Tissue resecting instrument

A tissue-resecting end effector includes an outer shaft having a hub housing, an inner shaft including a sun gear, and a drive assembly disposed within the hub housing. The drive assembly includes a first and second drivers disposed about the inner shaft distally and proximally of the sun gear, respectively. The drive assembly further includes a plurality of planetary gears radially disposed about and in meshed engagement with the sun gear between the drivers, and a locking clip proximal of the planetary gears and the sun gear, rotationally keyed to the second driver, and engaged with the first driver via at least one snap-fit engagement. The locking clip retains the drivers and the planetary gears in operable engagement with one another and the sun gear such that a rotational input provided to the second driver drives rotation of the inner shaft.

BACKGROUND

1. Technical Field

The present disclosure relates generally to the field of tissue resection. In particular, the present disclosure relates to a tissue resecting instrument configured to facilitate resection and removal of tissue from an internal surgical site, e.g., a uterus.

2. Background of Related Art

Tissue resection may be performed endoscopically within an organ, such as a uterus, by inserting an endoscope (or hysteroscope) into the uterus and passing a tissue resection instrument through the endoscope (or hysteroscope) and into the uterus. With respect to such endoscopic tissue resection procedures, it often is desirable to distend the uterus with a fluid, for example, saline, sorbitol, or glycine. The inflow and outflow of the fluid during the procedure maintains the uterus in a distended state and flushes tissue and other debris from within the uterus to maintain a visible working space.

SUMMARY

As used herein, the term “distal” refers to the portion that is described which is further from a user, while the term “proximal” refers to the portion that is described which is closer to a user. Further, to the extent consistent, any or all of the aspects described herein may be used in conjunction with any or all of the other aspects described herein.

Provided in accordance with aspects of the present disclosure is an end effector assembly of a tissue-resecting device. The end effector assembly includes an outer shaft including a hub housing disposed about a proximal end portion thereof, an inner shaft disposed within and rotatable relative to the outer shaft and including a sun gear disposed about a proximal end portion thereof, and a drive assembly rotatably disposed within the hub housing.

The drive assembly includes a first driver rotatably disposed about the inner shaft distally of the sun gear, a second driver rotatably disposed about the inner shaft proximally of the sun gear, a plurality of planetary gears, and a locking clip. The plurality of planetary gears is radially disposed about the sun gear in meshed engagement therewith. Each planetary gear of the plurality of planetary gears is rotatably mounted on a post extending between the first and second drivers. The locking clip is positioned proximally of the plurality of planetary gears and the sun gear, rotationally keyed to the second driver, and engaged with the first driver via at least one snap-fit engagement to thereby retain the first and second drivers and the plurality of planetary gears in operable engagement with one another and the sun gear. As such, a rotational input provided to the second driver drives rotation of the first driver, the plurality of planetary gears, and the sun gear to thereby drive rotation of the inner shaft.

In an aspect of the present disclosure, the hub housing including a ring gear disposed on an interior surface thereof and each of the planetary gears of the plurality of planetary gears is disposed in meshed engagement with the ring gear.

In another aspect of the present disclosure, the rotational input provided to the second driver drives rotation of the inner shaft at an output speed different from an input speed of the rotational input.

In still another aspect of the present disclosure, a third driver or a portion thereof is slidably disposed about a portion of the second driver in fixed rotational orientation relative thereto such that rotation of the third driver provides the rotational input to the second driver.

In yet another aspect of the present disclosure, the first driver includes a helical channel defined therein and the hub housing includes a cam follower engaged within the helical channel such that the rotational input provided to the second driver drives rotation and reciprocation of the inner shaft.

In still yet another aspect of the present disclosure, the third driver is slidably disposed about the second driver in fixed rotational orientation relative thereto such that rotation of the third driver provides the rotational input to the second driver and such that the first and second drivers reciprocate relative to the third driver.

In another aspect of the present disclosure, the inner shaft includes a seal disposed about the proximal end thereof and configured to selectively contact the third driver to seal off the proximal end of the inner shaft as the second driver is reciprocated within the third driver.

In another aspect of the present disclosure, the outer shaft defines a window towards a closed distal end thereof and the inner shaft defines an open distal end. In such aspects, at least one of the windows of the outer shaft or the open distal end of the inner shaft may be surrounded by a cutting edge.

In another aspect of the present disclosure, a cap is engaged with the hub housing. Engagement of the cap with the hub housing retains an RFID chip within a pocket defined within the cap.

A method of assembling an end effector assembly of a tissue resecting instrument in accordance with aspects of the present disclosure includes obtaining an inner shaft including a sun gear disposed about a proximal end portion thereof, inserting a first driver about the inner shaft in a distal-to-proximal direction to a position distally of the sun gear, and coupling a plurality of planetary gears to the sun gear such that the plurality of planetary gears is radially disposed about and in meshed engagement with the sun gear proximally of the first driver. The method further includes inserting a second driver about the inner shaft in a proximal-to-distal direction to a position proximally of the sun gear and the plurality of planetary gears, and positioning a locking clip proximally adjacent the sun gear and the plurality of planetary gears and engaging the locking clip with the first driver such that a portion of the second driver is disposed therebetween, thereby retaining the first and second drivers and the plurality of planetary gears in operable engagement with one another and the sun gear.

In an aspect of the present disclosure, the method further includes obtaining an outer shaft including at least a portion of a hub housing disposed about a proximal end portion thereof, and inserting the inner shaft, including the first and second drivers, the plurality of planetary gears, and the locking clip disposed thereon in operable engagement with one another and the sun gear, in a proximal-to-distal direction into the at least a portion of a hub housing and such that the inner shaft extends through the outer shaft.

In another aspect of the present disclosure, inserting the inner shaft further includes coupling the plurality of planetary gears in meshed engagement with a ring gear disposed within the hub housing.

In still another aspect of the present disclosure, the method further includes engaging a cam follower with the hub housing such that the cam follower extends into the hub housing to engage a helical channel defined within the first driver therein.

In yet another aspect of the present disclosure, the method further includes coupling a third driver to the second driver in slidable, rotationally fixed engagement.

In still yet another aspect of the present disclosure, the method further includes positioning a lockout cap about the third driver and engaging the lockout cap with the hub housing. In such aspects, positioning the lockout cap about the third driver and engaging the lockout cap with the hub housing may releasably lock the inner shaft in position relative to the outer shaft. Additionally or alternatively, positioning the lockout cap about the third driver and engaging the lockout cap with the hub housing may capture an RFID chip within a pocked defined within the lockout cap.

In another aspect of the present disclosure, engaging the locking clip with the first driver includes at least one snap-fit engagement.

DETAILED DESCRIPTION

Referring generally toFIGS. 1 and 23, a tissue resecting instrument10provided in accordance with the present disclosure and configured to resect tissue includes an end effector assembly100and a handpiece assembly200. Tissue resecting instrument10is adapted to connect to a control unit (not shown) via a cable300to provide power and control functionality to tissue resecting instrument10, although tissue resecting instrument10may alternatively or additionally include a power source, e.g., battery, and/or a control unit disposed within handpiece assembly200. Tissue resecting instrument10is further adapted to connect to a fluid management system (not shown) via outflow tubing (not shown) connected to outflow port400for applying suction to remove fluid, tissue, and debris from a surgical site via tissue resecting instrument10. The control unit and fluid management system may be integral with one another, coupled to one another, or separate from one another.

Tissue resecting instrument10may be configured as a single-use device that is discarded after use or sent to a manufacturer for reprocessing, a reusable device capable of being cleaned and/or sterilized for repeated use by the end-user, or a partially-single-use, partially-reusable device. With respect to partially-single-use, partially-reusable configurations, handpiece assembly200may be configured as a cleanable/sterilizable, reusable component, while end effector assembly100is configured as a single-use, disposable/reprocessable component. In any of the above configurations, end effector assembly100is configured to releasably engage handpiece assembly200to facilitate disposal/reprocessing of any single-use components and cleaning and/or sterilization of any reusable components. Further, enabling releasable engagement of end effector assembly100with handpiece assembly200allows for interchangable use of different end effector assemblies, e.g., different length, configuration, etc., end effector assemblies, with handpiece assembly200.

Continuing with reference toFIG. 1, end effector assembly100includes an outer shaft120, an inner shaft140, a hub assembly160, a drive assembly180(FIG. 4), and an RFID chip190(FIG. 4). Referring also toFIGS. 2 and 3, outer shaft120includes a proximal end portion122(FIG. 4) and a distal end portion124defining an at least partially closed distal end126and a transverse window128disposed adjacent the at least partially closed distal end126. Window128provides access to the interior of outer shaft120transversely through a sidewall thereof and may be surrounded by a cutting edge129about the outer perimeter of window128so as to facilitate cutting of tissue passing through window128and into outer shaft120.

Inner shaft140is translationally and rotatably disposed within outer shaft120and includes a proximal end portion142(FIG. 4) and a distal end portion144defining an open distal end146. A cutting edge149may surround the outer perimeter of open distal end146so as to facilitate cutting of tissue passing through open distal end146and into inner shaft140.

Referring still toFIGS. 1-3, inner shaft140is configured for translation and rotation within and relative to outer shaft120to thereby rotate and translate open distal end146relative to window128. More specifically, inner shaft140is configured to rotate and translate between a first position (FIG. 2), wherein open distal end146is disposed at or proximally of a proximal end of window128, through a second position (FIG. 3), wherein open distal end146is disposed within window128, to a third position (not shown), wherein open distal end146is disposed at or distally of a distal end of window128. The rotation of inner shaft140and, thus, cutting edge149thereof, facilitates the cutting of tissue as inner shaft140is translated between the first, second, and third positions. Suction is applied trough inner shaft140, as detailed below, to facilitate removal of the cut tissue, fluids, and debris through inner shaft140.

Inner shaft140is configured to continuously rotate and translate from the first position (FIG. 2) through the second position (FIG. 3) to the third position and back from the third position to the first position (FIG. 2) though the second position (FIG. 3). Other suitable configurations of outer shaft120and/or inner shaft140that cooperate to facilitate tissue cutting are also contemplated, such as those employing reciprocation, rotation, and/or oscillation of inner shaft140relative to outer shaft120.

With reference toFIGS. 1 and 4, as noted above, end effector assembly100includes outer shaft120, inner shaft140, a hub assembly160, and a drive assembly180. End effector assembly100further includes an RFID chip190captured between a lockout cap170of hub assembly160and a proximal extension portion164of a hub housing161of hub assembly160, as detailed below.

Hub assembly160includes a hub housing161having a distal body portion162and a proximal extension portion164that are configured for engagement with one another, e.g., via snap-fitting or other suitable engagement. Referring momentarily toFIGS. 23 and 24, with end effector assembly100engaged with handpiece assembly200, proximal extension portion164of hub housing161extends into handpiece assembly200while distal body portion162substantially abuts and extends distally from handpiece assembly200. Proximal extension portion164of hub housing161further defines an outflow opening165through a sidewall thereof that is configured to fluidly communicate with an internal bore214of handle housing210of handpiece assembly200when end effector assembly100is engaged therewith.

Returning toFIGS. 1 and 4, and with additional reference toFIGS. 6 and 7, distal body portion162of hub housing161is fixedly disposed about proximal end portion122of outer shaft120with outer shaft120extending distally therefrom. Inner shaft140extends through outer shaft120, as noted above, and extends proximally through distal body portion162of hub housing161into proximal extension portion164of hub housing161wherein drive assembly180is operably coupled to proximal end portion142of inner shaft140. Distal body portion162of hub housing161further defines an elongated ring gear181on an interior cylindrical surface thereof.

A follower assembly163aof hub assembly160is seated within a transverse aperture163bdefined through distal body portion162of hub housing161. Follower assembly163aincludes a cam follower163cand a cap163dconfigured to retain cam follower163cwithin transverse aperture163bsuch that cam follower163cextends into the interior of distal body portion162of hub housing161.

As illustrated inFIGS. 10 and 11, hub assembly160further includes an O-ring166configured for engagement about proximal extension portion164of hub housing161distally of outflow opening165. O-ring166, as illustrated inFIG. 24, is configured to establish a fluid-tight seal against the interior of handle housing210of handpiece assembly200when end effector assembly100is engaged therewith to inhibit fluid from travelling distally after exiting outflow opening165.

With reference toFIGS. 4 and 16-18, hub assembly160additionally includes an outer shell168configured for positioning about distal body portion162of hub housing161and for engagement therewith, e.g., via snap-fit engagement or in any other suitable manner. A cantilever engagement finger169aextends proximally from a lower surface of outer shell168of hub housing161and proximally from distal body portion162of hub housing161when outer shell168is engaged thereabout. Engagement finger169aincludes an engagement tooth169bextending therefrom that is configured for engagement within a corresponding aperture218defined within handle housing210of handpiece assembly200(seeFIG. 24) to enable releasable engagement of end effector assembly100with handpiece assembly200(FIG. 24). Grasping ribs169care defined on side surfaces of outer shell168to facilitate engagement and disengagement of end effector assembly100to and from handpiece assembly200(FIG. 24).

Referring toFIGS. 4, 13-15, 21, and 22, lockout cap170of hub assembly160is configured for snap-fit or other suitable engagement with a proximal end portion of proximal extension portion164of hub housing161. Lockout cap170defines a longitudinal lumen171extending therethrough and includes a proximal stop ring172, a distal stop ring174rotationally fixed relative to proximal stop ring172, and a biasing member176disposed between proximal and distal stop rings172,174, respectively. Proximal stop ring172defines a recess173oriented radially inwardly towards longitudinal lumen171.

Distal stop ring174is fixed relative to proximal extension portion164of hub housing161, e.g., via snap-fit engagement between distal stop ring174and proximal extension portion164. Distal stop ring174further includes an external collar179adefining a pocket179b. Pocket179bis configured to receive RFID chip190therein. When lockout cap170is engaged with proximal extension portion164, e.g., via snap-fitting, the open end of pocket179bis blocked by a proximal face of proximal extension portion164, thereby capturing RFID chip190therein.

Biasing member176may be a living hinge formed integrally with proximal and distal stop rings172,174, respectively, e.g., formed as a single molded component, although biasing member176may alternatively be formed separately from either or both of proximal and distal stop rings172,174, respectively, and/or may be any other suitable biasing member such as, for example, a compression spring. Biasing member176is configured to bias proximal stop ring172proximally away from distal stop ring174, corresponding to an at-rest position of lockout cap170.

Referring toFIGS. 4, 5, 8, 9, and 18, drive assembly180is configured to operably couple drive rotor260of handpiece assembly200(seeFIG. 24) with inner shaft140such that rotation of drive rotor260(FIG. 24) drives rotation and reciprocation of inner shaft140within and relative to outer shaft120. Drive assembly180, more specifically, includes a proximal driver182, a distal driver184, and a gear assembly186disposed between and operably coupling proximal and distal drivers182,184, respectively, with one another. Proximal driver182is configured to receive a rotational input from drive rotor260(FIG. 24), gear assembly186is configured to amplify or attenuate the output rotation of inner shaft140relative to the input rotation from drive rotor260(FIG. 24), and distal driver184is configured to impart the amplified or attenuated output rotation to inner shaft140as well as to reciprocate inner shaft140.

With additional reference toFIGS. 12 and 13, proximal driver182of drive assembly180includes a generally cylindrical body183adefining a lumen183bextending longitudinally therethrough. Body183aincludes an external collar183cdisposed annularly thereabout at a proximal end portion thereof. External collar183cincludes a radially-outwardly extending tab183d. Body183afurther includes a proximally-facing cavity183eat least a portion of which has a non-circular cross-sectional configuration, e.g., an 8-point star or other polygonal configuration, that is configured to at least partially receive drive rotor260of handpiece assembly200in fixed rotational orientation (seeFIG. 24). Body183aadditionally defines a distally-facing cavity183fincluding a longitudinally-extending channel183gdefined within an inwardly-facing surface of body183a. A longitudinally-extending slot183hdefined through a side wall of body183acommunicates with distally-facing cavity183fto define a flow path therethrough, e.g., from within distally-facing cavity183fto externally of body183a.

Turning toFIGS. 4, 8, 9, and 18, distal driver184of drive assembly180includes a proximal plate185aand a distal cylindrical body185bextending distally from proximal plate185a. Proximal plate185aincludes a plurality, e.g., three, posts185cextending proximally therefrom and arranged radially about a longitudinal axis defined through distal driver184. Proximal plate185afurther includes a plurality of engagement arms185darranged radially about the longitudinal axis of distal driver184and extending proximally from outer peripheral edges of proximal plate185a.

Distal cylindrical body185bof distal driver184defines a helical channel185eabout the outer annular periphery thereof. Helical channel185eincludes forward and reverse channel portions (defining similar or different pitches) blended at their ends to define a continuous helical channel185e. Helical channel185eis configured to receive cam follower163cof cam assembly163atherein such that as distal driver184is driven to rotate, the engagement of cam follower163cwithin helical channel185ereciprocates distal driver184, e.g., distally while cam follower163cis disposed within the forward channel portion of helical channel185e, proximally while cam follower163cis disposed within the reverse channel portion of helical channel185e, and changing directions when cam follower163cis disposed at the blended ends of helical channel185e. Distal driver184further includes a longitudinally-extending lumen185fdefined therethrough.

Continuing with reference toFIGS. 4, 8, 9, and 18, and with additional reference toFIG. 5, gear assembly186includes a sun gear187afixedly engaged about proximal end portion142of inner shaft140, a plurality of, e.g., three, planetary gears187b, an intermediate driver188a, and a locking clip189a.

Intermediate driver188aincludes a distal plate188band a proximal cylindrical body188cextending proximally from distal plate188b. Distal plate188bdefines a plurality of apertures188darranged radially about a longitudinal axis defined therethrough. Each apertures188dis configured to receive one of the posts185cof distal driver184to rotatably mount and retain planetary gears187bbetween intermediate driver188aand distal driver184. Distal plate188bfurther includes a plurality of, e.g., three, slots188eat outer peripheral edges thereof that are each configured to receive one of the engagement arms185dof distal driver184therethrough.

Proximal cylindrical body188cof intermediate driver188adefines a longitudinally-extending rail188fprotruding from and extending along an outer peripheral surface thereof. Proximal cylindrical body188cis configured for receipt within distally-facing cavity183fof body183aof proximal driver182, with longitudinally-extending rail188fslidably received within longitudinally-extending channel183gof proximal driver182to rotationally lock proximal driver182and intermediate driver188awith one another. Intermediate driver188afurther includes a longitudinally-extending lumen188gdefined therethrough that communicates with longitudinally-extending lumen185fof distal driver184. Further, an elastomeric seal188his engaged about a proximal end of proximal cylindrical body188cof intermediate driver188a, extending about lumen188g. Seal188hmay be resiliently retained about the proximal end of proximal cylindrical body188c, e.g., via the elastomeric material forming seal188h, or may be secured thereto in any other suitable manner.

Locking clip189a, as illustrated inFIGS. 4 and 9, is configured for positioning about proximal cylindrical body188cof intermediate driver188a, proximally adjacent distal plate188bof intermediate driver188a. Locking clip189a, more specifically, defines central opening189bconfigured to receive proximal cylindrical body188cof intermediate driver188aand a notch189cdefined within the annular interior edge of locking clip189athat defines central opening189bfor receipt of longitudinally-extending rail188ftherein. Locking clip189afurther includes a plurality of, e.g., three, lock tabs189deach configured to engage one of the engagement arm185dof distal driver184to thereby engage locking clip189awith distal driver184, retaining planetary gears187band intermediate driver188atherebetween.

With reference toFIGS. 5-17, the assembly of end effector assembly100is detailed. As illustrated in respectiveFIGS. 5 and 6, pre-assembly of sun gear187aabout proximal end portion142of inner shaft140in fixed relation relative thereto and pre-assembly of distal body portion162of hub housing161about proximal end portion122of outer shaft120in fixed relation relative thereto, is accomplished.

With gear assembly186assembled as noted above, locking clip189ais slid distally about intermediate driver188a, in fixed rotational engagement therewith (via the receipt of longitudinally-extending rail188fwithin notch189c), into abutment with distal plate188bof intermediate driver188awherein engagement arms185dof distal driver184engage, e.g., in snap-fit engagement, lock tabs189dof locking clip189ato thereby operably couple drive assembly180(with the exception of proximal driver182) about inner shaft140. At this point or prior thereto, seal188his engaged, e.g., resiliently retained, about the proximal end of intermediate driver188a.

Referring toFIG. 10, inner shaft140, including drive assembly180(with the exception of proximal driver182) operably engaged thereabout, is inserted, in a proximal-to-distal direction, through distal body portion162of hub hosing161and outer shaft120such that planetary gears187bare disposed in slidable, meshed engagement with elongated ring gear181. Thereafter, follower assembly163ais installed within distal body portion162of hub housing161via first inserting cam follower163cthrough transverse aperture163bof distal body portion162of hub housing161and thereafter installing cap163dwithin transverse aperture163bto retain cam follower163cwithin transverse aperture163band in engagement within helical channel185e.

With additional reference toFIG. 11, proximal extension portion164of hub housing161is slid, in a proximal-to-distal direction, about intermediate driver188a, and into engagement, e.g., via snap-fitting, with distal body portion162of hub housing161. Prior to or after the engagement of proximal extension portion164with distal body portion162, O-ring166is slid in a proximal-to-distal direction about proximal extension portion164of hub housing161to be seated within an annular recess167defined about proximal extension portion164of hub housing161distally of outflow opening165. Next, proximal driver182is inserted through distal body portion162of hub housing161and about intermediate driver188ain rotationally-fixed orientation relative to intermediate driver188a, e.g., via receipt of longitudinally-extending rail188fwithin longitudinally-extending channel183g.

Referring toFIGS. 13-15, RFID chip190is loaded into pocket179bof lockout cap170and, thereafter, lockout cap170is slid in a proximal-to-distal direction about proximal driver182into engagement, e.g., via snap-fitting, with proximal extension portion164of hub housing161. Lockout cap170, when engaged with proximal extension portion164of hub housing161, inhibits proximal driver182from passing proximally therethrough. Further, radially-outwardly extending tab183dof proximal driver182is received within recess173of proximal stop ring172of lockout cap170upon engagement of lockout cap170with proximal extension portion164of hub housing161and, while proximal stop ring172remains in the initial position under the bias of biasing member176, lockout cap170retains proximal driver182in rotationally-fixed orientation relative to hub housing161, thus retaining inner shaft140in fixed position relative to outer shaft120.

Turning toFIGS. 17 and 18, outer shell168is slid in a distal-to-proximal direction about outer shaft120and distal body portion162of hub housing161into engagement, e.g., via snap-fitting, with distal body portion162of hub housing161to complete the assembly of end effector assembly100(FIG. 1). In the fully assembled condition of end effector assembly100(FIG. 1), as noted above, biasing member176biases proximal stop ring172proximally such that proximal driver182is engaged with lockout cap170in rotationally fixed orientation. End effector assembly100, e.g., drive assembly180and lockout cap170, may be configured such that, in this rotationally locked position, inner shaft140is disposed in the third position relative to outer shaft120, wherein open distal end146of inner shaft140is disposed at or distally of the distal end of window128of inner shaft120(SeeFIGS. 1-3). Other configurations are also contemplated.

Referring toFIGS. 1, 23, and 24, handpiece assembly200generally includes handle housing210, an outflow path220defined through handle housing210and communicating with an outflow port400, a motor250disposed within handle housing210, and drive rotor260disposed within handle housing210and operably coupled to motor250. Handpiece assembly200may further include one or more controls270, e.g., buttons, disposed on handle housing210to facilitate activation of tissue resecting instrument10, toggle between various modes, and/or to vary the speed of motor250. Further, outflow tubing (not shown) is configured to connect to outflow port400to thereby connect outflow port400to a fluid management system (not shown). The fluid management system includes a vacuum source to establish suction through tissue resecting instrument10and the outflow tubing to facilitate removal of fluid, tissue, and debris from the surgical site and may also include a collection reservoir, e.g., a collection canister, for collecting the removed fluid, tissue, and debris. As an alternative or in addition to a vacuum source establishing suction through tissue resecting instrument10and the outflow tubing, vacuum may be created therethrough via a pressure differential between the surgical site and the outflow path.

Handle housing210defines a pencil-grip configuration, although other configurations are also contemplated, e.g., pistol-grip configurations, and includes an open distal end portion212communicating with an internal bore214. Open distal end portion212of handle housing210provides access to drive rotor260and internal bore214within handle housing210such that, upon engagement of end effector assembly100with handpiece assembly200, as detailed below, a portion of end effector assembly100extends through open distal end portion212and into internal bore214to operably couple with drive rotor260and fluidly couple end effector assembly100with internal bore214and, thus, outflow path220.

Cable300extends proximally from handle housing210and is configured to connect to the control unit (not shown) to provide power and control functionality to tissue resecting instrument10. Cable300, more specifically, houses one or more wires (not shown) that extend into handle housing210and electrically couple controls270and motor250with the control unit to power motor250and control operation of tissue resecting instrument10in accordance with controls270, the control unit, and/or other remote control devices, e.g., a footswitch (not shown). Cable300further includes one or more wires310that connect to an RFID transceiver290disposed within handle housing210towards the distal end thereof.

Drive rotor260is operably coupled with and extends distally from motor250such that, upon activation of motor250, motor250drives rotation of drive rotor260. Drive rotor260defines a base262and rotor body264extending distally from base262. Base262is stationary and surrounds body264. Rotor body264defines a non-circular cross-sectional configuration, e.g., a square or other polygonal configuration, and is configured for at least partial receipt within proximally-facing cavity183eof proximal driver182of end effector assembly100in fixed rotational orientation relative thereto upon engagement of end effector assembly100with handpiece assembly200such that activation of motor250drives rotation of body264of drive rotor260to, in turn, drive rotation of proximal driver182of end effector assembly100.

With reference toFIGS. 1 and 21-24, engagement of end effector assembly100with handpiece assembly200in preparation for use of tissue resecting instrument10is detailed. In order to engage end effector assembly100with handpiece assembly200, end effector assembly100is approximated relative to handpiece assembly200such that lockout cap170and proximal extension164of hub housing161are inserted into internal bore214of handle housing210of handpiece assembly200. As end effector assembly100is approximated in this manner, grasping ribs169cof outer shell168of hub assembly160of end effector assembly100are grasped and squeezed inwardly towards one another, thereby causing the upper and lower surfaces of outer shell168to flex outwardly. As the lower surface of outer shell168is flexed outwardly, engagement finger169aand engagement tooth169bare likewise flexed outwardly. This enables end effector assembly100to be approximated further towards handpiece assembly200such that engagement tooth169bis disposed in alignment with and below an engagement aperture218defined within handle housing210of handpiece assembly200

Upon release of grasping ribs169cof outer shell168, the upper and lower surfaces as well as engagement finger169aand engagement tooth169bare returned inwardly towards their initial positions. In this manner, engagement tooth169bis received within engagement aperture218to thereby engage end effector assembly100with handpiece assembly200. Disengagement and release of end effector assembly100from handpiece assembly200is affected in the opposite manner.

As end effector assembly100is approximated relative to handpiece assembly200to affect the above-detailed engagement, body264of drive rotor260of handpiece assembly200is received within proximally-facing cavity183eof proximal body portion183aof proximal driver182in fixed rotational orientation therewith, e.g., due to the at least partially complementary configurations thereof, while base262of drive rotor260contacts a proximally-facing surface of proximal stop ring172of lockout cap170to urge proximal stop ring172distally against the bias of biasing member176(thereby compression biasing member176). In this manner, tab183dof proximal driver182is disposed relative to and removed from within recess173of proximal stop ring172, thereby rotationally unlocking proximal driver182from lockout cap170and hub housing161and, thus, unlocking inner shaft140from fixed position relative to outer shaft120(seeFIGS. 1-3).

With end effector assembly100engaged with handpiece assembly200as detailed above, RFID chip190of end effector assembly100is disposed in vertical registration with RFID transceiver290of handpiece assembly200, e.g., wherein RFID transceiver290is radially aligned with and disposed radially-outwardly of RFID chip190relative to a longitudinal axis defined through end effector assembly100and handpiece assembly200, due to the required orientation of end effector assembly100to enable engagement with handpiece assembly200, e.g., such that engagement tooth169bis received within engagement aperture218. Thus, with end effector assembly100engaged with handpiece assembly200, RFID transceiver290may read/write data to/from RFID chip190and/or communicate read/write data to/from the control unit, e.g., via cable300.

The data stored on RFID chip190of end effector assembly100may include item number, e.g., SKU number; date of manufacture; manufacture location, e.g., location code; serial number; use count (which may be updated by writing data from RFID transceiver290to RFID chip190); the home/initial position of inner blade140; the rotation type (rotation versus oscillation); RPM settings (default, high, medium, low); max RPM; pressure setting information; vacuum setting information; outflow setting information; calibration information (e.g., amplification/attenuation information of gear assembly186; and/or encryption key(s). Additional or alternative data is also contemplated.

Referring toFIGS. 1, 19, 20, and 23-24, with end effector assembly100engaged with handpiece assembly200as detailed above, tissue resecting instrument10is ready for use. In use, motor250of handpiece assembly200is activated to drive rotation of drive rotor260. Upon activation of motor250, with a head-start or delay relative to activation of motor250, or independently thereof, suction is established through tissue resecting instrument10, e.g., via activating the vacuum source of the fluid management system.

Activation of motor250drives rotation of drive rotor260which, in turn, drives rotation of proximal driver182to driver rotation of intermediate driver188ato, in turn, drive rotation of distal driver184. Rotation of intermediate driver188aand distal driver184collectively rotates planetary gears187babout the longitudinal axis of drive assembly180and within and relative to elongated ring gear181of hub housing161. Rotation of planetary gears187bwithin and relative to elongated ring gear181effects rotation of each planetary gear187babout its axis due to its meshed engagement with elongated ring gear181. The rotation of the planetary gears187babout their axes, in turn, drives rotation of sun gear187adue to the meshed engagement of planetary gears187bwith sun gear187a. Sun gear187a, in turn, drives rotation of inner shaft140relative to outer shaft120due to the fixed engagement of sun gear187aabout proximal end portion142of inner shaft140.

The rotation of inner shaft140relative to outer shaft120and hub housing161also results in reciprocation of inner shaft140relative to outer shaft120due to the engagement of cam follower163cwithin helical channel185e. As inner shaft140is reciprocated relative to outer shaft120, drive assembly180is similarly reciprocated relative to hub housing161and maintained operably coupled therewith as planetary gears187bslide along and maintain meshed engagement within elongated ring gear181. In this manner, the rotational input provided by motor250and rotor260results in reciprocation and rotation of inner shaft140relative to outer shaft120, e.g., between the first, second, and third positions (seeFIGS. 1-3).

Referring also toFIGS. 2 and 3, the reciprocation and rotation inner shaft140relative to outer shaft120, together with the suction applied through inner shaft140, enables tissue to be drawn through window128of outer shaft120, cut by cutting edge129and/or cutting edge149, and withdrawn proximally through inner shaft140via open distal end146thereof. The cut tissue, along with fluids and debris, are suctioned proximally through inner shaft140and out the open proximal end thereof, through intermediate driver188aand out the open proximal end thereof, through proximal driver182exiting longitudinally-extending slot183hthereof, through proximal extension portion164of hub housing161and exiting output opening165thereof, and ultimately through outflow path220of handpiece assembly200to outflow port400for output to the collection reservoir of the fluid management system.

With additional reference toFIGS. 19 and 20, as inner shaft140is reciprocated and rotated, seal188h, engaged on the proximal end of intermediate driver188a, is reciprocated (and, in embodiments, rotated at a different speed) through and relative to proximal driver182. More specifically, seal188his reciprocated between a proximal-most position, e.g., the first position of inner shaft (FIG. 2), and a distal-most position, e.g., the closed position of inner shaft140.

When seal188his disposed in or in close proximity to the proximal-most position, seal188hestablishes a fluid-tight seal against an interior surface of proximal driver182to thereby seals off the flow path of tissue, fluid, and debris out of the open proximal end of inner shaft140. Thus, when seal188his disposed in or in close proximity to the proximal-most position, no suction is applied through inner shaft140. When seal188his sufficiently displaced from the proximal-most position, the flow path is re-established, enabling tissue, fluid, and debris to be suctioned proximally through tissue resecting instruments10(FIG. 23), as detailed above.

Upon engagement of end effector assembly100with handpiece assembly200, a control program (not shown) associated with motor250may record the rotational position of drive rotor260as a home position and, after activation, ensure that drive rotor260stops at a rotational position corresponding to the home position, e.g., the closed position of inner shaft140relative to outer shaft120. The control program may utilize correlation information, e.g., from RFID chip190, correlating, for example, rotation of drive rotor260with rotation of inner shaft140to ensure that inner shaft140is returned to the closed position relative to outer shaft120after each activation. Returning to the home position, corresponding to the closed position of inner shaft140, also returns proximal driver182to its initial rotational position whereby tab183dof external collar183cthereof is rotationally aligned with recess173of proximal stop ring172of lockout cap170such that, upon disengagement and withdrawal of end effector assembly100from handpiece assembly200, biasing member176returns proximal stop ring172proximally to thereby bias tab183dinto engagement within recess173and re-engage the lock fixing inner shaft140in the closed position relative to outer shaft120.

Referring generally toFIGS. 1 and 23, as an alternative to handpiece assembly200configured for manual grasping and manipulation during use, tissue resecting instrument10may alternatively be configured for use with a robotic surgical system wherein handle housing210is configured to engage a robotic arm of the robotic surgical system. The robotic surgical system may employ various robotic elements to assist the surgeon and allow remote operation (or partial remote operation). More specifically, various robotic arms, gears, cams, pulleys, electric and mechanical motors, etc. may be employed for this purpose and may be designed with the robotic surgical system to assist the surgeon during the course of an operation or treatment. The robotic surgical system may include remotely steerable systems, automatically flexible surgical systems, remotely flexible surgical systems, remotely articulating surgical systems, wireless surgical systems, modular or selectively configurable remotely operated surgical systems, etc.

The robotic surgical system may be employed with one or more consoles that are next to the operating theater or located in a remote location. In this instance, one team of surgeons or nurses may prep the patient for surgery and configure the robotic surgical system with the surgical device disclosed herein while another surgeon (or group of surgeons) remotely controls the surgical device via the robotic surgical system. As can be appreciated, a highly skilled surgeon may perform multiple operations in multiple locations without leaving his/her remote console which can be both economically advantageous and a benefit to the patient or a series of patients.

The robotic arms of the robotic surgical system are typically coupled to a pair of master handles by a controller. The handles can be moved by the surgeon to produce a corresponding movement of the working ends of any type of surgical instrument (e.g., end effectors, graspers, knifes, scissors, cameras, fluid delivery devices, etc.) which may complement the use of the tissue resecting devices described herein. The movement of the master handles may be scaled so that the working ends have a corresponding movement that is different, smaller or larger, than the movement performed by the operating hands of the surgeon. The scale factor or gearing ratio may be adjustable so that the operator can control the resolution of the working ends of the surgical instrument(s).

Although the foregoing disclosure has been described in some detail by way of illustration and example, for purposes of clarity or understanding, it will be obvious that certain changes and modifications may be practiced within the scope of the appended claims.