaß mit einem Verschluß la 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 Lichtleitfaser
3. Das bei einem chirurgischen Eingriff in der Hand des Operateurs liegende Handstück 4 bildet das Skalpell-
Führungsteil, überträgt den aus der Lichtleitfaser 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 Unterbrecbertaste ÄS wird der Verschluß la offen-
bzw. geschlossengehalten. Bei offenem Verschluß ia
wird ein Laserstrahl mit einer Generator 1 voreingestellten Ausgangsleistung 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 eingestellte Ausgangsleistung des
Laser-Generators 1 über die Taste t/P erhöht und durch die Taste D^reduziert werden kann, nach Vorwahl fest
z. B. +10% und — 10% begrenzt ist Durch diese Begrenzung bleibt die Operationssicherheit auch bei Bedienungsfehlern
gewahrt Allgemein wird der Detrag des Änderungsbereichs (Sicherheitsbereichs) von der
Größe der voreingestellten Ausgangsleistung abhängig sein. Da ein Änderungsbetrag um wenige Prozent bei
relativ großer voreingestellter Ausgangsleistung schon in die -zig Watt gehen würde, muß in diesem Fall der
Änderungsbereich noch schmaler gewählt werden. Andererseits kann bei sehr kleiner voreingestellter Ausgangsleistung
der Änderungsbereich ohne Bedenken auf z. B. 50% oder sogar 100% ausgedehnt werden. Der
gewünschte Leistungs-Änderungsbereich 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 D Wsind mit der in F i g. 2
schematisch dargestellten Steuerschaltung verbunden, die jeweils dur~h ein hochliegendes Signal auf Signalleitungen
a, b, c bzw. d einen entsprechenden Befehl »Ver-Schluß
auf«, »mehr Leistung«, »weniger Leistung« bzw. »voreingesteüte Leistung« an das Steuergerät 2 abgibt,
um den Laser-Generator 1 durch das betreffende Signal entsprechend zu steuern. Ferner enthält die Steuerschaltung
in F i g. 2 einen Schalter SW zum Ein- oder Ausschalten des Laser-Generators 1, Inverter Ii ... I5,
UND-Glieder Ai ... A5, ein ODER-Glied OR und ein
Excl. ODER-Glied EX. Das ODER-Glied OR gibt abhängig
davon, ob an seiner1 beiden Eingängen Signale mit hochliegenden oder unterschiedlich hohen Pegeln
anliegen, ein Ausgangssigna! für niedrige 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 la offengehalten und ein Laserstrahl mit der vöreingestellten 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 dzur Folge,
so daß die Laserstrahl-Ausgangsleistung am Handstück 4 wie gewünscht erhöht wird. Dagegen bewirkt ein Fingerdruck
auf Taste DW ύκ rch 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 Handstück 4 mit der vorgestellten 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-Ausgangsleistung verändern. Operationen können ununterbrochen und in kürzerer
Zeit durchgeführt werden. Der Operateur kann zwar die Laserstrahl-Ausgangsleistung 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 und keine Gefahr für den
Patienten entstehen.
Das in F i g. 3 dargestellte Ausführu -^sbeispiel unterscheidet
sich von dem zuvor erläuterten 'ladurch, 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 D Wbzw. UP entsprechend
abgestuft reagiert.
Das im Sinne der Erfindung ausgebildete Laser-Skalpell ist besonders leicht und problemlos zu bedienen,
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. Schalterbetätigung nur möglich ist, wird jede Gefahr aufgrund von
Schalter-Bedienungsfehlern ausgeschlossen, die Operationssicherheit bleibt immer gewährleistet
Da die gewünschte Änderung der Laserstrahl-Ausgangsleistung
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.
Hierzu ': Blatt Zeichnungen
Claims (1)
1. Laser-Skaipell mit einem Laser-Generator (1),
der mittels einer, an einem in der Hand des Operateur zu haltenden und zur Abgabe eines Laserstrahls
auf ein Operationsfeld eingerichteten Operationsund Bedienungsteil (4) angebrachten, manuell bedienbaren
Einstelleinrichtung (UP, DW) bezüglich seiner Ausgangsleistung kontinuierlich veränderbar
ist, dadurch gekennzeichnet, daß
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 DE3143421A1 (de) | 1982-05-27 |
DE3143421C2 true 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 (88)
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DE4341967A1 (de) * | 1993-12-09 | 1995-06-14 | Dornier Medizintechnik | Verfahren zum Betrieb eines Lasers |
DE19959698A1 (de) * | 1999-12-08 | 2001-06-28 | Aesculap Meditec Gmbh | Handstück zur kosmetischen oder medizinischen Behandlung |
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Also Published As
Publication number | Publication date |
---|---|
US4470414A (en) | 1984-09-11 |
JPS5778844A (en) | 1982-05-17 |
DE3143421A1 (de) | 1982-05-27 |
IL64087A (en) | 1984-10-31 |
FR2494986B1 (fr) | 1985-08-09 |
IL64087A0 (en) | 1982-01-31 |
FR2494986A1 (fr) | 1982-06-04 |
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