WO2007092739A2 - Microsurgical instrument - Google Patents

Microsurgical instrument Download PDF

Info

Publication number
WO2007092739A2
WO2007092739A2 PCT/US2007/061476 US2007061476W WO2007092739A2 WO 2007092739 A2 WO2007092739 A2 WO 2007092739A2 US 2007061476 W US2007061476 W US 2007061476W WO 2007092739 A2 WO2007092739 A2 WO 2007092739A2
Authority
WO
WIPO (PCT)
Prior art keywords
cutting member
port
inner cutting
wall portion
cutting
Prior art date
Application number
PCT/US2007/061476
Other languages
French (fr)
Other versions
WO2007092739A3 (en
Inventor
G. Lamar Kirchhevel
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.
Priority to CA2637816A priority Critical patent/CA2637816C/en
Priority to SI200730521T priority patent/SI1981416T1/en
Priority to PL07763558T priority patent/PL1981416T3/en
Priority to DE602007011395T priority patent/DE602007011395D1/en
Priority to EP07763558A priority patent/EP1981416B1/en
Priority to DK07763558.9T priority patent/DK1981416T3/en
Priority to BRPI0707392A priority patent/BRPI0707392B8/en
Priority to CN2007800046728A priority patent/CN101378703B/en
Priority to KR1020087021825A priority patent/KR101324145B1/en
Priority to AT07763558T priority patent/ATE492225T1/en
Priority to AU2007212114A priority patent/AU2007212114B2/en
Priority to JP2008553507A priority patent/JP5296556B2/en
Publication of WO2007092739A2 publication Critical patent/WO2007092739A2/en
Publication of WO2007092739A3 publication Critical patent/WO2007092739A3/en

Links

Classifications

    • 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00535—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated
    • A61B2017/00544—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated pneumatically
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B17/2909—Handles
    • A61B2017/2912—Handles transmission of forces to actuating rod or piston
    • A61B2017/2918—Handles transmission of forces to actuating rod or piston flexible handles
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/30—Surgical pincettes without pivotal connections
    • A61B2017/305—Tweezer like handles with tubular extensions, inner slidable actuating members and distal tools, e.g. microsurgical instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/03—Automatic limiting or abutting means, e.g. for safety
    • A61B2090/033—Abutting means, stops, e.g. abutting on tissue or skin
    • A61B2090/034—Abutting means, stops, e.g. abutting on tissue or skin abutting on parts of the device itself

Definitions

  • the present invention generally pertains to microsurgical instruments. More particularly, but not by way of limitation, the present invention pertains to microsurgical instruments having a port for aspirating and cutting tissue.
  • microsurgical procedures require precision cutting and/or removal of various body tissues.
  • certain ophthalmic surgical procedures require the cutting and/or removal of the vitreous humor, a transparent jelly-like material that fills the posterior segment of the eye.
  • the vitreous humor, or vitreous is composed of numerous microscopic fibers that are often attached to the retina. Therefore, cutting and removal of the vitreous must be done with great care to avoid traction on the retina, the separation of the retina from the choroid, a retinal tear, or, in the worst case, cutting and removal of the retina itself.
  • the use of microsurgical cutting probes in posterior segment ophthalmic surgery is well known. Such vitrectomy probes are typically inserted via an incision in the sclera near the pars plana. The surgeon may also insert other microsurgical instruments such as a fiber optic illuminator, an infusion cannula, or an aspiration probe during the posterior segment surgery. The surgeon performs the procedure while viewing the eye under a microscope.
  • Conventional vitrectomy probes typically include a hollow outer cutting member, a hollow inner cutting member arranged coaxially with and movably disposed within the hollow outer cutting member, and a port extending radially through the outer cutting member near the distal end thereof. Vitreous humor is aspirated into the open port, and the inner member is actuated, closing the port. Upon the closing of the port, cutting surfaces on both the inner and outer cutting members cooperate to cut the vitreous, and the cut vitreous is then aspirated away through the inner cutting member.
  • a guillotine style probe has an inner cutting member that reciprocates along its longitudinal axis.
  • a rotational probe has an inner cutting member that reciprocates around its longitudinal axis.
  • the inner cutting members are actuated using various methods. For example, the inner cutting member can be moved from the open port position to the closed port position by pneumatic pressure against a piston or diaphragm assembly that overcomes a mechanical spring. Upon removal of the pneumatic pressure, the spring returns the inner cutting member from the closed port position to the open port position.
  • the inner cutting member can be moved from the open port position to the closed port position using a first source of pneumatic pressure, and then can be moved from the closed port position to the open port position using a second source of pneumatic pressure.
  • the inner cutting member can be electromechanically actuated between the open and closed port positions using a conventional rotating electric motor or a solenoid.
  • U.S. Patent No. 4,577,629 provides an example of a guillotine style, pneumatic piston / mechanical spring actuated probe.
  • U.S. Patent Nos. 4,909,249 and 5,019,035 disclose guillotine style, pneumatic diaphragm / mechanical spring actuated probes.
  • 5,176,628 shows a rotational dual pneumatic drive probe.
  • the cutting stroke of the inner cutting member is limited by contact with the closed, distal end of the probe at the end of the cutting stroke. Such actuation may dull the cutting surfaces of the probe,
  • the return stroke of the inner cutting member is limited by the actuating piston or diaphragm contacting a stopping ring. This arrangement reduces the diaphragm area exposed to actuating pressure at the beginning of the cutting stroke.
  • conventional pneumatic piston (or diaphragm) / mechanical spring actuated probes the use of a pre-loaded return spring requires relatively large actuating pressures to initiate the cutting stroke.
  • the present invention is a microsurgical instrument having a cutting member and a base.
  • the cutting member has a tubular outer cutting member with a port for receiving tissue and a tubular inner cutting member disposed within the outer cutting member.
  • the base has an actuating mechanism for reciprocating actuation of the inner cutting member so that the inner cutting member opens and closes the port and cuts tissue disposed in the port.
  • the actuating mechanism includes a diaphragm chamber having a first wall portion and a second wall portion, a rigid center support disposed in the diaphragm chamber and having a first limiting surface and a second limiting surface, and a flexible diaphragm coupled to the center support and the base.
  • Figure 1 is a perspective view of a microsurgical instrument according to a preferred embodiment of the present invention.
  • Figure 2 is a top view of the microsurgical instrument of Figure 1;
  • Figure 3 is a side, sectional view of the microsurgical instrument of Figure 1 shown operatively coupled to a microsurgical system;
  • Figure 4 is an enlarged, perspective view of the cam member of the microsurgical instrument of Figure 1;
  • Figure 5 is a cross-sectional view of the cam member of Figure 4.
  • Figure 6 is an enlarged, fragmentary, side, sectional view of the portion of the microsurgical instrument of Figure 1 shown in circle 6 of Figure 2;
  • Figure 7 is an enlarged, fragmentary, side, sectional view of a portion of the actuating mechanism of the microsurgical instrument of Figure 1.
  • Microsurgical instrument 10 preferably includes a base 12, an actuating handle
  • microsurgical instrument 10 is a vitrectomy probe.
  • microsurgical instrument 10 maybe any microsurgical cutting, aspiration, or infusion probe.
  • Base 12 includes an actuating mechanism 13 for actuating a tubular inner cutting member 110 of cutting member 18 in a reciprocating manner.
  • Actuating mechanism 13 preferably includes a first pneumatic port 22, a second pneumatic port
  • Flexible diaphragm 28 is coupled to center support 30 and base 12. As shown in the
  • flexible diaphragm 28 is fractionally coupled to both center support 30 and base 12.
  • flexible diaphragm 28 maybe frictionally coupled to base 12 and over-molded onto center support 30.
  • Center support 30 has limiting surfaces 3 Ia and 3 Ib for interfacing with wall portions 33a and 33b of diaphragm chamber 26, respectively.
  • Base 12 further includes an aspiration port 34 and a distal portion 12a having an aperture 12b and a distal tip 12c.
  • a collar 36 couples distal portion 12a to actuating handle 14.
  • Inner cutting member 110 is coupled to center support 30 and is slidaby and fluidly coupled to base 12 via o-rings 38.
  • Actuating handle 14 preferably includes a proximal base 50, a distal base 52, and a plurality of flexible appendages 14a coupled to both base 50 and 52.
  • Flexible appendages 14a may be made from any suitable springy material having a memory, such as titanium, stainless steel, or a suitable thermoplastic.
  • Handle 14 surrounds distal portion 12a of base 12.
  • Proximal base 50 is coupled to collar 36.
  • Distal base 52 is received within a slidable collar 54.
  • a user grasps microsurgical instrument 10 via handle 14. When a user exerts an inward pressure on flexible appendages 14a, flexible appendages 14a bend at or near 14b, straightening and elongating flexible appendages 14a, and moving collar 54 toward distal tip 20. When such pressure is removed, spring 55 returns flexible appendages 14a to the position shown in Figure 2.
  • Nose member 16 preferably includes cam chamber 70 for receiving a cam member 72, a base chamber 74 for receiving distal tip 12c of base 12, a bushing 76 for receiving inner cutting member 110 of cutting member 18, and an outlet 78 for receiving a tubular outer cutting member 100 of cutting member 18.
  • Cam member 72 is rotationally coupled to nose member 16 within aperture 12b of base 12 via dowel pins (not shown) inserted into each end of a bore 79.
  • Cam member 72 preferably has a first stopping surface 80 for interfacing with collar 54, a second stopping surface 82 for interfacing with base 12, a clearance slot 84 for receiving inner cutting member 110 of cutting member 18, and a cam surface 86 for interfacing with bushing 76.
  • cutting member 18 preferably includes tubular outer cutter member 100 and tubular inner cutting member 110.
  • Outer cutting member 100 has an inner bore 102, a closed end 104, a port 106 for receiving tissue, and cutting surfaces 108.
  • Inner cutting member 110 has an inner bore 112, an open end 114, and a cutting surface 116.
  • vitrectomy probe 10 is operatively coupled to a microsurgical system 198. More specifically, pneumatic port 22 is fluidly coupled to a pneumatic pressure source 200 via a fluid line 202, pneumatic port 24 is fluidly coupled to a pneumatic pressure source 204 via fluid line 206, and aspiration port 34 is fluidly coupled to vacuum source 208 via fluid line 209. Inner bore 112 and fluid line 209 are primed with a surgical fluid.
  • Microsurgical system 198 also has a microprocessor or computer 210, which is electrically coupled to pneumatic pressure sources 200 and 204 via interfaces 212 and 214, respectively.
  • a surgeon inserts distal tip 20 into the posterior segment of the eye using a pars plana insertion.
  • the surgeon selects a desired vacuum level for vacuum source
  • Tissue is aspirated into inner bore 112 via port 106.
  • the surgeon selects a desired cut rate for probe 10 using microprocessor 210 and optionally a proportional control device (not shown), such as a foot controller. More specifically, microprocessor 210 uses pressurized gas sources 200 and 204 to create a cyclic pressure differential across diaphragm 28 so as to move center support 30, and thus inner cutting member 110, in a reciprocating manner at the desired cut rate.
  • a proportional control device not shown
  • This actuation closes port 106, allowing cutting surfaces 108 and 116 to cut the tissue within inner bore 112.
  • the cut tissue is aspirated through inner bore 112, aspiration port 34, fluid line 209, and into a collection chamber (not shown).
  • inner cutting member 110 is moved away from distal tip 20, opening port 106 and allowing the further aspiration of tissue.
  • limiting surface 31a of center support 30 contacts wall portion 33 a of diaphragm chamber 26 to precisely end the cutting stroke.
  • Limiting surface 31b of center support 30 contacts wall portion 33b of diaphragm chamber 26 to precisely end the return stroke.
  • cutting surface 116 of open end 114 of inner cutting member 110 is preferably disposed at or just past distal cutting surface 108 of outer cutting member 100.
  • open end 114 is preferably disposed at or near proximal cutting surface 108 of outer cutting member 100.
  • the present invention provides significant benefits over conventional vitrectomy probes.
  • the present invention is illustrated herein by example, and various modifications may be made by a person of ordinary skill in the art.
  • the present invention is described above in connection with a vitrectomy probe, it is equally applicable to aspiration probes, infusion probes, and other cutting probes.

Abstract

A microsurgical instrument including a cutting member and a base with an actuating mechanism that provides more efficient cutting of tissue.

Description

MICROSURGICAL INSTRUMENT
Field of the Invention
The present invention generally pertains to microsurgical instruments. More particularly, but not by way of limitation, the present invention pertains to microsurgical instruments having a port for aspirating and cutting tissue.
Description of the Related Art
Many microsurgical procedures require precision cutting and/or removal of various body tissues. For example, certain ophthalmic surgical procedures require the cutting and/or removal of the vitreous humor, a transparent jelly-like material that fills the posterior segment of the eye. The vitreous humor, or vitreous, is composed of numerous microscopic fibers that are often attached to the retina. Therefore, cutting and removal of the vitreous must be done with great care to avoid traction on the retina, the separation of the retina from the choroid, a retinal tear, or, in the worst case, cutting and removal of the retina itself. The use of microsurgical cutting probes in posterior segment ophthalmic surgery is well known. Such vitrectomy probes are typically inserted via an incision in the sclera near the pars plana. The surgeon may also insert other microsurgical instruments such as a fiber optic illuminator, an infusion cannula, or an aspiration probe during the posterior segment surgery. The surgeon performs the procedure while viewing the eye under a microscope.
Conventional vitrectomy probes typically include a hollow outer cutting member, a hollow inner cutting member arranged coaxially with and movably disposed within the hollow outer cutting member, and a port extending radially through the outer cutting member near the distal end thereof. Vitreous humor is aspirated into the open port, and the inner member is actuated, closing the port. Upon the closing of the port, cutting surfaces on both the inner and outer cutting members cooperate to cut the vitreous, and the cut vitreous is then aspirated away through the inner cutting member. U.S. Patent Nos. 4,577,629 (Martinez); 5,019,035 (Missirlian et al.); 4,909,249 (Akkas et al.); 5,176,628 (Charles et al.); 5,047,008 (de Juan et al.); 4,696,298 (Higgins et al.); and 5,733,297 (Wang) all disclose various types of vitrectomy probes, and each of these patents is incorporated herein in its entirety by reference.
Conventional vitrectomy probes include "guillotine style" probes and rotational probes. A guillotine style probe has an inner cutting member that reciprocates along its longitudinal axis. A rotational probe has an inner cutting member that reciprocates around its longitudinal axis. In both types of probes, the inner cutting members are actuated using various methods. For example, the inner cutting member can be moved from the open port position to the closed port position by pneumatic pressure against a piston or diaphragm assembly that overcomes a mechanical spring. Upon removal of the pneumatic pressure, the spring returns the inner cutting member from the closed port position to the open port position. As another example, the inner cutting member can be moved from the open port position to the closed port position using a first source of pneumatic pressure, and then can be moved from the closed port position to the open port position using a second source of pneumatic pressure. As a further example, the inner cutting member can be electromechanically actuated between the open and closed port positions using a conventional rotating electric motor or a solenoid. U.S. Patent No. 4,577,629 provides an example of a guillotine style, pneumatic piston / mechanical spring actuated probe. U.S. Patent Nos. 4,909,249 and 5,019,035 disclose guillotine style, pneumatic diaphragm / mechanical spring actuated probes. U.S. Patent No. 5,176,628 shows a rotational dual pneumatic drive probe. hi many conventional vitrectromy probes, the cutting stroke of the inner cutting member is limited by contact with the closed, distal end of the probe at the end of the cutting stroke. Such actuation may dull the cutting surfaces of the probe, hi many conventional vitrectomy probes, the return stroke of the inner cutting member is limited by the actuating piston or diaphragm contacting a stopping ring. This arrangement reduces the diaphragm area exposed to actuating pressure at the beginning of the cutting stroke. In conventional pneumatic piston (or diaphragm) / mechanical spring actuated probes, the use of a pre-loaded return spring requires relatively large actuating pressures to initiate the cutting stroke. Spring-returned probes also exhibit increasing spring Teturn force as the cutting stroke progresses, which requires increased pneumatic pressure to complete the cutting stroke. This limitation is exacerbated in modern probes with higher cutting speeds because greater spring pre-load forces require correspondingly greater pneumatic actuation pressures. Therefore, a need exists for an improved vitrectomy probe that exhibits more efficient cutting. Such efficiency should facilitate the minimization of the total air consumed during probe actuation, operation at lower pneumatic pressures, and operation at higher cutting speeds. Minimizing the total air consumed is particularly important for applications where pneumatic pressure is delivered via a pressurized tank that is periodically replaced. Operating at higher cutting speeds reduces the aspiration time between cuts and the turbulence of vitreous and retinal issues during cutting. Summary of the Invention
Ih one aspect, the present invention is a microsurgical instrument having a cutting member and a base. The cutting member has a tubular outer cutting member with a port for receiving tissue and a tubular inner cutting member disposed within the outer cutting member. The base has an actuating mechanism for reciprocating actuation of the inner cutting member so that the inner cutting member opens and closes the port and cuts tissue disposed in the port. The actuating mechanism includes a diaphragm chamber having a first wall portion and a second wall portion, a rigid center support disposed in the diaphragm chamber and having a first limiting surface and a second limiting surface, and a flexible diaphragm coupled to the center support and the base. Upon actuation of the inner cutting member, the first limiting surface contacts the first wall portion at an end of a cutting stroke of the inner cutting member, and the second limiting surface contacts the second wall portion at an end of a return stroke of the inner cutting member.
Brief Description of the Drawings
For a more complete understanding of the present invention, and for further objects and advantages thereof, reference is made to the following description taken in conjunction with the accompanying drawings in which:
Figure 1 is a perspective view of a microsurgical instrument according to a preferred embodiment of the present invention;
Figure 2 is a top view of the microsurgical instrument of Figure 1;
Figure 3 is a side, sectional view of the microsurgical instrument of Figure 1 shown operatively coupled to a microsurgical system; Figure 4 is an enlarged, perspective view of the cam member of the microsurgical instrument of Figure 1;
Figure 5 is a cross-sectional view of the cam member of Figure 4;
Figure 6 is an enlarged, fragmentary, side, sectional view of the portion of the microsurgical instrument of Figure 1 shown in circle 6 of Figure 2; and
Figure 7 is an enlarged, fragmentary, side, sectional view of a portion of the actuating mechanism of the microsurgical instrument of Figure 1.
Detailed Description of Preferred Embodiments The preferred embodiments of the present invention and tfieir advantages are best understood by referring to Figures 1 through 7 of the drawings, like numerals being used for like and corresponding parts of the various drawings.
Microsurgical instrument 10 preferably includes a base 12, an actuating handle
14, a nose member 16, and a cutting member 18 having a distal tip 20. As shown in the Figures, microsurgical instrument 10 is a vitrectomy probe. However, microsurgical instrument 10 maybe any microsurgical cutting, aspiration, or infusion probe.
Base 12 includes an actuating mechanism 13 for actuating a tubular inner cutting member 110 of cutting member 18 in a reciprocating manner. Actuating mechanism 13 preferably includes a first pneumatic port 22, a second pneumatic port
24, a diaphragm chamber 26, a flexible diaphragm 28, and a rigid center support 30.
Flexible diaphragm 28 is coupled to center support 30 and base 12. As shown in the
Figures, flexible diaphragm 28 is fractionally coupled to both center support 30 and base 12. Alternatively, flexible diaphragm 28 maybe frictionally coupled to base 12 and over-molded onto center support 30. Center support 30 has limiting surfaces 3 Ia and 3 Ib for interfacing with wall portions 33a and 33b of diaphragm chamber 26, respectively. Base 12 further includes an aspiration port 34 and a distal portion 12a having an aperture 12b and a distal tip 12c. A collar 36 couples distal portion 12a to actuating handle 14. Inner cutting member 110 is coupled to center support 30 and is slidaby and fluidly coupled to base 12 via o-rings 38.
Actuating handle 14 preferably includes a proximal base 50, a distal base 52, and a plurality of flexible appendages 14a coupled to both base 50 and 52. Flexible appendages 14a may be made from any suitable springy material having a memory, such as titanium, stainless steel, or a suitable thermoplastic. Handle 14 surrounds distal portion 12a of base 12. Proximal base 50 is coupled to collar 36. Distal base 52 is received within a slidable collar 54. A user grasps microsurgical instrument 10 via handle 14. When a user exerts an inward pressure on flexible appendages 14a, flexible appendages 14a bend at or near 14b, straightening and elongating flexible appendages 14a, and moving collar 54 toward distal tip 20. When such pressure is removed, spring 55 returns flexible appendages 14a to the position shown in Figure 2.
Nose member 16 preferably includes cam chamber 70 for receiving a cam member 72, a base chamber 74 for receiving distal tip 12c of base 12, a bushing 76 for receiving inner cutting member 110 of cutting member 18, and an outlet 78 for receiving a tubular outer cutting member 100 of cutting member 18. Cam member 72 is rotationally coupled to nose member 16 within aperture 12b of base 12 via dowel pins (not shown) inserted into each end of a bore 79. Cam member 72 preferably has a first stopping surface 80 for interfacing with collar 54, a second stopping surface 82 for interfacing with base 12, a clearance slot 84 for receiving inner cutting member 110 of cutting member 18, and a cam surface 86 for interfacing with bushing 76. An o-ring 88 slidaby and fluidly seals nose member 16 to inner cutting member 110. As described above, cutting member 18 preferably includes tubular outer cutter member 100 and tubular inner cutting member 110. Outer cutting member 100 has an inner bore 102, a closed end 104, a port 106 for receiving tissue, and cutting surfaces 108. Inner cutting member 110 has an inner bore 112, an open end 114, and a cutting surface 116.
In operation, vitrectomy probe 10 is operatively coupled to a microsurgical system 198. More specifically, pneumatic port 22 is fluidly coupled to a pneumatic pressure source 200 via a fluid line 202, pneumatic port 24 is fluidly coupled to a pneumatic pressure source 204 via fluid line 206, and aspiration port 34 is fluidly coupled to vacuum source 208 via fluid line 209. Inner bore 112 and fluid line 209 are primed with a surgical fluid. Microsurgical system 198 also has a microprocessor or computer 210, which is electrically coupled to pneumatic pressure sources 200 and 204 via interfaces 212 and 214, respectively.
A surgeon inserts distal tip 20 into the posterior segment of the eye using a pars plana insertion. The surgeon selects a desired vacuum level for vacuum source
208. Tissue is aspirated into inner bore 112 via port 106. The surgeon selects a desired cut rate for probe 10 using microprocessor 210 and optionally a proportional control device (not shown), such as a foot controller. More specifically, microprocessor 210 uses pressurized gas sources 200 and 204 to create a cyclic pressure differential across diaphragm 28 so as to move center support 30, and thus inner cutting member 110, in a reciprocating manner at the desired cut rate. When the pressure provided to pneumatic port 22 is greater than the pressure provided to pneumatic port 24, inner cutting member 110 is moved toward distal tip 20 until open end 114 is past cutting surface 108, as shown in Figure 6. This actuation closes port 106, allowing cutting surfaces 108 and 116 to cut the tissue within inner bore 112. The cut tissue is aspirated through inner bore 112, aspiration port 34, fluid line 209, and into a collection chamber (not shown). When the pressure provided to pneumatic port 24 is greater than the pressure provided to pneumatic port 22, inner cutting member 110 is moved away from distal tip 20, opening port 106 and allowing the further aspiration of tissue.
During actuation of inner cutting member 110, limiting surface 31a of center support 30 contacts wall portion 33 a of diaphragm chamber 26 to precisely end the cutting stroke. Limiting surface 31b of center support 30 contacts wall portion 33b of diaphragm chamber 26 to precisely end the return stroke. When limiting surface 31a contacts wall portion 33a, cutting surface 116 of open end 114 of inner cutting member 110 is preferably disposed at or just past distal cutting surface 108 of outer cutting member 100. When limiting surface 31b contacts wall portion 33b, open end 114 is preferably disposed at or near proximal cutting surface 108 of outer cutting member 100. Such precision control of the actuation of inner cutting member 110 greatly increases the cutting efficiency of probe 10.
From the above, it may be appreciated that the present invention provides significant benefits over conventional vitrectomy probes. The present invention is illustrated herein by example, and various modifications may be made by a person of ordinary skill in the art. For example, although the present invention is described above in connection with a vitrectomy probe, it is equally applicable to aspiration probes, infusion probes, and other cutting probes.
It is believed that the operation and construction of the present invention will be apparent from the foregoing description. While the apparatus and methods shown or described above have been characterized as being preferred, various changes and modifications may be made therein without departing from the spirit and scope of the invention as defined in the following claims.

Claims

What is claimed is:
1. A microsurgical instrument, comprising: a cutting member having a tubular outer cutting member with a port for receiving tissue and a tubular inner cutting member disposed within said outer cutting member; and a base having an actuating mechanism for reciprocating actuation of said inner cutting member so that said inner cutting member opens and closes said port and cuts tissue disposed in said port, said actuating mechanism comprising: a diaphragm chamber having a first wall portion and a second wall portion; a rigid center support disposed in said diaphragm chamber and having a first limiting surface and a second limiting surface; and a flexible diaphragm coupled to said center support and said base; whereby upon actuation of said inner cutting member, said first limiting surface contacts said first wall portion at an end of a cutting stroke of said inner cutting member, and said second limiting surface contacts said second wall portion at an end of a return stroke of said inner cutting member.
2. The microsurgical instrument of claim 1 wherein said first limiting surface contacts said first wall portion when said inner cutting member closes said port.
3. The microsurgical instrument of claim 2 wherein said second limiting surface contacts said second wall portion when said port is in a fully open position.
4. The microsurgical instrument of claim 1 wherein said instrument is a vitrectomy probe.
PCT/US2007/061476 2006-02-06 2007-02-01 Microsurgical instrument WO2007092739A2 (en)

Priority Applications (12)

Application Number Priority Date Filing Date Title
CA2637816A CA2637816C (en) 2006-02-06 2007-02-01 Microsurgical instrument
SI200730521T SI1981416T1 (en) 2006-02-06 2007-02-01 Microsurgical instrument
PL07763558T PL1981416T3 (en) 2006-02-06 2007-02-01 Microsurgical instrument
DE602007011395T DE602007011395D1 (en) 2006-02-06 2007-02-01 MICRO-SURGICAL INSTRUMENT
EP07763558A EP1981416B1 (en) 2006-02-06 2007-02-01 Microsurgical instrument
DK07763558.9T DK1981416T3 (en) 2006-02-06 2007-02-01 Microsurgical instrument
BRPI0707392A BRPI0707392B8 (en) 2006-02-06 2007-02-01 microsurgical instrument
CN2007800046728A CN101378703B (en) 2006-02-06 2007-02-01 Microsurgical instrument
KR1020087021825A KR101324145B1 (en) 2006-02-06 2007-02-01 Microsurgical instrument
AT07763558T ATE492225T1 (en) 2006-02-06 2007-02-01 MICROSURGICAL INSTRUMENT
AU2007212114A AU2007212114B2 (en) 2006-02-06 2007-02-01 Microsurgical instrument
JP2008553507A JP5296556B2 (en) 2006-02-06 2007-02-01 Microsurgical instruments

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US11/348,118 US8187293B2 (en) 2006-02-06 2006-02-06 Microsurgical instrument
US11/348,118 2006-02-06

Publications (2)

Publication Number Publication Date
WO2007092739A2 true WO2007092739A2 (en) 2007-08-16
WO2007092739A3 WO2007092739A3 (en) 2007-12-06

Family

ID=38335009

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US2007/061476 WO2007092739A2 (en) 2006-02-06 2007-02-01 Microsurgical instrument

Country Status (18)

Country Link
US (1) US8187293B2 (en)
EP (1) EP1981416B1 (en)
JP (1) JP5296556B2 (en)
KR (1) KR101324145B1 (en)
CN (1) CN101378703B (en)
AT (1) ATE492225T1 (en)
AU (1) AU2007212114B2 (en)
BR (1) BRPI0707392B8 (en)
CA (1) CA2637816C (en)
CY (1) CY1111329T1 (en)
DE (1) DE602007011395D1 (en)
DK (1) DK1981416T3 (en)
ES (1) ES2356785T3 (en)
PL (1) PL1981416T3 (en)
PT (1) PT1981416E (en)
RU (1) RU2432929C2 (en)
SI (1) SI1981416T1 (en)
WO (1) WO2007092739A2 (en)

Families Citing this family (48)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2008080148A2 (en) 2006-12-21 2008-07-03 Doheny Eye Institute Disposable vitrectomy handpiece
US8568391B2 (en) 2007-04-20 2013-10-29 Doheny Eye Institute Sterile surgical tray
JP2010524593A (en) 2007-04-20 2010-07-22 ドヘニー アイ インスティテュート Independent Surgery Center
US8080029B2 (en) * 2007-09-21 2011-12-20 Novartis Ag System for actuation of a vitreous cutter
EP2197368B1 (en) * 2007-09-27 2017-08-23 Doheny Eye Institute Selectable stroke cutter
WO2011025658A1 (en) 2009-08-31 2011-03-03 Alcon Research, Ltd. Pneumatic pressure output control by drive valve duty cycle calibration
US8666556B2 (en) * 2009-12-10 2014-03-04 Alcon Research, Ltd. Systems and methods for dynamic feedforward
CN102652006B (en) * 2009-12-10 2014-06-11 爱尔康研究有限公司 Systems and methods for dynamic pneumatic valve driver
US8821524B2 (en) 2010-05-27 2014-09-02 Alcon Research, Ltd. Feedback control of on/off pneumatic actuators
US8579887B2 (en) 2010-11-09 2013-11-12 Synergetics Usa, Inc. Axially reciprocating microsurgical instrument with radially compressed actuator handle
US8888802B2 (en) 2010-12-21 2014-11-18 Alcon Research, Ltd. Vitrectomy probe with adjustable cutter port size
US9101441B2 (en) 2010-12-21 2015-08-11 Alcon Research, Ltd. Vitrectomy probe with adjustable cutter port size
US8540743B2 (en) * 2010-12-22 2013-09-24 Alcon Research, Ltd. Hydraulic vitrectomy probe
JP6074422B2 (en) 2011-07-08 2017-02-08 ドヘニー アイ インスティテュート Eyepiece cutting device
CN102327159B (en) * 2011-08-18 2013-05-15 杨勋 Dual-purpose vitreous body cutting head
US9060841B2 (en) 2011-08-31 2015-06-23 Alcon Research, Ltd. Enhanced flow vitrectomy probe
US10070990B2 (en) 2011-12-08 2018-09-11 Alcon Research, Ltd. Optimized pneumatic drive lines
US9517161B2 (en) 2011-12-20 2016-12-13 Alcon Research, Ltd. Vitrectomy probe with adjustable cutter port size
US9629748B2 (en) * 2012-05-31 2017-04-25 Medical Instrument Development Laboratories, Inc. Multi-stage tubing for high-speed pneumatic surgical cutter
US9924963B2 (en) 2012-12-13 2018-03-27 Novartis Ag Vitrectomy probe with integral valve
US9615969B2 (en) 2012-12-18 2017-04-11 Novartis Ag Multi-port vitrectomy probe with dual cutting edges
EP2913035A1 (en) * 2014-02-27 2015-09-02 EOS GmbH Ophthalmic surgery device with a surgical handpiece and controls for controlling the stroke of the hollow needle
RU2554230C1 (en) * 2014-06-09 2015-06-27 федеральное государственное бюджетное учреждение "Межотраслевой научно-технический комплекс "Микрохирургия глаза" имени академика С.Н. Федорова" Министерства здравоохранения Российской Федерации Method of carrying out vitrectomy in surgical treatment of retinal detachment, complicated with proliferative vitreoretinopathy
WO2016033044A1 (en) * 2014-08-25 2016-03-03 Peregrine Surgical, Ltd Microsurgical instrument
US9693898B2 (en) 2014-11-19 2017-07-04 Novartis Ag Double-acting vitreous probe with contoured port
DE102014118575B4 (en) 2014-12-12 2016-10-06 Carl Zeiss Meditec Ag Surgical instrument
CA2979414C (en) 2015-04-13 2023-08-29 Novartis Ag High speed pneumatic valve
CN105310821A (en) * 2015-05-15 2016-02-10 以诺康医疗科技（苏州）有限公司 Ultrasonic vitrectomy needle and device thereof
CN105476744B (en) * 2016-02-23 2017-10-31 首都医科大学附属北京朝阳医院 A kind of anterior vitreous cutter device
US10729582B2 (en) 2016-05-17 2020-08-04 Alcon Inc. Vitrectomy probe with end tissue cutter and associated devices, systems, and methods
JP2020508167A (en) 2017-02-27 2020-03-19 アルコン インコーポレイティド Reciprocating surgical instrument with inertial damper
AU2018261640B2 (en) 2017-05-04 2023-04-27 Carl Zeiss Meditec Cataract Technology Inc. Devices and methods for ocular surgery
US10639197B2 (en) * 2017-06-19 2020-05-05 Alcon Inc. Vitrectomy probe
US10893978B2 (en) 2017-12-14 2021-01-19 Alcon Inc. Vitreous cutter pneumatic driver
WO2019236615A1 (en) 2018-06-05 2019-12-12 Carl Zeiss Meditec Cataract Technology Inc. Ophthalmic microsurgical tools, systems, and methods of use
WO2020012366A2 (en) 2018-07-13 2020-01-16 Alcon Inc. Vitrectomy instrument with precision cutter stop
EP3860535A1 (en) 2018-12-12 2021-08-11 Alcon Inc. Actuation handle
EP3897486A1 (en) 2019-02-01 2021-10-27 Alcon Inc. Actuation mechanism with arcuate levers
EP3917468B1 (en) 2019-02-01 2023-11-15 Carl Zeiss Meditec Cataract Technology Inc. Ophthalmic cutting instruments having integrated aspiration pump
EP3968912A1 (en) 2019-05-17 2022-03-23 Carl Zeiss Meditec Cataract Technology Inc. Ophthalmic cutting instruments having integrated aspiration pump
US11801163B2 (en) 2019-06-07 2023-10-31 Carl Zeiss Meditec Cataract Technology Inc. Multi-stage trigger for ophthalmology cutting tool
KR20220054574A (en) 2019-08-29 2022-05-03 알콘 인코포레이티드 Actuation mechanism with grooved actuation lever
USD934424S1 (en) 2019-08-29 2021-10-26 Alcon Inc. 360 degree actuation handle
AU2020350182A1 (en) 2019-09-16 2022-02-24 Alcon Inc. Reduced vibration vitrectomy probe
US11540941B2 (en) 2019-12-11 2023-01-03 Alcon Inc. Adjustable support sleeve for surgical instruments
US20220160544A1 (en) * 2020-11-20 2022-05-26 Alcon Inc. Fluid driven vitrectomy probe
CN114748241A (en) * 2021-01-09 2022-07-15 深圳市眼科医院 Intraocular forceps with membrane separation mechanism
DE102022107857A1 (en) * 2022-04-01 2023-10-05 Tuebingen Scientific Medical Gmbh Pneumatic drive device for translational and/or rotational movement

Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4577629A (en) 1983-10-28 1986-03-25 Coopervision, Inc. Surgical cutting instrument for ophthalmic surgery

Family Cites Families (45)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3884238A (en) * 1972-06-19 1975-05-20 Malley Conor C O Apparatus for intraocular surgery
US4493698A (en) * 1980-11-03 1985-01-15 Cooper Medical Devices Method of performing opthalmic surgery utilizing a linear intra-ocular suction device
US4449550A (en) * 1981-11-02 1984-05-22 Optikon Oftalmologia, S.P.A. Control system for intraocular surgical device
US4757814A (en) * 1985-02-28 1988-07-19 Alcon Laboratories, Inc. Proportional control for pneumatic cutting device
US4841984A (en) * 1985-09-16 1989-06-27 Armoor Ophthalmics, Inc. Fluid-carrying components of apparatus for automatic control of intraocular pressure
US4768506A (en) * 1985-09-26 1988-09-06 Alcon Laboratories, Inc. Handpiece drive apparatus for powered surgical scissors
US5020535A (en) * 1985-09-26 1991-06-04 Alcon Laboratories, Inc. Handpiece drive apparatus for powered surgical scissors
US4696298A (en) * 1985-11-19 1987-09-29 Storz Instrument Company Vitrectomy cutting mechanism
JPH0350894Y2 (en) * 1987-05-13 1991-10-30
JPS63279843A (en) * 1987-05-13 1988-11-16 Tokyo Optical Co Ltd Operating cutter
US4819635A (en) * 1987-09-18 1989-04-11 Henry Shapiro Tubular microsurgery cutting apparatus
US4986827A (en) * 1987-11-05 1991-01-22 Nestle S.A. Surgical cutting instrument with reciprocating inner cutter
US4909249A (en) * 1987-11-05 1990-03-20 The Cooper Companies, Inc. Surgical cutting instrument
US4940468A (en) * 1988-01-13 1990-07-10 Petillo Phillip J Apparatus for microsurgery
US5024652A (en) * 1988-09-23 1991-06-18 Dumenek Vladimir A Ophthalmological device
US5061238A (en) * 1989-02-23 1991-10-29 Linvatec Corporation Surgical cutting instrument with titanium nitride coating on an inner tubular member
US5019035A (en) * 1989-06-07 1991-05-28 Alcon Surgical, Inc. Cutting assembly for surgical cutting instrument
JPH0337059A (en) * 1989-07-05 1991-02-18 Topcon Corp Operation cutter
US5226910A (en) * 1989-07-05 1993-07-13 Kabushiki Kaisha Topcon Surgical cutter
JPH0339158A (en) * 1989-07-07 1991-02-20 Topcon Corp Operating cutter
US5106364A (en) * 1989-07-07 1992-04-21 Kabushiki Kaisha Topcon Surgical cutter
US5059204A (en) * 1989-10-26 1991-10-22 Site Microsurgical Systems, Inc. Ocular cutter with enhanced cutting action
US5047008A (en) * 1989-10-27 1991-09-10 Storz Instrument Company Vitrectomy probe
US5176628A (en) * 1989-10-27 1993-01-05 Alcon Surgical, Inc. Vitreous cutter
JP3218064B2 (en) * 1991-12-04 2001-10-15 株式会社トプコン Surgical equipment
US5284472A (en) * 1992-10-30 1994-02-08 Allergan, Inc. Vitreous cutter
US5354268A (en) 1992-11-04 1994-10-11 Medical Instrument Development Laboratories, Inc. Methods and apparatus for control of vacuum and pressure for surgical procedures
WO1994026181A1 (en) * 1993-05-07 1994-11-24 Danek Medical, Inc. Surgical cutting instrument
US5423844A (en) * 1993-10-22 1995-06-13 Promex, Inc. Rotary surgical cutting instrument
US5380280A (en) * 1993-11-12 1995-01-10 Peterson; Erik W. Aspiration system having pressure-controlled and flow-controlled modes
US6188869B1 (en) * 1994-04-07 2001-02-13 Hark C. Chan Information distribution and processing system
US5520852A (en) * 1994-06-08 1996-05-28 Neste Oy Processible electrically conducting polyaniline compositions
US5474532A (en) * 1994-11-22 1995-12-12 Alcon Laboratories, Inc. Cutting blade for a vitreous cutter
US5630827A (en) * 1995-06-19 1997-05-20 Dutch Ophthalmic Research Center International Bv Vitreous removing apparatus
US5674194A (en) * 1995-10-25 1997-10-07 Alcon Laboratories Inc. Process control system
US5669923A (en) * 1996-01-24 1997-09-23 Gordon; Mark G. Anterior capsulotomy device and procedure
US5833643A (en) * 1996-06-07 1998-11-10 Scieran Technologies, Inc. Apparatus for performing ophthalmic procedures
US6010496A (en) * 1996-08-29 2000-01-04 Bausch & Lomb Surgical, Inc. Vitrectomy timing device with microcontroller with programmable timers
US5733297A (en) * 1996-09-10 1998-03-31 Medical Instrument Development Laboratories, Inc. Cutter for surgical probe
CN1260161A (en) * 1999-01-10 2000-07-19 姜宪委 Surgical instrument for tissue excision and system for using said instrument
US6704929B1 (en) * 1999-08-18 2004-03-09 Webtv Networks, Inc. Tracking viewing behavior of a home entertainment system
US6514268B2 (en) * 1999-08-30 2003-02-04 Alcon Universal Ltd. Method of operating microsurgical instruments
JP2001087303A (en) * 1999-09-27 2001-04-03 Nidek Co Ltd Ophthalmic surgery apparatus
US7051352B1 (en) * 2000-02-04 2006-05-23 Koninklijke Philips Electronics N.V. Adaptive TV program recommender
US6488695B1 (en) * 2000-08-17 2002-12-03 Alcon, Inc. Ophthalmologic surgical probe

Patent Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4577629A (en) 1983-10-28 1986-03-25 Coopervision, Inc. Surgical cutting instrument for ophthalmic surgery

Also Published As

Publication number Publication date
BRPI0707392A2 (en) 2011-05-03
DK1981416T3 (en) 2011-02-14
EP1981416A2 (en) 2008-10-22
WO2007092739A3 (en) 2007-12-06
AU2007212114B2 (en) 2012-12-20
CA2637816A1 (en) 2007-08-16
KR101324145B1 (en) 2013-11-01
ATE492225T1 (en) 2011-01-15
PL1981416T3 (en) 2011-08-31
BRPI0707392B8 (en) 2021-06-22
KR20080091516A (en) 2008-10-13
EP1981416B1 (en) 2010-12-22
RU2432929C2 (en) 2011-11-10
US8187293B2 (en) 2012-05-29
CA2637816C (en) 2014-03-18
AU2007212114A1 (en) 2007-08-16
US20070185512A1 (en) 2007-08-09
CN101378703A (en) 2009-03-04
CY1111329T1 (en) 2015-08-05
CN101378703B (en) 2011-03-23
PT1981416E (en) 2011-02-23
BRPI0707392B1 (en) 2018-05-02
DE602007011395D1 (en) 2011-02-03
JP5296556B2 (en) 2013-09-25
RU2008135997A (en) 2010-03-20
ES2356785T3 (en) 2011-04-13
EP1981416A4 (en) 2009-05-27
SI1981416T1 (en) 2011-04-29
JP2009525783A (en) 2009-07-16

Similar Documents

Publication Publication Date Title
CA2637816C (en) Microsurgical instrument
US20070185514A1 (en) Microsurgical instrument
KR101192506B1 (en) Modular design for ophthalmic surgical probe
US20100312169A1 (en) Method of operating a vitrectomy probe
US9060841B2 (en) Enhanced flow vitrectomy probe
US20080172078A1 (en) Reduced traction vitrectomy probe
JP2010508073A5 (en)
WO2018138592A1 (en) Vacuum control for a vitrectomy probe

Legal Events

Date Code Title Description
WWE Wipo information: entry into national phase

Ref document number: 2637816

Country of ref document: CA

Ref document number: 2007763558

Country of ref document: EP

WWE Wipo information: entry into national phase

Ref document number: 2007212114

Country of ref document: AU

WWE Wipo information: entry into national phase

Ref document number: 12008501734

Country of ref document: PH

Ref document number: 3047/KOLNP/2008

Country of ref document: IN

WWE Wipo information: entry into national phase

Ref document number: MX/a/2008/009696

Country of ref document: MX

WWE Wipo information: entry into national phase

Ref document number: 2008553507

Country of ref document: JP

WWE Wipo information: entry into national phase

Ref document number: 200780004672.8

Country of ref document: CN

NENP Non-entry into the national phase

Ref country code: DE

ENP Entry into the national phase

Ref document number: 2007212114

Country of ref document: AU

Date of ref document: 20070201

Kind code of ref document: A

WWE Wipo information: entry into national phase

Ref document number: 1020087021825

Country of ref document: KR

ENP Entry into the national phase

Ref document number: 2008135997

Country of ref document: RU

Kind code of ref document: A

ENP Entry into the national phase

Ref document number: PI0707392

Country of ref document: BR

Kind code of ref document: A2

Effective date: 20080731