WO1998024513A1 - Multiple guide for laser fibres in the treatment of tumors in parenchymatous organs - Google Patents

Multiple guide for laser fibres in the treatment of tumors in parenchymatous organs Download PDF

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Publication number
WO1998024513A1
WO1998024513A1 PCT/IB1997/001495 IB9701495W WO9824513A1 WO 1998024513 A1 WO1998024513 A1 WO 1998024513A1 IB 9701495 W IB9701495 W IB 9701495W WO 9824513 A1 WO9824513 A1 WO 9824513A1
Authority
WO
WIPO (PCT)
Prior art keywords
needles
needle
laser
guide
fibres
Prior art date
Application number
PCT/IB1997/001495
Other languages
French (fr)
Inventor
Francesco Garbagnati
Sandro Rossi
Original Assignee
Thermo - Med 2000 Kft
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 Thermo - Med 2000 Kft filed Critical Thermo - Med 2000 Kft
Priority to AU49626/97A priority Critical patent/AU4962697A/en
Publication of WO1998024513A1 publication Critical patent/WO1998024513A1/en

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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
    • A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
    • A61B18/22—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
    • A61B18/24—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor with a catheter
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00—Radiation therapy
    • A61N5/06—Radiation therapy using light
    • A61N5/0601—Apparatus for use inside the body
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3403—Needle locating or guiding means
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B2017/22072—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with an instrument channel, e.g. for replacing one instrument by the other
    • A61B2017/22074—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with an instrument channel, e.g. for replacing one instrument by the other the instrument being only slidable in a channel, e.g. advancing optical fibre through a channel
    • A61B2017/22077—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with an instrument channel, e.g. for replacing one instrument by the other the instrument being only slidable in a channel, e.g. advancing optical fibre through a channel with a part piercing the tissue

Definitions

  • the present invention relates to a device for the heat treatment of tumors located in parenchymatous organs and particularly to a multiple guide for the laser fibres used in such a treatment.
  • the heat induced by laser fibres is known to have been recently used for obtaining the destruction of tumors located in parenchymatous organs such as liver, pancreas and the like. This is obtained by using a thin laser fibre, which, being inserted into a hollow needle, is passed through the skin and brought up to the interior of the tumor by the guide means at present known such as computerized axial tomography, ultrasonography and magnetic resonance. Once the laser fibre is placed inside the tumor, the laser apparatus is activated which emits a light beam being conveyed through the laser fibre inside the tumor, where it causes a localized rise of temperature resulting in the heat destruction of the tumor tissue.
  • the main limit of this technique is due to the fact that, by activating the laser fibre inside a single needle, the obtained thermal lesion is an ellipsoid having maximum diameters of about 2 cm. Since most of the tumors of the parenchymatous organs, when clinically detected, have by then equal diameters greater than 2 cm, their treatment by laser heating involves the repeated insertion of the needle carrying the laser fibre in the tumor. Such a repeated insertion results in a final necrosis ellipsoid, its surface being the envelope of as many necrosis ellipsoids, partially overlapping, as the repositionings and the activations of the laser fibre inside the tumor.
  • the object of the present invention is to provide a device allowing to place at the same time several fibres inside a parenchymatous tissue with a predetermined spatial arrangement in a repeatable and standardizable way, whatever the used guide system may be. Such an object is achieved by a device having the features specified in claim 1.
  • the device according to the present invention has the advantage of allowing the simultaneous positioning inside the parenchymatous tissue of two or more laser fibres in such a way that the tips of the same fibres are located in a predetermined position inside the tissue and with a predetermined mutual spatial arrangement.
  • the predetermined spatial arrangement is the one being deemed optimal for the laser fibres inside the tumor to be treated, so that, after their activation, a simultaneous thermal lesion is quickly obtained having a diameter equal or greater than 4 cm, and a predetermined shape being repeatable in any parenchymatous organ, due to the perfect envelope of the necrosis ellipsoids generated by each laser fibre.
  • FIGURE 1 shows a side elevation cross-sectional view of the device according to the present invention
  • FIGURE 2 shows a top plan view of the same device; and FIGURE 3 shows the same device of Figure 1 in the final position when used.
  • the device of the present invention is essentially formed of an outer guide 1, needle-shaped, wherethrough up to four guide needles 2 for the laser fibres (not shown) can slide, having their upper end fastened inside a slideable head 3, which makes the upper ends of the needles mutually integral and can slide through a suitable cavity 4, being provided in the upper portion of guide 1.
  • Guide 1 is made of a hard and little flexible material, such as steel or alloys thereof. It may have a length ranging form 10 to 45 cm and a diameter ranging from
  • Guide 1 is substantially shaped as a hollow needle and has, on the bottom, a sharp and cutting tip 5, allowing an easy penetration inside the body tissues.
  • guide 1 Extending from the opposite end with respect to tip 5, guide 1 has a cavity 4, preferably cylindrical, wherethrough the needle-carrier head 3 can axially slide.
  • Needle-carrier head 3 is preferably made of thermoplastic material, which, besides conferring lightness and resistance to the piece, allows an easy molding thereof, the upper end of needles 2 being already embedded therein.
  • Needles 2 are a little shorter than the needle-shaped guide 1 and are as well made of hard material, e.g. steel or alloys thereof, yet gifted with some flexibility and elasticity. They have a diameter ranging from 0.8 to 0.9 mm and are available on the market as "Chiba needles".
  • a number is the maximum value allowed by the thinness of the inner port of guide 1 wherethrough needles 2 must be freely slideable. A greater number of needles is possible by increasing the diameter of needle-shaped guide 1.
  • the upper portion of head 3 is square-shaped, but it may obviously be round-shaped like the body of head 3, the round shape being the most advantageous shape in order to ensure an easy sliding through cavity 4 of needle- shaped guide 1.
  • the cylindrical body of head 3 has advantageously, on its outer side, a millimetric scale (not shown), allowing to monitor the advancement of needles 2 along guide 1 and their penetration inside the neoplastic tissue to be treated.
  • each needle 2 is open for the passage of the laser fibre which will be contained therein and guided inside the tumor to be destroyed.
  • needles 2 have, in proximity of their lower end, a bent portion with an angle ranging from 30° to 80° with respect to its major axis.
  • the bending point may be 1-4 cm apart from the end, so that the greater or smaller length of the bent portion will result in necrosis ellipsoids more or less close to one another.
  • needles 2 when in their axial sliding the bending point protrudes from tip 5 of guide 1, spread apart outwards through elasticity, thereby assuming a predetermined mutual spatial arrangement.
  • a position may be most accurately predetermined by suitably selecting the angular value of the bending and the position of the bending point along each needle 2.
  • Such a position is indeed the optimal one, predetermined in order to reach the neoplastic tissue and to completely destroy it.
  • Needles 2 have as well a very sharp tip so as to be capable of easily penetrating into the body tissues. Needles 2 are of a known type and thus they do not require a more detailed description. They have, in a known way, a removable mandrel applied on their tip. Such a mandrel acts as to prevent needles 2 from clogging while passing through the body tissues.
  • needle-shaped guide 1 once inserted into the body of the patient, is guided towards the tumor by means of any known system of per cutem guide.
  • tip 5 of guide 1 Once tip 5 of guide 1 has reached the desired position inside the tumor, head 3 is pushed inside cavity 4 until needles 2 are positioned as represented in Figure 3. In such a position, the tips of the needles are located in the tumor tissue at the predetermined distance, being controllable both visually by the millimetric scale on the side of the body of head 3, and by the known guide systems.
  • the removable mandrels (not shown in the Figure), which are contained in needles 2, are removed and replaced by these latter.
  • the laser fibre of the laser apparatus having the fibres connected thereto allows by now to obtain the thermal lesion with the desired volume and shape. This is allowed by the mutual position assumed by the tips of needles 2 in the inner space of the neoplastic tissue when they protrude from tip 5 of needle-shaped guide 1.
  • head 3 is brought back to the position represented in Figure 1, thereby causing both needles 2 and the laser fibres contained therein to be retracted inside needle-shaped guide 1. This is allowed by the elasticity of the material needles 2 are made of. Once guide 1 has returned to the position of Figure 1, it may be removed from the patient's body.

Abstract

A device for the multiple guide of the laser fibres in the treatment of tumors in parenchymatous organs, comprising a needle-shaped guide (1), wherethrough a plurality of thin needles (2) can slide, each being capable of containing a laser fibre therein, said thin needles (2) having their lower ends bent at an angle of 30-80° with respect to their major axis and their upper ends embedded in a needle-carrier head (3), the body of which can slide through a cavity (4) located in the upper portion of the needle-shaped guide (1).

Description

"MULTIPLE GUIDE FOR LASER FIBRES IN THE TREATMENT OF TUMORS IN PARENCHYMATOUS ORGANS"
The present invention relates to a device for the heat treatment of tumors located in parenchymatous organs and particularly to a multiple guide for the laser fibres used in such a treatment.
The heat induced by laser fibres is known to have been recently used for obtaining the destruction of tumors located in parenchymatous organs such as liver, pancreas and the like. This is obtained by using a thin laser fibre, which, being inserted into a hollow needle, is passed through the skin and brought up to the interior of the tumor by the guide means at present known such as computerized axial tomography, ultrasonography and magnetic resonance. Once the laser fibre is placed inside the tumor, the laser apparatus is activated which emits a light beam being conveyed through the laser fibre inside the tumor, where it causes a localized rise of temperature resulting in the heat destruction of the tumor tissue.
The main limit of this technique is due to the fact that, by activating the laser fibre inside a single needle, the obtained thermal lesion is an ellipsoid having maximum diameters of about 2 cm. Since most of the tumors of the parenchymatous organs, when clinically detected, have by then equal diameters greater than 2 cm, their treatment by laser heating involves the repeated insertion of the needle carrying the laser fibre in the tumor. Such a repeated insertion results in a final necrosis ellipsoid, its surface being the envelope of as many necrosis ellipsoids, partially overlapping, as the repositionings and the activations of the laser fibre inside the tumor. It is therefore extremely important that the needle carrying the laser fibre is placed with millimetric precision inside the neoplastic tissue, but by now this is hindered by several technical problems. A great problem is the patient's breath, making his inner organs moving, and it is easy to comprehend how it is hard to hit a moving target. Another problem is represented by the deflections undergone by the guide needle of the laser fibre when passing through organs having a different density. Finally, it should be noted that, with the technical means by now available, the positioning and the activation of a laser fibre require a lot of time to be carried out, about 10 minutes for every perforation, wherefore repeated perforations are badly endured by the patient. In order to overcome such drawbacks, the simultaneous insertion of several laser fibres inside the neoplastic tissue has already been proposed by means of a guide formed of a solid block provided with a plurality of parallel holes, each being fitted to be passed through by a needle carrying a laser fibre. However, the drawback of such a technique is the fact that, whatever the per cutem guide means being used, it is practically impossible to bring the laser fibres in such an optimal position to obtain a necrosis having predetermined volume and shape, so as to be standardizable in any therapeutic institute.
The object of the present invention is to provide a device allowing to place at the same time several fibres inside a parenchymatous tissue with a predetermined spatial arrangement in a repeatable and standardizable way, whatever the used guide system may be. Such an object is achieved by a device having the features specified in claim 1.
The device according to the present invention has the advantage of allowing the simultaneous positioning inside the parenchymatous tissue of two or more laser fibres in such a way that the tips of the same fibres are located in a predetermined position inside the tissue and with a predetermined mutual spatial arrangement. The predetermined spatial arrangement is the one being deemed optimal for the laser fibres inside the tumor to be treated, so that, after their activation, a simultaneous thermal lesion is quickly obtained having a diameter equal or greater than 4 cm, and a predetermined shape being repeatable in any parenchymatous organ, due to the perfect envelope of the necrosis ellipsoids generated by each laser fibre.
Further advantages and features of the device according to the present invention will be evident from the following detailed description of an embodiment thereof with reference to the attached drawings, wherein:
FIGURE 1 shows a side elevation cross-sectional view of the device according to the present invention;
FIGURE 2 shows a top plan view of the same device; and FIGURE 3 shows the same device of Figure 1 in the final position when used.
Referring to Figure 1, the device of the present invention is essentially formed of an outer guide 1, needle-shaped, wherethrough up to four guide needles 2 for the laser fibres (not shown) can slide, having their upper end fastened inside a slideable head 3, which makes the upper ends of the needles mutually integral and can slide through a suitable cavity 4, being provided in the upper portion of guide 1.
Guide 1 is made of a hard and little flexible material, such as steel or alloys thereof. It may have a length ranging form 10 to 45 cm and a diameter ranging from
1 to 2 mm. Guide 1 is substantially shaped as a hollow needle and has, on the bottom, a sharp and cutting tip 5, allowing an easy penetration inside the body tissues.
Extending from the opposite end with respect to tip 5, guide 1 has a cavity 4, preferably cylindrical, wherethrough the needle-carrier head 3 can axially slide. Needle-carrier head 3 is preferably made of thermoplastic material, which, besides conferring lightness and resistance to the piece, allows an easy molding thereof, the upper end of needles 2 being already embedded therein.
Needles 2 are a little shorter than the needle-shaped guide 1 and are as well made of hard material, e.g. steel or alloys thereof, yet gifted with some flexibility and elasticity. They have a diameter ranging from 0.8 to 0.9 mm and are available on the market as "Chiba needles".
Referring to Fig. 2, in the represented embodiment there are four needles 2. Such a number is the maximum value allowed by the thinness of the inner port of guide 1 wherethrough needles 2 must be freely slideable. A greater number of needles is possible by increasing the diameter of needle-shaped guide 1.
In Figure 2 the upper portion of head 3 is square-shaped, but it may obviously be round-shaped like the body of head 3, the round shape being the most advantageous shape in order to ensure an easy sliding through cavity 4 of needle- shaped guide 1. The cylindrical body of head 3 has advantageously, on its outer side, a millimetric scale (not shown), allowing to monitor the advancement of needles 2 along guide 1 and their penetration inside the neoplastic tissue to be treated.
Finally, in Figure 2 the upper end of each needle 2 is open for the passage of the laser fibre which will be contained therein and guided inside the tumor to be destroyed.
Referring to Fig. 3, pushing the head 3 inside cavity 4 causes needles 2 and the fibres therein contained to axially slide through guide 1 and to protrude from tip 5. As the Figure shows, needles 2 have, in proximity of their lower end, a bent portion with an angle ranging from 30° to 80° with respect to its major axis. The bending point may be 1-4 cm apart from the end, so that the greater or smaller length of the bent portion will result in necrosis ellipsoids more or less close to one another.
By virtue of this arrangement, needles 2, when in their axial sliding the bending point protrudes from tip 5 of guide 1, spread apart outwards through elasticity, thereby assuming a predetermined mutual spatial arrangement. In fact such a position may be most accurately predetermined by suitably selecting the angular value of the bending and the position of the bending point along each needle 2. Such a position is indeed the optimal one, predetermined in order to reach the neoplastic tissue and to completely destroy it.
Needles 2 have as well a very sharp tip so as to be capable of easily penetrating into the body tissues. Needles 2 are of a known type and thus they do not require a more detailed description. They have, in a known way, a removable mandrel applied on their tip. Such a mandrel acts as to prevent needles 2 from clogging while passing through the body tissues.
At the time of use, needle-shaped guide 1, once inserted into the body of the patient, is guided towards the tumor by means of any known system of per cutem guide. Once tip 5 of guide 1 has reached the desired position inside the tumor, head 3 is pushed inside cavity 4 until needles 2 are positioned as represented in Figure 3. In such a position, the tips of the needles are located in the tumor tissue at the predetermined distance, being controllable both visually by the millimetric scale on the side of the body of head 3, and by the known guide systems.
Once the tips of needles 2 have reached the desired spatial position and configuration, the removable mandrels (not shown in the Figure), which are contained in needles 2, are removed and replaced by these latter. The laser fibre of the laser apparatus having the fibres connected thereto allows by now to obtain the thermal lesion with the desired volume and shape. This is allowed by the mutual position assumed by the tips of needles 2 in the inner space of the neoplastic tissue when they protrude from tip 5 of needle-shaped guide 1.
At the end of the treatment, head 3 is brought back to the position represented in Figure 1, thereby causing both needles 2 and the laser fibres contained therein to be retracted inside needle-shaped guide 1. This is allowed by the elasticity of the material needles 2 are made of. Once guide 1 has returned to the position of Figure 1, it may be removed from the patient's body.
The embodiment herein described and represented in the attached drawings has been reported by way of non limiting example of the present invention. In fact, modifications and/or changes may be made to it by those skilled in the art without departing from the scope of the invention. For example, a change may consist in the use of needles 2 with their distal end provided with several side openings so that the laser light hits also the tissue being on the side of the tip of needle 2, without having to move this latter.

Claims

1. A device for the multiple guide of the laser fibres in the treatment of tumors in parenchymatous organs, characterized in that it comprises a needle- shaped guide (1), wherethrough a plurality of thin needles (2) can slide, each being capable of containing a laser fibre therein, said thin needles (2) having their lower ends bent at an angle of 30-80° with respect to their major axis and their upper ends embedded in a needle-carrier head (3), the body of which can slide through a cavity (4) located in the upper portion of the needle-shaped guide (1).
2. A device according to claim 1, characterized in that the lower end of the needle-shaped guide (1) has a sharp tip (5).
3. A device according claim 1 or 2, characterized in that the head (3) carries four needles (2).
4. A device according one or more of the previous claims, characterized in that the needles (2) have their bending points at a distance from their lower ends ranging from 2 to 3 cm.
5. A device according to claim 4, characterized in that the tips of the needles (2) are provided with a removable mandrel.
6. A device according to claim 4, characterized in that the needles (2) have their lower ends provided with side holes.
PCT/IB1997/001495 1996-12-03 1997-12-01 Multiple guide for laser fibres in the treatment of tumors in parenchymatous organs WO1998024513A1 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU49626/97A AU4962697A (en) 1996-12-03 1997-12-01 Multiple guide for laser fibres in the treatment of tumors in parenchymatous organs

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
IT96MI002531A IT1286426B1 (en) 1996-12-03 1996-12-03 MULTIPLE GUIDE FOR FIBER LASERS IN THE TREATMENT OF TUMORS IN PARENCHYMATOUS ORGANS
ITMI96A002531 1996-12-03

Publications (1)

Publication Number Publication Date
WO1998024513A1 true WO1998024513A1 (en) 1998-06-11

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IT (1) IT1286426B1 (en)
WO (1) WO1998024513A1 (en)

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1615574A2 (en) * 2003-04-09 2006-01-18 Synergetics, Inc. Directional laser probe
WO2007104836A1 (en) * 2006-03-13 2007-09-20 Bruno Anastasie Laser instrument for vascular occlusion, in particular for intravenous treatment, and for perforation or detersion of tissue
US8265446B2 (en) 2006-12-05 2012-09-11 Elesta S.R.L. Kit of optical fibers for percutaneous ablative treatment
US9335455B2 (en) 2012-05-30 2016-05-10 Cygnus, LP Extended tip laser and illumination probe for retina surgery
US9370447B2 (en) * 2011-10-10 2016-06-21 Cygnus LP Probes for use in ophthalmic and vitreoretinal surgery

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0325426A1 (en) * 1988-01-19 1989-07-26 Robert Burnham Lufkin Magnetic resonance needle
US5298026A (en) * 1992-07-23 1994-03-29 General Electric Company Method and apparatus for laser medical treatment
US5312392A (en) * 1992-08-31 1994-05-17 Messerschmitt-Boelkow-Blohm Ag Interstitial laser coagulation treatment for benign prostatic hyperplasia
US5454782A (en) * 1994-08-11 1995-10-03 Perkins; Rodney C. Translumenal circumferential energy delivery device
US5469524A (en) * 1994-05-12 1995-11-21 Indigo Medical, Incorporated Fiberoptic delivery system and method of use

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0325426A1 (en) * 1988-01-19 1989-07-26 Robert Burnham Lufkin Magnetic resonance needle
US5298026A (en) * 1992-07-23 1994-03-29 General Electric Company Method and apparatus for laser medical treatment
US5312392A (en) * 1992-08-31 1994-05-17 Messerschmitt-Boelkow-Blohm Ag Interstitial laser coagulation treatment for benign prostatic hyperplasia
US5469524A (en) * 1994-05-12 1995-11-21 Indigo Medical, Incorporated Fiberoptic delivery system and method of use
US5454782A (en) * 1994-08-11 1995-10-03 Perkins; Rodney C. Translumenal circumferential energy delivery device

Cited By (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1615574A2 (en) * 2003-04-09 2006-01-18 Synergetics, Inc. Directional laser probe
EP1615574A4 (en) * 2003-04-09 2009-02-11 Synergetics Inc Directional laser probe
WO2007104836A1 (en) * 2006-03-13 2007-09-20 Bruno Anastasie Laser instrument for vascular occlusion, in particular for intravenous treatment, and for perforation or detersion of tissue
US8454586B2 (en) 2006-03-13 2013-06-04 Bruno Anastasie Laser instrument for vascular occlusion, in particular for intravenous treatment, and for perforation or detersion of tissue
US8265446B2 (en) 2006-12-05 2012-09-11 Elesta S.R.L. Kit of optical fibers for percutaneous ablative treatment
US9370447B2 (en) * 2011-10-10 2016-06-21 Cygnus LP Probes for use in ophthalmic and vitreoretinal surgery
US9335455B2 (en) 2012-05-30 2016-05-10 Cygnus, LP Extended tip laser and illumination probe for retina surgery

Also Published As

Publication number Publication date
AU4962697A (en) 1998-06-29
ITMI962531A0 (en) 1996-12-03
IT1286426B1 (en) 1998-07-08
ITMI962531A1 (en) 1998-06-03

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