US3734099A - Powered surgical cutter - Google Patents

Abstract

A powered surgical cutter with its own controlled vacuum system designed to clip tissue and remove each piece as it is clipped through a vacuum line. The apparatus has an elongated external fixed tubular cutter interiorly of which a similar cutter rotates. The inner cutter is driven by a motor by means of a hollow drive shaft, the interior of which shaft is in communication with the interior of the inner cutter. Vacuum is supplied through the interior of the drive shaft to the interior of the cutter. Control means are provided whereby tissue drawn into an opening in the tubular cutter by the vacuum is sheared off by the rotation of the inner cutter inside and against the bore of the external cutter.

Description

United States Patent [1 1 Bender et a1.

[54] POWERED SURGICAL CUTTER [76] Inventors: Herman G. Bender, 5205 SE. 37th Avenue, Portland, Oreg. 97202; Robert N. Page, Route 1, Box 872, Beaverton, Oreg. 97005; Leslie D. Wold, 539 S.W. 188th Avenue, Aloha, Oreg. 97006 [22] Filed: Apr. 7, 1971 [21] Appl. No.: 114,702

Related us. Application Data [63] Continuation of Ser. No. 841,741, July 15, 1969,

[451 May 22, 1973 Muir ..128/305 X Primary Examiner-Channing L. Pace Attorney-Buckhorn, Blore, Klarquist & Sparkman 57 ABSTRACT A powered surgical cutter with its own controlled vacuum system designed to clip tissue and remove each piece as it is clipped through a vacuum line. The apparatus has an elongated external fixed tubular cutter interiorly of which a similar cutter rotates. The inner cutter is driven by a motor by means of a hollow drive shaft, the interior of which shaft is in communication with the interior of the inner cutter. Vacuum is supplied through the interior of the drive shaft to the interior of the cutter. Control means are provided whereby tissue drawn into an opening in the tubular cutter by the vacuum is sheared off by the rotation of the inner cutter inside and against the bore of the external cutter.

7 Claims, 9 Drawing Figures PATENTED 2 3734.099

SHEET 1 OF 2 BUG/(HORN, BLORE, KLAROU/ST 8 SPAR/(MAN ATTORNEYS POWERED SURGICAL CUTTER This application is a continuation of Ser. No. 841,741, filed July 15, 1969, and now abandoned.

BACKGROUND OF THE INVENTION This invention relates to powered surgical cutters and more particularly, to a powered surgical cutter particula'rly adapted to perform eye surgery by cutting and removing tissue from inside the anterior aqueous chamher of the eye.

Eye surgery in the anterior aqueous chamber is presently performed by making two opposite incisions on the edge of the chamber and inserting a syringe containing fluid in one opening and a knife in the other opening, and cutting the tissue into small pieces. The knife is then removed and a second syringe is placed in the opening. The second syringe draws off the pieces of tissue while the liquid in the first syringe displaces that which is removed by the second syringe. The process is repeated several times. Due to the tough nature of the tissue itself and the fact that the tissue is suspended in a liquid in the anterior aqueous chamber, this is a very difficult operation to perform.

It is thus the object of the present invention to provide a powered surgical cutter for the above described operation. It is a further object of the present invention to provide a surgical cutter that can be inserted into the anterior aqueous chamber of the eye through a precut opening, the cutter being able to remain in place until the surgery is completed. It is a further object of the present invention to provide such a powered surgical cutter with its own controlled vacuum system, the cutterbeing designed to clip tissue and remove each piece as it is clipped through the vacuum line.

SUMMARY OF THE INVENTION The surgical cutter of the present invention comprises a housing and motor means mounted in the housing. An elongated external fixed tubular cutter is attached at one end of the housing, the external cutter having an axial bore therethrough. The distal end of the external cutter is closed off and less than half of the diameter of the cutter is removed at the distal end to form a sharp edged opening through which tissue can be drawn.

An elongated inner tubular cutter is mounted in the bore of the external cutter for at least partial rotation about the axis thereof. The distal end of the inner cutter is similarly closed off, less than half the diameter of the inner cutter also being removed at the distal end to form an opening therein. The openings in both the inner and external cutters are in register so that rotation of the inner cutter will shear off tissue drawn into the opening.

Drive means are connected to the motor means for rotating the inner cutter. Such drive means comprise a hollow drive shaft, the interior of the drive shaft being in communication with the interior of the inner cutter. A source of vacuum is provided. Means are also provided to supply the vacuum from the source to the interior of the drive shaft and thence to the interior of the inner cutter. Finally, means are provided to control the supply of vacuum to the cutter.

In using the powered surgical cutter of the present invention to perform eye surgery in the anterior aqueouschamber of the eye, two openings are made in the chamber. A liquid-filled syringe is placed in one opening as previously described. The powered surgical cutter of the present invention is then inserted in the other opening while the vacuum and cutter are turned off. Once inside the anterior aqueous chamber, the cutter is turned on. The rotating inner cutter clips off pieces of tissue and draws each piece into the interior thereof and thence out the vacuum line. The vacuum is com trolled by a control knob to stop the flow when desired. When the cutter is running, the tissue and liquid re moved are replaced with liquid from the syringe to keep the anterior aqueous chamber properly inflated. The powered surgical cutter of the present invention, however, is not removed until the operation is complete. l

BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is a view showing the powered surgical cutter of the present invention performing an operation in the anterior aqueous chamber of the eye.

FIG. 2 is a top plan view of the powered surgical cutter of the present invention.

FIG. 3 is a longitudinal cross-sectional view taken on line 3-3 of FIG. 2.

FIG. 4 is a sectional view taken online 44 of FIG. 2.

FIG. 5 is a sectional view taken on line 5-5 of FIG. 3.

FIG. 6 is a sectional view taken on line 66 of FIG. 3.

FIG. 7 is a sectional view taken online 77 of FIG. 3.

FIG. 8 is a view to an enlarged scale and with parts broken away of the external and inner tubular cutters.

FIG. 9 is a view of the cutter showing the electrical control and vacuum pump connection.

DESCRIPTION OF THE PREFERRED EMBODIMENT Referring now to the drawings and in particular to FIGS. 28, thesurgical cutter 10 of the present invention has aplastic body 11 of generally cylindrical form designed to be conveniently held in the surgeons hand. An outer or external fixedtubular cutter 12 is attached to one end of thebody 11 and an inner tubularrotatable cutter 13 is mounted within thecutter 12 for rotation about theaxis 14 thereof. Theinner cutter 13 is driven by amotor 15. A vacuum is drawn on the interior of theinner cutter 13, the vacuum being controlled by aknob 16 in a manner to be hereinafter described. Tissue drawn into anopening 17 at the end of the twocutters 12 and 13 is sheared off by the rotation of theinner cutter 13. The tissue is drawn through the center of theinner cutter 13 by the vacuum and thence into thebody 11.

The external fixedcutter 12 comprises a thin-walledstainless steel tube 18, thedistal end 19 of which is formed into a hemisphere, closing it off. A little less than half of the diameter of thetube 18 is ground away as at 20 to form theend 19 into a sharp-edged cutter. Theproximal end 21 of thetube 18 is enlarged in diameter and threaded as at 22, terminating in a slotteddisk 23 which is retained by a key 24 interiorly of analuminum holder 25. Aflange 26 adjacent theproximal end 27 of theholder 25 is retained against the front of thebody 11 by a knurledaluminum nut 28. Thedisk 23 is maintained snugly against the distal end of theholder 25 and in engagement with the key 24 by the pressure exerted by anut 29.

The innerrotatable cutter 13 is made the same way as theexternal cutter 12, but is smaller in diameter so as to just fit inside theexternal cutter 12 and still be free to rotate. The inner cutter l3 likewise comprises a thinwalled tube 30, thedistal end 31 of which is also closed off and formed into a hemisphere and ground away (as at 31a) so that a little less than half the diameter is removed. When the two cutters l2 and 13 are in place and lined up, the openings therein are in register so that the cutters appear to have been ground together. When theinner cutter 13 rotates inside theexternal cutter 12, theopening 17 gradually closes, thereby to clip off a piece of tissue drawn into theopening 17 by the action of the vacuum. The fact that the two cutters l2 and 13 are ground less than half their diameters allows theinner cutter 13 to be contained within theexternal cutter 12 at all positions of theinner cutter 13.

The proximal end 32 of thetube 30 is received in an enlarged hollow generallycylindrical portion 33 which is positioned within theholder 25. A hollowplastic drive coupling 34, keyed as at 35, is engaged in slots 36 in theportion 33 of thecutter 13. A hollow steel drive shaft 37 received in thecoupling 34 rotates the same and thus rotates thecutter 13 within thecutter 12. The shaft 37 is driven by themotor 15 through aplastic worm 38 andgear 39. (See FIG. 5.) A helical compression spring 40 encircling thecoupling 34 and being retained against an inner surface 41 in thebody 11 exerts pressure against theportion 33 of thecutter 13 through a thrust washer 42. The spring 40 forces theinner cutter 13 against thedistal end 19 of theexternal cutter 12, thereby to guarantee a good fit between the two cutting edges. A flange 43 on thedrive coupling 34 maintains an airtight seal between thecoupling 34 and theportion 33 of theinner cutter 13.

Themotor 15 is of the plug-in type and is mounted on a hightemperature plastic base 44 laterally offset within thebody 11 and enclosed within aremovable brass housing 45. Power to themotor 15 is furnished by electrical leads which enter the cutter from the rear and contact plugs 46 received insockets 47 received within thebody 11, the motor making contact with terminals 48 on theplugs 46 as-shown in FIG. 4. The drivingshaft 49 of themotor 15 furnishes power to theworm 38 which turns thegear 39 which in turn rotates the hollow drive shaft 37 which it encircles. (See FIG. 5.)

Acylindrical aluminum extension 51 is threadedly engaged with the rear of thebody 11. Analuminum sleeve 52 is threadedly engaged with the rear of theextension 51 and acable nut 53 received on the rear of thesleeve 52 effects the vacuum and electrical connections to thecutter 10. (See FIG. 9.)

A vacuum line V (see FIG. 3) is attached to a brass fitting 54 supported by abrass plate 55 within theextension 51. The inner end of the fitting 54 is received within a length offlexible hose 56 which is attached at its forward end to a plastic support fitting 57, which in turn makes an airtight connection by means of aflange 58 with the rear end of the hollow drive shaft 37. The

latter being received within thecoupling 34 extends the vacuum connection to thecylindrical portion 33 of thecutter 13 as previously mentioned.

The vacuum connection to thecutter 13 is normally closed. The vacuum supply is controlled by pressure applied to theknob 16. Avalve frame 60 preferably made of brass is mounted within theextension 51 and is provided with two generally parallel surfaces 62 and 72. Theframe 60 is positioned so that thehose 56 passes longitudinally through the frame and between the surfaces 62 and 72, the frame being supported at its rear in cooperating recesses cut in theplate 55, and at its front on asurface 73 of thebody 11. The forward hose support fitting 57 is supported by theframe 60 as shown.

Avalve spring 61 preferably made of copperberyllium and shown in its normal position by the dashed lines in FIG. 3 rests against the surface 62 of theframe 60. A U-shaped steel contact pin 66 is supported by one leg 67 inapertures 64 in theframe 60. (See FIG. 7.) Asteel valve arm 63 is pivotally supported as at 65 at the end of leg 67 of the pin 66, the other leg 69 of the pin 66 being received in anaperture 68 inarm 63. The lower surface of the leg 69 of the pin 66 rests on thespring 61 and the upper surface of the leg 69 is adapted to contact thevacuum hose 56.

Theknob 16 has a dependingportion 70 extending into thebody 11 which is slotted as at 71 to receive the forward end 74 of thearm 63. (See FIG. 6.) When theknob 16 is in its normal or upper position, the pressure of thespring 61 rotates the pin 66 in theapertures 64 to force the leg 69 up against thehose 56, pinching it against the surface 72 on theframe 60 and closing off vacuum to theinner cutter 13. When theknob 16 is pressed downwardly and inwardly of the apparatus, thearm 63 is forced downwardly and away from the surface 72, thus to rotate the pin 66 by exerting pressure against thespring 61 through the leg 69, and permit thehose 56 to carry vacuum to thecutter 13.

The cutter of the present invention, although specifically designed for eye surgery, could also be used to remove any other body tissue in the same manner. Similarly, although an electric motor has been shown as the source of power for the inner cutter, an air or vacuum motor could be used or the motor could be designed to impart partial rotation to produce an oscillating motion of the inner cutter instead of continuous rotation.

In operation, the powered surgical cutter of the present invention functions as follows. Twoopenings 76 and 77 are made in the anterioraqueous chamber 78, as shown in FIG. 1. A liquid-filled syringe 79 is inserted in one opening and thecutter 10 is inserted in the other. After the cutter is inserted into the anterior aqueous chamber and before the cutter is turned on, theknob 16 is depressed to permit the vacuum to reach the interior of theinner cutter 13 from the source P. Power to themotor 15 is controlled by thefoot treadle 75. (See FIG. 9.) As theinner cutter 13 turns, the edge 31a begins to close theopening 17. The vacuum draws tissue into the opening, and as theinner cutter 13 continues to turn, theopening 17 gets smaller until the outer edge of the inner cutter l3 shears against the inner edge of theexternal cutter 12. A piece of tissue is thus clipped off and is drawn through the center of theinner cutter 13 and into thebody 11. Theinner cutter 13 continues to rotate until it is again in its original position as shown in FIG. 8. The instrument is then ready to draw in another piece of tissue and repeat the operation.

In the foregoing description, the invention has been described with reference to a certain particular preferred embodiment, although it is to be understood that the specific details shown are merely illustrative and that the invention may be carried out in other ways without departing from the true spirit and scope of the following appended claims.

We claim:

1. A surgical cutter comprising:

a housing;

motor means mounted in said housing;

an elongated external fixed tubular cutter attached at one end to said housing, said external cutter having an axial bore therethrough, the other end of said external cutter being closed off, less than half the diameter of said external cutter being removed at said other end to form a sharp-edged opening in said cutter through which tissue can be drawn;

an elongated inner tubular cutter mounted in said bore for at least partial rotation about the axis thereof, and having an end adjacent said other end of said outer cutter, said end of said inner cutter being closed off, a portion of the diameter of said inner cutter being removed at said end of said inner cutter to form an opening therein, said opening in said inner cutter being in register with said opening in said external cutter;

drive means connected to said motor means for said rotation of said inner cutter, said drive means comprising a hollow drive shaft, the interior of said drive shaft being in communication with the interior of said inner cutter;

a source of vacuum;

means to supply vacuum from said source to said interior of said drive shaft and thence to said interior of said inner cutter; and

means to control the supply of vacuum to said interior of said drive shaft for drawing tissue into said opening in said inner cutter,

said tissue being sheared off by said rotation of said inner cutter inside and against said bore of said external cutter.

2. A cutter as in claim 1 in which said supply means comprise a flexible hose and means to attach said flexible hose to said hollow drive shaft.

3. A cutter as in claim 2 in which said control means comprise:

a frame mounted within said housing, said frame being provided with two generally parallel longitudinally-extending surfaces, said flexible hose passing longitudinally through said frame and between said surfaces;

spring means disposed against one of said surfaces of said frame and adapted normally to contact said flexible hose and pinch the same against the other of said surfaces; and means selectively to urge said spring means away from said other of said surfaces to permit a vacuum to be drawn through said hose to said interior of said drive shaft.

4. A cutter as inclaim 3 in which said selective means comprise:

a knob, said knob having a depending portion extending into said housing, said depending portion having a slot therethrough; and

an arm pivotally supported at one end on said frame, the other end of said arm being received in said slot, said arm being adapted to contact said spring means and press the same away from said other of said surfaces.

5. The cutter of claim 1 further comprising a hollow coupling disposed between said drive shaft and said inner cutter, said coupling being attachable to said inner cutter, said drive shaft being received within said coupling to rotate the same and thereby to rotate said inner cutter.

6. The cutter of claim 5 further comprising a helical spring encircling said coupling, one end of said spring being retained against said housing, the other end of said spring contacting the proximal end of said inner cutter to urge the same against said other end of said external cutter.

7. The cutter of claim 5 further comprising a flange on said coupling to maintain an airtight seal between said coupling and said inner cutter.

Claims (7)

1. A surgical cutter comprising: a housing; motor means mounted in said housing; an elongated external fixed tubular cutter attached at one end to said housing, said external cutter having an axial bore therethrough, the other end of said external cutter being closed off, less than half the diameter of said external cutter being removed at said other end to form a sharp-edged opening in said cutter through which tissue can be drawn; an elongated inner tubular cutter mounted in said bore for at least partial rotation about the axis thereof, and having an end adjacent said other end of said outer cutter, said end of said inner cutter being closed off, a portion of the diameter of said inner cutter being removed at said end of said inner cutter to form an opening theRein, said opening in said inner cutter being in register with said opening in said external cutter; drive means connected to said motor means for said rotation of said inner cutter, said drive means comprising a hollow drive shaft, the interior of said drive shaft being in communication with the interior of said inner cutter; a source of vacuum; means to supply vacuum from said source to said interior of said drive shaft and thence to said interior of said inner cutter; and means to control the supply of vacuum to said interior of said drive shaft for drawing tissue into said opening in said inner cutter, said tissue being sheared off by said rotation of said inner cutter inside and against said bore of said external cutter.

2. A cutter as in claim 1 in which said supply means comprise a flexible hose and means to attach said flexible hose to said hollow drive shaft.

3. A cutter as in claim 2 in which said control means comprise: a frame mounted within said housing, said frame being provided with two generally parallel longitudinally-extending surfaces, said flexible hose passing longitudinally through said frame and between said surfaces; spring means disposed against one of said surfaces of said frame and adapted normally to contact said flexible hose and pinch the same against the other of said surfaces; and means selectively to urge said spring means away from said other of said surfaces to permit a vacuum to be drawn through said hose to said interior of said drive shaft.

4. A cutter as in claim 3 in which said selective means comprise: a knob, said knob having a depending portion extending into said housing, said depending portion having a slot therethrough; and an arm pivotally supported at one end on said frame, the other end of said arm being received in said slot, said arm being adapted to contact said spring means and press the same away from said other of said surfaces.

5. The cutter of claim 1 further comprising a hollow coupling disposed between said drive shaft and said inner cutter, said coupling being attachable to said inner cutter, said drive shaft being received within said coupling to rotate the same and thereby to rotate said inner cutter.

6. The cutter of claim 5 further comprising a helical spring encircling said coupling, one end of said spring being retained against said housing, the other end of said spring contacting the proximal end of said inner cutter to urge the same against said other end of said external cutter.

7. The cutter of claim 5 further comprising a flange on said coupling to maintain an airtight seal between said coupling and said inner cutter.

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