Surgical cutting instrument having a offset probe for ophthalmic surgery

• US 4,753,234 A
• Filed: 11/03/1986
• Issued: 06/28/1988
• Est. Priority Date: 11/03/1986
• Status: Expired due to Fees

• Current Assignee: Miguel Martinez
• Original Assignee: Miguel Martinez
• Inventors: Martinez, Miguel
• Primary Examiner(s): Rosenbaum, C. Fred
• Assistant Examiner(s): KRUTER, JEROME
• Application Number:
  US06/925,978
• Time in Patent Office: 603 Days
• Field of Search: 433/121-123, 604/22, 128/305, 128/752-755, 30/241, 30/182
• US Class Current: 606/171
• CPC Class Codes: A61B 2017/00544 pneumatically
• CPC Class Codes: A61F 9/00763 with rotating or reciprocating cutting elements, e.g. concentric cutting needles atherectomy cutting instruments A61B17/3207; endoscopic cutting instruments A61B17/320016

Abstract

A surgical cutting instrument, particularly useful for ophthalmic surgery, includes a cylindrical body, a piston disposed for reciprocating movement in a chamber in the body and a probe having an elongate tubular outer probe member with a closed distal end and a port adjacent thereto and an elongate inner probe member slidably disposed in the outer probe member with a distal end movable across the port to provide a cutting action and a portion mounted to the piston such that the probe is positioned parallel to the longitudinal axis of the cylindrical body and axially offset therefrom such that the inner and outer probe members are in positive alignment and not subject to relative rotation and inadvertent misalignment. An evacuation tube receives cut material from the probe passing through the surgical cutting instrument and a supply tube supplies pressure to the chamber to reciprocate the piston.

Claims

1. A surgical instrument useful in ophthalmic surgery comprising:

a cylindrical, hollow body having a longitudinal axis, a front end, a rear end and a chamber disposed between said front and rear ends;

a piston means disposed in said chamber to be movable in a reciprocating manner toward and away from said front end and having a longitudinal axis;

probe means extending form said front end of said body at a position parallel to and offset from said longitudinal axis of said body including an elongate, tubular outer probe member having a closed distal end and a port adjacent said distal end, and an elongate inner probe member slidably disposed in said outer probe member and having a distal end movable across said port to provide a cutting action, a portion mounted to said piston means to prevent rotation of said piston means and said inner probe member a position offset from said longitudinal axis of said piston and passage means extending along said inner probe member from said distal end to said portion mounted to said piston means;

evacuating means communicating with said probe means to permit passage of cut material through said surgical cutting instrument; and

supply means communicating with said chamber to supply pressure to move said piston means to reciprocate said inner probe member in said outer probe member to produce said cutting action.

2. A surgical cutting instrument as recited in claim 1 wherein said inner probe member is tubular along a substantial portion of its length to define said passage means and is cutaway at said distal end to have a reduced cross section defining a cutting blade aligned with said port in said distal end of said outer probe member to provide a shearing cutting action.

3. A surgical instrument as recited in claim 2 wherein said piston means has a longitudinal bore therethrough off said longitudinal axis of said piston means and said longitudinal axis of said body, and said inner probe member has a proximal end received in said piston means bore.

4. A surgical instrument as recited in claim 3 wherein said piston means has a rear end, said piston means bore includes a counterbore at said rear end of said piston means, and said evacuating means includes a rigid tube received in said piston means counterbore.

5. A surgical instrument as recited in claim 3 wherein said body includes a cylindrical barrel having an open front end and an open rear end, a front plug received in said open front end of said barrel having a longitudinal bore therethrough offset from the said longitudinal axis of said body and receiving said probe means with said outer probe member secured in said front plug bore, and a rear plug received in said open rear end of said barrel having a first longitudinal bore therethrough aligned with said piston means bore and a second longitudinal bore therethrough, said evacuating means includes a rigid evacuating tube received in said first bore, and said supply means includes a rigid supply tube received in said second bore in said rear plug.

6. A surgical instrument as recited in claim 4 wherein said body includes a cylindrical barrel having an open front end and on open rear end, a front plug received in said open front end of said barrel having a longitudinal bore therethrough offset from said longitudinal axis of said body and receiving said probe means with said outer probe member secured in said front plug bore, and a rear plug received in said open rear end of said barrel having a first longitudinal bore therethrough aligned with said piston means bore and receiving said rigid evacuating tube and a second longitudinal bore therethrough and said supply means includes a rigid supply tube received in said second bore in said rear plug.

7. A surgical cutting instrument as recited in claim 6 wherein said rear plug has a threaded longitudinal bore therethrough threadedly receiving an adjustment screw having an end movable into said chamber to abut said piston means and limit movement of said inner probe member.

8. A surgical cutting instrument as recited in claim 7 wherein said front plug has a cylindrical protrusion extending into said chamber, and said piston means has a cylindrical protrusion facing and aligned with said front plug cylindrical protrusion, and further comprising a helical spring mounted in compression between said front plug and said piston means and around said cylindrical protrusions to bias said piston means away from said front plug.

9. A surgical cutting instrument as recited in claim 8 wherein said front plug has a front end and said front plug bore has a counterbore at said front end, and further comprising an irrigating sleeve extending coaxially around said probe means and having a proximal end received in said front plug counterbore, a distal end having an irrigating port therein disposed adjacent said distal end of said outer probe member and a coupling for supplying irrigating fluid to said irrigating sleeve for exit at said irrigating port.

10. A surgical instrument as recited in claim 1 wherein said piston means has a rear end, and a bore in said rear end of said piston means, and said evacuating means includes a rigid tube received in said piston means counterbore.

11. A surgical cutting instrument as recited in claim 1 wherein said body includes a rear plug having a threaded longitudinal bore therethrough threadedly receiving an adjustment screw having an end movable into said chamber to abut said piston means and limit movement of said inner probe member.

12. A surgical cutting instrument as recited in claim 1 wherein said body includes a front plug having a longitudinal bore therethrough offset from said longitudinal axis of said body and receiving said probe means, said front plug and said longitudinal bore including a counterbore at said front end, and further comprising an irrigating sleeve extending coaxially around said probe means and having a proximal end received in said front plug counterbore, a distal end having an irrigating port therein disposed adjacent said distal end of said outer probe member and a coupling for supply irrigating fluid to said irrigating sleeve for exit at said irrigating port.

13. A surgical instrument as recited in claim 1 wherein said piston means has a longitudinal bore therethrough offset from said longitudinal axis of said piston means and said longitudinal axis of said body, and said inner probe member has a proximal end received in said piston means bore.

14. A surgical cutting instrument useful in ophthalmic surgery comprising:

a body having a front end, a rear end and a chamber disposed between said front and rear ends;

a piston means disposed in said chamber to be movable in a reciprocating manner toward and away from said front end, said piston means having a longitudinal axis;

probe means extending from said front end of said body at a position parallel to and offset from said longitudinal axis of said piston means including an elongate, tubular outer probe member having a closed distal end and a port adjacent said distal end, and an elongate inner probe member slidably disposed in said outer probe member and having a distal end movable across said port to provide a cutting action, a portion mounted to said piston means at a position offset from said longitudinal axis of said piston means to prevent rotation of said piston means and said inner probe member and passage means extending along said inner probe member from said distal end to said portion mounted to said piston;

evacuating means communicating with said probe means to permit passage of cut material through said surgical cutting instrument; and

supply means communicating with said chamber to supply pressure to move said piston means to reciprocate said inner probe member in said outer probe member to produce said cutting action.

15. A surgical instrument as recited in claim 14 wherein said piston means has a longitudinal bore therethrough offset from said longitudinal axis of said piston means and said inner probe member has a proximal end received in said piston means bore.