The present disclosure relates generally to vitrectomy probes and surgical instruments and more specifically to a vitrectomy apparatus, system and method.
Around the world, roughly 250 million people may have some kind of vision impairment that requires removal of vitreous humor from the eye. Vitreous humor also herein referred to as vitreous is a complex and fibrous gel-like substance that fills about 80 percent of the eye and helps to maintain the eye's round shape.
Vitreous removal is accomplished via vitrectomy, a surgical procedure for the eye that involves the placement of ports in the eye through which various instruments can be passed. A vitrectomy cutter, for example, is passed through one of the ports to cut and remove vitreous from the eye. As is then apparent, given the importance of the human eye, the procedure must be performed optimally with instruments that facilitate vitrectomy and minimize trauma that can arise during this surgical procedure.
It is within the aforementioned context that a need for the present invention has arisen. Thus, there is a need to address one or more of the foregoing disadvantages of conventional systems and methods, and the present invention meets this need.
Various aspects of an apparatus, method and system for a vitrectomy cutter can be found in exemplary embodiments of the present invention.
In one embodiment, the apparatus includes an exterior cylindrical member that has two substantially oppositely disposed or separated sets of vitreous ports. During a vitrectomy procedure for a human eye, the vitreous ports are configured to receive vitreous humor that can then be severed and aspirated. In one embodiment, a first set of vitreous ports may be structured to have at least three ports. A second set of vitreous ports may also be structured to have a least three separate or oppositely disposed ports.
The exterior cylindrical member includes an open and a closed end, where the vitreous ports are located. The apparatus also includes an interior cylindrical member that reciprocates axially within the exterior cylindrical member. A cutting edge is formed on an open distal end of the interior cylindrical member to cut and aspirate vitreous humor from the first and second sets of vitreous ports.
In an embodiment, the cutting edge of the interior cylindrical member is flared or structured to have a funnel shape. The cutting edge may also be tapered (from a proximal to distal direction). In another embodiment, an electrolyte layer is disposed on an exterior surface of the interior cylindrical member, the electrolyte layer being configured to harden and sharpen the cutting edge of the interior cylindrical member.
In another embodiment, a spiral slot is cut axially on the interior cylindrical member, the spiral slot configured to reduce friction between an outer surface of the interior cylindrical member and the inner surface of the exterior cylindrical member. In another embodiment, the first set of vitreous ports includes a first port and the second set of vitreous ports includes a second port. The first and second ports are substantially oppositely disposed on a circumferential plane that is perpendicular to the axis of the exterior cylindrical member.
In another embodiment, a method is disclosed that comprises inserting through a port in an eye an exterior cylindrical member having two substantially separately disposed sets of ports including a first plurality of ports and a second plurality of ports that is disposed separately from the first plurality of ports, receiving, during a vitrectomy, vitreous via the two substantially separately disposed sets of ports, the exterior cylindrical member having an open proximal end and a closed distal end, and the two oppositely disposed sets of ports being positioned adjacent to the closed distal end of the exterior cylindrical member; reciprocating an interior cylindrical member axially within the exterior cylindrical member, the interior cylindrical member having an open proximal end and an open distal end that is adjacent to the closed distal end of the exterior cylindrical member wherein a cutting edge is formed on said open distal end of the interior cylindrical member, the method further comprising cutting with the cutting edge vitreous that is received through the two oppositely disposed sets of ports as the interior cylindrical member reciprocates within the exterior cylindrical member.
In another embodiment, the open distal end of the interior cylindrical member is structured to have a funnel shape, and an exterior surface of the interior cylindrical member includes an electrolyte configured to harden the cutting edge of the interior cylindrical member. In another embodiment, the interior cylindrical member includes an axial spiral slot that reduces friction between an outer surface of interior cylindrical member and the inner surface of the exterior cylindrical member.
In a further embodiment, a system comprises an exterior cylindrical member having two substantially oppositely disposed ports including a first port and a second port that is substantially oppositely disposed from the first port, the two substantially oppositely disposed ports for receiving vitreous during a vitrectomy procedure, the exterior cylindrical member having an open proximal end and a closed distal end, and the two substantially oppositely disposed ports being positioned adjacent to the closed distal end of the exterior cylindrical member with an interior cylindrical member reciprocating axially within the exterior cylindrical member, the interior cylindrical member having an open proximal end and an open distal end that is adjacent to the closed distal end of the exterior cylindrical member wherein a cutting edge is formed on said open distal end of the interior cylindrical member with the cutting edge for cutting vitreous received through the two substantially oppositely disposed ports as the interior cylindrical member reciprocates within the exterior cylindrical member.
In another embodiment, the open distal end of the interior cylindrical member is structured to have a funnel shape. In a further embodiment, an electrolyte disposed on an exterior surface of the interior cylindrical member, the electrolyte configured to harden and sharpen the cutting edge of the interior cylindrical member. Further yet, the interior cylindrical member includes an axial spiral slot, the axial spiral slot configured to reduce friction between an outer surface of the interior cylindrical member and the inner surface of the exterior cylindrical member.
A further understanding of the nature and advantages of the present invention herein may be realized by reference to the remaining portions of the specification and the attached drawings. Further features and advantages of the present invention, as well as the structure and operation of various embodiments of the present invention, are described in detail below with respect to the accompanying drawings. In the drawings, the same reference numbers indicate identical or functionally similar elements.
Reference will now be made in detail to the embodiments of the invention, examples of which are illustrated in the accompanying drawings. While the invention will be described in conjunction with the one embodiment, it will be understood that they are not intended to limit the invention to these embodiments. On the contrary, the invention is intended to cover alternatives, modifications and equivalents, which may be included within the spirit and scope of the invention as defined by the appended claims. Furthermore, in the following detailed description of the present invention, numerous specific details are set forth to provide a thorough understanding of the present invention. However, it will be obvious to one of ordinary skill in the art that the present invention may be practiced without these specific details. In other instances, well-known methods, procedures, components, and circuits have not been described in detail as to not unnecessarily obscure aspects of the present invention.
In
As shown in
After insertion of optical probe 204, a saline tube 206 is then passed through saline port 106, the saline tube 206 permitting introduction of saline (or other comparable liquid or gaseous matter) into the eye, thus maintaining the eye's roundness as vitreous humor 210 is removed from human eye 100.
A vitrectomy cutter port 108 is also inserted into human eye 100. As implied by its name, vitrectomy cutter port 108 enables eye surgeon 102 to pass a vitrectomy cutter 308 through vitrectomy cutter port 108 to cut and aspirate vitreous humor 210 from human eye 100. In accordance with principles and precepts of the present invention, vitrectomy cutter 308, in one embodiment, can efficiently remove vitreous humor 210 (and vitreous humor base) while maintaining high performance without sacrificing stiffness or rigidity of the instrument.
In
In
As shown in
Here, exterior cylindrical member 312 might be made of stainless steel, high grade aluminum or other comparable material that can maintain stiffness/rigidity consistent with the spirit and scope of the present invention. In the embodiment of
Referring to
Unlike traditional systems, the present embodiment includes at least three or more slots or vitreous ports 320, 322 and 324 on one side. The present embodiment also includes three or more vitreous ports 326, 328 and 330 that are separately or oppositely disposed. In this manner, additional vitreous humor not contemplated for removal by traditional systems can be drawn through the vitreous ports, cut and aspirated, thus enabling quicker and more efficient vitrectomy surgeries. The number of ports and rigidity are a fine balance; yet the embodiment of
In
As can be seen in
Here, each of vitreous ports 320, 322 and 324 has a length L3 0.022 inches and a width W1 of 0.005 inches. Each of vitreous ports 320, 322, 324 is spaced out from the others at a width W2 that is approximately 0.010 inches while the spacing W3 between vitreous port 324 and closed end 318 is about 0.010 inches. It can then be seen that unlike conventional vitrectomy systems, an embodiment of the present invention provides overall virtual port openings that are larger than conventional systems while maintaining the stiffness and rigidity of the vitrectomy cutter.
By increasing dimensions and the number of ports, additional vitreous can be allowed into the ports and cut such that a more efficient vitrectomy surgery may be performed. It is noted that increasing the number of ports and the size of each port is a delicate balance that has been realized by the present invention because while the number of ports and dimensions of each port have been increased, stiffness and rigidity have not been sacrificed by considering optimum placement, positioning, size and number of ports.
The exterior cylindrical member 312 maintains its stiffness or rigidity by defining and determining the appropriate number of ports and the optimum size for each of the ports. In one implementation, shown in
Referring to
Thus, as further illustrated in
In another embodiment, vitreous port 326 is oppositely disposed from vitreous port 320 because they are in opposite positions on the same plane in separate lower and upper ends. That is, vitreous port 326 and vitreous port 320 are substantially oppositely disposed because they are disposed at opposite positions on the circumference of a plane (not shown) that is cut perpendicular to axis X at the location of the two ports.
By having at least a second plurality of sets or ports that are disposed separately from the first plurality of ports, the present invention facilitates efficient vitrectomy surgeries because the amount of manipulation needed to turn vitreous ports toward vitreous humor is dramatically reduced.
As an example, in prior art systems that have only a single set of ports, once the vitreous that is facing the set of ports has been aspirated, it is necessary for the surgeon to then turn or manipulate the set of ports towards additional vitreous, thus causing unnecessary trauma to the patient. With embodiments of the present invention, such twisting and turning or manipulating of the vitrectomy cutter that can cause further trauma within human eye 100 is eliminated.
Referring now to
Although not shown, open proximal end 338 is coupled to a vacuum or aspiration system (not shown) that aspirates cut vitreous humor 210 from open distal end 340 through bore 343 and/or open proximal end 338 for disposal. Similarly, although not shown, interior cylindrical member 314 is coupled to either a pneumatic or electrical driver (not shown) that reciprocates interior cylindrical member 314 backwards and forwards along the longitudinal axis X (
In
As shown in
D4 and D3 are dimensioned such that a gap G (of about 0.002 inches) exists between the outer wall of interior cylindrical member 314 and the inner wall of exterior cylindrical member 312. The gap G reduces friction between the interior and exterior wall and facilitates smooth operation of the cylindrical members.
In operation, eye surgeon 102 begins by inserting vitrectomy cutter 308 through vitrectomy cutter port 108 of
As cutting edge 319 approaches closed distal end 318, vitreous humor 210 that enters vitreous ports 320, 322, 324, 326, 328 and 330 is severed by cutting edge 319. Specifically, at a 1st cutting point (vitreous port 320) and a 2nd cutting point (vitreous port 326), the embodiment of the present invention employs cutting edge 319 to contemporaneously sever vitreous humor 210 at both cutting points. Conventional systems have one or more aggregated ports with cutting edges angled toward the aggregated ports to accomplish cutting. Such angled ports thus preclude the use of separated or oppositely disposed ports.
Unlike such traditional systems that employ aggregated ports with angled cutters to accomplish cutting, an embodiment of the present invention employs the flared cutting edge 319 that can contact all sides of the inner diameter of exterior cylindrical member 312. This ability to contact all sides of the inner diameter allows the present embodiment to employ separated and/or oppositely disposed vitreous ports 320, 322, 324, 326, 328 and 330.
After vitreous humor 210 is contemporaneously severed at the 1st and 2nd cutting points, cutting edge 319 then proceeds to the 3rd and 4th cutting points where vitreous humor 210 is again contemporaneously severed. Vitreous humor 210 is also contemporaneously severed at the 5th (vitreous port 324) and 6th (vitreous port 330). After cutting, all of the severed vitreous humor 210 is aspirated and removed via bore 343. Hence, converting targeted vitreous into tiny particles, which become easier to aspirate.
Depending upon the cut rate of the cutting console employed, the present embodiment also significantly increases the cutting rate CPM (cuts per minute) relative to conventional systems. In one embodiment, a cutting console of 5,000 CPM is used; thus, a cut rate of 30,000 CPM (5,000 cuts per port×6 ports) is realized. Where a cutting console of 8,000 CPM is used, the output rate of the present embodiment is 48,000 CPM (8,000 cuts per port×6 ports).
Unlike the embodiment of
Another advantage of the present embodiment is that an electrolyte layer 642 may be deposited on the closed end area of exterior cylindrical member 312. Electrolyte layer 642 is also deposited on and about cutting edge 319 of interior cylindrical member 314 (
In
As shown, spiral slot 713 extends from cutting edge 319 axially towards open proximal end 338 of interior cylindrical member 314. Specifically, spiral slot 713 may extend for a length L3 which may be 0.010 inches. Electrolyte layer 742 is also deposited on interior cylindrical member 314 for the length L3 of spiral slot 713.
In
While the above is a complete description of exemplary specific embodiments of the invention, additional embodiments are also possible. Thus, the above description should not be taken as limiting the scope of the invention, which is defined by the appended claims along with their full scope of equivalents.