U.S. patent application number 09/846235 was filed with the patent office on 2001-11-08 for method of surgically reshaping the nasal bone.
Invention is credited to Cleveland, John T., Dinger, Fred B..
Application Number | 20010039428 09/846235 |
Document ID | / |
Family ID | 23599690 |
Filed Date | 2001-11-08 |
United States Patent
Application |
20010039428 |
Kind Code |
A1 |
Dinger, Fred B. ; et
al. |
November 8, 2001 |
Method of surgically reshaping the nasal bone
Abstract
A surgical handpiece adapter for converting rotary motion of a
powered surgical handpiece into reciprocating motion to drive a
cutting member includes a rear drive shaft for being removably
coupled to a rotatable drive shaft of the handpiece, a front drive
shaft for being removably coupled to the cutting member and a
motion converting mechanism causing reciprocation of the front
drive shaft and, therefore, the cutting member coupled thereto, in
response to rotation of the rear drive shaft by the drive shaft of
the handpiece. A handpiece adapter assembly is formed by an adapter
and a cutting member coupled thereto, and a powered surgical
handpiece assembly is formed by an adapter, a cutting member
coupled to the adapter and a powered surgical handpiece coupled to
the adapter. A cutting member includes a surgical suction rasp for
being reciprocatively driven to cut anatomical tissue and having a
tissue cutting surface and a suction passage with an inlet opening
along the tissue cutting surface for removing anatomical debris
from an operative site at which the rasp is used. A cutting member
includes an osteotome for being reciprocatively power driven to cut
anatomical tissue and having a cutting edge and a blunt tip
extending distally of the cutting edge. A method of facial surgery
includes the steps of reciprocating a distal end of a rasp to
reshape the nasal bone of a patient and removing anatomical debris
through a suction passage of the rasp while the nasal bone is being
reshaped. Another method of facial surgery includes the steps of
reciprocating a distal end of an osteotome via a powered surgical
handpiece and moving the distal end of the osteotome, while it is
being reciprocated, forwardly along the nasal bone of a patient in
a predetermined path with a cutting edge of the osteotome in
contact with the nasal bone to make a cut of desired length in the
nasal bone along the predetermined path.
Inventors: |
Dinger, Fred B.;
(Jacksonville, FL) ; Cleveland, John T.;
(Jacksonville, FL) |
Correspondence
Address: |
EPSTEIN, EDELL, SHAPIRO, FINNAN & LYTLE, LLC
1901 RESEARCH BOULEVARD
SUITE 400
ROCKVILLE
MD
20850
US
|
Family ID: |
23599690 |
Appl. No.: |
09/846235 |
Filed: |
May 2, 2001 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
09846235 |
May 2, 2001 |
|
|
|
09404460 |
Sep 24, 1999 |
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Current U.S.
Class: |
606/167 ;
606/170 |
Current CPC
Class: |
A61B 2017/0046 20130101;
A61B 17/32002 20130101; A61B 17/1657 20130101; A61B 17/1688
20130101; A61B 2017/00477 20130101; A61B 17/1604 20130101; A61B
17/1659 20130101; A61B 2017/320028 20130101 |
Class at
Publication: |
606/167 ;
606/170 |
International
Class: |
A61B 017/32 |
Claims
What is claimed is:
1. A handpiece adapter for converting rotary motion of a powered
surgical handpiece into reciprocating motion for reciprocatively
driving a cutting member coupled to the handpiece adapter, said
handpiece adapter comprising an adapter housing; a front drive
shaft having a proximal end reciprocatively mounted in said adapter
housing and having a distal end disposed externally of said adapter
housing, said distal end being capable of being removably coupled
to a cutting member to be reciprocatively driven by said front
drive shaft; a rear drive shaft having a distal end and having a
proximal end capable of being removably coupled to a rotatable
drive shaft of the powered surgical handpiece such that said rear
drive shaft is rotated by the drive shaft of the powered surgical
handpiece; a cam disposed at said distal end of said rear drive
shaft and being rotatable therewith, said cam being rotatably
disposed in said adapter housing; and a cam follower disposed at
said proximal end of said front drive shaft in engagement with said
cam whereby rotation of said rear drive shaft by the drive shaft of
the powered surgical handpiece is converted into reciprocation of
said front drive shaft to reciprocatively drive the cutting member
coupled therewith.
2. A handpiece adapter as recited in claim 1 wherein said distal
end of said front drive shaft includes a passage for receiving a
proximal end of the cutting member.
3. A handpiece adapter as recited in claim 2 and further including
an operating member carried on said front drive shaft for
selectively opening said passage to receive the proximal end of the
cutting member and for selectively closing said passage to secure
the proximal end of the cutting member to said front drive
shaft.
4. A handpiece adapter as recited in claim 3 wherein said operating
member is movable longitudinally relative to and along said front
drive shaft in a first longitudinal direction to selectively open
said passage and is movable longitudinally relative to and along
said front drive shaft in a second longitudinal direction to
selectively close said passage.
5. A handpiece adapter as recited in claim 4 wherein said operating
member includes a longitudinal passage extending entirely
therethrough and said front drive shaft is disposed in said passage
of said operating member to pass entirely through said operating
member, said operating member being rotatable relative to said
front drive shaft, said operating member being movable
longitudinally in said first longitudinal direction in response to
rotation of said operating member in a first rotational direction
relative to said front drive shaft, said operating member being
movable longitudinally in said second longitudinal direction in
response to rotation of said operating member in a second
rotational direction, opposite said first rotational direction,
relative to said front drive shaft.
6. A handpiece adapter as recited in claim 5 wherein said distal
end of said front drive shaft is formed as a collet defining a
plurality of longitudinally extending legs, said legs being movable
in a radially outward direction to receive the proximal end of the
cutting member in said passage of said front drive shaft when said
operating member is moved in said first longitudinal direction,
said legs begin moved in a radially inward direction to engage the
proximal end of the cutting member in said passage of said front
drive shaft when said operating member is moved in said second
longitudinal direction.
7. A handpiece adapter as recited in claim 5 wherein a locking
member is disposed in an aperture formed in said front drive shaft
and communicating with said passage of said front drive shaft, said
locking member being movable in a radially outward direction to
receive the proximal end of the cutting member in said passage of
said front drive shaft when said operating member is moved in said
first longitudinal direction, said locking member being moved in a
radially inward direction to protrude through said aperture into
said passage of said front drive shaft so as to engage the proximal
end of the cutting member in said passage of said front drive shaft
when said operating member is moved in said second longitudinal
direction.
8. A handpiece adapter as recited in claim 7 wherein said locking
member is spherical.
9. A handpiece adapter as recited in claim 7 and further including
an insert disposed in said passage of said operating member and
maintaining alignment of said locking member with said
aperture.
10. A handpiece adapter as recited in claim 5 and further including
a linear bearing disposed around said front drive shaft.
11. A handpiece adapter as recited in claim 10 wherein said housing
includes a housing portion having a longitudinal passage
therethrough, said front drive shaft extends entirely through said
passage of said housing portion, said front drive shaft has a
central longitudinal axis and a plurality of partial spherical,
longitudinally extending grooves in an external surface thereof,
said grooves being disposed in said passage of said housing
portion, said housing portion has a plurality of partial spherical,
longitudinally extending grooves in an internal surface thereof
defining said passage of said housing portion, each of said grooves
of said front drive shaft being aligned with one of said grooves of
said housing portion in a radial direction about said central
longitudinal axis of said front drive shaft to form an aligned pair
of grooves, and said linear bearing includes a hollow cylindrical
member through which said front drive shaft passes and a plurality
of balls retained by said cylindrical member, said cylindrical
member including a plurality of holes therein receiving said balls,
respectively, each of said holes being radially aligned with one of
said aligned pair of grooves such that each of said balls is partly
disposed in each of said grooves of said one of said aligned pair
of grooves and is longitudinally movable within at least one of
said grooves of said one of said aligned pair of grooves as the
front drive shaft is reciprocated in said housing.
12. A handpiece adapter as recited in claim 1 wherein said cam
includes a cam head having an angled track therein and said cam
follower is disposed in said track.
13. A handpiece adapter as recited in claim 12 wherein said
proximal end of said front drive shaft has a recess therein and
said cam head is rotatably disposed in said recess.
14. A handpiece adapter as recited in claim 13 wherein said cam has
a central longitudinal axis and said cam head includes forward and
rearward cam head sections between which said track is disposed,
said rearward cam head section having a maximum length and a
minimum length disposed at a 180.degree. spaced location from said
maximum length about said central longitudinal axis of said cam,
said cam follower includes a protrusion on said front drive shaft
disposed in said track, said distal end of said front drive shaft
being in a maximum longitudinal position beyond said housing when
said maximum length is in longitudinal alignment with said
protrusion and being in a minimum longitudinal position beyond said
housing when said minimum length is in longitudinal alignment with
said protrusion.
15. A handpiece adapter as recited in claim 14 wherein said cam
head has an overall length and said recess has a length greater
than said overall length of said cam head allowing said front drive
shaft to reciprocate relative to said rear drive shaft.
16. A handpiece adapter as recited in claim 15 wherein said
proximal end of said rear drive shaft is configured for mechanical
coupling with the drive shaft of the powered surgical
handpiece.
17. A handpiece adapter as recited in claim 16 wherein said
proximal end of said rear drive shaft includes a slot for receiving
a drive pin on the drive shaft of the powered surgical
handpiece.
18. A handpiece adapter as recited in claim 1 wherein said
handpiece adapter is reusable.
19. A powered surgical handpiece assembly comprising a powered
surgical handpiece having a rotatable drive shaft; a handpiece
adapter including a re a r drive shaft having a proximal end
removably coupled with said drive shaft of said handpiece and
having a distal end a front drive shaft having a distal end and a
proximal end, and a motion converting mechanism mechanically
coupling said proximal end of said front drive shaft with said
distal end Of said rear drive shaft, said motion converting
mechanism including a cam at said distal end of said rear drive
shaft and a cam follower at said proximal end of said front drive
shaft, said rear drive shaft being rotatable with said drive shaft
of said handpiece, said cam being rotatable with said rear drive
shaft, said cam follower being reciprocatively moved by said cam to
reciprocate said front drive shaft in response to rotation of said
cam by said rear drive shaft; and a cutting member having a
proximal end removably coupled with said distal end of said front
drive shaft and having a distal end for cutting anatomical tissue,
said cutting member being reciprocatively driven by said front
drive shaft of said adapter when said front drive shaft is
reciprocated, via said motion converting mechanism, in response to
rotation of said drive shaft of said handpiece.
20. A powered surgical handpiece assembly as recited in claim 19
wherein said cutting member is a rasp.
21. A powered surgical handpiece assembly as recited in claim 19
wherein said cutting member is an osteotome.
22. A powered surgical handpiece assembly as recited in claim 19
wherein said handpiece is an XPS.TM. StraightShot handpiece.
23. A powered surgical handpiece assembly as recited in claim 22
wherein said cutting member is a rasp.
24. A powered surgical handpiece assembly as recited in claim 22
wherein said cutting member is an osteotome.
25. A powered surgical handpiece assembly as recited in claim 19
wherein said handpiece and said adapter are reusable and said
cutting member is disposable.
26. A powered surgical handpiece assembly as recited in claim 19
wherein said front drive shaft includes an alignment member and
said proximal end of said cutting member is adapted to engage said
alignment member when said distal end of said cutting member is in
a specific orientation for use of said powered surgical handpiece
assembly.
27. A powered surgical handpiece assembly as recited in claim 26
wherein said alignment member includes a post and said proximal end
of said cutting member has a slot therein for receiving said post
when said distal end of said cutting member is in said specific
orientation.
28. A powered surgical handpiece assembly as recited in claim 27
wherein said drive shaft of said handpiece includes a pin and said
proximal end of said rear drive shaft includes a slot for receiving
said pin when said distal end of said cutting member is in said
specific orientation.
29. A powered surgical handpiece assembly as recited in claim 27
wherein said proximal end of said rear drive shaft includes spaced
prongs and said drive shaft of said handpiece includes a pin for
being received between said prongs when said distal end of said
cutting member is in said specific orientation.
30. A powered surgical handpiece assembly as recited in claim 19
wherein said adapter includes a housing, said proximal end of said
front drive shaft is reciprocatively mounted in said housing and
said distal end of said front drive shaft is disposed externally of
said housing, said cam has a central longitudinal axis and includes
a cam head disposed in said housing, said cam has an angled track
therein within which said cam follower is disposed, said cam head
includes forward and rearward cam head sections between which said
track is disposed, said rearward cam head section having a maximum
length and a minimum length disposed at a 180.degree. spaced
location from said maximum length about said central longitudinal
axis of said cam, said cam follower includes a protrusion on said
front drive shaft disposed in said track, said distal end of said
front drive shaft being in a maximum longitudinal position beyond
said housing when said maximum length is in longitudinal alignment
with said protrusion.
31. A powered surgical handpiece assembly as recited in claim 30
wherein said proximal end of said front drive shaft has a recess
therein and said cam head is rotatably disposed in said recess,
said cam head has an overall length and said recess has a length
greater than said overall length of said cam head allowing said
front drive shaft to reciprocate relative to said rear drive
shaft.
32. A powered surgical handpiece assembly as recited in claim 19
wherein said distal end of said front drive shaft includes a
passage receiving said proximal end of said cutting member, said
adapter includes an operating member carried on said front drive
shaft for selectively opening said passage to receive said proximal
end of said cutting member and for selectively closing said passage
to secure said proximal end of said cutting member to said front
drive shaft, said operating member includes a longitudinal passage
extending entirely therethrough and said front drive shaft is
disposed in said passage of said operating member to pass entirely
therethrough, said operating member is rotatable relative to said
front drive shaft, said operating member is movable longitudinally
in a first longitudinal direction in response to rotation of said
operating member in a first rotational direction relative to said
front drive shaft, said operating member is movable longitudinally
in a second longitudinal direction in response to rotation of said
operating member in a second rotational direction, opposite said
first rotational direction, relative to said front drive shaft.
33. A powered surgical handpiece assembly as recited in claim 32
wherein said distal end of said front drive shaft is formed as a
collet defining a plurality of longitudinally extending legs, said
legs being movable in a radially outward direction to receive said
proximal end of said cutting member in said passage of said front
drive shaft when said operating member is moved in said first
longitudinal direction, said legs being moved in a radially inward
direction to engage said proximal end of said cutting member in
said passage of said front drive shaft when said operating member
is moved in said second longitudinal direction.
34. A powered surgical handpiece assembly as recited in claim 32
wherein a locking member is disposed in an aperture formed in said
front drive shaft and communicating with said passage of said front
drive shaft, said locking member being movable in a radially
outward direction to receive said proximal end of said cutting
member in said passage of said front drive shaft when said
operating member is moved in said first longitudinal direction,
said locking member being moved in a radially inward direction to
protrude through said aperture into said passage of said front
drive shaft so as to engage said proximal end of said cutting
member in said passage of said front drive shaft when said
operating member is moved in said second longitudinal
direction.
35. A powered surgical handpiece assembly as recited in claim 34
wherein said locking member is configured as a ball.
36. A powered surgical handpiece assembly as recited in claim 34
wherein said proximal end of said cutting member has an external
annular groove and said locking member is received in said groove
when said operating member is moved in said second longitudinal
direction to lock said cutting member to said front drive
shaft.
37. A handpiece adapter assembly for a powered surgical handpiece
comprising a handpiece adapter including a rear drive shaft having
a proximal end for being removably coupled with a rotatable drive
shaft of a powered surgical handpiece and having a distal end, a
front drive shaft having a distal end and a proximal end and a
motion converting mechanism by which said proximal end of said
front drive shaft is in driving engagement with said distal end of
said rear drive shaft, said rear drive shaft being rotatable with
the drive shaft of the handpiece when said rear drive shaft is
coupled therewith, said motion converting mechanism including a cam
rotatable with said rear drive shaft and a cam follower
reciprocatively moved by said cam in response to rotation of said
cam with said rear drive shaft, said front drive shaft being
movable with said cam follower whereby said front drive shaft is
reciprocated relative to said rear drive shaft when said rear drive
shaft is rotated by the drive shaft of the handpiece; and a cutting
member having a proximal end removably coupled with said distal end
of said front drive shaft and having a distal end for cutting
anatomical tissue, said cutting member being reciprocatively driven
by said front drive shaft of said adapter when said front drive
shaft is reciprocated in response to rotation of said rear drive
shaft by the drive shaft of the handpiece.
38. A handpiece adapter assembly as recited in claim 37 wherein
said adapter includes an alignment member and said proximal end of
said cutting member is configured to drivingly engage said
alignment member when said distal end of said cutting member is in
a predetermined orientation relative to said adapter.
39. A handpiece adapter assembly as recited in claim 38 wherein
said front drive shaft includes a longitudinal passage receiving
said proximal end of said cutting member, said alignment member
includes a post extending transversely within said passage and said
proximal end of said cutting member includes a slot receiving said
post.
40. A handpiece adapter assembly as recited in claim 38 wherein
said front drive shaft includes a longitudinal passage receiving
said proximal end of said cutting member, said alignment member
includes a post extending transversely within said passage and said
proximal end of said cutting member includes spaced prongs
receiving said post therebetween.
41. A handpiece adapter assembly as recited in claim 37 wherein
said proximal end of said rear drive shaft has a configuration to
drivingly engage the drive shaft of the handpiece when said distal
end of said cutting member is in said predetermined orientation
relative to the handpiece.
42. A handpiece adapter assembly as recited in claim 37 wherein
said cutting member is a rasp.
43. A handpiece adapter assembly as recited in claim 37 wherein
said cutting member is an osteotome.
44. A handpiece adapter assembly as recited in claim 37 wherein
said adapter is reusable and said cutting member is disposable.
45. A handpiece adapter assembly as recited in claim 37 wherein
said adapter includes a housing, said proximal end of said front
drive shaft is reciprocatively mounted in said housing and said
distal end of said front drive shaft is disposed externally of said
housing, said cam head has a central longitudinal axis and includes
a cam disposed in said housing, said cam has an angled track
therein within which said cam follower is disposed, said cam head
includes forward and rearward cam head sections between which said
track is disposed, said rearward cam head section having a maximum
length and a minimum length disposed at a 180.degree. spaced
location from said maximum length about said central longitudinal
axis of said cam, said cam follower includes a protrusion on said
front drive shaft disposed in said track, said distal end of said
front drive shaft being in a maximum longitudinal position beyond
said housing when said maximum length is in longitudinal alignment
with said protrusion and being in a minimum longitudinal position
beyond said housing when said minimum length is in longitudinal
alignment with said protrusion.
46. A handpiece adapter assembly as recited in claim 45 wherein
said proximal end of said front drive shaft has a recess therein
and said cam head is rotatably disposed in said recess, said cam
head has an overall length and said recess has a length greater
than said overall length of said cam head allowing said front drive
shaft to reciprocate relative to said rear drive shaft.
47. A handpiece adapter assembly as recited in claim 37 wherein
said distal end of said front drive shaft includes a passage
receiving said proximal end of said cutting member, said adapter
includes an operating member carried on said front drive shaft for
selectively opening said passage to receive said proximal end of
said cutting member and for selectively closing said passage to
secure said proximal end of said cutting member to said front drive
shaft, said operating member includes a longitudinal passage
extending entirely therethrough and said front drive shaft is
disposed in said passage of said operating member to pass entirely
therethrough, said operating member is rotatable relative to said
front drive shaft, said operating member is movable longitudinally
in a first longitudinal direction in response to rotation of said
operating member in a first rotational direction relative to said
front drive shaft, said operating member is movable longitudinally
in a second longitudinal direction in response to rotation of said
operating member in a second rotational direction, opposite said
first rotational direction, relative to said front drive shaft.
48. A handpiece adapter assembly as recited in claim 47 wherein
said distal end of said front drive shaft is formed as a collet
defining a plurality of longitudinally extending legs, said legs
being movable in a radially outward direction to receive said
proximal end of said cutting member in said passage of said front
drive shaft when said operating member is moved in said first
longitudinal direction, said legs begin moved in a radially inward
direction to engage said proximal end of said cutting member in
said passage of said front drive shaft when said operating member
is moved in said second longitudinal direction.
49. A handpiece adapter assembly as recited in claim 47 wherein 47
locking member is disposed in an aperture formed in said front
drive shaft and communicating with said passage of said front drive
shaft, said locking member being movable in a radially outward
direction to receive said proximal end Of said cutting member in
said passage of said front drive shaft when said operating member
is moved in said first longitudinal direction, said locking member
being moved in a radially inward direction to protrude through said
aperture into said passage of said front drive shaft so as to
engage said proximal end of said cutting member in said passage of
said front drive shaft when said operating member is moved in said
second longitudinal direction.
50. A handpiece adapter assembly as recited in claim 49 wherein
said locking member is spherical.
51. A handpiece adapter assembly as recited in claim 49 wherein
said proximal end of said cutting member has an external annular
groove and said locking member is received in said groove when said
operating member is moved in said second longitudinal direction to
lock said cutting member to said front drive shaft.
52. A surgical suction rasp for being reciprocatively driven by a
reciprocating driver to shape anatomical tissue at an operative
site in a patient's body comprising an elongate member having a
proximal end for being removably coupled to a reciprocating driver
and having a distal end for being disposed at an operative site, a
tissue cutting surface at said distal end and a suction passage
having an inlet along said tissue cutting surface and having an
outlet disposed proximally of said inlet, said tissue cutting
surface being configured to abrade and thusly cut anatomical tissue
at the operative site when said tissue cutting surface is
positioned in contact with the anatomical tissue while said
elongate member is reciprocated by the reciprocating driver, said
outlet of said suction passage being adapted for connection to a
source of suction whereby anatomical debris is removed from the
operative site through said suction passage for withdrawal from the
patient's body.
53. A surgical suction rasp as recited in claim 52 wherein said
tissue cutting surface comprises a planar surface having a
plurality of sharp ridges for abrading bone.
54. A surgical suction rasp as recited in claim 53 wherein said
ridges are formed by a plurality of diamond shaped protuberances on
said planar surface.
55. A surgical suction rasp as recited in claim 52 wherein said
elongate member has a central longitudinal axis and said tissue
cutting surface is laterally offset from said central longitudinal
axis.
56. A surgical suction rasp as recited in claim 55 wherein said
central longitudinal axis is longitudinally straight and said
tissue cutting surface is parallel to said central longitudinal
axis.
57. A surgical suction rasp as recited in claim 55 wherein said
central longitudinal axis has a longitudinal curvature.
58. A surgical suction rasp as recited in claim 57 wherein said
longitudinal curvature corresponds to the natural curvature of a
human frontal bone.
59. A surgical suction rasp as recited in claim 52 wherein said
elongate member has a central longitudinal axis, said tissue
cutting surface is disposed on a cutting element at said distal end
Of said elongate member and said suction passage extends entirely
through said cutting element at an angle to said central
longitudinal axis.
60. A surgical suction rasp as recited in claim 59 wherein said
outlet is disposed proximally of said distal end of said elongate
member.
61. A surgical suction rasp as recited in claim 60 wherein said
suction passage includes a tube extending externally from said
cutting element alongside said elongate member.
62. A surgical suction rasp as recited in claim 61 wherein said
tube has a proximal end terminating at said outlet and said
proximal said of the tube is angled outwardly from said elongate
member.
63. A surgical suction rasp as recited in claim 62 wherein said
tube has a distal end terminating at said tissue cutting
surface.
64. A handpiece adapter assembly for a powered surgical handpiece
comprising a handpiece adapter for being removably coupled with a
rotatable drive shaft of a powered surgical handpiece and having a
front drive shaft and a motion converting mechanism by which rotary
motion of the drive shaft of the handpiece is converted to
reciprocating motion of said front drive shaft; and a suction rasp
removably coupled to said front drive shaft for being
reciprocatively driven thereby and including an elongate member
having a proximal end removably coupled to said front drive shaft,
a distal end for being disposed at an operative site in a patient's
body, a tissue cutting surface at said distal end and a suction
passage having an inlet along said tissue cutting surface and
having an outlet disposed proximally of said inlet, said tissue
cutting surface having a configuration to abrade and thusly cut
anatomical tissue at the operative site when said tissue cutting
surface is positioned in contact with the anatomical tissue while
said elongate member is reciprocated by said front drive shaft,
said outlet of said suction passage being adapted for connection to
a source of suction whereby anatomical debris is removed from the
operative site through said suction passage for withdrawal from the
patient's body.
65. A powered surgical handpiece assembly comprising a powered
surgical handpiece having a rotatable drive shaft; a handpiece
adapter removably coupled with said rotatable drive shaft and
having a front drive shaft and a motion converting mechanism by
which rotary motion of said rotatable drive shaft is converted to
reciprocating motion of said front drive shaft; and a suction rasp
removably coupled to said front drive shaft for being
reciprocatively driven thereby and including an elongate member
having a proximal end removably coupled to said front drive shaft,
a distal end for being disposed at an operative site in a patient's
body, a tissue cutting surface at said distal end and a suction
passage having an inlet along said tissue cutting surface and
having an outlet disposed proximally of said inlet, said tissue
cutting surface having a configuration to abrade and thusly cut
anatomical tissue at the operative site when said tissue cutting
surface is positioned in contact with the anatomical tissue while
said elongate member is reciprocated by said front drive shaft,
said outlet of said suction passage being adapted for connection to
a source of suction whereby anatomical debris is removed from the
operative site through said suction passage for withdrawal from the
patient's body.
66. A surgical osteotome for being reciprocatively driven by a
powered surgical handpiece to cut anatomical tissue at an operative
site in a patient's body comprising an elongate shaft having a
distal end and having a proximal end configured for coupling with a
powered surgical handpiece by which said elongate shaft is
reciprocated; and a cutting element at said distal end including a
longitudinal axis and a distal length portion having a lower part
and an upper part extending distally of said lower part, said upper
part being defined by an upper surface of said cutting element and
by lateral surfaces angled inwardly toward one another such that
said upper part is of decreasing width in a distal direction, said
lower part being defined by a lower surface of said cutting element
and by lateral surfaces angled inwardly toward one another, at a
greater angle than said lateral surfaces of said upper part, such
that said lower part is of decreasing width in said distal
direction with said lateral surfaces of said lower part disposed
laterally inwardly of said lateral surfaces of said upper part,
said lateral surfaces of said lower part merging at a transverse
cutting edge, said lateral surfaces of said upper part merging at a
blunt tip disposed distally of said cutting edge, said cutting edge
being adapted to cut anatomical tissue when said cutting element is
advanced distally along the tissue while being reciprocated, along
with said shaft, by the powered surgical handpiece, said tip
leading said cutting element as it is advanced distally along the
anatomical tissue.
67. A surgical osteotome as recited in claim 66 wherein said
cutting edge is transverse to said longitudinal axis.
68. A surgical osteotome as recited in claim 67 wherein said distal
length portion is longitudinally straight.
69. A surgical osteotome as recited in claim 67 wherein said distal
length portion is longitudinally angled in a lateral direction.
70. A surgical osteotome as recited in claim 69 wherein said distal
length portion is longitudinally curved in said lateral
direction.
71. A handpiece adapter assembly for a powered surgical handpiece
comprising a handpiece adapter for being removably coupled with a
rotatable drive shaft of a powered surgical handpiece and having a
front drive shaft and a motion converting mechanism by which rotary
motion of the drive shaft of the handpiece is converted to
reciprocating motion of said front drive shaft; and an osteotome
removably coupled to said front drive shaft for being
reciprocatively driven thereby and including an elongate shaft
having a proximal end removably coupled to said front drive shaft
and a cutting element at said distal end, said cutting element
including a longitudinal axis and a distal length portion having a
lower part and an upper part extending distally of said lower part,
said upper part being defined by an upper surface of said cutting
element and by lateral surfaces, said lower part being defined by a
lower surface of said cutting element and by lateral surfaces
disposed laterally inwardly of said lateral surfaces of said upper
part, said lower part tapering in width in a distal direction such
that said lateral surfaces of said lower part merge at a cutting
edge disposed transverse to said axis, said cutting edge being
adapted to cut anatomical tissue when said cutting element is
advanced distally along the tissue while being reciprocated by said
front drive shaft, said upper part terminating distally at a blunt
tip disposed distally of said cutting edge, said tip leading said
cutting element as it is advanced distally along the tissue.
72. A powered surgical handpiece assembly comprising a powered
surgical handpiece having a rotatable drive shaft; a handpiece
adapter removably coupled with said rotatable drive shaft and
having a front drive shaft and a motion converting mechanism by
which rotary motion of said rotatable drive shaft is converted to
reciprocating motion of said front drive shaft; and an osteotome
removably coupled to said front drive shaft for being
reciprocatively driven thereby and including an elongate shaft
having a proximal end removably coupled to said front drive shaft
and a cutting element at said distal end, said cutting element
including a longitudinal axis and a distal length portion having a
lower part and an upper part extending distally of said lower part,
said upper part being defined by an upper surface of said cutting
element and by lateral surfaces, said lower part being defined by a
lower surface of said cutting element and by lateral surfaces
disposed laterally inwardly of said lateral surfaces of said upper
part, said lower part tapering in width in a distal direction such
that said lateral surfaces of said lower part merge at a cutting
edge disposed transverse to said axis, said cutting edge being
adapted to cut anatomical tissue when said cutting element is
advanced distally along the tissue while being reciprocated by said
front drive shaft, said upper part terminating distally at a blunt
tip disposed distally of said cutting edge, said tip leading said
cutting element as it is advanced distally along the tissue.
73. A method of surgically reshaping the nasal bone of a patient
comprising the steps of introducing a distal end of a surgical
suction rasp through an incision in the patient's nose; advancing
the rasp along the nose to position the distal end at an operative
site at which an area of the nasal bone is to be reshaped;
positioning a tissue cutting surface at the distal end in contact
with the area of the nasal bone that is to be reshaped;
reciprocating the distal end of the rasp to abrade the nasal bone
in contact with the tissue cutting surface; moving the distal end
of the rasp, while it is being reciprocated, along the area of the
nasal bone to abrade and thusly reshape the nasal bone; removing
anatomical debris from the operative site through a suction passage
of the rasp while the area of the nasal bone is being reshaped; and
withdrawing the rasp from the nose upon completion of reshaping of
the nasal bone.
74. A method of surgically reshaping the nasal bone as recited in
claim 73 wherein said step of reciprocating includes reciprocating
the distal end of the rasp with a powered surgical handpiece.
75. A method of surgically reshaping the nasal bone as recited in
claim 74 wherein said step of reciprocating includes converting
rotary motion of a rotatable drive shaft of the powered surgical
handpiece into reciprocating motion of the rasp.
76. A method of surgically reshaping the nasal bone as recited in
claim 75 and further including, prior to said step of introducing,
the steps of removably coupling a proximal end of the rasp to a
front drive shaft of a handpiece adapter and removably coupling a
rear drive shaft of the handpiece adapter to the drive shaft of the
handpiece, and said step of converting includes the steps of
rotating the drive shaft of the handpiece following said step of
positioning, rotating the rear drive shaft of the handpiece adapter
in response to rotation of the drive shaft of the handpiece,
causing a cam of the rear drive shaft to reciprocate a cam follower
of the front drive shaft as the rear drive shaft is rotated by the
drive shaft of the handpiece such that the front drive shaft is
reciprocated to reciprocatively drive the rasp.
77. A method of surgically reshaping the nasal bone as recited in
claim 76 wherein said step of rotating the drive shaft of the
handpiece includes rotating the drive shaft of the handpiece at a
speed of 5,000 RPM.
78. A method of surgically reshaping the nasal bone as recited in
claim 76 wherein said step of rotating the drive shaft of the
handpiece includes rotating the rotatable drive shaft of the
handpiece with an electric motor of the handpiece.
79. A method of surgically reshaping the nasal bone as recited in
claim 78 wherein said step of moving includes manipulating the
handpiece to move the tissue cutting surface longitudinally and
laterally along the area of the nasal bone while the distal end is
being reciprocated.
80. A method of surgically reshaping the nasal bone as recited in
claim 73 wherein said step of removing includes drawing th e
anatomical debris into the suction passage through an inlet opening
of the suction passage disposed on the tissue cutting surface.
81. A method of surgically reshaping the nasal bone as recited in
claim 80 wherein said step of removing includes transporting the
anatomical debris through an outlet opening of the suction passage
disposed external of the patient's nose.
82. A method of surgically reshaping the nasal bone as recited in
claim 73 and further including the step of confirming proper
reshaping of the nasal bone.
83. A method of surgically reshaping the nasal bone as recited in
claim 82 wherein said step of confirming includes palpating the
patient's nose.
84. A method of surgically reshaping the nasal bone as recited in
claim 73 wherein said step of reciprocating includes reciprocating
the distal end of the rasp in a stroke of 3.0 mm.
85. A method of making a cut in the nasal bone of a patient in a
rhinoplasty procedure comprising the steps of removably coupling a
proximal end of an osteotome to a powered surgical handpiece;
introducing a distal end of the osteotome through an incision in
the patient's nose; advancing the osteotome along the nose to
position a cutting edge carried by the distal end at a location on
the nasal bone at which a cut is to be made; reciprocating the
distal end of the osteotome via the powered surgical handpiece;
moving the distal end of the osteotome, while it is being
reciprocated, forwardly along the nasal bone in a predetermined
path with the cutting edge in contact with the nasal bone to make a
cut of desired length in the nasal bone along the predetermined
path; and withdrawing the osteotome from the nose upon completion
of the cut being made.
86. A method of making a cut as recited in claim 85 wherein said
step of reciprocating includes converting rotary motion of a
rotatable drive shaft of the powered surgical handpiece into
reciprocating motion of the osteotome.
87. A method of making a cut as recited in claim 86 wherein said
step of removably coupling includes the steps of removably coupling
the proximal end of the osteotome to a front drive shaft of a
handpiece adapter and removably coupling a rear drive shaft of the
handpiece adapter to the drive shaft of the handpiece, and said
step of converting includes the steps of rotating the drive shaft
of the handpiece following said step of advancing, rotating the
rear drive shaft of-the handpiece adapter in response to rotation
of the drive shaft of the handpiece, causing a cam of the rear
drive shaft to reciprocate a cam follower of the front drive shaft
as the rear drive shaft is rotated by the drive shaft of the
handpiece such that the front drive shaft is reciprocated to
reciprocatively drive the osteotome.
88. A method of making a cut as recited in claim 87 wherein said
step of rotating the drive shaft of the handpiece includes rotating
the drive shaft of the handpiece at a speed of 6,000 RPM.
89. A method of making a cut as recited in claim 87 wherein said
step of rotating the drive shaft of the handpiece includes rotating
the drive shaft of the handpiece with an electric motor of the
handpiece.
90. A method of making a cut as recited in claim 85 wherein said
step of moving includes manipulating the handpiece to move the
distal end of the osteotome forwardly along the nasal bone in the
predetermined path.
91. A method of making a cut as recited in claim 90 wherein said
step of moving includes moving the distal end of the osteotome
forwardly along the nasal bone in a straight predetermined path to
form a longitudinally straight cut in the nasal bone.
92. A method of making a cut as recited in claim 90 wherein said
step of moving includes moving the distal end of the osteotome
forwardly along the nasal bone in a curved predetermined path to
form a longitudinally curved cut in the nasal bone.
93. A method of making a cut as recited in claim 85 wherein said
step of removably coupling includes removably coupling the proximal
end of a first osteotome having a longitudinally straight distal
length portion to the powered surgical handpiece and said step of
moving includes moving the distal end of the first osteotome
longitudinally along the nasal bone in a straight predetermined
path to make a straight medial cut in the nasal bone.
94. A method of making a cut as recited in claim 93 and further
including, subsequent to said step of withdrawing, the step of
removably coupling the proximal end of a second osteotome having a
laterally curved distal length portion to the powered surgical
handpiece, introducing the distal end of the second osteotome
through the incision, advancing the second osteotome along the nose
to position a cutting edge carried by the distal end of the second
osteotome at a location on the nasal bone at which a curved lateral
cut is to be made, reciprocating the distal end of the second
osteotome via the powered surgical handpiece, moving the distal end
of the second osteotome, while it is being reciprocated, forwardly
along the nasal bone in a predetermined curved path, laterally
spaced from the medial cut, with the cutting edge of the second
osteotome in contact with the nasal bone to make a curved lateral
cut of desired length in the nasal bone along the predetermined
curved path and withdrawing the second osteotome from the nose upon
completion of the lateral cut being made.
95. A method of making a cut as recited in claim 94 and further
including, prior to said steps of introducing, the step of marking
the skin of the patient's nose overlying the nasal bone to indicate
the locations and the predetermined paths for the medial and
lateral cuts, respectively.
96. A method of making a cut as recited in claim 85 and further
including the step of confirming proper formation of the cut.
97. A method of making a cut as recited in claim 96 wherein said
step of confirming includes palpating the patient's nose.
98. A method of making a cut as recited in claim 85 wherein said
step of reciprocating includes reciprocating the distal end of the
osteotome in a stroke of 2.0 mm.
99. A method of making a cut as recited in claim 85 and further
including, to said step of withdrawing, the steps of introducing a
distal end of a surgical suction rasp through the incision,
advancing the rasp along the nose to position the distal end of the
rasp at an operative site at which an area of the nasal bone is to
be contoured positioning a tissue cutting surface at the distal end
of the rasp in contact with the area of the nasal bone that is to
be contoured, reciprocating the distal end of the rasp to abrade
the nasal bone with the tissue cutting surface whereby the nasal
bone is contoured, removing anatomical debris from the operative
site through a suction passage of the rasp while the area of the
nasal bone is being contoured and withdrawing the rasp from the
nose upon completion of the contouring of the nasal bone.
Description
CROSS REFERENCE TO RELATED PATENT APPLICATIONS
[0001] This application is related to prior patent applications
Ser. No. 09/005,010, Ser. No. 09/005,012 and Ser. No. 09/005,014
filed Jan. 9, 1998, which are divisionals of prior application Ser.
No. 08/775,147 filed Dec. 31,1996 and now abandoned, and to Ser.
No. 09/005,189 filed Jan. 9, 1998, which is a continuation of Ser.
No. 08/775,147, which is a continuation-in-part of Ser. No.
08/719,130 filed Sep. 24, 1996 and now abandoned. The disclosures
of all of the foregoing patent applications are incorporated herein
by reference.
BACKGROUND OF THE INVENTION
[0002] 1. Field of the Invention:
[0003] The present invention generally relates to surgical
handpiece adapters for powered surgical handpieces, to cutting
members for being driven by surgical handpiece adapters, to powered
surgical handpiece assemblies and to methods of facial surgery.
More particularly, the present invention relates to a surgical
handpiece adapter by which rotary motion of a powered surgical
handpiece is converted to reciprocating motion, to cutting members
for being reciprocatively driven by a rotary powered surgical
handpiece via an adapter, to powered surgical handpiece assemblies
incorporating a powered surgical handpiece, an adapter and a
cutting member, to handpiece adapter assemblies incorporating an
adapter and a cutting member and to methods of facial surgery using
the same.
[0004] 2. Brief Description of the Prior Art
[0005] Powered surgical handpieces are commonly used in many
medical specialties to drive cutting members for performing various
diverse cutting functions. One particularly advantageous reusable,
powered or motorized surgical handpiece is the XPS.TM. StraightShot
handpiece of Xomed, Inc., Jacksonville, Fla., the XPS.TM.
StraightShot handpiece being the subject of prior patent
applications Ser. No. 09/005,010, Ser. No. 09/005,012, Ser. No.
09/005,014 and Ser. No. 09/005,189, all of which were filed Jan.
9,1998, Ser. No. 08/775,147 filed Dec. 31,1996 and now abandoned
and Ser. No. 08/719,130 filed Sep. 24, 1996 and now abandoned, the
disclosures of all the foregoing patent applications being
incorporated herein by reference. The XPS.TM. StraightShot
handpiece has a front drive shaft rotatably driven by a motor of
the handpiece. The front drive shaft has drive pins thereon for
drivingly engaging prongs disposed on a proximal end of a blade or
cutting member that is to be rotatably driven by the handpiece. The
blade or cutting member is selectively engageable and disengeable
with the front drive shaft allowing the handpiece to be used to
rotatably drive a variety of blades or cutting members selectively
coupled therewith. In accordance with the present invention, an
adapter for the XPS.TM. StraightShot handpiece is provided by which
the rotary motion of the front drive shaft is converted to
reciprocating motion in order to reciprocatively drive a blade or
cutting member.
[0006] Surgical cutting instruments wherein a rotatable output
shaft of a motor, i.e. a driver, is used to reciprocate, via a cam
and cam follower, a driven blade or cutting member have been
proposed as exemplified by U.S. Pat. No. 4,108,182 to Hartman et
al., U.S. Pat. No. 4,210,146 to Banco and U.S. Pat. No. 4, 246,902
to Martinez. In prior surgical cutting instruments wherein rotary
motion of the driver is converted to reciprocating motion of the
driven blade or cutting member, the mechanism or structure by which
the rotary motion is converted to the reciprocating motion is an
integral, permanently installed part of the cutting instrument and
cannot be detached or separated therefrom. Accordingly, such prior
surgical cutting instruments, of which the foregoing patents are
representative, can only be used to reciprocate a blade or cutting
member and cannot also be used with blades or cutting members which
are to be rotated.
[0007] Various other powered surgical handpieces having motors for
driving removable blades or cutting members have also been
proposed, as illustrated by the Stryker Hummer system of Stryker
Endoscopy, San Diego, Calif., the Apex System of Linvatec,
Incorporated, Largo, Fla., the PS 3500 and EP-1 Surgical Drive
System of Dyonics, Inc. of Andover, Mass. and the Wizard
microdebrider system of Xomed, Inc., Jacksonville, Fla. Such
powered surgical handpieces are limited for use with blades or
cutting members that are to be rotated and do not include any
mechanism or structure by which the powered surgical handpieces can
be adapted for use with blades or cutting members that are to be
reciprocated.
[0008] In various surgical procedures, particularly infacial
procedures including rhinoplasty and supraorbital reshaping, blades
or cutting members such as rasps and/or osteotomes have been used
to cut anatomical tissue such as bone. However, prior to the
present invention, reciprocating rasps could not be used with the
XPS.TM. StraightShot handpiece. In addition, prior reciprocating
rasps do not have suction passages with inlet openings,
respectively, disposed on tissue cutting surfaces, respectively, of
the rasps, by which anatomical debris is withdrawn or removed from
operative sites at which the rasps are used. Conventional
osteotomes have been used in facial surgery to make medial and
lateral cuts in the nasal bone of a patient during rhinoplasty.
Conventional osteotomes are manually tapped into and/or along the
nasal bone, via a mallet applied to proximal ends of the
osteotomes, in order to make the required cuts. The latter process
is tedious and time consuming, which places the patient at
increased risk of complications. Furthermore, manual tapping in of
conventional osteotomes is greatly subject to human error and
increases the risk of unsatisfactory results, such that the results
obtained with surgery are greatly dependent on the individual skill
of the surgeon. Accordingly, it would be desirable to
reciprocatively drive an osteotome with a powered surgical
handpiece in order to enhance the quality of cuts made therewith,
to reduce the time required to execute such cuts and to facilitate
accomplishment of satisfactory results by surgeons of varying
degrees of skill. It would also be desirable for various types of
rasps and osteotomes to be reciprocated, via a removable adapter,
by an XPS.TM. StraightShot handpiece which, when the adapter is
removed therefrom, can also be used to rotatably drive rotatable
blades or cutting members.
SUMMARY OF THE INVENTION
[0009] Accordingly, it is a primary object of the present invention
to overcome the aforementioned limitations or disadvantages of
prior powered surgical handpieces, rasps, osteotomes and methods of
facial surgery.
[0010] Another object of the present invention is to adapt a
powered surgical handpiece, having a rotatable driver, to
reciprocatively drive a blade or cutting member removably coupled
to the handpiece.
[0011] Yet another object of the present invention is to adapt the
XPS.TM. StraightShot handpiece to reciprocatively drive a blade or
cutting member.
[0012] A further object of the present invention is to provide a
removable adapter for a powered surgical handpiece by which rotary
motion of a drive shaft of the handpiece is converted to
reciprocating motion, via the removable adapter, to reciprocatively
drive a blade or cutting member removably coupled to the
adapter.
[0013] A still further object of the present invention is to
provide a removable adapter for the XPS.TM. StraightShot handpiece
by which the handpiece is capable of being used to reciprocatively
drive a blade or cutting member when the adapter is coupled with
the handpiece and, when the adapter is removed from the handpiece,
is capable of rotatably driving a blade or cutting member.
[0014] An additional object of the present invention is to provide
a surgical rasp having a suction passage with an inlet opening on a
tissue cutting surface of the rasp by which debris is withdrawn or
removed from an operative site at which the rasp is used to cut
anatomical tissue.
[0015] It is also an object of the present invention to
reciprocatively drive a surgical rasp via the XPS.TM. StraightShot
handpiece.
[0016] The present invention has as another object to
reciprocatively drive an osteotome via a powered surgical
handpiece.
[0017] Additionally, it is an object of the present invention to
facilitate the performance of surgical facial procedures,
particularly rhinoplasty and supraorbital procedures.
[0018] Some of the advantages of the present invention are that
various reciprocatively moveable blades or cutting members can be
used with a single adapter and handpiece, a single handpiece can be
used to drive both rotatable and reciprocative blades or cutting
members, various sizes of adapters can be provided in accordance
with the strokes desired for the blades or cutting members and/or
the forces exerted thereon by the blades or cutting members, the
adapter can be designed with a particular stroke, a plurality of
adapters can be provided with each adapter having a different
stroke, a single handpiece can be used with various sizes of
adapters, the handpiece and the adapters can be reusable while the
blades or cutting members can be disposable for single patient use,
the blades or cutting members can be reciprocated at various speeds
in accordance with the speed selected for the motor of the
handpiece, anatomical tissue can be cut by a rasp while
simultaneously removing anatomical debris via a suction passage of
the rasp, anatomical debris is removed from the operative site via
the suction passage to a location external of the patient's body,
the rasp can be designed with a curve or arc corresponding to the
natural curvature of the human head from behind the eyebrow to the
hairline for particularly advantageous use in supraorbital
procedures, the tissue cutting surface of the rasp can be designed
with various degrees of coarseness, the need for manually tapping
in osteotomes during rhinoplasty is eliminated, the time required
to cut bone during facial procedures is greatly reduced, the rasps
and osteotomes can be used with various adapters and/or powered
surgical handpieces, including conventional adapters and/or
conventional powered surgical handpieces, and the rasps and
osteotomes are particularly suited for use in minimally invasive
surgical procedures.
[0019] These and other objects, advantages and benefits are
achieved with the subject invention as generally categorized in a
surgical handpiece adapter for converting rotary motion of a
powered surgical handpiece into reciprocating motion for
reciprocatively driving a blade or cutting member. The adapter
includes a rear drive shaft having a proximal end for being
removably coupled to a drive shaft of the handpiece and having a
distal end, a front drive shaft having a distal end for being
removably coupled to the cutting member and a motion converting
mechanism by which rotation of the rear drive shaft by the drive
shaft of the handpiece is converted to reciprocating motion of the
front drive shaft and, therefore, the cutting member coupled
therewith. The motion converting mechanism includes a cam at the
distal end of the rear drive shaft and a cam follower on the front
drive shaft in engagement with the cam. The cam causes
reciprocation of the cam follower and, therefore, the front drive
shaft, when the rear drive shaft is rotated.
[0020] A surgical handpiece adapter assembly is formed by the
adapter and a cutting member coupled thereto. In one embodiment,
the cutting member has a proximal end adapted to drivingly engage
the distal end of the front drive shaft of the adapter when the
cutting member is in a specific orientation relative to the
adapter. In another embodiment, the cutting member has a groove for
receiving a locking member of the adapter. A powered surgical
handpiece assembly is formed by the adapter coupled to a powered
surgical handpiece and to a cutting member. In one embodiment, the
proximal end of the rear drive shaft of the adapter is adapted to
drivingly engage the drive shaft of the handpiece when the cutting
member is in a specific orientation relative to the handpiece, the
specific orientation corresponding to the preferred orientation for
use of the cutting member when the handpiece is manually grasped or
held by a surgeon in the normal manner. Various types of cutting
members, including rasps and osteotomes, may be used in a surgical
handpiece adapter assembly and/or a powered surgical handpiece
assembly incorporating the adapter of the present invention to be
reciprocatively driven via the adapter to cut anatomical tissue
including bone.
[0021] A surgical suction rasp according to the present invention
includes an elongate member having a distal end and a proximal end,
a tissue cutting surface at the distal end of the elongate member
and a suction passage having an inlet along the tissue cutting
surface and an outlet disposed proximally of the distal end of the
elongate member. The proximal end of the rasp is adapted to be
coupled with a drive shaft for reciprocating the distal end of the
rasp to cut anatomical tissue with the tissue cutting surface while
anatomical debris is removed through the suction passage. The rasp
may be assembled to an adapter, such as the adapter of the present
invention, to form a surgical handpiece adapter assembly. The rasp
may be assembled to an adapter and to a powered surgical handpiece
to form a powered surgical handpiece assembly.
[0022] Another surgical handpiece adapter assembly according to the
present invention includes an osteotome coupled with an adapter
capable of reciprocating the osteotome in response to the adapter
being rotatably driven. Another powered surgical handpiece assembly
according to the present invention includes an osteotome coupled
with an adapter which, in turn, is coupled with a powered surgical
handpiece. The adapter is capable of reciprocating the osteotome in
response to the adapter being rotatably driven by the
handpiece.
[0023] A method of facial surgery according to the present
invention wherein the nasal bone of a patient is surgically
reshaped includes the steps of introducing a distal end of a
surgical suction rasp through an incision in the patient's nose,
advancing the rasp along the nose to position the distal end at an
operative site at which an area of the nasal bone is to be
reshaped, positioning a tissue cutting surface at the distal end of
the rasp in contact with the area of the nasal bone that is to be
reshaped, reciprocating the distal end of the rasp to abrade and
thusly reshape the nasal bone with the tissue cutting surface, and
removing anatomical debris from the operative site through a
suction passage of the rasp while the nasal bone is being
reshaped.
[0024] A method of facial surgery according to the present
invention wherein a cut is made in the nasal bone of a patient
includes the steps of introducing a distal end of an osteotome
through an incision in the patient's nose, positioning a cutting
edge on the distal end of the osteotome at a location on the nasal
bone at which a cut is to be made, reciprocating the distal end of
the osteotome via a powered surgical handpiece, moving the distal
end of the osteotome, while it is being reciprocated, forwardly
along the bone in a predetermined path with the cutting edge in
contact with the nasal bone to make a cut of desired length in the
nasal bone along the predetermined path.
[0025] Other objects and advantages of the present invention will
become apparent from the following description of the preferred
embodiments taken in conjunction with the accompanying drawings,
wherein like parts in each of the several figures are identified by
the same reference characters.
BRIEF DESCRIPTION OF THE DRAWINGS
[0026] FIG. 1 is an exploded perspective view of a powered surgical
handpiece assembly according to the present invention illustrating
assembly of a surgical handpiece adapter to a powered surgical
handpiece and to a blade or cutting member to be driven by the
handpiece via the adapter.
[0027] FIG. 2 is a side view, partly in section, of the surgical
handpiece adapter according to the present invention.
[0028] FIG. 3 is a distal end view of a front drive shaft of the
surgical handpiece adapter.
[0029] FIG. 4 is a sectional view taken along line 4-4 of FIG.
2.
[0030] FIG. 5 is a proximal end view of a distal housing member of
the surgical handpiece adapter.
[0031] FIG. 6 is a top view of a cam of the surgical handpiece
adapter.
[0032] FIG. 7 is a side view of an alternative cam for the surgical
handpiece adapter.
[0033] FIG. 8 is a side view of a cutting member, which is a
surgical suction rasp, according to the present invention.
[0034] FIG. 9 is a bottom view of the rasp of FIG. 8.
[0035] FIG. 10 is a side view of an alternative surgical suction
rasp according to the present invention.
[0036] FIG. 11 is a side view of the cutting member, which is an
osteotome, of FIG. 1.
[0037] FIG. 12 is a bottom view of the osteotome.
[0038] FIG. 13 is a bottom view of an alternative osteotome for use
with the surgical handpiece adapter.
[0039] FIG. 14 is a perspective view illustrating use of the rasp
of FIG. 8 to reshape the nasal bone of a patient in a facial
procedure.
[0040] FIG. 15 is a perspective view illustrating use of the
osteotome of FIGS. 1, 11 and 12 to make a straight medial cut in
the nasal bone of a patient in a rhinoplasty procedure.
[0041] FIG. 16 is a perspective view illustrating use of the
osteotome of FIG. 13 to make a curved lateral cut in the nasal bone
of a patient in a rhinoplasty procedure.
[0042] FIG. 17 is a perspective view illustrating use of the rasp
of FIG. 10 in a supraorbital procedure.
[0043] FIG. 18 is a broken side view, partly in section, of a
distal portion of an alternative surgical handpiece adapter
according to the present invention.
[0044] FIG. 19 is a bottom view of a further alternative rasp
according to the present invention adapted for use with the adapter
of FIG. 18.
DESCRIPTION OF THE PREFERRED EMBODIMENTS
[0045] A powered surgical handpiece assembly according to the
present invention is illustrated in FIG. 1 and includes a powered
surgical handpiece, a surgical handpiece adapter removably coupled
to the handpiece and a blade or cutting member removably coupled to
the adapter for being driven by the handpiece via the adapter. A
surgical handpiece adapter or converter 10 of the powered surgical
handpiece assembly is illustrated in FIGS. 1 and 2. The surgical
handpiece adapter 10 according to the present invention includes a
front drive shaft 12, a rear drive shaft 14 for being rotatably
driven by the powered surgical handpiece 16 and a motion converting
mechanism 18 for converting or transforming rotary motion of the
rear drive shaft 14 into reciprocating motion of the front drive
shaft 12. The front drive shaft 12, which is preferably made of
17-4 PH stainless steel having a hardness of H900, includes a
distal or forward section 20, a distal or forward intermediate
section 22, a proximal or rearward intermediate section 24 and a
proximal or rearward section 26. The distal section 20 is formed or
provided as a collet 20 including a cylindrical proximal or
rearward portion 28 extending distally from the distal intermediate
section 22, a truncated conical proximal or rearward intermediate
portion 29 extending distally from the proximal portion 28, a
cylindrical distal or forward intermediate portion 30 extending
distally from the proximal intermediate section 29 and a truncated
conical distal or forward portion 31 extending distally from the
distal intermediate portion 30.
[0046] The proximal portion 28, the proximal intermediate portion
29, the distal intermediate portion 30 and the distal portion 31
are in longitudinal, coaxial alignment, and a longitudinal passage
or bore section 32 extends entirely through the distal section 20.
The proximal portion 28 and the distal intermediate portion 30 are
of constant or uniform cross-section or external diameter along
their lengths, respectively, and the external diameters of the
proximal portion 28 and the distal intermediate portion 30 are the
same or substantially the same. The proximal intermediate portion
29 is of non-constant or non-uniform cross-section or external
diameter along its length and has a minimum external diameter
joined to or merging with the distal intermediate portion 30 and a
maximum external diameter, greater than the external diameters of
the proximal portion 28 and the distal intermediate portion 30,
defining a transverse shoulder at which the proximal intermediate
portion 29 is joined to the proximal portion 28. The distal portion
31 is also of non-constant or non-uniform cross-section or external
diameter along its length and has a minimum external diameter at a
transverse surface defining a distal end of the adapter 10 and a
maximum external diameter, greater than the external diameters of
the proximal portion 28 and the distal intermediate portion 30,
defining a transverse shoulder at which the distal portion 31 is
joined to the distal intermediate portion 30. The maximum external
diameter of the distal portion 31 is smaller or less than the
maximum external diameter of the proximal intermediate portion 29.
The longitudinal passage section 32 is of uniform or constant
diameter or cross-section along the entire length of the distal
section 20.
[0047] As shown in FIGS. 2 and 3, a plurality of longitudinally
extending gaps 33 are formed in the wall of distal section 20, and
the gaps 33 extend the entire length of the distal section 20. In
the case of front drive shaft 12, four gaps 33 are provided in the
distal section 20 at 90 degree spaced locations about a central
longitudinal axis of the distal section 20, which is coaxial with a
central longitudinal axis of the front drive shaft 12 and with a
central longitudinal axis of the adapter 10. In this manner, four
longitudinally extending legs are defined by the wall of distal
section 20. Each gap 33 has a width between opposing gap edges 34
of adjacent legs, and the gap width is of a first or maximum size
when the collet 20 is open as shown in FIGS. 2 and 3. With the
collet 20 open, the maximum widths of the gaps 33 are the same or
substantially the same, and the gap widths are uniform or constant
along the length of the distal section 20.
[0048] The distal intermediate section 22 is coaxial with the
distal section 20 and has a cylindrical rearward or proximal
portion merging with a truncated conical or tapered distal or
forward portion, which is joined to or merges with the proximal
portion 28 of distal section 20. An external thread 35 is disposed
on the cylindrical portion of the distal intermediate section 22
and extends the entire length of such cylindrical portion. The
external thread 35 defines a maximum external diameter for distal
intermediate section 22 which is larger or greater than the maximum
external diameter of proximal intermediate portion 29 of distal
section 20. A longitudinal passage or bore section 36 extends
entirely through the distal intermediate section 22 and is
continuous with passage section 32 of distal section 20. The
passage section 36 has a diameter or cross-section, which is
uniform or constant along the entire length of distal intermediate
section 22, that is the same as the diameter or cross-section of
passage section 32.
[0049] An operating member in the form of a nut 38 is disposed on
the front drive shaft 12 and is threadedly engaged with the thread
35 of distal intermediate section 22 as shown in FIG. 2. The nut 38
has a cylindrical rearward or proximal section and a truncated
conical distal or forward section extending distally from the
rearward section thereof. A longitudinal passage extends entirely
through nut 38 and includes a cylindrical longitudinal passage
section 39 disposed in the cylindrical proximal section of nut 38
and a tapered or truncated conical longitudinal passage section 40
disposed in the truncated conical distal section of nut 38. The nut
38 is internally threaded as shown by a thread 41 disposed within
and along the cylindrical longitudinal passage section 39. The
thread 41 extends along the entire length of the cylindrical
longitudinal passage section 39, except for a relatively small,
unthreaded proximal length segment of passage section 39. The
thread 41 corresponds to the external thread 35 on the distal
intermediate section 22 of the front drive shaft 12 and is designed
for threaded engagement therewith as shown in FIG. 2. Engagement of
thread 41 with the thread 35 allows the nut 38 to be moved
longitudinally, proximally and distally, relative to and along the
front drive shaft 12 via rotation of nut 38 relative to the drive
shaft 12. All or part of the external surface of nut 38 can be
knurled, as shown in FIG. 1, or otherwise finished or configured to
facilitate grasping and, therefore, operation thereof.
[0050] When the nut 38 is in a distal longitudinal position
relative to the front drive shaft 12 as shown in FIG. 2, the collet
20 is open and the passage 46 is open so as to allow a proximal end
of a blade or cutting member to be inserted therein. A distal most
end surface of the truncated conical distal section of nut 38 is
close to or in engagement or abutment with the transverse shoulder
of distal portion 31 of front drive shaft 12. The shoulder of
distal portion 31 prevents removal of nut 38 from the drive shaft
12. The truncated conical distal section of nut 38 has an angled
interior surface in contact or engagement with a more steeply
angled exterior surface of proximal intermediate portion 29 of
front drive shaft 12 as shown in FIG. 2, the proximal intermediate
portion 29 being disposed within the tapered longitudinal passage
section 40 of nut 38. When the nut 38 is moved longitudinally,
proximally relative to and along the front drive shaft 12, in
response to rotation of nut 38 in a first rotational direction
relative to front drive shaft 12, the angled interior surface
slides along the exterior surface of proximal intermediate portion
29 and forces or moves the legs of collet 20 radially inwardly in
the direction of the central longitudinal axis of front drive shaft
12. In this manner, the gap edges 34 of each gap 33 are moved
closer to or into contact with one another to reduce the width of
gaps 33 and thereby place the collet in a closed position. In the
closed position, the passage 46 is closed so as to prevent passage
of a proximal end of a blade or cutting member therethrough.
[0051] A proximal end of a blade or cutting member can be disposed
within the passage section 32 when the collet is open and will be
forcefully engaged by the legs of the collet as the collet is
closed. Upon sufficient longitudinal, proximal movement of nut 38
relative to and along the front drive shaft 12, the nut 38 will be
in a proximal longitudinal position, relative to the front drive
shaft 12, wherein sufficient force is exerted by the legs upon the
blade or cutting member to firmly couple or secure the blade or
cutting member to the front drive shaft and prevent removal of the
blade or cutting member from the front drive shaft during use.
Accordingly, the proximal longitudinal position of nut 38
corresponds to the closed position for the collet 20 wherein the
blade or cutting member is secured or locked onto the front drive
shaft 12. Removal or detachment of the blade or cutting member from
the front drive shaft 12 and, therefore, from the adapter 10, is
effected by untightening the collet, i.e. by rotating the nut 38 in
a second rotational direction, opposite the first rotational
direction, relative to front drive shaft 12 to effect longitudinal,
distal movement of the nut 38 relative to and along the front drive
shaft 12. In this manner, the nut 38 is placed in the distal
longitudinal position corresponding to the open position for the
collet 20 wherein the legs are permitted to move radically
outwardly to allow the proximal end of the blade or cutting member
to be withdrawn from the passage of the front drive shaft.
[0052] The proximal intermediate section 24 is coaxial with the
distal intermediate section 22 and is of cylindrical configuration
having an external diameter that is the same or substantially the
same as the maximum external diameter of distal intermediate
section 22. A longitudinal passage or bore section 44 extends part
way into the proximal intermediate section 24, the passage section
44 being continuous with the passage section 36 and having the same
diameter as passage section 36. The passage section 44 terminates
in the proximal intermediate section 24 at a tapered end surface as
shown in FIG. 2. The longitudinal passage sections 32, 36 and 44
together define a continuous, unitary, longitudinal passage or bore
46 in the front drive shaft 12, the passage 46 being coaxially
aligned with the central longitudinal axis of the front drive
shaft. The passage 46 extends longitudinally in the front drive
shaft 12 from an open distal end of distal portion 31, which
defines the distal end of the adapter, to the end surface within
the proximal intermediate section 24.
[0053] As shown in dotted lines in FIG. 2, an alignment member 48
is disposed in the passage 46 distally of the end surface thereof.
The alignment member 48 includes a post, pin or peg extending in a
transverse direction in passage section 44, the alignment member 48
being disposed perpendicular to the central longitudinal axis of
the front drive shaft 12. The alignment member 48 may comprise a
single, unitary post, pin or peg extending diametrically within the
passage section 44 and having opposing ends secured to the wall of
front drive shaft 12 forming proximal intermediate section 24. As
another example, the alignment member 48 may comprise a pair of
individual post, pin or peg segments having first ends,
respectively, secured to the wall of front drive shaft 12 forming
the proximal intermediate section 24 and second ends terminating
within the passage section 44 adjacent or in abutment with one
another with the individual post, pin or peg segments being aligned
with one another in the transverse diametric direction. The
alignment member 48 facilitates proper alignment or positioning of
the proximal end of a blade or cutting member within the passage 46
for securement of the blade or cutting member to the adapter 10 in
a specific orientation as explained further below.
[0054] A plurality of longitudinally extending, partial spherical
grooves 50 are formed on an exterior surface of the proximal
intermediate section 24 as shown in FIGS. 2 and 4. The grooves 50
have distal ends disposed proximally of the alignment member 48 and
proximal ends disposed distally of proximal section 26. The grooves
50 are parallel to the central longitudinal axis of the front drive
shaft 12 and are disposed at spaced, radial locations about the
central longitudinal axis of the front drive shaft 12 as shown in
FIG. 4. In the case of front drive shaft 12, six grooves 50 are
provided on the proximal intermediate section 24 at 60 degree
spaced, radial locations about the central longitudinal axis of the
front drive shaft 12. Each groove 50 is defined by a concave
external surface of proximal intermediate section 24 as shown in
FIG. 4.
[0055] The proximal section 26 of front drive shaft 12 is coaxial
with the proximal intermediate section 24 and has an external
cylindrical configuration with a uniform or constant external
diameter that is greater or larger than the external diameter of
proximal intermediate section 24. A cylindrical recess 54 is formed
in the proximal section 26 concentric therewith. The recess 54 has
a length between an open proximal end of proximal section 26, which
defines a proximal end of front drive shaft 12, and a planar end
surface 55 within proximal section 26. The recess 54 is of uniform
or constant diameter, and a cylindrical aperture or hole 56 is
formed in proximal section 26 in communication with the recess 54
as shown in FIG. 2. In particular, the aperture 56 is formed in the
wall of front drive shaft 12 forming proximal section 26 and is
located near the open proximal end thereof. The aperture 56 is
internally threaded and extends entirely through the wall of front
drive shaft 12 in a direction transverse or perpendicular to the
central longitudinal axis of front drive shaft 12 and therefore,
the central longitudinal axis of adapter 10.
[0056] The proximal end of front drive shaft 12 is disposed within
a housing 57 of adapter 10, the housing 57 including a proximal
housing member or body 58 and a distal housing member or nose 60
connected to body 58. The body 58, which is preferably made of 17-4
PH stainless steel having a hardness of H900, includes a
cylindrical distal section 62 and a proximal section 63 extending
longitudinally, proximally from the cylindrical distal section 62.
The cylindrical distal section 62 has a uniform or constant
external diameter larger or greater than a uniform or constant
external diameter of a cylindrical distal segment of proximal
section 63 such that the cylindrical distal section 62 is joined to
the cylindrical distal segment of proximal section 63 by a
transverse shoulder of body 58. A cylindrical recess 64 is
concentrically disposed in the cylindrical distal section 62 and
has a length extending proximally from an open distal end of
cylindrical distal section 62 to an interior surface of the
transverse shoulder of body 58. The length of recess 64 is greater
than the length of proximal section 26, thusly providing room in
housing 57 for the front drive shaft 12 to reciprocate or move
longitudinally, proximally and distally relative thereto. The
recess 64 has a uniform or constant diameter of a size to closely
receive the external diameter of proximal section 26 while allowing
the proximal section 26 and, therefore, the front drive shaft 12,
to reciprocate or move longitudinally, proximally and distally,
within the recess 64. The proximal section 63 is coaxially aligned
with the cylindrical distal section 62 and has a longitudinal
passage or bore 65 extending therethrough. The bore 65 is
longitudinally or axially aligned with the recess 64 and has a
distal end in communication with the recess 64 and a proximal end
defining an open proximal end of the body 58, which also defines a
proximal end of the housing 57. The bore 65 is of uniform or
constant diameter, which is smaller or less than the diameter of
recess 64.
[0057] An annular flange 66 is concentrically disposed externally
on the proximal section 63, and a plurality of partial spherical
recesses 67 are disposed on an external surface of flange 66. In
the case of body 58, the flange 66 is located between the
cylindrical distal section 62 and the open proximal end of the body
58 and is slightly closer to the proximal end of body 58 than to
the cylindrical distal section 62. A cylindrical proximal segment
of proximal section 63 extends proximally of flange 66 and has a
uniform or constant external diameter that is slightly greater than
the external diameter of the distal segment of proximal section 63
but less than the external diameter of distal section 62. The
distal and proximal segments of proximal section 63 are in coaxial
alignment, and the flange 66 has an external diameter greater than
the external diameter of the proximal segment of proximal section
63 but less than external diameter of distal section 62. Twelve
recesses 67 are provided on flange 66 at 30.degree. spaced, radial
locations about a central longitudinal axis of body 58, which is
coaxial with the central longitudinal axis of drive shaft 12 when
the drive shaft 12 is assembled to the housing 57. The flange 66 is
designed to permit the adapter 10 to be releasably coupled with a
powered surgical handpiece and, in particular, with the XPS.TM.
StraightShot handpiece as explained further below. A plurality of
tapered holes 69, only one of which is visible in FIG. 2, are
formed through the wall of body 58 forming the cylindrical distal
section 62. The holes 69 are disposed adjacent or close to the open
distal end of distal section 62 and extend entirely through the
wall of body 58 to communicate with recess 64. In the case of body
58, three holes 69 are provided at 1200 spaced locations about the
central longitudinal axis of body 58 with the holes 69 being
inwardly tapering in a radial direction toward the central
longitudinal axis of body 58.
[0058] The nose 60 is preferably made of 17-4 PH stainless steel
having a hardness of H900 and includes a cylindrical intermediate
section 72, a truncated conical distal section 73 and a cylindrical
proximal section 74. The cylindrical intermediate section 72 has a
uniform or constant external diameter that is the same as the
external diameter of cylindrical distal section 62, and the
cylindrical proximal section 74 has a uniform or constant external
diameter smaller or less than the external diameter of cylindrical
intermediate section 72 such that a transverse shoulder is formed
or defined on nose 60 where the cylindrical proximal section 74 is
joined to the cylindrical intermediate section 72. The external
diameter of cylindrical proximal section 74 corresponds to the
diameter of recess 64 whereby the cylindrical proximal section 74
can be closely received within the recess 64 with the shoulder of
nose 60 in abutment with the distal end of body 58 as shown in FIG.
2. The truncated conical distal section 73 extends distally from
the cylindrical intermediate section 72 and has a non-uniform or
non-constant external diameter with a maximum external diameter
joined to or merging with cylindrical intermediate section 72 and a
minimum external diameter at a distal end of nose 60. A shallow
cylindrical recess is formed in the distal end of nose 60 in
communication with a longitudinal cylindrical bore 75 extending
through the nose 60.
[0059] As shown in FIGS. 2 and 5, a plurality of apertures 76,
corresponding in number to the holes 69, are formed in the wall of
nose 60 forming cylindrical proximal section 74. The apertures 76
extend entirely through the wall of nose 60 and thusly communicate
with the bore 75. In the case of nose 60, three apertures 76 are
provided in nose 60 at 120.degree. spaced locations about a central
longitudinal axis of nose 60; and, when the proximal section 74 of
nose 60 is disposed in recess 64 with the shoulder of nose 60 in
abutment with the distal end of body 58, the apertures 76 are in
alignment with the holes 69 as shown in FIG. 2. Preferably, each of
the apertures 76 is tapped to receive a screw inserted therein via
the holes 69 aligned therewith.
[0060] The bore 75 has a uniform or constant diameter of a size
sufficiently large to accommodate the external diameter of proximal
intermediate section 24 of front drive shaft 12. A plurality of
partial spherical grooves 77 are formed in an inner surface of nose
60 defining the bore 75 as shown in FIGS. 2, 4 and 5, and the
grooves 77 extend along the entire length of bore 75, except for a
small distal length segment of bore 75 defining the shallow recess.
The number, configuration and location of the grooves 77 correspond
to the number, configuration and location of grooves 50.
Accordingly, in the case of nose 60, six grooves 77 are provided in
nose 60 at 60.degree. spaced locations about the central
longitudinal axis of nose 60, and the grooves 77 are defined by
concave interior surfaces of nose 60 corresponding to concave
surfaces 51. When the front drive shaft 12 is assembled to the body
58 and the nose 60 as shown in FIG. 2, the proximal intermediate
section 24 of the front drive shaft 12 extends entirely through the
nose 60, the proximal intermediate section 24 extending through the
bore 75 and the shallow recess disposed at the open distal end of
the nose 60. As shown in FIG. 4, the grooves 77 of nose 60 are in
alignment with the grooves 50 of the front drive shaft 12.
Accordingly, each groove 50 is aligned in a radial direction, about
the central longitudinal axis of drive shaft 12, with a groove 77
to form an aligned pair of grooves. An annular insert or seal 78,
preferably made of stainless steel, is disposed in the shallow
recess at the open distal end of nose 60 and has an outer diameter
corresponding to the diameter of the shallow recess and an inner
diameter corresponding to the external diameter of proximal
intermediate section 24 while allowing the drive shaft 12 to move
longitudinally therethrough.
[0061] As further shown in FIG. 4, a linear bearing including a
cage 80, not shown in FIG. 2, and a plurality of spherical balls 81
is preferably disposed in bore 75 between the front drive shaft 12
and the nose 60. Preferably, the cage 80 includes a tubular or
hollow cylindrical member having a plurality of circular holes
therein for receiving or retaining balls 81, the cage 80 having an
outer diameter to be received in the diameter of bore 75 and an
inner diameter to receive the external diameter of proximal
intermediate section 24. The cage 80 is, as an example, secured to
the proximal intermediate section 24 of front drive shaft 12, such
as being shrink fit thereon, and has a length corresponding to the
length of grooves 50. A first set of six holes is provided in cage
80 and a second set of six holes is provided in cage 80
longitudinally spaced from the first set of six holes. The holes of
each set are disposed at 60.degree. spaced, radial locations about
the central longitudinal axis of drive shaft 12 such that each hole
is aligned with an aligned pair of grooves 50 and 77, as shown in
FIG. 4, when the front drive shaft 12 is assembled to the housing
57. Each hole of cage 80 has a diameter corresponding to the
diameter of the balls 81, and each ball 81 is disposed in a hole of
cage 80 to protrude into the grooves 50 and 77 aligned therewith,
each ball 81 being captured between the concave surfaces of the
aligned grooves, respectively. Each ball 81 is thusly partly
disposed in the groove 50 and partly disposed in the groove 77 of
an aligned pair of grooves. The balls 81 are capable of freely
rotating within the holes of cage 80, respectively, and the aligned
grooves 50 and 77 of the nose 60 and the front drive shaft 12. In
addition, as the drive shaft 12 is reciprocated relative to and
within the housing 57, each ball 81 moves longitudinally within at
least one of the grooves of the associated aligned pair of grooves,
or at least one of the grooves of each aligned pair of grooves
moves longitudinally relative to the associated ball 81. Where the
cage 80 is attached or secured to the front drive shaft 12, for
instance, the cage 80 will move with the front drive shaft, and the
balls 81 will move longitudinally within the grooves 77 of nose 60.
The cage 80 prevents displacement of the balls 81 and thusly
maintains the longitudinal spacing and position thereof. It should
be appreciated that the cage 80 does not have to be secured to the
front drive shaft 12 and that the cage 80 can be secured to the
nose 60, in which case the grooves 50 move longitudinally
relatively to the balls 81, or can merely be interposed between the
nose 60 and the front drive shaft 12 without any mechanical
connection between the cage and the front drive shaft or the
nose.
[0062] The motion converting mechanism 18 includes a cam 82, which
is solid and preferably made of 17-4 PH stainless steel having a
hardness of H900, coupled with the rear drive shaft 14 and a cam
follower 83, which is also preferably made of 17-4 PH stainless
steel having a hardness of H900, coupled with the front drive shaft
12. The cam 82 includes a cam head 84 disposed in the recess 54 of
proximal section 26 of front drive shaft 12 and a cam shaft or rod
85 extending proximally from cam head 84 and disposed within the
bore 65 of proximal section 63 of body 58. The cam shaft 85 extends
through the open proximal end of body 58 and is connected to or
formed as part of the rear drive shaft 14, which extends externally
of the body 58. An annular insert or seal is disposed in the open
proximal end of body 58 with the cam shaft 85 extending proximally
through the insert or seal. As shown in FIGS. 2 and 6, the cam head
84 includes forward and rearward cam head sections 86 and 86',
respectively, between which is defined a groove or track 87. The
forward and rearward cam head sections 86 and 86' each have a
planar end surface, perpendicular to a central longitudinal axis of
cam 82, and a non-planar cam surface, non-perpendicular or disposed
at an angle to the central longitudinal axis of cam 82. The planar
end surface of forward cam head section 86 defines a distal end of
cam head 84 while the planar end surface of rearward cam head
section 86' is disposed at a proximal end of cam head 84 such that
the track 87 is defined between the cam surfaces.
[0063] The forward and rearward cam head sections 86 and 86' each
have a maximum length tapering to a minimum length between their
planar end surfaces and their non-planar cam surfaces,
respectively, the minimum length being located 180.degree. from the
maximum length about the central longitudinal axis of cam 82. The
forward and rearward cam head sections 86 and 86' are arranged such
that the maximum length of forward cam head section 86 is
longitudinally aligned with the minimum length of the rearward cam
head section 86', and the minimum length of the forward cam head
section 86 is longitudinally aligned with the maximum length of the
rearward cam head section 86'. Accordingly, the maximum length of
the forward cam head section 86 and the minimum length of the
rearward cam head section 86' are disposed at the same radial
location about the central longitudinal axis of cam 82, while the
minimum length of the forward cam head section 86 and maximum
length of the rearward cam head section 86' are disposed at a
radial location located 180.degree. from the radial location of the
maximum length of the forward cam head section 86 and the minimum
length of the rearward cam head section 86'. The forward and
rearward cam head sections 86 and 86', respectively, each have a
maximum external transverse or diametric dimension, which defines a
maximum, external transverse or diametric dimension for the cam
head 84. An intermediate cam head section of the cam head 84,
around which the path of track 87 is defined, extends between the
forward and rearward cam head sections and has a cylindrical
configuration with an external diameter that is less than or
smaller than the maximum external transverse or diametric dimension
of the forward and rearward cam head sections. The cam head 84 has
a length, between the planar end surfaces thereof, less than the
length of recess 54 of proximal section 26 of front drive shaft 12
as shown in FIG. 2. The maximum, external transverse or diametric
dimension of cam head 84 corresponds or is close in size to the
diameter of recess 54 while allowing the cam head 84 to rotate,
relative to the front drive shaft 12, within recess 54 and allowing
the front drive shaft 12 to reciprocate or move longitudinally,
relative to the cam 82, within the recess 64 of body 58. The cam
shaft 85 is rotatable in the bore 65 of proximal section 63 of body
58, and the cam head 84 is rotated with the cam shaft 85 such that
the cam 82 rotates relative to the housing 57. The cam 82 is
secured in the housing 57 against longitudinal movement relative to
the housing 57.
[0064] The cam follower 83 includes an externally threaded end
secured in aperture 56 of proximal section 26 via engagement of an
external thread of the cam follower 83 with the internal thread of
aperture 56. The cam follower 83 includes a projection or
protrusion 88 longitudinally aligned with the externally threaded
end thereof and extending from the externally threaded end thereof
into the recess 54 of the proximal section 26. The projection 88 is
disposed in the track 87 of cam 82, which is coaxially aligned with
the front drive shaft 12. In this manner, the proximal end of the
front drive shaft 12 is mechanically coupled to or in driving
engagement with the rear drive shaft 14 via the motion converting
mechanism. The projection 88 has a length, in a direction parallel
to the central longitudinal axis of adapter 10, to be received
between the cam surfaces of the cam head 84 and has a height to be
received in the space defined by track 87 between the maximum
external transverse or diametric dimension of the forward and
rearward cam head sections and the external diameter of the
intermediate cam head section. When the maximum length of forward
cam head section 86 and the minimum length of rearward cam head
section 86' are longitudinally aligned with the projection 88 as
shown in FIG. 2, the front drive shaft 12 is in a proximalmost
longitudinal position, with the distal end of the front drive shaft
12 disposed a minimum longitudinal distance beyond the housing 57.
When the cam 82 is rotated from the position shown in FIG. 2, the
projection 88 follows the path of track 87 causing the front drive
shaft 12 to be moved longitudinally, distally relative to the cam
82 and, therefore, relative to the rear drive shaft 14 and the
housing 57. Once the cam 82 has been rotated 180.degree. from the
position shown in FIG. 2, such that the minimum length of the
forward cam head section 86 and the maximum length of the rearward
cam head section 86' are longitudinally aligned with the projection
88, the front drive shaft 12 will be in a distalmost longitudinal
position with the distal end thereof disposed a maximum
longitudinal distance beyond housing 57. Further rotation of the
cam 82 in the same rotational direction causes the front drive
shaft 12 to move longitudinally, proximally from the distal most
longitudinal position; and, when the cam 82 has been rotated an
additional 180.degree., the front drive shaft 12 will have been
returned to the proximalmost longitudinal position. When the rear
drive shaft 14 is continuously turned or rotated by the motor of
handpiece 16, the front drive shaft 12 is continuously reciprocated
or moved longitudinally back and forth, distally and proximally. As
the front drive shaft 12 is reciprocated, the proximal section 26
thereof moves longitudinally within the recess 64 of body 58.
[0065] The rear drive shaft 14 for adapter 10 is preferably made of
17-4 PH stainless steel having a hardness of H900 and has a distal
end secured to a proximal end of cam shaft 85, the rear drive shaft
14 being in axial alignment with cam 82. The rear drive shaft 14
has a proximal end for being removably coupled with the handpiece
16. The rear drive shaft 14 can be formed as a separate member
secured to cam shaft 85 or the rear drive shaft can be formed
integrally, unitarily with the cam shaft; and, accordingly, the
rear drive shaft 14 cannot move longitudinally relative to the
housing 57. The rear drive shaft 14 is at least partly tubular with
the proximal end thereof being open and in communication with a
lumen extending distally in the rear drive shaft from the open
proximal end thereof. A plurality of oblong slots 90 are formed in
the proximal end of rear drive shaft 14 at 90.degree. spaced
locations about a central longitudinal axis of rear drive shaft 14,
which is coaxial or coincident with the central longitudinal axis
of adapter 10. The slots 90 extend longitudinally, parallel to the
central longitudinal axis of adapter 10, to define a plurality of
spaced prongs 91. Each slot 90 has a distal portion of uniform
width and a proximal portion of increasing width in the proximal
direction such that the proximal portions of the slots 90,
respectively, flare out from the distal portions thereof to provide
prongs 91 with triangular shaped tips. The rear drive shaft 14 is
thusly adapted to be operatively coupled with the handpiece 16,
which is the XPS.TM. StraightShot handpiece of Xomed, Inc.
disclosed in the patent applications incorporated herein by
reference. In particular, drive pins of the front drive shaft of
the handpiece 16 are disposed in a pair of opposed slots 90 in
driving engagement with prongs 91 in the same manner as disclosed
in the prior applications incorporated herein by reference for
coupling a blade or cutting member to the handpiece. In this
manner, the proximal end of the rear drive shaft has a
configuration to mate with the drive shaft of the handpiece.
[0066] The adapter 10 is coupled with the handpiece 16 by moving
the middle collet member of the handpiece longitudinally
proximally, relative to the outer collet member of the handpiece,
to the retracted position, causing ball bearings within the middle
collet member to be aligned with the forward passage segment of the
middle collet member. The proximal end of rear drive shaft 14 is
introduced in the longitudinal passage of the middle collet member
and is moved longitudinally, proximally further into the handpiece
to enter the longitudinal passage of the inner collet member of the
handpiece 16 such that the drive pins of the front drive shaft of
the handpiece enter the slots 90, the triangular prongs 91
providing a self-centering function facilitating entry of the drive
pins of the handpiece 16 into a pair of opposed slots 90 of the
rear drive shaft 14 of the adapter 10. The annular flange 66 on
body 58 enters the passage of the inner collet member, causing the
ball bearings of the middle collet member to be moved outwardly
from their holes. When the rear drive shaft 14 is inserted in the
handpiece 16 in proper engagement with the front drive shaft of the
handpiece, a proximal surface or face of flange 66 will be in
abutment with an internal shoulder of the inner collet member of
the handpiece 16, and the partial spherical recesses 67 of flange
66 will be in alignment with the holes that receive the ball
bearings of the handpiece. When the middle collet member of
handpiece 16 is thereafter released, it is returned to the extended
position due to the bias of a spring, causing the ball bearings to
be moved inwardly into the partial spherical recesses 67 of flange
66. Accordingly, flange 66 of adapter 10 is prevented by the ball
bearings from moving longitudinally and rotationally relative to
the handpiece 16, and the adapter 10 is therefore locked in place
on the handpiece 16 as described in the prior applications
incorporated herein by reference. With the adapter 10 thusly
coupled with the handpiece 16, rotation of the drive shaft of the
handpiece 16 is effected by an electric motor of the handpiece 16,
causing rotation of the rear drive shaft 14 therewith. Rotation of
rear drive shaft 14 by handpiece 16 causes the front drive shaft 12
of the adapter 10 to be reciprocated via conversion or
transformation of the rotary motion of the rear drive shaft 14 into
reciprocating motion of the front drive shaft 12 via the motion
converting mechanism 18. Operation of handpiece 16 to rotate the
drive shaft thereof is typically controlled via a console or a foot
switch as described in the prior applications incorporated herein
by reference.
[0067] The adapter 10 is preferably made of durable, medically
acceptable materials, such as stainless steel or hard coated
anodized aluminum or titanium, for example, capable of being
sterilized to medical standards, such as by steam or flash
autoclaving, gas sterilization and/or soaking in a disinfectant
solution. Accordingly, the adapter 10 is designed for repeated use.
As described in the prior applications incorporated herein by
reference, the handpiece 16 is also designed for repeated use. The
adapter 10 can include various sizes of front and rear drive shafts
and/or motion converting mechanisms in accordance with the types of
blades or cutting members to be driven by the adapter, the stroke
desired for the blades or cutting members and/or the force or
stress to which the blades or cutting members are to be subjected
during use. The difference between the maximum and minimum lengths
of the rearward cam head section 86' defines the stroke for the
front drive shaft 12, i.e. the distance that the distal end of the
front drive shaft 12 travels between the proximalmost and the
distalmost longitudinal positions. Accordingly, it should be
appreciated that the stroke of the front drive shaft 12 and,
therefore, the stroke of the blade or cutting member coupled
therewith, can be varied or adjusted with the use of different cam
heads. In a preferred adapter according to the present invention
for use with a reciprocating rasp as described below, the cam head
is designed to provide a stroke of 3.0 mm. In another preferred
adapter according to the present invention for use with a
reciprocating osteotome as described below, the cam head is
designed to provide a stroke of 2.0 mm.
[0068] An alternative cam is illustrated at 182 in FIG. 7. The cam
182 is similar to cam 82 except that the cam head 184 for cam 182
is configured so as to obtain a smaller stroke for the front drive
shaft 12 and, therefore, for a blade or cutting member coupled to
the front drive shaft 12. Cam head 184 includes track 187 between
forward and rearward cam head sections 186 and 186', respectively.
The rearward cam head section 186' has a maximum length that is
less than the maximum length of rearward cam head section 86' and
has a minimum length that is greater than the minimum length of
rearward cam head section 86'. Accordingly, the difference between
the maximum and minimum lengths of rearward cam head section 186'
is less than the difference between the maximum and minimum lengths
of rearward cam head section 86' such that the stroke provided by
cam head 184 is smaller than that provided by cam head 84.
[0069] In the powered surgical handpiece assembly of FIG. 1, the
adapter 10 is coupled with the XPS.TM. StraightShot handpiece 16
and with an osteotome 294 described below. It should be
appreciated, however, that the adapter 10 can be coupled with
various handpieces and cutting members to form a powered surgical
handpiece assembly. The adapter 10 coupled with the ostetome 294
forms a handpiece adapter assembly. However, a handpiece adapter
assembly can be formed by adapter 10 coupled with various cutting
members.
[0070] A blade or cutting member 94 according to the present
invention for being reciprocatively driven by a reciprocative
driver is illustrated in FIGS. 8 and 9 and is a surgical rasp,
preferably made of stainless steel, including an elongate,
cylindrical member or shaft 95, a tissue cutting element 96
disposed at a distal end of shaft 95 and a suction passage 97
communicating with the cutting element 96. The cutting element 96
has a wedge shaped configuration with a planar lower surface 98 and
a gently curved or rounded upper surface 99 disposed at an angle to
lower surface 98. The lower surface 98 has an oblong perimetrical
configuration defined generally as a rectangle with curved or
rounded corners. The upper surface 99 is joined to or merges with
the perimeter of lower surface 98. The cutting element 96 has a
distal end defined by a curved or arcuate edge portion of its
perimeter and has a height, between lower and upper surfaces 98 and
99, respectively, that increases in the proximal direction from the
distal end thereof. A proximal end of the cutting element 96 is
joined or connected to the distal end of shaft 95 with the lower
surface 98 parallel to but laterally offset from a central
longitudinal axis of shaft 95. The lower surface 98 is also
laterally offset from an external diametric or circumferential
surface of shaft 95 such that the lower surface 98 protrudes
laterally beyond the shaft 95.
[0071] An oval shaped hole or aperture 92 is formed in lower
surface 98 in communication with a channel 93 that extends
angularly, proximally from the hole 92 through the cutting element
96, the hole 92 having a center that is disposed in a plane
containing the central longitudinal axis of shaft 95. Preferably,
the channel 93 is disposed at an angle of 30.degree. to the lower
surface 98. A plurality of tissue cutting, removing or abrading
ridges 100 are disposed on the entire remaining area of lower
surface 98 and are adapted to cut, remove, shape or abrade
anatomical tissue, such as bone, when the cutting element 96 is
reciprocated along the tissue. The ridges 100 can have various
configurations, such as being formed by triangular or
diamond-shaped protuberances as shown, and can be arranged in
various patterns on lower surface 98. The ridges 100 can be of
various sizes or sharpness such that a series of rasps can be
provided having various degrees of coarseness or sharpness, such as
fine, medium and coarse degrees of coarseness or sharpness. The
suction passage 97 includes a suction tube 89, preferably made of
stainless steel, secured within the channel 93 and having an open
distal end 101 terminating at the lower surface 98 and an open
proximal end terminating at a fitting 102 disposed proximally of
cutting element 96. The open distal end 101 of the suction passage
97 defines an inlet opening along the lower surface 98 through
which anatomical debris, such as blood and/or anatomical tissue,
enters the lumen of the suction tube 89 to be transported away from
the cutting element 96 and, therefore, away from an operative site
at which the blade or cutting member 94 is used. The fitting 102
defines an outlet opening of the suction passage 97 disposed
proximally of the distal end of shaft 95.
[0072] It should be appreciated that the open distal end 101 of the
suction tube 89 can be disposed within the channel 93 without being
aligned or flush with or disposed in the same plane as lower
surface 98, in which case the suction passage 97 will be formed by
the suction tube 89 and by a portion of the channel 93 with the
hole 92 in lower surface 98 constituting the inlet opening of the
suction passage. The fitting 102 is adapted to be connected to a
first end of a length of flexible, plastic tubing having a second
end coupled or connected with a source of suction, such as a
suction pump or vacuum. The suction tube 89 extends angularly and
rearwardly from the upper surface 99 of the cutting element 96 and
extends proximally alongside the shaft 95. A proximal length
segment of the suction tube 89 is angled upwardly from the shaft 95
and terminates at the fitting 102. Preferably, the suction tube 89
is secured to the shaft 95, such as by welding, soldering or
various adhesives. A central longitudinal axis of the suction
passage 97 is disposed in the same plane as the central
longitudinal axis of shaft 95. The shaft 95, which preferably is
solid, has a diameter for being closely received within the passage
46 of front drive shaft 12. A transverse slot 103 is formed through
the proximal end of shaft 95 and defines a pair of spaced prongs
104 for being disposed on opposite sides, respectively, of the
alignment member 48 of the adapter 10. In this manner, the proximal
end of the cutting member is configured to engage the alignment
member of the adapter when the cutting element is in a specific
orientation relative to the adapter. The specific orientation for
the cutting element relative to the adapter corresponds to the
configuration of the proximal end of the rear drive shaft of the
adapter in that the rear drive shaft of the adapter is configured
to drivingly engage the drive shaft of the handpiece when the
cutting element is in the specific orientation relative to the
handpiece. The specific orientation for the cutting element is the
desired orientation for use of the cutting member via manual
manipulation of the handpiece when grasped and held in the normal
or intended manner for grasping and holding of the handpiece.
[0073] The cutting members used in the powered surgical handpiece
assembly according to the present invention can have cutting
elements designed in various ways with various configurations in
accordance with the types of cutting functions to be performed
therewith. For example, the cutting element can be designed to cut
anatomical tissue, such as bone, by abrading the anatomical tissue
as in the case of cutting element 96, by incising, resecting or
otherwise removing, shaping and/or contouring the tissue.
Accordingly, as used herein, "cutting" is intended to include
abrasion, incision, removal, shaping and/or contouring of
anatomical tissue as well as other tissue cutting functions
involving reciprocation of the cutting element.
[0074] The blade or cutting member 94 is coupled with the adapter
10 by inserting the proximal end of shaft 95 into the longitudinal
passage section 32 of distal section 20 of front drive shaft 12
with the nut 38 in the distal longitudinal position so that the
collet is open. The proximal end of shaft 95 is moved through
longitudinal passage section 32 into and through the longitudinal
passage section 36 of distal intermediate section 22 and into the
longitudinal passage section 44 of proximal intermediate section
24. The shaft 95 is rotated, as necessary, while being pushed
proximally until the alignment member 48 enters the slot 103. The
prongs 104 will then be disposed on opposite sides of the alignment
member 48, which prevents rotation of the shaft 95 relative to the
front drive shaft 12. Engagement of the prongs 104 with the
alignment member 48 can be confirmed tactilely, by being felt by
the surgeon, and audibly, by a clicking sound, as the alignment
member engages the prongs. The central longitudinal axis of shaft
95 will be coaxial with the central longitudinal axis of the
adapter 10.
[0075] When the front drive shaft 12 is in the rotational position
illustrated in FIG. 2, the alignment member 48 is oriented
vertically; and, when the vertically oriented alignment member is
disposed in the slot 103, the blade or cutting member 94 will be
positioned such that the lower surface 98 faces downwardly relative
to the adapter 10 and relative to the handpiece 16 when the adapter
is coupled to the handpiece 16 and the handpiece 16 is in the
normal or intended position for being grasped or held by a surgeon.
An indicating or reference mark can be provided on the adapter 10
indicative of the position of the alignment member 48. The adapter
10 can be thusly assembled to the handpiece 16 and the blade or
cutting member 94 can be assembled to the adapter 10 such that the
cutting element is in the specific orientation for use thereof. In
the case of cutting member 94, the cutting element 96 is oriented
for use as a rasp with the cutting surface 98 facing downwardly and
disposed in a plane perpendicular to the plane containing the
central longitudinal axis of shaft 95, adapter 10 and the drive
shaft of handpiece 16, respectively, as shown in FIG. 14.
[0076] A handpiece adapter assembly is formed by rasp 94 coupled
with adapter 10. It should be appreciated however, that a handpiece
adapter assembly can be formed by rasp 94 coupled to various
adapters capable of reciprocating the rasp 94 in response to the
adapters being rotatably driven. A powered surgical handpiece
assembly is formed by rasp 94 coupled with the XPS.TM. StraightShot
handpiece 16 via the adapter 10. However, a powered surgical
handpiece assembly can be formed by rasp 94 coupled with various
rotary handpieces via various adapters capable of reciprocating the
rasp 94 in response to the adapters being rotatably driven by the
handpieces.
[0077] An alternative blade or cutting member according to the
present invention, which is also a rasp, is illustrated at 194 in
FIG. 10. The cutting member 194 is similar to the cutting member 94
except that the shaft 195 of cutting member 194 has a
longitudinally straight proximal length segment and a
longitudinally curving distal length segment. The cutting element
196 of cutting member 194 is similar to cutting element 96 and has
a proximal end joined to a distal end of shaft 195. The suction
passage 197 for cutting member 194 is similar to the suction
passage 97, except that the suction tube 189 of suction passage 197
follows the curvature of the distal length segment of shaft 195 and
extends further proximally of the distal end of shaft 195 than the
suction tube 89. The cutting member 194 is particularly
advantageous for use in supraorbital facial procedures, and the
curvature of shaft 195 corresponds to or mimics the natural
curvature of the human head and, in particular, the forehead,
between the upper hairline and the eyebrow. As with cutting member
94, the cutting member 194 has prongs (not visible in FIG. 10) to
insure proper alignment of the cutting member 194 relative to the
adapter 10 and the handpiece 16. When the prongs of cutting member
194 are disposed on opposite sides of the alignment member 48, the
proximal length segment of shaft 195 will be coaxial with the
central longitudinal axis of front drive shaft 12. The cutting
surface 198 of cutting element 196 will face downwardly relative to
the adapter 10, and relative to the handpiece 16 when the adapter
10 is coupled thereto, and the cutting surface 198 will be disposed
at an acute angle to the central longitudinal axis of adapter 10 as
shown in FIG. 17.
[0078] As with the rasp 94, the rasp 194 forms a handpiece adapter
assembly when the rasp 194 is coupled to adapter 10. However, a
handpiece adapter assembly can be formed by rasp 194 coupled with
various adapters capable of reciprocating the rasp 194 in response
to the adapters being rotatably driven. A powered surgical
handpiece assembly is formed by rasp 194 coupled with the XPS.TM.
StraightShot handpiece 16 via the adapter 10. It should be
appreciated, however, that a powered surgical handpiece assembly
can be formed by rasp 194 coupled with various rotary handpieces
via various adapters capable of reciprocating the rasp 194 in
response to the adapters being rotatably driven by the
handpieces.
[0079] A blade or cutting member, which is an osteotome, to be
reciprocatively driven by the handpiece 16 via the adapter 10 is
illustrated at 294 in FIGS. 1,11 and 12. The cutting member 294
includes an elongate cylindrical member or shaft 295, the proximal
end of which is provided with a slot 303 forming prongs 304, and
the distal end of which is joined to or formed as a cutting element
296. The cutting element 296 has a longitudinally straight proximal
length portion joined to the distal end of shaft 295 and including
flat or planar lateral surfaces 305a and 305b connected by curved
upper and lower surfaces 306a and 306b, respectively. The lateral
surfaces 305a and 305b are angled inwardly toward one another from
the distal end of shaft 295 such that the proximal length portion
of cutting element 296 is of gradually decreasing width, defined
between lateral surfaces 305a and 305b, in the distal direction.
The cutting element 296 has a longitudinally straight distal length
portion merging and continuous with the proximal length portion
thereof. The distal length portion of cutting element 296 has a
curved upper surface 306a' and a substantially flat lower surface
306b' merging and continuous with the upper and lower surfaces 306a
and 306b, respectively. An upper part of the distal length portion
of cutting element 296 extends further distally than a lower part
thereof and has flat or planar lateral surfaces 305a' and 305b',
respectively, merging and continuous with lateral surfaces 305a and
305b, respectively.
[0080] The lower part of the distal length portion of cutting
element 296 has lateral surfaces 305a" and 305b" merging and
continuous with the lateral surfaces 305a and 305b, respectively.
The lateral surfaces 305a' and 305b' are angled inwardly toward one
another from the lateral surfaces 305a and 305b, respectively, such
that the upper part of the distal length portion is of gradually
decreasing width, defined between the lateral surfaces 305a' and
305b', in the distal direction. In the case of the osteotome 294,
the lateral surfaces 305a' and 305b' are angled inwardly toward one
another at a greater or steeper angle than surfaces 305a and 305b.
It should be appreciated, however, that the lateral surfaces 305a'
and 305b' can follow or continue the angle or taper of the lateral
surfaces 305a and 305b, respectively. The lateral surfaces 305a"
and 305b" are also angled inwardly toward one another from the
lateral surfaces 305a and 305b, respectively, the lateral surfaces
305a" and 305b" being angled inwardly toward one another at a
greater or steeper angle than surfaces 305a' and 305b'. The lower
part of the distal length portion is therefore of gradually
decreasing width, defined between lateral surfaces 305a" and 305b",
in the distal direction, and the width of the lower part decreases
a greater amount or rate in the distal direction than the width of
the upper part. Accordingly, the lateral surfaces 305a" and 305b"
are recessed with respect to the lateral surfaces 305a' and 305b",
respectively, such that the lateral surfaces 305a" and 305b" are
disposed laterally inwardly of the lateral surfaces 305a' and
305b', respectively, with the lateral surfaces 305a' and 305b'
disposed laterally outwardly of the lateral surfaces 305a" and
305b", respectively.
[0081] The lateral surface 305a' is connected to the lateral
surface 305a" by a transverse surface 307a, and the lateral surface
305b' is connected to the lateral surface 305b" by a transverse
surface 307b. The lateral surfaces 305a" and 305b", merge or
connect distally with one another at a transverse distal edge 308,
which is transverse to the transverse surfaces 307a and 307b. The
edge 308 is in line with but is transverse to the central
longitudinal axis of shaft 295, which defines the central
longitudinal axis of the cutting member 294. The lateral surfaces
305a' and 305b' of the upper part of the distal length portion of
the cutting element 296 terminate or merge distally at a rounded or
blunt tip 309 disposed distally of edge 308. The distal edge 308 is
sharp and forms a cutting edge capable of cutting anatomical
tissue, such as bone, when the cutting member 294 is advanced by
the surgeon into and/or along the tissue while being reciprocated
by the adapter. The blunt tip 309 leads the cutting element 296 as
the cutting member 294 is advanced into and/or along the anatomical
tissue, the tip 309 and the upper part of the distal length portion
serving to guide the cutting element 296 and to separate, protect
or guard adjacent or surrounding anatomical tissue from the cutting
edge 308. The cutting member 294 is particularly advantageous for
use in forming a straight medial cut in the nasal bone of a patient
in a rhinoplasty procedure as described further below.
[0082] As with the rasps 94 and 194, the osteotome 294 forms a
handpiece adapter assembly when the osteotome 294 is coupled to
adapter 10. However, a handpiece adapter assembly can be formed by
osteotome 294 coupled with various adapters capable of
reciprocating the osteotome 294 in response to the adapter being
rotatably driven. A powered surgical handpiece assembly is formed
by osteotome 294 coupled with the XPS.TM. StraightShot handpiece 16
via the adapter 10. It should be appreciated, however, that a
powered surgical handpiece assembly can be formed by osteotome 294
coupled with various rotary powered surgical handpieces via various
adapters capable of reciprocating the osteotome 294 in response to
the adapters being rotatably driven by the handpieces.
[0083] As noted above, various adapters can be used in the
handpiece adapter assemblies and the powered surgical handpiece
assemblies including adapters using an off-axis cam as the motion
converting mechanism. For example, the rear drive shaft of the
adapter may be used to rotate an off-axis roller of the adapter in
an orbital manner causing a rocker engaged with the roller to exert
a linear force on the front drive shaft via a link coupled to the
rocker and the front drive shaft.
[0084] Another blade or cutting member, which is also an osteotome,
to be reciprocatively driven by the handpiece 16 via the adapter 10
is illustrated at 394 in FIG. 13. The cutting member 394 is similar
to the cutting member 294 except that the distal length portion of
the cutting element 396 of cutting member 394 is longitudinally
curved or bent in a lateral direction. Accordingly, the lateral
surfaces 405a', 405b', 405a" and 405b" of cutting element 396 are
not flat or planar but, rather, are curved in the lateral
direction. In this manner, the cutting edge 408 and the blunt tip
409 are both laterally offset from and not in line with the central
longitudinal axis of shaft 395. The cutting member 394 is
particularly advantageous for use in forming a curved lateral cut
in the nasal bone of a patient in a rhinoplasty procedure as
explained further below.
[0085] As with the rasps 94 and 194 and the osteotome 294, the
osteotome 394 forms a handpiece adapter assembly when the osteotome
394 is coupled to adapter 10. However, a handpiece adapter assembly
can be formed by osteotome 394 coupled with various adapters
capable of reciprocating the osteotome 394 in response to the
adapters being rotatably driven. A powered surgical handpiece
assembly is formed by osteotome 394 coupled with the XPS.TM.
StraightShot handpiece 16 via the adapter 10. It should be
appreciated, however, that a powered surgical handpiece assembly
can be formed by osteotome 3934 coupled with various rotary powered
surgical handpieces via various adapters capable of reciprocating
the osteotome 394 in response to the adapters being rotatably
driven by the handpieces.
[0086] For use in a surgical procedure, such as a facial procedure,
the adapter 10 is coupled with the handpiece 16 and a blade or
cutting member selected in accordance with the surgical procedure
to be performed is coupled with the adapter 10 as described above.
FIG. 14 illustrates the rasp 94 coupled with the adapter 10, which
is coupled with the XPS.TM. StraightShot handpiece 16, forming a
powered surgical handpiece assembly for use in a rhinoplasty
procedure. In addition, a length of tubing Tomita et al is
connected to the fitting 102 and to a source of suction (not
shown). In the rhinoplasty procedure illustrated in FIG. 14, the
cutting element 96 of the rasp 94 is introduced between the nasal
bone of the patient and the anatomical tissue A overlying the nasal
bone. The cutting element 96 is introduced via an incision I made
in the nasal passage P of the patient's nose as shown in FIG. 14 or
via an incision or flap made at or near the tip of the patient's
nose. The incision I is preferably no larger than necessary to
receive the cutting element 96 to minimize trauma to the patient.
The cutting element 96 is introduced at an operative site between
the nasal bone and the overlying tissue A with the cutting element
in the specific orientation so that the cutting surface 98 is
disposed over and faces an area of the nasal bone that is to be
reshaped or contoured via abrasion by the cutting surface 98. The
cutting element 96 is positioned at the proper location over the
nasal bone via manipulation of handpiece 16 by the surgeon. The
skin of the patient overlying the location on the nasal bone that
is to be reshaped or contoured can be marked, such as with a
medically acceptable ink, to facilitate proper positioning of the
cutting element 96. Proper positioning of the cutting element 96
can be confirmed via palpation of the patient's nose by the surgeon
since the cutting element can be felt beneath the overlying
anatomical tissue A and can be seen as a bulge in the tissue A.
[0087] Once the cutting element 96 is properly located at the
location on the nasal bone that is to be shaped or contoured, the
handpiece 16 is actuated, typically via an appropriate switch or
foot pedal as described in the prior applications incorporated
herein by reference, to rotate or turn the motor of the handpiece
16. As the motor of handpiece 16 is turned or rotated, rotary
motion of the drive shaft of the handpiece 16 is converted to
reciprocating motion of the front drive shaft 12 of adapter 10 via
the motion converting mechanism 18. For the rasp 94, the motor will
typically be operated at a speed of 5,000 RPM. The rasp 94 is
reciprocated with the front drive shaft 12; and, when the cutting
surface 98 is placed in contact with the nasal bone, the ridges 100
of the cutting element 96 abrade and remove some of the nasal bone
such that the nasal bone is reshaped or contoured. As the cutting
element 96 is reciprocated by the handpiece 16, the handpiece
assembly is also moved longitudinally and/or laterally by the
surgeon with the cutting surface 98 in contact with the nasal bone,
allowing the surgeon to reshape or contour the nasal bone in
accordance with a desired result.
[0088] As the cutting element 96 is reciprocated, suction from the
suction source is applied at the operative site via the suction
passage 97. In this manner, anatomical debris, including blood
and/or tissue, enters or is drawn into the inlet opening of the
suction passage and is removed from the operative site via the
suction passage and the tubing Tomita et al for withdrawal from the
patient's body. Once sufficient bone has been removed with the
cutting element 96 so that the nasal bone is shaped or contoured as
desired, the rasp 94 is withdrawn from the patient's nose via
incision 1. Proper shaping Pr contouring of the nasal bone and
removal of a desired amount of bone can be confirmed by the surgeon
via palpation of the patient's nose. In addition, it should be
appreciated that the procedure can be performed as a minimally
invasive procedure wherein a remote viewing device, such as an
endoscope, is used to provide visualization of the operative site.
As an example, an image receiving end of an endoscope can be
introduced at the operative site through the same or a different
incision in the patient's nose.
[0089] FIGS. 15 and 16 illustrate use of the osteotomes 294 and 394
in conjunction with adapter 10 and handpiece 16 to make medial and
lateral cuts in the nasal bone of a patient in a rhinoplasty
procedure. As an initial step in the procedure, the skin of the
patient's nose is marked with markings M and L at locations
overlying selected sites on the nasal bone at which medial and
lateral cuts, respectively, are to be made in the nasal bone, the
markings M and L being generally indicative of the configurations
or paths and the lengths for the medial and lateral cuts,
respectively. FIG. 15 illustrates the osteotome 294 coupled with
the adapter 10, which is coupled with handpiece 16, to form a
powered surgical handpiece assembly. The cutting element 296 is
introduced between the nasal bone of the patient and the anatomical
tissue A overlying the nasal bone. The cutting element 296 is
introduced through an incision I made in the nasal passage P as
shown in FIG. 15 or via an incision or flap made at or near the tip
of the patient's nose. The incision I is preferably no larger than
necessary to receive the cutting element 296 to minimize trauma to
the patient. The cutting element 296 is introduced at an operative
site between the nasal bone and the overlying tissue A with the
cutting element 296 in the specific orientation so that the lower
surface 306b' is disposed upon the nasal bone with the cutting edge
308 at a site corresponding to a lower or beginning end of the
medial cut. The blunt tip 309 leads and guides the cutting edge 308
to the site on the nasal bone and separates and protects
surrounding anatomical tissue from injury by the cutting edge 308
as the cutting edge 308 is advanced to the site via manipulation of
handpiece 16 by the surgeon. Proper positioning of the cutting
element 296 can be confirmed via palpation of the patient's nose
since the cutting element 296 can be felt beneath the overlying
anatomical tissue A and since the cutting element forms a visible
bulge in the overlying tissue.
[0090] Once the cutting edge 308 is properly disposed at the site
on the nasal bone at which the medial cut is to begin, the
handpiece 16 is actuated causing reciprocation of cutting member
294 via the adapter 10. For the osteotome 294, the motor of the
handpiece will typically be operated at a speed of 6,000 RPM. As
the cutting member 294 is reciprocated, the cutting edge 308 is
moved into and along the nasal bone via manual manipulation of the
handpiece assembly formed by adapter 10, handpiece 16 and cutting
member 294. In particular, the handpiece assembly is advanced
longitudinally distally or forwardly by the surgeon while the
cutting edge 308 is moved into the nasal bone. The handpiece 16 may
be angled upwardly relative to the nasal bone, as it is being
distally advanced, to facilitate movement of the cutting edge 308
into the bone. As indicated by the marking M, the medial cut has a
straight configuration or path, and the cutting element 296 is
advanced distally or forwardly along this straight configuration or
path to an upper or terminal end for the medial cut. The cutting
edge 308 in contact with the nasal bone as the cutting element 296
is moved forwardly therealong while being reciprocated at the same
time, causes a straight medial cut of desired length to be formed
in the nasal bone. The medial cut is formed very quickly with the
reciprocating osteotome or cutting member 294; and, once the medial
cut is formed, the cutting member 294 is withdrawn from the
patient's nose via the incision I. Proper formation of the medial
cut can be confirmed via palpation of the nose and/or a remote
viewing device where the procedure is performed as a minimally
invasive procedure.
[0091] Upon completion of the medial cut and withdrawal of the
cutting member 294 from the patient's nose, the osteotome or
cutting member 394 is used to form a lateral cut in the nasal bone
corresponding to marking L. The cutting member 294 is removed from
the adapter 10, which remains coupled with the handpiece 16, and
the cutting member or osteotome 394 is coupled with the adapter 10
to form another powered surgical handpiece assembly. The cutting
element 396 of osteotome 394 is introduced at the operative site
through the incision I in nasal passage P. The cutting element 396
is introduced between the nasal bone and the overlying anatomical
tissue A with the cutting element 396 in the specific orientation
so that the lower surface 406b' is disposed upon the nasal bone
with the cutting edge 408 at a site corresponding to a lower or
beginning end of the lateral cut. The blunt tip 409 leads and
guides the cutting edge 408 as the cutting edge 408 is advanced to
the site on the nasal bone and protects surrounding tissue from
injury or damage by the cutting edge 408. Proper positioning of the
cutting element 396 can be confirmed by feel and by observing a
bulge in the overlying tissue A due to the presence of the cutting
element therebeneath. As indicated by the marking L, the lateral
cut is spaced laterally from the medial cut and has a curved
configuration or path. Accordingly, the osteotome or cutting member
394 that is being used by the surgeon to make the lateral cut has
its distal portion curving laterally in the same direction as the
lateral cut as illustrated in FIG. 16.
[0092] Once the cutting edge 408 has been positioned at the proper
site on the nasal bone at which the lateral cut is to begin, the
handpiece 16 is actuated causing reciprocation of the cutting
member 394 via the adapter 10. For the osteotome 394, the motor of
the handpiece will typically be operated at a speed of 6,000 RPM.
As the cutting member 394 is reciprocated, the cutting edge 408 is
moved into and along the nasal bone via manipulation of the
handpiece assembly. The powered surgical handpiece assembly formed
by adapter 10, handpiece 16 and cutting member 394 is advanced
longitudinally distally or forwardly and is also moved angularly by
the surgeon as the cutting edge 408 is moved into the nasal bone.
As shown in dotted lines in FIG. 16, the handpiece assembly is
moved angularly or laterally in a pivoting motion so that the
cutting edge 408 follows the curved configuration or path for the
lateral cut and cuts the nasal bone along a preferred angle. In
this manner, a curved or angled lateral cut of a desired length is
automatically made in the nasal bone as the surgeon merely guides
the cutting element 408 along the preferred curve or angle from the
lower or beginning end to an upper or terminal end for the lateral
cut. Once the lateral cut has been completed, the osteotome or
cutting member 394 is removed from the patient's nose via the
incision I. Proper formation of the lateral cut can be confirmed
via palpation and/or a remote viewing device where the procedure is
performed as a minimally invasive procedure. Once the medial and
lateral cuts have been completed, a rasp such as the reciprocating
rasp 94, can be introduced at the operative site for shaping or
contouring of the nasal bone as described above.
[0093] A supraorbital surgical procedure utilizing the rasp or
cutting member 194 is illustrated in FIG. 17. The cutting member
194 is coupled with the adapter 10, which is coupled with the
handpiece 16, to form a powered surgical handpiece assembly as
described above. In addition, a length of tubing Tomita et al is
connected to the fitting 202 and to a source of suction. The
cutting element 196 of cutting member 194 is introduced between the
frontal bone or forehead of the patient's head and overlying
anatomical tissue A, the cutting element 196 being introduced
through an entry point or incision I disposed at or behind the
patient's hairline. Preferably, the incision I is no larger than
necessary to receive the cutting element 196 to reduce trauma. The
cutting element 196 is moved, via manipulation of the handpiece
assembly by the surgeon, distally or forwardly along the patient's
frontal bone until the cutting element 196 is positioned at an
operative site at the supraorbital bone just behind the patient's
eyebrow. Passage of the cutting element 196 from the entry point or
incision I to the operative site at the supraorbital bone is
facilitated due to the curvature of the shaft 195. The cutting
element 196 is introduced between the supraorbital bone and the
overlying anatomical tissue A with the cutting element 196 in the
specific orientation so that the cutting surface 198 is disposed
over and faces an area of the supraorbital bone that is to be
reshaped or contoured. Of course, the skin overlying the area of
the supraorbital bone that is to be reshaped or contoured can be
marked as described above. Proper positioning of the cutting
element 196 can be confirmed via palpation since the cutting
element 196 can be felt beneath the overlying tissue A as well as
by the bulge created in the overlying tissue A due to presence of
the cutting element therebeneath.
[0094] Once the cutting element 196 is properly located at the
location on the supraorbital bone that is to be shaped or
contoured, the handpiece 16 is actuated causing reciprocation of
cutting element 196. For the rasp 194, the motor of the handpiece
will typically be operated at a speed of 5,000 RPM. As the cutting
element 196 is reciprocated by the handpiece 16, the handpiece
assembly is moved longitudinally and/or laterally by the surgeon in
order to correspondingly move the cutting element 196 and thusly
abrade and remove some of the supraorbital bone as described above
for rasp 94. As the cutting element 196 is reciprocated, suction
from the suction source is applied at the operative site via the
suction passage 197. In this manner, the supraorbital bone is
shaped or contoured in accordance with a desired result while
anatomical debris enters the inlet opening of the suction passage
197 and is removed from the operative site via the suction passage
197 and the tubing Tomita et al for withdrawal from the patient's
body. The supraorbital bone can be felt through the overlying
tissue A when palpated by the surgeon to confirm proper shaping or
contouring of the supraorbital bone. Where the supraorbital
procedure is performed as a minimally invasive procedure, a remote
viewing device can be used to confirm proper shaping or contouring
and removal of the proper amount of bone. Once the supraorbital
bone has been properly shaped or contoured and the proper amount of
bone has been removed therefrom, the rasp 194 is removed from the
operative site and is withdrawn through the incision I.
[0095] FIG. 18 illustrates an alternative and preferred arrangement
for the distal section of the front drive shaft and the nut of the
surgical handpiece adapter. FIG. 18 illustrates a front drive shaft
512 having distal section 520 extending distally from distal
intermediate section 522. The distal intermediate section 522 is
similar to distal intermediate section 22 and has an external
thread 535 in threaded engagement with internal thread 541 of nut
538. The distal section 520 includes a cylindrical rearward portion
528, a cylindrical intermediate portion 529 and a cylindrical
forward portion 531 extending distally from intermediate portion
529. The rearward portion 528 has an aperture therein communicating
with the passage 546 of the front drive shaft and receiving a
locking member in the form of a ball 513. The ball 513 has a
diametric size capable of permitting protrusion of the ball 513
into the passage 546 while preventing passage of the ball 513
entirely through the aperture. An insert or positioner 515, which
is also a ball, is disposed in a notch or recess of the rearward
portion 528 and protrudes externally of the front drive shaft 512
to engage an interior surface of nut 538. The insert 515 assists in
preventing longitudinal movement of ball 513 and maintaining
alignment of ball 513 with its aperture.
[0096] The nut 538 is movable longitudinally relative to and along
the front drive shaft 512 in response to rotation of the nut 538 as
permitted by engagement of threads 535 and 541. When the nut 538 is
in a proximal longitudinal position relative to the front drive
shaft 512 as shown in FIG. 18, the distal section 520 is in a
closed position wherein a cylindrical interior surface of nut 538
engages ball 513 and forces ball 513 in a radially inward direction
to protrude through the aperture into the passage 546. The passage
546 is thusly closed so as to prevent passage of a proximal end of
a blade or cutting member therethrough. The cylindrical interior
surface of nut 538 in engagement with ball 513 in the closed
position prevents the ball 513 from moving in a radially outwardly
direction. When the nut 538 is moved longitudinally distally
relative to the front drive shaft 512 a sufficient distance, the
cylindrical interior surface of nut 538 is disengaged from or moved
distally of the ball 513 such that the ball 513 is capable of
moving in the radially outward direction so that the ball 513 no
longer protrudes into the passage 546. The distal section 520 will
then be in an open position, with the ball 513 movable in the
radially outward direction due to the space or room presented
between the front drive shaft and the nut when a sloping interior
surface of the nut is aligned with the ball 513. The passage 546
will then be in an open position allowing a proximal end of a blade
or cutting member to pass therethrough. The balls 513 and 515,
being spherical, facilitate longitudinal movement of the nut 538
relative to the front drive shaft 512.
[0097] The arrangement depicted in FIG. 18 is adapted to be used
with a cutting member having an external annular groove thereon for
being engaged and disengaged with the ball 513 to selectively lock
and unlock the cutting member to the front drive shaft. FIG. 19
illustrates a preferred surgical rasp 694 adapted for use with an
adapter having front drive shaft 512 and nut 538. Rasp 694 is the
same as rasp 94 except that shaft 695 for rasp 694 has an external
annular or circumferential groove 617 formed thereon. The groove
617 is disposed on shaft 695 at a location aligned with ball 513
and its aperture when the shaft 695 is fully inserted in the
passage 546 of the front drive shaft 512. The shaft 695 is
insertable in the passage 546 with the nut 538 in the distal
longitudinal position, the ball 513 being moved in the radially
outward direction by the shaft 695 to open the passage 546 as it is
inserted therein. The ball 513 is thusly moved by the shaft 695 out
of the passage 546 so that the distal section 520 is in the open
position allowing the shaft 695 to be fully inserted in the now
open passage 546. Once the shaft 695 is fully inserted in passage
546, the nut 538 is rotated or turned to move it to the proximal
longitudinal position. As a result thereof, the ball 513 is moved
in the radially inward direction causing it to protrude through the
aperture and into the groove 617 aligned therewith. The distal
section 520 will then be in the closed position with the ball 513
received in the groove 617 and closing the passage 546 to movement
of the shaft 695 therethrough. Since the ball 513 is captured it is
prevented from moving longitudinally, and the rasp 694 is locked to
the front drive shaft 512. The rasp 694 is removable or
disengageable from the front drive shaft by moving the nut 538 to
the distal longitudinal position allowing the shaft 695 to be
withdrawn from passage 546. As the shaft 695 is withdrawn, it moves
the ball 513 in the radially outward direction so that the distal
section 520 is in the open position.
[0098] Actuation of the powered surgical handpiece can be
controlled so that the motor thereof is turned or rotated at a
desired speed in accordance with the speed of reciprocation desired
for the cutting element. The adapter according to the present
invention permits the rotary output of the powered surgical
handpiece to be selectively converted into reciprocating motion in
order to reciprocatively drive a blade or cutting member. Although
the adapter of the subject invention is designed for use with the
XPS.TM. StraightShot handpiece to allow the XPS.TM. StraightShot
handpiece to be used to drive both rotary and reciprocative blades
or cutting members, it should be appreciated that the adapter can
be used with various powered surgical handpieces having rotatable
drive shafts. Accordingly, the proximal end of the rear drive shaft
of the adapter can be designed in various ways allowing the rear
drive shaft to be mechanically coupled to the drive shaft of the
handpiece. The adapter can be used to reciprocatively drive various
types of reciprocative blades or cutting members, and the adapter
and a blade or cutting member coupled therewith forms a handpiece
adapter assembly. The adapter can be used to drive reciprocative
blades at various speeds to perform various cutting functions in
anatomical tissue including bone. The adapter can be designed with
a particular stroke and a plurality of adapters can be provided
each having a different stroke. The adapter can be provided with an
alignment member to ensure coupling of a blade or cutting member
therewith in a specific orientation. The adapter can be designed
for mechanical coupling with the drive shaft of the handpiece with
the blade or cutting member that is coupled with the adapter
disposed in the specific orientation relative to the handpiece. In
this manner, the blade or cutting member is in the proper
orientation for use thereof when the handpiece is grasped or held
by the surgeon in the normal manner. The adapter can be used in a
powered surgical handpiece assembly to reciprocatively drive
various blades or cutting members thereof in surgical procedures
that are performed minimally invasively. The adapter can be
designed for reuse in conjunction with a reusable handpiece and
disposable blades or cutting members.
[0099] The rasps according to the present invention greatly
facilitate the performance of surgical procedures since anatomical
debris is removed from operative sites via the rasps themselves.
The suction passages of the rasps have inlet openings disposed
along cutting surfaces of the rasps and are thusly disposed at the
source of the anatomical debris. The rasps can be provided with a
longitudinal curve or bend particularly useful in specific
procedures to access internal operative sites from entry points or
incisions disposed at locations remote from the operative sites.
The rasps can be provided with cutting elements of varying
sharpness or coarseness. A plurality or series of rasps can be
provided each having a different sharpness or coarseness. The rasps
can be coupled with various adapters to form various handpiece
adapter assemblies. The rasps can be coupled with various
handpieces via various adapters to form various powered surgical
handpiece assemblies.
[0100] The osteotomes greatly reduce the amount of time needed to
perform various surgical procedures, particularly facial procedures
such as rhinoplasty. When used in a powered surgical handpiece
assembly, the osteotomes allowed medial and lateral cuts to be
formed in the nasal bone automatically, with the surgeon having
only to guide the cutting elements of the osteotomes. The
osteotomes can be longitudinally straight for formation of
longitudinally straight cuts or longitudinally curved or angled for
formation of longitudinally curved or angled cuts. The blunt distal
tips of the osteotomes lead and guide the cutting elements of the
osteotomes to operatives sties at which the osteotomes are to be
used and protect surrounding anatomical tissue from unwanted
contact with the cutting edges. The osteotomes can be coupled with
various adapters to form various handpiece adapter assemblies. The
osteotomes can be coupled with various handpieces via various
adapters to form various powered surgical handpiece assemblies.
[0101] The blades or cutting members can be provided with structure
cooperable with structure of the adapter to ensure that the blades
or cutting members are coupled to the adapter and, therefore, the
handpiece, in the proper orientation for use.
[0102] In as much as the present invention is subject to various
modification, and changes in detail, it should be appreciated that
the preferred embodiments described herein should be considered as
illustrative only and should not be taken in a limiting sense.
* * * * *