JPS6144500B2 - - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION The present invention relates to a laser scalpel device for surgical operations, and more particularly to an improvement of a conventional laser scalpel device in which a laser resonator is vertically arranged.

As is well known, the application of laser devices to the medical field has spread rapidly in recent years, and clinical examples of laser scalpel devices for surgical operations have been published in many fields, and their effectiveness is being established. There are two types of laser scalpel devices that have reached the stage of practical use, as described below, in terms of the structure and arrangement of the laser resonator support.

One method is to horizontally fix a support base for fixing a laser resonator onto a housing via a vertical axis, and fix a laser beam transmission device to a laser beam exit provided on the support base. It is something.

Other types include a support stand for fixing the laser resonator that is fixed vertically inside the housing, or a support stand with its lower end fixed inside the housing so that only the upper part of the support stand is exposed outside the housing. Some have a laser beam transmission device fixed to the upper end.

Naturally, various medical equipment and devices are placed in the operating room during surgery, and by using these devices simultaneously or individually, the surgeon, nurses, and other surgical witnesses can proceed with the work. That's why. Therefore, in order to allow the surgeon and other surgical attendants to smoothly perform their work in the operating room equipped with the various devices described above, it is desirable that the various devices be as small as possible. This also applies to laser scalpel devices without exception.

In this sense, the second type of device in which the support base is installed vertically and only a part of it is exposed outside the housing is the same as the first type in which the support base is installed horizontally. Since the device can be made smaller in comparison, the use of other equipment is less obstructed even in an operating room equipped with various surgical equipment, and a wide working area can be secured. Furthermore, there are many advantages, such as the fact that the device is relatively easy to move due to its small size.

In particular, Patent Application No. 33194 of 1972
133586) "Laser device", the lower end of the support is fixed in the housing via a vibration absorber, and the upper part of the support stands vertically upwardly protruding from an opening provided in the ceiling of the housing. , an articulated reflector manipulator at the upper end;
A laser light transmission device such as a flexible waveguide or optical fiber is fixed. With this configuration, the device is made smaller, and all vibrations and shocks transmitted to the housing from the outside are absorbed by the vibration absorbing device, thereby preventing the optical system from becoming distorted.

This gives the laser scalpel device good portability, making it convenient to move the device from operating room to operating room as necessary, and improving the operating rate of the laser scalpel device. It is something.

Particularly with this type of device, since the device can be miniaturized, it is less likely to interfere with the use of other medical equipment during surgery, and requires less work space around it - for example, the laser beam delivery device can be It is very effective for cutting, evaporating, etc. in minute areas limited to specific areas, such as when using a commercial microscope.

However, when used in general surgical operations, it is no longer optimal for reasons described below.
In other words, in a general surgical operation, the surgeon, assistant doctors, nurses, and other surgical witnesses stand around the operating table, and the surgeon grasps the tip output section of the laser beam transmission device and presses the tip of the laser beam transmission device. Surgery is performed by emitting output light emitted from the device to a desired position. At this time, the operator is located in a location where it is easy to perform the surgery, in most cases between the housing and the operating table, and proceeds with the operation with the cooperation of surrounding surgical witnesses. Furthermore, since the surgeon, assistant doctors, nurses, and other surgical witnesses need to move around and carry out their work depending on the surgical situation, there are places around the operating table that do not interfere with their actions. It is desirable to secure as wide a work area as possible. For these reasons, it is necessary to maintain an appropriate distance between the housing of the laser scalpel device and the output end of the laser beam transmission device.

A high-power CO ₂ laser is often used as a laser resonator in a surgical laser scalpel device, and an articulated reflector manipulator is currently used as a laser beam transmission device for this purpose. In this case, as described above, since a suitable distance is required from the housing to the operating table, the length of the horizontal arm of the multi-joint reflector manipulator must be relatively long.

On the other hand, the articulated reflector manipulator must have the ability to transmit the laser light passing through it to a desired position without reducing the output of the laser light as much as possible. Therefore, in order to prevent the optical axis of the transmitted laser beam from being distorted,
The parts of the arms that connect each joint are usually made thicker and more rigid to prevent them from bending due to their own weight.

This results in an increase in the weight of the multi-joint reflector manipulator, which increases the moment of inertia that opposes the movement of the arm. For this reason, it becomes a hindrance to surgical operations that require complexity and delicacy. Furthermore, due to the long arms, the mirrors fixed to each joint are required to have extremely high adjustment accuracy.

As mentioned above, in terms of operability and maintenance of the multi-joint reflector manipulator, it is desirable that the length of the arm, especially the length of the horizontal arm, be as short as possible. Moreover, in order to secure a working space for the operator, an appropriate distance must be maintained from the housing to the tip of the articulated reflector manipulator.

Furthermore, the following problems must be solved in a laser scalpel device in which the support base is vertically arranged. In this type of device, the laser resonator on the support is installed upright as described above, and the output light is emitted vertically upward from the output mirror fixed to the upper end and guided to the laser beam transmission device. It will be destroyed.
Since the output mirror is located horizontally above the laser resonator, dust floating in the air may accumulate on the mirror during long-term use of the laser scalpel device. It's something to put away.

When dust or the like adhering to the output mirror is hit by laser light, it absorbs the light and its temperature rises, causing a situation where part of the mirror surface is burnt. In the worst case, the mirror may be destroyed by heat. Therefore, in this type of laser scalpel device, maintenance is required to constantly manage the mirror and remove accumulated dust and the like.

The laser scalpel apparatus of the present invention provides an apparatus that solves the problems pointed out above while maintaining the characteristics of the conventional apparatus in which a support base is vertically installed, such as miniaturization and good portability.

Embodiments of the present invention will be described in detail below with reference to the accompanying drawings. In FIG. 1, the laser resonator 3
The support base 2 for fixing the is bent at a right angle at the middle part or at an appropriate position so that the shape forms an inverted L shape. On this support stand 2,
Mirror holders 32, 34, and 37 are fixed, and each holder has an output mirror 33 and a total reflection mirror 3.
5. An intermediate reflection mirror 36 is held.

A CO ₂ laser discharge tube 31 bent at right angles to form an inverted L shape is fixed at both ends to the mirror holders 32 and 34, and an intermediate reflection mirror 36 is fixed to the bent portion. The laser resonator 3 is configured in this manner.

An output port 5 is provided at the upper end of the support base 2 for passing the output light 11 that is output from the laser resonator 3 through the output mirror 33 and whose direction is changed upward by the reflection mirror 9. A laser beam transmission device 6 such as an articulated reflector manipulator, a flexible waveguide, or an optical fiber is fixedly connected to the mouth 5 for transmitting the output light 11 to a desired position. In this case, it goes without saying that the optical axis of the output light 11 and the incident optical axis of the laser beam transmission device 6 are made to coincide. In addition, a reinforcing member 10 is fixed to the bent portion of the support base 2 when there is a possibility that the support base 2 may be deformed due to its own weight.

An opening is provided in the ceiling of the housing 1 that houses the laser oscillation control section 7. The lower end of the support base 2 is inserted into the opening, and the lower end of the support base 2 is inserted directly or
It is fixed in the housing 1 via a vibration absorbing device 13 similar to that described in ``Laser Device'', No. 33194 (Japanese Unexamined Patent Publication No. 55-133586). In this case,
The support base 2 is fixed such that its horizontal portion is positioned above the front of the housing 1 (upper right in the figure).

Similarly to the first embodiment described above, it is also possible to realize a linear laser resonator 3. Second
The figure shows one example, and in the figure, the laser resonator 3
is fixed to the vertical part of the inverted L-shaped support base 2 in the same manner as in the first embodiment. A hood 12 is fixed to the upper end of the laser resonator 3, and the hood 12 houses the output mirror 33, its holder 32, and a reflection mirror 91 therein.

The hood 12 is made of a cylinder bent at a right angle and has openings at both ends.The upper end of the laser resonator 3 is inserted into one end of the hood 12 and is fixedly engaged therewith.
The other end may be left open or sealed with a transparent plate. The output light 11 emitted from the output mirror 33 of the laser resonator 3 is reflected by the reflection mirrors 91, 9.
2 and is guided to a laser beam transmission device 6 fixed on an exit aperture 5.

As explained in detail above, the laser scalpel device of the present invention is characterized by employing a support that is bent in an inverted L shape at the middle part or at an appropriate position, and furthermore, the horizontal part thereof is in front of the front surface of the housing. It is fixed so that it sticks out. That is, the mounting portion of the laser beam transmission device, such as the articulated reflector manipulator, flexible waveguide, or optical fiber, is located at a position that protrudes forward from the front surface of the housing.

Therefore, if a certain distance is to be left between the housing and the operating table in order to secure a working space for the surgeon during surgery, the laser light transmission is more difficult than with conventional devices in which the support table is simply placed vertically. The length of the horizontal arm of the device can be shortened by the length of the horizontal portion of the support base that protrudes forward.

In particular, in the case of surgical laser scalpels, a CO ₂ laser is often used, and therefore, in most cases, an articulated reflector type manipulator is used as the laser beam transmission device. As mentioned above, the multi-joint reflector manipulator has a problem in that the arms that connect the joints, especially the horizontal arms, cannot be made very long in terms of operability and accuracy. According to the laser scalpel device,
Articulated reflector manipulator, flexible waveguide,
The length of the arm of a laser beam transmission device such as an optical fiber can be shortened.

In particular, in the case of an articulated reflector type manipulator, the length of the horizontal arm can be shortened, so that operability can be improved and the required adjustment accuracy of the mirror can be kept low. On the other hand, if a conventional laser beam transmission device such as an articulated reflector manipulator is used as is, the operator can secure a wider working space during surgery.

Furthermore, according to the present invention, the following advantages can be obtained. As mentioned above, in the conventional apparatus in which the support stand is installed vertically, dust and the like adhere to and accumulate on the output mirror, and in the worst case, the output mirror may become unusable. However, according to the present invention, this problem is solved as follows.

In the device of the first embodiment in which a similarly inverted L-shaped laser resonator is fixed to an inverted L-shaped support, the output light emitted from the output mirror 33 fixed to one end of the laser resonator is emitted in the horizontal direction. , the direction is later changed by the mirror 9 and reaches the laser beam transmission device 6. That is, in this type of device, since the laser beam emitting surface of the output mirror is located vertically, dust in the air does not accumulate on the output mirror.

Next, in the device of the second embodiment in which the laser resonator is fixed upright on the vertical part of the inverted L-shaped support, the laser beam emitting surface of the output mirror is located horizontally, as in the conventional device. . However, in the present invention, since the dust-proof hood 12 is provided which collectively houses the output mirror and the optical system such as the reflection mirror for changing the direction of the emitted light, dust etc. may accumulate on the output mirror 33. That will no longer be the case.

As described above, the laser scalpel device of the present invention is not affected by the problem of accumulation of dust and the like in the air.
Therefore, maintenance and management of the output mirror is facilitated. In the laser scalpel device of the present invention, the horizontal part of the inverted L-shaped support base protrudes forward of the housing, which at first glance seems to interfere with surgical operations, but this is because the support base This can be improved by configuring the device to be raised to the required height during surgery, such as by providing a lifting device. In addition, when the support base is fixed to the housing via a vibration absorbing device, shocks and vibrations that occur when the device is moved may cause damage to the articulated reflector manipulator, mirror for changing the direction of the emitted laser beam, etc. This eliminates the possibility of causing distortion in the optical system.

In each of the above-mentioned embodiments, the support base 2 is bent at a right angle, but other forms such as those with a bending angle other than 90° are also possible.
It is also possible to realize Also, instead of the CO ₂ laser resonator 3, an A _r laser resonator or a CO 2 laser resonator 3 can be used.
It is also possible to employ a laser resonator.

In addition, in order to facilitate the use of the laser scalpel device, a visible light source for guiding the CO ₂ laser beam is also installed on the support base 2, and the beams of both are adjusted so that they have the same optical axis. It is also possible to easily realize an optical mixing device, a device provided with a beam shutter for emitting or blocking output light, and the like. Furthermore, when the linear laser resonator 3 is fixed to the support base 2, the optical mixing device can also be installed so as to be housed in the hood 12. If the support base 2 is rotatably attached to the housing 1, the floor space occupied by the support base 2 can be reduced by rotating the support base 2 when not in use. Furthermore, in order to shorten the length to 1/2 as the laser resonator in this case, it is also possible to easily adopt a resonator bent by 180 degrees at the middle part of the laser discharge tube.

[Brief explanation of the drawing]

1 and 2 are schematic cross-sectional views of embodiments of the present invention, respectively. DESCRIPTION OF SYMBOLS 1... Housing, 2... Support stand, 3... Laser resonator, 5... Output port, 6... Laser light transmission device, 7... Laser oscillation control unit, 12... Hood,
13... Vibration absorber, 33... Output mirror.

Claims (1)

[Claims] 1. An inverted L-shaped support for fixing a laser resonator, and a support provided at an end of a horizontal portion of the support to include an optical axis of output light emitted from the laser resonator. a laser beam transmission device fixed to the emission port; A laser scalpel device characterized in that it is attached to a housing. 2. The laser scalpel device according to item 1, wherein the laser resonator is bent to follow its support. 3. The laser resonator according to item 1 or 2, wherein the laser resonator is linear and further includes a reflecting mirror means for inputting the output light emitted almost vertically upward into the laser beam transmission device. Laser scalpel device. 4. The laser scalpel device according to item 3, further comprising a hood above the laser resonator that includes an output mirror and a reflection mirror therein.