CN105007974B - 用于闭塞涌动缓解的部分排放系统 - Google Patents
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Abstract
一种外科系统,其包括手持件;灌注导管,所述灌注导管与所述手持件流体连通以将流体朝向手术部位运算;抽吸导管,所述抽吸导管与所述手持件流体连通以将流体从所述手术部位运走;泵,所述泵与所述抽吸导管对接,所述泵在所述抽吸导管内产生真空压力以通过所述抽吸导管吸出流体;真空泄压阀,所述真空泄压阀与所述抽吸导管流体连通以泄放所述抽吸导管内的所述真空压力;压力传感器,所述压力传感器检测与所述手术部位相关联的压力;控制器,所述控制器与所述真空泄压阀和所述压力传感器通信,用以控制所述真空泄压阀,以在由所述压力传感器检测到的所述压力小于第一压力阈值时,降低所述抽吸导管中的所述真空压力。
Description
背景
本公开涉及超声乳化手术,并且更具体地说,涉及在白内障手术期间较好地调节眼睛所经历压力的装置。
人眼发挥的功能是通过以下方式来提供视力由称为角膜的透明外部部分透射光,并且借助于晶状体将图像聚焦到视网膜上。聚焦图像的质量取决于诸多因素,包括眼睛的大小和形状,以及角膜和晶状体的透明度。当年龄或疾病导致晶状体的透明度降低时,视力由于可被透射到视网膜的光减少而下降。眼睛晶状体的这一缺陷在医学上被称为白内障。这种病况的公认疗法是手术摘除晶状体并且用人工眼内晶状体(IOL)来代替晶状体功能。
在美国,大多数白内障晶状体是通过称为超声乳化术的外科技术来摘除。适用于超声乳化程序的典型外科手持件由以下部件组成:超声驱动的超声乳化手持件、由灌注套筒围绕的所附连的中空切割针和电子控制台。手持件组件通过电缆和柔性导管连附连到控制台。通过电缆,控制台改变由手持件传输到所附连的切割针的功率电平。柔性导管为手术部位提供灌注流体,并且通过手持件组件从眼睛吸出抽吸流体。
典型手持件中的操作部分是直接附连到一组压电晶体的居中定位的中空共振杆或者变幅杆(horn)。晶体供应在超声乳化期间驱动变幅杆和所附连的切割针所需的超声震动,并且所述晶体由控制台控制。晶体/变幅杆组装被柔性安装件悬挂在手持件的中空主体或壳体内。手持件主体终止在主体远端处的直径减小部分或者头锥。典型地,头锥在外部带螺纹以接收围绕切割针的大部分长度的中空灌注套筒。同样地,变幅杆腔孔在它的远端在内部带螺纹以接收切割尖端的外螺纹。灌注套筒也具有内部螺纹孔,所述内部螺纹孔被拧接到头锥的外部螺纹上。切割针被调节使得它的尖端仅仅从灌注套筒的敞口端突出预定量。
在超声乳化程序期间,切割针的尖端和灌注套筒的端部穿过眼部的外组织中的小切口被插入眼睛的眼前节中。外科医生将切割针的尖端带到与眼睛的晶状体接触,使振动尖端振碎晶状体。产生的碎片与在这个程序期间提供给眼睛的灌注液一起通过切割针的内部腔孔被吸出眼睛并且进入排放贮存器。
在整个手术过程中,灌注流体被泵送到眼睛中,穿过灌注套筒与切割针之间,并且在灌注套筒的尖端和/或从在灌注套筒中靠近其端部切出的一个或多个孔口或开口进入眼睛。这种灌注流体是非常重要的,因为它防止在摘除乳化晶状体期间眼睛的萎陷。灌注流体还保护眼组织免受由超声切割针的振动产生的热。此外,灌注流体悬浮乳化晶状体的碎片以供从眼睛抽吸出来。
在超声乳化程序期间的常见现象由于在外科程序过程中发生的变化流量而产生。变化流量导致在从灌注流体供应到眼睛的灌注流体路径中的变化压力损失,因此导致前房中压力(也被称为眼内压或者IOP)的改变。较高流量导致较大的压力损失和较低的IOP。因为IOP降低,所以眼睛内的操作空间减少。
在超声乳化过程期间的另一种常见并发情况由于抽吸针的阻塞或闭塞而产生。当灌注流体和乳化组织通过中空切割针被抽吸远离眼睛内部时,大于针的腔孔的直径的组织片段可能在针的尖端中引起堵塞。当针的尖端被堵塞时,真空压力在尖端内积累。当去除阻塞物时,闭塞破裂。当堵塞物被去除时,眼睛前房中产生的压力下降被称作闭塞后涌动(post-occlusion surge)。在一些情况下,这种闭塞后涌动可导致相对大量的流体和组织被过快地吸出眼睛,潜在地导致眼睛萎陷和/或导致晶状体囊被撕裂。
已设计出减少这种涌动的各种技术。然而,仍需要改进的超声乳化装置,其减少闭塞后涌动,并且在整个变化流动状态期间保持稳定的IOP。本公开解决了现有技术中的一个或多个缺点。
概述
在一个示例性方面中,本公开针对用于治疗眼部病况的外科系统。所述系统包括:手持件;灌注导管,所述灌注导管与手持件流体连通并且被配置来将流体朝向手术部位运送;以及抽吸导管,所述抽吸导管与手持件流体连通并且被配置来将流体从手术部位运走。所述系统还包括泵,所述泵与抽吸导管对接,并且被配置来在抽吸导管中产生真空压力以通过抽吸导管吸出流体。所述系统包括真空泄压阀,所述真空泄压阀与抽吸导管流体连通并且被配置来泄放抽吸导管中的真空压力。所述系统还包括:压力传感器,所述压力传感器被设置并且被配置来检测与手术部位相关联的压力;以及控制器,所述控制器与真空泄压阀和压力传感器通信,并且被配置来控制真空泄压阀,以在压力传感器检测到的压力小于第一压力阈值时,降低抽吸导管中的真空压力。控制器可被配置来控制真空泄压阀,以在真空压力达到如在眼睛处测量到的低于-50mmHg的真空水平之前,停止真空压力的降低。
在一方面中,压力传感器位于手持件上。在一方面中,所述系统包括排放贮存器和旁路导管,所述旁路导管绕过泵并且与抽吸导管和排放贮存器流体连通,其中真空泄压阀沿旁路导管定位,并且其中排放贮存器与抽吸导管流体连通。
在一个示例性方面,本公开针对操作抽吸系统的方法。所述方法包括引导流体穿过与超声乳化手持件流体连通的抽吸导管,使用与抽吸导管对接的泵在抽吸导管内产生真空压力以将抽吸流体从手术部位吸入到抽吸导管中,用压力传感器检测与手术部位相关联的压力,以及当与手术部位相关联的压力小于第一压力阈值时,使用真空泄压阀泄放抽吸导管中的真空压力,其中泄放真空压力包括使用真空泄压阀来维持真空压力大于约-50mmHg。
在一个示例性方面,本公开针对操作抽吸系统的方法。所述方法包括使用与抽吸导管对接的泵在抽吸导管内产生真空压力以将流体从手术部位吸入到抽吸导管中,用压力传感器检测与手术部位相关联的压力,将由压力传感器检测到的与手术部位相关联的压力与第一压力阈值相比较,以及当与手术部位相关联的压力低于第一压力阈值时,打开真空泄压阀以控制抽吸导管中的真空压力,以仅部分地排放真空压力,同时使用真空泄压阀来维持真空压力处于大于约-50mmHg的真空。
在以上任何方法的一方面中,压力传感器位于手持件上。在一方面中,真空泄压阀位于旁路导管上,所述旁路导管绕过泵并且与抽吸导管和排放贮存器流体连通,并且其中排放贮存器与抽吸导管流体连通。
应理解,前述一般描述和以下详细描述本质上都为示例性和解释性的,并且意图提供对本公开的理解而不限制本公开的范围。在这点来说,本领域技术人员将从以下详细描述中显而易见本公开的其它方面、特征和优点。
附图简述
附图示出了本文所公开的装置和方法的实施方案,并且与说明书一起用来解释本公开的原理。
图1是根据本公开的一方面的实现本文描述的技术和原理的示例性超声乳化手术控制台的示意图。
图2是图1的超声乳化控制台的框图,示出了包括根据本公开的原理驱动抽吸的流体子系统的各种子系统。
图3是根据本公开的一方面的可与图1和图2的超声乳化手术控制台一起使用的示例性流体子系统的原理图。
图4是示出根据与本公开的原理一致的实施方案的操作图3系统的方法的流程图。
图5是示出根据与本公开的原理一致的实施方案的操作图3系统的方法的流程图。
图6是示出根据与本公开的原理一致的实施方案的操作图3系统的方法的流程图。
优选实施方案的详细描述
为了达到促进对本公开原理的理解的目的,现在将参考附图中所示的实施方案,并且将使用特定语言来描述所述实施方案。然而将理解,不意图存在对本公开的范围的限制。如本公开所涉及领域的技术人员将会正常想到的,完全预期对所描述的装置、仪器、方法的任何改变和进一步修改,以及对本公开原理的任何进一步应用。具体来说,完全预期的是:关于一个实施方案所描述的特征、部件和/或步骤可与关于本公开的其它实施方案所描述的特征、部件和/或步骤组合。然而,为简洁起见,将不单独描述这些组合的众多迭代形式(iteration)。为简单起见,在一些实例中,相同参考数字在全部附图中始终用来指代相同或类似的部分。
本公开总体上涉及用于实施超声乳化程序的装置、系统和方法。在超声乳化期间,维持或迅速地恢复IOP至预定范围对手术程序的成功至关重要。对IOP变化,如对由于闭塞破裂所致变化的早期检测可为抽吸管线内将要减少的真空压力提供足够的时间,从而减或者防止闭塞后涌动以及其不良影响。真空压力是低于大气压的压少力,并且增加真空压力会进一步降低压力。减少或泄放真空压力是为了使压力与更接近大气压。
本文公开的装置、系统以及方法包括手持件,所述手持件具有压力传感器,用于迅速地检测手术部位处闭塞破裂。在本文公开的示例性实施方案中,当检测到闭塞破裂时,即打开位于泵旁路导管上的真空泄压阀,以降低抽吸管线内的真空压力(使真空压力更接近大气压),从而减少或防止闭塞后涌动。在一个示例性实施方案中,在打开真空泄压阀以降低真空压力后,真空泄压阀可基于触发事件而关闭,如当压力已被充分恢复时关闭。也就是说,在真空泄压阀被打开之后,抽吸压力传感器可检测出抽吸压力是否已恢复并且是否大于阈值真空压力。如果是,那么就关闭真空泄压阀以降低抽吸导管中的真空压力。接着,系统恢复正常操作直到检测到另一个闭塞破裂。在一些方面中,所述系统被配置成利用真空泄压管线仅部分地泄放真空,以使得真空压力从较高真空压力变化至减少的真空压力(更接近大气的压力)。
图1示出示例性乳化手术控制台,其大体上标示为100。图2是控制台100的框图,示出了操作来实施超声乳化程序的各种子系统。控制台100包括具有计算机单元103和相关联显示屏幕104的基座外壳102,所述相关联显示屏幕104示出与乳化手术程序期间的系统操作和性能有关的数据。控制台100还包括一起用于实施乳化手术程序的许多子系统。例如,子系统包括以下子系统中的一个或多个脚踏板子系统106,所述脚踏板子系统106包括例如脚踏板108;流体子系统110,所述流体子系统110包括手持件112;超声波发生器子系统116,所述超声波发生器子系统116利用带切割针的手持件112来产生超声波振荡;以及气动玻璃体切除切割器子系统120,所述气动玻璃切除切割器子系统120包括玻璃体切除手持件122。这些子系统可重叠并且协作来实施手术程序的各个方面。
图3示出展示了流体子系统110和手持件112的原理图。流体子系统110包括与手持件112流体连通的灌注系统300和抽吸系统305。
灌注系统300包括灌注流体源310和与位于手持件112上的套筒320流体连通的柔性灌注导管315。灌注系统300在灌注流体源310与手持件112之间延伸,并且将流体运送到手术部位(在图3中被标记为眼睛)。在一个实例中,无菌流体为盐水流体,然而可使用其它流体。灌注流体源310可为机械加压流体源,例如像图3所示的夹紧压力系统。在替代实施方案中,灌注流体源310为由IV杆悬挂的来源。调整来源高程可控制穿过灌注导管315到手术部位的流动水平。也预期其它流体源。
抽吸系统305包括定位成与手持件112流体连通的抽吸导管325、抽吸传感器330、与抽吸导管325对接的泵335以及排放贮存器340。在一些实施方案中,排放贮存器340可为引流袋或导管的交叉点。也预期其它排放贮存器。如图可见,抽吸系统305从手术部位(眼睛)延伸到排放贮存器340,并且最终延伸到引流贮存器341或废物贮存器341。泵335在泵335与眼睛之间的抽吸导管325内产生真空压力,以将抽吸流体从手术部位吸入到排放贮存器340中。旁路导管345也与抽吸管线325和排放贮存器340流体连通,并且绕过泵335。真空泄压阀350沿旁路导管345定位并且通过打开且关闭来控制抽吸导管325内的真空压力。在所示的示例性实施方案中,真空泄压阀350为可变真空泄压阀。在一个实施方案中,可变真空泄压阀为旋转阀。如以下更详细地描述,可控制真空泄压阀350来打开并且关闭,以减小闭塞涌动的作用,以便IOP可被维持或迅速地恢复到可接受的水平。例如,可控制真空泄压阀350来至少部分减轻或减少抽吸导管325中的真空压力。真空泄压阀350可被完全打开或者部分地打开来减少抽吸导管325中的真空压力。真空泄压阀350可被完全关闭或部分地关闭来增加抽吸导管325中的真空压力(增加压力与大气压之间的差异,从而使压力偏离大气压)。然而,随着真空泄压阀处于关闭的过程,真空压仍可持续降低。也就是说,当关闭真空泄压阀时,真空压力增加(偏离大气压移动),并且在关闭过程期间,真空压力可降低(朝向大气压移动)。
当打开真空泄压阀350时,抽吸导管325内的真空压力将流体从排放贮存器340吸入到旁路导管345中。在一个实施方案中,打开真空泄压阀350减少抽吸导管325内的真空压力。在另一个实施方案中,打开真空泄压阀350维持抽吸导管325内的真空压力,或者减慢抽吸导管325内真空压力的增加速率。因此,打开真空泄压阀350通过减少真空压力、通过维持真空压力或通过减慢真空压力的增加速率来控制真空压力。当关闭真空泄压阀350时,真空压力持续降低。然而,由于泄压阀350的关闭,抽吸导管325中的真空压力可被维持在所需的真空压力范围内,这将在以下进行描述。如以上所指出,在一些实施方案中,包括抽吸导管325的抽吸系统305与手持件112的切割针尖端355流体连通,并且在手术程序期间,被用来将流体和乳化颗粒抽吸穿过尖端355并且抽吸到抽吸系统305。
流体系统110还包括控制器360,所述控制器360与位于手持件112内的压力传感器365、吸入传感压力330和真空泄压阀350通信。控制器360还包括处理器和存储器,所述存储器可包括用于操作真空泄压阀350和或用于检测从传感器365和传感器330中接收到的信息的可执行程序。在一个实施方案中,控制器360为PID控制器,所述PID控制器被配置来控制阀350,以便缓解压力偏差,如闭塞涌动。
在一个实例中,控制器360可包括建立所需压力极限的一个或多个预定压力阈值。当测量或检测到的压力超出这些预定阈值时,控制器360即控制阀来使压力恢复到所需水平。在一个实例中,阈值随真空压力设置、流量以及眼内压(IOP)而变化。控制器360可包括第一压力阈值,所述第一压力阈值与作为眼压的表示的灌注压力有关;以及第二压力阈值,所述第二压力阈值与最小操作压力或者最小真空压力有关。可包括针对流量和真空设置的相似阈值。例如,抽吸导管内可以存在所需真空压力范围,所述真空压力范围表示系统在正常条件下操作(无闭塞或闭塞破裂)所处的真空压力范围。这些阈值可由操作者在制造期间输入或可预先设置或存储。
控制器360还接收来自压力传感器365和抽吸压力传感器330的信息。控制器360被配置来基于从压力传感器365和抽吸压力传感器330接收的信息而控制真空泄压阀350的操作。压力传感器365位于手持件112上、接近手术部位,并且在一些实施方案中,压力传感器365被设置成离手术部位不到12英寸。根据压力传感器365在手持件中的位置,压力传感器365检测与手术部位相关联的流体压力。所述压力传感器与眼睛的接近性使它能够迅速检测压力的改变(如在闭塞破裂期间可能发生的压力改变)并且允许实时的涌动抑制。一些实施方案在闭塞破裂的50毫秒内以同样迅速的方式检测到压力改变。这样的快速响应时间可使控制器360能在IOP受过度负面影响之前迅速地提供对压力偏差的响应。
在所示的示例性的实施方案中,压力传感器365沿灌注导管315设置在手持件112中。尽管压力传感器被示为设置在手持件112的近端,但是在其它实施方案中,所述压力传感器被设置在远端并且可以被设置成接近套筒320。在一个实施方案中,压力传感器365为沿灌注导管315定位在手持件112内的灌注压力传感器365。灌注压力传感器检测灌注导管315中的灌注压力。在另一个实施方案中,压力传感器365位于手持件112中并且通过连通元件而不是灌注导管315来与手术部位流体连通。例如,压力传感器365可被设置在它与手术部位连通的单独管道或探针内。在一个这样的实施方案中,单独管道或探针与手持件112是独立的,但是允许压力传感器365被设置在手术部位的附近范围内。在替代实施方案中,所述压力传感器可被设置在套筒320内或者手持件112上的其它地方。
在操作中,通过灌注导管315将灌注流体提供到手术部位。在所示的示例性的实施方案中,传感器365沿灌注导管315定位,以检测灌注导管315内的灌注压力。控制器360使用传感器365连续地监测压力。如果灌注压力下降到低于存储在控制器中的第一压力阈值,如在闭塞破裂期间可能发生的情况,那么控制器360打开真空泄压阀350以减少灌注导管325内的真空压力,以减少或防止闭塞后涌动。当抽吸压力传感器330检测到抽吸压力大于第二压力阈值时,那么控制器360关闭真空泄压阀350以控制抽吸导管325内压力的增加速率,并且允许抽吸系统在一段时间流动后继续正常操作。也就是说,一旦系统检测到抽吸压力大于第二压力阈值,那么真空泄压阀就开始关闭,并且在关闭过程期间,即使速率改变了,真空压力仍继续降低(移动得更接近大气压)。一旦关闭真空泄压阀,真空压力可增加(偏离大气压移动)或者保持不变(如果压力是正常操作条件真空压力的情况)。
在一些实施方案中,控制器360通过打开真空泄压阀350来使系统排气,以便真空水平返回到正常操作条件真空水平的±50%而没有追随性的完全损失。例如,在一些实施方案中,正常操作条件真空水平是大于约-50mmHg的真空,并且控制真空水平以使得在抽吸管线中产生真空的泵附近真空水平不升高至高于-50mmHg,如通过抽吸传感器所检测的。在一些实施方案中,控制真空水平以便防止压力不升高约-100mmHg,如通过抽吸传感器所检测的。在其它实施方案中,控制真空水平以防止压力升高至高于-150mmHg。但是也预期其它阈值。在一些实施方案中,设置第二压力阈值来确保压力不会升高超过以上确认的压力。
因此,在一些实施方案中,系统仅部分地排放真空压力,以使得压力不会升高至大气压,并且维持真空压力。因而,控制器可用真空泄压阀来控制真空压力,以使得真空压力从极度高的真空降低到合适的较低真空。如本文所使用的,术语“部分排放”或“部分地排放”真空压力意指使真空压力向大气压降低,但是所述真空压力被控制来防止其达到大气压。
在一些实施方案中,真空泄压阀350的打开量和打开速率与抽吸压力(通过抽吸压力传感器测量)与压力设定点阈值之间的差异相关。也就是说,如果压力偏差最低,那么真空泄压阀350仅部分地打开至最少打开设置状态,并且如果压力偏差较大,那么真空泄压阀更大量地打开。因为如此,所以系统不会降低追随性或保持能力。相反,阀控制可提供对涌动缓解的控制和稳定性,而在响应于超过阈值的偏差完全打开且关闭阀的情况下,所述涌动缓解可能不会实现。
在一些示例性实施方案中,在没有由抽吸传感器330进行的测量的情况下控制真空泄压阀350进行关闭。例如,在一些示例性实施方案中,真空泄压阀350通过在预定时间段内、在打开位置与关闭位置之间快速地脉动操作(pulsing)而减少抽吸导管325内的真空压力。例如,阀可按控制器360所引导而快速地打开且关闭,以便减轻由闭塞产生的真空压力。因为控制器360是在一段预先设置的时间长度后关闭阀,而不是基于检测到的压力读数来关闭阀,所以这种实施方案可不包括传感器330。由于假设闭塞后涌动将基于在预定时间段内的脉动操作真空泄压阀350而得以防止,所以抽吸传感器330不是必需的。在其它实施方案中,可控制真空泄压阀350来在预定时间内打开一次以减轻真空压力。例如,真空泄压阀350可打开,例如仅打开0.040秒,并且接着被配置来自动地关闭。在一些实施方案中,真空泄压阀350可打开约0.025秒,并且在其它实施方案中,打开时间段少于0.025秒。这些时间段只是示例性的并且预期其它时间段。在一方面中,可基于检测到的真空压力的水平或与阈值的偏差量,以上述方式来选择真空泄压阀350可打开的预定时间和阀可打开的程度。这种实施方案在继续正常操作之前还可等待一段时间,以允许系统从闭塞破裂中恢复。
图4示出了用于操作系统的示例性方法410。在步骤415,压力传感器365检测与手术部位相关联的压力并且将检测到的压力传达至控制器360。因此,控制器接收检测到的压力值。例如并且如上所述,压力传感器365可为使用灌注导管压力检测灌注压力的灌注压力传感器,或可为位于套筒320上并且检测手术部位附近的压力的传感器。
在步骤420,控制器360确定闭塞破裂是否已发生。这可包括将由压力传感器365测量的压力与预定压力阈值或第一压力阈值相比较,以确定压力是否已下降到第一压力阈值以下。当压力下降到第一压力阈值以下时,控制器360确定闭塞破裂已发生。然而,当压力保持在第一压力阈值以上或处于第一压力阈值时,那么控制器360确定闭塞破裂还未发生。如果闭塞破裂还未发生,正常操作在步骤425处继续进行,接着是步骤415。如果闭塞破裂已发生,那么下一步是步骤430。
在步骤430,控制器360操作真空泄压阀350进行打开或至少部分地打开,以便减少或泄放抽吸导管325中的真空压力。在真空泄压阀350的打开或至少部分打开时,抽吸导管325内的真空压力将流体从排放贮存器中吸入到旁路导管345中。流体从排放贮存器到旁路导管345中的这种移动减轻或减少了抽吸导管325内的真空压力量。如上所述,在一些实施方案中,真空泄压阀350的打开维持了真空压力或者增加了真空压力的减少速率。如上所述,在一些实施方案中,控制器360基于检测到的压力与压力阈值之间的差异来调节阀打开的量。因此,在这些实施方案中,控制器360可确定实际检测到的压力与第一阈值之间的差异,并且接着基于所述差异来控制真空泄压阀。在一个实施方案中,控制器包括表,所述表对应于具有与阈值的偏差量的阀设置。在操作期间,控制器360可基于表中找到的数据来将阀350打开某一个量。
在步骤435,控制器360确定抽吸压力是否大于预定真空压力或第二压力阈值。控制器是通过利用沿抽吸导管325定位的抽吸压力传感器330检测压力来执行这一步骤。控制器360与抽吸压力传感器330通信,并且可连续地从抽吸压力传感器330接受信息。控制器360将从抽吸压力330接收到的信息与第二压力阈值相比较。如果真空压力小于或等于第二压力阈值,那么真空压力处在最小操作压力之下,并且下一步是返回到步骤430,在步骤430,真空泄压阀350保持打开。
如果压力大于预定真空压力,那么在步骤440,关闭真空泄压阀350,并且经过一段时间来允许系统在闭塞破裂后进行恢复。在一些方面,第二压力阈值为真空压力阈值,并且系统被布置来使得真空泄压阀受控制以始终维持系统内的特定真空。在关闭真空泄压阀350后,泵的继续操作将会使抽吸导管325内的真空压力维持在所需的真空压力范围内。下一步是步骤425,这个步骤继续进行正常操作。使用这种方法,检测到闭塞破裂并且控制真空压力以减少或阻止闭塞后涌动。因为如此,手术期间的IOP可被维持在所需的范围内,并且IOP中的波动相对稳定,从而减少增强湍流和内皮细胞损伤的可能性。
在替代实施方案中,如图5所示,操作系统的方法大体上由参考数字510指代。步骤515、520、525和530大致上分别与方法410的步骤415、420、425和430类似,并且因此将不作详细讨论。在图5的方法510的步骤535中,在步骤530打开真空泄压阀后,真空泄压阀在预定时间后关闭。在步骤540,系统等待一段时间,之后在步骤525继续进行正常操作。正常操作在等待一段时间后就得以恢复,从而允许系统在闭塞破裂后恢复或正常化。
在另一个替代实施方案中,如图6所示,操作系统的方法大体上由参考数字610指代。步骤615、620、625和640大致上分别与方法510的步骤515、520、525和540相同,并且因此将不作详细讨论。如将从以下段落所理解的,图6的方法使用基于位置的操作来替代以上参考图5讨论的基于时间的操作。
图6的方法可在图3的真空泄压阀350为打开到特定角位置的旋转阀时进行实施。在这个实施方案中,控制器360接收指示阀打开的量的反馈。当真空泄压阀350达到预定角度设置时,控制器360即关闭真空泄压阀350。
参考图6,在步骤630,当控制器360确定闭塞破裂已发生时,控制器360打开真空泄压阀630至特定角位置。在一些实例中,特定角位置是小于约45度并且在一些实例中小于约30度的角位置。因此,在一些实施方案中,控制器360发送特定位置命令到真空泄压阀350。在步骤635,控制器360控制真空泄压阀350来关闭真空泄压阀。这可在控制器360确定阀350处于特定角位置时发生。在一些实施方案中,角位置可基于测量到的压力来即时地(on-the-fly)选择,以便补偿不同的偏差量。
本领域的普通技术人员将理解的是,本公开所涵盖的实施方案不限于以上描述的特定示例性实施方案。在这点来说,尽管已展示和描述了说明性实施方案,但是在前述公开内容中预期广泛的修改、改变和置换。应理解,可在不脱离本公开的范围的情况下对前述内容进行这类变化。因此,将随附权利要求书广泛地并且以与本公开一致的方式加以解释是适当的。
Claims (9)
1.一种用于治疗眼部病况的外科系统,所述外科系统包括:
手持件;
灌注导管,所述灌注导管与所述手持件流体连通并且被配置来将流体朝向手术部位运送;
抽吸导管,所述抽吸导管与所述手持件流体连通并且被配置来将流体从所述手术部位运走;
泵,所述泵与所述抽吸导管对接,所述泵被配置来在所述抽吸导管中产生真空压力以通过所述抽吸导管吸出流体;
真空泄压阀,所述真空泄压阀与所述抽吸导管流体连通并被配置来泄放所述抽吸导管中的所述真空压力;
第一压力传感器,所述第一压力传感器被设置并且被配置来检测与所述手术部位相关联的压力;
第二压力传感器,所述第二压力传感器沿所述抽吸导管定位,所述第二压力传感器被配置成检测所述抽吸导管内的抽吸压力;
控制器,所述控制器中存储有第一压力阈值和第二压力阈值并且所述控制器与所述真空泄压阀、所述第一压力传感器以及所述第二压力传感器通信,所述控制器被配置来控制所述真空泄压阀,以在所述第一压力传感器检测到的所述压力小于第一压力阈值时,部分地打开所述真空泄压阀以便降低所述抽吸导管中的所述真空压力,使得所述抽吸导管中的所述真空压力降低以接近大气压但达不到大气压,并且所述控制器还被配置来控制所述真空泄压阀,以在所述第二压力传感器检测到的压力大于所述第二压力阈值时关闭所述真空泄压阀,其中,所述真空泄压阀的部分打开的程度与所述第一压力阈值和由所述第二压力传感器检测到的压力之间的差值相关。
2.如权利要求1所述的系统,其中所述第一压力传感器位于所述手持件上。
3.如权利要求1所述的系统,其中所述第一压力传感器为灌注导管压力传感器,所述灌注导管压力传感器沿所述灌注导管定位,以检测所述灌注导管内的灌注压力。
4.如权利要求1所述的系统,所述系统还包括排放贮存器和旁路导管,所述旁路导管绕过所述泵并且与所述抽吸导管和所述排放贮存器流体连通,其中所述真空泄压阀沿所述旁路导管定位,并且其中所述排放贮存器与所述抽吸导管流体连通。
5.如权利要求4所述的系统,其中所述真空泄压阀被配置来在所述真空泄压阀降低所述抽吸导管中的所述真空压力时,允许排放贮存器流体进入所述旁路导管。
6.如权利要求1所述的系统,其中所述第二压力传感器位于所述泵与所述手术部位之间。
7.如权利要求1所述的系统,其中所述第一压力传感器被设置成离所述手术部位不到12英寸。
8.如权利要求1所述的系统,其中所述真空泄压阀被控制为部分打开至小于45度的特定角位置。
9.如权利要求1所述的系统,其中所述真空泄压阀被控制为部分打开至小于30度的特定角位置。
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CA2895814C (en) | 2020-10-27 |
EP2919850A1 (en) | 2015-09-23 |
US20170087283A1 (en) | 2017-03-30 |
AU2014257532B2 (en) | 2018-06-21 |
EP2919850A4 (en) | 2016-07-20 |
JP2016516528A (ja) | 2016-06-09 |
CN105007974A (zh) | 2015-10-28 |
AU2014257532A1 (en) | 2015-07-02 |
CA2895814A1 (en) | 2014-10-30 |
WO2014175961A1 (en) | 2014-10-30 |
JP6530379B2 (ja) | 2019-06-12 |
US10314953B2 (en) | 2019-06-11 |
EP2919850B1 (en) | 2018-10-03 |
US9549850B2 (en) | 2017-01-24 |
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US20140323953A1 (en) | 2014-10-30 |
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