Capsule suction punch instrument and method of use

• US 5,423,330 A
• Filed: 03/10/1993
• Issued: 06/13/1995
• Est. Priority Date: 03/10/1993
• Status: Expired due to Term

• Current Assignee: University of Miami
• Original Assignee: University of Miami
• Inventors: Lee, William G.
• Primary Examiner(s): Graysay, Tamara L.
• Application Number:
  US08/029,398
• Time in Patent Office: 825 Days
• Field of Search: 606/166, 606/184, 606/167, 606/172, 606/116, 606/180, 606/170, 128/753, 128/758
• US Class Current: 600/566
• CPC Class Codes: A61B 10/0233 Pointed or sharp biopsy instruments
• CPC Class Codes: A61B 10/0283 with vacuum aspiration, e.g. caused by retractable plunger or by connected syringe A61B10/025, A61B10/0266 take precedence
• CPC Class Codes: A61B 17/32053 Punch like cutting instruments, e.g. using a cylindrical or oval knife A61B17/326 takes precedence; trepans A61B17/1695; for use on the cornea A61F9/007
• CPC Class Codes: A61B 2017/306 holding by means of suction
• CPC Class Codes: A61F 9/00754 for cutting or perforating the anterior lens capsule, e.g. capsulotomes
• CPC Class Codes: A61F 9/013 Instruments for compensation of ocular refraction A61F9/008 takes precedence; Instruments for use in cornea removal, for reshaping or performing incisions in the cornea

Abstract

A surgical instrument is provided having a tubular body including a distal portion, a proximal portion and a mid portion. A cutting member having a cutting edge is longitudinally received within the tubular body for guided reciprocal movement therein between a cutting position wherein the cutting edge extends from the distal portion and a non-cutting position wherein the cutting edge is retracted within the tubular body. A urging mechanism is also provided within the mid portion of the tubular body for urging the cutting member to the cutting position. A vacuum source is coupled to the cutting member at a proximal end thereof and provides a vacuum directed to the distal portion to hold tissue to be cut. A method of cutting the tissue is also provided.

Claims

1. A surgical instrument comprising:

a tubular body having a distal portion and a proximal portion;

an elongated tubular cutting member having a cutting edge, said cutting member being constructed and arranged with respect to said tubular body so as to be longitudinally received within said tubular body for guided longitudinal reciprocal movement therein between a cutting position wherein said cutting edge projects from said distal portion and a non-cutting position wherein said cutting edge is retracted within the tubular body;

means for selectively urging said cutting member and thus said cutting edge toward said cutting position; and

a vacuum source coupled to at least one of said tubular body and said cutting member for generating a vacuum therein, said vacuum source being constructed and arranged with respect to one of said tubular body and said cutting member so as to hold tissue to be cut.

2. The surgical instrument as claimed in claim 1, wherein said cutting member includes a distal end, a proximal end and a passage therethrough, said distal end including said cutting edge, said proximal end being coupled to said vacuum source.

3. The surgical instrument as claimed in claim 1, wherein said distal portion of said tubular body terminates distally in a blunt end and said cutting edge extends beyond said blunt end when said cutting member is disposed in said cutting position.

4. The surgical instrument as claimed in claim 1, wherein said means for selectively urging comprises:

a diaphragm member having an outer periphery and inner periphery, said outer periphery of said diaphragm member being sealingly coupled to said tubular body, said inner periphery of said diaphragm member being sealingly coupled to said cutting member, said diaphragm member being resilient and being in a rest state when said cutting member is disposed in said non-cutting position; and

an actuating element slidably disposed within said tubular body and .coupled to said cutting member,

movement of said actuating element moves said cutting member so as to move said diaphragm member from said rest state through a cocked or loaded state whereafter the diaphragm member springs said cutting member forward into said cutting position.

5. The surgical instrument as claimed in claim 4, wherein said means for selectively urging further comprises a spring member coupled to said actuating element so as to make the actuating element resilient.

6. The surgical instrument as claimed in claim 4, wherein the cutting member includes a thrust plate disposed on a periphery thereof, said spring member being engaged with said thrust plate and said actuating element.

7. The surgical instrument as claimed in claim 4, wherein said tubular body includes stops to limit movement of said cutting member.

8. The surgical instrument as claimed in claim 4, wherein said actuating element is a finger slide slidably disposed in a channel defined in said tubular body.

9. The surgical instrument as claimed in claim 1, wherein said means for selectively urging comprises:

a spring member;

an actuating element slidably disposed within said tubular body and coupled to said spring member, said actuating element being urged toward the distal portion of the tubular body by said spring member; and

means for holding said actuating element against the urging force of said spring member,

said actuating element being constructed and arranged with respect to said cutting member such that release of said actuating element from said holding means permits said actuating element to move due to urging by said spring, said actuating element thereby moving said cutting member from said non-cutting position to said cutting position.

10. The surgical instrument as claimed in claim 9, further comprising a seal for sealing a gap between an inner periphery of said tubular body and an outer periphery of said cutting member.

11. The surgical instrument as claimed in claim 9, wherein said tubular body includes a stop surface, said spring member being disposed between said stop surface and said actuating member, said cutting member further including a thrust plate extending from a periphery thereof and forward of said actuating element, said spring member forcing said actuating element to contact said thrust plate to move the cutting member to said cutting position.

12. The surgical instrument as claimed in claim 9, wherein said tubular body includes stops to limit movement of said cutting member.

13. The surgical instrument as claimed in claim 9, wherein said actuating element is a finger slide slidably disposed in a channel defined in said tubular body.

14. The surgical instrument as claimed in claim 1, wherein said means for selectively moving comprises:

means defining shoulders in a surface of said cutting member;

an actuating element constructed and arranged with respect to said tubular body so as to be slidably disposed within said tubular body, said actuating element being constructed and arranged with respect to said cutting member and movable from a first position where said cutting member is in said non-cutting position to a second position where said cutting member is in said cutting position;

means for moving said actuating element to one of said first and second positions so that said actuating element contacts one of said shoulders to move said cutting member to one of said cutting and non-cutting position.

15. The surgical instrument as claimed in claim 14, wherein said moving means includes a vacuum and pressure source cooperating with said actuating element.

16. The surgical instrument as claimed in claim 15, wherein said actuating element is disposed between first and second shoulder means, pressure from said pressure source moving said actuating element to contact said first shoulder means to move said cutting member to said cutting position, vacuum from said vacuum source moving said actuating element to contact said second shoulder means to move said cutting member from said cutting position to said non-cutting position.

17. A surgical instrument comprising

a tubular body having a distal portion and a proximal portion;

a cutting member having a cutting edge, said cutting member being longitudinally received within said tubular body and being constructed and arranged with respect to said tubular body for guided reciprocal movement therein between a cutting position wherein said cutting edge projects from said distal portion and a non-cutting position wherein said cutting edge is retracted within the tubular body;

means for selectively urging said cutting member and thus said cutting edge toward said cutting position; and

a vacuum source coupled to at least one of said tubular body and said cutting member for generating a vacuum therein, said vacuum source being constructed and arranged with respect to one of said tubular body and said cutting member so as to hold tissue to be cut,

said means for selectively urging comprising;

means defining a shoulder in a surface of said cutting member;

a spring member;

an actuating element constructed and arranged with respect to said tubular body so as to be slidably disposed within said tubular body and movable from a first position wherein said cutting member is in said non-cutting position to a second position wherein said cutting member is in said cutting position, said spring member being coupled to said actuating element so as to urge said actuating element toward the second position; and

means for holding said actuating element against the urging force of said spring member,

whereby release of said actuating element from said holding means permits said actuating element to move due to urging by said spring forcing said actuating element into contact with said shoulder means, thereby moving said cutting member to said cutting position,

said actuating element including a slide member having a spring arm, said tubular body having surfaces defining a notch portion, said spring arm being in a first, relaxed position when disposed in said notch portion to retain said cutting member in said first, non-cutting position, movement of said spring arm from said first position to a second, biased position permits said spring member to force said slide member to contact said plate element and move said cutting member from said first, non-cutting position to said second, cutting position.

18. The surgical instrument as claimed in claim 17, wherein said tubular body includes stops to limit travel of said cutting member.

19. The surgical instrument as claimed in claim 17, further comprising a remote tripping device cooperating with said actuating element to remotely move said actuating element from said first position to said second position.

20. The surgical instrument as claimed in claim 17, wherein said tubular body includes a groove, said spring arm sliding in said groove when said slide member is pushed by said spring member.

21. The surgical instrument as claimed in claim 20, wherein said shoulder means includes a protrusion which extends into said groove to prevent rotation of said cutting member.

22. The surgical instrument as claimed in claim 17, further comprising a remote tripping device cooperating with said spring arm providing remote movement thereof.

23. A method for creating an incision in tissue comprising the steps of:

providing a surgical instrument including;

a tubular body having a distal portion and a proximal portion;

an elongated tubular cutting member having a cutting edge, said cutting member being constructed and arranged with respect to said tubular body so as to be longitudinally received within said tubular body for guided longitudinal reciprocal movement therein between a cutting position wherein said cutting edge projects from said distal portion and a non-cutting position wherein said cutting edge is retracted within the tubular body;

means for selectively urging said cutting member and thus said cutting edge from the non-cutting position to the cutting position; and

a vacuum source coupled to at least one of said tubular body and said cutting member, said vacuum source being constructed and arranged with respect to one of said tubular body and said cutting member so as to generate a vacuum therein;

directing the distal portion of the instrument to the tissue so that a blunt end of the distal portion is in contact with a portion of the tissue to be cut;

activating said vacuum source so that a vacuum is created at the distal portion of the instrument so as to hold the portion of the tissue to be cut;

actuating said urging member so as to move said cutting member from the non-cutting position to the cutting position, thereby causing said cutting edge to project from said blunt end and cut the tissue; and

removing the distal portion of the instrument and the cut portion of the targeted tissue from remaining tissue.