本申请以中国专利申请202211670198.5(申请日：2022年12月26日)为基础，并享受其优先权。本申请通过参考该申请，包含该申请的全部内容。This application is based on and enjoys the priority of Chinese patent application No. 202211670198.5 (filing date: December 26, 2022). This application includes all the contents of the application by reference.
本申请涉及医疗器械领域，尤其涉及一种激光和水射流协作切除装置和控制方法。The present application relates to the field of medical devices, and in particular to a laser and water jet collaborative removal device and a control method.
良性前列腺增生(BPH)是引起中老年男性排尿障碍最为常见的一种良性疾病，是全球泌尿外科临床诊疗中最为常见的疾病之一。流行病学组织学上BPH的发生率随年龄的增长而增加，一般发生在40岁以后，60岁男性人群中BPH的发生率大于50％，80岁时高达83％。主要表现为组织学上的前列腺间质和腺体成分的增生、解剖学上的前列腺增大(benign prostatic enlargement，BPE)尿动力学上的膀胱出口梗阻(bladder outlet obstruction，BOO)和以下尿路症状(LUTS)为主的临床症状。Benign prostatic hyperplasia (BPH) is the most common benign disease causing urination disorders in middle-aged and elderly men, and is one of the most common diseases in the clinical diagnosis and treatment of urology worldwide. Epidemiologically, the incidence of BPH increases with age, generally occurring after the age of 40. The incidence of BPH in men aged 60 is greater than 50%, and as high as 83% at the age of 80. The main manifestations are histological hyperplasia of prostatic stroma and glandular components, anatomical benign prostatic enlargement (BPE), urodynamic bladder outlet obstruction (BOO), and lower urinary tract symptoms (LUTS).
目前存在两种主流切除技术：(1)水射流消融术是利用高能水射流切割原理有效地消融实质组织，同时保留血管和外科包膜等胶原结构。在经直肠超声实时监控下，高速水射流能有效切割组织且不产生热能。例如：对于中重度LUTS的BPH患者，前列腺高能水切割术的疗效和安全性不劣于经尿道前列腺电切术(Trans Urethral Resection Prostate，TURP)，较大的前列腺(50～80ml)获益更明显，同时，术后患者发生性功能障碍的风险更低。(2)激光手术是利用不同波长激光对软组织的作用进行的切除、汽化、剜除或组织的凝固、坏死及迟发性组织脱落等手术，达到解除梗阻的目的。激光具备凝固止血效果好和非导电特性。近年来，经尿道激光手术已成为BPH重要的治疗方式。There are currently two mainstream resection techniques: (1) Water jet ablation is a procedure that uses the principle of high-energy water jet cutting to effectively ablate solid tissue while preserving collagen structures such as blood vessels and surgical capsules. Under real-time monitoring by transrectal ultrasound, high-speed water jets can effectively cut tissue without generating heat. For example, for BPH patients with moderate to severe LUTS, the efficacy and safety of high-energy water jet cutting of the prostate are not inferior to transurethral resection of the prostate (TURP). Larger prostates (50-80 ml) benefit more significantly. At the same time, the risk of sexual dysfunction in patients after surgery is lower. (2) Laser surgery is a procedure that uses different wavelengths of laser to act on soft tissue to perform resection, vaporization, excision, or coagulation, necrosis, and delayed tissue shedding to achieve the purpose of relieving obstruction. Lasers have good coagulation and hemostasis effects and non-conductive properties. In recent years, transurethral laser surgery has become an important treatment for BPH.
但是以上技术还存在一定缺点和副作用：(1)激光与组织热效应，在40℃以下，光刺激；40到100℃，蛋白变性、组织、血液凝固；100℃，汽化；300℃，碳化。(2)激光手术：学习曲线长；激光烧灼、组织碳化严重；如：手术还需要联合组织粉碎器粉碎抽取切除下的软组织，手术时间长。(3)水射流手术：不具备止血功能。However, the above technologies still have certain disadvantages and side effects: (1) Laser and tissue thermal effect: below 40°C, light stimulation; 40 to 100°C, protein denaturation, tissue, and blood coagulation; 100°C, vaporization; 300°C, carbonization. (2) Laser surgery: long learning curve; laser burning and tissue carbonization are serious; for example, the surgery also requires the use of a tissue pulverizer to pulverize and extract the removed soft tissue, and the operation time is long. (3) Water jet surgery: does not have a hemostatic function.
发明内容Summary of the invention
本发明提供了一种激光和水射流协作切除装置和控制方法，解决了切除手术时间长、避免激光手术产生高温汽化、碳化、蛋白变性等问题。The present invention provides a laser and water jet collaborative excision device and control method, which solves the problems of long excision operation time and avoids the problems of high temperature vaporization, carbonization, protein denaturation and the like caused by laser operation.
本发明提供一种激光和水射流协作切除装置，其特征在于，包括控制端和工作端，控制端与工作端电连接，控制端包括：水射流控制模块、激光水射流传输控制机构、激光控制模块，工作端包括：水射流输出通道和激光输出通道；The present invention provides a laser and water jet collaborative removal device, characterized in that it comprises a control end and a working end, the control end is electrically connected to the working end, the control end comprises: a water jet control module, a laser water jet transmission control mechanism, and a laser control module, and the working end comprises: a water jet output channel and a laser output channel;
所述水射流控制模块，用于控制水射流的发射开关和强度；The water jet control module is used to control the emission switch and intensity of the water jet;
所述激光水射流传输控制机构，用于控制水射流和/或激光发射端的运动、开关和发射角度，所述水射流发射端位于水射流输出通道末端，所述激光发射端位于激光输出通道末端；The laser water jet transmission control mechanism is used to control the movement, switch and emission angle of the water jet and/or the laser emitting end, the water jet emitting end is located at the end of the water jet output channel, and the laser emitting end is located at the end of the laser output channel;
所述激光控制模块，用于控制激光输出的开关和功率；The laser control module is used to control the switch and power of the laser output;
所述水射流输出通道，用于输出切割组织用高压水射流；The water jet output channel is used to output high-pressure water jet for cutting tissue;
所述激光输出通道，用于输出激光束。The laser output channel is used to output a laser beam.
优选地，所述控制端还包括抽吸灌注控制模块、内窥镜照明控制模块和图像采集控制模块，所述工作端还包括抽吸通道、灌注通道、内窥镜照明装置和图像采集装置，其中，Preferably, the control end further includes a suction and perfusion control module, an endoscope lighting control module and an image acquisition control module, and the working end further includes a suction channel, a perfusion channel, an endoscope lighting device and an image acquisition device, wherein:
所述抽吸灌注控制模块，用于控制所述抽吸通道的抽吸液体和灌注通道灌注洗液；The suction and perfusion control module is used to control the suction liquid of the suction channel and the perfusion liquid of the perfusion channel;
所述内窥镜照明控制模块，用于控制所述内窥镜照明装置；The endoscope lighting control module is used to control the endoscope lighting device;
所述摄像控制模块，用于控制所述图像采集装置；The camera control module is used to control the image acquisition device;
所述抽吸通道，用于从机体内抽取切割消融后的组织残渣和液体；The suction channel is used to extract tissue residues and liquid after cutting and ablation from the body;
所述灌注通道，用于将冲洗液注入体内；The perfusion channel is used to inject the flushing fluid into the body;
所述内窥镜照明装置，用于提供照明光源；The endoscope lighting device is used to provide a lighting source;
所述图像采集装置，用于记录采集到的画面用于监控出血点以及水射流和激光在体内的作用点。The image acquisition device is used to record the acquired images for monitoring the bleeding points and the action points of the water jet and the laser in the body.
优选地，所述激光输出通道采用空心导管传输激光，所述激光端的端口用石英窗口密封。Preferably, the laser output channel uses a hollow conduit to transmit the laser, and the port at the laser end is sealed with a quartz window.
优选地，所述激光输出通道采用光纤进行激光传导。Preferably, the laser output channel uses optical fiber for laser conduction.
优选地，所述光纤为直出光纤或侧射光纤。Preferably, the optical fiber is a straight-out optical fiber or a side-emitting optical fiber.
优选地，当所述光线为侧射光纤时，所述激光发射端的激光束输出端面与光纤轴之间夹角为90度。Preferably, when the light is a side-emitting optical fiber, the angle between the laser beam output end face of the laser emitting end and the optical fiber axis is 90 degrees.
优选地，所述光纤与所述内窥镜照明装置共用一条器械通道。Preferably, the optical fiber and the endoscope lighting device share an instrument channel.
优选地，所述光纤为石英光纤或卤化银红外光纤。Preferably, the optical fiber is a quartz optical fiber or a silver halide infrared optical fiber.
优选地，所述光纤传输的激光束为380nm到10.6μm的激光。Preferably, the laser beam transmitted by the optical fiber is a laser with a wavelength of 380 nm to 10.6 μm.
优选地，所述工作端预留光纤耦合端口，使用激光时，将所述激光控制模块的外接端口与所述光纤耦合端口进行连接，使激光束能传输到所述工作端的所述激光输出通道。Preferably, the working end reserves a fiber coupling port, and when using the laser, the external port of the laser control module is connected to the fiber coupling port so that the laser beam can be transmitted to the laser output channel of the working end.
优选地，所述光纤与所述抽吸通道共用一条器械通道。或者，所述光纤与所述水射流输出通道共用一条器械通道。Preferably, the optical fiber and the suction channel share an instrument channel. Alternatively, the optical fiber and the water jet output channel share an instrument channel.
优选地，所述激光输出通道采用水进行激光传导，所述工作端的所述水射流输出通道和激光输出通道为一体的激光水导输出通道。Preferably, the laser output channel uses water for laser conduction, and the water jet output channel and the laser output channel at the working end are an integrated laser water-conducting output channel.
优选地，所述激光水导输出通道中输入的激光波长为380nm到1064nm的激光。Preferably, the laser wavelength input into the laser water guide output channel is a laser with a wavelength of 380 nm to 1064 nm.
优选地，所述激光水导输出通道的输入端上设置有石英窗口，所述石英窗口镀有双面增透膜。Preferably, a quartz window is provided on the input end of the laser water guide output channel, and the quartz window is coated with a double-sided anti-reflection film.
优选地，所述激光水导输出通道发射端输出的水射流喷射压不超过水射流产生空化的临界值。Preferably, the injection pressure of the water jet outputted from the emission end of the laser water guide output channel does not exceed the critical value of cavitation generated by the water jet.
优选地，所述激光水导输出通道中装有蛇骨机，所述蛇骨机由所述激光水射流传输控制机构驱动控制，用于调整所述水射流输出通道中的所述水射流发射端和所述激光发射端的弯曲角度和长度。Preferably, a serpentine machine is installed in the laser water-conducting output channel, and the serpentine machine is driven and controlled by the laser water jet transmission control mechanism to adjust the bending angle and length of the water jet emitting end and the laser emitting end in the water jet output channel.
优选地，所述激光控制模块根据所述水射流控制模块的扫描参数设置激光扫描的起始位置、总行程和/或扫描角度。以及，所述激光控制模块根据激光发射端与出血点之间的距离设定激光的功率和/或作用时间。进一步地，所述激光控制模块还根据出血点的位置设定激光扫描的起始位置、总行程和/或扫描角度。Preferably, the laser control module sets the starting position, total stroke and/or scanning angle of the laser scanning according to the scanning parameters of the water jet control module. Also, the laser control module sets the power and/or action time of the laser according to the distance between the laser emission end and the bleeding point. Further Preferably, the laser control module also sets the starting position, total stroke and/or scanning angle of the laser scanning according to the position of the bleeding point.
本发明还提供一种切除装置的控制方法，应用于上述任意一种激光和水射流协作切除装置，包括步骤：The present invention also provides a control method for a cutting device, which is applied to any one of the above-mentioned laser and water jet collaborative cutting devices, and comprises the steps of:
根据控制指令发射水射流和/或激光；launching water jets and/or lasers according to control instructions;
根据控制指令启动抽吸通道进行冲洗。The suction channel is started for flushing according to the control command.
优选地，发射水射流和激光的顺序为：先发射激光再输出水射流、先输出水射流再发射激光或水射流和激光同时发出。Preferably, the order of emitting the water jet and the laser is: emitting the laser first and then the water jet, emitting the water jet first and then the laser, or emitting the water jet and the laser simultaneously.
优选地，发射水射流和激光的模式为：连续、脉冲或者连续和脉冲的组合。Preferably, the modes of emitting the water jet and the laser are: continuous, pulsed, or a combination of continuous and pulsed.
优选地，发射水射流和激光的强度为：恒定、变化或者恒定和变化的组合。Preferably, the intensity of the emitted water jet and laser is: constant, variable, or a combination of constant and variable.
本发明提供的装置和控制方法将激光与水射流结合，协同工作，可产生如下有益效果：(1)提高手术效率，缩短手术时间，降低医务人员工作强度；(2)实现切除软组织的同时或之后实现止血效果，避免多次更换手术器械对人体的潜在损伤；(3)可提供工作位置的指示；(4)通过准确的激光波长、激光作用时间、激光功率的控制，避免激光手术时易出现的高温汽化、碳化、蛋白变性等问题；(5)利用复用激光传输通道和抽吸通道或者射流通道，复用机械结构和控制装置，降低装置的复杂度和成本；(6)针对多出血点的场景，通过自动控制激光的发射，提高止血效率；(7)通过图像采集装置可观察到出血点，辅助引导激光和水射流的控制，提高控制的准确性；(8)可对人体或动物软组织消融、切除和止血的切除装置，适用于前列腺、甲状腺、肝脏等。The device and control method provided by the present invention combine laser and water jet to work together, which can produce the following beneficial effects: (1) improve surgical efficiency, shorten surgical time, and reduce the workload of medical staff; (2) achieve hemostasis effect while or after resecting soft tissue, avoiding potential damage to the human body caused by multiple replacements of surgical instruments; (3) provide an indication of the working position; (4) avoid high-temperature vaporization, carbonization, protein denaturation and other problems that are prone to occur during laser surgery by accurately controlling the laser wavelength, laser action time, and laser power; (5) utilize multiplexing laser transmission channels and suction channels or jet channels, multiplexing mechanical structures and control devices, and reducing the complexity and cost of the device; (6) for scenes with multiple bleeding points, improve hemostasis efficiency by automatically controlling the emission of laser; (7) the bleeding points can be observed through the image acquisition device, which assists in guiding the control of laser and water jet and improves the accuracy of control; (8) the resection device can be used for ablation, resection and hemostasis of human or animal soft tissue, and is suitable for the prostate, thyroid, liver, etc.
此处所说明的附图用来提供对本申请的进一步理解，构成本申请的一部分，本申请的示意性实施例及其说明用于解释本申请，并不构成对本申请的不当限定。在附图中：The drawings described herein are used to provide a further understanding of the present application and constitute a part of the present application. The illustrative embodiments of the present application and their descriptions are used to explain the present application and do not constitute an improper limitation on the present application. In the drawings:
图1为一种激光和水射流协作切除装置结构示意图；FIG1 is a schematic diagram of the structure of a laser and water jet collaborative removal device;
图2为一种带抽吸和内窥镜的激光和水射流协作切除装置结构示意图；FIG2 is a schematic diagram of the structure of a laser and water jet collaborative resection device with suction and endoscope;
图3为采用独立光纤传导激光的工作端剖面图；FIG3 is a cross-sectional view of a working end using an independent optical fiber to conduct laser light;
图4为水对不同波长激光的吸收曲线图；FIG4 is a graph showing the absorption curves of water to lasers of different wavelengths;
图5为一种光纤与抽吸通道共用一条器械通道的激光和水射流协作切除装置结构示意图；FIG5 is a schematic diagram of the structure of a laser and water jet collaborative removal device in which an optical fiber and a suction channel share an instrument channel;
图6为采用光纤抽吸输出通道的工作端剖面图；Fig. 6 is a cross-sectional view of the working end of the output channel using optical fiber suction;
图7为一种光纤与水射流输出通道共用一条器械通道的激光和水射流协作切除装置结构示意图；FIG7 is a schematic diagram of the structure of a laser and water jet collaborative removal device in which an optical fiber and a water jet output channel share an instrument channel;
图8为采用光纤水射流输出通道的工作端剖面图；FIG8 is a cross-sectional view of the working end of the fiber optic water jet output channel;
图9为一种激光水导通道合一的激光和水射流协作切除装置结构示意图；FIG9 is a schematic diagram of the structure of a laser and water jet collaborative removal device with integrated laser and water guide channels;
图10为采用激光水导输出通道的工作端剖面图。FIG10 is a cross-sectional view of the working end of the laser water-guided output channel.
为使本申请的目的、技术方案和优点更加清楚，下面将结合本申请具体实施例及相应的附图对本申请技术方案进行清楚、完整地描述。显然，所描述的实施例仅是本申请一部分实施例，而不是全部的实施例。基于本申请中的实施例，本领域普通技术人员在没有做出创造性劳动前提下所获得的所有其他实施例，都属于本申请保护的范围。In order to make the purpose, technical solutions and advantages of the present application clearer, the technical solutions of the present application will be clearly and completely described below in combination with the specific embodiments of the present application and the corresponding drawings. Obviously, the described embodiments are only part of the embodiments of the present application, not all of the embodiments. Based on the embodiments in the present application, all other embodiments obtained by ordinary technicians in this field without making creative work are within the scope of protection of the present application.
以下结合附图，详细说明本申请各实施例提供的技术方案。The technical solutions provided by various embodiments of the present application are described in detail below in conjunction with the accompanying drawings.
图1为本发明申请实施例中一种激光和水射流协作切除装置，本实施例方案包括控制端和工作端，控制端与工作端电连接。FIG1 is a laser and water jet collaborative removal device in an embodiment of the present invention. The embodiment includes a control end and a working end, and the control end is electrically connected to the working end.
工作端即进入体内的部分，通过控制端发送指令到工作端执行发射激光、水射流的操作。The working end is the part that enters the body. The control end sends instructions to the working end to execute the operation of emitting lasers and water jets.
控制端包括：水射流控制模块111、激光水射流传输控制机构112、激光控制模块113，工作端包括：水射流输出通道121和激光输出通道122。The control end includes: a water jet control module 111 , a laser water jet transmission control mechanism 112 , and a laser control module 113 ; the working end includes: a water jet output channel 121 and a laser output channel 122 .
控制端的主要作用是发出控制指令，通过指令控制工作端的具体操作，除了控制发射水射流和激光外还需要控制工作端运动方向、行进路线以及发射的角度和距离。The main function of the control end is to issue control instructions and control the specific operations of the working end through instructions. In addition to controlling the emission of water jets and lasers, it is also necessary to control the movement direction, route, and emission angle and distance of the working end.
所述水射流控制模块111，用于控制水射流的发射开关和强度。The water jet control module 111 is used to control the emission switch and intensity of the water jet.
水射流控制模块用于控制切割消融软组织的水射流发射开关和发射强度。The water jet control module is used to control the water jet launch switch and launch intensity for cutting and ablating soft tissue. Spend.
所述激光水射流传输控制机构112，用于控制水射流和/或激光发射端的运动、开关和发射角度，所述水射流发射端位于水射流输出通道末端，所述激光发射端位于激光输出通道末端；The laser water jet transmission control mechanism 112 is used to control the movement, switch and emission angle of the water jet and/or the laser emission end. The water jet emission end is located at the end of the water jet output channel, and the laser emission end is located at the end of the laser output channel.
激光水射流传输控制机构112由电机带动，控制激光发射端和水射流发射端的运动与发射角度。激光水射流传输控制机构控制工作端中激光发射端和水射流发射端的运动情况，包括运动轨迹、发射角度。The laser water jet transmission control mechanism 112 is driven by a motor to control the movement and emission angle of the laser emitting end and the water jet emitting end. The laser water jet transmission control mechanism controls the movement of the laser emitting end and the water jet emitting end in the working end, including the movement trajectory and the emission angle.
激光或水射流发射角度由激光水射流传输控制机构控制，由电机带动激光光纤或射流通道进退和角度旋转。The laser or water jet emission angle is controlled by the laser water jet transmission control mechanism, and the motor drives the laser optical fiber or jet channel to move forward and backward and rotate the angle.
所述激光控制模块113，用于控制激光输出的开关和功率；The laser control module 113 is used to control the switch and power of the laser output;
激光控制模块用于控制激光能量束的发射开关、发射模式(连续、脉冲)、发射功率和能量频率，避免激光手术时易出现的高温汽化、碳化、蛋白变性等问题。The laser control module is used to control the emission switch, emission mode (continuous, pulsed), emission power and energy frequency of the laser energy beam to avoid problems such as high-temperature vaporization, carbonization, protein denaturation, etc. that are prone to occur during laser surgery.
所述水射流输出通道121，用于输出切割组织用高压水射流；The water jet output channel 121 is used to output high-pressure water jet for cutting tissue;
利用高能水射流切割原理有效地消融前列腺实质组织，同时保留血管和外科包膜等胶原结构，高能高压水射流通过水射流输出通道发出，对准需要切割的部位进行切割。The high-energy water jet cutting principle is used to effectively ablate the prostate parenchyma tissue while retaining collagen structures such as blood vessels and surgical capsules. The high-energy and high-pressure water jet is emitted through the water jet output channel and cuts the area that needs to be cut.
所述激光输出通道122，用于输出激光束。The laser output channel 122 is used to output a laser beam.
激光输出通道的发射端对准出血点，发射激光束，达到止血效果。The emitting end of the laser output channel is aimed at the bleeding point and emits a laser beam to achieve a hemostatic effect.
激光与水射流可以同步工作。即，在高压水射流切除前列腺软组织时，输出连续或脉冲(准连续)的激光束，达到同步止血的作用。The laser and the water jet can work synchronously. That is, when the high-pressure water jet removes the prostate soft tissue, a continuous or pulsed (quasi-continuous) laser beam is output to achieve the effect of synchronous hemostasis.
激光与水射流可以交替工作。即，在高压水射流切除前列腺软组织的间歇期间，输出连续或脉冲(准连续)的激光束，达到止血的作用。The laser and the water jet can work alternately. That is, during the interval of high-pressure water jet cutting the prostate soft tissue, a continuous or pulsed (quasi-continuous) laser beam is output to achieve the effect of hemostasis.
图2为本发明申请实施例中一种带抽吸和内窥镜的激光和水射流协作切除装置结构示意图，在本实施方案中，在图1所示实施例基础上，所述控制端还包括抽吸灌注控制模块211、内窥镜照明控制模块212和图像采集控制模块213，所述工作端还包括抽吸通道221、灌注通道222、内窥镜照明装置223和图像采集装置224。Figure 2 is a schematic diagram of the structure of a laser and water jet collaborative resection device with suction and endoscope in an embodiment of the present invention. In this embodiment, based on the embodiment shown in Figure 1, the control end also includes a suction and perfusion control module 211, an endoscope lighting control module 212 and an image acquisition control module 213, and the working end also includes a suction channel 221, a perfusion channel 222, an endoscope lighting device 223 and an image acquisition device 224.
本实施方案同时具备灌注液体冲洗抽吸和拍摄的功能，因此需要在控制端增加抽吸灌注控制模块、内窥镜照明控制模块和图像采集控制模块，发出指令用来控制工作端的抽吸通道、灌注通道、内窥镜照明装置和图像采集装置。This embodiment has the functions of perfusion, flushing, suction and shooting at the same time, so it is necessary to add a suction and perfusion control module, an endoscope lighting control module and an image acquisition control module at the control end. The instructions are issued to control the suction channel, irrigation channel, endoscope lighting device and image acquisition device of the working end.
其中，所述抽吸灌注控制模块211，用于控制所述抽吸通道的抽吸液体和灌注通道灌注洗液；Wherein, the suction and perfusion control module 211 is used to control the suction liquid of the suction channel and the perfusion liquid of the perfusion channel;
抽吸灌注控制模块控制从机体内抽取切割消融后的软组织残渣和液体，可控制灌注和抽吸的速率。The suction and irrigation control module controls the extraction of soft tissue residues and liquid after cutting and ablation from the body, and can control the rates of irrigation and suction.
所述内窥镜照明控制模块212，用于控制所述内窥镜照明装置；所述摄像控制模块，用于控制所述图像采集装置；The endoscope lighting control module 212 is used to control the endoscope lighting device; the camera control module is used to control the image acquisition device;
内窥镜照明控制模块和图像采集控制模块为内窥镜提供照明光源和影像控制，可实时监控出血点以及水射流和激光在机体内的作用点。The endoscope lighting control module and image acquisition control module provide lighting source and image control for the endoscope, and can monitor the bleeding point and the action point of the water jet and laser in the body in real time.
所述抽吸通道221，用于从机体内抽取切割消融后的组织残渣和液体；所述灌注通道222，用于将冲洗液注入体内；The suction channel 221 is used to extract tissue residues and liquid after cutting and ablation from the body; the perfusion channel 222 is used to inject flushing liquid into the body;
水射流切割、消融软组织后，通过抽吸通道将软组织残渣和液体抽吸出体外，并将无菌生理盐水通过灌注通道注入体内，使工作视野清晰，利于内窥镜下观察。After the water jet cuts and ablates the soft tissue, the soft tissue residue and liquid are sucked out of the body through the suction channel, and sterile saline is injected into the body through the perfusion channel, making the working field clear and facilitating endoscopic observation.
所述内窥镜照明装置223，用于摄像和提供照明光源；所述图像采集装置224，记录采集到的图像画面，监控出血点以及水射流和激光在体内的作用点。The endoscope lighting device 223 is used for taking pictures and providing a lighting source; the image acquisition device 224 records the acquired images and monitors the bleeding points and the points of action of the water jet and the laser in the body.
在水射流或激光进行切割或止血的过程中，内窥镜照明装置和图像采集装置帮助操作人员查找确定切割位置和需要止血的位置，监控水射流和激光在体内的工作情况便于进一步操作。During the process of cutting or hemostasis by water jet or laser, the endoscope lighting device and image acquisition device help the operator to find and determine the cutting position and the position where hemostasis is required, and monitor the working conditions of the water jet and laser in the body to facilitate further operations.
作为本申请的一个实施例，所述激光输出通道采用空心导管传输激光(类似导光臂)，所述激光发射端的端口用石英窗口密封防水。As an embodiment of the present application, the laser output channel uses a hollow conduit to transmit the laser (similar to a light-guiding arm), and the port of the laser emission end is sealed with a quartz window for waterproofing.
作为本申请的一个实施例，激光输出通道采用光纤进行传导；如图3采用独立光纤传导激光的工作端剖面图所示，包括：抽吸通道221、水射流输出通道121、激光输出通道122，工作端的激光输出通道122的激光束采用独立的光纤传导，可以选用直出光纤，尤其是，还可以选用侧射光纤。As an embodiment of the present application, the laser output channel is conducted by optical fiber; as shown in the cross-sectional view of the working end using independent optical fiber to conduct laser in FIG3 , it includes: a suction channel 221, a water jet output channel 121, and a laser output channel 122. The laser beam of the laser output channel 122 at the working end is conducted by an independent optical fiber, and a straight-out optical fiber may be selected, and in particular, a side-emitting optical fiber may also be selected.
选用侧射光纤时，激光发射端的激光束输出端面与光纤轴之间夹角为90度，可以保证止血效果最佳且易操控。激光光纤置入激光输出通道，激光发射角度由激光水射流传输控制机构控制其发射角度，由电机带动激光光纤进退(例如行程80mm)和角度旋转(例如±120°范围)。When side-firing optical fiber is used, the angle between the laser beam output end face of the laser emitting end and the optical fiber axis is 90 degrees, which can ensure the best hemostasis effect and easy control. The laser fiber is placed in the laser output channel, and the laser emission angle is controlled by the laser water jet transmission control mechanism, and the laser is driven by the motor. Fiber advance and retraction (e.g. 80mm stroke) and angular rotation (e.g. ±120° range).
对于多出血点的情况，激光光纤可在控制软件的设置下，对于前列腺已切除的部分进行大面积扫描或者全扫描，用激光束照射，达到快速止血的效果。In the case of multiple bleeding points, the laser fiber can perform a large-area scan or a full scan of the resected part of the prostate under the setting of the control software, and irradiate it with a laser beam to achieve the effect of rapid hemostasis.
作为本申请的一个实施例，当工作端的激光输出通道采用光纤进行激光传导时，光纤可利用内窥镜照明装置的器械通道、抽吸通道、水射流输出通道作为光纤的导入通道，此时也不会增加工作端器械大小。此时可以选用石英光纤或卤化银红外光纤传输激光，选用380nm到10.6μm的激光，可达到手术预期效果。As an embodiment of the present application, when the laser output channel of the working end uses optical fiber for laser transmission, the optical fiber can use the instrument channel, suction channel, and water jet output channel of the endoscope lighting device as the optical fiber introduction channel, and the size of the working end instrument will not be increased. At this time, quartz optical fiber or silver halide infrared optical fiber can be used to transmit laser, and lasers from 380nm to 10.6μm can be used to achieve the expected surgical effect.
作为本申请的一个实施例，当工作端的激光输出通道采用水进行激光传导时，激光输出通道中输入的激光波长为380nm至1064nm。As an embodiment of the present application, when the laser output channel of the working end uses water for laser conduction, the laser wavelength input into the laser output channel is 380 nm to 1064 nm.
如图4中水对不同波长激光的吸收曲线图所示，由于水对激光有一定吸收作用，需要选择合适的激光波长与功率的组合对出血点进行扫描止血，既能满足水吸收少的要求又能够达到止血效果。As shown in the absorption curve of water for lasers of different wavelengths in FIG4 , since water has a certain absorption effect on lasers, it is necessary to select a suitable combination of laser wavelength and power to scan and stop bleeding points, which can both meet the requirement of less water absorption and achieve the hemostatic effect.
根据水对不同波长激光的吸收曲线，可选择水吸收少，同时能够具备止血功能的激光(如：波长为532nm、980nm的激光)。激光控制模块控制激光能量束输出(如：波长为532nm的激光，功率可不超过10W)。激光光纤输出端对准出血点，发射激光束，达到止血效果。According to the absorption curve of water to lasers of different wavelengths, lasers with less water absorption and hemostasis function can be selected (such as lasers with wavelengths of 532nm and 980nm). The laser control module controls the output of the laser energy beam (such as a laser with a wavelength of 532nm, the power can not exceed 10W). The output end of the laser fiber is aimed at the bleeding point and the laser beam is emitted to achieve the hemostasis effect.
作为本申请的一种实施例，所述工作端预留光纤耦合端口，使用激光时，将所述激光控制模块的外接端口与所述光纤耦合端口进行连接，使激光束能传输到所述工作端的所述激光输出通道。As an embodiment of the present application, the working end reserves a fiber coupling port. When using the laser, the external port of the laser control module is connected to the fiber coupling port so that the laser beam can be transmitted to the laser output channel of the working end.
将一段激光光纤预埋在装置工作端通道内，在操作手柄上预留光纤耦合端口，使用激光时，将激光控制模块的外接端口与光纤耦合端口进行连接，使激光束能传输到治疗端。A section of laser optical fiber is pre-buried in the working end channel of the device, and a fiber coupling port is reserved on the operating handle. When using the laser, the external port of the laser control module is connected to the fiber coupling port so that the laser beam can be transmitted to the treatment end.
作为本申请的一种实施例，所述光纤与所述抽吸通道共用一条器械通道为光纤抽吸通道521。如图6所示，光纤与抽吸通道共用一条器械通道。As an embodiment of the present application, the optical fiber and the suction channel share an instrument channel, which is the optical fiber suction channel 521. As shown in Fig. 6, the optical fiber and the suction channel share an instrument channel.
图5为光纤与抽吸通道共用一条器械通道的激光和水射流协作切除装置结构示意图，在本实施例中，水射流控制模块控制水射流实施切除，通过光纤抽吸通道521将残渣和液体抽吸出体外，并将无菌生理盐水通过灌注通道注入。使工作视野清晰，利于内镜下观察。将激光光纤从通道专用开口处插入光纤抽吸通道，在内镜观察下，光纤伸出光纤抽吸通道至少5mm，避免激光能量损伤内窥镜端面。该实施例优先选用直出光纤。FIG5 is a schematic diagram of the structure of a laser and water jet collaborative resection device in which the optical fiber and the suction channel share an instrument channel. In this embodiment, the water jet control module controls the water jet to perform resection, and the residue and liquid are sucked out of the body through the optical fiber suction channel 521, and sterile saline is injected through the perfusion channel. This makes the working field clear and facilitates endoscopic observation. The optical fiber suction channel is inserted into the opening, and under endoscope observation, the optical fiber extends out of the optical fiber suction channel by at least 5 mm to prevent the laser energy from damaging the end face of the endoscope. This embodiment preferably uses a straight-out optical fiber.
在水环境中进行手术治疗时，可根据水对不同波长激光的吸收曲线，选择被水吸收少，同时能够具备止血功能的激光(如：波长为380nm至1064nm的激光)。由激光控制模块控制激光能量束输出。When performing surgery in a water environment, lasers that are less absorbed by water and have a hemostatic function (such as lasers with wavelengths of 380nm to 1064nm) can be selected based on the absorption curve of water for lasers of different wavelengths. The laser energy beam output is controlled by the laser control module.
作为优选，在使用本申请的切除装置中的水射流完成切除后，根据激光发射端与出血点之间的距离，调节激光的功率和/或作用时间，实现止血。例如，当光纤的激光发射端直接接触出血点，发射激光束，激光功率一般不超过5W，激光作用时间1s到2s，达到止血效果。当激光发射端与出血点之间的距离不超过3mm时，可调节激光功率10W到15W，激光作用时间1s到3s，直至停止出血。当激光发射端与出血点之间的距离大于3mm，可调节激光功率达20W到30W，发射激光，并适当增加激光作用时间，例如1s到4s，在内镜下观察软组织表面凝固，出血点组织塌陷，达到止血目的。进一步地，所述激光发射端与出血点之间的距离通过内窥镜进行探测获取，或者通过对实时超声图像的计算处理获得。Preferably, after the water jet in the excision device of the present application is used to complete the excision, the power and/or action time of the laser are adjusted according to the distance between the laser emitting end and the bleeding point to achieve hemostasis. For example, when the laser emitting end of the optical fiber directly contacts the bleeding point and emits a laser beam, the laser power generally does not exceed 5W, and the laser action time is 1s to 2s, so as to achieve the hemostasis effect. When the distance between the laser emitting end and the bleeding point does not exceed 3mm, the laser power can be adjusted to 10W to 15W, and the laser action time is 1s to 3s until the bleeding stops. When the distance between the laser emitting end and the bleeding point is greater than 3mm, the laser power can be adjusted to 20W to 30W, the laser is emitted, and the laser action time is appropriately increased, for example, 1s to 4s, and the coagulation of the soft tissue surface is observed under the endoscope, and the tissue collapse of the bleeding point is achieved to achieve the purpose of hemostasis. Further, the distance between the laser emitting end and the bleeding point is detected and obtained by endoscope, or obtained by calculation and processing of real-time ultrasonic images.
在采用直出光纤的情况下，当需要光纤输出端接触软组织止血时，或者激光光纤输出端由于激光输出造成损耗缩短，可将直出光纤向输出端推进，直至光纤伸出所述抽吸与光纤通道至少5mm。When a straight optical fiber is used, when the optical fiber output end needs to contact soft tissue to stop bleeding, or the laser optical fiber output end is shortened due to loss caused by laser output, the straight optical fiber can be pushed toward the output end until the optical fiber extends out of the suction and optical fiber channel by at least 5 mm.
作为本申请的一种实施例，所述光纤与所述水射流输出通道共用一条器械通道为光纤水射流通道621。如图8所示，光纤与水射流输出通道共用一条器械通道。As an embodiment of the present application, the optical fiber and the water jet output channel share a device channel, which is the optical fiber water jet channel 621. As shown in Fig. 8, the optical fiber and the water jet output channel share a device channel.
图7为光纤与水射流输出通道共用一条器械通道的激光和水射流协作切除装置结构示意图。在水射流控制模块控制水射流输出，对软组织进行切割消融手术治疗，软组织切割消融后的表面存在一个或多个出血点，通过抽吸通道221将软组织残渣和液体抽吸出体外，并将无菌生理盐水通过灌注通道注入体内，使工作视野清晰，利于内镜下观察。水刀拔出光纤水射流通道621，将激光光纤插入光纤水射流通道621，直到内镜可以观察到完整的激光光纤输出端，避免激光能量损伤内窥镜端面。FIG7 is a schematic diagram of the structure of a laser and water jet collaborative resection device in which the optical fiber and water jet output channels share an instrument channel. The water jet control module controls the water jet output to perform cutting and ablation surgery on soft tissue. There are one or more bleeding points on the surface of the soft tissue after cutting and ablation. The soft tissue residue and liquid are sucked out of the body through the suction channel 221, and sterile saline is injected into the body through the perfusion channel to make the working field clear and facilitate endoscopic observation. The water jet pulls out the optical fiber water jet channel 621, and inserts the laser fiber into the optical fiber water jet channel 621 until the endoscope can observe the complete laser fiber output end to avoid laser energy damaging the end face of the endoscope.
激光光纤可选用侧射光纤，激光光纤输出端面与光纤轴呈90°。激光光纤插入光纤水射流通道621，激光发射角度由激光水射流传输控制机构控制其发射角度，由电机带动激光光纤进退和角度旋转。The laser fiber can be a side-emitting fiber, and the output end face of the laser fiber is 90° with the fiber axis. The laser fiber is inserted into the fiber water jet channel 621, and the laser emission angle is controlled by the laser water jet transmission control mechanism. The emission angle is controlled, and the motor drives the laser fiber to move forward and backward and rotate at an angle.
在水环境中进行手术治疗时，可根据水对不同波长激光的吸收曲线，选择被水吸收少，同时能够具备止血功能的激光(如：波长为380nm至1064nm的激光)。When performing surgical treatment in an aquatic environment, a laser that is less absorbed by water and has a hemostatic function (such as a laser with a wavelength of 380nm to 1064nm) can be selected based on the water's absorption curve for lasers of different wavelengths.
由激光控制模块控制激光能量束输出。光纤的激光发射端一般不接触出血点，可根据距离选择合适的激光功率发射激光束，激光功率一般从小功率开始，逐渐增加激光功率，最大距离在25mm，其最大激光功率可设定为50W，作用时间为10s-15s，在内镜下观察软组织表面凝固，出血点组织塌陷，直至达到止血。The laser control module controls the output of the laser energy beam. The laser emitting end of the optical fiber generally does not touch the bleeding point. The laser beam can be emitted by selecting the appropriate laser power according to the distance. The laser power generally starts from a low power and gradually increases. The maximum distance is 25mm. The maximum laser power can be set to 50W, and the action time is 10s-15s. The coagulation of the soft tissue surface and the collapse of the bleeding point tissue are observed under the endoscope until hemostasis is achieved.
对于多出血点的情况，激光光纤可在控制软件的设置下，对于软组织已切除的部分进行大面积扫描或全扫描。In the case of multiple bleeding points, the laser fiber can perform a large-area scan or a full scan of the resected soft tissue under the setting of the control software.
例如，在默认水射流切除组织后会导致多出血点的情况下，可设置激光控制模块，在水射流切除动作完成后启动激光扫描，并根据水射流控制模块设定的扫描参数(例如：起始位置、总行程、扫描角度)设定激光控制模块的扫描参数，并进而控制激光扫描模块在水射流切除后执行全扫描，实现全面止血。For example, when the default water jet excision of tissue will cause multiple bleeding points, a laser control module can be set to start laser scanning after the water jet excision action is completed, and the scanning parameters of the laser control module can be set according to the scanning parameters set by the water jet control module (for example: starting position, total stroke, scanning angle), and then the laser scanning module can be controlled to perform a full scan after water jet excision to achieve comprehensive hemostasis.
进一步地，也可通过水射流切除软组织时的扫描参数和图像采集装置的辅助监控定位软组织上的各个出血点，确定各出血点的位置，根据出血点的位置在上位机软件设定激光扫描的起始位置、总行程、扫描角度、激光的功率和/或作用时间。例如最大行程80mm，左右角度范围±120°，激光功率可设定为50W，每个点作用时间10s，激光光纤行程步进距离5mm，角度步进10°，用激光束照射，达到快速止血的效果。Furthermore, the scanning parameters during the water jet excision of soft tissue and the auxiliary monitoring of the image acquisition device can also be used to locate each bleeding point on the soft tissue, determine the position of each bleeding point, and set the starting position, total stroke, scanning angle, laser power and/or action time of the laser scanning in the upper computer software according to the position of the bleeding point. For example, the maximum stroke is 80mm, the left and right angle range is ±120°, the laser power can be set to 50W, the action time of each point is 10s, the laser fiber stroke step distance is 5mm, the angle step is 10°, and the laser beam is irradiated to achieve the effect of rapid hemostasis.
作为本申请的一种实施例，图9为一种激光水导通道合一的激光和水射流协作切除装置。如图9所示，所述工作端的所述水射流输出通道和激光输出通道为一体的激光水导输出通道721。As an embodiment of the present application, Fig. 9 is a laser and water jet collaborative removal device with integrated laser and water guide channel. As shown in Fig. 9, the water jet output channel and the laser output channel of the working end are integrated into a laser water guide output channel 721.
利用激光可以在水中被反射而传导的原理，激光水导输出通道721中激光以水作为介质传导，因此可以将激光传输通道和水传输通道合并为一体既可输送水又可传导激光，如图10所示，形成激光水导输出通道721。By utilizing the principle that laser can be reflected and conducted in water, the laser in the laser water-conducting output channel 721 is conducted using water as a medium. Therefore, the laser transmission channel and the water transmission channel can be combined into one to transport water and conduct laser, as shown in FIG. 10 , to form a laser water-conducting output channel 721 .
激光水导输出通道传输可用水传导的激光(如：波长为380nm到1064nm的激光)。The laser water-conducting output channel can transmit water-conducting lasers (eg, lasers with wavelengths of 380 nm to 1064 nm).
作为本申请的一种实施例，所述水射流激光输出通道中输入的激光波长为980nm、功率不大于30W。As an embodiment of the present application, the laser wavelength input into the water jet laser output channel is 980nm and the power is not more than 30W.
根据水对不同波长激光的吸收曲线，可选择水吸收少，同时能够具备止血功能的激光(如：波长为980nm的激光)。980nm激光既可以通过光纤传导，也可通过水流传导，激光功率可不超过30W。According to the absorption curve of water to lasers of different wavelengths, lasers with less water absorption and hemostasis function (such as lasers with a wavelength of 980nm) can be selected. 980nm lasers can be transmitted through optical fibers or water flow, and the laser power can not exceed 30W.
作为本申请的一种实施例，所述激光水导输出通道的输入端上设置有石英窗口，所述石英窗口镀有980nm的双面增透膜。As an embodiment of the present application, a quartz window is provided on the input end of the laser water guide output channel, and the quartz window is coated with a 980nm double-sided anti-reflection film.
激光水导通道输入端上设置有石英窗口，并镀有980nm的双面增透膜。激光控制模块产生和发射980nm激光。激光发生器产生激光束，激光束斜入射石英窗口，使得激光束能够在水导通道中行程全反射。A quartz window is provided at the input end of the laser water guide channel and coated with a 980nm double-sided anti-reflection film. The laser control module generates and emits 980nm laser. The laser generator generates a laser beam, which is incident obliquely on the quartz window, so that the laser beam can be totally reflected in the water guide channel.
激光束光斑为直径4mm的圆形，激光束通过光学透镜组整形为光斑1mm的圆形，激光束斜入射石英窗口，激光水导通道内壁镀有对应激光波长的全反膜层，使得激光束能够在水导通道中形成全反射，减小传输损耗。The laser beam spot is a circle with a diameter of 4mm. The laser beam is shaped into a circle with a spot size of 1mm through an optical lens group. The laser beam is incident on the quartz window at an angle. The inner wall of the laser water guide channel is coated with a total reflection film layer corresponding to the laser wavelength, so that the laser beam can form total reflection in the water guide channel to reduce transmission loss.
作为本申请的一种实施例，所述激光水导输出通道发射端输出的水射流喷射压不超过临界值。As an embodiment of the present application, the injection pressure of the water jet outputted from the emission end of the laser water guide output channel does not exceed a critical value.
水导通道工作端的末端(预期进入体内的部分)可调节喷嘴开度，使喷射压强不超过临界值，或通过水射流控制模块调节水射流喷射压力，使水射流不产生空化效应，水射流不会对软组织有切割消融作用，水导通道用于形成传导激光束的水流通道。该临界值可选用5Mpa。The nozzle opening of the end of the working end of the water channel (the part expected to enter the body) can be adjusted so that the injection pressure does not exceed the critical value, or the water jet injection pressure can be adjusted through the water jet control module so that the water jet does not produce cavitation effect and the water jet does not have a cutting and ablative effect on soft tissue. The water channel is used to form a water flow channel for conducting laser beams. The critical value can be selected as 5Mpa.
作为本申请的一种实施例，所述激光水导输出通道中装有蛇骨机，所述蛇骨机由所述激光水射流传输控制机构驱动控制，用于调整所述激光水导输出通道中的所述水射流发射端和所述激光发射端的弯曲角度和长度。As an embodiment of the present application, a serpentine machine is installed in the laser water-guided output channel, and the serpentine machine is driven and controlled by the laser water jet transmission control mechanism to adjust the bending angle and length of the water jet emitting end and the laser emitting end in the laser water-guided output channel.
激光水导输出通道中的蛇骨机可以伸缩和旋转，通过控制蛇骨机可以调整水射流、激光的发射角度和与切割/出血部位之间的距离。The snake-bone machine in the laser water-guided output channel can be extended and rotated. By controlling the snake-bone machine, the emission angle of the water jet and laser and the distance from the cutting/bleeding site can be adjusted.
如果出血点距离喷射位置超出了激光束的有效工作距离，激光水导输出通道末端由激光水射流传输控制机构驱动激光水导输出通道中的蛇骨机构调整激光发射端和出血点的距离，调整弯曲角度90°，长度可达30mm，使得激光束能有效止血。这个过程可在内窥镜下观察出血点情况(包括，位置点、出血量多少)。If the bleeding point is beyond the effective working distance of the laser beam, the laser water jet transmission control mechanism drives the snake mechanism in the laser water jet output channel to adjust the distance between the laser emission end and the bleeding point, and adjust the bending angle by 90°, with a length of up to 30mm, so that the laser beam can effectively stop bleeding. During this process, the bleeding point (including the location and amount of bleeding) can be observed under the endoscope.
本申请还提供一种切除装置的控制方法，应用于以上实施例的任意一种激光和水射流协作切除装置，包括步骤：The present application also provides a control method for a resection device, which is applicable to any one of the above embodiments. A laser and water jet collaborative removal device, comprising the steps of:
根据控制指令发射水射流和/或激光切除目标组织；launching a water jet and/or a laser to remove target tissue according to control instructions;
根据控制指令启动抽吸通道进行冲洗。The suction channel is started for flushing according to the control command.
作为本申请的一种实施例，发射水射流和激光的顺序可为：先发射激光再输出水射流、先输出水射流再发射激光或水射流和激光同时发出。As an embodiment of the present application, the order of emitting the water jet and the laser may be: emitting the laser first and then the water jet, or emitting the water jet first and then the laser, or emitting the water jet and the laser simultaneously.
在手术进行时可以先发射激光，再输出水射流；或者先输出水射流，再发射激光；也可以激光与水射流同时输出。手术中以上三种顺序均可。During the operation, the laser can be emitted first and then the water jet; or the water jet can be emitted first and then the laser; or the laser and the water jet can be emitted at the same time. All three sequences are possible during the operation.
作为本申请的一种实施例，发射水射流和激光的模式为：连续、脉冲或者连续和脉冲的组合。As an embodiment of the present application, the modes of emitting water jet and laser are: continuous, pulsed or a combination of continuous and pulsed.
激光与水射流可以同步工作，即，在高压水射流切除前列腺软组织时，输出连续或脉冲(准连续)的激光束，达到同步止血的作用。激光与水射流也可以交替工作，即，在高压水射流切除前列腺软组织的间歇期间，输出连续或脉冲(准连续)的激光束，达到止血的作用。The laser and water jet can work synchronously, that is, when the high-pressure water jet is removing the prostate soft tissue, a continuous or pulsed (quasi-continuous) laser beam is output to achieve the effect of synchronous hemostasis. The laser and water jet can also work alternately, that is, during the interval of the high-pressure water jet removing the prostate soft tissue, a continuous or pulsed (quasi-continuous) laser beam is output to achieve the effect of hemostasis.
作为本申请的一种实施例，发射水射流和激光的强度为：恒定、变化或者恒定和变化的组合。As an embodiment of the present application, the intensity of emitting the water jet and the laser is: constant, variable, or a combination of constant and variable.
手术中，水射流和激光的强度可变，可根据实际需要对输出强度进行恒定、变化或者恒定和变化的组合的调整。During the operation, the intensity of the water jet and the laser can be variable, and the output intensity can be adjusted to be constant, variable, or a combination of constant and variable according to actual needs.
在手术中通过内窥镜发现前列腺结石，将水射流(设置为低压强)对准结石发射激光束粉碎结石，或通过光纤将光纤输出头对准结石(可接触、也可不接触，同时有瞄准光束作为指引光)，发射激光粉碎结石。粉碎后的结石粉末，通过水射流抽吸通道吸出体外。During the operation, prostate stones are found through endoscope, and a water jet (set to low pressure) is aimed at the stone to emit a laser beam to crush the stone, or the fiber output head is aimed at the stone through an optical fiber (it can be in contact or not, and there is an aiming beam as a guide light), and a laser is emitted to crush the stone. The crushed stone powder is sucked out of the body through the water jet suction channel.
激光能提供水射流工作指示功能提供工作位置的指示功能，为实现精准手术提供帮助。在前列腺软组织切割、消融手术中该设备能够发射激光束和水射流，水射流对软组织进行切割，激光束具备止血、粉碎前列腺结石功能，能够用于指示水射流切割位置。Laser can provide water jet working indication function and working position indication function, which can help to achieve precise surgery. In prostate soft tissue cutting and ablation surgery, the device can emit laser beam and water jet. The water jet cuts the soft tissue, and the laser beam has the function of hemostasis and crushing prostate stones, which can be used to indicate the water jet cutting position.
本领域内的技术人员应明白，本发明的实施例可提供为方法、系统、或计算机程序产品。因此，本发明可采用完全硬件实施例、完全软件实施例、或结合软件和硬件方面的实施例的形式。而且，本发明可采用在一个或多个其中包含有计算机可用程序代码的计算机可用存储介质(包括但不限于磁盘存储器、CD-ROM、光学存储器等)上实施的计算机程序产品的形式。It should be understood by those skilled in the art that the embodiments of the present invention may be provided as methods, systems, or computer program products. Therefore, the present invention may take the form of a complete hardware embodiment, a complete software embodiment, or an embodiment combining software and hardware aspects. Moreover, the present invention may take the form of a computer program product implemented on one or more computer-usable storage media (including but not limited to disk storage, CD-ROM, optical storage, etc.) containing computer-usable program code. Mode.
还需要说明的是，术语“包括”、“包含”或者其任何其他变体意在涵盖非排他性的包含，从而使得包括一系列要素的过程、方法、商品或者设备不仅包括那些要素，而且还包括没有明确列出的其他要素，或者是还包括为这种过程、方法、商品或者设备所固有的要素。在没有更多限制的情况下，由语句“包括一个……”限定的要素，并不排除在包括所述要素的过程、方法、商品或者设备中还存在另外的相同要素。It should also be noted that the terms "include", "comprises" or any other variations thereof are intended to cover non-exclusive inclusion, so that a process, method, commodity or device including a series of elements includes not only those elements, but also other elements not explicitly listed, or also includes elements inherent to such process, method, commodity or device. In the absence of more restrictions, the elements defined by the sentence "comprises a ..." do not exclude the existence of other identical elements in the process, method, commodity or device including the elements.
以上所述仅为本申请的实施例而已，并不用于限制本申请。对于本领域技术人员来说，本申请可以有各种更改和变化。凡在本申请的精神和原理之内所作的任何修改、等同替换、改进等，均应包含在本申请的权利要求范围之内。The above is only an embodiment of the present application and is not intended to limit the present application. For those skilled in the art, the present application may have various changes and variations. Any modification, equivalent replacement, improvement, etc. made within the spirit and principle of the present application should be included in the scope of the claims of the present application.
| Application Number | Priority Date | Filing Date | Title |
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| CN202211670198.5 | 2022-12-26 | ||
| CN202211670198.5ACN115634042B (en) | 2022-12-26 | 2022-12-26 | Laser and water jet cooperative cutting device and control method |
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| WO2024140703A1true WO2024140703A1 (en) | 2024-07-04 |
| Application Number | Title | Priority Date | Filing Date |
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| PCT/CN2023/142012PendingWO2024140703A1 (en) | 2022-12-26 | 2023-12-26 | Laser and water jet cooperative resecting device and control method |
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