Classifications

• • 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
• • Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
  • Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
  • Y10T—TECHNICAL SUBJECTS COVERED BY FORMER US CLASSIFICATION
  • Y10T29/00—Metal working
  • Y10T29/49—Method of mechanical manufacture
  • Y10T29/49826—Assembling or joining

Definitions

• the present invention relates to the field of precision instrumentation used in microsurgery, for example in ophthalmic surgery. More specifically, it relates to a surgical micromanipulator tip, a surgical micromanipulator provided with this tip, and a method of manufacturing such a tip.
• microma ⁇ ipulators are used, with which crystalline lenses are manipulated. More specifically, such a manipulator is used in two operative procedures that must be performed with a very high precision inside an eye and which are the excision of the natural lens to be replaced then the placement of the artificial lens of replacement.
• a cataract surgery micromanipulator conventionally comprises a steel handle and a bent tip mounted at one end of this handle.
• a tip as found on the current micromanipulators comprises a rectilinear portion 5 comprising a proximal mounting base 7, a bend 4 and a distal manipulator finger 6 connected to said rectilinear portion 5 by this bend 4.
• the base mounting 7 is intended to be immobilized in the handle of the micromanipulator, while the finger 6 is intended to enter the eye to manipulate the lens. From the mounting base 7 or substantially, the remaining portion 9-4-6 of the tip is tapered toward its extremely thin free end.
• such a tip is made from a segment of straight steel wire which is ground by cylindrical grinding. More precisely, this segment is abraded by two grinding wheels. Between these two wheels, it then rotates on itself, in the opposite direction of the direction of rotation of said wheels. Its axis of rotation and those of these wheels are parallel to each other.
• the wheels have a profile complementary to the longitudinal sectional profile that the grinding is intended to give to the segment. For this purpose, these grinding wheels are diamond-set.
• the cylindrical grinding of the steel wire segment therefore requires expensive specific grinding wheels
• micromanipulators provided with points of this type, are of a high cost, which is already a disadvantage in itself Moreover, because of their high cost, these micromanipulators can not be thrown directly after their first use However, they can not be reused without having been previously cleaned and sanitized, which implies the establishment of a specific organization ranging from the collection of soiled micromanipulators to their storage free from contamination after sterilization, as well as an additional cost resulting from the mobilization of qualified personnel and investment in equipment and training of such personnel
• the aim of the invention is at least to enable a reduction in the cost of using a surgical micromanipulator
• a surgical micromanipulator tip comprising a proximal mounting base, at least a first elbow and a distal manipulation finger that this first elbow connects to the mounting base and which ends by a free end of the tip, at least one distal segment of the mounting base, the first bend and the manipulating finger together constitute a tip portion tapering substantially uniformly along its length toward said end free, having a decreasing diameter at a substantially constant linear decay rate, or a succession without recess of several portions each tapering substantially uniformly along its entire length towards said free end, and more specifically, a succession at least two truncated cones, namely a first truncated cone and a second truncated cone, the first elbow connects a proximal base and a distal vertex of the first truncated cone micromanipulator tip being mainly notable in that it has been thinned by pitting.
• the invention also relates to a method for manufacturing a surgical micromanipulator tip of the type comprising a proximal mounting base, at least a first elbow and a distal manipulator finger that the first elbow connects to the mounting base and which ends with the free end of the tip, at least one distal segment of the mounting base, the first bend and the manipulating finger together constitute a tip portion, characterized in that the uniform thinning of said portion peak, from a rectilinear segment of wire, is made by embossing.
• Thinning of the ophthalmic micromanipulator tips by imprinting requires a nonspecific grinding wheel, which makes it possible to increase the manufacturing speed and lower the production costs, which allows the production of inexpensive disposable instruments.
• Figure 1 is a schematic side view of an ophthalmic surgical micromanipulator according to the invention.
• Figure 2 is a side view of a constituent tip of the micromanipulator of Figure 1 and according to the invention
• Figure 3 is a view similar to Figure 2 and shows an ophthalmic surgery micromanipulator tip according to an alternative embodiment of the invention
• FIG. 4 is a detail view, on an enlarged scale, showing the free end of the micromanipulator tip represented by FIG. 3;
• Figures 5, 6 and 7 are views, schematic, respectively, front, in section along the line AA of Figure 5, and from above, illustrating the method of making tips by patching.
• FIG. 1 shows an ophthalmic surgery micromanipulator 1, which comprises a molded polymer handle 2 and a metal tip 3 carried by this handle 2 and preferably made of stainless steel, in particular stainless steel 302.
• the micromanipulator tip 3 comprises a bend 4 which connects, between them, a proximal mounting base 5 and a distal manipulator finger 6.
• a proximal section 7 of the base 5 is intended to be immobilized in the handle 2 and comprises for this purpose a flat portion 8.
• This proximal section 7 is substantially cylindrical except at the flat surface 8.
• the base 5 also comprises a distal section of generally frustoconical shape 9, which extends the proximal section 7 to the elbow 4 and thins uniformly over its entire length, towards this elbow 4.
• the finger 6 has the overall shape of a truncated cone. It thins uniformly over its entire length from the elbow 4, opposite which it ends with a free end 10, rounded.
• the reference 11 designates the assembly consisting of the section 9, the elbow 4 and the finger 6, that is to say the section which goes from the free end 10 to the junction of the sections 7 and 9 of the base 5. This section 11 thins over its entire length, towards the free end 10, and has no recess.
• the tip 3 has a circular cross section and its width, equal to its diameter d 9i decreases at a rate of substantially constant linear decay towards the free end 10.
• the tip 3 has a circular cross section and its width, equal to its diameter d 6, decreases at a substantially constant linear decay rate towards the free end 10.
• the linear decay rate of the diameter d 9 is at most equal to that of the diameter d 6
• the diameters d 9 and d 6 can decrease according to the same linear decay rate, in which case the reference 11 denotes a portion that is substantially uniformly thinning along its entire length, toward said free end 10.
• the linear decay rate of the diameter d 9 is smaller than that of the diameter d 6 , which is the case in the example shown.
• the reference 11 then designates a succession without detachment of two truncated cones 6 and 9, one of which has its distal vertex connected by the elbow 4 at the base of the other truncated cone 6.
• the section 9 has a length L 9 advantageously between 10 mm and 20 mm, preferably between 13 mm and 17 mm, for example of the order of 15 mm.
• the finger 6 has a length L 6 advantageously between 8 mm and 13 mm, preferably between 9 mm and 12 mm, for example of the order of 11 mm.
• the proximal section 7 of the base 5 has a diameter d 7 advantageously between 0.7 mm and 0.9 mm, preferably between 0.75 mm and 0.85 mm, for example of the order of 0, 8 mm.
• the sections 7 and 9 of the base 5 have the same diameter at their junction.
• the diameter d 9 of the section 9 decreases towards the free end 10, advantageously losing from 0.015 mm to 0.025 mm for each millimeter of length traveled towards the free end 10, preferably from 0.017 mm to 0.023 mm for every millimeter of length traveled to the free end 10, for example of the order of 0.017 mm for each millimeter of length traveled towards the free end 10.
• the diameter of the tip 3 is advantageously between 0.48 mm and 0.60 mm, preferably between 0.50 mm and 0.58 mm, for example of the order of 0.56 mm. mm.
• the diameter d 6 of the finger 6 decreases towards the free end 10, advantageously losing 0.015 mm to 0.025 mm for each millimeter of length traveled towards the free end 10, preferably from 0.017 mm to 0.023 mm for each millimeter of length traveled towards the free end 10, for example of the order of 0.021 mm for each millimeter of length traveled towards the free end 10.
• the diameter of the tip 3 is advantageously between 0.18 mm and 0.42 mm, preferably between 0.20 mm and 0.40 mm, for example of the order of 0 , 38 mm.
• the tips 3 are made from metal segments F which come, for example, from a coil of steel wire, preferably stainless steel 302, and by stitching.
• FIGS. 5, 6 and 7 illustrate, schematically, an example of implementation of the method of tilting the cylindrical segments, of metal wires, in order to give them the desired tapered shape, before shaping them to the shape of points of micromanipulator.
• the cylindrical sections 12 of metal son are distributed by a magazine 13 and are driven one by one, through one of their end portions 12a between a drive wheel 14 and a guide path
• This wheel 14 and / or this guide path is / are made of a material having a good coefficient of friction, so as to allow the sections 12 to rotate in rotation about themselves, from the input to the output (arrow F) of the guide path 15.
• the portion of the tips that is not caught between the drive wheel 14 and the guide path 15 is applied against a diabolo-shaped wheel 16 whose radius of curvature is identical to the radius of curvature of the wheel.
• guide path 15 and the radius of the drive wheel 14 said portion is thus gradually tapered during the movement of the tips from one end to the other of the curvilinear guide path 15.
• the axis of rotation of the diabolo-shaped grinding wheel 16 is perpendicular to the length of the tips 12-3 (in contrast to the cylindrical grinding); it is thus easy, by the microscopic observation of the direction of microrayures which appear on the surface of the tips, to differentiate these from the points obtained by a traditional cylindrical grinding process.
• the portion 9-6 generally has the shape of a truncated cone.
• the flat 8 is then formed by stamping in the segment 7, which is then polished by vibration.
• the elbow 4 is formed by arching the conical portion 11 locally, and then the completed tip 3 is ultrasonically degreased.
• the handle 2 is overmolded on the proximal section 7, its flat 8 has the function of immobilizing in particular in rotation relative to the handle 2 once the latter hardened.
• tip 3 is particularly low.
• the cost of the micromanipulator 1 which, therefore, can be proposed as a disposable tool, that is to say intended to be used only once and to be thrown after its first use, which is already advantageous in itself.
• the cost of using the micromanipulator 1 is particularly low while it has the properties making it suitable for use as an ophthalmic surgery micromanipulator.
• Such use is illustrated in Figure 1 where the finger 6 passes through an incision I of the order of 0.5 mm formed through the cornea C of an eye E and manipulates a crystalline lens not shown for the sake of clarity, inside this eye E, during a cataract operation.
• the particular dimensional characteristics of the tip 3 are such that this finger 6 can perfectly fulfill its function of finger manipulation of a lens inside an eye.
• the tip 3 has the rigidity needed to handle the lens, while its finger 6 can act through the incision I and its free end 10 can effectively handle a lens.
• FIGS 3 and 4 there is shown a tip 103 according to an alternative embodiment of the invention.
• this tip 103 is intended to be part of an ophthalmic surgical micromanipulator and comprises a proximal section 107 intended to be immobilized in the handle or the like of this micromanipulator.
• a reference used hereafter to designate a portion of the tip 103 similar or equivalent to a referenced part of the tip 3 is constructed by increasing from 100 the reference identifying this part on tip 3.
• the section 111 is made by embossing, then localized bending. Unlike the section 11, the section 111 has a diameter dm which decreases only according to a single constant rate of linear decrease over its entire length. However, the section 11 could also have several linear decay rates, each one constant on one of several portions in succession, such as the section 11.
• the handling finger 106 is not rectilinear, but has a bend 120 substantially at right angles, at a short distance from its free end 110, so as to end with a lug 121.
• the length L 12I of this lug 121 is advantageously between 0.5 mm and 0.9 mm, preferably between 0.6 mm and 0.8 mm, for example of the order of 0.7 mm.
• the distance L between bends 104 and 120 is advantageously between 8 mm and 12 mm, preferably between 9 mm and 11 mm, for example of the order of 10 mm.
• the diameter dm of the section 111 is, for example, of the order of 0.22 mm.
• the place where the rate of linear decay of the diameter changes may not be at the elbow 4, but shifted along the tip 3.

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• Health & Medical Sciences (AREA)
• Ophthalmology & Optometry (AREA)
• Life Sciences & Earth Sciences (AREA)
• Animal Behavior & Ethology (AREA)
• Engineering & Computer Science (AREA)
• Biomedical Technology (AREA)
• Heart & Thoracic Surgery (AREA)
• Vascular Medicine (AREA)
• Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
• Surgery (AREA)
• General Health & Medical Sciences (AREA)
• Public Health (AREA)
• Veterinary Medicine (AREA)
• Manipulator (AREA)
• Surgical Instruments (AREA)
• Dental Tools And Instruments Or Auxiliary Dental Instruments (AREA)

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• 2006
  • 2006-12-11 FR FR0610777A patent/FR2909546B1/fr not_active Expired - Fee Related
• 2007
  • 2007-12-10 CN CN200780049921.5A patent/CN101605517A/zh active Pending
  • 2007-12-10 WO PCT/FR2007/002029 patent/WO2008090271A1/fr active Application Filing
  • 2007-12-10 US US12/517,797 patent/US20100137876A1/en not_active Abandoned
  • 2007-12-10 JP JP2009540811A patent/JP2010512209A/ja active Pending
  • 2007-12-10 EP EP07871824A patent/EP2120818A1/de not_active Ceased

Non-Patent Citations (1)

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