Aspects of the present invention relate to surgical instruments including those used for minimally invasive and for open procedures. The instruments may include features that enable them to be used in conjunction with monopolar and/or bipolar electrosurgical energy sources. In particular, but not by way of limitation, aspects of the present invention relate to a grasper for attachment to and use with surgical instrument assemblies.
Surgical tools employing jaws with substantially parallel faces allow a user to apply a more uniform grasping pressure across tissue than with conventional (angular motion) graspers. The geometry of angular motion graspers causes the base of the jaws to compress tissue much tighter than the tips of the jaws, for a given handle force applied, due to the difference in distance from the fulcrum. When grasper jaws are partially open, angular motion jaws have a much larger space between jaws at the tip than at the base of the jaw, while a parallel jaw has the same width between the base of the jaw and the tip of jaw no matter what distance the jaws are apart. Therefore, if the jaws are full of tissue the parallel jaws would compress the tissue uniformly along its entire length while the angular motion jaws would compress the tissue at the base much more than at the tip.
The uniform distance between jaws in a parallel arrangement allows the user to have a more controlled manipulation of tissue. Depth perception and alignment of tissue with respect to the jaws is a lesser problem because the jaws are the same distance from each other along their entire length. The uniform distance and motion of parallel jaws eliminates any component of a force vector that would push tissue out of the jaws distally during closing. A parallel jaw design also allows for a more uniform coagulation of vessels because of the uniform compression of tissue between the jaws. For a given separation distance at the jaw tips, larger volumes of tissue may be grasped compared to an angular motion grasper.
A parallel jaw grasper will be less likely to become fouled with tissue from a prior coagulation when several coagulations are being performed in a sequence. This is because the jaws can be separated along their full length allowing tissue to be removed from one jaw using a second instrument (or by simply falling away). A conventional instrument tends to create a possibility for small amounts of tissue to become lodged near the proximal end of the jaw area.
However, there are also benefits to grasper configurations with an angular displacement of the jaws at the end of the opening motion. This allows the parallel jaws to get the tips much wider than is possible with a purely parallel motion. The angular displacement of the jaws allows effective grasping of tissue.
It would be beneficial to have a device that is capable of both parallel movement and angular movement in order to take advantage of the benefits associated with both configurations. For example, by adding an angular movement towards the end of the instrument motion, the jaws will more likely fit within a smaller trocar cannula but still open very wide at the tip to aid with dissection and get around larger tissue areas for grasping.
In accordance with one aspect a surgical instrument comprises an end effector, the end effector including opposing faces and adapted to perform a grasping motion, and an actuation mechanism engaged with the end effector. The opposing faces of the end effector are maintained in a substantially parallel manner for at least a first portion of the grasping motion, and the opposing faces of the end effector are maintained in a substantially angular manner for at least a second portion of the grasping motion.
In accordance with one aspect a surgical instrument comprises an end effector, the end effector including opposing faces and a positioning slot, the positioning slot including a linear portion and a radial portion. In accordance with other aspects the surgical instrument further comprises an actuation mechanism engaged with the positioning slot wherein the opposing faces of the end effector move in a parallel manner when the actuation mechanism moves within the linear portion of the positioning slot, and wherein the opposing faces of the end effector move in an angular manner when the actuation mechanism moves within the radial portion of the positioning slot.
In accordance with another aspect, a surgical instrument comprises a housing, an actuation rod extending through the housing, a jaw member, the jaw member including a positioning slot, the positioning slot including a linear portion and an radial portion. In accordance with other aspects, the surgical instrument further comprises an actuation link having a proximal end and a distal end, the proximal end of the actuation link coupled with the actuation rod, a pivot link having a proximal end and a distal end, the proximal end of the pivot link coupled with distal end of the actuation link, the distal end of the pivot link coupled with the jaw member, wherein the proximal end of the pivot link and the distal end of the actuation link are slidably engaged within the positioning slot.
In accordance with another aspect, a surgical instrument actuation device comprises an end effector, the end effector including a positioning slot, the positioning slot including a linear portion and a radial portion. The surgical instrument also includes an actuation link having a proximal end and a distal end, the proximal end of the actuation link coupled with an actuator of the surgical tool and a pivot link having a proximal end and a distal end, the proximal end of the pivot link coupled with distal end of the actuation link, the distal end of the pivot link coupled with the end effector. The proximal end of the pivot link and the distal end of the actuation link are slidably engaged with the positioning slot.
In accordance with another aspect, a surgical instrument, comprises a housing, the housing including a positioning slot, the positioning slot including a linear portion and a radial portion. The surgical instrument also includes an actuation rod, an end effector, the end effector including a cam portion, and an actuation link having a proximal end and a distal end, the proximal end of the actuation link coupled with the actuation rod, the distal end of the actuation link coupled with the end effector. The cam portion of the end effector is slidably engaged within the positioning slot.
Other aspects are disclosed herein and will become apparent to one of skill in the art when considered in conjunction with the drawings and description herein.
Various objects and advantages and a more complete understanding of the present invention are apparent and more readily appreciated by reference to the following Detailed Description and to the appended claims when taken in conjunction with the accompanying Drawings, wherein:
The following figures and associated descriptions present several possible embodiments of various aspects of a device constructed in accordance with the present invention. However, it is not intended that the scope of the invention be limited by reference to any of the examples disclosed herein. Any reference to “the invention” is not meant to be limiting to the claims and all embodiments disclosed herein are meant to be representative of devices, methods, and other structure that are within the broad spirit and scope of the aspects disclosed.
In accordance with one aspect of a device constructed in accordance with the present invention, a surgical grasper tool or instrument is disclosed in which the opposing jaw faces move substantially parallel to each other for at least a portion of the grasping motion. During another portion of the instrument motion, the jaws move with a substantially angular displacement. When closed, the jaws are essentially and functionally parallel. When the jaws begin to open, they remain parallel for the main part of the motion. Then, towards a fully open position, the jaws change their motion to achieve an angular displacement as opposed to a linear displacement. In general, this allows a surgeon to have parallel motion for the main part of the grasping technique, but also allows the jaws to open wider at the tip to grasp more material.
The motion of the jaws (or other surgical end effector tools) can be accomplished in a variety of ways as described in conjunction with the Figures. For example,
Proximate to its distal end 106 the housing 102 couples with a fulcrum pin 140 as described in more detail below. An activation rod 110 extends through the housing 102 and couples at pin 146 with a device activation mechanism located partly within the housing 102. A proximal end 112 of the activation rod 110 is designed to extend through the handle assembly 111 in order for a user to easily activate and control the surgical tool 100, and more particularly, the opening and closing of jaws 122a and 122b. As described in more detail below, one or more sets of links, cams, and/or other mechanisms engage with the activation rod 110. In concert with the linear movement of the activation rod, the various types of mechanisms cause the parallel and/or angular movement of the grasper jaws or other end effectors located on the distal end of the tool 100.
In
Connecting the actuation rod 110 and housing 102 to the grasper jaws 120 (e.g. the mounting portions 124a and 124b) are the pair of actuation links 132 and the pair of pivot links 130. The actuation links 132 include a proximal rotation point 146 that engages with the actuation rod 110 via a known connector such as a pin, hinge, pivot, etc. At a distal end of the actuation links 132 a pair of connectors 144a and 144b engage the actuation links with both the slots 126a and 126b as well as provide a proximal rotation point for the pair of pivot links 130. A distal end of the pivot links 130 includes a further pair of connectors 142a and 142b that engage with the mounting portions 124a and 124b of the grasper jaws 120. A fulcrum point 140 connects the pivot links together and also connects the pivot links with the housing 102.
Beginning with
It will be appreciated that the shape of the slots 126a and 126b will substantially dictate the movement of the grasper jaws and the attribution of both parallel movement and angular movement. Thus, a device can be designed with a very specific series of grasper jaw movements based on the shape of the slots 126a and 126b.
In
In
In
As shown in
Finally, in
The examples shown in connection with
Each of the rotation points described in connection with the previous embodiments (e.g. 142, 144, 146 and 140) may also be constructed of anything that provides for rotation such as rivets, pins, bearings, living hinges, etc. As long as the connection points are allowed to rotate, the design will function as described above. For the connection points 142 and 144, the same rotatable criteria exists but the connection mechanism must also be able to slide within the confines of slots 126a and 126b.
In accordance with another embodiment, the same type of combined parallel and angular movement between the faces of an end effector tool (for example, a grasper) can be achieved with a cam system as described below. With reference to
The pair of generally opposing grasper jaws 320 is engaged with the actuation rod 310 via a pair of actuation links 332 and a pair of cams 315 and 317 on mounting portions 307 and 309 of the grasper jaw structure. The grasper jaws 320 do not have any specific configuration as the instrument 300 is contemplated to be of such a general configuration as to work with any known end effector such as graspers, scissors, and any other known surgical end effector tool. In the embodiment shown in
Connecting the actuation rod 310 and housing 302 to the grasper jaws 320 (e.g. the mounting portions 324a and 324b) are a pair of actuation links 332 and a pair of cams 307 and 309. The actuation links 332 include a proximal rotation point 346 that engages with the actuation rod 310 via a connector such as a pin, hinge, pivot, or other rotatable structure. At a distal end of the actuation links 332 are another pair of connectors 342 and 344 that engage the cams 315 and 317. Pins or another structure engage the cams 315 and 317 with the cam guide channels 311 and 313 on the housing 302.
Similar to the embodiment described in conjunction with
Turning again to the embodiment shown in connection with
As shown in
If the pivot links are not sized as described above for parallel motion then the movement of the jaws will not be parallel. Instead the jaws will move up and down but will also include an angle between the faces. As can be appreciated, many different combinations of these linkages and the slot/distal rotation points can be used to create the same effect of parallel jaw motion.
In another embodiment that may be implemented with any of the foregoing examples, it is contemplated that the opposing faces of the end effector do not both need to move during the actuation of the device. For example, one of the end effector faces, or jaws, may be fixed so that a single action device is created. The opposing faces of the end effector may still be adapted to be maintained in a generally parallel orientation during a first part of the grasping motion, and maintained in a substantially angular orientation for at least a second portion of the grasping motion.
Those skilled in the art can readily recognize that numerous variations and substitutions may be made in the invention, its use, and its configuration to achieve substantially the same results as achieved by the embodiments described herein. Accordingly, there is no intention to limit the invention to the disclosed embodiments. Many variations, modifications and alternative constructions fall within the scope and spirit of the disclosed invention as expressed in the claims.
For example aspects of the invention relate to the orientation and capabilities of the jaws and allow a user to apply a more uniform grasping pressure across tissue than conventional (purely angular motion) graspers. With angular motion graspers, the base of the jaws squeeze much tighter than the tips of the jaws due to the difference in distance between the jaws when open at some angular displacement.
Easier visualization and depth perception—The uniform distance between the jaws allows a user to have a more controlled manipulation of tissue; that is, alignment of the tissue in the jaws and depth perception of where the tissue is sitting in the jaws is not an issue. The jaws are the same distance from each other along their entire length.
Uniform heating effect—Devices constructed in accordance with aspects disclosed herein allow for a more uniform coagulation of vessels because of the uniform distance between the jaws and because of uniform compression leading to uniform current density.
Grasping larger volumes of tissue—Along with the more controlled manipulation is the ability to grasp larger volumes of tissue between the jaws when they are open the same distance.
Larger jaw opening—The angular displacement of the jaws (at the end of the opening motion) allows the parallel jaws to get the tips much wider than is possible with a simple parallel motion. This is due to the linkage involved in the parallel motion. The more the jaws open, the longer the linkage has to be and thus the larger the trocar cannula the instrument would have to fit into. By adding this angular movement towards the end of the instrument motion, the jaws can now fit within a smaller trocar cannula but still open very wide at the tip to aid with dissection and get around larger tissue areas for grasping. It is at the end of the opening motion that the jaws become significantly non-parallel with the tips opening angularly. Thus, whenever the tissue is fully grasped and in condition for the power to be applied, the jaws have become functionally parallel even though they might be slightly non-parallel.
A parallel jaw grasper will be less likely to become fouled with tissue from a prior coagulation when several coagulations are being performed in a sequence. This is because the jaws can be separated along their full length allowing tissue to be removed from one jaw using a second instrument (or by simply falling away). A conventional instrument tends to create a possibility for small amounts of tissue to become lodged near the proximal end of the jaw area.
Those skilled in the art can readily recognize that numerous variations and substitutions may be made in the invention, its use and its configuration to achieve substantially the same results as achieved by the embodiments described herein. Accordingly, there is no intention to limit the invention to the disclosed exemplary forms. Many variations, modifications and alternative constructions fall within the scope and spirit of the disclosed invention as expressed in the claims.
This application claims the benefit of Provisional U.S. Application No. 61/055,064 filed on May 21, 2008. The details of Application No. 61/055,064 are incorporated by reference into the present application in its entirety and for all purposes.
Number | Name | Date | Kind |
---|---|---|---|
5301533 | Jackson | Apr 1994 | A |
5752973 | Kieturakis | May 1998 | A |
6582451 | Marucci et al. | Jun 2003 | B1 |
7032944 | Moilanen et al. | Apr 2006 | B2 |
20050165429 | Douglas et al. | Jul 2005 | A1 |
Number | Date | Country | |
---|---|---|---|
61055064 | May 2008 | US |