WO1998018394A1 - Piece a main a laser chirurgical a angle variable - Google Patents

Piece a main a laser chirurgical a angle variable Download PDF

Info

Publication number
WO1998018394A1
WO1998018394A1 PCT/US1997/019030 US9719030W WO9818394A1 WO 1998018394 A1 WO1998018394 A1 WO 1998018394A1 US 9719030 W US9719030 W US 9719030W WO 9818394 A1 WO9818394 A1 WO 9818394A1
Authority
WO
WIPO (PCT)
Prior art keywords
movable member
rotation
variable angle
laser beam
gear
Prior art date
Application number
PCT/US1997/019030
Other languages
English (en)
Inventor
Charles Christopher Negus
Lawrence P. Brodsky
Original Assignee
Plc Medical Systems, Inc.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Plc Medical Systems, Inc. filed Critical Plc Medical Systems, Inc.
Publication of WO1998018394A1 publication Critical patent/WO1998018394A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
    • A61B18/201—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser with beam delivery through a hollow tube, e.g. forming an articulated arm ; Hand-pieces therefor

Definitions

  • This invention relates to a variable angle surgical laser handpiece.
  • a handpiece In endoscopic laser surgery a handpiece is used to deliver a laser beam to a surgical target. The laser beam propagates through a passage in the handpiece barrel or member and an output port to the patient.
  • handpieces with different angles are used. For example, in transmyocardial revascularization (TMR) a number of different angle handpieces are used to reach areas on the sides and back of the heart. While this approach does reduce the number and size of incisions, the surgical unit must purchase and keep on hand a number of handpieces of different angles and the surgeon must interrupt an already difficult and time-consuming procedure to switch handpieces one or more times.
  • TMR transmyocardial revascularization
  • variable angle surgical laser handpiece which provides the convenience of a number of different fixed angle handpieces in a single handpiece. It is a further object of this invention to provide such a variable angle surgical laser handpiece which automatically keeps the laser beam aligned as the angle of the handpiece is changed.
  • the invention results from the realization that a truly compact, safe and effective variable angle surgical laser handpiece can be achieved with a control mechanism that moves a deflection member about a rotational axis at one half the angular motion of the movable member which rotates about the same axis so that the laser beam stays aligned with the passages through the members and the output port in the movable member, automatically, through the full range of rotation of the movable member.
  • This invention features a variable angle surgical laser handpiece including a fixed member and a movable member rotatably mounted to the fixed member for rotation about a rotation axis, through a range of rotational angles.
  • a deflection device rotatably mounted on the rotation axis directs the laser beam from the fixed member through the movable member and port.
  • a control mechanism constrains rotation of the reflection device to one half the rotational angle of the movable member to maintain the alignment of the laser beam with the passage and port throughout the range of rotation of the movable member.
  • the deflection device may be a reflection element.
  • the control mechanism may include a locking means for locking the movable member at selected positions in its range of rotation.
  • the control mechanism may include a first gear device for rotation with the movable member, a second device for rotation with the deflection device, and an actuator gear device for interconnecting the first and second gear devices.
  • the first and second gear devices may include first and second pinions, respectively, and the actuator gear device may be a double rack having a rack associated with each pinion.
  • the first pinion may have a predetermined radius and the second pinion has a radius which is twice the predetermined radius.
  • the first gear device may include a central gear
  • the actuator gear device may include a planetary ring gear
  • the second gear device may include an idler gear engaged with the central gear and the planetary ring gear.
  • the idler gear may include an actuator element for controlling motion of the deflection device.
  • the control mechanism may include a first curved surface for rotation with the movable member, a second curved surface for rotation with the deflection device and a linear actuator device for introducing equal linear motion to both the curved surfaces.
  • the first surface may have a predetermined radius and the second surface has a radius which is twice that of the first surface.
  • the control mechanism may include a first guide associated with the movable member, a second guide associated with the fixed member and intersecting with the first guide, and an actuator follower constrained by the guides for controlling motion of the deflection device.
  • the guides constrain the actuator follower to a path in which the deflection device is constrained to rotate at half the angular speed of the movable member.
  • Fig. 1 is a three-dimensional view of a CO 2 surgical laser system employing the handpiece of this invention
  • Fig. 2 is an enlarged view employing the handpiece of this invention and a portion of the articulated optical arm which carries it;
  • Figs. 3A-C are ray diagrams which illustrate the need for the deflection device to rotate at one half the angular rotation of the movable member of the handpiece in order to maintain alignment of the laser beam;
  • Fig. 4 is a schematic sectional side elevational view with portions broken away of a variable angle handpiece according to this invention using a rack and pinion control mechanism
  • Figs. 5A-C are schematic sectional side elevational views with portions broken away showing the operation of the rack and pinion gears of Fig. 4 to constrain the deflection device to move at half the angular rotation of the movable member;
  • Fig. 6 is a diagrammatic view of an alternative gearing mechanism according to this invention
  • Fig. 7 is a schematic three-dimensional view with portions shown in phantom of another construction of the variable angle handpiece according to this invention using partially stiff links and curved surfaces for the control mechanism;
  • Fig. 8 is a schematic diagram explaining the operation of the handpiece of Fig. 7;
  • Figs. 9A-C are schematic side elevational views illustrating the operation of the mechanism of Fig. 7 which constrain the deflection device to move at half the angular rotation of the movable member;
  • Fig. 10 is a schematic sectional side elevational view with portions broken away and parts shown in phantom of another construction of a variable angle handpiece according to this invention which has a control mechanism utilizing intersecting guideways and a follower to constrain the rate of motion of the deflection device with respect to the motion of the movable member;
  • Figs. 11A-C are schematic side elevational views illustrating the operation of the mechanism of Fig. 10 which constrains the movement of the deflection device to one half the angular rotation of that of the movable member;
  • Fig. 12 is an enlarged detailed view showing the intersecting guides and the actuator pin that control the movement of the deflection device;
  • Fig. 13 is a depiction of the construction of the curve on the movable member of Fig. 12 which defines the locus of motion of the center of the actuator pin plotted in accordance with the values in Table I of the specification; and Fig. 14 is a schematic diagram of the angles and distances used to calculate the values in Table I from which the curve of Fig. 13 is constructed.
  • a surgical laser system 10 including a power supply 12 and control panel 14 for operating CO 2 laser 16 whose output beam is directed through articulated arm 18 to handpiece 20.
  • Handpiece 20, Fig. 2 may be directed to a lens unit 22 including a lens for focusing the laser beam.
  • Handpiece 20 includes a fixed member, barrel 24, and a movable member, barrel 26, which rotate about axis 28.
  • Movable barrel 26 includes an aperture port 30 through which laser beam 32 exits.
  • the distal end of movable barrel 26 includes a contacting surface 34 for contacting the wall of the heart to be perforated by the laser beam in transmyocardial revascularization (TMR).
  • TMR transmyocardial revascularization
  • the contacting wall is made relatively large and flat to minimize the contact pressure between it and the heart wall and is flat with rounded edges to minimize interference with the heart.
  • Contacting wall 34 typically includes a textured surface such as a knurling for preventing slipping or skidding of the contacting surface 34 with respect to the heart wall during surgery.
  • An operator device 35 mounted on the proximal end of handpiece 20 is optionally provided to enable the surgeon to rotate the movable barrel 26 relative to the fixed barrel 24 from that remote location rather than having to actually grip the two barrels with his hands to rotate them.
  • movable barrel 26 is rotated with respect to fixed barrel 24
  • the deflection device such as mirror 36 shown in phantom, would rotate with the movable barrel 26.
  • this is unacceptable for if mirror 36 should move equally with movable barrel 26 the laser beam 32 which moves through passage 38 into fixed barrel 24 and passage 40 in movable barrel 26 would no longer be aligned with passage 40 in movable barrel 26 and would not exit port 30.
  • mirror 36 actually must move at one half the angular rate as does movable barrel 26.
  • Figs. 3A-C This can be seen from Figs. 3A-C.
  • the laser beam in fixed barrel 24 has been designated 32a while the same beam exiting from movable barrel 26 has been labeled 32b for easy discussion.
  • mirror 36 is at a 45° angle to the incoming laser beam 32a. Its angle of incidence I is therefore 45° with respect to the normal N of the surface of mirror 36.
  • the angle of reflection R of course is equal at 45°.
  • Fig. 3A the laser beam in fixed barrel 24 has been designated 32a while the same beam exiting from movable barrel 26 has been labeled 32b for easy discussion.
  • mirror 36 is at a 45° angle to the incoming laser beam 32a. Its angle of incidence I is therefore 45° with respect to the normal N of the surface of mirror 36.
  • the angle of reflection R of course is equal at 45°.
  • Fig. 3A the laser beam in fixed barrel 24 has been designated 32a while the same beam exiting from movable barrel 26 has been labeled 32
  • the angle I that mirror 36 makes with respect to incoming beam 32a is 30°, that is, 15° less than I for the original 90° position of barrel 26.
  • the mirror when movable barrel 26 has been moved 30° counterclockwise from the 90° position of Fig. 3 A to the 60° position of Fig. 3C, the mirror must be moved only 15° in that direction. In every case mirror 36 must move at half the rate or must be moved half the distance or must move at half the speed of the movable member or barrel 26.
  • the control mechanism 50, Fig. 4, of variable angle handpiece 20a may include a rack and pinion mechanism including a double rack slide 52 including an upper rack 54 and a lower rack 56 which are slidably fixed to the fixed barrel 24.
  • pinion gear 58 Engaged with rack 54 is pinion gear 58 which is centered at rotational axis 28, the rotational axis of mirror 36, and has a radius R.
  • a second pinion gear 60 is also centered at rotational axis 28 coincident with that of mirror 36 and has a radius of 2R.
  • Pinion gear 58 rotates movable member 26.
  • Pinion gear 60 rotates mirror 36.
  • Double rack 52 is fixed to slide along fixed barrel 24.
  • mirror 36 is at angle I of 30° to beam 32a with respect to the normal of the surface of mirror 36.
  • Fig. 5B with movable barrel 26 at 90° and movable member 26 having moved 30° clockwise to the 90° position, mirror angle I has increased 15° to 45°.
  • Fig. 5C where movable barrel 26 has moved an additional 30° clockwise to the 120° position it is apparent that mirror angle I has moved only an additional 15° to the 60° position, so that in each case as movable barrel 26 moved through a predetermined angular rotation, in this case 30°, the mirror moved at only half that rate through an angle of 15°.
  • FIG. 6 which can effect the same relative rotation, may include a planetary ring gear 82 which is fixed to fixed barrel 24, a central gear 84 which is fixed to movable barrel 26, and an idler gear 86 which engages planetary ring gear 82 and central gear 84, which has an actuating pin 88 that constrains the movement of mirror 36.
  • Central gear 84 would have a radius 2R while idler gear 86 would have a radius of simply R.
  • Another control mechanism 90, Fig. 7, employed in variable angle handpiece 20b according to this invention may include two curved camming surfaces, one of radius R 92, and the other of radius 2R, 94, both of which are pivoted for rotation about axis 28, the axis of rotation of mirror 36.
  • Curved surface 92 has attached to it a partially flexible, partially stiff element 96, and there is a similar element 98 fixed to curved surface 94.
  • Elements 96 and 98 may each be constructed of a metal band such as those used in a conventional carpenter's steel measurement tape. Elements 96 and 98 can be pushed and pulled while displaying some degree of stiffness in the longitudinal direction yet can easily deflect and conform to the curved surfaces 92 and 94 as they wrap around it. Elements or bands 96 and 98 may be fixed together such as at yoke 100 and connected to an operator line which for example could be connected to control 35, Fig.
  • control mechanism 90 is shown in Fig. 8.
  • operator 102 is moved to the right as indicated by arrow 104, the yoke 100 moves from position 106 to position 108 a fixed linear distance.
  • the connection points 110 and 112 of elements 96 and 98 to curved surfaces 92 and 94, respectively, are then initially at position 106'.
  • the mirror angle I moves in 15°increments from 60° to 45° to 30°: that is, at half the angular rotational rate of movable barrel 26.
  • the larger of the two surfaces 94 is fixed to mirror 36 while the smaller of the two surfaces 92 is fixed to the movable member or barrel 26.
  • in handpiece 20c includes a pair of straight slots 122, 124 in fixed barrel 24 and a pair of curved slots 126, 128 in the movable barrel 26 which intersect and guide actuator pin 130 to constrain the movement of mirror 36 to move at half the rate of movable barrel 26 so that beam 32b will stay aligned with passage 40 and port 30 throughout the range of rotational movement of movable barrel 26.
  • the operation of control mechanism 120 to constrain mirror 26 to rotate at half the rate of movable barrel 26 is illustrated in Figs. 11 A, B and C.
  • mirror angle I is increased only half that, or 15°, to 45°, and once again, when movable barrel 26 has been moved 30° from the 90° position to the 120°, Fig. 11C, it can be seen that mirror angle I has increased another 15° from 45° to 60°.
  • curved guides 126 and 128 The construction of the curved guides 126 and 128 is shown in greater detail in Fig. 12.
  • the locus of points described by actuator pin 130 which constrains the movement of mirror 36 is defined by identical curve guides 126 and 128 which ensure that mirror 36 will rotate about axis 28 at half the rate of rotation of movable member 26.
  • the construction of the locus of points of curve guides 126 and 128 with respect to axes E and F in Fig. 12 is constructed, as shown in Fig. 13, by plotting the points obtained in Table I. TABLE I

Landscapes

  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Physics & Mathematics (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Medical Informatics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Electromagnetism (AREA)
  • Optics & Photonics (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Otolaryngology (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Laser Surgery Devices (AREA)

Abstract

La présente invention concerne une pièce à main (20) pourvue d'un laser chirurgical à angle variable et comportant d'une part un élément fixe (24) et d'autre part un élément mobile (26) monté rotatif sur l'élément fixe (24) de façon à tourner, autour d'un axe de rotation (28), dans les limites d'une plage d'angles de rotation. La pièce à main comporte également un passage (38, 40) traversant les éléments (24, 26) de façon à laisser passer un faisceau laser (32). Un orifice (30) ménagé dans l'élément mobile (26) permet au faisceau laser (32) d'atteindre une cible chirurgicale. Un déflecteur (36) monté rotatif sur l'axe de rotation (28) dirige le faisceau laser (32), provenant de l'élément fixe (24), de façon à lui faire traverser l'élément mobile (26) et l'orifice (30). Enfin, un mécanisme de commande (50, 80, 90, 120) permet de limiter la rotation du réflecteur à la moitié de l'angle de rotation de l'élément mobile (26) de façon à maintenir le faisceau laser (32) en coïncidence avec le passage (38, 40) et l'orifice dans toute l'étendue de la plage de rotation de l'élément mobile (26).
PCT/US1997/019030 1996-10-30 1997-10-20 Piece a main a laser chirurgical a angle variable WO1998018394A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US73957996A 1996-10-30 1996-10-30
US08/739,579 1996-10-30

Publications (1)

Publication Number Publication Date
WO1998018394A1 true WO1998018394A1 (fr) 1998-05-07

Family

ID=24972944

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US1997/019030 WO1998018394A1 (fr) 1996-10-30 1997-10-20 Piece a main a laser chirurgical a angle variable

Country Status (1)

Country Link
WO (1) WO1998018394A1 (fr)

Cited By (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2003084605A1 (fr) 2002-04-05 2003-10-16 Oliver Holzner Procede et dispositif permettant de prevenir une crise epileptique
DE10225347B4 (de) * 2001-06-14 2006-05-24 Mobillasertec Gmbh Vorrichtung zur Laserbearbeitung
KR101106754B1 (ko) 2009-10-23 2012-01-18 김대연 임플란트 시술용 핸드피스
KR101454192B1 (ko) * 2014-05-02 2014-11-04 가톨릭대학교 산학협력단 각도 조절이 가능한 의료용 전동 드릴
KR20190059556A (ko) * 2017-11-23 2019-05-31 경북대학교 산학협력단 임플란트 핸드피스
WO2021250500A1 (fr) * 2020-06-09 2021-12-16 P-Laser N.V. Dispositif laser pour l'orientation d'un faisceau laser

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3528424A (en) * 1967-02-17 1970-09-15 Waldemar A Ayres Laser surgical knife equipment
US3913582A (en) * 1972-10-17 1975-10-21 Laser Ind Ltd Laser device with articulated arm
US4849859A (en) * 1986-04-22 1989-07-18 Kabushiki Kaisha Morita Seisakusho Laser-type handpiece
US5346489A (en) * 1992-11-18 1994-09-13 Luxar Corporation Medical laser delivery system
US5591161A (en) * 1995-10-25 1997-01-07 Plc Medical Systems, Inc. Angled beam delivery handpiece for laser or other monochromatic light source

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3528424A (en) * 1967-02-17 1970-09-15 Waldemar A Ayres Laser surgical knife equipment
US3913582A (en) * 1972-10-17 1975-10-21 Laser Ind Ltd Laser device with articulated arm
US4849859A (en) * 1986-04-22 1989-07-18 Kabushiki Kaisha Morita Seisakusho Laser-type handpiece
US5346489A (en) * 1992-11-18 1994-09-13 Luxar Corporation Medical laser delivery system
US5591161A (en) * 1995-10-25 1997-01-07 Plc Medical Systems, Inc. Angled beam delivery handpiece for laser or other monochromatic light source

Cited By (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE10225347B4 (de) * 2001-06-14 2006-05-24 Mobillasertec Gmbh Vorrichtung zur Laserbearbeitung
WO2003084605A1 (fr) 2002-04-05 2003-10-16 Oliver Holzner Procede et dispositif permettant de prevenir une crise epileptique
KR101106754B1 (ko) 2009-10-23 2012-01-18 김대연 임플란트 시술용 핸드피스
KR101454192B1 (ko) * 2014-05-02 2014-11-04 가톨릭대학교 산학협력단 각도 조절이 가능한 의료용 전동 드릴
WO2015167291A1 (fr) * 2014-05-02 2015-11-05 가톨릭대학교 산학협력단 Foreuse électrique médicale à angle ajustable
US10070872B2 (en) 2014-05-02 2018-09-11 The Catholic University Of Korea Industry-Academic Cooperation Foundation Medical motor drill with angle adjusting function
KR20190059556A (ko) * 2017-11-23 2019-05-31 경북대학교 산학협력단 임플란트 핸드피스
KR102108530B1 (ko) 2017-11-23 2020-05-13 경북대학교 산학협력단 임플란트 핸드피스
WO2021250500A1 (fr) * 2020-06-09 2021-12-16 P-Laser N.V. Dispositif laser pour l'orientation d'un faisceau laser
BE1028386B1 (nl) * 2020-06-09 2022-01-18 P Laser N V Laserapparaat voor het richten van een laserbundel

Similar Documents

Publication Publication Date Title
US7947052B2 (en) Suturing device with angled head
US5468250A (en) Endoscopic mechanism with friction maintaining handle
US6666854B1 (en) Endoscopic surgical instrument
US5817084A (en) Remote center positioning device with flexible drive
US5702349A (en) Endoscope with acutely angled handle and associated focus adjustment mechanism
US20190170227A1 (en) Deflection mechanism
ES2547001T3 (es) Empuñadura reductora de interferencias para instrumentos quirúrgicos articulados
US7108688B2 (en) Remote center positioner
EP2429441B1 (fr) Positionneur avec centre de rotation a distance
US5201743A (en) Axially extendable endoscopic surgical instrument
US7947050B2 (en) Surgical instrument coupling mechanism
US4174154A (en) Laser manipulator apparatus with double pivotal mirrors
US20130331826A1 (en) Surgical instrument
CA2107931A1 (fr) Mecanisme endoscopique rotatif avec mecanisme d'entrainement articule
IL95491A (en) Microscope-endoscope assembly, especially usable in surgery
KR20010052102A (ko) 외과용 기구의 위치 설정 장치
WO1998018394A1 (fr) Piece a main a laser chirurgical a angle variable
US20200179651A1 (en) Medical device with flexible tip
JP2009034506A (ja) 医療用装置を操縦するための配置
US5591161A (en) Angled beam delivery handpiece for laser or other monochromatic light source
JP6676643B2 (ja) 手術中に腹腔鏡を保持し移動させる為のデバイス
CN113367796B (zh) 后端传动装置、医疗器械和手术机器人
JP3759393B2 (ja) マニピュレータの支持装置
JP2001513214A (ja) 少なくとも１つの回動可能な観察筒を有する光学機器
JP2019136497A5 (fr)

Legal Events

Date Code Title Description
AK Designated states

Kind code of ref document: A1

Designated state(s): JP

AL Designated countries for regional patents

Kind code of ref document: A1

Designated state(s): AT BE CH DE DK ES FI FR GB GR IE IT LU MC NL PT SE

DFPE Request for preliminary examination filed prior to expiration of 19th month from priority date (pct application filed before 20040101)
121 Ep: the epo has been informed by wipo that ep was designated in this application
122 Ep: pct application non-entry in european phase