Surgical instrument

• US 5,334,198 A
• Filed: 10/09/1992
• Issued: 08/02/1994
• Est. Priority Date: 10/09/1992
• Status: Expired due to Term

• Current Assignee: Innovasive Devices Inc. (Johnson & Johnson)
• Original Assignee: Innovasive Devices Inc. (Johnson & Johnson)
• Inventors: Hart, Rickey D., Nicholson, James E., Rice, John T., Winters, Richard M.
• Primary Examiner(s): Pellegrino, Stephen C.
• Assistant Examiner(s): PEFFLEY, MICHAEL F
• Application Number:
  US07/959,121
• Time in Patent Office: 662 Days
• Field of Search: 606/32, 606/39, 606/41, 606/45, 606/46, 606/51, 606/52, 606/170, 606/205-209
• US Class Current: 606/52
• CPC Class Codes: A61B 10/02 Instruments for taking cell samples or for biopsy A61B10/0038 and A61B10/0045 take precedence; needle locating or guiding means A61B17/3403; samplers for enzymology or microbiology C12M1/26; sampling or preparing biological specimens G01N33/48
• CPC Class Codes: A61B 17/0467 Instruments for cutting sutures surgical cutting instruments A61B17/32
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic 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 17/3201 Scissors for biopsy A61B10/02
• CPC Class Codes: A61B 18/1442 Probes having pivoting end effectors, e.g. forceps
• CPC Class Codes: A61B 2017/2931 with releasable head
• CPC Class Codes: A61B 2018/1253 monopolar

Abstract

An improved surgical tool of the type comprising a handle assembly having a movable tool-operating handle member, a tool head having first and second tissue-engaging members movable between open and closed positions relative to one another, and a mechanism coupling the tool head to the handle assembly for causing opening and closing movement of the tissue-engaging members in response to manipulation of the movable tool-operating handle member. The improved tool is characterized by an inner shaft secured to a stationary part of the handle assembly, and a hollow outer shaft disposed in telescoping relation to the inner shaft, with the tool head being secured to the inner shaft and the outer shaft being movable axially relative to the inner shaft by manipulation of the movable tool-operating handle member, with the outer shaft causing opening and closing of the tissue-engaging members as it undergoes telescoping movement. Preferably an opaque tubular member surrounds the hollow outer shaft so as to conceal movement of the outer shaft. The tool also may include a manually-operated mechanism for selectively rotating the tool head relative to the handle assembly.

Claims

1. A surgical instrument comprising:

a handle assembly, said handle assembly having a handle unit and a trigger member pivotally mounted to said handle unit, said trigger member being movable on its pivot between first and second positions;

an elongate rod having a proximal end and a distal end;

means mounted in said handle unit for releasably securing said proximal end of said rod to said handle unit so that said rod forms an extension thereof;

a tool head attached to said distal end of saidrod, said tool head comprising first and second cooperating tool members movable relative to one another between a first open position and a second closed position, said first and second tool members normally being in said first open position;

a hollow tube coaxially and slidably surrounding said rod, said tube having a first proximal end slidably received in said handle unit and a second distal end that is movable into and out of overlapping relation with said first and second operating tool members as said hollow tube is reciprocated axially relative to said rod;

force transmitting means connecting said hollow tube and said trigger member for causing said hollow tube to shift axially relative to said rod between (1) a first retracted position when said trigger member is in its said first position and (2) a second extended position when said trigger member is in its said second position, said first and second tool members being in said first open position and said distal end of said hollow tube being in a non-biasing position relative to said tool head when said hollow tube is in its first retracted position, said distal end of said hollow tube overlapping and biasing said said first and second tool members into said second closed position when said hollow tube is moved to its said second extended position, said force transmitting means comprising a coupling member attached to the proximal end of said hollow tube and surrounding said rod; and

means attached to said handle unit for slidably supporting said coupling member for reciprocal movement relative to said rod lengthwise of the axis of said rod;

said force transmitting means further comprising first and second mutually engaging means on said coupling member and said trigger member respectively that form a pivotal connection between said coupling member and said trigger member, whereby pivoting movement of said trigger member relative to said handle unit causes said hollow tube to shift axially relative to said rod from one to the other of said first retracted position and said second extended position.

2. A surgical instrument according to claim 1 wherein said means for securing said rod to said handle unit is mounted for movement between a first rod-locking position and a second rod-releasing position.

3. A surgical instrument according to claim 1 wherein said rod and said tool head are electrically conductive, and said means for securing said rod to said handle unit comprises an electrically conductive terminal member.

4. A surgical instrument according to claim 3 wherein said terminal member extends through a hole in said handle unit and comprises a first inner portion connected to said rod and a second outer portion projecting outside of said handle assembly.

5. A surgical instrument according to claim 4 further comprising spring means urging said terminal member into said first rod-locking position.

6. A surgical instrument according to claim 1 wherein said coupling member comprises a tube housing having a proximal end and a distal end with said proximal end of said hollow tube being fixed to the distal end of said tube housing, and further wherein said second means comprises a bifurcated end on said trigger member that makes a pivotal engagement with said first means on said tube housing, whereby said tube housing and said hollow tube are caused to move relative to said rod along the axis thereof when said trigger member is moved from one to the other of its said first and second positions.

7. A surgical instrument according to claim 6 wherein said handle unit comprises first and second opposite side members secured to one another, said first and second side members defining a chamber in which said tube housing is slidably disposed.

8. A surgical instrument according to claim 1 wherein said tool head is a scissors head, and said first and second tool members are scissors blades.

9. A surgical instrument according to claim 1 wherein said means for slidably supporting said coupling member is a hollow member that is mounted in said handle unit and has an elongate chamber in which said coupling member is slidably disposed for reciprocal movement relative to said handle unit lengthwise of the axis of said rod.

10. A surgical instrument according to claim 1 further including manually operable means for rotating said rod and said tool head relative to said handle unit, said manually operable means comprising a first gear means affixed to said rod, an auxiliary trigger member pivotally mounted to said handle unit, and a second gear means on said auxiliary trigger member cooperatively engaged with said first gear means, said second gear means being adapted to cause rotation of first gear means and thereby rotation of said rod when said auxiliary trigger means is pivoted relative to said handle unit.

11. A surgical instrument according to claim 1 comprising a second tube that is fixed to said handle assembly and surrounds and conceals movement of said first-mentioned tube.

12. An instrument according to claim 11 wherein said second tube does not overlap said tool head but has a length sufficient to conceal said first-mentioned movable tube as said first-mentioned tube is moved by manipulation of said trigger member.

13. A surgical instrument according to claim 1 further including tool rotating means for rotating said rod and tool head relative to said handle assembly and said first and second tubes.

14. A surgical instrument comprising:

a handle assembly, said handle assembly including first and second manually graspable members pivotally mounted to one another so that said second member is movable on its pivot between first and second positions relative to said first member;

an elongate rod having a proximal end and a distal end with said proximal end secured to said first graspable member so that said rod forms an extension of said first manually graspable member;

a tool head attached to said distal end of said rod, said tool head comprising first and second cooperating tool members movable relative to one another between first and second tool member positions, said first and second tool members normally being in said first tool member position;

a hollow tube coaxially and slidably surrounding said rod, said tube having a first proximal end slidably received in said first manually graspable member and a second distal end that is disposed so as to be movable into overlapping relation with said tool head; and

force transmitting means connecting said hollow tube and said second manually graspable member for causing said hollow tube to shift axially relative to said rod between (1) a first retracted position when said second manually graspable member is in its said first position and (2) a second extended position when said second manually graspable member is in its said second position, said first and second tool members being in said first tool member position and said distal end of said hollow tube being in a non-biasing position relative to said first and second tool members when said hollow tube is in its first retracted position, said distal end of said hollow tube being disposed to engage and bias said first and second tool members into said second tool member position when said hollow tube is moved to its said second extended position;

said force transmitting means comprising a hollow housing secured to said first proximal end of said tube and surrounding said rod, said hollow housing being disposed in a chamber in said first manually graspable member and movable in said chamber longitudinally lenthwise of the axis of said rod, and means pivotally connecting said hollow housing and said second manually graspable member for causing said hollow housing and said tube to shift axially as said second manually graspable member is pivoted relative to said first manually graspable member.

15. A surgical instrument comprising:

a handle assembly, a tool head, and drive means connecting said handle assembly and said tool head;

said handle assembly comprising a handle and a trigger member pivotally mounted to said handle;

said tool head comprising first and second cooperating tool members movable between a first open position wherein they are spaced from one another and a second closed position wherein they are proximate to or engaged with one another; and

said drive means comprising an elongate rod, a tube surrounding said rod means, for releasably securing one end of said rod to said handle assembly, means for securing said tool head to the opposite end of said rod, support means attached to said handle for slidably supporting said tube for sliding axial movement relative to said rod, said support means comprising (1) a first housing releasably secured to said handle assembly and defining an elongate chamber, and (2) a second housing slidably mounted in said elongate chamber, said tube being secured to and movable with said second housing relative to said first housing lengthwise of the axis of said tube, and said rod extending through said second housing, and means connecting said support means and said trigger member whereby manipulation of said trigger member will cause said second housing and said tube to move axially relative to said rod between a first position wherein one end of said tube is retracted from said tool head and said first and second tool members are in said first open position and a second position wherein said tube overlaps said tool head and forces said first and second tool members into said second closed position;

said tool head and said drive means forming a discrete subassembly that is removably secured to said handle assembly.

16. A surgical instrument according to claim 15 wherein said rod and said tool head are made of electrically conductive material and said second housing and said tube are made of non-electrically conductive material, further including a second tube surrounding and concealing movement of said first-mentioned tube, said second tube being secured to said first housing and being sized so as to permit relative axial movement of said first-mentioned tube.

17. A surgical instrument according to claim 15 wherein said handle comprises a hollow body portion and said first housing extends within said hollow body portion of said handle.

18. A surgical instrument comprising:

a handle assembly, said handle assembly having at least a first handle member and a trigger member pivotally mounted to said first handle member, said trigger member being movable on its pivot between first and second positions;

an elongate rod;

means for securing said rod to said handle assembly so that said rod forms an extension thereof;

a tool head attached to said rod, said tool head comprising first and second cooperating tool members movable relative to one another between a first open position and a second closed position, said first and second tool members normally being in said first open position;

a hollow tube coaxially and slidably surrounding said rod, said tube having a first proximal end slidably received in said handle assembly and a second distal end that extends to said tool head and is movable axially into and out of overlapping relation with said first and second operating tool members; and

force transmitting means connecting said hollow tube and said trigger member for causing said hollow tube to shift axially relative to said rod between (1) a first retracted position when said trigger member is in its said first position and (2) a second extended position when said trigger member is in its said second position, said first and second tool members being in said first open position and said distal end of said hollow tube being in a non-biasing position relative to said tool head when said hollow tube is in its first retracted position, said distal end of said hollow tube being disposed to move said first and second tool members into said second closed position when said hollow tube is moved to its said second extended position;

said means for securing said rod to said handle assembly comprising a conductive terminal member having a key-shaped aperture characterized by a first relatively small diameter portion and a second relatively large diameter portion communicating with said first relatively small diameter portion, and the proximal end of said rod having (a) a relatively large diameter head section sized to fit in said relatively large diameter portion of said aperture but oversized with respect to said relatively small diameter portion of said aperture, and (b) a circumferential groove having a diameter smaller than said relatively small diameter portion of said aperture, said terminal member and said rod being positioned in said handle assembly so that said groove is positioned in alignment with said small diameter portion of said aperture, whereby said head section of said rod is captivated against axial movement relative to said handle assembly.

19. A surgical instrument comprising:

a handle assembly, said handle assembly having at least a first handle member and a trigger member pivotally mounted to said first handle member, said trigger member being movable on its pivot between first and second positions;

an elongate rod;

means for securing said rod to said handle assembly so that said rod forms an extension thereof;

a tool head attached to said rod, said tool head comprising first and second cooperating tool members movable relative to one another between a first open position and a second closed position, said first and second tool members normally being in said first open position;

a hollow tube coaxially and slidably surrounding said rod, said tube having a first proximal end slidably received in said handle assembly and a second distal end that extends to said tool head and is movable axially into and out of overlapping relation with said first and second operating tool members; and

force transmitting means connecting said hollow tube and said trigger member for causing said hollow tube to shift axially relative to said rod between (1) a first retracted position when said trigger member is in its said first position and (2) a second extended position when said trigger member is in its said second position, said first and second tool members being in said first open position and said distal end of said hollow tube being in a non-biasing position relative to said tool head when said hollow tube is in its first retracted position, said distal end of said hollow tube being disposed to move said first and second tool members into said second closed position when said hollow tube is moved to its said second extended position;

said tool head being removably attached to said rod by a tongue and groove connection.

20. A surgical instrument according to claim 19 wherein said tongue and groove connection is surrounded by said hollow tube when said hollow tube is in its first retracted position.

21. A surgical instrument comprising a handle assembly, a tool head, drive means connecting said handle assembly and said tool head, and tool head rotation means for rotating said tool head relative to said handle assembly;

said handle assembly comprising a handle and a trigger member pivotally mounted to said handle;

said tool head comprising first and second cooperating tool members movable between a first open position wherein they are spaced from one another and a s second closed position wherein they are proximate to or engaged with one another;

said drive means comprising an elongate rod, a hollow tube surrounding said rod, means for releasably securing one end of said rod to said handle assembly, means for securing said tool head to the opposite end of said rod, housing means for slidably supporting said tube for sliding axial movement relative to said rod, and means connecting said housing means and said trigger member whereby manipulation of said trigger member will cause said tube to move axially relative to said rod between a first position wherein said tube is retracted from said tool head and said first and second tool members are in said first open position and a second position wherein said tube is engaged with said first and second tool members and holds them in said second closed position;

said tool head and said drive means forming a discrete subassembly that is removably secured to said handle assembly; and

said tool head rotating means comprising a second trigger member pivotally attached to said handle assembly, and means coupling said rod and second trigger member for causing rotation of said rod and tool head when said second trigger member is moved about its pivot.

22. A surgical instrument comprising a handle and trigger assembly and an operating tool assembly separably connected to said handle and trigger assembly;

said handle and trigger assembly comprising a handle housing having a chamber therein and a trigger member pivotally mounted to said handle housing;

said operating tool assembly comprising at one end thereof a tool head with tissue-engaging members and at the opposite end thereof a tubular housing that extends into said chamber and is releasably connected to said handle housing, said tissue-engaging members being movable relative to one another between a first open position and a second closed position, said operating tool assembly further including a mechanism for moving said tissue-engaging members toward and away from one another, said mechanism including movable means in said tubular housing engaged and movable by said trigger member for causing said mechanism to move said tissue-engaging members toward and away from one another in response to pivotal movement of said trigger member;

said handle and trigger assembly further comprising locking means engaged with said operating tool assembly for releasably locking said tubular housing to said handle housing,

said operating tool assembly further comprising a rod having a proximal end and a distal end with said proximal end extending through said tubular housing and said distal end connected to and supporting said tool head, a hollow housing slidably surrounding said rod, said hollow housing being slidably disposed within said tubular housing, a hollow shaft disposed in coaxial and telescoping relation with said rod, said shaft having a proximal end affixed to said hollow housing and a distal end that is adapted to embrace said tissue-engaging members and force them into said closed position when said shaft is moved axially in a direction away from the proximal end of said rod toward the distal end of said rod, means locking said rod to said tubular housing, and means on said hollow housing for making a pivotal connection with said trigger member, whereby pivotal movement of said trigger member relative to said handle housing will cause said hollow housing and said shaft to shift axially according to the direction of pivotal movement of said trigger member;

said operating tool assembly further including a helical gear affixed to said rod; and

said handle and trigger assembly further including an auxiliary trigger means pivotally mounted to said handle housing having gear teeth engaged with said helical gear so that pivotal movement of said auxiliary trigger means will cause rotation of said rod and said tool head.

23. A surgical instrument according to claim 22 wherein said tool head is a scissors head and said first and second tissue-engaging members comprise scissors blades attached to spring arms that are shaped to bias said blades to open position.

24. A surgical instrument comprising:

a handle unit having means defining an elongate chamber open at one end of said unit;

a trigger member pivotally mounted to said handle unit, said trigger member being movable on its pivot between first and second positions;

a hollow housing disposed in said elongate chamber and secured to said handle unit, said first hollow housing having a proximal end and a distal end, with said distal end thereof having an opening;

a hollow tube having a proximal end and a distal end, said proximal end of said hollow tube extending slidably through said opening in said first hollow housing;

a slide member slidably positioned in said elongate chamber, said slide member having a proximal end and a distal end;

said proximal end of said hollow tube being attached to said slide member so as to project from said distal end thereof;

an elongate rod having a proximal end and a distal end, said rod being disposed in said hollow tube and extending through said slide member, and said hollow tube being slidable axially relative to said rod;

means for locking said rod against axial movement relative to said handle unit so that said rod forms an extension of said handle unit;

a tool head attached to said distal end of said rod, said tool head comprising first and second cooperating spring biased tool members movable relative to one another between a first open position and a second closed position, said first and second tool members being spring biased to favor said first open position;

said hollow tube having a length such that its distal end is movable into and out of overlapping relation with said first and second operating tool members as said hollow tube is reciprocated axially relative to said rod; and

force transmitting means connecting said slide member and said trigger member for causing said slide member and said hollow tube to shift axially relative to said rod between (1) a first retracted position when said trigger member is in its said first position and (2) a second extended position when said trigger member is in its said second position, said first and second tool members being in said first open position and said distal end of said hollow tube being in a non-biasing position relative to said tool head when said hollow tube is in its first retracted position, and said distal end of said hollow tube overlapping and biasing said said first and second tool members into said second closed position when said hollow tube is moved to its said second extended position.

25. An instrument according to claim 24 wherein said elongate chamber has an end wall at its proximal end, and further wherein said rod is locked to said end wall.

26. An instrument according to claim 24 wherein said hollow housing is releasably secured to said handle unit.

27. An instrument according to claim 26 wherein said hollow housing is releasably secured to said handle unit by virtue of being interlocked with said rod adjacent the proximal end of said rod.

28. An instrument according to claim 27 wherein said hollow housing has an end wall at its proximal end and said end wall has a slot therein, and further wherein said rod extends through said slot and has a peripheral groove that is interlocked with said end wall.

29. An instrument according to claim 24 wherein said hollow housing has an end wall at its proximal end and the proximal end of said rod projects through said end wall, and further wherein said means for locking said rod against axial movement relative to said handle unit comprises a locking member that is mounted in a passageway in said handle unit so as to be movable between a first rod-locking position and a second rod-releasing position, said locking member having a first portion that is accessible on the exterior side of said handle unit and a second portion located within said handle unit that is adapted to interlock with said rod in said first rod-locking position and release said rod in said second rod-releasing position, and a spring means mounted within said handle unit that urges said locking member to remain in said first position.

30. An instrument according to claim 29 wherein said second portion of said locking member has a keyhole through which said rod extends, said keyhole having a first section that is oversized with respect to said rod and a second section that is sized and shaped to interlock with said rod, said spring means being adapted to urge said locking member in a direction to cause said second section to engage said rod.

31. An instrument according to claim 29 wherein said locking member is made of an electrically conductive material and said first portion is shaped to function as an electrical terminal post.

32. An instrument according to claim 24 wherein said handle unit and said trigger member form a first subassembly, said second housing and said tube comprise a second subassembly that is releasably connected to said first subassembly and separable as a unit from said first subassembly.

33. An instrument according to claim 24 wherein said handle unit comprises a handle portion and a body portion integral with one end of said handle portion, said elongate chamber being formed in said body portion and said open end of said chamber being remote from said handle portion, and said trigger member being pivotally mounted to said body portion and extending into said chamber.

34. An instrument according to claim 24 wherein said hollow housing has an axially-extending slot confronting said trigger member, and said trigger member has means forming part of said force transmitting means that extends into and is slidable along said slot and makes a pivotal connection with said slide member.

35. An instrument according to claim 24 wherein said hollow housing has a slot confronting said trigger member and said slide member has a lug portion, and further wherein said trigger member has a finger portion that extends into and is slidable along said slot and is pivotally engaged with said lug portion, whereby pivoting movement of said trigger member relative to said handle unit causes said hollow tube to shift axially relative to said rod.

36. An instrument according to claim 24 wherein said tool head is a scissors head, with said first and second tool members comprising scissors blades attached to spring arms that are secured to said rod and are shaped so as to bias said scissors blades into said first open position, said scissors blades extending across each other when in said first open position.

37. An instrument according to claim 24 wherein said tool head is releasably connected to said distal end of said rod by a tongue-and-groove connection.

38. An instrument according to claim 24 wherein said slide member has an elongate gear-receiving chamber and a slot communicating with said chamber, and further including a helical gear on said rod within said gear-receiving chamber, and manually operated gear means movably mounted to said handle unit and engaged with said helical gear for rotating said rod on its axis whereby to change the relative angular orientation of said tool head relative to said handle unit.

39. An instrument according to claim 24 further including spring means in said hollow housing in engagement with said slide member for urging said slide member to move said hollow tube out of overlapping relation with said tool members.

40. A surgical instrument comprising:

a handle assembly having first and second handle members movably connected for movement relative to one another;

an elongate rod having a distal end and a proximal end, said rod being releasably secured at its proximal end to said first handle member so as to form a fixed extension thereof;

a tool head coupled to the distal end of said rod, said tool head having first and second members movable toward and away from one another;

a hollow shaft coaxially and slidably surrounding said rod, said hollow shaft having a first end slidably received in said first handle member and a second end in position to be moved into and out of overlapping relation with said first and second members of said tool head;

drive means connecting said hollow shaft and said second handle member for causing said hollow shaft to shift axially relative to said rod between (1) a first retracted position when said second handle member is moved to a first position relative to said first handle member and (2) a second extended position when said second handle member is moved to a second position relative to said first handle member, said first and second tool head members being in a first open position relative to one another when said second handle member is in its said second position and being forced by said hollow shaft to close relative to one another when said second handle member is moved to its said first position, said drive means including a drive member that is attached to said first end of said hollow shaft and is slidably disposed in a chamber in said first handle member, and means coupling said second handle member to said drive member for causing said hollow shaft to shift axially relative to said rod in response to movement of said second handle member relative to said first handle member; and

manually operable means carried by said first handle member for rotating said rod relative to said first handle member, said hollow shaft and said tool head, said manually operable means being operable independently of movement of said second handle member relative to said first handle member;

said rod, said tool head and said hollow shaft comprising part of a discrete subassembly that is detachable as a unit from said handle assembly.

41. An instrument according to claim 40 wherein said rod is releasably secured to said first handle member by means comprising an electrically conductive terminal member mounted in said first handle member and interlocked with said rod so as to prevent removal of said rod from said first handle member, and further wherein said hollow shaft is made of an electrically insulating material and said rod and said tool head are made of electrically conductive material, so that said tool head may be used for cauterization purposes when said terminal member is connected to a source of electrical potential and said hollow shaft insulates said rod from direct contact with a patient engaged by said tool head.

42. An instrument according to claim 40 further including spring means mounted within said first handle member for urging said hollow shaft into said first retracted position whereby to allow said tool head to assume its open position.

43. A surgical instrument comprising:

a handle assembly having first and second handle members movably connected for movement relative to one another;

an elongate rod having a distal end and a proximal end, said rod being releasably secured at its proximal end to said first handle member so as to form a fixed extension thereof;

a tool head coupled to the distal end of said rod, said tool head having first and second members movable toward and away from one another;

a hollow shaft coaxially and slidably surrounding said rod, said hollow shaft having a first end slidably received in said first handle member and a second end in position to be moved into and out of overlapping relation with said first and second members of said tool head;

drive means connecting said hollow shaft and said second handle member for causing said hollow shaft to shift axially relative to said rod between (1) a first retracted position when said second handle member is moved to a first position relative to said first handle member and (2) a second extended position when said second handle member is moved to a second position relative to said first handle member, said first and second tool head members being in a first open position relative to one another when said second handle member is in its said second position and being forced by said hollow shaft to close relative to one another when said second handle member is moved to its said first position; and

manually operable means carried by said first handle member for rotating said rod relative to said first handle member, said hollow shaft and said tool head, said manually operable means being operable independently of movement of said second handle member relative to said first handle member;

said means for rotating said rod comprising a movable trigger member mounted to said first handle member, a plurality of gear teeth carried by and movable with said trigger member, and a helical gear coaxially mounted on said rod, said helical gear being engaged by said gear teeth so that movement of said trigger member relative to said first handle member will cause rotation of said rod relative to said first handle member.