CN101198365B - 显微外科系统中的回流控制 - Google Patents

显微外科系统中的回流控制 Download PDF

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CN101198365B
CN101198365B CN2006800209970A CN200680020997A CN101198365B CN 101198365 B CN101198365 B CN 101198365B CN 2006800209970 A CN2006800209970 A CN 2006800209970A CN 200680020997 A CN200680020997 A CN 200680020997A CN 101198365 B CN101198365 B CN 101198365B
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slope
port
microsurgical system
sign
return pressure
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CN101198365A (zh
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科克·W·托德
马克·A·霍普金斯
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Novartis AG
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Alcon Universal Ltd
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    • 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
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/71—Suction drainage systems
    • A61M1/74—Suction control
    • 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
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • 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
    • A61M31/00—Devices for introducing or retaining media, e.g. remedies, in cavities of the body
    • 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
    • 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
    • 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
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/71—Suction drainage systems
    • A61M1/77—Suction-irrigation systems

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  • Health & Medical Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • General Health & Medical Sciences (AREA)
  • Biomedical Technology (AREA)
  • Anesthesiology (AREA)
  • Hematology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Engineering & Computer Science (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Vascular Medicine (AREA)
  • External Artificial Organs (AREA)
  • Infusion, Injection, And Reservoir Apparatuses (AREA)
  • Exhaust-Gas Circulating Devices (AREA)
  • Control Of Positive-Displacement Pumps (AREA)
  • Electrical Control Of Air Or Fuel Supplied To Internal-Combustion Engine (AREA)
  • Crystals, And After-Treatments Of Crystals (AREA)
  • Surgical Instruments (AREA)

Abstract

本发明提供一种在显微外科系统中控制回流的改进方法。其中涉及随时间监测回流压力以检测闭塞打开。

Description

显微外科系统中的回流控制
技术领域
本发明总的涉及显微外科系统中的回流控制，特别是涉及眼显微外科系统中的回流控制。
背景技术
在小切口外科手术中，特别是在眼科手术期间，将小探针插入手术位置以切除、去除或者以其他方式调整组织(tissue)。在上述手术过程中，通常将流体注入眼中，并且将注入流体和组织从手术位置吸出。这些探针具有容易被组织堵塞的小孔。上述堵塞通常称为“闭塞(occlusion)”、“末端闭塞”或“端口闭塞”。清理上述闭塞的处理通常称为“回流”。
回流的传统方法是：产生流体的回压脉冲，其经由抽吸管路到达探针的末端或端口以清理闭塞的组织。由于单个流体脉冲常常不能清理闭塞，因此外科医生通常必须利用一系列脉冲，直至他或她通过工作显微镜可视化地观测到探针的末端或端口被清理。尽管有上述清理闭塞的方法，对控制显微外科系统中的回流的改进方法的需求仍继续存在。
发明内容
本发明提供一种在显微外科系统中控制回流的方法。操作泵将冲洗液以恒定流速提供至外科装置的被闭塞端口。随时间感测端口附近的回流压力。将回流压力作为时间的函数进行监测以检测闭塞打开(break)。
附图说明
通过参照以下结合附图的详细说明，将更完整地理解本发明及其进一步目的和优点，在附图中：
图1为示出显微外科系统的注射管路的特定部分的示意图；以及
图2示意性示出在图1的注射管路中处于恒定流速的回流压力。
具体实施方式
通过参照附图1-2将最好地理解本发明的优选实施例及其优点。如图1所示，显微外科系统10包括注射液罐12、泵14、压力传感器16、外科装置18、以及计算机或微处理器20。注射液罐12包含外科冲洗液13，例如可以从Alcon实验室有限公司购得的眼内
Figure DEST_PATH_GA20188260200680020997001D00011
冲洗液。流体管线21流体耦合注射液罐12和泵14，流体管线22流体耦合泵14、压力传感器16和外科装置18。接口24电性耦合压力传感器16和微处理器20，接口26电性耦合微处理器20和泵14。
泵14可以为用以产生压力或真空的任何适当装置，但优选为蠕动泵、蜗旋泵或叶轮泵。压力传感器24可以为用以直接或间接测量压力或真空的任何适当装置。外科装置18可以为任何显微外科器械、探针或机头(handpiece)，但优选为超声探针、超声乳化探针(phacoemulsification probe)、液断机头(liquefracture handpiece)、抽吸探针(aspiration probe)或玻璃体切割探针(vitrectomy probe)。如图1所示，外科装置18为玻璃体切割探针。外科装置18具有用以与流体管线22流体耦合的注射端口28、用以与显微外科系统10的抽吸管路(未示出)流体耦合的抽吸端口30、以及末端或端口32。微处理器20能够实现反馈控制(优选地为PID控制)。
在工作时，吸出的流体和组织经由抽吸端口30被提供至显微外科系统10的抽吸管路。端口32的闭塞可以由外科医生通过操作显微镜检测，或者由微处理器20自动检测。一旦检测到闭塞，微处理器20经由接口26将适当信号发送到泵14，使其以恒定速度转动，从而将冲洗液13以恒定流速提供至端口32。压力传感器16实时地重复感测流体管线22中(由此感测端口32中)的回流压力，并将相应的信号经由接口24提供至微处理器20。如图2所示，只要端口32保持闭塞，通过压力传感器16和微处理器20产生的回流压力-时间曲线或者函数40就具有正斜率。在闭塞打开(occlusion break)42(当端口32被清理时)，曲线40将呈现负或零斜率。微处理器20监测曲线40以检测闭塞打开42。当出现闭塞打开42时，微处理器20发送信号至泵14以停止提供回流压力。
从上述说明可以理解，本发明提供一种控制显微外科系统中的回流的改进方法。与传统的回流相对照，清理端口32仅需要单个回流循环，并且通过泵14仅提供用以清理端口32所需的冲洗液13的确切压力和体积。因此，更加快速地清理闭塞，回流对于病人而言更加安全。
此处通过实例例示了本发明，而本领域的普通技术人员可以对其进行各种修改。例如，尽管以上针对眼显微外科系统中的回流控制描述了本发明，但是它同样适用于其它显微外科系统。
相信从前述说明中能够清楚本发明的操作和构造。尽管以上示出或描述的装置和方法具有优选的特点，但是可以对本发明进行各种改变和修改，而不脱离如所附权利要求限定的本发明的精神和范围。

Claims (4)

1.一种在显微外科系统中控制回流的方法，包括如下步骤：
对泵进行操作从而将冲洗液以恒定流速提供至外科装置的被闭塞端口；
随时间感测所述端口附近的回流压力；
使用计算机用于：
将所述回流压力作为时间的函数进行监测以检测闭塞打开；以及
当所述计算机检测到所述回流压力与时间关系函数的斜率的符号变化时，停止所述操作泵的步骤。
2.如权利要求1的方法，其中斜率的符号变化包括所述斜率从正号变为负号。
3.如权利要求1的方法，其中斜率的符号变化包括所述斜率从正号变为零。
4.如权利要求1的方法，其中所述操作泵的步骤在检测到所述端口的闭塞时开始。
CN2006800209970A 2005-06-21 2006-04-13 显微外科系统中的回流控制 Expired - Fee Related CN101198365B (zh)

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US11/157,714 2005-06-21
US11/157,714 US20070000301A1 (en) 2005-06-21 2005-06-21 Reflux control in microsurgical system
PCT/US2006/014066 WO2007001592A2 (en) 2005-06-21 2006-04-13 Reflux control in microsurgical system

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CN101198365B true CN101198365B (zh) 2010-09-01

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AU (1) AU2006262797B2 (zh)
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JP2015196026A (ja) * 2014-04-03 2015-11-09 セイコーエプソン株式会社 血流障害の治療方法、治療装置および治療システム
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AR061388A1 (es) 2008-08-27
ATE511866T1 (de) 2011-06-15
EP1893252B1 (en) 2011-06-08
AU2006262797B2 (en) 2012-01-19
CN101198365A (zh) 2008-06-11
WO2007001592A2 (en) 2007-01-04
BRPI0612290A2 (pt) 2011-01-04
JP2008543491A (ja) 2008-12-04
AU2006262797A1 (en) 2007-01-04
WO2007001592A3 (en) 2007-07-19
RU2008102127A (ru) 2009-07-27
MX2007014137A (es) 2008-02-07
US20070000301A1 (en) 2007-01-04
ES2367077T3 (es) 2011-10-28
CA2607593A1 (en) 2007-01-04
EP1893252A2 (en) 2008-03-05
RU2397782C2 (ru) 2010-08-27
JP4980350B2 (ja) 2012-07-18
EP1893252A4 (en) 2009-12-23

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