CN100448416C - 超声乳化套管 - Google Patents

超声乳化套管 Download PDF

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CN100448416C
CN100448416C CNB2004800330025A CN200480033002A CN100448416C CN 100448416 C CN100448416 C CN 100448416C CN B2004800330025 A CNB2004800330025 A CN B2004800330025A CN 200480033002 A CN200480033002 A CN 200480033002A CN 100448416 C CN100448416 C CN 100448416C
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hole
diameter
pin
far
phacoemulsification
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CN1878520A (zh
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詹姆斯·T·珀金斯
保罗·J·费雷拉
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Bausch and Lomb Inc
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007—Methods or devices for eye surgery
    • A61F9/00736—Instruments for removal of intra-ocular material or intra-ocular injection, e.g. cataract instruments
    • A61F9/00745—Instruments for removal of intra-ocular material or intra-ocular injection, e.g. cataract instruments using mechanical vibrations, e.g. ultrasonic
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M5/00—Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
    • A61M5/178—Syringes
    • A61M5/31—Details
    • A61M5/32—Needles; Details of needles pertaining to their connection with syringe or hub; Accessories for bringing the needle into, or holding the needle on, the body; Devices for protection of needles
    • A61M5/329—Needles; Details of needles pertaining to their connection with syringe or hub; Accessories for bringing the needle into, or holding the needle on, the body; Devices for protection of needles characterised by features of the needle shaft
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B2017/32007—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with suction or vacuum means

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Ophthalmology & Optometry (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • General Health & Medical Sciences (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Vascular Medicine (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Anesthesiology (AREA)
  • Hematology (AREA)
  • Dentistry (AREA)
  • Mechanical Engineering (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Infusion, Injection, And Reservoir Apparatuses (AREA)
  • Surgical Instruments (AREA)

Abstract

一种超声乳化套管10，包括用来与外科器械30相接合的套筒18。延伸的针12具有与套筒18相连的近端14和远端16。针12具有第一、第二内径22和24。第一内径22大于第二内径24，以及第一内径22向第二内径24的过渡区26距离近端14比距离远端16更近。

Description

超声乳化套管
技术领域
本发明涉及一种用于眼科手术，特别是用于白内障手术的超声乳化针。更具体地说，本发明涉及一种具有至少两个(2)不同内径的超声乳化针。
背景技术
众所周知，超声乳化(phaco)针在眼科手术中用于去除白内障。典型地，超声乳化针具有一内径，依靠该内径可以使病人的白内障晶状体被乳化或被破碎后的颗粒能通过针和手柄被抽吸入收集袋或容器中。利用从连接到针上的手柄传递过来的超声波能量来振动超声乳化针已经成为了一种惯例。超声波的作用是分解组织，然后这些被分解的组织被抽吸穿过超声乳化针的内径。
现有技术中已经提出了各种不同的超声乳化针结构，以帮助破碎病人的白内障。例如，Parisi在美国专利US4816018中公开了一种超声乳化针末端，与贯通超声乳化针其余部分的较小的第二孔相比较，在超声乳化针末端的远端处具有大内径的孔。超声乳化针远端处的这种较大的内径是为了将超声波能量集中在针的较大孔内，以使生物体组织能够被一个恒定直径的钻孔针更有效地乳化。
同样地，Geuder的美国专利US5451229公开了一种超声乳化针的阶梯式远端，其中各连续小孔有助于进一步破碎依靠针来抽吸的白内障组织。复合直径超声乳化针末端的另一个实例是Sutton等的美国专利US6533750，其公开了一种圆锥型的超声乳化针末端，用于集中超声波能量，以乳化白内障组织。
现有技术中这些具有大直径远端的超声乳化针，在其末端的内径中能有效地乳化组织，但是仍然存在不好的效果，常常会将大的晶状体碎块推离超声乳化针的末端，而且，特别是在较低的真空设备下，不允许超声乳化针有效地钻孔深入晶状体碎块。所述针的这些特征使得称之为劈核技术的普通白内障手术过程的应用更难进行。因此，希望有一种针，能够具有较大孔的超声乳化针末端的一些优点，而且还使超声乳化针更易于钻孔深入大的晶状体碎块中。
附图说明
图1是根据本发明超声乳化针的透视图；
图2是根据本发明的安装到外科手术手柄上的超声乳化针的剖面透视图；
图3是在不同真空水平下将标准超声乳化针与本发明进行对比的图表；
图4是根据本发明超声乳化针的剖面正视图；
图5是根据本发明可替换实施例的局部剖面正视图；以及
图6是根据本发明另一可替换实施例的局部剖面正视图。
具体实施方式
图1显示了根据本发明的超声乳化针或套管10。超声乳化针10包括针12，其具有近端14和远端16。近端14安装在套筒(hub)18上，套筒包括用于与下面显示的外科器械相接合的螺纹20。除螺纹20之外，其它安装结构也可以用于将套管10连接到外科器械。
图2显示了针10的剖面透视图。超声乳化套管10包括针12，其具有分别的第一和第二直径22和24。正如所看到的，第一内径22大于第二内径24。另外，从第一内径22向第二内径24的过渡区26距离针的近端14要比距离远端16近。以另一种方式看，套管10具有细长的针12，包括远端16和近端28，近端被构造成用于安装到外科器械30上的结构，如图2中显示的螺纹20。从这个角度看，过渡区26距离近端28比距离远端16近还是很重要的。
本发明的主要优点之一在于提供了一种减小的内径，以允许外科医生在较高的真空范围内、但仍具有较低的流动速率下进行操作。在一些现有技术的针中，较高真空度和较低流动速率相结合是可能的，允许了外科医生钻孔深入白内障并控制住白内障，同时利用第二器械破碎白内障(例如碎裂)。由于从接近套管的远端移动到接近其近端的过渡区，所以能够比现有技术更容易获得深的钻孔。这使外科医生具备了出众的真空控制能力，但流动速率还是较小，以便万一发生意外时，在无法挽回的伤害出现之前，外科医生来得及做出反应。
然而本发明的另一个优点和益处是，如果较大的内径朝向远端16的话，那么相比之下，从大内径向小内径的过渡区26提供了更高的超声波转移能量水平。将过渡区26设置成距离外科手术用手柄30尽可能的近，以确保被抽吸出的组织能完全乳化并将抽吸管(未示出)中任何可能的堵塞物最小化。因为过渡区被移至更接近超声波能量源-手柄，所以从大直径向小直径的过渡区具有更多的超声波能量。
图3显示了对标准超声乳化针和本发明的针来说，在瓶高度为0的条件下，以毫米汞柱表示的真空水平对以毫升/分钟表示的流动速率的图。能够看出，在任意给定的流动速率下，与标准针相比，本发明具有较高的真空水平。如同以上所指出的，这又使外科医生在较低的流动速率下对白内障具有更好的控制能力，从而确保更迅速、安全的外科手术过程。
图4显示了超声乳化针10，包括从远端16向着近端28延伸的第一孔或第一内径22，套管10内的第二孔或第二内径24，其从近端28延伸到第一孔22。可以看出，第二孔24的直径小于第一孔。也优选第二孔24具有足够的长度，以便在使用过程中穿过第二孔24长度提供所需的压力降。此压力降能够使使用者在利用较高真空水平的同时仍然保持相对低的流动速率。而且，优选的是，第一和第二孔22和24的交叉区或过渡区26距离近端28比距离远端16更近。
如图4所示，过渡区26可以是一个简单的倒圆(radius)。然而，第一孔22和第二孔24之间的过渡区还可以呈现其它结构，例如图5和图6中所示的结构。图5显示了针的一部分，其描绘了在第一孔32和第二孔34之间有一个圆锥形的过渡区36。同样地，图6显示了一个从第一孔38到第二孔40的阶梯式过渡区。很明显，也可以采用多级阶梯式过渡区。依赖于应用或特定外科医生的喜好，不同的过渡区26、36、42或其它一些结构也可以被用于本发明所述的针内。

Claims (4)

1.一种超声乳化套管，包括：
具有近端和远端的细长针，其中所述近端被构造成用于安装到外科手术器械；
所述针内从所述远端向着所述近端延伸的第一孔；
所述针内从所述近端延伸到所述第一孔的第二孔；
其中，所述第二孔的直径小于所述第一孔的直径，且第二孔具有足够的长度，以便在使用中穿过第二孔的长度提供所需的压力降，以及所述第一孔和所述第二孔的交叉处距离所述近端比距离所述远端更近。
2.权利要求1所述的超声乳化套管，其特征在于，所述交叉处包括倒圆。
3.权利要求1所述的超声乳化套管，其特征在于，所述交叉处包括连接第一孔和第二孔的圆锥形表面。
4.权利要求1所述的超声乳化套管，其特征在于，所述交叉处包括在第一孔的直径和第二孔的直径之间的至少一个阶梯式附加直径，其中所述附加直径小于第一孔的直径且大于第二孔的直径。
CNB2004800330025A 2003-09-17 2004-09-02 超声乳化套管 Expired - Fee Related CN100448416C (zh)

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US10/664,837 2003-09-17
US10/664,837 US20050059939A1 (en) 2003-09-17 2003-09-17 Phacoemulsification needle

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CN1878520A CN1878520A (zh) 2006-12-13
CN100448416C true CN100448416C (zh) 2009-01-07

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EP (1) EP1682057B1 (zh)
JP (1) JP4768616B2 (zh)
KR (1) KR20060086360A (zh)
CN (1) CN100448416C (zh)
AU (1) AU2004277872B2 (zh)
CA (1) CA2539421C (zh)
DE (1) DE602004019957D1 (zh)
ES (1) ES2322471T3 (zh)
WO (1) WO2005032439A1 (zh)

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AU2004277872A1 (en) 2005-04-14
CA2539421C (en) 2009-11-24
US20050059939A1 (en) 2005-03-17
ES2322471T3 (es) 2009-06-22
CA2539421A1 (en) 2005-04-14
KR20060086360A (ko) 2006-07-31
JP4768616B2 (ja) 2011-09-07
AU2004277872B2 (en) 2010-01-21
EP1682057A1 (en) 2006-07-26
WO2005032439A1 (en) 2005-04-14
JP2007505693A (ja) 2007-03-15
EP1682057B1 (en) 2009-03-11
CN1878520A (zh) 2006-12-13
DE602004019957D1 (de) 2009-04-23

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