CN116829076A - Ultrasonic surgical assembly with air cooled wide blade and irrigation sleeve - Google Patents

Abstract

An ultrasonic surgical assembly for use with a surgical handpiece to provide air cooling to an ultrasonic tip. The ultrasonic tip includes a shaft and a cutting portion. The tip includes first and second sides that are substantially planar and a cutting head. The tip is detachably coupled to the flare. The assembly includes a flush sleeve defining a chamber. The sleeve at least partially surrounds the shaft, defines an access aperture, and includes a conduit in fluid communication with the chamber. The conduit has an outlet orifice and is configured to be connected to a liquid source. The tip includes a seal member coupled to an outer surface thereof and having a first aperture defining an air inlet disposed adjacent the seal member and a second aperture extending from a proximal end of the shaft to the first aperture to form a fluid path therebetween.

Description

Ultrasonic surgical assembly with air cooled wide blade and irrigation sleeve

Cross Reference to Related Applications

The present application claims priority and all benefits from U.S. provisional patent application No.63/127,802, filed on 18 of 12 in 2020, and U.S. provisional patent application No.63/197,773, filed on 7 of 6 in 2021, the entire contents of which are incorporated herein by reference.

Disclosure of Invention

An ultrasonic surgical assembly for providing air cooling to an ultrasonic tip is disclosed. An ultrasonic surgical assembly includes an ultrasonic tip and an irrigation sleeve. The ultrasonic tip includes a shaft and a cutting portion and has a first side and a second side. The first side is substantially planar and extends from the proximal end to the distal end. The second side is substantially planar and disposed opposite the first side and extends from the proximal end to the distal end. The cutting portion includes a cutting head disposed at the distal end. The ultrasonic tip is detachably coupled to the horn. The shaft also includes a longitudinal axis. The irrigation sleeve has a distal region and a proximal region and defines a chamber extending along the longitudinal axis. The irrigation sleeve at least partially surrounds the shaft and defines an access aperture. The flush sleeve further includes a first conduit in fluid communication with the chamber. The first conduit has a discharge orifice and is configured to be connected to a liquid source. The ultrasonic tip further includes a seal member coupled to an outer surface thereof and further defines a first orifice and a second orifice. The first aperture defines an air inlet disposed adjacent the seal member and the second aperture extends from the proximal end of the shaft to the first aperture to form a fluid path between the first aperture and the second aperture.

A second ultrasonic surgical assembly is disclosed. The assembly includes an ultrasonic instrument, an ultrasonic tip, and a flush sleeve. The ultrasonic instrument includes a housing, a transducer, and a horn. The housing includes a proximal portion and a distal portion. The transducer is at least partially disposed within the housing. The horn is coupled to the transducer. The ultrasonic tip includes a shaft and is detachably coupled to the horn. The irrigation sleeve defines a chamber and includes a body, a sheath, and an irrigation catheter. The body is releasably connected to the distal portion of the housing and has a distal region and a proximal region. The body defines a helical groove that at least partially surrounds the shaft when the ultrasound tip is positioned in the chamber of the irrigation sleeve. A sheath is coupled to and disposed over a portion of the body to surround at least one complete revolution of the helical groove. The sheath has a proximal end and an opposite distal end. An irrigation conduit is disposed within the helical groove for delivering irrigation fluid and defines an inlet orifice and an outlet orifice. An inlet orifice is disposed at a proximal region of the body and an outlet orifice is disposed at a distal region of the body. The irrigation fluid enters the irrigation conduit at an inlet orifice and exits the irrigation conduit at an outlet orifice.

An ultrasonic tip is disclosed that includes a shaft and a cutting portion. The shaft defines a longitudinal axis. The cutting portion defines a first substantially planar side and a second substantially planar side and includes a cutting head. The cutting portion includes a base portion having a lateral dimension between the first side and the second side that extends perpendicular to the longitudinal axis of the cutting head. The cutting portion further includes a tapered portion including a bevel and extending from the base portion to the cutting edge. The cutting edge includes a length and has a U-shaped profile with a first leg portion, a second leg portion, and an arcuate distal portion. The first leg portion and the second leg portion are parallel to each other. Further, the maximum cross-sectional area of the ultrasonic tip defines the cross-sectional area of the first section. The cross-sectional area of the second section is defined at a location 20mm proximal to the distal end of the ultrasound tip. The second section and the first section are each perpendicular to the longitudinal axis of the shaft. The cross-sectional area of the second section is 16.7-20% of the cross-sectional area of the first section.

A second ultrasonic surgical assembly is disclosed that provides air cooling to an ultrasonic tip. The ultrasonic surgical assembly includes an ultrasonic instrument, an ultrasonic tip, an irrigation sleeve, and a sealing member. The ultrasonic instrument has a proximal region and a distal region and includes a housing, a transducer, and a horn. The housing includes a proximal portion and a distal portion. The transducer is at least partially disposed within the housing. The horn is coupled to a transducer configured to be coupled to a suction source through a first coupling. The ultrasonic tip includes a shaft and a cutting portion and is detachably coupled to the horn by a tip coupler. The shaft includes a longitudinal axis. The irrigation sleeve has a distal region and a proximal region and defines a chamber. The irrigation sleeve at least partially surrounds the shaft and defines an access aperture configured to receive irrigation liquid from an irrigation source. The flush sleeve further includes a first conduit in fluid communication with the chamber. The first conduit is configured to convey the flushing liquid from the inlet aperture to the outlet aperture. The sealing member is located between the outer surface of the ultrasonic tip and the inner surface of the chamber. The ultrasonic tip defines a first orifice and a second orifice. The first port defines an air inlet disposed adjacent to the seal member when the irrigation sleeve and the ultrasonic tip are coupled to the ultrasonic instrument. The second port extends from the proximal end of the ultrasound tip to the first port. The second port communicates with a suction source through the tip coupler. The irrigation sleeve defines a third aperture that is adjacent to the first aperture when the irrigation sleeve and the ultrasonic tip are coupled to the ultrasonic instrument. The ultrasonic surgical assembly defines a path for drawing air from the ambient environment through the third aperture, then through the first aperture, and back through the second aperture before the air exits the ultrasonic surgical assembly at the first coupler.

A method of cutting bone through an ultrasonic tip is disclosed. The method includes providing an ultrasonic tip including a shaft and a cutting portion, the ultrasonic tip being detachably coupled to the flare by a tip coupler. The horn is coupled to the transducer, and the transducer is coupled to the suction source through a first coupling. The shaft includes a longitudinal axis. The ultrasonic tip defines a first orifice defining an air inlet and a second orifice extending from a proximal end of the ultrasonic tip to the first orifice. The first port is transverse to the second port, which communicates with a suction source via a tip coupler. The method further includes providing an irrigation sleeve having a distal region and a proximal region and defining a chamber. The irrigation sleeve at least partially surrounds the shaft and is configured to be coupled to an irrigation source through an access port configured to receive irrigation liquid from the irrigation source. The flush sleeve defines a first conduit in fluid communication with the chamber. The first conduit is configured to convey the flushing liquid from the inlet aperture to the outlet aperture. The method further includes drawing air through the second and first channels via a suction source to cool the ultrasonic tip.

A third ultrasonic surgical assembly is disclosed. The assembly includes an ultrasonic instrument, an ultrasonic tip, and an irrigation sleeve. The ultrasonic instrument includes a housing, a transducer, and a horn. The housing includes a proximal portion and a distal portion. The transducer is at least partially disposed within the housing. The horn is coupled to the transducer. The ultrasonic tip includes a shaft and a cutting portion and is detachably coupled to the horn. The irrigation sleeve defines a chamber and includes a body releasably coupled to a distal portion of the housing and having a distal region and a proximal region. The ultrasonic tip further includes an annular sealing member disposed about the groove and disposed at the proximal region of the body and between an outer surface of the ultrasonic tip and an inner surface of the chamber when the sleeve and the ultrasonic tip are coupled to the ultrasonic instrument and defining the groove. The annular seal member is configured to prevent proximal movement of the fluid to the annular seal member.

A fourth ultrasonic surgical assembly is disclosed. The assembly includes an ultrasonic instrument and an irrigation sleeve. The ultrasonic instrument includes a housing, a transducer, and a horn. The housing includes a proximal portion and a distal portion. The transducer is at least partially disposed within the housing. The horn is coupled to the transducer. The irrigation sleeve defines a chamber and is configured to be detachably coupled to the first ultrasonic tip and the second ultrasonic tip. Each of the first ultrasonic tip and the second ultrasonic tip are configured to be detachably coupled to the flare by a tip coupler. Each of the first ultrasonic tip and the second ultrasonic tip includes a shaft, a cutting portion, and an annular sealing member. The cutting portion of the first ultrasonic tip includes a cutting geometry that is different from the cutting geometry of the cutting portion of the second ultrasonic tip. The first ultrasonic tip defines a first groove positioned a first distance from the tip coupler of the first ultrasonic tip. The second ultrasonic tip defines a second groove positioned a second distance from the tip coupler of the second ultrasonic tip. The first distance from the tip coupler of the first ultrasonic tip is not equal to the second distance from the tip coupler of the second ultrasonic tip. Each of the first and second ultrasonic tips includes an annular sealing member disposed about the respective first and second grooves. The irrigation sleeve includes a body and an irrigation catheter. The body is releasably coupled to the distal portion of the housing. An irrigation catheter is coupled to the body and configured to deliver irrigation fluid. The irrigation catheter further defines an access port disposed at the proximal region of the body and an exhaust port disposed at the distal region of the body, wherein the irrigation fluid enters the irrigation catheter at the access port and exits the irrigation catheter at the exhaust port.

Drawings

Advantages of the present disclosure will be readily appreciated by reference to the following detailed description when considered in connection with the accompanying drawings.

Fig. 1 is a top view of an ultrasonic surgical handpiece assembly.

Fig. 2 is a cross-sectional view of the ultrasonic surgical handpiece assembly of fig. 1.

Fig. 3 is a top view of an ultrasonic tip and an irrigation sleeve with the ultrasonic tip positioned within the irrigation sleeve.

Fig. 4A is a cross-sectional view of an ultrasonic tip and an irrigation sleeve assembly.

Fig. 4B is a cross-sectional view of the ultrasound tip of fig. 4A in a first cross-section.

Fig. 4C is a cross-sectional view of the ultrasonic tip of fig. 4A in a second cross-section.

Fig. 5 is a cross-sectional view of the flush sleeve assembly of fig. 3 with a tip inserted therethrough in an assembled configuration.

Fig. 6 is a partial cross-sectional view of the ultrasound tip, irrigation sleeve, sheath and irrigation catheter of the irrigation sleeve assembly of fig. 5.

Fig. 7 is another cross-sectional view of the flush sleeve assembly of fig. 3 with a tip inserted therethrough in an assembled configuration.

Fig. 8A is a top view of a distal portion of an ultrasonic tip including a cutting head.

Fig. 8B is a side view of a distal portion of an ultrasonic tip including a cutting head.

Detailed Description

As medical professionals strive to reduce the size of incisions and the recovery time required after invasive medical procedures, the size of medical instruments used in various medical procedures has also become smaller. Many medical instruments for performing various medical procedures may include cutting accessories, such as the use of ultrasonic tips. In performing the cutting, scraping or shaping operation, the cutting accessory will be exposed to varying degrees of force, thereby creating stresses within the cutting accessory.

Many of these cutting accessories may also require the use of irrigation or suction (i.e., aspiration) to reduce heat and/or clear debris at the surgical site. One example of a surgical instrument that may utilize an irrigation and/or aspiration system is an ultrasonic surgical handpiece. In general, one or more lines may be coupled to an ultrasonic surgical handpiece to supply irrigation and/or aspiration. The ultrasonic surgical handpiece may also include a sleeve including one or more chambers that may be used to direct fluid from the irrigation source to the surgical site and/or the cutting accessory, i.e., the ultrasonic tip. Such an ultrasonic surgical handpiece is described in PCT/US19/52609 entitled "Ultrasonic Surgical Handpiece Assembly", the entire contents of which are incorporated herein by reference.

However, a particularly flat or narrow cutting accessory may often not include such a cavity that would extend through the entire length of the cutting accessory, i.e., to the cutting edge or blade. In addition, the current in the cutting accessory is high, which may cause the handpiece to overheat because no suction or cooling chamber is running through the cutting accessory. Excessive heat build-up may adversely affect the life of the handpiece and may also be perceived by the surgeon.

Furthermore, the shape and geometry of the cutting accessory may affect the magnification factor or gain associated with the ultrasonic instrument. The inventors have realized that various benefits may be realized by configuring the ultrasound tip with lower gain in certain embodiments, including reduced stall, less power consumption to drive the tip, and the ability to drive the tip with higher current to the ultrasound handpiece, which may increase the cut rate without increasing stall.

Fig. 1 and 2 illustrate an exemplary configuration of an ultrasonic surgical handpiece assembly 10 that may be used by a medical professional to remove biological material from a patient. The ultrasonic surgical handpiece assembly 10 may include an ultrasonic handpiece 12 including a distal housing section 14 and a proximal housing section 16. The irrigation sleeve 18 may be detachably coupled to the distal housing portion 14 of the ultrasonic surgical handpiece 12. The irrigation sleeve 18 and the ultrasonic tip 20 may be configured such that when both the irrigation sleeve 18 and the ultrasonic tip 20 are coupled to the ultrasonic handpiece 12, the irrigation sleeve 18 surrounds at least a portion of the ultrasonic tip 20 along the length of the ultrasonic tip 20. The irrigation sleeve 18 and the ultrasonic tip 20 may at least partially comprise the ultrasonic sleeve assembly 14.

Fig. 2 shows a cross-sectional view of the ultrasonic surgical handpiece assembly 10 of fig. 1. As shown in fig. 2, the ultrasonic handpiece 12 may include a transducer 22 disposed within a void defined by the distal housing section 14 and the proximal housing section 16 of the ultrasonic handpiece 12. Transducer 22 may include a plurality of piezoelectric or magnetostrictive elements configured to generate mechanical energy.

The ultrasonic hand piece 12 may also include a flare 24, which may be at least partially disposed within the void defined by the distal and proximal housing portions 14, 16 of the ultrasonic hand piece 12. The flare 24 may include a distal end and a proximal end. The proximal end of the flare 24 may be coupled to the distal end of the transducer 22. The transducer 22 may be configured to provide mechanical energy generated by a piezoelectric element or a magnetostrictive element to the horn 24. The flare 24 may also be configured to define a flare chamber 26 that extends from the distal end to the proximal end of the flare 24. The flare chamber 26 may define a portion of a passage that extends through the ultrasonic hand piece 12 to provide suction. The flare chamber 26 has a distal end and a proximal end, and the proximal end may be in communication with a suction source 27. Transducer 22 may be coupled to suction source 27 via coupling 28.

The ultrasonic handpiece 12 may also include an irrigation line 38 disposed within the void defined by the distal housing section 14 and the proximal housing section 16 of the ultrasonic handpiece 12. The irrigation line 38 may be configured to extend from the proximal end to the distal end of the ultrasound handpiece 12. The irrigation line 38 may be used to deliver a liquid, such as water or saline from an irrigation system coupled to the ultrasonic handpiece 12 through the irrigation sleeve 18. It should be appreciated that the irrigation line 38 may be routed directly from an irrigation source (not shown) to the irrigation sleeve 18 (i.e., the irrigation line 38 need not always be routed through the handpiece 12).

Ultrasound tip 20 may include a shaft 42 including a distal region 44, a middle region 46, and a proximal region 48, all disposed along a longitudinal axis L1. The ultrasonic tip 20 may also include a coupling feature 50 positioned at the proximal region 48 of the shaft 42 and configured to couple the proximal region 48 of the ultrasonic tip 20 to the distal end of the flare 24 to allow the flare 24 to be in mechanical communication with the ultrasonic tip 20. The coupling feature 50 may be a threaded coupler 52 configured to engage a corresponding threaded coupler on the distal end of the flare 24. The ultrasonic tip 20 may be threaded into the flare 24 and tightened to a preset torque specification to removably secure the ultrasonic tip 20 to the ultrasonic handpiece 12. Although not illustrated in the figures, it is contemplated that the coupling feature 50 may be configured as a quick connect, quarter turn joint, or similar coupling mechanism. It is also contemplated that the coupling feature 50 may be configured to permanently secure the ultrasound tip 20 to the handpiece 12. For example, the ultrasonic tip 20 may be coupled to the ultrasonic handpiece 12 by welding, epoxy, or similar coupling methods.

Alternatively, it is also contemplated to form the ultrasonic tip 20 and the flare 24 as a unitary component. In such a configuration, the ultrasound tip 20 may include a base (horn) 24 for coupling to the transducer 22, and a body made up of a shaft 42 and a cutting portion 40. The bodies 40, 42 extend from the base 24 and are coupled to the base 24 at a shaft 42. The bodies 40, 42 extend along a longitudinal axis L1 from the shaft 42 to the cutting portion 40.

In some aspects, such as the one shown, the shaft 42 has no lumen in the distal region 44. In other words, the ultrasound tip may be free of chambers in the portion of the cutting tip having a rectangular cross-sectional area. The shaft 42 may be made of a metallic material such as titanium alloy, stainless steel, etc., or a non-metallic material such as a composite material, depending on the particular application. In one aspect, the shaft 42 and the cutting portion 40 may be unitary, single and integral. In another aspect, the cutting portion 40 of the ultrasonic tip 20 may be attached to the shaft 42 by a suitable mechanism, such as threads (not shown).

Fig. 3 shows a top view of an exemplary configuration of the irrigation sleeve 18, having a distal region 58 and a proximal region 60. The irrigation sleeve 18 may include an irrigation sleeve coupling mechanism 62 on a proximal region 60 of the irrigation sleeve 18. The irrigation sleeve coupling mechanism 62 may include one or more fingers 64 extending proximally from the proximal region 60 of the irrigation sleeve 18. Each of the one or more fingers 64 may include a tab 66 that extends in a radially outward direction relative to the longitudinal axis L1 of the flush sleeve 18. The fingers 64 act as a male connector configured to couple with a female connector (not shown) on the ultrasonic hand piece 12 to form a snap fit or interference fit. Other types of irrigation sleeve coupling mechanisms 62 are contemplated for coupling the irrigation sleeve 18 to the ultrasonic handpiece 12. By way of example and not limitation, the flush sleeve coupling mechanism 62 may be configured as a threaded connection. It should be understood that the irrigation sleeve 18 described herein may be used in conjunction with other tip designs other than those shown herein.

Referring now to fig. 4A, an exploded view of the ultrasonic tip and irrigation sleeve assembly 68 is shown. The flush sleeve assembly 68 includes the flush sleeve 18 defining a chamber 70 extending along the longitudinal axis L1. The irrigation sleeve 18 may have a sleeve body 72 defining a helical groove 74. In the assembled configuration, and when the ultrasound tip 20 is inserted through the irrigation sleeve 18, the irrigation sleeve 18 may at least partially surround the shaft 42 of the ultrasound tip 20 with the ultrasound tip 20 disposed within the chamber 70 of the irrigation sleeve 18 and the irrigation sleeve 18 coupled to the handpiece.

The irrigation sleeve assembly 68 may further include a sheath 76 having proximal and distal ends corresponding to the proximal and distal regions 60, 58, respectively, of the irrigation sleeve 18. The sheath 76 may be coupled to and disposed over at least a portion of the sleeve body 72 to surround at least one complete revolution of the helical groove 74, but may alternatively surround two or more than three revolutions of the helical groove to provide adequate retention.

The location of the spiral groove 74 may be different on different tips. By way of example and not limitation, in some configurations, one ultrasonic tip may define a groove positioned a first distance from a tip coupler (e.g., coupling feature 50) of the tip, while a different ultrasonic tip may define a groove positioned a second distance from a tip coupler (e.g., coupling feature 50) of the tip. In some configurations, the first distance is different from the second distance. This may be useful because different tips may have different node and antinode locations. It may be useful to locate the sealing member in alignment with a node or anti-node of a particular tip.

Referring to fig. 5, a cross-sectional view of the flush sleeve assembly 68 of fig. 3 is shown with the tip inserted therethrough in an assembled configuration. The assembled irrigation sleeve assembly 68 with the ultrasonic tip 20 inserted therethrough shows the ultrasonic tip 20 disposed within the chamber 70 such that the irrigation sleeve 18 partially surrounds the shaft 42.

Referring now to fig. 6, a partial cross-sectional view of the ultrasound tip 20, the irrigation sleeve 18, the sheath 76 and the irrigation catheter 78 of the irrigation sleeve assembly of fig. 5 is shown. The sheath 76 is at least partially disposed over the irrigation sleeve 18 to surround at least one complete revolution of the helical groove 74, thereby covering the irrigation catheter 78.

In some configurations, the sleeve body 72 may define a second helical groove 96. The second helical groove 96 may not have the irrigation catheter 78 and may also be partially surrounded by the sheath 76, in other words, one or more turns of the second helical groove 96 may be surrounded by the sheath 76.

The sheath 76 may be constructed of a heat shrink material or other suitable material that allows the sheath to deform according to the shape of the irrigation catheter 78 and the underlying (unrerling) profile of the sleeve body 72, which may include a second helical groove 96. When the sheath 76 is deformed following the contour of the second helical groove 96, the sheath may define undulations 98 that facilitate grasping by a user.

Referring again to fig. 4A, the irrigation sleeve assembly 68 may further include an irrigation conduit 78 disposed within the helical groove 74 for delivering irrigation fluid. The irrigation conduit 78 may be in fluid communication with or adjacent to the chamber 70 and may be connected to a liquid source (not shown). The irrigation conduit 78 may define an access aperture 80 (the access aperture being provided at the proximal region 60 of the sleeve body 72 when the irrigation sleeve assembly 68 is in the assembled configuration) and an exhaust aperture 82 (the exhaust aperture being provided at the distal region 58 of the sleeve body 72 when the irrigation sleeve assembly 68 is in the assembled configuration). The irrigation fluid may enter the irrigation conduit 78 at an entry orifice 80 and exit the irrigation conduit 78 at an exit orifice 82. In some configurations, the irrigation conduit 78 may comprise a single component defining a continuous length between the inlet orifice 80 and the outlet orifice 82. The irrigation catheter 78 may comprise a flexible material such that the irrigation catheter 78 may be configured to be directly coupled to a corresponding port of the surgical handpiece 12. In other words, the irrigation conduit 78 may be formed of a deformable material such that the access aperture 80 may partially encase a corresponding port of the (engulf) ultrasonic handpiece 12 to form a connection with an irrigation source. The spiral shape of the groove 74 ensures that the irrigation conduit 78 also has a spiral shape. This spiral shape of the flush conduit 78 (tubing) and groove 74 provides a longer fluid return path than a straight return path. This longer path makes it more difficult for the fluid to move back in the proximal direction after it is initially delivered through the irrigation catheter 78.

After the fluid has been conveyed distally along the sleeve body 72 through the flush catheter 78, the fluid may exit the flush catheter 78 at the discharge orifice 82. From there, the fluid may diffuse to the surface of the sleeve body 72 and/or the shaft 42. In some cases, fluid may return to the orifice 83 and back through the flush conduit 78. Otherwise, fluid may return proximally along the sleeve body 72 in a path to flow within the sheath 76 between the outer diameter of the irrigation catheter 78 and the inner surface of the sleeve body 72.

One of the irrigation sleeve 18 and the ultrasonic tip 20 may include a sealing member 86. The sealing member 86 may be an annular sealing member including, by way of example and not limitation, an O-ring. In some configurations, sealing member 86 may be coupled to tip 20. In such embodiments, the sealing member 86 is positioned about a groove 88 defined in the outer surface of the tip 20. This may allow the sealing member 86 to be positioned between the outer surface of the ultrasonic tip 20 and the inner surface of the chamber 70 to prevent movement of fluid from the discharge orifice 82 proximate to the sealing member 86. Alternatively, the sealing member 86 may be coupled to the sleeve 18 and positioned to engage an outer surface of the tip 20, also to prevent movement of fluid from the discharge orifice 82 proximate the sealing member 86.

The sealing member 86 may also be used to dampen the amplitude of vibrations of the ultrasonic tip 20. The amplitude of the vibrations at any point along the ultrasonic tip 20 may depend on the location along the ultrasonic tip 20 at which the vibrations are measured. The point along the standing wave at which the wave amplitude is minimal is generally referred to as a node. At the nodes, the vibration motion is typically minimal. Because the sealing member 86 is directly coupled to the tip 20, it may be located anywhere on the ultrasonic tip 20 to reduce lateral movement of the tip 20. In some configurations, it may be appropriate to place the sealing member 86 at or near a node on the tip 20. The location of the nodes may be different on different ultrasound tips.

Furthermore, because the sealing member 86 may be directly coupled to the tip 20, any sharp surfaces of the ultrasonic tip 20 do not contact the sealing member 86 during placement of the sleeve assembly on the ultrasonic tip 20. Thus, when the ultrasonic tip 20 is placed on the sleeve 18, the sealing member 86 is protected from wear and other damage. Placing the sealing member 86 on the ultrasound tip 20, rather than on the irrigation sleeve 18, may also prevent the sealing member 86 from spontaneously sliding off or out of the irrigation sleeve assembly 68.

Referring now to fig. 7, shown is another cross-sectional view of the flush sleeve assembly of fig. 3 with the tip inserted therethrough in an assembled configuration. The ultrasonic tip 20 may define a first orifice 90 that enters as air. When the irrigation sleeve assembly 68 including the ultrasonic tip 20 is coupled to the handpiece 12, the first aperture 90 may be disposed proximate the seal member 86. In some configurations, the first aperture 90 is distal to the seal member 86. The second bore 92 may extend from the proximal region 48 of the shaft 42, from the threaded coupler 52, to the first bore 90. In other words, the first port 90 and the second port 92 are positioned in fluid communication with each other, the first port 90 being transverse to the longitudinal axis L1 of the ultrasonic tip 20, the second port 92 being concentric with the longitudinal axis L1 of the tip 20. In one example, the axis N1 of the first porthole 90 may be perpendicular to the axis N2 of the second porthole 92. In some configurations, the first port 90 may comprise a single port. In other configurations, such as the configuration shown in fig. 7, the first port 90 may extend laterally from one side of the ultrasound tip 20 to the other to form the first port 90 in each side of the ultrasound tip 20. However, in other configurations, rather than forming a single channel with a first port 90 at each end as shown in fig. 7, more than one first port 90 may be included in the ultrasound tip 20, wherein each of the more than one first ports 90 is separate from each other (but each may still be in communication with a second port 92). Further, the first port 90 need not extend all the way through the head 20, so long as the first port 90 extends from the outermost periphery to the second port 92. Where multiple paths are defined from the outer periphery of the ultrasonic tip 20 to the second port 92, the ports may be arranged in various ways, such as circumferentially around the surface of the tip 20.

In some configurations, the irrigation sleeve assembly 68 further includes a third aperture 94 adjacent to the first aperture 90 when the irrigation sleeve assembly 68 including the ultrasound tip 20 is coupled to the handpiece. More specifically, the sleeve body 72 may define a third aperture 94 to further assist air from the ambient environment into the first aperture 90. Of course, it is contemplated that the irrigation sleeve assembly 68 may include more than one third port 94 defining an orifice to allow ambient air to move from outside the irrigation sleeve assembly 68 to the first port 90 when the suction source 27 is coupled to the tip 20.

In the illustrated configuration, the inlet orifice 80, the outlet orifice 82, the first orifice 90, the second orifice 92, and the third orifice 94 all have circular cross-sectional shapes. However, in some configurations, all or any combination of the inlet aperture 80, the outlet aperture 82, the first aperture 90, the second aperture 92, and/or the third aperture 94 may have shapes other than circular, such as various polygonal shapes or elliptical shapes.

The irrigation sleeve 18 may be made of any polymer, such as a thermoplastic. The distal region 58 of the irrigation sleeve 18 may have a portion of a frangible section that may be cut or sheared to change the length of the irrigation sleeve 18.

Referring again to fig. 5, when the irrigation sleeve assembly 68 is coupled to an irrigation source by a coupling, such as the irrigation line 38, the irrigation sleeve assembly may draw irrigation liquid through the irrigation source via the inlet orifice 80. The irrigation conduit 78 may then deliver irrigation liquid through the inlet orifice 80 and through the outlet orifice 82. The delivery of the irrigation liquid through the irrigation sleeve assembly 68 helps provide cooling to the shaft 42 of the ultrasonic tip 20. In addition, this helps to prevent the irrigation sleeve 18 from deforming or melting due to excessive heat generated by the ultrasonic cutting motion.

Further, when the irrigation sleeve assembly 68 including the ultrasonic tip 20 is coupled to the handpiece 12, the ultrasonic tip 20 draws air through the third port 94, then through the first port 90, and back through the second port 92, and finally out through the coupler 28. This air flow assists in cooling the tip in the region adjacent the seal member 86, which is prone to overheating due to frictional heat generated by the relative movement between the seal member 86 and the flush sleeve assembly 68.

Furthermore, in some applications, air suction through the tip and/or sleeve may operate as a smoke evacuation device. In the illustrated configuration, the ultrasound tip 20 may be used in lumbar and other relatively "heavy" osteotomies that generate a greater amount of smoke, dust particles, and airborne debris than other procedures. The air extraction feature may extract some of the smoke, dust particles, and airborne debris from the ambient air surrounding the ultrasonic hand piece 12 and evacuate it through the hand piece 12. The apparatus may be used with a smoke filter to remove these particles from the surrounding air after inhalation through the head 20.

Referring now to fig. 8A-8B, a top view and a side view of a distal portion of an ultrasound tip including a cutting head are shown. The ultrasound tip 20 may include a first side 100 that is substantially planar. The ultrasound tip 20 may also include a second side 102 that is substantially planar and disposed opposite the first side 100. Ultrasound tip 20 may also include a cutting head (also referred to herein as a "cutting portion") 104 disposed distally of shaft 42. The cutting head 104 may include a base portion 106 having a transverse dimension T1 between the first side 100 and the second side 102. The transverse dimension T1 may extend perpendicular to the longitudinal axis L1 of the cutting head 104. The cutting head 104 may also include a tapered portion 108 that includes a bevel extending from the base portion 106 to a cutting edge 110. By way of example and not limitation, in a preferred configuration, the lateral dimension of the base portion 106 is at least 7.975 millimeters. It should be understood that other ultrasonic tips may also be used with the irrigation sleeve assemblies shown above, such as those tips that do not have the cutting head features described in the present application, such as those shown in U.S. Pat. Nos.6,723,110, 6497715, D551764 and 6955680, the entire contents of which are incorporated herein by reference. Likewise, it should be understood that the ultrasound tip may also be used with other irrigation sleeve assemblies, such as those shown in PCT/US2019/052609, the entire contents of which are incorporated herein by reference.

The cutting edge 110 includes a length and may have a U-shaped profile with a first leg portion 112, a second leg portion 114, and an arcuate distal portion 116. By way of example and not limitation, in a preferred configuration, the arcuate distal portion 116 has a thickness of at least 1.35 millimeters. The first leg portion 112 and the second leg portion 114 may be parallel to one another and may each include a plurality of cutting teeth, one of which is labeled 118. In some configurations, no more than half of the length of the cutting edge 110 may have cutting teeth 118. In other configurations, more than half of the length of the cutting edge 110 may have cutting teeth 118. In some configurations, the arcuate distal portion 116 is devoid of cutting teeth 118, as shown in the illustrated configuration in fig. 8A-8B.

The cutting portion 40 defines a centerline 120 along the longitudinal axis L1. Further, the plurality of cutting teeth 118 includes at least two adjacent cutting teeth 118 and a notch 122 between each two adjacent cutting teeth 118. The recess 122 has a transverse dimension T2 along a recess base 124. Each of the cutting teeth 118 has a toothed cutting edge 126. In some configurations, the lateral dimension T2 of the recess 122 is at least 25 times smaller (at most 1/25) than the lateral dimension T1 of the base portion 106.

The centerline 120 to the tooth cutting edge 126 defines a first distance A1. The centerline 120 to the notch base 124 defines a second distance A2. The centerline 120 defines a third distance A3 to the beginning of the tapered portion 108. In some configurations, the difference between the first distance A1 and the second distance A2 is less than or equal to 0.25mm. In some configurations, the first distance A1 is greater than 1.5 times the third distance A3, but less than 2 times the third distance A3. In the example shown and without limitation, the first distance A1 is 3.4mm, the second distance A2 is 3.15mm, and the third distance A3 is 1.85mm. In this example, the difference between the first distance A1 and the second distance A2 is exactly 0.25mm. In addition, in this example, the first distance A1 is about 1.837 times the third distance A3.

The ultrasound tip 20 may be used to cut both hard and soft tissue. The toothed cutting edge 126 allows for cutting hard tissue, such as cortical bone. The serrated cutting edge 126 may perform a saw-like operation to sever more dense tissue. In contrast, the cutting edge 110 is a smooth, continuous blade. Although the cutting edge may be sharp enough to cut hard tissue, it may be blunt enough to be atraumatic with respect to contacting soft tissue. By way of example and not limitation, the thickness of the cutting edge 110 may be 0.2mm +/-0.05mm. Thus, the cutting edge 110 may contact soft tissue with minimal risk of puncturing critical structures (e.g., the spinal cord). Due to the natural difference in density between the different tissue structures, the surgeon may feel a tactile change as the cutting edge 110 moves between hard and soft tissue, indicating the need to terminate the cut when the cutting edge 110 has reached the soft tissue. Accordingly, the ultrasonic tip 20 is advantageous over conventional sharp osteotomy blades because both the toothed edge 126 and the cutting edge 110 of the ultrasonic tip are capable of cutting hard bone structures while avoiding trauma to underlying soft tissue.

Referring again to fig. 4A-4C, different points along the axis 42 have different cross-sectional areas. Although the transducer and the ultrasound tip are typically designed to have the same resonant frequency in a longitudinal resonant device, the reduction in cross-sectional area along the length of the ultrasound tip can amplify the vibration velocity of the output face of the transducer. The amplification factor, also known as gain, is determined by the reduction in cross-sectional area and the shape of the ultrasonic tip. The gain may be measured by displacing the tip with the handpiece displacement.

In the illustrated configuration, the cross-sectional area of the first section SL1 is defined as the largest circular cross-sectional area of the ultrasonic tip 20 and defines a plane perpendicular to the longitudinal axis L1. Fig. 4B shows a cross-sectional view of the ultrasonic tip of fig. 4A at a first cross-sectional area. The cross-sectional area of the second section SL2 is defined at a position 20mm proximal to the distal end of the tip. The second section SL2 defines a plane perpendicular to the longitudinal axis L1, and the second section SL2 is distal to the first section SL 1. Fig. 4C is a cross-sectional view of the ultrasound tip of fig. 4A at a second cut.

The cross-sectional area of the second section SL2 is 1/5 to 1/6 of the cross-sectional area of the first section SL 1. In other words, the cross-sectional area of the second section SL2 is 13-25, 15-21, 16-20, or 16.7-20% of the cross-sectional area of the first section SL 1. This results in an ultrasound tip with low gain. The low gain of the ultrasonic tip 20, calculated by dividing the displacement of the ultrasonic handpiece 12 by the displacement of the ultrasonic tip 20, results in reduced stall of the cutting portion 40 (e.g., the cutting head 104), thereby improving the performance of the ultrasonic tip 20 as a whole. The ultrasonic tip also requires less power to drive the ultrasonic tip 20 and allows the ultrasonic tip 20 to be driven at higher currents, which may increase the cutting rate without increasing the stall of the cutting portion 40 (e.g., the cutting head 104).

By way of example and not limitation, in the illustrated configuration, the first section SL1 has a diameter of 8mm and the gun drill has a diameter of approximately 2mm. In this configuration, the cross-sectional area of the first section SL1 is approximately 47.1mm ² . In some configurations, the cross-sectional area of the second section SL2 may be approximately 8.725mm ² . Thus, in this configuration, the value of the cross-sectional area of the second section SL2 is the transverse of the first section SL1The value of the cross-sectional area is about 1/5.4.

In the illustrated configuration, the gain of the ultrasound tip 20 is approximately 3. It should be appreciated that the ultrasound tip 20 may exhibit gains between 2 and 5, between 2 and 4,2.5 and 3.5, and between 2.75 and 3.25. In addition, the ultrasound tip 20 may exhibit a gain of less than 5. In contrast, similar ultrasound tips known in the art for similar applications have a gain of about 7.0-7.4. The low gain of the ultrasonic tip 20 (calculated by dividing the displacement of the ultrasonic tip 20 by the displacement of the ultrasonic handpiece 12) results in reduced stall of the cutting portion 40 (e.g., the cutting head 104), thereby improving the overall performance of the ultrasonic tip 20. It also requires less power to drive the ultrasonic tip 20 and allows the ultrasonic tip 20 to be driven at higher currents, which can increase the cutting rate without increasing the stall of the cutting portion 40 (e.g., the cutting head 104).

Gain may also be achieved by a uniform outer surface and be composed of two different materials longitudinally aligned with respect to each other, as described in U.S. Pat. No.9,962,183 entitled "Ultrasonic Torsional Tissue Dissection Utilizing Subaltern Modes of Longitudinal-Torsional Resonators," the entire contents of which are incorporated herein by reference.

The ultrasound tip 20 may have no longitudinal to torsional motion conversion mechanism and thus be configured to vibrate only in the longitudinal direction. The ultrasonic tip 20 may be composed of titanium.

The irrigation sleeve 18 described herein may be used with any type of ultrasonic tip. In other words, the irrigation sleeve 18 described herein may be used with an ultrasonic tip that does not include the first and second tunnels 90, 92. Furthermore, the irrigation sleeve 18 described herein may be used with an ultrasonic tip having a cutting head that does not have substantially planar sides. For example, the irrigation sleeve 18 described herein may be used with ultrasonic tips having a cylindrical shape and relying on longitudinal, torsional, or both longitudinal and torsional motion, such as those described in U.S. patent publication No.2005/0177184, U.S. patent No.8512340, U.S. patent publication No.2008/0208231, the entire contents of which are incorporated herein by reference.

The instruments described herein may be used with any tip configuration and/or any irrigation sleeve configuration described herein.

Additional protective clauses:

I. an ultrasonic tip comprising a shaft and a cutting portion, the ultrasonic tip comprising:

a first side, which is substantially planar and extends from a proximal end to a distal end,

a second side, which is substantially planar and disposed opposite the first side, and extends from the proximal end to the distal end, and

a cutting head disposed at the distal end thereof,

a first duct defining an air inlet disposed adjacent the cutting head, and

a second bore extending from the proximal end of the shaft to the first bore.

The ultrasonic tip of clause I, wherein the cutting head has a base portion having a transverse dimension between the first side and the second side, the transverse dimension extending perpendicular to the longitudinal axis of the cutting head, and a tapered portion comprising a bevel and extending from the base portion to a cutting edge, the cutting edge comprising a length and having a U-shaped profile having a first leg portion, a second leg portion, and an arcuate distal portion, wherein the first leg portion and the second leg portion are parallel to one another.

The ultrasound tip of clause I or clause II, wherein,

The cross-section of the first section of the largest circular cross-sectional area of the shaft defines a plane perpendicular to the longitudinal axis,

the cross-section of the second cross-section of smaller cross-sectional area at the proximal region of the shaft defines a plane perpendicular to the longitudinal axis, and

the value of the cross-sectional area of the second section is 1/5.4 of the value of the cross-sectional area of the first section.

The ultrasound tip of clause I, II or III, further comprising an ultrasound instrument having a proximal region and a distal region, the ultrasound instrument comprising:

a housing comprising a proximal portion and a distal portion,

a transducer disposed at least partially within the housing,

a horn coupled to the transducer, and

the transducer is coupled to a suction source by a first coupling, and the ultrasound tip is coupled to the horn.

V. the ultrasound tip of clause I, II, III, or IV, further comprising: an irrigation sleeve comprising a body having a distal region and a proximal region, the body defining a helical groove at least partially surrounding an axis of a tip when the tip is positioned in a chamber of the sleeve; and

a sheath coupled to and disposed over a portion of the body to surround at least one complete revolution of the helical groove, the sheath having a proximal end and an opposite distal end,

An irrigation conduit disposed within the helical groove for delivering irrigation fluid,

the irrigation catheter further defines an access port disposed at a proximal region of the body and an exhaust port disposed at a distal region of the body, wherein irrigation fluid enters the irrigation catheter at the access port and exits the irrigation catheter at the exhaust port.

An ultrasound tip, comprising: a shaft defining a longitudinal axis; and a cutting portion defining a first substantially planar side and a second substantially planar side, the cutting portion further comprising a cutting head including a cutting edge, and wherein: the maximum cross-sectional area of the tip defines the cross-sectional area of the first section; the cross-sectional area of the second section is defined at a location 20mm proximal to the distal end of the tip, the second section and the first section each being perpendicular to the longitudinal axis of the shaft, wherein the cross-sectional area of the second section is 15-20% of the cross-sectional area of the first section. Furthermore, in some configurations, the maximum cross-sectional area of the tip is specified to be at least 20mm in length. In other words, a section of the tip has a constant cross-sectional area and is equal to the maximum cross-sectional area of the tip. Furthermore, in some instances, it should be appreciated that the tip may include a diameter of no more than 9mm to provide an optimized fine cut bone.

An ultrasound tip, comprising: a shaft defining a longitudinal axis; and a cutting portion defining a first substantially planar side and a second substantially planar side, the cutting portion further comprising a cutting head including a cutting edge, and wherein: the maximum cross-sectional area of the tip defines the cross-sectional area of the first section; the cross-sectional area of the second section is defined at a location 20mm proximal to the distal end of the tip, the second section and the first section each being perpendicular to the longitudinal axis of the shaft, wherein the cross-sectional area of the second section is 1/5 to 1/6 of the cross-sectional area of the first section. Furthermore, in certain configurations, the maximum cross-sectional area of the tip is specified to be at least 20mm in length.

Several configurations have been discussed in the foregoing description. However, the configurations discussed herein are not intended to be exhaustive or to limit the invention to any particular form. For example, while the example configuration describes the surgical instrument as an ultrasonic handpiece, it is further contemplated that the features and concepts described with respect to the ultrasonic handpiece may be applied to other medical or surgical instruments. The same applies to ultrasonic tips, which may also include blades, drills, rotary drills, window razors, and the like. The terminology used is intended to be in the nature of words of description rather than of limitation. Many modifications and variations are possible in light of the above teaching, and the invention may be practiced otherwise than as specifically described.

Claims (33)

1. An ultrasonic surgical assembly for providing air cooling to an ultrasonic tip, the ultrasonic surgical assembly comprising:

an ultrasonic tip comprising a shaft and a cutting portion, the ultrasonic tip comprising:

a first side, which is substantially planar and extends from a proximal end to a distal end,

a second side, which is substantially planar and disposed opposite the first side, and extends from the proximal end to the distal end,

the cutting portion includes a cutting head disposed at the distal end, and

an ultrasonic tip is removably coupled to the horn, wherein the shaft further comprises a longitudinal axis; and

an irrigation sleeve having a distal region and a proximal region and defining a chamber extending along the longitudinal axis, the irrigation sleeve at least partially surrounding the shaft and defining an access aperture, the irrigation sleeve further comprising:

a first conduit in fluid communication with the chamber, the first conduit having an exhaust orifice, wherein the first conduit is configured to be connected to a liquid source;

the ultrasound tip further comprises:

a sealing member coupled to an outer surface of the ultrasonic tip,

ultrasound tip definition:

a first duct defining an air inlet disposed adjacent the seal member, and

A second bore extending from the proximal end of the shaft to the first bore to form a fluid path between the first bore and the second bore.

2. The ultrasonic surgical assembly of claim 1, further comprising an ultrasonic instrument configured to couple with the ultrasonic tip and the irrigation sleeve, and wherein the irrigation sleeve further comprises a third port adjacent to the first port when the irrigation sleeve and the ultrasonic tip are coupled to the ultrasonic instrument.

3. The ultrasonic surgical assembly of any one of claims 1 and 2, wherein the ultrasonic tip further defines a recess, and wherein the sealing member is disposed about the recess.

4. The ultrasonic surgical assembly according to any one of claims 1 and 2, wherein the first aperture is perpendicular to the axis of the second aperture.

5. The ultrasonic surgical assembly of claim 1, wherein the ultrasonic tip further comprises:

a base for coupling to a transducer and a body extending from the base, the body comprising the shaft and a cutting portion, wherein the body is coupled to the base at the shaft and the body extends along the longitudinal axis from the shaft to the cutting portion; and

Wherein the cutting head comprises a base portion and a tapered portion.

6. The ultrasonic surgical assembly of claim 5, wherein:

the base portion has a transverse dimension between the first side and the second side, the transverse dimension extending perpendicular to the longitudinal axis and

the tapered portion includes a bevel and extends from a base portion to a cutting edge, the cutting edge including a length and having a U-shaped profile with a first leg portion, a second leg portion, and an arcuate distal portion, wherein the first leg portion and the second leg portion are parallel to each other and each include a plurality of cutting teeth, wherein no more than half of the length of the cutting edge includes the plurality of cutting teeth at the distal end, and wherein the arcuate distal portion is devoid of the plurality of cutting teeth.

7. The ultrasonic surgical assembly of any one of claims 1, 2, 5, and 6, wherein the shaft of the ultrasonic tip has no chamber in the distal end.

8. An ultrasonic surgical assembly, comprising:

an ultrasonic instrument, comprising:

a housing comprising a proximal portion and a distal portion,

a transducer disposed at least partially within the housing, and

A horn coupled to the transducer;

an ultrasonic tip comprising a shaft, the ultrasonic tip being detachably coupled to the flare; and

a flush sleeve defining a chamber, the flush sleeve comprising:

a body releasably coupled to the distal portion of the housing and having a distal region and a proximal region, the body defining a helical groove at least partially surrounding the shaft of the ultrasound tip when the ultrasound tip is positioned in the chamber of the irrigation sleeve,

a sheath coupled to and disposed over a portion of the body to surround at least one complete revolution of the helical groove, the sheath having a proximal end and an opposite distal end,

an irrigation conduit disposed within the helical groove for delivering irrigation fluid, the irrigation conduit defining an access aperture disposed at a proximal region of the body and an exit aperture disposed at a distal region of the body, wherein irrigation fluid enters the irrigation conduit at the access aperture and exits the irrigation conduit at the exit aperture.

9. The ultrasonic surgical assembly of claim 8, further comprising an annular seal member disposed at the proximal region of the body and coupled to the outer surface of the ultrasonic tip, wherein the annular seal member is located between the outer surface of the ultrasonic tip and the inner surface of the chamber and is configured to prevent proximal movement of fluid to the annular seal member.

10. The ultrasonic surgical assembly of any one of claims 8 and 9, wherein the body defines a second helical groove devoid of an irrigation catheter and surrounded by the sheath, and wherein the second helical groove covered by the sheath defines a surface for grasping by a user.

11. The ultrasonic surgical assembly according to any one of claims 8 and 9, wherein the irrigation conduit is constructed of a flexible material, the irrigation conduit comprising a single component defining a continuous length between the inlet orifice and the outlet orifice.

12. An ultrasonic tip, comprising:

a shaft defining a longitudinal axis; and

a cutting portion defining a first substantially planar side and a second substantially planar side, the cutting portion further comprising a cutting head comprising:

a base portion having a transverse dimension between the first side and the second side, the transverse dimension extending perpendicular to a longitudinal axis of the cutting head,

a tapered portion comprising a bevel and extending from a base portion to a cutting edge, the cutting edge comprising a length and having a U-shaped profile with a first leg portion, a second leg portion, and an arcuate distal portion, wherein the first leg portion and the second leg portion are parallel to one another;

And wherein:

the maximum cross-sectional area of the ultrasonic tip defines the cross-sectional area of the first segment,

the cross-sectional area of the second section is defined at a position 20mm proximal to the distal end of the ultrasound tip, the second section and the first section each being perpendicular to the longitudinal axis of the shaft, and

the cross-sectional area of the second section is 15-20% of the cross-sectional area of the first section.

13. The ultrasonic tip of claim 12, wherein:

each of the first and second leg portions includes a plurality of cutting teeth, and wherein no more than half of the length of the cutting edge includes the plurality of cutting teeth, and wherein each of the cutting teeth includes a toothed cutting edge and a notch base.

14. The ultrasonic tip of any one of claims 12 and 13, wherein the cutting portion defines a centerline along the longitudinal axis, and wherein:

the centerline defines a first distance to the toothed cutting edge,

the centerline defines a second distance to the notch base, an

The centerline defining a third distance to the start of the tapered portion;

and wherein:

a difference between the first distance and the second distance of less than or equal to 0.25mm, and

the first distance is greater than 1.5 times the third distance but less than 2 times the third distance.

15. The ultrasound tip of any of claims 12 and 13, wherein the tip comprises a diameter of no greater than 9 mm.

16. The ultrasound tip of any one of claims 12 and 13, wherein:

the plurality of cutting teeth are disposed at a distal end of the cutting head,

the arcuate distal portion is devoid of the plurality of cutting teeth,

the plurality of cutting teeth includes at least two adjacent cutting teeth and a notch between the at least two adjacent cutting teeth, the notch having a transverse dimension, and

the lateral dimension of the recess is at most 1/25 of the lateral dimension of the base portion.

17. The ultrasonic tip of any one of claims 12 and 13, wherein the arcuate distal portion has a thickness of at least 1.35 millimeters.

18. The ultrasound tip of any of claims 12 and 13, wherein the shaft of the ultrasound tip has no lumen in the distal end.

19. The ultrasonic tip of claim 12, wherein the ultrasonic tip defines a recess, the ultrasonic tip comprising:

a sealing member disposed around the groove;

a first duct defining an air inlet disposed adjacent to the seal member; and

A second port extending from the proximal end of the ultrasound tip to the first port such that the second port and the first port are in fluid communication with each other.

20. An ultrasonic surgical assembly for providing air cooling to an ultrasonic tip, the ultrasonic surgical assembly comprising:

an ultrasonic instrument having a proximal region and a distal region, the ultrasonic instrument comprising:

a housing comprising a proximal portion and a distal portion,

a transducer disposed at least partially within the housing,

a horn coupled to the transducer, and

the transducer is configured to be coupled to a suction source by a first coupling;

an ultrasonic tip comprising a shaft and a cutting portion, the ultrasonic tip being detachably coupled to the flare by a tip coupler, wherein the shaft comprises a longitudinal axis;

an irrigation sleeve having a distal region and a proximal region and defining a chamber, the irrigation sleeve at least partially surrounding the shaft and defining an access aperture configured to receive irrigation liquid from an irrigation source, the irrigation sleeve further comprising:

a first conduit in fluid communication with the chamber, the first conduit configured to convey a flushing liquid from an inlet orifice to an outlet orifice; and

A sealing member positioned between an outer surface of the ultrasonic tip and an inner surface of the chamber; ultrasound tip definition:

a first port defining an air inlet disposed adjacent to the seal member when the irrigation sleeve and the ultrasonic tip are coupled to the ultrasonic instrument, an

A second port extending from the proximal end of the ultrasound tip to the first port, the second port being in communication with a suction source through the tip coupler;

the irrigation sleeve defines a third aperture adjacent to the first aperture when the irrigation sleeve and the ultrasonic tip are coupled to the ultrasonic instrument, an

Wherein the ultrasonic surgical assembly defines a path for drawing air from the ambient environment through the third aperture, then through the first aperture, and back through the second aperture before the air exits the ultrasonic surgical assembly at the first coupler.

21. The ultrasonic surgical assembly of claim 20, wherein the ultrasonic tip further defines a recess, and wherein the sealing member is disposed about the recess.

22. The ultrasonic surgical assembly of any one of claims 20 and 21, wherein said first aperture is perpendicular to an axis of said second aperture.

23. The ultrasonic surgical assembly of claim 20, wherein said ultrasonic tip further comprises:

a base for coupling to a transducer and a body extending from the base, the body comprising a shaft and a cutting portion, wherein the body is coupled to the base at the shaft and the body extends from the shaft to the cutting portion along the longitudinal axis; and

wherein the cutting portion includes a base portion and a tapered portion.

24. The ultrasonic surgical assembly of claim 23, wherein the ultrasonic tip further comprises:

a first side which is substantially planar and extends from a proximal end to a distal end, and

a second side, which is substantially planar and disposed opposite the first side, extends from the proximal end to the distal end.

25. The ultrasonic surgical assembly of claim 24, wherein:

the base portion has a lateral dimension between the first side and the second side, the lateral dimension extending perpendicular to the longitudinal axis and

the tapered portion includes a bevel and extends from a base portion to a cutting edge, the cutting edge including a length and having a U-shaped profile with a first leg portion, a second leg portion, and an arcuate distal portion, wherein the first leg portion and the second leg portion are parallel to each other and each include a plurality of cutting teeth, wherein no more than half of the length of the cutting edge includes a plurality of cutting teeth at the distal end, and wherein the arcuate distal portion is devoid of the plurality of cutting teeth.

26. The ultrasonic surgical assembly of any one of claims 20, 21, 23, 24, and 25, wherein said shaft of said ultrasonic tip has no chamber in said distal end.

27. A method of cutting bone through an ultrasonic tip, the method comprising:

providing an ultrasonic tip comprising a shaft and a cutting portion, the ultrasonic tip being detachably coupled to a horn by a tip coupler, the horn being coupled to a transducer, and the transducer being coupled to a suction source by a first coupler; wherein the shaft comprises a longitudinal axis, the ultrasound tip defines a first orifice and a second orifice, the first orifice defining an air inlet, and the second orifice extending from a proximal end of the ultrasound tip to the first orifice, the first orifice being transverse to the second orifice, the second orifice being in communication with a suction source via a tip coupler;

providing an irrigation sleeve having a distal region and a proximal region and defining a chamber, the irrigation sleeve at least partially surrounding the shaft and configured to be coupled to an irrigation source through an access port configured to receive irrigation liquid from the irrigation source, the irrigation sleeve defining a first conduit in fluid communication with the chamber, the first conduit configured to convey irrigation liquid from the access port to an exhaust port; and

Providing a sealing member between an outer surface of the ultrasonic tip and an inner surface of the chamber of the irrigation sleeve, wherein a first aperture is disposed proximal of the sealing member;

the method further comprises the steps of:

air is drawn through the second and first channels via the suction source to cool the ultrasonic tip.

28. The method of claim 27, further comprising:

one of the smoke and airborne particles is extracted through the first and second channels.

29. The method of any one of claims 27 and 28, further comprising:

air is drawn through the first port to the second port to cool the ultrasonic tip.

30. The method of claim 27, further comprising:

wherein a sealing member is coupled to an outer surface of the ultrasonic tip.

31. The method of claim 27, further comprising:

providing a third aperture defined in the irrigation sleeve, wherein the third aperture is adjacent to the first aperture when the irrigation sleeve and the ultrasonic tip are coupled to the handpiece, and

air is drawn from the surrounding environment through the third duct, then through the first duct, and back through the second duct.

32. An ultrasonic surgical assembly, comprising:

An ultrasonic instrument, comprising:

a housing comprising a proximal portion and a distal portion,

a transducer disposed at least partially within the housing,

a horn coupled to the transducer; and

an ultrasonic tip comprising a shaft and a cutting portion, the ultrasonic tip being detachably coupled to the flare;

a flush sleeve defining a chamber, the flush sleeve comprising:

a body releasably coupled to the distal portion of the housing and having a distal region and a proximal region; and

the ultrasound tip further comprises:

annular seal member, and

the ultrasonic tip defines a groove, an annular sealing member disposed about the groove and disposed at a proximal region of the body and between an outer surface of the ultrasonic tip and an inner surface of the chamber when the sleeve and ultrasonic tip are coupled to an ultrasonic instrument, the annular sealing member configured to prevent proximal movement of fluid to the annular sealing member.

33. An ultrasonic surgical assembly, comprising:

an ultrasonic instrument, comprising:

a housing comprising a proximal portion and a distal portion,

a transducer disposed at least partially within the housing,

a horn coupled to the transducer, and

An irrigation sleeve defining a chamber, the irrigation sleeve configured to be detachably coupled to the first and second ultrasonic tips, wherein each of the first and second ultrasonic tips is configured to be detachably coupled to the flare by a tip coupler, and wherein each of the first and second ultrasonic tips comprises:

the axis of the shaft is provided with a plurality of grooves,

a cutting portion, wherein the cutting portion of the first ultrasonic tip comprises a cutting geometry that is different from a cutting geometry of the cutting portion of the second ultrasonic tip,

annular seal member, and

wherein the first ultrasonic tip defines a first groove positioned a first distance from the tip coupler of the first ultrasonic tip, the second ultrasonic tip defines a second groove positioned a second distance from the tip coupler of the second ultrasonic tip, and the first distance from the tip coupler of the first ultrasonic tip is not equal to the second distance from the tip coupler of the second ultrasonic tip, wherein each of the first ultrasonic tip and the second ultrasonic tip includes an annular sealing member disposed about the respective first and second grooves; and is also provided with

The irrigation sleeve includes:

a body releasably coupled to the distal portion of the housing,

an irrigation catheter coupled to the body and configured to deliver an irrigation fluid, and

the irrigation catheter further defines an inlet orifice disposed at a proximal region of the body and an outlet orifice disposed at a distal region of the body, wherein irrigation fluid enters the irrigation catheter at the inlet orifice and exits the irrigation catheter at the outlet orifice.