Laser therapy device with improved patient positioning

Abstract

The invention relates to a laser therapy device (1), comprising an equipment base (26), an application arm (12) secured to the equipment base (26), and a laser light source (28) for generating therapy radiation (30), the application arm (12) having at least one working position (32) in which the application arm (12) is configured to guide the therapy radiation (30) into a processing region (22). Known laser therapy devices (1) have the disadvantage that a prepositioning (P1) needs to be repeated if performed incorrectly and thus increases a preparation time and reduces patient comfort. This is improved according to the invention by virtue of the laser therapy device (1) furthermore having a projection unit (6) for simplifying a positioning of a person (22b) to be treated relative to the laser therapy device (1), and the projection unit (6) being configured to project a positioning mark (20) in such a way that the latter represents a position of the processing region (22).

Description

[0001] Laser therapy device with improved patient positioning

[0002] The invention relates to a laser therapy device with improved patient positioning. The laser therapy device comprises a device base, an application arm attached to the device base, and a laser light source for generating therapeutic radiation. The application arm has at least one working position in which the application arm is configured to deliver the therapeutic radiation in a treatment area.

[0003] The positioning of a person to be treated (i.e., a patient) is a crucial aspect of medical treatment, especially when using medical devices such as laser therapy devices. Correct positioning not only ensures the comfort and safety of the person to be treated by avoiding unnecessary waiting times, but also ensures that the laser therapy device used is used effectively and efficiently. This disclosure particularly relates to pre-positioning and precision positioning, which represent preparatory steps for the fine positioning of a person to be treated with respect to a laser therapy device. All positioning steps are summarized and recorded under "positioning."

[0004] Generally, pre-positioning can be performed by an assistant. In the simplest case, the patient to be treated can be moved by the assistant on a patient couch to the laser therapy device. Manual pre-positioning can be error-prone, and incorrect pre-positioning can lead to the need to correct the position of the patient couch or even repeat the pre-positioning. This increases the time required for preparation for surgery (or surgery for short) and reduces patient comfort.

[0005] The aim of the present invention is therefore to improve solutions from the prior art in order to position a person to be treated more accurately, safely and quickly.

[0006] The invention achieves this objective for the laser therapy device mentioned above by providing a projection unit for simplifying the positioning of a person to be treated relative to the laser therapy device. The projection unit is configured to project a positioning mark such that it represents a position of the treatment area (of the laser therapy device). The position of the treatment area can, in particular, include the spatial location of the treatment area and its orientation.

[0007] Such a positioning mark enables simple and, above all, rapid pre-positioning of the person to be treated. Since the positioning mark represents the treatment area, the person to be treated, in particular an area of ​​the person to be treated (e.g. an eye), can be pre-positioned by a movement of the person to be treated relative to the positioning mark. Positioning is preferably carried out by a movement of the person to be treated relative to the laser therapy device, wherein it is irrelevant according to the invention whether the person to be treated moves relative to the laser therapy device or the laser therapy device moves relative to the person to be treated. According to the invention, only a part of the laser therapy device can move relative to the person to be treated, for example a device head.Combined movement of the person being treated (e.g., using a patient couch) and the laser therapy device, or parts thereof, is also conceivable. The decisive factor is relative movement between the person being treated and the laser therapy device.

[0008] The laser therapy device according to the invention can be improved by further specific embodiments described in more detail below. Features of the further embodiments are each advantageous in themselves and can be combined with one another and / or omitted as desired. If the embodiments use method steps for description, these are transferable to the corresponding device. This means that the corresponding embodiment of the laser therapy device according to the invention is designed to carry out a described method step. If a sequence of various method steps is specified, this means that the corresponding laser therapy device is designed to generate and / or store and / or process control data representing the sequence of these method steps.

[0009] In one embodiment, the application arm can be rigidly attached to the device head. In a further embodiment, the application arm can advantageously be movably attached to the device head. Particularly when using laser therapy devices of this type with an application arm that can be moved away from the treatment area (e.g., can be folded away, pivoted away, or rotated away), pre-positioning is subject to a certain degree of uncertainty, since the application arm, as a possible orientation point, is not close to, i.e., not above, the treatment area. If the application arm is rigid, it can itself restrict or block the view of a treating person and make rough positioning or pre-positioning more difficult. In the event of incorrect pre-positioning, which may not be discovered until the application arm has been moved to the treatment area, the position of the patient bed must be corrected or the pre-positioning must even be repeated.This increases the time required to prepare for surgery and reduces patient comfort due to avoidable waiting times.

[0010] According to the invention, the person to be treated, in particular an area of ​​the person to be treated (for example an eye) can be pre-positioned by a movement of the person to be treated to the positioning mark, without the application arm (as a possible orientation for the assistant) having to be located on or above the treatment area.

[0011] A working position is a position of the application arm in which treatment can be reliably performed within the treatment area. This working position is preferably assumed by the application arm only temporarily, i.e., not permanently. Rather, the application arm can preferably only be positioned after pre-positioning in the working position. The treatment area can be a 2-dimensional or 3-dimensional area in which treatment can take place.

[0012] The projection unit can comprise both optical elements for the actual projection of the positioning mark and control elements for its activation. Optical elements can be assigned to both the projection unit and other beam-guiding units of the laser therapy device, so that optical elements can have a double or multiple function. The projection unit according to the invention can thus utilize optical elements already provided in the laser therapy device. The projection unit preferably comprises a light source and / or a display device displaying the positioning mark, and optical elements for imaging the light source or the positioning mark displayed by the display device. The projection unit can be controlled using software, hardware, or a combination of software and hardware.Purely by way of example and not by way of limitation, FPGAs, separate software, or a separate software module can be used for control.

[0013] By “representing a processing area” we mean that the projected positioning mark marks the location of the processing area, i.e. that the positioning mark is imaged in such a way that the image takes place in the processing area or the image of the positioning mark encloses the processing area and can form the basis for sufficiently precise fine and ultra-fine positioning for a further positioning process (i.e. for a sequence of subsequent positioning steps). Since the processing area is determined by the laser therapy device and its geometric structure, e.g. the length and position of the application arm or a laser outlet attached to it, the position of the processing area relative to the laser therapy device is known. This position is identified or represented by the positioning mark.

[0014] The projection unit can be configured to project the positioning mark onto any projection surface, wherein the projection surface can be, for example, a patient bed, a support arranged on the patient bed, a sterile covering of the person to be treated, or the person to be treated themselves. Projection is also possible onto a test object, which can be used to check the correct functioning of the positioning of the projection unit of the laser therapy device according to the invention. The pre-positioning can comprise a relative movement between the area of ​​the person to be treated and the positioning mark projected onto the projection surface. This relative movement can preferably continue until the positioning mark is on the area to be treated or the area to be treated is within the positioning mark.Since the projection of the positioning mark occurs along a projection beam path, the position of the positioning mark can be limited to a predetermined area along this projection beam path, i.e., to a predetermined range of a z-coordinate (measured along the projection beam path). When viewed along the projection beam path, a height of this position can preferably correspond to the height above the floor of one eye of a person to be treated on a patient couch. This consideration naturally also applies to both eyes of a person to be treated or to another area of ​​a person to be treated.

[0015] The invention can furthermore also enable the positioning of a person to be treated who is sterilely covered except for the area to be treated. For example, nonwoven fabric or waterproof films can be used for the sterile covering, which can have cutouts or recesses. These recesses can allow access to the area to be treated. The positioning mark can also be projected onto such sterile coverings. Explanations relating to the projection of the positioning mark onto the face of a person to be treated can therefore also be applied to a person to be treated covered with a sterile covering, whereby in this case the projection takes place onto the covering. Purely by way of example, a sterile covering can be designed in the form of a mask or a drape.A sterile drape can, for example, cover those areas of the head where no treatment is to be carried out and, purely as an example, covers an area of ​​approximately 4 cm by 4 cm for the area to be treated, for example the eye or eyes with lines of symmetry for a center of the eye.

[0016] If the positioning mark is projected onto a surface that is at a different height than the area to be treated, i.e., at a z-position along the projection beam path, this may be evident from an incorrectly or unrecognizably projected positioning mark. Such an incorrectly or unrecognizably projected positioning mark may represent the condition of inadequate or incorrect height positioning of the person to be treated.

[0017] In general, however, a patient bed can have a height which, without or, if necessary, with a support for the head of the person to be treated, positions one eye of a person to be treated at the correct height for treatment by the laser therapy device.

[0018] According to the invention, the projection unit can be attached to the device base and / or the device head and / or the application arm in a replaceable and detachable or non-replaceable and non-detachable manner. The projection unit can, for example, be constructed in two or more parts. For example, there can be two (or three or more) light sources with corresponding optical imaging elements whose beam paths intersect in the treatment area. Three intersecting beam paths can define a correct position of the treatment area in the three spatial directions x, y and z. In a further embodiment, the positioning mark can consist of two (or three or more) partial projections intersecting in the treatment area, so that based on the overlap of the two (or three or more) partial projections, it can be determined whether the area of ​​the person to be treated is located in the treatment area.

[0019] In this embodiment, it is further possible for both (or the three or more) partial projections to be parallel projections that do not have a focal area. Thus, it may be possible to initially carry out the pre-positioning according to a first partial projection projected from the application arm, i.e., to move the patient bed with one head end towards the first partial projection projected on the floor. As soon as the patient bed has been moved into the beam path of the first partial projection, it is ideally also located in the beam path of the second (optionally also the third or further) partial projection(s), so that this second (optionally also the third or further) partial projection(s) is (are) projected onto the patient bed. The person to be treated, or more precisely the area to be treated, for example the eyes, can then be positioned using both partial projections so that this area to be treated is within the projection mark, i.e.is located within both (optionally within the three or within all) superimposed partial projections.

[0020] If, after this adjustment, the two (or three or more) partial projections still do not overlap, this may indicate that the height of the patient table needs to be adjusted. Once this adjustment has been made, subsequent repositioning of the area to be treated relative to the projection marker may be necessary.

[0021] The design of the projection unit with intersecting partial projections thus has the advantage that the treatment area can be represented based on the angle between the beam paths of the partial projections. The intersecting beam paths of the partial projections thus allow a three-dimensional position of the treatment area to be represented without having to influence the divergence or convergence of the light from the positioning mark. Thus, by changing the angle of the beam paths of the partial projections relative to each other, the entire laser therapy device can be adjusted to different patient beds of different heights, making it bed-independent.

[0022] In a preferred embodiment, the application arm can further have a rest position or be positionable in one. In this rest position, the application arm can be pivoted or folded away from the processing area or generally moved away, for example in a combined pivoting and folding movement. In particular, the projection unit can be designed to project the positioning mark when the application arm is in the rest position. This is advantageous because it enables pre-positioning precisely when the application arm, moved away from the processing area, facilitates movement of the patient couch, since the space potentially required to move the patient couch is freed up by the application arm. In particular, the area of ​​the person to be treated that is to be processed can advantageously be accessible from all directions.The projection unit still allows pre-positioning of the patient couch despite the application arm being moved away from the processing area and therefore not being usable as a (visual) reference.

[0023] It has already been explained above how pre-positioning can be performed when the positioning mark is not (yet) projected onto the patient bed. In a further advantageous embodiment, the projection unit can additionally or alternatively be configured to project a further positioning mark, wherein the positioning mark can have a projection distance that is shorter than a further projection distance of the further positioning mark.

[0024] The projection distance can be understood as the distance between the positioning mark and the projection unit at which a projected positioning mark is clearly projected. In one embodiment, a clear projection can be understood as a sharp projection, meaning that the positioning mark is sharply imaged at the projection distance, whereas it is no longer sharply imaged at a distance less than or greater than the projection distance.

[0025] A sharp image can thus be understood as meaning that a projection of the positioning mark and / or the additional positioning mark allows them to be distinguished at different projection distances. The term "sharp" can thus be understood as meaning that the positioning mark and / or the additional positioning mark are not washed out or blurred, or can be displayed and perceived as a clearly recognizable, projected, predefined pattern.

[0026] The image of the positioning mark can be considered sharp as long as it is within the depth of field. In other words, the projection distance is not to be understood as a precisely defined distance, but rather as a range of distance. This range can extend from several millimeters to centimeters, so that, according to the invention, the positioning of a person to be treated can be achieved regardless of their size. For example, people with different head sizes can be positioned equally for eye surgery regardless of head size. Optionally, the positioning mark and / or the additional positioning mark can each be composed of two partial projections, as described above.

[0027] In a further embodiment, the positioning mark and / or the further positioning mark can be a parallel projection. The further positioning mark preferably differs from the positioning mark in shape and / or size, so that confusion between the positioning mark and the further positioning mark can be avoided. Another possibility for distinguishing the positioning mark from the further positioning mark is the use of different spectral components of the light, i.e., different perceivable colors of the positioning mark and the further positioning mark.

[0028] The individual elements of the positioning mark, such as lines, can be constructed from substructures. For example, the lines can be constructed from, for example, and not limited to, cut or open circles. If the circles of the positioning mark can be perceived as separate, a sharp projection occurs. However, as soon as the circles can no longer be perceived as separate (i.e., they appear blurred or washed out), the projection occurs outside the projection distance. Other forms of substructures are conceivable, for example, rectangles, squares, triangles, polygons, diamonds, lines, and the like.

[0029] It can be particularly advantageous if the projection unit is designed to generate a sharp projection of the positioning mark at the height of a patient bed and if the projection unit is further designed to generate a sharp projection of the further positioning mark on the floor. The depth of field of the positioning mark is thus at the height of a patient bed, more preferably at the height of the area of ​​the person to be treated that is to be treated, and the depth of field of the further positioning mark is on the floor. This has the advantage that, using the further positioning mark projected onto the floor, pre-positioning is already possible before the positioning mark is projected onto the patient bed. The assistant can thus pre-position the bed towards this further positioning mark starting from the further positioning mark projected on the floor.If the positioning mark is projected onto the patient couch because the patient couch has been inserted into the beam path of the positioning mark, the pre-positioning can be completed using the positioning mark. Pre-positioning is thus independent of the position of the patient couch relative to the laser therapy device.

[0030] In an alternative embodiment, an intersection point of the beam paths of the partial projections of the positioning mark can be located at the height of a patient bed. Similarly, an intersection point of the beam paths of the partial projections of the further positioning mark can be located at floor level.

[0031] It is also conceivable that different spectral components are projected at different heights in order to check or ensure that the person to be treated is positioned at the correct height. For example, a color scheme that is intuitive for the treating person or the assistant can be selected: a red positioning mark represents that there is (still) a large deviation between the actual position of the person to be treated and the target position, for example a displacement distance of more than 50 centimeters, a yellow positioning mark can represent that the deviation has become smaller, for example corresponding to a displacement distance between 5 centimeters and 50 cm, and a green positioning mark can represent that the target position has almost been reached or has already been reached, i.e. that a displacement distance is less than 5 cm.The positioning mark and / or the additional positioning mark can each have at least one shape from the list of shapes comprising an oval; a circle; a rectangle; a triangle; a polygon; at least one crosshair; a guide path; a plurality of markings; or a combination of the aforementioned shapes. The positioning mark and / or the additional positioning mark can preferably have a size that corresponds to the area of ​​the person to be treated or includes this area.

[0032] Particularly advantageously, the additional positioning marker can be in the form of a guide path, for example, and not limited to, several consecutive lines and / or arrows. The guide path can represent a movement of the patient couch to a previous position, whereby the movement to be performed can be clearly and intuitively displayed for the assistant using projected structures such as arrows.

[0033] The positioning mark can preferably have a shape that encloses the area to be treated, wherein more preferably a further shape can be provided in the enclosing shape, which represents a center or a specific point within the treatment area. Thus, for pre-positioning a person to be treated, for example and not limited to during eye surgery, the positioning mark can be a circle, a rectangle, or an oval, the size of which can be selected such that the positioning mark encloses both patient eyes. Furthermore, the positioning mark can comprise crosshairs, which can, for example, represent a desired position of at least one eye, preferably both eyes, of the person to be treated. Likewise, a crosshair can represent a desired position of a central point located between both eyes on the bridge of the nose.Optionally, it is conceivable to project a first crosshair and / or a second crosshair, whereby the first crosshair can represent, without loss of generality, a desired position of the first eye and the second crosshair a desired position of the second eye. The position of the crosshair or crosshairs relative to each other or to an enclosing external structure can be set and adjusted depending on patient-specific data.

[0034] In a further advantageous embodiment of the laser therapy device according to the invention, it can further comprise a camera module which is designed to identify the positioning mark and / or the further positioning mark and a patient bed in a recorded image, to determine a (preferably relative) actual position of the patient bed with respect to the positioning mark and / or the further positioning mark, to compare the actual position with a (preferably relative) desired position of the patient bed with respect to the positioning mark and / or the further positioning mark and to provide from the comparison a necessary displacement distance and / or displacement direction of the patient bed to reach the desired position.This design has the advantage that the assistant can carry out the pre-positioning using the projected positioning mark(s) and at the same time, by determining the necessary displacement distance and / or displacement direction, a possibility of supporting partially or fully automatic pre-positioning is possible.

[0035] The displacement distance and / or displacement direction indicate the distance by which the patient table must be moved to reach the correct position. Successful pre-positioning occurs when the area of ​​the patient to be treated is positioned in a predetermined pre-position. The pre-position is not a precisely defined position, but can also include position tolerances ranging from millimeters to centimeters. The pre-position can correspond to a two-dimensional or three-dimensional position or a two-dimensional or three-dimensional position range.

[0036] In one embodiment, the camera module can comprise at least two cameras or at least one 3D camera. This enables the provision of three-dimensional displacement distances or displacement directions, i.e., a necessary height correction of the patient bed can also be determined and a height correction value representing the necessary height correction can be provided.

[0037] Measuring the displacement direction and / or displacement distance and / or any necessary height correction enables the projection or provision of a dynamic positioning mark. This means that the shape and / or color of the positioning mark changes or is dynamically adjusted depending on the displacement direction and / or displacement distance and / or any necessary height correction.

[0038] If, purely for example, the person to be treated approaches the correct position (the target position or pre-position) in the Y direction (transverse direction), parts or segments of the positioning mark can light up or be projected from the outside in (optionally movable). Likewise, purely for example, the parts or segments of the positioning mark can light up or be projected from the inside out if the person to be treated moves away from the target position. The target mark can be designed in the shape of a cross, whereby the lines can consist of dots and / or lines and / or segments and the shape and / or color of the lines in the X or Y direction represent the deviation of the actual position of the person to be treated from the target position in the X or Y direction.

[0039] Once the correct position (the target position) has been reached, all segments for the respective direction can be illuminated or projected, and / or the respective line can be projected in the corresponding color. Red can represent a large displacement distance still to be compensated, e.g., greater than 50 centimeters; yellow a smaller displacement distance, e.g., between 5 and 50 centimeters; and green the reaching of the target position or a small displacement distance, e.g., less than 5 centimeters.

[0040] To display the deviation of the actual position from the target position in the Z direction, a circle can also be projected or displayed purely as an example. This circle can have a diameter that is projected or displayed in a variable manner depending on the required height adjustment. This circle can, for example, "contract" as the correct height is approached, i.e., be projected or displayed with a decreasing diameter. Upon reaching the correct height, the circle can be projected or displayed as a point or a solid circle.

[0041] Technically, such a dynamic positioning mark can be realized using a scanner. If the color of the positioning mark depends on the displacement distance, the laser therapy device can further comprise colored LEDs or colored lasers, or a white light laser, and corresponding color-selective elements.

[0042] In a further embodiment of the dynamic positioning mark, it is conceivable that additional information representing the left or right eye of the person to be treated can be provided therein based on the recorded camera image and / or based on a treatment plan. For example, 'OD' or 'OS' can be displayed within the positioning mark at the location where the right or left eye (OD - oculus dexter, right eye; OS - oculus sinister, left eye) is to be positioned. Furthermore, according to the treatment plan, the area of ​​the positioning mark that represents the area of ​​the eye to be treated first can be projected with emphasis. This can reduce the likelihood of confusion between the left and right eyes or prevent confusion. It is also conceivable that the positioning mark clearly assigns a right or left eye in the surgical area.

[0043] Advantageously, the laser therapy device according to the invention can comprise an interaction interface which is designed to transmit the displacement distance and / or the displacement direction to an operator. This transmission can be carried out optically and / or acoustically and / or haptically. The determined displacement distance and / or displacement direction can thus be provided to the operator, for example the assistant, in a form that is understandable and preferably intuitive for humans. The displacement distance can be provided or transmitted either by color coding or by showing or hiding parts or segments of the dynamic positioning mark. In the case of color coding, different color profiles can be stored and called up in the laser therapy device, for example to take into account a possible red-green color deficiency of a treating person.Likewise, the displacement distance can alternatively or additionally be displayed on a display device. The display device can be a display device already provided on the laser therapy device, which can be used to display the displacement distance. Alternatively or additionally, a display device intended solely for the purpose of displaying the displacement distance can be provided. The display device can consist of one or more light sources (e.g., LEDs), which, for example, represent a displacement direction upon activation (i.e., upon light emission). An array of such light sources is also conceivable, with which the displacement direction and / or the displacement distance can be displayed.It is conceivable that an array of light sources arranged in concentric circles is provided, wherein, purely by way of example and not by way of limitation, a number of light sources activated in a radial direction, starting from a center of the array, can represent a displacement distance (the number of radially activated light sources is a function of or dependent on the displacement distance), and the angle to the center can represent the displacement direction. In other embodiments, the display means can be an LCD display or a monitor.

[0044] In one embodiment, the aforementioned dynamic positioning mark can be displayed, in addition to or alternatively to projection, on one or more (two, three, or four) display devices of the laser therapy device. Likewise, the dynamic positioning mark can alternatively or additionally be displayed in a microscopic view (monocular or binocular). This has the advantage that multiple people can monitor and / or control the positioning of the person being treated, regardless of the person's relative position to the person being treated.

[0045] Advantageously, a control unit for displaying the displacement distance can be configured to convert the value into the next smaller or next larger length unit in order to display an intuitive displacement distance to the operator. For example, displaying a displacement distance of "5 cm" is more intuitive for the operator than displaying "0.05 m." Furthermore, such a change in the length unit can be associated with a change in the color coding of the display, which, for example, when changing from a red display to a green display, informs the operator that the patient bed is close to the target position. This allows human-machine interaction based on information provided by the laser therapy device and facilitates positioning.

[0046] The direction of displacement can also be displayed on such a display device, e.g. by an arrow whose direction represents the direction of displacement and which is displayed on the display device together with a schematic representation of the laser therapy device and / or the operating room. Alternatively or additionally, in addition to the schematic representation of the laser therapy device, one of the four areas of the entire display device or areas towards the edge of the display device can be displayed in a way that is distinguishable from the rest of the schematic representation, e.g. by a different color or flashing. For example, a color-contrasting strip of the edge of the schematic representation on the display device on one of the four possible sides of the laser therapy device can represent a determined direction of displacement to the side of the actual laser therapy device represented by this side.

[0047] This type of representation of the displacement direction can also be done in an image section. For example, and not by way of limitation, it may be advantageous to select an image section displayed on the display device that, in the schematic representation of the laser therapy device, is located on the side on which the person to be treated is positioned. Alternatively, the schematic representation can schematically indicate the application arm and / or a target position of the patient bed. The displayed image section can, for example, comprise four areas that can be displayed in a different color than the remaining areas or flashing to indicate the displacement direction.It is also conceivable to display the displacement direction more finely and to divide the displacement direction into angular sectors, which can assume angular ranges of 60°, 45°, 30°, 15°, or any other division of the 360° range up to division into angular sectors in 1° increments. The control unit can be configured to change the size of the angular sectors from a predetermined value, for example, 90°, depending on the displacement distance, for example, to select a smaller angular sector as the displacement distance decreases.

[0048] Haptically, the direction and / or distance of movement can be achieved, for example, by vibrating certain areas of the patient bed's push handles. For this purpose, one or both push handles can have a certain number of vibration elements, such as vibration motors, that can be controlled by the control unit of the laser therapy device. The direction of movement can be represented, by way of example and not by way of limitation, by the selection of the controlled vibration elements, and the distance of movement can be represented by the intensity of the vibration of the vibration elements.

[0049] Since the display device may not be visible or not permanently visible to the assistant, the laser therapy device according to the invention can comprise an interaction interface which is designed to set a single tone repetition frequency of the acoustically transmitted displacement distance as a function of the displacement distance and a tone frequency of the acoustically transmitted displacement direction as a function of the displacement direction.

[0050] This has the advantage that pre-positioning can be carried out even if the display device is not visible.

[0051] Transmitting the displacement distance encoded by a single-tone repetition frequency is a purely exemplary and non-limiting way of providing the operator with the displacement distance. For example, an increasing single-tone repetition frequency, i.e. a more rapid temporal sequence of identical single tones, can indicate that the displacement distance is decreasing and the person to be treated is therefore getting closer to the target position. If, on the other hand, the single-tone repetition frequency decreases, this indicates that the displacement distance is increasing and the person to be treated is therefore moving away from the target position. Coding the displacement distance in this way can be particularly intuitive because parking aids installed in cars represent the remaining distances until a collision in a similar way. By analogy, reaching the target position of the person to be treated orof an area of ​​the person being treated that is to be treated can be represented by a continuous tone. The tone frequency of the individual pulses can be used to communicate the direction of displacement; a higher frequency can correspond to a first direction of displacement, and a lower frequency to a second direction of displacement opposite to the first direction of displacement. These first and second directions of displacement can preferably be oriented parallel to a longitudinal orientation of the patient bed. Directions of displacement along or against a transverse direction can be represented either by other frequencies of the individual tones or communicated by means of optical and / or haptic representation.

[0052] Another way to communicate the direction of displacement and provide it to the user in a distinguishable manner is coding using specific tone sequences, which, for example, may repeat periodically but may have a different number of individual tones depending on the direction of displacement, possibly with different spacing. Thus, purely by way of example and not by way of limitation, a required displacement in a first direction can be represented by a high tone frequency, the opposite direction by a lower tone frequency, a first transverse direction oriented perpendicular to these directions by two periodically repeating tone pulses, and an opposite second transverse direction by three periodically repeating tone pulses.

[0053] According to the invention, all of the above-described options for representing the displacement distance and / or displacement direction can be provided optionally, alternatively, in any combination, or simultaneously by the laser therapy device. The possible representations can be activated or deactivated in any combination. The application of the listed signaling variants can be carried out individually according to the physician's / assistant's experience with the effects on the patient and can be stored in at least one, optionally two, three, four, or any number of user profiles.

[0054] In a further advantageous embodiment of the laser therapy device according to the invention, it can comprise a control module which is designed to control an automated patient bed to the desired position based on the determined displacement distance and / or displacement direction. This embodiment has the advantage that pre-positioning can take place automatically from a point in time at which the displacement direction and / or the displacement distance can be determined. Control data representing the displacement direction and / or the displacement distance can then be provided directly or indirectly (e.g., by means of an intermediate controller) to a control unit. This control unit controlling the patient bed can be arranged in the laser therapy device or the automated patient bed.

[0055] If fully automatic or automated pre-positioning is provided, the wavelength of the light used to project the positioning mark can also be outside the visible spectral range, for example, and not limited to, the near-infrared spectral range. This configuration has the advantage that the person being treated is not distracted or irritated by the light from the positioning mark, while the positioning mark and / or the additional positioning mark can still be detected by the at least one camera.

[0056] The laser therapy device according to the invention can be further improved by having its projection unit configured to project a stripe pattern in the treatment area upon reaching a pre-position in which an area of ​​the person to be treated is positioned in the treatment area. The stripe pattern can comprise a plurality of longitudinal stripes spaced apart from one another and oriented along a longitudinal direction, and a plurality of transverse stripes intersecting the longitudinal stripes, spaced apart from one another, and oriented along a transverse direction. The laser therapy device can further comprise a camera module for recording the projected stripes and for providing an image of the projected stripes, as well as an evaluation module.The evaluation module can be designed to receive the image of the projected stripes, determine stripe spacings of the stripes depicted in the image, determine the position and / or angle of a longitudinally oriented symmetry axis and the position and / or angle of a transverse axis oriented transversely from a topography of the stripe spacings and / or a change in the stripe spacings, and provide a displacement distance and / or displacement direction and / or rotation required for positioning from the determined position and / or the determined angle of the symmetry axis and / or the transverse axis. Directly following the pre-positioning, fine positioning can thus be carried out using the projection unit, preferably using one and the same projection unit. The evaluation module can be part of a computing unit or designed separately.

[0057] The projection of the stripe pattern can be initiated manually, automatically, or semi-automatically. The longitudinal direction can correspond to the bridge of the nose, assuming optimal alignment of the area to be treated, for example, the eyes. The transverse direction can be oriented essentially perpendicular to the longitudinal direction.

[0058] The lines projected within the processing area can all be equally spaced from one another. If these are projected onto a flat surface, the spacing of the lines in the beam path also corresponds to the distance on the projection surface. If the projection surface is tilted, the spacing of the lines on it increases. At a 45° tilt, for example, this leads to an increase in the distance to a square root (2) factor (approx. 1.414). In order to be able to determine a change in distance, an axis along which the projection surface is observed is not collinear with the axis of illumination, i.e. both axes are arranged at an angle to one another. The multitude, i.e. a family of lines with the same orientation can thus be referenced to one another according to the inclination-related gradient (of the projection surface). As an alternative to the gradient, a height profile can be calculated.The gradient can be the first derivative of the height profile in two spatial directions x and y. For example, the lines can be oriented parallel to the forehead area. In this case, a first line can hardly be deformed by the flat forehead area. It is irrelevant whether the forehead area is covered with a sterile drape or not, since this drape takes on or maps the shape of the forehead area of ​​the person being treated. Referencing to structures of the face of the person being treated is therefore also possible when using sterile drapes. Referencing means that specific spatial points or structures are referenced, or that these spatial points or structures serve as a (positional) reference in three-dimensional space. The lines that are mapped onto the eye sockets, on the other hand, can be subject to significantly greater deformation during projection.Such a deformation is detectable according to the invention and allows a conclusion to be drawn as to where on the face or head of the person to be treated the line is depicted. Further referencing can be possible with regard to the longitudinal stripes, i.e. the lines parallel to the nasal structure. With regard to the nasal structure, e.g. the bridge of the nose, it is possible to determine malangular positions. A malangular position can be corrected by rotating the person to be treated. Optionally, after a malangular position has been detected, correction values ​​for correcting this can be provided. Even if the nose of the person to be treated is covered with a sterile cover, the evaluation module can be designed to analyze the topology of the recorded stripes, since the cover rests on or against the nose and thus approximately corresponds to the shape of the nose.Although the shape of a covered nose may not be identical to an uncovered nose, the relative positions of nasal gradients are virtually identical both with and without the cover. Explanations that refer to the nose of the patient are therefore also applicable to patients covered with a sterile cover.

[0059] In particular, during surgery, only the eye socket may be covered in a non-sterile manner. As a characteristic structure that can serve for orientation, it is conceivable in a further embodiment of the laser therapy device to use an eyelid speculum as an orientation feature. Starting from the advantageously curved eyelid speculum, the direction to the eye center can be approximated due to the curvature. Furthermore, the distance from the eyelid speculum to the eye center can also be estimated based on known average eye sizes. The use of the eyelid speculum as an orientation feature can be used in support of or as an alternative to the above pre-positioning methods for determining the displacement distance and / or the displacement direction.

[0060] To provide adequate imaging, the camera for recording the fringe projection can have a front-mounted lens, which can advantageously be aligned symmetrically to one of the projection line orientations to avoid potential aberrations. Particularly preferably, the camera can be positioned symmetrically to the nasal structure and also record it symmetrically. The camera can preferably detect both the left and right nasal flanks, as well as the area between the eyebrow(s) and the eye socket(s).

[0061] The nasal flank can be an important feature for positioning the patient in relation to the surgical device. The nasal flank can also be visible and identified when covered with a sterile drape. Preferably, the camera should initially be aligned symmetrically to an ideally aligned nasal flank. Alignment can preferably be achieved using an alignment element. An alignment element can represent or simulate a patient's head. This alignment makes it possible to simultaneously capture the left and right nasal flanks.

[0062] With such an initial alignment, for example, a central longitudinal stripe can be positioned on the nasal bridge (or a sterile drape applied to the nasal bridge). With ideal alignment of, for example, the nasal bridge (i.e., the area of ​​the patient to be treated), the longitudinal stripes on the right and left form geometrically mirror-inverted, approximately equally deformed stripes. Subsequently, observation of the forehead area and the eye sockets can be used for positioning. Here, too, a mirrored relationship of the projections of the forehead area lines should be apparent, relative to the nasal bridge.

[0063] With respect to the transverse direction (i.e., from the left to the right eye), symmetry of the stripe spacing is therefore preferentially checked. A corresponding axis of symmetry can mark the center, for example, the bridge of the nose.

[0064] With regard to the longitudinal alignment, i.e., for example, along a direction from the center of the voice to the nose, an increased stripe spacing can be detected at the transition from the eyebrow to the orbit. The drop from the eyebrow to the orbit can be taken as a reference here. This can represent a sufficient identification feature. This drop can further be offset against a standard, known distance from the center of the eye to the forehead bone, which can be understood as an offset. This observation using a known distance can also be combined with referencing the symmetry with regard to the bridge of the nose, so that the position of the center(s) of the eye can be inferred from a position along the longitudinal direction and a position along the transverse direction.To check the rotation using fringe projection, for example, it can be checked whether an increasing fringe spacing in the longitudinal direction begins at the same coordinate with respect to the transverse direction (Y-direction) for the left and right eyes. In other words, the gradient at positions symmetrical to the bridge of the nose can be compared with the same coordinate along the longitudinal direction. If this gradient is comparable or even the same, no angle correction is necessary. If, on the other hand, for example, the gradient in the area of ​​the patient's right eye is significantly lower than the gradient in the area of ​​the patient's left eye, this can mean that the head of the person being treated is rotated counterclockwise when viewed from above and a clockwise angle correction is necessary. In this case, for example, in the area of ​​the patient's right eyeThe area of ​​the eyebrow / stim is detected, which has a significantly lower gradient than the upper area of ​​the eye socket of the patient's left eye. According to the invention, the ultrasound therapy device can determine such an angle correction and optionally provide it as a corresponding angle correction value representing a correction angle.

[0065] The projection unit can thus comprise a stripe projector, a recording unit or camera, and an evaluation unit. The stripe projection can be realized, for example, using a 3-dimensional grid. Optionally or additionally, it is possible to imprint a specific intensity gradient on the individual elements. This makes it possible to provide images for evaluation that can be evaluated with regard to the symmetry of the stripe gradient and also with regard to the intensity or brightness information. An imprinted brightness gradient on the individual stripes enables easy identification of the corresponding stripe(s).

[0066] Optionally or additionally, the evaluation unit can be designed to analyze the stripes or their distances from each other after receiving the image, for example by means of fast Fourier transformation.

[0067] The evaluation unit can further compare a topography of the stripe spacing with known stripe spacings of a standardized face or a standardized head and can be designed to determine the necessary correction parameters for fine positioning from this comparison.

[0068] Alternatively or additionally, the evaluation unit can be designed to detect sequentially or in parallel the position and / or the orientation of the axis of symmetry longitudinally with respect to the left and right nasal flank and then to detect a region of increasing grazing distances which represents the (height) drop at the eye socket.

[0069] The information obtained by one of the above-mentioned methods for correcting the position of the area to be treated on the person to be treated can be used to provide the necessary measured values ​​to a control loop or a control unit for positioning the person to be treated and to carry out automatic fine positioning.

[0070] The projection of the stripes can be performed using light from a visible spectral range, but preferably from a spectral range that is only detectable with the camera(s) but not perceptible to the person being treated. Near-infrared light can be used purely as an example and not as a limitation.

[0071] In particular, a correction signal can be calculated from the measurement, which can be used to readjust the position of the area to be treated, in particular an eye of a person to be treated. The correction signal can, for example and not be limited to, represent the information that rotation is required by X millimeters to the left, Y millimeters downwards, and Z degrees clockwise. The compensating movement represented by the correction signal represents a relative movement between the area to be treated and the laser therapy device. Thus, this movement can be carried out, for example, by a patient couch or by the application arm or the device head, which can be movable in three spatial directions.

[0072] Thus, in a further advantageous embodiment, the laser therapy device can be designed to align the application arm depending on the provided displacement distance and / or displacement direction and / or rotation.

[0073] To ensure the positioning requirements of a person to be treated for a successful operation, it is advantageous to perform a type of cascade of technical positioning or positioning steps. Such a cascade can enable sufficiently precise positioning, which in turn can be a prerequisite for ultra-fine positioning. Such a cascade can advantageously comprise an embodiment of the above-described pre-positioning using a positioning mark and an embodiment of the above-described fine positioning using stripe projection. In some embodiments of the laser therapy device, only pre-positioning or only fine positioning can be provided as preparation for ultra-fine positioning.In these embodiments, the correspondingly not provided for fine positioning or not provided for pre-positioning can be provided by a separate device not provided by the laser therapy device according to the invention.

[0074] Pre-positioning can be used to position the area of ​​the person to be treated up to an effective range of the finest positioning. Purely as an example, pre-positioning can ensure positioning of the area to be treated up to a capture range of an eye tracker. Such an eye tracker can have a capture range of 15 mm by 15 mm, or 13 mm by 13 mm (this corresponds to an average iris diameter), or 10 mm by 10 mm, or 5 mm by 5 mm, or 3 mm by 3 mm, or 2 mm by 2 mm or a smaller capture range. The capture range can also have dimensions that lie between the specific numerical values ​​mentioned above. The eye tracker preferably has a capture range of at least 13 mm by 13 mm. This can ensure that the pupil (which has an average diameter of 13 mm) can be detected.Subsequently, it is conceivable that the eye tracker generates instructions for the refined alignment of the person being treated and provides them, for example, in the form of control and / or output data, so that an adequate working area can be maintained within the scanning range of a scanner of the laser therapy device. The capture area can also be rectangular instead of square. The fine positioning can subsequently be taken over by the eye tracker. This can preferably perform the fine positioning without any movement of the person being treated.

[0075] Likewise, such pre-positioning can ensure positioning of the area of ​​the person to be treated up to the capture range of a camera, for example, a top-view camera. Such a camera can be part of a device for ultra-fine positioning and / or provide analyzable image signals and / or provide control signals by performing ultra-fine positioning.

[0076] The invention may further comprise a computer-implemented method comprising the following method steps: reading in a recorded image; identifying the positioning mark and / or the further positioning mark and a patient support in the read-in image; determining a (preferably relative) actual position of the patient support with respect to the positioning mark and / or the further positioning mark; comparing the actual position with a (preferably relative) desired position of the patient support with respect to the positioning mark and / or the further positioning mark; determining and, if appropriate, providing a necessary displacement distance and / or displacement direction of the patient support to reach the desired position, calculated from the comparison.Optionally, the method may comprise the step of providing display data, wherein the display data may represent the necessary displacement distance and / or displacement direction of the patient bed and are configured to output the necessary displacement distance and / or displacement direction of the patient bed on a user interface, preferably a display device, provided that these display data are transmitted to a display device.

[0077] This computer-implemented method can be executed on any type of computing unit, such as an FPGA or PC. The computing unit can be part of a laser therapy device or connected to the laser therapy device.

[0078] The invention further encompasses a non-volatile storage medium comprising instructions that, when executed on a computing unit, perform an embodiment of the computer-implemented method according to the invention. The invention also encompasses a data structure and a data signal comprising these instructions.

[0079] The present invention will be explained in more detail below with reference to the accompanying drawings. Identical technical features and features with identical functions are provided with the same reference numerals. The individual technical features shown in the various drawings can be combined with one another as desired. The embodiments shown are purely exemplary and non-limiting, and a repetitive description of technical features is omitted.

[0080] Shown are: Fig. 1 a schematic representation of the laser therapy device and the positioning of a patient bed relative to the laser therapy device (top view);

[0081] Fig. 2 is a further schematic representation of the laser therapy device and the

[0082] Positioning using positioning mark (top view);

[0083] Fig. 3 is a schematic representation of the laser therapy device according to the invention in

[0084] side view;

[0085] Fig. 4-7 a schematic representation of possible positioning marks;

[0086] Fig. 8 is a schematic representation of the representation of the processing area by the

[0087] positioning mark and another positioning mark;

[0088] Fig. 9 is a schematic representation of a further embodiment of the representation of the

[0089] Machining area by the positioning mark and another positioning mark;

[0090] Fig. 10-13 a schematic representation of the fine positioning of the laser therapy device according to the invention by means of stripe projection and its evaluation; and

[0091] Fig. 14 / 15 a schematic representation of a dynamic positioning mark.

[0092] For the purpose of describing the invention, it is assumed below that the area of ​​the person to be treated is one or both eyes. However, the invention is not limited to this area and is applicable to other areas to be treated.

[0093] Fig. 1 shows a schematic top view of the laser therapy device 1 according to the invention and a patient support 2. The patient support 2 is shown purely schematically and represents any type of patient transport unit with which a person to be treated (not shown) can be moved to the laser therapy device 1, including transport chairs with movable backrests, simple support couches, special support couches, and possibly beds.

[0094] The patient couch 2 has a head region 4 in which the head of the person to be treated is arranged. A support can also be arranged in this head region 4, by means of which the head of the person to be treated rests indirectly on the head region 4 of the patient couch 2.

[0095] In a further embodiment (not shown), a test object can be arranged in this head region 4, which can correspond to the head of a person to be treated in terms of shape and / or size and / or distinctive elements or parts. Such a test object can be used to check the correct positioning of the patient bed 2 with respect to the laser therapy device 1 by means of the projection unit 6 described below. The patient bed 2 is shown with a solid line in an initial position 8, from which it is moved manually (for example by an assistant), semi-automatically, or automatically to a pre-position 10 shown in dashed lines. The distance between the initial position 8 and the pre-position 10 corresponds to a displacement distance 11a. Analogously, a displacement direction 11b is defined by the direction from the initial position 8 to the pre-position 10.

[0096] The laser therapy device 1 can have an application arm 12 that can assume a rest position 14. In the rest position 14, a laser exit 16 (see Fig. 3), through which therapeutic radiation (see Fig. 3) can be provided by the laser therapy device 1, is pivoted away from the person to be treated, so that the laser exit 16 cannot be used for orientation for correct positioning of the patient bed 2. This can lead to the rough positioning PI shown in Fig. 1 being incorrect, i.e., the patient bed 2 being arranged in a position that does not correspond to the pre-position 10 or is so far removed from this pre-position 10 that simple subsequent correction of the patient bed 2 using the laser therapy device 1 is not sufficient to achieve the pre-position 10.

[0097] The displacement distance 11a and / or the displacement direction 11b can be determined by the laser therapy device

[0098] 1 can be displayed on a display device 13a and / or communicated through a loudspeaker 13b and / or provided to a user through a haptic feedback module 13c in the patient couch 2. At least one property of the display can be dependent on the size of the displacement distance 11a and / or the direction of the displacement direction 11b.

[0099] Fig. 2 schematically illustrates a positioning mark 20 projected by a projection unit 6. The positioning mark 20 is drawn purely schematically and non-restrictively as a crosshair 20a. The positioning mark 20 in general and various embodiments thereof in particular are discussed in more detail below in Figures 5 to 11.

[0100] As can be seen in Fig. 2, the projection of the positioning mark 20 takes place in the rest position 14 of the application arm 12. As soon as the patient couch 2 is arranged in or near the pre-position 10, the positioning mark 20 is projected in the head area 4 of the patient couch 2. Here, the positioning mark 20 represents a processing area 22. The positioning mark 20 can be on a head 22a of a person to be treated 22b (see circle 18a), on a support area 22c of the patient couch

[0101] 2 for the head 22a of the person 22b to be treated (see circle 18b), or on a support 22d (see circle 18c). A support 22d allows the head 22a of the person 22b to be treated (not shown) to rest indirectly on the patient couch 2, particularly in the head region 4.

[0102] With regard to the illustrations in Fig. 1 and 10 to 13, it should be mentioned at this point that the person 22b to be treated is generally covered as sterilely as possible during an operation. Other elements may also have been used, for example an eyelid speculum to keep the eye open. These additional elements are neither shown nor described in detail for the sake of clarity. In particular, only the eye sockets may be covered in a non-sterile manner during an operation. However, the pre-positioning can still be based on characteristic features of the face, as explained in more detail below. This is the case because a sterile covering, e.g. made of nonwoven fabric or a film, rests against the skin of the face of the person to be treated and may even cling to it. The sterile covering can therefore have a shape that corresponds to the shape of the face of the person to be treated, including the corresponding topography.

[0103] The bridge of the nose can thus be used as a prominent elevation even with a sterile cover or drape. The eye sockets and the forehead area can also be used as noticeable landmarks. If the following explanations refer to the face or parts of the face of the person being treated (22b), the explanation also applies to the case where said parts of the face are covered with a sterile cover. The functionality of the laser therapy device according to the invention for faster positioning of a person being treated is not affected by a sterile cover.

[0104] The positioning mark 20 represents the processing area 22. In other words, the processing area 22 can correspond to the area in which the positioning mark 20 is projected. In one embodiment, the positioning mark 20 can completely enclose the processing area 22, or only enclose a center 21 of the processing area 22. The positioning mark 20 can preferably be arranged symmetrically in the center 21 of the processing area 22 or mark this center 21.

[0105] The processing area 22 is schematically shown in Fig. 2 (see circles 18a-18c) with a dotted line. Preferably, the processing area 22 is rectangular, but in other embodiments it can also be circular or oval. The shape and / or size of the processing area 22 can depend on the design of a scanning device (not shown) used in the laser therapy device 1. If this consists, for example, of two scanning mirrors (xy scanner), a rectangular area can be scanned. If, on the other hand, the scanning device consists of a rotating reflective element, for example a prism, and another mirror that is rotationally rigidly connected to the reflective element and whose distance from the reflective element is variable, the processing area 22 can be circular or oval. A round processing area 22 can also be obtained when using a scanning lens.

[0106] The positioning mark 20 can further consist of several elements which, on the one hand, can mark the center 21 of the processing area 22, e.g., intersecting lines 20b forming a crosshair 20a, and, on the other hand, can at least partially enclose the processing area.

[0107] The treatment area 22 of the laser therapy device 1 can, in particular, be an area of ​​a person 22b to be treated, which includes at least one, preferably both, eyes 24 of the person 22b to be treated. In some areas of the drawings, a single eye 24 is shown purely schematically, which is intended to encompass other possible areas of a person 22b to be treated or of a test object.

[0108] Any area of ​​a person 22b to be treated can be positioned more easily and reliably using the present laser therapy device 1. Positioning does not yet involve any treatment, i.e., any therapeutic or medical procedure on the body of the person 22b to be treated. Positioning is a step prior to such a treatment, which can also be performed, for example, with a test object (to verify the correct functioning of the laser therapy device 1).

[0109] Fig. 3 shows a schematic side view of the laser therapy device 1 according to the invention. The laser therapy device 1 comprises a device base 26 and a device head 27, the application arm 12 (preferably movably) attached to the device head 27, and the (schematically drawn) laser light source 28 for generating the therapeutic radiation 30. The laser light source 28 is drawn purely schematically in the device head 27 and can be arranged in the device base 26 in other embodiments.

[0110] The application arm 12 and the laser outlet 16 each have a working position 32 or can be positioned in this position. The working position 32 is shown in dashed lines. In this working position 32, the application arm 12 is designed to guide the therapy radiation through the laser outlet 16 into the processing area 22. The processing area 22 can be two-dimensional or three-dimensional. The processing area 22 is shown in Fig. 3 as a line; this extends into or out of the plane of the drawing (cf. Fig. 2). An eye 24 is shown schematically; this is located in the processing area 22. A patient's head is not shown in Fig. 3. Instead, a support 34 is shown, which rests on the patient couch 2 and supports a person to be treated (not shown) and / or indirectly holds them in position on the patient couch 2.The positioning mark 20 can, as shown in the figure described above, be projected onto the patient's head, the headboard of the patient couch 2, or onto the support 34. The latter is shown schematically here.

[0111] The laser therapy device 1 has the projection unit 6. This can be used to simplify the positioning of a person to be treated with respect to the laser therapy device 1.

[0112] The projection of the positioning mark 20 by the projection unit 6 preferably takes place in the rest position 14 of the application arm 12. In this rest position 14, a person to be treated can be moved into the pre-position 10 without the risk of a collision with the application arm 12.

[0113] This thus enables unhindered positioning of the patient couch 2 regardless of the position of the application arm 12. Preferably, the application arm 12 is only moved from the rest position 14 into the working position 32 (pivoted in the embodiment shown) when the patient couch 2 has reached the pre-position 10.

[0114] In the embodiment shown, the projection unit 6 is attached to the application arm 12. In other embodiments, the projection unit 6 can be attached to other locations on the laser therapy device 1, for example, on the device base 26.

[0115] In Fig. 3, a projection distance 36 is also shown, which corresponds to a distance between the projection unit 6 and the positioning mark 20 representing the processing area 22.

[0116] The position of the treatment area 22 relative to the laser therapy device 1 is determined by the latter. In addition to an extension in the x and y directions (the latter is shown in the plane of the drawing), the treatment area 22 also has a fixed height 38, which ideally corresponds to the position of the eye 24 or eyes 24 of the person 22b to be treated. The term "height 38" refers to a distance relative to the floor 40 on which the laser therapy device 1 stands.

[0117] Fig. 3 also shows a camera module 7 on the application arm 12. Using the camera module 7, an image of the patient bed 2 and the positioning mark 20 can be recorded. The image can be transmitted to a computing unit 9, which calculates the displacement distance 11a and / or the displacement direction 11b and makes it available to a user or is used for automatic positioning. In the embodiment shown, the computing unit 9 comprises an evaluation module 83. In other embodiments not shown, the evaluation module can be designed separately and not as part of the computing unit 9. The evaluation module 83 can be designed to evaluate the images of the positioning mark 20 and / or the patient bed 2 recorded by the camera module 7 (which can consist of or comprise at least one camera and / or at least one 3D camera).

[0118] Figs. 4-7 show schematic representations of possible positioning marks 20. Fig. 4 shows a rectangular positioning mark 20 comprising two crosshairs 20a and a frame 20c.

[0119] In Fig. 5 a circular positioning mark 20 is shown, in Fig. 6 an oval or elliptical positioning mark 20 is shown.

[0120] Figure 7 shows a rectangular positioning mark 20 with two crosshairs 20a and a discontinuous frame 20d. The discontinuous frame 20d may only include corners 20e, as schematically shown in Figure 7.

[0121] Before the concept of the projection distance 36 and how it can be determined is discussed in more detail, a description of Fig. 8 and Fig. 9 is provided, which is partially related to the explanation of the projection distance 36. Fig. 8 shows a first possibility of how the projection distance 36 can be determined. The projection unit 6 generates convergent light 42, which can be sharply imaged on a surface 46 in a region of the depth of field 44. The depth of field 44 can preferably be defined via the Rayleigh length of the light used, for example as twice the Rayleigh length. By the convergence of the light 42, i.e. by the optical elements (not shown) of the projection unit 6, a position of the depth of field 44 and thus the projection distance 36 can be determined.The positioning mark 20 can be sharply imaged both in a first layer 48a of the surface 46 and in a second layer 48b or in a third layer 48c of the surface 46 (schematically represented by different lines). Thus, the projection distance 36 does not describe a single, concrete value, but rather a range of values ​​of the dimension of a length. This is schematically represented by three possible concrete representatives of the projection distance 36, which are designated 36a, 36b, and 36c for differentiation. In the following description, only one projection distance 36 is referred to, whereby this is intended to encompass all representatives 36a, 36b, 36c, and all other representatives not shown.

[0122] By modifying the projection unit 6, in a further embodiment, a further positioning mark 50 can be projected in addition to the positioning mark 20. The further positioning mark 50 can have a further projection distance 52, which is, for example, greater than the projection distance 36.

[0123] The positioning mark 20 and the further positioning mark 50 can be projected simultaneously or alternately. The projection of both positioning marks 20, 50 can be performed by the same optical elements (for example, using a zoom lens, not shown) of the projection unit 6 or by separate optical elements for each positioning mark 20, 50 (fixed, but with a different focal length for both positioning marks; not shown). The definition of the further projection distance 52 corresponds to that of the projection distance 36 at which the further positioning mark 50 is imaged. The further projection distance 52 can preferably correspond to the height of the projection unit 6 above the floor 40.

[0124] In one possible embodiment, the laser therapy device 1 can thus be configured to project a positioning mark 20 and a further positioning mark 50. The positioning mark 20 can preferably be projected at a projection distance 36 and be sharply imaged, corresponding to the height of an eye 24 of a person 22b to be treated. The further positioning mark 50 can preferably be sharply imaged on the floor 40.

[0125] In this embodiment, the positioning mark 20 is thus not sharply imaged on the floor 40, and the further positioning mark 50 is not sharply imaged on the patient couch 2 or the head 22a of the person being treated. A sharp image is understood to mean that a projection of the positioning mark and / or the further positioning mark makes it possible to distinguish them for different projection heights. The term "sharp" can thus be understood to mean that the positioning mark and / or the further positioning mark cannot be blurred or rendered blurry, or can be displayed as a clearly recognizable, projected, predefined pattern.

[0126] This is schematically illustrated in Figure 7 using a first 54a and a second enlargement 54b of a corner 20e of the interrupted frame 20d.

[0127] In the first magnification 54a, substructures 56 of corner 22e are clearly projected. The substructures 56 are shown as squares for illustrative purposes and are not limiting.

[0128] In the second magnification 54b, however, the partial structures 56 are not projected in a way that can be separated from one another and cannot be perceived as distinguishable partial structures 56.

[0129] The first magnification 54a represents the case in which the positioning mark 20 or the further positioning mark 50 was projected at a correct projection distance 36 or at a correct further projection distance 52, ie in the case of the positioning mark 36 at the level of the patient couch 2 and in the case of the further positioning mark 50 on the floor 40.

[0130] The second magnification 54b, however, shows that the positioning mark 20 or the further positioning mark 50 were not projected at the correct projection distance 36 or the correct further projection distance 52, respectively. This may be the case if the positioning mark 36 is viewed on the floor 40 or the further positioning mark 50 is viewed on the patient couch 2. However, a blurred image of the positioning mark 20 or the further positioning mark 50 is obtained if the surface 46 onto which the projection takes place is located outside the depth of field 44 of the convergent light 42.

[0131] Preferably, the convergent light 42 of the positioning mark 20 can have a greater convergence than the light of the further positioning mark 50 in order to be able to detect even smaller deviations of the surface 46 from the projection distance 36.

[0132] The partial structures 56 shown in Figure 7 are purely schematic and can be replaced by any other structures and / or objects such as points, circles, triangles, lines or similar structures.

[0133] A further possibility for projecting a positioning mark 20 and / or a further positioning mark 50 and a definition of the projection distance 36 is shown in Fig. 8. In this embodiment, the projection unit 6 consists of two projector elements 58, each of which generates a partial projection 60. The partial projection 60 of a first 58a and / or a second projector element 58b can preferably be parallel projections 60c. This parallel projection 60c is projected correctly, i.e. sharply, onto the surface 46, regardless of the distance of the projector element 58 to the surface 46 on which the respective imaging takes place. In particular, the first projector element 58a can be designed to project the further positioning mark 50 as a first partial projection 60a. Furthermore, the second projector element 58b can be designed to generate a second partial projection 60b that intersects the first partial projection 60a.The intersection area 62 of both partial projections 60a, 60b represents the processing area 22.

[0134] The partial projections 60a, 60b can, in particular, be constructed from partial structures 56, which complement each other, for example, in the intersection area 62. This is schematically illustrated in the first enlargement 54a and also the second enlargement 54b of Fig. 8.

[0135] The first partial projection 60a is projected by the first projector element 58a and, in this embodiment, generates the further positioning mark 50. This further positioning mark 50 includes corners 20e but not edge regions 66 close to the corners, which adjoin the corners 20e.

[0136] The second projector element 58b generates the second partial projection 60b and, in contrast, projects only the edge regions 66 near the corners, but not the corners 20e themselves. Partial elements 56 not shown are marked by dotted ellipses.

[0137] With a correct superposition of the two partial projections 60a, 60b, a continuous frame 20c can be imaged and perceived. This is schematically illustrated in a third enlargement 54c.

[0138] The corner 20e and the edge areas 66 near the corner are drawn with different lines merely for differentiation. The continuous frame 20c of the positioning mark 20 is created by superimposing the first 60a and second partial projections 60b.

[0139] In this case, the complete or continuous frame 20c forms the positioning mark 20 and represents the processing area 22.

[0140] If the surface 46, ie the patient bed 2 or the head 22a of the person to be treated 22b or the support 34 is not at the correct height, the complementary partial structures 56 of the two partial projections 60a, 60b cannot complement each other.

[0141] A displacement 68 (represented by a double-headed arrow), as shown in a fourth enlargement 54d of Fig. 8, thus indicates an incorrect height of the area 22a to be treated of the person 22b to be treated. In the fourth enlargement 54d, it can be seen that the corner 20e of the first partial projection 60a and the edge regions 66 near the corner of the second partial projection 60b do not form a contiguous positioning mark 20. For example, the eye 24 to be treated may not be located in the processing area 22, but rather below or above it, and a height correction may be necessary. This case could, for example, indicate the use of an incorrect patient couch 2 or an incorrect support 34. The displacement can be used to detect and correct an incorrect alignment of the person 22a to be treated with regard to height.This embodiment further has the advantage that the further positioning mark 50 is projected onto the floor 40 only until the patient bed has been pushed into the second partial projection 60b. Subsequently, the first partial projection 60a, which forms the further positioning mark 50 on the floor 40, forms the positioning mark 20 together with the second partial projection 60b.

[0142] Figures 10-13 schematically illustrate the positioning of any patient support 2 within a capture range of the fine positioning. The fine positioning can, for example, have an adjustment range of ± 5 mm. Within this adjustment range, the application arm can, for example, be aligned with the person 22b to be treated.

[0143] The face or head 22a of a person 22b to be treated, with its nose 72 and eye sockets 74, offers significant fine positioning options. Intersecting principal symmetry lines 76a and 76b can be projected onto the bridge of the nose 72a and in the area of ​​the eye sockets 74. The principal symmetry line 76a extends along the bridge of the nose 72a, and the principal symmetry line 76b extends perpendicular to it. An intersection point 78 of the principal symmetry lines 76a, 76b can be used as a pivot point 80 for fine positioning of the person 22b to be treated.

[0144] In addition to the main symmetry lines 76a, 76b, symmetry check lines 82 can be projected. The symmetry check lines 82 are preferably at a constant distance from the respective adjacent symmetry check line 82 or from the respective parallel-oriented adjacent main symmetry line 76a, 76b. All parallel lines are preferably equidistant from one another.

[0145] For the sake of clarity, only two horizontal symmetry test lines 82 and four vertical symmetry test lines 82 are shown. In other embodiments, any number of vertical and horizontal symmetry test lines 82 can be combined.

[0146] In areas A and B, i.e. in the area of ​​the eye sockets 74 and at the same distance 84 from the main symmetry line 76a, a gradient or a height profile H can be determined using the symmetry test lines 82. This height profile H is shown schematically in the graphic 86a. It can be seen that the height profile H in area A and in area B is, on the one hand, comparable and, on the other hand, similar to an ideal curve 88. Similar means that the height profile H in area A and in area B is within predefined error limits (not shown) of the ideal curve 88.

[0147] In area C, i.e., on the bridge of the nose 72a, the height profile H is also determined based on the vertical symmetry lines 82. However, here, in particular, a symmetry of the height profile H with respect to the main axis of symmetry 76b indicates a correct alignment of the laser therapy device 1 with respect to the person 22b to be treated. This is shown schematically in the second graphic 86b. In Fig. 11, the person 22b to be treated is positioned with both a transverse deviation 89 and a longitudinal deviation 92 relative to the laser therapy device 1.

[0148] If we consider the areas A and B, shown in a third graphic 86c, the height profile H measured in these areas is similar or even identical, but does not correspond to the ideal curve 88. This indicates the longitudinal deviation 92.

[0149] In area C, the height profile H can also be determined; this is shown in a fourth graphic 86d, but is not symmetrical to the main axis of symmetry 76b, which indicates the transverse deviation 89.

[0150] In Fig. 12, the person to be treated is oriented with an angular deviation 90 (also: rotation 90) relative to the laser therapy device 1. This angular deviation 90 results in the height profile H differing from each other in areas A and B and possibly being shifted relative to the ideal curve 88. This is shown in a fifth graphic 86e.

[0151] In area C at the level of the nasal bridge 72a, an asymmetry to the main axis of symmetry 76b can also be seen when determining the height profile H (see sixth graphic 86f), which results from the angular deviation 90. Using the height profiles H measured in areas AB and C and their deviation from the ideal curve 88 or their asymmetry, the angular deviation 90 can thus be determined. The angular deviation corresponds to the rotation 90.

[0152] The symmetry lines 76a, 76b, 82 can be projected in addition to the positioning mark 20 or alternatively to it. For the sake of clarity, the positioning mark 20 is only shown in Fig. 10.

[0153] Initially, the person to be treated 22b can be guided into the pre-positioning area using the projection of the positioning mark 20. Using a height adjustment, the lines can be sharply projected onto the person to be treated at the intended height.

[0154] Figure 13 schematically shows that the lines cannot be perceived separately if the person being treated (22b) is not positioned at the correct height. The projection of lines 76a, 76b, and 82 can be used to maximize the contrast between the patient's skin and the lines. Many (spatial) frequencies in a small space are indicators of the person being treated's 'focus position'.

[0155] With respect to the main symmetry line 76a of the nose 72, a symmetry check can be performed to the right and left of this line by checking whether the symmetry test lines 82 have the same coordinates in terms of intensity magnitude. If not, the right-left alignment must be corrected.

[0156] A similar comparison can be made regarding the alignment based on the eye sockets 74: here, the coordinates on a symmetry test line 82 to the right and left of the main symmetry line 76a to the nose 72 should have the same intensity values, depending on the coordinate pair. If this is not the case, an angular alignment or rotation of the person to be treated 22b with respect to the pivot point 80 and the y-adjustment of the person to be treated can be corrected. Corresponding correction instructions can be displayed on the screen (not shown). To prevent facial asymmetries from becoming apparent, an image section should not be too long or wide, but should reliably capture the area of ​​the eyes.

[0157] The evaluations of the projected stripes 76a, 76b, 82 described with reference to Figs. 10 to 13 can preferably be carried out by the evaluation module 83 introduced in Fig. 3. The evaluation module 83 is particularly suitable for determining stripe spacings of the stripes or lines (76a, 76b, 82) depicted in the image and for determining the position and / or angle of a longitudinally oriented axis of symmetry (which is collinear with the main line of symmetry 76a) and the position and / or angle of a transverse axis oriented in the transverse direction (collinear with the main line of symmetry 76b) from a topography of the stripe spacings and / or a change in the stripe spacings. The evaluation module 83 can, in particular, provide a displacement distance (11a) and / or displacement direction (11b) and / or rotation (90) required for positioning from the determined position and / or angle of the axis of symmetry and the transverse axis.

[0158] A dynamic positioning mark 96 is schematically illustrated in Fig. 14 and Fig. 15. This is composed of various substructures 56, with substructures 56a representing the y-direction and substructures 56b representing the x-direction. Furthermore, a circular representation 94 is displayed or projected. The shape or size of the circular representation 94 represents a height setting.

[0159] If the person to be treated approaches the correct position in the Y direction, i.e., the pre-position, the substructures 56b can illuminate from the outside in. In the opposite case, i.e., if the person 22b to be treated moves away, the substructures 56b extinguish from the inside out. Additionally or alternatively, the substructures 56b can all be visible and, analogous to a running light of increased intensity, represent a distance from the pre-position from the inside out and an approach to the pre-position from the outside in.

[0160] Once the pre-position has been reached, all substructures 56 for the respective direction can be illuminated or projected. For the Z direction, the circular representation 94 is additionally displayed or projected.

[0161] Fig. 14 shows the case where the correct position has been reached in the x-direction. All substructures 56a are displayed or projected. This is not yet the case in the y-direction, since not all substructures 56b are yet displayed or projected. The circular representation 94 has a radius RI, which can represent the state that the person to be treated is not yet positioned at the correct height. Fig. 15, on the other hand, shows the case where the pre-position has been reached and the coordinates of the person 22b to be treated are correctly set for the x-direction, the y-direction, and the z-direction. The dynamic positioning mark 96 can be projected and / or displayed or superimposed on a display device or in a microscope view.

[0162]

Claims

1. Laser therapy device (1), comprising a device base (26), an application arm (12) fastened to the device base (26), and a laser light source (28) for generating therapeutic radiation (30), wherein the application arm (12) has at least one working position (32) in which the application arm (12) is designed to guide the therapeutic radiation (30) into a processing area (22), wherein the laser therapy device (1) further comprises a projection unit (6) for simplifying positioning of a person to be treated (22b) with respect to the laser therapy device (1), and wherein the projection unit (6) is designed to project a positioning mark (20) such that it represents a position of the processing area (22).

2. Laser therapy device (1) according to claim 1, wherein the application arm (6) is movably attached to the device base (26).

3. Laser therapy device (1) according to claim 1 or 2, wherein the projection unit (6) is attached to the device base (26) and / or to the application arm (6).

4. Laser therapy device (1) according to one of claims 1 to 3, wherein the application arm (6) further has a rest position (14) in which the application arm (6) is pivoted or folded away from the processing area (22), and wherein the projection unit (12) is designed to project the positioning mark (20) when the application arm (12) is in the rest position (14).

5. Laser therapy device (1) according to one of claims 1 to 4, wherein the projection unit (12) is designed to project a further positioning mark (50), wherein the positioning mark (20) has a projection distance (36) which is less than a further projection distance (52) of the further positioning mark (50).

6. Laser therapy device (1) according to claim 5, wherein the projection unit (12) is designed to generate a sharp projection of the positioning mark (20) at the level of a patient bed (2) and wherein the projection unit (12) is further designed to generate a sharp projection of the further positioning mark (50) on the floor (40).

7. Laser therapy device (1) according to one of claims 1 to 6, wherein the positioning mark (20) and / or the further positioning mark (50) each comprise at least one shape from the list of shapes comprising: An oval; A circle; A rectangle; At least one crosshair (20a); A guide path; A variety of markings; or Has a combination of the aforementioned forms.

8. Laser therapy device (1) according to one of claims 1 to 7, further comprising a camera module (7) which is designed to identify the positioning mark (20) and / or the further positioning mark (50) and a patient bed (2) in a recorded image, to determine an actual position of the patient bed (2) with respect to the positioning mark (20) and / or the further positioning mark (50), to compare the actual position with a desired position of the patient bed (2) with respect to the positioning mark (20) and / or the further positioning mark (50) and to provide, from the comparison, a necessary displacement distance (11a) and / or displacement direction (11b) of the patient bed (2) to reach the desired position.

9. Laser therapy device (1) according to claim 8, wherein the camera module (7) comprises at least two cameras or at least one 3D camera.

10. Laser therapy device (1) according to claim 8 or 9, further comprising an interaction interface (13) which is designed to transmit the displacement distance (11a) and / or the displacement direction (11b) to an operator optically and / or acoustically and / or haptically.

11. Laser therapy device (1) according to claim 10, wherein the interaction interface (13) is designed to set a single tone repetition frequency of the acoustically transmitted displacement distance (11a) depending on the displacement distance (11a) and a tone frequency of the acoustically transmitted displacement direction (11b) depending on the displacement direction (11b).

12. Laser therapy device (1) according to one of claims 8 to 11, further comprising a control module which is designed to control an automated patient bed (3) to the desired position based on the determined displacement distance (11a) and / or displacement direction (11b).

13. Laser therapy device (1) according to one of claims 1 to 12, wherein the projection unit (6) is designed, upon reaching a pre-position (10) in which a patient to be treated Area of ​​the person to be treated (22b) is positioned in the processing area (22), to project a stripe pattern in the processing area (22), wherein the stripe pattern A plurality of longitudinal stripes (76a, 82) spaced apart from one another and oriented along a longitudinal direction; and A plurality of transverse strips (76b, 82) intersecting the longitudinal strips (76a, 82), spaced apart from one another and oriented along a transverse direction, wherein the laser therapy device (1) further comprises a camera module (7) for recording the projected strips (76a, 76b, 82) and for providing an image of the projected strips and an evaluation module (83) which is designed to receive the image of the projected strips; to determine the stripe spacing of the stripes (76a, 76b, 82) shown in the image; To determine the position and / or angle of a longitudinally oriented symmetry axis and the position and / or angle of a transverse axis oriented transversely from a topography of the stripe spacing and / or a change in the stripe spacing; and To provide a displacement distance (11a) and / or displacement direction (11b) and / or rotation (90) necessary for positioning from the determined position and / or angle of the symmetry axis and the transverse axis.

14. Laser therapy device (1) according to claim 13, which is designed to align the application arm (12) depending on the provided displacement distance (11a) and / or displacement direction (11b) and / or rotation (90).

Images