This invention relates to surgical systems and their use, such as an arthroscopic and other endoscopic tissue cutting and removal system wherein a motor-driven electrosurgical device is provided for cutting and removing bone or soft tissue from a joint or other site. More specifically, this invention relates to systems and methods for device identification, monitoring, and control, such as controlled operational stopping and starting of motor-driven components in default positions.
In arthroscopic, endoscopic, and other surgical procedures including subacromial decompression, anterior cruciate ligament reconstruction involving notchplasty, and arthroscopic resection of the acromioclavicular joint, there is a need for cutting and removal of bone and soft tissue. Currently, surgeons use arthroscopic shavers and burrs having rotational cutting surfaces to remove hard tissue in such procedures.
To promote efficiency, endoscopic tool systems including a reusable handpiece and a selection of interchangeable tool probes having different working ends have been proposed. Such working ends may each have two or more functionalities, such as soft tissue removal and hard tissue resection, so such tools systems can provide dozens of specific functionalities, providing great flexibility.
While a significant advantage, the need for one tool system to accommodate such flexibility is a challenge. In particular, it is necessary that the handpiece and control unit for the system be provided with correct information on the identity of the tool probe that has been attached as well as the operational parameters of the tool probe during use.
It is therefore an object of the present invention to provide improved surgical systems and methods for their use, such as improved arthroscopic tissue cutting and removal system wherein a motor-driven electrosurgical device is provided for cutting and removing bone or soft tissue from a joint or other site. It is a further object invention to provide improved systems and methods for device identification, monitoring, and control, such as controlled operational stopping and starting of motor-driven components in default positions. At least some of these objectives will be met by the inventions described herein.
The present invention provides improved apparatus and methods for identifying and controlling working components, such as motor-driven and other powered components, of surgical systems, particularly for arthroscopic and other surgical systems including (1) handpieces having motor drive units and (2) probes which are selectively and removably attached to the handpieces. In exemplary embodiments, the present invention provides methods and systems which rely on magnets and magnetic sensors for providing information to system controllers both in a static mode, where a endoscopic or other tool is not being driven, and in a dynamic mode, where the tool is being driven by the motor drive. In particular embodiments, the magnets are permanent magnets having North poles and South poles, where the magnets are typically mounted on or otherwise attached or coupled to components of a detachable probe forming part of an arthroscopic system, and the sensors are Hall sensors which are in the handpiece of the arthroscopic system. By using multiple magnets and multiple sensors, different types of information can be provided to the system controller, such as identification of the tool in the detachable probe, operating characteristics of the probe, system calibration information, and the like. While the exemplary embodiments of present invention typically rely on magnetic sensors, static and dynamic data acquisition from the tool probe to the associated controller and be accomplished with other sensors as well, such as optical sensors which are able to read information in both a static mode and in a dynamic mode.
In a first aspect of the present invention, an arthroscopic system comprises a handpiece and a probe. The handpiece includes a motor drive, and the probe has a proximal hub and an elongate shaft which extends about a longitudinal axis to a working end of the probe. The hub is configured for detachably coupling to the handpiece, and the motor drive is configured to couple to a rotating drive coupling in the hub when the hub is coupled to the handpiece. A first magnetic component is carried by the hub, and a second magnetic component is coupled to rotate with the rotating drive coupling.
In specific aspects, the hub may be configured for detachable coupling to the handpiece in opposing rotational orientations, such as an orientation where a working end of the probe is facing upwardly and a second orientation where the working end of the probe is facing downwardly relative to the handpiece. In such embodiments, the first magnetic component may comprise first and second independent magnets, typically permanent magnets have North poles and South poles, disposed in or on opposing sides of the hub and spaced outwardly from the longitudinal axis. The first and second independent magnets of the first magnetic component will typically have a “polar orientation,” for example the North poles will be oriented in opposite directions relative to said axis. Typically, though not necessarily, the first and second independent magnets may have similar magnetic field strengths. In such embodiments, the handpiece may further comprise a first sensor configured for “statically” sensing a magnetic field of the first or second independent magnets when located adjacent the first sensor. By “statically” sensing, it is meant that the magnets do not need to be moving relative to the sensor. The sensor will thus be able to generate a signal indicating whether the working end is in its upward-facing orientation or its downward-facing orientation. The first sensor may be further configured for generating a probe identification signal based on the magnetic field strength (or other magnetic characteristic) which correlates a probe type with different magnetic field strengths, typically by using a look-up table maintained in an associated controller.
In still other embodiments, the second magnetic component comprises third and fourth independent magnets disposed in or on opposing sides of the rotating drive coupling. The third and fourth independent magnets of the second magnetic component will typically have North poles in opposing orientations relative to said axis, usually in a manner similar to the first and second independent magnets. The handpiece will further comprise a second sensor configured for sensing a magnetic field of the third or fourth independent magnets as the magnet comes into proximity to the second sensor. In this way, the second sensor can dynamically sense and generate a signal indicating a rotational parameter of the rotating drive coupling. For example, the rotational parameter may comprise a rotational position of the drive coupling. Alternatively or additionally, the rotational parameter may comprise a rotational speed of the drive coupling based on the rotational positioning over a time interval.
These arthroscopic and other surgical systems may be further configured for determining orientation of the motor-driven component so that the working end can be stopped in a desired position. For example, the second magnetic component carried by the drive coupling may be in a fixed predetermined rotational relationship to a motor-driven component in the working end. In this way, a rotational positioning of the component in the working end van be controlled based on the rotational position of the drive coupling.
Such systems of the present invention may further comprise a controller configured to receive the signals generated by the sensors and provide monitoring and control of the endoscopic or other surgical tool based on the received signals. For example, by receiving signals generated by the first sensor within the hub, at least one of probe-orientation and probe identification can be determined. Similarly, by receiving signals generated by the second sensor within the hub, the controller may be configured to monitor and/or control the motor speed and other operational characteristics.
In a second aspect of the present invention, a method for performing an arthroscopic procedure comprises providing a system including a handpiece with a sensor. The system further comprises a probe having a proximal hub, a longitudinal axis, and a working end. The hub typically carries first and second magnets having North and South poles. The hub is selectively coupled to the handpiece with the working end of the probe in either an upward orientation or a downward orientation. The first magnet is located proximately to sensor when the working end is in the upward orientation, and the second magnet is located proximately to sensor when the working end is in the down orientation. In this way, an upward orientation or a downward orientation of the working end can be determined based on whether a North pole or a South pole of the magnet is proximate to the sensor. Such “orientational” information is used for a variety of purposes, including selecting a controller algorithm for operating the probe based on the identified orientation of the working end.
In a third aspect of the present invention, an arthroscopic or other surgical method comprises providing a system including a handpiece with a sensor. The system further comprises a probe with a proximal hub, a longitudinal axis, and a working end. The hub will carry first and second magnets of similar strengths and having North and South poles. The hub is coupled to the handpiece, and a magnetic strength of either (or both) of the magnets is sensed using a sensor in the handpiece to identify the probe type based on the sensed magnetic strength. Identification of the probe type is useful for a variety of purposes, including allowing selection of a control algorithm (to be used by a controller coupled to probe and sensors) to control the working end of the tool based on the identified probe type.
In a fourth aspect, an arthroscopic or other surgical procedure comprises providing a system including a handpiece with a motor drive. The system further comprises a probe having a proximal hub, a longitudinal axis, a rotating drive coupling, and a working end. The rotating drive coupling typically carries first and second magnets having North and South poles where each pole is positioned in a different orientation relative to the axis. The hub is attached to the handpiece to couple the motor drive to the rotating drive coupling in the hub. The rotating drive coupling actuates a motor-driven or other component in the working end, e.g. the motor drive may be activated to rotate the drive coupling and actuate the motor-driven component. A varying magnetic parameter is sensed with a sensor in the handpiece as the drive coupling rotates in order to generate sensor signals. A rotational position of the drive coupling can thus be determined, and the corresponding positions of the motor-driven component calculated using a positioning algorithm responsive to the sensor signals. The motor drive can be selectively deactivated at a desired rotational position based on the positional information which has been thus determined. After deactivating the motor drive, the system can dynamically brake the motor drive to thereby stop rotation of the drive coupling and stop movement of the motor-driven component in a selective stop position in a highly accurate manner.
In a fifth aspect of the present invention, an arthroscopic procedure comprises providing a system including a handpiece with a motor drive. The system further comprises a probe with a proximal hub and an elongate shaft extending about an axis to a working end. The hub is configured for detachable coupling to the handpiece, and the motor drive is configured to couple to a rotating drive coupling in the hub. The drive coupling, in turn, carries first and second magnets with North and South poles positioned in different orientations relative to the axis. The hub is coupled to the handpiece, and the motor drive is activated to rotate the drive coupling and magnets through an arc of at least 180°. A varying strength of each magnet is then sensed with a sensor in the handpiece as the drive coupling rotates. A rotational position of the drive coupling responsive to the varying strength of each magnet can be calibrated in order to increase accuracy in subsequent calculation of the sensed strengths of the magnets.
In a sixth aspect of the present invention, an arthroscopic procedure comprises providing a handpiece with a motor drive. The system further comprises a probe having a proximal hub and an elongate shaft extending about a longitudinal axis to a working end having a motor-driven component. The motor-driven component includes a radio frequency (RF) electrode, and a hub is configured for detachable coupling to the handpiece. The motor drive is configured to couple to a rotating drive in the coupling of the hub, and the rotating drive coupling is configured to carry first and second magnets with North and South poles positioned in different orientations relative to the axis. The hub is coupled to the handpiece, and the drive coupling and motor-driven component are positioned in a selected stop position. The RF electrode is typically exposed in the selected stop position and can be introduced to a target site to engage or interface with tissue. RF current is then delivered to the RF electrode, and a positioning algorithm responsive to sensor signals continuously monitors the rotational position of the drive coupling and the corresponding position of the motor-driven component and the RF electrode while RF current is being delivered. Such position monitoring is useful because it allows the positioning algorithm to sense a rotation or rotational deviation greater than a predetermined amount, in which case the delivery of RF current to the RF electrode can be terminated. Additionally or alternatively, the positioning algorithm can further activate or adjust the motor drive to return the RF electrode back to a selected or desired stop position.
In a seventh aspect, an arthroscopic procedure comprises providing a handpiece with a motor drive and a probe with a proximal hub. An elongate shaft of the hub extends about an axis to a working end, and a motor driven component in the working end includes an RF electrode. The hub is configured for detachably coupling to the handpiece, and the motor drive is configured to couple to a rotating drive coupling in the hub. The rotating drive carries first and second magnets with North and South poles having different orientations relative to the axis. The hub is coupled to the handpiece, and the drive coupling and motor-driven component may be positioned in a selected stop position. The RF electrode may be engaged against a target issue surface or interface, and an RF current may be delivered to the RF electrode. Using a positioning algorithm responsive to sensor signals indicating a rotational position of the drive coupling, the RF electrode can be oscillated in the range from 20 Hz to 2000 Hz. Often, oscillation of the RF electrode at a rate ranging from 40 Hz to 400 Hz.
In an eighth aspect, the present invention comprises a method for providing information from a surgical probe to a controller. A hub of the probe is attached to a handpiece connected to the controller. The hub carries indicia, and a first set of data obtained from reading the first set of indicia on the hub may be read using a first sensor on the handpiece, where the first set of data can then be sent to the controller. A second set of indicia on the hub is also read using a second sensor on the handpiece, and a second set of data obtained from the second reading may also be sent to the controller. The first set of data includes at least one of probe identification information and probe orientation information, and the second set of data includes at least probe operational information.
In specific embodiments, the first and/or second set of indicia may comprise magnets, as taught in any of previously described embodiments. In alternative embodiments, however, the first and/or second sets of indicia may comprise optical encoding or any other type of data encoding that can be read using sensors in the handpiece. For example, the first set of indicia may comprise optical encoding including a scannable code on a stationary component of the hub, such as a housing. The first set of indicia incorporates said at least one of probe identification information and probe orientation information and can be read when the code is static relative to the handpiece, typically using a stationary optical scanner, such as a bar or 3D code reader. In other examples, the second set of indicia may comprise optical encoding configured to be read by a scannable code reader, e.g., markings on a rotatable component of the hub, wherein at least the probe operational information is configured to read from the markings as the rotatable component dynamically rotates. For example, the markings may be read by an optical counter that can determine a rotation speed, such as revolutions per minute (RPM).
In some embodiments, the probe will include a rotary-to-linear converter for receiving rotary motion from the rotary drive coupling in the hub and converting the rotary motion to linear motion, typically reciprocating motion, e.g., for driving a reciprocating electrode, a reciprocating cutting blade, pivoting a jaw member (where the reciprocating motion can be further converted into pivoting motion), and the like, as described elsewhere herein. In all such cases, a magnet or other detectable element can be placed on the reciprocating or pivoting element in addition to, or in some cases in place of, the magnet or other detectable element that is on or otherwise coupled to the rotary drive coupling in the hub. In such cases, a magnetic or other sensor in the handpiece will be located to detect linear motion, typically to determine reciprocation rate, reciprocation distance, or other performance parameter.
Various embodiments of the present invention will now be discussed with reference to the appended drawings. It should be appreciated that the drawings depict only typical embodiments of the invention and are therefore not to be considered limiting in scope.
The present invention relates to bone cutting and tissue removal devices and related methods of use. Several variations of the invention will now be described to provide an overall understanding of the principles of the form, function and methods of use of the devices disclosed herein. In general, the present disclosure provides for variations of arthroscopic tools adapted for cutting bone, soft tissue, meniscal tissue, and for RF ablation and coagulation. The arthroscopic tools are typically disposable and are configured for detachable coupling to a non-disposable handpiece that carries a motor drive component. This description of the general principles of this invention is not meant to limit the inventive concepts in the appended claims.
In one variation shown in
In
As can be seen in
In
It can be understood from
As can be understood from the above description of the system 100 and handpiece 104, the controller 165 and controller algorithms need to be configured to perform and automate many tasks to provide for system functionality. In a first aspect, controller algorithms are needed for device identification so that when any of the different probes types 110, 200A, 200B, 200C or 200D of
Referring to
The sectional views of
Referring now to
In another aspect of the invention, in probe 110 (
In another aspect of the invention, the Hall sensor 245 and magnets 255a and 255b (
As can be understood from
It can be understood that during use, when the electrode 155 is in the position shown in
Now turning to the stop mechanism or algorithms for stopping movement of a motor-driven component of working end 112,
In
Dynamic braking as shown schematically in
As background, the concept of dynamic braking is described in the following literature: https://www.ab.com/support/abdrives/documentation/techpapers/RegenOverview01.pdf and http://literature.rockwellautomation.com/idc/groups/literature/documents/wp/drives-wp004_-en-p.pdf. Basically, a dynamic braking system provides a chopper transistor on the DC bus of the AC PWM drive that feeds a power resistor that transforms the regenerative electrical energy into heat energy. The heat energy is dissipated into the local environment. This process is generally called dynamic braking with the chopper transistor and related control and components called the chopper module and the power resistor called the dynamic brake resistor. The entire assembly of chopper module with dynamic brake resistor is sometimes referred to as the dynamic brake module. The dynamic brake resistor allows any magnetic energy stored in the parasitic inductance of that circuit to be safely dissipated during the turn off of the chopper transistor.
The method is called dynamic braking because the amount of braking torque that can be applied is dynamically changing as the load decelerates. In other words, the braking energy is a function of the kinetic energy in the spinning mass and as it declines, so does the braking capacity. So the faster it is spinning or the more inertia it has, the harder you can apply the brakes to it, but as it slows, you run into the law of diminishing returns and at some point, there is no longer any braking power left.
In another aspect of the invention, a method has been developed to increase the accuracy of the stopping mechanism which is a component of the positioning algorithm described above. It has been found that each magnet in a single-use probe may vary slightly from its specified strength. As described above, the positioning algorithm uses the Hall effect sensor 245 to continuously monitor the field strength of magnets 255a and 255b as the drive coupling 150 rotates and the algorithm determines the rotational position of the magnets and drive coupling based on the field strength, with the field strength rising and falling as a magnet rotates past the Hall sensor. Thus, it is important for the algorithm to have a library of magnetic field strengths that accurately correspond to degrees of rotation away from a peak Hall signal when a magnet is adjacent the sensor 245. For this reason, an initial step of the positioning algorithm includes a “learning” step that allow the controller to learn the actual field strength of the magnets 255a and 255b which may vary from the specified strength. After a new single-use probe 110 (
In general, a method of use relating to the learning algorithm comprises providing a handpiece with a motor drive, a controller, and a probe with a proximal hub configured for detachable coupling to the handpiece, wherein the motor drive is configured to couple to a rotating drive coupling in the hub and wherein the drive coupling carries first and second magnets with North and South poles positioned differently relative to said axis, and coupling the hub to the handpiece, activating the motor drive to thereby rotate the drive coupling and magnets at least 180°, using a handpiece sensor to sense the strength of each magnet, and using the sensed strength of the magnets for calibration in a positioning algorithm that is responsive to the sensor sensing the varying strength of the magnets in the rotating drive coupling to thereby increase accuracy in calculating the rotational position of the drive coupling 150.
Another aspect of the invention relates to an enhanced method of use using a probe working end with an electrode, such as the working end 112 of
While the above description of the slight oscillation algorithm is provided with reference to electrode 155 on a rotating cutting member 145 of
Although particular embodiments of the present invention have been described above in detail, it will be understood that this description is merely for purposes of illustration and the above description of the invention is not exhaustive. Specific features of the invention are shown in some drawings and not in others, and this is for convenience only and any feature may be combined with another in accordance with the invention. A number of variations and alternatives will be apparent to one having ordinary skills in the art. Such alternatives and variations are intended to be included within the scope of the claims. Particular features that are presented in dependent claims can be combined and fall within the scope of the invention. The invention also encompasses embodiments as if dependent claims were alternatively written in a multiple dependent claim format with reference to other independent claims.
Other variations are within the spirit of the present invention. Thus, while the invention is susceptible to various modifications and alternative constructions, certain illustrated embodiments thereof are shown in the drawings and have been described above in detail. It should be understood, however, that there is no intention to limit the invention to the specific form or forms disclosed, but on the contrary, the intention is to cover all modifications, alternative constructions, and equivalents falling within the spirit and scope of the invention, as defined in the appended claims.
The use of the terms “a” and “an” and “the” and similar referents in the context of describing the invention (especially in the context of the following claims) are to be construed to cover both the singular and the plural, unless otherwise indicated herein or clearly contradicted by context. The terms “comprising,” “having,” “including,” and “containing” are to be construed as open-ended terms (i.e., meaning “including, but not limited to,”) unless otherwise noted. The term “connected” is to be construed as partly or wholly contained within, attached to, or joined together, even if there is something intervening. Recitation of ranges of values herein are merely intended to serve as a shorthand method of referring individually to each separate value falling within the range, unless otherwise indicated herein, and each separate value is incorporated into the specification as if it were individually recited herein. All methods described herein can be performed in any suitable order unless otherwise indicated herein or otherwise clearly contradicted by context. The use of any and all examples, or exemplary language (e.g., “such as”) provided herein, is intended merely to better illuminate embodiments of the invention and does not pose a limitation on the scope of the invention unless otherwise claimed. No language in the specification should be construed as indicating any non-claimed element as essential to the practice of the invention.
Preferred embodiments of this invention are described herein, including the best mode known to the inventors for carrying out the invention. Variations of those preferred embodiments may become apparent to those of ordinary skill in the art upon reading the foregoing description. The inventors expect skilled artisans to employ such variations as appropriate, and the inventors intend for the invention to be practiced otherwise than as specifically described herein. Accordingly, this invention includes all modifications and equivalents of the subject matter recited in the claims appended hereto as permitted by applicable law. Moreover, any combination of the above-described elements in all possible variations thereof is encompassed by the invention unless otherwise indicated herein or otherwise clearly contradicted by context.
All references, including publications, patent applications, and patents, cited herein are hereby incorporated by reference to the same extent as if each reference were individually and specifically indicated to be incorporated by reference and were set forth in its entirety herein.
This application claims the benefit of provisional application No. 62/326,544, filed on Apr. 22, 2016, the full disclosure of which is incorporated herein by reference.
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