Manipulatable surgical systems with selectively articulatable fastening device

• US 10,213,262 B2
• Filed: 03/14/2016
• Issued: 02/26/2019
• Est. Priority Date: 03/23/2006
• Status: Active Grant

• Current Assignee: Cilag Gmbh International (Johnson & Johnson)
• Original Assignee: Ethicon, LLC (Johnson & Johnson)
• Inventors: Shelton, IV, Frederick E., Morgan, Jerome R.
• Primary Examiner(s): Long, Robert
• Application Number:
  US15/069,127
• Publication Number:
  US 20160192996A1
• Time in Patent Office: 1,079 Days
• Field of Search: 2271751-1821
• CPC Class Codes: A61B 1/00042 for mechanical operation
• CPC Class Codes: A61B 1/0052 Constructional details of control elements, e.g. handles
• CPC Class Codes: A61B 1/0058 using shape-memory elements
• CPC Class Codes: A61B 17/068 Surgical staplers , e.g. containing multiple staples or clampsstaplers containing only one staple A61B17/10; magazines or containers for staples A61B17/105; for performing anastomosis A61B17/115; staplers in general B25C5/00
• CPC Class Codes: A61B 17/072 for applying a row of staples in a single action , e.g. the staples being applied simultaneously
• CPC Class Codes: A61B 17/07207 the staples being applied sequentially
• CPC Class Codes: A61B 17/115 Staplers for performing anastomosis in a single operation
• CPC Class Codes: A61B 17/320016 Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes A61B10/0233, A61B17/29, A61B17/3207 take precedence
• CPC Class Codes: A61B 17/32053 Punch like cutting instruments, e.g. using a cylindrical or oval knife A61B17/326 takes precedence; trepans A61B17/1695; for use on the cornea A61F9/007
• CPC Class Codes: A61B 2017/00057 Light
• CPC Class Codes: A61B 2017/00199 with a console, e.g. a control panel with a display
• CPC Class Codes: A61B 2017/0023 disposable
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/00309 Cut-outs or slits
• CPC Class Codes: A61B 2017/00314 Separate linked members
• CPC Class Codes: A61B 2017/00323 Cables or rods
• CPC Class Codes: A61B 2017/00327 with actuating members moving in opposite directions
• CPC Class Codes: A61B 2017/00367 Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
• CPC Class Codes: A61B 2017/0042 with special provisions for gripping
• CPC Class Codes: A61B 2017/00473 Distal part, e.g. tip or head A61B2017/00464 takes precedence
• CPC Class Codes: A61B 2017/00477 : Coupling A61B2017/0046 takes precedence
• CPC Class Codes: A61B 2017/00685 : Archimedes screw
• CPC Class Codes: A61B 2017/00734 : battery operated
• CPC Class Codes: A61B 2017/0688 : Packages or dispensers for surgical staplers
• CPC Class Codes: A61B 2017/07235 : containing different staples, e.g. staples of different shapes, sizes or materials
• CPC Class Codes: A61B 2017/07242 : achieving different staple heights during the same shot, e.g. using an anvil anvil having different heights or staples of different sizes
• CPC Class Codes: A61B 2017/07264 : characterised by its staple forming cavities, e.g. geometry or material
• CPC Class Codes: A61B 2017/07271 : characterised by its cartridge
• CPC Class Codes: A61B 2017/07278 : characterised by its sled or its staple holder
• CPC Class Codes: A61B 2017/2905 : flexible
• CPC Class Codes: A61B 2017/291 : the position of the handle being adjustable with respect to the shaft
• CPC Class Codes: A61B 2017/2919 : details of linkages or pivot points
• CPC Class Codes: A61B 2017/2923 : Toothed members, e.g. rack and pinion
• CPC Class Codes: A61B 2017/2927 : the angular position of the head being adjustable with respect to the shaft
• CPC Class Codes: A61B 2017/2933 : camming or guiding means
• CPC Class Codes: A61B 2017/2937 : with flexible part
• CPC Class Codes: A61B 2017/2946 : Locking means
• CPC Class Codes: A61B 2017/2947 : Pivots
• CPC Class Codes: A61B 2017/320052 : Guides for cutting instruments by marking A61B2090/395
• CPC Class Codes: A61B 2034/306 : Wrists with multiple vertebrae
• CPC Class Codes: A61B 2090/0811 : for the position of a particular part of an instrument with respect to the rest of the instrument, e.g. position of the anvil of a stapling instrument
• CPC Class Codes: A61B 2090/372 : Details of monitor hardware
• CPC Class Codes: A61B 34/30 : Surgical robots
• CPC Class Codes: A61B 34/71 : Manipulators operated by drive cable mechanisms
• CPC Class Codes: A61B 50/30 : Containers specially adapted for packaging, protecting, dispensing, collecting or disposing of surgical or diagnostic appliances or instruments for wound clamps A61B17/10; for ligaturing clips A61B17/122; packages or dispensers for surgical gloves or finger-stalls A61B42/40
• CPC Class Codes: A61B 50/36 : for collecting or disposing of used articles
• CPC Class Codes: A61B 90/37 : Surgical systems with images on a monitor during operation

Abstract

Devices and systems are provided for controlling movement of a working end of a surgical device by means of a robotic system. In one embodiment, systems and devices are provided for moving an end effector on a distal end of a surgical fastening device. Movement can include rotational movement of the end effector about an axis of the shaft, articulation of the end effector relative to the shaft, and actuation of an end effector, e.g., closing, firing, and/or cutting.

Claims

1. A surgical system, comprising:

a first rotary output member;

a second rotary output member;

a third rotary output member;

a surgical end effector, comprising;

a first jaw and a second jaw, wherein one of said first and second jaws is movable relative to the other of said first and second jaws between open and closed positions upon application of jaw control motions thereto and wherein one of said first and second jaws comprises a surgical staple cartridge; and

a firing member axially movable between a starting position and an ending position within said first and second jaws, said firing member configured to axially pass through said first and second jaws to eject surgical staples housed within said surgical staple cartridge and wherein said surgical system further comprises;

an elongate shaft assembly defining a longitudinal tool axis and operably coupled to said surgical end effector to facilitate selective articulation of said surgical end effector relative to said longitudinal tool axis, said elongate shaft assembly comprising;

a plurality of articulation members movably supported by said elongate shaft assembly and operably interfacing with said surgical end effector; and

a firing shaft operably interfacing with said firing member to apply a firing motion thereto and wherein said surgical system further comprises;

an articulation transmission operably interfacing with said first rotary output member and said plurality of articulation members such that rotation of said first rotary output member applies articulation motions to said plurality of articulation members;

a firing drive member operably coupled to said firing shaft and being configured to interface with said second rotary output member to apply firing control motion to said firing shaft; and

a closure clutch assembly operably interfacing with said elongate shaft assembly and said third rotary output member to receive a third rotary output motion therefrom to thereby selectively axially advance at least a portion of said elongate shaft assembly along said longitudinal tool axis to apply said jaw control motions to at least one of said first and second jaws.

2. The surgical system of claim 1, wherein said first rotary output member is configured to rotate about a first rotary axis and said second rotary output member is configured to rotate about a second rotary axis and wherein at least one of said first and second rotary axes is transverse to said longitudinal tool axis.

3. The surgical system of claim 1, wherein said articulation transmission comprises a converter configured to receive a rotary motion from said first rotary output member and convert said rotary motion to axial motions applied to said plurality of articulation members.

4. The surgical system of claim 3, wherein said firing drive member comprises:

a firing rack gear operably interfacing with said firing shaft; and

a firing gear assembly operably interfacing with said firing rack gear and said second rotary output member such that rotation of said second rotary output member causes said firing gear assembly to axially drive said firing rack gear and said firing shaft.

5. The surgical system of claim 1, wherein said first and second rotary output members are operably supported by a housing and wherein said surgical system further comprises:

a tool mounting portion operably coupled to said elongate shaft assembly and configured to be releasably coupled to said housing, said tool mounting portion rotatably supporting said firing drive member thereon in operational engagement with said firing shaft; and

a rotary drive transmission in operable engagement with said firing drive member and said second rotary output member.

6. The surgical system of claim 5, wherein said rotary drive transmission further comprises:

a rotary drive gear rotatably supported on said tool mounting portion; and

a first rotary driven gear in meshing engagement with said rotary drive gear and said firing drive member.

7. The surgical system of claim 5, wherein said elongate shaft assembly comprises:

an outer shaft assembly comprising a distal end operably coupled to said surgical end effector and a proximal end rotatably supported on said tool mounting portion for selective rotation about said longitudinal tool axis relative thereto, said outer shaft assembly operably supporting said firing shaft; and

a rotational transmission assembly operably supported on said tool mounting portion and configured to operably interface with a fourth rotary output member to receive a fourth rotary output motion therefrom to thereby selectively rotate said elongate shaft assembly about said longitudinal tool axis.

8. The surgical system of claim 7, wherein said rotational transmission assembly comprises:

a rotation drive gear operably interfacing with said fourth rotary output member;

a rotation driven gear in meshing engagement with said rotation drive gear; and

a rotation gear on said outer shaft assembly and in meshing engagement with said rotation driven gear and wherein said fourth rotary output member rotates about a fourth rotary output axis that is transverse to said longitudinal tool axis such that rotation of said fourth rotary output member about said fourth rotary output axis rotates said outer shaft assembly and said surgical end effector about said longitudinal tool axis.

9. The surgical system of claim 8, wherein said outer shaft assembly comprises:

a proximal outer shaft member; and

a distal outer shaft member movably coupled to said proximal outer shaft member for selective articulation relative thereto about an articulation axis that is transverse to said longitudinal tool axis.

10. The surgical system of claim 1, wherein said elongate shaft assembly further comprises:

a proximal outer shaft member; and

a distal outer shaft member movably coupled to said proximal outer shaft member for selective articulation relative thereto about an articulation axis that is transverse to said longitudinal tool axis.

11. The surgical system of claim 10, wherein said closure clutch assembly is operably coupled to said proximal outer shaft member to selectively axially advance said proximal outer shaft member and said distal outer shaft member along said longitudinal tool axis to apply said jaw control motions to at least one of said first and second jaws.

12. The surgical system of claim 1, wherein said third rotary output member rotates about a third rotary output axis that is transverse to said longitudinal tool axis and wherein said closure clutch assembly comprises:

a shifter rack gear coupled to said elongate shaft assembly; and

a shifter drive gear operably interfacing with said shifter rack gear and being configured to operably interface with said third rotary output member such that rotation of said third rotary output member causes said shifter drive gear to drive said shifter rack gear axially.

13. The surgical system of claim 11, wherein said third rotary output member rotates about a third rotary output axis that is transverse to said longitudinal tool axis and wherein said closure clutch assembly comprises:

a shifter rack gear coupled to said proximal outer shaft member; and

a shifter drive gear operably interfacing with said shifter rack gear and being configured to operably interface with said third rotary output member such that rotation of said third rotary output member causes said shifter drive gear to drive said shifter rack gear axially.

14. The surgical system of claim 1, wherein said surgical staple cartridge is removably supported in one of said first and second jaws and supports therein a plurality of said surgical staples.

15. The surgical system of claim 14, wherein said firing member comprises a tissue cutting surface and is configured to eject said surgical staples from said surgical staple cartridge as said firing member is axially driven in a distal direction through said surgical end effector.