Ultrasonic surgical assembly with air-cooled broad knife and irrigation sleeve - Patents.com

Abstract

An ultrasonic surgical assembly for use with a surgical handpiece to provide air cooling of an ultrasonic tip. The ultrasonic tip comprises a shaft and a cutting portion. The tip comprises a substantially planar first side and a second side, and a cutting head. The tip is removably coupled to the horn. The assembly comprises an irrigation sleeve defining a lumen. The sleeve at least partially surrounds the shaft, defines an inlet opening, and comprises a conduit in fluid communication with the lumen. The conduit has an outlet opening and is configured to be connected to a liquid source. The tip comprises a seal member coupled to an exterior surface thereof and has a first bore defining an air inlet disposed proximal to the seal member and a second bore extending from a proximal end of the shaft to the first bore forming a fluid reservoir therebetween.

Description

[Technical field]

[0001] Related Applications This application claims priority to and the entire benefit of U.S. Provisional Patent Application No. 63 / 127,802, filed December 18, 2020, and U.S. Provisional Patent Application No. 63 / 197,773, filed June 7, 2021, the entire contents of which are incorporated by reference into this application. Summary of the Invention

[0002] An ultrasonic surgical assembly for air cooling of an ultrasonic tip is disclosed. The ultrasonic surgical assembly includes an ultrasonic tip and an irrigation sleeve. The ultrasonic tip includes a shaft and a cutting portion and has a first side and a second side. The first side is substantially planar and extends from a proximal end to a distal end. The second side is substantially planar and disposed opposite the first side and extends from the proximal end to the distal end. The cutting portion includes a cutting head disposed at the distal end. The ultrasonic tip is removably coupled to the horn. The shaft further includes a longitudinal axis. The irrigation sleeve has a distal region and a proximal region and defines a lumen extending along the longitudinal axis. The irrigation sleeve at least partially surrounds the shaft and defines an inlet opening. The irrigation sleeve further includes a first conduit in fluid communication with the lumen. The first conduit has an outlet opening and is configured to be connected to a liquid source. The ultrasound tip further comprises a seal member coupled to an exterior surface thereof and further defines a first bore and a second bore, the first bore defining an air inlet disposed proximally of the seal member and the second bore extending from a proximal end of the shaft to the first bore forming a fluid pathway between the first bore and the second bore.

[0003] A second ultrasonic surgical assembly is disclosed. The assembly includes an ultrasonic instrument, an ultrasonic tip, and an irrigation sleeve. The ultrasonic instrument includes a housing, a transducer, and a horn. The housing includes a proximal portion and a distal portion. The transducer is at least partially disposed within the housing. The horn is coupled to the transducer. The ultrasonic tip includes a shaft and is removably coupled to the horn. The irrigation sleeve defines a lumen and includes a body, a sheath, and an irrigation conduit. The body is releasably coupled to a distal portion of the housing and has a distal region and a proximal region. The body defines a helical groove that at least partially surrounds the shaft when the ultrasonic tip is within the lumen of the irrigation sleeve. The sheath is coupled to and disposed over a portion of the body to surround at least a full turn of the helical groove. The sheath has a proximal end and an opposite distal end. The irrigation conduit is disposed within the helical groove for carrying an irrigation fluid and defines an inlet opening and an outlet opening. The inlet opening is disposed at a proximal region of the body and the outlet opening is disposed at a distal region of the body Irrigation fluid enters the perfusion conduit at the inlet opening and exits the perfusion conduit at the outlet opening.

[0004] An ultrasonic tip is disclosed that includes a shaft and a cutting portion. The shaft defines a longitudinal axis. The cutting portion defines a first side that is substantially planar and a second side that is substantially planar and includes a cutting head. The cutting portion includes a base portion having a lateral dimension between the first side and the second side that extends perpendicular to the longitudinal axis of the cutting head. The cutting portion further includes a tapered portion that includes a chamfer and extends from the base portion to a cutting edge. The cutting edge has a length and has a U-shaped profile with a first leg, a second leg, and an arcuate distal portion. The first leg and the second leg are parallel to each other. Furthermore, a maximum cross-sectional area of ​​the ultrasonic tip defines a cross-sectional area of ​​a first slice. The cross-sectional area of ​​the second slice is defined at a location 20 mm proximal to the distal end of the ultrasonic tip. The second slice and the first slice are each perpendicular to the longitudinal axis of the shaft. The cross-sectional area of ​​the second slice is 16.7-20% of the cross-sectional area of ​​the first slice.

[0005] A second ultrasonic surgical assembly is disclosed that provides air cooling of the ultrasonic tip. The ultrasonic surgical assembly includes an ultrasonic instrument, an ultrasonic tip, an irrigation sleeve, and a seal member. The ultrasonic instrument has a proximal region and a distal region and includes a housing, a transducer, and a horn. The housing includes a proximal portion and a distal portion. The transducer is at least partially disposed within the housing. The horn is coupled to the transducer, the transducer configured to be coupled to a suction source by a first coupler. The ultrasonic tip includes a shaft and a cutting portion and is removably coupled to the horn by the tip coupler. The shaft includes a longitudinal axis. The irrigation sleeve has a distal region and a proximal region and defines a lumen. The irrigation sleeve at least partially surrounds the shaft and defines an inlet opening configured to receive irrigation fluid from an irrigation source. The irrigation sleeve further includes a first conduit in fluid communication with the lumen. The first conduit is configured to convey irrigation fluid from the inlet opening to an outlet opening. The seal member is positioned between the outer surface of the ultrasonic tip and the inner surface of the lumen. The ultrasonic tip defines a first hole and a second hole. The first hole defines an air inlet located proximal to the seal member when the irrigation sleeve and the ultrasonic tip are coupled to the ultrasonic instrument. The second hole extends from a proximal end of the ultrasonic tip to the first hole. The second hole is in communication with a suction source via the tip coupler. The irrigation sleeve defines a third hole proximal to the first hole when the irrigation sleeve and the ultrasonic tip are coupled to the ultrasonic instrument. The ultrasonic surgical assembly defines a path for drawing air from the surrounding environment through the third hole and then through the first hole and back through the second hole before the air exits the ultrasonic surgical assembly at the first coupler.

[0006] A method of cutting bone with an ultrasonic tip is disclosed. The method includes providing an ultrasonic tip, the ultrasonic tip having a shaft and a cutting portion, removably coupled to a horn by a tip coupler. The horn is coupled to a transducer, the transducer is coupled to a suction source by a first coupler. The shaft has a longitudinal axis. The ultrasonic tip defines a first bore defining an air inlet and a second bore extending from a proximal end of the ultrasonic tip to the first bore. The first bore is transverse to the second bore, the second bore being in communication with the suction source via the tip coupler. The method further includes providing an irrigation sleeve, the irrigation sleeve having a distal region and a proximal region and defining a lumen. The irrigation sleeve at least partially surrounds the shaft and is configured to be coupled to an irrigation source by an inlet opening configured to receive irrigation fluid from the irrigation source. The irrigation sleeve defines a first conduit in fluid communication with the lumen. The first conduit is configured to carry irrigation fluid from the inlet opening to the outlet opening. The method further includes drawing air via a suction source through the second hole and the first hole to cool the ultrasound tip.

[0007] A third ultrasonic surgical assembly is disclosed. The assembly includes an ultrasonic instrument, an ultrasonic tip, and an irrigation sleeve. The ultrasonic instrument includes a housing, a transducer, and a horn. The housing includes a proximal portion and a distal portion. The transducer is at least partially disposed within the housing. The horn is coupled to the transducer. The ultrasonic tip includes a shaft and a cutting portion and is removably coupled to the horn. The irrigation sleeve includes a body defining a lumen and releasably coupled to the distal portion of the housing, and has a distal region and a proximal region. The ultrasonic tip further includes an annular seal member defining a groove, the annular seal member disposed about the groove, disposed in the proximal region of the body, and positioned between an outer surface of the ultrasonic tip and an inner surface of the lumen when the sleeve and ultrasonic tip are connected to the ultrasonic instrument. The annular seal member is configured to prevent migration of fluid proximal to the annular seal member.

[0008] A fourth ultrasonic surgical assembly is disclosed. The assembly includes an ultrasonic instrument and an irrigation sleeve. The ultrasonic instrument includes a housing, a transducer, and a horn. The housing includes a proximal portion and a distal portion. The transducer is at least partially disposed within the housing. The horn is coupled to the transducer. The irrigation sleeve defines a lumen and is configured to be removably coupled to a first ultrasonic tip and a second ultrasonic tip. Each of the first ultrasonic tip and the second ultrasonic tip is configured to be removably coupled to the horn by a tip coupler. Each of the first ultrasonic tip and the second ultrasonic tip includes a shaft, a cutting portion, and an annular seal member. The cutting portion of the first ultrasonic tip includes a cutting shape that is different from the cutting shape of the cutting portion of the second ultrasonic tip. The first ultrasonic tip defines a first groove located a first distance away from the tip coupler of the first ultrasonic tip. The second ultrasonic tip defines a second groove located a second distance from the tip coupler of the second ultrasonic tip. The first distance from the tip coupler of the first ultrasonic tip is not equal to the second distance from the tip coupler of the second ultrasonic tip. Each of the first ultrasonic tip and the second ultrasonic tip includes an annular seal member disposed around each of the first and second grooves. The irrigation sleeve comprises a body and an irrigation conduit. The body is releasably coupled to a distal portion of the housing. The irrigation conduit is coupled to the body and configured to carry an irrigation fluid. The irrigation conduit further defines an inlet opening disposed at a proximal region of the body and an outlet opening disposed at a distal region of the body, where the irrigation fluid enters the irrigation conduit at the inlet opening and exits the irrigation conduit at the outlet opening.

[0009] Advantages of the present disclosure may 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 description of the drawings]

[0010] [Figure 1] FIG. 2 is a top view of an ultrasonic surgical handpiece assembly. [Diagram 2]2 is a cross-sectional view of the ultrasonic surgical handpiece assembly of FIG. 1. [Diagram 3] FIG. 1 is a plan view of the ultrasound tip and irrigation sleeve, with the ultrasound tip positioned within the irrigation sleeve. [Figure 4A] FIG. 1 is an exploded view of the ultrasound tip and irrigation sleeve assembly. [Figure 4B] 4B is a cross-sectional view of the ultrasound tip of FIG. 4A in a first cross-sectional area. [Figure 4C] FIG. 4B is a cross-sectional view of the ultrasound tip of FIG. 4A in a second cross-sectional area. [Diagram 5] 4 is a cross-sectional view of the irrigation sleeve assembly of FIG. 3 in an assembled configuration with a tip inserted therethrough. [Figure 6] FIG. 6 is a partial cross-sectional view of the ultrasound tip, irrigation sleeve, sheath, and irrigation conduit of the irrigation sleeve assembly of FIG. 5. [Figure 7] 4 is another cross-sectional view of the irrigation sleeve assembly with the tip of FIG. 3 inserted therethrough in an assembled configuration. [Figure 8A] FIG. 2 is a top view of the distal portion of the ultrasound tip including the cutting head. [Figure 8B] FIG. 2 is a side view of the distal portion of the ultrasound tip including the cutting head. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0011] As medical professionals strive to reduce the size of incisions and the recovery time required after invasive medical procedures, the size of medical instruments used in various medical procedures is decreasing. Many of the medical instruments utilized in performing various medical procedures may include the use of a cutting accessory, such as an ultrasonic tip. When performing a cutting, shaving, or shaping process, the cutting accessory is subjected to various amounts of force, which creates stress on the cutting accessory.

[0012] Many of these cutting accessories may also require the use of irrigation or suction (i.e., aspiration) to reduce heat and / or remove debris from the surgical site. One example of a surgical instrument that may utilize an irrigation and / or aspiration system is an ultrasonic surgical handpiece. Generally, one or more lines may be coupled to the ultrasonic surgical handpiece to provide irrigation and / or aspiration. The ultrasonic surgical handpiece may further include a sleeve with one or more lumens that may be utilized to direct fluid from an irrigation source to the surgical site and / or the cutting accessory, i.e., the ultrasonic tip. One such ultrasonic surgical handpiece is described in PCT / US19 / 52609, entitled "Ultrasonic Surgical Handpiece Assembly," which is incorporated herein by reference in its entirety.

[0013] However, cutting accessories, particularly flat or narrow ones, often do not include a lumen along the entire length of the cutting accessory, i.e., all the way to the cutting edge or blade. Furthermore, high currents within the cutting accessory due to the lack of a full suction or cooling lumen can cause the handpiece to overheat. Excessive heat buildup can adversely affect the life of the handpiece and can be felt by the surgeon.

[0014] Additionally, the shape and geometry of the cutting attachment can affect the amplification factor or gain associated with the ultrasonic instrument. By configuring an ultrasonic tip with a lower gain in certain implementations, the inventors have recognized that various advantages can be achieved, including reduced stall, less power consumption to drive the tip, and the ability to drive the tip with higher current to the ultrasonic. The use of a handpiece can increase cutting speed without increasing stall.

[0015] 1 and 2 illustrate a typical configuration of an ultrasonic surgical handpiece assembly 10 that may be utilized by a medical professional to remove biological material from a patient. The ultrasonic surgical handpiece assembly 10 may include an ultrasonic handpiece 12 including a distal housing portion 14 and a proximal housing portion 16. An irrigation sleeve 18 may be removably coupled to the distal housing portion 14 of the ultrasonic surgical handpiece 12. The irrigation sleeve 18 and the ultrasonic tip 20 may be configured such that the irrigation sleeve 18 surrounds at least a portion of the ultrasonic tip 20 along a length of the ultrasonic tip 20 when both are coupled to the ultrasonic handpiece 12. The irrigation sleeve 18 and the ultrasonic tip 20 may at least partially comprise the ultrasonic sleeve assembly 14.

[0016] Figure 2 illustrates a cross-sectional view of the ultrasonic surgical handpiece assembly 10 of Figure 1. As shown in Figure 2, the ultrasonic handpiece 12 can include a transducer 22 disposed within a gap defined by the distal housing portion 14 and the proximal housing portion 16 of the ultrasonic handpiece 12. The transducer 22 can include a plurality of piezoelectric or magnetostrictive elements configured to generate mechanical energy.

[0017] The ultrasonic hand piece 12 may also include a horn 24 that may be at least partially disposed within a gap defined by the distal housing portion 14 and the proximal housing portion 16 of the ultrasonic hand piece 12. The horn 24 may include a distal end and a proximal end. The proximal end of the horn 24 may be coupled to a distal end of the transducer 22. The transducer 22 may be configured to impart mechanical energy generated by a piezoelectric or magnetostrictive element to the horn 24. The horn 24 may also be configured to define a horn lumen 26 that extends from the proximal end to the distal end of the horn 24. The horn lumen 26 may define a portion of a passageway extending through the ultrasonic hand piece 12 to provide aspiration. The horn lumen 26 has a distal end and a proximal end, and the proximal end may be in communication with a suction source 27. The transducer 22 may be coupled to the suction source 27 via a coupler 28.

[0018] The ultrasonic hand piece 12 may further include an irrigation line 38 disposed within a gap defined by the distal housing portion 14 and the proximal housing portion 16 of the ultrasonic hand piece 12. The irrigation line 38 may be configured to extend from the proximal end to the distal end of the ultrasonic hand piece 12. The irrigation line 38 may serve to conduct a liquid, such as water or saline, from an irrigation system coupled to the ultrasonic hand piece 12 through the irrigation sleeve 18. The irrigation line 38 may be routed directly from an irrigation source (not shown) to the irrigation sleeve 18 (i.e., the irrigation line 38 does not always have to be routed through the hand piece 12).

[0019] The ultrasonic tip 20 may include a shaft 42 including a distal region 44, an intermediate region 46, and a proximal region 48, all of which are disposed along a longitudinal axis L1. The ultrasonic tip 20 may also include a coupling mechanism 50 located at the proximal region 48 of the shaft 42 and configured to couple the proximal region 48 of the ultrasonic tip 20 to the distal end of the horn 24 to enable the horn 24 to be in mechanical communication with the ultrasonic tip 20. The coupling mechanism 50 may be a threaded coupler 52 configured to engage with a corresponding threaded coupler on the distal end of the horn 24. The ultrasonic tip 20 may be threaded onto the horn 24 and tightened to a predetermined torque specification to removably secure the ultrasonic tip 20 to the ultrasonic handpiece 12. Although not shown in the figures, it is contemplated that the coupling mechanism 50 may be configured as a quick connect, quarter turn fit, or similar coupling mechanism. It is further contemplated that the coupling mechanism 50 may be configured to permanently attach the ultrasonic tip 20 to the handpiece 12. For example, the ultrasonic tip 20 may be coupled to the ultrasonic handpiece 12 by welding, epoxy, or a similar coupling method.

[0020] Alternatively, it is contemplated that the ultrasonic tip 20 and horn 24 may be formed as a unitary component. In such a configuration, the ultrasonic tip 20 may include a base (horn) 24 for coupling to the transducer 22, and a body comprised of a shaft 42 and a cutting portion 40. The bodies 40, 42 extend from and are coupled to the base 24 by the shaft 42. The bodies 40, 42 extend from the shaft 42 to the cutting portion 40 along a longitudinal axis L1.

[0021] In some embodiments, such as the embodiment shown, the shaft 42 is lumen-free in the distal region 44. In other words, the ultrasonic tip may be lumen-free in the portion of the cutting tip characterized by a rectangular cross-sectional area. The shaft 42 may be formed of metallic materials, such as titanium alloys, stainless steel, etc., or non-metallic materials, such as composites, depending on the application. In one embodiment, the shaft 42 and cutting portion 40 may be unitary, integral, and one piece. In other embodiments, the cutting portion 40 of the ultrasonic tip 20 may be attached to the shaft 42 by a suitable mechanism, such as a screw (not shown).

[0022] FIG. 3 illustrates a top view of an exemplary configuration of an irrigation sleeve 18 having a distal region 58 and a proximal region 60. The irrigation sleeve 18 may include an irrigation sleeve coupling mechanism 62 on the proximal region 60 of the irrigation sleeve 18. The irrigation sleeve coupling mechanism 62 may include one or more fingers 64 extending proximally from the proximal region 60 of the irrigation sleeve 18. Each of the one or more fingers 64 may include a tab 66 extending in a radially outward direction relative to the longitudinal axis L1 of the irrigation sleeve 18. The fingers 64 function as male fittings configured to mate with a female fitting (not shown) on the ultrasonic hand piece 12 to form a snap or interference fit. It is contemplated that other types of irrigation sleeve coupling mechanisms 62 may be used to couple the irrigation sleeve 18 to the ultrasonic hand piece 12. By way of example and not limitation, the irrigation sleeve coupling mechanism 62 may be configured as a threaded connection. It should be understood that the irrigation sleeve 18 described herein may be used in combination with other tip configurations other than those shown herein.

[0023] 4A, an exploded view of an ultrasonic tip and irrigation sleeve assembly 68 is shown. The irrigation sleeve assembly 68 includes an irrigation sleeve 18 defining a lumen 70 extending along a longitudinal axis L1. The irrigation sleeve 18 can have a sleeve body 72 defining a helical groove 74. In an assembled configuration, when the ultrasonic tip 20 is inserted through the irrigation sleeve 18, the irrigation sleeve 18 can at least partially surround the shaft 42 of the ultrasonic tip 20 when the ultrasonic tip 20 is disposed within the lumen 70 of the irrigation sleeve 18 and the irrigation sleeve 18 is coupled to a handpiece.

[0024] The irrigation sleeve assembly 68 may further include a sheath 76 having proximal and distal ends to correspond, respectively, to the proximal and distal regions 60 and 58 of the irrigation sleeve 18. The sheath 76 may be coupled to and disposed over at least a portion of the sleeve body 72 to surround at least a full turn of the helical groove 74, although it may optionally surround more than two or three turns of the helical groove to provide sufficient retention.

[0025] The location of the helical groove 74 may be different for different tips. By way of example and not limitation, in some configurations, one ultrasonic tip may define a groove that is located a first distance from the tip coupler (e.g., coupling mechanism 50) of that tip, while a different ultrasonic tip may define a groove that is located a second distance from the tip coupler (e.g., coupling mechanism 50) of that tip. In some configurations, the first distance is different from the second distance. This is beneficial because different tips may have different node and antinode locations. It may be useful to position a seal member in alignment with the node or antinode of a particular tip.

[0026] 5, a cross-sectional view of the irrigated sleeve assembly 68 of FIG. 3 in an assembled configuration with a tip inserted therethrough is shown. The assembled irrigated sleeve assembly 68 with an ultrasound tip 20 inserted therethrough shows the ultrasound tip 20 disposed within the lumen 70 such that the irrigated sleeve 18 partially surrounds the shaft 42.

[0027] 6, there is shown a partial cross-sectional view of the ultrasound tip 20, irrigation sleeve 18, sheath 76, and irrigation conduit 78 of the irrigation sleeve assembly of FIG 5. The sheath 76 is disposed at least partially over the irrigation sleeve 18 such that it surrounds at least a full turn of the helical groove 74 and covers the irrigation conduit 78.

[0028] In some configurations, the sleeve body 72 can define a second helical groove 96. The second helical groove 96 can be free of the irrigation conduit 78 and can be partially surrounded by the sheath 76, i.e., one or more turns of the second helical groove 96 can be surrounded by the sheath 76.

[0029] The sheath 76 may be constructed of heat shrink or other suitable material that allows it to deform to conform to the shape of the irrigation conduit 78 as well as the underlying contours of the sleeve body 72, which may include the second helical groove 96. When the sheath 76 is contoured to the second helical groove 96, the sheath may define undulations 98 that are useful for a user to grasp.

[0030] 4A , the perfusion sleeve assembly 68 may further comprise an irrigation conduit 78 disposed within the spiral groove 74 for carrying irrigation fluid. The irrigation conduit 78 may be in fluid communication with or adjacent to the lumen 70 and may be connected to a fluid source (not shown). The irrigation conduit 78 may define an inlet opening 80 (disposed in the proximal region 60 of the sleeve body 72 when the irrigation sleeve assembly 68 is in the assembled configuration) and an outlet opening 82 (disposed in the distal region 58 of the sleeve body 72 when the irrigation sleeve assembly 68 is in the assembled configuration). Irrigation fluid may enter the irrigation conduit 78 at the inlet opening 80 and exit the irrigation conduit 78 at the outlet opening 82. In some configurations, the irrigation conduit 78 may comprise a unitary member defining a continuous length between the inlet opening 80 and the outlet opening 82. The irrigation conduit 78 may comprise a flexible material such that the irrigation conduit 78 can be configured to couple directly to a corresponding port of the surgical handpiece 12. In other words, the irrigation conduit 78 may be formed from a material that can be deformed such that the inlet opening 80 can partially envelop a corresponding port of the ultrasonic handpiece 12 to form a connection to an irrigation source. The helical shape of the groove 74 causes the irrigation conduit 78 to have a helical shape as well. The helical shape of the irrigation conduit 78 (tube) and groove 74 provides a longer fluid return path than a straight return path. This longer path makes it more difficult for the fluid to move back in the proximal direction after it is initially conveyed through the irrigation conduit 78.

[0031] After the fluid is conveyed distally along the sleeve body 72 through the perfusion conduit 78, the fluid may exit the perfusion conduit 78 at exit opening 82. From there, the fluid may spread over the surface of the sleeve body 72 and / or shaft 42. In some circumstances, the fluid may return to opening 83 and flow back through the perfusion conduit 78. In other cases, the fluid may return proximally along the sleeve body 72 in a path that flows between the outer diameter of the perfusion conduit 78 within the sheath 76 and the inner surface of the sleeve body 72.

[0032] One of the irrigation sleeve 18 and the ultrasonic tip 20 may include a seal member 86. The seal member 86 may be an annular seal member, including, by way of example and not limitation, an O-ring. In some configurations, the seal member 86 may be coupled to the tip 20. In such implementations, the seal member 86 is positioned about a groove 88 defined in an outer surface of the tip 20. The seal member 86 may thereby be positioned between the outer surface of the ultrasonic tip 20 and the inner surface of the lumen 70 to prevent migration of fluid from the exit opening 82 proximal to the seal member 86. Alternatively, the seal member 86 may be coupled to the sleeve 18 and may again be positioned to engage the outer surface of the tip 20 to prevent migration of fluid from the exit opening 82 proximal to the seal member 86.

[0033] The seal member 86 may also be used to dampen the amplitude of vibration of the ultrasonic tip 20. The amplitude of vibration at any point along the ultrasonic tip 20 may depend on the location along the ultrasonic tip 20 where the vibration is measured. The point along the standing wave where the amplitude of the wave is minimum is commonly called a node. At the node, the vibratory motion is usually minimal. The seal member 86 may be directly coupled to the tip 20 and therefore may be located anywhere on the ultrasonic tip 20 to reduce lateral movement of the tip 20. In some configurations, it may be appropriate to place the seal member 86 at or near a node of the tip 20. The location of the node may be different for different ultrasonic tips.

[0034] Additionally, because the seal member 86 may be bonded directly to the tip 20, sharp surfaces of the ultrasonic tip 20 never come into contact with the seal member 86 during placement of the sleeve assembly over the ultrasonic tip 20. Thus, the seal member 86 is protected from abrasion and other damage when the ultrasonic tip 20 is placed over the sleeve 18. Placing the seal member 86 on the ultrasonic tip 20 rather than the irrigated sleeve 18 also prevents the seal member 86 from spontaneously slipping off or becoming dislodged from the irrigated sleeve assembly 68.

[0035] 7, another cross-sectional view of the irrigation sleeve assembly with the tip of FIG. 3 inserted therethrough in an assembled configuration is shown. The ultrasonic tip 20 can define a first hole 90 that functions as an air inlet. This first hole 90 can be located proximal to the seal member 86 when the irrigation sleeve assembly 68 including the ultrasonic tip 20 is coupled to the handpiece 12. In some configurations, the first hole 90 is located distal to the seal member 86. The second hole 92 can extend from the proximal region 48 of the shaft 42 through the threaded coupler 52 to the first hole 90. In other words, the first hole 90 and the second hole 92 are positioned to be in fluid communication with each other with the first hole 90 transverse to the longitudinal axis L1 of the ultrasonic tip 20, and the second hole 92 concentric with the longitudinal axis L1 of the tip 20. In one example, the axis N1 of the first hole 90 can be perpendicular to the axis N2 of the second hole 92. In some configurations, the first hole 90 may comprise a single hole. In other configurations, such as the configuration shown in FIG. 7, the first hole 90 may extend laterally from one side of the ultrasonic tip 20 to the other, forming a first hole 90 on both sides of the ultrasonic tip 20. However, in other configurations, multiple first holes 90 may be included in the ultrasonic tip 20, each of the multiple first holes 90 being separate from one another (but each may still communicate with the second hole 92) rather than forming a single channel with the second hole 92 at each end as shown in FIG. 7. Furthermore, the first hole 90 need not extend all the way through the tip 20, so long as the first hole 90 extends from the outermost periphery to the second hole 92. When multiple paths are defined from the periphery of the ultrasonic tip 20 to the second hole 92, these holes may be arranged in various ways, such as circumferentially arranged around the surface of the tip 20.

[0036] In some configurations, when the irrigation sleeve assembly 68 including the ultrasonic tip 20 is coupled to the handpiece, the irrigation sleeve assembly 68 further comprises a third hole 94 proximal to the first hole 90. More specifically, the sleeve body 72 can define the third hole 94 to further facilitate the ingress of air from the surrounding environment into the first hole 90. Of course, it is contemplated that the irrigation sleeve assembly 68 can include a plurality of third holes 94 defining openings that allow ambient air to move from outside the irrigation sleeve assembly 68 to the first hole 90 when the suction source 27 is coupled to the tip 20.

[0037] In the illustrated configuration, the inlet opening 80, the outlet opening 82, the first holes 90, the second holes 92, and the third holes 94 all have a circular cross-sectional shape. However, in some configurations, all or any combination of the inlet opening 80, the outlet opening 82, the first holes 90, the second holes 92, and / or the third holes 94 may have shapes other than circular, such as various polygonal or elliptical shapes.

[0038] The irrigation sleeve 18 may be formed from any polymer, such as a thermoplastic. The distal region 58 of the irrigation sleeve 18 may have some weakened portions that can be cut or trimmed to change the length of the irrigation sleeve 18.

[0039] 5, when the irrigation sleeve assembly 68 is coupled to an irrigation source by a coupler, such as the irrigation line 38, the irrigation sleeve assembly can draw irrigation fluid through the irrigation source via the inlet opening 80. The irrigation conduit 78 can then transport irrigation fluid through the inlet opening 80 to the outlet opening 82. Transporting irrigation fluid through the irrigation sleeve assembly 68 helps to cool the shaft 42 of the ultrasonic tip 20. Additionally, transporting irrigation fluid through the irrigation sleeve assembly 68 can help prevent the irrigation sleeve 18 from deforming or melting due to excess heat generated by the ultrasonic cutting motion.

[0040] Additionally, when the irrigated sleeve assembly 68 containing the ultrasonic tip 20 is coupled to the handpiece 12, the ultrasonic tip 20 draws air in through the third hole 94, then through the first hole 90, back through the second hole 92, and finally out through the coupler 28. This air movement helps cool the tip in areas near the seal member 86 that tend to overheat due to frictional heat generated by the relative motion between the seal member 86 and the irrigated sleeve assembly 68.

[0041] Additionally, the aspiration of air through the tip and / or sleeve can also act as a smoke evacuation device in some applications. In the illustrated configuration, the ultrasonic tip 20 can be used for lumbar spinal procedures and other relatively "heavy duty" bone cutting procedures that generate a large amount of smoke, dust particles, and airborne debris compared to other procedures. The air aspiration function can draw some of this from the ambient air around the ultrasonic handpiece 12 and exhaust it through the handpiece 12. The instrument can be used in conjunction with a smoke filter to remove these particulates from the ambient air after it has been drawn through the tip 20.

[0042] 8A-8B, top and side views of a distal portion of an ultrasonic tip including a cutting head are shown. The ultrasonic tip 20 can include a first side 100 that is substantially planar. The ultrasonic tip 20 can further include a second side 102 that is substantially planar and disposed opposite the first side 100. The ultrasonic tip 20 can further include a cutting head (also referred to herein as a "cutting portion") 104 that is disposed distally of the shaft 42. The cutting head 104 can include a base portion 106 having a lateral dimension T1 between the first side 100 and the second side 102. The lateral dimension T1 can extend perpendicular to a longitudinal axis L1 of the cutting head 104. The cutting head 104 can further include a tapered portion 108 that includes a chamfer extending from the base portion 106 to a cutting edge 110. By way of example and not limitation, in a preferred configuration, the base portion 106 has a lateral dimension of at least 7.975 millimeters. It should be understood that other ultrasonic tips can be used with the above irrigation sleeve assemblies, such as those without the cutting head features described in this application, such as those shown in U.S. Patent Nos. 6,723,110, 6,497,715, D551,764, and 6,955,680, all of which are incorporated herein by reference in their entireties. Similarly, it should be understood that ultrasonic tips can be used with other irrigation sleeve assemblies, such as those shown in PCT / US2019 / 052609, which is incorporated herein by reference in its entirety.

[0043] The cutting edge 110 may have a length and a U-shaped profile with a first leg 112, a second leg 114, and an arcuate distal portion 116. By way of example and not limitation, in a preferred configuration, the arcuate distal portion 116 has a thickness of at least 1.35 millimeters. The first leg 112 and the second leg 114 may be parallel to one another and each may include a number of cutting teeth, one of which is labeled 118. In some configurations, less than half the length of the cutting edge 110 may have cutting teeth 118. In other configurations, more than half the length of the cutting edge 110 may have cutting teeth 118. In some configurations, the arcuate distal portion 116 is devoid of cutting teeth 118, as shown in the configuration shown in FIGS. 8A-8B.

[0044] The cutting portion 40 defines a centerline 120 along the longitudinal axis L1. Additionally, the plurality of cutting teeth 118 includes at least two adjacent cutting teeth 118 and a notch 122 between each adjacent cutting tooth 118. The notch 122 has a lateral dimension T2 along a notch base 124. Each cutting tooth 118 has a tooth cutting edge 126. In some configurations, the lateral dimension T2 of the notch 122 is at least 25 times smaller than the lateral dimension T1 of the base portion 106.

[0045] The centerline 120 to the tooth cutting edge 126 defines a first distance A1. The centerline 120 to the notch base 124 defines a second distance A2. The centerline 120 to the beginning of the tapered section 108 defines a third distance A3. In some configurations, the difference between the first distance A1 and the second distance A2 is 0.25 mm or less. In some configurations, the first distance A1 is greater than 1.5 times the third distance A3, but is less than twice the third distance A3. In the illustrated example, without limitation, the first distance A1 is 3.4 mm, the second distance A2 is 3.15 mm, and the third distance A3 is 1.85 mm. In this example, the difference between the first distance A1 and the second distance A2 is just 0.25 mm. Also, in this example, the first distance A1 is approximately 1.837 times greater than the third distance A3.

[0046] The ultrasonic tip 20 may be useful for cutting both hard and soft tissue. The toothed cutting edge 126 allows for cutting hard tissue, such as cortical bone. The serrated toothed cutting edge 126 may perform a saw-like action to cut denser tissue. In contrast, the cutting edge 110 is a smooth continuous blade. However, it may be sharp enough to cut hard tissue, but dull enough to be atraumatic compared to the soft tissue it contacts. By way of example and not limitation, the cutting edge 110 may be 0.2 mm + / - 0.05 mm thick. Thus, the cutting edge 110 may contact soft tissue while minimizing the risk of perforating critical structures, such as the spinal cord. The surgeon will feel a tactile change as the cutting edge 110 moves between hard and soft tissue due to the natural difference in density between different tissue structures, indicating that the cut should be terminated when the cutting edge 110 reaches the soft tissue. Thus, the ultrasonic tip 20 provides an advantage over conventional sharp bone-cutting blades because it is capable of cutting hard bone structures with both its tooth edge 126 and cutting edge 110 while avoiding trauma to the underlying soft tissue.

[0047] 4A-4C, different points along the shaft 42 have different cross-sectional areas. Although the transducer and ultrasonic tip are generally designed to have the same resonant frequency in a longitudinally resonating device, the reduction in cross-sectional area along the length of the ultrasonic tip can amplify the vibration velocity at the output face of the transducer. The amplification factor, also called gain, is determined by the reduction in cross-sectional area and the geometry of the ultrasonic tip. Gain can be measured by dividing the tip displacement by the handpiece displacement.

[0048] In the illustrated configuration, the cross-sectional area of ​​the first slice SL1 is defined as the maximum circular cross-sectional area of ​​the ultrasonic tip 20 and defines a plane perpendicular to the longitudinal axis L1. FIG. 4B shows a cross-sectional view of the ultrasonic tip of FIG. 4A at the first cross-sectional area. The cross-sectional area of ​​the second slice SL2 is defined at a position 20 mm proximal to the distal end of the tip. The second slice SL2 defines a plane perpendicular to the longitudinal axis L1, and the second slice SL2 is distal to the first slice SL1. FIG. 4C shows a cross-sectional view of the ultrasonic tip of FIG. 4A at the second slice.

[0049] The cross-sectional area of ​​the second slice SL2 is 5 to 6 times that of the first slice SL1. In other words, the cross-sectional area of ​​the second slice SL2 is 13 to 25, 15 to 21, 16 to 20, or 16.7 to 20% of the cross-sectional area of ​​the first slice SL1. This reduces the gain of the ultrasonic tip. The low gain of the ultrasonic tip 20, calculated by dividing the displacement of the ultrasonic tip 20 by the displacement of the ultrasonic handpiece 12, reduces the stall of the cutting portion 40 (e.g., the cutting head 104), improving the performance of the ultrasonic tip 20 as a whole. In addition, less power is consumed to drive the ultrasonic tip 20, making it possible to drive the ultrasonic tip 20 with a higher current, thereby improving the cutting speed without increasing the stall of the cutting portion 40 (e.g., the cutting head 104).

[0050] For example, and not by way of limitation, in the illustrated configuration, the first slice SL1 has a diameter of 8 mm and the gundrill hole has a diameter of approximately 2 mm. In this configuration, the cross-sectional area of ​​the first slice SL1 is approximately 47.1 mm. 2 In some configurations, the cross-sectional area of ​​the second slice SL2 is about 8.725 mm 2 Thus, in this configuration, the cross-sectional area value of the second slice SL2 is about 5.4 times smaller than the cross-sectional area value of the first slice SL1.

[0051] In the illustrated configuration, the gain of the ultrasonic tip 20 is approximately 3. It should be understood that the ultrasonic tip 20 may exhibit gains in the ranges of 2-5, 2-4, 2.5-3.5, and 2.75-3.25. Alternatively, the gain exhibited by the ultrasonic tip 20 may be less than 5. By comparison, similar ultrasonic tips known in the art for use in similar applications have gains of approximately 7.0-7.4. The lower gain of the ultrasonic tip 20, calculated by dividing the displacement of the ultrasonic tip 20 by the displacement of the ultrasonic handpiece 12, reduces stalls of the cutting portion 40 (e.g., cutting head 104) and improves the overall performance of the ultrasonic tip 20. Also, less power is consumed to drive the ultrasonic tip 20, allowing the ultrasonic tip 20 to be driven at a higher current, which can improve cutting speeds without increasing stalls of the cutting portion 40 (e.g., cutting head 104).

[0052] Gain can also be achieved with a uniform outer surface, composed of two different materials aligned longitudinally with respect to one another, as described in U.S. Pat. No. 9,962,183, entitled "Ultrasonic Torsional Tissue Dissection Utilizing Subaltern Modes of Longitudinal-Torsional Resonators," the entire contents of which are incorporated herein by reference.

[0053] The ultrasonic tip 20 may lack a longitudinal to torsional motion conversion mechanism and may therefore be configured to vibrate only longitudinally. The ultrasonic tip 20 may be constructed from titanium.

[0054] The irrigation sleeve 18 described herein can be used with any type of ultrasound tip. In other words, the irrigation sleeve 18 described herein can be used with an ultrasound tip that does not include the first and second holes 90, 92 described. Furthermore, the irrigation sleeve 18 described herein can be used with an ultrasound tip that does not have a cutting head with two substantially flat sides. For example, the irrigation sleeve 18 described herein can be used with an ultrasound tip that has a cylindrical shape and relies on longitudinal, torsional, or longitudinal and torsional motions, such as those described in U.S. Patent Application Publication No. 2005 / 0177184, U.S. Patent No. 8,512,340, and U.S. Patent Application Publication No. 2008 / 0208231, each of which is incorporated herein by reference in its entirety.

[0055] The devices described herein may be used with any of the tip configurations and / or any of the irrigation sleeve configurations described herein.

[0056] Further protection: I. An ultrasound tip comprising a shaft and a cutting portion, a substantially planar first side extending from the proximal end to the distal end; a second side that is substantially planar, disposed opposite the first side and extending from the proximal end to the distal end; a cutting head disposed at a distal end; a first aperture defining an air inlet disposed proximally of the cutting head; a second bore extending from the proximal end of the shaft to the first bore; An ultrasonic tip comprising: II. The ultrasonic tip of paragraph I, wherein the cutting head has a base having a lateral dimension between a first side and a second side, the lateral dimension extending perpendicular to the longitudinal axis of the cutting head, a tapered portion including a chamfer and extending from the base to a cutting edge, the cutting edge having a length and a U-shaped profile with a first leg, a second leg, and an arcuate distal portion, the first leg and second leg being parallel to one another. III. The cross-sectional area of ​​a first slice of the largest circular cross-sectional area of ​​the shaft defines a plane perpendicular to the longitudinal axis; a cross-sectional area of ​​a second slice of the smaller cross-sectional area at the proximal region of the shaft defines a plane perpendicular to the longitudinal axis; The cross-sectional area value of the second slice is 5.4 times smaller than the cross-sectional area value of the first slice. The ultrasonic tip of paragraph I or II. IV. An ultrasonic instrument having a proximal region and a distal region, the ultrasonic instrument further comprising: a housing having a proximal portion and a distal portion; a transducer disposed at least partially within the housing; a horn coupled to the transducer; Equipped with The transducer is coupled to a suction source by a first coupler and an ultrasonic tip is coupled to a horn. The ultrasonic tip of paragraph I, II, or III. V. an irrigation sleeve comprising a body having a distal region and a proximal region, the body defining a helical groove that at least partially surrounds the shaft of the tip when the tip is within the lumen of the sleeve; a sheath coupled to and disposed over a portion of the body so as to encompass at least a full turn of the helical groove, the sheath having a proximal end and an opposite distal end; an irrigation conduit disposed within the spiral groove for carrying an irrigation fluid; Further comprising: the perfusion conduit further defines an inlet opening disposed at a proximal region of said body and an outlet opening disposed at a distal region of said body, with perfusion fluid entering the perfusion conduit at the inlet opening and exiting the perfusion conduit at the outlet opening. The ultrasonic tip of paragraph I, II, III, or IV. VI. An ultrasonic tip comprising a shaft defining a longitudinal axis and a cutting portion, the ultrasonic tip defining a first side that is substantially planar and a second side that is substantially planar, the cutting portion further comprising a cutting head, the cutting head including a cutting edge, a maximum cross-sectional area of ​​the tip defining a cross-sectional area of ​​a first slice, the cross-sectional area of ​​the second slice being defined at a location 20 mm proximal to a distal end of the tip, the second slice and the first slice each being perpendicular to the longitudinal axis of the shaft, the cross-sectional area of ​​the second slice being 15-20% of the cross-sectional area of ​​the first slice. Further, in certain configurations, the maximum cross-sectional area of ​​the tip feature spans a length of at least 20 mm. In other words, there is a portion of the tip having a constant cross-sectional area and equal to the maximum cross-sectional area of ​​the tip. It should further be understood that in some cases, the diameter of the tip may be 9 mm or less to optimally cut delicate bones. VII. An ultrasonic tip comprising a shaft defining a longitudinal axis and a cutting portion, the ultrasonic tip defining a substantially planar first side and a substantially planar second side, the cutting portion further comprising a cutting head, the cutting head including a cutting edge, a maximum cross-sectional area of ​​the tip defining a cross-sectional area of ​​a first slice, the cross-sectional area of ​​the second slice being defined at a location 20 mm proximal to a distal end of the tip, the second slice and the first slice each being perpendicular to the longitudinal axis of the shaft, the cross-sectional area of ​​the second slice being 5-6 times smaller than the cross-sectional area of ​​the first slice. Further, in certain configurations, the maximum cross-sectional area of ​​the tip feature spans a length of at least 20 mm.

[0057] In the above description, several configurations have been described. However, the configurations discussed herein are not intended to be exhaustive or to limit the invention to any particular form. For example, while the example configuration describes the surgical instrument as an ultrasonic handpiece, it is further contemplated that the features and concepts described with respect to the ultrasonic handpiece may be applied to other medical or surgical instruments. This also applies to ultrasonic tips, which further include blades, drill bits, rotary burrs, open window shavers, and the like. The terminology used is for purposes of description, not limitation. Many modifications and variations are possible in light of the above teachings, and the invention may be practiced otherwise than as specifically described. The technical ideas that can be understood from the above-described embodiments will be described below. [Aspect 1] 1. An ultrasound tip comprising a shaft and a cutting portion, a substantially planar first side extending from the proximal end to the distal end; a second side that is substantially planar, disposed opposite the first side, and extending from the proximal end to the distal end; Equipped with the cutting portion includes a cutting head disposed at the distal end; an ultrasound tip, the ultrasound tip being removably coupled to a horn, the shaft further comprising a longitudinal axis; an irrigation sleeve having a distal region and a proximal region and defining a lumen extending along the longitudinal axis, the irrigation sleeve at least partially surrounding the shaft and defining an inlet opening, the irrigation sleeve further comprising a first conduit in fluid communication with the lumen, the first conduit having an outlet opening, the first conduit configured to be connected to a fluid source; 1. An ultrasonic surgical assembly for providing air cooling of an ultrasonic tip, comprising: the ultrasonic tip further comprises a seal member coupled to an outer surface of the ultrasonic tip; The ultrasonic tip comprises: a first aperture defining an air inlet disposed proximally of the seal member; a second bore extending from a proximal end of the shaft to the first bore forming a fluid pathway between the first bore and the second bore; To define Ultrasonic surgical assembly. [Aspect 2] The ultrasonic surgical assembly of aspect 1, further comprising an ultrasonic instrument configured to be coupled to the ultrasonic tip and the irrigation sleeve, the irrigation sleeve further comprising a third hole proximal to the first hole when the irrigation sleeve and the ultrasonic tip are coupled to the ultrasonic instrument. [Aspect 3] 3. The ultrasonic surgical assembly of claim 1 or 2, wherein the ultrasonic tip further defines a groove, and the seal member is disposed about the groove. [Aspect 4] 3. The ultrasonic surgical assembly of claim 1 or 2, wherein the first hole is perpendicular to the axis of the second hole. [Aspect 5] The ultrasonic tip comprises: a base for coupling to a transducer and a body extending from the base, the body comprising the shaft and the cutting portion, the body coupled to the base by the shaft, the body extending from the shaft to the cutting portion along the longitudinal axis; the cutting head comprising a base portion and a tapered portion; The ultrasonic surgical assembly according to claim 1. [Aspect 6] the base portion has a lateral dimension between the first side and the second side, the lateral dimension extending perpendicular to the longitudinal axis; the tapered portion includes a chamfer and extends from the base portion to a cutting edge, the cutting edge has a length and a U-shaped profile with a first leg, a second leg, and an arcuate distal portion, the first leg and the second leg are parallel to one another and each include a plurality of cutting teeth, less than half of the length of the cutting edge includes the plurality of cutting teeth at the distal end, and the arcuate distal portion is devoid of the plurality of cutting teeth; 6. An ultrasonic surgical assembly as described in embodiment 5. [Aspect 7] The ultrasonic surgical assembly of any one of aspects 1, 2, 5 and 6, wherein the shaft of the ultrasonic tip does not have a lumen at the distal end. [Aspect 8] 1. An ultrasonic instrument comprising: a housing having a proximal portion and a distal portion; a transducer disposed at least partially within the housing; a horn coupled to the transducer; an ultrasonic instrument comprising: an ultrasonic tip having a shaft and removably coupled to the horn; An irrigation sleeve defining a lumen, a body releasably coupled to the distal portion of the housing, the body having a distal region and a proximal region, the body defining a helical groove that at least partially surrounds the shaft of the ultrasonic tip when the ultrasonic tip is within the lumen of the irrigation sleeve; a sheath coupled to and disposed over a portion of the body so as to encompass at least a full rotation of the helical groove, the sheath having a proximal end and an opposite distal end; an irrigation conduit disposed within the spiral groove for carrying an irrigation fluid; Equipped with an irrigation sleeve, the irrigation conduit defining an inlet opening disposed at the proximal region of the body and an outlet opening disposed at the distal region of the body, the irrigation fluid entering the irrigation conduit at the inlet opening and exiting the irrigation conduit at the outlet opening; 1. An ultrasonic surgical assembly comprising: [Aspect 9] The ultrasonic surgical assembly of aspect 8, further comprising an annular sealing member disposed in the proximal region of the body and coupled to an outer surface of the ultrasonic tip, the annular sealing member positioned between the outer surface of the ultrasonic tip and an inner surface of the lumen and configured to prevent fluid migration proximally of the annular sealing member. [Aspect 10] An ultrasonic surgical assembly as described in aspect 8 or 9, wherein the body defines a second spiral groove free of the irrigation conduit and surrounded by the sheath, the second spiral groove covered by the sheath defining a gripping surface for a user. [Aspect 11] 10. The ultrasonic surgical assembly of claim 8 or 9, wherein the irrigation conduit comprises a flexible material, the irrigation conduit comprising a unitary member defining a continuous length between the inlet opening and the outlet opening. [Aspect 12] 1. An ultrasound tip comprising: a shaft defining a longitudinal axis; A cutting portion defining a substantially planar first side and a substantially planar second side, the cutting portion further comprising a cutting head, the cutting head comprising: a base having a lateral dimension between the first side and the second side, the lateral dimension extending perpendicular to a longitudinal axis of the cutting head; a tapered portion including a chamfer and extending from the base portion to a cutting edge, the cutting edge having a length and a U-shaped profile with a first leg, a second leg, and an arcuate distal portion, the first leg and the second leg being parallel to one another; A cutting portion comprising: Equipped with a maximum cross-sectional area of ​​the ultrasound tip defines a cross-sectional area of ​​a first slice; a cross-sectional area of ​​a second slice is defined at a location 20 mm proximal to the distal end of the ultrasound tip, the second slice and the first slice each being perpendicular to the longitudinal axis of the shaft; The cross-sectional area of ​​the second slice is 15 to 20% of the cross-sectional area of ​​the first slice. Ultrasonic tip. [Aspect 13] The ultrasonic tip of embodiment 12, wherein each of the first leg and the second leg includes a plurality of cutting teeth, less than half of the length of the cutting edge includes the plurality of cutting teeth, and each of the cutting teeth includes a tooth cutting edge and a notched base. [Aspect 14] the cut defines a centerline along the longitudinal axis; a first distance from the centerline to the tooth cutting edge; a second distance from the centerline to the notch base; a third distance is defined from the centerline to a start point of the tapered portion; the difference between the first distance and the second distance is 0.25 mm or less; the first distance is greater than 1.5 times the third distance but less than twice the third distance; 14. The ultrasound tip of claim 12 or 13. [Aspect 15] 14. The ultrasound tip of embodiment 12 or 13, wherein the tip comprises a diameter of 9 mm or less. [Aspect 16] the plurality of cutting teeth are disposed at a distal end of the cutting head; the arcuate distal portion is free of the plurality of cutting teeth; the plurality of cutting teeth comprises at least two adjacent cutting teeth and a notch therebetween, the notch having a lateral dimension; the lateral dimension of the cutout is at least 25 times smaller than the lateral dimension of the base; 14. The ultrasound tip of claim 12 or 13. [Aspect 17] 14. The ultrasound tip of any one of claims 12 to 13, wherein the arcuate distal portion has a thickness of at least 1.35 millimeters. [Aspect 18] 14. The ultrasound tip of claim 12 or 13, wherein the shaft of the ultrasound tip does not have a lumen at the distal end. [Aspect 19] The ultrasonic tip defines a groove, the ultrasonic tip comprising: a seal member disposed around the groove; a first aperture defining an air inlet disposed proximally of the seal member; a second hole extending from the proximal end of the ultrasound tip to the first hole such that the second hole and the first hole are in fluid communication with each other; 13. The ultrasound tip of embodiment 12, comprising: [Aspect 20] 1. An ultrasonic instrument having a proximal region and a distal region, a housing having a proximal portion and a distal portion; a transducer disposed at least partially within the housing; a horn coupled to the transducer; an ultrasonic instrument comprising: an ultrasonic tip having a shaft and a cutting portion, the ultrasonic tip being removably coupled to the horn by a tip coupler, the shaft having a longitudinal axis; an irrigation sleeve having a distal region and a proximal region and defining a lumen, the irrigation sleeve at least partially surrounding the shaft and defining an inlet opening configured to receive irrigation fluid from an irrigation source, the irrigation sleeve further comprising a first conduit in fluid communication with the lumen, the first conduit configured to convey irrigation fluid from the inlet opening to an outlet opening; a seal member disposed between an outer surface of the ultrasonic tip and an inner surface of the lumen; 1. An ultrasonic surgical assembly for providing air cooling of an ultrasonic tip, comprising: The ultrasonic tip comprises: a first aperture defining an air inlet disposed proximal to the seal member when the irrigation sleeve and the ultrasonic tip are coupled to the ultrasonic instrument; a second hole extending from a proximal end of the ultrasound tip to the first hole; Define the second hole communicates with the suction source via the tip coupler; the irrigation sleeve defines a third hole proximal to the first hole when the irrigation sleeve and the ultrasonic tip are coupled to the ultrasonic instrument; the ultrasonic surgical assembly defines a path for drawing air from the surrounding environment through the third port, passing it through the first port, and returning it through the second port before the air exits the ultrasonic surgical assembly at the first coupler. Ultrasonic surgical assembly. [Aspect 21] 21. The ultrasonic surgical assembly of claim 20, wherein the ultrasonic tip further defines a groove, and the seal member is disposed about the groove. [Aspect 22] 22. The ultrasonic surgical assembly of claim 20 or 21, wherein the first hole is perpendicular to the axis of the second hole. [Aspect 23] The ultrasonic tip comprises: a base for coupling to the transducer and a body extending from the base, the body comprising the shaft and the cutting portion, the body coupled to the base by the shaft, the body extending from the shaft to the cutting portion along the longitudinal axis; The cutting portion comprises a base portion and a tapered portion. 21. An ultrasonic surgical assembly as described in claim 20. [Aspect 24] The ultrasonic tip comprises: a substantially planar first side extending from the proximal end to the distal end; a second side that is substantially planar, disposed opposite the first side, and extending from the proximal end to the distal end; 24. The ultrasonic surgical assembly of claim 23, further comprising: [Aspect 25] the base portion has a lateral dimension between the first side and the second side, the lateral dimension extending perpendicular to the longitudinal axis; the tapered portion includes a chamfer and extends from the base portion to a cutting edge, the cutting edge has a length and a U-shaped profile with a first leg, a second leg, and an arcuate distal portion, the first leg and the second leg are parallel to one another and each include a plurality of cutting teeth, less than half of the length of the cutting edge includes the plurality of cutting teeth at the distal end, and the arcuate distal portion is devoid of the plurality of cutting teeth; 25. An ultrasonic surgical assembly as described in claim 24. [Aspect 26] An ultrasonic surgical assembly as described in any one of aspects 20, 21, 23, 24 and 25, wherein the shaft of the ultrasonic tip does not have a lumen at the distal end. [Aspect 27] providing an ultrasonic tip having a shaft and a cutting portion, the ultrasonic tip removably coupled to a horn by a tip coupler, the horn coupled to a transducer, the transducer coupled to a suction source by a first coupler, the shaft having a longitudinal axis, the ultrasonic tip defining a first bore defining an air inlet and a second bore extending from a proximal end of the ultrasonic tip to the first bore, the first bore being transverse to the second bore, the second bore communicating with the suction source via the tip coupler; providing an irrigation sleeve having a distal region and a proximal region and defining a lumen, the irrigation sleeve at least partially surrounding the shaft and configured to be coupled to an irrigation source with an inlet opening configured to receive irrigation fluid from the irrigation source, the irrigation sleeve defining a first conduit in fluid communication with the lumen, the first conduit configured to convey irrigation fluid from the inlet opening to an outlet opening; providing a seal member between an exterior surface of the ultrasound tip and an interior surface of the lumen of the irrigation sleeve, the first hole being disposed proximal to the seal member; A method for cutting bone using the ultrasonic tip, comprising: The method comprises: drawing air through the second hole and the first hole via the suction source to cool the ultrasonic tip; The method further comprises: [Aspect 28] 28. The method of claim 27, further comprising drawing one of smoke and airborne particulates through the first hole and the second hole. [Aspect 29] 30. The method of any one of aspects 27-28, further comprising drawing air through the first hole to the second hole to cool the ultrasound tip. [Aspect 30] 28. The method of embodiment 27, further comprising: the seal member being coupled to an outer surface of the ultrasound tip. [Aspect 31] providing a third hole defined in the irrigation sleeve, the third hole being proximal to the first hole when the irrigation sleeve and the ultrasound tip are coupled to a handpiece; drawing air from the surrounding environment through the third hole, then through the first hole and back through the second hole; 28. The method of embodiment 27, further comprising: [Aspect 32] 1. An ultrasonic instrument comprising: a housing having a proximal portion and a distal portion; a transducer disposed at least partially within the housing; a horn coupled to the transducer; an ultrasonic instrument comprising: an ultrasonic tip having a shaft and a cutting portion, the ultrasonic tip being removably coupled to the horn; an irrigation sleeve defining a lumen, the irrigation sleeve comprising a body releasably coupled to the distal portion of the housing and having a distal region and a proximal region; Equipped with The ultrasonic tip comprises: An annular seal member; the ultrasonic tip defining a groove; Further comprising: the annular seal member is disposed about the groove, disposed in the proximal region of the body and positioned between an outer surface of the ultrasonic tip and an inner surface of the lumen when the sleeve and the ultrasonic tip are coupled to the ultrasonic instrument, the annular seal member configured to prevent movement of fluid proximal to the annular seal member. Ultrasonic surgical assembly. [Aspect 33] 1. An ultrasonic instrument comprising: a housing having a proximal portion and a distal portion; a transducer disposed at least partially within the housing; a horn coupled to the transducer; an ultrasonic instrument comprising: an irrigation sleeve defining a lumen, the irrigation sleeve configured to be removably coupled to a first ultrasonic tip and a second ultrasonic tip, each of the first ultrasonic tip and the second ultrasonic tip configured to be removably coupled to the horn by a tip coupler, each of the first ultrasonic tip and the second ultrasonic tip comprising: A shaft, a cutting portion, the cutting portion of the first ultrasonic tip having a cutting shape that is different from a cutting shape of the cutting portion of the second ultrasonic tip; An annular seal member; Equipped with the first ultrasonic tip defines a first groove positioned a first distance from the tip coupler of the first ultrasonic tip, the second ultrasonic tip defines a second groove positioned a second distance from the tip coupler of the second ultrasonic tip, the first distance from the tip coupler of the first ultrasonic tip is not equal to the second distance from the tip coupler of the second ultrasonic tip, and each of the first ultrasonic tip and the second ultrasonic tip includes an annular seal member disposed about each of the first and second grooves; The irrigation sleeve comprises: a body releasably coupled to the distal portion of the housing; an irrigation conduit coupled to the body and configured to carry an irrigation fluid; Equipped with the perfusion conduit further defines an inlet opening disposed at a proximal region of the body and an outlet opening disposed at a distal region of the body, the perfusion fluid entering the perfusion conduit at the inlet opening and exiting the perfusion conduit at the outlet opening. an irrigation sleeve; 1. An ultrasonic surgical assembly comprising:

Claims

1. 1. An irrigation sleeve for an ultrasonic surgical assembly comprising: a housing having a proximal portion and a distal portion; a transducer at least partially disposed within the housing; a horn coupled to the transducer; and an ultrasonic tip having a shaft removably coupled to the horn, a body having a distal region and a proximal region; a sheath coupled to and disposed over a portion of the body, the sheath having a proximal end and an opposite distal end; a perfusion conduit for carrying a perfusion fluid, the perfusion conduit defining an inlet opening disposed in the proximal region of the body and an outlet opening, the perfusion fluid configured to enter the perfusion conduit at the inlet opening and exit the perfusion conduit at the outlet opening; Equipped with the body is releasably coupled to the distal portion of the housing and defines a helical groove that at least partially surrounds the shaft of the ultrasonic tip when the body is coupled to the distal portion of the housing such that the ultrasonic tip is located within a lumen defined by the irrigation sleeve; the sheath is coupled to and disposed over a portion of the body so as to surround at least a full rotation of the helical groove; the perfusion conduit is disposed within the spiral groove and the exit opening is disposed in a distal region of the body. Irrigation sleeve.

2. The irrigation sleeve of claim 1 , wherein the body defines a second spiral groove free of the irrigation conduit and surrounded by the sheath, the second spiral groove covered by the sheath defining a gripping surface for a user.

3. The irrigation sleeve of claim 1 or 2, wherein the irrigation conduit comprises a flexible material, the irrigation conduit comprising a unitary member defining a continuous length between the inlet opening and the outlet opening.

4. 1. An ultrasonic instrument comprising: a housing having a proximal portion and a distal portion; a transducer disposed at least partially within the housing; a horn coupled to the transducer; an ultrasonic instrument comprising: an ultrasonic tip having a shaft and removably coupled to the horn; The irrigation sleeve according to any one of claims 1 to 3, 1. An ultrasonic surgical assembly comprising:

5. 5. The ultrasonic surgical assembly of claim 4, further comprising an annular seal member disposed in the proximal region of the body and coupled to an outer surface of the ultrasonic tip, the annular seal member positioned between the outer surface of the ultrasonic tip and an inner surface of the lumen and configured to prevent migration of fluid proximally of the annular seal member.

6. The ultrasonic tip comprises: a first aperture defining an air inlet disposed proximally of the annular seal member; a second bore extending from a proximal end of the shaft to the first bore forming a fluid pathway to the first bore; 6. The ultrasonic surgical assembly of claim 5, defining:

7. The ultrasonic tip comprises: A cut portion; a substantially planar first side extending from the proximal end to the distal end; a substantially planar second side disposed opposite the first side and extending from the proximal end to the distal end; Further comprising: The ultrasonic surgical assembly of claim 6 , wherein the cutting portion includes a cutting head disposed at the distal end.

8. 8. The ultrasonic surgical assembly of claim 6 or claim 7, wherein the irrigation sleeve further comprises a third hole proximal to the first hole when the irrigation sleeve and the ultrasonic tip are coupled to the ultrasonic instrument.

9. The ultrasonic surgical assembly of any one of claims 5 to 8, wherein said ultrasonic tip further defines a groove, said seal member being disposed about said groove.

10. The ultrasonic surgical assembly of any one of claims 6 to 8, wherein the first bore is perpendicular to the axis of the second bore.

11. The ultrasonic tip comprises: a base for coupling to the transducer; a body extending from the base, the body including the shaft and the cutting portion, the body being coupled to the base by the shaft and extending from the shaft to the cutting portion along a longitudinal axis of the shaft; Equipped with An ultrasonic surgical assembly according to claim 7 or any one of claims 8 to 10, when dependent on claim 7, wherein the cutting portion comprises a base portion and a tapered portion.

12. the base portion has a lateral dimension between the first side and the second side, the lateral dimension extending perpendicular to the longitudinal axis; the tapered portion includes a chamfer and extends from the base portion to a cutting edge, the cutting edge having a length and a U-shaped profile with a first leg, a second leg, and an arcuate distal portion; The ultrasonic surgical assembly of claim 11 , wherein said first leg and said second leg are parallel to one another and each include a plurality of cutting teeth.

13. 13. The ultrasonic surgical assembly of any one of claims 7, 8, 11 and 12, wherein said shaft of said ultrasonic tip has no lumen at said distal end.

Images