|Número de publicación||US3818913 A|
|Tipo de publicación||Concesión|
|Fecha de publicación||25 Jun 1974|
|Fecha de presentación||30 Ago 1972|
|Fecha de prioridad||30 Ago 1972|
|Número de publicación||US 3818913 A, US 3818913A, US-A-3818913, US3818913 A, US3818913A|
|Cesionario original||Wallach M|
|Exportar cita||BiBTeX, EndNote, RefMan|
|Citas de patentes (7), Citada por (145), Clasificaciones (7)|
|Enlaces externos: USPTO, Cesión de USPTO, Espacenet|
1111 3,818,913 June 25, 1974 3,693,613 9/1972 Kelman..........;.....,.......... 128/303 R Primary ExaminerChanning L. Pace Attorney, Agent, or Firm-Howard C. Miskin  ABSTRACT Defective or unwanted tissue is removed such as from the lens of an eye directing a pulsating high velocity 128/305 128/278 liquid jet onto the defecting tissue to disintegrate the 17/32, A6191 1/00 tissue and sucking the liquid entraining the disintegra- Fleld of Search ted tissue from the area adjacent the tissue by a suc- 128/305 tion conduit. Upon clogging of the suction conduit 1 and a corresponding change in pressure, the suction action is momentarily reversed to eject the clogging tissue, which avoids excessive suction build-up. The liquid is advantageously isotonic and slightly alkaline and one or more jets converging; to a restricted area may be employed, the jets being ejected from a hand 0F TISSUE Inventor: Mark Wallach, 220 E. 63rd St.,
New York, NY. 10021 Aug. 30, 1972 Appl. No: 285,002
References Cited UNITED STATES PATENTS United States Patent 191 Wallach 1 SURGICAL APPARATUS FOR REMOVAL  Filed:
11/1970 Adams......, 12/1970 Balamuth... 3/1971 Crowson.... 6/1971 Bankoetal 10/1971 Moss........
16 Claims, 7 Drawing Figures PATENTEUJUNZSIBM SHEET 1.nr 2
PATENTEDJUHZSIGH sumzarz "Eli SURGICAL APPARATUS FOR REMOVAL OF TISSUE BACKGROUND OF THE INVENTION The present invention relates generally to improvements in surgical procedures and apparatus and relates more particularly to an improved method and apparatus for the disintegration and removal of selected sections of animal tissue.
There are numerous surgical procedures which require the removal of selected portions of tissue of an extremely delicate nature with a minimum or no interference with or damage to the surrounding or otherwise healthy tissue. Such procedures are frequently required in surgical operations connected with the eye; such as in the removal of cataracts and similar surgical procedures. The methods and equipment heretofore employed and proposed are awkward and highly time con- .suming in their use, require an extremely high degree of skill, are often accompanied by damage to adjoining healthy tissue and frequent failure and otherwise leave much to .be desired.
Instruments having a vibrating element or emitting pulses have been used for cutting of material for some time for various uses. For example, a vibrating element using a slurryfor cutting has been used for dental work and industrial applications with limited success in lim- SUMMARY OF THE INVENTION It is a principal object of the present invention to provide an improved surgical method and apparatus.
Another object of the present invention is to provide an improved'method and apparatus for disintegrating or fragmenting animal tissue in a preselected area and removing such disintegrated tissue from said area.
Still another, object of the present invention is to provide an improved method and apparatus for disintegrating'and removing animal tissue from a predetermined area without adversely effecting the surrounding tissue and which prevents excessive suction build-up. A further object of the present invention is to provide an improved method and apparatus for disintegrating and removing tissue from inaccessible areas with a minimum of adverse effect of the surrounding and masking tissue. I
Still a further object of the present invention is to provide a method and apparatus of the above nature characterized by their reliability, simplicity, fine areas of operation, great versatility and adaptability and ease of application even in delicate an highly hazardous environments.
The above and other objects of the present invention will become apparent from a reading of the following ing drawings which illustrate preferred forms of the improved apparatus. 7 r
In a sense the present invention is predicated on the discovery that hardened animal tissue in a closely confined and restricted areacan be disintegrated or finely description taken in conjunction with the accompany= i I fragmented by directing a fine pulsating high velocity jet onto the desired area sucking the liquid of the impinging jet which has entrained or emulsified therein the disintegrating tissue; The area of treatment can be veryprecisely delineated and obviates the need for any alteration, severance and significant penetration of any adjacent or overlying tissue. Als0,-the incision can be kept very small as contrasted to standard surgical techniques. The jet is produced by a very fine nozzle and the tissue entraining liquid is likewise withdrawn by a very fine conduit. Advantageously, any clogging of the suction conduit by the tissue is eliminated by reversing the liquid flow in the suction conduit in response to a sharp pressure drop therein. Excessive suction build-up can damage an organ of the body, such as an eyeball by collapsing the cornea. Also, the jet quickly dissipates its energy when it impinges onto a yielding surface. This is critical especially when the present suction is used in connection with eye surgery such as removing a hardened lens of the eye, with the tissue surrounding the lens being resilient.
The liquid jet contains no abrasive material and is advantageously an isotonic solution of slight alkalinity, for example, of a pH of about 7.4. The pulse, frequency of the jet is advantageously widely variable, depending on the specific organ with which it is used, and can vary from 1 pulse every 15 seconds (4 pulses per minute, i.e., 4 ppm) up to 333 pulses per second (20,000 ppm.). Further, for some applications a continuous fine steam can be used. The pressure is variable between about 15 and about200 pounds persquare inch, preferably between to p.s.i., and its velocity at the point of impingement between about 50 and about 500 feet per second. The liquid jet diameter at the point of impingement is advantageously of a diameter between about 0.001 "and about 0.010 of an inch and may be formed of a single jet stream or a plurality of converging jet streams.
The inlet port to the suction conduit may be annular and surround the liquid jet or it may be at the center of converging jets or adjacent to a jet either parallel or Y perpendicular to the jet.
The improved method and apparatus may be employed in very delicate and confined areas of little accessibility with a minimum of secondary surgery and is very versatile, adaptable and .easy and convenient to operate with'a minimum of side effects and hazards.
BRIEF DESCRIPTION OF THE DRAWINGS section of one form of nozzle and suction tip of the apv paratus of FIG. 1;
FIG. 4 is. a view similar to FIG. 3 of another tip structure;
FIG. 5 is a sectional view taken along line 5 5 in FIG. 6 is a view similar to FIG. 3 of still another form of tip; and
FIG. 7 isa view similar to FIG. 3 showing a further tip structure.
DESCRIPTION OF THE PRFERRED EMBODIMENTS Referring now to the drawings, and particularly FIGS. 1 and 3 thereof which illustrate a preferred embodiment of the present invention, the reference numeral generally designates the improved apparatus which is employed to great advantage in practicing the present improved process in the removal of unwanted tissue from the lens of a human eye, such as a cataract or the like. The apparatus comprises a fine hand implement 11 which is manipulated by the surgeon and includes three fine tubes joined along their lengths as an integral unit, a nozzle tube 12, a suction tube 13 and a drainage or bathing tube 14. The maximum transverse dimension of the assembled tubes advantageously does not exceed one hundred fifty thousandths of an inch (0150), each tube having an inside diameter of between about 10 and 65 thousandths of an inch (0.010 to 0.065") and an outside diameter of between about and seventyseven thousandths of an inch (0.020" to 0.077"), the length of the working tip of the assembly advantageously being about three-quarters of an inch for optical applications. Tube length can vary for other surgical applications.
The distal end of tube 12 is curved and closed and it is arranged side by side with suction tube 13 whose distal end is open and shortly rearwardly of the distal end of tube 12. A nozzle defining circular port 16 is formed in the joined adjacent walls of tubes 12 and 13 and is directed parallel to the suction or inlet port 17 of suction tube 13. The drainage liquid tube 14 extends somewhat less than the full lengths of tubes 12 and 13 and is provided along its distal length with small outlet ports 18. It should be noted that the diameter of the nozzle port 16 is advantageously between 0.001 and 0.0l0 of an inch. 7
The proximate end of the nozzle tube 12 is connected by a high pressure highly flexible tube 19 to the outlet of an adjustable pulsing liquid feed device 20 whose inlet is connected to an elevated tank 21 containing an isotonic solution of the composition previously described. The pulsing device 20 may be of any conventional construction in which the pulse frequency, pulse duration, pressure and liquid'volume velocity output are continuously adjustable by knobs or by corresponding foot operated controls. For example, the device 20 may include a positively displacement pressure pump, such as a piston pump whose stroke is adjustable and which is driven by a variable speed electric motor and is provided'with an adjustable pressure relief or by-pass valve so that the above variable and adjustable parameters are easily and conveniently achievable. Of course other systems serving-the same functions may be employe'd.
The proximate end of the suction tube 13 is connected by a flexible tube 23 to a vacuum or suction pump 26 to withdraw any liquid and entrained tissue from the area of the suction port 17. Advantageously, a vacuum of between 1 l0 and 130 mm. of mercury has been found satisfactory for eye surgery applications for the suction. However, it can vary according to the surgical application. A pressure sensing element 24 communicates with the tube 23 and is so adjusted that when the suction in tube 23 rise above or conversely when the pressure falls below a predetermined level consequent to the clogging of tube 13 or 23 bytissue sucked up by the tube, it reverses the vacuum pump 26 to reverse the flow in tubes 13 and 23 to eject the clogging tissue. Following the ejection of the clogging material the vacuum pump 36 returns to its normal functioning. The reverse flow in pipes 13 and 23 may be for successive predetermined'intervals until they are unclogged as evidenced by the proper pressure sensed by element 24.
The irrigating pipe 14 is connected by a flexible tube 27 to an elevated tank 28 by way of a valve 29 the tank- 28 containing any suitable washing solution, for example of the composition position of the liquid contained in tank 21. This irrigating fluid helps maintain the pressure in the eye and prevents the cornea from collapsing. It should be noted that the flexible tubes 19, 23 and '27 are joined side by side as a highly flexible assembly thereby greatly facilitating the convenient handling and manipulation of the instrument 11.
In employing the apparatus 10 in operating on the eye, for example in the removal of a cataract, the usual precautions are observed and a small incision i.e., about one hundred seventy-five thousandths of an inch (0.175) is made in the masking tissue, for example in the cornea, to provide access for entry of the instrument 11 into optimum engagement with the unwanted tissue. The lens L to be treated may be in its normal position, but advantageously is prolapsed into the anterior chamber.
The instrument 11 is inserted through the preformed incision into confronting engagement with the unwanted tissue and the pulser 20, the vacuum unit 26 is actuated and the valve 29 is opened, the various parameters being adjusted to optimum conditions are dictated by experience and as specified above;
A pulsating high velocity fine liquid jet is directed through the nozzle port 16 onto the area of unwanted tissue of lens L to fragment, disintegrate and emulsify the jet-subjected tissue, and the jet liquid containing the entrained and emulsified tissue is sucked up by suction unit 26. The liquid from the tube 14 keeps the eye bathed in the desired manner. The instrument 11 is then manipulated until all the unwanted tissue is fragmented and removed and the instrument 11 is then retracted and the usual post operative procedures followed. It'should be noted that in the event that a large tissue fragment is detached and lodges in tube 13 to clog the tube 13 theaction of the vacuum unit 26 is reversed in response to the pressure sensing device 24 to eject the clogging tissue, which is further fragmented by the jet so that itmay be properly withdrawn by the suction tube 13. Also, since the tissue surrounding the lens is soft and yielding, the jet energy is absorbed by the wall if the jet stream happens to miss the target tissue.
The apparatus illustrated in FIGS. 4 and 5 differs from the apparatus 10 primarily in the construction of the instrument 32 which corresponds to the instrument 11. Specifically the instrument 32 includes a pair of coaxial inner and outer tubes 33 and 34 respectively,
which delineate an annular outer conduit 36 and an inner axial conduit 37. The distal end of outer conduit is closed by an annular end wall 38 provided with circumferentially spaced nozzle defining ports 39 which are directed toward a common central point coaxial with the conduits 36 and 37 and forwardly thereof.
The outer conduit 36 is connected by a flexible tube to a liquid pulsing device corresponding to the pulsing device 20 andthe central conduit 37 is connected to a suction pump corresponding to vacuum unit 26, like- .ment 32 is similar to that using the instrument 10. A
plurality of pulsating high velocity jets 40 from nozzles 39 converge on a point located on the unwanted tissue in lens L to disintegrate the jet subjected tissue which is, entrained in the jet liquid and sucked into and with drawn through the central suction tube 37.
The instrument 41 illustrated in FIG. 6 differs from that last described primarily in that the pulsating jet emanates from the axial'tube and the tissue entraining liquid withdrawn by the surrounding outer annular tube. The instrument 41 includes an outer suction tube 42 open at its distal end and connected by a flexible hose to a suction device corresponding to device 26 and a coaxial tube 43 closed at its distal end and provided with a nozzle defining port 44. The tube 43 is connected by a flexible hose to a liquid pulsing device corresponding to device 20 and the apparatus is employed in the manner, earlier described.
in F167 of the drawings there is shown another form of tissue removing instrument differing from those first described primarily in that the pulsating liquid jet is directed at an angle to the tissue approaching tangency and the liquid suction port extends beyond the nozzle for an extended distance. Specifically the improved instruments 46 include three interconnected rigid side by side longitudinal tubes 47, 48 and 49 respectively. The tube 47 is closed at its distal end and has a nozzle defining centrally located port 50 formed in the front thereof and is connected by a flexible tube to a pulsating liquid source corresponding to the device 20. The second tube 48 is disposed alongside the tube 47 and projects beyond the front end of'tube 47 and is closed at its front end. An elongated suction opening 51 is formed in the side wall of tube 48 on the side, of tube 47 and extends from a point forward of the distal end of tube 47 to substantially the distal end of tube 48. The tube 49 is a bathing liquid tube and is secured to the outer face of tube 48 and is provided with a plurality of longitudinally spaced outlet ports. The tubes 48 and 49 are connected by corresponding flexible tubes to a vacuum unit corresponding to unit26 and to a bathing liquid tank corresponding to tank 28 respectively.
The instrument is employed in the manner similar to those earlier described except that the pulsating jet emerging from the nozzle 50 is at an obtuse angle to the 9 treated tissue and directs the tissue entraining liquid toward the large suction opening 51.
While separate liquid sources are shown, a single source may be used. Also, instead of a pump to produce the pressure for the jet, the source of liquid can be pressurized, such as by a pressurized tank, and a pulser only used. Also, while the jet stream from the tip is shown generally cylindrical, it may expand slightly to a conical shape; however, the area of contact should be kept as small as possible. Further, while the jet openings were illustrated as circular, other shapes can be used.
While there have been described and illustrated preferred embodiments of the present invention it is apparent that numerous alterations, omissions and additions may be made without departing from the spirit thereof.
1. An apparatus for disintegrating and removing animal tissue from a preselected enclosed area comprising a hand manipulatable first tube having a distallydisposed outlet port, a liquid pulsating pump having an inlet and an outlet, a source of liquid connected to said pump inlet, means including a flexible conduit connecting said first tube to said pump outlet, a suction conduit including an outlet port disposed proximate said first tube outlet port, a source of suction, and means including a flexible conduit connecting said suction conduit to said source of suction, said pump providing astream of pulsating liquid through said first tube outlet port at a frequency between 1 to 333 cycles per second,-at a pressure above atmospheric pressure of about 15 to about 200 p s i and having a velocity of between 50 and 500 feet per second.
2. The apparatus of claim 1 including means for varyingsaid pulse frequency of said pulsating pump.
3. The apparatus of claim 1 including means for varying the outlet pressure of said pulsating pump.
4. The apparatus of claim 1 wherein said'first tube and said suction conduit are parallel and joined side by side, said suction conduit having an inlet port adjacent the distal end of said first tube, the axis of said outlet port lying in a plane generally perpendicular to the longitudinal axis of said first tube and between thedistal end of said first tube and said inlet port of said suction conduit.
5. The apparatus of claim 1 wherein said first tube is longitudinally extending and of annular transverse cross section and having its leading annular end closed and provided with a plurality of outlet passages whose longitudinal axes converge to a common point, the axial portion of said tube defining said suction conduit.
6. The apparatus of claim 1 wherein said first tube and suction conduit are defined by coaxial inner and outer tubes respectively.
7. The apparatus claim 1 wherein said first tube and suction conduit are arranged side by side, said suction conduit is provided with a longitudinally extending side port, and said first tube includes an outlet port disposed proximally of said suction side-port.
8. The apparatus of claim 1 including means responsive to a drop in pressure in said suction conduit below a predetermined level for reversing the direction of flow in said suction conduit.
9. Apparatus of claim 8 wherein said reversing means returns to normal suction in said suction conduit in response to the suction pressure returning to said predetermined level.
10. Apparatus of claim 1 wherein said nozzle has an outlet port of fromabout 0.001 inch to about 0.010 inch. w
l 1. A nozzle for use with apparatus for disintegrating and removing animal tissue by liquid jets comprising a tubular member having inner and outer coaxial passageways, the outer passageway having a leading annular end closed and provided with a plurality of outlet ports whose longitudinal axes converge to a common point, first means on said nozzle adapted to be coupled to a source of pressurized fluid which interconnects to said outer passageway so that said fluid exits said nozzle through said ports, second means mounted on said nozzle interconnected to said inner passageway and adapted to be coupled to a suction source, whereby a plurality of fluid jets from said ports converge on said point located on the tissue to disintegrate it, and disintegrated portions of tissue and liquid are sucked into and withdrawn through the inner passageway.
12. The method of disintegrating and removing animal tissue from a preselected enclosed area with a nozsion of particles of said tissue from said preselected area.
13. The method claim 12 further including providing the liquid stream leaving said nozzle tip to have a cross sectional area at the point of impingement on said tissue to not exceeding 0.0000785 square inch.
14. The method of claim 12 including the step of reversing said suction responsive to the clogging of the flow of said sucked liquid by relatively large tissue fragments.
15. The method of claim-l2 including the step of providing said liquid to be isotonic.
16. The method of claim 12 including the step of providing said liquid to be alkaline.
|Patente citada||Fecha de presentación||Fecha de publicación||Solicitante||Título|
|US1987907 *||22 Nov 1929||15 Ene 1935||Joseph B Jenkins||Combination surgical air-blast and suction tip|
|US3542017 *||21 Nov 1967||24 Nov 1970||Moore Products Co||Intermittent fluid jet apparatus|
|US3547110 *||18 Abr 1968||15 Dic 1970||Ultrasonic Systems||Method and apparatus for maintaining tooth and gingival structures with ultrasonic energy|
|US3566869 *||26 Dic 1968||2 Mar 1971||Crowson David Lamar||Vacuum-utilizing hygienic teeth-cleaning system|
|US3589363 *||25 Jul 1967||29 Jun 1971||Cavitron Corp||Material removal apparatus and method employing high frequency vibrations|
|US3614953 *||21 Ene 1969||26 Oct 1971||Nat Res Dev||Drills for clearing obstructions in arteries|
|US3693613 *||9 Dic 1970||26 Sep 1972||Cavitron Corp||Surgical handpiece and flow control system for use therewith|
|Patente citante||Fecha de presentación||Fecha de publicación||Solicitante||Título|
|US3902495 *||28 Ene 1974||2 Sep 1975||Cavitron Corp||Flow control system|
|US3930505 *||2 Dic 1974||6 Ene 1976||Hydro Pulse Corporation||Surgical apparatus for removal of tissue|
|US4024866 *||10 Oct 1975||24 May 1977||Hydro Pulse Corporation||Surgical apparatus for removal of tissue|
|US4650461 *||18 Feb 1986||17 Mar 1987||Woods Randall L||Extracapasular cortex irrigation and extraction|
|US5074862 *||8 Jun 1989||24 Dic 1991||Rausis Claude F||Surgical equipment|
|US5312330 *||20 May 1992||17 May 1994||Summit Technology, Inc.||Medical treatment of the eye involving removal of the epithelium|
|US5437678 *||30 Nov 1992||1 Ago 1995||Neomedix Corporation||Ophthalmic lens removal method and apparatus|
|US5505729 *||15 Ene 1993||9 Abr 1996||Dornier Medizintechnik Gmbh||Process and an arrangement for high-pressure liquid cutting|
|US5556406 *||12 Sep 1994||17 Sep 1996||Medjet Inc.||Corneal template and surgical procedure for refractive vision correction|
|US5669923 *||24 Ene 1996||23 Sep 1997||Gordon; Mark G.||Anterior capsulotomy device and procedure|
|US5674226 *||10 May 1995||7 Oct 1997||Sentinel Medical, Inc.||Method and apparatus for tissue excision and removal by fluid jet|
|US5690641 *||11 Abr 1995||25 Nov 1997||Optex Ophthalmologics, Inc.||Rotary device for removing ophthalmic lens|
|US5697945 *||22 Nov 1995||16 Dic 1997||Black Hills Regional Eye Institute||Corneal surface marker and marking method for reducing irregular astigmatism during lamellar (LASIK) corneal surgery|
|US5713878 *||7 Jun 1995||3 Feb 1998||Surgi-Jet Corporation||Hand tightenable high pressure connector|
|US5752967 *||27 Mar 1996||19 May 1998||Kritzinger; Michiel S.||Corneal surface marker and marking method for improving laser centration|
|US5755700 *||22 Nov 1995||26 May 1998||Michiel S. Kritzinger||Corneal irrigation cannula and method of using|
|US5766194 *||23 Dic 1996||16 Jun 1998||Georgia Skin And Cancer Clinic, Pc||Surgical apparatus for tissue removal|
|US5792166 *||13 May 1997||11 Ago 1998||Gordon; Mark G.||Anterior capsulotomy device and procedure|
|US5800406 *||31 May 1996||1 Sep 1998||Kritzinger; Michael S.||Corneal irrigation cannula|
|US5827305 *||14 Feb 1997||27 Oct 1998||Gordon; Mark G.||Tissue sampling device|
|US5871462 *||7 Jun 1995||16 Feb 1999||Hydrocision, Inc.||Method for using a fluid jet cutting system|
|US5871492 *||31 May 1996||16 Feb 1999||Optex Ophthalmologics, Inc.||Rotary device for removing ophthalmic lens|
|US5934285 *||22 Nov 1995||10 Ago 1999||Michiel S. Kritzinger||Method for reducing irregular astigmatism and debris/epithelium in the interface during lamellar corneal flap/cap surgery|
|US5935140 *||31 Jul 1997||10 Ago 1999||Buratto; Lucio||Method for modifying the curvature of the cornea|
|US5944686 *||7 Jun 1995||31 Ago 1999||Hydrocision, Inc.||Instrument for creating a fluid jet|
|US5947988 *||4 Dic 1997||7 Sep 1999||Smith; Sidney Paul||Surgical apparatus for tissue removal|
|US5964775 *||12 Oct 1994||12 Oct 1999||New Jersey Institute Of Technology||Method and device for corneal shaping and refractive correction|
|US5984913 *||3 Jun 1996||16 Nov 1999||Michiel S. Kritzinger||Corneal aspiration cannula and method of using|
|US5989212 *||6 Ago 1998||23 Nov 1999||Alcon Laboratories, Inc.||Pumping chamber for a liquefaction handpiece having a countersink electrode|
|US5997499 *||6 Ago 1998||7 Dic 1999||Alcon Laboratories, Inc.||Tip for a liquefaction handpiece|
|US6004284 *||11 Mar 1999||21 Dic 1999||Alcon Laboratories, Inc.||Surgical handpiece|
|US6033395 *||3 Nov 1997||7 Mar 2000||Peyman; Gholam A.||System and method for modifying a live cornea via laser ablation and mechanical erosion|
|US6068640 *||27 Feb 1998||30 May 2000||Medjet Inc.||Removal of corneal epithelium|
|US6080128 *||4 Jun 1998||27 Jun 2000||Alcon Laboratories, Inc.||Liquefaction handpiece|
|US6110162 *||16 Ago 1999||29 Ago 2000||Alcon Laboratories, Inc.||Liquefaction handpiece|
|US6126668 *||24 Abr 1998||3 Oct 2000||Innovative Optics, Inc.||Microkeratome|
|US6156036 *||11 Jun 1999||5 Dic 2000||Alcon Laboratories, Inc.||Surgical handpiece tip|
|US6179805||28 Oct 1999||30 Ene 2001||Alcon Laboratories, Inc.||Liquefracture handpiece|
|US6196989||28 Oct 1999||6 Mar 2001||Alcon Laboratories, Inc.||Tip for liquefracture handpiece|
|US6216573||7 Jun 1995||17 Abr 2001||Hydrocision, Inc.||Fluid jet cutting system|
|US6231578||2 Ago 1999||15 May 2001||United States Surgical Corporation||Ultrasonic snare for excising tissue|
|US6287274||17 Nov 1999||11 Sep 2001||Alcon Manufacturing, Inc.||Liquefaction handpiece|
|US6315755||14 Dic 1999||13 Nov 2001||Alcon Manufacturing, Ltd.||Method of controlling a liquefracture handpiece|
|US6331171||1 Oct 1999||18 Dic 2001||Alcon Laboratories, Inc.||Tip for a liquefracture handpiece|
|US6398759||17 Oct 2000||4 Jun 2002||Alcon Manufacturing, Ltd.||Liquefracture handpiece tip|
|US6451017||10 Ene 2000||17 Sep 2002||Hydrocision, Inc.||Surgical instruments with integrated electrocautery|
|US6506176||16 Feb 2000||14 Ene 2003||Bausch & Lomb Incorporated||Methods, apparatus and system for removal of lenses from mammalian eyes|
|US6511493||10 Ene 2000||28 Ene 2003||Hydrocision, Inc.||Liquid jet-powered surgical instruments|
|US6575929||14 Dic 2001||10 Jun 2003||Alcon Manufacturing, Ltd.||Pumping chamber for a liquefaction handpiece|
|US6579270||21 Feb 2002||17 Jun 2003||Alcon Manufacturing, Ltd.||Liquefracture handpiece tip|
|US6589201||14 Mar 2000||8 Jul 2003||Alcon Manufacturing, Ltd.||Liquefracture handpiece tip|
|US6589204||27 Jun 2000||8 Jul 2003||Alcon Manufacturing, Ltd.||Method of operating a liquefracture handpiece|
|US6616677||21 Jun 2001||9 Sep 2003||Medjet, Inc.||Method and process for generating a high repetition rate pulsed microjet|
|US6648847||11 Feb 2003||18 Nov 2003||Alcon Manufacturing, Ltd.||Method of operating a liquefracture handpiece|
|US6669710||1 Oct 2002||30 Dic 2003||Hydrocision, Inc.||Liquid jet-powered surgical instruments|
|US6676628||22 Nov 1999||13 Ene 2004||Alcon Manufacturing, Ltd.||Pumping chamber for a liquefracture handpiece|
|US6860868||29 Ago 2003||1 Mar 2005||Alcon Manufacturing, Ltd.||Surgical handpiece|
|US6899712||10 Sep 2002||31 May 2005||Hydrocision, Inc.||Surgical instruments with integrated electrocautery|
|US6923792||8 Ago 2002||2 Ago 2005||Hydrocision, Inc.||Medical device with high pressure quick disconnect handpiece|
|US6960182||25 Oct 2001||1 Nov 2005||Hydrocision, Inc.||Fluid jet surgical instruments|
|US7122017||18 Mar 2002||17 Oct 2006||Hydrocision, Inc.||Fluid jet surgical instruments|
|US7276060||26 Feb 2004||2 Oct 2007||Alcon, Inc.||Surgical handpiece tip|
|US7431711||21 Nov 2002||7 Oct 2008||Hydrocision, Inc.||Liquid jet surgical instruments incorporating channel openings aligned along the jet beam|
|US7640119||30 Jun 2006||29 Dic 2009||Alcon, Inc.||System for dynamically adjusting operation of a surgical handpiece|
|US7708734||30 Jun 2006||4 May 2010||Alcon, Inc.||Method for dynamically adjusting operation of a surgical handpiece|
|US7717685||9 Ene 2004||18 May 2010||Hydrocision, Inc.||High pressure pumping cartridges for medical and surgical pumping and infusion applications|
|US7758585||16 Mar 2005||20 Jul 2010||Alcon, Inc.||Pumping chamber for a liquefaction handpiece|
|US7849875||31 Jul 2007||14 Dic 2010||Alcon, Inc.||Check valve|
|US7857794||14 Jun 2004||28 Dic 2010||Alcon, Inc.||Handpiece tip|
|US7951107||29 Jul 2005||31 May 2011||Hydrocision, Inc.||Medical device with high pressure quick disconnect handpiece|
|US7967775||9 Ene 2007||28 Jun 2011||Alcon, Inc.||Irrigation/aspiration tip|
|US7967799||16 Mar 2005||28 Jun 2011||Alcon, Inc.||Liquefaction handpiece tip|
|US8016823||5 Oct 2005||13 Sep 2011||Tsunami Medtech, Llc||Medical instrument and method of use|
|US8062246||14 Feb 2005||22 Nov 2011||Hydrocision, Inc.||Fluid jet surgical instruments|
|US8162966||27 Oct 2003||24 Abr 2012||Hydrocision, Inc.||Surgical devices incorporating liquid jet assisted tissue manipulation and methods for their use|
|US8187269||16 Nov 2010||29 May 2012||Tsunami Medtech, Llc||Medical instruments and techniques for treating pulmonary disorders|
|US8262645||9 Dic 2010||11 Sep 2012||Actuated Medical, Inc.||Devices for clearing blockages in in-situ artificial lumens|
|US8291933||25 Sep 2008||23 Oct 2012||Novartis Ag||Spring-less check valve for a handpiece|
|US8313485||21 Oct 2008||20 Nov 2012||Tsunami Medtech, Llc||Method for performing lung volume reduction|
|US8414546||15 Ago 2003||9 Abr 2013||Novartis Ag||Tip assembly|
|US8444636||10 Ene 2006||21 May 2013||Tsunami Medtech, Llc||Medical instrument and method of use|
|US8529498||9 Sep 2008||10 Sep 2013||Smith & Nephew, Inc.||Liquid jet surgical instruments incorporating channel openings aligned along the jet beam|
|US8574226||24 Oct 2008||5 Nov 2013||Tsunami Medtech, Llc||Method for treating tissue|
|US8579888||17 Jun 2009||12 Nov 2013||Tsunami Medtech, Llc||Medical probes for the treatment of blood vessels|
|US8579892||2 Jul 2008||12 Nov 2013||Tsunami Medtech, Llc||Medical system and method of use|
|US8579893||22 Ene 2010||12 Nov 2013||Tsunami Medtech, Llc||Medical system and method of use|
|US8721632||8 Sep 2009||13 May 2014||Tsunami Medtech, Llc||Methods for delivering energy into a target tissue of a body|
|US8758341||14 May 2009||24 Jun 2014||Tsunami Medtech, Llc||Thermotherapy device|
|US8814921||6 Mar 2009||26 Ago 2014||Aquabeam Llc||Tissue ablation and cautery with optical energy carried in fluid stream|
|US8851866||3 Mar 2008||7 Oct 2014||Hydrocision, Inc.||Methods and apparatuses for joining a pumping cartridge to a pump drive|
|US8858549||14 Mar 2012||14 Oct 2014||Tsunami Medtech, Llc||Medical instruments and techniques for treating pulmonary disorders|
|US8900223||8 Nov 2010||2 Dic 2014||Tsunami Medtech, Llc||Tissue ablation systems and methods of use|
|US8911430||19 Sep 2013||16 Dic 2014||Tsunami Medtech, Llc||Medical probes for the treatment of blood vessels|
|US9113944||19 Nov 2012||25 Ago 2015||Tsunami Medtech, Llc||Method for performing lung volume reduction|
|US9161801||30 Dic 2010||20 Oct 2015||Tsunami Medtech, Llc||Medical system and method of use|
|US9204889||12 Sep 2011||8 Dic 2015||Tsunami Medtech, Llc||Medical instrument and method of use|
|US9232959||4 Feb 2010||12 Ene 2016||Aquabeam, Llc||Multi fluid tissue resection methods and devices|
|US9232960||8 Mar 2013||12 Ene 2016||Aquabeam, Llc||Minimally invasive devices for multi-fluid tissue ablation|
|US9237902||11 Mar 2013||19 Ene 2016||Aquabeam, Llc||Multi-fluid tissue ablation methods for treatment of an organ|
|US9364250||8 Mar 2013||14 Jun 2016||Aquabeam, Llc||Minimally invasive devices for the treatment of prostate diseases|
|US9433457||8 Mar 2010||6 Sep 2016||Tsunami Medtech, Llc||Medical instruments and techniques for thermally-mediated therapies|
|US9468487||29 Abr 2013||18 Oct 2016||Tsunami Medtech, Llc||Medical instrument and method of use|
|US9510853||3 Ago 2015||6 Dic 2016||Procept Biorobotics Corporation||Tissue resection and treatment with shedding pulses|
|US9510854 *||13 Oct 2008||6 Dic 2016||Boston Scientific Scimed, Inc.||Thrombectomy catheter with control box having pressure/vacuum valve for synchronous aspiration and fluid irrigation|
|US9545337||5 Sep 2013||17 Ene 2017||Novartis Ag||Acoustic streaming glaucoma drainage device|
|US9561066||1 Jun 2012||7 Feb 2017||Virender K. Sharma||Method and apparatus for tissue ablation|
|US9561067||17 Ene 2014||7 Feb 2017||Virender K. Sharma||Method and apparatus for tissue ablation|
|US9561068||12 Ene 2015||7 Feb 2017||Virender K. Sharma||Method and apparatus for tissue ablation|
|US9597107||2 Feb 2004||21 Mar 2017||Hydrocision, Inc.||Nozzle assemblies for liquid jet surgical instruments and surgical instruments employing the nozzle assemblies|
|US9615875||17 Mar 2014||11 Abr 2017||Tsunami Med Tech, LLC||Medical instruments and techniques for thermally-mediated therapies|
|US20030088259 *||8 Ago 2002||8 May 2003||Staid Kevin P||Medical device with high pressure quick disconnect handpiece|
|US20030125660 *||21 Nov 2002||3 Jul 2003||Moutafis Timothy E.||Liquid jet surgical instruments incorporating channel openings aligned along the jet beam|
|US20040030349 *||8 Ago 2002||12 Feb 2004||Mikhail Boukhny||Liquefaction handpiece tip|
|US20040234380 *||9 Ene 2004||25 Nov 2004||Moutafis Timothy E.||High pressure pumping cartridges for medical and surgical pumping and infusion applications|
|US20040243157 *||27 Oct 2003||2 Dic 2004||Connor Brian G.||Surgical devices incorporating liquid jet assisted tissue manipulation and methods for their use|
|US20050038417 *||15 Ago 2003||17 Feb 2005||Ghannoum Ziad R.||Tip Assembly|
|US20050159765 *||14 Feb 2005||21 Jul 2005||Hydrocision, Inc.||Fluid jet surgical instruments|
|US20050192566 *||26 Feb 2004||1 Sep 2005||Madden Sean C.||Surgical handpiece tip|
|US20050267443 *||29 Jul 2005||1 Dic 2005||Hydrocision, Inc.||Medical device with high pressure quick disconnect handpiece|
|US20050283150 *||27 May 2005||22 Dic 2005||Hydrocision, Inc.||Surgical instruments with integrated electrocautery|
|US20060161101 *||18 Ene 2005||20 Jul 2006||Alcon, Inc.||Surgical system and handpiece|
|US20060212037 *||16 Mar 2005||21 Sep 2006||Alcon, Inc.||Pumping chamber for a liquefaction handpiece|
|US20060212038 *||16 Mar 2005||21 Sep 2006||Alcon, Inc.||Liquefaction handpiece tip|
|US20060212039 *||16 Mar 2005||21 Sep 2006||Alcon, Inc.||Pumping chamber for a liquefaction handpiece|
|US20060217740 *||25 Mar 2005||28 Sep 2006||Alcon, Inc.||Tip assembly|
|US20070032785 *||3 Ago 2006||8 Feb 2007||Jennifer Diederich||Tissue evacuation device|
|US20080122407 *||30 Jun 2006||29 May 2008||Alcon, Inc.||System for dynamically adjusting operation of a surgical handpiece|
|US20080154282 *||10 Dic 2007||26 Jun 2008||Stacy Faught||Fluidic Coupling For Surgical Hand Piece|
|US20080167604 *||9 Ene 2007||10 Jul 2008||Alcon, Inc.||Irrigation/Aspiration Tip|
|US20080195058 *||3 Mar 2008||14 Ago 2008||Hydrocision, Inc.||Methods and apparatuses for joining a pumping cartridge to a pump drive|
|US20090032121 *||31 Jul 2007||5 Feb 2009||Chon James Y||Check Valve|
|US20090032123 *||31 Jul 2007||5 Feb 2009||Bourne John M||Check Valve|
|US20090076440 *||9 Sep 2008||19 Mar 2009||Hydrocision, Inc.||Liquid jet surgical instruments incorporating channel openings aligned along the jet beam|
|US20090105703 *||24 Oct 2008||23 Abr 2009||Shadduck John H||Method for treating tissue|
|US20090227998 *||6 Mar 2009||10 Sep 2009||Aquabeam Llc||Tissue ablation and cautery with optical energy carried in fluid stream|
|US20100076416 *||17 Jun 2009||25 Mar 2010||Tsunami Medtech, Llc||Medical probes for the treatment of blood vessels|
|US20100094201 *||13 Oct 2008||15 Abr 2010||Boston Scientific Scimed, Inc.||Assisted aspiration catheter system|
|US20110106019 *||9 Dic 2010||5 May 2011||Piezo Resonance Innovations, Inc.||Devices for clearing blockages in in-situ artificial lumens|
|WO1994012132A1 *||29 Nov 1993||9 Jun 1994||Neomedix Corporation||Ophthalmic lens removal apparatus|
|WO1995017145A1 *||12 Oct 1994||29 Jun 1995||New Jersey Institute Of Technology||Method and device for corneal shaping and refractive correction|
|WO1996008212A2 *||12 Sep 1995||21 Mar 1996||Medjet, Inc.||Corneal template and surgical procedure for refractive vision correction|
|WO1996008212A3 *||12 Sep 1995||13 Jun 1996||Medjet Inc||Corneal template and surgical procedure for refractive vision correction|
|WO1999065408A1||17 Jun 1999||23 Dic 1999||Saphir Medical||Method for generating a pulse train of sterile liquid jet for medical uses|
|WO2001097900A1 *||21 Jun 2001||27 Dic 2001||Medjet Inc.||Method and process for generating a high repetition rate pulsed microjet|
|WO2011097505A1||4 Feb 2011||11 Ago 2011||Procept Corporation||Multi fluid tissue resection methods and devices|
|Clasificación de EE.UU.||606/169, 606/166, 604/28, 606/170|