Patent Publication Number: US-2023149212-A1

Title: Surgical apparatus for performing microsurgery including a multifunctional intraocular pick/dissector

Description:
RELATED APPLICATIONS AND CLAIM FOR PRIORITY 
     The present application is a continuation of U.S. patent application Ser. No. 16/391,028, titled “MULTIFUNCTIONAL INTRAOCULAR PICK/DISSECTOR,” Attorney Docket No. LAMBOO4US0 and filed Apr. 22, 2019; and a continuation of U.S. patent application Ser. No. 17/697,730, titled “OPHTHALMOLOGICAL SURGERY MICROSURGERY INSTRUMENTS AND METHODS OF USE FOR INCREASING SURGICAL PRECISION AND REDUCING VITREORETINAL INSTRUMENT INSERTIONS AND REMOVALS AND RELATED TRAUMA,” Attorney Docket No. LAMBOO7US0 and filed Mar. 17, 2022; which is a continuation-in-part of U.S. patent application Ser. No. 16/362,953, titled “MULTIFUNCTIONAL VITREORETINAL SCISSORS AND FORCEPS,” with Attorney Docket No. LAMBOO5US0 and filed Mar. 25, 2019; and a continuation-in-part of U.S. patent application Ser. No. 15/698,938, titled “MULTIFUNCTIONAL VITREOUS CUTTERS FOR PARS PLANA VITRECTOMY,” with Attorney Docket No. LAMBOO2US0 and filed Sep. 8, 2017; and a continuation-in-part of U.S. patent application Ser. No. 15/834,379, titled “SIDE FENESTRATED PARS PLANA INFUSION CANNULA,” with Attorney Docket No. LAMBOO1US0 and filed Dec. 7, 2017; all of which are incorporated herein by reference in their entirety. 
    
    
     FIELD OF INVENTION 
     The present subject matter generally relates to an apparatus for performing microsurgeries. More specifically, the present subject matter relates to a surgical apparatus for performing a microsurgery such as ophthalmological surgical procedure and the like. 
     BACKGROUND OF INVENTION 
     Microsurgeries such as vitreoretinal surgery began in the early 1970&#39;s. The first device invented to perform vitreoretinal surgery (vitrectomy) was called a Vitreous Infusion Suction Cutter (VISC). 
     Dr. Robert Machemer was the inventor of the VISC and is widely known for his development of pars plana vitrectomy, a surgical procedure which has revolutionized the treatment of posterior segment eye diseases. During 1970&#39;s a single instrument that provides a sizable scleral incision such as 2.5 millimeter was used. Upon removal of that instrument, the eye would immediately collapse. In order to overcome the above problem, Dr. Conor O&#39;Malley of Australia, invented a system, which required three small incisions of 0.9 mm or about 20 gauge, one with an infusion cannula, one with a light, and the third with a vitreous cutter. In order to use any other instruments like scissors, a laser, forceps, cautery, etc., eye surgeons or ophthalmologists had to remove one of the three main devices. Still, they couldn&#39;t readily remove the infusion or the light. With the removal of any instrument, the eye would depressurize and slightly collapse, leading to bleeding if the ophthalmologist were cutting vessels or vessels were bleeding due to causes like diabetic retinopathy. 
     With advent in technology, several surgical apparatuses have been developed that provide three incision systems, one infusion to keep the eye formed, another instrument a light, and another, the vitreous cutter. They have become smaller and smaller, now at the 27-gauge size. These surgical apparatuses still require the ophthalmologist to remove one instrument to insert another device. 
     Further, the cutting devices currently used are straight and therefore cutting around the patient&#39;s lens can cause damage to the curved lens. A curved cutter would greatly facilitate surgery around the lens. A multifunctional instrument wound further expedite safer surgery. 
     Therefore, there is a need in the art to provide improved apparatuses of 19 gauge (1.0 millimeter) or smaller that are multifunctional in their purpose and limit the number of times they need to be taken in and out during the microsurgery. 
     SUMMARY 
     It is an object of the present invention to provide a surgical apparatus for performing a microsurgery such as ophthalmological surgical procedure and the like and that avoids the drawback of known apparatus/instrument. 
     It is another object of the present invention to provide a cannula configured for use during a vitreoretinal and ocular surgery. 
     It is another object of the present invention to provide a vitreous cutter for use during an ocular surgery. 
     It is another object of the present invention to provide a multifunctional vitreoretinal surgical tool for cutting or peeling of membranes and cauterization at the same time during the vitreoretinal and ocular surgery. 
     It is yet another object of the present invention to provide a multifunctional intraocular surgical tool for picking and dissecting vascularized tissue, membranes or scar tissue during the vitreoretinal and ocular surgery. 
     In order to achieve one or more objects, the present invention provides a surgical apparatus for performing microsurgery. The microsurgery comprises vitrectomy (vitreoretinal and ocular surgery) such as Rhegmatogenous Retinal Detachment, Macular Holes, Epiretinal Membranes, Retinal Transplantation, Dislocated intraocular lens (IOL), Non-Clearing Vitreous Hemorrhage, Proliferative Diabetic Retinopathy, Traction Retinal Detachment, Retinopathy of Prematurity, Pediatric Rhegmatogenous Retinal Detachment, Uveitis induced Retinal Detachment, Choroidal and Retinal Biopsy, Giant Retinal Tears, Choroidal Hemorrhage, Submacular Hemorrhage, Age-Related Macular Degeneration, Uveal Effusion Syndrome, Endophthalmitis, Intraocular Foreign Body, Open Globe rupture, Retinoschisis Retinal Detachment, Optic Pit Maculopathy, Retinal Detachment, and Proliferative Vitreoretinopathy. 
     The surgical apparatus includes a cannula having an intraocular portion. The intraocular portion includes fenestrations at one end and connects to an infusion tube at another end. The intraocular portion includes a tapered tip or curved tip upon which the fenestrations position. The intraocular portion receives fluid through the infusion tube and dispenses the fluid through the fenestrations. Fluid flows through the fenestrations and this lessens the flow at an infusion site in an eye. 
     In one advantageous feature of the present invention, the fenestrations at the distal end of the intraocular portion include angled openings to distribute the flow of said fluid. This helps to avoid or reduce perpendicular injection of the fluid on to the eye and maximise posterior injection. 
     The surgical apparatus further includes a vitreous cutter having a handle. The vitreous cutter includes a suction tube at one end and a shaft at another end. The shaft includes a cutting or laser (liquifying of vitreous) port. Further, the shaft includes a light and/or a laser (cauterizing) and/or bipolar cautery at its distal end. The shaft comes in one of straight configuration, bent configuration and curved configuration. 
     In one advantageous feature of the present invention, the vitreous cutter operates at a cut rate greater than 7500 cuts per minute (cpm). The vitreous cutter operates using spring-driven mechanisms or dual pneumatic pumps that independently control the opening and closing of the cutter port or similar actuating device. The cutting port has a size of 19-gauge or smaller. The cutting port cuts vitreous into smaller pieces. The shaft receives the cut vitreous pieces and the suction tube draws out the cut vitreous pieces from the eye. In lieu of mechanical cutting, a laser that liquefies the vitreous is used. The “cutting” laser and the cauterizing laser would be separate wavelengths. The type treating/cauterizing the retina is different than the laser that would liquefy the vitreous depending on frequencies and need. The light and the laser aid in viewing the vitreous during cutting of the vitreous as well as lasering the retina, bleeders, etc. As the shaft provides light and laser at the end, it limits the number of times the vitreous cutter needs to be taken in and out during the vitreoretinal and ocular surgery. Most procedures can be completed with one entry into the eye with multifunctional instruments. 
     The surgical apparatus includes a vitreoretinal surgical tool having a vitreoretinal cutter or forceps or similar instrument. The vitreoretinal device comes in a scissor-like mechanism or forceps-like mechanism. The vitreoretinal cutter holds and/or cuts the membrane in the eye during the vitreoretinal and ocular surgery but provides other functions as well. 
     In one advantageous feature of the present invention, the vitreoretinal cutter cuts or peels of membranes and cauterizes when needed during the vitreoretinal and ocular surgery. This greatly decreases the time of surgery and likelihood of complications during and post vitreoretinal and ocular surgery since no instruments are removed. 
     The surgical apparatus further includes an intraocular pick and dissector for picking up the membrane or scar tissue in the eye. The intraocular pick and dissector includes a shaft having a pick at its distal end. The pick extends and retracts into the shaft with the help of a button. 
     In one advantageous feature of the present invention, the intraocular pick and dissector allows to perform multiple tasks intraocularly in place of inserting multiple tools repeatedly into the eye during the vitreoretinal and ocular surgery. 
     Features and advantages of the invention hereof will become more apparent in light of the following detailed description of selected embodiments, as illustrated in the accompanying FIGS. As will be realised, the invention disclosed is capable of modifications in various respects, all without departing from the scope of the invention. Accordingly, the drawings and the description are to be regarded as illustrative in nature. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       Further features and advantages of the present invention will become apparent from the following detailed description, taken in combination with the appended drawings, in which: 
         FIG.  1    illustrates an environment in which a surgical apparatus for performing a microsurgery implements, in accordance with one embodiment of the present invention; 
         FIG.  2    illustrates the surgical apparatus having a cannula (straight or curved), a vitreous cutter, and a vitreoretinal surgical tool; 
         FIGS.  3  and  4    illustrates a side view and a cross-sectional view, respectively of the cannula; 
         FIG.  5    illustrates the feature of angled fenestration; 
         FIG.  6    illustrates a side view of the cannula, in accordance with another embodiment of the present invention; 
         FIG.  7    illustrates a side view of the cannula, in accordance with yet another embodiment of the present invention; 
         FIGS.  8 A to  8 D  illustrate the vitreous cutter having a shaft in different configurations, in accordance with several embodiments of the present invention; 
         FIGS.  9 A to  9 C  illustrate a front, a top and a rear side view, respectively of a shaft having a cutting port; 
         FIG.  10    illustrates a perspective view of the shaft having laser at its distal end; 
         FIG.  11    illustrates a perspective view of the laser connecting via laser wire; 
         FIG.  12    illustrates a cross-section of the shaft having the laser; 
         FIG.  13    illustrates a perspective view of the shaft having light at its distal end; 
         FIG.  14    illustrates a perspective view of the light connecting via light wire; 
         FIG.  15    illustrates a cross-section of the shaft having the light; 
         FIG.  16    illustrates a perspective view of shaft having bipolar cautery probe and light; 
         FIG.  17    illustrates the feature of laser connecting via laser wire and light connecting via light wire; 
         FIG.  18    illustrates a cross-section of the shaft having bipolar cautery probe connecting via wire and light connecting via light wire; 
         FIGS.  19  and  20    illustrate a shaft having lights, laser and bipolar cautery probes; 
         FIG.  21    illustrates a perspective view of the vitreoretinal surgical tool; 
         FIG.  22    illustrates a vitreoretinal cutter, in accordance with one embodiment of the present invention; 
         FIG.  23    illustrates the feature of vitreoretinal cutter placed in the eye during a microsurgery; 
         FIGS.  24  to  28    illustrate an intraocular portion having a vitreoretinal cutter, in accordance with various embodiments of the present invention; 
         FIG.  29    illustrates a perspective view of an intraocular pick and dissector, in accordance with one embodiment of the present invention; 
         FIGS.  30  and  31    illustrate a perspective and a top view, respectively of a pick extending from a shaft; 
         FIGS.  32  and  33    illustrate the feature of the pick extending and retracting into the shaft, 
         FIGS.  34  and  35    illustrate the feature of the shaft receiving the pick; 
         FIG.  36    illustrates a feature of the intraocular pick and dissector placed in the eye; 
         FIG.  37    illustrates a perspective view of an intraocular pick and dissector, in accordance with another embodiment of the present invention; and 
         FIG.  38    illustrates the feature of the shaft having light and laser at distal end. 
     
    
    
     It will be noted that throughout the appended drawings, like features are identified by like reference numerals. 
     DETAILED DESCRIPTION OF THE EMBODIMENTS 
     Before the present features and working principle of a surgical apparatus is described, it is to be understood that this subject matter is not limited to the particular surgical apparatus as described, since it may vary within the specification indicated. Various features of a surgical apparatus might be provided by introducing variations within the components/subcomponents disclosed herein. It is also to be understood that the terminology used in the description is for the purpose of describing the particular versions or embodiments only, and is not intended to limit the scope of the present subject matter, which will be limited only by the appended claims. The words “comprising,” “having,” “containing,” and “including,” and other forms thereof, are intended to be equivalent in meaning and be open-ended in that an item or items following any one of these words is not meant to be an exhaustive listing of such item or items, or meant to be limited to only the listed item or items. 
     It should be understood that the present invention describes a surgical apparatus for performing a microsurgery. The surgical apparatus includes a cannula having an intraocular portion. The intraocular portion connects to an infusion tube. The intraocular portion includes fenestrations at its distal end. The intraocular portion receives fluid through the infusion tube and dispenses the fluid through the fenestrations lessening the flow at an infusion site in an eye. The surgical apparatus includes a vitreous cutter. The vitreous cutter includes a suction tube at one end and a shaft at another end. The cutting port cuts vitreous into smaller pieces. The shaft receives the cut vitreous pieces and the suction tube draws out the cut vitreous pieces from the eye. The surgical apparatus includes a vitreoretinal surgical tool having a vitreoretinal cutter. The vitreoretinal cutter has a scissor-like or forceps-like mechanism. The vitreoretinal cutter holds and/or cuts a membrane in the eye during the microsurgery. 
     Various features and embodiments of a surgical apparatus for performing a microsurgery are explained in conjunction with the description of  FIGS.  1 - 38   . 
     The present invention discloses a surgical apparatus for performing a microsurgery.  FIG.  1    shows an exemplary environment  10  as viewed by a surgeon using surgical apparatus  12  for performing a microsurgery on eye  14 , in accordance with one embodiment of the present invention. The microsurgery includes ophthalmological surgical procedure/vitrectomy/vitreoretinal and ocular surgery such as Rhegmatogenous Retinal Detachment, Macular Holes, Epiretinal Membranes, Retinal Transplantation, Dislocated intraocular lens (IOL), Non-Clearing Vitreous Hemorrhage, Proliferative Diabetic Retinopathy, Traction Retinal Detachment, Retinopathy of Prematurity, Pediatric Rhegmatogenous Retinal Detachment, Uveitis induced Retinal Detachment, Choroidal and Retinal Biopsy, Giant Retinal Tears, Choroidal Hemorrhage, Submacular Hemorrhage, Age-Related Macular Degeneration, Uveal Effusion Syndrome, Endophthalmitis, Intraocular Foreign Body, Open Globe rupture, Retinoschisis Retinal Detachment, Optic Pit Maculopathy, Retinal Detachment, and Proliferative Vitreoretinopathy. 
     In order to perform the microsurgery, an eye surgeon places speculums  15  to hold eye  14  open, as shown in  FIG.  1   . The surgeon inserts cannula  16 . Cannula  16  allows a fluid to go into the eye to replace vitreous. Further, the surgeon inserts vitreous cutter  18  for removing one of remove scar tissue, laser repair of retinal detachments and treatment of macular holes. The vitreous cut by the vitreous cutter  18  is removed through vitreous cutter  18 . During the surgery, fiberoptic light  19  projects light L for aiding the surgeon to cut and remove the vitreous. 
       FIG.  2    shows surgical apparatus  12  having cannula  16 , vitreous cutter  18 , and vitreoretinal surgical tool  20 , in accordance with one embodiment of the present invention.  FIG.  3    shows a side view of cannula  16 , in accordance with one embodiment of the present invention. Cannula  16  includes intraocular portion  22 . Intraocular portion  22  indicates a tube-like or syringe-like structure having interior  24  extending the entire length of intraocular portion  22 .  FIG.  4    shows a cross-sectional view of intraocular portion  22  having interior  24 . Intraocular portion  22  encompasses guard portion  26 . Guard portion  26  surrounds intraocular portion  22  and helps to operate cannula  16  by an eye surgeon or ophthalmologist. Intraocular portion  22  connects to infusion tube  28  at one end, as shown in  FIGS.  3  and  4   . Infusion tube  28  receives fluid that exits through the distal end of intraocular portion  22  to remove vitreous humor or vitreous inside eye  14 . In accordance with one embodiment, intraocular portion  22  presents tapered tip  30  at its distal end.  FIGS.  3  and  4    show the feature of intraocular portion  22  having tapered tip  30 . At the distal end, intraocular portion  22  presents plurality of fenestrations  32 . In one example, fenestrations  32  indicate openings or pores spread along the entire tapered tip  30 . In another example, fenestrations  32  spread the entire length of intraocular portion  22  (i.e., from the distal end having tapered tip  30  to other end where infusion tube  28  connects). Here, fenestrations  32  position at equal distance or varied distance from one another. A person skilled in the art understands that fenestrations  32  can come in different shapes, sizes and numbers depending on the need without departing from the scope of the present invention. Further, each fenestration  32  includes an angled opening allowing liquid  34  to dispense at a less pressure/flow.  FIG.  5    shows the feature of fenestration  32  having angled opening through which liquid  34  dispenses. 
     In conventional cannulas, the liquid exists through the distal end of the intraocular portion having a single opening (i.e., at tapered tip  30 ) during the vitreoretinal and ocular surgery. This creates a “jet stream” of fluid or gas being injected directly into the eye, which can hit the opposite side of the retina and potentially damage it. In order to overcome the above problem, the presently disclosed cannula  16  presents intraocular portion  22  having fenestrations  32 , through which the liquid received from infusion tube  28  is made to spread and then hit the eye. The spreading of the liquid from fenestrations  32  lessens the flow on the retina at a given infusion site and prevents the “jet stream” effect associated with the conventional cannulas. Further, angled fenestrations  32  help to avoid or reduce perpendicular injection of fluid and maximize posterior injection in side fenestrated pars plana infusion cannulas during the vitreoretinal and ocular surgery. 
       FIG.  6    shows cannula  40 , in accordance with another embodiment of the present invention. Similar to cannula  16 , cannula  40  includes intraocular portion  42 . Intraocular portion  42  encompasses guard portion  44 . Guard portion  44  surrounds intraocular portion  42  and helps to operate cannula  40  by an eye surgeon or ophthalmologist. Intraocular portion  42  connects to infusion tube  46  at one end and presents tapered tip  48  at its distal end. Here, intraocular portion  42  presents fenestrations  50  extending at tapered tip  48 . The present embodiment is shown to illustrate position of fenestrations  50  only at tapered tip  48 . A person skilled in the art understands that cannula  40  operates similarly to cannula  16 , as explained above and prevents the “jet stream” effect associated with the conventional cannulas. 
       FIG.  7    shows cannula  60 , in accordance with another embodiment of the present invention. Similar to cannula  16 , cannula  60  includes intraocular portion  62 . Intraocular portion  62  encompasses guard portion  64 . Guard portion  64  surrounds intraocular portion  62  and helps to operate cannula  60  by an eye surgeon or ophthalmologist. Intraocular portion  62  connects to infusion tube  66  at one end and presents curved tip  68  at its distal end. Here, intraocular portion  62  presents fenestrations  70  at curved tip  68 . A person skilled in the art understands that cannula  60  operates similarly to cannula  16 , as explained above and prevents the “jet stream” effect associated with the conventional cannulas. 
     As shown in  FIG.  2   , surgical apparatus  12  includes vitreous cutter  18 .  FIG.  8 A  shows the feature of vitreous cutter  18 , in accordance with one embodiment of the present invention. Vitreous cutter  18  presents handle  72 . In one implementation, handle  72  allows the ophthalmologist to hold vitreous cutter  18  and remove scar tissue, laser repair of retinal detachments and treatment of macular holes. At one end, handle  72  includes tapered portion  74 . At the other end, handle  72  connects to suction tube  76  that connects to port. Vitreous cutter  18  includes shaft or probe  78  extending from tapered portion  74  of handle  72 . Shaft  78  comes in a variety of configurations such as curved, bent, elongated in straight or bent, or straight.  FIG.  8 A  shows shaft  78  in a curved configuration.  FIG.  8 B  shows shaft  78  in a bent configuration.  FIG.  8 C  shows shaft  78  in an elongated configuration.  FIG.  8 D  shows shaft  78  in a straight configuration. A person skilled in the art understands that shaft  78  can come in any other configuration without departing from the scope of the present invention. 
     Shaft  78  encompasses a hollow structure or opening (not shown) extending the entire length of shaft  78 . Shaft  78  presents cutting port  80 . Cutting port  80  has a U-shaped configuration and positions at distal end  81  of shaft  78 .  FIGS.  9 A,  9 B and  9 C  show a front, a top and a rear side view, respectively of shaft  78  having cutting port  80 , in accordance with one embodiment of the present invention. In one example, cutting port  80  has a size of 19-gauge or 1 millimeter. In another example, cutting port  80  has a size of 27-gauge. A person skilled in the art understands that cutting port  80  can come in any other shape and size without departing from the scope of the present invention. 
     Although  FIGS.  9 A,  9 B and  9 C  show shaft  78  having a single cutting port  80 , it is possible to provide more than one cutting port  80  along the length (or its distal end  81 ) of shaft  78  to cut the vitreous into smaller pieces and to improve the flow into cut pieces into suction tube  76 . Further, a person skilled in the art understands that cutting port  80  can come any other size/dimension depending on the need. For instance, the ophthalmologist may select shaft  78  having cutting port  80  with a size of 17-gauge in a diabetic surgery, macular surgery, retinal detachment, and other procedures that require fine dissection of membranes in a traction-less environment. Here, the ophthalmologist selects shaft  78  having cutting port  80  based on a number of variables, including but not limited to, the port depth, port diameter, distance between the port and tip, external shaft diameter, and internal shaft diameter. 
     The presently disclosed vitreous cutter  18  is capable of operating at significantly higher cut rates of 7500 to 8000 or even more say up to 16,000 cuts per minute (cpm) using spring-driven mechanisms or dual pneumatic pumps that independently control the opening and closing of cutter port  80 . Faster cutting speed helps to achieve more efficient surgery as the vitreous is being cut into smaller pieces and thus the flow is improved. Further, faster cutters result in safer vitrectomy because of the reduced traction on the retina. Furthermore, curved shaft  78  greatly alleviates damage to the eye during the pars plana vitreoretinal and ocular surgery and facilitates better removal of the vitreous and proliferative and scar tissue. A person skilled in the art understands that curved shaft  78  can be used to remove the vitreous using mechanical, ultrasound, laser or any other conventional known means of removing the vitreous. 
     In pars plana vitreoretinal and ocular surgery, retinal or neovascular vessels may be cut. Further, removing of the vitreous cutter after surgery from the eye instantly lowers the flow in the eye allowing ongoing bleeding or to considerably worsen, sometimes filling the eye with vision obscuring blood requiring its removal before continuing. In order to address the above problem, a conventional vitreous cutter needs to be removed and cautery has to be replaced to stop bleeding. Subsequently a laser and a light are inserted separately to treat the retina or other structure. 
     In order to overcome the above problems, the presently disclosed vitreous cutter  18  includes a laser, a light and cautery probe fitted at distal end  81  of shaft  78 . This multifunctional vitreous cutter  18  with additional built-in features, such as light, laser, cautery probe and other devices allow it to be used without having to remove and insert several times during pars plana vitreoretinal and ocular surgery.  FIG.  10    shows a perspective view of shaft  78  having laser  82  at its distal end  81 , in accordance with one embodiment of the present invention. Laser  82  connects via laser wire  84  that draws power from a power source (not shown).  FIG.  11    shows the feature of laser  82  connecting via laser wire  84 . As can be seen, laser wire  84  draws and extends at the interior of shaft  78  and as such it is not visible from the outer side. This ensures laser wire  84  does not hinder operation of vitreous cutter  18  to remove scar tissue, laser repair of retinal detachments and treatment of macular holes, for example. Laser  82  draws power through laser wire  84  and projects laser  86  to treat the retina or other structure in eye  14 .  FIG.  12    shows a cross-section of shaft  78  having laser  82 . 
       FIG.  13    shows a perspective view of shaft  88  having light  94 , in accordance with another embodiment of the present invention. Here, shaft  88  encompasses cutting port  90 . Shaft  88  presents light  94  at its distal end  92 . Light  94  connects via light wire  96  that draws power from a power source (not shown).  FIG.  14    shows the feature of light  94  connecting via light wire  96 . Light  94  draws power through light wire  96  and projects light  98  to help the ophthalmologist to treat the retina or other structure in eye  14 .  FIG.  15    shows a cross-section of shaft  88  having light  94 . 
       FIG.  16    shows a perspective view of shaft  100  having bipolar cautery probe  106  and light  108 , in accordance with another embodiment of the present invention. Here, shaft  100  encompasses cutting port  102 . Shaft  100  presents bipolar cautery probes  106  and light  108  at its distal end  104 . Bipolar cautery probe  106  connects via wire  110  that draws power from a power source (not shown). Light  108  connects via light wire  112  that draws power from a power source (not shown).  FIG.  17    shows the feature of laser  106  connecting via laser wire  110  and light  108  connecting via light wire  112 . As can be seen, light wire  112  draws and extends at the interior of shaft  100 . This ensures light wire  112  does not hinder operation of vitreous cutter  18  to remove scar tissue, laser repair of retinal detachments and treatment of macular holes.  FIG.  18    shows a cross-section of shaft  100  having bipolar cautery probe  106  connecting via wire  110  and light  108  connecting via light wire  112 . Here, bipolar cautery probe  106  draws power through laser wire  110  and projects laser to treat the retina or other structure in eye  14  while light  108  projects light to help the ophthalmologist to treat the retina or other structure in eye  14 . 
       FIG.  19    shows a perspective view of shaft  114  having laser  118 , light  120  and bipolar cautery probe  122 , in accordance with yet another embodiment of the present invention. Here, shaft  114  encompasses cutting port  116 . Shaft  114  presents laser  118 , light  120  and bipolar cautery probe  122  at its distal end  117 . Laser  118  connects via laser wire  124  that draws power from a power source (not shown). Light  120  connects via light wire  126  that draws power from a power source (not shown). Further, bipolar cautery probes  122  connect via probe wires  128  that draw power from a power source (not shown).  FIG.  20    shows the feature of laser  118  connecting via laser wire  124 , light  120  connecting via light wire  126  and bipolar cautery probe  122  connecting via probe wires  128 . Here, laser  118  draws power through laser wire  124  and projects laser to treat the retina or other structure in eye  14  while light  120  projects light to help the ophthalmologist to treat the retina or other structure in eye  14 . Bipolar cautery probe  122  allows for cauterization in addition to cutting during the surgery. This ensures that vitreous cutter  18  (having light, laser and cautery probe) can be used without requiring insertion of separate cautery tools. In addition, laser wire  124 , light wire  126  and probe wires  128  position at the inner side of shaft  114 . As such, they do not interfere with the cutting or suction operation by shaft  114  and cutting port  116 . 
     From the above, a person skilled in the art understands that the presently disclosed vitreous cutter provides a multifunctional cutter that overcomes the need to remove vitreous cutter and insert a separate tool during the ocular surgery. This improves efficiency of the ocular surgery while potentially reducing the risk of serious damage to the eye due to removal and re-entry of additional tools during the surgery. Further, this increases safety and reduces the risks associated with certain ocular procedures during the ocular surgery. 
     As shown in  FIG.  2   , surgical apparatus  12  includes vitreoretinal surgical tool  20 . Typically, vitreoretinal and ocular surgeries tend to require the use of multiple tools, which in turn requires multiple entries into the eye to change the instrument. Multiple entries of instruments into the eye risks the loss of pressure/flow and potential for haemorrhage and complications with each entry. In order to overcome the above difficulties, the presently disclosed vitreoretinal surgical tool  20  provides a single tool to cut or peel of membranes and cauterization at the same time. This limits the number of entries into the eye and greatly decreases the time of surgery and likelihood of complications during the vitreoretinal and ocular surgery. 
       FIG.  21    shows a perspective view of vitreoretinal surgical tool  20 , in accordance with one embodiment of the present invention. Vitreoretinal surgical tool  20  includes handle  130  that receives tubular section  132 . Handle  130  connects to a power source and a light source  131  to provide light at the retina for operating vitreoretinal surgical tool  20 . Tubular section  132  has tapered portion  134 . Vitreoretinal surgical tool  20  encompasses intraocular portion  136  extending from tapered portion  134  of tubular section  132 . Intraocular portion  136  presents distal end  138 . At distal end  138 , intraocular portion  136  encompasses light  139 . Intraocular portion  136  includes vitreoretinal cutter  140 . Vitreoretinal cutter  140  encompasses a scissor-like or forceps-like mechanism for holding and/or cutting of membrane in eye  14 .  FIG.  22    shows an exemplary vitreoretinal cutter  140 , in accordance with one embodiment of the present invention. Vitreoretinal cutter  140  includes first cutter  142  and second cutter  144 . Each of first cutter  142  and second cutter  144  indicates a blade for holding and/or cutting of membrane in eye  14 .  FIG.  23    shows a feature of vitreoretinal cutter  140  placed in eye  14 . Here, vitreoretinal cutter  140  inserts in eye  14 . Upon placing vitreoretinal cutter  140 , light  138  emits light  145  for aiding the ophthalmologist during the vitreoretinal and ocular surgery. The ophthalmologist engages handle  130  to actuate intraocular portion  136  for operating vitreoretinal cutter  140  to cut and/or remove the membrane in eye  14 . 
     In one implementation, first cutter  142  acts as a positive pole for cauterization and second cutter  144  acts as a negative pole for cauterization. When actuated with the help of handle  130 , first cutter  142  and second cutter  144  cut the membrane and cauterize at the same time. This ensures the membrane is cut and cauterized with the same instrument without necessitating the removal and re-entry of multiple tools during the surgery. This reduces the time taken for surgery and the likelihood of complications taking in and out of multiple instruments during the surgery. 
     A person skilled in the art understands that vitreoretinal surgical tool  20  can also be used in proliferative vitreoretinopathy (PVR) procedures and diabetic retinopathy and other similar surgeries, such as those involving tumors. 
       FIG.  24    shows intraocular portion  146  having vitreoretinal cutter  150 , in accordance with another embodiment of the present invention. Here, intraocular portion  146  presents distal end  147 . At distal end  147 , intraocular portion  146  encompasses light ring  148 . Intraocular portion  146  includes vitreoretinal cutter  150 . Vitreoretinal cutter  150  encompasses a curved scissor-like mechanism for holding and/or cutting of membrane in eye  14 . Vitreoretinal cutter  150  includes first cutter  152  and second cutter  154 . Here, first cutter  152  indicates a curved blade having positive pole for cauterization and second cutter  154  indicates a curved blade having negative pole for cauterization. Here, vitreoretinal cutter  150  draws power from power source and a light source  131  and helps to hold and/or cut membrane in eye  14  during the vitreoretinal and ocular surgery. 
       FIG.  25    shows intraocular portion  156  having vitreoretinal cutter  160 , in accordance with another embodiment of the present invention. Here, intraocular portion  156  presents distal end  157 . At distal end  157 , intraocular portion  156  encompasses light  158 . Intraocular portion  156  includes vitreoretinal cutter  160 . Vitreoretinal cutter  160  encompasses a vertical scissor-like mechanism for holding and/or cutting of membrane in eye  14 . Vitreoretinal cutter  160  includes first cutter  162  and second cutter  164 . Here, first cutter  162  indicates a vertical blade having positive pole for cauterization and second cutter  164  indicates a vertical blade having negative pole for cauterization. Here, vitreoretinal cutter  160  draws power from power source and a light source  131  and helps to hold and/or cut membrane in eye  14  during the vitreoretinal and ocular surgery. 
       FIG.  26    shows intraocular portion  166  having vitreoretinal cutter  170 , in accordance with yet another embodiment of the present invention. Here, intraocular portion  166  presents distal end  167 . At distal end  167 , intraocular portion  166  encompasses light ring  168 . Intraocular portion  166  includes vitreoretinal cutter  170 . Vitreoretinal cutter  170  encompasses L-shaped forceps-like mechanism for holding and/or cutting of membrane in eye  14 . Vitreoretinal cutter  170  includes first blade  172  and second blade  174 . Here, first blade  172  indicates a L-shaped blade having positive pole for cauterization and second blade  174  indicates a L-shaped blade having negative pole for cauterization. Here, vitreoretinal cutter  170  draws power from power source and a light source  131  and helps to hold and/or cut membrane in eye  14  during the vitreoretinal and ocular surgery. 
       FIG.  27    shows intraocular portion  176  having vitreoretinal cutter  180 , in accordance with yet another embodiment of the present invention. Here, intraocular portion  176  presents distal end  177 . At distal end  177 , intraocular portion  176  encompasses light  178 . Intraocular portion  176  includes vitreoretinal cutter  180 . Vitreoretinal cutter  180  encompasses forceps-like mechanism i.e., serrated forceps for holding and/or cutting of membrane in eye  14 . Vitreoretinal cutter  180  includes first blade  182  and second blade  184 . Here, first blade  182  has a positive pole for cauterization and second blade  184  has a negative pole for cauterization. Each of first blade  182  and second blade  184  have teeth  185  (serrated forceps) to firmly grip the membrane during vitreoretinal and ocular surgery. 
       FIG.  28    shows intraocular portion  186  having vitreoretinal cutter  190 , in accordance with yet another embodiment of the present invention. Here, intraocular portion  186  presents distal end  187 . At distal end  187 , intraocular portion  186  encompasses light ring  188 . Intraocular portion  186  includes vitreoretinal cutter  190 . Vitreoretinal cutter  190  encompasses angled forceps for holding and/or cutting of membrane in eye  14 . Vitreoretinal cutter  190  includes first blade  192  and second blade  194 . Here, first blade  192  indicates an angled blade having positive pole for cauterization and second blade  194  indicates an angled blade having a negative pole for cauterization. Here, vitreoretinal cutter  190  draws power from power source and a light source  131  and helps to hold and/or cut membrane in eye  14  during the vitreoretinal and ocular surgery. 
     The presently disclosed vitreoretinal cutter provides for cutting or peeling of membranes and cauterization at the same time. This reduces the time of surgery and likelihood of complications as this limits the number of entries each instrument enters and exits the eye during the vitreoretinal and ocular surgery. 
     Surgical apparatus  12  further includes an intraocular pick and dissector.  FIG.  29    shows a perspective view of intraocular pick and dissector  200 , in accordance with one embodiment of the present invention. Intraocular pick and dissector  200  includes elongated tube or handle  202 . Elongated tube  202  encompasses tapered section  204  at one end. Intraocular pick and dissector  200  includes shaft  206  extending from tapered section  204  of elongated tube  202 . Shaft  206  presents distal end  208 . In one example, shaft  206  includes light  210  such as Light Emitting Diode (LED) at distal end  208 . Alternatively, shaft  206  includes a camera (not shown) for capturing and providing a live feed to aid the ophthalmologist during the surgery. In one implementation, intraocular pick and dissector  200  encompasses pick  212  that extends and retracts into shaft  206 .  FIGS.  30  and  31    show a perspective and a top view of pick  212  extending from shaft  206 . Pick  212  encompasses injector ports  214  at the end as shown in at least  FIGS.  30  and  31   . In the present embodiment, shaft  206  encompasses pick receiving area  216  ( FIG.  35   ) configured for receiving pick  212 . Here, pick  212  extends from shaft  206  ( FIG.  32   ) and retracts into pick receiving area  216  ( FIG.  33   ). In order to extend or retract pick  212 , elongated tube  202  presents button  218  that slides and operates pick  212 . Upon engaging ( FIG.  33   ), pick  212  retracts into pick receiving area  216  as shown in  FIGS.  34  and  35   . Further, elongated tube  202  includes fluid connecting port  220 , light port  222  and power receiving port  224  at the other end (i.e., opposite end of tapered section  204 ). 
       FIG.  36    shows a feature of intraocular pick and dissector  200  placed in eye  14 . Here, intraocular pick and dissector  200  inserts in eye  14 . Upon placing intraocular pick and dissector  200 , light  210  emits light  226  for aiding the ophthalmologist during the vitreoretinal and ocular surgery. The ophthalmologist engages elongated tube  202  to extend or retract pick  212  into shaft  206  during vitreoretinal and ocular surgery. 
       FIG.  37    shows a perspective view of intraocular pick and dissector  230 , in accordance with another embodiment of the present invention. Intraocular pick and dissector  230  includes elongated tube or handle  232 . Elongated tube  232  encompasses shaft  234  extending from elongated tube  232 . Shaft  234  presents distal end  236 . In one example, shaft  234  includes light  238  and laser  240  at distal end  236 .  FIG.  38    shows the feature of shaft  234  having light  238  and laser  240  at distal end  236 . As explained above, intraocular pick and dissector  230  encompasses pick  242  that extends and retracts into shaft  234 . Pick  242  encompasses injector ports  244  at the end, as shown in  FIG.  38   . Further, elongated tube  232  includes fluid connecting port  246 , light port  248 , laser port  250  and power receiving port  252  at the other end (i.e., opposite end of tapered section  234 ), as shown in  FIG.  37   . 
     The presently disclosed intraocular pick and dissector helps to pick and dissect highly vascularized tissue, membranes or scar tissue at the same time during the vitreoretinal and ocular surgery. This limits the number of entries of instruments used during the surgery. Limiting the number of entries of instruments helps to reduce potentially irreversible damage to the eye and increase the speed of the surgery. This greatly reduces the inconvenience to the patient undergoing the surgery. 
     Based on the above, it is evident that the presently disclosed surgical apparatus provides instruments that are multifunctional and reduces the number of times instruments enter in and out of the eye during the vitreoretinal and ocular surgery. This ensures faster and safer surgery. 
     In the above description, numerous specific details are set forth such as examples of some embodiments, specific components, devices, methods, in order to provide a thorough understanding of embodiments of the present disclosure. It will be apparent to a person of ordinary skill in the art that these specific details need not be employed, and should not be construed to limit the scope of the disclosure. 
     In the development of any actual implementation, numerous implementation-specific decisions must be made to achieve the developer&#39;s specific goals, such as compliance with system-related and business-related constraints. Such a development effort might be complex and time consuming, but is nevertheless a routine undertaking of design, fabrication, and manufacture for those of ordinary skill. Hence, as various changes could be made in the above constructions without departing from the scope of the invention, it is intended that all matter contained in the above description or shown in the accompanying drawings shall be interpreted as illustrative and not in a limiting sense. 
     The foregoing description of embodiments is provided to enable any person skilled in the art to make and use the invention. Various modifications to these embodiments will be readily apparent to those skilled in the art, and the novel principles and invention disclosed herein may be applied to other embodiments without the use of the innovative faculty. The invention set forth in the description is not intended to be limited to the embodiments shown herein, but is to be accorded the widest scope consistent with the principles and novel features disclosed herein. It is contemplated that additional embodiments are within the spirit and true scope of the disclosed invention.