JPS6116168B2 - - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION The present invention relates to a handpiece for a surgical device using a laser beam, namely a laser scalpel.

When a living tissue is irradiated with a laser beam of appropriate energy, the tissue in that area is damaged. If the energy is sufficient, phenomena such as tissue destruction and tissue evaporation will occur due to the instantaneous temperature rise. Utilizing these phenomena, attempts have been made to use laser beams to destroy tumor cells, stop bleeding, and apply them to scalpels, etc., and some have already reached the stage of practical use. The laser beam is 1.06μ obtained from Nd-YAG laser.
Laser light with a wavelength of 10.6μ, obtained from a CO ₂ gas laser, and laser light with a relatively long wavelength of 10.6μ are mainly used. The effect on living tissues naturally varies depending on the wavelength; Nd-YAG lasers are used primarily for hemostasis and destruction of tumor cells, and CO ₂ gas lasers are used for incisions.

Nd-YAG laser light is guided with low loss by communication fibers made of quartz or glass, so optical fibers made of the above materials are used as the light guide path, and can be used in conjunction with a gastrocamera to stop bleeding in the stomach. Attempts are being made to use it for

On the other hand, in the case of a laser scalpel that uses CO ₂ gas laser light, since suitable optical fibers have not been put into practical use, the laser light is guided to an arbitrary position using an articulated light guide path made up of multiple mirrors. That's what I do. However, articulated light guides have problems in terms of operability, shape, maintenance, etc., and attempts are being made to develop optical fibers for CO ₂ gas lasers. At present, halides such as KRS-5 are considered to be promising materials that can be used at this wavelength, but this material has flexibility problems. In other words, the power of the surgical laser beam is 10 to 50 W, and in order to transmit this power, the fiber diameter must be selected to be about 0.3 to 1.0 mm, but the minimum bending radius in this case is 100 mm or more. . Therefore, it is necessary to house the fiber in a flexible tube that has a curvature limiting function so that the fiber does not bend below the above-mentioned curvature. However, it has the advantage of being much lighter and easier to operate than mirror-articulated light guides. Usually, a lens or the like for condensing the laser beam is incorporated at the laser beam emitting end of the fiber, and a hand piece configured to be easily gripped by the operator is provided.
This does not pose a particular problem when performing surgery by standing the handpiece vertically and emitting laser light from above to below, but depending on the circumstances of the surgery, laser light may be applied laterally. There are times when you want to irradiate. In such cases, with conventional handpieces, the only option is to turn the handpiece sideways, but as mentioned above, the curvature of the fiber is over 100 mm, and the length of the handpiece is also about 100 to 150 mm, so it is turned sideways. It is very difficult to operate, has poor operability, and in some cases, excessive stress may cause the fiber to break, and if the surgical site is the inner surface of the abdominal wall, it is impossible to insert the handpiece, making the surgery difficult. There were drawbacks such as not being able to do so. For this reason, it has been proposed to bend the optical path by attaching a reflecting mirror to the laser beam output end, but conventional reflecting mirrors are either removable or simply change the angle of the reflecting mirror. The former requires time to attach and detach, making quick surgery difficult, while the latter has the disadvantage that when used without bending the optical path, the reflecting mirror is fixed to the output end, which obstructs the field of view.

The present invention eliminates the above-mentioned drawbacks of the conventional art by rotatably attaching a reflecting mirror to the laser beam emitting end of the handpiece and making movable a sliding ring that pivotally supports this reflecting mirror. The present invention will be described below based on drawings showing an example of implementation.
Figure 1 shows a laser scalpel device that uses a CO ₂ laser beam and an optical fiber. 1 is a main body containing a power supply and a control unit, 2 is a housing containing a laser oscillation tube, and 3 is a housing 2. A column erected from the main body 1 for support at a predetermined height and direction; 4 is an optical fiber cable having an optical fiber inside and covered with a protective flexible tube;
5 is a fiber connector for connecting the fiber cable 4 to the laser oscillation tube, and 6 is a handpiece incorporating a lens for condensing the laser beam emitted from the optical fiber, which is held and operated by the operator. This is the part to do.

The present invention relates to the structure of this handpiece 6, and its details are shown in FIGS. 2 to 5. 7 is
Optical fiber 8 for CO ₂ laser made of KRS-5 is a protective flexible tube whose curvature is limited so that optical fiber 7 does not bend below the minimum radius of curvature. One end of the optical fiber 7 is inserted through the fiber holder 9 and fixed by adhesive so that it does not protrude beyond the end surface of the fiber holder 9. The fiber holder 9 is fixed within the handpiece connecting tube 10 with a set screw 11. In addition, the flexible tube 8
One end of the handpiece connecting tube 10 is fitted into the handpiece connecting tube 10 and fixed with a screw 12 via a band (not shown). Reference numeral 13 denotes a rubber cap that smoothly connects the flexible tube 8 and the handpiece connecting tube 10 and protects the connection between them. Reference numeral 14 denotes a handpiece tube whose one end abuts one end of the handpiece connecting tube 10 and which is externally fitted and fixed to the fiber holder 19, and is a portion that is held and operated by the operator. Further, the inner surface of the handpiece tube 14 is adapted to allow light 15 emitted from the optical fiber 7 to pass therethrough. Reference numeral 16 denotes a lens made of ZnSe for condensing the light beam emitted from the optical fiber 7, and is fixed to the tip of the handpiece tube 14 by a threaded ring 17. A sliding ring 18 is fitted onto the handpiece tube 14 and can slide in the length direction of the handpiece tube 14. Details of the sliding ring 18 are shown in FIG. 3, and 18a and 18b are elastic arms formed by slits provided at both ends of the sliding ring 18, and projections provided at the output end side of the handpiece tube 14. 14a and handpiece connection tube 10
The sliding ring 18 can be fixedly held by being engaged with the protrusions 10 provided on the connecting portion side of the flexible tube 8, respectively. Reference numeral 19 denotes a reflecting mirror for bending the optical path, and is fixed to the reflecting mirror holding plate 20 with claws 20a. The reflecting mirror holding plate 20 is the aforementioned sliding ring 18.
21, which is supported by a shaft 18c that is press-fitted into the
is a washer, and 22 is a retaining ring that prevents the reflective mirror holding plate 20 from falling off. Further, a locking pin 18d is press-fitted into the sliding ring 18. 23 is Wasshya. 24 is a retaining ring fixed to the retaining pin 18d, and the retaining ring 24 is connected to the reflector holding plate 2 via a disc spring 25.
0 is frictionally held in the sliding ring 18. FIG. 4 is a view seen from the arrow XX direction in FIG.
An arc-shaped elongated hole 20b is provided at a position corresponding to the mirror holding plate 20, and the reflecting mirror holding plate 20 is held by rotating at an arbitrary angle about the shaft 18c.

FIG. 4 shows a state in which the laser beam is bent at right angles. Move the reflector holding plate 20 to the right from the state shown in Figure 4.
Figure 5 shows the state in which it has been rotated 45 degrees. At this time, the reflecting mirror 19 is parallel to the optical axis and located outside the handpiece tube 14. In this state, the laser beam is irradiated straight onto the affected area, but the visual field is obstructed by the reflector 19 and the reflector holding plate 20, making it difficult to perform surgery. Therefore, the sliding ring 18
is moved from the position indicated by the solid line in Figure 5 to the position indicated by the two-dot chain line. At this time, the sliding ring 18 is locked to the protrusion 10 of the handpiece connecting tube 10 as described above. Surgery is usually performed in this state. Since the reflector 19 and the reflector holding plate 20 are located close to the optical fiber connection end, there is no problem in gripping the handpiece and the field of vision is not obstructed. When it is desired to bend the laser beam, the sliding ring 18 is locked at a position near the output end and the reflecting mirror 19 is rotated, as shown in FIG.

The handpiece of the laser scalpel of the present invention can be implemented as described above, and can bend the laser beam extremely quickly with simple operation.
Even when used without being folded, it does not obstruct the field of view and has good operability, which is a great practical effect.

[Brief explanation of the drawing]

An example of the implementation of the present invention is shown in the drawings, in which Fig. 1 is an external perspective view of a laser scalpel device, Fig. 2 is a vertical sectional view of a hand piece, Fig. 3 is a perspective view of a sliding ring, and Fig.
The figure is a view taken along the line X--X in FIG. 2, and FIG. 5 is a side view showing a state in which the reflecting mirror in FIG. 4 is rotated and moved. 4... Optical fiber cable, 6... Hand piece, 7... Optical fiber, 8... Protective flexible tube, 10... Hand piece connecting tube, 10a... Protrusion, 14... Hand piece tube, 14a... …protrusion,
15...Light, 16...Lens, 18...Sliding ring, 18a, 18b...Elastic arm, 18c...
Shaft, 18d... Locking pin, 19... Reflector, 20
...Reflector holding plate, 20b...Elongated hole.

Claims (1)

[Claims] 1. A sliding ring that is slidably held on the outer peripheral surface of the handpiece of the laser scalpel in the optical axis direction and has a locking portion with the handpiece at least at both ends of the handpiece, and a sliding ring that is rotatably supported by the sliding ring. and a laser knife configured such that the reflecting mirror is held on the optical path of the emitted light at an angle with respect to the optical axis at a position where the sliding ring is locked on the laser light emitting end side. hand piece.