Lighting device

Abstract

The invention discloses a lighting device (1) for illuminating a surgical area with radiation to cause fluorescence during open surgery, the device comprising a body (2) comprising an opening (3) configured to release radiation (18), characterized in that the lighting device laterally removably connects the body (2) to an endoscope (5) by means of a connecting device (4).

Description

Technical Field

[0001] This invention relates to an improved device for use during fluorescence-guided open surgery. Background Technology

[0002] Fluorescence-guided open surgery is commonly used for tumor resection. The fluorescence radiation required for the surgery is typically detected by a camera, i.e., by a chip / light sensor, or by an eyepiece with the aid of a suitable filter that can distinguish radiation of any wavelength other than fluorescence.

[0003] Currently, fluorescence-guided / supported open surgery is performed in two ways.

[0004] The first approach involves using a dedicated camera designed, constructed, and purchased solely or primarily for fluorescence-guided / supported open surgeries. This dedicated camera includes a radiation source that emits the desired excitation radiation, which produces fluorescence. The disadvantage of this system is that a separate device must be purchased to perform fluorescence-guided open surgeries.

[0005] The second approach involves using a commonly used endoscopic imaging system. This system can be a camera coupled to the endoscope during endoscopic surgery, for example, through its eyepiece. The imaging system acquires fluorescence images. Fluorescence is generated by an illumination device, which can be connected to the imaging system, for example, via a coupler. Typically, the imaging system includes such a coupler, which accommodates the endoscope during endoscopic surgery. This is usually achieved by housing the endoscope's eyepiece within the coupler. When the eyepiece is removed from the imaging system, the aforementioned illumination device can be connected to it. Using an endoscopic imaging system, hospitals do not need to purchase additional equipment, such as the equipment described in the first approach, for fluorescence-guided / supported open surgery. However, a disadvantage of this second system is the need for a specially designed sterile cap, for the reasons explained below.

[0006] During endoscopic surgery, a standard sterile cover for the endoscopic imager is attached to the coupler along with the endoscope. Since the endoscope is typically sterilized before surgery, only the endoscopic imager, containing electronic components, cannot be sterilized and therefore must be covered with a sterile cover.

[0007] However, when endoscopic imaging is used in fluorescence-guided / supported open surgery without an endoscope, the endoscopic imaging coupler or opening is occupied by the illumination device. Typically, standard sterile covers cannot be connected to the coupler along with the illumination device, and even if possible, standard sterile covers cannot simultaneously cover both the endoscopic imaging device and the illumination device. Since endoscopic imaging devices and illumination devices are generally not sterile, expensive dedicated (non-standard) sterile covers must be purchased to use the second system described above.

[0008] The present invention aims to overcome the aforementioned drawbacks. Among other things, the present invention aims to provide a system that can utilize standard equipment available in most hospitals. Summary of the Invention

[0009] The above-mentioned problem is solved by the lighting device described below. Preferred embodiments are also described below.

[0010] According to an invention, a lighting device is used to illuminate a surgical area with radiation during open surgery to induce fluorescence, the lighting device comprising:

[0011] The main body includes an opening configured to release radiation; and

[0012] A connecting device for laterally connecting the main body to an endoscope imager.

[0013] Preferably, the body is reversibly / non-permanently connected to the endoscope imager.

[0014] The use of fluorescence imaging during surgery, such as in tumor resection, is known. Typically, radiation is used to illuminate the surgical area—the part of the body that needs to be operated on—to induce fluorescence in specific areas or cell types. For example, administering 5-aminolevulinic acid to a patient can help surgeons differentiate healthy tissue from cancer cells because it accumulates in metabolically active cancer cells and only induces fluorescence in them.

[0015] Fluorescent radiation, the radiation emitted by fluorescent molecules (such as 5-aminolevulinic acid) after absorbing corresponding excitation radiation, lies within a narrow portion of the electromagnetic spectrum, and therefore can be easily detected using appropriate filters. On one hand, surgeons visually inspect the surgical area to perform surgery. On the other hand, surgeons can observe fluorescent images captured by a suitable imaging device through an eyepiece or screen, thus helping them distinguish healthy tissue from, for example, cancerous tissue. The imaging device can be a specially designed camera or a subsequent endoscopic imager without an attached endoscope.

[0016] Within the scope of this invention, the term "endoscopic imager" includes cameras used to capture images or video images of surgical areas and to detect fluorescent radiation.

[0017] One advantage of this invention is that, in open surgeries supported by fluorescence imaging, a large number of existing endoscopic imaging devices in hospitals can be used without the need to purchase separate cameras.

[0018] As described below, the main body of the lighting equipment may include a radiation source that emits laser radiation that can cause fluorescence, or the main body of the lighting equipment may be connected to the radiation source via an optical cable or the like.

[0019] Preferably, the main body of the lighting device is removably connected to the endoscope imager.

[0020] The device according to the invention can be temporarily rather than permanently connected to an endoscopic imager, and it can be used with different kinds of endoscopic imagers, thus being very flexible in use.

[0021] Another key advantage of this invention is that most endoscopic imagers include a coupler that allows the endoscopic imager to connect to the endoscope, and then the axis of the endoscope is introduced into the patient's body. The coupler is provided with a focusing ring that can adjust the focus of the image captured by the endoscopic imager.

[0022] Since the shaft is only needed in endoscopic surgery and not in open surgery, the coupler is not occupied by the shaft in open surgery. Therefore, a standard sterile cap that can typically be connected to the aforementioned coupler can be connected to the coupler to cover both the endoscopic imager and the illumination device, without the need to provide a separate sterile cap. Because the main body of the illumination device is laterally connected to the endoscopic imager, both can be easily covered using the same sterile cap.

[0023] This is something that cannot be achieved using the most advanced lighting equipment currently available.

[0024] When state-of-the-art lighting devices are connected to the aforementioned coupler, they require separate sterile covers, which are typically very expensive because standard sterile covers or lighting devices can be connected to the coupler separately (but not simultaneously). However, in cases where both the lighting device and the sterile cover can be connected to the coupler, the standard sterile cover cannot cover the lighting device because it is connected longitudinally rather than laterally to the endoscopic imager. This invention overcomes this problem.

[0025] As described above, a standard sterile cover can accommodate an endoscope, particularly its eyepiece. Therefore, during surgery, the endoscope can be coupled to the sterile cover, allowing the endoscopic imager to "see" the image through the endoscope's eyepiece, while the endoscopic imager is enclosed within the sterile cover. Because standard equipment provides this coupling capability, the illumination device of this invention can also be coupled to the endoscopic imager during endoscopic surgery.

[0026] The advantage of this invention is that sometimes, due to the inability to perform endoscopic surgery (i.e., the inability to perform minimally invasive surgery), surgeons must open the patient's body. In such cases, since the illumination device according to the invention is laterally connected to the endoscopic imager, the surgeon can simply remove the endoscope and continue with the open surgery, i.e., perform a fluorescence-guided open surgery triggered by the illumination device.

[0027] The lighting device of the present invention also has another application: sometimes, because the area to be operated on is difficult to access, it is necessary to use an angled endoscope. Because the lighting device of the present invention can be laterally connected to an endoscopic imager, and the endoscope and sterile cover can be present simultaneously, the lighting device can illuminate the area that needs to be examined or operated on by an angled endoscope.

[0028] According to another embodiment, the combination of the above-described lighting device, sterile cover and endoscopic imager can also be used with a standard linear endoscope without angle.

[0029] The connection device for the lighting equipment according to the present invention can be selected from the following: snap-on means, clip-on means, strapping-on means, positive-locking means, screws, silicone rubber and other non-permanent adhesive devices.

[0030] The main body of the lighting device according to the invention may include a radiation source that provides radiation, i.e., excitation radiation that induces fluorescence. Integrating the radiation source, such as an LED light source, into the main body has the advantage of eliminating the need for a separate light source / radiation source, thus allowing for convenient and quick use during surgery.

[0031] Alternatively, the main body of the lighting device may not include a light source, but rather be connected to a light source that can induce fluorescent radiation. The advantage of separating the main body and the light source is that the lighting device can be constructed simply and directly, and the main body will not heat up during surgery due to the heat generated by the light source providing the excitation radiation. Another advantage of this approach compared to integrated radiation sources is that a separate radiation source / light source typically makes the lighting device lighter.

[0032] The main body of the lighting device according to the invention may include a plurality of finger-receiving devices. These finger-receiving devices are configured to accommodate the fingers of a surgeon operating the lighting device.

[0033] The lighting device can at least partially form a handle, allowing the surgeon to hold the lighting device instead of the endoscopic imager during surgery.

[0034] Finger-accommodating devices have at least two advantages.

[0035] First, they provide a more ergonomic hand position.

[0036] Second, if the lighting equipment and the endoscopic imager are connected in a specific way, that is, both are in a specific (rather than random or arbitrary) position relative to each other, the surgeon will automatically keep the endoscopic imager in the correct position and angle.

[0037] For example, the lighting equipment may be connected to the endoscope imager in only one way. Alternatively, there may be markings indicating how to connect the two components, etc. This can be implemented according to two alternatives of the invention.

[0038] When an endoscope imager includes the chip / light sensor preferred by this invention, it is not intuitively clear how, especially at what angle, the endoscope imager is held to create the desired image, and therefore can only be unintentionally rotated, such as by rotating 90° or 180°.

[0039] However, when the surgeon is not holding the endoscopic imaging device (which does not show the holding angle), but instead holds a lighting device with a finger-retaining device, the surgeon will intuitively hold the lighting device, thus also holding the endoscopic imaging device connected to it at the correct angle.

[0040] In the absence of a finger-accommodating device in the lighting equipment, the surgeon may somehow "grab" the endoscopic imager and rotate the images captured and displayed on the screen by 90° or 180°.

[0041] The present invention typically includes a device that ensures that the endoscopic imager and the illumination device are connected only in a specific manner and orientation.

[0042] The lighting device of the present invention preferably includes a body comprising means for connecting it to a stand. This means may be an alternative to the aforementioned finger-accommodating device. Preferably, the means is located within or at the body of the lighting device, allowing the surgeon to decide whether to hold it in their hand or connect it to the stand. Such stands are commonly used for taking timed exposure images.

[0043] A filter can be inserted into the opening of the lighting device, which only allows radiation that can cause fluorescence to pass through.

[0044] The direction in which radiation leaves the illumination device can be tilted relative to the optical axis of the endoscopic imager's optical elements. The tilt or angle can be selected such that, within a distance of 10 to 30 cm, preferably 15 to 25 cm, the majority of the illumination provided by the illumination device is directed towards the optical axis of the endoscopic imager. In other words, more generally, the illumination device can include means for guiding radiation so that the area "seen" by the endoscopic imager is well illuminated. Since the endoscopic imager and the illumination device of this invention are typically placed between 10 and 30 cm from the surgical area, the illumination device installed or connected after the endoscopic imager can guide most of the radiation within a distance of 10 to 30 cm, thereby placing the optical axis substantially at the center of the radiation area.

[0045] The direction of radiation / illumination leaving the lighting equipment is preferably referenced to the imaginary central axis of the light cone / radiation cone leaving the lighting equipment.

[0046] The radiation exits the illumination device at a certain angle, which has the advantage of reducing the probability of unwanted reflections. The probability of reflection is higher when the illumination / radiation is coaxial with the optical axis of the endoscopic imager, and lower when the radiation travels in a direction inclined to the optical axis. Using the angle according to embodiments of the invention can generate lower false signals and increase the depth of fluorescence detection.

[0047] According to an embodiment of the invention, the lighting device includes a mechanism such as a hinge for changing the tilt angle, i.e., the angle between the direction of illumination / radiation exiting the lighting device and the optical axis of the endoscopic imager. These mechanisms are preferably integrated into the lighting device and change the direction of illumination exiting the lighting device. Alternatively, the tilt angle can be changed by altering the connection angle between the lighting device and the endoscopic imager.

[0048] By changing the tilt angle, the user can adjust the working distance. Lighting equipment can be installed and used such that the intersection between the optical axis and the imaginary central axis equals the working distance. Therefore, the illumination / radiation provided by the lighting equipment is utilized most effectively. The lighting equipment can be equipped with a device to adjust the tilt angle, allowing adjustment of the intersection point at a distance of 10 to 50 cm from the lighting equipment and / or the endoscopic imager.

[0049] Generally, the lighting equipment may include a device that can change the tilt of the radiation exiting the lighting equipment. Changing the tilt preferably results in the ability to adjust its working distance between the lighting equipment and / or the endoscopic imager, between 10 and 50 cm.

[0050] The main body of the lighting equipment may include a connecting device that can connect the lighting equipment to a bracket, robotic arm, or semi-automatic arm.

[0051] The present invention also includes a system comprising the above-described lighting device and the above-described endoscopic imager. Attached Figure Description

[0052] The advantages, features, and details will become more apparent from the attached diagram below.

[0053] Figure 1 is a schematic diagram of the prior art endoscopic imager 5 and endoscope 21;

[0054] Figures 2 to 5 This is a schematic diagram of the lighting device 1 according to the present invention connected to the endoscope imager 5;

[0055] Figure 6 This is a schematic diagram of the lighting device 1 according to the present invention connected to the endoscope imager 5 and the sterile cover 16;

[0056] Figure 7 For standard sterile cap 16; and

[0057] Figure 8 This is a schematic diagram of the lighting device 1 according to the present invention connected to the endoscope imager 5 and the sterile cover 16.

[0058] Explanation of reference numerals in the attached figures

[0059] Lighting equipment 1

[0060] Main body 2 of the lighting equipment

[0061] Opening 3 of the lighting equipment

[0062] Connecting device 4

[0063] Endoscopic Imaging System 5

[0064] Finger receiving device 6

[0065] Bracket 7

[0066] Coupler 8

[0067] Eyepiece 9

[0068] Shaft 10

[0069] Imaging cable 11

[0070] Imager cable connector 12

[0071] 13 optical fiber cable

[0072] Hand 14

[0073] Protrusion 15

[0074] Sterile cap 16

[0075] Opening 17 of the endoscope imager

[0076] Fallout 18

[0077] Groove 19

[0078] Optical axis 20

[0079] Endoscope 21

[0080] Optical inlet 22

[0081] Imaging window and connector 23 Detailed Implementation

[0082] Figure 1 shows a prior art endoscope 21, which includes an eyepiece 9, a light inlet 22, and an axis 10. Furthermore, the endoscopic imager 5 shown includes an opening 17 and a coupler 8.

[0083] exist Figure 1b In the middle, the eyepiece 9 of the endoscope 21 is installed at the coupler 8.

[0084] Figure 1a and Figure 1b The only difference is that the eyepiece 9 (and therefore the entire endoscope 21) is separated from the coupler 8.

[0085] The arrangement shown in Figure 1b is for endoscopic surgery. An imager cable (not shown) can be connected to the endoscopic imager 5 via connector 12, allowing images from inside the body to be transmitted to a screen (not shown).

[0086] exist Figure 1a The standard endoscope 21 shown in the best illustration can also be used for endoscopic surgery without the endoscope imager 5. The surgeon then observes through the eyepiece 9, and light is introduced into the body via the light inlet 22.

[0087] Figure 1a The equipment and arrangement shown in / 1b are known in the prior art.

[0088] Figure 2-5 Different perspective views of an embodiment of the lighting device 1 according to the present invention are shown.

[0089] The lighting device 1 is connected to the conventional endoscopic imager 5 via the connecting device 4.

[0090] also, Figures 2 to 5 The image shows an opening 3 of the lighting device 1, a spring-type connecting device 4, a finger receiving device 6, a bracket 7, a coupler 8, a connector 12 for the internal imaging cable, an optical fiber cable 13, the user's hand 14, and a protrusion 15.

[0091] like Figures 2 to 5 As shown, the lighting device 1 according to the present invention operates as follows:

[0092] The main body 2 of the lighting device 1 is laterally connected to the conventional endoscopic imager 5 via the connecting device 4. (Reference) Figure 1a / 1b, any known endoscopic imager can be used 5.

[0093] Since the lighting device 1 according to the present invention does not occupy the coupler 8, the coupler can accommodate the sterile cover as described below.

[0094] like Figure 6 and 8 As shown, a standard sterile cover 16 can be connected to the coupler 8 and cover the endoscopic imager 5 and the illumination device 1. Radiation 18 emitted by the illumination device 1 passes through the normally transparent sterile cover 16. Therefore, although the illumination device 1 is covered by the sterile cover 16, the illumination device 1 can still illuminate the surgical area (not shown).

[0095] The standard sterile cap 16 is designed to be easy to attach to the coupler 8 and cover the entire endoscope imager 5.

[0096] Since the optics of the endoscopic imaging system "see" the surgical area through the opening 17, the sterile cover 16 covering the opening 17 is designed to ensure an unobstructed view. This can be achieved using methods such as... Figure 8 The combined imaging window and connector 23 are shown. The combined imaging window connector 23 combines a connector for accommodating an endoscope with a transparent imaging window that does not obstruct or hinder the view of the opening 17. Such a sterile cover 16 is known in the prior art.

[0097] Depend on Figures 2 to 6 Images captured by the endoscope imager 5 are transmitted to the processor, etc. via cable 11 connected to connector 12 and finally transmitted to the screen (not shown).

[0098] The radiation 18 sent from the lighting device 1 to the surgical area (not shown) is provided by a light source (not shown), which is connected to the lighting device 1 via an optical cable 13.

[0099] Compare Figure 3 and Figure 4 It is obvious how the finger-accommodating device 6 is used to allow the user to instinctively grasp the lighting device 1.

[0100] Figure 5 This demonstrates how to connect the lighting device 1 to the bracket 7 when the user does not want to hold the lighting device 1 in their hand 14. The bracket 7 can be easily connected to the protrusion 15 via the groove 19, as shown below. Figure 2 , 3 As shown in Figure 4.

[0101] The protrusion 15, together with the adjacent groove 19, forms a connector for connecting the lighting device 1 to the bracket 7 and one of the finger receiving devices 6. Figure 2 and Figure 3 The protrusion 15 shown has a high surface area, making it particularly suitable for accommodating fingers and connecting to the bracket 7.

[0102] like Figure 3 and Figure 6 As shown, the direction of the radiation 18 away from the lighting device can be tilted to some extent, so that the area around the optical axis 20 of the endoscope imager 5 is well illuminated within a distance of 10 to 30 cm.

[0103] like Figure 8 As shown, radiation 18 exiting the opening 3 of the main body 2 of the lighting device passes through the transparent sterile cover 16. Because the main body 2 is laterally connected to the endoscope imager 5, no component blocks radiation 18 from passing through the sterile cover 16.

Claims

1. A system comprising: Endoscopic imaging device (5), the endoscopic imaging device (5) having a distal and direct imaging axis leading to the surgical field of view in open surgery; as well as Lighting device (1), said lighting device (1) for illuminating a surgical area with radiation to produce fluorescence in open surgery, said lighting device (1) comprising: The main body (2) has an extension that defines an opening (3) configured to release radiation (18). The lighting device (1) is characterized in that it further includes: A connecting device (4) is used to laterally connect the body (2) to the endoscope imager (5) such that the extension of the body (2) extends beyond the distal end of the endoscope imager (5), and the radiation is released from the opening (3) along the optical axis, which is laterally spaced and inclined to the direct imaging axis of the endoscope imager (5), wherein the endoscope imager (5) includes a coupler (8) that allows the endoscope imager (5) to be connected to the endoscope (21), wherein the coupler (8) also includes a focusing ring that allows adjustment of the focus of the image captured by the endoscope imager (5).

2. The system of claim 1, wherein the connecting device (4) is selected from the following devices: snap-on device, buckle device, binding device, self-locking device, screw device, silicone rubber or other non-permanent adhesive device.

3. The system of claim 1, wherein the main body (2) includes a radiation source that provides the radiation.

4. The system of claim 1, wherein the body (2) is connected to a radiation source that provides the radiation.

5. The system of claim 1, wherein the body (2) integrally defines a protrusion (15) extending downward from the body (2) for contact with the fingers of a user of the system.

6. The system of claim 1, wherein the main body (2) includes a device that can be connected to a support, a robotic arm or a semi-automatic arm.

7. The system of claim 1, wherein a filter is inserted into the opening (3) and the filter allows only radiation that causes fluorescence to pass through.

8. The system as described in claim 1, characterized in that... Includes a device for changing the tilt of radiation exiting the lighting device (1) when the lighting device (1) is connected to the endoscope imager (5).

9. The system of claim 1, wherein the body (2) comprises an integral structure defining the connecting device (4), the extension and the opening (3).

Images