WO2007008437A1 - Système chirurgical - Google Patents

Système chirurgical Download PDF

Info

Publication number
WO2007008437A1
WO2007008437A1 PCT/US2006/025316 US2006025316W WO2007008437A1 WO 2007008437 A1 WO2007008437 A1 WO 2007008437A1 US 2006025316 W US2006025316 W US 2006025316W WO 2007008437 A1 WO2007008437 A1 WO 2007008437A1
Authority
WO
WIPO (PCT)
Prior art keywords
handpiece
liquefaction
lens
surgical
power
Prior art date
Application number
PCT/US2006/025316
Other languages
English (en)
Inventor
Glenn Sussman
Philippe Crozafon
Original Assignee
Alcon, Inc.
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 Alcon, Inc. filed Critical Alcon, Inc.
Publication of WO2007008437A1 publication Critical patent/WO2007008437A1/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
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00115—Electrical control of surgical instruments with audible or visual output

Definitions

  • This invention relates generally to the field of cataract surgery and more particularly to a system and handpiece for practicing the liquefaction technique of cataract removal.
  • the human eye in its simplest terms functions to provide vision by transmitting light through a clear outer portion called the cornea, and focusing the image by way of the lens onto the retina.
  • the quality of the focused image depends on many factors including the size and shape of the eye, and the transparency of the cornea and lens.
  • IOL intraocular lens
  • phacoemulsification In the United States, the majority of cataractous lenses are removed by a surgical technique called phacoemulsification. During this procedure, a thin phacoemulsification cutting tip is inserted into the diseased lens and vibrated ultrasonically. The vibrating cutting tip liquefies or emulsifies the lens so that the lens may be aspirated out of the eye. The diseased lens, once removed, is replaced by an artificial lens.
  • a typical ultrasonic surgical device suitable for ophthalmic procedures consists of an ultrasonically driven handpiece, an attached cutting tip, and irrigating sleeve and an electronic control console.
  • the handpiece assembly is attached to the control console by an electric cable and flexible tubings. Through the electric cable, the console varies the power level transmitted by the handpiece to the attached cutting tip and the flexible tubings supply irrigation fluid to and draw aspiration fluid from the eye through the handpiece assembly.
  • the operative part of the handpiece is a centrally located, hollow resonating bar or horn directly attached to a set of piezoelectric crystals.
  • the crystals supply the required ultrasonic vibration needed to drive both the horn and the attached cutting tip during phacoemulsification and are controlled by the console.
  • the crystal/horn assembly is suspended within the hollow body or shell of the handpiece by flexible mountings.
  • the handpiece body terminates in a reduced diameter portion or nosecone at the body's distal end.
  • the nosecone is externally threaded to accept the irrigation sleeve.
  • the horn bore is internally threaded at its distal end to receive the external threads of the cutting tip.
  • the irrigation sleeve also has an internally threaded bore that is screwed onto the external threads of the nosecone.
  • the cutting tip is adjusted so that the tip projects only a predetermined amount past the open end of the irrigating sleeve.
  • the ends of the cutting tip and irrigating sleeve are inserted into a small incision of predetermined width in the cornea, sclera, or other location.
  • the cutting tip is ultrasonically vibrated along its longitudinal axis within the irrigating sleeve by the crystal-driven ultrasonic horn, thereby emulsifying the selected tissue in situ.
  • the hollow bore of the cutting tip communicates with the bore in the horn that in turn communicates with the aspiration line from the handpiece to the console.
  • a reduced pressure or vacuum source in the console draws or aspirates the emulsified tissue from the eye through the open end of the cutting tip, the cutting tip and horn bores and the aspiration line and into a collection device.
  • the aspiration of emulsified tissue is aided by a saline flushing solution or irrigant that is injected into the surgical site through the small annular gap between the inside surface of the irrigating sleeve and the cutting tip.
  • Prior art phacoemulsification systems produce an audible tone of varying pitch indicative of aspiration pressure and flow rate.
  • the apparatus disclosed in the publication heats the solution separately from the surgical handpiece. Temperature control of the heated solution can be difficult because the fluid tubings feeding the handpiece typically are up to two meters long, and the heated solution can cool considerably as it travels down the length of the tubing.
  • the AQUALASE ® handpiece part of the INFINITI ® Vision System available from Alcon Laboratories, Inc., Fort Worth, Texas, produces pulses of heated irrigation fluid for lens removal and cortical cleanup.
  • This device does not produce any audible tone indicative of the amount of power being delivered to the handpiece. This is because the process of generating the pressurized pulse of fluid is relative silent, as opposed to a phacoemulsification handpiece where excitation of the piezoelectric crystals produces an audible tone.
  • the present invention improves upon the prior art by providing a control system for a liquefaction handpiece having audible tones indicative of the amount of power being delivered to the liquefaction handpiece.
  • the system may use existing, commercially available surgical consoles under appropriate software control to produce the audible tones.
  • one objective of the present invention is to provide a surgical console control system.
  • Another objective of the present invention is to provide a surgical console control system that generates audible tones indicative of the amount of power being delivered to the liquefaction handpiece.
  • FIG. 1 is a perspective view of a surgical system that can be used with the control system of the present invention.
  • FIG. 2 is a graft plotting volume or pitch versus power level for a tone to be used with a liquefaction handpiece with the power to the handpiece being delivered continuously.
  • FIG. 3 is a graft plotting volume or pitch versus power level for a tone to be used with a liquefaction handpiece with the power to the handpiece being delivered in pulses or bursts.
  • system 10 of the present invention generally includes control console 12 and handpiece 14.
  • System 10 may be any suitable system, such as the INFINITI ® Vision System available from Alcon Laboratories, Inc., Fort Worth, Texas.
  • Handpiece 14 may be any suitable handpiece, such as the AQUALASE ® handpiece available from Alcon Laboratories, Inc., Fort Worth, Texas.
  • Handpiece 14 is fluidly connected to console 12 by fluid tubings 16 and 18, and electrically connected to console 12 by electrical cable 20, such tubings and cabling being well- known in the art.
  • Control console 12 contains appropriate hardware and software (not shown, but well-known in the art) for providing control signals to handpiece 14, including power level control signals, and for producing audible tones indicative of the power level control signal being sent to handpiece 14.
  • system 10 may be programmed to produce an audible tone or tones indicative of the power being delivered to handpiece 14.
  • the tone may continuously rise in pitch or volume as the power increases.
  • the tone will be audible continuous, as shown in FIG. 2.
  • the tone till turn on and off with each pulse or burst, as shown in FIG. 3 or at a lower frequency (example - 50% burst will be 100ms on/ 100ms off, although another preferred tone is 1 second on/ 1 off).
  • Such a system allows users of a liquefaction system to have the same or a similar auditory feedback as users of phacoemulsification systems.

Landscapes

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

Abstract

Système chirurgical pour instrument de liquéfaction tenu à la main, lequel produit des sons audibles indiquant la quantité de puissance qui est délivrée à l'instrument de liquéfaction tenu à la main. Le système peut utiliser des consoles chirurgicales disponibles dans le commerce existantes sous le contrôle d'un logiciel approprié pour produire les sons audibles.
PCT/US2006/025316 2005-07-07 2006-06-29 Système chirurgical WO2007008437A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US17675205A 2005-07-07 2005-07-07
US11/176,752 2005-07-07

Publications (1)

Publication Number Publication Date
WO2007008437A1 true WO2007008437A1 (fr) 2007-01-18

Family

ID=37054622

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US2006/025316 WO2007008437A1 (fr) 2005-07-07 2006-06-29 Système chirurgical

Country Status (1)

Country Link
WO (1) WO2007008437A1 (fr)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9549850B2 (en) 2013-04-26 2017-01-24 Novartis Ag Partial venting system for occlusion surge mitigation
US9561321B2 (en) 2011-12-08 2017-02-07 Alcon Research, Ltd. Selectively moveable valve elements for aspiration and irrigation circuits

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4168707A (en) * 1977-06-13 1979-09-25 Douvas Nicholas G Control apparatus for microsurgical instruments
EP0962205A1 (fr) * 1998-06-04 1999-12-08 Alcon Laboratories, Inc. Embout pour une pièce à main de liquéfaction
WO2000064392A1 (fr) * 1999-04-28 2000-11-02 Georgia Tech Research Corporation Instrument et procede de phaco-emulsification par application d'un rayonnement thermique direct
EP1285642A1 (fr) * 2000-08-29 2003-02-26 Alcon Manufacturing Ltd. Dispositif et logiciel destiné à la commande d'une temperature peropératoire

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4168707A (en) * 1977-06-13 1979-09-25 Douvas Nicholas G Control apparatus for microsurgical instruments
EP0962205A1 (fr) * 1998-06-04 1999-12-08 Alcon Laboratories, Inc. Embout pour une pièce à main de liquéfaction
WO2000064392A1 (fr) * 1999-04-28 2000-11-02 Georgia Tech Research Corporation Instrument et procede de phaco-emulsification par application d'un rayonnement thermique direct
EP1285642A1 (fr) * 2000-08-29 2003-02-26 Alcon Manufacturing Ltd. Dispositif et logiciel destiné à la commande d'une temperature peropératoire

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9561321B2 (en) 2011-12-08 2017-02-07 Alcon Research, Ltd. Selectively moveable valve elements for aspiration and irrigation circuits
US9549850B2 (en) 2013-04-26 2017-01-24 Novartis Ag Partial venting system for occlusion surge mitigation

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