1. Field of the Invention
The invention relates to surgical scissors instruments and, more particularly, to endoscopic scissor instruments having small-sized scissor blades.
2. State of the Art
Endoscopy is a minimally invasive diagnostic medical procedure that is used to assess the interior of the human body using an endoscope. An endoscope generally consists of a rigid or flexible tube, an fiber optic illumination system to guide light provided by a light source through the tube of the endoscope in order to illuminate the organ or object under inspection, and a viewing system for collecting an image of the organ or object under inspection and for recording the image on an internal CCD device (video-endoscope) or for transmitting the image through the tube via a fiber optic bundle to an external video processor for viewing (fiber-endoscope). The endoscope can include one or more “operating” channels (typically 2-4 mm in diameter) that provide for passage of specialized medical instruments through the endoscope and into the field of view. Such specialized instruments (which can include biopsy forceps, brushes, needles, snares, scissors, graspers, cutters, clip appliers, etc.) can be used to take biopsies and retrieve organs (or pieces thereof) and/or foreign objects from the inside of the body. In all flexible endoscopes the distal end (4″-8″) is remotely steerable by the operator turning knobs on the back-end of the endoscope. This enables general direction control of the scope and any accessory instrument that may be in its working channel. In some instruments (especially those with lateral-viewing optics), the distal tip of the operating channel incorporates a small deflectable elevator or bridge, which permits some directional control over the instrument exiting therefrom. These general principles apply to most endoscopes, but specific instruments differ in length, size, stiffness, as well as other characteristics as the instruments are typically designed for a particular application. Endoscopy can involve, for example, the gastrointestinal tract such as the esophagus, stomach and duodenum, small intestine, and colon. It can also involve the respiratory tract, the urinary tract, the female reproductive system, and the organs of the chest. It can also involve the interior of a joint (arthroscopy). Many endoscopic procedures are considered to be relatively painless and, at worst, associated with moderate discomfort.
Laparoscopy is a minimally invasive surgical technique in which operations in the abdomen or thorax are performed through small incisions (usually 0.5-1.5 cm) via a laparoscope. There are generally two types of laparoscopes, including a telescopic rod lens system that is usually connected to a video camera (single chip or three chip) and a digital laparoscope where the camera is placed at the end of the laparoscope, thus eliminating the rod lens system. A fiber optic cable system connected to a light source (halogen or xenon) is inserted through a surgical port to illuminate the operative field for viewing. The abdomen is usually insufflated with carbon dioxide gas to create a working and viewing space. Specialized surgical instruments can be introduced into the abdomen or thorax through a surgical port in order to take biopsies and retrieve organs (or pieces thereof) and/or foreign objects from the inside of the body.
The specialized surgical instruments used for endoscopy, laparoscopy or arthroscopy generally include end effector means (e.g., graspers, cutters, forceps, scissors, clip appliers, etc.) mounted adjacent the distal end of a tube or coil. Handles (or other actuation control means) are mounted to the proximal end of the tube or coil and move an actuator axially through the tube or coil. The distal end of the actuator is mechanically coupled to the end effector means in a manner that transforms the axial movement of the actuator into the desired movement of the end effector means. Such specialized endoscopic, laparoscopic or arthroscopic surgical instruments are collectively referred to herein as endoscopic surgical instruments or endoscopic instruments. These general principles apply to most endoscopic instruments, but specific endoscopic instruments differ in length, size, stiffness, as well as other characteristics as the instruments are typically designed for a particular application as such instruments can be used for a wide variety of minimally invasive surgical procedures, including the endoscopic, laparoscopic and arthroscopic applications summarized above.
Endoscopic surgical scissors instruments generally include a pair of scissor blades pivotably mounted adjacent the distal end of a tube or coil. The scissor blades have sharpened edges that effect cutting of tissue during pivotal movement of the scissor blades relative to one another. Handles (or other actuation control means) are mounted to the proximal end of the tube or coil and move an actuator axially through the tube or coil. The distal end of the actuator is mechanically coupled to the scissor blades in a manner that transforms the axial movement of the actuator into pivoting movement of the scissor blades.
Endoscopic scissors instruments may be generally classified as either “single acting” or “double acting.” In a single acting instrument, a stationary scissor blade is supported adjacent the distal end of the tube or coil and a movable scissor blade is coupled to the distal end of the actuator and is supported adjacent the distal end of the tube or coil for rotation relative to the stationary scissor blade in accordance with actuation transmitted by the actuator. In double acting instruments, two scissor blades are coupled to the distal end of the actuator and supported adjacent the distal end of the tube or coil for rotation relative to one another in accordance with actuation transmitted by the actuator.
The construction of the scissor blades theoretically supplies a moving contact point between the opposing cutting edges as the scissor blades are closed by their pivotable movement. In order to effect a smooth cutting action, the engaging cutting edges must be kept in a moving contact point throughout the closing of the scissor blades. Typical scissor designs usually accomplish this by the use of any of the following methods: firstly, via a rigid mechanism or feature that biases the scissor blades together as the scissor blades are closed; secondly, by dimensioning the blades with a longitudinally bowed profile that forces the opposed scissor blades against each other as the scissor blades are closed and lastly by a very accurately constructed assembly with no mechanical slop in the dimensions of, or the positioning of, the scissors' blades or related components
The rigid biasing means of the first example typically is accomplished by tightening the scissors' pivot nut to remove all dimensional slop in the assembly or with a rigid cammed surface behind the pivot area that effects biasing of the scissor blades closer together as they close over each other. In the second method, which is used most commonly for larger or longer scissor blades, such as those in a standard full-sized scissor as used in regular “open” surgery, a bowed-profile that runs along the longitudinal axis of the scissor blade forces the cutting edges together. This method gives a mostly adequate cutting performance for open style surgical scissors. However for smaller scissor blades such as those used in endoscopic devices, the total loss of resiliency, due to the stiffness of small blades, means that a bowed profile in the scissor blade will not work and will only result in the contacting cutting edges gouging each other or quickly wearing away. Therefore in the currently available endoscopic scissor devices such small non-resilient and rigid blades must be designed to maintain the edge to edge contact through the use of components with very stringent dimensional accuracies, tight tolerances and tight fits. This last design method involves difficult and costly assembly and manufacturing processes. In addition, the effects of using rigid cams or similar features of the prior art in the design of small endoscopic scissors is limited by the remoteness of the cam surface from the cutting edges and because of persistent assembly “slop” offers little improvement to the problem of maintaining edge to edge contact. These design schemes have historically failed to give small surgical scissor instruments the desired sensitive feel and cutting performance that surgeons require and are familiar with through their experience in open surgery using larger hand-held surgical scissors.
The invention provides an endoscopic scissors instrument with small-size scissor blades with improved cutting performance through an improved biasing means whereby features contained in and as part of the blade itself automatically provide a preload to its cutting edge as two scissor blades move past one another.
In another aspect, the invention provides an endoscopic scissors with small size scissor blades with improved cutting performance through an improved biasing means whereby features of the clevis provide preload to the cutting edges as the two scissor bladed move past one another.
The invention also provides such an endoscopic scissors instrument that avoids inherently expensive components, assembly and manufacturing processes.
According to the invention, an endoscopic scissors instrument includes an elongate hollow member having a proximal end and a distal end, an actuator that moves axially through the hollow member, and first and second scissor blades with respective cutting edges. At least one of the first and second scissor blades are rotatably coupled to the hollow member adjacent its distal end. At least one of the first and second scissor blades includes a base supporting a resilient leaf-spring portion that defines a respective cutting edge. The resilient leaf-spring portion extends from the base in a cantilevered arrangement along the length of the base. The cantilevered leaf-spring arrangement and angling of the leaf-spring portion serves to generate a spring force acting on the respective cutting edge such that, when in a loaded state, there is an automatic preloading force imparted between the cutting edges of the scissors' blades that maintains a consistent and continuous mating force between the two opposed sharpened cutting edges, preferably over the complete range of rotational movement of the scissor.
In another aspect of the invention, an endoscopic scissors instrument includes an elongate hollow member having a proximal end and a distal end, an actuator that moves axially through the hollow member, and first and second scissor blades rotatably mounted in a clevis adjacent the distal end of the hollow member. The first and second scissor blades each have a respective distal feature that defines a cutting edge. The distal features of the first and second scissor blades are longitudinally angled to ensure that the cutting edges are in intersection planes as the cutting edges contact one another during rotational movement of the scissor blades relative to one another. The clevis includes a pivot mechanism and spring bias means, disposed adjacent the pivot mechanism on at least one external side of the first and second scissor blades, for biasing transverse movement of the scissor blades toward one another. The spring bias means of the clevis and the angling of the distal features of the scissor blades serves to generate spring forces acting on the respective cutting edge such that, when in a loaded state, there is an automatic preloading force imparted between the cutting edges of the scissors' blades that maintains a consistent and continuous mating force between the two opposed cutting edges, preferably over the complete range of rotational movement of the scissor.
In one embodiment, the spring bias means comprises at least one leaf spring arm that is rigidly secured to a hub proximally disposed from the pivot mechanism. The at least one leaf spring extends generally parallel the longitudinal axis of the clevis and has a thru-hole coaxially aligned with thru-holes of the first and second scissor blades for receiving the pivot mechanism. The spring bias means can further comprise a tension spring that surrounds the pivot mechanism.
In another embodiment, the spring bias means comprises at least one spring washer that is coaxially aligned with thru-holes of the first and second scissor blades and receives said pivot mechanism. In this configuration, the spring washer is disposed between a pivot support feature and one of the first and second scissor blades.
In another embodiment, the spring bias means comprises at least one leaf spring with a thru-hole that is coaxially aligned with thru-holes of the first and second scissor blades for receiving the pivot mechanism. In this configuration, the leaf spring is disposed between a pivot support feature and one of the first and second scissor blades.
It will be appreciated that the endoscopic scissor instruments of the present invention provides improved edge to edge preload of the opposed scissor blades and thus enables superior cutting quality and operator feel for endoscopic scissor instruments where historically it has not been available.
Additional advantages of the invention will become apparent to those skilled in the art upon reference to the detailed description taken in conjunction with the provided figures.
For purposes herein, the “distal end” of a surgical instrument or any part thereof, is the end most distant from the surgeon and closest to the surgical site, while the “proximal end” of the instrument or any part thereof, is the end most proximate the surgeon and farthest from the surgical site.
Turning now to
In the illustrative embodiment, the handle assembly 123 includes a movable front handle 135 and a fixed rear handle 137. The front handle 135 has an aperture 139 defined therethrough which enables a user to grasp and move the front handle 137 relative to the rear handle 137. More particularly, front handle 135 is selectively moveable by the user from a first position offset from the rear handle 137 to a second position in closer proximity to the rear handle 137. Such movement is transmitted to axial movement of the push rod actuator 50 extending through the hollow tubular member 125 in order to impart pivotal movement of the scissor blades 131, 133 relative to one another. A control wheel 141 can be supported within the housing 121 and extend through sidewalls of the housing 121 to allow the user to rotate together the hollow tubular member 125, the clevis 127 and the scissor blades 131, 133 mounted thereto or to rotate the clevis 127 and the scissor blades 131, 133 independently of and separately from, the hollow tubular member 125.
As shown in
As shown in
As best shown in the cross-section of
It is also contemplated that the distal portion 221 of the cutting feature 203 of the respective blades 131, 133 can extend beyond the distal end 223 of the base 201 of the respective blades as illustrated in
The cantilever spring arrangement and positional bias of the cutting features 203 ensure that the cutting edges 151, 153 of the two blades 131, 133 are in intersecting planes as the blades 131, 133 are closed. In the preferred embodiment as illustrated in
In the preferred embodiment, the blade support 201 of the respective blade has a thickness between 0.25 mm and 5 mm, while the cutting feature 203 of the respective blade has a thickness between 0.05 mm and 0.5 mm and a length less than 50 mm and preferably a the range between 5 mm and 20 mm.
Advantageously, the endoscopic scissor instrument of
In another aspect of the invention, the clevis of the endoscopic instrument of
In an exemplary embodiment illustrated in
As best shown in the cross-sectional views of
The clevis 301 includes exterior leaf-spring arms 329, 331 that are disposed opposite one another and extend longitudinally with the scissor blade proximal portions disposed therebetween. The proximal ends of the leaf-spring arms 329, 331 are rigidly secured to a hub member 333. The hub member 333 has an internal channel 335 that provides for passage of the actuator 325 therethrough. The distal ends 337, 339 of the leaf-spring arms 329, 331 act as cantilever springs that resiliently deflect towards or away from one another under loading conditions brought about through the opening or closing of the scissors. The distal ends have respective thru-holes 341, 343 that are coaxial with the pivot holes 317, 319 of the scissor blades 303, 305 in order to receive the pivot screw 307 therethrough.
The body of pivot screw 307 is surrounded by a tension spring 345. One end of the tension spring 345 is welded to or otherwise secured to one of the leaf-spring arms (331). The other end of the tension spring 345 interfaces to radially-extending thread-like facets 347 of the pivot screw 307 as best shown in
During rotational movement of the two scissor blades relative to one another about the pivot screw 307 (more particularly, during rotational movement from the open configuration (
In another exemplary embodiment illustrated in
As best shown in the cross-sectional view of
The clevis 301′ includes a hub 333′ with arms 329′, 331′ that extend distally therefrom. The arms 329′, 331′ are disposed opposite one another and extend longitudinally with the scissor blade proximal portions disposed therebetween. The hub member 333′ has an internal channel 335′ that provides for passage of the actuator 325 therethrough. The arms 329′, 331′ are substantially rigid in nature such that there is minimal deflection of the distal ends 337′, 339′ relative to one another under loading conditions. The distal ends 337′, 339′ have respective thru-holes 341, 343 that are coaxial with the openings 317, 319 of the scissor blades 303, 305 in order to receive the pivot screw 307 therethrough.
The body of the pivot screw 307 supports spring washers (in the exemplary embodiment, two spring washers 351, 353) disposed on opposite exterior sides of the scissor blades 303, 305 as shown in
During rotational movement of the two scissor blades relative to one another about the pivot screw 307 (more particularly, during rotational movement from the open configuration to the fully-closed configuration), the angled profiles of the distal features 309, 311 of the opposed scissor blades 303, 305 causes the scissor blades 303, 305 to move away from one another in the transverse direction (i.e., the direction orthogonal to the longitudinal direction of the two blades). Such transverse movement is transmitted to the spring washers 351, 353 via the contact interface therebetween, resulting in compression of the spring washers 351, 353. In response to such compression, the spring washers 351, 353 impart elastic forces that counteract the transverse movement of the scissor blades 303, 305 to ensure mating contact of the cutting edges 313, 315 of the opposed scissor blades. In this manner, the spring washers 351, 353 provide spring moments that are primarily directed inward along the transverse direction. During rotational movement from the fully-closed configuration to the open configuration, the spring washers 351, 353 impart elastic forces that cause transverse movement of the scissor blades 303, 305 toward one another to ensure mating contact of the cutting edges 313, 315 of the opposed scissor blades. In the preferred embodiment, the elastic forces imparted by the spring washers 351, 353 are constant during the full range of rotational movement of the scissor blades relative to one another, which maintains a consistent and continuous forceful contact of the cutting edges 313, 315 over the complete range of rotational movement of the scissor blades 303, 305.
In yet another exemplary embodiment, the spring washers of the endoscopic scissors instrument of
There have been described and illustrated herein scissors instruments with improved scissor blades. While particular embodiments of the invention have been described, it is not intended that the invention be limited thereto, as it is intended that the invention be as broad in scope as the art will allow and that the specification be read likewise. Thus, while the surgical scissors instrument illustrated herein for exemplary purposes were double acting scissors where both blades pivot relative to each other, it will be recognized that the invention can be applied to a single acting scissors with one blade fixed and the other blade pivoting relative to the fixed blade. It may also be applied to a scissors where only one blade incorporates the present invention coupled with a standard rigid opposing blade. Also, while particular actuation mechanisms were described for causing the rotation of the scissor blades, it will be appreciated that other mechanism could be utilized. Thus, for example, the instrument could be a flexible instrument with an outer tube formed from a coiled element which could be used through an endoscope channel or a rigid instrument with a relatively stiff outer tube of structural plastic or tubular metal which could be used through a laparoscope or arthroscope. In addition, while particular materials and dimensions have been disclosed for the scissor blades of the endoscopic scissors instruments, it will be understood that other materials and dimensions can be used. Moreover, while a particular unitary configuration of the respective scissor blades is shown, other non-unitary configurations can be used. For example, it is contemplated that the cutting features of the respective blades can be a separate and distinct part that is secured to the blade support of the scissor blade by welding (e.g., by laser welding, spot welding, resistance welding), one or more screws or rivets, or other suitable mechanical fixation means. In this configuration, the blade support can be realized from a wide range of materials, such as a stainless steel, plastics, ceramics, etc. It will therefore be appreciated by those skilled in the art that yet other modifications could be made to the provided invention without deviating from its spirit and scope as so claimed.
This application claims priority from U.S. patent application Ser. No. 12/335,656 filed on Dec. 16, 2008 which is hereby incorporated by reference in its entirety.