SURGICAL INSTRUMENTS WITH ARTICULATING SHAFTS

• US 20140005703A1
• Filed: 06/29/2012
• Published: 01/02/2014
• Est. Priority Date: 06/29/2012
• Status: Active Grant

• Current Assignee: Cilag Gmbh International (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Stulen, Foster B., Huang, Zhifan F., Weizman, Patrick A., Draginoff, Carl J. Jr., Smolik, Steven P.
• Granted Patent: US 9,408,622 B2
• Time in Patent Office: Days
• US Class Current: 606/169
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 17/320016 Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes A61B10/0233, A61B17/29, A61B17/3207 take precedence
• 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 18/1447 wherein sliding surfaces cause opening/closing of the end effectors
• 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 2017/22015 with details of the transmission member
• CPC Class Codes: A61B 2017/22018 segmented along its length
• CPC Class Codes: A61B 2017/2927 the angular position of the head being adjustable with respect to the shaft
• CPC Class Codes: A61B 2017/2932 Transmission of forces to jaw members
• CPC Class Codes: A61B 2017/294 Connection of actuating rod to jaw, e.g. releasable
• 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 2017/320075 single edge blade, e.g. for cutting
• CPC Class Codes: A61B 2017/320078 Tissue manipulating surface
• CPC Class Codes: A61B 2017/320089 node location
• CPC Class Codes: A61B 2017/320093 additional movable means performing cutting operation
• 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 2018/00196 reciprocating lengthwise
• CPC Class Codes: A61B 2018/00589 : Coagulation
• CPC Class Codes: A61B 2018/00595 : Cauterization
• CPC Class Codes: A61B 2018/00607 : Coagulation and cutting with the same instrument
• CPC Class Codes: A61B 2018/0063 : Sealing
• CPC Class Codes: A61B 2018/00642 : with feedback, i.e. closed loop control
• CPC Class Codes: A61B 2018/00702 : Power or energy
• CPC Class Codes: A61B 2018/00875 : Resistance or impedance
• CPC Class Codes: A61B 2018/0091 : Handpieces of the surgical instrument or device
• CPC Class Codes: A61B 2018/00994 : combining two or more different kinds of non-mechanical energy or combining one or more non-mechanical energies with ultrasound
• CPC Class Codes: A61B 2018/1452 : including means for cutting A61B2018/146 takes precedence
• CPC Class Codes: A61B 34/30 : Surgical robots

Abstract

Various embodiments are directed to articulatable surgical instruments. Some embodiments comprise an end effector to treat tissue, where the end effector comprises an ultrasonic blade. A hollow shaft may extend proximally from the end effector along a longitudinal axis. A waveguide may extend through the shaft and may be acoustically coupled to the ultrasonic blade. The waveguide may comprise a distally positioned flange positioned within the hollow shaft proximally from the blade and may be held stationary at a first pivot point positioned within the hollow shaft proximally from the flange. A reciprocating wedge may be positioned within the hollow shaft such that distal motion of the wedge pushes the wedge between the flange and the hollow shaft, causing the ultrasonic blade to pivot about the first pivot point in a first direction.

Claims

1. An articulatable surgical instrument comprising:

an end effector to treat tissue, wherein the end effector comprises an ultrasonic blade;

a hollow shaft extending proximally from the end effector along a longitudinal axis; and

a waveguide extending through the shaft and acoustically coupled to the ultrasonic blade, wherein the waveguide comprises a distally positioned flange positioned within the hollow shaft proximally from the blade, and wherein the waveguide is held stationary at a first pivot point positioned within the hollow shaft proximally from the flange;

a reciprocating wedge positioned within the hollow shaft such that distal motion of the wedge pushes the wedge between the flange and the hollow shaft, causing the ultrasonic blade to pivot about the first pivot point in a first direction.

2. The surgical instrument of claim 1, wherein the waveguide is coupled to the hollow shaft at the first pivot point.

3. The surgical instrument of claim 1, wherein the pivot point is positioned at a first node of the waveguide at a resonant frequency of the waveguide.

4. The surgical instrument of claim 3, wherein the flange is positioned at a second node of the waveguide at the resonant frequency of the waveguide.

5. The surgical instrument of claim 4, wherein the first node and the second node are separated by a single wavelength.

6. The surgical instrument of claim 1, wherein an interior wall of the hollow shaft defines a longitudinally directed slot and where at least a portion of the reciprocating wedge is positioned within the longitudinal slot as the wedge reciprocates distally and proximally.

7. The surgical instrument of claim 1, wherein the at least a portion of the flange is curved such that a concave side of the curve is directed towards the longitudinal axis, and wherein the reciprocating wedge is curved such that the reciprocating wedge contacts the curved portion of the flange.

8. The surgical instrument of claim 1, wherein the flange defines a notch and wherein the wedge comprises a corresponding step such that the step rides within the notch as the reciprocating wedge is moved distally.

9. The surgical instrument of claim 8, wherein the flange defines a second notch and wherein the wedge comprises a corresponding second step such that the second step rides within the second notch as the reciprocating wedge is translated distally.

10. The surgical instrument of claim 8, wherein the first and second notches form a step pattern.

11. The surgical instrument of claim 1, wherein the wedge defines:

a first wedge portion where the wedge has a first slope;

a flat portion where the wedge has substantially no slope, wherein the flat portion is positioned proximally from the first wedge portion; and

a second wedge portion, wherein the wedge has a second slope.

12. The surgical instrument of claim 11, wherein the wedge is positioned such that:

distal translation of the wedge to a first position causes the first wedge portion to pivot the ultrasonic blade about the pivot point by a first amount;

distal translation of the wedge from the first position to a second position causes the flat portion of the wedge to contact the flange; and

distal translation of the wedge from the second position to a third position causes the second wedge portion to pivot the ultrasonic blade about the pivot point by an additional amount.

13. The surgical instrument of claim 11, wherein the wedge further defines:

a second flat portion positioned proximally from the second wedge portion, wherein the wedge has substantially no slope and at the second flat portion; and

a third wedge portion having a third slope and positioned proximally from the second flat portion.

14. The surgical instrument of claim 11, wherein the first slope and the second slope are substantially equal to one another.

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

a second reciprocating wedge positioned within the hollow shaft opposite the first reciprocating wedge such that distal motion of the second wedge pushes the second wedge between the flange and the hollow shaft causing the ultrasonic blade to pivot about the first pivot point in a second direction.

16. An articulatable surgical instrument comprising:

an end effector to treat tissue, wherein the end effector comprises an ultrasonic blade;

a hollow shaft extending proximally from the end effector along a longitudinal axis, wherein an interior portion of the hollow shaft defines a shaft cam feature directed towards the longitudinal axis; and

a waveguide extending through the shaft and coupled to the ultrasonic blade, wherein the waveguide comprises a distally positioned flange positioned within the hollow shaft proximally from the blade, and wherein the waveguide is held stationary at a first pivot point positioned within the hollow shaft proximally from the flange, and wherein the flange defines a waveguide cam feature directed away from the longitudinal axis such that rotation of the hollow shaft relative to the waveguide causes the shaft cam feature to come into contact with the waveguide cam feature, resulting in bending of the waveguide and ultrasonic blade away from the longitudinal axis about the first pivot point in a first direction.

17. The surgical instrument of claim 16, wherein the flange further defines a second waveguide cam feature directed away from the longitudinal axis, wherein contact between the shaft cam feature and the second waveguide cam feature results in bending of the waveguide and ultrasonic blade away from the longitudinal axis in a second direction.

18. The surgical instrument of claim 16, wherein the pivot point is positioned at a first node of the waveguide.

19. The surgical instrument of claim 18, wherein the flange is positioned at a second node of the waveguide.

20. The surgical instrument of claim 19, wherein the first node and the second node are separated by a single resonant wavelength.

21. An articulatable surgical instrument comprising:

an end effector to treat tissue, wherein the end effector comprises an ultrasonic blade;

a hollow shaft extending proximally from the end effector along a longitudinal axis, the hollow shaft having an exterior wall and an interior wall, wherein the interior wall defines a groove within the hollow shaft with different portions of the groove positioned at different axial distances from the end effector;

a waveguide acoustically coupled to the ultrasonic blade and extending proximally through the hollow shaft;

a first interface member coupled to at least one of the waveguide and the ultrasonic blade at a coupling point and extending proximally, wherein the first interface member comprises a first peg member positioned within the groove;

a second interface member coupled to at least one of the waveguide and the ultrasonic blade at the coupling point and extending proximally, wherein the second interface member comprises a second peg member positioned within the groove, and wherein upon rotation of the hollow shaft relative to the waveguide, the first and second peg members translate within the groove, causing bending of the first and second interface members and deflection of the first and second interface members away from the longitudinal axis.

22. The surgical instrument of claim 21, wherein the first interface member has a first length between the first peg member and the coupling point, and wherein the second interface member has a second length between the second peg member and the coupling point less than the first length.

23. The surgical instrument of claim 21, wherein shifting of the first and second peg members within the groove causes distal translation of the first interface member and proximal translation of the second interface member, resulting in pivoting of the waveguide and ultrasonic blade away from the longitudinal axis towards the second interface member.

24. The surgical instrument of claim 21, wherein the coupling point corresponds to an ultrasonic node at a resonant frequency of the waveguide and ultrasonic blade.

25. An articulatable surgical instrument comprising:

an end effector to treat tissue, wherein the end effector comprises an ultrasonic blade;

a hollow shaft extending proximally from the end effector along a longitudinal axis, the hollow shaft comprising a rigid portion and a flexible portion at a first position on the longitudinal axis distal from the rigid portion;

a waveguide extending through the shaft and coupled to the ultrasonic blade, wherein the waveguide comprises a flexible portion at the first position on the longitudinal axis such that the end effector is pivotable away from the longitudinal axis from the first position.

26. The surgical instrument of claim 25, wherein the end effector further comprises:

a member, wherein the ultrasonic blade extends through the member;

a clamp arm coupled to the member at a pivot point offset from the longitudinal axis, wherein the clamp arm is pivotable relative to the ultrasonic blade about the pivot point; and

a flexible control cable coupled to the clamp arm at a point offset from the pivot point such that distal and proximal translation of the control cable causes the clamp arm to pivot relative to the ultrasonic blade.

27. The surgical instrument of claim 25, further comprising first and second articulation members, wherein the first articulation member is coupled to an interior wall of the hollow shaft at a first point distal from the flexible portion of the hollow shaft, and wherein the second articulation member is coupled to the interior wall of the hollow shaft at a second point distal from the flexible portion and substantially opposite the first point.

28. The surgical instrument of claim 27, wherein the first and second articulation members are coupled to the hollow shaft such that distal translation of the first articulation member coupled with proximal translation of the second articulation member causes the end effector to pivot away from the longitudinal axis towards the second articulation member.

29. The surgical instrument of claim 27, further comprising a pinion gear positioned within the hollow shaft at about the longitudinal axis, wherein the first and second articulation members comprises first and second rack gears in mechanical communication with the pinion gear such that translation of the first articulation member distally causes rotation of the pinion gear that, in turn, causes translation of the second articulation member proximally.

30. The surgical instrument of claim 25, further comprising:

a clamp arm configured to pivot relative to the ultrasonic blade about a pivot point;

a flexible, threaded cable extending through the shaft and coupled to the clamp arm at a position distal from the pivot point, wherein the surgical instrument comprises a fixed, threaded hole for receiving the threaded cable such that rotation of the threaded cable in a first direction translates the threaded cable distally relative to the pivot point, causing the clamp arm to pivot towards the ultrasonic blade.

31. The surgical instrument of claim 30, wherein rotation of the threaded cable in a second direction translates the threaded cable proximally relative to the pivot point, causing the clamp arm to pivot away from the ultrasonic blade.

32. The surgical instrument of claim 30, wherein the threaded hole is defined by at least one of the shaft and the end effector.

33. An articulatable surgical instrument for treating tissue, the instrument comprising:

an end effector; and

a shaft extending proximally from the end effector along a longitudinal axis, wherein the shaft comprises;

a proximal tube; and

a distal tube pivotably coupled to the proximal tube at a hinge interface offset from the longitudinal axis, wherein the distal tube comprises an axially directed peg member; and

an inner rotatable member extending proximally through at least a portion of the proximal tube and at least a portion of the distal tube, wherein the inner rotatable member defines a slanted slot such that the axially directed peg member rides at least partially within the slanted slot and such that rotation of the inner rotatable member in a first direction pushes the peg member and distal tube distally, and rotation of the inner rotatable member in a second direction opposite the first direction pushes the peg member and distal tube proximally.

34. The surgical instrument of claim 33, wherein distal translation of the peg member and distal tube causes the distal tube to pivot about the hinge interface away from the longitudinal axis.

35. The surgical instrument of claim 33, wherein proximal translation of the peg member and distal tube causes the distal tube to pivot about the hinge interface towards the longitudinal axis.

36. An articulatable surgical instrument comprising:

an end effector to treat tissue, wherein the end effector comprises an ultrasonic blade;

a hollow shaft extending proximally from the end effector along a longitudinal axis, wherein the hollow shaft comprises;

a first shaft defining a slot; and

a second shaft, wherein the first and second shafts are translatable relative to one another along the longitudinal axis;

a waveguide extending through the shaft and coupled to the ultrasonic blade, wherein the waveguide comprises;

a distally positioned first flange positioned within the hollow shaft proximally from the blade, wherein the first flange extends through the slot;

a bendable portion positioned proximally from the first flange; and

a second flange positioned proximally from the bendable portion and fixedly coupled to the second shaft, wherein the first shaft is translatable from a distal position where a proximal edge of the slot pushes the first flange distally, bending the ultrasonic blade away from the longitudinal axis to a proximal position.

37. The surgical instrument of claim 36, further comprising a spring positioned to bias the first shaft in a distal direction.

38. The surgical instrument of claim 36, further comprising at least one control member extending proximally from the first shaft.

39. The surgical instrument of claim 36, wherein the second flange is positioned at a first node of the waveguide at a resonant frequency of the waveguide.

40. The surgical instrument of claim 39, wherein the first flange is positioned at a second node of the waveguide at the resonant frequency of the waveguide.

41. The surgical instrument of claim 40, wherein the first node and the second node are separated by a single resonant wavelength.