CA2064271A1 - Feed device for bipolar electrodes for capsulotomy - Google Patents
Feed device for bipolar electrodes for capsulotomyInfo
- Publication number
- CA2064271A1 CA2064271A1 CA002064271A CA2064271A CA2064271A1 CA 2064271 A1 CA2064271 A1 CA 2064271A1 CA 002064271 A CA002064271 A CA 002064271A CA 2064271 A CA2064271 A CA 2064271A CA 2064271 A1 CA2064271 A1 CA 2064271A1
- Authority
- CA
- Canada
- Prior art keywords
- feed device
- capsulotomy
- fed
- pulse
- current
- Prior art date
- Legal status (The legal status 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 status listed.)
- Abandoned
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical 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
- A61B18/1206—Generators therefor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical 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
-
- 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
- A61F9/00754—Instruments 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
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00636—Sensing and controlling the application of energy
- A61B2018/0066—Sensing and controlling the application of energy without feedback, i.e. open loop control
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical 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
- A61B18/14—Probes or electrodes therefor
- A61B2018/1472—Probes or electrodes therefor for use with liquid electrolyte, e.g. virtual electrodes
-
- 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
- A61F9/0079—Methods or devices for eye surgery using non-laser electromagnetic radiation, e.g. non-coherent light or microwaves
Abstract
Summary A pulsed HF current is fed to a bipolar diathermy instrument for optimum execution of a section in capsulotomy. The pulse duration can constantly be altered between 3 ms and 11 ms, whereby a pause of 30 ms or 22 ms develops. This pause is sufficient to cool the instrument tip, Plushed with sodium chloride, in order to prevent the possibility of injury to adjacent tissue. The pulse repetition frequency is about 15 hz. The device necessary for the purpose includes pulse duration control (31) and HF oscillator (30). The HF current is synchronized by pulses from control (31) with AND gate (35). Amplifier (40) feeds handpiece (21) of the diathermy instrument by transformer (46). The required operation free from grounding is thereby assured.
Description
2~271 Feed Device ~or Bipolar Electrodes for Capsulotomy The present invention relates ~o a feed device according to the preamble of independent clai~ lo Bipolar wet field diathermy in microsurgery is described in "Klinische Monatsbl~tter f~r Augenheilkunde" (Clinical Ophthalmology Monthly), ~ay lg84, vol. ~, pp. 331 512. The possibility of hemostasis in the vitreous humor was investigated, starting with the first vitrectomies in 1972. A coaxial bipolar diathermy device was developed as a suitable instrument for the purpose. However, it is necessary to make sure that the heating is not too high for operations on the eye. The device was consequently equipped with an aspiration infusion irrigation device at that time to remove emerging liquid blood. It was possible to close the then visible hemorrhage source by coagulation.
It was then almost logical to replace the previous procedure for opening the capsule of the lens, namely that of cutting open the capsule sac, opening the capsule sac by perforation and then tearing, or by capsulorhexis, by a diathermy technique.
Two instruments were disclosed for the diathermic opening of the capsule sac.
In US Pat. 4, 367,7~4, an electrically insulating handpiece carries a cauterizing ring, which is fed with electric power to 2~2r~L
the handpiece ~rom b~hind by one wire. In order for it to be possible for a current to flow, i~ was proposed to conduct the procedur~ with two wires to the cauterizing loop. On applying the cauterizing loop to the lenticular sac, the current produces heat o ~
in a range of from 500 C to 2000 C. Such a high temperature may act for only a short time, and the cauterized site on the lenticular sac must be cooled as quickly as possible. Because the cauterizing loop must be introduced into the eye in already hot state in order to be able to perPorm the operation in as short a time as possible, it i5 necessary to proceed extremely carefully, in order not to injure any other parts of the eye.
US Pat. 4, 481,948 describes a cauterizing loop of similar type, but which is not heated with current flowing in the loop.
A high-frequency 10 khz current is instead fed to the loop.
An opposite pole is placed beneath the patient in order to close the circuit. ~he physician switches on the high-frequency circuit by means of a pedal.
High heat, which can be very injurious to the eye tissue, can also result with this arrangement. According to the older patent, the hot loop had to be introduced into the aqueous chamber until it could then be placed through the pupil into the posterior chamber onto the lenticular sac, in order to cauterize an opening there.
It is possible to activate, i.e., heat the loop with the high-frequency current as desired by the physician. The high-frequency current then can flow only when the loop is placed on a site covered with conducting liquid, thus on the lenticular sac.
i is not possible to control the heat acting to produc2 0~ 2 7 :1 coagulation at the border o~ the opening by ~his effect, so that mild injuries can result from the action of the heat.
Conseuqently, an object of the invention is that of controlling the current feed so that only precisely as much heat is produced for cuttin~ the lenticular sac and coagulating the border of the hole, but protecting other tissues against heat action without additional feed.
This is achieved according to the invention by a feed device in accordance with the features in the characterizing part of independent Claim 1.
The invention is illustrated with the aid of drawings in an execution example below. The following ~eatures are shown:
Fig. l an enlarged segment of a human eye in section view;
Fig. 2 the same seqment in perspective view with a bipolar diathermy instrument for capsulotomy;
Fig. 3 block diagram of a feed device for the bipolar diathermy instrument; and Fig. 4 two pulse diagrams for current flow from the eed device.
Fig. l shows a front section of human eye 1 in greatly enlarged scale. This section clearly shows aqueous chamber 10, which is sealed off outside by cornea 11. The lenticular capsule consists of capsule sac 12, nucleus lentis 15, and cortex 14 lying between. Dilated iris 17 lies above. Pupil 16 forms a large opening. Posterior chamber 13 is located behind iris 17.
Lenticular sac 12 with lens 15 lies between iris 17 and sclera 18.
2~2~
Fig. 2 shows a view of eye 1 after Fig. 1 from obliquely above, so that the entire iris 17 i~ visible. Cornea 11 i5 sectioned at its edge lla in order to create an access to aqueous chamber 10. Section llb is held together by loop llc on both sides, so that it canno~ tear. Bipolar diathermy instrument 20 is introduced through this ~lit wi~h handpiece 21, from which bipolar tip 23 protrudes. This bipolar tip 23 is bent in order for the instrument to be intro~uced ~t the side of eye 1 and parallel to lenticular sac 12 up to the section site, where section 12a can then be made in lenticular sac 12 with bent tip 23.
The physician can now coagulate lenticular sac 12 with high-frequency current reaching bipolar tip 23, or coagulate and sever with higher electrical feed. The severing runs into the difficulty mentioned at the outset~ due to strong heating of the area around the working field.
A feed device (Fig. 3) with which a pulse duration modulation high-frequency current can be produced is now provided according to the invention. The ~eed device accordingly includes high-frequency generator 30 and pulse duration control 31, which is fed at rated value input 32 with a control voltage of 0 to ~ 5 v, for example. The output 33 of high-frequency generator 30 and the output 34 of pulse duration control 31 are fed to inputs 36 and 37 of AND gate 35, whose output 38 is connected to input 39 of power amplifier 40. Power amplifier 40 is fed at input 41 from stabilized voltage source 42. The voltage source provides a current of 3 amp. at l~v voltage. It includes short-circuit 2 ~ ~ ~ 2~ ~ ~
m~Jnitoring. Outputs 43, 4~ are ~ed to the primary winding 45 of transformer ~6. Lines ~8, 49 lea~ from its secondary winding 47 to handpiece 21 of bipolar diathermy instrument 20.
It is possible to synchroniæe the high-frequency voltage with a frequency of 500 khz, for example, by this arrangement by selectîng a control voltage of ~rom O to 5 v~ so that a constant frequency rectangular signal with a frequency of 15 hz and consequently with a pulse duration of 3 to 11 ms and a pulse pause of 22 to 30 ms is produced at a control voltage of 0.5 to 5 v, with which the AND gate is synchronized. At higher control voltage, the pulse becomes longer and the pulse pause correspondingly shorter (Fig. 4). The frequency of the rectangular oscillation remains constant. Power amplifier 40 can be fed by connection in AND gate 35. It can release a pulse utput of P = 54 w by means of the stabilized voltage. The max tissue of the lenticular sac is severed by this high pulse output, so that more than coagulation is achieved. The method of feeding high-frequency pulses with a pulse pause which lasts at least twice as long as the pulse permits a sufficiently long cooling not to endanger the adjacent tissue. The capsulotomy handpiece is insulated from the device by the transformer, so that no potential burdened with grounding is present in this instrument. An ionizing solution, for example Healon, is required in order for the high-frequency current to be able to flow at all between the poles of the bipolar diathermy instrument.
It was then almost logical to replace the previous procedure for opening the capsule of the lens, namely that of cutting open the capsule sac, opening the capsule sac by perforation and then tearing, or by capsulorhexis, by a diathermy technique.
Two instruments were disclosed for the diathermic opening of the capsule sac.
In US Pat. 4, 367,7~4, an electrically insulating handpiece carries a cauterizing ring, which is fed with electric power to 2~2r~L
the handpiece ~rom b~hind by one wire. In order for it to be possible for a current to flow, i~ was proposed to conduct the procedur~ with two wires to the cauterizing loop. On applying the cauterizing loop to the lenticular sac, the current produces heat o ~
in a range of from 500 C to 2000 C. Such a high temperature may act for only a short time, and the cauterized site on the lenticular sac must be cooled as quickly as possible. Because the cauterizing loop must be introduced into the eye in already hot state in order to be able to perPorm the operation in as short a time as possible, it i5 necessary to proceed extremely carefully, in order not to injure any other parts of the eye.
US Pat. 4, 481,948 describes a cauterizing loop of similar type, but which is not heated with current flowing in the loop.
A high-frequency 10 khz current is instead fed to the loop.
An opposite pole is placed beneath the patient in order to close the circuit. ~he physician switches on the high-frequency circuit by means of a pedal.
High heat, which can be very injurious to the eye tissue, can also result with this arrangement. According to the older patent, the hot loop had to be introduced into the aqueous chamber until it could then be placed through the pupil into the posterior chamber onto the lenticular sac, in order to cauterize an opening there.
It is possible to activate, i.e., heat the loop with the high-frequency current as desired by the physician. The high-frequency current then can flow only when the loop is placed on a site covered with conducting liquid, thus on the lenticular sac.
i is not possible to control the heat acting to produc2 0~ 2 7 :1 coagulation at the border o~ the opening by ~his effect, so that mild injuries can result from the action of the heat.
Conseuqently, an object of the invention is that of controlling the current feed so that only precisely as much heat is produced for cuttin~ the lenticular sac and coagulating the border of the hole, but protecting other tissues against heat action without additional feed.
This is achieved according to the invention by a feed device in accordance with the features in the characterizing part of independent Claim 1.
The invention is illustrated with the aid of drawings in an execution example below. The following ~eatures are shown:
Fig. l an enlarged segment of a human eye in section view;
Fig. 2 the same seqment in perspective view with a bipolar diathermy instrument for capsulotomy;
Fig. 3 block diagram of a feed device for the bipolar diathermy instrument; and Fig. 4 two pulse diagrams for current flow from the eed device.
Fig. l shows a front section of human eye 1 in greatly enlarged scale. This section clearly shows aqueous chamber 10, which is sealed off outside by cornea 11. The lenticular capsule consists of capsule sac 12, nucleus lentis 15, and cortex 14 lying between. Dilated iris 17 lies above. Pupil 16 forms a large opening. Posterior chamber 13 is located behind iris 17.
Lenticular sac 12 with lens 15 lies between iris 17 and sclera 18.
2~2~
Fig. 2 shows a view of eye 1 after Fig. 1 from obliquely above, so that the entire iris 17 i~ visible. Cornea 11 i5 sectioned at its edge lla in order to create an access to aqueous chamber 10. Section llb is held together by loop llc on both sides, so that it canno~ tear. Bipolar diathermy instrument 20 is introduced through this ~lit wi~h handpiece 21, from which bipolar tip 23 protrudes. This bipolar tip 23 is bent in order for the instrument to be intro~uced ~t the side of eye 1 and parallel to lenticular sac 12 up to the section site, where section 12a can then be made in lenticular sac 12 with bent tip 23.
The physician can now coagulate lenticular sac 12 with high-frequency current reaching bipolar tip 23, or coagulate and sever with higher electrical feed. The severing runs into the difficulty mentioned at the outset~ due to strong heating of the area around the working field.
A feed device (Fig. 3) with which a pulse duration modulation high-frequency current can be produced is now provided according to the invention. The ~eed device accordingly includes high-frequency generator 30 and pulse duration control 31, which is fed at rated value input 32 with a control voltage of 0 to ~ 5 v, for example. The output 33 of high-frequency generator 30 and the output 34 of pulse duration control 31 are fed to inputs 36 and 37 of AND gate 35, whose output 38 is connected to input 39 of power amplifier 40. Power amplifier 40 is fed at input 41 from stabilized voltage source 42. The voltage source provides a current of 3 amp. at l~v voltage. It includes short-circuit 2 ~ ~ ~ 2~ ~ ~
m~Jnitoring. Outputs 43, 4~ are ~ed to the primary winding 45 of transformer ~6. Lines ~8, 49 lea~ from its secondary winding 47 to handpiece 21 of bipolar diathermy instrument 20.
It is possible to synchroniæe the high-frequency voltage with a frequency of 500 khz, for example, by this arrangement by selectîng a control voltage of ~rom O to 5 v~ so that a constant frequency rectangular signal with a frequency of 15 hz and consequently with a pulse duration of 3 to 11 ms and a pulse pause of 22 to 30 ms is produced at a control voltage of 0.5 to 5 v, with which the AND gate is synchronized. At higher control voltage, the pulse becomes longer and the pulse pause correspondingly shorter (Fig. 4). The frequency of the rectangular oscillation remains constant. Power amplifier 40 can be fed by connection in AND gate 35. It can release a pulse utput of P = 54 w by means of the stabilized voltage. The max tissue of the lenticular sac is severed by this high pulse output, so that more than coagulation is achieved. The method of feeding high-frequency pulses with a pulse pause which lasts at least twice as long as the pulse permits a sufficiently long cooling not to endanger the adjacent tissue. The capsulotomy handpiece is insulated from the device by the transformer, so that no potential burdened with grounding is present in this instrument. An ionizing solution, for example Healon, is required in order for the high-frequency current to be able to flow at all between the poles of the bipolar diathermy instrument.
Claims (5)
1. Feed device for bipolar electrodes for capsulotomy, characterized by the fact that the high-frequency current of the electrode can be fed with pulse duration control.
2. Feed device in accordance with Claim 1, characterized by an AND gate, to which a duration-controlled pulse and the high-frequency current are fed at input side.
3. Feed device in accordance with Claims 1 or 2, characterized by the fact that the pulse repetition time is 33 ms, and that the pause correspondingly resulting at a pulse duration range of between 3 ms and 11 ms is 30 ms or 22 ms.
4. Feed device in accordance with one of the foregoing Claims 1 to 3, characterized by the fact that the AND gate is connected to a power amplifier fed from a stabilized voltage source.
5. Feed device in accordance with Claim 4, characterized by the fact that the stabilized voltage source includes short-circuit monitoring.
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CH965/91-1 | 1991-03-28 | ||
| CH96591 | 1991-03-28 |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CA2064271A1 true CA2064271A1 (en) | 1992-09-29 |
Family
ID=4199311
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA002064271A Abandoned CA2064271A1 (en) | 1991-03-28 | 1992-03-27 | Feed device for bipolar electrodes for capsulotomy |
Country Status (7)
| Country | Link |
|---|---|
| US (1) | US5346491A (en) |
| EP (1) | EP0506618B1 (en) |
| JP (1) | JP2501509B2 (en) |
| AT (1) | ATE124617T1 (en) |
| CA (1) | CA2064271A1 (en) |
| DE (1) | DE59202774D1 (en) |
| ES (1) | ES2077384T3 (en) |
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US4211230A (en) * | 1978-07-31 | 1980-07-08 | Sybron Corporation | Electrosurgical coagulation |
| US4378801A (en) * | 1979-12-17 | 1983-04-05 | Medical Research Associates Ltd. #2 | Electrosurgical generator |
| US4481948A (en) * | 1980-12-29 | 1984-11-13 | Sole Gary M | Medical instrument, and methods of constructing and utilizing same |
| US4531524A (en) * | 1982-12-27 | 1985-07-30 | Rdm International, Inc. | Circuit apparatus and method for electrothermal treatment of cancer eye |
| GB2225534A (en) * | 1988-08-11 | 1990-06-06 | Kontron Holding Ag | Electrosurgical apparatus |
-
1991
- 1991-11-07 US US07/788,808 patent/US5346491A/en not_active Expired - Fee Related
-
1992
- 1992-03-11 JP JP4052676A patent/JP2501509B2/en not_active Expired - Lifetime
- 1992-03-20 ES ES92810203T patent/ES2077384T3/en not_active Expired - Lifetime
- 1992-03-20 EP EP92810203A patent/EP0506618B1/en not_active Expired - Lifetime
- 1992-03-20 DE DE59202774T patent/DE59202774D1/en not_active Expired - Fee Related
- 1992-03-20 AT AT92810203T patent/ATE124617T1/en not_active IP Right Cessation
- 1992-03-27 CA CA002064271A patent/CA2064271A1/en not_active Abandoned
Also Published As
| Publication number | Publication date |
|---|---|
| EP0506618B1 (en) | 1995-07-05 |
| JPH0576562A (en) | 1993-03-30 |
| ATE124617T1 (en) | 1995-07-15 |
| EP0506618A1 (en) | 1992-09-30 |
| ES2077384T3 (en) | 1995-11-16 |
| JP2501509B2 (en) | 1996-05-29 |
| DE59202774D1 (en) | 1995-08-10 |
| US5346491A (en) | 1994-09-13 |
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Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| EEER | Examination request | ||
| FZDE | Discontinued |