Surgical cutting assembly including an actuator assembly selectively operable in multiple modes - Patents.com

Abstract

A surgical cutting assembly having an actuator assembly operable in a first mode and a second mode. The wheel is rotatable in a first axial position to rotate the intermediate tube to orient the cutting window and is rotatable in a second axial position to rotate the intermediate tube to orient the bent portion of the tube assembly. The actuator assembly may be operably coupled to the intermediate tube and operably decoupled from the outer tube in the first mode and operably coupled to the outer tube and operably decoupled from the intermediate tube in the second mode. The actuator assembly may include a first gear, a second gear fixed to the outer tube, and a third gear fixed to the intermediate tube. The distal wheel portion and the proximal wheel portion may be separate components coupled together to define a cavity for a sub-component of the actuator assembly.

Description

[Technical field]

[0001] Priority claim This application claims priority to and the full benefit of U.S. Provisional Patent Application No. 63 / 178,571, filed April 23, 2021, the contents of which are incorporated by reference in their entirety herein. [Background technology]

[0002] Certain surgical instruments have been developed for use in surgical procedures where access, maneuverability, and visibility are limited. One example is a surgical shaver for ear, nose, and throat (ENT) procedures, and another example is a surgical burr. These surgical instruments may include a tube assembly in which an inner tube or drive shaft is rotatably disposed within an outer tube, and a cutting window is disposed radially proximal to the distal end of the tube assembly. Thus, the tissue exposed to the cutting window is based on the orientation of the cutting window and the approach with which the surgeon introduces the surgical instrument into the tissue. Known devices may undesirably require removal of the surgical instrument from the tissue and reintroduction in the desired approach. Additionally, surgical instruments are often designed to be held comfortably in a particular manner, and repositioning in the surgeon's hand may be non-ergonomic.

[0003] It is further known to include a bend in the tube assembly to provide better access to certain tissues. However, the presence of the bend exacerbates the aforementioned shortcomings of known devices. That is, the tissue exposed to the cutting window is further based on the orientation of the bend. For example, the bend may be oriented upward relative to the handpiece and the cutting window may be oriented toward the concave side of the tube assembly. For a given approach by which a surgeon introduces a surgical instrument into tissue, any number of combinations of cutting window orientation and bend orientation may be preferred or may become more preferred during a surgical procedure.

[0004] Certain known devices provide for orientation of the cutting window and / or the bend. One such device is disclosed in commonly owned International Publication No. WO 2017 / 163226, published Sep. 28, 2017, the entire contents of which are incorporated herein by reference. It is disclosed that a wheel can be rotated to orient the cutting window. It is further disclosed that a tube assembly can be operatively separated from the handpiece to selectively orient the bend in one of a limited number of configurations.

[0005] Thus, there is a need in the art for a surgical cutting assembly that allows multiple components of the assembly to be selectively adjusted in an intuitive, ergonomic, and efficient manner. Summary of the Invention

[0006] The presently disclosed surgical cutting assembly overcomes at least the above-mentioned shortcomings. The surgical cutting assembly includes an actuator assembly operable in at least a first mode and a second mode. A wheel may be rotatable to adjust a first subcomponent of the surgical cutting assembly in the first mode and to adjust a second subcomponent of the surgical cutting assembly in the second mode. For example, the actuator assembly orients the cutting window in the first mode and orients the bent portion of the tube assembly in the second mode. The wheel may be rotatable in a first axial position in the first mode and in a second axial position in the second mode. The second axial position may be proximal to the first axial position.

[0007] The actuator assembly may be operably coupled to the intermediate tube in a first mode and rotates the intermediate tube when the wheel rotates at a first axial position. The actuator assembly may be operably decoupled from the outer tube in the first mode and operably decoupled from the intermediate tube in a second mode. The actuator assembly may be operably coupled to the outer tube in the second mode and rotates the outer tube when the wheel rotates at a second axial position. The wheel may be axially movable relative to the housing between the first and second modes. The actuator assembly may include a biasing member coupled to the wheel. The biasing member may bias the actuator assembly alternatively to the first or second mode. The actuator assembly may include a first gear, a second gear fixed to the outer tube, and a third gear fixed to the intermediate tube.

[0008] In certain implementations, the actuator assembly includes a wheel, a first gear, a second gear, and a third gear. The first gear, the second gear, and / or the third gear may be configured to form a hilt joint. The first gear, the second gear, and / or the third gear may be a hilt joint that includes teeth arranged annularly and directed proximally or distally to form a face gear with complementary engagement features. Other types of gears may include spur, helical, bevel, worm, screw, etc. Any suitable joint may be provided that selectively disengages from a rotational input and reengages to transmit a force.

[0009] The second gear may be secured to the outer tube at an interface and the third gear may be secured to the intermediate tube at an interface. The interface may be provided by one or more of adhesives, fasteners, friction fit, interference fit, and the like. Rotation of the second gear rotates the outer tube, and thus the bent portion of the tube assembly is correspondingly reoriented. Rotation of the third gear rotates the intermediate tube, and because the intermediate tube defines a cutout window, the cutout window of the tube assembly is correspondingly reoriented. Rotation of the wheel with the actuator assembly in the first mode is configured to rotate the third gear, and rotation of the wheel with the actuator assembly in the second mode is configured to rotate the second gear.

[0010] The wheel may include a distal wheel portion and a proximal wheel portion. The distal wheel portion and the proximal wheel portion may be separate, individual pieces that are fixed together to form the wheel. The distal wheel portion and the proximal wheel portion may include a coupling feature configured to facilitate assembly of the wheel. The first and second cavities are dimensioned to accommodate the sub-components of the actuator assembly, i.e., the first gear, the second gear, the third gear, the biasing element, and the bearing, with the distal and proximal wheel portions fixed together. The distal wheel portion may include a contour that differs from the contour of the proximal wheel portion to form a flared surface. The flared surface may be considered to be more vertically oriented to provide a larger contact area when the wheel is pinched and pulled with the thumb and index finger.

[0011] According to a second aspect, an actuator assembly for a surgical instrument is provided. A wheel defines a cavity, and a first gear, a second gear, and a third gear are disposed within the cavity. The second gear is fixed to a first sub-component, and the third gear is fixed to a second sub-component. The first sub-component can be an outer tube of any surgical instrument, and the second sub-component can be a shaft, for example, a solid drive shaft or another tube. The second sub-component can be a solid shaft, and the end effector can be redirected. Such examples include radially disposed electrodes for ablation, eccentrically deployed balloons for vertebroplasty, radial side holes for vertebroplasty, etc. In such mechanisms, the inner tube can be optional.

[0012] The first gear can be selectively engaged with the housing. The second gear can be selectively engaged with the wheel. The third gear can be selectively engaged with the wheel. The first gear includes an engagement portion configured to engage with an engagement portion of the nose portion of the housing. The first gear can include a first ring, and the engagement portion is distally oriented teeth annularly disposed about the first ring. The first gear is dimensioned to be disposed within a first cavity defined by the distal wheel portion. The engagement portion of the first gear extends through an opening defined by a distal face of the distal wheel portion, and the first ring is in interference engagement with an inner surface defining the first cavity. The engagement portion of the nose portion can be proximally oriented teeth annularly disposed in a manner complementary to the teeth of the first gear. With the first gear engagement portion extending distally from the distal face of the distal wheel portion, the complementary engagement portion is configured to selectively engage based on an axial position of the wheel.

[0013] The first and second gears may include complementary keying configured to prevent relative rotation but permit relative movement between the first and second gears. The keying of the first gear may be at least one rail and the keying of the second gear may be at least one groove. A first ring of the first gear defines an aperture and the rail is axially disposed within the aperture. An outer diameter of the neck of the second gear is smaller than an inner diameter of the aperture in the first ring, and the complementary keying allows axial movement but not rotation between the first and second gears in each of the first and second modes.

[0014] The second gear includes an engagement portion configured to engage with the engagement portion of the distal wheel portion. The second gear may include a second ring having a neck extending distally therefrom, and the engagement portion of the second gear may be teeth annularly disposed about the second ring and oriented in the distal direction. The third gear includes an engagement portion configured to engage with the engagement portion of the proximal wheel portion. The third gear may include a third ring, and the engagement portion of the third gear may be teeth annularly disposed about the third ring and oriented in the distal direction.

[0015] Advantages of the present invention will be readily understood by considering the written description in conjunction with the following drawings. [Brief description of the drawings]

[0016] [Figure 1] FIG. 1 is a front perspective view of a surgical instrument including a surgical cutting assembly removably coupled from a main assembly. [Diagram 2] FIG. 1 is a rear perspective view of a partially disassembled surgical cutting assembly. [Diagram 3] FIG. 1 is a front perspective view of a partially disassembled surgical cutting assembly. [Figure 4] 1 is a cross-sectional elevation view of a surgical cutting assembly including a housing, an actuator assembly, and a tube assembly, the actuator assembly being in a first mode with the cutting window of the tube assembly facing the convex side of the tube assembly; [Diagram 5]1 is a cross-sectional elevation view of the surgical cutting assembly with the actuator assembly in a second mode, the cutting window of the tube assembly facing toward the concave side of the tube assembly and the bent portion of the tube assembly facing downward relative to the housing. [Figure 6] FIG. 2 is a cross-sectional elevation view of the actuator assembly in a first mode, with a portion of the tube assembly shown. [Figure 7] FIG. 2 is a cross-sectional elevation view of the actuator assembly in a second mode, with a portion of the tube assembly shown. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0017] FIG. 1 illustrates a surgical instrument 10 including a surgical cutting assembly 12 and a main assembly 14. The main assembly 14 includes a power line 16 configured to be placed in electrical communication with a power source, an aspiration line 18 configured to be placed in fluid communication with a suction source, and an irrigation line 20 configured to be placed in fluid communication with a fluid source. An electric motor (not shown) is powered by the power line 16. The geometry of the main assembly 14 (not shown) is configured to operably couple to a drive hub 22 of the cutting assembly 12 with a connection hub 24 of the cutting assembly 12 supported by the main assembly 14 and selectively locked relative to the main assembly. Specific details of the main assembly 14 are further disclosed in co-owned International Publication No. WO 2021 / 224862, published November 11, 2021, the contents of which are incorporated herein by reference in their entirety, and the aforementioned International Publication No. WO 2017 / 163226.

[0018] 2 and 3, the cutting assembly 12 includes a housing 26, a tube assembly 28, and an actuator assembly 30. The housing 26 may include opposing portions or halves 32, 34 coupled together to provide an ergonomic surgical instrument 10 form factor designed for easy one-handed operation. The opposing portions 32, 34 may also allow for cost-effective fabrication of the housing 26 with lower cost materials by reducing manufacturing complexity. Despite the advantageous functionality described, the cutting assembly 12 is a disposable component, thus avoiding the need for sterilization, reprocessing, aseptic handling, and the like.

[0019] Housing 26 may include spaced apart finger portions 36 and web portions 38 configured to ergonomically support the surgeon's hand. In particular, finger portions 36 and web portions 38 may at least partially define a cavity in which the web of the surgeon's hand may be readily supported. Modifications to housing 26 are contemplated with additional ergonomic features disclosed in the aforementioned WO 2017 / 163226.

[0020] The housing 26 includes a nose portion 40 and a collar 42 spaced from the nose portion 40 to define a space 44 dimensioned to receive the actuator assembly 30. A connection hub 24 coupled to the collar 42 extends proximally from the collar. The collar 42 further defines an opening 48 with a lip 46 as described and dimensioned to receive at least an inner tube 56 of the tube assembly 28. The nose portion 40 may extend generally upwardly from the finger portion 36 and may include a proximal surface 50 and a distal surface 52 defining an opening 54 therebetween. The opening 54 is dimensioned to receive the tube assembly 28. The proximal surface 50 may be flat so as to be flush with a distal wheel surface 90 of the wheel 74 of the actuator assembly 30. The distal surface 52 may be formed in any suitable manner that provides ergonomic support for the fingers of a surgeon's hand, particularly when the housing 26 is held in a pencil grip.

[0021] The tube assembly 28 includes an inner tube 56, a middle tube 58, and an outer tube 60. The middle tube 58 is rotatably and coaxially disposed within the outer tube 60, and the inner tube 56 is rotatably and coaxially disposed within the middle tube 58. The inner tube 56 may be longer than the middle tube 58 due to respective connections with the actuator assembly 30 described, and the middle tube 58 may be longer than the outer tube 60. The tube assembly 28 may include a bend portion 62 and a cutting window 64 disposed distally from the bend portion 62. More specifically, the middle tube 58 may be flexible such that the middle tube 58 and the outer tube 60 include complementary bend portions that form the bend portion 62. Additionally, the inner tube 56 may also be flexible to accommodate the bend portion 62, for example, during high speed rotation. The cutting window 64 may be defined by the intermediate tube 58, with the inner tube 56 including a cutting portion (not shown) configured to be rotatably disposed within the cutting window 64. The cutting portion may be a cutting window within a surgical shaver or teeth disposed about a burr head of a surgical burr. The inner tube 56 defines a suction pathway 66 (see FIGS. 4-7 ) in fluid communication with the cutting window 64 and configured to be disposed in fluid communication with a suction source coupled to the main assembly 14. It is further contemplated that an irrigation pathway 68 may be defined between the inner tube 56 and the intermediate tube 58, configured to be disposed in fluid communication with a fluid source coupled to the main assembly 14. Irrigation fluid is discharged from the irrigation pathway 68 adjacent the cutting window 64 at a distal end 70 of the intermediate tube 58. A distal end 72 of the outer tube 58 is disposed near the distal end 70 of the intermediate tube 58 and further distally disposed from the bend portion 62. For purposes of convention, the bent portion 62 may be considered to divide the tube assembly 28 into a distal portion and a proximal portion, with the proximal portion defining the longitudinal axis (LA) of the cutting assembly 12 (see FIG. 1).

[0022] 2 and 3, the actuator assembly 30 includes a wheel 74, a first gear 76, a second gear 78, and a third gear 80. The first gear 76, the second gear 78, and / or the third gear 80 may be configured to form a hilt joint. The first gear 76, the second gear 78, and / or the third gear 80 may be a hilt joint that includes teeth arranged annularly and directed proximally or distally to form a face gear with complementary engagements. Other types of gears may include spur, helical, bevel, worm, screw, and the like. Any suitable joint that selectively disengages from a rotational input and reengages to transmit a force may be provided. The actuator assembly 30 may optionally include a biasing member 82, a bearing 84, and a seal 85. The bearing 84 is configured to limit friction against relative rotation between the second gear 78 and the third gear 80, and the seal 85 may be an O-ring that prevents irrigation fluid from being directed through the irrigation path between the inner tube 56 and the intermediate tube 58 and being discharged at the surgical site.

[0023] The wheel 74 is dimensioned to be rotatably disposed within the space 44 defined by the housing 26. The wheel 74 may include a distal wheel portion 86 and a proximal wheel portion 88. The distal wheel portion 86 includes a distal wheel face 90 and a first inner wheel surface 92 that defines a first cavity 94. The distal wheel portion 86 may further include an engagement portion 96 disposed within the first cavity 94. The illustrated implementation shows the engagement portion 96 as teeth that are annularly disposed and proximally oriented within the first cavity 94 of the distal wheel portion 90. The proximal wheel portion 88 includes a proximal wheel face 98 and a second inner wheel surface 100 that defines a second cavity 102. The proximal wheel portion 88 may further include an engagement portion 104 disposed within the second cavity 102. The illustrated implementation shows the engagement portion 104 as distally oriented teeth disposed annularly within a second cavity 102 of the proximal wheel portion 88 .

[0024] The distal wheel portion 86 and the proximal wheel portion 88 may be separately formed individual pieces that are secured together to form the wheel 74. The distal wheel portion 86 and the proximal wheel portion 88 may include a coupling configured to facilitate assembly of the wheel 74, preferably in a permanent manner such that the distal wheel portion 86 does not separate from the proximal wheel portion 88. The illustrated implementation shows the coupling as barbs 106 (two identified) on the distal wheel portion 86 configured to resiliently deflect to engage grooves 108 (two identified) defined by the proximal wheel portion 88. It is understood that the reverse configuration is contemplated and that securing the distal wheel portion 86 to the proximal wheel portion 88 may be achieved by other suitable coupling means. The first cavity 94 and the second cavity 102 are sized to accommodate the sub-components of the actuator assembly 30, namely, the first gear 76, the second gear 78, the third gear 80, the biasing member 82, the bearing 84, and the seal 85, with the distal wheel portion 86 and the proximal wheel portion 88 fixed to one another.

[0025] The actuator assembly 30 is selectively operable in at least a first mode and a second mode. Figures 4 and 6 show the actuator assembly 30 in a first mode, and Figures 5 and 7 show the actuator assembly in a second mode. Operating or actuating the actuator assembly 30 in a first mode is configured to adjust one component of the cutting assembly 12, and operating the actuator assembly 30 in a second mode is configured to adjust another component of the cutting assembly 12. An exemplary mechanism of the actuator assembly 30 orients the cutting window in the first mode and orients the bent portion of the assembly in the second mode. More specifically, the wheel 74 may be rotated about a longitudinal axis in the first mode to orient the cutting window 64 and in the second mode to orient the bent portion 62 of the tube assembly 28. A reverse mechanism is contemplated. The actuator assembly 30 can be selectively moved between the first and second modes by moving the wheel 74 between a first axial position and a second axial position proximal to the first axial position.

[0026] The second gear 78 may be secured to the outer tube 60 at an interface 110, and the third gear 80 may be secured to the intermediate tube 58 at an interface 112. The interfaces 110, 112 may be provided by one or more of adhesives, fasteners, friction fit, interference fit, and the like. Rotating the second gear 78 rotates the outer tube 60, and thus the bent portion 62 of the tube assembly 28 is correspondingly reoriented (arrow 114 in FIG. 1 ). Rotating the third gear 80 rotates the intermediate tube 58, and with the intermediate tube 58 defining the cutting window 64, the cutting window 64 of the tube assembly 28 is correspondingly reoriented (arrow 116 in FIG. 1 ). When the actuator assembly 30 is in the first mode, rotation of the wheel 74 is configured to rotate the third gear 80, and when the actuator assembly 30 is in the second mode, rotation of the wheel 74 is configured to rotate the second gear 78.

[0027] Some components of the actuator assembly 30 include engagement portions as described that are configured to facilitate selective engagement and disengagement of the sub-components between the first and second modes. With reference to FIGS. 2-7, the first gear 76 includes an engagement portion 118 configured to engage an engagement portion 120 of the nose portion 40 of the housing 26. The first gear 76 may include a first ring 122, with the engagement portion 118 being distally toothed and annularly disposed about the first ring 122. The first gear 76 is dimensioned to be disposed within the first cavity 94 defined by the distal wheel portion 86. More specifically, the engagement portion 118 of the first gear 76 extends through an opening 124 defined by the distal face 90 of the distal wheel portion 86, with the first ring 122 in interference engagement with an inner surface defining the first cavity 94 (see FIGS. 6 and 7). The engagement portion 120 of the nose portion 40 may be teeth oriented annularly in a proximal direction, arranged in a complementary manner with the teeth of the first gear 76. The complementary engagement portions 118 and 120 are configured to selectively engage based on the axial position of the wheel 74, with the engagement portion 118 of the first gear 76 extending distally from the distal face 90 of the distal wheel portion 86. FIG. 4 illustrates the actuator assembly 30 in a first mode, with the wheel 74 in a first axial position and the complementary engagement portions 118 and 120 engaged to prevent rotation of the first gear 76 relative to the housing 26. FIG. 5 illustrates the actuator assembly 30 in a second mode, with the wheel 74 in a second axial position. A gap is noted between the proximal face 50 of the nose portion 40 and the distal face 90 of the distal wheel portion 86, with the complementary engagement portions 118 and 120 disengaged from one another. Taken together, the first gear 76 is configured to engage the housing 26 in a first mode and disengage from the housing 26 in a second mode.

[0028] The first gear 76 and the second gear 78 may include complementary keys 126, 128 configured to prevent relative rotation but permit relative movement between the first gear 76 and the second gear 78. The key 126 of the first gear 76 may be at least one rail and the key 128 of the second gear 78 may be at least one groove. The reverse configuration is also contemplated. The illustrated implementation shows two opposed rails slidably disposed within two opposed grooves defined by the neck 130 of the second gear 78. The first ring 122 of the first gear 76 defines an opening and the rails are axially disposed within the opening. The outer diameter of the neck 130 of the second gear 88 is smaller than the inner diameter of the opening in the first ring 122, and complementary keys 126 and 128 allow axial movement but not rotation between the first gear 76 and the second gear 78 in each of the first and second modes.

[0029] The second gear 78 includes an engagement portion 132 configured to engage with the engagement portion 96 of the distal wheel portion 86. The second gear 78 may include a second ring 134 from which a neck 130 extends distally, and the engagement portion 132 of the second gear 78 may be teeth annularly disposed about the second ring 134 and directed distally. FIG. 4 illustrates the actuator assembly 30 in a first mode with the wheel 74 in a first axial position and the complementary engagement portions 96 and 132 axially spaced apart. FIG. 5 illustrates the actuator assembly 30 in a second mode with the wheel 74 in a second axial position and the complementary engagement portions 96 and 132 engaged with one another. Taken together, the second gear 78 is configured to disengage from the distal wheel portion 86 in the first mode and engage with the distal wheel portion 86 in the second mode.

[0030] The third gear 80 includes an engagement portion 136 configured to engage with the engagement portion 104 of the proximal wheel portion 88. The third gear 80 may include a third ring 138, and the engagement portion 136 of the third gear 80 may be teeth disposed annularly about the third ring 138 and directed distally. FIG. 4 illustrates the actuator assembly 30 in a first mode with the wheel 74 in a first axial position and the complementary engagement portions 104 and 136 engaged to rotate the third gear 80 by rotation of the wheel 74. FIG. 5 illustrates the actuator assembly 30 in a second mode with the wheel 74 in a second axial position and the complementary engagement portions 104 and 136 disengaged from one another. Taken together, the third gear 80 is configured to engage the proximal wheel portion 88 in a first mode and disengage from the proximal wheel portion 88 in a second mode.

[0031] The third gear 80 includes a proximal face 139 disposed in abutting relationship with a boss 140 extending distally from the collar 42 of the housing 26 (see FIG. 3). The proximal wheel portion 88 of the wheel 74 defines an opening 142 dimensioned to be slidably disposed over the boss 140, which abuts the proximal face 139 of the third gear 80 in the first and second modes. In other words, the engagement between the boss 140 of the housing 26 and the third gear 80 may be considered to provide a reference plane for the axial stacking of the sub-components of the actuator assembly 30. Moving distally in the cross-sectional view of FIG. 6, the axial stacking includes a bearing 84 disposed between the boss 140 and the third gear 80. The axial stack further includes a seal 85 disposed between the third gear 80 and the second gear 78, sealing between the boss 140 and the proximal face 139 of the third gear 80. As a result, the second gear 78 is axially fixed relative to the third gear 80. The axial stack further includes a biasing member 82 disposed between the first gear 76 and the second gear 78. The second gear 78 may define an annular recess between the engagement portion 132 and the neck 130, the biasing member 82 being a coil spring having a diameter sized to be disposed within the recess. An opposite end of the coil spring may abut the proximal face of the first gear 76, the coil spring being configured to bias the first gear 76 in a distal direction relative to the second gear 78. More specifically, biasing member 82 is configured to bias first ring 122 into interference engagement with distal wheel portion 86 for the functionality previously described. Figure 6 shows distal face 144 of neck 130 of second gear 78 spaced from proximal face 146 of first gear 76, and Figure 7 shows distal face 144 of neck 130 engaging proximal face 146 of first gear 76 against the spring bias of biasing member 82.

[0032] Operation of the actuator assembly 30 in the first mode will be described with reference to Figures 4 and 6. The complementary engagement portions 118 and 120 engage such that the first gear 76 engages the housing 26. Rotation of the first gear 76 relative to the housing 26 is prevented. The complementary key portions 126 and 128 prevent relative rotation between the first gear 76 and the second gear 78, thereby preventing rotation of the second gear 78 relative to the housing 26. The engagement portion 132 of the second gear 78 disengages from the engagement portion 96 of the distal wheel portion 86. The engagement portion 136 of the third gear 80 engages with the engagement portion 104 of the proximal wheel portion 88. As a result, rotation of the wheel 74 causes a corresponding rotation of the third gear 80. The third gear 80 is fixed to the intermediate tube 58 at an interface 112 such that rotation of the third gear 80 correspondingly rotates the intermediate tube 58, thereby reorienting the cutting window 64 in the tube assembly 28 (arrow 116). Figure 4 shows the cutting window 64 rotated 180 degrees relative to Figure 1 so that it is on the convex side of the bent portion 62 of the tube assembly 28.

[0033] When the bent portion 62 of the tube assembly 28 is shown reoriented, the actuator assembly 30 is moved from the first mode to the second mode. To move the actuator assembly 30 from the first mode to the second mode, an input is provided to the wheel 74 that moves the wheel 74 from the first axial position to a second axial position proximal to the first axial position. The input may include grasping the wheel 74 with the thumb and index finger and pulling in a proximal direction against the spring bias from the biasing member 82. To facilitate ergonomic actuation of the actuator assembly 30 from the first mode to the second mode, the distal wheel portion 86 may include a contour that differs from the contour of the proximal wheel portion to form a flared surface 148. The flared surface 148 may be considered to be more vertically oriented to provide a larger contact area when the wheel 74 is grasped and pulled with the thumb and index finger.

[0034] 5 and 7, the wheel 74 is moved proximally against the spring bias from the biasing member 82. The aforementioned axial stacking of the sub-components of the actuator assembly 30 causes the distal wheel portion 86 and the proximal wheel portion 88, including their respective engagement portions 96, 104, to be moved into and out of engagement with the second gear 78 and the third gear 80, respectively. The distal wheel portion 86, the proximal wheel portion 88, and the first gear 76 move proximally while the second gear 78 and the third gear 80 still remain stationary. The proximal side of the proximal wheel portion 88 is received by or recessed beneath the lip 46 of the collar 42. The lip 46 of the collar 42 defines a portion of the gap 44 dimensioned to accommodate the wheel 74 moved to the second axial position by the actuator assembly 30 in the second mode. Among other benefits, the lip 46 serves the aesthetic role of providing a smoother visible transition between the housing 26 and the wheel 74 by eliminating the gap between the housing 26 and the wheel 74 in the first mode, which may be considered the default mode.

[0035] The proximal movement of the wheel 74 disengages the first gear 76 from the housing 26, the second gear 78 engages the distal wheel portion 86, and the third gear 80 disengages from the proximal wheel portion 88. More specifically, the engagement portion 118 of the first gear 76 disengages from the engagement portion 120 of the housing 26, the engagement portion 132 of the second gear 78 engages with the engagement portion 96 of the distal wheel portion 86, and the engagement portion 136 of the third gear 80 disengages from the engagement portion 104 of the proximal wheel portion 88. The disengagement and engagement can be simultaneous. Thereafter, as the wheel 74 rotates, the second gear 78 correspondingly rotates and is secured to the outer tube 60 at the interface 110. Thus, rotation of second gear 78 causes a corresponding rotation of outer tube 60, causing tube assembly 28 to rotate (arrow 114) about its longitudinal axis, reorienting bent portion 62 of tube assembly 28 about its longitudinal axis. Figure 5 shows bent portion 62 rotated 180 degrees relative to Figure 1 so that cutout window 64 is on the convex side of bent portion 62 of tube assembly 28. It can be seen that while rotating wheel 74 in the second mode, the axial position of wheel 74 is maintained against the spring bias from biasing member 82.

[0036] Once the orientation of the bent portion 62 of the tube assembly 28 is achieved, the surgeon simply releases the input to automatically return the actuator assembly 30 from the second mode to the first mode. The biasing member 82, no longer restrained by input from the surgeon, urges the first gear 76 distal to the second gear 78, and interference engagement between the first gear 76 and the distal wheel portion 86 urges the wheel 74 from the second axial position to the first axial position. The distal wheel portion 86, the proximal wheel portion 88, and the first gear 76 move distally, while the second gear 78 and the third gear 80 still remain stationary. The first gear 76 engages the housing 26, the distal wheel portion 86 disengages from the second gear 78, and the proximal wheel portion 88 engages the third gear 80. More specifically, the engagement portion 118 of the first gear 76 engages with the engagement portion 120 of the housing 26, the engagement portion 96 of the distal wheel portion 86 disengages from the engagement portion 132 of the second gear 78, and the engagement portion 104 of the proximal wheel portion 88 engages with the engagement portion 136 of the third gear 80. The disengagement and engagement may be simultaneous. A rotational input may be immediately provided to the wheel 74 to further orient the cutting window 64 with a view to reorienting the bent portion 62. The presently disclosed cutting assembly 12 provides an intuitive and ergonomic experience that the surgeon may efficiently accomplish with one hand without being distracted from the surgical site.

[0037] The foregoing disclosure is not intended to be exhaustive or to limit the invention to any particular form. The terminology used is intended to be descriptive in nature rather than limiting. Many modifications and variations are possible in light of the above teachings, and the invention may be practiced in other manners than as specifically described. One modification may include adjusting other characteristics of the cutting assembly 12 by a rotatable input in a first mode or a second mode. An example includes adjusting the curvature of the tube assembly by actuation of the actuator assembly 30 in a first mode, a second mode, or another mode. It is further understood that the actuator assembly 30 may be designed to be operable in more than two modes. Another modification may include adjusting a component of a surgical instrument by a rotatable input in a first mode or a second mode.

[0038] In certain implementations, the cutting assembly 12 may include an auditory indicator configured to provide auditory feedback (and in some cases tactile feedback) to the surgeon when the actuator assembly 30 moves between the first and second modes. The auditory indicator may be configured to provide a "click" sound when the wheel 74 returns to the first axial position under the spring bias from the biasing member 82 and / or when the wheel 74 is moved to the second axial position against the spring bias from the biasing member 82. The click sound indicates to the surgeon that the actuator assembly 30 has returned completely to the first mode or has been successfully transferred to the second mode. Examples of auditory indicators may include the housing 26 and the wheel 74 having features or components for providing a defeatable interference engagement with one another, such as resiliently deflectable arms, detents, radial springs, cams, snaps, etc. Engagement and disengagement of defeatable features or components may provide the click sound. In one variation, the biasing member 82 is optional and the actuator assembly 30 is configured to snap-lock into the first and second modes. For example, the actuator assembly 30 may provide a defeatable interference engagement between the housing 26 and the wheel 74 in the first and second axial positions. When the actuator assembly 30 is in the first mode, for example, a sufficient force may be applied to the wheel 74 to overcome the defeatable first function. The wheel 74 may be freely movable over most of the distance between the first and second axial positions. Once the defeatable second function associated with the second axial position is encountered, a sufficient force is again applied to the wheel 74. The wheel 74 is snap-locked into the second axial position. The actuator assembly 30 snap-locked into the first and second modes may be provided with a click sound. In yet another example, a button or other input may be provided on the housing 26 and / or the wheel 74 to disengage a feature that may be disabled and enable movement of the wheel 74 between the first axial position and the second axial position.Such a mechanism avoids the need for the surgeon to maintain wheel 74 against the spring bias of biasing member 82, thereby resulting in a shorter interaction and reducing fatigue on the surgeon's fingers.

[0039] In certain implementations, a locking mechanism may be provided to selectively prevent rotation of the wheel 74 relative to the housing 26. For example, the housing 26 may include a locking pin or keyed coupling that requires a user input to disengage the locking mechanism from the wheel 74. One exemplary locking mechanism is disclosed in the aforementioned WO 2017 / 163226. In certain implementations, visual indicators, such as laser markings, may be provided on the wheel 74, the housing 26, and / or the tube assembly 28 to provide visual information regarding the orientation of the bend portion 62 and / or the orientation of the cutting window 64. For example, the distal wheel portion 86 may be rotatable relative to the proximal wheel portion 88, with the distal wheel portion 86 including a first indicator indicative of the orientation of the bend portion 62 and the proximal wheel portion 88 including a second indicator indicative of the orientation of the cutting window 64. The first indicator may be an alignment arrow or an arc shape pictorially representing the bent portion 62 of the tube assembly 28, and the second indicator may be an oval shape pictorially representing the alignment arrow or the shape of the cutting window 64. In certain implementations, the actuator assembly 30 may be machined into separate pieces or molded together. An example includes the distal wheel portion 86 and the proximal wheel portion 88 being integrally formed by a suitable manufacturing process. It is further contemplated that the housing 26 and the wheels 74 may include separate finishes and / or textures to provide a comfortable feel as well as visual indication of the actuatable components of the cutting assembly 12. An exemplary navigation-assisted surgical system suitable for the cutting assembly 12 is disclosed in commonly owned International Publication No. WO 2016 / 066287, published May 6, 2016, the contents of which are incorporated herein by reference in their entirety.

[0040] Additionally, certain inventive aspects of the present disclosure will be described with reference to the following exemplary clauses.

[0041] Clause 1 - A method of operating a surgical cutting assembly including a housing, a tube assembly coupled to the housing including a bent portion, a cutting window disposed distally of the bent portion, an actuator assembly including a wheel, and a biasing member, the method comprising the steps of supporting a housing of the surgical cutting assembly, moving the wheel in a proximal direction against a spring bias from the biasing member to move the actuator assembly from a first mode to a second mode, and rotating the wheel with the actuator assembly in the second mode to orient the bent portion of the tube assembly.

[0042] Clause 2 - The method of clause 1, wherein the step of rotating the wheel further comprises the step of rotating the wheel while maintaining an axial position of the wheel against a spring bias from a biasing member.

[0043] Clause 3 - The method of clause 1 or 2, further comprising the step of releasing the wheel to return the actuator assembly from the second mode to the first mode under spring bias from the biasing member.

[0044] Clause 4 - The method of clause 3, wherein the surgical cutting assembly includes an auditory indicator, further comprising the step of detecting a clicking sound from the auditory indicator when the actuator assembly is returned to the first mode.

[0045] Clause 5 - A method of operating a surgical cutting assembly including a housing, a tube assembly coupled to the housing including a bent portion, a cutting window disposed distal to the bent portion, an actuator assembly including a wheel, a first interference, and a second interference, the method comprising the steps of supporting a housing of the surgical cutting assembly, disengaging the first interference from the actuator assembly in a first mode, moving the wheel proximally to move the actuator assembly from the first mode to a second mode, engaging the second interference to selectively lock the actuator assembly in the second mode, and rotating the wheel with the actuator assembly in the second mode to orient the bent portion of the tube assembly.

[0046] Clause 6 - The method of clause 5, wherein the step of disengaging the first interference portion and engaging the second interference portion further includes the step of applying a force to the wheel sufficient to overcome the first interference portion and the second interference portion.

[0047] Clause 7 - The method of clause 5 or 6, wherein the wheel is freely movable other than when the actuator assembly is fixed in the first mode and the second mode.

[0048] Clause 8 - The method of any one of clauses 1 to 7, wherein the step of moving the wheel in a proximal direction further comprises the step of pinching and pulling the wheel between the index finger and thumb of the hand while supporting the housing of the surgical cutting assembly on the web of the hand.

[0049] Clause 9 - The method of clause 8, further comprising the step of operating the lancing assembly with one hand by supporting the web portion of the housing with the web of the hand.

[0050] Clause 10 - The method of any one of clauses 1 to 9, wherein the step of rotating the wheel with the actuator assembly further comprises the step of orienting the cutting window of the tube assembly in a first mode.

[0051] Clause 11 - The method of any one of clauses 1 to 10, further comprising coupling a surgical cutting assembly to a main assembly including the motor.

[0052] Clause 12 - An actuator assembly for a surgical instrument including a housing, the actuator assembly comprising a wheel defining a cavity, a first gear, a second gear fixed to a first sub-component, and a third gear fixed to a second sub-component, the first gear, the second gear, and the third gear being disposed within the cavity of the wheel.

[0053] Clause 13 - An actuator assembly as described in clause 12, wherein at least one of: (i) the first gear is configured to selectively engage a housing; (ii) the second gear is configured to selectively engage the wheel; and (iii) the third gear is configured to selectively engage the wheel.

[0054] Clause 14 - An actuator assembly as described in clause 12 or 13, wherein the first gear and the second gear have complementary features configured to prevent relative rotation but permit relative movement between the first gear and the second gear.

[0055] Clause 15 - An actuator assembly as described in any one of clauses 12 to 14, wherein the actuator assembly further comprises a biasing member disposed between the first gear and the second gear.

[0056] Clause 16 - An actuator assembly as described in any one of clauses 12 to 15, wherein the wheel further comprises a distal wheel portion and a proximal wheel portion which are separate parts coupled together.

[0057] Clause 17 - An actuator assembly as described in any one of clauses 12 to 16, further comprising an audible indicator disposed on at least one of the housing and the wheel.

[0058] Clause 18 - An actuator assembly as described in any one of clauses 12 to 17, further comprising an interference portion disposed on at least one of the housing and the wheel, the interference portion configured to selectively engage and disengage to enable axial movement of the wheel.

Claims

1. 1. A surgical cutting assembly comprising: Housing and a tube assembly coupled to the housing, the tube assembly including an outer tube extending from the housing, an intermediate tube coaxially and rotatably disposed within the outer tube, and an inner tube coaxially and rotatably disposed within the intermediate tube, the tube assembly further including a bend and a cutting window disposed distally from the bend; an actuator assembly coupled to the housing and the tube assembly, the actuator assembly including a wheel and a biasing member; Equipped with 11. A surgical cutting assembly, wherein the actuator assembly is operable in a first mode in which the wheel is rotatable in a first axial position to rotate the intermediate tube to orient the cutting window, and in a second mode in which the wheel is rotatable in a second axial position to rotate the outer tube to orient the bent portion, and wherein the biasing member biases the actuator assembly toward the first axial position.

2. 1. A surgical cutting assembly comprising: Housing and a tube assembly coupled to the housing, the tube assembly including an outer tube extending from the housing, an intermediate tube coaxially and rotatably disposed within the outer tube, and an inner tube coaxially and rotatably disposed within the intermediate tube, the tube assembly further including a bend and a cutting window disposed distally relative to the bend; an actuator assembly coupled to the housing and the tube assembly, the actuator assembly including a wheel and a biasing member; Equipped with a first mode in which the actuator assembly is operably coupled to the intermediate tube and operably decoupled from the outer tube, and a second mode in which the actuator assembly is operably coupled to the outer tube and operably decoupled from the intermediate tube, the biasing member biasing the actuator assembly to the first mode.

3. 1. A surgical cutting assembly comprising: Housing and a tube assembly coupled to the housing, the tube assembly including an outer tube extending from the housing, an intermediate tube coaxially and rotatably disposed within the outer tube, and an inner tube coaxially and rotatably disposed within the intermediate tube, the tube assembly further including a bend and a cutting window disposed distally from the bend; an actuator assembly comprising: a wheel axially movable relative to the housing and configured to move the actuator assembly in one of a first mode and a second mode; and a biasing member coupled to the wheel and configured to bias the actuator assembly towards the first mode; A surgical incision assembly comprising:

4. A surgical incision assembly as described in any one of claims 1 to 3, wherein the actuator assembly further comprises a first gear configured to engage with the housing in the first mode and to disengage from the housing in the second mode.

5. A surgical incision assembly as described in claim 4, wherein the actuator assembly further comprises a second gear fixed to the outer tube and configured to disengage from the wheel in the first mode and engage with the wheel in the second mode.

6. A surgical incision assembly as described in claim 5, wherein the actuator assembly further comprises a third gear fixed to the intermediate tube, the third gear configured to engage with the wheel in the first mode and to disengage from the wheel in the second mode.

7. A surgical incision assembly as described in claim 5, wherein the first gear and the second gear have complementary key portions configured to prevent relative rotation between the first gear and the second gear but allow relative movement.

8. A surgical incision assembly as described in claim 1, wherein the housing comprises a nose portion and a collar spaced from the nose portion to define a gap dimensioned to receive the wheel, the nose portion comprising an engagement portion configured to engage with the first gear when the actuator assembly is in the first mode.

9. A surgical incision assembly as described in claim 8, wherein the collar includes a lip dimensioned to receive a proximal side of the wheel when the actuator assembly is in the second mode.

10. A surgical incision assembly comprising: Housing and a tube assembly coupled to the housing, the tube assembly including an outer tube extending from the housing, an intermediate tube coaxially and rotatably disposed within the outer tube, and an inner tube coaxially and rotatably disposed within the intermediate tube, the tube assembly further including a bend and a cutting window disposed distally from the bend; an actuator assembly including a wheel, a first gear, a second gear secured to the outer tube, a third gear secured to the intermediate tube, and a biasing member disposed between the first gear and the second gear; A surgical incision assembly comprising:

11. A surgical incision assembly as described in claim 10, configured to achieve at least one of the following: (i) the first gear selectively engages with the housing; (ii) the second gear selectively engages with the wheel; and (iii) the third gear selectively engages with the wheel.

12. A surgical incision assembly as described in claim 10 or 11, wherein the first gear and the second gear have complementary key portions configured to prevent relative rotation between the first gear and the second gear but allow relative movement.

13. A surgical incision assembly as described in claim 10, wherein the actuator assembly further comprises a bearing disposed between the second gear and the third gear.

14. The surgical incision assembly of claim 10, wherein the housing includes an engagement portion configured to be selectively engaged by the first gear.

15. The surgical incision assembly of claim 10, wherein the first gear, the second gear, and the third gear are disposed within the wheel.

16. The surgical incision assembly of claim 10, wherein the wheel further comprises a distal wheel portion and a proximal wheel portion which are separate components joined together.

17. A surgical incision assembly as described in any one of claims 1 to 3 and claim 10, wherein the tube assembly defines a suction path configured to be placed in fluid communication with a suction source and an irrigation path configured to be placed in fluid communication with a fluid source.

18. A surgical incision assembly as described in any one of claims 1 to 3 and claim 10, wherein the housing and the actuator assembly form disposable components of the surgical incision assembly.

19. A surgical incision assembly as described in any one of claims 1 to 3 and claim 10, further comprising an auditory indicator disposed on at least one of the housing and the wheel, the auditory indicator being configured to provide auditory feedback when the actuator assembly is in one of the first mode and the second mode.

20. A surgical incision assembly as described in any one of claims 1 to 3 and claim 10, further comprising an interference portion disposed on at least one of the housing and the wheel, the interference portion configured to selectively engage and disengage to enable movement of the wheel between the first mode and the second mode.

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