RU2017112959A - Устройства и способы для удаления хрусталиковой ткани - Google Patents

Устройства и способы для удаления хрусталиковой ткани Download PDF

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RU2017112959A
RU2017112959A RU2017112959A RU2017112959A RU2017112959A RU 2017112959 A RU2017112959 A RU 2017112959A RU 2017112959 A RU2017112959 A RU 2017112959A RU 2017112959 A RU2017112959 A RU 2017112959A RU 2017112959 A RU2017112959 A RU 2017112959A
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surgical device
deployed position
lumen
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distal end
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RU2703694C2 (ru
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Мария Цончева ГУГУЧКОВА
Льюк У. КЛАУСОН
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Янтек, Инк.
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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
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32Surgical cutting instruments
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32Surgical cutting instruments
    • A61B17/3205Excision instruments
    • A61B17/32056Surgical snare instruments
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • A61B17/3468Trocars; Puncturing needles for implanting or removing devices, e.g. prostheses, implants, seeds, wires
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/08Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by means of electrically-heated probes
    • A61B18/082Probes or electrodes therefor
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30Surgical robots
    • 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
    • A61F9/00754Instruments for removal of intra-ocular material or intra-ocular injection, e.g. cataract instruments for cutting or perforating the anterior lens capsule, e.g. capsulotomes
    • 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
    • A61F9/008Methods or devices for eye surgery using laser
    • A61F9/00825Methods or devices for eye surgery using laser for photodisruption
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/22004Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00831Material properties
    • A61B2017/00867Material properties shape memory effect
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00831Material properties
    • A61B2017/00876Material properties magnetic
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B2017/22079Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with suction of debris
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32Surgical cutting instruments
    • A61B2017/32006Surgical cutting instruments with a cutting strip, band or chain, e.g. like a chainsaw
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • A61B2018/1405Electrodes having a specific shape
    • A61B2018/1407Loop
    • A61B2018/141Snare
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30Surgical robots
    • A61B2034/301Surgical robots for introducing or steering flexible instruments inserted into the body, e.g. catheters or endoscopes
    • 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
    • A61F9/008Methods or devices for eye surgery using laser
    • A61F2009/00861Methods or devices for eye surgery using laser adapted for treatment at a particular location
    • A61F2009/0087Lens
    • 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
    • A61F9/008Methods or devices for eye surgery using laser
    • A61F2009/00885Methods or devices for eye surgery using laser for treating a particular disease
    • A61F2009/00887Cataract
    • A61F2009/00889Capsulotomy

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Public Health (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Veterinary Medicine (AREA)
  • Ophthalmology & Optometry (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Vascular Medicine (AREA)
  • Physics & Mathematics (AREA)
  • Optics & Photonics (AREA)
  • Plasma & Fusion (AREA)
  • Otolaryngology (AREA)
  • Robotics (AREA)
  • Pathology (AREA)
  • Mechanical Engineering (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Prostheses (AREA)
  • Surgical Instruments (AREA)

Claims (21)

1. Хирургическое устройство, имеющее дистальный участок, имеющий размер с возможностью вставки внутрь передней камеры глаза, при этом хирургическое устройство содержит:
стержень, имеющий дистальный конец и просвет, образованный по через стержень, причем просвет имеет продольную ось и дистальный конец; и
элемент, выполненный с возможностью перемещения из положения хранения в развернутое положение, в котором больший участок элемента выдвинут из дистального конца просвета;
причем перемещение из положения хранения в развернутое положение вынуждает первую сторону элемента продвигаться в дистальном направлении относительно дистального конца стержня и вынуждает вторую сторону элемента перемещаться в проксимальном направлении относительно дистального конца стержня.
2. Хирургическое устройство по п. 1, в котором весь элемент, кроме концевого участка, расположен внутри просвета в положении хранения.
3. Хирургическое устройство по п. 1, в котором, в развернутом положении, большая часть элемента, расположенная снаружи просвета, располагается с одной стороны от продольной оси просвета.
4. Хирургическое устройство по п. 1, в котором элемент имеет предварительно установленную форму и подвергается изменению формы к предварительно установленной форме в процессе движения элемента из положения хранения в развернутое положение.
5. Хирургическое устройство по п. 1, в котором элемент является проволокой.
6. Хирургическое устройство по п. 1, в котором элемент является лентой.
7. Хирургическое устройство по п. 1, в котором элемент в развернутом положении формирует по существу замкнутую форму, с, по меньшей мере, одной из первой и второй сторон элемента, продолжающимися из дистального конца просвета; при этом, вблизи от дистального конца просвета, вторая сторона в развернутом положении изгибается обратно больше, чем на 120 градусов относительно продольной оси просвета.
8. Хирургическое устройство по п. 1, в котором, в развернутом положении, элемент формирует по существу замкнутую искривленную и атравматическую предварительно установленную форму, при этом, при использовании, элемент способен продвигаться между хрусталиком и капсульным мешком глаза, при перемещении в развернутое положение.
9. Хирургическое устройство по п. 1, в котором, в развернутом положении, элемент формирует по существу замкнутую форму, которая задает плоскость, при этом продольная ось стержня лежит в данной плоскости.
10. Хирургическое устройство по п. 1, в котором устройство дополнительно содержит ручку, присоединенную к проксимальному концу стержня, при этом элемент перемещается из положения хранения в развернутое положение в ответ на приведение в действие, по меньшей мере, одного устройства управления, присоединенного к ручке.
11. Хирургическое устройство по п. 1, в котором устройство дополнительно содержит ручку, присоединенную к проксимальному концу стержня, и, по меньшей мере, одно устройство управления, функционально соединенное как с элементом, так и с кулачком, который обуславливает, что линейное движение устройства управления поворачивает элемент.
12. Хирургическое устройство по п. 1, в котором, в развернутом положении, элемент формирует по существу замкнутую форму, которая является искривленной и неплоской.
13. Хирургическое устройство по п. 1, в котором движение элемента из положения хранения в развернутое положение приводит к изменению элемента между первой формой и второй предварительно установленной формой,
при этом первая форма установлена по размеру с возможностью введения через капсулорексис на передней поверхности капсульного мешка глаза, и
причем вторая форма установлена по размеру с возможностью захвата, по меньшей мере, участка хрусталика; и
причем элемент допускает перемещение в третью форму из второй формы для приложения разрезающего усилия к хрусталику в то время, когда хрусталик остается внутри капсульного мешка.
14. Устройство по п. 13, в котором элемент допускает перемещение из первой формы во вторую форму для перемещения между хрусталиком и капсульным мешком, при одновременном приложении усилия к капсульному мешку ниже пороговой величины, соответствующей повреждению капсульного мешка.
15. Хирургическое устройство по п. 1, в котором элемент в развернутом положении содержит по существу замкнутую петлю с раскрытой зоной с размерами и формой, допускающими захват, по меньшей мере, участка хрусталика глаза в то время, когда хрусталик остается в капсульном мешке глаза.
RU2017112959A 2014-09-17 2015-09-17 Устройства и способы для удаления хрусталиковой ткани RU2703694C2 (ru)

Applications Claiming Priority (5)

Application Number Priority Date Filing Date Title
US201462051396P 2014-09-17 2014-09-17
US62/051,396 2014-09-17
US201562099590P 2015-01-05 2015-01-05
US62/099,590 2015-01-05
PCT/US2015/050820 WO2016044672A1 (en) 2014-09-17 2015-09-17 Devices and methods for the removal of lenticular tissue

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EP (2) EP3193795B1 (ru)
JP (2) JP6917305B2 (ru)
KR (2) KR102455953B1 (ru)
CN (2) CN107072814B (ru)
AU (2) AU2015317532B2 (ru)
BR (1) BR112017005315B1 (ru)
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