U.S. patent application number 10/172191 was filed with the patent office on 2002-10-17 for pulsed vacuum cataract removal system.
Invention is credited to Ross, Rod.
Application Number | 20020151835 10/172191 |
Document ID | / |
Family ID | 23969381 |
Filed Date | 2002-10-17 |
United States Patent
Application |
20020151835 |
Kind Code |
A1 |
Ross, Rod |
October 17, 2002 |
Pulsed vacuum cataract removal system
Abstract
An ophthalmic cutter system that includes a cutter adapted to
cut tissue such as a cataract lens and an irrigation handpiece
adapted to hold the lens. The irrigation handpiece may be coupled
to an irrigation system that introduces an irrigation fluid to the
surgical site through the handpiece. The cutter may be coupled to
an aspiration system that provides vacuum pulses to the surgical
site. The vacuum pulses may pull tissue into a wire located at a
distal end of a cutter cannula. The pulses may break and emulsify
the tissue which is then aspirated through the cannula by the
aspiration system. The wire may be connected to a controller that
provides a current which is transformed into heat. The heat may
assist in emulsifying the tissue.
Inventors: |
Ross, Rod; (Mission Viejo,
CA) |
Correspondence
Address: |
IRELL & MANELLA LLP
840 NEWPORT CENTER DRIVE
SUITE 400
NEWPORT BEACH
CA
92660
US
|
Family ID: |
23969381 |
Appl. No.: |
10/172191 |
Filed: |
June 13, 2002 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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10172191 |
Jun 13, 2002 |
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09495633 |
Feb 1, 2000 |
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6428508 |
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Current U.S.
Class: |
604/22 |
Current CPC
Class: |
A61M 1/75 20210501; A61M
1/0058 20130101; A61F 9/00763 20130101 |
Class at
Publication: |
604/22 |
International
Class: |
A61B 017/20 |
Claims
What is claimed is:
1. An aspiration system that can be coupled to a medical handpiece,
comprising: an aspiration tube; a vacuum generator adapted to
create a vacuum pressure within said aspiration tube; and, a pulse
generator adapted to create a plurality of vacuum pulses within
said aspiration tube.
2. The aspiration system of claim 1, wherein the vacuum pulses
decrease the pressure within said aspiration tube.
3. The aspiration system of claim 1, wherein said pulse generator
is coupled to an input device that can be manipulated to vary a
repetition rate of the vacuum pulses.
4. The aspiration system of claim 3, wherein said input device is a
foot pedal.
5. An medical handpiece, comprising: a first cannula that has an
inner passage which is in fluid communication with a distal
opening; and, a wire that extends across said distal opening.
6. The handpiece of claim 5, further comprising a second cannula
that extends over said first cannula.
7. The handpiece of claim 6, wherein said second cannula has a
plurality of external teeth.
8. The handpiece of claim 6, wherein said first cannula can be
rotated within said second cannula.
9. A tissue removal system, comprising: a cutter adapted to cut a
tissue; an irrigation handpiece adapted to hold the tissue; an
aspiration system coupled to said cutter; and, an irrigation system
coupled to said irrigation handpiece.
10. The system of claim 9, wherein said aspiration system includes
an aspiration tube, a vacuum generator adapted to create a vacuum
pressure within said aspiration tube, and a pulse generator adapted
to create a plurality of vacuum pulses within said aspiration
tube.
11. The system of claim 10, wherein the vacuum pulses decrease the
pressure within said aspiration tube.
12. The system of claim 10, wherein said pulse generator is coupled
to an input device that can be manipulated to vary a repetition
rate of the vacuum pulses.
13. The system of claim 12, wherein said input device is a foot
pedal.
14. The system of claim 9, wherein said cutter includes a first
cannula that has an inner passage in fluid communication with a
distal opening, and a wire that extends across said distal
opening.
15. The system of claim 14, further comprising a second cannula
that extends over said first cannula.
16. The system of claim 15, wherein said second cannula has a
plurality of external teeth.
17. The system of claim 15, wherein said first cannula can be
rotated within said second cannula.
18. A medical cutter, comprising: a first cannula that has an inner
passage that is in fluid communication with a distal opening; a
wire that extends across said distal opening; an aspiration tube
that is in fluid communication with said inner passage; a vacuum
generator adapted to create a vacuum pressure within said
aspiration tube; and, a pulse generator adapted to create a
plurality of vacuum pulses within said aspiration tube.
19. The cutter of claim 18, wherein the vacuum pulses decrease the
pressure within said aspiration tube.
20. The cutter of claim 18, wherein said pulse generator is coupled
to an input device that can be manipulated to vary a repetition
rate of the vacuum pulses.
21. The cutter of claim 20, wherein said input device is a foot
pedal.
22. The cutter of claim 18, further comprising a second cannula
that extends over said first cannula.
23. The cutter of claim 22, wherein said second cannula has a
plurality of external teeth.
24. The cutter of claim 22, wherein said first cannula can be
rotated within said second cannula.
25. A medical device, comprising: a first cannula that has an inner
passage which is in fluid communication with a distal opening; a
heating element that is coupled to said first cannula; and, a
controller that provides energy to said heating element.
26. The device of claim 25, wherein said heating element is a wire
that extends across said distal opening.
27. The device of claim 25, further comprising a second cannula
that extends over said first cannula.
28. The device of claim 25, wherein said second cannula has a
plurality of external teeth.
29. The device of claim 25, wherein said first cannula can be
rotated within said second cannula.
Description
BACKGROUND OF THE INVENTION
[0001] 1. Field of the Invention
[0002] The present invention relates to a system for removing
tissue from the human body.
[0003] 2. Background Information
[0004] Tissue, including cataract lenses, are typically removed
with an ultrasonically driven handpiece. For example, in a cataract
procedure, it is commonly referred to as phacoemulsification. A
phaco handpiece includes a tip that is inserted through an incision
formed in the cornea. The tip is oscillated by a driver unit at an
ultrasonic frequency. The oscillating tip breaks and emulsifies the
lens.
[0005] The tip is coupled to an irrigation system that introduces
irrigation fluid into the anterior chamber of the eye. The
irrigation fluid cools the tip and maintains the ocular pressure of
the anterior chamber. The irrigation fluid flows through an annular
channel formed between the oscillating tip and an external
protective sleeve. The sleeve is typically constructed from a
material with a low coefficient of thermal conductivity to reduce
the amount of heat that flows into the cornea. Excessive heating
may permanently damage the eye.
[0006] The tip is also coupled to an aspiration system that pulls
the emulsified tissue and irrigation fluid out of the anterior
chamber. The emulsified tissue and irrigation fluid flow through an
inner channel in the oscillating tip.
[0007] An intraocular lens is implanted into the eye after the
cataract lens is emulsified and removed. It is desirable to reduce
the size of the incision formed in the eye to reduce post-operative
complications. There have been developed intraocular lenses that
can be inserted through an incision approximately 2.5 millimeters
(mm). Most phaco tips require an incision of 3 mm. It is difficult
to further reduce the diameter of both the tip and the outer sleeve
of a phaco tip to fit the 2.5 mm profile. It would be desirable to
provide an ophthalmic cutting system that would require an incision
smaller than incisions formed in prior art procedures. It would
also be desirable to provide an ophthalmic cutting system that did
not generate heat at the corneal incision. Other types of
procedures would be enhanced by similar improvements.
SUMMARY OF THE INVENTION
[0008] One embodiment of the present invention is an ophthalmic
cutter system that includes a cutter adapted to cut tissue such as
a cataract lens and an irrigation handpiece adapted to hold the
lens. The irrigation handpiece may be coupled to an irrigation
system that introduces an irrigation fluid to the surgical site
through the handpiece. The cutter may be coupled to an aspiration
system that provides vacuum pulses to the surgical site. The vacuum
pulses may pull tissue into a wire located at a distal end of a
cutter cannula. The pulses may break and emulsify the tissue which
is then aspirated through the cannula by the aspiration system. The
wire may be connected to a controller that provides a current which
is transformed into heat. The heat may assist in emulsifying the
tissue.
BRIEF DESCRIPTION OF THE DRAWINGS
[0009] FIG. 1 is a schematic of an embodiment of an ophthalmic
cutter system of the present invention;
[0010] FIG. 2 is a perspective view of an embodiment of a cutter of
the system;
[0011] FIG. 3 is a graph showing vacuum pressure versus time within
an aspiration line of the system;
[0012] FIG. 4 is a top view of an embodiment of a pulse
generator.
DETAILED DESCRIPTION
[0013] Referring to the drawings more particularly by reference
numbers, FIG. 1 shows an embodiment of an ophthalmic cutter system
10 of the present invention. The cutter system 10 may be used by a
surgeon to cut and emulsify tissue. By way of example, the cutter
system 10 may be employed to emulsify and aspirate a cataract lens
within the eye.
[0014] The system 10 may include a cutter 12 that is coupled to an
aspiration system 14. The cutter 12 may include a tip 16 that
extends from a handpiece 18 adapted to be held by a surgeon. The
tip 16 can be inserted into the eye to emulsify a lens.
[0015] FIG. 2 shows an embodiment of a cutter tip 16. The tip 16
may include an inner cannula 20 that extends through an inner
passage 22 of an outer cannula 24. The inner cannula 20 may have an
inner passage 26 in fluid communication with an opening 28 located
at the distal end of the tip 16. The inner cannula 20 may have a
wire or wires 30 that extend across the opening 28. Although a pair
of wires is shown, it is to be understood that a different number
of wires may be employed in the present invention.
[0016] The outer cannula 24 may have a plurality of teeth 32 that
can become embedded into tissue. The outer cannula 24 may be fixed
to the handpiece 18 shown in FIG. 1. The inner cannula 20 may be
connected to a knob 34 that allows a surgeon to rotate the cannula
20. The cutter 12 may also have a bearing assembly (not shown) that
allows the inner cannula 20 to rotate relative to the outer cannula
24. The inner cannula 20 may be rotated relative to the outer
cannula 24 to induce a cutting action across the wires 30.
[0017] The aspiration system 14 may include an aspiration tube 36
that is coupled to the inner passage 26 of the inner cannula 20.
The aspiration tube 36 is connected to a vacuum pump 38 and a
collection canister 40. By way of example, the vacuum pump 38 may
be a peristaltic pump. The vacuum pump 38 creates a vacuum pressure
within the aspiration tube 36 and a flow of fluid from the opening
28 of the inner cannula 20 to the canister 40. The aspiration
system 14 can pull emulsified tissue and fluid through the inner
passage 26 and into the canister 40.
[0018] The aspiration system 14 may also have a pulse generator or
other device 42 that can create vacuum pulses within the aspiration
tube 36 and the inner passage 26. The pulse generator 42 may create
a series of vacuum pulses as shown in FIG. 3. The vacuum pulses
reduce the pressure within the tube 36. Although square pulses are
shown, it is to be understood that the pulses may have a variety of
different waveforms. For example, the pulses may have a sawtooth
waveform.
[0019] The pulse generator 42 and vacuum pump 38 may be connected
to a controller 44. The controller 44 can control the speed of the
pump 38 and the corresponding steady state vacuum pressure within
the aspiration tube 36. The controller 44 can also control the
repetition rate of the pulses generated by the pulse generator 42.
The vacuum pressure and pulse rate can be varied by an operator
through external knobs 46 and 48, respectively, located on a
console 50. The vacuum pressure and pulse rate may also be
controlled through a foot pedal 52 connected to the controller 44.
The foot pedal 52 and controller 44 may operate in two modes. The
steady state vacuum pressure may be varied in the first mode. The
pulse rate may be varied in the second mode. The first mode can be
initiated by depressing the foot pedal 52. Further depression of
the foot pedal 52 may initiate the second mode. The system 10 may
also be configured so that the operator can simultaneously vary the
vacuum pressure and the pulse rate.
[0020] The controller 44 may also be electrically connected to the
wire(s) 30. The controller 44 may provide a current to the wire(s)
30 to generate heat. The heat can assist in emulsifying the tissue.
The current may be direct current (DC) or alternating current (AC)
including AC current at a radio frequency (RF). The amplitude
and/or frequency of the current can be controlled through the foot
pedal 52 or knobs. Although a connection between the controller 44
and wire(s) 30 is described, it is to be understood that the
heating element may be another element or device.
[0021] The system 10 may have an irrigation system 54. The
irrigation system 54 may have an aspiration handpiece 56 adapted to
hold the tissue during emulsification. The handpiece 56 may have a
jaw portion 58 that extends from a handle portion 60. The handle
portion 60 may be held by the surgeon. The handpiece 56 may further
have an inner passage 62 that is in fluid communication with an
opening 64. The inner passage 62 is in fluid communication with an
irrigation tube 66. The irrigation tube 66 is connected to an
irrigation bag 68. The irrigation bag 68 may gravity feed
irrigation fluid into the inner passage 62 and through the opening
64.
[0022] In operation, the tip 16 may be inserted through an incision
formed in the eye. Because the tip of the present invention does
not have the outer sleeve typically found in phaco tip of the prior
art, the tip 16 of the present invention may be constructed so that
the incision is on the order of 1 millimeter. This incision size is
smaller than incisions found in the prior art. Especially with
respect to phaco procedures which utilize phaco devices that have
an outer irrigation sleeve. The outer sleeve of phaco tips
increases the overall diameter of the tips and the size of the
incision. By eliminating the outer sleeve, the device of the
present invention reduces the overall diameter of the tip and the
size of the incision.
[0023] The irrigation handpiece 54 can be introduced into the
anterior chamber through an opening separate from the incision used
for the aspiration tip. The irrigation system 54 provides
irrigation fluid to the anterior chamber to maintain the pressure
therein. The vacuum pump 38 may be actuated to create a flow of
fluid from the anterior chamber to the canister 40 by depressing
the foot pedal 52. The surgeon can manipulate the tip 16 so that
the teeth of the outer cannula 20 become embedded into the lens of
the eye. The pulse generator 42 can be activated to create the
vacuum pulses by further depressing the foot pedal 52. The vacuum
pulses repetitively pull the lens into the wires to cut the lens
tissue. The pulsing effect enhances the vacuum energy, resulting in
added efficiency of tissue removal. The surgeon can also rotate the
inner cannula 20 to further induce cutting of the lens. The broken
lens is then aspirated through the inner passage 26 and into the
canister 40.
[0024] The present invention is to be distinguished from
ultrasonically driven handpieces which move a tip into and out of
the lens with energy referred to as cavitation. The movement of
prior art tips relative to the outer protective sleeves generates
heat that may damage the eye typically through thermal shrinkage of
the cornea. The present invention pulls the lens into and away from
the tip and thus does not generate the heat found in ultrasonically
driven phaco tips of the prior art.
[0025] FIG. 4 shows an embodiment of a pulse generator 42. The
generator 42 may include a syringe 70 that is connected to the
aspiration tube 36. The generator 42 may further have a plurality
of rotating weights 72 that repetitively strike a plunger 74 of the
syringe 70. A vacuum pulse is created each time a weight engages
the plunger 74. The weights 72 may be connected to a rotary motor
76 by a plurality of spring rods 78. The speed of the motor 76 can
be controlled by the controller 44 shown in FIG. 1. The plunger 74
may be biased in an inward direction by a biasing spring (not
shown).
[0026] While certain exemplary embodiments have been described and
shown in the accompanying drawings, it is to be understood that
such embodiments are merely illustrative of and not restrictive on
the broad invention, and that this invention not be limited to the
specific constructions and arrangements shown and described, since
various other modifications may occur to those ordinarily skilled
in the art.
[0027] For example, although the system 10 has been described for
use in an eye, it is to be understood that the tip and other
components can be used to cut, emulsify, etc. tissue in other
areas. For example, the system could be used to perform procedures
on a prostate or a spinal disk and liposuction.
* * * * *