Combination electrosurgical and mechanical resection device
Inventors
Doll, Sean • Lathrop, Bob • Di-Stefano, Craig
Assignees
Smith and Nephew Orthopaedics AG • Smith and Nephew Asia Pacific Pte Ltd • Smith and Nephew Inc
Publication Number
US-12274493-B2
Publication Date
2025-04-15
Expiration Date
2040-02-24
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Abstract
A combination medical device for removing and treating tissue in a patient is disclosed. The device includes a reusable handle and a blade selectively connectable to the handle. The blade includes an outer sleeve having a lumen with an inner shaft disposed therein. The inner shaft may be coupled to a motor drive unit disposed within the handle and may rotate so as to mechanically cut tissue as the inner shaft rotates. The outer sleeve includes at least one electrode for electrosurgically treating tissue. The reusable handle includes at least one control switch for controlling a parameter associated with the rotation of the inner shaft. The blade also may include a switch assembly in electrical communication with the at least one electrode, the switch assembly including attachment means for selective attachment of the switch assembly to the reusable handle.
Core Innovation
The invention provides a combination medical device for removing and treating tissue in a patient that integrates both mechanical resection and electrosurgical treatment within a single system. The device includes a handle portion with a motor and a blade portion, where the blade features a stationary outer sleeve and a rotatable inner shaft. Mechanical cutting is achieved using a window with a cutting edge on the outer sleeve and a cooperating edge on the inner shaft, which may rotate to resect tissue. Simultaneously, the outer sleeve is constructed from an electrically conductive material, with at least one electrode for electrosurgical ablation, cutting, or coagulation of tissue.
A distinguishing feature is the inclusion of a dielectric spacer in the outer sleeve of the blade. This spacer extends through a lateral opening in the outer sleeve, replacing a portion of the metal to maintain device rigidity, and nests an active electrode while electrically isolating it from the return electrode. The use of a ceramic or plasma-hardy dielectric material for the spacer ensures minimal degradation during plasma formation. The active electrode, supported by the dielectric spacer, may include an aspiration opening that aligns with an opening in the inner shaft, enabling removal of tissue debris and plasma by-products during both mechanical and electrosurgical procedures with a shared aspiration path.
The problem addressed by the invention is the inefficiency and limitations of using separate mechanical resection and electrosurgical tools during procedures such as arthroscopic and endoscopic surgery. Prior solutions required tool exchanges, larger cannula sizes to accommodate multiple functionalities, or compromised cutting efficiency and device geometry. The disclosed system minimizes increases in tip diameter while integrating plasma-resistant materials and robust aspiration management, thereby reducing surgery time and the complications associated with blood loss or poor access.
Claims Coverage
The independent claim describes a medical device with several inventive features centering on the integration of mechanical and electrosurgical tissue treatment, enhanced electrode arrangement, and specialized structure for safe and effective combined use.
Combination blade with mechanical cutting and electrosurgical capability
The device comprises a blade portion with an outer sleeve containing a lumen, an inner shaft disposed within the lumen, and a window with a cutting edge configured for mechanical cutting of tissue when the inner shaft rotates. The outer sleeve further serves as an electrically conductive component with an exposed portion to function as a return electrode.
Dielectric spacer that electrically isolates active and return electrodes
A dielectric spacer is coupled to the outer sleeve, extending through a lateral opening circumferentially spaced from and coextensive with the cutting window. The spacer forms a cavity that nests an active electrode and provides electrical isolation from the return electrode, supporting safe and localized electrosurgical functionality.
The above inventive features provide a unified blade design integrating both mechanical resection and electrosurgical treatment, with structural innovations that ensure effective operation, electrical separation, and optimal tissue interaction.
Stated Advantages
The combination device reduces the need for multiple instruments during surgery, thus decreasing surgery time and minimizing complications associated with blood loss.
Integration of the dielectric spacer and optimized electrode placement allows the device to maintain a smaller cross-section, enabling its use with smaller cannulas and improved access to targeted tissues.
The use of plasma-hardy dielectric and electrode materials enhances device longevity and performance during electrosurgical procedures.
A shared aspiration path enables efficient removal of tissue debris and plasma by-products during both mechanical and electrosurgical operations.
Documented Applications
Use in arthroscopic surgery for combined mechanical tissue resection and electrosurgical treatment such as ablation, cutting, and coagulation.
Use in endoscopic procedures requiring both mechanical and electrosurgical tissue manipulation.
Applications specifically include surgical operations in joints such as the shoulder and knee, as well as use in natural orifices such as the uterus, urethra, nasal cavity, and mouth.
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