JP7395140B2 - Lighting device for endoscopic surgery - Google Patents

Description

The present invention relates to a lighting device for laparoscopic surgery used for endoscopic surgery on humans and animals.

Conventionally, in endoscopic surgery, when performing three-dimensional surgery on the affected area using various surgical instruments, relying on the two-dimensional monitor image from the endoscope, the optical axis of the endoscope and the visual axis of the observation overlap. In order to prevent insufficient shadows in the affected area and "white spots" caused by the reflection of the light source on the endoscope, an illumination device disclosed in Patent Document 1 has been proposed.

In this device, a horizontally elongated light source made of an LED is mounted inside a C-shaped ring-shaped tube on an inverted V-shaped mounting surface within the cross section of the ring, facing outward and inward.

Utility model registration No. 3185394

The device of Cited Document 1 has the advantage that the optical axis of the light source that irradiates the abdominal cavity and the camera that photographs it, that is, the visual axis of observation, are different, making it possible to display shadows in the image, and the effect that the light source has on the camera image. Although this is excellent in terms of reducing negative effects, the light source is arranged in an inverted V-shaped cross section with a cavity inside, distributing light outward and inward, so in addition to the thickness of the transparent tube, the outer diameter of the device In addition to being large and inconvenient for intraperitoneal use, the light source is distributed outward and inward, resulting in insufficient light to the affected area, and the structure is complex and costly. be.

In addition, when increasing the amount of irradiated light (LED amount) to perform surgery smoothly, even if the LED itself generates almost no heat, as the amount of integrated LED increases, the amount of heat generated by the circuit increases, making it difficult to use in vivo in humans and animals. There was a problem with this.

The lighting device of the present invention for solving the above problems firstly includes a plurality of light emitting elements 3 mounted in close proximity to the light emitting surface of a thin plate-like substrate 2 having a C-shaped ring shape in plan view. This is a lighting device for endoscopic surgery in which the surface of a device connected to a circuit so as to be able to emit electricity and emit light is hermetically covered with a translucent plastic covering member 8, and a ring is provided along the back side of the substrate 2. At the same time, a cooling pipe 6 is provided to circulate a coolant and radiate or cool heat generated on the substrate 2 side due to energization , and the cooling pipe 6 is coated with a soft covering member 8 together with the substrate 2 and the light emitting element 3. It is characterized by being molded and sealed .

Second, a plurality of light emitting elements 3 are arranged close to each other in the transverse direction of the ring, and the plurality of light emitting elements 3 are arranged in many rows in the ring direction, and each light emitting element 3 is arranged in the transverse direction with respect to the current-carrying circuit 5 along the C-shaped ring. The feature is that each column is connected in parallel.

Thirdly, the supply end 7a and the discharge end 7b of the cooling pipe 6 are provided at one open end side of the C-shaped ring together with the circuit terminals for energizing, and the cooling pipe 6 is used as a coolant circulation circuit along the C-shaped ring. It is characterized by the fact that it was formed.

Fourthly , the cover member 8 and the cooling pipe 6 are both made of silicone resin.

Fifth , the coolant supply end 7a and the coolant discharge end 7b of the cooling pipe 6 are connected to the supply pipe 22 and the return pipe 19 , respectively, for circulating the coolant.

According to the illumination device of the present invention configured as described above, while maintaining the expansion of the irradiation range and the sharpness of the shadows in the affected area image, the increased heat generation due to compensating for insufficient illumination can be reduced by cooling piping. It can eliminate harmful effects on living organisms, has no special light distribution mechanism to the outside or inside, and does not form a cavity in the cross section, making it possible to simplify and downsize the structure and reduce the cross-sectional thickness. There is an effect.

In particular, by using an LED element as a light emitting element, it is possible to prevent the light emitting element itself from generating heat, but since heat is generated by the current-carrying circuit resistance wired to the board, cooling efficiency can be improved by providing cooling piping along the back of the board. It has the characteristic of being high.
These detailed contents and other effects will be explained in detail in the description of the embodiments of the invention to be described later.

FIG. 2 is a schematic diagram showing the usage state of the device of the present invention. (A) and (B) are a bottom view and a plan view showing the LED arrangement and the piping state of the cooling pipe on the front and back surfaces of the lighting device, respectively. FIG. 3 is a plan view showing details of the front side of the lighting device. (A) and (B) are sectional views taken along the line AA in FIG. 3, respectively showing different embodiments of the lighting device. FIG. 3 is a plan view of the surface of another embodiment of the device of the present invention. FIG. 2 is a side view of a cooling device used in the lighting device of the present invention. FIG. 3 is a plan view of the lighting device.

FIG. 1 is a schematic diagram showing the state of endoscopic surgery using the device of the present invention in the case of a human body. The illumination device 1 is inserted from its distal end side while rotating in the ring direction, and the inserted illumination device 1 is attached to the inner surface of the peritoneum 33 with its lower surface (light emitting surface) facing downward, and the lower organ 34 is the surgical target. Light is emitted from a light source arranged in a ring around the area.

At this time, the inside of the abdomen 31 is filled with carbon dioxide gas, and as shown in the figure, a space is secured between the peritoneum 33 and the organs 34 for the camera view of the affected area and its surroundings and for the surgical work space. An endoscope (laparoscope) 36 equipped with a camera is inserted through the insertion hole 32, the camera image is displayed on an external monitor screen, and the surgical operation is performed based on this image. This series of procedures and working conditions are the same as when using the conventional lighting device shown in Cited Document 1.

In the example of Cited Document 1, a C-ring-shaped lighting device is suspended by a hanging thread passing through the peritoneum and fixed to the inner surface of the peritoneum. However, when using the device of the present invention, a magnetic material is attached to the back of the lighting device. In some cases, a material is attached in advance and a magnet is placed on the abdominal surface side to arbitrarily position and attach the device, or a skin stapler is used to fix the device to the inner surface of the peritoneum.

Next, a detailed embodiment of the present invention will be described based on FIGS. 2 to 4. FIGS. 2(A) and 2(B) show the bottom surface (light projecting surface) and top surface (cooling surface) of the lighting device 1 of the present invention. is shown in a plan view, and FIGS. 3 and 4 are a plan view and a sectional view showing details thereof. Of these, FIGS. 4A and 4B show cross-sectional structures of different embodiments of the lighting device 1.

As shown in the figure, in the cross section of the lighting device 1, there is a flat substrate 2 made of glass epoxy resin or film substrate, glass epoxy resin, etc. formed in a C-shaped ring shape when viewed from above, which connects the core material and the back side. In this example, the substrate 2 is a sheet-like material with a thickness of 0.5 mm, and the C-shaped arc (ring) has a diameter of 116 mm and a plate width of 13 mm. The open end of the section and the distal end (insertion end) are formed into semicircular arcs. Although the substrate 2 does not have to be strictly a flat plate, it is undesirable for the light to be extremely dispersed or concentrated on the inner and outer sides of the ring, and it is necessary to at least block light on the back side, and the light emitting surface side should be light-emitting. It is desirable to ensure a sufficient amount of light projection by using a reflective surface at the same time.

As shown in Fig. 3, a large number of LED elements 3 (white) are closely mounted on the bottom of the substrate 2 as a light source. Three LED elements 3 are mounted at 0.5 mm intervals in the direction, a total of 183 LED elements 3 are connected in series in the normal direction of the arc, and in parallel in the direction of the arc to form an internal current-carrying circuit 5. Circuit terminals 4a and 4b are formed on the end side. 4 is a cable connected to circuit terminals 4a and 4b. By arranging the LED elements 3 themselves in a high-density manner in this way, it is difficult to form shadows, and the effect as a shadowless light can be obtained, and the amount of light can be adjusted by changing the voltage or current.

On the back side of the substrate 2, a cooling pipe (piping) 6 made of silicone resin, etc., which is folded back into a loop shape at the open end on the distal end side, is installed along the C-shaped ring and supplies coolant to the proximal end side. An end 7a and a discharge end 7b are formed. As shown in FIG. 4(A) or (B), the front and back outer circumferential surfaces of these members are coated with a light-transmitting covering member 8 made of silicone resin or the like by molding, coating, or the like. In addition to silicone resin, this covering material may be made of a flexible urethane resin or other material having the same properties.

In this example, the cross-sectional width after molding is 15 mm, the center end between the open ends is approximately 36 mm, and the overall thickness of the ring is approximately 8 mm. The ring has an inner diameter of 92 mm and an outer diameter of about 118 mm, and the covering member 8 insulates the LED and its connection circuit, forms a cushioning material and an insertion guide surface when inserted into the abdominal cavity, and also protects the LED from the light projection surface. Transmits light to the outside. The illumination device 1 itself is configured such that the surface and the whole can be elastically deformed due to the elasticity of the covering member 8.

The cross-sectional shape of the covering member 8 is not limited to the shape shown in FIGS. 4(A) and 4(B). For example, it is also possible to form a flat surface on both the light projection surface side and the cooling surface side.

By the way, examples of specifications other than those mentioned above for the lighting device are as follows, but they are not limited to the specifications below, and voltage, current, color density, color rendering properties, etc. can be changed, for example, an RGB light source as a light source. It is also possible to use
・Voltage DC8V (8-9V)
・Current (total) 1.7A
・Current (per chip) 30mA
・Color density 5000K (white)
・Color rendering property 80

FIG. 5 shows another embodiment of the device of the present invention, in which the base end side of the open end of the C-shaped ring of the device 1, including the substrate 2, is shown by a phantom line in the circle of the above embodiment. The arcuate portion is deformed linearly in the outward opening direction and in the tangential direction of the arc of the C-shaped ring.

That is, by changing the center line _O1 of the circular arc of the C-shaped ring to the center line _O2 of a straight line tangential to a certain length (only the arrow part), the distance between the proximal end and the distal end of the C-shaped ring is changed. The length between the open ends is increased by ΔL, which has the advantage of allowing smoother insertion into and withdrawal from the abdominal cavity, as well as easier insertion and removal of surgical tools such as trocars and forceps.

6 and 7 show an example of a cooling device 11 used for cooling the lighting device of the present invention. In this example, a Peltier element 12 is used, and a radiator 13 is placed on the heat absorption side of the Peltier element 12, and a radiator 13 is placed on the heat radiation side of the Peltier element 12. A main body is constructed by attaching a heat sink 14 and a fan 16, and a pump 17 for circulating coolant is attached to the outer periphery of the main body. In this example, a pump 17 with a discharge rate of 240 L/H is used.

A heat exchange pipe 13a is installed inside the radiator 13, and a large number of fins 14a are protruded from the bottom surface of the heat sink 14 (on the fan 16 side). It has become.

On the import port 15a side of the pump 17, there is a return pipe 19 connected to the discharge end 7b of the cooling pipe 6 of the lighting device 1, and on the out port port 15b side, there is a connection pipe connected to the import side of the radiator 13. 21 are connected to each other. A supply pipe 22 whose end is connected to the discharge end 7b of the cooling pipe 6 of the lighting device 1 is connected to the outport side of the radiator 13. A circulation circuit for a coolant (medical saline is used in this example) is formed.

With the above mechanism, during endoscopic surgery on humans or animals, the heat generated by the energization of the lighting device inserted into the abdominal cavity as described above is removed by the pump 17 returning the coolant flowing through the circulation circuit to the radiator 13 and circulating it. By doing so, cooling can be suppressed.

At this time, the lighting device 1 generates heat to a maximum of about 60 to 70 degrees Celsius, but the heat absorption surface of the Peltier element 12 is cooled to about 18 degrees Celsius according to actual measurements, although it varies depending on the conditions, so that the heat flows through the cooling pipe 13a. By cooling the coolant (physiological saline) and flowing it to the back (cooling surface) of the lighting device 1, the device itself can be cooled to 32 to 40 degrees Celsius, which corresponds to the human body temperature level. Even if it comes into contact with the peritoneum, it will not cause burns or other problems.

In addition, since it is not possible to check from the outside whether or not the lighting device 1 is being cooled properly, a monitoring sensor or sensor switch that detects the surface temperature and temperature changes of the device is installed near the cross-sectional surface of the lighting device 1. By connecting this to an external control unit, switch, etc., if the temperature of the device rises (according to the standard is 43°C or higher), respond to temperature changes such as reducing the brightness of the lighting device 1 or turning it off. (none of these are shown).

1 Lighting device 2 Board 3 Light emitting element (LED)
4 Cable 4a, 4b Circuit terminal 5 Energizing circuit 6 Cooling pipe (cooling pipe)
7a Supply end 7b Discharge end 8 Covering member 11 Cooling device 17 Pump 19 Return pipe 22 Supply pipe

Claims (5)

A large number of light emitting elements (3) are mounted in close proximity to the light emitting surface of a thin plate-like substrate (2) having a C-shaped ring shape in plan view, and the surface of the light emitting elements (3) is connected to a circuit so that electricity can be emitted. A lighting device for endoscopic surgery that is hermetically covered with a transparent plastic covering member (8), in which a coolant is distributed along a ring on the back side of the substrate (2). , a cooling pipe (6) is provided to dissipate or cool the heat generated on the substrate (2) side due to energization , and the cooling pipe (6) is covered with a soft covering member ( 8) A lighting device for endoscopic surgery which is sealed by coating or mold coating . A plurality of light emitting elements (3) are arranged close to each other in the transverse direction of the ring, and the plurality of light emitting elements (3) are arranged in many rows in the ring direction, and each transverse direction The illumination device for endoscopic surgery according to claim 1, wherein the illumination device is connected in parallel for each column. The supply end (7a) and the discharge end (7b) of the cooling pipe (6) are provided on one open end side of the C-shaped ring together with a circuit terminal for energizing, and the cooling pipe (6) is connected to the coolant along the C-shaped ring. The illumination device for endoscopic surgery according to claim 1 or 2, which is formed as a circulation circuit. The illumination device for endoscopic surgery according to any one of claims 1 to 3 , wherein the covering member (8) is made of silicone resin. Any one of claims 1 to 4 , wherein the coolant supply end (7a) and the coolant discharge end (7b) of the cooling pipe (6) are respectively connected to a supply pipe (22) and a return pipe (19 ) for circulating the coolant. A lighting device for endoscopic surgery according to claim 1.

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