SURGICAL HAND PIECE WITH DUAL LUMEN WORK TIP FOR USE WITH INFUSION CANNULA

• US 20140114335A1
• Filed: 12/27/2013
• Published: 04/24/2014
• Est. Priority Date: 06/26/2008
• Status: Active Grant

• Current Assignee: Surgical Design Incorporated
• Original Assignee: Surgical Design Incorporated
• Inventors: Banko, William
• Granted Patent: US 10,166,317 B2
• Time in Patent Office: Days
• US Class Current: 606/169
• CPC Class Codes: A61B 17/3421 Cannulas
• CPC Class Codes: A61B 2017/320084 Irrigation sleeves
• CPC Class Codes: A61B 2217/005 with suction drainage system
• CPC Class Codes: A61B 2217/007 with irrigation system
• CPC Class Codes: A61F 9/00745 using mechanical vibrations, e.g. ultrasonic
• CPC Class Codes: A61M 1/774 Handpieces specially adapted for providing suction as well as irrigation, either simultaneously or independently

Abstract

A surgical hand piece has a source of ultrasonic energy provided to a connecting body having a first passage with one end to receive fluid from a first source and the other end at the connecting body distal end. A work tip has first and second tubes each having at least one opening at its distal end and the proximal end of one or both of the tubes connected to the connecting body distal end to receive the ultrasonic energy and to selectively receive or discharge fluid from either the first or second source as controlled by a valve. A cannula is provided which is adapted to be placed in an opening in the cornea through which the work tip extends during the removal of cataracts from the eye by phacoemulsification. The cannula may be equipped with channels that permit additional infusion of fluid into the eye during the procedure, which infusion also cools the surrounding corneal tissue to protect against heat generated by the ultrasonic vibration of the work tip.

Claims

1. A surgical hand piece comprising:

a source of ultrasonic energy;

a connecting body having a proximal end connected to said ultrasonic energy source and a distal end; and

a work tip having a proximal hub from which extend at least first and second tubes aligned side by side and adjacent to each other, said hub having first and second external openings, each of said tubes having a proximal end connected to separate passages in said hub leading to the external openings, said work tip being detachably connected to said connecting body distal end and being of a material suitable for conveying the ultrasonic energy from said ultrasonic energy source to the distal end of said at least one tube,

wherein each of said first and second tubes has a lumen that is to receive or discharge a fluid at its proximal end from one of first and second fluid sources that are respectively irrigation and aspiration fluids, the lumen of each of said first and second tubes being separate and spaced apart, and each said tube having an opening at its distal end through which the fluid received at or discharged from the proximal end of the respective lumen of each said tube exits from or enters the tube, with each said tube distal end opening being separate, independent of, spaced from and without being in communication with the distal end opening of the other tube.

2. The surgical hand piece according to claim 1 wherein the first and second external openings are on opposite sides of the hub and are at an angle to the respective tubes.

3. The surgical hand piece according to claim 1 further including a valve to receive the fluids from the first source and discharge fluid to the second source and for switching the received and discharged fluids respectively to be supplied to or received from the respective lumen of either one of said first and second tubes, wherein the respective lumen of each of said first and second tubes can receive or discharge the fluid from either one of said first and second sources as switched by said valve.

4. The surgical hand piece according to claim 1 further including a housing that covers the source of ultrasonic energy and the connecting body, but not the work tip;

and

wherein the work tip is detachable from the connecting body while leaving the connecting body attached to said source of ultrasonic energy, and the work tip is designed to be disposed after a single use.

5. The surgical hand piece according to claim 4 wherein a core of the proximal hub as well as the first and second tubes are made of titanium, and the portion of the hub surrounding the core, the separate passages in the hub and the external connectors are made of a hard plastics material.

6. The surgical hand piece according to claim 4 wherein the external openings are connectors.

7. The surgical hand piece according to claim 4 further including disposable tubes inserted into the passages in said hub that mate with respective ones of the first and second tubes.

8. The surgical hand piece according to claim 7 wherein the disposable tubes are made of plastic, the proximal ends of the tubes have sealing openings and the plastic protrudes through the sealing openings.

9. The surgical hand piece according to claim 7 wherein the disposable tubes have connectors at their ends.

10. The surgical hand piece according to claim 1 wherein one of the at least first and second tubes has a distal opening that is larger than the distal opening of the other.

11. The surgical hand pieces according to claim 10 wherein the tube with the larger distal opening has a single opening with a concave shape and the tube with the other distal opening as a plurality of small oval shaped openings.

12. A method of removing tissue or other objects from a patient by phacoemulsification with an ultrasonic surgical hand piece having at least a dual lumen vibrating work tip, comprising the steps of:

forming an incision in the patient;

inserting a cylindrical cannula in the incision, said cannula having a central opening;

introducing the work tip into opening in the cannula and bringing it into contact with the tissue or object, said work tip having at least first and second tubes aligned side by side and adjacent to each other, the lumen of each of said first and second tubes being separate and spaced apart, and each said tube having an opening at its distal end through which the fluid received at or discharged from the proximal end of the respective lumen of each said tube exits from or enters the tube, with each said tube distal end opening being separate, independent of, spaced from and without being in communication with the distal end opening of the other tube;

turning on the hand piece so that the work tip vibrates at an ultrasonic frequency and breaks up the tissue or object into small pieces;

circulating fluid in the cannula to cool it and protect the tissue surrounding the incision from heat generated by the vibrating work tip;

extracting the small pieces of tissue or object selectively through one of the at least dual lumens of the work tip.

13. The method according to claim 12 further including the step of injecting an infusion fluid into the patient through the other of the dual lumens of the work tip.

14. The method according to claim 12 further including the step of injecting an infusion fluid into the patient through channels in the cannula.

15. The method according to claim 12 wherein the step of inserting the cylindrical cannula in the incision involves the steps of:

providing a cylindrical cannula having a diameter about the size of the incision, said cannula having a large flange on its proximal end and a small flange or projections on its distal end;

pushing the distal end of the cannula into the incision so that the small flange or projections pass into the patient and the large flange comes to rest on the outer surface of the patient, whereby the patient'"'"'s about the incision is caught between the large flange and the small flange or projections and the cannula is stabilized.

16. The method according to claim 14 wherein the step of injecting an infusion fluid into the patient through channels in the cannula comprises the steps of:

providing a cannula with an internal cylindrical channel, a connector leading to the cylindrical channel and an exit; and

connecting an infusion line to the connector so that infusion fluid passes into the cylindrical channel and leaves from the exit.

17. The method according to claim 16 in which the cannula exit is a circular exit at the end of the cylindrical channel.

18. The method according to claim 16 in which the cannula exit is a plurality of holes in a side wall of the cannula.

19. The method according to claim 12 in which the cannula is made of TEFLON®

.

20. The method according to claim 12 wherein the tissue is a cataract in the eye of the patient.

21. A cannula for use with an ultrasonic surgical hand piece with a working tip that is vibrated at ultrasonic frequencies, comprising:

a cylindrical piece having a diameter about the size an incision;

a large flange located on the proximal end of the cylindrical piece, said flange being significantly larger than the incision;

a projection located on the distal end of the cylindrical piece, said projection being only slightly larger than the incision so that the cannula can be passed through the incision by expanding it without tearing the incision site;

an internal cylindrical channel within the cylindrical piece,

a connector at the proximal end of the cylindrical piece leading to the cylindrical channel; and

an exit from the cylindrical channel located beyond the projection toward the distal end of the cylindrical channel.

22. The cannula of claim 21 wherein the projection is a series of circumferential projections.

23. The cannula according to claim 21 wherein the projection is a small circumferential flange.

24. The cannula according to claim 21 in which the cannula exit is a circular exit at the end of the cylindrical channel.

25. The cannula according to claim 21 in which the cannula exit is a plurality of holes in a side wall of the cylindrical piece.

26. The cannula according to claim 21 in which the cannula is made of TEFLON®

.