Tissue-Sensing Vitrectomy Surgical Systems and Methods

• US 20150173948A1
• Filed: 12/20/2013
• Published: 06/25/2015
• Est. Priority Date: 12/20/2013
• Status: Active Grant

• Current Assignee: Alcon Incorporated
• Original Assignee: Alcon Research Limited (Nestle SA)
• Inventors: Heeren, Tammo
• Granted Patent: US 9,757,273 B2
• Time in Patent Office: Days
• US Class Current: 1/1
• CPC Class Codes: A61B 2017/00022 Sensing or detecting at the treatment site
• CPC Class Codes: A61B 2017/00026 Conductivity or impedance, e.g. of tissue
• CPC Class Codes: A61B 2017/00057 Light
• CPC Class Codes: A61F 9/00736 Instruments for removal of intra-ocular material or intra-ocular injection, e.g. cataract instruments A61F9/008 takes precedence
• 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 device for removing a tissue from an eye of a patient is disclosed, comprising a housing, a cutter, and an actuator. The cutter comprises an outer cutting tube coupled to the housing, an outer port formed in the outer cutting tube, an inner cutting tube slidable along the longitudinal axis within the outer cutting tube between a retracted position proximal to the outer port and an extended position distal to the outer port, and a tissue sensor positioned on the cutter and configured to measure a characteristic of the tissue received within the outer port to identify when nontarget tissue enters the outer port. The actuator within the housing is configured to reciprocate the inner cutting member between the retracted position and the extended position to open and close the outer port and cut the tissue.

Claims

1. A device for removing a tissue from an eye of a patient during a medical procedure, the device comprising:

a housing;

a cutter extending from a distal end of the housing along a longitudinal axis, the cutter comprising;

an outer cutting tube coupled to the housing, the outer cutting tube including an outer surface and an inner surface;

an outer port formed in the outer cutting tube, the outer port comprising an aperture extending from the outer surface to the inner surface of the outer cutting tube, the outer port sized to receive the tissue;

an inner cutting tube disposed within the outer cutting tube, the inner cutting tube having a distal tube end slidable along the longitudinal axis between a retracted position proximal to the outer port and an extended position distal to the outer port; and

a tissue sensor positioned on the cutter and configured to measure a characteristic of the tissue received within the outer port to identify when nontarget tissue enters the outer port; and

an actuator positioned within the housing and configured to reciprocate the inner cutting member to slide the distal tube end between the retracted position and the extended position to open and close the outer port and cut the tissue.

2. The device of claim 1, wherein the tissue sensor is disposed adjacent to the outer port on the outer cutting tube.

3. The device of claim 2, wherein the tissue sensor is disposed within a recess on the outer cutting tube.

4. The device of claim 2, wherein the tissue sensor is disposed within a recess embedded within the outer cutting tube between the inner and outer surfaces of the outer cutting tube.

5. The device of claim 1, wherein the tissue sensor is disposed within a recess on an outer surface of the inner cutting tube.

6. The device of claim 1, wherein the tissue sensor comprises a fiber-optic sensor configured to measure a degree of transparency of the tissue.

7. The device of claim 1, wherein the tissue sensor comprises a fiber-optic sensor configured to measure the reflectivity of the tissue.

8. The device of claim 1, further comprising an arresting mechanism positioned within the housing and configured to halt the motion of the inner cutting member in the retracted position during the medical procedure.

9. The device of claim 8, wherein the arresting mechanism comprises a damper element configured to grasp a proximal portion of the cutter within the housing to halt the motion of the inner cutting tube in the retracted position.

10. The device of claim 8, wherein the arresting mechanism comprises a first fastening element shaped and configured to interact with a second fastening element disposed on a proximal portion of the cutter within the housing to halt the motion of the inner cutting tube in the retracted position.

11. The device of claim 1, further including an over-ride element comprising a user input structure that is adjustable between an ON position and an OFF position.

12. The device of claim 11, wherein the over-ride element in the ON position is configured to disable the arresting mechanism.

13. The device of claim 11, wherein the over-ride element in the ON position is configured to disable the tissue sensor.

14. A vitrectomy surgical system comprising:

a vitrectomy probe including a cutter comprising an outer cutting tube, an outer port disposed on the outer cutting tube, and an inner cutting tube disposed within the outer cutting tube, the inner cutting tube being movable relative to the outer cutting tube to cut tissue during a vitrectomy procedure;

an actuator configured to move the inner cutting tube relative to the outer cutting tube to open and close the outer port to cut tissue aspirated through the outer port into the outer cutting tube;

at least one tissue sensor coupled to the vitrectomy probe adjacent the outer port, the tissue sensor configured to measure a characteristic of the tissue aspirated through the outer port; and

a processor communicatively coupled to the at least one tissue sensor and operable to control the movement of the inner cutting tube based on the measured characteristic.

15. The system of claim 14, further including an arresting mechanism disposed within the vitrectomy probe and coupled to the cutter, the arresting mechanism configured to halt the motion of the inner cutting tube.

16. The system of claim 15, wherein the processor is operable to activate the arresting mechanism when the processor determines that the measured characteristic of the tissue lies outside an acceptable range of values corresponding to a desired target tissue.

17. The system of claim 14, wherein the processor is operable to prevent actuation of movement of the inner cutting tube when the processor determines that the measured characteristic of the tissue lies outside an acceptable range of values corresponding to the desired target tissue.

18. The system of claim 14, wherein the characteristic comprises a degree of transparency.

19. The system of claim 14, wherein the characteristic comprises the amount of reflectivity.

20. The system of claim 14, wherein at least one the tissue sensor comprises a fiber-optic sensor.

21. The system of claim 14, further including an over-ride element comprising a user input structure that is adjustable between an ON position and an OFF position.

22. The device of claim 21, wherein the over-ride element in the ON position is configured to prevent the processor from controlling the movement of the inner cutting tube based on the measured characteristic.

23. The device of claim 21, wherein the over-ride element in the ON position is configured to disable the tissue sensor.

24. A method of treating an ophthalmic condition, the method comprising:

inserting a probe through a sclera into a vitreous chamber of a patient, the probe including a cutter comprising an inner cutting tube slidably disposed within an outer cutting tube, an outer port in the outer cutting tube, and at least one tissue sensor positioned near the outer port;

measuring a tissue characteristic of tissue aspirated into the cutter with the at least one tissue sensor;

communicating the tissue characteristic to a processor operable to control the motion of the inner cutting tube relative to the outer cutting tube;

evaluating the measured tissue characteristic with a logic algorithm of the processor; and

suspending the motion of the inner cutting tube based upon the measured tissue characteristic.

25. The method of claim 24, wherein evaluating the measured tissue characteristic with the processor comprises determining whether the measured tissue characteristic lies outside an acceptable range of values corresponding to typical target tissues.

26. The method of claim 24, wherein measuring a tissue characteristic of tissue aspirated into the cutter with the at least one tissue sensor comprises measuring a degree of transparency of the tissue aspirated into the cutter.

27. The method of claim 24, wherein measuring a tissue characteristic of tissue aspirated into the cutter with the at least one tissue sensor comprises measuring the reflectivity of the tissue aspirated into the cutter.

28. The method of claim 24, wherein suspending the motion of the inner cutting tube based upon the measured tissue characteristic comprises halting the transmission of driving power to the inner cutting tube.

29. The method of claim 24, further comprising evaluating whether an over-ride element configured to temporarily disable the logic algorithm of the processor is in an ON position.

30. The method of claim 24, wherein suspending the motion of the inner cutting tube based upon the measured tissue characteristic comprises halting the motion of the inner cutting tube relative to the outer cutting tube by engaging the cutter with an arresting mechanism positioned within the probe.

31. The method of claim 30, further comprising evaluating whether an over-ride element configured to temporarily disable the arresting mechanism is in an ON position.