Patent Description:
The vitreous humor itself is a clear gel that may be removed by an elongated probe when inserted through a pre-placed cannula at the eye. More specifically, the probe includes a central channel for removal of the vitreous humor. Further, the cannula provides a structurally supportive conduit strategically located at an offset location at the front of the eye, such as the pars plana. In this way, the probe may be guidingly inserted into the eye in a manner that avoids damage to the patient's lens or cornea.

Unfortunately, removal of the vitreous humor requires greater care than simply applying a vacuum through the channel of the probe. This is because the vitreous humor includes a fibrous matrix of collagen fibrils. Therefore, merely applying a vacuum to the gel would place the surrounding eye structure in jeopardy. That is, the fibrous nature of the gel is such that a vacuum pull on the gel into the probe might translate into a pull on the retina, optic nerve or other delicate eye structures.

In order to address this issue, vitrectomy probes are configured to cut vitreous humor as it is drawn into the channel of the probe. In this way, a continuous fibrous pull on the gel-like substance does not translate into a pull on delicate eye structures. Instead, the vitreous humor is pulled into the channel of the probe in very small, chopped segments. This chipping or cutting of the vitreous humor occurs by the reciprocation of a cutter within the channel of the probe. More specifically, the cutter reciprocates back and forth at a port for intake of the vitreous humor in a manner that cuts the substance as it is being drawn into the channel. Perhaps <NUM>,<NUM> to <NUM>,<NUM> cuts per minute (or more) may take place in this manner in order to safeguard the eye from pulling by the vitreous humor as it is being removed.

Of course, reciprocating a cutter in this manner means that during the vitrectomy, vibrations are naturally translated through the vitrectomy probe. Therefore, the surgeon that is manually carrying out the procedure faces the prospect of a vibration related distraction while manipulating the probe in tight delicate spaces.

In addition to vibration related distraction, the probe is generally outfitted with an extended handle or shell that supportively rests at the purlicue at the base of the surgeon's index finger close to the thumb during a vitrectomy. This is perhaps similar to how the extended end of a pencil would rest during writing. However, unlike writing, the precise delicate nature of a vitrectomy is such that some surgeons prefer holding the probe without utilizing the shell during the procedure. That is, surgeons have been known to pry the shell off the probe in a manner that allows for more fine control over the probe, much like manipulating a sewing needle in contrast to a long pencil. Prior art probes have a tight interference/friction fit between the shell and the probe that requires a large force to pull the shell off the probe. The outer part of the prior art shell would be forced outward when pulled off the probe because the outer part would slide over a protruding portion on a probe outer circumference. To inhibit accidental removal, the interfering geometry between the probe outer circumference and shell required the shell to be pried, wiggled, and/or twisted off to cause enough outer deformation on the shell to be pulled off the probe. Of course, crudely prying the end off a surgical tool in advance of eye surgery is problematic. Even for the surgeon that might be adept at shell removal without damaging the tool, a certain amount of user friendliness appears to be lacking.

Reference is made to <CIT> which relates to a surgical cutting instrument such as for use in intraocular surgery having a handpiece with an elongate probe extending forward from it. The probe includes an annular adapter, flange and dampening material in a particular arrangement. <CIT> provides a vibration dampening material of rubber or synthetic rubber in an ophthalmic pneumatic surgical instrument includes a housing, a tissue manipulating structure, a pneumatic driver, and a pneumatic power port.

The invention is as defined in independent claim <NUM>. Further features are provided in the dependent claims.

A vitrectomy probe is disclosed. The probe includes a component housing for accommodating moving components to support a vitrectomy procedure. An ergonomic shell is physically coupled to the housing at discrete catch extension locations. Further, a securing interface between the shell and the housing is provided which substantially eliminates contact between the shell and the housing outside of the extension locations. In one embodiment, deflection of the catch extensions may be employed to remove the shell. In another, the interface is of an elastomeric construction for isolation of vibration from the housing during the procedure.

In the following description, numerous details are set forth to provide an understanding of the present disclosure. However, it will be understood by those skilled in the art that the embodiments described may be practiced without these particular details. Further, numerous variations or modifications may be employed which remain contemplated by the embodiments as specifically described.

Embodiments are described with reference to certain types of vitrectomy probe surgical procedures. In particular, a procedure in which vitreous humor is removed to address vitreous hemorrhage is illustrated. However, tools and techniques detailed herein may be employed in a variety of other manners. For example, embodiments of a vitrectomy probe as detailed herein may be utilized to address retinal detachments, macular pucker, macular holes, vitreous floaters, diabetic retinopathy or a variety of other eye conditions. Regardless, so long as the vitrectomy probe incorporates an embodiment of an interfacing component to minimize contact between a housing and a shell of the probe, appreciable benefit may be realized.

Referring now to <FIG>, a perspective view of an embodiment of a vitrectomy probe <NUM> is shown utilizing a unique interfacing component <NUM>. This component <NUM> is positioned between a component housing <NUM> and a shell <NUM>. In absence of the shell <NUM>, the handheld portion of the probe <NUM> may include the housing that is generally under a few inches in total length. Therefore, the shell <NUM> is provided as a form of ergonomic support for the surgeon during a vitrectomy procedure.

As detailed further below, however, as a matter of user preference, some surgeons choose to utilize the probe <NUM> without the support of the shell <NUM>. Therefore, in the embodiment shown, the shell <NUM> is removable, rather than providing the probe <NUM> to the surgeon in a monolithic form. Thus, surgeons who wish to remove the shell <NUM> may do so in a user-friendly manner and in a manner that does not subject the probe <NUM> to potential damage with the surgeon crudely attempting to pry the shell <NUM> from the probe <NUM>. In this way, the vitrectomy procedure may be performed with the surgeon holding the housing <NUM> solely at the purlicue without any other interfering support.

Of course, the surgeon may more often prefer to leave the shell <NUM> in place for added support at the purlicue, like an extended pencil. Thus, the interfacing component <NUM> is configured to both stably accommodate securing of the shell <NUM> to the housing <NUM> during surgery while also facilitating a user friendly removal of the shell <NUM> if need be.

Stably accommodating the shell <NUM> during surgery means that the shell <NUM> may be subject to vibrations that are translated throughout the probe <NUM> during a procedure. More specifically, with added reference to <FIG>, the needle <NUM> accommodates an internal reciprocating cutter that traverses a port <NUM> as vitreous humor is drawn there into. In this way, vitreous humor may be cut as it is taken up so as to avoid a fibrous pull on delicate part of the patient's eye <NUM>. Reciprocating the cutter for this purpose means that moving components within the housing <NUM> subject the entire probe <NUM> to a certain degree of vibration.

In the embodiment shown, the interfacing component <NUM> may be tailored to mitigate the degree of vibration that is translated to the shell <NUM>. That is, the component <NUM> is strategically located between the housing <NUM>, which accommodates the moving components, and the shell <NUM>. Thus, with the proper architecture and material selection, the majority of the vibrations from the moving components in the housing <NUM> may be attenuated by the interfacing component <NUM> before reaching the shell <NUM>. Thus, potentially distracting vibrations to the surgeon may be avoided during a delicate eye surgery.

Continuing with reference to <FIG>, an exploded perspective view of the vitrectomy probe <NUM> of <FIG> is shown. In this view, the unique architecture of the interfacing component <NUM> is more apparent. Specifically, the component <NUM> is shaped to circumferentially interface and accommodate a leading edge <NUM> of the shell <NUM>. Only catch extensions <NUM> at two discrete locations reach beyond the interfacing component <NUM> to reach the structure of the housing <NUM>. Specifically, as illustrated, the extensions <NUM> may deflectingly secure the shell <NUM> to the component housing <NUM> through keyed orifices <NUM> at an internal housing <NUM> of the component housing <NUM>.

The coupling of the extensions <NUM> at the orifices <NUM> limits the direct physical interaction between the shell <NUM> and the housings <NUM>, <NUM> to these discrete points. All other physical interfacing at the leading edge <NUM> of the shell <NUM> is at and with the interfacing component <NUM>. As detailed further below, the housings <NUM>, <NUM> accommodate the moving parts of the probe <NUM>. Therefore, limiting contact between the shell <NUM> and the housings <NUM>, <NUM> to discrete locations as indicated, helps to minimize the translation of vibrations from the housings <NUM>, <NUM> to the shell <NUM>. Thus, the above noted potential for vibration distraction to the surgeon during an eye operation may also be minimized. Indeed, along these lines, the interfacing component <NUM> may be constructed of a conventional elastomeric polymer tailored to attenuate vibration.

The features of the interfacing component <NUM> described above are such that in one embodiment, the majority of vibrations from the vitrectomy probe <NUM> during operation do not reach the shell <NUM> when left in place by the surgeon. This is the case even where internal components of the probe <NUM> are moving rapidly enough to support over <NUM>,<NUM> cuts per minute as described above and further below. Of course, the shell <NUM> is also equipped with depressible tabs <NUM> at opposite sides from one another. Therefore, the surgeon may elect to pinch the tabs <NUM> toward one another to effectuate deflection of catch extensions <NUM> from the orifices <NUM> for removal of the shell <NUM> completely from the probe <NUM>. In this way, for surgeons who choose this technique, vibration distraction via the shell <NUM> may be eliminated altogether.

By way of specific example, in one embodiment the interfacing component <NUM> circumferentially contacts over <NUM>° of the leading edge <NUM> of the shell <NUM>. At the same time, direct contact between the shell <NUM> and the housings <NUM>, <NUM> is limited to the discrete locations of the extensions <NUM> at the orifices <NUM> which translates to an equivalent of under about <NUM>°. In this manner, the architectural and material makeup of the interfacing component <NUM> may attenuate a majority of the vibrations emanating from the housings <NUM>, <NUM> before they reach the shell <NUM> when it is left on the probe <NUM> during a surgical procedure.

Referring now to <FIG>, a side cross-sectional overview of a patient's eye <NUM> is shown during a vitrectomy procedure. During this surgical procedure, the vitrectomy probe <NUM> of <FIG> and <FIG> is utilized. Specifically, the needle <NUM> is inserted through a preplaced cannula <NUM> and directed toward a region <NUM> where vitreous humor is to be removed. Specifically, as described above, a suction is applied and the port <NUM> is used for the uptake of the vitreous humor or other substances. For example, in the procedure illustrated, a hemorrhage may be taking place in the region <NUM> such that blood is drawn into the port <NUM> along with the vitreous humor.

As also described above, a cutter is reciprocating within the needle <NUM> during this delicate procedure. As described further below, this means that a diaphragm <NUM> is repeatedly striking internal structure of the housings <NUM>, <NUM> of <FIG>, likely in excess of <NUM>,<NUM> times per minute (see <FIG>). Therefore, a notable amount of vibrations is prone to propagate through the probe <NUM> during a delicate eye surgery. However, due to the interfacing component <NUM> detailed above, a majority of this vibration may fail to reach the shell <NUM> in the surgeons hand at this critical time (see <FIG> and <FIG>).

Continuing with reference to <FIG>, the surgery illustrated includes the probe <NUM> and a light instrument <NUM> reaching into the eye <NUM> through cannulas <NUM>, <NUM> positioned in an offset manner at the sclera <NUM>. In this way, the more delicate cornea <NUM> and lens <NUM> may be avoided. By the same token, the optic nerve <NUM> and retina <NUM> are also quite delicate. Therefore, given that the needle <NUM> is capable of reaching these delicate features at the back of the eye <NUM>, the minimizing of potential distracting vibrations to the surgeon as described herein may be of substantial benefit.

Referring now to <FIG>, cross-sectional views of the vitrectomy probe <NUM> of <FIG> are shown revealing internal components. Specifically, <FIG> may be referred to as revealing a top view whereas <FIG> is rotated about <NUM>° from the top view to reveal another perspective of the internal components.

Notably, the internal housing <NUM> accommodates a diaphragm <NUM> that is reciprocated by an influx of air through channels. This occurs with the air alternatingly being applied to either side of the diaphragm <NUM> such that the reciprocation takes place. In this way, an extension tube <NUM> that accommodates the cutter may be reciprocating for cutting of vitreous humor as described above.

Reciprocating of the diaphragm <NUM> as described means that it will continuously strike structure of the internal housing <NUM> each time it completes a stroke in one direction or the other. This is the primary reason for the noted vibrations. However, as noted above, the interfacing component <NUM> is of such architecture and material construction that the majority of these vibrations fail to reach the shell <NUM> even when left in place during a surgical procedure.

Continuing with reference to <FIG>, catch extensions <NUM> are shown. It is at these discrete locations where contact between the internal housing <NUM> and the shell <NUM> occurs (see <FIG>). The remainder of the shell <NUM> is kept from direct interface with this housing <NUM> by the interfacing component <NUM> (see <FIG>).

With specific reference to <FIG>, a depressible tab <NUM> for one of the extensions <NUM> is visible. Thus, with simultaneous reference to <FIG> it is apparent how depressing such extensions <NUM> inward would result in release of the extensions <NUM> from engagement with the internal housing <NUM> for surgeons electing this option.

Referring now to <FIG>, an enlarged top view of the shell <NUM> of <FIG>, <FIG>, <FIG>, is illustrated. In this view, the depressible tab <NUM> is apparent with underlying catch extension <NUM> as described above. Additionally, ergonomic ridges <NUM> are shown at the surface of the shell <NUM>. These ridges <NUM> may promote a degree of rest or stillness of the shell <NUM> at the surgeon's hand during a vitrectomy procedure.

Referring now to <FIG>, a flow-chart summarizing an embodiment of utilizing a vitrectomy probe during a vitrectomy procedure is shown. Namely, an assembled vitrectomy probe is provided as indicated at <NUM>. The surgeon may then remove the shell in a user-friendly manner if desired (see <NUM>). Alternatively, the surgeon may keep the shell on the probe and allow it to rest at the purlicue of the hand as noted at <NUM>. In either case, the vitrectomy may be performed as indicated at <NUM> with distracting shell vibrations completely or substantially eliminated. Either way, the unique interfacing component of the probe has allowed for this benefit. In the end, the surgeon may complete a less distracting eye surgery and discard the probe as indicated at <NUM>.

Embodiments described hereinabove include a vitrectomy probe with an interfacing component that attenuates potentially distracting vibrations from a surgeon's perspective. Once more, for the surgeon that chooses, the shell may be removed entirely in a user-friendly manner without requiring that the surgeon crudely pry apart the probe.

Claim 1:
A vitrectomy probe (<NUM>) comprising:
a component housing (<NUM>) for accommodating moving components for supporting a vitrectomy procedure;
an ergonomic shell (<NUM>) for probe support during the procedure; and
a securing interface (<NUM>) accommodating each of the shell (<NUM>) and the housing (<NUM>) and positioned there between, the interface (<NUM>) for mitigating vibrations from reaching the shell (<NUM>) during the procedure from the moving components;
wherein the ergonomic shell (<NUM>) is physically coupled to the housing (<NUM>) at discrete catch extension (<NUM>) locations, the interface substantially eliminating contact between the shell and the housing outside of the extension locations for the mitigating of the vibrations;
wherein the shell (<NUM>) is removable by deflection of catch extensions (<NUM>) of the shell at the locations, and comprising depressible tabs (<NUM>) at an exterior surface of the shell to facilitate the deflection.