Surgical instruments

• US 20080234708A1
• Filed: 03/22/2007
• Published: 09/25/2008
• Est. Priority Date: 03/22/2007
• Status: Active Grant

• Current Assignee: Cilag Gmbh International (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Houser, Kevin L., Zwolinski, Andrew M., Malaviya, Prasanna, Price, Daniel W., DeLuca, Louis T., Lopes, Tracy D.
• Granted Patent: US 8,142,461 B2
• Time in Patent Office: Days
• US Class Current: 606/169
• CPC Class Codes: A61B 17/320068 using mechanical vibrations, e.g. ultrasonic A61B17/22012 takes precedence; dental tooth drilling devices operated by vibration A61C3/03; removing intra-ocular material using mechanical vibrations A61F9/00745
• CPC Class Codes: A61B 17/320092 with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw
• CPC Class Codes: A61B 2017/0046 with a releasable handle; with handle and operating part separable for prosthetic joint-implanting tools A61F2/4603
• CPC Class Codes: A61B 2017/00464 for use with different instruments with hole for different instruments A61B2017/22072
• CPC Class Codes: A61B 2017/00477 Coupling A61B2017/0046 takes precedence
• CPC Class Codes: A61B 2017/2837 with a locking ratchet
• CPC Class Codes: A61B 2017/2924 Translation movement of handle without rotating movement
• CPC Class Codes: A61B 2017/2946 Locking means
• CPC Class Codes: A61B 2017/320069 for ablating tissue
• CPC Class Codes: A61B 2017/320071 with articulating means for working tip
• CPC Class Codes: A61B 2017/320082 for incising tissue
• CPC Class Codes: A61B 2017/320089 node location
• CPC Class Codes: A61B 2017/320094 additional movable means performing clamping operation
• CPC Class Codes: A61B 2017/320095 with sealing or cauterizing means
• CPC Class Codes: A61B 2090/036 abutting on tissue or skin
• CPC Class Codes: A61B 2090/0807 Indication means

Abstract

A surgical instrument that may include a housing, a transducer engaged with the housing which can produce vibrations, and an end-effector engaged with the transducer. The surgical instrument can further include an adjustable sheath extending from the housing where the sheath is movable relative to the distal tip of the end-effector and where the distance between the distal tip of the sheath and the distal tip of the end-effector can be set such that the sheath can act as a depth stop. The sheath can be adjusted such that, when the distal tip of the sheath contacts the tissue or bone being incised, the surgeon can determine that the appropriate depth of the incision has been reached. In other embodiments, the end-effector can be moved with respect to the sheath in order to adjust the distance between the distal tip of the end-effector and the distal tip of the sheath.

Claims

1. A surgical instrument, comprising:

a transducer configured to produce vibrations;

an end-effector engaged with said transducer, wherein said end-effector defines an axis and a distal tip, and wherein said distal tip is movable relative to said axis by vibrations produced by said transducer; and

an adjustable depth stop movably supported relative to said end-effector, wherein said depth stop includes a distal tip, and wherein said distal tip of said depth stop is movable relative to said distal tip of said end-effector.

2. The surgical instrument of claim 1, wherein said depth stop includes a sheath at least partially surrounding said end-effector.

3. The surgical instrument of claim 1, wherein said vibrations include at least one of vibrations parallel to said axis, vibrations transverse to said axis, and vibrations torsional about said axis.

4. The surgical instrument of claim 1, further comprising a housing, wherein said transducer is supported by said housing and said depth stop is threadably engaged with said housing, and wherein relative rotational movement between said depth stop and said housing moves said distal end of said depth stop relative to said distal end of said end-effector.

5. The surgical instrument of claim 1, wherein said depth stop further includes indicia configured to indicate the distance between said distal tip of said end-effector and said distal tip of said depth stop.

6. The surgical instrument of claim 1, further comprising a housing, wherein said sheath is movably coupled to said housing by a collet assembly.

7. The surgical instrument of claim 1, further comprising a housing, wherein said housing includes an outer shaft portion, wherein said depth stop includes an intermediate shaft portion and an inner shaft portion, wherein said outer shaft portion is threadably engaged with said intermediate shaft portion, wherein said intermediate shaft portion is threadably engaged with said inner shaft portion, and wherein said inner shaft portion can be rotated relative to said intermediate shaft portion and said intermediate shaft portion can be rotated relative to said outer shaft portion to adjust a distance between said distal tip of said depth stop and said distal tip of said end-effector.

8. The surgical instrument of claim 1, further comprising:

a housing;

a handle extending from said housing;

an actuator extending from said housing, wherein said actuator is relatively movable with respect to said handle; and

a drive mechanism, wherein said depth stop is engaged with said drive mechanism, and wherein said actuator is operably engaged with said drive mechanism such that, when said actuator is moved relative to said handle, said distal end of said depth stop is moved relative to said distal end of said end-effector.

9. The surgical instrument of claim 1, further comprising:

an actuator; and

a ratchet mechanism, wherein said depth stop extends from said ratchet mechanism, and wherein said ratchet mechanism comprises;

a rack, wherein said depth stop is engaged with said rack;

a spring engaged with said rack;

a ratchet wheel engaged with said actuator; and

a pawl selectively engagable with said ratchet wheel, wherein, when said pawl is engaged with said ratchet wheel, said pawl and said ratchet wheel are configured to move said rack and said distal end of said depth stop with respect to said distal end of said end-effector, and wherein, when said pawl is disengaged from said ratchet wheel, said spring is configured to reposition said rack and said depth stop with respect to said distal end of said end-effector.

10. A method for processing an instrument for surgery, the method comprising:

obtaining the surgical instrument of claim 1;

sterilizing the surgical instrument; and

storing the instrument in a sterile container.

11. A method for processing an instrument for surgery, the method comprising:

obtaining the surgical instrument of claim 1;

detaching said depth stop from the surgical instrument; and

performing one of the following actions;

reforming at least a portion of said depth stop, resterilizing said depth stop, and reattaching said depth stop to the surgical instrument;

or

attaching a different said depth stop to the surgical instrument.

12. A surgical instrument, comprising:

a housing;

a transducer, wherein said transducer is configured to produce vibrations;

an end-effector engaged with said transducer, wherein said end-effector defines an axis and a distal tip, and wherein said distal tip is movable relative to said axis by vibrations produced by said transducer; and

a depth stop extending from said housing, wherein said depth stop includes a distal tip, and wherein a distance between said distal tip of said end-effector and said distal tip of said end-effector is adjustable.

13. The surgical instrument of claim 12, wherein said depth stop includes a sheath at least partially surrounding said end-effector.

14. The surgical instrument of claim 12, wherein said vibrations include at least one of vibrations parallel to said axis, vibrations transverse to said axis, and vibrations torsional about said axis.

15. The surgical instrument of claim 12, further comprising:

a handle extending from said housing;

an actuator extending from said housing, wherein said actuator is relatively movable with respect to said handle; and

a ratchet mechanism, wherein said end-effector is connected to said ratchet mechanism, wherein said actuator is operably engaged with said ratchet mechanism such that, when said actuator is moved relative to said handle, said distal end of said end-effector is moved with respect to said distal end of said depth stop.

16. The surgical instrument of claim 12, further comprising:

an actuator; and

a ratchet mechanism, comprising;

a rack, wherein said end-effector is engaged with said rack;

a spring engaged with said rack;

a ratchet wheel engaged with said actuator; and

a pawl selectively engagable with said ratchet wheel, wherein, when said pawl is engaged with said ratchet wheel, said pawl and said ratchet wheel are configured to advance said rack and said distal end of said end-effector with respect to said distal end of said depth stop, and wherein, when said pawl is disengaged from said ratchet wheel, said spring is configured to retract said rack and said end-effector with respect to said distal end of said depth stop.

17. The surgical instrument of claim 16, wherein said transducer is engaged with said rack.

18. The surgical instrument of claim 12, wherein said depth stop includes a first portion and a second portion, wherein said second portion is removably connected to said first portion, and wherein said second portion can be disconnected from said first portion to adjust the length of said depth stop.

19. A method for processing an instrument for surgery, the method comprising:

obtaining the surgical instrument of claim 12;

sterilizing the surgical instrument; and

storing the instrument in a sterile container.

20. A method for processing an instrument for surgery, the method comprising:

obtaining the surgical instrument of claim 12;

detaching said depth stop from the surgical instrument; and

performing one of the following actions;

reforming at least a portion of said depth stop, resterilizing said depth stop, and reattaching said depth stop to the surgical instrument;

or

attaching a different said depth stop to the surgical instrument.

21. A surgical instrument kit, comprising:

a surgical instrument, comprising;

a housing;

a transducer configured to produce vibrations; and

an end-effector engaged with said transducer, wherein said end-effector defines an axis and a distal tip, and wherein said distal tip is movable relative to said axis by vibrations produced by said transducer;

a first depth stop, wherein said first depth stop is configured to extend from said housing, wherein said first depth stop includes a distal tip, and wherein, when said first depth stop is assembled to said housing, said distal tip of said end-effector and said distal tip of said first depth stop define a first distance therebetween; and

a second depth stop, wherein said second depth stop is configured to extend from said housing, wherein said second depth stop includes a distal tip, wherein, when said second depth stop is assembled to said housing, said distal tip of said end-effector and said distal tip of said second depth stop define a second distance therebetween, and wherein said first distance is different than said second distance.

22. The surgical kit of claim 21, wherein said housing includes one of a projection and a slot, wherein said first depth and said second depth stop each include the other of said projection and said slot, and wherein said slot is configured to receive said projection and attach said depth stops to said housing.

23. The surgical kit of claim 21, wherein, when said projection is positioned in said slot, said projection and said slot are in a press-fit engagement.

24-74. -74. (canceled)

75. A surgical instrument, comprising:

a transducer configured to produce vibrations;

an end-effector engaged with said transducer, wherein said end-effector defines an axis and a distal tip, and wherein said distal tip is movable relative to said axis by vibrations produced by said transducer; and

a clamp having a jaw member movably supported relative to said end-effector, wherein said jaw member is movable between an open position and a closed position, and wherein said clamp is translatable between a first axial position and a second axial position with respect to said distal tip of said end-effector.

76. A method for processing an instrument for surgery, the method comprising:

obtaining the surgical instrument of claim 75;

sterilizing the surgical instrument; and

storing the instrument in a sterile container.

77. A method for processing an instrument for surgery, the method comprising:

obtaining the surgical instrument of claim 75;

detaching said clamp from the surgical instrument; and

performing one of the following actions;

reforming at least a portion of said clamp, resterilizing said clamp, and reattaching said clamp to the surgical instrument;

or

attaching a different said clamp to the surgical instrument.

78. A surgical instrument, comprising:

a housing;

a transducer engaged with said housing, wherein said transducer is configured to produce vibrations;

an end-effector engaged with said transducer, wherein said end-effector defines an axis and a distal tip, and wherein said distal tip is movable relative to said axis by vibrations produced by said transducer; and

a clamp, wherein said clamp includes a jaw member and a pivot, wherein said jaw member is rotatable with respect to said end-effector about said pivot, and wherein said jaw member is detachable from said clamp.

79. A method for processing an instrument for surgery, the method comprising:

obtaining the surgical instrument of claim 78;

sterilizing the surgical instrument; and

storing the instrument in a sterile container.

80. A method for processing an instrument for surgery, the method comprising:

obtaining the surgical instrument of claim 78;

detaching said clamp from the surgical instrument; and

performing one of the following actions;

reforming at least a portion of said clamp, resterilizing said clamp, and reattaching said clamp to the surgical instrument;

or

attaching a different said clamp to the surgical instrument.

81. A surgical instrument, comprising:

a housing;

a transducer engaged with said housing, wherein said transducer is configured to produce vibrations;

an end-effector engaged with said transducer, wherein said end-effector defines an axis and a distal tip, and wherein said distal tip is movable relative to said axis by vibrations produced by said transducer;

a clamp, wherein said clamp includes a jaw member and a pivot;

rotating means for rotating said end-effector between an open position and a closed position about said pivot; and

translating means for translating said clamp between a first position and a second position with respect to said distal tip of said end-effector.

82. A surgical instrument, comprising:

a transducer configured to produce vibrations;

an end-effector engaged with said transducer, wherein said end-effector defines an axis and a distal tip, wherein said distal tip is movable relative to said axis by vibrations produced by

said transducer, and wherein said end-effector includes a first treatment region and a second treatment region; and

at least one first indicium configured to identify said first treatment region.

83. A method for processing an instrument for surgery, the method comprising:

obtaining the surgical instrument of claim 82;

sterilizing the surgical instrument; and

storing the instrument in a sterile container.

84. A method for processing an instrument for surgery, the method comprising:

obtaining the surgical instrument of claim 82;

detaching said end-effector from the surgical instrument; and

performing one of the following actions;

reforming at least a portion of said end-effector, resterilizing said end-effector, and reattaching said end-effector to the surgical instrument;

or

attaching a different said end-effector to the surgical instrument.

85. A surgical instrument, comprising:

a transducer configured to produce vibrations;

an end-effector engaged with said transducer, wherein said end-effector defines an axis and a distal tip, wherein said distal tip is movable relative to said axis by vibrations produced by said transducer, and wherein said end-effector includes a first treatment region and a second treatment region; and

a demarcation on said end-effector configured to identify said first treatment region.

86. A method for processing an instrument for surgery, the method comprising:

obtaining the surgical instrument of claim 85;

sterilizing the surgical instrument; and

storing the instrument in a sterile container.

87. A method for processing an instrument for surgery, the method comprising:

obtaining the surgical instrument of claim 85;

detaching said end-effector from the surgical instrument; and

performing one of the following actions;

reforming at least a portion of said end-effector, resterilizing said end-effector, and reattaching said end-effector to the surgical instrument;

or

attaching a different said end-effector to the surgical instrument.

88. A surgical instrument, comprising:

a transducer configured to produce vibrations;

an end-effector engaged with said transducer, wherein said end-effector defines an axis and a distal tip, wherein said distal tip is movable relative to said axis by vibrations produced by said transducer; and

means for indicating portions of said end-effector which vibrate at a higher intensity relative to portions of said end-effector which vibrate at a lower intensity.

89. A surgical instrument, comprising:

a transducer configured to produce vibrations;

an end-effector engaged with said transducer, wherein said end-effector defines an axis and a distal tip, wherein said distal tip is movable relative to said axis by vibrations produced by said transducer, and wherein said end-effector includes a first treatment region and a second treatment region; and

means for indicating which portions of said end-effector include said first treatment region and said second treatment region.