# US 2019/0167415 A1 · Surgical tool and method > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 2019/0167415 A1 - Document ID: US20190167415A1 - Status: Published application - Kind: A1 - Application number: 16/210,683 - Filed: 2018-12-05 - Published: 2019-06-06 - Earliest claimed: 2017-12-05 - Inventors: Theodore Todd Richmond; Albert Jun; Jan McGlumphy - Web page: https://patentgrep.com/patent/US20190167415A1 ## CPC - A61F 2/148: {Implantation instruments specially adapted therefor} - A61B 17/2909: {Handles} - A61F 2/142: {Cornea, e.g. artificial corneae, keratoprostheses or corneal implants for repair of defective corneal tissue} - A61F 9/007: Methods or devices for eye surgery - A61B 17/29: Forceps for use in minimally invasive surgery - A61B 17/34: Trocars; Puncturing needles - A61B 2017/00539: {hydraulically} - A61B 2017/00969: {used for transplantation} - A61B 2017/2918: {flexible handles} - A61B 2017/305: {Tweezer like handles with tubular extensions, inner slidable actuating members and distal tools, e.g. microsurgical instruments} - A61B 2217/007: with irrigation system - A61F: FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS (dental prosthetics A61C) - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) ## Abstract A surgical tool assembly is disclosed. The surgical tool assembly includes a forceps instrument including a proximal handle portion with an actuator, and a distal forceps portion including jaws. The actuator selectively moves the jaws. The surgical tool assembly includes an infusion assembly including a tube configured to be connected to a fluid source at a primary tube end and connected to a fitting at a paracentesis tube end. The fitting defines a passage configured to receive the distal forceps portion of the forceps instrument. An infusion sleeve extends away from the fitting. The infusion sleeve is arranged concentric around an outer surface of the distal forceps portion to define a fluid pathway. The jaws extend beyond a terminal end of the infusion sleeve such that the jaws are arranged outside of the infusion sleeve. ## Claims ### Claim 1 A surgical tool assembly comprising: a forceps instrument including a proximal handle portion with an actuator, and a distal forceps portion including jaws, where the actuator selectively moves the jaws; and an infusion assembly including a tube configured to be connected to a fluid source at a primary tube end and connected to a fitting at a paracentesis tube end, the fitting defines a passage configured to receive the distal forceps portion of the forceps instrument, an infusion sleeve extending away from the fitting, the infusion sleeve being arranged concentric around an outer surface of the distal forceps portion to define a fluid pathway, and the jaws extend beyond a terminal end of the infusion sleeve such that the jaws are arranged outside of the infusion sleeve. ### Claim 2 (depends on 1) The surgical tool assembly of claim 1, further comprising a donor tissue preparation tool configured to support a donor tissue. ### Claim 3 (depends on 2) The surgical tool assembly of claim 2 wherein the donor tissue preparation tool has a circular spoon to hold the prepared donor tissue. ### Claim 4 (depends on 1) The surgical tool assembly of claim 1, wherein the surgical tool assembly is used for Descemet membrane endothelial keratoplasty (DMEK) surgery. ### Claim 5 (depends on 1) The surgical tool assembly of claim 1, wherein the distal forceps portion has a pre-formed curvature. ### Claim 6 (depends on 1) The surgical tool assembly of claim 1, wherein the actuator is configured to grip the jaws when the actuator is squeezed. ### Claim 7 (depends on 1) The surgical tool assembly of claim 1, wherein fluid is provided via the tube to a terminal end of the infusion sleeve at 1.0 psi-30.0 psi. ### Claim 8 (depends on 1) The surgical tool assembly of claim 1, wherein the passage of the fitting is press-fit onto the distal forceps portion. ### Claim 9 (depends on 1) The surgical tool assembly of claim 1, further comprising a sleeve adapted to engage around an outer surface of both the infusion assembly and the forceps instrument to provide a sealed connection. ### Claim 10 A method of performing corneal surgery, the method comprising: (a) providing a surgical tool assembly including: (i) a forceps instrument including a proximal handle portion with an actuator, and a distal forceps portion including jaws, where the actuator selectively moves the jaws; (ii) an infusion assembly including a tube configured to be connected to a fluid source at a first tube end and connected to a fitting at a second tube end, an infusion sleeve extending away from the fitting, the fitting defines a passage configured to receive the distal forceps portion of the forceps instrument, the infusion sleeve being arranged concentric around an outer surface of the distal forceps portion to define a fluid pathway, and the jaws extend beyond a terminal end of the infusion sleeve such that the jaws are arranged outside of the infusion sleeve; and (b) cutting two incisions on the anterior chamber of the patient's eye; (c) placing the donor tissue adjacent to a primary incision; (d) inserting the distal forceps portion of the forceps instrument through a paracentesis incision through the anterior chamber of the patient's eye and out of the primary incision; (e) securing the donor tissue via the jaws and withdrawing the distal forceps portion back through the primary incision and into the anterior chamber of the patient's eye at an installation site; (f) providing pressurized fluid to the fluid pathway of the infusion sleeve while gripping the donor issue to orient and unscroll the donor tissue at the implantation site; and (g) while holding the donor tissue in position, an amount of fluid is aspirated to shallow the anterior chamber of the patient's eye to prevent the donor tissue from scrolling. ### Claim 11 (depends on 10) The method of claim 10, further comprising: providing a donor tissue preparation tool configured to support the donor tissue; and placing the donor tissue in a scrolled state on the donor tissue preparation tool during step (c). ### Claim 12 (depends on 10) The method of claim 10, wherein the two incisions of step (b) are on diametrically opposed halves of the anterior chamber of the patient's eye. ### Claim 13 (depends on 10) The method of claim 10, wherein the amount of fluid in step (g) is 0.010 ml to 1.0 ml. ### Claim 14 (depends on 10) The method of claim 10, wherein step (e) includes gripping a circumferential edge of the donor tissue. ### Claim 15 (depends on 10) The method of claim 10, wherein the corneal surgery is keratoplasty surgery. ### Claim 16 (depends on 15) The method of claim 15, wherein the keratoplasty surgery is Descemet membrane endothelial keratoplasty (DMEK). ### Claim 17 (depends on 16) The method of claim 16, wherein a patient's existing Descemet membrane is removed prior to step (d). ### Claim 18 (depends on 10) The method of claim 10, wherein the donor tissue is Descemet membrane and endothelial tissue. ### Claim 19 (depends on 10) The method of claim 10, wherein the primary incision and the paracentesis incision each have a length less than 2.5 mm. ### Claim 20 (depends on 10) The method of claim 10, wherein the primary incision has a length of 2.0 mm to 2.5 mm and the paracentesis incision has a length of 1.0 mm to 1.5 mm. ### Claim 21 A method of positioning and placing corneal donor tissue in the anterior chamber of a patient's eye, the method comprising: (a) providing a surgical tool assembly including: (i) a forceps instrument including a proximal handle portion with an actuator, and a distal forceps portion including jaws, where the actuator selectively moves the jaws; (ii) an infusion assembly including a tube configured to be connected to a fluid source at a primary tube end and connected to a fitting at a paracentesis tube end, an infusion sleeve extending away from the fitting, the fitting defines a passage configured to receive the distal forceps portion of the forceps instrument, the infusion sleeve being arranged concentric around an outer surface of the distal forceps portion to define a fluid pathway, and the jaws extend beyond a terminal end of the infusion sleeve such that the jaws are arranged outside of the infusion sleeve; and (iii) a donor tissue preparation tool configured to support a donor tissue; (b) placing donor tissue on the donor tissue preparation tool; (c) securing the donor tissue from the donor tissue preparation tool via the jaws and positioning the donor tissue into the anterior chamber of the patient's eye at an installation site; (d) providing pressurized fluid to the fluid pathway of the infusion sleeve while gripping the donor issue to orient and unscroll the donor tissue at the installation site; and (e) while holding the donor tissue in position, a small amount of fluid is aspirated to shallow the anterior chamber of the patient's eye to prevent the donor tissue from scrolling. ### Claim 22 A configuration of a surgical tool securing a donor tissue, the configuration comprising (a) an assembly comprising: a forceps instrument including a proximal handle portion with an actuator, and a distal forceps portion including jaws, where the actuator selectively moves the jaws; and an infusion assembly including a tube configured to be connected to a fluid source at a primary tube end and connected to a fitting at a paracentesis tube end, the fitting defines a passage configured to receive the distal forceps portion of the forceps instrument, an infusion sleeve extending away from the fitting, the infusion sleeve being arranged concentric around an outer surface of the distal forceps portion to define a fluid pathway, and the jaws extend beyond a terminal end of the infusion sleeve such that the jaws are arranged outside of the infusion sleeve; and (b) a donor tissue.