ARTHROSCOPIC DEVICES AND METHODS
An arthroscopy system includes both a motorized handpiece and a detachable probe. The motorized handpiece includes a rotating driver which is configured to engage a rotatable drive coupling within a hub of the probe. The probe has a shaft with an articulating distal region, and the rotatable drive coupling is configured to convert the rotary motion of the rotating driver to an articulating motion within the articulating region of the probe.
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This application claims the benefit of provisional application No. 62/357,786 (Attorney Docket No. 41879-726.101), filed on Jul. 1, 2016, the full disclosure of which is incorporated herein by reference.
BACKGROUND OF THE INVENTION 1. Field of the InventionThis invention relates to arthroscopic surgical devices by which anatomical tissues in knee joints, hip joints and the like may be ablated, cut and/or removed from a joint. More specifically, this invention relates to electrosurgical probes that can be articulated with a motor drive in an arthroscopy handpiece.
Arthroscopic joint and other procedures, such as hip treatments, subacromial decompression, treatment of the acromioclavicular joints, often require a number of different tools having different functions and structures. In order to reduce the cost and inventory burdens associated with using a large array of tools in a single procedure, “resposable” tools having a disposable working end and a reusable handpiece have been proposed. The handpiece will be designed to work with a large number of different tool types having different functions and “working ends” so that the cost and inventory of necessary tools can be reduced.
While the use of resposable tools holds great promise, a successful resposable tool system requires that one type of handpiece be compatible with as many types of tools and working ends as possible. For example, many handpieces will have motor drives with a rotating drive shaft. Such motor drives need to be compatible not only with rotating end effectors, such as drills, shavers, grinders, and the like, they should also be compatible with non-rotating end effectors.
Of particular interest to the present invention, it would be desirable to provide tools and working ends having articulating end effectors which can be driven by a motorized handpiece having a rotatable drive element. Arthroscopic probes having an articulating working end allow physicians to reach targeted tissues which would otherwise be difficult to access. The need thus exists for improved and alternative articulating arthroscopic devices that that can ablate and extract soft tissue rapidly and also be compatible with rotating drive elements. At least some of these objectives will be met by the inventions described and claimed herein.
2. Description of the Background ArtArthroscopic tissue ablation and extraction devices are described in the following commonly owned patents and published applications: U.S. Pat. Nos. 9,603,656; 9,585,675; 9,592,085; 9,277,954; 9,204,918; and 8,323,280; and U.S. Patent Publication Nos. US 2016/0346036; US 2016/0157916; and US 2016/0113706, the full disclosures of which are incorporated herein by reference.
SUMMARY OF THE INVENTIONThe present invention provides arthroscopic and other minimally invasive tools and tool systems. The tool systems include motorized handpieces and detachable tools, where the detachable tools are usually intended for only a single use by a single patient (often being referred to as disposable tools) and the motorized handpieces are usually intended to be reused in multiple procedures for multiple patients (often being referred to as “resposable”). The motorized handpieces will provide a rotating drive element or drive shaft which is configured to engage or mate with a rotatable coupling in or on the tool. The rotatable coupling, in turn, will be configured to convert the rotary motion of the drive shaft or driver into an articulating motion within a distal region of the tool. In this way, the “resposable” handpiece can be used with conventional rotary and other tools as well as with the particular tools of the present invention which have articulating regions as described in detail below.
In a first specific aspect, the present invention comprises a device intended for use with a motorized handpiece having a rotating driver. The device comprises a shaft having a proximal end and an articulating distal region. A hub is attached to the proximal end of the shaft, and the hub is adapted for or configured to detachably connect to the motorized handpiece. A rotatable drive coupling on or within the hub is configured to detachably engage the rotating driver when the hub is connected to the handpiece. In this way, rotation of the drive coupling by the driver causes the articulating distal region of the shaft to articulate.
In particular embodiments, the shaft of the device comprises outer and inner concentric or coaxial sleeves, where a proximal end of the outer sleeve is fixed in or to the hub and a proximal portion of the inner sleeve is axially movably or translatably mounted in an interior bore of the outer sleeve in response to rotation of the driver. Usually, the shaft will have at least one distal component that maintains the distal ends of the outer and inner sleeves in a fixed relationship, i.e., the distal component fixedly couples the two ends together. Typically, a threaded collar on a proximal end of the inner sleeve threadably engages the drive coupling to longitudinally drive the threaded collar as the rotatable drive coupling is rotated by the rotating driver of the handpiece.
In an alternative embodiment, the rotatable drive coupling can rotate in a first direction relative to a first collar fixed to a proximal end of the inner sleeve and rotation of the drive coupling rotates a pin thereon to engage against an engaging surface of the first collar to longitudinally drive the first collar to articulate the distal region of the shaft.
In still further embodiments, a reciprocatable electrode is disposed at a distal tip of the articulating distal region of the shaft and is carried by a third concentric sleeve having a distal end and a proximal end. The distal end of the third sleeve is attached to the reciprocatable electrode and proximal end is attached to the drive coupling. The rotatable drive coupling is configured to rotate in a second direction and rotation of the drive coupling and pin in the second direction against a cam surface on the first collar longitudinally drives the third sleeve to reciprocate the reciprocatable electrode.
In other specific embodiments, the at least one distal component at the distal end of the shaft is a ceramic member and carries at least one electrode, typically carrying at least a first polarity electrode and a distal region of the shaft comprises a second polarity electrode. In other specific embodiments, the articulating region of the shaft comprises a series of slots in the outer and/or inner sleeves. For example, slots in the outer sleeve may be radially offset from slots in the inner sleeve. By adjusting the degree of radial offset, the direction of deflection of the articulating distal region can be adjusted. In still other specific embodiments, an insulation layer may be disposed between the outer and inner sleeves, and first and second electrical contacts may be provided in the hub to connect respectively to first and second polarity electrodes on the shaft to provide for delivery of radio frequency (RF) current to the electrode(s).
The motorized handpiece will typically comprise a motor within a housing of the handpiece, and the housing will usually have one or more actuators for effecting various functions of the handpiece. In one example, an actuator on an outer surface of the handpiece provides for manually activating the motor to bend the articulating region. In another example, an actuator on an outer surface of the handpiece provides for controlling delivery of RF current to the first and second polarity electrodes.
In still further examples, the inner sleeve of the shaft may have an interior passageway extending to an open termination in a distal region of the shaft. The interior passageway is typically adapted to be connected to a negative pressure source in order to provide for aspiration through the tool and the handpiece when the handpiece is connected to the negative pressure source.
In a second specific aspect, an arthroscopy system comprises a motorized handpiece having a motor-driven driver or drive shaft. The system further comprises a probe having both (a) a proximal hub adapted for detachable connection to the motorized handpiece and (b) a probe shaft having an articulating distal region. A rotatable drive coupling disposed within the hub is adapted for coupling to the motor-driven driver or drive shaft, where rotation of the drive coupling by the driver will cause articulation of the articulating distal region.
In specific embodiments of the arthroscopy system, the shaft comprises outer and inner concentric sleeves, where a proximal end of the outer sleeve is fixed in or on the hub and a proximal end of the inner sleeve is fixed in the rotatable drive coupling. A proximal portion of the inner sleeve is typically axially or longitudinally moveable in an interior bore of the outer sleeve so that relative axial translation of the sleeves will cause articulation of the distal region. A ceramic member is typically used to connect the distal ends of the outer and inner sleeves, and first and/or second polarity electrodes may be carried on the ceramic member. An insulation layer may be disposed between the inner and outer sleeves, and electrical contacts on the handpiece are typically adapted for coupling with cooperating or corresponding electrical contacts in the hub to allow for energizing the first and second polarity electrodes.
The arthroscopy system may further comprise a reciprocatable electrode at a distal tip of the articulating distal region of the shaft carried by a third concentric sleeve having a distal end and a proximal end. The distal end is attached to the reciprocatable electrode, and the proximal end is driven by the rotatable drive coupling to longitudinally drive the third sleeve to reciprocate the reciprocatable electrode.
In a third specific aspect, the present invention provides an arthroscopy system comprising a motorized handpiece having a motor and a motor actuator button. A probe having a hub connected to a shaft having an articulating region is detachably connectible to the motorized handpiece. In particular, a hub is adapted for detachable connection to the motorized handpiece where a motor within the handpiece is configured to articulate the articulating region of the probe shaft. The actuator button and motor are configured or adapted to continuously articulate the articulating region when pressure is applied to the button to cause deformation of the articulating region between a linear shape or configuration and a fully articulated shape or configuration, or a release of pressure on the actuator button will stop such continuous articulation.
In a fourth aspect, an arthroscopy system comprises a motorized handpiece having a motor and a motor actuator button. A probe having a hub connected to a shaft has an articulating distal region. The hub is adapted for detachable connection to the motorized handpiece, and the motor and motor actuator button are configured to articulate the articulating region of the probe shaft such that pressure on the actuator button articulates the articulating region between a linear shape and a fully articulated shape.
In a fifth aspect of the present invention, an arthroscopy system comprises a motorized handpiece having a motor and a motor actuator button. A probe having a hub connected to a shaft has an articulating distal region. The hub is adapted for detachable connection to the motorized handpiece, and the motor and motor actuator button are configured to articulate the articulating region of the probe shaft such that pressure and release of pressure on the actuator button articulates the articulating region a selected number of degrees from a linear shape or configuration to a fully articulated shape or configuration.
In a sixth aspect, the present invention comprises an arthroscopy system including a motorized handpiece having a motor and at least one motor actuator button. A hub on a probe is adapted for a detachable connection to the motorized handpiece, and the motor and a motor actuator button are configured to articulate the articulating region of the probe shaft and to initiate or energize different modes of RF current delivery to bi-polar or other electrodes carried on the probe shaft. The RF current delivery mode may comprise an ablation wave form or a coagulation wave form for delivery of RF current to the electrodes.
Various embodiments of the present invention will now be discussed with reference to the appended drawings. It should be appreciated that the drawings depict only typical embodiments of the invention and are therefore not to be considered limiting in scope.
The present invention relates to arthroscopy systems and related methods of use. Several variations of the invention will now be described to provide an overall understanding of the principles of the form, function and methods of use of the devices disclosed herein. In general, the present disclosure provides for an articulating arthroscopic system that includes a single-use articulating RF probe that can be detachable coupled to a re-usable motorized handpiece. This description of the general principles of this invention is not meant to limit the inventive concepts in the appended claims.
Referring now to the drawings and the reference numbers marked thereon,
More in particular, the articulating probe 100 as shown in
Referring to
The electrosurgical functionality of the probe 100 can be described with reference to
Referring to
In one variation, the ceramic member 140 is a form of zirconia. Zirconia-based ceramics have been widely used in dentistry and such materials were derived from structural ceramics used in aerospace and military armor. Such ceramics were modified to meet the additional requirements of biocompatibility and are doped with stabilizers to achieve high strength and fracture toughness. The types of ceramics used in the current invention have been used in dental implants, and technical details of such zirconia-based ceramics can be found in Volpato, et al., “Application of Zirconia in Dentistry: Biological, Mechanical and Optical Considerations”, Chapter 17 in Advances in Ceramics—Electric and Magnetic Ceramics, Bioceramics, Ceramics and Environment (2011).
The ceramic member 140 can be fabricated of an yttria-stabilized zirconia as is known in the field of technical ceramics, and can be provided by CoorsTek Inc., 16000 Table Mountain Pkwy., Golden, Colo. 80403 or Superior Technical Ceramics Corp., 600 Industrial Park Rd., St. Albans City, Vt. 05478. Other technical ceramics that may be used consist of magnesia-stabilized zirconia, ceria-stabilized zirconia, zirconia toughened alumina and silicon nitride.
The components of hub 118 and cooperating handpiece that provide electrical pathways for delivering RF current to and from the probe working end 105 can now be described. As can be seen in
In
Now turning to operation of the system,
In another variation, the joystick 188 and a controller algorithm could operate so that a single push on the joystick 188 would articulate the working end 102 from the linear configuration to the fully articulated configuration of
In another variation, the joystick 188 can be pressed backwards to activate rotation of the motor drive 115 in the opposite rotational direction to thereby articulate the working end 102 in the opposite direction compared to the articulation direction shown in
Still referring to
In another variation, referring to
In another variation, referring to
In the embodiment of working end 102 shown in
Now turning to
The variation of
As can be understood from
However, the probe of
Referring to
Referring to
Finally,
Now describing the dual rotational mechanisms of
Referring now to
In the lower right portion of
As also can be seen in
Now turning to the reciprocation mechanism provided by the mechanisms shown in
In
Thus, it can be understood how the controller 185 by using the motor drive 115 can both articulate the working end of the probe 400 and reciprocate an active electrode 420 (
Still referring to
Although particular embodiments of the present invention have been described above in detail, it will be understood that this description is merely for purposes of illustration and the above description of the invention is not exhaustive. Specific features of the invention are shown in some drawings and not in others, and this is for convenience only and any feature may be combined with another in accordance with the invention. A number of variations and alternatives will be apparent to one having ordinary skills in the art. Such alternatives and variations are intended to be included within the scope of the claims. Particular features that are presented in dependent claims can be combined and fall within the scope of the invention. The invention also encompasses embodiments as if dependent claims were alternatively written in a multiple dependent claim format with reference to other independent claims.
Other variations are within the spirit of the present invention. Thus, while the invention is susceptible to various modifications and alternative constructions, certain illustrated embodiments thereof are shown in the drawings and have been described above in detail. It should be understood, however, that there is no intention to limit the invention to the specific form or forms disclosed, but on the contrary, the intention is to cover all modifications, alternative constructions, and equivalents falling within the spirit and scope of the invention, as defined in the appended claims.
The use of the terms “a” and “an” and “the” and similar referents in the context of describing the invention (especially in the context of the following claims) are to be construed to cover both the singular and the plural, unless otherwise indicated herein or clearly contradicted by context. The terms “comprising,” “having,” “including,” and “containing” are to be construed as open-ended terms (i.e., meaning “including, but not limited to,”) unless otherwise noted. The term “connected” is to be construed as partly or wholly contained within, attached to, or joined together, even if there is something intervening. Recitation of ranges of values herein are merely intended to serve as a shorthand method of referring individually to each separate value falling within the range, unless otherwise indicated herein, and each separate value is incorporated into the specification as if it were individually recited herein. All methods described herein can be performed in any suitable order unless otherwise indicated herein or otherwise clearly contradicted by context. The use of any and all examples, or exemplary language (e.g., “such as”) provided herein, is intended merely to better illuminate embodiments of the invention and does not pose a limitation on the scope of the invention unless otherwise claimed. No language in the specification should be construed as indicating any non-claimed element as essential to the practice of the invention.
Preferred embodiments of this invention are described herein, including the best mode known to the inventors for carrying out the invention. Variations of those preferred embodiments may become apparent to those of ordinary skill in the art upon reading the foregoing description. The inventors expect skilled artisans to employ such variations as appropriate, and the inventors intend for the invention to be practiced otherwise than as specifically described herein. Accordingly, this invention includes all modifications and equivalents of the subject matter recited in the claims appended hereto as permitted by applicable law. Moreover, any combination of the above-described elements in all possible variations thereof is encompassed by the invention unless otherwise indicated herein or otherwise clearly contradicted by context.
All references, including publications, patent applications, and patents, cited herein are hereby incorporated by reference to the same extent as if each reference were individually and specifically indicated to be incorporated by reference and were set forth in its entirety herein.
Claims
1. A device for use with a motorized handpiece having a rotating driver, said device comprising:
- a shaft having a proximal end and an articulating distal region;
- a hub attached to the proximal end of the shaft, said hub adapted for detachable connection to the motorized handpiece; and
- a rotatable drive coupling within the hub configured to detachably engage the rotating driver when the hub is connected to the handpiece, wherein rotation of the drive coupling by the driver causes the articulating distal region of the shaft to articulate.
2. The medical device of claim 1 wherein the shaft comprises outer and inner concentric sleeves, wherein a proximal end of the outer sleeve is fixed in the hub and a proximal portion of the inner sleeve is axially moveable in the interior bore of the outer sleeve in response to rotation of the driver.
3. The medical device of claim 2 wherein the shaft has at least one distal component that maintains the distal ends of the outer and inner sleeves in a fixed relationship.
4. The medical device of claim 3 further comprising a first collar on a proximal end of the inner sleeve, wherein the rotatable drive coupling engages the first collar to longitudinally drive the collar as the rotatable drive coupling is rotated by the rotating driver of the handpiece.
5. The medical device of claim 4 wherein the first collar is threaded and the rotatable drive coupling threadably engages the collar to longitudinally drive the first collar to articulate the distal region of the shaft.
6. The medical device of claim 4 wherein the first collar has an engaging surface and the rotatable drive coupling rotates a pin against the engaging surface to longitudinally drive the first collar to articulate the distal region of the shaft.
7. The medical device of claim 6 further comprising a reciprocatable electrode at a distal end of the articulating distal region of the shaft.
8. The medical device of claim 7 further comprising a third concentric sleeve having a distal end and a proximal end, wherein the distal end is attached to the reciprocatable electrode and a proximal end is attached to the drive coupling, the rotatable drive coupling being configured to rotate the pin in an opposite direction against a cam surface on the first collar to longitudinally drive the third sleeve to reciprocate the reciprocatable electrode.
9. The medical device of claim 3 wherein the at least one distal component includes a ceramic member.
10. The medical device of claim 2 wherein rotation of the drive coupling moves the inner sleeve axially relative to the outer sleeve.
11. The medical device of claim 2 wherein the articulating region includes a series of slots in the outer and inner sleeves.
12. The medical device of claim 11 wherein the slots in the outer sleeve are radially offset from the slots in the inner sleeve.
13. The medical device of claim 9 further comprising a first polarity electrode carried at a distal end of the shaft.
14. The medical device of claim 13 wherein the first polarity electrode is carried by the ceramic member.
15. The medical device of claim 13 wherein a surface of outer sleeve comprises a second polarity electrode.
16. The medical device of claim 2 further comprising an insulation layer disposed between the outer and inner sleeves.
17. The medical device of claim 15 further comprising first and second electrical contacts in the hub connected respectively to the first and second polarity electrodes.
18. The medical device of claim 1 wherein the rotatable drive coupling is configured to rotate clockwise to bend the articulating region in a first direction and to rotate counter-clockwise to bend the articulating region in a second direction.
19. The medical device of claim 1 wherein the motorized handpiece comprises an electric motor.
20. The medical device of claim 19 wherein the handpiece has an actuator on an outer surface thereof for manually activating the motor to bend the articulating region.
21. The medical device of claim 17 wherein the handpiece has an actuator on an outer surface thereof for controlling delivery of RF energy to the first and second polarity electrodes.
22. The medical device of claim 17 wherein the inner sleeve has an interior passageway extending to an open termination in a distal region of the shaft.
23. The medical device of claim 22 wherein the interior passageway is adapted to connect to a negative pressure source.
24. An arthroscopy system, comprising:
- a motorized handpiece having a motor shaft;
- a probe having (a) a proximal hub adapted for detachable connection to the motorized handpiece and (b) a shaft having an articulating distal region; and
- a rotatable drive coupling within the hub adapted for coupling to the motor shaft, wherein rotation of the drive coupling by the motor shaft causes articulation said articulating region.
25. The arthroscopy system of claim 24 wherein the shaft comprises outer and inner concentric sleeves, wherein a proximal end of the outer sleeve is fixed in the hub and a proximal end of the inner sleeve is driven by the rotatable drive coupling in a first direction to articulate the articulating distal region.
26. The arthroscopy system of claim 24 wherein a proximal potion of the inner sleeve is axially moveable in the interior bore of the outer sleeve.
27. The arthroscopy system of claim 24 further including a ceramic member that connects the distal ends of the outer and inner sleeves.
28. The arthroscopy system of claim 24 further comprising a first polarity electrode carried by the ceramic member.
29. The arthroscopy system of claim 28 wherein a surface of outer sleeve comprises a second polarity electrode.
30. The arthroscopy system of claim 29 further comprising an insulation layer disposed between the outer and inner sleeves.
31. The arthroscopy system of claim 30 further comprising electrical contacts in the handpiece that are adapted for coupling with cooperating electrical contacts in the hub to energize the first and second polarity electrodes.
32. The arthroscopy system of claim 25 further comprising a reciprocatable electrode at a distal tip of the articulating distal region of the shaft.
33. The arthroscopy system of claim 32 further comprising a third concentric sleeve having a distal end and a proximal end, wherein the distal end is attached to the reciprocatable electrode and the proximal end is driven by the rotatable drive coupling in an opposite direction to longitudinally drive the third sleeve to reciprocate the reciprocatable electrode.
34. An arthroscopy system, comprising:
- a motorized handpiece having an electronic display; and
- a probe having a hub connected to a shaft having an articulating distal region, the hub adapted for detachable connection to the motorized handpiece, wherein the motor is configured to articulate the articulating region of the probe shaft;
- wherein the display provides a visual indication showing a shape of the articulating region induced by the motorized handpiece.
35. The arthroscopy system of claim 34 wherein the visual indication on the visual display can vary between between a linear shape and a fully articulated shape.
36. An arthroscopy system, comprising:
- a motorized handpiece having a motor actuator button;
- a probe having a hub connected to a shaft having an articulating distal region, the hub adapted for detachable connection to the motorized handpiece wherein the motor is configured to articulate the articulating region of the probe shaft; and
- wherein the actuator button is configured such that continued pressure on the actuator button continuously articulates the articulating region between a linear shape and a fully articulated shape or vice versa, and wherein release of pressure on the actuator button stops the articulating region in a selected shape.
37. An arthroscopy system, comprising:
- a motorized handpiece having a motor actuator button;
- a probe having a hub connected to a shaft having an articulating distal region, the hub adapted for detachable connection to the motorized handpiece wherein the motor is configured to articulate the articulating region of the probe shaft; and
- wherein the actuator button is configured such that pressure and release of pressure on the actuator button articulates the articulating region from a linear shape to a fully articulated shape or vice versa.
38. An arthroscopy system, comprising:
- a motorized handpiece having a motor actuator button;
- a probe having a hub connected to a shaft having an articulating distal region, the hub adapted for detachable connection to the motorized handpiece wherein the motor is configured to articulate the articulating region of the probe shaft; and
- wherein the actuator button is configured such that pressure and release of pressure on the actuator button articulates the articulating region a selected number of degrees from a linear shape to a fully articulated shape or vice versa.
39. An arthroscopy system, comprising:
- a motorized handpiece having at least one actuator button;
- an RF probe having a hub connected to a shaft having an articulating distal region, the hub adapted for detachable connection to the motorized handpiece wherein the motor is configured to articulate the articulating region of the probe shaft; and
- wherein an actuator button is configured to select different modes of RF current delivery to bi-polar electrodes carried by the probe shaft.
40. The arthroscopy system of claim 39 wherein a mode of RF current delivery comprises delivering an ablation waveform to the electrodes.
41. The arthroscopy system of claim 39 wherein a mode of RF current delivery comprises delivering a coagulation waveform to the electrodes.
Type: Application
Filed: Jun 26, 2017
Publication Date: Jan 4, 2018
Applicant: RELIGN Corporation (Cupertino, CA)
Inventors: Aaron Germain (San Jose, CA), Jan Echeverry (San Jose, CA), Jeff Norton (Emerald Hills, CA)
Application Number: 15/633,372