CA1044548A - Surgical cutting instrument - Google Patents

Surgical cutting instrument

Info

Publication number
CA1044548A
CA1044548A CA306,102A CA306102A CA1044548A CA 1044548 A CA1044548 A CA 1044548A CA 306102 A CA306102 A CA 306102A CA 1044548 A CA1044548 A CA 1044548A
Authority
CA
Canada
Prior art keywords
drive housing
sheath
housing
micromotor
cutting instrument
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Expired
Application number
CA306,102A
Other languages
French (fr)
Inventor
David E. Staub
Carl L. Foltz
Raymond W. Simmons
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Linvatec Corp
Original Assignee
Concept Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from US05/567,087 external-priority patent/US4014342A/en
Application filed by Concept Inc filed Critical Concept Inc
Application granted granted Critical
Publication of CA1044548A publication Critical patent/CA1044548A/en
Expired legal-status Critical Current

Links

Abstract

ABSTRACT OF THE DISCLOSURE
A surgical cutting instrument has a sheath surrounding a drive housing and mounted to the drive housing, a removable cutter mounted to the drive housing in engagement with the sheath to form a fluid tight seal between the drive housing, the sheath the cutter, and a motor mounted in the drive housing. The motor comprises a micromotor with a drive shaft, the motor and a source of power being enclosed in the drive housing, and the cutter comprises a transfer member for connection to the micromotor and a blade adapted to be connected to the transfer member and to be driven thereby when the micromotor is energized.

Description

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This application is a division of Application No.
249,022 filed March 29, 1976.
The present invention relates toa powered surgical cut-terandmore particularly to a sterile disposable powered surgical cutter particularly adaptedtoperformeye surgery bycuttinq and re-moving vitreousfrominside the anterior aqueous chamberofthe eye.

:, , A history of the development of such cutting devices is described in the AORN Journal, November 1973, Vol. 18, No. 5 page 908 in an article entitled "Pars Plana Vitrectomy, a New Treatment for Vitreous Disease".
Eye surgery for management of vitreous in the anterior chamber after cataract extraction orin corneal surgeryhasbeen accomplished by several methods. Suchmethods have included sweep- -ing of the vitreous from a wound with a spatula, aspiration of liquid vitreous through the pupil with aglass syringe and 18 gauge needle and aspiration ofvitreous via the pars plana before opening the anterior chamber and removing vitreous directly from the anterior chamber with cellulose sponges and blunt scissors.
The problems inherent in such techniques and methods and appara-:. . , tu8 are disclosed in the Annals of Ophthalmology, September 1974, page 947 in an article entitled "Anterior Vitrectomy in Cataract . . .
`~ Surgery, Aphakic Keratoplasty and Pa~ients with Vitreous Pathol-''~r Ogy Using a Simple Vitreophage", and in the American Journal of Ophthalmology, June 1974, page 824, in an article entitled j "Companied Keratoplasty and Cataract Extraction".
:~ In accomplishing eye surgery in the anterior aqueous , chamber it has been found that after the incision is made that - it is sometimes necessary to draw off vitreous or in turn add vitreous fluid. Apparatus for accomplishing these ends is dis-cussed in both of the above-mentioned periodicals. This initial .
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apparatus was developed by Herbert E. Kaufman and incorporated various components and concepts that were well known in the art as is disclosed by the following patent references.
~, U.S. Patent 3,734,099 discloses a hand held powered .,.;;
,J. surgical cutter utilizing a cutter tip having an outer fixed . tubular cutter in which an inner tubular cutter is rotated. The . . .
cutter tip is inserted into the eye and the inner cutter i~
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rotated cutting the vitreous. The pieces of the severed vitreous are then removed through the interior of the inner tubular cutter ., to a dispo~al means.
...
., 'I U.S. Patent 3,618,861 discloses another ~imilar hand held tubular cutting apparatus adapted to cut the vitreou~ in the , eye and suck the cut vitreous to disposal means.
~, The use of ultrasonic energy in a surgical instrument .
to cut the vitreous is taught by U.S. Patent 3,805,787. The ap-.
paratus has a probe head with bores cut therein to receive both ., suction means adapted to re ve material emulsified by the probe and fluid transfer mean~ to tran~mit irrigation fluid into the .
r 20 eye, `, Another hand held vitreou~ cutter is disclosed in U.S.
$
'' Patent 3,732,858 which utilizes a rotating blade mounted in a ...
tube to cut the vitreous material. A~ the vitreous is cut suction means draw~ the vitreou~ material back up through the tube housing of the cutting blade to an area for disposal. The ap-~` paratu~ is also shown in another embodiment adapted to be used with infusion means for submitting or directing fluid into the :. .
~ eye. The present invention represents an improvement over this `.-'3 previously identified prior art.
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~-~ 30 All of the previously disclosed apparatus must be ,.'' . ~., .

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10~4548 sterilized after each operation. A common sterilization technique in hospitals is to sterilize the units with ethylene oxide. The construction of the apparatus is such that the cutter blade assembly which is hardest to sterilize, is difficult to reach in sterilizing processes, expensive to manufacture and is constructed to form a complex cutter assembly. Furthermore the drive mechanism ;
of the cutter blade assembly has to he sterilized after each use resulting in damage to the mechanism after re-peated sterilization, not to mention the time, labor and expense required for each sterilization.
According to the present invention, there is provid-ed a surgical cutting instrument comprising a drive housing;
~ sheath means surrounding the drive housing and method ? to the drive housing; a removable cutting means mounted to the drive housing in engagement with the sheath means to form a fluid tight seal between the drive housing, sheath means and removable cutting means; motor means mounted in the drive housing; the motor means including a micromotor with a drive shaft; a source of power mounted , in the drive housing; the motor means and source of power being enclosed in the drive housing; the removable cut-` ting means comprising transfer means for connection to the micromotor and blade means adapted to be connected to the transfer means and to be driven by the transfer means when the micromotor is energized.
- Although theinvention willbeset forth inthe claims ` the invention itselfandthe manner inwhich itmay be made and :~

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used, may be better understood by referring to the ~ollowing description of a preferred embodiment thereof taken in con-. nection with the accompanying drawings forming a part hereof in which like reference numerals refer to like parts throughout the several views and in which:-Figure 1 is a perspective view showing a powered surgical cutter embodying the present invention;
Figure 2 is a perspective view of the disposable sterile sheath assembly used with the powered surgical cutter;
:~ 10 Figure 3 is a cross-sectional view of the disposable cutter head of the cutter shown in Figure l;
Figure 4 i9 an end view of the disposable cutter head ' shown in Figure 3;
!,~, Figure 5 is an exploded perpsective view partially in cross-section of the blade and blade drive assembly shown in '. Figure 3;
$ Figure 6 is a side view of the motor end of the drive housing partially in section;
Figure 7 is a perspective view of the cutter showing : 20 the instrument drive housing about to be placed in a sterile ;~ surgical receptacle;
Figure 8 discloses the instrument of Figure 7 inside the sterile sheath with the end of the instrument and sheath . . .
partially shown in cross-section to show the relation of the instrument with the sheath;
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Figure 9 discloses the instrument with the cutter head placed on the sheath and drive housing when locked into position;

Figure 10 discloses a cross-sectional view of the ~1 cutter head housing;

~ 30 Figure 11 shows a cross-sectional view of the drive :i - 4 -~: .
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1~ 548 7 housing;
Figure 12 discloses a partial englarged cro~-section-al view of Figure 11 taken along lines 12' - 12';
Figure 13 discloses an enlarged side view of the end ; of the cutter head housing taken along line~ 13' - 13' of Figure 10; and Figure 14 shows an enlarged cros -sectional view of the blade housing tube of the cutter head assembly.
Referring now to the drawings, a di~posable surgical cutting instrument 10 has a drive housing 12 of qenerally c~-lindrical form designed to be easily held in the surgeon's hand.
It should be noted at the outset that all parts of the instrument 10 which could possibly come in contact with the ~ patient during an operation are sterilized and pyrogen free.
`~ A protective latex sheath 14 is adapted to be placed over the drive housing 12 to protect the drive housing 12 from contamination when the operation is performed. A disposable cutting head 16 is mounted on the drive housing 12 in engage-ment with the sheath 14. The disposable cutting head 16 iis drivèn by a drive shaft of a micromotor 40 ~Figure 12) mounted in the drive housing 12 so that only the cutting head 16 and sheath 14 comes into contact with blood vitreous and other materials during the operation.
i The drive housing 12 as shown in Figures 6-9, 11 and :' 12 iis constructed of two components comprising a power source section 18 and a motor section 20. The power source section 18 has one end provided with an outer threaded surface 19 which is adapted to be screwed into a threaded inner surface 22 of the motor section to form the complete drive housing 12. A free ,.,~
~` 30 seated coiled spring 24 is seated in one end of the power source ' :
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~(~44548 section 18 and abuts against a battery 26 which is slidably mounted in the housing for easy replacement to urge the battery toward a sta~doff sleeve 28. The battery does not enga~e the standoff sleeve. The sleeve merely prevents electrical contact in case the battery is inadvertently installed bac~ward. The standoff sleeve 28 is secured to a bulkhead 30 or press fit on the conductor. One end of the battery is engaged with a modified rivet contact 32 that i8 riveted in place. The bulkhead 30 is positioned within the motor housing section by a retaining ring 31 which is mounted in a channel cut in the housing. A set screw 34 contacts a motor support 36 mounted to the housing and holds the Motor in place. A stripped wire 38 is bent and squeezed between the micromotor 40 and motor support 36 to form a connection. The micromotor 40 is mounted in the motor housing and is electrically connected to the contact 32 by wire 42 80 that when switch 44 is depressed an electrical contact is made between the battery and the micromotor energizing the micromotor 40 to drive a hexagonal shaped drive shaft 46 of the micromotor.
It should be noted that while the preferred embodiment discloses a hexagonal drive shaft 46, the drive shaft could be square, flat or shaped in any other manner. The drive shaft end of the motor section 20 forms a seat or channel 48, depending upon its construction, and has two locking pins 50 protruding inwardly from the collar to fit bayonet slots 51 formed in the disposable cutting head 16. The drive housing 12 is covered by using a sheath assembly 52 comprising a sleeve 54 having a tapered end ' 56 upon which the latex sheath 14 is stretched and mounted. The other end 58 of sleeve 54 is open and flanged outward so that the drive housing can be easily inserted to the mounted sheath.
The flexible latex sheath 14 has an open end 62 formed ~ .

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10~548 with a lip 64 which fits into the seat 48 defined in the motor section of the drive housing. The other end 66 of sheath 14 i8 closed. After the drive housing 12 has been deposited into the protective covering of the latex sheath, the sleeve 54 is re-moved and lip 64 is inserted into the seat 48 formed in the end : , of the housing.
The cutter head 16 is constructed with a body 70 having a varying diameter axial bore 71 cut therethrough. The bore 71 is cut in a series of steps so that the diameter narrow~ after each step. The ~teps form shoulders 69, 72, 73 and 74 which are adapted to respectively receive retainer ring 99, retainer ring 92, "O" ring 90 and flange 89.
The cutter body 70 is provided with a second bore 75 and a tubular extension 76 axially aligned with the bore 75 and allowing a section or irrigation device to communicate with bore 71. Thus, a syringe can be connected to the tubular extension 76 by a hose to provide suction to a chamber portion 71a and the interior of tube 86 so that material severed by blade 84 travels through the tube 86 into chamber portion 71a, through bore 75 and into a suitable disposal means such as the syringe~
A saline solution or other suitable fluid can travel the same path, but in the opposite direction, through the tube 86 to the eye.
~ The body 70 has a generally tapered exterior surface .
and i8 cut at one end in an annular manner to receive a skirt 77 which is cemented to the annularly cut end of the body. The i ., .
outer surface of an annularly cut end or tip 78 of the body 70 is provided with the bayonet slots 51. When the tip 78 is in-~; serted into the motor section, the tip 78 fits around the hexagonal drive shaft 46 of the micromotor with the skirt 77 ., .

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. ~ - , projecting over the outer surface of the motor section and the latex sheath 14.
A clear plastic coupling member 80 is mounted in the cutter body bore 71. The coupling member 80 has an axial bore 81 with a circular configuration at one end suitable to hold a coupling member drive shaft 82 and a hexagonal portion at the other end to slidably receive and hold the drive shaft 46. In the preferred embodiment a coiled spring member 91 i~ seated in the hexagonal portion of the bore 81 and abuts against shoulder 93, which fonms the end of the hexagonal portion of bore 81.
When the hexagonal drive shaft 46 is inserted into the hexagonal portion of the bore 81, the coupling member 80 i8 urged forward by spring member 91 to place blade 84 against the end of a tube housing 86. The drive shaft 82 is notched at 83 to freely hold `. the blade 84. In.this preferred embodiment the blade 84 is freely mounted in notch 83 and i9 not secured to the drive shaft 82. The external fixed thin walled tube housing 86 projects from the end of the body 70 with its hemispherically shaped distal end 87 closing off the tube hou8ing 86. ~he proximal end 88 is opened and flanged outwardly so that it is ~eated on the ~' fir~t shoulder 74 in the interior of the body 70. The flanged end 88 is press fitted to the shoulder or stop but it can be cemented if desired. A small cutting hole 89 is located in the distal end of the tube, and preferably positioned 180 from the . hoze nozzle or projection 76. The blade 84 is preferably : twisted into at least two revolutions with one end being flat .:
.:j` 80 that it can be seated in the notch 83 cut in the end of . ,;, ~; driv~ shaft 82 and with its distal end 85 being rounded so that it can easily rotate in the hemispherically shaped end 87 of the tube 86. If desired, a flat blade can be substituted for :, `:
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~0445~8 , ' the twisted blade. In the twisted construction, the blade is continuously urged forward against end 87 by spring means 91.
The blade is smaller in width than the inner diameter of tube 86 so as to just fit inside tube 86 and still be free to rotate.
The rotation of the blade helps drive the severed material back through the tube 86.
A clear plastic seal retainer ri~g 92 and "O" ring 90 are mounted around the coupling member drive shaft B2 to keep fluids from entering into the cavity housing the coupling meanC, thus preventing any leakage of vitreous material, fluid, blood or other materials past the shaft. The "O" ring seal also pre-vents air from being drawn into the syringe via motor shaft leakage. The shaft 82 and "O" ring 90 effectively seal off bore 71 to form the fluid receiving chamber 71a.
A syringe 94 is connected to the hose nozzle 76 by flexible tubing 98 which is inserted over the hose nozzle or pro-jection 76 on one end and onto a female luer-lok 96 in the syringe. Thus, suction or fluid can be transmitted to tube 86.
In the operation and before the actual cutting of the .. ,. .
j 20 vitreous is to take place, the surgeon takes the drive housing . ,.~
i~; 12, drops it into the sleeve 54 made of a suitable material into an associated sheath 14. The sheath lip 64 is inserted into the seat 48 of the drive housing and the disposable plastic cutter head 16 is mounted on to the housing so that bayonet slots 51 ` cut into the cutter head are mounted over the pins 50 of the -' motor section with the cutter head then being depressed and ~ turned so that it is locked into place on pins 50. Simultaneous-. . -~
-~ ly its outer skirt 77 extends down over the drive housing which is covered by flexible sheath 14. The lip 64 in combination -` 30 with the drive housing and cutter head forms a fluid tight seal _ g --~ ~ ' .~ . .

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~049~548 so that any fluid that might enter under skirt 77 is prevented from contacting the motor housing by sheath 14. The syringe 94 is then connected to the cutter hose nozzle 76 so that suction can be applied. A check valve 97 is mounted in the flexible , tubing 98 to prevent the introduction of fluid into the eye.
When the opening is made in the anterior aqueous chamber, the cutter tube 86 is inserted in the chamber. The surgeon depresses a switch 44 of the micromotor 40 through the protective sheath 14, thus activating the motor and thereby rotating the blade 84 within the tube 86. The blade 84 is constantly urged forward by the coupling member 80 through spring means 91 in the coup-ling member 90 that the blade edge 85 i9 pressed against the front of the tube and rotates over hole 89 cut in the end of the tube. A~ suction is applied to the instrument vitreou~
material is drawn into the hole. The rapidly rotating spring loaded blade 84 which fits flush against the hole 89 severs the vibreous, carrying it into the tube with the construction of the blade 84 being ~uch that it is carried into chamber 71a of ~ the cutter head and from there into a syringe or other ~uitable ; 20 material di~posal mean~.
The present cutter, although specifically designed for eye surgery, could also be used to remove any other body tissue in the same manner. Because of the sealed nature of the internal 1;.~
~^~ Ytructure of the tip, foreign materials cannot proceed past the blade drive shaft or the chamber 71a so that no foreign materials contact the hexagonal drive shaft or interior of the drive , ~
`~ housing. After the operation has been completed, the surgeon ` rotates the cutter head, thus releasing it from its bayonet . .
connection and removes the head from the drive housing. The head is then thrown away or sterilized for future reuse and the ` ' '''.
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' '' ,' "'` ' ' '.' 10~548 latex protective sheath 14 is removed from the drive housing so that the drive housing is ready for the next operation. When the next operation is ready to begin a new disposable cutter head and a new disposable sheath are placed on the instrument so that no problem of sterilizing the instrument is incurred with the instrument being maintained in a sterile condition.
As will be apparent to those skilled in the art, the above-described apparatus is con~tructed with a ~imple disposable cutter as~embly which can be either disposed of or ~terilized while another cutter assembly is placed on the drlve hou~ing.
The novel use of a removable protective bag which i~ sealed by the disposable cutter assembly to the drive housing prevents the drive housing from being contaminated so that the drive housing can be reused within minutes or within a minute after its use in the previous operation. Because of the self-contained power source, the instrument can be used in the field or in other remote places where power is not available. Thus, the above-described apparatus provides a sophisticated low cost sterile medical instrument available for use under any environ-ment or condition.
In the foregoing description a particular preferred embodiment of the invention has been described. However, it is to be understood that the specific details shown are merely illustrative and that the invention may be carried out in other ways without the departing from the true spirit and scope of the following claims.

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Claims (7)

The embodiments of the invention in which an exclusive property or privilege is claimed are defined as follows:
1. A surgical cutting instrument comprising:
a drive housing;
sheath means surrounding said drive housing and mounted to said drive housing;
a removable cutting means mounted to said drive housing in engagement with said sheath means to form a fluid tight seal between said drive housing, sheath means and re-movable cutting means;
motor means mounted in said drive housing;
said motor means including a micromotor with a drive shaft;
a source of power mounted in said drive housing;
said motor means and source of power being enclosed in said drive housing;
said removable cutting means comprising transfer means for connection to said micromotor and blade means adapted to be connected to said transfer means and to be driven by said transfer means when said micromotor is energized.
2. A surgical cutting instrument as claimed in claim 1, wherein said cutting means comprises a body defining an axial bore, said transfer means being slidably mounted in said bore and comprising a coupling member, a shaft secured to one end of said coupling member, the other end of said coupling member being formed to receive a drive shaft of said micromotor, seal means surrounding said coupling member shaft and dividing said axial bore into at least two separate compartments, and a tube secured to said body in axial alignment with said bore, said blade means being mounted on said coupling member shaft and positioned in said tube.
3. A surgical cutting instrument as claimed in claim 1, wherein said sheath means comprises a flexible pack having a closed end and an open end with an annular lip.
4. A surgical cutting instrument as claimed in claim 3, wherein said sheath means is latex.
5. A surgical cutting instrument as claimed in claim 1, 2 or 3 wherein said cutting means includes a pressure change means connected therewith and adapted to change the pres-sure around said blade means.
6. A surgical cutting instrument as claimed in claim 1, wherein said sheath means is latex.
7. A surgical cutting instrument as claimed in claim 1, wherein said sheath comprises annular lip means held within an annular channel formed in said housing in a fluid tight seal between said housing, sheath means and cutter means.
CA306,102A 1975-04-11 1978-06-23 Surgical cutting instrument Expired CA1044548A (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US05/567,087 US4014342A (en) 1975-04-11 1975-04-11 Vitreous cutter
CA249,022A CA1042300A (en) 1975-04-11 1976-03-29 Vitreous humor cutter

Publications (1)

Publication Number Publication Date
CA1044548A true CA1044548A (en) 1978-12-19

Family

ID=25668253

Family Applications (1)

Application Number Title Priority Date Filing Date
CA306,102A Expired CA1044548A (en) 1975-04-11 1978-06-23 Surgical cutting instrument

Country Status (1)

Country Link
CA (1) CA1044548A (en)

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