Reciprocating rotary arthroscopic surgical instrument

• US 20040092980A1
• Filed: 12/13/2002
• Published: 05/13/2004
• Est. Priority Date: 10/26/2001
• Status: Active Grant

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Smith & Nephew Incorporated (Smith & Nephew PLC)
• Inventors: Jezierski, Rafal, Cesarini, Peter M., Drucker, Karen, Cassidy, Roger R. Jr.
• Granted Patent: US 7,510,563 B2
• Time in Patent Office: Days
• US Class Current: 606/159
• CPC Class Codes: A61B 17/32002 with continuously rotating, oscillating or reciprocating cutting instruments
• CPC Class Codes: A61B 2017/00477 Coupling A61B2017/0046 takes precedence

Abstract

A surgical instrument includes a cutting member with an implement for cutting tissue, and a drive coupled to the cutting member. The drive may include a drive member having a helical groove and being attached to the cutting member. Furthermore, the drive may include an inner drive hub coupled to the drive member such that the drive member rotates with the inner drive hub while being free to translate relative to the inner drive hub. The drive simultaneously rotates and translates the cutting member in response to a force applied to the drive.

Claims

1. A surgical instrument, comprising:

a cutting member including an implement for cutting tissue; and

a drive coupled to the cutting member to simultaneously rotate and translate the cutting member in response to a force applied to the drive.

2. The instrument of claim 1, wherein the drive is configured such that the translation of the cutting member comprises reciprocation.

3. The instrument of claim 1, wherein the drive includes a drive member attached to the cutting member, the drive member including a helical groove.

4. The instrument of claim 3, wherein the drive includes a translation piece disposed in the groove such that rotary driving of the drive member results in simultaneous reciprocation of the drive member relative to the translation piece.

5. The instrument of claim 3, wherein the drive further comprises an inner drive hub coupled to the drive member and defining a slot, and the drive member includes a key received in the slot and rotary coupling the drive member to the inner drive hub such that the drive member rotates with the inner drive hub while being free to translate relative to the inner drive hub.

6. The instrument of claim 3, wherein the helical groove comprises a left-hand threaded helical channel.

7. The instrument of claim 3, wherein the helical groove comprises a right-hand threaded helical channel.

8. The instrument of claim 3, wherein the helical groove comprises two helical channels, a first helical channel being a left-hand threaded helical channel and a second helical channel being a right-hand threaded helical channel.

9. The instrument of claim 8, wherein the first helical channel and the second helical channel form a continuous path.

10. The instrument of claim 3, wherein the cutting member is attached to the drive member to move rotatably and axially with the member.

11. The instrument of claim 1, wherein the implement comprises a chamfered cutting edge at a distal end of the cutting member.

12. The instrument of claim 11, wherein the chamfered edge of the cutting member comprises a straight cutting edge.

13. The instrument of claim 11, wherein the chamfered edge comprises an angled cutting edge.

14. The instrument of claim 1 further comprising an outer tubular member that receives the cutting member.

15. The instrument of claim 14, wherein the outer member includes a cutting window disposed proximate to a tip of the outer member.

16. The instrument of claim 15, wherein the cutting window comprises an opening in the outer member exposing the cutting member to tissue.

17. The instrument of claim 16, wherein the cutting window comprises a U-shaped proximal end and a saddle-shaped distal end.

18. The instrument of claim 16, wherein the saddle-shaped distal end of the cutting window includes a hook.

19. The instrument of claim 3, wherein the translation piece includes a follower received within the groove and a sealing cap over the follower, with the follower being free to swivel relative to the sealing cap.

20. The instrument of claim 19, wherein the follower has an arched bridge shape.

21. The instrument of claim 3, wherein the translation piece is coupled to the drive member such that the translation piece is disposed in the helical groove and swivels to follow the helical groove as the drive member rotates.

22. The surgical instrument of claim 3, wherein the drive member comprises:

an opening formed in an outer wall of the drive member, and

a lumen for attaching the cutting member.

23. The surgical instrument of claim 22, wherein the drive member opening is oriented at an angle relative to the lumen.

24. The surgical instrument of claim 23, wherein the drive member opening is angled at approximately 45 degrees relative to the lumen of the drive member.

25. The surgical instrument of claim 22, further comprising an opening in the inner drive hub such that at a predetermined point during simultaneous rotation and translation of the cutting member, the drive member opening and the inner drive hub opening align to permit a fluid pulse through the openings.

26. The surgical instrument of claim 25, wherein the inner drive hub includes an aspiration opening and the inner drive hub opening is formed integral with a distal end of the aspiration opening.

27. The surgical instrument of claim 22, wherein the drive member comprises a flattened portion.

28. The surgical instrument of claim 27, wherein the flattened portion is formed adjacent to the drive member opening.

29. The surgical instrument of claim 28, wherein the flattened portion and the inner drive hub opening define a second opening extending between the drive member opening and the inner drive hub opening.

30. The instrument of claim 1, wherein the drive includes:

a drive member attached to the cutting member and having a helical groove, and

an inner drive hub coupled to the drive member and having an opening,

wherein the drive member is positioned within the inner drive hub and includes;

a hollow cylindrical wall extending along a longitudinal axis and defining a lumen that extends along the longitudinal axis, and

an opening formed in the cylindrical wall and integral with the lumen.

31. The instrument of claim 1, wherein the drive includes:

a drive member that is attached to the cutting member and includes an opening, and

an inner drive hub that rotates with the drive member and includes an opening;

wherein a fluid outflow path including an interior of the cutting member, the drive member opening, and the inner drive hub opening is formed when the drive member opening aligns with the inner drive hub opening.

32. The instrument of claim 1, wherein:

the cutting member includes a cutting window at a proximal end and a lumen extending from and communicating with the cutting window, and

the drive includes an aspiration opening.

33. The instrument of claim 32, further comprising a restriction mechanism that restricts fluid flow from the lumen to the aspiration opening when the cutting window is open.

34. The instrument of claim 1, wherein the cutting member includes an active electrode and a return electrode located at a non-insulated distal end portion of the cutting member.

35. The instrument of claim 34, further comprising an electrical connector that connects to the return and active electrodes of the cutting member and to a generator to provide high frequency energy to the cutting member.

36. A method of cutting tissue, comprising:

positioning an outer member such that tissue is located within the outer member;

engaging the tissue with a cutting member received within the outer member; and

simultaneously rotating and translating the cutting member to cut the tissue.

37. The method of claim 36, wherein translating comprises reciprocating.

38. The method of claim 36, wherein cutting tissue includes slicing the tissue.

39. The method of claim 36, wherein positioning the outer member comprises orienting the outer member tangentially to the tissue.

40. The method of claim 36, wherein engaging the tissue includes providing high frequency energy to the engaged tissue.

41. A method of cutting tissue, comprising:

providing a surgical instrument having an outer member and a cutting member received within the outer member for movement relative to the outer member, and

applying a tangential cutting force to the tissue with the cutting member to mechanically cut the tissue.

42. A method of cutting tissue, comprising

applying an axial cutting motion to tissue with a member, and

mechanically driving the member to undergo simultaneous rotation and translation.

43. The method of claim 42, wherein the translation comprises reciprocation.

44. A method of cutting tissue, comprising:

pulsing fluid through a cutting window and a lumen of a cutting member to remove cut tissue;

wherein pulsing includes restricting fluid flow from the lumen of the cutting member to an aspiration opening proximal the lumen when the cutting window is open.

45. The method of claim 44, wherein:

pulsing includes;

coupling a lumen opening communicating the cutting member lumen with the aspiration opening to permit fluid to flow from the cutting member lumen to the aspiration opening, and

decoupling the lumen opening from the aspiration opening to restrict fluid flow;

decoupling includes permitting fluid to flow from the cutting member lumen to the aspiration opening.

46. A method of cutting tissue, comprising:

coupling first and second openings in a surgical instrument during a cutting cycle to pulse fluid through a lumen of a drive member to remove fluid from the surgical instrument; and

decoupling the first and second opening in a surgical instrument during the cutting cycle to prevent fluid from flowing from the surgical instrument.