JP2005058440A - Retractor with led - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a simple-structure retractor lighting an operation range inside the body cavity at large light quantity and wide area and dispensing with a separate light source part. <P>SOLUTION: Lighting means by LEDs are provided in the tips of blades 15 and 16 of the retractor used for opening and retaining an incised part in a surgical operation. In the operation, the blades 15 and 16 are inserted in the body cavity, a handle 17 is rotated to widen an interval between the blades 15 and 16 and open the incised part, and the LEDs provided in the tips of the blades 15 and 16 are lit to light the operation range. An LEG module 21 formed by accumulating LED chips on a substrate with high heat conduction is used as the lighting means to provide a further large light quantity and the heat generated from the LED can efficiently radiates the retractor body via the substrate. The LED module 21 is connected to a dimmer means and a power supply with a cord 23. Cants are provided in the tips of the blades 15 and 16 to collect the light lit from the LEDs to the center. <P>COPYRIGHT: (C)2005,JPO&NCIPI

Description

  The present invention relates to a retractor used to open and hold an incision during a surgical operation.

  In the surgical operation, a retractor for opening and holding the incision is used in various forms according to the surgical site and purpose. As an example of such a retractor, FIG. 1 shows a retractor for thoracic surgery. This chest surgical retractor includes a base bar 12 with teeth 11 engraved on one side, and a first arm portion 13 and a second arm portion 14 provided perpendicular to the base bar 12. The first arm portion 13 is fixed to the base bar 12, and the second arm portion 14 is slidably attached along the base bar 12 by inserting the base bar 12 into the base portion. Further, blades 15 and 16 are provided perpendicularly to the arm portions at the end portions of the arm portions on the side opposite to the base bar 12. A handle 17 and a gear (not shown) are provided at the base of the second arm portion 14, and the gear meshes with the teeth 11 carved in the base bar 12. When the handle 17 is rotated, the gear rotates, and the second arm portion 14 slides along the base bar 12 accordingly.

  During the operation, the pair of blades 15 and 16 are inserted into the chest incision site in a closed state, and then the handle 17 is rotated to widen the gap between the blades 15 and 16 to push open the ribs. Moreover, since the space | interval of the braid | blades 15 and 16 can be hold | maintained uniformly, it can operate | operate, keeping the incision location in the open state.

However, during surgery, it is desirable to keep the opening as small as possible to minimize patient trauma, so lighting installed on the ceiling or the like will not reach the surgical area within the body cavity. There was no problem.
As a solution to such a problem, Patent Document 1 discloses a retractor provided with illumination means. This retractor is used for surgical removal of the gallbladder, and is provided with a light source such as a halogen lamp outside, and guides light to the tip of the retractor with an optical fiber to illuminate the surgical site. However, the illumination by the optical fiber has a narrow range that can be irradiated and the amount of light is insufficient. Further, since the connecting cable is relatively thick and inflexible, there is a problem in that it interferes with the operation and lowers workability.
Japanese Patent Laid-Open No. 4-336059

  The present invention has been made to solve such a problem, and the object of the present invention is to provide an illumination means with an LED at the distal end portion, so that a surgical region in a body cavity can have a large amount of light and a wide range. An object of the present invention is to provide a retractor having a simple structure that illuminates and does not require a separate light source.

  A retractor according to the present invention, which has been made to solve the above-mentioned problems, is a retractor used for opening / holding an incision during surgery, and a retractor having a blade inserted into the incision, An illumination means using LEDs is provided at the tip of the blade.

  By providing an LED at the tip of the retractor, it is possible to illuminate the surgical area in the body cavity, and since there is no need to provide a separate light source, the configuration can be simplified and miniaturized, and the workability of the surgery can be improved. it can. In addition, when an LED module using a substrate with high thermal conductivity is used, a large amount of light and a wide range of illumination can be performed, and heat generated by the LED can be efficiently dissipated to the retractor body.

  In the present invention, the tip of the retractor blade is provided with LED illumination. The LED provided at the tip of the blade is desirably an LED module in which LED chips are integrated on a substrate. As a result, more LED chips can be arranged in a smaller space and a larger amount of light can be obtained than when using an LED unit in which individual LED chips are covered with a transparent resin or glass package. By changing the size of the LED module and the number of LED chips laid on the substrate, LED modules with various emission intensities can be made, so that the LED module can be used according to the purpose. In addition, an appropriate size and number of LED modules can be used according to the area and shape of the attachment site. The solder terminal portion of the LED module is preferably coated with silicon resin. Thereby, it is possible to eliminate the possibility that the fine solder balls fall off from the LED reflow joint and fall into the patient's body.

LEDs are characterized by high energy conversion efficiency and low calorific value, but the amount of calorific value inevitably increases when a large number of chips are integrated as described above. Furthermore, in the present invention, since the LED module is attached to the tip of the retractor and used in the patient's body, the fever cannot be ignored. Therefore, in the present invention, a substrate with good thermal conductivity is used for the LED module, and the LED module is attached so that the surface of the retractor is in close contact. Thereby, the heat generated in the LED chip can be efficiently dissipated to the retractor body through the substrate. As such a substrate having high thermal conductivity, for example, an alumina substrate, an aluminum nitride ceramic substrate, an aluminum substrate, etc. are used in addition to a diamond substrate proposed by the applicant of the present invention in Japanese Patent Laid-Open No. 2002-329896. can do. The retractor body is made of aluminum with high thermal conductivity and has a large heat capacity. Therefore, the heat generated from the LED chip can be sufficiently absorbed.
Alternatively, the LED module may be attached to a plate having good thermal conductivity, and the plate may be attached to the retractor. Thereby, even when a plurality of LED modules are attached, the attachment can be easily performed.
Furthermore, it is desirable to cover the entire LED mounting part with a cover made of transparent glass or heat-resistant plastic in order to prevent the high temperature part of the LED or plate from directly touching the patient's body tissue during surgery and causing burns.

  A white LED can be suitably used for normal use. As a white LED, in addition to a method of closely mounting LEDs of three primary colors of red (R), green (G), and blue (B), a blue LED (for example, an InGaN-based LED) is yellow with the blue as excitation light. Cover with fluorescent material that emits fluorescent light (for example, YAG fluorescent material) to produce white light as a whole, or use light that emits white light with a combination of purple to near-ultraviolet LEDs and phosphors that emit light in R, G, and B, respectively. can do. A white LED based on a combination of a violet to near-ultraviolet LED and an RGB phosphor can easily set a color temperature and a color rendering property by a mixing ratio of the phosphor.

  Further, as a lighting means, an assembly of a set of LEDs including a red LED, a green LED, and a blue LED may be used. By setting the combination of the three primary colors of red (R), green (G), and blue (B) and the emission intensity of each color in advance, illumination with an arbitrary emission color is possible. Thereby, it can illuminate by adjusting so that the color of skin, the color of blood, etc. may become a natural hue | tone at the time of an operation.

  Furthermore, an ultraviolet LED can be used as the illumination means. According to this, when used as an ultraviolet illumination device for surgery, only a lesioned part such as a tumor that has been fluorescently labeled in advance can be visualized with ultraviolet rays. Conventionally, an ultraviolet illuminating device using an optical fiber has been used as such an ultraviolet illuminating device. However, since the present invention can illuminate a surgical region over a wide range with a large amount of light by an LED module, It becomes possible to visually recognize the lesioned part more clearly than in the case of using. This ultraviolet LED may be used alone, or may be used in combination with the white and visible multicolor LEDs. When used in such a combination, the light emission may be performed at the same time, or the light emission color may be switched depending on the case by a changeover switch.

  In a preferred embodiment of the present invention, a dimming means capable of adjusting the light emission intensity of the LED is provided. Thereby, it is possible to irradiate the surgical region with an arbitrary illuminance. In addition, when LEDs of different colors (including ultraviolet rays) are provided, it is desirable that the intensity can be adjusted for each color. For example, when using the above R, G, and B LEDs, it is possible to adjust the emission color at the time of use by providing dimming means for individually controlling the emission intensity of each color. The color of the illumination light can be easily changed and adjusted according to the irradiation target (internal tissue, organ). In addition, by changing the emission color at the time of surgery, it is possible to enlarge the color difference between two parts having a small color difference so that both can be clearly identified.

The LED is connected to a light control means and a power source by a cord. This cord is thinner than conventional cables used for illumination by optical fibers and is flexible so that it does not interfere with the operation. It is desirable to fix the cord to the blade so that it is not entangled or caught. Alternatively, it is more desirable to form a patterning wiring on the surface of the retractor via an insulating layer, thereby supplying power to the LED. A protective layer made of an insulator is further provided on the patterning wiring.
The cord or patterning wiring is fixed or formed on the side of the blade surface of the retractor that does not directly touch the patient's body tissue.
A portable battery (primary battery or secondary battery) can be used as the power source. Further, an AC power supply may be converted to a DC power supply and supplied to the LED. The battery can be attached to the surgeon's belt or hung from the neck. Further, when the battery is used for a short time or when a more compact battery is developed in the future, it is possible to install the battery together with the light control means outside the arm portion of the retractor.

  When applied to a retractor for thoracic surgery or the like, in the conventional retractor, the tip of the blade is bent at a right angle as shown in FIG. It is desirable to incline (provide a cant). Since the light emitted from the LED is highly directional, there is a risk that the light will not hit the center when the distance between the arms is wide when the tip is at a right angle. The irradiation light can be collected in the center.

  Embodiments of the present invention will be described below with reference to the drawings. FIG. 2 is a perspective view of a retractor with LED for thoracic surgery which is an embodiment of the present invention. The portions denoted by the same reference numerals as those in FIG. 1 are the same as or equivalent to those of the conventional chest surgical retractor, and thus the description thereof is omitted.

The retractor with LED of the present embodiment is applied to a retractor for expanding a rib used for thoracic surgery. In the retractor with LED of the present embodiment, illumination by a white LED is provided at the tip of the blades 15 and 16 of the retractor for conventional thoracic surgery as shown in FIG. The surgical region can be illuminated by inserting the blades 15 and 16 into the body cavity and turning on the LED provided at the tip thereof.
The tip of the blades 15 and 16 is provided with a cant, and the light emitted from the LED can be collected in the center.

  As a white LED, a blue LED (InGaN LED) chip is integrated on a substrate and covered with a phosphor that emits yellow fluorescence using the blue light as excitation light (YAG phosphor). An LED module 21 that emits light is used. As the substrate of the LED module 21, a diamond substrate having good thermal conductivity is used. Further, the LED module 21 is placed on a plate 22 made of diamond, and the plate 22 is attached to the tips of the blades 15 and 16 of the retractor. A total of 8 LED modules with a total luminous flux of 23 lm are attached, 4 on each blade. As a result, a total amount of light of 184 lm can be obtained, and the surgical area can be sufficiently illuminated.

  A portable battery 24 that can be worn by an operator is used as a power source, and is connected to the LED module 21 via a dimmer 25. The dimmer 25 adjusts a current supplied to the LED module 21 and is connected to the LED module 21 by a cord 23 fixed inside the blades 15 and 16.

  In this embodiment, the retractor for thoracic surgery has been described. However, the present invention is not limited to the retractor for thoracic surgery, and can be applied to retractors used in various other parts. .

Perspective view showing a conventional retractor for thoracic surgery The perspective view which shows the retractor for thoracic surgery with LED which is an Example of this invention

Explanation of symbols

DESCRIPTION OF SYMBOLS 11 ... Teeth 12 ... Base bar 13 ... 1st arm part 14 ... 2nd arm part 15, 16 ... Blade 17 ... Handle 21 ... LED module 22 ... Plate 23 ... Cord 24 ... Battery 25 ... Dimmer

Claims (11)

A retractor used for opening / holding an incision during surgery, and having a blade inserted into the incision,
A retractor characterized in that an LED illumination means is provided at the tip of the blade.   The retractor with LED according to claim 1, wherein a cant is provided at a tip of the blade.   The retractor with LED according to claim 1 or 2, wherein the illumination means is an LED module in which a plurality of LED chips are integrated on a substrate having high thermal conductivity.   The retractor with LED according to any one of claims 1 to 3, wherein the illumination means is a white LED.   The retractor with LED according to any one of claims 1 to 4, wherein the illumination means includes three primary color LEDs.   The retractor with LED according to any one of claims 1 to 5, wherein the illumination means includes an ultraviolet LED.   The retractor with LED according to any one of claims 3 to 6, wherein a solder terminal portion of the LED module is coated with a silicon resin.   The retractor with LED according to any one of claims 1 to 7, further comprising a heat-resistant transparent cover that covers the entire LED mounting portion.   The retractor with LED according to any one of claims 1 to 8, further comprising dimming means for adjusting light emission intensity of the LED.   The retractor with LED according to any one of claims 1 to 9, wherein power is supplied to the LED by a patterning wiring formed on the surface of the retractor via an insulating layer.   11. The retractor with LED according to any one of claims 1 to 10, wherein the retractor is a retractor for thoracic surgery.

Images