Surgical instrument

• US 5,611,813 A
• Filed: 04/28/1995
• Issued: 03/18/1997
• Est. Priority Date: 04/15/1992
• Status: Expired due to Fees

• Current Assignee: Microsurge, Inc. (Imagyn Medical Technologies, Inc.)
• Original Assignee: Microsurge, Inc. (Imagyn Medical Technologies, Inc.)
• Inventors: Lichtman, Philip R.
• Primary Examiner(s): Buiz, Michael Powell
• Assistant Examiner(s): LEWIS, WILLIAM W
• Application Number:
  US08/431,023
• Time in Patent Office: 690 Days
• Field of Search: 606/51, 606/52, 606/174, 606/205-211, 604/22, 128/750-755
• US Class Current: 606/205
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 17/2909 Handles
• CPC Class Codes: A61B 17/30 Surgical pincettes without pivotal connectionsfor holding suture needles or materials A61B17/0483; wound clamps A61B17/08 ; hand-held gripping tools without pivotal connections in general B25B9/02
• 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 18/1233 with circuits for assuring patient safety
• CPC Class Codes: A61B 18/1402 Probes for open surgery
• CPC Class Codes: A61B 18/1442 Probes having pivoting end effectors, e.g. forceps
• 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 2017/2825 Inserts of different material in jaws
• CPC Class Codes: A61B 2017/2923 Toothed members, e.g. rack and pinion
• CPC Class Codes: A61B 2017/2937 with flexible part
• CPC Class Codes: A61B 2017/2943 Toothed members, e.g. rack and pinion
• CPC Class Codes: A61B 2017/2946 Locking means
• CPC Class Codes: A61B 2017/3445 used as instrument channel for multiple instruments
• CPC Class Codes: A61B 2090/0813 Accessories designed for easy sterilising, i.e. re-usable
• CPC Class Codes: A61B 2217/005 with suction drainage system

Abstract

A surgical instrument is provided of the type having first and second telescoping shafts, a jaw assembly comprising two jaws carried by the front end of the first shaft, and a novel handle mechanism, and connecting member for connecting the rear ends of the two shafts to the novel handle mechanism, so that manipulation of the handle mechanism by the surgeon will cause relative reciprocal axial motion of the two shafts, thereby resulting in opening and closing of the jaws. In a preferred embodiment, the novel handle mechanism comprises a first fixed handle member, a second movable handle member, gear member connecting the two handle members so that when the handles are moved relative to one another in a first direction, the jaws will be squeezed into clamping relation with tissue by the collet-like action of the second shaft moving in a first direction relative to the second shaft, and spring member for urging the second shaft to move in a direction to open the jaws. The instrument may include a device member for conducting electrosurgery, releasable locking member for locking the two handle members so that the jaws are releasably locked in gripping engagement with tissue, a reversing gear for reversing the effect of movement of the two handle members on the two jaws so as to accommodate jaw mechanisms of different designs, and/or device for conducting cleaning of the instrument or irrigation of the surgical site.

Claims

1. A surgical instrument for performing electrosurgery comprising:

a handle housing with a first handle member affixed thereto, and at least first and second concentrically arranged shafts extending longitudinally away from said housing, said second shaft having proximal and distal ends and being affixed to said housing at its proximal end so as to be immobile with respect to said housing, and said first shaft surrounding said second shaft and being arranged to translate longitudinally with respect to said second shaft;

a jaw unit carried by said distal end of said second shaft, said jaw unit comprising at least two jaws, a rear section, and intermediate leaf spring elements connecting each of said jaws to said rear section, said leaf spring elements biasing said jaws so that when said leaf spring elements are unrestrained, said jaws are deployed in angular spaced relation with one another;

said first shaft having a length such that when said first shaft is caused to translate towards the distal end of said second shaft, the distal end of said first shaft will slide over said jaw unit and mechanically cause said jaws to close towards one another;

translation means for causing said first shaft to translate longitudinally relative to said second shaft, said translation means comprising a second handle member mounted for pivotal movement relative to said first handle member, and means coupling said second handle member and said first shaft for causing reciprocal movement of said first shaft relative to said second shaft as said second handle member is pivoted relative to said first handle member, whereby to cause said first shaft to move into and out of jaw-closing relation with said jaws; and

electrically-conductive means carried in part by said handle housing for applying an electrical potential to said jaws, whereby an electrical current will flow in tissue engaged by said jaws.

2. An instrument according to claim 1 wherein said electrically-conductive means comprise electrical connector means mounted in said handle housing, and means for electrically connecting said electrical connector means to said second shaft.

3. A surgical instrument according to claim 2 comprising retaining means for releasably retaining said electrical connector means in said housing.

4. A surgical instrument for performing bipolar electrosurgery on tissue comprising:

a housing provided with an internal bore,

first and second concentrically arranged tubular elements within said bore, said first and second tubular elements each having a proximal end and a distal end, with said first tubular element being immobile with respect to said housing and said second tubular element being capable of translating axially relative to said first tubular element;

means attached to said housing for causing said second tubular element to translate axially relative to said first tubular element;

a jaw head comprising first and second separately formed jaws, with said jaws being spring biased so as to normally occupy an open position relative to one another;

means connecting said jaw head to the distal end of one of said tubular elements;

said first and second tubular elements being disposed so that they can undergo relative axial movement bidirectionally and so that when said they undergo relative axial movement in a first direction, said second tubular element will force said jaws to close towards one another; and

electrically-conductive means carried by said housing for applying an electrical potential to said jaws, said electrically-conductive means being arranged for connection to an external source of electrical power.

5. An instrument according to claim 4 comprising insulation means disposed so as to prevent one jaw from physically contacting the other jaw.

6. A surgical instrument for performing electrosurgery comprising:

a hollow outer shaft having a longitudinal axis, a first proximal end and a first distal end;

a hollow inner shaft coaxially disposed in said outer shaft for reciprocal movement with respect to said outer shaft, said inner shaft having a second proximal end and a second distal end;

means for surgical interaction with animal tissue associated with said first and second distal ends, said surgical interaction means comprising first and second tissue-interacting members movable relative to one another between a first open position and a second closed position by axially directed changes in the relative positions of said first and said second distal ends;

a handle mechanism coupled to said outer and inner shafts for effecting relative axial movement of said shafts and thereby changing the relative positions of said first and said second distal ends lengthwise of said longitudinal axis;

said handle mechanism comprising a first handle member affixed to the proximal end of one of said shafts, driver-responsive means attached to the other of said shafts, a second handle member movable relative to said first handle member between first and second operating positions, driver means carried by said second handle member engageable with said driver-responsive means for effecting reciprocal axial movement of said other shaft relative to said one shaft in response to movement of said first handle member between said first and second operating positions;

unidirectional locking means for locking said first and second handle members against relative movement in one predetermined direction; and

electrically-conductive means carried in part by a handle housing for applying an electrical potential across said tissue-interacting members, whereby an electrical current will flow through tissue engaged by said tissue-interacting members.

7. An instrument according to claim 6 wherein said first and second tissue-interacting members comprise first and second electrically conductive jaw members mounted to the distal end of said inner shaft and electrically insulated from one another, and said electrically-conductive means comprises first electrical conductor means connected to said first jaw member and second electrical conductor means connected to said second jaw member.

8. An instrument according to claim 7 wherein said first and second jaw members comprise first and second electrically-conducting leaf spring members and first and second electrically-conducting jaws carried by said first and second leaf spring member respectively, and further including an insulating member attached to the distal end of said inner shaft for supporting said jaw members on the distal end of said inner shaft.

9. An instrument according to claim 7 wherein said inner shaft is electrically conductive and said second jaw member is electrically coupled to said inner shaft.

10. An instrument according to claim 7 wherein said first electrical conductor is a cable that extends along the interior of said inner shaft and is connected to said first jaw member.

11. An instrument according to claim 6 wherein at least one space exists between said outer and inner shafts, and further including means for introducing fluid to or removing fluid from said at least one space.

12. An instrument according to claim 11 further characterized by at least one radially-extending opening in said outer shaft, and a collar assembly surrounding said outer shaft, said collar assembly having a chamber that communicates with said at least one radially-extending opening and a port that permits fluid to be introduced to or removed from said chamber.

13. An instrument according to claim 12 wherein said collar assembly is provided with a fitting that is coupled to said port and is adapted to be connected to an auxiliary device.

14. A surgical instrument comprising:

a hollow outer shaft having a longitudinal axis, a first proximal end, and a first distal end;

an inner shaft coaxially disposed in said outer shaft, said inner shaft having a second proximal end and a second distal end;

means for surgical interaction with animal tissue attached to the distal end of said inner shaft, said surgical interaction means comprising first and second tissue-interacting members movable relative to one another between a first open position and a second closed position by axially directed changes in the relative positions of said first and said second distal ends of said shafts; and

a handle mechanism coupled to said outer and inner shafts for effecting relative axial movement of said shafts and thereby changing the relative positions of said first and said second distal ends lengthwise of said longitudinal axis;

said handle mechanism comprising a housing that surrounds the proximal ends of said shafts, means securing one of said shafts to said housing so as to prevent movement thereof relative to said housing, a first handle member affixed to said housing, driver-responsive means attached the other of said shafts, a second handle member, pivot means connecting said second handle member to said first handle member, said second handle member being movable on its pivot relative to said first handle member between first and second operating positions, driver means carried by said second handle member engageable with said driver-responsive means for effecting axial movement of said other shaft relative to said one shaft in response to movement of said second handle member from one to the other of said first and second operating positions; and

unidirectional locking means for locking said first and second shafts against relative axial movement in one predetermined direction; and

bi-polar electrically-conductive means for applying an electrical potential difference across said tissue-interacting members, whereby an electrical current will flow through tissue engaged by said tissue-interacting members.

15. A surgical instrument comprising:

a handle housing with a first handle member affixed thereto, and at least first and second concentrically arranged shafts extending longitudinally away from said housing, said first and second shafts each having proximal and distal ends;

a jaw unit carried by said distal end of said second shaft, said jaw unit comprising first and second jaw members with at least portions of said jaw members being electrically conductive;

means for causing one of said shafts to translate axially relative to the other of said shafts whereby said first shaft will act on said jaw members so as to cause said jaw members to close on one another when said translation is in a first axial direction; and

means for connecting said electrically conductive portions of said jaw members to sources of electrical potential, whereby if different electrical potentials are applied to said jaw members an electrical current will flow between said jaw members to electrify a subject matter disposed between and engaged by said jaw members.

16. An instrument according to claim 15 wherein said jaw members are spring-biased to a normally open position.

17. A surgical instrument for conducting electrosurgery comprising:

a handle housing;

a first outer shaft and a second inner shaft having corresponding proximal and distal ends with said proximal ends being supported by said housing, with one of said shafts being movable axially relative to the other;

a jaw unit carried by one of said shafts, said jaw unit comprising at least first and second jaws with said jaws normally being deployed in spaced relation to one another in an open position;

manually operable means for causing relative axial movement of said shafts in a first axial direction or a second axial direction;

said outer shaft being disposed so as to extend over said jaws when said shafts undergo relative movement in said first axial direction, whereby when said shafts undergo relative movement in said first axial direction said outer shaft will cause said jaws to close towards one another; and

means carried by said handle and extending along said second shaft for connecting said first and second jaws to different sources of electrical potential.

18. An instrument according to claim 17 wherein said last-mentioned means comprises first and second electrical leads disposed within said second shaft and connected to said first and second jaws.

19. An instrument according to claim 17 wherein said last-mentioned means comprises first and second electrical leads disposed within said second shaft and connected to said first and second jaws, and a bi-polar connector assembly attached to and projecting from said handle housing, said leads being connected to said connector assembly, whereby said jaws will be electrified with a potential difference between them when said connector assembly is coupled to a d.c. electrical power source.

20. An instrument according to claim 17 further including means electrically insulating said jaws from one another.

21. An instrument according to claim 20 wherein said jaws have proximal ends and distal ends, and further wherein said last-mentioned means comprises a mechanical member disposed between the proximal ends of said jaws.

22. An instrument according to claim 17 wherein said distal end of said inner shaft has a hollow extension, and said jaw unit comprises a pair of jaws each having a proximal end and a distal end, with said proximal ends extending into said hollow extension.

23. A surgical instrument comprising:

a hollow outer shaft having a longitudinal axis, a first proximal end and a first distal end;

an inner shaft coaxially disposed in said outer shaft with a space existing between said shafts, said inner shaft having a longitudinal axis, a second proximal end, and a second distal end, said shafts being disposed for relative axial movement;

means for surgical interaction with animal tissue attached to the distal end of said inner shaft, said surgical interaction means comprising first and second tissue interacting members movable relative to one another between a first open position and a second closed position by axially directed changes in the relative positions of said first and said second distal ends;

a handle mechanism coupled to said outer and inner shafts for effecting relative axial movement of said shafts and thereby changing the relative positions of said first and said second distal ends lengthwise of said longitudinal axis;

said handle mechanism comprising a first handle member affixed to the proximal end of said inner shaft, driver-responsive means attached to said outer shaft, a second handle member pivotally connected to said first handle member and movable relative to said first handle member between first and second operating positions, driver means carried by said second handle member engageable with said driver-responsive means for effecting reciprocal axial movement of said outer shaft relative to said inner shaft in response to movement of said first handle member between said first and second operating positions; and

unidirectional locking means for locking said first and second handle members against relative movement in one predetermined direction; and

means for introducing fluid to or removing fluid from said space.

24. An instrument according to claim 23 further characterized by at least one radially-extending opening in said outer shaft, and a collar assembly surrounding said outer shaft, said collar assembly having a chamber that communicates with said at least one radially-extending opening and a port that permits fluid to be introduced to or removed from said chamber.

25. A surgical instrument for conducting electrosurgery comprising:

a handle assembly;

an elongate dual shaft assembly having a proximal end retained within said handle assembly and a distal end to which is mounted a jaw assembly having at least two jaws that are movable relative to one another between open and closed positions, said shaft assembly comprising inner and outer shafts with one shaft movable axially relative to the other and said jaw assembly being arranged so that said jaws are urged to a closed position when said shafts undergo relative axial movement in a first direction, said handle assembly being operable to provide relative axial motion between said inner and outer shafts;

a ratchet device coupled between said dual shaft assembly and said handle assembly at the proximal end of said shaft assembly within said handle assembly, said ratchet device comprising a first member comprising a plurality of teeth, and a second member engageable with the teeth on said first member, said first and second members being movable relative to one another as the shafts undergo relative axial movement in response to operation of said handle assembly, the relative motion between said first and second members causing locking engagement and disengagement of said second member and said teeth, and said teeth and said second member being arranged so that when they are engaged the ratchet device will allow the shafts to undergo relative axial movement in said first direction but prevent the shafts from undergoing relative axial movement in a second opposite direction; and

first and second means carried by said handle assembly for applying an electrical potential across said jaws.

26. A surgical instrument according to claim 25 further including selectively operable means for preventing engagement of said teeth and said second member, whereby said shafts are free to be moved axially relative to one another in said first or second directions by operation of said handle assembly.

27. A surgical instrument comprising:

a hollow outer shaft having a longitudinal axis, a first proximal end, and a first distal end;

an inner shaft coaxially disposed in said outer shaft, said inner shaft having a longitudinal axis, a second proximal end and a second distal end, said shafts being capable of relative reciprocal axial movement;

means for surgical interaction with animal tissue attached to the forward end of one of said shafts, said surgical interaction means comprising first and second tissue interacting members movable relative to one another between a first open position and a second closed position by axially directed changes in the relative positions of said first and said second distal ends; and

a handle mechanism coupled to said outer and inner shafts for effecting relative axial movement of said shafts and thereby changing the relative positions of said first and said second distal ends lengthwise of said longitudinal axis;

said handle mechanism comprising a first handle member affixed to the proximal end of one of said shafts, driver-responsive means attached to the other of said shafts, a second handle member, means mounting said second handle member so that it is movable relative to said first handle member between first and second operating positions, driver means carried by said second handle member engageable with said driver-responsive means for effecting reciprocal axial movement of said other shaft relative to said one shaft in response to movement of said second handle member between said first and second operating positions;

ratchet means located within a housing for preventing relative axial movement of said shafts in one predetermined axial direction while permitting relative axial movement in a second opposite axial direction; and

means carried by said handle mechanism for applying an electrical potential between said first and second tissue-interacting members.

28. An instrument according to claim 27 further including selectively operable means for disabling said ratchet means so as to free said other shaft for axial movement in said one predetermined axial direction.