Laser treatment device

Abstract

A surgical instrument includes a handle located in a proximal region of the surgical instrument. A shaft assembly extends distally from the handle and has a proximal portion and a distal portion, the distal portion being sized and shaped to be inserted into a subject during surgery. The shaft assembly includes a grinding head, an optical fiber, and at least one motor configured to rotate the grinding head. The grinding head is located at the distal end of the shaft assembly and is shaped to define an opaque external diamond-coated cutting surface. The optical fiber is operatively connected to the distal portion of the shaft assembly and is configured to emit laser energy from within the surgical instrument to heat the opaque external diamond-coated cutting surface. Other embodiments are also described.

Description

Cross-reference to related applications

[0001] This application claims priority to U.S. Provisional Patent Application No. 63 / 558,803, filed February 28, 2024, which has been assigned to the assignee of this application and is incorporated herein by reference in its entirety. Technical Field

[0002] This invention relates to a surgical tool, and more particularly to a minimally invasive surgical tool. Background Technology

[0003] US Patent 5,342,358, invented by Daikuzono et al., describes an apparatus for cutting, coagulating, and evaporating biological tissues such as human tissue using a laser. It describes a device for performing surgical operations on biological tissue using a laser while a blade is in contact with the tissue. The device includes a grip portion held by an operator, a blade integrally formed with the grip portion and made of a material that generates heat when exposed to a laser and does not allow the laser to pass through itself, and an optical fiber that receives the laser and emits it from its tip. The blade is positioned such that a portion of the blade is within the irradiation area of ​​the laser from the optical fiber, and the optical fiber is movable toward and away from the blade while being held by the grip portion.

[0004] US Patent 11,369,398, inventord by Perets et al., describes a tool having a handle and an elongated shaft extending distally from the handle. The distal portion of the shaft is inserted into a subject during surgery. An optical fiber transmits laser energy to a tip at the distal portion of the shaft. The tip includes a mechanical cutting mechanism comprising a moving part that absorbs the laser energy, thermally conducts the absorbed energy to tissue disposed between the moving part and another part, and moves relative to the other part to cut the tissue disposed between the parts using a mechanical force lower than that required to cut the tissue in the absence of the laser energy. Other embodiments are also described.

[0005] US Patent 4,994,060, invented by Rink et al., describes a laser-heated cauterization cap assembly comprising a catheter assembly adapted for insertion into a cavity such as an arterial opening. The catheter assembly includes at least one optical fiber connected to a laser source adapted to generate short output pulses. The cauterization cap, located at the distal end of the catheter, includes a transparent base member configured to receive laser energy from the optical fibers(s). The base member is preferably formed of a crystalline solid having a smooth, curved outer surface and a central guidewire aperture extending therethrough. One end of the aperture has a tapered countersunk hole, and the opposite end of the base member is an input surface configured to receive laser energy from the optical fibers. A nose component includes a central guidewire aperture coaxial with the aperture of the base member, and the nose component includes a tapered proximal end sized to fit within the countersunk hole of the base. The surfaces of the countersunk hole and the aperture of the base, as well as a major portion of the curved outer surface, are coated with a highly reflective material, and another portion of the outer surface is coated with a material that absorbs the laser energy and is thereby heated. The input surface of the substrate receives laser irradiation from the optical fiber and conducts it to the countersunk surface, which internally reflects the light to the absorbent coating portion. Therefore, a portion of the cap structure is heated, while the nose component and the remainder of the substrate surface remain relatively cool. Summary of the Invention

[0006] According to some applications of the present invention, a minimally invasive surgical tool is provided, comprising a tissue treatment tip that absorbs laser energy (e.g., from an optical fiber), converting the laser energy photothermally into absorbed thermal energy, and treating the tissue by conducting the absorbed energy from the surface of the tissue treatment tip to the tissue of the subject while the surface of the tissue treatment tip is at an elevated temperature due to the absorbed energy.

[0007] In some applications of the invention, the tissue treatment tip includes a burr disposed at the distal end of a shaft assembly. The burr is shaped to define a cutting wall, which is shaped to define an opaque outer cutting surface and an inner surface. A distal portion of the shaft assembly is shaped to define a distally facing surface. The inner surface and the distally facing surface together at least partially define a cavity. An optical fiber is operatively connected to the distal portion of the shaft assembly and is configured to emit laser energy into the cavity such that the inner surface of the cutting wall conducts heat through the energy to the opaque outer cutting surface.

[0008] In some applications of this invention, the opaque outer cut surface is coated with diamond.

[0009] The following is a non-limiting list of the target tissues of the subjects and various surgical types that can be performed using the surgical tools described herein: • The meniscus of the subject's knee joint, for example, in the case of meniscectomy or partial meniscectomy; • Cartilage debridement; Microfracture surgery; • Bone drilling; • Hip tissues, for example, in hamstring repair or gluteus medius repair; • Spinal decompression surgery; • Intervertebral disc replacement surgery; • Shoulder tissues, for example, in shoulder joint synovectomy or frozen shoulder surgery; • Arthroscopic capsular release and rotator cuff repair; • Tendons or ligaments, for example, used in joint adhesion release surgery; • Biceps brachii tissue, for example, in biceps brachii long head tendon transection; or • Hand tissues, such as in carpal tunnel surgery.

[0010] Other examples of surgical procedures that may use the surgical tools described herein include hemorrhoidectomy, fecal impaction removal, adenoidectomy, hysteroscopic surgery (e.g., pedunculated submucosal myoma resection), laparoscopic surgery (e.g., subserosal myoma resection), abdominal surgery (e.g., performed laparoscopically), cyst incision, and endoscopic gastric polypectomy.

[0011] In some applications, the tissue treatment tip uses absorbed laser energy and mechanical force to treat the tissue. The tissue treatment tip treats the tissue by transferring the absorbed energy heat to the tissue, while a motor causes the tissue treatment tip to move.

[0012] In some such applications, the absorbed laser energy raises the temperature of the tissue treatment tip, thereby reducing the amount of mechanical force required to treat the tissue.

[0013] Therefore, according to the application of the present invention, a surgical tool is provided for performing a surgical procedure on a subject, the surgical tool comprising: A handle is located in a proximal region of the surgical instrument; A shaft assembly extending distally from the handle, the shaft assembly having a proximal portion and a distal portion, the distal portion of the shaft assembly being sized and shaped to be insertable into the subject during the surgical procedure, the shaft assembly comprising: A grinding head, disposed at a distal end of the shaft assembly, and shaped to define an opaque, externally diamond-coated cutting surface; and An optical fiber, operably connected to the distal portion of the shaft assembly, is configured to emit laser energy that heats the opaque outer diamond-coated cutting surface from within the surgical instrument; and At least one motor is configured to rotate the grinding head.

[0014] For some applications, the optical fiber passes through at least a portion of the shaft assembly.

[0015] In some applications, the surgical tool shields the optical fiber to prevent it from emitting light outside the tool.

[0016] In some applications, the at least one motor is configured to rotate the grinding head relative to the optical fiber.

[0017] For some applications: The grinding head is shaped to define a cutting wall, which is shaped to define the opaque outer diamond-coated cutting surface and an inner surface. The distal portion of the shaft assembly is shaped to define a surface facing the distal side. The internal surface and the distally facing surface together at least partially define a cavity; and The optical fiber is configured to emit the laser energy into the cavity, such that the inner surface of the cut wall conducts the energy thermally to the opaque outer diamond-coated cut surface.

[0018] For some applications, at least a portion of the internal surface is curved.

[0019] For some applications, the surface facing the far side has higher reflectivity than the inner surface.

[0020] For some applications, the optical fiber is configured to directly emit the laser energy to at least 5% of the surface area of ​​the internal surface, for example, at least 20% of the surface area, or at least 30% of the surface area.

[0021] For some applications, the average thickness of the cut wall is 0.1 to 1.3 mm, for example 0.1 to 0.25 mm or 1 to 1.3 mm.

[0022] For some applications, one distal end of the optical fiber is positioned within the cavity.

[0023] For some applications, the distal end of the optical fiber is flush with the distal surface.

[0024] Furthermore, according to one application of the present invention, a surgical tool is provided for performing a surgical procedure on a subject, the surgical tool comprising: A handle is located in a proximal region of the surgical instrument; A shaft assembly extending distally from the handle, the shaft assembly having a proximal portion and a distal portion, the distal portion of the shaft assembly being (a) sized and shaped to be insertable into the subject during the surgical procedure; and (b) shaped to define a distally oriented surface, the shaft assembly comprising: A grinding head, disposed at a distal end of the shaft assembly, is shaped to define a cutting wall, the cutting wall being shaped to define (i) an opaque outer cutting surface; and (ii) an inner surface, wherein the inner surface and the distally facing surface together at least partially define a cavity; and An optical fiber, operably connected to the distal portion of the shaft assembly, is configured to emit laser energy into the cavity such that the inner surface of the cut wall thermally conducts the energy to the opaque outer cut surface; and At least one motor is configured to rotate the grinding head.

[0025] For some applications, the optical fiber passes through at least a portion of the shaft assembly.

[0026] In some applications, the surgical tool shields the optical fiber to prevent it from emitting light outside the tool.

[0027] For some applications, at least a portion of the internal surface is curved.

[0028] For some applications, the average thickness of the cut wall is 0.1–1.3 mm.

[0029] For some applications, the distal end of the optical fiber is positioned within the cavity.

[0030] For some applications, the distal end of the optical fiber is flush with the distal surface.

[0031] In some applications, the at least one motor is configured to rotate the grinding head relative to the optical fiber.

[0032] For some applications, the external cut surface is coated with diamond.

[0033] For some applications, the surface facing the far side is reflective.

[0034] For some applications, the optical fiber is configured to directly emit the laser energy to at least 5% of the surface area of ​​the internal surface, such as at least 20% or at least 30%.

[0035] Furthermore, according to one application of the present invention, a surgical tool is provided for performing a surgical procedure on a subject, the surgical tool comprising: A handle is located in a proximal region of the surgical instrument; A shaft assembly extending distally from the handle, the shaft assembly having a proximal portion and a distal portion, the distal portion of the shaft assembly being (a) sized and shaped to be insertable into the subject during the surgical procedure; and (b) shaped to define a lateral window, the shaft assembly comprising: A grinding head is disposed at a distal end of the shaft assembly and is shaped to define an external cutting surface; At least one planing blade is disposed within the distal portion of the shaft assembly; and An optical fiber, operably connected to the distal portion of the shaft assembly, and configured to emit laser energy to the grinding head; and At least one motor is configured as follows: Rotate the grinding head about the central longitudinal axis of the shaft assembly; and The at least one planer blade is rotated about the central longitudinal axis of the shaft assembly such that when the at least one planer blade is axially aligned with and exposed through the side window, the at least one planer blade cuts tissue along the side of the distal portion of the shaft assembly.

[0036] For some applications, the optical fiber passes through at least a portion of the shaft assembly.

[0037] In some applications, the surgical tool shields the optical fiber to prevent it from emitting light outside the tool.

[0038] For some applications, the surgical tool shields the optical fiber to prevent it from emitting light that heats the shaving blade.

[0039] In some applications, the at least one planer blade is shaped into multiple teeth.

[0040] In some applications, the at least one motor is configured to rotate the grinding head relative to the optical fiber.

[0041] For some applications, the outer cut surface is opaque.

[0042] For some applications, the optical fiber is configured to emit the laser energy to heat the external cut surface.

[0043] For some applications, the external cut surface is coated with diamond.

[0044] For some applications, the at least one motor is configured to rotate the grinding head and the at least one planing blade about the central longitudinal axis of the shaft assembly, respectively.

[0045] In some applications, the at least one motor is configured to rotate the at least one planer blade in a reciprocating rotary motion.

[0046] In some applications, the at least one motor is configured to rotate the grinding head in a rotational direction.

[0047] For some applications, the shaft assembly further includes (a) an elongated shaft and (b) a planer sleeve defining a lateral opening having a circumference defining the at least one planer blade; and At least one longitudinal portion of the planer sleeve is disposed within the slender shaft.

[0048] For some applications, a distal portion of the elongated shaft is shaped to define the lateral window.

[0049] In some applications, the planer sleeve is rotated and fixed relative to the grinding head.

[0050] For some applications, the surgical tool further includes an inner fiber optic sleeve, which is rotatably fixed relative to the grinding head and disposed within at least a longitudinal portion of the planer sleeve, thereby defining a space radially between an outer surface of the inner fiber optic sleeve and an inner surface of the planer sleeve. The optical fiber passes through the inner optical fiber sleeve.

[0051] For some applications, a distal portion of the elongated shaft is shaped to define the lateral window.

[0052] For some applications, the shaving blade sleeve and the elongated shaft can slide axially relative to each other, such that the surgical tool presents at least: In a planer-operated state, (a) the grinding head is retracted proximally into the elongated shaft and located proximal to a distal opening of the elongated shaft, and (b) the lateral opening of the planer sleeve at least partially overlaps longitudinally with the lateral window of the elongated shaft; and A grinding head in an activated state, wherein (a) the grinding head is exposed distally from the distal opening of the elongated shaft; and (b) the lateral opening of the planer sleeve does not at least partially overlap longitudinally with the lateral window of the elongated shaft.

[0053] For some applications, the shaft assembly further includes (a) an inner fiber optic sleeve through which the optical fiber passes; and (b) a grinding head sleeve that is rotatably fixed relative to the grinding head. At least one longitudinal portion of the grinding head sleeve is disposed within the slender shaft; At least one longitudinal portion of the planer sleeve is disposed within the grinding head sleeve; and The at least one motor is configured to rotate the grinding head and the at least one planing blade about the central longitudinal axis of the shaft assembly, respectively.

[0054] For some applications, the inner fiber optic sleeve is rotated and fixed relative to the planer sleeve.

[0055] For some applications: The grinding head is shaped to define a cutting wall, which is shaped to define the outer cutting surface and an inner surface; The distal portion of the shaft assembly is shaped to define a surface facing the distal side; Wherein, the inner surface and the distally facing surface together at least partially define a cavity; and The optical fiber is configured to emit laser energy into the cavity, such that the inner surface of the cutting wall conducts the energy heat to the outer cutting surface.

[0056] For some applications, one distal end of the optical fiber is positioned within the cavity.

[0057] For some applications, one distal end of the optical fiber is flush with the distal-facing surface.

[0058] For some applications, the surgical tool is configured such that the distally facing surface is rotatable relative to the cutting wall.

[0059] The invention will be more fully understood in conjunction with the accompanying drawings and the following detailed description of embodiments thereof. Attached Figure Description

[0060] Figure 1 This is a schematic diagram of a surgical tool according to one application of the present invention; Figure 2A and Figure 2B These are respectively one application according to the present invention Figure 1A schematic diagram and a cross-sectional view of the tissue treatment tip of the surgical instrument shown; Figure 3A and Figure 3B These are, respectively, a structural schematic diagram and a cross-sectional schematic diagram of the tissue treatment tip of another surgical tool according to an application of the present invention; Figure 4 This is a schematic diagram of another surgical tool according to an application of the present invention; Figure 5A and Figure 5B These are respectively one application according to the present invention Figure 4 A schematic diagram and a cross-sectional view of the tissue treatment tip of the surgical instrument shown; Figure 6 This is a schematic diagram of another surgical tool according to one application of the present invention; Figure 7A and Figure 7B These are respectively one application according to the present invention Figure 6 The diagram shows the structure and cross-sectional view of the tissue treatment tip of the surgical tool in the shaving blade activation state; and Figure 8A and Figure 8B These are respectively one application according to the present invention Figure 6 The diagram shows a schematic diagram and a cross-sectional view of the tissue treatment tip of the surgical tool in the activated state of a grinding head. Detailed Implementation

[0061] refer to Figure 1 , Figure 1 This is a schematic diagram of a surgical tool 20 according to one application of the present invention. The surgical tool 20 includes a shaft assembly 28, which includes an elongated shaft 30 and a tissue treatment tip 40 disposed on a distal portion 60 of the shaft assembly 28.

[0062] Further reference Figure 2A and Figure 2B , Figure 2A and Figure 2B These are schematic diagrams and cross-sectional views of the tissue treatment tip 40 of a surgical tool 20 according to an application of the present invention.

[0063] Typically, surgical instrument 20 is used with or includes a laser energy source (not shown). Figure 1 The surgical instrument 20 is shown to include a laser energy interface 24, which transmits laser energy from a laser energy source toward a tissue treatment tip 40 via an optical fiber 26. The distal portion 60 of the shaft assembly 28 is sized and shaped to be inserted into the subject during surgical procedures.

[0064] For some applications, the optical fiber 26 passes through at least a portion of the shaft assembly 28 (optionally including at least a portion of the elongated shaft 30), as shown; alternatively or additionally, the optical fiber 26 extends along at least a portion of the shaft assembly 28 (optionally including at least a portion of the elongated shaft 30) (structure not shown).

[0065] Surgical instrument 20 is typically used by healthcare professionals (e.g., surgeons) to treat a subject's tissue and therefore includes a handle 22 at a proximal portion 62 of shaft assembly 28 (and typically at a proximal portion of elongated shaft 30). The handle 22 is typically used to advance tissue treatment tip 40 to the tissue to be treated (i.e., target tissue). At least a portion of tissue treatment tip 40 contacts and is heated (not necessarily in this order), as described below. For some applications, contacting the target tissue with tissue treatment tip 40 results in at least a portion of the target tissue vaporizing. Alternatively or additionally, contacting the target tissue with tissue treatment tip 40 results in at least a portion of the target tissue coagulating. Target tissue may include, but is not limited to, tissue of joints (e.g., knee, shoulder, hip, or spine), such as bone, tendon, or cartilage tissue, such as a meniscus.

[0066] For some applications, the angular direction of the tissue treatment tip 40 relative to the angular direction of the handle 22 is fixed. For some such applications, the distance from the handle 22 to the tissue treatment tip 40 is fixed.

[0067] The tissue treatment tip 40 both (i) conducts heat to the target tissue and (ii) is operatively coupled to one or more motors 32, which transmit mechanical force to the tissue treatment tip, thereby inducing movement of the tissue treatment tip. In this way, the surgical tool 20 utilizes both thermal energy and mechanical force to treat the tissue.

[0068] The surgical instrument 20 (and its tissue treatment tip 40) includes a grinding head 70, which is disposed at the distal end 72 of the shaft assembly 28 and optionally also at the distal end of the elongated shaft 30, such as... Figure 1 and Figure 2A In the structure shown in -B, the grinding head 70 is shaped to define an opaque outer cutting surface 74. Typically, at least a portion of the opaque outer cutting surface 74 is at least partially oriented in a distal direction, and may also be at least partially oriented radially outward. Alternatively, the entire opaque outer cutting surface 74 is oriented radially outward, and not distally.

[0069] For some applications, the cut surface 74 is coated with diamond.

[0070] For example, the outer cutting surface 74 may include a hard material (e.g., a metal) with diamond particles attached.

[0071] Optical fiber 26 is operatively connected to the distal portion 60 of shaft assembly 28 and is configured to emit laser energy that heats the opaque external cutting surface 74 from inside the surgical tool 20.

[0072] Typically, the surgical instrument 20 shields the optical fiber 26 to prevent the optical fiber from emitting light to the outside of the surgical instrument.

[0073] The surgical tool 20 also includes one or more motors 32 configured to rotate the grinding head 70 as described above. For example, the one or more motors 32 may be at least partially (e.g., completely) located within the handle 22, and / or partially (e.g., completely) located outside the handle 22, for example, mounted on the outer surface of the handle 22 or on the shaft assembly 28.

[0074] refer to Figure 2B For some applications, the grinding head 70 is shaped to define a cutting wall 76, which is shaped to define an opaque outer cutting surface 74 and an inner surface 78. The distal portion 60 of the shaft assembly 28 is shaped to define a distally facing surface 80. The inner surface 78 and the distally facing surface 80 together at least partially define a cavity 82. (Optionally, the cavity 82 is also further partially defined by another inner surface of the surgical tool 20, for example by a longitudinal portion of the surgical tool extending longitudinally between the distally facing surface 80 and the proximal end of the cutting wall 76.) Fiber 26 is configured to emit laser energy into cavity 82, causing the inner surface 78 of the cutting wall 76 to absorb the laser energy and conduct the absorbed energy heat to the opaque outer cutting surface 74, thereby raising the temperature of the opaque outer cutting surface 74. When the opaque outer cutting surface 74 comes into contact with the target tissue, it further conducts the absorbed energy heat to the tissue. Typically, the laser energy absorbed by the cutting wall 76 undergoes photothermal conversion and is conducted heat to the opaque outer cutting surface 74. Therefore, it is generally desirable for the cutting wall 76 to conduct heat efficiently. Suitable materials for the cutting wall 76 include metals such as tungsten, molybdenum, stainless steel, cobalt, chromium, and / or their alloys.

[0075] For some applications, the combined use of absorbed heat and mechanical force reduces the total amount of mechanical force required for the surgical tool 20 to treat tissue (e.g., trim a portion of the tissue). For example, even without heat, the treatment tip 40 can trim the tissue to some extent by rotating the opaque outer cutting surface 74 while in contact with the tissue. However, without heat, the surgical tool 20 might require greater mechanical force to trim the tissue. Therefore, heat helps to trim the tissue using lower mechanical force.

[0076] The surface 80 facing the far side can be flat (as shown), curved (structure not shown), or partially flat and partially curved (structure not shown).

[0077] For some applications, at least a portion of the inner surface 78 of the cut wall 76 is curved, as shown in the figure.

[0078] For some applications, the distal surface 80 is rotationally fixed relative to the cut wall 76, such as... Figure 2B (and as described below) Figure 3B , Figure 7B and Figure 8B As shown in the figure.

[0079] For some applications, the distal surface 80 has higher reflectivity than the inner surface 78 of the cut wall 76. For example, the distal surface 80 may include a reflective coating, such as gold or silver. This reflectivity can help concentrate laser energy onto the inner surface 78 of the cut wall 76.

[0080] refer to Figure 2B For some applications, fiber 26 is configured to emit laser energy to irradiate and heat a large portion of the internal surface 78 in a substantially uniform manner. For example, fiber 26 can be configured to emit said laser energy by configuring the following parameters: • Configure the position of fiber 26 (e.g., distal end 84 of fiber 26) relative to the inner surface 78, such as the maximum distance and / or average distance; and / or • Configure the shape and / or optical characteristics of the distal end 84 of the optical fiber 26, such as the fiber aperture size and / or numerical aperture (NA); for example, fiber end lensing may be employed during the fabrication of the distal end 84 of the optical fiber 26.

[0081] For some applications, the optical fiber 26 is configured to directly irradiate laser energy onto at least 5% of the surface area of ​​the internal surface 78, not exceeding 80% of the surface area, and / or 5% to 80% of the surface area.

[0082] For some applications, the optical fiber 26 is configured to directly irradiate laser energy onto the surface area of ​​the internal surface 78 by at least 5%, and no more than 30%, and / or 5% to 30% of the surface area. For example, in these applications, the optical fiber 26 may comprise a standard cleaved optical fiber.

[0083] For some applications, the optical fiber 26 is configured to directly irradiate laser energy onto at least 20% (e.g., at least 30%), no more than 80% (e.g., no more than 70%), and / or 20% to 80%, for example, 30% to 70%, of the surface area of ​​the internal surface 78. For example, in these applications, the distal end 84 of the optical fiber 26 may be shaped as a spherical lens.

[0084] In some applications, the average thickness of the cut wall 76 is at least 0.1 mm, not more than 1.3 mm, and / or 0.1–1.3 mm. For example, the average thickness of the cut wall 76 can be: • At least 0.1 mm, not exceeding 0.25 mm, and / or 0.1–0.25 mm, for example in structures with relatively large cavities 82; or • At least 1 mm, no more than 1.3 mm and / or 1–1.3 mm, for example in structures with relatively small cavities 82.

[0085] One advantage of providing cavity 82 is that, especially when the cutting wall 76 is relatively thin, the resulting relatively small thermal mass of the grinding head 70 allows the laser energy to cause rapid temperature changes in the grinding head 70. This rapid temperature change increases the likelihood of tissue vaporization or coagulation while reducing the likelihood of tissue carbonization.

[0086] Continue to refer to Figure 2B In some applications, the distal end 84 of the optical fiber 26 is disposed inside the cavity 82, as shown. In other applications, the distal end 84 of the optical fiber 26 is flush with the distal surface 80 (structure not shown).

[0087] In some applications, one or more motors 32 are configured to rotate the grinding head 70 relative to the optical fiber 26, as shown. In these applications, the optical fiber 26 is typically stationary in rotation during use of the surgical instrument 20.

[0088] In some applications, the shaft assembly 28 also includes an inner fiber optic sleeve 34, which is rotatably fixed relative to the grinding head 70. The optical fiber 26 passes through the inner fiber optic sleeve 34.

[0089] Now refer to Figure 3A and Figure 3BThese are, respectively, a structural schematic diagram and a cross-sectional schematic diagram of the tissue treatment tip 140 of a surgical tool 120 according to an application of the present invention. Except as described below, the surgical tool 120 and the tissue treatment tip 140 are respectively similar to those described above. Figure 1 and Figure 2A -B describes the surgical tool 20 and tissue treatment tip 40, and the same component symbols represent the same parts.

[0090] Surgical instrument 120 includes a shaft assembly 128 comprising an elongated shaft 130 and a tissue treatment tip 140. The shaft assembly 128 extends distally from a handle 22. The shaft assembly 128 has a proximal portion 62 and a distal portion 160, the distal portion 160 being sized and shaped to allow insertion into a subject during surgical procedures. Surgical instrument 120 includes the above-described references. Figure 1 and Figure 2A -B describes the grinding head 70 and the optical fiber 26.

[0091] The distal portion 160 of the shaft assembly 128 is shaped to define a lateral window 166. For example, the distal portion of the elongated shaft 130 can be shaped to define the lateral window 166, such as... Figures 3A to 3B As shown. The shaft assembly 128 includes one or more planer blades 186 disposed within the distal portion 60 of the shaft assembly 128.

[0092] One or more motors 32 of the surgical instrument 120 are configured to: • The central longitudinal axis 188 of the shaft assembly 128 rotates the grinding head 70; and • One or more planer blades 186 are rotated about the central longitudinal axis 188 of the shaft assembly 128 such that, when the one or more planer blades 186 are axially aligned and exposed through the side window 166, the one or more planer blades 186 cut tissue adjacent to the distal portion 60 of the shaft assembly 128, such as… Figures 3A to 3B As shown.

[0093] Surgical tool 120 is advanced toward target tissue, allowing the target tissue to enter lateral window 166, and the movement of one or more shaving blades 186 trims the target tissue. In some applications, surgical tool 120 is configured to connect to an external suction source and to have the external suction source in fluid communication with lateral window 166, typically via the interior of shaft assembly 128. The applied suction draws the trimmed target tissue into shaft assembly 128. For this purpose, surgical tool 120 may include a suction port 168 (in... Figure 1 (Winning bid).

[0094] In some applications, one or more planer blades 186 are shaped into multiple teeth 190, such as Figure 3A -B is shown. Alternatively, one or more planer blades 186 may have different cutting shapes.

[0095] In some applications, one or more motors 32 are configured to simultaneously rotate the grinding head 70 and one or more planer blades 186 about the central longitudinal axis 188 of the shaft assembly 128.

[0096] Typically, one or more motors 32 are configured to rotate the grinding head 70 and one or more planer blades 186 in one direction of rotation. Alternatively, one or more motors 32 are configured to cause the grinding head 70 and one or more planer blades 186 to perform a reciprocating rotational motion.

[0097] In some applications, the shaft assembly 128 also includes a planer sleeve 192 that defines a lateral opening 194 having a circumference 196 defining one or more planer blades 186 (e.g., a plurality of teeth 190). At least one longitudinal portion of the planer sleeve 192 is disposed within the elongated shaft 130.

[0098] For some of these applications, the planer sleeve 192 is rotated and fixed relative to the grinding head 70, such as... Figure 3A -B is shown.

[0099] In some applications, the shaft assembly 128 further includes an inner fiber optic sleeve 34, which is rotatably fixed relative to the grinding head 70 and disposed within at least one longitudinal portion of the planer sleeve 192, thereby radially defining a space 206 between the outer surface 208 of the inner fiber optic sleeve 34 and the inner surface 210 of the planer sleeve 192. Figure 3B (Winning bid). Fiber 26 passes through the inner fiber optic sleeve 34.

[0100] Now refer to Figure 4 This is a schematic diagram of a surgical tool 320 according to an application of the present invention.

[0101] Further reference Figure 5A and Figure 5B These are schematic diagrams and cross-sectional views of the tissue treatment tip 340 of a surgical tool 320 according to an application of the present invention.

[0102] Except as described below, the surgical instrument 320 and the tissue treatment tip 340 are similar to those described above. Figure 3A -B describes the surgical instrument 120 and tissue treatment tip 140, and / or similar to those described above. Figure 1 and Figure 2A-B describes the surgical tool 20 and tissue treatment tip 40; the surgical tool 320 may implement one or both of the features of these other surgical tools with necessary modifications. The same component symbols represent the same parts.

[0103] Surgical instrument 320 includes a shaft assembly 328 comprising an elongated shaft 330 and a tissue treatment tip 340. The shaft assembly 328 extends distally from a handle 322. The shaft assembly 328 has a proximal portion 62 and a distal portion 360, the distal portion 360 being of a size and shape suitable for insertion into a subject during surgical procedures. The shaft assembly 328 includes the above-described references. Figure 1 and Figure 2A -B describes the grinding head 70 and optical fiber 26. The surgical tool 320 also includes one or more motors 332 configured to rotate the grinding head 70 and one or more planer blades 186 about the central longitudinal axis 388 of the shaft assembly 328.

[0104] In some applications, the shaft assembly 328 also includes a planer sleeve 392 that defines a lateral opening 194 having a circumference 196 that defines one or more planer blades 186. At least one longitudinal portion of the planer sleeve 392 is disposed within the elongated shaft 330.

[0105] In some applications, the shaft assembly 328 further includes an inner fiber optic sleeve 34 through which the optical fiber 26 passes; and a grinding head sleeve 346 rotatably fixed relative to the grinding head 70. At least one longitudinal portion of the grinding head sleeve 346 is disposed within the elongated shaft 330. At least one longitudinal portion of the planer sleeve 392 is disposed within the grinding head sleeve 346.

[0106] For some of these applications, one or more motors 332 are configured to rotate the grinding head 70 and one or more planer blades 186 about the central longitudinal axis 388 of the shaft assembly 328, respectively. This separate control of rotation allows healthcare workers to choose whether to operate the grinding head or the planer. Typically, the planer operates at a lower rotational speed than the grinding head so that tissue can be effectively drawn between the lateral window 166 and the planer sleeve 392.

[0107] The grinding head 70 is rotated by rotating the grinding head sleeve 346. Typically, during the rotation of the grinding head sleeve 346, the planer sleeve 392 rotates at the same speed and in the same direction as the grinding head sleeve 346 to suppress or prevent lateral planing during the rotation of the grinding head.

[0108] One or more planer blades 186 are rotated by rotating the planer sleeve 392.

[0109] For some of these applications, the surgical tool 320 includes exactly one motor 332 and also includes two gears 334 that, by selectively engaging with a single motor 332, are capable of rotating the grinding head 70 and one or more planer blades 186 respectively.

[0110] For some of these applications, the inner fiber optic sleeve 34 is rotated and fixed relative to the planer sleeve 392.

[0111] In this configuration, one or more motors 332 are typically configured to rotate the grinding head 70 relative to the optical fiber 26.

[0112] In some applications, one or more motors 332 are configured to cause one or more planer blades 186 to reciprocate.

[0113] In some applications, one or more motors 332 are configured to rotate the grinding head 70 in one rotational direction. Alternatively, one or more motors 332 are configured to rotate the grinding head 70 by reciprocating rotational motion.

[0114] Reference Figure 5B In some applications, the distal portion 360 of the shaft assembly 328 is shaped to define a distally facing surface 380. For example, a distal side of the planer sleeve 392 may be shaped to define a distally facing surface 380; alternatively, another distal portion of the shaft assembly is shaped to define a distally facing surface. The inner surface 78 of the cutting wall 76 of the grinding head 70 and the distally facing surface 380 together at least partially define the cavity 382. (Optionally, the cavity 382 is also partially defined by another inner surface of the surgical tool 320, for example, a longitudinal portion of the surgical tool located in the longitudinal direction between the distally facing surface 380 and the proximal end of the cutting wall 76.) In some applications, the surgical tool 320 is configured such that the distally facing surface 380 can rotate relative to the cutting wall 76, such as Figure 5B As shown.

[0115] Now refer to Figure 6 This is a schematic diagram of a surgical tool 420 according to an application of the present invention.

[0116] Further reference Figure 7A and Figure 7B These are schematic diagrams and cross-sectional views of a tissue treatment tip 440 of a surgical tool 420 in the shaving blade activation state according to an application of the present invention.

[0117] Further reference Figure 8A and Figure 8BThese are schematic diagrams and cross-sectional views of a tissue treatment tip 440 of a surgical tool 420 in an activated grinding head state according to an application of the present invention.

[0118] Except as described below, the surgical instrument 420 and the tissue treatment tip 440 are similar to those described above. Figure 3A -B describes the surgical instrument 120 and tissue treatment tip 140, and / or similar to those described above. Figure 1 and Figure 2A -B describes the surgical tool 20 and tissue treatment tip 40; the surgical tool 420 may incorporate features of one or both of these other surgical tools, and / or the above references, with necessary modifications. Figure 4 and Figure 5A -B describes the characteristics of the surgical tool 320. The same component symbols represent the same parts.

[0119] Surgical instrument 420 includes a shaft assembly 428 comprising an elongated shaft 430 and a tissue treatment tip 440. The shaft assembly 428 extends distally from a handle 422. The shaft assembly 428 has a proximal portion 462 and a distal portion 460, the distal portion 460 having a size and shape suitable for insertion into a subject during surgical procedures. The shaft assembly 428 includes the above-described references. Figure 1 and Figure 2A -B describes the grinding head 70 and optical fiber 26. The surgical tool 420 also includes one or more motors 32 configured to rotate the grinding head 70 and one or more planer blades 186 about the central longitudinal axis 488 of the shaft assembly 428.

[0120] In some applications, the shaft assembly 428 also includes a planer sleeve 492 that defines a lateral opening 494 having a circumference 496 defining one or more planer blades 186 (e.g., a plurality of teeth 190). At least one longitudinal portion of the planer sleeve 492 is disposed within the elongated shaft 430.

[0121] In some applications, the distal portion 412 of the elongated shaft 430 is shaped to define a lateral window 466.

[0122] For some of these applications, the shaving sleeve 492 and the elongated shaft 430 are axially slidable relative to each other, such that the surgical tool 420 (including its tissue treatment tip 440) presents at least: • Planer in operation, such as Figure 7AAs shown in -B, in this state, (a) the grinding head 70 is retracted proximally into the elongated shaft 430 and located proximal to the distal opening 436 of the elongated shaft 430, and (b) the lateral opening 494 of the planer sleeve 492 at least partially overlaps longitudinally with the lateral window 466 of the elongated shaft 430; and • Grinding head in operation, such as Figure 7A As shown in -B, in this state, (a) the grinding head 70 is exposed distally from the distal opening 436 of the elongated shaft 430, and (b) the lateral opening 494 of the planer sleeve 492 does not at least partially overlap longitudinally with the lateral window 466 of the elongated shaft 430, as... Figure 7A As shown in -B, for example, it does not overlap longitudinally with the side window 466 at all (structure not shown).

[0123] Typically, the surgical tool 420 includes a user controller 498 that switches the surgical tool 420 (including its tissue treatment tip 440) between a planer-enabled state and a grinding head-enabled state.

[0124] In one embodiment, the technologies and devices described in one or more of the following applications are combined with the technologies and devices described herein: • U.S. Provisional Application 63 / 067,368, filed on August 19, 2020; • U.S. Patent No. 11,369,398 to Perets et al.; • U.S. Provisional Application 63 / 252,276, filed on October 5, 2021; • International application PCT / IL2022 / 050211, filed on February 23, 2022, is published as PCT Publication No. WO 2023 / 021497 by Perets et al.; • U.S. Provisional Application 63 / 390,067, filed on July 18, 2022.

[0125] Those skilled in the art will understand that the present invention is not limited to the specific details shown and described above. Rather, the scope of the present invention includes combinations and sub-combinations of the various features described above, as well as variations and modifications that would occur to those skilled in the art upon reading the foregoing description and not found in the prior art.

Claims

1. A surgical instrument for performing a surgical procedure on a subject, characterized in that: The surgical instruments include: A handle is located in a proximal region of the surgical instrument; A shaft assembly extending distally from the handle, the shaft assembly having a proximal portion and a distal portion, the distal portion of the shaft assembly being sized and shaped to be insertable into the subject during the surgical procedure, the shaft assembly comprising: A grinding head, disposed at a distal end of the shaft assembly, and shaped to define an opaque, externally diamond-coated cutting surface; and An optical fiber, operably connected to the distal portion of the shaft assembly, is configured to emit laser energy that heats the opaque outer diamond-coated cutting surface from within the surgical instrument; and At least one motor is configured to rotate the grinding head.

2. The surgical tool as described in claim 1, characterized in that: The optical fiber passes through at least a portion of the shaft assembly.

3. The surgical tool as described in claim 1, characterized in that: The surgical instrument shields the optical fiber to prevent light from emitting from the outside of the surgical instrument.

4. The surgical tool as described in claim 1, characterized in that: The at least one motor is configured to rotate the grinding head relative to the optical fiber.

5. The surgical instrument as described in any one of claims 1 to 4, Its features are: The grinding head is shaped to define a cutting wall, which is shaped to define the opaque outer diamond-coated cutting surface and an inner surface. The distal portion of the shaft assembly is shaped to define a surface facing the distal side. Wherein, the inner surface and the distally facing surface together at least partially define a cavity; and The optical fiber is configured to emit laser energy into the cavity, such that the inner surface of the cutting wall conducts the energy thermally to the opaque outer diamond-coated cutting surface.

6. The surgical instrument as described in claim 5, characterized in that: At least a portion of the inner surface is curved.

7. The surgical tool as described in claim 5, characterized in that: The surface facing the far side has higher reflectivity than the inner surface.

8. The surgical tool as described in claim 5, characterized in that: The optical fiber is configured to directly emit the laser energy to at least 5% of the surface area of ​​the internal surface.

9. The surgical instrument as described in claim 8, characterized in that: The optical fiber is configured to directly emit the laser energy to at least 20% of the surface area of ​​the internal surface.

10. The surgical tool as described in claim 9, characterized in that: The optical fiber is configured to directly emit the laser energy to at least 30% of the surface area of ​​the internal surface.

11. The surgical tool as described in claim 5, characterized in that: The average thickness of the cut wall is 0.1 to 1.3 mm.

12. The surgical instrument as described in claim 11, characterized in that: The average thickness of the cut wall is 0.1 to 0.25 mm.

13. The surgical tool as described in claim 5, characterized in that: One end of the optical fiber is disposed within the cavity.

14. The surgical tool as described in claim 5, characterized in that: One distal end of the optical fiber is flush with the distal surface.

15. A surgical instrument for performing a surgical procedure on a subject, characterized in that: The surgical instruments include: A handle is located in a proximal region of the surgical instrument; A shaft assembly extending distally from the handle, the shaft assembly having a proximal portion and a distal portion, the distal portion of the shaft assembly being (a) sized and shaped to be insertable into the subject during the surgical procedure; and (b) shaped to define a distally oriented surface, the shaft assembly comprising: A grinding head, disposed at a distal end of the shaft assembly, is shaped to define a cutting wall, the cutting wall being shaped to define (i) an opaque outer cutting surface; and (ii) an inner surface, wherein the inner surface and the distally facing surface together at least partially define a cavity; and An optical fiber, operably connected to the distal portion of the shaft assembly, is configured to emit laser energy into the cavity such that the inner surface of the cut wall thermally conducts the energy to the opaque outer cut surface; and At least one motor is configured to rotate the grinding head.

16. The surgical instrument as described in claim 15, characterized in that: The optical fiber passes through at least a portion of the shaft assembly.

17. The surgical instrument as described in claim 15, characterized in that: The surgical instrument shields the optical fiber to prevent light from emitting from the outside of the surgical instrument.

18. The surgical instrument as described in claim 15, characterized in that: At least a portion of the inner surface is curved.

19. The surgical instrument as described in claim 15, characterized in that: The average thickness of the cut wall is 0.1 to 1.3 mm.

20. The surgical instrument as described in claim 15, characterized in that: One end of the optical fiber is disposed within the cavity.

21. The surgical instrument as described in claim 15, characterized in that: One distal end of the optical fiber is flush with the distal surface.

22. The surgical instrument as described in claim 15, characterized in that: The at least one motor is configured to rotate the grinding head relative to the optical fiber.

23. The surgical instrument as described in any one of claims 15 to 22, characterized in that: The external cut surface is coated with diamond.

24. The surgical instrument as described in any one of claims 15 to 22, characterized in that: The surface facing the far side is reflective.

25. The surgical instrument as described in any one of claims 15 to 22, characterized in that: The optical fiber is configured to directly emit the laser energy to at least 5% of the surface area of ​​the internal surface.

26. The surgical instrument as described in claim 25, characterized in that: The optical fiber is configured to directly emit the laser energy to at least 20% of the surface area of ​​the internal surface.

27. The surgical instrument as described in claim 26, characterized in that: The optical fiber is configured to directly emit the laser energy to at least 30% of the surface area of ​​the internal surface.

28. A surgical instrument for performing a surgical procedure on a subject, characterized in that: The surgical instruments include: A handle is located in a proximal region of the surgical instrument; A shaft assembly extending distally from the handle, the shaft assembly having a proximal portion and a distal portion, the distal portion of the shaft assembly being (a) sized and shaped to be insertable into the subject during the surgical procedure; and (b) shaped to define a lateral window, the shaft assembly comprising: A grinding head is disposed at a distal end of the shaft assembly and is shaped to define an external cutting surface; At least one planing blade is disposed within the distal portion of the shaft assembly; and An optical fiber, operably connected to the distal portion of the shaft assembly, and configured to emit laser energy to the grinding head; and At least one motor is configured as follows: Rotate the grinding head about the central longitudinal axis of the shaft assembly; and The at least one planer blade is rotated about the central longitudinal axis of the shaft assembly such that when the at least one planer blade is axially aligned with and exposed through the side window, the at least one planer blade cuts tissue along the side of the distal portion of the shaft assembly.

29. The surgical instrument as described in claim 28, characterized in that: The optical fiber passes through at least a portion of the shaft assembly.

30. The surgical instrument as described in claim 28, characterized in that: The surgical instrument shields the optical fiber to prevent light from emitting from the outside of the surgical instrument.

31. The surgical instrument as described in claim 28, characterized in that: The surgical tool shields the optical fiber to prevent the emission of light that would heat the shaving blade.

32. The surgical instrument as described in claim 28, characterized in that: The at least one planer blade is formed into multiple teeth.

33. The surgical instrument as described in claim 28, characterized in that: The at least one motor is configured to rotate the grinding head relative to the optical fiber.

34. The surgical instrument as described in any one of claims 28 to 33, characterized in that: The outer cut surface is opaque.

35. The surgical instrument as described in claim 34, characterized in that: The optical fiber is configured to emit the laser energy to heat the external cut surface.

36. The surgical instrument as described in claim 34, characterized in that: The external cut surface is coated with diamond.

37. The surgical instrument as described in any one of claims 28 to 33, characterized in that: The at least one motor is configured to rotate the grinding head and the at least one planing blade about the central longitudinal axis of the shaft assembly, respectively.

38. The surgical instrument as described in claim 37, characterized in that: The at least one motor is configured to rotate the at least one planer blade in a reciprocating rotational motion.

39. The surgical instrument as described in claim 38, characterized in that: The at least one motor is configured to rotate the grinding head in a rotational direction.

40. The surgical instrument as claimed in any one of claims 28 to 33, characterized in that: The shaft assembly further includes (a) an elongated shaft and (b) a planer sleeve, the planer sleeve defining a lateral opening having a circumference defining the at least one planer blade. as well as At least one longitudinal portion of the planer sleeve is disposed within the slender shaft.

41. The surgical instrument as described in claim 40, characterized in that: A distal portion of the elongated shaft is shaped to define the lateral window.

42. The surgical instrument as described in claim 40, characterized in that: The planer sleeve is rotated and fixed relative to the grinding head.

43. The surgical instrument as described in claim 42, characterized in that: It also includes an inner fiber optic sleeve, which is rotatably fixed relative to the grinding head and disposed within at least one longitudinal portion of the planer sleeve, thereby radially defining a space between an outer surface of the inner fiber optic sleeve and an inner surface of the planer sleeve. The optical fiber passes through the inner optical fiber sleeve.

44. The surgical instrument as described in claim 42, characterized in that: A distal portion of the elongated shaft is shaped to define the lateral window.

45. The surgical instrument as described in claim 44, characterized in that: The shaving blade sleeve and the slender shaft are axially sliding relative to each other, such that the surgical tool presents at least: In a planer-operated state, (a) the grinding head is retracted proximally into the elongated shaft and located proximal to a distal opening of the elongated shaft, and (b) the lateral opening of the planer sleeve at least partially overlaps longitudinally with the lateral window of the elongated shaft; and A grinding head in an activated state, wherein (a) the grinding head is exposed distally from the distal opening of the elongated shaft; and (b) the lateral opening of the planer sleeve does not at least partially overlap longitudinally with the lateral window of the elongated shaft.

46. ​​The surgical instrument as described in claim 40, characterized in that: The shaft assembly further includes (a) an inner fiber optic sleeve through which the optical fiber passes; and (b) a grinding head sleeve that is rotatably fixed relative to the grinding head. Wherein, at least one longitudinal portion of the grinding head sleeve is disposed within the slender shaft; Wherein, at least one longitudinal portion of the planer sleeve is disposed within the grinding head sleeve; and The at least one motor is configured to rotate the grinding head and the at least one planing blade about the central longitudinal axis of the shaft assembly, respectively.

47. The surgical instrument as described in claim 46, characterized in that: The inner fiber optic sleeve is rotated and fixed relative to the planer sleeve.

48. The surgical instrument as described in any one of claims 28 to 33, characterized in that: The grinding head is shaped to define a cutting wall, which is shaped to define the outer cutting surface and an inner surface; The distal portion of the shaft assembly is shaped to define a surface facing the distal side; Wherein, the inner surface and the distally facing surface together at least partially define a cavity; and The optical fiber is configured to emit laser energy into the cavity, such that the inner surface of the cutting wall conducts the energy heat to the outer cutting surface.

49. The surgical instrument as described in claim 48, characterized in that: One distal end of the optical fiber is positioned within the cavity.

50. The surgical instrument as described in claim 48, characterized in that: One distal end of the optical fiber is flush with the distal surface.

51. The surgical instrument as described in claim 48, characterized in that: The surgical tool is configured such that the distally facing surface is rotatable relative to the cutting wall.

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