Vitreous body cutter
By introducing an adjustable spring cavity and a compressed air pulse drive system into the vitreous cutter, the problem of difficulty in adjusting the spring stiffness in the prior art is solved, and the effect of efficient cutting at different cutting rates is achieved.
Patent Information
- Application Number
- CN202280098721.3
- Authority / Receiving Office
- CN · China
- Patent Type
- Applications(China)
- Current Assignee / Owner
- Filing Date
- 2022-08-02
- Publication Date
- 2025-04-04
AI Technical Summary
Existing reciprocating vitreous cutters have difficulty in effectively adjusting the stiffness of the spring at high cutting rates, resulting in poor cutting efficiency and requiring excessive driving force to achieve cutting and retraction.
By introducing an adjustable spring cavity into the vitreous cutter, the reciprocating movement of the inner cutter sleeve is driven by pulses of compressed air, and the stiffness of the spring is changed by adjusting the air pressure in the spring cavity to meet the needs of different cutting rates.
Optimized cutting efficiency at different cutting rates is achieved, reducing driving force requirements, and improving the performance of vitreous cutters at high cutting rates.
Smart Images
Figure CN119768136A_ABST
Abstract
Description
Technical Field
[0001] The invention relates to a surgical instrument for ophthalmic surgery, in particular to a reciprocating guillotine type vitreous cutter for removing vitreous body and other tissues from eyes. Background Art
[0002] This section provides background information related to the present disclosure which is not necessarily prior art.
[0003] Known reciprocating vitrectomy cutters have a fixed helical compression spring for returning or retracting the inner cutting member after it has been pneumatically or mechanically extended to cut tissue. The spring is typically a linear device that must be sized to work over a wide range of cutting rates, which may range from a single cut to thousands of cuts per minute. Therefore, a single fixed spring constant or stiffness of the spring must accommodate the need to return the inner cutting member to the starting position very quickly at high cutting rates, but without requiring an unacceptably high drive force to extend the inner cutting member to cut tissue. Under equal resistance forces relative to the spring, a compression spring with a greater stiffness will return the inner cutting member faster than a spring with a smaller stiffness. This can be problematic for pneumatic vitrectomy cutters because it may take too much time to establish sufficient drive pressure to extend the inner cutting member and to fully release the pressure to allow the spring to retract the inner cutting member at higher cutting rates. Therefore, there is a need for a spring whose stiffness can be varied during use to optimize cutting efficiency within a desired cutting rate window. BRIEF DESCRIPTION OF THE DRAWINGS
[0004] The drawings described herein are for illustrative purposes only of selected embodiments and not all possible implementations, and are not intended to limit the scope of the present disclosure.
[0005] Figure 1 A view of a vitreous cutter according to the present invention;
[0006] Figure 2 is coupled to Figure 1 Schematic diagram of the control system of the vitrectomy tool.
[0007] Corresponding reference numerals indicate corresponding parts or features throughout the several views of the drawings. DETAILED DESCRIPTION
[0008] Example embodiments will now be described more fully with reference to the accompanying drawings.
[0009] Figure 1A surgical cutting device or vitrectomy according to an example embodiment of the present invention is shown, which is generally indicated by the reference numeral 100. The vitrectomy 100 includes a guillotine-type cutting assembly 102 for removing vitreous from the eye during ophthalmic surgery. The cutting assembly 102 includes an inner cutter cannula 104, which is configured to rapidly reciprocate or translate within an outer cutter cannula 106. The inner cutter cannula 104 includes a cutting edge 108 located at the distal end or tip of the inner cutter cannula 104, and is hollow or tubular, which defines a passage for aspirating and removing vitreous from the eye. The outer cutter cannula 106 includes an aperture or port 110 through which vitreous is drawn into the surgical cutting device. As the inner cutter cannula 104 reciprocates within the outer cutter cannula 106, the vitreous drawn through the aperture 110 is cut when the cutting edge 108 of the inner cutter cannula 104 slides through the aperture 108 of the outer cutter cannula 106. The vitreous body is aspirated and removed through aspiration port 112 coupled to endocutter cannula 104 .
[0010] Vitreous body cutter 100 also includes a housing 114 coupled to cutting assembly 102. Housing 114 includes a drive chamber 116 and a spring chamber 118. Drive chamber 116 is adapted to receive compressed air pulses in the drive chamber to drive or translate the inner cutter sleeve 104 toward a closed position to cut the vitreous body of the eye. Spring chamber 118 is filled with a fluid (such as air) and acts as a spring to bias and / or return the inner cutter sleeve 104 toward a retracted or open position when pressurized. Drive chamber 116 is separated from spring chamber 118 by a first diaphragm 120. First diaphragm 120 is fixed to the inner surface of housing 114 and is located between drive chamber 116 and spring chamber 118. In this way, first diaphragm 120 interfaces with drive chamber 116 and spring chamber 118. Housing 114 also includes a second diaphragm 122, which adheres to the inner surface of housing 114. Spring chamber 118 is defined by first diaphragm 120 and second diaphragm 122. Depending on the application, the second diaphragm 122 may also be a rigid wall that does not substantially deflect during use compared to the first diaphragm 120 .
[0011] The inner cutter sleeve 104 passes through the first and second membranes 120, 122. Typically, the inner cutter sleeve 104 is located in the center of the first and second membranes 120, 122. Figure 1As shown, the first and second diaphragms 120, 122 are generally perpendicular to the inner cutter sleeve 104. In an exemplary embodiment, the inner cutter sleeve 104 is adhered to the first diaphragm 120. In some embodiments, the second diaphragm 122 is also adhered to the inner cutter sleeve 104. In all embodiments, whether the second diaphragm 122 is adhered to the inner cutter sleeve 104 or not, there should be a seal or close tolerance between the second diaphragm 122 and the inner cutter sleeve 104 to allow the spring chamber 118 to be pressurized. Of course, in some embodiments, it may be necessary to adopt a design that accommodates leakage between the diaphragm and the inner cutter sleeve to allow the inner cutter sleeve to have greater freedom of movement; however, intentionally creating leakage may cause unnecessary noise during use.
[0012] like Figure 2 As shown, the vitrectomy cutter 100 is coupled to a control system 200. The control system 200 includes a drive chamber valve 124, which is coupled to a port 126 of a drive chamber 116 of the vitrectomy cutter 100 through a drive chamber pressure line 128. The drive chamber valve 124 is adapted to supply compressed air to the drive chamber 116 and exhaust the compressed air from the drive chamber 116. Specifically, a pressure source 130 is coupled to the drive chamber valve 124 and supplies compressed air pulses to the drive chamber 116 through the drive chamber pressure line 128 based on a desired cutting rate. The processor 132 is configured to apply a pulse to the drive chamber valve 124, which causes the pulse of compressed air to enter the drive chamber 116 and the inner cutter sleeve 104 to reciprocate at the desired cutting rate. When compressed air is supplied to the drive chamber 116, the compressed air in the drive chamber 116 causes the first diaphragm 120 to move toward the distal end of the vitrectomy cutter 100 and compress the spring chamber 118. As first diaphragm 120 moves, inner cutter cannula 104 (which is adhered to first diaphragm 120) translates within outer cutter cannula 106 to a closed position, thereby cutting the vitreous of the eye.
[0013] When the pressure in the drive chamber 116 is reduced or released, the spring chamber 118 forces the inner cutter sleeve 104 and the first diaphragm to be sent back to the open position. Based on the desired cutting rate, the spring chamber 118 is pressurized to a specified pressure to send the inner cutter sleeve 104 back and / or bias. For example, when the desired high cutting rate (e.g., high cutting strokes per minute), a larger spring force is needed to send the inner cutter sleeve 104 back to the open position. This larger spring force ensures that before another pulse of compressed air is supplied to the drive chamber 116, the inner cutter sleeve 104 has been fully returned to the open position. Additionally, a pedal 134 (such as a foot pedal) is coupled to the processor 132 to indicate the desired cutting rate to the processor 132 based on the position of the pedal 134.
[0014] In some embodiments, the spring chamber 118 of the vitrectomy cutter 100 is sealed (e.g., not coupled to a valve, the port 138 of the spring chamber 118 is closed, etc.), and the spring chamber is pressurized at a specific pressure so that the vitrectomy cutter 100 can operate at a range of cutting rates. Alternatively, in an exemplary embodiment, the spring chamber 118 of the vitrectomy cutter 100 is not sealed, and the spring chamber valve 136 is coupled to the port 138 of the spring chamber 118 via the spring chamber pressure line 140. The spring chamber valve 136 allows the pressure within the spring chamber 118 to be adjusted, for example, based on the desired cutting rate. Specifically, a pressure source 142 is coupled to the spring chamber valve 136 to supply pressurized air to the spring chamber 118, and the pressurized air is exhausted from the spring chamber 118 by opening and closing the spring chamber valve 136 through the processor 132. In this way, the stiffness of the spring chamber 118 can be adjusted to allow the vitrectomy cutter 100 to operate over a wider range of cutting rates.
[0015] In some embodiments, the processor 132 is configured to increase the gas pressure in the spring chamber 118 through the spring chamber valve 136 when the desired cutting rate increases. In this way, the stiffness of the spring chamber 118 increases to allow the vitrectomy cutter 100 to operate at a higher cutting rate, which requires a greater spring force to return the inner cutter sleeve 104 to the open position. Similarly, the processor 132 is also configured to reduce the gas pressure in the spring chamber 118 through the spring chamber valve 136 when the desired cutting rate decreases. As the cutting rate decreases, a lower spring force is required to return the inner cutter sleeve 104 to the open position, thereby reducing the pressure in the spring chamber 118. In some embodiments, the processor 132 is configured to supply compressed air to the spring chamber 118 through the spring chamber valve 136 in proportion to the increase in the desired cutting rate, and to exhaust compressed air from the spring chamber 118 through the spring chamber valve 136 in proportion to the decrease in the desired cutting rate. In this way, as the cutting rate is adjusted, the pressure in the spring chamber 118 is also adjusted in proportion. It will be appreciated that even though the drive chamber valve 124 and the spring chamber valve 136 both operate based on the same desired cutting rate, they operate at different rates. For example, the air supplied to the spring chamber 118 is not pulsed rhythmically with the air supplied to the drive chamber 116. Instead, for a given cutting rate, compressed air from the pressure source 130 is continuously pulsed into the drive chamber 116, but the pressure within the spring chamber 118 is not adjusted (e.g., no air is pulsed into the spring chamber 118).
[0016] Alternatively, in some embodiments, the processor 132 is configured to increase the air pressure in the spring chamber 118 based on one or more thresholds, rather than adjusting the pressure or stiffness of the air chamber 116 when adjusting the cutting rate. For example, when the cutting rate increases from the starting cutting rate to the threshold cutting rate (e.g., the upper threshold), the processor 132 does not adjust the air pressure in the spring chamber 118. Once the desired cutting rate is above the threshold, the processor 132 operates the spring chamber valve 136 to supply compressed air from the pressure source 142 to the spring chamber 118. Similarly, in some embodiments, the processor 132 is configured to reduce the air pressure in the spring chamber when the desired cutting rate is below the threshold cutting rate (e.g., the lower threshold). In this way, once the desired cutting rate indicated by the pedal 134 is below the lower threshold, the processor 132 operates the spring chamber valve 136 to discharge a specified amount of compressed air from the spring chamber 118, so that the pressure or stiffness of the spring chamber 118 is reduced.
[0017] like Figure 2 As shown, the processor 132 is also coupled to an exhaust valve 144 for exhausting and / or releasing pressure, an accumulator 146, and a pressure sensor 148 for sensing the pressure of air supplied to the drive chamber valve 124. The exhaust valve 144, the accumulator 146, and the pressure sensor 148 are associated with the drive chamber 116. Additionally, the processor 132 is also coupled to an exhaust valve 150, an accumulator 152, and a pressure sensor 154 associated with the spring chamber 118.
[0018] The description of the above-described embodiments is provided for the purpose of illustration and description. It is not intended to be exhaustive or to limit the present disclosure. The individual elements or features of a particular embodiment are generally not limited to that particular embodiment, but, where applicable, may be interchangeable and may be used in selected embodiments even if not specifically shown or described. It may also be varied in a variety of ways. Such variations should not be considered as departing from the present disclosure, and all such modifications are intended to be included within the scope of the present disclosure.
[0019] Example embodiments are provided to make the present disclosure exhaustive and to fully convey the scope to those skilled in the art. Many specific details, such as examples of specific components, devices, and methods, are set forth to provide a detailed understanding of the embodiments of the present disclosure. It will be appreciated by those skilled in the art that specific details need not be used, that example embodiments may be embodied in a variety of different forms, and that they should not be construed as limiting the scope of the present disclosure. In some example embodiments, well-known processes, well-known device structures, and well-known technologies are not described in detail.
[0020] The terms used herein are only used to describe specific example embodiments and are not intended to be limiting. The singular forms "one", "an", and "the" used herein may also be intended to include plural forms unless the context clearly indicates otherwise. The terms "comprise", "include", "contain", and "have" are inclusive, and thus specify the presence of the features, integers, steps, operations, elements, and / or components, but do not exclude the presence or addition of one or more other features, integers, steps, operations, elements, components, and / or groups thereof. The method steps, processes, and operations described herein should not be interpreted as necessarily requiring execution in the specific order discussed or described, unless clearly identified as an execution order. It should also be understood that additional or alternative steps may be adopted.
[0021] Although the terms "first", "second", "third", etc. may be used herein to describe various elements, components, regions, layers and / or parts, these elements, components, regions, layers and / or parts should not be limited by these terms. These terms can only be used to distinguish one element, component, region, layer or part from another region, layer or part. Such as "first", "second" and other numerical terms used herein do not represent order or sequence unless the context clearly indicates. Therefore, the first element, component, region, layer or part discussed below may be referred to as the second element, component, region, layer or part without departing from the teachings of the exemplary embodiments.
[0022] For ease of description, spatially relative terms such as "inside," "outside," "below," "below," "lower," "above," and "above" may be used herein to describe the relationship of one element or feature to another element or feature, as shown in the figures. In addition to the orientation shown in the figures, spatially relative terms may also include different orientations of the device in use or operation. For example, if the device in the figure is turned over, an element described as "below" or "below other elements or features" will be located "above" the other elements or features. Therefore, the example term "below" may include both above and below directions. The device may be oriented in other ways (rotated 90 degrees or other orientations), and the spatially relative descriptors used herein may be interpreted accordingly.
Claims
1. A vitrectomy system comprising: A surgical cutting device comprising: a cutting assembly including an outer cutter and an inner cutter; a housing coupled to the cutting assembly, the housing containing a drive chamber, a spring chamber, and at least a first diaphragm, wherein at least the first diaphragm is adhered to the endocutter and positioned between the drive chamber and the spring chamber; a drive chamber valve coupled to the drive chamber to supply compressed air to the drive chamber; a spring chamber valve coupled to the spring chamber to regulate air pressure within the spring chamber; and a processor operatively coupled to the surgical cutting device and configured to: pulsing the drive lumen valve based on the desired cutting rate, thereby translating the endocutter at the desired cutting rate; and The air pressure within the spring chamber is adjusted based on the desired cutting rate to adjust the stiffness of the spring chamber.
2. The vitrectomy system according to claim 1, wherein: The processor is further configured to increase the gas pressure in the spring chamber through the spring chamber valve when the desired cutting rate increases, and Wherein, the processor is further configured to reduce the gas pressure in the spring chamber through the spring chamber valve when the desired cutting rate decreases.
3. The vitrectomy system according to claim 1, wherein: The processor is configured to increase the gas pressure within the spring chamber when the desired cut rate is above a threshold cut rate.
4. The vitrectomy system according to claim 1, wherein: The processor is configured to reduce the gas pressure within the spring chamber when the desired cut rate is below a threshold cut rate.
5. The vitrectomy system according to claim 1, wherein: The inner cutter is adhered to the second membrane.
6. The vitrectomy system according to claim 1, wherein: The spring chamber is sealed and the air within the spring chamber is pressurized.
7. The vitrectomy system of claim 1 further comprising a pedal coupled to the processor, the pedal indicating to the processor a desired cutting rate based on a position of the pedal.
8. A vitrectomy system comprising: A surgical cutting device comprising: a cutting assembly including an outer cutter cannula and an inner cutter cannula; a housing coupled to the cutting assembly, the housing including a drive chamber and a spring chamber; a first diaphragm coupled to the housing, wherein the first diaphragm is adhered to the inner cutter sleeve and is in communication with the drive chamber and the spring chamber, wherein the spring chamber is defined by the first diaphragm and a wall of the housing, the wall being substantially perpendicular to the inner cutter sleeve; a drive chamber valve coupled to the drive chamber to supply compressed air to the drive chamber; and a spring chamber valve coupled to the spring chamber to regulate gas pressure within the spring chamber; a processor operatively coupled to the surgical cutting device and configured to: pulsing the drive lumen valve based on the desired cutting rate to translate the endocutter at the desired cutting rate; and The air pressure in the spring chamber is adjusted via the spring chamber valve based on the desired cutting rate.
9. The vitrectomy system according to claim 8, wherein: The processor is also configured to open and close the spring chamber valve to supply compressed air to the spring chamber when the desired cutting rate increases, and to exhaust compressed air from the spring chamber when the desired cutting rate decreases.
10. The vitrectomy system according to claim 8, wherein: The processor is configured to supply compressed air when the desired cutting rate increases above a threshold cutting rate.
11. The vitrectomy system according to claim 8, wherein: The processor is configured to reduce the gas pressure within the spring chamber when the desired cut rate decreases below a threshold cut rate.
12. The vitrectomy system of claim 8, further comprising a pedal coupled to the processor, the pedal indicating to the processor a desired cutting rate based on a position of the pedal.