Patent Publication Number: US-2016220267-A1

Title: Multi-plane surgical incision guide

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     This Application is a continuation of prior application Ser. No. 13/572,349 filed Aug. 10, 2012. 
    
    
     FIELD OF THE INVENTION 
     The present disclosure relates to a surgical instrument, and, more particularly, to a surgical instrument for making surgical incisions. 
     BACKGROUND OF THE INVENTION 
     Some surgical procedures require a surgical instrument with an extremely sharp blade. In order to create very precise incisions in a tissue that is difficult to cut due to, e.g., the tissue&#39;s biological composition, it is important for a surgeon to have an instrument with an extremely sharp blade. For example, eye surgeons may need to cut a patient&#39;s cornea during various surgical procedures, e.g., a common cataract surgery. If a patient&#39;s cornea is not cut with an extremely sharp blade, then the force required to make an incision in the patient&#39;s cornea with a less than extremely sharp blade may cause the corneal surface to indent before the less than extremely sharp blade pierces the patient&#39;s cornea. The corneal surface indentation creates a non-uniform surgical incision which prevents the cornea tissue from healing in a natural position. Rather, the cornea tissue heals in an aspherical position with an imprecise optical surface, e.g., resulting in a corneal astigmatism. 
     Unfortunately, surgical instruments with extremely sharp blades present an inherent risk of injury to professionals involved in the packaging, shipping, handling, and use of the surgical instruments for surgical procedures. Although any sharp edge may be capable of causing injury if mishandled, extremely sharp blades can cause significant trauma with very little force. If a small amount of force applied to a conventional blade against a person&#39;s tissue may cause a superficial incision in the person&#39;s tissue, then the same small amount of force applied to an extremely sharp blade against the person&#39;s tissue may be capable of inflicting a deep and serious wound. Thus, there is a need for a surgical instrument with an extremely sharp blade that minimizes the risk of injury to individuals involved in the packaging, shipping, handling, and use of the surgical instrument for surgical procedures. 
     Although extremely sharp blades may facilitate a surgeon&#39;s ability to create precise, uniform surgical incisions, there is still a risk that an incision performed with an extremely sharp blade may heal improperly. For example, severed edges of tissue may heal unevenly unless sutures are used to hold the severed edges in a natural position. Unfortunately, suturing delicate tissue may pose additional risks to a patient. However, a surgeon may attempt a multi-plane incision to ensure that a surgical incision heals properly. A surgeon may perform a multi-plane incision by initially penetrating a tissue to a first depth with a blade oriented at a first angle relative to the tissue and then penetrating the tissue to a second depth with the blade oriented at a second angle relative to the tissue. A successful multi-plane incision increases the total surface area of the tissue severed by a surgical blade and also creates a surgical geometry in each side of the tissue severed by the surgical blade wherein two sides of the tissue may only be reunited and heal in a single position, i.e., a natural position. 
     Unfortunately, multi-plane surgical incision procedures are difficult for a surgeon to perform accurately. Additionally, it is difficult for a surgeon to repeat an accurate multi-plane incision with precision. Thus, there is a need for a surgical instrument with a surgical incision guide configured to allow surgeons to perform accurate and repeatable multi-plane surgical incisions. 
     BRIEF SUMMARY OF THE INVENTION 
     The present disclosure provides a surgical instrument handle for selectively actuating a surgical blade. Illustratively, the surgical blade may comprise a surgical incision guide configured to guide a surgical incision. In one or more illustrative embodiments, a surgical instrument handle may selectively actuate a surgical blade between a safe position wherein the surgical blade is contained within an outer sleeve and an extended position wherein the surgical blade is at least partially extended from a distal end of the outer sleeve. Illustratively, a surgeon or a surgeon&#39;s assistant may receive a surgical instrument handle for selectively actuating a surgical blade in a safe position wherein the surgical blade is contained within an outer sleeve. The surgeon or the surgeon&#39;s assistant may then selectively actuate the surgical blade from the safe position to an extended position wherein the surgical blade is at least partially extended from a distal end of the outer sleeve. After completion of all or a portion of a surgical procedure, the surgeon or the surgeon&#39;s assistant may then selectively actuate the surgical blade from the extended position to the safe position. 
     In one or more embodiments, a surgical instrument may comprise an outer sleeve, an inner handle configured to actuate relative to the outer sleeve, a surgical blade fixed to a distal end of the inner handle, and a detent configured to selectively fix a position of the inner handle relative to the outer sleeve. Illustratively, the surgical instrument may be selectively actuated between a first position of the inner handle relative to the outer sleeve and a second position of the inner handle relative to the outer sleeve. In the first position, the surgical blade may be contained within the outer sleeve. In the second position, the surgical blade may be at least partially extended from a distal end of the outer sleeve for use in a surgical procedure. In one or more embodiments, the surgical blade may comprise a surgical incision guide configured to guide a surgical incision. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The above and further advantages of the present invention may be better understood by referring to the following description in conjunction with the accompanying drawings in which like reference numerals indicate identical or functionally similar elements: 
         FIGS. 1A and 1B  are schematic diagrams illustrating a surgical blade; 
         FIGS. 2A, 2B, and 2C  are schematic diagrams of an outer sleeve; 
         FIG. 3  is a schematic diagram of an inner handle; 
         FIG. 4  is a schematic diagram of an exploded view of a surgical instrument handle; 
         FIG. 5  is a schematic diagram illustrating a surgical blade in a safe position; 
         FIG. 6  is a schematic diagram illustrating a surgical blade in a surgical position; 
         FIGS. 7A, 7B, 7C, 7D, 7E, 7F, and 7G  are schematic diagrams illustrating an actuation of a surgical blade from a first fixed position to a second fixed position; 
         FIGS. 8A, 8B, 8C, 8D, 8E, 8F, and 8G  are schematic diagrams illustrating an actuation of a surgical blade from a second fixed position to a first fixed position; 
         FIGS. 9A, 9B, and 9C  are schematic diagrams illustrating a surgical blade; 
         FIGS. 10A and 10B  are schematic diagrams illustrating a surgical blade. 
     
    
    
     DETAILED DESCRIPTION OF AN ILLUSTRATIVE EMBODIMENT 
       FIGS. 1A and 1B  are schematic diagrams illustrating a surgical blade  100 .  FIG. 1A  illustrates a top view, a side view, and a bottom view of surgical blade  100 .  FIG. 1B  illustrates a side view and a top view of surgical blade  100 . In one or more embodiments, surgical blade  100  may comprise a blade mount  110  and a blade  120 . Illustratively, blade mount  110  is configured to support blade  120 . Blade mount  110  comprises a blade mount distal end  111  and a blade mount proximal end  112 . In one or more embodiments, blade mount  110  may be configured to orient blade  120  at an angle  130 , e.g., for making surgical incisions. Blade mount  110  may be manufactured from any suitable material, e.g., polymers, metals, metal alloys, etc., or from any combination of suitable materials. 
     Illustratively, blade  120  may be configured to make surgical incisions. Blade  120  comprises a blade distal end  121 , a blade proximal end  122 , and at least one blade edge  123 . In one or more embodiments, blade proximal end  122  interfaces with blade mount distal end  111 . Blade  120  may be manufactured from any suitable material, e.g., sapphire, diamond, silicon, polymers, metals, metal alloys, etc., or from any combination of suitable materials. 
       FIGS. 2A, 2B, and 2C  are schematic diagrams of an outer sleeve  200 .  FIG. 2A  illustrates a top view, a side view, and a bottom view of outer sleeve  200 . In one or more embodiments, outer sleeve  200  may comprise an outer sleeve distal end  201 , an outer sleeve proximal end  202 , an ergonomic surgical safety grip  210 , and an actuation guide  220 . Illustratively, ergonomic surgical safety grip  210  may be configured to prevent undesirable movements of surgical blade  100  during a surgical procedure. For example, ergonomic surgical safety grip  210  may be configured to prevent unintentional movements of surgical blade  100  before a surgical procedure, during a surgical procedure, and after a surgical procedure. 
     In one or more embodiments, ergonomic surgical safety grip  210  may comprise one or more grip points  211 . Illustratively, grip points  211  may be configured to conform to a surgeon&#39;s finger tips. In one or more embodiments, grip points  211  may be configured to increase a total contact area between a surgeon&#39;s finger tips and ergonomic surgical safety grip  210 . Illustratively, grip points  211  may be manufactured as one or more indents in outer sleeve  200 , e.g., to increase a total contact area between a surgeon&#39;s finger tips and ergonomic surgical safety grip  210 . In one or more embodiments, grip points  211  may be manufactured as one or more apertures in outer sleeve  200 . Illustratively, ergonomic surgical safety grip  210  may comprise a sleeve configured to fit over outer sleeve  200 . Ergonomic surgical safety grip  210  may be manufactured from any suitable material, e.g., polymers, metals, metal alloys, etc., or from any combination of suitable materials. 
     Illustratively, actuation guide  220  may be configured to guide an actuation of surgical blade  100 . In one or more embodiments, actuation guide  220  may comprise a distal detent  221 , a proximal detent  222 , and an actuation channel  225 . Actuation channel  225  may comprise an actuation channel distal end  226  and an actuation channel proximal end  227 . Illustratively, an actuation pin  230  may be configured to actuate in conjunction with surgical blade  100 . In one or more embodiments, distal detent  221  may be configured to temporarily fix actuation pin  230  in a distal position in actuation guide  220 , and proximal detent  222  may be configured to temporarily fix actuation pin  230  in a proximal position in actuation guide  220 . Illustratively, actuation channel  225  may be configured to allow actuation pin  230  to actuate between a distal position and a proximal position in actuation guide  220 . For example, actuation channel  225  may be configured to allow actuation pin  230  to actuate between actuation channel proximal end  227  and actuation channel distal end  226 . In one or more embodiments, actuation pin  230  may be accessed, e.g., for replacement, repair, etc., via an actuation pin access port  240 . 
       FIG. 2B  illustrates a view of a cross-section of outer sleeve  200 . In one or more embodiments, an interior of outer sleeve  200  may comprise an outer sleeve proximal core  250 , outer sleeve distal core  260 , and a pressure mechanism distal interface  270 . Illustratively, outer sleeve distal core  260  may be configured to conform to blade mount  110 . 
       FIG. 2C  illustrates a top view of outer sleeve  200 . In one or more embodiments, actuation guide  220  may comprise a distal detent  221 , a proximal detent  222 , and an intermediate detent  223 . Illustratively, proximal detent  222  may be configured to fix actuation pin  230  in an intermediate position in actuation guide  220 . 
       FIG. 3  is a schematic diagram of an inner handle  300 .  FIG. 3  illustrates a top view, a side view, and a bottom view of inner handle  300 . Inner handle  300  comprises an inner handle distal end  301  and an inner handle proximal end  302 . Illustratively, inner handle  300  may be configured to actuate relative to outer sleeve  200 . In one or more embodiments, inner handle  300  may comprise a pressure mechanism foundation  310 , a distal outer sleeve interface  320 , a proximal outer sleeve interface  330 , an inner handle base  340 , and an actuation control apparatus  350 . Illustratively, distal outer sleeve interface  320  and proximal outer sleeve interface  330  may be configured to conform to the dimensions of outer sleeve proximal core  250 . 
     In one or more embodiments, distal outer sleeve interface  320  may be configured to contain actuation pin  230 . Illustratively, distal outer sleeve interface  320  may comprise a pressure mechanism proximal interface  321  and a distal actuation guide  322 . In one or more embodiments, distal actuation guide  322  may be configured to minimize a friction force during an actuation of inner handle  300 . Illustratively, proximal outer sleeve interface  330  may comprise a proximal actuation guide  331  and an actuation control apparatus interface  332 . In one or more embodiments, proximal actuation guide  331  may be configured to minimize a friction force during an actuation of inner handle  300 . 
     In one or more embodiments, actuation control apparatus  350  may be configured to initiate an actuation of surgical blade  100 . Illustratively, actuation control apparatus  350  may be configured to manipulate an actuation of surgical blade  100 . For example, actuation control apparatus  350  may be configured to control a lateral actuation of surgical blade  100  relative to outer sleeve  200 . In one or more embodiments, actuation control apparatus  350  may be configured to control a rotational actuation of surgical blade  100  relative to outer sleeve  200 . Illustratively, actuation control apparatus  350  may comprise a diamond or knurl grip pattern configured to improve a surgeon&#39;s or an assistant&#39;s ability to grasp actuation control apparatus  350 . Actuation control apparatus  350  may be manufactured from any suitable material, e.g., polymers, metals, metal alloys, etc., or from any combination of suitable materials. 
     In one or more embodiments, actuation control apparatus  350  may comprise a blade indication signal  355 . Illustratively, blade indication signal  355  may be a visual signal, e.g., a color, configured to indicate one or more properties of surgical blade  100 . In one or more embodiments, blade indication signal  355  may comprise a solid or multicolored mark configured to indicate one or more properties of blade  120 . For example, a particular color or color combination displayed by blade indication signal  355  may indicate a particular property of blade  120 , e.g., a length of blade  120 , a width of blade  120 , a surgical geometry of blade  120 , a composition material of blade  120 , etc. Illustratively, blade indication signal  355  may be configured to display specific colors wherein the colors yellow, beige, black, blue, red, brown, green, and grey may indicate blade  120  dimension lengths of 1.0 mm, 1.8 mm, 2.2 mm, 2.4 mm, 2.65 mm, 2.8 mm, 3.0 mm, and 3.2 mm, respectively. 
       FIG. 4  is a schematic diagram of an exploded view of a surgical instrument handle  400 .  FIG. 4  illustrates an exploded top view and an exploded side view of surgical instrument handle  400 . In one or more embodiments, surgical instrument handle  400  may comprise a surgical blade  100 , an outer sleeve  200 , an actuation pin  230 , an inner handle  300 , a fixation mechanism  410 , and a pressure mechanism  420 . Illustratively, fixation mechanism  410  is configured to attach blade mount proximal end  112  and inner handle distal end  301 . In one or more embodiments, fixation mechanism  410  may comprise a set screw configured to firmly attach blade mount proximal end  112  to inner handle distal end  301 . In one or more embodiments, fixation mechanism  410  may comprise an adhesive material configured to attach blade mount proximal end  112  to inner handle distal end  301 , or fixation mechanism  410  may comprise one or more magnets configured to attach blade mount proximal end  112  to inner handle distal end  301 . 
     Illustratively, pressure mechanism  420  may comprise a pressure mechanism distal end  421  and a pressure mechanism proximal end  422 . In one or more embodiments, surgical instrument handle  400  may be assembled by fitting pressure mechanism  420  on pressure mechanism foundation  310  by, e.g., guiding pressure mechanism proximal end  422  over inner handle distal end  301  until pressure mechanism proximal end  422  abuts pressure mechanism proximal interface  321 . Illustratively, pressure mechanism  420  may be disposed between pressure mechanism distal interface  270  and pressure mechanism proximal interface  321 . For example, pressure mechanism distal end  421  may abut pressure mechanism distal interface  270  and pressure mechanism proximal end  422  may abut pressure mechanism proximal interface  321 . In one or more embodiments, pressure mechanism  420  may be coupled to pressure mechanism foundation  310 . For example, pressure mechanism  420  and pressure mechanism foundation  310  may be manufactured from a single suitable material or a combination of suitable materials. 
     Illustratively, pressure mechanism  420  may be configured to provide a force. In one or more embodiments, pressure mechanism  420  may be configured to provide a constant or uniform force. In one or more other embodiments, pressure mechanism  420  may be configured to provide a variable force. For example, pressure mechanism  420  may comprise a spring or a coil. In one or more embodiments, pressure mechanism  420  may comprise a spring with a spring constant in a range of 0.01 N/mm to 5.0 N/mm. In one or more other embodiments, pressure mechanism  420  may comprise a spring with a spring constant less than 0.01 N/mm or greater than 5.0 N/mm. Illustratively, pressure mechanism  420  may comprise a pneumatic system. In one or more embodiments, pressure mechanism  420  may be configured to provide a resistive force to resist an actuation. For example, pressure mechanism  420  may be configured to provide a resistive force to resist an actuation of surgical blade  100  from an enclosed position wherein surgical blade  100  is contained within outer sleeve  200  to an extended position wherein surgical blade  100  is at least partially extended from outer sleeve distal end  201 . Illustratively, pressure mechanism  420  may be configured to provide a resistive force that resists actuation pin  230  from an egression out of distal detent  221  or proximal detent  222 . In one or more embodiments, pressure mechanism  420  may be configured to provide a facilitating force to facilitate an actuation. For example, pressure mechanism  420  may be configured to provide a facilitating force to facilitate an actuation of surgical blade  100  from an extended position wherein surgical blade  100  is at least partially extended from outer sleeve distal end  201  to an enclosed position wherein surgical blade  100  is contained within outer sleeve  200 . 
     In one or more embodiments, blade indication signal  355  may comprise a blade indication band  356 . Illustratively, blade indication band  356  may be configured to fit over a portion of actuation control apparatus  350 . For example, blade indication band  356  may be a single color or a combination of single colors configured to indicate one or more properties of surgical blade  100 . Illustratively, a blade indication band  356  of a particular color or color combination may indicate a particular property of blade  120 , e.g., a length of blade  120 , a width of blade  120 , a surgical geometry of blade  120 , a composition material of blade  120 , etc. 
       FIG. 5  is a schematic diagram illustrating a surgical blade  100  in a safe position  500 . In one or more embodiments, surgical blade  100  may be in safe position  500  when actuation pin  230  is temporarily fixed in proximal detent  222 . Illustratively, surgical blade  100  may be contained in outer sleeve  200  when actuation pin  230  is temporarily fixed in proximal detent  222 . In one or more embodiments, pressure mechanism  420  may be configured to provide a resistive force that resists actuation pin  230  from an egression out of proximal detent  222 . 
       FIG. 6  is a schematic diagram illustrating a surgical blade  100  in a surgical position  600 . In one or more embodiments, surgical blade  100  may be in surgical position  600  when actuation pin  230  is temporarily fixed in distal detent  221 . Illustratively, surgical blade  100  may extend from outer sleeve distal end  201  when actuation pin  230  is temporarily fixed in distal detent  221 . In one or more embodiments, pressure mechanism  420  may be configured to provide a resistive force that resists actuation pin  230  from an egression out of distal detent  221 . 
       FIGS. 7A, 7B, 7C, 7D, 7E, 7F, and 7G  are schematic diagrams illustrating an actuation of a surgical blade  100  from a first fixed position  700  to a second fixed position  760 .  FIG. 7A  illustrates a surgical blade  100  in a first fixed position  700 . Illustratively, first fixed position  700  may comprise a safe position  500  wherein surgical blade  100  may be contained within outer sleeve  200 . For example, in first fixed position  700 , actuation pin  230  may be temporarily fixed in proximal detent  222 . 
       FIG. 7B  illustrates an egress  710  of actuation pin  230  from proximal detent  222 . 
     Illustratively, egress  710  of actuation pin  230  from proximal detent  222  may be accomplished by an application of a force vector, e.g., applied to actuation control apparatus  350 , with a direction oriented toward outer sleeve distal end  201 . For example, a surgeon or a surgeon&#39;s assistant may cause an egress  710  of actuation pin  230  from proximal detent  222  by, e.g., grasping actuation control apparatus  350  and pushing inner handle  300  into outer sleeve  200 . In one or more embodiments, pressure mechanism  420  may be configured to provide a resistive force that resists an egress  710  of actuation pin  230  out of proximal detent  222 . 
       FIG. 7C  illustrates an ingress  720  of actuation pin  230  into actuation channel  225 . Illustratively, ingress  720  of actuation pin  230  into actuation channel  225  may be accomplished by a rotation of actuation control apparatus  350  after an egress  710  of actuation pin  230  from proximal detent  222 . For example, after causing an egress  710  of actuation pin  230  from proximal detent  222 , a surgeon or a surgeon&#39;s assistant may cause an ingress  720  of actuation pin  230  into actuation channel  225  by, e.g., grasping actuation control apparatus  350  and rotating inner handle  300  relative to outer sleeve  200 . 
       FIG. 7D  illustrates an actuation  730  of actuation pin  230  along actuation channel  225 , e.g., away from actuation channel proximal end  227  and toward actuation channel distal end  226 . Illustratively, an actuation  730  of actuation pin  230  along actuation channel  225  may be accomplished by an application of a force vector, e.g., applied to actuation control apparatus  350 , with a direction oriented toward outer sleeve distal end  201  after an ingress  720  of actuation pin  230  into actuation channel  225 . For example, after causing an ingress  720  of actuation pin  230  into actuation channel  225 , a surgeon or a surgeon&#39;s assistant may cause an actuation  730  of actuation pin  230  along actuation channel  225  by, e.g., grasping actuation control apparatus  350  and pushing inner handle  300  into outer sleeve  200 . In one or more embodiments, pressure mechanism  420  may be configured to provide a resistive force that resists an actuation  730  of actuation pin  230  along actuation channel  225 . 
       FIG. 7E  illustrates an ingress alignment  740  of actuation pin  230  with distal detent  221 . Illustratively, ingress alignment  740  of actuation pin  230  with distal detent  221  may be accomplished by guiding an actuation  730  of actuation pin  230  to actuation channel distal end  226 . 
       FIG. 7F  illustrates actuation pin  230  in a position for ingress  750  into distal detent  221 . Illustratively, actuation pin  230  may be guided to position for ingress  750  into distal detent  221  by a rotation of actuation control apparatus  350  after an ingress alignment  740  of actuation pin  230  with distal detent  221 . For example, after causing an ingress alignment  740  of actuation pin  230  with distal detent  221 , a surgeon or a surgeon&#39;s assistant may guide actuation pin  230  to position for ingress  750  into distal detent  221  by, e.g., grasping actuation control apparatus  350  and rotating inner handle  300  relative to outer sleeve  200 . 
       FIG. 7G  illustrates a surgical blade  100  in a second fixed position  760 . Illustratively, surgical blade  100  may be temporarily fixed in a second fixed position  760  by an application of a force vector, e.g., applied to actuation control apparatus  350 , with a direction oriented toward outer sleeve proximal end  202  after actuation pin  230  is in position for ingress  750  into distal detent  221 . For example, after guiding actuation pin  230  to position for ingress  750  into distal detent  221 , a surgeon or a surgeon&#39;s assistant may temporarily fix surgical blade  100  in a second fixed position  760  by, e.g., grasping actuation control apparatus  350  and pulling inner handle  300  out of outer sleeve  200 . In one or more embodiments, pressure mechanism  420  may be configured to provide a facilitating force that facilitates an actuation of actuation pin  230  from position for ingress  750  to a second fixed position  760 . 
       FIGS. 8A, 8B, 8C, 8D, 8E, 8F, and 8G  are schematic diagrams illustrating an actuation of a surgical blade from a second fixed position  760  to a first fixed position  700 .  FIG. 8A  illustrates a surgical blade  100  in a second fixed position  760 . Illustratively, second fixed position  760  may comprise a surgical position  600  wherein surgical blade  100  may be at least partially extended from outer sleeve  200 . For example, surgical blade  100  may be in second fixed position  760  when actuation pin  230  is temporarily fixed in distal detent  221 . 
       FIG. 8B  illustrates an egress  810  of actuation pin  230  from distal detent  221 . Illustratively, egress  810  of actuation pin  230  from distal detent  221  may be accomplished by an application of a force vector, e.g., applied to actuation control apparatus  350 , with a direction oriented toward outer sleeve distal end  201 . For example, a surgeon or a surgeon&#39;s assistant may cause an egress  810  of actuation pin  230  from distal detent  222  by, e.g., grasping actuation control apparatus  350  and pushing inner handle  300  into outer sleeve  200 . In one or more embodiments, pressure mechanism  420  may be configured to provide a resistive force that resists an egress  810  of actuation pin  230  out of distal detent  221 . 
       FIG. 8C  illustrates an ingress  820  of actuation pin  230  into actuation channel  225 . Illustratively, ingress  820  of actuation pin  230  into actuation channel  225  may be accomplished by a rotation of actuation control apparatus  350  after an egress  810  of actuation pin  230  from distal detent  221 . For example, after causing an egress  810  of actuation pin  230  from distal detent  221 , a surgeon or a surgeon&#39;s assistant may cause an ingress  820  of actuation pin  230  into actuation channel  225  by, e.g., grasping actuation control apparatus  350  and rotating inner handle  300  relative to outer sleeve  200 . 
       FIG. 8D  illustrates an actuation  830  of actuation pin  230  along actuation channel  225 , e.g., away from actuation channel distal end  226  and toward actuation channel proximal end  227 . Illustratively, an actuation  830  of actuation pin  230  along actuation channel  225  may be accomplished by an application of a force vector, e.g., applied to actuation control apparatus  350 , with a direction oriented toward inner handle proximal end  302  after an ingress  820  of actuation pin  230  into actuation channel  225 . For example, after causing an ingress  820  of actuation pin  230  into actuation channel  225 , a surgeon or a surgeon&#39;s assistant may cause an actuation  830  of actuation pin  230  along actuation channel  225  by, e.g., grasping actuation control apparatus  350  and pulling inner handle  300  out of outer sleeve  200 . In one or more embodiments, pressure mechanism  420  may be configured to provide a facilitating force that facilitates an actuation  830  of actuation pin  230  along actuation channel  225 . 
       FIG. 8E  illustrates an ingress alignment  840  of actuation pin  230  with proximal detent  222 . Illustratively, ingress alignment  840  of actuation pin  230  with proximal detent  222  may be accomplished by guiding an actuation  830  of actuation pin  230  to actuation channel proximal end  227 . 
       FIG. 8F  illustrates actuation pin  230  in a position for ingress  850  into proximal detent  222 . Illustratively, actuation pin  230  may be guided to position for ingress  850  into proximal detent  222  by a rotation of actuation control apparatus  350  after an ingress alignment  840  of actuation pin  230  with proximal detent  222 . For example, after causing an ingress alignment  840  of actuation pin  230  with proximal detent  222 , a surgeon or a surgeon&#39;s assistant may guide actuation pin  230  to position for ingress  850  into proximal detent  222  by, e.g., grasping actuation control apparatus  350  and rotating inner handle  300  relative to outer sleeve  200 . 
       FIG. 8G  illustrates a surgical blade  100  in a first fixed position  700 . Illustratively, surgical blade  100  may be temporarily fixed in a first fixed position  700  by an application of a force vector, e.g., applied to actuation control apparatus  350 , with a direction oriented toward inner handle proximal end  302  after actuation pin  230  is in position for ingress  850  into proximal detent  222 . For example, after guiding actuation pin  230  to position for ingress  850  into proximal detent  222 , a surgeon or a surgeon&#39;s assistant may temporarily fix surgical blade  100  in a first fixed position  700  by, e.g., grasping actuation control apparatus  350  and pulling inner handle  300  out of outer sleeve  200 . In one or more embodiments, pressure mechanism  420  may be configured to provide a facilitating force that facilitates an actuation of actuation pin  230  from position for ingress  850  to a first fixed position  700 . 
     In one or more embodiments, actuation guide  220  may comprise a distal detent  221 , a proximal detent  222 , and an intermediate detent  223 . Illustratively, intermediate detent  223  may be configured to temporarily fix surgical blade  100  in a third fixed position relative to outer sleeve  200 ; distal detent  221  may be configured to temporarily fix surgical blade  100  in a second fixed position  760  relative to outer sleeve  200 ; and proximal detent  222  may be configured to temporarily fix surgical blade  100  in a first fixed position  700  relative to outer sleeve  200 . For example, while temporarily fixed in a third fixed position relative to outer sleeve  200 , surgical blade  100  may extend a first distance from outer sleeve distal end  201 . Illustratively, while temporarily fixed in a second fixed position  760  relative to outer sleeve  200 , surgical blade  100  may extend a second distance from outer sleeve distal end  201 , wherein the second distance from outer sleeve distal end  201  may be greater than the first distance from outer sleeve distal end  201 . 
     In one or more embodiments, intermediate detent  223  may be configured to temporarily fix surgical blade  100  in a first position relative to outer sleeve  200  wherein surgical blade  100  extends a first distance from outer sleeve distal end  201  and blade  120  has a first exposed blade width. Illustratively, distal detent  221  may be configured to temporarily fix surgical blade  100  in a second position relative to outer sleeve  200  wherein surgical blade  100  extends a second distance from outer sleeve distal end  201  and blade  120  has a second exposed blade width. In one or more embodiments, the second exposed blade width may be greater than the first exposed blade width. For example, a surgeon or a surgeon&#39;s assistant may selectively actuate surgical blade  100  from a first position relative to outer sleeve  200  to a second position relative to outer sleeve  200 . Illustratively, while temporarily fixed in the first position relative to outer sleeve  200 , surgical blade  100  may be configured to make a surgical incision, e.g., of a first width, and while temporarily fixed in the second position relative to outer sleeve  200 , surgical blade  100  may be configured to make a surgical incision, e.g., of a second width. 
     In one or more embodiments, pressure mechanism  420  may be configured to provide a variable resistive force to resist an actuation of actuation pin  230 . For example, pressure mechanism  420  may be configured to provide a first resistive force with a first magnitude to resist an actuation of actuation pin  230  when actuation pin  230  is in a first position relative to outer sleeve  200 . Illustratively, pressure mechanism  420  may be configured to provide a second resistive force with a second magnitude to resist an actuation of actuation pin  230  when actuation pin  230  is in a second position relative to outer sleeve  200 . 
     In one or more embodiments, pressure mechanism  420  may be configured to provide a first resistive force with a first magnitude that resists an egress  710  of actuation pin  230  out of proximal detent  222 . Illustratively, pressure mechanism  420  may be configured to provide a second resistive force with a second magnitude that resists an actuation  730  of actuation pin  230  along actuation channel  225 . In one or more embodiments, the first magnitude of the first resistive force may not be identical to the second magnitude of the second resistive force. For example, the second magnitude of the second resistive force may be greater than the first magnitude of the first resistive force. 
     Illustratively, pressure mechanism  420  may be configured to provide a variable resistive force to resist an actuation of actuation pin  230  along actuation channel  225  wherein the magnitude of the variable resistive force increases as actuation pin  230  is actuated from actuation channel proximal end  227  towards actuation channel distal end  226 . In one or more embodiments, pressure mechanism  420  may be configured to provide a variable resistive force to resist an actuation of actuation pin  230  wherein the variable resistive force has a maximum magnitude when actuation pin  230  is located at actuation channel distal end  226 . For example, pressure mechanism  420  may be configured to provide a small resistive force to resist an egress  710  of actuation pin  230  from proximal detent  222  and a large resistive force to resist an egress  810  of actuation pin  230  from distal detent  221 . Illustratively, pressure mechanism  420  may be configured to allow a surgeon or a surgeon&#39;s assistant to initiate an actuation of surgical blade  100  from a safe position  500  to a surgical position  600  with a smaller force magnitude, e.g., applied to actuation control apparatus  350 , than a force magnitude that may be required to initiate an actuation of surgical blade  100  from a surgical position  600  to a safe position  500 . 
       FIG. 9A  is a schematic diagram illustrating a surgical blade  900 . In one or more embodiments, surgical blade  900  may comprise a blade mount  910  and a blade  920 . Illustratively, blade mount  910  may be configured to support blade  920 . Blade mount  910  may be manufactured from any suitable material, e.g., polymers, metals, metal alloys, etc., or from any combination of suitable materials. Illustratively, blade  920  may be configured to make surgical incisions. Blade  920  comprises a blade distal end  921 , a blade proximal end  922 , and at least one blade edge  923 . Blade  920  may be manufactured from any suitable material, e.g., sapphire, diamond, silicon, polymers, metals, metal alloys, etc., or from any combination of suitable materials. 
     In one or more embodiments, surgical blade  900  may comprise a surgical incision guide  930 . Illustratively, surgical incision guide  930  may be configured to provide information, e.g., information about a surgical incision. For example, surgical incision guide  930  may be located at a specific distance  940  from blade distal end  921 . Illustratively, a surgeon may compare a location of an outer surface of a tissue with a location of surgical incision guide  930  during a surgical incision, e.g., to provide information about the surgical incision. For example, surgical incision guide  930  may be configured to indicate a surgical incision depth of blade  920  in a tissue. In one or more embodiments, surgical incision guide  930  may be configured to indicate a desired surgical incision depth, e.g., to inform a surgeon that blade  920  is penetrating a tissue at a desirable depth. Illustratively, surgical incision guide  930  may be configured to indicate an undesirable surgical incision depth, e.g., to inform a surgeon that blade  920  is penetrating a tissue at an undesirable depth. 
     In one or more embodiments, surgical incision guide  930  may be configured to guide a multi-plane surgical incision. A surgeon may perform a multi-plane incision by initially penetrating a tissue to a first depth with blade  920  oriented at a first angle relative to the tissue and then penetrating the tissue to a second depth with blade  920  oriented at a second angle relative to the tissue. Illustratively, surgical incision guide  930  may be configured to indicate that blade  920  is at an optimal depth within a tissue, e.g., by a comparison of an outer surface of the tissue with a location of surgical incision guide  930 , for a surgeon to change surgical incision planes within the tissue. For example, when a surgeon is performing a multi-plane surgical incision, surgical incision guide  930  may be configured to guide the surgeon to penetrate blade  920  to a first depth in a tissue wherein blade  920  may be orientated at a first angle relative to a plane normal to a portion of the surface of the tissue. After penetrating blade  920  to the first depth in the tissue at the first angle relative to the plane normal to the portion of the surface of the tissue, the surgeon may adjust an orientation of blade  920  to a second angle relative to the plane normal to the portion of the surface of the tissue, and then the surgeon may penetrate blade  920  to a second depth in the tissue. 
     Illustratively, surgical incision guide  930  may comprise a visual signal configured to differentiate a first portion of blade  920  from a second portion of blade  920 . For example, surgical incision guide  930  may comprise a marking, e.g., a line, on the surface of blade  920 . Illustratively, surgical incision guide  930  may comprise a biocompatible paint or ink. Surgical incision guide  930  may be manufactured by any suitable means for marking a portion of blade  920 . In one or more embodiments, surgical incision guide  930  may be manufactured by etching, e.g., laser etching, a marking on blade  920 . Illustratively, surgical incision guide  930  may be configured to minimize friction, e.g., between blade  920  and a tissue during a surgical procedure. For example, surgical incision guide  930  may be configured to minimize variation in a geometry of a portion of blade  920 . 
     In one or more embodiments, blade  920  may comprise information about blade  920 . Illustratively, one or more dimensions of blade  920  may be marked on blade  920 , e.g., by laser etching or by biocompatible paint or ink, or by any other suitable means. For example, a blade  920  with a width of, e.g., 2.0 mm, may have the numbers and distance units “2.0 mm” marked on a portion of blade  920 . Illustratively, a blade  920  with a width of, e.g., 2.0 mm, may have the numbers “2.0” or the number “2” marked on a portion of blade  920 . 
     In one or more embodiments, blade  920  may comprise information about a location of surgical incision guide  930  on blade  920 . Illustratively, information about a location of surgical incision guide  930  may be marked on blade  920 , e.g., by laser etching or by biocompatible paint or ink, or by any other suitable means. For example, a distance between a location of surgical incision guide  930  and blade distal end  921  may be marked on a portion of blade  920 . Illustratively, if a distance between surgical incision guide  930  and blade distal end  921  is, e.g., 0.25 mm, the numbers and the distance units “0.25 mm” may be marked on a portion of blade  920 . For example, if a distance between surgical incision guide  930  and blade distal end  921  is, e.g., 0.25 mm, the numbers “0.25” or the number “0.25” may be marked on a portion of blade  920 . 
       FIG. 9B  is a schematic diagram illustrating a surgical blade  901 . In one or more embodiments, surgical blade  901  may comprise a first surgical incision guide  950  and a second surgical incision guide  951 . Illustratively, first surgical incision guide  950  may be located at a first specific distance  960  from blade distal end  921 . In one or more embodiments, second surgical incision guide  951  may be located at a second specific distance  961  from first surgical incision guide  950 . 
     Illustratively, first surgical incision guide  950  and second surgical incision guide  951  may be configured to provide information, e.g., information about a surgical incision. For example, first surgical incision guide  950  and second surgical incision guide  951  may be configured to indicate a safe or desirable range of surgical penetration depths. Illustratively, a surgeon may need to penetrate blade  920  at least a required depth in a particular tissue, but also need to not penetrate blade  920  more than an undesirable depth in the particular tissue. In one or more embodiments, first surgical incision guide  950  may be configured to indicate a required surgical penetration depth and second surgical incision guide  951  may be configured to indicate an undesirable surgical penetration depth in a particular tissue. 
     In one or more embodiments, first surgical incision guide  950  and second surgical incision guide  951  may be configured to guide a multi-plane surgical incision. Illustratively, first surgical incision guide  950  may be configured to indicate that blade  920  is at a first optimal depth within a tissue, e.g., by a comparison of an outer surface of the tissue with a location of first surgical incision guide  950 , for a surgeon to change surgical incision planes within the tissue. In one or more embodiments, second surgical incision guide  951  may be configured to indicate that blade  920  is at a second optimal depth within a tissue for the surgeon to change surgical incision planes within the tissue. 
     For example, when a surgeon is performing a multi-plane surgical incision, first surgical incision guide  950  may be configured to guide the surgeon to penetrate blade  920  to a first depth in a tissue wherein blade  920  may be orientated at a first angle relative to a plane normal to a portion of the surface of the tissue. After penetrating blade  920  to the first depth in the tissue at the first angle relative to the plane normal to the portion of the surface of the tissue, the surgeon may adjust an orientation of blade  920  to a second angle relative to the plane normal to the portion of the surface of the tissue, and then the surgeon may penetrate blade  920  to a second depth in the tissue. Illustratively, second surgical incision guide  951  may be configured to guide the surgeon to penetrate blade  920  to a second depth in the tissue wherein blade  920  may be oriented at a second angle relative to the plane normal to the portion of the surface of the tissue. After penetrating blade  920  to the second depth in the tissue at the second angle relative to the plane normal to the portion of the surface of the tissue, the surgeon may adjust an orientation of blade  920  to a third angle relative to the plane normal to the portion of the surface of the tissue, and then the surgeon may penetrate blade  920  to a third depth in the tissue. 
       FIG. 9C  is a schematic diagram illustrating a surgical blade  902 . In one or more embodiments, surgical blade  902  may comprise a first surgical incision guide  970 , a second surgical incision guide  971 , and a third surgical incision guide  972 . Illustratively, first surgical incision guide  970  may be located at a first specific distance  980  from blade distal end  921 . In one or more embodiments, second surgical incision guide  971  may be located at a second specific distance  981  from first surgical incision guide  970 . Illustratively, third surgical incision guide  972  may be located at a third specific distance  982  from second surgical incision guide  971 . 
     In one or more embodiments, first surgical incision guide  970 , second surgical incision guide  971 , and third surgical incision guide  972  may be configured to guide a multi-plane surgical incision. Illustratively, first surgical incision guide  970  may be configured to indicate that blade  920  is at a first optimal depth within a tissue, e.g., by a comparison of an outer surface of the tissue with a location of first surgical incision guide  970 , for a surgeon to change surgical incision planes within the tissue. In one or more embodiments, second surgical incision guide  971  may be configured to indicate that blade  920  is at a second optimal depth within a tissue for the surgeon to change surgical incision planes within the tissue. Illustratively, third surgical incision guide  972  may be configured to indicate that blade  920  is at a third optimal depth within a tissue for the surgeon to change surgical incision planes within the tissue. 
     For example, when a surgeon is performing a multi-plane surgical incision, first surgical incision guide  970  may be configured to guide the surgeon to penetrate blade  920  to a first depth in a tissue wherein blade  920  may be orientated at a first angle relative to a plane normal to a portion of the surface of the tissue. After penetrating blade  920  to the first depth in the tissue at the first angle relative to the plane normal to the portion of the surface of the tissue, the surgeon may adjust an orientation of blade  920  to a second angle relative to the plane normal to the portion of the surface of the tissue, and then the surgeon may penetrate blade  920  to a second depth in the tissue. Illustratively, second surgical incision guide  971  may be configured to guide the surgeon to penetrate blade  920  to a second depth in the tissue wherein blade  920  may be oriented at a second angle relative to the plane normal to the portion of the surface of the tissue. After penetrating blade  920  to the second depth in the tissue at the second angle relative to the plane normal to the portion of the surface of the tissue, the surgeon may adjust an orientation of blade  920  to a third angle relative to the plane normal to the portion of the surface of the tissue, and then the surgeon may penetrate blade  920  to a third depth in the tissue. Illustratively, third surgical incision guide  972  may be configured to guide the surgeon to penetrate blade  920  to a third depth in the tissue wherein blade  920  may be oriented at a third angle relative to the plane normal to the portion of the surface of the tissue. After penetrating blade  920  to the third depth in the tissue at the third angle relative to the plane normal to the portion of the surface of the tissue, the surgeon may adjust an orientation of blade  920  to a fourth angle relative to the plane normal to the portion of the surface of the tissue, and then the surgeon may penetrate blade  920  to a fourth depth in the tissue. 
       FIG. 10A  is a schematic diagram illustrating a surgical blade  1000 . In one or more embodiments, surgical blade  1000  may comprise a blade mount  1010  and a blade  1020 . Illustratively, blade mount  1010  may be configured to support blade  1020 . Blade mount  1010  may be manufactured from any suitable material, e.g., polymers, metals, metal alloys, etc., or from any combination of suitable materials. Illustratively, blade  1020  may be configured to make surgical incisions. Blade  1020  comprises a blade distal end  1021 , a blade proximal end  1022 , and at least one blade edge  1023 . Blade  1020  may be manufactured from any suitable material, e.g., sapphire, diamond, silicon, polymers, metals, metal alloys, etc., or from any combination of suitable materials. 
     In one or more embodiments, surgical blade  1000  may comprise a universal surgical incision guide  1030 . Illustratively, universal surgical incision guide  1030  may comprise a plurality of surgical guide marks configured to provide information, e.g., information about a surgical incision. For example, a plurality of surgical guide marks of universal surgical incision guide  1030  may be located on blade  1020  at discrete distances from blade distal end  1021  and the plurality of surgical guide marks of universal surgical incision guide  1030  may be configured to indicate a surgical incision depth in a tissue. Illustratively, a first surgical guide mark of universal surgical incision guide  1030  may be located, e.g., 0.5 mm from blade distal end  1021 ; a second surgical guide mark of universal surgical incision guide  1030  may be located, e.g., 1.0 mm from blade distal end  1021 ; a third surgical guide mark of universal surgical incision guide  1030  may be located, e.g., 1.5 mm from blade distal end  1021 ; a fourth surgical guide mark of universal surgical incision guide  1030  may be located, e.g., 2.0 mm from blade distal end  1021 , etc. In one or more embodiments, universal surgical incision guide  1030  may be configured to guide a multi-plane surgical incision. For example, one or more surgical guide marks of universal surgical incision guide  1030  may be configured to indicate an optimal depth within a tissue for a surgeon to adjust a surgical incision plane within the tissue. Illustratively, universal surgical incision guide  1030  may be configured to train a surgeon, e.g., to correctly perform a multi-plane surgical incision. 
     In one or more embodiments, blade  1020  may comprise information about blade  1020 . Illustratively, one or more dimensions of blade  1020  may be marked on blade  1020 , e.g., by laser etching or by biocompatible paint or ink, or by any other suitable means. For example, a blade  1020  with a width of, e.g., 2.0 mm, may have the numbers and distance units “2.0 mm” marked on a portion of blade  1020 . Illustratively, a blade  1020  with a width of, e.g., 2.0 mm, may have the numbers “2.0” or the number “2” marked on a portion of blade  1020 . 
     In one or more embodiments, blade  1020  may comprise information about a location of one or more surgical guide marks of surgical incision guide  1030  on blade  1020 . Illustratively, information about a location of one or more surgical guide marks of surgical incision guide  1030  may be marked on blade  1020 , e.g., by laser etching or by biocompatible paint or ink, or by any other suitable means. For example, a distance between a location of one or more surgical guide marks of surgical incision guide  1030  and blade distal end  1021  may be marked on a portion of blade  1020 . 
     In one or more embodiments, if a distance between a first surgical guide mark of surgical incision guide  1030  and blade distal end  1021  is, e.g., 0.5 mm, the numbers and the distance units “0.5 mm” may be marked on a portion of blade  1020 . For example, if a distance between a first surgical guide mark of surgical incision guide  1030  and blade distal end  1021  is, e.g., 0.5 mm, the numbers “0.5” or the number “0.5” may be marked on a portion of blade  1020 . Illustratively, if a distance between a second surgical guide mark of surgical incision guide  1030  and blade distal end  1021  is, e.g., 1.0 mm, the numbers and the distance units “1.0 mm” may be marked on a portion of blade  1020 . For example, if a distance between a second surgical guide mark of surgical incision guide  1030  and blade distal end  1021  is, e.g., 1.0 mm, the numbers “1.0” or the number “1” may be marked on a portion of blade  1020 . 
       FIG. 10B  is a schematic diagram illustrating a surgical blade  1001 . In one or more embodiments, surgical blade  1001  may comprise a universal surgical incision guide  1040 . Illustratively, universal surgical incision guide  1040  may comprise a plurality of surgical guide marks configured to provide information, e.g., information about a surgical incision. For example, a plurality of surgical guide marks of universal surgical incision guide  1040  may be located on blade  1020  at discrete distances from blade distal end  1021  and the plurality of surgical guide marks of universal surgical incision guide  1040  may be configured to indicate a surgical incision depth in a tissue. Illustratively, a first surgical guide mark of universal surgical incision guide  1040  may be located, e.g., 0.25 mm from blade distal end  1021 ; a second surgical guide mark of universal surgical incision guide  1040  may be located, e.g., 0.5 mm from blade distal end  1021 ; a third surgical guide mark of universal surgical incision guide  1040  may be located, e.g., 0.75 mm from blade distal end  1021 ; a fourth surgical guide mark of universal surgical incision guide  1040  may be located, e.g., 1.0 mm from blade distal end  1021 , etc. In one or more embodiments, universal surgical incision guide  1040  may be configured to guide a multi-plane surgical incision. For example, one or more surgical guide marks of universal surgical incision guide  1040  may be configured to indicate an optimal depth within a tissue for a surgeon to adjust a surgical incision plane within the tissue. 
     The foregoing description has been directed to particular embodiments of this invention. It will be apparent; however, that other variations and modifications may be made to the described embodiments, with the attainment of some or all of their advantages. Specifically, it should be noted that the principles of the present invention may be implemented in any instrument regardless of the instrument&#39;s purpose or use. Furthermore, while this description has been written in terms of an ophthalmic surgical blade, the teachings of the present invention are equally suitable to any instrument where the functionality of the invention may be employed. Therefore, it is the object of the appended claims to cover all such variations and modifications as come within the true spiry it and scope of the invention.