Surgery – Instruments – Light application
Reexamination Certificate
1997-11-25
2001-09-25
Peffley, Michael (Department: 3739)
Surgery
Instruments
Light application
C606S013000, C606S019000, C600S108000
Reexamination Certificate
active
06293940
ABSTRACT:
FIELD OF THE INVENTION
The present invention relates generally to laser devices and biomedical applications thereof. More specifically, the invention relates to setting-up a laser-based system in preparation for performing a myringotomy in a child's ear without the need for anaesthesia.
BACKGROUND OF THE INVENTION
Myringotomy is a widely-performed procedure used in the treatment of “Otitis Media”-acute inflammation of the middle ear. Typically, it involves a surgical procedure whereby the surgeon performs a tiny incision of the eardrum in order to enable the drainage of fluids that accumulate in the eardrum. The incision in the eardrum must remain open and thus an open drainage ring is placed in the incision to prevent rapid healing and occlusion of the incision. This surgery is done under general anaesthesia.
Over the last few years surgeons performed myringotomy surgery using a pulsed CO
2
laser. The advantage of the pulsed CO
2
laser is its generation of thermal heat resulting in delayed healing of the incision of the eardrum. The incision remains open for approximately 3-6 weeks without the aid of an open drainage ring. Both the incision diameter and laser pulse time duration affect the incision healing time. Typically, the incision diameter is approximately 1 mm and the laser pulse time duration is 0.1 second at a 3-5 Watt power. This surgical technique is generally performed under anaesthesia, because the surgery uses a “defocused” beam that does not account for a child's unexpected movement.
There is a need to perform the myringotomy procedure more accurately without the need for anaesthesia. Moreover, there is a need to perform the myringotomy on the tympanic membrane of the child's ear drum such that any sudden, unexpected movement of the child's head will not adversely affect the carrying out of the myringotomy. The present invention, as described as follows, provides such an improved myringotomy procedure in children without anaesthesia.
SUMMARY OF THE INVENTION
One aspect of the invention relates to a method and apparatus suitable for carrying out laser surgery, such as for performing a myringotomy, but without the need for anaesthesia. The apparatus includes a viewing device and beam positioning device. The beam positioning device has an exit region from which emerges a laser beam.
Both the viewing device and the exit region of the beam positioning device are retained to move in unison with the target area that is to undergo the laser surgery. A viewing screen displays an image as viewed by the viewing device and, based on observation of the image, the physician decides where the laser surgery should take place and causes the beam positioning device to position the laser beam accordingly.
A common housing with two channels may be provided; one channel contains the viewing device and the entrance of the other is arranged to be neighboring the exit region of the beam positioning device. This housing may be retained with an adhesive strip to the ear of the patient or the housing may be defined by a helmet worn by the patient. Alternatively, the viewing device may be rigidly fixed to a handpiece, which is configured to permit passage of the laser beam.
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