US2598060A - Surgical trephine - Google Patents

Description

y 7 1952 D. KADESKY 2,598,060

SURGICAL TREPHINE Filed Jan. 17, 1950 INVENTOR. 0a w'a /(ades/4g Patented May 27, 1952 UNITED STATES PATNT FFlCE SURGICAL TREPHINE David- Kade'sky, San Francisco, Calif ass'ignor to Vinko V. Suglian, David Kade'sky, Einar V.

Blak, and David A. Gold, copartners doing b'usi ness under the name of Greens- Eye Hospital,

San Francisco, Calif.

Application January 17, 1950, Serial- No. 139,037

I 3 Claims; 1

This invention relates generally to trephine tools and instruments for eye surgery.

In certain types of surgical operations performed on the human eye, a plug-like transplant is cut from the donor eye, and transplanted into an opening cut into the host eye. For such operations a trephine is employed which. is in the form of a cylindrical cutter and which; is rotated at a relatively high speed. Such a tool makes it possible for the surgeon to remove a cleanly cut cylindrical shaped plug-like mass or transplant from the donor eye, and to provide a bore inthe host eye of proper size to receive the transplant.

Because of-the delicate operations. in which. they are used, it will be evident that trephines for this purpose involve special problems and dificulties. Great care must. be. taken to cut to a proper predetermined depth. After a out has been made and the tool retracted. to remove a transplant, care must be taken to avoid. damage to the sensitive tissues upon the surfaces of the transplant. In addition the transplant should retain a position within. the tool with. its axis aligned With the tool axis, thus facilitating its ready removal. Trephines such as have been used in the past have not satisfactorily solvedthese cliinculties. Transplants have been damaged by turning end for end within the tool, delicate surface tissues and membranes have been frayed and scarred, and. in many instances itv has been difficult to remove the transplant from: the tool for introduction into the host eye.

It is an object of the present invention to provide a trephine which will overcome the above difiiculties, and which in general will greatly facilitate eye surgery.

Further objects of the invention will appear from the following description in which the preferred embodiment has been set forth in detail in conjunction with the accompanying drawing.

Referring to the drawing:

Figure 1 is a side elevational view showing a trephine tool incorporating the present invention and applied to an instrument for rotating the tool at a proper speed.

Figure 2 is a side elevational View in section and on an enlarged scale, showing the manner in which the tool is constructed.

Figure 3 is an enlarged cross-sectional detail illustrating the manner in which the tool of Fig ure 2 is employed in eye surgery.

Figure 4 is a View like Figure 3 and showing a transplant such as is removed by the tool, and immediately before the transplant is removed for insertion into the host eye.

Figure 5 is a View like Figure 4 but showing how the transplant is retained within the tool without damage to surface tissue or membrane. 7

Figure 6 isv a side elevational View, partly in section and illustrating a guard for the tool.

Figure I illustrates my trephine tool Ill removably attached to the shaft ll of the instrument l 2. The instrument includes a handle portion I3,

which contains an electric driving motor, and the stem portion M through which a shaft I I extends from. the motor. A push. button I6 is adapted to be depressed by the operator for controlling operation. of the motor.

The. tool It) is preferably made in the manner illustrated in Figurefi. It consists of a cylindrical shaped. body ll having a threaded bore Ill at one end for application to the threaded end of shaft it. At the other end of the body there is a, blade portion [3 which has a circular cutting, edge 21 in a plane at right angles to the axis of the body.- The blade is formed integral with the body and is beveled at 22 to form the cutting edge 2i. It surrounds acylindrical shaped recess or cavity 23,. which serves to receive the transplant.-

Extending through the body from thethreaded bore; 18 to the base of the cavity 23, there is an axial passage-'24. The base-of the cavity 23,- which is. in communication with passage 24',- is defined by a concave surface 26', which in this instance i conical. shaped. In the region where surface 25 merges with the periphery of the cavity 23, the body is formed-to provide the annular retaining shoulder 27. Itwi-llbe noted that this shoul-- der is disposed generally in a plane at-right angles to the axis of the tool.

Adjacent the base of the blade t9, the body is formedto provide the annular depth limiting shoulder 28. As will be presently explained this shoulder serves to limit the depth of the out.

As illustrated in Figure 6 it is desirable to provide a guard for the cutter IS in order to protect the cutting edge 2|, and to guard against accidental injury to the operator. Thus a cylindrical shell 29 is shown fitted over the body IT, and one end of the shell is slotted at 39 to provide resilient portions for frictionally engaging the sides of the body. The tool is normally handled and applied to the shaft H with the guard 29 positioned as illustrated in Figure 6. When it is desired to use the tool the guard 29 is removed by sliding it forwardly.

Figures 3 to 5 inclusive serve to illustrate how my tool can be used in eye surgery. Figure 3 illustrates the tool being applied to the human eye for the removal of a transplant cornea. It will be noted that the tool has cut to a depth determined by the shoulder 28, and that the cornea is within the cavity 23. In such a cutting operation the tool is rotated at a relatively high speed, and is carefully guided and advanced into the eye. When the tool has cut to the depth determined by the shoulder 28, the tool is permitted to come to rest, and then it is retracted to remove the cornea transplant substantially as illustrated in Figure 4. Assuming that the tool is tipped toward the vertical, the transplant may slide to the position illustrated in Figure 5. It will be noted that in this position only a small peripheral edge portion of the transplant contacts the shoulder 21, but this engagement serves to prevent further displacement of the transplant, and also serves to retain the transplant against turning end for end in the cavity. The concave surface 26 is spaced a substantial distance from the membrane of the transplant, thereby avoiding possible scarring or like injury.

With the transplant positioned in the tool cavity with its axis aligned with the axis of the tool, it is a simple matter to remove the transplant for insertion into the host eye. This can be accomplished by thrusting a rod through the passage 24, or more preferably by application of sterile liquid under pressure from a syringe, the syringe being applied to the threaded bore I8.

It will be evident that the trephine described above can be used in various eye operations. Assuming its use for cornea transplant operations, two tools are employed, one to cut an opening of proper size in the host eye, and a second to remove a transplant of slightly smaller diameter from the donor eye.

By way of example, rather than by limitation, a tool for a cornea transplant operation may in a typical instance have a cavity 23 which is 0.172 inch in diameter, a blade [9 with a depth from cutting edge 2! to shoulder 28 of 0.0471 inch. A slightly larger tool (in cavity diameter) was employed for the tool used in cutting a transplant receiving opening in the host eye. In general it is desirable that the distance from the cutting edge 2! to the shoulder 28 be substantially onehalf the depth of the cavity from cutting edge 2! to shoulder 21. With such dimensioning the transplant is properly retained within the cavity without danger of the same turning end for end.

It will be evident from the foregoing that I have provided a trephine which will greatly facilitate eye transplant operations, and which will avoid the difiiculties experienced in the past. Although the tool has been used with particular success in cornea transplant operations, it can be used for other eye operations, as for example surgical operations used in the treatment of glaucoma.

I claim:

1. A trephine tool for eye surgery comprising a cylindrical body, a cylindrical cutter portion formed on one end of the body, said cutter portion embracing a cylindrical receiving cavity, an annular depth limiting shoulder formed on the body at the base of the cutter, a passage extending through the body and communicating with the base of the cavity, and a retaining shoulder formed within the body at the base of the cavity, said body presenting a concave surface to said cavity and which extends inwardly from said retaining shoulder to the adjacent end of said passage.

2. A trephine tool for eye surgery comprising a cylindrical body, a cylindrical blade portion formed on one end of the body and aligned with the axis of the body, said blade portion embracing a cylindrical transplant receiving cavity, an annular depth limiting shoulder formed on the body at the base of the cutter, a passage extending through the body and communicating with the base of the cavity, an annular retaining shoulder formed within the body at the base of the cavity, the depth of the cavity from the cutting edge to said retaining shoulder being approximately twice the distance from said edge to said limiting shoulder, said body being formed to present a substantially conical shaped surface extending from the inner periphery of said retaining shoulder to the adjacent end of said passage.

3. A trephine tool for use in eye surgery comprising a cylindrical body, a cylindrical blade portion formed on one end of the body and embracing a cylindrical receiving cavity, the blade portion having a circular cutting edge, an annular depth limiting shoulder formed on the body at the base of the blade portion, a passage extending through the body and communicating with the cavity, and an annular retaining shoulder within the body at the base of the cavity, the depth of the cavity from the cutting edge to said last named shoulder being greater than the distance from said edge to said depth limiting shoulder.

DAVID KADESKY.

REFERENCES CITED The following references are of record in the file of this patent:

UNITED STATES PATENTS Number Name Date 398,139 Eaton Feb. 19, 1889 847,133 Velasco Mar. 12, 1907 2,473,968 Paton June 21, 1949

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