TWI401068B - 具多區液體室之外科用卡匣 - Google Patents

具多區液體室之外科用卡匣 Download PDF

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TWI401068B
TWI401068B TW096108910A TW96108910A TWI401068B TW I401068 B TWI401068 B TW I401068B TW 096108910 A TW096108910 A TW 096108910A TW 96108910 A TW96108910 A TW 96108910A TW I401068 B TWI401068 B TW I401068B
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fluid
suction chamber
surgical
sectional area
cross
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Mark A Hopkins
Shawn X Gao
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Alcon Inc
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/71—Suction drainage systems
    • A61M1/73—Suction drainage systems comprising sensors or indicators for physical values
    • A61M1/732—Visual indicating means for vacuum pressure
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/60—Containers for suction drainage, adapted to be used with an external suction source
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/71—Suction drainage systems
    • A61M1/72—Cassettes forming partially or totally the fluid circuit
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/71—Suction drainage systems
    • A61M1/74—Suction control
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/71—Suction drainage systems
    • A61M1/74—Suction control
    • A61M1/743—Suction control by changing the cross-section of the line, e.g. flow regulating valves
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/71—Suction drainage systems
    • A61M1/77—Suction-irrigation systems
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M3/00—Medical syringes, e.g. enemata; Irrigators
    • A61M3/02—Enemata; Irrigators
    • A61M3/0201—Cassettes therefor
    • 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/80—Suction pumps
    • A61M1/804—Suction pumps using Laval or Venturi jet pumps
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2205/00—General characteristics of the apparatus
    • A61M2205/12—General characteristics of the apparatus with interchangeable cassettes forming partially or totally the fluid circuit
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2205/00—General characteristics of the apparatus
    • A61M2205/12—General characteristics of the apparatus with interchangeable cassettes forming partially or totally the fluid circuit
    • A61M2205/123—General characteristics of the apparatus with interchangeable cassettes forming partially or totally the fluid circuit with incorporated reservoirs
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2205/00—General characteristics of the apparatus
    • A61M2205/33—Controlling, regulating or measuring
    • A61M2205/3379—Masses, volumes, levels of fluids in reservoirs, flow rates
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2205/00—General characteristics of the apparatus
    • A61M2205/33—Controlling, regulating or measuring
    • A61M2205/3379—Masses, volumes, levels of fluids in reservoirs, flow rates
    • A61M2205/3389—Continuous level detection

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  • Health & Medical Sciences (AREA)
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Description

具多區液體室之外科用卡匣 發明領域
本發明一般關於和顯微外科系統一起使用的外科用卡匣，且更特別地關於和眼科顯微外科系統一起使用的此種卡匣。
 發明背景
在小型切口外科手術過程中，尤其是在眼科外科手術過程中，將小型探針插入操作部位以切割、移除或另外操作組織。在這些外科手術過程中，典型地將流體輸注進眼內，並從手術部位吸入輸注流體和組織。在本發明之前，所用吸入系統的類型一般以流體受控或真空受控為特徵，視系統內所使用的泵浦類型而定。各類型的系統均具有某些優點。
藉由對系統尋求維持的所需真空等級進行設定，操作真空控制的抽吸系統。流速視眼內壓力、真空等級、及流道內的流動阻力而定。實際流速資訊是難以得到的。真空受控式抽吸系統典型地利用文氏管式泵浦或隔膜泵浦。真空受控式抽吸系統提供快速回應時間、對降低真空等級的控制、以及在例如空氣/流體交換期間的吸入空氣時的良好流體性能的優點。此種系統的缺點是缺少流體資訊，導致在無法同時進行阻塞檢測的晶狀體乳化或碎化過程中出現短暫的高流量。因為即時地非侵入性測定流體的問題，使得真空受控式系統難以用流體受控模式來操作。
流體受控式抽吸系統藉由為欲維持的系統設定所需的抽吸流速進行操作。流體受控式抽吸系統典型地利用蠕動式泵浦、渦卷泵浦、或輪葉泵浦。流體受控式抽吸系統提供在閉塞情況下的穩定流速和自動地增加真空等級的優點。此種系統的缺點是相對較慢的回應時間、當使用較大順應性元件時不合意的阻塞打通回應、以及在尖端阻塞時真空無法作線性地降低。因為測定真空的時間延遲可造成控制循環不穩定，降低動力性能，所以流體受控式抽吸系統難於以真空控制模式操作。
一個當前可用的眼科外科用系統－－來自Storz儀器公司的MILLENIUM系統－－既包含真空控制式抽吸系統(利用文氏管式泵浦)也包含分離的流體受控式抽吸系統(利用渦卷泵浦)。兩個泵浦不可同時地使用，且各個泵浦要求分開的抽吸管和卡匣。
另一當前可用的眼科外科用系統－－來自Alcon Laboratories公司的ACCURUS－－包含可串聯操作的文氏管式泵浦和蠕動式泵浦。文氏管式泵浦將來自手術部位的材料吸入到小型收集室。蠕動式泵浦不給手術部位提供吸入真空。因此，該系統作為真空控制式系統進行操作。
儘管存在這些傳統系統，但仍舊存在對眼科手術系統內的抽吸和輸注射流技術進行改良的需要。
 發明概要
本發明關於一種在其內配置吸入室或輸注室的外科用卡匣。該卡匣包括使流體高度變化能夠被準確測定的下部感測部分、及在外科手術過程中能夠存儲流體的上部存儲部分。該感測部分的橫剖面面積比該存儲部分的橫剖面面積小。
圖式簡單說明
為更全面理解本發明、以及其進一步的目的和優點，參照結合了所呈圖式的下列描述，其中：第1圖是揭示顯微外科系統內的吸入控制裝置的示意性圖式；第2圖是外科用卡匣本體的前視圖；以及第3圖是第2圖的外科用卡匣本體的後視圖。
 較佳實施例之詳細說明
藉由參照圖式的第1－3圖可最佳理解本發明的較佳實施例及其等優點，相似標號用於標識本發明的相似和對應部件。
顯微外科系統10包括加壓氣源12、隔離閥14、真空比例閥16、可選的第二真空比例閥18、壓力比例閥20、真空發生器22、壓力轉換器24、吸入室26、流體高度感測器28、泵浦30、收集袋埠32、吸氣埠34、外科用裝置36、電腦或微處理器38、及比例控制裝置40。系統10的各種元件經流體管線44、46、48、50、52、54、56及58流體耦接。系統10的各種元件經界面60、62、64、66、68、70、72、74及76電氣耦接。閥14較佳是“開/關”電磁閥。閥16－20較佳是比例電磁閥。真空發生器22可為產生真空的任何合適裝置，但較佳是在隔離閥14和真空比例閥16及/或18開通、且來自加壓氣源12的氣體通過真空發生器22時產生真空的真空晶片或文氏管晶片。壓力轉換器24可為直接地或間接地測定壓力和真空的任何合適裝置。流體高度感測器28可為測定吸入室26內流體42的高度的任何合適裝置，但較佳能夠以連續方式流體高度。流體高度感測器28最佳為能夠以連續方式測定流體高度的光學感測器。泵浦30可為產生真空的任何合適裝置，但較佳是蠕動式泵浦、渦卷泵浦、或輪葉泵浦。微處理器38能夠實施回饋式控制，且較佳為PID控制裝置。比例控制器40可為成比例地控制系統10及/或外科用裝置36的任何合適裝置，但較佳為腳踏控制器。
系統10較佳地利用三種不同的控制吸氣的方法，即真空式控制、抽吸式控制、及流體式控制。這些方法較全面地述於2005年6月21日提出申請的共同申請的美國專利申請案系列號第11/158,238號、和2005年6月21日提出申請的共同申請的美國專利申請案系列號第11/158,259號，這兩個專利申請案就該主題申請被共同擁有並藉由參照方式併入本文。
在這些方法的每一個中，可經流體管線50、56、和58給外科用裝置36和吸入室26提供真空。吸入室26用外科用裝置36所吸入的流體42填充。流體42包括輸注流體以及所吸入的眼部組織。吸入室26由存儲部分130和感測部分132組成。存儲部分130具有比感測部分132的大的橫剖面面積。存儲部分130的橫剖面面積較佳地達到比感測部分132的大7.5倍，且最佳的比感測部分132的約大7.5倍。存儲部分130和感測部分132流體耦接。存儲部分130和感測部分132之間的角度最佳為約90度。可從第2圖中看出，吸入室26定向為，使存儲部分130接近外科用卡匣100的頂部。
如第2圖和第3圖所示，外科用卡匣100具有包括吸入室26的本體102。為清楚起見，未顯示流體密封到本體102前側的蓋。為清楚起見，未顯示流體密封到本體102後側的夾板。埠108流體耦接到流體管線50。入口110流體耦接到吸入室26的感測部分132和流體管線56。如上所述，流體管線56經埠34和流體管線58流體耦接到外科用裝置36。入口112流體耦接到吸入室26的感測部分132和流體管線52。吸入室26；埠32和34；流體管線52、54和56；埠108；入口110；及入口112較佳地一體模制進本體102內。
在操作期間，給吸入室26供應真空。流體42自外科用裝置36引導到吸入室26。吸入室26具有兩個功能。這些功能之一個是支持連續高度感測，由此可決定流速的測量。流體的測定可依照下式獲得：
其中Q是流速，A是感測部分132的剖面面積，△L是由流體高度感測器28所測得的流體高度的變化，△t是時間的變化。關鍵是對吸入室26內流體42的高度進行準確和精確的測定。為提高流體測定的靈敏度，吸入室26垂直於流體高度感測器28的橫剖面面積，需要較小。這個功能由吸入室26的感測部分132實現。流體42經入口110進入吸入室26的感測部分132。感測部分132的較小剖面面積使流體高度感測器28能夠準確地和精確地決定吸入室26內的流體高度變化。吸入室26的另一功能是在交換流體耦接到收集袋埠32的收集袋(未圖示)過程中，保持附加流體42以支持非中斷外科手術。如果在外科手術過程中，存在在吸入室26內存儲流體的需要，如在收集袋交換過程中的情況下，則吸入室26的存儲部分130設置成可為流體存儲提供足夠容積的大剖面。
本文藉由示例揭示本發明，且此領域中具有通常知識者可進行各種修改。例如，對比本文上述的吸入室26，本發明可實施進具有存儲部分130和感測部分132的外科用卡匣的輸注室26內。
相信可從前面的描述中清楚本發明的操作和構造。雖則以所示或上述的裝置和方法的特徵為佳，但在不脫離下列申請專利範圍所界定的本發明的精神和範圍情況下可在其中作出各種變化和修改。
10．．．顯微系統
12．．．加壓氣源
14．．．隔離閥
16．．．真空比例閥
18．．．第二真空比例閥
20．．．壓力比例閥
22．．．真空發生器
24．．．壓力感測器
26．．．吸入室
28．．．流體高度感測器
30．．．泵浦
32．．．收集袋埠
34．．．吸入埠
36．．．外科用裝置
38．．．電腦/微處理器
40．．．比例控制裝置
42．．．流體
44．．．流體管線
46．．．流體管線
48．．．流體管線
50．．．流體管線
52．．．流體管線
54．．．流體管線
56．．．流體管線
58．．．流體管線
60．．．界面
62．．．界面
64．．．界面
66．．．界面
68．．．界面
70．．．界面
72．．．界面
74．．．界面
76．．．界面
100．．．外科用卡匣
102．．．本體
108．．．埠
110．．．入口
112．．．入口
130．．．存儲部分
132．．．感測部分
第1圖是揭示顯微外科系統內的吸入控制裝置的示意性圖式；第2圖是外科用卡匣本體的前視圖；以及第3圖是第2圖的外科用卡匣本體的後視圖。
26．．．吸入室
32．．．收集袋埠
34．．．吸入埠
52．．．流體管線
54．．．流體管線
56．．．流體管線
100．．．外科用卡匣
102．．．本體
108．．．埠
110．．．入口
112．．．入口
130．．．存儲部分
132．．．感測部分

Claims (4)

  1. 一種在其內配置吸入室的外科用卡匣，該吸入室包含：一具有第一橫剖面面積的流體高度感測部分，該感測部分係在該卡匣使用過程中提供連續流體高度變化的準確和精確證據；以及在供應真空給該吸入室的過程中流體耦接到該感測部分並具有一比該第一橫剖面面積大的第二橫剖面面積的一存儲部分，該存儲部分係在該卡匣使用過程中提供足夠的流體存儲；藉以在最接近該吸入室的一底部處配置該感測部分，使得外科用吸入流體首先進入位在該吸入室的一底部處的該感測部分，並在進入該存儲部分之前實質填充該感測部分，該存儲部分被配置於最接近該吸入室的一頂部處；藉以使該第一橫剖面面積提供針對該連續流體高度變化及一所計算外科手術流體吸入流速兩者之經改良測定靈敏度；且藉以使該第二橫剖面面積提供一足夠量的該外科手術流體來在流體耦接到該吸入室的一收集袋交換過程中支持非中斷外科手術。
  2. 如申請專利範圍第1項所述的外科用卡匣，其中該第二橫剖面面積比該第一橫剖面面積約大7.5倍。
  3. 如申請專利範圍第1項所述的外科用卡匣，其中該感測部分和該存儲部分之間的角度約是90度。
  4. 如申請專利範圍第1項所述的外科用卡匣，其中該吸入室未對大氣作排放。
TW096108910A 2006-03-20 2007-03-15 具多區液體室之外科用卡匣 TWI401068B (zh)

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