SELF CONTAINED ILLUMINATED INFUSION CANNULA SYSTEMS AND METHODS AND DEVICES
A cannula is described having a housing, a first lumen, a second lumen, and a port capable of fluid communication with the first lumen. The second lumen configured to receive fluid from the first lumen and to direct the fluid to a surgical site. A light emitting diode light source is positionable within the housing and configured to direct light through the second lumen to the surgical site.
This application is a continuation of U.S. patent application Ser. No. 14/155,113, titled SELF CONTAINED ILLUMINATED INFUSION CANNULA SYSTEMS AND METHODS AND DEVICES, filed Jan. 14, 2014, which is a continuation of U.S. patent application Ser. No. 13/106,780, titled SELF CONTAINED ILLUMINATED INFUSION CANNULA SYSTEMS AND METHODS AND DEVICES, filed May 12, 2011, which claims priority benefit of U.S. Provisional Patent Application No. 61/334,531, titled SELF CONTAINED ILLUMINATED INFUSION CANNULA SYSTEMS AND METHODS AND DEVICES, filed May 13, 2010. Each of the foregoing applications is hereby incorporated by reference herein in its entirety.
BACKGROUND1. Field of the Invention
The present invention relates generally to medical surgery, and more particularly to cannula systems and methods, and more specifically, to an illuminated cannula device.
2. Description of the Related Art
Minimally invasive surgical procedures utilize assorted systems and methods, such as endoscopes or the like, for observing a surgical site or a wound to enable a surgeon to perform various surgical procedures. Generally, in some eye surgeries the surgical field is observed through the pupil. Various medical tools, devices, instruments, or the like are inserted into the vitreal cavity by performing a sclerotomy and/or other procedures to facilitate completion of the surgical procedure. The complexity of the ophthalmic surgery increases the duration of surgery and increases the number of support personnel required to assist the surgeon. Surgical procedure complexity is influenced by instrumentation introduced through various ports created by performing sclerotomies that are controlled by the surgeon. For example, generally, three ports can be created during a posterior operative surgical procedure, although additional or fewer ports can be created as necessary. The multiple ports provide various functions for the surgical procedure. For example, the multiple ports maintain the intraocular pressure through fluid infusion of a fluid, air, oil, or gas, illuminate the interior of the eye via a light source, and provide a controlled access channel for inserting surgical instruments, devices, or the like.
SUMMARYThe systems and methods disclosed herein are related to an illuminated infusion cannula for internally illuminating biological tissue, organs, body lumens, and/or body cavities to enable a surgeon to perform various orthopedic surgeries, neurosurgeries, and/or other surgical procedure. Various embodiments of the present disclosure can also relate generally to an illuminated cannula device for internally illuminating an eye to enable a surgeon to perform various surgical procedures in, on, around, and/or near the eye.
In accordance with one embodiment, the present disclosure provides a medical treatment system having a self-contained illuminated infusion cannula system, including a light source, such as a light emitting diode or an organic light emitting diode light source, located in the cannula device, and transmitting light and infusion fluid through the same cannula into the surgical site within the eyeball.
A cannula system can include a body, a light source contained within the body, an infusion port and a cannula. The infusion port can be formed in the body for receiving fluids to be delivered to a surgical site. The cannula can also be formed with the body. The cannula can have a lumen for delivering the fluids received through the infusion port and for transmitting light from the light source. In some embodiments, the system can include one or more lens or other optical elements. Some embodiments may also or alternatively include a trocar sized to pass through the cannula.
Another embodiment of a cannula system can comprise a housing element having a lumen and a port configured to provide a flow of fluid to the lumen and a light emitting diode light source. The light source can be positionable within the housing element and configured to direct light through the lumen when disposed within the housing element. The lumen can be transparent and configured to permit light to pass through the lumen from the light emitting diode light source to a surgical site. The lumen can also be configured to direct fluid to the surgical site.
A cannula system can have a body, an insert and an elongate member. The body can have a proximal portion and a distal portion, a first lumen extending between the proximal portion and the distal portion, and a port coupled to a second lumen. The second lumen can communicate with the first lumen. The body can also have a first aperture extending to the first lumen at the proximal portion. The insert element can have a light source positionable within the first aperture to permit light from the light source to pass through the first lumen. The elongate member can be transparent and can have a first portion and a second portion with a third lumen extending through the elongate member from the first portion to the second portion. The first portion of the elongate member can be coupled to the distal portion of the first lumen. The transparent member third lumen can permit light to pass from the light source to a surgical site and be capable of fluid communication with the port, the first lumen, and the second lumen.
In accordance with another embodiment the present disclosure provides a cannula comprising a housing element having a distal portion and a proximal portion, a first lumen extending between the proximal portion and the distal portion, and a port capable of fluid communication with the first lumen. A light emitting diode light source can be removably positionable within the housing element. The light emitting diode light source is configured to direct light through the first lumen when disposed within the housing. The light emitting diode light source comprises at least a red light emitting diode, a blue light emitting diode, and a yellow light emitting diode. The embodiment further includes a transparent second lumen having a first portion and a second portion. The first portion is coupled to the distal portion of the first lumen, and the transparent second lumen is configured to permit light to pass through from the light emitting diode light source to a surgical site. The embodiment additionally includes the transparent second lumen being configured to receive fluid from the first lumen. The diameter of the transparent second lumen is 20 gauge or smaller.
In accordance with another embodiment the present disclosure provides a cannula comprising a housing element having a distal portion and a proximal portion, a first lumen extending between the proximal portion and the distal portion, and a port capable of fluid communication with the first lumen. A light emitting diode light source can be removably positionable within the housing element. The light emitting diode light source is configured to direct light through the first lumen when disposed within the housing. The light emitting diode light source comprises at least a red light emitting diode, a blue light emitting diode, and a yellow light emitting diode. The embodiment further includes a transparent second lumen having a first portion and a second portion. The first portion is coupled to the distal portion of the first lumen, and the transparent second lumen is configured to permit light to pass through from the light emitting diode light source to a surgical site. The embodiment additionally includes the transparent second lumen being configured to receive fluid from the first lumen.
In accordance with another embodiment the present disclosure provides a cannula system comprising a body having a distal portion and a proximal portion, with a first lumen extending between the proximal portion and the distal portion and a periphery surface extending between the proximal portion and the distal portion. The embodiment further includes a port coupled to a second lumen. The second lumen communicating with the first lumen, and a first aperture extending to the first lumen. The embodiment can additionally include an insert element comprising a light emitting diode light source positionable within the first aperture to permit light from the light emitting diode light source to pass through the first lumen. The embodiment still further includes an elongate transparent member, having a first portion and a second portion, wherein a third lumen can extend through the elongate member from the first portion to the second portion, and the first portion is coupled to the distal portion of the first lumen. The transparent member third lumen can be configured to permit light to pass from the light emitting diode light source to a surgical site, and the transparent member third lumen can be capable of fluid communication with the port and the first lumen and the second lumen.
In accordance with another embodiment, the present disclosure provides a method of treating an eye. The method includes providing a cannula comprising a body having a first lumen therein, and an elongate member extending from a distal portion of the body, the elongate member having a second lumen substantially coaxial with the first lumen, the first and second lumen capable of fluid communication with a fluid source, and an insert having a light emitting diode light source, the insert positionable through a first aperture to permit light to pass through the first lumen and the second lumen. The embodiment further includes projecting an incision instrument through the first and second lumen with the insert removed to allow passage of the instrument. The embodiment additionally includes creating an incision in the eye tissue by penetrating the tissue with a sharp distal end of the incision instrument. The embodiment still further includes inserting the elongate member through the incision to position a distal portion of the elongate member such that the distal portion lies within the eye with the distal surface of the body adjacent the outer surface of the eye. The embodiment additionally includes removing the incision instrument from the transparent elongate member and the body, and positioning the insert adjacent the first lumen to permit light to pass from the light emitting diode through at least a portion of the second lumen. The embodiment still further includes illuminating the internal portion of the eye by permitting light to pass through the transparent elongate member and dispersing the light within the eye, and irrigating the interior of the eye with fluid delivered through the transparent elongate member, the fluid exiting from at least a portion of the transparent elongate member.
For purposes of this summary, certain aspects, advantages, and novel features of the invention are described herein. It is to be understood that not necessarily all such advantages may be achieved in accordance with any particular embodiment of the invention. Thus, for example, those skilled in the art will recognize that the invention may be embodied or carried out in a manner that achieves one advantage or group of advantages as taught herein without necessarily achieving other advantages as may be taught or suggested herein.
The foregoing and other features, aspects and advantages of the invention are described in detail below with reference to the drawings of various embodiments, which are intended to illustrate and not to limit the invention. The drawings comprise the following figures in which:
The efficiency and comfort of the surgeon during a surgical procedure can be increased with a reduction in the quantity and/or mass of the various instruments controlled by the surgeon. Thus, it is desired to reduce the number of instruments inserted into the eye during ophthalmic surgery. Challenges of known infusion and/or fiber-optic light cannulas include obtaining sufficient illumination of the inside of the eyeball at the surgical site, the need for support personnel to assist the surgeon in handling the numerous instruments, and the fatigue incurred by the surgeon while handling the appurtenant illumination and infusion instrumentation connected to the surgical control panel. Additional issues arise with the heat emitted from the light source of fiber-optic systems, the short operating life of the light sources, and the fragility of the fiber optics of such systems.
Accordingly, there is a need in the art for an improved illumination infusion cannula device or system that solves some of the disadvantages discussed above. Particularly, there is a need for a self-contained illuminated infusion cannula system that reduces the efforts and attention a surgeon needs to direct to the illumination of the surgical site during a surgical procedure, and increases the transmittance of light to the surgical site within the eyeball. Further, a need exists for an improved illumination device that provides greater durability and reliability than currently available fiber-optic light sources.
The associated drawings and specification discuss aspects and features of the disclosure in the context of several different embodiments of illuminated infusion cannula devices and methods that are configured for use in surgical procedures, in particular ophthalmic surgery. Discussing these features in connection with ophthalmic surgery provides for clarity and consistency in presenting these inventive features and concepts. However, it is to be understood that the features and concepts discussed herein can be applied to surgical methods other than ophthalmic procedures.
With reference to
The self-contained illuminated infusion cannula system 100 can generally include a body 102, an elongate member or cannula 104, a conduit 106, and a light source 108. The cannula system 100 can further include a power source 110, an infusion port 116, and an outlet 118. The body or housing 102, can receive infusion fluid 119 through the infusion port 116 at a distal end of the conduit 106 and light transmittance 109 from the light source 108. The body 102 can direct fluid and permit the light to pass out the outlet 118 of the cannula 104.
The light source 108 can generate light and can be in the form of, for example, one or more of a light emitting diode (LED), an organic light emitting diode (OLED), a light bulb, or a lamp. The light source 108 contained in the infusion cannula system 100 provides certain benefits over currently available fiber optic systems, such as not being tethered to a separate light source to generate the light directed down the fiber optic. Thus, the light source 108 allows for a self-contained system where the light source 108 can be contained within the body 102 of the system 100.
The infusion port 116 can be coupled to a fluid source 120 to provide a fluid inlet flow of infusion fluid. The fluid source 120 can be part of, for example, a remote console, or control, system that is not shown. The conduit 106 can extend from the infusion port 116 at one end to the body 102 at the other end. The cannula 104 can extend from a distal end 112 of the body 102 to the outlet 118 at a distal end of the cannula 104. The cannula outlet 118 can establish the furthest point, or location, of entry within the tissue, or eyeball as shown in
With reference to
With continued reference to
In the illustrated embodiments of
Internal to the body 102, the first lumen 202 can define a generally circular cross-sectional passageway extending from the proximal most portion of the cannula system 100 to the distal most portion of the cannula system 100. Thus, the first lumen 202 can extend through the body 102 and the cannula 104. The first lumen 202 can generally be concentric with the centerline axis 300. The infusion fluid 119 provided via the second lumen 204, flows through the first lumen 202; hence the first lumen 202 is a common lumen for delivering infusion fluid 119 and transmitting light 109 of the LED 108 through the cannula 104. In an embodiment, the first lumen 202 can include a cross-sectional passageway that can be any geometric shape, for example, polygonal, oval, triangular, rectangular, or the like.
The first lumen 202 can provide an additional capability, which is that of an accessway for an incision instrument, not shown, from the proximal surface 114 to the outlet 118 of the cannula 104. The incision instrument or trocar can include a sharp distal tip that can facilitate cutting or puncturing the sclera 14 of the eye 10. The cannula 104 can pass through this incision into the vitreous cavity of the eye 10. The first lumen 202 can allow the trocar to be inserted through the cannula system 100, create the incision, and be removed from the cannula system 100 upon insertion of the cannula 104 into the eye 10. As described below in detail, the insertion of an independent trocar through the first lumen 202 may require access through the LED cavity 107. Thus, the LED 108 and any optical elements can be removed, or moved aside, prior to trocar insertion, then installed or inserted into the cannula system 100 after the cannula 104 is inserted into the eye 10.
The second lumen 204 can define a generally circular cross-sectional passageway extending from the infusion port 116, through the conduit 106, and meeting the first lumen 202 at a junction adjacent the centerline axis 300. The second lumen 204 can provide the passageway to deliver the infusion fluid 119 from the fluid source 120 into the first lumen 202, whereupon the fluid can provide a light transmittance medium for the light 109 emitted by the LED 108. The second lumen 204 and the conduit 106 can be sized to receive, or couple to, the fluid source tubing, not shown.
The fluid source tubing can generally have an internal diameter of between about 0.030 inches and about 0.125 inches, more preferably between about 0.050 inches and about 0.070 inches. Accordingly, the infusion port 116 can be sized to receive the tubing within the infusion port 116 internal diameter, or more preferably, to be received within the tubing internal diameter, thus having the tubing fit over the infusion port outer diameter. The second lumen 204 cross-section can generally have a diameter of between about 0.030 inches and about 0.125 inches, more preferably between about 0.050 inches and about 0.070 inches, as well. In an embodiment, the first lumen 202 can include a cross-sectional passageway that can be any geometric shape, for example, polygonal, oval, triangular, rectangular, or the like.
With reference to
In the illustrated embodiment of
With reference now to
With reference to
With reference to
The body 102 can further include a lens 304 located along centerline axis 300 and adjacent the LED cavity 107 such that the lens can be adjacent the LED 108 and the light 109 emitted from the LED 108. The lens 304 can be integrally molded into the body 102 during fabrication. In some embodiments, the lens 304 can be fabricated independently of the body 102 and assembled into the body 102. In some embodiments, the lens 304 can be fabricated as a part of an LED housing assembly and inserted, or installed, into the body 102 upon installation of the LED housing assembly.
The lens 304, as shown in
The body can be fabricated integrally with the conduit 106 and the cannula 104 to define a single piece cannula system 100. The body 102, and the cannula system 100 can be fabricated by injection molding to obtain the complex geometry and small form factor required for ophthalmic surgery and insertion into the eye 10. In some embodiments, the cannula system can be fabricated with more than one piece and can be assembled to make the cannula system 100. In some embodiments, any manufacturing method, e.g. machining, adhesive bonding, or the like, can be implemented to fabricate the cannula 104 and/or the cannula system 100.
The body 102, as shown in
The body 102 can generally have a round, or circular, periphery extending between the distal end 112 and the proximal end 114. The diameter of the periphery can be between about 0.030 inches and about 0.125 inches, more preferably between about 0.050 inches and about 0.070 inches. The body 102 can have a wall thickness between about 0.010 inches to 0.030 inches. The height, or length, along the centerline axis 300 of the body 102 can generally be between about 0.030 inches and about 0.125 inches, more preferably between about 0.050 inches and about 0.070 inches.
The cannula 104, as shown in
The cannula 104 can generally include a small form factor to facilitate insertion, function, and interoperability with the possible assortment of additional instruments required at or adjacent the surgical site. The cannula 104 can have a relatively much smaller cross-section normal to the centerline axis 300, as compared to the body 102. The cannula 104 can include a size of between about 35 gauge and about 15 gauge, more preferably between about 30 gauge and about 20 gauge, even more preferably a size of 25 gauge or 23 gauge or 20 gauge cannula. The cannula 104 can be longitudinally sized to have a length sufficient to penetrate and extend beyond the sclera 14 of the eyeball 10 and into the vitreous cavity, yet minimize the interference with surgical site requiring visual line of sight to the surgeon and physical access to the other various instruments to perform the ophthalmic surgery. The cannula 104 can have a length of between about 2.0 mm and about 10.0 mm, more preferably between about 2.0 mm and about 3.0 mm, and still more preferably between about 2.3 mm and about 2.7 mm. The cannula 104 can protrude beyond the sclera a length of between about 01.0 mm and about 10.0 mm, more preferably between about 01.0 mm and about 3.0 mm, and still more preferably between about 1.5 mm and about 2.5 mm.
With continued reference to
With continued reference to
The cannula system 100 can further include a conduit 106, illustrated in
With continued reference to
LED light sources used in/for embodiments of the present disclosure can provide various advantages. As they are based on electronic component design, LEDs are largely, if not entirely, immune from or resistant to system vibrations. LEDs can be protected from dirt and moisture, facilitating useful lifetimes that can increase to, or approach, thousands of hours, which is much higher than a non-LED light source. Further, LED-based light sources can operate at lower temperatures, and therefore have lower heat dissipation requirement, thereby eliminating complex heat sink systems commonly used for lighting techniques. Cost of a single LED system is exponentially less expensive than a standard light source system because of the simpler packaging. Additionally, LEDs are available in multiple colors/including high output efficiency.
As is known, LEDs are devices that convert electrical energy into optical energy. An LED is a semiconductor based diode, or device, including a p-doped region and a n-doped region. The principle behind an LED provides that as an electron in the conduction band recombines with a hole in the valence band, the electron makes a transition to a lower-lying energy state. This leads to the release of energy in an amount equal to the band-gap energy. In general, the energy is dissipated by phonons, i.e. heat, or photons, i.e. light. In an LED, this energy is directed into emitted light energy.
When an LED is stimulated electrically by a pulsed current or by a current produced in response to an applied voltage, electrons and hole carriers in the p-n junction recombine, emitting photons as an incoherent narrow spectrum of light. This phenomenon is termed electroluminescence, where the color, e.g. UV, Visible, or IR, of light depends on the type of the semiconductor materials used for the p-doped region and n-doped region. The optical power the LED emits can be dependent on the doping and/or the forward current through the diode interface. The frequency response of LED's are approximately 120 Hz and the light can be collimated with a lens system. Further details are provided in application Ser. No. 12/237,110 filed Sep. 24, 2008, the entirety of which is hereby incorporated by reference herein.
With continued reference to
The LED 108 parameters can provide intensity to the eye 10 of between about 4 lumens and about 25 lumens, more preferably between about 7 lumens and about 20 lumens. The wavelength of light transmitted to the eye 10, after being emitted from the LED and subsequently transmitted and conditioned through a window, filter, lens, or combination thereof, can be between about 400 nm and about 700 nm, more preferably between about 430 nm and about 660 nm. The beam size can be between about 0.2 mm and about 3.0 mm, more preferably between about 0.3 mm and about 1.4 mm, and more preferably between about 0.4 mm and about 1.0 mm. In an embodiment, the beam size is defined adjacent an optical element, such as lens 304, or the like.
The direct transmission of the LED 108 light source into the vitreous cavity of the eye 10 via the first lumen 202 and the transparent cannula 104 can advantageously minimize light transmission loss and can improve light intensity because of the adjacent positioning of the light source to the eye as compared to currently available fiber optic light systems. The use of a direct transmission LED eliminating a fiber optic line can also reduce the torque applied to the cannula system 100 by the appurtenant instruments, and can enable hands-free surgical illumination. In an embodiment, the self contained illuminated infusion cannula system 100 can reduce the number of incisions required, thereby allowing bimanual, or two ports, surgery. In an embodiment, the cannula system 100 can illuminate the eye with various colors and/or tints with and without combinational instruments. In some embodiments a fiber optic light source can be provided to augment the LED 108. In some embodiments, both a fiber optic light source and an LED may increase torque on the cannula system 100 which can be acceptable under certain conditions.
In an embodiment, the LED housing can be utilized to house an ultrasonic transducer, rather than an LED light source. The ultrasonic transducer can be implemented for treatment of the eye 10. For example, the transducer can be a high intensity focused ultrasound (HIFU) that can direct concentrated heat and/or vibration at tissue within the eye, or the transducer can be a high power focused ultrasound (HPFU) to transmit vibration across a larger area to emulsify tissue within the eye. The use of an ultrasonic transducer can be combined with any of the cannula system embodiments disclosed herein.
The power source 110 can comprise a separate power supply box from which electrical lines can be coupled to the LED 108 light source (
In the illustrated embodiment of
The body 624 can include a proximal end 612 and a protrusion 608 adjacent the proximal end 612. The protrusion 608 can be located substantially around the periphery of the body 624 to ensure a tight equally distributed load between the cap 600 and the body 624 when the cap 600 is located or snapped over the protrusion 608. In an embodiment, the protrusion 608 can include a plurality of independent protrusions spaced circumferentially about the periphery of the body 624.
The cap 600 can include a distal end 620 and a proximal end 622, as determined when the cap 600 is attached to the body 624. The cap 600 can further include a recess 610, a lens 614, an LED 616, and a lip 618. The LED 616 is located in a central portion of the proximal end 622, substantially aligned with a cap centerline axis 626. The lens 614 can be coupled to the cap adjacent the LED 616, also substantially aligned with a cap centerline axis 626.
The lip 618 can be configured to be placed around the body 624 protrusion 608, such that the cap 600 receives the body 624. The cap 600 and the body 624 can be coupled together, the axis 626 can be substantially coaxial with the body centerline axis 300 when the cap 600 and the body 624 are coupled. The recess 610 extends substantially around an internal cavity of the cap 600, the recess being shaped to receive and interface with the protrusion 608. The fit, or dimensional tolerancing, between the cap 600 and the body 624 is sufficiently tight that when the cap 600 is coupled to the body 624, a sufficient load is distributed across the interfacing surfaces to prevent fluid 119 leakage. In an embodiment, the cap 600 is configured to be received into the proximal end 612 of the body 624 to couple the body 624 and the cap 600 together.
The cap 600 can be hinged or coupled to the body 624 via at least a pair of arms 602, 604 that can be hingedly coupled to each other. The opposing ends of the arms 602, 604 can be hingedly coupled to the cap 600 and the body 624, respectively. The arms 602, 604, cap 600, and body 624 are coupled via hinges 606a-c, which can provide relative rotation between the hinged elements about the hinge. Other hinging configurations or embodiments are possible. The hinged coupling advantageously provides the convenience of containing the cap 600 adjacent the surgical site when the cap 600 is removed from the body 624 to insert the incision instrument, or trocar. Upon completing the incision, inserting the cannula 104 into the eye 10, and removing the trocar, the cap 600 can be rotated about the hinged arms and lockingly engaged onto the body 624. The arms 602, 604 can be removed, including destructively removed, from the cap 600 and body 624 to create an open work area about the surgical site and avoid inadvertent contact with the flexible hinge.
In the illustrated embodiment of
In the illustrated embodiment of
The cap extension 708 can locate the LED 616, and lens 614, if applicable, closer to the junction between the first lumen 706 and the second lumen 204. The chamber 704 can be shaped to receive the cap extension 708. Placement of the LED 616 closer to the cannula outlet 118 can reduce light losses and improve the light transmittance to the eye 10. The cap 600 having cap extension 708 can be coupled to the body 624 by flexible arm 702, hinged arms 602, 604, or a functionally equivalent hinging mechanism, device, or method.
In the illustrated embodiment of
The chamber 828, as illustrated in
In the illustrated embodiment of
The body 902 can include a distal end 908 and a proximal end 906. A first aperture 904 can be positioned adjacent the proximal surface at the proximal end 906. The first aperture 904 can open to a first lumen 1024 that extends the full length of the body 902 and the cannula 104. The second aperture 910 can define an opening into the body 902, the opening defining a chamber 912. The chamber 912 can be configured to receive an insert or LED tray/housing 916. The chamber 912 can include a tapered surface 1002 on a proximal surface of the chamber 912. The tapered surface 1002 can define a decreasing thickness, or longitudinal height, of the chamber 912 as the second aperture 910 extends further away from the opening of the second aperture 910. The decreasing height of the chamber 912 can define a wedge-like feature that lockingly receives a similarly shaped end of the insert or LED tray/housing 916. The wedge shape can force the insert 916 distally, creating downward forces, and can create a fluid seal between a bottom face 924 of the insert 916 and a distal surface of the chamber 912. In an embodiment, the sealing function can be provided by any acceptable means, for example, a tightly toleranced dimensional fit between the insert 916 and the chamber 912, a biologically compatible sealing material between the insert 916 and the chamber 912, e.g. a seal, a gasket, a viscous lubricant, or the like, or other suitable means.
The insert 916, as illustrated in
The body 902 and the insert 916 can be coupled by a pair of connector members 914. The connector members can provide for a single piece integrally molded assembly of the cannula system 900. Upon removal of the trocar from the cannula system, the connector members 914 can be decoupled at the insert 916. The surgeon can use instruments, such as a pair of forceps, to urge the insert 916 into the aperture 910 and chamber 912. The connector members 914 can provide an additional locking mechanism, in addition to the tapered wedge locking feature, to retain the insert 916 in the chamber 912. The locking mechanism of connector members 914 can also prevent removal of the insert 916 such that the cannula system 900 can only be a single use medical device system.
In the illustrated embodiment of
With reference to
With reference to
With reference to
In an embodiment of the cannula system illustrated in
In an embodiment of the cannula system illustrated in
The use of lenses to disperse a specific wavelength bandwidth can be combined with multiple LEDs for selective colorization and tint of an illuminated area. Independent LED power control can give the surgeon illumination options for various surgical procedure needs. The use of bandwidth limited wavelength light allows physicians to operate with improved contrast for visualization of specific structures in the eye. Additional features include controlling not only the intensity, but also the quality of the light, which is improved by changing the color, or color temperature, of the light from the light source via a filter device, with the light produced from one or more sources. Further details regarding these bandwidth limited light and light coloration modifying devices, systems, and methods for providing illumination are shown and described in U.S. Pat. No. 7,654,716 and in U.S. Publication 2009-0146583, and the entirety of both are incorporated by reference herein and form a part of this specification.
With reference to
With reference to
The LED position adjacent the first lumen 202 can direct the light transmitted from the LED across laterally through the first lumen 202 rather than distally toward the eye 10. The optical element 2108 can redirect, filter, magnify, or the like, the light 109 from the lateral direction to be directed distally through the first lumen 202 toward the eye 10. The optical element 2108 can be springingly coupled to a window 2118 defined by a thin transparent portion of the body 102 that can be positioned between the LED 2104 and the first lumen 202. The resilient spring-like, spring-loaded characteristic of the optical element 2108 can provide for temporary displacement of the optical element 2108 adjacent the sidewall of the first lumen 202 while the trocar is inserted through the first lumen 202. Thus, the optical element 2108, the first lumen 202, and the trocar can be sized such that the optical element and the trocar can movingly fit relative each other within the first lumen 202.
The LED 2104 position illustrated in
In the illustrated embodiment of
The position of the LEDs 2104 to the sides of the body 102 can also negate the need to move the LED(s) 2104 out of the first lumen 202 to provide a passage for the incision instrument or trocar 2114.
The multiple LEDs 2104 can include LEDs of various colors, such as blue, red, yellow, and white. The multiple LEDs 2104 of different colors can be provided on separate individual dies, or can include different color LEDs on a single die. These LED light sources can provide an optical signal/output for illumination in a band of specific wavelengths. The different sources, red, green, blue, white, etc., can be configured in a designated pattern for maximum light output efficiency. One of the advantages of using this configuration is that by controlling the current to the LED, the output light can be tuned to various intensities. This can allow for better safety, visualization, and illumination that is tunable to individual cases and surgeons. In addition, the variation in light of different spectrum from the outputs of the LEDs 2104 can allow for improved contrast ratios for surgical illumination.
In some embodiments, an illumination system can use multiple LED 2104 sources to provide increased flux strength for illumination. The multiple LEDs 2104 can be arranged in desired configurations about the first lumen 202, such as equally spaced circumferentially, hex, line, chandelier, or the like. The entire visible spectrum of the LED 2104 light source wavelength optical output is usable. Additionally, the optical intensities of the LEDs 2104 are easily tunable with the input current.
Light produced by the LEDs can be dispersed through the lens 2108. The lens 2108 can be made using any suitable materials and/or shapes. Further, any suitable configuration, e.g., thin film, Fabry-Perot, or the like, and/or material can be used for a filter applied to the light 109 dispersed from the LED 2104. One or more lenses can provide optional magnification, collimation, or focusing within the first lumen 202. Further details are provided in application Ser. No. 12/237,110, filed Sep. 24, 2008, incorporated by reference above.
With reference to
With reference to
With reference to
With reference to
The cannula system 2600 can further include the LED tray 2606, an LED 2614, and a resilient member, or spring 2610. In an embodiment, any suitable resilient material can be included in the cannula system 2600. The spring can be positioned to a lateral side adjacent the opening 2608. The opening 2608 can provide access to the LED tray 2606 and the spring 2610. The access through the opening 2608 can provide for the LED 2614 to be potted into the LED tray 2606. The chamber 2616 can receive the LED tray 2606, whereupon the LED tray 2606 can be urged to a lateral side against the resistance of spring 2610 and away from the first lumen 202 to allow the trocar 2612 to pass through the first lumen 202.
With continued reference to
In an embodiment, the LED tray 2606 can pivot about an end of the tray, rather than laterally slidable as described above. The tray can pivot about an end that is coupled to a portion of the chamber 2616. The free end, or any portion of the LED tray 2606, can be resiliently coupled to a portion of the chamber 2616. Accordingly, the LED tray 2606 can pivot into and out of the first lumen 202 with resilient resistance provided by a suitable resilient member or spring 2610. A trocar can be inserted and removed, urging aside and releasably positioning the LED tray 2606 adjacent the first lumen 202 in the process. The LED tray 2606 can be configured to pivot in any suitable direction that can place the LED tray adjacent the first lumen 202 for directing the light 109 out through cannula 104, e.g., laterally, axially, or the like. Accordingly, the LED tray can be configured to move from a normal, at rest, first position to a second position as the trocar is inserted into the first lumen 202, thereby allowing the trocar to pass through the lumen 202. When in the first position, the LED tray 2606 can be urged into a lateral position or a position that is perpendicular to the longitudinal axis of the lumen 202. In an embodiment, the LED tray 2606 forms a seal with the side walls of the lumen 202. To further ensure a tight seal, the side walls of the lumen 202 can have a lip to interface with the LED tray 2606. In an embodiment, the LED tray 2606 is positioned above the second lumen 204, thereby allowing the force of the entering infusion fluid to further push or urge the LED tray 2606 upward or proximally to form a tighter seal to prevent fluid from exiting the body 2602.
The above described details are combined and configured to provide a self contained illuminated infusion cannula that can readily positions, and is capable of readily repositioning, a medical implant at a desired location within a patient. The sclera incision, cannula insertion, incision instrument removal, and light transmittance to the vitreous cavity of the eye 10 is described with reference to
The cannula system 2600 can include assembling the LED 2614 into the LED tray 2606. The LED 2614 can be coupled to the tray 2606 by potting the LED into an LED cavity within the tray, and locating the LED adjacent a transparent window for transmitting light 109 through the first lumen 202. Assembling the cannula system 2600 can include placing a trocar 2612 and extending it through, and out, the distal end of the cannula 104. The inserting of the trocar through the cannula 104 and thus, the first lumen 202, advantageously urges the LED tray 2606, laterally moving the tray 2606 in the direction toward and against the resilience of the spring 2610.
The sharpened tip of the trocar 2612 can be aligned with the desired incision, or insertion, location on the sclera 14 of the eye 10 that is suitable to illuminate the surgical site within the vitreous cavity. Locating the cannula 104 and the trocar 2612 adjacent and substantially normal, or any suitable angle of entry for the trocar 2612, the cannula 104 and body 2602 is statically positioned. Urging the trocar 2612 through the statically positioned body 2602 and cannula 104, the sharpened distal tip of the trocar 2612 penetrates the sclera, creating a suitable passage for the cannula 104. The trocar can then be held statically positioned in the course of urging the body 2602 toward the outer surface of the sclera and concurrently urging the cannula 104 through the incision created by the trocar 2612. The cannula 104 slides distally about the statically positioned trocar 2612. The elastic nature of the sclera 14 forms a sealing engagement about the cannula 104 to prevent leakage of vitreous fluid, infusion fluid, or the like.
The trocar 2612 can be removed from the cannula system 2600 by proximally urging and sliding the trocar outward away from the eye 10 and out of the first lumen 202. Removing the trocar 2612 allows the LED tray 2606 to releasably and slidably enter the chamber 2616. The resiliency of the spring 2610 is configured to laterally move or suitably position the LED light transmittance portion over, or adjacent, the first lumen 202.
Urging of the LED tray 2606 into the wedge receiving geometry of the chamber 2616 generates fluid sealing downward forces between the LED tray 2606 and the distal surfaces of the chamber 2616. The opening 2608 provides access to supply additional locating loads against the LED tray 2606 to assist the spring 2610 and facilitate suitable location of the LED 2614 about the first lumen 202. The cannula 104 can be adjusted by positioning the cannula system into a suitable arrangement and orientation adjacent the outer surface of the sclera 14 as well as in the vitreous cavity of the eye 10.
Providing power to the LED transmits light 109 out of the LED 2614 and the LED tray 2606. The light 109 is transmitted, or permitted to pass, distally through the first lumen 202 into the vitreous cavity of the eye 10. Modifying the power source provided to the LED 2614 can vary the light transmittance to the surgical site according to a suitable illumination within the vitreous cavity and adjacent the eye 10.
Body 2712 also includes an infusion port 2714 for receiving fluid to be delivered to a surgical site through lumen 2706. Also, shown is a power source 2716 contained within the body 2712 for powering light source 2710. It is also possible with advances in LED technology that light source 2710 may be placed at distal end 2718 of cannula 2708 and still allow infusion fluid to flow to a surgical site through lumen 2706. If light source 2710 is placed at distal end 2718, an electrical connection may extend through lumen 2706, instead of fiber optic 2702, and connect to power source 2716 or to a remote power source connection (not shown).
In some embodiments, the systems, processes, and methods described above are implemented using a computing system, such as the one shown in
The computer system 2802 includes an illumination and infusion control module 2814 that carries out the functions, methods, acts, and/or processes described herein. The illumination and infusion control module 2814 is executed on the computer system 2802 by a central processing unit 2810 discussed further below.
In general the word “module,” as used herein, refers to logic embodied in hardware or firmware or to a collection of software instructions, having entry and exit points. Modules are written in a program language, such as JAVA, C or C++, or the like. Software modules may be compiled or linked into an executable program, installed in a dynamic link library, or may be written in an interpreted language such as BASIC letters, PERL, LUA, or Python. Software modules may be called from other modules or from themselves, and/or may be invoked in response to detected events or interruptions. Modules implemented in hardware include connected logic units such as gates and flip-flops, and/or may include programmable units, such as programmable gate arrays or processors.
Generally, the modules described herein refer to logical modules that may be combined with other modules or divided into sub-modules despite their physical organization or storage. The modules are executed by one or more computing systems, and may be stored on or within any suitable computer readable medium, or implemented in-whole or in-part within special designed hardware or firmware. Not all calculations, analysis, and/or optimization require the use of computer systems, though any of the above-described methods, calculations, processes, or analyses may be facilitated through the use of computers. Further, in some embodiments, process blocks described herein may be altered, rearranged, combined, and/or omitted.
Computing System ComponentsThe computer system 2802 includes one or more processing units (CPU) 2810, which may include a microprocessor. The computer system 2802 further includes a memory 2812, such as random access memory (RAM) for temporary storage of information, a read only memory (ROM) for permanent storage of information, and a mass storage device 2804, such as a hard drive, diskette, or optical media storage device. Alternatively, the mass storage device may be implemented in an array of servers. Typically, the components of the computer system 2802 are connected to the computer using a standards based bus system. The bus system can be implemented using various protocols, such as Peripheral Component Interconnect (PCI), Micro Channel, SCSI, Industrial Standard Architecture (ISA) and Extended ISA (EISA) architectures.
The computer system 2802 includes one or more input/output (I/O) devices and interfaces 2808, such as a keyboard, mouse, touch pad, and printer. The I/O devices and interfaces 2808 can include one or more display devices, such as a monitor, that allows the visual presentation of data to a user. More particularly, a display device provides for the presentation of GUIs as application software data, and multi-media presentations, for example. The I/O devices and interfaces 2808 can also provide a communications interface to various external devices. The computer system 2802 may include one or more multi-media devices 2806, such as speakers, video cards, graphics accelerators, and microphones, for example.
Computing System Device/Operating SystemThe computer system 2802 may run on a variety of computing devices, such as a server, a Windows server, and Structure Query Language server, a Unix Server, a personal computer, a laptop computer, and so forth. In other embodiments, the computer system 2802 may run on a mainframe computer suitable for controlling and/or communicating with large databases, performing high volume transaction processing, and generating reports from large databases. The computing system 2802 is generally controlled and coordinated by an operating system software, such as z/OS, Windows 95, Windows 98, Windows NT, Windows 2000, Windows XP, Windows Vista, Windows 7, Lenox, BSD, SunOS, Solaris, or other compatible operating systems, including proprietary operating systems. Operating systems control and schedule computer processes for execution, perform memory management, provide file system, networking, and I/O services, and provide a user interface, such as a graphical user interface (GUI), among other things.
NetworkThe computer system 2802 illustrated in
The browser module or other output module may be implemented as a combination of an all-points addressable display such as a cathode ray tube (CRT), a liquid crystal display (LCD), a plasma display, or other types and/or combinations of displays. The output module may be implemented to communicate with input devices 2808 and they also include software with the appropriate interfaces which allow a user to access data through the use of stylized screen elements, such as menus, windows, dialogue boxes, tool bars, and controls (e.g., radio buttons, check boxes, sliding scales, and so forth). Furthermore, the output module may communicate with a set of input and output devices to receive signals from the user.
Other SystemsThe computing system 2802 may include one or more internal and/or external data sources (e.g., data sources 2822). In some embodiments, one or more of the data repositories and the data sources described above may be implemented using a relational database, such as DB2, Sybase, Oracle, CodeBase, and Microsoft® SQL Server as well as other types of databases such as a flat-file database, an entity relationship database, and object-oriented database, and/or a record-based database.
The computer system 2802 as shown in
The computer system 2802 also accesses one or more consumer verification databases. The consumer verification databases may be stored in a database or data repository. The computer system 2802 may access the one or more consumer verification databases through a network 2818 or may directly access the database or data repository through I/O devices and interfaces 2808. The data repository storing the one or more consumer verification databases may reside within the computer system 2802.
ADDITIONAL EMBODIMENTSConditional language, such as, among others, “can,” “could,” “might,” or “may,” unless specifically stated otherwise, or otherwise understood within the context as used, is generally intended to convey that certain embodiments include, while other embodiments do not include, certain features, elements and/or steps. Thus, such conditional language is not generally intended to imply that features, elements and/or steps are in any way required for one or more embodiments or that one or more embodiments necessarily include logic for deciding, with or without user input or prompting, whether these features, elements and/or steps are included or are to be performed in any particular embodiment.
The embodiments discussed above have been discussed in detail in connection with specific designs. It is to be understood, however, that skilled artisans will be able to implement inventive features by employing structures that may differ from the specific structures described above. Applicants in no way intend for the scope of the inventive features discussed herein to be limited to the specific structure used in certain embodiments. For example, the illustrated cannula system can provide illumination to arthroscopic or endoscopic procedures.
Although this invention has been disclosed in the context of certain preferred embodiments and examples, it will be understood by those skilled in the art that the present invention extends beyond the specifically disclosed embodiments to other alternative embodiments and/or uses of the invention and obvious modifications and equivalents thereof. In addition, while a number of variations of the invention have been shown and described in detail, other modifications, which are within the scope of this invention, will be readily apparent to those of skill in the art based upon this disclosure, for example, the arrangement and combination of LED light sources and optical elements can be any suitable arrangement sufficient to illuminate the vitreous cavity, or any other applicable body cavity. It is also contemplated that various combinations or subcombinations of the specific features and aspects of the embodiments may be made and still fall within the scope of the invention. Accordingly, it should be understood that various features and aspects of the disclosed embodiments can be combined with or substituted for one another in order to form varying modes of the disclosed invention. Thus, it is intended that the scope of the present invention herein disclosed should not be limited by the particular disclosed embodiments described above, but should be determined only by a fair reading of the claims that follow.
Claims
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25. A cannula system comprising:
- a body comprising a surface configured to be placed on a sclera of an eye;
- a white light emitting diode system contained within the body;
- a conduit coupled to the body, the conduit comprising an infusion port;
- a transparent cannula coupled to the body and extending from the surface, the cannula comprising: a distal end comprising an outlet, and a plurality of optical elements longitudinally spaced along the cannula and proximal to the distal end, each of the plurality of optical elements extending circumferentially around at least a portion of the cannula; and
- a lumen configured to transmit the white light from the light emitting diode system out of the outlet and to deliver fluid from the infusion port out of the outlet,
- the plurality of optical elements configured to disperse the white light at angles,
- at least some of the angles being the same or at least some of the angles being different.
26. The cannula system of claim 25, wherein the plurality of optical elements comprises at least one of a prism, a lens, and a filter.
27. The cannula system of claim 25, wherein the cannula comprises a plurality of fluid apertures proximal to the outlet.
28. The cannula system of claim 25, wherein the plurality of optical elements is configured to selectively disperse wavelengths of the white light and energy associated with the wavelengths.
29. A cannula system comprising:
- a housing comprising a surface configured to be placed adjacent to or on a surface of an eye;
- a light system in the housing, the light system configured to generate white light;
- a conduit coupled to the housing, the conduit comprising an infusion port;
- a cannula coupled to the housing, the cannula comprising an outlet and an optical element configured to selectively disperse wavelengths of the white light and energy associated with the wavelengths; and
- a lumen configured to deliver fluid from the infusion port out of the outlet and at least a portion of the lumen configured to transmit the white light out of the outlet.
30. The cannula system of claim 29, wherein the optical element comprises at least one of a prism, a lens, and a filter.
31. The cannula system of claim 29, wherein the optical element is configured to collimate the selectively dispersed wavelengths.
32. The cannula system of claim 29, wherein a plurality of optical elements comprises the optical element.
33. The cannula system of claim 29, wherein the optical element is located at the outlet.
34. The cannula system of claim 29, wherein the cannula comprises a plurality of fluid apertures between the surface of the housing and the outlet.
35. The cannula system of claim 29, wherein at least a portion of the cannula comprises a phosphorescent material.
36. A cannula system comprising:
- a housing;
- a light source;
- an infusion port;
- an elongate member extending from the housing, the elongate member comprising a distal end comprising an outlet; and
- an optical element,
- a channel in fluid communication with the infusion port and the outlet, and at least a portion of the channel in optical communication with the light source and the outlet.
37. The cannula system of claim 36, wherein the optical element comprises a prism.
38. The cannula system of claim 36, wherein the optical element comprises a lens.
39. The cannula system of claim 36, wherein the optical element comprises a filter.
40. The cannula system of claim 36, wherein the optical element is configured to disperse the light at a predetermined angle.
41. The cannula system of claim 36, wherein the optical element is configured to selectively disperse wavelengths of the light and energy associated with the wavelengths.
42. The cannula system of claim 42, wherein the optical element is configured to collimate the selectively dispersed wavelengths.
43. The cannula system of claim 36, wherein a plurality of optical elements comprises the optical element and wherein the optical elements of the plurality of optical elements are longitudinally spaced along the elongate member.
44. The cannula system of claim 44, wherein the optical elements of the plurality of optical elements are configured to disperse the light at angles, wherein at least some of the angles are the same or wherein at least some of the angles are different.
45. The cannula system of claim 36, wherein the optical element is located at the outlet.
46. The cannula system of claim 36, wherein the elongate member comprises a fluid aperture between the housing and the outlet.
47. The cannula system of claim 36, wherein at least a portion of the elongate member comprises a phosphorescent material.
48. The cannula system of claim 36, wherein the light source comprises a light system configured to generate white light.
Type: Application
Filed: Jun 8, 2015
Publication Date: Sep 24, 2015
Inventors: Prashant Bhadri (Pico Rivera, CA), Ralph Kerns (Laguna Niguel, CA), Jaw-Chyng Lue (San Gabriel, CA), Matthew McCormick (Yucaipa, CA), Mark Humayun (Glendale, CA)
Application Number: 14/733,597