IL124817A

IL124817A - Surgical sealing sleeve

Info

Publication number: IL124817A
Application number: IL12481798A
Authority: IL
Original assignee: Front Door Ocular Technology L
Priority date: 1998-06-08
Filing date: 1998-06-08
Publication date: 2001-12-23
Also published as: AU4162499A; IL124817A0; WO1999063917A1

Abstract

A surgical sealing sleeve (1) for temporary seating in an access tissue, for connecting to a source of irrigation fluid and for enabling the introduction of a surgical instrument therethough, the surgical sealing sleeve comprising: (a) an axially extending rigid tubular sleeve (2) for attachment to the access tissue and having an interior surface defining an axially extending passageway (3) with a proximal end and a distal end (16); (b) at least one sheath support member distally extending along said interior surface from adjacent said proximal end to adacent said distal end and terminating proximate thereto; (c) an elastomeric elongated sheath sealingly interdisposed between said sleeve יריעה מס' 51 10/2001 124817/1 and said at least one sheath support member and distally extending so as to fit over said at least one sheath support member, said sheath having an a priori sealed end adapted to be cut in situ to provide a normally closed unidirectional slit valve whereby the surgical instrument is enwrapped thereby on its introduction through said sleeve along substantially the entire length of said sleeve; and (d) at least one axially extending conduit integrally formed with said sleeve and in intimate contact therewith, each said conduit having an inlet port (13) at its proximal end for connection to the source of irrigation fluid and an outlet port (17) at its distal end. 10/2001

Description

124817/2 >*m>-> 001 t niw Surgical sealing sleeve Front Door Ocular Technology Ltd. »"«» ™ C. 111896 1 124817/2 SURGICAL SEALING SLEEVE FIELD OF THE INVENTION The present invention relates to surgical sealing sleeves in general and for ophthalmic surgical procedures in particular.

BACKGROUND OF THE INVENTION Phacoemulsification is performed via a slit formed in an eye's anterior segment tissue which is particularly susceptible to heat. To protect such tissue from heat, a bare ultrasound probe is encircled in a soft elongated tubular jacket having inlet and outlet ports respectively at its proximal and distal ends for administering a flow of irrigation fluid for cooling the probe and maintaining normal intraocular pressure in the face of, on the one hand, leakage between the jacket and the slit's side walls and, on the other hand, suction of unwanted debris from the phacoemulsification. The jacket has an overall diameter of about 3 mm which is considerably greater than the diameter of the probe itself which is about 1 mm and which militates against the probe's manipulation.

SUMMARY OF THE INVENTION In accordance with the present invention, there is provided a surgical sealing sleeve for temporary seating in an access tissue, for connecting to a source of irrigation fluid and for enabling the introduction of a surgical instrument therethrough, the surgical sealing sleeve comprising: (a) an axially extending rigid tubular sleeve for attachment to the access tissue and having an axially extending passageway with a proximal end and a distal end; (b) at least one sheath support member distally extending along said 2 124817/2 passageway adjacent said proximal end and terminating adjacent said distal end and proximal thereto; (c) an elastomeric elongated sheath sealingly interdisposed between said tubular sleeve and said at least one sheath support member and distally extending so as to fit over said at least one sheath support member, said sheath having an a priori sealed end adapted to be cut in situ to provide a normally closed unidirectional slit valve whereby the surgical instrument is enwrapped thereby along substantially the entire length of the surgical sealing sleeve on its introduction therethrough; and (d) at least one axially extending conduit integrally formed with said tubular sleeve and in intimate contact therewith, each said conduit having an inlet port at its proximal end for connection to the source of irrigation fluid and an outlet port at its distal end.

The surgical sealing sleeve of the present invention is a development of the surgical sealing device illustrated and described in PCT/IL97/00171 published under International Publication WO97/47247. However, in practice, the prior surgical sealing sleeve is restricted to ophthalmic procedures performed through an eye's sclera, for example, vitrectomy, requiring the repeated introduction of a number of sharp instruments whilst, against this, the surgical sealing sleeve of the present invention is envisaged for ophthalmic procedures performed through an eye's anterior segment tissue and in particular for phacoemulsification.

By virtue of its construction, the surgical sealing sleeve of the present invention enables the use of a conventional bare ultrasonic probe in phacoemulsification whereupon its vibrations are isolated therefrom on its introduction through its passageway by the elastomeric sheath which in 3 124817/2 addition functions as an uni-directional slit valve. At the same time, the at least one axially extending conduit enables a flow of irrigation fluid therethrough for, on the one hand, cooling the surgical sealing sleeve which would otherwise be heated by a bare ultrasound probe for protecting an eye's delicate anterior segment tissue from heat and, on the other hand, maintaining normal intraocular pressure in the face of intraocular liquid losses. Thus, the surgical sealing sleeve of the present invention affords for more convenient phacoemulsification through a smaller slit with improved flow irrigation and reduced leakage.

Further objects, features and advantages of the present invention will become apparent from the following detailed description when take in conjunction with the accompanying drawings wherein like reference numerals designate like elements through the several views.

BRIEF DESCRIPTION OF THE DRAWINGS Figs. 1 and 2 are respectively a perspective view and a partial cross section perspective view of a surgical sealing sleeve in accordance with the present invention; Figs. 3A and 3B are respectively a schematic cross section side view and a front view of a human eye through whose anterior segment tissue a surgical sealing sleeve of the present invention has been temporarily inserted for phacoemulsification; and Fig. 4 is the same view of the surgical sealing sleeve as in Figure 1 with a bare ultrasound probe introduced therethrough for phacoemulsification. 4 124817/2 DETAILED DESCRIPTION OF THE INVENTION With reference now to the drawings, Figure 1 shows a surgical sealing sleeve 1 having an axially extending rigid tubular sleeve 2 with a passageway 3 axially extending between a proximal end 3A associated with an access environment and a distal end 3B associated with an eye's interior. At its proximal end, the sleeve 2 is formed with an annular fixation plate 4 having an upright projection 6 for use with a cutting tool 7 and an internal screw thread 8 for releasable engagement with a matching external screw thread 9 of a hand held insertion tool 11, the cutting tool 9 and the hand held insertion tool 11 corresponding to the cutting tool and the hand held insertion tool of International Publication WO 97/47247.

A pair of diametrically opposite axially extending conduits 12A and 12B are in intimate contact with the sleeve 2 for cooling same and for irrigation purposes. Each conduit 12A and 12B has a L-shaped proximal section 13A and 13B with an inlet port 14A and 14B and a crescent shaped distal portion 16A and 16B with an outlet port 17A and 17B slightly short of the distal end 3B, the crescent shaped distal portions 16A and 16B substantially circumscribing the entire circumference of the sleeve 2. The overall width of the surgical sealing sleeve 1 is about 2 mm including a 1.5 mm diameter passageway.

Turning now to Figure 2, the sleeve 2 is formed with a recessed shoulder 18 at its proximal end 3 A for receiving a ring 19 formed with a pair of downwardly depending diametrically opposite rods 21 A and 2 IB members whose tips lie proximal of the distal end 3B, the ring 19 and the rods 21 A and 2 IB constituting a sheath securing member 22 and the rods 21A and 21B each constituting a sheath support member. The rods 21A 5 124817/2 and 2 IB are received in channels 23 A and 23B formed along the sleeve's interior surface 24 so as to be flush therewith. The sheath securing member 22 sealingly secures an ultrafine elongated elastomeric sheath 26 to the sleeve 2 such that it extends very slightly beyond the tips of the rods 21 A and 2 IB, thereby presenting side walls 27 A and 27B converging at a transversely directed sealed sheath end 28. On cutting the sealed sheath end 28 by means of the cutting tool 7, the side walls 27A and 27B act as a normally closed uni-directional silt valve under the prevailing pressure in an eye's interior.

As shown in Figures 3A and 3B, a single surgical sealing sleeve 1 on temporary insertion into an eye enables phacoemulsification with a bare ultrasound probe 29. The conduits 12A and 12B are each connected to a source of irrigation fluid whereby they cool down the sleeve 2 so as not to impair an eye's anterior segment tissue and at the same time maintain normal intraocular pressure in the face of suction of unwanted debris from the phacoemulsification upwards through the bare ultrasonic probe 29. The probe's vibrations are substantially isolated from the sleeve 2 by means of the sheath 26 which tends to enwrap the probe 29 substantially along the entire length of the sleeve 2 when introduced therethrough (see Figure 4).

While the invention has been described with respect to a limited number of embodiments, it will be appreciated that many variations, modifications and other applications of the invention may be made without departing from the scope of the claims as appended hereto.

Claims

6 124817/2 CLAIMS:

1. A surgical sealing sleeve for temporary seating in an access tissue, for connecting to a source of irrigation fluid and for enabling the introduction of a surgical instrument therethrough, the surgical sealing sleeve comprising: (a) an axially extending rigid tubular sleeve for attachment to the access tissue and having an axially extending passageway with a proximal end and a distal end; (b) at least one sheath support member distally extending along said passageway adjacent said proximal end and terminating adjacent said distal end and proximal thereto; (c) an elastomeric elongated sheath sealingly interdisposed between said tubular sleeve and said at least one sheath support member and distally extending so as to fit over said at least one sheath support member, said sheath having an a priori sealed end adapted to be cut in situ to provide a normally closed unidirectional slit valve whereby the surgical instrument is enwrapped thereby along substantially the entire length of the surgical sealing sleeve on its introduction therethrough; and (d) axially extending conduit means integrally formed with said sleeve and substantially circumscribing the sleeve in intimate contact therewith, said conduit means comprising at least one conduit having an inlet port at its proximal end for connection to the source of irrigation fluid and an outlet port at its distal end.

2. A surgical sealing sleeve according to Claim 1, further comprising a bipod like securing member for securing said sheath at said proximate end, said bipod like securing member including a pair of diametrically opposite rods each of which constitutes the sheath support member. 7 124817/2 A surgical sealing sleeve according to Claim 2, wherein said pair of sheath support members are each received in a channel extending along said inner surface. A surgical sealing sleeve according to any one of Claims 1 to 3, wherein said conduit means comprise a pair of diametrically opposite axially extending conduits, each conduit substantially circumscribing a semi-cylindrical portion of the sleeve. For the Applicants