Articulation joint with improved moment arm extension for articulating an end effector of a surgical instrument

• US 20070102474A1
• Filed: 11/09/2005
• Published: 05/10/2007
• Est. Priority Date: 11/09/2005
• Status: Active Grant

• Current Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Swayze, Jeffrey, Shelton, Frederick
• Granted Patent: US 7,673,780 B2
• Time in Patent Office: Days
• US Class Current: 227/175.100
• CPC Class Codes: A61B 17/07207 the staples being applied sequentially
• CPC Class Codes: A61B 2017/00539 hydraulically
• CPC Class Codes: A61B 2017/07214 Stapler heads
• CPC Class Codes: A61B 2017/07278 characterised by its sled or its staple holder
• CPC Class Codes: A61B 2017/07285 characterised by its cutter
• CPC Class Codes: A61B 2017/2927 the angular position of the head being adjustable with respect to the shaft
• CPC Class Codes: A61B 2017/320052 Guides for cutting instruments by marking A61B2090/395

Abstract

An articulation joint for use in connection with a surgical instrument that has a portion that must be passed through a trocar or similar structure and then articulated relative to another portion of the instrument received within the trocar. Various embodiments of the articulation joint provide structures for increasing the moment arm between the actuator and the pivot point between the proximal and distal tube segments interconnecting a handle assembly of the surgical instrument to a surgical implement such as an end effector of an endocutter.

Claims

1. A surgical instrument, comprising:

a handle assembly;

an elongated tube assembly coupled to said handle assembly, said elongated tube assembly comprising;

a proximal tube segment attached to said handle assembly, said proximal hollow tube segment having a proximal tube wall; and

a distal tube segment pivotally attached to said proximal tube segment and being selectively pivotable between a position wherein said distal tube segment is in substantial axial alignment with said proximal tube segment and positions wherein said distal tube segment is not substantially axially aligned with said proximal tube segment, said distal tube segment having a distal wall;

an actuator assembly supported by at least one of said proximal and distal tube segments and being coupled to at least one portion of one of said proximal and distal walls such that, upon actuation of said actuator assembly, said portion of one of said proximal and distal walls is pivoted out of substantial axial alignment with a corresponding portion of one of said proximal and distal walls to cause said distal tube segment to articulate out of substantial axial alignment with said proximal tube segment; and

a surgical implement attached to said distal tube segment.

2. The surgical instrument of claim 1 wherein said at least one portion of said proximal and distal walls comprises:

a first wall segment pivotally coupled to a remaining portion of said proximal wall and being selectively pivotable between a position wherein said first wall segment is substantially axially aligned with said remaining portion of said proximal wall and positions wherein said first wall segment is not substantially axially aligned with said remaining portion of said proximal wall; and

a second wall segment pivotally coupled to said first wall segment and being attached to said actuator assembly, said second wall segment being selectively pivotable between another position wherein said second wall segment is substantially axially aligned with said first wall segment and said remaining portion of said proximal wall and other positions wherein said second wall segment is not substantially axially aligned with said first wall segment.

3. The surgical instrument of claim 2 wherein said actuator assembly comprises:

a first actuator supported by said distal tube segment and attached to said second wall segment; and

a second actuator supported by said proximal tube segment and attached to said second wall segment.

4. The surgical instrument of claim 3 wherein said first and second actuators comprise first and second hydraulic cylinders, respectively.

5. The surgical instrument of claim 4 wherein said first hydraulic cylinder comprises:

a first cylinder housing supported by said distal tube segment, said first cylinder housing movably supporting a first piston therein; and

a first actuator rod extending from said first housing and being selectively extendable and retractable relative thereto in response to movement of said first piston within said first housing, said first actuator rod attached to a portion of said second wall segment and wherein said second hydraulic cylinder comprises;

a second cylinder housing supported by said proximal tube segment, said second cylinder housing movably supporting a second piston therein; and

a second actuator rod extending from said second housing and being selectively extendable and retractable relative thereto in response to movement of said second piston within said second housing, said second actuator rod attached to another portion of said second wall segment.

6. The surgical instrument of claim 1 wherein said at least one portion of said proximal and distal walls comprises:

a first wall segment pivotally coupled to a remaining portion of said proximal wall and being selectively pivotable between a position wherein said first wall segment is substantially axially aligned with said remaining portion of said proximal wall and positions wherein said first wall segment is not substantially axially aligned with said remaining portion of said proximal wall;

a second wall segment pivotally coupled to said first wall segment and being attached to said actuator assembly, said second wall segment being selectively pivotable between another position wherein said second wall segment is substantially axially aligned with said first wall segment and said remaining portion of said proximal wall and other positions wherein said second wall segment is not substantially axially aligned with said first wall segment;

a third wall segment pivotally coupled to another portion of said remaining portion of said proximal wall and being selectively pivotable between a position wherein said third wall segment is substantially axially aligned with said another portion of said remaining portion of said proximal wall and positions wherein said third wall segment is not substantially axially aligned with said another portion of said remaining portion of said proximal wall; and

a fourth wall segment pivotally coupled to said third wall segment and being attached to said actuator assembly, said fourth wall segment being selectively pivotable between a third position wherein said fourth wall segment is substantially axially aligned with said third wall segment and said another portion of said remaining portion of said proximal wall and other positions wherein said fourth wall segment is not substantially axially aligned with said third wall segment.

7. The surgical instrument of claim 6 wherein said actuator assembly comprises:

a first actuator supported by said distal tube segment and attached to said second wall segment;

a second actuator supported by said proximal tube segment and attached to said second wall segment;

a third actuator supported by said distal tube and attached to said fourth wall segment;

a fourth actuator supported by said proximal tube and attached to another portion of said fourth wall segment.

8. The surgical instrument of claim 7 wherein said first, second, third and fourth actuators comprise first, second, third, and fourth hydraulic cylinders, respectively.

9. The surgical instrument of claim 8 wherein said first hydraulic cylinder comprises:

a first cylinder housing supported by said distal tube segment, said first cylinder housing movably supporting a first piston therein; and

a first actuator rod extending from said first housing and being selectively extendable and retractable relative thereto in response to movement of said first piston within said first housing, said first actuator rod attached to a portion of said second wall segment and wherein said second hydraulic cylinder comprises;

a second cylinder housing supported by said proximal tube segment, said second cylinder housing movably supporting a second piston therein; and

a second actuator rod extending from said second housing and being selectively extendable and retractable relative thereto in response to movement of said second piston within said second housing, said second actuator rod attached to another portion of said second wall segment and wherein said third hydraulic cylinder comprises;

a third cylinder housing supported by said distal tube segment, said third cylinder housing movably supporting a third piston therein; and

a third actuator rod extending from said third housing and being selectively extendable and retractable relative thereto in response to movement of said third piston within said third housing, said third actuator rod attached to a portion of said fourth wall segment and wherein said fourth hydraulic cylinder comprises;

a fourth cylinder housing supported by said proximal tube segment, said fourth cylinder housing movably supporting a fourth piston therein; and

a fourth actuator rod extending from said fourth housing and being selectively extendable and retractable relative thereto in response to movement of said fourth piston within said fourth housing, said fourth actuator rod attached to another portion of said fourth wall segment.

10. The surgical instrument of claim 1 wherein said surgical implement comprises an endocutter end effector.

11. The surgical instrument of claim 1 wherein when said portion of one of said proximal and distal walls is substantially axially aligned with said remaining portion of said one of said primal and distal walls to which it is attached, said tube assembly and said surgical implement may be inserted through a trocar.

12. A surgical instrument, comprising:

a handle assembly;

an elongated tube assembly coupled to said handle assembly, said elongated tube assembly comprising;

a proximal tube segment attached to said handle assembly; and

a distal tube segment pivotally coupled to said proximal tube segment by a pivot pin;

an actuator supported by one of said proximal and distal tube segments, said actuator having an extendable and retractable actuation rod;

a moment arm rod coupled to said actuation rod and slidably extending through an opening in said pivot pin such that by extending and retracting said actuation rod, said distal tube segment is pivoted about said pivot pin relative to said proximal tube segment; and

a surgical implement attached to said distal tube segment.

13. The surgical instrument of claim 12 further comprising:

a first yoke on a proximal end of said distal tube segment, said first yoke having a first upper leg having a first upper pin receiving hole therein and a first lower leg spaced from said first upper leg having a first lower pin receiving hole therein; and

a second yoke on a distal end of said proximal tube segment, said second yoke having a second upper leg corresponding to said first upper leg of said first yoke and having a second upper pin-receiving hole therethrough in alignment with said first pin-receiving hole, said second yoke further comprising a second lower leg corresponding to said first lower leg of said first yoke and having a second lower pin-receiving hole therethrough in alignment with said first lower pin-receiving hole and wherein said pivot pin extends through said aligned first and second lower holes and said first and second upper holes such that said first yoke is attached to said pivot pin for pivotal travel therewith and said pin is free to rotate within said second upper and second lower holes in said second yoke.

14. The surgical instrument of claim 12 wherein said surgical implement comprises and endocutter end effector.

15. The surgical instrument of claim 12 wherein said distal tube segment has a distal axis and wherein said proximal tube segment has a proximal axis, said distal tube segment being selectively pivotal relative to said proximal tube segment between a position wherein said distal and proximal axes are substantially coaxially aligned and other positions wherein said distal and proximal axes are not substantially coaxially aligned.

16. The surgical instrument of claim 15 wherein said actuation rod has an actuation axis that is substantially parallel to the axis of said distal tube segment or proximal tube segment supporting said actuator and wherein said moment arm rod has a moment axis that is substantially transverse to said actuation axis.

17. A method of performing a surgical procedure through a trocar installed in a patient, said method comprising:

providing a surgical instrument having a handle assembly and a manipulatable surgical implement articulatably attached to the handle assembly by a tube assembly comprising;

a proximal tube segment attached to the handle assembly, the proximal tube segment sized to permit the proximal tube segment to axially pass through the trocar;

a distal tube segment attached to the surgical implement and pivotally coupled to the proximal tube segment for selective pivotal travel about a pivot axis, the distal tube segment sized to permit the distal tube segment to axially pass through the trocar; and

an actuator supported by one of the proximal and distal tube segments, the actuator having a selectively extendable and retractable actuation rod wherein a portion of the actuation rod is attached to the other of the proximal and distal tube segments at a point of attachment to define a moment arm between the pivot axis and the point of attachment;

substantially coaxially aligning the proximal and distal tube segments;

passing the surgical implement and the substantially coaxially aligned distal and proximal tube segments through the trocar into the patient; and

increasing the moment arm to pivot the distal tube segment and surgical implement out of substantial coaxial alignment with the proximal tube segment.

18. The method of claim 17 wherein the proximal tube segment has a wall portion and a movable wall segment pivotably attached to the wall portion and selectively movable between a position wherein the movable wall segment is substantially coaxially aligned with the wall portion and positions wherein the wall segment is not substantially coaxially aligned with the wall portion and wherein the actuation rod is attached to the movable wall segment at the point of attachment and wherein said increasing the moment arm comprises pivoting the movable wall segment out of substantial coaxial alignment with the wall portion.

19. The method of claim 18 wherein the proximal tube segment further comprises a second movable wall segment pivotally coupled to the first pivotal wall segment and is selectively movable between a position wherein the second pivotal wall segment is substantially coaxially aligned with the first pivotal segment and the wall portion and positions wherein the second wall segment is not substantially coaxially aligned with the first wall segment and wall portion and wherein the point of attachment is located wherein the actuation rod is attached to the second movable wall portion and wherein said increasing the moment arm comprises pivoting the second movable wall segment out of substantial coaxial alignment with the first movable wall segment and the first wall portion of the proximal tube segment.

20. The method of claim 19 wherein the tube assembly further comprises another actuator supported by the proximal tube segment and having another actuation rod attached to another portion of the second wall segment and wherein said increasing the moment arm comprises actuating the first and second actuators to pivot the second wall segment out of substantial coaxial alignment with the first wall segment and wall portion of the first proximal tube segment.