Surgical system and its operating method

Abstract

To provide improved device and method for an arthroscopic procedure.SOLUTION: In general, arthroscopic medical implements and assemblies, and methods of operating arthroscopic medical implements and assemblies are provided. Devices, systems, and methods are described herein in connection with accessing a surgical site using an arthroscopic medical implement. In an exemplary implementation, an optical sensor of the arthroscopic medical implement can gather and output image data, and an inertial sensor of the arthroscopic medical implement can gather and output orientation data. The orientation data can be used to modify the gathered optical image to maintain a display of the gathered optical image in a predetermined desired orientation before, during, and after any rotation of the arthroscopic medical implement. The arthroscopic medical implement can also include at least one sensor configured to gather and output pressure and / or temperature.SELECTED DRAWING: Figure 1

Description

[Technical Field]

[0001] The present disclosure generally relates to arthroscopic medical instruments and assemblies, and methods of operating arthroscopic medical instruments and assemblies. [Background Art]

[0002] Various disorders and injuries may require arthroscopic procedures to repair any soft tissue injury. These procedures often require multiple arthrosporic devices including a camera, a fluid source, a fluid evacuator, and tissue removal means.

[0003] For arthroscopic repair procedures, conventional devices and surgical methods have several drawbacks. For example, current arthroscopic devices combine concentrically arranged tubes to provide necessary sub-devices such as a photosensor, a light source, and fluid flow and evacuation elements at the working distal end of the arthroscopic device. This concentric tube arrangement requires a rotational seal to allow each sub-device to operate independently during rotation of the arthroscopic device during a procedure, such as keeping the photosensor oriented upright. This may create difficulties for an operator during the procedure because multiple hands are required to handle conventional arthroscopic devices to operate all of the sub-devices appropriately. [Summary of the Invention] [Problem to be Solved by the Invention]

[0004] Accordingly, there still remains a need for improved devices and methods for arthroscopic procedures. [Means for Solving the Problem]

[0005] In general, arthroscopic medical instruments and assemblies, and methods of operating arthroscopic medical instruments and assemblies are provided.

[0006] In one embodiment, an arthroscope is provided, comprising a handpiece having a proximal end, a distal end, and a longitudinal axis extending between them. The arthroscope also includes a shaft extending distally from the handpiece along its longitudinal axis. The shaft is configured to advance arthroscopically into the patient's body, and a plurality of lumens extend through the shaft, at least one of the plurality of lumens configured to allow fluid to pass through its interior, and at least one of the plurality of lumens configured to have a wire extending through its interior. The arthroscope also includes an optical sensor in the distal portion of the shaft. The optical sensor is configured to collect image data. The arthroscope also includes an inertial sensor configured to collect orientation data indicating the orientation of the image data collected by the optical sensor.

[0007] Arthroscopy can vary in various ways. For example, an arthroscope may also include a plurality of input actuators arranged on the outer surface of the handpiece, each of which may be operated by the user and configured to produce the same function regardless of which of the input actuators is operated. In at least some embodiments, the function may include providing irrigation fluid through at least one of a plurality of lumens configured to allow fluid to pass through its interior, the function may include providing negative suction pressure through at least one of a plurality of lumens configured to allow fluid to pass through its interior, and / or the handpiece may be substantially cylindrical and the input actuators may be arranged circumferentially around the entire circumference of the handpiece.

[0008] In another embodiment, the orientation data may include both angular orientation information and axial orientation information.

[0009] In yet another embodiment, the arthroscope may also include a first wire extending through one of a plurality of lumens, the first wire being configured to operably couple a photosensor and a control unit, and the collected image data may be configured to be transmitted to the control unit using the first wire. In at least some embodiments, the arthroscope may also include a temperature sensor in the distal portion of the shaft configured to collect temperature data, the arthroscope may also include a second wire extending through a second of a plurality of lumens, the temperature sensor being operably coupled to a control unit via the second wire, and the collected temperature data may be configured to be transmitted to the control unit using the second wire, and / or the arthroscope may also include a pressure sensor in the distal portion of the shaft configured to collect pressure data, the arthroscope may also include a second wire extending through a second of a plurality of lumens, the pressure sensor being operably coupled to a control unit via the second wire, and the collected pressure data may be configured to be transmitted to the control unit using the second wire.

[0010] In yet another embodiment, the arthroscope may also include multiple fiber optic cables extending along the shaft and surrounding the optical sensor. In at least some embodiments, the fiber optic cables may be mounted within the wall of the shaft.

[0011] In another embodiment, the arthroscope may also include a lens positioned distal to the light sensor, and the arthroscope may also include a prism positioned distal to the lens. In at least some embodiments, the prism may be angled in the range of about 30° to about 70°, and in at least some embodiments, the prism may be attached to the distal portion of the shaft, the distal portion of the shaft may be configured to pivot relative to the proximal portion of the shaft, and the arthroscope may also include a motion actuator in the handpiece configured to actuate the pivot of the distal portion.

[0012] In yet another embodiment, the arthroscope may also include an actuation member extending through at least one of a plurality of lumens, the actuation member may be operably coupled to the distal portion of the shaft, the distal portion of the shaft may be configured to pivot relative to the proximal portion of the shaft, and an actuation actuator in the handpiece may be configured to actuate a change in tension of the actuation member, thereby causing the pivot of the distal portion. In at least some embodiments, the actuation actuator may also include a slider in the handpiece, which is actuated by sliding against the handpiece, thereby configuring a change in tension of the actuation member. In at least some embodiments, the actuation actuator may also include a tensioner in the handpiece, which, when actuated, is configured to translate the actuation force along the actuation member to the distal portion. In at least some embodiments, the actuation actuator may include a rotatable dial in the handpiece, which is actuated by rotating against the handpiece, thereby configuring a change in tension of the actuation member.

[0013] In yet another embodiment, the proximal end of the handpiece may include a connector matable with a cable assembly that includes an electrical conduit, an optical conduit, and a fluid conduit, each configured to communicate with one of a plurality of lumens. In at least some embodiments, the connector may be a single connector. In at least some embodiments, the connector may include connectors for each of the electrical conduit, optical conduit, and fluid conduit.

[0014] In yet another embodiment, the arthroscope may be substantially symmetrical about its longitudinal axis. In yet another embodiment, the inertial sensor may be located at the distal portion of the shaft. In yet another embodiment, the inertial sensor may be located at the handpiece.

[0015] In another embodiment, a surgical system is provided that includes an arthroscope comprising a handpiece, a shaft, an optical sensor, and an inertial sensor. The handpiece comprises a proximal end, a distal end, and a longitudinal axis extending between them. The shaft extends distally from the handpiece along its longitudinal axis. The shaft is configured to advance arthroscopically into the patient's body, and a plurality of lumens extend through the shaft, at least one of the plurality of lumens configured to allow fluid to pass through its interior, and at least one of the plurality of lumens configured to have a wire extending through its interior. An optical sensor is located at the distal end of the shaft and is configured to collect image data. An inertial sensor is located in the handpiece and is configured to collect orientation data indicating the orientation of the image data collected by the optical sensor. The surgical system also includes a control unit configured to receive the image data collected from the optical sensor, receive the orientation data collected from the inertial sensor, and modify the image data using the orientation data.

[0016] Surgical systems can vary in various ways. For example, orientation data may include both angular orientation information and axial orientation information.

[0017] In another embodiment, the modification may include rotating the image data to a desired orientation based on orientation data, and the control unit may be configured to output the rotated image to the display unit. In at least some embodiments, the control unit may be configured to modify the image data using orientation data in real time with the rotation of the handpiece around the longitudinal axis of the handpiece, and the control unit may be configured to output the rotated image to the display unit in real time with the rotation of the handpiece.

[0018] In yet another embodiment, the control unit may include a pump, and the surgical system may also include a cartridge configured to be releasably coupled to the control unit, the cartridge may include tubing configured to be operably coupled to the pump, with the cartridge operably coupled to the control unit, such that the pump is configured to pump fluid through the cartridge. In at least some embodiments, the tubing may be configured to be operably coupled to a fluid source containing irrigation fluid, and with the cartridge operably coupled to the control unit, the pump may be configured to pump irrigation fluid into at least one of a plurality of lumens configured to allow fluid to pass through the interior. In at least some embodiments, with the cartridge operably coupled to the control unit, the pump may be configured to provide suction to at least one of a plurality of lumens configured to allow fluid to pass through the interior.

[0019] In yet another embodiment, the surgical system may also include an insertion tool comprising an occlusion and a guide member, the guide member comprising a channel on its outer surface configured to releasably seat an occlusion therein, the occlusion seated in the channel may be configured to advance through a skin incision, and the arthroscope shaft may be configured such that, with the guide member positioned within the incision, the occlusion advances through the skin incision and is released from the channel, and then releasably seated in the channel.

[0020] In yet another embodiment, the arthroscope may also include a plurality of input actuators located on the outer surface of the handpiece, each of which may be actuated by the user and configured to produce the same function regardless of which of the input actuators is actuated. In at least some embodiments, the function may include providing an irrigation fluid through at least one of a plurality of lumens configured to allow fluid to pass through its interior, the function may include providing negative suction pressure through at least one of a plurality of lumens configured to allow fluid to pass through its interior, and / or the handpiece may be substantially cylindrical and the input actuators may be arranged circumferentially around the entire circumference of the handpiece.

[0021] In another embodiment, the arthroscope may also include a first wire extending through one of a plurality of lumens, the first wire being configured to operably couple a photosensor and a control unit, and the collected image data may be configured to be transmitted to the control unit using the first wire. In at least some embodiments, the arthroscope may also include a temperature sensor at the distal end of the shaft configured to collect temperature data, the arthroscope may also include a second wire extending through a second of a plurality of lumens, the temperature sensor being operably coupled to a control unit via the second wire, and the collected temperature data may be configured to be transmitted to the control unit using the second wire, and / or the arthroscope may also include a pressure sensor at the distal end of the shaft configured to collect pressure data, the arthroscope may also include a second wire extending through a second of a plurality of lumens, the pressure sensor being operably coupled to a control unit via the second wire, and the collected pressure data may be configured to be transmitted to the control unit using the second wire.

[0022] In yet another embodiment, the arthroscope may also include multiple optical fibers extending along the shaft and surrounding the optical sensor. In at least some embodiments, the optical fibers may be attached to the wall of the shaft.

[0023] In another embodiment, the arthroscope may also include a lens positioned distal to the light sensor, and the arthroscope may also include a prism positioned distal to the lens. In at least some embodiments, the prism may be angled in the range of about 30° to about 70°, and in at least some embodiments, the prism may be attached to a pivotable distal portion of the shaft, and the arthroscope may also include a motion actuator in the handpiece configured to actuate pivoting of the pivotable distal portion.

[0024] In yet another embodiment, the arthroscope may also include a wire extending through at least one of a plurality of lumens, the wire operably coupled to a pivotable distal portion of the shaft, and an operating actuator in the handpiece may be configured to actuate a change in the tension of the wire, thereby causing pivoting of the pivotable distal portion. In at least some embodiments, the operating actuator may include a slider in the handpiece, which is actuated by sliding against the handpiece, thereby changing the tension of the wire. In at least some embodiments, the operating actuator may include a tensioner in the handpiece, which, when actuated, is configured to translate the actuating force along the wire to the pivotable distal portion. In at least some embodiments, the operating actuator may include a rotatable dial in the handpiece, which is actuated by rotating against the handpiece, thereby changing the tension of the wire.

[0025] In yet another embodiment, the proximal end of the handpiece may include a connector matable with a cable assembly that includes an electrical conduit, an optical conduit, and a fluid conduit, each configured to communicate with one of a plurality of lumens. In at least some embodiments, the connector may be a single connector. In at least some embodiments, the connector may include connectors for each of the electrical conduit, optical conduit, and fluid conduit.

[0026] In yet another embodiment, the arthroscope may be substantially symmetric about its longitudinal axis.

[0027] In another embodiment, a surgical system includes an arthroscope, a control unit, and a cartridge. The arthroscope includes a handle, a cable assembly extending proximally from the handle, and an elongated shaft extending distally from the handle. The cable assembly includes a first cable, a second cable, and a cable connector at a proximal end of the cable assembly. A first lumen and a second lumen extend through the shaft. The first lumen is in communication with a first conduit of the first cable, and the second lumen is in communication with a second conduit of the second cable. The control unit is configured to releasably couple to the cable connector. The control unit includes a pump, and with the control unit releasably coupled to the cable connector, the control unit is configured to provide power to the arthroscope via the first cable and the first conduit. The cartridge is configured to releasably couple to the control unit. The cartridge includes tubing. With the cartridge releasably coupled to the control unit, the pump is configured to cause fluid flow through the tubing, the second conduit, and the second cable.

[0028] The surgical system can vary in many ways. For example, the tubing can be configured to operably couple to a fluid source containing an irrigation fluid therein, and the fluid flow can comprise a flow of irrigation fluid. In at least some embodiments, with the cartridge releasably coupled to the control unit and a second tubing of the cartridge operably coupled to a surgical instrument configured to deliver suction to a surgical site, the pump can be configured to cause suction to be provided within the second tubing such that the surgical instrument delivers suction.

[0029] In another embodiment, inducing fluid flow may include providing suction force within tubing, the second conduit, and the second cable. In at least some embodiments, the cable assembly may include a third cable, a third lumen may extend through the shaft, the third lumen may be in communication with a third conduit of the third cable, the control unit may include a second pump, the cartridge may include second tubing configured to be operably coupled to a fluid source containing an irrigation fluid therein, and with the cartridge releasably coupled to the control unit, the pump may be configured to induce flow of the irrigation fluid within the second tubing, the third conduit, and the third cable.

[0030] In yet another embodiment, the arthroscope may include a photosensor at a distal portion of the shaft, the photosensor may be configured to collect image data, and power provided to the arthroscope may be configured to supply power to the photosensor. In at least some embodiments, the arthroscope may include an inertial sensor configured to collect orientation data indicating an orientation of the image data collected by the photosensor, and the control unit may be configured to receive the collected image data via a wire extending through the first conduit and the first cable. The inertial sensor may be located on the handpiece or at the distal portion of the shaft. In at least some embodiments, the control unit may be configured to correct an image of the received image data using the received orientation data, and may be configured to cause the display unit to output the corrected image. In at least some embodiments, the correcting may include rotating the image to a predetermined desired orientation based on the orientation data, and / or the control unit may be configured to correct the image using the orientation data in real time with rotation of the handle about a common longitudinal axis of the handle and the shaft, and the control unit may be configured to cause the display unit to output the corrected image in real time with rotation of the handle.

[0031] In another embodiment, a surgical method is provided which includes accessing a surgical site with an arthroscope defining a longitudinal axis. The arthroscope handpiece includes an electrical path, an optical path, and a fluid path. The arthroscope is mated to a cable which includes an electrical conduit communicating with the electrical path, an optical conduit communicating with the optical path, and a fluid conduit communicating with the fluid path. The arthroscope includes an optical sensor operably coupled to a control unit, and the arthroscope includes an inertial sensor operably coupled to the control unit. The surgical method also includes rotating the arthroscope about a longitudinal axis while the control unit causes an optical image of the surgical site to be provided on a display unit based on image data collected by the optical sensor. Throughout the rotation of the arthroscope, the control unit causes the orientation of the optical image to be maintained in the same orientation on the display unit based on orientation data collected by the inertial sensor.

[0032] The surgical method can have a wide range of variations. For example, orientation data may include both angular orientation information and axial orientation information. In another embodiment, the orientation of the optical image may be one of upright orientation and lateral orientation. In yet another embodiment, the arthroscope may include a temperature sensor operably coupled to a control unit, and during rotation of the arthroscope, the control unit may provide temperature information on a display unit based on temperature data collected by the temperature sensor. In yet another embodiment, the arthroscope may include a pressure sensor operably coupled to a control unit, and during rotation of the arthroscope, the control unit may provide pressure information on a display unit based on pressure data collected by the pressure sensor. In yet another embodiment, the arthroscope may be substantially symmetrical about its longitudinal axis. In another embodiment, the handpiece may be substantially cylindrical.

[0033] In another embodiment, the surgical method includes: acquiring an image of the surgical site using an arthroscopic optical sensor; acquiring the orientation of the arthroscopic using an arthroscopic inertial sensor; and determining whether the acquired orientation of the arthroscopic matches a predetermined desired orientation. The surgical method also includes displaying the image on a display unit if the acquired orientation matches a predetermined desired orientation. The surgical method also includes correcting the image based on the acquired orientation and displaying the corrected image on a display unit if the acquired orientation does not match a predetermined desired orientation.

[0034] Surgical methods can vary in various ways. For example, image acquisition may include acquiring multiple images while the arthroscope rotates around its longitudinal axis, orientation acquisition may include acquiring multiple orientations while the arthroscope rotates, each acquired orientation may correspond to one of the acquired images, and determination may be made for each acquired image against its corresponding acquired orientation. In at least some embodiments, the arthroscope may include a handpiece and a shaft extending distally from the handpiece, the distal portion of the shaft may pivot with respect to the longitudinal axis and the proximal portion of the shaft while the arthroscope rotates, the longitudinal axis may be defined by the handpiece and the proximal portion of the shaft, and an optical sensor may be located in the distal portion of the shaft. In at least some embodiments, image acquisition may include acquiring a plurality of additional images, orientation acquisition may include acquiring a plurality of additional orientations, each of the acquired additional orientations may correspond to one of the acquired additional images, determination may be made for each of the acquired additional images with respect to its corresponding acquired additional orientation, and the additional images and additional orientations may be acquired such that the distal portion of the shaft is not pivoted relative to the longitudinal axis and the proximal portion of the shaft.

[0035] In another embodiment, the surgical method may also include, in response to the operation of any one of a plurality of input actuators of the arthroscope, which are arranged around the arthroscopic handpiece, bringing an irrigation fluid from a fluid source to the surgical site through a first internal lumen of the arthroscope, and providing suction to the surgical site through a second internal lumen of the arthroscope. In yet another embodiment, a predetermined desired orientation may be one of an upright orientation and a lateral orientation. In yet another embodiment, the surgical method may also include, at least one of, displaying temperature information on a display unit based on temperature data collected by a temperature sensor of the arthroscope, and displaying pressure information on a display unit based on pressure data collected by a pressure sensor of the arthroscope.

[0036] In another embodiment, the surgical method includes supplying power from a control unit that is releasably coupled to the arthroscope and to the cartridge in order to supply power to the arthroscope via a first cable. The arthroscope is releasably coupled to the control unit via cable connectors of a cable assembly which also includes the first cable and the second cable, and the cartridge is releasably seated in a cartridge holder of the control unit. The surgical method also includes using a pump of the control unit to induce a fluid flow in the tubing of the cartridge, thereby inducing a fluid flow in the second cable.

[0037] The surgical method can have a variety of variations. For example, the fluid flow may include the flow of an irrigation fluid. In at least some embodiments, the surgical method may also include using a second pump of a control unit to provide suction within the second tubing so that a surgical instrument operably coupled to the second tubing of the cartridge delivers suction force to the surgical site.

[0038] In another embodiment, inducing fluid flow may involve providing suction force within the tubing. In at least some embodiments, the surgical method may also involve using a second pump of the control unit to induce a flow of irrigation fluid within the second tubing of the cartridge, thereby inducing a flow of irrigation fluid within the third cable of the cable assembly.

[0039] In yet another embodiment, the surgical method may also include collecting image data using an optical sensor located distal to the arthroscope, and a control unit may receive the collected image data via a wire extending through a first cable, and the surgical method may also include collecting orientation data using an inertial sensor. In at least some embodiments, the surgical method may also include the control unit modifying the image of the received image data using the received orientation data in real time with the execution of the surgical procedure, and the surgical method may also include using the control unit to display the modified image on a display unit in real time with the execution of the surgical procedure. In at least some embodiments, modification may include rotating the image to a predetermined desired orientation based on the orientation data, and / or modifying and displaying the modified image may occur in real time with the rotation of the handle about a common longitudinal axis between the handle of the arthroscope and the shaft of the arthroscope extending distally from the handle. [Brief explanation of the drawing]

[0040] This disclosure will be better understood by reading the following detailed description in conjunction with the attached drawings. [Figure 1] This is a perspective view of one implementation example of an arthroscopic medical device. [Figure 2] Figure 1 is a schematic diagram of an arthroscopic medical instrument. [Figure 3A] Figure 1 is a distal end view of one implementation example of the tip of an arthroscopic medical instrument. [Figure 3B] Figure 1 is a distal end view of another implementation example of the tip of an arthroscopic medical instrument. [Figure 3C] Figure 1 shows a distal end view of yet another implementation example of the tip of an arthroscopic medical instrument. [Figure 3D] Figure 1 shows a distal end view of yet another implementation example of the tip of an arthroscopic medical instrument. [Figure 4A] Figure 1 is a partial perspective view of one implementation example of a motion actuator for an arthroscopic medical device. [Figure 4B] Figure 4A is a partial perspective view of the operating actuator. [Figure 4C] Figure 4A is an exploded perspective view of a part of an arthroscopic medical instrument and a motion actuator. [Figure 5A] Figure 1 is a partial perspective view of one implementation example of a motion actuator for an arthroscopic medical device. [Figure 5B] Figure 5A is a partial perspective view of the operating actuator. [Figure 6A] Figure 1 is a partial perspective view of another implementation example of the motion actuator for an arthroscopic medical device. [Figure 6B] Figure 6A is a partial perspective view of the operating actuator. [Figure 7] Figure 1 is a side view of yet another implementation example of the motion actuator for the arthroscopic medical device. [Figure 8] Figure 1 is a schematic side view of one implementation example of the longitudinal shaft and pivotable tip of an arthroscopic medical instrument. [Figure 9] Figure 1 is a perspective view of the arthroscopic medical instrument inserted into the surgical site. [Figure 10] This is an example of an implementation method for operating the arthroscopic medical instrument shown in Figure 1 within the surgical site. [Figure 11A] This is a schematic diagram of the arthroscopic medical instrument shown in Figure 1 at the first angular position. [Figure 11B] This is a schematic diagram of the arthroscopic medical instrument shown in Figure 1, located at the second angular position. [Figure 11C] This is a schematic diagram of the arthroscopic medical instrument shown in Figure 1, located at the third angular position. [Figure 12A] This is a perspective view of one implementation example of an insertion tool. [Figure 12B] Figure 12A is another perspective view of the insertion tool. [Figure 13] This is a perspective view of one implementation example of a cable connector and cable assembly. [Figure 14] This is a perspective view of a portion of an implementation example of a control unit. [Figure 15] Figure 14 is a front view of the control unit. [Figure 16] Figure 14 is a perspective view of one embodiment of the control unit and cartridge. [Figure 17] This is a perspective view of another implementation example of the control unit. [Figure 18] Figure 17 is a perspective view of the control unit operably coupled to another example of cartridge implementation. [Figure 19] Figure 17 is a perspective view of the control unit operably coupled to another example of cartridge implementation. [Modes for carrying out the invention]

[0041] Specific exemplary embodiments are described below to provide an overall understanding of the structure, function, manufacturing and use principles of the apparatus and methods disclosed herein. One or more of these embodiments are illustrated in the accompanying drawings. Those skilled in the art will understand that the apparatus, systems and methods described in detail herein and shown in the accompanying drawings are non-limiting exemplary embodiments, and that the scope of the invention is defined solely by the claims. Features illustrated or described in relation to one exemplary embodiment can be combined with features of other embodiments. Such modifications and variations are considered to fall within the scope of the invention.

[0042] Furthermore, in this disclosure, components with similar names in embodiments generally have similar characteristics, and therefore, in a particular embodiment, each characteristic of each component with a similar name is not necessarily described in full detail. In addition, to the extent that linear or circular dimensions are used in the description of the disclosed systems, apparatus, and methods, such dimensions are not intended to limit the types of shapes that can be used in combination with such systems, apparatus, and methods. Those skilled in the art will recognize that dimensions equivalent to such linear and circular dimensions can be readily determined for any geometric shape. The size and shape of the systems and apparatus, and their components, may depend at least on the anatomical structure in which the systems and apparatus are used internally, the size and shape of the components in which the systems and apparatus are used, and the methods and techniques in which the systems and apparatus are used.

[0043] Generally, arthroscopic medical instruments and assemblies, as well as methods for operating arthroscopic medical instruments and assemblies, are provided.

[0044] Various figures illustrate embodiments of arthroscopic medical instruments (also referred to herein as “arthroscopes”) and assemblies, as well as methods, of the present disclosure. Devices, systems, and methods relating to accessing a surgical site using arthroscopic medical instruments are described herein. In one exemplary implementation, an optical sensor of the arthroscopic medical instrument may collect and output image data, and an inertial sensor of the arthroscopic medical instrument may collect and output orientation data. The orientation data may be used to modify the collected optical image and maintain the display of the collected optical image in a predetermined desired orientation before, during, and after any rotation of the arthroscopic medical instrument. The image data may be images of the surgical site collected during the performance of a surgical procedure, so that a surgeon and / or other medical professional can easily interpret the condition at the surgical site by viewing a consistently oriented image regardless of the rotational position of the arthroscopic medical instrument. The arthroscopic medical instrument may also include at least one sensor configured to collect and output pressure and / or temperature. The collected pressure and / or temperature data may be displayed during the surgical procedure, thereby providing surgeons and / or other medical professionals with useful information about the surgical site from which the pressure and / or temperature data was collected.

[0045] The arthroscopic medical instruments disclosed herein may be particularly useful for providing multiple functions to the surgical site while being operated with one hand by a user. The arthroscopic medical instrument may include an electrical path, an optical path, and a fluid path integrated within the handpiece. Furthermore, the arthroscopic medical instrument may include an optical sensor, for example, at the distal end of a shaft extending from the handpiece of the arthroscopic medical instrument, which is operably coupled to a control unit. During rotation of the arthroscopic medical instrument about its longitudinal axis, the image of the surgical site provided to the display by the optical sensor is maintained in a desired orientation. This modification of the optical image is due, for example, to measured orientation data from an inertial sensor of the arthroscopic medical instrument, which is located within the handpiece of the arthroscopic medical instrument or at the distal end of the arthroscopic medical instrument and configured to determine the orientation of the optical sensor.

[0046] Figures 1 and 2 show one implementation example of the arthroscopic medical instrument 100. The arthroscopic medical instrument 100 is configured for use in minimally invasive surgical procedures, such as arthroscopic procedures for diagnosing and treating joint problems. In one embodiment using the arthroscope 100, the surgeon inserts the shaft 108 of the arthroscope 100 into the patient through a small incision during a minimally invasive surgical procedure, such as an arthroscopic procedure. Images obtained from within the surgical site using the arthroscope 100 are transmitted to a high-definition video monitor via the arthroscopic medical instrument 100's optical image sensor, for example, an optical image sensor located on the distal end of the shaft 102. During the procedure, the surgeon holds the arthroscopic medical instrument 100 by the handpiece 120 (also referred to herein as the “handle”) of the arthroscopic medical instrument 100 so as to angle the shaft 108 within the surgical site. In one exemplary implementation, the arthroscopic medical instrument 100 is used in combination with at least one secondary tool, such as a shaver for tissue or bone or other therapeutic device. Secondary tools(s) may be inserted into the surgical site through the secondary incision.

[0047] In general, the arthroscopy medical instrument 100 includes a shaft assembly 102, a handpiece assembly 104, and a cable assembly 106. The shaft assembly 102 includes a shaft 108 that extends from the handpiece 120 of the handpiece assembly 104 along a common longitudinal axis LA of the shaft assembly 102 and the handpiece assembly 104. Thus, as shown in Figures 1 and 2, the arthroscopy 100 has an in-line design in which the shaft 108 and the handpiece 120 are axially aligned with each other. The in-line design can facilitate easy and predictable user rotation of the arthroscopy medical instrument 100 around the longitudinal axis LA. As also shown in Figure 1, the shaft 108 and the handpiece 120 are substantially symmetrical around the longitudinal axis LA. Thus, the longitudinal axis LA is the neutral axis. Those skilled in the art will understand that the configuration may not be exactly symmetrical, but may nevertheless be considered substantially symmetrical due to any number of factors such as manufacturing tolerances and the sensitivity of measuring instruments. The substantially symmetrical nature of the shaft 108 and handpiece 120 may facilitate easy and predictable user rotation of the arthroscopic medical instrument 100 around the longitudinal axis LA, which may help reduce damage to the patient at the skin incision where the shaft 108 is positioned, as the shaft 108 rotates predictably around the longitudinal axis LA within the incision, and may help reduce damage to tissues and / or other materials within the patient's body where the shaft 108 is positioned, as the shaft 108 rotates predictably around the longitudinal axis LA within the patient's body.

[0048] The shaft 108 includes a distal end 107A and a proximal end 107B. As shown in Figure 3A, several lumens 184, 186, and 188 extend through the shaft 108. The several lumens 184, 186, and 188 are located inside the shaft 108 and may have various configurations to provide various functions to and from the surgical site. In one exemplary implementation, the first lumen 186 is configured to selectively provide irrigation fluid to the surgical site through its interior, the second lumen 188 is configured to provide negative suction pressure to the surgical site through its interior, and the third lumen 184 is used to carry one or more electrical connectors, such as one or more data and power cables, to one or more sensors located at the distal end 107A of the shaft 108. For example, in one exemplary implementation, the optical sensor 140 is located on the pivotable portion 110 of the shaft 108 and at the distal end 107A of the shaft 108, such as within the third lumen 184, and one or more electrical connectors are operably coupled to the optical sensor 140. As will be discussed further below, one or more working members may also be carried by the third lumen 184 (or within the fourth lumen).

[0049] The positions, sizes, and shapes of the lumens 184, 186, and 188 shown in Figure 3A may differ in other implementations. For example, while the fluid lumens 186 and 188 in this illustrated implementation each have a crescent-shaped cross-section, they may have other cross-sectional shapes such as circular or oval. In another embodiment, the lumens 184, 186, and 188 in this exemplary implementation are each radially offset from the longitudinal axis LA, whereas in other implementations, one of the lumens, for example, the electrical lumen 184, may be aligned with the longitudinal axis LA, while the other two lumens, for example, the fluid lumens 186 and 188, are radially offset from the longitudinal axis LA. In yet another embodiment, the first lumen 186 provides irrigation and the second lumen 188 provides suction. In this implementation, each of the fluid lumens 186 and 188 is configured to provide a different fluid function. In other implementations, each of the fluid lumens 186 and 188 may be configured to provide suction, or each of the fluid lumens 186 and 188 may be configured to provide irrigation, or the fluid functions of the lumens 186 and 188 may be reversed, such that the second lumen 188 provides irrigation and the first lumen 186 provides suction.

[0050] The fact that the shaft 108 is rotatable using the handpiece 120 allows the multiple lumens 184, 186, and 188 to be rotated using the handpiece 120. Thus, the fluid lumens 186 and 188 may be rotatable without having to pass through any rotatable seals. Rotatable seals are conventionally used in devices that provide irrigation and / or aspiration, but are susceptible to fluid leakage during and / or caused by rotation. Therefore, the arthroscope 100, which does not include rotatable seals through which the fluid lumens 186 and 188 pass, eliminates the possibility of leakage in such rotatable seals. Furthermore, seals can be heavy, and therefore, the absence of rotatable seals in the arthroscope 100 can make the arthroscope 100 lighter than conventional tools that provide irrigation and / or aspiration, which can make the arthroscope 100 less tiring for the user to handle and / or make it easier for the user to handle it with one hand for rotation, operation, etc.

[0051] Figure 3B shows another implementation example of shaft 102 in the form of shaft 308 of an arthroscope shaft assembly 302, having multiple lumens 384, 386, and 388 extending through shaft 308. The shaft assembly 302 and shaft 308 are configured and used similarly to the shaft assembly 102 and shaft 108 in Figures 1 and 2, respectively. The lumens 384, 386, and 388 are configured and used similarly to the lumens 184, 186, and 188 in Figure 3A, respectively. In this exemplary implementation, multiple lights 390 are located within and extending through shaft 308. In this illustrated implementation, the lights 390 are fiber optics, but other lights such as LEDs may be used with appropriate electronic leads for the lights located within shaft 308. The lights 390 are positioned around the shaft 308 and configured to provide light directed distally, which helps to illuminate the surgical site and / or reduce shadows, thereby enabling the light sensor 140 to acquire a clearer and more easily visible image. The lights 390 are positioned equidistantly and radially around the shaft 308 and thus surround the light sensor 140. The lights 390 are mounted within the wall 392 of the shaft 308, or otherwise may be assembled within the shaft 308. Mounting the lights 390 within the wall 392 allows the shaft 308 and the lights 390 (at least as fiber optics) to be co-extruded. The lights 390 are operably coupled to an external light source and / or control unit 160, which is shown in Figure 2 and discussed further below. The control unit 160 is configured to control the activation of the lights 390, for example, to turn on the illumination, and the deactivation of the lights 390, for example, to turn off the illumination. The exemplary implementation includes eight lights 390, but the arthroscope may include a different number of lights 390. Including multiple lights 390 instead of just one can help ensure that the field of view of the photosensor is fully illuminated regardless of the rotational orientation of the shaft 308 and regardless of whether the pivotable portion of the shaft 308 (if any) is pivoted.

[0052] Figure 3C shows another implementation example of shaft 102 in the form of shaft 408 of arthroscopic shaft assembly 402, having multiple lumens 484, 486, and 488 extending through shaft 408. Shaft assembly 402 and shaft 408 are configured and used similarly to shaft assembly 102 and shaft 108 in Figures 1 and 2, respectively. Lumens 484, 486, and 488 are configured and used similarly to lumens 184, 186, and 188 in Figure 3A, respectively. In this exemplary implementation, fluid lumens 486 and 488 each have a circular cross-sectional shape instead of a crescent cross-sectional shape. In this exemplary implementation, a fourth lumen 185 extends through shaft 408. The fourth lumen 485, like the third lumen 184, is an electrical lumen used to carry one or more electrical connectors, such as one or more data and power cables, to one or more sensors located at the distal end of shaft 408. In this exemplary implementation, one or more sensors are the light sensor 140 and pressure and temperature sensors 144, 146 described above, but other sensors may be used. Also in this exemplary implementation, multiple lights 490 are arranged within and extending through the shaft 408. The lights 490 are configured and used similarly to the lights 390 in Figure 3B.

[0053] Figure 3D shows another implementation example of shaft 102 in the form of shaft 420 of an arthroscope shaft assembly 422, having multiple lumens 424, 426, 428, and 430 extending through shaft 420. The shaft assembly 422 and shaft 420 are configured and used similarly to the shaft assembly 102 and shaft 108 in Figures 1 and 2, respectively. Lumens 424, 426, and 428 are configured and used similarly to lumens 184, 186, and 188 in Figure 3A. The fourth lumen 430 is configured and used similarly to the fourth lumen 485 in Figure 3C. In this exemplary implementation, the electrical lumen 424 has an irregular cross-sectional shape instead of a circular cross-sectional shape, the fluid lumens 426 and 428 each have a tapered arc cross-sectional shape instead of a crescent cross-sectional shape, and the fourth lumen 430 has an irregular cross-sectional shape instead of a circular cross-sectional shape.

[0054] Referring again to Figures 1 and 2, the pivotable portion 110 of the shaft 108 is located at the distal end of the shaft 108 and is configured to pivot at pivot point 112 relative to the handpiece assembly 104 and relative to the proximal portion of the shaft 108, which is located proximal to pivot point 112. The pivoting motion of the pivotable portion 110 can enable a larger field of view at the surgical site when the arthroscopic medical instrument 100 is inserted into the surgical site. With the pivotable portion 110 pivoted at pivot point 112 relative to the handpiece 120 and relative to the proximal portion of the shaft 108, the handpiece 120 and the proximal portion of the shaft 108 maintain their in-line configuration relative to each other. The pivotal connection between the pivotable portion 110 and the proximal portion of the shaft 108 can be achieved in any of the following ways, such as by using a hinge joint (e.g., a living hinge or other hinge), a pivot pin fixed in a pivot hole, etc. In other implementations, the shaft 108 does not include a pivotable portion 110, such that the shaft 108 has a fixed zero angle along the longitudinal axis LA, and the arthroscope 100 has a fixed in-line design defined by the handpiece 120 and the shaft 108.

[0055] As described above, the arthroscope 100 is configured for use in arthroscopic surgical procedures. Therefore, the shaft 108 may have a size that facilitates its use in arthroscopic surgical procedures in which the joint is minimally invasively examined and / or operated upon. For example, the outer diameter of the shaft 108 may range from about 3 mm to about 8 mm. In another embodiment, the outer diameter of the shaft 108 may range from about 5 mm to about 7 mm. In yet another embodiment, the outer diameter of the shaft 108 may be about 6 mm. Those skilled in the art will understand that the values ​​may not be exact, but nevertheless, they can be considered approximate due to any number of factors such as manufacturing tolerances and the sensitivity of the measuring instrument.

[0056] In exemplary implementations, the shaft 108 is made from one or more biocompatible materials, and the handpiece 120 is made from one or more biocompatible materials. Examples of biocompatible materials that may be used for the shaft 108 and / or handpiece 120 include stainless steel, e.g., Grade 316 or 304 stainless steel, and thermoplastic materials, e.g., polycarbonate, acrylonitrile butadiene styrene (ABS), polycarbonate / ABS (PC / ABS) blends, etc. In exemplary implementations where the shaft 108 and handpiece 120 are made from thermoplastic materials, the shaft 108 and handpiece 120 may include extruded thermoplastic tubing having conduits for communicating electrical and fluid circuits. To simplify the structure of the arthroscope 100, it is practical to co-extrude different materials, such as wires and fiber optic cables.

[0057] The handpiece assembly 104 of the arthroscopic medical instrument 100 is configured to be held in one hand by the user for operating and maneuvering the arthroscope 100. In one exemplary implementation, the handpiece assembly 104 includes a substantially cylindrical handpiece 120. Those skilled in the art will understand that the shape may not be exactly cylindrical, but may nevertheless be considered substantially cylindrical due to any number of factors such as manufacturing tolerances and the sensitivity of measuring instruments. The substantially cylindrical shape of the handpiece 120 may facilitate the handling of the arthroscopic instrument 100 by providing a shape that is easy for the user to hold firmly in one hand. However, the handpiece 120 may have other shapes, such as bulbous or pear-shaped or hourglass-shaped. As described above, in one exemplary implementation, the handpiece 120 is substantially symmetrical about the longitudinal axis LA, which can be achieved by shapes such as cylindrical, bulbous or pear-shaped, and hourglass-shaped.

[0058] The handpiece 120 includes a distal end 122A and a proximal end 122B, with a longitudinal axis LA extending between the distal end 122A and the proximal end 122B.

[0059] The handpiece 120 includes at least one input actuator 124 configured to control various functions of the arthroscopy medical instrument 100. As in this exemplary implementation, the handpiece 120 may include a plurality of input actuators 124 arranged on the surface of the handpiece 120 to facilitate user access to the plurality of input actuators 124. The plurality of input actuators 124 are arranged circumferentially on the handpiece 120 such that the input actuators 124 completely surround the handpiece 120. This circumferential arrangement of the input actuators 124 allows the surgeon or other user of the arthroscope 100 to easily interact with the input actuators 124 regardless of the rotational position of the handpiece 120. The input actuators 124 are configured to actuate functions of the arthroscopy medical instrument 100, such as providing irrigation fluid through one of the lumens of the shaft 108. The input actuator 124 can have various configurations, such as a button configured to be actuated by being pressed by a user (as in this exemplary implementation where multiple buttons are arranged circumferentially around the handpiece 120), a lever or switch configured to be actuated by being moved by a user from a first position to a second position, a dial configured to be rotated by a user from a first position to a second position, or a slider configured to be actuated by sliding within a channel from a first position to a second position.

[0060] The handpiece 120 includes an action actuator 126 positioned on the handpiece 120, as also shown in Figures 4A and 4B. The action actuator 126 and input actuators 124 are positioned on the handpiece 120 so as to allow the user to operate the input actuators 124 and the action actuator 126 with one hand holding the handpiece 120 without requiring a second hand to activate any of the input actuators 124 or the action actuator 126, thereby freeing the user's second hand for other surgical tasks, and eliminating the need for the user to put down and readjust their grip on the handpiece 120 between the activation of an input actuator 124 and the activation of an action actuator 126, thereby saving time during the execution of a surgical procedure, and / or allowing the desired action to occur more quickly because there is no need to change the grip on the handpiece 120 to trigger the desired action.

[0061] The actuation actuator 126 is configured to actuate a pivotable portion 110 of the shaft 108. In one exemplary implementation, the actuation actuator 126 actsuate an actuation force along an actuation member 131, such as a wire or rod, extending through one of the lumens 184, 186, or 188 of the shaft 108, to the pivotable portion 110 located at the distal end 107A of the shaft 108. The actuation actuator 126 can have various configurations. As in this exemplary implementation, the actuation actuator 126 may include a slider located in a channel 128 on the handpiece 120, the slider 126 being actuated by sliding longitudinally within the channel 128. Other examples of the actuation actuator 126 include a button configured to be actuated by being pressed by a user, a lever or witch configured to be actuated by being moved by a user from a first position to a second position, and a dial configured to be rotated by a user from a first position to a second position.

[0062] Channel 128 includes a gap 127 located at the bottom of channel 128. The gap 127 is configured to allow the operating actuator 126 to be fixed to the actuarial member 131 via a mount 133. The actuarial member 131 is a wire in this exemplary implementation. The wire 131 extends longitudinally along the arthroscope 100, and more specifically distally from the handpiece 120, through a third lumen 184 of the shaft 108 to the pivotable portion 110 of the shaft 108. However, as described above, the actuarial member 132 may extend through a fourth lumen of the shaft 108 instead of through the third lumen 184 through which one or more electrical connectors extend. The actuarial member 131 is fixed to the pivotable portion 110, for example, with the distal end of the actuarial member 131 attached to the proximal end of the pivotable portion 110.

[0063] Figure 4C shows one embodiment in which a mount 133 is used to secure an actuation member 131 to an actuation actuator 126. The actuation actuator 126 includes an upper part 126U and a lower part 126L configured to be handled by the user, the lower part 126L having an opening 126G formed therein. The mount 133 includes an upward-extending pin 133P that extends through the opening 126G and is configured to be firmly seated in the opening formed in the upper part 126U (hidden in Figure 4C) by press-fitting, by using adhesive, etc. In this exemplary implementation, a spring 133S is wound around the pin 133P, which may help to secure the pin 133P within the upper opening.

[0064] Figures 1 and 4A show the actuation actuator 126 in a first position, corresponding to the pivotable portion 110 being unpivoted. When the actuation actuator 126 is in the first position, the wire 131 is untensioned. The default state of the wire 131 is untensioned, which allows the default state of the actuation actuator 126 to be the first position. Figure 4B shows the actuation actuator 126 in a second position, corresponding to the pivotable portion 110 being pivoted. When the actuation actuator 126 is actuated and moves from the first position to the second position, for example, when a user moves the slider 126 proximal along the channel 128, the mount 133 operably coupled to the actuation actuator 126 also moves proximal. Therefore, the proximal movement of the actuation actuator 126 also applies tension to the wire 131 operably coupled to the mount 133. Tension is applied to the wire 131 in the first longitudinal direction of movement MD1, which is the proximal direction in this exemplary implementation. The tension causes the pivotable portion 110 to pivot at the pivot point 112 by the wire 131 pulling proximal on the pivotable portion 110. Similarly, when the operating actuator 126 moves in a second longitudinal direction of movement opposite to the first longitudinal direction of movement MD1, for example distally, from a second position to a first position, the tension in the wire 131 decreases. The decreasing tension causes the pivotable portion 110 to pivot back toward the inline position that the pivotable portion 110 reaches when the operating actuator 126 reaches its first position.

[0065] The default state of the motion actuator 126 allows the motion actuator 126 to be in the first position without requiring the surgeon or other user to hold the motion actuator 126 in the first position. Thus, the pivotable portion 110 can remain in line unless otherwise desired by the surgeon or other user. The motion actuator 126 may be configured to be manually held in any position within the channel 128 up to a second position, including the second position, thereby allowing the pivotable portion 110 to pivot to the maximum possible angular position at any angle with respect to the longitudinal axis LA. Alternatively or additionally, the motion actuator 126 may be configured to lock in a predetermined position within the channel 128 at one or more preset positions. For example, the arthroscope 100 may include a locking mechanism configured to lock the motion actuator 126 in the second position. The locking mechanism may have any of a variety of configurations. For example, the locking mechanism may include a protrusion formed on one of the shaft 108 and the operating actuator 126, which automatically and releasably engages with a recess formed in the other of the shaft 108 and the operating actuator 126, and is configured to automatically disengage from each other when the operating actuator 126 is moved from a second position. In another embodiment, the locking mechanism may include a clip on one of the shaft 108 and the operating actuator 126, which automatically and releasably engages with a portion of the other of the shaft 108 and the operating actuator 126, and is configured to automatically disengage the portion when the operating actuator 126 is moved from a second position. In yet another embodiment, the locking mechanism may include a first magnet on or within the operating actuator 126 and a second magnet on or within the shaft 108, configured to magnetically engage with the first magnet when within operable distance of the first magnet, so that the operating actuator 126 is held in a second position when the first and second magnets are magnetically attracted to each other and can be released from the second position by moving the operating actuator 126 from the second position toward the first position.Regardless of the configuration of the locking mechanism configured to lock the actuation actuator 126 to a second position, the actuation actuator 126 may be configured to be manually held in any selected position between the first position and the second position. Alternatively, the actuation actuator 126 may be configured to lock in one or more additional positions between the first position and the second position. For example, the locking mechanism may include a protrusion formed on one of the shaft 108 and the actuation actuator 126, configured to automatically and releasably engage with each of a plurality of recesses formed in the other of the shaft 108 and the actuation actuator 126, each recess corresponding to a different position in which the actuation actuator 126 can be locked. In another embodiment, the locking mechanism may include a recess formed in one of the shaft 108 and the actuation actuator 126, configured to automatically and releasably engage with each of a plurality of protrusions formed on the other of the shaft 108 and the actuation actuator 126, each protrusion corresponding to a different position in which the actuation actuator 126 can be locked. In yet another embodiment, the locking mechanism may include a first magnet on or within the operating actuator 126 and a plurality of additional magnets on or within the shaft 108, configured to magnetically engage with the first magnet when within an operable distance of the first magnet, so that the operating actuator 126 is held in place when the first magnet is magnetically attracted to one of the plurality of additional magnets.

[0066] As described above, the actuation actuator 126 is shown as a slider in Figures 1, 4A, and 4B. Figures 5A and 5B show another implementation example of the actuation actuator 126 in the form of a pair of buttons 226A, 226B located within the handpiece 220. The handpiece 220 is configured and used in the same way as the handpiece 120. In this exemplary implementation, the actuation member 231, which is a wire configured and used in the same way as the wire 131, is fixed within the handpiece 220 via a mount 235, which is configured and used in the same way as the mount 133. Each of the buttons 226A, 226B includes tensioners 233A, 233B. The tensioners 233A, 233B are configured to selectively engage with the wire 231 to change the tension of the wire 231, thereby causing the pivotable portion 110 to pivot.

[0067] Figure 5A shows the actuation actuators 226A and 226B in a first position, corresponding to the pivotable portion 110 being unpivoted. When the actuation actuators 226A and 226B are in the first position, the wire 231 is untensioned. Figure 5B shows the actuation actuators 226A and 226B in a second position, corresponding to the pivotable portion 110 being pivoted. When the actuation actuators 226A and 226B are in the second position, the wire 231 is under tension. When the actuation actuators 226A and 226B are actuated, they move from the first position to the second position, and tension is applied to the wire 231, for example, when the user squeezes each of the buttons 226A and 226B radially inward in a first direction of movement MD2 which is substantially perpendicular to the longitudinal axis LA. More specifically, when buttons 226A and 226B are compressed, tensioners 233A and 233B move and come into contact with the wire 231, deforming the wire 231 against the curved convex surfaces of tensioners 233A and 233B facing radially inward, thereby creating tension within the wire 231. The deformation of the wire 231 applies a proximal force to the pivotable portion 110, thereby causing the pivotable portion 110 to pivot at the pivot point 112, similar to what is described above for the wire 131. When buttons 226A and 226B are released, the tension is released, allowing the pivotable portion 110 to pivot again at the pivot point 112 and return to its inline position.

[0068] The default state of the motion actuators 226A and 226B allows them to be in the first position without requiring the surgeon or other user to hold them in the first position. Thus, the pivotable portion 110 can remain in line unless otherwise desired by the surgeon or other user. The motion actuators 226A and 226B can be biased to their default state by biasing elements such as springs or elastic bands configured to bias the motion actuators 226A and 226B to the first position. For example, the arthroscope may include a first biasing element configured to bias the first button 226A radially outward so that the first button 226A is in the first position, and a second biasing element configured to bias the second button 226B radially outward so that the second button 226B is in the first position.

[0069] The motion actuators 226A and 226B may be configured to be manually held in any position up to a second position, including the second position, thereby allowing the pivotable portion 110 to pivot at any angle with respect to the longitudinal axis LA to the maximum possible angular position. Alternatively or additionally, the motion actuators 226A and 226B may be configured to lock in place relative to the handpiece 220 at one or more preset positions. For example, the arthroscope may include a locking mechanism configured to lock the motion actuators 226A and 226B in the second position. The locking mechanism may have any of the various configurations described above with respect to the motion actuator 126. Regardless of the configuration of the locking mechanism configured to lock the motion actuators 226A and 226B in the second position, the motion actuators 226A and 226B may be configured to be manually held in any selected position between the first position and the second position. Alternatively, the actuation actuators 226A and 226B may be configured to lock into one or more additional positions between the first position and the second position, similar to those described above with respect to the actuation actuator 126.

[0070] Figures 6A and 6B show another implementation example of the actuation actuator 126 as an actuation actuator 326 in the form of a rotatable dial positioned within the handpiece 320. The handpiece 320 is configured and used similarly to the handpiece 120. The actuation actuator 326 is movably seated within an opening 334 formed within the handpiece 320. In this exemplary implementation, the actuation member 331, which is a wire configured and used similarly to the wire 131, is fixed within the handpiece 320 by being fixed to the bottom 333 of the rotatable dial 320, which is positioned within the handpiece 320. Figures 6A and 6B show the wire 331 fixed to the mount 335 within the bottom 333 by being welded to the mount 335, being secured to the mount 335, or being crimped by the mount 335. The mount 335 may be the inner surface of the bottom 333 or may be a separate element fixed to the bottom 333. The base 333 contains an opening 336 located approximately 180° from the mount 335 around a rotatable dial 326. A wire 331 extends through the opening 336 and across the rotatable dial 326 within the base 333 and is fixed to the mount 335. The rotatable dial 326 is configured to be actuated by rotation, thereby changing the tension of the wire 331 and causing the pivotable portion 110 to pivot at the pivot point 112.

[0071] Figure 6A shows the operating actuator 326 in a first position, corresponding to the pivotable portion 110 not being pivoted. When the operating actuator 326 is in the first position, the wire 331 is untensioned, which allows the default state of the operating actuator 326 to be the first position. The default state of the wire 331 is untensioned, which allows the default state of the operating actuator 326 to be the first position. Figure 6B shows the operating actuator 326 in a second position, corresponding to the pivotable portion 110 being pivoted. When the operating actuator 326 is in the second position, the wire 331 is under tension. When the actuation actuator 326 is activated, it moves from a first position to a second position. For example, when the user rotates the rotatable dial in a first direction of movement MD3, tension is applied to the wire 331 as it deforms due to winding along the outer surface of the bottom 333 of the rotatable dial 326. This tension causes the wire 331 to apply a proximal force to the pivotable portion 110, thereby causing the pivotable portion 110 to pivot at the pivot point 112, similar to what is described above with respect to the wire 131. Releasing the rotatable dial 326 releases the tension, thereby causing the pivotable portion 110 to pivot again at the pivot point 112 and return to its inline position as the rotatable dial 326 rotates in a second direction of movement opposite to the first direction of movement MD3. In this exemplary implementation, the first direction of movement MD3 is counterclockwise and the second direction of movement is clockwise; however, the first direction of movement MD3 may also be clockwise, and the second direction of movement may also be counterclockwise.

[0072] The default state of the motion actuator 326 allows it to be in the first position without requiring the surgeon or other user to hold the motion actuator 326 in the first position. Thus, the pivotable portion 110 can remain in line unless otherwise desired by the surgeon or other user. The motion actuator 326 may be configured to be manually held in any position up to a second position, including the second position, thereby allowing the pivotable portion 110 to pivot to the maximum possible angular position at any angle with respect to the longitudinal axis LA. Alternatively or additionally, the motion actuator 326 may be configured to lock in place relative to the handpiece 320 in one or more preset positions. For example, the arthroscope may include a locking mechanism configured to lock the motion actuator 326 in a second position. The locking mechanism may have any of a variety of configurations, similar to those described above with respect to the motion actuator 126. Regardless of the configuration of the locking mechanism configured to lock the actuation actuator 326 to a second position, the actuation actuator 326 may be configured to be manually held in any selected position between the first position and the second position. Alternatively, the actuation actuator 326 may be configured to lock in one or more additional positions between the first position and the second position, similar to those described above with respect to the actuation actuator 126.

[0073] Figure 7 shows another implementation example of the actuation actuator 126 as an actuation actuator 426 in the form of a lever movably mounted on the handpiece 420 at a pivot point 435. The handpiece 420 is configured and used similarly to the handpiece 120. In this exemplary implementation, the actuation member 431, which is a wire configured and used similarly to the wire 131, is fixed within the handpiece 420 via a mount 433, which is configured and used similarly to the mount 133. The lever 426 is configured to be actuated by pivoting at a pivot point 435, thereby changing the tension of the wire 431 and causing the pivotable portion 110 to pivot at a pivot point 112.

[0074] Figure 7 shows the operating actuator 426 in a first position, corresponding to the pivotable portion 110 not being pivoted. When the operating actuator 426 is in the first position, the wire 431 is untensioned. When the operating actuator 426 is in a second position, corresponding to the pivotable portion 110 being pivoted, the wire 431 is under tension. When the operating actuator 426 is actuated, it moves from the first position to the second position, and tension is applied to the wire 431 when, for example, the user pushes the lever 426 toward the handpiece 420 in the first direction of movement MD4. More specifically, when the lever 426 is pushed radially inward toward the handpiece 420 and pivots at the pivot point 435, the mount 433 fixed to the lever 426 moves radially outward, thereby creating tension in the wire 431 by pulling it proximally. By pulling the wire 431, the wire 431 applies a proximal force to the pivotable portion 110, thereby causing the pivotable portion 110 to pivot at the pivot point 112, similar to what is described above with respect to the wire 131. Releasing the lever 426 releases the tension, thereby allowing the pivotable portion 110 to pivot again at the pivot point 112 and return to its inline position.

[0075] The default state of the motion actuator 426 allows it to be in the first position without requiring the surgeon or other user to hold the motion actuator 426 in the first position. Thus, the pivotable portion 110 can remain in line unless otherwise desired by the surgeon or other user. The motion actuator 426 may be configured to be manually held in any position up to a second position, including the second position, thereby allowing the pivotable portion 110 to pivot to the maximum possible angular position at any angle with respect to the longitudinal axis LA. Alternatively or additionally, the motion actuator 426 may be configured to lock in place relative to the handpiece 420 in one or more preset positions. For example, the arthroscope may include a locking mechanism configured to lock the motion actuator 426 in a second position. The locking mechanism may have any of a variety of configurations, similar to those described above with respect to the motion actuator 126. Regardless of the configuration of the locking mechanism configured to lock the actuation actuator 426 to a second position, the actuation actuator 426 may be configured to be manually held in any selected position between the first position and the second position. Alternatively, the actuation actuator 426 may be configured to lock in one or more additional positions between the first position and the second position, similar to those described above with respect to the actuation actuator 126.

[0076] Referring again to Figures 1 and 2, the cable assembly 106 of the arthroscope 100 is configured to provide various functions to the shaft 108 through the handpiece 120. The cable assembly 106 is operably coupled to the handpiece assembly 104 to provide such functions. As in this exemplary implementation, the proximal end 122B of the handpiece 120 may include a connector 129 that can be mated with the cable assembly 106. The cable assembly 106 includes an electrical conduit, an optical conduit, and a fluid conduit, each of which is a separate cable, and the handpiece 104 includes individual connectors 129 for each of the electrical conduit, optical conduit, and fluid conduit. Alternatively, each of the conduits may be formed within a single cable configured to be coupled to a single connector 129 of the handpiece 120. The connector 129 may be fixedly mated with the cable assembly 106, as in this exemplary embodiment, or the connector 129 may be configured to be releasably coupled to the cable assembly 106.

[0077] The handpiece 120 includes at least one internal lumen, for example, the same number of internal lumen as the shaft 108, for operably connecting the conduit of the cable assembly 106 to the internal lumen of the shaft 108. In this exemplary implementation, the cable assembly 106 includes a first cable 130 and a second cable 132. The first cable 130 includes a first conduit containing internal wires configured to transmit power and data to and from any sensor of the arthroscope 100, for example, any sensor located within the shaft 108 or the handpiece 120. The actuarial member 131 may also be located within the first conduit. The second cable 132 includes a second conduit configured to deliver irrigation fluid from a fluid source to the surgical site through one of the internal lumen 186 of the handpiece 120 and the shaft 108. The second cable 132 also includes a third conduit configured to deliver negative suction pressure to the surgical site through another one 188 of the internal lumens of the handpiece 120 and shaft 108.

[0078] As described above, the arthroscopic medical instrument 100 may include various sensors that can be placed within the shaft 108 and handpiece 120. As shown in Figure 2, the arthroscopic instrument 100 in this exemplary implementation includes an optical sensor 140 (e.g., a photodiode, phototransistor, photoresistor, optical fiber camera, or other optical sensor) configured to collect optical data, a pressure sensor 142 (e.g., a strain gauge, gauge pressure sensor, differential pressure sensor, or other pressure sensor) configured to collect pressure data, a temperature sensor 144 (e.g., a thermistor, thermocouple, thermistor, or other temperature sensor) configured to collect temperature data, and an inertial sensor 146 (e.g., an inertial measuring unit (IMU), gyroscope, accelerometer, tilt angle switch (mercury-free), or other inertial sensor) configured to collect orientation data. In other implementations, a single sensor, for example, a single chip with multiple sensor capabilities, may be configured to collect data on two or more parameters, so that one, two, or three sensors can be provided to collect optical, inertial, pressure, and temperature data. In yet another implementation, one or more of sensors 140, 142, 144, and 146 may be omitted. For example, the arthroscope 100 may include an optical sensor 140 and an inertial sensor 146, but may not include a pressure sensor 142 and / or a temperature sensor 144.

[0079] Figure 2 shows a light sensor 140, a pressure sensor 142, a temperature sensor 144, and an inertial sensor 146, all located within the pivotable portion 110 of the shaft 108. In this implementation example, sensors 140, 142, 144, and 146 are shown to be fully housed within the pivotable portion 110, which may help protect them from damage. However, at least one of sensors 140, 142, 144, and 146 may be partially housed within the pivotable portion 110 of the shaft 108, and / or (fully or partially) housed within the shaft 108 adjacent to the pivotable portion 100. The placement of the optical sensor 140, pressure sensor 142, temperature sensor 144, and inertial sensor 146 within (or partially within) the pivotable portion 110 facilitates the collection of useful and accurate data at the surgical site by the sensors 140, 142, 144, and 146, regardless of whether the pivotable portion 110 is articulated with respect to the longitudinal axis L at the pivot point 112, and regardless of the angle at which the pivotable portion 110 is articulated when it is articulated. For example, the placement of the optical sensor 140 within the pivotable portion 110 allows the optical sensor 140 to collect image data indicating at least the region in which the pivotable portion 110 is directed towards the surgical site (or, if the pivotable portion 110 is omitted, the shaft 108 is directed towards the surgical site), and a visual image of the surgical site can be output to a display when the shaft 108 is inserted into the surgical site. In another embodiment, the placement of pressure and temperature sensors 142 and 144 within the pivotable portion 110 allows the pressure and temperature sensors 142 and 144 to collect pressure and temperature data, respectively, at the site of interest where irrigation and / or aspiration is occurring, rather than at any location close to the site of interest where pressure and / or temperature may differ due to distance from the irrigation and / or aspiration. In surgical procedures where radiofrequency (RF) energy is applied to tissue, monitoring pressure data may be particularly important, for example, to help ensure that the RF energy is applied safely.Similarly, monitoring temperature can be particularly important in surgical procedures where RF energy is applied to tissue.

[0080] In some implementations, the arthroscope 100 includes first and second inertial sensors 146, the first inertial sensor 146 located in the pivotable portion 110, and the second inertial sensor 146 located within the handpiece 120, for example, entirely or partially disposed therein, or within the shaft 108, for example, entirely or partially disposed therein in close proximity to the pivotable portion 110. Regardless of whether the second inertial sensor 146 is located on the shaft 108 or in the handpiece 120, providing the second inertial sensor 146 proximal to the pivotable portion 110 can facilitate the determination of the arthroscope orientation by collecting orientation data in the pivotable portion 110 which can pivot at a pivot point 112, and in the shaft 108 or handpiece 120 which do not pivot with respect to the longitudinal axis LA (proximal to the pivot point 112).

[0081] The arthroscope 100 includes a lens 114 positioned distal to the optical sensor 140. The lens 114 is configured to protect the optical sensor 140 from damage by preventing direct contact between the optical sensor 140 and any fluids and / or solid materials at the surgical site. In some implementations, the lens 114 may provide optical features such as magnification to enhance the optical data collected by the optical sensor 140.

[0082] The arthroscope 100 includes a prism 115 positioned distal to the lens 114 and therefore distal to the optical sensor 140. The prism 115 is configured to provide a larger field of view of the optical sensor 140 than would be achievable without the prism 115. The prism 115 is located on a pivotable portion 110 of the shaft 108, thereby allowing the prism 115 to pivot together with the pivotable portion 110, and the optical sensor 140 and lens 114 attached thereto. In one exemplary implementation, the prism 115 is angled in the range of approximately 30° to approximately 70°. Arthroscopic hip surgery has conventionally involved the use of two scopes or other imaging devices, one having a fixed field of view of 30° and the other having a fixed field of view of 70°. The prism 115 and the pivotable portion 110 enable the arthroscope 100 to provide a 30° field of view and a 70° field of view, and as a result, one device can be used instead of two devices so that space can be freed up at the surgical site for other instruments and / or to provide better visualization opportunities and / or the number of incisions made in the patient can be reduced because it is not necessary to make two incisions for two different devices. In some implementations, the prism 115 is omitted, but an angular range of approximately 30° to approximately 70° can still be achieved with the arthroscope 100 via the pivot of the pivotable portion 110.

[0083] Exemplary implementations of the light sensor 140 include the OMV7695, OC01A10, and OH0A10 sensors, available from OmniVision Technologies, Inc. in Santa Clara, California, but other light sensors can also be used.

[0084] The handpiece 120 may include one or more image control actuators (e.g., buttons, levers, etc.) configured for one or more functions configured on the light sensor 140. For example, the handpiece 120 may include an image control actuator configured to act on the light sensor 140 to collect images and transmit the collected data to the control unit 160, for example, to trigger the control unit 160 to cause the light sensor 140 to collect still images on demand. In another embodiment, the handpiece 120 may include an image control actuator configured to act on the light sensor 140 to start or stop collecting video images, for example, to trigger the control unit 160 to turn the image data acquisition of the light sensor on and off.

[0085] In one exemplary implementation, the motion actuator 126 is configured to indicate the angular orientation of the prism 115 when the pivotable portion 110 of the arthroscope 100 is not pivoted (or when the pivotable portion 110 is omitted). As described above, the motion actuator 126 is located on the handpiece 120. The radial position of the motion actuator 126 around the circumference of the handpiece 120 corresponds to the direction in which the prism 115 is angled when the pivotable portion 110 of the arthroscope 100 is not pivoted (or when the pivotable portion 110 is omitted). Thus, a surgeon or other user of the arthroscope 100 can look at the motion actuator 126 located outside the patient's body and know the orientation of the prism 115 located inside the patient's body, which can help the surgeon or other user adjust the rotational position of the arthroscope 100 and / or the pivotal position of the pivotable portion 110.

[0086] Figure 8 shows an example of pivoting of the pivotable portion 110 of the arthroscopic medical instrument 100. In Figure 8, the pivotable portion 110 is shown in an inline position where it is not pivoted and labeled with reference number 110, and in Figure 8, the pivotable position where it is pivoted at pivot point 112 and labeled with reference number 110'. Although only one pivotable position is shown in Figure 8, numerous pivotable positions of the pivotable portion 110 are possible, as will be discussed herein.

[0087] Figure 8 also shows the field of view of the photosensor 140 corresponding to the pivotable portion 110 in the inline position (prism 115 labeled reference number 115) and in the pivoted position (prism 115 labeled reference number 115'). With the pivotable portion 110 in the inline position, the photosensor 140 has a field of view VA2, which is approximately 90° in this exemplary implementation, but may be a different angle assuming a particular configuration of the photosensor. The prism 115 allows the field of view VA2 to be larger than it is possible without the prism 115. Without the prism 115, the field of view of the photosensor 140 is a smaller field of view VA1, which is approximately 30° in this exemplary implementation, but may be a different angle assuming a particular configuration of the photosensor. Thus, the prism 115 is configured to increase the field of view of the photosensor 140. In one exemplary implementation, the prism 115 is angled in the range of approximately 30° to approximately 70°, thereby increasing the field of view of the light sensor. In this exemplary implementation, the prism 115 is angled at approximately 60° to increase the field of view of the light sensor by approximately 60°, for example, from approximately 30° to approximately 90°.

[0088] When the pivotable portion 110' is in the pivot position, the light sensor 140 still has a field of view VA2' of approximately 90°, which is an increase from the smaller field of view VA1' of approximately 30° achieved without the prism 115'. Combined with the pivoting of the pivotable portion 110, by positioning the prism 115 distal to and above the light sensor 140, the light sensor 140 can acquire images at angles of approximately 90° from the longitudinal axis LA, and in some implementations, at angles greater than approximately 90°. For example, as in this exemplary implementation where the pivotable portion 110' is in the pivot position, a field of view VA2' of approximately 90° allows the light sensor 140 to acquire images at angles greater than approximately 90° from the longitudinal axis LA.

[0089] Referring again to Figures 1 and 2, the optical sensor 140, pressure sensor 142, temperature sensor 144, and inertial sensor 146 are operably coupled to the control unit 160 via an electrical connector in the form of a cable 148. The cable 148 passes through one of the internal lumens of the shaft 108, through the handpiece 120, and to the first cable 130 of the cable assembly 106, enabling the transmission of power and data as described above.

[0090] As shown in Figure 2, each of the cables 130 and 132 is operably coupled to the control unit 160. The control unit 160 includes a processor 162, a memory 164, a storage device 166, and a system bus 168 interconnecting the processor 162, memory 164, and storage device 166 of the control unit 160. The processor 162 is configured to provide control functions for the control unit 160 by executing instructions stored in the memory 164 and / or on the storage device 166. In some implementations, the processor 162 is a single-threaded processor. In other implementations, the processor 162 is a multi-threaded processor. The memory 164 is configured to store information and is a computer-readable medium such as a volatile memory unit or a non-volatile memory unit. The storage device 166 is configured to provide mass storage for the control unit 160 and is a computer-readable medium such as a floppy disk device, hard disk device, optical disk device, tape device, or non-volatile solid-state memory. In one exemplary implementation, memory 164 is configured to store pre-programmed instructions configured to be executed by processor 162, and storage device 166 is configured to store collected sensor data. As discussed herein and as indicated by arrows on the first cable 130 and electrical connector 148 in Figure 2, data collected by sensors 140, 142, 144, and 146 may be provided to control unit 160, and processor 162 may cause this data to be stored in storage device 166. Control unit 160 may also be configured to provide instructions to one or more of sensors 140, 142, 144, and 146 via cables 130 and 148, such as instructions to collect data and provide the collected data to control unit 160.

[0091] The control unit 160 is operably coupled to a display unit 172, such as a CRT screen, LCD screen, or touchscreen, configured to display information. The display unit 172 is operably coupled to the processor 162 of the control unit via a cable 174, enabling the processor 162 and the display unit 172 to communicate with each other. Although the arrows on the cable 174 in Figure 2 only show the data flow from the control unit 160 to the display unit 172, the display unit 172 may be configured to transmit data to the control unit 160, such as error information or user input entered by the user via the user interface of the display unit 172 (e.g., buttons, touchscreen, etc.). The control unit 160 is configured to provide the display unit 172 with display commands and data to display, such as commands for displaying an optical image from the light sensor 140, commands for displaying pressure information collected by the pressure sensor 142, commands for displaying temperature information collected by the temperature sensor 144, and commands for displaying orientation information from the inertial sensor 146, using a processor 162, for example. Instead of a wired connection using cable 174, the control unit 160 may be configured to communicate wirelessly with the display unit 172, either additionally or alternatively. In some implementation examples, the display unit 172 and the control unit 160 may be part of the same computer system, such as a single electronic tablet or a single laptop computer.

[0092] The control unit 160, for example, its processor 162, is configured to determine the orientation of the photosensor 140 using orientation data collected by the inertial sensor 146. In one exemplary implementation, the orientation data measured by the inertial sensor 146 includes angular orientation data and axial orientation data. Collecting angular orientation data and axial orientation data facilitates the control unit 160 to accurately determine the orientation of the photosensor 140 by enabling the determination of the rotation of the photosensor, for example, whether the photosensor 140 is rotating about the X-axis, the Y-axis, or the Z-axis, and the translation of the photosensor, for example, whether the photosensor 140 is translating along the X-axis, the Y-axis, or the Z-axis.

[0093] As described above, the control unit 160 is configured to receive optical image data from the light sensor 140 and orientation data from the inertial sensor 146, and may be configured to modify the optical image data using the orientation data. The modification includes rotating the optical image output to the display unit 172 to maintain the displayed optical image in a desired orientation during and after the rotation of the handpiece 120, for example, while the handpiece 120 is rotating around the longitudinal axis LA. In one exemplary implementation, the desired orientation is upright, but could be another orientation such as sideways.

[0094] As shown in Figure 2, multiple input actuators 124 are operably coupled to a control unit 160 via a cable 150 which is operably coupled to a first cable 130. The connection between the input actuators 124 and the control unit 160 allows a surgeon or other user to deliver irrigation fluid to the surgical site by activating one of the input actuators 124, for example, the one that is most easily accessible to the user, assuming the user's current hand position relative to the handpiece 120 and therefore to the input actuator 124. The activation of any one of the input actuators 124 is configured to send an input activation signal from the activated input actuator 124 along the cable 150 and then along the first cable 130 to the control unit 160, for example, its processor 162. In response to receiving an input activation signal from the control unit, the control unit 160, for example, the processor 162, is configured to cause the pump 134 to transmit an activation signal along the third cable 170 (or, instead of along the third cable 170, along the wireless connection between the pump 134 and the control unit 160). The pump 134 is fluidically coupled to an external fluid source 136 located outside the arthroscope 100. In response to receiving the activation signal, the pump 134 is configured to pump irrigation fluid from the fluid source 136 to the arthroscope 100, particularly to the handpiece 120, and then through one of the internal lumens of the shaft 108, and from the shaft 108 to the surgical site. In the exemplary implementation shown in Figure 2, the pump 134 is outside the control unit 160, but may be integrated with the control unit 160.

[0095] Pump 134 is configured to continue pumping fluid from the fluid source 136 to the arthroscope 100 until it receives a stop signal from the control unit 160. Thus, fluid can be continuously supplied to the surgical site. The control unit 160 is configured to send a stop signal to pump 134 in response to the surgeon / user release of the activated input actuator 124. The surgeon / user release of the activated input actuator 124 stops the input signal from being sent from there to the control unit 160 and / or causes the deactivated input actuator 124 to send a deactivation signal to the control unknit 160, thereby triggering the control unit 160 to send a stop signal to pump 134. For example, if the input actuator 124 is in the form of a button, the surgeon or other user can press the button down to initiate the flow of irrigation fluid and release the pressed button to stop the flow of irrigation fluid. In another embodiment, if the input actuator 124 is in the form of a lever, the surgeon or other user can move the lever from a first position to a second position to induce a flow of irrigation fluid, and move the lever from the second position back to the first position to stop the flow of irrigation fluid.

[0096] In other implementations, a first actuation of one selected input actuator 124 is configured to trigger a control unit 160 to send an actuation signal to the pump 134, and a second actuation of one selected input actuator 124 (same as or different from the input actuator 124 actuated by the first actuation) is configured to trigger a control unit 160 to send a stop signal to the pump 134. Thus, the surgeon or other user does not need to operate continuously (e.g., by holding down a button, applying pressure to a lever) to ensure that the fluid is continuously pumped to the surgical site, thereby reducing hand fatigue and / or facilitating rotation of the arthroscope 100 while the fluid is being pumped to the surgical site.

[0097] Figure 9 shows an arthroscopic medical instrument 100 inserted into the patient and up to the surgical site 10. In this exemplary implementation, the surgical site 10 is located in the patient's shoulder, but it may be in another location such as the hip or knee. As shown in Figure 9, the shaft 108 is inserted arthroscopically through an incision in the patient's skin and positioned at the surgical site 10 together with the distal portion of the medical instrument 100. An optical sensor 140 is located on the pivotable portion 110 of the shaft 108, allowing the surgeon to observe the surgical site 10 on the display unit 172. To observe different parts of the surgical site 10, the surgeon or other user handling the arthroscope 100 can tilt the shaft 108 within the incision, the surgeon or other user handling the arthroscope 100 can rotate the handpiece 120 and shaft 108 (including the pivotable portion 110) around the longitudinal axis LA, and / or the surgeon or other user handling the arthroscope 100 can pivot the pivotable portion 110 by operating the action actuator 126.

[0098] As shown in Figure 9, the secondary tool 12 can be inserted into the patient and up to the surgical site 10. In this exemplary implementation, the secondary tool 12 is a shaver, but other secondary tools such as a second arthroscope may be used. The shaver 12 includes a suction conduit 14 configured to remove materials such as shaved tissue, shaved bone, and irrigation fluid from the surgical site 10 through its interior. The same user can handle the arthroscope 100 and the secondary tool 12 simultaneously by holding the arthroscope 100, for example, its handpiece 120, in one hand and the secondary tool 12, for example, its handle 16, in the other hand.

[0099] Figure 10 shows an exemplary method 200 for operating an arthroscopic medical instrument. Method 200 is described with respect to the arthroscopic medical instrument 100 of Figures 1 and 2, but other implementations of the arthroscopic medical instrument described herein may be used similarly. Generally, Method 200 can be used when performing arthroscopic procedures in which the surgical site is accessed by the arthroscopic medical instrument 100, and optical image data output from the optical sensor 140 is modified based on orientation data from the inertial sensor 146, and the modified optical image is output to the display unit 172 so that the display unit 172 continuously displays the surgical site in the desired orientation.

[0100] Method 200 includes a user, such as a surgeon, accessing a surgical site with an arthroscopic medical instrument 100 by inserting the distal end 107A of the shaft 108 into the patient and to the surgical site 202. Method 200 also includes the user rotating the handpiece 120 around the longitudinal axis LA 204, thereby rotating the shaft 108 (including the pivotable portion 110 on which sensors 140, 142, 144, and 146 are located) while maintaining the image of the surgical site shown on the display unit 172 in a desired orientation 204. In order for the image to remain in the desired orientation, the optical image data received by the control unit 160 from the optical sensor 140 is corrected by the control unit 160 using orientation data provided to the control unit 160 from the inertial sensor 146. For example, when the optical sensor 140 is first activated, the control unit 160 uses orientation data from the inertial sensor 146 to determine the zero rotation point on which the optical sensor 140 is oriented upright. As the handpiece 120 rotates along the longitudinal axis LA, the control unit 160 can measure the angular position of the optical sensor 140 from the zero rotation point based on the collected orientation data. Before outputting an image of the surgical site to the display 172, the control unit 160 corrects the image by rotating it by an angular amount around the longitudinal axis LA where the angular position of the optical sensor 140 from the zero rotation point is the same as indicated by the orientation data collected by the inertial sensor 146. Since the optical sensor 140 is configured to transmit the collected optical image data to the control unit 160 in real time as it is collected, the correction of the optical image data by the control unit is performed in real time as the optical image data is collected. The inertial sensor 146 is also configured to transmit its collected orientation data to the control unit 160 in real time. Therefore, there is little to no delay between the rotation of the handpiece 120 and shaft 108 and the output of the corrected image to the display unit 172.

[0101] Pressure and temperature sensors 142 and 144 may also be configured to collect and transmit their respective collected pressure and temperature data in real time, so that the pressure and temperature information can be displayed in real time on the display unit 172, which helps to provide accurate and up-to-date information to surgeons and / or other healthcare professionals monitoring the information displayed on the display unit 172.

[0102] Figures 11A-11C show one implementation example of the rotation of the handpiece 204 and the maintenance of the image 182 in the desired orientation on the display unit 172 204. Image 182 is a smile in Figures 5A-5C for illustrative purposes and to facilitate understanding, but in use it would be an image of the surgical site 10.

[0103] As shown in Figure 11A, the angular position AP of the optical sensor 140 is positioned at the zero rotation point ZR, and for example, the angular position AP of the optical sensor is aligned with the zero rotation point ZR. This relative positioning corresponds to the initial activation of the optical sensor 140, for example, when power is first supplied to the optical sensor 140 during a surgical procedure and / or when the control unit 160 causes the optical sensor 140 to start acquiring optical data for the first time during a surgical procedure. When the angular position AP of the optical sensor 140 is aligned with the zero rotation point ZR, the image data is already in the desired orientation when acquired, so the control unit 160 does not need to correct the acquired optical image. The zero rotation point ZR is depicted as a reference image 180 on the display unit 172, which also shows the optical image 182. In one exemplary implementation, image 180 is displayed on the display unit 172 to show the surgeon and / or other medical personnel how much the optical sensor 140 is rotated from the zero rotation point ZR. However, in some implementations, the reference image 180 is not displayed on the display unit 172, which may help reduce clutter on the display unit 172. In this exemplary implementation, the reference image 180 is star-shaped, but may also have other forms such as a spirit level (artificial spirit level) similar to those on aircraft instruments, a circle, a triangle, text (e.g., "zero", "zero point", "reference", "ZR", etc.), a square, or a house (home) icon. In this exemplary implementation, the desired orientation is upright, as indicated by an upright-oriented smile with the eyes at the top and the mouth at the bottom, but other orientations are also possible, such as a rightward sideways orientation with the eyes on the right and the mouth on the left, or a leftward sideways orientation with the eyes on the left and the mouth on the right.

[0104] When the handpiece 120 is rotated in the rotational direction RD about the longitudinal axis LA from the position shown in Figure 11A, the optical sensor 140 also rotates about the longitudinal axis LA. In the exemplary implementation shown in Figure 11A, the rotational direction RD is clockwise, but it may also be counterclockwise. When the optical sensor 140 is rotated in the rotational direction RD, the angular position AP of the optical sensor 140 is no longer aligned with the zero rotation position ZR, resulting in an angular displacement AD of the optical sensor 140 from the zero rotation position ZR, as shown in Figure 11B. The control unit 160 is notified of the angular displacement AD by orientation data collected by the inertial sensor 146 and transmitted to the control unit 160. Figure 11B shows an angle of approximately 90° between the zero rotation point ZR and the angular position AP of the optical sensor 140, assuming an angular displacement of approximately 90°, but other angular displacements AD are possible. The control unit 160 modifies the optical image data transmitted from the optical sensor 140 to the control unit 160 based on orientation data from the inertial sensor 146, for example, based on the angular displacement AD. Figure 11B shows the modified image 182 and reference image 180 on the display unit 172. The zero rotation point ZR represented by reference image 180 has been rotated by approximately 90° on the display unit 172 from its initial position shown in Figure 11A, but image 182 remains in the desired orientation compared to image 182 shown in Figure 11A, where the angular displacement AD is 0°.

[0105] When the handpiece 120 is further rotated in the rotational direction RD about the longitudinal axis LA from the position shown in Figure 11B, the control unit 160 modifies the image 182 accordingly for display on the display unit 172. Figure 11C shows an angle of approximately 180° between the zero rotation point ZR and the angular position AP of the optical sensor 140, assuming an angular displacement AD of approximately 180°, but other angular displacements AD are possible as described above. The zero rotation point ZR, represented by reference image 180, is rotated approximately 180° on the display unit 172 from its initial position shown in Figure 11A, and approximately 90° on the display unit 172 from its first intermediate position shown in Figure 11B, while the image 182 of its second intermediate position shown in Figure 11C remains in the desired orientation compared to the images 182 shown in Figures 11A and 11B.

[0106] The control unit 160 is configured to continuously update the display unit 172 as the arthroscope 100 is rotated, so that the image 182 remains in the desired orientation and the reference image 180 (if present on the display unit 172) is precisely positioned relative to the image 182. The control unit 160 is also configured to continuously update the display unit 172 in other ways, such as by updating the image 182 when zooming in, zooming out, or when different elements move into and out of the field of view of the optical sensor, while maintaining the image 182 in the desired orientation on the display unit 172 and the reference image 180 in the same relative position to the image 182 on the display unit 172.

[0107] Referring again to Figure 10, method 200 also includes measuring the temperature of the surgical site 10 using the temperature sensor 144 of the arthroscope 100 206, and measuring the pressure of the surgical site 10 using the pressure sensor 142 of the arthroscope 100 208. The temperature and pressure measurements are transmitted to the control unit 160 as described above, and the control unit may output the pressure and temperature information to the display unit 172 for real-time display on the display unit 172.

[0108] The method 200 shown in Figure 10 shows that the arthroscope rotation 202 occurs before the temperature measurement 204 and the temperature measurement 206 occurs before the pressure measurement 206. However, the rotation 202, temperature measurement 204, and pressure measurement 206 may occur in any other order, and the same action (e.g., rotation 202, temperature measurement 204, or pressure measurement 206) may occur two or more times in succession before any of the other two actions 202, 204, or 206 occurs, and each may occur multiple times throughout the execution of the surgical procedure.

[0109] Accessing the surgical site 202 with the arthroscopic medical instrument 100 may involve the use of an insertion tool. Generally, insertion tools can facilitate the safe and easy guidance of the arthroscopic medical instrument 100 into the surgical site. Insertion tools may have a variety of configurations.

[0110] Figures 12A and 12B show an example implementation of an insertion tool 600 configured to facilitate the insertion of an arthroscope, such as arthroscopic medical device 100 or other arthroscopic medical devices described herein, into a surgical site. The insertion tool 600 includes an occlusion device 602 and a guide member 604 (also referred to herein as a “thread”) releasably fixed to the occlusion device 602. The occlusion device 602 may include a handle 603 and an elongated shaft 606 extending distally from the handle 603. The elongated shaft 606 includes a tapered distal end 607A. The handle 603 is configured to receive an insertion force applied distally, for example, by hand or by a tool that pushes distally against the handle 603, to insert the insertion tool 600 into the patient’s body and into the surgical site therein. The tapered shape of the distal end 607A of the shaft is configured to assist in the insertion of the insertion tool 600 into the patient's body by widening a pre-formed incision in the patient's skin, such as one made by cutting the skin with a scalpel or other cutting tool, as the insertion tool 600 advances through the incision. In other implementations, the tapered distal end 607A may include a sharp blade configured to form an incision in the patient's skin and then widen the incision as the insertion tool 600 advances through the incision.

[0111] The thread 604 includes a guide channel 610 that extends along its length. The guide channel 610 runs along the outer surface of the thread 604. The occlusion 602 is configured to be releasably seated within the guide channel 610 and releasably secured to the thread 604. The occlusion 602 and the guide channel 610 are sized and shaped such that the occlusion 602, which includes an elongated shaft 606 and a handle 603, is configured to be seated within the guide channel 610 in a friction fit. The friction fit between at least the thread 604 and the elongated shaft 606 may help ensure that the occlusion 602 and the thread 604 remain mated together during insertion of the insertion tool 600 into the patient's body and into surgical sites within the patient. As shown in Figures 12A and 12B, the configuration in which the handle 603 is seated within the guide channel 610 so as to be positioned proximal to the thread 604 can help ensure that the thread 604 and the occlusion device 602 remain fixed relative to each other as the insertion tool 600 is advanced distally into the patient's body and towards the surgical site. The occlusion device 602 is configured to be released from the thread 604, for example, by pulling the occlusion device 602 proximal to it with the handle 603, thereby sliding the occlusion device 602 out of the guide channel 610.

[0112] In one implementation of a method of using the insertion tool 600 with an arthroscope, such as arthroscope 100 or other arthroscopes described herein, the occlusion device 602 is released from the guide member 604 once the insertion tool 600 has advanced to a desired position at the surgical site. The occlusion device 602 is removed from the surgical site and from the patient's body by, for example, pulling the handle 603 proximal to move the occlusion device 602 through and out of the incision. The elongated shaft 606 slides proximal within the guide channel 610 during the removal of the occlusion device. After the occlusion device 602 has been released from the guide channel 610 and removed from the surgical site and from the patient's body, the guide member 604 remains positioned within the incision and at the surgical site. The guide member 604 has a length that allows the proximal portion of the guide member 604 to be located outside the patient's body and the distal portion of the guide member 604 to be located inside the patient's body, with the guide member 604 extending through the incision to the surgical site. Next, the shaft 108 of the arthroscopic medical instrument 100 or any other arthroscope described herein is seated in the guide channel 610 and slid distally to access the surgical site. The arthroscope 100 can later be released from the guide member 604, as described above with respect to the release of the insertion member 602 from the guide channel 610. The arthroscope 100 and / or one or more other tools are seated and slid within the guide channel 610 to access the surgical site. Because the guide member 604 keeps the incision partially open, the guide member 604 allows for the removal and reinsertion of the arthroscope 100 and / or other tools without the need to create a new incision.

[0113] As described above, in one exemplary implementation, whether a single connector or multiple connectors, the connector is configured to make all electrical, optical, and fluid connections for the arthroscope by connecting to multiple cables configured to provide electrical, optical, and fluid functions. The multiple cables are also configured to be operably coupled to a control unit. The connector is located at the distal end of the multiple cables, and the control unit is located at the proximal end of the multiple cables. Figures 1 and 2 show one such implementation in which the connector 129 is located at the distal end of a cable assembly 106 containing first and second cables 130, 132, and the control unit 160 is located at the proximal end of the cable assembly 106. Figures 1 and 2 show the connector 129 at the distal end of the cable assembly 106, and Figure 2 shows the proximal end of the cable assembly 106 operably coupled to the control unit 160.

[0114] Multiple cables can be configured to operably connect to a control unit in various ways. Figure 13 shows one implementation example of a cable connector 190 configured to operably connect to a control unit. The cable connector 190 is located at the proximal end of a cable assembly 191 and is configured to operably connect to a control unit, such as a control unit 700 (further discussed below) or other implementation examples of the control unit described herein. The cable assembly 191 is generally configured and used in the same way as the cable assembly 106 in Figures 1 and 2. The cable assembly 191 in this exemplary implementation includes a first cable 193 and a second cable 195. The first cable 193 includes a first conduit containing electric wires and is configured and used in the same way as described above with respect to the first cable 130 of the cable assembly 106. The second cable 195 includes a second conduit configured to provide irrigation fluid from a fluid source and is configured and used in the same way as described above with respect to the second conduit of the second cable 132 of the cable assembly 106. In this exemplary implementation, the second cable 195 does not include a third conduit for suction.

[0115] The cable connector 190 includes an electrical connector 192 and a fluid connector 194. The electrical connector 192 is configured to operably couple to a corresponding electrical connector on the control unit, and the fluid connector 194 is configured to operably couple to a corresponding fluid connector on the control unit. Figure 14 shows one example of an implementation of the electrical and fluid connectors of such a control unit. The electrical connector 192 is configured to operably couple to a corresponding electrical connector 702 at the cable port 704 of the control unit 700, which will be discussed further below. With the electrical connector 192 operably coupled to the electrical connector 702 of the control unit, the control unit 700 may supply power to the arthroscope 100 via the first cable 130, and data may be communicated from the arthroscope 100 to the control unit 700 and / or from the control unit 700 to the arthroscope 100 via the first cable 191. The fluid connector 194 is configured to operably couple to the corresponding fluid connector 706 at the cable port 704 of the control unit 700. With the fluid connector 194 operably coupled to the fluid connector 706 of the control unit, the control unit 700 can provide fluid injection via the second cable 193.

[0116] The cable connector 190 also includes a fixing member 196 configured to facilitate a secure and releasable connection of the cable connector 190 to the control unit 700. As shown in the implementation example in Figure 14, the control unit 700 may include a corresponding fixing member 708 of the cable port 704, configured to engage securely and releasably with the fixing member 196. One of the fixing members 196, 708 of the cable connector 190 and the control unit 700 may include male members, such as pins, pointed ends, etc., while the other fixing member 196, 708 of the cable connector 190 and the control unit 700 may include female members of corresponding size and shape, such as holes, blind bores, etc.

[0117] The control unit, configured to be removably connected to the cable connector 190, can have various configurations as described above. Figure 2 schematically shows one implementation example of such a control unit 160. The control unit 700 in Figures 15 and 16 is one implementation example of the control unit 160.

[0118] In the exemplary implementations shown in Figures 15 and 16, the control unit 700 includes a pump, but in other implementations, the pump may be a separate unit configured to be operably coupled to the control unit, as shown in Figure 2, which has a pump 134 and a control unit 160. In this exemplary implementation, the pump of the control unit 700 includes a peristaltic pump, but the pump may have other configurations. The pump of the control unit 700 is generally configured and used similarly to the pump 134 in Figure 2. The control unit 700 is configured to be releasably coupled to a cartridge (also referred to herein as a “cassette”) configured to be operably coupled to the pump of the control unit 700. Figure 16 shows one implementation example of such a cartridge 710. The control unit 700 includes a cartridge holder 712 configured to releasably seat the cartridge 710 inside. In this exemplary implementation, the cartridge 710 and the cartridge holder 712 have complementary rectangular shapes, but they may have other complementary shapes. Figure 16 shows a cartridge 710 that is not yet seated in the cartridge holder 712. Arrow 714 indicates the direction in which the cartridge 710 is inserted into the cartridge holder 712. Once the cartridge 710 is seated in the cartridge holder 712, it is configured to be removed from the cartridge holder 712 in the direction opposite to that of arrow 714.

[0119] The tubing 716 extends from the cartridge 710 and is configured to be coupled to a fluid source that is generally configured and used similarly to the fluid source 136 in Figure 2. With the cassette 710 operably coupled to the control unit 700, the pump of the control unit 700 is configured to pump fluid from the fluid source through the tubing 716 to the fluid connector 706, and from the control unit 700 through the fluid connector 706 into the fluid connector of the cable assembly 106, through which the fluid is pumped into a second cable 193, for example, its second fluid conduit, for output from the arthroscope 100. The cassette 710 can have various configurations. Exemplary implementations of the cassette are further described in U.S. Patent No. 7,857,792, issued December 28, 2010, entitled “Cassette For Irrigation Or Aspiration Machine For Endoscopy,” which is incorporated herein by reference in its entirety.

[0120] The tubing 716 is in fluid communication with the outlet port 718 of the cartridge 710. The control unit 700 includes an inlet port (not clearly visible in Figure 16) configured to be operably coupled to the outlet port 718 in a fluid-sealed relationship. With the cartridge 710 coupled to the control unit 700, the outlet port 718 is configured to be in fluid communication with the fluid connector 706 of the control unit. Thus, fluid can be pumped from the fluid source through the tubing 716 into the cartridge 710, from the cartridge 710 through the outlet port 718 into the control unit 700, and from the control unit 700 through the fluid connector 706.

[0121] Cartridge 710 is disposable, for example, to be discarded as medical waste, or to be fully or partially recycled. Therefore, cartridge 710 may be discarded after a single use, for example, after being used on a patient in a surgical procedure. Control unit 700 is configured to be reusable and therefore may be used in multiple surgical procedures performed on different patients, each time. Control unit 700 typically includes elements such as a processor, memory, and pump, which are more expensive and / or more complex to manufacture and assemble than elements of cartridge 710, such as the outer housing and tubing 716. Therefore, the reusability of control unit 700 may allow its more expensive and / or more complex elements to be reused rather than having to be discarded after a single use. The fact that the control unit 700 is configured to be releasably coupled to a cartridge allows the control unit 700 to be coupled to a variety of different cartridges, such as cartridges configured to be operably coupled to different types of fluid sources, and cartridges containing tubing of different sizes, thereby allowing surgeons and / or other medical professionals to select the cartridge best suited to the specific surgical procedure in which the cartridge will be used.

[0122] Figures 17 and 18 show another implementation example of the control unit 800 configured to be operably coupled to a cable connector. The control unit 800 is another implementation example of the control unit 160 in Figure 2 and is generally configured and used similarly to the control unit 700 in Figures 15 and 16.

[0123] The control unit 700 in Figures 15 and 16 is configured as a back-loading unit, where a cartridge, such as a cartridge 710, is coupled to the control unit 700 at its rear. The front of the control unit 700, where a cable assembly, such as a cable assembly 106, extends, is typically desirable to be accessible and visually observable during use of the control unit 700, for example, to facilitate the connection and disconnection of the cable assembly to and from the control unit 700, and to facilitate user visibility of a user interface 720 on the front of the control unit 700, which is configured to receive user input and / or display information to the user. The back-loading nature of the control unit 700 can facilitate this accessibility and visual observation by placing the cartridge 710 and tubing 716 on the opposite side of the control unit 700 from the cable port 704 and the user interface. The control unit 800 in Figures 17 and 18 is configured as a side-loading unit, where a cartridge is coupled to the control unit 800 at its side. In the exemplary implementation, this side is shown as the right side of the control unit 800, but it may instead be on the left side. The side-loading of the control unit 800 provides the cartridge holder 802 of the control unit in a position that may be more easily accessible to the user before, during, and / or after the surgical procedure, while still allowing accessibility and visual observation of the control unit 800. The control unit may be used while resting on a cart, shelf, or other support member that has a rear, abuts against a wall at the rear, or faces a wall at the rear. Therefore, the rear of the control unit may be more difficult for the user to access than the side of the control unit in at least some situations. Thus, the side-loading of the control unit 800 may facilitate the connection of cartridges to and from the control unit 800 by being in a position that is more easily accessible to the user than a back-loading control unit.

[0124] The control unit 800 includes a cartridge holder 802 which is generally configured and used in a similar manner to the cartridge holder 712 of the control unit 700. One example of an implementation of a cartridge 804 which is configured to be operably coupled to the control unit 800 by coupling with the cartridge holder 802 is shown in Figure 18. The cartridge 804 is generally configured and used in a similar manner to the cartridge 710 in Figure 16. As described above, exemplary implementations of cartridges are further described in U.S. Patent No. 7,857,792, entitled "Cassette For Irrigation Or Aspiration Machine For Endoscopy," issued on December 28, 2010.

[0125] In the exemplary implementation shown in Figures 17 and 18, a cable port 806 configured to be operably coupled to a cable connector is defined by a first cable port 808 of the control unit 800 and a second cable port 810 of the cartridge 804. With the cartridge 804 operably coupled to the control unit 806, for example with the cartridge 804 received by the cartridge holder 802, the first and second cable ports 808 and 810 are aligned with each other to form a cable port 806 configured to be releasably coupled to a cable connector.

[0126] Figure 18 shows an example cable connector 812 configured to operably couple to a cable port 806. The cable connector 812 is located at the proximal end of the cable assembly 814 and is configured to operably couple to a control unit 800 or other examples of control units described herein. The cable assembly 814 is generally configured and used in the same manner as the cable assembly 106 in Figures 1 and 2. In this exemplary configuration, the cable assembly 814 includes a first cable 816 and a second cable 818. The first cable 816 includes a first conduit containing a wire(s) and is configured and used in the same manner as described above with respect to the first cable 130 of the cable assembly 106. The second cable 818 includes a second conduit configured to provide irrigation fluid from a fluid source and is configured and used in the same manner as described above with respect to the second conduit of the second cable 132 of the cable assembly 106. In this exemplary configuration, the second cable 818 does not include a third conduit for suction.

[0127] The cable connector 812 includes an electrical connector (not clearly visible in Figure 18) configured and used similarly to the electrical connector 192 in Figure 13, a fluid connector (not clearly visible in Figure 18) configured and used similarly to the fluid connector 194 in Figure 13, and a fixing member (not clearly visible in Figure 18) configured and used similarly to the fixing member 196 in Figure 13. With the electrical connector of the cable connector 812 operably coupled to the electrical connector of the control unit (not clearly visible in Figure 18), the control unit 800 may supply power to the arthroscope via the first cable 816, and data may be communicated from the arthroscope to the control unit 800 and / or from the control unit 800 to the arthroscope via the first cable 816. With the fluid connector of the cable connector 812 operably coupled to the fluid connector of the control unit (not clearly visible in Figure 18), the control unit 800 may supply fluid infusion via the second cable 818. As shown in the implementation example in Figure 14, the cable port 806 may include a corresponding fixing member (not clearly visible in Figure 18) configured to engage securely and releasably with the fixing member of the cable connector 812.

[0128] In the implementation examples shown in Figures 17 and 18, the control unit 800 includes the pump 820, but in other implementation examples, the pump may be a separate unit configured to be operably coupled to the control unit, as shown in Figure 2, which has the pump 134 and the control unit 160. In this exemplary implementation example, the pump 820 includes a first peristaltic pump 822 and a second peristaltic pump 824, but the pump may have other configurations. The pump 820 is generally configured and used similarly to the pump 134 in Figure 2.

[0129] The irrigation tubing 820 extends from the cartridge 804 and is generally configured and used similarly to the tubing 716 in Figure 15. The irrigation tubing 820 is configured to connect to a fluid source 826 which is generally configured and used similarly to the fluid source 136 in Figure 2. In this exemplary implementation, the fluid source 826 includes an intravenous (IV) bag, but may have other configurations. With the cassette 804 operably coupled to the control unit 800, the first pump 822 is configured to pump fluid 828 from the fluid source 826 through the irrigation tubing 820 to the fluid connector of the cartridge 804 located at the cable port 806, and from the cartridge 804 through the fluid connector into the fluid connector of the cable assembly 814, through which the fluid 828 is pumped into a second cable 818, for example, its second conduit, for output from the arthroscope. In this exemplary implementation, the fluid 828 includes saline solution, but may include water or other irrigation fluids.

[0130] In this exemplary implementation, cartridge 804 includes a suction tubing 830 extending therefrom. The suction tubing 830 is configured to operably couple to an outlet 832 from which solid and / or liquid substances aspirated through the suction tubing 830 can be collected. In this exemplary implementation, the outlet 832 is a wall outlet operably coupled to a collection container or other containment mechanism, but may have other configurations. With cassette 804 operably coupled to control unit 800, a second pump 824 is configured to provide suction force to the suction tubing 830 to provide proximal suction toward the outlet 832. The suction tubing 830 is configured to operably couple to a surgical instrument 838 configured to provide suction to a surgical site via the suction force provided through the suction tubing 830. In this exemplary embodiment, the surgical instrument 838 is a shaver, but various surgical instruments having suction capabilities, as will be understood by those skilled in the art, may be used. The surgical instrument 838 may be fixedly coupled to the suction tubing 830 and therefore to the cartridge 804, or the suction tubing 830 may be configured to be releasably coupled to the surgical instrument 838. As in this exemplary embodiment, the releasably coupling of the suction tubing 830 to the surgical instrument 838 may allow the suction tubing 830 and the cartridge 804 to be disposable, while the surgical instrument may be reusable.

[0131] In this exemplary implementation, the cartridge 804 and the control unit 800 include corresponding circuit connectors 834 and 836. The circuit connector 834 of the cartridge 804 is configured to operably connect to the circuit connector 836 of the control unit 800 when the cartridge 804 is held in place by the cartridge holder 802. The operable coupling of the circuit connection sections 834 and 836 enables various functions, such as the control unit 800 being able to detect the coupling of cartridge 804 to cartridge holder 802, for example, verifying the reliability of cartridge 804, verifying the compatibility of cartridge 804 with control unit 800, triggering control unit 800 to receive pumping information from cartridge holder 802 indicating that control unit 800 may be configured to be used for controlling the first and second pumps 822 and 824 to safely control the flow through the irrigation and suction tubing 820 and 830, and triggering control unit 800 to be configured to turn on any(more) lights of the arthroscope operably coupled to the arthroscope.

[0132] Cartridge 804 is configured to be disposable, similar to the configuration described above for cartridge 710 in Figure 16. The control unit 800 is configured to be reusable, similar to the configuration described above for control unit 700 in Figures 15 and 16.

[0133] Figure 19 shows another implementation example of cartridge 900 configured to be operably coupled to the control unit 800 in Figure 17. Cartridge 900 is generally configured and used similarly to cartridge 804 in Figure 18, and includes, for example, an irrigation tubing 902 configured to be coupled to a fluid source 904 and pumped by a first pump 822, a suction tubing 906 configured to be coupled to an outlet 908 and pumped by a second pump 824, and a circuit connector 910 configured to be coupled to a circuit connector 836 of the control unit. The suction tubing 906 is configured to be operably coupled to a surgical instrument 838, similar to what is described above with respect to the suction tubing 830 in Figure 18. Cartridge 900 is configured to be disposable, similar to what is described above with respect to cartridge 710 in Figure 16. As mentioned above, exemplary implementations of the cartridge are further described in U.S. Patent No. 7,857,792, entitled "Cassette For Irrigation Or Aspiration Machine For Endoscopy," issued on December 28, 2010.

[0134] In the exemplary implementation shown in Figure 19, the arthroscope cable assembly is not operably coupled to a cable port defined by the control unit 800 and the cartridge 904 when coupled to the control unit 800. Instead, a cable assembly 912, including the first and second cables 914, 916, extends from the cartridge 904. The cable assembly 912 is configured to operably couple to the arthroscope 918. The arthroscope 918 is configured and used similarly to the arthroscope 100 in Figures 1 and 2. In this exemplary implementation, the arthroscope 918 is configured to couple detachably to the cable assembly 912, although in other implementations it may be coupled permanently to the cable assembly 912. The first and second cables 914, 916 are configured and used similarly to the first and second cables 130, 132 in Figures 1 and 2. The first cable 914 includes a first conduit containing the wire(s) and is configured and used similarly to the first cable 130 of the cable assembly 106 described above. The second cable 916 includes a second conduit configured to provide irrigation fluid from a fluid source and is configured and used in the same manner as described above with respect to the second conduit of the second cable 132 of the cable assembly 106. In this exemplary implementation, the second cable 916 does not include a third conduit for suction. Instead, as described above, the suction tubing 930 is configured to provide suction function to the surgical site via the surgical instrument 838.

[0135] The devices disclosed herein may be designed to be discarded after a single use or may be designed to be used multiple times. However, in either case, the devices may be readjusted for reuse after at least one use. Readjustment may include any combination of disassembly of the device, a subsequent cleaning or replacement of specific parts, and a subsequent reassembly. Specifically, the device may be disassembled, and any number of specific parts or components of the device may be selectively replaced or removed in any combination. After cleaning and / or replacing specific parts, the device may be readjusted for reuse after at least one use. Readjustment may include any combination of disassembly of the device, a subsequent cleaning or replacement of specific parts, and a subsequent reassembly. Specifically, the device may be disassembled, and any number of specific parts or components of the device may be selectively replaced or removed in any combination. After cleaning and / or replacing specific parts, the device may be reassembled for subsequent use either in a readjustment facility or by a surgical team immediately before a surgical procedure. Those skilled in the art will understand that various techniques for disassembly, cleaning / replacement, and reassembly can be used to readjust the apparatus. The use of such techniques, and the resulting readjusted apparatus, are all within the scope of this application.

[0136] Based on the embodiments described above, further features and advantages of arthroscopic medical devices and assemblies, as well as methods, will be understood by those skilled in the art. Therefore, this disclosure is not limited to what is specifically shown and described, except as provided by the appended claims. All publications and documents referenced herein are expressly incorporated herein by their entirety.

[0137] This disclosure is described only within the context of the entire disclosure provided herein, through the examples. It will be understood that modifications can be made to the intent and scope of the claims without departing from the overall scope of this disclosure.

[0138] [Implementation Method] (1) A surgical system, It is an arthroscope, The handlebars and A cable assembly extending proximal to the handle, comprising a first cable, a second cable, and a cable connector at the proximal end of the cable assembly, An arthroscope comprising an elongated shaft extending distally from the handle, wherein a first lumen and a second lumen extend through the shaft, the first lumen communicates with a first conduit of the first cable, and the second lumen communicates with a second conduit of the second cable, A control unit configured to be releasably coupled to the cable connector, wherein the control unit includes a pump, and is configured to supply power to the arthroscope via the first cable and the first conduit while the control unit is releasably coupled to the cable connector. A cartridge configured to be releasably coupled to the control unit, comprising a cartridge including a tube, A system in which, with the cartridge releasably coupled to the control unit, the pump is configured to induce fluid flow in the tube, the second conduit, and the second cable. (2) The tube is configured to be operably coupled to a fluid source containing an irrigation liquid, The system according to Embodiment 1, wherein the fluid flow includes the flow of the irrigation liquid. (3) The system according to Embodiment 2, wherein the cartridge is releasably coupled to the control unit, and the second tube of the cartridge is operably coupled to a surgical tool configured to deliver suction force to a surgical site, and the pump is configured to cause the surgical tool to deliver suction force into the second tube. (4) The system according to Embodiment 1, wherein causing the fluid flow provides an attractive force within the tube, the second conduit, and the second cable. (5) The cable assembly includes a third cable, A third lumen extends through the shaft, and the third lumen communicates with the third conduit of the third cable. The control unit includes a second pump, The cartridge includes a second tube configured to be operably coupled to a fluid source containing an irrigation liquid, The system according to Embodiment 4, wherein the cartridge is releasably coupled to the control unit, and the pump is configured to cause the flow of the irrigation fluid into the second tube, the third conduit, and the third cable.

[0139] (6) The arthroscope includes an optical sensor in the distal portion of the shaft, and the optical sensor is configured to collect image data. The system according to Embodiment 1, wherein the power supplied to the arthroscope is configured to supply power to the optical sensor. (7) The arthroscope includes an inertial sensor configured to collect orientation data indicating the orientation of the image data collected by the optical sensor, The system according to embodiment 6, wherein the control unit is configured to receive the collected image data via a wire extending through the first conduit and the first cable. (8) The system according to Embodiment 7, wherein the control unit is configured to modify the image of the received image data using the received orientation data, and to output the modified image to the display unit. (9) The system according to embodiment 8, wherein the modification includes rotating the image to a predetermined desired orientation based on the orientation data. (10) The control unit is configured to use the orientation data to rotate the handle around a common longitudinal axis of the handle and the shaft and to correct the image in real time, The system according to embodiment 8, wherein the control unit is configured to output the modified image to the display unit in real time with the rotation of the handle.

[0140] (11) Surgical methods, To provide power to an arthroscope via a first cable, wherein the arthroscope is releasably coupled to the control unit via a cable connector of a cable assembly including the first cable and the second cable, and the cartridge is releasably seated in a cartridge holder of the control unit. A method comprising using the pump of the control unit to induce a fluid flow in the tube of the cartridge, thereby causing a fluid flow in the second cable. (12) The method according to embodiment 11, wherein the fluid flow includes a flow of irrigation liquid. (13) The method of Embodiment 12, further comprising using a second pump of the control unit to cause a surgical tool operably coupled to the second tube of the cartridge to deliver suction force into the second tube so as to deliver suction force to the surgical site. (14) The method according to Embodiment 11, wherein causing the fluid flow provides an attractive force within the tube. (15) The method according to embodiment 14, further comprising using the second pump of the control unit to cause a flow of irrigation fluid into the second tube of the cartridge, thereby causing a flow of irrigation fluid into the third cable of the cable assembly.

[0141] (16) Collecting image data using an optical sensor in the distal portion of the arthroscope, wherein the control unit receives the collected image data via a wire extending through the first cable, The method according to Embodiment 11, further comprising using an inertial sensor to collect orientation data. (17) The control unit uses the received orientation data to modify the image of the received image data in real time with the execution of the surgical procedure. The method of Embodiment 16, further comprising using the control unit to display the modified image on a display unit in real time with the execution of the surgical procedure. (18) The method of Embodiment 17, wherein the modification includes rotating the image to a predetermined desired orientation based on the orientation data. (19) The method of Embodiment 17, wherein the modification and the display of the modified image occur in real time with the rotation of the handle of the arthroscope and the shaft of the arthroscope extending distally from the handle.

Claims

1. A surgical system, It is an arthroscope, The handlebars and A cable assembly extending proximal to the handle, comprising a first cable, a second cable, and a cable connector at the proximal end of the cable assembly, An arthroscope comprising an elongated shaft extending distally from the handle, wherein a first lumen and a second lumen extend through the shaft, the first lumen communicates with a first conduit of the first cable, and the second lumen communicates with a second conduit of the second cable, A control unit configured to be releasably coupled to the cable connector, wherein the control unit includes a pump, and is configured to supply power to the arthroscope via the first cable and the first conduit while the control unit is releasably coupled to the cable connector. A cartridge configured to be releasably coupled to the control unit, comprising a tube, the tube configured to be operably coupled to a fluid source containing an irrigation liquid, A system in which, with the cartridge releasably coupled to the control unit, the pump is configured to cause a fluid flow of the irrigation liquid into the tube, the second conduit, and the second cable.

2. The system according to claim 1, wherein the cartridge is releasably coupled to the control unit, and the second tube of the cartridge is operably coupled to a surgical tool configured to deliver suction force to a surgical site, and the pump is configured to cause the surgical tool to deliver suction force into the second tube.

3. The system according to claim 1, wherein causing the fluid flow includes providing an attractive force within the tube, the second conduit, and the second cable.

4. The cable assembly includes a third cable, A third lumen extends through the shaft, and the third lumen communicates with the third conduit of the third cable. The control unit includes a second pump, The cartridge includes a second tube configured to be operably coupled to a fluid source containing an irrigation liquid, The system according to claim 3, wherein the cartridge is releasably coupled to the control unit, and the second pump is configured to cause a flow of the irrigation fluid into the second tube, the third conduit, and the third cable.

5. The arthroscope includes an optical sensor in the distal portion of the shaft, and the optical sensor is configured to collect image data. The system according to claim 1, wherein the power supplied to the arthroscope is configured to supply power to the optical sensor.

6. The arthroscope includes an inertial sensor configured to collect orientation data indicating the orientation of the image data collected by the optical sensor, The system according to claim 5, wherein the control unit is configured to receive the collected image data via a wire extending through the first conduit and the first cable.

7. The system according to claim 6, wherein the control unit is configured to modify the image of the received image data using the received orientation data, and to output the modified image to the display unit.

8. The system according to claim 7, wherein the modification includes rotating the image to a predetermined desired orientation based on the orientation data.

9. The control unit is configured to use the orientation data to rotate the handle around a common longitudinal axis of the handle and the shaft and to correct the image in real time. The system according to claim 7, wherein the control unit is configured to output the modified image to the display unit in real time with the rotation of the handle.

10. A method for operating a surgical system, A control unit, which is removably coupled to the arthroscope and to the cartridge, provides power to the arthroscope via a first cable. The control unit includes using a pump to induce a fluid flow of irrigation liquid into the tube from a fluid source operably coupled to the tube of the cartridge, thereby causing a fluid flow in the second cable, An operating method wherein the arthroscope is releasably coupled to the control unit via a cable connector of a cable assembly including the first cable and the second cable, and the cartridge is releasably seated in a cartridge holder of the control unit.

11. The operating method according to claim 10, further comprising the control unit causing the control unit to use a second pump to provide the suction force into the second tube so that a surgical tool operably coupled to the second tube of the cartridge delivers the suction force to the surgical site.

12. The operating method according to claim 10, wherein causing the fluid flow includes providing an suction force within the tube.

13. The operating method according to claim 12, further comprising the control unit using a second pump to cause a flow of irrigation fluid into a second tube of the cartridge, thereby causing a flow of the irrigation fluid into a third cable of the cable assembly.

14. The optical sensor in the distal part of the arthroscope is used to collect image data, The control unit receives the collected image data via a wire extending through the first cable, The operating method according to claim 10, further comprising using an inertial sensor to collect orientation data.

15. The control unit uses the received orientation data to modify the image of the received image data in real time during the execution of the surgical procedure. The operating method according to claim 14, further comprising the control unit displaying the modified image on a display unit in real time with the execution of the surgical procedure.

16. The operating method according to claim 15, wherein the modification includes rotating the image to a predetermined desired orientation based on the orientation data.

17. The operating method according to claim 15, wherein the modification and the display of the modified image occur in real time with the rotation of the handle of the arthroscope and the shaft of the arthroscope extending distally from the handle.

Images