The present disclosure relates to articulation assemblies for use with surgical instruments and, more particularly, to articulation assemblies for use with surgical instruments including jaw members for grasping, treating, sealing, stapling, and/or dividing tissue.
Many surgical instruments are known for sealing, stapling, or otherwise joining tissue. Some of these surgical include one or more movable handles, levers, actuators, triggers, etc. for actuating and/or manipulating one or more functional components of the surgical instrument. For example, a surgical forceps may include a movable handle that is selectively actuatable relative to a stationary handle for moving at least one jaw member with respect to another jaw member of the forceps between spaced-apart and approximated positions for grasping tissue therebetween. Such a forceps may further include additional triggers for selectively actuating electrosurgical energy or for deploying staples, and/or for deploying a knife between the jaw members to cut tissue grasped therebetween.
In certain types of surgical procedures, it may be useful to use an energy-based device during endoscopic, laparoscopic and other minimally invasive surgeries.
During use in minimally invasive surgeries, one noted challenge for surgeons has been the inability to manipulate the jaw members or end effector assembly of the surgical forceps to grasp tissue in multiple planes, i.e., off-axis, while generating the required forces to affect a reliable seal. It would therefore be desirable to develop an endoscopic or endoluminal surgical forceps that includes an end effector assembly capable of being manipulated along multiple axes to enable the surgeon to grasp and seal vessels lying along different planes within a surgical cavity.
The present disclosure relates to an articulation assembly for use with a surgical instrument. The articulation assembly includes a plurality of joints, a plurality of cables, and a first drive member. Each joint defines a plurality of openings extending longitudinally therethrough, a central opening extending longitudinally therethrough, a pair of projections extending from a first surface, and a pair of grooves extending at least partially through a second surface. Each groove of at least one joint is configured to engage one projection of the pair of projections from an adjacent joint. Each cable extends through one opening of the plurality of openings of each joint. The first drive member extends through the central opening of each joint.
In aspects of the present disclosure, each projection of at least one joint is configured to be at least partially positioned within one groove of the pair of grooves of an adjacent joint.
In other aspects, each projection of at least one includes an arcuate surface configured to contact an arcuate wall defining the groove of an adjacent joint.
In yet other aspects, each joint of the plurality of joints is substantially identical.
In still other aspects, each joint of the plurality of joints includes a pair of contours and a pair of platforms, each contour of the pair of contours of at least one joint is configured to engage one platform of the pair of platforms of an adjacent joint. Each contour of the pair of contours of at least one joint may be configured to pivot with respect to one platform of the pair of platforms of an adjacent joint. Each contour of the pair of contours of at least one joint may also be configured to pivot against a flat surface of one platform of the pair of platforms of an adjacent joint. Each projection of each joint may be 90° offset from each groove, and each contour of each joint may be 90° offset from each platform
In aspects of the present disclosure, a second drive member extends through the central opening of each joint. Each of the first drive member and the second drive member may include a semi-circular cross-section at locations that are longitudinally aligned with each joint.
In other aspects, the articulation assembly further comprising an actuator disposed in mechanical cooperation with a handle assembly of the surgical instrument. The cable actuator includes at least one aperture. The plurality of cables extends through the at least one aperture of the actuator.
In yet other aspects, the plurality of cables includes four cables. The articulation assembly may further comprise an actuator disposed in mechanical cooperation with a handle assembly of the surgical instrument. The cable actuator includes a first aperture and a second aperture defined therethrough. Two cables of the plurality of cables extend through the first aperture of the actuator, and two cables of the plurality of cables extend through the second aperture of the actuator.
The present disclosure also relates to an articulation assembly for use with a surgical instrument. The articulation assembly includes a pivot, a drive member, and an outer tube. The pivot includes a first lateral pivot pin, a second lateral pivot pin, an upper pivot portion, a lower pivot portion, and an aperture extending therethrough. The first lateral pivot pin is disposed in mechanical cooperation with the first jaw member, the second lateral pivot pin is disposed in mechanical cooperation with the second jaw member. A portion of the drive member extends through the aperture of the pivot. The outer tube includes an upper aperture pivotally engaged with the upper pivot portion of the pivot, and a lower aperture pivotally engaged with the lower pivot portion of the pivot. The pivot is configured to pivot about a first axis defined therethrough to cause articulation of the jaw members, and the jaw members are configured to pivot about a second axis defined through the pivot to cause the jaw members to move between an open position and an approximated position.
In aspects of the present disclosure, a reduced-perimeter portion of the drive member is longitudinally aligned with the aperture of the pivot.
In other aspects, the articulation assembly further comprises a distal member disposed in mechanical cooperation with the pivot. The distal member is rotatable with respect to the drive member. The distal member may include a first angled slot defined therein and configured to engage the first lateral pivot pin and a second angled slot defined therein and configured to engage the second lateral pivot pin.
In yet other aspects, the articulation assembly comprises a control member disposed in mechanical cooperation with only one of the first lateral pivot pin or the second lateral pivot pin. The control member may include a T-shaped slot configured to engage a T-shaped portion of the pivot.
Various aspects of the present disclosure are described herein with reference to the drawings wherein like reference numerals identify similar or identical elements:
Embodiments of the presently disclosed surgical instrument are described in detail with reference to the drawings, in which like reference numerals designate identical or corresponding elements in each of the several views. As used herein the term “distal” refers to that portion of the surgical instrument that is farther from the user, while the term “proximal” refers to that portion of the surgical instrument that is closer to the user.
Referring initially to
Surgical instrument 100 includes a housing or handle assembly 112 near a proximal end, an end effector 120 near a distal end and an elongated shaft 118 extending therebetween. A proximal portion of elongated shaft 118 defines a longitudinal axis “A-A.” The end effector 120 includes a first jaw member 130 and a second jaw member 140, which are movable relative to each other. The end effector 120 may be positioned within a body cavity to engage tissue at a surgical site while handle assembly 112 is manipulatable by a surgeon from outside the body cavity to control the movement and operation of the end effector 120. Handle assembly 112 includes a movable handle 112a, which is manipulatable to open and close jaw members 130, 140 of the end effector 120, and a trigger 112b, which is manipulatable to initiate an electrosurgical current.
Actuation of the movable handle 112a longitudinally translates a drive bar or a control rod of a drive assembly to approximate jaw members 130, 140 and to apply a pressure between the jaw members 130 and 140 in the range of about 3 kg/cm2 to about 16 kg/cm2. Further details of a vessel sealing device including a handle assembly and drive assembly for controlling actuation of an end effector can be found in U.S. Pat. Nos. 7,101,371 and 7,083,618, which are incorporated herein in their entirety by reference.
In the approximated configuration where tissue can be grasped and/or cut between the jaw members 130, 140, a separation or gap distance is maintained between the jaw members 130, 140 by one or more stop members (not shown). In some embodiments, to provide an effective tissue seal, an appropriate gap distance of between about 0.001 inches to about 0.006 inches may be provided. The stop members may be positioned on one or more jaw members 130, 140 and may be made from a thermally sprayed ceramic (e.g. Alumina Titania), epoxy, or a high temperature plastic, for example. Other configurations are also contemplated.
The present disclosure includes elongated shaft 118 that is articulatable or movable off-axis to help increase the functionality of the surgical instrument 100. To achieve the articulation or off-axis movement of the elongated shaft 118, various articulation mechanisms are disclosed. In
With initial reference to
With reference to
Referring now to
Joint 260 includes a plurality of openings 262 extending longitudinally therethrough; each opening 262 is configured to allow one cable 240 or a portion one cable 240 to pass therethrough. A central opening 263 is also included on each joint 260 to allow first drive member 220 and second drive member 230 to pass therethrough (see
Each contour 265 is configured to engage a single platform 269; contours 265 and platforms 269 are configured to pivot a predetermined amount with respect to each other in the general directions of arrows “A” and “B” in
In the illustrated embodiments, joint assembly 250 includes four joints 260, however more or fewer joints 260 may be included without departing from the scope of the present disclosure. In embodiments where more than four joints 260 are included, the geometry of various features of the joints 260 can be altered to allow a relatively smaller amount of pivotal movement between adjacent joints 260. In embodiments where fewer than four joints 260 are included, the geometry of various features of the joints 260 can be altered to allow a relatively larger amount of pivotal movement between adjacent joints 260. In each of these situations, the total amount of desired articulation (e.g., up to about 45°) may be accomplished.
With particular reference to
Additionally, with particular reference to
Cables 240 extend between handle assembly 112, through openings 262 of joints 260, and into mechanical engagement with end effector 120. More particularly, cables 240 include a first cable 240a and a second cable 240b (see
With particular reference to
With particular reference to
As first portion 272a of controller 272 is rotated, each plunger 276, 278 is contacted by a respective ridge 272d, which forces plungers 276, 278 laterally outward in the general direction of arrows “C” and “D” in
Further, and with particular reference to
Accordingly, rotation of controller 272 in a first direction (e.g., clockwise) causes first cable 240a to be pushed distally, causes second cable 240b to be pulled proximally, which causes joint assembly 250 and thus end effector 120 to articulate in the general direction of arrow “B” (
As shown in
Referring now to
Initially, to seal tissue, a user causes inner tube 340 to be distally translated (e.g., by actuating a lever, knob or button on handle assembly). Inner tube 340 is connected to drive member 350 via pins 352, such that longitudinal translation of inner tube 340 causes a corresponding longitudinal translation of drive member 350. More particularly, a pair of pins 352 extends between a slot 342 defined adjacent a distal portion of inner tube 340, and a pair of holes 351 defined adjacent a proximal portion of drive member 350. Proximal and distal walls 342a, 342b of slot 340 limit the movement of pins 352 with respect to inner tube 340.
A drive pin 353 extends through a hole 353a in a distal portion of drive member 350, and extends through a slot 314 defined in first jaw 310 and a slot 324 defined in second jaw 320. Longitudinal translation of drive member 350 causes drive pin 353 to travel through slots 314, 324. More particularly, and with reference to
During the process of sealing tissue, drive pin 353 is within first sections 314a, 324a of slots 314, 324, respectively. When the jaw members 310, 320 are in the approximated position an angle α2 between first sections 314a, 324a with respect to longitudinal axis “A-A” is between about 20° and about 45° (see
During the process of cutting tissue, after drive pin 353 has been distally advanced through first sections 314a, 324a, drive pin 353 is within second sections 314b, 324b of slots 314, 324, respectively. As shown in
With general regard to the pivotal movement of the jaw members, first jaw 310 and second jaw 320 are pivotable about a first pivot axis “P1” (
More specifically, and with particular reference to
With continued reference to
As shown in
Referring now to
Additionally, angled slot 368a is configured to engage first, lateral pivot pin 372 of pivot 370, and angled slot 368b is configured to engage second, lateral pivot pin 374 of pivot 370, such first jaw 310 and second jaw 320 are pivotal with respect to distal member 360. Moreover, the fact that angled slots 368a, 368b are angled with respect to the longitudinal axis “A-A” allows first jaw 310 and second jaw 320 to articulate in the directions of “F” and “G” with respect to distal member 360. Additionally, as shown in
Accordingly, longitudinal translation or rotation of distal member 360 causes lateral pivot pins 372 and 374 to rotate about the second pivot axis “P2,” which causes articulation of first jaw 310 and second jaw 320 in the general directions of “F” and “G.” More particularly, for example, distal translation of distal member 360 with respect to inner tube 340 causes rotation of distal member 360 in a first direction (e.g., clockwise) and causes first jaw 310 and second jaw 320 to articulate in the general direction of arrow “G.” Likewise, for instance, proximal translation of distal member 360 with respect to inner tube 340 causes rotation of distal member 360 in a second direction (e.g., counter-clockwise) and causes first jaw 310 and second jaw 320 to articulate in the general direction of arrow “F.” For example,
Referring now to
Initially, to seal tissue, a user causes inner tube 440 to be distally translated (e.g., by actuating a lever, knob or button on handle assembly). Inner tube 440 is connected to drive member 450 via pins 452, such that longitudinal translation of inner tube 440 causes a corresponding longitudinal translation of drive member 450. More particularly, pins 452 extend between a pair of apertures 442 adjacent a distal portion of inner tube 440, and a pair of holes 451 defined adjacent a proximal portion of drive member 450.
A drive pin 453 extends through a hole 453a in a distal portion of drive member 450, and extends through a slot 414 of first jaw 410 and a slot 424 of second jaw 420. Longitudinal translation of drive member 450 causes drive pin 453 to travel through slots 414, 424 in a manner similar to the translation of drive member 350 through slots 314, 324 of second articulation assembly 300, discussed above.
With general regard to the pivotal movement of the jaw members, first jaw 410 and second jaw 420 are pivotable about first pivot axis “P1” between an open position and an approximated position, and are pivotable about second pivot axis “P2” in the general directions of arrows “H” and “I” in
More specifically, and with particular reference to
With continued reference to
As shown in
Referring now to
Accordingly, longitudinal translation of control member 460 causes pivot 470 to rotate about second pivot axis “P2,” which results in articulation of jaw members 410, 420. More particularly, for example, movement of control member 460 in a first longitudinal direction (e.g., distally) causes control member 460 to push first, lateral pivot pin 472 distally, which causes pivot 470 to rotate in a first direction, and which causes first jaw 410 and second jaw 420 to articulate in the general direction of arrow “H.” Likewise, for instance, proximal movement of control member 460 causes control member 460 to pull first, lateral pivot pin 472 proximally, which causes pivot 470 to rotate in a second direction, and which causes first jaw 410 and second jaw 420 to articulate in the general direction of arrow “I.”
The various embodiments disclosed herein may also be configured to work with robotic surgical systems and what is commonly referred to as “Telesurgery.” Such systems employ various robotic elements to assist the surgeon and allow remote operation (or partial remote operation) of surgical instrumentation. Various robotic arms, gears, cams, pulleys, electric and mechanical motors, etc. may be employed for this purpose and may be designed with a robotic surgical system to assist the surgeon during the course of an operation or treatment. Such robotic systems may include remotely steerable systems, automatically flexible surgical systems, remotely flexible surgical systems, remotely articulating surgical systems, wireless surgical systems, modular or selectively configurable remotely operated surgical systems, etc.
The robotic surgical systems may be employed with one or more consoles that are next to the operating theater or located in a remote location. In this instance, one team of surgeons or nurses may prepare the patient for surgery and configure the robotic surgical system with one or more of the surgical instruments disclosed herein while another surgeon (or group of surgeons) remotely controls the instrument(s) via the robotic surgical system. As can be appreciated, a highly skilled surgeon may perform multiple operations in multiple locations without leaving his/her remote console which can be both economically advantageous and a benefit to the patient or a series of patients.
The robotic arms of the surgical system are typically coupled to a pair of master handles by a controller. The handles can be moved by the surgeon to produce a corresponding movement of the working ends of any type of surgical instrument (e.g., end effectors, graspers, knifes, scissors, etc.) which may complement the use of one or more of the embodiments described herein. The movement of the master handles may be scaled so that the working ends have a corresponding movement that is different, smaller or larger, than the movement performed by the operating hands of the surgeon. The scale factor or gearing ratio may be adjustable so that the operator can control the resolution of the working ends of the surgical instrument(s).
The master handles may include various sensors to provide feedback to the surgeon relating to various tissue parameters or conditions, e.g., tissue resistance due to manipulation, cutting or otherwise treating, pressure by the instrument onto the tissue, tissue temperature, tissue impedance, etc. As can be appreciated, such sensors provide the surgeon with enhanced tactile feedback simulating actual operating conditions. The master handles may also include a variety of different actuators for delicate tissue manipulation or treatment further enhancing the surgeon's ability to mimic actual operating conditions.
With particular reference to
Each of the robot arms 1002, 1003 may include a plurality of members, which are connected through joints, and an attaching device 1009, 1011, to which may be attached, for example, a surgical tool “ST” supporting an end effector 1100, in accordance with any one of several embodiments disclosed herein, as will be described in greater detail below.
Robot arms 1002, 1003 may be driven by electric drives (not shown) that are connected to control device 1004. Control device 1004 (e.g., a computer) may be set up to activate the drives, in particular by means of a computer program, in such a way that robot arms 1002, 1003, their attaching devices 1009, 1011 and thus surgical tool “ST” (including end effector 1100) execute a desired movement according to a movement defined by means of manual input devices 1007, 1008. Control device 1004 may also be set up in such a way that it regulates the movement of robot arms 1002, 1003 and/or of the drives.
Medical work station 1000 may be configured for use on a patient 1013 lying on a patient table 1012 to be treated in a minimally invasive manner by means of end effector 1100. Medical work station 1000 may also include more than two robot arms 1002, 1003, the additional robot arms likewise being connected to control device 1004 and being telemanipulatable by means of operating console 1005. A medical instrument or surgical tool (including an end effector 1100) may also be attached to the additional robot arm. Medical work station 1000 may include a database 1014, in particular coupled to with control device 1004, in which are stored, for example, pre-operative data from patient/living being 1013 and/or anatomical atlases.
From the foregoing and with reference to the various figure drawings, those skilled in the art will appreciate that certain modifications can also be made to the present disclosure without departing from the scope of the same. 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.
Filing Document | Filing Date | Country | Kind |
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PCT/CN2016/073584 | 2/5/2016 | WO | 00 |
Publishing Document | Publishing Date | Country | Kind |
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WO2017/132970 | 8/10/2017 | WO | A |
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Joseph Ortenberg “LigaSure System Used in Laparoscopic 1st and 2nd Stage Orchiopexy” Innovations That Work, Nov. 2002. |
Sigel et al. “The Mechanism of Blood Vessel Closure by High Frequency Electrocoagulation” Surgery Gynecology & Obstetrics, Oct. 1965 pp. 823-831. |
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Levy et al. “Randomized Trial of Suture Versus Electrosurgical Bipolar Vessel Sealing in Vaginal Hysterectomy” Obstetrics & Gynecology, vol. 102, No. 1, Jul. 2003. |
“Reducing Needlestick Injuries in the Operating Room” Sales/Product Literature 2001. (1 page). |
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Strasberg et al. “A Phase I Study of the LigaSure Vessel Sealing System in Hepatic Surgery” Section of HPB Surger, Washington University School of Medicine, St. Louis MO, Presented at AHPBA, Feb. 2001. |
Sayfan et al. “Sutureless Closed Hemorrhoidectomy: A New Technique” Annals of Surgery vol. 234 No. 1 Jul. 2001; pp. 21-24. |
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Strasberg et al., “Use of a Bipolar Vessel-Sealing Device for Parenchymal Transection During Liver Surgery” Journal of Gastrointestinal Surgery, vol. 6, No. 4, Jul./Aug. 2002 pp. 569-574. |
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Crawford et al. “Use of the LigaSure Vessel Sealing System in Urologic Cancer Surgery” Grand Rounds in Urology 1999 vol. 1 Issue 4 pp. 10-17. |
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E. David Crawford “Use of a Novel Vessel Sealing Technology in Management of the Dorsal Veinous Complex” Sales/Product Literature 2000. |
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U.S. Appl. No. 08/926,869, filed Sep. 10, 1997; inventor: James G. Chandler, Abandoned. |
U.S. Appl. No. 09/177,950, filed Oct. 23, 1998; inventor: Randel A. Frazier, abandoned. |
U.S. Appl. No. 09/387,883, filed Sep. 1, 1999; inventor: Dale F. Schmaltz, abandoned. |
U.S. Appl. No. 09/591,328, filed Jun. 9, 2000; inventor: Thomas P. Ryan, abandoned. |
U.S. Appl. No. 12/336,970, filed Dec. 17, 2008; inventor: Paul R. Sremeich, abandoned. |
U.S. Appl. No. 14/065,644, filed Oct. 29, 2013; inventor: Reschke, abandoned. |
Number | Date | Country | |
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20200163687 A1 | May 2020 | US |