CN101849868B - Self-controlled laser surgery equipment - Google Patents

Abstract

The invention relates to self-control laser surgical equipment, which consists of a main controller, a display, a charge-coupled device (CCD) camera, a laser, light source equipment, a main bracket, a cantilever arm, a suspension surgical treatment head, a microscopic observation system and a microscopic surgical adapter. The main controller recognizes and processes images and light spectrums of focal tissues and normal tissues acquired by the CCD camera and correspondingly send a command to control the operation of the laser so as to prevent faulty operation of a laser surgery from damaging the normal tissues and making a surgery mistake; the main controller sends a command to control the startup and shutdown of the laser and modify laser output; an optical lens group forms a light path; and the microscopic observation system, a microscopic observation mirror, the CCD camera and the microscopic surgical adapter are integrated with one another through the optical lens group. The equipment has the advantages of simple structure, reasonable design, simple and easily-grasped operation, capability of eliminating the focal tissues without damaging the normal tissues in a surgery process, various control modes, adjustable parameter, wide application and capability of accurately controlling the number of surgeries and improving treating effect.

Description

Self-controlled laser surgery equipment

The present invention is a divisional application of "Automatic Control Laser Surgery Equipment" with application number: 200810154587.6 and application date: December 26, 2008.

technical field

The invention relates to a laser surgery medical instrument, in particular to an automatic control laser surgery equipment.

Background technique

Laser microsurgery has been widely used, not only in surgery, internal medicine, ENT and ophthalmology, but in the treatment of glaucoma, laser microsurgery is the main method of treatment. Traditional filtering surgery mainly includes trabeculectomy and scleral bite, but there are many complications after traditional filtering surgery, such as early postoperative shallow anterior chamber and no anterior chamber, ciliary prolapse, malignant Glaucoma, hemorrhage and non-formation of filtering blebs, etc.; late stage filter opening blockage, scar formation, cystoid degeneration, rupture of filtering blebs, cataract and infection, etc. The existing laser microsurgery system mainly observes the changes of the biological tissue irradiated by the laser in real time through the microscopic system, and manually controls the amount of laser irradiation during the operation according to the needs of the operation. Therefore, these treatment equipment and treatment methods must observe the operation situation while manually controlling the amount of laser irradiation during the entire operation process, which is cumbersome. Most surgeons rely on their surgical experience to perform laser surgery. It is difficult to control the operation well, and there are still many problems to be solved urgently.

Contents of the invention

The main purpose of the present invention is to solve the above-mentioned problems in laser surgery medical equipment and laser surgery, to provide a method that can control the elimination of lesion tissue during surgery without damaging normal tissue, has multiple control modes, adjustable parameters, and wide application. It is a self-controlled laser surgery equipment that precisely controls the operation volume and improves the treatment effect.

The technical solution adopted by the present invention to solve its technical problems is:

It consists of a main controller, a display, a CCD camera, a laser, a light source device, a main bracket, a cantilever, a suspended surgical treatment head, a microscopic observation system and a microsurgical adapter.

The present invention mainly consists of a main controller, a display, a CCD camera, a laser, a light source device, a main bracket, a cantilever, a suspending surgical treatment head, a microscopic observation system, a microsurgical adapter, an image acquisition card, an interface circuit between a laser and a microcomputer, a pulse CO ₂ laser, pointing light laser, microcomputer and software system are composed of several parts. The invention treats eye diseases such as glaucoma, presbyopia and myopia, as well as diseases such as nasal polyps and laryngeal cancer.

The camera output end of the CCD camera is connected with the main controller through the line, the laser control connection port of the laser is connected with the main controller through the line, the laser output port of the laser is connected with the adapter input port of the microsurgical adapter through the optical fiber, The CCD camera collects images and spectra of lesion tissue and normal tissue and transmits them to the main controller through the camera output terminal.

The main controller, monitor, CCD camera, laser and microsurgical adapter are connected by lines to form a system of surgical equipment. The main controller, display, CCD camera, laser and microsurgical adapter each play the role of components in this system. The CCD camera detects the changes in the light intensity and color of the surgical site in real time, records the surgical process, and compares the lesion tissue with the normal one. The image and spectrum of the tissue are transmitted to the main controller. The image and spectrum are monitored and processed by the main controller to precisely control the surgical process, and the laser can be turned on and off through the I/O interface. The present invention adopts the image acquisition card to directly take the video signal of the CCD imaging device as input without signal preprocessing; the analog signal is directly communicated with the main controller through the PCI bus after A/D conversion; the software system controls the CCD imaging device to obtain the required Images and spectra of the surgical site before and after surgery, and store, convert, and analyze the image data and spectral data. The main controller can adopt PC computer.

The main controller identifies and processes the image and spectrum of the lesion tissue and normal tissue collected by the CCD camera, and sends out instructions to control the operation of the laser accordingly, so as to avoid the misoperation of laser surgery from damaging the normal tissue and causing surgery mistakes.

The main controller of the present invention recognizes and processes the image and spectrum of the lesion tissue and normal tissue collected by the CCD camera, and when treating glaucoma, the area array CCD monitors the light reflection intensity and color changes of the tissue at the laser perforated part in real time. Cutting must be accompanied by sudden changes in light intensity and color. Detect this sudden change at any time and control the laser to turn off in time. This process can be controlled within the limit of one laser pulse, so that excessive laser damage can be effectively and reliably prevented. During the treatment of presbyopia, real-time monitoring of the curvature of the crystal surface (that is, diopter) and changes in the anterior cavity distance, timely control of laser energy, spot size and scleral resection pattern, to improve the treatment effect of presbyopia.

The display is connected to the display connection port of the main controller, and the display or touch screen is used as the display of the main controller. The display immediately displays the images and spectra of the lesion tissue and normal tissue collected by the CCD camera, and the operation parameters are displayed on the display at the same time.

The display of the present invention can use a display screen or a touch screen, and the use of the touch screen can simplify the computer, and directly operate the correction parameters on the touch screen; the display can display the images and spectra collected by the CCD camera in real time, and at the same time display the operation parameters and the operation instructions issued by the main controller, which is convenient for doctors Observation and treatment. The image and spectrum of the lesion tissue and normal tissue, the energy of the laser output light, the operation parameters, the size of the light spot and the graph of lesion tissue resection are fully displayed on the monitor.

The laser output port of the laser is connected to the adapter input port of the microsurgical adapter through an optical fiber or a light guide arm to transmit laser light for treatment. The laser for treatment is a gas laser or a solid laser or a semiconductor laser or a fiber laser in a pulsed working mode. Pulse width: 250μs~100ms, energy density: 5~20J/cm ² , pulse frequency: <200Hz.

The selection of laser parameters has a direct impact on the effect of surgery. The present invention generally refers to all laser parameters that can affect surgery, including laser wavelength, output mode (pulse, continuous), pulse energy density, pulse width, pulse frequency, laser Control methods (manual control, feedback control), etc.

In external laser sclerectomy, the selection of laser parameters should follow three principles: minimal thermal and mechanical damage; precise control of surgical volume; high resection efficiency and less operation time. Obtaining minimal thermal damage is a crucial principle, as it is critical for postoperative wound healing and scar reduction, both in terms of damage to adjacent tissues. Under this premise, the operation volume should be precisely controlled to avoid excessive damage to deep tissues. Only when the above two conditions are met, can we consider improving the resection efficiency and reducing the operation time.

The mid-to-far infrared laser with short pulse output is suitable for glaucoma filtration surgery due to its superficial thermal effect, less damage, and less surgical bleeding. Among them, CO ₂ laser has a strong hemostatic function when removing tissue, and it causes little damage to surrounding tissues during removal, so it is suitable for external laser resection. CW _CO2 lasers and pulsed lasers interact with ocular tissue differently, and using short pulsed lasers to limit thermal diffusion is one way to reduce thermal damage.

The laser control connection port of the laser is connected with the control laser connection port of the main controller through a line, and the main controller sends instructions to control the start-up and shutdown of the laser and correct the laser output.

The present invention controls the output mode of the laser through the main controller, including continuous wave, single pulse, multi-pulse, compound pulse, etc.; the main controller can be preset or can be changed at any time according to the needs during the operation. The operation parameters include: Continuous wave output power, irradiation time, pulse wave output energy, pulse width and frequency, etc. The present invention uses a high-speed I/O interface circuit to connect the main controller with the laser, and uses D/A conversion to complete the functions of setting parameters and controlling the laser switch. The A/D conversion can monitor the state of the laser in real time and record the actual pulse total of the laser. number and total duration of action.

The upper part of the main bracket is provided with a cantilever, and one end of the cantilever is provided with a suspended surgical treatment head, the main support and the cantilever support the suspended suspended surgical treatment head, and the suspended surgical treatment head maintains a treatment state or moves freely at the end of the cantilever.

The suspended surgical treatment head is suspended on the cantilever of the main bracket. The main bracket and the cantilever not only keep the suspension and support the suspended surgical treatment head in the best treatment position, but also can move freely up, down, left, right, front and back during the operation , so that the hanging surgical treatment head is always in the best treatment state.

A microscopic observation system and a microscopic observation mirror are installed on the upper part of the suspended surgical treatment head, and a CCD camera is installed on one side of the suspended surgical treatment head. The received images and spectra are transmitted to the main controller.

The lower part of the suspended surgical treatment head is provided with a microsurgery adapter, the adapter input port of the microsurgery adapter is connected to the laser, and one side of the suspended surgical treatment head is provided with a light source interface, and the light source output end of the light source device is connected to the light source through the light source interface for lighting operations. parts.

The microscopic observation system, microscopic observation mirror, microsurgical adapter and CCD camera are placed on the suspended surgical treatment head. The laser, light source equipment and main controller are all connected to each other through lines, and the suspended surgical treatment head becomes the center of treatment.

An optical lens group is arranged in the suspension operation treatment head, the optical lens group forms an optical path, and a microscopic observation system, a microscopic observation mirror, a CCD camera and a microsurgical adapter are formed as a whole through the optical lens group.

The micro-observation system, micro-observation mirror, CCD camera and micro-surgical adapter set on the suspended surgical treatment head are organically connected as a whole through the optical lens group. The micro-observation system, micro-observation mirror, CCD camera and microscope The microsurgical adapters are respectively in the corresponding positions of the optical lens group.

The foot switch is connected to the main controller, and the on-off foot switch manually controls the start and stop of the laser through the main controller. When a sudden change occurs during the operation, turn off the foot switch to immediately turn off the laser, and turn on the foot switch when the sudden change is over. , resume working status.

The operation of the foot switch is manually controlled, and the doctor turns off the laser after making a subjective judgment according to the operation situation. When it is necessary to continue the operation, turn on the foot switch to resume the working state. In addition, there are two ways to turn off the laser. One is the "operation end" button on the main controller, which is controlled by the operator and is an added precautionary measure to protect personal safety in case of emergency; Image and spectrum of tissue and normal tissue-threshold control, which belongs to the automatic control method. When any one of these three measures is active, the laser will be turned off, and these three measures do not conflict with each other, thus increasing the safety of the overall system.

It is composed of a main controller, a display, an image acquisition head, a laser, a light source device and an endoscope. The display is connected to the display connection port of the main controller. A general-purpose display or a touch screen display is used as the display of the main controller. The display immediately displays the CCD The image and spectrum of the lesion tissue and normal tissue collected by the camera, and the surgical parameters are displayed on the monitor.

The present invention mainly consists of a main controller, a display, a CCD camera, a laser, a light source device, a main bracket, a cantilever, a suspending surgical treatment head, a microscopic observation system, a microsurgical adapter, an image acquisition card, an interface circuit between a laser and a microcomputer, a pulse It is composed of several parts such as laser, pointing light laser, microcomputer and software system. The monitor displays the images and spectra collected by the CCD camera in real time, as well as the operation parameters and the operation instructions issued by the main controller, which is convenient for doctors to observe and treat. The image and spectrum of the lesion tissue and normal tissue, the energy of the laser output light, the operation parameters, the size of the light spot and the graph of lesion tissue resection are fully displayed on the monitor. The invention treats diseases of esophageal cancer, gastric cancer and rectal polyps.

The upper part of the endoscope is provided with a biopsy port, air hole, water hole, light source interface and endoscope data port. The biopsy port, air hole, water hole and light source interface are connected from the upper part of the endoscope to the observation and treatment end. The part constitutes the biopsy port, the stomata port, the water hole port and the light source head. The waste gas generated after being vaporized by the surgical lesion tissue is discharged through the stomata port. Exhaust, the light source output port of the light source device is transmitted to the light source head of the observation and treatment port by the fiber bundle through the light source interface of the endoscope. At least 3 light source heads are arranged on the observation and treatment port, and the light source head illuminates the surgical site.

The image acquisition head of the CCD camera is set at the observation and treatment end of the endoscope, and the endoscope data port set on the upper part of the endoscope is connected to the data information interface of the main controller through a line and connected to the image card of the main controller , the image acquisition head of the CCD camera collects images and spectra of the lesion tissue and normal tissue, and the main controller recognizes and processes the images and spectra of the lesion tissue and normal tissue collected by the CCD camera, and issues instructions accordingly to control the operation of the laser to avoid laser Surgical misoperation damages normal tissue and leads to surgical errors.

The laser output port of the laser is connected to the optical fiber, the optical fiber is inserted from the biopsy port of the endoscope, the end of the optical fiber reaches the biopsy port at the observation treatment port, and the therapeutic laser is transmitted. The therapeutic laser adopts the pulse working mode Gas laser or solid laser or semiconductor laser or fiber laser, pulse width: 250μs-100ms, energy density: 5-20J/cm ² , pulse frequency: <200Hz.

The laser control connection port of the laser is connected with the control laser connection port of the main controller through a line, and the main controller sends instructions to control the start-up and shutdown of the laser and correct the laser output.

The foot switch is connected to the main controller, and the on-off foot switch manually controls the start and stop of the laser through the main controller. When a sudden change occurs during the operation, turn off the foot switch to immediately turn off the laser, and turn on the foot switch when the sudden change is over. , resume working status.

After the preoperative preparation, turn on the main controller, monitor, CCD camera and light source equipment, adjust the cantilever on the main bracket and suspend the surgical treatment head, the treatment end enters the operation area, and align the microsurgical adapter on the suspended surgical treatment head with the operating area. parts.

The present invention mainly consists of a main controller, a display, a CCD camera, a laser, a light source device, a main bracket, a cantilever, a suspending surgical treatment head, a microscopic observation system, a microsurgical adapter, an image acquisition card, an interface circuit between a laser and a microcomputer, a pulse It is composed of several parts such as laser, pointing light laser, microcomputer and software system. Using Visual C for programming, the system software can be divided into three parts according to functions - CCD control and image processing part, laser control part and case management database. The invention treats eye diseases such as glaucoma, presbyopia and myopia in ophthalmology.

Through the microscopic observation system and the images and spectra displayed on the display on the suspending surgical treatment head, observe the lesion tissue and normal tissue at the surgical site, the main controller identifies and confirms the image and spectrum of the lesion tissue and normal tissue, and connects the microsurgical adapter Lock the lesion tissue site.

In laser surgery, the operation volume is generally controlled manually, and the doctor observes the depth of laser resection in real time. The control method has a great influence, and it is difficult to accurately control the operation volume. In order to meet higher requirements, the feedback control method-area array CCD is used to monitor the light reflection intensity and color changes of the tissue at the laser perforation site in real time. It has a variety of control methods, adjustable parameters, and a system for surgery.

Turn on the laser, the main controller corrects the surgical parameters of the laser, adjusts the output power of the laser, and the laser is ready to turn on and emit light.

When the present invention starts to work, click the "start operation" button, and the information box "please select the operation site" will pop up automatically on the display, click the pointing light laser point in the image with the mouse, and draw a 52×52 pixel automatically with this point as the center The box indicates that the pixel points in the box will be taken as the data for threshold judgment, and after pressing the "OK" button, wait for the signal of the doctor to turn on the machine.

Lock the lesion tissue, the main controller sends out the operation command of "starting up", the laser is turned on and emits light, and the laser outputs therapeutic laser. The laser treatment laser cuts or vaporizes the lesion tissue at the surgical site. Or semiconductor laser or fiber laser, pulse width: 250μs-100ms, energy density: 5-20J/cm ² , pulse frequency: <200Hz.

The CCD camera always feeds back the captured images and spectra to the main controller, and the monitor always displays the images and spectra captured by the CCD camera. The main controller monitors the changes of the captured images and spectra at any time, and issues operation instructions to the laser in time. Shut down or start up or correct the output of the laser.

The selection of laser parameters has a direct impact on the effect of the operation. In laser sclerectomy through the external route, the selection of laser parameters should follow three principles: minimal thermal and mechanical damage; precise control of surgical volume; high resection efficiency, The operation time is less. The mid-to-far infrared laser with short pulse output is suitable for glaucoma filtration surgery due to its superficial thermal effect, less damage, and less surgical bleeding. Among them, the laser has a strong hemostatic function when removing tissue, and the damage to the surrounding tissue is small during the removal, so it is suitable for external laser resection. Continuous wave lasers and pulsed lasers interact with eye tissue differently, and using short pulsed lasers to limit thermal diffusion is one way to reduce thermal damage.

The foot switch is connected with the main controller, and the on-off foot switch controls the laser on and off through the main controller.

The operation of the foot switch is manually controlled, and the doctor turns off the laser after making a subjective judgment according to the operation situation. When it is necessary to continue the operation, turn on the foot switch to resume the working state.

When the image and spectrum of the lesion tissue disappear, the CCD camera will capture the image and spectrum of the normal tissue and feed it back to the main controller. The main controller monitors the appearance of the image and spectrum of the normal tissue, and immediately issues a "stop" operation command to the laser , the laser receives the "shutdown" operation command, and stops outputting laser light before sending out the next pulse laser, without damaging normal tissues.

The main controller of the present invention can be preset or can be changed at any time according to the needs during the operation. The operation parameters include: continuous wave output power, irradiation time, pulse wave output energy, pulse width and frequency, etc. The invention can monitor the state of the laser in real time, and record the total number of actual pulses and the total action time of the laser.

Adjust the cantilever on the main bracket and the suspending surgical treatment head to find the lesion tissue at the surgical site, align the microsurgical adapter on the suspending surgical treatment head with the lesion tissue at the surgical site, and the main controller identifies and confirms the difference between the lesion tissue and the normal tissue. The image and spectrum lock the lesion tissue, the main controller issues an operation command, the laser turns on and emits light, the laser outputs a therapeutic laser, the therapeutic laser cuts or vaporizes the lesion tissue at the surgical site, and reciprocates until the lesion tissue at the surgical site is completely eliminated.

When a part of the lesion tissue at the surgical site is eliminated, continue to treat the other part of the lesion tissue, adjust the treatment position of the suspended surgical treatment head, lock it and continue the treatment until the lesion tissue is completely eliminated, and the operation is over.

When the lesion tissue at the surgical site is completely eliminated, turn off the laser and stop outputting the therapeutic laser; observe the normal tissue and lesion tissue at the surgical site through the microscopic observation system on the suspending surgical treatment head and the image displayed on the monitor, and the main controller confirms that the surgical site is completely eliminated After the lesion is organized, move the cantilever on the main frame and the suspending surgical treatment head, and move the microsurgical adapter on the suspending surgical treatment head away from the operation site.

Turn off the main controller, monitor, CCD camera and light source, and the operation is over.

The foot switch is connected to the main controller. When there is a sudden change in the operation, the foot switch is turned off, and the foot switch turns off the laser through the main controller. The laser stops immediately and stops outputting therapeutic laser;

When the accident is over, turn on the foot switch, and the laser will resume working.

Once a sudden change occurs, the main controller does not issue an operation command to turn off the laser, and the operation is not over yet, the doctor can use the foot switch, the operation of the foot switch is controlled manually, and the doctor makes a subjective judgment based on the operation situation. Turn off the laser; when the sudden change eliminates the need to continue the operation, turn on the foot switch to resume the working state.

After preoperative preparation, turn on the main controller, display, light source equipment and CCD camera, turn on the light source equipment to observe the light source head of the treatment port to illuminate the surgical site, and the observation and treatment end of the endoscope enters the surgical area and aligns with the surgical site.

The present invention is mainly made up of main controller, laser device, display, endoscope light source, endoscope and foot switch, the connection of laser device and main controller is to connect through A/D card and data line, the connection between main controller and display The connection is through the signal line of the display adapter, the connection between the main controller and the endoscope is through a set of data lines, and the connection between the light source device and the endoscope is through the line to connect with the light source interface of the endoscope. The invention treats the diseases of nasal polyps, laryngeal cancer, esophageal cancer, gastric cancer and rectal polyps.

The laser output port of the laser is connected to the optical fiber, the optical fiber is inserted from the biopsy port of the endoscope, the end of the optical fiber reaches the biopsy port at the observation and treatment port, and light is emitted from the observation and treatment port to treat the lesion.

Aim the observation and treatment port of the endoscope at the surgical site, display the image and spectrum of the surgical site on the monitor, observe the lesion tissue and normal tissue at the surgical site, and the main controller identifies and confirms the image and spectrum of the lesion tissue and normal tissue.

Correct the surgical parameters through the main controller, adjust the output power of the laser, and the laser is ready to start and emit light.

Lock the lesion tissue, the main controller sends out operation instructions, the laser is turned on and emits light, the laser outputs therapeutic laser, the therapeutic laser cuts or vaporizes the lesion tissue at the surgical site, and the therapeutic laser adopts a gas laser or a solid laser or a semiconductor laser in a pulsed working mode. Or fiber laser, pulse width: 250μs-100ms, energy density: 5-20J/cm ² , pulse frequency: <200Hz.

The CCD camera always feeds back the captured images and spectra to the main controller, and the monitor always displays the images and spectra captured by the CCD camera. The main controller monitors the changes of the captured images and spectra at any time, and issues operation instructions to the laser in time. Shut down or start up or correct the output of the laser.

During the operation, the waste gas produced by the vaporization of the operated lesion tissue is discharged from the stomata through the stomata port, and the tissue fluid and moisture generated in the operated part during the operation are discharged from the water hole through the water hole port.

When the image and spectrum of the lesion tissue disappear, the CCD camera will capture the image and spectrum of the normal tissue and feed it back to the main controller. The main controller monitors the appearance of the image and spectrum of the normal tissue, and immediately issues a "stop" operation command to the laser , the laser receives the "shutdown" operation command, and stops outputting laser light before sending out the next pulse laser, without damaging normal tissues.

Adjust the observation and treatment port of the endoscope to find the lesion tissue at the surgical site, align the observation and treatment port of the endoscope with the lesion tissue at the surgical site, the main controller identifies and confirms the images and spectra of the lesion tissue and normal tissue, and locks the lesion Tissue, the main controller sends out operation instructions, the laser is turned on to emit light, the laser outputs therapeutic laser, the therapeutic laser cuts or vaporizes the lesion tissue at the surgical site, and reciprocates until the lesion tissue at the surgical site is completely eliminated.

When the lesion tissue at the surgical site is completely eliminated, turn off the laser and stop outputting the therapeutic laser.

Observe the normal tissue and lesion tissue of the surgical site through the image displayed on the monitor. After the main controller confirms that the surgical site has completely eliminated the lesion tissue, the observation and treatment port of the endoscope exits the surgical site, and the main controller, monitor, CCD camera and light source equipment are turned off. , the operation is over.

The foot switch is connected with the main controller. When there is a sudden change in the operation, the foot switch is turned off, and the foot switch turns off the laser through the main controller. The laser stops immediately and stops outputting therapeutic laser light.

When the accident is over, turn on the foot switch, and the laser will resume working.

In order to explore the feasibility and effect of laser surgery, and compare it with traditional trabeculectomy, the present invention implements animal experiments.

Experimental Materials

1. Animals: 30 healthy adult white rabbits of the Japanese big-eared white rabbit species provided by the Experimental Animal Center of Tianjin Medical University, weighing 1.8-2.9 kg. Male and female are half and half, and they are fed in separate cages.

2. Laser: laser surgery instrument

3. Tonometer: Perkins applanation tonometer

4. Ophthalmic Microsurgery Magnifiers and Surgical Instruments

experimental method

1. Divide 30 white rabbits into two groups according to the left and right eyes. The right eye is the experimental group, which uses CO ₂ laser surgery system to perform laser sclerectomy combined with iridectomy; the left eye is the control group, which undergoes traditional trabeculectomy. The preoperative intraocular pressure of both eyes has been measured before, and there is no significant difference by statistical test.

2. Apply 0.25% chloramphenicol eye drops and 0.5% cortisone eye drops to both eyes three days after operation, 3 times a day. The intraocular pressure, filtering bleb, cornea, anterior chamber, iris and lens were collected and recorded before operation and on the 1st, 2nd, 3rd, 7th, 14th, and 28th day after operation.

Experimental results

1. Anterior segment inspection:

The anterior chamber reaction in the experimental group was mild, and the anterior chamber reaction completely disappeared 3 days after the operation, while the control group recovered completely after 28 days, indicating that the impact of traditional surgery on the anterior chamber is far greater than that of laser surgery on the anterior chamber, and the anterior chamber recovery slow.

2. Filter bleb analysis

The postoperative distribution of the number of filtering blebs at various levels in the experimental group and the control group was tested by a rank sum test. The comparison results of postoperative 3 days and postoperative 28 days, P<0.01, the difference was statistically significant, and the experimental group was obviously superior. Compared with the control group; the comparison result of 7 days after operation, P<0.05, the difference is statistically significant, the experimental group is better than the control group; the comparison result of 14 days after operation, P>0.05, there is no statistically significant difference. This indicated that the filtering bleb function of the experimental group and the control group had significant differences most of the time, and the experimental group was better than the control group.

3. Changes in intraocular pressure

The results of comparison between the two groups at 1 day, 2 days, 3 days, and 7 days after operation, P<0.01, have significant differences. During this period, the average intraocular pressure of the control group was lower than that of the experimental group. 14 days after the comparison of the results, P> 0.05, no significant difference. On the 28th day, the average intraocular pressure of the experimental group was lower than that of the control group (P<0.01). That is to say, in a short period of time after the operation, the average intraocular pressure of the control group was lower than that of the experimental group, and then the average intraocular pressure of the two groups tended to be the same. By 28 days, the average intraocular pressure of the experimental group was lower than that of the control group.

The experimental results show that compared with the traditional mechanical trabeculectomy, laser sclerectomy combined with iridectomy has obvious advantages: the operation method is simple, easy to control the operation, and the operation time is short; the operation volume can be precisely controlled to meet the operation requirements ; Mild anterior chamber reaction, no hemorrhage; good functional filtering bleb formed; stable and long-lasting drop in intraocular pressure; regular pores, complete epithelial tissue covering, and good healing of the pores; tissue inflammation and fibrosis around the pores lighter.

The present invention is a self-controlled laser surgery device. The structure is simple, the design is reasonable, the production is simple, and the operation is simple and easy to master. During the operation, the lesion tissue is eliminated while the normal tissue is not damaged. It has a variety of control methods, adjustable parameters, and wide application. It can precisely control the operation volume and improve the treatment effect. It can be widely used in the treatment of surgery, internal medicine, ENT and ophthalmic diseases. It can monitor the operation process in real time and adjust the parameters. It can accurately control the operation volume and reduce the damage to the tissues around the hole, and the operation effect is ideal.

A variety of output modes can be selected, including continuous wave, single pulse, multi-pulse, composite pulse, etc. Continuous wave output power, irradiation time, pulse wave output energy, pulse width and frequency and other parameters can be preset and changed at any time as needed; continuous laser irradiation time or the total number of pulsed laser pulses can be controlled manually or automatically fed back control, and can display the results immediately after the operation; the adjustment knob made of software adjusts various parameters of the laser through the interface circuit. Compared with analog adjustment, it has the advantages of convenient adjustment, intuitive, accurate adjustment, and reliability; The device monitors the operation process in real time, and can detect the cut-through of the filter hole in time, and feedback controls the laser to turn off, effectively preventing the laser from over-injury; it can record the operation process in real time to facilitate the management of patient data. The medical records management database system can not only record pre-operative and post-operative image data, but also provide doctors and patients to search at any time; It is the injury of deep tissue, which adopts two control methods. One is the active control method, and the other is the feedback control method. The former is based on the analysis of the characteristics of the tissue to be resected, and after a large number of repeated experiments, the optimal control parameters are summarized, and automatic control is realized through a preset program. The latter method uses a camera device to detect changes in the brightness and color of the cut hole in real time. Experiments have found that hole cutting is often accompanied by sudden changes in light intensity and color. Timely detection of this sudden change and feedback control of laser shutdown can effectively prevent laser damage; the red laser in the visible light band is used as a guide light, and the feedback control It is necessary to detect the change of the light intensity or color when the hole is cut through. In order to avoid the interference of the red guide light on the detection, two methods are adopted: one is to use a laser other than red as the guide light, and the other is to use the main controller to control the timely Automatically turns off the guide light.

Description of drawings

The present invention will be described in detail below in conjunction with the accompanying drawings and embodiments.

Figure 1 Schematic diagram of self-controlled laser surgery equipment

Fig. 2 Schematic diagram of partial cutaway of self-controlled laser surgery equipment

Figure 3 Schematic diagram of self-controlled laser surgery equipment

Figure 4 Schematic diagram of the endoscope (A) and observation treatment end (B) of the self-controlled laser surgery equipment

Fig. 5 Schematic block diagram of the treatment method of the self-controlled laser surgery equipment

1 main bracket, 2 cantilever, 3 suspended surgical treatment head, 4 microscopic observation system, 5 microscopic observation mirror, 6 microsurgical adapter, 7 light source interface, 8CCD camera, 9 laser, 10 main controller, 11 display, 12 Foot switch, 13 camera output port, 14 adapter input port, 15 optical lens group, 16 endoscope, 17 laser output port, 18 laser control connection port, 19 biopsy port, 20 air hole, 21 water port, 22 observation and treatment end , 23 endoscope data port, 24 light source head, 25 image acquisition head, 26 air hole port, 27 water hole port, 28 biopsy port, 29 light source device, 30 light source output port, 31 control laser connection port, 32 data information interface , 33 monitor connection ports

Detailed ways

Example 1

It consists of a main controller (10), a display (11), a CCD camera (8), a laser (9), a light source device (29), a main support (1), a cantilever (2), a suspension surgical treatment head (3), a display It consists of a micro-observation system (4) and a micro-surgery adapter (6).

The camera output terminal (13) of the CCD camera (8) is connected with the main controller (10) by the line, and the laser control connection port (18) of the laser device (9) is connected with the main controller (10) by the line, and the laser device ( 9) the laser output port (17) is connected with the adapter input port (14) of the microsurgical adapter (6) through the optical fiber wire, and the image and spectrum of the lesion tissue and normal tissue are collected by the CCD camera (8) and output through the camera. Terminal (13) is transmitted to main controller (10).

The main controller (10) recognizes and processes the images and spectra of the lesion tissue and normal tissue collected by the CCD camera (8), and sends instructions accordingly to control the operation of the laser (9), so as to avoid damage to normal tissue caused by misoperation of laser surgery and cause surgery mistakes.

Display (11) is connected with the display connection port (33) of main controller (10), adopts display screen or touch screen as the display (11) of main controller (10), and display (11) shows CCD camera (8) immediately The images and spectra of the collected lesion tissue and normal tissue are displayed, and the operation parameters are displayed on the monitor (11).

The laser output port (17) of the laser (9) is connected to the adapter input port (14) of the microsurgical adapter (6) through an optical fiber or a light guide arm to transmit therapeutic laser light. The therapeutic laser (9) adopts pulsed Working mode of gas laser or solid laser or semiconductor laser or fiber laser, pulse width: 250μs ~ 100ms, energy density: 5 ~ 20J/cm ² , pulse frequency: <200Hz.

The laser control connection port (18) of the laser device (9) is connected with the control laser connection port (31) of the main controller (10) by a line, and the main controller (10) sends instructions to control the start-up, shutdown and shutdown of the laser device (9). Correct the laser output.

The upper part of the main support (1) is provided with a cantilever (2), and one end of the cantilever (2) is provided with a suspended surgical treatment head (3), and the main support (1) and the cantilever (2) support the suspended suspension surgical treatment head (3), The suspended surgical treatment head (3) maintains a treatment state or moves freely at the end of the cantilever (2).

A microscopic observation system (4) and a microscopic observation mirror (5) are arranged on the top of the suspended surgical treatment head (3), and a CCD camera (8) is set on one side of the suspended surgical treatment head (3), and the camera of the CCD camera (8) The output terminal (13) is connected with the data information interface (32) of the main controller (10) through a line, and the captured images and spectra are transmitted to the main controller (10) in real time.

A microsurgical adapter (6) is arranged on the lower part of the suspending surgical treatment head (3), and the adapter input port (14) of the microsurgical adapter (6) is connected with the laser (9), and one side of the suspended surgical treatment head (3) A light source interface (7) is provided, and the light source output terminal (30) of the light source device (29) is connected to a light source to illuminate the surgical site through the light source interface (7).

The optical lens group (15) is set in the suspension operation treatment head (3), and the optical lens group (15) forms an optical path, and the microscopic observation system (4), the microscopic observation mirror (5), The CCD camera (8) and the microsurgical adapter (6) form a whole.

The foot switch (12) is connected with the main controller (10), and the opening and closing foot switch (12) manually controls the start and stop of the laser (9) through the main controller (10). The foot switch (12) turns off the laser (9) at once, and the sudden change ends and the foot switch (12) is turned on to resume the working state, as shown in Fig. 1 and Fig. 2 .

Example 2

Composed of a main controller (10), a display (11), an image acquisition head (25), a laser (9), a light source device (29) and an endoscope (16), the display (11) and the main controller (10) The monitor connection port (33) is connected, and a general-purpose monitor or a touch screen monitor is used as the monitor (11) of the main controller (10), and the monitor (11) immediately displays the images of the lesion tissue and normal tissue collected by the CCD camera (8) And spectrum, display operation parameter on the monitor (11) simultaneously.

The top of endoscope (16) is provided with biopsy port (19), air hole (20), water hole (21), light source interface (7) and endoscope data port (23), biopsy port (19), air hole (20 ), the water hole (21) and the light source interface (7) are penetrated from the upper part of the endoscope (16) to the observation and treatment end (22), and the biopsy port (28) and stomata port are formed at the observation and treatment end (22) (26), the water hole port (27) and the light source head (24), the waste gas produced after being vaporized by the surgical lesion tissue is discharged from the stomata (20) through the stomata port (26), and the tissue liquid and moisture produced by the surgical site during the operation Discharged from the water hole (21) through the water hole port (27), the light source output port (30) of the light source device (29) is transmitted to the observation treatment port (22) by the optical fiber bundle through the light source interface (7) of the endoscope (16) ), at least three light source heads (24) are arranged on the observation treatment port (22), and the light source head (24) illuminates the surgical site.

The observation and treatment end portion (22) of the endoscope (16) is provided with the image acquisition head (25) of the CCD camera (8), and the endoscope data port (23) provided on the top of the endoscope (16) is connected with the host through the line. The data information interface (32) of the controller (10) is connected and connected with the image card of the main controller (1), and the image and spectrum of the image acquisition head (25) of the CCD camera (8) collects lesion tissue and normal tissue , the main controller (10) recognizes and processes the images and spectra of the lesion tissue and normal tissue collected by the CCD camera (8), and correspondingly issues instructions to control the operation of the laser (9), so as to avoid damage to normal tissue caused by misoperation of laser surgery. Surgical error.

The laser output port (17) of the laser (9) is connected to the optical fiber, the optical fiber is inserted from the biopsy port (19) of the endoscope (16), and the end of the optical fiber reaches the biopsy port at the observation treatment port (22) (28) Transmission of therapeutic lasers. The therapeutic lasers are gas lasers or solid-state lasers or semiconductor lasers or fiber lasers in a pulsed working mode. Pulse width: 250μs-100ms, energy density: 5-20J/cm ² , pulse frequency: <200Hz.

The laser control connection port (18) of the laser device (9) is connected with the control laser connection port (31) of the main controller (10) by a line, and the main controller (10) sends instructions to control the start-up, shutdown and shutdown of the laser device (9). Correct the laser output.

The foot switch (12) is connected with the main controller (10), and the opening and closing foot switch (12) manually controls the start and stop of the laser (9) through the main controller (10). The foot switch (12) turns off the laser (9) at once, and the sudden change ends and the foot switch (12) is turned on to resume the working state, as shown in Fig. 3 and Fig. 4 .

Example 3

After the preoperative preparation, turn on the main controller (10), monitor (11), CCD camera (8) and light source equipment (29), adjust the cantilever (2) on the main bracket (1) and suspend the surgical treatment head (3) , the treatment end enters the operation area, and the microsurgical adapter (6) on the suspended operation treatment head (3) is aligned with the operation site.

By suspending the images and spectra displayed by the microscopic observation system (4) and the monitor (11) on the surgical treatment head (3), observe the lesion tissue and normal tissue at the surgical site, and the main controller (10) identifies and confirms the lesion tissue and the normal tissue. For images and spectra of normal tissues, lock the microsurgical adapter (6) on the lesion tissue site.

Turn on the laser (9), the main controller (10) corrects the surgical parameters of the laser (9), adjusts the output power of the laser (9), and the laser (9) is ready to start up and emit light.

Lock the lesion tissue, the main controller sends out the operation command of "starting up", the laser (9) starts to emit light, the laser (9) outputs the treatment laser, the treatment laser (9) cuts or vaporizes the lesion tissue of the surgical site, and the treatment laser adopts pulse Gas laser or solid-state laser or semiconductor laser or fiber laser with working mode, pulse width: 250μs-100ms, energy density: 5-20J/cm ² , pulse frequency: <200Hz.

CCD camera (8) feeds back the captured image and spectrum to main controller (10) all the time, and display (11) shows the image and spectrum captured by CCD camera (8) all the time, and main controller (10) monitors and captures at any time changes in the image and spectrum of the laser, and issue an operation command to the laser (9) in time, stop or start up or correct the output of the laser.

The foot switch (12) is connected with the master controller (10), and the on-off foot switch (12) controls the start-up and shutdown of the laser (9) by the master controller (10).

When the image and spectrum of the lesion tissue disappear, the CCD camera (8) will capture the image and spectrum of the normal tissue and feed it back to the main controller (10), and the main controller (10) will monitor the appearance of the image and spectrum of the normal tissue. The laser (9) is instructed to "shut down" operation, and the laser (9) receives the "shutdown" operation instruction, and stops outputting laser light before sending out the next pulse laser, without damaging normal tissues.

Adjust the cantilever (2) and the suspended surgical treatment head (3) on the main support (1), find the lesion tissue of the surgical site, and align the microsurgical adapter (6) on the suspended surgical treatment head (3) with the surface of the surgical site. For the lesion tissue, the main controller (10) identifies and confirms the image and spectrum of the lesion tissue and normal tissue, locks the lesion tissue, the main controller issues an operation command, the laser (9) turns on and emits light, and the laser (9) outputs a therapeutic laser, and the laser ( 9) The treatment of laser cutting or vaporizing the lesion tissue at the operation site, reciprocating cycle until the lesion tissue at the operation site is completely eliminated.

When the lesion tissue at the surgical site is completely eliminated, turn off the laser (9) to stop outputting the therapeutic laser; observe the normal tissue at the surgical site through the images displayed by the microscopic observation system (4) and the monitor (11) suspended on the surgical treatment head (3) and focus tissue, after the main controller (10) confirms that the operation site completely eliminates the focus tissue, it moves the cantilever (2) on the main support (1) and the suspending surgical treatment head (3), and puts the suspension arm (2) on the surgical treatment head (3) The microsurgical adapter (6) moves away from the surgical site.

Turn off the main controller (10), display (11), CCD camera (8) and light source, and the operation ends, as shown in Figure 1, Figure 2, and Figure 5.

Example 4

The foot switch (12) is connected with the main controller (10). When a sudden change occurs during the operation, the foot switch (12) is turned off, and the foot switch (12) turns off the laser (9) through the main controller (10). , the laser (9) shuts down immediately, and stops outputting the therapeutic laser;

When the sudden change ends, the foot switch (12) is turned on, and the laser (9) returns to the working state, as shown in Fig. 1 and Fig. 5 .

Example 5

After the preoperative preparation, turn on the main controller (10), display (11), light source device (29) and CCD camera (8), and turn on the light source device (29) to observe the three light source heads (24) of the treatment port (22) The site of the illumination operation is illuminated, and the observation and treatment end (22) of the endoscope (16) enters the operation area and is aimed at the operation site.

The laser output port (17) of the laser (9) is connected to the optical fiber, the optical fiber is inserted from the biopsy port (19) of the endoscope (16), and the end of the optical fiber reaches the biopsy port at the observation treatment port (22) (28), emit light at the observation treatment port (22) to treat the lesion.

Align the observation and treatment port (22) of the endoscope (16) at the surgical site, display images and spectra of the surgical site through the monitor (11), observe the lesion tissue and normal tissue at the surgical site, and the main controller (10) recognizes, Confirm images and spectra of lesion and normal tissue.

The operation parameters are corrected by the main controller (10), the output power of the laser (9) is adjusted, and the laser (9) is ready to be turned on to emit light.

The lesion tissue is locked, the main controller issues an operation command, the laser (9) is turned on and emits light, and the laser (9) outputs a therapeutic laser. The therapeutic laser (9) cuts or vaporizes the lesion tissue at the surgical site, and the therapeutic laser adopts a pulsed working mode Gas laser or solid laser or semiconductor laser or fiber laser, pulse width: 250μs-100ms, energy density: 5-20J/cm ² , pulse frequency: <200Hz.

CCD camera (8) feeds back the captured image and spectrum to main controller (10) all the time, and display (11) shows the image and spectrum captured by CCD camera (8) all the time, and main controller (10) monitors and captures at any time changes in the image and spectrum of the laser, and issue an operation command to the laser (9) in time, stop or start up or correct the output of the laser.

During the operation, the waste gas produced by the vaporization of the operated lesion tissue passes through the stomata port (26) and is discharged from the stomata (20), and the tissue liquid and moisture generated at the operated site pass through the water hole port (27) through the water hole. (21) DISCHARGE.

When the image and spectrum of the lesion tissue disappear, the CCD camera (8) will capture the image and spectrum of the normal tissue and feed it back to the main controller (10), and the main controller (10) will monitor the appearance of the image and spectrum of the normal tissue. The laser (9) is instructed to "shut down" operation, and the laser (9) receives the "shutdown" operation instruction, and stops outputting laser light before sending out the next pulse laser, without damaging normal tissues.

Adjust the observation and treatment port (22) of the endoscope (16), find the lesion tissue of the surgical site, align the observation and treatment port (22) of the endoscope (16) with the focus tissue of the surgical site, and the main controller (10) Identify and confirm the image and spectrum of the lesion tissue and normal tissue, lock the lesion tissue, the main controller issues an operation instruction, the laser (9) turns on and emits light, the laser (9) outputs therapeutic laser, and the therapeutic laser cutting or vaporization surgery of the laser (9) The lesion tissue at the surgical site is reciprocated until the focal tissue at the surgical site is completely eliminated.

When the lesion tissue at the operation site is completely eliminated, the laser (9) is turned off to stop outputting the therapeutic laser.

Observe the normal tissue and the lesion tissue of the operation site through the image displayed on the monitor (11), after the master controller (10) confirms that the operation site has completely eliminated the focus tissue, the observation and treatment port (22) of the endoscope (16) withdraws from the operation site, Close main controller (10), display (11), CCD camera (8) and light source equipment (29), operation finishes, as shown in Fig. 3, Fig. 4, Fig. 5.

Example 6

The foot switch (12) is connected with the main controller (10). When a sudden change occurs during the operation, the foot switch (12) is turned off, and the foot switch (12) turns off the laser (9) through the main controller (10). , the laser (9) shuts down immediately, and stops outputting the therapeutic laser.

When the sudden change ends, the foot switch (12) is turned on, and the laser (9) returns to the working state, as shown in Fig. 3 and Fig. 5 .

Example 7

After the preoperative preparation, start the machine, the observation treatment port (22) of the endoscope (16) enters the nasal cavity, aligns with the surgical site—nasal polyps, and the CCD camera (8) captures images and images of the lesion tissue and normal tissue at the surgical site in real time. Spectrum, the main controller (10) identifies and confirms the image and spectrum of the lesion tissue and normal tissue, the main controller (10) corrects the surgical parameters of the laser (9), and the laser (9) is ready to emit light; lock the lesion tissue of the nasal polyp, The main controller (10) sends out operation instructions, the laser (9) emits light, and the main controller (10) monitors the CCD camera (13) at any time to capture the image and spectrum of the lesion tissue and normal tissue at the surgical site. disappear, the main controller (10) immediately instructs the laser (9) to shut down; look for the focal tissue of nasal polyps at the surgical site in the nasal cavity, find the focal tissue of nasal polyps at the surgical site in the nasal cavity, and use the observation of the endoscope (16) The treatment port (22) is aligned with the lesion tissue at the surgical site, the main controller (10) identifies and confirms the images and spectra of the lesion tissue and normal tissue, locks the lesion tissue, the main controller issues an operation command, and the laser (9) starts to emit light. The laser (9) outputs therapeutic laser, and the therapeutic laser of the laser (9) cuts or vaporizes the lesion tissue at the operation site, and reciprocates until the lesion tissue at the operation site is completely eliminated.

When the lesion tissue at the operation site is completely eliminated, the laser (9) is turned off to stop outputting the therapeutic laser. Observe the normal tissue and lesion tissue of the surgical site through the image displayed on the monitor (11), and after the main controller (10) confirms that the surgical site has completely eliminated the focal tissue of the nasal polyps, the observation treatment port (22) of the endoscope (16) exits Nasal cavity, close master controller (10), display (11), CCD camera (8) and light source equipment (29), operation finishes, as shown in Fig. 3, Fig. 4, Fig. 5.

Example 8

After the preoperative preparation, turn on the machine, the observation and treatment port (22) of the endoscope (16) enters the oral cavity, and aligns with the surgical site - laryngeal cancer, and the CCD camera (8) captures the images and spectra of the lesion tissue and normal tissue at the surgical site in real time , the main controller (10) identifies and confirms the images and spectra of the lesion tissue and normal tissue, the main controller (10) corrects the surgical parameters of the laser (9), and the laser (9) is ready to emit light; the lesion tissue of laryngeal cancer is locked, and the main The controller (10) sends out operation instructions, the laser (9) emits light, and the main controller (10) monitors the CCD camera (13) at any time to capture images and spectra of the lesion tissue and normal tissue at the surgical site, and the image and spectrum of the lesion tissue disappear , the main controller (10) immediately instructs the laser (9) to shut down; look for the lesion tissue of laryngeal cancer at the surgical site in the oral cavity, find the lesion tissue of laryngeal cancer at the surgical site in the oral cavity, and use the observation and treatment of the endoscope (16) The port (22) is aligned with the lesion tissue at the surgical site, the main controller (10) identifies and confirms the image and spectrum of the lesion tissue and normal tissue, locks the lesion tissue of laryngeal cancer, the main controller issues an operation command, and the laser (9) is turned on Light is emitted, and the laser (9) outputs a therapeutic laser. The therapeutic laser of the laser (9) cuts or vaporizes the lesion tissue at the operation site, and reciprocates until the laryngeal cancer focus tissue at the operation site is completely eliminated.

When the lesion tissue at the operation site is completely eliminated, the laser (9) is turned off to stop outputting the therapeutic laser. Observe the normal tissue and lesion tissue of the operation site through the image displayed on the monitor (11), and after the main controller (10) confirms that the lesion tissue of the laryngeal cancer is completely eliminated in the operation site, the observation treatment port (22) of the endoscope (16) exits Oral cavity, close master controller (10), display (11), CCD camera (8) and light source equipment (29), operation finishes, as shown in Figure 3, Figure 4, Figure 5.

Example 9

After the preoperative preparation, start the machine, the observation and treatment port (22) of the endoscope (16) enters the esophagus from the oral cavity, and aligns with the surgical site-esophageal cancer, and the CCD camera (8) captures images of the lesion tissue and normal tissue at the surgical site in real time and spectrum, the main controller (10) identifies and confirms the image and spectrum of the lesion tissue and normal tissue, the main controller (10) revises the surgical parameters of the laser (9), and the laser (9) is ready to emit light; lock the lesion tissue of esophageal cancer , the main controller (10) sends an operation command, the laser (9) emits light, and the main controller (10) monitors the CCD camera (13) at any time to capture the images and spectra of the lesion tissue and normal tissue at the surgical site, and the image and spectrum of the lesion tissue As soon as it disappears, the main controller (10) immediately instructs the laser (9) to shut down; look for the lesion tissue of esophageal cancer at the surgical site in the esophagus, find the lesion tissue of the esophageal cancer at the surgical site in the esophagus, and place the endoscope (16) The observation treatment port (22) is aimed at the lesion tissue of the operation site, the main controller (10) identifies and confirms the images and spectra of the lesion tissue and normal tissue, locks the lesion tissue of esophageal cancer, the main controller issues an operation instruction, and the laser (9 ) is turned on to emit light, the laser (9) outputs a therapeutic laser, and the therapeutic laser of the laser (9) cuts or vaporizes the lesion tissue at the operation site, and reciprocates until the esophageal cancer focus tissue at the operation site is completely eliminated.

When the lesion tissue at the operation site is completely eliminated, the laser (9) is turned off to stop outputting the therapeutic laser. Observe the normal tissue and focus tissue of the operation site through the image displayed on the monitor (11), and after the main controller (10) confirms that the focus tissue of esophageal cancer is completely eliminated in the operation site, the observation treatment port (22) of the endoscope (16) exits Oral cavity, close master controller (10), display (11), CCD camera (8) and light source equipment (29), operation finishes, as shown in Figure 3, Figure 4, Figure 5.

Example 10

After the preoperative preparation, turn on the machine, the observation and treatment port (22) of the endoscope (16) enters the stomach from the oral cavity through the esophagus, and is aimed at the surgical site - gastric cancer, and the CCD camera (8) captures the lesion tissue and normal tissue of the surgical site in real time images and spectra, the main controller (10) identifies and confirms the images and spectra of the lesion tissue and normal tissue, the main controller (10) corrects the surgical parameters of the laser (9), and the laser (9) is ready to emit light; the focus of gastric cancer is locked tissue, the main controller (10) sends out operation instructions, the laser (9) emits light, and the main controller (10) monitors the CCD camera (13) at any time to capture the image and spectrum of the lesion tissue and normal tissue at the surgical site, the image of the lesion tissue and As soon as the spectrum disappears, the main controller (10) immediately instructs the laser (9) to shut down; search for the lesion tissue of gastric cancer at the surgical site in the stomach, find the lesion tissue of gastric cancer at the surgical site in the stomach, and use the observation of the endoscope (16) The treatment port (22) is aimed at the lesion tissue of the surgical site, the main controller (10) identifies and confirms the images and spectra of the lesion tissue and normal tissue, locks the lesion tissue of gastric cancer, the main controller issues an operation command, and the laser (9) is turned on Light is emitted, and the laser (9) outputs therapeutic laser. The therapeutic laser of the laser (9) cuts or vaporizes the lesion tissue at the operation site, and reciprocates until the gastric cancer lesion tissue at the operation site is completely eliminated.

When the lesion tissue at the operation site is completely eliminated, the laser (9) is turned off to stop outputting the therapeutic laser. The normal tissue and lesion tissue of the operation site are observed through the image displayed on the monitor (11), and after the main controller (10) confirms that the lesion tissue of gastric cancer is completely eliminated in the operation site, the observation and treatment port (22) of the endoscope (16) withdraws from the oral cavity , close main controller (10), display (11), CCD camera (8) and light source equipment (29), and operation finishes, as shown in Fig. 3, Fig. 4, Fig. 5.

Example 11

After the preoperative preparation, turn on the machine, the observation and treatment port (22) of the endoscope (16) enters the rectum from the anus, and aligns with the surgical site-rectal polyp, and the CCD camera (8) captures the images of the lesion tissue and normal tissue at the surgical site in real time and spectrum, the main controller (10) identifies and confirms the image and spectrum of the lesion tissue and normal tissue, the main controller (10) revises the surgical parameters of the laser (9), and the laser (9) is ready to emit light; lock the lesion tissue of the rectal polyp , the main controller (10) sends an operation command, the laser (9) emits light, and the main controller (10) monitors the CCD camera (13) at any time to capture the images and spectra of the lesion tissue and normal tissue at the surgical site, and the image and spectrum of the lesion tissue As soon as it disappears, the main controller (10) immediately instructs the laser (9) to shut down; look for the lesion tissue of rectal polyp at the surgical site in the rectum, find the lesion tissue of rectal polyp cancer at the surgical site in the rectum, and place the endoscope (16) The observation treatment port (22) is aimed at the lesion tissue of the operation site, the main controller (10) identifies and confirms the images and spectra of the lesion tissue and normal tissue, locks the lesion tissue of the rectal polyp, the main controller issues an operation instruction, and the laser ( 9) Turn on the light, the laser (9) outputs therapeutic laser, the therapeutic laser of the laser (9) cuts or vaporizes the lesion tissue at the operation site, and reciprocates until the rectal polyp lesion tissue at the operation site is completely eliminated.

When the lesion tissue at the operation site is completely eliminated, the laser (9) is turned off to stop outputting the therapeutic laser. Observe the normal tissue and lesion tissue of the operation site through the image displayed on the monitor (11), after the main controller (10) confirms that the lesion tissue of the rectal polyp is completely eliminated at the operation site, the observation treatment port (22) of the endoscope (16) exits Anus, close master controller (10), display (11), CCD camera (8) and light source equipment (29), operation finishes, as shown in Figure 3, Figure 4, Figure 5.

Claims (1)

1. automatic control laser operation equipment, it is characterized in that forming by master controller (10), display (11), image collecting joint (25), laser instrument (9), light source (29) and endoscope (16), display (11) is connected with the display connection port (33) of master controller (10), adopt display screen or touch screen display (11) as master controller (10), display (11) instant playback CCD photographic head (8) lesion tissue of being gathered and the image of normal structure and spectrum, display (11) is gone up and is shown surgical parameters simultaneously; The top of endoscope (16) is provided with biopsy mouth (19), pore (20), water hole (21), light source interface (7) and endoscope's FPDP (23), biopsy mouth (19), pore (20), water hole (21) and light source interface (7) are connected to observation treatment end (22) by the top of endoscope (16), constitute biopsy mouth port (28) in observation treatment end (22), pore port (26), water hole port (27) and light source head (24), discharged by pore (20) by pore port (26) by the waste gas that produces behind the surgical lesion tissue vaporization, organize liquid and the moisture that are produced by operative site in the operation process are discharged by water hole (21) by water hole port (27), the light source output port (30) of light source (29) is transferred to the light source head (24) of observation treatment port (22) by fibre bundle by the light source interface (7) of endoscope (16), on the observation treatment port (22) 3 light source heads (24) are set at least, the position of light source head (24) illumination operation; The figure collection head (25) of CCD photographic head (8) is set in the observation treatment end (22) of endoscope (16), endoscope's FPDP (23) that endoscope (16) top is provided with is connected with the data message interface (32) of master controller (10) by circuit and is connected with the image card of master controller (1), the figure collection head of CCD photographic head (8) is gathered the image and the spectrum of lesion tissue and normal structure, the lesion tissue that master controller (10) identification and processing CCD photographic head (8) are gathered and the image and the spectrum of normal structure, and the operation of correspondingly sending instruction control laser instrument (9), avoid the maloperation damage normal structure of laser surgery to cause the error of performing the operation; The laser output mouth (17) of laser instrument (9) connects optical fibers, the biopsy mouth (19) of optical fibers from endoscope (16) inserted, the biopsy mouth port (28) that fibre-optic end is located until observation treatment port (22), transmission treatment laser, treatment is adopted gas laser or solid state laser or the semiconductor laser or the optical fiber laser of pulse operation mode, pulse CO with laser instrument ₂Laser, pulse width: 250 μ s～100ms, energy density: 5～20J/cm ², pulse frequency:＜200Hz; The laser controlling connectivity port (18) of laser instrument (9) is connected with the control laser instrument connectivity port (31) of master controller (10) by circuit, and master controller (10) sends start, the shutdown of instruction control laser instrument (9) and revises the laser output; Foot switch (12) is connected with master controller (10), keying foot switch (12) is manually controlled the startup of laser instrument (9) by master controller (10) and is closed, the accident that occurs happening suddenly in operation is closed foot switch (12) and is closed laser instrument (9) at once, the burst accident finishes to open foot switch (12), the state of resuming work.

Images