JPH0259741B2 - - Google Patents

Description

Claim 1: A fluid control device for use in a surgical irrigation and aspiration instrument configured to irrigate and aspiration a surgical site, comprising: an irrigation fluid source; and introducing irrigation fluid from the irrigation fluid source into the surgical site. an irrigation fluid conduit; an aspiration fluid conduit for removing fluid from the surgical site; a controllable pump device in fluid communication with the aspiration fluid conduit to provide suction to the aspiration fluid conduit; a pressure sensing transducer device in fluid communication with the suction fluid conduit to sense pressure within and generate a control signal to the pump device; and fluid communication between the irrigation fluid source and the suction fluid conduit. a pressure equalization fluid conduit connecting the irrigation fluid source to the suction fluid conduit to provide; a control valve arrangement for controlling fluid flow in the pressure equalization fluid conduit; and a control arrangement for controlling the control valve arrangement. A fluid control device comprising:

2. The device of claim 1, wherein the control valve device is an electrically controllable valve.

3. The apparatus of claim 2, wherein said control device for said electrically controllable valve is an electrical switch.

4. The apparatus of claim 3, wherein said electrical switch is a foot switch.

5. The device of claim 1, wherein the pump device is a peristaltic pump.

6. The apparatus of claim 1, further comprising a check valve arrangement for preventing backflow in said irrigation fluid conduit.

7. The apparatus of claim 1 further comprising a shutoff valve arrangement in said irrigation fluid conduit.

8. The apparatus of claim 6, wherein said check valve arrangement is located in said irrigation fluid conduit to prevent backflow in said irrigation fluid conduit toward said irrigation fluid source and into said suction fluid conduit. .

9. The apparatus of claim 8, further comprising a control valve located in said irrigation fluid conduit between said irrigation fluid source and said check valve arrangement.

10 Claim 9, wherein the control valve is a shutoff valve
Sectional equipment.

11. The apparatus of claim 9, wherein said control valve is actuated by a solenoid.

12. The apparatus of claim 1, wherein the pressure equalization fluid conduit is directly connected to the irrigation fluid conduit for providing irrigation fluid to the suction fluid conduit when needed.

13. A fluid control device for use in a surgical irrigation and suction instrument configured to irrigate and suction a surgical site, the fluid control device comprising:
an aspiration fluid conduit for directing fluid from the surgical site; a suction pump for providing suction power to the aspiration fluid conduit; and a pressure equalization fluid conduit for venting irrigation fluid to the aspiration fluid conduit; and a transducer operatively connected to the suction pump, further having a fluid coupling connection connectable to the suction pump at a first end and connected to the suction fluid conduit at a second end. a first tubular fluid conduit having a possible fluid coupling connection; and an opposite end having an end in fluid communication with the first tubular fluid conduit and connectable with the pressure equalizing fluid conduit. , a second tubular fluid conduit disposed substantially perpendicular to the first tubular fluid conduit, and having an end in fluid communication with the second tubular fluid conduit; a third tubular fluid conduit having an opposite connectable end and disposed substantially perpendicular to the second tubular fluid conduit and substantially parallel to the first tubular fluid conduit; A fluid control device comprising:

BACKGROUND OF THE INVENTION Field of the Invention: The present invention relates to fluid control systems for irrigation and aspiration in surgical procedures, and more particularly to means for irrigation of a surgical site and means for aspiration of fluids from a surgical site. The present invention relates to a fluid control system for use with an ultrasonic surgical tool.

Description of the Prior Art: Intraocular surgery, in particular cataract removal, involves cutting or fracturing means in combination with means of irrigating the intraocular surgical site and aspirating the irrigation fluid along with the surgically excised tissue fragments. It has been significantly aided by the development of tools and instruments. One device of this type is disclosed in Banko et al., US Pat. No. 3,589,363. The surgical instrument disclosed in this patent consists of a handpiece that holds an elongated ultrasonic surgical tool and has means for exciting longitudinal ultrasonic vibrations in the tool. When a vibrating tool is applied to tissue, such as the crystalline lens of an eye with developed cataracts, it can break up the tissue into small pieces. The tool is provided with means for supplying irrigation fluid to the surgical site and suction means for removing the irrigation fluid and tissue debris from the surgical site. The suction means has a hole passing through the ultrasonic tool in the axial direction,
This hole is connected to a source of suction, by means of which the excised tissue pieces are suctioned from the surgical site along with irrigation fluid. The ultrasonic surgical tool disclosed in the above-mentioned US patent fragments the incised tissue into extremely small particles and removes these tissue fragments along with the irrigation fluid used for irrigation, thereby reducing the size of the incision in the eyeball. The incision need only be large enough to insert the tool and is substantially smaller than the size of the incision required to remove a single lens. However, since ocular surgery is only large enough to insert ultrasonic surgical tools and irrigation means, the surgical site is virtually completely enclosed and the flow of irrigation and aspiration fluids cannot be controlled. extremely important. In particular, the suction applied to the suction means must be limited to a safe value so that there is no risk of crushing the eyeball. The fluid control system disclosed by Vanko et al. is operated by the surgeon and includes an electrically actuated suction pump for connecting and disconnecting the pump's suction port to a suction tube that carries fluid away from the surgical site. and valve means. The valve is controlled by a foot switch operated by the surgeon.

An improved fluid control system is disclosed in US Pat. No. 3,693,313 to Kelman. This device seeks to solve the problem of maintaining adequate pressure on an enclosed surgical site even if a suction conduit becomes occluded. The occlusion is e.g.
This occurs when debris larger than the size of the axial bore of the surgical tool is drawn into the entrance of the axial bore of the tool. If such a blockage occurs in the suction line, negative pressure or suction within the suction conduit between the surgical site and the vacuum pump increases. If the occlusion is suddenly removed by the mechanical action of an ultrasonic tool or by increased suction, fluid within the surgical site tends to rush into the suction conduit, which can lead to catastrophic consequences. may have consequences. This is a particularly important problem in eye surgery because the total volume of fluid at the surgical site is smaller than the volume of fluid in the irrigation and suction lines. Accordingly, the fluid control system of Kelman US Pat. No. 3,693,613 is configured to automatically and quickly equalize the pressure within the suction conduit when the blockage is removed. To this end, a flow sensing transducer is provided within the suction conduit to sense the flow rate of the fluid and generate an electrical signal that is sent to the controller. Whenever there is a sudden increase in flow, indicating that the obstruction has just been removed, the controller immediately opens the vent valve in the suction conduit, thereby relieving suction pressure and removing fluid from the surgical site. prevents it from being drawn out excessively.

The flow control system of Kelman US Pat. No. 3,693,613 is effective but somewhat complex in construction.
Accordingly, another surgical flow control system of this type is disclosed in U.S. Pat. No. 3,902,495 to Weiss et al.
Developed by No. The flow control system includes a pressure relief valve in the irrigation conduit that supplies irrigation fluid to the surgical site from a fluid source to prevent the irrigation fluid from becoming too high in pressure. Similarly, the suction conduit is provided with a relief vent valve to vent to the atmosphere at a preset pressure differential, thereby preventing the suction pressure within the suction conduit from exceeding a preset value. In this manner, the suction pressure in the suction line is never exceeded and the surgical site is not subjected to excessive suction pressure when the occlusion is removed.

Another variation of the method of US Pat. No. 3,693,613 is disclosed in US Pat. No. 4,496,342 to Vanco. In the Vanco device, irrigation fluid is supplied to an enclosed surgical site, such as the interior of the eye, and withdrawn from the surgical site via a suction conduit. A flow sensing transducer in the suction conduit senses the sudden increase in flow rate that occurs upon removal of the blockage in the suction tube and actuates a valve to release fluid into the suction line from the second fluid source. . At the same time,
Stop operation of the suction pump until the flow rate returns to approximately normal. This method results in very little fluid flow out of the eye when the occlusion in the suction line is released.

Although the conventional flow control systems described above are effective, they do not attempt to solve the problem of releasing the blockage itself. At best, it limits suction pressure to a maximum value or alternatively senses a rapid flow of fluid after the occlusion is released. These do not provide the ability to sense occlusions and control by the surgeon to quickly and reliably equalize the pressure within the irrigation and suction lines to rapidly remove occlusions.

Therefore, there remains a need for a fluid control system for a surgical irrigation and suction instrument that controls and quickly releases excessive vacuum that develops within a suction tube after occlusion.

SUMMARY OF THE INVENTION It is therefore an object of the present invention to provide a surrounding surgical site irrigation and suction device.

Another object of the present invention is to provide a device for controlled release of occlusions within a surgical suction conduit.

Another object is to provide a device for quickly releasing suction pressure in the suction line of a surgical suction device.

Another object is to provide a device that quickly equalizes pressure in a surgical irrigation and suction system to remove an obstruction.

Another object of the present invention is to provide a method for controlling and eliminating blockages in surgical irrigation and aspiration systems by equalizing the pressure within the irrigation and aspiration conduits.

Another object is to provide a fluid connection for conveniently connecting irrigation suction and pressure sensing fluid conduits to a surgical irrigation and suction system.

Other objects of the invention will become apparent from the following description of the invention.

According to the present invention, a source of irrigation fluid, an irrigation fluid conduit for introducing said irrigation fluid into a surgical site, an aspiration fluid conduit for directing fluid from the surgical site, an aspiration fluid conduit and a fluid conduit for aspirating fluid from the surgical site. a suction means in communication, pressure sensing control means for isolating the suction source from the suction fluid conduit when a predetermined suction pressure value is exceeded, and means for controllingly introducing irrigation fluid into the suction fluid conduit. A device has now been developed that can control the pressure in the suction line to quickly relieve the pressure in the suction line in the event of a line blockage.

That is, in accordance with the present invention, a fluid control device for use in a surgical irrigation and aspiration instrument configured to irrigate and aspirate a surgical site includes: a source of irrigation fluid; and a source of irrigation fluid for irrigating the surgical site from the source of irrigation fluid. an irrigation fluid conduit for introducing fluid; an aspiration fluid conduit for removing fluid from the surgical site; and a controllable pump device in fluid communication with the aspiration fluid conduit to provide suction to the aspiration fluid conduit. a pressure sensing transducer device in fluid communication with the suction fluid conduit to sense pressure within the suction fluid conduit and generate a control signal to the pump device; and between the irrigation fluid source and the suction fluid conduit. a pressure equalization fluid conduit connecting the irrigation fluid source to the suction fluid conduit to provide fluid communication to the suction fluid conduit; a control valve arrangement for controlling fluid flow in the pressure equalization fluid conduit; and a control valve arrangement for controlling the control valve arrangement. A fluid control device is provided, comprising a control device.

By employing this configuration, the fluid control device itself has the ability to sense suction line occlusion (clogging), and the surgeon can quickly and reliably equalize the pressure in the irrigation and suction lines under control. The system allows for rapid removal of occlusions without causing fluid within the surgical site to rush into the suction fluid conduit when the occlusion is removed, as with conventional devices, and is relatively simple to construct. It is.

Further in accordance with the present invention, a special modified T-shaped fitting is provided for conveniently connecting fluid conduits used in fluid flow control systems. That is, according to another aspect of the present invention, a fluid control device for use in a surgical irrigation and aspiration instrument configured to irrigate and suction a surgical site, the fluid control device directing fluid from the surgical site. a suction fluid conduit for providing suction fluid to the suction fluid conduit, a suction pump for providing suction power to the suction fluid conduit, a pressure equalization fluid conduit for relief of irrigation fluid to the suction fluid conduit, and a suction fluid conduit in fluid communication with the suction fluid conduit and actuated by the suction pump. a fluid coupling connection connectable to the suction pump at a first end and a fluid coupling connection connectable to the suction fluid conduit at a second end; a first tubular fluid conduit having one end in fluid communication with the first tubular fluid conduit and an other end connectable with the pressure equalizing fluid conduit; a second tubular fluid conduit disposed substantially perpendicular to the conduit; and an opposite end having an end in fluid communication with the second tubular fluid conduit and connectable with the pressure equalizing fluid conduit. and a third tubular fluid conduit disposed substantially perpendicular to the second tubular fluid conduit and substantially parallel to the first tubular fluid conduit. Equipment is provided. Note that the "fluid conduit" is hereinafter simply referred to as a conduit.

[Brief explanation of drawings]

A better understanding of the nature and advantages of the invention may be understood from a consideration of the detailed description of the invention taken in conjunction with the accompanying drawings. In the drawings, FIG. 1 schematically shows a fluid control system for a surgical irrigator and aspirator.

FIG. 2 shows an electrical control system for operating the fluid control system of the present invention.

FIG. 3 shows a fluid connector specifically configured to connect the suction conduit, pressure equalization conduit, and pressure sensing conduit in the surgical irrigation aspiration system of the present invention.

DETAILED DESCRIPTION OF THE INVENTION AND PREFERRED EMBODIMENTS The present invention will now be described with reference to a preferred embodiment of the invention shown in FIG.

Although the fluid control system is illustrated in connection with an ultrasonic surgical handpiece 50 of the type described in U.S. Pat. No. 3,589,363, the fluid control system is applicable to any surgical irrigation aspiration system; It will be appreciated that it is extremely useful in any situation where a blockage may occur in the suction system.
The surgical handpiece 50 includes an ultrasonic tool 52.
is mounted and the tool has an axial suction passage connected to a suction tube 54. Irrigation fluid is supplied through tube 56 and directed to the surgical site through a passageway restricted by jacket 58 coaxially with ultrasonic tool 52 .

Irrigation fluid source 102 supplies fluid via irrigation conduit 104 to irrigation fluid supply tube 56 of handpiece 50.
supply to. Irrigation fluid source 102 is configured to provide the required irrigation pressure by suspending a bottle or bag containing an irrigation fluid, such as any suitable ophthalmic irrigation fluid conventionally used in eye surgery, at a height above the surgical site. It can be configured to supply the information. This pressure is typically 10 mmH for anterior chamber surgery.
g to 100 mmHg, preferably 30 mmHg to
60mmHg. A shutoff valve 106 is provided in the irrigation conduit to control the start and stop of irrigation. Preferably, the isolation valve 106 is a remotely controllable valve, such as an electrically controlled valve operated by a solenoid 108.

Fluid drawn from the surgical site through suction tube 54 is drawn by vacuum pump 112 through suction conduit 110 of the fluid control system and discharged through waste conduit 114 to a waste container, not shown. The vacuum pump 112 is connected to the pump tube 11
3 and a rotor 115. Such pumps are preferred in the present invention because they are free from fouling, have good control performance, have a relatively high suction capacity, and do not require special measures to prevent backflow. This is because the pump can be easily stopped. However, any suitable vacuum source may be used, provided that the device for disconnecting the vacuum source from the suction line must be adapted to the requirements of each type of pump, as explained in more detail below. . For example, peristaltic pumps can be stopped by simply de-energizing their drive motor and have the inherent property of preventing backflow when they are stopped, whereas other types of pumps do not connect the vacuum source to the suction conduit. A secondary valve may be required for isolation.

According to the blockage removal method according to the present invention, the vacuum source is immediately stopped or disconnected from the suction conduit 110 as soon as the vacuum exceeds a predetermined level, indicating that the suction hole in the ultrasonic tool 52 is clogged. . For this purpose, it is configured and arranged in fluid communication connection with the suction conduit 110 of the pressure sensing transducer 120. Typically, the transducer has a special connection 104 attached to the suction conduit 110.
It is connected to suction conduit 110 by a short tube 122 connected by. A hydrophilic-hydrophobic filter 124 mounted on a filter holder 126 is interposed between the suction conduit 110 and the transducer connection tube 122 to prevent contact with tissue particles or other particles carried along with the suction fluid. This protects the transducer from contamination.

Pressure sensing transducer 120 is pump 1
12 generates an electrical signal proportional to the vacuum within suction conduit 110 created by suction conduit 110 . This signal is used to control the pump 112 and is configured to quickly disconnect the vacuum source from the suction conduit 110 when the vacuum exceeds a predetermined value, indicating that an occlusion has occurred. In its simplest form, a pressure sensing transducer 12
0 can be configured with a simple pressure switch,
This pressure switch turns off the peristaltic pump motor (not shown). When using a peristaltic pump, simply turning off the drive motor can stop the pump, maintain the suction vacuum at the level achieved, and prevent backflow of waste irrigation fluid. Using a continuously running pump, this pump and the suction conduit 110
It will be appreciated that a controllable isolation valve may also be provided between the two. This arrangement allows the signal from the pressure sensing transducer 120 to cause the isolation valve to close, thereby preventing vacuum from building up, and which is reached before the connection is disconnected. It is also possible to maintain the suction conduit at a vacuum level. Isolation valves are also required when using pumps that cannot prevent backflow when the pump is stopped; for example, when the vacuum source is disconnected from the suction conduit 110 by stopping the pump 112. , it is desirable to equalize the pressure in the irrigation and suction lines to relieve the occlusion. When the pressures are equalized in this manner, the suction force that holds the tissue piece against the suction inlet of the ultrasonic tool 52 is removed, and the tissue piece can be easily removed. In the apparatus of the present invention, pressure is equalized by directing fluid from the irrigation fluid source 102 to the suction conduit 110 by a pressure equalization conduit 130. Valve 132 in pressure equalization conduit 130 is
Controls the flow of fluid through conduit 130. Valve 132 is normally closed when the device is being used to aspirate fluid and tissue from a surgical site. When an occlusion occurs within the suction line 110 , for example, when a piece of tissue blocks the axial bore of the ultrasonic tool 52 , an increase in suction pressure within the suction line 110 is sensed by the pressure sensing transducer 120 . , this transducer sends a signal to stop pump 112. Therefore, this surgeon
the suction conduit 110 by opening the valve 132 and introducing irrigation fluid from the irrigation fluid source 102 into the suction conduit 110 through the pressure equalization conduit 130, which is connected to the suction conduit 110 via a special fitting 140. The vacuum within 110 can be released. Because the entire system is filled with fluid, the pressure equalizes very quickly, much more quickly than systems that adjust the pressure by introducing air into the system. Once the pressure equalizes, transducer 120 detects the drop in suction pressure and restarts the pump. However, valve 13
2 is open, fluid is supplied to the irrigation fluid source 10.
2 directly into the suction conduit 110, which causes little suction work at the surgical site. When valve 132 is closed, pump 112 closes suction conduit 1
Fluid is again drawn from 10, thereby reapplying suction to the surgical site.

Highly preferably, valve 132 is e.g.
A remote control valve such as an electrically controlled valve actuated by a solenoid diagrammatically shown at 4. Solenoid 134 is energized by a power supply controlled by a switch controlled by the surgeon. Preferably, the switch is a foot switch so that the surgeon can easily equalize the pressure and remove the occluded tissue without removing the surgeon's hands from the surgical procedure. A check valve 109 is provided in irrigation conduit 56 to prevent fluid from flowing back into irrigation conduit 56 when valve 132 is opened to allow irrigation fluid to flow into the suction conduit.

An electrical circuit that can be used to control the fluid control system of the present invention is shown in FIG. A source of electrical energy 302, such as, for example, conventional line current, is provided to operate the electrical controls of the device. The main switch 304 turns on the device, and the foot switch 3
06. This foot switch is 4
It has two positions, which are shown as positions 0-4. The foot switch 306 is provided with at least three movable contacts 308, 310 and 330;
Each movable contact has an off position 308a, 310a, 330a, respectively, corresponding to position 0 of the foot switch, and a fixed contact 308b- with which each movable contact engages.
d, 310b-d and 330b-d correspond to foot switch positions 1-3, respectively. When no depressing force is applied to the foot switch by the foot, the switch is in position 0, the position shown, in which contacts 308, 310, and 330 are in off positions 308a, 310a, and 330a; No power is connected to the control circuit. Therefore, solenoids 108 and 13
4 has no power applied and valves 106 and 1
32 is closed to prevent irrigation fluid from flowing. When foot switch 306 is depressed to position 1, power is applied to contacts 308b and 310b. Therefore, solenoid 108 is energized to open valve 106 and supply irrigation fluid to surgical handpiece 50. However, switch 3
With 16 in the normally open position, solenoid 134 is not energized and therefore valve 132 remains closed. Pump 112 is not activated in footswitch position 1. When foot switch 306 is further depressed to position 2, contacts 308c and 3
Power is applied to 10c. Solenoid 108 remains energized, so valve 106 remains open and supplies irrigation fluid. solenoid 1
34 is disconnected so that when the footswitch is in position 2, valve 132 will not open. Pump 112 is powered through normally closed switch 312, which is controlled by pressure transducer 120. This control can be achieved by mechanical or electrical means known to those skilled in the art. The pumping action therefore fills the suction conduit 110 with irrigation fluid. The switch 312 is normally closed when the suction pressure within the suction conduit 110 does not exceed a predetermined value, and opens when the suction pressure exceeds the predetermined value. At the beginning of the surgery, foot switch 306 is depressed to position 3 and power is applied to the ultrasonic surgical instrument via lead 320 which is connected to the ultrasonic generator and control circuitry of the handpiece. The ultrasonic generator and handpiece control circuitry are all known in the art and are therefore not shown. Next, the surgeon uses tool 52 on handpiece 50 to perform an ultrasonic cut. During a normal surgical procedure, switch 312 is closed and pump 112 is used as a suction source to draw fluid and tissue debris from the surgical site while irrigation fluid is supplied through open isolation valve 106. . Pressure equalization conduit 130 normally remains closed. When an occlusion occurs, the vacuum in suction conduit 110 increases and pressure sensing transducer 120 opens switch 312, causing pump 1 to open.
12 is stopped. Surgeons are typically alerted to the occurrence of an occlusion when the motor of a running pump stops making noise. The surgeon can of course observe the occurrence of the occlusion with a surgical microscope, or a special alarm can be provided which is likewise activated by a pressure sensitive transducer. At this time, the surgeon equalizes the pressure by raising his foot and moving foot switch 306 from position 3 to position 1, returning the foot switch contacts to the energized position of contacts 308b and 310b. be able to. When foot switch 306 moves from position 2 to position 1, triggered controller 324 controlling switch 316 is actuated, momentarily opening switch 316. The triggered controller 324 is the switch 30
It receives power through contact 308b of switch 316 and includes a simple single pulse circuit, such as a one-shot or multivibrator, which supplies a single pulse to an actuator, such as a relay coil, to activate switch 316 Can be closed instantly. Foot switch 306 moves from position 2 to position 1
, the single pulse circuit can be triggered via connection line 326. The triggered controller 324 therefore switches 3
16 momentarily actuates valve 132 in pressure equalization conduit 130 to admit irrigation fluid from irrigation fluid source 102 directly into suction conduit 110 and relieve suction pressure in suction conduit 110. By removing the suction pressure within the suction conduit 110, the suction force on the tissue piece is no longer retained at the entrance of the axial hole of the ultrasonic tool 52, allowing the tissue piece to be easily removed. The surgeon can therefore proceed with the operation by depressing the footswitch to positions 2 and 3. Until this time, valve 132 is closed and suction pressure is maintained in suction conduit 110. Although the control system described above represents one circuit that accomplishes the objectives of the invention, it will be appreciated that other circuits may be used.

The invention also includes a special fitting 400, shown in cross-section in FIG. This fitting is specially constructed to serve the function of connecting together a suction conduit, a pressure relief conduit, and a pressure sensing transducer. The illustrated fitting includes a rigid tubular fluid conduit 402 with a receptacle connection 404 at one end for receiving aspiration conduit 110 from handpiece 52 . The suction conduit carries the aspirated fluid along with the tissue debris, and the receptacle connection has a smooth inner wall relative to the conduit to prevent clogging. The other end of the tubular conduit 402 is provided with a spigot connection 406, for example, for pump 1.
A tube 11 connected to a suction source such as 12
It is formed so that it can be connected to 3. A second tubular conduit 408 is provided generally perpendicular to the first tubular conduit 402 in fluid communication between the first tubular conduit 402 and connections 404 and 406 . The second fluid conduit 408 has a free end with a taper fitting 410 configured to plug into a taper fitting on the filter housing 126 or into a tube 122 that connects to the pressure sensing transducer 120. has. A third fluid conduit 412 is connected at one end to the second fluid conduit 408 at a point midway between the ends of the second fluid conduit 408 in fluid communication. The other end 414 of the third tubular conduit 412 is tapered for insertion into the tube end of the pressure equalization conduit 130. Third fluid conduit 4
12 is disposed substantially perpendicular to the second tubular conduit 408 and substantially parallel to the first tubular conduit 402 . This special connection 400 allows a quick and simple connection of all the fluid guiding elements in connection with the pressure equalization function of the device of the invention.

Although the present invention has been fully described herein, it will be understood that it may be embodied in other specific forms or modifications without departing from its spirit or essential characteristics. Therefore, the embodiments described above should be considered to be illustrative in all respects and not restrictive, and the scope of the present invention is not indicated by the above description. It is indicated by the following claims, and all changes within the meaning and range of equivalents of the claims are to be embraced within their scope.