CN101528165B - 眼外科手术探针 - Google Patents

眼外科手术探针 Download PDF

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CN101528165B
CN101528165B CN2007800404164A CN200780040416A CN101528165B CN 101528165 B CN101528165 B CN 101528165B CN 2007800404164 A CN2007800404164 A CN 2007800404164A CN 200780040416 A CN200780040416 A CN 200780040416A CN 101528165 B CN101528165 B CN 101528165B
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cutting knife
probe
connector
pin
ophthalmic surgical
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CN101528165A (zh
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S·瓦伦西亚
J·L·洛佩斯
J·R·奥尔德
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Novartis AG
Alcon Inc
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F9/00Methods 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
    • A61F9/007Methods or devices for eye surgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F9/00Methods 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
    • A61F9/007Methods or devices for eye surgery
    • A61F9/00736Instruments for removal of intra-ocular material or intra-ocular injection, e.g. cataract instruments
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32Surgical cutting instruments
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F9/00Methods 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
    • A61F9/007Methods or devices for eye surgery
    • A61F9/00736Instruments for removal of intra-ocular material or intra-ocular injection, e.g. cataract instruments
    • A61F9/00763Instruments for removal of intra-ocular material or intra-ocular injection, e.g. cataract instruments with rotating or reciprocating cutting elements, e.g. concentric cutting needles
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/0046Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00535Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated
    • A61B2017/00544Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated pneumatically

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  • Health & Medical Sciences (AREA)
  • Ophthalmology & Optometry (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
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  • Heart & Thoracic Surgery (AREA)
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Abstract

一种眼外科手术探针,该眼科外科手术探针具有标准驱动组件和外壳,所述外壳可从所述驱动组件拆卸。该设计简化了探针制造并提供了更高的制造适应性。

Description

眼外科手术探针
技术领域
本发明通常涉及微型外科手术工具。更具体的说,但不是为了限制,本发明涉及在后段(posterior segment)眼外科手术中使用的微型外科手术工具,例如玻璃体切除术探针。 
背景技术
许多微型外科手术过程需要对各种身体组织进行精确的切割和/或移除。例如,某些眼外科手术过程需要切割和/或移除玻璃体液(填充眼睛后段的透明胶状材料)。玻璃体液或者玻璃体,包括许多显微镜下可见的纤维,所述纤维通常附接到视网膜。因此,对玻璃体的切割和移除操作必须相当小心,以避免在视网膜上牵拉、视网膜从脉络膜分离、视网膜破裂、或者最坏的情况,视网膜自身切割并移除。 
在眼科外科手术后段中使用微型外科手术切割探针是已知的。通常这种玻璃体切除术探针通过在睫状体平坦部附近的巩膜中的切口插入。外科医生也可以插入其它微型外科手术工具,例如光纤照明装置、灌注插管、或者在后段外科手术期间的抽吸探针。当外科医生在显微镜下观察眼睛时执行手术。 
通常,传统的玻璃体切除术探针包括中空的外部切割构件、中空的内部切割构件以及端口,所述中空的内部切割构件与中空的外部切割构件同轴布置,并可移动地设置在中空的外部切割构件内,所述端口径向延伸通过在其远端附近的外部切割构件。玻璃体液抽吸进入打开的端口,并且驱动内部构件,关闭所述端口。在关闭端口时,内部切割构件和外部切割构件上的切割表面协作,以便切割玻璃体,然后被切割的玻璃体通过内部切割构件抽吸离开。美国专利USNo.4,577,629(Martinez);No.5,019,035(Missirlian等人); No.4,909,249(Akkas等人);5,176,628(Charles等人);No.5,047,008(de Juan等人);No.4,696,298(Higgins等人);以及No.5,733,297(Wang),所有上述专利公开了各种类型的玻璃体切除术探针,并且通过参考这些专利中的每个都以其整体包括在本文中。 
传统的玻璃体切除术探针包括“剪切类型”探针以及旋转探针。剪切类型探针具有内部切割构件,所述内部切割构件沿其纵向轴线往复运动。旋转探针具有内部切割构件,所述内部切割构件绕其纵向轴线旋转。在两种类型的探针中,内部切割构件利用各种方法驱动。例如,内部切割构件可以通过克服机械弹簧的、作用在活塞或隔膜组件上的气动压力而从打开端口位置运动到关闭端口位置。在除去气动压力时,弹簧使内部切割构件从关闭的端口位置回复到打开的端口位置。如另一个例子所述,内部切割构件利用第一气动压力源可以从打开的端口位置运动到关闭的端口位置,然后利用第二气动压力源可以从关闭的端口位置运动到打开的端口位置。如另一个实施例所述,内部切割构件可以利用传统的旋转电动马达或螺线管在打开和关闭端口位置之间进行机电式驱动。美国专利US No.4,577,629提供了剪切类型的、气动活塞/机械弹簧驱动探针的实例。美国专利US No.4,909,249和No.5,019,035公开了剪切类型的、气动隔膜/机械弹簧驱动的探针。美国专利No.5,176,628示出了旋转的双气动驱动探针。 
在许多传统的玻璃体切除术探针中,发动机和壳体或者外壳连接在一起,以屈服于功能性探针。对此的一个缺点是,所述外壳用作人机工程学元件以及用作功能的部件。在不同探针类型(即20、23、25规格探针)之间的改变需要改变外壳的内部特征,以便适应相应的功能接口,例如密封设计和尖端几何形状。这导致了较小的适应性。 
因此,对具有较高适应性的改进的玻璃体切除术探针的需求存在。这种适应性应该能够使得进一步设计和制造灵活、在整个探针设计中使用许多常规元件、能够利用相同的发动机部件转变多种规格尺寸的探针。 
发明内容
本发明为一种眼外科手术探针,所述眼外科手术探针具有可拆卸式连接到发动机的外壳、针固定器、针和切刀。所述发动机具有驱动轴支承构件以及从发动机轴向延伸的驱动轴。针固定器具有设置在其中的轴衬和用于与驱动轴支承构件可拆卸式接合的开口。所述针具有刚性连接到其上的第一连接件。所述第一连接件用于与轴衬可拆卸式接合。所述切刀具有刚性连接到其上的第二连接件。所述切刀可滑动式设置在针内,并且所述第二连接件用于与驱动轴可拆卸式接合。 
附图说明
为了更完整地理解本发明以及本发明另外的目的和优点,参照下面的说明并结合附图进行,其中: 
图1是本发明眼外科手术探针的截面图; 
图2是是图1的眼外科手术探针的分解的截面图。 
具体实施方式
本发明的优选实施例和其优点通过参照附图的图1-2得到最好的理解,不同图的相同的附图标记用于相同和相应的部件。 
玻璃体切除术探针10包括发动机12、壳体或外壳14、针保持器16、驱动轴18、切刀20和针24。虽然本发明的眼外科手术探针在本文中与玻璃体切除术探针10相关,但是本发明可应用于其它眼科或其它外科手术探针、工具和机头。切刀连接件22整体式形成在切刀20的近端上。针连接件26整体式形成在针24的近端上。驱动轴18从发动机12轴向延伸。驱动轴18的远端可拆卸式接合到切刀20的切刀连接件22。驱动轴支承构件34与针保持器16的开口36可拆卸式接合。驱动轴支承构件34、驱动轴18和切刀连接件22设置在针保持器16内。针保持器16内的轴衬28与针24的针连接件26可拆卸式接合,这样使得切刀20可滑动式设置在针24内。针连接件26、针保持器16、切刀连接件22、驱动轴18以及驱动轴支承构件34整个设置在外壳14 内。外壳14包括开口38,所述开口38与发动机12的主体40可拆卸式接合。针24穿过外壳14中开口42延伸。 
发动机12可以是用于驱动玻璃体切除术探针10的任何类型的发动机,但是最优选的是气动发动机。驱动轴18可以用任何合适的材料制成,但是最优选的是不锈钢。针24和切刀20可以是适合用于后段眼外科手术的任何材料制成,但是最优选的是由外科手术不锈钢制成。外壳14、针连接件26和切刀连接件22最优选的是由重量轻的材料,如铝或刚性塑料制成。 
在制造组件期间,探针10的标准化设计允许工人快速和方便地在各种针规格的构造探针之间转换,例如探针10具有20规格针24、23规格针24或者25规格针24。更具体的说,将外壳14快速安装到发动机12的主体40以及从发动机12的主体40拆卸的能力、通过针连接件26和轴衬28将不同规格的针24与针保持器16和切刀20快速连接的能力、以及通过切刀连接件22将切刀20快速连接到驱动轴18的能力极大地增强了制造的适应性并简化了探针10的组装过程。 
可以相信,本发明的操作和构造从前面的描述中可知是清楚的。而上面所示或所述的设备和方法已经被描述为优选,在不脱离如下述权利要求所限定的本发明的精神和范围的情况下,在其中可以做出各种改变和修改。 

Claims (6)

1.一种眼外科手术探针,包括:
外壳,所述外壳可拆卸式连接到发动机,所述发动机具有驱动轴支承构件和从所述发动机轴向延伸的驱动轴;
针,所述针具有针连接件,所述针连接件刚性连接到针上,所述针连接件具有开口的近端;
切刀,所述切刀具有切刀连接件,所述切刀连接件刚性连接到切刀上,所述切刀连接件具有开口的近端和一远端;以及
针保持器,所述针保持器具有开口的远端、开口的近端、中空的内部和设置在所述中空的内部中的轴衬;
其中,所述切刀可滑动式设置在所述轴衬和所述针内,所述切刀连接件的所述远端可拆卸式设置在所述针连接件的所述开口的近端内,所述针连接件的所述近端可拆卸式接合在所述针保持器的所述中空的内部内,且可拆卸式设置在所述轴衬上方,所述切刀连接件可拆卸式设置在所述针保持器的所述中空的内部内,所述驱动轴可拆卸式接合在所述切刀连接件的开口的近端内,且所述驱动轴支承构件可拆卸式接合在所述针保持器的所述中空的内部内。
2.如权利要求1所述的眼外科手术探针,其中所述发动机包括气动发动机。
3.如权利要求1所述的眼外科手术探针,其中所述发动机包括电动发动机。
4.如权利要求1所述的眼外科手术探针,其中所述驱动轴支承构件、所述针保持器和所述切刀连接件整体设置在所述外壳内。
5.如权利要求1所述的眼外科手术探针,其中所述探针是玻璃体切除术探针。
6.如权利要求1所述的眼外科手术探针,其中在所述探针的制造过程中,所述探针便于改变成所述针的不同规格。
CN2007800404164A 2006-10-31 2007-07-26 眼外科手术探针 Active CN101528165B (zh)

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US11/554,812 US8038692B2 (en) 2006-10-31 2006-10-31 Modular design for ophthalmic surgical probe
PCT/US2007/074433 WO2008054900A2 (en) 2006-10-31 2007-07-26 Modular design for ophthalmic surgical probe

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