JPS6045529B2 - laser surgical instruments - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION The present invention relates to a laser surgical instrument useful for performing surgical operations, which includes an edge member for irradiating laser light that contacts tissue.

In recent years, optical surgical devices such as non-contact laser scalpels and contact-type photocoarguulators (coagulation and hemostasis devices) have been rapidly developed and put into practical use. It is beginning to demonstrate advantages that it does not have.

In the contact type photocoagulator disclosed in Japanese Patent Application Laid-open No. 56-156150 by Guyunter Ato, which is the background art of the present invention, infrared rays from an incandescent lamp heat ray source are passed through a quartz rod to the tip of the rod to the affected area. Because the pressure is applied to the tube to block blood flow and the tip is irradiated with light to coagulate and stop bleeding, the pressure area of the tube may stubbornly adhere to the coagulated tissue or may move due to this. On the other hand, this photocoagulator has the great advantage that the coagulated tissue does not peel off and cause re-bleeding when the tissue is separated, but on the other hand, this photocoagulator is equipped with a mirror-polished, scratch-free pressurizing surface as a tissue pressurizer. During a short period of light irradiation during coagulation or tissue occlusion, heat rays are emitted directly from the mirror-polished end surface of the rod and directly impinge on the tissue. In this way, coagulation difficulties may vary depending on tissue/tissue location or individual patient characteristics.
The heat absorption or dissipation properties are directly reflected, causing local burning, blackening, or uneven coagulation on the tissue surface, which increases the reflectance of heat rays in the dry or blackened local area, and further penetration of heat rays. This may cause uneven evaporation of tissue water or uneven coagulation depth, resulting in incomplete therapeutic effects. Furthermore, even if the tissue pressurizing body is brought into direct pressure contact with the tissue, the edges of the pressurizing body are neatly chamfered, so there is no possibility of cutting or incising the tissue. Nakatsuta. The present invention completely eliminates the difficulties of the above-mentioned conventional techniques when irradiating tissue with infrared isothermal rays from a laser light source with high light intensity, and not only can the tissue be cut or intersected, but also the surface irradiated with the laser light The present invention provides a surgical instrument equipped with a sharp blade member (edge member) that treats tissue with a uniform irradiation intensity that is reduced by scattering by imparting light scattering ability to a light emitting portion.

That is, the present invention includes a fiber light guide, an edge member optically connected to the fiber light guide, a gripping member that mechanically holds and fixes the edge member and the fiber light guide, and The present invention provides a laser surgical instrument characterized by having a laser beam emitting surface subjected to a clouding process, and the edge member can be incorporated into tweezers, scalpels, or scissors to form a surgical instrument depending on the purpose. suitable. Furthermore, the edge member is preferably formed of sapphire, which has much higher strength, hardness, and chemical resistance than quartz glass, and has a thermal conductivity of about 1 quartz. Embodiments of the invention will be described below with reference to the accompanying drawings.

In Fig. 1, a laser (neodymium-YAG laser or argon laser) is driven by a light source 1 to transmit infrared rays to a surgical instrument 4 via a quartz optical fiber 2 of a light guide 2, a distributor 3, and a quartz fiber light guide 2'' again. A laser beam is guided and emitted from the light emitting surface of the instrument 4 toward the patient's tissue.The surgical instrument 4 includes the tweezers 10 in FIGS. Scalpel 20 in the figure,
The scissors 30 shown in FIGS. 6 and 7 may be used, or any suitable combination thereof may be used. Tweezers 10 as a laser surgical instrument are Safa! The device includes a pair of edge members 11 made of aluminum, a pair of grip members 12 made of an insulating material such as plastic, and a laser light guide 13 made of quartz fiber. Further, a connecting spring 14 that forms the tweezers connects the rear ends of the pair of gripping members 12 and is secured by a fixing screw 16.
has been established. In this case, the tip of the laser light guide 13 is housed in a cavity or recess with a thermal conductivity of 12, and in particular, the tip is held and fixed by a fixing piece 17 as shown in FIG. The rear end surface and the front end surface of the light guide 13 are fixed at an optical connection portion 18 so as to be close to each other and face each other. In the tweezers 10, a scraping process 15 is applied to the tip of the opposing surface of the edge member 11, and the laser beam emitted after passing through the edge member actually passes through the scraping process 15 surface to the clamping gap 19. oriented towards organizations.

The tweezers 10 uniformly emit laser light in a diffused manner from the scraped surface 15 while pinching and holding the tissue, thereby forming a uniform coagulation layer and achieving complete hemostasis against bleeding in exposed blood vessels and the gastrointestinal tract. I can do it. Note that only one side of the laser beam emitting surface may be polished 15. Fourth
5, the scalpel 20 according to the present invention includes a knife-shaped edge member 21, a gripping member 22, a laser light guide 2
3.

One end of the gripping member 22 is connected to the rear end of the edge member and the fixture 2.
The holding member 22 has an opening or a receiving portion large enough to insert the tail plug 24 thereinto, and a notch is formed at the other end of the gripping member 22 so that the tail plug 24 can be fitted therein. The tip of the light guide 23 is shown in Figures 2 and 3.
As in the illustrated example, it is held and fixed to the fixture 27, and the fixture 27 is further fixed to the gripping member 22 with screws 26. Knife-shaped oblique blade surface 2 of the edge member 21
Reference numeral 9 forms a laser beam emitting surface, and at least a portion or the entire surface of the emitting surface is ground 25.

In this way, when the laser beam from the light source is transmitted to the edge member 21 through the light guide 23 and the optical connection part 28, the sharp blade surface 29 cuts the tissue while scraping the oblique blade surface 29 2.
The light P is emitted from the five surfaces and is uniformly emitted in a diffused light pattern.The cut or resection surface can be immediately and uniformly coagulated to stop bleeding.

Of course, it goes without saying that this female surgical instrument can also be used for simple cauterization that does not require cutting or excision of tissue. Referring to Figures 6 and 7, both are scissor-shaped surgical instruments, but the former is a type that transmits light only to one edge member (upper in the figure) through a laser light guide, and the latter is a type of scissors-shaped surgical instrument. This type transmits light through a laser light guide to both edge members.

These devices are used depending on the type of disease, resection, and severity of hemostasis at the resection site.Either way, they aim to achieve almost complete hemostasis of the tissue while performing efficient and uniform resection/cutting. It is. In the figure, the scissors 30 includes a pair of edge members 31, a grip member 32, and
A light guide 33 is provided, and a side end of the light guide 33 is opposed to the rear end of the edge member 31 by an optical connection part 38, and a fixture 37 is provided.
It is fixed by A fixing piece 34 passing through the light guide 33 is fixed to the inside of the rear end of the gripping member 32 by a pin 36'', and the rear ends of the pair of gripping members 32 are elastically connected by a spring 35. The scissors 30 is gripped by the gripping member 32 around the pin 36 to reduce the scissoring light emitting gap 39 of the opposing blade surface of the edge member 31, and to cut tissue such as a tumor with the sharp blade surface having abrasion processing. In the scissors shown in Fig. 7, both blade surfaces of a pair of edge members 41 are abraded 48, and a guide beam is applied to each of these edge members. By transmitting laser light through the light body 43, cutting and complete coagulation and hemostasis can be achieved in the gap 49 at the same time.

As shown in FIG. 4, the gripping members 42 are pivotally connected to each other by a pin 46 and elastically connected by a spring 45 at their rear ends.
This is the same as the case in FIG. As described above, according to the laser surgical instrument according to the present invention, the laser light emitting surface of the edge member that directly contacts the tissue is polished, and from this surface a uniformly diffused light, that is, a surface light to some extent, is emitted. is released, giving a uniform and gentle cauterization and cutting action to the tissue, allowing for clean treatment without leaving surgical defects such as uneven coagulation, uneven evaporation, and uneven coagulation depth in the irradiated area. Thus, the present invention has great utility as a surgical instrument.

[Brief explanation of the drawing]

FIG. 1 is a basic configuration diagram of an apparatus in which a plurality of laser surgical instruments according to the present invention are arranged in a row and can be used simultaneously. FIG. 2 is a perspective view of a tweezers-type laser surgical instrument according to the present invention. 2 is a partial side sectional view of the instrument shown in FIG. 2, FIG. 7 is a perspective view of a female laser surgical instrument according to the present invention, FIG. 5 is a side sectional view of the instrument shown in FIG. 7 shows a scissor-shaped laser surgical instrument according to the invention, the former showing a partial side sectional view and the latter a perspective view of a variant. 2, 2'', 13, 23, 33, 43... Fiber light guide, 11, 21, 31, 41... Edge member, 12, 22, 32, 42... Gripping Part, 1
5, 25, 48... Polished laser beam emitting surface.

Claims (1)

[Scope of Claims] 1. A fiber light guide, an edge member optically connected to the fiber light guide, and a gripping member that mechanically holds and fixes the edge member and the fiber light guide. A laser surgical instrument comprising: a laser beam emitting surface of the edge member is subjected to a clouding process. 2. The laser surgical instrument according to claim 1, wherein the frosted edge member is incorporated into tweezers. 3. The laser surgical instrument according to claim 1, wherein the edge member subjected to the clouding process is incorporated into a scalpel. 4. The laser surgical instrument according to claim 1, wherein the edge member subjected to the clouding process is incorporated into a scalpel. 5. The laser surgical instrument according to any one of claims 1 to 4, wherein the frosted edge member is made of sapphire.