Abstract: A tissue repair device. The tissue repair device includes a tubular shaft having a longitudinal bore for delivering biological material to a soft tissue defect, and an awl having a distal end configured for microfracturing bone underlying the defect. The tubular shaft and the awl are movable relative to one another such that the awl is at least partially positioned within the longitudinal bore of the tubular shaft.

Abstract: A device for removing material from within the body, includes an elongated element formed from hollow segments sequentially interconnected at effective hinges. The device assumes an insertion configuration for insertion of the segments sequentially through an opening of a first dimension into the body. A portion of the elongated element inserted into the body progressively assumes a material removing configuration in which a relative position of each segment relative to an adjacent segment is delineated by the effective hinge together with additional abutment surfaces defining a fully deflected state of the effective hinge. The material removing configuration has at least two dimensions exceeding the first dimension. At least two of the segments are formed with at least one cutting configuration deployed so as to collect material into a hollow volume of the segment during progressive formation of the material removing configuration as the elongated element is advanced.

Abstract: A cavity creator including a tube with a lumen. A tip able to penetrate bone extends forward from the distal end of the tube. A blade is moveably attached to the outer tube proximal to the tip so as to move between retracted and extended states. The tube has a discharge port adjacent the blade. The tip is used to position the upper tube in bone. The blade is extended to form a cavity in the bone. Once the cavity is created filler material can be introduced into the cavity by flowing the material through the tube lumen.

Abstract: An instrument kit is provided for reaming bone around a head of a bone, the bone including an implanted epiphysis component. The instrument kit includes a reaming guide and a reamer. The reaming guide is couplable to the epiphysis component and has a first reamer support feature and a second reamer support feature. The reamer is couplable to one of the first reamer support feature and the second support feature to ream bone around the epiphysis component.

Abstract: The invention provides instruments and methods for prophylactic treatment of an osteoporotic vertebral body or for treating a vertebral compression fracture (VCF). In one exemplary method, a probe system uses a high speed rotational elastomeric cutter having an optional expandable abrasive surface for abrading or cutting at least one path or region within vertebral cancellous bone. Irrigation and aspiration sources are included in the probe system for removing abraded bone debris. In one embodiment, the high speed rotational abrader uses a tissue-selective abrading surface that abrades or cuts bone but does not cut soft tissue. In another embodiment, an expandable abrading surface allows the treatment of bone with low pressures to create paths or spaces without explosive expansion forces known in prior art balloon procedures that are designed to crush and compact cancellous bone in a vertebra.

Abstract: A method of reaming an acetabulum includes the steps of: providing an acetabular reamer including a partially hemispherical shell having a shell radius, and a base including a first circumferential base segment and a second circumferential base segment, the shell including a first part on one side of the first circumferential base segment and the second circumferential base segment, and a second part on another side of the first circumferential base segment and the second circumferential base segment, the acetabular reamer further including a first non-planar surface connected to the first part, the first non-planar surface having a first curvature not equal to the shell radius, and a second non-planar surface connected to the second part, the second non-planar surface having a second curvature not equal to the shell radius; connecting the acetabular reamer to a driver; and reaming the acetabulum.

Abstract: A bone cutting assembly includes a guide pin that may be securely inserted into a bone to define a cutting axis. The bone cutting assembly also includes a housing having a cam surface and features for temporarily fastening the housing to the bone. The bone cutting assembly also includes a burr mounting arm that rotatably and slidably fits onto the guide pin so that the arm can swing around the cutting axis and also translate up and down the guide pin. A user may move the burr mounting arm about the cutting axis so that the arm follows along the cam surface of the housing.

Abstract: A double-bladed cutting device providing a practical method for obtaining costal cartilage specimens in both an operating room and research setting. The device reduces the skill and time required to fashion cartilage slices, while increasing the uniformity of the cut specimens. Furthermore, via an adjustable guide, slices can be obtained precisely from the central core of the rib. Although specimen lengths up to 4 cm are preferred, longer lengths can be attained without modification of the device. The cartilage specimen may be held in place within the device via means of compression or tension.

Abstract: A remote-controlled actuator includes a spindle guide section of an elongated shape, a distal end member fitted to a distal end of the spindle guide section for alteration in attitude and rotatably supporting a tool, and a drive unit housing having a base end of the spindle guide section connected therewith. A rotary shaft for transmitting rotation of a tool rotation drive source within the drive unit housing to the tool and an attitude altering member for altering the attitude of the distal end member by the drive of an attitude altering drive source within the drive unit housing are accommodated within the spindle guide section. A cutting force estimator is provided for estimating the magnitude of at least one component force of a principle force, a radial force and a feed force in a cutting force which the tool applies to a work to be processed.

Abstract: A device for sectioning a vertebral lamina, which can comprise a base for positioning the device and protecting the medullar canal when sectioning the lamina, sectioning means slide-mounted in the base along a first axis, a first piston slide-mounted in a sleeve of the sectioning means along a second axis secant to the first sliding axis of the sectioning means, a second piston made integral with the first piston and slide-mounted in the base along a third axis, the sectioning means being provided with a cutting element oriented in opposite direction to the second piston with respect to the sleeve, and the sliding of the second piston along the third axis causing the sliding of the sectioning means along the first axis via the first piston.

Abstract: Surgical instruments and surgical methods associated therewith are described. The surgical instruments described herein can be used for scraping or for other purposes such as measuring distances between two points in hard to reach locales.

Abstract: Surgical instruments and procedures are disclosed that enable the injection of an optimal amount of curable resin and/or the placement of an internal fixation device in an intramedullary canal of a fractured bone. The disclosed instruments and procedures enable a surgeon to clear a portion of the canal of cancellous bone and marrow across the fracture site without damaging the cortical wall.

Abstract: A surgical instrument includes distal and proximal tube sections and a coupling that couples the distal tube section to the proximal tube section. The coupling includes first and second connector portions coupled to one of the distal tube section and the proximal tube section. The first and second connector portions are selectively engageable and disengageable with respect to each other and each include selectively engageable fixing members. The distal and proximal tube sections are rotationally fixed to each other when the fixing members of the second connector portion are engaged with the fixing members of the first connector portion. The distal and proximal tube sections can rotate relative to each other when the fixing members of the second connector portion are disengaged from the fixing members of the first connector portion.

Abstract: A medical device and method of using the device to reinforce and stabilize a compressed tissue is disclosed. The medical device is inserted into the tissue, typically a vertebral bone, cuts the tissue inside, and then a binding cement is injected into the pulped tissue without removing the tissue. The medical device is designed to disrupt and pulp the tissue without exerting a compressive force against the walls by using thin blades that buckle away from the core, and by rotating the blades while expanding/contracting the blades at the same time.

Abstract: A surgical instrument having a shaft with a fixed handle part having a sliding part arranged thereon, and axially movable by means of a pivotable handle. The sliding part is guided on the shaft within an axial working stroke by proximal and distal guidance mechanism. A locking mechanism limit the axial displacement of the sliding part on the proximal end of the working stroke. In use, after unlocking the locking mechanism. the sliding part is movable beyond the proximal end of the working stroke into a cleaning position, in which the distal guidance mechanism are disengaged, so that the sliding part can be lifted away from the shaft.

Abstract: The present disclosure relates to a method of use during arthroscopic surgery. The method includes inserting a cannulated needle into a joint area of the body, inserting a guidewire through the needle, removing the needle, and inserting an arthroscopy knife into the joint area via the use of the guidewire. An arthroscopy knife and another method of its use is also disclosed.

Abstract: A device is disclosed for reducing a vertebral compression fracture, comprising a superior end plate and an inferior end plate disposed along a vertical axis. The superior end plate and the inferior end plate are slidably separable in a vertical direction along the vertical axis. An interior chamber is provided in fluid communication with a port extending from an exterior to the interior chamber. The device is deployable within a vertebral body and expandable within the vertebral body by injecting a flowable material into the interior chamber thereby displacing the superior and inferior end plates along the vertical axis.

Abstract: Methods and apparatus are provided for selective surgical removal of tissue, e.g., for enlargement of diseased spinal structures. The current invention includes specific tools that enable safe tissue modification in epidural space, including a barrier that separates the area where tissue modification will take place from adjacent vulnerable neural and vascular structures. In one variation, a tissue abrasion device is provided including a thin belt or ribbon with an abrasive cutting surface. The device optionally may be placed within a protective sheath that exposes the abrasive surface of the ribbon only in the area where tissue removal is desired.

Abstract: A medical system comprises a first medical probe having indicia, and a second medical probe in a coaxial arrangement with the first medical probe. The second medical probe has a detector (e.g., an optical detector) configured for detecting a passage of the indicia as the first and second medical probes are moved relative to each other. In one embodiment, the first medical probe is an inner medical probe, and the second medical probe is an outer medical probe. The medical system further comprises an electromechanical driver coupled to the first and second medical probes, and a controller configured for directing the electromechanical driver to move the first and second medical probes relative to each other, and for receiving signals from the detector indicating the relative movement between the first and second medical probes.

Abstract: An assembly for use in cutting a bone during a surgical procedure comprises a cutting tool and a guide block. The cutting tool includes a blade and a drive unit for imparting a cutting motion to the blade. The guide block can be positioned against the bone and has a reference surface for guiding the blade during the cutting step, the guide block having a screen surface which provides a point of reference to indicate proper alignment of the blade. The cutting tool includes means for directing a collimated beam of light in a direction parallel to the blade, on to the screen surface on the guide block when the blade is in contact with the guide surface, the distance between the blade axis and the light beam being equal to the distance between the reference surface and the point of reference on the screen surface.

Abstract: A kit for use in performing joint arthroplasty on a head of a long bone is disclosed. The kit includes: a first implant including a first implant articulating surface and an opposed first implant mounting surface having a first implant location feature; and an instrument for preparing a cavity in the head of the long bone. The instrument includes a body and a punch extending from the body. The punch includes a portion thereof having a shape similar to the first implant location surface of the implant. A method for providing joint arthroplasty is also disclosed.

Abstract: Disclosed herein are methods and devices for tissue and joint repair. Devices as disclosed herein can be used during surgical procedures, for example, to repair biceps tendons, elbows, shoulders, and knees. Methods disclosed herein relate to methods for repairing the same using the disclosed devices.

Abstract: A surgical procedure is disclosed utilizing a cordless surgical handpiece powered from a sterile battery pack that contains a battery in condition for immediate use without further charging or sterilization. The battery chemistry is based upon lithium/manganese dioxide, and the battery after a single use may be disposed of into non-hazardous waste. The compact surgical handpiece has a brushless DC motor and a manually operated external trigger for activating and controlling the motor operations. Interengaging sets of contacts on the handpiece and battery are adapted to become lockingly and conductively interengaged upon rotation of the battery pack relative to the handpiece, in a manner that rapidly achieves correct alignment of the parts and also ensures stable mechanical attachment and support during the surgical procedure.

Abstract: A device for in situ milling of joint surfaces, including a milling device (20, 24) and a joint clamping device (10). The joint clamp device (10) is designed to be inserted between two joint components forming a joint, particularly bones (1, 3), and for pushing the joint components (1, 3) apart with a predetermined or adjustable tension, wherein the joint clamping device (10) includes a recess (11) in which the milling device (20, 24) can be inserted, wherein the milling device (20, 24) includes a face milling cutter (21).

Abstract: The present invention comprises the provision and use of new and improved arthroscopic instrumentation for (i) harvesting a tissue biopsy from a non-critical section of a joint, and (ii) sizing and seating an autologous graft at an implant site.

Abstract: A surgical tool can include a main unit and a first rigid sheath. The main unit includes an inner tube that is received within an outer tube. The first rigid sheath removably receives the main unit and connects to the main unit via a coupling between a first connector portion of the main unit and a second connector portion of the rigid sheath. The first rigid sheath can be completely removed from the main unit when the first connector portion is decoupled from the second connector portion. A different rigid sheath having a different shape from the shape of the first rigid sheath can then be removably attached to the main unit instead of the first rigid sheath. A surgical tool kit includes a plurality of rigid sheaths having different shapes and having the ability to be removably attached to the main unit.

Abstract: A miller assembly for creating a cavity in a bone. The cavity has a cross section which has a generally triangular profile having a first side generally parallel with an axis of the bone and a second side forming an acute angle with the first side, and is contiguous with a pre-existing conical cavity in the bone. The miller assembly includes a cutter and a frame for carrying the cutter. The frame includes a connection portion having a longitudinal axis and a cutter mount for mounting the cutter at a first angle approximating the acute angle with respect to the longitudinal axis of the connection portion. The cutter mount extends at the first angle from the longitudinal axis of the connection portion and is configured to receive a portion of the cutter and maintain the received cutter oriented at the first angle during rotation. The frame further includes a handle configured to form a portion of a drive joint for coupling the frame to a drill, the handle having a longitudinal axis.

Abstract: Described herein are devices and methods for cutting tissue in a patient. In some embodiments, a bimanually controlled device may include a tissue modification region; at least two flexible elongate lengths of cable that extend substantially adjacent to each other proximally to distally; a plurality of rungs extending between the lengths of cable; and a pair of flexible elongate cutting members extending along the length of the tissue modification region of the device. Each elongate cutting member has a thickness cuts a discrete trough into tissue to a depth that is greater than the thickness of the cutting member. The device may further include a substrate sized and configured to releasably hold the cutting members a distance from one another and a pair of couplers positioned toward an outer edge region of the substrate and configured to releasably secure a cutting member to the outer edge region of the substrate.

Abstract: A hip implant assembly including a ball and stem. An annular rim separates the ball from the stem and abuts over an exterior reconditioned surface of the femur upon inserting the stem within an interior femur passageway. A cup shaped support seats the ball in articulating fashion via a ligament which extends from the ball and is received within a recess passageway of the cup. The cup includes a mounting surface with a central projecting portion which in turn resistively fits within an undercut recess formed in the ilium bone in communication with a base surface of the reconditioned acetabulum socket. An installation kit assists the preparation of the femur and ilium bones, as well as the installation of the implant body into the conditioned femur end and the cup outer socket support to a reconditioned acetabulum defined in the ilium bone.

Abstract: A surgical instrument for cutting an elongated element. The surgical instrument may have a compact size for use in-situ during a surgical procedure. The surgical instrument is also configured to provide the necessary mechanical advantage to cut the elongated element. The surgical instrument may include first and second arms that are pivotally connected together at a pivot. The arms include blades positioned at or towards distal ends of the arms that act together to cut the elongated element. A force mechanism is positioned between the arms to pivot the arms between an open orientation and a closed cutting orientation. The force mechanism may be positioned directly between the arms to reduce the overall size of the instrument.

Abstract: The present invention relates generally to medical devices and medical methods, in particular, devices and methods useful for stabilizing fractures of long bones. In one embodiment, the present invention is a device comprising a housing having a lumen; a plunger having a proximal portion and a distal portion, where the plunger is disposed within the lumen and is movable relative to the housing; a plurality of blades, where the blades can expand radially from the axis of the housing; and a manipulator functionally connected to the plunger, wherein the manipulator is operable to: move the plunger relative to the housing; expand the blades radially from the axis of the housing; and move the blades about the axis of the plunger.

Abstract: A surgical scalpel is presented which combines the attributes of cost-effectiveness in design and safety of single use scalpel devices and the ability to be autoclavable so as to promote the device as a multiple use device as well. The design of the device is such as to afford medical personnel the feel, weight and balance of the original metal unguarded scalpel, while maintaining safety through the shielding of the blade during non-use and the ability to dispose of the blade in a safe controlled manner. The user is able to remove the blade through the biasing action of a living hinge and have it securely attached to the shield of the device for later discharge into a sharps container, all without having to place ones hands near the unguarded sharp. The device to designed to use existing styles of blades without needing costly inventories of specially created blades.

Abstract: The invention is directed toward a surgical kit having component parts capable of use in excising a cartilage defect site on a patient to prepare the same for receipt of an implant plug, the kit comprising a cylindrical gauge with a central bore used to measure the defect area, a guide rod adapted to be driven through the gauge tube into the center of said defect area and a cartilage cutting assembly adapted to be mounted over the guide rod and used for excising the defect area and cutting a cylindrical bore into the defect area. The method for use of the kit comprises the steps of: marking the defect area to be cut; placing a guide rod into the center defect area and driving the same to a predetermined distance to secure the same in the defect area and placing a drill bit over the guide rod and rotating the drill bit to cut a cylindrical blind bore removing the cartilage defect.

Abstract: An implement for orientating a tool at a predetermined angle with respect to a plane of a target surface to be engaged by the tool, particularly for orientating a surgical cutting tool perpendicularly to bone tissue for harvesting and implanting a bone plug to repair damaged bone tissue, includes a rod having a distal end coupled to a head formed with three contact points arranged in a circular array around the longitudinal axis of the rod, such that the three contact points define a plane. The rod is coupled to the head with the longitudinal axis of the rod at the predetermined angle to the plane defined by the three contact points, such that when the three contact points of the rod are in contact with the target surface, the longitudinal axis of the rod is at the predetermined angle with respect to the plane of the target surface.

Abstract: A customized patient-specific orthopaedic surgical system including a first surgical block, a second surgical block, and a computer-controlled milling machine. The first surgical block includes a first bone-facing surface having a first customized patient-specific negative contour to receive a first corresponding contour of a bone of a patient and a first mounting surface. The second surgical block includes a second bone-facing surface having a second customized patient-specific negative contour to receive a second corresponding contour of the bone of the patient and a second mounting surface to be separately mated with the first mounting surface. The computer-controlled milling machine includes a third mounting surface to be separately mated with the first mounting surface of the first surgical block.

Abstract: A method of accessing target tissue adjacent to a spinal nerve of a patient includes the steps of accessing a spine location of the patient by entering the patient through the skin at an access location, inserting a flexible tissue modification device through the access location to the spine location, advancing a distal portion of the first flexible tissue modification device from the spine location to a first exit location, passing through the first exit location and out of the patient, advancing the first or a second flexible tissue modification device through the same access location to the spine location and to a second exit location, and passing through the second exit location and out of the patient.

Abstract: Instruments and methods for reducing and stabilizing bone fractures are presented. One method provides for cutting a portion of a bone having a fracture to create a cavity, wherein the cavity is substantially axisymmetric, and expanding the volume of the cavity thereby reducing the fracture. The fracture may be further reduced and/or stabilized by adding a material, such as an implant, in-situ curable material and/or in-situ hardenable material.

Abstract: A microfracture awl includes an articulating portion that enables the microfracture awl to strike a subchondral bone plate at a precise desired angle to prevent scuffing or undue scraping of the targeted subchondral bone plate. The articulating portion of the microfracture awl is received through a guide sleeve. A proximal end of the articulating portion is rigid and connects to a base. The articulating portion is placed through a guide sleeve and the base resides in a handle attached to the sleeve. The guide sleeve has a curved distal end. The practitioner strikes the rigid base of the microfracture awl and thereby transmits a force to the articulating portion of the awl however, the force is not transmitted to the guide sleeve or handle. Accordingly, the articulating portion of the awl may smoothly travel through the guide sleeve at the angle defined by the curved distal end of the guide sleeve, thereby angularly positioning the tip of the awl with the targeted bone plate.

Abstract: A tool for preparing vertebral surfaces following a discectomy has a body and a rotary cutting tool mounted at the distal end of a lever which extends through the body. The proximal end of the lever can be squeezed toward the body to force the cutting tool against the vertebral surface facing it, while the tool is rotated by turning a crank supported on the tool body, or by a motor. The cutting tool is preferably a flexible rasp or blade which can conform to and control the convexity of the prepared surface.

Abstract: The invention includes a system and method for loosening of tissue. In one embodiment, an intervertebral tissue removal system includes at least one abrading member for abrading tissue in an area to be cleared and at least one expandable member operable to be expanded from a first condition to a second condition, wherein the volume defined by the at least one expandable member in the second condition is greater than the volume defined by the at least one expandable member in the first condition, the at least one expandable member operably connected to the at least one abrading member such that as the at least one expandable member expands from the first condition to the second condition, the at least one abrading member is moved from a first position to a second position.

Abstract: A chisel system for harvesting an implantable graft from an area of a human having a cartilage overlying a condyle, according to which a module is provided that has one end connected to a handle. A cutting surface is formed at the other end of the module that cuts through the cartilage and condyle.

Abstract: A system for implanting a prosthetic device with an opening into a bone includes a plug that is removably received within the opening of the prosthetic device. The system also includes a bone removal tool that advances into the bone from outside the bone and that removes a portion of the bone while advancing into the bone to reveal the plug. The bone removal tool includes a plug engaging portion that engages with the plug. The bone removal tool at least partially removes the plug from the opening of the prosthetic device while engaged with the plug. Moreover, the system includes an alignment system that detects whether the bone removal tool and the plug are substantially axially aligned.

Abstract: A hip implant assembly including body exhibiting a substantially spherical shaped ball and an elongated stem. An annular defining rim separates the ball from the stem and abuts, in a maximum inserting condition, an exterior surface of a reconditioned femur upon inserting the stem within an interior passageway associated with the femur. A three dimensional and interior volume defining support secures around the ball in a universally articulating permitting fashion, the support being fixed to a reconditioned acetabulum socket associated with an ilium bone by interconnecting posts and anchors established between the fixed support and the reconditioned surface of the acetabulum. A corresponding installation kit assists the preparation of the femur and ilium bones defining the hip joint, as well as the installation of the implant body into the upper conditioned femur end and the outer socket support to a reconditioned acetabulum defined in the ilium bone.

Abstract: Apparatus and methods for removing tissue from an intervertebral disc are disclosed. The apparatus can include an elongated guide tube, a rotary cutting member and a drive shaft. Other apparatus can include an elongated guide tube, an inner guide tube, a cutting head, a rotary cutting member and a drive shaft. The elongated guide tube has a bendable end. The apparatus are generally configured to extend and withdraw a rotary cutting member while controllably bending the bendable end of the guide tube.

Abstract: Improved instruments (tools) and surgical techniques are provided for use in surgical procedures that treat femoroacetabular impingement of both the Cam and Pincer types.

Abstract: A method is provided to perform an anterior cervical microdiskectomy to remove at least one bone spur on a pair of adjacent vertebrae in a spinal column that includes a posterior longitudinal ligament. Each vertebra contacts a disk positioned therebetween. The disk includes an annulus and a nucleus. The method comprises the steps of removing a portion of the annulus of the disk; removing the nucleus of the disk; removing the vertebral plates with a first burr; removing a portion of the bone spur with a second burr having a spherically shaped abrading head; and, providing a third burr. The third burr comprises an elongate shaft having a distal end and a proximate end; and, a head attached to and extending outwardly from the distal end of the shaft. The head includes a smooth end surface; and, a smooth rounded peripheral edge circumscribing the end surface.

Abstract: A tunnel notcher and guidewire delivery device is provided for creating a notch and positioning a guidewire within a bone tunnel. In general, the device includes an elongate member having proximal and distal ends with an inner lumen extending therebetween that is adapted to receive a guidewire. The device also includes a cutting element disposed on a distal portion of the elongate member that is adapted to remove bone within an opening of a bone tunnel. In use, the device 10 can be at least partially positioned within a bone tunnel containing a bone plug, and it can be manipulated to form a notch within or adjacent to an opening of the bone tunnel using the cutting element 18. The device 10 is also effective to deliver a guidewire 16 to the bone tunnel at a location adjacent to the notch.

Abstract: Milling and drilling tools and soft tissue management techniques are provided for arthroplasty that facilitate intraoperative and postoperative efficacy and ease of use. In one embodiment, resiliently biased soft tissue protective sleeves surround a side cutting tool and are interposed along the longitudinal axis of the cutting tool, preferably adjacent each side of the bone. The soft tissue protective sleeves are biased to track along the contour of the side of the bone and prevent the cutting tool from being exposed to soft tissue during the resection. In another embodiment, a pilot drill is initially utilized to create an initial bore in the bone to be resected. The pilot drill preferably has an end cutting arrangement and a non-cutting removal channel that minimizes the tendency of the pilot drill bit to drift off-axis as the initial bore in the bone is created.

Abstract: The present invention relates generally to medical devices and medical methods, in particular, devices and methods useful for stabilizing compression fractures of the spine. In one embodiment, the present invention is a device comprising a housing having a lumen; a plunger having a proximal portion and a distal portion, where the plunger is disposed within the lumen and is movable relative to the housing; a plurality of blades, where the blades can expand radially from the axis of the housing; and a manipulator functionally connected to the plunger, wherein the manipulator is operable to: move the plunger relative to the housing; expand the blades radially from the axis of the housing; and move the blades about the axis of the plunger.

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.