lighting equipment

Abstract

To provide an illumination apparatus which does not need another apparatus for releasing desired excitation radiation, to execute an open surgery under a fluorescent guide.SOLUTION: Provides is an illumination apparatus 1 for illuminating an operating field with radiation 18 during an open surgery to cause fluorescence, the apparatus comprising a main body 2 comprising an opening 3 configured to release the radiation. The apparatus also comprises attachment means 4 for removably attaching the main body 2 sideways to an endoscope 5.SELECTED DRAWING: Figure 6

Description

[Technical Field]

[0001] The present invention relates to an improved device for use during fluoroscopically guided open surgery. [Background technology]

[0002] Fluorescence-guided open surgery is commonly used for tumor resection. The deployed fluorescence radiation is usually detected by a camera, i.e., by a chip / photosensor, or through an eyepiece with a respective filter that selects out radiation of any wavelength other than the fluorescence radiation.

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

[0004] First, a special camera is used that is designed, built, and purchased solely, or at least primarily, for the purpose of fluorescence-guided / assisted open surgery. This special camera has a radiation source that emits the desired excitation radiation that produces fluorescence. A drawback of such a system is the need to purchase separate equipment to perform fluorescence-guided open surgery.

[0005] The second approach uses a commonly used endoscopic imaging device. The endoscopic imaging device can be a camera connected to the endoscope via its eyepiece during endoscopic surgery. This endoscopic imaging device is used to capture fluorescence images. The fluorescence is generated by an illumination device that can be connected to the endoscopic imaging device via a coupler, for example. Typically, an endoscopic imaging device has only one such coupler, which houses the endoscope during endoscopic surgery. This is usually achieved by housing the endoscope's eyepiece in the coupler. When the endoscope's eyepiece is removed from the endoscopic imaging device, the illumination device can be connected thereto. Using an endoscopic imaging device eliminates the need for hospitals to purchase additional equipment like the first approach described above for performing fluorescence-guided / assisted open surgery. However, a disadvantage of this second system is that a specially designed sterilization cover is required, for reasons explained below.

[0006] During endoscopic surgery, a standard sterile cover that covers the endoscopic imaging device is connected to the coupler along with the endoscope. Because endoscopes are typically sterilized before surgery, only the endoscopic imaging device, which cannot be sterilized due to its electrical components, needs to be shielded with a sterile cover.

[0007] However, when the endoscopic imaging device is used without an endoscope for fluoroscopically guided / assisted open surgery, the opening of the coupler or endoscopic imaging device is occupied by the illumination device. Typically, a standard cover cannot be connected to the coupler together with the illumination device, and even if it were possible, a standard sterile cover cannot cover both the endoscopic imaging device and the illumination device. Because neither the endoscopic imaging device nor the illumination device can typically be sterilized, using the second system described above requires the purchase of expensive, specialized (non-standard) covers. Summary of the Invention [Problem to be solved by the invention]

[0008] The present invention aims to overcome the above-mentioned drawbacks, and in particular to provide a system that can utilize standard equipment present in most hospitals. [Means for solving the problem]

[0009] The above problem is solved by a lighting device according to claim 1. Preferred embodiments are set out in the dependent claims.

[0010] The illumination device according to the present invention for illuminating a surgical field with radiation to generate fluorescence during open surgery comprises: a body having an opening configured to emit radiation; and an attachment means for attaching the main body to the endoscopic imaging device from the lateral direction.

[0011] Preferably, the body is attached to the endoscopic imaging device in a reversible / non-permanent manner.

[0012] It is known to use fluorescence imaging during surgery, for example, in tumor resection. Typically, the surgical field, i.e., the part of the body being operated on, is illuminated with radiation that causes fluorescence in specific areas or cell types. For example, 5-aminolevulinic acid is administered to a patient and accumulates in metabolically active cancer cells, causing only the cancer cells to fluoresce, which can help the surgeon distinguish between healthy tissue and cancer cells.

[0013] Fluorescence radiation, i.e., radiation emitted by fluorescent molecules such as 5-aminolevulinic acid after absorbing corresponding excitation radiation, lies within a narrow portion of the electromagnetic spectrum, making its absence easily detectable using appropriate filters. On the one hand, the surgeon performs surgery by viewing the surgical field with his or her own eyes. On the other hand, the surgeon can view, through an eyepiece or on a screen, a fluorescent image captured by an appropriate imaging device to help the surgeon distinguish between healthy tissue and, for example, cancerous tissue. The imaging device can be a camera specially designed for that purpose, or an endoscopic imaging device used without an endoscope attached.

[0014] Within the scope of the present invention, the term "endoscopic imaging device" includes cameras suitable for taking images or videos of the surgical field and for detecting fluorescent radiation.

[0015] One advantage of the present invention is that endoscopic imaging equipment, which is readily available in hospitals, can be used for open surgery assisted by fluorescence imaging, without the need to purchase a separate camera.

[0016] As will be explained below, the main body of the lighting device may have a radiation source that emits excitation radiation that causes fluorescence radiation, or may be connected to a radiation source via a light guide cable or the like.

[0017] Preferably, the main body of the illumination device is removably connected to the endoscopic imaging device.

[0018] A device according to the present invention that is temporarily and non-permanently connected to an endoscopic imaging device allows it to be used with many different types of endoscopic imaging devices and is therefore very flexible in use.

[0019] Another major advantage is that most endoscopic imaging devices include a coupler that allows the endoscopic imaging device to be connected to an endoscope, the shaft of which can be introduced into the patient's body, and the coupler may have a focus ring that allows the focus of the image captured by the endoscopic imaging device to be adjusted.

[0020] Because a shaft is only required for endoscopic surgery and not for open surgery, the coupler is not occupied by a shaft during open surgery. Therefore, a standard sterile cover that would normally connect to the coupler can be connected to the coupler to cover both the endoscopic imaging device and the illumination device, eliminating the need to provide a separate sterile cover. Because the main body of the illumination device is connected laterally to the endoscopic imaging device, it can easily be covered with the same cover.

[0021] This is typically not possible using current state of the art equipment.

[0022] In the current state of the art, an illumination device is connected to the coupler, and because only the standard cover or the illumination device (but not both) can be connected to the coupler, a separate sterile cover, which is often very expensive, is required. However, when both the illumination device and the sterile cover can be connected to the coupler, the standard sterile cover cannot cover the illumination device because it is connected to the endoscopic imaging device vertically, rather than horizontally. The present invention overcomes this problem.

[0023] As noted above, a standard sterile cover can accommodate an endoscope, particularly its eyepiece. Thus, while the endoscopic imaging device is housed in the sterile cover during surgery, the endoscope can be docked to the sterile cover so that the endoscopic imaging device can "see" images through the endoscope's eyepiece. Because this docking capability is provided with standard equipment, an illumination device according to the present invention can be docked to an endoscopic imaging device even during endoscopic surgery.

[0024] The advantage of this is that endoscopic surgery, i.e. minimally invasive surgery, cannot be performed and the surgeon has to open the patient's body because endoscopic surgery would not work, in this case the illumination device according to the present invention is already attached laterally to the endoscopic imaging device and the surgeon can simply remove the endoscope and continue with the open surgery, which may be a fluorescence-guided open surgery, with the illumination device.

[0025] There is another mode of use for how the illumination device according to the present invention can be used: when an angled endoscope must be used because the surgical area is nearly impossible to access. The illumination device can be attached laterally to the endoscopic imaging device, and the endoscope and sterile cover can be present at the same time. Thus, the illumination device can illuminate the area of ​​investigation and / or the surgical area with the angled endoscope. According to another example, the above-described combination comprising an illumination device, a sterile cover, and an endoscopic imaging device may also be used with a standard straight endoscope without any angle.

[0026] The attachment means for the lighting device according to the present invention can be selected from the list comprising snap-on means, clip-on means, strap-on means, positive lock means, screw means, silicone rubber or other non-permanent adhesive means.

[0027] The main body of the illumination device according to the present invention may have a radiation source that provides the radiation, i.e., the excitation radiation that causes fluorescence. Integrating the radiation source, such as an LED light source, into the main body has the advantage that a separate light source / radiation source is not required and it can be used immediately and easily during surgery.

[0028] Alternatively, the body may not have a light source, but may be connected to a light source that provides the radiation that induces fluorescence. Separating the body and light source provides the advantage that the illumination device is very simple and straightforward to construct, and that the body does not heat up during surgery due to heat generated by the light source that provides the excitation radiation. Another advantage over an integrated radiation source is that a separate radiation / light source typically results in a lighter illumination device.

[0029] The body of the lighting device according to the invention may have finger receiving means, which are adapted to receive the fingers of a surgeon who handles the lighting device.

[0030] The illumination device may be formed at least in part as a handle so that the surgeon holds the illumination device rather than the endoscopic imaging device during surgery.

[0031] The finger accommodation means provides at least two advantages.

[0032] First, it provides a more ergonomic hand placement.

[0033] Second, if the illumination device and the endoscopic imaging device are connected in a specific way, i.e., if both adopt a specific (and not random or arbitrary) position relative to each other, the surgeon will automatically hold the endoscopic imaging device in the correct position and angle.

[0034] For example, there may be only one way that the illumination device can be connected to the endoscopic imaging device, or there may be markings etc. that indicate how the two parts connect, and both alternatives may be implemented with the present invention.

[0035] When an endoscopic imaging device has a preferred chip / optical sensor according to the present invention, it is not intuitively obvious how, i.e., particularly at what angle, to hold the endoscopic imaging device to create the desired image without inadvertently rotating the image, for example, by 90° or 180°.

[0036] However, if the surgeon holds the illumination device with the finger accommodation means rather than the endoscopic imaging device (which does not provide an indication of what angle to hold it at), the surgeon will intuitively hold the illumination device, and therefore the endoscopic imaging device connected to it, at the correct angle.

[0037] Without a finger accommodation means for the illumination device, the surgeon may somehow "grab" and hold the endoscopic imaging device so that the image taken from the endoscopic imaging device and displayed on the screen is rotated 90° or 180°.

[0038] The present invention generally includes a means for ensuring that the endoscopic imaging device and the illumination device are only connected in one particular way and orientation.

[0039] The lighting device, preferably its body, may have means that allow it to be connected to a stand. These means may be an alternative to the finger accommodation means described above. Preferably, these means are also present on the lighting device or its body so that the surgeon can decide whether to hold it in his hand or connect it to a stand. Such stands are known from cameras commonly used to take long exposure images.

[0040] A filter can be inserted into the opening of the illuminator, which only passes the radiation used to fluoresce.

[0041] The direction in which the radiation leaves the illumination device may be tilted relative to the optical axis of the endoscopic imaging device's optical system. The tilt or angle may be selected so that within a distance of 10 to 30 cm, preferably 15 to 25 cm, most of the illumination provided by the illumination device is directed toward the optical axis of the endoscopic imaging device. In other words, and more generally, the illumination device may include means for directing the radiation so that the area "seen" by the endoscopic imaging device is adequately illuminated. Since the endoscopic imaging device, and thus the illumination device according to the present invention, is typically positioned between 10 and 30 cm from the surgical field, the illumination device, once mounted or attached to the endoscopic imaging device, may direct most of the radiation in a direction such that the optical axis is approximately centered in the radiation field within a distance of 10 to 30 cm.

[0042] The direction of radiation / illumination leaving the lighting device preferably refers to the imaginary central axis of the light / radiation cone leaving the lighting device.

[0043] An additional benefit of radiation leaving the illumination device with some degree of tilt is that the likelihood of unwanted reflections may be reduced. The likelihood of reflections is high when the illumination / radiation is coaxial with the optical axis of the endoscopic imaging device and low when the radiation travels in a direction tilted relative to the optical axis. Using tilt according to one embodiment of the present invention further reduces false signals generated and increases the depth of fluorescence detection. According to one embodiment of the present invention, the illumination device has means, such as a hinge, for changing the tilt, i.e., the angle between the direction of illumination / radiation leaving the illumination device and the optical axis of the endoscopic imaging device. These means are preferably integrated into the illumination device and change the direction of illumination leaving the illumination device. Alternatively, the mounting angle between the illumination device and the endoscopic imaging device can be changed to change the tilt.

[0044] By varying the tilt, the user can adjust the working distance. The illuminator can be installed and used so that the intersection of the optical axis and the virtual central axis is equal to the working distance. Thus, the illumination / radiation provided by the illuminator can be used most efficiently. Means for varying the tilt can be provided so that the intersection can be adjusted at a distance between 10 and 50 cm relative to the illuminator and / or the endoscopic imaging device.

[0045] Generally speaking, the illuminator may have means for varying the inclination of the radiation exiting the illuminator when attached to an endoscopic imaging device. Varying the inclination preferably provides the possibility to adjust the working distance from the illuminator and / or endoscopic imaging device between 10 and 50 cm.

[0046] The body of the lighting device may have means that allow it to be connected to a stand or to a robotic or semi-automatic arm.

[0047] The present invention also includes a system having the above illumination device and the above endoscopic imaging device descriptor.

[0048] The advantages, features and details will become more apparent from the figures shown below. [Brief explanation of the drawings]

[0049] [Figure 1] 1 is a schematic diagram of an endoscopic imaging device 5 and an endoscope 21 according to the state of the art. [Figure 2] 1 shows an illumination device 1 according to the present invention attached to an endoscopic imaging device 5. FIG. [Figure 3]1 shows an illumination device 1 according to the present invention attached to an endoscopic imaging device 5. FIG. [Figure 4] 1 shows an illumination device 1 according to the present invention attached to an endoscopic imaging device 5. FIG. [Figure 5] 1 shows an illumination device 1 according to the present invention attached to an endoscopic imaging device 5. FIG. [Figure 6] 1 is a schematic diagram of an illumination device 1 according to the present invention connected to an endoscopic imaging device 5 and a sterile cover 16. FIG. [Figure 7] FIG. 1 shows a standard sterile cover 16. [Figure 8] 1 shows an illumination device 1 according to the present invention connected to an endoscopic imaging device 5 and a sterile cover 16. FIG. DETAILED DESCRIPTION OF THE INVENTION

[0050] 1 shows a state of the art endoscope 21 having an eyepiece 9, a light conducting entrance 22, and a shaft 10. Additionally, an endoscopic imaging device 5 having an opening 17 and a coupler 8 is shown.

[0051] In FIG. 1 b , the eyepiece 9 of the endoscope 21 is attached to the coupler 8 .

[0052] FIG. 1 a differs from FIG. 1 b only in that the eyepiece 9 , and therefore the entire endoscope 21 , has been removed from the coupler 8 .

[0053] The arrangement shown in Figure 1b is used in endoscopic surgery. An imager cable (not shown) can be connected to the endoscopic imager 5 via a connecting piece 12 to transmit images from inside the body to a screen (not shown).

[0054] A standard endoscope 21, best shown in Figure 1a, can also be used in endoscopic surgery without the endoscopic imaging device 5. The surgeon then looks through the eyepiece 9, and light is introduced into the body through the light guide port 22.

[0055] The device and arrangement shown in Figure 1a / Figure 1b are known from the state of the art.

[0056] 2 to 5 show different perspective views of an embodiment of a lighting device 1 according to the invention.

[0057] The illumination device 1 is attached to a conventional endoscopic imaging device 5 via attachment means 4 .

[0058] 2 to 5 further show the opening 3 of the lighting device 1, showing the attachment means 4 in the form of a clip 4, the finger receiving means 6, the stand 7, the coupler 8, the connecting part 12 of the imaging device cable 11, the light guide cable 13, the user's hand 14, and the protrusion 15.

[0059] 2 to 5, the lighting device 1 according to the present invention functions as follows.

[0060] The main body 2 of the illumination device 1 is laterally connected via attachment means 4 to a conventional endoscopic imaging device 5. Referring to Figures 1a / 1b, any known endoscopic imaging device 5 can be used.

[0061] Since the lighting device 1 according to the invention does not occupy the coupler 8, the coupler 8 can accommodate a sterile cover, as will be explained below.

[0062] As shown only in Figures 6 and 8, a standard sterile cover 16 can be connected to coupler 8 to cover both endoscopic imaging device 5 and illumination device 1. Radiation 18 emitted by illumination device 1 passes through sterile cover 16, which is typically transparent. Thus, the surgical field (not shown) is illuminated by illumination device 1, even though sterile cover 16 covers illumination device 1.

[0063] Standard sterile covers 16 are designed so that they can be easily connected to coupler 8 and cover the entire endoscopic imaging device 5 .

[0064] Because the optics of the endoscopic imaging device "see" the field of view through the opening 17, the portion of the cover 16 that covers the opening 17 is designed so that the view is not impaired. A combined imaging window and connecting piece 23 as shown in Figure 8 can be used. The piece 23 combines a connecting piece that can accommodate, for example, an endoscope, with a transparent imaging window that ensures that the view of the opening 17 is not obstructed or impaired. Such covers 16 are known from the state of the art.

[0065] Images captured by the endoscopic imaging device 5 of Figures 2 to 6 are transmitted via an imaging device cable 11 connected to a connecting piece 12 to a processor or the like and ultimately to a screen (not shown).

[0066] The radiation or illumination 18 transmitted by the illumination device 1 to the surgical field (not shown) is provided by a light source (not shown) connected to the illumination device 1 via a light guide cable 13 connected to the illumination device 1.

[0067] Comparing Figures 3 and 4 it is clear how the finger accommodation means 6 allows the user to instinctively grasp the lighting device 1.

[0068] Figure 5 shows how the lighting device 1 can be connected to the stand 7 if the user does not want to hold the lighting device 1 in their hand 14. The stand 7 can be simply connected to the protrusion 15 using the recess 19 shown in Figures 2, 3 and 4.

[0069] The protrusion 15, together with the adjacent recess 19, can form both a connection part for connecting the lighting device 1 to the stand 7 and one of the finger receiving means 6. The design of the protrusion 15 shown in Figures 2 and 3 is particularly suitable for receiving a finger and connecting to the stand 7 due to its large surface area.

[0070] As can be seen in Figures 3 and 6, the direction of the radiation 18 leaving the illumination device may be tilted in such a way that the area around the optical axis 20 of the endoscopic imaging device 5 is sufficiently illuminated within a distance of 10 to 30 cm.

[0071] 8, radiation 18 leaving opening 3 in body 2 of illumination device 1 passes through transparent sterile cover 16. Because body 2 is laterally attached to endoscopic imaging device 5, no parts prevent radiation 18 from exiting sterile cover 16. [Explanation of symbols]

[0072] 1. Lighting equipment 2. Main body of lighting device 3 Lighting device opening 4. Mounting means 5 Endoscopic imaging device 6 Finger accommodation means 7 Stand 8 Coupler 9 Eyepiece 10 shaft 11 Imaging device cable 12 Imaging device cable connection parts 13 Optical guide cable 14 moves 15 protrusions 16 Sterile Cover 17 Opening of endoscopic imaging device 18 Radiation 19 Recess 20 Optical axis 21 Endoscopy 22 Light guide entrance 23 Imaging window and connecting parts

Claims

1. A system comprising an endoscopic imaging device (5) and an illumination device (1) for illuminating a surgical field with radiation during direct vision surgery to produce fluorescence, said illumination device (1) having a body (2) with an opening (3) configured to emit said radiation (18); 1. A system characterized in that the illumination device (1) has mounting means (4) for laterally mounting the main body (2) to the endoscopic imaging device (5), the endoscopic imaging device (5) having a coupler (8) that allows the endoscopic imaging device (5) to be connected to an endoscope (21).

2. 2. The system of claim 1, wherein the attachment means (4) is selected from the list comprising snap-on means, clip-on means, strap-on means, positive locking means, screw means, silicone rubber or other non-permanent adhesive means.

3. 3. The system according to claim 1 or 2, wherein the body (2) comprises a radiation source for providing the radiation.

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

5. 5. The system according to at least one of claims 1 to 4, wherein the body (2) comprises finger receiving means (6).

6. 6. System according to at least one of the preceding claims, characterized in that the body comprises means (15) allowing it to be connected to a stand or to a robotic arm or to a semi-automatic arm.

7. 7. The system according to claim 1, wherein a filter is inserted in the opening (3) that passes only the radiation used to produce fluorescence.

8. 8. The system according to any one of claims 1 to 7, characterized by means for varying the inclination of the radiation leaving the illumination device (1) when attached to the endoscopic imaging device (5).

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