![]() Medical device for controlled nail penetration
专利摘要:
The present invention relates to a device for penetrating human nails (1) as a part of a treatment for Onychomycosis, commonly known as fungal nail. The device comprises a reusable electromechanical system and a single use cutting component. The electromechanical system incorporates an electric motor (5,11) and drive train (6) to advance the cutting component (2) through the nail (1). The electromechanical system also incorporates sensors (7-10,12) for measuring the cutting resistance for the purpose of preventing the cutting device (2) from overrunning into the nail bed. The device can be used to penetrate the nail (1) in a controlled manner which will create a portal through the nail without penetrating the nail bed below the nail (1). 公开号:AU2012360238A1 申请号:U2012360238 申请日:2012-12-18 公开日:2014-08-21 发明作者:Rolf Lewis THOMAS 申请人:Medical Device Development Ltd; IPC主号:A61B17-54
专利说明:
WO 2013/098555 PCT/GB2012/053174 MEDICAL DEVICE FOR CONTROLLED NAIL PENETRATION 5 CROSS-REFERENCE TO RELATED APPLICATION None. BACKGROUND TO THE PRESENT INVENTION 10 The present invention relates to a device for controlled penetration of the nail found on the hands and feet of a patient, and more particularly a device for the controlled penetration of the nail to aid in the treatment of infection of the nail such as for example the treatment for Onychomycosis commonly known as fungal nail. The device will penetrate 15 the nail using a cutter advanced by a control system that will prevent the cutter from overrunning and entering the nail bed below. Onychomycosis is an example of a fungal nail infection that is most common in the feet of the elderly affecting as many as 60% in the United States. It causes the nail to change shape, thicken and becoming brittle. Over the counter creams and ointments have 20 a very low level of efficacy (of between 5-12%). Oral treatments are much more effective, however they must be taken for 2-3 months and can affect the liver making them contraindicated for some patients. An alternative means of treatment is the use of lasers to treat the infection, however the cost of the equipment and treatment is very high making it unavailable to many patients. 25 If untreated the nail can be permanently deformed and can have a significant impact upon the patient's quality of life due to the unsightly appearance of the nail and pain when wearing shoes. To increase the local efficacy of topically applied treatment it is advantageous to deliver the treatment to areas within and below the nail. This greatly increases 30 concentration levels that can be achieved in the nail bed and consequently improves efficacy of the treatment. The matrix is the tissue upon which the nail rests, the part of the nail bed that extends beneath the nail root and contains nerves, lymph and blood vessels. The matrix is responsible for the production of the cells that become the nail plate. The nail plate or body of nail is like hair and skin, made of translucent keratin protein made of amino 35 acids. In the nail it forms a strong flexible material made of several layers of dead, flattened cells. If the nail is perforated then it allows antifungal treatment to be applied directly to the nail bed below the nail, where the infection resides. The challenge with drilling through the nail is to penetrate the nail without piercing the nail bed below. The nail bed is very sensitive and piercing it can cause the patient a lot of pain. 40 US patent application number 2006/0225757 Al describes a drill for making a hole in the fingernail or toenail, however there is no provision for preventing the drill from overrunning into the nail bed, other than the skill of the user. US patent number 6,264,628 B1 describes a device for cutting a notch in the nail. In order to prevent damage to the nail bed, the depth to which the notch is cut is - 1 - WO 2013/098555 PCT/GB2012/053174 predetermined prior to use. There is no method described for detecting the point at which the cutter breaks through the nail. US patent application number 2011/0046626 Al describes a method for drilling through the nail without drilling far into the nail bed. The author describes a method for 5 detecting the point at which the drill breaks through the nail and into the nail bed below by measuring the electrical impedance of the tissue being drilled. The electrical impedance of the material being drilled is measured by using the drill as one electrode and having a second electrode placed on the skin of the patient. A change in impedance between the two electrodes may be used to detect the point at which the drill breaks through the nail 10 and into the nail bed below. At this point however the drill may have progressed further into the nail bed than is desirable. US patent application number 2010/0145373 Al describes apparatus for drilling a hole in a nail of a subject. The Author describes a drill control unit configured to 2-60 back and forth motions per second. The apparatus is fed into the nail by the user and is 15 dependent upon the user to ensure that it is not pressed too deeply into the nail bed. The Author describes a control unit configured to stop drilling in response to the force exceeding a threshold force, however the force will fluctuate according to the amount applied by the user. 20 SUMMARY OF THE PRESENT INVENTION The present invention provides a device for automatically controlling the drilling through a nail of a human or other animal as claimed in claim 1 and also provides a device for automatically controlling the drilling through a tissue of a human or other animal as 25 claimed in claim 34. Optional features of both of these devices are described in the dependent claims. The present invention also provides a method of automatically controlling the drilling through a nail of a human or other animal as claimed in claim 35. It will be appreciated that the optional features described in relation to the device in the dependent 30 claims may be used as optional features of the method of the present invention. The method of the present invention may also be used to drill through tissues other than nails. The present invention also provides a method of treating a nail infection in a human or other animal as claimed in claim 37 and claim 38. The devices and methods according to the present invention do not require the user 35 to advance the cutter (i.e. drill bit), but instead utilise a control system that controls the rate at which the cutter is advanced and the force that is applied by the cutter. The control system advances the cutter through the nail whilst monitoring the position of the cutter and automatically stops the cutter from advancing once it breaks through the nail in order to ensure that is does not overrun and enter into the nail bed. 40 The devices and methods according to the present invention may be used to detectably predict the point at which the drill bit or cutter will break out of the nail and then control it so as to prevent it from entering the nail bed and causing the patient pain. -2- WO 2013/098555 PCT/GB2012/053174 BRIEF DESCRIPTION OF THE DRAWINGS Various embodiments of the present invention will now be described, by way of example only, and with reference to the accompanying drawings in which: 5 FIG 1 is a schematic illustration of the nail penetration device and a possible method of holding the device against the nail during use. FIG 2 is a schematic illustration showing that the device consists of two primary components; 1) a reusable hand-piece non-sterile and 2) detachable single use sterile cutting element. 10 FIG 3 is a schematic illustration showing how the device may be used to produce an elongated slot shaped aperture in the nail. FIG 4 is a schematic illustration showing a simplified drive mechanism that may be used to advance the cutter in the axial plane during operation (more detail is provided in FIG 5). 15 FIG 5 is a schematic illustration showing an embodiment of the drive mechanism and control system that may be used to advance the cutter in the axial plane and prevent it from overrunning into the nail bed during operation. A numbered components are as follows: 1. A cross-section of the nail 20 2. The cutter that may take the form of a twist drill, slot cutter, end mill or other appropriate design; possibly including helical or spiral features. 3. Spring used to ensure that the nail is pressed against the nail with sufficient force to ensure reliable operation of the device. 4. A switch or sensor to detect that the spring 3 has been sufficiently compressed. 25 5. The motor for rotating the cutter possibly also including an integral or separate tachometer for measuring the rotational speed during operation. 6. A component that transfers force between the drive screw for advancing the motor 5 and preventing it from being rotated by the reaction from the cutter 2. A more detailed description is provided in FIG 7. 30 7. At least one strain gauge that may be arranged in a Wheatstone Bridge configuration in order to measure axial forces. 8. At least one strain gauge that may be arranged in a Wheatstone Bridge configuration in order to torque or rotational forces. 9. A resistor placed in series for detecting the current flow through the motor 11 used 35 to power the drive mechanism for advancing and retracting the cutter in the axial direction. 10. A resistor placed in series with the motor for detecting the current flow through the motor 5 used to rotate the cutter 2. 11. The motor 11 used to power the drive mechanism for advancing and retracting the 40 cutter in the axial direction. 12. A torque sensor or component used to measure the torque applied to the motor 11 used to power the drive mechanism for advancing and retracting the cutter in the axial direction. -3- WO 2013/098555 PCT/GB2012/053174 13. The PCB control system used to automate the system and ensure that the cutter does not overrun the nail and enter the nail bed below. FIG 6 is a schematic illustration of the nail contacting part of the single use component that will ensure that the device is pressed against the nail with sufficient force 5 to prevent undesirable movement during operation. This also shows the cutter 2 not in contact with the nail 1 at this point. FIG 7 is a schematic illustration of an embodiment of a component 6 that may be used for one of the proposed methods for measuring the axial force and the torque produced during the cutting process, by using strain gauges 7 and 8 to measure elastic 10 deformation of a component connecting the motor and the drive mechanism shown in FIG 5. FIG 8 is a schematic illustration showing the cutter positioned on a toenail and three distinct stages of operation during use when the cutter is; 1) coming into contact with the nail, 2) passing through the nail, 3) breaking through the nail. 15 FIG 9 is a set of illustration of graphs showing the force profiles likely to be seen whilst drilling through a solid material with special reference to features that may be seen during stages 1, 2, and 3 shown in FIG 8; a) Reaction force on the cutter 2 or motor 5, b) Reaction torque on the cutter 2 or motor 5, c) Power consumed by motor 5, and d) Rotational velocity of the cutter 2. 20 FIG 10 is a schematic illustration of graphs showing the how the signals may be filtered including the first-order differential of the signals that may be used to detect the point at which the drill (or cutter 2) breaks through the nail: a) An unfiltered signal for the force profile b) The same signal shown in a) filtered using a low-pass filter for example a Kalman 25 filter c) The first-order differential of an unfiltered signal for the force profile as seen in a) d) The first-order differential for the filtered signal for the force profile as seen in b) FIG 11 a-f is a set of illustration profiles of various cutter design that may be used 30 and that will change the signal profiles shown in FIG 9: a) Conventional drill point design, where 50% of the axial force is carried on the leading chisel edge b) Centre point design similar to a wood drilling bit c) Circumference cutting design 35 d) Combination of centre point b) and circumference cutting c) designs e) Counter bore design designed to produce a counter bore hole f) Flat end design to help prevent damage to the nail bed when exiting the nail 1. Summary of Preferred Embodiments 40 Reference is now made to FIG 1, 2, 4 and 5, of the drawings showing schematic illustrations of an embodiment of the nail penetration device. The device may be handheld and presses against the nail during use as in FIG 1. The device may require a predetermined load to be applied, determined by the spring elements 3 shown in FIG 6, in order to ensure that the device is stable and there is -4- WO 2013/098555 PCT/GB2012/053174 no motion that may prevent the control system from correctly determining the position of the cutter in relation to the surface of the nail. The device may incorporate a pressure activated switch 4 as in FIG 5 in order to prevent the device from being operated when not firmly pressed against the nail, where the 5 applied load will help to prevent accidental motion in both the axial and horizontal planes i.e. less likely to slide across the surface of the nail. The component in FIG 6, also seen in FIG 5, helps prevent the likelihood of the device slipping across the surface of the nail. The device may be either activated by the depression of a button or upon the 10 application of the required amount of load. The control system may rotate the cutter and advance it into the nail at a constant feed rate until it is halted, e.g. using the drive mechanism 6 shown in FIG 5 and FIG 4. The control system may monitor the progress of the cutter as it is advanced through the nail in order to stop the cutter from advancing as it breaks through the nail thus 15 preventing it from entering the nail bed below. Various designs of cutter may be used (see some of the possible profiles shown in FIG 11) in order to make it easier to detect the point at which the cutter breaks through the nail and also reduce the likelihood of unwanted splinters or debris at the point of break out. The control system may energise the motor in FIG 4 which rotates the cutter at a 20 suitable rotational speed, for example between 1000 rpm and 100000 rpm. The control system may energise the lead-screw motor 11 in order to advance the cutter towards the nail 1. The control system may monitor the progress of the cutter through the nail including stages 1 to 3 depicted in FIG 8. 25 The control system may monitor any combination of the following signals in order to determine the progress of the cutter while it is advanced through the nail: The axial reaction force experienced by the cutter measured by the strain gauges 7 in FIG 5 and 7 or the current flow through the resistor 9 in series with the motor 11 or a drop in speed in motor 11 powering the drive mechanism to advance the cutter in the axial 30 direction; the reaction torque experienced by the cutter measured by the strain gauges 8 in FIG 5 and 7 or the current flow through the resistor 10 in series with motor 5 rotating the cutter 6 or the power required to drive the motor rotating the cutter or the change in rotational speed of the cutter and/or the motor rotating the cutter. The control system may be configured to stop advancing the cutter upon detecting 35 the point at which the cutter breaks through the nail (stage 3 in FIG 8) by detecting the axial reaction force reducing below a pre-determined threshold as in FIG 9a. The control system may be configured to stop advancing the cutter upon detecting the point at which the cutter breaks through the nail (stage 3 in FIG 8) by detecting the reaction torque reducing below a pre-determined threshold as in FIG 9b and c. 40 The control system may be configured to stop advancing the cutter upon detecting the point at which the cutter breaks through the nail (stage 3 in FIG) by detecting a change in rotational speed of the cutter as in FIG 9d. Once the drill bit has cut to the desired depth it may be moved in a translational direction to produce a portal that is longitudinal in form such as a slot as in FIG 3. -5- WO 2013/098555 PCT/GB2012/053174 DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS The present invention relates to a fully automated device that drills through the nail 5 in a controlled manner in order to prevent overrun of the drill 2 into the nail bed below. The device must be held in against the nail 1 (see FIG 1 and FIG 6) in a controlled manner in order to accurately track the progress of the cutter 2 through the nail 1 thus preventing it overrunning into the nail bed (see FIG 8 and FIG 9). When the device is first placed against the nail 1 the cutter 2 will not be in contact with the nail 1 (see FIG 6). Upon activation the 10 cutter will start to rotate and will then be advanced in an axial direction towards the nail 1. When the cutter makes contact with the nail 1 there will be a reaction force from the nail 1 in the axial direction and a reaction torque applied to the cutter. These forces can be measured using various sensors, for example; both forces could be measured by using strain gauges 7 and 8 to detect elastic deformation of a component 6 connected indirectly 15 to the cutter as shown in FIG 5 and FIG 7. Measuring these forces tells us about the mechanical properties of the material that the cutter 2 is in contact with. The amount of energy required to rotate the cutter will depend upon the material that the cutter is passing through, i.e. significantly less energy will be required to rotate the cutter whilst it is rotating in free space, when compared to the amount of energy required to 20 rotate the cutter as it is advanced through the nail 1. The amount of energy required to rotate the cutter can be measured (e.g. by measuring the voltage drop across a resistor 10) or controlling the amount of power that is delivered to the motor 5 that drives the cutter. The same principle can also be used in order to measure the amount of energy required to advance the cutter e.g. by measuring the voltage drop across resistor 9 in series with 25 motor 11 it is possible to determine the current drawn by motor 11 and thus determine the axial reaction force generated by the material being drilled. Possibly the simplest way to measure the mechanical properties of the material being drilled would be to measure the current drawn by the motor 5 when rotating the cutter and/or changes in the speed of rotation using a tachometer that is either separate or integral to the motor 5. 30 As explained in the earlier paragraphs, measuring the forces required to drill through a material provides information about the mechanical properties of the material. As the nail 1 can be considered to be relatively uniform in its mechanical properties we can predict the force profiles that would be obtained by drilling through this material. FIG 9 a to d shows the force profiles that we would expect to see as the cutter 2 advances through 35 the nail 1. Drilling through a uniform material (such as the nail 1) may be divided into the following three distinct stages (as shown in FIG 8). As can be seen from FIG 9 a to d each stage can be identified by features in the force profiles. Stage 1 is when the drill (or cutter 2) starts to enter the material the force profiles rise sharply in line with the increased energy required to rotate the cutter. Stage 2 is while the drill (or cutter 2) is passing through 40 the material and the force profile remains relatively constant. Stage 3 is the point at which the drill (or cutter 2) starts to break out of the material and where a sharp drop in the axial force can be seen. The same is torque also drops sharply once the cutter has broken out of the material, however this is often preceded by an initial increase in torque at the point of breakthrough (see FIG 9 b, c and a,). This information can be used to track the progress of -6- WO 2013/098555 PCT/GB2012/053174 the drill (or cutter 2) through the nail in order to stop the advancement of the drill (or cutter 2) at the point of breakthrough in order to prevent it entering the nail bed below. The nail bed contains lymph and blood vessels and is much softer than the nail which is constructed of primarily keratin. Consequently if the drill (or cutter 2) where to pass through the nail into 5 the nail bed below the system can easily detect a change in the materials being drilled. The actual signals that may be detected using the methods described in the previous paragraphs may contain noise or fluctuation creating a profile similar to that shown in FIG 10 a. In order to make the system more reliable it may be necessary to filter the signal using a low-pass filter for example a Kalman filter. This will produce a smoother 10 profile similar to the one shown in FIG 10 b. As stages 1 and 3 are denoted by either a rapid increase or decrease in the forces measured these features may be more easily identified by measuring the first-order differential as in FIG 10 d. The first-order differential may also need to be smoothed using a low pass filter (see FIG 10 c and d). 15 There are a number of ways to detect the point at which the drill (or cutter 2) begins to break out of the material including setting a minimum threshold for the forces or the first order differential of the forces. Once the system has detected that the drill (or cutter 2) has broken through the material it will stop advancing the drill (or cutter 2) in order to prevent it from penetrating 20 and damaging the nail bed below. At this point the cutter may either be retracted or remain at the same depth and transversely in order to produce a longitudinal slot in the nail (see FIG 3). Once a suitable cutter 2 has perforated the nail to produce an access port, a suitable anti-fungal agent (for example a solution containing 1% Terbinafine) can be 25 applied to the nail bed through the access port. The cutter may be used to apply the antifungal agent to the nail bed. If the cutter contains a spiral or helix portion (as in standard twist drill, slot or milling cutter designs) this will facilitate the removal of swarf while cutting. When rotated in the opposite direction the spiral or helix portion may be used to drive (or pump) anti-fungal agent through the nail to the nail bed. A vacuum device may 30 also be incorporated in the device or used in conjunction with the device in order to remove debris that may cause cross-infection. Reference is now made to FIG 8 to 10 which are schematic representations of the stages of the cutter passing through the nail and the signals that may be used and processed in order to detect the point at which the cutter breaks through the nail in order to 35 stop the cutter from advancing into the nail bed. The axial reaction force may be measured by using strain gauges 7 to detect elastic deformation of a component applying force to advance the cutter as shown in FIG 5 and FIG 7. The axial reaction force may be measured by sensing the level of current required 40 to advance the cutter using the motor 11 for the drive mechanism shown in FIG 5. The reaction torque may be measured by strain gauges to detect elastic deformation of a component 12 used to prevent the drive motor 11 for the drive mechanism from rotating as shown in FIG 5. -7- WO 2013/098555 PCT/GB2012/053174 The reaction torque may be measured by strain gauges 8 to detect elastic deformation of a component applying used to prevent the drive motor for the cutter from rotating as shown in FIG 5 and FIG 7. The reaction torque may be measured by sensing the level of current required drive 5 the motor 5 that rotates the cutter 2 shown in FIG 5. The reaction torque may be measured by sensing the level of power required drive the motor 5 that rotates the cutter 2 shown in FIG. The reaction torque may be measured by sensing the rotational speed of the motor 5 that rotates the cutter 2 or the cutter itself shown in FIG 5. 10 The point at which the cutter breaks through the nail stage 3 in FIG 8 can be detected by the any of the cutting forces dropping below a threshold that is either pre determined of calculated from measurements recorded during cutting as in FIG 9 a to d. The signals from the various methods of sensing the cutting forces may contain noise or erratic changes, making it difficult to detect the point at which the cutter breaks 15 though the nail as shown in FIG 1 Ob and c. In this case a low pass filter may be used to smooth the signal and amplify the feature used to detect the point at which the cutter breaks through the nail see FIG 10 a and d. A low pass filter such as a Kalman filter may be used to smooth the signals obtained from various sensors. 20 The cutter may also cut or mill horizontally in order to produce a slot for example a slot cutter as used in a conventional vertical milling machine. Once the cutter has been advanced to the point of breaking through the nail without overrunning, the cutter can then be moved in a translational direction in order to produce a slot shaped aperture in the nail as in FIG 3 in order to facilitate better access to the nail bed for antifungal agents used to 25 treat the Onychomycosis. -8-
权利要求:
Claims (38) [1] 1. A device for automatically controlling the drilling through a nail of a human or other 5 animal, said device comprising: a drill bit having a longitudinal axis; a motor for rotating the drill bit about said axis; a mechanism for moving the drill bit axially along said axis; and at least one sensor configured to monitor at least one parameter of the device that 10 varies depending on the force exerted on the drill bit by a material that the drill bit is in contact with; wherein the device is configured to control said mechanism and hence the axial movement of the drill bit based on the parameter monitored by the sensor. 15 [2] 2. The device of claim 1, wherein said mechanism is configured to advance the drill bit along said axis for passing the drill bit through the nail and wherein the mechanism is configured to halt advancement of the drill but when said at least one sensor detects a change in the parameter that is indicative of the drill bit having broken through the underside of the nail. 20 [3] 3. The device of claim 1 or 2, wherein the device is configured to control said mechanism for moving the drill bit such that the drill bit is prevented from drilling through said nail and then entering a nail-bed beneath the nail. 25 [4] 4. The device of claim 1, 2 or 3, wherein one of the at least one sensors is configured to either directly or indirectly monitor the reaction torque exerted on the drill bit by the drill bit passing through a material to be drilled through in use. [5] 5. The device of claim 4, wherein said mechanism is configured to axially advance 30 said drill bit only until the reaction torque decreases below a threshold value or the rate of change of the reaction torque increases above a threshold rate. [6] 6. The device of claim 4 or 5, wherein the device comprises a strain gauge associated with the motor for rotating the drill bit, wherein the strain gauge is configured to measure 35 said reaction torque on the drill bit as a function of the change in strain in the strain gauge. [7] 7. The device of any preceding claim, wherein one of the at least one sensors is configured to monitor a change in the electrical current supplied to the motor for rotating the drill bit. 40 [8] 8. The device of claim 7, wherein said mechanism is configured to axially advance said drill bit only until the electrical current decreases below a threshold value or the rate of change of the electrical current increases above a threshold rate. -9- WO 2013/098555 PCT/GB2012/053174 [9] 9. The device of any preceding claim, wherein the drill bit has an end connected to the motor for rotating the drill bit and an opposite free end, and wherein one of the at least one sensors is configured to either directly or indirectly monitor the axial force exerted on the drill bit in a direction from the free end to the connected end. 5 [10] 10. The device of claim 9, wherein said mechanism is configured to axially advance said drill bit only until the axial force decreases below a threshold value or the rate of change of the axial force increases above a threshold value. 10 [11] 11. The device of claim 9 or 10, wherein the device comprises a strain gauge associated with the mechanism for moving the drill bit, wherein the strain gauge is configured to measure said axial force as a function of the change in strain in the strain gauge. 15 [12] 12. The device of claim 6 or 11, wherein a strain gauge is mounted on an elastic or otherwise deformable component connected to the mechanism for moving the drill bit; and/or wherein a strain gauge is mounted on an elastic or otherwise deformable component connected to the motor for rotating the drill bit. 20 [13] 13. The device of any preceding claim, wherein said mechanism comprises a motor for advancing said drill bit axially, and wherein one of the at least one sensors is configured to monitor a change in the electrical current supplied to the motor. [14] 14. The device of claim 13, wherein said mechanism is configured to axially advance 25 said drill bit only until the electrical current decreases below a threshold value or the rate of change of the electrical current increases above a threshold value. [15] 15. The device of any preceding claim, wherein one of the at least one sensors is configured to monitor the rotational speed of the drill bit directly or indirectly and wherein 30 said mechanism is configured to axially advance said drill bit only until the rotational speed of the drill bit increases above a threshold value or the rate of change of the rotational speed decreases below a threshold rate. [16] 16. The device of claim 15, wherein the sensor is configured to monitor the speed of 35 the motor that rotates the drill bit. [17] 17. The device of any preceding claim, wherein the device is configured to use any combination of two or more of the sensors for monitoring the following parameters in order to detect the point at which the drill bit breaks through an underside surface of the nail and 40 to halt advancement of the drill bit; said axial force on the drill bit, said reaction torque, power consumption of said motors, and said rotational speed of the drill bit. [18] 18. The device of any preceding claim, wherein the device is configured to reduce the rotational speed of the drill bit or stop rotation of the drill bit when said parameter rises - 10- WO 2013/098555 PCT/GB2012/053174 above a threshold or falls below a threshold, or when said parameter changes at a rate above a threshold rate or below a threshold rate. [19] 19. The device of any preceding claim, wherein the device is configured to retract the 5 drill bit when said parameter rises above a threshold or falls below a threshold, or when said parameter changes at a rate above a threshold rate or below a threshold rate. [20] 20. The device of any preceding claim, wherein the device is configured to obtain the first differential with respect to time of a signal generated by the at least one sensor, and 10 wherein the device is configured to perform one or more of the following when said first differential rises above a threshold or falls below a threshold: reduce the rotational speed of the drill bit; stop rotation of the drill bit; stop advancement of the drill bit; or retract the drill bit into the device. 15 [21] 21. The device of any preceding claim, wherein the device comprises a low-pass filter for filtering a signal generated by the at least one sensor or for filtering said first differential, and wherein the device is configured to control said mechanism and hence the axial movement of the drill bit based on the filtered signal. 20 [22] 22. The device of claim 21, wherein the filter is a Kalman filter. [23] 23. The device of any preceding claim, wherein the device comprises a removable drill bit or is part of a kit comprising a plurality of interchangeable drill bits, the drill bits preferably being sterile. 25 [24] 24. The device of any preceding claim, wherein the device is portable and/or hand held. [25] 25. The device of any preceding claim, wherein the device is configured to determine the axial force exerted against the drill bit when the drill bit is pressed against a nail, and 30 wherein the device is configured to only allow rotation of the drill bit and/or advancement of the drill bit when the axial force is above a threshold value. [26] 26. The device of any preceding claim, further comprising a guard member surrounding the drill bit and a resilient biasing mechanism configured to resiliently bias the guard 35 member so that it surrounds and extends beyond the free end of the drill bit. [27] 27. The device of claim 26, wherein the resilient biasing mechanism is configured to be compressed when the guard member is forced against a nail in use so that the free end of the drill bit passes through and out of the guard member and contacts the nail. 40 [28] 28. The device of claim 27, wherein the device includes a switch which prevents the drill bit from rotating and/or advancing until the resilient biasing mechanism has been compressed such that the free end of the drill bit passes through and out of the guard member. - 11 - WO 2013/098555 PCT/GB2012/053174 [29] 29. The device of any preceding claim, comprising a safety mechanism configured to retract the drill bit into the device and away from the nail in the event of an axial force 5 exerted on the drill bit rising above a threshold or falling below a different threshold. [30] 30. The device of any preceding claim, wherein the free end of the drill bit has one or more sharp features for contacting the nail surface and preventing the drill bit from slipping on the nail surface in use. 10 [31] 31. The device of any preceding claim, wherein the circumferential surface of the drill bit is profiled such that once it has vertically penetrated through the surface of the nail and whilst it is rotating, it is able to mill a slot in the nail when moved sideways through the nail. 15 [32] 32. The device of any preceding claim, further comprising a suction system or a blower system arranged and configured for sucking or blowing nail debris away from the end of the drill bit as the nail is drilled through, in use. [33] 33. The device of any preceding claim, wherein the circumferential surface of the drill 20 bit includes a groove or ridge that spirals around and up the drill bit from the free end of the drill bit towards the other end of the drill bit, wherein the motor is configured to rotate the drill bit about its axis in a first direction for drilling a hole or slot through the nail and to rotate the drill bit about its axis in the opposite direction for using the spiral groove or ridge to convey a fluid down the drill bit towards its free end and thus through the hole or slot in 25 the nail. [34] 34. A device for automatically controlling the drilling through tissue in a human or other animal, said device comprising: a drill bit having a longitudinal axis; 30 a motor for rotating the drill bit about said axis; a mechanism for moving the drill bit axially along said axis; and at least one sensor configured to monitor at least one parameter of the device that varies depending on the force exerted on the drill bit by a material that the drill bit is in contact with; 35 wherein the device is configured to control said mechanism and hence the axial movement of the drill bit based on the parameter monitored by the sensor. [35] 35. A method of automatically controlling the drilling through a nail of a human or other animal, the method comprising: 40 providing a drill bit having a longitudinal axis; rotating the drill bit about said axis; moving the drill bit axially along said axis so as to drill through said nail; - 12- WO 2013/098555 PCT/GB2012/053174 using at least one sensor to monitor at least one parameter of the device that varies depending on the force exerted on the drill bit by the nail that the drill bit is drilling through; and controlling the axial movement of the drill bit through the nail based on the 5 parameter monitored by the sensor. [36] 36. The method of claim 35, wherein the circumferential surface of the drill bit is profiled for milling, the method comprising penetrating the drill bit vertically into the nail and then moving the drill bit sideways so as to mill a slot in the nail. 10 [37] 37. A method of treating a nail infection in a human or other animal comprising a method as claimed in claim 35 or 36, wherein the circumferential surface of the drill bit includes a groove or ridge that spirals around and up the drill bit from a free end of the drill bit towards the other end of the drill bit, wherein the drill bit is rotated about its axis in a first 15 direction so as to drill a hole through the nail, and wherein the drill bit is then rotated about its axis in the opposite direction whilst providing a topical treatment agent for said nail infection onto the drill bit such that the spiral groove or ridge conveys the agent down the drill bit towards its free end and through the hole in the nail. 20 [38] 38. A method of treating a nail infection in a human or other animal comprising: providing a drill bit comprising a groove or ridge that spirals around and up the drill bit from a free end of the drill bit towards the other end of the drill bit; and rotating the drill bit about its axis whilst providing a topical treatment agent for said nail infection onto the drill bit such that the spiral groove or ridge conveys the agent down 25 the drill bit towards its free end and through a hole in the nail. - 13-
类似技术:
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同族专利:
公开号 | 公开日 WO2013098555A1|2013-07-04| EP2800531A1|2014-11-12| US9826983B2|2017-11-28| GB201200005D0|2012-02-15| US20140371751A1|2014-12-18|
引用文献:
公开号 | 申请日 | 公开日 | 申请人 | 专利标题 US3583821A|1969-04-02|1971-06-08|Melvin H Shaub|Chip catcher| US3766923A|1972-04-03|1973-10-23|Us Health Education & Welfare|Device for treating sub-unqual hematoma| US4267841A|1978-01-06|1981-05-19|Fraser Alexander R|Nail matrix trephine| US4180058A|1978-08-15|1979-12-25|Jacob Brem|Method of treating pathological conditions of the nail| US5823720A|1996-02-16|1998-10-20|Bitmoore|High precision cutting tools| US5645554A|1996-05-14|1997-07-08|Hugh; Donald C.|Trephinator for treating subungual hematomas| US5795314A|1996-06-19|1998-08-18|Berenstein; Moshe|Therapeutic fingernail treatment device| US6015418A|1997-11-19|2000-01-18|Wymond; Tyler R.|Fingernail and toenail drill| US6572580B2|1998-08-06|2003-06-03|Profoot, Inc.|Set depth nail notcher with patch system and method for treating nail fungus| US6264628B1|1998-08-06|2001-07-24|Profoot, Inc.|Set depth nail notcher and method for treating nail fungus| US8430104B2|2001-08-21|2013-04-30|Cooltouch Incorporated|Method for treatment of microbial infection| US9345487B2|2013-02-05|2016-05-24|Path Scientific, Llc|Precision bone drill and method of use| WO2004086938A2|2003-03-25|2004-10-14|Herndon Terry O|Drill device and method for forming microconduits| US20060225757A1|2005-03-24|2006-10-12|Jamison Terry Jr|Nail drill| US20070104664A1|2005-10-26|2007-05-10|California Institute Of Technology|Treatment of toenail fungus| GB0612452D0|2006-06-22|2006-08-02|Univ Aston|Improvements in or relating to drilling apparatus and methods| US8150505B2|2007-05-03|2012-04-03|Path Scientific, Llc|Method and apparatus for the formation of multiple microconduits| US8511945B2|2008-03-28|2013-08-20|Quanser Consulting Inc.|Drill assembly and method to reduce drill bit plunge| US20110301628A1|2008-12-05|2011-12-08|Yossi Gross|Techniques for use with a nail penetration device| US20100145373A1|2008-12-05|2010-06-10|Ruth Alon|Nail drill| US20110243673A1|2010-04-02|2011-10-06|Bohus Svagr|Retractable drill bit apparatus, system, and method| US9301775B2|2013-02-18|2016-04-05|Moshe Dolev|Fingernail drill| US20140236203A1|2013-02-18|2014-08-21|Moshe Dolev|Fingernail drill| US9504849B2|2013-03-14|2016-11-29|Plumeria Holdings, Llc|Destruction of target cells utilizing harmonic resonance cavitation| US20160175612A1|2014-12-22|2016-06-23|Fotona D.D.|Nail fungus laser treatment|US8366719B2|2009-03-18|2013-02-05|Integrated Spinal Concepts, Inc.|Image-guided minimal-step placement of screw into bone| EP2671531B1|2010-08-24|2016-01-20|W & H Dentalwerk Bürmoos GmbH|Medical, in particular dental drilling tool| US20150257808A1|2014-03-13|2015-09-17|Spinal Generations, Llc|Method and apparatus for determining whether to deliver a substance to bone| GB201404667D0|2014-03-14|2014-04-30|Medical Device Treat Ltd|Improvements in or relating to medical and veterinarian rotary tools| KR101864751B1|2015-05-29|2018-06-08|한국생산기술연구원|Method of machining stack of carbon fiber reinforced plastics using monitering sensor| CN107743384B|2015-06-16|2020-12-22|柯惠Lp公司|Robotic surgical system torque sensing| EP3485760A1|2017-11-16|2019-05-22|Nokia Technologies Oy|Nail clipper| US11123088B2|2020-01-16|2021-09-21|Spinal Innovations, Llc|Pressure activated surgical tool for use in spinal decompression procedures and methods of using the same| USD930246S1|2020-04-02|2021-09-07|Shenzhen Sist Technology Co,. ltd|Electric manicure set|
法律状态:
2014-09-11| PC1| Assignment before grant (sect. 113)|Owner name: MEDICAL DEVICE DEVELOPMENT LIMITED Free format text: FORMER APPLICANT(S): THOMAS, ROLF | 2017-07-13| MK4| Application lapsed section 142(2)(d) - no continuation fee paid for the application|
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申请号 | 申请日 | 专利标题 GB1200005.5||2012-01-01|| GBGB1200005.5A|GB201200005D0|2012-01-01|2012-01-01|Medical device for controlled tissue penetration and uses thereof| PCT/GB2012/053174|WO2013098555A1|2012-01-01|2012-12-18|Medical device for controlled nail penetration| 相关专利
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