Patent ID: 12239339

DETAILED DESCRIPTION

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. Additional components can be paired to the housing to further modify the device for various uses. One approach to debridement is to use a completely disposable device manufactured for specific use at a particular site. This approach can be costly and prohibitive to a professional. Another approach to debridement is to use a reusable debrider housing outfitted with disposable components (i.e., a blade, a handle, or other components) sized and shaped for each specific procedure or technique. A problem with that approach, however, is that a professional must locate, assemble, and clean several parts to construct a device fit for the procedure. Further, the professional is limited during surgery to using the device-as-assembled and 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 a collapsible handle or elongate grip of the handle. Alternatively or additionally, the device can be configured to be held by the device housing, and the elongate grip of the handle can recede to a collapsed position. The device, where the elongate grip is in the collapsed position, can be configured to be securely held and easily rotated due to presence of a truncate stub. 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.1shows a perspective view of an example of a debrider. A debrider100can include or use an elongate housing102, a blade106, a cutter104, a nosecone108, and an actuator116. The housing102can be elongate and can be substantially cylindrically shaped. The housing102can also be substantially elliptically, cylindrically shaped. Diameters of housings102shaped as such can be within a range of about 0.25 inches to about 2 inches. In some examples, the housing diameters can be within the range of about 0.875 inches to about 1.25 inches. The housing102can be reusable, such as can be washable or autoclavable. Alternatively, the housing102can be disposable, its inner contents configurable to a new housing. The debrider100can also include or use a handle134coupled to the housing102. The handle134can be not intended for removal from the housing102once it has been coupled. The handle can be unable to be removed from the housing102without excessive force or breakage once it has been coupled. The handle134can include or use a truncate stub110and an elongate grip112coupled to the truncate stub about a pivot point118. The handle can additionally include or use a removeable grip cover133(seeFIG.2B). The blade106can be attached or coupled to the housing102and extend therefrom. The blade106can extend at least partially through the housing102. The blade106can include or use a cutting mechanism, referred to herein as cutter104. The blade106can be curved at a variety of different angles such as to allow for precision in placement of the cutter104during debridement. The cutter104can be a reciprocating or oscillating pair of cutting members, a rotating cutting member, or both. Alternatively or additionally, the cutter104can be a rotating burr. The cutter104can also be an electrode cutter. An illustrative example of an electrode cutter is described in U.S. patent application Ser. No. 15/936,678, filed on Mar. 27, 2018, and entitled Electrode Blade for Shavers, which is incorporated by reference herein in its entirety, 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 cutter104can also include or use other mechanisms suitable for debridement blades. The cutter104can include a cutter window such as to focus the cutting action in a particular lateral direction relative to the blade106. The housing can include or use a blade drive mechanism configured to drive the cutter104. The blade drive mechanism can be an electric motor, a solenoid assembly, or other appropriate mechanism to move the cutter104. For example, the cutter104can be motorized. The blade drive mechanism can be activated by an actuator116. The actuator116can be a switch, a knob, a button, or other mechanism for actuation of the cutter104. The actuator116can be located on the housing102, such as located on the top of the housing as depicted inFIG.1. The actuator116can 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 blade106can include or use a nosecone108at or near a blade connection point at a distal end of the housing102. Turning the nosecone108about a medial axis of the housing102can cause rotation of the blade106. Where the cutter104of the blade106has a cutter window, turning of the nosecone108can alter the lateral direction of the cutter window. Further, where the blade106is curved at an angle, turning of the nosecone108can alter the lateral direction in which the angled blade106extends. The debrider100can be itself a component of a larger debridement system. For example, the debrider100can be tethered to a source of suction, irrigation, or both via one or more connection lines142(seeFIGS.2A and2B). Accordingly, the debrider100can provide aspiration and removal of tissue and other objects as they are shaved, cut, or drilled. For example, the debrider100can contain a port configured to supply remote suction and/or irrigation to a lumen of the blade or shaft106. Aspiration can be a helpful feature of a debrider100with respect to cutting performance.

FIG.2Ashows a side view of an example of a debrider in operation with a pen grip. A professional can hold or grasp the debrider100by the housing for certain procedures and techniques. Generally, such a hold can be referred to as “pen grip”.FIG.2Ashows one way a professional can use the debrider100in pen grip. The housing102can rest at or near a dominant hand150between a thumb154and an index finger156. While distinguished herein as the dominant hand150and the non-dominant hand, it is understood that either hand can be interchangeably used. The housing102can also rest at or near the middle finger158, as shown. The professional can securely grip the housing between the thumb154and index finger156and further anchor the hold by gripping the truncate stub110with the middle finger158. Other fingers, such as a ring finger or pinky finger can also be used to grip the truncate stub110. Pen grip can enable a professional to have enhanced control and placement of the cutter104relative to the surgical site140. For instance, pen grip with the truncate stub110as an anchor can enable secure, ergonomic rotation of the debrider100without excess strain on a wrist152. 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. In the collapsed position, the elongate grip112can be at least partially disposed in a cavity103of the housing102. The elongate grip112can also be fully disposed in the cavity103of the housing102or can be collapsed parallel to the housing but not within a housing cavity. The debrider100can be used in pen grip without the elongate grip112extending distally from the housing102such as to avoid interference of the elongate grip112during the procedure.

FIG.2Bshows a side view of an example of a debrider in operation with a pistol grip. The elongate grip112can be moved to a deployed position (as depicted inFIG.1) and coupled to a removable grip cover133as shown inFIG.2B. A professional can hold or grasp the debrider100by the handle134including or using the truncate stub110and an elongate grip112coupled to the truncate stub110about a pivot point118. Generally, such a hold can be referred to as “pistol grip”.FIG.2Bshows one way a professional can use the debrider100in pistol grip. The elongate grip112can extend distally from the housing102such as to allow for the debrider100to be gripped by the elongate grip112and the truncate stub110. A professional can hold the debrider100solely by this handle134or can also hold the debrider holding the handle134and the housing102. In one example of a hold depicted inFIG.2B, a professional can securely grab the handle134between the thumb154and fingers, the handle134being held in an arch of the hand150. Other techniques of holding the handle134can be used. Pistol grip can provide a professional with enhanced power and stability in using the debrider100. Pistol grip can also enable ergonomic rotation of the nosecone108relative to the housing102using the non-dominant hand, such as to allow for secure, anchored counterforce applied by the dominant hand150. Using the nosecone108(rather than rotating the housing102) to rotate the cutter104can be beneficial for certain procedures as the housing102is generally tethered to the one or more connection lines142. 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.

FIG.3Ashows a side view of an example of a debrider in a collapsed configuration. The debrider100can include or use the handle134having the truncate stub110and the elongate grip112coupled to the truncate stub110about the pivot point118. The truncate stub110can extend distally from the housing102at a length within a range of about 0.1 inches to about 2 inches. In some examples, the truncate stub110can extend at a length within the range of about 0.5 inches to about 0.85 inches. The pivot point118can be a pin extending through a bore of the truncate stub110. The pivot point118can also be a physical, rotatable connection between the elongate grip112and the truncate stub110. The pivot point118can also be one or more projections on the truncate stub110which can mate with one or more apertures on the elongate grip112. The pivot point118can also be one or more projections on the elongate grip112which can mate with one or more apertures on the truncate stub110. Other suitable connections can be used to create the pivot point118as well. In one example, as depicted inFIG.3A, the elongate grip112can pivot to be closed aft in a collapsed position and can be at least partially disposed in a cavity103of the housing102. One or more grip locks114can be used to retain the elongate grip112in the collapsed position and restrict the grip112thereto. Additionally, as depicted inFIG.3B, the elongate grip112can pivot to be opened fore in a deployed position where the grip112extends distally from the housing. The handle134, having the elongate grip112in the deployed position, can extend distally from the housing102at a length within a range of about 0.2 inches to about 6 inches. In some examples, the deployed handle134can extend at a length within the range of about 2 inches to about 3.5 inches.

In operation and use, a professional can provide or obtain a medical device100for use in debridement. The professional can turn the elongate grip112about the pivot118on the truncate stub110to manipulate the orientation of components of the device100. For example, the professional can turn or close the elongate grip112completely aft and use the device in “pen grip”. In another example, the professional can turn or open the elongate grip112completely fore and use the device in “pistol grip”. The professional can turn the elongate grip to a position between completely closed aft and completely open fore and unlock the handle134with respect to longitudinal sliding action along the housing102. The professional can place the handle134at a preferred longitudinal position of the housing102and turn or open the elongate grip completely open fore to lock the handle134with respect to longitudinal sliding action along the housing102. The professional can position the cutter104relative to a surgical site140, and sever, cut, shave, drill, and/or remove tissue or other objects therefrom.

FIGS.4A &4Bshow an isolated view of an example of a grip lock114. The grip lock114can include or use a lock pin124, a lock spring126, a lock channel128, and one or more lock guides122. In a locked position, as depicted inFIG.4A, the grip lock114can impede movement of the elongate grip112fore, restricting it to the collapsed position. The lock spring126can bias the lock114such as to extend the lock pin124at least partially into the cavity103of the housing102. The elongate grip112can include a grip bore at an end distal to the pivot point118. Thus, the lock pin124can extend at least partially through the grip bore, restricting movement of the elongate grip112. As depicted inFIG.4B, moving the grip lock114to an unbiased position can cause the lock pin124to retract from the bore of the elongate grip112, restoring pivoting action to the grip112. The grip lock114can include or use one or more components to secure travel of the lock114such as the lock channel128and/or the one or more lock guides122. The elongate grip112and lock pin124can both be sized and shaped such as to allow the elongate grip112to be closed aft while the grip lock114is in the biased position, the lock114able to be displaced momentarily by manipulation of an elongate grip edge113before locking the grip112in the closed position. In other words, the elongate grip112can displace the lock pin124when closed aft, even where the grip112cannot displace the lock pin124when opened fore. The grip lock114, while described herein and depicted specifically, can be one of any suitable, equivalent locking mechanisms to restrict pivoting action of the elongate grip112. Other suitable mechanisms for locking the grip112can be used herewith as will be appreciated by persons skilled in the art.

The handle134can be fixedly coupled to the housing102such as to provide a single, fixed longitudinal placement of the handle134and truncate stub110. Alternatively, some examples of the debrider100can include or use mechanisms such as to allow for variable longitudinal placement of the handle134relative to the housing102. Variable longitudinal placement of the handle134can be available in predefined increments, such as by incremental indentations or protrusions on the housing102. Alternatively, variable longitudinal placement of the handle can be available continuously along the housing102.FIG.5Ashows a side view of an example of a debrider having sliding action. In some examples, the debrider100can include or use one or more longitudinal grooves of the housing120. The debrider100can have a pair of longitudinal grooves120running parallel on opposing side walls of the housing102. The truncate stub110of the handle134can include or use one or more bars111sized and shaped to ride the one or more longitudinal grooves120. Where the bars111of the truncate stub110ride the grooves120, the handle134can be slidingly paired to the housing102. As such, the handle134can slide longitudinally along a length of the grooves120. While the connection is described herein as having bars111riding grooves120, other equivalent connections enabling longitudinal sliding motion of the handle134relative to the housing102are commonly known by persons skilled in the art and can be used herewith. For instance, alternatively or additionally the grooves120can be on the handle134and the bars111can be on the housing102.

FIG.5Bshows an isolated cross-section view of an example of an elongate grip. The handle134can include or use the elongate grip112being at least partially housed within the truncate stub110. The elongate grip112can further include or use an eccentric locking cam130. The cam130can be located eccentrically relative to the pivot point118and can function to engage on the housing102when the elongate grip112is in the deployed position. Such an engagement of the cam130on the housing102can restrict longitudinal movement of the handle134relative to the housing102. The cam130can include or use a rubber bearing or surface finish such as to secure the engagement of the cam130with the housing102. The cam130can include or use a compressible material, a tacky material, a roughened surface finish, or other materials or finishes such as to secure the engagement of the cam130with the housing102. Turning the elongate grip112completely fore to the deployed position can cause the handle134to lock with respect to the sliding action, such as sliding action of the bars111within the grooves120. The locking of sliding action as such can occur at several longitudinal points along the housing102. Such locking can occur continuously along the housing102. Alternatively, such locking can occur digitally at one of several predetermined positions along the housing102. Thus, longitudinal sliding of the handle134or truncate stub110can be restricted where the handle is completely deployed. Where the debrider100includes or uses mechanisms to allow for variable longitudinal placement of the handle134relative to the housing102, placing the elongate grip112in the collapsed position can restrict travel of the truncate stub110relative to the housing102. Thus, longitudinal sliding of the handle134or truncate stub110can also be restricted where the handle is completely collapsed.

FIG.6Ashows a side view of an example of a debrider unpaired with a grip cover. The debrider100with the elongate grip112in the deployed position can be paired to a grip cover133. The grip cover133can include a grip cover bore136that is sized and shaped such as to be substantially conformal to an outer shape of the elongate grip112. The grip112and grip cover bore136can be sized and shaped such as to provide sufficient pressure between the grip112and grip cover133for prevention of accidental twisting or unpairing during the procedure. The grip cover133can be formed of one of several thermoplastic elastomers. Other materials can also be used to form the grip cover133. The grip cover133can be slid over the elongate grip112, as exemplified inFIG.6B.

FIGS.7A-7Cshow further examples of the grip cover. The grip cover133can be constructed using one of several manufacturing techniques to include one or more cavities138. The cavities138can allow the grip cover133to be reduced in weight and can prevent sinks and other manufacturing defects. Grip covers133with various outer sizes and shapes can be available to accommodate the professional's hand size, finger length, facility, and other factors. The grip cover133can be reusable, such as can be washable or autoclavable. Alternatively, the grip cover133can be disposable.

FIGS.8A-Edepict another an example of a debrider. Debrider200is similar to debrider100, but contains a housing recess213which can be enclosed by the elongate grip212of the handle234. An elongate grip212can be c-shaped, u-shaped, v-shaped, or can be otherwise shaped such as to mate with the housing recess213. Alternatively, the elongate grip212can be sized and shaped such as to enclose the housing202where the housing202does not have a housing recess213. The elongate grip212in the deployed position can extend distally from the housing202at a length within a range of about 0.2 inches to about 6 inches. In some examples, the deployed elongate grip212can extend at a length within the range of about 2 inches to about 3.5 inches. Elongate grip212can be sized and shaped such as to allow for secure, ergonomic grip without the need to utilize grip cover133. The housing202or housing recess213can contain indentations or protrusions sized and shaped to mate with indentations or protrusions of the elongate grip212to secure or lock the grip212in the closed position (shown inFIG.8A).

The above description includes references to the accompanying drawings, which form a part of the detailed description. The drawings show, by way of illustration, specific embodiments in which the invention can be practiced. These embodiments are also referred to herein as “examples.” Such examples can include elements in addition to those shown or described. However, the present inventors also contemplate examples in which only those elements shown or described are provided. Moreover, the present inventors also contemplate examples using any combination or permutation of those elements shown or described (or one or more aspects thereof), either with respect to a particular example (or one or more aspects thereof), or with respect to other examples (or one or more aspects thereof) shown or described herein. In the event of inconsistent usages between this document and any documents so incorporated by reference, the usage in this document controls.

In this document, the terms “a” or “an” are used, as is common in patent documents, to include one or more than one, independent of any other instances or usages of “at least one” or “one or more.” In this document, the term “or” is used to refer to a nonexclusive or, such that “A or B” includes “A but not B,” “B but not A,” and “A and B,” unless otherwise indicated. In this document, the terms “including” and “in which” are used as the plain-English equivalents of the respective terms “comprising” and “wherein.” Also, in the following claims, the terms “including” and “comprising” are open-ended, that is, a system, device, article, composition, formulation, or process that includes elements in addition to those listed after such a term in a claim are still deemed to fall within the scope of that claim. Moreover, in the following claims, the terms “first,” “second,” and “third,” etc. are used merely as labels, and are not intended to impose numerical requirements on their objects.

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.

The above description is intended to be illustrative, and not restrictive. For example, the above-described examples (or one or more aspects thereof) can be used in combination with each other. Other embodiments can be used, such as by one of ordinary skill in the art upon reviewing the above description. The Abstract is provided to comply with 37 C.F.R. § 1.72(b), to allow the reader to quickly ascertain the nature of the technical disclosure. It is submitted with the understanding that it will not be used to interpret or limit the scope or meaning of the claims. Also, in the above Detailed Description, various features can be grouped together to streamline the disclosure. This should not be interpreted as intending that an unclaimed disclosed feature is essential to any claim. Rather, inventive subject matter can lie in less than all features of a particular disclosed embodiment. Thus, the following claims are hereby incorporated into the Detailed Description as examples or embodiments, with each claim standing on its own as a separate embodiment, and it is contemplated that such embodiments can be combined with each other in various combinations or permutations. The scope of the invention should be determined with reference to the appended claims, along with the full scope of equivalents to which such claims are entitled.