Patent Description:
This document pertains generally, but not by way of limitation, to devices and example methods for debridement.

In a medical procedure, such as debridement, a medical device can be used such as to remove portions of tissue, bone, and/or other objects from a surgical site. The medical device can be a shaver, a debrider, a microdebrider, morcellator, or other suitable device for debridement. The medical device can have a cutting portion extending from a housing. During the procedure, the housing can be held by a professional and positioned relative to a patient such as to provide precise and careful removal of objects. Modern debriders can incorporate various minimally intrusive cutting mechanisms to shorten recovery time from the procedure. In such minimally intrusive cutting mechanisms, the cutter can be partially enclosed such as to only allow for cutting in a small window of the cutting mechanism. A shaft supplying the cutter can also be curved such as to enable further precision. Axial rotation of the elongated housing of the medical device can alter the direction of a cutting window and/or the angle of the cutting portion. <CIT> discloses a medical instrument having a slidable handle.

In an approach to debridement, a medical device can be used such as to abrade and remove portions of tissue or other objects. A medical device can have a cutting mechanism which can be rotatable relative to a housing by manipulation of a nosecone. One example of a medical device can have a housing without a handle and can be gripped by the professional like a pen between a thumb, index finger, and middle finger. Some professionals can prefer pen grip for certain placements and procedures of debridement. Another example of a medical device can have a housing connected to a handle and can be gripped by the professional like a pistol. Some professionals can prefer the pistol grip for certain placements and procedures of debridement and can utilize the ergonomic ease of manipulating the nosecone while the housing is securely anchored by hold of the handle.

Optimal grip of the device can vary among professionals across procedures depending on user hand size and shape, user technique, surgical site location, and other factors. The present inventors have recognized, among other things, that the limited available grip orientations available to a user of a medical device can create the need to alternate between multiple devices or can cause the professional to undertake the procedure without optimal ergonomic position of the device.

In the drawings, which are not necessarily drawn to scale, like numerals can describe similar components in different views. Like numerals having different letter suffixes can represent different instances of similar components.

The present disclosure, in one or more embodiments, relates to devices and methods for surgical debridement. More particularly, the present disclosure relates to an adjustable debrider and methods for versatile and precise debridement. A debridement procedure can be undergone to remove dead, damaged, necrotic, or infected tissue or other objects from a surgical site. A medical device such as a debrider, multidebrider, microdebrider, shaver, or other device can be utilized for selective, minimally invasive debridement. Debridement can be used to remove bone or tissue in ear, laryngeal, paranasal, nasal, uterine, tonsil, adenoid, and skull base surgeries. Debridement can also be used for other beneficial surgical purposes and at other surgical sites.

A debrider can include or use a handpiece, referred to herein as an elongate housing, which can be coupled to a shaft, also referred to herein as a blade. The debrider can be connected to other elements in a debridement system, such as a power supply, suction supply, irrigation line, motor control unit, declog valves, or other elements. The debrider can function to cut, shave, or drill material from a surgical site and can facilitate aspiration of the material from the site and to a collection cannister or other destination. The blade can be removably coupled to the housing and can be sized and shaped according to the specific surgical site. Accordingly, a professional can interchangeably couple one of a wide variety of blades to the housing depending on the procedure at hand. Depending on the size and shape of the blade and the surgical site, a professional can alter technique and grip in using the debrider. The housing can also be sized and shaped according to a preferential technique of a professional or to accommodate operation at a specific site. One approach to debridement is to use a completely disposable device manufactured for specific use at a particular site. This disposable device can have a handle fixed at a predetermined position on the housing. A problem with that approach, however, is that a professional cannot make adjustments to handle placement or employ several holds on the device during the procedure. As such, the professional can be inhibited from dynamically altering their technique to meet the needs of the procedure at hand. The present devices and techniques can help avoid such problems because the device is easily and quickly adjustable to several configurations.

The present disclosure relates to, among other things, a device and method enabling debridement at multiple surgical sites. The device also can help reduce the number of exchanges of medical devices during a procedure and can increase ease and precision of debridement by a professional. The device can be configured to be held by a professional during debridement using any of several common techniques. Additionally, the device can be configured to be held by an adjustable, removable handle. Alternatively or additionally, the device can be configured to be held by the device housing, and the handle can be easily removed from the device such as to remain out of the way for pen grip. The device can be configured to allow for various secure holding positions of the device with a dominant hand and ergonomic rotation of a nosecone with a non-dominant hand. Further, the device can be configured to allow for multiple points of connection of the handle along the length of the housing.

<FIG> shows a perspective view of an example of a debrider. A debrider <NUM> can include or use an elongate housing <NUM>, a blade <NUM>, a cutter <NUM>, a nosecone <NUM>, and an actuator <NUM>. The housing <NUM> can be elongate and can be substantially cylindrically shaped. The housing <NUM> can also be substantially elliptically, cylindrically shaped. Diameters of housings <NUM> shaped as such can be within a range of about <NUM> inches to about <NUM> inches. <NUM> inch ≈ <NUM>.

In some examples, the housing diameters can be within the range of about <NUM> inches to about <NUM> inches. The housing <NUM> can be reusable, such as can be washable or autoclavable. Alternatively, the housing <NUM> can be disposable, its inner contents configurable to a new housing. The debrider <NUM> can also include or use a handle <NUM> coupled to the housing <NUM>. The handle <NUM> can be intended for removal from the housing <NUM> once it has been coupled. The handle can be able to be removed from the housing <NUM> without excessive force or breakage once it has been coupled. The handle <NUM> can include or use an adjustment knob <NUM>. The handle can be sized and shaped such as to pair with a longitudinal channel or slot <NUM> of the housing <NUM>. The blade <NUM> can be attached or coupled to the housing <NUM> and extend therefrom. The blade <NUM> can extend at least partially through the housing <NUM>. The blade <NUM> can include or use a cutting mechanism, referred to herein as cutter <NUM>. The blade <NUM> can be curved at a variety of different angles such as to allow for precision in placement of the cutter <NUM> during debridement. The cutter <NUM> can be a reciprocating or oscillating pair of cutting members, a rotating cutting member, or both. Alternatively or additionally, the cutter <NUM> can be a rotating burr. The cutter <NUM> can also be an electrode cutter. An illustrative example of an electrode cutter is described in <CIT>, and entitled Electrode Blade for Shavers, including for its teaching of a medical device having an electrode blade, which can be used in combination with the debridement device described in the present disclosure. The cutter <NUM> can also include or use other mechanisms suitable for debridement blades. The cutter can include a cutter window such as to focus the cutting action in a particular lateral direction relative to the blade <NUM>. The housing can include or use a blade drive mechanism configured to drive the cutter <NUM>. The blade drive mechanism can be an electric motor, a solenoid assembly, or other appropriate mechanism to move the cutter <NUM>. For example, the cutter <NUM> can be motorized. The blade drive mechanism can be activated by an actuator <NUM>. The actuator <NUM> can be a switch, a knob, a button, or other mechanism for actuation of the cutter <NUM>. The actuator <NUM> can be located on the housing <NUM>, such as located on the top of the housing as depicted in <FIG>. The actuator <NUM> can be located at other locations on the housing, or alternatively or additionally can be located at a remote location, such as on a footswitch. The blade <NUM> can include or use a nosecone <NUM> at or near a blade connection point at a distal end of the housing <NUM>. Turning the nosecone <NUM> about a medial axis of the housing <NUM> can cause rotation of the blade <NUM>. Where the cutter <NUM> of the blade <NUM> has a cutter window, turning of the nosecone <NUM> can alter the lateral direction of the cutter window. Further, where the blade <NUM> is curved at an angle, turning of the nosecone <NUM> can alter the lateral direction in which the angled blade <NUM> extends. The debrider <NUM> can be itself a component of a larger debridement system. For example, the debrider can be tethered to a source of suction, irrigation, or both via one or more connection lines <NUM> (see <FIG>). Accordingly, the debrider <NUM> can provide aspiration and removal of tissue and other objects as they are shaved, cut, or drilled. For example, the debrider <NUM> can contain a port configured to supply remote suction and/or irrigation to a lumen of the blade or shaft <NUM>. Aspiration can be a helpful feature of a debrider <NUM> with respect to cutting performance.

<FIG> shows a side view of an example of a debrider in operation with a pen grip. A professional can hold or grasp the debrider <NUM> by the housing for certain procedures and techniques. Generally, such a hold can be referred to as "pen grip". <FIG> shows one way a professional can use the debrider <NUM> in pen grip. The housing <NUM> can rest at or near a dominant hand <NUM> between a thumb <NUM> and an index finger <NUM>. While distinguished herein as the dominant hand <NUM> and the non-dominant hand, it is understood that either hand can be interchangeably used. The housing <NUM> can also rest at or near the middle finger <NUM>, as shown. The professional can securely grip the housing between the thumb <NUM> and index finger <NUM> and further anchor the hold by gripping the housing <NUM> with the middle finger <NUM>. Other fingers, such as a ring finger or pinky finger can also be used to grip the housing <NUM> in pen grip. Pen grip can enable a professional to have enhanced control and placement of the cutter <NUM> relative to the surgical site <NUM>. For instance, pen grip can enable secure, ergonomic rotation of the debrider <NUM> without excess strain on a wrist <NUM>. Pen grip can further be advantageous for certain techniques and procedures depending on the professional's facility, hand size, and other factors. It can also be used to accommodate various individual patient anatomies and pathologies. For pen grip, the handle (as depicted in <FIG>) can be removed. The debrider <NUM> can be used in pen grip without the handle <NUM> extending distally from the housing <NUM> such as to avoid interference of the handle <NUM> during the procedure.

<FIG> shows a side view of an example of a debrider in operation with a pistol grip. A professional can hold or grasp the debrider <NUM> by the handle <NUM>. Generally, such a hold can be referred to as "pistol grip". <FIG> shows one way a professional can use the debrider <NUM> in pistol grip. The handle <NUM> can extend distally from the housing <NUM> such as to allow for the debrider <NUM> to be held solely by the handle <NUM>. A professional can also hold the debrider holding the handle <NUM> and the housing <NUM>. In one example of a hold depicted in <FIG>, a professional can securely grab the handle <NUM> between the thumb <NUM> and fingers, the handle <NUM> being held in an arch of the hand <NUM>. Other techniques of holding the handle <NUM> can be used. Pistol grip can provide a professional with enhanced power and stability in using the debrider <NUM>. Pistol grip can also enable ergonomic rotation of the nosecone <NUM> relative to the housing <NUM> using the non-dominant hand, such as to allow for secure, anchored counterforce applied by the dominant hand <NUM>. Using the nosecone <NUM> (rather than rotating the housing <NUM>) to rotate the cutter <NUM> can be beneficial for certain procedures as the housing <NUM> is generally tethered to the one or more connection lines <NUM>. Pistol grip can further be advantageous for certain techniques and procedures depending on the professional's facility, hand size, and other factors. It can also be used to accommodate various individual patient anatomies and pathologies. The handle <NUM> can include or use mechanisms such as to allow for variable longitudinal placement of the handle <NUM> relative to the housing <NUM>. Variable longitudinal placement of the handle <NUM> can be available in predefined increments, such as by incremental indentations or protrusions on the housing <NUM>. Alternatively, variable longitudinal placement of the handle can be available continuously along the housing <NUM>. The handle <NUM> can include or use one of several locking mechanisms to fix the handle <NUM> to the housing at a plurality of different longitudinal positions along the housing <NUM>. The handle <NUM> can extend distally from the housing <NUM> at a length within a range of about <NUM> inches to about <NUM> inches. In some examples, the handle <NUM> can extend at a length within the range of about <NUM> inches to about <NUM> inches <NUM> inch ≈ <NUM>.

<FIG> shows a front view of an example of a handle paired to a debrider. A handle <NUM> can include or use a knob <NUM>, a rod <NUM> (as depicted in <FIG>), a tongue <NUM>, and one or more tongue grips <NUM>. The housing <NUM> of the debrider <NUM> can include or use a channel or slot <NUM> located on the underside of the housing <NUM>. The slot <NUM> can be a t-shaped slot. The slot <NUM> can also be triangular shaped, or can be otherwise shaped for coupling in a similar manner. The handle <NUM> can be sized and shaped such that the tongue <NUM> can mate to the slot <NUM> of the housing <NUM>. As such, the tongue <NUM> can be a t-shaped tongue. The tongue <NUM> can also be triangular shaped, or can be otherwise shaped for coupling in a similar manner. The tongue can include or use one or more tongue grips <NUM>. <FIG> depicts a pair of tongue grips <NUM> located on the underside of a t-shaped tongue <NUM>. The tongue grips <NUM> can be located between the tongue <NUM> and the slot <NUM> and can function to increase friction between the two. The tongue grips can also be located in the slot <NUM> of the housing, or located on both the tongue <NUM> and the slot <NUM>. The tongue grips <NUM> can be members made of rubber, plastic, metal, or other suitable material for providing friction. The tongue grips <NUM> can also be a surface finish on either or both of the tongue <NUM> and slot <NUM>. For example, the tongue grips <NUM> can be knurling, serrations, or other finish on the surface of the tongue <NUM>, slot <NUM>, or both. While the slot <NUM> is described herein being located on the housing <NUM> and sized and shaped to mate with the tongue <NUM> located on the handle <NUM>, it is also understood that the slot <NUM> can be located on the handle <NUM> and the tongue <NUM> on the housing and can function similarly.

<FIG> shows a cross-section view of an example of a handle paired to a portion of a debrider. Here, the cross-section view of the portion of the debrider <NUM> is taken along a plane 3B-3B as shown in <FIG>. The knob <NUM> can be attached to the rod <NUM> which extends through a bore <NUM> of the handle <NUM>. The rod <NUM>, which can be threaded as depicted in <FIG> & <FIG>, can attach by screwing to a threaded hole of the knob <NUM>. Alternatively or additionally, the rod <NUM> can be attached to the knob <NUM> such as with an ultraviolet-curable adhesive. The rod <NUM> can also be bonded to the knob <NUM> such as with the use of radiofrequency welding, solvent, or glue. Other suitable methods of attachment can also be used. Both the rod <NUM> and the bore <NUM> can be threaded complementarily such that the rod <NUM> can be screwed into the bore <NUM>. Turning the knob <NUM> can cause the rod <NUM> to protrude out the bore <NUM> proximally towards the housing <NUM>. Turning the knob <NUM> can cause the rod <NUM> to be retracted into the bore distally away from the housing <NUM>.

<FIG> shows an isolated cross-section view of an example of a handle paired to a debrider. When the tongue <NUM> is mated to the slot <NUM>, the handle <NUM> can be slidably connected to the housing <NUM>. When the knob <NUM> is turned to cause the rod <NUM> to protrude out the bore <NUM> proximally towards the housing, a superior end <NUM> of the rod <NUM> can contact slot <NUM> of the housing <NUM>. Protrusion of the rod <NUM> can create pressure between the housing <NUM> and the handle <NUM>, causing the tongue <NUM> to be pressed distally away from the housing <NUM>. Thus, protrusion of the rod <NUM> can compress the tongue grips <NUM> against the slot <NUM>, such as against rails of the slot <NUM>. Similar compression can occur where the tongue grips <NUM> are located in the slot <NUM>. Where the tongue grips <NUM> are compressed between the slot <NUM> and the tongue <NUM>, longitudinal sliding of the handle <NUM> relative to the housing <NUM> can be restricted. Turning the knob <NUM> an opposite direction can cause the rod <NUM> to retract into the bore <NUM> distally away from the housing <NUM>. Releasing the rod <NUM> pressure on the slot <NUM> can cause decompression of the tongue grips <NUM> and restore free longitudinal movement of the handle <NUM> relative to the housing <NUM>.

In operation and use, a professional can provide or obtain a medical device <NUM> for use in debridement. The professional can turn the knob <NUM> of the handle <NUM> in a locking direction to clamp the handle <NUM> to the housing <NUM>, restricting longitudinal motion of the handle <NUM> relative to the housing <NUM>. The professional can turn the knob <NUM> of the handle <NUM> in an unlocking direction to restore longitudinal motion of the handle <NUM> relative to the housing <NUM>. In one example, the professional can turn the knob <NUM> in the unlocking position, unclamping the handle <NUM>, and can slidably remove the handle <NUM> from the housing <NUM> and use the device in "pen grip". In another example, the professional can secure the handle <NUM> to a desired longitudinal position of the housing <NUM> by turning the knob <NUM> in a locking direction and use the device in "pistol grip". The professional can position the cutter <NUM> relative to the surgical site <NUM>, and sever, cut, shave, drill, and/or remove tissue or other objects therefrom.

<FIG> show another example of a debrider handle. Particularly <FIG> shows a cross-section view of an example of a handle paired to a portion of a debrider. Here, the cross-section view of the portion of the debrider <NUM> is taken along a plane 3B-3B as shown in <FIG>. Handle <NUM> is similar to handle <NUM>, but contains a lever <NUM> connected to the handle <NUM> about a pivot <NUM>. The pivot <NUM> can be a pin, rod, or other substantially cylindrical portion extending through the handle <NUM> and the lever <NUM>. The pivot <NUM> can also be a physical, rotatable connection between the body of the lever <NUM> and the handle <NUM>. The pivot <NUM> can also be one or more projections on the handle <NUM> which can mate with one or more apertures on the lever <NUM>. The pivot <NUM> can also be one or more projections on the lever <NUM> which can mate with one or more apertures on the handle <NUM>. The lever <NUM> can be connected to the handle <NUM> eccentrically about the pivot <NUM> such that a cam <NUM> is created about the pivot <NUM>. The cam <NUM> can be attached to the rod <NUM>, such as can attach by screwing to a threaded hole of the cam <NUM>. Alternatively or additionally, the rod <NUM> can be attached to the cam <NUM> such as with an ultraviolet-curable adhesive. The rod <NUM> can also be bonded to the cam <NUM> such as with the use of radiofrequency welding, solvent, or glue. Other suitable methods of attachment can also be used. The cam <NUM> can be oriented eccentrically such as to convert rotational motion from the lever <NUM> to linear motion of the rod <NUM> within the bore <NUM>. Turning or closing the lever <NUM> radially about the pivot <NUM> towards the handle <NUM> can cause the cam <NUM> to manipulate the rod <NUM> to protrude out the bore <NUM> to contact the housing, compressing the tongue grips <NUM> against the slot <NUM>, such as against rails of the slot <NUM>. Similar compression can occur where the tongue grips <NUM> are located in the slot <NUM>. Where the tongue grips <NUM> are compressed between the slot <NUM> and the tongue <NUM>, longitudinal sliding of the handle <NUM> relative to the housing <NUM> can be restricted. Thus, when the lever <NUM> is turned completely to a locked position, as depicted in <FIG>, the handle <NUM> can be secured to a desired position along the length of the housing <NUM>. Releasing the lever <NUM> from the locked position can cause the rod <NUM> to retract into the bore <NUM> distally away from the housing <NUM>. Releasing the lever to an unlocked position, as depicted in <FIG>, can cause decompression of the tongue grips <NUM> and restore free longitudinal movement of the handle <NUM> relative to the housing <NUM>.

In operation and use, a professional can provide or obtain a medical device <NUM> for use in debridement. The professional can radially turn the lever <NUM> of the handle <NUM> to the locked position to clamp the handle <NUM> to the housing <NUM>, restricting longitudinal motion of the handle <NUM> relative to the housing <NUM>. The professional can radially turn the lever <NUM> of the handle <NUM> to the unlocked position to restore longitudinal motion of the handle <NUM> relative to the housing <NUM>. In one example, the professional can radially turn the lever <NUM> to the unlocked position, unclamping the handle <NUM>, and can slidably remove the handle <NUM> from the housing <NUM> and use the device in "pen grip". In another example, the professional can secure the handle <NUM> to a desired longitudinal position of the housing <NUM> by radially turning the lever <NUM> to the locked position and use the device in "pistol grip". The professional can position the cutter <NUM> relative to the surgical site <NUM>, and sever, cut, shave, drill, and/or remove tissue or other objects therefrom.

<FIG> show another example of a debrider handle. In some examples, a debrider <NUM> (as depicted in <FIG>) can include or use one or more longitudinal grooves <NUM> of a housing <NUM>. The debrider <NUM> can have a pair of longitudinal grooves <NUM> running parallel on opposing side walls of the housing <NUM>. A handle <NUM> can include or use one or more bars <NUM> sized and shaped to ride the one or more longitudinal grooves <NUM>. Where the bars <NUM> of the handle <NUM> ride the grooves <NUM>, the handle <NUM> can be slidingly paired to the housing <NUM>. As such, the handle <NUM> can slide longitudinally along a length of the grooves <NUM>. While the connection is described herein as having bars <NUM> riding grooves <NUM>, other equivalent connections enabling longitudinal sliding motion of the handle <NUM> relative to the housing <NUM> are commonly known by persons skilled in the art and can be used herewith. For instance, alternatively or additionally the grooves <NUM> can be on the handle <NUM> and the bars <NUM> can be on the housing <NUM>. <FIG> shows a perspective view of an example of the debrider handle <NUM>. The handle <NUM> can include one or more bars <NUM> sized and shaped to conform to one or more grooves <NUM> of the housing <NUM>. The one or more bars <NUM> can house one or more detent balls <NUM> sized and shaped to conform to one of a plurality of groove detents <NUM> (as shown in <FIG>) of the longitudinal grooves <NUM>. The detents <NUM> can protrude medially from the bars <NUM>. The handle <NUM> can also include or use one or more tabs <NUM>. The one or more tabs can be located on the handle <NUM> at or near the one or more bars <NUM>.

<FIG> shows a side view of an example of a portion of a handle paired to a portion of a debrider. The handle <NUM> can be slidably connected to the housing <NUM> where the bars <NUM> are sized and shaped to ride the grooves <NUM> of the housing. The longitudinal grooves <NUM> can include or use groove detents <NUM> sized and shaped to at least partially receive the one or more detent balls <NUM>. In some examples, each longitudinal groove <NUM> can contain an amount of groove detents <NUM> within a range of <NUM> to <NUM> detents <NUM>. Each longitudinal groove <NUM> can contain an amount of groove detents <NUM> within a range of <NUM> to <NUM> detents <NUM>. When one or more of the detent balls <NUM> of the rails <NUM> are at least partially disposed in one or more of the plurality of groove detents <NUM>, longitudinal movement of the handle <NUM> relative to the housing <NUM> can be restricted.

<FIG> shows an isolated cross-section view of an example of a debrider handle in a locked position. Here, the cross-section view of the portion of the debrider <NUM> is taken along a plane 5C-5C as shown in <FIG>. The handle can include or use the tabs <NUM> located at or near the bars <NUM>. Each of the one or more tabs <NUM> can include or use a tab detent <NUM>. The handle <NUM> can be biased towards a locked position by one or more springs <NUM> located at or near the rails <NUM>. The springs <NUM> can be fixed to the tabs <NUM>. The springs <NUM> can bias the tabs <NUM> such that the tab detents are inaccessible by the detent balls <NUM>. In one example, the springs can bias the tabs <NUM> distally towards the housing <NUM> and bias the tab detents <NUM> away from the detent balls <NUM> as they are housed in the rails <NUM>. Where the tabs are biased to place the handle <NUM> in a locking position, the detent balls <NUM> can protrude medially towards the housing <NUM> and can be at least partially disposed within the plurality of groove detents <NUM> of the housing <NUM>. While the handle <NUM> is in the locked position, the handle <NUM> can be fixed at one of several predetermined positions along the length of the housing <NUM>.

<FIG> is an isolated cross-section view of a debrider handle in an unlocked position. Here, the cross-section view of the portion of the debrider <NUM> is taken along a plane 5C-5C as shown in <FIG>. The tabs <NUM> can be manually moved against the bias of the springs <NUM>, as depicted. Moving the tabs <NUM> against the bias can move the tab detents <NUM> to become accessible by the detent balls <NUM>. Where the detent balls <NUM> have access to the tab detents <NUM>, they can be retracted away from the groove detents <NUM> towards the tab detents <NUM>. Thus, in the unlocked position, the detent balls <NUM> can be removed from the groove detents <NUM> and sliding motion of the rails <NUM> riding the grooves <NUM> can be restored. It is understood that the bars <NUM>, and the mechanisms contained within, could be alternatively configured to be located on the housing <NUM> and the grooves <NUM> on the handle.

In operation and use, a professional can provide or obtain a medical device <NUM> for use in debridement. The professional can manually move the one or more tabs <NUM> against their spring <NUM> bias to retract the detent balls <NUM> back into the handle. The professional can slide the one or more bars <NUM> along the one or more grooves <NUM> to slidingly attach the handle <NUM> to the housing <NUM>. The professional can place the handle <NUM> at a desired, predetermined position and release the tabs <NUM> to lock the handle in place. In one example, the professional can use this handle for debridement with "pistol grip". In another example, the professional can manually move the tabs <NUM> against their bias to the unlocked position and can slidably remove the handle <NUM> from the housing <NUM> and use the device in "pen grip". The professional can position the cutter <NUM> relative to the surgical site <NUM>, and sever, cut, shave, drill, and/or remove tissue or other objects therefrom.

<FIG> show yet another example of a debrider handle. <FIG> depicts a portion of a debrider <NUM> in phantom as it is paired with a handle <NUM>. The debrider <NUM> can be paired to the handle <NUM> which can include or use a handle base <NUM>, a sleeve <NUM> and a pair of jaws <NUM> each having bars <NUM> sized and shaped to conform to grooves <NUM> of a housing <NUM>. <FIG> shows a cross-section view of a portion of a debrider taken along a plane 6B-6B as shown in <FIG>. The bars <NUM> can have a sticky or tacky surface finish, knurling, or serrations (as depicted in <FIG>) such as to increase friction between the bars <NUM> and the grooves <NUM>. Alternatively or additionally, the grooves <NUM> can have a sticky or tacky surface finish, knurling, or serrations. The pair of jaws can be hingedly connected to the handle base about a pivot <NUM>. The pivot <NUM> can be a pin, rod, or other substantially cylindrical portion extending through the jaws <NUM> and the handle base <NUM>. The pivot <NUM> can also be a physical, rotatable connection between the body of the handle base <NUM> and the jaws <NUM>. The pivot <NUM> can also be one or more projections on the jaws <NUM> which can mate with one or more apertures on the handle base <NUM>. The pivot <NUM> can also be one or more projections on the handle base <NUM> which can mate with one or more apertures on the jaws <NUM>. The jaws <NUM> can intersect about the pivot <NUM> such as to create a vertical pair of jaw angles: an inferior jaw angle <NUM> and a superior jaw angle <NUM>. The jaws can both be attached to a jaw spring <NUM> at or near the inferior angle <NUM>. The jaw spring <NUM> can bias the jaws laterally at both the inferior jaw angle <NUM> and superior jaw angle <NUM>. Thus, the above described jaw configuration can function to spread the jaws apart, creating a relatively wide vertical pair of jaw angles <NUM> and <NUM>.

The sleeve <NUM> can be a tube and can be sized and shaped such as to slidably couple to an outer diameter of the handle base <NUM>. The sleeve <NUM> is shown in phantom in <FIG> in order to depict the other components therein. The sleeve <NUM> can further be sized and shaped such that the inner diameter of the sleeve <NUM> is smaller than a jaw width <NUM> (as depicted in <FIG>) when clamped to a housing <NUM>. The sleeve <NUM> and handle base <NUM> can be attached to a sleeve spring <NUM>. The sleeve spring can bias the sleeve <NUM> to slide upward distally from the handle base. In doing so, the inner diameter of the sleeve <NUM> can clamp the jaws <NUM> such as to move the jaws medially against the bias of the jaw spring <NUM>. The sleeve spring <NUM> can have a significantly higher spring force than that of the jaw spring <NUM>. Thus, the sleeve spring <NUM> can cause the mechanism to overcome the bias of the jaw spring <NUM> except where manual pressure is exerted on the mechanism against the direction of the sleeve spring <NUM>. A professional can exert such manual pressure on the sleeve <NUM> in a superior direction in order to move the handle <NUM> to an unlocked position as depicted in <FIG>. In the unlocked position, the jaws <NUM> are at least partially released by the sleeve <NUM> allowing the vertical pair of jaw angles <NUM> and <NUM> in increase. The professional can return the handle <NUM> to locking position by releasing the sleeve <NUM>, allowing it to return to its bias as depicted in <FIG>.

In another example, as depicted in 7A and 7B, the sleeve <NUM> can include or use a channel mechanism to supply the superior clamping pressure.

<FIG> depicts a portion of the debrider <NUM> in phantom as it is paired with a handle <NUM>. <FIG> also show the sleeve <NUM> in phantom in order to depict the contents therein. The channel mechanism can include or use a channel <NUM> and a follower <NUM>. The channel <NUM> can be included in the handle base <NUM> and the follower <NUM> can be included in the sleeve <NUM>. Alternatively, the channel <NUM> can be included in the sleeve <NUM> and the follower <NUM> can be included in the handle base <NUM>. Manually turning the sleeve <NUM>, such as turning the sleeve <NUM> clockwise in accordance with <FIG>, can cause the sleeve <NUM> to slide upward distally from the handle base <NUM>. The sleeve <NUM>, channel <NUM>, and follower <NUM> can alternatively be configured such as to allow for counter-clockwise turning to cause the sleeve <NUM> to slide upward distally from the handle base <NUM>. The channel <NUM> can include or use inclined segments, horizontal segments, or both. The channel <NUM> can be s-shaped such as to allow for a horizontal, unlocked position, a vertical rise position, and a horizontal, locked position. Other appropriate shapes and configurations of a channel <NUM> and a follower <NUM> can also be used. The sleeve <NUM> can be turned in an opposite direction to move the sleeve <NUM> in an inferior direction, releasing the clamping pressure on the jaws <NUM>, as depicted in <FIG>.

In operation and use, a professional can provide or obtain a medical device <NUM> for use in debridement. The professional can manually move the sleeve <NUM> in an inferior direction to release clamping pressure on the jaws. The professional can slide the one or more bars <NUM> along the one or more grooves <NUM> to slidingly attach the handle <NUM> to the housing <NUM>. The professional can place the handle <NUM> at a desired, predetermined position and release or turn the sleeve <NUM> to cause the sleeve <NUM> to move in a superior direction, clamping the jaws <NUM> and locking the handle <NUM> to the housing <NUM>. In one example, the professional can use this handle for debridement with "pistol grip". In another example, the professional can manually move the sleeve <NUM> in an inferior direction to the unlocked position and can slidably remove the handle <NUM> from the housing <NUM> and use the device in "pen grip". The professional can position the cutter <NUM> relative to the surgical site <NUM>, and sever, cut, shave, drill, and/or remove tissue or other objects therefrom.

The above description includes references to the accompanying drawings, which form a part of the detailed description.

Geometric terms, such as "parallel", "perpendicular", "round", or "square", are not intended to require absolute mathematical precision, unless the context indicates otherwise. Instead, such geometric terms allow for variations due to manufacturing or equivalent functions. For example, if an element is described as "round" or "generally round," a component that is not precisely circular (e.g., one that is slightly oblong or is a many-sided polygon) is still encompassed by this description.

Claim 1:
A medical device for tissue removal, the medical device comprising:
an elongate housing (<NUM>) including at least one longitudinal groove;
a shaft extending through the elongate housing (<NUM>) and distally therefrom, the shaft containing a cutter (<NUM>) configured to sever tissue;
a drive configured to rotate the cutter (<NUM>), reciprocate the cutter (<NUM>), or both;
a handle (<NUM>) slidably coupled to the elongate housing (<NUM>) at the at least one longitudinal groove and extending distally therefrom; and
at least one locking mechanism configured to fix the handle (<NUM>) to the elongate housing (<NUM>) at a plurality of different longitudinal positions along the elongate housing;
characterised in that
the longitudinal groove comprises a T-shaped slot (<NUM>),
wherein the locking mechanism comprises a tongue (<NUM>) mating the slot (<NUM>) and a rod (<NUM>) moveable though the tongue (<NUM>) to push the tongue (<NUM>) away from the housing (<NUM>) against rails of the slot (<NUM>).