Neuromonitoring integration with ultrasound surgical systems

Abstract

An ultrasonic handpiece assembly is provided. The ultrasonic handpiece assembly includes a housing, an electromechanical transducer at least partially disposed within the housing, a tip coupled to the electromechanical transducer, an electrical cord having a console connector, and a line connector. The electrical cord includes a first conductor, the first conductor being in electrical communication with the electromechanical transducer. The line connector includes a first tubing coupler configured to receive an irrigation line, a second tubing coupler configured to receive an aspiration line, and a receptacle including a first terminal, the receptacle being configured to receive a line extending from a neuromonitor, the first terminal being in electrical communication with the tip.

Description

Summary of the Invention

[0001] A first aspect of the present disclosure includes an ultrasonic handpiece assembly comprising: a housing; an electromechanical transducer at least partially disposed within the housing; a tip operably coupled to the electromechanical transducer; an electrical cord having a console connector; and a line connector, wherein the electrical cord includes a first conductor, the first conductor in electrical communication with the electromechanical transducer; the line connector including a first tubing coupler configured to receive an irrigation line, a second tubing coupler configured to receive an aspiration line, and a receptacle including a first terminal, the receptacle configured to receive a line extending from a neural monitor, the first terminal in electrical communication with the tip.

[0002] A second aspect of the present disclosure is a line connector for coupling to an ultrasound handpiece, the line connector comprising: a first tubing coupler configured to receive an irrigation line; a second tubing coupler configured to receive an aspiration line; and a receptacle including a first terminal, the receptacle configured to receive a line extending from a neuromonitor.

[0003] In some embodiments, the line connector is formed from a resilient material.

[0004] In some embodiments, the housing includes a perfusion conduit, and the first terminal is in electrical communication with the perfusion conduit. In some embodiments, the line connector includes a jumper conductor arranged to position (dispose) the first terminal in electrical communication with the perfusion conduit. In some embodiments, the line connector includes a switch, and the switch is in electrical communication with the first terminal and operable to place (position) the first terminal in electrical communication with the perfusion conduit. In some embodiments, the line connector defines (defines, forms, has) a cavity (space) for receiving a portion of the electrical cord. In some embodiments, the line connector includes a base, and the first tubing coupler and the second tubing coupler are integrally formed with the base.

[0005] A third aspect of the present disclosure includes an ultrasound handpiece assembly comprising a housing, an electromechanical transducer at least partially disposed within the housing, a tip operably coupled to the electromechanical transducer, and an electrical cord having a console connector, the electrical cord including a first conductor, the first conductor in electrical communication with the electromechanical transducer and the tip, the console connector including a first terminal in electrical communication with the first conductor, the first terminal for engaging an ultrasound control console, a second terminal for engaging a potential source (a source of potential) of a nerve monitor, and a jump conductor arranged to position the second terminal in electrical communication with the first conductor.

[0006] In some embodiments, the console connector includes a third terminal, the third terminal for establishing a connection with a reference probe. In some embodiments, the console connector includes a fourth terminal, the fourth terminal for establishing a connection with a stimulation probe, the stimulation probe being separate from the ultrasound handpiece assembly.

[0007] In some embodiments, the ultrasonic handpiece assembly further includes a switch, the switch being in electrical communication with the second terminal and operable to place the second terminal out of communication with the first conductor. In some embodiments, the switch is a foot switch. In some embodiments, the console connector includes the switch.

[0008] A fourth aspect of the present disclosure is an ultrasonic surgical system including an ultrasonic handpiece assembly including a housing, an electromechanical transducer at least partially disposed within the housing, a tip operably coupled to the electromechanical transducer, and an electrical cord having a console connector, the electrical cord including a first conductor, the first conductor in electrical communication with the electromechanical transducer and the tip, the console connector including a first terminal in electrical communication with the first conductor, the ultrasonic surgical system further including an adapter for connecting the ultrasonic handpiece assembly to a neuromonitor, the adapter including a second terminal for engaging an ultrasound control console, a third terminal for engaging an electrical potential source of the neuromonitor, and a jump conductor arranged to position the third terminal in electrical communication with the second terminal, wherein electrical communication is established from the third terminal to the first terminal upon connection of the console connector to the adapter.

[0009] In some embodiments, the adapter includes a fourth terminal. In some embodiments, the fourth terminal is for establishing a connection with a reference input from a neuromonitor, and the sixth terminal is for establishing a connection with a reference probe. In some embodiments, the fourth terminal is for establishing a connection with a stimulation probe, the stimulation probe being separate from the ultrasound handpiece assembly.

[0010] In some embodiments, the ultrasonic surgical system further comprises a switch, the switch being in electrical communication with the third terminal and operable to place the second terminal out of communication with the first conductor. In some embodiments, the switch is a foot switch. In some embodiments, the adapter includes the switch.

[0011] A fifth aspect of the present disclosure is an ultrasonic surgical system comprising: a control console including a pump; and a surgical fluid cassette, wherein the control console defines a cassette receptacle and a handpiece port for connection to a console connector of an ultrasonic handpiece assembly, the cassette receptacle including a first fluid port and a first terminal, the handpiece port including a second terminal, the first terminal in electrical communication with the second terminal, the surgical fluid cassette (surgical fluid cassette) including a surgical tubing (surgical tubing), a second fluid port coupled to the surgical tubing, a third terminal, and a third terminal. and a fourth terminal for being positioned to be in electrical communication with a source of electrical potential of the transcutaneous monitor, wherein the second fluid port is configured to engage with the first fluid port to form a fluid connection between the pump and the surgical tubing when a surgical fluid cassette is inserted into the cassette receptacle, the third terminal is configured to engage with the first terminal when a surgical fluid cassette is inserted into the cassette receptacle such that the first terminal is in electrical communication with the third terminal when the cassette is inserted into the cassette receptacle, and the fourth terminal is in electrical communication with the third terminal.

[0012] In some embodiments, the surgical fluid cassette further includes a fifth terminal. In some embodiments, the fifth terminal is for receiving a reference input from a neuromonitor, and the sixth terminal is for establishing a connection with a reference probe. In some embodiments, the fifth terminal is for establishing a connection with a stimulation probe, the stimulation probe being separate from the ultrasound handpiece assembly.

[0013] In some embodiments, the ultrasonic surgical system further comprises an ultrasonic handpiece assembly comprising a housing, an electromechanical transducer at least partially disposed within the housing, a tip operably coupled to the electromechanical transducer, and an electrical cord having a console connector, the electrical cord comprising a first conductor, the first conductor in electrical communication with the electromechanical transducer and the tip, and the first conductor in electrical communication with the second terminal.

[0014] In some embodiments, the ultrasonic surgical system further comprises a switch, the switch being in electrical communication with the third terminal and operable to place the third terminal out of electrical communication with the first terminal. In some embodiments, the switch is a foot switch. In some embodiments, the foot switch is connected through the surgical fluid cassette. In some embodiments, the surgical fluid cassette includes the switch.

[0015] In some embodiments, the surgical fluid cassette includes a printed circuit board, the printed circuit board defining a third terminal. In some embodiments, the surgical fluid cassette defines an exterior surface, and the printed circuit board defines a portion of the exterior surface. In some embodiments, the printed circuit board communicates with a fourth terminal. In some embodiments, the fourth terminal is a roller pin.

[0016] In some embodiments, the surgical tubing is a suction line and the pump is a suction pump. In some embodiments, the surgical tubing is an irrigation line and the pump is an irrigation pump.

[0017] A sixth aspect of the present disclosure is a surgical system comprising: a control console including a pump; and a surgical fluid cassette, wherein the control console defines a cassette receptacle and a handpiece port for connection to a console connector of a handpiece, the cassette receptacle including a first fluid port and a first terminal, the handpiece port including a second terminal, the first terminal in electrical communication with the second terminal, the surgical fluid cassette including a surgical tubing, a second fluid port coupled to the surgical tubing, a third terminal, and a potential source and electrical connection with a nerve monitor. and a fourth terminal for being positioned to communicate with the second fluid port, the second fluid port configured to engage with the first fluid port to form a fluid connection between the pump and the surgical tubing when the cassette is inserted into the cassette receptacle, the third terminal configured to engage with the first terminal when the surgical fluid cassette is inserted into the cassette receptacle such that the first terminal is in electrical communication with the third terminal when the cassette is inserted into the cassette receptacle, and the fourth terminal is in electrical communication with the third terminal.

[0018] A seventh aspect of the present disclosure includes a surgical system comprising: a control console including a pump; and a surgical fluid cassette, wherein the control console defines a cassette receptacle and a handpiece port for connection of the handpiece to a console connector, wherein the cassette receptacle includes a first fluid port and a first terminal, the handpiece port includes a second terminal, the first terminal being in electrical communication with the second terminal, the surgical fluid cassette including surgical tubing, a second fluid port coupled to the surgical tubing, and a third terminal, wherein the second fluid port is configured to engage with the first fluid port to form a fluid connection between the pump and the surgical tubing when the cassette is inserted into the cassette receptacle, and the third terminal is configured to engage with the first terminal when the surgical fluid cassette is inserted into the cassette receptacle, such that the first terminal is in electrical communication with the third terminal when the cassette is inserted into the cassette receptacle.

[0019] These and other configurations, features, and advantages of the present disclosure will be apparent to those skilled in the art, and the present disclosure is not intended to be limited to or by these configurations, embodiments, features, and / or advantages.

[0020] Referring now to the drawings, exemplary figures are shown in detail. While the drawings depict schematic embodiments, the drawings are not necessarily to scale and certain features may be exaggerated to better illustrate and explain the innovative aspects of the exemplary embodiments. Moreover, the exemplary figures described herein are not intended to be exhaustive or otherwise limited or restricted to the exact forms and configurations shown in the drawings and disclosed in the following detailed description.

[0021] Advantages of the present invention will be readily appreciated as the same becomes better understood by reference to the following detailed description when considered in conjunction with the accompanying drawings, in which: [Brief explanation of the drawings]

[0022] [Figure 1] FIG. 1 is a side view of an ultrasonic surgical handpiece assembly including an ultrasonic handpiece, an irrigation sleeve, an ultrasonic tip, and a control console. [Figure 2] FIG. 2 is a plan view of the ultrasonic surgical handpiece assembly of FIG. 1. [Figure 3] FIG. 2 is a cross-sectional view of the ultrasonic surgical handpiece assembly of FIG. 1. [Figure 4] 4 is a zoomed (enlarged) cross-sectional view of the rear housing portion of the ultrasonic handpiece of FIG. 3. [Figure 5] FIG. 2 is a perspective view of a front housing portion of the ultrasonic handpiece of FIG. 1. [Figure 6] FIG. 5 is an exploded view of the front housing portion of FIG. 4. [Figure 7] FIG. 7 is a front view of the ultrasonic handpiece of FIG. 6. [Figure 8]2 is a partial exploded view of the ultrasonic surgical handpiece assembly of FIG. 1 showing an exemplary configuration of the interface between the front housing portion of the ultrasonic handpiece and the irrigation sleeve. [Figure 9] FIG. 1 is a zoomed (enlarged) cross-sectional view of a front housing portion of an ultrasonic handpiece coupled to an irrigation sleeve. [Figure 10] 2 is a perspective view of the irrigation sleeve and ultrasonic tip of the ultrasonic surgical handpiece assembly of FIG. 1 for use with the ultrasonic handpiece. [Figure 11A] FIG. 11 is a bottom view of the irrigation sleeve and ultrasound tip of FIG. [Figure 11B] FIG. 11 is a cross-sectional view of the irrigation sleeve and ultrasound tip of FIG. [Figure 12] 2 is a perspective view of an exemplary configuration of a tubing connector for use with the ultrasonic surgical handpiece assembly of FIG. 1, including the ultrasonic handpiece shown in dotted lines. [Figure 13] FIG. 13 is a first perspective view of the tubing connector of FIG. 12. [Figure 14] FIG. 13 is a second perspective view of the tubing connector of FIG. 12. [Figure 15] FIG. 13 is a third perspective view of the tubing connector of FIG. 12. [Figure 16] 13 is a cutaway cross-sectional view of the tubing connector of FIG. 12 coupled to an ultrasound handpiece having power, suction, and irrigation lines extending therefrom. [Figure 17] FIG. 1 is a diagram of an ultrasonic surgical handpiece in proximity to one or more nerve locations. [Figure 18] FIG. 1 is an electrical schematic diagram for an ultrasonic surgical system. [Figure 19] FIG. 1 is a perspective view of an ultrasonic surgical system including an adapter. [Figure 20] FIG. 20 is an exploded view of the components of the system of FIG. 19. [Figure 21] FIG. 20 is a schematic diagram of the system of FIG. 19. [Figure 22A] FIG. 20 is an exploded view of the adapter of FIG. 19. [Figure 22B] FIG. 20 is an exploded view of the adapter of FIG. 19. [Figure 23] FIG. 20 is a schematic diagram of the system of FIG. 19. [Figure 24] FIG. 10 is a perspective view of another possible embodiment of an ultrasonic surgical system. [Figure 25] FIG. 1 is a schematic diagram of a surgical fluid cassette. [Figure 26] FIG. 25 is a schematic diagram of the ultrasonic surgical system of FIG. 24. [Figures 27A-27B] FIG. 25 is a perspective view of the internal components of the surgical fluid cassette and surgical console of FIG. 24. [Figure 28] 25A and 25B illustrate possible conductive paths within the surgical fluid cassette of FIG. 24. [Figure 29] FIG. 10 is a perspective view of a line connector of another possible embodiment of an ultrasonic surgical system. [Figure 30A-30B] FIG. 30 is a perspective view of the ultrasonic surgical system of FIG. 29. [Figure 31] FIG. 30 is a schematic diagram of the ultrasonic surgical system of FIG. 29. [Figure 32] 30 is a cutaway cross-sectional view of a line connector and ultrasonic surgical handpiece of the ultrasonic surgical system of FIG. 29. DETAILED DESCRIPTION OF THE INVENTION

[0023] As medical professionals strive to reduce the size of incisions and the amount of recovery time required following invasive medical procedures, the size of medical equipment used in various medical procedures has become smaller. Many of the medical equipment utilized in performing various medical procedures may involve the use of cutting accessories, such as ultrasonic handpieces, high-speed drills, rotating burrs, open-window shavers, and the like. Many of these cutting accessories may require the use of irrigation or aspiration (i.e., suction) to reduce heat and / or remove debris at the surgical site. Similarly, irrigation may be utilized to lubricate the cutting accessory.

[0024] One example of a surgical instrument that may utilize an irrigation and aspiration system is an ultrasonic handpiece. Typically, one or more lines may be coupled to the ultrasonic handpiece to provide irrigation and aspiration. The ultrasonic handpiece may further include a sleeve with one or more lumens that may be used to deliver fluid from an irrigation source to the surgical site and the cutting accessory, i.e., the ultrasonic tip. Irrigation and / or aspiration lines have typically been coupled to the outside of the ultrasonic handpiece for coupling to the sleeve. The sleeve and / or cutting accessory may be disposable, such that the sleeve and / or cutting accessory are only temporarily attached to the ultrasonic handpiece. The introduction of additional elements, such as irrigation and / or aspiration lines, to the outside of the handpiece can increase the size, profile, and / or overall bulk of the ultrasonic handpiece. This may obstruct a medical professional's view and / or distract the medical professional during operation of the medical device during a medical procedure. The placement of irrigation and / or aspiration lines relative to the ultrasonic handpiece may also affect the ergonomics of the ultrasonic handpiece, hindering the medical professional's ability to operate the ultrasonic handpiece.

[0025] Thus, an ultrasonic surgical handpiece assembly 10, such as the ultrasonic surgical handpiece assembly 10 shown in Figures 1-3, can be configured with an ultrasonic handpiece 12 that includes an internal irrigation lumen and an internal aspiration lumen to reduce the size of the handpiece and improve ergonomics.

[0026] 1 and 2, an exemplary configuration of an ultrasonic surgical handpiece assembly 10 is shown. The ultrasonic surgical handpiece assembly 10 may include an ultrasonic handpiece 12 having a proximal end 14 and a distal end 16. The ultrasonic surgical handpiece assembly 10 may further include an ultrasonic tip 20 and a sleeve 18 that may be coupled to the distal end of the ultrasonic handpiece 12. The sleeve 18 may be configured to provide irrigation to the ultrasonic tip 20 and / or the surgical site. It is further contemplated that the sleeve 18 may also be configured to provide suction to the ultrasonic tip 20. The ultrasonic tip 20 may include a cutting feature 34 configured to cut, shape, and / or remove biological tissue.

[0027] The ultrasound tip 20 may have a variety of features such as those described in US Pat. Nos. 6,497,715, 6,955,680, and 6,984,220, which are incorporated by reference herein in their entireties.

[0028] The ultrasonic surgical handpiece assembly 10 may also include a cable 30 or other power cord with a power connector 28 or adapter configured to couple the ultrasonic surgical handpiece assembly 10 to a power source, such as a control console 13 configured to adjust various aspects of the ultrasonic handpiece 12. For example, the console 13 may be configured to adjust the power and signals supplied to the ultrasonic handpiece 12. The console 13 may also be configured to adjust the irrigation and / or aspiration functions of the ultrasonic handpiece 12 to optimize the performance of the ultrasonic surgical handpiece assembly 10.

[0029] Referring to Figure 3, a cross-sectional view of the ultrasonic surgical handpiece assembly 10 of Figure 1 is provided. The ultrasonic handpiece 12 may include a proximal housing portion 14 and a distal housing portion 16, each of which may be configured to define a cavity. The proximal housing portion 14 and the distal housing portion 16 may be configured as two separate components and coupled to one another by laser welding or a similar bonding process. Alternatively, the proximal housing portion 14 and the distal housing portion 16 may include corresponding coupling features configured to couple the proximal housing portion 14 and the distal housing portion 16 to one another. It is also contemplated that the proximal housing portion 14 and the distal housing portion 16 may be configured as one integral component.

[0030] A transducer 44 may be disposed in a cavity defined by the ultrasonic handpiece 12. The transducer 44 may include multiple driver elements 46, such as piezoelectric crystals, arranged in a stacked configuration. The piezoelectric crystals 46 may expand and contract based on applied changes in electricity (power). The transducer 44 may include a tube 43 defining a lumen 45 extending from a proximal end to a distal end of the transducer 44 to form a fluid path through the transducer 44. The tube 43 may take the form of a post (e.g., rod-shaped). The tube 43 may extend through the collinear longitudinal axes of the driver elements 46. A proximal end mass 41 may be disposed adjacent to a proximal face of a proximally most proximally disposed driver element 46.

[0031] It is further contemplated that transducer 44 may alternatively include multiple magnetostrictive elements.

[0032] The horn 40 may be at least partially disposed within a cavity defined by the ultrasonic handpiece 12. The horn 40 may be coupled to the distal end of the transducer 44. The horn 40 may be constructed of a rigid steel alloy, titanium, or similar material. In operation, the horn 40 vibrates as the transducer 44 expands and contracts. The horn 40 may be removably coupled to the transducer 44. For example, the proximal end of the horn 40 may include a threaded male coupler, and the distal end of the transducer 44 may include a corresponding female-threaded coupler. Alternatively, the transducer 44 and horn 40 may be permanently coupled via welding, adhesive, or a similar joining process. The horn 40 may be configured to define a second conduit 42 in fluid communication with a lumen 45 defined by a tube 43 of the transducer 44. Collectively, the lumen 45 through the transducer 44 and the second conduit 42 through the horn 40 form part of a continuous fluid pathway extending from the distal end of the ultrasonic handpiece 12 to the proximal end of the ultrasonic handpiece 12. The ultrasonic surgical handpiece assembly 10 is configured such that the driver element 46 is compressed between the proximal end mass 41 and the horn 40.

[0033] The fluid passageway through the ultrasonic hand piece 12 may be utilized to provide irrigation fluid and / or vacuum through the ultrasonic hand piece 12. The distal end of the horn 40 may further include a threaded coupler 38 configured to removably couple the ultrasonic tip 20 to the ultrasonic hand piece 12 via the horn 40. The threaded coupler 38 at the distal end of the horn 40 may include threads configured to engage corresponding threads on the ultrasonic tip 20, although it is further contemplated that other coupling methods may be utilized. For example, the distal end of the horn 40 may include features that allow for a snap-fit ​​engagement with the ultrasonic tip 20.

[0034] The control console 13 of the ultrasonic surgical handpiece assembly 10 may be configured to receive a drive signal via the cable 30 to which the ultrasonic handpiece 12 is connected. In many, but not all, versions of the ultrasonic surgical handpiece assembly 10, the ultrasonic handpiece 12 and cable 30 are assembled as a single unit. The drive signal is provided to the piezoelectric crystals 46. At any given moment, the same drive signal is provided to each of the multiple piezoelectric crystals 46. The application of the drive signal causes the multiple piezoelectric crystals 46 to simultaneously and cyclically expand and contract. The horn 40 may be configured to amplify this movement. As a result, the distal end of the horn 40, and by extension, the ultrasonic tip 20, typically moves a maximum of 1000 μm, more frequently 500 μm or less, when moving from a fully contracted position to a fully extended position. Some ultrasonic tips 20 are further designed so that longitudinal expansion / contraction of the ultrasonic tip 20 can also induce torsional motion of the cutting feature 34. When the ultrasonic handpiece 12 is actuated to cause cyclical movement of the ultrasonic tip 20, the cutting feature 34 is believed to vibrate.

[0035] The control console 13 may also include a vacuum pump and processor / controller, and an irrigation pump and processor / controller. The vacuum pump may be coupled to the ultrasonic surgical handpiece assembly 10 via aspiration line 27. The irrigation pump may be coupled to the ultrasonic handpiece assembly 10 via irrigation line 29.

[0036] The control console 13 may have any of the features described in U.S. Patent Application Publication Nos. 2017 / 0071621 and 2018 / 0056328, which are incorporated by reference herein in their entireties.

[0037] The ultrasonic hand piece 12 may also include a tube 58, which is at least partially disposed within the ultrasonic hand piece 12 and configured to define a lumen 59 therethrough for irrigation and / or aspiration. The tube 58 defines an additional lumen 59 therethrough in addition to the passageway defined by the lumen 45 of the transducer 44 and the second conduit 42 of the horn 40. For example, the tube 58 may define an irrigation lumen 59 therethrough, and the lumen 45 through the transducer 44 and the second conduit 42 through the horn 40 may define an aspiration lumen 45 therethrough. Alternatively, the tube 58 may define an aspiration passageway 59 therethrough, and the lumen 45 through the transducer 44 and the second conduit 42 through the horn 40 may define an irrigation passageway therethrough.

[0038] As mentioned above, the irrigation and / or aspiration passageways are located mostly within the ultrasonic handpiece 12 to provide ergonomic benefits by eliminating one or more tubes that are typically attached to the outside of the ultrasonic handpiece. While portions of the lines defining the aspiration and / or irrigation passageways from the proximal end of the ultrasonic surgical handpiece assembly 10 to the distal end of the passageways may be exposed, i.e., visible to the user during operation, it should be understood that the user is not required to attach any irrigation or aspiration lines to the sides of the ultrasonic surgical handpiece assembly 10 during use. Instead, the irrigation line 29 and the aspiration line 27 are, in certain embodiments, attached only to the proximal end, or even the rear surface of the proximal end, of the ultrasonic handpiece 12. Additionally, in certain embodiments, during setup of the ultrasonic surgical handpiece assembly 10, all aspiration and irrigation connections included in the sleeve are obtained directly from the ultrasonic handpiece 12. In other words, there are no irrigation or aspiration lines coupled to the sides of the sleeve 18. Thus, the ultrasonic handpiece 12 may include connections for both irrigation and aspiration.

[0039] Referring to Figure 4, a cross-sectional view of a portion of the ultrasonic handpiece 12 is shown. As described above, the transducer 44 may have a distal end and a proximal end disposed within a cavity of the ultrasonic handpiece 12. The transducer 44 may be configured to expand and contract along a longitudinal axis of the transducer 44. A lumen 45 through the transducer 44 has a distal portion and a proximal portion. The horn 40 is also at least partially disposed within the ultrasonic handpiece 12.

[0040] The ultrasonic hand piece 12 may further include a barrier member 49 disposed within a cavity defined by the ultrasonic hand piece 12 and configured to define a cavity. The transducer 44 may be encapsulated within the barrier member 49, such that the barrier member 49 may be configured to aid in mounting and isolating the transducer 44 within the ultrasonic hand piece 12. The barrier member 49 may not occupy the entire cavity defined within the ultrasonic hand piece 12. Accordingly, the ultrasonic hand piece 12 may further include a substance or potting element 47 disposed within the cavity defined by the ultrasonic hand piece 12. The potting element 47 may be disposed within the cavity defined by the ultrasonic hand piece 12 and outside of the barrier member 49, such that the potting element 47 may occupy or fill the portion of the cavity within the hand piece 12 not occupied or blocked by the barrier member 49. The potting element 47 may be configured to secure the position of the barrier member 49 within the cavity defined by the ultrasonic hand piece 12. The potting element 47 may also function as an insulator or absorber configured to prevent the transfer of thermal energy (ie, heat) and mechanical energy (ie, vibration) from the transducer 44 to the user's hand.

[0041] The barrier member 49 may further define a channel 53 extending generally proximally from the proximal end of the barrier member 49. The channel 53 forms a passageway between the proximal end of the ultrasonic handpiece 12 and the tubing 43 that defines the lumen 45 through the transducer 44. The channel 53 may further include a coupling portion 54, such as a hose barb or similar fitting, extending proximally from the proximal end of the ultrasonic handpiece 12 and configured to form a friction fit to couple the channel 53 to the aspiration line 27 of the control console 13.

[0042] The transducer 44 may be partially mounted in the cavity defined by the barrier member 49 by a rear seal 48 disposed between the proximal end of the transducer 44 and the inner surface of the barrier member 49. The rear seal 48 may be configured to define a first opening adjacent the proximal end of the transducer 44 and in fluid communication with the lumen 45 through the transducer 44. The rear seal 48 is positioned between the barrier member 49 and the exterior of the transducer 44 to help prevent moisture from entering the volume surrounding the transducer 44. The rear seal 48 also functions to prevent moisture from entering between the outer surface of the tube 43 and the inner surface of the transducer 44. The rear seal 48 may be formed from an elastomeric material resistant to heat and vibration degradation, including a material capable of withstanding the temperatures of an autoclave process.

[0043] The ultrasonic handpiece 12 may further include a front seal 52 radially disposed around the outer surface of the horn 40 to prevent moisture ingress between the inner surface of the distal housing portion 16 and the horn 40, since the outer surface of the horn 40 is exposed to liquids during operation of the ultrasonic handpiece 12. The front seal 52 may further include a plurality of protrusions or projections configured to facilitate engagement between the horn 40 and the distal housing portion 16 and to prevent moisture ingress into the cavity between the horn 40 and the distal housing portion 16 of the ultrasonic handpiece 12.

[0044] The ultrasonic hand piece 12 may further include a potting seal 50 disposed between and engaging the distal end of the barrier member 49 and the proximal end of the horn 40. The potting seal 50 may also be configured to contact the interior surface of the distal housing portion 16 of the ultrasonic hand piece 12 adjacent the barrier member 49 and the proximal end of the horn 40. The potting seal 50 may be configured adjacent the distal end of the barrier member 49 and to define a second opening for receiving a mating feature of the horn 40. The potting seal 50 may be configured to prevent the potting element 47 from entering the barrier member 49 and contacting the transducer 44 during the potting process. When the potting element 47 is in place, the potting element 47 in association with the potting seal 50 helps prevent moisture from entering between the barrier member 49 and the horn 40.

[0045] 5 and 6, an exemplary configuration of the distal housing portion 16 is shown. The distal housing portion 16 may include a coupling feature 60 configured to removably couple the distal housing portion 16 to a distal portion of a barrier member 49 disposed within the proximal housing portion 14. The coupling feature 60 may include a pair of tabs configured to form a snap and / or friction fit with corresponding coupling features on the barrier member 49. However, alternative coupling features, such as hooks or protrusions, are also contemplated. The coupling feature 60 may assist in attaching and / or positioning the barrier member 49 within the cavity defined by the distal housing portion 16 and the proximal housing portion 14.

[0046] The distal housing portion 16 of the ultrasonic handpiece 12 may further include a flex circuit 62 that may be molded into the distal housing portion 16. The flex circuit 62 may be composed of a conductive material configured to transmit electrical signals between a distal region and a proximal region of the flex circuit 62. The flex circuit 62 may include an attachment portion 64 disposed in the proximal region of the flex circuit 62 and configured to be coupled to a processor disposed within the ultrasonic handpiece 12 that is configured to communicate with the control console 13. The flex circuit 62 may also include a transceiver 66 disposed in the distal region of the flex circuit 62.

[0047] 5 also shows tubing 58 defining the aforementioned lumen 59, which is at least partially disposed within the ultrasonic handpiece 12. The tubing 58 may be at least partially disposed within the distal housing portion 16 and the proximal housing portion 14. The tubing 58 may also include a coupling feature 56, such as a hose barb or similar fitting configured to form a friction fit, disposed at the proximal end of the tubing 58 and configured to couple the tubing 58 to the irrigation line 29 leading from the control console 13 to the ultrasonic surgical handpiece assembly 10. The irrigation line 29 from the console 13 may be coupled to the ultrasonic handpiece 12 via the hose barb 56 to facilitate (promote, assist) the flow of irrigation fluid through the tubing 58 within the ultrasonic handpiece 12 to the sleeve 18 and / or ultrasonic tip 20. In the above-described configuration, irrigation fluid may flow within the ultrasonic hand piece 12 or sleeve 18 from the proximal end to the distal end of the ultrasonic hand piece 12, eliminating the need for bulky irrigation lines coupled to the side of the ultrasonic hand piece 12 or the side of the sleeve 18. Routing the irrigation lines through the hand piece 12 makes this configuration possible. Thus, neither the sleeve nor the ultrasonic hand piece includes irrigation couplings along the side. Alternatively, in other configurations, tubing 58 may be coupled to the aspiration line 27 via coupling feature 56. The aspiration line 27 may be utilized to draw a vacuum through tubing 58. Tubing 58 may be in communication with the sleeve 18 and / or ultrasonic tip 20 to remove biological material and / or fluids from the surgical site.

[0048] 7-9, exemplary configurations of the interface between the distal housing portion 16 and the sleeve 18 and / or ultrasonic tip 20 are shown. FIG. 7 illustrates a front view of an exemplary configuration of the distal end of the distal housing portion 16 described above. This may also be referred to as the distal end of the ultrasonic hand piece 12. The distal end of the ultrasonic hand piece 12 may include an attachment region 69 configured to serve as the interface between the ultrasonic hand piece 12 and the sleeve 18 and ultrasonic tip 20. The attachment region 69 may include a recess 71 defined by proximal and distal surfaces 78 and 79 connected by a plurality of walls 77 extending perpendicular to the proximal and distal surfaces 78 and 79. The proximal surface 78 may include an opening 73 including a mating feature 75 at the periphery of the opening 73 (see FIG. 9). The mating feature 75 may include a tab, lip, or similar snap-fit ​​mating mechanism.

[0049] The distal end of the horn 40 may be configured to extend partially through an opening 73 defined in the proximal face 78, with at least a portion of the horn 40 and the threaded coupler 38 disposed within a recess 71 at the distal end of the ultrasonic handpiece 12. The second conduit 42 extending through the horn 40 may similarly open into the recess 71.

[0050] The proximal surface 78 may further include an irrigation coupler 76 disposed at the distal end of the tubing 58 that defines a lumen 59 through the ultrasonic hand piece 12. The irrigation coupler 76 may include a fitting, hose barb, or similar coupling member for coupling the distal end of the tubing 58 to a corresponding irrigation line 29 of the sleeve 18. The irrigation coupler 76 may be configured to be in fluid communication with the lumen 59 disposed within the ultrasonic hand piece 12 to provide irrigation fluid to the sleeve 18. The irrigation coupler 76 may function as an inlet or outlet for transporting substances and / or fluids between the ultrasonic hand piece 12 and the sleeve 18.

[0051] Referring to FIG. 8 , a partial exploded view of the interface between the distal end of the ultrasonic hand piece 12 and the sleeve 18 is shown. The sleeve 18 may include a hub 21 disposed at the proximal end of the sleeve 18 and a sleeve body 19 extending distally from the hub 21. The sleeve 18 may include a lumen 98 defined by the hub 21 and the sleeve body 19, the lumen 98 extending the length of the sleeve 18 and configured to enclose at least a portion of the ultrasonic tip 20 when coupled to the ultrasonic hand piece 12. The hub 21 may include a protrusion 80 extending proximally from a distal face 84 of the hub 21 and terminating at a proximal face 82. The proximal face 82 of the protrusion 80 may be oriented substantially parallel to the distal face 84. The shape of the protrusion 80 may be defined by a plurality of circumferential surfaces 81 or wall members extending between the distal face 84 and the proximal face 82 and configured to define the periphery of the protrusion 80. The outer peripheral surface 81 may be oriented approximately perpendicular to the proximal surface 82 and / or the distal surface 84 .

[0052] The hub 21 may further include a mating portion 94 extending from the proximal surface 82 of the protrusion 80. The mating portion 94 may be configured to mate with a corresponding mating portion 76 of the ultrasonic hand piece 12. The mating portion 94 of the sleeve 18 and the corresponding mating portion 76 of the ultrasonic hand piece 12 may be configured to facilitate the exchange of fluid between the sleeve 18 and the ultrasonic hand piece 12. In particular, the mating portion 76 is sized to fit within the mating portion 94 when the sleeve 18 is coupled to the ultrasonic hand piece 12. For example, irrigation fluid from the ultrasonic hand piece 12 may be dispersed to the sleeve 18 through connection of the mating portion 94 to the mating portion 76. This eliminates the need to connect the sleeve to an irrigation line separate from the ultrasonic hand piece 12, such as an irrigation line connected to the side of the sleeve 18. Alternatively, a vacuum may be provided to the ultrasonic hand piece 12 configured to aspirate material from the sleeve through the mating portions 94 and 76 when coupled in an alternative configuration.

[0053] The sleeve 18 may further include a conduit 96 formed in the sleeve body 19 that extends adjacent to the lumen 98 of the sleeve 18. The fitting 94 may be coupled to a proximal end of the conduit 96. The conduit 96 may be separate from the lumen 98 of the sleeve 18 and configured to conduct irrigation fluid through the sleeve 18. The conduit 96 may be routed in a variety of ways through the sleeve 18.

[0054] The hub 21 may further include a cavity 86 in the protrusion 80, including an opening in the proximal face 82 of the protrusion 80. The cavity 86 may be configured to at least partially enclose a tag 88, antenna, transceiver, or similar wireless communication device configured to communicate with the transceiver 66 located in the distal housing portion 16 of the ultrasonic handpiece 12.

[0055] 9, tag 88 may be secured in cavity 86 by pin 89. Pin 89 may comprise a plastic or alloy material and may be configured to form a friction fit within the opening of cavity 86 to secure RFID tag 88 within cavity 86 and protect RFID tag 88 from damage.

[0056] The protrusion 80 may be configured with a shape complementary to the shape defined by the recess 71 at the distal end of the ultrasonic hand piece 12, and the protrusion 80 may be configured to be disposed within the recess 71 when the sleeve 18 is coupled to the ultrasonic hand piece 12. Furthermore, the shapes of the recess 71 and the protrusion 80 may be configured to align the sleeve 18 with respect to the ultrasonic hand piece 12 and prevent rotational movement of the sleeve 18 with respect to the ultrasonic hand piece 12. For example, as shown in FIG. 8 , the recess 71 of the ultrasonic hand piece 12 includes multiple walls 77 that define the periphery of the recess 71. In the exemplary configuration of the recess 71 shown in FIGS. 7 and 8 , the walls 77A, 77B, 77C, and 77D define a doghouse shape. Accordingly, the multiple outer surfaces 81A, 81B, 81C, and 81D that define the periphery of the protrusion 80 may be configured to define a doghouse shape that corresponds to the shape of the recess 71.

[0057] The shape of the protrusion 80 and recess 71 may also be configured to orient a tag 88 disposed in the cavity 86 of the hub 21 relative to a transceiver 66 disposed in the distal housing portion 16 of the ultrasonic handpiece 12. Utilizing the shape of the protrusion 80 and recess 71 to orient the tag 88 relative to the transceiver 66 may increase the reliability of establishing communication between the tag 88 and the transceiver 66.

[0058] The hub 21 may further include a plurality of retention fingers 90 extending distally from the proximal surface 82 of the protrusion 80. The plurality of retention fingers 90 may be spaced apart along the circumference of a lumen 98 defined in the proximal surface 82. The plurality of retention fingers 90 may further include tabs 92, protrusions, or projections configured to engage with coupling features 75 on the circumference of the opening 73 in the proximal surface 78 of the recess 71 in the ultrasonic hand piece 12. The tabs 92 of each of the plurality of retention fingers 90 may engage with the coupling feature 75 of the recess 71 to form a snap fit and / or friction fit to removably couple the sleeve 18 to the ultrasonic hand piece 12.

[0059] 9, a cross-sectional view of an exemplary configuration of the interface between the distal housing portion 16 and the sleeve 18 and ultrasonic tip 20 of the ultrasonic hand piece 12 is shown. As shown in FIG. 9, the distal surface 79 of the distal housing portion 16 may abut the distal surface 84 of the protrusion 80 when the sleeve 18 is coupled to the ultrasonic hand piece 12. Similarly, the proximal surface 78 of the distal housing portion 16 may abut the proximal surface 82 of the protrusion 80 when the protrusion 80 is positioned within the recess 71 to couple the sleeve 18 to the ultrasonic hand piece 12.

[0060] 10, 11A, and 11B, exemplary configurations of an ultrasonic tip 20 disposed within a sleeve 18 are shown. Referring to FIG. 11B, a cross-sectional view of the ultrasonic tip 20 disposed within the sleeve 18 is shown. As described above, the sleeve 18 may include a conduit 96 formed in the sleeve body 19 and extending adjacent to a lumen 98 of the sleeve 18. The distal end of the conduit 96 may terminate in an opening 108 or nozzle disposed on an inner surface of the lumen 98. The opening 108 may be configured to direct fluid radially inward toward the center of the lumen 98. Thus, fluid may be provided to an outer surface of the ultrasonic tip 20 and / or directed toward the distal end of the sleeve 18, where it may exit the lumen 98 and be provided to a surgical site.

[0061] The sleeve 18 may further include a seal 100, such as an O-ring, disposed within the lumen 98 and configured to contact a portion of the ultrasonic tip 20 when the sleeve 18 is coupled to the ultrasonic handpiece 12 and the ultrasonic tip 20 is coupled to the ultrasonic handpiece 12.

[0062] The ultrasonic tip 20 may include a distal end and a proximal end. The ultrasonic tip 20 may include a cutting feature 34 at the distal end of the ultrasonic tip 20 and a coupling feature 104 disposed at the proximal end. The coupling feature 104 may be configured to engage with the threaded coupler 38 of the horn 40 to removably couple the ultrasonic tip 20 to the ultrasonic handpiece 12.

[0063] The ultrasonic tip 20 may be configured to define a lumen 102 extending from the proximal end to the distal end of the ultrasonic tip 20. The lumen 102 may be configured to be in fluid communication with a fluid passageway through the ultrasonic hand piece 12 defined by the conduit 42 of the horn 40 and the lumen 45 of the transducer 44 when the ultrasonic tip 20 is coupled to the ultrasonic hand piece 12. The lumen 102 may be configured to provide irrigation and / or aspiration at the surgical site based on a system coupled to the fluid passageway through the ultrasonic hand piece 12 defined by the conduit 42 of the horn 40 and the lumen 45 of the transducer 44. For example, the lumen 102 may be configured to provide irrigation fluid to the surgical site near the cutting feature 34 when an irrigation system is coupled to the fluid passageway through the ultrasonic hand piece 12 defined by the conduit 42 of the horn 40 and the lumen 45 of the transducer 44. Alternatively, when an aspiration system is coupled to the fluid passageway through the ultrasonic handpiece 12 defined by the conduit 42 of the horn 40 and the lumen 45 of the transducer 44, the lumen 102 may be configured to remove fluids and / or materials from the surgical site near the cutting feature 34.

[0064] The ultrasonic tip 20 may also include an opening 106 configured to be in fluid communication with the lumen 102. The opening 106 may be positioned between the proximal and distal ends of the ultrasonic tip 20 such that the opening 106 is located distal to the seal 100 of the sleeve 18 when the ultrasonic tip 20 is disposed within the lumen 98 of the sleeve 18. Furthermore, the opening 106 may be positioned on the ultrasonic tip 20 such that the opening 106 is surrounded by the sleeve 18 when the ultrasonic tip 20 is disposed within the lumen 98 of the sleeve 18.

[0065] The ultrasonic tip 20 may further include a resonator 105 disposed between the proximal and distal ends of the ultrasonic tip 20. The resonator 105 may be configured to convert longitudinal vibrations transmitted from the transducer 44 to the ultrasonic tip 20 via the mechanical connection formed by the horn 40 into longitudinal and torsional motion of the ultrasonic tip 20 located distal to the resonator 105.

[0066] 12-16, an exemplary configuration of a tubing connector 22 for use with the ultrasonic handpiece 12 as part of the ultrasonic surgical handpiece assembly 10 is shown. The tubing connector 22 may include a base 24 including a distal end and a proximal end. The base 24 may be constructed of a rigid material, such as plastic. Alternatively, the base 24 may be constructed of a flexible or resilient material, such as an elastomer. The tubing connector may be removable from the ultrasonic surgical handpiece and shipped with tubing for connecting the tubing connector 22 to a cassette for connecting the ultrasonic handpiece to irrigation and aspiration sources. The tubing connector may be discarded after use with a particular patient.

[0067] The base 24 may be configured to define one or two lumens 112, 114 extending therethrough. The lumens 112, 114 may define a fluid passageway through the base 24 of the tubing connector 22 and may be configured to be in fluid communication with one or more conduits or lumens through the ultrasonic hand piece 12. For example, the first lumen 112 may be configured to be in fluid communication with the passageway formed by the conduit 42 of the horn 40 and the lumen 45 of the transducer 44 when the tubing connector 22 is coupled to the ultrasonic hand piece 12. Additionally, the second lumen 114 may be configured to be in fluid communication with the lumen 59 disposed within the ultrasonic hand piece 12 when the tubing connector 22 is coupled to the ultrasonic hand piece 12.

[0068] The base 24 may also define a groove 110 at its outer periphery extending between the distal and proximal ends of the base 24. The groove 110 may be configured to receive a cable 30, wire harness, or similar conductor extending proximally from the proximal end of the ultrasonic handpiece 12. For example, the groove 110 of the tubing connector may be configured to receive and partially surround the cable 30, as shown in FIG. 1. The groove 110 may be shaped and / or configured to removably couple the base 24 of the tubing connector 22 to the cable 30 via a friction fit or an interference fit. For example, the groove 110 may include a U-shape or a crescent shape, with the width of the opening of the groove 110 at the surface of the base 24 being less than the maximum width of the cable 30.

[0069] The tubing connector 22 or line connector may further include a resilient member 26 extending proximally from the base 24 and configured to receive the suction line 27. The resilient member 26 and the base 24 may be formed as a unitary component, with the resilient member 26 defining a portion of a lumen 112 through the base 24. The resilient member 26 may be configured to allow the suction line 27 to be inserted into the lumen 112 at the proximal end of the resilient member 26. The suction line 27 may be for a friction fit within the lumen of the resilient member. Alternatively, the suction line 27 may be bonded to the resilient member 26 using glue, epoxy, or a similar adhesive configured to form a chemical bond.

[0070] Although not shown, it is also contemplated that the resilient member 26 may be removably coupled to the base 24. For example, the distal end of the resilient member 26 may be configured to form a friction fit with the base 24 when inserted into the lumen 112.

[0071] Although the figures show the aspiration line 27 and / or irrigation line 29 as being inserted directly into the lumens 112, 114 defined in the base 24 of the tubing connector 22, it is further contemplated that the aspiration line 27 and / or irrigation line 29 may be coupled to the base 24 by a hose barb or similar fitting. For example, the proximal end of a hose barb may be inserted into an opening in the aspiration line 27 and / or irrigation line 29. The proximal end of the hose barb may then be inserted into the respective lumens 112, 114 defined in the base 24. The hose barb may be coupled to the base 24 via a friction fit within the lumens 112, 114, or the hose barb may be coupled to the base 24 using an epoxy, glue, sealant, or similar adhesive.

[0072] The base 24 may be configured to be removably coupled to the proximal end of the ultrasonic handpiece 12 via an interference fit. The interference fit may be formed between the coupling feature 56 of the irrigation tubing 58 and the coupling portion 54 of the channel 53 and the respective lumens 112, 114. For example, the coupling feature 56 and the coupling portion 54 may each include a hose barb or similar fitting configured to be inserted into the corresponding lumens 112, 114 to form a friction fit that removably secures the tubing connector 22 to the proximal end of the ultrasonic handpiece 12.

[0073] Alternatively, although not shown in the drawings, it is contemplated that the distal end of the base 24 may include a retention feature, such as a tab or finger, configured to form a snap fit with the proximal end of the ultrasonic hand piece 12. For example, the retention feature may include a tab or protrusion that surrounds the periphery of the distal end of the base 24 and is configured to engage the proximal end of the ultrasonic hand piece 12 to removably couple the tubing connector 22 to the ultrasonic hand piece 12 via a snap fit.

[0074] The tubing connector 22 may serve as a means for quickly attaching and detaching both the irrigation line 29 and the aspiration line 27 to the proximal end of the ultrasonic hand piece 12. Additionally, the tubing connector 22 may removably secure the irrigation line 29 and / or the aspiration line 27 to the ultrasonic hand piece 12 in a manner that reduces stress on the lines near the ultrasonic hand piece 12. The tubing connector 22 may reduce bending and / or kinking of the lines near the ultrasonic hand piece 12. For example, the resilient member may include a resilient material configured to support and / or resist bending or kinking of the aspiration line 17. Additionally, the proximal offset created by the resilient member extending proximally from the base 24 offsets the locations at which the aspiration line 27 and the irrigation line 29 are coupled to the base 24. This may prevent tangling of the lines as they hang from the proximal end of the tubing connector 22. This serves to provide support to the lines 27, 29 against bending of the lines 27, 29 near the ultrasonic handpiece 12 to reduce the occurrence of sharp bends in the lines 27, 29 that could restrict flow through the lines 27, 29.

[0075] It is contemplated that the ultrasonic handpiece 12 may be used in conjunction with a nerve monitor to provide detection of nerves near the ultrasonic handpiece 12. For example, in FIG. 17, a nerve monitor 200 detects cranial nerves N1 and N2 near the ultrasonic handpiece 12. This provides nerve monitoring while applying suction to reduce the possibility of inadvertently contacting nerves with a cutting instrument. This also provides a single instrument so that less time is spent by the surgeon switching between the nerve monitor and the ultrasonic handpiece 12. The additional requirement of a separate stimulation probe means additional equipment in the sterile field, and having to insert and reinsert the stimulation probe and the ultrasonic handpiece 12 are both undesirable. While the surgeon is using the ultrasonic handpiece 12, the ultrasonic tip 20 is also selectively operating while a nerve monitor stimulation signal 202 is emitted from the ultrasonic tip 20. This allows the surgeon to detect nerves, such as cranial nerves N1 and N2, without using a separate stimulation probe. This integration can save a lot of time for the surgeon.

[0076] A variety of different neuromonitors 200 could potentially be used with the proposed system. One exemplary neuromonitor device is described in U.S. Pat. No. 9,084,551, which is incorporated herein by reference in its entirety. Another example is described in U.S. Pat. No. 5,775,331, which is also incorporated herein by reference in its entirety. The neuromonitor 200 typically includes a stimulation circuit for generating a stimulus, such as the neuromonitor stimulation signal 202 shown in FIG. 17, and a response detection means for detecting and measuring the response and indicating the tissue response to the user. The neuromonitor 200 includes an indicator that is controlled based on the tissue response. The indicator may be audible via a speaker, tactile by controlling a vibration motor associated with one or more of the described components, or visual by controlling a light or suitable display device. The light or display device may be present on the neuromonitor 200, the ultrasound console 13, the ultrasound handpiece assembly 10, or a device at a remote location.

[0077] Although the following description describes the integration of neuromonitoring functionality into an ultrasound handpiece, similar implementations can be used for other types of surgical handpieces, such as electrosurgical forceps or probes, rotary handpieces such as high-speed drills, or end effectors used with robotic tools.

[0078] 18 provides a schematic diagram of the electrical system of the ultrasonic handpiece 12 and associated console 13. Additional details can be found in WO 2015 / 021216, which is incorporated herein by reference in its entirety.

[0079] 19 and 20 illustrate a first embodiment of integration with a neuromonitor 200, where the neuromonitor 200 is connected to an ultrasound handpiece assembly 10 via an adapter 212. As shown, the embodiment includes an ultrasound control console 13, an ultrasound handpiece assembly 10, and an adapter 212. The ultrasound handpiece assembly 10 includes an ultrasound handpiece 12, an electrical cord including conductors 208, and a console connector. The electrical cord may be the previously described cable 30, and the console connector may be the previously described power connector 28. Referring to FIG. 20, the ultrasound control console 13 includes a handpiece port 204. The system will allow connection of the ultrasound handpiece 12 to the neuromonitor 200 or other physiological sensing device. The neuromonitor 200 may be a source of electrical potential.

[0080] 21 illustrates the terminals of the ultrasonic handpiece assembly 10 and the control console 13. As shown, the console connector 28 of the ultrasonic handpiece assembly 10 includes at least one terminal 214. The console connector 28 is shaped to mate with the handpiece port 204 of the control console 13, which includes terminal 205, during normal use. Terminals 214, 205 are also shown in FIG.

[0081] 21 also shows the terminals of the adapter 212. As shown, the adapter 212 includes a first connector 216 and a second connector 218, where the first connector 216 includes at least one terminal 220 and the second connector 218 includes at least one terminal 222. The first connector 216 is configured to mate with the console connector 28 of the ultrasonic handpiece assembly 10. The first connector 216 of the adapter 212 is configured similarly to the handpiece port 204 of the control console 13 so that electrical communication can be established between the adapter 212 and the ultrasonic handpiece assembly 10. The adapter 212 further includes a second connector 218 for engaging with the handpiece port 204 of the control console 13. The terminals 214 of the console connector 28 are configured to mate with the terminals 220 of the first connector 216 to enable electrical communication between the ultrasonic handpiece assembly 10 and the adapter 212. Terminals 222 of second connector 218 are configured to mate with terminals 205 of control console 13 to enable electrical communication between adapter 212 and control console 13. First connector 216 and terminals 220 are further shown in Figure 22A, and second connector 218 and terminals 222 are further shown in Figure 22B.

[0082] FIG. 21 also shows that the adapter 212 includes at least one terminal 224 configured to mate with various connectors from the neuromonitor 200. For example, the at least one terminal 224 may include an input terminal 226. The input terminal 226 is further shown in FIG. 22A. As shown in FIG. 23, the input terminal 226 may be configured to accept a terminal 229 from the neuromonitor 200. The adapter 212 may utilize a jumper conductor 228 (shown in FIG. 21) to establish electrical communication between the input terminal 226 and the adapter's first connector 216, thereby establishing electrical communication between the neuromonitor 200 and the ultrasound handpiece assembly 10.

[0083] In some configurations, at least one terminal 224 of the adapter 212 may include additional terminals to enhance functionality. For example, as shown in FIG. 21 , the adapter 212 may additionally include a reference input terminal 232 and a reference output terminal 234. The reference input terminal 232 and the reference output terminal 234 are further shown in FIG. 22A . Referring to FIG. 23 , the reference input terminal 232 may accept a terminal 233 of the neuromonitor 200 to receive a reference signal. It is also shown that the reference output terminal 234 may be connected to an auxiliary stimulation probe 238. The reference input terminal 232 and the reference output terminal 234 allow the adapter 212 to function as a conduit for the reference signal to be sent from the auxiliary stimulation probe 238 through the adapter 212 and back to the neuromonitor 200. This feature allows multiple cords associated with a procedure, such as the cable 30 from the ultrasound handpiece 12 and the cord 207 extending from the auxiliary stimulation probe, to extend from one location to the surgical site, i.e., the adapter 212, as opposed to a first cord extending from the neuromonitor 200 to the auxiliary stimulation probe and a second cord extending from the control console 13 to the ultrasound handpiece 12.

[0084] 23 illustrates the operation of the adapter 212 and the neural monitor 200. As shown, when the ultrasound tip 20 and the tip 240 of the auxiliary stimulation probe 238 are in electrical contact with neural tissue, a circuit is completed between the ultrasound handpiece 12 and the auxiliary stimulation probe 238. This allows the neural monitor stimulation signal 202 transmitted from the neural monitor 200 to be transmitted (emitted) from the ultrasound tip 20 to the neural tissue. The neural monitor 200 can then detect and measure the response of the neural tissue by measuring the response signal 203 to detect the presence of a nerve in the vicinity of the ultrasound handpiece 12.

[0085] 21 and 23 , adapter 212 may optionally include a switch 236. Switch 236 may be disposed in electrical communication between input terminal 226 and first connector 216 to control transmission of neural stimulation signal 202 from neural monitor 200 through ultrasound handpiece 12. In examples where switch 236 is open, neural stimulation signal 202 is not transmitted from neural monitor 200 through ultrasound handpiece 12. In examples where switch 236 is closed, neural stimulation signal 202 may be transmitted from neural monitor 200 through ultrasound handpiece 12. It may be advantageous to stop neural stimulation signal 202 from being transmitted through ultrasound handpiece 12 during certain aspects of a procedure, such as during a period during a craniotomy when neural stimulation signal 202 may be bothersome to the patient. Switch 236 may be digital or electrical. The switch 236 may be accessible on an exterior surface of the adapter 212, such as on the housing 213 of the adapter 212, as shown in Figures 19, 20, and 22A.

[0086] 21 and 23, the terminals 224 of the adapter 212 can optionally include an output terminal 230. As shown in FIG. 23, the output terminal 230 can be connected to a secondary probe 242. It is also shown that the output terminal 230 can be in electrical communication with the input terminal 226 from the nerve monitor 200. The secondary probe 242 can be used in addition to or instead of the ultrasound handpiece 12 when detecting the presence of a nerve. The output terminal 230 serves as another way for the surgeon to deliver stimulation energy to the surgical site.

[0087] 24-27 provide another possible embodiment of integrating neuromonitoring functionality with the ultrasound handpiece assembly 10. In such an embodiment, a cassette / cassette receptacle interface may provide a connection between the neuromonitor 200 and the ultrasound handpiece 12 or other type of handpiece. As shown, the previously described control console 13 may define a cassette receptacle 244 that may accept a cassette 246. The cassette 246 may be any suitable cassette, such as an irrigation cassette, an aspiration cassette, or a dual irrigation / aspiration cassette. While not limited to the cassette configurations described herein, exemplary cassette / cassette receptacle configurations are described in International Publication No. WO 2020 / 068509, which is incorporated herein by reference in its entirety.

[0088] As discussed above with respect to the adapter, the cassette-style embodiment may be utilized with other surgical handpieces and other surgical consoles other than those for ultrasonic surgical devices, such as RF surgical devices, high-speed drills, and other cutting or ablation devices.

[0089] 25 , cassette 246 may include a cassette fluid port 248 shaped to mate with a console fluid port 250 on control console 13. Cassette 246 may also include surgical tubing 252 in communication with cassette fluid port 250. The other end of surgical tubing 252 may extend to ultrasonic surgical handpiece 12. Surgical tubing 252 may also be referred to as an irrigation line or an aspiration line. Console fluid port 250 may be in fluid communication with an aspiration pump 254 or an irrigation pump 256 on control console 13, depending on the type of cassette 246. Thus, the two fluid ports 248, 250 are configured to establish a fluid connection between one of pumps 254, 256 and surgical tubing 252 when cassette 246 is inserted into cassette receptacle 244.

[0090] 26, the control console 13 may include cassette receiver terminals 258, and the cassette 246 may include cassette terminals 260. As shown in FIG. 27A, the control console 13 and the cassette 246 may be configured such that an electrical connection is established between the cassette receiver terminals 258 and the cassette terminals 260 when the cassette 246 is fully inserted into the cassette receiver 244 of the control console 13. The cassette receiver terminals 258 may be implemented as roller pins. As shown in FIG. 27, the cassette terminals 260 may be defined on a printed circuit board PCB. This printed circuit board PCB may define a portion of the exterior surface of the cassette 246. For example, the printed circuit board PCB may define a portion of a housing 262 of the cassette 246.

[0091] 24 , the control console 13 may further include the previously described handpiece port 204. The handpiece port 204 may be configured to mate with the previously described console connector 28 of the ultrasonic handpiece assembly 10, such that when the console connector 28 is engaged with the handpiece port 204, an electrical connection is established between the console terminal 205 and the terminal 214 of the console connector 28, establishing an electrical connection between the control console 13 and the handpiece assembly 10. The control console 13 may also include a jump conductor 264 or other conductive path between the cassette receiver 244 and the console terminal 205, thereby establishing an electrical connection between the ultrasonic handpiece assembly 10 and the cassette receiver terminal 244. The jump conductor 264 may be implemented using an SMA connector.

[0092] Cassette 246 may include several other components. Cassette 246 may include an input terminal 266 for receiving a connector from neuromonitor 200. A conductive path extends from input terminal 266 to cassette terminal 260, allowing neurostimulation signal 202 from neuromonitor 200 to extend from neuromonitor 200 handpiece assembly 10 through cassette 246 and control console 13.

[0093] Cassette 246 may also include a switch 268 in electrical communication between cassette terminal 260 and input terminal 266. Switch 268 may selectively control whether neural stimulation signal 202 is transmitted from neuromonitor 200 to ultrasound handpiece assembly 10. As shown in FIG. 27B , switch 268 may be defined on a printed circuit board PCB of cassette 246.

[0094] 24, the cassette may include a separate connector 270 for engaging an external switch, such as a foot switch. A foot switch may be used in such a configuration to control the cassette's switch 268. Alternatively, the switch 268 may be engageable by the user on the surface of the cassette or elsewhere.

[0095] 26, the cassette may further include a reference input terminal 272 and a reference output terminal 274. The reference input terminal 272 is configured to receive a connector from the neuromonitor 200 to provide a reference signal. The reference output terminal 274 is for receiving a connector from a reference probe or other reference device. Similar to the advantages described for the configuration including the adapter 212, the reference input terminal 272 and the reference output terminal 274 provide fewer origin locations for medical lines extending to the surgical site. This is because lines associated with the reference probe can be routed from the cassette 246 to the surgical site, and lines associated with the ultrasonic handpiece assembly 10 can be routed from the cassette 246 to the ultrasonic handpiece assembly 10 positioned at the surgical site.

[0096] 26, the cassette may further include an output terminal 276 for a secondary or auxiliary stimulation probe. The output terminal 276 may be in electrical communication with the input terminal 266 from the neuromonitor 200. The output terminal 276 serves as another way for the surgeon to provide stimulation energy to the surgical site.

[0097] 28, the printed circuit board PCB may act as a hub for the various terminals 266, 270, 274, 272 and connector 270 to route signals as needed. Conductors 278 extending from the various terminals 266, 270, 274, 272 and connector 270 may be routed within the cassette 244.

[0098] Referring to FIG. 29 , in another possible embodiment, the ultrasonic handpiece assembly 10 may feature a line connector at the proximal end 14. The line connector may be an example of the previously described tubing connector 22 and is referred to herein as the “line connector 22′.” The line connector 22′ may include an irrigation tubing coupler 282, an aspiration tubing coupler, which may be the previously described elastic member 26, and a cavity for receiving a power cord, which may be the previously described groove 110 for receiving the cord 30. Additionally, the line connector 22′ may include a receptacle 288 including a terminal 290 for receiving an input signal, such as the neural stimulation signal 202, from the neural monitor 200. As shown in FIG. 30A , the irrigation line coupler 282 defines an irrigation lumen 114 and may be configured to releasably (removably) engage the irrigation line 29. It is also shown that the aspiration line coupler 26 defines an aspiration lumen 112 and may be configured to releasably engage the aspiration line 27. 30B, receptacle 288 is shaped to receive a connector 292 extending from neuromonitor 200, thereby allowing terminal 290 of receptacle 288 to receive an input signal from neuromonitor 200. Additionally, cavity 110 may receive cord 30. As shown in FIG. 30B, this embodiment provides a convenient location for connecting ultrasound handpiece 12 to neuromonitor 200 that does not interfere with handling of ultrasound handpiece 12.

[0099] Referring to FIG. 31, an electrical schematic diagram of the embodiment of FIGS. 29-31B is shown. In this embodiment, the receptacle 288 includes an input terminal 290 that receives an input signal from the neuromonitor 200. The ultrasound handpiece 12 includes an irrigation conduit 58 and an electromechanical transducer 44. The terminal 290 in the line connector 22′ is positioned to be in electrical communication with the irrigation conduit 58 and / or the electromechanical transducer 44 when the line connector is coupled to the proximal end of the handpiece, and optionally when saline or other electrically conductive fluid flows through the irrigation conduit. More specifically, the ultrasound tip 20 is in electrical communication with the irrigation conduit 58 and / or the electromechanical transducer 44 via a jump conductor 294. This is because the irrigation conduit 58 in the handpiece 12 may be formed from a metallic component, such as stainless steel, or the irrigation conduit may contain an electrically conductive fluid. Based on this configuration, an input signal transmitted from the neuromonitor 200 , such as a neurostimulation signal 202 , is provided to the tip 20 of the ultrasound handpiece 12 via a terminal 290 in the receptacle 288 .

[0100] In some examples, the line connector 22′ may include a switch 296. The switch 296 may be positioned in electrical communication between the terminal 290 and the irrigation conduit 58 to control the transmission of the neural stimulation signal 202 from the neural monitor 200 through the ultrasound handpiece 12. The switch 296 may be accessible at an exterior surface of the line connector 22′, as shown in FIG.

[0101] In some examples, the line connector 22′ may be detachable from the ultrasound handpiece 12. For example, the line connector 22′ may be a disposable component that may be coupled to the ultrasound handpiece 12 in embodiments in which the neuromonitor 200 is integrated. In the example of FIG. 31 , the line connector 22′ may be detachable from the ultrasound handpiece 12. In such an example, the line connector 22′ may include a jump conductor 294 that may be disposed in electrical communication between the terminal 290 and the irrigation conduit 58 via the lumen 114. This allows the neural stimulation signal 202 to be transmitted to the irrigation conduit 58 via the irrigation fluid flowing through the lumen 114. In an alternative embodiment, a jump conductor may be used to place the neuromonitor in communication with the aspiration line or conduit along with the handpiece assembly.

[0102] To further illustrate that the jump conductor 294 may be in electrical communication with the lumen 114, a cutaway cross-sectional view of the ultrasound handpiece 12 and line connector 22' is shown in FIG. 32. Because the lumen 114 is in fluid communication with the ultrasound tip 20 of the ultrasound assembly 10, the input signal from the neuromonitor 200 may travel to the ultrasound tip 20 via the fluid within the lumen 114 or via the tubing defining the lumen 114. It should be appreciated that a terminal may be used in combination with the jump conductor 294 to facilitate transmission of the input signal to the tip 20.

[0103] It should be noted that Figure 31 selectively omits, for purposes of illustration, the control console 13, the line connector 22', and components of the ultrasonic handpiece assembly 10. For example, the aspiration lumen 112 of the line connector 22' has been selectively omitted for purposes of illustration.

[0104] Several embodiments have been described in the foregoing description. However, the embodiments described herein are not intended to be exhaustive or to limit the invention to any particular form. For example, while the exemplary configuration describes the surgical instrument as an ultrasonic handpiece, it is further contemplated that the features and concepts described in connection with an ultrasonic handpiece may be applied to other medical or surgical instruments. This equally applies to the ultrasonic tip 20, which may further include a blade, drill bit, rotary burr, open window shaver, etc. The terminology used is intended to be in the nature of description rather than limitation. Many modifications and variations are possible in light of the above teachings, and the invention may be practiced otherwise than as specifically described.

Claims

1. 1. An ultrasonic handpiece assembly comprising: Housing and an electromechanical transducer disposed at least partially within the housing; a chip operably coupled to the electromechanical transducer; an electrical cord having a console connector; A line connector; Equipped with the electrical cord includes a first conductor, the first conductor in electrical communication with the electromechanical transducer; The line connector a first tubing coupler configured to receive a perfusion line; a second tubing coupler configured to receive a suction line; a receptacle including a first terminal; Equipped with the receptacle is configured to receive a line extending from a neurological monitor; The ultrasonic handpiece assembly, wherein the first terminal is in electrical communication with the tip.

2. The ultrasonic handpiece assembly of claim 1 , wherein the line connector is formed from a resilient material.

3. The ultrasonic handpiece assembly of claim 1 or claim 2, wherein the housing includes an irrigation conduit, and the first terminal is in electrical communication with the irrigation conduit.

4. The ultrasonic handpiece assembly of claim 3 , wherein the line connector includes a jumper conductor disposed to position the first terminal in electrical communication with the irrigation conduit.

5. 5. The ultrasonic handpiece assembly of claim 3 or claim 4, wherein the line connector includes a switch operable to place the first terminal in electrical communication with the first terminal and to place the first terminal out of electrical communication with the irrigation conduit.

6. The ultrasonic handpiece assembly of any one of claims 1 to 5, wherein the line connector defines a cavity for receiving a portion of the electrical cord.

7. 1. A line connector for coupling to an ultrasound handpiece, comprising: a first tubing coupler configured to receive a perfusion line; a second tubing coupler configured to receive a suction line; a receptacle including a first terminal; Equipped with The receptacle is a line connector configured to receive a line extending from a neurological monitor.

8. The line connector of claim 7 , wherein the line connector is formed from a resilient material.

9. 9. The line connector according to claim 7 or 8, wherein the line connector includes a base, and the first tubing coupler and the second tubing coupler are integrally formed with the base.

10. 10. The line connector of claim 9, further comprising a jumper conductor disposed to position the first terminal in electrical communication with an irrigation conduit of the ultrasonic handpiece when the line connector is coupled to the ultrasonic handpiece.

11. 11. The line connector of claim 9 or claim 10, wherein the line connector includes a switch, the switch being in electrical communication with the first terminal.

12. The line connector according to any one of claims 9 to 12, further defining a cavity for receiving a portion of the electrical cord.

13. 1. An ultrasonic handpiece assembly comprising: Housing and an electromechanical transducer disposed at least partially within the housing; a chip operably coupled to the electromechanical transducer; an electrical cord having a console connector; Equipped with the electrical cord includes a first conductor, the first conductor in electrical communication with the electromechanical transducer and the chip; The console connector a first terminal for engaging an ultrasound control console, the first terminal being in electrical communication with the first conductor; a second terminal for engaging a source of electrical potential of a neural monitor; a jumper conductor disposed to position the second terminal in electrical communication with the first conductor; 1. An ultrasonic handpiece assembly comprising:

14. The ultrasonic handpiece assembly of claim 13 , wherein the console connector includes a third terminal for establishing a connection with a reference probe.

15. 15. The ultrasonic handpiece assembly of claim 13 or claim 14, wherein the console connector includes a fourth terminal for establishing a connection with a stimulation probe, the stimulation probe being separate from the ultrasonic handpiece assembly.

16. 16. The ultrasonic handpiece assembly of claim 13, further comprising a switch, the switch being operable to be in electrical communication with the second terminal and to place the second terminal in a state where it is not in communication with the first conductor.

17. The ultrasonic handpiece assembly of claim 16, wherein the switch is a foot switch.

18. 18. The ultrasonic handpiece assembly of claim 16 or claim 17, wherein the console connector includes the switch.

19. 1. An ultrasonic surgical system, comprising: an ultrasonic handpiece assembly; an adapter for connecting the ultrasound handpiece assembly to a neuromonitor; Equipped with The ultrasonic handpiece assembly includes: Housing and an electromechanical transducer disposed at least partially within the housing; a chip operably coupled to the electromechanical transducer; an electrical cord having a console connector; Including, the electrical cord includes a first conductor, the first conductor in electrical communication with the electromechanical transducer and the chip; the console connector includes a first terminal in electrical communication with the first conductor; The adapter is a second terminal for engaging an ultrasound control console; a third terminal for engaging a source of electrical potential of a nerve monitor; a jumper conductor disposed to position the third terminal in electrical communication with the second terminal; Including, When the console connector is connected to the adapter, electrical communication is established from the third terminal to the first terminal.

20. The adapter is a fourth terminal for establishing a connection with a reference input from the neuromonitor; a sixth terminal for establishing a connection with a reference probe; 20. The system of claim 19, comprising:

21. 21. The system of claim 19 or claim 20, wherein the adapter includes a fourth terminal for establishing a connection with a stimulation probe, the stimulation probe being separate from the ultrasound handpiece assembly.

22. 22. The system of claim 19, further comprising a switch, the switch operable to place the second terminal in electrical communication with the third terminal and out of communication with the first conductor.

23. 23. The system of claim 22, wherein the switch is a foot switch.

24. 23. The system of claim 22, wherein the adapter includes the switch.

25. 1. An ultrasonic surgical system, comprising: a control console including a pump; a surgical fluid cassette; Equipped with the control console defining a cassette receptacle and a handpiece port for connection to a console connector of an ultrasonic handpiece assembly; the cassette receptacle includes a first fluid port and a first terminal; the handpiece port includes a second terminal, the first terminal being in electrical communication with the second terminal; The surgical fluid cassette comprises: A surgical tube, a second fluid port coupled to the surgical tubing; a third terminal; and a fourth terminal for being positioned in electrical communication with a source of electrical potential of a neural monitor; Including, the second fluid port is configured to engage with the first fluid port to form a fluid connection between the pump and the surgical tubing when the surgical fluid cassette is inserted into the cassette receptacle; the third terminal is configured to engage with the first terminal when the surgical fluid cassette is inserted into the cassette receptacle, such that the first terminal is in electrical communication with the third terminal when the surgical fluid cassette is inserted into the cassette receptacle; The fourth terminal is in electrical communication with the third terminal.

26. 26. The ultrasonic surgical system of claim 25, wherein the surgical fluid cassette further includes a fifth terminal for receiving a reference input from the neuromonitor and a sixth terminal for establishing a connection with a reference probe.

27. 27. The ultrasonic surgical system of claim 26, wherein the surgical fluid cassette further includes a fifth terminal for establishing a connection with a stimulation probe, the stimulation probe being separate from the ultrasonic handpiece assembly.

28. further comprising an ultrasonic handpiece assembly; The ultrasonic handpiece assembly includes: Housing and an electromechanical transducer disposed at least partially within the housing; a chip operably coupled to the electromechanical transducer; an electrical cord having a console connector; Including, 28. The ultrasonic surgical system of claim 27, wherein the electrical cord includes a first conductor, the first conductor in electrical communication with the electromechanical transducer and the tip, and the first conductor in electrical communication with the second terminal.

29. 29. The ultrasonic surgical system of claim 25, further comprising a switch, the switch being operable to be in electrical communication with the third terminal and to place the third terminal in a state where it is not in electrical communication with the first terminal.

30. 30. The ultrasonic surgical system of claim 29, wherein the switch is a foot switch.

31. 31. The ultrasonic surgical system of claim 30, wherein the foot switch is connected through the surgical fluid cassette.

32. The ultrasonic surgical system according to any one of claims 29 to 31, wherein the surgical fluid cassette includes the switch.

33. The ultrasonic surgical system of any one of claims 25 to 32, wherein the surgical fluid cassette includes a printed circuit board, the printed circuit board defining the third terminal.

34. 34. The ultrasonic surgical system of claim 33, wherein the surgical fluid cassette defines an exterior surface and the printed circuit board defines a portion of the exterior surface.

35. 35. The ultrasonic surgical system of claim 34, wherein the printed circuit board is in communication with the fourth terminal.

36. The ultrasonic surgical system according to any one of claims 25 to 35, wherein the fourth terminal is a roller pin.

37. The ultrasonic surgical system according to any one of claims 25 to 36, wherein the surgical tube is a suction line and the pump is a suction pump.

38. The ultrasonic surgical system according to any one of claims 25 to 37, wherein the surgical tube is an irrigation line and the pump is an irrigation pump.

39. 1. A surgical system comprising: a control console including a pump; a surgical fluid cassette; Equipped with the control console defining a cassette receptacle and a handpiece port for connection of a handpiece to the console connector; the cassette receptacle includes a first fluid port and a first terminal; the handpiece port includes a second terminal, the first terminal being in electrical communication with the second terminal; The surgical fluid cassette comprises: A surgical tube, a second fluid port coupled to the surgical tubing; a third terminal; and a fourth terminal for being positioned in electrical communication with a source of electrical potential of a neural monitor; Including, the second fluid port is configured to engage with the first fluid port to form a fluid connection between the pump and the surgical tubing when the surgical fluid cassette is inserted into the cassette receptacle; the third terminal is configured to engage with the first terminal when the surgical fluid cassette is inserted into the cassette receptacle, such that the first terminal is in electrical communication with the third terminal when the surgical fluid cassette is inserted into the cassette receptacle; The fourth terminal is in electrical communication with the third terminal.

40. 1. A surgical system comprising: a control console including a pump; a surgical fluid cassette; Equipped with the control console defining a cassette receptacle and a handpiece port for connection of a handpiece to the console connector; the cassette receptacle includes a first fluid port and a first terminal; the handpiece port includes a second terminal, the first terminal being in electrical communication with the second terminal; The surgical fluid cassette comprises: A surgical tube, a second fluid port coupled to the surgical tubing; a third terminal; and Including, the second fluid port is configured to engage with the first fluid port to form a fluid connection between the pump and the surgical tubing when the surgical fluid cassette is inserted into the cassette receptacle; the third terminal is configured to engage with the first terminal when the surgical fluid cassette is inserted into the cassette receptacle, such that the first terminal is in electrical communication with the third terminal when the surgical fluid cassette is inserted into the cassette receptacle.

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