Cutting assembly with irrigation and aspiration capabilities

Abstract

A cutting assembly is provided in which an inner tube is rotatably disposed within an outer tube to define an aspiration path.SOLUTION: The inner tube 18 can include segments, which can define flexible regions associated with the curved portions of the outer tube 16. The outer tube defines an irrigation channel 60 and may further define an irrigation opening disposed near the cutting window or distal to the flexible region. The irrigation channel fluidly isolates the aspiration lumen from the irrigation path to prevent irrigation fluid from flowing into the aspiration lumen via the slots defined by the segments. The inner jacket may be coaxially disposed within the inner tube and configured to provide a seal between the suction path and the irrigation path. A distal end of the inner jacket may be disposed within the expanded diameter portion and a proximal end of the inner jacket may be proximate the inner tube.SELECTED DRAWING: Figure 3

Description

[Technical Field]

[0001] Priority claims This application is a continuation of U.S. Provisional Application No. 63 / 124,207, filed December 11, 2020. This application claims priority to and all benefit of the U.S. Provisional Application No. 10 / 199,992, filed on Dec. 1, 2002, the entire contents of which are incorporated herein by reference. No. 60 / 699,493, filed on Oct. 1, 2003, which is incorporated [Background technology]

[0002] Angled cutting instruments for surgical procedures are not accessible with straight instrumentation Angled cutting instruments typically have a drive shaft, or external The inner tube is rotatably disposed within the side tube, and the inner tube is adapted to follow or bend along a curve. Angled shavers often require torque transmission around the inner tube. Suction can be provided via a suction lumen defined by the tube. The geometry often required to facilitate torque transmission around curves is This makes the draw lumen susceptible to unwanted inflow or outflow of fluid through the geometry. One such cutting instrument is described in U.S. Patent No. 8,623,266 to Adams. An angled shaver mounted on a heat shrink sleeve that fits over a continuous spiral cutout of the inner tube. The heat shrink sleeve, together with the outer tube, forms a journal bearing structure. Another known angled shell is susceptible to wear when rotated at high speeds in The server is described in U.S. Pat. No. 5,922,003 to Anctil et al. A section of the side tube is replaced by a fixed length flexible joint. Effectively overmolding flexible joints at lap joints between adjacent components Furthermore, it is difficult to effectively control the torque required for a particular cutting operation. Furthermore, certain flexible joints have the capacity to effectively transmit bending loads. In some cases, they tend to twist, or Flexure joints are typically too large for most desirable surgical applications. Thus, there are techniques in the art that provide irrigation and aspiration as well as torque transmission around curves. There is a need for an improved cutting assembly. Summary of the Invention

[0003] The cutting assembly includes a suction tube to suck up the excised tissue and other surgical debris. The surgical site may include a suction channel, a suction channel, and an irrigation channel for irrigating the surgical site. The inner tube can define at least a portion of the aspiration path, and the irrigation path can define at least a portion of the inner tube. The cutting assembly may be external to the tube. means for preventing the cutting of the cutting blades, thereby maximizing irrigation and suction capabilities. The assembly can include a straight or angled tube assembly. The means for preventing fluid inflow is particularly suitable for angled cutting assemblies. The cutting assembly may be a shaver, a burr, or a device incorporating suction and irrigation. Alternatively, other tissue manipulation devices may be used to prevent fluid inflow. The means may be an implement having irrigation but not suction, or an implement having suction but irrigation. The note can be used for devices that do not have one as well.

[0004] The cutting assembly includes a housing hub, and the tube assembly is attached to the housing hub. The tube assembly includes at least an outer tube and an inner tube. The drive hub is movably or rotatably disposed within the outer tube. and configured to releasably engage complementary components of the electric motor and the primary equipment. The drive hub and inner tube are attached to the distal end of the tube assembly. The cutting tip may define an aspiration lumen in fluid communication with the cutting tip disposed at the distal end. The cavity can define a suction path. The excised tissue and other debris, as well as fluids, are removed through the cavity. In certain implementations, the material is aspirated through the inner tube. The fluid passes through the bend in the tube assembly and exits the housing for collection through the main equipment. The housing hub defines an irrigation cavity or lumen. The seal is connectable to the hub and defines an opening in fluid communication with the irrigation cavity. During irrigation delivered through surgical instruments, the main equipment The tube assembly is configured to be disposed in a sealing relationship with a complementary feature of the housing. The outer tube extends distally from the hub. The outer tube can be rigidly coupled to the housing hub. The inner tube can rotate within the outer tube, thus forming a housing hub. When the drive hub of the cutting assembly is coupled to the main equipment, Relative axial movement between the inner and outer tubes is prevented.

[0005] In certain implementations, the cutting tip has a cutting window such that the cutting assembly is a shaver. The cutting assembly may include an outer tip portion and an inner tip portion. The tip section is rigidly connected to the outer tube. The outer tip section is welded to the outer tube. Distal to the outer diameter of the collar, the outer tip portion is thin The thinned region may include a thinned region having an outer diameter smaller than the outer diameter of the collar. The thinned areas may be formed by plunge grinding or other suitable manufacturing techniques. The thinned region can extend in a direction toward the outer window defined by the outer tip portion, for example. It can be tapered to a

[0006] The cutting teeth can be located adjacent the outer window. The inner tip portion is rigidly attached to the inner tube. The inner tip portion defines an inner window, and the cutting teeth are disposed adjacent to the inner window. Within the inner tip portion there is located an element to minimize clogging of the cutting assembly. A gap may be defined between the outer tip portion and the inner tip portion. This gap provides clearance for the inner tip section to rotate within the outer tip section. as well as providing clearance for drainage of irrigation from the cutting assembly at the surgical site. Fluid can be directed through the gap and evacuated through the perimeter of the outer window. It is possible.

[0007] The curved portion of the tube assembly is formed by the curved portion of the outer tube and the flexible region of the inner tube. The outer tube may be rigid or malleable. Another tube is placed coaxially on the outside of the outer tube, eliminating any bends in the tube assembly. It is also possible to provide a structure that provides rotation of the cutting window in relation to the flexible region. In one example, the flexible regions can be interlocked with one another to define slots. These segments must be castellated as shown. Other interlocking geometries are envisioned. The segments are The inner tube may be axially spaced or may include at least a flexible region. Alternatively, the inner tube may be towed around the bend. It is also possible to include spirals, T-slots, windings, braids, etc. to transmit torque. do.

[0008] In certain implementations, the outer tube extends longitudinally along the length of the outer tube. The housing hub defines an irrigation channel, the irrigation channel being in fluid communication with the irrigation cavity of the housing hub. The irrigation channel may be defined by the outer tube itself. Alternatively, the outer tube may be integral in structure and encapsulate the irrigation channel. The tube may also define a longitudinal slot or recess, and the hypotube or An intermediate tube may be secured within the outer tube to define an irrigation channel. This structure provides an irrigation channel that defines an irrigation path that is fluidly isolated from the aspiration lumen. Note: Fluid may be drawn into the aspiration lumen via the slots between the segments to prevent unwanted drawing. Passing through bends towards gaps without risk. Any number of irrigation channels It is envisioned that the irrigation channels may be arranged in any suitable radial configuration.

[0009] The outer tube has an irrigation channel and a groove defined between the inner and outer tip portions. The cap further defines an irrigation opening that provides fluid communication between the cap and the outer tube. The irrigation opening may be a slot defined by the inner surface of the gear. formed by the inner thickness of the outer tube terminating in an effective opening into the cap Any number of irrigation openings is contemplated, and the irrigation openings may be arranged in any suitable radial configuration. The irrigation openings are located distal to the curved portion. The irrigation openings can be configured with multiple sections. The irrigation channel can be located distal to the most distal of the two segments. It may be located near or adjacent to the end portion and outer tip portion. The inlet opening is near the cutting tip but allows fluid to pass from the irrigation channel to the gap distal to the bend. The irrigation fluid exits the cutting assembly through the cutting tip.

[0010] Fluid communication is established between the irrigation channel and the irrigation cavity of the housing hub. The hub may define an irrigation opening through which the inner tube extends. The irrigation opening may further define a recess extending from the irrigation opening in rotational alignment with the irrigation channel. This structure allows for an irrigation cavity in the housing hub that is further guided through an irrigation channel. In an alternative implementation, the recess and / or irrigation channel , can provide fluid communication in any rotational alignment. The well and / or recess and irrigation channel may be provided with a tubing assembly and / or a hand At least one of the plurality of irrigation channels may be positioned in any rotational orientation between the housing hubs. a portion of the plurality of recesses in fluid communication with at least a portion of one of the plurality of recesses, the portion being in fluid communication with at least a portion of the plurality of recesses. It is possible.

[0011] In certain implementations, the tube assembly includes an inner tube coaxially disposed within the inner tube. The inner jacket has an outer diameter approximately the same as the inner diameter of the inner tube. The inner jacket can be considered a sleeve or liner. The inner jacket allows the inner tube to maintain flexibility along the curved section. and a seal for preventing aspiration of irrigation fluid through the slots in the segments. The inner jar has mechanical properties that allow it to be further delivered into the cavity. The socket may or may not facilitate the transmission of torque. The inner jacket may be a multi-layered, reinforced tube. The jacket is disposed between or sandwiched between the polymer layers. The inner and / or outer layers of the inner jacket are made of polyether block. The braid may be made of quamid and the braid may be stainless steel. The inner jacket can also be made from polytetrafluoroethylene (PTFE) The braid may be an extremely thin ribbon-like structure. The innermost layer is optionally The inner layer can be chemically etched and can be made from PTFE. The layer or innermost layer itself defines a liner lumen that defines at least a portion of the aspiration lumen. The innermost layer, which is PTFE, is smooth and therefore Reduces potential blockages as debris is pulled through the liner lumen.

[0012] The inner jacket has a distal end disposed adjacent the inner tip portion and an inner tube. The cutting tip includes a proximal end coupled to a drive hub or drive hub. This structure allows for the proximity of the cutting tip to the drive hub. An inner jacket is obtained that lines almost the entire aspiration lumen between the distal end and the distal end. The inner tip portion may include an enlarged diameter portion sized to approximately the thickness of the inner jacket. The distal end of the inner jacket is disposed within the enlarged portion. The end can be located near the proximal end of the inner tube. A portion of the jacket is attached to the drive hub using adhesive or other suitable attachment means. The proximal and distal ends of the inner jacket may be positioned within the flexible region of the inner tube. The inner jacket is positioned on the opposite side of the segment to allow irrigation fluid to pass through the slots in the segments. A seal is provided along the curve to prevent suction.

[0013] In certain implementations, the cutting assembly may be a burr. The cutting tip is attached to the inner tube. The outer tube may terminate in a tubular distal end. The cutting tip may have a neck, and an inner tube may extend through the tubular distal end. An opening extending from the bar head and adjacent to the bar head is disposed near the bar head. The inner tube can be connected to the cutting tip and the opening can be in fluid communication with the aspiration lumen. The distal end of the inner tube can be secured to the proximal end of the neck of the cutting tip. The inner jacket is coaxially disposed within the inner tube. and a distal end of the inner tube opposite the flexible region where the slot is located. The inner jacket is configured to have a complementary curvature or curve. The distal end of the inner jacket may be positioned adjacent to the proximal end of the neck. The proximal end of the inner jacket can be disposed adjacent the proximal end of the inner tube. A portion of the inner jacket adjacent the tube may be coupled to the drive hub. The distal end of the jacket may or may not be attached to the cutting tip. The jacket-containing implementation may be combined with an implementation that includes irrigation channels and openings. can be done.

[0014] The cutting assembly includes an irrigation spacer disposed within the housing hub distal to the drive hub. The irrigation spacer may further include a distal cavity extending distally from the irrigation cavity. In one implementation, the irrigation spacer can be positioned within the sinus. a hub defining a bore through which the inner jacket extends; The irrigation spacer may have at least one extending fin between the irrigation spacer and the drive hub. The irrigation spacer may be positioned axially from the irrigation opening to the drive hub. spacing, while also providing irrigation passages that allow robust fluid flow through the irrigation pathways. provide.

[0015] Accordingly, a first aspect of the present disclosure is a device configured to be coupled to an irrigation source and a suction source. The present invention relates to a cutting assembly, the cutting assembly comprising a housing, an outer tube, and The proximal end of the outer tube is coupled to the housing. The inner tube is coupled to the drive hub and is rotatably coaxially disposed within the outer tube. An irrigation pathway is defined between the inner and outer tubes. The cutting tip is fixed to the inner tube. An inner jacket is coupled to the drive hub and is coaxially disposed within the inner tube. A suction path is defined within the inner jacket. The inner jacket is It is configured to provide a fluid seal between it and the irrigation pathway.

[0016] In certain implementations, the inner tube can define a slot. The fluid seal provided by the socket is designed to prevent irrigation fluid from entering through the slots. The outer tube may include a bend, and the slot in the inner tube may be configured as follows: The inner jacket can be disposed axially along the curved portion. The proximal end of the drive shaft can be coupled to the drive hub at a location adjacent to the portion where the drive shaft is coupled to the drive hub. The inner jacket does not have to be attached to the cutting tip. The inner jacket is made of polymer. It may also be a multi-layered reinforcing tube, such as a braided cord disposed between inner and outer layers of material. The braid may be stainless steel and the polymer material may be polyether block amide. It is also possible.

[0017] In certain implementations, the outer tube includes an outer tip portion defining an outer window, and an inner tip The part includes an inner window so that the cutting assembly is a shaver. The end may be a burr head. The burr head may include a cutting element, and the cutting element A suction port may be defined adjacent the housing. The irrigation spacer can be placed in the irrigation area. The irrigation spacer allows the inner tube to pass through and rotate. a hub defining a hole in which the hub is disposed, and a flange extending radially from the hub and secured within the cavity; It may contain

[0018] According to a second aspect of the present disclosure, a cutting assembly includes a housing, an outer tube, and an inner a proximal end of the outer tube coupled to the housing and defining an outer window; The inner tube is rotatably and coaxially disposed within the outer tube and includes an outer tip portion. The inner tube defines an aspiration lumen configured to be placed in fluid communication with the source. an inner tip portion defining a window, and a gap defined between the inner tip portion and the outer tip portion; The outer tube extends longitudinally from near the proximal end and is disposed in fluid communication with an irrigation source. The outer tube defines an irrigation channel configured to receive the outer and inner windows. configured to provide fluid communication between the irrigation channel and the gap at a location proximate to An irrigation opening may be further defined. The irrigation opening may be located near the outer window. The tube may include a curved portion and the inner tube may include a flexible region. can be positioned distal to the flexible region.

[0019] According to a third aspect of the present disclosure, a cutting assembly includes a housing, an outer tube, and an inner The outer tube includes a distal end and a side tube that angles the distal end relative to the longitudinal axis. The inner tube is rotatably and coaxially disposed within the outer tube, and the outer tube includes a curved portion for The cutting tip is fixed to the inner tube and has a flexible region that passes through the curve of the side tube. The outer tube is configured to be in fluid communication with an irrigation source. An irrigation channel is defined, the irrigation channel being fluidly isolated from the flexible region of the inner tube. The outer tube is disposed distal to the flexible region, and the irrigation channel and the cutting tip and the outer tube and further defining an irrigation opening configured to provide fluid communication between the gap between the do.

[0020] In certain implementations, the outer tube can include an outer tip portion that defines an outer window. The cutting tip may define an inner window such that the cutting assembly is a shaver. Alternatively, the cutting tip may be a burr head. The outer tube may include a curved portion. The inner tube has a flexible region, allowing the irrigation channel to pass through this curve. The irrigation channel may include a segment defining the irrigation channel. The irrigation channel may be fluidly isolated from the segment. The outer tube may be integral and the irrigation channel may be encapsulated within the outer tube. Alternatively, the hypotube may be placed within and bonded to the outer tube. It is also possible for the irrigation channel to be defined between the outer tube and the hypotube. The irrigation opening may be a recess defined in the distal end of the irrigation channel. There may be four irrigation channels equally spaced radially about the axis, and the irrigation openings may be four irrigation openings equally spaced radially about the longitudinal axis. The tubing includes an irrigation cavity, an opening through which the inner tube extends, and a tubing that is connected to the opening and irrigation channel. The recesses in the housing may be in a cross-shaped configuration. or any other suitable structure.

[0021] Benefits of the present disclosure may be better understood by reference to the following detailed description when considered in conjunction with the accompanying drawings. The benefits of the disclosure will be better appreciated and therefore readily appreciated. [Brief explanation of the drawings]

[0022] [Figure 1] FIG. 1 is a perspective view of a cutting assembly of a surgical instrument; [Figure 2] FIG. 2 is a cross-sectional view of the cutting assembly of FIG. 1 taken along section line 2-2. [Figure 2A] FIG. 2B is a detailed view of a portion of the cutting assembly within circle 2A. [Figure 3] FIG. 3 is an axial cross-sectional view of the cutting assembly of FIG. 1 taken along section line 3-3. [Figure 4] FIG. 4 is an axial cross-sectional view of the cutting assembly of FIG. 1 taken along section line 4-4. [Figure 5] 1 is an exploded view of the distal portion of the cutting assembly, showing the inner and outer tip portions exploded from the inner and outer tubes, respectively, so that the irrigation openings are visible. [Figure 6] 6 is an axial cross-sectional view of the housing of the cutting assembly of FIG. 1 taken along section line 6-6. [Figure 7] FIG. 10 is a rear perspective view of the hub of the cutting assembly. [Figure 8] FIG. 10 is an exploded view of a cutting assembly according to another implementation, in which the inner jacket is configured to be coaxially disposed within the inner tube. [Figure 9] 9 is a cross-sectional view of the inner and outer tip portions of FIG. 8 with an inner jacket bonded to the inner tip portion. [Figure 10] FIG. 10 is a cross-sectional view of a housing with an inner jacket coupled to a drive hub of a cutting assembly. [Figure 11] FIG. 1 is a perspective view of a cutting assembly of a surgical instrument; [Figure 12] FIG. 12 is a cross-sectional view of the cutting assembly of FIG. 11 taken along section line 12-12. [Figure 12A] FIG. 12B is a detailed cross-sectional view of a portion of the cutting assembly within circle 12A. [Figure 13] FIG. 10 is a detailed cross-sectional view of another portion of the cutting assembly within rectangle 13. [Figure 14] FIG. 10 is a detailed cross-sectional view of another portion of the cutting assembly within rectangle 13. DETAILED DESCRIPTION OF THE INVENTION

[0023] FIG. 1 illustrates a cutting assembly 10 configured to resect tissue. The cutting assembly 10 of FIG. 1 can be considered an angled shaver. The bridge 10 includes a main body that may include one or more of a motor, an irrigation source, and a suction source. The primary equipment is configured to be removably coupled to a primary equipment (not shown). Although it can be reused in a procedure, the cutting assembly 10 may be a disposable component. One exemplary main equipment suitable for this application is the Stryker Corporation (Michael). manufactured by the ESSx Microdebrider Company (Kalamazoo, IL) and sold under the trade name ESSx Microdebrider. Sold and / or co-owned U.S. Patent No. issued November 28, 2000 No. 6,152,941, and International Publication WO202 published on November 11, 2021 No. 1 / 224862, the contents of which are incorporated herein by reference in their entirety. It is incorporated into.

[0024] The cutting assembly 10 includes a housing hub 12 and a The tube assembly 14 includes at least an outer tube 1 6 and an inner tube 18 rotatably disposed within the outer tube 16. The tube 18 is configured to be coupled to the electric motor of the main equipment and is externally connected by the electric motor. The drive hub 20 is further configured to rotate within the inner tube 16. 18 and configured to releasably engage a complementary component of the primary equipment. The key 22 and other features are included.

[0025] A drive hub 20 and inner tube 18 are disposed at the distal end of the tube assembly 14. The cutting tip 26 may define an aspiration lumen 24 in fluid communication with the cutting tip 26. 24 can define a suction path. The cutting assembly 10 can be detached from the main equipment. When coupled, the suction pathway is configured to be placed in fluid communication with a suction source. The relative rotation of the tube and outer tube 16, 18 causes the excised tissue to move towards the cutting tip 2 6, other debris and fluids can be aspirated from the surgical site as well. Material drawn through the inner tube 18 passes through the curved portion 28 of the tube assembly 14. The air passes through the housing hub 12 for collection via the main equipment. , aspiration of fluid through the curved portion of the rotatable tube (which is The technical problems overcome using the cutting assembly 10 of the present disclosure are: It is related to the task.

[0026] The housing hub 12 defines an irrigation cavity 30 or lumen. The irrigation cavity 30 includes a distal end 32 and a distal end 34. ... One of the seals suitable for the present application is disclosed in the above-mentioned International Publication WO2021 / 224862. The seal 32 prevents fluid from escaping during irrigation delivered through the surgical instrument. The device is configured to be disposed in a sealing relationship with a complementary feature of the primary device to prevent

[0027] A tube assembly 14 extends distally from the housing hub 12. The tube 16 can be rigidly coupled to the housing hub 12. The inner tube 18 is It can rotate within the tube 16 and therefore rotate relative to the housing hub 12. When the drive hub 20 of the cutting assembly 10 is coupled to the main equipment, the inner tube Relative axial movement between the tube 18 and the outer tube 16 is prevented. When the main equipment is removed, the small gap between the inner tube 18 and the outer tube 16 Relative axial movement may be permitted.

[0028] The cutting tip 26 defines a cutting window such that the cutting assembly 10 is a shaver. With further reference to FIG. 5, the cutting assembly 10 includes an outer tip portion 36 and an inner The outer tip portion 36 is rigidly connected to the outer tube 16. In an embodiment, outer tip portion 36 is welded to outer tube 16 (as shown in FIG. 5). The collar 40 is configured to have an outer tip portion 44 extending distally from the collar 40. The portion 36 may include a thinned region 41. The thinned region 41 may be a color 40. The thinned region 41 of the outer tip portion 36 has an outer diameter smaller than that of the outer tip portion 36. The cutting teeth 44 are positioned adjacent to the outer window 42 to allow the surgeon to easily see the cutting target. This improves visibility of the end 26. The thinned area 41 may be formed by plunge grinding or other suitable The thinned region 41 can be formed by a manufacturing technique, for example, in the outer tip portion 3 6. The outer window 42 defined by the outer window 42 may be tapered.

[0029] The inner tip portion 38 is rigidly connected to the inner tube 18. A side window 46 may be defined, and the cutting teeth 48 may be positioned adjacent the inner window 46. The window and outer windows 42, 46 collectively form the cutting window of the cutting assembly 10. When the inner tip portion 38 is rotatably disposed within the outer tip portion 36, The cutting teeth 44, 48 intersect with each other in a shearing action to cut tissue. An element 50 may be positioned within 38 to minimize clogging of the cutting assembly 10. This is based on the above-mentioned International Publication WO2018 / 01390 published on January 18, 2018. No. 6, the contents of which are incorporated herein by reference in their entirety. It is being eaten.

[0030] 2 and 2A, the curved portion 28 of the tube assembly 14 is The outer tube 16 may include a curved portion 52 and a flexible region 54 of the inner tube 18. The outer tube 16 may be rigid or malleable. The curved portion 52 of the tube 16 generally defines the angled shape of the tube assembly 14. The curved portion 28 may be formed at any suitable angle, and this angle is often determined by the procedure. For example, the angle may be 30°, 60° or 90°, Alternatively, the torque transmission capacity may be further limited only by the flexible region 54 of the inner tube 18. The curved portion 28 of the tube assembly 14 provides a connection between the housing hub 12 and the cutting tip 26. The bend 28 can be positioned at any axial position between the housing hub 12 and the bend 28. and can be oriented in any radial direction (e.g., upward, downward, or sideways). It is further understood that these parameters also depend on the type of procedure. For example, proximal curvature can be indicated for spinal surgery, and medical curvature can be indicated for general thoracic surgery. The distal curvature can be shown for ENT surgery. An angle of approximately 30° between opposing portions of the tube assembly 14 opposite the bend 28 Furthermore, another tube is placed coaxially outside the outer tube 16. and obtaining a structure that provides for rotation of the cutting window independent of the curved portion 28 of the tube assembly 14. It is assumed that:

[0031] FIG. 2A best illustrates an exemplary implementation of flexible region 54 of inner tube 18. The flexible region 54 can define a slot. In one example, the flexible region defines a slot. These segments 56 are interlocked to define 56 can be castellated as shown, but other interlocking geometric structures are also possible. The interlocking of segment 56 is assumed to be due to the inner It provides for the transmission of torque as the tube 18 rotates. The blade 18 has a helical or wound characteristic configured to transmit torque around the curved portion 28. Or it can include braided properties. For less complex geometries , segment 56 is less likely to experience irrigation fluid suction losses and / or The relatively smaller slots allow less irrigation fluid to enter. Despite the slots, the improvement in suction performance of the cutting assembly 10 remains significant. The importance of this is the improvement of the tube assembly, which is often simultaneous with suction. This is particularly noticeable in implementations where the cutting assembly 10 also provides irrigation via the rib 14. The segments 56 may be present throughout the inner tube 18 and may Alternatively, as shown in FIG. 8, the portion of the inner tube 18 that includes the flexible region 54 may be It is envisioned that the flexible region 54 will form the length of the inner tube 18 to the extent that: This may depend on the flexure requirements of the tube assembly 14. For example, the larger the angle of curvature, the , and / or the smaller the radius of curvature, the longer the length of the inner wall formed from the flexible region 54. In an exemplary implementation, the flexible region 54 is a tube assembly. forming less than 20% of the length of the assembly 14, and more particularly less than 20% of the length of the inner tube 18 The flexible region 54 minimizes the distance that defines the length of the inner tube 18. This reduces whipping or chattering of the inner tube 18 when rotating at relatively high speeds. Furthermore, by making the length of the flexible region 54 relatively short, , fewer segments 56 are required, and torque transmission from the drive hub 20 to the inner window 46 is improved. The data is better preserved, even though the tolerance between the segments 56 is extremely small. Regardless, cumulative buildup can result in some lag between the drive hub 20 and the inner window 46. By reducing the number of segments 56, any delay can be reduced.

[0032] A gap 58 may be defined between the outer tip portion 36 and the inner tip portion 38 ( (Best seen in FIG. 9B). This gap 58 occurs when the inner tip portion 38 is In addition to providing clearance for rotation within portion 36, the cutting It provides clearance for the evacuation of irrigation from the assembly 10. In particular, can be guided through the gap 58 and can be exhausted around the outer window 42. Gap 58 is configured to be placed in fluid communication with an irrigation source. By way of reference, the outer tube 16 extends longitudinally along the length of the outer tube 16. The irrigation channel 60 defines an irrigation channel for the housing hub 12. 30, so that when the cutting assembly 10 is coupled to the main equipment, , in fluid communication with the irrigation source. In the exemplary implementation shown in FIG. 3, the irrigation channel 60 It is defined by the structure of the outer tube 16 itself. The outer tube 1 is integral in structure and can encapsulate the irrigation channel 60. 6 can be formed with irrigation channels 60 by an extrusion process. Alternatively, the outer tube 16 may define a longitudinal slot or recess, and the hypotube A tube (not shown) or intermediate tube is secured within the outer tube 16 and has a slot. It is also possible to define an irrigation channel 60 through which the This structure includes an irrigation lumen that is fluidly separated from the aspiration lumen 24, particularly along the curve 28. The irrigation channels 60 define a path through which the irrigation fluid passes. 56 into the aspiration lumen 24 through the slots between the 3 shows the tube assembly 1. Four irrigation channels 60 are shown equiangularly spaced radially about the axis 4. More or fewer irrigation channels 60 are envisioned, and irrigation channels 6 The 0s can be arranged in any suitable configuration.

[0033] The outer tube 16 has an irrigation channel 60 and an inner tip portion 38 and an outer tip portion 36. and further defining an irrigation opening 62 that provides fluid communication between the gap 58 defined therebetween. 4 and 5, the irrigation openings 62 are defined by the inner surface of the outer tube 16. In the implementation shown, the irrigation opening 62 is an irrigation channel. The channel 60 terminates so as to effectively open into the gap 58 as shown in FIG. This can be effectively formed by the inner thickness 64 of the outer tube 16 (see FIG. 3). However, irrigation opening 62 provides fluid communication between irrigation channel 60 and gap 58. The conductors may take on or be formed in any suitable geometry to provide It is further envisioned that the irrigation openings 62 may be spaced radially at equal angular intervals. or any suitable configuration about the axis of the tube assembly 14. Additionally, more or fewer irrigation channels 60 are envisioned.

[0034] The irrigation channel 60 passes through the curved portion 28 and the irrigation channel 60 extends inwardly around the curved portion 28. Fluidically isolated from the tube 18, the irrigation opening 62 is located distal to the curved portion 28. The irrigation openings 62 are spaced apart to eliminate the possibility of irrigation fluid being drawn through the slots. The distal end of the segment 56 may be located distal to the most distal end of the plurality of segments 56. In certain implementations, the irrigation channel 60 can be connected to the inner and outer tip portions 36. , 38. Thus, the irrigation openings 62 are Proximal to the cutting tip 26, but directing fluid from the irrigation channel 60 to the gap distal to the curved section 28. The irrigation fluid is discharged from the cutting assembly 10 through the cutting tip 26. do.

[0035] 6 and 7 show the irrigation channel 60 and the irrigation cavity 30 of the housing hub 12. As previously explained, the inner tube 18 is a housing. The housing hub 12 is rotatable relative to the inner tube 1. 8 extends therethrough (see also FIG. 2). 2 from the irrigation opening 66, aligned with the irrigation channel 60 as best shown in FIG. The cutting assembly 1 may further define a recess 68 extending therethrough. Assembly of the 0 may require rotational alignment of the recess 68 and irrigation channel 60. This requires rigidly coupling the outer tube 16 to the housing hub 12 in a single rotational orientation. The cross-shaped arrangement is further guided through the recess 68 and the irrigation channel 60. irrigation fluid into the irrigation cavity 30 of the suction hub 12. Separated irrigation paths optimize irrigation and aspiration performance, especially on instrumentation containing curved sections. In an alternative implementation, the tube assembly 14 is straight and the cutting assembly The remaining aspects of the device may be as described herein. Such a straight implementation does not include the segment 56. Preferably, the inner tube 18 can be of rigid construction.

[0036] In an alternative implementation, either the tube assembly 14 and / or the housing hub 12 Specific modifications to improve fluid flow between the irrigation cavity 30 and the irrigation channel 60 For example, recesses 68 and irrigation channels that are rotationally aligned in a single rotational orientation. Unlike the recesses 68 and / or irrigation channels 60, the recesses 68 and / or irrigation channels 60 provide fluid communication in any rotational orientation. There may be five or more recesses 68 and / or 68 can be for a larger arc than the implementation shown in FIG. Alternatively, any circuit between the tube assembly 14 and / or the housing hub 12 may be In the inverted orientation, at least a portion of one of the plurality of irrigation channels 60 is positioned within the plurality of recesses 68. irrigation channel 60 or irrigation channel 61 so as to be in fluid communication with at least a portion of one of the The proximal opening into the o is also capable of a relatively larger arc. In another example, the proximal end of the outer tube 16 may have an inlet opening in communication with the irrigation channel 60. This inlet opening may include a port (not shown), similar to the irrigation opening 62 already described. The inlet opening may extend radially inward from the outer diameter of the outer tube 16. The irrigation channel 60 shown in FIG. 6 is located at the proximal edge or near the outer tube 16. The irrigation port is defined within the distal end and may be limited in size, but may also be an irrigation cavity. 30 to irrigation channel 60, larger size to allow for a larger flow rate of fluid. In yet another example, the irrigation port may be located near the proximal end of the tubing assembly 14 or or a seal (not shown) between the inner tube 18 and the outer tube 16 adjacent the proximal end. This seal can be positioned to engage the rotating inner tube 18. The seal may be a dynamic seal configured between the inner tube 18 and the outer tube 11. 6, thereby preventing fluid from entering the annular space between the irrigation channel 60. In other words, a smaller portion of the irrigation fluid may be more effective. Otherwise, less fluid will flow into the annular space and less into the irrigation channel 60. A seal located near the opening (or inlet opening) prevents the flow of irrigation fluid into the annular space. This prevents inflow so that all irrigation fluid is directed into the irrigation channel 60 and into the cutting assembly. The performance of the assembly 10 is improved.

[0037] 8-10 illustrate a cutting assembly 1 in which irrigation fluid is isolated from potential fluid communication with suction. 0 alternative embodiments. Like numerals refer to like elements, and The tube assembly 14 includes an outer tube 16 having a curved portion 52, an inner tube 16 having a flexible region 54, and a The tube assembly 14 is coaxially disposed within the inner tube 18. More specifically, the inner jacket 70 includes an inner tube. The inner jacket 70 may have an outer diameter approximately the same as the inner diameter of the tube 18. It can be considered a tube or liner.

[0038] The inner jacket 70 keeps the inner tube 18 flexible along the curve 28. and for preventing aspiration of irrigation fluid through the slots in the segments 56. The aspiration lumen 24 may have mechanical properties configured to further provide a seal within the aspiration lumen 24. The inner jacket 70 can facilitate the transmission of torque, and Known thin-walled monopolymers have properties that, when stretched in a curved configuration, may not be possible. In some cases, they tend to kink or are too large for typical surgical instrumentation. The inner jacket 70 allows for a thinner wall thickness without the kinking mentioned above. This is advantageously achieved by the multi-layered and reinforced tube. In one implementation, the inner jacket 70 is disposed between the polymer layers. The braided wire 72 is shown in FIG. More specifically, the inner layer and / or the outer layer of the inner jacket 70 are made of Ark Distributed by ema SA (Colombes, France) under the trade name PEBAX The braided wire 72 may be made of stainless steel. Alternatively, the inner jacket 70 may be made of polytetrafluoroethylene (P The braid may be an extremely thin ribbon-like structure. The innermost layer can optionally be chemically etched within the inner layer, The inner or innermost layer may itself be formed from a small portion of the aspiration lumen 24. The liner may define a liner lumen 80 that at least partially defines the liner lumen 80. The inner layer is smooth so that debris is pulled through the liner lumen 80 This reduces potential blockages during

[0039] 9 and 10, an inner jacket 70 is attached to the inner tip portion 38. adjacently disposed distal end 74 and coupled to inner tube 18 or drive hub 20 This structure provides suction between the cutting tip 26 and the proximal end of the drive hub 20. An inner jacket 70 is obtained that lines almost the entire length of the pull tube lumen 24. Due to the thickness of the jacket 70, the inner tip portion 38 is 9, the inner diameter of the inner tube 70 may be increased to approximately the size of the inner tube 70. The distal end 74 of the jacket 70 is disposed within the expanded diameter portion 78. 8, from the inner surface of the inner tip portion 38 to the inner jacket 70 In other words, this structure allows the aspirated material to pass through the gap that would otherwise be filled with Prevents exposure of a lip or edge from the distal end 74 of the inner jacket 70 that may be snagged. The proximal end 76 of the inner jacket 70 is secured to the inner tube 72 as shown in FIG. The inner tube 18 may be located near the proximal end 82 of the inner tube 18. A portion of the jacket 70 is attached to the drive hub 20 using adhesive or other suitable attachment means. In certain implementations, the inner jacket 70 can be attached to the inner tip portion. 38 and / or drive hub 20, but rather in a suitable axial direction. The axial position is relative to each of the flexible regions 54 of the inner tube 18. The engagement between the curve of the complementary inner jacket 70 and the curved portion 52 of the outer tube 16 The proximal end 76 and the distal end 74 of the inner jacket 70 can be maintained by is located opposite the flexible region of the inner tube 18 and therefore the inner jacket 7 0 have complementary curvatures or curves. The inner jacket 70 is The seal follows a curve or contour to prevent irrigation fluid from being drawn through the slot. provide.

[0040] 11-14, the cutting assembly 10 may be a bar, similar Numerals indicate similar components for the shavers of Figures 1 to 10. Cutting tip 26 The outer tube 16 may be a burr head 84 coupled to the inner tube 18. It may not include a side window 42, but rather terminates in a tubular distal end 86. The side tube 18 extends through this tubular distal end 86 and connects the burr head 84 to the tubular distal end 86. The neck 88 of the cutting tip 26 extends from the burr head 84. 2, adjacent to the bar head 84, an opening 90 is defined which is disposed near the bar head 84. The opening 90 is in fluid communication with the aspiration lumen 24. In mirror applications, a partially shielded bar head can be rotated within the window.

[0041] Similar to the shaver implementation described with reference to Figures 8-10, the cutting assembly 10 includes: It may include an outer tube 16, an inner tube 18 and an inner jacket 70. As best seen in FIG. 13, the inner tube 18 is coupled to a cutting tip 26. More specifically, the distal end 92 of the inner tube 18 is connected to the proximal end 9 of the neck 88 of the cutting tip 26. 4. The distal end 92 of the inner tube 18 and the proximal end 94 of the neck 88 are welded together. They may be secured together by welding, brazing, or any other suitable joining means. The inner jacket 70 is coaxially disposed within the inner tube 18. The proximal and distal ends 76, 74 of the slot 70 are spaced apart by the slots defined by the segments 56. It is configured to be positioned at least opposite the flexible region 54 of the existing inner tube 18. The inner jacket 70 is thus configured to have a complementary curvature or curve. In this implementation, the distal end 74 of the inner jacket 70 is adjacent to the proximal end 94 of the neck 88. The proximal end 76 of the inner jacket 70 is shown in FIG. 1. The inner tube 18 may be positioned near the proximal end 82 of the inner tube 18 as shown in FIG. Effectively extending substantially the entire aspiration lumen 24 between the cutting tip 26 and the proximal end of the drive hub 20 The inner jacket 70 is formed to line the inner tube 18. A portion of the jacket 70 is attached to the drive hub 20 using adhesive or other suitable attachment means. The inner jacket 70 can be used to irrigate through slots in the segments 56. It provides a seal along the curve or contour to prevent fluid aspiration. The distal end 74 of the jacket 70 may or may not be attached to the cutting tip 26 .

[0042] The cutting assembly 10 includes an irrigation system disposed within a housing hub 12 and distal to a drive hub 20. Note that the cutting assembly 10 may further include a spacer 96. Similarly, interference between the closed distal ends of the outer tip portion 36 and the inner tip portion 38 is This prevents relative movement between the side tube 16 and the inner tube 18. irrigation cavity 30. Distal movement of drive hub 20 within irrigation cavity 30 is via irrigation opening 66. The irrigation spacer 96 of this implementation may restrict or block the flow of irrigated fluid. Advantageously, this provides axial spacing of the drive hub 20 from the opening 66 while allowing for irrigation passages. The irrigation spacer 96 also provides an irrigation passageway that allows robust fluid flow. As shown, the distal cavity 98 extends distally from the irrigation cavity 30. In one implementation, the irrigation spacer 96 is connected to the inner tube 18 and the inner A hub defining a bore through which the jacket 70 extends, and a hub 72 extending radially away from the hub. The irrigation spacer 96 may have fins extending therethrough. At least one washer 100 may be placed. Irrigation spacer 96 and associated structure Further disclosure of the constituent elements is disclosed in the above-mentioned International Publication WO2021 / 224862. It is being done.

[0043] The above description is not intended to be exhaustive or to describe the invention in any particular form. No limitation is intended. The terminology used is by its nature a limiting term. These and other modifications and variations are possible in light of the above teachings. and modifications are possible and the invention may not be practiced otherwise than as specifically described. can be done.

Claims

1. a cutting assembly configured to be coupled to an irrigation source and a suction source, Housing and an outer tube having a proximal end coupled to the housing; A drive hub; An inner tube coupled to the drive hub and rotatably and coaxially disposed within the outer tube an inner tube and an outer tube, wherein an irrigation path is defined between the inner tube and the outer tube; Side tube and a cutting tip secured to the inner tube; an inner jacket coupled to the drive hub and coaxially disposed within the inner tube; a suction path is defined within the inner jacket, an inner wall configured to provide a fluid seal between the aspiration path and the irrigation path; -Jacket and A cutting assembly comprising:

2. The inner tube defines a slot and is provided by the inner jacket. the fluid seal is configured to prevent inflow of irrigation fluid through the slot. The cutting assembly of claim 1 .

3. The outer tube includes a curved portion, and the slot in the inner tube extends beyond the curved portion. The cutting assembly of claim 1 or 2, wherein the cutting assembly is axially arranged along

4. The inner jacket is disposed at a portion where the proximal end of the inner tube is coupled to the drive hub.

4. A switch according to claim 1, wherein the switch is coupled to the drive hub at a position near the center of the shaft. Cutting assembly.

5. 5. Any one of claims 1 to 4, wherein the inner jacket is not fixed to the cutting tip.

10. The cutting assembly of claim 1.

6. 6. Any one of claims 1 to 5, wherein the inner jacket is made of a multi-layer reinforcing tube. Item 10. A cutting assembly according to item 10.

7. The multi-layer reinforced tube comprises a braid disposed between inner and outer layers of polymeric material.

7. The cutting assembly of claim 6.

8. The braid is made of stainless steel and the polymer material is a polyether block copolymer.

8. The cutting assembly of claim 7, wherein the cutting assembly is a mid.

9. The outer tube has an outer tip portion defining an outer window, and an inner tip portion is 9. The cutting assembly according to claim 1, further comprising an inner window so that the cutting assembly is a shaver. The cutting assembly according to claim 1.

10. 10. The cutting assembly of claim 1, wherein the cutting tip is a burr head. Nburi.

11. the burr head includes a cutting element and defines a suction port adjacent the cutting element.

11. The cutting assembly of claim 10.

12. an irrigation spacer disposed within a cavity defined by the housing; the irrigation spacer including a hub defining a bore through which the inner tube is rotatably disposed; and fins extending radially from the hub and secured within the cavity.

12. The cutting assembly according to claim 10 or 11.

13. a cutting assembly configured to be coupled to an irrigation source and a suction source, Housing and an outer tip portion having a proximal end coupled to the housing and defining an outer window; Side tube and a rotatably coaxially disposed within the outer tube and in fluid communication with the suction source; an inner tube defining an aspiration lumen configured to receive the aspiration fluid; an inner tip defining an inner window; an inner tip portion and an outer tip portion, the inner tip portion defining a gap therebetween; Side tube and Equipped with The outer tube extends longitudinally from near the proximal end and is in fluid communication with the irrigation source. and defining an irrigation channel configured to be positioned adjacent the outer window and the inner window. and configured to provide fluid communication between the irrigation channel and the gap at a location adjacent the irrigation channel. a cutting assembly further defining an irrigation opening.

14. The cutting assembly of claim 13, wherein the irrigation opening is located adjacent the exterior window. 。

15. The outer tube includes a curved portion, the inner tube includes a flexible region, and the irrigation 15. The cutting assembly of claim 13 or 14, wherein an opening is located distal to the flexible region. Li.

16. a cutting assembly configured to be coupled to an irrigation source, Housing and an outer tube having a distal end and a curved portion for angling the distal end relative to a longitudinal axis; Bu and, a shaft rotatably and coaxially disposed within the outer tube, the shaft passing through the curved portion of the outer tube; an inner tube having a flexible region passing through the inner tube; a cutting tip secured to the inner tube and angled relative to the longitudinal axis; Equipped with The outer tube defines an irrigation channel configured to be in fluid communication with the irrigation source. the irrigation channel is fluidly isolated from the flexible region of the inner tube and A tube is disposed distal to the flexible region and connects the irrigation channel, the cutting tip, and the an irrigation opening configured to provide fluid communication between the outer tube and the gap between the outer tube and the Further defining a cutting assembly.

17. The outer tube has an outer tip portion defining an outer window, and the cutting tip 17. The cutting assembly of claim 16, wherein the cutting assembly defines an interior window such that the cutting assembly is a shaver. Nburi.

18. The cutting assembly of claim 16 , wherein the cutting tip is a burr head.

19. the outer tube includes a curved portion, and the irrigation channel passes through the curved portion.

19. The cutting assembly of claims 13 to 18.

20. The inner tube includes a segment that defines the flexible region, and the irrigation channel 20. The cutting method of claim 13, wherein the cutting is fluidly isolated from the segment. assembly.

21. The outer tube is integral and the irrigation channel is encapsulated within the outer tube.

21. The cutting assembly of any one of claims 13 to 20, wherein the cutting assembly is sealed.

22. a hypotube disposed within and coupled to the outer tube; the irrigation channel is defined between the outer tube and the hypotube.

22. The cutting assembly of any one of claims 13 to 21,

23. 14. The method of claim 13, wherein the irrigation opening is a recess defined in the distal end of the irrigation channel.

23. A cutting assembly according to any one of claims 22.

24. The irrigation channels are four equally spaced radially about the longitudinal axis. the irrigation openings are four irrigation openings equally spaced radially about the longitudinal axis.

24. A cutting assembly according to any one of claims 13 to 23, which is a dispensing opening.

25. The housing includes an irrigation cavity, an opening through which the inner tube extends, and the 25. The method of claim 13, further comprising: defining an opening and a recess in fluid communication with the irrigation channel.

10. The cutting assembly of claim 1.

26. 26. The cutting assembly of claim 25, wherein the recesses in the housing are in a cross-shaped configuration. 。

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