Microsurgical injection and/or distending instruments and surgical method and apparatus utilizing same

• US 20030171722A1
• Filed: 02/27/2003
• Published: 09/11/2003
• Est. Priority Date: 01/04/2001
• Status: Abandoned Application

• Current Assignee: Michel Paques, Nathanael Benhamou
• Original Assignee: Michel Paques, Nathanael Benhamou
• Inventors: Benhamou, Nathanael, Paques, Michel
• Application Number:
  US10/362,837
• Publication Number:
  US 20030171722A1
• Time in Patent Office: Days
• US Class Current: 604/264
• CPC Class Codes: A61B 2090/306 using optical fibres
• CPC Class Codes: A61F 2009/0052 the instrument being supported on the patient's eye
• CPC Class Codes: A61F 9/0017 implantable in, or in contact with, the eye, e.g. ocular inserts

Abstract

A microsurgical injection instrument particularly useful by a physician for injecting a liquid substance or a suspension into a blood vessel in the retina of a subject'"'"'s eye, includes a handpiece carrying a hollow needle at its distal end, for penetrating the blood vessel. The longitudinal axis of the distal end of the handpiece and of the needle is at an angle of from 90°-180°, preferably about 145°, to the longitudinal axis of the proximal end of the handpiece to facilitate orienting the needle substantially tangentially to the plane of the subject'"'"'s retina coaxially to a blood vessel for penetrating the blood vessel. The instrument may also be used to treat an occluded blood vessel by moving a flexible tube through the hollow needle, after the needle has penetrated the blood vessel, to enter and catheterize the blood vessel.

Claims

1. A microsurgical injection instrument particularly useful by a physician for injecting a liquid substance or suspension into a blood vessel in the retina of a subject'"'"'s eye, comprising:

a handpiece having a proximal end graspable by the physician, and a distal end carrying a hollow needle sharpened at its tip for penetrating the blood vessel in the subject'"'"'s retina;

said handpiece being formed with at least one passageway therethrough from its proximal end to said hollow needle at the distal end for the delivery thereto of the liquid substance to be injected;

the longitudinal axis of the distal end of the handpiece and of the hollow needle being at an angle of from 90°

-180°

to the longitudinal axis of the proximal end of the handpiece, to facilitate orienting said needle substantially tangentially to the plane of the subject'"'"'s retina and thereby to facilitate penetrating the blood vessel in the subject'"'"'s retina.

2. The instrument according to claim 1, wherein said angle is variable, such that said hollow needle is positionable coaxially to a bllod vessel to be penetrated.

3. The instrument according to claim 1, wherein the instrument further comprises a syringe at the proximal end of the handpiece communicating with said hollow needle at the distal end of the handpiece for feeding therethrough the liquid substance to be injected.

4. The instrument according to claim 1, wherein said hollow needle has an outer diameter of 30-120 microns.

5. The instrument according to claim 1, wherein said hollow needle has a length of approximately 300-600 microns.

6. The instrument according to claim 1, wherein said angle between the longitudinal axes of the distal and proximal ends of the handpiece is approximately 145°

, and said hollow needle has a length of approximately 500 microns.

7. The instrument according to claim 1, wherein the external diameter of the distal end of the handpiece is from 0.5 mm to 2.5 mm.

8. The instrument according to claim 1, wherein said passageway includes a flexible tube movable in said passageway of the hollow needle, after the needle has penetrated the blood vessel in the subject'"'"'s retina, to enter and to catheterize the blood vessel.

9. The instrument according to claim 1, wherein said handpiece include a second passageway therethrough from its proximal end to its distal end;

and an optical fiber in said second passageway;

said optical fiber having a distal end coaxial with the distal end of the handpiece and having an end face spaced from the hollow needle for illuminating the hollow needle and the blood vessel to be penetrated by the hollow needle.

10. The instrument according to claim 1, wherein the instrument further includes an external guiding member for placement against the outer surface of the eye, and formed with a hole for receiving and guiding said hollow needle to penetrate the blood vessel in the subject'"'"'s retina.

11. The instrument according to claim 10, wherein said external guiding member is made of a soft material which controls the movement of the hollow needle.

12. The instrument according to claim 10, wherein said external guiding member is of a hollow cylindrical configuration.

13. The instrument according to claim 10, further comprising a stabilizer connected to or integrally formed with a distal portion of said handpiece, said stabilizeer being positionale against the retina and serves for stabilization while penetrating the blood vessel in the subject'"'"'s retina.

14. Surgical apparatus comprising:

a microsurgical injection instrument according to claim 1, and a microsurgical illumination instrument for use therewith;

said microsurgical illumination instrument also comprising a handpiece having a proximal end graspable by the physician, and a distal end to be inserted into the subject'"'"'s eye and also being formed with a passageway therethrough from said proximal end to said distal end;

said latter passageway including an optical fiber having a proximal end to be exposed to a source of light, and a distal end to be located in the vicinity of the injection site in the subject'"'"'s eye to illuminate same.

15. The apparatus according to claim 14, wherein said distal end of the handpiece of the microsurgical illumination instrument is constructed so as to be engagable with the distal end of the microsurgical injection instrument for stabilizing and guiding the distal end of the injection instrument when inserted into the subject'"'"'s eye.

16. A microsurgical instrument particularly useful by a physician for catheterizing a blood vessel, comprising:

a handpiece having a proximal end graspable by the physician, and a distal end carrying a hollow needle sharpened at its tip for penetrating the blood vessel;

said handpiece being formed with at least one passageway therethrough from its proximal end to said hollow needle at the distal end;

and a flexible tube movable in said passageway of the hollow needle, after the needle has penetrated the blood vessel, to enter and catheterize the blood vessel.

17. The instrument according to claim 16, particularly useful for cannulation of a blood vessel in the retina of a subject'"'"'s eye, wherein the longitudinal axis of the distal end of the handpiece and of the hollow needle are at an angle of from 90°

-180°

to the longitudinal axis of the proximal end of the handpiece, to facilitate orienting said needle substantially tangentially to the plane of the subject'"'"'s retina and thereby to facilitate its penetrating the blood vessel in the subject'"'"'s retina.

18. The instrument according to claim 16, wherein said hollow needle has an outer diameter of 30-120 microns.

19. The instrument according to claim 16, wherein said hollow needle has a length of approximately 300-600 microns.

20. The instrument according to claim 16, wherein said angle between the longitudinal axes of the distal and proximal ends of the handpiece is approximately 145°

, and said hollow needle has a length of approximately 500 microns.

21. The instrument according to claim 16, wherein the external diameter of the distal end of the handpiece is from 0.5 mm to 2.5 mm.

22. The instrument according to claim 16, wherein the instrument further comprises a syringe at the proximal end of the handpiece communicating with said distal end of the cannula for feeding therethrough a liquid substance to be injected.

23. The instrument according to claim 16, wherein said handpiece include a second passageway therethrough from its proximal end to its distal end;

and an optical fiber in said second passageway;

said optical fiber having a distal end coaxial with the distal end of the handpiece and having an end face spaced from the hollow needle for illuminating the hollow needle and the blood vessel to be penetrated by the hollow needle.

24. The instrument according to claim 16, wherein the instrument further includes an external guiding member for placement against the outer surface of the eye, and formed with a hole for receiving and guiding said hollow needle to penetrate the blood vessel in the subject'"'"'s retina.

25. The instrument according to claim 24, wherein said external guiding member is made of a soft material which controls the guided movement of the hollow needle.

26. The instrument according to claim 24, wherein said external guiding member is of a hollow cylindrical configuration.

27. Surgical apparatus comprising:

a microsurgical injection instrument according to claim 16, and a microsurgical illumination instrument for use therewith;

said microsurgical illumination instrument also comprising a handpiece having a proximal end graspable by the physician, and a distal end to be inserted into the subject'"'"'s eye, and also being formed with a passageway therethrough from said proximal end to said distal end;

said latter passageway including an optical fiber having a proximal end to be exposed to a source of light, and a distal end to be located in the vicinity of the injection site in the subject'"'"'s eye to illuminate same.

28. The apparatus according to claim 27, wherein said distal end of the handpiece of the microsurgical illumination instrument is constructed so as to be engagable with the distal end of the microsurgical injection instrument for stabilizing and guiding the distal end of the injection instrument when inserted into the subject'"'"'s eye.

29. A method of treating a venous occlusive disease in a subject comprising injecting a fibrinolytic agent into an occluded retinal vein of the subject by a microsurgical injection instrument including a handpiece having a proximal end graspable by the physician, and a distal end carrying a hollow needle sharpened at its tip for penetrating the blood vessel in the subject'"'"'s retina.

30. The method according to claim 29, wherein the longitudinal axis of the distal end of the handpiece and of the hollow needle is at an angle of from 90°

to 180°

to the longitudinal axis of the proximal end of the handpiece, to facilitate orienting said needle substantially tangentially to the plane of the subject'"'"'s retina and thereby to facilitate penetrating the blood vessel in the subject'"'"'s retina.

31. A method of treating an occluded blood vessel in a subject, comprising penetrating the occluded blood vessel with a hollow needle having a sharpened tip, and moving a flexible tube through said hollow needle to enter and catheterize said blood vessel.