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WO2007073802A1 - Method for illuminating the site of an operation, illumination device and surgical instrument - Google Patents

Method for illuminating the site of an operation, illumination device and surgical instrument

Info

Publication number
WO2007073802A1
WO2007073802A1 PCT/EP2006/010878 EP2006010878W WO2007073802A1 WO 2007073802 A1 WO2007073802 A1 WO 2007073802A1 EP 2006010878 W EP2006010878 W EP 2006010878W WO 2007073802 A1 WO2007073802 A1 WO 2007073802A1
Authority
WO
Grant status
Application
Patent type
Prior art keywords
liquid
surgical
line
illumination
site
Prior art date
Application number
PCT/EP2006/010878
Other languages
German (de)
French (fr)
Inventor
Andreas Obrebski
Original Assignee
Carl Zeiss Surgical Gmbh
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

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007Methods or devices for eye surgery
    • A61F9/00736Instruments for removal of intra-ocular material or intra-ocular injection, e.g. cataract instruments
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/30Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure
    • GPHYSICS
    • G02OPTICS
    • G02BOPTICAL ELEMENTS, SYSTEMS, OR APPARATUS
    • G02B6/00Light guides
    • G02B6/02Optical fibre with cladding with or without a coating
    • G02B6/032Optical fibre with cladding with or without a coating with non solid core or cladding

Abstract

The invention relates to a method for illuminating the site of an operation by means of illuminating beams, wherein a fluid (115) flowing through the fluid line (107) is guided from the site of the operation and/or to the site of the operation by at least one fluid line (107) comprising a distal end (105) which is oriented towards the site of the operation. The illuminating beam is injected into the distal end (105) of the fluid line (107) which is at a distance in the direction of the distal end (105) in the flowing liquid (115), and the liquid (115) is used as a light conducting medium.

Description

Applicant: Carl Zeiss Surgical GmbH, 73447 Oberkochen

Our reference: Z50064 ath / ehä

A method for illuminating a surgical site, illumination device and surgical instrument

The present invention relates to a method for illuminating a surgical site with illumination radiation, an illumination device for illuminating a surgical site as well as a surgical instrument with such an illumination device.

The illumination of a surgical site, ie a body location at which an operation is carried out is very important, because only with optimum lighting for the surgeon optimal conditions are achieved. A lighting means, arranged above the operating table operation lamp is so far not optimal, as shadows of the surgical site, for example, by the hand of the operating surgeon, can not always be excluded. Especially with microsurgical and minimally invasive procedures shadows can complicate the work of the surgeon. In addition, surgical lights are far away from the surgical site and not always spatially displaced that can illuminate as desired by the physician at the surgical site. Even the light field, and the spectral distribution and intensity of illumination for surgical lights are not always optimal set.

Furthermore, care must be taken when lighting a surgical site that the lighting does not harm the tissue around the surgical site. For example, in ophthalmic surgery, so

Eye surgery is to consider the compatibility of the lighting. So an unfavorable lighting may be associated etc about a desiccation of the tissue, phototoxicity. Also can form highlights, which may affect the view of the attending surgeon at the surface of the eye.

Therefore, lighting devices are known from the prior art in which illumination light is guided directly to the surgical site with the aid of light conductors. For example, US 5,275,593 describes an apparatus for ophthalmic surgery, so the eye surgery, in which a metal needle is present, which forms a flow path for a fluid. In this metal cannula is disposed an optical fiber, which guides light from an illumination device directly to the distal end of the cannula.

From US 4,617,013 a device for the irrigation, aspiration and illumination of a surgical site is described. Under Irrigation supplying a fluid to the surgical site and aspiration here is the

to understand aspirating a fluid from the surgical site. The

Device comprises an irrigation tube disposed centrally in an aspiration tube. The aspiration tube is surrounded by a light-conducting jacket which illumination light to the distal end of the two

Tubes passes.

The US 6,080,143 describes a phaco tip with a sleeve having a distal end which is to be inserted into an eye. An optical fiber bundle through the sleeve and aspiration / irrigation line are guided to the distal end of the sleeve.

The WO2005 / 027740 A1 describes a surgical irrigation / aspiration and lighting equipment. The apparatus comprises a tube forming an irrigation or aspiration. The jacket of the tube is made of a light-conducting material so that illumination light can be through the casing to the distal end of the tube, and thus guided to the surgical site. Similar devices are 4,872,837 in US 6,569,089 B1, US and US 5,931, 670 describes. If an optical fiber on or in Irrigationsröhrchen or Aspirationsröhrchen a surgical device is disposed so characterized either the volume available for the flowing liquid disposal is reduced or the size of the tip, which is inserted into the enlarged surgical site. Especially in minimally invasive surgeries increasing the dimensions is undesirable.

If the light guide is formed by the jacket of a irrigation or aspiration, this restricts the choice of possible materials for the shell. This may for example bring with regard to the sterilization and / or the mechanical properties of the material disadvantages.

Object of the present invention is therefore to provide an alternative method for illuminating the surgical site is available, with which the illumination radiation can be guided up to the surgical site.

It is another object of the present invention to provide a lighting apparatus, with which can realize the inventive method.

Finally, it is an object of the present invention to provide an advantageous surgical device is available, with which can be implemented directly at the surgical site illumination of a surgical site.

The first object is achieved by a method for illuminating a surgical site according to claim 1, the second object by an illumination device according to claim 7, and the third object is achieved by a surgical instrument according to claim 13. The dependent claims contain advantageous embodiments of the invention.

In the inventive method for illuminating a surgical site with illumination radiation is supplied via at least one fluid line to a side facing the surgical site distal end of a flowing fluid through the fluid line to the surgical site and / or removed from the surgical site. The illumination radiation is coupled from the distal end of the fluid line located in the direction of the distal end of the fluid conduit into the flowing liquid which is used as a light transmitting medium. The flowing liquid can be used within and / or outside of the fluid conduit for directing the illuminating radiation.

As illumination radiation to visible light, ultraviolet light, or infrared radiation coming eg. In question. In particular, they also may have a specifically adjusted spectral distribution. Also, the coupling of laser radiation as illumination radiation is possible. The latter can be useful, for example. To achieve a contrast enhancement in the surgical site.

The illumination radiation can be directed in particular injected into the fluid line, that is, the coupling is performed such that the direction of a liquid entering the illuminating beam at the entry is maintained in the liquid. This can be realized by suitable optical probes or the coupling of laser radiation as the illumination radiation. Alternatively, the illumination radiation in-coupling into the liquid optical fiber can be introduced into the fluid directly, thus without coupling optics. In this case, the refractive index of the optical fiber may, for example, be selected so that the refractive index of the fiber core corresponds to the liquid largely, so that at the transition occurs little or no refraction. It is also possible to influence the opening angle of the illumination beam in the fluid selectively by appropriate choice of the ratio between the refractive index of the optical fiber and the liquid, eg. in order to reduce the opening angle in the liquid opposite the opening angle of the illuminating radiation in the optical fiber.

The inventive method makes it possible to cause the illumination radiation to the liquid as a light transmitting medium to the targeted surgical site without the need for a to the distal end of the liquid line reaching optical fiber or a light-conducting property of the wall of the fluid line would be necessary. Therefore, in the region of the distal end the diameter of the fluid conduit may be relatively low, even if the wall has no light guiding properties. The inventive method can be used which have already liquid conduits, for example, irrigation lines or aspiration lines, particularly in surgical instruments.

A directing the illuminating radiation through the liquid arises in particular when the liquid is transparent for the illumination radiation and, in comparison to the surrounding material, such as air or a transparent material of the liquid line, a higher refractive index. The coupling of the radiation can then be such that where the liquid is to serve as a light pipe, most of the radiation is incident at an angle to the interface with the surrounding medium which is greater than the critical angle for the occurrence of total reflection at the interface , Angle of impact and critical angle are defined herein with respect to the surface normal of the interface.

As long as the surrounding material is not transparent and the distance between coupling point and the exit of the liquid from the liquid line is relatively small, the refractive index of the surrounding material, however, need not to be lower than that of the liquid. occurs at the interface between the liquid and the surrounding material, although an absorption which reduces the light intensity, but this can be compensated by coupling a sufficiently high intensity. In addition, an appropriate choice of absorption or reflection coefficient of the walls of the liquid line can be used to keep the intensity loss within limits. In particular, an internal mirror of the fluid conduit may be at least present in the range between coupling and the distal end of the fluid line.

If the liquid leaks from the liquid conduit into the air, the liquid acts because of their higher compared to the air refractive index than the light guide.

If instead of a liquid supply to a surgical site removal from the surgical site is performed, for example, a suction of a previously supplied liquid, it is also possible to use the discharged liquid as a light guide, as long as the liquid is dissipated constantly enough.

As liquids, for example, saline water and come in particular physiological into consideration. These are well transparent to visible light as illumination radiation, but can also be used in the near infrared and near ultraviolet, as their transparency is high enough in these areas. Also have water and in particular physiological saline good compatibility. Furthermore, these liquids are used in surgical procedures already commonly used, so that for performing the method, for example, irrigation lines, which are used as during surgery for other purposes for lighting can also be used for lighting.

The coupling of the illumination radiation may in particular be in the vicinity of the distal end of the liquid line. Up to the coupling-in the illumination radiation can be guided through an optical fiber or a fiber bundle. The coupling in the vicinity of the distal end is particularly advantageous when the material from which the liquid line, the illumination radiation absorbed. Due to the Einkoppeins near the distal end of the path of light through the liquid line is relatively short, so that only a relatively small proportion is absorbed at the illuminating radiation. is the shorter the distance through the liquid line, the lower the absorption. However, the coupling point should be in a not intended to be introduced to the surgical site portion of the liquid line, so that in the proposed for insertion area is no increase in the diameter of the liquid line. In addition, the angle of the coupling of the illumination radiation should be chosen so that where the liquid is to serve as a light guide, is exceeded for a large portion of the illumination radiation of the critical angle of total reflection.

The distal end of the fluid conduit may be disposed in close proximity to the surgical site in either or, ie the distance between the distal end and the available at the distal end outlet opening of the liquid passage and the surgical site is small and amounts to a maximum of a few millimeters. The direct arrangement at or in the surgical site may be particularly advantageous if the fluid line is integrated into an instrument which also fulfills other functions. Thus, the liquid line, for example, as an aspiration or irrigation line in a phaco tip, also called Phaco- end, be integrated. Phaco-end pieces found to remove the lens of the eye and have use, for example, an ultrasonic generator in which the lens comminuted generated ultrasonic vibrations are directed to the distal end of the phaco tip. With the distal end of the ultrasonic vibration is selectively introduced into the lens. Besides phaco tips can also have blades with which cuts can be put in the lens. If, for example, an irrigation line of a phaco tip comes to perform the process of the invention applies, the distal end of the liquid line is located generally in the vicinity of the point in the surgical site, where crushing takes place of the lens. but the distal end of the liquid conduit may also be disposed at a greater distance from the surgical site, ie the distance between the distal end disposed in the outlet opening and the surgical site is in the range of several millimeters to several centimeters. The supply of fluid to the surgical site is then carried out by adding a is directed out of the distal end of the liquid conduit emerging liquid jet aimed at the surgical site. The liquid jet acts due to its surrounding compared to air higher refractive index than the light guide so that someone can realize a highly targeted illumination with an adjustment of incidence of the beam on the surgical site.

The opening angle of the illumination can be varied in the present process by adjusting the divergence of the emerging liquid jet.

If a liquid is used as liquid, which has luminescence which illumination radiation can be distributed with the liquid particularly in the surgical site. It is also possible to use a different illumination radiation than visible light, if it is able to stimulate the luminescence of the liquid. The illumination of the surgical site is then via the luminescent light. Especially in the presence of phosphorescence, ie after the end of the illumination of the liquid-lasting luminescence, an illumination of the surgical site can also take place by the phosphorescent light when no illumination radiation is present, but previously illuminated liquid at the operation site is available. In addition, an illumination of the surgical site can be made where, although the liquid passes through, the phosphorescence stimulating illumination light is not executed forwards.

A lighting device according to the invention for illuminating a surgical site with illumination radiation is equipped with at least one fluid line to a surgical site is to face the distal end. The fluid conduit is formed for supplying a liquid through the conduit to the surgical site through the flowing liquid and / or for removing a liquid from the surgical site, wherein the discharged liquid forms a flowing liquid through the liquid line. The lighting device is further provided with a distance from the distal end opening into the fluid line coupling device for coupling the illuminating radiation into the flowing liquid. The coupling device is arranged in the fluid line, the illumination radiation is coupled in the direction of the distal end of the fluid conduit into the flowing liquid and carried out the coupling such that the fluid flowing in the fluid line and / or after the exit from the or in front of the enters acts as a light guide in the fluid line. In other words, the coupling of the illumination beam in the liquid is carried out such that where the liquid is to serve as an optical waveguide, the critical angle of total reflection at the interface with the surrounding medium for a high proportion of the illumination radiation is exceeded. As liquid flows in the inventive Beieuchtungsvorrichtung particular a liquid can be used, having the luminescence.

The lighting device according to the invention allows in particular the carrying out the method according to the invention.

If the distance that has to travel through the fluid line, the illumination radiation should be kept short, the coupling device in the vicinity of the distal end of the fluid conduit may be disposed. In this case, even at a relatively highly absorbing wall of the fluid conduit nor a sufficiently high intensity of illumination at the distal end of the liquid line, are provided. For brevity rather than to be covered by the illumination radiation within the liquid line section or in addition to this measure, a suitable absorption or reflection coefficient of the wall of the liquid line can be chosen to keep the intensity loss within limits. Especially advantageous is an internal mirror of the wall of the fluid line, in particular between coupling and its distal end.

In a particular embodiment of the lighting device according to the invention, the distal end of the fluid conduit to an exit opening having a shape which at least one liquid jet, in particular to at least one laminar liquid jet forms the exiting liquid. By means of the liquid jet, the illumination radiation may be selectively passed to the surgical site, wherein the liquid jet is used as a light guide. In the area of ​​the outlet opening, an insert can be displaced, for example. Displaceable, and in particular, be arranged parallel to the direction of flow of the outflowing liquid displaced. A displacing of the insert allows the divergence of the emerging at the outlet opening at least to change a jet of liquid and thereby vary the opening angle of the illumination. Also influence the distribution of the liquid in the liquid jet exiting up for splitting into partial beams is possible in principle by displacing the insert.

The material forming the liquid line does not need to be selected in view of light-guiding properties. Rather, any material is suitable that can be used for forming a liquid line basically. It is however possible to design the lighting device such that the liquid line is produced, at least in the region between the coupling point of the illumination radiation and the distal end of a transparent material having a refractive index less than the refractive index of the fluid flowing through the fluid conduit. The liquid can then already serve within the liquid line as a light guide. Alternatively, the fluid conduit may be coated on the inside with such a material. An inventive surgical instrument is equipped with an inventive lighting device. The surgical instrument may comprise a surgical site is to face the distal end of a particular irrigation and / or aspiration. The irrigation and / or aspiration can then be used as the liquid line of the lighting device according to the invention. In this way, the surgical instrument need not be equipped with another line. No reduction of the flow cross-section takes place at the extreme distal end, as there must be in any optical fiber. In addition, the materials previously used for the wall of the fluid line, such as metals or plastics for irrigation for the aspiration can still be used, since they need to take any light guiding function. Therefore, existing surgical instruments with irrigation and / or aspiration can be subsequent or converted in a particularly simple way with an inventive lighting device. For this, the coupling device only needs to be introduced into the liquid line. The surgical element can be configured as a phaco tip or as an infusion cannula in particular.

Further features, properties and advantages of the present invention will become apparent from the following description of exemplary embodiments with reference to the accompanying figures.

Fig. 1 shows a phacoemulsification device as a first embodiment of the inventive illumination device.

Fig. 2 shows the tip of the phacoemulsification device shown in Fig. 1 in a sectional detail view.

FIGS. 3a to 3c show an irrigation line as another embodiment of the inventive illumination device. Fig. 4 shows the tip of an infusion cannula as still another embodiment of the inventive illumination device.

Fig. 5 shows in detail a particularly advantageous embodiment of the lighting device according to the invention.

Fig. 1 shows a first embodiment of the inventive illumination device, which is integrated in this embodiment, in a phacoemulsification device 1. The Phacoemulsifikations- device 1 comprises a handle 2 having disposed therein ultrasound transmitter (not shown). To the handle 2, a tube 3 connects to, the distal end 5 serves as a tip that can be brought up to the lens to be removed during a cataract surgery through an opening in the cornea. The tube 3 is engaged with the ultrasonic transducer in combination, to transmit the ultrasonic vibrations generated by this on the lens in order to crush out. The tube 3 comprises a first lumen 7, which serves as an irrigation line for supplying a physiological saline solution into the eye during cataract surgery. It also includes a second lumen 9, which is delimited by a disposed in the interior of the tube 3 tube 10 of smaller diameter. The second lumen serves as the aspiration line 9 for suction of lens pieces together with the introduced into the chamber of the eye physiological saline. It should be noted at this point that although the irrigation line is arranged around the aspiration around in the present embodiment, the arrangement of irrigation and aspiration line that is the function of the lumens may be interchanged 7 and 9 and vice versa.

In the present embodiment the apparatus 1 further comprises Phacoemulsifikations- four light conductors 11, which may be configured as a single light-conducting fibers, or as a light-conducting fiber bundle and which are connected either to a light source in the interior of the handle. 2 The ends remote from the light source 13 of the light guide 11 opening into the first lumen 7, ie in the irrigation line. They are arranged such that light coupled 11 is coupled to the irrigation fluid, ie in the present embodiment, in the physiological saline solution from the light source into the light guide. The core of each optical fiber 11 has a refractive index which is matched to the refractive index of the physiological saline. In this way, refraction of the light beam on exit from the end 13 of the optical fiber 11 can be suitably set, and in particular to avoid.

As soon as the physiological saline solution 15 exits the arranged in the distal end 5 of the tube 3 and the outlet opening 17 forms a run, for example by air jet 16, the beam 16 can be used as a light guide. The reason for this lies in the fact that the refractive index of the physiological saline solution of about 1, 33 is higher than that of air at about 1.0. Thus, the beam 16 acts as a light guide, the illumination light is coupled in such a way into the liquid 15 such that at least a significant portion of the light satisfies the condition for total reflection at the interface between the liquid 15 of the beam 16 and the surrounding air. The condition for the occurrence of total reflection that an incident from the interior of the liquid jet on the interface light beam with the normal of the boundary surface encloses an angle which is greater than the critical angle for total reflection. This can be achieved in the irrigation fluid 11 by suitably arranging the end 13 of the light guide. The relevant parameter is here in particular of the opening angle of the emerging from the light guide 11 in the liquid-ray beam.

With the use of beam 16 as a light guide to the illumination light for the operation can be specifically perform the surgical site. Unlike devices of the prior art, no light guide need not be led through the entire tip 11, which particularly in the region of the extreme distal end 5 permits a reduction in the tube cross-section. Absorption losses of the illumination radiation at the wall of the irrigation line can be kept within limits in that the coupling of the illumination radiation in the region of the distal end 5 takes place near the outlet opening 17 and / or that the opening angle of the exiting from the light guide light beam is small and the exit direction of the light beam to the outlet opening 17, in particular to the center of the exit opening, FIG. The ends 13 of the light guide 11 are thereby brought only as close to the outlet opening 17, as is necessary for a sufficient illumination intensity, but without penetrating it in the intended for insertion into the eye area of ​​the distal end. 5 Setting a small opening angle can be supported by at least one suitable additional optics, which are either facing the illumination source at the end and / or on the irrigation fluid end facing the optical fiber 11 is arranged. Advantageously, a small opening angle as possible should be chosen.

Also, by appropriate choice of the absorption or reflection coefficient of the walls of the irrigation line 17 of intensity loss can be kept within the irrigation line within limits. It is particularly advantageous in this case, an internal mirror of the wall of the irrigation line, at least in the region between coupling of the illumination radiation and the outlet opening 17th

A particularly advantageous embodiment of the invention is shown schematically in Fig. 5. in a sectional view, this shows an irrigation line 107 and which opens in the end 113 of a light guide. Between the end 113 of the light guide and the outlet opening 117 of the irrigation line 107, irrigation line 107 the restricting wall is provided with a coating 119, which has a lower refractive index than the physiological saline 115th Suitable materials for this coating include, for example Teflon AF having a refractive index between 1, 29 and 1.31 or nano-porous dielectric polymers, with which the refractive indices can be achieved in the range between about 1, 15 and 1; 3. Suitable coating materials are in WP. Risk et al. therefore "Optical waveguides with at wässrige core and a low-index nanoporous cladding" described in Optical Express 6446, Volume 12, No. 26. In this publication regarding suitable coating materials, reference is made. It should also be noted that instead of the wall 108 the irrigation line to be provided with such a coating 107, also the possibility of manufacturing the complete wall of Teflon AF or a nanoporous dielectric material.

The embodiment shown in Fig. 5 has 117 light-transmitting properties due to the ratio of the refractive indexes between the coating and the physiological saline solution also between the end of the optical fiber 113 and the outlet end. For coupling the light into the liquid 115 is true with respect to the first embodiment applies analogously, with the proviso that instead of the interface between the liquid and air, the interface between the liquid 115 and the coating 119 or the wall is to be considered , In addition, the refractive index of the light conducting core of the physiological saline 115 corresponds.

In particular, the ability to provide the entire irrigation line with one of the coatings described or the wall of the irrigation line 107 is made completely in the illustrated in Fig. 5 embodiment, that is to produce over the entire length, of such a material. In this case, the coupling of the illumination light can be made in the irrigation line and at the proximal end, that is at the far end of the outlet opening 117. The optical fiber 111 may then be completely omitted, as the irrigation fluid itself forms the light guide. It should be noted at this point that the embodiment shown in Fig. 5 has been described with reference to an irrigation line 107th Generally, however, an aspiration line can be configured as described with reference to FIG. 5. It can then be used as a light guide, in particular when the process performed with the aspiration extraction process results in a continuous fluid flow through the aspiration line. Of course, it is also possible for both aspiration and an irrigation line, for example, the phacoemulsification device shown in Fig. 1 as a light guide to design.

A third embodiment of an inventive device is shown in Figures 3a to 3c. This embodiment can also, like all other embodiments, also be equipped with the embodiment described with reference to FIG. 5 coating or wall.

Figures 3a to 3c show a Irrigationsröhrchen 203 through which an irrigation line 207, is located for supplying irrigation fluid, such as water or physiological saline into a surgical site. The distal end 205 has an angled tip 206 by approximately 90 degrees, which makes it possible to guide the irrigation line 207 substantially parallel to the body surface to the surgical site. In the tip 206 an outlet opening 217 is arranged, which allows the discharge of the irrigating fluid 217th It should be mentioned at this point that the Irrigationsröhrchen 203 need not have angled tip 206th The irrigation line can therefore be completely straight.

In the area of ​​the distal end 205 of the Irrigationsröhrchens 203, the end 213 of optical fiber 211 flows into the irrigation line 207. The core of the optical fiber has a refractive index which is matched to the refractive index of the irrigation fluid, eg. By an appropriate opening angle of the from the end 213 adjust the optical fiber 211 exiting beam.

The other end of the optical fiber 211 is associated with a light source whose light is coupled into the optical fiber 211 and guided by this to the distal end 205 of the Irrigationsröhrchens 203rd There, the light is coupled into the suitable flowing through the irrigation line 207 irrigating fluid 215th The irrigating fluid 215 passes through the outlet opening 217 of the irrigation line 207 in the direction of the operating site to be illuminated from. Particularly with an eye operation, the light can pass directly into the eye so without any highlights. The direction of the light can be easily controlled by the position of the distal end of the irrigation line.

By means of a in the region of the outlet port is slidably disposed in the top of the insert 206 217 219, the divergence of the exiting Irrigationsflüssigkeitsstrahls 216A, 216B, 216C are changed. The further the insert is withdrawn into the interior of the outlet opening 217, the lower the divergence of the Irrigationsflüssigkeitsstrahls. About the divergence. of

Irrigtaionsflüssigkeitsstrahles 216A, 216B, 216C of the opening angle of the illuminating radiation to the exit of the irrigation fluid 215 can be adjusted from the irrigation 207th Although the irrigation fluid can be supplied according to the invention alone for the purpose of illuminating the surgical site, it is advantageous to select an irrigation fluid, which can also fulfill another function in the area of ​​the surgical site. It is therefore particularly advantageous physiological saline, through their application, for example, the drying out of the surgical site is prevented during an operation.

A further embodiment of the inventive illumination device is shown in Fig. 4. Fig. 4 illustrates the distal portion of an infusion cannula 302. The distal portion of the infusion cannula 302 comprises a plate 305 with a hole from which a thin tip 309 protrudes with a liquid line 308. This is designed for insertion into a surgical site or in the a surgical site surrounding tissue. Its outlet opening 317 represents the distal end of the liquid line 308. From it, a particular laminar liquid jet 316 exit. For example, the infusion cannula 303 may be used to supply the chambers eyes during eye surgery liquid in order to maintain the intraocular pressure constant.

Side of the plate 305 on which the thin tip 309 is located remote from a lead portion 311, via which the infusion liquid 315 is directed to the thin tip 309th In addition, an optical fiber is guided by the lead portion 311 312 whose end 313 is located zuleitungsabschnitt- side in front of the plate 305th The core of the optical fiber 312 has a refractive index which is matched to the refractive index of the infusion liquid 315, for example. Order to get a suitable aperture angle of the emerging from the optical fiber beam. Via the optical fiber 312 illumination light a remote source of illumination in a current flowing in the thin tip 309 infusion liquid 315 may be coupled. In a particularly advantageous embodiment of this embodiment, the thin top may be provided with a coating 309, as has been described with reference to Fig. 5. Alternatively, the thin tip 309 may be manufactured entirely from a material whose refractive index is less than the refractive index of the infusion liquid 315, for example, physiological saline, water, or hyaluronic acid. Using the thus formed infusion cannula illumination radiation can be introduced directly into the surgical site.

In the present embodiments, physiological saline and hyaluronic acid were used as liquid water used. However, the method according to the invention can be carried out with other liquids, provided they supplied for the

Illumination radiation have a sufficiently high transparency. They should also be biocompatible. For example, water has the entire visible spectrum as well as in the adjoining near infrared and near ultraviolet sufficiently high transparency to be used as liquid light guide. Specifically, during coupling of UV radiation into the liquid with a suitable choice of the liquid in the invention may also include a luminescence, so fluorescence or phosphorescence are generated in the liquid. With the help of a local luminescence lighting throughout Operattonssitus can be done with the liquid. If phosphorescence is present and this continues long enough yet taken place even after switching off the illumination beam illuminating the surgical site with the phosphorescence of distributed fluid.

Claims

claims
1. A method for illuminating a surgical site with illumination radiation, in which via at least one fluid line (7, 9,
107, 207, 308) with a side facing the surgical site distal end (5, 105, 205, 303) a through the liquid pipe (7, 9, 107, 207, 308) passing fluid (15, 115, 215, 315) to the surgical site is supplied and / or removed from the surgical site, wherein the illumination radiation from the distal end (5, 105, 205, 303) of the liquid pipe (7, 9, 107, 207, 308) away in the direction of the distal end (5, 105, 205 , 303) in the flowing liquid (15, 115, 215, 315) is coupled and - 315) is used as a light transmitting medium, the liquid (15, 115, 215,.
2. The method of claim 1, wherein water as a flowing liquid (15, 115, 215, 315) is used.
3. The method of claim 1, in which physiological saline as a flowing liquid (15, 115, 215, 315) is used.
4. The method according to any one of claims 1 to 3, in which the coupling of the illumination radiation in the vicinity of the distal end (5, 105,
takes place 205, 303) of the liquid pipe (7, 9, 107, 207, 308).
5. The method according to any one of claims 1 to 4, in which at least one of the distal end (5, 105, 205, 303) of the liquid pipe (7, 9, 107, 207, 308) emerging, directed to the surgical site
A liquid jet (16, 116, 216, 316) is used as a light guide for the illumination radiation.
6. The method of claim 5 in which takes place a setting of an opening angle of the illumination by adjusting the divergence of the emerging liquid steel (216) and / or the distribution of the liquid in the exiting liquid jet (216).
7. A method according to any one of claims 1 to 6, in which a liquid is used as liquid, having the luminescence.
has 8. The illumination device for illuminating a surgical site with illumination radiation having at least one fluid line (7, 9, 107, 207, 308) having a distal end (5, 105, 205, 303) which is turn to the surgical site, and for supplying a through the liquid pipe (7, 9, 107, 207, 308) passing fluid (15, 115, 215, 315) to the surgical site and / or for discharging a
Liquid is configured from the surgical site, wherein the heat removed from the surgical site, fluid forms a fluid line (7, 9, 107, 207, 308) flowing liquid, and - a from the distal end (5, 105, 205, 303) located in the
Liquid pipe (7, 9, 107, 207, 308) opens coupling device (13, 113, 213, 313) for coupling the illuminating radiation into the flowing fluid (15, 115, 215, 315), wherein the coupling device (13, 113, 213 , 313) so (in the liquid line 7, 9, 107, 207, 308) opens out that the
Illumination radiation towards the distal end (5, 105, 205, 303) is coupled, and is effected, the coupling such that the fluid flowing in the fluid line and / or after exit or before entry (in the liquid line 7, 9 , 107, 207, 308) acts as a light transmitting medium.
9. The illumination device according to claim 8, in which the coupling device (13, 113, 213, 313) near the distal end (5, 105, 205, 303) of the liquid pipe (7, 9, 107, 207, 308) is arranged ,
10. Lighting device according to claim 9, wherein - the distal end (5, 105, 205, 303) the at least one
Liquid pipe (7, 9, 107, 207, 308) has an outlet opening (17,117, 217, 317), through which by the liquid pipe (7, 9, 107, 207, 308) passing fluid (15, 115, 215, 315 ) exits to the surgical site through, and - the outlet opening has a shape which the leaving
Liquid (15, 115, 215, 315) to at least one liquid jet (16, 116, 216, 316) forms.
comprises 11 lighting device according to claim 10, in which the outlet opening (17, 117, 217, 317) has a shape which the leaving
Liquid (15, 115, 215, 315) to at least a laminar liquid jet (16, 116, 216, 316) forms.
12. Lighting device according to claim 9 or 10, an insert (219) is displaceably arranged in the region of the outlet opening (217).
13. Lighting device according to any one of claims 8 to 12, in which the liquid conduit (107) at least in the region between the coupling-in device (113) and the outlet opening (117) of a material (119) having a smaller refractive index than that of
is refractive index of the flowing liquid (115) produced or with such a material (119) is internally coated.
14. Lighting device according to any one of claims 8 to 14, in which the flowing liquid luminescence.
15. A surgical instrument having a lighting device according to any one of claims 8 to fourteenth
16. A surgical instrument according to claim 15, having a irrigation line (7, 107, 207, 308) and / or an aspiration line (9) with a made facing the surgical site distal end (5, 105, 205, 303), wherein the irrigation line ( 7, 107, 207, 308) and / or the aspiration line (9) which forms a fluid conduit at least or form.
17. A surgical instrument according to claim 15, which is designed as Phaco- end piece or as an infusion cannula.
PCT/EP2006/010878 2005-12-15 2006-11-01 Method for illuminating the site of an operation, illumination device and surgical instrument WO2007073802A1 (en)

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Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN102313166A (en) * 2010-05-17 2012-01-11 夏普株式会社 Light emitting element, light emitting device, illuminating device, and vehicle headlamp
DE102011111285A1 (en) * 2011-08-26 2013-02-28 Geuder Ag Device for introducing light and aura in e.g. eyes during surgical operation for illuminating surgical site, has light conductor executed in distal end region and allowed to open with hollow end region to form application region
DE102012018982A1 (en) * 2012-09-27 2014-03-27 Carl Zeiss Meditec Ag Control device for a ophthalmochirurgisches System

Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4551129A (en) * 1983-04-08 1985-11-05 Coleman D Jackson Technique and apparatus for intraocular and microsurgery including lighter-irrigator hypodermic tube
US4617013A (en) * 1983-03-14 1986-10-14 Timron Instruments, Incorporated Method and apparatus for surgical irrigation, aspiration and illumination
EP0201280A2 (en) * 1985-05-01 1986-11-12 Kabushiki Kaisha TOPCON Infusion instrument
EP0618465A1 (en) * 1993-04-01 1994-10-05 Bridgestone Corporation Fluid filled optical waveguide
EP0647863A2 (en) * 1993-10-08 1995-04-12 United States Surgical Corporation Liquid light guide
US5425730A (en) * 1994-02-16 1995-06-20 Luloh; K. P. Illumination cannula system for vitreous surgery
US20050031281A1 (en) * 2003-08-09 2005-02-10 Gunther Nath Illumination device with light guide and light diffuser

Patent Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4617013A (en) * 1983-03-14 1986-10-14 Timron Instruments, Incorporated Method and apparatus for surgical irrigation, aspiration and illumination
US4551129A (en) * 1983-04-08 1985-11-05 Coleman D Jackson Technique and apparatus for intraocular and microsurgery including lighter-irrigator hypodermic tube
EP0201280A2 (en) * 1985-05-01 1986-11-12 Kabushiki Kaisha TOPCON Infusion instrument
EP0618465A1 (en) * 1993-04-01 1994-10-05 Bridgestone Corporation Fluid filled optical waveguide
EP0647863A2 (en) * 1993-10-08 1995-04-12 United States Surgical Corporation Liquid light guide
US5425730A (en) * 1994-02-16 1995-06-20 Luloh; K. P. Illumination cannula system for vitreous surgery
US20050031281A1 (en) * 2003-08-09 2005-02-10 Gunther Nath Illumination device with light guide and light diffuser

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN102313166A (en) * 2010-05-17 2012-01-11 夏普株式会社 Light emitting element, light emitting device, illuminating device, and vehicle headlamp
DE102011111285A1 (en) * 2011-08-26 2013-02-28 Geuder Ag Device for introducing light and aura in e.g. eyes during surgical operation for illuminating surgical site, has light conductor executed in distal end region and allowed to open with hollow end region to form application region
DE102012018982A1 (en) * 2012-09-27 2014-03-27 Carl Zeiss Meditec Ag Control device for a ophthalmochirurgisches System
WO2014048552A1 (en) * 2012-09-27 2014-04-03 Carl Zeiss Meditec Ag Control device for an ophthalmic surgical system

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