WO2005110509A1 - Fenetre de sortie d'un manchon de perfusion effile - Google Patents

Fenetre de sortie d'un manchon de perfusion effile Download PDF

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Publication number
WO2005110509A1
WO2005110509A1 PCT/US2004/011671 US2004011671W WO2005110509A1 WO 2005110509 A1 WO2005110509 A1 WO 2005110509A1 US 2004011671 W US2004011671 W US 2004011671W WO 2005110509 A1 WO2005110509 A1 WO 2005110509A1
Authority
WO
WIPO (PCT)
Prior art keywords
external margin
sleeve
infusion
infusion sleeve
proximal
Prior art date
Application number
PCT/US2004/011671
Other languages
English (en)
Inventor
Richard J. Mackool
Original Assignee
Mackool Richard J
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Mackool Richard J filed Critical Mackool Richard J
Priority to CA002576497A priority Critical patent/CA2576497A1/fr
Priority to PCT/US2004/011671 priority patent/WO2005110509A1/fr
Priority to EP04821988A priority patent/EP1765431A1/fr
Publication of WO2005110509A1 publication Critical patent/WO2005110509A1/fr

Links

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
    • A61F9/00745—Instruments for removal of intra-ocular material or intra-ocular injection, e.g. cataract instruments using mechanical vibrations, e.g. ultrasonic
    • 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
    • A61M1/84—Drainage tubes; Aspiration tips
    • A61M1/85—Drainage tubes; Aspiration tips with gas or fluid supply means, e.g. for supplying rinsing fluids or anticoagulants
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B2017/320084—Irrigation sleeves

Definitions

  • the present invention relates to an infusion portal on the side of an infusion sleeve of a surgical instrument.
  • Phacoemulsification instruments and irrigation/aspiration instruments are known that have infusion portals in their malleable infusion sleeves.
  • Alcon Surgical Laboratories commercializes such a phacoemulsification system under the name SERIES 20000® LEGACY®.
  • the phacoemulsification system is commercialized with a handpiece and malleable infusion sleeves with infusion portals.
  • the sleeves partially shroud needles, such as those commercialized under the tradename Mackool System® such as the MACKOOL MICROTIP or the MACKOOL FLARED ABS, which are named after the present inventor.
  • the infusion portal in the malleable infusion sleeve is typically formed by punching out that portion of the sleeve that is to form the infusion portal, thereby leaving a hole or orifice.
  • the wall of the infusion port is at a 90° angle to the entry of the hole or orifice.
  • a larger than necessary incision results in fluid leakage from the eye during the procedure, with resultant greater difficulty in controlling eye pressure during the surgery, potential collapse of the eye with trauma to ocular structures such as the cornea, iris, posterior lens capsule, etc.
  • a larger incision results in greater total fluid flow through the eye, and this fact alone cause greater trauma.
  • the current design requires greater force in order to accomplish insertion unless the incision is made larger than would otherwise be necessary to permit insertion of the tip or the portals are made smaller than optimally desirable. If the latter is done, the portals may be placed more toward the tip of the tapered infusion sleeve, where its diameter is less. Thus the portal may avoid contact with the sides of the incision during insertion.
  • One aspect of the present invention resides in configuring at least a portion of an external margin of a portal of an infusion sleeve of a surgical instrument and an adjacent portion of an exterior of the infusion sleeve of the surgical instrument to be other than perpendicular to each other and other than substantially perpendicular to each other.
  • the portion of the external margin may have a configuration that is either rounded off, beveled, inclined, tapered or curved.
  • a surgeon using the present invention may apply a substantially steady and constant force on the surgical instrument to insert its tip with the infusion sleeve through an incision without edges of the portal becoming caught or ensnared by the incision. Trauma to the surrounding tissues that might otherwise occur as a result of trying to break the portal free of being caught on the edges of the incision is avoided.
  • Fig. 1 is an elevation side view of a surgical instrument's needle and sleeve with infusion port in accordance with the prior art.
  • Fig. 2 is a cross section of the surgical instrument's needle and sleeve with infusion port of Fig. 1.
  • Fig. 3. is a cross section of the surgical instrument's needle and sleeve with infusion port in accordance with my invention.
  • FIGs. 1 and 2 a conventional needle 10 and malleable infusion sleeve 20 are depicted.
  • the malleable infusion sleeve 20 has one or more infusion portals 30 that includes at least one orifice 32 whose wall 34 terminates at the external surface 36 of the infusion sleeve 20 to form a sharp edge 40. That is, the wall of each of the infusion portals 30 is essentially is at a 90° angle to the external surface 36.
  • the infusion portal is arranged closer to the distal end of the sleeve than to the proximal end for delivering infusion fluid to an operating site adjacent the tip of the needle 10.
  • the edges of the external margin of the portals needed to be rounded off. This is desirable, even if small portals are placed on the tapering portion of the infusion sleeve, because it is still possible for them to traumatize the cornea during tip insertion, although less likely than with larger portals.
  • Each external margin 70 of the portals 60 is rounded off, inclined, curved, tapered or beveled to provide a more gradual transition to the external surface 36 of the sleeve 20 and thus is less sharp than is the case for the infusion portals 30 of Fig. 1.
  • the external margin 70 and the external surface 36 of the infusion sleeve 20 are arranged other than perpendicular to each other and other than substantially perpendicular to each other.
  • the external margin 70 forms at least a portion of at least one orifice of at least one of the portals 60.
  • This rounding off, inclining, tapering or beveling of the external margin 70 of the portals 60 may be effected in any conventional manner, whether done simultaneously with the forming of the portals 60 (such as at the time of the punch-out by employing a punch that converges as it presses from the exterior surface of the sleeve to penetrate through the sleeve to reach the interior surface of the sleeve) or subsequently with a conventional rounding or beveling tool.
  • Possible mechanisms include lathe cutting or laser ablation.
  • This rounding, tapering or beveling off may be done over an entirety of the circumference of the external margin 70 of the portals 60 or on any portion of the external margin 70.
  • the distal portion of the portals 60 should be rounded, tapered or beveled off because if left as a sharp margin, the distal portion is likely to encounter the tissues while passing through the incision to become caught or ensnared and thus result in the unwanted trauma condition.
  • the infusion sleeve 20 preferably has a tapering portion that tapers to the distal end or preferably has reduced diameter portion at a distal end that is of a smaller diameter than the proximal end.
  • the portal is preferably located in this tapering portion or reduced diameter portion.
  • the needle 10 is of conventional construction and has an aspiration inlet port on one side of the needle and an internal flow passage.
  • a generator of ultrasonic energy is used to apply ultrasonic energy to vibrate or oscillate the needle.
  • An aspiration suction force is applied to the internal flow passage to aspirate tissue into the aspiration inlet port.
  • the sleeve 20 surrounds at least a portion of the needle and is malleable so as to compress against a wall at the opening of an incision as the sleeve passes through to conform to the shape of the opening.
  • Infusion fluid is administered through a space between the needle 10 and an interior surface of the sleeve 20 and flows through an outlet port to reach the operating site.
  • an infusion sleeve of a surgical instrument has an orifice whose exterior margin is either rounded off, beveled, tapered, inclined, curved or otherwise forms an angle with an adjacent exterior of the sleeve that is other than ninety degrees and other than substantially ninety degrees.
  • the external margin of the portal may taper or converge inwardly toward the interior of the infusion sleeve from the exterior as it traverses the thickness of the infusion sleeve. As a result, the exterior margin is less likely to become caught or ensnared when being passed through an incision opening.
  • a surgeon using the present invention may apply a substantially steady and constant force on the surgical instrument to insert the tip through an incision without edges of the portals becoming caught or ensnared by the adjacent incision. Trauma to the surrounding tissues that might otherwise occur as a result of trying to break the portal free of being caught on the edges of the adjacent incision is avoided.
  • Infusion sleeves are used for different types of surgical instruments.
  • irrigation/aspiration instruments remove portions of the cataract from the eye (generally softer portions) that do not require the use of a vibrating ultrasonic generator to impose a vibrating force on the needle.
  • the sleeves on these instruments have portals that suffer from the same problem as the phacoemulsification instrument infusion sleeves currently have, and the solution as set forth in this patent application applies as well to them.
  • At least a portion of the external margin and an adjacent portion of an exterior of the infusion sleeve of the irrigation/aspiration instruments need to be configured and arranged to be other than perpendicular to each other and other than substantially perpendicular to each other.

Landscapes

  • Health & Medical Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Ophthalmology & Optometry (AREA)
  • Vascular Medicine (AREA)
  • Veterinary Medicine (AREA)
  • Surgery (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Pulmonology (AREA)
  • Anesthesiology (AREA)
  • Hematology (AREA)
  • Infusion, Injection, And Reservoir Apparatuses (AREA)

Abstract

L'invention se rapporte à un manchon de perfusion effilé (20) qui présente un orifice (32) dont le bord extérieur (70) est soit arrondi, biseauté, effilé, incurvé, incliné ou formant d'une manière ou d'une autre un angle avec une partie extérieure adjacente du manchon (20) qui n'est pas égal à 90 DEG ni sensiblement égal à 90 DEG . En conséquence, le bord extérieur (70) risque peu d'être pris ou piégé lors de son passage à travers une ouverture d'incision formée au moyen d'un instrument chirurgical.
PCT/US2004/011671 2004-04-15 2004-04-15 Fenetre de sortie d'un manchon de perfusion effile WO2005110509A1 (fr)

Priority Applications (3)

Application Number Priority Date Filing Date Title
CA002576497A CA2576497A1 (fr) 2004-04-15 2004-04-15 Fenetre de sortie d'un manchon de perfusion effile
PCT/US2004/011671 WO2005110509A1 (fr) 2004-04-15 2004-04-15 Fenetre de sortie d'un manchon de perfusion effile
EP04821988A EP1765431A1 (fr) 2004-04-15 2004-04-15 Fenetre de sortie d'un manchon de perfusion effile

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/US2004/011671 WO2005110509A1 (fr) 2004-04-15 2004-04-15 Fenetre de sortie d'un manchon de perfusion effile

Publications (1)

Publication Number Publication Date
WO2005110509A1 true WO2005110509A1 (fr) 2005-11-24

Family

ID=35394003

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US2004/011671 WO2005110509A1 (fr) 2004-04-15 2004-04-15 Fenetre de sortie d'un manchon de perfusion effile

Country Status (3)

Country Link
EP (1) EP1765431A1 (fr)
CA (1) CA2576497A1 (fr)
WO (1) WO2005110509A1 (fr)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8267891B2 (en) 2008-12-18 2012-09-18 Alcon Research, Ltd. Gilled phacoemulsification irrigation sleeve
US8852091B2 (en) 2012-04-04 2014-10-07 Alcon Research, Ltd. Devices, systems, and methods for pupil expansion

Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5919157A (en) * 1998-04-28 1999-07-06 Strukel; Igor Shaped flexible infusion sleeve

Patent Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5919157A (en) * 1998-04-28 1999-07-06 Strukel; Igor Shaped flexible infusion sleeve

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8267891B2 (en) 2008-12-18 2012-09-18 Alcon Research, Ltd. Gilled phacoemulsification irrigation sleeve
US8852091B2 (en) 2012-04-04 2014-10-07 Alcon Research, Ltd. Devices, systems, and methods for pupil expansion

Also Published As

Publication number Publication date
CA2576497A1 (fr) 2006-11-24
EP1765431A1 (fr) 2007-03-28

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