Surgical apparatus and methods asociated therewith

• US 20100312170A1
• Filed: 06/04/2010
• Published: 12/09/2010
• Est. Priority Date: 06/04/2009
• Status: Active Grant

• Current Assignee: Alex Urich, Armand Maaskamp
• Original Assignee: Alex Urich, Armand Maaskamp
• Inventors: Maaskamp, Armand, Urich, Alex
• Granted Patent: US 8,801,653 B2
• Time in Patent Office: Days
• US Class Current: 604/22
• CPC Class Codes: A61F 9/00745 using mechanical vibrations, e.g. ultrasonic
• CPC Class Codes: A61M 1/74 Suction control underwater drainage A61M1/61

Abstract

A surgical apparatus 10, used in a phaco procedure, includes a filter assembly 44/44a for near, or complete, elimination of air bubbles in an aspiration line of an aspiration system 38. The apparatus 10 includes a suppressor 110, which, during an aspiration mode of operation, maintains a fluid flow rate at 50 cc/min, and, upon an occlusion breaking free, dynamically decreases the fluid flow rate from a high surge rate to the rate at 50 cc/min. The apparatus 10 includes facility for operating in a reflux mode to direct unrestricted fluid flow through the aspiration line of the aspiration system 38.

Claims

1. A dynamic surge suppressor for use in a phacoemulsification surgical procedure for the removal of lens tissue from an eye of a patient, which comprises:

a suppressor housing having an inner passage;

a mesh filter located within a portion of the inner passage of the suppressor housing;

a tube, having an unobstructed inner passage with a prescribed diameter, located in a portion of the inner passage of the suppressor housing not occupied by the mesh filter;

the tube unattached to any portion of the suppressor housing, and movable freely and independently within the inner passage of the suppressor housing; and

a separate inner passage, independent of the unobstructed inner passage of the tube, formed by a space between an outer surface of the tube and an adjacent portion of an inner wall of the separate inner passage of the suppressor housing.

2. The dynamic surge suppressor as set forth in claim 1, which further comprises:

the unobstructed inner passage of the tube having a diameter in a range between, and including, 0.005 inch and 0.015 inch.

3. The dynamic surge suppressor as set forth in claim 1, which further comprises:

a distance of the space between the outer surface of the tube and the adjacent portion of the inner wall of the inner passage of the surge suppressor being in a range between, and including, 0.005 inch and 0.0020 inch.

4. The dynamic surge suppressor as set forth in claim 1, which further comprises:

the tube has an axial length of between, and including, 0.500 inch to 1.500 inch.

5. The dynamic surge suppressor as set forth in claim 1, which further comprises:

a force responder attached to the tube for facilitating movement of the tube in response to a force of fluid flowing in either axial direction within the inner passage of the suppressor housing.

6. The dynamic surge suppressor as set forth in claim 5, which further comprises:

the force responder is a compliant member which blocks the inner passage of the suppressor housing in response to the force of fluid flowing in prescribed direction within the inner passage of the suppressor housing.

7. The dynamic surge suppressor as set forth in claim 6, which further comprises:

the force responder is a limiter for engaging structure of the suppressor housing to limit the axial movement of the tube.

8. The dynamic surge suppressor as set forth in claim 1, which further comprises:

the space surrounds the outer surface of the tube.

9. The dynamic surge suppressor as set forth in claim 1, which further comprises:

the unobstructed inner passage of the tube and the separate inner passage located in a common portion of the inner passage of the suppressor housing such that fluid flowing through the common portion will be separated, with a portion of the separated fluid flowing though the unobstructed inner passage and a remainder portion flowing through the separate inner passage.

10. The dynamic surge suppressor as set forth in claim 9, which further comprises:

a force responder attached to the tube for facilitating movement of the tube in response to an increase or decrease in the level of a force, from a prescribed level of force, of fluid flowing in either axial direction within the inner passage of the suppressor housing.

11. The dynamic surge suppressor as set forth in claim 10, which further comprises:

the force responder is a compliant member which blocks the separate inner passage in response to an increase, from the prescribed level, in the level of the force of fluid flowing in a prescribed direction within the inner passage of the suppressor housing such that all of the fluid in the inner passage of the suppressor housing flows through the unobstructed inner passage.

12. The dynamic surge suppressor as set forth in claim 11, which further comprises:

the unobstructed inner passage being formed with a fixed restrictive diameter which limits the rate of flow of the fluid through the inner passage of the suppressor housing during a period when the separate inner passage is blocked.

13. The dynamic surge suppressor as set forth in claim 12, which further comprises:

the fixed restrictive diameter of the unobstructed inner passage being in a range between, and including, 0.005 inch to 0.020 inch.

14. The dynamic surge suppressor as set forth in claim 10, which further comprises:

the force responder responds to changes in the force of fluid flowing in the inner passage of the suppressor housing to increase or decrease the rate of fluid flowing through the separate inner passage.

15. The dynamic surge suppressor as set forth in claim 1, which further comprises:

the space defines a volume of the separate inner passage through which fluid flows, with the volume being altered upon movement of the tube.

16. An in-line filter assembly for use in a phacoemulsification surgical procedure in the removal of lens tissue from an eye of a patient, which comprises:

a filter housing having an input end with an opening, and formed with an inner passage extending, and having a uniform diameter, between the input end and an output end of the filter housing;

a mesh filter located within the inner passage of the filter housing and having an inlet opening located at an input end of the filter housing;

the mesh filter being uniformly spaced from an inner wall of the inner passage of the filter housing;

an input luer having a body which extends axially between an input end and an output end of the input luer, and which is formed with an input section and an output section;

the input luer having a through passage which extends from the input end to the output end thereof;

the through passage of the input luer including an output passage section at the output end of the body;

the output passage section of the input luer having a uniform diameter;

the output section of the input luer being located within the mesh filter at the open end of the mesh filter, and

a ratio of the uniform diameter of the inner passage of the filter housing to the uniform diameter of the output passage section of the input luer being less than two.

17. The filter assembly as set forth in claim 16, which further comprises:

the uniform diameter of the inner passage of the filter housing being in a range between, and including, 0.200 inch and 0.210 inch; and

the uniform diameter of the output passage section of the input luer being in a range between, and including, 0.105 inch and 0.125 inch.

18. The filter assembly as set forth in claim 16, which further comprises:

the inner passage of the filter housing being formed with an inner wall;

the mesh filter located within the inner passage of the filter housing and formed with an outer surface; and

the outer surface of the mesh filter being spaced by a prescribed distance from the inner wall of the inner passage of the filter housing.

19. The filter assembly as set forth in claim 18, which further comprises:

the prescribed distance being in a range between, and including, 0.005 and 0.015 inch.

20. The filter assembly as set forth in claim 18, which further comprises:

the mesh filter having a volume which is less than 2 cc.

21. The filter assembly as set forth in claim 16, which further comprises:

a pore size of the mesh filter is 170 microns.

22. The filter assembly as set forth in claim 18, which further comprises:

the thickness of the mesh filter being in a range between, and including, 0.005 inch and 0.010 inch.

23. The filter assembly as set forth in claim 16, which further comprises:

the inner passage of the filter housing being formed with a diameter between, and including, 0.200 inch and 0.210 inch.

24. The filter assembly as set forth in claim 16, which further comprises:

the inner passage of the filter housing being formed with an inner wall;

the outer surface of the mesh filter being spaced by a distance in a range between, and including, 0.005 inch and 0.015 inch from the inner wall of the inner passage of the filter housing;

the mesh filter having a volume which is less than 2 cc;

the thickness of the mesh filter being in a range between, and including, 0.005 inch and 0.010 inch; and

the inner passage of the filter housing formed with a diameter in a range between, and including, 0.200 inch and 0.210 inch.

25. The filter assembly as set forth in claim 16, which further comprises:

at least portions of the output section of the input luer being located within, and in friction-fit engagement with, the mesh filter at the inlet end of the mesh filter.

26. The filter assembly as set forth in claim 16, which further comprises:

a pair of diametrically opposed ribs extending radially inward from an inner wall of the inner passage of the filter housing by a distance in a range between, and including, 0.005 inch and 0.015 inch; and

longitudinal outer-surface portions of the mesh filter being in engagement with radially inwardmost surfaces of each of the pair of diametrically to maintain the mesh filter in a cylindrical shape, and at a distance from the inner wall of the inner passage of the filter housing, in a range between, and including, 0.005 inch and 0.015 inch.

27. The filter assembly as set forth in claim 16, which further comprises:

a pair of diametrically opposed ribs formed on an inner wall of the inner passage of the filter housing and extending radially inward therefrom; and

the ribs extending axially from the output end of the filter housing towards, and spaced from, the input end of the filter housing.

28. The filter assembly as set forth in claim 27, which further comprises:

the portion of the outer surface of the filter, which is radially outwardly spaced from the assembly of the output section of the input luer within the inner passage of the filter, being free of any engagement with any portion of the ribs

29. An aspiration system for use in a phacoemulsification surgical procedure for the removal of lens tissue from an eye of a patient, which comprises:

a suppressor housing having an inner passage;

a filter-housing portion of the suppressor housing having an input end with an opening, and formed with an inner passage which is coincidental with a portion of the inner passage of the suppressor housing;

the inner passage of the filter-housing portion extending, and having a uniform diameter, between the input end and an output end of the filter-housing portion;

a mesh filter located within a section of the inner passage of the filter-housing portion;

the mesh filter being uniformly spaced from an inner wall of the inner passage of the filter-housing portion;

a tube, having an unobstructed inner passage with a prescribed diameter, located in a portion of the inner passage of the suppressor housing not occupied by the mesh filter;

the tube unattached to any portion of the suppressor housing, and movable freely and independently within the inner passage of the suppressor housing;

a separate inner passage, independent of the unobstructed inner passage of the tube, formed by a space between an outer surface of the tube and an adjacent portion of an inner wall of the separate inner passage of the suppressor housing.

an input luer having a body which extends axially between an input end and an output end of the input luer, and which is formed with an input section and an output section;

the input luer having a through passage which extends from the input end to the output end thereof;

the through passage of the input luer including an output passage section at the output end of the body;

the output passage section of the input luer having a uniform diameter;

the output section of the input luer being located within the mesh filter at the open end of the mesh filter, and

a ratio of the uniform diameter of the inner passage of the filter-housing portion to the uniform diameter of the output passage section of the input luer being less than two.

30. The aspiration system as set forth in claim 29, which further comprises:

the unobstructed inner passage of the tube having a diameter in a range between, and including, 0.005 inch and 0.015 inch.

31. The aspiration system as set forth in claim 29, which further comprises:

a distance of the space between the outer surface of the tube and the adjacent portion of the inner wall of the inner passage of the surge suppressor being in a range between, and including, 0.005 inch and 0.0020 inch.

32. The aspiration system as set forth in claim 29, which further comprises:

the tube has an axial length of between, and including, 0.500 inch to 1.500 inch.

33. The aspiration system as set forth in claim 29, which further comprises:

a force responder attached to the tube for facilitating movement of the tube in response to a force of fluid flowing in either axial direction within the inner passage of the suppressor housing.

34. The aspiration system as set forth in claim 33, which further comprises:

the force responder is a compliant member which blocks the inner passage of the suppressor housing in response to the force of fluid flowing in prescribed direction within the inner passage of the suppressor housing.

35. The aspiration system as set forth in claim 34, which further comprises:

the force responder is a limiter for engaging structure of the suppressor housing to limit the axial movement of the tube.

36. The aspiration system as set forth in claim 29, which further comprises:

the space surrounds the outer surface of the tube.

37. The aspiration system as set forth in claim 29, which further comprises:

the unobstructed inner passage of the tube and the separate inner passage located in a common portion of the inner passage of the suppressor housing such that fluid flowing through the common portion will be separated, with a portion of the separated fluid flowing though the unobstructed inner passage and a remainder portion flowing through the separate inner passage.

38. The aspiration system as set forth in claim 37, which further comprises:

a force responder attached to the tube for facilitating movement of the tube in response to an increase or decrease in the level of a force, from a prescribed level of force, of fluid flowing in either axial direction within the inner passage of the suppressor housing.

39. The aspiration system as set forth in claim 38, which further comprises:

the force responder is a compliant member which blocks the separate inner passage in response to an increase, from the prescribed level, in the level of the force of fluid flowing in a prescribed direction within the inner passage of the suppressor housing such that all of the fluid in the inner passage of the suppressor housing flows through the unobstructed inner passage.

40. The aspiration system as set forth in claim 39, which further comprises:

the unobstructed inner passage being formed with a fixed restrictive diameter which limits the rate of flow of the fluid through the inner passage of the suppressor housing during a period when the separate inner passage is blocked.

41. The aspiration system as set forth in claim 40, which further comprises:

the fixed restrictive diameter of the unobstructed inner passage being in a range between, and including, 0.005 inch to 0.020 inch.

42. The aspiration system as set forth in claim 38, which further comprises:

the force responder responds to changes in the force of fluid flowing in the inner passage of the suppressor housing to increase or decrease the rate of fluid flowing through the separate inner passage.

43. The aspiration system as set forth in claim 29 which further comprises:

the space defines a volume of the separate inner passage through which fluid flows, with the volume being altered upon movement of the tube.

44. The aspiration as set forth in claim 29, which further comprises:

the uniform diameter of the inner passage of the filter-housing portion being in a range between, and including, 0.200 inch and 0.210 inch; and

the uniform diameter of the output passage section of the input luer being in a range between, and including, 0.105 inch and 0.120 inch.

45. The aspiration system as set forth in claim 29, which further comprises:

the inner passage of the filter-housing portion being formed with an inner wall;

the mesh filter located within the inner passage of the filter-housing portion and formed with an outer surface; and

the outer surface of the mesh filter being spaced by a prescribed distance from the inner wall of the inner passage of the filter-housing portion.

46. The aspiration system as set forth in claim 45, which further comprises:

the prescribed distance being in a range between, and including, 0.005 and 0.015 inch.

47. The aspiration system as set forth in claim 45, which further comprises:

the mesh filter having a volume which is less than 2 cc.

48. The aspiration system as set forth in claim 29, which further comprises:

a pore size of the mesh filter is 170 microns.

49. The aspiration system as set forth in claim 45, which further comprises:

the thickness of the mesh filter being in a range between, and including, 0.005 inch and 0.010 inch.

50. The aspiration system as set forth in claim 29, which further comprises:

the inner passage of the filter-housing portion being formed with a diameter between, and including, 0.200 inch and 0.210 inch.

51. The aspiration system as set forth in claim 29, which further comprises:

the inner passage of the filter-housing portion being formed with an inner wall;

the outer surface of the mesh filter being spaced by a distance in a range between, and including, 0.005 inch and 0.015 inch from the inner wall of the inner passage of the filter housing;

the mesh filter having a volume which is less than 2 cc;

the thickness of the mesh filter being in a range between, and including, 0.005 inch and 0.010 inch; and

the inner passage of the filter-housing portion formed with a diameter in a range between, and including, 0.200 inch and 0.210 inch.

52. The aspiration system as set forth in claim 29, which further comprises:

at least portions of the output section of the input luer being located within, and in friction-fit engagement with, the mesh filter at the inlet end of the mesh filter.

53. The aspiration system as set forth in claim 29, which further comprises:

a pair of diametrically opposed ribs extending radially inward from an inner wall of the inner passage of the filter-housing portion by a distance in a range between, and including, 0.005 inch and 0.015 inch; and

longitudinal outer-surface portions of the mesh filter being in engagement with radially inwardmost surfaces of each of the pair of diametrically to maintain the mesh filter in a cylindrical shape, and at a distance from the inner wall of the inner passage of the filter-housing portion, in a range between, and including, 0.005 inch and 0.015 inch.

54. The aspiration system as set forth in claim 29, which further comprises:

a pair of diametrically opposed ribs formed on an inner wall of the inner passage of the filter-housing portion and extending radially inward therefrom; and

the ribs extending axially from the output end of the filter-housing portion towards, and spaced from, the input end of the filter housing.

55. The aspiration system as set forth in claim 54, which further comprises:

the portion of the outer surface of the filter, which is radially outwardly spaced from the assembly of the output section of the input luer within the inner passage of the filter, being free of any engagement with any portion of the ribs

56. A method of dynamically altering a rate of flow of fluid through an aspiration line of an aspiration system used in a phacoemulsification procedure for the removal of lens tissue from an eye of a patient, which comprises the steps of:

providing an aspiration line with a fluid flowing therethrough in an aspiration direction at a prescribed rate of flow;

providing, in a section of the aspiration line, an unobstructed passage and a separate passage, arranged in a parallel and separate from each other;

separating the fluid into two portions;

moving a first portion of the two portions of fluid through the unobstructed passage;

moving a second portion of the two portions of fluid through the separate passage;

responding dynamically to a changed rate of flow from the prescribed rate of flow in the aspiration line; and

adjusting dynamically a rate of flow of the second portion of the fluid through the separate passage to dynamically return the flow of fluid in the aspiration line to the prescribed rate of flow.

57. The method as set forth in claim 56, which further comprises the steps of:

providing a force responder within the aspiration line responsive to a force of the fluid moving through the aspiration line, where the force is a prescribed force when the fluid is flowing at the prescribed rate of flow; and

moving the force responder in dynamic response to an increase or a decrease in the rate of flow of the fluid in the aspiration line.

58. The method as set forth in claim 57, which further comprises the step of:

positioning dynamically the force responder, in response to an increase or decrease of the rate of flow of the fluid in the aspiration line to provide varying partial obstruction of the fluid flowing through the separate passage to return the flow of fluid in the aspiration line to the prescribed rate of flow.

59. The method as set forth in claim 58, which further comprises the step of:

continuing the flow of fluid through the unobstructed passage during a period of varying partial obstruction of the separate passage.

60. The method as set forth in claim 57, which further comprises the step of:

positioning dynamically the force responder, in response to an increasing surge in the rate of flow of the fluid in the aspiration line, to block the fluid from flowing through the separate passage until the fluid approaches the prescribed rate of flow.

61. The method as set forth in claim 60, which further comprises the step of:

continuing the flow of fluid through the unobstructed passage during a period when the separate passage is blocked.

62. A method of moving fluid through an aspiration line of an aspiration system in either an aspiration direction or a reflux direction during a phacoemulsification procedure for the removal of lens tissue from an eye of a patient, which comprises the steps of:

providing an aspiration line with a fluid flowing therethrough in an aspiration direction at a prescribed rate of flow;

providing, in a section of the aspiration line, a facility for adjusting the rate of flow of the fluid in the aspiration direction when a change occurs in the rate of flow from the prescribed rate of flow; and

providing facility for reversing the direction of flow of the fluid in a reflux direction through the aspiration line.

63. A method of filtering particles from a fluid flowing through an aspiration line of an aspiration system used in a phacoemulsification procedure for the removal of lens tissue from an eye of a patient, which comprises the steps of:

providing a filter housing within an aspiration line of an aspiration system;

mounting a filter within the filter housing such that a space is formed between an outer side surface of the filter and an inner side wall of the filter housing;

moving particle-laden fluid into an inner passage of the filter and into the filter where the particles are captured in, and particle-free fluid moves through, the filter; and

moving the particle-free fluid into the space between the filter and the filter housing, and out of the filter housing.

64. The method as set forth in claim 63, which, prior to moving the particle-laden fluid into the inner passage of the filter, further comprises the steps of:

moving the particle-laden fluid through an input luer having an output passage section with a first prescribed diameter;

moving the particle-laden fluid from the output section passage of the input luer into a passage of the filter housing with a second prescribed diameter greater than the first prescribed diameter; and

forming the output passage section and the passage of the filter housing such that the ratio of the prescribed diameter of the passage of the filter housing to the prescribed diameter of the output passage section of the input luer is less than two.