1. A surgical micro-resecting instrument for use with an ENT procedure, the instrument comprising:
an outer tubular member formed of an electrically conductive material and defining a proximal section, a distal section, and a lumen, wherein the distal section forms a cutting window open to the lumen and an axial passage distal the cutting window, the axial passage being fluidly connected to the lumen;
an inner tubular member disposed within the lumen of the outer tubular member, the inner tubular member defining a proximal portion and a distal portion, wherein the distal portion forms a cutting tip;
a hub assembly maintaining the proximal section of the outer tubular member and the proximal portion of the inner tubular member; and
an electrical insulator covering a region of the outer tubular member distal the hub assembly, wherein at least the cutting window is not covered by the insulator.
2. The instrument of claim 1, wherein the distal section of the outer tubular member includes a ring distal the cutting window, the ring defining the axial passage.
3. The instrument of claim 2, wherein at least a portion of the ring is not covered by the insulator.
4. The instrument of claim 3, wherein the ring terminates in a radial face, and further wherein at least the radial face is not covered by the insulator.
5. The instrument of claim 4, wherein the insulator covers a portion of the ring proximal the radial face and distal the cutting window.
6. The instrument of claim 5, wherein the insulator extends at least 0.01 inch distal the cutting window.
7. The instrument of claim 5, wherein an axial length of at least 0.01 inch of the ring proximal the radial face is not covered by the insulator.
8. The instrument of claim 2, wherein the ring has a diameter equal to a diameter of the outer tubular member immediately proximal the cutting window.
9. The instrument of claim 1, wherein an exposed exterior surface area of the distal section of the outer tubular member is less than 0.066 inch2.
10. The instrument of claim 1, wherein the axial passage has a diameter not less than one-half a diameter of the lumen.
11. The instrument of claim 10, wherein the diameter of the axial passage approximates the diameter of the lumen immediately proximal the cutting window.
12. The instrument of claim 1, wherein the outer tubular member forms teeth along a perimeter of the cutting window.
13. The instrument of claim 1, wherein the inner tubular member forms a central lumen and an axial opening distal the cutting tip, the axial opening being fluidly connected to the central lumen.
14. The instrument of claim 13, wherein the distal portion of the inner tubular member includes a ring distal the cutting tip, the ring defining the axial opening.
15. The instrument of claim 13, wherein the instrument is configured such that upon final assembly, the axial passage of the outer tubular member remains open to the central lumen of the inner tubular member regardless of a rotational position of the distal portion of the inner tubular member.
16. The instrument of claim 1, wherein the hub assembly includes:
an outer hub connected to the proximal section of the outer tubular member;
an inner hub connected to the proximal portion of the inner tubular member; and
a washer assembly disposed over the proximal portion of the inner tubular member, the washer assembly providing a bearing surface for movement of the inner tubular member relative to the outer tubular member.
17. The instrument of claim 16, wherein upon final assembly, the washer assembly contacts the outer hub.
18. The instrument of claim 17, wherein the washer assembly includes a first washer abutting a distal end of the inner hub and a second washer distal the first washer.
19. The instrument of claim 18, wherein the second washer is comprised of an amorphous thermoplastic polyetherimide material.
20. A surgical micro-resecting system comprising:
a micro-resecting instrument including:
an outer tubular member formed of an electrically conductive material and defining a proximal section, a distal section, and a lumen, wherein the distal section forms a cutting window open to the lumen and an axial passage distal the cutting window, the axial passage being fluidly connected to the lumen;
an inner tubular member disposed within the lumen of the outer tubular member, the inner tubular member defining a proximal portion and a distal portion, wherein the distal portion forms a cutting tip;
a hub assembly maintaining the proximal section of the outer tubular member and the proximal portion of the inner tubular member; and
an electrical insulator covering a region of the outer tubular member distal the hub assembly, wherein at least the cutting window is not covered by the insulator;
a powered surgical handpiece coupled to the proximal portion of the inner tubular member for driving the inner tubular member relative to the outer tubular member;
an energy source; and
wiring electrically connecting the energy source to the outer tubular member.
21. The system of claim 20, further comprising:
a vacuum source connected to the hub assembly;
wherein the hub assembly fluidly connects the vacuum source to a central lumen of the inner tubular member.
22. The system of claim 20, wherein the distal section of the outer tubular member includes a ring distal the cutting window, the ring defining the axial passage.
23. The system of claim 22, wherein the ring terminates in a radial face, and further wherein at least the radial face is not covered by the insulator.
24. The system of claim 20, wherein the axial passage has a diameter not less than one-half a diameter of the lumen.
25. The system of claim 20, wherein the outer tubular member forms teeth along a perimeter of the cutting window.
26. The system of claim 20, wherein the inner tubular member forms a central lumen and an axial opening distal the cutting tip, the axial opening being fluidly connected to the central lumen.
27. The system of claim 26, wherein the instrument is configured such that the axial passage of the outer tubular member remains open to the central lumen of the inner tubular member regardless of a rotational position of the cutting tip relative to the cutting window.
28. The system of claim 27, wherein the hub assembly includes:
an outer hub connected to the proximal section of the outer tubular member;
an inner hub connected to the proximal portion of the inner tubular member;
a first washer co-axially received over the inner tubular member and abutting a distal end of the inner hub; and
a second washer co-axially received over the inner tubular member distal the first washer.
29. A method for performing a micro-resecting operation at a target site of a patient as part of an ENT surgical procedure, the method comprising:
providing a micro-resecting instrument including an outer tubular member having a lumen and a distal section forming a cutting window and an axial passage distal the cutting window, the cutting window and the axial passage being fluidly connected to the lumen, an inner tubular member disposed within the lumen and having a distal portion forming a cutting tip, a hub assembly maintaining the proximal section of the outer tubular member and the proximal portion of the inner tubular member, and an electrical insulator covering a region of the outer tubular member distal the hub assembly such that at least the cutting window is not covered by the insulator;
delivering the distal section of the outer tubular member to the target site such that the cutting window is located at the target site and the cutting tip is located within the cutting window;
driving the inner tubular member relative to the outer tubular member such that the cutting tip resects tissue at the target site to effectuate a portion of an ENT procedure;
supplying energy to an exposed region of the distal section of the outer tubular member; and
cauterizing tissue at the target site via the energized exposed region.
30. The method of claim 29, further comprising:
selectively coupling the micro-resecting instrument to a powered surgical handpiece.
31. The method of claim 29, further comprising:
aspirating material from the target site into the instrument via the axial passage.
32. The method of claim 31, wherein the inner tubular member defines a central lumen, and further wherein material is aspirated through the axial passage into the central lumen.
33. The method of claim 32, wherein the inner tubular member forms an axial opening distal the cutting tip, the axial opening being fluidly connected to the central lumen of the inner tubular member, and further wherein material is aspirated through the axial opening into the central lumen.
34. The method of claim 32, wherein material is further aspirated into the central lumen via the cutting window.
35. The method of claim 32, further comprising:
orienting the inner tubular member relative to the outer tubular member such that the cutting window is closed;
wherein aspirating material into the central lumen occurs while the cutting window is closed.
36. The method of claim 31, wherein aspirating material into the instrument occurs apart from supplying energy to an exposed region of the distal section.
37. The method of claim 29, wherein the axial passage has a transverse diameter not less than one-half a diameter of the lumen immediately proximal the cutting window.
The claims below are in addition to those above.
All refrences to claim(s) which appear below refer to the numbering after this setence.
1. A sink setting system for mounting a sink to a support structure, the system comprising:
first and second channel members, the first channel member having a first bracket portion at a bracket end thereof, the second channel member having a second bracket portion at a bracket end thereof, each of the channel members including a web portion connecting opposed leg portions, and wherein the second channel member is adapted to nest into the first channel member such that the respective web portions are in a facing relationship, along a range of positions to provide a variable length sink support system;
wherein said first and second channel members have clearance bracket regions formed in the respective channel leg portions adjacent their respective bracket ends, and said first and second channel members have clearance regions formed in the respective channel leg portions adjacent distal ends of the channel members from their respective bracket ends;
a plurality of first slots and a plurality of first threaded fastener structures formed in or attached to the web portion of the first channel member;
a plurality of second slots and a plurality of second threaded fastener structures formed in or attached to the web portion of the second channel member;
wherein the plurality of said first slots overlap one or more of said second threaded fastener structures at a plurality of positions in said range of positions, and the plurality of said second slots overlap one or more of said first threaded fastener structures at said plurality of positions;
a plurality of leveling devices adapted for engagement with either said first threaded fastener structure or said second threaded fastener structures; and
a plurality of fastening devices for fastening said first and second channel members together at a position in said range of positions, said fastening devices adapted to be inserted through one of a first slot or a second slot to fasten said first and second channel members together.
2. The system of claim 1, wherein said first slots have a first length dimension, and said second slots have a second length dimension which is smaller than said first dimension.
3. The system of claim 2, wherein said first and second channel members are adapted to provide either a first threaded fastener structure or a second threaded fastener structure in alignment with either a respective second slot or a first slot at a leveling device interval spacing along a longitudinal extent of the system which does not exceed a predetermined minimum spacing distance.
4. The system of claim 3, wherein said minimum spacing distance is about four inches.
5. The system of claim 1, in which the leveling device include a threaded bolt.
6. The system of claim 1, wherein the plurality of first slots and first threaded fastener structures and said plurality of second slots and second threaded structures are arranged in respective alternating patterns.