The present disclosure relates generally to surgical instruments and methods and, more particularly, to surgical instruments for use in surgeries to treat disorders of the ear, nose, and throat.
Functional endoscopic sinus surgery (FESS) is a common type of surgery used to treat chronic sinusitis, as well as remove tumors, polyps and other aberrant growths from the nose. In a typical FESS procedure, an endoscope is inserted into the nostril along with one or more surgical instruments. The endoscope typically provides the surgeon with a direct line-of-sight view to permit the surgeon to visualize a number of relevant anatomical structures within the surgical field. Under visualization through the endoscope, the surgeon may remove diseased or hypertrophic tissue or bone and/or enlarge the ostia of the sinuses to restore normal drainage of the sinuses. A number of surgical instruments may be used to cut and remove tissue and/or bone, cauterize, suction, etc. during a FESS procedure.
Nasal polyp surgery is one type of FESS procedure that is typically performed in an operating room with the patient under general anesthesia. It typically involves a powered fixed piece of capital equipment that includes a console and a hand piece. This equipment usually requires electrical, vacuum, and saline hookups. This surgical method is highly invasive and requires substantial recovery time for the patient
Nasal polyps can also be removed in the physician's office with simple tools such as forceps. The patient is typically awake during the procedure. The physician is limited by what he can comfortably reach and remove without creating too much discomfort to the patient. This procedure is relatively limited in the ability to remove substantial nasal polyps.
Another removal tool is a microdebrider, which is a rotary cutting tool that may be used to shave tissue and/or bone. Microdebriders may be connected to a vacuum source, which may be used to create suction that remove excess blood and tissue from the surgical field.
According to one aspect of the disclosure, a surgical instrument is disclosed. The instrument includes an electrical power source configured to generate an alternating current, a hand piece configured to be coupled to the electrical power source, an outer shaft extending distally from the hand piece, a first inner shaft positioned in the outer shaft, and a second inner shaft positioned in the outer shaft. The outer shaft has a slot defined in a distal end. The first inner shaft is configured to rotate relative to the slot in a first direction. The second inner shaft is configured to rotate relative to the slot in a second direction opposite the first direction. The first inner shaft is electrically connected to the electrical power source, the second inner shaft is electrically conductive, and the first inner shaft is electrically isolated from the second inner shaft.
In some embodiments, the first inner shaft may include a first plurality of splines that are aligned axially with the slot, and the second inner shaft may include a second plurality of splines that are interdigitated with the first plurality of splines of the first inner shaft.
In some embodiments, the outer shaft may have a passageway defined therein. The passageway may be configured to be fluidly coupled to a negative pressure source.
In some embodiments, the distal end of the outer shaft may be formed from a non-conductive material. In some embodiments, the outer shaft may include a first plurality of cutting teeth that partially define the slot at the distal end.
Additionally, in some embodiments, the first inner shaft may include a second plurality of cutting teeth aligned axially with the first plurality of cutting teeth.
In some embodiments, the first inner shaft may include a passageway, and the first plurality of cutting teeth and the second plurality of cutting teeth may be configured to cooperate to cut tissue advanced into the passageway through the slot. Additionally, in some embodiments, the outer shaft may include a third plurality of cutting teeth that partially define a second slot in the distal end, and the second inner shaft may include a fourth plurality of cutting teeth that are aligned axially with the third plurality of cutting teeth.
In some embodiments, the second inner shaft may include a second passageway, and the third plurality of cutting teeth and the fourth plurality of cutting teeth may be configured to cooperate to cut tissue advanced into the second passageway through the slot.
In some embodiments, the hand piece may include a negative pressure source connector configured to be coupled to a negative pressure source to fluidly connect the outer shaft to the negative pressure source.
The surgical instrument may also include a drive mechanism configured to rotate the first inner shaft and the second inner shaft relative to the outer shaft. In some embodiments, the drive mechanism may include an electric motor positioned in the hand piece.
In some embodiments, the electrical power source may be configured to generate a radio frequency electric current. In some embodiments, the outer shaft may have a rounded, convex distal surface. In some embodiments, the second inner shaft may be electrically connected to the electrical power source. In some embodiments, the distal end of the outer shaft is formed from an electrically-conductive material.
According to another aspect, a method of performing a surgical procedure is disclosed. The method includes advancing a distal end of a surgical instrument into a cavity of a patient, activating the surgical instrument to rotate a first inner shaft in a first direction within an outer shaft and rotate a second inner shaft in a second direction opposite the first direction within the outer shaft, and advancing the first inner shaft and the second inner shaft into contact with a portion of the patient's tissue in the cavity such that the patient's tissue contacting the first inner shaft and the second inner shaft completes an electrical circuit and electrical current flows through the portion of the patient's tissue. In some embodiments, activating the surgical instrument may include generating negative pressure to draw the portion of the patient's tissue into a passageway defined in the surgical instrument.
In some embodiments, advancing the first inner shaft and the second inner shaft into contact with the portion of the patient's tissue may include pinching the portion of the patient's tissue between a plurality of splines.
In some embodiments, advancing the first inner shaft and the second inner shaft into contact with the portion of the patient's tissue may include engaging a first plurality of cutting teeth of the first inner shaft with the portion of the patient's tissue, and engaging a second plurality of cutting teeth of the second inner shaft with the portion of the patient's tissue.
In some embodiments, advancing the first inner shaft and the second inner shaft into contact with the portion of the patient's tissue may further include engaging a set of cutting teeth of the outer shaft with the portion of the patient's tissue.
In some embodiments, the electrical circuit may include the outer shaft.
In some embodiments, the first inner shaft may be isolated electrically from the second inner shaft until advanced into contact with the patient's tissue.
According to another aspect, the surgical instrument includes a hand piece, an outer shaft coupled to the hand piece that extends to a distal end, and a hub including a barb that extends outwardly from a depressible outer wall. The depressible outer wall is movable between a first position in which the barb is engaged with the hand piece to secure the outer shaft to the hand piece and a second position in which the barb is disengaged from the hand piece to permit the outer shaft to be detached from the hand piece. The instrument also includes an inner shaft positioned in the outer shaft. The outer shaft has a first plurality of cutting teeth defined at the distal end, and the inner shaft has a passageway and a second plurality of cutting teeth.
The surgical instrument includes a cutting slot that is partially defined by the first plurality of cutting teeth, and the inner shaft is configured to rotate relative to the outer shaft such that the first plurality of cutting teeth and the second plurality of cutting teeth cooperate to cut tissue advanced into the passageway through the cutting slot.
The detailed description particularly refers to the following figures, in which:
While the concepts of the present disclosure are susceptible to various modifications and alternative forms, specific exemplary embodiments thereof have been shown by way of example in the drawings and will herein be described in detail. It should be understood, however, that there is no intent to limit the concepts of the present disclosure to the particular forms disclosed, but on the contrary, the intention is to cover all modifications, equivalents, and alternatives falling within the spirit and scope of the invention as defined by the appended claims.
Referring now to
The hand piece 12 of the surgical instrument 10 includes an elongated body 22 and a grip 24 formed on the body 22. The grip 24 is configured to be grasped by a user during operation of the surgical instrument 10. In other embodiments, the hand piece may include a handle or may include one or more ergonomic features to facilitate use of the instrument 10. The elongated body 22 and the grip 24 may be formed from the same material such as, for example, a plastic, rigid polymer, or other rigid materials suitable for autoclaving. The grip 24 may also be formed from a soft or padded material such as neoprene. In some embodiments, the hand piece 12 may be wholly or partially covered by a disposable outer skin or wrap during surgery such that the hand piece 12 does require re-sterilization or autoclaving between surgeries. In other embodiments, the hand piece 12 may be configured to be disposable after a single-use.
The hand piece 12 includes an aperture 30 defined in a longitudinal end 32 of the elongated body 22. As shown in
The connector 42 extends from a hose 46 that is connected to a source of negative pressure such as, for example, vacuum pump 48. The connector 36 of the hand piece 12 is configured to engage the hose connector 42 such that the hand piece 12 (and hence the blade assembly 14) may be connected to the vacuum pump 48. It should be appreciated that in other embodiments the negative pressure source may take the form of an air compressor, or other suction device.
In the illustrative embodiment, the electrical cable 52 includes the connector 44, which is coupled to a power source 50 such as, for example, a standard domestic power outlet. The power source 50 is configured to supply electrical power to the hand piece 12. The cable 38 of the hand piece 12 includes a connector (not shown) that is configured to engage the connector 44. In that way, electrical power may be supplied from the source 50 to the electrically-operated components (see
As shown in
In still other embodiments, the negative pressure source may be integrated into a portable console. Similarly, the power source may be included in a surgical console. The hand piece 12 may be configured to be plugged into a wall electrical socket via a plug or adaptor. The hand piece 12 may also be configured to be battery-powered similar to the embodiment shown in
The hand piece 12 includes a drive mechanism 66 that is positioned in the elongated body 22. In the illustrative embodiment, the drive mechanism 66 includes an electric motor powered by direct current (DC) and a gear assembly operable to transmit the output of the motor to the blade assembly 14. In other embodiments, the drive mechanism 66 may be powered by alternating current (AC). When the button 62 is toggled or pressed by the user, an electrical contact switch is configured to generate an electrical output, which is relayed to the pump 48 and the power source 50 via the cable 52, thereby activating the pump 48 and energizing the drive mechanism 66.
As described above, the hand piece 12 is configured to receive the blade assembly 14. In the illustrative embodiment, the hand piece 12 of the surgical instrument 10 includes a mounting collar 72, which receives the proximal end 34 of the blade assembly 14. As shown in
As described above, the blade assembly 14, which is the cutting tool of the surgical instrument 10, includes the inner blade shaft 90. The blade shaft 90 is positioned within an outer blade shaft 92. The cutting slot 16 is defined in the outer blade shaft 92, and the inner blade shaft 90 includes a longitudinal passageway 94 that opens into the cutting slot 16. The inner blade shaft 90 and the outer blade shaft 92 also include cutting edges 96, 98 that are axially aligned with the cutting slot 16. The edges 96, 98 are configured to cut or shaft tissue placed in the cutting slot 16 when the inner blade shaft 90 is rotated about its longitudinal axis 100. Exemplary inner blade shaft and outer blade shaft configurations are further shown and described in U.S. Patent App. Ser. No. 61/992,596, entitled “APPARATUS AND METHOD FOR TREATING DISORDERS OF THE EAR, NOSE, AND THROAT,” which was filed on May 13, 2014 and is expressly incorporated herein by reference.
As shown in
The inner hub 110 is positioned at the proximal end 34 of the blade assembly 14 and has a longitudinal bore 116 defined therein. As shown in
The outer hub 112 of the blade assembly 14 is positioned distal of the inner hub 110. The hub 112, like the inner hub 110, has a longitudinal bore 118 defined therein. As shown in
As described above, the surgical instrument 10 also includes a locking mechanism 20 to facilitate coupling and decoupling the blade assembly 14 to the hand piece 12. In the illustrative embodiment, the locking mechanism 20 includes a plurality of retention barbs 130 formed on the outer hub 112 and corresponding annular ring 132 formed in the mounting collar 72 of the hand piece 12. As shown in
As shown in
The outer hub 112 also includes a cylindrical grip 140 that extends outwardly from the cylindrical outer surface 120. The grip 140 is spaced apart from the barbs 130, and a channel 142 is defined between the grip 140 and the barbs 130. The channel 142 is sized to receiver the annular ring 132, as shown in
As shown in
Each of the outer walls 156, 158 is configured to move from the undeflected position shown in
In use, the proximal end 34 of the blade assembly 14 is aligned with the aperture 30 defined in the distal end 32 of the hand piece 12. The blade assembly 14 is then advanced into the aperture 30. As the blade assembly 14 is moved along the aperture 30, the inner hub 110 is moved through the passageway 78 defined in the mounting collar 72. The blade assembly 14 may be rotated to align the splines 88 of the inner hub 110 with the slots defined in the splined surface of the hand piece 12.
As the blade assembly 14 is advanced further into the aperture 30, the tapered proximal surfaces 138 of the retention barbs 130 are advanced into contact with the annular ring 132. The engagement between the barbs 130 and the ring 132 applies a force to the outer walls 156, 158 of the outer hub 112 in the direction indicated by arrows 170. When the force is high enough to overcome the spring bias of the outer walls 156, 158, the outer walls 156, 158 deflect, thereby drawing the barbs 130 radially inward and permitting further insertion of the blade assembly 14. It should also be appreciated that a user may apply sufficient force to the knurled surfaces 144, 146 of the grip 140 to deflect the outer walls 156, 158.
The blade assembly 14 may be advanced further into the aperture to engage the splines 88 with the drive mechanism 66, thereby connecting the hub 110 with the drive mechanism 66. As the blade assembly 14 is advanced further into the aperture 30, the splines 76 of the outer hub 112 engage the splined surface 74 of the mounting collar 72, thereby fixing the outer hub 112 (and hence the outer blade shaft 92) in position relative to the hand piece 12. When the barbs 130 are advanced beyond the annular ring 132, the outer walls 156, 158 are urged outward so that the annular ring 132 is positioned in the channel 142 defined between the grip 140 and the barbs 130. In that way, the blade assembly 14 is secured to the hand piece 12 by the engagement between the barbs 130 and the annular ring 132. With the blade assembly 14 attached, a user may proceed with a surgical procedure.
To detach the blade assembly 14, a user may apply sufficient force to the knurled surfaces 144, 146 of the grip 140 to overcome the spring bias of the outer walls 156, 158. When the outer walls 156, 158 are deflected, the barbs 130 are drawn radially inward, thereby permitting removal of the blade assembly 14.
Referring now to
The instrument 210 is configured to be coupled to a power source 50 via a cable 52, which is configured to supply alternating current to the instrument 210. The instrument 210 is also configured to be coupled to a negative pressure source such as a vacuum pump 48 to evacuate the severed tissue from the instrument 210. As described above in regard to the instrument 10, the instrument 210 may include any connectors, cables, converters, or the like necessary to provide the connections between the pump 48, the power source 50, and the instrument 210.
The instrument 210 is also configured to be coupled to a radio frequency (RF) generator 220. In the illustrative embodiment, the radio frequency generator 220 may be a separate power source configured to supply alternating electrical current (AC) at radio frequencies to the cutting tool assembly 214, as described in greater detail below. In other embodiments, the RF generator may be a frequency generator that generates a low power RF signal that is combined by the instrument 210 with the electrical current generated by the power source 50 and supplied to the cutting tool assembly 214. The instrument 210 may include any connectors, cables, converters, or the like necessary to provide the connection between the instrument 210 and the radio frequency generator 220.
The hand piece 212 of the surgical instrument 210 includes an elongated body 222. The body 222 is configured to be grasped by a user during operation of the surgical instrument 210. The elongated body 222 may be formed from a plastic, rigid polymer, or other rigid materials. The hand piece 212 also includes a drive mechanism 224. In the illustrative embodiment, the drive mechanism 224 includes an electric motor powered by alternating current and a gear assembly operable to transmit the output of the motor to the cutting tool assembly 214. In other embodiments, the drive mechanism 224 may be powered by direct current.
A button 226 positioned on the body 22 may be toggled or pressed by the user to activate the pump 48 and the power source 50 and energize the drive mechanism 224. A separate button 228 positioned on the body 222 may be toggled or pressed by the user to activate the radio frequency generator 220. In other embodiments, the pump 48, the power source 50, and the generator 220 may be controlled by a single button or control located on the hand piece 212 or located external to the instrument 210 on, for example, a foot pedal.
The cutting tool assembly 214 includes a pair of inner shafts 240, 242 and an outer shaft 244 that is secured to the hand piece 212. In the illustrative embodiment, a proximal end 246 of the outer shaft 244 is press fit into a collar 248 secured to the elongated body 222 of the hand piece 212. A longitudinal passageway 250 extends from the proximal end 246 of the outer shaft 244 to cutting slot 216 at the closed distal end 218. The passageway 250 is connected to the vacuum pump 48 such that negative pressure may be created through the longitudinal passageway 250 to draw severed tissue from the distal end 218 of the cutting tool assembly 214, through the hand piece 212, and out of the instrument 210.
Referring now to
The other inner shaft 242 also has a distal end 270 that is attached to the distal end 218 of the outer shaft 244 via a cylindrical pin 272. The pin 272 is received in a bore 274 defined in the outer shaft 244 such that the inner shaft 242 may be rotated about its longitudinal axis 276 relative to the outer shaft 244. The proximal end (not shown) of the inner shaft 242 is connected to the drive mechanism 224. As such, when the drive mechanism 224 is energized, the inner shaft 242 is rotated about its axis 276.
As shown in
As shown in
As shown in
In other words, the shafts 240, 242 and the RF generator 220 form a circuit 294 that is incomplete or open unless a conductor is added to electrically connect the shafts 240, 242. In the illustrative embodiment, the circuit 294 is configured to be completed or closed by the tissue to be removed from the patient. As shown in
Additionally, the synchronized rotation of the shafts 240, 242 pinches the cauterized tissue 296 and draws the cauterized tissue 296 into the cutting slot 216. The suction provided by the vacuum pump 48 facilitates the passage of the tissue through the shafts 240, 242. As shown in
Referring now to
As shown in
The inner shaft 340 also includes a cutting edge 358 that defines one side of the opening 356. The cutting edge 358 is illustratively serrated and includes a number of cutting teeth 360. In other embodiments, the inner shaft may include additional cutting edges and the cutting edges may include additional cutting teeth. In still other embodiments, one or both of the edges may include a single, continuous sharp edge.
The other inner shaft 342 has an elongated tube 370 that extends from a distal end 372. A passageway 374 is defined therein. In the illustrative embodiment, the tube 370 and the passageway 374 have a constant diameter along the length of the shaft 342. In other embodiments, the tube 370 and/or passageway 374 may be stepped or tapered along their lengths to facilitate suction and reduce the possibility of clogging in certain applications. The elongated tube 370 also includes an opening 376 that is axially aligned with the cutting slot 320 of the outer shaft 344. The passageway 374 and hence opening 376 are connected to a vacuum pump or other vacuum source.
The inner shaft 342 also includes a cutting edge 378 that defines one side of the opening 376. The cutting edge 378 is illustratively serrated and includes a number of cutting teeth 380. In other embodiments, the inner shaft may include additional cutting edges and the cutting edges may include additional cutting teeth. In still other embodiments, one or both of the edges may include a single, continuous sharp edge.
As shown in
The inner shaft 344 also includes a pair of cutting edges 398, 400 that define the sides of the cutting slots 316, 320, respectively. The cutting edges 398, 400 are illustratively serrated and include a number of cutting teeth 402, 404. In other embodiments, the outer shaft may include additional cutting edges and the cutting edges may include additional cutting teeth. In still other embodiments, one or both of the edges may include a single, continuous sharp edge.
As shown in
When the drive mechanism is energized, the shaft 340 is configured to rotate in a direction opposite the direction of rotation of the shaft 342, as indicated by arrows 406, 408 in
In use, the surgeon may toggle or press a control on a hand piece to energize the drive mechanism and cause the shafts 340, 342 to rotate. The surgeon may also separately activate the vacuum pump 48 and the RF generator 220. It should be appreciated that the drive mechanism may operate a single, continuous speed or at a variable speed.
To remove tissue, the distal end 318 of the blade assembly 314 is advanced into contact with the target tissue 412 as shown in
The movement of the inner shaft 340 in the direction indicated by arrow 406 presses the tissue 412 into engagement with the cutting edges 358, 398, and the edges 358, 398 cooperate to slice the target tissue 412. Similarly, movement of the inner shaft 342 in the direction indicated by arrow 408 presses the tissue 412 into engagement with the cutting edges 378, 400, which cooperate to slice the target tissue 412. As shown in
In other embodiments, the outer shaft 344 may be formed from a conductive material like the inner shafts 340, 342. In such embodiments, the shaft 344 may also be electrically coupled to the RF generator or to ground. Both shafts 340, 342 may carry a charge of one polarity and the shaft 344 may carry the other charge. In such embodiments, insulating elements may be included to isolate the shafts 340, 342, 344 from each other.
Referring now to
In the illustrative embodiment, the instrument 510 includes a handle 514 that is attached to tool body 512. The handle 514 includes a power supply 516 such as, for example, a rechargeable electric battery. As shown in
In use, the handle 514 is attached to the tool body 512 as shown in
The tool body 512, handle 514, and cutting tool assembly 14 may be formed from materials suitable for autoclaving. In other embodiments, each component may be configured for only a single use.
Referring now to
As shown in
The surgical instrument 610 also includes a cauterizing mechanism 616 to enable cautery while dissecting and resecting tissue. In the illustrative embodiment, the cauterizing mechanism 616 includes the distal wire tip 612, which is powered electrically by a power source 618 that is configured to provide a low voltage direct current (DC). In that way, electrical current is prevented from being transmitted to the patient. In other embodiments, the power source may be a high frequency AC current generator.
As shown in
In the illustrative embodiments, the wires 620, 622 and the wire tip 612 are formed from a single piece of wire having a cross sectional diameter of between about 0.010 inches and about 0.020 inches that is attached to the blade assembly 614. The blade assembly 614 has a cross sectional diameter at its distal end of between about 2 millimeters and about 4 millimeters. The wire is sized to ensure the distal wire tip 612 is heated to a temperature hot enough to cauterize tissue by high resistance electrical current. For example, the heated temperature of the wire may be above 50 degrees Celsius. The wire is illustratively made from a high resistance, high strength metal that can heat up instantaneously to cauterize the tissue and also cool down quickly when power is removed. It should be appreciated that in other embodiments the wire diameter may be changed depending on the diameter of the distal end of the blade assembly 614.
In the illustrative embodiment, the power source 618 is separate from the power source (not shown) that energizes the drive mechanism of the surgical instrument 610. In that way, the distal wire tip 612 may be supplied with power and operated independently of the blade assembly 614. In other embodiments, a single, common power source may be used.
In use, the distal wire tip 612 and the blade assembly 614 may be advanced unpowered with an endoscope into the nasal passage of a patient to provide a view of the surgical area. The surgeon may toggle or press a control button (not shown) to supply power to the distal wire tip 612. As electrical current flows through the tip 612, the tip 612 is rapidly heated. The surgeon may then advance the distal wire tip 612 into contact with a patient's tissue, thereby cauterizing the tissue or a tissue plane. With the distal wire tip 612 powered or unpowered, the surgeon may then advance the distal end of the blade assembly 614 into contact with the cauterized tissue. While doing so, the surgeon may activate the drive mechanism to cause the inner shaft 90 to rotate relative to the outer shaft 92. The surgeon may also separately activate the vacuum pump 48. To remove tissue, the target area is positioned in the cutting slot 16. As the inner blade shaft 90 is rotated about its axis 100, the cutting edge 96, for example, is advanced into engagement with the tissue. The rotation of the blade shaft 90 moves the tissue into contact with the cutting edge 98 of the blade shaft 92. The cutting edges 96, 98 cooperate to slice and resect the tissue, which is advanced into the passageway 94 and evacuated by the vacuum pump 48.
Referring now to
While the blade assembly 714 is similar to the blade assembly 14 described above, it should be appreciated that the light source 712 may be used with any of the blade assemblies described above. A similar light source may also be used with any of the shaft configurations shown and described in U.S. Patent App. Ser. No. 61/992,596, entitled “APPARATUS AND METHOD FOR TREATING DISORDERS OF THE EAR, NOSE, AND THROAT.”
In use, the light source 712 and the distal end 18 of the blade assembly 714 may be advanced into the nasal passage of a patient to provide a view of the surgical area. The light source 712 projects light to illuminate the submucosal pocket during resection. The resection may be performed with the naked eye or with an endoscope. In addition to illuminating the submucosal pocket, the light source 712 creates a glow on the external tissue surface, thereby indicating to the surgeon the location of the light surface 712 and hence the distal end 18 of the blade assembly 714.
Referring now to
The hand piece 12 includes a body 22 and a connector 36 attached to the longitudinal end 40 of the body 22. The connector 36 is configured to be coupled with corresponding connector 42 of a vacuum pump (not shown). The hand piece 12 also includes a connector 812 that is attached to the longitudinal end 40 of the body 22. The connector 812 is configured to mate with a corresponding connector 814 of an electrical cable 816 such that power may be supplied to the electrically-operated components (e.g., motor 66) of the hand piece 12, as described in greater detail below.
The hand piece 12 also includes a control panel 60 positioned on the elongated body 22. In the illustrative embodiment, the control panel 60 includes a single control button 62, which may be toggled to operate the surgical instrument 810. In other embodiments, the hand piece 12 may include additional controls such as toggles, levers, or other buttons to individually activate the electrically-operated components of the instrument 810 and/or the vacuum pump.
As shown in
In the illustrative embodiment, the control box 820, cable 816, and cable 828 are sized such that the control box 820 may be positioned on the floor adjacent to the surgeon's work area. In the illustrative embodiment, the control box 820 fits within a prism of approximately six inches by four inches by inches.
The control button 824 on the control box 820 is sized such that it may be operated by the foot of the surgeon. In other embodiments, the control box 820 may include additional controls such as toggles, levers, or other buttons to individually activate the electrically-operated components of the instrument 810 and/or the vacuum pump. In the illustrative embodiment, when either of the control buttons 62, 824 is pressed, a switch or switches (not shown) of the circuitry 830 closes to connect the power source to the motor 66, thereby energizing the motor 66 and operating the blade assembly 14. In that way, the surgeon may use either of the control buttons 62, 824 to activate the surgical instrument 810.
As described above, the control box 820 also includes the indicators 826. In the illustrative embodiment, the indicators 826 are a pair of colored LEDs 832, 834 connected to, and powered by, the circuitry 830. The circuitry 830 is operable to energize one or both of the LEDs 832, 834 to provide a visual indication to the user of the condition of the unit. For example, the LED 832 may be energized continuously to indicate power is supplied to the surgical instrument 810 and/or control box 820, while LED 834 may be energized intermittently to indicate only when the motor 66 is energized. It should be appreciated that in other embodiments other indicators such as, for example, displays and audible indicators may be used to inform the user of the condition of the surgical instrument 810.
In other embodiments, the surgical instrument 810 may be cable-driven. In such embodiments, the control box may be configured as a mechanical drive box, and the cable connecting the control box to the hand piece may include coaxial drive cable. The drive cable may include a core that serves as the rotational power source for the hand piece.
Referring now to
A cutting slot 16 is positioned at the distal end 918 of the blade assembly 914. This embodiment of the surgical instrument is configured to be used with a cable drive mechanism 920, which may be included in a portable surgical console or a control box similar to the one described above. The cable drive mechanism 920 is used to operate the blade assembly 914 to shave or cut tissue within the cutting slot 16. The surgical instrument 910 is also configured to be coupled to a negative pressure source such as a vacuum pump (not shown) to evacuate the severed tissue from the instrument 610.
The hand piece 912 of the surgical instrument 910 includes an elongated body 922. A handle 924 extends downwardly from the body 922 and includes a grip 926 that is configured to be grasped by a user during operation of the surgical instrument 910. As shown in
The hand piece 912 may be formed from a plastic, rigid polymer, or other rigid materials. In the illustrative embodiment, the surgical instrument 910 is sized to be approximately 120 grams in weight. The positioning of the handle 924 at the center gravity and the light weight of the surgical instrument 910 each provide ergonomic benefit to the user.
As shown in
The hand piece 912 also includes a connector 938 that extends downwardly from the handle 924. The connector 938 is configured to engage a connector 942 of a drive cable 944 of the drive mechanism 920. One such mechanism is commercially available from Heraeus Medical Components. The connectors 938, 942 also includes a pair of electrical contacts (now shown), which permit the user to activate the cable drive mechanism 920 using the hand piece 912.
As shown in
As shown in
Similar to the blade assembly 14 described above, the blade assembly 914 includes an inner blade shaft (not shown) that is configured to rotate relative to an outer blade shaft 92 to slice tissue advanced into the cutting slot 16. Another exemplary blade assembly and transmission mechanism for a cable-driven surgical instrument is shown and described in U.S. Patent App. Ser. No. 61/992,596, entitled “APPARATUS AND METHOD FOR TREATING DISORDERS OF THE EAR, NOSE, AND THROAT.”
As shown in
As described above, the surgical instrument 910 includes a drive cable 944 that has a connector 942 secured to the handle 924 of the hand piece 922 and another connector 976 attached to the housing 970. As shown in
As shown in
As shown in
In nasal polyp surgeries, vibration and whip are issues for precision control of the device. To reduce the vibration and whip transmitted to the handle 924, the core 968 is frictionally isolated from sheath 980 by a plurality of support bearings 1000, 1002, which are positioned at the opposite ends 982, 984. In the illustrative embodiment, two roller bearings 1000 are positioned at the end 982 and another two roller bearings 1002 are positioned at the end 984. Additionally, in the illustrative embodiment, the bearings 1000, 1002 and the cable core 968 are lubricated to further reduce vibration.
In the illustrative embodiment, whip is further reduced by the tapering of the cable 944 such that the sheath 980 has a smaller diameter at the handle 924 (i.e., the end 982). This reduction in diameter also assists with the flexibility and maneuverability of the handle 924 and hence the blade assembly 914. The diameter of the sheath 980 at the opposite end 984 is larger and more robust to withstand the inertial torque load of the drive unit 972.
As described above, the cable 944 also includes a spheroidal joint 986 that is attached to the opposite longitudinal end 982 of the sheath 980. As shown in
Referring now to
To reduce the vibration and whip transmitted to the handle 924, the core 1068 of the cable 1044 is frictionally isolated from sheath 1080 by a plurality of support bearings 2000, 2002, 2004, which are positioned at the opposite ends 1082, 1084 and at the stepped section 1086 of the sheath 1080. In the illustrative embodiment, two roller bearings 2000 are positioned at the end 1082, another two roller bearings 2002 are positioned at the end 1084, and two more roller bearings 2004 are positioned at the stepped section 1086. Additionally, in the illustrative embodiment, the bearings 2000, 2002, 2004 and the cable core 1068 are lubricated to further reduce vibration.
It should be appreciated that the size and configuration of each of the instruments, blade assemblies, and other cutting tools described herein permit the devices to be portable and facilitate the ease of use of the device in surgical procedures. It should be appreciated that in other embodiments the RF generator may be omitted and the instruments configured to remove tissue through the mincing, pinching, or cutting actions described above.
While the disclosure has been illustrated and described in detail in the drawings and foregoing description, such an illustration and description is to be considered as exemplary and not restrictive in character, it being understood that only illustrative embodiments have been shown and described and that all changes and modifications that come within the spirit of the disclosure are desired to be protected. For example, it should be understood that the materials used to form the various surgical instruments described herein may be modified or changed to reduce the weight of the instrument and facilitate single-handed use. Similarly, other materials may be selected to reduce friction of the inner passageways and outer surfaces. Still other materials may be selected for their anti-reflective properties. Additionally, as described above, the materials used to form the distal ends of the inner and outer blade shafts are dissimilar metallic materials. It should be appreciated that in other embodiments other dissimilar materials may be used. In still other embodiments, the same materials may be used. It should also be appreciated that in other embodiments any of the inner shafts and outer shafts described may utilize the shaft configurations shown and described in U.S. Patent App. Ser. No. 61/992,596, entitled “APPARATUS AND METHOD FOR TREATING DISORDERS OF THE EAR, NOSE, AND THROAT,” which is expressly incorporated by reference.
There are a plurality of advantages of the present disclosure arising from the various features of the apparatus, system, and method described herein. It will be noted that alternative embodiments of the apparatus, system, and method of the present disclosure may not include all of the features described yet still benefit from at least some of the advantages of such features. Those of ordinary skill in the art may readily devise their own implementations of the apparatus, system, and method that incorporate one or more of the features of the present invention and fall within the spirit and scope of the present disclosure.
Cross-reference is made to co-pending U.S. Patent App. Ser. No. 61/992,596, entitled “APPARATUS AND METHOD FOR TREATING DISORDERS OF THE EAR, NOSE, AND THROAT,” which was filed on May 13, 2014 and is expressly incorporated herein by reference.
Number | Date | Country | |
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62082361 | Nov 2014 | US | |
61992596 | May 2014 | US |