Abstract: A minimally invasive method for accessing a facet joint of the spine is provided. Embodiments of the method include creating a small incision directly over the facet joint and to allow direct access and visualization of the joint. A second incision, which may be a puncture wound, is provided at a distance from the first incision. A path between the second incision and the facet joint is then formed which may be curved or substantially straight. The path is preferably configured to intersect both facet surfaces. The path may be formed using an instrument which can be used to drill a hole across the facets, insert a fastener across the facets, or the like.

Abstract: Methods and devices are described for modifying tissue in a spine of a patient to treat or alleviate spinal stenosis. In one embodiment, a method may include: advancing at least a distal portion of an elongate tissue modification device into an epidural space and between target tissue and non-target tissue in the spine; positioning the tissue modification device so that at least one abrasive surface of the device faces target tissue and at least one non-abrasive surface faces non-target tissue; applying tensioning force at or near separate distal and proximal portions of the tissue modification device; and translating the tissue modification device back and forth while maintaining at least some tensioning force to abrade at least a portion of the target tissue with the at least one abrasive surface. Unwanted damage to the non-target tissue may be prevented via the at least one non-abrasive surface.

Abstract: Techniques and reconstruction systems for fixation of bone to bone, or soft tissue to bone, that allow a double-bundle type construct with only three tunnels, a single graft and individual tensioning in each of the three tunnels. Alternative double-bundle ACL/PCL fixation techniques are provided that employ a double-bundle type construct with only a single graft and three tunnels/sockets. The double-bundle ACL and PCL techniques and constructs allow individual tensioning of each of the bundles (e.g., tensioning of each of the anteromedial (AM) and posterolateral (PL) bundles of the ACL) and eliminate the need for additional fixation devices (for example, interference screws) to secure the bundles within the bone tunnels/sockets.

Abstract: An instrument for selectively decorticating a bony surface is described. The instrument may have a decorticating implement having a truncated scoop on its medial face and an inclined blade disposed on its opposing lateral face. The blade edge may be coincident with the linear distal edge of the truncated scoop. Also described is a method for using such an instrument to selectively decorticate a bony surface in order to prepare it for service as a bone graft bed.

Abstract: An orthopedic system prepares a surface of an anatomical structure to receive an orthopedic prosthesis. A method for using the same is also disclosed. The orthopedic system includes a surgical instrument and a guide. The guide includes an anterior portion and a distal portion that is at least partially elevated relative to the anterior portion. The distal portion includes at least one track that is sized to receive the surgical instrument while preparing the surface of the anatomical structure.

Abstract: A drill bit locking device and a drill bit are provided. The locking device includes a boss with a through hole, a bearing and a support member are arranged an inner wall of a small cylinder above the boss; a locking sleeve is sleeved over the boss, a first bulge is on an inner wall of an upper part of the locking sleeve, and a second bulge is on an inner wall of a lower part; a spring is between the second bulge and an upper bottom surface of the boss; a press plate is threadedly connected with an outer wall of a top part of the small cylinder and presses against the first bulge; holes of different sizes are on the inner wall of the small cylinder and the support member to form a stepped hole, and a steel ball is arranged in the stepped hole.

Abstract: Flexible shavers and curved access ports that reduce access and trajectory problems associated with conventional lateral approaches to the lower spine. These devices and methods allow for preparing a disc space in the lower spine at an angle that is parallel to the disc space. Consequently, these devices and methods allow for preparing with less endplate damage.

Abstract: An expandable implant system is configured to increase the height of a target bone, for instance that has been subjected to a compression fracture. The expandable implant system includes an implant assembly that can be inserted into the target bone, and subsequently expanded so as to increase the height of the target bone. The expandable implant system further includes an insertion assembly that is configured to create an insertion channel into the target bone, such that the implant assembly can be inserted in a collapsed configuration into the target bone along the insertion channel, and subsequently expanded.

Abstract: The invention relates to the preparation of an intervertebral space with a trial implant (9), the insertion of an implant (5, 6, 7), the inserters (13, 16), and the method for feeding and inserting the implant (5, 6, 7) by means of an oblique anterior approach. In the novel improved method, the associated instruments (13, 16) for inserting an implant (5, 6, 7) into an intervertebral space, in particular for the lumbar spine at an oblique anterior angle of 45° was developed, the left side of the body being preferred for insertion of the implant (5, 6, 7). Either the implant (5, 6, 7) can be inserted all in one, or first the upper part (5) and lower parts (7) and then the inlay (6) may be inserted. By insertion by means of the left oblique anterior approach at 45°, optimum utilization of the area of the intervertebral space is ensured (footprint), and better retention of the implant is guaranteed by the exact chiselling at an angle of 90° normal to the respective intervertebral surface.

Abstract: A kit for use in shoulder arthroplasty includes a tamp configured to form a generally oval cavity in grafting material in a glenoid vault, the tamp including a body and a forming portion shaped complementary to the oval cavity, and a glenoid component including a body having a stem portion with an oval cross section for inserting at least partially into the generally oval cavity, the stem portion configured to substantially fill the glenoid vault.

Abstract: The bur includes a shaft to which a bur head is attached. The bur head includes a plurality of flutes. Each flute at least has a rake surface, a cam surface and a cutting edge. The rake surface extends radially outwardly from the longitudinal axis of the head. The rake surfaces define the flute cutting edge (38). The associated cam surface curves away from the rake surface. One or more ribs extend radially outwardly from the cam surface.

Abstract: An orthopedic device for cutting or resurfacing an outer bone surface of a bone of a patient includes first and second guides. Each guide has a patient-specific surface preoperatively configured as a negative surface of a portion of the outer bone surface of the bone and a plurality of elongated slots. The elongated slots of the second guide are offset relative to the elongated slots of the first guide and configured for guiding a tool to resurface the outer bone surface.

Abstract: An epidural space is cleared of fat and scar tissue in preparation for implantation of a medical lead by utilizing a clearing tool. The clearing tool has multiple links that allow the creation of a deflection angle. A wire passes through the links and once the links are positioned with the desired deflection angle, tension is placed on the wire to lock the links into the current position. The clearing tool is inserted through a window into the epidural space, and once the tension is applied to the wire, the clearing tool becomes rigid to allow advancement of the clearing tool within the epidural space. The clearing tool is then removed from the epidural space, and the medical lead is inserted through the window and cleared epidural space until reaching the target site.

Abstract: A power tool constructed in accordance to one example of the present disclosure can include a repositionable tool accessory. The repositionable tool accessory can be selectively coupled to a first mounting structure on the tool. The repositionable tool accessory can include a tool accessory housing, a rod, a roller, and a locking knob. The tool accessory housing can define a first rod opening and include engaging structure that is configured to cooperatively mate with the first mounting structure. The rod can slidably translate along the first rod opening. The roller can be rotatably coupled to a distal portion of the rod. The locking knob can be movable between an unlocked position wherein the rod is freely translatable along the first rod opening to locate the roller at different locations relative to the output member, and a lock position wherein the rod is fixed relative to the tool accessory housing.

Abstract: An orthopedic bone cutter for cutting bone and tissue is described. The cutting device has a frame on which cutting blades are affixed. The frame is designed with sidewalls that are positioned at an angular relationship with respect to a rotational axis that extends vertically through the cutting device. The cutting blades have a hemispherical side profile with a cutting surface extending from a curved outer distal blade end. The blades are affixed to the frame such that an apex of each of the cutting blades is coincident with the rotational axis at an apex point of the bone cutter.

Abstract: A dual-bladed surgical saw and methods of use are described. A preferred embodiment of the dual-bladed surgical saw include a saw body having a blade assembly attached thereto, the blade assembly being positioned about a rotational axis. A first blade is radially spaced about the rotational axis, extending outwardly from the blade assembly substantially parallel to the rotational axis, and terminating at a first cutting surface. A second blade is radially spaced about the rotational axis, extending outwardly from the blade assembly parallel to the rotational axis, and terminating at a second cutting surface. An oscillator mechanism is coupled to the first and second blades for simultaneously reciprocating the first and second blades. The first blade is independently rotatable relative to the second blade about the rotational axis for defining a predetermined cutting angle between the first blade and second blade.

Abstract: A prosthesis (20) for use in performing joint arthroplasty is provided. The prosthesis (20) is to be fitted to a long bone (3). The prosthesis includes a first body (22) having a first body articulating surface (24) defining a generally circular outer periphery (26) of the first body articulating surface (24). The first body (22) has a support surface (28) opposed to the articulating surface (24). The support surface (28) is adapted to receive the head of the long bone (3). The prosthesis (20) also includes a second body (30) operably associated with the first body (22). The second body (30) has a second body articulating surface (32) extending from a portion of the circular outer periphery (26) of the first body articulating surface (24). A tool kit for preparing a humerus to receive a prosthesis is also disclosed.

Abstract: A hollow disposable sleeve suction retractor. The sleeve suction retractor is an ergonomically shaped combination suction/retractor instrument for holding and retracting tissues, suctioning tissue pieces, blood and fluids and a surgical smoke plume from an electrosurgery device all at the same time. The suction sleeve retractor is comfortable to hold securely and allows a surgeon a clear line of sight on an area of tissue dissection. It can be used without the need for having another hand (e.g., surgeon's or an assistant, etc.) sponge or separate suction devices in a wound. It is economical to purchase and does not have to be sterilized or autoclaved since it disposable.

Abstract: A bone rifling system for use in prosthesis, which allows improved prosthetic bone fixation. The system comprises orthopedic undercut reamer, which can cut controlled internal groove circles or spiral grooves on the internal surface of host bone. The system converts the commonly reamed smooth bone to grooved or rifled bony tube. Used together with bone cements, the bone rifling system ensures prosthetic bone fixation by significantly increasing the pull out strength, and decreasing the rate of clinical loosening and failure of replacement joints. Also disclosed is a method for preparing a bone for a prosthesis using such a bone rifling system to cut grooves in a host bone for increased prosthetic bone fixation.

Abstract: A technique for locating an axis of a bone, which extends through the center of rotation of the bone around a joint between that bone and another bone, involves a. moving the bone in a plane about the said joint, between a first point and a second point, b. locating a third point which is equidistant from the first and second points, and c. locating the axis which passes through the third point, perpendicular to a line which connects the first and second points. The invention provides an instrument for performing this technique.

Abstract: A perforation instrument and method of using same, including a shaft capable of being inserted into a joint of a patient, having a longitudinal axis, and carrying at least one piercing member, each piercing member having a tip suitable to pierce sub-chondral bone. The instrument is capable of being altered between an exposed condition wherein the tip of the at least one piercing member is exposed and a safety condition wherein the tip of the at least one piercing member is not capable of piercing tissue.

Abstract: A fluid injection device includes a fluid supply unit that accommodates and supplies fluid, a fluid injection unit that injects fluid supplied from the fluid supply unit, and a driving waveform generating device which is equipped with at least one adjusting device, a one-input multiple-control parameter changing unit that simultaneously changes plural control parameters for determining a fluid injection condition of the fluid injection unit on the basis of a signal from the at least one adjusting device, and a driving waveform generator that generates and outputs a driving waveform of the fluid injection unit on the basis of the control parameters set by the one-input multiple-control parameter changing unit.

Abstract: Various embodiments of the present invention provide a distal femoral trial that allows a surgeon to cut the central box geometry of a distal femur using an implant-shaped trial. The trial includes a cutting guide that is removable from the trial and adjustable with respect to the trial. The guide is intended to control the depth and direction of the cutting instruments used to prepare the femur for a posterior stabilized implant.

Abstract: A puncture instrument has a simple configuration and can accurately control the insertion position and direction of the puncture instrument when in use to form a pilot hole in the vertebral pedicle. The puncture instrument is configured by including a puncture needle 2 for forming the pilot hole, and a reference bar 3 that is provided at the puncture needle to have a predetermined angle with respect to the puncture needle 2 and serves as a reference for guiding the puncture needle 2 to a desired position at a desired angle. With the present invention, the puncture needle 2 is guided by the reference bar 3 to a desired position at a desired angle, and hence the puncture needle can be controlled by a simple configuration as compared with the case where a guiding device is separately provided.

Abstract: Apparatus and methods for preparing the interior of a bone for therapy. The therapy may include therapy for a bone fracture. The apparatus and methods may involve orienting a surgical instrument for proper deployment in the interior of the bone. An instrument guide may be positioned and retained against translation along, and rotation about one or more of three substantially orthogonal axes. Apparatus placed exterior to the bone may register the guide to a region inside the bone that is designated for preparation or treatment. One or more broaching members may be used to prepare the region for treatment. A broaching member may be expandable inside the bone. A broaching member may be flexible such that it broaches bone having a relatively lower density and it leaves bone having a relatively higher density substantially intact.

Abstract: Methods are described for treating a target tissue with a radioisotope. Some methods include determining a distance between a target tissue and a surface of a matrix material to be positioned adjacent the target tissue and, based on the determined distance, determining an activity to be mixed with the matrix material to obtain a desired activity concentration. Some methods further include mixing the radioisotope with the matrix material. In some embodiments, the matrix material is a bone cement, and the target tissue is a tumor in a bone. The radioisotope may be a beta-emitting radioisotope mixed in the cement at a concentration to form a radioactive cement.

Abstract: A medical catheter extrusion forms a sheath around a wire. The extrusion is coupled to a steering and motivating handle. The handle is part of a housing that houses a motivation component fixed to the housing, a crankshaft, or similar eccentric component, couples to the motivation component, which is coupled to a proximal end of the wire. At the wire's distal end, a cutting tip with canted teeth couples to the wire. The cutting tip is capable of cutting bone when moving axially toward the catheter extrusion but glides across the bone without cutting it when moving axially away from the catheter extrusion. The motivation component can be a motor or buttons or a trigger, that couple to the wire and converts manual movement into reciprocating motion of the flexible shaft. The shaft's reciprocating motion moves the flexible and steerable shaft back and forth to move the cutting tip.

Abstract: A medical puncturing serves for penetrating into a bone or a cartilage. It has a shaft and a tool carrier connected with its proximal end to a distal end of the shaft. The tool carrier has a puncturing tool being a punch or a multi-fracture chisel. The tool carrier is connected at its proximal end via a freely articulated joint to the distal end of said shaft. A stop limits a laterally pivoting movement of said tool carrier to a maximum angle of 45°.

Abstract: A surgical milling cutter includes a milling cutter holder, a locking device, a locking seat, and a main machine. The milling cutter holder includes a fixing seat with a through hole. A finger guider with an L-type holder on a top end thereof is arranged at an upper part of the fixing seat. A distal end of a short side of the L-type holder is disposed with a downward projection, and a lowest point of the projection is lower than that of a cylindrical head when the milling cutter works normally. A bolt with a central through hole is fixed in a cavity of the finger guider. A pressing disk is arranged at the upper part of the fixing seat, and a nut is connected to the bolt through a hole in the pressing disk.

Abstract: A surgical tool for removing a portion of an implant is provided that includes a housing, a motor contained within the housing and coupled to the housing, and an output shaft having a distal end and a proximal end opposite the distal end, wherein the proximal end is coupled to the motor and the distal end has an opening configured to rotatably engage an implant. The surgical tool further includes a counter-torque sleeve extending around the output shaft having a proximal end and a distal end opposite the proximal end, wherein the proximal end is coupled to the housing and the distal end is configured to couple to the implant relative to the counter-torque sleeve. Upon a rotational force to the implant, the forces transmitted by the output shaft and the counter-torque sleeve are balanced by the coupling of the output shaft and counter-torque sleeve through the housing.

Abstract: A method and system are provided for preparing an interspinous space to receive an implantable device. The system may comprise a cutting tool guide having a guiding surface for directing a cutting tool therethrough and a holder for positioning the cutting tool guide relative to the interspinous space. The holder may be configured to adjustably attach to at least one of a pair of spinous processes defining the interspinous space.

Abstract: Exemplary embodiments are directed to instruments, methods and systems for harvesting and implanting graft materials, including instruments for capturing a surface topography of an anatomical location, instruments for defining an implant region, and graft harvesting devices. Exemplary embodiments are also directed to methods for capturing a surface topography of an anatomical location, methods for defining an implant region, and methods for harvesting a donor plug. The exemplary instruments, methods and systems generally include capturing a surface topography of a defect region, creating a defect region cavity, and harvesting a donor plug configured and dimensioned to be implanted in the defect region cavity.

Abstract: A surgical instrument system functional in multiple orthopedic applications, including but not limited to shoulder, knee, hip, wrist, ankle, spinal, or other joint procedures. The system comprises a cutting head which includes jaw members which may be urged between open and closed positions to providing a biting or chewing action for removal of targeted tissues. The instrument system is configured to be driven by an attached hub that translates a rotational movement into a reciprocating motion to open and close the jaw members. Suction for removal of bone fragments or other tissues is provided through a suction opening.

Abstract: A surgical apparatus includes a surgical device, configured to be manipulated by a user to perform a procedure on a patient, and a computer system. The computer system is programmed to create a representation of an anatomy of a patient; to associate the anatomy and a surgical device with the representation of the anatomy; to manipulate the surgical device to perform a procedure on a patient by moving a portion of the surgical device in a region of the anatomy; to control the surgical device to provide at least one of haptic guidance and a limit on manipulation of the surgical device, based on a relationship between the representation of the anatomy and at least one of a position, an orientation, a velocity, and an acceleration of a portion of the surgical device; and to adjust the representation of the anatomy in response to movement of the anatomy during the procedure.

Abstract: A medical device suitable for scrubbing a joint, such as a distal interphalangeal (DIP) joint, is disclosed. The device may include a first end, a second end, and a space there between, and a joint scrubber having a first end coupled to the second end of the arm. The joint scrubber is configured to break apart or loosen material in a joint in order to facilitate the insertion of another device, such as a bone screw.

Abstract: An ultrasonic surgical includes a probe with an operative edge or surface at a distal end, an electromechanical transducer connected to the probe, and an activation circuit connected to the transducer for supplying thereto an electrical waveform having an ultrasonic frequency and an amplitude. The activation circuit includes a signal generator and further includes a power reduction circuit operatively connected to the signal generator for inducing the signal generator to automatically reduce the amplitude of the waveform upon a sensing by the power reduction circuit of reduced load on the probe.

Abstract: Devices and methods for creating lumens in the articular process of the vertebra are provided. An embodiment of the invention can be a tool that can cut a curved lumen through the articular process. The tool can have a lumen-forming arm with a rotating drill contained within that can be powered by a drill motor. The lumen-forming arm can be axially translated to cut a path through the articular process. Methods of using the resulting lumens to anchor or stabilize facet joint prosthesis, and also altering the spacing and motion at the facet joints of the vertebral column, are provided.

Abstract: A system for preparing a bone implant includes a cutting guide having a body including a plurality of sides that together define a cavity that is accessible via an opening defined by a first side of the plurality of sides. A second side of the plurality of sides defines a plurality of slots and is disposed adjacent to the first side. Each of the plurality of slots is in communication with the cavity that is sized and configured to receive a bone implant therein, and each of the plurality of slots is located at a different location of the second wall to facilitate cutting a bone implant into one of a plurality of sizes.

Abstract: A robotic system for performing minimally invasive spinal stabilization, using two screws inserted in oblique trajectories from an inferior vertebra pedicle into the adjacent superior vertebra body. The procedure is less traumatic than such procedures performed using open back surgery, by virtue of the robot used to guide the surgeon along a safe trajectory, avoiding damage to nerves surrounding the vertebrae. The robot arm is advantageous since no access is provided in a minimally invasive procedure for direct viewing of the operation site, and the accuracy required for oblique entry can readily be achieved only using robotic control. This robotic system also obviates the need for a large number of fluoroscope images to check drill insertion position relative to the surrounding nerves. Disc cleaning tools with flexible wire heads are also described. The drilling trajectory is determined by comparing fluoroscope images to preoperative images showing the planned path.

Abstract: A total hip femoral prosthesis provides a shortened neck and more proximal coating level. Additionally, a means for strengthening the neck may be incorporated to increase stress transfer to the native bone. A method for reducing potential impingement that results from a high neck resection level includes instrumentation for cutting chamfered surfaces into the bone surrounding the proximal end of the implant. Instrumentation and methods of creating chamfered cuts are disclosed.

Abstract: An ultrasonic surgical instrument includes at least two tools each having a respective operating head with an operative surface or edge. At least one source of ultrasonic mechanical vibratory energy is provided which produces at least two vibration modes out of phase with one another. The tools are each connected to the source of ultrasonic mechanical vibratory energy for enabling transmission of a respective one of the vibration modes into the respective tool so that the tools are driven out of phase with one another.

Abstract: The present invention is a self-locking internal adapter for D-shaped orthopedic tools. A locking ball mechanism prevents movement of the adapter components relative to each other, while a plurality of securing ball mechanisms releasably secure a D-shaped orthopedic tool in the adapter. A chamfered surface of the adapter engages a chamfer of the tool to centrally stabilize the tool in the adapter. The internal adapter may be used with driver handles, ratcheting handles and torque-limiting handles.

Abstract: An anti-clogging device for a vacuum-assisted tissue removal system is provided. The device includes a tissue-separation chamber in a close proximity to (i) a cutting head operated by a physician and (ii) the physician for a filling and emptying by the physician during a tissue removal procedure, the cutting head and the tissue separation chamber in an operable communications with the suction assembly. The tissue separation chamber has an entry port in an operable communication with the cutting head for the entry of an excised tissue into the chamber, the excised tissue having a solid component and a liquid component; a baffle to separate the liquid component from the solid component; and, an exit port for the exit of liquid component out of the chamber. The tissue can include any tissue accessible through a small surgical opening, such as a nucleus pulposus tissue removed during a discectomy procedure.

Abstract: This disclosure describes devices and methods for performing spinal surgical procedures. In some embodiments, a method may include positioning at least a portion of at least one surgical instrument in at least one naturally occurring orifice of a human by a user. In some embodiments, a method may include accessing an interior space of the human using at least one of the surgical instruments. The method may include performing at least a portion of a spinal surgical procedure using at least one of the surgical instruments positioned in at least one of the naturally occurring orifices of the human. The method may include removing at least one of the surgical instruments from at least one of the naturally occurring orifices upon completion of at least a portion of the spinal surgical procedure.

Abstract: A method for preparing a femur for receiving a prosthesis can include positioning an intramedullary (IM) member in the femur. A femoral trial component can be positioned onto a distal end of the femur. The femoral trial component can have an attachment portion and at least two cut surfaces thereon. A modular boss assembly can be attached to the attachment portion of the femoral trial component. The modular boss assembly can have a boss stem that is configured to operably connect to the IM member. A desired contact between the femoral trial component and the distal femur can be confirmed based on the attaching. The femoral trial component can be fixed to the distal femur based on the confirming. The modular boss assembly can be removed from the femoral trial component. A reamer bushing can be coupled relative to the femoral trial component.

Abstract: A distance interbody device for introducing a biomaterial to a vertebral body includes a shaped body and a dispense mechanism operable to dispense biomaterial. The shaped body includes a top side, a bottom side, and a lateral wall forming a peripheral wall that extends between the top and bottom sides. The shaped body is provided with at least one through channel and at least one anchoring element. The through channel includes an internal reservoir for the biomaterial. The through channel passes through the anchoring element to at least one outlet opening located in the at least one anchoring element.

Abstract: A bone resector tool comprises an ultrasonic transducer, typically generating longitudinal mode vibrations at around 40 kHz, and having an elongate blade portion mounted thereto. The transducer and blade portion are mounted to a rotatably-drivable converter element. Rotation of the converter element produces reciprocal longitudinal motion of the transducer and blade portion. A counterweight is also mounted to the converter element, moving exactly out of phase with the transducer and blade portion, such that a centre of mass of the whole system is stationary, reducing vibration of the tool in a user's hand. The peak velocity due to the ultrasonic vibrations of a distal tip of the blade portion is up to seven times greater than its peak velocity due to the reciprocal longitudinal motion. This permits rapid, low-effort cutting of bone with easy removal of cut debris and minimal consequent necrosis.

Abstract: A surgical device capable of interconnecting to an external motorized hand pieces, bending a distal end segment, rotating a window element positioned distal to the distal end segment and rotating independently of it, and actuating a cutting element positioned within the outer window element and rotating independently of it.

Abstract: A measurement system and method for determining a depth of penetration of a working portion of a surgical instrument (e.g., a rotating drill bit in a bore). A first sensor outputs a first signal representative of a displacement of the leading edge of the drill bit in the bore. A second sensor outputs a second signal representative of a force applied to the leading edge of the drill bit. A processor outputs a third signal representative of the depth of penetration of the leading edge of the drill bit when the leading edge of the drill bit passes from a first medium having a first density to a second medium having a second density. The third signal is based on the first and second signals.

Abstract: A trackable medical instrument for use in a computer assisted image guided medical and surgical navigation systems that generate images during medical and surgical procedures, includes a guide member having an emitter array for being tracked by the system and a drive shaft contained within the guide member having a proximal and a distal end, the drive shaft being rotatable within the guide member while being fixable axially inside the guide member, the proximal end of the drive shaft having a first connector for interchangeably receiving at least one drive source, and the distal end having a second connector for interchangeably receiving at least one instrument tip.