Method of controlling a surgical system based on irrigation flow

• US 8,048,020 B2
• Filed: 06/03/2010
• Issued: 11/01/2011
• Est. Priority Date: 03/22/2004
• Status: Active Grant

• Current Assignee: Alcon Incorporated
• Original Assignee: Alcon Incorporated
• Inventors: Yadlowsky, Ann, Chon, James Y., Boukhny, Mikhail, Salehi, Ahmad
• Primary Examiner(s): Lucchesi; Nicholas D
• Assistant Examiner(s): PATEL, PRITESH ASHOK
• Application Number:
  US12/793,293
• Publication Number:
  US 20100268388A1
• Time in Patent Office: 516 Days
• Field of Search: None
• US Class Current: 604/22
• CPC Class Codes: A61B 2017/00973 pedal-operated
• 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 3/0216 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 a temperature of an eye using 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, the method comprising the steps of:

establishing a threshold temperature;

monitoring an irrigation pressure in a line running to the ultrasound handpiece;

calculating a rate of flow of the irrigation fluid;

determining a heat absorption capacity for the calculated rate of flow of irrigation fluid;

determining a temperature of an eye based on the determined heat absorption capacity and an amount of power being supplied to the ultrasound handpiece;

comparing the determined temperature of the eye to the threshold temperature; and

determining a rate of change of the irrigation pressure;

determining a stage of occlusion based on the rate of change of the irrigation fluid; and

if necessary, adjusting an amount of power delivered to the cutting tip of the ultrasound handpiece based on the determined stage of occlusion and based on the comparison of the determined and threshold temperatures by enabling torsional vibration of the cutting tip.

2. The method of claim 1, wherein adjusting the amount of power further comprises adjusting a duty cycle of the ultrasound handpiece.

3. The method of claim 1, wherein adjusting power further comprises adjusting a stroke or amplitude of the output of the ultrasound handpiece.

4. The method of claim 1, wherein adjusting power further comprises reducing power if the determined temperature exceeds the threshold temperature.

5. The method of claim 1, wherein the power is maintained or increased if the determined temperature is below the threshold temperature.

6. The method of claim 1, further comprising the step of detecting a pattern of data of the irrigation pressure.

7. The method of claim 6, wherein the step of detecting the pattern further comprises determining a linear correlation between a predefined pattern and data of the irrigation pressure during operation of the surgical system.

8. The method of claim 7, wherein the step of determining the linear correlation further comprises performing a linear transformation.

9. The method of claim 7, wherein the step of detecting the pattern further comprises calculating a derivative of data of the first operating parameter over time.

10. The method of claim 6, wherein the step of detecting the pattern comprises performing a convolution of a predefined pattern and data of the first operating parameter during operation of the surgical system.

11. The method of claim 1, wherein the step of determining the stage of occlusion comprises identifying an onset or preliminary indication of occlusion.

12. The method of claim 11, wherein the onset is identified by an increasing aspiration vacuum.

13. The method of claim 12, further comprising determining a rate of change of aspiration vacuum, the onset being identified by increasing irrigation pressure and aspiration vacuum.

14. The method of claim 13, wherein the irrigation pressure is increasing at a faster rate than the aspiration vacuum.

15. The method of claim 1, wherein the step of determining the stage of occlusion comprises identifying a pre-occlusion condition.

16. The method of claim 15, wherein the pre-occlusion condition is identified by an a substantially constant irrigation pressure.

17. The method of claim 12, further comprising the step of determining a rate of change of an aspiration vacuum, the pre-occlusion condition being identified by a substantially constant irrigation pressure and an increasing aspiration vacuum.

18. The method of claim 17, wherein 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.

19. The method of claim 1, further comprising the step of determining the stage of occlusion comprises identifying a full occlusion.

20. The method of claim 19, further comprising the step of determining a rate of change of an aspiration vacuum, the full occlusion being identified by substantially constant irrigation pressure and aspiration vacuum.

21. The method of claim 1, wherein the step of determining the stage of occlusion comprises identifying a break of an occlusion.

22. The method of claim 21, wherein the first operating parameter comprises an irrigation pressure, the break being identified by a decreasing irrigation pressure.

23. The method of claim 22, further comprising the step of determining a rate of change of an aspiration vacuum, the break of an occlusion being identified by decreasing irrigation pressure and aspiration vacuum.

24. The method of claim 1, wherein the step of determining the stage of occlusion comprises identifying a recovery from a break of an occlusion.

25. The method of claim 24, wherein the recovery is identified by a slowing of a rate of decrease of the irrigation pressure.

26. The method of claim 25, further comprising the step of determining a rate of change of an aspiration vacuum, the recovery being identified by a slowing of a rate of decrease of the irrigation pressure and a slowing of a rate of decrease of the aspiration vacuum.

27. The method of claim 1, wherein the step of determining the stage of occlusion comprises 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.

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

establishing a threshold temperature;

monitoring an irrigation pressure in a line running to ultrasound handpiece;

calculating a rate of flow of the irrigation fluid;

determining a heat absorption capacity for the calculated rate of flow of irrigation fluid;

determining a temperature of an eye based on the determined heat absorption capacity and an amount of power being supplied to the ultrasound handpiece;

comparing the determined temperature of the eye to the threshold temperature; and

determining a rate of change of the irrigation pressure;

determining a stage of occlusion based on the rate of change of the irrigation fluid; and

if necessary, adjusting an amount of power delivered to the cutting tip of the ultrasound handpiece based on the determined stage of occlusion and based on the comparison of the determined and threshold temperatures by enabling torsion vibration of the cutting tip, the power delivered to the handpiece being reduced if the determined temperature exceeds the threshold temperature, the power delivered to the handpiece being maintained or increased if the determined temperature is below the threshold temperature.

29. The method of claim 28, wherein the step adjusting the amount of power further comprises adjusting a duty cycle of the output of the ultrasound handpiece.

30. The method of claim 28, wherein the step of adjusting the amount of power further comprises adjusting a stroke or amplitude of the output of the ultrasound handpiece.

31. The method of claim 28, further comprising the step of detecting a pattern of data of the irrigation pressure.

32. The method of claim 31, wherein the step of detecting the pattern comprises determining a linear correlation between a predefined pattern and data of the irrigation pressure during operation of the surgical system.

33. The method of claim 32, wherein the step of determining the linear correlation comprises performing a linear transformation.

34. The method of claim 31, wherein the step of detecting the pattern comprises calculating a derivative of data of the irrigation pressure over time.

35. The method of claim 28, wherein the step of detecting the pattern comprises performing a convolution of a predefined pattern and data of the irrigation pressure during operation of the surgical system.

36. The method of claim 28, further comprising the step of determining a rate of change of an aspiration vacuum.

37. The method of claim 36, wherein the step of determining the stage of occlusion is based on the rate of change of the irrigation pressure and aspiration vacuum.

38. The method of claim 28, wherein the step of determining the stage of occlusion comprises identifying an onset or preliminary indication of occlusion.

39. The method of claim 38, the onset is identified by an increasing aspiration vacuum.

40. The method of claim 28, wherein the step of determining the stage of occlusion comprises identifying a pre-occlusion condition.

41. The method of claim 40, wherein the pre-occlusion condition is identified by a substantially constant irrigation pressure.

42. The method of claim 41, further comprising the step of determining a rate of change of an aspiration vacuum, the pre-occlusion condition being identified by a substantially constant irrigation pressure and an increasing aspiration vacuum.

43. The method of claim 42, wherein the vacuum pressure during the pre-occlusion condition is increasing at a slower rate than during a period of time between an onset of occlusion and the pre-occlusion condition.

44. The method of claim 28, wherein the step of determining the stage of occlusion comprises identifying a full occlusion.

45. The method of claim 44, further comprising the step of determining a rate of change of an aspiration vacuum, the full occlusion being identified by substantially constant irrigation pressure and aspiration vacuum.

46. The method of claim 28, wherein the step of determining the stage of occlusion comprises identifying a break of an occlusion.

47. The method of claim 46, wherein the first operating parameter comprises an irrigation pressure, the break being identified by a decreasing irrigation pressure.

48. The method of claim 47, further comprising the step of determining a rate of change of an aspiration vacuum, the break of an occlusion being identified by decreasing irrigation pressure and aspiration vacuum.

49. The method of claim 28, wherein the step of determining the stage of occlusion comprises identifying a recovery from a break of an occlusion.

50. The method of claim 49, wherein the recovery is identified by a slowing of a rate of decrease of the irrigation pressure.

51. The method of claim 50, further comprising the step of determining a rate of change of an aspiration vacuum, the recovery being identified by a slowing of a rate of decrease of the irrigation pressure and a slowing of a rate of decrease of the aspiration vacuum.

52. The method of claim 28, wherein the step of determining the stage of occlusion comprises 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.