Surgical micro-burring instrument

ES 2 348 722 T3

SURGICAL INSTRUMENT WITH MICRO-BLADES

BACKGROUND

The present invention relates to a burred surgical instrument. More particularly, it relates to a micro-burr surgical instrument whose distal tip is configured to assist in tissue separations as part of a surgical procedure and which is particularly useful for septoplasty and turbinoplasty procedures.

Numerous processes have been developed to correct or address abnormalities in the breast. One such procedure, known as a septoplasty, is done to correct a deformity of the nasal septum. In general, the nasal septum is made up of cartilage (septal cartilage) in the front and thin bone in the back, lined with a thin membrane of tissue known as the mucosa. The nasal septum is normally straight. However, over time, there is a tendency for the septum to twist to one side or the other, or for an uneven platform of cartilage or bone to develop, resulting in a deviated septum. The septoplasty procedure is carried out to correct this deformity of the nasal septum. Generally speaking, a small incision is made inside the nose and the mucosal wall of the septum is lifted or separated from the cartilage and bone. The deviated portions of the septum are removed or straightened (such as when deviated cartilage and / or bone is removed or debrided), and the mucosal membrane of the nasal wall is replaced. Splints or compresses are then placed in the nose to hold the septal cartilage and bone in a preferred midline position. Currently, multiple hand instruments, such as Cottle elevators, chisels, and osteotomes, are required to complete a septoplasty procedure. Although it is well accepted, the use of these manual instruments requires elevation of mucous flaps on both sides of the septum to prevent mucosal tearing when bone and / or cartilage is removed, providing only limited access to maxillary ridge deviations, and the process can be time consuming. Notably, similar concerns are present in other sinus surgeries, such as submucosal removal of the turbinate bone (eg, turbinoplasty).

Surgical instruments with a motor have been developed for use in other unrelated ear-nose-throat (ENT) operations. For example, US Patent No. 6,214,009 describes a burr instrument provided with a motor for rhinoplasty that includes an internal burr mount.

ES 2 348 722 T3 rotatably received within an outer tubular member. In one embodiment, the outer tubular member forms curved wings or fins that extend laterally outward from a window or pocket through which the burr is exposed. The wings or fins are specifically provided to facilitate the rhinoplasty procedure. However, in relation to the septoplasty operation, the wings or fins are highly undesirable. In addition, a separate Cottle elevator (or similar elevator device) would be required to perform a septoplasty procedure using the described rhinoplasty burr instrument.

In contrast, US Patent No. 6,503,263 describes a motorized micro-resection instrument in which an inner tubular member, having a serrated cutting tip at a distal end thereof, is coaxially held, at a reciprocally movable form, within an outer tubular member. The outer tubular member forms a window or pocket through which the cutting tip is exposed, along with a lifting tip extending distally from there. While highly competent to perform inferior turbinate reduction where only soft tissue has to be removed, this micro-resection instrument is unsuitable for hard bone or cartilage removal applications as required instead. , in a septoplasty procedure, submucosal removal of the turbinate bone, etc. Furthermore, the contour of the lifting tip described may not satisfy the space requirements associated with, for example, a septoplasty procedure.

Septal reconstruction with a micro-burr or micro-debridement surgical instrument appears to be highly feasible, and can eliminate complications on the contrary associated with accepted techniques that require multiple hand instruments. Unfortunately, currently available microburr instruments are not designed to meet the needs of the septal site. Therefore, there is a need for a micro-burr surgical instrument for the sinus, particularly capable of facilitating a septoplasty procedure.

COMPENDIUM

One aspect of the present invention relates to a micro-burr surgical instrument that includes an outer tubular member having a proximal section, an intermediate section, a distal section, and a central lumen (46) extending from the proximal section to the distal section, forming the distal section: a pocket fluidly connected to the central lumen, where the pocket has a surface

ES 2 348 722 T3 lower and an opposite upper opening; a lifting tip extending distally from the pocket; and characterized by an inner tubular member rotatably received within the central lumen, a distal end of the inner tubular member forming a burr located within the pocket, such that after final assembly, at least a portion of the burr is exposed relative to the member. external tubular through the top pocket opening.

In the following, preferred embodiments are described by way of example only, with reference to the figures.

BRIEF DESCRIPTION OF THE FIGURES

FIG. 1 is a side view of a micro-burr surgical instrument in accordance with the present invention;

FIG. 2 is an exploded side view of the instrument of FIG. 1;

FIG. 3A is an enlarged, side view of a distal portion of an outer tubular member of the instrument of FIG. 1;

FIG. 3B is an enlarged top view of FIG. 3A;

FIG. 4A is an enlarged, cross-sectional view of a distal portion of an outer tubular member of an alternative embodiment in accordance with the present invention;

FIG. 4B is a top view of FIG. 4A;

FIG. 5 is an enlarged cross-sectional view of a portion of an inner tubular member of the instrument of FIG. 1;

FIG. 6 is an enlarged, cross-sectional view of a distal region of the instrument of FIG. 1;

FIG. 7 is a side view of a micro-burr instrument of an alternative embodiment in accordance with the present invention;

FIG. 8 is an enlarged, cross-sectional view of a distal portion of an alternate embodiment micro-burr instrument in accordance with the present invention;

FIG. 9A is an exploded, enlarged view of a distal portion of a micro-burr instrument of an alternate embodiment in accordance with the present invention;

FIG. 9B is a cross-sectional view of a portion of the instrument of FIG. 9A; and FIG. 10 is a perspective view of the instrument of FIG. 1 mounted to a motorized handpiece.

ES 2 348 722 T3

DETAILED DESCRIPTION

A preferred embodiment of a micro-burr surgical instrument 10 is illustrated in FIG. 1. Instrument 10 includes an outer tubular mount 12 and an inner tubular mount 14 (generally referenced in FIG. 1). The outer tubular assembly 12 includes an outer hub 16 and an outer tubular member 18, while the inner tubular assembly 14 includes an inner hub 20, and an inner tubular member 22 (illustrated in FIG. 2). The inner tubular member 22 is measured to be coaxially received within the outer tubular member 18 and forms a burr 24. As described in greater detail below, the microburr instrument 10 is configured to optimally perform a procedure. breast surgery, for example a septoplasty or turbinoplasty procedure.

The outer tubular member 18 extends distally from the outer hub

16. For this purpose, the outer hub 16 can take on a wide variety of shapes known in the art. In addition, and in one embodiment, an irrigation tube 30 is externally secured to the outer tubular member 18. With this configuration, a connector 32 is provided at one end of the irrigation tube 30, adapted to fluidly connect the irrigation tube 30 with a irrigation reservoir (not shown). An opposite end of the irrigation tube 30 is fluidly connected to a portion of the outer tubular member 18 as described in greater detail below. Alternatively, the outer tubular assembly 12 can be adapted to internally deliver irrigation fluid through the outer tubular member 18. Even the irrigation feature can be completely eliminated.

With further reference to FIG. 2, the outer tubular member 18 is an elongated tubular body that defines a proximal section 40, an intermediate section 42, a distal section 44, and a central lumen 46. The central lumen 46 extends from the proximal section 40 to the distal section 44 In this regard, and as described in greater detail below, distal section 44 forms a pocket or window 48 (referred to generally in FIG. 2) in fluid communication with central lumen 46. Similarly, proximal section 40 is open at a proximal end thereof 50 to facilitate positioning of inner tubular member 22 within central lumen 46.

The end section 40 is adapted to receive the outer hub 16, and therefore has a suitable outer diameter. However, the remainder of the outer tubular member 18 preferably provides a relatively uniform outer diameter.

ES 2 348 722 T3 selected to carry out the desired procedure in the sinus and a relatively uniform internal diameter selected to rotatably receive the internal tubular member 22. For example, in one embodiment, the intermediate section 42, as well as the distal section 44 immediately proximal to the pocket 48, has an internal diameter of approximately 3.5 mm which otherwise facilitates the assembly and use of the internal tubular member 22. / burr 24 as part of a septoplasty procedure. Alternatively, other dimensions may be employed.

A preferred embodiment of the distal section 44 of the outer tubular member 18 is shown in greater detail in FIGS. 3A and 3B. As previously described, distal section 44 forms pocket 48 which is otherwise in fluid communication with central lumen 46. In particular, distal section 44 includes proximal portion 60, pocket 48, and a lifting tip 62. Proximal portion 60 is adapted to be contiguous with intermediate section 42 (FIG. 2) and provides a closed tubular section that continues central lumen 46. As described in greater detail, pocket 48 is formed distally from proximal portion 60, and riser tip 60 is formed distally from pocket 48.

Pocket 48 is defined by a side wall (generally referenced in FIG. 3A) that forms a bottom surface 72, an end surface 74, and opposite side surfaces 76, and defines an upper opening 78 opposite bottom surface 72 In one embodiment, one or more ports 80 are formed through bottom surface 72 which otherwise fluidly connects pocket 48 to irrigation tube 30 (FIG. 1). As best shown by the cross-sectional view of FIG. 3A, the side surfaces 76 (one of which is shown in FIG. 3A) terminate in an edge 82 which otherwise defines a perimeter of the upper opening 78. In this regard, the edge 82 includes a proximal area. 84, an intermediate zone 86, and a distal zone 88. Proximal zone 84 extends downward (relative to the orientation of FIG. 3A) in a primarily angular shape from the proximal portion 60. In one embodiment, this angular extension forms an angle α included in the range of 100 ° -140 °, more preferably 120 °, relative to a central axis A of the central lumen 46. Intermediate zone 86 extends in a primarily linear fashion (ie, parallel to central axis A) from proximal zone 84. In one embodiment, relative to the longitudinal cross-sectional view of FIG. 3A, the intermediate zone is aligned with the central axis A. In any case, the included angle α described above is thus also defined between the proximal and intermediate zones 84, 86 in the longitudinal transverse plane. Finally,

ES 2 348 722 T3 distal area 88 extends downwardly (relative to the orientation of FIG. 3A) from intermediate area 86. In one embodiment, distal area 88 of edge 82 defines a curve in a longitudinal transverse plane , this curve being continued by the lifting tip 62. Regardless, the preferred pocket 48 provides a relatively large top opening 78 so as to expose a relatively large portion of the burr 24 (FIG. 2) after final assembly. Alternatively, other dimensions and / or configurations of pocket 48 may also be employed.

Riser tip 62 extends distally from pocket 48, and in particular to a more distal end 90 thereof. In this regard, the lifting tip 62 includes an upper surface 100 and a lower surface 102 that combine to define a distal end point 104. The upper surface 100 is generally defined by a proximal region 106 and a distal region 108. Proximal region 106 extends from distal region 88 of pocket edge 82, preferably curving slightly upward (relative to the orientation of FIG. 3A) approximately proportional to the curvature defined by distal region 88. The region distal 108 extends upward (relative to an orientation of FIG. 3A) from proximal region 1087 in a generally linear fashion (in a longitudinal transverse plane). In this regard, the upward extension of distal region 108 defines an included angle β in the range of 10 ° -50 ° relative to the central axis A of lumen 46. With the embodiment of FIGS. 3A-3B, the included angle β is approximately 20 °, indicating that the distal end point 104 is positioned at, or slightly below (relative to the orientation of FIG. 3A), the central axis A, thus as the intermediate zone 86 of the edge of the pocket 82. The lower surface 103 is preferably curved, generally conforming to the angular extent of the distal region 108 of the upper surface 100. With this embodiment, the elevator tip 62 has a distal extension (i.e., longitudinal distance between the most distal end point 90 of pocket 48 and the most distal end point 104 of elevator tip 62 of at least 1.27 mm (0, 05 inches); more preferably at least 2.54 mm (0.1 inches); still more preferably at least 3.53 mm (0.139 inches) such that the distal end point 104 of the lifting tip 64 is discernibly spaced from the pocket 48.

Various features / dimensions of the distal section 44 described above can be altered and remain within the scope of the present invention. For example, FIGS. 4A and 4B illustrate a distal section of an alternative embodiment 120 (otherwise provided as part of a member

ES 2 348 722 T3 tubular similar to the outer tubular member 18 shown in FIG. 2). The distal section 120 is similar to the distal section 44 (FIGS. 3A and 3B previously described), and includes the proximal portion 60, the pocket 48, and an elevator tip 122. The proximal portion 60 and the pocket 48 are, in one embodiment , identical to the description provided above. In addition, the lifting tip 122 again includes an upper surface 124 and a lower surface 126 that connect at a distal end point 128. The upper surface 124 includes a proximal region 130 and a distal region 132. The proximal region 130 defines a curvature toward above proportional to the curvature of the distal area 88 of the edge of the pocket 82. As compared to the distal region 108 (FIG. 3A), the distal region 132 has a smaller radius of a curvature (in a longitudinal transverse plane). Distal region 132 extends in a generally upward fashion (relative to the orientation of FIG. 4A) from proximal region 130, and preferably generally linear in a longitudinal transverse plane. For this purpose, the extension of the distal region 132 defines an included angle β of approximately 40 ° relative to the central axis A of lumen 46, the distal end point 128 being positioned over (relative to the orientation of FIG. 4A) the central axis A and the intermediate zone 68 of the edge of the pocket 82. However, again, the distal end point 128 is positioned at least 2.54 mm (0.1 inch) from the most distal end point 90 of the pocket 48 .

Regardless of the exact shape, in one embodiment, the distal section 44 (FIG. 3A) or 120 (FIG. 4A) is formed separately from a remainder of the outer tubular member 18 (FIG. 2) and then mounted to the same. With this fabrication technique, the distal section 44, 120 can be formed from a material more susceptible to precise fabrication tolerances. For example, in one embodiment, the distal section 44, 120 is formed from heat-treated 17-4 stainless steel, while a remainder of the outer tubular member is a 304 stainless steel material. Regardless, the distal section so formed 44, 120 is secured to the intermediate section 42 of the outer tubular member 18, such as by means of a laser seam.

Returning to FIG. 2, and with further reference to FIG. 5, inner tubular member 22 extends from inner hub 20. In a preferred embodiment, inner hub 20 is configured for selective attachment to a handpiece (described in greater detail below) that can be operated to automatically rotate the member inner tubular 22 during use.

ES 2 348 722 T3

As previously described, inner tubular member 22 forms burr 24 at a distal end thereof. The burr 24 can take on a variety of shapes and is adapted to cut or scrape body tissue after rotation thereof. Thus, the burr 24 forms a plurality of cutting grooves 138. Although a burr of cylindrical configuration is shown, it will be appreciated that other configurations may be used including, without limitation, spherical, hemispherical, ellipsoid, and pear-shaped configurations.

In one embodiment, inner tubular member 22 defines a central lumen 140 extending from a proximal end 142 thereof. As best shown in FIG. 5, a distal shape 144 of the burr 24 forms a hole 146 that is otherwise open to the central lumen 140. Alternatively, an outer extension passage may be formed proximal to the burr 24 that is otherwise fluidly connected to the central lumen. 140. Independently, the central lumen 140 acts as an aspiration conduit for the microburned instrument 10 (FIG. 1) as described below.

With reference to FIGS. 1 and 2, the micro-burr instrument 10 is mounted by coaxial positioning of the inner tubular member 22 within the outer tubular member 18 through the central lumen 46. The inner hub 20 abuts against the outer hub 16. For this purpose, a position of the inner hub 20 relative to the burr 24 and a position of the outer hub 16 relative to the pocket 48 indicate a desired position of the burr within the pocket 48 as best shown in FIG. . 6. In particular, outer tubular member 22 is coaxially disposed within outer tubular member 18 such that burr 24 is within pocket 48 and exposed relative to outer tubular member 18 through upper opening 78 provided by pocket 48. In one embodiment, a gap 150 is defined between the distal end 144 of the burr 24 and the surface of the distal end 74, and in particular the most distal end point 90, of the pocket 48. Recess 150 is preferably provided not only to ensure free rotation of flash 24 within pocket 48, but also to provide sufficient space for administration of irrigation fluid (such as irrigation tube 30) and / or removal of tissue through suction lumen 140, otherwise provided by inner tubular member 22. In a preferred embodiment, gap 150 has a longitudinal dimension in the range of 0.368-0.648mm (0.0145-0.0255 inches), more preferably 0.508mm (0.020 inches). Alternatively, the

ES 2 348 722 T3 burr 24 may be positioned closer to the distal end of surface 74 of pocket 48.

While the micro-burr instrument 10 of the present invention has been illustrated as being relatively straight (eg, relative to the view of FIG. 1, the outer tubular member 18 is relatively straight), other configurations may be employed. which, by other means, facilitate a desired procedure. For example, FIG. 7 illustrates an alternative embodiment micro-burr instrument 106 highly useful for a septoplasty procedure that again includes an external tubular assembly 162 and an internal tubular assembly 164. The external and internal tubular assemblies 162, 164 are, in one embodiment, highly similar to the outer and inner tubular assemblies 12, 14 (FIG. 1), respectively, previously described. However, with the instrument of alternative embodiment 160 of FIG. 7, the outer and inner tubular members 162, 164 define a slight curvature (generally referenced at 166) proximal to a portion of the distal end 168 of the instrument 160. In one embodiment, the curvature 166 defines an angle θ in the range of 10 ° -14 °, more preferably about 12 °, relative to a central axis B of a proximal portion 170 of instrument 160. This curvature 166 is particularly useful in the proper positioning of the distal end portion 68 during a septoplasty procedure. To facilitate the necessary rotation of the inner tubular assembly 164 in the region of curvature 166 (such as to rotate the burr (not numbered) at a distal end thereof)), an inner tubular member (hidden in the view of FIG. 7, but similar to the inner tubular member 22 of FIG. 2)) is preferably flexible, and is formed of a suitable material such as spiral wrapping technology. Alternatively, other constructions may be employed.

While the micro-burr instrument of the present invention has been described to provide the lifting tip that is spatially fixed relative to the burr after final assembly, other configurations are acceptable. For example, FIG. 8 depicts a distal portion of an alternate embodiment microburr instrument 200 in accordance with the present invention. The micro-burr instrument 200 includes an inner tubular member 202 having a burr 204 at a distal end thereof, an intermediate tubular member 206, and an outer tubular member 208. Generally speaking, the outer tubular member 208 forms a lifting tip. 210, and is axially movable along the member

ES 2 348 722 T3 intermediate tubular 206 and thus is retractable relative to burr 204 from the position shown in FIG. 8.

Inner tubular member 202 is preferably identical to inner tubular member 22 (FIG. 2) previously described. Furthermore, the intermediate tubular member 206 is preferably similar to the previously described outer tubular member 18 (FIG. 2), except that the intermediate tubular member 206 does not form a lifting tip. Instead, the intermediate tubular member 206 defines a window 212, through which the burr 204 is exposed, terminating in a curved distal wall 213 that is otherwise not configured to facilitate lifting of tissue. In one embodiment, an irrigation tube (not shown, but similar to irrigation tube 30 of FIG. 2) is structurally connected to the exterior of intermediate tubular member 206 and fluidly connected to window 212.

The outer tubular member 208 forms a pocket 214 proximal to the lifting tip 210. In this regard, the lifting tip 210 can assume any of the forms previously described, as can pocket 214. With the embodiment of FIG. 8, pocket 214 is open relative to a central lumen 216 which is otherwise defined and extends to a proximal section (not shown) of outer tubular member 208. Central lumen 216 is sized so that outer tubular member 208 is co-axially received on intermediate tubular member 206 by sliding. In other words, the outer tubular member 208 is axially slidable along an outer diameter of the intermediate tubular member 206 in a direction shown by arrow "A" in FIG. 8. Thus, the outer tubular member 208 acts as a sheath, and can be made from a variety of materials such as stainless steel, etc.

In one embodiment, the outer tubular member 208 forms a slot (not shown) that is received over the irrigation tube (not shown, but similar to the irrigation tube 30 of FIG. 2) that is otherwise attached to the tubular member. intermediate 206 to prevent inner tubular member 208 from rotating relative to intermediate tubular member 206. In addition, a hub component (not shown) is preferably connected to a proximal end of outer tubular member 208 and is configured to selectively close outer tubular member 208 to intermediate tubular member 206 at desired axial positions.

After final assembly and during use, an axial position of the lifting tip 210 relative to the burr can be altered by sliding the outer tubular member 208 along the intermediate tubular member 206. Then, with this

In a configuration, an exposed length of the lifting tip 210 can be selectively increased to accomplish a desired tissue lifting or removal procedure. The lifting tip 210 can then be axially retracted relative to the burr 204 and with some configurations, fully retracted from a region of the burr 204.

A portion of a micro-burr instrument of yet another alternate embodiment 250 is shown in FIGS. 9A and 9B. Similar to instrument 200 of FIG. 8, the micro-burr instrument 250 includes an inner tubular member 252 having a burr 254 at a distal end thereof, an intermediate tubular member 256, and an outer tubular member 258. Again, the outer tubular member 258 forms a lifting tip 260, and is axially movable along the intermediate tubular member 256, and thus is axially movable relative to the burr 254.

The inner tubular member 252, which includes the burr 254, is preferably identical to previous embodiments. The intermediate tubular member 256 is also similar to the previously described intermediate tubular member 206 (FIG. 8), forming a window 262 and characterized by the absence of a lifting tip. Compared to the embodiment of FIG. 8, window 262 defines a wider opening in which an outer wall 264 thereof extends only slightly upward (relative to the orientation of FIG. 9A). Finally, in one embodiment, an irrigation tube 266 is attached to the exterior of the intermediate tubular member 256 and is fluidly connected to the window 262.

The outer tubular member 258 forms a pocket 268 proximal to the lifting tip 260. Again, the lifting tip 260 can take any of the forms previously described. Pocket 268, and in particular a side wall 270 that otherwise terminates in an edge 272 to define pocket 268, is preferably similar in size and shape to pocket 48 (FIG. 3A) previously described, and is fluidly connected to a central lumen 274 formed by outer tubular member 258. In addition, side wall 270 forms a slot 276 opposite edge 272 that is mediated to receive irrigation tube 266 after final assembly. Independently, central lumen 274 is measured to be co-axially received over, and axially slidable relative to, intermediate tubular member 256. Thus, after final assembly, lifting tip 260 is axially movable relative to burr 254 at a direction shown by arrow "B" in FIG. 9B, so that the outer tubular member 258 acts as a sheath. With the embodiment of FIGS. 9A and 9B, the interaction between irrigation tube 266 and slot 276 prevents

ES 2 348 722 T3 that the outer tubular member 256 rotates relative to the intermediate tubular member 256. Alternatively, the slot 276 and / or the irrigation tube 266 may be removed or replaced with variable constructions.

Regardless of the exact shape, the micro-burr instrument 10, 160, 200, 250 of the present invention is useful in performing various breast operations, and finds particular utility as part of a septoplasty procedure. By way of example, and with reference to the embodiment of FIGS. 1 and 2, the assembled instrument 1 is used at the site of the white sinus. For example, with a septoplasty procedure, the lifting tip 62 is directed between the mucosal wall of the septum, and then the instrument 10 is maneuvered to lift or elevate the mucosal wall of the cartilage and / or bone of the septum through the tip. elevator 62. Where instrument 10 is configured to allow axial movement of elevator tip 62 relative to burr 24 (such as with instrument 200 of FIG. 8 or instrument 250 of FIGS. 9A and 9B), the lifting tip 62 is extended axially relative to the burr 24 prior to lifting the mucosa wall. Once sufficient elevation is achieved, the burr 24 is positioned against the cartilage and / or white bone of the septum. The inner tubular member 22 is then rotated relative to the outer tubular member 18 so that the burr 24 burns (eg, cuts or scrapes) the contacted cartilage and / or bone. Where the lifting point 62 is axially movable relative to the barb 24, the lifting point 62 can be retracted before, during or after the rotation of the barb 24. Independently, the pocket 48 and the barb 24, and thus the location destination, they are periodically or continuously flushed with a liquid irrigation line, eg, irrigation tube 30 that is otherwise fluidly connected to pocket 48. The pocket 48, and thus the target site, are then periodically or continuously aspirated through the central lumen 140 (FIG. 5) of the inner tubular member 22 to remove scraped tissue from the pocket 48 and the target site. Once a desired amount of cartilage and / or bone tissue has been removed, the rotation of the burr 24 is stopped, and the instrument 10 is removed from the target site, allowing the mucous membrane of the nasal wall to return to its natural position. If necessary, splints or compresses are placed in the nasal cavity to ensure approximately midline positioning of the septum.

In addition to the septoplasty procedure described above, the micro-burr instrument 10, 160, 200, 250 of the present invention can be used to perform a variety of other procedures on the breast. By

ES 2 348 722 T3 example, submucosal removal of turbinate or septal bone / cartilage can be achieved with the instrument of the present invention, whereby only a relatively small puncture wound is required to provide sufficient access to the target site, in contrast with current techniques where a relatively invasive incision is required to cut or remove the turbinate (in addition to the removal of other soft tissues). In summary, the micro-burr instrument of the present invention is useful for performing a wide variety of surgical procedures in which it is desired to lift soft tissue from stiffer tissue and then remove stiffer tissue (or portions thereof). in a minimally invasive way. For example, sub-fascial and sub-perichondral removal of bone spurs in the spine is easily accomplished in accordance with the present invention.

Independently, and in one embodiment, the micro-burr instrument 10, 160 is attached to a handpiece provided with a motor as shown in FIG. 10. The handpiece 280 can take on a variety of shapes known in the art, and in a preferred embodiment is a handpiece fitted with a StraightShot® motor available from Medtronic-Xomed.

The micro-burr surgical instrument of the present invention provides a marked improvement over previous designs. With respect to breast surgeries, eg septoplasty procedures, the use of a microburr instrument provides a definite advantage over currently accepted techniques that require multiple hand tools. The lifting tip associated with the present invention greatly facilitates the lifting or elevation of soft tissue (such as the mucous membrane of the nasal wall) from more rigid tissue (such as cartilage and / or septal bone), and positions a burr rotary endoscopically at the target site.