Patent Application
20140277108
Implementations of the present invention relate to surgical instruments and methods of grasping multiple locations on an organ or tissue during surgical procedures.
During a surgical procedure, a surgeon may need to manipulate an organ or tissue. Surgeons may utilize a grasper to access or manipulate the organ or tissue, such as the instrument described in U.S. Pat. No. 5,402,342, which is herein incorporated by reference. However, known grasping instruments only provide one grasper per instrument. Therefore, surgeons have had to use two or more instruments to grasp the organ or tissue in two different locations to manipulate the organ or tissue with sufficient dexterity. One instrument may be manipulated by the surgeon, but the other instrument is typically manipulated by an assistant while the surgeon uses his or her other hand to perform a surgical procedure. One drawback to using two or more instruments is that each instrument requires its own incision. Another drawback is that the surgeon has to communicate with the assistant to coordinate the movements of each instrument in manipulating the organ or tissue.
Accordingly, an improved surgical instrument and method are needed to provide improved manipulation of organs or tissues within the body during surgery and to reduce the number of incisions required.
According to various implementations, a surgical instrument is provided that has two graspers for remotely grasping an organ or tissue in two different locations. The surgeon can manipulate the organ or tissue using the instrument with one hand while using his or her other hand to perform a surgical procedure. Using one instrument also reduces the number of incisions required. This instrument is especially useful in laproscopic procedures and other minimally invasive surgeries.
In particular, a surgical instrument according to various implementations includes a handle configured for being held in one hand, an elongated portion extending from the handle substantially along an axis, a first pair of cooperating end effectors operatively disposed adjacent a distal end of the elongated portion, and a second pair of cooperating end effectors operatively disposed adjacent the distal end of the elongated portion. The handle includes an extension mechanism and a linear extension mechanism. The extension mechanism is configured for extending distal ends of the first pair of cooperating end effectors outwardly from the distal end of the elongated portion and laterally relative to the axis. The linear extension mechanism is configured for urging distal ends of the second pair of cooperating end effectors outwardly from the distal end of the elongated portion and substantially parallel to the axis. The instrument may also include a locking mechanism configured for preventing movement of the distal ends of the first cooperating pair of end effectors relative to each other.
In one implementation in which the end effectors are graspers, the second pair of graspers may include first and second leaflets that are made of a spring-like material. The first and second leaflets may include distal ends that are biased away from each other and proximate ends opposite the distal ends that are held in a fixed position relative to each other. In addition, each leaflet may define a serrated surface that substantially mates with the serrated surface of the opposing leaflet when the leaflets are compressed toward each other.
The linear extension mechanism may include a push rod that has a proximate end disposed adjacent the handle and a distal end disposed adjacent the proximate ends of the leaflets. The push rod is slidable in a first direction that is substantially parallel to the axis to urge the distal ends of the leaflets outwardly from the distal end of the elongated portion. The push rod is slidable in a second, opposite direction to urge the proximate ends of the leaflets toward the distal end of the elongated portion. The instrument may also include a second locking mechanism configured for preventing axial movement of the push rod.
Alternatively, the linear extension mechanism may include a threaded rod that has a proximate end disposed adjacent the handle and a distal end disposed adjacent the distal end of the elongated portion. The proximate end of the threaded rod is configured for rotation in a first direction about its axis to move a distal end of the threaded rod outwardly from the distal end of the elongated portion. The rod is rotatable in a second, opposite direction about its axis to move the distal end of the threaded rod toward the distal end of the elongated portion.
The extension mechanism may be configured for remotely extending distal ends of the first pair of graspers up to around 7 cm from distal ends of the second pair of graspers. For example, in one implementation, the extension mechanism includes an axially movable member disposed adjacent the handle and a proximate end of the elongated portion, which is an outer elongated portion. The extension mechanism also includes a fixed, inner elongated portion mounted coaxially within at least a portion of the outer elongated portion and an extension member comprising a shape memory alloy. The extension member has a distal end disposed adjacent the first pair of graspers and a proximate end disposed adjacent a distal end of the inner elongated portion. The shape memory alloy is bent at an angle greater than 0 degrees when unstressed and is substantially coaxial with the inner elongated portion when stressed. The axially movable member is configured for being axially translated in a first axial direction to move the outer elongated portion relative to the inner elongated portion, which stresses the extension member such that the extension member is substantially coaxial with the inner elongated portion. In addition, the axially movable member is configured for being axially translated in a second, opposite axial direction, which releases stress on the extension member such that the extension member extends laterally from an axis of the inner elongated portion. In one implementation, the axially movable member is a slidable barrel assembly. In another implementation, the axially movable member is a drive screw assembly.
A method of using a surgical instrument according to one implementation includes: (1) providing a surgical instrument that includes a handle, an elongated portion extending from the handle along an axis, and first and second pairs of graspers disposed adjacent a distal end of the elongated portion; (2) guiding at least a portion of the elongated portion of the surgical instrument through a small incision in a patient's body; (3) remotely extending the first and second pairs of graspers away from the distal end of the elongated portion toward a tissue or organ in the patient's body; (4) remotely positioning the first pair of graspers into a first position and the second pair of graspers into a second position; (5) grasping the tissue or organ in a first location adjacent the first position; (6) grasping the tissue or organ in a second location adjacent the second position, the first location being spaced apart from the second location; and (7) after grasping the tissue or organ with the first and second pairs of graspers, moving the handle of the surgical instrument with one hand to manipulate the tissue or organ. The method may further include locking the first pair of graspers into the first position or the second pair of graspers into the second position, or both.
According to various implementations, a surgical instrument is provided that has two graspers for remotely grasping an organ or tissue in two different locations. The surgeon can manipulate the organ or tissue using the instrument with one hand while using his or her other hand to perform a surgical procedure. Using one instrument also reduces the number of incisions required. This instrument is especially useful in laproscopic procedures and other minimally invasive surgeries.
As shown in
The handle 11 includes an extension mechanism 16 and a linear extension mechanism 18. The extension mechanism 16 is configured for extending distal ends 17 of the first pair of cooperating end effectors 13 outwardly from the distal end 14 of the elongated portion 12 and laterally relative to the axis A-A. The linear extension mechanism 18 is configured for urging distal ends 19 of the second pair of cooperating end effectors 15 outwardly from the distal end 14 of the elongated portion 12 and substantially parallel to the axis A-A. The end effectors 13, 15 may be graspers, scissors, dissectors, or clamps.
In one implementation in which the second pair of end effectors 15 are a pair of graspers, the second pair of graspers 15 may include a first leaflet 20 and a second leaflet 21 that are made of a spring-like material, such as tungsten. The first and second leaflets 20, 21 may include distal ends 19 that are biased away from each other and proximate ends 22 opposite the distal ends 19 that are held in a fixed position relative to each other. For example, in one implementation in which the leaflets 20, 21 are formed from one piece of material, the proximate ends 22 of each leaflet 20, 21 may be the fold in the material. In another implementation in which the leaflets 20, 21 comprise two separate pieces of material, the proximate ends 22 may be welded together or joined by other suitable means. In addition, each leaflet 20, 21 may define a serrated surface 23 that substantially mates with the serrated surface 23 of the opposing leaflet when the leaflets 20, 21 are compressed toward each other.
The linear extension mechanism 18 may include a push rod 28 that has a proximate end 24 disposed adjacent the handle 11 and a distal end 25 disposed adjacent the proximate ends 22 of the leaflets 20, 21. The proximate end 24 of the push rod 28 is slidable in a first direction that is substantially parallel to the axis A-A, such as toward the handle 11, to urge the distal ends 19 of the leaflets 20, 21 outwardly from the distal end 14 of the elongated portion 12. The proximate end 24 is slidable in a second, opposite direction, such as away from the handle 11, to urge the proximate ends 22 of the leaflets 20, 21 toward the distal end 14 of the elongated portion 12. When the proximate ends 22 of the leaflets 20, 21 pass through the distal end 14 of the elongated portion 12, the distal ends 19 of the leaflets 20, 21 are urged toward each other, allowing them to grasp an organ or tissue. In addition, the proximate end 24 of the push rod 28 may be rotated about its axis to remotely rotate the leaflets 20, 21 into position for grasping the organ or tissue.
The instrument 10 may also include a locking mechanism configured for preventing axial movement of the push rod, such as the locking mechanism illustrated in
The extension mechanism 16 may be configured for remotely extending distal ends 17 of the first pair of graspers 13 outwardly and laterally relative to the axis A-A, such as up to about 90 degrees from the axis A-A. This extension may allow the distal end 17 of the first pair of graspers 13 to be spaced apart from the distal end 19 of the second pair of graspers 15 up to around 7 cm.
The shape memory alloy is bent at an angle greater than 0 degrees when unstressed and is substantially coaxial with the inner elongated portion 63 when stressed. The slidable barrel assembly 61 is configured for being axially translated in a first axial direction to move the outer elongated portion 64 relative to the inner elongated portion 63, which stresses the extension member 31 such that the extension member 31 is substantially coaxial with the inner elongated portion 63. In addition, the slidable barrel assembly 61 is configured for being axially translated in a second, opposite axial direction, which releases stress on the extension member 31 such that the extension member 31 extends laterally from an axis of the inner elongated portion 63.
As shown in
The handle 11 further comprises an axially rotatable collar 40 that is operatively engaged with a proximate end 62 of the inner elongated portion 63 such that rotation of the collar 40 about an axis of the inner elongated portion 63 rotates the inner elongated portion 63 and the extension member 31 about the axis of the inner elongated portion 63. As shown in
A cable assembly is configured for remotely opening and closing the first pair of graspers 13 in response to moving a pivoting portion 35 of the handle 11 relative to a fixed portion 36 of the handle 11. One implementation of the cable assembly is shown in
The instrument 10 also includes a locking mechanism configured for preventing movement of the distal ends 17 of the first cooperating pair of end effectors 13 relative to each other. For example, as shown in
The described methods, systems, and apparatus should not be construed as limiting in any way. Instead, the present disclosure is directed toward all novel and nonobvious features and aspects of the various disclosed implementations, alone and in various combinations and sub-combinations with one another. The disclosed methods, systems, and apparatus are not limited to any specific aspect, feature, or combination thereof, nor do the disclosed methods, systems, and apparatus require that any one or more specific advantages be present or problems be solved.
Although the operations of some of the disclosed methods are described in a particular, sequential order for convenient presentation, it should be understood that this manner of description encompasses rearrangement, unless a particular ordering is required by specific language set forth below. For example, operations described sequentially may in some cases be rearranged or performed concurrently. Moreover, for the sake of simplicity, the attached figures may not show the various ways in which the disclosed methods, systems, and apparatus can be used in conjunction with other systems, methods, and apparatus.
