DE3233410A1 - Illumination for medical purposes - Google Patents

Abstract

An illumination (1) for medical purposes exhibits a light source (2) and a plastic optical waveguide (3) connected thereto. By using such a plastic optical waveguide (3), the possibility is given to modify the latter in accordance with the respective requirements. For example, it can be cut by scissors or a knife or the like, it can be bent into a desired direction by heat action on areas; in addition, it can be fused to a lens by means of a flame so that entry and exit losses are reduced, and the exit angle can also be reduced for a higher light concentration. Finally, one or more interruptions of the reflecting jacket layer can be made laterally at the optical waveguide, by means of which a light exit is also possible, for example at 90 DEG to the optical axis. Nevertheless, light still emerges at the same time at the outlet end so that combined illuminations are also possible under difficult conditions. To hold the optical waveguide end, holders can be provided at the corresponding instruments so that full illumination can be produced in each case at the point just being treated. A cross sectional deformation of the plastic optical waveguide under heat effect is also possible. <IMAGE>

Description

Lighting for medical purposes The invention relates to lighting For medical purposes, especially for illuminating body cavities or the like., with a light source and one connected to it, one essentially punctiform Light guide having light exit.

Such lights with light guides are already known.

They are used, for example, in connection with endoscopes.

Glass fiber bundles with an active one serve to transmit light Fiber bundle diameter between 2.5 mm and 10 mm depending on the application. Disadvantageous is with these light guides, among other things, that with them after a period of operation Movement of the light guide Break individual fibers and then the entire light guide becomes unusable. Another disadvantage is that the exit angle, opening angle, The beam characteristics and shape of the exit surface cannot be changed. A subsequent adjustment of the light guide end by the doctor to changed applications is not possible with these known light guides, so that only a comparative results in a small area of application.

The object of the present invention is to provide lighting of the initially to create the type mentioned, which enables a much wider range of applications, in particular, adjustments to the respective treatment situations also afterwards can be carried out in a simple manner. In addition, the medical The hygienic conditions required for the instruments must be met. In the end should malfunctions even after a long period of operation, even under higher bending loads be largely excluded.

To solve this problem, it is proposed according to the invention in particular that that at least one plastic light guide is provided as the light guide.

Such plastic light guides are already used in the automotive industry for Monitoring headlights and the like. Used by at the exit end of the fiber optic cable it can be seen whether the lamp to be monitored is in operation.

In contrast, the light guide in the present case is used for approximately punctual Illumination e.g. for surgical interventions in the medical field. Also for control purposes in body cooling or the like. A major advantage of the used Plastic fiber optic cable consists in that it can be removed with the simplest means (scissors, lighter) processed and thus adaptable to the most varied of application situations is. For example, it can be converted into a desired area by heating it in areas Bend the shape so that difficult-to-access areas can be illuminated.

In addition, such plastic fiber optics can be re-cut without any problems, so that cumbersome cleaning work can be avoided. This is for example in series examinations and the like. Advantageous.

The plastic light guide preferably has a protective sheath on, especially a plastic tube that can be pushed over preferably made of transparent silicone if necessary. This plastic hose forms a mechanical, chemical and thermal protection of the plastic fiber optic cable. This plastic hose too can be trimmed if necessary.

The plastic light guide can have an outside diameter of about 0.2 mm to about 2.5 mm, preferably from about 0.5 mm to 1.5 mm. On the one hand you can For example, in dentistry, even the smallest cavities, if necessary by inserting them the exit end of the plastic light guide are illuminated and on the other hand there is the option of using a slightly thicker light guide to create a very high light intensity to the point to be illuminated or illuminated bring.

An embodiment of the invention of independent importance sees before that the plastic fiber optic cable has a connector at its light inlet end has, which preferably has at least one receptacle for replaceable connection having different plastic light guides.

This makes it possible to use different fibers as required to be connected to the connector or that has become too short due to recutting Replace the light guide.

The connector is expediently with its connection end Shaped in such a way that it can be connected to existing light sources, in particular cold light sources is connectable. This can, if necessary.

existing light sources can be used without further conversion.

An embodiment of the invention provides that to hold the Light guide on an instrument, e.g. on a retractor, a suction device or the like. an attached to the instrument or

attachable holding tube for receiving or pushing through the Light guide is provided. This eliminates the need for a special, separate holder and in addition, the light exit point is then in the area already provided guided.

According to a further development of the invention, the light source one or more winding devices for light guides may be provided, which are preferably are powered by a single light source. If the lighting is not required, in this way, the light guide can be kept ready when it is wound up and is available in case of need by being unrolled from the winding device will.

Additional refinements of the invention are set out in the further subclaims listed. The invention with its essential details is based on the following the drawing explained in more detail.

It shows partly more schematically: FIG. 1 shows a view of a lighting according to the invention when used for a dental examination, 2 shows a perspective partial view of a set of teeth with an attached light guide, 3 shows a plan view of the essential parts of a lighting according to the invention, 4 shows a sectional representation of a suction tube with a light guide attached thereto, FIG. 5 shows an angle mirror with an attached light guide, FIG. 6 shows a retractor with a light guide attached to it, FIG. 7 shows a holder for the outlet side End of a light guide, 8 shows a longitudinal section of a connector plug with inserted light guide with protective sheathing, FIG. 9 is a longitudinal sectional view similar to FIG. 8, but here with several receptacles for light guides and FIG. 10 one Top view of a very schematically shown light source with winding devices.

A lighting 1 for medical purposes essentially has a Light source 2 and a light guide 3 with a connector 4. This essential Individual parts of the lighting 1 are also shown again individually in FIG. 3. It can also be seen that the particular as so-called. Cold light source trained Light source 2, for example, a halogen lamp 5 with an upstream heat protection filter 6 has. With 7 a color filter insert and with 8 a filter wheel or the like. referred to, by means of which several color filters alternately for the most diverse Applications can be used.

The four light guides shown here are intended to indicate that the connector 4 for receiving optical fibers 3 of different diameters suitable is.

The plastic light guide (s) 3 used have a plastic core and a cladding also made of plastic with a lower refractive index. For example, such a plastic light guide can have a core made of polymethyl methacrylate and have a jacket made of a transparent polymer. Such a plastic light guide In contrast to fiber optic light guides, it is insensitive to breakage, torsion, tension, Pressing and the like.

It is true that the use of plastic results in a slight one lower transmission, but this is somewhat greater attenuation in the single fiber again balanced by the fact that more reflections occur overall in the glass fibers, so that im Ultimately, the transmission powers are roughly the same.

To protect against mechanical and / or chemical influences, the Light guide 3 has a protective sheath, preferably made of opaque silicone. At the end of the light source or

at the light entry end is the light guide with the connector 4 connected. An embodiment of such a connector is shown in Fig. 8 shown. It can be seen that it has a receptacle 10 for interchangeable connection also has different plastic light guides 3. The recording is included formed by a central hole in which the light guide 3 with protective sheath 9 can be introduced tapering receiving channel 11 for the light guide 3 without protective sheathing 9. The conicity of the receiving channel 11 results in a certain centering of the Light guide 3, but with an exactly central arrangement in most applications because of the somewhat larger stray field of the lamp 5 is not necessary. That of the lamp facing opening in the connector 4 is dimensioned so that even the thickest provided Light guide 3 just fits through. The light guide 3 with protective sheathing 9 can be set by means of a clamping screw 12, but not directly but Via a spring-loaded clamping piece 13, the light guide 3 with protective sheath 9 applied.

Possibly. the connector 4a, as shown in FIG. 9, could also have several Have receptacles 10 for light guides 3. For example, two or more such receptacles 10 can be arranged concentrically.

The use of a plastic fiber optic cable offers a Variety of processing or processing options shown in Fig. 3 in the Rectangles are shown symbolically. For example, the light guide can with shortened with scissors, a knife or other cutting tool, without this results in a great loss of light. This cutting off of the light guide end used is particularly advantageous where the light guide end is contaminated and no longer clinically clean by simple spray disinfection can be cleaned, or where such cleaning is too cumbersome, for example for serial examinations. This previously described cutting of the light guide 3 is shown symbolically in box 14.

Next to it in the box 15 it is indicated that the light guide through partial removal of the outer reflective layer can also be used there can where a lateral light emission is desired. In the box 16 it is indicated that the light guide tip can be melted by punctual heating, whereby a lens is formed which reduces the entry and exit losses and can reduce the exit angle, which in turn increases the concentration of light has the consequence. This can also remove any cutting marks that may be present. In the box 17 is shown symbolically that the light guide end by heating Can be bent in a desired direction, so that otherwise difficult to access Places are easily illuminated. The form once given is thereby of the Maintain light guide, whereby there is also the possibility of the light guide self-supporting to protrude. It should also be mentioned that through a corresponding section of the exit end, for example, at 450 a light exit at 90 ° to optical Axis takes place so that extremely short light deflections are possible.

The exit end of the light guide can also be heated and simultaneous Shapes are brought into a different cross-sectional shape, which in certain applications, especially when inserting into smaller cavities with a certain cross-sectional shape can be helpful.

The lighting 1 according to the invention can be used, for example, in the dental field, in ENT, surgery, etc.

insert. The designs shown in the figures are limited for example in the dental sector. The most important sub-areas are included endodontics, dental surgery, periodontal surgery, conservative dentistry, Prosthetics, oral hygiene, dental technology. In endodontics, this results in a targeted, Mirror-free illumination of cavities to find the canal entrances. aside from that Reflex-free lighting is possible for high-gloss trephined crowns.

Finally, there is also very good illumination, so that too a visual positioning even with mechanical processing by Giromatik or similar is possible. By the possibility of the light guide end in its direction and also to be able to adapt training to the respective anatomical conditions, the light is brought specifically to the area to be processed, whereby a disturbance the view through stray light is avoided.

To hold the light guide 3 at its exit end, a on the instrument, z.S. attached to a retractor, a suction device or the like or attachable holding tubes 18 are used, as shown in FIGS. 4 to 6 and in particular can also be seen in FIG. 7. This holding tube 18 can be attached to the respective instrument attached from the outset, e.g. soldered on, or else it is, as in Fig. 7 recognizable, one or more clips 19 connected to the holding tube 18, by means of which can be connected to the corresponding instrument. In FIG. 4 is, for example, a suction pipe 20, in FIG. 5 an angle mirror 21 and in FIG 6 shows a retractor 22.

In these three instruments, the holding tubes 18 are directly with them connected to the tools. As already mentioned, however, you can use the tubes brackets (clips 19) can also be provided, through which connection as required possibly also possible with different instruments. Possibly. can instead of one Such a holding tube 18 also has a holder that acts directly on the light guide 3, based on the respective instrument, be provided.

The holding tubes 18 are expediently with their rear end so arranged or designed that there the protective sheath 9 is pushed on by friction while the light guide 3 is passed through the holding tube 18 and depending on the application more or less protrudes from the tube. In 4 and 7 can also be seen that the holding tube 18 according to the desired Lighting direction is curved. This preform is provided so that they results in the most required main direction of illumination, but with the particular Permanent bending of the light guide 3, which is possible under the influence of heat, is still precise Alignment allows, as is required in the individual case.

The clear inside diameter of the holding tube is expedient dimensioned so that the largest provided light guide fits through. try have shown that, for example, light guides with an active outer diameter from about 0.2 mm to about 2.5 mm can be used. Even with the thinner ones Light guides, however, are well fixed in position via the protective sheathing 9, which are pushed onto the rear end of the holding tube 18 in the functional position is. Unintentional twisting of the light guide 3 is avoided.

It should also be mentioned that in dental surgery especially that direct illumination of the surgical field by attaching the respective light guide on the surgical tool or the like.

e.g. on retractors, wound spreader, mouth gag, suture scissors, mouth mirror, Suction device and the like. Is particularly advantageous. By such a light guide arrangement is also the combination of sucking out and illuminating the in an advantageous manner Alveolus possible. Also let you through diaphanoscopy with such a light guide also find root remnants that are difficult to locate radiologically and without any further Damage to the later Remove the denture bearing. Also is one Particularly good lighting for checking resection cavities and retrograde root fillings possible. When connecting the light guide with a suction cup, you can also use strong bleeding wounds good visibility is created, with the operator has both hands free to work.

With periodontal surgery there is also the possibility of simultaneous Lighting to make a suction with curettage and scaling. Besides is also good control of intra-alveolar bone pockets under vision, even with strong ones Bleeding possible. Finally, the root surface can be smoothed after removal check the concretions well.

Especially in interventions with very heavy bleeding, the results ~ On-site lighting with the precisely adapted light guide 3 in some cases only the possibility of performing certain interventions.

In conservative dentistry, in particular, in connection Use with a mirror of the light guide 3 as a diagnosis and examination light. For example, the otherwise very poorly illuminable area is also the upper wisdom teeth accessible. In addition, it results from streiff and dark field illumination the possibility of early diagnosis of carious enamel defects, enamel lesions and Cracks. In the case of deep cavities, insert an appropriately shaped light guide a targeted visual check to ensure that there are no caries is possible (see also Fig. 1). Even a precise diagnosis can be made by spotlighting whether, for example the filling margins are still exact.

In the field of oral hygiene can be done by using a special Filters at the light source 2 also absorbed. Blacklight transfer as it is necessary in the presentation of plaque. When coloring with Fuchsin or similar preparations can be used with the mirror and the light guide the plaque build-up are shown. This is especially true in the context of screening intended.

In prosthetics, the lighting according to the invention results good control options, especially of the preparation margins for inlays and onlays and partial crowns. There is also the possibility of a mirror, in particular of both To illuminate sides by means of light guides arranged in the mirror plane, so that if the marking lines are incised, light emerges. For example, can two such marking lines may be provided in parallel with a spacing, by means of which then the possibility of checking the parallelism of bridge piers is possible is. There is also a good way of visually checking the marginal seal Shine through and / or shadow formation given. In addition, the surface texture check a prepared stump. Finally, there is also surveillance the pulp layer under the preparation without additional X-ray imaging. By selective illumination also gives the possibility of checking the oral cavity after full or partial dentures have been placed on pressure points or others Changes in the mucous membrane. After all, fluoroscopy is also the smallest Crowns for casting defects, veneering defects, material defects under veneers and like. possible.

In Fig. 10 it is still very schematically shown that the light source 2 one or, as in the exemplary embodiment, two or more winding devices 23 can be provided for the light guide. The inner end of the winding is the respective Light guide winding guided coaxially to the winding axis and forms a with its end Light coupling point 24. The light lead to this point 24 can also be via Light guide 3a take place, the vzw. are connected to a common light source. The winding drum 25 or the like belonging to the respective winding device 23. is expediently pretensioned in the winding direction and has a locking device for fixing, especially in intermediate positions.

This can be done by loosening the Locking device takes place an automatic winding of this light guide. in the Embodiment is shown that the light guide 3 with protective sheathing 9 is wound.

If necessary, the protective casing 9 can also be attached to the housing or the like.

be attached to the light source, in which case the one on the winding drum 25 light guides 3 that are wound or that can be wound there within this protective casing 9 is longitudinally displaceable.

It should also be mentioned that several, possibly within a protective cover guided light guides can be provided. This is advantageous, for example, when light are available at different angles or from different sides target.

The guidance of the light guide can depending on the practical requirements starting from the connector in a single cable with a branch at the outlet end or through a separate cable run.

At the end of the protective sheath 9 on the light exit side of the Light guide 3 can also have a particularly slidable seal to complete the Opening of the protective casing 9 may be provided.

Another advantage of the plastic light guide 3 used is there also in its elastic resilience, so that it comes into contact with tools e.g. during an operation, can easily evade. Disruptions in handling are thereby avoided.

The light guides 3 can with appropriate design (diameter or number) can be used for light-curing tooth fillings. For example Twenty-eight combined light guides, each 1 mm in diameter, are required, to achieve the desired curing effect.

The lighting 1 according to the invention can, as described above, both individually as well as in connection with medical instruments in the most diverse medical areas. It is also advantageous that this light guide 3 also on smaller instruments with little available for a holder Space can be attached as they are only a fraction of a millimeter or even but are a few millimeters thick. It makes sense to use the inventive Lighting 1 wherever light is directed selectively and precisely in a confined space certain point must be brought, so that not the entire operating area or the like. is illuminated, but only the point that is really being worked on.

In the illustration according to FIG. 1, it is shown, for example, how a appropriately aligned light guide 3 is inserted into a tooth cavity. It is therefore both a direct view of this cavity and a side view X-raying possible. For lateral candling, it is useful if the Light guide with a corresponding distance from the exit end her an interruption its reflective cladding layer to allow light to exit in this area to have. In the illustration according to FIG. 2, one lying in the tooth is outward towards closed cavity 26 made visible by this tooth from one side lit up by means of the light guide 3 and thus for a viewer from the the other side is x-rayed. The cavity 28 is thereby clearly recognizable and also can be localized so that a corresponding targeted intervention is possible.

All of the features shown in the description, the claims and the drawing can be essential to the invention both individually and in any combination with one another.

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Claims (1)

Claims lighting for medical purposes lighting for medical purposes Purposes, in particular for illuminating body cavities or the like., With a light source and an essentially punctiform light outlet connected to it having light guide, d a -d u r c h e k e n n n z e i c h n e t that as light guide at least one plastic light guide (3) is provided. 2. Lighting according to claim 1, characterized in that the plastic light guide (2) has a protective jacket (9), in particular a plastic tube that can be pushed over vzw. made of opaque silicone if necessary. 3. Lighting according to claim 1 or 2, characterized in that the plastic light guide (3) has an outer diameter of about 0.2 mm to about 2.5 mm vzw. from about 0.5 mm to 1.5 mm and that vzw. Monofibers are provided. 4. Lighting according to one of claims 1 to 3, characterized in that that at the exit end of the light guide (3) an exit lens is provided which is formed in particular by melting. 5. Lighting according to one of claims 1 to 4, characterized in that that at the exit end of the light guide (3) a flattening to form a e.g. oval light exit is provided. 6. Lighting according to one of claims 1 to 5, characterized in that that before the exit end of the light guide (3) one or more interruptions or the like. the reflective cladding layer of the light guide are provided. 7. Lighting in particular according to one or more of the claims 1 to 6, characterized in that the plastic light guide (3) at its light entry end has a connector (4, 4a) which has at least one receptacle (10) for the interchangeable Connecting vzw. has different plastic light guides (3). 8. Lighting according to claim 7, characterized in that the connector (4, 4a) is shaped with its connection end in such a way that it connects to existing Light sources, especially cold light sources, fits. 9. Lighting according to claim 7 or 8, characterized in that the light guide (3) in particular with a protective sheath (9) on the connector (4,4a) can be fixed by means of a clamping device, vzw. by means of a clamping screw (12), which in particular acts on a clamping piece (13) with the interposition of a spring. 10. Lighting according to one of claims 1 to 9, characterized in that that the connector (4,4a) to the # coupling end towards the clamping device vzw. has a conically tapering receiving channel (11) for the light guide (3). 11. Lighting according to one of claims 1 to 10, characterized in that that for holding the light guide (3) on an instrument, e.g. on a retractor, a suction device or the like, a holding tube attached or attachable to the instrument (18) is provided for receiving or for inserting the light guide (3). 12. Lighting according to claim 10 or 11, characterized in that that the outer diameter of the holding tube (18) is slightly larger than the clear Inner diameter of the protective sheath (9) and that at the inlet end of the holding tube (18) a free slip-on section is provided for the protective casing (9). 13. Lighting according to claim 11 or 12, characterized in that that the holding tube (18) at least in the region of its outlet end one in its Has longitudinal shape adapted approximately to the desired direction of illumination. 14. Lighting according to one of claims 11 to 13, characterized in that that the clear inner diameter of the holding tube (18) is approximately the largest outer diameter a provided light guide (3) corresponds. 15. Lighting according to one of claims 1 to 14, characterized in that that the connector (4a) has several receptacles (10) for light guides (3). 16. Lighting according to one of claims 1 to 15, characterized in that that at the light source (2) one or more winding devices (23) for light guides and the like. Are provided, the vzw. are supplied by a single light source (2). 17. Lighting according to claim 16, characterized in that the belonging to a winding device winding drum (25) or the like. in the winding direction is biased and a locking device for setting in particular also in Has intermediate positions. 18. Lighting according to claim 16 or 17, characterized in that that the inner winding end of the respective light guide coil is coaxial with the winding axis is guided and forms a light coupling point (24) with its end. 19. Lighting according to one of claims 16 to 18, characterized in that that the light guide (3) with protective sheathing (9) is wound onto a winding drum (25) is. 20. Lighting according to one of claims 16 to 18, characterized in that that the protective coating (9) on the housing od. Like. The light source (2) is attached and that on a winding drum wound or windable light guide (3) within this protective sheathing (9) is longitudinally displaceable. .21. Lighting according to one of claims 1 to 20, characterized in that that several light guides, possibly guided within a protective sheath (9), are provided are. 22. Lighting according to one of claims 1 to 21, characterized in that that at the end of the light exit side of the protective sheathing (9) of the light guide (3) a particularly displaceable seal to close the opening of the protective casing (9) is provided. 23. Lighting according to one of claims 1 to 22, characterized in that that the light guide (3) has a core, e.g. made of polymethyl methacrylate, and a cladding e.g. made of a transparent polymer with a low refractive index. description