The present disclosure relates to surgical instruments and, more particularly, to anti-backdrive mechanisms 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 including a housing having a shaft extending from a distal end thereof. A distal end of the shaft includes an end effector assembly having a pair of opposing first and second jaw members operably coupled thereto. One or both of the first or second jaw members is moveable 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. One or both of the first or second jaw members is adapted to connect to a generator configured to provide electrosurgical energy thereto in accordance with a sealing algorithm upon activation thereof.
An anti-backdrive mechanism is operably associated with the end effector assembly and includes a drive shaft operably coupled at a proximal end to a controller and at a distal end to a screw. The screw is configured to operably engage one (or both) of the first and second jaw members upon extension thereof to provide additional closure pressure between the jaw members. The drive shaft is selectively rotatable by the controller to extend the screw in response to tissue expansion during sealing based on the sealing algorithm.
In aspects according to the present disclosure, upon rotation of the drive shaft in a first direction, the screw engages an abutting surface disposed on a proximal end of the first jaw member. In other aspects according to the present disclosure, the first jaw member is rotatable relative to the second jaw member about a pivot and wherein the abutting surface is offset relative to the pivot.
In aspects according to the present disclosure, upon rotation of the drive shaft in a second direction, the screw retracts relative to the first jaw member allowing the first jaw member to open relative to the second jaw member. In other aspects according to the present disclosure, the controller rotates the drive shaft to extend the screw in response to tissue expansion during sealing based on the sealing algorithm, the screw configured to maintain the closure pressure between jaw members within the range of about 3 kg/cm2 to about 16 kg/cm2.
In accordance with other aspects of the present disclosure is a vessel sealing instrument including a housing having a shaft extending from a distal end thereof. A distal end of the shaft includes an end effector assembly having a pair of opposing first and second jaw members operably coupled thereto. One or both of the first or second jaw members is moveable 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 mechanism is operably associated with the end effector assembly and includes a drive shaft operably coupled at a proximal end to a controller and at a distal end to a screw. The screw is configured to operably engage one (or both) of the first and second jaw members upon extension thereof to provide additional closure pressure between the jaw members. The controller is configured to continually monitor the closure pressure between the jaw members. The drive shaft is selectively rotatable by the controller to extend the screw in response to the closure pressure falling outside the range of about 3 kg/cm2 to about 16 kg/cm2.
In aspects according to the present disclosure, upon rotation of the drive shaft in a first direction, the screw engages an abutting surface disposed on a proximal end of the first jaw member. In other aspects according to the present disclosure, the first jaw member is rotatable relative to the second jaw member about a pivot and wherein the abutting surface is offset relative to the pivot.
In aspects according to the present disclosure, upon rotation of the drive shaft in a second direction, the screw retracts relative to the first jaw member allowing the first jaw member to open relative to the second jaw member.
In aspects according to the present disclosure, the controller is configured to continually monitor the closure pressure between the jaw members when the surgical instrument is activated to seal tissue and wherein the controller rotates the drive shaft to extend the screw in response to the closure pressure falling outside the range of about 3 kg/cm2 to about 16 kg/cm2.
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. A distal end of the shaft includes an end effector assembly having a pair of opposing first and second jaw members operably coupled thereto. One or both of the first or second jaw members is moveable 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. One or both of the first or second jaw members is adapted to connect to a generator configured to provide electrosurgical energy thereto in accordance with a sealing algorithm upon activation thereof.
An anti-backdrive mechanism is operably associated with the end effector assembly and includes a drive shaft operably coupled at a proximal end to a controller and at a distal end to a camming wedge. The camming wedge is configured to operably engage one (or both) of the first and second jaw members upon extension thereof to provide additional closure pressure between the jaw members. The drive shaft is selectively translatable by the controller to move the camming wedge in response to tissue expansion during sealing based on the sealing algorithm to increase the closure pressure.
In aspects according to the present disclosure, upon translation of the drive shaft, the camming wedge engages an abutting surface disposed on a proximal end of the first jaw member. In other aspects according to the present disclosure, the first jaw member is rotatable relative to the second jaw member about a pivot and wherein the abutting surface is offset relative to the pivot.
In aspects according to the present disclosure, the controller is configured to continually monitor the closure pressure between the jaw members when the surgical instrument is activated to seal tissue and wherein the controller translates the drive shaft to move the camming wedge against the abutting surface in response to the closure pressure falling outside the range of about 3 kg/cm2 to about 16 kg/cm2. In other aspects according to the present disclosure, the abutting surface is angled to complement the angle of the camming wedge.
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. A distal end of the shaft includes an end effector assembly having a pair of opposing first and second jaw members operably coupled thereto. One or both of the first or second jaw members is moveable 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. One or both of the first or second jaw members is adapted to connect to a generator configured to provide electrosurgical energy thereto in accordance with a sealing algorithm upon activation thereof. One or both of the first or second jaw members includes integrated carbon disposed therein configured to increase the rigidity thereof to resist expansion forces during sealing.
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. A distal end of the shaft includes an end effector assembly having a pair of opposing first and second jaw members operably coupled thereto. One or both of the first or second jaw members is moveable 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. One or both of the first or second jaw members is encapsulated with a liquid metal, alloy of carbide structure to increase the rigidity thereof to resist expansion forces during sealing.
In aspects according to the present disclosure, the one or both jaw members is encapsulated by spraying, dipping or casting.
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. Patent No. 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.
Jaw member 410 of end effector assembly 400 includes a rear flange 430 having an abutting surface 411 defined in a proximally-facing surface thereof configured to engage the screw 453 upon extension thereof. The abutting surface 411 is located above-center of the pivot 403 such that, after the jaw members 410, 420 are closed about tissue via actuation of pin 405 within cam slot 433 defined within the flange 430, the controller 460 extends the screw 453 into engagement with abutting surface 411 to further cam jaw member 410 about pivot 403 to increase closure pressure as needed. The controller 460 may extend the screw 453 upon: user request; based on a sealing algorithm; on reaction to feedback from the jaw members 410, 420 or tissue disposed therebetween; or in anticipation of tissue expansion during sealing.
The controller 460 may continually monitor the jaw members 410, 420 for feedback and adjust the screw 453 accordingly to maintain the appropriate closure pressure between the jaw members 410, 420 during the entire sealing process. Various types of sensors (not shown) or algorithms may be utilized for this purpose. Once sealed, the screw 453 is fully retracted to allow the jaw members 410, 420 to open via handle 40 (or 40′).
Turning now to
Jaw member 510 of end effector assembly 500 includes a rear flange 530 having an angled surface 511 defined in a proximally-facing surface thereof configured to engage the wedge 553 upon extension thereof. The angled surface 511 is located above-center of the pivot 503 such that, after the jaw members 510, 520 are closed about tissue via actuation of pin 505 within cam slot 533 defined within the flange 530, the controller 560 extends the drive shaft 555 and wedge 553 into engagement with angled surface 511 to further cam jaw member 510 about pivot 503 to increase closure pressure. The controller 560 may extend the drive shaft 555 and wedge 553 upon: user request; based on a sealing algorithm; on reaction to feedback from the jaw members 510, 520 or tissue disposed therebetween; or in anticipation of tissue expansion during sealing.
Much like controller 460, controller 560 may continually monitor the jaw members 510, 520 for feedback and adjust the wedge 553 accordingly to maintain the appropriate closure pressure between the jaw members 510, 520 during the entire sealing process. Various types of sensors (not shown) or algorithms may be utilized for this purpose. Once sealed, the wedge 553 is fully retracted to allow the jaw members 510, 520 to open via handle 40 (or 40′).
Anti-backdrive mechanism 650 includes a tension rod, tension cable or flat spring steel 653 (hereinafter “flat spring 653”) operably coupled at a proximal end to the cam pin 605 and fixed at a distal end thereof to a distal end of the jaw member 610. When the cam pin 605 is translated via drive rod 652 to close jaw members 610, 620 under an initial closure pressure within the above-identified closure pressure range, the flat spring 653 is moved into position to offset the forces associated with tissue expansion or resist the jaw members 610, 620 from opening or moving due to tissue expansion. As can be appreciated, this maintains the closure pressure within the appropriate ranges for consistent and effective tissue sealing. Once sealed, the drive rod 652 is fully retracted to allow the jaw members 610, 620 to open via handle 40 (or 40′) and the closure force associated with the flat spring 653 is released.
In embodiments, the drive rod 652 or cam pin (or the drive rods or cam pins with any aforementioned embodiment) may be actuated using the activation energy associated with the jaw members 610, 620 when sealing tissue. For example, energy may be diverted from the electrosurgical generator “G” to actuate the drive rod, e.g., drive rod 652, to resist the forces of expansion during sealing. Other devices may also be energized utilizing electrosurgical energy from the generator “G”, e.g., solenoids, sensors, or any of the above-identified anti-backdrive mechanisms or elements thereof.
Compared to the anti-backdrive mechanisms 450, 550 of
In embodiments, the jaw members or jaw housings may be made from a carbide structure or integrated with a carbide material in fashion to resist the forces of tissue expansion during the sealing process. For example, jaw members 410, 420 (or any of the abovementioned jaw members) may be configured to include a carbide material integrated therein to significantly stiffen the jaw members 410, 420 to resist the forces associated with tissue expansion. Various configurations are envisioned such as matrix patterns, truss patterns or other known construction patterns.
In embodiments, the jaw members or jaw housings may be encapsulated with a liquid metal, alloy or carbide structure and allowed to cure to stiffen the jaw members. Various liquid metals, alloys and carbide structures are envisioned in varying thicknesses and may be configured to encapsulate the jaw members, e.g., jaw members 410, 420, by spraying, dipping, casting etc.
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. 63/214,928 filed Jun. 25, 2021, the entire contents of which being incorporated by reference herein.
Number | Date | Country | |
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63214928 | Jun 2021 | US |