Method and devices for minimally invasive arthroscopic procedures

A device for diagnostic or surgical procedures comprising:

• a handle at a proximal end;
• an operable end at a distal end;
• an outer rigid or semi-rigid body member fixed relative to the handle;
• an inner body member slidably housed and rotatably positioned within the outer body member, the inner body member having flexibility along at least a portion of its length;
• and
• an pre-formed element, rotatably fixed to the handle and slidably fixed within the inner body member, the pre-formed element defining a bend radius;
• wherein as the inner body member is retracted within outer body member, the inner body member takes on the profile of the outer member, and wherein as the inner body member is extended outside the outer body member, the inner body member takes on a curved profile proportional to the bend radius of the pre-formed element, the curved profile providing the inner body member with an arcuate axis, and wherein the operable end is rotatable about the arcuate axis of the inner member.

A device for diagnostic or surgical procedures comprising:

• a handle;
• a rigid outer body member extending from the handle;
• and
• a pre-bent flexible inner body member slidably received within the outer body member;
• the inner body member being disposed so as to advance out of the outer body member in an arcuate shaped path, the device providing rotation about the linear axis of the outer body member and/or the arcuate axis of the inner body member;
• and
• the inner body member having an operable end at its distal end in the form of a visualization device, an electrical manipulation device, and/or a mechanical manipulation device.

A device for diagnostic or surgical procedures comprising:

• a handle at a proximal end;
• an operable end rotatably mounted at a distal end;
• a rigid or semi-rigid elongate body member fixed relative to the handle and interconnected with the operable portion via a flexible distal portion;
• flexion control means for bending the flexible distal portion;
• one or more pairs of cables interconnecting the flexion control means and the flexible distal portion, wherein manipulation of flexion control means places a tensile force on one or more cables and causes the flexible distal portion to bend proportionally to the tensile force, wherein bending of the flexible distal portion provides the flexible distal portion with an arcuate axis;
• and
• rotation control means in connection with the operable portion for rotating the operative end about the arcuate axis of the flexible distal segment.

A device for diagnostic or surgical procedures comprising:

• a handle;
• a rigid or semi-rigid tubular body member extending from the handle and having a proximal end and a distal end;
• and
• a flexible, steerable, distal end segment with an operable end rotatably mounted to the distal end of the body member, the operable end in the form of a visualization device, an electrical tissue manipulation device, and/or a mechanical tissue manipulation device.

A method for performing minimally invasive diagnostic and surgical procedures on the hip comprising:

• (a) providing a visualization and/or an operable device(s) comprising:
• a handle at a proximal end;
• an operable end at a distal end;
• a rigid or semi rigid elongate body member extending between the handle and the operable end;
• a distal flexible end segment that rotatably connects the operable end to the elongate body member;
• the handle comprising control means to precisely maneuver the operable end by iterively adjusting each of the following degrees of freedom:
• linear translation of the operable end into the hip joint capsule;
• rotation about the linear axis of the elongated body member;
• curvilinear bending of the distal flexible end segment;
• and
• rotation about an axis of a bend in the distal end segment;
• (b) disposing the flexible end segment into a straight configuration;
• (c) inserting the distal end of the device into the body and into the hip capsule;
• (d) linearly translating the operable end into the capsule
• (e) iterively adjusting the curvilinear bend radius of the distal flexible end segment while translating the operable end toward the operative target;
• (f) performing the procedure;
• (g) disposing the end segment into a straight configuration;
• and
• (h) removing the device from the capsule.

A method of performing arthroscopic procedures comprising:

• providing a first portal in the posterolateral position and second portal in the anterolateral position;
• inserting a first device in the anterolateral position, the first device comprising a handle at a proximal end, an operable end comprising a visualization device at a distal end, a body member extending between the handle and the operable end, and an end segment connecting the operable end to the body member and capable of being iterively manipulated to translate, bend, and rotate to achieve a desired position at the target site and to achieve a desired field of view;
• and
• inserting a second device in the posterolateral position, the second device comprising a handle at a proximal end, an operable end comprising an electrical manipulation device or a mechanical manipulation device at a distal end, a body member extending between the handle and the operable end, and an end segment connecting the operable end to the body member and capable of being iterively manipulated to translate, bend, and rotate to achieve a desire position at the target site and to actuate to achieve the desired surgical outcome.