The present disclosure relates generally to surgical instruments and methods.
More specifically, the present disclosure relates to surgical instruments with an evacuation port and methods for evacuating smoke from a surgical site where an evacuation port is in fluid communication with a distal portion of the surgical instrument.
Surgical instruments and methods for energy-based tissue treatment utilize mechanical clamping action and application of energy, e.g., electrosurgical energy, ultrasonic energy, microwave energy, light energy, etc., to affect hemostasis by heating tissue to coagulate, cauterize, and/or seal tissue. Coagulation may be sufficient to achieve hemostasis on non-vascular tissues, small blood vessels, e.g., vessels below about two millimeters in diameter, and tissues including small vessels. With respect to larger blood vessels, e.g., vessels above about two millimeters in diameter, and tissues including larger vessels, coagulation may be insufficient to achieve hemostasis; instead, these larger vessels and tissues including the same may be required to be sealed, a process by which the collagen in the tissue is heated up, denatured, and reformed into a fused mass to permanently close the vessel(s). Once hemostasis is achieved, e.g., via coagulation (for smaller vessels) or sealing (for larger vessels), the tissue may be cut (mechanically, electrically, or electro-mechanically) to divide the tissue.
When the tissue is heated by these or other methods, smoke may form at or near the surgical site. It is often helpful to evacuate this smoke to help with visualization, for instance.
Currently, surgeons may utilize a port on a trocar or other surgical access device to evacuate smoke from a surgical site.
The present disclosure relates to a surgical instrument including a handle assembly, an elongated shaft, an end effector, and an evacuation port. The elongated shaft extends distally from the handle assembly and includes an outer wall. The end effector is coupled to a distal portion of the elongated shaft. The evacuation port is configured for fluid communication with a suction device. A portion of the evacuation port is disposed within the outer wall of the elongated shaft.
In disclosed embodiments, a portion of the evacuation port may extend through an opening in the handle assembly.
It is also disclosed that the portion of the evacuation port that is disposed within the outer wall of the elongated shaft may be a distal portion of the evacuation port. In embodiments, the distal portion of the evacuation port may include an inner ring and an outer ring. It is disclosed that the inner ring may be disposed concentrically within the outer ring. In embodiments, the distal portion of the evacuation port may include a proximal wall interconnecting the inner ring and the outer ring. In further embodiments, the inner ring and the outer ring may define an annular space therebetween, and the annular space is in fluid communication with a proximal end of the evacuation port. In embodiments, longitudinal movement of a drive shaft of the surgical instrument relative to the elongated shaft may cause movement of a first jaw member of the end effector relative to a second jaw member of the end effector, and the inner ring of the evacuation port is disposed radially outward of the drive shaft.
It is further disclosed that the evacuation port may be in fluid communication with an opening between a first jaw member and a second jaw member of the end effector.
The present disclosure also relates to a method of evacuating gas from a surgical site. The method includes suctioning gas through a distal portion of a surgical instrument that is configured to seal tissue, passing the gas through an elongated shaft of the surgical instrument, and passing the gas through an evacuation port that extends through an opening of a handle assembly of the surgical instrument.
In disclosed embodiments of the method, suctioning gas through a distal portion of a surgical instrument that is configured to seal tissue may include passing the gas proximally between jaw members of the surgical instrument.
It is further disclosed that the method may include suctioning gas through a distal portion of the evacuation port that is disposed within an outer wall of the elongated shaft of the surgical instrument.
In disclosed embodiments, the method may include suctioning gas between an inner ring and an outer ring of the evacuation port. In embodiments, the method may also include suctioning gas through an annular space between the inner ring and the outer ring of the evacuation port, and through a proximal end of the evacuation port.
It is also disclosed that the method may include suctioning gas between an inner wall of the elongated shaft of the surgical instrument and an outer wall of a drive shaft of the surgical instrument.
Various aspects and features of the present disclosure are described herein with reference to the drawings, which are incorporated in and constitute a part of this specification, and together with a general description of the disclosure given above and the detailed description of the embodiments given below, serve to explain the principles of the disclosure, wherein:
Embodiments of the presently disclosed surgical instruments and methods for removing or evacuating smoke or other fluids or gasses during surgical procedures will now be described in detail with reference to the drawings wherein like numerals designate identical or corresponding elements in each of the several views. As is common in the art, the term “proximal” refers to that part or component closer to the user or operator, i.e. surgeon or physician, while the term “distal” refers to that part or component farther away from the user.
Turning to
Actuation of movable handle 40 (e.g., pivoting movable handle 40 relative to housing 30) causes longitudinal movement of drive bar 70 relative to elongated shaft 60, which causes first jaw member 110 to move (e.g., pivot) toward second jaw member 120 to grasp tissue therebetween. As shown in
An evacuation port 200 is disposed in mechanical cooperation with surgical instrument 10 and is configured to remove or evacuate smoke or other fluids (e.g., gases or liquids) from a surgical site before, during or after a surgical procedure. More particularly, evacuation port 200 includes a tubular portion 210 and a connector 220. A first part 212 of tubular portion 210 is configured to connect to a suction or evacuation device “SD.” A second part 214 of tubular portion 210 is configured to connect to a proximal portion 230 (
It is envisioned that the cord 55 supplying electrosurgical energy is the same cord that provides suction to evacuation port 200. Here, a single cord may include an active channel, a return channel, and an air evacuation lumen.
With particular reference to
Referring now to
More particularly, an outer ring 252 of distal portion 250 of connector 220 radially surrounds an outer diameter of the proximal end 62 of the elongated shaft 60 of surgical instrument 10 (at a location that is radially within rotating knob 80). In embodiments, an inner diameter of outer ring 252 of distal portion 250 of connector 220 sealingly engages the outer diameter of elongated shaft 60, e.g., in a friction fit matter, via ultrasonic welding, or using an O-ring therebetween, for instance.
With continued reference to
With particular reference to
Referring now to
In use, when a surgical procedure is performed at a surgical site, smoke that is created at or near the surgical site as a result of sealing tissue, for instance, can be evacuated from the surgical site through openings 67, 68, 69. Since openings 67, 68, 69 are in fluid communication with the rest of the evacuation path “EP,” the smoke is moved proximally through the evacuation path “EP” in response to the pressure and/or suction provided by the suction device “SD.” Since the distal portion of the evacuation path “EP” is located at or near the surgical site (e.g., between jaw members 110, 120), the smoke created during the surgical procedure (e.g., between jaw members 110, 120) is rapidly removed from the surgical site, thereby increasing visibility at the surgical site, for instance.
Surgical instruments such as the surgical instrument 10 and evacuation port 200 described herein may also be configured to work with robotic surgical systems and what is commonly referred to as “Telesurgery.” Such systems employ various robotic elements to assist the surgeon and allow remote operation (or partial remote operation) of surgical instrumentation. Various robotic arms, gears, cams, pulleys, electric and mechanical motors, etc. may be employed for this purpose and may be designed with a robotic surgical system to assist the surgeon during the course of an operation or treatment. Such robotic systems may include remotely steerable systems, automatically flexible surgical systems, remotely flexible surgical systems, remotely articulating surgical systems, wireless surgical systems, modular or selectively configurable remotely operated surgical systems, etc.
The robotic surgical systems may be employed with one or more consoles that are next to the operating theater or located in a remote location. In this instance, one team of surgeons or nurses may prep the patient for surgery and configure the robotic surgical system with one or more of the instruments disclosed herein while another surgeon (or group of surgeons) remotely control the instruments via the robotic surgical system. As can be appreciated, a highly skilled surgeon may perform multiple operations in multiple locations without leaving his/her remote console which can be both economically advantageous and a benefit to the patient or a series of patients.
The robotic arms of the surgical system are typically coupled to a pair of master handles by a controller. The handles can be moved by the surgeon to produce a corresponding movement of the working ends of any type of surgical instrument (e.g., end effectors, graspers, knifes, scissors, etc.) which may complement the use of one or more of the embodiments described herein. The movement of the master handles may be scaled so that the working ends have a corresponding movement that is different, smaller or larger, than the movement performed by the operating hands of the surgeon. The scale factor or gearing ratio may be adjustable so that the operator can control the resolution of the working ends of the surgical instrument(s).
The master handles may include various sensors to provide feedback to the surgeon relating to various tissue parameters or conditions, e.g., tissue resistance due to manipulation, cutting or otherwise treating, pressure by the instrument onto the tissue, tissue temperature, tissue impedance, etc. As can be appreciated, such sensors provide the surgeon with enhanced tactile feedback simulating actual operating conditions. The master handles may also include a variety of different actuators for delicate tissue manipulation or treatment further enhancing the surgeon's ability to mimic actual operating conditions.
Referring to
Each of the robot arms 1002, 1003 may include a plurality of members, which are connected through joints, and an attaching device 1009, 1011, to which may be attached, for example, a surgical tool “ST” supporting an end effector 1100, in accordance with any one of several embodiments disclosed herein, as will be described in greater detail below.
Robot arms 1002, 1003 may be driven by electric drives (not shown) that are connected to control device 1004. Control device 1004 (e.g., a computer) may be set up to activate the drives, in particular by means of a computer program, in such a way that robot arms 1002, 1003, their attaching devices 1009, 1011 and thus the surgical tool (including end effector 1100) execute a desired movement according to a movement defined by means of manual input devices 1007, 1008. Control device 1004 may also be set up in such a way that it regulates the movement of robot arms 1002, 1003 and/or of the drives.
Medical work station 1000 may be configured for use on a patient 1013 lying on a patient table 1012 to be treated in a minimally invasive manner by means of end effector 1100. Medical work station 1000 may also include more than two robot arms 1002, 1003, the additional robot arms likewise being connected to control device 1004 and being telemanipulatable by means of operating console 1005. A medical instrument or surgical tool (including an end effector 1100) may also be attached to the additional robot arm. Medical work station 1000 may include a database 1014, in particular coupled to with control device 1004, in which are stored, for example, pre-operative data from patient/living being 1013 and/or anatomical atlases.
It should be understood that the foregoing description is only illustrative of the disclosure. Various alternatives and modifications can be devised by those skilled in the art without departing from the disclosure. Accordingly, the disclosure is intended to embrace all such alternatives, modifications and variances. The embodiments described with reference to the attached drawing figures are presented only to demonstrate certain examples of the disclosure. Other elements, steps, methods and techniques that are insubstantially different from those described above and/or in the appended claims are also intended to be within the scope of the disclosure.
Number | Name | Date | Kind |
---|---|---|---|
4347842 | Beale | Sep 1982 | A |
4562838 | Walker | Jan 1986 | A |
4683884 | Hatfield et al. | Aug 1987 | A |
4719914 | Johnson | Jan 1988 | A |
4850352 | Johnson | Jul 1989 | A |
4911159 | Johnson et al. | Mar 1990 | A |
4919129 | Weber, Jr. et al. | Apr 1990 | A |
5013300 | Williams | May 1991 | A |
5035695 | Weber, Jr. et al. | Jul 1991 | A |
5071418 | Rosenbaum | Dec 1991 | A |
5085657 | Ben-Simhon | Feb 1992 | A |
5108389 | Cosmescu | Apr 1992 | A |
5154709 | Johnson | Oct 1992 | A |
5181916 | Reynolds et al. | Jan 1993 | A |
5192267 | Shapira et al. | Mar 1993 | A |
5197963 | Parins | Mar 1993 | A |
5199944 | Cosmescu | Apr 1993 | A |
5234428 | Kaufman | Aug 1993 | A |
5242442 | Hirschfeld | Sep 1993 | A |
5318516 | Cosmescu | Jun 1994 | A |
5318565 | Kuriloff et al. | Jun 1994 | A |
5348555 | Zinnanti | Sep 1994 | A |
5360427 | Majlessi | Nov 1994 | A |
5413575 | Haenggi | May 1995 | A |
5431650 | Cosmescu | Jul 1995 | A |
5449357 | Zinnanti | Sep 1995 | A |
5451222 | De Maagd et al. | Sep 1995 | A |
5451223 | Ben-Simhon | Sep 1995 | A |
5460602 | Shapira | Oct 1995 | A |
5479019 | Gross | Dec 1995 | A |
5496314 | Eggers | Mar 1996 | A |
D373190 | Monson | Aug 1996 | S |
5554172 | Horner et al. | Sep 1996 | A |
5578000 | Greff et al. | Nov 1996 | A |
5593406 | Eggers et al. | Jan 1997 | A |
5609573 | Sandock | Mar 1997 | A |
D384148 | Monson | Sep 1997 | S |
5674219 | Monson et al. | Oct 1997 | A |
5681262 | Isse | Oct 1997 | A |
5683359 | Farkas | Nov 1997 | A |
5693044 | Cosmescu | Dec 1997 | A |
5707402 | Heim | Jan 1998 | A |
5797901 | Cosmescu | Aug 1998 | A |
5800431 | Brown | Sep 1998 | A |
5830214 | Flom et al. | Nov 1998 | A |
5836909 | Cosmescu | Nov 1998 | A |
5836944 | Cosmescu | Nov 1998 | A |
5935125 | Zupkas | Aug 1999 | A |
5951548 | DeSisto et al. | Sep 1999 | A |
5968042 | Ernster | Oct 1999 | A |
6099525 | Cosmescu | Aug 2000 | A |
6120498 | Jani et al. | Sep 2000 | A |
6142995 | Cosmescu | Nov 2000 | A |
6149648 | Cosmescu | Nov 2000 | A |
6210323 | Gilhuly et al. | Apr 2001 | B1 |
6258088 | Tzonev et al. | Jul 2001 | B1 |
6287305 | Heim et al. | Sep 2001 | B1 |
6293945 | Parins et al. | Sep 2001 | B1 |
6355034 | Cosmescu | Mar 2002 | B2 |
6364853 | French et al. | Apr 2002 | B1 |
6451017 | Moutafis et al. | Sep 2002 | B1 |
6458125 | Cosmescu | Oct 2002 | B1 |
6524307 | Palmerton et al. | Feb 2003 | B1 |
6533781 | Heim et al. | Mar 2003 | B2 |
6558379 | Batchelor et al. | May 2003 | B1 |
6602249 | Stoddard et al. | Aug 2003 | B1 |
6616658 | Ineson | Sep 2003 | B2 |
6635034 | Cosmescu | Oct 2003 | B1 |
6702812 | Cosmescu | Mar 2004 | B2 |
6899712 | Moutafis et al. | May 2005 | B2 |
6918902 | French et al. | Jul 2005 | B2 |
7033353 | Stoddard et al. | Apr 2006 | B2 |
7083601 | Cosmescu | Aug 2006 | B1 |
7112199 | Cosmescu | Sep 2006 | B2 |
7172592 | DeSisto | Feb 2007 | B2 |
7303559 | Peng et al. | Dec 2007 | B2 |
7329253 | Brounstein et al. | Feb 2008 | B2 |
7377919 | Heim et al. | May 2008 | B2 |
7537594 | Sartor | May 2009 | B2 |
7731713 | Christoudias | Jun 2010 | B2 |
7761188 | Palmerton et al. | Jul 2010 | B2 |
7828794 | Sartor | Nov 2010 | B2 |
7935109 | Cosmescu | May 2011 | B2 |
7967816 | Ocel et al. | Jun 2011 | B2 |
8057470 | Lee et al. | Nov 2011 | B2 |
8095241 | Palmerton et al. | Jan 2012 | B2 |
8109929 | Eitenmueller | Feb 2012 | B2 |
8211103 | Greep | Jul 2012 | B2 |
8414576 | Cosmescu | Apr 2013 | B2 |
8518018 | Minskoff et al. | Aug 2013 | B2 |
8690872 | Jayaraj | Apr 2014 | B2 |
8702700 | Maeda et al. | Apr 2014 | B2 |
9987074 | Ineson | Jun 2018 | B2 |
10251636 | Hess et al. | Apr 2019 | B2 |
20020019631 | Kidder et al. | Feb 2002 | A1 |
20020058931 | Parker et al. | May 2002 | A1 |
20020072651 | Vilos | Jun 2002 | A1 |
20020103485 | Melnyk et al. | Aug 2002 | A1 |
20030088247 | Ineson | May 2003 | A1 |
20040030328 | Eggers et al. | Feb 2004 | A1 |
20040064136 | Papineau et al. | Apr 2004 | A1 |
20040260280 | Sartor | Dec 2004 | A1 |
20040267326 | Ocel et al. | Dec 2004 | A1 |
20060058778 | Arcusa Villacampa et al. | Mar 2006 | A1 |
20060264928 | Kornerup et al. | Nov 2006 | A1 |
20070066970 | Ineson | Mar 2007 | A1 |
20070129722 | Cosmescu | Jun 2007 | A1 |
20070249990 | Cosmescu | Oct 2007 | A1 |
20080103431 | Brounstein et al. | May 2008 | A1 |
20080114355 | Whayne | May 2008 | A1 |
20080287893 | Ineson | Nov 2008 | A1 |
20090018490 | Wuchinich | Jan 2009 | A1 |
20090018539 | Cosmescu | Jan 2009 | A1 |
20090062791 | Lee et al. | Mar 2009 | A1 |
20090076486 | Cucin | Mar 2009 | A1 |
20090192441 | Gelbart et al. | Jul 2009 | A1 |
20100094283 | Cosmescu | Apr 2010 | A1 |
20100125172 | Jayaraj | May 2010 | A1 |
20100168745 | Loeser | Jul 2010 | A1 |
20110034921 | Sartor | Feb 2011 | A1 |
20110077645 | Lin | Mar 2011 | A1 |
20110190768 | Shvetsov et al. | Aug 2011 | A1 |
20110230878 | Ryan et al. | Sep 2011 | A1 |
20110319892 | Blomeyer | Dec 2011 | A1 |
20120101497 | Jayaraj | Apr 2012 | A1 |
20120203223 | Terry et al. | Aug 2012 | A1 |
20120283718 | Cosmescu | Nov 2012 | A1 |
20120283728 | Cosmescu | Nov 2012 | A1 |
20130006236 | Greep et al. | Jan 2013 | A1 |
20130204246 | Greep et al. | Aug 2013 | A1 |
20140046413 | Kane | Feb 2014 | A1 |
20140081086 | Shvetsov et al. | Mar 2014 | A1 |
20140336634 | Gomez | Nov 2014 | A1 |
20150005761 | Zinnanti | Jan 2015 | A1 |
20150080876 | Worrell | Mar 2015 | A1 |
20170086815 | Hess | Mar 2017 | A1 |
20170105789 | Boudreaux | Apr 2017 | A1 |
20190059988 | Davison et al. | Feb 2019 | A1 |
20190247068 | Whipple | Aug 2019 | A1 |
Number | Date | Country |
---|---|---|
2012155922 | Nov 2012 | WO |
Entry |
---|
Australian Examination Report No. 1, dated May 17, 2017, corresponding to Australian Application No. 2012388657; 4 pages. |
Australian Examination Report No. 1, dated May 23, 2018, corresponding to Australian Application No. 2014324006; 3 pages. |
Canadian Office Action and Examination Search Report dated Sep. 28, 2018, corresponding to Canadian Application No. 2,883,231; 5 total pages. |
Extended European Search Report dated Dec. 22, 2020 issued in coresponding EP Appln. No. 20194849.4. |
Number | Date | Country | |
---|---|---|---|
20210068890 A1 | Mar 2021 | US |