WO2017180423A1

WO2017180423A1 - Cutting tool with bearing

Info

Publication number: WO2017180423A1
Application number: PCT/US2017/026302
Authority: WO
Inventors: Cemal Shener-Irmakoglu
Original assignee: Smith & Nephew, Inc
Priority date: 2016-04-14
Filing date: 2017-04-06
Publication date: 2017-10-19
Also published as: JP2019528802A

Abstract

Various embodiments include a cutting tool, such as a rotating blade or burr cutting tool for use in endoscopic surgery, with an outer component (110), an inner component (120) and a bearing (130) between the outer component and the inner component. Some embodiments of the bearing reduce both axial friction and lateral friction between an outside surface of the inner component and an inside surface of the outer component. Some embodiments also include one or more of drive units, resection controls, and fluid management systems.

Description

CUTTING TOOL WITH BEARING

CROSS-REFERENCE TO RELATED APPLICATIONS

[0001] This application claims the benefit of U.S. Provisional Application Serial No. 62/322,554 filed April 14, 2016, which provisional application is incorporated by reference herein as if reproduced in full below.

FIELD

[0002] The various embodiments relate to the field of surgical instruments, and more particularly relate to surgical instruments such as blades or burrs used in endoscopic surgery to cut tissue.

BACKGROUND

[0003] Surgical cutting or resection devices with drive units and rotating blades or burrs are commonplace in endoscopic surgery. Inner and the outer blades may be made of tubular stainless steel and may be coated with various types of plating materials such as nickel, tin- nickel, silver, chromium and titanium-nitride. Some implementations further specify that lubricants be applied to provide a surface between the inner and the outer blades. One of the challenges associated with such instruments is that friction between moving components of the instruments may lead to scoring or shedding of components. The scoring and shedding may further result in metallic particulates being created and introduced into a surgical site during use. In addition to potential metallic contamination, metallic particulates may result in yet more friction between components. Increased friction in some extreme cases may result in seizing of such instruments during use.

SUMMARY

[0004] An embodiment is a cutting tool including: an outer tube that defines a proximal end and a distal end; an inner tube that defines a proximal end and a distal end; a bearing disposed within the outer tube at the distal end of outer tube; and the inner tube telescoped within the outer tube such that the distal end of the inner tube abuts the bearing.

[0005] Other embodiments are methods including: turning an inner tube telescoped within an outer tube, the inner tube and outer tube have a shared central axis; bearing a lateral force at the distal end the inner tube and the outer tube by a bearing device disposed at the distal end of the inner and the outer tube, the force perpendicular to the shared central axis; and cutting tissue by inner tube through a window of the outer tube.

[0006] An embodiment is a cutting tool with an outer component with an inner open volume and an inner component sized to fit within the inner open volume in the outer component and be rotated relative to the outer component. Some embodiments also include a bearing positioned between the outer component and the inner component to reduce friction between the outer component and the inner component, wherein the bearing at least in some appreciable amount reduces both axial friction and lateral friction between an outside surface of the inner component and an inside surface of the outer component.

[0007] Another embodiment is a system for cutting that includes at least a cutting tool, a resection control electrically coupled to the cutting tool, and a fluid management system comprising a pump control and a fluid passage between the pump control and the cutting tool. Embodiments of the cutting tool may include an outer component with an inner open volume and an inner component sized to fit within the inner open volume in the outer component and be rotated relative to the outer component. Some embodiments also include a bearing positioned between the outer component and the inner component to reduce friction between the outer component and the inner component, wherein the bearing at least in some appreciable amount reduces both axial friction and lateral friction between an outside surface of the inner component and an inside surface of the outer component.

[0008] Yet another embodiment is a method of applying a bearing between an outer component with an inner open volume and an inner component sized to fit within the inner open volume in the outer component. The method may include at least separating the inner component from the inner open volume in the outer component and placing a bearing against a portion of a distal end of the inner open volume in the outer component, wherein the bearing contacts both the portion of the distal end and a portion of a lateral side of the inner open volume in the outer component. The method embodiment may also include coupling the bearing to the outer component and inserting the inner component in the inner open volume in the outer component.

[0009] Still another embodiment is a method of applying a bearing between an outer component with an inner open volume and an inner component sized to fit within the inner open volume in the outer component. The method embodiment may include at least separating the inner component from the inner open volume in the outer component and placing a bearing against a portion of a far distal tip of the inner component, wherein the bearing contacts both the far distal tip and a portion of a lateral side of the inner component. The method embodiment may also include coupling the bearing to the inner component and inserting the inner component in the inner open volume in the outer component.

BRIEF DESCRIPTION OF THE DRAWINGS

[0010] FIG. 1 is a perspective view of an embodiment of a cutting tool.

[0011] FIG. 2 is an enlarged perspective view of a distal end the cutting tool of FIG. 1.

[0012] FIG. 3 is a cross-sectional view of a distal end of the cutting tool of FIG. 1 taken through the section illustrated in FIG. 2.

[0013] FIG. 4 is a perspective view of a distal end of an inner component of the cutting tool of FIG. 1.

[0014] FIG. 5 is a perspective view of a distal end of an outer component of the cutting tool of FIG. 1.

[0015] FIG. 6 is a perspective view of a bearing of the cutting tool of FIG. 1.

[0016] FIG. 7 is an enlarged perspective cross-sectional view of a distal end of the cutting tool of

FIG. 1.

[0017] FIG. 8 is a system diagram of the cutting tool of FIG. 1 in combination with a drive unit and control system for controlling use of the cutting tool and managing fluids.

DEFINITIONS

[0018] Certain terms are used throughout the following description and claims to refer to particular system components. As one skilled in the art will appreciate, different companies may refer to a component by different names. This document does not intend to distinguish between components that differ in name but not function. In the following discussion and in the claims, the terms "including" and "comprising" are used in an open-ended fashion, and thus should be interpreted to mean "including, but not limited to... ." Also, the term "couple" or "couples" is intended to mean either an indirect or direct connection. Thus, if a first device couples to a second device, that connection may be through a direct connection or through an indirect connection via other devices and connections.

[0019] "Bearing" shall mean a physical structure disposed between two elements, where the bearing reduces friction between the two elements compared to the two elements directly abutting. A conformal coating (e.g., a substance electroplated to an inner tube or an outer tube) shall not be considered a bearing claimed as a distinct component.

[0020] "Inner open volume" shall mean that some volume of space is available to receive another component at some stage of assembly and/or use. A component is still considered to be open herein if the opening has been filled by another component or portion of the device at some stage of assembly.

[0021] "Spherical" in relation to a feature of an object shall mean that the feature of the object defines spherical surface at least in part, but shall not be read to require the feature define a complete sphere.

DETAILED DESCRIPTION

[0022] A system for cutting 1 with a cutting tool 100 and their respective component parts are illustrated in FIGS. 1-8. As used herein the term "cutting tool" may include not only tools that cut with a blade but tools that abrade, scratch, rub, dislodge, or otherwise manipulate tissue. The cutting tool 100 illustrated includes a drive unit 101 (FIG. 8), an outer component 110, and an inner component 120. The drive unit 101 may be a motorized drive unit powered by an electric motor and a battery, transformer, capacitor, wire, or other source of electricity, may be powered by air pressure or other fluid pressure, may be powered by manual or automated user manipulation, or may be powered by any other effective mechanism. The drive unit 101 may include any effective set controls for dictating the function of the drive unit 101. The set of controls may include buttons, switches, sliders, indicators, and other mechanisms or displays to adjust and control functions of the drive unit 101. For example and without limitation, the controls may be used to one or more of power the drive unit 101 on and off, set a rotating speed for a portion of the drive unit, activate a clockwise or counterclockwise rotation of a portion of the drive unit, indicate a status or function of the drive unit 101, and provide any other useful control or display associated with the drive unit 101. Function and control may also be accomplished by use of a control system coupled with the drive unit 101, and may further include use of separate controls such as foot operated controls.

[0023] The outer component 110 (FIGS. 1-3, 5, 7, and 8) has an inner open volume 114, as illustrated in FIG. 5. As used in the phrase "inner open volume" herein, the term "open" means that some volume of space is available to receive another component at some stage of assembly. A component is still considered to be open herein if the opening has been filled by another component or portion of the device at some stage of assembly. The outer component 110 illustrated includes a connector or base 111 (FIG. 1) near a proximal end of the outer component 110. The base 111 depicted is configured to releasably lock with the drive unit 101 through the latch 112 (FIG. 1). Insertion of the base 111 into the drive unit 101 leads to engagement of the latch 112 with the drive unit 101 (FIG. 8). The latch 112 may be released by pressing the adjacent guide pin 113. While pressed, the base 111 may be removed from the drive unit 101.

[0024] The outer component 110 shown also comprises an outer tube or elongated tube 115 coupled to a distal end of the base 111. In the illustrated embodiment, as particularly well illustrated in FIGS. 3 and 7, a distal portion 116 of the outer component 110 inside the inner open volume 114 (FIG. 5) is substantially spherical. In this illustrated embodiment, the distal portion 116 of the elongated tube 115 is also considered a distal portion 116 of the outer component 110. In other embodiments, a distal inner portion of an outer component, such as an elongated tube, may be formed in another shape to interact with an adjacent component, such as a bearing, that has a complementary shape. For example and without limitation, a distal inner portion of an elongated tube may have angular features that fit with or abut angular features of a bearing to lock the bearing relative to the elongated tube. As depicted in FIGS. 1-3, 5, and 7, a section of the distal portion of outer component 1 10, which is in this embodiment the elongated tube 115, has been removed to expose part of the inner open volume 114 in the outer component 110 along an aperture or opening 117.

[0025] The inner component 120 shown in FIGS. 1-4 and 7 is sized to fit within the inner open volume 114 (FIG. 5) in the outer component 110 and be rotated relative to the outer component 110. In particular, the inner component 120 includes a drive tang or torque transfer element 125 (FIG. 1) configured to engage with and be turned by the drive unit 101. The torque transfer element 125 extends from a proximal end of the inner component 120 to enable the inner component 120 to be turned by the drive unit 101 when the outer component 110 is seated in the drive unit 101, as shown in FIG. 8. Any effective mechanism for transferring torque from a drive unit to an inner component may be used in other embodiments. The inner component 120 shown is an inner tube and this thus tubular. This configuration may be useful in removing material cut or otherwise manipulated by a cutting tool by applying a negative pressure to the pathway within the tubular inner component 120.

[0026] The distal end 121 of the inner component 120 of the illustrated embodiment includes a cutter 122. The cutter 122 may include an aperture with sharpened edge 123 that slices tissue directly and may include an edge that works in combination with an inner edge of the aperture or opening 117 of the outer tube 115 to shear tissue between the inner component 120 and the outer component 110. A sharpened edge of some embodiments may be the same edge that shears tissue in combination with an outer component. The cutter 122 is integral with the distal end 121 of the inner component 120. In other embodiments, a cutter may be a module or component configured to couple at a distal end of the inner member by any effective mechanism. Cutting elements may be formed from the same material as a rotatable shaft or a different material. Cutting elements of various embodiments may include blades, burrs, rasps, abrasives, or any other devices effective to cut, abrade, scratch, rub, dislodge, or otherwise manipulate tissue.

[0027] As shown in FIGS. 2-4 and 7, a far distal end or distal tip 124 of the inner component 120 has a substantially spherical outer portion. Other embodiments may include other shapes that are configured to rotate effectively with a bearing, such as a bearing 130 illustrated. In the embodiment depicted, a radius of the far distal tip 124 has a substantially spherical outer portion with a smaller radius than a radius of the substantially spherical distal portion 116 of the elongated tube 115 inside the inner open volume 114.

[0028] The bearing 130 shown in FIGS. 2, 3, and 5-7 is disposed or positioned between the outer component 110 and the inner component 120. As used herein, the term "bearing" is a component that has a relatively substantial thickness compared with a coating, such as but not limited to, paint, electroplating, galvanizing, or vapor deposition processes. In other words, a conformal coating alone is not a "bearing" as specified herein. Some embodiments of a bearing may be between about 0.1mm and 4mm, although other thicknesses, including thicknesses that vary across the surfaces of a bearing are contemplated. The bearing 130 illustrated reduces friction between the outer component 110 and the inner component 120 by providing a material that has a lower coefficient of friction than the materials of the surfaces of one or more of the outer component 110 and the inner component 120. A non-limiting list of materials from which a bearing may at least in part be made includes one or more of a ceramic, an oxidized metal, or a polymer, including cross-linked polymers. More specifically and without limitation, bearing materials may include silicon carbide, tungsten carbide, boron carbide, silicon nitride, boron nitride, silicon dioxide, aluminum oxide, zirconium dioxide, oxidized zirconium of any type, and cross-linked and highly cross-linked polyethylene. Bearings of various embodiments may be made by milling, casting, sintering, otherwise forming, or any other effective process or technique.

[0029] As shown in FIG. 3, the bearing 130 reduces the amount of both axial friction and lateral friction between an outside surface of the inner component 120 and an inside surface of the outer component 110 by being positioned between the outer component 110 and the inner component 120. More specifically, in the illustrated embodiment, the inner component 120 is being pushed distally toward the bearing 130 and the inside surface of the outer component 110 and a resulting force A is being created between the bearing 130 and the inner component 120 along their shared central axis, which creates what is referred to here as an axial friction between the bearing 130 and the inner component 120. In the illustrated embodiment, the inner component 120 is being pushed distally toward the bearing 130 and the inside surface of the outer component 110 and the inner component 120 may be used to push against tissue to be cut so that a resulting force N normal to a substantially spherical outer portion of an inner component 120 is created against the bearing 130. Due to the substantially continuous contact between the inner component 120 and the bearing 130, similar forces are created substantially continuously along the surface of the bearing 130 to different degrees. However, for the purpose of demonstrating the resolution of the forces, only a single resulting force N is discussed specifically. The resulting force N can be resolved into a lateral force component L and an axial force component AN. The resulting force N is being created between the bearing 130 and the inner component 120. The lateral force component L creates what is referred to here as a lateral friction between the bearing 130 and the inner component 120, and the lateral friction is perpendicular to the shared central axis of the inner and outer components. The axial force component AN creates an addition to the axial friction between the bearing 130 and the inner component 120 noted above. Therefore, in this embodiment the bearing 130 at least in some appreciable amount reduces both axial and lateral friction (and thus axial and lateral forces) between an outside surface of the inner component 120 and an inside surface of the outer component 110. As used herein, the term "some appreciable amount" of friction reduction means an amount of friction reduction that would protect one or both of the inner and outer components from negative effects of wear or deterioration over a typical service life.

[0030] The illustrated bearing 130 is coupled to the outer component 110. In particular, in the embodiment shown, an exterior surface 131 (FIGS. 3, 6, and 7) of the bearing 130 has a shape and size that substantially matches and abuts a distal portion 116 (FIGS. 3 and 7) of the outer component 110 inside the inner open volume 114 (FIG. 5). The bearing 130 shown also has an interior surface 132 (FIGS. 3, 6, and 7) configured to substantially match and abut an outer portion of a far distal tip 124 (FIGS. 3 and 7) of the inner component 120). In other embodiments, surfaces of a bearing may or may not substantially match one or both of the adjacent portions of inner and outer components. In the illustrated embodiment, the exterior surface 131 of the bearing 130 and the interior surface 132 of the bearing 130 are substantially spherical. Additionally, matching surfaces of the outer component 110 and the inner component 120 shown are substantially spherical. Any of these four elements may have other shapes in other embodiments. For example and without limitation, surfaces may be elliptical or parabolic. Additionally, surfaces may be complementary without matching precisely. Also, in some embodiments one side of a bearing may have an angular cross-section that fits with an inner or outer component such that relative rotation is discourage, and the other side of the bearing may have a rounded cross-section intended to permit rotation between the bearing and one of the inner or outer components.

[0031] In the illustrated embodiment, the bearing 130 is coupled directly to the outer component 110 with an adhesive. The bearing 130 could also be press-fit with the outer component 110 and thus still coupled directly to the outer component 110. Other embodiments may include features that promote locking between a bearing and an outer component when press-fit into place. Such features may be a part of an outer component, a part of a bearing, or a combination of elements of an outer component and a bearing of such embodiments, such as but not limited to their shapes and sizes. It follows that in the example embodiments when the inner tube 115 is turning, the bearing 130 is stationary relative to the outer component 110. [0032] The bearing 130 of the illustrated embodiment may also be coupled directly to the inner component 120 with an adhesive. The bearing 130 could also be press-fit with the inner component 120. Other embodiments may include features that promote locking between a bearing and an inner component when press-fit into place. Such features may be a part of an inner component, a part of a bearing, or a combination of elements of an inner component and a bearing of such embodiments, such as but not limited to their shapes and sizes. It follows that in these alternative example embodiments when the inner tube 115 is turning, the bearing 130 is stationary relative to the inner tube 115.

[0033] Embodiments of the cutting tool may also include a drive unit coupled to an outer component of the cutting tool and coupled to an inner component of the cutting tool. Such drive unit embodiments are capable of turning the inner component relative to the outer component. Drive units of some embodiments are motorized. Other embodiments may be manually moved or may be actuated by any other effective mechanism. The cutting tool 100 depicted in FIGS. 1 and 8 includes the drive unit 101 coupled to the base 111 of the outer component 110, as specifically described herein. The cutting tool 100 is also coupled to the inner component 120 through the torque transfer element 125 that extends from a proximal end of the inner component 120. Activation of the drive unit 101 of some embodiments will enable rotation of the inner component 120 relative to the outer component 110. Function and control of the drive unit 101 in combination with the other components of the cutting tool 100 are illustrated in a system diagram in FIG. 8. Drive units of some embodiments may include a processor coupled with a power control. These elements may be electrically coupled with such elements as a revolution rate selector, a revolution direction selector, alert controls, and an indicator. The alert control may be used to one or both select and indicate whether an alert is to be provided with a lighted indication, an audible indication, a vibratory indication, or any other effective indication. The indicator may be used in association with one or more of the other functions of a drive unit. For example and without limitation, the indicator may be used to set or display a speed or direction of rotation for the device, may be used as a power indicator, or may be used for one or a combination of these or other purposes. Control and display functions may be accomplished with hardwired or so-called "soft" programmable function buttons or keys that are part of a drive unit. The system may further include display screens of various types. These and other function and control mechanisms may alternatively or in combination be performed by an external control system.

[0034] A control system is illustrated in FIG. 8 coupled with the drive unit 101, which is couple with the cutting tool 100 as part of a system for cutting 1. The system for cutting 1 illustrated in FIG. 8 therefore includes a cutting tool 100 with a drive unit 101, a control system with a resection control 510, and a fluid management system. The illustrated control system includes the resection control 510 that is electrically coupled with the drive unit 101 by a cable 511. The resection control 510 may be used to one or more of provide power to the drive unit 101, receive operator inputs from the drive unit 101, sense operating parameters of the drive unit 101, receive operator inputs from external switches or controls such as foot operated switches or controls, provide, set, or display alerts to a user based on operations of the cutting tool 100, and send and receive signals to and from the pump control 520. The resection control 510 illustrated also includes a resection display panel 518, which may be used to communicate information to a user and may be used to input settings or other information into the resection control 510 or other connected components of the control system. Other knobs, switches, controls, and the like may be used to control, set, or calibrated the resection control 510 as well.

[0035] In the illustrated embodiment, the pump control 520 is part of a fluid management system used in conjunction with fluid supply, tubing, and disposal components as described herein to facilitate the use of the cutting tool 100. For example and without limitation, fluids such as saline may be used during endoscopic surgical procedures to provide a clear operating medium in which to perform endoscopic surgical tasks. The pump control 520 may be used to one or more of provide fluid to the drive unit 101, sense operating parameters of the drive unit 101, manage waste fluid, receive operator inputs from external switches or controls such as foot operated switches or controls, and send and receive signals to and from the resection control 510. A fluid inflow line 521 is shown coupled between the pump control 520 and a patient joint cannula 522. The patient joint cannula 522 may provide one or both a passageway through which the cutting tool 100 may be introduced into a joint and an entry port for fluid supplied though the fluid inflow line 521. In other embodiments, one or more additional fluid lines may be used to supply fluid or remove fluid from a surgical site from locations different than those illustrated. A saline bag 523 is shown providing a fresh fluid supply to the pump control 520 through a supply line 524 in the present embodiment. Any other effective fluid source may be used in various embodiments. A suction line 525 is shown coupled between the cutting tool 100 and the pump control 520, which when activated draws waste fluid through the cutting tool 100 and into the pump control 520 where the fluid may be diverted for waste removal. A waste line 527 is shown coupled between the pump control 520 and a waste receptacle 529. Any other effective supply or waste handling mechanisms may be used in other embodiments. The pump control 520 illustrated also includes a pump control display panel 528, which may be used to communicate information to a user and may be used to input settings or other information into the pump control 520 or other connected components of the control system. Other knobs, switches, controls, and the like may be used to control, set, or calibrated the pump control 520 as well.

[0036] Another embodiment is a method of applying a bearing between an outer component with an inner open volume and an inner component sized to fit within the inner open volume in the outer component. As depicted in the embodiment illustrated in FIGS. 1-8, the outer component 110 has an inner open volume 114. The inner component 120 is sized to fit within the inner open volume 114 of in the outer component 110, as specifically shown in the combination of FIGS. 1-3, 5, 7, and 8. The bearing 130 is shown applied between the outer component 110 and the inner component 120. Specific acts of some method embodiments include at least separating the inner component from the inner open volume in the outer component and placing a bearing against a portion of a distal end of the inner open volume in the outer component, wherein the bearing contacts both the portion of the distal end and a portion of a lateral side of the inner open volume in the outer component; and coupling the bearing to the outer component and inserting the inner component in the inner open volume in the outer component.

[0037] As used herein, the term "separating" the inner and outer components may include an affirmative act of separating or may in addition or in the alternative include acting upon inner and outer components that have already been separated by an act or multiple acts of others. For example, the inner component 120 of FIG. 4 has been separated from the outer component 110 of FIG. 5 and demonstrates the separating act as used herein.

[0038] The result of the act of placing a bearing 130 against a distal portion 116 of the elongated tube 115 inside the inner open volume 114 in the outer component 110 is illustrated in FIGS. 2, 3, 5, and 7. The bearing 130 illustrated contacts both the distal portion 116 (also referred to as a distal end of the inside of the outer component 110) and a portion of a lateral side 119 (FIGS. 3 and 7) of the inner open volume 114 in the outer component 110.

[0039] The act of coupling the bearing 130 to the outer component 110 may include any effective act of coupling. For example and without limitation, the act of coupling the bearing 130 to the outer component 110 in some embodiments includes putting an adhesive between the bearing 130 and the outer component 110. The adhesive may be any effective type of adhesive, including but not limited to, an epoxy, a temperature cured adhesive, or a light cured adhesive. Other embodiments may include the act of press-fitting the bearing 130 to the outer component 110 by pressing the bearing 130 and the outer component 110 together with an adequate force. The force required will be different for different material types and shapes of the outer component and the bearing. After the bearing 130 has been coupled to the outer component 110, another act of some method embodiments is to insert the inner component 120 into the inner open volume 114 of the outer component 110. With the inner component 120 seated against the bearing 130, the inner component 120 and the outer component 110 are in a position to be used clinically.

[0040] Still another embodiment is a method of applying a bearing between an outer component with an inner open volume and an inner component sized to fit within the inner open volume in the outer component. As depicted in the embodiment illustrated in FIGS. 1-8, the outer component 110 has an inner open volume 114. The inner component 120 is sized to fit within the inner open volume 114 of in the outer component 110, as specifically shown in the combination of FIGS. 1-3, 5, 7, and 8. The bearing 130 is shown applied between the outer component 110 and the inner component 120. Specific acts of some method embodiments include at least separating the inner component from the inner open volume in the outer component and placing a bearing against a portion of a far distal tip of the inner component, wherein the bearing contacts both the far distal tip and a portion of a lateral side of the inner component; and coupling the bearing to the inner component and inserting the inner component in the inner open volume in the outer component. The inner component 120 of FIG. 4 has been separated from the outer component 110 of FIG. 5 and demonstrates the separating act as used herein.

[0041] The figures do not specifically illustrate placing the bearing 130 against a far distal tip 124 of the inner component 120 separate from the outer component 110, but such a placement may be accomplished with the bearing 130. An alternatively shaped bearing could also be placed against a larger or smaller portion of the far distal tip 124 in other embodiments. A placed bearing may contact both the far distal tip 124 and a portion of a lateral side of the inner component 120.

[0042] The act of coupling a bearing to the inner component 120 may include any effective act of coupling. For example and without limitation, the act of coupling a bearing to the inner component 120 in some embodiments includes putting an adhesive between the bearing and the inner component 120. The adhesive may be any effective type of adhesive, including but not limited to, an epoxy, a temperature cured adhesive, or a light cured adhesive. Other embodiments may include the act of press-fitting a bearing to the inner component 120 by pressing the bearing and the inner component 120 together with an adequate force. The force required will be different for different material types and shapes of the inner component 120 and the bearing. After the bearing has been coupled to the inner component 120, another act of some method embodiments is to insert the inner component 120 into the inner open volume 114 of the outer component 110. With the outer component 110 seated against the bearing, the inner component 120 and the outer component 110 are in a position to be used clinically.

[0043] Various embodiments of a system wholly or its components individually may be made from any biocompatible material. For example and without limitation, biocompatible materials may include in whole or in part: non-reinforced polymers, reinforced polymers, metals, ceramics, adhesives, reinforced adhesives, and combinations of these materials. Reinforcing of polymers may be accomplished with carbon, metal, or glass or any other effective material. Examples of biocompatible polymer materials include polyamide base resins, polyethylene, Ultra High Molecular Weight (UHMW) polyethylene, low density polyethylene, polymethylmethacrylate (PMMA), polyetheretherketone (PEEK), polyetherketoneketone (PEKK), a polymeric hydroxyethylmethacrylate (PFEMA), and polyurethane, any of which may be reinforced. Polymers used as bearing surfaces in particular may in whole or in part include one or more of cross-linked and highly cross-linked polyethylene. Example biocompatible metals include stainless steel and other steel alloys, cobalt chrome alloys, zirconium, oxidized zirconium, tantalum, titanium, titanium alloys, titanium-nickel alloys such as Nitinol and other superelastic or shape-memory metal alloys. [0044] Terms such as proximal, distal, near, far, and the like have been used relatively herein. However, such terms are not limited to specific coordinate orientations, distances, or sizes, but are used to describe relative positions referencing particular embodiments. Such terms are not generally limiting to the scope of the claims made herein. Any embodiment or feature of any section, portion, or any other component shown or particularly described in relation to various embodiments of similar sections, portions, or components herein may be interchangeably applied to any other similar embodiment or feature shown or described herein.

[0045] While embodiments of the invention have been illustrated and described in detail in the disclosure, the disclosure is to be considered as illustrative and not restrictive in character. All changes and modifications that come within the spirit of the invention are to be considered within the scope of the disclosure.

Claims

CLAIMS What is claimed is:

1. A cutting tool comprising:

an outer tube that defines a proximal end and a distal end;

an inner tube that defines a proximal end and a distal end;

a bearing disposed within the outer tube at the distal end of outer tube; and

the inner tube telescoped within the outer tube such that the distal end of the inner tube abuts the bearing.

2. The cutting tool of claim 1 further comprising:

an inside surface of the distal end of the outer tube is spherical and defines a first radius; an outside surface of the distal end of the inner tube is spherical and defines a second radius; and

the second radius is smaller than the first radius.

3. The cutting tool of claim 1 further comprising an aperture defined through the outer tube proximal the distal end.

4. The cutting tool of claim 3 wherein the distal end of the inner tube comprises a cutter in operational relationship to the aperture.

5. The cutting tool of any preceding claim wherein the bearing comprises ceramic.

6. The cutting tool of claim 1 further comprising an adhesive disposed between the bearing and the outer tube.

7. The cutting tool of claim 1 further comprising an adhesive disposed between the bearing and inner tube.

8. The cutting tool of claim 1 wherein the bearing is press-fit within the outer tube.

9. The cutting tool of claim 1 wherein the bearing comprises:

a distal surface configured to abut an interior distal surface of the outer tube; and a proximal surface configured to abut an exterior of the distal surface of the inner tube.

10. The cutting tool of claim 9 wherein the distal surface of the bearing is spherical.

11. The cutting tool of claim 9 wherein the proximal surface of the bearing is spherical.

12. The cutting tool according to any of the preceding claims and further comprising:

drive unit coupled to the outer tube and the inner tube, and the drive unit configured to rotate the inner tube relative to the outer tube; and

a fluid management system comprising a pump control and a fluid passage between the pump control and the cutting tool.

13. The cutting tool according to any of the preceding claims and further comprising the bearing configured to support at least force selected from the group consisting of: axial force; and lateral force.

14. A method of resecting tissue comprising:

turning an inner tube telescoped within an outer tube, the inner tube and outer tube have a shared central axis;

bearing a lateral force at the distal end the inner tube and the outer tube by a bearing device disposed at the distal end of the inner and the outer tube, the force perpendicular to the shared central axis; and

cutting tissue by inner tube through a window of the outer tube.

15. The method of claim 14 further comprising bearing an axial force at the distal end the inner tube and the outer tube by the bearing device, the force coaxial with to the shared central axis.

16. The method of claim 14 wherein turning further comprising turning the inner tube against the bearing that is stationary relative to the outer tube.

17. The method of claim 14 wherein turning further comprises turning the inner tube and bearing relative to the outer tube which is stationary.