Surgical device with a single portal

Abstract

Some implementations of the present disclosure are directed to a single-portal surgical system. In one implementation, the device includes first, second, and third cannulas. Fluid flows through the proximal opening of the first cannula. The second cannula joins within the first cannula such that the outer wall of the second cannula contacts the inner wall of the first cannula. The second cannula includes a first distal opening and a first slot extending longitudinally along the second cannula. Fluid entering the proximal opening flows through the first slot and exits at the distal end. The third cannula joins within the second cannula such that the outer wall of the third cannula is in contact with the inner wall of the second cannula. The third cannula includes a second distal opening that rotationally interacts with the first distal opening within the tissue debris removal.

Description

Technical Field

[0001] Cross - Reference to Related Applications This application claims priority to U.S. Provisional Patent Application No. 63 / 352,502, entitled "SINGLE PORTAL, SLOTTED MICRODEBRIDER," filed on June 15, 2022, the entire content of which is incorporated herein by reference.

Background Art

[0002] Orthopedic arthroscopic examinations have historically utilized two or three surgical portals to successfully navigate instruments within the joint cavity under endoscopic guidance. One of the more common instruments used in this regard is the surgical microdebrider. A microdebrider is an electric - powered, elongated cannula having an inner cannula and an outer cannula. The inner cannula rotates or vibrates within the outer cannula. The inner cannula and the outer cannula have openings at the end of the cannula with sharp or serrated edges. These openings are typically oriented along the side of the cannula tip, such that the blunt, rounded tip can protect distal tissue from the cutting action of the microdebrider. In other types of microdebriders, burrs are located at the distal tip of the inner shaft that aligns with the side openings of the distal outer cannula tip, again keeping the tip of the cannula protected. Perfusion and aspiration pumps are often used to maintain joint cavity fluid pressure and to adjust aspiration and perfusion in a manner sufficient to minimize tissue breakdown that obscures visualization.

Summary of the Invention

Means for Solving the Problems

[0003] For the microdebrider cannula to function effectively, suction and irrigation must be available to prevent tissue, cartilage, and bone from clogging the tip or shaft of the microdebrider cannula. Historically, suction for removing fluid from the joint cavity has been applied to the rear end of the inner microdebrider cannula or through a suction port located on the side of a separate cannula through which the endoscope or microdebrider is delivered via a different portal through which it is placed. For there to be sufficient space for irrigation to flow into the joint cavity, a gap is required between the outer surface of the endoscope or microdebrider cannula shaft and the inner surface of the outer orthopedic cannula shaft used to gain access to the joint. By eliminating this gap, the overall outer diameter of the optical cannula can be reduced.

[0004] The arthroscopic surgery market is moving towards smaller endoscopes and instruments to minimize patient discomfort and enable arthroscopic procedures within the hospital. For example, ARTHREX introduced the 1.9 mm "Nanoscope" with a 2.2 mm inflow sheath. However, these devices are used for visualization within the joint cavity. To use an instrument for tissue removal, a second portal is required to pass the instrument through. The ARTHREX inflow cannula is not large enough to accommodate an endoscope and an instrument such as forceps or a microdebrider cannula within the same inflow cannula.

[0005] It would be advantageous to perform the surgery through a single optical orthopedic cannula. A single portal system minimizes the number of incision sites and instrument portals, thereby reducing pain and blood loss while simultaneously improving the speed and efficiency of the surgery. The smaller the diameter of the single portal optical cannula, the better the surgical arthroscopic examination can be tolerated by the patient. On the other hand, for certain applications, it is necessary to make the microdebrider shaft as large as possible in order to minimize the time required for tissue removal. The smaller the inner diameter of the microdebrider cannula, the longer it takes to excise the tissue. In a single portal system, the optical orthopedic cannula used to gain access to the joint cavity must provide an inner diameter large enough to allow for perfusion, aspiration, and the passage of a microdebrider shaft or another shaft-like instrument. If the inner diameter of the working channel is too small, there is not enough space to pass fluid outside the microdebrider or instrument shaft. In such a situation, standard aspiration through the inner microdebrider cannula quickly overtakes the amount of perfusion flowing into the joint from around the cannula. Similarly, the forceps instrument shaft passing through the single-channel optical cannula can provide only one surrounding space between the forceps shaft and the inner wall of the channel for propagating either aspiration or perfusion. Aspiration and perfusion cannot be performed simultaneously through the same cannula.

[0006] To address these and other drawbacks of existing or future optical cannula surgical systems and to advance single-portal surgical systems, implementations of the present disclosure are directed to single-portal surgical systems and methods that include a slotted microdebrider and a customized shaft suitable for a single portable surgical application. By innovating means by which aspiration and irrigation can be simultaneously directed through a smaller caliper single optical cannula, the need for multiple instruments inserted into an anatomical space through multiple portals is minimized. The techniques described herein can be applied to multiple procedures across multiple surgical specialties, including orthopedics, otolaryngology, OB / GYN, general surgery, urology, neurosurgery, and veterinary medicine.

[0007] In one embodiment, the device comprises a first cannula coupled to a fluid receptacle such that fluid flows from the fluid receptacle through a proximal opening of the first cannula; a second cannula coupled within the first cannula such that an outer wall of the second cannula is in contact with an inner wall of the first cannula, the second cannula including a first distal opening and a first slot extending longitudinally along a length of the second cannula, wherein fluid entering the proximal opening of the first cannula flows through the first slot and exits at a distal end of the device; and a third cannula coupled within the second cannula such that an outer wall of the third cannula is in contact with an inner wall of the second cannula, the third cannula including a second distal opening that rotationally interacts with the first distal opening during tissue debridement. The fluid can exit at a distal end of the device proximal to the first distal opening of the second cannula.

[0008] In some implementations, the second cannula further includes a second slot extending longitudinally along a length of the second cannula, wherein fluid entering the proximal opening of the first cannula flows through the first slot and the second slot and exits at a distal end of the device.

[0009] In some embodiments, the second cannula further includes a third slot that extends longitudinally along the length of the second cannula, and the first slot, the second slot, and the third slot are circumferentially spaced along the second cannula.

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

[0011] In some embodiments, the first slot is substantially linear along the length of the second cannula.

[0012] In some embodiments, the first slot is helical along the length of the second cannula.

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

[0014] In some embodiments, the outer wall of the second cannula is in contact with the inner wall of the first cannula without a gap along the longitudinal length of the first cannula.

[0015] In some embodiments, the apparatus further includes a housing coupled to the proximal end of the third cannula, the housing including a port configured to couple to a suction line that suctions tissue after debridement or fluid that exits after the distal end of the apparatus.

[0016] In some embodiments, the edge of the third cannula along the second distal opening is sharp.

[0017] In some implementations, the device further comprises a light source that sends light to a location of the tissue within the debrider, and an image sensor that images that location within the debrider. In some implementations, the first cannula comprises an optical channel through which the light sent by the light source travels. In some implementations, the light source is located at the distal end of the first cannula (e.g., an LED light source), and an optical channel is not required.

[0018] In some implementations, the device further comprises a fluid receptacle configured to fluidly couple to a fluid source. In some implementations, the fluid receptacle is rotatable longitudinally.

[0019] In some implementations, the third cannula is removably coupled within the second cannula.

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

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

[0022] In one embodiment, the device includes a first cannula coupled to a fluid receptacle such that fluid flows from the fluid receptacle through a proximal opening of the first cannula, a second cannula coupled within the first cannula such that an outer wall of the second cannula is in contact with an inner wall of the first cannula, the second cannula including a first distal opening and at least one slot extending longitudinally along a length of the second cannula, and fluid entering the proximal opening of the first cannula flowing through the at least one slot and exiting at a distal end of the device, and an instrument shaft coupled within the second cannula such that an outer wall of the instrument shaft is in contact with an inner wall of the second cannula. The fluid can exit at a distal end of the device proximal to the first distal opening of the second cannula.

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

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

[0025] In some embodiments, the single portal device further comprises a cable wire coupled to the proximal end of the first tool, and the cable wire extends through the first instrument channel to the proximal end of the single portal surgical device.

[0026] In some embodiments, the single portal device further comprises a second tool extending distally from the instrument shaft. In some embodiments, the interior of the instrument shaft further comprises a second instrument channel separate from the first instrument channel, and the second tool extends distally from the distal end of the second instrument channel.

[0027] In some embodiments, the first and second structures are circumferentially helical around the instrument shaft along their longitudinal lengths.

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

[0029] In some embodiments, at least two fluid channels comprise a first fluid channel and a second fluid channel. Fluid entering the proximal opening of the first cannula flows through the first fluid channel and exits at the distal end of the first cannula, and the second fluid channel is configured to aspirate fluid or tissue.

[0030] In some embodiments, the second fluid channel is coupled to a suction line proximal to the first cannula.

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

[0032] In some implementations, the single-port surgical device further includes a light source that sends light to an anatomical site during surgery and an image sensor that images the anatomical site during surgery.

[0033] In some implementations, the image sensor is integrated into a first cannula, and the first cannula either includes a channel through which the light sent by the light source travels or has a distal end of the first cannula that includes the light source.

[0034] In some implementations, the single-port surgical device further includes a handle proximal to the first cannula and the instrument shaft and coupled to the first cannula and the instrument shaft, and the handle includes a control unit configured to be actuated to move a first instrument.

[0035] In some implementations, the single-port surgical device further includes a connector distal to the handle, and the connector is configured to removably couple a proximal end of the instrument shaft to the handle.

[0036] Other features and aspects of the disclosed technology will become apparent from the following detailed description in conjunction with the accompanying drawings that illustrate features by way of example of implementations of the disclosed technology. This summary is not intended to limit the scope of the invention described herein, which is defined by the claims and equivalents.

Brief Description of the Drawings

[0037] This disclosure will be described in detail with reference to the following figures in accordance with one or more implementations. The figures are provided for purposes of illustration only and merely show exemplary implementations. Further, note that the elements in the figures are not necessarily drawn to scale in order to make the description clear and easy.

[0038] Some of the figures included in this specification illustrate various implementations of the disclosed technology from different viewing angles. The accompanying description may refer to figures such as "top", "bottom", or "side" views, but such references are merely illustrative and do not imply or require that the disclosed technology be implemented or used in a particular spatial orientation unless otherwise specified.

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[0064] The figures are not exhaustive and do not limit the present disclosure to the exact forms disclosed.

DETAILED DESCRIPTION OF THE INVENTION

[0065] Figures 1A-1B show a single portal microdebrider device 10 according to some implementations of the present disclosure. FIG. 1A shows the disassembled microdebrider device 10, and FIG. 1B shows the assembled microdebrider device 10. The microdebrider device 10 includes an optical or endoscopic component 100, a microdebrider outer component 200, and a microdebrider inner component 300. As shown by the example of FIGS. 1A-1B, all of the components 100-300 are removably coupled and they can be disassembled. However, depending on the implementation of the device, all, some, or none of the components 100-300 can be disassembled. For example, in one implementation, all of the components are integrated or otherwise combined in a different way.

[0066] The optical component 100 includes a fluid port 105, a fluid receptacle 110, and a cannula 120. The optical component 100 may also include an endoscopic light source and an image sensor (not shown). The light source and / or the image sensor may be positioned at the distal end of the cannula 120 or within a housing (not shown) at the proximal end of the optical component 100. For example, during endoscopic operation of the optical component 100, light emitted from a light source (e.g., an LED light source) housed within an endoscopic housing can send light traveling through the cannula 120 via an illumination channel that terminates at the distal end of the cannula 120. The illumination channel can be a molded illumination pipe. Alternatively, in other implementations, the light source may be integrated inside and / or outside the cannula 120. In such implementations, the light source may be positioned near the distal end of the cannula 120 (e.g., within a different channel near the camera sensor so that the light emitted by the light source does not interfere with the operation of the camera sensor), or at some other segment of the cannula 120.

[0067] Figure 2 shows an enlarged view of the fluid receptacle 110 and the fluid port 105. As shown, the fluid port 105 is coupled to the interior of the fluid receptacle at the junction or channel 105a. Fluid received in the channel 105a flows into the cannula 120 at the proximal opening 125a of the cannula 120. In this example, the fluid receptacle 110 can rotate longitudinally to enable better positioning of a fluid line (not shown) that extends to the fluid port 105 or otherwise improve the ergonomics of the device 10. In some implementations, the fluid receptacle 110 can be removably coupled to the optical component 110.

[0068] The microdebrider outer component 200 includes a head 210, a cannula 220, and a distal end or cannula tip 230 having an opening 230a. FIGS. 3A - 3D show various enlarged views of the cannula 220 and the distal end 230 of the outer component 200 according to some implementations of the present disclosure. At least one slot 225 extends longitudinally along the length of the cannula 220, which provides a means for delivering fluid to the distal end of the device 10, as further described below.

[0069] The microdebrider inner component 300 includes a head 310, a cannula 320, and a distal end or cannula tip 330 having an opening 330a. FIGS. 4A - 4C show different perspective views of the cannula 320 and the distal end 330 of the inner component 300. The proximal end of the head 310 can be coupled to a suction tool (not shown) via a suction line (not shown) that sucks the tissue and / or the perfusion fluid excised at the distal end 330 during operation of the device 10. The distal end 330 of the cannula 320 can include a rotating instrument (e.g., a blade or a burr) for performing the excision function.

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

[0071] In this example, the device 10 is assembled by moving the microdebrider inner component 300 through the microdebrider outer component 200 (e.g., starting at the opening at the proximal end of the head 210 of the outer component 200) such that the cannula 320 moves through the cannula 220, and by moving the optical component 100 over the cannula 220 (e.g., starting at the distal end of the microdebrider outer component 200) such that the cannula 120 moves over the cannula 220. Although an assembly style where the integral parts are non - detachable or manufactured as a single part is also envisioned, it should be understood that the device 10 incorporates the optical component 100 having a cannula 130 that includes the cannula 220 of the outer component 200 and the cannula 320 of the inner component 300.

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

[0073] Figures 5-6 show the assembled device 10 in two different positions. As shown, cannula 120 covers slot 225 except near the distal end of cannula 220, cannula 320 covers the bottom of slot 225, and provides a floor for any fluid flowing through the channel between cannulas 120 and 220. In Figure 5, cannulas 220 and 320 are rotatably positioned such that the tip of device 10 opens and the opening 330a of cannula tip 330 is exposed. In Figure 6, cannula 320 is rotated approximately 180 degrees relative to the position in Figure 5 such that opening 330a is no longer exposed and the tip of device 10 is closed.

[0074] Figure 7 shows a cross-sectional view of cannulas 120, 220, and 320 of the three components 100-300 after the device 10 is assembled, and is referred to herein when explaining the operation of the microdebrider device 10. During use of the microdebrider device 10, fluid (e.g., irrigation fluid) is delivered via a fluid line (not shown) to fluid port 105 and into channel 105a of fluid receptacle 110a. The fluid proceeds into cannula 120 via proximal opening 125a. The fluid flows through the space within slot 225 between cannulas 120 and 220 as shown in Figure 7. The fluid flows along the longitudinal end of device 10 and exits from the distal end of the combined cannulas of device 10 that is proximal to the distal opening of cannula 230 and distal to the distal endpoint of outer cannula 120. The distance between the endpoint of cannula 120 and the amount of the exposed irrigation slot 225 can vary between 1 mm and 5 mm.

[0075] The above design enables the irrigation fluid or other fluid to be delivered through the optical component 100 into the joint cavity in a manner that maximizes the outer diameter of the microdebrider (e.g., twice r2 in FIG. 7) and minimizes the inner diameter of the optical component working channel (i.e., the spacing between cannulas 120 and 220). By disposing at least one slot 225 extending longitudinally along the microdebrider cannula 220, fluid can be delivered through the slot 225 to the component tip. Thus, this design can eliminate the conventional gap between the inner wall of the working channel of the optical component 100 and the outer wall of the microdebrider outer component 200, as shown in FIG. 7. The fluid can be sent to the end of the component without the need to expand the entire space occupied by the component.

[0076] In the above configuration, the outer wall of the cannula 320 of the microdebrider inner component 300 can fit flush within the inner wall 220a of the cannula 220 of the microdebrider outer component 200. Thereby, the microdebrider inner component 300 forms a floor for one or more slots 225 disposed in the microdebrider outer component 200. Similarly, the inner wall 120a of the working channel of the cannula 120 of the optical component 100 provides a roof or ceiling for the slot 225. Thus, the slot 225 can be limited by the material thickness of the cannula 220 of the outer microdebrider component 200 and the width of the slot 225 for the irrigation channel.

[0077] In some embodiments, a plurality of slots 225 (e.g., 2, 3, 4, 5, 6, or more) can be spaced apart in the circumferential direction and extend longitudinally along the outer cannula 220. For example, FIG. 8 shows a cross-sectional view of an exemplary implementation of an assembled microdebrider device having a microdebrider outer component with a cannula 420 having four spaced slots extending longitudinally along the outer cannula 220. By having a plurality of spaced slots 225, more uniform delivery and an increase in the volume of fluid can be ensured at the distal end of the device, and the delivery is often made under pressure.

[0078] In some embodiments, the slots are assumed to be straight in shape, but in other embodiments, the slots may be non-linear in shape and width. Such embodiments can include helical or mixed horizontal and longitudinal slot configurations. For example, a helical slot configuration can enable the torsional closure of the slot in certain applications, whereby it would be beneficial to change the size of the slot and thus the fluid conveyance capacity. As an example, FIG. 9 shows a side view of a cannula 920 of a microdebrider outer component of a microdebrider device, the cannula 920 including a helical slot 925. In addition to extending longitudinally along the length of the cannula 920, the slot 925 is helical around the circumference of the cannula 920. The dashed lines in FIG. 9 indicate portions of the slot 925 that are not visible from the illustrated side view. FIG. 9 shows an example of a cannula 920 having one helical slot 925, but in some embodiments, the outer cannula can have a plurality of helical slots. In such embodiments, the helical slots can remain parallel to each other along the longitudinal length of the cannula.

[0079] FIG. 10 shows an example of an optical component including a light source 1005 and an image sensor 1030. For ease of illustration, other parts of the optical component (e.g., fluid ports and receptacles) are not shown. The exemplary optical component includes a cannula 1020 that extends distally from an endoscope housing 1000. The endoscope housing 1000 includes a light source 1005 that sends light traveling through an optical channel 1025 of the cannula 1020, and the optical channel terminates at the distal end of the cannula 1020. The optical channel 1025 can be a channel formed in the cannula 1020 (e.g., through the wall of the cannula) separate from the channel through which fluid moves (e.g., the main cannula opening). An image sensor 1030 positioned at the distal end of the cannula 1020 collects light reflected from an anatomical structure illuminated by the light sensor 1005. The image sensor 1030 itself can also be positioned within the wall of the cannula 1020 or in a separate channel attached outside the cannula 120. To power and operate the light source 1005 and the image sensor 1030, the endoscope housing 1000 can provide power to the light source (and the image sensor) via separate power lines or power line communication.

[0080] FIG. 11 shows an example of an inner component cannula 1120 of a microdebrider coupled to a housing 1100. The housing includes a suction channel 1106 for receiving tissue and / or irrigation fluid excised through the cannula 1120. The housing also includes a port 1105 that couples to a suction line 1150 (e.g., via the suction channel 1106). The suction line 1150 can suction tissue after debriding. The suction line can also suction fluid after it exits the distal end of the microdebrider device. In some implementations, the port 1105 can be directly coupled to the cannula 1120, in which case the suction channel 1106 can be omitted.

[0081] The cannulas 120, 220, and 320 can be made from metal and / or a rigid or flexible polymer such as PEBA, PEEK, or LCP. Disposable and reusable cannulas are also envisioned. In some implementations, the optical cannula shaft 120 can be articulated, flexible, malleable, or otherwise non-linear or curved in configuration. An optical cannula shaft that relays anatomical tip positioning information to an image-guided computer is also envisioned. The inner cannulas 220 and 320 can also be flexible and / or articulated, thereby being able to move passively or actively relative to the outer flexible or articulated optical cannula.

[0082] In some implementations, a powered rotary shaft instrument can be inserted through a second cannula 220 instead of the rotary hollow cannula 320. For example, a shaft burr can be inserted through the second cannula 220 instead of the rotary hollow cannula 320 so that aspiration can still occur around the burr tip.

[0083] Delivery of irrigation fluid through the cannula and the slot configurations described herein are not limited to arthroscopic microdebriders. Similar applications are envisioned for shaft instruments that can be passed through an outer cannula when slots or indentations / grooves incorporated into the outer diameter of the instrument shaft are required for fluid delivery. It should also be noted that the outer profile of the instrument shaft can be circular or some other geometric outer profile, and the cannula can also have an outer or inner profile that is not necessarily circular in configuration.

[0084] Figures 12A - 14B show exemplary implementations of a single-port surgical device that utilizes an instrument shaft that extends through an outer cannula (e.g., outer optical cannula 120), is in contact with the inner wall of the outer cannula, and is configured to divide the interior of the optical cannula into a plurality of discrete fluid channels suitable for irrigation and / or aspiration operations.

[0085] Figures 12A and 12D show a single-portal surgical device 1200 that includes a winged instrument shaft 1250 that extends through an outer / optical cannula 1280 and is configured to divide the interior of the outer / optical cannula into a plurality of separate fluid channels. The illustrated device includes a handle 1210, a control unit 1205 operable to drive a distal tool / tool tip 1255, an instrument shaft having a winged portion 1252, and an instrument shaft connector 1220 distal to the handle 1210. The device 1200 may also include an outer / optical cannula 1280 configured to receive the winged instrument shaft 1250. The outer / optical cannula 1280 can include components similar to those of the cannula described above with reference to the optical components 100 and / or the optical components of FIG. 10 (e.g., image sensors, light sources, fluid couplings, etc.). FIGS. 12B-12C show side and perspective views of the instrument shaft and distal tool 1255, respectively.

[0086] The instrument shaft 1250 includes a winged portion 1252 and a connector portion 1253 for connecting the instrument shaft 1250 to the handle 1210. The connector portion 1253 mechanically couples the proximal end of the instrument shaft 1250 to an instrument shaft connector 1220 that extends distally from the handle 1210. The housing that houses or extends from the instrument shaft connector 1220 can also incorporate a perfusion and aspiration mechanism that attaches to aspiration and perfusion lines that extend to the device 1200. The connector portion 1253 can be rigid or semi-rigid, and the coupling mechanism of the instrument shaft connector 1220 can enable a removable coupling mechanism such as a snap fit, press fit, friction fit, magnetic attachment, and / or any other attachment mechanism. One embodiment can include a longitudinal slot within the housing 1220 that rotates around the shaft connector portion 1253 after 1253 is positioned within a slot (not shown). In an alternative implementation, the instrument shaft is integrated and not removable.

[0087] Proximally of the connector portion 1253, a cable / wire 1254 configured to drive the tool tip 1255 extends. The cable / wire 1254 can be configured to extend through the instrument shaft 1250 to the tool tip 1255. The instrument handle 1210, the housing 1220, and the actuation control unit 1205 can be configured to removably secure the instrument shaft segment 1253 to the proximal end of the cable / wire 1254, whereby the cable / wire 1254, when engaged, can move back and forth within the shaft 1252 when engaged and actuated by the control unit 1205. As shown in this example, the tool tip 1255 includes forceps. However, as will be further described below, various other instrument tools for use with the single-port surgical device 1200 or its variations are envisioned. During operation, the control unit 1205 can be actuated to drive the distal tool 1255 via the cable 1254. The control unit 1205 is shown as having a finger grip that can be grasped to actuate the distal tool 1255. For example, other control units including a trigger, a button, a dial, a slide, etc. are envisioned.

[0088] The winged portion 1252 of the instrument shaft 1250 projects from the length of the instrument shaft and includes circumferentially spaced-apart wings / structures 1252a and 1252b that extend longitudinally along the length of the instrument shaft. When the device 1200 is assembled, the shaft 1252 can be inserted through the outer / optical cannula 1280 shown in FIG. 12D such that each of the circumferentially spaced-apart wings 1252a and 1252b is in continuous contact with the surface of the inner wall of the outer cannula along the longitudinal length of the inner wall. With this configuration, the inside of the outer cannula 1280 can be divided into a plurality of fluid channels that can be configured for suction and / or perfusion functions. Fluids (e.g., liquids or air / gases) can be sent and / or received by each of the fluid channels. An exemplary implementation of the instrument shaft extending through the outer cannula is shown and further described below with reference to FIGS. 13A - 13B and FIGS. 14A - 14B.

[0089] The instrument shaft and the outer cannula can be assembled together by inserting the distal end of the instrument shaft 1250 through the proximal end of the outer cannula until the distal end of the instrument shaft reaches or extends through the distal end of the outer cannula 1280. In such an implementation, the instrument shaft 1250 can first be coupled to the instrument shaft connector 1220 via the connector portion 1253 and subsequently to the outer cannula. Alternatively, the proximal end of the instrument shaft 1250 can be inserted or pushed through the distal end of the optical cannula and then coupled to the handle 1210 and / or the connector 1220. The latter form of assembly may be preferred if the distal tool is too large to fit through the outer cannula.

[0090] Two circumferentially spaced wings / structures 1252a and 1252b are shown for dividing the inside of the outer cannula 1280 into two fluid channels, but it should be understood that additional circumferentially spaced structures can be included to divide the inside of the outer cannula 1280 into three or more fluid channels. Further, the wings 1252a and 1252b are circumferentially spaced approximately 180 degrees along the instrument shaft to enable the formation of two fluid channels of substantially equal size, but it should be understood that other spacing configurations can be implemented and the formed fluid channels need not be of substantially equal size.

[0091] The material properties of the winged portion 1252 (and in particular the wings 1252a and 1252b), including rigidity, flexibility, malleability, and / or roughness, can be selected to enable each wing to remain in continuous contact with the surface of the inner wall along its longitudinal length. In making this selection, the material properties of the inner wall of the outer cannula 1280 can also be taken into account. For example, there may be longitudinal or helical grooves incorporated into the inner surface wall of the cannula that engage the wings, thereby fixing the position and creating a tighter fluid or suction seal.

[0092] Figures 13A - 13B show an exemplary assembly 1300 of a single - portal surgical device according to some implementations of the present disclosure. The assembly 1300 includes an instrument shaft 1320 that extends through an outer / optical cannula 1310 and is in contact with the inner wall of the outer cannula 1310. Figure 13A shows a front perspective view and Figure 13B shows a front cross - sectional view. As shown, the outer surfaces 1320a and 1320b of the instrument shaft 1320 are in continuous contact with the inner wall of the outer cannula 1310, dividing the inside of the outer cannula 1310 into two separate fluid channels, namely fluid channel 1335 and fluid channel 1345. Additionally, the instrument shaft 1320 is structured to accommodate two separate instruments, namely a first instrument or cable wire through instrument channel 1322 and a second instrument through instrument channel 1324. The instruments can be removably coupled or integrated into their respective channels. For example, various instruments are envisioned for use, including forceps, injection needles, laser fibers for ablation, suture / suture guides, drills, image - guided probes, and the like.

[0093] Figures 14A - 14B show another exemplary assembly 1400 of a single - portal surgical device according to some implementations of the present disclosure. The assembly 1400 includes an instrument shaft 1420 that extends through an outer / optical cannula 1410 and is in contact with the inner wall of the outer cannula 1410. Figure 14A shows a front perspective view, and Figure 14B shows a front cross - sectional view. As shown, the circumferentially spaced finned structures 1420a and 1420b of the instrument shaft 1420 are in continuous contact with the inner wall of the outer cannula 1410, dividing the inside of the outer cannula 1410 into two separate fluid channels, namely fluid channel 1435 and fluid channel 1445. The instrument shaft 1420 is structured to accommodate an instrument through an instrument channel 1421. The instrument can be removably coupled or integrated to the channel 1421. As shown in Figure 14A, the finned structures 1420a and 1420b are circumferentially helical around the instrument shaft along its longitudinal length. This configuration allows the instrument shaft to be better stabilized within the outer cannula 1410. In an alternative implementation, the finned structures 1420a and 1420b can extend linearly along the longitudinal length.

[0094] Although various exemplary implementations and embodiments have been described above, the various features, aspects, and functions described in one or more of the individual implementations are not limited in their applicability to the specific implementations in which they are described. Instead, such features, whether or not such implementations are described and whether or not such features are presented as part of the implementations in which they are described, can be applied, alone or in various combinations, to one or more of the other implementations of the present application. It should be understood, therefore, that the breadth and scope of the present application should not be limited by any of the above - described exemplary implementations.

[0095] It should be understood that all combinations of the foregoing concepts (as long as such concepts do not contradict each other) are considered to be part of the subject matter of the invention disclosed herein. In particular, all combinations of the claimed subject matter that appear at the end of this disclosure are considered to be part of the subject matter of the invention disclosed herein.

[0096] The terms "substantially" and "about" as used throughout this disclosure, including in the claims, are used to describe and account for minor variations, such as due to manufacturing tolerances. For example, they can refer to ±5% or less, such as ±2% or less, such as ±1% or less, such as ±0.5% or less, such as ±0.2% or less, such as ±0.1% or less, such as ±0.05% or less.

[0097] To the extent applicable, the terms "first", "second", "third", etc. in this specification are used merely to indicate each object described by these terms as a separate entity, and do not imply a chronological meaning unless specifically stated otherwise in this specification.

[0098] The terms and phrases used in this specification, and variations thereof, unless otherwise specified, should be construed as open-ended and not limiting. By way of example, the term "comprising" should be read to mean "including, but not limited to", the term "example" is used to provide some examples of the item under discussion, rather than an exhaustive or limiting list, the term "a" or "an" should be read to mean "at least one", "one or more", etc., and adjectives such as "conventional", "traditional", "ordinary", "standard", "known", and terms of similar meaning should not be construed as limiting the item described to items available at a given period or point in time, but rather should be read to include conventional, traditional, ordinary, or standard techniques that are or may be available or known at any current or future point in time. Similarly, when this specification refers to techniques that are obvious or known to those of ordinary skill in the art, such techniques include those that are or may be obvious or known to those of ordinary skill in the art at any current or future point in time.

[0099] In some cases, the presence of broad words and phrases such as "one or more", "at least", "but not limited to", or other similar phrases should not be construed to mean that a narrower case is intended or required where such broad phrases may not be present. The use of the term "module" does not mean that all components or functions described or claimed as part of the module are configured within a common package. In fact, any or all of the various components of a module can be combined into a single package, whether control logic or other components, or maintained separately, and further distributed into multiple groups or packages, or in multiple locations.

[0100] Furthermore, the various implementations described herein are described with respect to example block diagrams, flowcharts, and other drawings. As will be apparent to those skilled in the art after reading this document, the illustrated implementations and their various alternative forms can be implemented without being limited to the illustrated examples. For example, the block diagrams and their accompanying descriptions should not be construed as requiring a particular architecture or configuration.

[0101] Although the various implementations of the present disclosure have been described above, it should be understood that they are presented by way of example only and not by way of limitation. Similarly, the various figures may show an exemplary architecture or other configuration of the present disclosure made to assist in understanding the features and functions that may be included in the present disclosure. The present disclosure is not limited to the illustrated exemplary architecture or configuration, and the desired features can be implemented using various alternative architectures and configurations. In fact, it will be apparent to those skilled in the art how alternative functional, logical, or physical divisions and configurations can be implemented to implement the desired features of the present disclosure. Also, numerous different configuration module names other than those shown herein can be applied to the various divisions. Furthermore, with respect to the flow diagrams, operation descriptions, and method claims, the order in which steps are presented herein does not require that various implementations be implemented in the same order to perform the recited functions unless the context indicates otherwise.

Claims

**Claim 1** An apparatus comprising: a first cannula coupled to a fluid receptacle such that fluid flows from the fluid receptacle through a proximal opening of the first cannula; a second cannula coupled within the first cannula such that an outer wall of the second cannula is in contact with an inner wall of the first cannula, the second cannula including a first distal opening and a first slot extending longitudinally along a length of the second cannula, wherein the fluid entering the proximal opening of the first cannula flows through the first slot and exits at a distal end of the apparatus; a third cannula coupled within the second cannula such that an outer wall of the third cannula is in contact with an inner wall of the second cannula, the third cannula including a second distal opening that rotatably interacts with the first distal opening within a tissue debrider; the apparatus. **Claim 2** The apparatus of claim 1, wherein the second cannula further includes a second slot extending longitudinally along a length of the second cannula, and wherein the fluid entering the proximal opening of the first cannula flows through the first slot and the second slot and exits at a distal end of the apparatus. The apparatus according to claim 1, wherein the fluid entering the proximal opening of the first cannula flows through the first slot and the second slot and exits at the distal end of the apparatus. The apparatus according to claim 1. **Claim 3** The apparatus of claim 2, wherein the second cannula further includes a third slot extending longitudinally along a length of the second cannula, and wherein the first slot, the second slot, and the third slot are circumferentially spaced along the second cannula. The apparatus according to claim 2, wherein the first slot, the second slot, and the third slot are circumferentially spaced along the second cannula. The apparatus according to claim 2. **Claim 4** The apparatus of claim 1, wherein the fluid entering the proximal opening of the first cannula flows through a channel defined by an opening between a first boundary and a second boundary, the opening including the first slot, the first boundary including a longitudinal portion of an inner wall of the first cannula, and the second boundary including a longitudinal portion of an outer wall of the third cannula. **Claim 5** The apparatus of claim 1, wherein the first slot is substantially linear along a length of the second cannula. **Claim 6** The apparatus of claim 1, wherein the first slot is helical along a length of the second cannula. **Claim 7** The apparatus according to claim 1, wherein the thickness of the channel is substantially the same as the thickness of the second cannula between the outer wall of the second cannula and the inner wall of the second cannula.

8. The apparatus according to claim 1, wherein the outer wall of the second cannula is in contact with the inner wall of the first cannula without a gap along the longitudinal length of the first cannula.

9. The apparatus according to claim 1, further comprising a housing coupled to the proximal end of the third cannula, the housing comprising a port configured to couple to a suction line that suctions the tissue after debriding or the fluid after exiting the distal end of the apparatus.

10. The apparatus according to claim 1, wherein an edge of the third cannula along the second distal opening is sharp.

11. A light source that sends light to a position of the tissue during debriding, and an image sensor that images the position during debriding The apparatus according to claim 1, further comprising.

12. The apparatus according to claim 11, wherein the first cannula comprises a channel through which the light sent by the light source travels.

13. The apparatus according to claim 1, further comprising the fluid receptacle, the fluid receptacle being configured to be fluidly coupled to a fluid source, and the fluid receptacle being rotatable in the longitudinal direction.

14. The apparatus according to claim 1, wherein the third cannula is removably coupled within the second cannula.

15. The apparatus according to claim 1, wherein the third cannula is integrated within the second cannula, or the second cannula is integrated within the first cannula.

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

17. An apparatus, a first cannula, the first cannula being coupled to the fluid receptacle such that fluid flows from the fluid receptacle through the proximal opening of the first cannula. A second cannula, coupled within the first cannula such that an outer wall of the second cannula is in contact with an inner wall of the first cannula, the second cannula including a first distal opening and at least one slot extending longitudinally along a length of the second cannula, fluid from the fluid source entering the proximal opening of the first cannula flowing through the at least one slot and exiting at a distal end of the device, the second cannula; An instrument shaft, coupled within the second cannula such that an outer wall of the instrument shaft is in contact with an inner wall of the second cannula; A device comprising. **Claim 18** A single-port surgical device, comprising: A first cannula, coupled to a fluid source such that fluid flows from the fluid source through a proximal opening of the first cannula; An instrument shaft extending longitudinally within the first cannula, an outer surface of the instrument shaft including circumferentially spaced first and second structures extending longitudinally along a distal portion of the instrument shaft, the first structure being in continuous contact with a first surface of an inner wall of the first cannula along a first position, the second structure being in continuous contact with a second surface of the inner wall along a second position, whereby an interior of the first cannula is divided into at least two fluid channels having boundaries defined by at least the first and second positions, the instrument shaft; A first tool extending distally from the instrument shaft; A single-port surgical device comprising. **Claim 19** The interior of the instrument shaft includes a first instrument channel extending longitudinally along the instrument shaft; The first tool extends distally from a distal end of the first instrument channel; The single-port surgical device according to claim 18. **Claim 20** Further comprising a cable wire coupled to a proximal end of the first tool, the cable wire extending through the first instrument channel to a proximal end of the single-port surgical device, the single-port device according to claim 19. **Claim 21** Further comprising a second tool extending distally from the instrument shaft; The interior of the instrument shaft further includes a second instrument channel separate from the first instrument channel; the second tool extending distally from the distal end of the second instrument channel The single-portal surgical device according to claim 19 **Claim 22** The single-portal surgical device according to claim 18, wherein the first and second structures are helical in a circumferential direction around the instrument shaft along their longitudinal lengths **Claim 23** The single-portal surgical device according to claim 22, wherein the first and second structures are winged structures **Claim 24** the at least two fluid channels comprising a first fluid channel and a second fluid channel the fluid entering the proximal opening of the first cannula flowing through the first fluid channel and exiting at the distal end of the first cannula the second fluid channel being configured to aspirate the fluid or tissue The single-portal surgical device according to claim 18 **Claim 25** The single-portal surgical device according to claim 24, wherein the second fluid channel is coupled to a suction line proximal to the first cannula **Claim 26** the outer surface of the instrument shaft further comprising a third structure extending longitudinally along the distal portion of the instrument shaft, the third structure being in continuous contact with a third surface of the inner wall along a third position, the third structure being circumferentially spaced from the first and second structures the at least two fluid channels comprising three or more fluid channels the interior of the first cannula being divided into the three or more fluid channels having boundaries defined by at least the first position, the second position, and the third position The single-portal surgical device according to claim 18 **Claim 27** a light source for sending light to an anatomical site during surgery an image sensor for imaging the anatomical site during surgery The single-portal surgical device according to claim 18, further comprising **Claim 28** the image sensor being integrated with the first cannula the first cannula comprising a channel through which the light sent by the light source travels, or the distal end of the first cannula comprising the light source The single-portal surgical device according to claim 27 **Claim 29** A single-port surgical device according to claim 18, further comprising a handle proximal to the first cannula and the instrument shaft, the handle being coupled to the first cannula and the instrument shaft and comprising a control unit configured to be actuated to move the first instrument.

30. The single-port surgical device according to 18, further comprising a connector distal to the handle, the connector being configured to removably couple the proximal end of the instrument shaft to the handle.

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