Endoscopic microsurgical instruments and methods
First Claim
1. A microsurgical instrument comprising:
- an outer shaft having a proximal end, a distal end, and an axial lumen therebetween;
an inner shaft slidably disposed in the axial lumen and having a proximal end and a distal end;
an end effector coupled to the distal end of the inner shaft and movable relative to the outer shaft; and
an actuator at the proximal end of the outer shaft, the actuator comprising;
an actuator body attached to a first shaft selected from the outer shaft and the inner shaft;
a first arm having a proximal end and a distal end, the proximal end being pivotally coupled to the actuator body by a pin means, and the distal end extending distally and outwardly from the actuator body on a first lateral side of the outer shaft to form an acute angle therewith;
a second arm having a proximal end and a distal end, the proximal end being pivotally coupled to the actuator body by a pin means, and the distal end extending distally and outwardly from the actuator body on a second lateral side of the outer shaft opposite the first lateral side to form an acute angle therewith;
a first link having an outer end and an inner end, the outer end being coupled to the first arm at a first pivot point distal to the proximal end of the first arm, and the inner end being coupled to a second shaft selected from the outer shaft and the inner shaft; and
a second link having an outer end and an inner end, the outer end being coupled to the second arm at a second pivot point distal to the proximal end of the second arm, and the inner end being coupled to the second shaft;
wherein the first and second arms are symmetrically pivotable to translate the inner shaft relative to the outer shaft, thereby actuating the end-effector.
3 Assignments
0 Petitions
Accused Products
Abstract
The invention provides devices and method for performing extremely small-scale, minimally-invasive microsurgery such as thoracoscopic coronary artery bypass grafting. The instruments of the invention utilize a symmetrical, forcep-like actuator which provides extremely precise actuation and control of the instrument and which mimics the feel of instruments used in conventional open surgical procedures. The instruments generally include a pair of coaxially arranged shafts, an end-effector at the distal ends of the shafts, and an actuator at the proximal ends of the shafts. The actuator includes a pair of arms pivotally coupled to one of either the outer or inner shaft, and a pair of links pivotally coupled at one end to the arms, and at a second end to the other of the shafts. The links are coupled to a proximal portion of the arms to maximize mechanical advantage and reduce interference. The actuator may be easily adapted for either pull-type or push-type actuation, and for either outer shaft or inner shaft translation. The end-effectors may have a variety of configurations, including needle drivers, forceps, scissors, and clip appliers.
-
Citations
51 Claims
-
1. A microsurgical instrument comprising:
- an outer shaft having a proximal end, a distal end, and an axial lumen therebetween;
an inner shaft slidably disposed in the axial lumen and having a proximal end and a distal end; an end effector coupled to the distal end of the inner shaft and movable relative to the outer shaft; and an actuator at the proximal end of the outer shaft, the actuator comprising; an actuator body attached to a first shaft selected from the outer shaft and the inner shaft; a first arm having a proximal end and a distal end, the proximal end being pivotally coupled to the actuator body by a pin means, and the distal end extending distally and outwardly from the actuator body on a first lateral side of the outer shaft to form an acute angle therewith; a second arm having a proximal end and a distal end, the proximal end being pivotally coupled to the actuator body by a pin means, and the distal end extending distally and outwardly from the actuator body on a second lateral side of the outer shaft opposite the first lateral side to form an acute angle therewith; a first link having an outer end and an inner end, the outer end being coupled to the first arm at a first pivot point distal to the proximal end of the first arm, and the inner end being coupled to a second shaft selected from the outer shaft and the inner shaft; and a second link having an outer end and an inner end, the outer end being coupled to the second arm at a second pivot point distal to the proximal end of the second arm, and the inner end being coupled to the second shaft; wherein the first and second arms are symmetrically pivotable to translate the inner shaft relative to the outer shaft, thereby actuating the end-effector. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23)
- an outer shaft having a proximal end, a distal end, and an axial lumen therebetween;
-
24. A microsurgical instrument comprising:
-
an outer shaft having a proximal end, a distal end, and an axial lumen therebetween; an inner shaft slidably disposed in the axial lumen and having a proximal end and a distal end; a fixed jaw at the distal end of the outer shaft; a movable jaw coupled to the distal end of the inner shaft and movable relative to the fixed jaw; and an actuator at the proximal end of the outer shaft, the actuator comprising; a first arm having a proximal end and a distal end, the proximal end being pivotally coupled to a first shaft selected from the outer shaft and the inner shaft, and the distal end being disposed on a first lateral side of the outer shaft and biased outwardly to form an acute angle therewith; a second arm having a proximal end and a distal end, the proximal end being pivotally coupled to the first shaft, and the distal end being disposed on a second lateral side of the outer shaft opposite the first lateral side and biased outwardly to form an acute angle therewith; a first link having an outer end and an inner end, the outer end being coupled to the first arm at a first pivot point, and the inner end being coupled to a second shaft selected from the outer shaft and the inner shaft; and a second link having an outer end and an inner end, the outer end being coupled to the second arm at a second pivot point, and the inner end being coupled to the second shaft, the first pivot point being closer to the proximal end of the first arm than to the distal end of the first arm, and the second pivot point being closer to the proximal end of the second arm than to the distal end of the second arm; wherein the first and second arms are symmetrically pivotable such that the first and the second links exert symmetrical forces on the inner shaft to move the movable jaw relative to the fixed jaw. - View Dependent Claims (25, 26, 27, 28, 29, 30, 31)
-
-
32. A method of endoscopic manipulation of a body structure within a body cavity, the method comprising:
-
providing an instrument having a shaft with a distal end and a proximal end, a pair of jaws at the distal end movable relative to each other, an actuator body at the proximal end, and a pair of arms pivotally coupled to the actuator body, each arm having a proximal end coupled by pin means to the actuator body and a distal end extending distally and outwardly therefrom forming an acute angle with the shaft; introducing the distal end of the shaft through a percutaneous penetration into the body cavity; viewing the body cavity through a percutaneous penetration; and pressing inwardly on outer surfaces on a distal portion of the arms to symmetrically pivot both arms toward the shaft, thereby closing the jaws on the body structure. - View Dependent Claims (33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51)
-
Specification