CN101862801A - 形成显微外科探针的方法 - Google Patents

形成显微外科探针的方法 Download PDF

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CN101862801A
CN101862801A CN201010105479A CN201010105479A CN101862801A CN 101862801 A CN101862801 A CN 101862801A CN 201010105479 A CN201010105479 A CN 201010105479A CN 201010105479 A CN201010105479 A CN 201010105479A CN 101862801 A CN101862801 A CN 101862801A
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distal end
pin
distal
probe
instrument
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CN101862801B (zh
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R·S·莫勒
B·D·伯克曼
R·R·马丁
D·E·凯特纳
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Novartis AG
Alcon Inc
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    • 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
    • A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • 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
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • 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
    • A61F9/00763—Instruments 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
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B21—MECHANICAL METAL-WORKING WITHOUT ESSENTIALLY REMOVING MATERIAL; PUNCHING METAL
    • B21D—WORKING OR PROCESSING OF SHEET METAL OR METAL TUBES, RODS OR PROFILES WITHOUT ESSENTIALLY REMOVING MATERIAL; PUNCHING METAL
    • B21D22/00—Shaping without cutting, by stamping, spinning, or deep-drawing
    • B21D22/14—Spinning
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B21—MECHANICAL METAL-WORKING WITHOUT ESSENTIALLY REMOVING MATERIAL; PUNCHING METAL
    • B21D—WORKING OR PROCESSING OF SHEET METAL OR METAL TUBES, RODS OR PROFILES WITHOUT ESSENTIALLY REMOVING MATERIAL; PUNCHING METAL
    • B21D41/00—Application of procedures in order to alter the diameter of tube ends
    • B21D41/04—Reducing; Closing
    • B21D41/045—Closing
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B21—MECHANICAL METAL-WORKING WITHOUT ESSENTIALLY REMOVING MATERIAL; PUNCHING METAL
    • B21G—MAKING NEEDLES, PINS OR NAILS OF METAL
    • B21G1/00—Making needles used for performing operations
    • B21G1/08—Making needles used for performing operations of hollow needles or needles with hollow end, e.g. hypodermic needles, larding-needles
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B21—MECHANICAL METAL-WORKING WITHOUT ESSENTIALLY REMOVING MATERIAL; PUNCHING METAL
    • B21J—FORGING; HAMMERING; PRESSING METAL; RIVETING; FORGE FURNACES
    • B21J5/00—Methods for forging, hammering, or pressing; Special equipment or accessories therefor
    • B21J5/06—Methods for forging, hammering, or pressing; Special equipment or accessories therefor for performing particular operations
    • B21J5/063—Friction heat forging
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B21—MECHANICAL METAL-WORKING WITHOUT ESSENTIALLY REMOVING MATERIAL; PUNCHING METAL
    • B21K—MAKING FORGED OR PRESSED METAL PRODUCTS, e.g. HORSE-SHOES, RIVETS, BOLTS OR WHEELS
    • B21K21/00—Making hollow articles not covered by a single preceding sub-group
    • B21K21/12—Shaping end portions of hollow articles
    • B21K21/14—Shaping end portions of hollow articles closed or substantially-closed ends, e.g. cartridge bottoms
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B23—MACHINE TOOLS; METAL-WORKING NOT OTHERWISE PROVIDED FOR
    • B23K—SOLDERING OR UNSOLDERING; WELDING; CLADDING OR PLATING BY SOLDERING OR WELDING; CUTTING BY APPLYING HEAT LOCALLY, e.g. FLAME CUTTING; WORKING BY LASER BEAM
    • B23K11/00—Resistance welding; Severing by resistance heating
    • B23K11/002—Resistance welding; Severing by resistance heating specially adapted for particular articles or work
    • B23K11/004—Welding of a small piece to a great or broad piece
    • B23K11/0046—Welding of a small piece to a great or broad piece the extremity of a small piece being welded to a base, e.g. cooling studs or fins to tubes or plates
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B23—MACHINE TOOLS; METAL-WORKING NOT OTHERWISE PROVIDED FOR
    • B23K—SOLDERING OR UNSOLDERING; WELDING; CLADDING OR PLATING BY SOLDERING OR WELDING; CUTTING BY APPLYING HEAT LOCALLY, e.g. FLAME CUTTING; WORKING BY LASER BEAM
    • B23K11/00—Resistance welding; Severing by resistance heating
    • B23K11/02—Pressure butt welding
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B23—MACHINE TOOLS; METAL-WORKING NOT OTHERWISE PROVIDED FOR
    • B23K—SOLDERING OR UNSOLDERING; WELDING; CLADDING OR PLATING BY SOLDERING OR WELDING; CUTTING BY APPLYING HEAT LOCALLY, e.g. FLAME CUTTING; WORKING BY LASER BEAM
    • B23K11/00—Resistance welding; Severing by resistance heating
    • B23K11/16—Resistance welding; Severing by resistance heating taking account of the properties of the material to be welded
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B23—MACHINE TOOLS; METAL-WORKING NOT OTHERWISE PROVIDED FOR
    • B23K—SOLDERING OR UNSOLDERING; WELDING; CLADDING OR PLATING BY SOLDERING OR WELDING; CUTTING BY APPLYING HEAT LOCALLY, e.g. FLAME CUTTING; WORKING BY LASER BEAM
    • B23K33/00—Specially-profiled edge portions of workpieces for making soldering or welding connections; Filling the seams formed thereby
    • B23K33/004—Filling of continuous seams
    • B23K33/006—Filling of continuous seams for cylindrical workpieces
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B23—MACHINE TOOLS; METAL-WORKING NOT OTHERWISE PROVIDED FOR
    • B23K—SOLDERING OR UNSOLDERING; WELDING; CLADDING OR PLATING BY SOLDERING OR WELDING; CUTTING BY APPLYING HEAT LOCALLY, e.g. FLAME CUTTING; WORKING BY LASER BEAM
    • B23K2101/00—Articles made by soldering, welding or cutting
    • B23K2101/04—Tubular or hollow articles
    • B23K2101/06—Tubes

Abstract

本发明公开了一种形成显微外科探针的方法，所述方法包括：将管状针放置在车床的夹头中；高速转动所述夹头和所述针；提供工具，所述工具具有大致平的远侧表面，所述远侧表面上有球状突起；使所述针的远侧端部的边缘与所述球状突起接触；以及使所述工具在所述针的所述远侧端部上从所述边缘移动到稍稍越过所述针的中心线，从而使所述针的所述远侧端部形成为具有平的外表面和平的内表面的闭合远侧末端。

Description

形成显微外科探针的方法
本申请是国际申请日为2006年9月25日、中国国家申请号为200680038045.1的中国发明专利申请的分案申请。
技术领域
本发明总的来说涉及形成显微外科探针的方法。
技术背景
后段眼外科手术程序通常要求切割和/或者去除玻璃体液，一种填充眼睛后段的透明胶状材料。玻璃体液或者玻璃体常常包含结合到视网膜上的大量微观纤维。因此，切割和去除玻璃体必须万分小心地进行，以免造成对视网膜的牵扯、视网膜从脉络膜上分离、视网膜撕裂，或者，最坏情况中，切割和去除视网膜本身。
在后段眼外科手术中使用显微外科切割探针是公知的。这种玻璃体切除术探针一般是经睫状环附件的巩膜上的切口插入。在后段外科手术过程中，外科医生还插入其他的显微外科仪器，例如纤维光学照明器、输注套管或者抽吸探针。外科医生在显微镜下观看眼睛的同时完成该程序。
传统玻璃体切除术探针一般包括中空外切割构件、可动地设置在中空外切割构件内部并同轴布置的中空内切割构件以及在外切割构件远侧端部附近沿径向穿过外切割构件延伸的端口。玻璃体液被抽吸到打开的端口中，然后内构件被启动，关闭该端口。一旦关闭该端口，内、外切割构件的内、外切割表面相互配合切割玻璃体，然后切割下来的玻璃体经内切割构件被抽吸走。美国专利第4,577,629(Martinez)、5,019,035(Missirlian等人)、4,909,249(Akkas等人)、5,176,628(Charles等人)、5,047,008(de Juan等人)、4,696,298(Higgins等人)以及5,733,297(Wang)都公开了各种类型的玻璃体切除术探针，这些专利中的每一个都通过引用而整体包含在本说明书中。
在后端眼外科手术过程中，通常希望在对位于下面的视网膜进行任何修复程序之前，去除尽可能多的位于上面的玻璃体。但是，由于探针末端以及切割端口的几何形状，在能将传统玻璃体切除术探针在多大程度上靠近视网膜放置方面，外科医生是受限制的。所以，一直存在着对不受上述限制的改进的玻璃体切除术探针的需要。
发明内容
本发明的一个方面是一种显微外科探针。这种探针包括具有内孔的管状本体、提供通向所述内孔的通道的端口以及闭合的远侧末端。所述远侧末端具有平的内表面。
本发明的另一方面是形成显微外科探针的第一种方法。将管状针放置在车床的夹头中。所述夹头和针以高速旋转。提供具有其上带有球状突起的、大致平的远侧表面的工具。所述针的远侧端部的边缘与所述球状突起接触。所述工具在所述针的远侧端部上从所述边缘移动到稍稍超过所述针的中心线，使所述针的所述远侧端部形成为具有平的外表面和平的内表面的闭合远侧末端。
本发明的另一方面是形成显微外科探针的第二种方法。将管状针的远侧端部放置成接触一片金属薄片。将压力施加到所述针和所述金属薄片上。在所述针和所述金属薄片之间发送电脉冲，使所述金属薄片焊接到所述针上。将所述针放置到冲模中，然后经所述金属薄片对所述针进行冲压，以形成具有平的外表面和平的内表面的闭合远侧末端。
附图说明
为了更完整地理解本发明以及本发明进一步的目的和优点，结合附图引入了下述描述。在附图中：
图1是根据本发明一个优选实施例的玻璃体切除术探针远侧部分的侧面局部剖视图；
图2是一种传统玻璃体切除术探针远侧部分的侧面局部剖视图；
图3是第二种传统玻璃体切除术探针远侧部分的侧面局部剖视图；
图4A～图4C示意性图示出制造根据本发明一个优选实施例的图1玻璃体切除术探针的一种工艺；
图5是用于图4A～4C的工艺的优选工具的局部放大剖视示意图；
图6A～图6C示意性图示出制造根据本发明一个优选实施例的图1玻璃体切除术探针的第二种工艺。
具体实施方式
本发明的优选实施例及其优点通过参照附图中的图1到图6得以最佳理解。类似的数字被用于各附图中相似以及对应部件。
图1显示了根据本发明一个优选实施例的玻璃体切除术探针10的远侧部分。探针10通常包括管状本体12，管状本体12具有内孔14、闭合的远侧末端16以及提供通向内孔14的通道的端口18。管状本体12优选地用不锈钢制造。内切割构件(没有显示)沿纵向在内孔14内往复运动，以切割在外科手术控制台(没有显示)作用下经端口18抽吸到内孔14中的组织。远侧末端16具有平的外表面16a和平的内表面16b。探针10优选地具有20～25标准规格的直径。
图2和图3分别显示了传统玻璃体切除术探针22和24的远侧部分。探针22和24每个都通常包括管状本体26，管状本体26具有内孔28、闭合的远侧末端30和30a以及提供通向内孔28的通道的端口32。管状本体26优选地用不锈钢制造。内切割构件(没有显示)沿纵向在内孔28内往复运动，以切割在外科手术控制台(没有显示)作用下经端口32抽吸到内孔28中的组织。
远侧末端30具有凸出的球状外表面34和凹入的球状内表面36。远侧末端30使用传统的旋压成形工艺制造。在传统的旋压成形中，管状针料转动，具有大致凹入的远侧端部的工具与针的端部接触。工具作用在转动着的针上的力闭合了管的端部，并产生了具有球状几何形状的远侧末端30。
远侧末端30a具有平的外表面42和凸出的球状内表面44。远侧末端30a使用传统的焊珠(或TIG)焊接工艺制造。在传统的珠焊中，电极放在管状针料的上方，并使电流通过针和电极之间。在针端部上形成材料焊珠，产生具有球状几何形状的闭合远侧末端30a。对外表面42进行二次机加操作以使其变平。但是，因为内侧焊闪(weld flash)难以控制，所以内表面44保持凸出的球状形状。
如下面更详细解释的，平的外表面16a和平的内表面16b优选地使用改进的旋压成形工艺或者电阻焊工艺形成。与传统探针22的端口32的远侧端部38和外表面34之间的距离40相比，或者与传统探针24的端口32的远侧端部46和外表面42之间的距离48相比，平的外表面16a和平的外表面16b导致端口18的远侧端部18a距外表面16a更短的距离20。平的内表面16b还允许端口18的远侧端部18a几乎与内表面16b成共面布置地设置。与此相反，传统探针22的端口32的远侧端部38由于内表面36的凹入的球状几何形状而偏离其内表面36。类似地，传统探针24的端口32的远侧端部46由于珠焊工艺中内侧焊闪不确定的公差而偏离其内表面44。距离20优选地为大约0.006英寸到大约0.016英寸，最优选地为大约0.006英寸到大约0.011英寸。端口18的远侧端部18a优选地设置成距内表面16b大约0.003英寸到大约0.005英寸。通过使距离20最小，外科医生可以将探针10放置得更靠近视网膜而不会接触视网膜。因此，与利用传统探针22或者24相比，利用探针10，外科医生可以在对位于下面的视网膜进行任何修复程序之前去除更多的位于上面的玻璃体。
图4A～4C和图5示意性地图示了用来形成玻璃体切除术探针10的优选、改进的旋压成形工艺。管状针料100以传统方式置于车床(没有显示)的夹头102中。夹头102以及因此针100如箭头104所示高速转动。工具106具有带有大致球状的突起110的大致平的远侧表面108。使工具106如图4B所示接触针100的远侧端部114的边缘112。工具106沿着箭头118的方向从边缘112开始移动通过远侧端部114的整个面。可选方式是，工具106沿着箭头118的方向在远侧端部114的面上从边缘112移动到稍稍超过针100的中心线116，如图4C所示。突起110接触针100的远侧端部114的力造成材料成形针100变形。当突起110到达中心线116时，针100的远侧端部114闭合而形成探针10的远侧端部16。球状突起110的直径优选地为针100外径的±10％。平的外表面16a优选地加工成在其周边具有导圆或者倒角，以便于形成睫状环切口。
图6A～6C示意性地图示了用于形成玻璃体切除术探针10的优选的电阻焊工艺。管状针料100的远侧端部114接触一片不锈钢金属薄片150，并在针100和金属薄片150上施加箭头152所示的压力。金属薄片150优选地具有大约0.004英寸的厚度。电极154放置在针100的一侧，电极156放置在金属薄片150上。电脉冲发送到电极154和156之间。当电脉冲从针100向金属薄片150运动时，遇到高电阻的局部区域，该局部区域产生热并将远侧端部114在熔融区158焊接到金属薄片150。针100被放置到冲模160中，然后经金属薄片150进行冲压(如图6C所示)，使焊接的金属薄片末端162形成探针10的远侧端部16。优选的电阻焊机是可以从加利福尼亚Monrovia的Miyachi Unitek Corporation得到的125型电阻焊机。可从MiyachiUnitek Corporation得到的含有电极156的微型焊头，优选地与125型电阻焊机一起使用。优选的焊接周期是双脉冲周期，位于10％～60％的功率范围内。平的外表面16a优选地被加工成在其周边具有导圆或者倒角，以便于形成睫状环切口。
从上面可以明白，本发明提供了进行玻璃体外科手术的改进设备和方法。本发明在这里通过举例进行了图示，但本领域普通技术人员可以做出各种变型。例如，虽然本发明在这里是结合玻璃体切除术探针进行的描述，但是，本发明可以应用于其他眼显微外科探针和非眼显微外科探针。作为另一个例子，虽然本发明在这里是结合切割探针进行描述的，但是本发明也可以应用于抽吸探针。
相信从前面的描述中本发明的操作和构造将很清楚。虽然显示或者上面描述的设备和方法被特征化为优选的，但是，这里可以做出各种改变和变型，而不脱离权利要求限定的本发明的精神和范围。

Claims (1)

1.一种形成显微外科探针的方法，包括：
将管状针放置在车床的夹头中；
高速转动所述夹头和所述针；
提供工具，所述工具具有大致平的远侧表面，所述远侧表面上有球状突起；
使所述针的远侧端部的边缘与所述球状突起接触；以及
使所述工具在所述针的所述远侧端部上从所述边缘移动到稍稍越过所述针的中心线，从而使所述针的所述远侧端部形成为具有平的外表面和平的内表面的闭合远侧末端。
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