U.S. patent application number 12/463939 was filed with the patent office on 2009-10-29 for surgical tool system.
Invention is credited to Milton Barnes, Steven Carusillo, Bruce D. Henniges.
Application Number | 20090270899 12/463939 |
Document ID | / |
Family ID | 30117924 |
Filed Date | 2009-10-29 |
United States Patent
Application |
20090270899 |
Kind Code |
A1 |
Carusillo; Steven ; et
al. |
October 29, 2009 |
SURGICAL TOOL SYSTEM
Abstract
A surgical tool system comprising a handpiece and a cutting
accessory that is releaseably secured to the handpiece. The
handpiece has a gear assembly with two drive heads. The gear
assembly turns the drive heads at different rotational speeds
relative to each other. The cutting accessory is provided with one
of two drive hubs. If the cutting accessory is provided with a
first drive hub, the drive hub mates to a first one of the drive
heads so as to turn of the speed of that head. If the cutting
accessory is provided with a second drive hub, the drive hub mates
to the second drive head so as to turn at the speed of that head.
Thus, the speed at which the cutting accessory is actuated is a
function of the associated drive head.
Inventors: |
Carusillo; Steven;
(Kalamazoo, MI) ; Henniges; Bruce D.; (Kalamazoo,
MI) ; Barnes; Milton; (Fort Worth, TX) |
Correspondence
Address: |
INTEL. PROP./ RND;STRYKER CORPORATION
4100 EAST MILHAM AVE.
KALMAZOO
MI
49001-6197
US
|
Family ID: |
30117924 |
Appl. No.: |
12/463939 |
Filed: |
May 11, 2009 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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11234344 |
Sep 23, 2005 |
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12463939 |
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10251646 |
Sep 21, 2002 |
6958071 |
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11234344 |
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60395881 |
Jul 13, 2002 |
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Current U.S.
Class: |
606/170 |
Current CPC
Class: |
A61M 1/0058 20130101;
A61B 17/24 20130101; A61B 2217/007 20130101; A61B 2017/00477
20130101; A61B 2217/005 20130101; A61B 17/32002 20130101 |
Class at
Publication: |
606/170 |
International
Class: |
A61B 17/32 20060101
A61B017/32 |
Claims
1. A surgical handpiece for actuating a cutting accessory, said
handpiece having: a body, said body having a distal end and a
proximal end and being shaped to have: a primary bore adjacent the
distal end for receiving a cutting accessory, the bore being
defined by an inner wall of said handpiece; a supply bore that
extends from said proximal and that opens into the inner wall of
said handpiece that defines the primary bore; and a suction bore
that extends from the primary bore to the proximal end; a coupling
assembly attached to said body for releasably holding the cutting
accessory to said body; a power generating unit in said body
adapted for attachment to the cutting accessory to actuate the
cutting accessory; an inlet fitting attached to said body adjacent
the proximal end of said body, said inlet fitting being in fluid
communication with the supply bore in said body and being
configured to be connected to a fluid supply line; and a suction
fitting attached to said body adjacent the proximal end of said
body, said suction fitting being in fluid communication with the
suction bore in said bore and being configured to be connected to a
suction line.
Description
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] The present invention is a continuation of U.S. patent
application Ser. No. 11/234,344, filed on 23 Sep. 2005, which is a
Continuation of U.S. patent application Ser. No. 10/251,646, filed
21 Sep. 2002, now U.S. Pat. No. 6,958,071, which claims priority to
Prov. App. Ser. No. 60/395,881, filed 13 Jul. 2002. All
applications are hereby incorporated by reference in their
entireties.
FIELD OF INVENTION
[0002] This invention relates generally to a surgical tool system.
More particularly this invention relates to a surgical tool system
with a handpiece capable of driving a cutting accessory attached to
the handpiece at a wide range of speeds and that is also capable of
supplying irrigating fluid to the cutting accessory automatically,
upon attachment of the cutting accessory to the handpiece.
BACKGROUND OF THE INVENTION
[0003] The goal of many surgical procedures is to remove, and/or
remove so as to shape, body tissue at the site at which the
procedure is performed. Surgery on the nasal and sinus cavities
and/or the throat frequently involves performing this type of
selective removal of tissue. For example, sinus surgery often
involves the removal of diseased membranes and/or bone partitions
and/or malformed portions of sinus tissue, sometimes referred to as
the sinus layer, and bony material entrained in this layer.
Orthopedic surgery involves the shaping of bones and soft tissue
that form the joints of the skeletal system.
[0004] A number of surgical instruments and tools have been
developed to facilitate the performance of these surgical
procedures. For example, the Applicant's Assignee manufactures a
line of surgical tools under the trademark HUMMER that are
especially designed to perform nasal, sinus and throat surgery.
This line of tools includes a handpiece with an electrically driven
motor. Different cutting accessories are designed to selectively be
connected to the handpiece. Each cutting accessory typically has a
hollow rotating or reciprocating shaft that is housed in a fixed,
tube-like, housing. Irrigating solution is flowed to the distal end
of the cutting accessory, the end applied to the surgical site,
through an annular space between the moving shaft and the
complementary housing. This fluid is then drawn away from the
surgical site by a suction that is applied through the rotating or
reciprocating shaft. This fluid serves as a transport media that
flushes debris proximally, away from the patient.
[0005] While current surgical tools have proven useful, there are
some limitations associated with their use. For example, many
surgical handpieces and their complementary attachments are
provided with conduits through which suction can be drawn from the
complementary attached cutting accessory. Collectively, these
handpieces and cutting accessories are constructed so that the
coupling of the cutting accessory to the handpiece results in the
establishment of a fluid communications path between the suction
channel in the cutting accessory and the suction conduit in the
handpiece.
[0006] However, to date, it has proven difficult to provide a
surgical tool system that, upon attachment of the cutting accessory
to the handpiece, establishes a fluid path through which irrigating
solution is supplied to the cutting accessory. In many commercially
available surgical tool systems, in order to establish this fluid
path, medical personnel must manually connect a small flexible
irrigation fluid supply line associated with the handpiece to an
inlet fitting integral with the cutting accessory. Requiring
medical personnel to perform this task, and disconnect the line
when the accessory is removed from the handpiece, adds to the
overall time it takes to remove, replace or change the
accessory.
[0007] There have been some surgical tool systems proposed that
include handpieces with complementary irrigation fluid outlet
ports. These systems are designed so that the complementary cutting
accessory must be precisely aligned with the handpiece in order to
establish the desired fluid communications path. Thus, when a new
accessory is fitted to one of these handpieces, care must be taken
to properly align these two components. Again, requiring medical
personnel to perform this step adds to the overall time it takes to
fit the new accessory to the handpiece.
[0008] Moreover, in the known surgical tool systems, the need to
precisely align the cutting accessory with the handpiece means that
the cutting element integral with the cutting accessory must be
placed in a select, fixed orientation relative to the handpiece.
Thus, in these systems, the surgeon is not able to position the
cutting accessory so that, relative to the handpiece, the cutting
element is in an orientation that makes it more convenient, or even
possible, for the surgeon to perform some surgical tasks.
[0009] Moreover, like any motor, the motors integral with
handpieces of surgical tool systems only operate within a given
operating range. The motors integral with some handpieces operate
within a relatively limited rotational speed range. This is
especially true for handpieces that include brushless, sensorless
motors. These motors, owing to the fact that the back EMF signals
they produce are employed to control their operation, have
operational rotational speed ranges that are less than similar
motors in which sensors are installed that provide an indication of
rotor position.
[0010] The limited rotational speed range of some handpiece motors
means that the accessories attached to these headpieces can only be
driven through a relatively limited range of speeds. This means
that sometimes a cutting accessory, such as a laryngeal cutter
cannot be driven at a relatively low speed that might be useful.
Similarly, another accessory, such as a bur cannot be driven at a
relatively high speed that may be sometimes desired for its
operation.
[0011] One solution to this problem is to provide the surgeon with
two different handpieces; one with a relatively slow speed motor,
the second with a relatively high speed motor. A second solution to
this problem has been to provide intermediate attachments between
the handpiece and the cutting accessory. Typically, this attachment
is connected to a handpiece with a relatively high speed motor.
Internal to the attachment is a gear assembly that reduces the
output speed at which the associated accessory is driven. A
disadvantage of both of these solutions is they require the
introduction of an extra component, either the supplemental
handpiece or the ancillary attachment to the operating room.
Moreover, the medical personnel using the components of these
systems must spend time ensuring that the cutting accessory is
attached to the appropriate handpiece or intermediate attachment in
order to operate the accessory at the desired speed. The time
making sure this connection is established adds to the overall time
it takes to make the cutting accessory available to perform the
desired surgical procedure.
SUMMARY OF THE INVENTION
[0012] This invention is related to a new and useful surgical tool
system. The system of this invention includes a handpiece to which
complementary cutting accessories are removably attached. The
handpiece has a motor for driving the cutting accessories. A gear
train is attached to the motor. The gear train has plural rotating
output heads, each of which rotates at a different speed. Each
cutting accessory is provided with a drive hub that is dimensioned
to be coupled to one of the specific output shafts. Thus, the
coupling of the accessory drive hub to the complementary specific
output shaft results in the cutting accessory being rotated at the
appropriate speed for its operation.
[0013] Internal to the handpiece of this invention there is a
conduit through which irrigating fluid is supplied. This conduit
opens into a discharge port. The cutting accessories of this system
are provided with a complementary circumferential conduit for
receiving the irrigating fluid.
BRIEF DESCRIPTION OF THE DRAWINGS
[0014] The invention is pointed out with particularity in the
claims. The above and further features and benefits of the
invention may be better understood by reference to the following
description in combination with the accompanying drawings, in
which:
[0015] FIG. 1 is an overall view of the components of the surgical
system of this invention;
[0016] FIG. 2 is a view of the front of the handpiece of the
surgical tool system of this invention;
[0017] FIG. 2A is a cross-sectional view of the handpiece taken
along line 2A-2A of FIG. 2;
[0018] FIG. 2B is a cross-sectional view of the handpiece taken
along line 2B-2B of FIG. 2;
[0019] FIG. 3 is an exploded view of the handpiece of the surgical
tool system of this invention;
[0020] FIGS. 4A and 4B are, respectively, exploded and
cross-sectional views of the motor of the handpiece;
[0021] FIGS. 5A and 5B are, respectively, cross-sectional and
exploded views of the gear train assembly of the handpiece;
[0022] FIG. 5C is a detailed cross-sectional view of the interface
around the proximal end of the bearing ring of the gear train
assembly;
[0023] FIGS. 6A and 6B are, respectively, cross-sectional and
perspective views of the low speed head of the gear train
assembly;
[0024] FIG. 6C is a cross-sectional view of the bearing ring of the
gear train assembly;
[0025] FIG. 7 is a perspective view of the lock assembly;
[0026] FIG. 8 is an exploded view of the lock assembly;
[0027] FIG. 9 is a cross-sectional view of the lock assembly;
[0028] FIG. 10 is a perspective view of the release collar of the
lock assembly;
[0029] FIG. 11 is an exploded view of the valve;
[0030] FIG. 12 is a cross-sectional of the valve;
[0031] FIG. 13 is a perspective view of the valve housing;
[0032] FIG. 14 is a cross-sectional view of the valve housing;
[0033] FIG. 15 is a perspective view of the valve member;
[0034] FIG. 16 is a cross-sectional view of the valve member;
[0035] FIG. 17 is a partially exploded view of one cutting
accessory of this invention;
[0036] FIG. 18 is a cross-sectional view of the cutting accessory
of FIG. 17;
[0037] FIGS. 19A and 19B are, respectively, perspective and
cross-sectional views of an outer hub of the cutting accessory;
[0038] FIGS. 20A and 20B are, respectively, side and perspective
views of a high speed drive hub of a cutting accessory;
[0039] FIGS. 21A and 21B are, respectively, side and perspective
views of a low speed drive hub of a cutting accessory;
[0040] FIG. 22 depicts how a cutting accessory with a high speed
drive hub is coupled to a handpiece; and
[0041] FIG. 23 depicts how a cutting accessory with a low speed
drive hub is coupled to a handpiece.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT
[0042] FIGS. 1, 2 and 2A illustrate a surgical tool system 20 of
this invention. System 20 includes a handpiece 22 to which a
cutting accessory 24 is removably attached. Internal to the
handpiece 22 is a motor 26 that actuates tile cutting accessory 24.
Power to actuate the motor 26 is supplied from an external control
console 28. One such control console and some of its internal
circuitry are disclosed in the Applicant's Assignee's U.S. Pat. No.
5,689,159, SURGICAL TOOL SYSTEM WITH BRUSHLESS, SENSORLESS MOTOR,
issued 18 Nov. 1997 and U.S. Pat. No. 6,017,354, INTEGRATED SYSTEM
FOR POWERED SURGICAL TOOLS, issued 25 Jan. 2000, both of which are
incorporated herein by reference. Handpiece 22 is connected to
control console 28 by a power cable 30 that extends from the
proximal end of the handpiece. (In this application, "proximal" is
understood to be towards the surgeon holding the handpiece 22;
"distal" is understood as being away from the surgeon.)
[0043] A pump 32 is attached to control console 28. Pump 32
supplies irrigating fluid from a container 33 to the handpiece
through supply line 34. As described hereinafter, this irrigating
fluid is flowed through the handpiece to the cutting accessory 24.
The handpiece 22 is connected to a suction pump 36 through a
suction line 38. The distal end of the cutting accessory 22 is
provided with windows 342 and 382 (FIG. 17). When the suction pump
36 is actuated, a suction is drawn through accessory windows 342
and 382, the cutting accessory 24 and through the handpiece 22 to a
collection receptacle 37. Collection receptacle 37 is located
between two sections of suction line 38. The material drawn through
the system 20 by pump 36 is discharged into the collection
receptacle 37. This sub-assembly thus allows irrigating fluid and
debris present at the surgical site to be drawn away from the site
through the surgical tool system 20.
[0044] Handpiece 22, now described by reference to FIGS. 2, 2A, 2B
and 3, includes an elongated body 40 to which the other components
of the handpiece are housed and/or to which these components are
attached. The body 40 is formed with a longitudinally extending
main bore 41 in which most of the components internal to the
handpiece 22 are located. A back cap 39 covers the proximal end of
body 40 including bore 41. The distal end, the front end, of bore
41 is open to receive the proximal end of cutting accessory 24.
[0045] Motor 26 is one component disposed in bore 41. A gear train
42 is located in bore 41 forward of motor 26. Gear train 42
includes a set of gears and two output heads. The gears reduce,
step-down, the speed of the rotational moment produced by the
output shaft of the motor. More specifically, the gear train
rotates each output head at a specific ratio relative to the output
speed of the motor shaft. The attached cutting accessory 24 is
provided with one of two drive hubs. Each drive hub is dimensioned
to engage a specific one of the output shafts of the gear train 42.
Thus, the speed at which the handpiece drives the cutting accessory
24 is a function of which output head is engaged by the
accessory.
[0046] Motor 26 and gear train 42 are both cannulated. Thus,
collectively these assemblies are provided with components that
define a conduit that extends axially through the handpiece 22.
This conduit is connected to suction line 38 through a fitting 43
attached to the rear, proximal end, of the handpiece 22. This
conduit serves as the conduit through which a suction is drawn
through the cutting accessory 24 and handpiece 22.
[0047] A lock assembly 44 is disposed in body bore 41 forward of
the gear train 42. The lock assembly 44 releasably holds the
proximal end of the cutting accessory 24 in bore 41.
[0048] The handpiece body 40, as best seen in FIGS. 2A and 2B, is
formed with a longitudinally extending fluid supply bore 46 that is
located above main bore 41. The body 40 is further formed so that
fluid supply bore 46 is offset from the plane that extends along
the lateral axis of the body. Fluid supply bore 46 extends from the
proximal end of body 40 towards the distal end. The fluid supply
bore 46 does not extend completely through body 40. Instead, the
fluid supply bore 46 terminates before the distal end of the
handpiece 22. A small discharge bore 48 extends diagonally forward
from the distal end of the fluid supply bore 46 into main bore 41.
An inlet fitting 50 that extends from end cap 39 serves as the
member that establishes a fluid communication path from the
external supply line 34 to the fluid supply bore 46.
[0049] A valve 52 is rotatably mounted in body bore 41 immediately
rearward of the motor 26. Valve 52 is selectively positioned to
regulate fluid flow through the conduit that extends through the
motor 26 and gear train 42. Depending on the position of valve 52,
this conduit is either: connected to the suction fitting 43; or
connected to the inlet fitting 50. The setting of valve 52 is
controlled by button 54 that is slidably mounted to the distal
front end of the handpiece body 22. A linkage rod 56 connects
button 54 to the valve 52. Rod 56 is disposed in a bore 58 formed
in the handpiece body 40 that extends parallel to and is located
above main bore 41.
[0050] Motor 26, which is a brushless, sensorless motor, is now
described in detail by reference to FIGS. 4A and 4B. The motor 26
includes a generally tubular-shaped, open at both ends housing 59
that is closely fitted in bore 41. Housing 59 is further formed so
as to have an inwardly directed lip 60 that extends
circumferentially around the front end of the housing. A field coil
assembly 62 and rotor assembly 64 are disposed in housing 59 to,
respectively, form the primary static and rotating parts of the
motor 26. The field coil assembly 62, which is generally tubular in
shape, includes the static windings of the motor 26, (windings not
identified). Rotor assembly 64 is disposed inside the field coil
assembly 62. The rotor assembly includes a tubular shaft 66. A
plurality of magnets 68 are disposed around the portion of shaft 66
that is subtended by the windings of the field coil assembly 62.
Magnets 68 are encased in a cylindrical sleeve 70.
[0051] Shaft 66 of the rotor assembly 64 is dimensioned to extend
forward of motor housing 59. A bearing assembly 72 rotatably holds
shaft 66 to housing 59. Specifically, the bearing assembly 72 is
press fit in a groove 74 that has a rectangular cross-sectional
profile that extends circumferentially around the inner parameter
of housing lip 60.
[0052] The bearing assembly 72 has an inner race, (not illustrated)
against which a shoulder 76 of shaft 66 is fitted. Shoulder 76, it
will be observed, has an outer diameter greater than that of the
main body of shaft 66. The shaft 66 is further formed so that a
small ridge 78 extends outwardly from the proximal end of the
shoulder and extends circumferentially around the shoulder. Ridge
78 prevents the forward movement of shaft 66.
[0053] Rotor shaft 66 is further formed to have a head 80 located
forward of shoulder 76 that is located in front of housing 59. The
outer surface of head 80 is formed to have teeth 82. Teeth 82
engage complementary gears of the gear train 42.
[0054] Field coil assembly 61 and rotor 64 are encased in front and
back shells 86 and 88, respectively, formed of non-conductive
material such as liquid crystal polymer. Front shell 86 has a
ring-shaped head 90. Extending rearwardly from head 90 are a number
of spaced apart, parallel, rearwardly extending fingers 92. Small
raised ribs 94 extend outwardly from the outer surfaces of fingers
92. When the front shell is fitted within housing 59, ribs 94
ensure a tight fit of the shell. Back shell 88 has a ring shaped
base 96. Parallel, spaced apart fingers 98 extend forward from base
88. When motor 26 is assembled, fingers 98 of the back shell 88
seat in the interstitial spaces between fingers 92 of front shell
86. Shells 86 and 88 thus provide a barrier between the field coil
and rotor assemblies 64 and 66, respectively, and the motor housing
59.
[0055] A flex circuit 102 that is wrapped into a C-shape is
disposed around the outer surface of back shell base 88. Not shown
are the conductive traces formed on the flex circuit 102. These
traces form the conductive links to the windings integral with the
field coil assembly 62.
[0056] A set of insulated conductors 106 extends rearwardly from
flex circuit 102 through body bore 41. Conductors 106 are connected
to a second set of conductors, conductors 108, now described by
reference to FIGS. 2A and 3, that extends rearwardly out of the
handpiece body 40. Specifically, conductors 108 extend through an
angled tube 110 that extends rearwardly from back cap 39. A plug
112 extends from tube 110. Conductors 108 extend through plug 112
and power cable 30. Plug 112 is the distal end plug of power cable
30 and conductors 108 are the power conductors internal to the
cable.
[0057] The gear train 42, is now described by reference to FIGS.
5A, 5B and 5C. The gear train 42 includes a cylindrical housing 116
in which the other components of the gear train are housed. Housing
116 is designed be closely slip-fitted in handpiece bore 41. The
inner surface of housing 116 is formed with teeth 118 so that the
housing functions as the outer static ring of two planetary gear
assemblies that comprise the gear train. Housing 116 is also formed
with two rearwardly extending tabs 120, (one tab shown). Tabs 120
seat in complementary slots 122 formed in motor assembly housing 59
(FIG. 4B). Tabs 120 prevent gear train housing 116 from rotating
relative to the motor 26.
[0058] Gear train 42 also includes a motor tube 124 that is
disposed in the gear train housing 116 and extends rearwardly
beyond the proximal end of the rotor shaft 66. The distal end of
the motor tube 124, the end disposed in the gear train housing 116,
is seated in the center bore of a high speed head 128. High speed
head 128 is shaped to have a through bore. The distal end of the
motor tube 124 is press fit in a rearward facing counterbore that
extends coaxially with the through bore. (High speed head bores not
identified). Thus, the motor tube 124 and high speed head 128
rotate in unison. A triangularly-shaped planet carrier 130 is press
fit over the proximal end of the high speed head 128 so that the
head and carrier rotate in unison. Three planet gears 132 are
rotatably mounted to pins 134 that extend rearwardly from carrier
130. When the handpiece 22 of this invention is assembled, planet
gears 132 engage both the teeth 82 of motor rotor shaft 66 and the
inner teeth 118 of gear train housing 116.
[0059] Immediately forward of planet carrier 130, high speed head
128 is formed to have a toothed ring 137. The distal end of high
speed head 128 is formed to have two diametrically opposed,
forward-directed, pointed teeth 138. When a cutting accessory with
a high speed drive hub is coupled to the handpiece 22, teeth 138
engage the drive hub.
[0060] A low speed head 142 is rotatably fitted over the portion of
the high speed head 128 located forward of planet carrier 130. The
low speed head 142, seen best in FIGS. 6A and 6B, is formed to have
a through bore 144. The section of high speed head 128 distal to
toothed ring 137 and proximal to pointed teeth 138 are seated
within a rearwardly directed counterbore 146 coaxial with bore 144.
Collectively, the high and low speed heads 128 and 142,
respectively, are shaped so that teeth 138 are spaced inwardly from
the inner wall of low speed head 128 that defines bore 144. The
high and low speed heads 128 and 142, respectively, are further
shaped so that there is an annular gap between the outer surface of
the high speed head 128 and the inner surface of low speed head 142
that defines counterbore 146.
[0061] A bearing assembly 148 located in counterbore 146 rotatably
holds the high speed head 128 in low speed head 142. A bearing ring
150 is located against the proximal-facing end of bearing assembly
148. Bearing ring 150, as seen best in FIGS. 5B and 6C, is formed
to have a flat inner surface 152. The bearing ring is formed so
that the diameter of inner surface 152 is slightly larger than the
outer diameter of the adjacent underlying section of the high speed
head 128. Bearing ring 150 is further formed so that there is a
V-shaped, circumferentially extending groove 156 in the outer
surface of the ring.
[0062] Two washers 158 and 160 are located adjacent the proximal
facing end of bearing ring 150. Washer 160 prevents bearing ring
150 from pressing down against the toothed ring 137. Washer 158 is
located between the bearing ring 150 and washer 158. Washer 158
provides a low-friction interface between bearing ring 150 and
washer 160. Seen in FIG. 5C is an undercut 162 provided forward of
toothed ring 137 in low speed head 142 for manufacturing
reasons.
[0063] A set screw 164 longitudinally holds the low speed head 142
to bearing ring 150. Specifically, set screw 164 is seated in a
threaded bore 166 that extends radially through the low speed head
142. Set screw 164 has a conical tip, (not identified) that seats
in the groove 156 of bearing ring 150. Set screw 164 thus captures
the high speed head 128 in the low speed head 142.
[0064] A retaining ring 167, located forward of bearing assembly
148, blocks rearward movement of the high speed head 128. The
retaining ring, which is C-shaped, is snap-fitted in a
circumferential groove 168 formed in the high speed head 128
located immediately forward of the portion of head 128 subtended by
bearing assembly 148.
[0065] A dynamic seal 170 is located in the base of counterbore 146
of low speed head 142. Seal 170 extends between the inner surface
of the low speed head 142 that defines counterbore 146 and the
outer surface of the high speed head 128 from which teeth 138
extend forward. Seal 170, includes a U-shaped ring of flexible, low
friction material and a metallic circular spring formed in the
center of the ring that presses the sides outwardly, (seal
components not identified). Dynamic seal 170 thus forms a
liquid-tight barrier between the high and low speed heads 128 and
142, respectively.
[0066] A ring-shaped spacer 176 surrounds and is spaced from
retaining ring 167. The opposed proximal and distal ends of spacer
176 abut, respectively, the outer race of bearing assembly 148 and
the ring of dynamic seal 170. Spacer 176 thus prevents the dynamic
seal 170 from bearing against retaining ring 167.
[0067] The distal sections of low speed head 142 generally have a
circular cross-sectional profile. However, low speed head 142 is
further formed to have a proximally-located base 180 that has a
triangular profile and is further shaped to extend outwardly beyond
the other sections of the head 142. Base 180 is the portion of the
low speed head 142 in which threaded bore 166 is formed. Three
planet gears 182 are mounted to pins 184 that extend rearwardly
from positions near the apices of base 180. When handpiece 22 is
assembled, gears 182 engage both the toothed ring 137 of the high
speed head and the toothed inner surface of gear train housing
116.
[0068] As seen in FIG. 5B, washers 186 are located around pins 184
between gears 182 and the adjacent proximal facing surface of base
180 of the low speed head 142. Washers 186 reduce the friction of
the gears-to-head contact.
[0069] Immediately distal to base 180, low speed head 142 is formed
with a shoulder section 188 that has a circular profile. A bearing
assembly 190 extends between shoulder section 188 and the adjacent
inner wall of the handpiece body 40 that defines the main bore 41.
Bearing assembly 190 thus rotatably centers the low speed head 142
in bore 41. When the handpiece 22 is assembled the outer race of
bearing assembly 190, (race not illustrated) seats against the
adjacent distally-directed end face of housing 116. A C-shaped
retaining ring 192 is located around the distally-directed face of
the inner race of bearing assembly 190, (race not illustrated).
Retaining ring 192 is snap-fitted in a circumferential groove 193
formed in the head shoulder section 188.
[0070] Located forward of the portion of low speed head 142 that
defines bore 144, the head 142 is formed to have a nose section 194
of reduced diameter than the adjacent proximal section. Nose
section 194 forms a second counterbore 196 also coaxial with bore
144. Two diametrically opposed, spaced apart pointed teeth 198
extend forward from nose section 194. When a cutting accessory 24
with a low speed drive hub is coupled to the handpiece 22, teeth
198 engage the hub.
[0071] Lock assembly 44 is now described generally by reference to
FIGS. 7, 8 and 9. The lock assembly 44 includes a multi-section,
generally tubularly shaped housing 202 that is disposed in the body
main bore 41. A bore 204 extends axially through housing 202.
Housing 202 is further formed to have a proximally-located base 208
that has the largest diameter of the different sections of the
housing. More particularly, housing base 208 is dimensioned to
closely slip-fit against the inner wall of handpiece body 40 that
defines bore 41. The proximal end of base 208 abuts the
distal-facing face of the outer race of bearing assembly 190. Base
208 thus holds housing 202 off of retainer ring 192. In the Figures
opposed slots 210 are seen in the proximal end of base 208. Slots
210 are designed to accommodate a tool used to insert, align and
remove housing 202.
[0072] A dynamic seal 212 is located immediately inside the
proximal end opening of bore 204 in the housing base 208. Dynamic
seal 212 is similar in structure to previously described dynamic
seal 170. Dynamic seal 212 extends between the inner wall of base
208 that defines bore 204 and the adjacent outer surface of low
speed head nose 194. Seal 212 thus provides a liquid-tight barrier
between the low speed head 142 and lock assembly housing 202.
Housing 202 is further formed so that, internal to the base 208
there is an inwardly-directed, circumferentially extending lip 214
that extends into bore 204. Lip 214 thus prevents the forward
movement of seal 212.
[0073] Forward of base 208, housing 202 has a waist 216 with a
outer diameter less than that of base 208. Forward of waist 216
housing 202 has a shoulder 218 with a diameter between that of the
base 208 and waist 216. An anti-rotation pin 220 extends through an
opening in housing shoulder 218 into bore 204, (opening not
identified). Forward of the location at which pin 220 is seated,
the housing shoulder 218 is formed to have an arcuate slot 222 that
extends partially around the housing.
[0074] An arcuately shaped release collar 224, best seen in FIG.
10, is fitted around housing shoulder 218. The release collar 224
is generally C-shaped and is further formed so that the collar can
rotate around the underlying housing shoulder 218. Collar 224, it
will be observed, is shaped so that one end, end 226, has a
relatively short length as opposed to the opposed end, end 228. The
release collar 224 is fitted to the housing 202 so that collar end
226 is located adjacent and forward of anti-rotation pin 220. Thus,
when the release collar 224 is rotated, end 226 is able to clear
pin 220.
[0075] A release pin 230 is seated in a hole 232 in release collar
224. The release collar is formed to define a rim, (not
illustrated) that extends upwardly around hole 232. Pin 230 has a
head 231 that is dimensioned to extend above collar 224 and through
an arcuate slot 236 formed in the handpiece body 40, (FIG. 2B). Pin
230 also has a base section that extends through housing slot 222
into bore 204 and handpiece bore 41.
[0076] A helical torsion spring 238 biases the release collar and
pin 224 and 230, respectively, in a locked position. The torsion
spring 238 is disposed over the housing waist 216. One end of the
spring 238 seats in a slot 240 formed in the outer surface of the
housing base 208. The opposed end of spring 238 is seated in a slot
242 formed in the release collar 224. In the illustrated version of
the invention, slot 242 is longitudinally aligned with collar hole
232. This need not always be the case. Collectively housing 202,
release collar 224 and spring 238 are designed so that when these
components are assembled, the release pin 230 abuts an edge of
housing slot 222 and the spring places a biases the collar so that
the release pin is pressed against the adjacent edge surface.
[0077] Extending forward from shoulder 218, housing 202 has a neck
240. Neck 240 is formed to have a number of circumferentially
extending grooves 242. Distal to neck 240 housing 202 has a head
244 with an outwardly threaded surface. When the handpiece 22 of
this invention is assembled, lock assembly housing 202 is held in
bore 41 by a nut 246 (FIG. 2B) that is secured over head 244. Nut
246 is designed to be slip fit in a counterbore 248 that extends
inwardly from the distal end of handpiece body 40. Nut 246 thus
prevents rearward movement of the lock assembly 44.
[0078] When the lock assembly 44 is fitted in body 40, the
distally-directed face of base 208 seats against an annular step
that defines two different diameter sections of bore 41, (step not
identified). This abutment of housing 202 against the inner wall of
the body 40 blocks forward movement of the lock assembly 44.
[0079] When the handpiece is assembled, O-rings 250 are seated in
grooves 242 of the lock assembly housing 202. The O-rings 250 thus
function as a seal between the housing 202 and the adjacent inner
wall of the handpiece body 40 that defines bore 41.
[0080] Returning to FIGS. 2A, 2B and 3, back cap 39 is now
discussed. Back cap 39 includes a plate 256 that covers the open
end of the body 40. The back cap 39 is further formed to have a
head 258 that is in form of a block that extends rearwardly from
plate 256 beyond the handpiece body 40. Plate and head 256 and 258,
respectively, are collectively formed to define a first through
hole, hole 260, that is aligned with the center axis of body bore
41. Fitting 43 extends through hole 260 on both sides of the back
cap 39. A second hole, hole 262, extends through the plate 256 and
head 258 below hole 260. The distal end of tube 110 is secured in
hole 262.
[0081] Back cap 39 is further formed to have a third hole, hole
264, that extends through plate 256 and head 258. Hole 264 is
located above hole 260 and is axially aligned with the fluid supply
bore 46 formed in the handpiece body 40. Inlet fitting 50 extends
rearwardly out of the proximal end opening of hole 264. When
handpiece 22 is assembled, an elongated tube 266 is seated in the
proximal end of the fluid supply bore 41 and extends a short
distance beyond the portion of the body 40 that defines bore 46.
The proximal end of tube 266 is located in back cap hole 264. Thus,
hole 264 and tube 266 collectively define the fluid path between
fitting 50 and fluid supply bore 46.
[0082] Back cap 39 is further formed to have stem 268 that extends
forward from plate 256. Stem 268 is located between holes 260 and
264 and shares a common horizontal axis with hole 260. A bore 269
extends through stem 268. The back cap 39 is further formed so that
a branch conduit, (not illustrated) provides a fluid communication
path between the opening of hole 264 and bore 269.
[0083] A lock plate 270, seen best in FIG. 3, is secured in housing
bore 41 immediately in front of back cap 39. In one particular
version of the invention, it will be noted that the proximal end
opening of bore 41 has a tear drop shape cross sectional profile.
Lock plate 270 is cam fitted in an arcuate groove 267 formed in the
inner wall of body 40 that defines the wide diameter portion of the
open end of bore 40. Lock plate 270 serves as the static member
against which back cap 39 is secured by fasteners 271. Washers 272
are located between the heads of the fasteners 271 and the back cap
39. The fasteners 271 in the lock plate 270 are secured into
threaded openings in the lock plate 270, (openings not identified).
Lock plate 270 is formed to have an oval-shaped center opening 273.
The stem of fitting 43 and back cap stem 268 extend through opening
273. Lock plate 270 does not extend to the bottom of bore 41 so as
to provide a space through which the flex circuit tail 106 can
extend.
[0084] Valve 52, seen best in FIGS. 11 and 12, includes a valve
housing 274. The housing 274, described primarily by reference to
FIGS. 13 and 14, has a ring shaped collar 276. Collar 276 is
dimensioned to closely fit in main bore 41. A block 278 is
integrally formed with collar 276 and extends downwardly from the
collar. Block 278 is shaped so as to have a circular head 280. When
handpiece 22 is assembled, the outer circular wall of collar 276
seats against the inner circular wall of motor back shell base 98.
Block 278 is further shaped so that there is an opening 279 in
collar 276. Opening 279 functions as a through passage for
conductors 106.
[0085] Block 278 is further formed to have a multisection bore 282
that extends through the block and is coaxially aligned with head
280. More particularly the block is formed so that, extending
proximally from the distal end of head 280, bore 282 has a first,
second, third and fourth counterbores 284, 286, 288 and 290,
respectively, of increasingly smaller diameters. When handpiece 22
is assembled, motor rotor shaft 66 seats in first counterbore 284.
Motor tube 124 is disposed in the first, second and third
counterbores 284, 286, and 288, respectively. As seen in FIG. 2A, a
bearing assembly 285 extends between the proximal end of rotor
shaft 66 and the wall of block 278 that defines the first
counterbore 284. A bearing assembly 287 rotatably holds motor tube
124 in the second counterbore 286. A dynamic seal 289 is disposed
between the proximal end of motor tube 124 and the surrounding
circumferentially extending wall of block 278 that defines third
counterbore 288.
[0086] Block 278 is further formed to define a circular valve bore
292 that intersects bore 282. More specifically, valve bore 292 has
a longitudinal axis that extends perpendicular to the longitudinal
axis of bore 282. The longitudinal axis of the valve bore 292 is
located above the longitudinal axis of bore 282. Block 278 is
formed so that valve bore 292 completely intersects bore 282.
[0087] When handpiece 22 is assembled, a stem section of fitting 43
that has a relatively narrow outer diameter, is seated in the
portion of block bore 282 that is proximal to valve bore 292. An
O-ring 294 seated in a groove 296 contiguous with bore 282 extends
around the outer surface of the fitting stem section. O-ring 294
thus provides a seal between fitting 43 and the adjacent inner wall
of block 278 that defines bore 282.
[0088] Block 278 is further formed to define a supplemental bore
298 that is located above and laterally axially aligned with bore
280. The supplemental bore 298 extends proximally from a portion of
valve bore 292. The stem 268 of back cap 39 seats in a counterbore
302 formed in block 278 that extends from the supplemental bore
298. An O-ring 304 is seated in groove 305 formed in the distal end
of stem 268 that is seated in counterbore 302. O-ring 304 thus
provides a seal between the adjacent outer surface of stem 268 and
the inner wall of block 278.
[0089] Valve 52 includes a valve member 306 that is rotatably
mounted in valve bore 292. The valve member 306, best seen by
reference to FIGS. 15 and 16, has a generally disk-like shape.
Valve member 306 is further formed to have two spaced apart,
parallel grooves 308 that extend circumferentially around the outer
curved surface of the member. An O-ring 310 is seated in each
groove 308 so as to provide a seal between the adjacent outer
surface of the valve member 306 and inner surface of block 278.
[0090] Valve member 306 is further formed to have two through bores
312 and 314 that intersect. A first one of the bores, bore 312, has
the same diameter as block bore 282. Valve member 306 is formed so
that when the member is in a first select rotational orientation
within block 278, bores 282 and 312 are axially aligned. The second
bore, bore 314 has a diameter less than that of bore 312. Bore 314
is located within valve member 306 so that when the valve member is
in a second select rotational orientation, bore 314 establishes a
fluid communications path between the distal portion of bore 282,
the portion in front of valve bore 292, and the supplemental bore
298.
[0091] Valve member 306 is further formed to have a head 316 on one
side of the member. Head 316 has an outer diameter greater than the
diameter of valve bore 292. A disk-like lock plate 318, which has
the same diameter as head 316, is fitted over the end of valve
member 306 opposite head 316. Lock plate 318 is press fit over a
boss 320 that extends outwardly from the adjacent surface of valve
member 306. More specifically, boss 320 is press-fit into a hole
322 in the center of lock plate 318. Owing to their size, head 316
and lock plate 318 collectively hold valve member 306 in the valve
bore 292.
[0092] A valve guide 324 connects linkage rod 56 to valve member
306. The valve guide 324 has a ring shaped head 326 in which the
proximal end of linkage rod 56 is secured. A neck 328 extends
downwardly from head 326. Two opposed arms 330 extend outwardly
away from neck 328. Each arm 330 is generally diagonally downwardly
oriented and is further shaped to have an end flat palm section 333
that extends vertically downward. Valve guide pins 334 connect the
opposed ends of valve member 306 to valve guide 324. More
particularly, each guide pin 334 has a head and stem, (heads and
stems not identified). The head of a first guide pin 334 is seated
in a U-shaped slot 336 that is formed in valve member head 316. The
head of the second guide pin 334 is seated in a similarly shaped
slot 338 formed in lock plate 318. The pin stems each rotatably
extend through an opening in the adjacent palm section 333 of valve
guide 324, (openings not identified).
[0093] FIGS. 17 and 18 depict the basic components of one cutting
accessory 24 that can be used with system 20 of this invention.
Cutting accessory 24 includes a tubularly-shaped outer housing 340.
The particular cutting accessory, a shaver, is constructed so that
the distal end of outer housing 340 is closed. A small window 342
is formed in outer housing 340 proximal to the closed distal end
tip of the housing. An outer hub 344, seen best in FIGS. 19A and
19B, is secured to the proximal end of the outer housing 340. Outer
hub 344 is a generally tubular member that extends a short distance
beyond the distal end of the proximal end of outer housing 340. The
outer hub 344 is formed to have a set of spaced apart, generally
L-shaped teeth 346. Teeth 346 are shaped to define lock slots 348
between the teeth. Teeth 346 are further shaped so that the
proximal facing faces 350 are shaped to have a V-shaped profile,
the apexes being the most proximal points of the teeth.
[0094] Extending distally from teeth 346, the outer hub 344 is
shaped so as to have two spaced apart, circumferentially extending
grooves 352 in the outer surface of the hub. Grooves 352 are shaped
to accommodate O-rings 354. The outer hub 344 is further shaped so
as to have a relatively shallow concave groove 356 in the outer
surface between grooves 352. A bore 358 extends through the outer
hub from the base of groove 356 to the underlying axially extending
bore in the center of the hub.
[0095] Extending distally from the portion of the outer hub 344
that defines the most distal groove 352, the hub is formed to have
a set of longitudinally extending spaced apart webs 360. An
outwardly directed circumferentially extending flange 362
intersects webs 360. Webs 360 abut and terminate at the proximally
directed face of a flat ring 364 also part of outer hub 344. Webs
366, which are aligned with webs 360, extend forward from the
distally directed face of ring 364 to the distal end of the outer
hub 344. Webs 366 have a triangular profile such that they are at
their widest distance from the center axis of hub 344 at the points
from which they extend forward from ring 364. Webs 360, flange 362,
ring 364 and webs 366 provide structural strength to the outer hub
344. Providing webs 366 also simplifies the process of forming the
outer hub 344.
[0096] Outer hub 344 is further formed so that the interior has a
number of coaxially extending bores that are centered along the
longitudinal axis of the hub. A housing bore 370 extends from the
distal end of the hub 344 to a portion of the hub that is subtended
by the section that defines the distal most groove 352. Housing
bore 370 is the portion of the outer hub 344 in which the proximal
end of housing 340 is seated. A reservoir bore 372 extends
proximally from housing bore 370. Reservoir bore 372 has a diameter
wider than that of housing bore 390. Reservoir bore 372 is
subtended by the portion of the hub that defines groove 356.
Laterally extending bore 358 opens into reservoir bore 372. A first
counterbore 374 extends proximally from the proximal end of
reservoir bore 372. First counterbore 374 has a diameter greater
than that of reservoir bore 372. A second counterbore 376 extends
distally from the reservoir bore 374 to the proximal end of the
outer hub 344. Second counterbore 376 has a wider diameter than
first counterbore bore 374. The outer hub 344 is formed so that the
inner walls that define the bores have a short tapered section 378
that defines the transition between the counterbores 374 and
376.
[0097] A tubular rotating shaft 380 is disposed inside housing 340.
The distal end of shaft 380 is closed. Extending proximally from
the distal end, shaft 380 is formed to have a window 382. The
window 382 is defined by edge surface 384 formed in the shaft 380.
Window 342 of housing 340 is defined by a similarly sharp beveled
edge 343 of the housing. Thus, edges 343 and 384 function as
scissors when shaft 380 is rotated.
[0098] The Applicant's Assignee's U.S. Pat. No. 6,342,061, SURGICAL
TOOL WITH INTEGRATED CHANNEL FOR IRRIGATION, issued Jan. 29, 2002,
and incorporated herein by reference, provided additional
discussion regarding how the distal end of a cutting accessory may
be constructed. It should likewise be recognized that alternative
cutting accessories, such as burs and resectors, can be constructed
in accordance with this invention.
[0099] A drive hub is attached to the proximal end of rotating
shaft 380. Some cutting accessories 24 of this invention are
provided with a drive hub 390, now described by reference to FIGS.
20A and 20B, that is designed to engage teeth 138 of high speed
head 128. Drive hub 390, hereinafter, the high speed drive hub, has
a generally cylindrical body. A bore 392 extends axially through
the hub 390. High speed drive hub 390 is formed to have a head 394
with a relatively narrow outer diameter and a proximally adjacent
neck 396 that has a wider diameter. Not identified is a tapered
section between head 394 and neck 396. A ring shaped collar 398
extends around the distal end of neck 396. Collar 398 has an outer
diameter greater than that of neck 396. While not illustrated,
internal to the high speed hub 390, the hub is formed with a
counterbore within head 394, neck 396 and collar 398 that is
coaxial to bore 392. This counterbore is the portion of the drive
hub 390 in which the proximal end of rotating shaft 380 is heat
staked or otherwise secured.
[0100] Extending proximally from collar 398, drive hub 390 is
formed to have a cylindrically shaped torso section 402. Torso
section 402 has a diameter slightly greater than that of neck 396.
Proximal to torso section 402 the drive hub 390 has a skirt section
404 that has a diameter less than that of torso section 402. A
cylindrical stem 406 extends proximal to skirt section 404. Stem
406 has a diameter less than that of skirt section 404.
[0101] High speed drive hub 390 is further formed to have four
spaced apart parallel teeth 408 that extend proximally from skirt
section 404 of stem 406. Each tooth 408 has a distal section 410
that extends directly from skirt section 404 that has the same
radial outer diameter as the skirt section. Each tooth also has a
proximal section 412 that is raised relative to the distal section
410. Proximal sections 412 of teeth 408 have proximal facing faces
413 that are pointed.
[0102] A spring 414 is disposed around high speed drive hub 390.
The spring is located over skirt section 404 and teeth distal
sections 410. When the cutting accessory 24 with which the high
speed drive hub 390 is integral is fitted to handpiece 22, spring
414 thus extends between the distal end of the high speed drive
head 128 and the circumferentially stepped surface between the hub
torso and skirt sections 402 and 404, respectively. Spring 414 thus
urges drive hub 390 and shaft 380 forward so that the distal end of
the shaft abuts the adjacent inner surface of the distal end of
housing 340.
[0103] Alternatively, a low speed drive hub, hub 418 illustrated in
FIGS. 21A and 21B may be secured to the proximal end of drive shaft
380. Hub 418 is incorporated into a cutting accessory 24 intended
for connection to low speed head 142. Drive hub 418 has a bore 420,
a head 422 and a neck 424, similar in shape to bore 392, head 394
and neck 396 of high speed drive hub 390. Neck 424 of the low speed
drive hub 418 extends further along the length of the hub than neck
396 of the high speed drive hub 390. Internal to low speed drive
hub 418 is a counterbore, (not illustrated), that extends through
head 422 and neck 424 that is coaxial with bore 420. This
counterbore is the space internal to the drive hub 418 in which the
proximal end of shaft 380 is secured.
[0104] Located proximal to neck 424, drive hub 418 is formed to
have a collar 426 that extends outwardly from the neck. A number of
spaced apart teeth 428 are formed on the outer surface of collar
426. Teeth 428 have pointed, proximally directed faces 430.
Extending rearwardly from collar 426 drive hub 418 has a
cylindrical shoulder section 432 that has a diameter between that
of neck 424 and collar 426. Proximal to shoulder section 432, the
low speed drive hub 418 has a stem 434. Stem 434 is dimensioned to
closely slide fit within the open end gear train high speed head
128.
[0105] A spring 435 (FIG. 23) extends over the shoulder and stem
432 and 434, respectively, of the low speed drive hub 418. When a
cutting accessory 24 that includes the low speed drive hub 418 is
coupled to handpiece 22, spring 435 extends between the
circumferential step surface between low speed drive bore 144 and
counterbore 196 and the circumferential step between hub collar 426
and shoulder 432. Spring 435 pushes drive hub 418 and rotating
shaft 380 forward for the same reason spring 414 places a similar
force of shaft 380.
[0106] When a cutting accessory 24 is assembled, an O-ring 436
(FIG. 18) is fitted to the hub stem. This O-ring 436 is fitted in a
groove 438 formed in the proximal end of high speed drive hub stem
406 or a groove 440 formed in the same location of the low speed
drive hub stem 434. The O-ring 436 functions as a seal between the
drive hub stem 406 or 434 and the adjacent inner wall of the gear
train high speed head 128. An O-ring 442 is located over the head
394 or 422 of drive hub 390 or 418. O-ring 442 thus provides a seal
between the shaft 380 and the adjacent inner surface of outer hub
344.
[0107] While not illustrated and not part of the invention to which
this application pertains, it should be understood that a memory
chip may be fitted in the cutting accessory outer hub 344. The
memory chip contains data that describes the operating
characteristics of the cutting accessory 24. A coil is disposed in
the distal end of handpiece body 40 so as to subtend the portion of
the outer hub 344 in which the memory chip is seated. When the
cutting accessory 24 is secured in the handpiece 22, data in the
memory are inductively read by the control console 28 through cable
30 and the coil in the handpiece. The data read from the cutting
accessory memory are used to regulate the actuation of motor 26. A
more complete understanding of this feature is found in the
Applicants' Assignee's U.S. patent application Ser. No. 10/214,973,
SURGICAL TOOL SYSTEMS THAT PERFORM INDUCTIVE DATA TRANSFER, filed 8
Aug. 2002, now U.S. Pat. No. ______ and incorporated herein by
reference.
[0108] The surgical tool system 20 of this invention is prepared
for use by plugging the proximal end of power cable 30 to control
console 28. Suction line 38 is attached to fitting 43; supply line
34 is connected to inlet fitting 50.
[0109] A cutting accessory 24 is then inserted in the distal open
end of handpiece main bore 41. Both main bore 41 and the portion of
the outer hub 344 inserted in the bore are cylindrical. The outer
hub 344 has a number of lock slots 348 the entry to which is
defined by the pointed faces 350 of teeth 346. Collectively, this
means that medical personnel inserting the cutting accessory 24 in
place do not have to concentrate on aligning the cutting accessory
24 in a select orientation relative to the handpiece 22 to ensure
that the components will couple.
[0110] Instead, the abutment of one of the cutting accessory teeth
346 against release pin 230 causes the hub or release pin to be
rotated so that the pin seats in the longitudinal portion of one of
the slots 348. As the outer hub is further pressed into the
handpiece 22, anti-rotation pin 220 seats in the longitudinally
extending section of a second one of the slots. Once the release
pin 230 is positioned in the laterally extending portion of the
slot 348 in which the pin 230 is seated, spring 238 rotates the
release collar 224 and pin 230 back to their static positions. This
displacement of the release pin 230 seats the pin in the laterally
extending portion of slot 348 that is spaced from the open ended
longitudinally aligned portion. Thus, when the release pin 230 is
in this position, the pin holds the cutting accessory 24 to the
handpiece 22.
[0111] A cutting assembly 24 is removed from the handpiece 22 by
the simple manual, arcuate displacement of release pin 230. This
motion aligns the release pin with the longitudinally extending
section of the outer hub slot 248 in which the pin is seated. Once
the release pin 230 is so aligned, it is a simple task to simply
pull the cutting accessory out of the bore 41 so a new accessory
can be installed.
[0112] The insertion of the cutting accessory 24 into the main bore
41 also results in the coupling of the drive hub 390 or 418 to the
gear train head 128 or head 142, respectively. When the cutting
accessory 22 is provided with high speed drive hub 390, high speed
head teeth 138 seat between adjacent hub teeth proximal sections
412 as seen in FIG. 22. When the cutting accessory 24 is provided
with the low speed drive hub, low speed head teeth 198 seat in the
slots between adjacent hub teeth 428 shown in FIG. 23. Given the
profiles of the opposed faces of teeth pairs 138/408 and 198/428
and, since the drive hubs have more inter-teeth slots than there
are complementary head teeth, the drive hub, upon insertion into
the main bore automatically rotates to lock into the appropriate
complementary head 128 or 148 of the gear train. Thus, again,
medical personnel do not need to spend time aligning the drive hub
when the cutting accessory 24 is fitted to the handpiece 22 to
ensure that it is properly coupled to the gear train.
[0113] Another feature of the surgical tool system 20 of this
invention is that, when the cutting accessory 24 is secured in the
handpiece bore 41, outer hub groove 356 is aligned with the body
with the open end of body discharge bore 48. Thus, irrigating
fluid, when forced through the handpiece 22 by pump 32, is
discharged from bore 48 into groove 356. O-rings 354 prevent
longitudinal flow of the fluid through bore 41. Thus, the
irrigating fluid is forced to flow through bore 358 in the outer
hub 344. From bore 358 the fluid flows proximally in the annular
space between housing 340 and shaft 380 and out window 342. Thus,
the system of this invention is further designed to automatically
establish a flow path for irrigation fluid from the handpiece 22
into the cutting accessory 24 without medical personnel having to
either make an additional line connection or having to ensure that,
when the cutting accessory is fitted to the handpiece, these two
components are in a select orientation.
[0114] Still another advantage of the above feature of the surgical
tool system 20 of this invention is that cutting accessory 24 can
be placed in different rotational orientations relative to
handpiece 22. In the particular version of the invention, the
accessory can be selectively positioned in one of four rotational
orientations that are spaced 90 degrees apart from each other. This
means the windows 342 and 348 of the cutting accessory, the cutting
element, can be placed in one of four rotational orientations
relative to the handpiece 22. Thus, a surgeon using the system of
this invention can selectively position the cutting accessory so
that it is most favorable position relative to the handpiece 22 to
perform the desired surgical task.
[0115] The cutting accessory is actuated by the surgeon depressing
a control member connected to the control console 28. Often this
control member is a foot switch, (not illustrated). In alternative
versions of the invention the control member may be a hand switch
(not illustrated) the components of which are wholly or partially
disposed within handpiece body 40.
[0116] The depression of the control member results in the control
console supplying a current to energize motor 26. In some versions
of the invention, the motor 26 operates at speeds between 4,000 and
60,000 RPM. This is the speed at which rotor shaft 66 turns. The
toothed surface of the gear train housing 116, gears 132 and
carrier 130 form a first planetary gear assembly. In some versions
of the invention, this assembly steps down the speed of the output
rotation of motor tube 124 relative to rotor shaft 66 at ratio of
from 2.8:1 to 5.0:1.0. When the cutting accessory 24 is provided
with a high speed drive hub 390, the hub engages motor tube 124
through teeth 138 so as to rotate in unison with the motor
tube.
[0117] Toothed ring 137, gears 182 and the toothed inner surface of
gear train housing 116 form a second planetary gear assembly. This
assembly steps down the rotational moment of the low speed head 142
relative to that of the high speed head 128 at a ratio of from
2.8:1 to 5.0:1. When cutting accessory 24 is provided with a low
speed drive hub 418, the hub engages the low speed head 142 to
rotate in unison with this head.
[0118] Thus, depending which drive hub 390 or 418 is connected to a
cutting accessory, an accessory may be driven at a speed that is
between 20 or 36% of the output speed of the rotor shaft 66 or 4 to
13% of the output speed of the rotor shaft speed. An advantage of
this feature of the system of this invention is that cutting
accessories can be operated at a relatively wide range of speeds
relative to the motor speed.
[0119] Valve 52 regulates fluid flow through the bore that extends
axially through drive shaft 380. It is anticipated that often the
valve 52 will be set so that valve member bore 312 is wholly or
partially aligned with block bore 282. When the valve member 306 is
so positioned there is, respectively, a full or partial suction is
drawn by pump 36 through the drive shaft. It should be understood
that the valve member bore 312 is wholly aligned with block bore
282 when handpiece button 54 is in its most distal position, shown
best in FIG. 2A. The retraction of button 54 proximally results in
a like displacement of rod 56 and valve guide 324. The rearward
displacement of valve guide 324 results in the rotation of valve
member 306 that turns the bore out of alignment with bore 282. When
valve member bore 312 is aligned to any degree with block bore 282,
the second valve member bore 314 is wholly out of alignment with
supplemental bore 298.
[0120] The further rotation of valve member 306 brings it into the
position illustrated by FIG. 22. Here, bore 312 is out of
registration with bore 282 and bore 314 establishes a fluid
communications path between bore 282 and supplemental bore 298.
Thus, when the valve 52 is in this state, irrigating fluid is
supplied through bores 298, 314 and 282 and the drive hub bore to
the center of the cutting accessory shaft 380. This fluid, since it
is under pressure, flushes debris from the shaft. The fluid may
also be used to, when desired, apply additional irrigating fluid to
the surgical site to which the cutting accessory is applied.
[0121] The above description is limited to one specific version of
the invention. Other versions of the invention may vary from what
has been described. Thus, there is no requirement that all versions
of the system of this invention include all of the described
features. For example, some versions of the invention may only
include the gear train assembly but not the assembly for
automatically supplying irrigating fluid to the outer hub of the
cutting accessory. Alternatively, other versions of the invention
may only include the assembly for supplying irrigating fluid to the
outer hub and not the gear train assembly.
[0122] It should also be recognized that other versions of the
invention may have other features than those that have been
described. For example, there is no requirement that all versions
of the invention include an electrically driven motor let alone a
brushless, sensorless, electric motor. In other versions of the
invention alternative power generating units may be integral with
the system handpiece. Alternative power generating units that may
be incorporated into this invention include: pneumatically driven
motors; light emitting devices, including lasers; electrosurgical
members; and sound or ultrasonic generators. When a system of this
invention with an alternative power generating unit is provided,
again, it may not be necessary to provide all the features of the
system disclosed in this application.
[0123] Alternative versions of this invention may have features
that are different from what has been described. For example,
alternative constructions of a gear train capable of receiving
different drive hubs and driving those hubs at different speeds may
be provided. For example, in some versions of the invention, the
motor rotor may run at a speed range which is appropriate to also
actuate a cutting accessory. In these versions of the invention, a
high speed head, capable of receiving an accessory high speed
driver, may be attached to the motor rotor to turn in unison with
the rotor. In these versions of the invention, only a single speed
reduction gear assembly is provided; the low speed head being part
of this gear assembly. Also, in other versions of the invention,
the gear train may have three or more heads for driving the
associated cutting accessory within three or more distinct speed
ranges. These versions of the gear train would typically have at
least two speed reduction gear assemblies.
[0124] Also, there is no requirement that the gear trains of
alternative versions of the invention be only provided with speed
reduction gear assemblies. For some versions of the invention, it
may be desirable to provide the gear train with at least one gear
assembly with an output head that turns at a rate faster than that
of the associated input gear.
[0125] Similarly, it should be recognized that it may be possible
to provide a gear train with plural drive heads each of which are
capable of receiving a common cutting accessory drive hub. In these
versions of the invention, a release or guide mechanism that is
manually actuated may be provided to ensure that the drive hub is
mated to the intended drive head.
[0126] It should likewise be understood that not all versions of
the invention may have gears that form planetary gear assemblies.
Alternative gear assemblies may be provided. For example, one such
alternative assembly may include spur gears. In these versions of
the invention, including versions of the invention provided only
with gear assemblies, there is no requirement that the low speed
drive head always be located forward of the high speed drive head.
In alternative versions of the invention this arrangement of the
drive heads may be reduced.
[0127] In the described version of the invention, the gears all
rotate in the direction in which the motor shaft 66 rotates. This
may not always be the case. In some versions of the invention it
may be desirable to provide one or more gears that rotate in a
direction opposite the direction of rotation of the motor shaft. An
advantage of this version of the invention is that, when the motor
is driven an oscillatory mode, shaft 66 is rotated in
forward/reverse/forward/reverse pattern, the gears that rotate in
the direction opposite of that of shaft 66 will offset the
oscillatory kick that occurs when the other gears of the handpiece
change rotational direction.
[0128] It should likewise be recognized that there is no
requirement that in all versions of the invention with motors and
gear trains, that the motors have cannulated rotors through which a
suction from the handpiece is drawn. Clearly, this type of motor is
not required if the system is not designed so that the system can
be employed to draw a suction from the surgical site. Also, in
alternative versions of the invention, the suction may be drawn
through a bore in the handpiece body that is in addition to a
substitute for the irrigating fluid supply bore. In these versions
of the invention, the motor is a wholly sealed device, the only
exposed member of which is the distal end of the output shaft. The
gear train is seated in a chamber in the handpiece and the suction
bore extends from the chamber.
[0129] It should likewise be recognized that alternative lock
assemblies employed to releasably hold the cutting accessory to the
handpiece. For exampled, in some alternative versions of the
invention, the lock assembly may have one or more members that are
designed to abut against and retract away from complementary
seating spaces in the cutting accessory.
[0130] There may also be variations in the valve assembly
incorporated into alternative versions of this invention. Clearly,
in versions of the invention not provided with a fluid supply
assembly, the valve would only control the suction drawn at the
surgical site. If the motor does not have a cannulated flow
conduit, the valve may be positioned in a location other than the
proximal end of the handpiece. Also, some versions of the invention
may not be provided with a fluid supply assembly configured to
deliver fluid to the cutting accessory outer hub. These versions of
the invention may still be provided with both a fluid inlet and
suction outlet. Here, as in the described version of the invention,
the valve may be designed to connect one conduit integral with the
cutting accessory to either the fluid inlet or suction outlet.
[0131] In still other versions of the invention, the valve assembly
may have a three state valve. That is a valve that, prior to
switching the cutting accessory fluid connection from the suction
fitting to the inlet fitting, completely closes the fluid
connection to/from the cutting accessory.
[0132] Also, it should be understood that, in the current version
of the invention, control console 28 is configured to actuate
irrigation pump 32 simultaneously with the actuation of the
handpiece motor 26 by the surgeon. The system is further configured
to allow the surgeon to also turn pump 32 on and off independently
of the actuation of motor 26. This control is typically through a
foot switch attached to the control console 28. It is contemplated
that, when irrigation flow through the center of cutting accessory
shaft 380 is required, the surgeon will first stop motor 26. Thus,
when the valve is first moved to establish an inlet
fitting-to-accessory shaft fluid connection, irrigating fluid is
not being forced into the handpiece. Thus, when the valve is in
this state, there is no fluid flow to/from the cutting accessory
shaft 380. In order to force irrigating fluid through the cutting
accessory shaft 380 the surgeon is required to actuate the pump.
Again, this is performed by depression of a foot switch or a button
presented on the control console 26.
[0133] In an alternative version of the invention, the valve is
assembled so that there is arc through which the valve member 306
can be rotated in which it will establish an inlet
fitting-to-accessory shaft fluid communications path. A sensor is
used to monitor the position of valve member 306. This sensor may
take the form of a proximity sensor mounted in body 40 that
generates a bistate signal as a function of the relative position
of linkage rod 56. In these versions of the invention, the output
signal generated by the sensor undergoes a state change when the
valve in its further rotational position. The output signal
generated by this sensor is applied to the control console and used
to regulate the actuation of pump 32. Thus, initially when the
valve member 306 is moved to establish the inlet
fitting-to-accessory shaft fluid communications path, the signal
produced by the sensor does not change. As button 54 is pushed
further rearwardly the resultant displacement of the linkage rod 56
is detected by the sensor. As a result of the state change of the
output signal from the sensor, control console 28 actuates pump 32
so as to force irrigating fluid through the cutting accessory shaft
380.
[0134] An advantage of the above version of the invention is that
the surgeon, with a single member, button 54, is able to both set
the valve and actuate pump 32. Thus, with the single button 54 the
surgeon is able to place handpiece 22 into one of three state: a
first state in which there is an accessory shaft-to-suction fitting
connection; a second state in which there is an inlet
fitting-to-accessory shaft connection without fluid flow, a no
fluid flow state; and a third state in which there is fluid flowing
from the pump 32 to the accessory shaft.
[0135] This configuration of the invention thus makes it possible
to provide a three state fluid control with a single finger even
though the valve member itself may be relative small, both diameter
and length both 0.5 inches in size or smaller. It is necessary to
provide valves of this size because the handpieces themselves are
relatively small in size, typically having a maximum length of 6
inches and a maximum width of 1 inch or less. Moreover, it should
also be understood that, within the handpiece, often up to 1 inch
of its initial length may be the bore space in which the outer hub
of the cutting accessory is seated. These bores are so long because
in a handpiece designed for use with an image guided surgery
system, it is necessary to fit the cutting accessory to the
handpiece so that the position of the distal end of the accessory
to the handpiece does not vary. It has been found that one ready
way to ensure this type of securement is to design the system so
that the outer hub tightly fits in the handpiece bore in which the
hub is seated and that the hub have a relatively long length, for
example between 0.6 and 1.0 inches.
[0136] Thus, given that surgeons prefer working with handpieces
that are relatively small in size and that the space in the front
ends of handpieces are designed to accommodate a large sized hub,
there is little space in the handpiece to accommodate a valve. Even
in view of these design factors, the valve assembly of this
invention allows a surgeon to, with a single on valve control
member, set the valve so that a suction is drawn through the
cutting accessory shaft 380, the shaft is closed to fluid
inflow/outflow or irrigating fluid is forced down the shaft.
[0137] It should be similarly recognized that alternative
constructions of the valve may be provided. In some versions of the
invention, the valve body may be disposed in the handpiece body so
as to rotate around an axis that is coaxial and/or at least
parallel with the longitudinal axis of the handpiece body.
Alternatively, the valve may have a valve member that slidably
moves in order to be placed into different valve states.
[0138] Also, while the components of one particular version of this
invention are designed to perform sinus and throat surgery, it is
understood that other versions of the invention are dimensioned to
perform other surgical procedures, including, but not limited to,
orthopedic surgery, general surgery and gynecological surgery.
Also, while many versions of this invention are well suited to
perform endoscopic surgical procedures, it should be understood
that the use of this invention and its alternative designs are not
so limited.
[0139] It should likewise be understood that, in some versions of
the invention, the drive heads integral with the gear train may not
be concentrically aligned.
[0140] Also, the geometry of the outer hub and drive hubs of the
cutting accessory are exemplary, not limiting. For example, the
number of axially aligned bore sections in the outer hub may be
different from what has been described. There may even just be a
single, constant diameter bore. Similarly, it may be desirable to
provide plural lateral irrigation inlet bores into the axial bores.
Also, for the outer hub, only single type of surface member is
shown for receiving the complementary handpiece locking member.
Similarly, for each of the drive hubs, only a single type of
surface member is shown for facilitating the coupling of the hub to
the complementary drive head. Clearly, the shape and size of these
surface members may be different in other cutting accessories of
this invention when these accessories are designed for use with
handpieces that having alternative lock assemblies and/or drive
heads.
[0141] Also, while in some preferred versions of the invention, it
is possible to position the cutting accessory in different
rotational positions relative to the handpiece, in other versions
of the invention, this feature may not be necessary or desired. In
these versions of the invention, the cutting accessory may only be
provided with a single surface feature or member designed to
facilitate its attachment to the handpiece in a specific angular
orientation.
[0142] Similarly, the outer hub may be provided with an alternative
arrangement of surface members or features that allow the hub, and
therefore the cutting accessory, to be mounted to the complementary
handpiece in more or less than four positions as described in the
exemplary embodiment. In some versions of the invention,
collectively the handpiece lock assembly and the surface features
of the outer hub may be designed to allow the mounting of the hub,
and therefore the cutting accessory, to the handpiece in any
angular orientation.
[0143] Thus, it is the object of the appended claims to cover all
such variations and modifications that come within the true spirit
and scope of the invention.
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