METHODS AND DEVICES FOR CONTROLLING ARTICULATION

• US 20070221700A1
• Filed: 03/23/2006
• Published: 09/27/2007
• Est. Priority Date: 03/23/2006
• Status: Active Grant

• Current Assignee: Cilag Gmbh International (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Ortiz, Mark, Spivey, James, Shelton, Frederick
• Granted Patent: US 8,721,630 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 17/1633 Sleeves, i.e. non-rotating parts surrounding the bit shaft, e.g. the sleeve forming a single unit with the bit shaft A61B17/1644 takes precedence
• CPC Class Codes: A61B 2017/003 Steerable
• 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 2017/00464 for use with different instruments
• 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 2017/2931 with releasable head
• CPC Class Codes: A61B 2034/306 Wrists with multiple vertebrae
• CPC Class Codes: A61B 34/70 Manipulators specially adapted for use in surgery
• CPC Class Codes: A61B 34/71 Manipulators operated by drive cable mechanisms
• CPC Class Codes: A61B 34/72 Micromanipulators

Abstract

Methods and devices are provided for controlling movement of a working end of a surgical device. In one embodiment, methods 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. In other embodiments, a single cable actuator is provided and is movable between a first position, in which it is effective to rotate an end effector without actuating (i.e., closing and firing) the end effector, and a second position, in which it is effective to actuate the end effector without rotating the end effector. In other aspects, methods and devices are provided for moving a flexible neck formed on a distal end of an accessory channel for use with an endoscope. Movement of the flexible neck can be used to control positioning of a tool extending through the flexible neck.

Claims

1. A surgical device, comprising:

an elongate shaft having a proximal end with a handle movably coupled thereto, and a distal end having a flexible neck extending therefrom, wherein the handle and the flexible neck are operatively associated such that movement of the handle is mimicked by the flexible neck.

2. The device of claim 1, wherein the mimicking movement is proportional.

3. The device of claim 1, wherein the handle is adapted to articulate relative to the proximal end of the elongate shaft.

4. The device of claim 3, wherein the handle is coupled to the proximal end of the elongate shaft by a joint selected from the group consisting of a ball and socket joint, a hinge joint, and a flexing joint.

5. The device of claim 1, wherein the handle and the flexible neck are operatively associated by an actuator extending between the handle and the flexible neck, the actuator being configured to transfer movement from the handle to the flexible neck.

6. The device of claim 5, wherein the actuator comprises at least one cable extending along a length of the elongate shaft and effective to apply a force to the flexible neck to move the flexible neck in at least one plane of motion.

7. The device of claim 6, wherein the at least one cable is formed from an electroactive polymer material, and wherein movement of the handle is effective to selectively deliver energy to the at least one cable to cause the at least one cable to axially contract and radially expand and thereby cause at least one of the flexible neck to mimic the motion of the handle.

8. The device of claim 6, wherein the at least one cable comprises a plurality of cables extending along a length of the elongate shaft, each cable being effective to apply a force to the flexible neck to move the flexible neck in a different plane of motion.

9. The device of claim 8, wherein the plurality of cables are equally spaced apart from one another around a circumference of the actuator.

10. The device of claim 8, wherein the plurality of cables comprise at least three cables extending along a length of the elongate shaft.

11. The device of claim 8, wherein at least one of the handle and the plurality of cables include a locking mechanism associated therewith and configured to maintain at least one of the handle and the plurality of cables in a fixed position.

12. The device of claim 1, wherein the flexible neck includes an end effector coupled to a distal end thereof and adapted to deliver at least one fastener to tissue.

13. A method of reconditioning the device of claim 12, comprising:

removing and replacing a cartridge removably disposed in the end effector to prepare the device for re-use, the cartridge containing a plurality of fasteners disposed therein.

14. The device of claim 1, wherein the elongate shaft includes a central lumen extending therethrough along a length thereof, the central lumen being adapted to receive a tool therethrough.

15. The device of claim 14, wherein the elongate shaft includes a mating element formed on and extending along a length of an external surface thereof for mating to a complementary mating element formed on a sleeve adapted to receive an endoscope.

16. A surgical device, comprising:

an elongate shaft having a proximal end and a distal end with a flexible neck defining a working end of the device, the flexing neck being made flexible by a plurality of slits formed therein;

a handle movably coupled to the proximal end of the elongate shaft and operatively associated with the flexible neck such that movement of the handle is effective to cause the flexible neck to articulate in multiple planes.

17. The device of claim 16, wherein the handle is operatively associated with the flexible neck by a plurality of cables spaced circumferentially about the elongate shaft and extending between the handle and a distal end of the flexible neck, the plurality of cables being configured to slide relative to an axis of the elongate shaft in response to movement of the handle and to tension the flexible neck to cause the flexible neck to articulate.

18. The device of claim 17, further comprising a locking mechanism positioned to engage at least one of the handle and the plurality of cables to lock the handle and the plurality of cables in a fixed position and thereby maintain the flexible neck in a fixed position.

19. A surgical device, comprising:

a flexible elongate shaft having proximal and distal ends;

a plurality of cables spaced circumferentially about the elongate shaft and extending between the proximal and distal ends of the elongate shaft, the plurality of cables being configured to slide relative to an axis of the elongate shaft and to apply tension to the elongate shaft to cause at least a portion of the elongate shaft to flex and bend; and

a locking mechanism coupled to the elongate shaft and positioned to engage the plurality of cables to lock the plurality of cables in a fixed position and thereby maintain the elongate shaft in a fixed position.

20. The device of claim 19, wherein the elongate shaft is configured to passively flex and bend when it is inserted through a tortuous lumen.

21. A surgical method, comprising:

inserting an elongate shaft into a body lumen to position a flexible neck coupled to a distal end of the elongate shaft adjacent to tissue to be treated;

moving a handle pivotally coupled to a proximal end of the elongate shaft to cause the flexible neck to mimic the motion of the handle.

22. The method of claim 21, wherein the mimicking motion is proportional.

23. The method of claim 21, wherein the flexible neck mirrors movement of the handle.

24. The method of claim 21, wherein movement of the flexible neck directly corresponds to movement of the handle.

25. The method of claim 21, wherein the handle is pivotally articulated about the proximal end of the elongate shaft to cause the flexible neck to mimic the motion of the handle.

26. The method of claim 21, further comprising engaging tissue between opposed jaws of an end effector coupled to a distal end of the flexible neck, and delivering at least one fastener to the tissue.

27. The method of claim 21, wherein inserting the elongate shaft comprises mating the elongate shaft to a sleeve disposed around an endoscope, and sliding the elongate shaft along the sleeve to position the flexible neck adjacent to a distal end of the endoscope.

28. The method of claim 27, further comprising inserting a tool through a central lumen formed in the elongate shaft to position a working end of the tool in proximity to a distal end of the flexible neck such that moving the handle pivotally coupled to a proximal end of the elongate shaft causes the working end of the tool to move as the flexible neck proportionally mimics the motion of the handle.