Multifunctional tool and method for minimally invasive surgery

• US 20030065358A1
• Filed: 08/05/2002
• Published: 04/03/2003
• Est. Priority Date: 08/06/2001
• Status: Active Grant

• Current Assignee: Penn State Research Foundation
• Original Assignee: Penn State Research Foundation
• Inventors: Haluck, Randy S., Dziedzic, Ryan P., Schadler, Jeremy R., Frecker, Mary I.
• Granted Patent: US 7,208,005 B2
• Time in Patent Office: Days
• US Class Current: 606/205
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• 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 17/3201 Scissors for biopsy A61B10/02
• CPC Class Codes: A61B 2017/00353 one mechanical instrument performing multiple functions, e.g. cutting and grasping channel for multiple instruments A61B2017/3445; instrument channel A61B2017/22072; replaceable heads A61B2017/2931; suction A61M1/00
• CPC Class Codes: A61B 2017/2902 characterized by features of the actuating rod
• CPC Class Codes: A61B 2017/2926 Details of heads or jaws
• CPC Class Codes: A61B 2017/2927 the angular position of the head being adjustable with respect to the shaft
• CPC Class Codes: A61B 2017/2936 Pins in guiding slots
• CPC Class Codes: A61B 2017/2939 Details of linkages or pivot points

Abstract

An apparatus and method for minimally invasive surgery. The apparatus can comprise a tool which includes a multi-functioning end effector for insertion into a patient, a user control adapted for use by the surgeon external of the patient, and an intermediate section between the end effector and the user control to translate control instructions from the user control through an actuating mechanism to operate the end effector in one of at least two different functioning states. No instrument exchange is necessary to change between states. The actuation mechanism could be a manually operated mechanical mechanism. Alternatively, it could be partially or fully electromechanical or electrical or electronic. According to one aspect, the end effector is a rigid link mechanism. According to another aspect, the end effector could be a compliant mechanism, at least in part. Another aspect of the invention includes the ability of the end effector to have at least some articulation in addition to grasping and cutting functions.

Claims

1. An end-effector for utilization at a surgical site on or in a patient comprising:

(a) a working end adapted for surgical functioning and including an interface adapted for operative connection to an actuating mechanism;

(b) said working end being configurable to

(1) a first state capable of a first surgical function;

(2) a second state capable of a second surgical function;

(3) wherein selection of said first or second state is effected through said interface.

2. The end-effector of claim 1 wherein said interface comprises a non-compliant mechanism.

3. The end-effector of claim 1 wherein said interface comprises a compliant mechanism.

4. The end-effector of claim 1 wherein the working end comprises at least one portion which is moveable relative to another portion.

5. The end-effector of claim 4 wherein at least one of said one portion and said another portion is moveable towards and away from the other.

6. The end-effector of claim 5 wherein said one portion comprises a first grasping surface moveable in a first plane.

7. The end-effector of claim 5 wherein said another portion is a second grasping surface having a portion in said first plane and having a portion that is moveable outside of said first plane.

8. The end-effector of claim 5 wherein said one portion is a first jaw pivotable in a first plane and said another portion is a second jaw positionable in said first plane.

9. The end-effector of claim 8 wherein said second jaw comprises at least a portion that is moveable outside of said first plane.

10. The end-effector of claim 9 wherein said portion of said second jaw is pivotable in a second plane.

11. The end-effector of claim 10 wherein said second plane is generally perpendicular to said first plane.

12. The end-effector of claim 1 wherein said first surgical function is grasping.

13. The end-effector of claim 12 wherein said second surgical function is cutting action.

14. The end-effector of claim 13 further comprising a third state for a third surgical function.

15. The end-effector of claim 14 wherein the third surgical function is articulation of the working end.

16. The end-effector of claim 1 wherein the first surgical function is grasping and the second surgical function is articulation of the grasping.

17. The end-effector of claim 1 wherein the interface is adapted to translate linear motion.

18. The end-effector of claim 1 wherein the interface is adapted for connection to a mechanically actuated mechanism.

19. The end-effector of claim 1 wherein the interface is adapted for connection to a manually actuated mechanism.

20. The end-effector of claim 1 in combination with an actuating mechanism.

21. The end-effector and actuating mechanism of claim 20 wherein the actuating mechanism comprises a control and a connection between the control and the interface of the end effector.

22. The end-effector and actuating mechanism of claim 20 wherein the control comprises handle including a manually actuatable member for creating a force for translation through the connection to the end effector.

23. The end-effector of claim 20 wherein the control comprises a non-manually powered force generator.

25. The end-effector and actuating mechanism of claim 20 further in combination with a surgical tool.

26. The end-effector of claim 1 further comprising a third state.

27. The end-effector of claim 26 wherein the third state is capable of a third surgical function.

28. The end-effector of claim 26 wherein the third state comprises an enhancement of at least one of said first and second states.

29. The end-effector of claim 28 wherein said first surgical function comprises grasping and said third state comprises articulation of said grasping function relative to a reference position.

30. The end-effector of claim 1 wherein the interface comprises a compliant mechanism, wherein the compliant mechanism switches between first and second states dependent upon magnitude and location of input force to the compliant mechanism.

31. The end-effector of claim 1 wherein selection between first and second states is without working end exchange from the site.

32. The end-effector of claim 1 wherein the two states can be performed with portions of a single working end.

33. The end-effector of claim 1 wherein the end-effector is adapted for minimally invasive surgery.

24. The end-effector of claim 123 wherein the force generator is an electrically powered device.

34. A method of providing multiple surgical functioning at a surgical site on or in a patient comprising:

(a) configuring a working end of a surgical tool for a first surgical function;

(b) reconfiguring the working end for a second surgical function without exchange of said working end.

35. The method of claim 34 wherein selection of said first or second surgical functions is effected through an interface.

36. The method of claim 34 wherein said interface comprises a non-compliant mechanism.

37. The method of claim 34 wherein said interface comprises a compliant mechanism.

38. The method of claim 37 wherein the compliant mechanism switches between said first and second surgical functions dependent upon magnitude and location of input force to the compliant mechanism.

39. The method of claim 34 wherein said working end comprises a first jaw pivotable in a first plane and a second jaw positionable in said first plane.

40. The method of claim 39 wherein said second jaw comprises at least a portion that is moveable outside of said first plane.

41. The method of claim 34 wherein said first surgical function is grasping.

42. The method of claim 34 wherein said second surgical function is cutting action.

43. The method of claim 34 further comprising a third surgical function.

44. The method of claim 43 wherein the third surgical function is articulation of the working end.

45. The method of claim 34 wherein the first surgical function is grasping and the second surgical function is articulation of the grasping.

46. A multifunction tool for use in minimally invasive surgery, comprising:

(a) an elongated shaft or flexible scope adapted to be inserted through an incision in a patient'"'"'s body, and having opposite first and second ends;

(b) a control handle on the first end;

(c) a tool head on the second end, the tool head including a pair of jaws pivotal about a first axis so as to provide a grasping function and pivotal about a second axis so as to provide a cutting function; and

(d) an actuator operatively connected to the handle and the tool head to move the jaws in response to user input at the handle.

47. The tool of claim 46 wherein the jaws each have a grasping surface and a cutting edge.

48. The tool of claim 46 wherein the actuator includes a push rod for pivoting the jaws about the first axis.

49. The tool of claim 46 wherein the actuator includes wires for pivoting the jaws about the second axis.

50. The tool of claim 46 wherein the first and second axes are perpendicular to one another.

51. The tool of claim 46 wherein the tool head is articulated such that the grasping and cutting functions are performable at various angles.

52. The tool of claim 46 wherein each jaw includes an inner end pivotal about the first axis and an outer end pivotal about the second axis.

53. The tool of claim 52 wherein the second ends of the jaws are pivoted in opposite directions for the cutting action.

54. The tool of claim 52 wherein the second ends of the jaws are pivotal in the same direction about the second axis to provide for articulated grasping and cutting.

55. The tool of claim 46 wherein the actuator is a compliant mechanism.

56. The tool of claim 55 wherein the compliant mechanism has an input interface that changes the orientation and plane of movement of the jaws in response to the location and force applied to the interface.

57. A multifunction end-effector tool for use in minimally invasive surgery, comprising:

(a) an mechanism adapted to be inserted through an incision in a patient'"'"'s body, the mechanism comprising;

(b) a tool head, the tool head including a pair of jaws pivotal about a first axis so as to provide a grasping function and pivotal about a second axis so as to provide a cutting function; and

(c) an interface adapted for operative communication with a control external of the patient'"'"'s body and to an actuator operatively connected to the tool head to move the jaws in response to user input from a control.

58. The tool of claim 57 wherein the jaws each have a grasping surface and a cutting edge.

59. The tool of claim 57 further comprising an actuator, wherein the actuator includes a push rod for pivoting the jaws about the first axis.

60. The tool of claim 57 further comprising an actuator which includes wires for pivoting the jaws about the second axis.

61. The tool of claim 57 wherein the first and second axes are perpendicular to one another.

62. The tool of claim 57 wherein the tool head is articulatable such that the grasping and cutting functions are performable at various angles.

63. The tool of claim 57 wherein each jaw includes an inner end pivotal about the first axis and an outer end pivotal about the second axis.

64. The tool of claim 57 wherein the second ends of the jaws are pivoted in opposite directions for the cutting action.

65. The tool of claim 64 wherein the second ends of the jaws are pivotal in the same direction about the second axis to provide for articulated grasping and cutting.

66. The tool of claim 57 further comprising an actuator which comprises a compliant mechanism.

67. The tool of claim 66 wherein the compliant mechanism has an input interface that changes the orientation and plane of movement of the jaws in response to the location and force applied to the interface.

68. A surgical instrument for performing multiple surgical tasks comprising:

(a) a shaft having a proximal portion and a distal portion;

(b) a handle positioned on the proximal portion of the shaft;

(c) jaws pivotable relative to each other, positioned on the distal portion of the shaft; and

(d) an actuation system for imparting articulation motion to the jaws.

69. The surgical instrument of claim 68 wherein the pivotable jaws comprise multifunctional scissors, a grasper, a dissector, a cauterizer, or an irrigator.

70. The surgical instrument of claim 68 wherein the actuation system comprises a mechanical actuator, an electrical actuator, a pneumatic actuator, a hydraulic actuator, an electroactive material, or a combination thereof.

71. The surgical instrument of claim 70, wherein the mechanical actuator is mechanically linked to an actuating rod or tendon wire disposed within the shaft, which tendon wire is in turn linked to the distal portion of the shaft, for effecting movement of the jaws from a closed position to an actuated position;

for retaining the jaws in the actuated position; and

enabling the jaws to return to the closed position.

72. The surgical instrument of claim 70, wherein the electrical actuator is electrically linked to an electroactive material embedded within, bonded to, or connected to the jaws for effecting movement of the jaws from a closed position to an actuated position;

for retaining the jaws in the actuated position; and

enabling the jaws to return to closed position.

73. The surgical instrument of claim 70, wherein the electrical actuator or electroactive material system comprises a switch or array of switches and electronic components for controlling the flow of electrical current along the shaft to the jaws.

74. The surgical instrument of claim 70 wherein the actuated position comprises a cutting, grasping, dissecting, cauterizing, or irrigating configuration.

75. The surgical instrument of claim 68 wherein said instrument is configured for minimally invasive surgical tasks.

76. The surgical instrument of claim 68, wherein multifunctionality of the pivotable jaws is enabled by a compliant mechanism.

77. A surgical instrument for performing multiple surgical tasks comprising:

(a) a shaft having a proximal portion and a distal portion;

(b) a handle mounted on the proximal portion of the shaft;

(c) two-part jaws pivotable relative to each other, mounted on the distal portion of the shaft, said jaws having a proximal portion and a distal tip, wherein the tips of said jaws are able to articulate in a plane perpendicular to a plane of jaw opening and closing; and

(d) an actuation system for imparting articulation motion to the jaws.

78. The surgical instrument of claim 77 wherein the two-part jaws comprise scissors, a dissector, or a grasper.

79. The surgical instrument of claim 77 wherein the device that enables relative rotation between the two-part jaws comprises a hinge, a slot, or a gear system.

80. The surgical instrument of claim 77, wherein the jaw actuation system is mechanically linked to push rods or tendon wires disposed within the shaft, which rods or wires are in turn linked to the distal portion of the shaft, for effecting movement of the two-part jaws from a closed position to an actuated position;

for retaining the jaws in the actuated position; and

for enabling the jaws to return to the closed position.

81. The surgical instrument of claim 77, wherein the jaw actuation system is electrically linked to an electroactive material embedded within, bonded to, or connected to the two-part jaws for effecting movement of the jaws from a closed position to an actuated position;

for retaining the jaws in the actuated position; and

for enabling the jaws to return to the closed position.

82. The surgical instrument of claim 80 wherein the actuated position comprises a cutting, dissecting, or grasping configuration.

83. The surgical instrument of claim 81 wherein the actuated position comprises a cutting, dissecting, or grasping configuration.

84. The surgical instrument of claim 77 wherein said instrument is configured for minimally invasive surgical tasks.

85. The surgical instrument of claim 77 wherein the jaws are able to be articulated simultaneously or independently.

86. The surgical instrument of claim 77 wherein the two-jaws are able to be locked in intermediate positions.

87. The surgical instrument of claim 80 wherein a ratchet-type device retains the two-part jaws in an actuated position.

88. The surgical instrument of claim 81 wherein a ratchet-type device retains the two-part jaws in an actuated position.

89. The surgical instrument of claim 77, wherein multifunctionality of the pivotable jaws is enabled by a compliant mechanism.

90. The surgical instrument of claim 89 further comprising a static balance mechanism to the actuating mechanism for the compliant mechanism.

91. The surgical instrument of claim 77 further comprising the jaws are rotatably about a center axis of the shaft.