Multiple Cannula Retrocurl Assembly

Abstract

A trocar assembly for ophthalmic surgery having a blade configured to accommodate multiple cannulas simultaneously. The blade may include one or more stoppers to hold any cannula in place before placement. By accommodating multiple cannulas in this way, it facilitates a novel method of ophthalmic cannula placement that minimizes the waste of the trocar assembly and improves the efficiency associated with instrument changes in surgery.

Description

Technical Field

[0001] The present invention relates to a multi-cannula trocar assembly.

Background Art

[0002] Vitreous resection is the removal of part or all of the vitreous humor from the patient's eye. In the case of surgery limited to the removal of turbid vitreous humor, in some cases, vitrectomy may account for the majority of the treatment. However, vitrectomy may involve retinal repair surgery, macular patching, or surgery to address many other problems.

[0003] Regardless of the details, in ophthalmic surgery, several different incisions may be required. For example, one incision may be created to provide access for a lighting device to illuminate the surgery. Another incision may be created for a vitrectomy probe or other surgical instrument. In some cases, in view of the removal of vitreous humor through the vitrectomy probe, another corresponding incision may be required to supply perfusion fluid to maintain an appropriate balance within the eye.

[0004] For each of these incisions, a cannula and trocar assembly can be used to create the incision and then support the corresponding instrument. Specifically, the trocar blade can be used to puncture the eye at an appropriate position to form an incision. Thereafter, the blade can be inserted into the eye until the lower surface of the cannula surrounding the blade generally contacts the outer surface of the eye at the scleral position.

[0005] Once the cannula is set, the trocar can be discarded and the process can be repeated (e.g., two more times with two more trocars and cannula assemblies). Regardless of the number of cannulas set as described, each cannula requires its own dedicated trocar for placement. The trocar blade may be less than 1 mm (millimeter) in diameter, and the cannula may be less than 5 mm at its hub.

[0006] Unfortunately, routinely discarding several trocars in almost all ophthalmic surgeries results in a considerable amount of waste and wasted labor. Furthermore, the disposal of such trocars not only increases the amount of medical waste involved, but also means that the manufacturing labor spent on highly precise instruments is tripled. [Overview of the Initiative] [Means for solving the problem]

[0007] A trocar assembly for housing multiple cannulas for ophthalmic surgery. The assembly includes a handle for the surgeon to manipulate and a trocar blade extending from the handle. The blade includes at least one stopper extending from its outer surface. Multiple cannulas are arranged around the trocar blade, and at least one of the multiple cannulas is held in place by at least one stopper. [Brief explanation of the drawing]

[0008] [Figure 1] This is a perspective view of one embodiment of a multiple cannula retrocurl assembly for use in ophthalmic surgery. [Figure 2] This is a magnified view of the needles in a multiple cannula retrocurl assembly. [Figure 3A] Figure 2 is a magnified view of the needle during the placement of the first cannula from the assembly. [Figure 3B] Figure 2 is a close-up view of the needle during the placement of the second cannula from the assembly. [Figure 3C] Figure 2 is a close-up view of the needle during the placement of the third cannula from the assembly. [Figure 4] This is a cross-sectional view of the eye during a vitrectomy surgical procedure facilitated by the placement of multiple cannulas using a single trocar assembly. [Figure 5] This flowchart illustrates one embodiment of using a multiple cannula retrocurl assembly to facilitate ophthalmic surgery. [Modes for carrying out the invention]

[0009] The following description includes many details to provide an understanding of the disclosure. However, those skilled in the art will understand that the embodiments described may be carried out without these specific details. Furthermore, numerous variations or modifications may be employed, which are also contemplated by the embodiments specifically described.

[0010] Embodiments will be described with reference to a particular type of surgical procedure. For example, a procedure to remove vitreous fluid to address vitreous hemorrhage is shown. In such a procedure, embodiments of the multiple cannula trocar assembly may be used at various eye locations to position the cannulas to support a variety of different procedures. For example, the cannulas positioned by the assembly can facilitate the positioning of a vitreous probe needle, light source, or perfusion device. Such procedures may be used to address retinal detachment, macular fold formation, macular hole, vitreous floatations, diabetic retinopathy, or various other eye conditions. In any case, considerable benefits can be realized as long as multiple cannulas can be positioned as shown by the same trocar assembly. Furthermore, although the trocar cannula is described in relation to intraocular use, it should be understood that the trocar cannula may be used at any appropriate body site where a cannula may be required for a surgical procedure.

[0011] Referring here to Figure 1, a perspective view of one embodiment of a multiple cannula retrocurl assembly 100 for use in ophthalmic surgery is shown. The assembly 100 includes a trocurl blade 190 extending from a surface 140 of the trocurl body 127. The body 127 includes a conventional handle 125 and a gripping area 130.

[0012] The trocar blade 190 is configured to create an incision in the eye. More specifically, the incision in the eye can be created using the blade 190, which can be left in place for the delivery of a cannula (e.g., 175). Thus, ophthalmic surgery can be facilitated as shown in Figure 4. In any case, in the illustrated embodiment, the blade 190 is configured to accommodate multiple cannulas 155, 165, and 175. Thus, unlike conventional trocar assemblies that are discarded after the placement of a single cannula, multiple cannulas can be placed using a single assembly 100 as shown, making ophthalmic surgery easier. As a result, both equipment costs and surgical efficiency due to reduced instrument changes can be beneficially affected.

[0013] Referring now to Figure 2, a magnified view of the needle 190 of a multi-cannula retrocurl assembly 100 taken from Figure 1, section 2-2, is shown. This highlights that three separate cannulas 155, 165, and 175 are housed by a single needle 190. For illustrative purposes, the cannulas 155, 165, and 175 are shown spaced apart for better visibility. However, in some embodiments, the spacing between the cannulas 155, 165, and 175 may be smaller (for example, due to the presence of stoppers 200, 201 as described below).

[0014] As shown in the figure, each cannula 155, 165, and 175 includes a conventional valve hub 265 and a tubular cannula extension 267. Therefore, since the inner diameter of the extension 267 is slightly larger than the outer diameter of the blade 190, the blade 190 can accommodate multiple cannulas 155, 165, and 175 in series as shown in the figure.

[0015] Naturally, with multiple cannulas 155, 165, 175 on the blade 190, it may be beneficial to hold in place a cannula (e.g., 155, 165) that is not yet ready to be placed in the eye. Therefore, limpet stoppers 200, 201 are provided. These limpet stoppers 200, 201 may constitute any suitable form of a mechanically raised shape on the outer surface of the needle 190. For illustrative purposes, the size of the limpet stoppers 200, 201 is slightly exaggerated. For example, the limpet stoppers 200, 201 may not be visually perceptible unless the surgeon observes carefully.

[0016] As a mere example, the assembly 100 in Figure 1 may include 25-gauge cannulas 155, 165, 175 paired with a 26-gauge trocar blade or needle 190. In such a scenario, the inner diameters of the cannulas 155, 165, 175 are generally sufficient to accommodate the needle 190 through the extension 167 and hub 265. However, the raised outer shape of the stoppers 200, 201 extending the blade gauge to about 24 is also large enough to prevent the cannulas 155, 165 from accidentally moving toward the distal end of the needle 190 (e.g., opposite the handle 125) (e.g., by frictional engagement between the outer surface of the stopper and the inner surface of the cannula).

[0017] Note that in the illustrated embodiment, the stoppers 200, 201 are not shown distal to the first cannula 175 being positioned. Rather, with respect to this cannula 175, the conventional outer surface of the needle 190 may be utilized without concern for the more proximal cannulas 155, 165 to come into contact with this first cannula 175 or for this first cannula 175 to advance prematurely and unintentionally. Naturally, in another embodiment, additional stoppers 200, 201 may be positioned distal to this first cannula 175 to add stability. On the other hand, in yet another embodiment, the stoppers 200, 201 may be limited to a position between this first cannula 175 and the next cannula (e.g., 165) for positioning. In other words, depending on the shape and properties of the movement stoppers 200 and 201, the movement stopper located immediately proximal to the first cannula 175 can function as a sufficient safety measure against the possibility of the other cannulas 165 and 155 advancing.

[0018] The stoppers 200 and 201 can be any suitable minimum shape sufficient to prevent the cannulas 155, 165, and 175 from advancing prematurely (for example, by frictional engagement between the stoppers and the inner surface of the cannula). At the same time, the stoppers 200 and 201 are small enough to allow the minimum amount of force required to advance the cannulas 155, 165, and 175 distally away from the handle 125 in Figure 1. In fact, this may be less than the minimum force a surgeon uses when setting the cannulas 155, 165, and 175. For example, a surgeon performing an ophthalmic surgery as shown in Figure 4 may achieve this advancement solely by manual manipulation.

[0019] Referring now to FIGS. 3A - 3C, enlarged views of the needle 190 during the placement of the cannulas 155, 165, 175 of FIG. 2 are shown. In this figure, the placement of the first cannula 175 is shown in FIG. 3A. Note that the stop 200 is shown only above or proximal to the set cannula 175 in the patient's eye 300. In this embodiment, the relationship between the cannula 175 to be placed and the needle 190 is conventional such that the cannula 175 is allowed some flexibility in movement along the needle 190. The illustrated stop 200 is limited to a position proximal or above this first cannula 175, a position sufficient to avoid unintentional contact or advancement as a result of any physical interference by the more proximal cannulas 165, 155.

[0020] The illustrated stop 200 is also shown as a rather smooth raised bump, ring or other slight protrusion on the outer surface of the needle 190 that presents a raised profile for temporarily holding the more proximal cannulas 165, 155 in a position above the first cannula 175. However, in other embodiments, the stop 200 may be a deflectable, stowable or reciprocating arm. In any case, unintentional advancement of the first cannula 175 beyond the stop 200 during setting is prevented.

[0021] Referring now to FIG. 3B, an enlarged view of the needle 190 of FIG. 2 during the placement of the second cannula 165 from the assembly 100 of FIG. 1 is shown. In this figure, this second cannula 165 has advanced beyond the stop 200 and is positioned at a predetermined location in the eye 300 to facilitate the ophthalmic surgery shown in FIG. 4. As described above, this can be achieved with a minimal force applied manually by the surgeon or using other aids such as a cannula mounting instrument.

[0022] Referring now to FIG. 3C, an enlarged view of the needle 190 of FIG. 2 during placement of the third cannula 155 from the assembly 100 of FIG. 1 is shown. In this figure, it is clear that three different cannulas 155, 165, 175 are successively placed from the same assembly needle 190. This means that, as shown in FIG. 4, three different surgical access points are provided without the need for any instrument replacement or disposal. Rather, the same needle 190 is used for the same patient and eye 300, and is configured to avoid the need to successively introduce, discard, and reintroduce the needle. Instead, a single assembly 100 as shown in FIG. 1 can be used to place all three cannulas 155, 165, 175. For the purposes of illustration, a three-cannula assembly will be described here, assuming it is a common practice in ophthalmic surgery. Of course, in actual practice, two cannulas, four cannulas, or other numbers of multiple cannula embodiments may be used, taking into account the details of the surgery.

[0023] Referring now to FIG. 4, a cross-sectional view of the eye 300 during a vitrectomy surgical procedure is shown. This procedure is facilitated by the pre-placement of multiple cannulas (165, 175) by the single trocar assembly 100 of FIG. 1. In this embodiment, the last cannula 155 of FIGS. 1, 2, and 3A is placed in the portion of the opposite eye 300 that is not visible in the illustrated figure.

[0024] The cannulas 165, 175 shown in FIG. 4 are arranged to facilitate the guided support of the vitrectomy probe 400 and the light source 425. The cannulas 165, 175 are of a relatively short length and serve to avoid the risk of damaging the optic nerve 460, the retina 475, and other more delicate features behind the eye 300 by means of the cannula extensions 267 (see FIG. 2). Similarly, the trocar blade or needle 190 and the instruments 400, 425 are here configured to connect to the cannulas 165, 175, which also prevents reaching too deep into the eye 300.

[0025] The support and guidance of the positioned cannulas 165 and 175 ensure that the surgery can proceed smoothly. In the illustrated example, the needle of the vitrectomy probe 400 is inserted through one of the cannulas 175 and directed towards the area 410 from which vitreous fluid is to be removed. Specifically, suction is applied, and port 477 is used to draw up vitreous fluid or other substances. For example, in the illustrated procedure, bleeding may occur within area 410, so the blood is drawn into port 477 along with the vitreous fluid.

[0026] The illustrated surgery also includes an illuminator 425 that reaches into the eye 300 through another cannula 165. In both cases, the cannulas 165 and 175 are positioned offset in the sclera 470. In this way, the more delicate cornea 490 and lens 480 can be avoided.

[0027] Referring here to Figure 5, a flowchart is shown summarizing one embodiment of using a multi-cannula trocar assembly to facilitate ophthalmic surgery. As shown in reference no. 515, with the multi-cannula single trocar assembly in hand, the blade of the assembly can be used to access the inside of the eye and deliver the first cannula to the access position in the eye (see reference no. 530, 545). However, the blade can be reused without spending time reloading another cannula. Instead, the blade is already equipped with another cannula. Therefore, as shown in reference no. 560, the blade can be moved to another position in the eye to provide access to the inside from another access position (see reference no. 575). With the blade in place, another cannula may be delivered to this other access position (see reference no. 590).

[0028] For example, the first stopper may be sized to frictionally engage the first cannula of multiple cannulas with the trocar blade when the trocar blade is inserted into the body and the first cannula is positioned within the body. The first stopper may have an outer diameter sized to frictionally engage with the inner surface of the first cannula. In some embodiments, the friction engagement holds the first cannula in place relative to the trocar blade while the first cannula is being inserted into the body. The trocar blade may include a second stopper on the trocar blade, located closer to the handle than the first stopper, and the second stopper may frictionally engage with the second cannula. Similarly, additional stoppers may hold additional cannulas along the trocar blade. In some embodiments, the second stopper is sized to allow the second cannula to advance beyond the second stopper and be positioned against the first stopper by manual operation by the user. In some embodiments, the first stopper is sized to frictionally engage the second cannula with the trocar cannula when the trocar cannula is reinserted into the body and the second cannula is positioned within the body. The second cannula may then remain in the body when the trocar blade is withdrawn (for example, the interference between the outer surface of the cannula and the body portion in contact with the cannula may be greater than the frictional interference between the first stopper and the inner surface of the cannula). In some embodiments, the user may also assist in retaining the cannula in the body by applying pressure to the hub (for example, with the user's fingers) when the trocar blade is withdrawn.

[0029] The embodiments described herein include instruments and techniques that enable the delivery of multiple ocular cannulas from a single trocar assembly. In this way, the discarding of the trocar assembly between multiple uses on the same eye can be avoided. In fact, the blade of the assembly may be pre-loaded to avoid stopping the procedure to reload another cannula onto the blade. Instead, after the first cannula has been placed by the assembly, the surgeon can proceed directly to the placement of the next cannula. Thus, both discard efficiency and surgical efficiency can be improved.

[0030] The foregoing description is presented with reference to several embodiments. However, other embodiments and / or features of embodiments that are disclosed but not detailed above may be adopted. Furthermore, those skilled in the art and the technical field to which these embodiments belong will understand that other alternative and modified forms of the described structures and methods of operation can be implemented without departing significantly from the principles and scope of these embodiments. In addition, the foregoing description should not be read as relating only to the exact structures described and shown in the accompanying drawings, but rather as being consistent with and supporting the following claims, which will have their maximum and most appropriate scope.

Claims

1. A trocar assembly for arranging multiple cannulas, comprising a body of the assembly having a handle, A trocar blade extending from the main body, including at least one stopper extending from the outer surface of the trocar blade, A plurality of cannulas surrounding the trocar blade, wherein the at least one stopper is sized to frictionally engage with the trocar blade when the trocar blade is inserted into the body and the at least one cannula is positioned within the body, A trocar assembly, including the trocar assembly.

2. The trocar assembly according to claim 1, wherein the at least one stopper includes a first stopper having an outer diameter sized to frictionally engage with the inner surface of the at least one cannula.

3. The trocar assembly according to claim 2, wherein the friction engagement holds the at least one cannula in a predetermined position relative to the trocar blade while the at least one cannula is inserted into the body.

4. The trocar assembly according to claim 2, wherein the at least one stopper includes a second stopper on the trocar blade, which is positioned closer to the handle than the first stopper, and the second stopper is configured to frictionally engage with a second cannula of the at least one cannula.

5. The trocar assembly according to claim 4, wherein the second stopper is sized to engage with friction, but the second cannula can still be advanced beyond the second stopper and positioned against the first stopper by manual operation by the user.

6. The trocar assembly according to claim 5, wherein the first stopper is sized to cause frictional engagement of the second cannula with the trocar cannula when the trocar cannula is reinserted into the body and the second cannula is positioned within the body.

7. Each of the aforementioned cannulas has a hub for fixing it to the outer surface of the eye, A tubular extension is connected to the hub and provides access to the inside of the body, The assembly according to claim 1, including the assembly described in claim 1.

8. A method for positioning multiple cannulas to assist in a surgical procedure, The procedure involves puncturing the surface of the body at a first position using a trocar blade that accommodates multiple cannulas, To deliver the first cannula of the plurality of cannulas from the trocar blade to the first position, Moving the aforementioned trocar blade to another position, Using the trocar blade to puncture the surface of the body at another location, To deliver the second cannula of the plurality of cannulas from the trocar blade to the second position, Methods that include...

9. The method according to claim 8, further comprising accessing the inside of the body with one extension of the cannula.

10. The method according to claim 8, wherein the trocar blade includes at least one stopper for holding the second cannula before the trocar blade moves to another position.

11. The procedure further includes performing a surgical procedure through the cannula, wherein the surgical procedure is The first surgical instrument is placed inside through the first cannula, The second surgical instrument is placed inside through the second cannula, The method according to claim 8, including the method described in claim 8.

12. The method according to claim 8, wherein delivering the first cannula includes frictionally engaging the first cannula via a first stopper on the trocar blade when the trocar blade is inserted into the body and the first cannula is positioned within the body.

13. Before delivering the second cannula, The second cannula is frictionally engaged via a second stopper on the trocar blade, which is located closer to the handle than the first stopper. The method according to claim 12, further comprising:

14. The method according to claim 13, further comprising manually moving the second cannula forward beyond the second stopper and positioning it at the first stopper by a user.

15. The method according to claim 14, wherein delivering the second cannula includes frictionally engaging the second cannula with the trocar cannula when the trocar cannula is reinserted into the body and the second cannula is delivered to a second position.

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