Patent Description:
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. <CIT> is related to a surgical instrument comprising a cutting member and a drive coupled to the cutting member to simultaneously rotate and translate the cutting member. <CIT> is related to an endoscopic tissue resecting system including a reciprocating rotary surgical instrument for cutting tissue that includes a planetary gear to vary rotational speed.

The invention is defined by independent claim.

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 instrument. The end effector assembly includes a proximal hub housing, an outer shaft extending from the proximal hub housing, an inner shaft disposed within the outer shaft and configured to rotate and reciprocate relative to the outer shaft for cutting tissue, and an inner core drive assembly disposed at least partially within the proximal hub housing. The inner core drive assembly is operably coupled to the inner shaft and configured such that a rotational input provided to the inner core drive assembly effects the rotation and reciprocation of the inner shaft relative to the outer shaft. The inner core drive assembly includes a proximal receiver configured to receive the rotational input and to rotate relative to the proximal hub housing in response thereto. The proximal receiver includes a seal member disposed thereon. The inner core drive assembly further includes a connector operably coupled to the proximal receiver such that the rotation of the proximal receiver effects rotation of the connector relative to the proximal hub housing and reciprocation of the connector relative to the proximal receiver and the proximal hub housing between a proximal position and a distal position. The connector is operably coupled to the inner shaft such that the rotation and reciprocation of the connector effects the rotation and reciprocation of the inner shaft. The connector defines a cavity disposed in fluid communication with an interior of the inner shaft. In the proximal position, the connector abuts the seal member to establish a seal that blocks outflow from the cavity In the distal position, the connector is displaced from the seal member to permit outflow from the cavity.

In an aspect of the present disclosure, the inner core drive assembly further includes a threaded coupler operably coupled to the connector and a follower operably engaged with the threaded coupler. The rotation of the connector in response to the rotation of the proximal receiver rotates the threaded coupled relative to the follower, thereby reciprocating the threaded coupler and the connector relative to the proximal receiver.

In another aspect of the present disclosure, the connector is rotationally fixed relative to the proximal receiver via at least partial receipt of a distal spine of the proximal receiver within the cavity of the connector.

In another aspect of the present disclosure, the distal spine is slidable relative to the cavity of the connector to permit the reciprocation of the connector relative to the proximal receiver.

In still another aspect of the present disclosure, the seal member is disposed about the distal spine.

In yet another aspect of the present disclosure, the reciprocation of the connector effects similar reciprocation of the inner shaft.

In still yet another aspect of the present disclosure, gearing is operably coupled between the connector and the inner shaft such that the rotation of the inner shaft is amplified or attenuated relative to the rotation of the connector.

In another aspect of the present disclosure, the outer shaft defines a window and the inner shaft is configured to rotate and reciprocate relative to the window to cut tissue extending through the window.

In yet another aspect of the present disclosure, the proximal position of the connector corresponds to a proximal position of the inner shaft relative to the outer shaft.

A tissue resecting instrument provided in accordance with aspects of the present disclosure includes a handpiece assembly including a drive rotor and an outflow conduit, and an end effector assembly configured to releasably engage the handpiece assembly. The end effector assembly includes an outer shaft, an inner shaft disposed within the outer shaft and configured to rotate and reciprocate relative to the outer shaft for cutting tissue, and an inner core drive assembly. The inner core drive assembly includes a proximal receiver configured to receive a rotational input from the drive rotor and to rotate in response thereto. The proximal receiver includes a seal member disposed thereon. The inner core drive assembly further includes a connector operably coupled to the proximal receiver such that the rotation of the proximal receiver effects rotation of the connector and reciprocation of the connector between a proximal position and a distal position. The connector is operably coupled to the inner shaft such that the rotation and reciprocation of the connector effects the rotation and reciprocation of the inner shaft. The connector defines a cavity disposed in fluid communication with an interior of the inner shaft. In the proximal position, the connector abuts the seal member to establish a seal that blocks outflow from the cavity into the outflow conduit. In the distal position, the connector is displaced from the seal member to permit outflow from the cavity into the outflow conduit.

In an aspect of the present disclosure, the handpiece assembly further includes a motor configured to drive rotation of the drive rotor.

In another aspect of the present disclosure, the inner core drive assembly further includes a threaded coupler operably coupled to the connector and a follower operably engaged with the threaded coupler. The rotation of the connector in response to the rotation of the proximal receiver rotates the threaded coupled relative to the follower, thereby reciprocating the threaded coupler and the connector relative to the proximal receiver.

In still another aspect of the present disclosure, the connector is rotationally fixed relative to the proximal receiver via at least partial receipt of a distal spine of the proximal receiver within the cavity of the connector. In such aspects, the distal spine may be slidable relative to the cavity of the connector to permit the reciprocation of the connector relative to the proximal receiver. Additionally or alternatively, the seal member is disposed about the distal spine.

In yet another aspect of the present disclosure, wherein the reciprocation of the connector effects similar reciprocation of the inner shaft.

In an aspect of the present disclosure, the proximal position of the connector corresponds to a proximal position of the inner shaft relative to the outer shaft.

In another aspect of the present disclosure, the drive rotor is configured to provide a further rotational input to the proximal receiver after the rotational input to the proximal receiver to return the connector to the proximal position, thereby establishing the seal that blocks outflow from the cavity into the outflow conduit.

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.

Referring generally to <FIG>, a tissue resecting instrument <NUM> provided in accordance with the present disclosure and configured to resect tissue includes an end effector assembly <NUM> and a handpiece assembly <NUM>. Tissue resecting instrument <NUM> is adapted to connect to a control unit (not shown) via a cable <NUM> to provide power and control functionality to tissue resecting instrument <NUM>, although tissue resecting instrument <NUM> may alternatively or additionally include controls associated with handpiece assembly <NUM> and/or a power source, e.g., battery, disposed within handpiece assembly <NUM>. Tissue resecting instrument <NUM> is further adapted to connect to a fluid management system (not shown) via outflow tubing <NUM> for applying suction to remove fluid, tissue, and debris from a surgical site via tissue resecting instrument <NUM>, as detailed below. 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 <NUM> 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 <NUM> may be configured as a cleanable/sterilizable, reusable component, while end effector assembly <NUM> is configured as a single-use, disposable/reprocessable component. In any of the above configurations, end effector assembly <NUM> is configured to releasably engage handpiece assembly <NUM> 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 <NUM> with handpiece assembly <NUM> allows for interchangable use of different end effector assemblies, e.g., different length, configuration, etc., end effector assemblies, with handpiece assembly <NUM>.

Continuing with reference to <FIG>, handpiece assembly <NUM> generally includes a handle housing <NUM>, an outflow conduit <NUM> defined through (as shown), extending through, disposed on, or otherwise associated with handle housing <NUM>, a motor <NUM> disposed within handle housing <NUM>, and a drive rotor <NUM> disposed at least partially within handle housing <NUM> and operably coupled to motor <NUM>. Handpiece assembly <NUM> may further include one or more controls (not shown) disposed on or operably associated with handle housing <NUM> to facilitate activation of tissue resecting instrument <NUM>. Further, outflow tubing <NUM> is configured to connect to a proximal end portion of outflow conduit <NUM> to thereby connect outflow conduit <NUM> to the fluid management system (not shown). The fluid management system includes a vacuum source to establish suction through tissue resecting instrument <NUM> and outflow tubing <NUM> 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 <NUM> and outflow tubing <NUM>, vacuum may be created therethrough via a pressure differential between the surgical site and the outflow path.

Handle housing <NUM> defines a pencil-grip configuration, although other configurations are also contemplated, e.g., pistol-grip configurations, and includes a distal hub <NUM> disposed at an open distal end portion <NUM> thereof. Distal hub <NUM> defines an annular recess <NUM> configured to facilitate releasably engagement of end effector assembly <NUM> with handpiece assembly <NUM>, as detailed below. Open distal end portion <NUM> of handle housing <NUM> provides access to drive rotor <NUM> and a distal end portion of outflow conduit <NUM> within handle housing <NUM> such that, upon engagement of end effector assembly <NUM> with handpiece assembly <NUM>, as also detailed below, a portion of end effector assembly <NUM> extends through open distal end portion <NUM> and into the interior of handle housing <NUM> to operably couple with drive rotor <NUM> and a distal end portion of outflow conduit <NUM>.

Cable <NUM> extends proximally from handle housing <NUM> and is configured to connect to the control unit (not shown) to provide power and control functionality to tissue resecting instrument <NUM>. Cable <NUM>, more specifically, houses one or more wires <NUM> that extend into handle housing <NUM> and connect to the controls thereof and/or motor <NUM> to power motor <NUM> and control operation of tissue resecting instrument <NUM> in accordance with controls associated with handpiece assembly <NUM>, the control unit, and/or other remote control devices, e.g., a footswitch (not shown).

Drive rotor <NUM> is operably coupled with and extends distally from motor <NUM> such that, upon activation of motor <NUM>, motor <NUM> drives rotation of drive rotor <NUM>. At least a portion of drive rotor <NUM> defines a non-circular cross-sectional configuration, e.g., a square or other polygonal configuration. Drive rotor <NUM> is configured for at least partial receipt within proximal receiver <NUM> of end effector assembly <NUM> (see <FIG>) in fixed rotational orientation relative thereto upon engagement of end effector assembly <NUM> with handpiece assembly <NUM>. As such, activation of motor <NUM> drives rotation of drive rotor <NUM> to, in turn, drive rotation of inner cutting shaft <NUM> of end effector assembly <NUM>, as detailed below.

Referring to <FIG>, end effector assembly <NUM> includes a proximal hub housing <NUM>, an elongated outer shaft <NUM> monolithically formed, fixedly engaged, or otherwise connected with and extending distally from proximal hub housing <NUM>, an inner cutting shaft <NUM> disposed within elongated outer shaft <NUM>, and an inner core drive assembly <NUM>.

Proximal hub housing <NUM> of end effector assembly <NUM> includes a distal body portion <NUM> and a proximal extension portion <NUM> that may be monolithically formed, engaged, or otherwise connected to one another. With end effector assembly <NUM> engaged with handpiece assembly <NUM>, proximal extension portion <NUM> of proximal hub housing <NUM> extends into handle housing <NUM> of handpiece assembly <NUM> while distal body portion <NUM> substantially abuts and extends distally from handle housing <NUM> of handpiece assembly <NUM>. An engagement lever <NUM> extends from proximal hub housing <NUM>. Engagement lever <NUM> includes a finger tab 117a and an engagement tooth 117b disposed on opposite sides of a living hinge pivot 117c such that urging finger tab 117a towards proximal hub housing <NUM> urges engagement tooth 117b away from proximal hub housing <NUM>, and vice versa.

Upon insertion of proximal extension portion <NUM> of proximal hub housing <NUM> of end effector assembly <NUM> into handle housing <NUM> of handpiece assembly <NUM>, engagement tooth 117b is configured to cam over distal hub <NUM> of handpiece assembly <NUM> and into engagement within annular recess <NUM> of distal hub <NUM> of handpiece assembly <NUM> to engage end effector assembly <NUM> and handpiece assembly <NUM> with one another. Disengagement of end effector assembly <NUM> from handpiece assembly <NUM> is effected by depressing finger tab 117a towards proximal hub housing <NUM> to thereby withdraw engagement tooth 117b from annular recess <NUM>. With engagement tooth 117b disengaged from annular recess <NUM>, end effector assembly <NUM> may be moved distally relative to handpiece assembly <NUM> to withdraw proximal extension portion <NUM> from handle housing <NUM>, thereby disengaging end effector assembly <NUM> from handpiece assembly <NUM>.

With reference to <FIG>, elongated outer shaft <NUM> of end effector assembly <NUM>, as noted above, includes a proximal end portion <NUM> fixedly engaged with distal body portion <NUM> of proximal hub housing <NUM> (see <FIG>). Elongated outer shaft <NUM> further includes a distal end portion <NUM> defining a closed distal end <NUM> and a window <NUM> proximally-spaced from closed distal end <NUM>. Window <NUM> provides access to the interior of elongated outer shaft <NUM> and may be surrounded by a cutting edge <NUM> about the outer perimeter of window <NUM> so as to facilitate cutting of tissue passing through window <NUM> and into elongated outer shaft <NUM>.

Inner cutting shaft <NUM> of end effector assembly <NUM> extends through elongated outer shaft <NUM> and defines a proximal end portion <NUM> and a distal end portion <NUM> defining an open distal end <NUM>. Proximal end portion <NUM> of inner cutting shaft <NUM> is operably coupled with inner core drive assembly <NUM>, as detailed below (see <FIG>). Inner cutting shaft <NUM> defines an annular cutting edge <NUM> surrounding open distal end <NUM> so as to facilitate cutting of tissue passing into inner cutting shaft <NUM> via open distal end <NUM>. Inner cutting shaft <NUM> is rotatable and reciprocatable within and relative to elongated outer shaft <NUM>. More specifically, inner cutting shaft <NUM> is configured to reciprocate and rotate such that annular cutting edge <NUM> is exposed within window <NUM> of elongated outer shaft <NUM> during at least a portion of the reciprocation motion of inner cutting shaft <NUM> to enable cutting of tissue therewith. As detailed below, suction is provided to facilitate drawing tissue into window <NUM> of elongated outer shaft <NUM> and, thus, to facilitate the cutting of tissue with inner cutting shaft <NUM> and removal of tissue through inner cutting shaft <NUM>. Other suitable configurations of elongated outer shaft <NUM> and/or inner cutting shaft <NUM> that cooperate to facilitate tissue cutting are also contemplated.

Referring to <FIG> and <FIG>, inner core drive assembly <NUM> is partially disposed within proximal hub housing <NUM> and extends proximally from proximal hub housing <NUM> to facilitate operable engagement with handpiece assembly <NUM>. Further, inner core drive assembly <NUM> is coupled to inner cutting shaft <NUM> within proximal hub housing <NUM> such that rotational input imparted to inner core drive assembly <NUM>, e.g., via handpiece assembly <NUM>, drives reciprocation and rotation of inner cutting shaft <NUM> within and relative to elongated outer shaft <NUM>, as detailed below.

Inner core drive assembly <NUM>, more specifically, includes a ferrule <NUM> fixedly engaged about proximal end portion <NUM> of inner cutting shaft <NUM>, a threaded coupler <NUM>, a proximal receiver <NUM>, and a connector <NUM> operably coupling ferrule <NUM>, threaded coupler <NUM>, and proximal receiver <NUM> with one another, as detailed below. Inner core drive assembly <NUM> further includes a follower <NUM> fixed relative to proximal hub housing <NUM>. Follower <NUM> includes a cap <NUM> fixedly engaged with proximal hub housing <NUM> and an arm <NUM> extending from cap <NUM> into operable engagement with helical channel <NUM> of threaded coupler <NUM>.

Continuing with reference to <FIG> and <FIG>, proximal receiver <NUM> of inner core drive assembly <NUM> includes a proximally-facing cavity 147a at least a portion of which has a non-circular cross-sectional configuration, e.g., an <NUM>-point star or other polygonal configuration, that is configured to at least partially receive drive rotor <NUM> of handpiece assembly <NUM> in fixed rotational orientation (see <FIG> and <FIG>). Proximal receiver <NUM> further includes a central collar 147b received within an interior annular recess <NUM> defined within proximal extension portion <NUM> of proximal hub housing <NUM> to longitudinally fixed and rotatably couple proximal receiver <NUM> relative to proximal hub housing <NUM>. Proximal receiver <NUM> additionally includes a distal spine 147c extending distally from central collar 147b and a seal member <NUM> engaged about distal spine 147c. At least a portion of distal spine 147c defines a non-circular cross-sectional configuration, e.g., a rectangular or other polygonal configuration.

Connector <NUM> defines a proximally-facing cavity 149a at least a portion of which has a non-circular cross-sectional configuration, e.g., a rectangular or other polygonal configuration, that is configured to receive at least a portion of distal spine 147c of proximal receiver <NUM> in fixed rotational orientation while permitting relative translation therebetween. Connector <NUM> additionally includes an annular, proximally-facing surface 149b surrounding proximally-facing cavity 149a. Proximally-facing surface 149b may be a substantially flat, smooth surface to facilitate establishing a fluid-tight seal between proximally-facing surface 149b and seal member <NUM>, as detailed below. Connector <NUM> further includes a distal body 149c that is fixedly engaged with threaded coupler <NUM> and operably engaged with ferrule <NUM> to thereby translationally fix and rotationally couple connector <NUM> and threaded coupler <NUM> with inner cutting shaft <NUM>. Distal body 149c of connector <NUM>, more specifically, is operably engaged with ferrule <NUM> via gearing <NUM> to amplify or attenuate the rotational input to inner cutting shaft <NUM> relative to the rotation output from drive rotor <NUM>. Alternatively, distal body 149c of connector <NUM> may be fixedly engaged about ferrule <NUM> (or operably coupled via a <NUM>:<NUM> gear ratio or other suitable <NUM>:<NUM> input to output ratio) such that the rotation imparted to inner cutting shaft <NUM> is equal to the rotational output from drive rotor <NUM>. In either configuration, ferrule <NUM> and connector <NUM> are positioned relative to proximal end portion <NUM> of inner cutting shaft <NUM> such that proximally-facing cavity 149a of connector <NUM> is disposed in fluid communication with the interior of inner cutting shaft <NUM> via the open proximal end of inner cutting shaft <NUM>.

Turning to <FIG> and <FIG>, in use, motor <NUM> of handpiece assembly <NUM> (see <FIG>) is activated to drive rotation of drive rotor <NUM>. Upon activation of motor <NUM> (<FIG>), with a head-start or delay relative to activation of motor <NUM>, or independently thereof, suction is established through outflow conduit <NUM> of handpiece assembly <NUM> and outflow tubing <NUM>, e.g., via activating the vacuum source of the fluid management system.

Due to the fixed rotational engagement of drive rotor <NUM> at least partially within proximally-facing cavity 147a of proximal receiver <NUM> of inner core drive assembly <NUM>, rotation of drive rotor <NUM> effects similar rotation of proximal receiver <NUM>. Rotation of proximal receiver <NUM> relative to proximal hub housing <NUM>, in turn, is transmitted to connector <NUM> via the fixed rotational engagement of distal spine 147c of proximal receiver <NUM> at least partially within proximally-facing cavity 149a of connector <NUM>. This rotation imparted to connector <NUM>, in turn, is transmitted to threaded coupler <NUM> via the fixed engagement of distal body 149c of connector <NUM> therewith.

Further, due to the operable engagement of arm <NUM> of follower <NUM> within helical channel <NUM> of threaded coupler <NUM>, the imparted rotation to threaded coupler <NUM> reciprocates threaded coupler <NUM> and, thus, also reciprocates connector <NUM> relative to proximal hub housing <NUM> and proximal receiver <NUM> (whereby distal spine 147c of proximal receiver <NUM> reciprocates within proximally-facing cavity 149a of connector <NUM>). The reciprocation and rotation of threaded coupler <NUM> and connector <NUM> is also transmitted to inner cutting shaft <NUM> by way of gearing <NUM> and ferrule <NUM> such that inner cutting shaft <NUM> is rotated and reciprocated within and relative to elongated outer shaft <NUM>. While gearing <NUM> may vary the rotation of inner cutting shaft <NUM> relative to threaded coupler <NUM> and connector <NUM>, inner cutting shaft <NUM> is reciprocated similarly as threaded coupler <NUM> and connector <NUM>.

With additional reference to <FIG>, while motor <NUM> is active, threaded coupler <NUM> and connector <NUM> are rotated and reciprocated to effect rotation and reciprocation of inner cutting shaft <NUM>. With respect to reciprocation in particular, inner cutting shaft <NUM>, threaded coupler <NUM>, and connector <NUM> are repeatedly reciprocated from respective proximal-most positions to respective distal-most positions and back to the respective proximal-most positions.

When connector <NUM> is displaced from the proximal-most position thereof, as illustrated in <FIG>, proximally-facing surface 149b of connector <NUM> is spaced-apart from seal member <NUM> and, thus, proximally-facing cavity 149a of connector <NUM>, which is disposed in fluid communication with the interior of inner cutting shaft <NUM>, is also disposed in fluid communication with outflow conduit <NUM> of handpiece assembly <NUM> such that suction applied through outflow conduit <NUM> establishes vacuum within inner cutting shaft <NUM> to draw tissue through window <NUM> of elongated outer shaft <NUM> and into inner cutting shaft <NUM>, while cutting edges <NUM>, <NUM> facilitate cutting of tissue as it passes through window <NUM> and into inner cutting shaft <NUM>. The cut tissue, fluids, and debris are suctioned through inner cutting shaft <NUM>, proximally-facing cavity 149a of connector <NUM>, outflow conduit <NUM> of handpiece assembly <NUM>, and outflow tubing <NUM> to the collection reservoir.

However, when connector <NUM> is disposed in the proximal-most position thereof, as illustrated in <FIG>, proximally-facing surface 149b of connector <NUM> is sealingly engaged with seal member <NUM>, thus sealing proximally-facing cavity 149a of connector <NUM> from outflow conduit <NUM> of handpiece assembly <NUM> and inhibiting fluid communication therebetween. Thus, in the proximal-most position of connector <NUM>, no suction is applied through inner cutting shaft <NUM>.

The proximal-most position of connector <NUM> illustrated in <FIG> (which also corresponds to the proximal-most position of threaded coupler <NUM> and inner cutting shaft <NUM>), wherein proximally-facing surface 149b of connector <NUM> is sealingly engaged with seal member <NUM>, may correspond to an initial and/or home position of end effector assembly <NUM>. More specifically, end effector assembly <NUM> may initially be disposed with connector <NUM> in its proximal-most position prior to engagement of end effector assembly <NUM> with handpiece assembly <NUM>. Thus, upon engagement of end effector assembly <NUM> with handpiece assembly <NUM>, proximally-facing cavity 149a of connector <NUM> is sealed off from outflow conduit <NUM> of handpiece assembly <NUM>. Further, this initial position may be designated as a home position, whereby a control program (not shown) associated with motor <NUM> records the rotational position of drive rotor <NUM> upon engagement of end effector assembly <NUM> with handpiece assembly <NUM> (see <FIG>) and, after activation, ensures that drive rotor <NUM> stops at a rotational position corresponding to the proximal-most position of connector <NUM> and, thus, a position where proximally-facing cavity 149a of connector <NUM> is sealed off from outflow conduit <NUM> of handpiece assembly <NUM>.

The control program may utilize correlation information correlating, for example, rotation of drive rotor <NUM> with reciprocation of connector <NUM> to ensure that connector <NUM> is returned to its proximal-most position after each activation. As the correlating information may vary depending upon the particular end effector assembly <NUM> utilized, the control program may communicate with or read information from end effector assembly <NUM> in order to correlate rotation of drive rotor <NUM> with reciprocation of connector <NUM> and, thus, set the home position.

Turning to <FIG>, seal member <NUM> is shown. Other suitable seal members configured for use with tissue resecting instrument <NUM> (<FIG>) are also contemplated such as, for example, seal member <NUM> (<FIG>). Seal member <NUM> includes a generally cylindrical body <NUM>, a proximal rim <NUM> protruding radially outwardly from body <NUM>, and a distal rim <NUM> protruding radially outwardly from body <NUM> at a position spaced-apart relative to proximal rim <NUM>. Seal member <NUM> may be monolithically formed, e.g., molded, from any suitable material, e.g., silicone, rubber, PTFE, etc..

With additional reference to <FIG> and <FIG>, body <NUM> defined a longitudinal lumen <NUM> extending therethrough that is configured to receive distal spine 147c of proximal receiver <NUM> to secure seal member <NUM> about distal spine 147c. Distal rim <NUM> defines a distally-facing seal surface <NUM> and is configured to establish a seal against proximally-facing surface 149b of connector <NUM>, in response to proximal-urging of proximally-facing surface 149b into contact with distally-facing seal surface <NUM>, e.g., in the proximal-most position of connector <NUM> (see <FIG>). In this manner, distal rim <NUM> functions as a face seal. An outer periphery <NUM> of proximal rim <NUM>, on the other hand, is configured to sealingly engage an interior surface of proximal extension portion <NUM> of proximal hub housing <NUM> to inhibit any fluids disposed within proximal extension portion <NUM> of proximal hub housing <NUM> from passing proximally beyond seal member <NUM> and to inhibit fluid proximally of seal member <NUM> (but outside the outflow path) from being suctioned into the outflow path. Proximal rim <NUM> is configured as a dynamic seal in that outer periphery <NUM> thereof maintains a seal with the interior surface of proximal extension portion <NUM> of proximal hub housing <NUM> throughout rotation of distal spine 147c and, thus, seal member <NUM> relative to proximal extension portion <NUM> of proximal hub housing <NUM>. Accordingly, seal member <NUM> provides a dual-seal configuration.

Turning to <FIG>, another seal member <NUM> configured for use with tissue resecting instrument <NUM> (<FIG>) is shown. Seal member <NUM> includes a generally cylindrical body <NUM> defining a proximal end portion <NUM>, a distal end portion <NUM>, and a lumen <NUM> extending longitudinally therethrough. Distal end portion <NUM> of seal member <NUM> is inverted outwardly and back onto the exterior of body <NUM> to define a distally-facing surface 1168a and a radially-outwardly-facing surface 1168b.

With additional reference to <FIG> and <FIG>, body <NUM> is configured for positioning about distal spine 147c of proximal receiver <NUM> (with distal spine 147c extending through lumen <NUM>) to secure seal member <NUM> about distal spine 147c. Distally-facing surface 1168a is configured to establish a seal against proximally-facing surface 149b of connector <NUM>, in response to proximal-urging of proximally-facing surface 149b into contact with distally-facing seal surface 1168a, e.g., in the proximal-most position of connector <NUM> (see <FIG>). In this manner, distally-facing surface 1168a functions as a face seal. Radially-outwardly-facing surface 1168b, on the other hand, is configured to sealingly engage an interior surface of proximal extension portion <NUM> of proximal hub housing <NUM> to inhibit any fluids disposed within proximal extension portion <NUM> of proximal hub housing <NUM> from passing proximally beyond seal member <NUM> and to inhibit fluid proximally of seal member <NUM> (but outside the outflow path) from being suctioned into the outflow path. Radially-outwardly-facing surface 1168b is configured as a dynamic seal that is configured to maintain a seal with the interior surface of proximal extension portion <NUM> of proximal hub housing <NUM> throughout rotation of distal spine 147c and, thus, seal member <NUM> relative to proximal extension portion <NUM> of proximal hub housing <NUM>. Accordingly, seal member <NUM> provides a dual-seal configuration.

Referring generally to <FIG>, as an alternative to handpiece assembly <NUM> configured for manual grasping and manipulation during use, tissue resecting instrument <NUM> may alternatively be configured for use with a robotic surgical system wherein handle housing <NUM> 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 control 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).

Claim 1:
A tissue resecting instrument (<NUM>), comprising:
a handpiece assembly (<NUM>) including a drive rotor (<NUM>) and an outflow conduit (<NUM>); and
an end effector assembly (<NUM>) configured to releasably engage the handpiece assembly (<NUM>), the end effector assembly (<NUM>) comprising:
an outer shaft (<NUM>);
an inner shaft (<NUM>) disposed within the outer shaft (<NUM>) and configured to rotate and reciprocate relative to the outer shaft (<NUM>) for cutting tissue; and
an inner core drive assembly (<NUM>), including:
a proximal receiver (<NUM>) configured to receive a rotational input from the drive rotor (<NUM>) and to rotate in response thereto, the proximal receiver (<NUM>) including a seal member (<NUM>, <NUM>) disposed thereon; and
a connector (<NUM>) operably coupled to the proximal receiver (<NUM>) such that the rotation of the proximal receiver (<NUM>) effects rotation of the connector (<NUM>) and reciprocation of the connector (<NUM>) between a proximal position and a distal position, the connector (<NUM>) operably coupled to the inner shaft (<NUM>) such that the rotation and reciprocation of the connector (<NUM>) effects the rotation and reciprocation of the inner shaft (<NUM>), the connector (<NUM>) defining a cavity disposed in fluid communication with an interior of the inner shaft (<NUM>), characterized in that, in the proximal position, the connector (<NUM>) abuts the seal member (<NUM>, <NUM>) to establish a seal that blocks outflow from the cavity into the outflow conduit (<NUM>), and wherein, in the distal position, the connector (<NUM>) is displaced from the seal member (<NUM>, <NUM>) to permit outflow from the cavity into the outflow conduit (<NUM>).