Method of Controlling a Surgical System Based on a Load on the Cutting Tip of a Handpiece

• US 20100036406A1
• Filed: 10/12/2009
• Published: 02/11/2010
• Est. Priority Date: 03/22/2004
• Status: Active Grant

• Current Assignee: Alcon Incorporated
• Original Assignee: Alcon Incorporated
• Inventors: Gordon, Raphael, Yadlowsky, Ann, Boukhny, Mikhail, Morgan, Michael D.
• Granted Patent: US 8,257,307 B2
• Time in Patent Office: Days
• US Class Current: 606/169
• CPC Class Codes: A61B 17/320068 using mechanical vibrations, e.g. ultrasonic A61B17/22012 takes precedence; dental tooth drilling devices operated by vibration A61C3/03; removing intra-ocular material using mechanical vibrations A61F9/00745
• CPC Class Codes: A61B 2017/00017 Electrical control of surgical instruments
• CPC Class Codes: A61B 2017/0003 of parts of the instruments
• CPC Class Codes: A61B 2017/00973 pedal-operated
• CPC Class Codes: A61B 2017/32007 with suction or vacuum means
• CPC Class Codes: A61F 9/00745 using mechanical vibrations, e.g. ultrasonic
• CPC Class Codes: A61M 1/77 Suction-irrigation systems aspiration tips supplying fluids A61M1/85; specific for negative pressure wound therapy A61M1/92; combined with tracheal tubes A61M16/0463
• CPC Class Codes: A61M 2205/3368 Temperature
• CPC Class Codes: A61M 2205/50 with microprocessors or computers
• CPC Class Codes: A61M 3/0202 with electronic control means or interfaces
• CPC Class Codes: A61M 3/0208 before use
• CPC Class Codes: A61M 3/0216 Pressure
• CPC Class Codes: A61M 3/022 Volume; Flow rate
• CPC Class Codes: A61M 3/0258 by means of electric pumps

Abstract

A surgical system that is able to sense the onset of an occlusion or other surgical event as well as the instant an occlusion breaks. To help avoid overheating of the tip, the system determines an approximate temperature of the eye using an irrigation flow rate and reduces the power to the handpiece automatically if an overheating situation is predicted. Alternatively or in addition, the system monitors the power drawn by the handpiece, which is indicative of the cutting load on the tip, and automatically adjusts the power or stroke of the tip to compensate for increased loads on the tip.

Claims

1. A method of controlling a surgical system, the surgical system having an ultrasound handpiece, the ultrasound handpiece having a cutting tip for cutting tissue, the s method comprising the steps of:

establishing a threshold power level;

monitoring a load on the cutting tip of the ultrasound handpiece by monitoring a voltage and a current drawn by the handpiece during a non-zero sense power interval, the sense power interval being between cutting power intervals;

comparing the amount of power drawn by the handpiece and the threshold power level; and

adjusting an amount of power delivered to the cutting tip of the ultrasound handpiece if the power drawn by the handpiece exceeds the threshold power level by adjusting an amplitude or stroke of the output of the ultrasound handpiece.

2. The method of claim 1, the threshold power level being based on the cutting tip being operated in saline or reference environment.

3. The method of claim 1, monitoring the amount of power drawn by the handpiece being determined by a linear calculation of multiplying the current and the voltage drawn by the ultrasound handpiece.

4. The method of claim 1, the duty cycle of the output of the ultrasound handpiece remaining constant or being controlled by a surgeon.

5. The method of claim 1, monitoring the load being performed at a power level that is lower than a power level of the cutting intervals or pulses.

6. The method of claim 1, adjusting the amount of power delivered to the cutting tip of the ultrasound handpiece comprising adjusting an amount of power up to a maximum amount of power requested by a user.

7. The method of claim 1, adjusting the amount of power comprising adjusting a stroke of the cutting pulse or interval following the non-zero sense interval.

8. The method of claim 1, further comprising adjusting an amount of power to be delivered to the cutting tip with a sensitivity coefficient.

9. The method of claim 1, monitoring the load comprising monitoring the load on the cutting tip of the ultrasound handpiece by monitoring a voltage and a current drawn by the handpiece during a non-zero sense power interval, the sense power interval having about the same duration as the cutting power intervals.

10. The method of claim 1, monitoring the load comprising monitoring the load on the cutting tip of the ultrasound handpiece by monitoring a voltage and a current drawn by the handpiece during a non-zero sense power interval, the sense power intervals being longer or shorter than the cutting power intervals.

11. The method of claim 1, monitoring the load comprising monitoring the load on the cutting tip of the ultrasound handpiece by monitoring a voltage and a current drawn by the handpiece during a non-zero sense power intervals having a fixed duration.

12. The method of claim 1, monitoring the load comprising monitoring the load on the cutting tip of the ultrasound handpiece by monitoring a voltage and a current drawn by the handpiece during a non-zero sense power intervals having a variable duration.

13. The method of claim 1, monitoring the load comprising monitoring the load on the cutting tip of the ultrasound handpiece by monitoring a voltage and a current drawn by the handpiece during a plurality of non-zero sense power intervals that are separate pulses between cutting pulses.

14. The method of claim 1, monitoring the load comprising monitoring the load on the cutting tip of the ultrasound handpiece by monitoring a voltage and a current drawn by the handpiece during a non-zero sense power interval immediately prior to a cutting interval.

15. The method of claim 1, monitoring the load comprising monitoring the load on the cutting tip of the ultrasound handpiece by monitoring a voltage and a current drawn by the handpiece during a non-zero sense power interval immediately following a cutting interval.

16. The method of claim 1, monitoring the load comprising monitoring the load on the cutting tip of the ultrasound handpiece by monitoring a voltage and a current drawn by the handpiece during a decay of a non-zero sense power interval.

17. The method of claim 16, further comprising correlating a rate of decay of the non-zero sense power interval to the load drawn by the handpiece.

18. The method of claim 1, further comprising cutting tissue during monitoring the load.

19. A method of controlling a surgical system, the surgical system having an ultrasound handpiece, the ultrasound handpiece having a cutting tip for cutting tissue, the method comprising the steps of:

establishing a threshold power level;

monitoring a load on the cutting tip of the ultrasound handpiece by monitoring a voltage and a current drawn by the handpiece during a non-zero sense power interval, the sense power interval being between cutting power intervals;

comparing the amount of power drawn by the handpiece and the threshold power level; and

adjusting an amount of power delivered to the cutting tip of the ultrasound handpiece if the power drawn by the handpiece exceeds the threshold power level by adjusting an amplitude or stroke of the output of the ultrasound handpiece;

determining a rate of change of a first operating parameter of the surgical system;

determining a stage of occlusion based on the rate of change of the first operating parameter; and

adjusting an amount of power delivered to the cutting tip of the ultrasound handpiece based on the determined stage of occlusion.

20. The method of claim 19, determining the rate of change of the first operating parameter comprising determining a rate of change of aspiration vacuum.

21. The method of claim 19, determining the rate of change of the first operating parameter comprising determining a rate of change of an irrigation pressure.

22. The method of claim 19, further comprising determining a rate of change of the second operating parameter of the surgical system.

23. The method of claim 20, wherein determining the stage of occlusion is based on the rate of change determinations of the first operating parameter and the second operating parameter.

24. The method of claim 19, the first operating parameter being aspiration vacuum, and the second operating parameter comprising irrigation pressure.

25. The method of claim 19, determining the stage of occlusion comprising identifying an onset or preliminary indication of occlusion.

26. The method of claim 19, further comprising determining a rate of change of a second operating parameter of the surgical system, determining the stage of occlusion comprising determining a stage of occlusion being based on the determinations involving the first and second operating parameters, the first operating parameter comprising an irrigation pressure, the second operating parameter comprising aspiration vacuum, the onset of occlusion being identified by increasing vacuum and irrigation pressures.

27. The method of claim 19, determining the stage of occlusion comprising identifying a pre-occlusion condition.

28. The method of claim 27, the first operating parameter comprising aspiration vacuum, the pre-occlusion condition being identified by an increasing aspiration vacuum.

29. The method of claim 28, the aspiration vacuum increasing at a slower rate following the pre-occlusion condition than during a period of time between an onset of occlusion and the pre-occlusion condition.

30. The method of claim 19, further comprising

determining a rate of change of a second operating parameter of the surgical system,

determining the stage of occlusion being based on the first and second operating parameters, the first operating parameter being an irrigation pressure, the second operating parameter being aspiration vacuum.

31. The method of claim 30, the pre-occlusion condition being identified by an increasing aspiration vacuum and a substantially constant irrigation pressure.

32. The method of claim 30, the aspiration vacuum during the pre-occlusion condition increasing at a slower rate than during a period of time between an onset of occlusion and the pre-occlusion condition.

33. The method of claim 19, determining the stage of occlusion comprising identifying a full occlusion.

34. The method of claim 19, further comprising determining a rate of change of a second operating parameter of the surgical system, determining the stage of occlusion being based on the determinations involving the first and second operating parameters, the first operating parameter comprising an irrigation pressure, the second operating parameter comprising a aspiration vacuum, the break being identified by a decreasing aspiration vacuum and a decreasing irrigation pressure.

35. The method of claim 34, the first operating parameter comprising aspiration vacuum, the recovery being identified by a slowing of a rate of decrease of the aspiration vacuum.

36. The method of claim 34, the first operating parameter comprising an irrigation pressure, the recovery being identified by a slowing of a rate of decrease of the irrigation pressure.

37. The method of claim 36, further comprising

determining a rate of change of a second operating parameter of the surgical system,

determining a stage of occlusion being based on the determinations involving the first and second operating parameters, the first operating parameter comprising an irrigation pressure, the second operating parameter comprising aspiration vacuum, the recovery period having a substantially constant aspiration vacuum and a substantially constant irrigation pressure.

38. The method of claim 19, determining the stage of occlusion comprising determining identifying

an onset of an occlusion,

a pre-occlusion condition following the onset,

a full occlusion following the pre-occlusion condition,

a break of the full occlusion;

or

a recovery following the break.

39. The method of claim 19, adjusting power comprising adjusting a duty cycle of the output of the ultrasound handpiece.

40. The method of claim 19, adjusting power comprising adjusting an amplitude or stroke of the output of the ultrasound handpiece.

41. A method of controlling a surgical system, the surgical system having an ultrasound handpiece, the ultrasound handpiece having a cutting tip for cutting tissue, the method comprising the steps of:

establishing a threshold power level;

monitoring a load on the cutting tip of the ultrasound handpiece by monitoring a voltage and a current drawn by the handpiece during a non-zero sense power interval, the sense power interval being between cutting power intervals;

comparing the amount of power drawn by the handpiece and the threshold power level; and

adjusting an amount of power delivered to the cutting tip of the ultrasound handpiece if the power drawn by the handpiece exceeds the threshold power level by adjusting a duration of the cutting power interval.

42. The method of claim 41, the threshold power level being based on the cutting tip being operated in saline or reference environment.

43. The method of claim 41, monitoring the amount of power drawn by the handpiece being determined by a linear calculation of multiplying the current and the voltage drawn by the ultrasound handpiece.

44. The method of claim 41, monitoring the load being performed at a power level that is lower than a power level of the cutting intervals or pulses.

45. The method of claim 41, adjusting the amount of power delivered to the cutting tip of the ultrasound handpiece comprising adjusting an amount of power up to a maximum amount of power requested by a user.

46. The method of claim 41, further comprising adjusting an amount of power to be delivered to the cutting tip with a sensitivity coefficient.

47. The method of claim 41, monitoring the load comprising monitoring the load on the cutting tip of the ultrasound handpiece by monitoring a voltage and a current drawn by the handpiece during a non-zero sense power interval, the sense power interval having about the same duration as the cutting power intervals.

48. The method of claim 41, monitoring the load comprising monitoring the load on the cutting tip of the ultrasound handpiece by monitoring a voltage and a current drawn by the handpiece during a non-zero sense power interval, the sense power intervals being longer or shorter than the cutting power intervals.

49. The method of claim 41, monitoring the load comprising monitoring the load on the cutting tip of the ultrasound handpiece by monitoring a voltage and a current drawn by the handpiece during a non-zero sense power intervals having a fixed duration.

50. The method of claim 41, monitoring the load comprising monitoring the load on the cutting tip of the ultrasound handpiece by monitoring a voltage and a current drawn by the handpiece during a non-zero sense power interval having a variable duration.

51. The method of claim 41, monitoring the load comprising monitoring the load on the cutting tip of the ultrasound handpiece by monitoring a voltage and a current drawn by the handpiece during a plurality non-zero sense power intervals that are separate pulses between cutting pulses.

52. The method of claim 41, monitoring the load comprising monitoring the load on the cutting tip of the ultrasound handpiece by monitoring a voltage and a current drawn by the handpiece during a non-zero sense power interval immediately prior to a cutting interval.

53. The method of claim 41, monitoring the load comprising monitoring the load on the cutting tip of the ultrasound handpiece by monitoring a voltage and a current drawn by the handpiece during a non-zero sense power interval immediately following a cutting interval.

54. The method of claim 41, monitoring the load comprising monitoring the load on the cutting tip of the ultrasound handpiece by monitoring a voltage and a current drawn by the handpiece during a decay of a non-zero sense power interval.

55. The method of claim 54, further comprising correlating a rate of decay of the non-zero sense power interval to the load drawn by the handpiece.

56. The method of claim 41, further comprising cutting tissue during monitoring the load.