Electrosurgical instrument with an operational sequencing element

• US 20020099372A1
• Filed: 01/24/2001
• Published: 07/25/2002
• Est. Priority Date: 01/24/2001
• Status: Active Grant

• Current Assignee: Sorin Group USA Incorporated (LivaNova Plc)
• Original Assignee: Ethicon Incorporated (Johnson & Johnson)
• Inventors: Nuchols, Richard P., Schulze, Dale R.
• Granted Patent: US 6,620,161 B2
• Time in Patent Office: Days
• US Class Current: 606/51
• CPC Class Codes: A61B 17/00008 Vein tendon strippers tube strippers A61M1/83
• CPC Class Codes: A61B 17/07207 the staples being applied sequentially
• CPC Class Codes: A61B 17/12009 Implements for ligaturing other than by clamps or clips, e.g. using a loop with a slip knot
• CPC Class Codes: A61B 17/32 Surgical cutting instruments A61B18/042 takes precedence; suture cutters A61B17/0467; instruments for ligaturing or cutting A61B17/128; instruments for rupturing the amniotic membrane A61B17/4208; specially adapted knives for eye surgery A61F9/0133
• CPC Class Codes: A61B 18/1442 Probes having pivoting end effectors, e.g. forceps
• CPC Class Codes: A61B 18/1445 at the distal end of a shaft, e.g. forceps or scissors at the end of a rigid rod
• CPC Class Codes: A61B 2017/1225 for clipping and cutting in a single operation
• CPC Class Codes: A61B 2018/00345 Vascular system
• CPC Class Codes: A61B 2018/00404 Blood vessels other than those in or around the heart
• CPC Class Codes: A61B 2018/00916 with means for switching or controlling the main function of the instrument or device
• CPC Class Codes: A61B 2018/1412 Blade
• CPC Class Codes: A61B 2018/1455 having a moving blade for cutting tissue grasped by the jaws

Abstract

A surgical instrument useful in harvesting blood vessels such as veins and arteries. The instrument has a pair of jaws and a central cutting element displaceable distally and proximally to dissect tissue contained between the jaws. A sequencing element prevents the cutting element from being engaged when the jaws are in the open configuration.

Claims

1. A surgical instrument comprising:

a) a handle having a proximal end, a distal end, a top and a bottom;

b) first actuator and a second actuator operably mounted to the handle;

c) a shaft having a distal end, a proximal end, a longitudinal axis, and having a lumen therethrough, the proximal end of the shaft mounted to the distal end of the handle;

d) a first jaw and an opposed second jaw mounted to the distal end of the shaft, the jaws each having a distal end and a proximal end, the distal ends of the jaws being spaced apart when the first actuator is in an open position and the distal ends of the jaws being adjacent when the first actuator is in a closed position for approximating tissue in a tissue grasping region, the jaws each having a distal dissecting member;

e) a dissecting tip extending from the distal ends of the jaws formed by the distal dissecting members when the first actuator is in said closed position;

f) an elongated member having a distal end, a proximal end, and a longitudinal axis, said longitudinal element slidably mounted in the lumen of said shaft, and the proximal end of the elongated member mounted to the second actuator;

g) a cutting element mounted to said the distal end of the elongated member, said cutting element comprising a first blade proximally oriented and a second blade distally oriented, such that movement of the second actuator from a central position to a proximal position causes the cutting element to move in the proximal direction wherein the first blade cuts through tissue held in the tissue grasping region between the jaws, and further such that movement of the second actuator from the proximal position to the central position causes the cutting element to move in the distal direction wherein the second blade cuts through tissue held in the tissue grasping region between the jaws, and further wherein movement of the second actuator from the central position to a distal position causes the second blade of said cutting element to extend distally from the dissecting tip to cut tissue distally adjacent to said dissecting tip; and

,

h) a sequencing element mounted in the handle and operationally engaged with the first and second actuators, wherein the sequencing element locks out movement of the second actuator between the central and proximal positions when the first actuator is in the open position.

2. The surgical instrument of claim 1 further comprising a centering spring that engages the elongated member for biasing said second actuator in said central position.

3. The surgical instrument of claim 1 wherein said sequencing element is adapted to lock said first actuator in said closed position when an operator moves said second actuator from said central position to said proximal direction.

4. The surgical instrument of claim 1 further comprising at least two bipolar electrodes of opposite polarity in at least one of said first and second jaws, said electrodes electrically connected to conductor elements adapted for connection to a bipolar electrosurgical energy generator, said electrodes adapted to contact tissue held in said tissue grasping region when said first actuator is in said closed position.

5. A method of grasping and cutting tissue, the method comprising the steps of:

I. providing a surgical instrument, the instrument comprising;

a handle having a proximal end, a distal end, a top and a bottom;

first actuator and a second actuator operably mounted to the handle;

a shaft having a distal end, a proximal end, a longitudinal axis, and having a lumen therethrough, the proximal end of the shaft mounted to the distal end of the handle;

a first jaw and an opposed second jaw mounted to the distal end of the shaft, the jaws each having a distal end and a proximal end, the distal ends of the jaws being spaced apart when the first actuator is in an open position and the distal ends of the jaws being adjacent when the first actuator is in a closed position for approximating tissue in a tissue grasping region, the jaws each having a distal dissecting member;

a dissecting tip extending from the distal ends of the jaws formed by the distal dissecting members when the first actuator is in said closed position;

an elongated member having a distal end, a proximal end, and a longitudinal axis, said longitudinal element slidably mounted in lumen of said shaft, and the proximal end of the elongated member mounted to the second actuator;

a cutting element mounted to said the distal end of the elongated member, said cutting element comprising a first blade proximally oriented and a second blade distally oriented, such that movement of the second actuator from a central position to a proximal position causes the cutting element to move in the proximal direction wherein the first blade cuts through tissue held in the tissue grasping region between the jaws, and further such that movement of the second actuator from the proximal position to the central position causes the cutting element to move in the distal direction wherein the second blade cuts through tissue held in the tissue grasping region between the jaws, and further wherein movement of the second actuator from the central position to a distal position causes the second blade of said cutting element to extend distally from the dissecting tip to cut tissue distally adjacent to said dissecting tip; and

,

a sequencing element mounted in the handle and operationally engaged with the first and second actuators, wherein the sequencing element locks out movement of the second actuator between the central and proximal positions when the first actuator is in the open position;

II. engaging tissue between the jaws in the tissue grasping region and actuating the first actuator to grasp the tissue by closing the jaws; and

,

III. actuating the second actuator to cause the cutting element to cut the tissue.