LV11268B - Detection of anatomic passages using infrared emitting catheter - Google Patents

Description

1 LV 11268

DETECTION OF ANATOMIC PASSAGES USING INFRARED EMITTING CATHETER

RELATED APPLICATIONS

This application is a continuation-in-part of Serial No. 08/016,565, filed February 11, 1993.

FIELD OF THE INVENTION

The present invention relates to the avoidance of or locating internai orgāns or passages of the body during surgery and more particularly to a method employing and to apparatus including an infrared emitting source and a detection system one or the other of which is inserted into the organ or passage and the other located adjacent the organ or body to thus indicate proximity thereto of an instrument inserted into the body and to which one of the source or the detector is adjacent to, thus assisting in locating or avoiding during surgery the organ or duct in which one of the raembers is inserted.

BACKGROUND OF THE INVENTION

During surgery on the human body, it is essential that orgāns or passages, such as the urethra and ureter, not be cut. The presence of blood, sponges, intervening tissue and the like make it extremely difficult to locate with great accuracy such orgāns or passages in the vicinity and particularly immediate vicinity of the region on which surgery is being performed. 2

Light emitting catheters are used to detect irregularities in a duct, vessel, organ or the like. U.S. Patent No. 4,248,214 provides an illuminated urethral catheter to assist a surgeon in locating the junction of the bladder and the urethra to permit the proper performance of the Marshall-Marchetti-Kranz procedure. U.S. Patent No. 4,782,819 is representative of many patents using catheters for illuminating orgāns for internai inspection.

The use of infrared sensors internally of the body to locate heat generating body tissue, such as cancers, is disclosed in several patents, for instance, U.S. Patent No. 4,784,128. U.S. Patent No. 4,821,731 uses a sound generating catheter to image internai features of the body.

None of the references cited disclose the concept of employing an infrared generating catheter and infrared detector for the purpose of defining the location of the passage, organ, etc. so as to permit a surgeon working in the region to have a clear knowledge of the location of the region to be avoided. OBJECTS OF THE INVENTION It is an object of the present invention to provide an infrared emitting catheter for insertion into a passage, duct, organ or the like during surgery and an infrared detection system so as to precisely locate such and warn the surgeon of dangerous approach thereto. 3 LV 11268

It is another object of the present invention to provide a method of precisely locating orgāns, passages, duets and the like whereby a surgeon will not invade the body part so located. 5 It is stili another object of the present invention to provide a catheter for insertion into a body passage or the like that gives off infrared emissions over an extended region of the passage or the organ or may be configured as a point source. 10 Stili another object of the present invention is to provide infrared detection systems that provide readily detected signāls or displays clearly indicating the location of an infrared source in the body of a being. 15 Stili another object of the present invention is to provide an electronic switch system and control system to inhibit cauterization or lasing based on the location of an infrared emitting catheter relative to the proximity of the detection system which is fixed to the 20 cauterization or lasing instrument.

It is yet another object of the present invention to provide an infrared light source and an infrared light guide connected to an infrared deteetor positioned such as to provide an indication of the 25 location of one or more body members.

It is yet another object of the present invention to provide in eonjunetion with a systera using 4 infrared light to locate internai body members a source of light for illuminating the area of a region adjacent such body members and a display system associated with such source of light to display the organ on a monitor if 5 desired.

BRIEF DESCRIPTION OF THE PRESENT INVENTION

The present invention is described as employed to precisely locate ureters in the necessity to locate or in consequence of the danger to these passages 10 particularly during performance of a hysterectomy. The infrared emitting catheter and detection system of the present invention is not limited to such use, but this use is illustrative of the utility of the apparatus and method. 1 5 The infrared emitting catheter comprises a flexible, polymeric, preferably round light guide encased in a flexible essentially infrared transparent outer covering. The light guide may be constructed of glass or polymer with or without cladding. The outer surface of 20 the light guide is abraded or otherwise rendered infrared transparent over an extended area of its length so that infrared is essentially circumferentially emitted over the entire length of the duct, passage, etc., in the present example, the ureter. 25 A reflector may be placed at the distal end of the infrared emitting light guide to reflect any light 5 LV 11268 energy not initially scattered out the side thereby to increase the efficiency of radiation from the guide.

In reference to the abraded emitting light guide, in another embodiment multiple fibers of different lengths are employed, i.e., a fiber bundle consisting of very thin light guides. More specifically, multiple small diameter (25 to 50 microns) fibers are assembled, twined, then terminated at approximately 1 to 10 mm increments in the emitting region of the emitting catheter. In addition, the terminus of the each small fiber in the bundle is cut at an angle so as to direct infrared out of the emitting catheter.

Various different types of infrared detectors may be used, such as infrared photodetectors, endoscopes, cameras, audible devices, systems in which the sound intensity and frequency vary as a function of proximity to the infrared emitting catheter and thus the passage, etc. The infrared source may be pulsed or modulated so that the intensity of a blinking light on a monitor or the like can provide an indication of proximity.

Regardless of the type of infrared detector employed an important feature of the invention is that with the use of infrared, intervening blood tissue, sponges and the like do not mask the emission and thus the incidence of unfortunate errors are, if not eliminated, at least materially reduced. 6

In a preferred embodiment, an emitter control Circuit Controls the energy to the emitting catheter. A safety detector in one embodiment is placed superior to the iliac crest. The safety detector determinēs the integrity of the coupling between the infrared emitting catheter and its control Circuit and/or the continuity of the infrared emitting light guide, and actually may be the detector used during surgery and just looks for infrared emission when the system is turned on. If an audible system is employed the energy supplied to the infrared emitting catheter is adjusted to provide tonē amplitude desired by the surgeon. If the safety detector fails to detect infrared emissions a warning tonē is emitted.

As indicated above to locate the ureter during a surgical procedure, the infrared detector is placed in the site of the operation and moved as the surgeon penetrates new reģions. The tonē amplitude and/or frequency provides the indications necessary to locate the ureter or ureters. In the preferred embodiment an infrared emitting catheter is inserted preferably in both ureters.

Rather than insert the infrared detector into the operation site a light guide coupled to the detector may be inserted into the site. A 600 ym or 1000 pm light guide may be employed and is coupled to the infrared detector through an optical coupler. 7 LV 11268

The infrared detecting light guide may be physically coupled to the instrument employed for cutting. If, for instance, a laparoscopic electrocautery instrument is employed the infrared detector system may be employed to prevent energization of the instrument if the cauterizing has approached to close to the ureter and the infrared detector system is deactivated when the instrument is energized since heat generated by the cauterization process might otherwise deactivate the instrument.

The position of the infrared source and the light guide of the detector may be reversed with the light guide inserted into the organ to be protected with the source directed at the organ. A visual light source video camera and monitor may be employed with the system to provide a visual display of the organ.

The term "light guide" as used herein is employed to indicate a single light pipe or a bundle of their light conducting fibers or a combination of both.

The above and other features, objects and advantages of the present invention, together with the best means contemplated by the inventor thereof for carrying out his invention will become more apparent from reading the following description of a preferred embodiment and perusing the associated drawings in which: 8

BRIEF DESCRIPTION OF THE DRAWINGS

Figurē 1 is a view in longitudinal cross section of the catheter and light tube with Controls;

Figurē 2 illustrates a catheter with multiple light guiding fibers of different lengths;

Figurē 3 illustrates in partial section the catheter inserted into the ureter;

Figurē 4 illustrates catheters inserted into both ureters together with detection equipment;

Figurē 5 is a block diagram of the control for light energy supplied to the light guide;

Figurē 6 is a Circuit diagram of one form of infrared detector;

Figurē 7 is a block diagram of the system of the present invention;

Figurē 8 illustrates the use of a light reflector with the infrared light guide;

Figurē 9 illustrates the use of a light guide in the detection apparatus of the system;

Figurē 10 illustrates the physical coupling of a light guide to a electrocautery instrument and the circuitry for controlling the interrelationship between the detector and instrument;

Figurē 11 illustrates the detector control Circuit of Figurē 9 in block diagram form; 9 LV 11268

Figurē 12 illustrates in transverse cross-section an example of a catheter with a urine drainage channel;

Figurē 13 is an illustration of an arrangement in which the locations of the probe and the guide are reversed relative to Figurē 3;

Figurē 14 is an illustration of light guide employed in the apparatus of Figurē 13;

Figurē 15 is a block diagram of the electrical system associated with the probe illustrated in Figurē 13;

Figurē 16 is a block diagram of the electrical system associated with the light guide of the present invention; and

Figurē 17 is an illustration of the system of Figurē 13 in conjunction with a television system for displaying the ureter on a monitor screen.

DETAILED DESCRIPTION OF THE PRESENT INVENTION

The term "light guide" refers to light emitting structures as illustrated in Figurēs 1 and 2.

Referring now specifically to Figurē 1 of the accompanying drawings, an emitting catheter 2 in accordance with the invention comprises an infrared emitting light guide 4 located inside of the emitting catheter and a source 6, of infrared energy driven by a variable voltage power supply 8 (D&B Power, Inc., Modei F240-1000). Energy passes through an optical couple 3 10 (Motorola MFOE-1102) into the light guide, fabricated from either a polymeric or glass material (preferably fiber ESKA SH-4001 or SK-40) with or vithout cladding that passes infrared light with little attenuation. The 5 light guide 4 has its surface abraded over a region 10 so the infrared may be circumferentially emitted in ali directions into the surrounding region through the wall 12 of the catheter. The length of the region 10 is a function of the use to which the catheter is to be put; 10 in the application being described, the length of the ureter about 30 cms. The overall length of the catheter is typically 65 cm and is 2.33 mm in diameter. The light guide is about 2 meters long.

In order to increase the efficiency of emission 15 from the light guide 4, and reference is made to Figurē 8 of the accompanying drawings, an infrared reflector 5 reflects infrared not scattered from the region 10, reflecting it back into region 10 to provide additionally radiated infrared thus increasing the efficiency of the 20 system.

Referring now to Figurē 2, the light emitting light guide may be fabricated from a plurality of light conducting fibers 21 of different lengths collected into a bundle 23. The ends 25 of the fibers are cut at an 25 angle so that the light is projected out of the catheter at an angle to its length whereby to illuminate the surrounding area with infrared. The angle of the cut LV 11268 1 1 need not be uniform whereby to spread the infrared energy and insure substantially complete coverage of the surrounding region. The end of the fiber to be applied to a detector Circuit is terminated with cable connector 5 HFBR 450/HFBR 4511 from Hewlett Packard.

Referring to Figurē 3 of the accompanying drawings, catheter 2 is inserted through the urethra 14 and the bladder 16 into the ureter 18 so as to emit infrared through the wall of the ureter into the 10 surrounding region. An infrared detector 20 is used to sense the presence of the infrared energy radiated from the infrared emitting light guide 4. The energy transmitted to the fiber should not exceed 20 millivolts.

Referring to Figurē 4 of the accompanying 15 drawings, there is illustrated a modification of the system of Figurē 3 in which two catheters 2 and 2' are situated one in each ureter and driven from the same infrared source 6 through a light splitter 22. Other than the use of two catheters and a light splitter, the 20 basie systems are the same. In Figurē 3, however, there is also illustrated the use of a small TV camera 24 fitted with a scope 25 to permit an image of the illuminated ureter to be displayed on a video monitor 26. The intensity of the image is a funetion of the proximity 25 of the scope to the infrared source. Also as will become apparent in the subsequent discussion a beep resulting from modulation of the infrared may also be broadcast by 12 the monitor as well as by an infrared detection system 28. A safety detector may be placed on the surface of the body near the location of the emitting catheter, superior to the iliac crest in the case of the ureters. The safety detector determinēs the integrity of the coupling betveen the infrared emitting catheter and its control Circuit and/or the continuity of the infrared emitting light guide. An alarm sounds when infrared emissions are not sensed by the safety light guide. An alarm sounds when infrared emissions are not sensed by the safety detector Circuit which may be the same as the detector Circuit of Figurē 3 of the accompanying drawings.

Referring now specifically to Figurē 5 of the accompanying drawings, there is illustrated in block diagram form the infrared transmitter employed with the present invention. The transmitter is purchasable from electronic supply stores and employs a 555 IC timer. A 6-volt battery 30 powers the timer 555 designated by reference numeral 32 v/hich drives an infrared source or radiator 34 coupled to a light guide.

The timer 32 modulates the emitted signal at a frequency of approximately 800 Hz. The frequency is variable by a potentiometer or variable resistor 36 (2 K ohms) connected between pins 2 and 7 of the element 32 in series with a 6.8 K ohm resistor. The use of a modulated LV 11268 13 signal reduces response of the system to ambient or extraneous infrared energy and also provides a signal specific for the safety detector.

Infrared detector 38 and Circuit 40 are illustrated in Figurē 6 of the accompanying drawings.

The infrared detector is also available from electronic supply stores by the designation Motorola MFOD73 infrared receiver. The detector 38 drives a simple one transistor (2N3904) amplifier 41 supplying a signal to pin 3 of a 567 (IC) tonē decoder 42. The tonē decoder drives its output high and lights an LED or sounds a buzzer 44 whenever it detects a freguency within its band pass, in this example 800 Hz. With proper amplification the 567 IC 42 can drive a sound generator from its output at pin 8. A block diagram of the system of Figurēs 5 and 6 is illustrated in Figurē 7. Emitter control Circuit 8 drives the infrared source 34 that supplies infrared to the emitting light guide 4 or light guides. The light guide(s) emits infrared into the body designated by the reference numeral 46, and is detected by detector 38.

The detector 38 may be located in the body or if the scope 25 - camera 24 arrangement is employed the camera 24 may be located externally of the body. The infrared detector may also be located on an instrument, endoscope or the like. 14

In Figurē 4 a scope 25 is inserted into the area of the operation to transmit the infrared to a camera 24 to display of Information on a monitor. Similarly an infrared light guide may be employed to direct infrared energy from the interior of the area to an infrared detector external to the body. Referring to Figurē 9 of the accompanying drawings, an infrared light guide 50 may be equipped at its end remote from the ureter with an optical coupler 52 for coupling infrared energy to an infrared photodetector 54.

The guide 50 typically can transmit light in the infrared range, have a diameter of 1000 μτη and is designed to be inserted into the body to direct infrared energy, the detector 54 external to the body.

The light guide of Figurē 9 may be employed in one example with a laparoscopic electrocautery instrument. Referring to Figurē 10 of the accompanying dravings, an electrocautery instrument 56 is energized from a source 58 via a detector control Circuit 63 which receives a signal from detector 68 via light guide 59 to control excitation of the instrument.

Referring to Figurē 11, the details of the control 63 is illustrated, an infrared detector 68 is connected through an infrared photodetector Circuit 70 to a voltage comparator 66 and a speaker transistor switch 64. The voltage comparator 66 compares the voltage from Circuit 70 with a reference voltage and producēs an LV 11268 1 5 output signal on lead 60 indicative of the Ievel of voltage from Circuit 64 relative to the Ievel of the reference voltage. The lead 60 is connected to provide an input signal to the transistor switch 61 and also to an AND gate 72. The output of the AND gate 72 is applied through an inverter 75 to the speaker switch 64. The output signal from the speaker switch 64 is applied to a speaker-speaker Circuit 74.

In operation, when the output voltage from the infrared photodetector Circuit 70 equals or exceed the variable reference voltage in comparator 66, the current to the electrocautery transistor switch 61 goes to zero, thus opening the Circuit between the electrocautery power supply 58 and the electrocautery instrument 56 and shutting the instrument off. Otherwise, as long as the output voltage from the infrared photodetector Circuit is below the variable reference voltage at the comparator, the Circuit between the electrocautery power supply and the electrocautery instrument remains closed.

Referring to the AND gate 72, when both inputs to the AND gate are high, indicating the use of the electrocautery instrument 56 and that voltage to the comparator from the infrared photodetector Circuit is below the threshold voltage, the output of the AND gate goes high and the output of the inverter 75 goes low, driving the speaker transistor switch 64 off. Thus, the power to the speaker is suspended temporarily. Once 16 cauterization is complete, power to the speaker and speaker Circuit is restored and the detector may be employed to detect initial correct operation of the catheter. 5 It should be noted that the cauterization process may cause sufficient heat to shut off the instrument before it approaches dangerously close to the ureter. This problem is readily overcome by simply de-energizing the instrument in which case the speaker 10 Circuit is operational and will sound if approach to the ureter is too close for safety.

Referring now specifically to Figurē 12, a catheter 76 having a urine drainage channel is illustrated. The catheter includes a light emitting 15 guide 78 and a drainage channel 80. Urine in the channel 80 reduces the infrared energy passing through the channel but once the catheter has entered the ureter, urine flow is in the form of occasional drops so that little attenuation of infrared energy occurs and even 20 then it is sporadic.

Referring now specifically to Figurē 13, there is illustrated a configuration in which the locations of the infrared light emitting body and the infrared detector have been reversed. 25 A light emitting probe 86 receives pulsed infrared energy from a light source 88 described subsequently. The end 90 of the probe 86 is manipulated 17 LV 11268 until light sensor 92 emits an audible tonē indicating thereby the location of ureter 94. More specifically, a fiber optic light guide 96 is located in a catheter 98 positioned in the ureter 94. The light guide is provided 5 with a detecting segment 100, located over an extended longitudinal region of the guide 96 (20 cms) completely around the circumference of the guide.

The light guide directs infrared energy to a sensor 99 which, as indicated above, emits an audible 10 tonē when it receives energy of a magnitude that indicates the position of the probe end 90 relative to the organ, in this case, the ureter.

Referring now to Figurē 14 of the accompanying drawings, the light guide comprises a fiber optical 15 bundle 102 (see Figurē 2) having a distal end 104, with a roughened (abraded or scored) surface (about 20 cm long) so that infrared light can penetrate into the bundle and be directed along the fibers through an optical connector 106 to a clear plastic rod 108 to an optic port receiver 20 110 (Motorola MLED 73) in a detector Circuit which may be included in the Circuit of Figurē 16. In the preferred embodiment of the invention the guide 102 is Mitsuibishi light fiber ESKA SK40 and the connector 106 AMP's Optimatic Optical Connector 228087-1. 25 The light source 88 is illustrated in block diagram form in Figurē 15 of the accompanying drawings. Referring to Figurē 15 a regulator 112 driven by ac 18 through on-off switch 114 provides regulated +12 volts to a pulsē generator 116. The pulsē generator producēs triangular or sawtooth waves and drives a pair of optic ports 118 and 120, port 120 being illustrated as providing infrared energy to the light emitting probe 86 at about 5 millivolts. The optic port 120 converts pulsed electrical energy from generator 116 into pulsed infrared energy that is applied to the probe. The probe 86 is the same as light guide 96 except that no region is roughened and light is emitted only from the end of the probe 86. Complete galvanic isolation is thus provided. A segment type power display 122 is driven by a display driver 124 of conventional design. The display is a light emitting bar; the display having nine segments to indicate the Ievel of the energy launched.

Referring now specifically to Figurē 16 of the accompanying drawings, light from the light detector guide 96 is fed to an optic port receiver 110 that converts the light energy to electrical energy. Again, complete galvanic isolation is provided. The output of receiver 126 is passed to a voltage controlled oscillator 128 through a preamplifier 130, filter 132 dc post amplifier 134. A preamplifier 131 provides isolated low noise regulated voltage to the preamplifier 130. The output frequency of oscillator 128 is triangular wave and is a function of the Ievel of the dc voltage output from 19 LV 11268 amplifier 134 thus providing an indication of the amplitude of the light impinging upon the guide 96.

The output voltage of the oscillator 128 is fed to a speaker 136 serially through a sine converter 138, volume filter network 140 and audio amplifier. Thus the sound of the output of the speaker is a function of the proximity of the probe 86 to the ureter. Specifically, defining the exact function of each of the above elements the preamplifier 130 discriminates between the pulsed light received and background radiation received from the sources. It attenuates background light and amplifies the pulsed light signal. The filter 132 includes a peak average detector that splits the preamplified signal into peak and average components while the dc post amplifier 134, which is a high pass filter, accentuates the difference between the peak (high frequency) and average (low frequency) signal components. The voltage controlled oscillator 128 converts the difference between the peak and average components into a sawtooth voltage that is converted to a sine wave by the sine converter 138. The volume filter network permits control of the volume and also reduces the base tonēs.

It should also be noted that the difference signal is provided by the VCO to a detector display that drives a bar type indicator such as illustrated in Figurē 13. 20

Referring now specifically to Figurē 17 of the accompanying drawings, there is illustrated the system of Figurē 13 in conjunction with an illumination apparatus comprising a laparoscopic light source 150 providing light energy to a light conductor 152. The light conductor illuminates a surgical field with light from source 150 having no infrared component. Light from the area of the operation is also transmitted through the light conductor 152 to a laparoscopic camera 154 with the infrared blocking filter removed from the chip or chips in a three chip camera. The camera 154 transmits a signal over lead 156 to a monitor 158 which provides a display of the ureter in this case.

It is apparent that other sources of infrared are ambient in the body but the use of a pulsed infrared source to the light guide eliminates signāls from such sources.

Penetration into the body for both the probe 86 and light guide 152 is through conventional trocars. The probe 86 is secured by conventional techniques to the instruments inserted into the body for surgical procedures.

There are occasions, for instance in brain surgery on tumors, when a point source is indicated. In such instances the probe emits infrared light only from its end and acts as an indicator of the tumor's location. LV 11268 21

Once given the above disclosure, many other features, modifications and improvements will become apparent to the skilled artisan. Such other modifications, features and improvements are, therefore, considered a part of this invention, the scope of which is to be determined by the following claims. LV 11268

What is claimed is: 1. The method locating or reducing the danger during surgery or other invasion of a body of injury to body members into which a catheter may be inserted comprising the steps of inserting a catheter into the body member, inserting an elongated infrared light guide having a region that emits such light into the catheter, directing infrared light energy into the light guide, indicating the proximity of an ongoing surgical procedure to the body member by determining the intensity of the infrared radiation exiting the body member at the surgical site 2. The method according to claim 1 further including the step of inserting an infrared detector into a surgical opening in the vicinity of the body member. 3. The method according to claim 1 further including the step of energizing an infrared detector located external to a body undergoing a surgical procedure, and directing infrared energy emitted from the body member to the infrared detector located external to the body. 4. The method according to claim 1 further including the step of modulating the light at a detectable frequency and producing a signal indicative of the modulating frequency. 5. The method according to claim 1 reflecting from a distal end of the light guide infrared energy not emitted from the light guide 1 6. The method according to claim 1 energizing an infrared detector located external to the body undergoing a surgical procedure, and employing a light guide insertable into the body for directing infrared energy to the detector. 7. The method according to claim 6, physically attaching the last mentioned light guide to an energizable surgical instrument, and employing an infrared responsive Circuit for disabling the surgical instrument in response to a Ievel of detected infrared energy above a predetermined Ievel. 8. The method according to claim 7, disabling the infrared responsive Circuit during energization of the surgical instrument. 9. Apparatus for detecting the proximity to at least one body member adjacent an anatomical body on which a surgical procedure is being conducted comprising a catheter for insertion into a body member, a light guide having means to emit light transverse to its length along a length thereof inserted into said catheter, a source of light energy infrared into said light guide, an infrared light energy detector located such as to detect infrared light energy emitted by said light guide, and means responsive to the intensity of the infrared light energy detected by said detector for producing a signal of an intensity indicative of the proximity of the surgical procedure to the body member, a signal generating device, means for applying said signal to said signal generating device, said signal generating device having means for producing an indication of the intensity of said signal. 10. The apparatus according to claim 9 vvherein said infrared detector configured to be insertable into the body at the surgical sight. 11. The apparatus according to claim 10 vvherein said source of infrared light energy has means for producing a modulated signal of a predetermined frequency. 12. The apparatus according to claim 11 vvherein said signal generating device includes means for responding only to modulation of the predetermined frequency. 13. The apparatus according to claim 12 vvherein said means for producing an indication of the intensity of said signal includes means providing a signal detectable by human senses that is a function of the intensity of the signal produced by the signal generating device. 2 LV 11268 14. The apparatus according to claim 12 vvherein said source of infrared light energy includes means for producing a modulated signal at approximately 800 Hz. 15. The apparatus according to claim 9 vvherein said infrared detector is adapted to be located external to the body, and means for directing to the infrared detector infrared light energy of an intensity that is a function of the proximity of said means to the body member. 16. An apparatus according to claim 9 further comprising an infrared reflector at an end of said light guide remote from said source whereby to reflect infrared light energy not emitted back into the emitting region. 17. An apparatus according to claim 9 vvherein said infrared detector is adapted to be located external to the body and further comprising a further light guide insertable into a site of an operation for transmitting infrared light energy from a region internai to the body to said infrared detector. 18. An apparatus according to claim 17 vvherein said further light guide is configured to be connected to an energizable surgical instrument, and further comprising a control Circuit, said control Circuit connected to receive infrared light energy from said further light guide, said control Circuit responsive to said infrared light energy for preventing energization of the surgical instrument to vvhich said further light guide is to be connected when infrared light energy supplied to said infrared light detector is above a predetermined Ievel and for de-energizing the infrared detector when such surgical instrument is energized. 19. An apparatus according to claim 19 vvherein said light guide comprises a plurality of thin light conducting fibers of different lengths, said fibers terminating in angled facets whereby to direct infrared light energy out of said catheter. 20. An apparatus according to claim 19 vvherein said fibers have ends lying at 1 mm to 10 mm intervāls adjacent an end of the catheter. 21. The method of determining during surgery or other intentional invasion of the body, the proximity of an instrument to a body member other than the body member on vvhich a procedure is to be conducted, comprising the steps of inserting into the body a source of infrared light energy, inserting into the body an infrared light guide, inserting one of said source and guide into said body member other than the body member on vvhich a procedure is to performed, establishing the position of the other of the source and guide as a function of the position of the instrument relative to the body latter member, and 3 indicating the proximity of the other of said guide and source relative to said latter body member. 22. The method according to claim 21, physically attaching the source to an instrument to be inserted into the body for procedūrai purposes. 23. The method according to claim 21, pulsing the source to provide a signal that may be differentiated from background infrared energy. 24. The method according to claim 23, illuminating the area of entry into the body extemal to the organ into which one of the source and guide has been inserted, and monitoring such area with an infrared sensitive video camera and monitor. 25. Apparatus for detecting the proximity of an instrument to at least one body member adjacent an anatomical body on vvhich a procedure is to be performed comprising a source of infrared energy, an infrared detector, a light guide connected to said infrared detector for guiding infrared energy impinging thereon to said infrared detector, one of said source and light guide adapted to be inserted into the body member proximate the anatomical body, the other of said source and light guide positioned relative to the said one of said source and light guide such that infrared energy from said source impinges upon said light guide, and means for producing a signal displaying the proximity of an instrument to the body member. 26. The apparatus according to claim 25 further comprising means for pulsing said source. 27. The apparatus according to claim 26 vvherein said means for producing a signal includes, means for producing a signal determined by the difference betvveen the peak of said pulsed light and background infrared, and means for producing a voltage of a frequency determined by the amplitude of said signal. 28. The apparatus according to claim 27 further comprising means connected to receive said voltage for converting said last-mentioned voltage to a sine wave and a generator connected to said means for connecting the sine wave signal to producē an audible signal. 4 LV 11268 29. Apparatus for detecting the proximity of an instrument to at least one body member adjacent an anatomical body on vvhich a procedure is being conducted comprising a light guide having means to emit light transverse to its length along a length thereof adapted to be inserted into a body member to be protected during procedures being conducted on the anatomical body by an instrument adjacent to the body member, a light source having infraret energy located to direct light energy into said light guide, an infrared detector located such light guide, and a signal generator having circuitry Circuit means responsive to the intensity of the light energy detected by said detector for producing a signal indicative of the proximity of the procedure to the body member. 5

Claims (29)

LV 11268 Izgudrojuma formula 1. Paņēmiens tādu orgānu, kuros var ievadīt kateteru vai līdzīgu ierīci, pasargāšanai no ievainojumiem un ievainojuma iespēju savlaicīgai pamanīšanai, ķirurģisku operāciju vai līdzīgu iejaukšanos gaitā, kas atšķiras ar to, ka: minētajā orgānā ievada kateteru, kateterā ievada garu infrasarkanās gaismas gaismvadu ar posmu, kas izstaro infrasarkano gaismu, gaismvadā ievada infrasarkano gaismu, nosaka bīstamu notiekošās ķirurģiskās procedūras tuvību minētajam orgānam izmērot tā infrasarkanā starojuma intensitāti, kas tiek izstarota no operējamā orgāna operācijas vietā.1. A method for protecting organs in which a catheter or similar device can be administered from injury and early detection of surgical operations or similar interventions, characterized in that: catheter is introduced into said organ, long infrared is introduced into the catheter. a light-emitting duct with a section emitting infrared light, infrared light is introduced into the light guide, detecting the dangerous closeness of the ongoing surgical procedure to that organ by measuring the intensity of the infrared radiation emitted from the operating organ at the site of operation. 2. Paņēmiens pēc 1. punkta, kas atšķiras ar to, ka tajā papildus paredzēta infrasarkanā starojuma detektora ievadīšana ķirurģiskās operācijas griezuma vietā minētā orgāna tuvumā.Method according to claim 1, characterized in that it further comprises the introduction of an infrared detector at a surgical cut-off near the said organ. 3. Paņēmiens pēc 1. punkta, kas atšķiras ar to, ka tajā papildus paredzēta: infrasarkanā starojuma detektora iedarbināšana ķirurģiskajai operācijai pakļautā ķermeņa ārpusē un infrasarkanā starojuma novadīšana no orgāna uz ārpus ķermeņa novietoto detektoru.3. A method according to claim 1, further comprising: activating the infrared detector on the outside of the body subjected to the surgical operation and discharging the infrared radiation from the organ to the off-body detector. 4. Paņēmiens pēc 1. punkta, kas atšķiras ar to, ka tajā paredzēta starojuma modulācija ar nosakāmu frekvenci un frekvenci uzrādoša signāla veidošana. 14. A method according to claim 1, characterized in that it provides for modulation of radiation with a detectable frequency and for generating a frequency signal. 1 5. Paņēmiens pēc 1. punkta, kas atšķiras ar to, ka tajā paredzēta no gaismvada neizstarotās infrasarkanā starojuma enerģijas atstarošana no gaismvada attālākā gala.5. A method according to claim 1, characterized in that it is reflected from the distal end of the light path by the irradiated infrared energy of the light guide. 6. Paņēmiens pēc 1. punkta, kas atšķiras ar to, ka tajā paredzēta: infrasarkanā starojuma detektora iedarbināšana ķirurģiskajai operācijai pakļautā ķermeņa ārpusē un organismā ievadāma gaismvada izmantošana infrasarkanā starojuma novadīšanai uz detektoru.Method according to claim 1, characterized in that it comprises: activating the infrared detector on the outside of the body subjected to the surgical operation, and introducing the use of a light line for transmitting the infrared radiation to the detector. 7. Paņēmiens pēc 6. punkta, kas atšķiras ar to, ka tajā paredzēta: minētā gaismvada fiziska piestiprināšana pie ķirurģiskā instrumenta, kas ir ieslēdzams un izslēdzams darba stāvoklim, uz infrasarkano starojumu reaģējošas elektroniskās shēmas izmantošana ķirurģiskā instrumenta izslēgšanai, kad detektētā infrasarkanā starojuma enerģijas līmenis pārsniedz iepriekš noteikto līmeni.7. The method of claim 6, further comprising: physically attaching said light beam to a surgical instrument that can be turned on and off for use by an infrared-responsive electronic circuitry for shutting off a surgical instrument when the detected infrared energy level above a predetermined level. 8. Paņēmiens pēc 7. punkta, kas atšķiras ar to, ka tajā paredzēta uz infrasarkano starojumu reaģējošas elektroniskās shēmas izslēgšana, kad tiek ieslēgts ķirurģiskais instruments.8. A method according to claim 7, wherein the infrared responsive electronic circuitry is switched off when the surgical instrument is switched on. 9. ierīce, kas dod iespēju noteikt vismaz viena orgāna bīstamu tuvību tam ķermeņa orgānam, kurā tiek veikta ķirurģiska procedūra, atšķiras ar to, ka tā satur: kateteru ievadīšanai orgānā, kateterā ievadītu gaismvadu, kas spēj izstarot gaismu perpendikulāri minētā gaismvada virsmai kādā tā posmā, infrasarkanās gaismas avotu, kas izvietots tā, lai varētu ievadīt gaismas enerģiju minētajā gaismvadā, infrasarkanā starojuma detektoru, kas izvietots tā, lai varētu detektēt no minētā gaismvada nākošo infrasarkano starojumu, līdzekli, kas reaģē uz minētā detektora detektētās gaismas enerģijas intensitāti un dod signālu, kura intensitāte raksturo, cik bīstami tuvu ķirurģiskā operācija ir minētajam orgānam, ierīci signāla veidošanai, 2 LV 11268 līdzekli minētā signāla pievadīšanai minētajai signāla veidošanas ierīcei, pie kam minētā signāla veidošanas ierīce aprīkota ar līdzekli, kas uzrāda minētā signāla intensitāti.9. A device for detecting a dangerous proximity of at least one organ to a body organ undergoing a surgical procedure, characterized in that it comprises: administering a catheter to the organ, a tube of light introduced into the catheter, capable of emitting light perpendicular to the surface of said light path at any stage thereof , an infrared light source disposed to be capable of delivering light energy to said light guide, an infrared detector positioned so as to detect the next infrared radiation from said light beam, a means responsive to the energy intensity of the light detected by said detector and providing a signal; the intensity of which describes the severity of the close surgical operation of said organ, the device for signal generation, the means for delivering said signal to said signal generating device, said signal generating device being provided with means for presenting said sig. intensity. 10. ierīce pēc 9. punkta, kas atšķiras ar to, ka minētais infrasarkanā starojuma detektors ir izveidots tāds, ka tas ir ievadāms ķermenī ķirurģiskās operācijas vietā.A device according to claim 9, characterized in that said infrared detector is designed to be injected into the body at the site of a surgical operation. 11. Ierīce pēc 10. punkta, kas atšķiras ar to, ka minētais infrasarkanā starojuma avots apgādāts ar līdzekli modulēta starojuma ar noteiktu frekvenci ģenerēšanai.Device according to claim 10, characterized in that said infrared source is provided with means for generating a modulated radiation with a certain frequency. 12. Ierīce pēc 11. punkta, kas atšķiras ar to, ka minētā ierīce signāla ģenerēšanai ietver līdzekli, kas reaģē uz modulētu starojumu ar noteiktu frekvenci.Device according to claim 11, characterized in that said device for generating a signal comprises means for reacting to modulated radiation at a specified frequency. 13. Ierīce pēc 12. punkta, kas atšķiras ar to, ka līdzeklis, kas uzrāda minētā signāla intensitāti satur līdzekli, kas dod ar cilvēka maņu orgāniem nosakāmu signālu, kura intensitāte ir tieši atkanga no tā signāla intensitātes, ko veido ierīce signāla ģenerēšanai.Device according to claim 12, characterized in that the means for displaying the intensity of said signal comprises means for providing a signal to be determined by the human senses, the intensity of which is a direct response to the intensity of the signal generated by the device for generating the signal. 14. Ierīce pēc 12. punkta, kas atšķiras ar to, ka minētais infrasarkanā starojuma avots ietver līdzekli starojuma ar aptuveni 800 Hz frekvenci veidošanai.Device according to claim 12, characterized in that said infrared source comprises means for generating radiation with a frequency of about 800 Hz. 15. Ierīce pēc 9. punkta, kas atšķiras ar to, ka: minētais infrasarkanā starojuma detektors piemērots izvietošanai ārpus ķermeņa un minētā ierīce satur līdzekli, kas dod iespēju novadīt infrasarkano starojumu uz infrasarkanā starojuma detektoru, pie kam starojuma intensitāte ir tieši atkarīga no minētā līdzekļa attāluma līdz ķermeņa orgānam.Device according to claim 9, characterized in that said infrared detector is suitable for deployment outside the body and said device comprises means for providing infrared radiation to an infrared detector, wherein the intensity of the radiation is directly dependent on said device. distance to body organ. 16. lence pēc 9. punkta, kas atšķiras ar to, ka tā papildus satur infrasarkanā starojuma atstarotāju tajā minētā gaismvada galā, kas ir pretējs minētajam avotam, lai neizstaroto enerģiju atstarotu atpakaļ tajā posmā, kurā notiek izstarošana.16. The lumen of claim 9, further comprising an infrared reflector at the end of said duct, opposite to said source, to reflect the non-irradiated energy back to the stage at which the irradiation occurs. 17. Ierīce pēc 9. punkta, kas atšķiras ar to, ka tajā: infrasarkanā starojuma detektors ir piemērots izvietošanai ārpus ķermeņa un 3 papildus satur vēl vienu gaismvadu, kas var tikt ievadīts operācijas vietā, lai novadītu infrasarkano starojumu no ķermeņa iekšienes uz minēto infrasarkanā starojuma detektoru.Device according to claim 9, characterized in that the infrared detector is suitable for being placed outside the body and 3 further comprises a further light tube which can be injected at the site of operation to deliver infrared radiation from the body to said infrared radiation. detector. 18. Ierīce pēc 17. punkta, kas atšķiras ar to, ka: minētais papildus gaismvads ir izveidots piestiprināms pie ķirurģiskā instrumenta, kas ieslēdzams un izslēdzams darba stāvoklim un papildus satur elektronisko vadības shēmu, pie kam minētā vadības shēma reaģē uz minēto infrasarkano starojumu, lai nedotu iespēju ieslēgt darba stāvoklim minēto ķirurģisko instrumentu, pie kura piestiprināms minētais papildus gaismvads, kad minētajam infrasarkanā starojuma detektoram pievadītā infrasarkanā starojuma enerģijas līmenis pārsniedz iepriekš noteikto līmeni un paredzēta arī infrasarkanā starojuma detektora izslēgšanai, kad minētais ķirurģiskais instruments ir ieslēgts darba stāvoklī.Device according to claim 17, characterized in that: said additional line is attached to a surgical instrument to be switched on and off and further comprising an electronic control circuit, said control circuit being responsive to said infrared radiation; would not allow the surgical instrument mentioned above to be switched on, to which the said additional line is attached, when the infrared radiation energy supplied to said infrared detector exceeds a predetermined level and is also intended to deactivate the infrared detector when said surgical instrument is in the working position. 19. Ierīce pēc 9. punkta, kas atšķiras ar to, ka tajā: minētais gaismvads sastāv no lielāka skaita gaismu vadošām šķiedrām ar dažādu garumu, pie kam minēto šķiedru gali noslēdzas ar slīpi vērstām virsmām, lai izvadītu infrasarkano starojumu no minētā katetera.Device according to claim 9, characterized in that said light guide consists of a plurality of light-conducting fibers of different lengths, the ends of said fiber being closed by inclined surfaces to expel the infrared radiation from said catheter. 20. Ierīce pēc 19. punkta, kas atšķiras ar to, ka minēto šķiedru gali izvietoti ar 1-10 mm intervālu katetera izstarojošā posma ietvaros.Device according to claim 19, characterized in that said fiber can be disposed at intervals of 1-10 mm within the radiating section of the catheter. 21. Paņēmiens ķirurģiskā instrumenta bīstamas tuvības noteikšanai citam orgānam, kas atrodas procedūrai pakļautā orgāna tuvumā, ķirurģiskās operācijas vai citas paredzētas iejaukšanās laikā, kas atšķiras ar to, ka paredz: ievadīt ķermenī infrasarkanās gaismas avotu, ievadīt ķermenī infrasarkanā starojuma gaismvadu, minētajā orgānā, kas atrodas operējamā orgāna tuvumā, ievadīt vai nu minēto avotu vai arī minēto gaismvadu, noteikt orgānā neievadītā minētā gaismvada vai avota stāvokli atkarībā no ķirurģiskā instrumenta bīstamās tuvības minētajam orgānam un indicēt minētā, orgānā neievadītā, avota vai minētā, orgānā neievadītā, gaismvada stāvokli attiecībā pret minēto orgānu. 4 LV 1126821. A method for detecting a dangerous proximity of a surgical instrument to another organ located near an organ undergoing the procedure, surgical operations, or other intended interventions, characterized in that: infrared light source is introduced into the body, infrared light is introduced into the body, said located in the vicinity of the organ being administered, either to supply the said source or said light source, to determine the state of that light line or source not introduced into the organ, depending on the dangerous proximity of the surgical instrument to that organ, and to indicate the state of said non-administered, source or said non-administered light source relative to said organ organ. 4 EN 11268 22. Paņēmiens pēc 21. punkta, kas atšķiras ar to, ka minēto avotu fiziski piestiprina pie instrumenta, kuru paredzēts ievadīt ķermenī procedūru veikšanai.22. The method of claim 21, wherein said source is physically attached to an instrument intended to be administered to the body for the purpose of carrying out the procedures. 23. Paņēmiens pēc 21. punkta, kas atšķiras ar to, ka minētais avots dod pulsējošu starojumu, kas dod iespēju to atšķirt no fona infrasarkanā starojuma.23. The method of claim 21, wherein said source provides pulsating radiation that allows it to be distinguished from the background infrared radiation. 24. Paņēmiens pēc 23. punkta, kas atšķiras ar to, ka tas paredz: apgaismot ķermeņa atvēruma vietu, kas atrodas ārpus tā orgāna, kurā ievadīts vai nu minētais avots vai arī minētais gaismvads, monitorēt minēto vietu ar videokameru, kas jūtīga pret infrasarkano gaismu un tai pievienotu monitoru.24. The method of claim 23, further comprising: illuminating the location of the body opening located outside said organ in which said source or said line of light is introduced to monitor said site with an infrared-sensitive camera and add a monitor to it. 25. Ierīce ķirurģiskā instrumenta bīstamas tuvības noteikšanai vismaz vienam citam orgānam, kas atrodas tā orgāna tuvumā, kurš pakļauts kādai procedūrai, kas atšķiras arto, ka satur: infrasarkanā gaismas avotu, infrasarkanā starojuma detektoru, ar minēto infrasarkanā starojuma detektoru savienotu gaismvadu uz tā krītošā infrasarkanā starojuma novadīšanai līdz minētajam infrasarkanā starojuma detektoram, vai nu minēto avotu vai arī minēto gaismvadu, piemērotu ievadīšanai orgānā, kas atrodas operējamā orgāna tuvumā, minēto, orgānā neievadīto, gaismvadu, vai arī minēto, orgānā neievadīto, avotu, novietotu pret minēto, orgānā ievadīto avotu vai gaismvadu tādā stāvoklī, ka infrasarkanais starojums no minētā avota nokļūst minētajā gaismvadā, un līdzekli, kas dod signālu, ziņojot par ķirurģiskā instrumenta bīstamu tuvību minētajam orgānam.25. A device for detecting a dangerous proximity of a surgical instrument to at least one other organ adjacent to an organ subjected to a procedure that comprises: an infrared light source, an infrared detector, an infrared detector connected to said infrared detector for discharging to said infrared detector, either of said sources or of said light emitting diodes, suitable for administration to an organ located in the vicinity of the organ being operated, to a non-administered source of light, or said, non-administered, source, placed in said organ by said organ. or a light fixture in such a condition that the infrared radiation from said source enters said light path and a means for signaling the dangerous proximity of the surgical instrument to said organ. 26. Ierīce pēc 25. punkta, kas atšķiras ar to, ka tā papildus satur līdzekli minētās gaismas pulsēšanai. 526. The device of claim 25, further comprising a means for pulsating said light. 5 27. Ierīce pēc 26. punkta, kas atšķiras ar to, ka minētā ierīce signāla došanai ietver: līdzekli, kas dod signālu, atkarīgu no minētās pulsējošās gaismas maksimuma un fona infrasarkanā starojuma līmeņu starpības, līdzekli, kas izmaina strāvas frekvenci atkarībā no minētā signāla lieluma.27. A device as claimed in claim 26, wherein said device for signaling comprises: means for providing a signal dependent on said difference in pulsating peak and background infrared levels, a means for changing the current frequency depending on said signal size . 28. Ierīce pēc 27. punkta, kas atšķiras ar to, ka tā papildus satur: līdzekli, kas uztver minētās strāvas izmaiņas minēto izmaiņu pārvēršanai sinusoidālā formā, ģeneratoru, kas pievienots minētajam līdzeklim, kurā ievada sinusoi-dālo signālu, lai dotu ar dzirdi uztveramu signālu.28. A device according to claim 27, further comprising: means for detecting said current change to sinusoidal change, a generator attached to said device, in which a sinusoidal signal is introduced to give a hearing aid. signal. 29. Ierīce ķirurģiskā instrumenta bīstamas tuvības noteikšanai vismaz vienam citam orgānam, kas atrodas tā orgāna tuvumā, kurš pakļauts kādai procedūrai, kas atšķiras arto, ka satur: gaismvadu, kas apgādāts ar līdzekli gaismas izstarošanai perpendikulāri tā virsmai kādā tā posmā, un kas piemērots ievadīšanai tajā orgānā , kurš jāpasargā no ķirurģiskā instrumenta to procedūru laikā, kurām tiek pakļauts kāds cits ķermeņa orgāns minētā orgāna tuvumā, gaismas avotu, kas dod infrasarkano starojumu un izvietots tā, ka var ievadīt gaismas enerģiju minētajā gaismvadā, infrasarkanā starojuma detektoru, kas izvietots tā, ka spēj detektēt no minētā gaismvada izstaroto infrasarkano starojumu un signāla ģeneratoru, kuram ir kā elektroniskā shēma izveidots līdzeklis, kas reaģē atbilstoši minētā detektora detektētās gaismas enerģijas intensitātei, dodot signālu, kas norāda procedūras bīstamu tuvību minētajam orgānam. 629. A device for detecting a dangerous proximity of a surgical instrument to at least one other organ adjacent to an organ which is subjected to a procedure, characterized in that it comprises: a light source provided with a means for radiating light perpendicular to its surface at any stage thereof and suitable for administration in an organ to be protected from a surgical instrument during procedures subjected to another body organ in the vicinity of that organ, a light source that emits infrared radiation and is positioned so as to be able to inject light energy into that light guide, disposed in the infrared detector, that is capable of detecting infrared radiation and a signal generator emitted from said light beam, which has a device created as an electronic circuit that responds to the intensity of light energy detected by said detector, giving a signal indicating a dangerous proximity of the procedure to said organ am. 6