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TWI380805B - 用於眼外科手術探針之模組化設計 - Google Patents

用於眼外科手術探針之模組化設計 Download PDF

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TWI380805B
TWI380805B TW096128026A TW96128026A TWI380805B TW I380805 B TWI380805 B TW I380805B TW 096128026 A TW096128026 A TW 096128026A TW 96128026 A TW96128026 A TW 96128026A TW I380805 B TWI380805 B TW I380805B
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needle
drive shaft
engine
probe
cutter
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TW200819116A (en
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Salomon Valencia
Jose Luis Lopez
Jack R Auld
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Alcon Inc
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    • 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
    • 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • 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
    • A61B2017/0046—Surgical instruments, devices or methods with a releasable handle; with handle and operating part separable
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/00535—Surgical instruments, devices or methods pneumatically or hydraulically operated
    • A61B2017/00544—Surgical instruments, devices or methods pneumatically or hydraulically operated pneumatically

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  • Health & Medical Sciences (AREA)
  • Ophthalmology & Optometry (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Public Health (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Biomedical Technology (AREA)
  • Vascular Medicine (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Surgical Instruments (AREA)
  • Ultra Sonic Daignosis Equipment (AREA)
  • Prostheses (AREA)

Description

用於眼外科手術探針之模組化設計 發明領域
本發明通常係與顯微手術器具有關。更明確地說，但是不侷限於此，本發明係與用於後段眼外科手術(posterior segment ophthalmic surgery)之顯微手術器具有關，例如玻璃體切除探針。
 發明背景
許多顯微手術的步驟都需要精確地切割及/或移除各種不同身體組織。舉例來說，某些眼外科手術的步驟需要切割及/或移除玻璃體液(一種充滿在該眼睛後段之透明的果凍狀物質。該玻璃體液或玻璃體係由通常係附接至視網膜的許多微觀纖維所組成。因此，該玻璃體的切割和移除一定要非常小心地進行以避免拉引視網膜、避免視網膜與脈絡膜的分離、避免視網膜撕裂、或者避免在最糟的情形下會切割和移除該視網膜本身。
在後段眼外科手術中使用顯微手術切割探針係為人所熟知。此等玻璃體切除探針係典型地經由位在平坦部附近的鞏膜中之切口來插入。外科醫生也可以在該後段外科手術期間插入例如一光纖照明器、灌注套管或是吸液探針之其他顯微手術器具。外科醫生會於在一顯微鏡下監看眼睛的同時，進行該手術步驟。
傳統的玻璃體切除探針係典型地包括有一中空的外部切割元件、一與該中空的外部切割元件同軸向地配置並且係可移動地設置在該中空的外部切割元件內之中空的內部切割元件，以及一通口在其之遠側端附近徑向地延伸通過該外部切割元件。玻璃體液係被吸入該開啟之通口，並啟動該內部元件以關閉該通口。在該等內部與外部之切割元件上的切割表面會在該通口關閉時互相作用以切割該玻璃體，並且該切割下來的玻璃體然後會經過該內部切割元件而吸走。美國專利第4577629號(Martinez)；第5,019,035號(Missirlain等人)；第4,909,249號(Akkas等人)；第5,176,628號(Charles等人)；第5,047,008號(de Juan等人)；第4,696,298號(Higgins等人)；以及第5,733,297號(Wang)全部都揭示各種不同類型的玻璃體切除探針，而這些專利文獻都在此被併入以供參考。
傳統的玻璃體切除探針包括有"鍘刀型"探針與旋轉型探針。鍘刀型探針具有一沿著其之縱軸而往復運動的一內部切割元件。旋轉型探針則具有繞著其之縱軸而旋轉之內部切割元件。在這兩種類型的探針中，該等內部切割元件都係以各種不同的方式來啟動。舉例來說，該內部切割元件可藉著可以克服一機械彈簧之相對於一活塞或是膈膜總成的氣壓，而自該通口開啟位置移動到通口關閉位置。在該氣壓移除時，該彈簧會將該內部切割元件自該通口關閉位置退回到通口開啟位置。在另一具體例中，該內部切割元件可以運用一第一來源的氣壓而自該通口開啟位置移動到該通口關閉位置，並接著運用一第二來源的氣壓而自該通口關閉位置移動到該通口開啟位置。在更進一步的具體例中，該內部切割元件可以使用傳統旋轉電動馬達或是螺線管而在該等開啟與關閉位置之間被電機地啟動。美國專利第4,577,629號係提供一種鍘刀型、氣動式活塞/機械彈簧啟動探針之範例。美國專利第4,909,249號與第5,019,035號則揭示鍘刀型、氣動式膈膜/機械彈簧啟動探針。美國專利第5,176,628號顯示一種旋轉式雙氣動式探針。
在許多傳統的玻璃體切除探針中，該等引擎和殼體或外殼係被結合在一起以產生一具有功能之探針。這種方式的缺點在於該外殼係被用來作為人體工學元件以及一用於功能之部件。為了在不同的探針類型(也就是20、23、25號規格之探針)之間變換，該外殼的內部特徵需要有變化以因應諸如密封設計與尖端的幾何構形之對應的功能界面。這使得其比較不具備變通性。
因此，目前需要有一種具有更大變通性之改良的玻璃體切除探針。此等變通性應該可以使得未來的設計和製造具有變通性、在整體探針設計上使用一些共同的元件，並便於轉變使用相同引擎部件之數個針號規格大小之探針。
 發明概要
本發明係為一種具有一可移除地連結至一引擎的外殼、一針頭固定器、一針頭以及一切割器之眼外科手術探針。該引擎具有一驅動軸支持元件和一軸向地從引擎延伸的驅動軸。該針頭固定器具有一被設置於其中之軸襯以及一用於可移除地與該驅動軸支持元件囓合的開口。該針頭具有一與其牢固地連結之第一連結器。該第一連結器係被用來可移除地囓合該軸襯。該切割器具有一與其牢固地連結之第二連結器。該切割器係被可滑動地設置於該針頭裡面，並且該第二連結器係被用來可移除地囓合該驅動軸。
圖式簡單說明
為了得到對本發明以及其之目的與優點更充份的理解，就須在參照隨附的圖式下參考下列描述，其中：第1圖是本發明的眼外科手術探針之剖面圖；並且第2圖是第1圖的眼外科手術探針之分解剖面圖。
 較佳實施例之詳細說明
本發明的較佳具體例以及其等之優點可以在參考該等第1－2圖的圖式而得到最充分的了解，其中類似的元件符號係用於該等不同圖式中之類似的與對應的部件。
玻璃體切除探針10包含有引擎12、殼體或外殼14、針頭固定器16、驅動軸18、切割器20以及針頭24。雖然本發明的眼外科手術探針係在其中依據一玻璃體切除探針10而加以描述，但是本發明也適用於其他的眼科或其他的外科手術探針、器具和手持工具。切割器連結器22係被一體化地形成於該切割器20的近側端末端上。該針頭連結器26係被一體化地形成於該針頭24的近側端末端上。驅動軸18係自引擎12而軸向地延伸。驅動軸18的遠側末端係可移除地與切割器20的切割器連結器22囓合。驅動軸支持元件34係可移除地與針頭固定器16中的開口36囓合。驅動軸支持元件34、驅動軸18以及切割器連結器22均係被設置於該針頭固定器16內。在針頭固定器16內的軸襯28係可移除地與針頭24的針頭連結器26囓合，以使得切割器20係被可滑動地設置於針頭24內。針頭連結器26、針頭固定器16、切割器連結器22、驅動軸18以及驅動軸支持元件34係被完全地設置於外殼14裡面。外殼14包含有與引擎12的本體40可移除地囓合之開口38。針頭24係延伸通過在外殼14中之開口42。
引擎12可以是任何類型之適合於驅動玻璃體切除探針10的引擎，但是其最佳地係為一種氣動式引擎。驅動軸18可以採用任何適當的材料來製成，但是最佳地係為不銹鋼。針頭24與切割器20可以由任何適合於後段眼外科手術的材料來製成，但是其係最佳地以外科不銹鋼(surgical stainless steel)來製成。外殼14、針頭連結器26以及切割器連結器22係最佳地由例如鋁或硬質塑膠之輕重量材料來製成。
在製造該總成的期間，探針10的模組設計使得工作人員可以在所架構的探針之間很快地而且輕易地更換各種不同針頭規格，例如具有一20號規格的針頭24、一23號規格的針頭24，或是一25號規格的針頭24之探針10。更明確地說，該等可以快速地將外殼14附接至引擎12的本體40以及自其移除，以快速地藉著針頭連結器26和軸襯28而將不同針號規格的針頭24連結至針頭固定器16和切割器20，並且快速地藉著切割器連結器22而將切割器20連結至驅動軸18的能力，會大幅地增加探針10的製造變通性並且簡化裝配製程。
應該要相信的是，本發明的運作與構造將可以從前面的描述中變得明顯。雖然在上述中所顯示或描述之裝置和方法係為較佳的，其可以進行各種不同的變化和修改而不會背離在下列申請專利範圍各項所界定之本發明的精神和範圍。
10．．．探針
12．．．引擎
14．．．殼體或外殼
16．．．針頭固定器
18．．．驅動軸
20．．．切割器
22．．．連結器
24．．．針頭
26．．．針頭連結器
28．．．軸襯
34．．．驅動軸支持元件
36．．．開口
38．．．開口
40．．．本體
42．．．開口
第1圖是本發明的眼外科手術探針之剖面圖；並且第2圖是第1圖的眼外科手術探針之分解剖面圖。
12．．．引擎
14．．．殼體或外殼
16．．．針頭固定器
18．．．驅動軸
20．．．切割器
22．．．連結器
24．．．針頭
26．．．針頭連結器
28．．．軸襯
34．．．驅動軸支持元件

Claims (5)

  1. 一種具有模組結構之眼外科手術探針，其包含：一外殼，其具有遠端開口及一近端開口；一引擎，其具有一本體、一驅動軸支持元件和遠離該引擎之軸向延伸的一驅動軸；一針頭固定器，其具有一被設置於其中之軸襯，以及一用於可移除地與該驅動軸支持元件囓合的近端開口；一針頭，其具有一與其牢固地連結之針頭連結器，該針頭連結器可移除地囓合該軸襯；以及一切割器，其具有一與其牢固地連結之切割器連結器，該切割器係被可滑動地設置於該針頭裡面，並且該切割器連結器係被用來可移除地囓合該驅動軸；藉此該驅動軸支持元件、該驅動軸及該切割器連結器係可操作地置於該針頭固定器中；該針頭固定器係經由該外殼之近端開口容納，以致使該驅動軸支持元件、該針頭固定器及該切割器連結器完全地置於該外殼中；該針頭延伸通過該外殼之遠端開口；且該外殼係可移除地被囓合至該引擎的本體。
  2. 如申請專利範圍第1項的眼外科手術探針，其中該引擎包含一氣動式引擎。
  3. 如申請專利範圍第1項的眼外科手術探針，其中該引擎包含一電動引擎。
  4. 如申請專利範圍第1項的眼外科手術探針，其中該探針係為一玻璃體切除探針。
  5. 如申請專利範圍第1項的眼外科手術探針，其係在製造該探針的期間有助於變換成不同規格針頭。
TW096128026A 2006-10-31 2007-07-31 用於眼外科手術探針之模組化設計 TWI380805B (zh)

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