A variety of surgical instruments include a tissue cutting element and one or more elements that transmit RF energy to tissue (e.g., to coagulate or seal the tissue). An example of such a device is the ENSEAL® Tissue Sealing Device by Ethicon Endo-Surgery, Inc., of Cincinnati, Ohio. Further examples of such devices and related concepts are disclosed in U.S. Pat. No. 6,500,176 entitled “Electrosurgical Systems and Techniques for Sealing Tissue,” issued Dec. 31, 2002, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 7,112,201 entitled “Electrosurgical Instrument and Method of Use,” issued Sep. 26, 2006, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 7,125,409, entitled “Electrosurgical Working End for Controlled Energy Delivery,” issued Oct. 24, 2006, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 7,169,146 entitled “Electrosurgical Probe and Method of Use,” issued Jan. 30, 2007, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 7,186,253, entitled “Electrosurgical Jaw Structure for Controlled Energy Delivery,” issued Mar. 6, 2007, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 7,189,233, entitled “Electrosurgical Instrument,” issued Mar. 13, 2007, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 7,220,951, entitled “Surgical Sealing Surfaces and Methods of Use,” issued May 22, 2007, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 7,309,849, entitled “Polymer Compositions Exhibiting a PTC Property and Methods of Fabrication,” issued Dec. 18, 2007, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 7,311,709, entitled “Electrosurgical Instrument and Method of Use,” issued Dec. 25, 2007, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 7,354,440, entitled “Electrosurgical Instrument and Method of Use,” issued Apr. 8, 2008, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 7,381,209, entitled “Electrosurgical Instrument,” issued Jun. 3, 2008, the disclosure of which is incorporated by reference herein; U.S. Pub. No. 2011/0087218, entitled “Surgical Instrument Comprising First and Second Drive Systems Actuatable by a Common Trigger Mechanism,” published Apr. 14, 2011, now U.S. Pat. No. 8,939,974, issued Jan. 27, 2015, the disclosure of which is incorporated by reference herein; and U.S. Pat. App. No. 13/151,481, entitled “Motor Driven Electrosurgical Device with Mechanical and Electrical Feedback,” filed Jun. 2, 2011, now U.S. Pat. No. 9,161,803, issued Oct. 20, 2015, the disclosure of which is incorporated by reference herein.
In addition, a variety of surgical instruments include a shaft having an articulation section, providing enhanced positioning capabilities for an end effector that is located distal to the articulation section of the shaft. Examples of such devices include various models of the ENDOPATH® endocutters by Ethicon Endo-Surgery, Inc., of Cincinnati, Ohio. Further examples of such devices and related concepts are disclosed in U.S. Pat. No. 7,380,696, entitled “Articulating Surgical Stapling Instrument Incorporating a Two-Piece E-Beam Firing Mechanism,” issued Jun. 3, 2008, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 7,404,508, entitled “Surgical Stapling and Cutting Device,” issued Jul. 29, 2008, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 7,455,208, entitled “Surgical Instrument with Articulating Shaft with Rigid Firing Bar Supports,” issued Nov. 25, 2008, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 7,506,790, entitled “Surgical Instrument Incorporating an Electrically Actuated Articulation Mechanism,” issued Mar. 24, 2009, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 7,549,564, entitled “Surgical Stapling Instrument with an Articulating End Effector,” issued Jun. 23, 2009, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 7,559,450, entitled “Surgical Instrument Incorporating a Fluid Transfer Controlled Articulation Mechanism,” issued Jul. 14, 2009, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 7,654,431, entitled “Surgical Instrument with Guided Laterally Moving Articulation Member,” issued Feb. 2, 2010, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 7,780,054, entitled “Surgical Instrument with Laterally Moved Shaft Actuator Coupled to Pivoting Articulation Joint,” issued Aug. 24, 2010, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 7,784,662, entitled “Surgical Instrument with Articulating Shaft with Single Pivot Closure and Double Pivot Frame Ground,” issued Aug. 31, 2010, the disclosure of which is incorporated by reference herein; and U.S. Pat. No. 7,798,386, entitled “Surgical Instrument Articulation Joint Cover,” issued Sep. 21, 2010, the disclosure of which is incorporated by reference herein.
While several medical devices have been made and used, it is believed that no one prior to the inventors has made or used the invention described in the appended claims.
While the specification concludes with claims which particularly point out and distinctly claim this technology, it is believed this technology will be better understood from the following description of certain examples taken in conjunction with the accompanying drawings, in which like reference numerals identify the same elements and in which:
The drawings are not intended to be limiting in any way, and it is contemplated that various embodiments of the technology may be carried out in a variety of other ways, including those not necessarily depicted in the drawings. The accompanying drawings incorporated in and forming a part of the specification illustrate several aspects of the present technology, and together with the description serve to explain the principles of the technology; it being understood, however, that this technology is not limited to the precise arrangements shown.
The following description of certain examples of the technology should not be used to limit its scope. Other examples, features, aspects, embodiments, and advantages of the technology will become apparent to those skilled in the art from the following description, which is by way of illustration, one of the best modes contemplated for carrying out the technology. As will be realized, the technology described herein is capable of other different and obvious aspects, all without departing from the technology. Accordingly, the drawings and descriptions should be regarded as illustrative in nature and not restrictive.
It is further understood that any one or more of the teachings, expressions, embodiments, examples, etc. described herein may be combined with any one or more of the other teachings, expressions, embodiments, examples, etc. that are described herein. The following-described teachings, expressions, embodiments, examples, etc. should therefore not be viewed in isolation relative to each other. Various suitable ways in which the teachings herein may be combined will be readily apparent to those of ordinary skill in the art in view of the teachings herein. Such modifications and variations are intended to be included within the scope of the claims.
I. Exemplary Electrosurgical Device with Articulation Feature
A. Exemplary Handpiece and Shaft
Electrosurgical instrument (10) of the present example includes a handpiece (20), a shaft (30) extending distally from handpiece (20), and an end effector (40) disposed at a distal end of shaft (30). Handpiece (20) of the present example includes a pistol grip (22), a pivoting trigger (24), an activation button (26), and an articulation control (28). Trigger (24) is pivotable toward and away from pistol grip (22) to selectively actuate end effector (40) as will be described in greater detail below. Activation button (26) is operable to selectively activate RF circuitry that is in communication with end effector (40), as will also be described in greater detail below. In some versions, activation button (26) also serves as a mechanical lockout against trigger (24), such that trigger (24) cannot be fully actuated unless button (26) is being pressed simultaneously. Examples of how such a lockout may be provided are disclosed in one or more of the references cited herein. It should be understood that pistol grip (22), trigger (24), and button (26) may be modified, substituted, supplemented, etc. in any suitable way, and that the descriptions of such components herein are merely illustrative. Articulation control (28) of the present example is operable to selectively control articulation section (36) of shaft (30), which will be described in greater detail below. Various examples of forms that articulation control (28) may take will also be described in greater detail below, while further examples will be apparent to those of ordinary skill in the art in view of the teachings herein.
Shaft (30) of the present example includes an outer sheath (32) and an articulation section (36). Articulation section (36) is operable to selectively position end effector (40) at various angles relative to the longitudinal axis defined by sheath (32). Various examples of forms that articulation section (36) and other components of shaft (30) may take will be described in greater detail below, while further examples will be apparent to those of ordinary skill in the art in view of the teachings herein. For instance, it should be understood that various components that are operable to actuate articulation section (36) may extend through the interior of sheath (32). In some versions, shaft (30) is also rotatable about the longitudinal axis defined by sheath (32), relative to handpiece (20), via a knob (34). Such rotation may provide rotation of end effector (40) and shaft (30) unitarily. In some other versions, knob (34) is operable to rotate end effector (40) without rotating any portion of shaft (30) that is proximal of articulation section (36). As another merely illustrative example, electrosurgical instrument (10) may include one rotation control that provides rotatability of shaft (30) and end effector (40) as a single unit; and another rotation control that provides rotatability of end effector (40) without rotating any portion of shaft (30) that is proximal of articulation section (36). Other suitable rotation schemes will be apparent to those of ordinary skill in the art in view of the teachings herein. Of course, rotatable features may simply be omitted if desired.
B. Exemplary End Effector
End effector (40) of the present example comprises a first jaw (42) and a second jaw (44). In the present example, second jaw (44) is substantially fixed relative to shaft (30); while first jaw (42) pivots relative to shaft (30), toward and away from second jaw (42). In some versions, actuators such as rods or cables, etc., may extend through sheath (32) and be joined with first jaw (42) at a pivotal coupling (43), such that longitudinal movement of the actuator rods/cables/etc. through shaft (30) provides pivoting of first jaw (42) relative to shaft (30) and relative to second jaw (44). Of course, jaws (42, 44) may instead have any other suitable kind of movement and may be actuated in any other suitable fashion. By way of example only, and as will be described in greater detail below, jaws (42, 44) may be actuated and thus closed by longitudinal translation of a firing beam (60), such that actuator rods/cables/etc. may simply be eliminated in some versions.
As best seen in
As best seen in
With jaws (42, 44) in a closed position, shaft (30) and end effector (40) are sized and configured to fit through trocars having various inner diameters, such that electrosurgical instrument (10) is usable in minimally invasive surgery, though of course electrosurgical instrument (10) could also be used in open procedures if desired. By way of example only, with jaws (42, 44) in a closed position, shaft (30) and end effector (40) may present an outer diameter of approximately 5 mm. Alternatively, shaft (30) and end effector (40) may present any other suitable outer diameter (e.g., between approximately 2 mm and approximately 20 mm, etc.).
As another merely illustrative variation, either jaw (42, 44) or both of jaws (42, 44) may include at least one port, passageway, conduit, and/or other feature that is operable to draw steam, smoke, and/or other gases/vapors/etc. from the surgical site. Such a feature may be in communication with a source of suction, such as an external source or a source within handpiece (20), etc. In addition, end effector (40) may include one or more tissue cooling features (not shown) that reduce the degree or extent of thermal spread caused by end effector (40) on adjacent tissue when electrode surfaces (50, 52) are activated. Various suitable forms that such cooling features may take will be apparent to those of ordinary skill in the art in view of the teachings herein.
In some versions, end effector (40) includes one or more sensors (not shown) that are configured to sense a variety of parameters at end effector (40), including but not limited to temperature of adjacent tissue, electrical resistance or impedance of adjacent tissue, voltage across adjacent tissue, forces exerted on jaws (42, 44) by adjacent tissue, etc. By way of example only, end effector (40) may include one or more positive temperature coefficient (PTC) thermistor bodies (54, 56) (e.g., PTC polymer, etc.), located adjacent to electrodes (50, 52) and/or elsewhere. Data from sensors may be communicated to controller (82). Controller (82) may process such data in a variety of ways. By way of example only, controller (82) may modulate or otherwise change the RF energy being delivered to electrode surfaces (50, 52), based at least in part on data acquired from one or more sensors at end effector (40). In addition or in the alternative, controller (82) may alert the user to one or more conditions via an audio and/or visual feedback device (e.g., speaker, lights, display screen, etc.), based at least in part on data acquired from one or more sensors at end effector (40). It should also be understood that some kinds of sensors need not necessarily be in communication with controller (82), and may simply provide a purely localized effect at end effector (40). For instance, a PTC thermistor bodies (54, 56) at end effector (40) may automatically reduce the energy delivery at electrode surfaces (50, 52) as the temperature of the tissue and/or end effector (40) increases, thereby reducing the likelihood of overheating. In some such versions, a PTC thermistor element is in series with power source (80) and electrode surface (50, 52); and the PTC thermistor provides an increased impedance (reducing flow of current) in response to temperatures exceeding a threshold. Furthermore, it should be understood that electrode surfaces (50, 52) may be used as sensors (e.g., to sense tissue impedance, etc.). Various kinds of sensors that may be incorporated into electrosurgical instrument (10) will be apparent to those of ordinary skill in the art in view of the teachings herein. Similarly various things that can be done with data from sensors, by controller (82) or otherwise, will be apparent to those of ordinary skill in the art in view of the teachings herein. Other suitable variations for end effector (40) will also be apparent to those of ordinary skill in the art in view of the teachings herein.
C. Exemplary Firing Beam
As also seen in
Distal blade (64) is substantially sharp, such that distal blade will readily sever tissue that is captured between jaws (42, 44). Distal blade (64) is also electrically grounded in the present example, providing a return path for RF energy as described elsewhere herein. In some other versions, distal blade (64) serves as an active electrode. In addition or in the alternative, distal blade (64) may be selectively energized with ultrasonic energy (e.g., harmonic vibrations at approximately 55.5 kHz, etc.).
The “I-beam” type of configuration of firing beam (60) provides closure of jaws (42, 44) as firing beam (60) is advanced distally. In particular, flange (62) urges jaw (44) pivotally toward jaw (42) as firing beam (60) is advanced from a proximal position (
In the present example, flange (62) is configured to cam against a ramp feature at the proximal end of jaw (44) to open jaw (42) when firing beam (60) is retracted to a proximal position and to hold jaw (42) open when firing beam (60) remains at the proximal position. This camming capability may facilitate use of end effector (40) to separate layers of tissue, to perform blunt dissections, etc., by forcing jaws (42, 44) apart from a closed position. In some other versions, jaws (42, 44) are resiliently biased to an open position by a spring or other type of resilient feature. While jaws (42, 44) close or open as firing beam (60) is translated in the present example, it should be understood that other versions may provide independent movement of jaws (42, 44) and firing beam (60). By way of example only, one or more cables, rods, beams, or other features may extend through shaft (30) to selectively actuate jaws (42, 44) independently of firing beam (60). Such jaw (42, 44) actuation features may be separately controlled by a dedicated feature of handpiece (20). Alternatively, such jaw actuation features may be controlled by trigger (24) in addition to having trigger (24) control firing beam (60). It should also be understood that firing beam (60) may be resiliently biased to a proximal position, such that firing beam (60) retracts proximally when a user relaxes their grip on trigger (24).
D. Exemplary Operation
In an exemplary use, end effector (40) is inserted into a patient via a trocar. Articulation section (36) is substantially straight when end effector (40) and part of shaft (30) are inserted through the trocar. Articulation control (28) may then be manipulated to pivot or flex articulation section (36) of shaft (30) in order to position end effector (40) at a desired position and orientation relative to an anatomical structure within the patient. Two layers of tissue of the anatomical structure are then captured between jaws (42, 44) by squeezing trigger (24) toward pistol grip (22). Such layers of tissue may be part of the same natural lumen defining anatomical structure (e.g., blood veseel, portion of gastrointestinal tract, portion of reproductive system, etc.) in a patient. For instance, one tissue layer may comprise the top portion of a blood vessel while the other tissue layer may comprise the bottom portion of the blood vessel, along the same region of length of the blood vessel (e.g., such that the fluid path through the blood vessel before use of electrosurgical instrument (10) is perpendicular to the longitudinal axis defined by end effector (40), etc.). In other words, the lengths of jaws (42, 44) may be oriented perpendicular to (or at least generally transverse to) the length of the blood vessel. As noted above, flanges (62, 66) cammingly act to pivot jaw (44) toward jaw (44) when firing beam (60) is actuated distally by squeezing trigger (24) toward pistol grip (22).
With tissue layers captured between jaws (42, 44) firing beam (60) continues to advance distally by the user squeezing trigger (24) toward pistol grip (22). As firing beam (60) advances distally, distal blade (64) simultaneously severs the clamped tissue layers, resulting in separated upper layer portions being apposed with respective separated lower layer portions. In some versions, this results in a blood vessel being cut in a direction that is generally transverse to the length of the blood vessel. It should be understood that the presence of flanges (62, 66) immediately above and below jaws (42, 44), respectively, may help keep jaws (42, 44) in a closed and tightly clamping position. In particular, flanges (62, 66) may help maintain a significantly compressive force between jaws (42, 44). With severed tissue layer portions being compressed between jaws (42, 44), electrode surfaces (50, 52) are activated with bipolar RF energy by the user depressing activation button (26). In some versions, electrodes (50, 52) are selectively coupled with power source (80) (e.g., by the user depressing button (26), etc.) such that electrode surfaces (50, 52) of jaws (42, 44) are activated with a common first polarity while firing beam (60) is activated at a second polarity that is opposite to the first polarity. Thus, a bipolar RF current flows between firing beam (60) and electrode surfaces (50, 52) of jaws (42, 44), through the compressed regions of severed tissue layer portions. In some other versions, electrode surface (50) has one polarity while electrode surface (52) and firing beam (60) both have the other polarity. In either version (among at least some others), bipolar RF energy delivered by power source (80) ultimately thermally welds the tissue layer portions on one side of firing beam (60) together and the tissue layer portions on the other side of firing beam (60) together.
In certain circumstances, the heat generated by activated electrode surfaces (50, 52) can denature the collagen within the tissue layer portions and, in cooperation with clamping pressure provided by jaws (42, 44), the denatured collagen can form a seal within the tissue layer portions. Thus, the severed ends of the natural lumen defining anatomical structure are hemostatically sealed shut, such that the severed ends will not leak bodily fluids. In some versions, electrode surfaces (50, 52) may be activated with bipolar RF energy before firing beam (60) even begins to translate distally and thus before the tissue is even severed. For instance, such timing may be provided in versions where button (26) serves as a mechanical lockout relative to trigger (24) in addition to serving as a switch between power source (80) and electrode surfaces (50, 52).
While several of the teachings below are described as variations to electrosurgical instrument (10), it should be understood that various teachings below may also be incorporated into various other types of devices. By way of example only, in addition to being readily incorporated into electrosurgical instrument (10), various teachings below may be readily incorporated into the devices taught in any of the references cited herein, other types of electrosurgical devices, surgical staplers, surgical clip appliers, and tissue graspers, among various other devices. Other suitable devices into which the following teachings may be incorporated will be apparent to those of ordinary skill in the art in view of the teachings herein.
II. Exemplary Articulation Joint Configurations
Articulation section (36) of shaft (30) may take a variety of forms. By way of example only, articulation section (36) may be configured in accordance with one or more teachings of U.S. patent application Ser. No. 13/235,660, entitled “Articulation Joint Features for Articulating Surgical Device,” filed Sep. 19, 2011, now U.S. Pat. No. 9,402,682, issued Aug. 2, 2016, the disclosure of which is incorporated by reference herein. As another merely illustrative example, articulation section (36) may be configured in accordance with one or more teachings of U.S. patent application Ser. No. 13/235,683, entitled “Articulation Joint Features for Articulating Surgical Device,” filed on even date herewith September 19, 2011, published Mar. 29, 2012 as U.S. Pub. No. 2012/0078248, now U.S. Pat. No. 9,220,559, issued Dec. 29, 2015, the disclosure of which is incorporated by reference herein. Furthermore, articulation section may be configured in accordance with the teachings of at least one other of the references cited herein. Various other suitable forms that articulation section (36) may take will be apparent to those of ordinary skill in the art in view of the teachings herein.
III. Exemplary Articulation Control Configurations
As noted above, some versions of handpiece (20) include an articulation control (28), which is operable to control articulation section (36) of shaft (30) to thereby selectively position end effector (40) at various angles relative to the longitudinal axis defined by sheath (32). Several examples of forms that articulation control (28) and other components of handpiece (20) may take will be described in greater detail below, while further examples will be apparent to those of ordinary skill in the art in view of the teachings herein. By way of example only, some merely illustrative alternative examples of articulation control (28) are disclosed in U.S. patent application Ser. No. 13/235,648, entitled “Control Features for Articulating Surgical Device,” filed Sep. 19, 2011, published as U.S. Pub. No. 2012/0078244 on Mar. 29, 2012, the disclosure of which is incorporated by reference herein.
A. Exemplary Articulation Control with Perpendicular Rotary Knob
Shaft (130) of the present example includes an outer sheath (132), an articulation section (136) at the distal end of sheath (132), and a cutting member driver tube (138) that is slidably and coaxially disposed within sheath (132). Cutting member driver tube (138) is secured to a driver block (139), which is further secured to a cutting member (146) of end effector (140). Cutting member driver tube (138) is movable longitudinally to drive driver block (139) longitudinally, to thereby move cutting member (146) longitudinally. Cutting member (146) is essentially equivalent to firing beam (60) described above. The proximal portion (148) of end effector (140) includes an insert (not shown) that defines a channel containing the part of cutting member (146) that extends through proximal portion (148). This channel is configured to permit cutting member (146) to readily translate relative to the insert, while also preventing cutting member (146) from buckling within the insert when cutting member (146) encounters a load during distal advancement of cutting member (146).
In the present example, driver tube (138) is advanced distally by squeezing trigger (124) toward pistol grip (122); while driver tube (138) is retracted proximally by releasing trigger (124) and/or by actively moving trigger (124) away from pistol grip (122). As shown in
In some versions, shaft (130) is also rotatable about the longitudinal axis defined by sheath (132), relative to handpiece (120), via a knob (134). Such rotation may provide rotation of end effector (140) and shaft (130) unitarily. In some other versions, knob (134) is operable to rotate end effector (140) without rotating any portion of shaft (130) that is proximal of articulation section (136). As another merely illustrative example, electrosurgical instrument (100) may include one rotation control that provides rotatability of shaft (130) and end effector (140) as a single unit; and another rotation control that provides rotatability of end effector (140) without rotating any portion of shaft (130) that is proximal of section (136). Other suitable rotation schemes will be apparent to those of ordinary skill in the art in view of the teachings herein. Of course, rotatable features may simply be omitted if desired. In any versions of a device that provide rotation of a shaft (130) and/or end effector (140), a rotation knob (134) and/or shaft (130) and/or end effector (140) may include one or more markings facilitating visual identification of the rotational position. For instance, a user may correlate a marking on a rotation knob (134) with a corresponding marking on a shaft (130) and/or end effector (140) to better understand the orientation of such components with respect to the patient and instrument (100).
In the present example, separator (150) is formed as two pieces arranged in an end-to-end configuration, with a distal projection from the proximal piece helping to define gap (158). Of course, separator (150) may alternatively be formed as a single piece or any other suitable number of pieces. By way of example only, gap (158) may be formed as a cutout from a single piece of material.
As will be described in greater detail below, a wire (900) extends through separator (150) to provide electrical communication to end effector (140). In particular, wire (900) extends through middle lumen (152) from the proximal end of separator (150) until wire (900) reaches gap (158). At gap (158), wire (900) transitions down to lower lumen (153), and extends through lower lumen (153) until reaching the distal end of separator (150). Wire (900) then extends across articulation section (136) to end effector (140). Wire (900) is thus operable to communicate power from a power source to end effector (140) in accordance with the teachings herein and in accordance with the teachings of various references cited herein. Distal projection (156) protects wire (900) from driver block (139), such that driver block (139) is unable to contact wire (900) regardless of the longitudinal position of driver block (139) along distal projection (156).
First articulation band (160) is slidably disposed in one side recess (154) of separator (150) while second articulation band (170) is slidably disposed in the other side recess (154) of separator (150). Referring back to
As best seen in
As shown in
As best seen in
The angles of threading (181, 182, 185, 186) are also configured such that articulation section (136) will be effectively locked in any given articulated position, such that transverse loads on end effector (140) will generally not bend articulation section (136), due to friction between threading (181, 182, 185, 186). In other words, articulation section (136) will only change its configuration when knob (128) is rotated. While the angles of threading may substantially prevent bending of articulation section (136) in response to transverse loads on end effector (140), the angles may still provide ready rotation of articulation knob (128) to translate lead screws (183, 184). By way of example only, the angles of threading (181, 182, 185, 186) may be approximately +/−2 degrees or approximately +/−3 degrees. Other suitable angles will be apparent to those of ordinary skill in the art in view of the teachings herein. It should also be understood that threading (181, 182, 185, 186) may have a square or rectangular cross-section or any other suitable configuration.
As best seen in
First tensioner gear (191) is also engaged with a washer (193), which is further engaged with notch (174) of drive member (172). The engagement between washer (193) and drive member (172) is such that washer (193) and drive member (172) will translate together. In some versions, washer (193) is secured to tensioner gear (191) in such a manner that tensioner gear (191) both pulls washer (193) distally and pushes washer (193) proximally. Thus, in some such versions, first lead screw (183) is operable to both push articulation band (170) distally and pull articulation band (170) proximally, depending on which direction knob (128) is rotated. In the present example, however, tensioner gear (191) merely abuts washer (193), such that tensioner gear (191) is operable to push washer (193) proximally but cannot pull washer (193) distally. Thus, in the present example, first lead screw (183) is operable to pull articulation band (170) proximally but cannot actively push articulation band (170) distally. Instead, first lead screw (183) may simply pull tensioner gear (191) distally to enable articulation band (170), drive member (172), and washer (193) to be driven distally in response to proximal retraction of articulation band (160) as communicated through articulation section (136). Other suitable relationships will be apparent to those of ordinary skill in the art in view of the teachings herein. It should also be understood that drive member (172) and/or washer (193) may be rotatable relative to tensioner gear (191), which may permit rotation of shaft (130) by knob (134). As described in greater detail below, tensioner gear (191) may be used to take out any tolerance gaps between drive member (172) and lead screw (183).
Similarly, second tensioner gear (192) is engaged with a washer (194), which is further engaged with notch (164) of drive member (162). The engagement between washer (194) and drive member (162) is such that washer (194) and drive member (162) will translate together. In some versions, washer (194) is secured to tensioner gear (192) in such a manner that tensioner gear (192) both pulls washer (194) distally and pushes washer (194) proximally. Thus, in some such versions, second lead screw (184) is operable to both push articulation band (160) distally and pull articulation band (160) proximally, depending on which direction knob (128) is rotated. In the present example however, tensioner gear (192) merely abuts washer (194), such that tensioner gear (192) is operable to push washer (194) proximally but cannot pull washer (194) distally. Thus, in the present example, second lead screw (184) is operable to pull articulation band (160) proximally but cannot actively push articulation band (160) distally. Instead, second lead screw (184) may simply pull tensioner gear (192) distally to enable articulation band (160), drive member (162), and washer (194) to be driven distally in response to proximal retraction of articulation band (170) as communicated through articulation section (136). Other suitable relationships will be apparent to those of ordinary skill in the art in view of the teachings herein. It should also be understood that drive member (162) and/or washer (194) may be rotatable relative to tensioner gear (192), which may permit rotation of shaft (130) by knob (134). As described in greater detail below, tensioner gear (192) may be used to take out any tolerance gaps between drive member (162) and lead screw (184).
In some versions, knob (128) includes a visual indicator that is associated with articulation section (136) being in a substantially straight configuration. Such a visual indicator may align with a corresponding visual indicator on housing (121) of handpiece (120). Thus, when a user has rotated knob (128) to make articulation section (136) approach a substantially straight configuration, the user may observe such indicators to confirm whether articulation section (136) has in fact reached a substantially straight configuration. By way of example only, this may be done right before instrument (100) is withdrawn from a trocar to reduce the likelihood of articulation section (136) snagging on a distal edge of the trocar. Of course, such indicators are merely optional.
In some instances, manufacturing inconsistencies may result in articulation bands (160, 170) having slightly different lengths. In addition or in the alternative, there may be inherent manufacturing related inconsistencies in the initial positioning of lead screws (183, 184) relative to articulation knob (128), inconsistencies in the initial positioning of tensioner gears (191, 192) relative to lead screws (183, 184), and/or other inconsistencies that might result in undesirable positioning/relationships of articulation bands (160, 170). Such inconsistencies may result in lost motion or slop in the operation of the articulation features of instrument (100). To address such issues, tensioner gears (191, 192) may be rotated relative to lead screws (183, 184) to adjust the longitudinal position of drive members (162, 172) relative to lead screws (183, 184). For instance, if there is insufficient tension in articulation band (170), tensioner gear (191) may be rotated to drive washer (193) and drive member (172) proximally until articulation band (170) reaches a sufficient degree of tension. Similarly, if there is insufficient tension in articulation band (160), tensioner gear (192) may be rotated to drive washer (195) and drive member (162) proximally until articulation band (160) reaches a sufficient degree of tension. Lead screws (183, 184) may remain substantially stationary during such adjustments. Articulation section (136) may remain substantially straight during such adjustments and may even be held substantially straight during such adjustments.
In some versions, tensioner gears (191, 192) are rotated manually. In some other versions, tensioner gears (191, 192) are rotated automatically by a rack or other gear. In some such automated calibration systems, a control logic may monitor the load on a motor that is being used to drive a calibrating rack or gear that is engaged with tensioner gear (191, 192), and may automatically stop driving such a rack or gear when the load reaches a threshold associated with proper tensioning of band (160, 170). For instance, in cases where manufacturing inconsistencies or tolerance provide an initial gap between tensioner gears (191, 192) and washers (193, 194), or between washers (193, 194) and drive members (162, 172), tensioner gears (191, 192) may be rotated until such gaps are closed and sufficient contact is made between previously gapped components. As another merely illustrative variation, tensioner gears (191, 192) may be automatically stopped when the proximal ends of bands (160, 170) and/or drive members (162, 172) reach a certain point. Various suitable ways in which tensioner gears (191, 192) may be adjusted will be apparent to those of ordinary skill in the art in view of the teachings herein. It should also be understood that tensioner gears (191, 192) may be heat staked, glued, welded, or otherwise bonded to the respective lead screws (183, 184) when the gaps between drive members (162, 172) and their respective washers (193, 194) reach zero. Such bonding may prevent subsequent movement of tensioner gears (191, 192) relative to their respective lead screws (183, 184).
As another merely illustrative example, manufacturing inconsistencies may be addressed at the distal ends of bands (160, 170). For instance, before the distal ends of bands (160, 170) are secured to the proximal portion (148) of end effector (140), articulation section (136) may be held in a straight configuration and bands (160, 170) may be pulled distally to remove any slack in bands (160, 170). With bands (160, 170) both being in tension, bands (160, 170) may then be welded or otherwise secured to proximal portion (148) of end effector (140). It should be understood that this form of calibration is not limited to instrument (100), such that this form of calibration may be readily applied to various other instruments described herein, among others. Other suitable structures and methods for calibration will be apparent to those of ordinary skill in the art in view of the teachings herein.
B. Exemplary Articulation Control with Angled Rotary Knob
Shaft (230) of the present example includes an outer sheath (232), an articulation section (236) at the distal end of sheath (232), and a cutting member driver tube (238) that is slidably and coaxially disposed within sheath (232). Cutting member driver tube (238) is secured to a firing beam (not shown), which is essentially equivalent to firing beam (60) described above. Cutting member driver tube (238) is movable longitudinally to drive the firing beam longitudinally. In the present example, driver tube (238) is advanced distally by squeezing trigger (224) toward pistol grip (222); while driver tube (238) is retracted proximally by releasing trigger (224) and/or by actively moving trigger (224) away from pistol grip (222). As shown in
In some versions, shaft (230) is also rotatable about the longitudinal axis defined by sheath (232), relative to handpiece (220), via a knob (234). Such rotation may provide rotation of end effector (240) and shaft (230) unitarily. In some other versions, knob (234) is operable to rotate end effector (240) without rotating any portion of shaft (230) that is proximal of articulation section (236). As another merely illustrative example, electrosurgical instrument (200) may include one rotation control that provides rotatability of shaft (230) and end effector (240) as a single unit; and another rotation control that provides rotatability of end effector (240) without rotating any portion of shaft (230) that is proximal of section (236). Other suitable rotation schemes will be apparent to those of ordinary skill in the art in view of the teachings herein. Of course, rotatable features may simply be omitted if desired. In any versions of a device that provide rotation of a shaft (230) and/or end effector (240), a rotation knob (234) and/or shaft (230) and/or end effector (240) may include one or more markings facilitating visual identification of the rotational position. For instance, a user may correlate a marking on a rotation knob (234) with a corresponding marking on a shaft (230) and/or end effector (240) to better understand the orientation of such components with respect to the patient and instrument (200).
It should be understood that the components of shaft (230) that provide control for articulation section (236) may be substantially the same as those described above with reference to
Distal lead screw (283) is threadingly engaged with distal drive nut (261). In particular, distal lead screw (283) includes external threading (285) that meshes with internal threading (281) of distal drive nut (261). Similarly, proximal lead screw (284) is threadingly engaged with proximal drive nut (260). In particular, proximal lead screw (284) includes external threading (286) that meshes with internal threading (282) of distal drive nut (260). Threading (281, 285) is oriented/angled in one direction while threading (282, 286) is oriented/angled in the opposite direction. Thus, threadings (281, 282, 285, 286) are analogous to threadings (181, 182, 185, 186) described above. Drive nuts (260, 261) are secured together in the present example such that drive nuts (260, 261) rotate together. Thus, when drive nuts (260, 261) are rotated, articulation band (270) translates in one direction while articulation band (276) translates in the other direction, depending on which direction drive nuts (260, 261) are rotated.
Drive nut (261) comprises an upper recess (263) and an opposing lower recess (not shown). Similarly, drive nut (260) comprises an upper recess (262) and an opposing lower recess (not shown). These recesses (262, 263) align and cooperate to receive pins (264) when drive nuts (260, 261) are joined together. These pins (264) are used to rotate drive nuts (260, 261). In particular, pins (264) are disposed in corresponding openings (266) of gimbal ring (250). Thus, drive nuts (260, 261) will rotate in response to rotation of gimbal ring (250). Gimbal ring (250) also includes another pair of opposing openings (252), which also receive a set of pins (254). These pins (254) are used to rotate gimbal ring (250). In particular, pins (254) are disposed in corresponding openings (256) of knob (228). Thus, gimbal ring (250) and drive nuts (260, 261) will rotate in response to rotation of knob (228). Unlike knob (128) described above, knob (228) of this example is oriented at an angle that is oblique relative to the longitudinal axis defined by shaft (230). Knob (228) is still nevertheless rotatable about the longitudinal axis defined by shaft (230). This configuration and operability is permitted by the pivotal couplings of pins (254, 264) in gimbal ring (250). In other words, gimbal ring (250) provides transfer of rotary motion of knob (228) to drive nuts (260, 261) in a manner similar to a universal joint, with simultaneous pivoting and rotation.
In some versions, the edges along which drive nuts (260, 261) contact each other include serrations or other mating features that enable the rotational positions of drive nuts (260, 261) relative to each other to be adjusted before drive nuts (260, 261) are secured together. By way of example only, this may enable the rotational positions of drive nuts (260, 261) to be adjusted to take up slack in articulation bands (270, 276) and/or to compensate for other manufacturing inconsistencies.
As also shown in
C. Exemplary Articulation Control with Pivoting Semispherical Knob
Shaft (330) of the present example includes an outer sheath (332), an articulation section (336) at the distal end of sheath (332), and a cutting member driver tube (338) that is slidably and coaxially disposed within sheath (332). Cutting member driver tube (338) is secured to a firing beam (not shown), which is essentially equivalent to firing beam (60) described above. Cutting member driver tube (338) is movable longitudinally to drive the firing beam longitudinally. In the present example, driver tube (338) is advanced distally by squeezing trigger (324) toward pistol grip (322); while driver tube (338) is retracted proximally by releasing trigger (324) and/or by actively moving trigger (324) away from pistol grip (322). As shown in
In some versions, shaft (330) is also rotatable about the longitudinal axis defined by sheath (332), relative to handpiece (320), via a knob (334). Such rotation may provide rotation of end effector (340) and shaft (330) unitarily. In some other versions, knob (334) is operable to rotate end effector (340) without rotating any portion of shaft (330) that is proximal of articulation section (336). As another merely illustrative example, electrosurgical instrument (300) may include one rotation control that provides rotatability of shaft (330) and end effector (340) as a single unit; and another rotation control that provides rotatability of end effector (340) without rotating any portion of shaft (330) that is proximal of section (336). Other suitable rotation schemes will be apparent to those of ordinary skill in the art in view of the teachings herein. Of course, rotatable features may simply be omitted if desired. In any versions of a device that provide rotation of a shaft (330) and/or end effector (340), a rotation knob (334) and/or shaft (330) and/or end effector (340) may include one or more markings facilitating visual identification of the rotational position. For instance, a user may correlate a marking on a rotation knob (334) with a corresponding marking on a shaft (330) and/or end effector (340) to better understand the orientation of such components with respect to the patient and instrument (300).
It should be understood that the components of shaft (330) that provide control for articulation section (336) may be substantially the same as those described above with reference to
Pinion (374) meshes with a pair of opposing racks (350, 356), such that pivoting post (371) about pin (372) translates racks (350, 356) simultaneously in opposite directions. Rack (350) is unitarily secured to articulation band (370); while rack (356) is unitarily secured to articulation band (376). Thus, pivoting post (371) and pinion (374) in one direction will translate articulation band (370) distally while simultaneously translating articulation band (376) proximally; and pivoting post (371) and pinion (374) in the opposite direction will translate articulation band (370) proximally while simultaneously translating articulation band (376) distally. It should be understood that post (371) and pinion (374) may be pivoted by engaging knob (328). It should also be understood that such pivoting will bend articulation section (336) in a direction depending on the direction in which knob (328), post (371), and pinion (374) are pivoted. In some versions, a user may engage knob (328) with the thumb of the hand holding pistol grip (322), such that all features of instrument (300) may be entirely operated with a single hand.
As noted above, shaft (330) of the present example is rotatable relative to main housing (321) of handpiece (320). In some versions, articulation bands (370, 376), racks (350, 356), pin (372), post (371), knob (328), and housing portions (323, 325) all rotate together with shaft (330) relative to main housing (321) of handpiece (320). Thus, a user may rotate this entire assembly via either knob (334) or knob (328) and/or housing portions (323, 325). In such versions, the plane along which knob (328) pivots will also rotate with shaft (330), thereby providing the user with a more intuitive sense of the angular orientation of end effector (340) and the plane of articulation for articulation section (336). In some other versions, articulation bands (370, 376), racks (350, 356), pin (372), post (371), knob (328), and housing portions (323, 325) remain rotationally stationary relative to main housing (321) of handpiece (320) while shaft (330) rotates relative to main housing (321) of handpiece (320). Other suitable ways in which instrument (300) may be configured and operable will be apparent to those of ordinary skill in the art in view of the teachings herein.
D. Exemplary Articulation Control with Pivoting Fin
Shaft (430) of the present example includes an outer sheath (432), an articulation section (436) at the distal end of sheath (432), and a cutting member driver tube (438) that is slidably and coaxially disposed within sheath (432). Cutting member driver tube (438) is secured to a firing beam (not shown), which is essentially equivalent to firing beam (60) described above. Cutting member driver tube (438) is movable longitudinally to drive the firing beam longitudinally. In the present example, driver tube (438) is advanced distally by squeezing trigger (424) toward pistol grip (422); while driver tube (438) is retracted proximally by releasing trigger (424) and/or by actively moving trigger (424) away from pistol grip (422). As shown in
In some versions, shaft (430) is also rotatable about the longitudinal axis defined by sheath (432), relative to handpiece (420), via a knob (434). Such rotation may provide rotation of end effector (440) and shaft (430) unitarily. In some other versions, knob (434) is operable to rotate end effector (440) without rotating any portion of shaft (430) that is proximal of articulation section (436). As another merely illustrative example, electrosurgical instrument (400) may include one rotation control that provides rotatability of shaft (430) and end effector (440) as a single unit; and another rotation control that provides rotatability of end effector (440) without rotating any portion of shaft (430) that is proximal of section (436). Other suitable rotation schemes will be apparent to those of ordinary skill in the art in view of the teachings herein. Of course, rotatable features may simply be omitted if desired. In any versions of a device that provide rotation of a shaft (430) and/or end effector (440), a rotation knob (434) and/or shaft (430) and/or end effector (440) may include one or more markings facilitating visual identification of the rotational position. For instance, a user may correlate a marking on a rotation knob (434) with a corresponding marking on a shaft (430) and/or end effector (440) to better understand the orientation of such components with respect to the patient and instrument (400).
It should be understood that the components of shaft (430) that provide control for articulation section (436) may be substantially the same as those described above with reference to
Actuation arms (480, 490) serve as linkages transferring pivotal movement of fin (428) and post (471) into translational movement of actuation beams (470, 476). In particular, pivotal movement of fin (428) in one direction is communicated through arms (480, 490) to translate articulation beam (470) distally while simultaneously translating articulation beam (476) proximally. Pivotal movement of fin (428) in the opposite direction is communicated through arms (480, 490) to translate articulation beam (470) proximally while simultaneously translating articulation beam (476) distally. It should also be understood that such pivoting will bend articulation section (436) in a direction depending on the direction in which fin (428) and post (471) are pivoted. In some versions, a user may engage fin (428) with the thumb of the hand holding pistol grip (422), such that all features of instrument (400) may be entirely operated with a single hand.
In some versions, the pivotal position of fin (428) may be selectively locked in place. For instance, instrument (400) may be configured to require fin (428) to be moved vertically (either up or down) to unlock and/or to pivot fin (428). By way of example only, housing (421) may comprise a plurality of recesses configured to selectively receive post (471) depending on the pivotal position of post (471) about pin (472). A resilient member may bias post (471) into engagement with recesses, such that the user must deflect post (471) away from the recesses, against this resilient bias, in order to pivotally adjust the position of fin (428). As another merely illustrative variation, instrument (400) may require fin (428) to be pushed distally or pulled proximally to unlock fin (428) for pivotal movement. Again, such features may resiliently bias fin (428) to a locked configuration. Other suitable ways in which the pivotal position of fin (428) may be selectively locked will be apparent to those of ordinary skill in the art in view of the teachings herein. Alternatively, instrument (400) may simply lack such locking altogether.
Other suitable ways in which instrument (400) may be configured and operable will be apparent to those of ordinary skill in the art in view of the teachings herein.
IV. Other Exemplary Features
It should be understood that any of the versions of electrosurgical instrument (10) described herein may include various other features in addition to or in lieu of those described above. Several examples of such other features are described below, while other features will be apparent to those of ordinary skill in the art in view of the teachings herein.
A. Exemplary Electrical Couplings
As noted above, one or more components of end effector (40, 140, 240, 340, 440) may be placed in electrical communication with a power source. Such a power source may be internal to instrument (10, 100, 200, 300, 400) or may be external to instrument.
As shown in
As noted above, wire (900) extends through separator (150) to provide electrical communication to end effector (140). For instance, wire (900) may be in electrical communication with one or more electrodes of end effector (140). Wire (900) may thus serve as a ground return path for end effector (140) or may communicate active power to end effector (140). In some versions, wire (900) communicates active power to one or more electrodes of end effector (140) while driver tube (138) serves as a ground return path.
As shown in
B. Exemplary Return Stroke Assist
As noted above, a trigger (24, 124, 224, 324, 424) may be squeezed toward a pistol grip (22, 124, 224, 324, 424) to actuate an end effector (40, 140, 240, 340, 440). In the foregoing examples, a spring (not shown) resiliently biases trigger (24, 124, 224, 324, 424) away from pistol grip (22, 124, 224, 324, 424). Thus, after a user has fully squeezed trigger (24, 124, 224, 324, 424) toward pistol grip (22, 124, 224, 324, 424) to actuate end effector (40, 140, 240, 340, 440), the user may simply release trigger (24, 124, 224, 324, 424), and the spring may then return trigger (24, 124, 224, 324, 424) to a “home” position where it is pivoted away from pistol grip (22, 124, 224, 324, 424). In some versions, friction through articulation section (36, 136, 236, 336, 436) may provide substantial resistance to trigger (24, 124, 224, 324, 424) returning to the home position, particularly when articulation section (36, 136, 236, 336, 436) is in a bent configuration. This resistance may be most pronounced when trigger (24, 124, 224, 324, 424) is near the end of its return stroke. It may therefore be desirable in some instances to provide additional mechanical assistance to trigger (24, 124, 224, 324, 424) as it approaches the end of its return stroke.
Cam lever (1200) is pivotally secured to housing (1021) by a pin (1202). A torsion spring (1210) is coaxially disposed about pin (1202) and resiliently biases cam lever (1200) to the rotational position shown in
The spring constant of torsion spring (1210) is selected such that it does not significantly increase the resistance against actuation of trigger (1024) from the home position to the actuated position by a user. However, torsion spring (1210) does provide significant assistance to coil spring (1102) in returning trigger (1024) from the actuated position to the home position, particularly once trigger (1024) reaches the position shown in
It should be understood that any of the devices herein may also include one or more of the various features disclosed in U.S. patent application Ser. No. 13/235,648, entitled“Control Features for Articulating Surgical Device,” filed Sep. 19, 2011, published as U.S. Pub. No. 2012/0078244 on Mar. 29, 2012, the disclosure of which is incorporated by reference herein; U.S. patent application Ser. No. 13/235,660, entitled “Articulation Joint Features for Articulating Surgical Device,” filed Sep. 19, 2011, now U.S. Pat. No. 9,402,682, issued on Aug. 2, 2016, the disclosure of which is incorporated by reference herein; and/or U.S. patent application Ser. No. 13/235,683, entitled “Articulation Joint Features for Articulating Surgical Device,” filed Sep. 19, 2011, published Mar. 29, 2012 as U.S. Pub. No. 2012/0078248, now U.S. Pat. No. 9,220,559, issued on Dec. 29, 2015, the disclosure of which is incorporated by reference herein.
It should also be understood that any of the devices described herein may be modified to include a motor or other electrically powered device to drive an otherwise manually moved component. Various examples of such modifications are described in U.S. patent application Ser. No. 13/151,481, entitled “Motor Driven Electrosurgical Device with Mechanical and Electrical Feedback,” filed Jun. 2, 1011, now U.S. Pat. No. 9,161,803, issued Oct. 20, 2015, the disclosure of which is incorporated by reference herein. Various other suitable ways in which a motor or other electrically powered device may be incorporated into any of the devices herein will be apparent to those of ordinary skill in the art in view of the teachings herein.
It should also be understood that any of the devices described herein may be modified to contain most, if not all, of the required components within the medical device itself. More specifically, the devices described herein may be adapted to use an internal or attachable power source instead of requiring the device to be plugged into an external power source by a cable. Various examples of how medical devices may be adapted to include a portable power source are disclosed in U.S. Provisional Application Ser. No. 61/410,603, filed Nov. 5, 2010, entitled “Energy-Based Surgical Instruments,” the disclosure of which is incorporated by reference herein. Various other suitable ways in which a power source may be incorporated into any of the devices herein will be apparent to those of ordinary skill in the art in view of the teachings herein.
VI. Miscellaneous
While the examples herein are described mainly in the context of electrosurgical instruments, it should be understood that the teachings herein may be readily applied to a variety of other types of medical instruments. By way of example only, the teachings herein may be readily applied to tissue graspers, tissue retrieval pouch deploying instruments, surgical staplers, ultrasonic surgical instruments, etc. It should also be understood that the teachings herein may be readily applied to any of the instruments described in any of the references cited herein, such that the teachings herein may be readily combined with the teachings of any of the references cited herein in numerous ways. Other types of instruments into which the teachings herein may be incorporated will be apparent to those of ordinary skill in the art.
It should be appreciated that any patent, publication, or other disclosure material, in whole or in part, that is said to be incorporated by reference herein is incorporated herein only to the extent that the incorporated material does not conflict with existing definitions, statements, or other disclosure material set forth in this disclosure. As such, and to the extent necessary, the disclosure as explicitly set forth herein supersedes any conflicting material incorporated herein by reference. Any material, or portion thereof, that is said to be incorporated by reference herein, but which conflicts with existing definitions, statements, or other disclosure material set forth herein will only be incorporated to the extent that no conflict arises between that incorporated material and the existing disclosure material.
Embodiments of the present invention have application in conventional endoscopic and open surgical instrumentation as well as application in robotic-assisted surgery. For instance, those of ordinary skill in the art will recognize that various teaching herein may be readily combined with various teachings of U.S. Pat. No. 6,783,524, entitled “Robotic Surgical Tool with Ultrasound Cauterizing and Cutting Instrument,” published Aug. 31, 2004, the disclosure of which is incorporated by reference herein.
Embodiments of the devices disclosed herein can be designed to be disposed of after a single use, or they can be designed to be used multiple times. Embodiments may, in either or both cases, be reconditioned for reuse after at least one use. Reconditioning may include any combination of the steps of disassembly of the device, followed by cleaning or replacement of particular pieces, and subsequent reassembly. In particular, embodiments of the device may be disassembled, and any number of the particular pieces or parts of the device may be selectively replaced or removed in any combination. Upon cleaning and/or replacement of particular parts, embodiments of the device may be reassembled for subsequent use either at a reconditioning facility, or by a surgical team immediately prior to a surgical procedure. Those skilled in the art will appreciate that reconditioning of a device may utilize a variety of techniques for disassembly, cleaning/replacement, and reassembly. Use of such techniques, and the resulting reconditioned device, are all within the scope of the present application.
By way of example only, embodiments described herein may be processed before surgery. First, a new or used instrument may be obtained and if necessary cleaned. The instrument may then be sterilized. In one sterilization technique, the instrument is placed in a closed and sealed container, such as a plastic or TYVEK bag. The container and instrument may then be placed in a field of radiation that can penetrate the container, such as gamma radiation, x-rays, or high-energy electrons. The radiation may kill bacteria on the instrument and in the container. The sterilized instrument may then be stored in the sterile container. The sealed container may keep the instrument sterile until it is opened in a medical facility. A device may also be sterilized using any other technique known in the art, including but not limited to beta or gamma radiation, ethylene oxide, or steam.
Having shown and described various embodiments of the present invention, further adaptations of the methods and systems described herein may be accomplished by appropriate modifications by one of ordinary skill in the art without departing from the scope of the present invention. Several of such potential modifications have been mentioned, and others will be apparent to those skilled in the art. For instance, the examples, embodiments, geometrics, materials, dimensions, ratios, steps, and the like discussed above are illustrative and are not required. Accordingly, the scope of the present invention should be considered in terms of the following claims and is understood not to be limited to the details of structure and operation shown and described in the specification and drawings.
This application claims priority to U.S. Provisional Application Ser. No. 61/386,094, filed Sep. 24, 2010, entitled “Articulating Surgical Device,” the disclosure of which is incorporated by reference herein.
Number | Name | Date | Kind |
---|---|---|---|
2715341 | Hogan | Aug 1955 | A |
2818744 | Moody | Jan 1958 | A |
2857776 | Williams | Oct 1958 | A |
2881645 | Kruchten | Apr 1959 | A |
3079606 | Sergeevich et al. | Mar 1963 | A |
3194530 | Heyl | Jul 1965 | A |
3490675 | Green et al. | Jan 1970 | A |
4203430 | Takahashi | May 1980 | A |
4483562 | Schoolman | Nov 1984 | A |
4723936 | Buchbinder et al. | Feb 1988 | A |
4880015 | Nieman | Nov 1989 | A |
4945920 | Clossick | Aug 1990 | A |
5020514 | Heckele | Jun 1991 | A |
5125895 | Buchbinder et al. | Jun 1992 | A |
5171249 | Stefanchik et al. | Dec 1992 | A |
5330502 | Hassler et al. | Jul 1994 | A |
5383888 | Zvenyatsky et al. | Jan 1995 | A |
5391180 | Tovey et al. | Feb 1995 | A |
5395329 | Fleischhacker et al. | Mar 1995 | A |
5409498 | Braddock et al. | Apr 1995 | A |
5411519 | Tovey et al. | May 1995 | A |
5441499 | Fritzsch | Aug 1995 | A |
5454827 | Aust et al. | Oct 1995 | A |
5462546 | Rydell | Oct 1995 | A |
5514130 | Baker | May 1996 | A |
5514157 | Nicholas et al. | May 1996 | A |
5540685 | Parins et al. | Jul 1996 | A |
5549637 | Crainich | Aug 1996 | A |
5562682 | Oberlin et al. | Oct 1996 | A |
5582617 | Klieman et al. | Dec 1996 | A |
5607450 | Zvenyatsky et al. | Mar 1997 | A |
5609601 | Kolesa et al. | Mar 1997 | A |
5626587 | Bishop et al. | May 1997 | A |
5632432 | Schulze et al. | May 1997 | A |
5643294 | Tovey et al. | Jul 1997 | A |
5673841 | Schulze | Oct 1997 | A |
5700275 | Bell et al. | Dec 1997 | A |
5704534 | Huitema et al. | Jan 1998 | A |
5743456 | Jones et al. | Apr 1998 | A |
5766196 | Griffiths | Jun 1998 | A |
5766205 | Zvenyatsky et al. | Jun 1998 | A |
5782859 | Nicholas et al. | Jul 1998 | A |
5817119 | Klieman et al. | Oct 1998 | A |
5833695 | Yoon | Nov 1998 | A |
5865361 | Milliman et al. | Feb 1999 | A |
5915616 | Viola et al. | Jun 1999 | A |
5921956 | Grinberg et al. | Jul 1999 | A |
5931832 | Jensen | Aug 1999 | A |
5964394 | Robertson | Oct 1999 | A |
6010054 | Johnson et al. | Jan 2000 | A |
6162208 | Hipps | Dec 2000 | A |
6179809 | Khairkhahan et al. | Jan 2001 | B1 |
6202914 | Geiste et al. | Mar 2001 | B1 |
6423059 | Hanson et al. | Jul 2002 | B1 |
6500176 | Truckai et al. | Dec 2002 | B1 |
6554794 | Mueller et al. | Apr 2003 | B1 |
RE38335 | Aust et al. | Nov 2003 | E |
6669073 | Milliman et al. | Dec 2003 | B2 |
6783524 | Anderson et al. | Aug 2004 | B2 |
6978921 | Shelton et al. | Dec 2005 | B2 |
6991627 | Madhani et al. | Jan 2006 | B2 |
7004938 | Ormsby et al. | Feb 2006 | B2 |
7055731 | Shelton et al. | Jun 2006 | B2 |
7070595 | Ormsby et al. | Jul 2006 | B2 |
7081114 | Rashidi | Jul 2006 | B2 |
7087071 | Nicholas et al. | Aug 2006 | B2 |
7112201 | Truckai et al. | Sep 2006 | B2 |
7125409 | Truckai et al. | Oct 2006 | B2 |
7128254 | Shelton et al. | Oct 2006 | B2 |
7141897 | Park | Nov 2006 | B2 |
7143925 | Shelton et al. | Dec 2006 | B2 |
7150749 | Dycus et al. | Dec 2006 | B2 |
7156846 | Dycus et al. | Jan 2007 | B2 |
7159750 | Racenet et al. | Jan 2007 | B2 |
7169146 | Truckai et al. | Jan 2007 | B2 |
7186253 | Truckai et al. | Mar 2007 | B2 |
7189233 | Truckai et al. | Mar 2007 | B2 |
7208005 | Frecker et al. | Apr 2007 | B2 |
7220951 | Truckai et al. | May 2007 | B2 |
7309849 | Truckai et al. | Dec 2007 | B2 |
7311709 | Truckai et al. | Dec 2007 | B2 |
7338513 | Lee et al. | Mar 2008 | B2 |
7354440 | Truckal et al. | Apr 2008 | B2 |
7380696 | Shelton, IV et al. | Jun 2008 | B2 |
7381209 | Truckai et al. | Jun 2008 | B2 |
7404508 | Smith et al. | Jul 2008 | B2 |
7424965 | Racenet et al. | Sep 2008 | B2 |
7455208 | Wales et al. | Nov 2008 | B2 |
7481348 | Marczyk | Jan 2009 | B2 |
7494039 | Racenet et al. | Feb 2009 | B2 |
7500979 | Hueil et al. | Mar 2009 | B2 |
7506790 | Shelton, IV | Mar 2009 | B2 |
7540872 | Schechter | Jun 2009 | B2 |
7549564 | Boudreaux | Jun 2009 | B2 |
7553275 | Padget et al. | Jun 2009 | B2 |
7559450 | Wales et al. | Jul 2009 | B2 |
7584880 | Racenet et al. | Sep 2009 | B2 |
7594913 | Ormsby et al. | Sep 2009 | B2 |
7597230 | Racenet et al. | Oct 2009 | B2 |
7615044 | Scheibe et al. | Nov 2009 | B2 |
7654431 | Hueil et al. | Feb 2010 | B2 |
7658311 | Boudreaux | Feb 2010 | B2 |
7691095 | Bednarek et al. | Apr 2010 | B2 |
7703653 | Shah et al. | Apr 2010 | B2 |
7708182 | Viola | May 2010 | B2 |
7721935 | Racenet et al. | May 2010 | B2 |
7766910 | Hixson et al. | Aug 2010 | B2 |
7771425 | Dycus et al. | Aug 2010 | B2 |
7780054 | Wales | Aug 2010 | B2 |
7784662 | Wales et al. | Aug 2010 | B2 |
7793814 | Racenet et al. | Sep 2010 | B2 |
7798386 | Schall et al. | Sep 2010 | B2 |
7799028 | Schechter et al. | Sep 2010 | B2 |
7815090 | Marczyk | Oct 2010 | B2 |
7815091 | Marczyk | Oct 2010 | B2 |
7815637 | Ormsby et al. | Oct 2010 | B2 |
7819298 | Hall et al. | Oct 2010 | B2 |
7828725 | Maruyama | Nov 2010 | B2 |
7832408 | Shelton et al. | Nov 2010 | B2 |
7842025 | Coleman et al. | Nov 2010 | B2 |
7857183 | Shelton, IV | Dec 2010 | B2 |
7909220 | Viola | Mar 2011 | B2 |
8033441 | Marczyk | Oct 2011 | B2 |
8062306 | Nobis et al. | Nov 2011 | B2 |
8092451 | Schechter et al. | Jan 2012 | B2 |
8100309 | Marczyk | Jan 2012 | B2 |
8142473 | Cunningham | Mar 2012 | B2 |
8152799 | Ormsby et al. | Apr 2012 | B2 |
8161838 | Duval | Apr 2012 | B2 |
8197479 | Olson et al. | Jun 2012 | B2 |
8205619 | Shah et al. | Jun 2012 | B2 |
8236010 | Ortiz et al. | Aug 2012 | B2 |
8241320 | Lyons et al. | Aug 2012 | B2 |
8292147 | Viola | Oct 2012 | B2 |
8292889 | Cunningham et al. | Oct 2012 | B2 |
8308659 | Scheibe et al. | Nov 2012 | B2 |
8317811 | Laporte Rosello et al. | Nov 2012 | B2 |
8323239 | Bednarek et al. | Dec 2012 | B2 |
8323297 | Hinman et al. | Dec 2012 | B2 |
8353902 | Prakash | Jan 2013 | B2 |
8357161 | Mueller | Jan 2013 | B2 |
8361067 | Pellegrino et al. | Jan 2013 | B2 |
8366709 | Schechter et al. | Feb 2013 | B2 |
8372064 | Douglass et al. | Feb 2013 | B2 |
8398673 | Hinchliffe et al. | Mar 2013 | B2 |
8403832 | Cunningham et al. | Mar 2013 | B2 |
8403945 | Whitfield et al. | Mar 2013 | B2 |
8789741 | Baxter, III et al. | Jul 2014 | B2 |
9089327 | Worrell et al. | Jul 2015 | B2 |
9545253 | Worrell et al. | Jan 2017 | B2 |
9545323 | Cully | Jan 2017 | B2 |
20030163085 | Tanner et al. | Aug 2003 | A1 |
20060259071 | Nicholas et al. | Nov 2006 | A1 |
20070043353 | Dycus et al. | Feb 2007 | A1 |
20070095877 | Racenet et al. | May 2007 | A1 |
20070175961 | Shelton et al. | Aug 2007 | A1 |
20070219550 | Thompson et al. | Sep 2007 | A1 |
20070282324 | Vaska et al. | Dec 2007 | A1 |
20080161798 | Podmore et al. | Jul 2008 | A1 |
20090088792 | Hoell et al. | Apr 2009 | A1 |
20090125019 | Douglass et al. | May 2009 | A1 |
20090188965 | Levin et al. | Jul 2009 | A1 |
20090198272 | Kerver et al. | Aug 2009 | A1 |
20090283568 | Racenet et al. | Nov 2009 | A1 |
20100094289 | Taylor et al. | Apr 2010 | A1 |
20100179540 | Marczyk | Jul 2010 | A1 |
20100179545 | Twomey | Jul 2010 | A1 |
20100193566 | Scheib et al. | Aug 2010 | A1 |
20100249759 | Hinman et al. | Sep 2010 | A1 |
20100298824 | Rothstein et al. | Nov 2010 | A1 |
20110009863 | Marczyk et al. | Jan 2011 | A1 |
20110087218 | Boudreaux et al. | Apr 2011 | A1 |
20110184459 | Malkowski et al. | Jul 2011 | A1 |
20110213361 | Cunningham et al. | Sep 2011 | A1 |
20110213363 | Cunningham et al. | Sep 2011 | A1 |
20110230875 | Walberg et al. | Sep 2011 | A1 |
20110264074 | Tegg et al. | Oct 2011 | A1 |
20110282176 | Tegg | Nov 2011 | A1 |
20120074200 | Schmid et al. | Mar 2012 | A1 |
20120109186 | Parrott et al. | May 2012 | A1 |
20120143088 | Schultz | Jun 2012 | A1 |
20120179151 | Mueller | Jul 2012 | A1 |
20120203169 | Tegg | Aug 2012 | A1 |
20120215220 | Kerver et al. | Aug 2012 | A1 |
20120253326 | Kleyman | Oct 2012 | A1 |
20120265186 | Burger et al. | Oct 2012 | A1 |
20120303013 | Burell et al. | Nov 2012 | A1 |
20120316560 | Hassoun | Dec 2012 | A1 |
20130012929 | Malkowski | Jan 2013 | A1 |
20130012986 | Suzuki | Jan 2013 | A1 |
20130026868 | Klafter et al. | Jan 2013 | A1 |
20130032627 | Viola | Feb 2013 | A1 |
20130041403 | Cunningham et al. | Feb 2013 | A1 |
20130096407 | Bednarek et al. | Apr 2013 | A1 |
Number | Date | Country |
---|---|---|
1163558 | Oct 1997 | CN |
102166129 | Aug 2011 | CN |
102647949 | Aug 2012 | CN |
43 00 307 | Jul 1994 | DE |
1637086 | Mar 2006 | EP |
2151204 | Feb 2010 | EP |
2 198 787 | Jun 2010 | EP |
2 915 873 | Nov 2008 | FR |
WO 0067834 | Nov 2000 | WO |
WO 2008045348 | Apr 2008 | WO |
WO 2010104755 | Aug 2010 | WO |
WO 2011044343 | Apr 2011 | WO |
WO 2012067468 | May 2012 | WO |
WO 2012078951 | Jun 2012 | WO |
Entry |
---|
International Search Report dated Dec. 16, 2011 for Application No. PCT/US2011/052707. |
International Search Report dated Dec. 28, 2011 for Application No. PCT/US2011/052712. |
International Search Report dated Mar. 19, 2012 for Application No. PCT/US2011/053028. |
International Search Report and Written Opinion dated Jan. 24, 2012 for PCT/US2011/052734. |
U.S. Appl. No. 13/151,481, filed Jun. 2, 2011, Yates et al. |
U.S. Appl. No. 13/235,648, filed Sep. 19, 2011, Worrell et al. |
U.S. Appl. No. 13/235,660, filed Sep. 19, 2011, Worrell et al. |
U.S. Appl. No. 13/235,683, filed Sep. 19, 2011, Worrell et al. |
International Search Report dated Jan. 30, 2014 for Application No. PCT/US2013/060537. |
International Search Report dated Jan. 31, 2014 for Application No. PCT/US2013/060536. |
Restriction Requirement dated Sep. 4, 2014 for U.S. Appl. No. 13/235,648. |
Office Action Non Final dated Sep. 5, 2014 for U.S. Appl. No. 13/622,729. |
U.S. Appl. No. 61/410,603, filed Nov. 5, 2010. |
Australian Examiner's Report dated Aug. 15, 2013 for Application No. AU 2011305198, 5 pages. |
Australian Examiner's Report dated Aug. 14, 2013 for Application No. AU 2011305205, 4 pages. |
Australian Examiner's Report dated Aug. 8, 2013 for Application No. AU 2011305397, 5 pages. |
Chinese First Office Action dated Dec. 17, 2014 for Application No. CN 2011800460673, 13 pages. |
International Written Opinion dated Dec. 16, 2011 for Application No. PCT/US2011/052707, 7 pages. |
International Written Opinion dated Dec. 28, 2011 for Application No. PCT/US2011/052712, 8 pages. |
International Written Opinion dated Jun. 13, 2012 for Application No. PCT/US2011/053016, 8 pages. |
International Written Opinion dated Mar. 19, 2012 for Application No. PCT/US2011/053028, 7 pages. |
International Written Opinion dated Jan. 31, 2014 for Application No. PCT/US2013/060536, 5 pages. |
International Written Opinion dated Jan. 30, 2014 for Application No. PCT/US2013/060537, 5 pages. |
U.S. Office Action, Notice of Allowance, dated Dec. 17, 2014 for U.S. Appl. No. 13/622,729, 5 pages. |
U.S. Office Action, Non-Final, dated Dec. 19, 2014 for U.S. Appl. No. 13/622,735, 7 pages. |
Abstract and Machine Translation of German Patent No. DE 43 00 307. |
Abstract and Machine Translation of French Patent No. FR 2 915 873. |
U.S. Appl. No. 13/241,629. |
Australian Examiner's Report dated May 28, 2015 for Application No. AU 2011305395, 4 pages. |
Chinese First Office Action dated Dec. 8, 2014 for Application No. CN 2011800460565, 9 pages. |
Chinese Second Office Action dated Sep. 1, 2015 for Application No. CN 2011800460565, 16 pages. |
Chinese Third Office Action dated Feb. 1, 2016 for Application No. CN 2011800460565, 3 pages. |
Chinese First Office Action dated Dec. 29, 2014 for Application No. CN 2011800460599, 15 pages. |
Chinese Second Office Action dated Sep. 8, 2015 for Application No. CN 2011800460599, 5 pages. |
Chinese Third Office Action dated Mar. 22, 2016 for Application No. CN 2011800460599, 5 pages. |
Chinese First Office Action dated Feb. 4, 2015 for Application No. CN 2011800460654, 11 pages. |
Chinese Second Office Action dated Oct. 10, 2015 for Application No. CN 2011800460654, 6 pages. |
Japanese Office Action, Notification of Reasons for Refusal, dated Jun. 23, 2015 for Application No. JP 2013-530302, 4 pages. |
Japanese Office Action, Notification of Reasons for Refusal, dated Jun. 9, 2015 for Application No. JP 2013-530303, 5 pages. |
Japanese Office Action, Notification of Reasons for Refusal, dated Jun. 23, 2015 for Application No. JP 2013-530363, 4 pages. |
Japanese Office Action, Notification of Reasons for Refusal, dated Jun. 23, 2015 for Application No. JP 2013-530365, 4 pages. |
Russian Office Action dated Jul. 1, 2015 for Application No. 2013118706, 5 pages. |
U.S. Office Action, Non-Final, dated Mar. 5, 2015 for U.S. Appl. No. 13/235,648, 11 pages. |
U.S. Office Action, Final, dated Oct. 1, 2015 for U.S. Appl. No. 13/235,648, 14 pages. |
U.S. Office Action, Non-Final, dated Oct. 6, 2016 for U.S. Appl. No. 13/235,648, 14 pages. |
U.S. Office Action, Notice of Allowance, dated Mar. 2, 2015 for U.S. Appl. No. 13/622,729, 5 pages. |
U.S. Office Action, Notice of Allowance, dated Apr. 14, 2016 for U.S. Appl. No. 13/622,735, 5 pages. |
International Search Report dated Jun. 13, 2012 for Application No. PCT/US2011/053016. |
Chinese Office Action dated Oct. 10, 2016 for Application No. CN 201380048783.4, 7 pgs. |
Chinese Office Action dated Oct. 10, 2016 for Application No. CN 201380048566.5, 11 pgs. |
U.S. Appl. No. 61/386,094, filed Sep. 24, 2010. |
U.S. Appl. No. 13/235,648. |
U.S. Appl. No. 13/622,729. |
U.S. Appl. No. 13/622,735. |
Canadian Office Action dated Jun. 16, 2017 for Application No. CA 2,811,337, 6 pgs. |
Canadian Office Action dated Jul. 7, 2017 for Application No. CA 2,812,146, 4 pgs. |
Number | Date | Country | |
---|---|---|---|
20120078243 A1 | Mar 2012 | US |
Number | Date | Country | |
---|---|---|---|
61386094 | Sep 2010 | US |