Single entry surgical instrument

Abstract

The present application relates to single entry surgical instruments. Some embodiments of the present disclosure relate to a single entry surgical system. In one embodiment, the instrument includes first, second, and third cannulas. Fluid flows through a proximal opening of the first cannula. The second cannula is coupled within the first cannula such that an outer wall of the second cannula is in contact with an inner wall of the first cannula. The second cannula includes a first distal opening and a first slot extending longitudinally along the second cannula. Fluid entering the proximal opening flows through the first slot and exits at a distal end. The third cannula is coupled within the second cannula such that an outer wall of the third cannula is in contact relationship with an inner wall of the second cannula. The third cannula includes a second distal opening that rotationally interacts with the first distal opening during a tissue debridement.

Description

[0001] Cross-reference of related applications This application claims priority to U.S. Provisional Patent Application No. 63 / 352,502, filed June 15, 2022, entitled “SINGLEPORTAL, SLOTTED MICRODEBRIDER,” the entire contents of which are incorporated herein by reference. Background Technology

[0002] Historically, orthopedic arthroscopy has used two or three surgical portals to facilitate successful endoscopic navigation of the instrument within the joint space. A more popular instrument used in this area is the surgical micro-debridement device. A micro-debridement device is a slender, electrically powered cannula with an inner cannula and an outer cannula. The inner cannula rotates or oscillates within the outer cannula. Both the inner and outer cannulas have openings at their ends with sharp or serrated edges. These openings are typically oriented laterally along the cannula tip so that the blunt, rounded tip can protect distal tissue from the cutting action of the micro-debridement device. In other types of micro-debridements, burrs are located at the distal tip of the inner cannula, aligned with the lateral opening at the distal tip of the outer cannula, again protecting the cannula tip. Irrigation and aspiration pumps are typically used to regulate aspiration and irrigation in an appropriate manner to maintain fluid pressure within the joint space and minimize tissue collapse that would obscure visualization. Utility Model Content

[0003] For a microdebridement cannula to function effectively, it must be capable of aspiration and irrigation to prevent tissue, cartilage, and bone from clogging the tip or shaft of the cannula. Historically, aspiration to remove fluid from the joint space was applied either to the rear end of the internal microdebridement cannula or through a suction port located on the side of a separate cannula, delivered through a different inlet for placing the endoscope or microdebridement device. To allow sufficient space for irrigation fluid to flow into the joint space, a slit is required between the outer surface of the endoscope or microdebridement cannula shaft and the inner surface of the external orthopedic cannula shaft for access to the joint. Eliminating this slit would allow for a smaller overall diameter of the external optical cannula.

[0004] The arthroscopic surgery market is moving towards smaller endoscopes and instruments in an attempt to minimize patient discomfort and allow for outpatient arthroscopic procedures. For example, ARTHREX introduced the 1.9mm “Nanoscope” with a 2.2mm inlet sheath. However, these devices are intended for visualization within the joint space. A second inlet is needed to allow for tissue removal using the instrument. ARTHREX's inlet sheath is not large enough to accommodate both the endoscope and instruments such as forceps or micro-debridement cannulas within the same inlet sheath.

[0005] Performing surgery through a single optical orthotic cannula is advantageous. A single-entry system minimizes the number of incision sites and instrument entry points, thus reducing pain and blood loss while increasing surgical speed and efficiency. The smaller the diameter of the single-entry optical cannula, the better the patient's tolerance to the surgical arthroscopy. On the other hand, in some applications, the micro-debridement shaft should be kept as large as possible to minimize the time required for tissue removal. Smaller-diameter micro-debridement cannulas require longer to remove tissue. In a single-entry system, the optical orthotic cannula used to access the joint space must provide a sufficiently large inner diameter to allow for irrigation, aspiration, and the passage of the micro-debridement shaft or another shafted instrument. If the working channel inner diameter is too small, there is insufficient space to push fluid past the outside of the micro-debridement or instrument shaft. In this case, standard aspiration through the internal micro-debridement cannula will quickly exceed the amount of irrigation fluid flowing into the joint from around the cannula. Similarly, the forceps instrument shaft passing through the single-channel optical cannula can only provide a surrounding space between the forceps shaft and the inner channel wall for aspiration or irrigation propagation. Suction and flushing cannot be performed simultaneously through the same tubing.

[0006] To address these and other shortcomings of existing or future optical cannula surgical systems and to advance single-entry surgical systems, embodiments of this disclosure relate to single-entry surgical systems and methods, comprising a slotted micro-debridement device and a custom shaft suitable for single portable surgical applications. An innovative means of simultaneously guiding aspiration and irrigation through a single optical cannula with a small diameter minimizes the need to insert multiple instruments into the anatomical space through multiple inlets. The techniques described herein can be applied to a variety of procedures across multiple surgical specialties, including orthopedics, otolaryngology, obstetrics and gynecology, general surgery, urology, neurosurgery, and veterinary medicine.

[0007] In one embodiment, the instrument includes: a first cannula coupled to a fluid container such that fluid flows from the fluid container through a proximal opening of the first cannula; a second cannula coupled within the first cannula such that the outer wall of the second cannula contacts the inner wall of the first cannula, the second cannula including a first distal opening and a first groove extending longitudinally along the length of the second cannula, wherein fluid entering the proximal opening of the first cannula flows through the first groove and exits at a distal end of the instrument; and a third cannula coupled within the second cannula such that the outer wall of the third cannula contacts the inner wall of the second cannula, the third cannula including a second distal opening that, during tissue debridement, rotatably interacts with the first distal opening. Fluid can exit at the distal end of the instrument near the first distal opening of the second cannula.

[0008] In some embodiments, the second cannula further includes a second groove extending longitudinally along the length of the second cannula; and fluid entering the proximal opening of the first cannula will flow through the first and second grooves and exit at the distal end of the instrument.

[0009] In some embodiments, the second sleeve further includes a third groove extending longitudinally along the length of the second sleeve; and the first groove, the second groove, and the third groove are spaced apart circumferentially along the second sleeve.

[0010] In some embodiments, fluid entering the proximal opening of the first sleeve will flow through a channel defined by an opening between a first boundary and a second boundary, the opening including a first groove, the first boundary including a longitudinal portion of the inner wall of the first sleeve, and the second boundary including a longitudinal portion of the outer wall of the third sleeve.

[0011] In some implementations, the length of the first groove along the second sleeve is substantially linear.

[0012] In some implementations, the first groove is spiral-shaped along the length of the second sleeve.

[0013] In some implementations, the thickness of the channel is substantially the same as the thickness of the second sleeve between the outer wall of the second sleeve and the inner wall of the second sleeve.

[0014] In some implementations, the outer wall of the second sleeve is flush with the inner wall of the first sleeve along its longitudinal length.

[0015] In some embodiments, the device further includes a housing coupled to the proximal end of a third cannula, the housing including a port configured to be coupled to an aspiration conduit for aspirating tissue after debridement or for aspirating fluid after it has left the distal end of the device.

[0016] In some implementations, the edge of the third sleeve along the second distal opening is sharpened.

[0017] In some embodiments, the device further includes: a light source that transmits light to the tissue location during debridement; and an image sensor that images the location during debridement. In some embodiments, the first cannula includes an optical channel through which light transmitted by the light source travels. In some embodiments, the light source is located at the distal end of the first cannula (e.g., an LED light source), and an optical channel is not required.

[0018] In some embodiments, the device further includes a fluid container, and the fluid container is configured to be fluidly connected to a fluid source. In some embodiments, the fluid container is longitudinally rotatable.

[0019] In some implementations, the third sleeve is removably connected within the second sleeve.

[0020] In some implementations, the third sleeve is integrated within the second sleeve and / or the second sleeve is integrated within the first sleeve.

[0021] In some implementations, the length of the device is between 5 cm and 25 cm, the outer diameter of the first sleeve is between 2.2 mm and 8 mm, and the inner diameter of the third sleeve is between 2.0 mm and 7.5 mm.

[0022] In one embodiment, the device includes: a first sleeve coupled to a fluid container such that fluid flows from the fluid container through a proximal opening of the first sleeve; a second sleeve coupled within the first sleeve such that the outer wall of the second sleeve contacts the inner wall of the first sleeve, the second sleeve including a first distal opening and at least one groove extending longitudinally along the length of the second sleeve, wherein fluid entering the proximal opening of the first sleeve flows through the at least one groove and exits at a distal end of the device; and an instrument shaft coupled within the second sleeve such that the outer wall of the instrument shaft contacts the inner wall of the second sleeve. Fluid can exit at the distal end of the device near the first distal opening of the second sleeve.

[0023] In one embodiment, the single-entry surgical instrument includes: a first cannula coupled to a fluid source such that fluid flows from the fluid source through a proximal opening of the first cannula; an instrument shaft extending longitudinally within the first cannula, the outer surface of the instrument shaft including circumferentially spaced first and second structures extending longitudinally along a distal portion of the instrument shaft, the first structure being in continuous contact with a first surface of the inner wall of the first cannula at a first position, and the second structure being in continuous contact with a second surface of the inner wall at a second position, such that the interior of the first cannula is divided into at least two fluid channels having boundaries defined at least by the first and second positions; and a first tool extending distally from the instrument shaft.

[0024] In some embodiments, the interior of the instrument shaft includes a first instrument channel extending longitudinally along the instrument shaft; and a first tool extending distally from the distal end of the first instrument channel.

[0025] In some embodiments, the single-entry instrument further includes a cable conductor coupled to the proximal end of the first instrument, the cable conductor advancing through the first instrument channel to the proximal end of the single-entry surgical instrument.

[0026] In some embodiments, the single-entry instrument further includes a second tool extending distally from the instrument axis. In some embodiments, the interior of the instrument axis further includes a second instrument channel separate from the first instrument channel; and the second tool extends distally from the distal end of the second instrument channel.

[0027] In some implementations, the first and second structures are spirally arranged around the instrument axis along its longitudinal length.

[0028] In some implementations, the first and second structures are winged structures.

[0029] In some embodiments, at least two fluid channels include a first fluid channel and a second fluid channel; fluid entering the proximal opening of the first cannula will flow through the first fluid channel and exit at the distal end of the first cannula; and the second fluid channel is configured to aspirate fluid or tissue.

[0030] In some implementations, the second fluid channel is connected to a suction pipe near the first sleeve.

[0031] In some embodiments, the outer surface of the instrument shaft further includes a third structure extending longitudinally along the distal portion of the instrument shaft, the third structure being in continuous contact with a third surface of the inner wall at a third position, and the third structure being circumferentially spaced from the first and second structures; at least two fluid channels include three or more fluid channels; and the interior of the first sleeve is divided into three or more fluid channels having boundaries defined by at least the first position, the second position, and the third position.

[0032] In some implementations, the single-entry surgical instrument further includes: a light source that transmits light to the anatomical site during surgery; and an image sensor that images the anatomical site during surgery.

[0033] In some implementations, the image sensor is integrated into a first sleeve; and the first sleeve includes a channel through which light transmitted by the light source travels; or the distal end of the first sleeve includes the light source.

[0034] In some embodiments, the single-entry surgical instrument further includes a handle proximate to and coupled to the first cannula and the instrument shaft, the handle including a controller configured to be actuated to move the first instrument.

[0035] In some implementations, the single-entry surgical instrument further includes a connector on the distal side of the handle, the connector being configured to removably attach the proximal end of the instrument shaft to the handle.

[0036] Other features and aspects of the disclosed technology will become apparent from the following detailed description taken in conjunction with the accompanying drawings, which illustrate by way of example the features of embodiments according to the disclosed technology. This utility model is not intended to limit the scope of any invention described herein, which is defined by the claims and their equivalents. Attached Figure Description

[0037] This disclosure is described in detail with reference to the following figures, according to one or more embodiments. These figures are provided for illustrative purposes only and depict only exemplary embodiments. Furthermore, it should be noted that the elements in the figures are not necessarily drawn to scale for clarity and ease of explanation.

[0038] The figures included in this document illustrate various embodiments of the disclosed technology from different perspectives. Although the accompanying descriptive text may refer to such views as “top,” “bottom,” or “side,” such references are descriptive only and do not imply or require that the disclosed technology be implemented or used in a particular spatial orientation unless explicitly stated otherwise.

[0039] Figure 1A A perspective view of the components of a disassembled miniature debridement instrument according to some embodiments of this disclosure is shown.

[0040] Figure 1B This demonstrates assembly according to some embodiments of the present disclosure. Figure 1A Components of a miniature debridement instrument.

[0041] Figure 2 Some embodiments according to this disclosure are shown. Figure 1A-1B Enlarged view of the fluid container and fluid port of the optical component of the miniature debridement instrument.

[0042] Figure 3A Some embodiments according to this disclosure are shown. Figure 1A-1B Enlarged view of the cannula and distal end of the external components of the miniature debridement instrument.

[0043] Figure 3B Some embodiments according to this disclosure are shown. Figure 1A-1B Another enlarged view of the cannula and distal end of the external component of the miniature debridement instrument.

[0044] Figure 3C Some embodiments according to this disclosure are shown. Figure 1A-1B Another enlarged view of the cannula and distal end of the external component of the miniature debridement instrument.

[0045] Figure 3D Some embodiments according to this disclosure are shown. Figure 1A-1B Another enlarged view of the cannula and distal end of the external component of the miniature debridement instrument.

[0046] Figure 4A Some embodiments according to this disclosure are shown. Figure 1A-1B Enlarged view of the cannula and distal end of the internal components of the miniature debridement instrument.

[0047] Figure 4B Some embodiments according to this disclosure are shown. Figure 1A-1B Another enlarged view of the cannula and distal end of the internal components of the miniature debridement instrument.

[0048] Figure 4C Some embodiments according to this disclosure are shown. Figure 1A-1B Another enlarged view of the cannula and distal end of the internal components of the miniature debridement instrument.

[0049] Figure 5 Depicting a position Figure 1B The distal portion of the assembled micro-debridement instrument, wherein the outer and inner cannulas of the micro-debridement instrument are rotatably positioned such that the tip of the micro-debridement instrument is opened and the opening at the distal end of the inner cannulas is exposed.

[0050] Figure 6 Depicting a location in another position Figure 1B The distal portion of the assembled micro-debridement instrument, wherein the outer and inner cannulas of the micro-debridement instrument are relative to... Figure 5 The position is rotatable by approximately 180 degrees, allowing the tip of the micro-debridement instrument to close and the opening at the distal end of the inner cannula to remain unexposed.

[0051] Figure 7 Some embodiments according to this disclosure are shown. Figure 1B Cross-sectional view of the three cannulas of the miniature debridement instrument.

[0052] Figure 8 A cross-sectional view is depicted of an example embodiment of an assembled miniature debridement device according to some embodiments of the present disclosure, the device having a miniature debridement device external component with a cannula having four spaced slots extending longitudinally along the cannula.

[0053] Figure 9 A side view of a cannula of the external component of a miniature debridement instrument according to some embodiments of the present disclosure is shown, the cannula including helical grooves.

[0054] Figure 10 Examples of optical components including a light source and an image sensor according to some embodiments of this disclosure are described.

[0055] Figure 11 Examples of internal component sleeves of a miniature debridement device coupled to a housing, according to some embodiments of the present disclosure, are shown, the housing having a port coupled to a suction tube.

[0056] Figure 12A A single-entry surgical instrument including a winged instrument shaft is shown according to some embodiments of the present disclosure. The winged instrument shaft is configured to extend through the outer sheath / optical sheath to divide the interior of the outer sheath / optical sheath into multiple separate channels.

[0057] Figure 12B Showing Figure 12AA side view of the instrument axis and distal tool of a single-entry surgical instrument.

[0058] Figure 12C Showing Figure 12A A perspective view of the instrument axis and distal tool of a single-entry surgical instrument.

[0059] Figure 12D This demonstrates the connection between the outer tube / optical sleeve and the instrument shaft extending through the outer tube / optical sleeve. Figure 12A Single-entry surgical instruments.

[0060] Figure 13A A front perspective view of an assembly of a single-entry surgical instrument according to some embodiments of the present disclosure is shown, the assembly including an instrument shaft extending through an outer sheath / optical sheath and in contact with the inner wall of the outer sheath.

[0061] Figure 13B Showing Figure 13A Front cross-sectional view of the component.

[0062] Figure 14A A front perspective view of another component of a single-entry surgical instrument according to some embodiments of the present disclosure is shown, the component including an instrument shaft that extends through the outer sheath / optical sheath and is in contact with the inner wall of the outer sheath.

[0063] Figure 14B Showing Figure 14A Front cross-sectional view of the component.

[0064] These figures are not exhaustive, nor do they limit this disclosure to the precise form disclosed. Detailed Implementation

[0065] Figure 1A-1B Miniature debridement device 10 is described according to some embodiments of the present disclosure. Figure 1A The disassembled miniature debridement instrument 10 is depicted, and Figure 1B An assembled miniature debridement instrument 10 is depicted. The miniature debridement instrument 10 includes an optical or endoscopic component 100, an external miniature debridement component 200, and an internal miniature debridement component 300. (As shown...) Figure 1A-1B As depicted in the examples, components 100-300 are all removably connected and can be disassembled. However, depending on the device implementation, all, some, or no components of 100-300 may be disassembled. For example, in one implementation, all components are integrated or otherwise combined.

[0066] Optical component 100 includes a fluid port 105, a fluid container 110, and a sleeve 120. Optical component 100 may also include an endoscope light source and an image sensor (not shown). The light source and / or image sensor may be located at the distal end of sleeve 120 or within a housing (not shown) located near the proximal end of optical component 100. For example, during endoscopic operation of optical component 100, light emitted from a light source (e.g., an LED light source) contained within the endoscope housing may be transmitted through the sleeve 120 via an illumination channel terminating at the distal end of sleeve 120. The illumination channel may be a molded illumination tube. Alternatively, in other embodiments, the light source may be integrated internally and / or externally into sleeve 120. In such embodiments, the light source may be located near the distal end of sleeve 120 (e.g., close to a camera sensor, in a separate channel such that the light emitted by the light source does not interfere with the operation of the camera sensor) or in some other segment of sleeve 120.

[0067] Figure 2 An enlarged view of the fluid container 110 and fluid port 105 is shown. As depicted, the fluid port 105 is coupled to the interior of the fluid container at a connector or channel 105a. Fluid received in channel 105a flows into sleeve 120 at a proximal opening 125a. In this example, the fluid container 110 is longitudinally rotatable to better position the fluid conduit (not shown) leading to the fluid port 105, or to otherwise improve the ergonomics of the device 10. In some embodiments, the fluid container 110 is removably coupled to the optical component 110.

[0068] The external component 200 of the miniature debridement device includes a head 210, a cannula 220, and a distal end or cannula tip 230 having an opening 230a. Figures 3A-3D Various enlarged views of the sleeve 220 and distal end 230 of the external component 200 according to some embodiments of the present invention are shown. At least one groove 225 extends longitudinally along the length of the sleeve 220, as further described below, providing a means of delivering fluid to the distal end of the device 10.

[0069] The internal components 300 of the miniature debridement device include a head 310, a cannula 320, and a distal end or cannula tip 330 having an opening 330a. Figures 4A-4C Different perspective views of the cannula 320 and distal end 330 of the internal component 300 are shown. The proximal end of the head 310 can be coupled to a suction tool (not shown) via a suction tube (not shown), which aspirates debrided tissue and / or irrigation fluid at the distal end 330 during operation of the instrument 10. The distal end 330 of the cannula 320 may include a rotating instrument (e.g., a blade or burr) for performing debridement functions.

[0070] During operation, the inner component 300 can rotate or swing within the outer component 200 to facilitate tissue debridement via the instrument 10. Multiple options are envisioned for the length of the cannula instrument 10, the diameter of the outer cannula 120, and the diameter of the inner cannula / channel 320. The cannula instrument length can range from 5 cm to 25 cm, the outer diameter from 2.2 mm to 8 mm, and the inner diameter from 2.0 mm to 7.5 mm.

[0071] In this example, the instrument 10 is assembled by moving the inner component 300 of the micro-debridement device through the outer component 200 of the micro-debridement device (e.g., starting from an opening near the proximal end of the head 210 of the outer component 200) to move the cannula 320 through the cannula 220, and by moving the optical component 100 above the cannula 220 (e.g., starting from the distal end of the outer component 200 of the micro-debridement device) to move the cannula 120 above the cannula 220. Assemblies in which the integral parts are not disassembled or not manufactured as a single unit are also contemplated; however, it should be understood that the instrument 10 incorporates the optical component 100 having a cannula 130 that includes the cannula 220 of the outer component 200, which in turn includes the cannula 320 of the inner component 300.

[0072] In some embodiments, head 210 and head 310 may be implemented as a single housing. In some embodiments, head 210 and head 310 may be omitted from outer component 200 and inner component 300, respectively. For example, each of sleeve 220 and sleeve 320 may be coupled (removable or non-removable) to the same proximal housing. In such embodiments, optical component 100 may also be coupled to the same proximal housing.

[0073] Figure 5-6 The assembly device 10 is depicted in two different locations. As depicted, sleeve 120 covers groove 225, except near the distal end of sleeve 220, and sleeve 320 covers the bottom of groove 225, providing a floor for any fluid flowing through the channel between sleeve 120 and sleeve 220. Figure 5 In this configuration, cannulas 220 and 320 are rotatably positioned such that the tip of instrument 10 is opened, and the opening 330a of the cannulas tip 330 is exposed. Figure 6 In the middle, the bushing 320 is relative to Figure 5 The position is rotated approximately 180 degrees so that the opening 330a is no longer exposed and the tip of the instrument 10 is closed.

[0074] Figure 7Cross-sectional views of the cannulas 120, 220, and 320 of the three components 100-300 after assembly of the instrument 10 are depicted and will be referenced herein when describing the operation of the micro-debridement instrument 10. During use of the micro-debridement instrument 10, fluid (e.g., irrigation fluid) is delivered through a fluid conduit (not shown) to a fluid port 105 and into a channel 105a of a fluid container 110a. The fluid enters the interior of the cannulas 120 via a proximal opening 125a. Figure 7 As depicted, fluid flows through the space in groove 225 between cannulas 120 and 220. The fluid flows along the longitudinal end of the device 10 and exits from the distal end of the combined cannulas of the device 10, near the distal opening of cannulas 230 and away from the distal end of the outer cannulas 120. The distance between the end of cannulas 120 and the amount of fluid in the exposed irrigation groove 225 can vary between 1 mm and 5 mm.

[0075] The above design allows the irrigation fluid or other fluid to maximize the outer diameter of the micro-debridement device (e.g., Figure 7 The fluid is delivered through the optical component 100 in the engagement space between the sleeves 120 and 220 in a manner that minimizes the inner diameter of the working channel of the optical component (i.e., the distance between the sleeves 120 and 220). Fluid can be delivered to the tip of the component through at least one groove 225 positioned longitudinally along the micro-debridement sleeve 220 by placing the groove 225. Therefore, with this design, fluid can be delivered as... Figure 7 The depiction eliminates the usual gap between the inner wall of the working channel of the optical component 100 and the outer wall of the outer component 200 of the micro-debridement device. Fluid can be delivered to the end of the component without increasing the total space occupied by the component.

[0076] In the aforementioned arrangement, the outer wall of the sleeve 320 of the inner component 300 of the micro-debridement device is flush with the inner wall 220a of the sleeve 220 of the outer component 200 of the micro-debridement device. Therefore, the inner component 300 of the micro-debridement device creates a bottom surface for one or more slots 225 placed within the outer component 200 of the micro-debridement device. Similarly, the inner wall 120a of the working channel of the sleeve 120 of the optical component 100 provides a roof or ceiling for the slot 225. Thus, the slot 225 can limit the irrigation channel to the material thickness of the sleeve 220 of the outer micro-debridement device component 200 and the width of the slot 225.

[0077] In some embodiments, multiple slots 225 (e.g., 2, 3, 4, 5, 6 or more) may be circumferentially spaced and longitudinally advanced along the outer sleeve 220. For example, Figure 8A cross-sectional view is depicted of an example embodiment of an assembled micro-debridement device having a micro-debridement outer component with a cannula 420 having four spaced slots extending longitudinally along the outer cannula 220. The multiple spaced slots 225 ensure more uniform delivery and increased fluid volume at the distal end of the device, typically under pressure.

[0078] In some implementations, the groove is contemplated to be linear in shape; however, in other implementations, the groove may be non-linear in both shape and width. Such implementations may include helical or mixed horizontal and vertical groove configurations. For example, a helical groove structure is configured to allow for twisting of the closed groove in certain applications, thereby altering the groove's dimensions and thus its fluid-carrying capacity, which would be advantageous. As an example, Figure 9 A side view of the cannula 920 of the external component of the micro-debridement instrument is shown, the cannula 920 including a helical groove 925. In addition to extending longitudinally along the length of the cannula 920, the groove 925 is helical around the circumference of the cannula 920. Figure 9 The dashed line in the diagram indicates the portion of slot 925 that is not visible from the side view shown. Although Figure 9 An example of a sleeve 920 with a single spiral groove 925 is shown, but in some embodiments, the outer sleeve may have multiple spiral grooves. In such embodiments, the spiral grooves may remain parallel to each other along the longitudinal length of the sleeve.

[0079] Figure 10 An example of an optical component including a light source 1005 and an image sensor 1030 is depicted. For ease of illustration, other parts of the optical component (e.g., fluid ports and containers) are not shown. The example optical component includes a cannula 1020 extending distally from an endoscope housing 1000. The endoscope housing 1000 includes a light source 1005 transmitting light traveling through a light path 1025 terminating at the distal end of the cannula 1020. The light path 1025 may be a channel formed within the cannula 1020 (e.g., through the wall of the cannula) separate from a channel through which fluid travels (e.g., a main cannula opening). An image sensor 1030, positioned at the distal end of the cannula 1020, collects light reflected from anatomical structures illuminated by the light sensor 1005. The image sensor 1030 itself may also be positioned within the wall of the cannula 1020 or in a separate channel attached to the outside of the cannula 1020. In order to power the light source 1005 and the image sensor 1030 for operation, the endoscope housing 1000 can power the light source (and image sensor) via a separate power line or via power line communication.

[0080] Figure 11An example of a cannula 1120, an internal component of a micro-debridement device, is shown attached to a housing 1100. The housing includes an aspiration channel 1106 for receiving debridement tissue and / or irrigation fluid via the cannula 1120. The housing also includes a port 1105, which is coupled to an aspiration conduit 1150 (e.g., via the aspiration channel 1106). The aspiration conduit 1150 allows for aspiration of tissue after debridement. This aspiration conduit can also be used for aspiration after the distal end of the fluid micro-debridement device has been dislodged. In some embodiments, the port 1105 may be directly coupled to the cannula 1120, in which case the aspiration channel 1106 may be omitted.

[0081] Sleeves 120, 220, and 320 may be made of metal and / or rigid or flexible polymers (such as PEBA, PEEK, or LCP). Disposable and reusable sleeves are also envisioned. In some embodiments, the configuration of the optical sleeve axis 120 may be articulated, flexible, extensible, or otherwise non-linear or curved. The relaying of anatomical tip positioning information to an image-guided computer via the optical sleeve axis is also envisioned. Inner sleeves 220 and 320 may also be flexible and / or articulated, thereby allowing them to move passively or actively relative to the outer flexible or articulated optical sleeve.

[0082] In some implementations, the powered rotating belt tool can be inserted through the second sleeve 220 instead of the rotating hollow sleeve 320. For example, the belt burr can be inserted through the second sleeve 220 instead of the rotating hollow sleeve 320, allowing suction to still occur around the burr tip.

[0083] The delivery of irrigation fluid via the cannula and groove configuration described herein is not limited to arthroscopic micro-debridements. Similar applications are envisioned for shafted instruments that pass through the outer cannula, in which case fluid delivery requires a groove or recess / recess incorporated into the outer diameter of the instrument shaft. It should also be noted that the outer profile of the instrument shaft may be circular or have other geometrical profiles, and the cannula may also be configured with an outer or inner profile that is not necessarily circular.

[0084] Figure 12A-14B An example embodiment of a single-entry surgical instrument is shown, which utilizes an instrument shaft configured to extend through an outer sheath (e.g., an outer optical sheath 120) and in contact with the inner wall of the outer sheath to divide the interior of the optical sheath into multiple separate fluid channels suitable for irrigation and / or aspiration operations.

[0085] Figure 12A and 12DA single-entry surgical instrument 1200 is shown, comprising a winged instrument shaft 1250 configured to extend through an outer sheath / optical cannula 1280 to divide the interior of the outer sheath / optical cannula into multiple individual fluid channels. The depicted instrument includes a handle 1210, a controller 1205 actuable to drive a distal tool / tool ​​tip 1255, an instrument shaft with a winged portion 1252, and an instrument shaft connector 1220 remote from the handle 1210. The instrument 1200 may also include an outer sheath / optical cannula 1280 configured to receive the winged instrument shaft 1250. The outer sheath / optical cannula 1280 may include components similar to the referenced optical component 100 above and / or Figure 10 The optical components described in the sleeve are components (e.g., image sensors, light sources, fluid couplings, etc.). Figure 12B-12C Side and perspective views of the instrument axis and the distal tool 1255 are shown respectively.

[0086] Instrument shaft 1250 includes a winged portion 1252 and a connector portion 1253 for connecting instrument shaft 1250 to handle 1210. Connector portion 1253 mechanically engages the proximal end of instrument shaft 1250 to instrument shaft connector 1220 extending distally from handle 1210. A housing including or extending from instrument shaft connector 1220 may also incorporate irrigation and aspiration mechanisms attached to aspiration and irrigation canals advancing into instrument 1200. Connector portion 1253 may be rigid or semi-rigid, and the engagement mechanism of instrument shaft connector 1220 may enable removable engagement mechanisms such as snap-fit, clamp-fit, friction fit, magnetic attachment, and / or some other attachment mechanisms. One embodiment may include a longitudinal slot in housing 1220 that rotates about shaft connector portion 1253 after shaft connector portion 1253 is positioned within the slot (not shown). In an alternative embodiment, the instrument shaft is integrated and non-removable.

[0087] Extending near the connector portion 1253 is a cable / wire 1254 configured to drive the tool tip 1255. The cable / wire 1254 is configured to advance through the instrument shaft 1250 to the tool tip 1255. The instrument handle 1210, housing 1220, and actuation controller 1205 are configured to removably secure the instrument shaft segment 1253 relative to the proximal end of the cable / wire 1254 so that the cable / wire 1254 can move back and forth within the shaft 1252 once engaged (when engaged and actuated by the controller 1205). As depicted in this example, the tool tip 1255 includes forceps. However, various other instrumental tools are contemplated for use with the single-entry surgical instrument 1200 or variations thereof, as further described below. During operation, the controller 1205 can be actuated to drive the distal tool 1255 via the cable 1254. The controller 1205 is shown having a finger grip that can be grasped to actuate the distal tool 1255. Other controllers were also envisioned, including triggers, buttons, dashboards, sliders, etc.

[0088] The winged portion 1252 of the instrument shaft 1250 includes circumferentially spaced wings / structures 1252a and 1252b, which extend from the length of the instrument shaft and longitudinally along its length. When assembling the instrument 1200, the shaft 1252 can be... Figure 12D The outer sleeve / optical sleeve 1280 shown is inserted such that each of the circumferentially spaced wings 1252a and 1252b is in continuous contact with the surface of the inner wall of the outer sleeve along its longitudinal length. With this configuration, the interior of the outer sleeve 1280 can be divided into multiple fluid channels, which can be configured for suction and / or irrigation functions. Fluid (e.g., liquid or air / gas) can be transferred and / or received by each fluid channel. (Refer to below...) Figures 13A-13B and Figures 14A-14B An example implementation of an instrument shaft extending through the outer sleeve in this manner is shown and further described.

[0089] The instrument shaft and outer tube can be assembled by inserting the distal end of the instrument shaft 1250 through the proximal end of the outer tube until the distal end of the instrument shaft 1250 reaches or extends through the distal end of the outer tube 1280. In such embodiments, the instrument shaft 1250 may first be coupled to the instrument shaft connector 1220 via the connector portion 1253, followed by the outer tube. Alternatively, the proximal end of the instrument shaft 1250 may be inserted or pushed through the distal end of the optical sleeve and then coupled to the handle 1210 and / or the connector 1220. The latter form of assembly may be preferred in cases where the distal tool is too large to pass through the outer tube.

[0090] Although two circumferentially spaced wings / structures 1252a and 1252b are shown for dividing the interior of the outer tube 1280 into two fluid channels, it should be understood that additional circumferentially spaced structures may be included to divide the interior of the outer tube 1280 into more than two fluid channels. Furthermore, although wings 1252a and 1252b are circumferentially spaced approximately 180 degrees along the instrument axis to enable the formation of two fluid channels of substantially equal size, it should be understood that other spacing configurations may be implemented, and the resulting fluid channels need not be substantially equal in size.

[0091] The material properties of the winged portions 1252 (and especially wings 1252a and 1252b) can be selected, including stiffness, flexibility, ductility, and / or roughness, to ensure that each wing maintains continuous contact with the inner wall surface along its longitudinal length. In making this selection, the material properties of the inner wall of the outer sleeve 1280 can also be considered. For example, longitudinal or helical grooves may be present in the inner surface wall of the sleeve to engage the wing, thereby fixing the position and creating a tighter fluid or suction seal.

[0092] Figures 13A-13B An example assembly 1300 of a single-entry surgical instrument according to some embodiments of the present disclosure is shown, the assembly 1300 including an instrument shaft 1320 extending through an outer sheath / optical sheath 1310 and in contact with the inner wall of the outer sheath 1310. Figure 13A The front perspective view is shown, and Figure 13B A front cross-sectional view is shown. As shown, the outer surfaces 1320a and 1320b of the instrument shaft 1320 are in continuous contact with the inner wall of the outer sleeve 1310, dividing the interior of the outer sleeve 1310 into two separate fluid channels (fluid channel 1335 and fluid channel 1345). Furthermore, the instrument shaft 1320 is configured to accommodate two separate instruments: a first instrument or cable conductor passing through instrument channel 1322, and a second instrument passing through instrument channel 1324. The instruments are removably coupled to or integrated into each corresponding channel. Various instruments are envisioned for use, including, for example, tweezers, injection needles, laser fibers for ablation, sutures / suture guides, drills, image-guided probes, etc.

[0093] Figures 14A-14B Another example assembly 1400 of a single-entry surgical instrument according to some embodiments of the present invention is shown, the assembly 1400 including an instrument shaft 1420 extending through an outer sheath / optical sheath 1410 and in contact with the inner wall of the outer sheath 1410. Figure 14A The front perspective view is shown, and Figure 14BA front cross-sectional view is shown. As shown, the circumferentially spaced winged structures 1420a and 1420b of the instrument shaft 1420 are in continuous contact with the inner wall of the outer sleeve 1410, dividing the interior of the outer sleeve 1410 into two separate fluid channels (fluid channel 1435 and fluid channel 1445). The instrument shaft 1420 is configured to accommodate instruments passing through the instrument channel 1421. The instruments are removably coupled to or integrated into the channel 1421. Figure 14A As depicted, the winged structures 1420a and 1420b are circumferentially helical around the instrument axis along its longitudinal length. This configuration allows for better stability of the instrument axis within the outer sleeve 1410. In an alternative embodiment, the winged structures 1420a and 1420b can advance linearly along their longitudinal length.

[0094] Although the foregoing has described various example embodiments and implementations, it should be understood that the various features, aspects, and functions described in one or more individual embodiments are not limited to their applicability to the particular embodiment described, but can be applied individually or in various combinations to one or more other embodiments of the application, whether or not such embodiments are described and whether or not such features are presented as part of the described embodiments. Therefore, the breadth and scope of this application should not be limited by any of the example embodiments described above.

[0095] It should be understood that all combinations of the foregoing concepts (provided that these concepts are not inconsistent with each other) are considered part of the utility model subject matter disclosed herein. In particular, all combinations of the claimed subject matter appended to this disclosure are considered part of the utility model subject matter disclosed herein.

[0096] The terms “substantially” and “about” as used in this disclosure (including the claims) are used to describe and illustrate small fluctuations, such as those due to variations in manufacturing tolerances. For example, they may refer to less than or equal to ±5%, such as less than or equal to ±2%, such as less than or equal to ±1%, such as less than or equal to ±0.5%, such as less than or equal to ±0.2%, such as less than or equal to ±0.1%, such as less than or equal to ±0.05%.

[0097] To the extent applicable, the terms “first,” “second,” “third,” etc., used herein are used only to refer to the various objects described by these terms as independent entities, and unless otherwise expressly stated herein, do not imply any temporal order.

[0098] Unless otherwise expressly stated, the terms and phrases used in this document and their variations shall be interpreted as open-ended rather than restrictive. As for the foregoing examples: the term “including” shall be understood to mean “including, without limitation”; the term “example” is used to provide some examples of the items discussed, not an exhaustive or limited list; the terms “a” or “an” shall be understood to mean “at least one,” “one or more,” etc.; and adjectives such as “conventional,” “traditional,” “normal,” “standard,” “known,” and terms with similar meanings shall not be interpreted as limiting the described items to items available up to a given time period, but shall be understood to include conventional, traditional, normal, or standard techniques available or known now or in the future. Similarly, if this document refers to techniques that will be obvious or known to a person skilled in the art, such techniques include those that are obvious or known to a person skilled in the art now or in the future.

[0099] In some cases, expanding terms and phrases such as "one or more," "at least," "but not limited to," or other similar phrases exist. These should not be construed as an intention or requirement to use a narrower term where such expanding phrases might not exist. The use of the term "module" does not imply that all components or functions described or claimed as part of a module are configured within a common package. In fact, any or all of the various components of a module, whether control logic or other components, can be combined in a single package or maintained separately, and can be further distributed across multiple groups or packages or across multiple locations.

[0100] Furthermore, the various implementations described herein are illustrated with example block diagrams, flowcharts, and other diagrams. As will become apparent to those skilled in the art upon reading this document, the illustrated implementations and their various alternatives can be implemented without limitation to the examples shown. For instance, the block diagrams and their accompanying descriptions should not be construed as requiring a particular architecture or configuration.

[0101] While various embodiments of this utility model have been described above, it should be understood that they are presented by way of example only and not as limitations. Similarly, various schematic diagrams may depict example architectures or other configurations used in this disclosure to aid in understanding the features and functions that may be included in this disclosure. This disclosure is not limited to the example architectures or configurations shown, but various alternative architectures and configurations can be used to implement the desired features. Indeed, it will be apparent to those skilled in the art how alternative functions, logical or physical partitions and configurations can be implemented to carry out the desired features of this disclosure. Furthermore, in addition to the module names depicted herein, various different component module names may be applied to various partitions. Moreover, regarding flowcharts, instructions for operation, and method claims, unless the context otherwise requires, the order of steps presented herein should not compel various embodiments to perform the described functions in the same order.

Claims

1. An instrument, characterized in that... The device includes: A first sleeve is connected to a fluid container, such that fluid flows from the fluid container through a proximal opening of the first sleeve. A second cannula, connected within the first cannula such that the outer wall of the second cannula is in contact with the inner wall of the first cannula, the second cannula including a first distal opening and a first groove extending longitudinally along the length of the second cannula, wherein fluid entering the proximal opening of the first cannula flows through the first groove and exits at the distal end of the instrument; and A third sleeve is connected inside the second sleeve such that the outer wall of the third sleeve is in contact with the inner wall of the second sleeve. The third sleeve includes a second distal opening, which rotates and interacts with the first distal opening during tissue debridement.

2. The apparatus according to claim 1, wherein: The second sleeve further includes a second groove extending longitudinally along the length of the second sleeve; and The fluid entering the proximal opening of the first cannula will flow through the first groove and the second groove, and exit at the distal end of the instrument.

3. The device according to claim 2, wherein: The second sleeve further includes a third groove extending longitudinally along the length of the second sleeve; and The first groove, the second groove, and the third groove are spaced apart along the circumference of the second sleeve.

4. The apparatus according to claim 1, wherein: The fluid entering the proximal opening of the first sleeve will flow through a channel defined by an opening between a first boundary and a second boundary, the opening including the first groove, the first boundary including a longitudinal portion of the inner wall of the first sleeve, and the second boundary including a longitudinal portion of the outer wall of the third sleeve.

5. The device according to claim 1, wherein the first groove is linear along the length of the second sleeve.

6. The device according to claim 1, wherein the first groove is spiral-shaped along the length of the second sleeve.

7. The device according to claim 4, wherein the thickness of the channel is substantially the same as the thickness of the second sleeve between the outer wall and the inner wall of the second sleeve.

8. The device according to claim 1, wherein the outer wall of the second sleeve is flush with the inner wall of the first sleeve along the longitudinal length of the first sleeve.

9. The apparatus of claim 1, wherein Further includes: A housing attached to the proximal end of the third cannula, the housing including a port configured to be attached to an aspiration conduit for aspirating tissue after debridement or for aspirating fluid after the distal end of the instrument has exited.

10. The device of claim 1, wherein the third sleeve is sharpened along the edge of the second distal opening.

11. The apparatus of claim 1, wherein Further includes: A light source that transmits light to the location of the tissue during debridement; and An image sensor that images the location during debridement.

12. The apparatus of claim 11, wherein the first sleeve includes a channel through which light transmitted by the light source travels.

13. The apparatus of claim 1, wherein It further includes: the fluid container, wherein the fluid container is configured to be fluidly connected to a fluid source, and the fluid container is rotatable longitudinally.

14. The device of claim 1, wherein the third sleeve is removably connected within the second sleeve.

15. The device according to claim 1, wherein the third sleeve is integrated within the second sleeve; or the second sleeve is integrated within the first sleeve.

16. The device according to claim 1, wherein the length of the device is between 5 cm and 25 cm, the outer diameter of the first sleeve is between 2.2 mm and 8 mm, and the inner diameter of the third sleeve is between 2.0 mm and 7.5 mm.

17. An instrument, characterized in that... The device includes: A first sleeve is connected to a fluid container, such that fluid flows from the fluid container through a proximal opening of the first sleeve. A second cannula, connected within the first cannula such that the outer wall of the second cannula is in contact with the inner wall of the first cannula, the second cannula including a first distal opening and at least one groove extending longitudinally along the length of the second cannula, wherein fluid entering the proximal opening of the first cannula flows through the at least one groove and exits at the distal end of the instrument; and The instrument shaft is connected inside the second sleeve, such that the outer wall of the instrument shaft is in contact with the inner wall of the second sleeve.

18. A single entry surgical instrument, characterized by The single-entry surgical instrument includes: A first sleeve is connected to a fluid source, such that fluid flows from the fluid source through a proximal opening of the first sleeve; An instrument shaft extending longitudinally within a first sleeve, the outer surface of the instrument shaft including circumferentially spaced first and second structures extending longitudinally along a distal portion of the instrument shaft, the first structure being in continuous contact with a first surface of the inner wall of the first sleeve at a first position, and the second structure being in continuous contact with a second surface of the inner wall at a second position, such that the interior of the first sleeve is divided into at least two fluid channels having boundaries defined at least by the first and second positions; and The first tool extends distally from the axis of the instrument.

19. The single-entry surgical instrument according to claim 18, wherein: The interior of the instrument shaft includes a first instrument channel extending longitudinally along the instrument shaft; and The first tool extends distally from the distal end of the first instrument channel.

20. The single entry surgical instrument of claim 19, wherein Further includes: A cable conductor is connected to the proximal end of the first tool, the cable conductor passing through the first instrument channel to the proximal end of the single-entry surgical instrument.

21. The single access surgical instrument of claim 19, wherein It further includes a second tool extending axially distal to the instrument, wherein: The interior of the instrument shaft further includes a second instrument channel separate from the first instrument channel; and The second tool extends distally from the distal end of the second instrument channel.

22. The single-entry surgical instrument of claim 18, wherein the first structure and the second structure are spirally arranged around the instrument axis along the longitudinal length of the instrument axis.

23. The single-entry surgical instrument according to claim 22, wherein the first structure and the second structure are winged structures.

24. The single-entry surgical instrument according to claim 18, wherein: The at least two fluid channels include a first fluid channel and a second fluid channel; The fluid entering the proximal opening of the first sleeve will flow through the first fluid channel and exit at the distal end of the first sleeve; and The second fluid channel is configured to aspirate the fluid or tissue.

25. The single-entry surgical instrument according to claim 24, wherein: The second fluid channel is connected to a suction pipe near the first sleeve.

26. The single-entry surgical instrument according to claim 18, wherein: The outer surface of the instrument shaft further includes a third structure extending longitudinally along the distal portion of the instrument shaft, the third structure being in continuous contact with the third surface of the inner wall at a third position, and the third structure being circumferentially spaced from the first structure and the second structure. The at least two fluid channels include three or more fluid channels; and The interior of the first sleeve is divided into the three or more fluid channels, each having a boundary defined by at least the first position, the second position, and the third position.

27. The single access surgical instrument of claim 18, wherein Further includes: A light source that transmits light to the anatomical site during surgery; and An image sensor that images the anatomical site during surgery.

28. The single-entry surgical instrument according to claim 27, wherein: The image sensor is integrated into the first sleeve; and The first sleeve includes a channel through which light transmitted by the light source travels; or the distal end of the first sleeve includes the light source.

29. The single-entry surgical instrument according to claim 18, characterized in that... Further includes: A handle is located near and connected to the first sleeve and the instrument shaft, the handle including a controller configured to be actuated to move the first tool.

30. The single-entry surgical instrument according to claim 29, characterized in that... Further includes: The connector on the distal side of the handle is configured to removably attach the proximal end of the instrument shaft to the handle.

Images