JPH07132124A - Laser forceps for operation in abdominal cavity - Google Patents

Abstract

PURPOSE:To provide the laser forceps capable of making disposition by irradiating only the lesion tissues in the abdominal cavity to be operated with a yag laser. CONSTITUTION:An operator increases the gap between a contact chip 12 and a hook 141 by manipulating an operating lever 15 toward an arrow C. The operator hooks the lesion in such a manner that the lesion to be operated comes into this gap. The lesion is held between the hook and the contact chip by manipulating the operating lever toward an arrow D until the gap is made small. The properly adjusted laser is supplied to the contact chip from an optical fiber 13 to irradiate the lesion with the laser. Further, the hook is pressed to the contact chip so as to make the gap smaller and the lesion is excised. The laser makes hemostasis as well at the time of the excision.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a handpiece or probe for irradiating an affected area with a medical YAG laser, and more particularly to a forceps type handpiece.

[0002]

2. Description of the Related Art Conventionally, when a YAG laser is used for an affected area under a laparoscope, a contact tip 22 is attached to the tip of an elongated rigid pipe 21 inserted into a trocar provided in the abdominal area as shown in FIG. The optical fiber 23 is used to guide the yag laser to the contact tip 22 to irradiate the tissue, or as shown in FIG. 3, the contact fiber 33 arranged in the suction perfusion probe 31 is directly contacted with the tissue to irradiate the yag laser. It was However, these methods only allowed a linear approach to the affected area. Therefore, as a modification of these, as shown in FIG. 4, a hook type tip 42 is attached to the tip of an elongated rigid pipe 41, and a yag laser is guided to the hook type tip 42 by an optical fiber 43 to irradiate the corresponding tissue. There is something I did.

[0003]

As described above, in the apparatus shown in FIG. 4, the diseased tissue can be excised by irradiating with a yag laser while hooking the diseased tissue inside the hook of the hook type tip. However, since the yag laser is emitted from the hook type tip not only to the inside but also to the outside, there is a problem in that the tissue to be preserved, not the ablation target, is also irradiated with the yag laser.

In view of the above problems, it is an object of the present invention to provide a laser forceps capable of irradiating only a diseased tissue in the abdominal cavity of a surgical treatment target with a yag laser for treatment.

[0005]

The laser forceps of the present invention comprises:
A pistol-shaped main body composed of a long tubular part and a holder part extending a predetermined angle from one end of the tubular part, and one end facing the connecting part between the tubular part and the holder part as an operation drive end. The other end is the operating end, and the intermediate point is the connecting part, and the operating lever is rotatably connected to the holder part of the main body part,
A contact tip detachably fixed to the other end of the tubular portion, an optical fiber for supplying a laser to the contact tip, one end of which is connected to the drive end of the operating lever, and the tubular portion of the main body portion is operated by operating the operating lever. A hook lever attached to the main body so that the hook lever can be slid along the other end, and the other end is bent as a facing hook along the end face of the contact tip.

The end surface of the contact tip has a semi-cylindrical shape, and one end of the hook lever is connected to the driving end by an operating knob so that the hook of the hook lever does not face the end surface of the contact tip. When the hook lever is rotated, the spring preferably biases the operation knob to retract the hook from the end surface of the contact tip toward the holder portion. It is also preferable that the contact tip is made of artificial sapphire, the hook lever is made of stainless steel, at least the hook of the hook lever is made of ceramic, and the laser supplied to the optical fiber is a YAG laser.

[0007]

[Operation] The operation lever is operated to increase the gap between the contact tip and the hook. The affected part is hooked on the hook so that the affected part to be surgically treated comes into this void. The operation lever is operated to make the gap small, and the affected area is sandwiched between the hook and the contact tip. An appropriately adjusted laser is supplied from an optical fiber to the contact tip to irradiate the affected area with the laser. If necessary, the hook is pressed against the contact tip so as to reduce the gap, and the affected area is excised. During ablation, the laser also stops bleeding.

[0008]

Embodiments of the present invention will now be described with reference to the drawings. FIG. 1A is a configuration diagram showing an embodiment of a laser forceps for intra-abdominal surgery of the present invention, and FIG. 1B is a closed state of the laser forceps of FIG. 1A with a hook opened. It is a figure which shows the case where it is made to. Laser forceps 10 of this embodiment
Has a pistol shape as a whole, and the main body 11 is composed of a long tubular portion 11 ₁ (having a desirable diameter of about φ5) and a holder portion 11 ₂ . A contact tip 12 (preferably made of, for example, artificial sapphire or artificial diamond) is attached to the tip of the cylindrical portion 11 ₁ , and the optical fiber 13 is attached to the holder portion 1.
It is inserted from the tip of 1 ₂ and arranged so as to contact the contact tip.

The hook lever 14 has a straight portion of the main body 11.
Tubular part 11₁Along the longitudinal direction as indicated by arrow A
It is arranged slidably. Also, hook lever
-One end of 14 has a semicircular cross section of contact tip 12.
Hook 14 along₁Is bent as. hook
One end of the operation knob 16 is attached to the other end of the lever 14.
The hook 14 as shown by the solid line in FIG.₁Is facing downwards
When it is being kicked, the hook lever 14 and the operating lever 1
Operation knob 16 so that one end of 5 moves together
Joins the two. However, the dotted line in Fig. 1 (a)
Sea urchin hook 14 ₁Is compressed when is directed upwards
The spring 17 that was attached is the operation knob 16 and the operation lever 1.
5 is urged so as to separate it from one end of FIG.
Slide hook lever 14 to the right in
Hook 14₁To the position indicated by the dotted line.

Next, a method of using the laser forceps 10 of this embodiment will be described. The hook 14 ₁ of the hook lever 14 is directed downward as shown by the solid line in FIG. 1A, and the operating end 15 ₂ of the operating lever 15 is rotated in the direction of arrow C with the connecting portion 15 ₃ as a fulcrum. The hook lever 14 slides to the left and opens the hook 14 ₁ so that a sufficient space is formed between the hook 14 ₁ and the contact tip 12. After hooking the affected part to be treated on the hook 14 ₁ , the operating end 15 ₂ is rotated in the direction of arrow D, as shown in FIG.
As shown in (b), the affected area is sandwiched between the hook 14 ₁ and the contact tip 12.

After sandwiching as shown in FIG. 1 (b), if the operating end 15 ₂ is further rotated in the direction of arrow D and the yag laser is appropriately irradiated from the contact tip 12, the affected area can be excised and hemostasis can be performed. Therefore, the surgical procedure can be smoothly performed. In this case, the YAG laser emitted from the contact tip 12 hits the hook 14 ₁ even if there is a portion not irradiated on the affected area, so that irradiation of the tissue to be preserved can be avoided.

[0012] When wishing to make a similar way to use a conventional contact tip (Fig. 2), the operation knob 16 so as to face the upper hook 14 ₁ in FIG. 1 (a) 180
Rotate by °. When rotated, the hook lever 14 and the operation knob 16 slide to the right by the spring 17 and are set at a position retracted from the tip of the contact tip 12. Therefore, by irradiating a yag laser from the contact tip 12, the same surgical procedure as the conventional one can be performed.

[0013]

As described above, according to the present invention, the laser irradiation surface of the contact tip is made to face the hook of the hook lever, and the affected part can be irradiated with the laser by sandwiching the affected part with the contact tip and the hook, and thus the tissue to be preserved. There is an effect that excision of the affected area or hemostasis can be easily performed without irradiating the laser.

[Brief description of drawings]

FIG. 1A is a configuration diagram showing an embodiment of a laser forceps of the present invention. (B) is a figure which shows the case where the laser forceps of (a) whose hook was opened was made into a closed state.

FIG. 2 is a view showing a conventional example in which a contact tip is attached to the tip of a hard pipe.

FIG. 3 is a diagram showing a conventional example in which a contact fiber is arranged in a suction perfusion probe.

FIG. 4 is a diagram showing a conventional example in which a hook type tip is attached to the tip of an elongated rigid pipe, and a yag laser is guided to the hook type tip by an optical fiber to irradiate the corresponding tissue.

[Explanation of symbols]

10 Laser forceps 11 Main body 11 ₁ Cylindrical part 11 ₂ Holder part 12 Contact tip 13 Optical fiber 14 Hook lever 14 ₁ Hook 15 Operation lever 15 ₁ Operation drive end 15 ₂ Operation end 15 ₃ Coupling part 16 Operation knob 17 Spring

Claims (5)

[Claims] 1. A pistol-shaped main body portion comprising a long tubular portion and a holder portion extending a predetermined angle from one end of the tubular portion, and the tubular portion and the holder portion having one end as an operation drive end. The operation lever is rotatably connected to the holder part of the main body part, and the other end is the operation end, and the intermediate point is the connection part, and the other end of the operation part is detachably fixed to the other end of the tubular part. Contact tip, an optical fiber for supplying a laser to the contact tip, and one end connected to the drive end of the operation lever, and attached to the main body so that it can be slid along the tubular portion of the main body by operating the operation lever. , And a hook lever having the other end bent as a hook facing along the end surface of the contact tip. 2. The laser forceps according to claim 1, wherein an end surface of the contact tip has a semi-cylindrical shape. 3. One end of the hook lever is connected to the drive end by an operation knob, and when the hook lever is rotated so that the hook of the hook lever does not face the end surface of the contact tip, the spring is actuated. The laser forceps according to claim 1, wherein the operation knob is biased to retract the hook from the end surface of the contact tip toward the holder portion side. 4. The laser forceps according to claim 1, wherein the contact tip is made of artificial sapphire, and the hook lever is made of stainless steel. 5. The laser forceps according to claim 1, wherein the hook of the hook lever is made of ceramic, and the laser supplied to the optical fiber is a YAG laser.