Orthopedic Arthroscopy Optical Cannula System

Abstract

The implementations described herein are directed to an improved orthopedic arthroscopy system that reduces the number of arthroscopic portals required while at the same time improving endoscopic visualization and instrumentation capabilities within the joint space. The primary embodiment of the disclosed system replaces a traditional rod-like endoscope with a rotatable optical cannula through which instruments can be passed for use in manipulating tissue and performing surgery. The addition of the cannula's rotational ability allows for easy adjustment of visualization of the instrument's tool tip. The disclosed system eliminates the need for unnecessary wrist rotation by the surgeon, making it easier to adjust hand position while performing a surgical task.

Description

[Technical field]

[0001] cross reference This application claims the benefit of U.S. Patent Application No. 63 / 169,366, filed April 1, 2021, which is incorporated by reference herein in its entirety.

[0002] The present disclosure relates generally to devices, systems, and methods for arthroscopic procedures. [Background technology]

[0003] Arthroscopy is a procedure to diagnose and treat joint problems. The surgeon inserts a small tube or cannula into the joint space through a small incision or portal. A fiber optic or endoscopic camera is then passed through the portal and used to transmit high resolution images of the joint space to a video monitor. Arthroscopy allows the surgeon to see inside the joint without making a large incision. Arthroscopy is used to visualize many joints, including the knee, hip, shoulder, ankle, spine, and wrist. Traditional arthroscopy uses a single portal for an endoscope and a second portal to pass instrumentation used to manipulate tissue within the joint space. Summary of the Invention [Means for solving the problem]

[0004] The implementations described herein are directed to an improved orthopedic arthroscopy system that reduces the number of arthroscopic portals required while at the same time improving endoscopic visualization and instrumentation capabilities within the joint space. The primary embodiment of the disclosed system replaces a conventional rod-like endoscope with a rotatable optical cannula through which instruments can be passed for use in manipulating tissue and performing surgery. Reusable and disposable implementations of such a system are envisioned. By adding the rotational ability of the cannula, visualization of the instrument's tool tip can be easily adjusted by rotation about the longitudinal axis of the cannula. Conventional optically enabled spinal cannulas cannot be rotated independently of the handle. The disclosed system eliminates the need for unnecessary wrist rotation by the surgeon, making it easier to adjust hand position while performing a surgical task. Features and aspects of the disclosed technology allow for mechanized operation of the instrument's tools through an endoscope handle that is operated and held in the same hand. This ability frees the other hand to rotate the cannula via a holding dial, thus allowing the surgeon's tool actuating grip and wrist position to remain stationary in a comfortable ergonomic position.

[0005] In certain implementations, the electrical wires carrying the camera signal from the cannula tip through the length of the cannula interface via an electrical coupler (e.g., an electrical commutator or service loop) that allows at least 90 degrees of cannula rotation (or alternatively, at least 360 degrees of cannula rotation, or unlimited cannula rotation) without breaking the electrical connection.

[0006] In conventional arthroscopy systems, as the diameter of the endoscope tip becomes smaller, fewer optical fibers are allocated to image capture and more optical fibers are required for light delivery. Conventional spinal arthroscopy techniques also have LED light sources and camera chips separate from the arthroscopic handle. Light is transmitted from an LED source housed in an external box through a long fiber optic cable to the cannula. Using the techniques described herein, an optical camera chip (e.g., a complementary metal oxide semiconductor (CMOS), charge-coupled device (CCD), lens, or other type of image sensor) is placed at the tip of the arthroscopic cannula. The placement of the optical camera chip at the distal tip can increase image resolution. This implementation includes an LED light source either housed in the arthroscopic handle or positioned at the tip of the cannula, thus eliminating the need for a separate video rack to hold separate light sources that take up space in the operating room and increase the cost of the equipment. Another embodiment of this invention provides a multi-camera chip design with camera sensors angled slightly away from each other in a divergent manner. The angle of divergence and number of CMOS chips may vary, but utilizing this design allows the cannula working passage to be digitally subtracted from the overall image, thereby improving visualization of the joint space without the need for removal of the instrument shaft. Alternatively, integrating multiple camera chips at different angles allows a split view of the joint space to be presented on a monitor, head mounted display, or handheld display device. In other embodiments, through the use of AI (artificial intelligence) technology, multiple 2D images obtained from multiple cameras positioned at the tip of the cannula can be used to create a 3D image or virtual reality depiction of the anatomical joint space.

[0007] The embodiments disclosed herein allow for two different instrumentation approaches through the optical cannula. The first approach involves passing an instrument through the optical cannula from proximal to distal. The tool tip in this situation must remain smaller than the working channel diameter to effectively advance the instrument through the cannula. The second approach allows a removable instrument shaft (with a tool tip attached distally) to be advanced through the cannula from distal to proximal. In both situations, the proximal end of the tool shaft can be made to engage a portion of the mechanized handle in a manner that allows the surgeon to operate the tool tip attached to the distal end of the instrument shaft by squeezing a lever built into the design of the endoscope handle. For those instrument shafts passed distal to proximal, the tool tip can remain larger than the working channel of the cannula, thus allowing for larger tool options for a particular surgical application. In some embodiments, the handle of the mechanized endoscope remains in a straight line orientation to the instrument shaft, allowing for a right-handed surgeon's grasp. In other implementations, the endoscope handle may be offset from the long axis of the optical cannula and instrument shaft, thereby allowing the surgeon to hold the device in a more "pistol-like grip" fashion. In certain instances, it may be advantageous to utilize a conventional arthroscopic forceps (with a handle already attached and a tool tip sized small enough to pass the disclosed optical cannula). In these situations, there is no need for a mechanized handle portion of the disclosed device. While most arthroscopic systems currently on the market are capable of passing instruments, current systems do not have the option of both passive and active methods for instrument engagement, thus limiting their surgical applications.

[0008] Other features of the invention include means for maintaining organized and immobile positioning of the electrical suction and irrigation hoses behind the endoscope handle during surgery. An embodiment of the system utilizes a disposable suction / irrigation harness that fits removably or permanently around the cannula in a watertight manner. Within the harness are peripheral fluid and / or suction chambers that line up with corresponding holes or ports disposed through the outer wall of the optical cannula. Inside the cannula, these holes communicate with suction and irrigation spaces or passages formed between the instrument shaft and the cannula wall. In some embodiments, the holes are offset from one another along the periphery of the outer cannula to separate the two fluid passages as much as possible. Cannula embodiments that use inserted instrument shafts rather than integrated working passages in the cannula to form the fluid passages maximize the inner diameter of the cannula for passage of more rigid or flexible instrument tips, shafts, and microdebriders. By applying these or similar practices, suction and irrigation capabilities can remain constant even during cannula rotation. Thus, the traditional vertical or angled orientation of the side suction / irrigation ports found in existing arthroscopic cannula systems is eliminated. Utilizing this methodology, all hoses and endoscope cords will remain in a stable position even while the cannula is rotated. Thus, the hoses and cords can be bundled together and secured in a neat bundle behind the device, thereby improving clutter in the surgical field.

[0009] In some implementations, the endoscope handle and cannula may be disposable, along with the integrated optics and irrigation / aspiration passageways. In these implementations, the electrical coupler connecting the cannula camera line to the endoscope handle may be housed or included in the aspiration / irrigation harness with slack lines (i.e., service loops) to allow rotation of the cannula. In other implementations, the endoscope handle may be reusable, but may be cased in a manner that allows for easy cleaning and sterilization. In other embodiments, the individual system components and optical interface connections may be either disposable or reusable. If the optical cannula and endoscope handle are configured for reusable use, the electrical connection may utilize peripheral electrical contact leads or bands around the outer cannula periphery (i.e., commutator). Still other electrical contact methods to allow free rotation are contemplated. Regardless of reusability, all of the individual components of the disclosed system combine in a manner that is intuitive and easy to assemble, disassemble, and clean / sterilize.

[0010] In yet other embodiments, the optical and rotatable cannula may be articulated. The direction and angle of articulation may vary, but may be unidirectional or multidirectional with angulation anywhere between 0 and 180 degrees. Actuation of articulation may involve a dial, lever, telescopic mechanism, robotic mechanism, or some other integrated means built into or attached to the endoscope handle or optical forceps system. Such mechanisms would largely eliminate the need to lever the cannula to access poorly visualized areas of the joint space. This further serves to minimize tissue damage and instrument breakage. An articulated cannula would further enable and extend the use of flexible instrument shafts and microdebriders. Such advances may be applied to other surgical specialties, including, but not limited to, ENT, neurosurgery, general surgery, urology, obstetrics and gynecology, plastic surgery, podiatry, veterinary medicine, and the like. In some implementations, one or more notches may be incorporated into the side or tip of the cannula to allow for facilitated articulation of the instrument shaft as it exits the distal cannula.

[0011] The foregoing summary is merely illustrative and is not intended to be limiting. Other aspects, features, and advantages of the systems, devices, and methods and / or other subject matter described in this application will become apparent in the teachings set forth below. The summary is provided to introduce a selection of some of the concepts of the present disclosure. The summary is not intended to identify key or essential features of the subject matter described herein.

[0012] The present disclosure, in accordance with one or more implementations, is described in detail with reference to the accompanying drawings. The figures are provided for illustrative purposes only and merely depict example implementations. Furthermore, it should be noted that for clarity and ease of illustration, elements in the figures are not necessarily drawn to scale.

[0013] Some of the figures included herein show various implementations of the disclosed technology from different viewing angles. Although the accompanying description may refer to views such as "top," "bottom," "front," "rear," or "side" views, such references are for illustrative purposes only and do not imply or require that the disclosed technology be implemented or used in a specific, particular orientation unless expressly stated otherwise. [Brief description of the drawings]

[0014] [Figure 1] FIG. 2 is a side view of the optical cannula system. [Diagram 2] FIG. 2 is an exploded view of the optical cannula system shown in FIG. 1. [Diagram 3] FIG. 2 is a front view of the optical cannula system of FIG. 1. [Figure 4] FIG. 2 is a perspective view of the two camera cannula embodiment of FIG. [Diagram 5] FIG. 3 is an example of image cancellation obtained from the two camera cannula of FIG. 2. [Figure 6] FIG. 2 illustrates an example of an electrical coupler for transmitting image data in accordance with an implementation of the present disclosure. [Figure 7] FIG. 2 is a front view of an optical cannula housing a camera chip and the resulting spatial relationship of the camera chip to the cannula due to its position. [Figure 8] 2 is a perspective view of the optical cannula of FIG. 1 attached to an aspiration / irrigation harness in accordance with an implementation of the present disclosure. [Figure 9] FIG. 9 is a sagittal section through the cannula and aspiration / irrigation harness depicted in FIG. 8. [Figure 10A] FIG. 1 is a perspective view of an endoscope having an electrical cable attached thereto. [Figure 10B] 1 is a perspective view of the endoscope handle in greater detail, highlighting various cutouts and recesses designed to accommodate various other components of the optical cannula system 100. FIG. [Figure 11]13 is a diagram of an instrument lock key prior to engagement with an instrument shaft and lever component of an endoscope handle in accordance with an implementation of the present disclosure. [Figure 12] 2 is a bottom view of the optical cannula system of FIG. 1 highlighting the neat nature of where the endoscope cord and suction / irrigation hoses exit the device in accordance with an implementation of the present disclosure. [Figure 13] FIG. 2 is a coronal cutaway rear view of the optical cannula system of FIG. 1. [Figure 14] 1A-1C are diagrams of another embodiment of an optical cannula system. [Figure 15] FIG. 15 is a diagram of the optical cannula system of FIG. 14 including an endoscope and a tool. [Figure 16] FIG. 15 is an endoscope view of the optical cannula system of FIG. 14. [Figure 17] FIG. 17 is an exploded view of the endoscope of FIG. 16. [Figure 18] FIG. 17 is a rear view of the endoscope of FIG. 16. [Figure 19] FIG. 17 is a front view of the endoscope of FIG. 16. [Figure 20] FIG. 20 is a cross-sectional view taken at line 20-20 of FIG. 18. [Figure 21] FIG. 21 is a detail of FIG. 20. [Figure 22] FIG. 17 is a view of the distal tip of the cannula of the endoscope of FIG. 16. [Diagram 23] 17 is a front view of the distal tip of the cannula of the endoscope of FIG. 16, including a tool shaft within the working channel. [Figure 24] FIG. 15 is a diagram of a tool of the optical cannula system of FIG. 14. [Diagram 25] FIG. 25 is an exploded view of the tool of FIG. 24. [Figure 26] FIG. 25 is a cross-sectional view of the gripping portion of the tool of FIG. 24. [Figure 27] FIG. 13 is a view of the gripping portion of the tool in an open configuration for assembling and disassembling the shaft of the tool. [Figure 28] 15 is a cross-sectional view of the optical cannula system of FIG. 14 in a first configuration. [Figure 29]15 is a cross-sectional view of the optical cannula system of FIG. 14 in a second configuration. [Diagram 30] FIG. 29 is a detail of FIG. 28. [Diagram 31] FIG. 15 is a diagram of the optical cannula system of FIG. 14 with the body of the endoscope removed for clarity. [Diagram 32] FIG. 15 is a diagram of the optical cannula system of FIG. 14 with the body of the endoscope, harness block, and rotating member removed for clarity. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0015] Various features and advantages of the systems, devices, and methods of the technology described herein will become more fully apparent from the following description of examples illustrated in the figures. These examples are intended to illustrate the principles of the disclosure, and the disclosure should not be limited to only the illustrated examples. Features of the illustrated examples can be modified, combined, eliminated, and / or substituted as would be apparent to one skilled in the art upon consideration of the principles disclosed herein.

[0016] Arthroscopy is a procedure for diagnosing and treating joint problems. The surgeon inserts a small tube or cannula into the joint space through a small incision or portal. A fiber optic or endoscopic camera is then passed through the portal and used to transmit high resolution images of the joint space to a video monitor. Arthroscopy allows the surgeon to see inside the joint without making a large incision. Arthroscopy is used to visualize many joints, including the knee, hip, shoulder, ankle, spine, and wrist. Traditional arthroscopy uses a single portal for an endoscope (with or without irrigation and suction) and a second portal to pass instrumentation used to manipulate tissue within the joint space. A current trend in the surgical orthopedic market is the miniaturization of arthroscopes and associated instrumental forceps. Newer arthroscopic systems, such as the Nanoscope system made by Arthrex, use a very small endoscopic cannula in one portal and a second portal to pass a miniaturized forceps used for tissue manipulation in the second portal.

[0017] Smaller incisions and fewer portals allow for improved patient comfort, lower costs, reduced surgical time, and the ability to perform arthroscopic procedures in the clinic rather than in a hospital or ambulatory surgery center setting. Until recently, systems that visualize and manipulate tissue through a single portal have rarely been considered. The Stryker SPA system uses a two cannula device that is inserted through only one portal incision. Unfortunately, the portal is sized to accept both cannulas, one for the endoscope and the other for the powered microdebrider. Having to manipulate two cannulas through only one portal is technically challenging.

[0018] Arthroscopy generally requires irrigation fluids and suction to flush debris and swell the joint for improved visualization. Suction and irrigation hoses attach to connectors on the outside of a rigid cannula through which the endoscope is passed. These hoses are oriented perpendicular to the long axis of the cannula and extend laterally off the cannula, thereby increasing surgical clutter in the field and frustration for the surgeon during the procedure. The camera head cable and fiber optic light cable further increase the number of tangled cables and hoses in the surgical field. When using a suction microdebrider powered through a second portal, two additional cables / hoses are added to this mess, so that it is not uncommon to have a total of six hoses / cords competing for space in the surgical field. The surgeon must rotate and twist the scope during the procedure to improve visualization, and the hoses often become tangled and twisted, making the situation more difficult and frustrating for the surgeon and scrub nurses.

[0019] Traditional arthroscopy used standard rod-like fiberoptic endoscopes for visualization. These endoscopes have a distal tip that allows visualization at different angles depending on the endoscope. Some examples include 0 degree, 30 degree, and 70 degree rigid endoscopes. When an endoscope with an angled field of view is passed into the joint space, the surgeon must rotate the scope along its horizontal axis to visualize the entire joint space. The surgeon must also lever the rod of the scope in multiple directions to obtain a larger field of view. This rocking or levering handling of the scope as it passes through the portal can result in greater trauma to the incision site and the joint space, not to mention damage to the scope and increased fatigue for the surgeon.

[0020] Traditionally, only one instrument can be passed through the arthroscopic portal at a time. Some spinal arthroscopy systems have begun to utilize a single rigid fiber optic cannula through which instruments can be passed (JOIMAX® Minimally Invasive Spine Surgery). These systems utilize fiber optic strands to transmit images from the joint space, through the cannula, to a camera head CMOS chip attached to the proximal end of the instrument cannula. This results in image quality that is potentially limited by the number of optical fibers that deliver the image to the CMOS sensor. With improvements in miniaturization and resolution of CMOS chip technology, an endoscopic camera / CMOS chip located at the tip of the cannula becomes advantageous. Similarly, these optical spinal cannulas require the entire handle to be rotated to change the viewing angle or view around the instrument shaft. Such an action causes hoses and cords that detach from the handle to flap around the rear of the handle while the cannula is being turned. These cannulas are also larger in diameter and in all instances require that instruments be passed through the cannula from proximal to distal and manipulated by a second hand.

[0021] In some orthopedic arthroscopic procedures, a second instrument is required to effectively manage the surgical task. When a second instrument is required, it becomes necessary to create a third incision / portal to accommodate the second instrument. This increases operative time, tissue damage, and patient discomfort. Clearly, any means by which a surgeon can improve image resolution, limit the number of surgical portals, reduce the size of the incision, reduce the need for endoscopic rotation and / or lever manipulation, and minimize the number of surgical cords / hoses in the operative field would be a beneficial and welcomed advantage to the global surgical commerce.

[0022] As previously mentioned, orthopedic arthroscopic cannulas, arthroscopic instruments, and arthroscopic endoscopes (arthroscopes) have limitations with respect to the ability to operate and visualize through a single portal and cannula. Current systems are cumbersome, difficult to set up, require augmented video and stacked accessories to operate, and are not integrated in an accessible manner. Other limitations of current arthroscopic systems include limited visualization within the joint space, the need for lever manipulation of the arthroscope to access different parts of the joint space, the need for a second or third incision / portal for instrument access, suction hoses, irrigation tubing, and electrical cable management, awkward hand / wrist positioning for the surgeon, and the inability to rotate the camera orientation relative to the instrument shaft and tool tip (and vice versa).

[0023] To that end, implementation of this disclosure is directed to the design of an improved arthroscopy system that corrects these current deficiencies while at the same time reducing the number of necessary portals required for a particular procedure. In effect, implementation of this disclosure frees the surgeon with one hand and at least one surgical portal. In doing so, the surgeon can manipulate the tip with one hand while visualizing and using mechanical instrumentation with the other. The rotating cannula design allows the image angle to be changed without having to turn the entire wrist or the entire endoscope handle. This simplified ergonomic approach improves physician fatigue and minimizes tasks that would normally require a second assistant. It also reduces surgical time, increases patient comfort, fewer parts require sterilization, improves optical clarity, and reduces the overall cost of the procedure. Implementation of the disclosed system also allows the surgeon to perform instrumentation with tools larger than the diameter in the optical cannula while maintaining optical visualization of the tool tip. The implementations disclosed herein offer better "mousetraps" and improved options for surgical instrumentation and visualization during arthroscopy. Very importantly, implementations of this device make it easier to move surgical procedures from hospitals and outpatient medical centers to physician offices, thereby reducing facility and anesthesia costs and improving surgeon efficiency and patient satisfaction.

[0024] 1-2 show an implementation of a rotatable optical cannula system 100 according to the present disclosure. As shown in FIGS. 1-2, the optical cannula system 100 may include a reusable or disposable cannula 120 with an outer rotating dial 130. The cannula fits within an elongated semicircular recess (178 in FIG. 10A) located on the top surface of an endoscope handle 170. The rotating dial 130 has an annular extension 125 that fits within a molded recess (173 in FIG. 2) in the inner surface of the distal endoscope handle 170. When attached to the endoscope handle, rotation of the rotating dial 130 rotates the optical cannula in a circumferential manner either clockwise or counterclockwise. Located at the proximal end of the cannula 120 is an aspiration / irrigation harness 140 that is permanently or removably attached to the optical cannula 120. The cannula is free to rotate within the irrigation harness when secured to the endoscope handle. Within the proximal face of endoscope handle 170 is a molded recess designed to accept irrigation harness 140 using a "snap-in" mechanism or alternative means such as magnets, clips, fasteners, grooves, or other means not limited to the implementations described herein. Not depicted in Figures 1-2 is an electrical coupler located along the underside of irrigation harness 140 and a separate mating electrical coupler (see item 177 in Figure 10A) within proximal molded recess 174 of handle 170.

[0025] In certain implementations, a removable lever 175 is attached to the endoscope handle 170. Along the proximal face of the lever are extensions 171 on both sides. These lever extensions engage a removable locking key 150 designed to integrate into the rear end of the instrument shaft 110. The instrument shaft 110 is comprised of an inner shaft 199 and an outer shaft 190. Movement of the inner instrument shaft within the outer shaft causes mechanized movement of a tool tip attached to the end of the instrument shaft 110 (not shown). Hinged movement of the lever relative to the endoscope body causes the locking key to reversibly move the inner instrument shaft in the opposite direction to the outer instrument shaft. In doing so, the tool tip is actuated. In certain situations where the mechanized aspect of the endoscope handle is not required, the instrument lever can be removed or snapped into a matching recess molded into the body of the endoscope handle 172. Locking the lever 175 into the handle recess 172 can be facilitated by a magnet or alternative mechanism, depending on the implementation.

[0026] Rearward of the locking key 150 is a rotatable instrument shaft rotation dial 160 that internally engages with a small circular gear 117 formed in a small horizontal portion of the outer instrument shaft 110. The instrument shaft rotation dial 160 rotates independently of the locking key 150. When the locking key 150 is fully engaged, a gear projection within the inner periphery of the rotation dial engages with a gear projection on the outer instrument shaft in a manner that allows easy rotation of the instrument shaft as it exits the proximal end of the optical cannula. Instrument shaft rotation is thereby independent of the optical cannula rotation, which is accomplished by rotating a separate rotation dial 130 positioned at the opposite, more distal end of the cannula.

[0027] A removable endoscope electrical cable 180 is shown connecting to the proximal, lower surface of the endoscope handle 170. A suction hose 185 and an irrigation hose 186 are attached to the lower surface of the suction / irrigation harness (FIG. 11). Various implementations of how the suction and irrigation hoses interact with the suction / irrigation harness 140 are envisioned and described later herein. However, when compared to current systems, it is clear that the neat orientation of all the electrical cables and suction / irrigation hoses is advantageous.

[0028] FIG. 3 shows a front view of the disclosed optical cannula system 100. FIG. 3 highlights the internal features of the optical cannula 120. In this implementation, a single camera CMOS chip 200 is seen just inside the periphery of the cannula. It is important to note that in these implementations, the camera chip is located at the distal tip of the cannula, not inside a separate camera head attached to the proximal end of the cannula or endoscope handle. Locating the CMOS sensor at the tip of the cannula eliminates the loss of image resolution seen in conventional systems that use limited optical fiber to transmit images to a distal sensor. As imaging technology advances and CMOS chips decrease in size and improve in resolution, implementations of the disclosed system will show incremental improvements in the quality of the displayed image when compared to systems that use conventional optical fiber technology.

[0029] FIG. 3 shows irrigation and aspiration passages 210 and 220 circumferentially oriented within the lumen or cannula 120. These irrigation and aspiration passages are carried horizontally along the length of the cannula and ultimately terminate in holes in the outer cannula that communicate with fluid chambers located in the irrigation / aspiration harness 140 mounted along the rear end of the cannula. The boundaries of the irrigation and aspiration passages of the optical cannula are formed by the instrument shaft 110 and / or instrument working passage 230 on the inside, the optical cannula wall 121 on the outside, and the CMOS chip and optical fiber 200 in the center. In other implementations, an LED emitter located next to the CMOS chip may be used instead of the fiber optic. In some implementations, there may not be a separate inner working cannula incorporated into the central lumen of the outer cannula, and in other implementations, only the instrument shaft can act as the inner boundary for the irrigation and aspiration passages of the cannula.

[0030] FIG. 4 shows a perspective view of a two camera chip optical cannula 300, which may be one implementation of the cannula 120. Small gaps 320, 321 adjacent to the sides of the CMOS chips 310, 311 can be used to accommodate optical fibers or LED emitters required for joint illumination. By utilizing two separate CMOS chips in a divergent orientation, both camera images may be displayed individually or side-by-side on a split image monitor. Each image provides a different viewing angle of the anatomical view. Alternatively, the images may be digitally combined or "stitched" together in a manner that creates a larger panoramic view. In this implementation, the CMOS chips of the optical cannula embodiment 300 are oriented with a divergence of 30 degrees from the center. Cannula systems with varying angles of divergence of the camera chips using more than one camera CMOS chip are envisioned. By incorporating multiple camera chips into the tip of the cannula, multiple regions of the joint space can be visualized simultaneously and displayed in segmented 3D or panoramic fashion on a monitor display. Conventional arthroscopic systems have a limited field of view that is restricted by the angulation of the rigid scope lens.

[0031] FIG. 5 shows a diagrammatic depiction of an example of image cancellation using a two camera chip cannula configuration. In this application, computerized digital manipulation of the combined CMOS camera images allows the cancellation / removal of the display of the instrument shaft occupying the central plane of the surgical field of view. A split screen image 330 of two photographs without the alterations produced by the divergent CMOS sensors is located at the top of this figure. The visualized object 360 is obscured by the instrument shaft 370 shown centrally along the inner surface of each top photograph. The lower left photograph 340 combines the digitally manipulated photographs into a single photograph in a manner that shows a transparent but still visible outline of the instrument shaft 380. The lower right photograph 350 shows a digitally enhanced image in which the instrument shaft has been completely removed from the scene. The photographed object is visually complete, as if the instrument shaft was not there. By digitally removing and reinserting the instrument shaft from the displayed image without actually removing the instrument shaft from the joint space, it can be seen how image cancellation technology can be used to improve visualization of the joint space during reduced portal surgical procedures.

[0032] 6 shows various implementations of how the rotatable optical cannula 120 can interact with stationary electrical couplers 111a, 111b, 111c embedded within the endoscope handle 170. The stationary electrical couplers 111a, 111b may include contacts to which wires may be attached (e.g., in a service loop connection with the cannula 120) to provide continuous electrical contact with the shaft 110 and the camera chip 200. The stationary electrical coupler 111c may include peripheral contacts that form part of a commutator. Other portions of the cannula system (e.g., the endoscope handle 170) may include contacts that align with each of the peripheral contacts to provide continuous electrical contact with the shaft 110 and the camera chip 200.

[0033] 7 shows a visual depiction of how a 1 millimeter camera tip 200 affects the size of the inner working passage 230, irrigation passage 210, and aspiration passage 220 of an optical cannula. Cannula 120 with an outer diameter 240 of 8 mm, working passage 230 with a diameter 230a of 6.1 mm, working passage 230 with an outer diameter 250 of 6 mm, working passage 230 with a diameter 230b of 4.1 mm, outer diameter 260 of 4 mm, and working passage 230 with a diameter 230c of 2.1 mm, respectively, are included for comparison.

[0034] Conventional arthroscopic cannulas typically require aspiration and / or irrigation ports integrated into the sidewall of the cannula. These ports typically have shut-off valves / levers that regulate fluid flow through the cannula. Often these ports are oriented between 30 and 90 degrees away from the longitudinal axis of the cannula. Implementations of the disclosed system use alternative means for directing aspiration and irrigation into and out of the cannula. FIGS. 8-9 are see-through and sagittal cross-sectional views, respectively, of an aspiration / irrigation harness 140 that interfaces with an optical cannula 120.

[0035] Instead of using fixed ports on the sides of the cannula, the disclosed cannula system 100 utilizes the rotating nature of the cannula and uses two independent fluid ports 411, 412 to drain two separate fluid passages 421 or aspiration passages 422, respectively, positioned within the interior periphery of the harness 140. A series of rubber seals 431, 432, 433 separate the two harness passages from each other and maintain a watertight seal against the cannula wall. A first port 441 in the outer cannula wall aligns with one of the inner passages of the aspiration / irrigation harness 140 and provides fluid or aspiration access between either the aspiration passage 220 or the irrigation passage 210 spaced apart within the cannula interior. A second port 442, which may be longitudinally and / or circumferentially offset from the first port 441, provides access to the second harness chamber 422. By offsetting the ports in the cannula wall and separating the harness passageways, the aspiration and irrigation passageways remain separate from one another. When optical cannula 120 is rotated, ports 441, 442 maintain communication with corresponding internal fluid passageways 421, 422 of harness 140 during rotation.

[0036] In some embodiments, there may be rubber seals or protrusions attached to the outer cannula wall that align with one or more of the passageways in the aspiration / irrigation harness. When the cannula is rotated to a particular circumferential position, these protrusions / seals seal the irrigation port 411 or aspiration port 412, preventing further fluid movement through the respective port. Alternatively, more conventional valve mechanisms may be incorporated into or just outside the harness ports 411, 412, possibly with mechanical extensions that close the port openings to regulate fluid inflow or outflow in a more conventional manner. Other methods of regulating fluid and aspiration flow through the harness ports are contemplated.

[0037] One embodiment of the optical cannula system 100 described herein is unique when compared to conventional arthroscopy systems because it combines rotatable cannula optics, mechanical actuation of the tool tip, suction irrigation, and an endoscope fully integrated into a device that is held in one hand. FIG. 10A shows a simplified schematic highlight of one alternative endoscope handle 170a with an electrical cable 180 attached to a receiving coupler 179. The endoscope handle 170a has a molded cutout 174 (e.g., rectangular) that is integrated into the endoscope housing that is meant to receive the irrigation / suction harness 140 described in FIGS. 8-9. An electrical path may be provided to transmit image data from a camera tip positioned at the distal end of the cannula, through the length of the cannula, to a slack wire in the suction / irrigation harness (not shown). The slack wire (not shown) connects to an electrical coupler positioned on the flat lower surface of the harness that contacts an endoscope coupler 177 positioned at the bottom of the endoscope harness cutout 174. The electrical coupler may include an image processing module that receives signals through a slack line (or commutator). The image processing module may be located in (e.g., internal to) the handle 170a. The electrical coupler may also be connected to the endoscope coupler 177. Thus, the handle 170a may be reusable to reduce the cost of assembly. Alternatively, the image data travels through the endoscope coupler 177 to a receiving coupler 179 of the electrical cable 180 and then to the endoscope cord, which transmits signals to an image processing control board located outside the surgical field.

[0038] FIG. 10B shows a more detailed depiction of the endoscope handle embodiment shown without the electrical connector. A curvilinear cutout 181 is seen in the base of the harness recess 174 that allows the suction and irrigation tubes to pass through the bottom of the endoscope handle. This spatial relationship between the endoscope handle and the cords exiting the suction / irrigation harness is better understood in FIGS. 11-12. The suction / irrigation tubes 185, 186 can exit the endoscope handle in an orientation (186 in FIG. 12) that allows the tubes and electrical cable 180 to exit the device in a parallel neat manner. In one implementation, two semicircular recesses 182 can be incorporated into the lateral projections along the outer base of the harness recess 174. These recesses receive small circular projections (not shown) that are positioned along the medial surface of the lever extension (171 in FIG. 2) along the rear end of the endoscope lever 175. The projections are positioned at the medial surface of the lever extension and not at the very end of the extension. The small circular protrusion acts to anchor the lever to the endoscope handle while at the same time hinges the lever 175 off the proximal face of the endoscope handle.

[0039] Certain implementations and embodiments of the disclosed system allow for mechanical actuation of the tool tip of the instrument. Any of a variety of tool tips may be attached to the instrument shaft. For instrument tool tips that are too large to pass through the inner diameter of the working passage of the optical cannula, the shaft may be inserted into the optical cannula from distal to proximal. Conversely, if the tool tip of the instrument is too small to pass through the cannula, the instrument shaft may be passed from proximal to distal or from distal to proximal. In either instance, the intent is to move the tool tip of the tool by a lever mechanism built into the endoscope handle. The prior art has demonstrated means by which mechanized handles can operate interchangeable tool tips and instrument shafts in a manner that utilizes two integral sliding instrument shafts, one inside the other. The outer circular shaft has a central passage through which the smaller diameter shaft can move back and forth. The interplay of movements between the two instrument shafts can cause the tool tip to open and close.

[0040] FIG. 11 shows the instrument shaft protruding out of the proximal end of the optical cannula. In this implementation, the rear end 191 of the inner shaft has an enlarged rear extension attached to the inner instrument shaft component. The implementation shown diagrammatically in FIG. 13 shows this widened shaft portion adapted into a geared configuration 193. Such a configuration facilitates precise rotation of the instrument shaft 110 within the cannula 120. In these and other contemplated implementations, the gear teeth 193 located at the rear end of the instrument shaft 110 can be integrated with the gear teeth 161 located within the central opening of the rotatable instrument shaft rotation dial 160. The ability to independently rotate the instrument shaft and corresponding tool tip in a manner independent of the position of the optical camera tip (which is itself independently rotatable) provides the surgeon with expanded visualization capabilities beyond those provided by conventional arthroscopic systems. Additionally, the ability to mount larger tool tips, or tool tips configured in a manner that prevents them from passing through the cannula inner diameter, on the instrument shaft expands the tool options available to the surgeon. Adding articulation capability to the cannula still further improves surgical access and visualization, especially when combined with other features of the disclosed system.

[0041] Immediately distal to segment 191 is a segment of the instrument shaft that includes a small circumferential central groove 192. This groove is recessed into the profile of the outer instrument shaft component 110. FIG. 11 highlights the removable instrument shaft locking key 150. The key is shown prior to engagement with the instrument shaft and endoscope handle lever extension 171 on both sides. The locking key interacts with the instrument shaft, aspiration / irrigation harness, endoscope handle, and handle lever extension in a manner that secures all items into position along the rear end of the endoscope handle. Locking key 150 has front and rear sections 195, 198 connected by a semi-flexible bridge 194 and separated by a slot 196. This bridge 194 acts as a tension hinge to allow the front and rear components of the locking key to spread apart from one another. When the locking key is fully engaged, the lever extension 171 protrudes into a gap 197 in the lower side of the locking key.

[0042] When the instrument lever 175 is gripped relative to the endoscope handle 170, the superior most aspect of the lever extension rotates counterclockwise about the pivot point, thereby displacing the rear section 198 of the locking key away from the front section 195. In this implementation, the front section 195 of the locking key is fixed in position against the irrigation / aspiration harness, the outer instrument shaft, and the endoscope handle, while the rear section of the locking key only engages the proximal shaft extension 191. Counterclockwise movement of the rear segment of the locking key moves the inner instrument shaft rearward relative to the outer instrument shaft, thereby actuating the distal tool tip mechanism.

[0043] 14-32 show an optical cannula system 500. The optical cannula system 500 may include the structure and function as the optical cannula system 100 as shown and described in connection with FIGS. 1-13, with the differences noted below. The optical cannula system 500 may include an endoscope 600 and a surgical tool 700. The endoscope 600 may provide physical access to the surgical site for the surgical tool 700, visual imaging, irrigation, suction, and / or other surgical functions. The surgical tool 700 may be insertable into and removable from the endoscope 600. Although shown as a pair of graspers, the tool 700 may include any of a variety of different surgical instruments. Alternatively, the tool 700 is a cutting tool, a wiping tool, a grasping tool, an abrasive tool, a cauterizing tool, a piercing tool, a tissue sampling tool, or other type of surgical tool.

[0044] The endoscope 600 may include a body 670, a cannula 620, a rotation mechanism 660, an entrance hub 683, an electrical cable 680, a first tube 681, and / or a second tube 682. The body 670 may include a distal end 671 and a proximal end 672. The proximal end 672 may include an opening through an outer wall providing access to an interior 673. The body 670 is generally cylindrical between the distal end 671 and the proximal end 672. The distal end 671 may be tapered towards the cannula 620. The body 670 may include an entrance hub 683. The electrical cable 680, the first tube 681, and / or the second tube 682 may enter the body 670 through the entrance hub 683. The electrical cable 680, the first tube 681, and / or the second tube 682 may extend outward in a parallel manner to prevent excessive interference or entanglement when the endoscope 600 is in use. The electrical cable 680 may be removably or permanently coupled to the entrance hub 683.

[0045] The cannula 620 may include a distal end 621 and a proximal end 622. The cannula 620 may extend along an axis between the distal end 621 and the proximal end 622. The cannula 620 may have an outer wall extending from the distal end 621 to the proximal end 622. The outer wall may have a cross-sectional shape extending from the distal end 621 to the proximal end 622. The cannula 620 may include a first passageway 623. The first (working) passageway 623 may extend from the proximal end 622 to the distal end 621. The cannula 620 may include a second passageway 624. The second passageway 624 may extend from the proximal end 622 to the distal end 621. An inner wall 629 may separate the first passageway 623 from the second passageway 624. The inner wall 629 may extend from the proximal end 622 to the distal end 621. The first passageway 623 and the second passageway 624 may have substantially the same cross-sectional shape from the proximal end 622 to the distal end 621. The second passageway 624 may include a cut-out section 625. The cut-out section 625 may extend along a portion of the proximal end 622 (e.g., within the body 670). The cannula 620 may include a metal alloy, a medical grade polymer, or other material. In certain examples, the cannula 620 may include polyetheretherketone (PEEK), a liquid crystal polymer (LCP) material, carbon reinforced nylon, glass reinforced nylon, or other composite material. The cannula 620 may comprise a monolithic construction of a single material.

[0046] The cannula 620 may include a first port 626. The first port 626 may extend through an outer wall of the cannula 620. The first port 626 may be in communication with the first passageway 623. A second port 627 may be spaced apart from the first port 626. The second port 627 may extend through an outer wall of the cannula 620. The second port 627 may be in communication with the first passageway 623. The first port 626 and the second port 627 may extend through opposite sides of the outer wall of the cannula 620. In the alternative, the first opening 626 and the second opening 627 can each extend through one side of the outer wall of the cannula 620, which one side can be on either side of the first passageway 623 (e.g., the first port 626 can be located on a first side of the outer wall and the second port 627 can be located on an opposite side of the outer wall). In another alternative, the first port 626 and / or the second port 627 can be in communication with the second passageway 624. The first port 626 and the second port 627 can each extend through one side of the outer wall of the cannula 620, which one side can be on an opposite side of the second passageway 624. In another alternative, the first port 626 is in communication with the first passageway 623 and the second port 627 is in communication with the second passageway 624.

[0047] The proximal end 622 of the cannula 620 can be received within an interior 673 of the body 670 through the distal end 671. The distal end 621 can protrude from the distal end 671. A cut-out section 625 can be in the body 670. The distal end 671 can include an opening for receiving the cannula 620.

[0048] Endoscope 600 may include a forward seal 628. Forward seal 628 may be formed from a resilient material. Forward seal 628 may include a central opening. The central opening may be sized to receive cannula 620 and seal against an outer wall of cannula 620. Seal 628 may include a portion that is at least partially received within distal end 671. Forward seal 628 may provide a fluid-tight seal between cannula 620 and an inner wall of the central opening, and between the portion and distal end 671 of body 670.

[0049] The rotation mechanism 660 may include a dial portion 662, an insert portion 661, and / or an opening 663. The dial portion 662 may have a circumferential outer circumference. The dial portion 662 may have a diameter similar to or greater than the diameter of the body 670 at the proximal end 672. The insert portion 661 may be cylindrical in shape. The insert portion 661 may extend distally from the dial portion 662. The distal end of the insert portion 661 may have a smaller diameter relative to the proximal portion of the insert portion 661. The opening 663 may extend through the dial portion 662 and the insert portion 661. The opening 663 may include an inner wall sized to receive the proximal end 622 of the cannula 620. The insert portion may include a first opening 664 and a second opening 665 spaced from the first opening 664. A first opening 664 and a second opening 665 may extend through an outer wall of the insert portion 661 to provide communication within the opening 663 .

[0050] The rotation mechanism 660 can be assembled with the body 670. The rotation mechanism 660 can be assembled with the proximal portion 672 of the body 670. The insert portion 661 can be inserted into the interior space 673. The dial 662 can abut the proximal end 672. The rotation mechanism 660 can be rotatable relative to the body 670, similar to the dial 160 of the system 100. The proximal end 622 of the cannula 620 can be received within the insert portion 661. The proximal end 622 of the cannula 620 can be rotatably fixed with the insert portion 661 such that rotation of the dial 662 rotates the cannula 620. The openings 664, 665 can be aligned with and / or in communication with the ports 626, 627, respectively, of the cannula 620.

[0051] Endoscope 600 may include a harness assembly 650. Harness assembly 650 may provide communication between tubes 681, 682 and cannula 620, including when rotated. Harness assembly 650 may include a plurality of spacers and seals configured to create one or more circumferential paths for providing irrigation and / or suction to cannula 620 (e.g., through first port 626 and second port 627, respectively, as discussed further below). Harness assembly 650 may include first seal 651, second seal 652, and / or third seal 653. Seals 651-653 may be in the form of O-rings. Harness assembly 650 may include first spacer 654, second spacer 655, third spacer 656, and / or fourth spacer 657. First spacer 654 and fourth spacer 657 may be cylindrical in shape. The second spacer 655 and the third spacer 656 may include double rings spaced apart by extension members 655a, 656a (FIG. 32). Circumferential fluid paths 658, 659 (FIG. 21) may be positioned between the double rings created by the extension bars. A central opening may extend through the harness assembly. The central opening may extend through the first seal 651, the second seal 652, and the third seal 653 and through the first spacer 654, the second spacer 655, the third spacer 656, and the fourth spacer 657.

[0052] The endoscope 600 can include a harness block 640. The harness block 640 can fit around the harness assembly 650 to form circumferential paths 658, 659. The harness block 640 can include a central opening 642. The central opening 642 can have an inner diameter and an inner surface. The harness assembly 650 can be assembled within the central opening 642. The seals 651, 662, 653 can engage the inner surface of the central opening 642. The harness block 640 can include a tab portion 641. The tab portion 641 can be positioned on one side of the harness block 640 to provide a non-cylindrical cross-sectional shape (i.e., to prevent rotation within the body 670). A first opening (port) 644 can extend through an outer wall of the harness block 640 and can provide fluid communication with the central opening 642. A second opening (port) 645 can be spaced from the first opening 644 and can extend through the outer wall and can provide fluid communication with the central opening 642 .

[0053] The endoscope 600 can include a tool seal 630. The tool seal 630 can include a first seal 631. The first seal 631 can include a flap or slit through which a tool shaft can pass. The tool seal can include a seal body 633. The seal body 633 can be a cylindrically shaped member having an opening (e.g., sized to receive a tool shaft) therethrough. The seal body 633 can include a circumferential recess 633a. The recess 633a can be sized to receive an O-ring 632. The O-ring 632 can be mounted within the recess 633a. The proximal end of the seal body 633 can include a tapered recessed opening. In some implementations, the tool seal 630 can be configured to be reversible.

[0054] Endoscope 600 can include a camera assembly 690. Camera assembly 690 can include a camera chip such as camera chip 200 and / or additional camera chips. Camera assembly 690 can include a light source (e.g., an LED or fiber optic filament). Camera assembly 690 can be assembled in distal tip 621 of cannula 620, such as in second passage 624. Signal wires (not shown) can extend along passage 624 between distal end 621 and a cutout section 625 in second passage 624. The wires can be attached to (or connected with electrical cable 680) an electronic controller (PCB board) 675 in body 670. Controller 675 can include image processing capabilities and / or other functions. The connection between the signal wires and electronic controller board 675 can be through a service loop, an electrical commutator, or other means.

[0055] 21-22 show the internal assembly of the endoscope 600. The harness block 640 can be assembled in the interior space 673. The tab 641 can engage with the inner surface of the body 670 to prevent rotation of the harness block within the body 670. The harness assembly 650 can be assembled in the interior space or opening 642 of the harness block 640. The interior space 673 can be shaped to be in a fixed position (i.e., rotationally fixed position) within the interior space 673 such that the harness block 640 is fixed to the body 670. The first opening 644 can be aligned with the first tube 681 and can be in fluid communication with the first tube 681 through the outer wall of the body 670. The second opening 645 can be aligned with the second tube 682 and can be in fluid communication with the second tube 682 through the outer wall of the body 670.

[0056] The harness assembly 650 is assembled in the central opening 642 of the harness block 640. The first seal 651 can be positioned between the first spacer 654 and the second spacer 655. The second seal 652 can be positioned between the second spacer 655 and the third spacer 656. The third seal can be positioned between the third spacer 656 and the fourth spacer 657. The first spacer 654 can be positioned at a distal end of the harness assembly 650. The fourth spacer 657 can be positioned at a proximal end of the harness assembly 650. The second spacer member 655 can form a circumferential fluid pathway 658. The third spacer 656 can form a circumferential fluid pathway 659. The seals 651, 652, 653 can contact an inner surface of the harness block 640 to isolate the pathways 658, 659 from one another. The circumferential paths 658, 659 can be aligned with and / or in fluid communication with the respective openings 644, 645 of the harness block 640. The circumferential paths 658, 659 can thereby be aligned with and / or in fluid communication with the respective tubes 681, 682.

[0057] The rotation mechanism 660 can be assembled with the body 670. The insert portion 661 can be inserted into a central passage of the harness assembly 650 through a proximal end 672. The seals 651, 652, 653 can contact an outer surface of the insert portion 661 to isolate the passages 658, 659 from one another. A first opening (port) 664 and a second opening (port) 665 can be aligned and in fluid communication with the respective circumferential passages 658, 659.

[0058] The proximal end 622 and the cannula 620 may be received within the interior space 673, such as through the distal end 671. The distal end 621 may be received within the insertion portion 661. The opening 664 of the rotation mechanism 660 may be aligned with and / or in fluid communication with the first port 626 of the cannula 620. Thus, the first tube 681, the opening 644, the circumferential path 658, the opening 664, and the port 626 may be in fluid communication. The opening 665 of the rotation mechanism 660 may be aligned with and / or in fluid communication with the second port 627 of the cannula 620. Thus, the second tube 682, the opening 645, the circumferential path 659, the opening 665, and the port 627 may be in fluid communication.

[0059] The insert portion 661 may be rotatable along its longitudinal axis (e.g., by rotating a dial 662). The cannula 620 may be locked into rotation with a rotation mechanism 660. The rotation mechanism 660 may rotate relative to the harness assembly 650, the harness block 640, and / or the body 670. Rotation of the insert portion 661 within the harness assembly 650 may maintain alignment and / or fluid communication between the openings of the cannula 620 and the tubes 681, 682 through the circumferential paths 658, 659. Rotation of the insert portion 661 within the harness assembly 650 may be at least 90° or 360°, but may not be operationally limited (e.g., for a commutator).

[0060] The shaft seal 630 can be inserted into the insert portion 661 through the opening 663. The shaft seal 630 can be a one-way seal. The shaft seal 630 can be inserted into the opening 663 through a proximal end of the rotating assembly 660. The shaft seal 630 and the opening 663 can be aligned with the first passageway 623. The shaft seal 630 (e.g., O-ring 632) can seal against an inner surface of the opening 663. A tapered portion of the insert portion 661 can provide a seat for the seal 630. The shaft seal 630 can be inserted into a proximal portion of the insert portion 661. The first seal 631 can include a first seal member 631a and a second seal member 631b. The first seal member 631a can have a hemispherical shape. The second seal member 631b can be attached to the first seal member 631a. First seal member 631a and / or second seal member 631b may include a central opening or slit therethrough. Optionally, shaft seal 630 may be inserted in a reverse orientation as shown in FIG. 21 (e.g., to accommodate distal-to-proximal loading on an instrument shaft in a cannula). In an alternative embodiment, a rotatable or switchable lever may be included in association with shaft seal 630. The lever may be capable of switching between one-way seals (e.g., to accommodate distal-to-proximal loading on an instrument shaft in a cannula or a differently sized seal) and / or may provide the option of no seal at all depending on the instrument inserted into the handle.

[0061] 22-23 show a distal end 621 of a cannula 620 including a first passageway 623 and a second passageway 624 within an interior space defined by an outer wall of the cannula 620. The outer wall of the cannula 620 may include a curved or circular lower portion 621a. The outer wall of the cannula 620 may include a flat or upper portion 621b. The curved portion 621a may be attached to the flat portion 621b on either side through a curved or planar side portion. The first passageway 623 may be positioned within the curved lower portion 621a. Additionally, the first passageway 623 may include a first side portion 623a and a second side portion 623b. Optionally, the first side portion 623a and the second side portion 623b may be at least partially separated during use. The first passageway 623 may be sized to receive the shaft 710 of the tool 700. The shaft 710 may comprise an outer shaft 780 and an inner shaft 790. The first passageway 623 may be sized such that the shaft 710 generally fills the passageway 623. Suction and irrigation may occur along the first lateral portion 623a and the second lateral portion 623b, or otherwise around the shaft 710. Optionally, the passageway 623 and the shaft 710 may be sized such that the shaft 710 separates the first lateral portion 623a from the second lateral portion 623b, which may be located at an upper opposite corner of the first passageway 623. In one alternative, the first lateral portion 623a may be aligned with the first port 626 and the second lateral portion 623b may be aligned with the second port 627 such that irrigation can occur along the first lateral portion 623a and suction can occur independently along the second lateral portion 623b.

[0062] An inner wall 629 separates the first passageway 623 from the second working passageway 624. The inner wall 629 may extend from the proximal end 622 to the distal end 621. Alternatively, additional inner walls may be included to further divide the interior space of the cannula 620. The second passageway 624 may have a rectangular or trapezoidal cross-sectional shape. The shape of the second passageway 624 may be sized such that a camera assembly 690 fits within the distal end of the second passageway 624. Alternatively, an additional camera chip or light, or other instrument, may fit within the second passageway 624. The camera assembly 690 may include a camera chip 691 and a light source 692. The first passageway 623 may have an arched cross-sectional shape with a circular portion and a flat portion. The outer wall of the cannula 620 may have a thickness T1 between the flat portion 621b and the second passageway 624. The outer wall of the cannula 620 may have a first upper rounded edge R1 and a second upper rounded edge R2. A third curvature R3 may extend below the first passageway 623. An inner portion of the outer wall within the first passageway 623 may have a curvature R4. The second passageway has a height H1 and / or a width W1. The inner wall 629 may have a thickness T2. The outer wall between the third curvature R3 and the fourth curvature R4 may have a thickness T3. The second passageway 624 may be spaced apart from the first passageway 623 by a height H2. The outer wall of the cannula 620 may have a height H3 (e.g., from centerline to centerline). The first passageway 623 may have a height H4. The following table provides certain desired values ​​and ranges for the dimensions of the cannula 620. Alternatively, other cannula and passageway dimensions are within the scope of the present disclosure.

[0063] [Table 1]

[0064] 24-27 show tool 700 in further detail. Tool 700 may include a shaft 710 with a tool 720 on a distal end 711 of the shaft 710. A proximal end 712 of shaft 710 may be attached to a grip assembly 730. Grip assembly 730 may include a grip body 740, a lever 750, and / or an assembly sleeve 760.

[0065] The shaft 710 can comprise an outer shaft 780. The outer shaft 780 can comprise a distal end 781 and a proximal end 782. The distal end 781 can be attached to the tool assembly 720. The proximal end 782 can include a proximal portion that includes a shoulder to aid in assembly with the grip portion 730.

[0066] The shaft 710 can include an inner shaft 790. The inner shaft 790 can be a control mechanism for the tool 720. The inner shaft 790 can include a distal end 791. The distal end 791 can be connected to the tool 720, such as to actuate the pair of grippers. A proximal end 792 can be attached to the gripper assembly 730 (e.g., lever 750) for actuation purposes.

[0067] The grip body 740 includes a distal portion 741 and a proximal portion 742. The distal portion 741 may include a generally cylindrical shape with a slot 743 extending proximally from a distal end towards the proximal portion 742. The slot 743 may provide access for assembling the shaft 710 with the grip portion 730. The distal portion 741 may include a distal flange 745. The slot 743 may extend through the distal flange 745. A proximal flange 746 may be positioned proximal to the distal flange 745. The grip body 740 may include a slot 744 for receiving one end of the grip lever 750. The distal portion 741 may include a shoulder or recess 747. The shoulder or recess 747 may engage a shoulder on the proximal end 782 of the outer shaft 780. Shoulder or recess 747 may be aligned with or accessible through slot 743 .

[0068] The gripping assembly 730 may additionally comprise a capture member 770. The capture member 770 may comprise a distal end with a capture portion 771. The capture portion 771 may be configured to engage a proximal end 792 of the inner shaft 790. The capture portion 771 may be aligned with or accessible through the slot 743. The capture member 770 may comprise a proximal end 772. The proximal end 772 may comprise a slot 773. The capture member 770 may be assembled into the gripping body 740 and held in place by the assembly sleeve 760. The capture member 770 may be attached in conjunction with a lever 750 to provide actuation of the inner shaft 790. The proximal end of the inner shaft 790 may comprise a shoulder for attachment of the capture portion 771.

[0069] The lever 750 may include a gripping portion 751, which may include one or more finger holes. The lever 750 may include a shaft portion 753 including a pivot portion 752. The pivot portion 752 may be attached to the lever 750 in a slotted opening 744. The lever 750 may be pivotally connected at the pivot portion 752. Alternatively, the lever 750 may be integrally formed with the gripping body 740 (e.g., a living hinge). The lever 750 may include a pin 754. The pin 754 may engage within a slot 773 in a proximal end 772 of the capture member 770. Movement of the lever 750 may move the capture member 770, which is axially aligned with the shaft 710.

[0070] The assembly sleeve 760 may be assembled between the distal flange 745 and the proximal flange 746. The assembly sleeve 760 may be rotatable about the distal portion 741 of the grip body 740. The assembly sleeve 760 may be rotatable into and out of an assembly configuration in which the slot 763 of the assembly sleeve 760 aligns with the slot 743 in the grip body 740. The shafts 780, 790 may be assembled through the slot 743 when the slot 763 is in the assembled configuration (FIG. 27). This may also provide a quick assembly and disassembly configuration for the tool 700. After the shafts 780, 790 are inserted into the slot 743, the assembly sleeve 760 may be rotated to move the assembly slot 763 and cover the slot 743. This may lock the proximal ends 782, 792 in position within the grip assembly 730.

[0071] Figures 28-32 show optical cannula system 500 in an assembly in which tool 700 is received within endoscope 600. Figure 28 shows a first configuration with the jaws of tool 720 in a first configuration (closed). Figure 29 shows tool 720 in a second configuration with the jaws open. Lever 750 has been actuated to advance capture member 770 and actuate the jaws through shaft 790.

[0072] Shaft 710 is received within cannula 620. When loaded from proximal to distal, the shaft is inserted through rotation mechanism 660 (e.g., opening 663) into first passageway 623 of cannula 620. Shaft 710 may be inserted through shaft seal 630. Sealing member 631 of seal 630 may seal against the passage of fluid back through opening 663. First seal 631 may seal around shaft 710. First seal 631 may be positioned distally relative to body 633.

[0073] When installed distally to proximally, tool 700 may be at least partially disassembled. Shaft 710 may be inserted into proximal end 712 and into distal end 621 of cannula 620. Shaft seal 630 may be removed from opening 663 and repositioned in a reverse orientation. Proximal end 712 may be installed into rotation mechanism 660 (e.g., opening 663) from first passageway 623 of cannula 620. Shaft 710 may be inserted through shaft seal 630. Seal member 631 of seal 630 may seal against passage of fluid back through opening 663. First seal 631 may seal around shaft 710. First seal 631 may be positioned proximally relative to body 633. Shaft 710 may then be reassembled with gripping assembly 730. Alternatively, a second seal in a reverse orientation may be installed in opening 633 for reversing seal 630.

[0074] The distal portion 741 of the tool 700 can be at least partially received within the opening 663. The opening 663 can include a length such that the distal portion 741 can be inserted to varying depths within the opening 663 but still be engaged with the rotation mechanism 660. In this manner, the tool portion 720 can be moved relative to the cannula 620 (e.g., the tool portion 720 can be extended and retracted relative to the distal end 621). Optionally, the distal portion 741 can be sized such that the tool 700 can be placed within the rotation mechanism 660. In this configuration, the tool 700 can rotate with the rotation mechanism 660. In this configuration, the surgeon has one hand free to attend to other tasks while the endoscope 600 and tool 700 are held in the other hand. Otherwise, the tool 700 can be rotated or otherwise moved independently of the cannula 620.

[0075] Specific Terms Orientation terms used herein, such as "superior," "inferior," "proximal," "distal," "longitudinal," "lateral," and "end," are used in the context of the illustrated examples. However, the present disclosure should not be limited to the illustrated orientations. Indeed, other orientations are possible and within the scope of the present disclosure. Circular terms as used herein, such as diameter or radius, should be understood not to require a perfectly circular structure, but rather should apply to any suitable structure with a cross-sectional area that can be measured from side to side. Terms relating to general shapes, such as "circular," "cylindrical," "semicircular," "semi-cylindrical," or any related or similar term, need not strictly conform to the mathematical definition of a circle, cylinder, or other structure, but can encompass structures that are a reasonably close resemblance.

[0076] Conditional language such as "can," "may," "may," or "potential," unless otherwise expressly stated or otherwise understood within the context in which it is used, is generally intended to convey that a particular example includes or does not include certain features, elements, and / or steps. Thus, such conditional language is generally not intended to imply that features, elements, and / or steps are in any way required with respect to one or more examples.

[0077] Transitive language, such as the phrase "at least one of X, Y, and Z," is understood with the context as being generally used to convey that an article, condition, etc., may be either X, Y, or Z, unless expressly stated otherwise. Thus, such transitive language is generally not intended to include that a particular example requires the presence of at least one of X, at least one of Y, and at least one of Z.

[0078] The terms "approximately," "about," and "substantially" as used herein refer to an amount close to a stated amount that still performs a desired function or achieves a desired result. For example, in certain instances, as the context may dictate, the terms "approximately," "about," and "substantially" may refer to an amount that is within 10% or less of a stated amount. The term "generally" as used herein refers to a value, amount, or characteristic that primarily includes or tends toward a specific value, amount, or characteristic. By way of example, in certain instances, as the context may dictate, the term "generally parallel" may refer to a deviation of 20 degrees or less from exact parallelism. All ranges are inclusive of their endpoints.

[0079] summary Several illustrated examples of optical cannula systems have been disclosed. Although this disclosure has been described in terms of certain illustrated examples and uses, other examples and other uses are within the scope of this disclosure, including examples and uses that do not provide all of the features and advantages described herein. Components, elements, features, acts, or steps may be arranged or performed differently than described, and components, elements, features, acts, or steps may be combined, mixed, added, or removed in various examples. All possible combinations and components of elements and components are intended to be included in this disclosure. No single feature or group of features is required or essential.

[0080] Certain features described in this disclosure in the context of separate implementations can also be implemented in combination in a single implementation. Conversely, various features described in the context of a single implementation can be implemented separately in multiple implementations or in any suitable subcombination. Furthermore, although features may be described above as acting in a specific combination, one or more features from a claimed combination can be implemented in some instances from the combination, and the combination can be claimed as a subcombination or a change of the subcombination.

[0081] Any portion of any of the steps, processes, structures, and / or devices disclosed or described in an example in this disclosure may be combined or used with (or in place of) any other portion of any of the steps, processes, structures, and / or devices disclosed or illustrated in a different example or flow diagram. The examples described herein are not intended to be discrete and separate from one another. Combinations, variations, and implementations of the disclosed features are within the scope of this disclosure.

[0082] Although operations may be depicted in the drawings or described in the specification in a specific order, such operations need not be performed in the specific order shown or in sequential order to achieve the desired results, or all of the operations may be performed. Other operations not depicted or described may be incorporated in the example methods and processes. For example, one or more additional operations may be performed before, after, simultaneously with, or between any of the described operations. Also, operations may be rearranged or reordered in some implementations. Also, the separation of various components in the implementations described above should not be understood as requiring such separation in all implementations, and it should be understood that the combinations and systems described may generally be integrated together in a single product or packaged into multiple products. Also, some implementations are within the scope of the present disclosure.

[0083] Moreover, although illustrated examples are described, any examples having equivalent elements, modifications, omissions, and / or combinations are also within the scope of this disclosure. Furthermore, although certain aspects, advantages, and novel features are described herein, it is not necessarily the case that all such advantages can be achieved by any particular example. For example, some examples within the scope of this disclosure achieve one advantage or group of advantages as taught herein without necessarily achieving other advantages taught or suggested herein. Furthermore, some examples may achieve advantages different from those taught or suggested herein.

[0084] Some examples are described in conjunction with the accompanying drawings. Although the figures are drawn and / or illustrated to scale, such scale should not be considered limiting, as dimensions and proportions other than those illustrated are contemplated and are within the scope of the disclosed invention. Distances, angles, etc. are merely illustrative and do not necessarily bear precise relationship to the actual dimensions and layout of the illustrated devices. Components can be added, removed, and / or rearranged. Furthermore, any specific features, aspects, methods, properties, characteristics, qualities, attributes, elements, or the like in relation to the various examples can be used in all other examples described herein. Additionally, any method described herein may be implemented using any device suitable for performing the proposed steps.

[0085] For purposes of summarizing this disclosure, certain aspects, advantages, and features of the invention are described herein. Not all such advantages, or any such advantages, are necessarily achieved by any particular example of the invention disclosed herein. No aspect of the disclosure is essential or required. In many examples, the devices, systems, and methods may be configured differently than shown in the figures or descriptions herein. For example, various functionalities provided by the illustrated modules may be combined, rearranged, added, or eliminated. In some implementations, additional or different processing units or modules may perform some or all of the functionality described with respect to the examples described and the examples shown in the figures. Many implementation variations are possible. Any of the features, structures, steps, or processes disclosed herein may be included in any example.

[0086] In summary, various examples of optical cannula systems and related methods have been disclosed. The disclosure extends beyond the examples expressly disclosed to other alternative examples and / or other uses of the examples, as well as to specific modifications and equivalents thereof. Moreover, the disclosure expressly contemplates that various features and aspects of the disclosed examples can be combined with or substituted for one another. Thus, the scope of the disclosure should not be limited by the specific disclosed examples set forth above, but should be determined solely by a fair interpretation of the claims. [Explanation of symbols]

[0087] 100 Optical Cannula System 110 Outer Instrument Shaft Component 111a, 111b, 111c Electrical couplers 117 Circular Gear 120 Optical Cannula, Lumen 121 Optical Cannula Wall 125 Annular extension 130 Outer rotating dial 140 Suction / Irrigation Harness 150 Lock Key 160 Instrument shaft rotation dial 161 Gear Teeth 170, 170a Endoscope handle 171 Endoscope handle lever extension, lever extension 172 Recess 173 Recess 174 Recesses, cutouts 175 Instrument Lever 177 Electric coupler, endoscope coupler 178 Semicircular recess 179 Receiving Coupler 180 Electrical Cable 181 Cutout 182 Recess 185 Suction hose, suction pipe 186 Irrigation hoses, irrigation pipes 190 Outer Shaft 191 Rear end of inner shaft, segment 192 Central groove 193 Gear configuration, gear teeth 194 Bridge 195 Front Section 196 Slots 197 Gap 198 Rear Section 199 Inner Shaft 200 Camera CMOS chip, optical fiber 210 Irrigation Passage 220 Suction passage 230 Tool operating passage, inner operating passage 240, 250, 260 Outer diameter of cannula 120 230a, 230b, 230c Diameter of working passage 230 300 Two camera chip optical cannula 320, 321 Gap 330 images on screen 340 Lower left photo 350 Lower right photo 360 Visualized Objects 370 Instrument shaft 380 Instrument Shaft 411, 412 Fluid port, harness port 421 Fluid passage 422 Suction passage, second harness chamber 431, 432, 433 Rubber seal 441 Primary Port 442 Secondary Port 500 Optical Cannula System 600 Endoscope 620 Cannula 621 Distal end 621a Curved or circular lower part 621b Flat or upper part 622 Proximal end 623 First Passage, Working Passage 623a First side portion 623b Second lateral part 624 Second Passage 625 Cutout Section 626 First port, first opening 627 Second port, second opening 628 Front Seal 629 Interior wall 630 Tool seal, shaft seal 631 First Seal 632 O-ring 633 Seal body, opening 633a Circumferential recess 640 Harness Block 641 Tab part 642 Central opening 644 First opening, port 645 Second opening, port 650 Harness Assembly 651 First Seal 652 Second Seal 653 Third Seal 654 First Spacer 655 Second Spacer 655a Extension member 656 Third Spacer 656a Extension member 657 4th Spacer 658, 659 Circumferential fluid path 660 Rotation mechanism, rotation assembly 661 Insertion 662 Dial part, dial 663 Aperture 664 First opening, port 665 Second opening, port 670 Body 671 Distal end 672 Proximal end, proximal part 673 Interior, interior space 675 Electronic control device, PCB board 680 Electrical Cable 681 First Tube 682 Second Tube 683 Inlet Hub 690 Camera Assembly 691 Camera Chip 692 light source 700 Tools 700 Surgical Tools 710 Shaft 711 Distal end 712 Proximal end 720 Tool assembly, tool part 730 Gripping assembly, gripping part 740 Grip body 741 Distal part 742 Proximal part 743 Slots 744 Slots 745 Distal Flange 747 Shoulder, recess 750 Gripping Lever 751 Gripping part 752 Pivot 753 Shaft part 754 Pins 760 Assembly Sleeve 763 Slots 770 Capturing Parts 771 Capture Department 772 Proximal end 773 Slots 780 Outer Shaft 781 Distal end 782 Proximal end 790 Inner Shaft 791 Distal end 792 Proximal end H1 Height of second aisle H2 Height of separation H3 Cannula 620 outer wall height H4 Height of 1st aisle 623 W1 Width of second aisle R1 First upper rounded edge R2 Second upper rounded edge R3 Third curve R4 Curved T1 Outer wall thickness of cannula 620 T2 Inner wall thickness 629 T3 Exterior wall thickness

Claims

1. 1. An optical cannula system comprising: A cannula comprising: The proximal portion, Distal end, an axis extending between the proximal portion and the distal end; an outer cannula wall defining an interior space extending along said axis; and an inner cannula wall within the outer cannula wall extending along the axis, the inner cannula wall dividing the interior space into a first passageway and a second passageway; A cannula comprising: a body configured to receive the proximal portion of the cannula, the cannula being rotatable within the body; and a first camera chip positioned within the first passage at the distal end; An optical cannula system comprising:

2. An optical cannula system, comprising: A cannula comprising: The proximal portion, Distal end, an axis extending between the proximal portion and the distal end; an outer cannula wall defining an interior space extending along said axis; and an inner cannula wall within the outer cannula wall extending along the axis, the inner cannula wall dividing the interior space into a first passageway and a second passageway; A cannula comprising: a body configured to receive the proximal portion of the cannula, the cannula being rotatable within the body; and a first camera chip positioned within the first passage at the distal end; A harness, an inner surface disposed about the proximal portion of the cannula; a first peripheral seal disposed between the outer cannula wall and the interior surface of the harness; a second peripheral seal disposed between the outer cannula wall and the inner surface of the harness, the second peripheral seal being spaced from the first peripheral seal to define a first fluid passageway between the outer cannula wall and the inner surface; and a first harness port in fluid communication with the first fluid passage; A harness comprising: a first cannula port disposed through the outer cannula wall and into the interior space; Equipped with The first fluid passageway is in fluid communication with the interior space through the first cannula port.

3. An optical cannula system, comprising: A cannula comprising: The proximal portion, Distal end, an axis extending between the proximal portion and the distal end; an outer cannula wall defining an interior space extending along said axis; an inner cannula wall within the outer cannula wall extending along the axis, the inner cannula wall dividing the interior space into a first passageway and a second passageway; a first cannula port disposed through the outer cannula wall and into the interior space; and a second cannula port disposed through the outer cannula wall and into the interior space; A cannula comprising: a body configured to receive the proximal portion of the cannula, the cannula being rotatable within the body; and a first camera chip positioned within the first passage at the distal end; A harness, an inner surface disposed about the proximal portion of the cannula; a first peripheral seal disposed between the outer cannula wall and the interior surface of the harness; a second peripheral seal disposed between the outer cannula wall and the inner surface of the harness, the second peripheral seal being spaced from the first peripheral seal to define a first fluid passageway between the outer cannula wall and the inner surface; a third peripheral seal disposed between the outer cannula wall and the inner surface of the harness, the third peripheral seal being spaced from the second peripheral seal to define a second fluid passageway between the outer cannula wall and the inner surface; a first harness port in fluid communication with the first fluid passage; and a second harness port in fluid communication with the second fluid passageway; A harness comprising: Equipped with The first fluid passageway is in fluid communication with the interior space through the first cannula port, and the second fluid passageway is in fluid communication with the interior space through the second cannula port.

4. 4. The optical cannula system of claim 3, wherein the first and second fluid passageways are in fluid communication with the first and second cannula ports, respectively, during rotation of the cannula relative to the harness.

5. the harness is rotationally fixed within the body; 5. The optical cannula system of claim 4, wherein the first and second cannula ports are in fluid communication with first and second hoses, respectively, through the first and second fluid passageways and the first and second harness ports.

6. The harness includes a harness block, the harness block including: a central opening defined by the inner cannula wall; the first harness port and the second harness port; Equipped with The optical cannula system of claim 5 , wherein the harness block is rotationally fixed within the body.

7. The optical cannula system further comprises an insert portion to which a rotation mechanism is attached, the insert portion being positioned between the outer cannula wall and the first, second, and third peripheral seals of the harness such that the first and second fluid passages are positioned between an outer wall of the insert portion and the inner surface of the harness block; 7. The optical cannula system of claim 6, wherein the insertion portion comprises first and second insertion portion ports aligned with the first and second fluid passages, respectively, and the first and second cannula ports are in fluid communication with the first and second hoses during rotation of the cannula relative to the harness through the first and second fluid passages, the first and second harness ports, and the first and second insertion portion ports.

8. 8. The optical cannula system of claim 5, wherein the first hose is an irrigation hose and the second hose is a suction hose.

9. 8. The optical cannula system of claim 5, wherein the first cannula port and the second cannula port are in fluid communication with the second passageway of the cannula.

10. 10. The optical cannula system of claim 9, wherein an instrument shaft is disposed within the second passageway and divides a first side of the second passageway from a second side of the second passageway, the first cannula port in communication with the first side of the second passageway and the second cannula port in communication with the second side of the second passageway.

11. The optical cannula system, a camera signal line in the first passage, connected to the first camera chip, the camera signal line being electrically connected to an electrical coupler by a service loop or an electrical commutator; an external electrical cable including an external coupler configured to electrically connect with the electrical coupler; Further equipped with 8. The optical cannula system of claim 2, wherein the cannula, the first camera chip, the harness and any attached tubing, the external electrical cable, and the external coupler are removable from the body such that the body is reusable.

12. The optical cannula system of claim 1 , further comprising a rotation dial engaged with the outer cannula wall and configured to transmit torque to the cannula.

13. An optical cannula system comprising: A cannula comprising: The proximal portion, Distal end, an axis extending between the proximal portion and the distal end; an outer cannula wall defining an interior space extending along said axis; and an inner cannula wall within the outer cannula wall extending along the axis, the inner cannula wall dividing the interior space into a first passageway and a second passageway; A cannula comprising: a body configured to receive the proximal portion of the cannula, the cannula being rotatable within the body; and a first camera chip positioned within the first passage at the distal end; A tool, an instrument shaft configured to be inserted into the interior space of the outer cannula wall; a surgical tool at a distal end of the instrument shaft; A tool comprising: An optical cannula system comprising:

14. An optical cannula system comprising: A cannula comprising: The proximal portion, Distal end, an axis extending between the proximal portion and the distal end; an outer cannula wall defining an interior space extending along said axis; and an inner cannula wall within the outer cannula wall extending along the axis, the inner cannula wall dividing the interior space into a first passageway and a second passageway; A cannula comprising: a body configured to receive the proximal portion of the cannula, the cannula being rotatable within the body; and a first camera chip positioned within the first passage at the distal end; A tool, an instrument shaft configured to be inserted into the interior space of the outer cannula wall, the instrument shaft comprising an inner shaft and an outer shaft; a surgical tool at a distal end of the instrument shaft, the distal end of the inner shaft being coupled to the surgical tool. A tool comprising: Equipped with An optical cannula system, wherein a proximal end of the inner shaft is coupled to a lever, the lever being squeezed to actuate the surgical tool.

15. An optical cannula system comprising: A cannula comprising: The proximal portion, Distal end, an axis extending between the proximal portion and the distal end; an outer cannula wall defining an interior space extending along said axis; and an inner cannula wall within the outer cannula wall extending along the axis, the inner cannula wall dividing the interior space into a first passageway and a second passageway; A cannula comprising: a body configured to receive the proximal portion of the cannula, the cannula being rotatable within the body; and a first camera chip positioned within the first passage at the distal end; A tool, an instrument shaft configured to be inserted into the interior space of the outer cannula wall, the instrument shaft comprising an inner shaft and an outer shaft; a surgical tool at a distal end of the instrument shaft, the distal end of the inner shaft being coupled to the surgical tool; a lever coupled to a proximal end of the inner shaft; a gripping portion to which the proximal end of the instrument shaft is attached, the lever being attached to the gripping portion; a catch coupled to the lever, the outer shaft coupled to the gripping portion and the proximal end of the inner shaft coupled to the catch such that squeezing the lever activates the surgical tool; A tool comprising: An optical cannula system comprising:

16. An optical cannula system comprising: A cannula comprising: The proximal portion, Distal end, an axis extending between the proximal portion and the distal end; an outer cannula wall defining an interior space extending along said axis; and an inner cannula wall within the outer cannula wall extending along the axis, the inner cannula wall dividing the interior space into a first passageway and a second passageway; A cannula comprising: a body configured to receive the proximal portion of the cannula, the cannula being rotatable within the body; and a first camera chip positioned within the first passage at the distal end; A tool, an instrument shaft configured to be inserted into the interior space of the outer cannula wall, the instrument shaft comprising an inner shaft and an outer shaft; a surgical tool at a distal end of the instrument shaft, the distal end of the inner shaft being coupled to the surgical tool; a lever coupled to a proximal end of the inner shaft; a gripping portion to which the proximal end of the instrument shaft is attached, the lever being attached to the gripping portion; a catch coupled to the lever, the outer shaft coupled to the gripping portion and the proximal end of the inner shaft coupled to the catch such that squeezing the lever activates the surgical tool; A tool comprising: an assembly sleeve having a first slot; Equipped with the gripping portion includes a second slot; an optical cannula system, wherein alignment of the first slot with the second slot allows for assembly or disassembly of the outer shaft with the gripping portion and assembly or disassembly of the inner shaft with the capture, and misalignment of the first slot with the second slot locks the outer shaft within the gripping portion and locks the inner shaft within the capture.

17. 17. The optical cannula system of claim 13, wherein rotation of the instrument shaft is independent of rotation of the cannula.

18. 17. The optical cannula system of any one of claims 1-7 or 13-16, further comprising a second camera chip positioned within the first passage at the distal end, the first camera chip positioned on a first side of the first passage and the second camera chip positioned on a second side of the first passage.

19. 20. The optical cannula system of claim 18, wherein the first camera chip and the second camera chip are in divergent orientations to provide different viewing angles.

20. The optical cannula system of claim 18, wherein images from the first camera chip and images from the second camera chip are digitally combined to create a panoramic field of view, and an image of the distal end of the cannula is digitally removed or reduced from the combined panoramic field of view.

Images