Surgical instrument and method

• US 20060264927A1
• Filed: 02/14/2006
• Published: 11/23/2006
• Est. Priority Date: 03/04/2005
• Status: Active Grant

• Current Assignee: Gyrus ENT LLC (Olympus Corporation)
• Original Assignee: Gyrus ENT LLC (Olympus Corporation)
• Inventors: Ryan, Phillip A.
• Granted Patent: US 7,699,846 B2
• Time in Patent Office: Days
• US Class Current: 606/45
• CPC Class Codes: A61B 17/32 Surgical cutting instruments A61B18/042 takes precedence; suture cutters A61B17/0467; instruments for ligaturing or cutting A61B17/128; instruments for rupturing the amniotic membrane A61B17/4208; specially adapted knives for eye surgery A61F9/0133
• CPC Class Codes: A61B 17/32002 with continuously rotating, oscillating or reciprocating cutting instruments
• CPC Class Codes: A61B 18/148 having a short, rigid shaft for accessing the inner body transcutaneously, e.g. for neurosurgery or arthroscopy
• CPC Class Codes: A61B 2017/320032 Details of the rotating or oscillating shaft, e.g. using a flexible shaft
• CPC Class Codes: A61B 2018/00208 actively driven, e.g. by a motor
• CPC Class Codes: A61B 2018/1861 with an instrument inserted into a body lumen or cavity, e.g. a catheter

Abstract

A surgical instrument comprises a hollow tube (18) having a cutting window (16) at the distal end portion. An inner tube (15) is disposed within the tube (18) and is mounted for rotation about its longitudinal axis. A cutting tool (17) is located at the distal end of the tube (15), and is positioned adjacent to the cutting window (16). An outer tube (14) is provided over the tube (18). A motor (5) is provided for rotating the inner tube (15), and saline is fed to the cutting window (16) via a passageway (25) between the tubes (15) and (18). The inner tube (15) has a central lumen (24) through which tissue cut by the cutting tool (17) is removed under the action of a source of suction (12). The outer surface of the tube (18) is covered with an electrically insulating layer (22) and coagulating RF signals are supplied between the tube (18) and the outer tube (14) so as to coagulate tissue at the cutting window (16). A weakened portion (43) of the outer tube (14) ensures that when the outer tube (14) and hollow tube (18) are bent to form a curved portion (42), the relative positioning of the respective distal ends of the tubes (14) and (18) is maintained.

Claims

1. A blade assembly for a surgical instrument including;

a) an intermediate hollow tube having a central passageway and a cutting window at a distal end thereof, the tube being substantially straight but having a portion designated for bending, the bend portion being located over a finite distance between its proximal end and the cutting window;

b) an inner hollow tube rotatably mounted in the central passageway of the intermediate tube and providing a central suction lumen, the inner tube having a flexible portion corresponding to the bend portion of the intermediate tube;

c) a cutting tool disposed at the distal end of the inner tube such that the cutting tool is accessible through the cutting window of the intermediate tube, the cutting tool including a cut-out defining a tissue-cutting edge;

d) an outer tube disposed over the intermediate hollow tube and having an opening at its distal end so as to allow access to the cutting window of the intermediate tube, the outer tube having a weakened portion located between the proximal end of the tube and the distal opening therein, the weakened portion corresponding to the bend portion of the intermediate tube and being such that the inter-relationship between the opening in the outer tube and the cutting window in the intermediate tube is substantially the same whether in a first condition in which the outer tube and intermediate tube are straight, or in a second condition in which the outer tube and intermediate tube are bent at the bend portion and weakened portion respectively.

2. A blade assembly according to claim 1 wherein the weakened portion comprises a portion of the outer tubular member with one or more sections removed therefrom.

3. A blade assembly according to claim 2 wherein the weakened portion comprises a portion of the wall of the tube in the form of a strip, with the remainder of the tubular member being removed.

4. A blade assembly according to claim 3 wherein the strip is a longitudinally extending strip.

5. A blade assembly according to claim 4 wherein the strip extends in the form of a parallel strip with straight sides.

6. A blade assembly according to claim 4 wherein the strip extends in the form of a zig-zag element.

7. A blade assembly according to claim 3 wherein the strip extends helically around the circumference of the tubular element.

8. A blade assembly according to claim 3 wherein the strip constitutes less than 50% of the circumference of the tubular member.

9. A blade assembly according to claim 8 wherein the strip constitutes less than 20% of the circumference of the tubular member.

10. A blade assembly according to claim 9 wherein the strip constitutes less than 10% of the circumference of the tubular member.

11. A blade assembly according to claim 2 wherein the weakened portion comprises a portion of the tubular member in the form of a mesh.

12. A blade assembly according to claim 2 wherein the weakened portion comprises a plurality of ring elements connected one to another by joining members.

13. A blade assembly according to claim 1 wherein the intermediate and outer tubes are both electrically conducting, and there is an electrically insulating layer disposed between the intermediate and outer tubes.

14. A blade assembly according to claim 1 wherein the electrically insulating layer is provided by means of an insulating material deposited on to the outer surface of the intermediate tube.

15. A blade assembly according to claim 1 wherein there are first and second contacts respectively associated with the outer and intermediate tubes for connecting the tubes to respective poles of an electrosurgical generator.

16. A curved blade assembly for a surgical instrument including;

a) an intermediate hollow tube having a central passageway and a cutting window at a distal end thereof, the tube having a bend portion, the bend portion being located over a finite distance between its proximal end and the cutting window;

b) an inner hollow tube rotatably mounted in the central passageway of the intermediate tube and providing a central suction lumen, the inner tube having a flexible portion corresponding to the bend portion of the intermediate tube;

c) a cutting tool disposed at the distal end of the inner tube such that the cutting tool is accessible through the cutting window of the intermediate tube, the cutting tool including a cut-out defining a tissue-cutting edge;

d) an outer tube disposed over the intermediate hollow tube and having an opening at its distal end so as to allow access to the cutting window of the intermediate tube, the outer tube having a weakened portion located between the proximal end of the tube and the distal opening therein, the weakened portion corresponding to the bend portion of the intermediate tube and being such that the inter-relationship between the opening in the outer tube and the cutting window in the intermediate tube is substantially the same in its bent condition as it was before the bend was formed.

17. A surgical system including

ii) a blade assembly comprising;

a) an intermediate hollow tube having a central passageway and a cutting window at a distal end thereof, the tube having a bend portion, the bend portion being located over a finite distance between its proximal end and the cutting window;

b) an inner hollow tube rotatably mounted in the central passageway of the intermediate tube and providing a central suction lumen, the inner tube having a flexible portion corresponding to the bend portion of the intermediate tube;

c) a cutting tool disposed at the distal end of the inner tube such that the cutting tool is accessible through the cutting window of the intermediate tube, the cutting tool including a cut-out defining a tissue-cutting edge;

d) an outer tube disposed over the intermediate hollow tube and having an opening at its distal end so as to allow access to the cutting window of the intermediate tube, the outer tube having a weakened portion located between the proximal end of the tube and the distal opening therein, the weakened portion corresponding to the bend portion of the intermediate;

e) an electrically insulating layer disposed between the intermediate and outer tubes, the intermediate and outer tubes both being electrically conducting; and

f) first and second contacts associated with the outer and intermediate tubes respectively for connecting the tubes to respective poles of an electrosurgical generator;

ii) a motor adapted to rotate the inner hollow tube within the intermediate tube;

iii) a source of suction connected to the central suction lumen of the inner hollow tube; and

iv) an electrosurgical generator connected to the first and second contacts so as to selectively supply RF energy between the intermediate and outer tubes;

the arrangement being such that the rotation of the cutting tool is capable of causing the cutting of tissue in the region of the cutting window, while the RF energy supplied to the intermediate and outer tubes coagulates tissue in the region of the cutting window.

18. A surgical system according to claim 17 wherein there is additionally provided a source of irrigating fluid, adapted to irrigate the blade assembly.

19. A surgical system according to claim 18 wherein the irrigating fluid is transmitted to the distal end of the blade assembly between the inner tube and the intermediate tube.

20. A surgical system according to 18 wherein the irrigating fluid is an electrically conducting fluid.

21. A method of manufacturing a curved blade assembly for a surgical instrument comprising the steps of

i) taking a first straight hollow tube having a central passageway and a cutting window at a distal end thereof;

ii) applying a second outer tube over the first tube, the outer tube having an opening at its distal end so as to allow access to the cutting window of the first tube, the outer tube having a weakened portion located between the proximal end of the tube and the distal opening therein;

iii) locating the outer tube with respect to the first tube such that the opening in the outer tube is in a predetermined fixed spatial relationship with respect to the cutting window in the first tube; and

iv) bending the first and second tubes in the region of the weakened portion, the weakened section being such that the said predetermined fixed spatial relationship between the opening in the outer tube and the cutting window in the first tube is maintained notwithstanding the bending of the two tubes.