Endoscopic Vessel Sealer and Divider Having a Flexible Articulating Shaft

• US 20100179540A1
• Filed: 03/05/2010
• Published: 07/15/2010
• Est. Priority Date: 10/06/2006
• Status: Active Grant

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Covidien LP (Medtronic Plc)
• Inventors: Pribanic, Russell, Marczyk, Stanislaw, Hathaway, Peter, Taylor, Eric J., Farascioni, David
• Granted Patent: US 8,475,453 B2
• Time in Patent Office: Days
• US Class Current: 606/41
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 17/295 combined with cutting implements
• CPC Class Codes: A61B 18/1445 at the distal end of a shaft, e.g. forceps or scissors at the end of a rigid rod
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2018/00619 Welding
• CPC Class Codes: A61B 2018/00642 with feedback, i.e. closed loop control
• CPC Class Codes: A61B 2018/00922 by switching or controlling the treatment energy directly within the hand-piece
• CPC Class Codes: A61B 2018/1412 Blade
• CPC Class Codes: A61B 2018/1455 having a moving blade for cutting tissue grasped by the jaws

Abstract

An electrosurgical instrument for treating tissue includes a housing having a shaft extending therefrom having an axis A-A defined therethrough. The shaft is at least partially flexible and includes first and second jaw members attached at a distal end thereof. Each jaw member includes an electrically conductive tissue contacting surface adapted to connect to a source of electrosurgical energy such that the electrically conductive tissue contacting surfaces are capable of conducting electrosurgical energy through tissue held therebetween. A drive assembly is disposed in the housing and has a first actuator operably coupled to a drive rod for reciprocation thereof to move the jaw members from a first position in spaced relation to one another to a second position closer to one another for engaging tissue. A second actuator is disposed on the housing and is actuatable to articulate the shaft.

Claims

1. An endoscopic forceps, comprising:

a housing;

a shaft extending from the housing and defining a longitudinal axis, the shaft including a flexible portion,

an end effector supported at a distal end of the shaft, the end effector including a pair of jaw members, the jaw members being adapted to connect to a source of electrosurgical energy, at least one jaw member being moveable relative to the other;

a drive assembly disposed within the housing, the drive assembly operable to move the movable jaw member relative to the other jaw member from a first position wherein the movable jaw member is disposed in spaced relation relative to the other jaw member to a second position wherein the movable jaw member is closer to the other jaw member for manipulating tissue;

a movable handle supported on the housing, the movable handle in mechanical cooperation with the drive assembly such that the movable handle is rotatable about a pivot to move the jaw members between the first and second positions; and

an articulation assembly including at least one steering cable operably coupled to the flexible portion of the shaft such that movement of the articulation assembly induces the flexible portion of the shaft to articulate relative to the longitudinal axis, said articulation assembly including at least one articulating wheel disposed atop the housing that operably couples to the at least one steering cable such that articulation of the at least one articulation wheel moves the at least one steering cable to articulate the flexible portion of the shaft relative to the longitudinal axis.

2. The endoscopic forceps according to claim 1, wherein the articulation assembly includes a plurality of steering cables that are movable to articulate the flexible portion of the shaft in multiple planes relative to the longitudinal axis.

3. The endoscopic forceps according to claim 1, wherein the articulation assembly includes at least one slider coupled to the at least one steering cable, and wherein the at least one slider cooperates with the at least one articulating wheel to move the at least one steering cable longitudinally in response to rotational movement of the at least one articulating wheel.

4. The endoscopic forceps according to claim 3, wherein the at least one articulating wheel is operably coupled to the at least one slider by a spindle, the spindle configured to rotate along with the at least one articulating wheel.

5. The endoscopic forceps according to claim 4, wherein the spindle operably couples to an indexing wheel that allows the articulating wheel to move in discreet increments thereby permitting discreet articulation of the flexible portion of the shaft.

6. The endoscopic forceps according to claim 4, wherein the spindle is operably coupled to the at least one slider by a cam member configured to rotate along with the spindle, and wherein the cam member includes an eccentric arcuate surface thereon having a center dissimilar from a center of rotation of the cam member, and wherein the at least one slider is operatively coupled to the eccentric arcuate surface such that rotation of the cam member induces longitudinal motion of the slider.

7. The endoscopic forceps according to claim 2, wherein the articulation assembly includes two articulating wheels that are operably coupled to the plurality of steering cables to move the flexible portion of the shaft, a first articulating wheel configured to move the flexible portion of the shaft substantially along a first plane and a second articulating wheel configured to move the flexible portion of the shaft substantially along a second plane.

8. The endoscopic forceps according to claim 7, wherein movement of each of the two articulating wheels is independent of movement of the other such that movement of the articulating wheels sequentially or simultaneously induces a corresponding sequential or simultaneous motion of the flexible portion of the shaft in the first and second planes.

9. The endoscopic forceps according to claim 1, wherein the flexible portion of the shaft includes a plurality of joints that are nestingly arranged to facilitate articulation of the flexible portion of the shaft relative to the longitudinal axis.

10. The endoscopic forceps according to claim 9, wherein each joint of the plurality of joints includes at least one distal knuckle and at least one proximal clevis that nestingly engage one another to form the flexible portion of the shaft.

11. The endoscopic forceps according to claim 10, wherein each joint of the plurality of joints includes a pair of opposing distal knuckles and a pair of opposing proximal clevises, said pair of opposing distal knuckles and said pair of opposing proximal clevises being offset ninety degrees) (90°

) relative to one another.

12. The endoscopic forceps according to claim 9, wherein a portion of the shaft disposed proximally of the plurality of joints is substantially flexible along a length thereof to facilitate negotiation along a tortuous path

13. The endoscopic forceps according to claim 1, wherein said at least one steering cable is adapted to provide a return path to the electrosurgical energy source.

14. The endoscopic forceps according to claim 1, wherein the drive assembly includes a drive rod extending at least partially through the flexible portion of the shaft, the drive rod operably coupled to the movable jaw member such that longitudinal reciprocation of the drive rod induces movement of the movable jaw member between the first and second positions.

15. The endoscopic forceps according to claim 14, wherein the drive assembly includes a four bar mechanical linkage operably coupled to the drive rod to induce reciprocation of the drive rod, and wherein the four bar mechanical linkage is operable from the housing.

16. The endoscopic forceps according to claim 14, wherein the drive rod is substantially flexible.

17. An endoscopic surgical instrument comprising:

an end effector including a pair of jaw members, at least one jaw member of the pair of jaw members being movable relative to the other to move the end effector between an open configuration wherein the jaw members are substantially spaced for receiving tissue and a closed configuration wherein the jaw members are closer together for contacting the tissue;

a handle being manually movable to selectively induce motion in the end effector between the open configuration and the closed configuration;

an elongated shaft defining a longitudinal axis and including distal and proximal ends, the distal end coupled to the end effector and the proximal end coupled to the handle, the elongated shaft including an articulating portion movable between an aligned configuration and an articulated configuration with respect to the longitudinal axis,

an articulation assembly operable to move the articulating portion of the elongated shaft between the aligned configuration and articulated configuration, the articulation assembly comprising;

a first actuator positioned on the instrument for manipulation by an operator during a surgical procedure;

a first cam member coupled to the first actuator such that the first actuator is operable to rotate the first cam member about a center of rotation, the first cam member including an eccentric arcuate surface thereon having a center dissimilar from the center of rotation of the cam member; and

a first pair of cables coupled to the arcuate surface of the first cam member such that rotation of the cam member induces differential longitudinal motion in the cables, the first pair of cables coupled to the distal end of the elongated shaft such that the differential longitudinal motion in the first pair of cables moves the articulating portion of the elongated shaft between the aligned configuration and the articulated configuration in a first plane of articulation.

18. The instrument according to claim 17, wherein the articulation assembly includes a second actuator positioned on the instrument for manipulation by an operator during a surgical procedure, the second actuator operable to induce motion of the articulating portion of the elongated shaft between the aligned configuration and the articulated configuration in a second plane of articulation.

19. The instrument according to claim 18, wherein the second actuator is operable to rotate a second cam member about a center of rotation, and wherein the second cam member is coupled to a second pair of cables being coupled to the distal end of the elongated shaft.

20. The instrument according to claim 17, wherein the first actuator comprises a rotatable wheel and wherein the first cam member comprises a cam wheel, the cam wheel being coupled to the rotatable wheel such that a given angular displacement of the rotatable wheel induces an equivalent angular displacement of the cam wheel.

21. The instrument according to claim 20, wherein the arcuate surface includes a cam slot defined in the cam wheel, the cam slot extending between a radially inward position and a radially outward position on the cam wheel.

22. The instrument according to claim 21, wherein the cam slot is tapered such that a given angular displacement of the cam wheel induces greater differential longitudinal motion in the first pair of cables when the cam wheel is closer to a home position wherein the articulating portion is in the aligned configuration than when the cam wheel is further from the home position.

23. The instrument according to claim 17, further comprising an indexing mechanism for maintaining the articulation assembly in a plurality of relatively stable configurations to facilitate orienting the end effector in one of a plurality of discrete orientations.

24. The instrument according to claim 23, wherein the indexing mechanism includes an indexing slide for engaging a plurality of teeth disposed on an outer circumferential surface of the first cam member.

25. The instrument according to claim 18, wherein the articulating portion includes a plurality of links arranged sequentially such that each of the links may pivot relative to a neighboring link to move the articulating portion between the aligned and articulated configurations.

26. The instrument according to claim 25, wherein a first pivoting axis defined by one of the links is radially offset from a second pivoting axis defined by another of the plurality of links by about 90°

to define the second plane of articulation such that the second plane of articulation is substantially orthogonal to the first plane of articulation.

27. An endoscopic surgical instrument comprising:

an end effector including a pair of jaw members, at least one jaw member of the pair of jaw members being movable relative to the other to move the end effector between an open configuration wherein the jaw members are substantially spaced for receiving tissue and a closed configuration wherein the jaw members are closer together for contacting the tissue;

a handle being manually movable to selectively induce motion in the end effector between the open configuration and the closed configuration;

an elongated shaft defining a longitudinal axis and including distal and proximal ends, the distal end coupled to the end effector and the proximal end coupled to the handle, the elongated shaft including an articulating portion to permit the end effector to articulate with respect to the longitudinal axis;

a pair of steering cables extending between the distal and proximal ends of the elongated shaft, the steering cables coupled to the distal end of the elongated shaft such that differential longitudinal motion in the steering cables induces articulation of the end effector; and

an actuator coupled to the pair of steering cables by a cam member, the actuator being movable through a range of motion to impart rotational motion to the cam member, the cam member being configured to impart longitudinal motion to the steering cables as a function of a distance the actuator is moved through the range of motion.