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WO1999063917A1 - Surgical sealing sleeve - Google Patents

Surgical sealing sleeve Download PDF

Info

Publication number
WO1999063917A1
WO1999063917A1 PCT/IL1999/000305 IL9900305W WO9963917A1 WO 1999063917 A1 WO1999063917 A1 WO 1999063917A1 IL 9900305 W IL9900305 W IL 9900305W WO 9963917 A1 WO9963917 A1 WO 9963917A1
Authority
WO
WIPO (PCT)
Prior art keywords
sheath
sealing sleeve
sleeve
surgical sealing
axially extending
Prior art date
Application number
PCT/IL1999/000305
Other languages
French (fr)
Inventor
Yehoshua Ben Nun
Original Assignee
Front Door Ocular Technology Ltd.
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 Front Door Ocular Technology Ltd. filed Critical Front Door Ocular Technology Ltd.
Priority to AU41624/99A priority Critical patent/AU4162499A/en
Publication of WO1999063917A1 publication Critical patent/WO1999063917A1/en

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS 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
    • A61F9/00—Methods 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
    • A61F9/007—Methods or devices for eye surgery
    • A61F9/00736—Instruments for removal of intra-ocular material or intra-ocular injection, e.g. cataract instruments
    • A61F9/00745—Instruments for removal of intra-ocular material or intra-ocular injection, e.g. cataract instruments using mechanical vibrations, e.g. ultrasonic
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3462—Trocars; Puncturing needles with means for changing the diameter or the orientation of the entrance port of the cannula, e.g. for use with different-sized instruments, reduction ports, adapter seals
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3498—Valves therefor, e.g. flapper valves, slide valves
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B2017/320084—Irrigation sleeves
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/08—Accessories or related features not otherwise provided for
    • A61B2090/0801—Prevention of accidental cutting or pricking

Definitions

  • the present invention relates to surgical sealing sleeves in general and for ophthalmic surgical procedures in particular.
  • Phacoemulsification is performed via a slit formed in an eye's anterior segment tissue which is particularly susceptible to heat.
  • a bare ultrasound probe is encircled in a soft elongated tubular jacket having inlet and outlet ports respectively at its proximal and distal ends for administering a flow of irrigation fluid for cooling the probe and mamtaining normal intraocular pressure in the face of, on the one hand, leakage between the jacket and the slit's side walls and, on the other hand, suction of unwanted debris from the phacoemulsification.
  • the jacket has an overall diameter of about 3 mm which is considerably greater than the diameter of the probe itself which is about 1 mm and which militates against the probe's manipulation.
  • a surgical sealing sleeve for temporary seating in an access tissue, for connecting to a source of irrigation fluid and for enabling the introduction of a surgical instrument therethrough, the surgical sealing sleeve comprising:
  • an elastomeric elongated sheath sealingly interdisposed between said tubular sleeve and said at least one sheath support member and distally extending so as to fit over said at least one sheath support member, said sheath having an a priori sealed end adapted to be cut in situ to provide a normally closed unidirectional slit valve whereby the surgical instrument is enwrapped thereby along substantially the entire length of the surgical sealing sleeve on its introduction therethrough;
  • the prior surgical sealing sleeve is restricted to ophthalmic procedures performed through an eye's sclera, for example, vitrectomy, requiring the repeated introduction of a number of sharp instruments whilst, against this, the surgical sealing sleeve of the present invention is envisaged for ophthalmic procedures performed through an eye's anterior segment tissue and in particular for phacoemulsification.
  • the surgical sealing sleeve of the present invention enables the use of a conventional bare ultrasonic probe in phacoemulsification whereupon its vibrations are isolated therefrom on its introduction through its passageway by the elastomeric sheath which in addition functions as an uni-directional slit valve.
  • the at least one axially extending conduit enables a flow of irrigation fluid therethrough for, on the one hand, cooling the surgical sealing sleeve which would otherwise be heated by a bare ultrasound probe for protecting an eye's delicate anterior segment tissue from heat and, on the other hand, maintaining normal intraocular pressure in the face of intraocular liquid losses.
  • the surgical sealing sleeve of the present invention affords for more convenient phacoemulsification through a smaller slit with improved flow irrigation and reduced leakage.
  • Figs. 1 and 2 are respectively a perspective view and a partial cross section perspective view of a surgical sealing sleeve in accordance with the present invention
  • Figs. 3A and 3B are respectively a schematic cross section side view and a front view of a human eye through whose anterior segment tissue a surgical sealing sleeve of the present invention has been temporarily inserted for phacoemulsification;
  • Fig. 4 is the same view of the surgical sealing sleeve as in Figure 1 with a bare ultrasound probe introduced therethrough for phacoemulsification.
  • Figure 1 shows a surgical sealing sleeve 1 having an axially extending rigid tubular sleeve 2 with a passageway 3 axially extending between a proximal end 3A associated with an access environment and a distal end 3B associated with an eye's interior.
  • the sleeve 2 is formed with an annular fixation plate 4 having an upright projection 6 for use with a cutting tool 7 and an internal screw thread 8 for releasable engagement with a matching external screw thread 9 of a hand held insertion tool 11, the cutting tool 9 and the hand held insertion tool 11 corresponding to the cutting tool and the hand held insertion tool of International Publication WO 97/47247.
  • a pair of diametrically opposite axially extending conduits 12A and 12B are in intimate contact with the sleeve 2 for cooling same and for irrigation purposes.
  • Each conduit 12A and 12B has a L-shaped proximal section 13A and 13B with an inlet port 14A and 14B and a crescent shaped distal portion 16A and 16B with an outlet port 17A and 17B slightly short of the distal end 3B, the crescent shaped distal portions 16A and 16B substantially circumscribing the entire circumference of the sleeve 2.
  • the overall width of the surgical sealing sleeve 1 is about 2 mm including a 1.5 mm diameter passageway.
  • the sleeve 2 is formed with a recessed shoulder 18 at its proximal end 3 A for receiving a ring 19 formed with a pair of downwardly depending diametrically opposite rods 21 A and 2 IB members whose tips lie proximal of the distal end 3B, the ring 19 and the rods 21 A and 2 IB constituting a sheath securing member 22 and the rods 21 A and 2 IB each constituting a sheath support member.
  • the rods 21 A and 2 IB are received in channels 23A and 23B formed along the sleeve's interior surface 24 so as to be flush therewith.
  • the sheath securing member 22 sealingly secures an ultrafme elongated elastomeric sheath 26 to the sleeve 2 such that it extends very slightly beyond the tips of the rods 21 A and 2 IB, thereby presenting side walls 27A and 27B converging at a transversely directed sealed sheath end 28.
  • the side walls 27A and 27B act as a normally closed uni-directional silt valve under the prevailing pressure in an eye's interior.
  • a single surgical sealing sleeve 1 on temporary insertion into an eye enables phacoemulsification with a bare ultrasound probe 29.
  • the conduits 12A and 12B are each connected to a source of irrigation fluid whereby they cool down the sleeve 2 so as not to impair an eye's anterior segment tissue and at the same time maintain normal intraocular pressure in the face of suction of unwanted debris from the phacoemulsification upwards through the bare ultrasonic probe 29.
  • the probe's vibrations are substantially isolated from the sleeve 2 by means of the sheath 26 which tends to enwrap the probe 29 substantially along the entire length of the sleeve 2 when introduced therethrough (see Figure 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 sealing sleeve (1) for temporary seating in an access tissue, for connecting to a source of irrigation fluid and for enabling the introduction of a surgical instrument therethrough. The surgical sealing sleeve (1) includes an axially extending rigid tubular sleeve (2) for attachment to the access tissue and has an axially extending passageway (3) with a proximal end 3A) and a distal end (3B); at least one sheath support member (22) distally extends along the passageway (3) from adjacent the proximal end to adjacent the distal end and terminates proximate thereto; an elastomeric elongated sheath (26) is sealingly interdisposed between the tubular sleeve (2) and the at least one sheath support member (22) and distally extends so as to fit over the at least one sheath support member (22), the sheath (26) having an a priori sealed end adapted to be cut in situ to provide a normally closed unidirectional slit valve whereby the surgical instrument is enwrapped thereby along substantially the entire length of the surgical sealing sleeve (1) on its introduction therethrough; and at least one axially extending conduit (12) is integrally formed with the tubular sleeve (2) and is in intimate contact therewith, each conduit (12) having an inlet port (14) at its proximal end for connection to the source of irrigation fluid and an outlet port (17) at its distal end.

Description

SURGICAL SEALING SLEEVE
FIELD OF THE INVENTION
The present invention relates to surgical sealing sleeves in general and for ophthalmic surgical procedures in particular.
BACKGROUND OF THE INVENTION
Phacoemulsification is performed via a slit formed in an eye's anterior segment tissue which is particularly susceptible to heat. To protect such tissue from heat, a bare ultrasound probe is encircled in a soft elongated tubular jacket having inlet and outlet ports respectively at its proximal and distal ends for administering a flow of irrigation fluid for cooling the probe and mamtaining normal intraocular pressure in the face of, on the one hand, leakage between the jacket and the slit's side walls and, on the other hand, suction of unwanted debris from the phacoemulsification. The jacket has an overall diameter of about 3 mm which is considerably greater than the diameter of the probe itself which is about 1 mm and which militates against the probe's manipulation.
SUMMARY OF THE INVENTION
In accordance with the present invention, there is provided a surgical sealing sleeve for temporary seating in an access tissue, for connecting to a source of irrigation fluid and for enabling the introduction of a surgical instrument therethrough, the surgical sealing sleeve comprising:
(a) an axially extending rigid tubular sleeve for attachment to the access tissue and having an axially extending passageway with a proximal end and a distal end;
(b) at least one sheath support member distally extending along said passageway adjacent said proximal end and terminating adjacent said distal end and proximal thereto;
(c) an elastomeric elongated sheath sealingly interdisposed between said tubular sleeve and said at least one sheath support member and distally extending so as to fit over said at least one sheath support member, said sheath having an a priori sealed end adapted to be cut in situ to provide a normally closed unidirectional slit valve whereby the surgical instrument is enwrapped thereby along substantially the entire length of the surgical sealing sleeve on its introduction therethrough; and
(d) at least one axially extending conduit integrally formed with said tubular sleeve and in intimate contact therewith, each said conduit having an inlet port at its proximal end for connection to the source of irrigation fluid and an outlet port at its distal end. The surgical sealing sleeve of the present invention is a development of the surgical sealing device illustrated and described in PCT/TL97/00171 published under International Publication W097/47247. However, in practice, the prior surgical sealing sleeve is restricted to ophthalmic procedures performed through an eye's sclera, for example, vitrectomy, requiring the repeated introduction of a number of sharp instruments whilst, against this, the surgical sealing sleeve of the present invention is envisaged for ophthalmic procedures performed through an eye's anterior segment tissue and in particular for phacoemulsification.
By virtue of its construction, the surgical sealing sleeve of the present invention enables the use of a conventional bare ultrasonic probe in phacoemulsification whereupon its vibrations are isolated therefrom on its introduction through its passageway by the elastomeric sheath which in addition functions as an uni-directional slit valve. At the same time, the at least one axially extending conduit enables a flow of irrigation fluid therethrough for, on the one hand, cooling the surgical sealing sleeve which would otherwise be heated by a bare ultrasound probe for protecting an eye's delicate anterior segment tissue from heat and, on the other hand, maintaining normal intraocular pressure in the face of intraocular liquid losses. Thus, the surgical sealing sleeve of the present invention affords for more convenient phacoemulsification through a smaller slit with improved flow irrigation and reduced leakage. Further objects, features and advantages of the present invention will become apparent from the following detailed description when take in conjunction with the accompanying drawings wherein like reference numerals designate like elements through the several views.
BRIEF DESCRIPTION OF THE DRAWINGS
Figs. 1 and 2 are respectively a perspective view and a partial cross section perspective view of a surgical sealing sleeve in accordance with the present invention;
Figs. 3A and 3B are respectively a schematic cross section side view and a front view of a human eye through whose anterior segment tissue a surgical sealing sleeve of the present invention has been temporarily inserted for phacoemulsification; and
Fig. 4 is the same view of the surgical sealing sleeve as in Figure 1 with a bare ultrasound probe introduced therethrough for phacoemulsification. DETAILED DESCRIPTION OF THE INVENTION
With reference now to the drawings, Figure 1 shows a surgical sealing sleeve 1 having an axially extending rigid tubular sleeve 2 with a passageway 3 axially extending between a proximal end 3A associated with an access environment and a distal end 3B associated with an eye's interior. At its proximal end, the sleeve 2 is formed with an annular fixation plate 4 having an upright projection 6 for use with a cutting tool 7 and an internal screw thread 8 for releasable engagement with a matching external screw thread 9 of a hand held insertion tool 11, the cutting tool 9 and the hand held insertion tool 11 corresponding to the cutting tool and the hand held insertion tool of International Publication WO 97/47247.
A pair of diametrically opposite axially extending conduits 12A and 12B are in intimate contact with the sleeve 2 for cooling same and for irrigation purposes. Each conduit 12A and 12B has a L-shaped proximal section 13A and 13B with an inlet port 14A and 14B and a crescent shaped distal portion 16A and 16B with an outlet port 17A and 17B slightly short of the distal end 3B, the crescent shaped distal portions 16A and 16B substantially circumscribing the entire circumference of the sleeve 2. The overall width of the surgical sealing sleeve 1 is about 2 mm including a 1.5 mm diameter passageway.
Turning now to Figure 2, the sleeve 2 is formed with a recessed shoulder 18 at its proximal end 3 A for receiving a ring 19 formed with a pair of downwardly depending diametrically opposite rods 21 A and 2 IB members whose tips lie proximal of the distal end 3B, the ring 19 and the rods 21 A and 2 IB constituting a sheath securing member 22 and the rods 21 A and 2 IB each constituting a sheath support member. The rods 21 A and 2 IB are received in channels 23A and 23B formed along the sleeve's interior surface 24 so as to be flush therewith. The sheath securing member 22 sealingly secures an ultrafme elongated elastomeric sheath 26 to the sleeve 2 such that it extends very slightly beyond the tips of the rods 21 A and 2 IB, thereby presenting side walls 27A and 27B converging at a transversely directed sealed sheath end 28. On cutting the sealed sheath end 28 by means of the cutting tool 7, the side walls 27A and 27B act as a normally closed uni-directional silt valve under the prevailing pressure in an eye's interior. As shown in Figures 3A and 3B, a single surgical sealing sleeve 1 on temporary insertion into an eye enables phacoemulsification with a bare ultrasound probe 29. The conduits 12A and 12B are each connected to a source of irrigation fluid whereby they cool down the sleeve 2 so as not to impair an eye's anterior segment tissue and at the same time maintain normal intraocular pressure in the face of suction of unwanted debris from the phacoemulsification upwards through the bare ultrasonic probe 29. The probe's vibrations are substantially isolated from the sleeve 2 by means of the sheath 26 which tends to enwrap the probe 29 substantially along the entire length of the sleeve 2 when introduced therethrough (see Figure 4).
While the invention has been described with respect to a limited number of embodiments, it will be appreciated that many variations, modifications and other applications of the invention may be made without departing from the scope of the claims as appended hereto.

Claims

CLAIMS:
1. A surgical sealing sleeve for temporary seating in an access tissue, for connecting to a source of irrigation fluid and for enabling the introduction of a surgical instrument therethrough, the surgical sealing sleeve comprising:
(a) an axially extending rigid tubular sleeve for attachment to the access tissue and having an axially extending passageway with a proximal end and a distal end;
(b) at least one sheath support member distally extending along said passageway adjacent said proximal end and terminating adjacent said distal end and proximal thereto;
(c) an elastomeric elongated sheath sealingly interdisposed between said tubular sleeve and said at least one sheath support member and distally extending so as to fit over said at least one sheath support member, said sheath having an a priori sealed end adapted to be cut in situ to provide a normally closed unidirectional slit valve whereby the surgical instrument is enwrapped thereby along substantially the entire length of the surgical sealing sleeve on its introduction therethrough; and (d) at least one axially extending conduit integrally formed with said sleeve and in intimate contact therewith, each said conduit having an inlet port at its proximal end for connection to the source of irrigation fluid and an outlet port at its distal end.
2. A surgical sealing sleeve according to Claim 1 further comprising a bipod like securing member for securing said sheath at said proximate end, said securing member including a pair of diametrically opposite sheath support members.
3. A surgical sealing sleeve according to Claim 2 wherein said pair of sheath support members are each received in a channel extending along said inner surface.
4. A surgical sealing sleeve according to any one of Claims 1 to 3 wherein said at least one axially extending conduit substantially circumscribes the sleeve.
5. A surgical sealing sleeve according to any one of Claims 1 to 4 and comprising a pair of diametrically opposite axially extending conduits, each conduit substantially circumscribing a semi-cylindrical portion of the sleeve.
PCT/IL1999/000305 1998-06-08 1999-06-08 Surgical sealing sleeve WO1999063917A1 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU41624/99A AU4162499A (en) 1998-06-08 1999-06-08 Surgical sealing sleeve

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
IL12481798A IL124817A (en) 1998-06-08 1998-06-08 Surgical sealing sleeve
IL124817 1998-06-08

Publications (1)

Publication Number Publication Date
WO1999063917A1 true WO1999063917A1 (en) 1999-12-16

Family

ID=11071597

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/IL1999/000305 WO1999063917A1 (en) 1998-06-08 1999-06-08 Surgical sealing sleeve

Country Status (3)

Country Link
AU (1) AU4162499A (en)
IL (1) IL124817A (en)
WO (1) WO1999063917A1 (en)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1345561A1 (en) * 2000-11-28 2003-09-24 Anthony Maloof A device for sealing the capsular bag of an eye and a method for delivering fluid or treatment substances to the lens of an eye
NL2010857C2 (en) * 2013-05-24 2014-11-26 D O R C Dutch Ophthalmic Res Ct International B V A cannula system, a kit and a method for assembling a cannula system.

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4033349A (en) * 1976-04-13 1977-07-05 The United States Of America As Represented By The Administrator Of The National Aeronautics And Space Administration Corneal seal device
WO1997047247A1 (en) 1996-06-13 1997-12-18 One Way Ocular Technology, Ltd. Surgical sealing sleeve
WO1998009673A1 (en) * 1996-09-05 1998-03-12 Applied Medical Resources Corporation Modular trocar

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4033349A (en) * 1976-04-13 1977-07-05 The United States Of America As Represented By The Administrator Of The National Aeronautics And Space Administration Corneal seal device
WO1997047247A1 (en) 1996-06-13 1997-12-18 One Way Ocular Technology, Ltd. Surgical sealing sleeve
WO1998009673A1 (en) * 1996-09-05 1998-03-12 Applied Medical Resources Corporation Modular trocar

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1345561A1 (en) * 2000-11-28 2003-09-24 Anthony Maloof A device for sealing the capsular bag of an eye and a method for delivering fluid or treatment substances to the lens of an eye
EP1345561A4 (en) * 2000-11-28 2006-12-13 Anthony Maloof A device for sealing the capsular bag of an eye and a method for delivering fluid or treatment substances to the lens of an eye
NL2010857C2 (en) * 2013-05-24 2014-11-26 D O R C Dutch Ophthalmic Res Ct International B V A cannula system, a kit and a method for assembling a cannula system.

Also Published As

Publication number Publication date
AU4162499A (en) 1999-12-30
IL124817A0 (en) 1999-01-26
IL124817A (en) 2001-12-23

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