Abstract:
An apparatus and method for collecting particulate bone from the operating site during an osteotomy or bone drilling procedure so that it can be used subsequently to augment the bone fusion process. A bone cutting or drilling tool is provided with a module for collecting particulate bone simultaneously with cutting or drilling the bone. The collected particulate bone is transferred continuously to a sterile containment module and maintained under sterile conditions until it is prepared for re-use in the patient.

Description:
CROSS-REFERENCE TO RELATED APPLICATION 
     This application is a continuation of Ser. No. 11/409,816 filed Apr. 24, 2006 now abandoned. 
    
    
     BACKGROUND OF THE INVENTION 
     1. Field of the Invention 
     The present invention has to do with apparatus and methods for performing osteotomies and drilling holes in bones. More specifically, the invention relates to apparatus and methods for harvesting bone from the operating site during the osteotomy or bone drilling procedure so that it can be used to augment the bone fusion process. 
     2. The Related Art 
     Osteotomies are routinely performed for surgical access or to divide (and reposition) a bone for the correction of a skeletal deformity. Holes may be drilled in bones for various reasons to accommodate screws, pins and various other implantable devices and materials or to take a bone sample for analysis. 
     One of the more common examples of an osteotomy for surgical access is a craniotomy. In this procedure, the surgeon removes a significant portion of the patient&#39;s skull (termed a craniotomy flap, a cranial flap, a skull flap or bone flap) for access to the brain. The removed section of the skull is set aside in a sterile field and at the end of surgery, it is returned to its original position and affixed to the native skull, typically with plates and screws. The intent of the surgeon is to restore the patient&#39;s skull to its original contour and to provide physical protection for the brain. The ideal outcome would be complete fusion of the craniotomy flap to the native skull, leaving no long term bony deficit or weakness. In addition, many surgeons would prefer there to be minimal foreign bodies remaining and no imaging artifacts postoperatively. Unfortunately this is difficult to accomplish with the current surgical techniques. 
     The surgical instrument used to cut the craniotomy (a craniotome) utilizes a rotating cutter approximately 2 mm in diameter. The bone that is removed by this instrument is lost during surgery and as a result, when the cranial flap is returned to its original position, there is a gap around the entire periphery which corresponds to the diameter of the cutter. This gap creates a number of problems. The most obvious deficiency is that bone-to-bone contact, essential for achieving bony fusion, is impossible around the periphery of the cranial flap. This continuous gap (or kerf) creates a surgical “dead space” which is never desirable, it also allows soft tissue (the scalp and dura) to intrude into this space and inhibit bony healing. The step-off between the skull and cranial flap also may result in a cosmetic deformity for the patient. To combat these problems, surgeons use one or more strategies which have their own shortcomings. For example, the surgeon may choose to bias the cranial flap toward one side of the craniotomy. This produces bone-to-bone contact in a local area but increases the gap elsewhere around the periphery. 
     The surgeon may also elect to fill the gap between the skull and skull flap with a material which will encourage bony fusion. These fill materials can be autologous, allograft, or artificial. Autologous bone grafts are harvested directly from the patient and are the “gold standard,” since they are inherently biocompatible, osteoconductive, osteoinductive, and osteogenic. Harvesting autologous bone is currently carried out by taking bone from a part of the patient&#39;s body other than the surgical site. This results in additional surgical time and the additional (surgical) harvest has its own attendant risk of complications such as donor site pain and morbidity. Allografts, derived from donor (cadaver) tissues, are only osteoconductive, and they involve considerable cost, pose the risk of disease transmission and are objectionable to certain religious groups. Artificial materials such as alloplastic bone cement are another alternative. These bone cements are almost always used in conjunction with plates and screws. The drawbacks to this approach include substantial additional cost, risk of infection and no certainty that the bone cement will ever remodel into actual bone. 
     While this problem is illustrated with a craniotomy example, it occurs whenever an osteotomy is created strictly for surgical access and the bones must be returned to their original positions in order to prevent a postoperative deformity or a functional problem. In the skull alone, this problem exists in skull base surgery, craniofacial tumor surgery and mandibular osteotomies for oncologic resection. At the conclusion of all these procedures, the surgical goal is to restore the original bony anatomy. This precludes achieving bone-to-bone contact of the severed ends since they must remain separated by the width of the blade (or cutter) used for the osteotomy. 
     Perforations (or holes) are routinely created in bones for surgical access and other reasons. These perforations may be performed for biopsy purposes, to create access for minimally invasive surgery or as the prelude to an osteotomy. An example of the latter is the burr hole that is initially created in the skull which allows the craniotome to be inserted for completion of the craniotomy. In these cases, it is desirable to close the perforation, preferably in a manner which restores the bone to its original condition. Additionally, holes are routinely drilled into bone as a step in preparation for orthopedic screw or pin insertion. Most of these cases would also benefit from the availability of autologous bone graft. 
     When osteotomies are used to divide a bone so that it may be repositioned to correct a surgical deformity, a different problem exists. In many cases, bone graft material is needed to fill the gaps created as the bones are repositioned and severed bony ends move relative to each other. This is obviously the case where a gap is intentionally created, such as an osteotomy to elevate a collapsed tibial plateau. It also may occur when the intent of the osteotomy is to decrease the bone volume. In these surgeries it is not uncommon for the contours of the bony ends to be slightly mismatched and in these cases the surgeon may elect to augment the fusion with additional bone graft material. As previously discussed, allograft bone, autogenous bone or alloplastic materials may all be used in such situations, each with their related problems. 
     In all these procedures where an osteotomy (or perforation) is necessary, a common problem exists: bone is removed by the osteotomy or drilling instrument and at the conclusion of surgery, additional bone is required to complete the reconstruction. 
     The current surgical practice is to manually irrigate the bone as it is cut and also to manually suction off the resulting solids and liquids into the operating room&#39;s non-sterile vacuum system. These activities are performed concurrently by other operating room personnel while the surgeon operates the osteotomy instrument. Some of the shortcomings of these practices are detailed in the following text which is excerpted from the USC Neurosurgery website. (http://uscneurosurgery.com/infonet/ecrani/instruments.htm). 
     Irrigation
         With even optimal illumination and magnification and organization of his field, the surgeon is still incapacitated by obscuring blood, cloudy irrigation fluid, or other debris. Efficient intracranial surgery requires keeping the operative field clear of physical and visual obstacles by diligent irrigation, attentive aspiration, and meticulous hemostasis.   Irrigation and aspiration are complimentary aspects of surgical field maintenance. The irrigating-aspirating assistant must concentrate on following the movements of the surgeon&#39;s hands visually and with irrigant and suction. Areas of surgical interest are most safely addressed at the time of maximal cleanliness; immediately after they have been washed clean and aspirated dry.   Irrigant should be squirted onto the field under enough pressure to displace blood, but if the bulb is squeezed too hard and fluid issues under too much pressure, fluid from the bulb will be reflected back against the stream because it cannot dissipate fast enough, with the consequence that a splashing of mixed blood-irrigant fluid ends up in the surgeon&#39;s face and widely scattered across the field. Better control of the stream from the irrigation fluid bulb is achieved by manipulating it with the dominant hand.   The primarily aqueous solution used for surgical irrigation not only dilutes the blood but pushes it ahead of the irrigant stream. This washing force is greatest at the tip of a irrigation bulb where the irrigant fluid pressure is maximal.       

     Suction
         Blood accumulates with irrigation fluid in dependent portions of the field as it escapes and is washed from lacerated vessels. The bloody fluid then interferes with the working of the electrocautery devices used to stop further bleeding from the openings in the vessels. To this is added the problem of blood&#39;s opacity, so that even in small quantities as even a thin layer, it obscures the surgical field.   Suction is a maintenance activity, keeping the operative field clear of debris, blood, or smoke that can obstruct visualization. Whenever possible the suction attachment should be held in the non-dominant hand.   Surgical field suction instrumentation attaches to the same suction canisters which provide suction for anesthesia. Distally non-sterile, proximally sterile tubing connects the suction device to the distal end of the metal suction handle and tip. The proximal end of the metal sucker connects to the suction tubing.       

     The importance and difficulty of performing simultaneous irrigation and suction in concert with the surgeon&#39;s movements are detailed above. Later in the text they discuss the importance of irrigation when cutting the bone:
         Bone is perforated and/or cut in the course of any intracranial trauma surgery. Irrigation accomplishes two purposes in the setting of drilling bone. First, it cools down the bone. This is important in terms of the mechanics of bone cutting. The bits cut more effectively through cooler bone and in the absence of bone dust that can clog its rotations.       

     These comments are directed toward neurosurgical craniotomies but the same principles apply to all osteotomies and perforations. Proper irrigation not only improves the efficiency of the cutting instrument, it also prevents thermal necrosis of the bone which can later retard the healing process. This principle takes on even greater importance when one intends to collect the bone particles generated during the cutting process and reuse them in surgery. Irrigation has traditionally been conducted using a liquid. But according to the present invention we can irrigate with a liquid or compressed gas source or a combination of liquid and a compressed gas source. The compressed gas can be chilled if required and also can be intermixed with a fluid (e.g., saline). 
     Up until now, a reliable and essentially free source of autogenous bone has been overlooked by the surgical community. Manufacturers of surgical cutting instruments have incorporated irrigation on some instruments but none have ever proposed taking the concept one step further—collecting the bone particulate in a sterile fashion for later use in the bony reconstructive phase of the surgery. 
     We have now developed apparatus and methods for sterilely collecting and containing the particulate bone created during osteotomy and bone drilling procedures. The apparatus and methods also enable more controlled irrigation of the bone as it is cut or drilled and a reduction in the amount of patient bone that is scattered or aerosolized during surgery. 
     The terms particulate bone, bone particulate and bone particles are used interchangeably in this patent and all are intended to have the same meaning. 
     SUMMARY OF THE INVENTION 
     A collection module is provided on the cutting end, also referred to herein as the distal end, of a bone cutting tool to prevent the scatter and loss of particulate bone created at the operating site during an osteotomy or bone drilling procedure. The collection module suctions off the bone particulate as well as irrigant, blood and other body fluids and reduces contamination of the surgical field from the cutting operation. The module can be partially or completely disposable. 
     The collection module contains a suction port which evacuates the particulate bone from the cutting operation. A sterile containment module is provided downstream for collecting the particulate bone and separating it from irrigant and body fluids suctioned off from the surgical field. 
     An irrigation system is incorporated in some cutting tools and when it is not, it can be incorporated in the collection module to provide a reliable and effective source of irrigation to the cutting area. The irrigant prevents thermal necrosis, prevents the formation of bone dust, improves cutting efficiency and improves visibility within the surgical field. As previously disclosed, the irrigation system in our invention can disperse fluids, gasses or a combination of the two. 
     The sterile bone particles which are harvested according to the invention are used to augment the reconstructive portion of the surgery. The particulate bone can be used “as is” or mixed with any number of readily available additives such as, but not limited to: 
     a. Patient&#39;s blood; 
     b. Patient&#39;s platelet rich plasma (PRP); 
     c. Bone morphogenic proteins; 
     d. Other bone growth factors; and 
     e. Antibiotics. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The drawing figures are provided for purposes of illustrating the elements of the invention and are not intended to be drawn to scale. 
         FIG. 1  is an expanded perspective view of a bone cutting tool (a craniotome) of the invention which has been provided with integral irrigation and suction systems. A collection module of the invention is illustrated to the left before attachment to the tool. The craniotome is attached to a handpiece which in turn is attached to a pneumatic line or an electric power source. 
         FIG. 2  is a perspective view of the craniotome of  FIG. 1  with the collection module and the pneumatic line attached. 
         FIG. 3  is an elevation view of the craniotome of  FIG. 2 . 
         FIG. 3A  is a view of the left end of  FIG. 3 . 
         FIG. 4  is a section view of  FIG. 3A  taken at section line  4 - 4  of  FIG. 3A  and illustrating a portion of the suction system. 
         FIG. 4A  is a section of  FIG. 3A  taken at section line  3 - 3  of  FIG. 3A  and illustrating a portion of the irrigation system. 
         FIG. 5  is an elevation view of a collection module of the invention. 
         FIG. 6  is a distal end view of the collection module of  FIG. 5 . 
         FIG. 7  is a section view of the collection module of  FIGS. 5 and 6 . 
         FIG. 8  is an expanded elevation view of a standard prior art craniotome and a collection module of the invention. This embodiment of a collection module is for use with standard craniotomes and is illustrated to the left before attachment to the tool. 
         FIG. 9  is an elevation view of the craniotome of  FIG. 8  with the collection module and the pneumatic line attached. 
         FIG. 9A  is a view of the left end of  FIG. 9 . 
         FIG. 10  is a section view of  FIG. 9A  taken at section line  10 - 10  of  FIG. 9 . 
         FIG. 11  is an elevation view of the collection module of  FIGS. 8-10 . 
         FIG. 12  is a distal end view of  FIG. 11 . 
         FIG. 13  is a section view of the collection module of  FIGS. 11 and 12  taken at section line  13 - 13  of  FIG. 12 . 
         FIG. 14  is an illustration of an apparatus of the invention in operation during a cranial osteotomy. 
         FIG. 15  is a perspective view of a drill guide of the invention which can suction and collect bone particulate during a bone drilling procedure. 
         FIG. 16  is a bottom view of  FIG. 15 . 
         FIGS. 17 and 18  are partial section views of  FIG. 16 .  FIG. 17  is taken at section line  17 - 17  of  FIG. 16  and  FIG. 18  is taken at section line  18 - 18  of  FIG. 16 . 
         FIG. 19  is a perspective view of the guide of  FIG. 15  illustrating the relationship of the guide to a drill and a bone plate. 
         FIG. 20  is a partial section of  FIG. 19  taken at section line  20 - 20  of  FIG. 19 . 
         FIG. 21  is a perspective view of another embodiment of a bone particulate collection system for use with a drill. 
         FIG. 22  is a distal end view of  FIG. 21 . 
         FIG. 23  is a section view of  FIG. 22  taken at section line  23 - 23  of  FIG. 22 . 
         FIG. 24  is an elevation view of a transparent embodiment of the  FIG. 21  collection module affixed to a drill. 
         FIG. 25  is an enlarged section view of a portion of  FIG. 24 . 
         FIG. 26  illustrates a sterile containment module of the invention. 
     
    
    
     DESCRIPTION OF THE PREFERRED EMBODIMENT 
       FIG. 1  is an expanded perspective view of a bone cutting tool of the invention having integral irrigation and suction systems. The tool is a craniotome which is used to cut an opening in the skull for brain surgery. The craniotome  1  is attached to a handpiece  2  which in turn is attached to a pneumatic line  3  (see  FIGS. 2-4 ) or an electric power source. Cutting burr  5  has a diameter and an axis and is actuated by a foot switch (not shown). And the foot plate  6  is used to guide the tool along the inside of the skull in order to prevent penetration of the dura. A suction tube  11  is provided with a barbed fitting  12  and an irrigation tube  13  has a barbed fitting  14 . Collection module  10  is illustrated before it is attached to craniotome  1 . 
       FIG. 2  is a perspective view of  FIG. 1  with the collection module  10  of the invention attached to the craniotome. A flexible bellows  15  is shown in this embodiment with a cylindrical duct in the form of shield  16  and a cap in the form of elastomeric seal  17  affixed at the distal end of the shield, the proximal end of the shield being affixed to the distal end of the bellows. The shield  16  has a diameter and is approximately coaxial with the axis of the cutting burr  5 . The shield normally will be comprised of a relatively stiff, clear plastic tube. 
       FIG. 3  is an elevation view of  FIG. 2  and  FIG. 4  is a section view of  FIG. 3 . 
       FIG. 4  illustrates suction tube  11  which has an open mouth  23  at its distal end around cutting burr  5 .  FIG. 4A  is a different section view of  FIG. 3  which illustrates irrigation tube  13  of the irrigation system. 
       FIG. 5  illustrates the collection module  10  in an elevation view and  FIG. 6  illustrates the distal end of the collection module  10 .  FIG. 7  is a section view of the collection module  10 . 
       FIG. 8  illustrates in expanded elevation another embodiment of the invention. Collection module  110  is made for use with a standard prior art craniotome  101 , the craniotome having a distal end  102 .  FIG. 9  is an elevation view of craniotome  101  with collection module  110  affixed thereto. The collection module  110  comprises a housing  103  (see also  FIG. 13 ) having an inner wall  104 , an outer wall  107  coaxially disposed around the inner wall and spaced therefrom, and an end wall  108  capping the distal end of the outer wall. The collection module  110  further comprises a suction tube  111  having a barbed fitting  112 , an irrigation tube  113  having a barbed fitting  114 , a flexible bellows  115  and a clear cylindrical tubular shield  116 , the flexible bellows  115  and tubular shield  116  disposed around the housing  103  and extending distally beyond the distal end thereof. An optional indicator tab  119  is also illustrated. The craniotome has a foot plate  106  and a cutting burr  105 . 
       FIG. 10  is a section view of  FIG. 9  illustrating the relationship of the elements of collection module  110  to the craniotome  101 . In particular, the suction tube  111  connects to a suction channel  121  and the irrigation tube  113  connects to an irrigation channel  123 , the suction channel  121  and the irrigation channel  123  being disposed between the inner wall  104  and the outer wall  107 . 
       FIG. 11  is an elevation view of the collection module  110  by itself. The collection module  110  provides the irrigation and suction capability needed to carry out the objectives of the invention when a standard craniotome having no irrigation or suction capability is employed. (Some commercially available craniotomes have irrigation capability in which case the embodiment of  FIG. 11  described herein can be made with suction capability but without irrigation capability as will be apparent to those skilled in the art.) This embodiment does not employ a seal of the type illustrated as element  17  in  FIGS. 1-7 . In  FIG. 12 , the distal end of the module is illustrated with a slot or opening  118  for a cutting burr and foot plate. An irrigation port  133  is also provided in end wall  108 . Referring to the section view  FIG. 13 , the irrigation port  133  and the irrigation channel  123  are illustrated as well as the suction channel  121  and a suction port  131 . 
       FIG. 8  illustrates in expanded elevation another embodiment of the invention. Collection module  110  is made for use with a standard prior art craniotome  101 .  FIG. 9  is an elevation view of craniotome  101  with collection module  110  affixed thereto. The collection module  110  comprises a suction tube  111  having a barbed fitting  112 , an irrigation tube  113  having a barbed fitting  114 , a flexible bellows  115  and a clear tubular shield  116 . An optional indicator tab  119  is also illustrated. The craniotome has a foot plate  106  and a cutting burr  105 . 
     The collection module  10  is adapted to the distal end of the craniotome  1  (as shown in  FIGS. 2-4 ). Module  10  mates with the outer diameter of the craniotome  1  and is sealingly engaged therewith. The two are aligned in the correct orientation to set the slot  18  in the seal  17  in-line with the footplate  6 . The burr  5  extends through slot  18  as illustrated in  FIGS. 2 and 3 . Slot  18  must be larger than burr  5 , as illustrated, and the diameter of shield  16  must be larger than slot  18  as illustrated in  FIGS. 3 ,  4 ,  4 A,  6  and  7 . Optional indicator tabs  19  (in the direction that the instrument will cut, arrow  20 ) can be used to facilitate correct orientation. The bellows  15  is constructed from an elastomer, allowing it to flex so that the distal portion of the collection module  10  can follow the irregularities of the skull  30  without excessive resistance. On the other end of the bellows is an internal lip seal  22  which prevents debris from being forced into the radial space between the craniotome  1  and the bellows  15 . It should be noted that the cutting burr, or the drill bit or saw blade in other tools, may or may not extend beyond the distal end of the module when the tool is not in use. This is because the collection module is sufficiently flexible to allow such burr, bit or blade to extend beyond the distal end of the module when the tool is in use. 
       FIG. 10  is a section view of  FIG. 9  illustrating the relationship of the elements of collection module  110  to the craniotome  101 . In particular, the suction tube  111  connects to a suction channel  121  and the irrigation tube  113  connects to an irrigation channel  123 . 
       FIG. 15  is a perspective view of a drill guide of the invention which can suction and collect bone particulate in a sterile environment during a bone drilling procedure. The guide  201  comprises a handle  202  and a collection module  210 . Sterile vacuum tube  241  connects to suction tube  211  and irrigant supply tube  243  connects to irrigation tube  213  during operation of the guide. Slot or opening  218  accommodates a drill bit  205  (see  FIGS. 19 and 20 ) and irrigation and suctioning take place generally through the same opening. A bottom view of guide  201  is illustrated in  FIG. 16 . 
       FIG. 11  is an elevation view of the collection module  110  by itself. The collection module  110  provides the irrigation and suction capability needed to carry out the objectives of the invention when a standard craniotome having no irrigation or suction capability is employed. (Some commercially available craniotomes have irrigation capability in which case the embodiment of  FIG. 11  described herein can be made with suction capability but without irrigation capability as will be apparent to those skilled in the art.) This embodiment does not employ a seal of the type illustrated as element  17  in  FIGS. 1-7 . In  FIG. 12 , the distal end of the module is illustrated with an opening  118  for a cutting burr and foot plate. An irrigation port  133  is also provided. Referring to the section view  FIG. 13 , the irrigation port  133  and the irrigation channel  123  are illustrated as well as the suction channel  121  and a suction port  131 . 
       FIG. 14  illustrates the operation of the distal (cutting) end of the embodiment of the invention illustrated in  FIGS. 1-7 . The craniotome  1  has a cutting burr  5  (and burr shaft  5   a ) and an integral foot plate  6 . Unlike current instruments, however, the improved craniotome of the invention has many advantageous features. In this embodiment, the craniotome also incorporates internal passages for suction and irrigation. Each of these terminates proximally in a barbed fitting. The collection module  10  comprises an elastomeric bellows  15 , a clear tubular shield  16  and an elastomeric seal  17 . The collection module can constitute a preassembled, sterile, disposable item, although other configurations are certainly possible. 
     The collection module  10  is adapted to the distal end of the craniotome  1  (as shown in  FIGS. 2-4 ). Module  10  mates with the outer diameter of the craniotome  1  and is sealingly engaged therewith. The two are aligned in the correct orientation to set the slot  18  in the seal  17  in-line with the footplate  6 . Optional indicator tabs  19  (in the direction that the instrument will cut, arrow  20 ) can be used to facilitate correct orientation. The bellows  15  is constructed from an elastomer, allowing it to flex so that the distal portion of the collection module  10  can follow the irregularities of the skull  30  without excessive resistance. On the other end of the bellows is an internal lip seal  22  which prevents debris from being forced into the radial space between the craniotome  1  and the bellows  15 . It should be noted that the cutting burr, or the drill bit or saw blade in other tools, may or may not extend beyond the distal end of the module when the tool is not in use. This is because the collection module is sufficiently flexible to allow such burr, bit or blade to extend beyond the distal end of the module when the tool is in use. 
     The shield  16  is a relatively stiff, clear tubular section that forms the radial wall of the collection module  10 . Attached to the distal end of the shield  16  is the elastomeric seal  17 . Ideally this would be a relatively clear material as well to aid in visualizing the cut. The seal  17  has an optionally, outwardly domed flexible end with a slot  18  to better contain and suction the bone particulate. The domed shape limits the contact area with the bone to reduce resistance. As the surgeon operates the craniotome, he applies both sideways force to cut as well as upward force to keep the tip of the footplate  6  in contact with the underside of the skull. This allows the footplate to ride between the dura  4  (the outer covering of the brain  104 ) and the inner table of the skull  30 . Ahead of the cutting burr  5  is solid skull  30  and trailing the cutting burr is the kerf  31 . The rotation of the cutting burr  5  and its helical flutes help to draw much of the bone particulate  32  upwards into a collection chamber  24  of the collection module. A funnel shaped depression or mouth  23  at the junction of the suction tube  11  and the distal face of the craniotome guides these bone fragments into the suction tube  11  and draws in by vacuum additional bone particles, irrigant and bodily fluids. The suction tube  11  is connected to a sterile vacuum tube  40 . A barbed fitting  12  is provided for this connection. The sterile vacuum tube  40  is connected downstream to a containment module  60  as will be discussed later. (See  FIG. 26 .) Suction is applied to tube  40  and the result is that all material aspirated into the collection module  10  (bone fragments, irrigant, blood, tissue, etc.) is evacuated in the direction of arrow  41 . The irrigation system is not illustrated because it is behind the suction system in this drawing. But the irrigation system is illustrated and discussed above in connection with  FIGS. 1 ,  2  and  4 A. Irrigant supply can be most easily provided from a pressurized IV bag of saline or from a hand syringe, peristaltic pump, sterile compressed gas source, or other common means. When the irrigant is a combination of gas and liquid an additional channel can be provided in either the craniotome of the invention (see  FIGS. 1-4  and  14 ) or the collection module, for the purpose of introducing a second irrigation means. This additional channel could communicate with the liquid channel to serve as a mixing device as will be apparent to those having skill in the art based on the disclosures herein. 
       FIG. 23  is a section view of collection module  310  illustrating a collection chamber  321  and irrigation duct  323  in relation to slot or opening  318 . 
       FIG. 15  is a perspective view of a drill guide of the invention which can suction and collect bone particulate in a sterile environment during a bone drilling procedure. The guide  201  comprises a handle  202  and a collection module  210 . Sterile vacuum tube  241  connects to suction tube  211  and irrigant supply tube  243  connects to irrigation tube  213  during operation of the guide. Opening  218  accommodates a drill bit  205  (see  FIGS. 19 and 20 ) and irrigation and suctioning take place generally through the same opening. A bottom view of guide  201  is illustrated in  FIG. 16 . 
       FIGS. 17 and 18  are section views of collection module  210  taken through line A-A and line B-B, respectively, of  FIG. 16 . The  FIG. 17  section illustrates a barbed fitting  212  at the end of suction tube  211  and the connection of tube  211  with suction chamber  221 . Irrigation channel  223  and irrigation ports  233  are illustrated. The  FIG. 18  section illustrates another part of suction chamber  221 . The  FIG. 18  section also illustrates the barbed fitting  214  at the end of irrigation tube  213  and the connection of tube  213  with irrigation channel  223 . 
     A perspective view illustrating the relationship of the guide with a drill  203 , drill bit  205  and a bone plate  206  is illustrated in  FIG. 19 .  FIG. 20  is a partial section of  FIG. 19  illustrating the relationship of drill bit  205  to the suction chamber  221 , irrigation channel  223  and irrigation ports  233 . During drilling, bone particulate is carried upward by the drill bit  205  and by suction. Suction vacuum tube  241  is connected to suction tube  211  and the particulate bone is carried by vacuum to a sterile containment module  60  (see  FIG. 26 ). The operating area is irrigated by irrigant exiting irrigation ports  233 . 
       FIG. 21  is a perspective view of another embodiment of a bone particulate collection system for use with a drill. Collection module  310  is comprised of an outer telescoping section  301  and an inner telescoping section  302 . A spring  304  is biased between section  301  and distal end section  303 . When drilling, inner telescoping section  302  telescopes into outer telescoping section  301  and when the drilling is complete spring  304  returns section  302  to its original position (as illustrated). Sterile vacuum tube  341  and irrigant supply tube  343  are also illustrated. 
       FIG. 22  is a distal end view of the collection module  310  also illustrating opening  318  which accommodates a drill bit  305  (see  FIGS. 24 and 25 ) and irrigation and suctioning take place through the same opening. 
       FIG. 23  is a section view of collection module  310  illustrating a collection chamber  321  and irrigation duct  323  in relation to opening  318 . 
       FIG. 24  is an elevation view of a transparent embodiment of collection module  310  affixed to drill  303  having a drill bit  305 . An enlarged section view of a portion of  FIG. 24  is provided in  FIG. 25 . Arrow  320  illustrates the direction of the telescoping movement of section  302  into section  301  when the drill bit is drilled into a bone. Spring  304  causes section  302  to return to the position illustrated when drilling is completed. Sterile vacuum tube  341  is in suctioning communication with suction chamber  321  and irrigant supply tube  343  is in irrigating communication with irrigation duct  323 . The suctioning and irrigating operations function in the same manner as the other embodiments of the invention discussed above. 
       FIGS. 1-25  depict just a few possible configurations of a cutting or drilling and collection apparatus of the invention which would be consistent with the method of the invention. The principles of the invention can easily be adapted to other osteotomy instruments (e.g. an oscillating saw, a rotary saw or a reciprocating saw) to achieve the same results. 
     According to the method of the invention, a surgeon can simultaneously cut or drill bone and irrigate and suction with essentially no additional effort. Eliminated is the splatter of the irrigant and cutting debris and also the need for an assistant to precisely coordinate with the movements of the surgeon as he or she irrigates and suctions. These benefits however, are secondary to the main purpose of the apparatus and method of the invention, namely, the ability to collect the sterile bone particulate generated by the osteotomy or drilling process for use in the reconstructive portion of the procedure. 
       FIG. 26  illustrates an embodiment of a sterile containment module  60  for the separation of the bone particles  32  from liquids  33 , the liquids comprising irrigant and body fluids. Unlike traditional hospital suction systems, this is a sterile system so that the bone particles collected can be reused in the reconstructive portion of surgery. 
     The aspirate from the containment chamber is conveyed though the sterile vacuum tube  40  to the containment module  60 . The aspirate consists of bone particles, irrigant, small amounts of tissue, blood and other body fluids. The containment module comprises three sterile parts: the canister  61 , the collection cup  62  and the cover  63 . Of course, other embodiments are certainly possible and would be apparent to those skilled in the art based upon the disclosures herein. It is envisioned that all three items would be provided as a sterile unit for single use. All could be produced (molded) from a clear polymer for visualizing the contents. The suction tube  40  connects to a fitting  64  molded into the cover. A second fitting  65  is then connected to the hospital suction system in a sterile fashion through tube  66 . The suction travels in the direction of the arrows  67 . When the aspirate enters the canister  61 , a deflector  68  forces the flow downward and gravity then separates the contents (solid and liquid) from the air flow. The solids and liquids fall into the cup  62  and settle to the bottom where perforations  69  allow the liquid to drain into the bottom of the canister  61 . Optionally the cup may be fitted with a filter to better trap the smaller bone particles. At the conclusion of the osteotomy or drilling procedure, the bone particles in the cup can be left to drain until needed, at which point the cover  63  is removed and the cup  62  is extracted with its sterile contents. As mentioned previously, the bone particles can then be used “as is” or mixed with other biological additives for use in the reconstructive portion of the procedure. 
     In today&#39;s operating room environment, the contents of the canister  61  described above are simply suctioned into the non-sterile hospital system and discarded. A valuable and much-needed commodity, (autologous) bone graft, is simply wasted and later replaced with autograft harvested from a second site, allograft or with alloplastic materials.