Removal of tissue

Abstract

To reduce damage to surrounding tissue while fragmenting some tissue such as for example not damaging the capsular wall while removing the lens during cataract removal surgery or not damaging artery or vein walls during bypass surgery while freeing the artery or vein to be transplanted, an incision is made for the insertion of a handpiece tip. The tip is rotated and reciprocated ultrasonically at the same time so that tissue is fragmented by the combined motion of a fragmenting surface perpendicular to the surface and at an angle to the surface many times during a single revolution or part of a revolution.

What is claimed is:  
     
         1 . Apparatus for removing tissue from a patient, comprising: 
 means for ultrasonically reciprocating a tip of a handpiece having a longitudinal axis along said longitudinal axis wherein the tip is symmetrical about its longitudinal axis and has an opening extending along its longitudinal axis;    means for rotating said tip about said longitudinal axis in a first of clockwise and counterclockwise direction;    means for rotating said tip in a second of clockwise and counterclockwise direction about its longitudinal axis;    means for changing directions repeatedly between said first and second of clockwise and counterclockwise direction.    
     
     
         2 . Apparatus in accordance with  claim 1  in which the means for ultrasonically reciprocating the tip of the hand piece is a piezoelectric crystal.  
     
     
         3 . Apparatus in accordance with  claim 1  in which the means for ultrasonically reciprocating the tip of the handpiece is an electromagnetic vibrator.  
     
     
         4 . Apparatus in accordance with  claim 1  in which the means for rotating the tip of the handpiece is an electrical motor.  
     
     
         5 . Apparatus for removing tissue from a patient in accordance with  claim 1  further comprising means for aspirating particles through the tip of the handpiece.  
     
     
         6 . Apparatus in accordance with  claim 5  in which the means for aspirating particles is an opening and a vacuum pressure means.  
     
     
         7 . Apparatus for removing tissue from a patient in accordance with  claim 1  comprising means for aspirating vitreous fluids through the tip of the handpiece.  
     
     
         8 . Apparatus for removing tissue from a patient comprising means for reciprocating a tip of a handpiece ultrasonically and rotating the tip of the handpiece in more than one direction.  
     
     
         9 . Apparatus in accordance with  claim 8  in which the means for reciprocating the tip of the handpiece ultrasonically is an ultrasonic vibrator and the means for rotating the tip of the handpiece is an electrical rotational motor.  
     
     
         10 . Apparatus for removing tissue from a patient comprising means by which a power source that energizes a handpiece may drive any of a plurality of handpieces or instruments.  
     
     
         11 . Apparatus in accordance with  claim 10  in which the means for driving any of a plurality of handpieces or instruments is an interface which includes a handpiece simulator connected to a console that matches an output impedance of the console to an input impedance of the handpiece.  
     
     
         12 . A method of removing tissue from a patient comprising the step of driving a cutting tip with an electrical rotational motor; said step of driving comprising applying a pulse having a first polarity to the electrical rotational motor to cause the tip to turn in a first direction and applying a pulse having a second polarity to the electrical rotational motor to turn the tip in a second direction.  
     
     
         13 . Apparatus for removing tissue from a patient comprising: 
 a cuffing tip;    an electrical rotational motor connected to the cutting tip to rotate the cutting tip; and    a pulse circuit for applying pulses of different polarities to the rotational motor.    
     
     
         14 . A method according to  claim 12  further including the step of ultrasonically reciprocating the cutting tip with an ultrasonic vibrator.  
     
     
         15 . A method according to  claim 12  further including the step of alternating between the step of applying a pulse having a first polarity to the electrical rotational motor and applying a pulse having a second polarity to the electrical rotational motor so that the cutting tip turns in the first direction, then in the second direction repeatedly.  
     
     
         16 . A method according to  claim 12  wherein the cutting tip is driven by a power source which may drive any of a plurality of handpieces or instruments.  
     
     
         17 . Apparatus in accordance with  claim 13  further comprising a piezoelectric crystal connected to the cutting tip to ultrasonically reciprocate the cutting tip.  
     
     
         18 . Apparatus in accordance with  claim 13  further comprising an electromagnetic vibrator connected to the cutting tip to ultrasonically reciprocate the cutting tip.  
     
     
         19 . Apparatus in accordance with  claim 13  further comprising means for aspirating particles and vitreous fluids through the cutting tip.