Device for making surgical operations

FIELD: medical engineering.

SUBSTANCE: device has spectacle-like mask, upper eyelid holder and retroauricular units. The device has electrorheologic patch for fixing lower eyelid, micromanipulators having mechanisms for replacing instruments mounted on upper and lower arches of the spectacle-like mask, micro-bars with drive and electrorheologic nozzles for guiding eye to zone of interest mounted on lateral and central arches of the spectacle-like mask and reciprocating video camera movably mounted on lateral and central arches of the spectacle-like mask.

EFFECT: higher degree of surgical operation process automation.

1 dwg

 

The invention relates to the field of ophthalmology and can be used for carrying out surgical operations on the human eye.

Known ocular retainer containing microstage with electrorheological nozzle (USSR Author's certificate No. 1082427, class a 61 P 9/00, BI No. 34, 1982).

However, this release is intended for manual use.

Known diadem, comprising upper and lower retainers century to avoid trauma to the eye, it is made in the form of a mask-points to arcs which strengthened the chains vectorially in the form of a fenestrated hooks, and on the lateral and Central arches her adjustably mounted in horizontal and vertical directions blocks with Petersville (USSR Author's certificate No. 490471, class a 61 F 9/00, BI No. 41, 1974).

However, this diadem does not provide the possibility of conducting operations using micromanipulators.

The technical result - the automation of carrying out major surgical operations.

The task is solved in that the device for carrying out surgical operations in the form of a mask-points, including chain with top vectorially and adjustable temples, contains electrorheological stickers, micromanipulators with the mechanism of change tools, located on the lower and upper arc mask-glasses, Microstar the drive and electrorheological nozzles, mounted on the Central and side arcs mask glasses and camera, also fortified on the side and Central arcs mask glasses with the possibility of reciprocating motion.

The drawing shows a device for carrying out surgical operations.

The device for carrying out surgical operations consists of mask points 1, which contains located on the lower arc of the micromanipulator 2, connected with the change mechanism of the tool 3, the micromanipulator 4, located on the upper arc of the mask points to the mechanism of change tools 3, the upper westerhall 5, also located on the top arc, the camera 6 is connected by means of a slider with a Central arc and directly over the bar with a lateral arc, drives Microstar with electrorheological nozzles 7, located on the lateral and Central arches, adjustable temples 8, attached to the lateral arches, and electrorheological stickers 9 located outside of the mask points 1.

The device operates as follows. Pull the lower lid and lock it electrorheological sticker 9, wearing a device for surgical operations and fix it using the adjustable ear hook 8. The second lid lock top vesteraalen 5, configure microstage with electrorheological nozzles 7 on the eye. Start auth mechanisms of change tools 3 micromanipulators 2 and 4 instruments, necessary for the operation. Perform the operation, choosing the right tool or replacing it with another. The micromanipulator 4 depending on the nozzles makes shots, plays the role of a dropper or pulls, pushes tissue, assisting micromanipulator 2. The video camera 6 which is located above the area of operation, are used to monitor the progress of the operation and block damaging movements. When the micromanipulator 2 does not have enough degrees of mobility or range of movement, include drives Microstar electrorheological nozzles 7 and lead the eye to the desired area. The tool change is as follows. Assign the micromanipulator 2 in the far distant from the eye point, down the mechanism of change of the tools 3, which sets or changes the tool in the micromanipulator 2, then the mechanism of change tools 3 assign to its original position, and the micromanipulator 2 return to the working area. Similarly, change the tool changer mechanism tools 3 in the micromanipulator 4. For the other eye using the identical fixtures and devices.

Thus, the inventive device for carrying out surgical operations in comparison with the prototype allows for the use of micromanipulators to produce high precision with a small section of the operated area is oftalmologica surgical operations on the human eye. Using systems Supervisory control has the ability to automatically perform certain types of operations. Ultimately, this reduces the number of complications in the postoperative period and to reduce the cost of operations.

A device for surgical operations on the eye, made in the form of a mask glasses, including top vectorially and the temples, characterized in that it contains electrorheological sticker for fixing the lower eyelid, micromanipulators with the mechanisms of change tools, located on the upper and lower arcs of the mask points, microstage with drive and electrorheological nozzles for leading the eye to the desired area, mounted on side and Central arches of the mask, glasses, and a video camera mounted on the side and Central arcs mask glasses with the possibility of reciprocating motion.



 

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FIELD: medicine, ophthalmology.

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FIELD: medicine, ophthalmology.

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FIELD: medicine.

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2 dwg

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7 dwg

FIELD: medicine.

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2 cl

FIELD: medicine.

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3 cl, 5 dwg

FIELD: medicine.

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3 cl, 5 dwg

FIELD: medicine.

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4 dwg

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1 dwg

FIELD: medicine; medical engineering.

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3 cl

FIELD: medicine.

SUBSTANCE: method involves making incision in conjunctiva and Tenon's capsule of 3-4 mm in size in choroid hemangioma projection to sclera 3-4 mm far from limb. Tunnel is built between sclera and Tenon's capsule to extrasclerally introduce flexible polymer magnetolaser implant through the tunnel to the place, the choroid hemangioma is localized, after performing transscleral diaphanoscopic adjustment of choroid hemangioma localization and size, under visual control using guidance beam. The implant has permanent ring-shaped magnet in the center of which a short focus scattering lens of laser radiator is fixed. The lens is connected to light guide in soft flexible envelope. The permanent implant magnet is axially magnetized and produces permanent magnetic field of 2-3 mTesla units intensity. It is arranged with its north pole turned towards the choroid hemangioma so that extrascleral implant laser radiator disposition. The other end of the implant is sutured to sclera 5-6 mm far from the limb with two interrupted sutures through prefabricated openings. The implant is covered with conjunctiva and relaxation sutures are placed over it. Light guide outlet is attached to temple using any known method. 0.1-1% khlorin solution is injected in intravenous bolus dose of 0.8-1.1 mg/kg as photosensitizer and visual control of choroid hemangioma cells fluorescence and fluorescent diagnosis methods are applied. After saturating choroid hemangioma with the photosensitizer to maximum level, transscleral choroid hemangioma laser radiation treatment is carried out via laser light guide and implant lens using divergent laser radiation at wavelength of 661-666 nm with total radiation dose being equal to 30-120 J/cm2. The flexible polymer magnetolaser implant is removed and sutures are placed on conjunctiva. Permanent magnet of the flexible polymer magnetolaser implant is manufactured from samarium-cobalt, samarium-iron-nitrogen or neodymium-iron-boron system material. The photosensitizer is repeatedly intravenously introduced at the same dose in 2-3 days after the first laser radiation treatment. Visual intraocular neoplasm cells fluorescence control is carried out using fluorescent diagnosis techniques. Maximum level of saturation with the photosensitizer being achieved in the intraocular neoplasm, repeated laser irradiation of the choroid hemangioma is carried out with radiation dose of 30-60 J/cm2.

EFFECT: enhanced effectiveness of treatment.

4 cl

FIELD: medicine.

SUBSTANCE: method involves making incision in conjunctiva and Tenon's capsule of 3-4 mm in size in choroid hemangioma projection to sclera 3-4 mm far from limb. Tunnel is built between sclera and Tenon's capsule to extrasclerally introduce flexible polymer magnetolaser implant through the tunnel to the place, the choroid hemangioma is localized, after performing transscleral diaphanoscopic adjustment of choroid hemangioma localization and size, under visual control using guidance beam. The implant has permanent ring-shaped magnet in the center of which a short focus scattering lens of laser radiator is fixed. The lens is connected to light guide in soft flexible envelope. The permanent implant magnet is axially magnetized and produces permanent magnetic field of 2-3 mTesla units intensity. It is arranged with its north pole turned towards the choroid hemangioma so that extrascleral implant laser radiator disposition. The other end of the implant is sutured to sclera 5-6 mm far from the limb with two interrupted sutures through prefabricated openings. The implant is covered with conjunctiva and relaxation sutures are placed over it. Light guide outlet is attached to temple using any known method. 0.1-1% khlorin solution is injected in intravenous bolus dose of 0.8-1.1 mg/kg as photosensitizer and visual control of choroid hemangioma cells fluorescence and fluorescent diagnosis methods are applied. After saturating choroid hemangioma with the photosensitizer to maximum level, transscleral choroid hemangioma laser radiation treatment is carried out via laser light guide and implant lens using divergent laser radiation at wavelength of 661-666 nm with total radiation dose being equal to 30-120 J/cm2. The flexible polymer magnetolaser implant is removed and sutures are placed on conjunctiva. Permanent magnet of the flexible polymer magnetolaser implant is manufactured from samarium-cobalt, samarium-iron-nitrogen or neodymium-iron-boron system material. The photosensitizer is repeatedly intravenously introduced at the same dose in 2-3 days after the first laser radiation treatment. Visual intraocular neoplasm cells fluorescence control is carried out using fluorescent diagnosis techniques. Maximum level of saturation with the photosensitizer being achieved in the intraocular neoplasm, repeated laser irradiation of the choroid hemangioma is carried out with radiation dose of 30-60 J/cm2.

EFFECT: enhanced effectiveness of treatment.

4 cl

FIELD: medicine.

SUBSTANCE: method involves creating tunnel between sclera and Tenon's capsule in intraocular neoplasm projection. Intraocular neoplasm localization and size is adjusted by applying transscleral diaphanoscopic examination method. 0.1-0.3 ml of photosensitizing gel based on viscoelastic of hyaluronic acid, selected from group containing chealon, viscoate or hyatulon, is transsclerally introduced into intraocular neoplasm structure using special purpose needle in dosed manner. The photosensitizing gel contains khlorin, selected from group containing photolon, radachlorine or photoditazine in the amount of 0.1-1% by mass. Flexible polymer magnetolaser implant is extrasclerally introduced into the built tunnel in intraocular neoplasm projection zone under visual control using guidance beam. The implant has permanent ring-shaped magnet axially magnetized and producing permanent magnetic field of 3-4 mTesla units intensity, in the center of which a short focus scattering lens of laser radiator is fixed. The lens is connected to light guide in soft flexible envelope. The implant is arranged with its north pole turned towards the intraocular neoplasm so that implant laser radiator lens is extrasclerally arranged in intraocular neoplasm projection zone. The implant light guide is sutured to sclera 5-6 mm far from the limb with single interrupted suture. The implant is covered with conjunctiva and relaxation sutures are placed over it. Light guide outlet is attached to temple using any known method. Visual control of intraocular neoplasm cells is carried out by applying fluorescence and fluorescent diagnosis methods. After saturating the intraocular neoplasm with the photosensitizer to maximum saturation level, transscleral intraocular neoplasm laser radiation treatment is carried out via laser light guide and implant lens using divergent laser radiation at wavelength of 661-666 nm. The treatment course being over, the flexible polymer magnetolaser implant is removed and sutures are placed on conjunctiva. Permanent magnet of the flexible polymer magnetolaser implant is manufactured from samarium-cobalt, neodymium-iron-boron or samarium-iron-nitrogen. 0.1-1% khlorin solution as photosensitizer, selected from group containing photolon, radachlorine or photoditazine, is additionally intravenously introduced in 2-3 days at a dose of 0.8-1.1 mg/kg and repeated laser irradiation of the intraocular neoplasm is carried out with radiation dose of 30-45 J/cm2 15-20 min later during 30-90 s.

EFFECT: complete destruction of neoplasm; excluded its further growth.

4 cl

FIELD: medicine.

SUBSTANCE: method involves creating tunnel between sclera and Tenon's capsule in intraocular neoplasm projection. Intraocular neoplasm localization and size is adjusted by applying transscleral diaphanoscopic examination method. 0.1-0.3 ml of photosensitizing gel based on viscoelastic of hyaluronic acid, selected from group containing chealon, viscoate or hyatulon, is transsclerally introduced into intraocular neoplasm structure using special purpose needle in dosed manner. The photosensitizing gel contains khlorin, selected from group containing photolon, radachlorine or photoditazine in the amount of 0.1-1% by mass. Flexible polymer magnetolaser implant is extrasclerally introduced into the built tunnel in intraocular neoplasm projection zone under visual control using guidance beam. The implant has permanent ring-shaped magnet axially magnetized and producing permanent magnetic field of 3-4 mTesla units intensity, in the center of which a short focus scattering lens of laser radiator is fixed. The lens is connected to light guide in soft flexible envelope. The implant is arranged with its north pole turned towards the intraocular neoplasm so that implant laser radiator lens is extrasclerally arranged in intraocular neoplasm projection zone. The implant light guide is sutured to sclera 5-6 mm far from the limb with single interrupted suture. The implant is covered with conjunctiva and relaxation sutures are placed over it. Light guide outlet is attached to temple using any known method. Visual control of intraocular neoplasm cells is carried out by applying fluorescence and fluorescent diagnosis methods. After saturating the intraocular neoplasm with the photosensitizer to maximum saturation level, transscleral intraocular neoplasm laser radiation treatment is carried out via laser light guide and implant lens using divergent laser radiation at wavelength of 661-666 nm. The treatment course being over, the flexible polymer magnetolaser implant is removed and sutures are placed on conjunctiva. Permanent magnet of the flexible polymer magnetolaser implant is manufactured from samarium-cobalt, neodymium-iron-boron or samarium-iron-nitrogen. 0.1-1% khlorin solution as photosensitizer, selected from group containing photolon, radachlorine or photoditazine, is additionally intravenously introduced in 2-3 days at a dose of 0.8-1.1 mg/kg and repeated laser irradiation of the intraocular neoplasm is carried out with radiation dose of 30-45 J/cm2 15-20 min later during 30-90 s.

EFFECT: complete destruction of neoplasm; excluded its further growth.

4 cl

FIELD: medicine.

SUBSTANCE: method involves applying transscleral diaphanoscopic examination method for adjusting intraocular neoplasm localization and size. Rectangular scleral pocket is built 2/3 times as large as sclera thickness which base is turned from the limb. Several electrodes manufactured from a metal of platinum group are introduced into intraocular neoplasm structure via the built scleral pocket. Next to it, intraocular neoplasm electrochemical destruction is carried out in changing electrodes polarity with current intensity of 100 mA during 1-10 min, and the electrodes are removed. Superficial scleral flap is returned to its place and fixed with interrupted sutures. 0.1-2% aqueous solution of khlorin as photosensitizer, selected from group containing photolon, radachlorine or photoditazine, is intravenously introduced at a dose of 0.8-1.1 mg/kg. Visual control of intraocular neoplasm cells is carried out by applying fluorescence and fluorescent diagnosis methods. After saturating the intraocular neoplasm with the photosensitizer to maximum saturation level, transpupillary laser radiation of 661-666 nm large wavelength is applied at a dose of 30-120 J/cm2. the operation is ended with placing sutures on conjunctiva. Platinum, iridium or rhodium are used as the metals of platinum group. The number of electrodes is equal to 4-8. 0.1-1% khlorin solution, selected from group containing photolon, radachlorine or photoditazine, is additionally repeatedly intravenously introduced in 2-3 days at a dose of 0.8-1.1 mg/kg. Visual control of intraocular neoplasm cells is carried out by applying fluorescence and fluorescent diagnosis methods. After saturating the intraocular neoplasm with the photosensitizer to maximum saturation level, repeated laser irradiation of the intraocular neoplasm is carried out with radiation dose of 30-45 J/cm2.

EFFECT: complete destruction of neoplasm; excluded tumor recurrence; reduced risk of tumor cells dissemination.

3 cl, 3 dwg

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