JP5301945B2 - Perfusion suction device - Google Patents

Description

  The present invention relates to a perfusion suction device that supplies a perfusate to a patient's eye and sucks it together with waste tissue.

  In cataract surgery and vitreous surgery, a perfusion suction device is used that suctions and removes together with waste tissue while supplying perfusate into the eye. In cataract surgery, the perfusate is supplied into the eye via a perfusion tube connected to a surgical instrument for crushing and emulsifying the lens. The waste tissue in the eye is sucked and discharged from the surgical instrument by applying a suction pressure to the suction tube connected to the surgical instrument. A part of the perfusion tube is passed through a pinch valve of the apparatus, and the supply of the perfusate is controlled by opening and closing the pinch valve. The suction tube is connected to a peristaltic suction pump arranged in the apparatus, and suction pressure is applied to the suction tube. The suction pressure of the suction tube (suction path) is detected by a suction pressure detection sensor. The vent path branched from the suction tube is passed through a vent pinch valve, and perfusate or air flows into the suction tube by opening and closing the pinch valve.

In recent years, a cassette in which each path is stored has been used in order to facilitate the setting of each tube device (see, for example, Patent Documents 1 and 2).
Japanese Patent Application Laid-Open No. 11-3332907 Japanese National Patent Publication No. 8-505065

  In Patent Document 1 (Japanese Patent Application Laid-Open No. 11-3332907), in order to selectively use a plurality of surgical instruments without changing them, a perfusion path and a suction path are branched into two systems in one cassette. It has a structure. For this reason, the cassette is relatively large. In cataract surgery, the perfusion route and the suction route are often used with only one system each. In this case, the cassette of Patent Document 1 is costly and has a drawback of increasing the capacity of waste after use. In Patent Documents 1 and 2, there is a problem that the operation cannot be continued if the suction pump, the suction pressure detection sensor, or the like fails.

  In view of the above-mentioned problems of the prior art, the present invention enables switching between two systems without using a large cassette, and can suppress the cost of the cassette and the volume of waste when only one system is used. Furthermore, it is an object of the present invention to provide a perfusion suction device capable of continuing surgery even when a suction pump, a suction pressure detection sensor, or the like fails.

  In order to solve the above problems, the present invention is characterized by having the following configuration.

A perfusate that holds a cassette having at least an aspiration path for aspirating waste tissue in the eye and is supplied into the eye from a perfusion bottle through the surgical instrument connected to the cassette and the aspiration path of the cassette the waste tissue a perfusion suction device for sucking with the first cassette is the cassette for use in cataract surgery, and the second both selectively cassette is the cassette for use in vitreous surgery Two cassette holding units that can be held, and the fluid in the path provided in the held first cassette or the second cassette regardless of which of the first cassette and the second cassette is held by the cassette holding unit The flow adjusting means disposed in each of the two cassette holding units, and the two cassette holding units. Among the units, a holding unit selection means for inputting a holding unit selection signal for selecting at least one cassette holding unit to be used for surgery, and the cassette holding unit selected by the holding unit selection signal are arranged. Control means for controlling the flow adjusting means .

  According to the present invention, two systems can be switched without using a large cassette, and the cost of the cassette and the volume of waste can be suppressed when only one system is used. Furthermore, even when a failure occurs in the suction pump, the suction pressure detection sensor, etc., the operation can be continued using the other cassette holding unit.

  Hereinafter, embodiments of the present invention will be described with reference to the drawings. FIG. 1 is a schematic external view of a perfusion suction device. FIG. 6 is a block diagram of the control system of the apparatus.

  On the apparatus body 1, an operation panel 2 having a touch panel function for inputting various operation screens and setting values such as surgical conditions is arranged. A connection panel 5 having connectors to which cables of various surgical instruments are connected is disposed on the front surface of the apparatus main body 1. Two first cassette holding units 100A and a second cassette holding unit 100B to which a cataract surgery cassette 200P or a vitreous surgery cassette 200V is attached are arranged on the side surface of the apparatus main body 1. The perfusion bottle 3 in which a perfusion solution such as physiological saline supplied to the patient's eye is placed is suspended from a support portion 4 a disposed at the upper end of the pole 4. Two support portions 4a are provided. Two perfusion bottles 3 can be used, such as when two cassettes 200P are used in cataract surgery. The pole 4 is moved up and down by the drive unit 6 to change the height of the perfusion bottle 3. By changing the height of the perfusion bottle 3, the pressure of the perfusate supplied to the patient's eye is adjusted.

  In cataract surgery, an ultrasonic handpiece (hereinafter, US handpiece) 500 that crushes and emulsifies the lens nucleus by ultrasonic vibration and a perfusion suction handpiece (hereinafter, I / A handpiece) 510 are selectively used as surgical instruments. Used for. In vitreous surgery, a vitreous cutter 520 and a backflush needle 530 are used as surgical instruments. The perfusion tube 501 connected to the US handpiece 500 or the I / A handpiece 510 is connected to the connection port 214 of the perfusion path of the cataract surgery cassette 200P. The suction tube 502 connected to the US handpiece 500 or the I / A handpiece 510 is connected to the connection port 220 of the suction path of the cassette 200P. The suction tube 522 connected to the vitreous cutter 520 or the backflush needle 530 is connected to the connection port 220 of the suction path of the vitreous surgery cassette 200V.

  Next, the configuration of the first cassette holding unit 100A will be described with reference to FIG. 2A is a perspective view of the first cassette holding unit 100A, and FIG. 2B is a cross-sectional view taken along line AA of FIG. 2A. The cassette holding unit 100A includes a panel 110A that forms the side surface of the apparatus main body 1, and a slot cover 150A having a slot 150aA into which the cassettes 200P and 200V are inserted. Two shafts 102A extending in the front-rear direction (arrow B direction) with respect to the apparatus main body 1 are attached to the slot cover 150A. The two shafts 102A are slidably held on a base 101A attached to the panel 110A. A motor 103A that moves the shaft 102A back and forth is attached to the base 101A. By rotation of the motor 103A, the shaft 102A is moved in the front-rear direction (arrow B direction) via a known slide mechanism such as a cam mechanism, and the slot cover 150A is opened and closed. The panel 110A is provided with a SET switch 111A and an EJECT switch 112A for inputting a command signal for opening and closing the slot cover 150A.

  A peristaltic suction pump 115A is disposed below the panel 110A. The suction pump 115A includes a roller head 115aA connected to a suction tube arranged in the cassette 200P (or 200V), and a motor 115bA that rotates the roller head 115aA. In the slot cover 150A, a tube presser 152A is disposed at a position facing the roller head 115aA. When the slot cover 150A is closed, the suction tube disposed in the cassette 200P (or 200V) is pressed against the roller head 115aA by the tube presser 152A. Then, by rotating the roller 115aA, a suction force is applied to the suction tube in the cassette 200P (or 200V).

  The panel 110A, the base 101A, the shaft 102A, the motor 103A, the slot cover 150A, the tube presser 152A, and the like constitute a clamp mechanism 105A that clamps the cassette 200P (or 200V).

  At the center position of the panel 110A, a perfusion pinch valve 130A for opening and closing the perfusate supply path in the cassette 200P (or 200V), and a vent pinch valve 132A for opening and closing the vent path in the cassette 200P (or 200V), Is arranged. The pinch valves 130A and 132A are moved by motors 131A and 133A disposed behind the panel 110A, respectively.

  In addition, the cassette holding unit 100A is provided with a suction pressure detection sensor 170A that detects the pressure in the suction path disposed in the cassette 200P (or 200V). The suction pressure detection sensor 170A is used to hold the load sensor (load cell) 171A disposed on the slot cover 150A side and the chamber unit 230 (see FIG. 4) disposed on the cassette 200P (or 200V) toward the load sensor 171A. And a pressing unit 172A. The technology described in Japanese Patent Application Laid-Open No. 11-332904 is used for the configuration of the suction pressure detection sensor 170A.

  The panel 110 is provided with a sensor unit 120A for discriminating the types (types) of the cataract surgery cassette 200P and the vitreous surgery cassette 200V. The sensor unit 120A includes two pin members 121aA and 121bA that are movably held in the direction of arrow B, and micro switches 122aA and 122bA that are disposed behind the panel 110A and detect the movement of the pin members 121aA and 121bA, respectively. Consists of The cassette 200P and the cassette 200V are provided with an opening hole or a cover lid at a position corresponding to the pin members 121aA and 121bA as an identifier of the cassette type. In the case where the cover is provided, the pin members 121aA and 121bA are pushed to the panel 110 side, and the microswitches 122aA and 122bA are turned ON / OFF, so that either the cataract surgery cassette 200P or the vitreous surgery cassette 200V is selected. It is determined whether it is set in the cassette holding unit 100A. The result of discriminating the cassette type is displayed on the display unit 165A arranged on the panel 110A. If the type of the cassette set in the slot 150aA is different from the setting, the alarm display unit 165A is lit in red to warn. When the cassette type is correct, the display portion 165A is lit in green.

  The slot cover 150A incorporates a cassette detection unit 160A that detects whether or not the cassette 200P (or 200V) is installed. The cassette detection unit 160A includes a pin member 161A that is held at the upper end of the slot cover 150A so as to be movable up and down, and a micro switch 162A that is disposed below the pin member 161A. When the cassette 200P (or 200V) is inserted into the slot 150aA of the slot cover 150, the lower surface of the convex portion 205 formed on the cassette 200P comes into contact with the pin member 161A, and the pin member 161A is pushed down. When the micro switch 162A detects that the pin member 161A is pushed down, it is detected that the cassette 200P is set in the slot cover 150A.

  2A and 2B show only the configuration diagram of the first cassette holding unit 100A, the components of the second cassette holding unit 100B are the same as the components of the first cassette holding unit 100A. For this reason, the description of the components of the second cassette holding unit 100B will be omitted assuming that the symbol “A” appended to the end of each element of the first cassette holding unit 100A is replaced with “B”.

  Next, the configuration of the cataract surgery cassette 200P will be described. 3A is an external perspective view of the cataract surgery cassette 200P from the front, and FIG. 3B is a rear view of the cassette 200P. FIG. 4 is an internal configuration diagram of the cataract surgery cassette 200P.

  In the upper right of FIG. 4, a perfusate reservoir chamber 210 is disposed (see Japanese Patent Application Laid-Open No. 2008-35922 for the configuration and operation of the perfusate reservoir chamber 210). At the upper end of the perfusion fluid reservoir chamber 210, a connection port 211 to which a perfusion tube 3a extending from the perfusion bottle 3 is connected is provided. The lower side of the perfusate reservoir chamber 210 is branched into two connection ports. A perfusion path 212 in which a tube is arranged on the way is connected to one branched connection port. The perfusion path 212 is connected to the connection port 214 on the left side in FIG. 3A. A tube pressing member 216 that presses the pinch valve 130A (or 130B) of the cassette holding unit 100A (or 100B) is disposed in the tube portion that is disposed in the middle of the perfusion path 212.

  In FIG. 4, the connection port 220 to which the suction tube 502 from the surgical instrument is connected is connected to the path branching member 222. The suction path 224 branched from the path branch member 222 is guided to the waste liquid bag 204. In FIG. 4, the suction path 224 is disposed on the right side of the cassette 200 </ b> P by being disposed on the right side of the cassette 200 </ b> P, the path 224 a extending downward from the path branching member 222, the path 224 b extending laterally below the cassette 200 </ b> P, and introduced into the waste liquid bag 204. Path 224c. The path 224c extending in the lateral direction is formed of a flexible tube and is exposed from a notch portion 208 formed on the lower side of the case of the cassette 200P. The tube portion exposed from the notch portion 208 is disposed on the roller head 115aA (115aB) of the peristaltic suction pump 115A (115B) of the cassette holding unit 100A (100B).

  In addition, a vent path 226 connected to the lower connection port of the perfusate reservoir chamber 210 is disposed in another branch portion of the path branching member 222. In the middle of the vent path 226, a chamber unit 230 that is in contact with a load sensor 171A (171B) of the cassette holding unit 100A (100B) is disposed. The chamber unit 230 has a piston rod 231 arranged so as to be movable in a direction perpendicular to the paper surface of FIG. 4, and the load of the piston rod 231 pressed against the load sensor 171A (171B) according to the suction pressure of the vent path 226 is received. Changed. A flexible tube 226 b is disposed in the vent path 226 between the chamber unit 230 and the perfusate reservoir chamber 210. The tube 226b is provided with a tube pressing member 227 for pressing a pinch valve 132A (132B) of the cassette holding unit 100A (100B).

  The chamber unit 230 may be disposed in the suction path 224 that is closer to the surgical instrument than the suction pump 115A (115B). In this case, the suction pressure detection sensor 170A (170B) is also arranged corresponding to the position of the chamber unit 230.

  In FIG. 3A, a convex portion 205 having a step is formed at the upper and lower central portions on the surface side of the cassette 200P. By inserting the lower part of the convex portion 205 into the slot 150aA (150aB) of the cassette holding unit 100A (100B), the cassette detection unit 160 detects the arrangement of the cassette. A handle 202 is formed on the upper side of the cassette 200P. The convex portion 205 is provided with attachment members 203 a and 203 b for attaching the disposal bag 204.

  3B, on the back of the cassette 200P, an opening hole 234 corresponding to the pinch valve 130A (130B) for opening and closing the perfusate path 212 and a pinch valve 132A (132B) for opening and closing the tube 226b disposed in the vent path 226 are provided. And an opening hole 236 corresponding to. In addition, an identifier 240 for determining the type (type) of the cassette is provided on the back surface of the cassette 200P. In the cataract surgery cassette 200P, the two identifiers 240a and 240b are both used as a lid. The sensor unit 120A (120B) provided in the cassette holding unit 100A (100B) detects the presence / absence of the cover lid and determines the type of the cassette.

  FIG. 5 is an internal block diagram of the vitrectomy cassette 200V. Regarding the vitreous surgery cassette 200V, only elements different from the cataract surgery cassette 200P will be described. In vitreous surgery, the perfusate is supplied directly from the perfusion bottle 3 into the eye without going through the device pinch valve 130A (130B). For this reason, the vitreous surgery cassette 200V has a configuration in which the perfusion liquid reservoir chamber 210, the connection port 211, the perfusion path 212, and the connection port 214 are removed from the cataract surgery cassette 200P. Further, since the perfusate is not guided into the cassette 200V, the tip of the tube 226b of the vent path 226 extending from the chamber unit 230 is an air inlet, and a filter 250 is connected instead of the perfusate reservoir chamber 210. Yes. In the vitreous surgery cassette 200V, when the pinch valve 132A (132B) is opened, air flows into the chamber unit 230 and the suction path 224, and the suction pressure of the suction path 224 is lowered.

  The filter 250 is constituted by a membrane filter made of a resin having a pore diameter of about 0.2 μm, for example, and minute dust, dust and the like in the air flowing into the suction path of the vitreous cutter through the vent path 226 Sterilization is filtered. When the filter 250 is not disposed, the waste liquid is discharged back into the eye (vitreous portion) from the suction path of the vitreous cutter when the pinch valve 132A is opened. On the other hand, the filter 250 serves as an air resistance, prevents air from flowing into the vent path 226 abruptly, and suppresses the discharge of waste liquid into the eye. On the other hand, the cataract surgery cassette 200V is configured such that the perfusate flows into the vent path 226. This is because in the use of a cataract surgical instrument as compared with a vitreous cutter, the rise of suction is slow when air flows in, and the responsiveness of the peristaltic pump 115A (115B) also deteriorates. In cataract surgery, even if there is a discharge of waste fluid from the cataract surgery instrument into the eye, the volume of the part from which the lens has been removed is smaller than that of the vitreous body, so the subsequent waste tissue is cleaned by suction. Is easy. For this reason, perfusate is used for the vent path 226 in cataract surgery.

  In addition, the identifier 240a of the cassette 200V has an identifier 240a formed as an opening hole and an identifier 240b formed as a cover lid. The other components and the basic shape of the outer case of the cassette 200V are the same as the cassette 200P for cataract surgery. For this reason, both the cassettes 200P and 200V can be clamped in both the first cassette holding unit 100A and the second cassette holding unit 100B. In addition, in the case of the cassettes 200P and 200V, as long as the portion clamped by the clamp mechanism 105A (105B) (the portion below the convex portion 205) is the same, the shapes of the other portions may not be exactly the same.

  In the control system block diagram of FIG. 6, the operation panel 2, the connection panel 5, the drive unit 6, the foot switch 8, the first cassette holding unit 100 </ b> A, and the second cassette holding unit 100 </ b> B are connected to the control unit 40. The foot switch 8 (operation switch) inputs a perfusion liquid supply start / stop signal and a suction start / stop signal according to the depression position of the operator's foot. When use of the US handpiece 500 is set, the foot switch 8 inputs a signal for starting / stopping ultrasonic vibration of the US handpiece 500 according to the depressed position.

  Next, the operation of the perfusion suction apparatus having the above configuration will be described. The operator selects the type of operation and the cassette holding units 100A and 100B using the cassette 200P or 200V on the screen of the operation panel 2.

  FIG. 7 is an example of a setting screen for selecting the type of operation and the cassette holding units 100A and 100B. On the setting screen 500 displayed on the operation panel 2, “Pump 1” corresponding to the first cassette holding unit 100A is displayed as a key for inputting a selection signal indicating which of the cassette holding units 100A and 100B is used. And a selection key 501b on which “Pump 2” is displayed corresponding to the second cassette holding unit 100B. In addition, as a key for inputting a selection signal for performing either cataract surgery or vitreous surgery, a selection key 502a for performing only cataract surgery, a selection key 502b for performing only vitreous surgery, and cataract surgery or vitreous surgery. A selection key 502c for performing both is provided. Hereinafter, selection of each operation and selection patterns of the cassettes 200P and 200V set in the cassette holding units 100A and 100B will be described.

<Pattern 1: Cataract surgery using two cassettes 200P for cataract surgery>
In this operation, the operator selects both the “pump 1” selection key 501a and the “pump 2” selection key 501b. In addition, “cataract surgery” is selected by the surgery selection key 502a. In this case, the cassette holding units 100A and 100B are set to the cataract surgery cassette 200P.

  The surgeon sets the cataract surgery cassette 200P in the slot 150aA of the cassette holding unit 100A. When the SET switch 111A is pressed, the motor 103A is driven by the control unit 40, and the slot cover 150A is moved to the panel 110A side. Thereby, the cassette 200P is clamped by the panel 110A and the slot cover 150A. By moving the slot cover 150A, the tube 224b of the suction path 224 exposed from the notch 208 is sandwiched between the roller head 115aA of the suction pump 115A and the tube presser 152A on the slot cover 150A side. Thereby, the connection of the suction tube to the suction pump 115A is completed. Further, when the slot cover 150A is moved, the perfusate path 212 and the vent path 226 that is the vent path for the pinch valves 130A and 132A are also set. Similarly, the surgeon sets the cataract surgery cassette 200P in the slot 150aB of the cassette holding unit 100B.

  At this time, the suitability of the cassette is determined by the control unit 40 based on the selection signal of the cassette holding units 100A and 100B, the selection signal of the operation type, and the determination signal of the cassette type by the sensor units 120A and 120B. If the cataract surgery cassette 200P is set in each of the cassette holding units 100A and 100B, it is determined that the cassette is properly set, and the display portions 165A and 165B are displayed in green. If the vitrectomy cassette 200V is set by mistake, the alarm display portions 165A and 165B are displayed in red and a warning sound is emitted from the speaker 41. Thereby, selection mistake of a cassette is prevented.

  The perfusion tube 501 and the suction tube 502 are connected to the connection ports 214 and 220 of the cassette 200P set in the cassette holding unit 100A, and are connected to the US handpiece 500, respectively. Further, the perfusion tube 501 and the suction tube 502 are also connected to the connection ports 214 and 220 of the cassette 200P set in the cassette holding unit 100B, and are connected to the I / A handpiece 510, respectively. Further, the perfusion tubes 3a extending from the two perfusion bottles 3 are connected to the connection ports 211 of the two cassettes 200P, respectively.

  When the preparation of the cassette and the surgical instrument is completed, the surgeon switches to the cataract surgery screen 550 shown in FIG. 8, and sets the surgical conditions by the US handpiece 500 and the I / A handpiece 510 by operating predetermined keys. When the setting of the operation conditions is completed, the operation is started. When the US handpiece 500 is selected by the selection key 551a on the cataract operation screen 550, each operation of perfusion / aspiration is set on the first cassette holding unit 100A side. That is, the control unit 40 operates the suction pump 115A and the pinch valves 130A and 132B on the first cassette holding unit 100A side in response to the input of the selection key 551a of the US handpiece 500, and drives the suction pressure detection sensor 170A and the like. Decide to control. When the supply start signal of the perfusate is input by operating the foot switch 8, the pinch valve 130A on the first cassette holding unit 100A side is opened, and the perfusate is supplied to the perfusion tube connected to the US handpiece 500. . When a suction start signal is input by operating the foot switch 8, the suction pump 115A is driven, and suction pressure is applied to the suction tube connected to the US handpiece 500. When the suction pressure detected by the suction pressure detection sensor 170A exceeds the set value, the control unit 40 stops driving the suction pump 115A. When the suction signal is stopped by the operation of the foot switch 8 (when the suction stop signal is input), the pinch valve 132A is opened, and the perfusate flows into the suction path 224. Thereby, the suction pressure in the suction path 224 is lowered.

  When the I / A handpiece is selected by the selection key 551b on the cataract operation screen 550 as the next operation stage after the operation with the US handpiece 500 is completed, the setting of each operation of perfusion / aspiration is the second cassette holding unit. It is switched to the 100B side. That is, the control unit 40 determines to control the driving of each component on the second cassette holding unit 100B side in response to the input of the selection key 551a. The pinch valve 130B on the second cassette holding unit 100B side is driven based on the perfusion fluid supply start / stop signal from the foot switch 8, and the suction pump 115B is driven based on the suction start / stop signal. The monitoring of the suction pressure is switched to the suction pressure detection sensor 170B on the second cassette holding unit 100B side.

  In the setting in which the cassette 200P for cataract surgery is set in each of the first cassette holding units 100A and 100B, for example, when performing surgery with the I / A handpiece 501 following surgery with the US handpiece 500 as a surgical stage, Switching between the two systems of perfusion / suction can be easily performed by operating the operation panel 2 without changing the equipment. For this reason, when different surgical instruments are used continuously in cataract surgery, surgery can be performed efficiently.

<Pattern 2: Cataract surgery using only one cataract surgery cassette 200P>
In this operation, the operator selects only one of the first cassette holding unit 100A or the second cassette holding unit 100B by using the selection key 501a of "Pump 1" or the selection key 501b of "Pump 2". In addition, “cataract surgery” is selected by the surgery selection key 502a. The surgeon sets the cassette 200P in the first cassette holding unit 100A or the second cassette holding unit 100B on the side corresponding to the selected “pump 1” or “pump 2”. For example, it is assumed that the first cassette holding unit 100A of “Pump 1” is selected by the selection key 501a. At this time, when the cassette 200P is set in the second cassette holding unit 100B, a detection signal from the cassette detector 160B is input to the control unit 40. Based on this input signal, the control unit 40 displays a warning message indicating that a cassette is set in the second cassette holding unit 100B on the operation panel 2 and generates a warning sound from the speaker 41. Further, when the vitreous cassette 200V is set in the first cassette holding unit 100A by mistake, a warning is given by the display unit 165A and the speaker 41 as described above.

  In the operation of this setting, the operator first performs an operation by connecting the US handpiece 500 to the perfusion tube and the suction tube of the cassette 200P. When the US handpiece is selected by the selection key 551a on the screen 550 in FIG. 8, the control unit 40 sets each operation of perfusion / suction to the first cassette holding unit 100A side. After the operation with the US handpiece 500 is completed, the operator changes the connection between the perfusion tube and the suction tube of the cassette 200 </ b> P to the I / A handpiece 510. In the subsequent operation stage, the operator selects the I / A handpiece by using the selection key 551b on the screen 550. However, regardless of the input of the selection signal of the I / A handpiece, the setting of each operation of perfusion / aspiration is performed. The first cassette holding unit 100A is left as it is. Thereby, the cataract operation which one cassette 200P used can be performed.

  In an operation using only one cataract surgery cassette 200P, the number of cassettes 200P used can be reduced, and the waste capacity of the cassette can be suppressed.

<Pattern 3: Cataract Surgery and Vitreous Surgery Using Cataract Surgery Cassette 200P and Vitreous Surgery Cassette 200V>
In this operation, the operator selects both the “pump 1” selection key 501a and the “pump 2” selection key 501b. Further, “cataract surgery / vitreous surgery” is selected by the surgery selection key 502c. In this case, the cassette holding unit 100A corresponding to “Pump 1” is set to the cataract surgery cassette 200P, and the cassette holding unit 100B corresponding to “Pump 2” is set to the vitreous surgery cassette 200V. Note that it can be changed on another setting screen as to which of the cassettes 200P and 200V corresponds to the initial setting of the cassette holding units 100A and 100B.

  The surgeon sets the cataract surgery cassette 200P in the first cassette holding unit 100A and the vitreous surgery cassette 200V in the second cassette holding unit 100B. When the types of cassettes set in the respective cassette holding units 100A and 100B are different, as described above, the cassette type discrimination signal by the sensor units 120A and 120B of each cassette holding unit and the screen 500 are selected. The appropriateness of the cassette is determined based on the selected cassette holding unit selection signal and operation type selection signal. When an incorrect cassette is set, a warning is issued from the display units 165A and 165B and the speaker 41.

  The surgeon first connects the perfusion tube and suction tube of the cassette 200P set in the first cassette holding unit 100A to the US handpiece 500, and performs an operation with the US handpiece 500 by using the selection key 551a on the screen 550 in FIG. Do. Subsequently, when it is necessary to use the I / A handpiece 510, the perfusion tube and the suction tube of the cassette 200P are connected, and an operation using the I / A handpiece is performed with the selection key 551b. When the selection keys 551a and 551b for cataract surgery are selected, the perfusion / aspiration operations are set on the first cassette holding unit 100A side.

  In order to perform the vitreous surgery following the cataract surgery, the operator switches to the vitreous surgery screen 560 by the selection key 551c on the screen 550 of FIG. When the vitreous cutter 520 is selected by the key 561a, the setting of each operation of perfusion / suction is switched to the second cassette holding unit 100B side. When the vitreous cutter 520 is used, a suction start / stop signal is input by an operation signal of the foot switch 8, and the driving of the suction pump 151B on the second cassette holding unit 100B side is controlled. The perfusate is directly supplied into the eye from the perfusion bottle by a perfusion cannula or the like without using the cassette 200V.

  In this operation, the perfusion / aspiration system can be easily switched by operating the operation panel 2 without changing the connection between the cataract surgical instrument and the vitreous surgical instrument, and the operation can be performed efficiently.

<Pattern 4: Vitreous Surgery Using Two Vitreous Surgery Cassettes 200V>
In this operation, the operator selects both the “pump 1” selection key 501a and the “pump 2” selection key 501b. Further, “vitreous surgery” is selected by the surgery selection key 502b. In this case, both the cassette holding units 100A and 100B are set to the vitreous cassette 200V. If the cataract surgery cassette 200P is erroneously set in the cassette holding units 100A and 100B, a warning is issued based on the discrimination signals of the sensor units 120A and 120B of each cassette holding unit.

  In vitreous surgery using two cassettes 200V, for example, the suction tube of the vitreous cutter 520 is connected to the suction path of the cassette 200V on the cassette holding unit 100A side, and the suction path of the cassette 200V on the cassette holding unit 100B side is connected. Is connected to the suction tube of the backflush needle 530. In vitreous surgery, the perfusate is supplied directly into the eye by a perfusion cannula or the like without going through the cassette 200V.

  FIG. 9 shows an operation screen when selecting vitreous surgery. When the selection key 561a of the vitreous cutter as the first vitreous surgical instrument on the screen 560 is selected, the suction operation and the suction pressure detection operation are set on the first cassette holding unit 100A side. When a suction start signal / stop signal is input by operating the foot switch 8, the driving of the suction pump 115A is controlled by the control unit 40. When the suction pressure detected by the suction pressure detection sensor 170A exceeds the set value, the driving of the suction pump 115A is stopped (or reversely rotated) by the control unit 40. When the suction signal is stopped by the operation of the foot switch 8, the pinch valve 132 </ b> A is opened, and air flows into the suction path 224 through the filter 250 and the vent path 226.

  When the selection key 561b of the second vitreous surgery instrument is selected, the suction operation and the suction pressure detection operation are switched to the second cassette holding unit 100B side. When a suction start / stop signal is input by operating the foot switch 8, the driving of the suction pump 115B is controlled by the control unit 40. When the suction pressure detected by the suction pressure detection sensor 170B exceeds the set value, the control unit 40 stops driving the suction pump 115B. When the suction signal is stopped by the operation of the foot switch 8, the pinch valve 132B is opened, and air flows into the suction path 224.

  In vitreous seed surgery with this setting, switching between the two systems of suction can be easily performed by operating the operation panel 2 without changing each surgical instrument, and vitreous surgery can be performed efficiently.

<Pattern 5: Vitreous Surgery Using Only One Cassette for Vitreous Surgery 200V>
In this operation, the operator selects only one of the first cassette holding unit 100A or the second cassette holding unit 100B by using the selection key 501a of "Pump 1" or the selection key 501b of "Pump 2". Further, “vitreous surgery” is selected by the surgery selection key 502b. For example, assume that the first cassette holding unit 100A is selected by the selection key 501a. When the cassette 200V is set in the second cassette holding unit 100B, a warning that the cassette is set incorrectly is displayed on the operation panel 2 based on the detection signal of the cassette detector 160B.

  In the operation of this setting, when the selection keys 561a and 561b on the screen 560 are selected, both the suction operation and the suction pressure detection operation are set to the first cassette holding unit 100A side. For example, the surgeon first connects the suction tube of the vitreous cutter 520 to the suction path of the cassette 200V, and performs the vitreous surgery with the vitreous cutter 520. Next, the suction tube of the back flash needle 530 is connected to the suction path of the cassette 200V, and an operation using the back flash needle 530 is performed. In such a vitreous surgery, since only one vitreous surgery cassette 200V is used, the number of cassettes 200V used can be reduced, and the waste capacity of the cassette can be suppressed.

  In the above operation, even when a failure occurs in one of the cassette holding units 100A or 100B, the operation can be continued by switching to the other use. For example, if the suction pump 115A, the suction pressure detection sensor 170A, the pinch valve 132A, etc. of the cassette holding unit 100A set initially are out of order in the operation of the above pattern 2 or 5, the operator selects the selection key on the screen 500. The operation can be continued by switching to the selection of the second cassette holding unit 100B by 501b and transferring the cassette 200P or 200V to the second cassette holding unit 100B. In the patterns 1, 3, and 4, when a component on the cassette holding unit 100A side fails, the selection key 501b switches to the selection of only the second cassette holding unit 100B, and the cassette 200P or 200V set in the second cassette holding unit 100B. The operation can be continued by using.

  In the above description, switching between the first cassette holding unit 100A and the second cassette holding unit 100B is automatically determined in response to the selection signal (key 551a, 551b, 561a, 561b) of the surgical instrument. However, this may be a case where the operator decides and switches. That is, the operator selects which one of the first cassette holding unit 100A and the second cassette holding unit 100B is to be used by using the selection keys 501a and 501b on the screen 500, and also selects the cataract using the operation selection keys 502a and 502b. Select the type of surgery and vitreous surgery. The control unit 40 switches the control of the first cassette holding unit 100A and the second cassette holding unit 100B according to the selection signals of the selection keys 501a and 501b. At this time, the control unit 40 determines whether or not the cassette is appropriate based on the selection signal of the selection keys 501a and 501b, the selection signal of the operation by the operation selection keys 502a and 502b, and the determination signal of the sensor units 120A and 120B that determine the type of the cassette. If the cassette type is wrong, a warning is issued by the display units 165A and 165B. Even in this case, the switching of the two systems of the patterns 1, 3, and 4 can be easily performed by operating the operation panel 2, and the surgery can be performed efficiently. Further, even when a failure occurs in one of the cassette holding units 100A or 100B, the operation can be continued using the other.

1 is a schematic external view of a perfusion suction device. A perspective view of the cassette holding unit, It is AA sectional drawing of FIG. 2A. It is an external appearance perspective view from the front direction of the cassette for a cataract surgery. It is a rear view of the cassette for cataract surgery. It is an internal block diagram of the cassette for cataract surgery. It is an internal block diagram of the cassette for vitreous surgery. It is a control system block diagram of a perfusion suction device. It is an example of the setting screen which selects the kind of operation and a cassette holding | maintenance unit. It is an example of a screen which selects the surgical instrument of a cataract operation. It is an example of a screen which selects the surgical instrument of a vitreous surgery.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Apparatus main body 2 Operation panel 40 Control unit 100A 1st cassette holding unit 200B 2nd cassette holding unit 105A Clamp mechanism 115A Suction pump 120A Sensor unit 130A Perfusion pinch valve 132A Vent pinch valve 165A Display part 170A Suction pressure detection sensor 200P Cataract Surgery cassette 200V Vitreous surgery cassette 212 Perfusion path 224 Suction path 226 Vent path 240 Identifier 500 Setting screen 550 Cataract surgery screen 560 Vitreous surgery screen

Claims (3)

A perfusate that holds a cassette having at least an aspiration path for aspirating waste tissue in the eye and is supplied into the eye from a perfusion bottle through the surgical instrument connected to the cassette and the aspiration path of the cassette a perfusion suction device for sucking the waste tissue with,
Two cassette holding units capable of selectively holding both the first cassette that is the cassette used for cataract surgery and the second cassette that is the cassette used for vitreous surgery ;
Regardless of which of the first cassette and the second cassette is held in the cassette holding unit, the flow of fluid in the path provided in the held first cassette or the second cassette can be adjusted. Flow adjusting means disposed in each of the two cassette holding units;
A holding unit selection means for inputting a holding unit selection signal for selecting at least one cassette holding unit to be used for surgery among the two cassette holding units;
Control means for controlling the flow adjusting means arranged in the cassette holding unit selected by the holding unit selection signal ;
A perfusion suction device comprising: The perfusion suction device of claim 1,
An identifier provided on each cassette to identify the type of cassette;
A cassette discrimination sensor for discriminating whether the cassette held in the cassette holding unit is the first cassette or the second cassette based on the identifier;
Surgery selection means for inputting a surgery selection signal for selecting the type of cataract surgery and vitreous surgery,
Based on the determination result and the operation selection signal of the cassette discrimination sensor, and determining means for determining the type of appropriateness of the cassette held by the cassette holding unit,
A perfusion suction device comprising: In perfusion suction device according to claim 1 or 2,
When the use of the two cassette holding units is performed by the holding unit selection signal,
The control pattern executed by the control means includes
For one of the two flow adjustment means, control is performed when a US handpiece is connected to the first cassette as the surgical instrument, and for the other of the two flow adjustment means, A pattern for performing control in cataract surgery by performing control when a perfusion suction handpiece is connected to the first cassette as the surgical instrument;
For one of the two flow adjustment means, control is performed when the vitreous cutter is connected to the second cassette as the surgical instrument, and for the other of the two flow adjustment means, By performing control when a backflush needle is connected to the second cassette as the surgical instrument, a pattern for executing control in vitreous surgery,
Is provided at least .