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WO2003007861A1 - Systeme pour realiser une operation de micro-forage chez un homme ou un animal et son procede d'utilisation - Google Patents

Systeme pour realiser une operation de micro-forage chez un homme ou un animal et son procede d'utilisation Download PDF

Info

Publication number
WO2003007861A1
WO2003007861A1 PCT/IL2001/000671 IL0100671W WO03007861A1 WO 2003007861 A1 WO2003007861 A1 WO 2003007861A1 IL 0100671 W IL0100671 W IL 0100671W WO 03007861 A1 WO03007861 A1 WO 03007861A1
Authority
WO
WIPO (PCT)
Prior art keywords
drill
micro
control box
sleeve
tube
Prior art date
Application number
PCT/IL2001/000671
Other languages
English (en)
Inventor
Yehiel Sheffer
Original Assignee
Cutmed Ltd.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Cutmed Ltd. filed Critical Cutmed Ltd.
Priority to PCT/IL2001/000671 priority Critical patent/WO2003007861A1/fr
Publication of WO2003007861A1 publication Critical patent/WO2003007861A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting in contact-lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007—Methods or devices for eye surgery
    • A61F9/00772—Apparatus for restoration of tear ducts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/00234—Surgical instruments, devices or methods for minimally invasive surgery
    • A61B2017/00345—Micromachines, nanomachines, microsystems
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/00831—Material properties
    • A61B2017/00867—Material properties shape memory effect
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/00973—Surgical instruments, devices or methods pedal-operated
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/30—Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure
    • A61B2090/306—Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure using optical fibres

Definitions

  • the present invention relates to a system for performing a micro-drilling
  • the present invention relates to a system for performing
  • DCR dacryocystorhinostomy
  • Obstruction may occur in the lacrimal
  • DCR dacryocystorhinostomy
  • the procedure can be extremely bloody
  • present invention utilizes the natural lacrimal pathway in order to
  • the present invention relates to a system for performing micro-drilling of
  • control box is adapted
  • micro-drill is operable through the control box when said
  • micro-drill is inserted through said sleeve and said micro-drill
  • waste produced during the drilling of the bone can be aspirated from the surgical site.
  • the system of the present invention is especially useful in the
  • micro-drilling refers to the drilling of a relatively small hole, on the
  • micro-drill refers to a drill that is capable of forming a hole of
  • the system further comprises an optic fiber.
  • the optic fiber extends through the flexible tube and also extends from
  • the distal end of the tube such that the optic fiber may be connected to a
  • the connecting member is formed form rubber or
  • the optic fiber and the sleeve are affixed to the inner wall of
  • the affixment can be accomplished through any combination
  • adhesive means such as silicone glue.
  • system further comprises a cover for
  • micro-drill becomes positioned at the "zero" location
  • the micro-drill moves from the
  • the resistance to the advance is sensed by the system, which causes the
  • micro-drill to rotate in the clockwise direction at a high speed
  • the micro-drill has a diameter of approximately 0.5
  • the sleeve has an outer diameter of approximately 0.8
  • the flexible tube in other preferred embodiments of the present invention, the flexible tube
  • control box In other preferred embodiments of the present invention, the control box
  • control card containing program control and a display card
  • control box In other preferred embodiments of the present invention, the control box
  • the release/retract mechanism is coupled to the control
  • the empty sleeve can be used to thread a
  • control box further includes a mechanism for controlling the directional and rotational
  • the drilling mechanism is controlled by the control card
  • the drilling mechanism allows for both
  • control card which controls the rotation speed of the micro-drill.
  • control box In other preferred embodiments of the present invention, the control box
  • a laser diode that is connectable to a first end of an optic fiber through a plug on the panel of the control box for providing
  • illumination is produced at the proximal end of the tube so
  • control box In other preferred embodiments of the present invention, the control box
  • the air pump is detachably connected to the air suction tube
  • control box In other preferred embodiments of the present invention, the control box
  • control box and coupled to the display card such that the particular
  • control box In other preferred embodiments of the present invention, the control box
  • the micro-drill can be made of NITINOL or any other suitable material.
  • Nitinol is formed from nickel and titanium and can exist in two different
  • the micro-drill in plastic form and it can be
  • micro-drill is raised during disinfection (causing a to change to the
  • the micro-drill returns to the original, substantially
  • the present invention also relates to a method for performing a
  • the micro-drill is located immediately behind a
  • the method need not be restricted only to the performance of a DCR.
  • the present invention also relates to a control box for use in the system
  • opening of a blocked biological pathway comprising:
  • control box and said mechanism is directly controlled by the
  • alpha-numeric display on said panel of the control box
  • the air-pump is connectable to an exterior air suction tube and said air-pump is
  • control card directly controlled by the control card.
  • the control box is adapted for connection to an external electrical power
  • control box further comprises a laser
  • the laser diode is connectable to the optic fiber for enabling
  • the present invention also relates to a system for performing
  • control box is adapted
  • micro-drill and flexible sleeve extend from the proximal end of
  • sleeve is detachably connected to the proximal end of the handle.
  • the drill cable is positioned inside a sleeve, and the sleeve
  • micro-drill is disposable.
  • said micro-drill is comprised of
  • NITINOL extends between 0.6-0.8mm from the end of the sleeve.
  • the present invention also relates to a method for performing a DCR
  • the cannula remains in the lacrimal pathway
  • steps a-h are repeated by advancing
  • the method preferably comprises drawing the two ends of
  • a stent may be inserted into the hole in
  • the cannula has a slit extending on one
  • cannula has two longitudinal slits positioned 180 from one another for
  • Figure 1 is a side-view of a flexible tube and the components extending
  • Figure 2 is a cross-sectional view of the flexible tube of Figure 1.
  • Figure 3 is a schematic view of a control box and central components
  • FIG. 4 is an isometric view of the control box of Figure 3, showing the
  • Figure 5 is an isometric view of a mechanism for controlling the
  • Figure 6 is an isometric view of a mechanism for releasing a drill cable
  • Figure 7 is a schematic side view of a handle for facilitating performance
  • Figures 8A and 8B are side views of two preferred embodiments of cannulas, according to preferred embodiments of the present invention.
  • the system of the present invention includes a
  • silicone tube (alternatively, the flexible tube can be adapted in shape and
  • (9) has a proximal end (52) and a distal end (51). Extending from the
  • distal end (51) of the flexible tube (9) is a hollow sleeve (6) adapted for insertion therethrough of the micro-drill and a drill cable that is attached
  • a filament or optic fiber bundle used as a guide can be inserted
  • suction tube (2) that connects with the distal end (51) of the tube (9) to
  • optic fiber (18) also extends from the distal end (51) of the tube (9) for
  • system further includes a removable cover (53) that can fit onto the
  • the optic fiber (18) is connectable to a laser
  • the air suction tube (referred to in Figure 1) communicates
  • the hollow inner portion (11) is essentially comprised of the longitudinal
  • the flexible tube (9) is approximately 1.2 millimeters in inner
  • the flexible tube may be dimensioned differently according to the
  • the sleeve (6) has a diameter of approximately 0.25 millimeters.
  • the flexible tube (9) allows for incorporation of various materials
  • the flexible tube could be adapted for insertion therethrough of other
  • control box (31) of the system includes a
  • control card (16) that contains information and instructions for directing
  • the system is powered by an external electric power
  • central components of the control box (31) include a mechanism (4) for
  • control box also referred to as the "release/retract mechanism"
  • the drill cable is connected to the drilling
  • the control box (31) further includes an air pump (5) that is connectable, by a plug on
  • control box (31) for adjusting
  • the optic fiber referred to in Figure 1 may be plugged into the laser diode
  • any other optic fiber or optic fiber bundle may be any other optic fiber or optic fiber bundle.
  • control box (31) is also equipped with
  • the panel (71) of the control box (31) includes
  • alpha-numeric display (8) and an alpha-numeric display selector (23).
  • the panel (71) furthermore includes a series of indicator lamps, for indicating activities or providing warnings for the surgeon during a DCR
  • Indicator light 26 is for indicating the ON/OFF status of the
  • Indicator light 30 is for indicating READY status of the system.
  • Indicator light 29 is for indicating retraction and/or releasing of the drill
  • 57 is for indicating the air-pump status (ACTIVE/INACTIVE) of the
  • Indicator light 58 is for indicating the drill status (drilling
  • Warning light 17 is to
  • Warning light 15 is to alert the surgeon when the micro-drill reaches the
  • the panel (71) further includes a series of plugs, for providing connection
  • control box (31) controls the control box (31) and the other components of the system.
  • Plug 27 provides for connection between the drill cable and the
  • release/retract mechanism also referred to as the "retract/release plug”
  • Plug 19 provides for connection between the air suction tube and the
  • Plug 21 provides for connection between the drill cable and the
  • the control box (31) is also connected to a foot pedal (1) through a foot pedal cable (7) that
  • directional and rotational movement of the micro-drill includes a motor
  • micro-drill hereinafter referred to as the "directional motor" and a motor
  • the rotational motor (63) rests on a platform (62) and is
  • the directional motor (60) is coupled to a gear (39) that is movable
  • the release/retract mechanism includes a
  • the release/retract mechanism further includes a connective
  • the retracting motor (50) is connected to the release/retract plug.
  • the retracting motor (50) is connected to the release/retract plug.
  • the releasing motor (42) is coupled to a lower roller (45b)
  • cord (69) and drill cable (32) can move such that when the releasing
  • the system first is switched ON (switch 24). The system then switches ON (switch 24).
  • the micro-drill is
  • micro-drill reaches the bone of the nose, the sharp change in the
  • control card sensed by the control card and causes the following events to occur
  • indicator light 17 turns ON, to indicate reaching of the
  • an audio warning is sounded, also indicating that the bone of the
  • indicator light 17 turns OFF and indicator light 15
  • indicator light 29 is ON.
  • micro-drill (and drill cable) empty empty (said components having been
  • the sleeve can be used in order to thread a
  • numeric display (8) may convey other information as well, as one skilled
  • a handle (80) is adapted for facilitating performance of the
  • the handle has a generally cylindrical shape
  • Said handle has a distal end (87) and a proximal end (89).
  • a circular opening (81) is
  • the drill cable (32) is connected to the micro-drill (82) via a mechanical
  • micro-drill (82) rotates and is advanced within the handle (80) (and
  • the flexible sleeve (85) is of a flexible metal
  • Said sleeve (85) is attached to the proximal end (89) of the
  • the drill cable (32) is positioned inside a second flexible sleeve (91)
  • sleeve (91) is also connected to the handle via a ring (93) clamped to the
  • the bone is drilled in the same manner as described above.
  • the micro-drill (82) is
  • the ring (86) remain inside the lacrimal pathway.
  • a cannula is then inserted through the ring and the flexible sleeve into the
  • the cannula is then retracted and disengaged from around the tube or
  • the cannula comprises a flexible tubular member having either
  • the slit (98) is sized to allow for removing the tube or fiber from within the cannula (96).
  • silicone tube or optic fiber is inserted through the cannula.
  • micro-drill, cannula, optic for the next operation. It is appreciated that the micro-drill, cannula, optic
  • a stent Prior to insertion of the cannula inside the flexible sleeve (85), a stent is
  • stent is preferably 6- 15mm in length and is comprised of nitinol (conventionally used for blood vessel stents).
  • the diameter of the stent is
  • the stent is
  • a second stent is

Landscapes

  • Health & Medical Sciences (AREA)
  • Ophthalmology & Optometry (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Plastic & Reconstructive Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

La présente invention concerne un système pour réaliser une opération de micro-forage chez un homme ou un animal et son procédé d'utilisation. Ce système permet de réaliser un micro-forage sur un os ou un cartilage ou d'ouvrir une voie biologique bloquée et est notamment utile dans le cadre d'une dacryocystorhinostomie. Ledit système comprend (a) un boîtier de commande, conçu pour commander le fonctionnement et la régulation du système et pour être connecté à une source d'alimentation électrique externe, (b) un tube souple, présentant une extrémité proximale, une extrémité distale et une gaine, qui s'étend sur le tube et est conçue pour accueillir un micro-foret et un câble de forage, qui est attaché audit micro-foret et est connecté de manière amovible au boîtier de commande de façon que le micro-foret fonctionne par l'intermédiaire du boîtier de commande lorsque le micro-foret est inséré dans ladite gaine, le micro-foret étant situé à l'extrémité proximale du tube souple, ainsi que (c) un tube d'aspiration d'air, connecté à une partie interne creuse du tube souple et connecté de manière amovible au boîtier de commande de façon à pouvoir aspirer du site chirurgical les déchets qui sont produit au cours du forage de l'os.
PCT/IL2001/000671 2001-07-20 2001-07-20 Systeme pour realiser une operation de micro-forage chez un homme ou un animal et son procede d'utilisation WO2003007861A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
PCT/IL2001/000671 WO2003007861A1 (fr) 2001-07-20 2001-07-20 Systeme pour realiser une operation de micro-forage chez un homme ou un animal et son procede d'utilisation

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/IL2001/000671 WO2003007861A1 (fr) 2001-07-20 2001-07-20 Systeme pour realiser une operation de micro-forage chez un homme ou un animal et son procede d'utilisation

Publications (1)

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WO2003007861A1 true WO2003007861A1 (fr) 2003-01-30

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Cited By (24)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7560612B2 (en) 2002-03-13 2009-07-14 Pioneer Hi-Bred International, Inc. Early-inflorescence-preferred regulatory elements and uses thereof
US8058508B2 (en) 2002-03-19 2011-11-15 Stichting Dienst Landbouwkundig Onderzoek Optimizing glycan processing in plants
US8193415B2 (en) 1999-10-26 2012-06-05 Stichting Dienst Landbouwkundig Onderzock Plant expressing mammalian β1,4-galactosyltransferase and β1,3-glucuronyltransferase
US8439947B2 (en) 2009-07-16 2013-05-14 Howmedica Osteonics Corp. Suture anchor implantation instrumentation system
US8492613B2 (en) 2002-03-19 2013-07-23 Stichting Dienst Landbouwkundig Onderzoek GNTIII expression in plants
US8821494B2 (en) 2012-08-03 2014-09-02 Howmedica Osteonics Corp. Surgical instruments and methods of use
US8829276B2 (en) 2007-04-17 2014-09-09 Stichting Dienst Landbouwkundig Onderzoek Mammalian-type glycosylation in plants by expression of non-mammalian glycosyltransferases
US9078740B2 (en) 2013-01-21 2015-07-14 Howmedica Osteonics Corp. Instrumentation and method for positioning and securing a graft
US9232954B2 (en) 2009-08-20 2016-01-12 Howmedica Osteonics Corp. Flexible ACL instrumentation, kit and method
US9402620B2 (en) 2013-03-04 2016-08-02 Howmedica Osteonics Corp. Knotless filamentary fixation devices, assemblies and systems and methods of assembly and use
US9463013B2 (en) 2013-03-13 2016-10-11 Stryker Corporation Adjustable continuous filament structure and method of manufacture and use
US9788826B2 (en) 2013-03-11 2017-10-17 Howmedica Osteonics Corp. Filamentary fixation device and assembly and method of assembly, manufacture and use
US9795398B2 (en) 2011-04-13 2017-10-24 Howmedica Osteonics Corp. Flexible ACL instrumentation, kit and method
US9986992B2 (en) 2014-10-28 2018-06-05 Stryker Corporation Suture anchor and associated methods of use
WO2019064292A1 (fr) * 2017-09-27 2019-04-04 Prof. Arie Nemet Sherutei Refuah Outils et procédés de dacryocystorhinostomie
US10448944B2 (en) 2011-11-23 2019-10-22 Howmedica Osteonics Corp. Filamentary fixation device
US10568616B2 (en) 2014-12-17 2020-02-25 Howmedica Osteonics Corp. Instruments and methods of soft tissue fixation
US10610211B2 (en) 2013-12-12 2020-04-07 Howmedica Osteonics Corp. Filament engagement system and methods of use
WO2020202156A1 (fr) * 2019-04-03 2020-10-08 Tearflow Care Ltd. Outils et procédés de dacryocystorhinostomie
USD902405S1 (en) 2018-02-22 2020-11-17 Stryker Corporation Self-punching bone anchor inserter
US11331094B2 (en) 2013-04-22 2022-05-17 Stryker Corporation Method and apparatus for attaching tissue to bone
CN115708704A (zh) * 2022-10-26 2023-02-24 南京市第一医院 一种泪囊鼻腔钻孔器
US11759271B2 (en) 2017-04-28 2023-09-19 Stryker Corporation System and method for indicating mapping of console-based surgical systems
CN111200974B (zh) * 2017-06-05 2023-10-20 康曼德公司 多筒钻孔导向器及其系统

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Cited By (46)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8193415B2 (en) 1999-10-26 2012-06-05 Stichting Dienst Landbouwkundig Onderzock Plant expressing mammalian β1,4-galactosyltransferase and β1,3-glucuronyltransferase
US7560612B2 (en) 2002-03-13 2009-07-14 Pioneer Hi-Bred International, Inc. Early-inflorescence-preferred regulatory elements and uses thereof
US8058508B2 (en) 2002-03-19 2011-11-15 Stichting Dienst Landbouwkundig Onderzoek Optimizing glycan processing in plants
US8492613B2 (en) 2002-03-19 2013-07-23 Stichting Dienst Landbouwkundig Onderzoek GNTIII expression in plants
US8829276B2 (en) 2007-04-17 2014-09-09 Stichting Dienst Landbouwkundig Onderzoek Mammalian-type glycosylation in plants by expression of non-mammalian glycosyltransferases
US10159478B2 (en) 2009-07-16 2018-12-25 Howmedica Osteonics Corp. Suture anchor implantation instrumentation system
US9545252B2 (en) 2009-07-16 2017-01-17 Howmedica Osteonics Corp. Suture anchor implantation instrumentation system
US8911474B2 (en) 2009-07-16 2014-12-16 Howmedica Osteonics Corp. Suture anchor implantation instrumentation system
US11304690B2 (en) 2009-07-16 2022-04-19 Howmedica Osteonics Corp. Suture anchor implantation instrumentation system
US8439947B2 (en) 2009-07-16 2013-05-14 Howmedica Osteonics Corp. Suture anchor implantation instrumentation system
US12016548B2 (en) 2009-07-16 2024-06-25 Howmedica Osteonics Corp. Suture anchor implantation instrumentation system
US9232954B2 (en) 2009-08-20 2016-01-12 Howmedica Osteonics Corp. Flexible ACL instrumentation, kit and method
US10231744B2 (en) 2009-08-20 2019-03-19 Howmedica Osteonics Corp. Flexible ACL instrumentation, kit and method
US12419655B2 (en) 2009-08-20 2025-09-23 Howmedica Osteonics Corp. Flexible ACL instrumentation, kit and method
US11364041B2 (en) 2009-08-20 2022-06-21 Howmedica Osteonics Corp. Flexible ACL instrumentation, kit and method
US10238404B2 (en) 2009-08-20 2019-03-26 Howmedica Osteonics Corp. Flexible ACL instrumentation, kit and method
US9795398B2 (en) 2011-04-13 2017-10-24 Howmedica Osteonics Corp. Flexible ACL instrumentation, kit and method
US11844508B2 (en) 2011-11-23 2023-12-19 Howmedica Osteonics Corp. Filamentary fixation device
US10448944B2 (en) 2011-11-23 2019-10-22 Howmedica Osteonics Corp. Filamentary fixation device
US10123792B2 (en) 2012-08-03 2018-11-13 Howmedica Osteonics Corp. Soft tissue fixation devices and methods
US10653410B2 (en) 2012-08-03 2020-05-19 Howmedica Osteonics Corp. Soft tissue fixation devices and methods
US12171422B2 (en) 2012-08-03 2024-12-24 Howmedica Osteonics Corp. Soft tissue fixation device and methods
US8821494B2 (en) 2012-08-03 2014-09-02 Howmedica Osteonics Corp. Surgical instruments and methods of use
US9226744B2 (en) 2012-08-03 2016-01-05 Howmedica Osteonics Corp. Surgical instruments and methods of use
US9078740B2 (en) 2013-01-21 2015-07-14 Howmedica Osteonics Corp. Instrumentation and method for positioning and securing a graft
US10285685B2 (en) 2013-03-04 2019-05-14 Howmedica Osteonics Corp. Knotless filamentary fixation devices, assemblies and systems and methods of assembly and use
US9402620B2 (en) 2013-03-04 2016-08-02 Howmedica Osteonics Corp. Knotless filamentary fixation devices, assemblies and systems and methods of assembly and use
US9788826B2 (en) 2013-03-11 2017-10-17 Howmedica Osteonics Corp. Filamentary fixation device and assembly and method of assembly, manufacture and use
US9463013B2 (en) 2013-03-13 2016-10-11 Stryker Corporation Adjustable continuous filament structure and method of manufacture and use
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