Abstract:
An ophthalmic surgical system for filling a syringe with a retinal tamponading gas is disclosed. The system includes a surgical console having a user interface, a computer, first and second bottles containing pressurized retinal tamponading gases, and a port for fluidly coupling to an automatic gas filling consumable including a syringe. A user selects a particular retinal tamponading gas via the user interface, and the system fills the syringe.

Description:
This application is a divisional of U.S. application Ser. No. 11/855,198 filed on Sep. 14, 2007 which claims the priority of U.S. Provisional Application Ser. No. 60/845,387 filed on Sep. 18, 2006. 
    
    
     FIELD OF THE INVENTION 
     The present invention generally pertains to vitreoretinal surgery and more particularly to improved systems for helping to perform fluid exchanges typically used in such surgeries. 
     DESCRIPTION OF THE RELATED ART 
     In a healthy human eye, the retina is physically attached to the choroid in a generally circumferential manner behind the pars plana. The vitreous humor, a transparent jelly-like material that fills the posterior segment of the eye, helps to cause the remainder of the retina to lie against, but not physically attach, to the choroid. 
     Sometimes a portion of the retina becomes detached from the choroid. Other times a portion of the retina may tear, allowing vitreous humor, and sometimes aqueous humor, to flow between the retina and the choroid, creating a build up of subretinal fluid. Both of these conditions result in a loss of vision. 
     To surgically repair these conditions, a surgeon typically inserts a vitrectomy probe into the posterior segment of the eye via a scleratomy, an incision through the sclera at the pars plana. The surgeon typically also inserts a fiber optic light source and an infusion cannula into the eye via similar incisions, and may sometimes substitute an aspiration probe for the vitrectomy probe. While viewing the posterior segment under a microscope and with the aid of the fiber optic light source, the surgeon cuts and aspirates away vitreous using the vitrectomy probe to gain access to the retinal detachment or tear. The surgeon may also use the vitrectomy probe, scissors, a pick, and/or forceps to remove any membrane that has contributed to the retinal detachment or tear. During this portion of the surgery, a saline solution is typically infused into the eye via the infusion cannula to maintain the appropriate intraocular pressure. 
     Next, the surgeon must manipulate the detached or torn portion of the retina to flatten against the choroid in the proper location. A soft tip cannula, forceps, or pick is typically utilized for such manipulation. Many surgeons also inject perfluorocarbon liquid as a retinal tamponading fluid into the posterior segment of the eye while aspirating the saline solution in the posterior segment to help cause the detached or torn portion of the retina to flatten against the choroid in the proper location. This procedure is typically referred to as a “fluid/perfluorocarbon” exchange. Other surgeons inject air as a retinal tamponading fluid into the posterior segment of the eye while aspirating the saline solution. This procedure is typically referred to as a “fluid/air” exchange. Finally, other surgeons inject a mixture of air and a gas such as SF 6 , C 3 F 8 , or C 2 F 6  as a retinal tamponading fluid into the posterior segment of the eye while aspirating the saline solution. This procedure is typically referred to as a “fluid/gas” exchange. As used herein, a “fluid” may include any liquid or gas that is suitable for use in the eye, including, but not limited to, saline solution with or without additives, silicone oil, a perfluorocarbon liquid, air, or a perfluorocarbon gas. The fluid exchange process is most typically performed by using a syringe filled with gas. 
     The process of filling the syringe with gas is currently time consuming. The process of filling the syringe with gas is a two person activity, requiring one person to be sterile, and one person not to be sterile. Often times, the coordination of activity between the two individuals results in the loss of gas and a waste of time, and, possibly, the violation of the sterile field. 
     As a result, a need still exists in vitreoretinal surgery for an improved system for helping to fill syringes with gas to be used in a fluid/gas exchange. The system should allow a scrub nurse to fill the gas syringe single handed, allow the nurse to maintain the integrity of the sterile field, eliminate the waste of expensive gas, provide early warning when gas bottles are depleted, and eliminate time lost as a result of mistakes. 
     SUMMARY OF THE INVENTION 
     In one aspect, the present invention is an ophthalmic surgical system for filling a syringe with a retinal tamponading gas. The system includes a surgical console having a user interface, a computer, first and second bottles containing pressurized retinal tamponading gases, and a port for fluidly coupling to an automatic gas filling consumable including a syringe. A user selects a particular retinal tamponading gas via the user interface, and the system fills the syringe. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       For a more complete understanding of the present invention, and for further objects and advantages thereof, reference is made to the following description taken in conjunction with the accompanying drawing in which  FIG. 1  is a schematic view of a surgical system including an automatic gas filling module and an automatic gas filling consumable. 
     
    
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS 
     The preferred embodiments of the present invention and their advantages are best understood by referring to  FIG. 1  of the drawings. Surgical system  10  generally includes a surgical console  11  and an automatic gas filling consumable  26 . Surgical system  10  is preferably an ophthalmic surgical system. 
     Surgical console  11  preferably includes a pressurized gas bottle  12  having an integral valve  16  and regulator  20 , a pressurized gas bottle  14  having an integral valve  18  and regulator  22 , an automatic gas filling module  24  having an automatic gas filling port  34 , a microprocessor  98  electrically coupled to automatic gas filling module  24  via an interface  99 , a graphical user interface  100  electrically coupled to microprocessor  98  via interface  101 , and a pressurized air line  102  capable of providing pressurized air in a proportional manner. Pressurized gas bottle  12  preferably holds a first retinal tamponading gas such as, by way of example, C 3 F 8 . Pressurized gas bottle  14  preferably holds a second retinal tamponading gas such as, by way of example, SF 6 . Gas bottles  12  and  14 , valves  16  and  18 , and regulators  20  and  22  are fluidly coupled with automatic gas filling module  24  via connection points  30  and  32 . Likewise, automatic gas filling module  24  is fluidly coupled with automatic gas filling consumable  26  via automatic gas filling port  34 . 
     Automatic gas filling module  24  preferably includes shutoff valves  50  and  52 , each of which is fluidly coupled with a regulator  54 . Regulator  54  is fluidly coupled to timing valve  56 . A pair of pressure transducers  60  and  62  are positioned on either side of regulator  54  to monitor gas pressure and flow. Alternatively, pressure transducer  60  may be positioned between regulator  54  and transducer  62 . Pressurized air line  102  is fluidly coupled to automatic gas filling module  24  via connection point  66 , and is also fluidly coupled with timing valve  56  via a gas line  64 . A gas line  68  fluidly couples timing valve  56  and automatic gas filling port  34 . A gas line  65  fluidly couples gas line  64  and automatic gas filling port  34  via timing valve  56 . Alternatively, timing valve  56  may be eliminated, and a shutoff valve (not shown) may be included on pressurized air line  102  instead. 
     Automatic gas filling consumable  26  preferably includes a check valve  80  fluidly coupled to automatic gas filling port  34  via gas line  68 . A relief valve  82  is fluidly coupled with gas line  68  via a gas line  90 . Gas line  68  also fluidly couples filter  84 , stop cock  86 , filter  88 , and a distal end  89  of a syringe  104 . Pressurized air line  102  is fluidly coupled to an end cap  108  of syringe  104  via gas lines  64  and  65 . 
     Gas bottles  12  and  14  are installed in console  11  with valves  16  and  18  open, and with regulators  20  and  22  pre-set. During operation, a scrub nurse will insert a sterile automatic gas filling consumable  26  into automatic gas filling port  34  on automatic gas filling module  24 . Preferably, an RFID tag  200  on consumable  26  will be read by an RFID receiver  202  within surgical console  11 . RFID receiver  202  is electrically coupled to microprocessor  98  via an interface  204 . Surgical console  11  will thus detect that consumable  26  is an automatic gas filling consumable, and will populate the graphical user interface  100  appropriately. Alternatively, population of graphical user interface  100  may be performed manually in the event that RFID is not available. 
     Using graphical user interface  100 , the scrub nurse will then select the retinal tamponading gas to be used and initiate the automatic gas filling process. At this point, depending on the retinal tamponading gas selected, microprocessor  98  opens one of gas shutoff valves  50  or  52 . Regulator  54  will regulate the gas to a preset pressure that will flow to timing valve  56 . Pressure transducers  60  and  62  will be monitored to verify that sufficient gas pressure and flow are available (i.e. that the readings in pressure transducers  60  and/or  62  are at or near the set point of regulator  54 ). In the event that sufficient gas pressure and flow are not available, microprocessor  98  will signal the scrub nurse via graphical user interface  100  that the active gas bottle  12  or  14  needs to be replaced. 
     Next, timing valve  56  will be energized, and retinal tamponading gas will flow through automatic gas filling port  34  into automatic gas filling consumable  26 , and into distal end  89  of syringe  104 . Gas pressure will overcome the friction of a stopper  106  within syringe  104 , and stopper  106  will travel toward end cap  108 , filling syringe  104  with retinal tamponading gas. Pressurized air within pressurized air line  102  will be vented to atmosphere during this process. 
     Timing valve  56  will then be closed and pressurized air from pressurized air line  102  will be supplied to end cap  108  of syringe  104 , overcoming the friction of stopper  106  and allowing retinal tamponading gas to flow through syringe  104 , filter  88 , stop cock  86 , and filter  84 . Relief valve  82  is overcome so that retinal tamponading gas is vented to atmosphere. Microprocessor  98  repeats this cycle of introducing gas to syringe  104 , and purging gas from syringe  104 , a sufficient number of times until the concentration of retinal tamponading gas within syringe  104  is at or near 100%. In the embodiment where timing valve  56  is not utilized, microprocessor  98  controls the opening, closing, and cycling of (a) either shutoff valve  50  or  52  and (b) the shutoff valve on pressurized air line  102  in a manner similar to that described above. 
     The scrub nurse will then remove end cap  108  from syringe  104  and will install a plunger (not shown) into syringe  104 . The scrub nurse then closes stop cock  86  and disconnects consumable  26  from surgical console  11  at section A. Gas filled syringe  104  is then presented to the surgeon for final mixing and administration. The portion of automatic gas filling consumable  26  that remains on console  11  will be removed and discarded when the case is complete. 
     From the above, it may be appreciated that the present invention provides improved apparatus and methods for helping to fill a syringe with gas and helping to perform fluid/gas exchanges in vitreoretinal surgery. The system allows a scrub nurse to fill a gas syringe single handed, allows the nurse to maintain the integrity of the sterile field, eliminates the waste of expensive gas, provides an early warning when gas bottles are near depleted, and saves time lost due to mistakes. 
     It is believed that the operation and construction of the present invention will be apparent from the foregoing description. While the apparatus and methods shown or described above have been characterized as being preferred, various changes and modifications may be made therein without departing from the spirit and scope of the invention as defined in the following claims.