Medical instrument having an articulatable end effector

• US 20070250111A1
• Filed: 04/25/2006
• Published: 10/25/2007
• Est. Priority Date: 04/25/2006
• Status: Active Grant

• Current Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Lu, Ifung, Nobis, Rudolph
• Granted Patent: US 7,927,327 B2
• Time in Patent Office: Days
• US Class Current: 606/205
• CPC Class Codes: A61B 17/221 Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions surgical snare instruments A61B17/32056
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• 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 2017/003 Steerable
• CPC Class Codes: A61B 2017/00398 using powered actuators, e.g. stepper motors, solenoids
• CPC Class Codes: A61B 2017/2212 having a closed distal end, e.g. a loop
• CPC Class Codes: A61B 2017/2215 having an open distal end
• CPC Class Codes: A61B 2017/2905 flexible
• CPC Class Codes: A61B 2017/2927 the angular position of the head being adjustable with respect to the shaft
• CPC Class Codes: A61B 2017/2939 Details of linkages or pivot points

Abstract

A medical instrument includes a flexible tube, a distal member, a flexible end-effector activation wire, a proximal member, and a flexible first cable. The distal member is connected to the distal tube portion. The activation wire is positioned within the tube. The proximal member is attached to the tube. The first cable is positioned outside the tube, is substantially transversely constrained by the proximal member, and has a first distal cable portion attached to the distal member. Lengthwise translation of the first cable articulates the distal member with respect to the proximal member. Another instrument includes a drive screw which articulates an end effector (e.g., a grasper) pivotally connected to a tube. An additional instrument includes a drive screw which articulates a distal medical instrument member pivotally connected to a tube. A medical end effector (e.g., a snare) is positionable in a lumen of the distal medical instrument member.

Claims

1. A medical instrument comprising:

a) a flexible tube having a distal tube portion insertable within a patient;

b) a medical end effector connected to the distal tube portion;

c) a flexible medical-end-effector activation wire disposed within the tube;

d) a proximal medical instrument member spaced apart from, and disposed proximal to, the medical end effector, wherein the proximal medical instrument member is attached to the tube; and

e) a flexible, lengthwise-translatable first cable disposed outside the tube, substantially transversely constrained by the proximal medical instrument member, and having a distal cable portion attached to the medical end effector, wherein lengthwise translation of the first cable articulates the medical end effector with respect to the proximal medical instrument member.

2. The medical instrument of claim 1, wherein pulling of the first cable articulates the medical end effector with respect to the proximal medical instrument member.

3. The medical instrument of claim 1, also including a flexible first pipe surrounding the first cable and attached to the proximal medical instrument member.

4. The medical instrument of claim 3, wherein the first pipe does not extend distally of the proximal medical instrument member.

5. The medical instrument of claim 3, wherein the first pipe is a first coil pipe, and the tube is a coil-pipe tube.

6. The medical instrument of claim 3, wherein the proximal medical instrument member has a longitudinal axis, and wherein the tube is substantially coaxially aligned with the longitudinal axis within the proximal medical instrument member.

7. The medical instrument of claim 6, wherein the proximal medical instrument member has a longitudinally-extending circumferential surface, and wherein the first pipe is disposed in a surface groove of the circumferential surface of the proximal medical instrument member.

8. The medical instrument of claim 1, wherein the medical end effector has a proximal end-effector portion, and wherein the first cable is attached to the proximal end-effector portion of the medical end effector.

9. The medical instrument of claim 8, wherein the proximal medical instrument member has a first diameter, and wherein the proximal end-effector portion has a second diameter which is substantially equal to the first diameter.

10. The medical instrument of claim 1, also including a flexible, lengthwise-translatable second cable disposed outside the tube, substantially transversely constrained by the proximal medical instrument member, and having a distal cable portion attached to the medical end effector, wherein lengthwise translation of the second cable articulates the medical end effector with respect to the proximal medical instrument member.

11. The medical instrument of claim 10, also including a flexible, lengthwise-translatable third cable disposed outside the tube, substantially transversely constrained by the proximal medical instrument member, and having a distal cable portion attached to the medical end effector, wherein lengthwise translation of the third cable articulates the medical end effector with respect to the proximal medical instrument member.

12. The medical instrument of claim 11, wherein the medical end effector has a proximal end-effector portion, and wherein the first, second and third cables are attached to the proximal end-effector portion of the medical end effector.

13. The medical instrument of claim 12, wherein the proximal end-effector portion has a circumferential surface, and wherein the first, second and third cables are spaced apart from each other by substantially 120 degrees about the circumferential surface of the proximal end-effector portion.

14. A medical instrument comprising:

a) a flexible tube defining a passageway and having a distal tube portion insertable within a patient;

b) a distal medical instrument member connected to the distal tube portion and having a lumen in communication with the passageway;

c) a medical end effector disposable in the lumen of the distal medical instrument member;

d) a flexible activation wire disposable in the passageway and connected to the medical end effector;

d) a proximal medical instrument member spaced apart from, and disposed proximal to, the distal medical instrument member, wherein the proximal medical instrument member is attached to the tube; and

e) a flexible, lengthwise-translatable first cable disposed outside the tube, substantially transversely constrained by the proximal medical instrument member, and having a distal cable portion attached to the distal medical instrument member, wherein lengthwise translation of the first cable articulates the distal medical instrument member with respect to the proximal medical instrument member.

15. The medical instrument of claim 14, also including a flexible first pipe surrounding the first cable and attached to the proximal medical instrument member, wherein the proximal medical instrument member has a longitudinally-extending circumferential surface, wherein the first pipe is disposed in a surface groove of the circumferential surface of the proximal medical instrument member, and wherein the first pipe does not extend distally of the proximal medical instrument member.

16. The medical instrument of claim 15, wherein the first pipe is a first coil pipe, and wherein the tube is a coil-pipe tube.

17. A medical instrument comprising:

a) a tube having a distal tube end insertable within a patient;

b) a medical end effector having a distal portion and a proximal portion, wherein the proximal portion of the medical end effector is pivotally connected to the tube proximate the distal tube end;

c) a drive screw disposed in the tube proximal the proximal portion of the end effector; and

c) a sled translatable by rotation of the drive screw; and

d) a linkage having a first end portion pivotally connected to the sled and having a second end portion pivotally connected to the medical end effector between the proximal and distal portions of the medical end effector, wherein rotation of the drive screw translates the sled moving the linkage to articulate the medical end effector with respect to the distal tube end.

18. The medical instrument of claim 17, wherein the tube is a flexible tube.

19. A medical instrument comprising:

a) a tube defining a passageway and having a distal tube portion insertable within a patient;

b) a distal medical instrument member having a proximal end portion pivotally connected to the distal tube portion and having a lumen in communication with the passageway;

c) a medical end effector disposable in the lumen of the distal medical instrument member;

d) an activation wire disposable in the passageway and connected to the medical end effector;

e) a drive screw disposed in the tube proximal the distal medical instrument member;

f) a sled translatable by rotation of the drive screw; and

g) a linkage having a first end portion pivotally connected to the sled and having a second end portion pivotally connected to the distal medical instrument member distal the proximal end portion of the distal medical instrument member, wherein rotation of the drive screw translates the sled moving the linkage to articulate the distal medical instrument member with respect to the distal tube portion.

20. The medical instrument of claim 19, wherein the tube is a flexible tube.

21. A medical instrument comprising:

a) a flexible tube having a distal tube portion insertable within a patient;

b) a distal medical instrument member connected to the distal tube portion;

c) a flexible medical-end-effector activation wire disposed within the tube;

d) a proximal medical instrument member spaced apart from, and disposed proximal to, the distal medical instrument member, wherein the proximal medical instrument member is attached to the tube; and

e) a flexible, lengthwise-translatable first cable disposed outside the tube, substantially transversely constrained by the proximal medical instrument member, and having a distal cable portion attached to the distal medical instrument member, wherein lengthwise translation of the first cable articulates the distal medical instrument member with respect to the proximal medical instrument member.

22. The medical instrument of claim 21, wherein the proximal medical instrument member has a first lumen surrounding the activation wire and has a second lumen surrounding the first cable.

23. The medical instrument of claim 21, also including a flexible sheath attached to, and extending proximally from, the proximal medical instrument member, wherein the sheath has a first lumen surrounding the activation wire and has a second lumen surrounding the first cable.

24. The medical instrument of claim 23, wherein the distal medical instrument member is a medical end effector.

25. The medical instrument of claim 23, also including a medical end effector, wherein the distal medical instrument member has a lumen, and wherein the medical end effector is extendable from the lumen of the distal medical instrument member by translating the activation wire.