The present disclosure relates to forceps used for open surgical procedures. More particularly, the present disclosure relates to a bipolar forceps for treating tissue that is capable of sealing and cutting tissue.
A hemostat or forceps is a simple plier-like tool which uses mechanical action between its jaws to constrict vessels and is commonly used in open surgical procedures to grasp, dissect and/or clamp tissue. Electrosurgical forceps utilize both mechanical clamping action and electrical energy to effect hemostasis by heating the tissue and blood vessels to coagulate, cauterize and/or seal tissue.
Certain surgical procedures require sealing and cutting blood vessels or vascular tissue. Several journal articles have disclosed methods for sealing small blood vessels using electrosurgery. An article entitled Studies on Coagulation and the Development of an Automatic Computerized Bipolar Coagulator, J. Neurosurg., Volume 75, July 1991, describes a bipolar coagulator which is used to seal small blood vessels. The article states that it is not possible to safely coagulate arteries with a diameter larger than 2 to 2.5 mm. A second article is entitled Automatically Controlled Bipolar Electrocoagulation—“COA-COMP”, Neurosurg. Rev. (1984), pp. 187-190, describes a method for terminating electrosurgical power to the vessel so that charring of the vessel walls can be avoided. By utilizing an electrosurgical forceps, a surgeon can either cauterize, coagulate/desiccate, reduce or slow bleeding and/or seal vessels by controlling the intensity, frequency and duration of the electrosurgical energy applied to the tissue. Generally, the electrical configuration of electrosurgical forceps can be categorized in two classifications: 1) monopolar electrosurgical forceps; and 2) bipolar electrosurgical forceps.
Monopolar forceps utilize one active electrode associated with the clamping end effector and a remote patient return electrode or pad which is typically attached externally to the patient. When the electrosurgical energy is applied, the energy travels from the active electrode, to the surgical site, through the patient and to the return electrode.
Bipolar electrosurgical forceps utilize two generally opposing electrodes which are disposed on the inner opposing surfaces of the end effectors and which are both electrically coupled to an electrosurgical generator. Each electrode is charged to a different electric potential. Since tissue is a conductor of electrical energy, when the effectors are utilized to grasp tissue therebetween, the electrical energy can be selectively transferred through the tissue.
The present disclosure relates to forceps used for open surgical procedures. More particularly, the present disclosure relates to a bipolar forceps for treating tissue that is capable of sealing and cutting tissue.
As is traditional, the term “distal” refers herein to an end of the apparatus that is farther from an operator, and the term “proximal” refers herein to the end of the bipolar forceps that is closer to the operator.
The bipolar forceps includes a mechanical forceps including first and second shafts each having a jaw member extending from its distal end and a handle disposed at its proximal end for effecting movement of the jaw members relative to one another about a pivot from a first position wherein the jaw members are disposed in spaced relation relative to one another to a second position wherein the jaw members cooperate to grasp tissue. A disposable housing is configured to releasably couple to one or both shafts. An electrode assembly has a first electrode releasably coupleable to the jaw member of the first shaft and a second electrode releasably coupleable to the jaw member of the second shaft. Each electrode is adapted to connect to a source of electrosurgical energy to allow selective conduction of electrosurgical energy through tissue to effect a tissue seal. One or both of the electrodes includes a knife channel defined along its length. The knife channel is configured to receive a knife blade therethrough to cut tissue grasped between the jaw members. A tissue stop disposed between at least a portion of the distal ends of the shafts is configured to prevent tissue held between the electrodes from moving proximal to the tissue stop. A knife slot is defined through the tissue stop and is configured to align with the knife channel to receive the knife blade. An actuation mechanism is at least partially disposed within the housing and is configured to selectively advance the knife blade through the knife channel to cut tissue.
Additionally or alternatively, the tissue stop may be constructed from a flexible material.
Additionally or alternatively, the tissue stop may be configured to expand and contract upon movement of the jaw members between the first and second positions.
Additionally or alternatively, the pivot may define a longitudinal slot therethrough and the knife blade may be configured to move within the longitudinal slot.
Additionally or alternatively, the longitudinal slot may be configured to longitudinally align with the knife slot defined through the tissue stop when the jaw members are in the second position.
Additionally or alternatively, the bipolar forceps may also include a knife guide supported in the housing. A longitudinal slot may be defined through the knife guide that receives the knife blade therein.
Additionally or alternatively, the longitudinal knife slot defined through the knife guide may be configured to longitudinally align with the knife slot defined through the tissue stop when the jaw members are in the second position.
Additionally or alternatively, the bipolar forceps may also include a knife lockout mechanism configured to prohibit advancement of the knife blade into the knife channel when the jaw members are in the first position.
According to another aspect of the present disclosure, a bipolar forceps is provided. The bipolar forceps includes a mechanical forceps including first and second shafts each having a jaw member extending from its distal end and a handle disposed at its proximal end for effecting movement of the jaw members relative to one another about a pivot from a first position wherein the jaw members are disposed in spaced relation relative to one another to a second position wherein the jaw members cooperate to grasp tissue. A disposable housing is configured to releasably couple to one or both shafts. An electrode assembly has a first electrode releasably coupleable to the jaw member of the first shaft and a second electrode releasably coupleable to the jaw member of the second shaft. Each electrode is adapted to connect to a source of electrosurgical energy to allow selective conduction of electrosurgical energy through tissue held between the electrodes to effect a tissue seal. One or both of the electrodes includes a knife channel defined along its length. The knife channel is configured to receive a knife blade therethrough to cut tissue grasped between the jaw members. A flexible tissue stop is disposed between at least a portion of the distal ends of the shafts configured to prevent tissue held between the electrodes from moving proximal to the tissue stop. The tissue stop is configured to expand and contract upon movement of the jaw members between the first and second positions. A knife slot is defined through the tissue stop and is configured to align with the knife channel to receive the knife blade therethrough. A knife guide is supported in the housing and has a longitudinal slot defined therethrough configured to longitudinally align with the knife slot defined through the tissue stop when the jaw members are in the second position to permit advancement of the knife blade into the knife channel. An actuation mechanism is at least partially disposed within the housing and is configured to selectively advance the knife blade through the knife slots defined through the knife guide and the tissue stop and into the knife channel to cut tissue.
Additionally or alternatively, the pivot may define a longitudinal slot therethrough configured to longitudinally align with the knife slot defined through the tissue stop when the jaw members are in the second position.
Additionally or alternatively, the bipolar forceps may also include one or more handle members extending from the housing and operably coupled to the actuation mechanism. The one or more handle members are moveable relative to the housing to effect advancement of the knife blade through the knife slots defined through the knife guide and the tissue stop and into the knife channel to cut tissue.
Additionally or alternatively, each of the electrodes may include an electrically conductive sealing surface and an insulating substrate coupled to the electrically conductive sealing surface.
Additionally or alternatively, each of the electrodes may include one or more mechanical interfaces configured to complement a corresponding mechanical interface on one of the jaw members to releasably couple the electrode to the jaw member.
Additionally or alternatively, the bipolar forceps may also include a knife lockout mechanism configured to be engaged by one or both shafts to move the knife lockout mechanism from a first position wherein the knife lockout mechanism engages the actuation mechanism to prohibit advancement of the knife blade into the knife channel when the jaw members are in the first position to a second position wherein the knife lockout mechanism disengages the actuation mechanism when the jaw members are in the second position to permit advancement of the knife blade through the knife channel.
Various embodiments of the subject instrument are described herein with reference to the drawings wherein:
Referring initially to
Shaft members 12 and 14 are affixed to one another at their distal end portions 17 and 19, respectively, by a pivot 25 such that movement of shaft members 12, 14, imparts movement of the jaw members 42, 44 from an open position or configuration (
Each shaft member 12 and 14 also includes a ratchet portion 32 and 34, respectively. Each ratchet 32, 34 extends from the proximal end portion 13, 15 of its respective shaft member 12, 14 towards the other ratchet in a generally vertically aligned manner such that the inner facing surfaces of each ratchet 32 and 34 abut one another when the shaft members 12, 14 are approximated. Each ratchet 32 and 34 includes a plurality of flanges 31 and 33 (
Referring to
As shown in
As shown in
Referring now to
Substantially as described above with respect to electrode 120, electrode 110 includes an electrically conductive sealing surface 116 configured to conduct electrosurgical energy therethrough and an electrically insulative substrate 111 attached thereto, as shown in
Referring to
To electrically control the end effector 24, the housing 70 supports a pair of depressible activation buttons 50a, 50b that are operable by the user to actuate corresponding switches 60a, 60b, respectively, disposed within housing 70. Switches 60a, 60b are electrically interconnected with wires 61, 62, respectively, and serve to initiate and terminate the delivery of electrosurgical energy from a suitable energy source to the end effector 24 to effect a tissue seal.
Once a tissue seal is established, the knife blade 85 may be advanced through the knife channel 58 to transect the sealed tissue, as detailed below. However, in some embodiments, knife blade 85 may be advanced through the knife channel 58 before, during, or after tissue sealing. In some embodiments, a knife lockout mechanism 80 is provided to prevent extension of the knife blade 85 into the knife channel 58 when the jaw members 42, 44 are in the open configuration, thus preventing accidental or premature transection of tissue, as detailed below.
With reference to
A biasing member 95 (e.g., torsion spring) is disposed coaxially about at least a portion of the shaft member 47 between the first link 92 and handle member 45a. The biasing member 95 is operably coupled at one end to a portion of the first link 92 and at the other end to a suitable mechanical interface within the housing 70 that braces or stabilizes biasing member 95 during use of the knife actuation mechanism 90. The biasing member 95 serves to bias the trigger 45 such that subsequent to actuation of the knife blade 85 through the knife channel 58 (
With reference to
A knife guide 86 is supported within the housing 70 between the end effector 24 and the knife actuation mechanism 90 and extends through passageway 27. The knife guide 86 includes a longitudinal slot 87 that provides lateral support to the knife blade 85 and constrains side-to-side lateral motion of the knife blade 85. Thus, the knife guide 86 serves to urge the knife blade 85 into a central position relative to end effector 24, thereby ensuring proper alignment of the knife blade 85 as the knife blade 85 advances through knife slot 48 defined through tissue stop 46 and enters the knife channel 58 defined in electrodes 110, 120.
In some embodiments, the forceps 10 includes a knife blade lockout mechanism 80 supported within the housing 70 and that serves to prevent advancement of the knife blade 85 into the knife channel 85 when the jaw members 42, 44 are in the open configuration (
The tissue seal thickness and tissue seal effectiveness may be influenced by the pressure applied to tissue between jaw members 44, 42 and the gap distance between the opposing electrodes 110 and 120 (
Referring now to
The jaw members 42, 44 may be moved from the open configuration of
Upon movement of the safety link 81 out of engagement with the pivot pin 94a, handle members 45a, 45b may be selectively moved from the unactuated configuration of
In some embodiments, the knife actuation mechanism 90 may be positioned relative to shaft member 14 different than the depiction of knife actuation mechanism 90 in
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 examples of particular embodiments. Those skilled in the art will envision other modifications within the scope and spirit of the claims appended hereto.
Although the foregoing disclosure has been described in some detail by way of illustration and example, for purposes of clarity or understanding, it will be obvious that certain changes and modifications may be practiced within the scope of the appended claims.
This application is a continuation of U.S. patent application Ser. No. 14/907,185, filed on Jan. 22, 2016, which is a U.S. National Stage Application under 35 U.S.C. § 371(a) of PCT/CN2013/080954, filed on Aug. 7, 2013.
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Number | Date | Country | |
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20200367959 A1 | Nov 2020 | US |
Number | Date | Country | |
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Parent | 14907185 | US | |
Child | 16991091 | US |