ILLUMINATING DEVICES FOR MEDICAL USE
Field of the Invention
The present invention provides a series of new illuminating devices,
intended for use by physicians, surgeons, veterinarians and other medical
staff, in their daily activities. More specifically, it offers cord-less and
fiberoptic-less illumination devices characterized by being long lasting,
small, light-weight, portable, sterilizable, disposable, user friendly, highly
effective, energy efficient and cold light emitters.
Background of the Invention
There are several methods currently used for illuminating operating
theaters:
1. Heavy top lamps connected to the ceiling. Many operation theaters are
equipped with more than one top light. These illuminating devices have
some major disadvantages, among them are:
■High power devices (3000-6000 Watt).
■It is very difficult to keep the illumination focused on the desired
spot.
■There are shaded areas where the top light cannot provide a
satisfactory illumination effect.
■The top lamps have a side effect of heating which causes discomfort
to the surgeons and the related staff.
■Focusing and adjustment of top light lamps require special sterile
handles and may cause sterilization and cleaning problems.
■Top light lamps can get in the way of the surgeons and hit their head
or shoulders.
■Top light lamps are high cost items.
2. There is a wide range of illuminating devices based on
fiber optic technology - among them are:
- Fiberoptic head light: This device is a kind of helmet which the
surgeon carries on his head, and consequently, should direct his
head to the desired area that needs to be illuminated.
It has several major disadvantages:
(i) The device is heavy and may cause pain in the surgeon's neck and
back,
(ii) It is sometimes difficult, or impossible, to direct the illumination
to a desired angle, in particular in shaded areas in the open
abdomen or chest,
(iii) The light coming out of the fiber is focused to illuminate a certain
area, according to the distance of illumination. In other words, the
surgeon must stay at a constant distance from the operated area.
Beside the need to direct the light continuously with his head, this
causes the surgeon a further inconvenience.
(iv) The device is expensive. In addition, the fiber cable that connects
the generator and the helmet, gets damaged frequently.
(v) The thick cable connected to the helmet may limit the surgeon's
movement.
- Illuminated retractors: These devices are. specifically designed to
have built-in fiberoptic cables. The beam of light is very narrow and
its direction is dictated by the shape of the retractor. Consequently,
the device is not as effective as this kind of illuminating device should
be. In addition, the fiberoptic cable that connects the device to the
generator causes further disadvantages as described above.
- Fiberoptics-based devices used in illumination of laparoscopic and
endoscopic procedures are also common.
- Some drilling equipment for dentists' use contain fiberoptic means
for illumination.
Prior art teaches mostly of fiberoptic-based illuminating devices for use in
surgery and other medical applications, among them are:
US Patent 4,551,129 provides technique and apparatus for intraocular
and microsurgery including hghter-irrigator hypodermic tube which
utilizes a central hght guide to conduct light into the area of the surgery
along the fluid infusion pathway. An auxiliary to the lighter-irrigator
comprises a fiberoptic work cord or light pipe characterized by light
transmission and light dispersion along the path between a hght source
and the lighter-irrigator.
US Patent 5,569,300 relates to a surgical instrument for performing
subcutaneous surgery, specifically the utilization of the surgical
instrument to illuminate the carpal tunnel area of a patient to effect the
severance of the transverse carpal ligament. The patent discloses dilating
surgical forceps having fiberoptics illumination means on the blade inner
surface.
US Patent 5,722,426 discloses a coronary light probe for determining the
location of arterial structures and blockages thereof during surgery so as
to facilitate making incisions where necessary. The light probe has an
elongated portion with fiberoptic cables for conveying light to a distal tip of
the probe. The hght emitted from the distal tip illuminates the vessel
adjacent the distal tip.
US Patent 5,931,670 teaches of an illuminated dental suction appliance
that contains a suction component having a tubular member and a hght
projecting tip. Light is transmitted from a fiberoptic illuminator along the
length of the tubular member to the hght projecting tip.
WO 99,56633Al reveals an illuminated surgical retractor for creating a
working space for dissecting instruments in support of a surgical
procedure such as coronary bypass procedure or other type of vessel
harvest procedures. More specifically, the patent provides an illuminated
retractor for illuminating a subcutaneous surgical field in the space
between a vessel, such as the saphenous vein, the subcutaneous tissue
when the illuminated retractor is used to retract the subcutaneous tissue
away from the superior surface of the vessel. A distal end of the second
blade section is connected to an illumination source so that the second
blade section is substantially illuminated.
The above devices suffer from the disadvantage of having cords or cables
connecting the device to an external electrical or illumination source.
Furthermore, they create heat, have a small illumination area and are
relatively expensive. Consequently, there is a need for an illuminating
device free of these shortcomings, applicable in medical fields, in
particular, in surgery.
Upon searching for such a device it was found that a combination of
self-maintained power (a battery), a cold white hght emitter (a white
LED), and various devices, applicable in medical treatment, in particular
in surgery, may provide a new device, highly effective in illumination of
the region of interest while at the same time, being free of the above
mentioned shortcomings. Such combination of a battery, white LED and a
device applicable in medical treatment, is new. The present invention is an
example of how ingenuity may provide a relatively simple solution to
several yet unsolved problems. In other words, such a solution, in this
particular case, has led to a new series of illuminating devices applicable
in a wide range of medical applications, free of any of the above described
long-lasting shortcomings.
Objects and Summary of the Invention
It is the object of present invention to provide a self-maintained, fiber optic-free illuminating device characterized by being long lasting, small,
light-weight, portable, sterilizable, disposable, user friendly, highly
effective, energy efficient and cold light emitter.
It is an additional object of the present invention to provide a series of
small and portable illumination devices containing white LEDs and
batteries.
It is a further object of present invention to provide an illumination device
that is free of many disadvantages existing in present illumination devices, as described here-in-above.
The illumination device of the present invention provides a white LED light power-supplied by a built-in battery. Both, the LEDs and the battery are integrated parts of the devices. The device according to the present
invention has some major advantages over the current existing illumination devices:
1. The illuminating part is placed inside the operation field, unlike the top light which is placed distantly.
2. No need for a connecting cable that causes inconvenience.
3. No need for highly expensive fiberoptic means such as light generators,
which are placed next to the operating site and are very expensive.
4. The device is small, portable, sterilizable and disposable and as such is
easily inserted into body cavities and any surgery field to provide light
in any desired direction and angle.
5. The combination of a white LED and suitable powered battery provides
a desired amount of illumination for a significant period of time.
Furthermore, this combination intends to provide a new illumination
tool applicable in examination and treatment of "internal" cavities (such
as in laparoscopy and endoscopy procedures), as well as in examination
and treatment of "external" cavities, such as ear, nose, throat, mouth
(ENT, laryngoscopy, etc.).
6. Same principle of combination (white LEDs + baterry) is apphcable for
a series of illumination devices specifically designed for use by dentists,
general practitioners, ophthalmologists and other physicians and
specialists, including veterinary and veterinarian surgeons.
Brief Description of the Drawings
FIG. 1 demonstrates a cross section of a human under open surgery. The
illuminating device comprises of an illuminating head (3) is attached to
the inner part of the abdominal wall. A flexible cord (2) supphes energy
from a second part of the device (1), which includes a battery and an
operating switch (9)
FIG. 2 depicts an illuminating device comprising a main housing (1) which
includes a 4 to 6 volt battery inside it, an illuminating head (3) carries
4-12 white LED's (5) arranged in rows or in any other desired manner. A
built- in clip is placed on the main housing including a spring-loaded
moveable clip (10) and stationary teeth (11) on the opposite side. The main
housing is connected to the illumination head in a rigid, firm manner. The
complete illuminating device may be attached to the abdominal wall by
means of the clip (8).
FIG. 3 demonstrates a miniature, disposable illuminating device
comprising a two button battery housing (12), a disposable switch (13) that
when pulled out switches the light on, one LED (14), a led housing (15)
allowing to adjust LED direction for providing optimal effective
illumination in any desired direction. Attachment means comprising at
least one long needle (16), which penetrate through the patients skin or
other surface tissues (17) and at least one short needle that insure the
device from shaking, moving, vibrating or rotating. An additional
attachment mean (18) is placed in the opposite side of the skin surface and
together with the long needle(s) attaches the device firmly to place.
FIG. 4 depicts an illuminating device which is similar to the one described
in FIG 2. The device is illustrated when the illuminating head (3) is
detached from the battery housing (1) and a thin flexible cord (2) supplies
the power from the batteries to the illuminating head. The head (3) has
built in portions (19) with holes (20) allowing attachment of the device to
the patient by stitching with sutures (21) in the desired place.
The device described in 4a is similar to the device in figure 4. However, in
the first, all the 1 to 4 sutures (6) are originally built-in and connected to
the device. Furthermore, the sutures have needles (7) at their distal end
for stitching the device in place.
FIG. 5 describes attachment means (88) which allows the attachment of
an illuminating device to a rigid retractor in a firm manner (89).
FIG. 6 illustrates a surgical retractor with a built-in illuminating device
carrying a set of LED's (23) on either side of the retractor. In some
retractors there are up to four retraction elements, each may carry a set of
LEDs . A built-in operating switch (24), and batteries (25) on the retractor
is one of the preferred embodiments. When using said retractor, the whole
operation cavity (26) is illuminated sufficiently.
FIG. 7a demonstrates a Duval forceps with a built-in illuminating device,
which comprises a battery housing (27) an operating switch (28), a double
illuminating head (29) including two LEDs (30)..
FIG. 7b depicts a spatula with 2-4 built-in LEDs (31), a battery housing
(32) with one or two button batteries (33) and a battery cover (34).
FIG. 8 demonstrates an illuminating device having the same battery
setting (35) as shown in FIG. .2, an attachment means (36) as shown in
FIG. 3, and an operating switch (37). This device has a 20-30 cm, flexible,
neck (38) consisting of a main tube (44), a soft stainless-steel wire (39) and
an electric cord (40) for transmitting power to a set of 6-12 LEDs (42) that
are desirely arranged in the illuminating head (41). The device is
attachable to the patient's body (45) in a firm way, wherein the
illuminating head (41) can be placed in the operation area by manually
bending the neck (43) and directing the head to the desired position and
location. The stainless-steel wire maintains the selected position of the
neck.
FIG. 9 illustrates a patient (46) in a Mediastinoscopy procedure. The
device shown (47) represents a Mediastinoscop with built-in illumination
means (48) comprising a set of LEDs arranged in a ring formation or may
be arranged in any other desired formation.
FIG. 10 describes a catheter (49) especially designed for illuminating the
point of the esophagus — gastric junction (50). The catheter comprises of a
main body portion (51), which allows good pushability of the catheter, an
inflatable flexible balloon (52) at the distal part, an inflating valve (53)
through which the balloon is inflated and deflated. 2-5 LEDs (54) are
placed in the distal portion of the catheter adjacent to the balloon. When
switched on, the light is seen through the transparent wall of the catheter.
An electric cord (58) supplies the power from the battery, which is placed
in the battery housing (55) and operated by the operating switch (56).
Distance measurement marks on the catheter body (61) allow to measure
or appreciate the distance from the balloon to the catheter's proximal side.
A main lumen (59) allows access to the stomach from the entrance (57).
The catheter is inserted to the stomach via the esophagus, the balloon is
then inflated and the catheter is pulled back until the balloon stops at the
joining point. The illuminated distal portion is seen through the esophagus
wall, indicating the exact point of interest. The distance from the stomach
to the throat can be easily appreciated and measured by the marks on the
catheter body.
FIG.ll depicts a similar illuminating device as described in FIG. 10.
However, in this case, a set of 6-20 LEDs (62) are arranged in the distal
portion of the catheter creating a 4-15 cm portion of illuminating catheter.
The catheter is inserted to the colon or intestine via the rectum. It is then
possible to see differences in trans -illumination between normal parts of
the organ (63) and the pathologic parts. For example, a tumor (67) in the
colon causes a dark portion (64) when examining the trans-illuminated
colon. Another use of this device is in surgery procedures. For example,
trans -illumination clarifies the shape of the organ and helps avoiding
dissections in wrong places and cutting blood vessels (66).
FIG.12 illustrates a rod-shaped instrument, a suction device (68) for
example. An illuminating device (69) comprised of a battery housing (70),
a head (71) a . set of 2-4 LEDs (72) attachment means (74) and an operating
switch button (73). This device is attached to the suction instrument
providing an excellent illumination.
FIG. 13 depicts a disposable dentist mirror. (75) having built-in
illuminating means in the form of LEDs (76) pointing to the mirrors sight
direction, a battery housing (77) and an operating switch (78). In one
option the battery is a reusable battery, and inserted into the disposable
mirror prior to use.
FIG. 14 demonstrates a headlight having fitting means to the surgeon's
head (84). Said headlight device comprises an illuminating head with a set
of 6-15 LEDs (79), an angle adjustment capability (82), a battery housing
(81), an operating switch (83) and a focusing lens (80).
FIG.15 demonstrates a disposable, illuminating thimble. Said illuminating
thimble comprising a housing (85), two LEDs (86) and an operating switch
button (87).
FIG.16 illustrates a miniature illuminating device comprising a battery
housing (90), an illuminating head (91) having a set of 2-5 LEDs (95),
electric cord (92) and an operating switch (93). The illustrated setting
allows the illuminating head (91) to be placed apart and independently of
the battery housing. When it is placed at the operation field (94) it
provides a very close and effective illumination.
FIG. 17 describes an illuminating device (98) attached to a mounting
device which comprises a set of rods (96) and hinges (99) to maintain
positioning of the illuminating head in the desired position. The mounting
device is attachable to the operating table (97). A further way of achieving positioning of said illuminating device is by means of a flexible neck, as
described in FIG. 8.
FIG. 18 demonstrates an illuminating device (103) placed in a mouth of a
patient suffering from sinusitis (100). The light creates trans-illumination effect through the sinuses. The left sinus (101) is clear, whereas the right
(102) is blocked, as reflected by the difference in light brightness.
FIG. 19 depicts a miniature illuminating device (104), similar to the one shown in FIG. 16, including a shield (105) preventing from the light to be seen from the side, hence helps in hiding the light beam from spectators
away from the focused beam of light (106). The said shield can be moved to a second back position (107) allowing a wide beam as well.
FIG. 20 describes theracotomy retractor (108) with an illumination accessory device, including an illumination head (109) with 7-12 LEDs
(110) an extension neck (113), battery housing (111), operating button
(115) and attachment means (112) to the retractor. The surgeon can move
the neck (113) and adjust it to any desired direction.
Examples and Clinical Applications
As was mentioned here-in-before there are numerous medical procedures,
in particular, surgical operations, that require highly effective
illumination means.
1. Open chest surgery is a common operation procedure that requires
effective illumination. In heart surgery, for example, the surgeon may
dissect and stitch blood vessels of less than 2 mm in diameter.
Furthermore, he may insert up to 15 miniature stitches into the vessel
wall, at a shortest possible time, usually within up to ten minutes. This
procedure may be repeated several times during a single operation.
Consequently, a highly effective illumination of the operation area, should
facilitate the surgeon to achieve a better quality surgery procedure in a
shorter time. In this connection, it should be pointed out that top and/or
headlights, currently in use in same surgical procedures, found to be very
uncomfortable for surgeons and sometimes limited in lighting hidden
cavities, in the surgery area. The illumination device of present invention
(FIG 1) may be inserted into the operation area to provide an effective
illumination of any hidden spot. Such a. device must be attached to the
operation area by fast and friendly means, the invention reveals several
different options of attachment means as shown in drawings: built in
forceps to attach the device (FIG 2), specially designed pins which are
inserted from the inner part of the open belly via the abdominal wall and
attached by a clip to the outer surface of the patients belly (FIG -3). This
allows steady and firm attachment of the device in the operation field. A
different approach to the attachment is by suturing the device to the inner
wall inside the operation area, either by means of standard stitching (FIG
4.), or by a built in suture and needle setting which already exists on the
device (FIG 5). In any case, using the device of the present invention,
should relieve the surgeon from the current headlight that was found to be
both inconvenient and not always sufficiently effective.
2. Chest surgery is carried out either in a regular approach or in a less
invasive approach, where the chest is opened in-between two ribs. In both
approaches, by using instruments such as varies retractors, it allows the
surgeon a sufficient opening for approaching the operation area.
Illumination of the operated zone, in this kind of procedures, is very
difficult to achieve, as most of the operated area is placed deep in the body,
relatively far away from the retractor. Using the device of the invention for
illuminating the operation zone in such procedures, for example a
retractor containing a built-in illumination capability (FIG. 6), or a special
illumination accessory device attached to the retractor (FIG. 20) may
overcome the above obstacle and yields an improved result, namely a more
accurate performance, in a shorter time.
3. Chest surgery also includes lung operations. In such operations, highly
effective illumination, is required for enabling manipulation of soft tissue
and identifying pathological f dings. A series of manual surgical
instruments are in use in such procedures including, Collin-Duval
grasping forceps, Martel tissue holders, Israel retractors, spatulas, suction
tubes and many others. According to the present invention, a device
including white LEDs and a battery are attached to these instruments to
convert them into illuminating devices, as well (FIGS 7a and 7b).
Consequently, said surgical instruments may have dual functions: in
addition to their regular function as manual surgical instruments, they
may function as illuminating devices that provide a closed, very effective,
illumination of the operation area.
4. While performing Mediastinoscopy, a tube is inserted into the cavity of
the upper chest through the lower part of the neck. The tube provides
ability to see the inside of the chest cavity and enables the surgeon to '
observe findings that should be diagnosed in real-time. The present
invention provides a Mediastinoscope tube containing built-in illumination
means, namely, white LEDs and a battery (FIG 9).
5. Many operations in the abdominal cavity suffer from deficient
illumination. Specially, in the upper abdominal procedures (such as, liver,
spleen, esophagus, stomach, and left colon), or the lower abdominal and
pelvic procedures (such ' as, rectum and sigmoid colon), improved
illumination is necessary. The device shown in FIG. 8 comprises a housing
that includes a battery, an operation button, attachment means, an
illumination head and a flexible neck in-between. The neck having a soft
stainless steel rod in it, allows bending and moving it to the exact desired
position needed for achieving the maximum illumination in the desired
spot.
6. Some of the common operations are carried out while the patient lies on
his side, for example, during spine and back surgeries. The top light is
usually not effective in such conditions and the headlights cause
inconvenience.
7. Other cold-lighted illumination special devices revealed here are
trans-illuminating devices. The devices shown in the present invention are
useful in the surgery of specific organs, such as, for example, rectum,
sigmoid, colon, esophagus and stomach. Said cold-lighted
trans-illuminating devices are in the form of a long flexible tube with
illumination means (white LEDs) at its tip or on its whole distal portion
and marks along its length to indicate the distance between the light and
the marks.
This device illuminates the operated organ from the inside and at the
same time allows the physician to estimate the location of the illuminated
end and to determine the distance from that location to the entrance to
the body.
8. When performing anti reflux procedure, in open surgery or laparoscopic surgery, it
is required to find the exact point of the esophago - gastric junction, in
order to prevent hazardous damage to the esophagus and to perform the
rap in the exact location.
A special trans -illumination catheter (FIG 10) consisting of a catheter
body, an inflatable balloon at the .distal portion, illumination means
proximal to the balloon, power supply, and an open lumens through the
catheter. The device revealed here allows the surgeon to insert the
catheter into the stomach via the esophagus, inflate the balloon and pull
the catheter back, at this stage the laminated LED will indicate the exact
required point. The advantage of this device is that the surgeons will save
time finding the point and furthermore will decrease the danger of damage
to the esophagus, which can be fatal.
9. In another different procedure the surgeon needs to locate the exact
location of a tumor in the sigmoid colon, intestine or rectum (for example).
Presently it is done by feehng the organ with the fingers via the feroza
during performance of open surgery. The trans-illumination catheter
shown in FIG 11 has a series of LEDs on its distal portion, which when
inserted into the colon via the rectum allow the surgeon to see a tumor
through the colon wall. Tumors in the colon, which are thick and
non-transparent, will be clearly seen as dark areas compared to the
trans-illuminated areas, which are seen with bright light. The distance
marks on the catheter will also help in more precise description of the
operation, a feature important for the medical file (FIGS 10 and 11).
10. This trans -illumination catheter will also be used in operation of the
rectum. When performing such procedures there is a need to separate the
organ from the surrounding tissue. The trans-illumination catheter will
help identifying the exact borders of the rectum and assist in dissecting in
a more precise way.
11. Another use of a trans -illumination device shown in fig 16 is to
diagnose the sinus cavities in a patient face, the doctor inserts the device
into the patients mouth and can see clearly a difference between a clear
sinus and a sinus cavity which is blocked with liquid.
12. There are many non-surgical procedures that require effective
illumination. The devices of the present invention may be useful tools in
illumination of such procedures. Among these procedures are: ENT,
gynecological procedures, and many others (FIGS 3,4, 5, 7,15,16,17)
In addition, the device of present invention includes instruments of a
rod-shaped design, applicable in diathermia, suction, etc., in which white
LEDs and a battery are implemented, in order to convert them to
illuminating devices, as well. (FIG 12).
13. Other medical disciplines, may also get benefit resulting from the use
of the device of the present invention. For example, veterinarians who
perform all procedures in their clinic cannot usually afford purchasing
heavy top-light equipment. Dentists may use a special designed mirror in
which white LEDs and a battery are implemented (FIG 13). Same is true
regarding specially designed illumination devices for the general surgery
in form of an illuminating thimble (FIG 15). The military medicine as well
may get benefit of present invention. A special illuminating device
designed for using by an army physician, in the battle field, provides an
effective focused illumination beam with a shield which prevents the hght
from being seen from side directions, and helps in preventing disclosure of
the medical units location (FIG 19).
14. A new design of head light which is cable free and comprises LEDs
batteries as well as a focus lens is shown in FIG. 14.