Abstract:
An ultrasonic aspirator includes a body, an aspirator wand extending from the body, a shield to cover the aspirator wand, a removable headpiece removably attached to the aspirator wand, and a guard extending past an end of the headpiece in a direction distal to the body. the aspirator also includes a generator or a detector to generate or detect electrical pulses, light sources, endoscopy, modified body angles, image navigation integration for improved visualization and optimization of the surgical field.

Description:
CROSS-REFERENCE TO RELATED APPLICATION 
       [0001]    This application claims priority from U.S. Provisional Application No. 61/983,759 filed Apr. 24, 2014, U.S. Provisional Application No. 62/028,044 filed Jul. 23, 2014, and U.S. Provisional Application No. 62/114,824 filed Feb. 11, 2015, the disclosures of which are incorporated herein by reference. 
     
    
     BACKGROUND 
       [0002]    1. Field 
         [0003]    Exemplary embodiments relate to an ultrasonic aspirator, and more particularly, to an ultrasonic aspirator that enables safer and expanded use around vital structures of a body. 
         [0004]    2. Description of the Related Art 
         [0005]    In recent years, brain and spine surgery has progressed to include minimally invasive procedures, which reduces a patient&#39;s hospital stay and reduces recovery time, which has led to an overall reduction in costs. However, the use of minimally invasive procedures requires that standard operating room tools be modified to complete these tasks. 
         [0006]    There presently exists ultrasonic aspirators for use in removing tissue in the human body. These conventional ultrasonic aspirators use ultrasound energy transmitted along a length of metal to cause a vibration of the metal and destruction of the tissue. The ultrasonic aspirator also integrates suction and irrigation to reduce thermal injury to tissue adjacent to the target area by the heating of the metal tip. Due to the bulk of the apparatuses and the lack of visualization associated of the conventional technology, the conventional technology is unsuitable for use in minimally invasive surgeries. 
         [0007]    Accordingly, an ultrasound tissue aspirator is needed for use around sensitive and easily damaged tissue, including nerves and brain matter, by minimizing thermal injury to the tissue and by minimizing or eliminating the unintended destructive effects of the ultrasound itself. 
         [0008]    In addition, the need to integrate a light sources, nerve stimulators/monitors, endoscopes, and navigation probes, to further enhance the safety of ultrasound tissue aspirators in small working spaces with poor visibility is required. Moreover, exemplary embodiments integrate various tools with an ultrasound aspirator to reduce the need to change devices in a fixed, closed space, thereby reducing the operating time. 
       SUMMARY 
       [0009]    It is an aspect of the exemplary embodiments to provide a guard for an ultrasonic aspirator to prevent the unintentional destruction of tissue around a targeted aspiration area. Further, it is an aspect of the exemplary embodiments to provide an endoscope and/or a light to provide better visualization of a targeted surgical area. 
         [0010]    An ultrasonic aspirator according to an exemplary embodiment includes a body, an aspirator wand extending from the body, a shield to cover the aspirator wand, a removable headpiece removably attached to the aspirator wand, and a guard extending past an end of the headpiece in a direction distal to the body. 
         [0011]    According to an exemplary embodiment, the guard is attached to the shield. 
         [0012]    According to an exemplary embodiment, the guard is attached to the body. 
         [0013]    According to an exemplary embodiment, the guard is integral with the headpiece. 
         [0014]    According to an exemplary embodiment, the guard is separated from the headpiece by a material that is non-conductive of heat or vibration. 
         [0015]    According to an exemplary embodiment, the ultrasonic aspirator further includes a light integrally formed at an end of the shield in a direction distal to the body. 
         [0016]    According to an exemplary embodiment, the ultrasonic aspirator further includes an endoscope integrally formed with the body and the shield, extending from the body to an end of the shield in a direction distal to the body. 
         [0017]    According to an exemplary embodiment, a first side of the headpiece includes a working surface to aspirate an object, and the first side of the headpiece further includes a suction opening in a direction proximal to the body from the headpiece. 
         [0018]    According to an exemplary embodiment, the ultrasonic aspirator further includes a hollow tube extending from the body through the shield and terminating at the suction opening. 
         [0019]    According to an exemplary embodiment, the headpiece includes a working surface having a plurality of protrusions to cut the object. 
         [0020]    According to an exemplary embodiment, the headpiece includes a working surface being having a width greater than a width of the headpiece. 
         [0021]    According to an exemplary embodiment, the headpiece includes at least one joint around which a working surface of the headpiece can bend. 
         [0022]    According to an exemplary embodiment, the headpiece includes a sensor receives an input from an adjacent object. 
         [0023]    According to an exemplary embodiment, the sensor receives as input a vibration of the adjacent object. 
         [0024]    According to an exemplary embodiment, the headpiece includes a grasper at the end of the headpiece distal to the body. 
         [0025]    An ultrasonic aspirator/sonicator according to an exemplary embodiment includes a body, an aspirator wand extending from the body, a shield to cover the aspirator wand, a removable headpiece removably attached to the aspirator wand, and a sensor to determine a change in a density of an object contacted by the headpiece, where the aspirator is stopped when the sensor determines that the density of the object has changed. 
         [0026]    According to an exemplary embodiment, the sensor is a pressure sensor. 
         [0027]    According to an exemplary embodiment, the sensor is an ultrasonic sensor. 
         [0028]    According to an exemplary embodiment, the sensor is a displacement sensor. 
         [0029]    According to an exemplary embodiment, the sensor tip is integrated into image navigation. 
         [0030]    An ultrasonic aspirator/sonicator according to an exemplary embodiment includes a body, an aspirator wand extending from the body, a shield to cover the aspirator wand, and a removable headpiece removably attached to the aspirator wand, where at least part of the headpiece is bends according to a user&#39;s input. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0031]    These and/or other aspects will become apparent and more readily appreciated from the following description of exemplary embodiments, taken in conjunction with the accompanying drawings of which: 
           [0032]      FIGS. 1A-1D  are views showing a conventional ultrasound aspirator; 
           [0033]      FIGS. 2A-2D  are views showing an ultrasound aspirator having a guard attached to a shield of the ultrasound aspirator according to an exemplary embodiment; 
           [0034]      FIGS. 3A-3C  are views showing an ultrasound aspirator having a guard integrally formed with a headpiece of the ultrasound aspirator according to an exemplary embodiment; 
           [0035]      FIGS. 4A-4C  are views showing an ultrasound aspirator having a guard attached to a shield and connected to the headpiece of the ultrasound aspirator by a non-conductive material according to an exemplary embodiment; 
           [0036]      FIGS. 5A-5C  are views showing an ultrasound aspirator having an integrated light according to an exemplary embodiment; 
           [0037]      FIGS. 6A-6C  are views showing an ultrasound aspirator having an integrated guard and endoscope according to an exemplary embodiment; 
           [0038]      FIGS. 7A-7C  are views showing an ultrasonic aspirator having a guard integrally formed with the headpiece of the ultrasound aspirator showing an enhanced suction opening at a distal end of the headpiece according to an exemplary embodiment; 
           [0039]      FIGS. 8A-8D  are views showing an ultrasound aspirator having an integrated light according to an exemplary embodiment; 
           [0040]      FIGS. 9A-9C  are views showing an ultrasound aspirator having an integrated endoscope only according to an exemplary embodiment; 
           [0041]      FIGS. 10A-10C  are views showing an ultrasound aspirator having a suction opening on the headpiece at a location proximal to the body from a working surface of the cutting surface of the headpiece according to an exemplary embodiment; 
           [0042]      FIGS. 11A-11C  are views showing an ultrasound aspirator having a sensor to determine different densities of an object according to an exemplary embodiment; 
           [0043]      FIGS. 12A-12C  are views showing a conventional ultrasound aspirator/sonicator having a specialty cutting blade projections on the headpiece; 
           [0044]      FIGS. 13A-13D  are views showing an ultrasound aspirator/sonicator having a specialty cutting blade on the headpiece and a guard integrally formed with the headpiece according to an exemplary embodiment; 
           [0045]      FIGS. 14A-14D  are views showing an ultrasound aspirator/sonicator having a specialty cutting blade on the headpiece and a guard integrally formed with the shield according to an exemplary embodiment; 
           [0046]      FIGS. 15A and 15B  are view showing an ultrasound aspirator having a headpiece with a working surface which is curved according to an exemplary embodiment; 
           [0047]      FIG. 16  is a view showing an ultrasound aspirator having a cutting surface and integrated guard that is flexible and/or jointed according to an exemplary embodiment; 
           [0048]      FIGS. 17A-17D  are views showing an ultrasound aspirator having a guard attached to a shield with an integrated nerve stimulator/sensor on an end of the headpiece according to an exemplary embodiment; 
           [0049]      FIG. 18A  shows an ultrasonic aspirator having a conventional angled body; 
           [0050]      FIGS. 18B  shows an ultrasonic aspirator having an angled/bayoneted body and a guard for the headpiece according to an exemplary embodiment; 
           [0051]      FIG. 19  shows an ultrasonic aspirator having a guard, a light, and an endoscope where the headpiece includes a grasper, according to an exemplary embodiment; 
           [0052]      FIG. 20A  shows an ultrasonic aspirator having a guard where the headpiece includes a cutting blade integrated into a biting/grasping tool, according to an exemplary embodiment; 
           [0053]      FIG. 20B  shows an ultrasonic aspirator having a guard, a light, and an endoscope Where the headpiece includes a cutting blade integrated into a biting/grasping tool, according to an exemplary embodiment; and 
           [0054]      FIG. 21  shows an ultrasonic aspirator having a headpiece with a retractable reverse facing guard mechanism according to an exemplary embodiment. 
       
    
    
     DETAILED DESCRIPTION 
       [0055]    Reference will now be made in detail to exemplary embodiments, examples of which are illustrated in the accompanying drawings, wherein like reference numerals refer to like elements throughout. However, known functions associated with the exemplary embodiments or detailed descriptions on the configuration and other matters which would unnecessarily obscure the present disclosure will be omitted. 
         [0056]      FIGS. 1A-1D  are views showing a conventional ultrasonic aspirator  1 . The ultrasonic aspirator  1  is used to remove tissue from a body, such as a human body or an animal body. Ultrasound energy is transmitted from the body  5  of the ultrasound aspirator  1 , down an aspirator wand  15 , and to the removable headpiece  20 . The ultrasound energy causes the headpiece  20  to vibrate and destroy tissue. As shown in  FIG. 1A , an irrigation hose  2  can provide fluid to the body  5 , through the irrigation port  2   a,  provide the fluid to the headpiece  20  to aid in the removal of destroyed tissue and reduce thermal injury to adjacent tissue caused by the heating of the headpiece  20 . The ultrasound aspirator is powered by power cables  3 . 
         [0057]    As shown in  FIGS. 1A-1D , the ultrasonic aspirator  1  further includes a shield  10  to carry fluid for aspiration of sonicated tissue and prevent contact of the aspirator wand  15  with tissue or other objects. Referring to  FIGS. 1B and 1D , there is provided a suction opening  30  at a distal, tip end of the headpiece  20 . The suction opening  30  can be used to remove liquid, tissue, and other debris in the body during use of the ultrasonic aspirator  1 . The headpiece  20  includes a working surface  25 . The working surface  25  contacts the tissue or other objects and destroys the tissue or objects by vibrating the working surface  25 . 
         [0058]    However, tissue and other objects surrounding the targeted tissue may be unintentionally destroyed by the working surface  25  the ultrasonic aspirator  1 . That is, the working areas in which the ultrasonic aspirator  1  is used are very small, and the headpiece  20  and working surface  25  is used may unintentionally contact tissue or other objects adjacent to the targeted structures. Accordingly, exemplary embodiments are provided to prevent the unintentional contact between the headpiece  20  and working surface  25  of the ultrasonic aspirator  1  and untargeted tissue or other objects. 
         [0059]      FIGS. 2A-2D  show an ultrasonic aspirator  1  according to an exemplary embodiment. The ultrasonic aspirator  1  according an exemplary embodiment includes a body  5 , an irrigation tube  2  connected to the body  5  via an irrigation port  2   a,  an aspirator wand  15  extending from the body  5 , and a headpiece  20  having a working surface  25 . Further, the ultrasonic aspirator  1  includes a guard  35 . As shown in  FIG. 2B , the guard  35  extends past the headpiece  20  in a direction distal to the working surface  25 . The distance between the distal end of the working surface  25  and the guard  35  may vary depending on the procedure being performed. 
         [0060]    According to an exemplary embodiment, the guard  35  extends from the shield  10 , where a space exists between the guard  35  and the headpiece  20  and working surface  25 . 
         [0061]    The shield  10  may be formed of a plastic, a metal alloy, or any other material that does not conduct heat or ultrasonic vibrations or dampen ultrasonic vibrations. The guard  35  may also be formed of a plastic a metal alloy, or any other material that does not conduct heat or ultrasonic vibrations. The headpiece  20  and the working surface  25  may be formed of any metal or other material that conducts heat and ultrasonic vibrations. It will be understood by those skilled in the art that these materials are only exemplary, and any material suitable for the intended purpose of the structure may be used. 
         [0062]    Referring to  FIGS. 3A-3D , an ultrasonic aspirator  1  according to an exemplary embodiment is shown. The ultrasonic aspirator  1  includes a body  5 , an irrigation tube  2  connected to the body  5  via an irrigation port  2   a,  an aspirator wand  15  extending from the body  5 , and a headpiece  20  having a working surface  25 . As shown in  FIG. 3B , a guard  35  is integrally formed with the headpiece  20  and extends past the headpiece  20  in a direction distal to the body  5 . The guard  35  is formed of a material that does not conduct heat or a vibration. Thus, the guard  35  protects tissue surrounding the targeted tissue from being unintentionally destroyed while using the ultrasonic aspirator  1 . 
         [0063]    Referring to  FIGS. 4A-4C , there is shown an ultrasonic aspirator  1  according to an exemplary embodiment. The ultrasonic aspirator  1  includes a body  5 , an irrigation tube  2  connected to the body  5  via an irrigation port  2   a,  an aspirator wand  15  extending from the body  5 , and a headpiece  20  having a working surface  25 . As shown in  FIG. 4B , a guard  35  is separated from the headpiece  20  by a non-conducting material  40  that does not conduct heat or ultrasonic vibrations. The non-conducting material  40  may be a plastic, an alloy, or any other material that does not conduct heat or ultrasonic vibrations. Further, the guard  35  extends past the headpiece  20  in a direction distal to the body  5 . Thus, the guard  35  protects tissue surrounding the targeted tissue from being unintentionally destroyed while using the ultrasonic aspirator  1 . 
         [0064]    Referring to  FIGS. 5A-5C , there is shown an ultrasonic aspirator  1  according to an exemplary embodiment. The ultrasonic aspirator  1  according an exemplary embodiment includes a body  5 , an irrigation tube  2  connected to the body  5  via an irrigation port  2   a,  an aspirator wand  15  extending from the body  5 , and a headpiece  20  having a working surface  25 . Further, the ultrasonic aspirator  1  includes a guard  35  attached to the shield  10 . However, the guard  35  is not limited to being connected to the shield  10 . 
         [0065]    Referring to  FIG. 5B , there is shown a light  45  integrally formed with the shield  10 . However, it will be understood that the light  45  is not limited to being integrally formed with the shield  10 . The light  45  may be provided at any location on the ultrasonic aspirator  1  to provide a user with a good visualization of the area that is targeted by the user. In this manner, a safety of the ultrasonic aspirator will be improved. 
         [0066]    The light  45  may be powered by a battery or may be connected to a constant power supply by an electrical cord. However, the light  45  is not limited to being powered in this mariner, and may be powered by any means known in the art. 
         [0067]    Referring to  FIGS. 6A-6C , there is shown an ultrasonic aspirator  1  according to an exemplary embodiment. The ultrasonic aspirator  1  according an exemplary embodiment includes a body  5 , an irrigation tube  2  connected to the body  5  via an irrigation port  2   a,  an aspirator wand  15  extending from the body  5 , and a headpiece  20  having a working surface  25 . Further, the ultrasonic aspirator  1  includes a guard  35  attached to the shield  10 . However, the guard  35  is not limited to being connected to the shield  10 . 
         [0068]    Referring to  FIG. 6A , there is shown an endoscope  50  located at an end of the body  5 . Further, the ultrasonic aspirator  1  includes an endoscope tube  52  extending toward the headpiece  20  and terminating at the endoscope opening  53 , as shown in  FIGS. 6B and 6C , which is at a location proximal of the headpiece  20  to the body  5 . 
         [0069]    Referring to  FIGS. 6B and 6C , the endoscope opening  52  is integrally formed with the shield  10 . However, it will be understood that the endoscope opening  52  is not limited to being integrally formed with the shield  10 . The endoscope opening  52  may be provided at any location on the ultrasonic aspirator  1  to provide a user with a good visualization of the area that is targeted by the user. In this manner, a safety of the ultrasonic aspirator will be improved. 
         [0070]    Referring to  FIGS. 7A-7C , an ultrasonic aspirator  1  according to an exemplary embodiment is shown. The ultrasonic aspirator  1  includes a body  5 , an irrigation tube  2  connected to the body  5  via an irrigation port  2   a,  an aspirator wand  15  extending from the body  5 , and a headpiece  20  having a working surface  25 . As shown in  FIGS. 7B and 7C , a guard  35  is integrally formed with the headpiece  20  and extends past the headpiece  20  in a direction distal to the body  5 . 
         [0071]    As shown in  FIGS. 7B and 7C , there is provided a suction opening  30  at a distal end of the headpiece  20 . The suction opening  30  can be used to remove liquid, tissue, and other debris in the body during use of the ultrasonic aspirator  1 . In this manner, the guard  35  protects tissue surrounding the targeted tissue from being unintentionally destroyed while using the ultrasonic aspirator  1 , while debris generated during the procedure may be aspirated using the suction opening  30 . 
         [0072]    Referring to  FIGS. 8A-8D , there is shown an ultrasonic aspirator  1  according to an exemplary embodiment. The ultrasonic aspirator  1  according an exemplary embodiment includes a body  5 , an irrigation tube  2  connected to the body  5  via an irrigation port  2   a,  an aspirator wand  15  extending from the body  5 , a headpiece  20  having a working surface  25 , and a suction opening  30 . Further, as shown in  FIGS. 8B and 8C , a light  45  integrally formed with the shield  10 . 
         [0073]    It will be understood that the light  45  is not limited to being integrally formed with the shield  10 . The light  45  may be provided at any location on the ultrasonic aspirator  1  to provide a user with a good visualization of the area that is targeted by the user. In this manner, a safety of the ultrasonic aspirator will be improved. According to an exemplary embodiment, light from the light  45  is directed toward the working surface  25  of the headpiece  20 , as shown in  FIGS. 8B-8D . 
         [0074]    Further, the light  45  may be powered by a battery or may be connected to a constant power supply by an electrical cord. However, the light  45  is not limited to being powered in this manner, and may be powered by any means known in the art. 
         [0075]    Referring to  FIGS. 9A-9C , there is shown an ultrasonic aspirator  1  according to an exemplary embodiment. The ultrasonic aspirator  1  according an exemplary embodiment includes a body  5 , an irrigation tube  2  connected to the body  5  via an irrigation port  2   a,  an aspirator wand  15  extending from the body  5 , a headpiece  20  having a working surface  25 , and a suction opening  30 . Further, as shown in  FIG. 9A , there is provided endoscope  50  located at an end of the body  5 . 
         [0076]    According to an exemplary embodiment, the ultrasonic aspirator  1  includes an endoscope tube  52  extending toward the headpiece  20  and terminating at the endoscope opening  53 , as shown in  FIGS. 9B and 9C , which is at a location proximal of the headpiece  20  to the body  5 . The endoscope opening  52  is integrally formed with the shield  10 . However, it will be understood that the endoscope opening  52  is not limited to being integrally formed with the shield  10 . The endoscope opening  52  may be provided at any location on the ultrasonic aspirator  1  to provide a user with a good visualization of the area that is targeted by the user. In this manner, a safety of the ultrasonic aspirator will be improved. 
         [0077]      FIGS. 10A-10C  show an ultrasonic aspirator according to an exemplary embodiment. The ultrasonic aspirator  1  includes a body  5 , an irrigation tube  2  connected to the body  5  via an irrigation port  2   a,  an aspirator wand  15  extending from the body  5 , and a headpiece  20  having a working surface  25 . 
         [0078]    As shown in  FIGS. 10B and 10C , there is provided a suction opening  30  on one side of the headpiece  20 , the suction opening  30  being proximal of a distal end of the headpiece  20  and working surface  25  with respect to the body  5 . 
         [0079]    According to an exemplary embodiment, the suction opening  30  provided at the proximal location prevents damage from occurring to areas that are not targeted by the user. That is, when the working surface  25  of the headpiece  20  removes tissue or other debris, the debris is sucked through suction opening  30 . In the conventional art, the suction opening  30  is provided on a distal end of the headpiece  20  and working surface  25 , as shown in  FIGS. 1B and 1D . In the conventional art, a user must extend the headpiece  20  toward the debris. However, this can cause unintentional contact between the headpiece  20  and objects that have not been targeted. Thus, by having the suction opening  30  provided at a position proximal of a distal end of the headpiece  20  with respect to the body  5 , such unintentional contact can be avoided. 
         [0080]    Further, although not shown, the ultrasonic aspirator  1  of  FIGS. 10A-10C  may include a guard  35 . It will be understood that the guard could be integrally formed with the headpiece  20  or in any other manned, according to the exemplary embodiments. 
         [0081]    Referring to  FIGS. 11A-11C , there is provided an ultrasonic aspirator  1  according to an exemplary embodiment. While not shown, it will be understood that the ultrasonic aspirator  1  may include a body  5 , an irrigation tube  2  connected to the body  5  via an irrigation port  2   a,  and an aspirator wand  15  extending from the body  5 . As shown in each of  FIGS. 11A-11C , a shield  10  is provided to cover the aspirator wand  15  and a headpiece  20  having a working surface  25  extending from the shield  10 . 
         [0082]    The headpiece  20  may include a sensor to determine when the density of an object is changed. That is, a user may be using the ultrasonic aspirator in an environment having objects, such as tissues, of various densities. According to an exemplary embodiment, there is provided a pressure sensor  55   a,  an ultrasound sensor  55   b,  or a displacement sensor  55   c  on the headpiece  20 . The sensor determines when the density of an object which the working surface  25  is in contact with changes. Once the sensor determines that the density of the object changes, the ultrasonic aspirator may be turned off, or a mode of the ultrasonic aspirator  1  may be switched. In this manner, a user can prevent unintentionally damaging tissue surrounding the targeted tissue. It will be understood that a pressure sensor  55   a,  an ultrasound sensor  55   b,  or a displacement sensor  55   c  are merely exemplary embodiments, and the sensor may be any sensor known in the art to determine a change in density of an object which the working surface  25  is contacting. 
         [0083]      FIGS. 12A-12C  are views showing a conventional ultrasonic aspirator  1  having a headpiece  20  with a working surface  25  containing projections  25   a.  The projections  25   a  allow a user to use the ultrasonic aspirator  1  as a cutting instrument in addition to using the vibration of the headpiece  20  to destroy tissue. Similar to the conventional ultrasonic aspirator  1  of  FIGS. 1A-1D , the ultrasonic aspirator  1  shown in  FIGS. 12A-12C  includes a body  5 , an aspirator wand  15  (not shown), a shield  10  covering the aspirator wand  15 , and an irrigation hose connected to the body  5  via an irrigation port  2   a.  The headpiece  20  having the working surface  25  with projections  25   a  is removably attached to a distal end of the aspirator wand. 
         [0084]    Referring to  FIGS. 13A-13D , there is shown an ultrasonic aspirator  1  according to an exemplary embodiment. The ultrasonic aspirator  1  includes a body  5 , an aspirator wand  15  (not shown), a shield  10  covering the aspirator wand  15 , and an irrigation hose connected to the body  5  via an irrigation port  2   a.  A headpiece  20  having a working surface  25  with projections  25   a  is removably attached to a distal end of the aspirator wand  15 . The projections  25   a  allow the use of the ultrasonic aspirator  1  in a knifelike manner to cut objects and other debris, in addition to using the vibration of the headpiece  20  to destroy tissue. As shown in  FIGS. 13B-13D , the headpiece  20  includes a guard  35  integrally formed with the headpiece  20  according to an exemplary embodiment. As shown in  FIG. 13B , the guard  35  extends past the headpiece  20  in a direction distal to the body  5 . Thus, the guard  35  protects tissue surrounding the targeted tissue from being unintentionally destroyed while using the ultrasonic aspirator  1 . 
         [0085]      FIGS. 14A-14D  show an ultrasonic aspirator  1  according to an exemplary embodiment. Similar to the embodiment shown in  FIGS. 13A-13D , the ultrasonic aspirator  1  includes a body  5 , an aspirator wand  15  (not shown), a shield  10  covering the aspirator wand and an irrigation hose connected to the body  5  via an irrigation port  2   a.  A headpiece  20  having a working surface  25  with knifelike projections  25   a  is removably attached to a distal end of the aspirator wand  15 . As shown in  FIG. 14B , the guard  35  extends from the shield  10  and is separated from the headpiece  20  by a space. As shown in FIGS,  13 B and  13 D, the guard  35  extends past the headpiece  20  in a direction distal to the body  5  and does not contact the headpiece  20 . 
         [0086]    Referring to  FIGS. 15A and 15B , a headpiece  20  according to an exemplary embodiment is shown. The headpiece  20  includes a working surface  25  that is curved and a guard  35  extending past the headpiece  20  in a direction distal to the body  5  and following a contour of the headpiece  20 . However, exemplary embodiments are not limited to this shape. 
         [0087]    As shown in  FIG. 15A , the working surface  25  of the headpiece  20  has a width greater than the width of the headpiece  20 . This configuration provides a large contact surface for the working surface  25  to remove tissue. Further, the guard  35  has a same or greater width as the working surface  35   a  and protects tissue outside the targeted area from being contacted by the working surface  35   a.    
         [0088]      FIG. 16  shows a headpiece  20  have a working surface  25  according to an exemplary embodiment. The working surface  25  is flexible to enable the headpiece  20  to access nonlinear access ports and to contact objects that are not easily accessible in an area of the body. 
         [0089]    The working surface  25  may include hinges or may be formed of a material that is malleable along an entire surface. However, exemplary embodiments are not limited thereto. Further, the flexible area is not limited to the working surface  25 , and the flexible area may include a part or the entirety of the headpiece  20 . In addition, while not shown, a guard may be provided for the headpiece  20 . The guard may extend past the headpiece  20  and working surface  25  in a direction distal to the body  5  and does not contact the headpiece  20  or working surface  25 . Further, the guard may be rigid or may be flexible to follow the movement of the flexible working surface  25  and headpiece  20 . 
         [0090]    The flexible portion of the headpiece  20  moves according to an input by a user. While not shown, an exemplary embodiment includes handles or another input mechanism by which to manipulate the flexible portion of the headpiece  20 . The headpiece  20  may be manipulated such that the headpiece  20  can be moved in a three-hundred-sixty degree rotation around an axis of the headpiece  20 . In this manner, the surgeon may manipulate the headpiece  20  to access areas of the surgical area that would otherwise be difficult to access with a rigid or straight headpiece  20 . It will be understood that if the ultrasonic aspirator  1  includes a guard  35 , the guard  35  may bend along with the headpiece  20  or the guard  35  remain rigid with the headpiece  20  bending by the user&#39;s input. 
         [0091]    Referring to  FIGS. 17A-47D , there is shown an ultrasonic aspirator  1  according to an exemplary embodiment. The ultrasonic aspirator  1  includes a body  5 , an irrigation tube  2  connected to the body  5  via an irrigation port  2   a,  an aspirator wand  15  (not shown) extending from the body  5 , a shield  10  covering the aspirator wand  15 , and a headpiece  20  having a working surface  25 . The working surface  25  of  FIGS. 17B-17D  include projections  25   a.  However, the working surface  25   a  is not limited thereto. 
         [0092]    As shown in  FIG. 17B , a guard  35  extends from the shield  10  to extend past the headpiece  20  and working surface  25  in a direction distal to the body  5  and does not contact the headpiece  20  or working surface  25 . However, the guard  35  is not limited to this configuration, and may be any configuration according to the exemplary embodiments disclosed herein. 
         [0093]    Guard  35  includes a stimulator or sensor  35   a  at a distal end of the guard  35  and a stimulator or sensor wire  35   b  extending from the stimulator  35   a.  The stimulator or sensor  35   a  receives as input a pressure, vibration, electrical or other input of adjacent structures, including an adjacent nerve, during the removal of tissue and other debris. When the stimulator/sensor  35   a  receives the input from an adjacent structure, a signal is sent from the stimulator  35   a  down the stimulator wire  35   b  to a user interface (not shown). In this manner, the user is made aware of an adjacent neural structure to the area that debris and tissue are being removed. This allows the user to avoid this structure, which provides an added safety measure during aspiration. In addition an electrical signal could be sent from an external source (not shown) from the stimulator wire to the stimulator which if adjacent to a neural structure could result in electrical stimulation of that structure which can be detected by sensors placed on or in skin, muscles, subcutaneous tissue or other manner known in the art in a distal area of the body enervated by that neural structure. In addition, the stimulator  35   a  provides additional information to a user, especially a user new to the aspiration technique, and helps prevent trauma from an unintentional contact between the headpiece  20  and the adjacent structure. Although the stimulator  35   a  is provided at a distal end of the guard  35 , the stimulator  35   a  is not limited thereto, and may be provided at any location along the guard  35  to provide information of an adjacent object to the user. Further, although a stimulator wire  35   b  is provided to send a signal from the stimulator  35   a  to a user interface, exemplary embodiments are not limited thereto. The signal may be sent in any manner known in the art, including, but not limited to, using a wireless signal. This integrated nerve stimulator/sensor can be added to all shields in this application. 
         [0094]    As shown in  FIGS. 18A and 18B , there is provided a conventional ultrasonic aspirator  1  having a body  5  and a shield  10 , where the body  5  is angled. 
         [0095]    Referring to  FIG. 18B , there is provided an ultrasonic aspirator  1  according to an exemplary embodiment having a body  5  and a shield  10 , where the shield  10  and wand  15  are angled. According to an exemplary embodiment, the angled portion of the shield  10  and the wand  15  may be of varying length and diameter. 
         [0096]      FIG. 19  shows an exemplary embodiment of an ultrasonic aspirator  1  having a working area  25  which includes a grasper. The ultrasonic aspirator  1  further includes a guard  35  extending past the headpiece  20  in a direction distal to the body  5 , an endoscope  50 , and a light  45 . The grasper on the working area  25  is operated using the finger notch  60  and the grasper handle  61  provided on the body  5 . The endoscope  50  and the light  45  provide a user with a better visualization field, which improves performance of the ultrasonic aspirator  1  and improves safety. Further, the guard  35  protects adjacent tissue from the grasper provided on the working area  25 . 
         [0097]      FIG. 20A  shows a conventional Kerrison-Ronguer action ultrasonic aspirator  1 . The base  5  includes handles  65  to manipulate the working area  25 .  FIG. 20B  shows a Kerrison-Ronguer ultrasonic aspirator  1  according to an exemplary embodiment, further including a guard  35 , an endoscope  50  having an endoscope opening  52 , and a light  45 . The ultrasonic aspirator  1  may include one or more of the guard  35 , the endoscope  50 , or the light  45 . Further, the guard  35  extending past the headpiece  20  in a direction distal to the body  5 . 
         [0098]    Referring to  FIG. 21 , there is shown all ultrasonic aspirator  1  having a body  5 , an irrigation hose  2  connected to the body  5 , a shield  10  covering an aspirator and (not shown), and a headpiece  20  connected to the aspirator wand. In addition, the ultrasonic aspirator  1  includes an integrated retractor  70  provided at an end of the ultrasonic aspirator  1  in a direction distal of the body  5 . The retractor  70  allows the user to move structures during aspiration. According to an exemplary embodiment, the retractor  70  may be used to retract a nerve root during spinal disc removal. However, exemplary embodiments are not limited thereto. 
         [0099]    Although exemplary embodiments of the disclosure have been shown and described, it would be appreciated by those skilled in the art that changes may be made in these exemplary embodiments without departing from the principles and spirit of the exemplary embodiments, the scope of which is defined in the claims and their equivalents.