The present disclosure relates to surgical instruments and, more particularly, to anti-backdrive assemblies for vessel sealing instruments configured to maintain closure pressure during sealing.
A surgical forceps is a pliers-like surgical instrument that relies on mechanical action between its jaw members to grasp, clamp, and constrict tissue. Electrosurgical forceps utilize both mechanical clamping action and energy to heat tissue to treat, e.g., coagulate, cauterize, or seal, tissue. Typically, once tissue is grasped under a closure pressure suitable to seal vessels or tissue, the actuation mechanism (e.g., handle) is locked during the delivery of electrosurgical energy to produce a seal. In some instance the surgeon holds the actuation mechanism during electrosurgical activation. During sealing, the tissue naturally expands against the closure pressure which, in some instances, can affect the resulting tissue seal as the closure pressure no longer falls within a particular closure pressure range.
Accordingly, there exists a need to maintain the closure pressure within the desired closure pressure range during the sealing process.
As used herein, the term “distal” refers to the portion that is being described which is further from a user, while the term “proximal” refers to the portion that is being described which is closer to a user. Further, to the extent consistent, any or all of the aspects detailed herein may be used in conjunction with any or all of the other aspects detailed herein.
Provided in accordance with aspects of the present disclosure is a vessel sealing instrument includes a housing having a shaft extending from a distal end thereof having an end effector assembly including a pair of opposing first and second jaw members operably coupled thereto. A drive assembly is disposed within the housing and is configured to move the jaw members upon actuation thereof between an open position and a closed position for clamping tissue with a closure pressure within the range of about 3 kg/cm2 to about 16 kg/cm2. An anti-backdrive assembly is operably disposed within the housing and includes a drive wedge. A solenoid controller is operably coupled to the drive wedge and is configured to selectively move the drive wedge into the drive assembly upon activation thereof to increase the closure pressure between the jaw members in response to tissue expansion during sealing.
In aspects according to the present disclosure, the solenoid controller selectively moves the drive wedge in response to a sealing algorithm. In other aspects according to the present disclosure, the solenoid controller selectively moves the drive wedge in response to a sensor.
In aspects according to the present disclosure, the housing includes a moveable handle disposed therein operably coupled to the drive assembly, actuation of the moveable handle correspondingly moves the drive assembly to move the jaw members between open and closed positions. In other aspects according to the present disclosure, a portion of the handle is disposed between a drive ring and a biasing flange of the drive assembly, actuation of the handle biases the biasing flange and the drive ring relative to one another to move the jaw members. In still other aspects according to the present disclosure, the drive wedge is disposed between the handle and the drive ring or the handle and the biasing flange such that upon actuation of the solenoid controller, the drive wedge further biases the drive ring and the biasing flange relative to one another.
In aspects according to the present disclosure, the drive assembly includes a spring configured to regulate the closure pressure between the jaw members.
Provided in accordance with aspects of the present disclosure is a vessel sealing instrument including a housing having a shaft extending from a distal end thereof including an end effector assembly having a pair of opposing first and second jaw members operably coupled thereto. A drive assembly is disposed within the housing and is configured to move the jaw members upon actuation thereof between an open position and a closed position for clamping tissue with a closure pressure within the range of about 3 kg/cm2 to about 16 kg/cm2. An anti-backdrive assembly is operably disposed within the housing and includes a drive wedge. A thermally controlled spring is operably coupled to the drive wedge and is transitional between a first configuration and one or more second configurations upon activation thereof via a change in temperature. The thermally controlled spring is configured to selectively move the drive wedge into the drive assembly upon transition thereof to increase the closure pressure between the jaw members in response to tissue expansion during sealing.
In aspects according to the present disclosure, the thermally controlled spring is operably coupled to a thermal controller configured to selectively transition the thermally controlled spring. In other aspects according to the present disclosure, the thermal controller selectively moves the thermally controlled spring and drive wedge in response to a sealing algorithm. In yet other aspects according to the present disclosure, the thermal controller selectively moves the thermally controlled spring and drive wedge in response to a sensor.
In aspects according to the present disclosure, the housing includes a moveable handle disposed therein operably coupled to the drive assembly, actuation of the moveable handle correspondingly moves the drive assembly to move the jaw members between open and closed positions. In other aspects according to the present disclosure, a portion of the handle is disposed between a drive ring and a biasing flange of the drive assembly, actuation of the handle biases the biasing flange and the drive ring relative to one another to move the jaw members. In yet other aspects according to the present disclosure, the drive wedge is disposed between the handle and the drive ring or the handle and the biasing flange such that upon actuation of the thermal controller and thermally controlled spring, the drive wedge further biases the drive ring and the biasing flange relative to one another.
In aspects according to the present disclosure, the drive assembly includes a spring configured to regulate the closure pressure between the jaw members.
In aspects according to the present disclosure, the drive wedge and thermally controlled spring are disposed within a cutout defined within the handle.
The above and other aspects and features of the present disclosure will become more apparent in view of the following detailed description when taken in conjunction with the accompanying drawings wherein like reference numerals identify similar or identical elements.
Referring to
Forceps 10 further includes a shaft 12 having a distal end portion 14 configured to engage (directly or indirectly) end effector assembly 100 and a proximal end portion 16 that engages (directly or indirectly) housing 20. Rotating assembly 60 is rotatable in either direction to rotate shaft 12 and end effector assembly 100 relative to housing 20 in either direction. Housing 20 houses the internal working components of forceps 10.
An electrosurgical cable 300 connects forceps 10 to an electrosurgical generator “G” or other suitable energy source, although forceps 10 may alternatively be configured as a handheld instrument incorporating energy-generating and/or power components thereon or therein. Cable 300 includes wires (not shown) extending therethrough, into housing 20, and through shaft 12, to ultimately connect electrosurgical generator “G” to jaw member 110 and/or jaw member 120 of end effector assembly 100. Activation button 92 of activation assembly 90 is disposed on housing 20 are electrically coupled between end effector assembly 100 and cable 300 to enable the selective supply of energy to jaw member 110 and/or jaw member 120, e.g., upon activation of activation button 92. However, other suitable electrical connections and/or configurations for supplying electrosurgical energy to jaw member 110 and/or jaw member 120 may alternatively be provided, as may other suitable forms of energy, e.g., ultrasonic energy, microwave energy, light energy, thermal energy, etc.
Forceps 10 additionally includes a knife assembly 170 (
With additional reference to
Each jaw member 110, 120 of end effector assembly 100 includes an electrically-conductive tissue-contacting surface 116, 126. Tissue-contacting surfaces 116 are positioned to oppose one another for grasping and treating tissue. More specifically, tissue-contacting surfaces 116, 126 are electrically coupled to the generator “G,” e.g., via cable 300, and activation button 92 to enable the selective supply of energy thereto for conduction through tissue grasped therebetween, e.g., upon activation of activation button 92. One or both of tissue-contacting surfaces 116, 126 may include one or more stop members 115 extending therefrom to define a minimum gap distance between electrically-conductive tissue-contacting surfaces 116, 126 in the approximated position of jaw members 110, 120, facilitate grasping of tissue, and/or inhibit shorting between electrically-conductive tissue-contacting surfaces 116, 126.
The stop member(s) 115 may be formed at least partially from an electrically-insulative material or may be effectively insulative by electrically isolating the stop member(s) from one or both of the electrically-conductive tissue-contacting surfaces 116, 126. The one or more stop members 115 may be disposed on one or both jaw members 110, 120 or on the tissue-contacting surfaces 116, 126 and are configured to regulate the distance therebetween. Details relating to various stop member designs are disclosed in U.S. Pat. Nos. 7,857,812, 10,687,887 the entire contents of each of which being incorporated by reference here.
A pivot pin 103 of end effector assembly 100 extends transversely through aligned apertures defined within jaw members 110, 120 and shaft 12 to pivotably couple jaw member 110 to jaw member 120 and shaft 12. A cam pin 105 of end effector assembly 100 extends transversely through cam slots defined within jaw members 110, 120 and is operably engaged with a distal end portion of a drive bar 152 (
More specifically, distal translation of cam pin 105 relative to jaw members 110, 120 urges cam pin 105 distally through the cam slots to thereby pivot jaw members 110, 120 from the spaced-apart position towards the approximated position, although cam slots may alternatively be configured such that proximal translation of cam pin 105 pivots jaw members 110, 120 from the spaced-apart position towards the approximated position. One suitable drive assembly is described in greater detail, for example, in U.S. Pat. No. 9,655,673, the entire contents of which are hereby incorporated herein by reference.
Referring to
A biasing spring (not shown) associated with movable handle 40 and/or the drive assembly may be provided to bias jaw members 110, 120 towards a desired position, e.g., the spaced-apart position or the approximated position. Various drive assemblies are shown and described in any one of the above-identified commonly-owned U.S. Patents referenced herein.
Fixed handle 50 operably supports activation button 92 of activation assembly 90 thereon in an in-line position, wherein activation button 92 is disposed in the actuation path of movable handle 40. In this manner, upon pivoting of movable handle 40 relative to fixed handle 50 from the actuated position to an activated position, protrusion 94 of movable handle 40 is urged into contact with activation button 92 to thereby activate activation button 92 and initiate the supply of energy to electrically-conductive surfaces 116, 126, e.g., to treat tissue grasped therebetween. Alternatively, actuation button 92 may be disposed in any other suitable position, on housing 20 or remote therefrom, to facilitate manual activation by a user to initiate the supply of energy to electrically-conductive surfaces 116, 126.
With reference to
Referring to
As mentioned above, pivoting of movable handle 40 relative to fixed handle 50 from an un-actuated position towards an actuated position pivots jaw members 110, 120 from the spaced-apart position towards the approximated position for grasping tissue therebetween. When fully grasped, the drive assembly 300 is configured to initially generate a closure pressure suitable for sealing vessels upon activation of electrosurgical energy from generator “G”. Maintaining closure pressures within the range of about 3 Kg/cm2 to about 16 Kg/cm2 are known to promote quality seals.
With in-line actuation instruments, the surgeon is typically required to maintain the handle 40 in position to continually maintain the closure pressure. For example and as shown in
Other forceps e.g., forceps 10′ of
After the initial closure pressure within the above-identified range is generated and the jaw members 110, 120 (or 110′, 120′) are clamped on a vessel or on tissue, the forceps 10 (10′) is ready for activation. As mentioned above, during sealing the vessel or tissue expands against the jaw members, e.g., jaw members 110′, 120′, which may reduce the actual closure pressure during formation of the seal. If the closure pressure falls outside of the above-noted range, the seal may not be as effective.
Turning now to
Each upper flange, e.g., flange 45a, also includes a force-actuating flange or drive flange 47 which is aligned along longitudinal axis “A” and which abut the drive assembly 150 such that pivotal movement of the handle 40 forces actuating flange against the drive assembly 150 which, in turn, closes the jaw members 110 and 120. As the handle 40 is squeezed and flange 76′ is incorporated into fixed handle 50, the driving flange 47, through the mechanical advantage of the above-the-center pivot points, biases flange 154 of drive ring 159 which, in turn, compresses a spring 67 against a rear ring 156 of the drive assembly 150 (
As mentioned above, once the jaw members 110, 120 are closed about tissue under the above-identified closure pressure and the jaw members 110, 120 are energized to seal tissue, any forces associated with tissue expansion are offset by the additional closure pressure associated with the various anti-backdrive assemblies described herein.
For example,
When configured for use with solenoid controller 460, the drive rod 405 is operably coupled to the solenoid controller 460 such that, upon request or in accordance with a sealing algorithm, the solenoid controller 460 provides additional closure force to the jaw members 110, 120 by extending the drive rod 405 which, in turn, moves the drive wedge further between the biasing flange 154 and the drive flange 47b thereby increasing closure pressure. One or more sensors or other types of feedback mechanisms (not shown) may be utilized to communicate with the solenoid controller 460 to regulate the additional closure pressure to ensure the closure pressure continually falls within the above-identified closure pressure range during the entire sealing process. Alternatively, the solenoid controller 460 may be configured to cooperate with a sealing algorithm and regulated accordingly to apply additional closure pressure in accordance therewith.
Solenoid controller 460 may continually monitor the jaw members 110, 120 for feedback and adjust the drive rod 405 accordingly to maintain the appropriate closure pressure between the jaw members 110, 120 during the entire sealing process. Various types of sensors (not shown) or algorithms may be utilized for this purpose. Once sealed, the drive rod 405 is fully retracted to allow the jaw members 110, 120 to open via handle 40 (or 40′).
When configured for use with thermal controller 560, the thermally controlled spring 505, upon request or in accordance with a sealing algorithm, provides additional closure force to the jaw members 110, 120 by forcing the drive wedge between the drive flange 47a and drive ring 159 thereby increasing closure pressure. One or more sensors or other types of feedback mechanisms (not shown) may be utilized to communicate with the thermal controller 560 to regulate the additional closure pressure to ensure the closure pressure continually falls within the above-identified closure pressure range during the entire sealing process. Alternatively, the thermal controller 560 may be configured to cooperate with a sealing algorithm and regulated accordingly to apply additional closure pressure in accordance therewith.
Thermal controller 560 may continually monitor the jaw members 110, 120 for feedback and adjust thermal response of the thermally controlled spring 505 accordingly to maintain the appropriate closure pressure between the jaw members 110, 120 during the entire sealing process. Various types of sensors (not shown) or algorithms may be utilized for this purpose. Once sealed, thermally controlled spring 505 is fully retracted by regulating the temperature thereof to allow the jaw members 110, 120 to open via handle 40 (or 40′).
As mentioned above, during sealing, tissue expansion forces may be large enough to pry the jaw members 110, 120 away from one another and reduce the closure pressure therebetween. Drive ferrule 610 prevents the drive sleeve 65 from recoiling thereby counteracting any increase in closure pressures during tissue expansion. Anti-backdrive assembly 600 acts more passively than the other aforementioned anti-backdrive assemblies 400, 500 and only when the expansion forces associated with tissue sealing cause the closure pressure between jaw members 110, 120 to fall will anti-backdrive 600 work to counteract these forces to maintain the closure pressure within the appropriate closure pressure range. Upon release of the handle 40, the drive ferrule 610 is retracted to allow translation of the drive sleeve 65.
While several embodiments of the disclosure have been shown in the drawings, it is not intended that the disclosure be limited thereto, as it is intended that the disclosure be as broad in scope as the art will allow and that the specification be read likewise. Therefore, the above description should not be construed as limiting, but merely as exemplifications of particular embodiments. Those skilled in the art will envision other modifications within the scope and spirit of the claims appended hereto.
This application claims the benefit of U.S. Provisional Application Ser. No. 63/214,937 filed Jun. 25, 2021, the entire contents of which being incorporated by reference herein.
Number | Date | Country | |
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63214937 | Jun 2021 | US |