DE3231693A1 - Instrument for ophthalmological surgery for removing lens residues by suction - Google Patents

Abstract

A double cannula, which can be inserted into the anterior chamber of an eye to be operated on and has lumina which run coaxially relative to one another, extends from a handpiece, each of these lumina being connectable to a tubing. With formation of an annular flow channel for the supply of rinsing liquid, an inner cannula extends through an outer cannula, the inner cannula in turn having an axially running suction channel and having an approximately radially directed suction orifice in the vicinity of its free end which projects above the end of the outer cannula. The free end of the outer cannula surrounds the inner cannula in an essentially fluid-tight manner, and the annular flow channel for supply of rinsing liquid opens in at least one radially directed outlet opening which extends in the vicinity of the front end of the outer cannula through the wall of the latter.

Description

dr. ing. HEINRICH GEITZ patent attorney 7500 Karlsruhe 1. post box 27οβ

821982/1983

Applicant: Company

Hans Geuder GmbH
Hertzstrasse 4

f.900 Heidelberg

Ophthalmic surgical instrument for suctioning off lens grids)

The invention also relates to a surgical instrument for suctioning off lens residues, in which a double cannula with coaxial lumen extending axially from a handpiece through an incision near the corneal edge of an eye in its anterior chamber extends and each of these lumen can be connected to a hose line is, wherein an inner cannula extends axially over the latter, forming a circular flow channel :: concentrically enclosing the cannula for supplying irrigation fluid into the anterior chamber of the eye and at a distance from the free end of the outer cannula p-.it; 'Mi ₁ , \ - qu <- r.'<Ϊ́ί · cannulas 1 änpiicrstreckur.g "P'.er i rhi.fM.fii nfTnuhi ¹ ; i ', 11111 ΛΝί'.ίΐιιμνη vrm;> pül Y 1 iir. ν, i jrki> i 1 and

ORIGINAL INSPECTED

I BÄOFÖfatGlNAL

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Lens grid! from the anterior chamber over one is provided axially through this inner cannula extending i suction channel.

Instruments of this type are known and are used in extracapsular cataract operations after opening the anterior I., lens capsule and the smashing of the; .. liiit-: ". un. At. · '·! .fen von Linpenresion, including im Sirins of the present invention all include such Op "rat. Ions - ^ -. To understand falling lens particles oirid. IjIi- ο ρ er'it. i ven measures to open the front Linüenkapael and £ are interested in smashing the lens however here · not.

i -. '·.! fiiiif.-rr. br ·; annten i'ristrument of this type extends a double cannula continues from a handpiece, which penetrates the anterior chamber through an irisision on the edge of the endocrine disruptor one eye is insertable. The lumen of an outer cannula through which the inner cannula extends, is used to supply rinsing liquid, whereas the Lui;. ·., · !. the inner cannula to suction the Rinsing liquid with the remnants of the lens.

Γ-as vorbeKanr.'e instrument has proven itself in practice as ur.i ►: fr ': ·. Ji {_ ■ ·· '- ■:.: Rwi <: r <? N, να. i .1 -.- r- -ius a Vielsani, "eweils

BAD ORIGINAL ORIGINAL INSPECT ""

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for the purpose of cleaning instruments to be dismantled parts to be dismantled is constructed in a highly complicated manner and also with regard to its suction ur.d
Rinsing effect does not meet the requirements of practice. Above all, it is unsatisfactory that lie about one. annular gap-shaped flow channels within the outer. Cannula made from a dimensionally stable silicone-smarter,.-E - ,: i 'ei,:.,:>,.'' : i' ^: \ u V- τ ".'t Li if i'ioS L ^ -k ^ 11, '- uinfaiis to. --- ..
the suction point flows over, so that on the one hand r.
led flushing fluid i gke.it directly in the short snLurr. again
sucked off wIi'-λ <xr.d -a. iererye I to ini "jlge .ie ^" Ub ^ rströniens ier suction opening in the suctioned 3pülf l'iss ig.-iei stream contained uinsenreste can be washed away from the suction point.

Accordingly, there is an object of the present invention
in the creation of an ophthalmic surgical instrument
for suctioning off lens residues, which with regard to the
Rinsing and suction is improved compared to the Teonni, but also through
should be characterized by a simple and inexpensive structure and unproblematic handling.

Starting from an instrument of the type specified at the beginning, the aim is to improve the irrigation and suction

BATH ORIGINAL

ORIGINAL INSPECTED

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021982/198 ^v .

effect-oriented problem solved in that the outer cannula in the area of its remote from the handpiece the free end of the inner cannula extending axially beyond the latter substantially encloses liquid-tight and that the annular gap. shaped inflow channel for the rinsing liquid in at least one transverse to the longitudinal axis of the cannula ger; i-M .'.'.- t ·. ·. ' Aiuu, r ili.süf'fnung; empties into the vicinity of the end of the outer cannula remote from the handpiece extends through its wall.

With such a design of the double cannula, the supplied rinsing liquid flow occurs in the vicinity of the front end of the outer cannula essentially radially to the cannula longitudinal axis, whereby equally thorough irrigation of the anterior chamber of the eye to be operated on and effective suction of Lens residue is guaranteed because the suction point is not washed over by supplied rinsing liquid and thus a suction flow can develop, which acts as a carrier liquid for lens residues to be carried along suitable is. A particularly favorable rinsing and suction effect is achieved if, according to a design The feature of the invention is the suction opening opening into the suction channel of the inner tube and the suction opening

ORIGINAL INSPECTED

the inflow channel for the rinsing liquid opening out Outlet opening are arranged offset from one another in the circumferential direction, for example with inclusion a circumferential angle of about 90 °. Of course In the context of the present invention, a plurality of cannulas distributed over the circumference of the outer cannula can also be used Outlet openings may be provided, two being arranged offset from one another by 180 ° in the circumferential direction Outflow openings have proven to be useful.

The solution of the on a simple and inexpensive Construction of such an instrument directed tasks is through a front end cone of the handpiece designed in the manner of a hollow cone characterized, from whose tapered end the double cannula and from whose blunt side each a pipeline for the supply of rinsing liquid on the one hand and for suctioning off lens residues and rinsing liquid on the other hand ibrt-extend the ends remote from the terminating cone each with a coupling section for connecting a hose line is provided. These hose lines connect the instrument to a rinsing liquid squel Ie and a suction pump, whereby the liquid supply utul the suction center, * 1 ;; eiti <; r

BATH ORIGINAL

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821982/1983 / fo

not further interesting unit are controlled here, so that on the subject of the present Registration forming instrument no tax manipulation: are required.

A particularly simple design is achieved if, according to a further design feature of the invention the outer cannula grows out of the tapered end of the end cone and the latter on the rear is closed by a plate, wherein the inner cannula extends through the cavity of the end cone extends through and liquid-tight through the latter rear panel closing off is passed through and the pipeline for supplying rinsing liquid in the area of the rear end plate the end cone opens into its inner cavity, so that the flushing media supply to the annular gap-shaped channel between the inner cannula and the outer cannula via the inner cavity the end cone takes place.

Another useful embodiment of the invention is that the end corius with that of its tapered end extending double cannula and at their ends remote from the latter with

ORIGINAL INSPECTED

821982/1983 * λ

Coupling sections for the connection of tubing provided pipelines an integral handpiece insert ISt ₃ , which is fixedly but detachably received in the handpiece. With such a design of the instrument, its assembly is achieved by simply pushing the handpiece insert from the rear end into the handpiece in the correct position and then fixing it in a manner which is not of further interest here. The handpiece insert can advantageously be accommodated in an essentially cylindrical sleeve that extends over the entire length of the handpiece »

In the interests of advantageous manageability of the instrument, it has also proven to be expedient to equip the handpiece with a rotary stop in the area of the end remote from the double cannula, which enables the instrument to be rotated in the surgeon's hand around the _{longitudinal axis of the instrument and a predetermined circumferential angle, see above} that with the essentially radially directed suction opening the opened area of the anterior lens capsule can be practically completely swept over as a result of such a rotation of the instrument about its longitudinal axis.

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ORiGINAL INSPECT ^

821982/1 ^ 83 /% L

This rotary stop can be attached to the side of the longitudinal axis of the handpiece on that of the double cannula be formed distal end arranged sleeve part in which the coupling portion one dt-r two pipelines axially extending through the handpiece can be.-

An exemplary embodiment of the invention will be explained below with reference to the accompanying drawing. In ochematic views show:

1 shows the ophthalmic surgical instrument for suctioning off lens residues in a perspective view General view roughly natural size,

Fig. 2 according to the section line II-II in Fig. 1 a enlarged sectional view of the hollow cone-shaped, front end cone for the handpiece with the double cannula extending from the tapered end of the cone and the two pipes for supplying rinsing liquid and for suctioning off lens residues and rinsing liquid, which extend on the other side of the end cone,

-13-ORäGINAL INSPECTED

// 3

Pig. 3 in a sectional view similar to FIG. 2, ieioch in a once again considerably enlarged view, the front end of the double cannula and,

4 shows a view of the double cannula with a view of its free end according to arrow IV in FIG.

In the ophthalmic surgical instrument 10 shown in its entirety in FIG. 1, one end of a handpiece Yd consisting essentially of an elongated sleeve 11 is closed by an AL cone 13, one of which is tapered. End I ^ a double cannula 15 forterstreckt axially, which is seen with regard to their details from FIGS. 2 and 3. In the Abschlußkorius l ^"7 is a hollow cone, the front of the se :, tapered end l ^l \ a standing with the internal cavity 16 in flow communication outer cannula 17 grows, while the rear end of this hollow cone terminated by a plate 18 The cannula 17 extends from the tapered end of the Abi'c'li 1 ιιί.Μ \ οιιιι: "- 1" Ί iMTauRwneluu'rnli 'nut shape, forming a channel 19 in the form of an annular gap, coaxially to the outer cannula 17 an inner cannula 20 on and through the cavity if

DKGiMAL INSPECTED

; - ..; ;: ■ "Χ" "323Ίby

821982/1983

of the terminating cone 13 and the plate 18 terminating this at the rear. This inner cannula 20 is connected, in a manner not of further interest here, to a pipe 21 extending longitudinally through the handpiece 12, at the free end of which there is a coupling pin 22 for attaching a hose line (not shown). ^{Parallel to this pipeline runs another pipeline J} ', which also extends essentially over the entire length of the handpiece, is connected in a liquid-tight manner to the plate 18 which closes off the cavity I ^ of the terminating cone 13 on the rear side and opens into the cavity lfi. The end of the end ^{cone 13 f} vr.tferrite this pipe 23 is offset laterally in the area of the free end of the handpiece 12 with respect to the end of the other pipe 21 provided with a coupling pin 22 and with a. Equipped coupling sleeve 24, which is received in a laterally attached sleeve part 25 at the rear end of the handpiece and also provides the connection of a -not shown- hose line.

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82I982 / I983 yjg-

The annular gap-shaped flow channel 19 between the inner cannula 20 and the concentrically enclosing cannula 17, which is in flow connection with the cavity of the conical end cone 13, opens out via radially directed outlet openings 26 which are near the free end of the outer cannula are arranged, and in the axial respect the channel 1? is through the inner cannula 20 essentially liquidke ityd i ν u ::. ö ch 1. ie β c η d t-1 ₁ ν ο rder f. r ι «L sc η η i 11 "Y aDgtochlöi'j '.' i-. Lio axially beyond iac fr ^ it end · - \ ^ \ - outer cannula protruding inner ^{ca. R} i "Le _£ C has eirioTi in the axial direction through this - '. Okenden suction canal.": - ur.'x an ir .Axial spacing in front of the outlet openings 2 ′ of the outer cannula 17, likewise radially directed suction openings 29.

The end cone 13 closing off the handpiece 12 on the cannula side is together with the forward-stretching double cannula IS, which is tapered in front of the cone end, and the pipes 21, 23 extending to the other side, one of which has a coupling pin 22 at its distal end and the other with a coupling sleeve ? Λ

moo

are equipped, designed in one piece as a handpiece insert. Together with the sleeve 11, which essentially extends over the entire length of the handpiece, this insert forms the handpiece 12. When the instrument is installed, the insert is inserted from the rear into the sleeve 11, which extends essentially over the entire handpiece inserted, wherein the coupling pin 22 of the: t.rifTf-n Kan'iL · 20 in flow communication stand-end Hohrli · itutig d \ of the spine of a double cannula 15 N '.. r-nt' -.- n. Hndo from d ^f> r sleeve protrudes and on the:... '"nr · ir, - fi'ir ί -t Π (· ί ·; - ir itung honrli-substantially parallel to said 21 extending pipe 23 for supplying rinsing liquid with its t ^ ndo laterally offset from the double carriageway to the first-mentioned pipe line and the coupling sleeve 2k , which provides the connection of a hose line, is received in the sleeve part 25 connected laterally to the rear end of the said sleeve 11.

When the instrument 10 according to the invention is used in accordance with the present invention, irrigation fluid is supplied by means of a hose line connected to the coupling sleeve 2k

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ORIGINAL INSPECTED

Ö21982 / 19Ö3

via the pipeline 23 into the cavity IG of the cone 13 closing the handpiece on the front side, which flows out of the cavity via the annular inflow channel 19 between the inner cannula 20 and the outer cannula 17 and in the vicinity of the outer cannula removed from the handpiece through the outlet openings? Jj extending radially outward through their walls essentially in a radial direction, as α it, - flow arrows 30 in FIGS. 3 and 4 indicate. The inner cannula 20, which extends axially beyond the free end of the outer cannula 17, with the suction opening 29, which is offset by 90 ° in the circumferential direction relative to the outlet openings 26, is used for sucking off T, residues and rinsing liquid from the anterior capsule of the eye the axially extending suction channel 28 of the inner cannula opens. The arrow 31 in P ¹ Ig. 4 'illustrates the direction of the suction flow, which is offset in the circumferential direction by 90 ° with respect to the flow directions of the supplied rinsing liquid.

ORIGINAL INSPECTED -lö-

ί. <J

8P1982 / 1983

That the coupling sleeve 24 for the connection of a , Hose line for the supply of rinsing liquid receiving sleeve part 25 at the rear end of which extends essentially over the entire axial length of the handpiece 12 extending sleeve 11 is with respect to the suction opening 29 on the axially over the outer cannula 17 extending anterior End of the inner cannula 20 arranged in the circumferential direction so that in the anterior chamber one Double cannula inserted into the eye to be operated on αϊ '". · ALG? tur" f opening 29 to which then by removing 3er anterior lens capsule exposed lens directed and can be held in the operator's hand during the suction process by turning the handpiece its longitudinal axis can be pivoted by approximately 180 ° until the coupling sleeve 24 receiving, laterally attached sleeve part 25 to rest on corresponding parts of the operator's hand arrives and thereby limits the rotational mobility of the instrument. With appropriate instrument guidance It is therefore possible, by means of the suction opening 29, to cover the entire area of the opened and to coat in a way that is not of further interest here, and therefore in the lens

ORIGINAL INSPECTED

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821982/1983

The anterior capsule of the eye to suck off any lens residues encountered in the area of the front end of the outer cannula 17 radially to the longitudinal extent of the cannula and in the circumferential direction Rinsing liquid supplied from the suction point offset by about 90 ° with respect to the suction opening is kept away, causing the announcement of a flush through the anterior chamber of the eye Rinsing liquid with the lens parts carried along in it is favored.

In addition to the advantageous manageability of the inventive system Instruments has a particular advantage also in the fact that it can be cleaned after each use and sterilized before each reuse the instrument does not need to be dismantled.

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Claims (1)

Claims Iy ophthalmic surgical instrument for suction before: lens remnants in which a double cannula with coaxially extending lumens extends axially from a handpiece through an incision near the edge of the cornea of an eye to be operated in its anterior chamber and each of these lumens can be connected with a hose line with an inner cannula extending axially over the latter, forming an annular gap-shaped flow channel for supplying irrigation fluid into the anterior chamber of the eye concentrically enclosing cannula and at a distance from the free end of the outer cannula with an opening directed transversely to the longitudinal extension of the cannula for sucking off irrigation fluid and lens remnants from the anterior chamber are provided via an axially extending through this inner cannula through a coping canal, characterized, ORIGINAL INSPECTED BATH ORIGINAL J I 0 ID that the outer cannula (17) in the area of its free end remote from the handpiece (12) encloses the inner cannula (20) extending axially beyond the latter in an essentially liquid-tight manner and that the annular gap-shaped inflow channel (19) for the rinsing liquid in at least one transverse to the cannula longitudinal axis directed outlet opening (26) opens extending therethrough in the vicinity of the line from the handpiece entfV r'rit.eti-end 'i ^f -r' iußeren cannula through the wall thereof. ? .. Instrument according to claim 1, characterized in that the suction opening (29) opening into the suction channel (28) of the inner cannula (20) and the outlet opening (26) opening out of the inflow channel (19) for the rinsing liquid are offset from one another in the circumferential direction are arranged. 3. Instrument according to claim 2, characterized by a circumferential angle of approximately 90 ° between the suction opening (29) of the inner cannula (20) and the outlet opening (26) for supplying rinsing liquid in the outer cannula (17). 4. Instrument according to one of claims 1 to 3, characterized by one formed in the manner of a hollow cone front end cone (13) of the handpiece (12), from whose tapered end (14) the ORIGINAL INSPECTED -3- 8 ^ 1982/190 ^ «> - ^ - Double cannula [Yb) and from its blunt side £ i :: a pipe each (.2I ₃ , 23) for the supply vci. .Sr'll liquid on the one hand and κ to suck off Lir.str.ri- "er. And rinsing liquid on the other hand, let ά :. their ends remote from the terminating cone ir.with a coupling section (22, 24) to the connector, one each Hose line are provided. 5. Instrument according to claim 4, characterized in that the outer: cannula ClT) consists of the / or,: "ii ^ t -;:,; - ':. ; -.- .-. Of the firing cone (1.3) . grows Urid latter jerk side is closed by a plate (18),: i ~ / j ie inner: - cannula (.-ν; ^ I lui'ch J :. :: _- RJR ;; _<:: . '-1 ^): -e Al-. • ehlußk ■ _ »!". Us hi: dur -'.-.- i'.iirotrockt and f J. ". Es igrioit. ;;:! Jr.t is passed through the plate r. .-riur. connection is established. 6. Instrument according to claim 4 or b, characterized in that the terminating cone (13) with the νυη its tapered end forterstreckenden DoppelKar.üIe (15) and at their distant Enaen with coupling sections (22, 24) for the connection Pipelines provided with hose lines t?!, .. ⁷ '-ir. one-piece handpiece insert is, the · im ORIGINAL INSPECTED -M- BATH ORIGINAL 0 10 I. Handpiece (Ii '; firmly, but detachably received, 7. Instrument according to claim 6, characterized in that the handpiece insert in a substantially cylindrical Sleeve (11), which forms a handle, is added. 6. Instrument according to one of claims 4 to 7, characterized by a Drehanscnlag (25) of the handpiece (1 ″. :) in the area of the double cannula (15) ent- Vt. .rirttiti fianaatückendes. 9. Instrument according to claim 7, characterized in that ^J. -ier coupling section (24) of one of the two pipes (21,23) extending ixial d'irch through the handpiece is arranged to the side of the longitudinal axis of the handpiece and is received in a sleeve part (25) forming the rotary stop of the handpiece.