Slotted Tube Security Platform

Abstract

A platform configured to secure a service loop of tubing from a fixed position surgical device. The platform allows for avoiding taping and retaping of the service loop. Additionally, the platform provides stability to the surgical device to avoid unintentional changes in device position or orientation. This is particularly beneficial for injection ports during ophthalmic surgery and other similar devices where the orientation of the installed device aids in the performance of the device.

Description

[Technical field]

[0001] The present invention relates to a slotted tube security platform. [Background technology]

[0002] Over the years, many dramatic advances have occurred in the field of ophthalmic surgery. In some ophthalmic surgeries, at least part of the procedure includes a vitrectomy. A vitrectomy is the removal of some or all of the vitreous humor from a patient's eye. In some cases, a vitrectomy may comprise the majority of the procedure if the surgery is limited to removing the cloudy vitreous humor. However, a vitrectomy may be accompanied by surgery to address cataract surgery, retinal repair surgery, macular pucker, or many other issues.

[0003] The vitreous humor itself is a clear gel that can be removed by an elongated probe when inserted through a cannula that has been previously placed in the eye. More specifically, the probe includes a central channel for removing the vitreous humor. Additionally, the cannula provides a structurally supportive conduit that is strategically located at an offset location in the anterior portion of the eye, such as the pars plana. In this manner, the probe may be guided into the eye in a manner that avoids damage to the patient's lens or cornea.

[0004] Unfortunately, removal of vitreous fluid requires more care than simply applying a vacuum through the channels of a vitrectomy probe. For example, assuming the vitreous fluid has been removed, measures may be taken to ensure that intraocular pressure is maintained. This may include the use of an injection port. That is, as in interventions to remove material from the eye, a separate pre-placed cannula may be provided to accommodate the inflow of fluid into the eye to maintain pressure equilibrium. So, for example, if the pressure inside the eye is about 30 mm / Hg (millimeters of mercury), an injection port may be used to maintain the pressure inside the eye at, for example, about 15 mm / Hg to about 60 mm / Hg.

[0005] Apart from maintaining the overall health of the eye, maintaining intraocular pressure may be important in eye procedures in general. For example, in addition to vitrectomy, other instruments, such as scissors or forceps, may be used to interact with or remove some structural features within the eye. However, when the pressure becomes too low, cutting, peeling, or other direct interaction with these structural features may be prohibited. A further concern may be a situation in which intraocular pressure reduction occurs too rapidly. For example, consider the fact that a surgeon may prescribe an intervention on an ocular feature with an accuracy that requires millimeter, if not micrometer, level precision. Any sudden change in intraocular pressure may lead to a corresponding change in the location of the feature.

[0006] Maintenance of pressure by the injection port device means that a tubular line extending to the port is used to deliver the injection fluid, or in some cases air. Nevertheless, this means that the fixed port device can be fixed to the pre-placed cannula by a tubular line extending across the external drape or surgical sheet in the area over the patient's upper face. Usually, this line is simply taped to the sheet to hold it in place and avoid pulling on the injection port. In addition to managing an unstable line, this is also done to help maintain the orientation of the injection port. This prevents the port from angling too far away from the vertical, which can lead to the port interacting with the choroidal tissue in the eye and ultimately blocking the injection function.

[0007] Of course, taping and retaping the injection port lines can be a time-consuming and tedious task for the surgeon. This is especially true in the case of ophthalmic surgery, where there may be several occasions requiring repositioning of the injection port, for example, to another pre-placed cannula in a different location. However, because of the importance of maintaining the injection port in the proper orientation so that it is not blocked relative to the interior of the eye, any necessary orientation, taping, and retaping of loose lines is nevertheless performed.

[0008] A similar situation may also be found with other surgical tools used in ophthalmic surgery that are intended to be maintained in a generally fixed position. For example, this is often the case with lights; that is, in many cases the light may be a hanging light that is intended to be positioned through another pre-placed cannula and fixed in place. The orientation of the light may be important during some parts of the surgery; that is, once positioned for optimal illumination of the interior of the eye, movement of the light's orientation may impede visibility of the interior of the eye. Therefore, to prevent this from occurring, the power lines extending from the light may also be taped in place to help maintain the orientation of the light during ophthalmic surgery. Of course, just like the injection port, various light positions may be used during the same surgery; therefore, taping and retaping of the light lines may be required again.

[0009] The need for surgeons to periodically tape and re-tape external lines or tubes during ophthalmic surgery, whether for illuminators, injection ports, or any number of other fixed-position devices, may simply be avoided. Surgeons are generally not at liberty to simply leave such lines and / or tubes loose. Thus, currently, surgeons are forced only with the cumbersome option of taping and re-taping various otherwise loose lines throughout most ophthalmic surgeries. Summary of the Invention

[0010] A surgical system for ophthalmic surgery using a slotted tube security platform is disclosed. In one embodiment, the system includes a handheld instrument for performing a surgical procedure with a first pre-placed cannula at an eye location. In some embodiments, the system also includes a stabilized instrument for reaching into the patient's eye from a fixed location in a second pre-placed cannula at another location of the eye. The slotted tube security platform may be used to immobilize a tube coupled to the stabilized instrument, for example, to facilitate a substantially vertical orientation of the stabilized instrument relative to the patient's eye during surgery. [Brief description of the drawings]

[0011] [Figure 1] FIG. 1 illustrates a perspective view of one embodiment of a slotted tube security platform. [Diagram 2] FIG. 2 is a top view of a draped patient's eye during surgery using the slotted tube security platform of FIG. 1. [Diagram 3] 3 is a side cross-sectional view of an eye during surgery as shown in FIG. 2 with multiple instruments in fixed orientation as supported by the platform of FIG. 1. [Figure 4A] FIG. 13 is a perspective view of an alternative embodiment of a slotted tube security platform. [Figure 4B] FIG. 13 is a side view of another alternative embodiment of a slotted tube security platform. [Figure 4C] FIG. 13 is another side view of yet another alternative embodiment of the slotted tube security platform. [Diagram 5] 1 is a flow chart summarizing one embodiment of using a slotted tube security platform to facilitate immobilization of instruments during ophthalmic surgery. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0012] In the following description, numerous details are set forth to provide an understanding of the present disclosure. However, it will be understood by those skilled in the art that the described embodiments may be practiced without these specific details. Moreover, numerous variations or modifications may be employed that are still contemplated in the embodiments as specifically described.

[0013] The embodiments are described with reference to certain types of vitrectomy probe surgical procedures. In particular, a procedure is shown to remove vitreous fluid to address vitreous hemorrhage. This is similarly accomplished by an injection port that remains in a fixed position to maintain an acceptable intraocular pressure range during the procedure. However, the tools and techniques detailed herein may be employed in a variety of other ways. For example, the vitrectomy probe embodiments as detailed herein may be utilized to address retinal detachment, macular pucker, macular hole, vitreous floaters, diabetic retinopathy, or a variety of other ocular conditions. Nevertheless, significant benefits may be realized insofar as the procedure is accompanied by the use of a slotted tube security platform to facilitate the maintenance of accessory instruments and any associated lines or tubes.

[0014] 1, a perspective view of one embodiment of a slotted tube security platform 100 is shown. With further reference to FIG. 2, the platform 100 is configured to immobilize a tube 215 extending from a fixed position instrument 210 that may be used as an aid in ophthalmic surgery (see eye 250). More specifically, the platform 100 includes a number of slots 160, 170 with orifices 165, 175 that may serve as locations for holding the tube 215 of the instrument 210. For example, in one embodiment, the body 150 of the platform 100 may be a die cut form with orifices 165, 175 sized to hold the tube 215 in a secure manner. The amount of force applied to the tube 215 may be sufficient to hold it without reaching a level that would tend to specifically crimp or restrict the flow of fluid inside any of the tubes 215.

[0015] By way of example, in one embodiment, the tube 215 of FIG. 2 may range anywhere from 0.050 inches to about 0.095 inches in diameter, with the corresponding diameter (D) of the orifice 165 being slightly smaller, perhaps about 5-10% smaller. Additionally, the body 150 may be 1-2 inches long, with a profile of less than about 1 inch. In an embodiment such as the one shown, where the platform 100 is a die cut form, retention of the tube 215 may result in a slight press-to-fit. This may be sufficient to inhibit movement of the tube 215 without creating any visible restriction, as discussed above.

[0016] With continued reference to Figures 1 and 2, the platform 100 may grip the tube 215 firmly as proposed. However, the platform 100 itself may be correspondingly fixed, which may further prevent the tube from moving. Therefore, the body 150 of the platform 100 may be bonded to an adhesive 125 on its underside, as shown in Figure 1. In this way, the platform 100 may be attached to a surgical drape or sheet 201 that is typically present for such surgical procedures, for example, to keep the eye 250 in a more isolated surgical environment. This means that the fixation of the tube 215 by the platform 100, which is similarly immobilized in the sheet, serves to prevent the tube from moving, i.e. to keep the tube fixed relative to the patient. As will be explained in more detail below, this may be beneficial when it comes to ensuring a fixed and immobilized orientation of the corresponding instrument 210 in the eye 250 during surgery.

[0017] It is worth noting that the term "tube" is not meant to imply that the tube 215, such as that shown in FIG. 2, needs to be hollow or include an inner channel through which a fluid can pass. For example, a "tube" may include a line, such as a polymer jacket or other casing structure used to deliver power to the fixture. Indeed, as described further below, a fixed fixture may be a pendant lighting fixture 300 with its own tube or line 315 in the form of a power line that may benefit from immobilization of the platform 100 as described herein (see FIG. 3).

[0018] Referring now specifically to FIG. 2, a top view of a patient's eye 250 during draped surgery using the slotted tube security platform 100 of FIG. 1 is shown. As with other minimally invasive procedures, a drape or sheet 201 of material is often found covering the patient in the surgical area, with an opening to show the surgeon the sanitarily isolated area where the surgery will be performed. In this case, the eye 250 is presented. The eye 250 includes a centrally located cornea 290 and a sclera 280. Due to the delicate nature of the cornea 290, the intervention is generally routed through the sclera 280 in an offset position. Specifically, in the illustrated embodiment, three separate pre-positioned cannulas 220, 240, 280 are shown at the sclera location. The cannulas 220, 240, 280 are of such minimal size that they are placed on the less delicate sclera 280 to minimize recovery time.

[0019] Although the embodiments herein are not limited to the scenario depicted in FIG. 2, it is quite common for ophthalmic surgery to include three separate cannula arrangements as shown. In this manner, one position is shown (280) through which a surgical tool may be presented for operation inside the eye 250, while two other positions are also available, one for illumination (240) and the other for an injection port (220) (see also FIG. 3). Of course, additional positions may be included, and possibly fewer. However, so long as one cannula position 220, 240, 280 is configured to accommodate a fixed position instrument, such as the injection port 210, significant benefits of having an available slotted tube security platform 100 may be realized.

[0020] As shown, FIG. 2 shows the platform 100 adhered to a sheet 201 surrounding a surgical site. The immobilized platform 100 and body 150 may also be used to immobilize / prevent movement of a tube 215 extending from a fixed position instrument, such as an injection port 210. As shown, the tube 215 is shaped to form a service loop between the platform 100 and a corresponding cannula 220. In this manner, the flexible tube 215 is left tension-free between the stabilized cannula 220 and multiple positions on the platform 100. Therefore, the tube 215 is prevented from imparting any forced movement to the fixed port 210. As a result, a properly placed port 210, for example, oriented substantially perpendicular to the eye 250, is protected from any pulling due to the weight of the tube that may affect the orientation of the port. Once again, this is accomplished without the need for the surgeon to tape and re-tape the tube 215 and form the appropriate service loop with each taping and re-taping.

[0021] Avoiding the taping and retaping steps can be particularly beneficial to the surgeon in ophthalmic surgery, since instrument interchangeability is fairly common in ophthalmic procedures. For example, given the illustrated scenario, the procedure requires moving the injection port 210 from the illustrated position to the pre-positioned cannula at 240. However, once the platform 100 is ready for use, untapping and retaping of the tube 215 is no longer necessary. Instead, the surgeon disconnects the tube 215 from the platform 100, moves the port 210 to the adjacent cannula 240, and then restabilizes the tube 215 back to the platform 100 with a newly routed and shaped service loop consistent with the new positioning. Thus, not only is the tube 215 more accurately stabilized than the taping and retaping process, but the efficiency afforded to the surgeon in changing the position is also increased.

[0022] 3, there is shown a side cross-sectional view of an eye 250 during surgery as shown in FIG. 2 with multiple instruments 210, 300 in a fixed orientation as supported by the platform 100 of FIG. 1. For both instruments 210, 300 shown, the fixed orientation is approximately 45° off-center from a vertical axis through the eye 250 (e.g., approximately 45°-135°). Furthermore, the fixed nature means that the surgical procedure can proceed hands-free for both instruments 210, 300. That is, with the injection port 210 or the illuminator 300 properly placed and oriented, there may not be a regular desire to reposition or change the depth of the intervention. Therefore, as long as the associated tubes 215, 315 are included, the surgery can proceed without any substantial further concern or care regarding these instruments 215, 315. This is a significant benefit to the surgeon who can now focus primarily on manual interventional tools, such as a vitrectomy probe through a separate pre-placed cannula (e.g., 280 in FIG. 2).

[0023] Continuing with reference to FIG. 3 and the example vitrectomy procedure, the interior 310 of the eye 250 is illuminated by a lighting fixture 300, which may be a conventional hanging light chandelier or other suitable fixed location device. Thus, a vitrectomy through another cannula (e.g., 280, FIG. 2) may proceed illuminated, for example, avoiding the retina 360 or other more delicate features. Reliability of the illumination may be facilitated by stable holding of the associated line 315 by the platform 100, FIG. 1 and FIG. 2.

[0024] In addition to reliably and fixed illumination, pressure within the eye 250 may also be more reliably maintained by the injection port 210. That is, orientation stability of the port 210 is more easily ensured, also due to the unique manner of reliable retention of the tube 215 by the platform 100. As discussed above, this reduces the likelihood that the port 210 will unintentionally angle too far from vertical and become occluded by the surface of the choroid 285 that defines the interior 310 of the eye. Thus, sufficient pressure, for example, about 15-60 mm / Hg, may be maintained within the interior 310 of the eye. This not only benefits the health of the eye, but may also help the surgeon perform the vitrectomy or other more directly manual portions of the procedure. Sufficient pressure may aid visualization, presenting the features of the eye to the surgeon in a clearer manner, and facilitating peeling, cutting, or other more manipulative interactions. Additionally, avoiding sudden pressure changes also helps avoid unintended damage to the eye 250 by manual surgical tools due to sudden changes in the position of features of the eye 250.

[0025] 2, in addition to the benefit of maintaining a secure line 315 or tube 215, the platform 100 provides a stable, fixed, reusable device. Thus, when a procedure such as that shown in FIG. 3 requires a change of instrumentation, for example by replacing the lighting instrument 300 in one cannula 240 with the injection port 210 in the other cannula 220, this can be accomplished effectively without imprecise taping and retaping. Instead, the surgeon can simply remove the line 315 and tube 215 from the platform 100, if necessary, and reposition in its place a new service loop that fits into the new location of the instrument 300, 210.

[0026] 4A-4C, an alternative embodiment of the slotted tube security platform 401, 402, 403 is shown. As with the embodiment of FIG. 4A, the body 450 may be an injection molded hard plastic. An adhesive layer 425 is again provided as detailed above. However, with this embodiment, retention of the orifices 460, 470, 480 is not by foam compression. Instead, the illustrated orifices 460, 470, 480 act as slots that are also partially defined by raised structures 490 that lead to a snap fit for different tube sizes.

[0027] 4B, the platform 402 again includes a body 451 and an adhesive layer 426. In this embodiment, the body 451 is also curved on the outer surface 405 to expand the amount of surface presented from the surgeon's point of view. Thus, reaching a given slot 461 or 471 to direct a tube into the orifice 465 or 467 can be accomplished in a more ergonomically usable manner. Once again, with respect to the embodiment shown, the orifices 465, 467 and the slots 461, 471 may be of different sizes depending on the likely size of the tube to be held. Along these lines, the body 451 may be a die cut form with the orifices 465, 467 and the slots 461, 471 sized slightly smaller than the anticipated tube size as detailed above.

[0028] For the embodiment of platform 403 of FIG. 4C, a different die cut foam body 452 with underlying adhesive layer 427 may be used. In this case, slots 462, 472 may be concave to ergonomically locate closed slits 463, 473 that may be traversed by the tube when reaching orifices 465, 467 described below. Of course, slits 463, 473 may include two foam sides that meet and the sides may separate when the tube traverses orifice 465, 467. However, as also described above, the diameter of each orifice 465, 467 may be 5-10% smaller than the diameter of the tube to be held by platform 403 in a compressible manner that does not materially restrict any flow through the tube. Alternatively, in yet another embodiment, body 452 may have no orifices and slots 462, 472 may terminate at slits 463, 473 that directly aid in achieving tube retention.

[0029] 5, a flow chart is shown summarizing one embodiment of using a slotted tube security platform to facilitate immobilization of instruments during ophthalmic surgery. Specifically, as noted at 515, the platform is secured to a surgical sheet adjacent to the eye. A fixed position instrument is then placed through a cannula on the surface of the eye (see 530). As noted at 560, a service loop of tubing from the placed instrument may be secured with the platform. Similarly, as noted at 545, another instrument may be positioned through another cannula on the surface of the eye. This may be a manual or otherwise mobile intervention device, or may be a separate device for placement where another service loop of tubing is secured to the platform, as noted at 575. Nevertheless, the position of the instrument may be efficiently swapped without the use of tape, as noted at 590, by removing the instrument tube and re-securing it to the platform as needed.

[0030] The embodiments described above include unique devices and techniques for avoiding the taping and retaping of service loops extending from fixed position surgical devices. This is particularly beneficial when it comes to injection ports used during ophthalmic surgery for reasons detailed above. However, other fixed position surgical devices, such as lighting instruments, or even devices used outside of ophthalmic surgery, may also benefit.

[0031] The foregoing description has been presented with reference to the presently preferred embodiment. However, other embodiments and / or features of embodiments disclosed but not detailed above may be employed. Moreover, those skilled in the art and technology to which these embodiments pertain will appreciate that still other substitutions and modifications in the described structure and method of operation may be made without significantly departing from the principles and scope of these embodiments. In addition, the foregoing description should not be read as relating solely to the exact structure described and shown in the accompanying drawings, but rather as consistent with and in support of the following claims, which shall have their fullest and most reasonable scope.

Claims

1. 1. A slotted tube security platform for facilitating surgery, said platform comprising: a body having at least one slot for receiving a tube extending from a surgical device at a fixed surgical position on a patient; and an adhesive mechanism coupled to the body for securing the platform to a surgical sheet adjacent the surgical site; Includes a slotted tube security platform.

2. The platform of claim 1 , wherein the slot is a channel to an orifice for receiving.

3. The platform of claim 2 , wherein the diameter of the orifice is less than an outer diameter of the tube.

4. The platform of claim 3 , wherein the body is a die cut form for compressibly retaining the tube in the orifice.

5. The platform of claim 1 , wherein the body is a die cut form and the slot is a guide to a slit for compressibly retaining the tube in the orifice.

6. The platform of claim 1 , wherein the body is a hard molded form for snap-fit ​​retention of the tube.

7. 1. A surgical system for ophthalmic surgery, the system comprising: a handheld instrument for performing a surgical procedure on a patient's eye through a first pre-placed cannula at the eye; a stabilized instrument for reaching into the patient's eye from a fixed location on a second pre-placed cannula at another location on the eye; and a slotted tube security platform for inhibiting movement of a tube coupled to the stabilized instrument to facilitate fixed orientation of the stabilized instrument relative to the eye of the patient; A surgical system comprising:

8. The surgical system of claim 7 , wherein the tube is one of a fluid line and a power line.

9. The surgical system of claim 7, wherein the fixed orientation is between about 45° and 135° relative to the eye of the patient.

10. The surgical system of claim 9 , wherein the fixed orientation is substantially perpendicular to the eye of the patient.

11. The surgical system of claim 7 , wherein the stabilized instrument is one of an injection port and a lighting instrument.

12. 1. A method of performing ophthalmic surgery, the method comprising: securing a slotted tube security platform to a surgical sheet adjacent to the eye; placing a fixed position device through a cannula on the surface of the eye; and Securing a service loop of tubing from said instrument at said platform. A method comprising:

13. 13. The method of claim 12, further comprising positioning another instrument through another cannula on the surface of the eye at another location.

14. securing another service loop of tubing from another instrument on said platform; and Performing manual surgical procedures with other instruments The method of claim 13 further comprising one of:

15. swapping the position of instruments between said cannulas; and Re-securing the service loop of the tubing to the platform. The method of claim 13 further comprising:

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