Dynamically adjustable reinforcement sleeve

Abstract

A surgical tool having a reinforcing sleeve that can be dynamically retracted during surgery. The tool includes a needle or instrument for performing minimally invasive surgery through a cannula pre-positioned at a surgical site. The reinforcing sleeve of the tool around the instrument can provide an additional degree of rigidity, such as when the instrument is particularly thin. However, when the instrument is advanced over the cannula for surgery, the end of the sleeve remains in place on the cannula. Nevertheless, as determined by the surgeon, the instrument can be advanced further, if necessary, by corresponding intentional retraction of the sleeve into the tool body.

Description

Technical Field

[0001] Cross - Reference to Related Applications This application claims the benefit of priority of U.S. Provisional Patent Application No. 63 / 126,731, entitled "DYNAMICALLY ADJUSTABLE STIFFENING SLEEVE", filed on December 17, 2020, with inventors Reto Gruebler and Klaus Dorawa, and the entire disclosure of which is hereby incorporated by reference as if fully and completely set forth herein.

Background Art

[0002] Over the years, many dramatic advancements have occurred in the field of minimally invasive surgical procedures. Consequently, spontaneous patient injury and healing time have been dramatically reduced. As an example, in the area of ophthalmic surgery, damaged or deteriorated tissue that was previously inaccessible can now be repaired or directly treated by minimally invasive procedures. When ophthalmic surgery involves access to the retina, it is common for at least a portion of the procedure to include a vitrectomy. A vitrectomy is the removal of some or all of the vitreous humor from the patient's eye. In the case of a surgery limited to the removal of cloudy vitreous humor, in some cases, the vitrectomy may account for the majority of the procedure. However, a vitrectomy may also be associated with surgeries for retinal repair, macular pucker formation, or a number of other diseases.

[0003] In the case of ophthalmic surgery and vitrectomy, the vitreous fluid itself is a clear gel and can be removed by an elongated needle once an elongated probe is inserted through a pre-positioned cannula in the eye. More specifically, the vitrectomy probe is a surgical tool held in a grasping position by the surgeon with the needle emerging from the tool, as described. The needle contains a central channel for removing the vitreous fluid. Furthermore, the cannula provides a conduit for structural support strategically located in an offset position in the anterior part of the eye, such as the ciliary body squamata. In this way, the probe needle may be inserted so as to be guided into the eye in a manner that avoids damage to the patient's lens or cornea.

[0004] As illustrated, the needle is generally guided and supported by a cannula and trocar assembly pre-positioned at the site of the ciliary body incision. Thus, the needle can be reliably advanced into the eye to perform the surgical procedure. Naturally, as with the probe needle for vitrectomy, various other surgical instruments can be similarly advanced through the cannula and trocar assembly for various different surgical purposes. These may include forceps, scissors, illuminators, and other instruments.

[0005] Over the years, minimally invasive surgeries such as vitrectomy have utilized increasingly smaller instruments for increasingly precise surgical techniques. For example, a vitrectomy probe needle, which may have traditionally been around 23 gauge, may now be around 25 or 27 gauge. This reduces the needle diameter from approximately 0.5 mm to less than 0.4 mm. Considering that vitrectomy probe needles are likely to be hollow, instruments with progressively smaller gauges may be more flexible. Similar flexibility challenges may arise with other instruments as well, including vitrectomy probe needles, as their size decreases.

[0006] Increased flexibility or pliability of surgical instruments is not necessarily beneficial to the surgeon during a procedure. Generally, surgeons can be better assisted by the greater control provided by a certain degree of rigidity of the instrument. That is, if the instrument is not very flexible, the surgeon's manual manipulation of the instrument in an external position is more likely to be reliably transmitted to the surgical site. For example, in a vitrectomy procedure, the probe may include a grip, and the needle extends from the grip toward and through the described cannula structure in the eye. A larger and more rigid reinforcing sleeve may extend from the structural support of the cannula toward the body and grip of the tool. Thus, the presence of the reinforcing sleeve may prevent bending of the needle, at least in the space between the surgeon's gripping position and the anterior aspect of the eye. Rather, a reliable and dependable linear motion is transmitted from the grip to the pivot position on the surface of the eye (e.g., where the reinforcing sleeve contacts the cannula). Again, the actual length of the needle present in the eye and not structurally constrained by the reinforcing sleeve is limited. Thus, needle bending is further minimized. Unfortunately, using reinforced sleeves as described in detail may reduce the usable length of the needle that can be used intraocularly, because the outer diameter of the sleeve may not fit inside the cannula. [Overview of the project]

[0007] A surgical tool is provided. The tool includes a gripping element that is held in place by the surgeon's hand, and the surgical instrument can extend from the element for surgical access to the patient's tissue area. A reinforcing sleeve is provided around the instrument to stabilize it during surgical procedures in the area where the instrument is used. A biasing mechanism is coupled to the sleeve. The biasing mechanism extends the sleeve to its maximum extent from the element, but allows it to retract into the element in response to the instrument making contact with a structure in the tissue area. [Brief explanation of the drawing]

[0008] [Figure 1]This is a side perspective view of a surgical tool using a needle, supported by one embodiment of a dynamically adjustable reinforcing sleeve. [Figure 2a] This is a side cross-sectional view of a first embodiment of a reinforcing sleeve in an extended configuration. [Figure 2b] This is a side cross-sectional view of a first embodiment of a reinforcing sleeve in a compression configuration. [Figure 2c] This is a side cross-sectional view of a second embodiment of a reinforcing sleeve in an extended configuration. [Figure 2d] This is a side cross-sectional view of a second embodiment of a reinforcing sleeve in a compression configuration. [Figure 3] This is a schematic diagram of a surgical procedure performed with the tool shown in Figure 1, supported by a reinforcing sleeve. [Figure 4A] This is an enlarged view of the procedure in Figure 3, taken from 4-4 in Figure 3, showing the procedure when the sleeve is in the first extended position. [Figure 4B] This is an enlarged view of the procedure shown in Figure 4A, which indicates the sleeve at the second retraction position. [Figure 5] This flowchart outlines one embodiment of a minimally invasive surgical procedure performed using a needle supported by a dynamically adjustable reinforcement sleeve. [Modes for carrying out the invention]

[0009] In the following description, numerous details are provided to provide an understanding of this disclosure. However, it will be understood by those skilled in the art that the embodiments described may be carried out without these specific details. Furthermore, numerous variations or modifications still intended in the embodiments described specifically may be adopted.

[0010] Embodiments will be described with reference to certain types of surgical procedures. In particular, forceps tools are shown in Figures 2a–2d, while vitrectomy tools for removing vitreous fluid to address vitreous hemorrhage are shown in Figures 1, 3, 4A, and 4B. However, the tools and techniques detailed herein may also be used in a variety of other methods. For example, instruments that reach into the eye for the procedure may be forceps, vitrectomy probes, scissors, etc. Furthermore, although vitrectomy procedures are primarily discussed herein, embodiments of vitrectomy probes detailed herein may be used to address retinal detachment, macular folds, macular holes, vitreous floatations, diabetic retinopathy, or a variety of other ocular conditions. Moreover, vitrectomy and other ophthalmic surgeries often benefit from the use of fairly fine instruments, while other types of surgery may benefit from the unique structures and techniques detailed herein. In fact, considerable advantages can be realized insofar as a dynamically adjustable supportive reinforcement sleeve is used during surgery.

[0011] Referring here to Figure 1, a side perspective view of a surgical tool 101 using a needle 175 supported by one embodiment of a dynamically adjustable reinforcing sleeve 100 is shown. In the illustrated embodiment, the tool 101 is a vitrectomy probe that may be used in procedures further detailed herein. However, such dynamically adjustable reinforcing sleeves 100 may be used in other types of instruments for various different surgical applications. For example, like many other surgical tools, the probe 101 comprises a particularly thin instrument (e.g., a needle 175) (e.g., 20 gauge or smaller). Therefore, even when stainless steel or other suitable durable surgical materials are used, the needle 175 alone may lack the desired rigidity from the surgeon's point of view and may be prone to some degree of bending.

[0012] The aforementioned lack of rigidity exhibited by the needle 175 can be addressed by including the illustrated sleeve 100 around the needle 175. However, unlike conventional sleeves, the illustrated sleeve 100 is dynamically adjustable in terms of the length or distance that the sleeve 100 can extend from the probe 101 to its gripping element 150. Thus, as will be detailed below, the surgeon can advantageously control how much sleeve support is provided for how far the needle 175 can reach. This can be done dynamically, with the distance of the needle 175 changing throughout a given surgical procedure. It should be noted that the dynamically adjustable length of the sleeve 100, as used herein, refers to its extension range from the gripping element 150 of the tool 101. This means, by analogy, that the sleeve 100 includes any distal body portion of the tool 101 that the sleeve 100 may extend, regardless of whether such a feature is generally considered to be essentially for "gripping".

[0013] Continuing to refer to Figure 1, the tool 101 includes a shell 125 behind the gripping element 150. Thus, for example, in the case of a vitrectomy probe, the surgeon can hold the instrument at the gripping element 150 between the thumb and index finger, with the shell placed in the first interdigital space (perlicue) of the hand and the instrument components protectively housed within the shell. As will be further described below, the needle 175 may support a cutter within the needle 175 that interacts with its port 177 to aspirate vitreous fluid in a controlled manner. With respect to such procedures, it is the dynamically positionable nature of the reinforcing sleeve 100 that uniquely supports and facilitates the surgeon's work in this effort.

[0014] Referring now to Figure 2a, a side cross-sectional view of another tool 101 (forceps) is shown. This figure shows the internal structure of the first embodiment of the reinforcing sleeve 100, namely the biasing mechanism 200 that facilitates the dynamic movement of the reinforcing sleeve 100 during a surgical procedure. Thus, for example, in one embodiment, the reinforcing sleeve 100 can be extended by 4-6 mm (other shorter and longer lengths are also intended) when stationary. For example, the reinforcing sleeve can be extended to 2 mm, 0.5 cm (centimeters), 1 cm, 1.5 cm, 2 cm, 2.5 cm, 3 cm, 3.5 cm, etc. Nevertheless, as required by a given surgical procedure, the sleeve 100 may be retracted into the probe 101 by a few centimeters (cm) or millimeters (as seen, for example, in Figure 2b), with the sleeve 100 extended by perhaps about 1 mm or less from the end 230 of the gripping element 150 when fully retracted. As will be further explained below, such retraction or a certain degree of "movement" by the sleeve 100 is translated into extension or exposure of the corresponding needle 175, facilitating surgical access during surgical procedures. Naturally, if a greater degree of movement is desired, the biasing mechanism 200 may include a longer spring or perhaps even multiple aligned springs.

[0015] As seen in Figures 2c and 2d, springs with different diameters can be used as biasing mechanisms. Figure 2c shows a biasing mechanism (in this case, a spring) in an extended position, showing a series of three diameter sections (from smallest to largest, from the reinforcing member to the base). Other numbers of diameters (e.g., 2, 4, 5, 10, etc.) can also be used. By using different diameters, when the spring is compressed, the spring can further retract into itself. For example, as seen in Figure 2d, the spring is shown in a cross-sectional view to show that the smaller diameter spring section is partially pushed into the larger diameter spring section, which in turn is partially pushed into the intermediate diameter spring section. This can result in a smaller final compressed spring length compared to when the spring had a single continuous diameter (as seen in Figures 2a and 2b).

[0016] Continuing to refer to Figures 2a to 2d, the illustrated biasing mechanism 200 is a spring integrally aligned axially with the reinforcing sleeve 100 to provide positional dynamic characteristics to the reinforcing sleeve 100. Support is obtained from a base 250 mounted within the component housing 240 of the probe 101. As shown, the base 250 is also integrally aligned axially with the spring 200 and sleeve 100 so that all three features can be provided as a single integral component for assembly with the probe 101. In some embodiments, the integral sleeve and spring may be made of stainless steel, cobalt steel, or nitinol. Other materials are also intended (e.g., other metals, or plastics such as high-density polyethylene (HDPE), polyvinyl chloride (PVC), or polycarbonate (PC)). In some embodiments, the length of the spring 200 may be short enough to ensure that it does not extend beyond the end 230 even when the spring 200 is fully extended. In some embodiments, the space between the coils of the spring 200 may be selected based on the degree of retraction or extension required of the spring 200. In some embodiments, the connection portion 280 between the sleeve 100 and the end portion 230 may include a slight friction fit so that the sleeve 100 can move relative to the connection portion 280 without large lateral (perpendicular to the outer surface of the sleeve) movement. In some embodiments, the connection portion 280 may include additional space between the sleeve 100 and the base 230 to allow for a quicker spring response (at the expense of some slight further lateral movement). In some embodiments, a lubricant may be applied to the connection portion 280 (or the surface of the sleeve 100 at the connection portion 280 may be smoothed to reduce friction between the sleeve 100 and the end portion 230).

[0017] Figures 2a to 2d also reveal other internal features, such as a probe spring 275 that further biases the fixed base 250 to dampen the spring's movement. A cutter 260, which ultimately reciprocates within the needle 175 to support a vitrectomy procedure, is also revealed. In this regard, the cutter 260 may be reciprocated by other mechanical components within the probe. The cross-section of the proximal end 130 and the method of coupling it to the gripping element 150 are also revealed by referring to Figures 2a to 2d. In some embodiments, the proximal end 130 may be grasped by the surgeon, or further coupled to a handle that is grasped by the surgeon.

[0018] Referring now to Figure 3, a schematic diagram of a surgical procedure performed using the tool 101 of Figure 1 is shown. In particular, the procedure is assisted by a reinforcing sleeve 100. This figure shows a lateral cross-sectional schematic of a patient's eye 350, and the procedure is a vitrectomy. During the procedure, the needle 175 of the probe 101 is inserted through a pre-positioned cannula 330 and directed towards the area 310 from which vitreous fluid is to be removed. Specifically, as described above, aspiration is applied, and the port 177 is used to draw up vitreous fluid or other substances. For example, in the illustrated procedure, bleeding may occur within the area 310, and the blood, along with the vitreous fluid, is drawn into the port 177.

[0019] In the procedure as described, it should be noted that the needle 175 reaches inside the eye 350, but the reinforcing sleeve 100 surrounding the needle 175 does not reach inside the eye 350. Rather, the end of the sleeve 100 is firmly seated on the internal structure of the cannula 330. More specifically, the internal structure of the cannula can be in the form of a funnel or other accommodating configuration to receive and support the end of the reinforcing sleeve 100 during the procedure. Similarly, in the center of the cannula 330 is an orifice large enough to allow passage of the needle 175. Of course, the orifice is also too small to allow passage of the sleeve 100. Thus, for example, in one embodiment, the orifice may have a diameter of about 0.475 mm to allow passage of a 25-gauge and smaller needle 175 (e.g., with a diameter of 0.455 mm or less). At the same time, this orifice blocks passage of a 23-gauge and larger sleeve 100 (e.g., with a diameter of 0.58 mm or more). Of course, various different combinations of dimensions may be used to facilitate passage of the needle through the orifice of the cannula 330 as described and block passage of the sleeve.

[0020] With the sleeve 100 stably connected to the internal structure of the cannula 330, the surgeon can manipulate the needle about the fulcrum of the cannula 330. In this way, a certain stable working area is obtained while the needle 175 is inside the eye 350. Further, the sleeve 100 provides auxiliary rigidity between the cannula 330, where there is concern about unintended bending, and the tool 101 of FIG. 1.

[0021] Continuing to refer to FIG. 3, as described above, the cutter reciprocates within the needle 175 during this delicate procedure. The illustrated surgery also includes a lighting device 325 that reaches into the eye 350 through a separate cannula 315. In either situation, the cannulas 315, 330 are offset in the sclera 370. In this way, the more delicate cornea 390 and lens 380 can be avoided.

[0022] Similarly, the optic nerve 360 and the retina 375 are also extremely delicate. Keeping this in mind, the reinforcement sleeve 100 can play a first role in preventing the needle 175 from unintentionally reaching deep into the eye 350. However, similarly, the surgeon may also apply an intentional force so that the sleeve 100 can overcome the biasing mechanism 200 inside the tool 101 (see FIG. 1). Thus, as will be described in more detail below, the sleeve 100 can be dynamically drawn into the gripping element 150 at the end 230 of the gripping element 150, allowing for further intended advancement of the needle 175.

[0023] Referring now to FIG. 4A, an enlarged view of the procedure of FIG. 3 taken from 4-4 of FIG. 3 is shown. Specifically, FIG. 4A shows the procedure with the sleeve 100 in the first extended position. In the extended position, the sleeve 100 covers an extension distance (d) between the cannula 330 and the end 230 of the gripping element 150 that is substantially larger than a retraction distance (d') as shown in FIG. 4B. More specifically, FIG. 4B shows an enlarged view of the procedure of FIG. 4A with the sleeve 100 in a second retracted position that is intentionally guided by the surgeon during the procedure. Additionally referring to FIG. 2, the retracted position of the sleeve 100 being drawn into the tool 101 corresponds to the internal spring 200 being compressed and the needle 175 being further intentionally extended into the eye 350 by the surgeon. In one embodiment, the sleeve 100 can extend up to about 5 mm or more (e.g., 1 cm, 1.5 cm, 2 cm, 2.5 cm, 3 cm, 3.5 cm, etc.) at the extension distance (d) and can be retracted to about 1 mm or less at the retraction distance (d'). Of course, various different ranges, maximum values, and minimum values may be used in this regard.

[0024] Further reference to Figure 2, the procedure described requires only that the surgeon intentionally apply sufficient force to overcome the internal biasing mechanism 200 and extend the needle 175. In this way, the spring 200 is sufficiently energized to substantially avoid accidental slippage, but not to the extent that it requires excessive force application by the surgeon. Thus, the reinforcing sleeve 100 can be considered reliably and dynamically adjustable for the procedure, as detailed herein.

[0025] Referring here to Figure 5, a flowchart outlines one embodiment of performing a minimally invasive surgical procedure using a needle supported by a dynamically adjustable reinforcing sleeve. With the cannula positioned at the surgical site for support, as shown in reference no. 515, an instrument such as a needle can be guided through the orifice of the cannula, as shown in reference no. 540. Thus, the needle can extend from the surgical tool beyond the cannula to a more specific tissue area. Similarly, the reinforcing sleeve of the tool positioned around the needle can be stabilized by the cannula structure that does not reach the tissue area (see reference no. 565). However, without significant sacrifice to the stabilization provided by the sleeve on the needle, the sleeve can also be dynamically retracted into the tool by the surgeon. That is, if the surgeon desires to extend the needle further toward the tissue area, as shown in reference no. 590, this can be achieved by the dynamic retraction of the sleeve into the tool for improved and more precise surgical manipulation.

[0026] The embodiments described herein include structures and methods that enable the practical use of reinforcing sleeves to assist in surgical procedures using relatively thin surgical instruments. That is, rather than determining surgical access by the instrument still depending on the length of the reinforcing sleeve, the sleeve can be dynamically adjusted over a predetermined range. Thus, as illustrated and detailed herein, surgical access to tissue areas can be assisted over a variety of different distances. This provides flexibility in the design of surgical tools, for example, in terms of the length of needle instruments. Perhaps even more noteworthy is the avoidance of tool or instrument changes during surgery where multiple lengths or depths are problematic or where the target depth is estimated with some degree of error.

[0027] The foregoing description is presented with reference to the current preferred 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 to which these embodiments belong will understand that further modifications and changes to the described structures and methods of operation may be implemented without significant departure 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. Furthermore, this disclosure includes the following inventions. The first aspect is, A tool body including a proximal end and a distal end configured to be grasped by the user, A surgical instrument extending from the distal end of the main body, configured to access the patient's tissue area, A reinforcing sleeve extending from the distal end of the main body and surrounding at least a portion of the instrument extending from the distal end of the main body to stabilize the instrument during surgical procedures, Includes, The reinforcing sleeve includes a biasing mechanism integrated with the sleeve, the biasing mechanism is configured to allow the sleeve to be pulled towards the distal end of the body in response to a force pushing the reinforcing sleeve into the body, and to allow the sleeve to return to the extended position when the force is removed. It is a surgical tool. The second aspect is, The surgical instrument is a surgical tool in the first embodiment, which is one of a vitrectomy probe, forceps, and scissors. The third aspect is, The sleeve is a surgical tool in a second embodiment, having a range of motion between its maximum position and a position in which it is fully retracted into the end of the body, which is greater than approximately 4 mm. The fourth aspect is, The surgical tool in the second embodiment is a surgical tool in which the tissue region is the patient's eye and the surgical procedure is one of vitrectomy and membrane removal. The fifth aspect is, The biasing mechanism is a surgical tool in a first embodiment, comprising at least one spring. The sixth aspect is, The biasing mechanism is a surgical tool in a fifth embodiment, fixed within the body of the tool. The seventh aspect is, The biasing mechanism is configured to remain inside the main body even when fully extended, in a sixth embodiment of the surgical tool. The eighth aspect is, The biasing mechanism is a surgical tool in a first embodiment, comprising a spring having sections of at least two different diameters, wherein at least one section of the at least two different diameters having a smaller diameter than an adjacent section of the at least two different diameters is configured to fit at least partially into the adjacent section having a larger diameter when the spring is compressed. The ninth aspect is, A surgical system for use in ophthalmic surgery, A cannula to be inserted into the patient's eye to provide access to the inside of the eye, An instrument including an external needle for performing ophthalmic surgery, which is extended into the eye through the cannula, wherein the instrument further includes a dynamically adjustable reinforcing sleeve around the instrument, the dynamically adjustable reinforcing sleeve contacting the inner surface of the cannula to prevent the sleeve from passing through the cannula together with the needle, and the sleeve includes a biasing mechanism to facilitate the retraction of the sleeve into the body of the probe when the needle is inserted into the eye through the cannula, Includes, The sleeve and the biasing mechanism form a single, integrated component. It is a system. The tenth aspect is, The inner surface of the cannula includes a funnel portion having an orifice for guiding the needle. The connection between the sleeve and the surface of the funnel portion of the cannula provides the surgeon with a fulcrum for the ophthalmic surgery. This is a surgical system in the ninth aspect. The eleventh aspect is, The surgical system in the tenth embodiment is such that the orifice is sized to accommodate a needle with a diameter smaller than approximately 23 gauge. The twelfth aspect is, A method for performing surgery, Positioning the cannula by inserting it into the surgical site, Extending the surgical tool through the orifice of the cannula to the tissue area of ​​the surgical site, In the case of the cannula that does not reach the tissue area, the reinforcing sleeve of the tool is stabilized around the instrument, When the instrument is extended into the tissue area, the cannula pushes the sleeve back against the biasing mechanism, thereby dynamically drawing the sleeve into the body of the tool. Includes, The sleeve and the biasing mechanism form a single, integrated component. It is a method. The 13th aspect is, The stabilization is a method in a twelfth embodiment, which includes using a biasing mechanism to extend the reinforcing sleeve around the surgical tool. The 14th aspect is, The dynamic retraction of the sleeve is a method in a thirteenth embodiment, which includes the surgeon pushing the sleeve against the cannula when the instrument is inserted. The 15th aspect is, The retraction of the sleeve is a method in a 14th embodiment that facilitates further extension of the instrument through the orifice toward the tissue region for the surgery.

Claims

1. A tool body including a proximal end and a distal end configured to be grasped by the user, A surgical instrument extending from the distal end of the tool body, configured to access a patient's tissue area, A reinforcing sleeve extending from the distal end of the tool body and surrounding at least a portion of the surgical instrument extending from the distal end of the tool body to stabilize the surgical instrument during a surgical procedure, A biasing mechanism connected to the reinforcing sleeve, A base connected to the biasing mechanism, the base configured to support the biasing mechanism within the tool body, The system includes a damping mechanism configured to bias the base in such a way as to dampen the motion of the biasing mechanism, The biasing mechanism and the damping mechanism extend distally from the base, The biasing mechanism is integrated with the reinforcing sleeve, The biasing mechanism is, In response to a force pushing the reinforcing sleeve into the tool body, it is possible to retract the reinforcing sleeve towards the distal end of the tool body, and A surgical tool configured such that the reinforcing sleeve returns to its extended position when the force is removed.

2. The surgical tool according to claim 1, wherein the surgical instrument is one of a vitrectomy probe, forceps, and scissors.

3. The surgical tool according to claim 2, wherein the reinforcing sleeve has a range of movement between a maximum position and a position in which it is fully retracted into the end of the tool body, the range of movement being greater than approximately 4 mm.

4. The surgical tool according to claim 2, wherein the tissue region is the eye of the patient, and the surgical procedure is one of vitrectomy and membrane removal.

5. The surgical tool according to claim 1, wherein the biasing mechanism includes at least one spring.

6. The surgical tool according to claim 5, wherein the biasing mechanism is fixed within the tool body of the surgical tool.

7. The surgical tool according to claim 6, wherein the biasing mechanism is configured to remain inside the tool body even when fully extended.

8. The surgical tool according to claim 1, wherein the biasing mechanism includes a spring having sections of at least two different diameters, and at least one section of the at least two different diameters having a smaller diameter than an adjacent section of the at least two different diameters is configured to fit at least partially into the adjacent section having a larger diameter when the spring is compressed.

9. A surgical system for use in ophthalmic surgery, A cannula to be inserted into the patient's eye to provide access to the inside of the eye, A probe, wherein the probe is An instrument including an external needle for performing the ophthalmic surgery, which is extended into the eye through the cannula, A dynamically adjustable reinforcing sleeve positioned around the instrument, the dynamically adjustable reinforcing sleeve contacting the inner surface of the cannula to prevent the reinforcing sleeve from passing through the cannula together with the outer needle, A biasing mechanism connected to the reinforcing sleeve, configured to facilitate the reinforcing sleeve to be pulled into the body of the probe when the external needle is inserted into the eye through the cannula, A base fixed within the device to support the reinforcing sleeve and the biasing mechanism, The system includes a damping mechanism configured to bias the base in such a way as to dampen the motion of the biasing mechanism, The reinforcing sleeve, the base, and the biasing mechanism form a single, integrated component. The biasing mechanism extends from the proximal end of the reinforcing sleeve, A surgical system comprising a probe, wherein the biasing mechanism and the damping mechanism extend distally from the base.

10. The inner surface of the cannula includes a funnel portion having an orifice for guiding the outer needle. The surgical system according to claim 9, wherein the connection between the reinforcing sleeve and the surface of the funnel portion of the cannula provides a fulcrum for the ophthalmic surgery to the surgeon.

11. The surgical system according to claim 10, wherein the orifice is sized to accommodate a needle with a diameter smaller than approximately 23 gauge.

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