SURGICAL SHAVER

Description

[0001] The invention relates to a surgical shaver with a tubular inner sleeve rotatable about its longitudinal axis, which can be connected to a rotary drive, and a tubular outer sleeve surrounding the inner sleeve.

[0002] Arthroscopic and endoscopic procedures are frequently performed to diagnose and treat joint problems. Ligament reconstruction, bone grafting, and replacement of a worn meniscus, for example, can be performed using arthroscopic reconstruction techniques, which typically require the surgeon to work through a series of relatively small openings. Such procedures may require the removal of meniscus or other soft tissue located within the joint space.

[0003] Surgical shavers are motor-driven instruments suitable for various of the aforementioned applications, for example, for the (partial) resection of meniscus tissue. Such surgical shavers have a tubular inner sleeve that rotates about its longitudinal axis and is connectable to a rotary drive, and a tubular outer sleeve that surrounds the inner sleeve and is non-rotatable relative to it. The inner sleeve is driven by a rotary drive, usually in an oscillating manner at high rotational speeds (up to several thousand revolutions per minute). This (relative) rotational movement between the inner and outer sleeves creates a cutting effect when the shaver is guided with its cutting edges on the inner and outer sleeves to the edge of the tissue to be removed.

[0004] US Pat. No. 5,741,287 A discloses a surgical shaver comprising an outer sleeve and an inner sleeve, which is rotatably received within the non-rotatable outer sleeve about its longitudinal axis, wherein the inner sleeve is connectable to a drive motor. The inner sleeve and the outer sleeve have conically tapered distal free end regions, with an oval window with cutting edges recessed adjacent to the end regions in both the outer sleeve and the inner sleeve. A further development of such a surgical shaver with a special geometric design of the window openings is known from EP 2 907 460 B1.

[0005] However, these well-known shavers still need improvement. Due to their height and the positioning of the cutting edges, these shavers are not able to sufficiently reach the tissue to be removed, for example, in narrow joint spaces. In some cases, neither a shaver nor any other instrument can be used. This often results in a relatively long operation.

[0006] A shaver is known from DE10 2019 105 514 A1. In this shaver, both the inner and outer sleeves are rotatable in opposite directions around a common longitudinal axis. The inner sleeve protrudes with its distal end from the distal end of the outer sleeve and has cutting tips in the distal end region, which make it possible to cut a hole in the tissue when applied frontally. However, this shaver cannot be used to grasp and remove a tissue edge. US 2008 / 0249553 A1 discloses a shaver with the features of the preamble of patent claim 1, which is also not suitable for grasping and removing a tissue edge.

[0007] The object of the invention is to significantly improve a surgical shaver with regard to its usability and cutting effect in order to achieve a significantly shorter operation time.

[0008] This object is achieved with a surgical shaver having the features of claim 1. Further embodiments are defined in the dependent claims.

[0009] With such a surgical shaver, significantly better cutting results can be achieved during tissue removal than with conventional shavers, so that the duration of the operation can be significantly reduced. The shaver is guided with its open distal end to the edge of the tissue to be removed and grasps the tissue edge, i.e. in this situation the tissue edge is located between the at least one cutting bar and the at least one counter bar. When the inner sleeve is then set in rotation, the shaver does not only cut in the longitudinal direction with its first cutting edge like conventional shavers, but also additionally cuts in the circumferential direction with its further inward-facing cutting edge, so that tissue can be removed in a much shorter time. In addition, the shaver can also remove tissue in narrow joint spaces without any further measures, since its distal free end can be inserted frontally into the joint space.

[0010] In a preferred embodiment, the inner sleeve has at least one longitudinally extending, longitudinally protruding second counter-web, which does not extend to the free end of the at least one cutting web. The outer surface of this second counter-web is preferably designed to taper slightly toward its free end. Particularly preferably, the inner sleeve has two first and one second counter-web.

[0011] According to a first preferred embodiment, a second cutting edge is provided on the front edge region of the at least one cutting rib, said second cutting edge having an inwardly directed component in the circumferential direction. In this embodiment, this second cutting edge is then the further cutting edge. In an outer sleeve with a second cutting edge, the first counter-rib of the inner sleeve is only long enough to leave a sufficiently large annular gap between the second cutting edge and the free, distal end of the first counter-rib for cutting the tissue in the circumferential direction.

[0012] Alternatively or additionally, a third cutting edge can be provided adjacent to the first cutting edge in the free end region of the at least one cutting ridge, said third cutting edge having an inwardly directed component in the circumferential direction. The third cutting edge is then the further cutting edge, or two further cutting edges are provided, namely the second and the third.

[0013] Furthermore, it is advantageously provided that the at least one cutting rib of the outer sleeve has a first cutting edge on both sides. The cutting rib is then effective in both directions of rotation.

[0014] Accordingly, it is preferably provided that the at least one cutting web of the outer sleeve has a third cutting edge on each of its two sides.

[0015] In a further embodiment, the third cutting edge is formed in a recess or protrusion of the cutting ridge. If the cutting ridge has a third cutting edge on both sides, both cutting edges can be formed in a recess or protrusion, or alternatively, one third cutting edge can be formed in a recess and the other third cutting edge in a protrusion. If the outer sleeve has multiple cutting ridges, their third cutting edges can also be designed identically or differently in the manner described above.

[0016] Furthermore, it can advantageously be provided that the first cutting edge has at least two cutting sections which have a different inclination relative to the longitudinal axis.

[0017] A further embodiment is characterized in that the first cutting edge is curved at least in some areas.

[0018] The third cutting edge can also be curved at least in some areas, preferably when it is formed in a recess or indentation.

[0019] The edges of the counter web(s) of the inner sleeve can also be designed as cutting edges, at least in some areas.

[0020] The invention is explained in more detail below with reference to the drawings, which show in perspective Fig. 1 a complete view of a surgical shaver, Fig. 2 a partial view of a shaver in a first embodiment, Fig. 3 the shaver according to Fig. 2 in a second position, Fig. 4 the shaver Fig. 2 in a third position, Fig. 5 a partial view of the outer sleeve of the shaver after Fig. 2 , Fig. 6the outer sleeve according Fig. 5 from a different perspective, Fig. 7 a partial view of the inner sleeve of the shaver after Fig. 2 , Fig. 8the inner sleeve according Fig. 7 from a second perspective, Fig. 9the inner sleeve after Fig. 7 from a third perspective, Fig. 10 a partial view of an outer sleeve in a second embodiment, Fig. 11 the outer sleeve according to Fig. 10 from a second perspective, Fig. 12 the outer sleeve after Fig. 10 from a third perspective, Fig. 13 a partial view of a shaver with an outer sleeve according to Fig. 10 and with an inner sleeve Fig. 7 , Fig. 14the shaver Fig. 13 in a second position, Fig. 15 the shaver Fig. 13 in a third position, Fig. 16 a partial view of an outer sleeve in a third embodiment, Fig. 17 a partial view of an outer sleeve in a fourth embodiment, Fig. 18 a partial view of an outer sleeve in a fifth embodiment, Fig. 19 a partial view of an outer sleeve in a sixth embodiment, Fig. 20 a partial view of an outer sleeve in a seventh embodiment, Fig. 21 the outer sleeve according to Fig. 20from a second perspective, Fig. 22 a partial view of an outer sleeve in an eighth embodiment, Fig. 23 the outer sleeve according to Fig. 22 from a second perspective, Fig. 24 a partial view of an outer sleeve in a ninth embodiment and Fig. 25 a partial view of an outer sleeve in a tenth embodiment.

[0021] A surgical shaver according to the invention is in Fig. 1generally designated 1. This shaver 1 has at its rear end a coupling piece, generally designated 2, for coupling to a rotary drive (not shown). A tubular outer sleeve 3 is arranged on the coupling piece 2 in a rotationally fixed manner. Within this outer sleeve 3, a tubular inner sleeve 4 is received, which can rotate relative to the outer sleeve 3 about a longitudinal axis 5 of the shaver 1. For this purpose, the inner sleeve 4 is coupled in the usual way via the coupling piece 2 to the rotary shaft of the rotary drive. The rotary drive can set the inner sleeve 4 in a rotary motion at high speeds (several thousand revolutions per minute), preferably in an oscillating manner. The annular gap between the inner sleeve 4 and outer sleeve 3 is dimensioned such that the inner sleeve 4 is, on the one hand, guided largely centrally to the longitudinal axis 5 and, on the other hand, is received freely rotatably within the outer sleeve 3.

[0022] Essential to the invention is the design of the shaver 1 in its Fig. 1 generally designated 6 free distal end region or the design of the outer sleeve 3 and the inner sleeve 4 in the free distal end region 6. This design is shown in various embodiments in the Figures 2 to 25 , wherein both the outer sleeve 3 and the inner sleeve 4 are each shown only in the free end region 6 of the shaver 1. The free distal ends of the inner sleeve 4 and the outer sleeve 5 are open in the longitudinal direction, i.e. in the direction of the longitudinal axis 5, in all embodiments, so that the shaver 1 can engage with its free end region 6 around the edge of a tissue (not shown) to be severed (for example, meniscus tissue) when the longitudinal axis 5 of the shaver 1 approximately coincides with the surface of the tissue.

[0023] A first embodiment of the outer sleeve 3 and the inner sleeve 4 is shown greatly enlarged in Figures 2 to 9. The outer sleeve 3 has, adjacent to its tubular region 3a in the region of its free end, at least one longitudinally extending, longitudinally projecting cutting ridge 7, wherein two cutting ridges 7 are provided in all illustrated embodiments. Each cutting ridge 7 has a first cutting edge 8 with a component in the longitudinal direction. This first cutting edge 8 extends from the base region 7a of the cutting ridge 7 and is arcuate in the first embodiment. Each cutting ridge 7 further has, in the free end region 6, at least one further cutting edge with an inwardly directed component in the circumferential direction. In the first embodiment according to Figures 2 to 6This additional cutting edge is formed by a second cutting edge 9 on the front edge region 7b of the cutting ridge 7. Both cutting ridges 7 are identical in the first embodiment.

[0024] The inner sleeve 4 has, adjacent to its tubular region 4a in the region of its free end, at least one longitudinally extending, longitudinally projecting first counter-web 10, which extends substantially to the free end of the at least one cutting web 7. As best seen from the Figures 2 to 4 As can be seen, in this first embodiment, the first counter-web 10 is slightly shorter than the respective cutting web 7, so that an annular gap for the tissue to be severed remains between the free end of the first counter-web 10 and the second cutting edge 9. The longitudinal edges 10a of the first counter-web 10 are preferably designed such that they also form cutting edges.

[0025] In the first embodiment, the inner sleeve 4 has two identically designed first counter webs 10. Furthermore, the inner sleeve 4 has at least one longitudinally extending, longitudinally projecting second counter web 11, which does not extend to the free end of the at least one cutting web 7, but is preferably substantially shorter. The second counter web 11 is preferably designed such that its outer surface 11a tapers slightly inwardly, so that the distance between the second counter web 11 and the cutting webs 7, viewed in the longitudinal direction, increases towards the free end of the second counter web 11. The longitudinal edges 11b of the second counter web 10 are preferably designed such that they also form cutting edges.

[0026] In the Figures 2 to 4 Three different rotational positions between the outer sleeve 3 and the inner sleeve 4 are shown. In the position according to Fig. 2A first counter-web 10 is located in contact (naturally at a certain distance) with a cutting web 7, so that the free distal end of the first counter-web 10 is located in the region of the second cutting edge 9 of the cutting web 7, and thus tissue (not shown) is severed by the second cutting edge 9 in the circumferential direction. In addition, a longitudinal edge 10a of the first counter-web 10 is located approximately point-like in contact with the first cutting edge 8. As a result, the tissue (not shown) is severed by the first cutting edge 8 essentially in the longitudinal direction. Figures 3 and 4 show further rotational positions with correspondingly changed spatial assignments of the cutting webs 7 and the first and second counter webs 10, 11.

[0027] It can be seen that due to the design of shaver 1, i.e., its free end region 6, the tissue to be severed is not only severed longitudinally, as with known shavers, but also circumferentially. This allows tissue to be removed in a significantly shorter time.

[0028] In the Figures 10 to 12A second embodiment of the outer sleeve 3 is shown. In contrast to the first embodiment, each cutting ridge 7 has, on one side adjacent to the first cutting edge 8, a further cutting edge, namely a third cutting edge 12, which has an inwardly directed component in the circumferential direction. This third cutting edge 12 is formed in a recess 13 of the cutting ridge 7 and is arcuate. The third cutting edge 12 merges into the second cutting edge 9 towards the free distal end. In a modification of this embodiment, the second cutting edge 9 can also be omitted; in this case, the third cutting edge 12 is the only further cutting edge.

[0029] In this embodiment, the indentations 13 of the two cutting ribs 7 are oriented opposite to each other in the circumferential direction, so that, depending on the direction of rotation, only one of the two third cutting edges 12 is effective. In a further embodiment, indentations 13 with third cutting edges 12 can also be provided on both sides of the respective cutting rib 7. As shown, however, the side of the cutting rib 7 without the indentation 13 can also be designed as in the first embodiment.

[0030] In the Figures 13 to 15 the outer sleeve 3 according to the second embodiment is shown together with an unchanged inner sleeve 4 in three different rotational positions.

[0031] In Fig. 16a third embodiment of the outer sleeve 3 is shown. In this embodiment, the outer sleeve 3 has a third cutting edge 12 on a cutting web 7, which is curved along a bulge 14. In principle, both cutting webs 7 in this third embodiment can each have at least one bulge 14 with a second cutting edge 12. It is also possible for an indentation 13 with a third cutting edge 12 to be provided on one side of a cutting web 7 and a bulge 14 with a third cutting edge 12 to be provided on the other side. If two cutting webs 7 are present, at least one indentation 13 and / or bulge 14 can be provided on them in different orientations.

[0032] In Fig. 17 a fourth embodiment of the outer sleeve 3 is shown, which differs from that according to Fig. 16only differs in that the bulge 14 and the second cutting edge 12 formed on it are not curved but rectangular.

[0033] Fig. 18 shows a fifth embodiment of the outer sleeve 3. In this embodiment, a rectangular indentation 13 is provided on a cutting web 7. The third cutting edge 12 merges into the second cutting edge 9. In this embodiment, in contrast to the second embodiment, an indentation 13 is provided only on one cutting web 7.

[0034] Fig. 19 shows a sixth embodiment of the outer sleeve 3. This embodiment differs from that according to Fig. 18 only because the indentation 13 and thus the course of the third cutting edge 12 is curved.

[0035] The Figures 20 and 21show an outer sleeve 3 in a seventh embodiment. On a cutting web 7, the first cutting edge 8 has two cutting sections 8a and 8b, which have a different inclination relative to the longitudinal axis 4. A first cutting section 8a is arcuate, while the second cutting section 8b is essentially straight. Furthermore, this cutting web 7 is provided with the second cutting edge 9 continuing into an annular web 15.

[0036] The Figures 22 and 23 show an outer sleeve 3 in an eighth embodiment. This eighth embodiment of the outer sleeve 3 differs from the seventh embodiment only in that the web 15 is omitted.

[0037] In Fig. 24A ninth embodiment of the outer sleeve 3 is shown. In this embodiment, two cutting ribs 7 are provided, one cutting rib 7 having an arcuate indentation 13 with a third cutting edge 12, and the other cutting rib 7 having an arcuate protrusion 14 with a third cutting edge 12. Furthermore, first and second cutting edges 8, 9 are present on both cutting ribs 7.

[0038] Finally, in Fig. 25 A tenth embodiment of the outer sleeve 3 is shown. This embodiment differs from the ninth embodiment only in that the indentation 13 with the third cutting edge 12 on one cutting web 7 and the bulge 14 with the third cutting edge 12 on the other cutting web 7 are not arcuate, but rectangular.

[0039] Of course, the invention is not limited to the illustrated embodiments. Further configurations are possible without departing from the basic concept. Thus, the various geometric configurations of the outer sleeve 3 can be combined with one another in any way within the scope of the previously described embodiments. For example, a cutting rib 7 can have an indentation 13 on one side and a bulge 14 on the other side. In principle, only one cutting rib 7 can be provided, or alternatively, more than two. The inner sleeve 4 can also have only a first counter-rib 10, with or without a second counter-rib 11. List of reference symbols:

[0040] 1 surgical shaver 2 coupling piece 3 outer sleeve 3 tubular area 4 inner sleeve 4 tubular area 5 longitudinal axis 6 free end area 7 cutting ridge 7 a foot area 7 b edge area 8 first cutting edge 8 a first cutting section 8 b second cutting section 9 second cutting edge 10 first counter ridge 10 a longitudinal edge 11 second counter ridge 11 a outer surface 11 b longitudinal edge 12 third cutting edge 13 indentation 14 protrusion 15 ridge

Claims

1. Surgical shaver with a tubular inner sleeve (4) which can be rotated about its longitudinal axis (5) and can be connected to a rotation drive, and with a tubular outer sleeve (3) which surrounds the inner sleeve (4) and is rotationally fixed with respect thereto, wherein the free distal ends of the inner sleeve (4) and of the outer sleeve (3) are open in the longitudinal direction, and wherein the outer sleeve (3) has, in the region of its free end, at least one cutting bar (7) extending in the longitudinal direction, projecting in the longitudinal direction and with at least one first cutting edge (8) which has a component in the longitudinal direction and starts from the foot region (7a) of the cutting bar (7), and wherein the inner sleeve (4) has, in the region of its free end, at least one first mating bar (10) extending in the longitudinal direction, projecting in the longitudinal direction and extending substantially up to the free end of the at least one cutting bar (7), characterized in that the at least one cutting bar (7) of the outer sleeve (3) has at least one further cutting edge (9, 12) in the free end region, which edge has a component that is directed inward in the circumference direction.

2. Shaver according to claim 1, characterized in that the inner sleeve (4) has at least a second mating bar (11) that extends in the longitudinal direction and projects in the longitudinal direction, which bar does not extend all the way to the free end of the at least one cutting bar (7).

3. Shaver according to claim 1 or 2, characterized in that a second cutting edge (9) is provided on the end-face edge region (7b) of the at least one cutting bar (7), which edge has a component that is directed inward in the circumference direction.

4. Shaver according to claim 1, 2 or 3, characterized in that a third cutting edge (12) is provided adjacent to the first cutting edge (8), in the free end region of the at least one cutting bar (7), which edge has a component that is directed inward in the circumference direction.

5. Shaver according to one or more of claims 1 to 4, characterized in that the at least one cutting bar (7) of the outer sleeve (3) has a first cutting edge (8) on both sides, in each instance.

6. Shaver according to claim 4 or 5, characterized in that the at least one cutting bar (7) of the outer sleeve (3) has a third cutting edge (12) on both sides, in each instance.

7. Shaver according to one or more of claims 4 to 6, characterized in that the third cutting edge (12) is formed in an indentation (13) or convexity (14) of the cutting bar (7).

8. Shaver according to one or more of claims 1 to 7, characterized in that the first cutting edge (8) has at least two cutting sections (8a, 8b) which have a different inclination relative to the longitudinal axis.

9. Shaver according to one or more of claims 1 to 7, characterized in that the first cutting edge (8) is formed in arc shape, at least in certain regions.

10. Shaver according to one or more of claims 1 to 9, characterized in that the third cutting edge (12) is formed in arc shape, at least in certain regions.