CN106456367A - 手术器械 - Google Patents

手术器械 Download PDF

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CN106456367A
CN106456367A CN201580024489.9A CN201580024489A CN106456367A CN 106456367 A CN106456367 A CN 106456367A CN 201580024489 A CN201580024489 A CN 201580024489A CN 106456367 A CN106456367 A CN 106456367A
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far
pipe cutting
inner tube
light
light output
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R·德拉海姆
D·弗劳恩菲尔德
V·盖德
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Geuder AG
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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
    • 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
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/30Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/30Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure
    • A61B2090/306Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure using optical fibres

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Ophthalmology & Optometry (AREA)
  • General Health & Medical Sciences (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Animal Behavior & Ethology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Vascular Medicine (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Pathology (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Surgical Instruments (AREA)
  • Laser Surgery Devices (AREA)
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  • Endoscopes (AREA)

Abstract

本发明涉及一种手术器械,尤其是一种玻璃体切除器,其包括外管和内管,所述外管和内管在功能上交互,所述手术器械的特征在于,所述外管和/或所述内管由光传导材料制成或者涂敷该类材料或者包括该类材料,例如光传导纤维、纤芯或类似物,用于将光由近端传导至远端的区域处或远端的区域内部。

Description

手术器械
技术领域
本发明涉及一种手术器械,尤其涉及一种玻璃体切除器,其包括外管和内管,该外管和内管在功能上彼此交互。
本文所讨论的器械基本上是手术器械,尤其是用于移除组织的切除器械。所述器械可用以切除在身上的组织,或更具体来说切除在体内的组织,并且将所述已切除的组织从身体抽吸或更具体来说从身体吸出。在特定的情况下,所述器械可以是特定切除器械,该特定切除器械可在玻璃体切除手术期间消除眼内的玻璃体,或更具体来说打散眼内的玻璃体,并将玻璃体从眼睛移除。此外,可藉由该器械在视网膜脱落期间移除血液、血块、类似连接组织的病变组织,以及视网膜的部分。
关于现有技术,仅作为例子参考专利US5,630,827,从其中得知的是一种适用于玻璃体手术的切除器械。切除装置在近端是开放的。所述切除装置在远端上具有闭合的外鞘,该外鞘的闭合端的附近设有多个端口。每个端口形成缝隙并且允许玻璃体组织进入该外鞘的内腔。此外,该切除器械具有内鞘,该内鞘经设置成与该外鞘同心并以允许纵向运动的方式容纳在该外鞘中,以及为了当该内鞘向前滑动时切除玻璃体组织,该内鞘的远端具有锐刃。
从专利US5,630,827中得知的该装置的重要特征是内管在其自由前端具有开放的环形刃以及该环形刃用作切除刃。为了这个目的,将该环形刃成形,具体来说将该环形刃打磨。外刃区具有切除作用,因此从这里开始,将焦点放在内管的外刀刃。该外刀刃与外管的一个或多个内刀刃一起作用使得当外刀刃和内刀刃彼此滑过时将进入该装置的组织切除或更明确来说将该组织切断。接着可从该装置的内部吸出该组织,或更准确地说可通过内管吸出该组织。
从专利WO98/52502亦得知一种用于移除玻璃体组织的通用切除器械。在该器械的远端设有闭合的外鞘;并在该外鞘的远端附近设有多个缝隙,玻璃体组织可通过该缝隙进入。设有与该外鞘同心并可纵向移动的内鞘,该内鞘的远端设有用于切除进入该管的玻璃体组织的锐刃。此外,为该内鞘提供了驱动机构,该驱动机构可将该内鞘连同其在远端区中的刀刃移动经过设置在该外鞘中的缝隙,使得切除工序在个别位置进行。
然而,实际上,只要通常有必要藉由独立装置(尤其在人眼手术期间)为手术位置提供光,已知的通用型装置是有问题的。
发明内容
上述目的借助于权利要求1中披露的特征实现,特别是借助于以下特征:外管和/或内管由光传导材料制成或者涂敷该类材料或者包括该类材料,例如光传导纤维、纤芯或类似物,用于将光由近端传导至远端的区域处或远端的区域内部。
根据本发明已知的是手术器械还可以理想的方式供应光,特别是在所述外管和/或所述内管由光传导材料制成的情况下供应光。同样可想到的是在所述外管和/所述内管涂敷光传导材料。根据第三种变型,可想到的是所述外管和/或所述内管的材料包括光传导纤维或纤芯,通过该光传导纤维或纤芯传导光。
在任何情况下,所述外管和/或所述内管用于将光从近端传导到远端,或至少将光传导到远端的区域中,光在近端耦合到所述外管和/或所述内管中,在该远端的区域中光可出现以用于照明手术位置。
所述光传导材料可以是玻璃、聚甲基丙烯酸甲酯、聚碳酸酯等等。在这方面,无论在任何情况下,所有光传导材料只要具有所需硬度,都是适合的,以致所述外管和/或所述内管至少在凹部的区域中具有切除功能。适当的硬度是需要的。
如上所已述,本文所讨论的器械可以是玻璃体切除器,其包括外切管和在该外切管内在轴向方向上延伸的内切管。所述外切管具有至少一个形成刀刃的端口。至少所述内切管的前端与所述外切管的刀刃交互,以便实现一种剪切功能。
可在所述外管的刀刃的区域中或所述内管的前端限定光输出,以便在手术位置就地进行照明。
就本文所讨论的玻璃体切除器而言,所述外切管的远端可以是闭合的。即使在该位置限定的光输出也是可能的。在一个特别有利的方式中,为了限定的光输出,玻璃体(优选地呈透镜形式的玻璃体)可设计在所述远端上。
也可想到的是在由玻璃或任何其他光传导材料制成的所述物件(即是所述外管和/或内管)涂敷材料,该材料防止光输出并且也用于稳定所述外管和/或所述内管,或更具体来说用于强化所述外管和/或所述内管。在尤其需要光输出的限定位置,相应地没有提供涂层;并因此光可随着衍射和折射出现。
至此,有以有利方式设计和进一步改良本发明的教导的多种选择。为此,一方面参考从属于专利权利要求1的专利权利要求,以及另一方面,参考以下本发明的优选示例性实施例的说明并参照附图。在参照附图的本发明的优选示例性实施例的说明的文本中,也说明了其他一般优选实施例以及该教导的改良。
附图说明
图1以示意图以玻璃体切除器作为例子部分地示出了一种具有创造性的器械的切除器示例性实施例。
具体实施方式
图1示出了以玻璃体切除器作为例子的手术器械。提供了外切管A和内切管B,其中在这情况下外切管A和/或内切管B可由玻璃或任何其他光传导材料制成。或者作为替代,可想到的是所述外切管和/或所述内切管设有光传导涂层。在这情况下,该切管是设有光传导涂层的常用切管。
外切管A和内切管B在设于外切管A中的端口E的区域中一起作用。也就是说,所述外切管和内切管在所述端口的锐利刀刃D上起作用。可将所述刀刃D限定于不同后角。
如果外切管A和/或内切管B全部由光传导材料制成,那么在切管A,B涂敷不透光材料以便避免不想要的光输出也是有利的。在切除端口E的区域中可以限定方式(即是在刀刃D的区域中)提供光输出。
还可想到的是将光传导材料引入特定的槽中、并注入、喷洒或如常通过涂敷产生光传导材料。无论在任何情况下,重要的特征是在外切管A的远端中(例如端口E的区域中)提供限定的光输出。
此外,可想到的是在端侧透镜的区域中不同定义的光输出通过透镜C(即是光锥、光点、寛角等等)在远端出现。
如果外切管A和/或内切管B全部由光传导材料制成,涂层确保光输出只在远端C或切除端口E的区域中出现。该涂层可具有稳定玻璃的额外任务(例如使玻璃在某种程度上可伸缩或易弯曲)。
至于本发明的手术器械的其他有利的实施例,参考说明书的一般部分和附有的专利权利要求书以避免重复。
最后,必须明确指出的是,上述具有创造性的手术器械的示例性实施例仅用于说明所要求的教导,而该教导并不限于该示例性实施例。

Claims (6)

1.一种手术器械,尤其是一种玻璃体切除器,其包括外管和内管,所述外管和内管在功能上彼此交互,其特征在于,所述外管和/或所述内管由光传导材料制成或者涂敷该类材料或者包括该类材料,例如光传导纤维、纤芯或类似物,用于将光由近端传导至远端的区域处或远端的区域内部。
2.如权利要求1所述的器械,其特征在于,所述光传导材料是玻璃、聚甲基丙烯酸甲酯、聚碳酸酯等等。
3.如权利要求1或2所述的器械,其中所述器械是玻璃体切除器,所述玻璃体切除器包括外切管和可在所述外切管中轴向移动的内切管;以及至少一个形成刀刃的端口,其特征在于,将光输出限定在所述刀刃的区域中。
4.如权利要求3所述的器械,其中所述外切管的远端是闭合的,其特征在于,所述远端限定光输出。
5.如权利要求1至4中任一项所述的器械,其特征在于,在所述远端上形成玻璃体,形成限定的光输出,所述玻璃体优选地呈透镜形式。
6.如权利要求1至5中任一项所述的器械,其特征在于,将所述外管和/或所述内管涂敷光传导材料,并且仅在限定的光输出处不作任何涂敷,以避免出现不想要的光输出。
CN201580024489.9A 2014-03-11 2015-03-11 手术器械 Pending CN106456367A (zh)

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DE102014204480 2014-03-11
DE102014204480.4 2014-03-11
DE102014223304.6A DE102014223304A1 (de) 2014-03-11 2014-11-14 chirurgisches Instrument
DE102014223304.6 2014-11-14
PCT/DE2015/200144 WO2015135544A1 (de) 2014-03-11 2015-03-11 Chirurgisches instrument

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EP (1) EP3041443B1 (zh)
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DE (1) DE102014223304A1 (zh)
ES (1) ES2678768T3 (zh)
HK (1) HK1231362A1 (zh)
PL (1) PL3041443T3 (zh)
TR (1) TR201811070T4 (zh)
WO (1) WO2015135544A1 (zh)

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CN108478257A (zh) * 2018-03-19 2018-09-04 广东工业大学 一种软组织冲裁刀组
CN110996864A (zh) * 2017-06-19 2020-04-10 爱尔康公司 玻璃体切割术探针

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US11096753B1 (en) 2020-06-26 2021-08-24 Procept Biorobotics Corporation Systems and methods for defining and modifying range of motion of probe used in patient treatment
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US20220347015A1 (en) * 2021-05-03 2022-11-03 VisionCare Devices LLC. Vitrector Cutting Device with Distal Illumination Module

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CN110996864B (zh) * 2017-06-19 2022-04-26 爱尔康公司 玻璃体切割术探针
CN108478257A (zh) * 2018-03-19 2018-09-04 广东工业大学 一种软组织冲裁刀组

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EP3041443B1 (de) 2018-05-09
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US20170014269A1 (en) 2017-01-19
TR201811070T4 (tr) 2018-08-27
PL3041443T3 (pl) 2018-10-31
EP3041443A1 (de) 2016-07-13
HK1231362A1 (zh) 2017-12-22
WO2015135544A1 (de) 2015-09-17

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