Surgical forceps have been in wide use to provide for grasping and precise manipulation of objects or tissue in proximity to surgical sites. Surgeons frequently use forceps to hold and manipulate tissue with their secondary hand, that is, their primary hand is used to perform a procedure such as cutting or suturing while their secondary hand uses the forceps to manipulate the tissue at the same time. This process can be prolonged, frequently lasting many hours, resulting in fatigue. Frequently wounds or incisions require movement within confined spaces and the combination of fatigue and the need for precision can adversely impact surgical outcomes. Frequently, the surgeon must rotate his entire arm at the shoulder, as the flat forceps handle that is frequently used in operating rooms cannot be rotated easily without risk of damaging tissue. There is also a need for sterility and cost effective solutions in medical care so that surgical instruments can be repeatedly used and sterilized without loss of performance. Thus, an ongoing need exists for improvements in surgical implements to both lower cost and improve the quality of care.
The present invention relates to forceps having a geometry suitable for precise grasping and manipulation required in many surgical procedures. A preferred embodiment of the invention uses contoured arms having generally rounded surfaces along their longitudinal length. This shape enables the surgeon to easily rotate the forceps to different angles to reduce the need to hold the handle differently. This enables rotation of the forceps within a body cavity without a substantial change of arm position and viewing angle. The contoured surface provides an increase in the grasped surface area thereby increasing the amount of functional contact at many angles.
A preferred embodiment provides an integral molded body that includes arms connected by a hinge mechanism, or flexible arms that provide for rotation about a hinge point or one or more axes of rotation. The user can apply pressure with their fingers to compress the arms, and the attached tips of the forceps, towards each other. The user can release pressure such that the spring force of the arms causes the arms to separate. The amount of resilience can be selected during manufacture depending upon the application.
This present invention further relates to a forceps adapter that can be attached to a forceps. The arm adapter provides rounded arm elements that are easier to hold, thereby giving the surgeon greater control and ability to more precisely manipulate objects or tissues. The adapter of the present invention includes a cavity extending between the arms that receives the proximal end of the forceps such that the tips extend from the distal end of the adapter. An outer surface region of the adapter includes handle elements that are gripped manually by the hand of the user during a surgical procedure. The handle elements have contoured surfaces to provide for proper orientation of the tips of the forceps relative to the surgical site. The contoured surface of the handle elements can include a proximal section with a thicker diameter that tapers to a smaller diameter section at the distal end. The distal section can have a recess for the thumb of the user. The tips can be rigidly oriented relative to the surface features to improve manual manipulation. The handle elements can be shaped for left or right handed use.
In accordance with a preferred embodiment, the method for using the adapter of the present invention involves selecting a forceps, inserting it into the adapter, performing the selected procedure, removing the forceps for cleaning, sterilization, and reuse, and either sterilizing or disposing of the adapter.
In another preferred embodiment, the handle elements are an onlay that is assembled with the forceps during manufacture. The elements in this embodiment can be made of a material suitable for sterilization after use. The elements can be molded as unitary bodies with selected portions of the surface having a hatched, braided or dimpled surface to provide frictional surface regions unlikely to slip when grasped by the user.
The forceps handle can be manufactured using an injection molding or 3D printing process. A molded plastic material may be used and can be adapted for single use (disposable), or alternatively, manufactured using a material suitable for sterilization procedures for reuse. The forceps handle elements can be color coded such that the color can indicate a particular size and/or type of forceps for the type of procedure.
Many applications require the forceps to have a spring force that is preferably within a range that aids the surgeon in the sensation of force feedback during tissue manipulation. It is preferred in certain embodiments to apply limited forces of compression, as well as limited torque during rotation of the forceps, to avoid damaging the tissue. It is further desirable to have a sufficient spring force operating to separate the arms of the forceps to release the tissue in a predictable way. The two arms of the forceps preferably are not displaced laterally during rotation thereof while grasping tissue, that is, the arms must have sufficient lateral rigidity that they remain aligned with the application of torques directed in opposite rotational directions on each arm.
The surgical forceps enable the grasping of different sizes of objects or tissue features. The increase in surface area on the contoured grasping surfaces, and the resulting increase in tactile feedback, improves the range of force that can be applied.
The foregoing and other features and advantages of the systems and methods for using contoured forceps will be apparent from the following more particular description of preferred embodiments of the system and method as illustrated in the accompanying drawings in which like reference characters refer to the same parts throughout the different views.
A preferred embodiment of the invention relates to a forceps adapter that can be attached to existing forceps. The adapter can be elliptical in shape at least along a longitudinal portion thereof and crosshatched or beveled to give the handle a more natural feel thereby making it easier to hold to provide superior manipulation.
The adapter can be a sterilizable or disposable, contoured plastic handle that can be used on existing forceps. In addition to making the handle of the forceps easier to hold, the design of the adapter also has the advantage of making the handle less slippery than the traditional steel handle. Through use of the adapter, the forceps are easier to manipulate thereby allowing the precision of the grasping and manipulation to be increased and to reduce user fatigue over the course of use.
Between the distal and central portions is a first concave section 20 or trough adapted to be grasped by the thumb/forefinger and middle finger of the user. Between the central portion and the proximal portion is a second concave section 22 or trough adapted to rest in the web of the user's hand between the thumb and forefinger.
The dimensions of the handle portion are selected to provide for precision and control of the blade during use as well as comfort to the user. The dimensions of the handle features are also of importance as they maximize contact surface area to improve tactile feeling of the handle in the user's hand, which increases the user's sensitivity to the amount of gripping force being applied to the forceps. A common grip of the forceps is the pencil grip where the thumb, forefinger and middle finger of the user's hand provide three points of contact in the first trough section 20. In a preferred embodiment, the first trough 20 of each arm has a partially circular cross-section with a lateral diameter or width in the range of 1.0-1.5 cm, preferably about 1.2-1.4 cm. In a distal direction from the trough 20, the diameter of the handle increases to prevent the fingers from sliding distally toward the tips of the forceps extending distally from the adapter, particularly when more force is exerted in a distal direction. The larger diameter distal portion 14 has a flared diameter in the range of 1.2 to 1.8 cm, preferably about 1.4-1.6 cm. The central portion 18 has a diameter in the range of 1.6 to 2.0 cm, preferably about 1.8 cm. The larger central portion increases the area of contact with the fingers to further stabilize the device in the user's hand. The second trough 22 has a diameter in the range of 1.0 to 1.5 cm, preferably about 1.2-1.4 cm. The second trough fits within the web extending between the user's thumb and forefinger. The proximal portion 12 is flared, with a diameter in the range of 1.4 to 2.0 cm, preferably 1.6-1.8 cm.
These dimensions are correlated with the longitudinal distance between features to achieve the described fit to the user's hands. The distance 26 between the minimum trough diameters is a range of 5-7 cm, preferably about 6 cm. The distance 28 from the distal end of the adapter to the proximal end of the adapter as seen in
An important factor in surgical applications is the need to rotate the forceps, frequently with the secondary or second hand of the surgeon. As seen in
Precise control of the forceps during use is critical. If the handle is awkward to hold, this can contribute to fatigue and the difficulty of the procedure by compelling the user to awkwardly grasp the tool to achieve the proper angle and level of force required to grasp and manipulate the object or tissue as needed. Thus, proper balance, good contact between the user's hand and the handle, and the ability to rotate the handle without having to grip the tool differently can be of great importance. Further, in contrast to traditional flat sided forceps, which can only be rotated approximately 60 degrees without moving hand position, the rounded contours of the adapter 10 allow for the forceps to be comfortably rotated up to 90 degrees.
The material and configuration of the arms 44 and 46 are adapted to be flexible to allow for the manipulation of the forceps blades. As shown in
In one embodiment, the arms 44 and 46 are optimized to minimize the force required to compress the tips 47 of forceps 40 to further increase the control and tactile feedback of the system. Reducing compression resistance also has the benefit of minimizing hand fatigue from extended use. The structure in
Between the distal and central portions is a first concave section 120 or trough adapted to be grasped by the thumb/forefinger and middle finger of the user. Between the central portion and the proximal portion is a second concave section 122 or trough adapted to rest in the web of the user's hand between the thumb and forefinger. The forceps can have a length 124 and a longitudinal distance 126 between the first and second troughs. The tips 111 can be flat, curved, have sharp edges or can have teeth 145.
Shown in
Shown in
In accordance with certain embodiments, the textured region 102 can comprise larger diameter raised nubs or protrusions of greater thickness 117. As the user rotates the handle, the unbalanced force imparted by the user's hand to an edge of a nub causes that edge and the portion of the nub near the edge to compress. In this way, the nubs can provide feedback to the user's hand about the rotational attitude of the forceps as it is being held and moved by the user. This palpable feedback increases the user's ability to make fine-tuned adjustments to the rotation of the forceps while grasping and manipulating objects.
The step of grasping 2402 a surgical forceps having a first contoured surface and a second contoured surface may be performed, for example but not limited to, grasping a surgical forceps having a roughened surface or a textured surface. In accordance with certain embodiments, the grasping 2402 step may be performed with a user's secondary hand (i.e., their non-preferred hand or “off” hand). In accordance with certain embodiments, the method 2400 may include an additional step of performing 2408 a surgical procedure using a tool in the primary (i.e. dominant) hand of the user while simultaneously manipulating tissue or objects with the surgical forceps.
The step of fabricating 2502 a forceps handle having a first arm and a second arm, the first arm having a first contoured surface and the second arm having a second contoured surface such that the forceps handle can be held in a hand of a user, each arm having a contoured surface that includes a distal trough, a larger central portion and a proximal trough extending along a longitudinal axis of each arm may be performed, for example but not limited to, using an injection molding process or a 3D printing process. In accordance with various embodiments, the first arm and the second arm of the fabricated handle may comprise textured or roughened surfaces at their proximal ends. These textured or roughened surfaces may comprise raised nobs, hexagonal protrusions, or diamond-shaped protrusions.
The claims should not be read as limited to the described order or elements unless stated to that effect. All embodiments that came within the scope and spirit of the following claims and equivalents thereto are claimed as the invention.
This application is related to U.S. Provisional Patent Application No. 61/983,994, filed on Apr. 24, 2014, the entire contents of the above application being incorporated herein by reference.
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