CN101384296A - 用于眼压控制的外科手术盒 - Google Patents
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Abstract
一种改进的外科手术盒,用来在眼外科手术过程中控制眼压。
Description
技术领域
本发明总体上涉及显微外科系统,更具体地,涉及在眼外科手术中对眼压的控制。
背景技术
在小切口外科手术中,尤其是在眼外科手术中,要将小探针插进手术位置进行切割、去除,或者相反,对组织进行操纵。在这些外科手术过程中,一般要将流体注入眼中,然后从外科手术处抽吸出注入流体和组织。
在眼外科手术过程中保持最佳的眼压当前是有问题的。当不发生抽吸时,眼内的压力变成正被注入眼内的流体的压力。这个压力一般被称为“静压头”。但是,当施加抽吸时,由于抽吸回路中所有与抽吸流动相关的压力损失,眼压从静压头急剧下降。因此,眼外科医生目前容许高过希望压力的静压头,以补偿否则抽吸会将眼压降低到软眼条件(soft-eye conditions)的情形。在临床上,眼睛的这种过压是不理想的。
相应地,继续存在改进用于在眼外科手术过程中控制眼压的设备的需要。
发明内容
一方面,本发明是一种外科手术盒,其包括一个双注入腔和第一到第四流体线路。所述双注入腔具有不与第二腔流体连接的第一腔。所述第一流体线路流体连接到所述第一腔,用来向所述第一腔提供冲洗用流体。所述第二流体线路流体连接到所述第一腔,用来向外科手术器件提供冲洗用流体。所述第三流体线路流体连接到所述第二腔,用来向所述第二腔提供冲洗用流体。所述第四流体线路流体连接到所述第二腔,用来向外科手术器件提供冲洗用流体。
另一方面,本发明是一种包括注入腔和流体线路的外科手术盒。所述注入腔具有上表面和下表面。所述流体线路流体连接到所述注入腔,用于向所述注入腔提供冲洗用流体。所述注入腔具有针对所述流体线路设置在所述下表面附近的开口。
附图说明
为了更完整地理解本发明,以及为了说明本发明进一步的目的和优点,引入了下面结合附图进行的描述。在附图中:
图1是表示眼显微外科系统中注入控制的示意图;
图2是表示眼显微外科系统中注入控制和冲洗控制的示意图;
图3是用于图1、2眼显微外科系统的优选外科手术盒的前视透视图;
图4是图3外科手术盒中双注入腔的前视局部分解透视图。
具体实施方式
通过参照附图中的图1~图4,本发明的优选实施例和它们的优点将得到最好的理解。类似的数字被用于各图中类似的以及相应的部分。如图1所示,眼显微外科系统10包括:压力袖12;注入源14;具有腔16a和腔16b的双注入腔16;流体液位传感器18、20;流量传感器22;过滤器24、26;外科手术器件29;计算机或者微处理器28;气体歧管30、32;加压气体源34;比例电磁阀36、38、40;“开/关”电磁阀42、44、46、48、50、52、54;执行器56、58、60、62;以及压力变送器64、66、68。双注入腔16、流体液位传感器18、20、部分注入流体线路70、72、74、76、78、80以及部分气体线路84、86,优选地放置在外科手术盒27中。注入源14、双注入腔16、流量传感器22、过滤器24、26以及外科手术器件29经注入流体线路70~80流体连接。注入源14、双注入腔16、气体歧管30、32、加压气体源34以及执行器56、58、60、62经气体线路82、84、86、88、90、92、94、96流体连接。注入源14、流体液位传感器18~20、流量传感器22、微处理器28、比例电磁阀36~40、“开/关”电磁阀42~54、执行器56~62以及压力变送器64~68经接口100、102、104、106、108、110、112、114、116、118、120、122、124、126、128、130、132电连接。
注入源14优选地是柔性注入源。如在图3~4最佳示出的,双注入腔16优选地形成在外科手术盒27的后表面27a上。外科手术盒27优选地还有顶面27b和底面27c。腔16a和16b优选地用分隔件16c分开,并且腔16a和16b不流体连接。双注入腔16优选地还具有上表面16d和下表面16e。如图1~2最佳所示,腔16b具有针对流体线路74设置在下表面16e上或者附近的开口226,腔16a具有针对流体线路72设置在下表面16e上或者附近的开口228。前面句子中所使用的“附近”优选地是指,与靠近经过下表面16e和上表面16d之间的中点的横截面相比,更靠近下表面16e,“附近”更优选地是指,与靠近经过距下表面16e四分之一的距离并距上表面16d四分之三的距离的点的横截面相比,更靠近下表面16e。流体液位传感器18和20可以是用来分别测量注入腔16a和16b中的流体的液位的任何合适器件。流体液位传感器18、20优选地能够以连续的模式测量注入腔16a和16b中的流体的液位。流量传感器22可以是用来测量流体线路80内的流体流率的任何器件。流量传感器22优选地是非侵入式流量传感器。过滤器24和26是憎水性微生物过滤器。一种优选的过滤器是可以从纽约的Pall Corporation of East Hills得到的薄膜过滤器(0.8微米)。微处理器28能够进行反馈控制,优选地能进行PID控制。外科手术器件29可以是用来向眼睛提供外科手术冲洗用流体的任何合适器件,但优选地是注入套管、冲洗机头、或者/以及冲洗/抽吸机头。设置在外科手术盒27中的部分流体线路70~80以及设置在外科手术盒27中的部分气体线路84~86可以是用来运送流体的任何合适的线路、管路或者歧管,但优选地是整体模制在外科手术盒27中的歧管。
在操作中,流体线路70、72、74、腔16a、16b、流体线路76、78、80、以及外科手术器件29都用有压力的注入源14来灌注外科手术冲洗用流体140。外科冲洗用流体140可以是适合眼科使用的任何外科冲洗用流体,举例来说,如可以从Alcon Laboration,Inc.得到的BSS 眼内冲洗用溶液。
注入源14的加压优选地用压力袖12执行。更具体地说,微处理器28分别经接口106发送打开电磁阀42的控制信号,经接口108和110发送关闭电磁阀44和46的控制信号。微处理器28还经接口104发送打开比例电磁阀40的控制信号,使歧管30供给合适量的加压空气来驱动压力袖12。压力变送器68感测到气体线路82内的压力,然后经接口126向微处理器28提供相应的信号。电磁阀48~54开始时是打开的,使歧管32提供加压空气来驱动执行器56~62关闭流体线路72~78。微处理器28经接口114~120发送关闭电磁阀48~54的控制信号。电磁阀48~54的关闭驱动执行器56~62打开流体线路72~78。当所有腔和流体线路都被灌注后,微处理器28关闭执行器56~62,并因此关闭流体线路72~78。可选方式是,注入源14的加压可以仅仅通过重力来实现。
灌注之后,使用人员接着经输入装置134向微处理器28提供希望的眼压。输入装置134可以是任何合适的输入装置,但优选地是触摸屏显示器或者实际的旋钮。腔16b优选地是开始时有效的注入腔。微处理器28发送打开电磁阀44以及打开比例电磁阀36(经接口100)的适当控制信号,以向腔16b提供合适大小的加压空气。压力变送器64感测气体线路84内的压力,并经接口124向微处理器28提供相应的信号。微处理器28还发送合适的控制信号来打开执行器60,并因此打开流体线路78。腔16b经流体线路78、80和外科手术器件29向眼睛供应有压力的流体140。流量传感器22测量流体140的流率,并经接口132向微处理器28提供相应的信号。微处理器28利用来自流量传感器22的信号计算预估眼压,并按经验确定显微外科系统10的阻抗信息。然后,微处理器28向比例电磁阀36发出合适的反馈控制信号,以在全部的外科手术过程中将该预估眼压保持在希望眼压或者希望眼压附近。
流体液位传感器20在外科手术过程中不断地监视腔16b中的流体140的液位,并经接口130向微处理器28提供相应的信号。微处理器28对供给腔16b的空气压力进行调整,以适应随着流体140的液位的降低流体头液位的差异。当腔16b中流体140的液位达到底限液位时,微处理器28关闭电磁阀44和执行器60,而打开电磁阀46和执行器58、62。现在,腔16a是有效的注入腔。微处理器28经接口102向比例电磁阀38发出合适的控制信号,以向腔16a提供合适大小的加压空气。压力变送器66感测气体线路86内的压力,并经接口122向微处理器28提供相应的信号。腔16a经流体线路76、80和外科手术器件29向眼睛供应带压力的流体140。流量传感器22测量流体140的流率,并经接口132向微处理器28提供相应的信号。微处理器28如上所述计算预估眼压,并向比例电磁阀38发送合适的反馈信号,以在全部外科手术过程中将预估眼压维持在希望眼压或者希望眼压附近。一旦腔16b被重新装填流体140,微处理器28关闭执行器58和流体线路74。
流体液位传感器18在外科手术过程中连续监视腔16a中流体140的液位降低,并经接口128向微处理器28提供相应的信号。微处理器28对提供给腔16a的空气压力进行调整,以适应随着流体140液位的下降流体头液位的不同。当腔16a中流体140的液位达到底限液位时,微处理器28将腔16b切换为有效的注入腔,使腔16a无效,并经流体线路72给腔16a重新填充流体140。腔16a和16b之间的这种循环在整个外科手术过程中持续进行。
注入源14优选地经流体液位传感器(没有示出)进行监视,这个液位传感器能够在源14达到接近空限时经接口112向微处理器28提供一个信号。腔16a和16b还优选地每个都有一定的容积,该容积能够使注入源14在接近排空时进行更换,而不会干扰外科手术过程。更具体地说,腔16a和16b优选地每个都有大约30cc的容积。这种容积在最大流量条件(例如核心玻璃体切除术)下允许用大约两分钟来对接近空的注入源14进行更换。此外,由于流体线路72和74在或者接近下表面16e处分别流体连接到腔16a和16b,所以一旦更换了注入源14,流体线路70、72、74内的所有气泡将随着无效腔16a或者16b重新填充而自动被“洗刷掉”,无需重新灌注。
万一腔16a或者16b中的某一个失效,微处理器28能优选地只利用一个有效腔继续外科手术。万一两个腔16a和16b都失效,微处理器28能优选地只使用注入源14继续外科手术。
图2示出了一种改进的眼外科系统10a。除了显微外科系统10a在上述用于系统10的注入系统之外还具有清洗系统,显微外科系统10a类似于显微外科系统10。更具体地说,除了系统10a还包括清洗源200、流体线路202、206、气体线路208、216、电磁阀210、218、执行器214、222、电气接口212、220以及外科手术器件224之外,系统10a同系统10一样。如图2中所示,清洗源200仅仅用重力加压。放置在外科手术盒27中的部分流体线路202、206以及放置在外科手术盒27中的部分气体线路208、216可以是用来运输流体的任何合适的线路、管路或者歧管,但优选的是一体模制在外科手术盒27中的歧管。象本领域普通技术人员将会明白的,显微外科系统10a独立地允许外科手术清洗用流体140经流体线路80被传递到外科手术器件29(注入),外科手术清洗用流体140经流体线路206被传递到外科手术器件224(清洗)。通过连续地监视腔16b里面由流体传感器20指示的流体体积变化,微处理器28能计算流体线路206内流体140流动的信息。
从上面可以明白,本发明提供了一种改进的用显微外科系统控制眼压的方法。本发明以举例的方式在这里进行了图示,但本领域普通技术人员可以做出各种变型。例如,虽然本发明上面相对于在眼显微外科系统中控制眼压进行了描述,但是,本发明还可以应用于在其他类型的显微外科过程中在手术组织内进行压力控制。
相信本发明的操作和结构会从前面描述中变得显而易见。虽然显示或者上面描述的设备和方法被表征为优选的,但是,这里可以做出各种改变和变型,而不脱离权利要求所限定的本发明的精神和范围。
Claims (7)
1.一种外科手术盒,包括:
双注入腔,所述双注入腔具有不与第二腔流体连接的第一腔;
第一流体线路,流体连接到所述第一腔,用来向所述第一腔提供冲洗用流体;
第二流体线路,流体连接到所述第一腔,用来向外科手术器件提供所述冲洗用流体;
第三流体线路,流体连接到所述第二腔,用来向所述第二腔提供所述冲洗用流体;
第四流体线路,流体连接到所述第二腔,用来向所述外科手术器件提供所述冲洗用流体。
2.如权利要求1所述的外科手术盒,其中,所述第一腔和所述第二腔用分隔件分开。
3.如权利要求1所述的外科手术盒,还包括第五流体线路,所述第五流体线路流体连接到所述第一腔或者所述第二腔,用来向所述第一腔或者所述第二腔提供所述清洗用流体。
4.如权利要求3所述的外科手术盒,还包括第六流体线路,所述第六流体线路流体连接到所述第一腔或者所述第二腔,用来向第二外科手术器件提供所述清洗用流体。
5.一种外科手术盒,包括:
注入腔,所述注入腔具有上表面和下表面;和
流体线路,流体连接到所述注入腔,用于向所述注入腔提供冲洗用流体,所述注入腔具有针对所述流体线路设置在所述下表面附近的开口。
6.如权利要求5所述的外科手术盒,其中,将所述开口设置在所述下表面附近有利于去除位于所述清洗用流体内的气泡。
7.如权利要求5所述的外科手术盒,其中,所述开口设置在所述下表面上。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
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US11/237,568 US7713237B2 (en) | 2005-09-28 | 2005-09-28 | Surgical cassette for intraocular pressure control |
US11/237,568 | 2005-09-28 | ||
PCT/US2006/033909 WO2007037900A2 (en) | 2005-09-28 | 2006-08-30 | Surgical cassette for intraocular pressure control |
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CN101384296A true CN101384296A (zh) | 2009-03-11 |
CN101384296B CN101384296B (zh) | 2012-05-30 |
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US (2) | US7713237B2 (zh) |
EP (2) | EP2286851A3 (zh) |
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AU (1) | AU2006295262B2 (zh) |
BR (1) | BRPI0616435B8 (zh) |
CA (1) | CA2620367C (zh) |
CY (1) | CY1111888T1 (zh) |
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PT (1) | PT1960032E (zh) |
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