NL2034561B1

NL2034561B1 - An ophthalmic surgery instrument

Info

Publication number: NL2034561B1
Application number: NL2034561A
Authority: NL
Inventors: Attinger Jürg; Molenaar Pieter
Original assignee: D O R C Dutch Ophthalmic Res Center International B V
Priority date: 2023-04-12
Filing date: 2023-04-12
Publication date: 2024-10-24

Abstract

The invention relates to an ophthalmic surgery instrument, comprising a handling unit, a surgical module provided on the handling unit, and a shaft at least partially surrounding the surgical module, wherein the surgical module and the shaft are mutually movable relative. The handling unit further comprises a guiding element arranged at a distal end of the handling unit. The handling unit comprises an actuation unit having a plurality of actuation arms, and a driving unit for driving the shaft relative to the guiding element back and forth through the central bore of the guiding element, wherein the driving unit includes a set of pivoting joint elements having ends that are pivotably connected to corresponding actuation arms.

Description

P134892NL00

Title: An ophthalmic surgery instrument

The invention relates to an ophthalmic surgery instrument, comprising a handling unit having a longitudinal axis, a surgical module provided on the handling unit and extending away therefrom along the longitudinal axis thereof, and a shaft at least partially surrounding the surgical module, wherein the surgical module and the shaft are mutually movable relative along the longitudinal axis of the handling unit, a guiding element arranged at a distal end of the handling unit, the guiding element being provided with a central bore that is traversed by the surgical module and the shaft extending from the handling unit outwardly along the longitudinal axis thereof, wherein the handling unit comprises an actuation unit comprising a plurality of actuation arms arranged around the longitudinal axis of the handling unit, and a driving unit arranged to, upon manual actuation of the actuation unit, drive the shaft relative to the guiding element back and forth through the central bore of the guiding element.

The above ophthalmic surgery instrument is known for example for ophthalmic surgery in the interior of the eye wherein the surgical module includes a movable distal portion such as a forceps. By providing a shaft partially surrounding the surgical module such that the shaft and the surgical module are movable relative to each other, the movable distal portion can selectively at least partly be covered or closed, or exposed or opened by the shaft, e.g. for actuating the surgical module and/or for inserting or removing the surgical module from the eye.

There is an ongoing need to improve manual operation of the ophthalmic surgery instrument.

It is an object of the present invention to provide an ophthalmic surgery instrument having improved manual operation characteristics.

Therefore, according to the invention, an ophthalmic surgery instrument is provided, comprising a handling unit having a longitudinal axis, a surgical module provided on the handling unit and extending away therefrom along the longitudinal axis thereof, and a shaft at least partially surrounding the surgical module, wherein the surgical module and the shaft are mutually movable relative along the longitudinal axis of the handling unit, a guiding element arranged at a distal end of the handling unit, the guiding element being provided with a central bore that is traversed by the surgical module and the shaft extending from the handling unit outwardly along the longitudinal axis thereof, wherein the handling unit comprises an actuation unit comprising a plurality of actuation arms arranged around the longitudinal axis of the handling unit, the actuation arms each having a proximal end and a distal end, and a driving unit arranged to, upon manual actuation of the actuation unit, drive the shaft relative to the guiding element back and forth through the central bore of the guiding element, the driving unit including a radial-to-axial linkage constructed and arranged to convert a radial movement provided by the actuation unit through the actuation arms to axial movement of the shaft with respect to the surgical module, wherein the radial-to-axial linkage comprises a set of pivoting joint elements, each pivoting joint element having a first end and a second end, said second end being associated with the shaft, wherein the number of pivoting joint elements corresponds with the number of actuation arms, and wherein the first end of each pivoting joint element is pivotably connected to a corresponding actuation arm.

By providing the driving unit with a radial-to-axial linkage comprising a set of pivoting joint elements having first and second ends, the first ends being pivotably connected to corresponding arms and the second ends being associated with the shaft, operation of the instrument can be improved, e.g. in that operation of the shaft can be performed easily and reliably, based on a robust design.

Advantageously, the first end of the pivoting joint element 1s connected to the corresponding actuation arm so as to transfer both a pushing force from the actuation arm and a pulling force from the pivoting joint element, such that the actuation arms move as an ensemble. The pivotable connection can e.g. be realized using an axle bearing mechanism or a hinge structure.

Preferably, the first end of the pivoting joint element is removably connected to the corresponding actuation arm, for ease of production.

Further advantageous embodiments according to the invention are described in the following claims.

It should be noted that the technical features described above or below may each on its own be embodied in an ophthalmic surgery instrument and/or in a method, i.e. isolated from the context in which it is described, separate from other features, or in combination with only a number of the other features described in the context in which it is disclosed. Each of these features may further be combined with any other feature disclosed, in any combination.

The invention will be further elucidated on the basis of exemplary embodiments which are represented in the drawings. The exemplary embodiments are given by way of non-limitative illustrations of the invention. In the drawings:

Fig. 1 shows a schematic cross sectional view of an ophthalmic surgery instrument according to the invention;

Fig. 2 shows a schematic cross sectional partial view of the ophthalmic surgery instrument shown in Fig. 1, in a compressed state;

Fig. 3 shows a schematic cross sectional partial view of the ophthalmic surgery instrument shown in Fig. 1, in a decompressed state;

Fig. 4 shows a first schematic perspective view of a pivoting joint element in the ophthalmic surgery instrument shown in Fig. 1;

Fig. 5 shows a second schematic perspective view of a pivoting joint element in the ophthalmic surgery instrument shown in Fig. 1;

Fig. 6 shows a third schematic perspective view of a pivoting joint element in the ophthalmic surgery instrument shown in Fig. 1, and

Fig. 7 shows a schematic perspective view of another ophthalmic surgery instrument according to the invention.

In the figures identical or corresponding parts are represented with the same reference numerals. The drawings are only schematic representations of embodiments of the invention.

Figure 1 shows a schematic cross sectional view of an ophthalmic surgery instrument 1 according to the invention. The instrument 1 includes a handling unit 2 having a longitudinal axis L. Further, the instrument 1 includes a surgical module 3 provided on the handling unit 2 and extending away therefrom along the longitudinal axis L thereof, and a shaft 4 that at least partially surrounds the surgical module 3. The surgical module 3 and the shaft 4 are mutually movable along the longitudinal axis L of the handling unit 2. In the shown embodiment, the shaft 4 moves along the longitudinal axis L relative to the handling unit 2, while the surgical module 3 remains mainly stationary along the longitudinal axis L relative to the handling unit 2.

The ophthalmic surgery instrument 1 also includes a guiding element 5 arranged at a distal end 6 of the handling unit 2, the guiding element 5 being provided with a central bore 7 that is traversed by the surgical module 3 and the shaft 4 extending from the handling unit 2 outwardly along the longitudinal axis L thereof.

The handling unit 2 further comprises an actuation unit 9 having a plurality of actuation arms 9a-d, also referred to as levers, arranged along the circumferential direction C around the longitudinal axis L of the handling unit 2. The actuation arms or levers 9, also referred to as basket, each have a proximal end 9” and a distal end 9”. Generally, the actuation arms 9 are bendable, and adjustable between a compressed state and a decompressed state, wherein the actuation arms 9 in the compressed state are closer to the longitudinal axis L of the handling unit 2 than in the decompressed state. Preferably, the actuation arms 9 are biased towards the decompressed state.

The actuation unit 9 further includes a proximal stationary 5 element 13 that remains axially stationary relative to the handling unit 2.

The arm proximal ends 9? of the actuation arms are connected to the proximal stationary element 13, e.g. vla respective intermediate hinges, while the arm distal ends 9? of the actuation arms 9 are free ends.

The handling unit 2 also comprises a driving unit 8 for driving, upon manual actuation of the actuation unit 9, the shaft 4 relative to the guiding element 5 back and forth through the central bore 7 of the guiding element 5.

Figure 2 shows a schematic cross sectional partial view of the ophthalmic surgery instrument 1 shown in Fig. 1, in a compressed state. In

Fig. 2, the driving unit 8 is more visible than in Fig. 1.

As shown in Fig. 2, the driving unit 8 includes a radial-to-axial linkage that is constructed and arranged to convert a radial movement provided by the actuation unit 9 through the actuation arms 9 to axial movement of the shaft 4 with respect to the surgical module 3. The radial- to-axial linkage 9 has a set of pivoting joint elements 8a-d, also referred to as crank arms, each pivoting joint element 8a-d having a first end 8 actuated by the actuation unit 9, and a second end 8” associated with the shaft 4. The number of pivoting joint elements or crank arms 8 is the same as the number of actuation arms or levers 9, such that each actuation arm 9 actuates a corresponding pivoting joint element 8. As described in more detail below, the first ends 8’ of the pivoting joint elements 8 are pivotably connected to corresponding actuation arms 9, the actuation unit 9 directly driving the driving unit 8.

Further, in the shown embodiment, the guiding element 5 includes a cavity 14 aligned with the central bore 7, wherein the driving unit 8 further includes an annular holding element 15 received in the cavity 14 of the guiding element 5, the annular holding element 15 being fixedly attached to the shaft 4 and associated with the second ends 8” of the pivoting joint elements or crank arms 8a-d.

Upon adjusting the actuation arms 9 from the decompressed state towards the compressed state, by manually compressing the actuation arms 9, the second end 8” of the pivoting joint elements 8 moves along the longitudinal axis L of the handling unit 2, away from the proximal stationary element 13, and towards the guiding element 5, the result as shown in Fig. 2. In this process, the first ends 8’ of the pivoting joint elements 8 pivot with respect to the second ends 8” towards the longitudinal axis L.

The instrument 1 further has a spring element 16 received in the cavity 14 for biasing the annular holding element 15 towards the handling unit 2. Similarly, the actuation arms 9 are biased towards the decompressed state. Then, the actuation arms 9 are in the decompressed state or are at least tending towards said decompressed state, when not manually actuated.

In the shown embodiment, refer in particular to Fig. 3, the number of visible actuation arms 9 is four, while the total number of actuation arms 9 of the actuation unit 9, around the longitudinal axis L of the handling unit 2, in the circumferential direction C, is eight. The number of actuation arms 9 may be more or less than eight. Preferably, the number of actuation arms 9 is even, such as four, six or eight. Then, the circumferential positions of the individual actuation arms can be chosen, preferably evenly distributed in the circumferential direction C, in such a manner that each actuation arm forms, together with another actuation arm positioned at circa 180 degrees in the circumferential direction C, a pair of opposing actuation arms 9. The actuation arms 9 can be formed as pairs of actuation arms. A user of the ophthalmic surgery instrument 1 may operate a pair of actuation arms by pressing said specific pair of actuation arms simultaneously. The multiple pairs of opposing actuation arms each have a specific circumferential orientation with respect to the surgical module. As an example, in the case of eight actuation arms, the user may select a specific a specific circumferential orientation of the arms 9 with respect to the surgical module 3, e.g. circa 0 degrees, circa 45 degrees, circa 90 degrees or circa 135 degrees in the circumferential direction C. Upon compressing the selected pair of actuation arms 9 the annular holding element 15 moves along the longitudinal axis L towards the guiding element 5, towards an extended axial position E. Alternatively, the actuation unit may have an uneven number of arms 9. Generally, the number of actuation arms 9 is at least two or three.

Figure 3 shows a schematic cross sectional partial view of the ophthalmic surgery instrument shown in Fig. 1, in a decompressed state.

Here, the second ends 8” of the pivoting joint elements 8 are located in a rest axial position R along the longitudinal axis L. The first ends 8 of the pivoting joint elements 8 are pivotably connected to the corresponding actuation arms 9, e.g. removably or permanently, so as to transfer both a pushing force from the actuation arm 9 and a pulling force from the pivoting joint element 8. The pushing force is applied by the actuation arm 9, upon manual actuation, moving the actuation arm 9 towards the compressed state. Then, the annular holding element 15 moves away from the handling unit 2 pulling the second ends 8” of all pivoting joint elements 8 also away from the handling unit 2. As a consequence, the first ends 8 and the corresponding actuation arms 9 are pulled radially towards the longitudinal axis L, into the compressed state. Hence, the actuation arms 9 are mutually coupled and move as an ensemble when at least a subset of actuation arms 9 is manually compressed.

Fig. 4 shows a first schematic perspective view of a pivoting joint element 8 in the ophthalmic surgery instrument 1 shown in Fig. 1. Here, the first end 8’ of the pivoting joint element 8 is pivotably coupled to the corresponding actuation arm 9 via an axle bearing mechanism. The first end 8’ is mainly formed as a disc 18 received in a corresponding cavity 19 formed on the actuation arm 9. The first end 8’ further has a notch 20, and the actuation arm 9 has block shaped structures 214,b locking the disc 18 in the cavity 19 when the pivoting joint element 8 1s in operational use, 1.e. swiveling in a limited angle range of operation. During assembly and de- assembly, the pivoting joint element 8 can be brought in an orientation outside said angle range of operation, for positioning and releasing, respectively, the first end 8 from the actuation arm 9.

Fig. 5 shows a second schematic perspective view of a pivoting joint element in the ophthalmic surgery instrument shown in Fig. 1. Here, both the first end 8’ and the second end 8” of the pivoting joint element 8 are shown. The pivoting connection structure of the second end 8”, to the annular holding element 15, is similar to the pivoting connection structure of the first end 8 to the corresponding actuation arm 9, the second end 8” having a similar disc 18’, notch 20’ and corresponding receiving cavity 19° and blocking structures 21’a,b.

Figure 6 shows a third schematic perspective view of a pivoting joint element 8 in the ophthalmic surgery instrument 1 shown in Fig. 1, wherein the first end 8° of the pivoting joint element 8 is shown in more detail.

Figure 7 shows a schematic perspective view of another ophthalmic surgery instrument 1 according to the invention. Here, the first end 8 of the pivoting joint element 8 is connected to the corresponding actuation arm 9 via another axle bearing mechanism. The actuation unit has six actuation arms 9a-f that are connected to the first end 8’ of the corresponding pivoting joint elements 8. Each first end 8’ is provided with a ring-shaped element 22 that is bearingly and rotatably received and connected in curved cavity 23 formed on the corresponding actuation arm 9 such that both a pulling force and a pushing force can be transferred through the hingeable connection.

It is noted that the cavity 19 or bearing can be formed on the actuation arm 9, as shown in the implementations illustrated in Figs. 4-7, or alternatively, on the first end 8 of the pivoting joint element 8. It is further noted that the pivotably connection of the first end 8 to the actuation arm 9 can be implemented in another manner, e.g. using a hinge structure.

The actuation arms 9 are integrally formed. By providing the actuation arms 9 with portions having different stiffness, a bendable arm structure is realized. By pressing the arms radially inwardly, at least portions of the arms 9 bend radially inwardly. In an alternative embodiment, the actuation arms may each include at least two arm segments and at least a hinge 9” interconnecting the at least two arm segments, the arm segments having a stiffness that is larger than a stiffness of the hinge. The arm segments can be made separately and assembled to each other, via the hinge, or, alternatively, can be made as an integral part having locally different stiffness values. In principle, further arm segments can be added to the two segment arm structure, e.g. via an additional hinge.

A local stiffness can be set by making the arm thinner or thicker and/or by changing its material. As a further alternative, the actuation arm can be formed without hinge, however preferably such that the actuation arm bends upon manual actuation.

The actuation arms 9 can be designed in a way to provide different material properties to set the haptic conditions of the mechanism.

Further, the actuation arms 9 or basket can be personalized for instance as a 2k injected part with variable and different hardness and/or flexibility of the at least 2 arm segments 9, 9”.

In the shown embodiment, the guiding element 5 is stationary relative to the handling unit 2.

As discussed, the ensemble of the actuation unit 9 and the driving unit 8 are arranged for driving the shaft 4, in particular for driving the shaft 4 away from the handling unit 2 upon manual actuation of the actuation unit 9. Here, the surgery unit 3 may be axially stationary relative to the handling unit 2. It is noted however, that, in principle, the ensemble of the actuation unit 9 and the driving unit 8 may be arranged for moving the surgery unit 3 along the longitudinal axis L, while the shaft 4 remains axially stationary relative to the handling unit 2. Then, the driving unit 8 may be axially coupled, directly or indirectly, with the surgery unit 3.

In the shown embodiment, in particular referring to Fig. 2, the guiding element 5 is provided with a nosecone 29 comprising at least one cone-shaped portion 30 or truncated cone-shaped portion having a proximal end 31 and a distal end 32, wherein the nosecone is located at a distal position with respect to the actuation arms 9.

In a particular embodiment, in a decompressed state, a distal end 9D of at least one of the actuation arms 9 is located at a first axial distance

Al from the proximal end 31 of the cone-shaped part 30 of the nosecone 29 between about 8 mm and about 16 mm. Further, the distal end 9 of at least one of the actuation arms 9 may be located at a second axial distance A2 from the distal end 32 of the cone-shaped part 30 of the nosecone 29 between about 12mm and about 25mm. Preferably, the cone-shaped portion 30 of the nosecone 29 has an axial length A of between about 2 mm and about 10 mm.

The surgical module 3 is formed as an integral part or as an assemblage of separate parts. The surgical module 3 may have a rod that is provided, at a distal end thereof, with an operating unit, such as a forceps, pair of scissors, fibre, scraper, vertical scissor or fiber assembly. At least one the actuation arms 9 of the actuation unit may have an outer or exterior contour deviating from an outer or exterior contour of other actuation arms, such that the at least one actuation arm is aligned with a circumferential orientation of the operating unit of the surgical module 3, e.g. the orientation of the forceps. By moving the shaft 4 relative to the surgical module 3, the distal end can selectively be exposed or opened so as to actuate or operate the operating unit, e.g. for grabbing and/or releasing tissue.

The invention is not restricted to the embodiments described herein. It will be understood that many variants are possible.

These and other embodiments will be apparent for the person skilled in the art and are considered to fall within the scope of the invention as defined in the following claims. For the purpose of clarity and a concise description features are described herein as part of the same or separate embodiments. However, it will be appreciated that the scope of the invention may include embodiments having combinations of all or some of the features described.

Claims

Conclusions

1. An ophthalmic surgical instrument comprising: - an operating unit having a longitudinal axis, - a surgical module provided on the operating unit and extending therefrom along the longitudinal axis thereof, and - a shaft at least partially surrounding the surgical module, the surgical module and the shaft being movable relative to each other along the longitudinal axis of the operating unit, - a guide member disposed at a distal end of the operating unit, the guide member having a central hole pierced through the surgical module and the shaft extending outwardly from the operating unit along the longitudinal axis thereof, the operating unit comprising: - a trigger unit comprising a plurality of trigger arms disposed about the longitudinal axis of the operating unit, and - a drive unit adapted to, upon manual actuation of the trigger unit, drive the shaft relative to the guide member back and forth through the central hole of the guide member, the drive unit comprising a radial-to-axial linkage constructed and arranged to convert radial movement provided by the engagement unit through the engagement arms into axial movement of the shaft relative to the surgical module, the radial-to-axial linkage including a series of pivoting linkages, each pivoting linkage having a first end and a second end, said second end being associated with the shaft, the plurality of pivoting linkages corresponding to the plurality of engagement arms, and the first end of each pivoting linkage being pivotally connected to a corresponding engagement arm.

2. The ophthalmic surgical instrument of claim 1, wherein the first end of the hinged connecting element is releasably connected to the corresponding attachment arm.

38. The ophthalmic surgical instrument of claim 1 or 2, wherein the first end of the pivoting linkage is connected to the corresponding engagement arm to transmit both a compressive force from the engagement arm and a tensile force from the pivoting linkage.

4. An ophthalmic surgical instrument according to any one of claims 1 to 3, wherein the first end of the pivoting connecting element is connected to the corresponding engagement arm via an axle-mounted mechanism.

5. An ophthalmic surgical instrument according to any one of claims 1 to 3, wherein the first end of the hinged connecting element is connected to the corresponding attachment arm via a hinge structure.

6. An ophthalmic surgical instrument according to any preceding claim, wherein the engagement arms are adjustable between a compressed position and a relaxed position, the engagement arms being closer to the longitudinal axis of the control unit in the compressed position than in the relaxed position.

7. An ophthalmic surgical instrument according to any preceding claim, wherein the trigger arms are biased towards the relaxed position.

8. An ophthalmic surgical instrument according to any one of the preceding claims, wherein the number of attachment arms is an even number, preferably four, six or eight.

9. An ophthalmic surgical instrument according to any preceding claim, wherein the pivoting connecting element is arranged such that the second end moves along the longitudinal axis of the control unit when adjusting the engagement arms from the relaxed position to the compressed position.

10. An ophthalmic surgical instrument according to any preceding claim, wherein, in the relaxed position, the second ends of the hinged connecting elements are in an axial rest position along the longitudinal axis of the operating unit, and wherein, in the compressed position, the second ends of the hinged connecting elements are driven toward the guide element.

11. An ophthalmic surgical instrument according to any preceding claim, wherein the actuation unit directly operates the drive unit.

12. An ophthalmic surgical instrument according to any preceding claim, wherein the guide element is substantially axially stationary relative to the control unit.

13. The ophthalmic surgical instrument of any preceding claim, wherein the guide member includes a cavity aligned with the central hole, and wherein the drive unit further comprises an annular retaining member received in the cavity of the guide member, the annular retaining member being fixedly attached to the shaft and associated with the second ends of the pivoting connecting members.

14. An ophthalmic surgical instrument according to any one of the preceding claims, wherein the actuation unit and the drive unit are adapted to drive the shaft, in particular to drive the shaft away from the control unit after manual actuation of the actuation unit.

15. An ophthalmic surgical instrument according to any preceding claim, wherein the guide element comprises a nose cone comprising at least a conical portion having a proximal end and a distal end, the nose cone being at a distal position relative to the attachment arms.

16. The ophthalmic surgical instrument of claim 15, wherein a distal end of at least one of the attachment arms is located at an axial distance from the proximal end of the conical portion of the nose cone of between about 8 mm and about 16 mm and/or at an axial distance from the distal end of the conical portion of the nose cone of between about 12 mm and about 25 mm.

17. An ophthalmic surgical instrument according to claim 15 or 16, wherein the conical portion of the nose cone has an axial length between about 2 mm and about 10 mm.