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WO1999015120A1 - Surgical handpiece - Google Patents

Surgical handpiece Download PDF

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Publication number
WO1999015120A1
WO1999015120A1 PCT/US1998/014767 US9814767W WO9915120A1 WO 1999015120 A1 WO1999015120 A1 WO 1999015120A1 US 9814767 W US9814767 W US 9814767W WO 9915120 A1 WO9915120 A1 WO 9915120A1
Authority
WO
WIPO (PCT)
Prior art keywords
handpiece
core
shell
connector
irrigation
Prior art date
Application number
PCT/US1998/014767
Other languages
French (fr)
Inventor
Thomas G. Capetan
Original Assignee
Alcon Laboratories, Inc.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Alcon Laboratories, Inc. filed Critical Alcon Laboratories, Inc.
Priority to AU84084/98A priority Critical patent/AU8408498A/en
Publication of WO1999015120A1 publication Critical patent/WO1999015120A1/en

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007Methods or devices for eye surgery
    • A61F9/00736Instruments for removal of intra-ocular material or intra-ocular injection, e.g. cataract instruments
    • A61F9/00745Instruments for removal of intra-ocular material or intra-ocular injection, e.g. cataract instruments using mechanical vibrations, e.g. ultrasonic
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32Surgical cutting instruments
    • A61B17/320068Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B2017/320084Irrigation sleeves

Definitions

  • This invention relates to surgical handpieces and more particularly to an ophthalmic phacoemulsification handpiece.
  • a typical ultrasonic surgical device suitable for ophthalmic procedures consists of an ultrasonically driven handpiece, an attached hollow cutting tip, an irrigating sleeve and an electronic control console.
  • the handpiece assembly is attached to the control console by an electric cable and flexible tubings. Through the electric cable, the console varies the power level transmitted by the handpiece to the attached cutting tip and the flexible tubings supply irrigation fluid to and draw aspiration fluid from the eye through the handpiece assembly.
  • the operative part of the handpiece is a centrally located, hollow resonating bar or horn directly attached to a set of piezoelectric crystals. The crystals supply the required ultrasonic vibration needed to drive both the horn and the attached cutting tip during phacoemulsification and are controlled by the console.
  • the crystal/horn assembly is suspended within the hollow body or shell of the handpiece at its nodal points by relatively inflexible mountings.
  • the handpiece body terminates in a reduced diameter portion or nosecone at the body's distal end.
  • the nosecone is externally threaded to accept the irrigation sleeve.
  • the horn bore is internally threaded at its distal end to receive the external threads of the cutting tip.
  • the irrigation sleeve also has an internally threaded bore that is screwed onto the external threads of the nosecone.
  • the cutting tip is adjusted so that the tip projects only a predetermined amount past the open end of the irrigating sleeve. Ultrasonic handpieces and cutting tips are more fully described in U.S. Pat. Nos.
  • the cutting tip is ultrasonically vibrated along its longitudinal axis within the irrigating sleeve by the crystal-driven ultrasonic horn, thereby emulsifying upon contact the selected tissue in situ.
  • the hollow bore of the cutting tip communicates with the bore in the horn and the piezoelectric crystals that in turn communicates with the aspiration line from the handpiece to the console.
  • a reduced pressure or vacuum source in the console draws or aspirates the emulsified tissue from the eye through the open end of the cutting tip, the bore of the cutting tip, the horn bore, and the aspiration line and into a collection device.
  • the aspiration of emulsified tissue is aided by a saline flushing solution or irrigant that is injected into the surgical site through the small annular gap between the inside surface of the irrigating sleeve and the outside surface of the cutting tip.
  • This small annular gap separates the vibrating, hot tip from eye tissue and the flow of fluid within the gap cools the tip. In some cases, the gap and the fluid flow are insufficient to prevent the burning of tissue.
  • phacoemulsification handpieces Prior to the present invention, phacoemulsification handpieces were relatively expensive due to the cost of the materials and the precise machining required in manufacturing the handpieces. As a result, phacoemulsification handpiece are not disposed of at the end of surgery, but are reused a number of times. Handpieces that are reused must be sterilized, usually by steam autoclaving. Steam autoclaving is extremely injurious to the seals, piezoelectric crystals and other electrical components of the handpiece. As a result, prior art phacoemulsification handpieces can be unreliable and must be rebuilt frequently. Additionally, prior art handpieces require numerous connections to a surgical console, making the handpieces more difficult and time consuming to set up.
  • the present invention improves upon prior art handpieces by providing a handpiece having a central core which is removably received in an outer shell.
  • the central core may be an ultrasonic element, a laser element or any other desired operative core and the core and/or the outer shell may be intended as a single use disposable or reusable element.
  • a separate core and outer shell is easier to manufacture and the core does not have to be steam autoclaved.
  • all the required connections for the handpiece can be preassembled on the handpiece and for easy connection to the surgical console, thereby reducing set up time.
  • one objective of the present invention is to provide an inexpensive surgical handpiece.
  • Another objective of the present invention is to provide a surgical handpiece having increased reliability.
  • Still another objective of the present invention is to provide a phacoemulsification handpiece having a solid resonating core and tip.
  • FIG. 1 is an expanded prospective view of the first embodiment of the surgical handpiece of the present invention.
  • FIG. 2 is a cross-sectional view of the first embodiment of the surgical handpiece of the present invention.
  • FIG. 3 is a cross-sectional view of the second embodiment of the surgical handpiece of the present invention.
  • FIG. 4 is an expanded prospective view of the second embodiment of the surgical handpiece of the present invention.
  • handpiece 10 of the present invention preferably may be a phacoemulsification handpiece which will generally includes resonating core 12 and outer shell 14.
  • Core 12 generally includes piezoelectric crystal portion 16, horn 18 and solid tip 20.
  • Horn 18 and tip 20 preferably are machined as a single piece from any suitable material, for example, titanium, but the tip can be removable using a screw connector.
  • Crystals 16 are attached to horn 18 at one end 22 by any suitable means, for example, epoxy glue and contain electrical connector and seal 24 at the opposite end that allows handpiece 10 to be connected to a suitable power and control source (not shown) through cable 26. Crystals 16 are caused to vibrate in a manner well-known in the art.
  • Handpiece 10 may also be used as a laser handpiece, an irrigation/aspiration handpiece, a liquefaction handpiece or any other desired handpiece by appropriate substitution of core 12.
  • Shell 14 contains aspiration port 28, irrigation port 30, integral aspiration sleeve 32 and integral irrigation sleeve 34. As best seen in FIG. 2, aspiration port 28 communicates with aspiration sleeve 32 through internal aspiration line 36, and irrigation port 30 communicates with irrigation sleeve 34 through internal irrigation line 38. The use of dual sleeves 32 and 34 provides further isolation of tip 20 from tissue.
  • Shell 14 may be made of any suitable material such as stainless steel, titanium or plastic. Suitable external tubings 29 and 31 can be preassembled to aspiration port 28 and irrigation port 30 and made to conveniently connect to the surgical console (not shown), for example, by preconnecting tubings 29 and 31 to the surgical cassette (not shown) that may be used with the console.
  • tip 20 is coaxially sealed fluid tight within aspiration sleeve 32 by seal 40.
  • Core 12 may be sealed within shell 14 by a friction connector/seal 24, as shown in FIGS. 1 and 2, or screw connector/seal 124, as shown in FIGS. 3 and 4.

Landscapes

  • Health & Medical Sciences (AREA)
  • Ophthalmology & Optometry (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

A surgical handpiece having a central operative core which is removably received in an outer shell. The operative core and outer shell is easier to manufacture and assemble, thereby decreasing cost and increasing reliability.

Description

SURGICAL HANDPIECE
This invention relates to surgical handpieces and more particularly to an ophthalmic phacoemulsification handpiece.
Background of the Invention
A typical ultrasonic surgical device suitable for ophthalmic procedures consists of an ultrasonically driven handpiece, an attached hollow cutting tip, an irrigating sleeve and an electronic control console. The handpiece assembly is attached to the control console by an electric cable and flexible tubings. Through the electric cable, the console varies the power level transmitted by the handpiece to the attached cutting tip and the flexible tubings supply irrigation fluid to and draw aspiration fluid from the eye through the handpiece assembly. The operative part of the handpiece is a centrally located, hollow resonating bar or horn directly attached to a set of piezoelectric crystals. The crystals supply the required ultrasonic vibration needed to drive both the horn and the attached cutting tip during phacoemulsification and are controlled by the console. The crystal/horn assembly is suspended within the hollow body or shell of the handpiece at its nodal points by relatively inflexible mountings. The handpiece body terminates in a reduced diameter portion or nosecone at the body's distal end. The nosecone is externally threaded to accept the irrigation sleeve. Likewise, the horn bore is internally threaded at its distal end to receive the external threads of the cutting tip. The irrigation sleeve also has an internally threaded bore that is screwed onto the external threads of the nosecone. The cutting tip is adjusted so that the tip projects only a predetermined amount past the open end of the irrigating sleeve. Ultrasonic handpieces and cutting tips are more fully described in U.S. Pat. Nos. 3,589,363; 4,223,676; 4,246,902; 4,493,694; 4,515,583; 4,589,415; 4,609,368; 4,869,715; 4,922,902 and 5,178,605 the entire contents of which are incorporated herein by reference. When used to perform phacoemulsification, the ends of the cutting tip and irrigating sleeve are inserted into a small incision of predetermined width in the cornea, sclera, or other location in the eye tissue in order to gain access to the anterior chamber of the eye. The cutting tip is ultrasonically vibrated along its longitudinal axis within the irrigating sleeve by the crystal-driven ultrasonic horn, thereby emulsifying upon contact the selected tissue in situ. The hollow bore of the cutting tip communicates with the bore in the horn and the piezoelectric crystals that in turn communicates with the aspiration line from the handpiece to the console. A reduced pressure or vacuum source in the console draws or aspirates the emulsified tissue from the eye through the open end of the cutting tip, the bore of the cutting tip, the horn bore, and the aspiration line and into a collection device. The aspiration of emulsified tissue is aided by a saline flushing solution or irrigant that is injected into the surgical site through the small annular gap between the inside surface of the irrigating sleeve and the outside surface of the cutting tip. This small annular gap separates the vibrating, hot tip from eye tissue and the flow of fluid within the gap cools the tip. In some cases, the gap and the fluid flow are insufficient to prevent the burning of tissue.
Prior to the present invention, phacoemulsification handpieces were relatively expensive due to the cost of the materials and the precise machining required in manufacturing the handpieces. As a result, phacoemulsification handpiece are not disposed of at the end of surgery, but are reused a number of times. Handpieces that are reused must be sterilized, usually by steam autoclaving. Steam autoclaving is extremely injurious to the seals, piezoelectric crystals and other electrical components of the handpiece. As a result, prior art phacoemulsification handpieces can be unreliable and must be rebuilt frequently. Additionally, prior art handpieces require numerous connections to a surgical console, making the handpieces more difficult and time consuming to set up.
Accordingly, a need continues to exist for a simple, reliable and safer surgical handpiece.
Brief Summary of the Invention
The present invention improves upon prior art handpieces by providing a handpiece having a central core which is removably received in an outer shell. The central core may be an ultrasonic element, a laser element or any other desired operative core and the core and/or the outer shell may be intended as a single use disposable or reusable element. A separate core and outer shell is easier to manufacture and the core does not have to be steam autoclaved. In addition, all the required connections for the handpiece can be preassembled on the handpiece and for easy connection to the surgical console, thereby reducing set up time.
Accordingly one objective of the present invention is to provide an inexpensive surgical handpiece.
Another objective of the present invention is to provide a surgical handpiece having increased reliability.
Still another objective of the present invention is to provide a phacoemulsification handpiece having a solid resonating core and tip.
Other objects, features and advantages of the present invention will become apparent with reference to the drawings, and the following description of the drawings and claims.
Brief Description of the Drawings
FIG. 1 is an expanded prospective view of the first embodiment of the surgical handpiece of the present invention.
FIG. 2 is a cross-sectional view of the first embodiment of the surgical handpiece of the present invention. FIG. 3 is a cross-sectional view of the second embodiment of the surgical handpiece of the present invention.
FIG. 4 is an expanded prospective view of the second embodiment of the surgical handpiece of the present invention.
Detailed Description of the Invention
As best seen in FIG. 1, handpiece 10 of the present invention preferably may be a phacoemulsification handpiece which will generally includes resonating core 12 and outer shell 14. Core 12 generally includes piezoelectric crystal portion 16, horn 18 and solid tip 20. Horn 18 and tip 20 preferably are machined as a single piece from any suitable material, for example, titanium, but the tip can be removable using a screw connector. Crystals 16 are attached to horn 18 at one end 22 by any suitable means, for example, epoxy glue and contain electrical connector and seal 24 at the opposite end that allows handpiece 10 to be connected to a suitable power and control source (not shown) through cable 26. Crystals 16 are caused to vibrate in a manner well-known in the art.
Handpiece 10 may also be used as a laser handpiece, an irrigation/aspiration handpiece, a liquefaction handpiece or any other desired handpiece by appropriate substitution of core 12.
Shell 14 contains aspiration port 28, irrigation port 30, integral aspiration sleeve 32 and integral irrigation sleeve 34. As best seen in FIG. 2, aspiration port 28 communicates with aspiration sleeve 32 through internal aspiration line 36, and irrigation port 30 communicates with irrigation sleeve 34 through internal irrigation line 38. The use of dual sleeves 32 and 34 provides further isolation of tip 20 from tissue. Shell 14 may be made of any suitable material such as stainless steel, titanium or plastic. Suitable external tubings 29 and 31 can be preassembled to aspiration port 28 and irrigation port 30 and made to conveniently connect to the surgical console (not shown), for example, by preconnecting tubings 29 and 31 to the surgical cassette (not shown) that may be used with the console.
As best seen in FIGS. 2 and 3, when core 12 is inserted into shell 14, tip 20 is coaxially sealed fluid tight within aspiration sleeve 32 by seal 40. Core 12 may be sealed within shell 14 by a friction connector/seal 24, as shown in FIGS. 1 and 2, or screw connector/seal 124, as shown in FIGS. 3 and 4.
While certain embodiments of the present invention have been described above, these descriptions are given for purposes of illustration and explanation. Variations, changes, modifications and departures from the systems and methods disclosed above may be adopted without departure from the scope or spirit of the present invention.

Claims

I claim:
1. A surgical handpiece, comprising: a) a core having a piezoelectric crystal portion and a horn portion, the horn portion having an integral solid cutting tip and attached to the crystal portion; b) a hollow outer shell having internal aspiration and irrigation lines that communicate with integral aspiration and irrigation sleeves, respectively, the shell adapted to receive the core;
7 c) a seal for sealing the solid cutting tip within the irrigation sleeve; and
8 d) a connector for sealing the core within the shell.
l 2. The handpiece of claim 1 wherein the connector is a friction seal,
l 3. The handpiece of claim 1 wherein the connector is a screw seal.
1 4. The handpiece of claim 1 wherein external tubings are preassembled to
2 ports on the shell.
1 5. A surgical handpiece, comprising:
2 a) an operative core;
3 b) a hollow outer shell having internal aspiration and irrigation lines that
4 communicate with integral aspiration and irrigation sleeves, respectively, the shell
5 adapted to receive the core; and
6 c) a connector for sealing the core within the shell.
l 6. The handpiece of claim 5 wherein the connector is a friction seal,
l 7. The handpiece of claim 5 wherein the connector is a screw seal.
1 8. The handpiece of claim 5 wherein external tubings are preassembled to
2 ports on the shell.
PCT/US1998/014767 1997-09-23 1998-07-16 Surgical handpiece WO1999015120A1 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU84084/98A AU8408498A (en) 1997-09-23 1998-07-16 Surgical handpiece

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US93579797A 1997-09-23 1997-09-23
US08/935,797 1997-09-23

Publications (1)

Publication Number Publication Date
WO1999015120A1 true WO1999015120A1 (en) 1999-04-01

Family

ID=25467671

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US1998/014767 WO1999015120A1 (en) 1997-09-23 1998-07-16 Surgical handpiece

Country Status (2)

Country Link
AU (1) AU8408498A (en)
WO (1) WO1999015120A1 (en)

Cited By (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB2355661A (en) * 1999-09-17 2001-05-02 Michael John Radley Young Ultrasonic surgical tool
EP1151724A1 (en) * 2000-05-03 2001-11-07 Celon AG Medical Instruments Ultrasound applicator for disintegration of tissue
US6723094B1 (en) 1998-12-18 2004-04-20 Kai Desinger Electrode assembly for a surgical instrument provided for carrying out an electrothermal coagulation of tissue
EP1591071A1 (en) 2004-04-28 2005-11-02 Olympus Corporation Ultrasonic treatment device with mist suctioning structure
WO2007035171A1 (en) * 2005-09-26 2007-03-29 Nanyang Technological University Ultrasonic mechanical emulsifier
US8092449B2 (en) 2003-07-11 2012-01-10 Celon Ag Surgical probe
US9433725B2 (en) 2011-12-23 2016-09-06 Alcon Research, Ltd. Combined coaxial and bimanual irrigation/aspiration apparatus
US9839738B2 (en) 2013-06-06 2017-12-12 Novartis Ag Transformer irrigation/aspiration device

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3805787A (en) * 1972-06-16 1974-04-23 Surgical Design Corp Ultrasonic surgical instrument
US3994297A (en) * 1974-12-09 1976-11-30 Kopf J David Ophthalmic instrument
US4316465A (en) * 1979-03-30 1982-02-23 Dotson Robert S Jun Ophthalmic handpiece with pneumatically operated cutter
WO1989003202A2 (en) * 1987-10-14 1989-04-20 Schneider Richard T Method and apparatus for laser emulsification
WO1992018075A1 (en) * 1991-04-23 1992-10-29 Allergan, Inc. Ophthalmic instrument
US5344395A (en) * 1989-11-13 1994-09-06 Scimed Life Systems, Inc. Apparatus for intravascular cavitation or delivery of low frequency mechanical energy

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3805787A (en) * 1972-06-16 1974-04-23 Surgical Design Corp Ultrasonic surgical instrument
US3994297A (en) * 1974-12-09 1976-11-30 Kopf J David Ophthalmic instrument
US4316465A (en) * 1979-03-30 1982-02-23 Dotson Robert S Jun Ophthalmic handpiece with pneumatically operated cutter
WO1989003202A2 (en) * 1987-10-14 1989-04-20 Schneider Richard T Method and apparatus for laser emulsification
US5344395A (en) * 1989-11-13 1994-09-06 Scimed Life Systems, Inc. Apparatus for intravascular cavitation or delivery of low frequency mechanical energy
WO1992018075A1 (en) * 1991-04-23 1992-10-29 Allergan, Inc. Ophthalmic instrument

Cited By (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6723094B1 (en) 1998-12-18 2004-04-20 Kai Desinger Electrode assembly for a surgical instrument provided for carrying out an electrothermal coagulation of tissue
GB2355661A (en) * 1999-09-17 2001-05-02 Michael John Radley Young Ultrasonic surgical tool
EP1151724A1 (en) * 2000-05-03 2001-11-07 Celon AG Medical Instruments Ultrasound applicator for disintegration of tissue
US8092449B2 (en) 2003-07-11 2012-01-10 Celon Ag Surgical probe
EP1591071A1 (en) 2004-04-28 2005-11-02 Olympus Corporation Ultrasonic treatment device with mist suctioning structure
US7507212B2 (en) 2004-04-28 2009-03-24 Olympus Corporation Ultrasonic treatment device with mist suctioning structure
WO2007035171A1 (en) * 2005-09-26 2007-03-29 Nanyang Technological University Ultrasonic mechanical emulsifier
US7876025B2 (en) 2005-09-26 2011-01-25 Nanyang Technological University Ultrasonic mechanical emulsifier
US9433725B2 (en) 2011-12-23 2016-09-06 Alcon Research, Ltd. Combined coaxial and bimanual irrigation/aspiration apparatus
US9839738B2 (en) 2013-06-06 2017-12-12 Novartis Ag Transformer irrigation/aspiration device

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Publication number Publication date
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