System and method for pulsed ultrasonic power delivery employing cavitation effects

• US 20040092921A1
• Filed: 03/12/2003
• Published: 05/13/2004
• Est. Priority Date: 10/21/2002
• Status: Abandoned Application

• Current Assignee: Advanced Medical Optics Incorporated (Johnson & Johnson)
• Original Assignee: Advanced Medical Optics Incorporated (Johnson & Johnson)
• Inventors: Rockley, Paul W., Schafer, Mark, Kadziauskas, Kenneth E.
• Application Number:
  US10/387,327
• Publication Number:
  US 20040092921A1
• Time in Patent Office: Days
• US Class Current: 606/27
• CPC Class Codes: A61B 2017/00176 Two pulses, e.g. second pulse having an effect different from the first one
• CPC Class Codes: A61B 2017/00194 Means for setting or varying the repetition rate
• CPC Class Codes: A61B 2018/00666 using a threshold value
• CPC Class Codes: A61F 9/00745 using mechanical vibrations, e.g. ultrasonic
• CPC Class Codes: B06B 1/0215 for generating pulses, e.g. bursts of oscillations, envelopes
• CPC Class Codes: B06B 1/023 and stepped in amplitude, e.g. square wave, 2-level signal
• CPC Class Codes: B06B 1/0253 taken directly from the generator circuit
• CPC Class Codes: B06B 2201/76 Medical, dental

Abstract

A method and apparatus for delivering energy during a surgical procedure such as phacoemulsification is provided. The method and apparatus include delivering energy during a surgical procedure, including applying energy at a level and for a time period sufficient to induce transient cavitation, and reducing applied energy after applying energy during a second nonzero lower energy period.

Claims

1. A method for delivering energy during a surgical procedure performed within a surgical environment comprising a fluid, comprising:

applying energy at a first energy level sufficient to induce transient cavitation within the fluid; and

providing energy at a predetermined period after attaining transient cavitation within the fluid, said providing energy comprising applying energy at a second energy level lower than the first energy level.

2. The method of claim 1, wherein the predetermined period is less than three milliseconds.

3. The method of claim 1, wherein the predetermined period is less than one millisecond.

4. The method of claim 1, further comprising providing additional energy at a predetermined period after said providing energy at a third energy level.

5. The method of claim 1, wherein the second energy level is essentially zero.

6. The method of claim 1, further comprising applying de minimis energy subsequent to said providing energy at the second energy level.

7. The method of claim 6, further comprising repeating said applying and providing after applying de minimis energy.

8. A method of delivering ultrasonic energy during a tissue removal procedure employed in association with a fluid, comprising:

applying energy at a high energy amplitude level capable of inducing transient cavitation within the fluid; and

providing energy at a low energy amplitude level, thereby having the effect of minimizing adverse tissue damage resulting from ultrasonic energy transmission.

9. The method of claim 8, wherein providing energy at a low energy level comprises providing energy at a de minimis power level.

10. The method of claim 8, further comprising providing additional energy at a second low energy amplitude level subsequent to said energy providing.

11. The method of claim 8, further comprising refraining from power delivery subsequent to said energy providing and repeating said applying and providing after a predetermined time period.

12. The method of claim 8, wherein applying energy occurs for a predetermined period of time calculated to induce said transient cavitation.

13. The method of claim 8, wherein applying energy causes a cavitational energy having a duration of less than eight milliseconds.

14. The method of claim 8, wherein applying energy causes a cavitational energy having a duration of less than four milliseconds.

15. A surgical apparatus, comprising:

means for applying transient energy to a surgical area comprising a fluid, said transient energy applying means applying energy at an amplitude and for a time period sufficient to induce transient cavitation within the fluid; and

means for reducing said transient energy to a lower amplitude energy level subsequent to said time period, thereby reducing risk of energy related injury.

16. The apparatus of claim 15, wherein the means for reducing said transient energy comprises means for providing energy at a de minimis power level.

17. The apparatus of claim 15, further comprising means for providing additional energy at a second lower amplitude energy level subsequent to reducing said transient energy to a lower amplitude energy level.

18. The apparatus of claim 15, further comprising:

means for refraining from power delivery subsequent to said transient energy reducing; and

means for repeating said applying, reducing, and refraining.

19. The apparatus of claim 15, further comprising:

means for repeating said applying and reducing.

20. The apparatus of claim 15, wherein said means for applying transient energy causes application of an elevated level of transient cavitational energy for the time period of less than eight milliseconds.

21. The apparatus of claim 15, wherein said means for applying transient energy causes application of an elevated level of transient cavitational energy for the time period of less than four milliseconds.

22. The apparatus of claim 15, wherein said means for applying comprise a phacoemulsification handpiece having a needle and electrical means for ultrasonically vibrating said needle.

23. The apparatus of claim 22, further comprising engagement/disengagement means, wherein operation of the apparatus is engaged at a first desired time when energy application is desired and operation of the apparatus is disengaged at a second desired time when energy application is not desired.

24. The apparatus of claim 23, wherein said engagement/disengagement means comprises a switch.

25. A method for providing modulated ultrasonic energy to an ocular region during a phacoemulsification procedure, the method comprising:

applying energy to the ocular region at a high energy level calculated to induce transient cavitation within fluid in the ocular region, said energy applying occurring for a first predetermined time;

reducing application of energy to the ocular region after said first predetermined time;

waiting for a second predetermined period of time; and

repeating said applying and reducing to the ocular region.

26. The method of claim 25, wherein time between completing said applying and initiating said reducing is essentially zero.

27. The method of claim 25, wherein applying energy results in cavitational energy having a duration of less than eight milliseconds.

28. The method of claim 25, wherein applying energy results in cavitational energy having a duration of less than four milliseconds.

29. An apparatus comprising:

a handpiece having a needle and electrical means for ultrasonically vibrating said needle;

power source means for providing pulsed electrical power to the handpiece electrical means;

input means for enabling an operator to select an amplitude of the electrical pulses;

means for providing fluid from the handpiece needle; and

control means for controlling ultrasonic power supplied to the handpiece during a surgical procedure conducted in a surgical environment having a fluid associated therewith, said control means controlling ultrasonic power supplied by applying power at a level and for a time period sufficient to induce transient cavitation in the fluid and reducing power after said time period to a lower level, thereby decreasing likelihood of injury.

30. The apparatus of claim 29, wherein the control means further provides energy at a de minimis power level subsequent to reducing power to the lower level.

31. The apparatus of claim 29, wherein the control means further provides additional energy at a second lower level subsequent to reducing power after said time period to the lower level.

32. The apparatus of claim 29, wherein the control means further comprise:

means for refraining from power delivery subsequent to reducing power to the lower level; and

means for repeating said applying, reducing, and refraining.

33. The apparatus of claim 29, wherein the control means further comprise:

means for repeating said applying and reducing.

34. The apparatus of claim 29, wherein applying power for said time period results in cavitational energy having duration of less than eight milliseconds.

35. The apparatus of claim 29, wherein applying power for said time period results in cavitational energy having duration of less than four milliseconds.

36. The apparatus of claim 29, said control means further comprising engagement/disengagement means, wherein operation of the control means is engaged at a first desired time when energy application is desired and operation of the apparatus is disengaged at a second desired time when energy application is not desired.

37. The apparatus of claim 36, wherein said engagement/disengagement means comprise a switch.

38. An apparatus comprising:

a handpiece having a needle and electrical means for ultrasonically vibrating said needle;

power source means for providing pulsed electrical power to the handpiece electrical means;

input means for enabling an operator to select an amplitude of the electrical pulses;

means for providing fluid from the handpiece needle; and

control means for controlling oscillatory mechanical power supplied to the handpiece, said control means controlling oscillatory mechanical power supplied by applying power at a level and for a time period calculated to induce transient cavitation within a surgical environment wherein the apparatus is employed.

39. The apparatus of claim 38, wherein the control means further controls power by reducing power subsequent to the time period calculated to induce transient cavitation.

40. The apparatus of claim 39, wherein the control means applies reduced power at the amplitude specified via the input means.

41. The apparatus of claim 38, wherein said control means control power by delivering de minimis energy subsequent to applying power at the level and for the time period calculated to induce transient cavitation.

42. The apparatus of claim 38, further comprising means for engaging the control means at a first desired time when energy application is desired and disengaging the method at a second desired time when energy application is not desired.

43. The apparatus of claim 42, wherein said engaging means comprises a switch.

44. A method for delivering ultrasound energy in an environment, comprising:

initially applying ultrasound energy at a level and for a time period sufficient to induce transient cavitation in the environment; and

reducing applied ultrasound energy after initially applying during a second nonzero lower ultrasound energy period.

45. The method of claim 44, said method being used for diagnosis.

46. The method of claim 44, said method employed for chemical processing.

47. The method of claim 46, wherein said applying tends to minimize heat resulting from ultrasound energy transmission.

48. The method of claim 46, wherein said applying tends to minimize input energy required to effectuate a given chemical result.

49. The method of claim 44, said method employed for medical treatment.

50. The method of claim 44, said method being used to enhance medical treatment.

51. The method of claim 44, wherein said applying and reducing minimizes adverse tissue damage resulting from ultrasonic energy transmission.

52. The method of claim 44, said transient cavitation comprising relatively rapid expansion and forceful collapse of bubbles within the environment resulting from force associated with the ultrasound energy.

53. A method for delivering ultrasound energy within an environment comprising dissolved gas, the method comprising:

applying a relatively high level of ultrasound energy within the environment sufficient to induce transient cavitation therein, said transient cavitation comprising relatively rapid expansion and forceful collapse of dissolved gas within the environment resulting from force associated with the ultrasound energy for a relatively short duration of time.

54. The method of claim 53, further comprising:

applying a lower level of ultrasound energy within the environment subsequent to applying the relatively high level of ultrasound energy.

55. The method of claim 53, said method being used for diagnosis.

56. The method of claim 53, said method employed for chemical processing.

57. The method of claim 56, wherein said applying tends to minimize heat resulting from ultrasound energy transmission.

58. The method of claim 56, wherein said applying tends to minimize input energy required to effect a given chemical result.

59. The method of claim 53, said method employed for medical treatment.

60. The method of claim 53, said method being used to enhance medical treatment.

61. The method of claim 53, wherein said applying and reducing minimizes adverse tissue damage resulting from ultrasonic energy transmission.

62. The method of claim 53, wherein said applying minimizes adverse tissue damage resulting from ultrasonic energy transmission.