JP4436899B2 - Ophthalmic surgery equipment - Google Patents

Description

[0001]
BACKGROUND OF THE INVENTION
The present invention relates to an ophthalmic surgical apparatus for surgically treating a patient's eye.
[0002]
[Prior art]
As an ophthalmic surgical apparatus, a cataract surgical apparatus and a vitreous surgical apparatus are known. For example, in a cataract surgery device, ultrasonic vibration is amplified and transmitted to a tip attached to the tip of a handpiece to crush and emulsify the lens nucleus that becomes cloudy due to cataract, and the crushed nucleus is supplied to the tip together with the perfusate supplied into the eye. Remove by suction from the provided suction holes. Since the surgeon holds the handpiece during the operation, the operator operates the foot switch foot pedal with his / her foot. An operator generates operation signals for performing various operations such as supply of perfusate, suction, and generation of ultrasonic vibrations by depressing the foot pedal.
A foot switch having an auxiliary petal in addition to the main pedal has been proposed.
[0004]
[Problems to be solved by the invention]
However, the function of each operation switch such as a foot pedal or an auxiliary petal (in this specification, an input device that generates an operation signal is referred to as a switch) has been determined in advance. The functions that each operation switch wants to have may differ depending on the individual operator. In order to respond to each operator's request, it is necessary to prepare a foot switch of a type corresponding to that, but this is very troublesome and management is complicated.
[0005]
In view of the above problems, an object of the present invention is to provide an ophthalmic surgical apparatus capable of setting the function of a foot switch as desired by an operator and performing a surgery smoothly.
[0006]
[Means for Solving the Problems]
In order to solve the above problems, the present invention is characterized by having the following configuration.
[0007]
(1) Operate the patient's eye using a foot switch with a main switch that emits an operation signal for controlling the operation of perfusion suction, ultrasonic oscillation, etc. based on the operation mode of perfusion suction, ultrasonic oscillation, etc. In an ophthalmologic surgical apparatus, each input of the plurality of auxiliary switches is an operation switch other than the main switch, and each of the plurality of auxiliary switches provided in the foot switch and each operation mode including the I / A mode and the US mode. A program storage means for storing an assignment program for setting the assignment of the operation signal of the apparatus to the signal, and a predetermined selection screen including a screen that is arranged on the apparatus main body side having the control unit and can set and input the operation condition is displayed. has a display, a function changing screen of the foot switch, the each operation mode including the I / a mode and US mode In accordance with the assignment program, the operation signal of the device corresponding to the input signal of each auxiliary switch is selected from among assignable functions including a function of switching supply / stop of perfusate and a function of temporarily reversing suction. An assigning means for assigning, and a combination storage means for storing a combination of operation signals for each input signal of the auxiliary switch assigned by the assigning means, are provided.
[0013]
DETAILED DESCRIPTION OF THE INVENTION
Hereinafter, embodiments of the present invention will be described with reference to the drawings. FIG. 1 is a schematic configuration diagram of a cataract surgery apparatus according to the present invention.
[0014]
Reference numeral 1 denotes a perfusion bottle in which a perfusion solution such as physiological saline for supplying to the patient's eye E is placed. The perfusion bottle 1 is suspended from a pole 2, and the pole 2 is moved up and down by a vertical drive device 13 to adjust the perfusion pressure of the perfusate supplied to the patient's eye E by changing the height of the perfusion bottle 1. To do. 3 is a perfusion tube for guiding the perfusate to the patient's eye E. A control valve 4 is provided in the middle of the perfusion tube 3, and the outflow control of the perfusate is performed by opening and closing the control valve 4.
[0015]
The other end of the perfusion tube 3 is connected to a US handpiece 5 for crushing, for example. At the tip of the US handpiece 5, a tubular crushing tip 5a having a suction hole is attached, and ultrasonic vibration generated by the vibrator of the US handpiece 5 is amplified and transmitted to the tip 5a. The chip 5a crushes and emulsifies the lens nucleus. The output of the vibrator of the US handpiece 5 is adjusted by the control of the control unit 20 based on a preset value or an operation signal from the foot switch unit 6 described later. A flexible suction tube 7 is connected to the rear end of the US handpiece 5. In the middle of the rear side of the suction tube 7, a peristaltic type suction pump unit 8 for generating suction pressure is disposed. The suction pump unit 8 is controlled by the control unit 20, and the suction flow rate is adjusted. The sucked waste liquid is discharged into the waste liquid bag 9.
[0016]
The perfusion tube 3 and the suction tube 7 are used by being connected to a handpiece dedicated to perfusion, an I / A handpiece for perfusion suction, or a vitreous cutter according to a surgical stage, a surgical method, or the like. By providing a member that branches into 2WAY or 3WAY in the middle of the perfusion tube 3 and the suction tube 7, it is possible to connect a plurality of surgical instruments at the same time. In this case, it is possible to save the trouble of changing the surgical instruments. Can do.
[0017]
10 is a pressure sensor and 11 is a solenoid valve. The pressure sensor 10 and the electromagnetic valve 11 are connected to the suction tube 7 via the connection portion 12. The pressure sensor 10 always detects the suction pressure. When the suction hole at the tip of the crushing tip 5a is blocked by a cold substance such as a crystalline lens nucleus and the suction pressure in the suction tube 7 reaches a set value, the control unit 20 performs a suction pump based on a detection signal from the pressure sensor 10. After the part 8 is stopped, the pressure in the suction tube 7 is kept at a set value. Further, if necessary, the electromagnetic valve 11 is opened to lower the suction pressure.
[0018]
A control panel 21 is provided with a touch-type liquid crystal display 22. By operating various keys displayed on the display 22, various settings and inputs such as surgical conditions can be performed. The control unit 20 to which the control panel 21 is connected has a program for setting the allocation of the operation signal of the apparatus to each input signal from the plurality of operation switches of the foot switch unit 6, and by an instruction input by a touch key of the display 22 The program is executed, and the operation signal of the apparatus is assigned to each operation switch (specific assignment will be described later). Reference numeral 23 denotes a memory card reading / writing device. The memory card 24 stores device setting condition data, assignment data of each operation switch of the foot switch unit 6, and the like, and the stored data is read to easily set the device. Can be done. Reference numeral 26 denotes an audio output device.
[0019]
FIG. 2 is a schematic external view of the foot switch unit 6. The foot switch unit 6 according to the embodiment includes a main switch 40 that is depressed at the center, a first auxiliary switch 41 and a second auxiliary switch 42 that are provided on the left and right of the main switch 40 and fall laterally, and a foot switch. A third auxiliary switch 43, a fourth auxiliary switch 44, and a fifth auxiliary switch 45 are provided at the upper left and right of the housing of the unit 6. In the main switch 40, the amount of depression is detected by a potentiometer (not shown), and an operation signal corresponding to the depression position is input to the control unit 20, and perfusion, suction, ultrasonic waves are set according to the operation mode setting. Each operation such as oscillation can be controlled. Other functions of the auxiliary switches 41 to 45 can be arbitrarily set and changed by the control panel 21.
[0020]
The function change (setting) of the auxiliary switches 41 to 45 will be described. In the initial setting of the apparatus, IRR mode for irrigating the perfusate, I / A mode for perfusion and suction, US mode for ultrasonic emulsification using a US handpiece, and DIA mode for using a vitreous cutter Depending on the setting of each operation mode, the function of each switch is assigned as shown in FIG. For example, in the US mode, the main switch 40 can control the operation of perfusion, suction, and ultrasonic oscillation according to each position, the first auxiliary switch 41 is a reflux function that temporarily reverses the suction, and the second auxiliary switch 42 is previously set. The function of switching the registered condition setting (suction pressure, suction flow rate, ultrasonic output, ultrasonic output control method, etc.) pattern, the third auxiliary switch 43 raises the pole, the fourth auxiliary switch 44 The function of lowering the pole, and the fifth auxiliary switch 45 is set with a switching function of each operation mode (IRR mode, I / A mode, US mode, DIA mode).
[0021]
When changing the assignment of the function of the operation signal of the device to the input signal of each switch, the following is performed. First, by selecting the “change memory contents” item from the menu screen displayed on the display 22 and selecting the “foot switch change” item on the next screen, each input signal from the auxiliary switches 41 to 45 is selected. A program for setting the operation signal allocation of the apparatus is executed. The display 22 displays a screen for changing (setting) the allocation of each auxiliary switch. FIG. 4 shows an example of the screen at this time. A layout diagram of each switch is displayed in the left window 51 on the screen, and functions assigned to each switch are displayed in the upper right window 52 (FIG. 4 shows the initial state in the US mode). The lower right window 53 lists items of functions that can be assigned to each switch.
[0022]
The operator (operator) confirms the function of each current switch displayed in the left window 51 and the upper right window 52, and touches the switch number displayed in the left window 51 when there is a switch that needs to be changed. To select the switch to be changed. For example, when changing the function of the first auxiliary switch 41 to which the reflux function is assigned to the free flow function of the perfusate (the function of switching supply / stop of the perfusate by turning the switch ON / OFF), the left window Touch switch number 1 on 51 and then touch and select “FREE FLOW” from the items in the lower right window 53. Then, the display of the function of the switch number 1 in the upper right window 52 is changed to the selected one.
[0023]
In this way, the operator makes the setting of the operation signal assignment of the apparatus with respect to the input signal from each switch desired, and when the change is completed, the “determine” key displayed in the lower window 54 is pressed. Since a screen for inputting an identification name for registering the changed content is displayed on the display 22 (not shown), the identification name (name of the surgeon, etc.) is displayed using the character keys displayed on the screen. Is stored in the memory card 24 via the memory card reader / writer 23. Since many changes can be stored in the memory card 24 by identification names, it is possible to register a plurality of patterns in advance for each operator. Of course, the contents changed for each operator can be stored together with the identification name in another storage means in the apparatus. However, if a storage medium that can be taken out from the apparatus, such as a memory card 24, is used, When using another device, it is convenient that the change contents can be easily recalled. Needless to say, it can be changed to a portable storage medium such as a floppy disk or MO (magneto-optical disk) instead of a memory card.
[0024]
Next, the operation of the cataract surgery device having the above configuration will be briefly described. Here, the operation of the operation by the ultrasonic emulsification suction method will be described as an example.
[0025]
At the time of the operation, preparations necessary for the operation such as installation of the perfusion bottle 1 and attachment of each tube to the handpiece to be used are performed. In order to make the function of each switch of the foot switch unit 6 desired by an operator, a memory card 24 in which desired contents are stored in advance for each operator is used. The memory card 24 is inserted into the memory card reading / writing device 23, and the call screen key displayed on the display 22 is operated to call the contents registered by the surgeon. Thereby, the data of the operation function of the apparatus corresponding to the input signal from each switch of the foot switch 6 stored in the memory 25 is rewritten. Thus, if the data which changed the function of the foot switch was memorize | stored in the memory card 24, since the change operation as mentioned above does not need to be performed every operation, the preparation before an operation can be performed efficiently. Hereinafter, it is assumed that the function of the first auxiliary switch 41 is changed to the free flow function of the perfusate with respect to the initial setting of FIG.
[0026]
When the necessary settings on the device side have been made, the operation is started. The surgeon selects the US mode by pressing the fifth auxiliary switch 45. The operation mode is switched in turn each time the switch 45 is pressed, and the switching state is notified by voice by the voice output device 26.
[0027]
The surgeon incises the corneal annulus with a scissors while observing the patient's eyes with a surgical microscope (not shown). At this time, if hemostasis is necessary, the operation mode is switched to the DIA mode by the fifth auxiliary switch 45, and then the main switch 40 is depressed to apply driving energy to the diathermy insulator to perform hemostasis. Return to US mode when hemostasis is complete. When diathermy insulators are frequently used, if the function assignment of the fifth auxiliary switch 45 is changed to the dithermy insulator ON / OFF function, the number of switch operations can be reduced.
[0028]
After incision of the limbus, an anterior capsulotomy is performed and the crushing tip 5a of the US handpiece 5 is inserted into the eye through the incision. At the time of anterior capsulotomy, anterior aqueous humor flows out of the incision, so that a perfusate is supplied to prevent the anterior chamber from collapsing. Although the supply of the perfusate can be performed by depressing the main switch 40 to the position 1, it is necessary to keep the depressed position, so that it may be difficult for some operators to operate. In such a case, the perfusate can always be supplied by pressing the first auxiliary switch 41 to turn on the free flow function. This switching is also notified by voice by the voice output device 26. Further, the perfusion pressure can be adjusted by moving the pole 2 up and down by operating the third auxiliary switch 43 and the fourth auxiliary switch 44.
[0029]
When crushing and emulsifying the lens nucleus, the main switch 40 is depressed to generate ultrasonic vibration in the crushing chip 5a. When the crushing chip 5a vibrates, the lens nucleus is crushed and emulsified, and is sucked from the suction hole at the tip of the crushing chip 5a and discharged outside the body.
[0030]
After the removal of the lens nucleus, the I / A handpiece is used instead of the US handpiece 2 when the residual cortex remaining in the sac is removed by suction. The operation mode can be easily switched and set by the operator himself in the fifth auxiliary switch mode 45.
[0031]
【The invention's effect】
As described above, according to the present invention, the foot switch can be provided with a function desired by the operator, so that the operability of the switch is improved. In addition, a single device can cope with the diverse needs of different surgeons. Thereby, each operator can perform a smoother operation.
[Brief description of the drawings]
FIG. 1 is a schematic configuration diagram of a cataract surgery device according to an embodiment.
FIG. 2 is a schematic external view of a foot switch unit according to an embodiment.
FIG. 3 is a diagram illustrating the function of each switch in the initial setting.
FIG. 4 is a diagram showing an example of a screen when changing the assignment of each switch.
[Explanation of symbols]
6 foot switch unit 20 control unit 23 memory card reader / writer 24 memory card 25 memory 40 main switch 41 first auxiliary switch 42 second auxiliary switch 43 third auxiliary switch 44 fourth auxiliary switch 45 fifth auxiliary switch

Claims (1)

An ophthalmic surgical apparatus for operating a patient's eye using a foot switch having a main switch that emits an operation signal for controlling operations such as perfusion suction and ultrasonic oscillation based on operation modes such as perfusion suction and ultrasonic oscillation And a plurality of auxiliary switches provided in the foot switch, and a device for each input signal of the plurality of auxiliary switches for each operation mode including the I / A mode and the US mode. A program storage means for storing an allocation program for setting the operation signal allocation of the operation signal, and a display arranged on the apparatus main body side having a control unit for displaying a predetermined selection screen including a screen for setting and inputting a surgical condition. On the function change screen of the foot switch , the allocation is made for each operation mode including the I / A mode and the US mode. According to the allocation program, the operation signal of the device corresponding to the input signal of each auxiliary switch is selected from the assignable functions including the function of switching the supply / stop of the perfusate and the function of temporarily reversing the suction. An ophthalmic surgical apparatus comprising: an assigning unit; and a combination storage unit that stores a combination of operation signals for each input signal of the auxiliary switch assigned by the assigning unit.

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