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EP-4545023-B1 - SINGLE PORTAL, SURGICAL APPARATUS

EP4545023B1EP 4545023 B1EP4545023 B1EP 4545023B1EP-4545023-B1

Inventors

  • NOYES, WILLARD S.
  • SEIDL, Robert K.

Dates

Publication Date
20260513
Application Date
20230615

Claims (13)

  1. A single portal surgical apparatus (1400), comprising: a first cannula ( 1410) to couple to a fluid source such that fluid flows from the fluid source through a proximal opening of the first cannula; an instrument shaft ( 1420) longitudinally extending within the first cannula ( 1410), an outer surface of the instrument shaft comprising circumferentially spaced first and second winged structures ( 1420a-1420b) longitudinally extending along a distal portion of the instrument shaft, the first winged structure in continuous, touching relation with a first surface of an inner wall of the first cannula along a first location, and the second structure in continuous, touching relation with a second surface of the inner wall along a second location such that an interior of the first cannula is partitioned into at least two fluid channels ( 1435, 1445) having boundaries defined by at least the first location and the second location; and a first tool (1255) distally extending from the instrument shaft ( 1420), wherein the first and second winged structures circumferentially spiral about the instrument shaft (1420) along its longitudinal length.
  2. The single portal surgical apparatus of claim 1, wherein: an interior of the instrument shaft comprises a first instrument channel ( 1421) longitudinally extending along the instrument shaft; and the first tool (1255) distally extends from a distal end of the first instrument channel.
  3. The single portal apparatus of claim 2, further comprising: a cable wire (1254) coupled to the proximal end of the first tool (1255), the cable wire (1254) running through the first instrument channel ( 1421) to a proximal end of the single portal surgical apparatus.
  4. The single portal surgical apparatus of claim 2, further comprising a second tool distally extending from the instrument shaft, wherein: an interior of the instrument shaft further comprises a second instrument channel separate from the first instrument channel; and the second tool distally extends from a distal end of the second instrument channel.
  5. The single portal surgical apparatus of claim 1, wherein: the at least two fluid channels comprise a first fluid channel and a second fluid channel; the fluid entering the proximal opening of the first cannula is to flow through the first fluid channel and exit at a distal end of the first cannula; and the second fluid channel is configured to suction the fluid or tissue.
  6. The single portal surgical apparatus of claim 5, wherein: the second fluid channel is coupled to a suction line proximal to the first cannula.
  7. The single portal surgical apparatus of claim 1, wherein: the outer surface of the instrument shaft further comprises a third winged structure longitudinally extending along the distal portion of the instrument shaft, the third winged structure in continuous, touching relation with a third surface of the inner wall along a third location, and the third winged structure circumferentially spaced with the first and second winged structures; the at least two fluid channels comprise three or more fluid channels; and the interior of the first cannula is partitioned into the three or more fluid channels having boundaries defined by at least the first location, the second location, and the third location.
  8. The single portal surgical apparatus of claim 1, further comprising: a light source (1005) to transmit light to an anatomical site during surgery; and an image sensor (1030) to image the anatomical site during surgery.
  9. The single portal surgical apparatus of claim 8, wherein: the image sensor (1030) is integrated into the first cannula; and the first cannula comprises a channel (1025) via which the light transmitted by the light source travels; or a distal end of the first cannula comprises the light source (1005).
  10. The single portal surgical apparatus of claim 1, further comprising: a handle (1220) proximal to and coupled to the first cannula and the instrument shaft, the handle comprising a control (1205) configured to be actuated to move the first instrument.
  11. The single portal surgical apparatus of claim 10, further comprising: a connector (1220) distal to the handle (1210), the connector (1220) configured to removably couple a proximal end of the instrument shaft to the handle.
  12. The single portal surgical apparatus of claim 1, wherein the inner wall of the first cannula comprises spiral grooves to engage the first and second winged structures.
  13. The single portal surgical apparatus of claim 4, wherein a respective instrument can be removably coupled into each of the first instrument channel and the second instrument channel.

Description

Cross-Reference to Related Applications This application claims priority to U.S. Provisional Patent Application No. 63/352,502, titled "SINGLE PORTAL, SLOTTED MICRODEBRIDER" filed June 15, 2022. Description of the Related Art Orthopedic arthroscopy historically utilizes two or three surgical portals in order to successfully navigate instrumentation within a joint space under endoscopic guidance. One of the more popular instruments used in this regard is a surgical microdebrider. Microdebriders are motorized elongated cannulas that have an inner and outer cannula. The inner cannula rotates or oscillates within the outer cannula. The inner and outer cannula have an opening at the end of the cannula that has sharp or serrated edges. These openings are typically oriented along the side of the cannula tip so that the blunt, rounded tip can protect distal tissue from the cutting action of the microdebrider. In other types of microdebriders a burr is located on the distal tip of the inner shaft that lines up with the side opening of the distal outer cannula tip, again keeping the tip of the cannula protected. Irrigation and suction pumps are often used to regulate the suction and irrigation in a manner adequate to maintain joint space fluid pressure and minimize tissue collapse which would obscure visualization. US 2007/0010823 A1 describes devices and methods aspiration and clearing of debris from a surgical field during use of an arthroscopic shaver. US 6,638,289 B1 describes cutting accessories used with powered surgical handpieces to perform endoscopic surgical procedures. WO2006/026236 A2 describes a tissue resecting system. US10,271,869 B2 describes a vascular surgical apparatus for removing plaque or other deposits from the interior of a vessel. Summary The single portal surgical apparatus according to the invention is defined in claim 1. Embodiments are defined in the dependent claims. In order for the microdebrider cannulas to work effectually, suction and irrigation must be available in order to prevent tissue, cartilage, and bone from clogging the tip or shaft of the microdebrider cannula. Historically, suction to remove fluid from a joint space is applied either to the back end of the inner microdebrider cannula or via suction ports located on the sides of a separate cannula delivered through a different portal through which an endoscope or microdebrider is placed. In order for there to be enough room for irrigation to flow into the joint space, there needs to be a gap between the outer surface of the endoscope or microdebrider cannula shaft and the inner surface of the outer orthopedic cannula shaft used to gain access to the joint. Eliminating this gap would allow for a smaller overall outer optical cannula diameter. The arthroscopic surgery market is moving toward smaller endoscopes and instrumentation in an attempt to minimize patient discomfort and allow for in-office arthroscopic procedures. ARTHREX for instance introduced a 1.9mm "Nanoscope" with a 2.2mm inflow sheath. These devices however are used for visualization within the joint space. In order to use instruments for tissue removal, a second portal is required to pass instrumentation. The ARTHREX inflow cannula is not large enough to accommodate an endoscope and an instrument such as a forceps or microdebrider cannula within the same inflow cannula. Performing surgery through a single, optical, orthopedic cannula would be advantageous. A single portal system would minimize the number of incision sites and instrument portals thereby reducing pain and blood loss while at the same time improving surgical speed and efficiency. The smaller the single portal optical cannula diameter, the better tolerated the surgical arthroscopy may be for the patient. On the other hand, in certain applications, a microdebrider shaft should remain as large as possible in order to minimize time necessary for tissue removal. Smaller caliber microdebrider cannulas take longer to debride the tissue. In a single portal system, the optical orthopedic cannula used to gain access to the joint space must provide a large enough inner diameter to allow irrigation, suction, and the passage of a microdebrider shaft or another shafted instrument. If the working channel inner diameter is too small, there would not be enough space to push fluid past the outside of a microdebrider or instrument shaft. In such a situation, standard suctioning through the inner microdebrider cannula would quickly overtake the amount of irrigation flowing into the joint from around the cannula. Similarly, a forceps instrument shaft passed through a single channel optical cannula could only provide one surrounding space between the forceps shaft and inner channel wall for either suction or irrigation to propagate. Suction and irrigation could not occur at the same time through the same cannula. To address these and other deficiencies of existing or future optical cannula surgical systems, and in an e