The present disclosure relates generally to an injection system, and more particularly, to an injection system in which a syringe is connected to an actuator assembly via a drive cable.
Injection devices are well known in the medical field for delivering medication. These injection devices typically include syringes for the injection and/or aspiration of fluids or other materials. Often syringes are coupled to a syringe pump to control the discharge of a particular volume of fluid from the syringe. In some uses, the syringe includes a needle tip that is directly inserted into an injection site for injection of the fluid. Alternately, the syringe may be connected to a tubing that is attached at the injection site, typically via an intra venous line (IV).
Some injection devices may include a syringe pump to operate the syringe to improve the control and precision of the volume of fluid that is discharged. The pump in these devices may be coupled to an actuator to move a plunger or stopper within the syringe and push the fluid or other material through the tubing of the syringe and into the injection site. These systems attempt to control the plunger at a predetermined rate to deliver the fluid according to a prescribed dose requirement. This type of injection of fluid is important for intravenous drug administration including for pain medications, antibiotics, cancer fighting drugs, and the like where precise control is critical. For example, many ophthalmic drug therapies require precise control of the delivered dose and flow rate of medication.
However, developed injection devices with these types of syringe pumps and actuators are bulky and often difficult to manipulate due to the design of the combined syringe and actuator. Many are not capable of delivering hyper accurate doses either. Some of these systems also require the user to manually operate the system to actuate the syringe which increases the risk of excessive movement during delicate surgical procedures. The developed systems are also not ergonomic for some surgical applications thus contributing to hand fatigue during use. In other developed systems, the motor of the actuator causes vibration during operation increasing the risk of error during administration of the fluid. For example, the over delivery of injectable material and the under delivery of injectable material.
Accordingly, there is a need to develop a syringe pump system that ensures for precise control of the fluid administration without requiring manual manipulation of an actuator.
The above information disclosed in this Background section is only for enhancement of understanding of the background of the disclosure and therefore it may contain information that does not form the prior art that is already known to a person of ordinary skill in the art.
The techniques of this disclosure generally relate to an apparatus and method for delivering a precise quantity of a therapeutic material at a precise flow rate via a cable driven syringe system.
According to various embodiments, the present disclosure provides an injection system that includes a syringe into which a fluid is filled and from which the fluid is discharged to an injection site. A stopper is coupled to the syringe and is slidable within an interior of the syringe. In addition, an actuator controls the stopper within the syringe which is located remote from the actuator. A drive cable connects the actuator and the syringe. The drive cable includes a flexible inner wire and a flexible outer sleeve that encloses the flexible inner wire.
Further, a first end of the flexible inner wire is connected to the stopper and a second end of the flexible inner wire is releasably connected to the actuator. A minimal gap is formed between the flexible inner wire and the flexible outer sleeve. This minimal gap may be about 0.001 to 0.002 inches. In various embodiments, the syringe includes a distal end which is configured to connect to a cannula tip through which the fluid may be discharged into the injection site. The syringe may be pre-filled with the fluid.
In some embodiments, the flexible outer sleeve includes a reinforcing wire braid that eliminates axial and lateral expansion of the flexible outer sleeve to improve accuracy of power transmission. The flexible outer sleeve is made of a polyimide material and the flexible inner wire is made of a nitinol material and has a thickness of about 0.025 to 0.027 inches. Additionally, an inner lumen of the flexible outer sleeve may include a polytetrafluoroethylene (PTFE) layer that reduces friction between the flexible inner wire and the flexible outer sleeve during movement. In some embodiments, the drive cable may be about 24 to 36 inches in length. In other embodiments, the drive cable may be about six feet in length.
In addition, the actuator is connected to a controller configured to execute an operation program of the injection system. The actuator is configured to move forward and backwards in response to a signal of the controller to push and pull the flexible inner wire and move the stopper within the syringe. The operation program may include a volume and a flow rate of the fluid to be discharged to the injection site. In some embodiments, the actuator is actuated by a foot pedal or button located remote from the syringe.
According to another embodiment, the present disclosure provides a method of injection a fluid to an injection site. The method may include connecting a syringe to a drive cable, the drive cable including a flexible inner wire and a flexible outer sleeve that encloses the flexible inner wire. The method then includes connecting the drive cable to an actuator connected to a controller and injecting a cannula tip connected to the syringe into the injection site. The controller then receives an operation program, and the actuator is actuated to activate a stopper coupled to and slidable within an interior of the syringe based on the operation program to discharge a fluid stored in the syringe into the injection site. The actuation of the actuator causes the actuator to move forward and backwards to push and pull the flexible inner wire and move the stopper within the syringe.
In some embodiments, prior to injecting the cannula tip connected to the syringe into the injection site, the method includes operating the actuator to advance the stopper to purge air bubbles within the syringe and/or the cannula tip connected to the syringe. The discharge of the fluid may be stopped automatically in response to determining that the operation program is completed. In some embodiments, the discharge of the fluid is stopped when the volume of the fluid reaches a predetermined threshold. In some embodiments, the discharge of the fluid is stopped and restarted manually.
A cable driven injection system is disclosed. The system may include a syringe including a stopper disposed within an interior cavity thereof that is configured to receive a fluid and discharge the fluid at a surgical site. The system may include an actuator assembly including an electric motor and a rotatable shaft configured to linearly translate a block in a longitudinal direction, and a drive wire coupled to the block and the stopper that is configured to move forward upon activation of the actuator assembly thereby moving the stopper forward and causing the syringe to discharge the fluid. The system may include a control box having a computing system including at least one controller and a non-transitory memory storage containing an operation program comprising computer executable code, and the operation program may contain target volume information for the discharge of the fluid. In various embodiments, the controller may be configured to supply a target power to the electric motor such that a volume of fluid discharged from the syringe corresponds to the target volume information of the operation program.
In various embodiments, upon supplying the target power to the electric motor, a measured amount of fluid discharged from the syringe is within +/−3 microliters or less of the target volume.
In various embodiments, the operation program further contains flow rate information for the discharge of the fluid, and the controller may be further configured to supply the target power to the electric motor such that a flow rate of fluid being discharged from the syringe corresponds to the flow rate information of the operation program. In various embodiments, the drive cable includes: a flexible inner wire; and a flexible outer sleeve enclosing the flexible inner wire.
In various embodiments, the operation program may be user customizable via a user interface. In various embodiments, the operation program further includes target volume information for a plurality of different fluids. In various embodiments, the operation program further includes target flow rate information for a plurality of different fluids. In various embodiments, the system may include an occlusion sensor configured to detect if the syringe is occluded; and the operation program may be further configured to cause an occlusion notification if the occlusion sensor indicates the syringe is occluded. In various embodiments, a flow rate sensor may be included that is configured to detect a volume and flow rate of fluid being dispensed from the syringe; and the operation program may be further configured to cause a volume notification and a flow rate notification to be displayed by a display in electrical communication with the computing system.
Notably, the present disclosure is not limited to the combination of the device elements as listed above and may be assembled in any combination of the elements as described herein. Other aspect of the disclosure are disclosed infra.
The above and other features of the present disclosure will now be described in detail with reference to certain embodiments thereof illustrated in the accompanying drawings which are given herein by way of illustration only, and thus are not limitative of the present disclosure, and wherein:
The appended drawings are not necessarily to scale, and, at times, illustrate a simplified representation of various features illustrative of the principles of the disclosure. The specific design features of the present disclosure as described herein, including, for example, specific dimensions, orientations, locations, and shapes will be determined in part by the particular intended application and use environment. In the figures, reference numerals refer to the same or equivalent parts of the present disclosure throughout the several figures of the drawing.
The terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting of the disclosure. As used herein, the singular forms “a”, “an” and “the” are intended to include the plural forms as well, unless the context clearly indicates otherwise. It will be further understood that the terms “comprises” and/or “comprising,” when used in this specification, specify the presence of stated features, integers, steps, operations, elements, and/or components, but do not preclude the presence or addition of one or more other features, integers, steps, operations, elements, components, and/or groups thereof. As used herein, the term “and/or” includes any and all combinations of one or more of the associated listed items.
The following discussion omits or only briefly describes certain components, features and functionality related to medical devices and associated surgical techniques, which are apparent to those of ordinary skill in the art. It is noted that various embodiments are described in detail with reference to the drawings, in which like reference numerals represent like parts and assemblies throughout the several views, where possible. Reference to various embodiments does not limit the scope of the claims appended hereto because the embodiments are examples of the inventive concepts described herein. Additionally, any example(s) set forth in this specification are intended to be non-limiting and set forth some of the many possible embodiments applicable to the appended claims. Further, particular features described herein can be used in combination with other described features in each of the various possible combinations and permutations unless the context or other statements clearly indicate otherwise.
Terms such as “same,” “equal,” “planar,” “coplanar,” “parallel,” “perpendicular,” etc. as used herein are intended to encompass a meaning of exactly the same while also including variations that may occur, for example, due to manufacturing processes. The term “substantially” may be used herein to emphasize this meaning, particularly when the described embodiment or component has the same or nearly the same functionality or characteristic, unless the context or other statements clearly indicate otherwise.
Unless specifically stated or obvious from context, as used herein, the term “about” is understood as within a range of normal tolerance in the art, for example within 2 standard deviations of the mean. “About” can be understood as within 10%, 9%, 8%, 7%, 6%, 5%, 4%, 3%, 2%, 1%, 0.5%, 0.1%, 0.05%, or 0.01% of the stated value. Unless otherwise clear from the context, all numerical values provided herein are modified by the term “about.”
Components of the disclosed embodiments can be fabricated from biologically acceptable materials suitable for medical applications, including metals, synthetic polymers, ceramics and bone material and/or their composites. For example, the components, individually or collectively, can be fabricated from materials such as stainless steel alloys, commercially pure titanium, titanium alloys, Grade 5 titanium, super-clastic titanium alloys, cobalt-chrome alloys, superelastic metallic alloys (e.g., Nitinol, super elasto-plastic metals, such as GUM METAL®), ceramics and composites thereof such as calcium phosphate (e.g., SKELITE™), thermoplastics such as polyaryletherketone (PAEK) including polyetheretherketone (PEEK), polyetherketoneketone (PEKK) and polyetherketone (PEK), carbon-PEEK composites, PEEK-BaSO4 polymeric rubbers, polyethylene terephthalate (PET), fabric, silicone, polyurethane, silicone-polyurethane copolymers, polymeric rubbers, polyolefin rubbers, hydrogels, semi-rigid and rigid materials, elastomers, rubbers, thermoplastic elastomers, thermoset elastomers, elastomeric composites, rigid polymers including polyphenylene, polyamide, polyimide, polyetherimide, polyethylene, epoxy, and their combinations.
Advantageously, the present disclosure is capable of providing a greatly improved system for administering drugs, especially during delicate surgical procedures during which high accuracy is essential. The system may include a syringe connected to and/or otherwise effectuated by a controller via a drive cable. The controller may be actuated by a variety of modalities, for example, a foot pedal, a switch, audio feedback, etc. In a conventional system, an actuator, e.g., a plunger, is often provided directly on the syringe which has the disadvantage of requiring a user to hold the syringe steady while simultaneously attempting to operate the actuator. Embodiments in accordance with the disclosure herein may improve operation accuracy by, e.g., providing the actuator remote from the syringe.
In various embodiments, a controller may be capable of being pre-programmed with relevant information, e.g., specific volume and flow rate information (of fluid or other materials) to be administered for a particular medicine and/or weight class of an individual. Medical treatments such as, e.g., ophthalmic drug therapies, may require a heightened precise control of the delivered dose and flow rate of the medication as a critical aspect of a successful therapeutic treatment plan. Another difficulty in these procedures may be the location of the medication delivery and the limited nature of the drug. For example, some medications such as stem cell and gene therapy treatments often require delivery beneath the retina of the eye (which is a very delicate surgical procedure requiring a steady injection, a precise dosage, and a precise delivery rate). In at least one relevant procedure, a surgeon may insert a cannula (or needle) into the eye, pierce the retina, and then deliver the injection beneath the retina. This procedure may require the surgeon to maintain perfect control of the cannula during the initial insertion and throughout the injection of material. Conventional systems that provide the actuator locally integrated with the syringe for manual operation by the surgeon substantially increase the risk of excessive movement of the cannula tip during the injection. For example, as the surgeon depresses the actuator movement of the cannula tip, which may be inside of delicate patient tissue, often occurs.
For these types of delicate procedures, other conventional systems have been developed that include an extension tube that connects the syringe to the cannula. However, these systems require a highly skilled assistant to actuate the syringe. These systems also still utilize manual operation (rather than automated operation) which increases the variability in injection pressure and in turn decreases the constant control of the injection. For example, manually depressing a plunger often leads to a non-constant delivery of material that may be in excess of a target delivery rate or below a target delivery rate and in some cases, over the total delivery time, both. In addition, a tubing between the injection site and the syringe requires the fluid to be filled in the dead space of the tube, thus increasing waste of the drug. Furthermore, the long tube may adversely affect the delivery due to fluid dynamics implications and friction of the sidewall of an elongated delivery tube vs. those fluid dynamics of a relatively smaller syringe. Other systems include a pneumatically driven syringe in which the injection pressure is set and controlled by a surgeon. However, both systems rely on manual reading of the graduation markings on the syringe which decreases the accuracy of the injection and specifically, increases the risk of inaccurate dose delivery. Conversely, embodiments in accordance with the present disclosure provide an improved system which provides accurate control of the dose delivery without manual operation of an actuator and without manual reading of the syringe graduation markings and with limited waste of the drug product.
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In various embodiments, the actuation assembly 60 may be disposed inside of the control box 50 in a first internal area of the housing defined by the switch/port side plate 4, internal center plate 6, and the connector side plate 5 (see
As mentioned above, the drive cable (flexible sleeve 28 and wire 27) connects to the control box 50 at the control box connector 26. Additionally, the drive cable may be surrounded by a connection segment 99 disposed within an internal portion of the control box connector 26 (sec
In terms of a supporting frame or structure for supporting the actuation assembly 60 within the control box 50, various beams, blocks, columns etc. may be provided as a counter torque for motor 15. In the illustrated embodiment two guide rods 22 and a shaft 17 extend from the connector side plate 5 through the mounting block 19 and slide bearings 23, and then they each extend through the motor mount block 16, which accommodates the motor 15. Motor 15 can be any type of electrical motor, e.g., a step motor may be advantageous because of the associated precision in mechanical movements relative to other motors. Additionally, in various embodiments at least a portion of shaft 17 may be threaded. For example, the shaft 17 may include a central threaded portion defined by a first thread pattern which may be engaged with a second corresponding thread pattern of mounting block 19. For example, as shown in
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As explained previously, the drive cable comprises the flexible sleeve 28 in which the flexible wire 27 is accommodated therein such that the flexible wire may slide forward and backward within the flexible sleeve 28. In various embodiments, the drive cable may be formed to provide a minimal gap of about 0.001 inches to about 0.002 inches between the flexible outer sleeve 28 and the flexible inner wire 27. For example, an outer diameter of the flexible wire 27 and an inner diameter of the flexible sleeve 28 may provide a minimal gap to prevent air entrainment and contamination and generally provide a lightweight comfortable to use device. In various embodiments, the flexible wire 27 may have a thickness of about 0.025 inches to about 0.027 inches and the overall thickness of the drive cable may be about 0.050 inches to about 0.052 inches. However, it shall be understood these dimensions are merely exemplary and of course the wire 27 and sleeve 28 may even have varying thickness and supporting intermediate sleeves or bushings across a length thereof. However, it shall also be understood that a relatively thin diameter of the drive cable 27 has certain advantages. In various embodiments, the flexible sleeve 28 may include a reinforcing wire braid around an outside thereof that protects a user of the device while also eliminating and/or suppressing axial and lateral expansion of the flexible sleeve 28, e.g., bulging. Additionally, an inner lumen of the flexible sleeve 28 may include a polytetrafluoroethylene (PTFE) layer that reduces the friction between the flexible sleeve 28 and the flexible wire 27 during movement. In this sense, a flexible sleeve 28 having low friction interior sidewalls and a relatively small gap between the low friction sidewalls and the inner wire 27 may be especially advantageous for effectuating the linear motion of the actuation assembly 60 into linear motion of the wire 27. In various embodiments, the flexible sleeve 28 may be made of, e.g., a polyimide material and the flexible wire 27 may be made of a nitinol material. However, the present disclosure is not limited to these materials. Additionally, the cable may have a length of about 24 inches to about 36 inches which allows for sufficient separation between the syringe and the control box 50.
Referring to
In various embodiments, the processor 1100 may be a central processing unit (CPU) or a semiconductor device that processes instructions stored in the memory 1300 and/or the storage memory 1600. The memory 1300 and the storage 1600 may include various volatile or nonvolatile storage media. For example, the memory 1300 may include a read only memory (ROM) and a random access memory (RAM) which may also be referred to as a “non-transitory” memory as would be understood by a person of ordinary skill in the art. In particular, the processor 1100 and/or computing system 1000 at large may be referred to as a “controller” and it may be configured to send and receive various electric signals which in turn are outputted to various mechanical devices to effectuate the delivery of a therapeutic material. For example, the computing system 1000 may be configured to control the motor 15 by the sending and receiving of electrical signals (i.e., a current amount or power) to effectively deliver a precise and highly accurate dosage amount of a therapeutic material and at a specific predetermined flow rate.
Accordingly, methods of operating the cable driven syringe system 100 may be implemented directly by hardware executed by the processor 1100, a software module, or any combination thereof. The software module may reside in a storage medium (that is, the memory 1300 and/or the storage 1600), such as a RAM memory, a flash memory, a ROM memory, an EPROM memory, an EEPROM memory, a register, a hard disk, a detachable disk, or a CD-ROM. The example storage medium may be coupled to the processor 1100, and the processor 1100 may read information from the storage medium and may write information to the storage medium. In another example, the storage medium may be directly integrated with the processor 1100. The processor and the storage medium may reside in an application specific integrated circuit (ASIC) as well. In this embodiment, the ASIC may reside in a user terminal, e.g., the control box 50.
In various embodiments, the software module may include various types of information specific to a particular type of therapeutic material. For example, a first therapeutic material may be delivered for a dosage of 20 microliters and at a flow rate of 5 microliters per second. A second therapeutic material may be delivered for a dosage of 40 microliters and at a flow rate of 20 microliters per second. In this sense, the computing system 1000 may have predetermined information to effectively deliver a dosage of a specific material in view of best practices in the industry. Furthermore, the computing system 1000 may be updated periodically from time to time via, e.g., the network interface 1700. Additionally, network interface 1700 may be configured to send and transmit operating information to an external server owned and operated by the manufacturer or a relevant third party. In this sense, the manufacturer may receive relevant operating information of the cable driven syringe system 100 and may also be able to notify an owner or operator of the cable driven syringe system 100 when maintenance may be required.
Furthermore, through extensive testing performed by the manufacturer, the software may be pre-programmed to know precisely how much power to send to the motor 15. In this sense, the particular material attributes of the wire 27, flexible sleeve 28, the length thereof, the internal friction thereof, the material attributes of the stopper 34 etc. affect how much power should be transmit to the motor 15 in view of a specific dosage and flow rate target requirements for a particular therapeutic material. In at least one embodiment, the software is programmed to ensure that a delivery of a therapeutic material is delivered with an accuracy of about +/−3 microliters by precisely controlling the amount of power transmit to the motor. For example, the computing system 1000 may be configured to control a power of an electrical control signal transmit to the motor such that a delivery of a volume of a therapeutic material is performed with an accuracy of about +/−3 microliters.
With the attributes of the cable driven syringe system 100 now being fully enabled, the operation of the system components will be described by referring back to the various numbering scheme shown in the FIGS. when convenient. Prior to use of the cable driven syringe system 100, the syringe 30 may be pre-filled with a fluid or other therapeutic material. Alternately, prior to injecting an end of a cannula connected to the syringe 30 into the injection site, the fluid may be loaded into the syringe 30 by operating the actuation assembly 60 to retract the stopper 34 and aspirate the fluid into the syringe 30. Then, the actuator assembly 60 may be operated to slowly advance the stopper 34 within the syringe 30 to purge any air bubbles within the syringe 30 and the cannula tip connected thereto. Either prior to filling the syringe 30 or thereafter, a user may enter desired dose parameters including volume and flow rate using the keypad 7 on the control box 50. The display 8 may show a confirmation of the entered parameters. The display 8 may also be used to output various notifications to the user such as a start notification and a stop notification of the fluid dispensing, start and stop of the actuation assembly 60, a remaining dose amount to be administrated, a counter, or any other contemplated visual notifications. The dose parameters may also be stored in an operation software program stored within a memory storage 1300, 1600 of the control box 50 for a specific type of therapeutic material as explained hereinabove.
Once the syringe 30 is filled, the syringe 30 may be connected to the drive cable including the flexible wire 27 and the flexible sleeve 28. The drive cable may then be connected to the actuator assembly 60 as described above. A cannula tip attached to a distal end of the syringe 30 may then be inserted into the injection site. For example, the cannula may be inserted into the eye and the tip thereof placed beneath the retina. Once the cannula tip has been placed at an injection site, the syringe 30 may be operated using the actuator. For example, the motor 15 may be actuated on/off by using a foot pedal connected to port 12 which is operated by a first medical practitioner. Alternatively, a button may be manipulated by a second medical practitioner to begin the process of dispensing a predetermined desired dose volume and flow rate of the fluid while the first medical practitioner holds the syringe 30 steady. The discharging or dispensing of the fluid stored within the syringe 30 into the injection site may be based on a stored operation program as explained above. In particular, the actuation of the motor 15 may cause a forward movement activation of the stopper 34 to move within the syringe 30 based on the push and pull movement of the flexible wire 27 as discussed above.
As another example, a user may elect to dose 50 microliters of fluid at a speed of 10 microliters per second. When ready to deliver the predetermined dose, the user may manipulate the foot pedal or button to initiate the operation software program. This process eliminates the need for the user to manually control the dosage or even visually confirm a predetermined dosage since the program controls both the amount of fluid to be administered as well as the flow rate at which it is discharged. The discharge of the fluid may be stopped automatically once the operation program is complete and optional sound or visual indication may be provided to indicate that the procedure has been completed. For example, the discharge of the fluid may be stopped when the volume of the fluid reaches a predetermined threshold. After the operation has been initiated, the program may also be stopped and restarted at any time by the user. This may be accomplished by, for example, disengaging the foot pedal or pressing the button again. The present disclosure, however, is not limited to such manipulations to stop the program.
Advantageously, the cable driven syringe pump system 100 described herein addresses limitations of conventional systems and challenges of particular drug therapies using a system that provides precise administration of medications during delicate surgical procedures requiring extremely small doses of a drug. The system 100 described herein allows the syringe containing the fluid to be administered to be located at the injection site thus preventing waste of the drug product typically remaining in conventional system with relatively long tubes that are delivered by fluid mechanisms and pumps. That is, typically, the dead space in the tubing must be filled with the fluid prior to the injection which unnecessarily consumes the drug. In addition, the system includes a control box 50 with an actuation subassembly separated from the syringe 30. This may eliminate and/or greatly suppress added potential vibration introduced from a medical practitioners hands and also decreases the weight a surgeon must bear during the performance of various procedures. In this way, the system reduces unintended movement of a cannula tip attached to syringe 30 during the injection process and also provides an ergonomic configuration improving user comfort.
The many features and advantages of the disclosure are apparent from the detailed specification, and thus, it is intended by the appended claims to cover all such features and advantages of the disclosure which fall within the true spirit and scope of the disclosure. Further, since numerous modifications and variations will readily occur to those skilled in the art, it is not desired to limit the disclosure to the exact construction and operation illustrated and described, and accordingly, all suitable modifications and equivalents may be resorted to, falling within the scope of the disclosure.
This application claims the benefit of priority to U.S. Provisional Application 63/288,395, titled Cable Drive Syringe Pump System filed on Dec. 10, 2021, the entire contents of which are hereby incorporated by reference.
| Filing Document | Filing Date | Country | Kind |
|---|---|---|---|
| PCT/US2022/081144 | 12/8/2022 | WO |
| Number | Date | Country | |
|---|---|---|---|
| 63288395 | Dec 2021 | US |