WO2021147693A1 - Optical fiber sheathing canal - Google Patents

Abstract

A sheathing canal (20) having directivity and capable of adjusting output of a laser surgical device or a surgical robot (01) of the position of an optical fiber laser window (12). According to the sheathing canal (20), the directivity of the laser window (12) is obtained by means of the sheathing canal (20) sleeved on the laser transmission optical fiber (10), the optimal laser and tissue action effect is obtained by advancing and retreating the relative position of the optical fiber laser window (12) and a port (22) of the sheathing canal (20) or the relative position of an operation focus such as soft tissue and calculus by means of the optical fiber position adjuster (33), and the laser operation efficiency is improved jointly in two aspects.

Description

Fiber sheath Technical field

The optical fiber sheath used for laser minimally invasive surgery is used to transmit the laser energy of laser surgery equipment including surgical robots and has good laser window directivity. At the same time, the position of the laser window is changed by the optical fiber position adjuster to obtain the best laser energy pair The effect of tissue, together to improve the efficiency of laser minimally invasive surgery, clinically used in laser lithotripsy, soft tissue cutting, vaporization, etc.

Background technique

Laser surgery equipment can be used in the field of minimally invasive surgery because it can enter the human body through the transmission fiber to reach the lesion to complete the treatment of calculus and lithotripsy, soft tissue and tumor resection, and vaporization. The surgical robot controls the robotic arm through software to avoid human disadvantages and improve the accuracy and success rate of the operation. The surgical robot needs to use an energy source including a laser source.

The mid-infrared laser, represented by holmium laser and thulium laser, can be efficiently absorbed by water molecules, and human tissue is rich in water, which has a very good clinical surgical treatment application market. Through the pulse output of laser energy, a better laser energy blasting effect on stones and tissues is obtained, and the effects of stone crushing, soft tissue cutting and vaporization treatment are realized. US Patent 5,387,211 discloses a multi-holmium laser cavity synthesis of high-frequency and high-power output holmium laser patented technology, which lays the foundation for high-efficiency lithotripsy and soft tissue cutting, but the blasting effect produced by high-frequency laser pulses also makes soft fibers The laser window trembles with the frequency of the laser pulse, so that the fiber cannot be kept at the same position of the surgical lesion for cutting and blasting, and this jitter will also consume laser energy. The deviation of the laser energy from the target point causes the distance between the lesion and the laser window to increase. Therefore, the consumption of laser energy for flushing with saline around the lesion also increases, which affects the effect of laser energy on tissues.

U.S. Patent 5,963,575 discloses a dual-frequency laser lithotripsy machine invented by the Germans. The pulsed green laser generates plasma and absorbs 1064nm pulsed laser energy, thereby generating shock wave crushing technology. The same soft fiber causes the fiber laser window to vibrate violently when the high-frequency laser pulse is output, which causes the high-frequency lithotripsy effect to be inferior to the low-frequency lithotripsy effect.

In order to obtain better surgical results, usually the fiber laser window must be close to or against the lesions such as stones, prostate glands, etc., to reduce the holmium laser pulse energy caused by the distance from being absorbed by the saline or to facilitate the green laser to generate plasma on the surface of the stone. In general, this method of operation makes the fiber laser window easy to be damaged by blasting force or impact force, so the fiber laser window needs to be cut and adjusted intraoperatively to re-adjust to the lesion.

In order to reduce the loss of the fiber laser window during the operation and the absorption of infrared laser energy by the physiological saline, US Patent 9678275 discloses a related technology of introducing a ferrule at the end of the fiber laser emission window. This technology uses the ferrule and the fiber laser window for permanent The fixed method is a technical feature. The absorption of laser energy by the physiological saline is reduced by the internal bubbles in the ferrule, and the efficiency of the operation is improved. However, this method of using the fiber laser end ferrule will still produce jitter, and at the same time, it is long for high power. Time surgery such as prostate cutting is a serious problem for the life of this optical fiber.

Summary of the invention

The technical problem to be solved by the utility model is to provide an optical fiber sheath, which is used to transmit the laser energy of laser surgery equipment including surgical robots and has good laser window directivity. At the same time, the position of the laser window is changed by the optical fiber position adjuster. The best effect of laser energy on tissues, together to improve the efficiency of laser minimally invasive surgery.

In order to solve the above technical problems, the optical fiber sheath of the present invention has a certain hardness sheath on the output fiber set. The pipe inside the sheath is used to pass and guide the output fiber, whether it is pulse or continuous wave mode when launching laser. , The fiber laser window is limited to reduce jitter and improve the directivity of the fiber sheath laser window. Through the fiber position adjuster, the fiber laser window can be moved back and forth in the sheath to obtain the best laser energy and tissue effect.

The sheath of the above-mentioned optical fiber sheath is either a rigid stainless steel metal tube, a polymer resin tube, a nylon tube, a ceramic tube, a glass tube, or a flexible polymer resin. The material itself meets the requirements of biocompatibility, or the sheath tube is wrapped in contact Part of the protective film of the human body meets the requirements of biocompatibility.

In the embodiment, the port of the sheath is open, and the shape is either flat or closed.

In order to better fix the fiber laser window, you can embed the original parts made of high laser energy reflective materials at the position of the laser window, which is also the head end position of the fiber sheath, such as gold tubes, silver tubes, or optical elements with high laser energy transmittance such as Quartz tube to further strengthen the limiting effect on the fiber laser window.

The design of the fiber position adjuster can move the position of the fiber laser window back and forth during the operation. The position change can be continuous or in a fixed step. The design of the fiber position adjuster can also adopt an intermittent operation process. After loosening the fiber fastener, the position of the fiber laser window is changed. After the fastener is tightened, the position of the fiber laser window during the operation is fixed.

The position of the fiber laser window is to retract to the proper position of the pipe within the sheath port, so that it is possible to lock the air bubble in the space between the inner wall channel of the sheath port and the fiber laser window. In this state, The fiber sheath port directly contacts the lesion, and the laser energy acts on the lesion through the locked air channel to avoid or reduce the absorption of the laser energy pulse by the water and obtain a higher laser energy organization effect. Of course, the fiber laser window can also protrude from the sheath port. At this time, the laser emission window of the fiber sheath will stay close to the lesion during the operation.

An optical fiber sheath for a laser surgical robot, which is composed of the output component optical fiber of the laser surgical robot, an optical fiber support, an optical fiber position adjuster, and a connecting component. Its technical feature is that the optical fiber support restricts the optical fiber to make the laser window have a relatively high Good directivity, and at the same time, the best laser energy and tissue effect can be obtained by advancing and retreating the position of the fiber laser window through the fiber position adjuster.

For the optical fiber sheath of the surgical robot, the optical fiber support is either a consumable part of the surgical robot, or a component part of the surgical robot arm.

For the optical fiber sheath of the laser surgical robot, the optical fiber position adjuster is either a component of the surgical robot, or a consumable part of the surgical robot, and the control software drives the electric transmission mechanism or the mechanical transmission mechanism to advance and retract the position of the fiber laser window.

For the optical fiber sheath of the laser surgical robot, the optical fiber support adopts the structure of installing optical fibers on the operation site.

For the optical fiber sheath of the laser surgical robot, the optical fiber position adjuster adopts the structure of installing optical fibers on the surgical site.

The optical fiber sheath has an operating handle, which is the handle of the surgeon holding the optical fiber sheath or the connecting part of the surgical machine and the optical fiber sheath, which is convenient for the surgeon or robot hand to operate the optical fiber sheath. According to the surgical scene and ergonomic requirements, the operating button of the fiber position adjuster is usually installed on the operating handle, so that the surgeon can advance and retract the position of the fiber laser window with one hand during the operation, and at the same time can control the movement of the fiber sheath as a whole . When the fiber sheath is a surgical robot arm or a component of the robot arm, the adjustment of the fiber position can be controlled by the surgeon through the console or operating interface of the surgical robot, or by the software of the surgical machine.

Whether it is a laser surgical equipment or a fiber sheath of a laser surgical robot, the fiber sheath port is installed with an optical element to form a terminal to output laser energy, which protects the fiber laser window and prolongs the service life of the fiber sheath.

The above-mentioned sheath port is equipped with the optical fiber sheath of the optical element, the end of the sheath tube is made of laser transparent material, and the shape of the end surface is either flat, inclined, or curved.

Through the optical fiber sheath of the present invention, due to the better laser emission window directivity and the control of the distance between the laser window and the lesion or the laser window (sheath) end with a longer life, better laser energy and tissue effects can be obtained, Significantly improve the efficiency of surgery.

Description of the drawings

Figure 1 Schematic diagram of an embodiment of an optical fiber sheath

Figure 2 Cross-sectional view of the embodiment

Figure 3 Cross-sectional view of fiber sheath port 2-2 in the direction of view

Figure 4 Cross-sectional view of fiber position adjuster 3-3 in the direction of view

Figure 5 The laser window is inside the fiber sheath port

Figure 6 The laser window protrudes out of the fiber sheath port

Figure 7 Installing the optical originals on the fiber sheath port

Fig. 8 Cross-sectional view of an embodiment where the position of the laser window cannot be adjusted during the operation

Figure 9: The overall structure of the optical fiber sheath is a structural schematic diagram of the components of the surgical robot arm

Figure 10 The principle diagram of the surgical robot when the optical fiber support and the position adjuster are surgical consumables of the surgical robot arm

Figure 11 The principle diagram of the surgical robot when the optical fiber support is the surgical consumable of the surgical robot

Detailed ways

FIG. 1 is a schematic structural diagram of an embodiment of an optical fiber sheath, and FIG. 2 is a schematic cross-sectional structure diagram of an embodiment of an optical fiber sheath. The optical fiber 10 is the laser transmission element of the laser surgical device, and the end of the laser surgical device is connected to the optical fiber joint 16. The optical fiber 10 is usually composed of a fiber jacket, a buffer layer, a cladding and a fiber core. The part of the optical fiber 14 in FIG. 2 is a complete optical fiber, and the optical fiber 13 is the cladding and core part after the fiber coat is stripped off, and the buffer layer is removed. The optical fiber 12 is the laser window of the optical fiber, that is, the end face of the optical fiber outputting the laser beam.

The sheath tube 20 is a stainless steel hollow tube that meets the requirements of biocompatibility. The maximum diameter of the outer diameter of the stainless steel tube is limited by the inner diameter of the working channel of the endoscope. The inner diameter of the stainless steel tube is slightly larger than the outer diameter of the received optical fiber. In order to cooperate with the operation of the endoscope, the outer surface of the stainless steel casing is smoothed. In addition, medical polymer materials can also be used. The processing of medical polymer materials adopts extrusion or molding injection technology. The material itself has the advantages of certain hardness, smooth appearance, and convenient batch processing. It is also convenient to operate through the endoscope and to avoid the requirement of sharp edges and corners from contacting the human body. The port 22 of the sheath 20 can adopt a chamfered or closed structure. The sleeve 20 is connected and fixed to the handle of the optical fiber sheath by means of screw or glue bonding. The optical fiber passes through the inner tube of the sheath to reach the position of the port 22 of the optical fiber sheath.

The optical element 21 further restricts the position of the optical fiber laser window, reduces the amount of jitter of the optical fiber window 12 during laser emission, and achieves the axis of the optical fiber 10 and the axis of the sheath 20 to coincide as much as possible. The original 21 is installed in the inner wall of the sheath tube port 22, and is fixed to the inner wall of the sheath tube 20 by a glue that meets biocompatibility. The shape of the element 21 is a cylinder, and its material can be quartz glass that is transparent to the laser beam, or a metal material that is highly reflective to the laser beam, such as a metal body, can be selected. The outer diameter of the optical element is smaller than the inner diameter of the sheath tube and larger than the outer diameter of the optical fiber 13 part. Fig. 3 is a cross-sectional view of the fiber sheath port 2-2 as viewed from the direction, and the optical element 21 is installed on the inner wall of the sheath port.

Taking an optical fiber with a core diameter of 550um as an example, the nominal outer diameter of the optical fiber 14 is 750um, and the fiber part 13 is the cladding fiber after stripping the fiber coat and buffer layer. Its nominal diameter is 600um, so the optical element 21 The inner diameter can be 620um, the outer diameter is 960um, and the sheath inner diameter is 1000um.

Figure 4 is a schematic diagram of the cross-sectional structure of the fiber position adjuster 33. 33-1 is the adjuster button, 33-2 is the connector between the button and the adjuster fiber holding member 33-3, and 33-4 is the fiber position adjuster Connect with the inner wall of the handle 30. A structure of the optical fiber position adjuster 33 is that the optical fiber holding member always holds the optical fiber 10 under the action of a spring, pressing the button 33-1, the connecting member 33-4 releases the locked state with the inner wall of the handle 30, and pushing the button back and forth At 33-1, the connecting piece 33-2, the optical fiber holding piece 33-3 and the optical fiber 10 are driven to move back and forth, thereby changing the position of the optical fiber laser window 12. The opening part 31 of the handle part 32 may adopt a limit tooth design, so that the forward and backward advance and retreat of the laser window 12 are discontinuous and change according to the set step length. This has an advantage. By designing a reasonable step length, it is convenient for the doctor to judge the adjustment position of the laser window 12 through the feel without eye observation. When the pressing button 33-1 is released, the connecting piece 33-4 is locked to the position of the inner wall of the handle 30, so that the position of the fiber laser window 12 is fixed. The moving distance of the fiber laser window in this structure is mainly limited by the opening length of the opening part 31 of the handle 30. There is also a structure of the fiber position adjuster 33. This structure has the same operation function and result as the above embodiment except for the above. The difference is that after the button 33-1 is pressed, the button 33 is further pressed. After -1, the fiber holding member 33-3 can loosen the fiber 10, so that the button 33-1 can move relative to the handle 30 under the action of external force, so that a greater distance of movement of the fiber laser window can be obtained. During the operation, the position of the fiber laser window 12 can be moved back and forth. Since the structural design adopted by the optical fiber position adjuster is a conventional design of the structural designer, a detailed description is not given in this patent specification.

In order to change the position of the fiber laser window 12, the fiber in the laser window 12 section of the fiber 10 needs to be processed, that is, after stripping off the fiber coat and buffer layer, the fiber core and fiber cladding are retained. The length of the laser window 12 to the fiber 14 meets As the position of the optical fiber needs to be changed, the distance from the window 12 to the optical fiber 14 is generally greater than the opening length of the handle opening part 31.

Figure 5 is a schematic diagram of the position of the laser window in the fiber sheath port. For the holmium laser or thulium laser commonly used in surgery, in order to avoid the absorption of laser energy by the flushing water, the fiber laser window 12 can be adjusted in the sheath as shown in Figure 5 In the port 22, the maximum distance 22-12 is limited by the divergent laser beam cutting to the edge of the sheath port 22 to form bubbles in the tube wall of the sheath port 22. In this way, when the fiber sheath port 22 contacts the stones or soft tissues, since the air bubbles replace water to occupy the transmission path behind the laser window 12, the attenuation effect of the water on the laser energy is minimized. This is especially meaningful for holmium laser and thulium laser lithotripsy. If the loss of the fiber laser window 12 is encountered during the operation and the operation effect becomes worse, the position of the fiber laser window 12 can be changed by the fiber position adjuster 33.

Figure 6 is a schematic diagram of the position of the laser window outside the fiber sheath port. As shown in Figure 6, the fiber laser window 12 can protrude from the sheath port 22, and the protruding length 12-22 needs to be within a certain range to reduce the fiber laser window 12's jitter. If the laser window 12 is ablated during the operation, the position of the laser window 12 can be moved forward by the optical fiber position adjuster 33. Of course, the fiber laser window 12 can also be flush with the sheath port 22.

Fig. 7 is an embodiment of a fiber sheath with an optical element installed at its port. The smaller the diameter of the fiber laser window 12 is, the more likely it is to be damaged during the operation. For this reason, the optical element 11 can be used as the end of the fiber sheath as shown in FIG. 7 to separate the laser window 12 from the surgical lesion. The optical element 11 is an optical material with high transmittance in the laser waveband, such as glass, quartz glass, gemstones, and the like. The optical element 11 is processed into a shape such as a cylinder that is easy to install with the port 22 of the sheath 20, and is fixed and sealed by a glue that meets the biocompatibility. The end surface of the optical element 11 may be a flat surface, a curved surface, and an inclined surface.

The fiber position adjuster 33 is installed on the operating handle 30. As shown in Figure 2, the operating handle has a hollow cylindrical shape, and its connection end with the sheath tube 20 can adopt a threaded connection structure, and the other end adopts the conventional tapered element tube 35, which provides the forward and backward of the optical fiber 10. The channel restricts the bend of the optical fiber. The operating handle 32 can be made of engineering plastics or metal parts, which are made by processing. The optical fiber position adjuster 33 is installed on the operating handle 30, so that the surgeon can operate the optical fiber sheath with one hand, and can adjust the front and rear positions of the laser window 12 and change the pointing position of the sheath.

Fig. 8 is a schematic cross-sectional view of another embodiment of the fiber sheath. The biggest difference from the embodiment shown in Fig. 2 is that the position of the fiber laser window 12 cannot be adjusted during the operation. If the fiber laser window 12 is in the operation In case of damage or ablation, the operation needs to be interrupted, the end cap 34 is loosened from the operating handle 30, and the position of the fiber laser window 12 is manually adjusted, and then the end cap 34 is tightened again. The end cap 34 holds the optical fiber tightly and engages the operating handle fix. The connection between the end cap 34 and the operating handle 30 adopts a threaded connection.

Surgical robots are getting more and more attention in clinical applications today. Surgeons give instructions through the operating console or interface. The control software or control components of the surgical robots are transformed into robotic arm operations, replacing the operations of the surgeon’s arms, thereby improving the accuracy of the operation. Degree and precision reduce the intensity of the doctor’s surgical work. The optical fiber sheath becomes the output part of the surgical robot, and its structure can be used as a consumable part of the surgical robot, an arm component, or a combination of the two.

Figure 9 is a schematic diagram of the structure of the optical fiber sheath as a component of the surgical robot arm. As shown in Figure 9, the optical fiber support 20 and the optical fiber position adjuster 33 are used as the output component of the surgical robot or the component part of the robotic arm for the convenience of the operating room. When installing the optical fiber 10, the supporting member 20 can adopt a tubular structure that can be opened and closed axially, or adopt a channel structure to facilitate the installation of the optical fiber 10 at the operation site. The optical fiber supporting member has the same structure as a traditional optical fiber sheath. Or similar. The regulator 33 may adopt a structure design that can install optical fibers on site, such as opening the cover, and the drive motor or transmission structure is installed in the component 33, and is connected to the surgical robot host 01 through a connecting cable or a mechanical transmission component. In this structure, the operating handle of the optical fiber sheath is both the surgical robot arm itself.

Fig. 10 is a schematic diagram of the surgical robot when the optical fiber support and position adjuster are surgical consumables of the surgical robot arm. As shown in Fig. 10, the optical fiber 10, the optical fiber support 20, and the optical fiber position adjuster 33 are integrally used as consumables of the surgical robot 01 and are installed On the robotic arm of the surgical robot, it is connected to the surgical robot 01 through a connecting cable or a mechanical transmission mechanism, instead of operating with the fingers of the surgeon. A micro-motor can be installed in the fiber position regulator to drive the movement of the fiber laser window 12. At this time, the connection with the surgical robot 01 is through a cable. If a structural member is designed in the optical fiber position adjuster to drive the movement of the optical fiber 10, the connection between the optical fiber position adjuster 33 and the surgical robot is through a mechanical structure. The installation part of the entire fiber sheath and the surgical robot arm is similar to the handle part of the traditional fiber sheath. The directivity of the optical fiber support to the optical fiber is the same as or similar to the structure of the traditional optical fiber sheath.

Fig. 11 is a schematic diagram of the surgical robot when the optical fiber support is the surgical consumable of the surgical robot. As shown in Fig. 11, the optical fiber 10 and the support 20 are the consumables of the surgical robot 01, and the optical fiber position adjuster 33 is a component of the surgical robot 01 If it is selected to be installed on the surgical robot arm, the optical fiber is installed in the optical fiber position adjuster 33 by means of on-site installation.

For the above-mentioned optical fiber sheath as the output component of the surgical robot, the laser source can be a separate laser surgical device or a unit that comes with the surgical robot. Figures 9-11 show a continuous way of bending the optical cable with the surgical robot 01 or laser surgery equipment, but it is not limited to other connection methods such as the light guide arm, and the butting method of the optical cable and the optical cable.

The traditional method of manually operating the fiber position adjuster button 33-1 by the surgeon will be replaced by the surgical robot. The surgeon will issue fiber position instructions through the console or interface, or the surgical robot system will automatically select the position of the fiber laser window and then drive it. The moving parts or mechanical transmission parts are electrically controlled to change or select the position of the fiber laser window to realize the movement of the fiber laser window 12.

The optical fiber sheath of the present invention improves the directivity of the optical fiber laser window 12 by restricting the position of the optical fiber 10. For the clinical application of the dual-frequency laser lithotripter, the amount of jitter on the laser window 12 when the shock wave generated by the laser pulse is greatly reduced, so that the laser impact force can be aimed at the same part of the stone during high-frequency output, which greatly improves the efficiency of the operation. For holmium laser surgery equipment, because it is a pulse output mode, and the separation of lithotripsy and prostate glands are all dependent on the shock wave generated by this pulsed laser, the optical fiber sheath greatly improves the directivity of the laser window 12, especially at high frequencies. When the pulse is output, the high directivity of the laser pulse greatly improves the efficiency of the operation. In addition, by retracting the window 12 into the sheath port 22, the air bubble occupies the laser emission path, which greatly improves the efficiency of the laser energy on the tissue.

Claims (13)

An optical fiber sheath is composed of the output optical fiber of a laser surgery equipment, a sheath sheathed on the optical fiber, an optical fiber position adjuster and an operating handle. It is characterized in that the sheath restricts the optical fiber so that the laser window has good directivity. The fiber position adjuster advances and retracts the position of the fiber laser window to obtain the best laser energy and tissue effect. The optical fiber sheath, sheath, or rigid stainless steel metal tube, polymer resin tube, nylon tube, ceramic tube, glass tube, or flexible polymer resin tube according to claim 1, the material itself or the material is wrapped The protective film that touches the human body meets the requirements of biocompatibility. The optical fiber sheath of claim 2, wherein the port of the sheath is an opening, and the shape is either a flat mouth or a narrow mouth. The optical fiber sheath according to claim 2, wherein the inner tube of the sheath port is equipped with a hollow cylindrical element, the cylindrical element or a metal material gold or silver tube with high reflection laser energy, or a high laser energy Transparent material quartz, glass tube. The optical fiber sheath of claim 1, wherein the optical fiber position adjuster realizes the advance and retreat of the position of the optical fiber laser window during the operation. The position change is either continuous or non-continuous advance and retreat, and the optical fiber position adjuster may pass halfway Stop the procedure and move in and out of the fiber laser window. The optical fiber sheath according to claim 5, wherein the position of the optical fiber laser window is either inside the sheath port, or protrudes out of the sheath port, or is flush with the sheath port. An optical fiber sheath is composed of the output component optical fiber of a laser surgical robot, an optical fiber support, an optical fiber position adjuster and a connecting component. Its technical feature is that the optical fiber support restricts the optical fiber so that the laser window has good directivity, and at the same time The best laser energy and tissue effect can be obtained by advancing and retreating the position of the fiber laser window through the fiber position adjuster. The optical fiber sheath according to claim 7, characterized in that it is an optical fiber support or a consumable part of a surgical robot, or a component of an arm of a surgical robot. The optical fiber sheath according to claim 7, wherein the optical fiber position regulator is a component of a surgical robot, or a consumable component of a surgical robot, and the electric drive mechanism or the mechanical drive mechanism is driven by the control software to advance and retreat the optical fiber laser window. Location. 8. The optical fiber sheath according to claim 8, wherein the optical fiber support adopts a structure in which an optical fiber is installed at the operation site. The optical fiber sheath according to claim 9, wherein the optical fiber position adjuster adopts a structure method of installing optical fibers on the surgical site. The optical fiber sheath according to claim 1 or 7, characterized in that the optical element is installed at the port of the optical fiber sheath to form a tip to output laser energy. The optical fiber sheath of claim 12, wherein the end of the sheath is made of a laser transparent material, and the shape of the end surface is either a flat surface, an inclined surface, or a curved surface.

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