Method of using fluid jet surgical cutting tool

Abstract

A pulsed fluid jet surgical instrument includes a cannula extending from a handpiece, the cannula emitting a pulsed fluid jet for cutting and emulsification purposes, and also providing suction for aspiration and evacuation of the fluid and tissue. A pressure intensifier piston arrangement receives fluid at relatively low pressure, and operates reciprocally and reiteratively to pump the fluid through the jet needle in a series of high pressure pulses, each having a nearly rectangular pressure waveform. The pressure intensifier piston is T-shaped, including a broad end which divides a drive bore into a driving chamber and a retracting chamber. A bistable valve is connected to admit high pressure gas into the actuating chamber, driving the piston to translate. The narrow end of the piston is disposed in a fluid pumping chamber connected to a supply of fluid. The translating piston drives the fluid from the pumping chamber through a first check valve into a fluid jet needle, which directs the high pressure fluid pulse to a tissue target. The bistable valve switches to admit pressurized gas to the retracting chamber, driving the piston retrograde and allowing the pumping chamber to refill with fluid through a second check valve. There is no high pressure fluid supplied to the handpiece, and only the pressure intensifying pumping action of the piston creates a high pressure fluid pulse. The gas supply to drive the piston is at a relatively low pressure, so that gas pressure cannot comprise a safety risk to the patient. Thus failure of the piston mechanism cannot result in the emission of a stream of high pressure fluid, and the instrument is inherently safer than prior art instruments that are connected to a high pressure fluid source.