Patent Publication Number: US-2022226020-A1

Title: Tissue resecting instrument

Description:
CROSS-REFERENCE TO RELATED APPLICATION 
     This application is a continuation of U.S. patent application Ser. No. 16/793,126, filed on Feb. 18, 2020, the entire contents of which are hereby incorporated herein by reference. 
    
    
     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 including an outer shaft, a drive wire, a distal cutting tip, a hub housing, and a driver. The outer shaft defines a proximal end portion and a distal end portion. The distal end portion of the outer shaft defines a window therethrough. The drive wire extends through the outer shaft and defines a proximal end portion and a distal end portion. The distal cutting tip is disposed within the outer shaft and engaged with the distal end portion of the drive wire. The distal cutting tip at least partially overlaps the window. The hub housing is engaged with the proximal end portion of the outer shaft. The driver is disposed within the hub housing and is engaged with the proximal end portion of the drive wire. The driver is configured to be driven to rotate relative to the hub housing to thereby rotate the drive wire and distal cutting tip within and relative to the outer shaft. The driver defines an internal lumen and at least one lateral opening disposed in communication with the internal lumen. An outflow path is defined from the window through the outer shaft and about the drive wire, into an interior of the hub housing, through the at least one lateral opening, and through the internal lumen. 
     In an aspect of the present disclosure, the outer shaft includes a cutting edge surrounding the window. The cutting edge defines a plurality of cutting teeth. 
     In another aspect of the present disclosure the distal cutting tip defines a mouth in communication with the window in at least one rotational orientation of the distal cutting tip relative to the outer shaft. In such aspects, the outflow path may further be defined from the window through the mouth, through outer shaft and about the drive wire, into an interior of the hub housing, through the at least one lateral opening, and through the internal lumen. Additionally or alternatively, the distal cutting tip may include a plurality of teeth disposed along opposing sides of the mouth. 
     In yet another aspect of the present disclosure, a proximal extension extends proximally from the hub housing and defines an interior in fluid communication with the internal lumen such that the outflow path is further defined from the internal lumen into an interior proximal extension. In such aspects, the proximal extension may further define an outflow opening to further define the outflow path from the interior of the proximal extensions through the outflow opening. 
     Another end effector assembly of a tissue-resecting device provided in accordance with aspects of the present disclosure includes an outer shaft, a driver wire, a distal cutting tip, a hub housing, and a driver. The outer shaft defines a proximal end portion and a distal end portion defining a window therethrough. The drive wire extends through the outer shaft and defines a proximal end portion and a distal end portion. The proximal end portion of the drive wire includes a longitudinally-extending segment and a finger disposed at an angle relative to a longitudinally-extending segment. The distal cutting tip is disposed within the outer shaft, engaged with the distal end portion of the drive wire, and at least partially overlaps the window. The hub housing is engaged with the proximal end portion of the outer shaft. The driver is disposed within the hub housing, and defines a longitudinally-extending slot and a transverse slot disposed in communication with the longitudinally-extending slot at an angle relative thereto. The longitudinally-extending slot is configured to receive the longitudinally-extending segment of the drive wire and the transverse slot configured to receive the finger of the drive wire to thereby engage the driver with the proximal end portion of the drive wire. The driver is configured to be driven to rotate relative to the hub housing to thereby rotate the drive wire and distal cutting tip within and relative to the outer shaft. 
     In an aspect of the present disclosure, the finger is disposed at about a 90 degree angle relative to the longitudinally-extending segment and the transverse slot is disposed at about a 90 degree angle relative to the longitudinally-extending slot. 
     In another aspect of the present disclosure, the outer shaft includes a cutting edge surrounding the window. The cutting edge defines a plurality of cutting teeth. 
     In still another aspect of the present disclosure the distal cutting tip defines a mouth in communication with the window in at least one rotational orientation of the distal cutting tip relative to the outer shaft. In such aspects, the distal cutting tip may include a plurality of teeth disposed along opposing sides of the mouth. 
     In yet another aspect of the present disclosure, adhesive between at least one of the longitudinally-extending slot and the longitudinally-extending segment or the transverse slot and the finger further secures engagement of the driver with the proximal end portion of the drive wire. 
     In still yet another aspect of the present disclosure, the driver is overmolded about the proximal end portion of the drive wire to thereby define the longitudinally-extending slot receiving the longitudinally-extending segment and the transverse slot receiving the finger and engage the driver about the proximal end portion of the drive wire. 
     In another aspect of the present disclosure, the driver defines first and second lateral openings on either side of the longitudinally-extending slot and disposed in communication with an internal lumen of the driver. 
     Another end effector assembly of a tissue-resecting device provided in accordance with aspects of the present disclosure includes an outer shaft, a drive wire, a distal cutting tip, a hub housing, a driver, and a connector. The outer shaft defines a proximal end portion and a distal end portion defining a window therethrough. The drive wire extends through the outer shaft and defines a proximal end portion and a distal end portion. The distal cutting tip is disposed within the outer shaft, engaged with the distal end portion of the drive wire, and at least partially overlaps the window. The hub housing is engaged with the proximal end portion of the outer shaft. The driver is disposed within the hub housing and configured to be driven to rotate relative to the hub housing. The connector couples the proximal end portion of the drive wire with the driver such that rotation of the driver relative to the hub housing thereby rotates the drive wire and distal cutting tip within and relative to the outer shaft. 
     In an aspect of the present disclosure, the outer shaft includes a cutting edge surrounding the window. The cutting edge defines a plurality of cutting teeth. 
     In another aspect of the present disclosure the distal cutting tip defines a mouth in communication with the window in at least one rotational orientation of the distal cutting tip relative to the outer shaft. In such aspects, the distal cutting tip may include a plurality of teeth disposed along opposing sides of the mouth. 
     In still another aspect of the present disclosure, the connector is engaged with the proximal end portion of the drive wire in a first manner and is engaged with the driver in a second, different manner. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       Various aspects and features of the present disclosure are described hereinbelow with reference to the drawings wherein like numerals designate identical or corresponding elements in each of the several views. 
         FIG. 1  is a perspective view of an end effector assembly of a tissue resecting instrument provided in accordance with aspects of the present disclosure; 
         FIG. 2  is an enlarged, perspective view of a proximal end portion of the end effector assembly of  FIG. 1 ; 
         FIG. 3  is a partial, longitudinal, cross-sectional view taken across section line “ 3 , 4 - 3 , 4 ” of  FIG. 2 ; 
         FIG. 4  is a longitudinal, cross-sectional view taken across section line “ 3 , 4 - 3 , 4 ” of  FIG. 2 ; 
         FIG. 5  is an exploded, perspective view of the end effector assembly of  FIG. 1 ; 
         FIG. 6  is an enlarged, perspective view of the area of detail indicated as “ 6 ” in  FIG. 5 ; 
         FIG. 7  is an exploded, perspective view illustrating a drive wire, a cutting tip, and a portion of a drive assembly of the end effector assembly of  FIG. 1 ; 
         FIG. 8  is an enlarged, perspective view of the area of detail indicated as “ 8 ” in  FIG. 5 ; 
         FIG. 9  is an exploded, perspective view illustrating an outer shaft and a portion of a hub assembly of the end effector assembly of  FIG. 1 ; 
         FIGS. 10-12  are enlarged, perspective views of the area of detail indicated as “ 10 ” in  FIG. 1 , illustrating rotation of the cutting tip within and relative to the outer shaft; 
         FIG. 13  is a longitudinal, cross-sectional view taken across section line “ 13 - 13 ” of  FIG. 10 ; 
         FIG. 14  is an enlarged, perspective view of another configuration of the distal end portion of the end effector assembly of  FIG. 1 ; 
         FIG. 15  is a longitudinal, cross-sectional view taken across section line “ 15 - 15 ” of  FIG. 14 ; 
         FIG. 16  is an enlarged, perspective view of yet another configuration of the distal end portion of the end effector assembly of  FIG. 1 ; 
         FIG. 17  is a longitudinal, cross-sectional view taken across section line “ 17 - 17 ” of  FIG. 16 ; 
         FIG. 18  is an enlarged, perspective view of a distal end portion of another end effector assembly provided in accordance with aspects of the present disclosure; 
         FIG. 19  is an enlarged, perspective view of a distal end portion of still yet another end effector assembly provided in accordance with aspects of the present disclosure; 
         FIG. 20  is a longitudinal, cross-sectional view taken across section line “ 20 - 20 ” of  FIG. 19 ; 
         FIG. 21  is a longitudinal, cross-sectional view taken across section line “ 21 - 21 ” of  FIG. 20 ; 
         FIG. 22  is a longitudinal, cross-sectional view of another configuration for engaging a drive wire with a distal driver of the end effector assembly of  FIG. 1 ; and 
         FIG. 23  is a perspective view of a tissue resecting instrument provided in accordance with aspects of the present disclosure including the end effector assembly of  FIG. 1  engaged with a handpiece assembly. 
     
    
    
     DETAILED DESCRIPTION 
     Referring generally to  FIGS. 1 and 23 , a tissue resecting instrument  10  provided in accordance with the present disclosure and configured to resect tissue includes an end effector assembly  100  and a handpiece assembly  200 . Tissue resecting instrument  10  is adapted to connect to a control unit (not shown) via a cable  300  to provide power and control functionality to tissue resecting instrument  10 , although tissue resecting instrument  10  may alternatively or additionally include a power source, e.g., battery, and/or a control unit disposed within handpiece assembly  200 . Tissue resecting instrument  10  is further adapted to connect to a fluid management system (not shown) via outflow tubing (not shown) connected to outflow port  400  for applying suction to remove fluid, tissue, and debris from a surgical site via tissue resecting instrument  10 . The control unit and fluid management system may be integral with one another, coupled to one another, or separate from one another. 
     Tissue resecting instrument  10  may 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 assembly  200  may be configured as a cleanable/sterilizable, reusable component, while end effector assembly  100  is configured as a single-use, disposable/reprocessable component. In any of the above configurations, end effector assembly  100  is configured to releasably engage handpiece assembly  200  to facilitate disposal/reprocessing of any single-use components and cleaning and/or sterilization of any reusable components. Further, enabling releasable engagement of end effector assembly  100  with handpiece assembly  200  allows for interchangable use of different end effector assemblies, e.g., different length, configuration, etc., end effector assemblies, with handpiece assembly  200 . 
     Continuing with reference to  FIG. 1 , end effector assembly  100  includes an outer shaft  120 , a drive wire  140 , a hub assembly  160 , a drive assembly  180  ( FIG. 5 ), and an RFID chip  190  ( FIG. 5 ). Referring also to  FIGS. 2-5, 8, and 9 , outer shaft  120  includes a proximal end portion  122  and a distal end portion  124  defining an at least partially closed distal end  126  and a transverse window  128  disposed adjacent the at least partially closed distal end  126 . Window  128  provides access to the interior of outer shaft  120  transversely through a sidewall thereof and may be surrounded by a cutting edge  129   a  extending about at least a portion of the outer perimeter of window  128  to facilitate cutting of tissue passing through window  128  and into outer shaft  120 . Cutting edge  129   a  may define a serrated configuration including a plurality of cutting teeth  129   b  extending along longitudinal sides of cutting window  128  or may define any other suitable configuration. In embodiments, cutting teeth  129   b  are arcuate in configuration to conform to the tubular shape of outer shaft  120 . 
     Outer shaft  120  may be formed as a single, monolithic piece of material or may be formed from multiple pieces that are formed separately and subsequently joined to one another. For example, outer shaft  120  may include an elongated cylindrical body portion  121   a  and a distal tip portion  121   b  (which includes at least partially closed distal end  126 , window  128 , and cutting edge  129   a ) joined to one another via laser welding or in any other suitable manner. Outer shaft  120  may be formed from stainless steel or other suitable material. Outer shaft  120  may define an outer diameter of, in embodiments, equal to or less than about 0.085 inches; in other embodiments, equal to or less than about 0.075 inches and, in still other embodiments, equal to or less than about 0.065 inches. Outer shaft  120  may define an inner diameter of, in embodiments, equal to or less than about 0.070 inches; in other embodiments, equal to or less than about 0.060 inches and, in still other embodiments, equal to or less than about 0.050 inches. “About” as utilized herein takes into account tolerances and variations generally accepted in the field, including but not limited to material, manufacturing, environmental, use, and measurement tolerances. 
     With reference to  FIGS. 1-7 , drive wire  140  is rotatably disposed within outer shaft  120  and includes a body  142  ( FIG. 7 ) and a distal end portion  144 . A proximal end portion  143   a  of body  142  of drive wire  140  is bent to define a finger  143   b  that, as detailed below, facilitates engagement of proximal end portion  143   a  of drive wire  140  within distal driver  184  of drive assembly  180 , although other engagement configurations are also contemplated. Distal end portion  144  of drive wire  140  is at least partially received within and engaged with a distal cutting tip  150 . 
     Referring to  FIGS. 6 and 7 , body  142  of drive wire  140  defines a cylindrical configuration having a substantially circular cross-section with an outer diameter of, in embodiments, equal to or less than about 0.045 inches; in other embodiments, equal to or less than about 0.035 inches and, in still other embodiments, equal to or less than about 0.025 inches. Material is removed from distal end portion  144  of drive wire  140  such that, rather than defining a circular cross-sectional configuration, distal end portion  144  defines a semi-circular cross-sectional configuration having a semi-cylindrical (semi-circular in cross-section) bottom surface  145   a  and a planar upper surface  145   b . A transition section  146   a  defining an angled transition surface  146   b  is disposed between body  142  and distal end portion  144  of drive wire  140  to define a tapered transition between the radiused outer surface of body  142  and the planar upper surface  145   b  of distal end portion  144 . Drive wire  140  may be formed as a solid rod of material, e.g., stainless steel, although other suitable materials and/or configurations are also contemplated. 
     Continuing with reference to  FIGS. 6 and 7 , as noted above, distal end portion  144  of drive wire  140  is at least partially received within and engaged with distal cutting tip  150 . Distal cutting tip  150  includes a semi-cylindrical body  152  defining a semi-cylindrical lumen  154 . Distal cutting tip  150  may be formed from any suitable material, e.g., stainless steel, and may be machined or otherwise formed. Semi-cylindrical body  152  defines a semi-cylindrical bottom surface  155   a , a planar upper surface  155   b , an open proximal end  155   c , and an at least partially closed distal end  155   d . Planar upper surface  155   b  is defined by first and second side walls  156  that are spaced apart from one another to define an elongated mouth  157  providing access to semi-cylindrical lumen  154  along the length thereof. Open proximal end  155   c  likewise provides access to semi-cylindrical lumen  154 . 
     First and second side walls  156  may define a plurality of cutting teeth  158  protruding from (and/or defining valleys therebetween that are recessed from) planar upper surface  155   b  and extending along portions of the lengths of first and second side walls  156 . With momentary reference to  FIG. 10 , cutting teeth  158  may be complementary to cutting teeth  129   b  such that, in one orientation of cutting tip  150  within outer shaft  120 , the surfaces defined by cutting teeth  158  and cutting teeth  129   b  are fully aligned with one another, e.g., to appear as a single set of teeth. In embodiments, cutting teeth  158 , like cutting teeth  129   b , are arcuate in configuration to conform to the tubular shape of outer shaft  120  (where the radius defined by cutting teeth  158  is smaller than the radius defined by cutting teeth  129   b  since cutting teeth  158  are disposed radially inwardly of cutting teeth  129   b ). 
     Turning back to  FIGS. 6 and 7 , cutting tip  150 , in embodiments, may define an outer diameter (e.g., of semi-cylindrical body  152 ) of, in embodiments, equal to or less than about 0.070 inches; in other embodiments, equal to or less than about 0.060 inches and, in still other embodiments, equal to or less than about 0.050 inches. An inner diameter of cutting tip  150  (e.g., of semi-cylindrical lumen  154 ) may be, in embodiments, equal to or less than about 0.055 inches; in other embodiments, equal to or less than about 0.045 inches and, in still other embodiments, equal to or less than about 0.035 inches. Referring also to  FIGS. 10-12 , the annular clearance defined between the outer diameter of cutting tip  150  and the inner diameter of outer shaft  120  may be, in embodiments, from about 0.001 inches to about 0.006 inches; and, in other embodiments from about 0.003 to about 0.004 inches. 
     With reference again to  FIGS. 6 and 7 , as noted above, distal end portion  144  of drive wire  140  is at least partially received within and engaged with distal cutting tip  150 . More specifically, distal end portion  144  of drive wire  140  is received within semi-cylindrical lumen  154  such that the outer, semi-cylindrical bottom surface  155   a  of distal end portion  144  of drive wire  140  mates, complementarily, with the semi-cylindrical interior surface of cutting tip  150  that defines the semi-cylindrical bottom of semi-cylindrical lumen  154 . In this position, planar upper surface  145   b  of distal end portion  144  of drive wire  140  may be co-planar with upper surface  155   b  (defined by side walls  156 ) of cutting tip  150 . In order to secure distal end portion  144  of drive wire  140  within distal cutting tip  150  in this position, the abutting edges of planar upper surface  145   b  and upper surface  155   b  (defined by side walls  156 ) may be welded (e.g., via laser welding) or otherwise attached to one another on both sides thereof. The attachment, e.g., weld, locations may be proximal of cutting teeth  129   b ,  158  and/or any other suitable location(s). 
     Referring to  FIGS. 10-12 , drive wire  140  is configured for rotation or oscillation within and relative to outer shaft  120  to thereby rotate or oscillate distal cutting tip  150  relative to window  128 . More specifically, inner shaft  140  is configured to rotate or oscillate between a first, open position ( FIG. 10 ), a second, partially-closed position ( FIG. 11 ), and a third, closed position ( FIG. 12 ). In the first position, as illustrated in  FIG. 10 , cutting teeth  129   b ,  158  are aligned with one another and elongated mouth  157  is aligned with window  128  to enable maximum fluid communication therebetween. In the second position, as illustrated in  FIG. 11 , cutting teeth  129   b ,  158  are misaligned with one another (wherein only the teeth  158  on one side of distal cutting tip  150  are exposed) and elongated mouth  157  is misaligned with window  128  to enable only partial fluid communication therebetween. In the third position, as illustrated in  FIG. 12 , cutting teeth  129   b ,  158  are offset about 180 degrees relative to one another or in any other suitable position such that cutting teeth  158  are not exposed. Likewise, elongated mouth  157  and window  128  are offset about 180 degrees relative to one another or in any other suitable position such that fluid communication therebetween is substantially inhibited. With respect to rotational embodiments, drive wire  140  may be rotated in a single direction from the first position, to the second position, to the third position, and back to the first position (and may rotation continuously to repeat the same). With respect to oscillatory embodiments, drive wire  140  may be rotated in a first direction from the first position, to the second position, to the third position, and then in a second, opposite direction from the third position, to the second position, back to the first position (and may then return in the first direction in the same manner or may continue in the second direction to the third position before returning to the first position and repeating the same). Other oscillatory patterns and/or combinations of rotation and oscillation (e.g., where multiple revolutions are performed before switching directions) are also contemplated. 
     Turning to  FIGS. 10 and 13-15 , in embodiments, either or both of the proximal and distal surfaces  128   a ,  128   b  of outer shaft  120  that define the longitudinal boundaries of window  128  may define a plane “P 1 ” disposed at an angle “a” relative to a plane “P 2 ” (vertically in the orientation illustrated in  FIG. 13 ) which extends perpendicularly relative to a longitudinal axis of outer shaft  120 . Plane “P 1 ” defined by proximal and/or distal surfaces  128   a ,  128   b  may be angled longitudinally away from window  128  (e.g., wherein proximal surface  128   a  is angled proximally away from window  128  in a radially outward direction and/or distal surface  128   b  is angled distally away from window  128  in a radially outward direction). Angle “a” may be, in embodiments, from about 25 degrees to about 55 degrees; in other embodiments, from about 30 degrees to about 50; and, in other embodiments, from about 35 degrees to about 45 degrees. Alternatively, as illustrated in  FIGS. 16 and 17 , either or both of the proximal and distal surfaces  128   a ,  128   b  of outer shaft  120  may define a plane that extends perpendicularly relative to the longitudinal axis of outer shaft  120 . In any of the above embodiments, distal cutting tip  150  may extend distally beyond window  128  to facilitation constraining distal cutting tip  150  within outer shaft  120 . Additionally or alternatively, one or more of the proximal-most cutting teeth  158  of distal cutting tip  150  may be at least partially disposed proximal of window  128 . 
     In the embodiments of  FIGS. 10 and 13-15 , distal end  126  of outer shaft  120  is partially closed in that distal end  126  does not extend about a full 180 degrees but, rather, extends  180  minus “a” degrees. In the embodiment of  FIGS. 16 and 17 , on the other hand, distal end  126  of outer shaft  120  is fully closed in that it extends about a full 180 degrees (e.g., wherein “α” is equal to about 0 degrees). 
     Turning to  FIG. 18 , in embodiments, rather than providing teeth, both outer shaft  1120  and distal cutting tip  1150  may define a generally planar cutting edge  1129 ,  1158 , respectively. In such embodiments, distal ends  1126 ,  1155  of outer shaft  1120  and distal cutting tip  1150 , respectively, may be only partially closed and include respective U-shaped openings  1121 ,  1151  defined therein. Cutting edge  1129 ,  1158  may extend about U-shaped openings  1121 ,  1151  or U-shaped openings  1121 ,  1151  may be defined by blunt surfaces. 
     As shown in  FIG. 19 , in other embodiments, rather than both including teeth, one of outer shaft  2120  and distal cutting tip  2150 , e.g., distal cutting tip  2150 , may define a generally planar cutting edge  1158  while the other of outer shaft  2120  and distal cutting tip  2150 , e.g., outer shaft  2120 , defines teeth  2129 . The reverse configuration is also contemplated. 
     With reference to  FIGS. 1-5 , as noted above, end effector assembly  100  includes outer shaft  120 , drive wire  140 , a hub assembly  160 , and a drive assembly  180 . End effector assembly  100  further includes an RFID chip  190  captured between a retainer cap  170  of hub assembly  160  and a proximal extension portion  164  of a hub housing  161  of hub assembly  160 , as detailed below. 
     Hub assembly  160  includes a hub housing  161  having a distal body portion  162  and a proximal extension portion  164  that are configured for engagement with one another, e.g., via snap-fitting or other suitable engagement. With additional momentary reference to  FIG. 23 , with end effector assembly  100  engaged with handpiece assembly  200 , proximal extension portion  164  of hub housing  161  extends into handpiece assembly  200  while distal body portion  162  substantially abuts and extends distally from handpiece assembly  200 . Proximal extension portion  164  of hub housing  161  further defines an outflow opening  165  through a sidewall thereof that is configured to fluidly communicate with an internal bore (not shown) of handle housing  210  of handpiece assembly  200  when end effector assembly  100  is engaged therewith. 
     Returning to  FIGS. 1-5 and 9 , distal body portion  162  of hub housing  161  is fixedly disposed about proximal end portion  122  of outer shaft  120  with outer shaft  120  extending distally therefrom. Drive wire  140  extends through outer shaft  120 , as noted above, and extends proximally through distal body portion  162  of hub housing  161  into proximal extension portion  164  of hub housing  161  wherein drive assembly  180  is operably coupled to finger  143   b  of proximal end portion  143   a  of body  142  of drive wire  140 . 
     Hub assembly  160  further includes an O-ring  166  configured for engagement about proximal extension portion  164  of hub housing  161  distally of outflow opening  165  (see  FIG. 20 ). O-ring  166 , is configured to establish a fluid-tight seal against the interior of handle housing  210  of handpiece assembly  200  (see  FIG. 23 ) when end effector assembly  100  is engaged therewith to inhibit fluid from travelling distally after exiting outflow opening  165 . 
     Hub assembly  160  additionally includes an outer shell  168  configured for positioning about distal body portion  162  of hub housing  161  and for engagement therewith, e.g., via snap-fit engagement or in any other suitable manner. A cantilever engagement finger  169  extends proximally from outer shell  168  of hub housing  161  and proximally from distal body portion  162  of hub housing  161  when outer shell  168  is engaged thereabout. Engagement finger  169  is configured for engagement within a corresponding aperture (not shown) defined within handle housing  210  of handpiece assembly  200  (see  FIG. 23 ) to enable releasable engagement of end effector assembly  100  with handpiece assembly  200  ( FIG. 23 ). 
     Continuing with reference to  FIGS. 1-5 , retainer cap  170  of hub assembly  160  is configured for snap-fit or other suitable engagement with a proximal end portion of proximal extension portion  164 . Retainer cap  170  defines a longitudinal lumen  174  extending through retainer cap  170 . Retainer cap  170  further defines a pocket  178  configured to receive RFID chip  190  therein. When retainer cap  170  is engaged with proximal extension portion  164 , e.g., via snap-fitting, the open end of pocket  178  is blocked by a proximal face of proximal extension portion  164 , thereby capturing RFID chip  190  therein. 
     Drive assembly  180  is configured to operably couple a drive rotor (not shown) of handpiece assembly  200  (see  FIG. 23 ) with drive wire  140  such that rotation of the drive rotor drives rotation and/or oscillation of drive wire  140 , thereby driving the rotation and/or oscillation of distal cutting tip  150  within and relative to outer shaft  120 . Drive assembly  180 , more specifically, includes a proximal driver  182 , a distal driver  184 , and a biasing spring  186 , e.g., a coil compression spring. Additionally, drive assembly  180  may include gearing (not shown) configured to amplify or attenuate the output rotation of drive wire  140  relative to the input rotation received from the drive rotor of handpiece assembly  200  ( FIG. 23 ). 
     Referring to  FIG. 7 , distal driver  184  of drive assembly  180  includes a proximal body portion  185   a , a distal body portion  185   b , and a collar  185   c  disposed between proximal and distal body portions  185   a ,  185   b , respectively. A seal  189  may be engaged annularly about collar  185   c . Seal  189  is configured to establish a fluid-tight seal across the annular gap between distal driver  184  and distal body portion  162  of hub housing  161  to inhibit fluid flow within the annular gap proximally beyond seal  189  (see  FIG. 20 ). Distal drier  184  further includes a lumen  185   d  extending partially therethrough. Proximal body portion  185   a  of distal driver  184  further includes a proximal foot  185   e  extending proximally therefrom. At least a portion of proximal foot  185   e  defines a non-circular cross-sectional configuration, e.g., a semi-circular, rectangular or other polygonal configuration. Further, lumen  185   d  is open at proximal foot  185   e , e.g., proximal foot  185   e  defines an open portion in communication with lumen  185   d.    
     Referring also to  FIG. 21 , distal body portion  185   b  of distal driver  184  of drive assembly  180  is configured to receive and engage finger  143   b  of proximal end portion  143   a  of body  142  of drive wire  140 . More specifically, distal body portion  185   b  defines a longitudinally-extending slot  185   f  communicating with a transverse slot  185   g . Transverse slot  185   g  is configured to receive finger  143   b  while longitudinally-extending slot  185   f  is configured to receive a portion of body  142  of drive wire  140  extending distally from finger  143   b . Finger  143   b  may be disposed at about a right angle relative to body  142  or at any other suitable angle and, thus, transverse slot  185   g  may be disposed at about a right angle relative to longitudinally-extending slot  185   f  or at any other suitable angle. This right angle engagement facilitates torque transmission and provides axial securement between distal driver  184  and drive wire  140 . Further, an adhesive (e.g., epoxy) disposed within transverse slot  185   g  and/or longitudinally-extending slot  185   f  (and/or on finger  143   b  and/or body  142 ) may be utilized to facilitate the engagement between distal driver  184  and drive wire  140 . Instead of or in addition to the above-detailed transverse-finger (and adhesive) engagement, in embodiments, distal driver  184  is overmolded about proximal portion  143   a  of body  142  of drive wire  140  to secure distal driver  184  and drive wire  140  with one another. 
     As shown in  FIG. 22 , as an alternative to direct engagement of drive wire  140  with distal driver  184 , a connector  3143  may be provided to engage drive wire  140  with distal driver  184 . Drive wire  140  may be connected to connector  3143  via snap-fit engagement, adhesives (with or without a transverse-finger engagement as detailed above), press-fit engagement, heat staking, combinations thereof, or in any other suitable manner. Connector  3143 , in turn, may be connected to distal drive  184  via spin welding, over-molding, heat staking, combinations thereof, or in any other suitable manner. Connector  3143  may be formed from a metal, e.g., stainless steel, a plastic, or may include both plastic and metal portions. 
     With reference to  FIG. 20 , distal driver  184  defines a flow path therethrough. More specifically, distal body portion  185   b  of distal driver  184  defines opposed lateral openings  185   h  on either side thereof that communication with lumen  185   d  of distal driver  184 . In this manner, fluid, tissue, and debris that are suctioned through window  128  ( FIGS. 10-12 ) and proximally through outer shaft  120  (about drive wire  140 ) into distal body portion  162  of hub housing  161  are further suctioned through lateral openings  185   h  and into lumen  185   d.    
     Referring to  FIGS. 4, 5, 20, and 21 , proximal driver  182  of drive assembly  180  includes a proximal body portion  183   a  and a distal body portion  183   b . Proximal body portion  183   a  includes an external collar  183   c  disposed annularly thereabout. Proximal body portion  183   a  further includes a proximally-facing cavity  183   d  at 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 the drive rotor of handpiece assembly  200  ( FIG. 23 ) in fixed rotational orientation. Distal body portion  183   b  defines a distally-facing cavity  183   e  at least a portion of which has a non-circular cross-sectional configuration, e.g., a semicircular, rectangular, or other polygonal configuration. A longitudinally-extending slot  183   f  ( FIG. 21 ) defined through a side wall of distal body portion  183   b  communicates with distally-facing cavity  183   e . Distally-facing cavity  183   e  of distal body portion  183   b  of proximal driver  182  is configured to slidably receive proximal foot  185   e  of distal driver  184  in fixed rotational orientation due to the non-circular, and at least partially complementary, configurations thereof. 
     As illustrated in  FIGS. 20 and 21 , longitudinally-extending slot  183   f  of proximal driver  182  is disposed in fluid communication with lumen  185   d  of distal driver  184  such that fluid, tissue, and debris may be suctioned from lumen  18   d , through longitudinally-extending slot  183   f , and through outflow opening  165  of proximal extension portion  164  of hub housing  161  in at least some rotational orientations of proximal and distal drivers  182 ,  184 , respectively, relative to hub housing  164 . Fluid, tissue, and debris suctioned through outflow opening  165  of proximal extension portion  164  of hub housing  161  may further be suctioned through the outflow path defined through handle housing  210  of handpiece assembly  200  ( FIG. 23 ) and, ultimately, through outflow port  400  ( FIG. 23 ) and the outflow tubing (not shown) to a collection vessel (not shown). As understood, the suction may also be provided through the above-defined outflow path. More specifically, the outflow tubing (not shown) is configured to connect to outflow port  400  to thereby connect outflow port  400  to a fluid management system (not shown). The fluid management system includes a vacuum source to establish suction through tissue resecting instrument  10  and 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 instrument  10  and the outflow tubing, vacuum may be created therethrough via a pressure differential between the surgical site and the outflow path. 
     Referring again to  FIGS. 4, 5, 20, and 21 , biasing spring  186  is disposed about proximal body portion  185   a  of distal driver  184  and includes a distal end that abuts collar  185   c  of distal driver  184 . Biasing spring  186  includes a proximal end that is configured to abut a distal end of distal body portion  183   b  of proximal driver  182 . In this manner, biasing spring  186  biases proximal driver  182  proximally relative to distal driver  184 . Complementary features on proximal driver  182  and retainer cap  170  may mate in this more-proximal position of proximal driver  182  to rotationally lock proximal and distal drivers  182 ,  184  relative to retainer cap  170  and hub housing  161  and, as a result, rotationally fix drive wire  140  relative to outer shaft  120  in this position. Upon engagement of end effector assembly  100  with handpiece assembly  200  ( FIG. 23 ), the drive rotor (not shown, or other portion) of handpiece assembly  200  is received within proximally-facing cavity  183   d  of proximal body portion  183   a  of proximal driver  182  in fixed rotational orientation thereof, e.g., due to the at least partially complementary configurations thereof. As the driver rotor is inserted within proximally-facing cavity  183   d  and bottoms out therein, further insertion of end effector assembly  100  urges proximal driver  182  distally through and relative to retainer cap  170 , against the bias of biasing spring  186 , to thereby displace proximal driver  182  distally relative to retainer cap  170 , displacing the complementary features and thereby rotationally unlocking proximal and distal drivers  182 ,  184  from retainer cap  170  and hub housing  161 . Thus, upon engagement of end effector assembly  100  with handpiece assembly  200 , drive wire  140  is unlocked from outer shaft  120  and permitted to rotate relative thereto. 
     Referring to  FIGS. 21 and 23 , with end effector assembly  100  engaged with handpiece assembly  200  as detailed above, RFID chip  190  of end effector assembly  100  is disposed in vertical registration with an RFID transceiver (not shown) of handpiece assembly  200  to enable the RFID transceiver to read/write data to/from RFID chip  190  and/or communicate read/write data to/from the control unit, e.g., via cable  300 . 
     The data stored on RFID chip  190  of end effector assembly  100  may 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 transceiver  290  to RFID chip  190 ); the home/initial position of drive wire  140 ; 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; and/or encryption key(s). Additional or alternative data is also contemplated. 
     With general reference to  FIGS. 1-5, 10-12, 20, 21, and 23 , with end effector assembly  100  engaged with handpiece assembly  200  as detailed above, tissue resecting instrument  10  is ready for use. In use, the motor (not shown) of handpiece assembly  200  is activated to drive rotation of the drive rotor. Upon activation of the motor, with a head-start or delay relative to activation of the motor, or independently thereof, suction is established through tissue resecting instrument  10 , e.g., via activating the vacuum source of the fluid management system. 
     Activation of the motor, in either a rotating or oscillating fashion, drives rotation of the drive rotor which, in turn, drives rotation of proximal driver  182  to, in turn, drive rotation of distal driver  184  and thereby rotate or oscillate drive wire  140  and, thus, distal cutting tip  150  relative to outer shaft  120 . The rotation or oscillation of distal cutting tip  150  relative to outer shaft  120 , together with the suction applied through outer shaft  120 , enables tissue to be drawn through cutting window  128 , cut by distal cutting tip  150  and/or cutting edge  129   a , and suctioned, along with fluids and debris, proximally through outer shaft  120  (about drive wire  140 ), drive assembly  180 , through output opening  165  of proximal extension portion  164  of hub housing  161 , and through the outflow path of handpiece assembly  200  to outflow port  400  for output to the collection reservoir of the fluid management system. 
     Referring to  FIG. 23 , as an alternative to handpiece assembly  200  configured for manual grasping and manipulation during use, tissue resecting instrument  10  may alternatively be configured for use with a robotic surgical system wherein handle housing  210  is 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). 
     While several embodiments of the disclosure have been shown in the drawings, it is not intended that the disclosure be limited thereto, as it is intended that the disclosure be as broad in scope as the art will allow and that the specification be read likewise. Therefore, the above description should not be construed as limiting, but merely as examples of particular embodiments. Those skilled in the art will envision other modifications within the scope and spirit of the claims appended hereto. 
     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.