Surgical instrument

• US 5,620,415 A
• Filed: 09/23/1994
• Issued: 04/15/1997
• Est. Priority Date: 01/29/1993
• Status: Expired due to Fees

• Current Assignee: Smith & Nephew Incorporated (Smith & Nephew PLC)
• Original Assignee: Smith & Dyonics Incorporated
• Inventors: Smith, Graham, Torrie, Paul A., Lucey, Paul V., Seifert, C. Vaughan
• Primary Examiner(s): Buiz, Michael Powell
• Assistant Examiner(s): SHAI, DAPHNA
• Application Number:
  US08/319,057
• Time in Patent Office: 935 Days
• Field of Search: 128/751, 128/752, 128/753, 128/754, 606/170, 606/174, 606/205, 606/206, 606/207, 606/208, 606/209, 606/210, 606/159, 606/171, 606/180, 606/194, 604/22
• US Class Current: 604/22
• CPC Class Codes: A61B 1/042 characterised by a proximal camera, e.g. a CCD camera
• CPC Class Codes: A61B 1/317 for bones or joints, e.g. osteoscopes, arthroscopes
• CPC Class Codes: A61B 17/1608 the two jaw elements being linked to two elongated shaft elements moving longitudinally relative to each other
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 2017/00309 Cut-outs or slits
• CPC Class Codes: A61B 2017/2904 curved, but rigid
• CPC Class Codes: A61B 2017/2929 with a head rotatable about the longitudinal axis of the shaft
• CPC Class Codes: A61B 2090/034 abutting on parts of the device itself
• CPC Class Codes: A61B 2090/038 during shipment
• CPC Class Codes: A61B 2217/005 with suction drainage system
• CPC Class Codes: A61B 90/37 Surgical systems with images on a monitor during operation

Abstract

A surgical instrument in which a surgical tool is carried distally of a bend region in a stationary support member by an assembly that transmits proximally applied forces through the bend region to both operate the surgical tool and selectively change the rotational orientation of the surgical tool with respect to the stationary member. In another aspect, in which the stationary member does not include a bend region, a rotatable member supported by the stationary member transmits rotational force to the surgical tool to selectively change the rotational orientation of the tool, and a driver member supported by the stationary member transmits axial force to the surgical tool to operate it. In still another aspect in which the stationary member includes the bend region but the surgical tool is not rotatable, a movable member supported by the stationary member is constructed to transmit a proximally applied axial force through the bend region to operate a surgical tool disposed in a distal region of the instrument.

Claims

1. A surgical instrument comprising

a stationary member disposed generally along an axis and including a bend region that angularly offsets a distal region of said stationary member from said axis,

an assembly including a driver member and a generally rigid movable member that extend along said stationary member and are movable with respect to each other,

said driver member having a distal end coupled to a surgical too including a first element and a second element engaged with said first element, said driver member being relieved with a first opening pattern to render it at least partially flexible for transmitting a first force applied at a proximal region of said instrument through said bend region of said stationary member to operate said surgical tool, said first element being stationary with respect to said distal region when said surgical tool is operated by applying said first force, and

said generally rigid movable member having a distal end coupled to said surgical tool to carry and support said first element of said surgical tool thereat, said movable member being relieved with a second opening pattern different from said first opening pattern to provide a relatively flexible region axially aligned with said bend region proximally of said surgical tool for transmitting a second, different force applied at said proximal region through said bend region to rotate said first element and said second element with respect to said stationary member to selectively change a rotational orientation of said surgical tool with respect to said stationary member.

2. The instrument of claim 1 wherein said first element and said second element each comprises a jaw having tissue cutting edges, said second element being adapted to pivot with respect to said first element in response to said first force to move toward and closely past said first element thereby to cut tissue engaged by said cutting edges.

3. A surgical instrument comprising

a stationary member including a tube, said stationary member being disposed generally along an axis and including a bend region that angularly offsets a distal region of said stationary member from said axis,

an assembly including a driver member disposed within said stationary member and a generally rigid movable member, said driver member and said movable member extending along said stationary member and being movable with respect to each other,

said driver member including a hollow tube and having a distal end coupled to a surgical tool, said driver member being relieved with a first opening pattern disposed with in said bend region, said first opening pattern rendering said driver member at least partially flexible for transmitting a first force applied at a proximal region of said instrument through said bend region of said stationary member to operate said surgical tool, said first opening pattern including an axially elongated opening in a wall of said tube of said driver member, said elongated opening extending a selected amount axially along said tube and extending radially over at least 60% of a diameter of said tube and

said generally rigid movable member having a distal end coupled to said surgical tool and being relieved with a second opening pattern different from said first opening pattern to provide a relatively flexible region axially aligned with said bend region proximally of said surgical tool for transmitting a second, different force applied at said proximal region through said bend region to selectively change a rotational orientation of said surgical tool with respect to said stationary member.

4. A surgical instrument comprising

a stationary member including a tube, said stationary member being disposed generally along an axis and including a bend region that angularly offsets a distal region of said stationary member from said axis,

an assembly including a driver member disposed within said stationary member and a generally rigid movable member, said driver member and said movable member extending along said stationary member and being movable with respect to each other,

said driver member including a hollow tube and having a distal end coupled to a surgical tool, said driver member being relieved with a first opening pattern disposed with in said bendregion, said first opening pattern rendering said driver member at least partially flexible for transmitting a first force applied at a proximal region of said instrument through said bend region of said stationary member to operate said surgical tool, said first opening pattern including an axially elongated opening in a wall of said tube of said driver member, said elongated opening extending a selected amount axially along said tube and extending radially over at least 75% of a diameter of said tube and

said generally rigid movable member having a distal end coupled to said surgical tool and being relieved with a second opening pattern different from said first opening pattern to provide a relatively flexible region axially aligned with said bend region proximally of said surgical tool for transmitting a second, different force applied at said proximal region through said bend region to selectively change a rotational orientation of said surgical tool with respect to said stationary member.

5. A surgical instrument comprising

a stationary member including a tube, said stationary member being disposed generally along an axis and including a bend region that angularly offsets a distal region of said stationary member from said axis,

an assembly including a driver member disposed within said stationary member and a generally rigid movable member, said driver member and said movable member extending along said stationary member and being movable with respect to each other,

said driver member having a distal end coupled to a surgical tool including a first element carried by said movable member and a second element, said driver member being relieved with a first opening pattern disposed with said bend region, said first opening pattern rendering said driver member at least partially flexible for transmitting a first force applied at a proximal region of said instrument through said bend region of said stationary member to operate said surgical tool, said second element being adapted to be moved by said driver member with respect to said first element of said tool in response to said first force to operate said surgical tool, and

said generally rigid movable member having a distal end coupled to said surgical tool and being relieved with a second opening pattern different from said first opening pattern to provide a relatively flexible region axially aligned with said bend region proximally of said surgical tool for transmitting a second, different force applied at said proximal region through said bend region to selectively change a rotational orientation of said surgical tool with respect to said stationary member.

6. The instrument of claim 5 wherein said first element and said second element each comprises a jaw having tissue cutting edges, said second element being adapted to pivot with respect to said first element in response to said first force to move toward and closely past said first element thereby to cut tissue engaged by said cutting edges.

7. The instrument of claim 6 wherein said driver member includes a passage disposed therein for transporting tissue fragments cut by said surgical tool through said instrument in response to suction applied to a proximal region of said driver member.

8. The instrument of claim 6 wherein said first force is applied axially and said driver member is adapted to slide axially toward said distal region in response to said first force to close said jaws.

9. A surgical instrument comprising

a stationary member disposed generally along an axis and including a bend region that angularly offsets a distal region of said stationary member from said axis,

an assembly including a driver member and a generally rigid movable member that extend along said stationary member and are movable with respect to each other,

said driver member having a distal end coupled to a surgical tool and being relieved with a first opening pattern to render it at least partially flexible for transmitting a first force applied at a proximal region of said instrument through said bend region of said stationary member to operate said surgical tool, and

said generally rigid movable member having a distal end coupled to said surgical tool and being relieved with a second opening pattern different from said first opening pattern to provide a relatively flexible region axially aligned with said bend region proximally of said surgical tool for transmitting a second, different force applied at said proximal region in a rotational direction with respect to said axis, through said bend region to selectively change a rotational orientation of said surgical tool with respect to said stationary member, said assembly being constructed to allow said movable member to rotate in response to said second force and change said rotational orientation of said surgical tool without disrupting the ability of said driver member to operate said surgical tool, said driver member remaining substantially rotationally stationary with respect to said bend region as said movable member rotates said surgical tool.

10. A surgical instrument comprising

a stationary member disposed generally along an axis and including a bend region that angularly offsets a distal region of said stationary member from said axis,

an assembly including a driver member and a generally rigid movable member that extend along said stationary member and are movable with respect to each other,

said driver member having a distal end coupled to a surgical tool and being relieved with a first opening pattern to render it at least partially flexible for transmitting a first force applied at a proximal region of said instrument through said bend region of said stationary member to operate said surgical tool, and

said generally rigid movable member having a distal end coupled to said surgical tool and being relieved with a second opening pattern different from said first opening pattern to provide a relatively flexible region axially aligned with said bend region proximally of said surgical tool for transmitting a second, different force, applied at said proximal region in a rotational direction with respect to said axis, through said bend region to selectively change a rotational through said bend region to selectively change a rotational orientation of said surgical tool with respect to said stationary member, said assembly being constructed to allow said movable member to rotate in response to said second force and change said rotational orientation of said surgical tool without disrupting the ability of said driver member to operate said surgical tool, said surgical tool including a first element carried by and rotatable with said movable member and a second element actuated by said driver member with respect to the first element to operate said tool, said first element engaging said second element to cause said second element to rotate with said first element in response to said second force, said driver member remaining substantially rotationally stationary with respect to said bend region as said first element and said second element rotate.

11. The instrument of claim 10 further comprising a rotational joint disposed between a distal end of said driver element and said second element to allow said driver member to remain substantially rotationally stationary with respect to said bend region as said first element and said second element rotate.

12. A surgical instrument comprising

a stationary member disposed generally along an axis and including a bend region that angularly offsets a distal region of said stationary member from said axis,

an assembly including a driver member and a generally rigid movable member that extend along said stationary member and are movable with respect to each other,

said driver member having a distal end coupled to a surgical tool and being relieved with a first opening pattern to render it at least partially flexible for transmitting a first force applied at a proximal region of said instrument through said bend region of said stationary member to operate said surgical tool, and

said generally rigid movable member having a distal end coupled to said surgical tool and being relieved with a second opening pattern different from said first opening pattern to provide a relatively flexible region axially aligned with said bend region proximally of said surgical tool for transmitting a second, different force, applied at said proximal region in a rotational direction with respect to said axis, through said bend region to selectively change a rotational orientation of said surgical tool with respect to said stationary member, said assembly being constructed to allow said movable member to rotate in response to said second force and change said rotational orientation of said surgical tool without disrupting the ability of said driver member to operate said surgical tool, said driver member being rotatably coupled to said surgical tool to rotate with said surgical tool in response to rotation of said movable member.

13. A surgical instrument comprising

a stationary member disposed generally along an axis and including a bend region that angularly offsets a distal region of said stationary member from said axis,

an assembly including a driver member and a generally rigid movable member that extend along said stationary member and are movable with respect to each other,

said driver member having a distal end coupled to a surgical tool and being relieved with a first opening pattern to render it at least partially flexible for transmitting a first force applied at a proximal region of said instrument through said bend region of said stationary member to operate said surgical tool, and

said generally rigid movable member having a distal end coupled to said surgical tool and being relieved with a second opening pattern different from said first opening pattern to provide a relatively flexible region axially aligned with said bend region proximally of said surgical tool for transmitting a second, different force, applied at said proximal region through said bend region to selectively change a rotational orientation of said surgical tool with respect to said stationary member, and

a manual actuator disposed at said proximal region of said instrument for supporting said stationary member and coupled to a proximal region of said assembly for applying said first force to said assembly to operate said surgical tool, and means for decoupling said actuator from said assembly if said first force exceeds a threshold thereby to avoid applying excessive force to said surgical tool.

14. The instrument of claim 13 wherein said means for decoupling includes a spring for coupling said actuator to said proximal region of said assembly, said spring being constructed to transmit said first force to said assembly if said first force is below said threshold and to compress in response to forces that exceed said threshold to avoid applying said excessive force to said assembly.

15. A surgical instrument comprising

a stationary member supporting a surgical tool at a distal region thereof,

a rotatable member supported by said stationary member and having a distal end coupled to said surgical tool and being relieved with a first opening pattern to render it at least partially flexible for transmitting rotational force applied at a proximal region of said instrument to said surgical tool to selectively change a rotational orientation of said surgical tool with respect to said stationary member,

a driver member supported by said stationary member and having a distal end coupled to said surgical tool and being relieved with a second pattern different from said first opening pattern to render it at least partially flexible for transmitting an axial force applied at said proximal region to said surgical tool to operate said surgical tool and cause said surgical tool to sever body material, and

one of said rotatable member or said driver member being hollow to provide a passage that extends from a distal end of said one member proximally through said one member to said proximal region of said instrument for transporting body material severed by said surgical tool from said distal region to said proximal region of said instrument in response to suction applied at said proximal region of said instrument.

16. The instrument of claim 15 wherein said stationary member is generally disposed along an axis and includes a bend region to offset said distal region from said axis.

17. The instrument of claim 16 wherein said stationary member comprises a tube, wherein said rotatable member includes a generally rigid tube disposed within said stationary member and wherein said first opening pattern is disposed within said bend region.

18. The instrument of claim 16 wherein said stationary member comprises a tube, wherein said driver member includes a generally rigid tube disposed within said stationary member and wherein said second opening pattern is disposed within said bend region.

19. The instrument of claim 18 wherein said passage is disposed through said driver member.

20. The instrument of claim 16 further comprising means for allowing said surgical tool to be rotated by said rotatable member to change said rotational orientation without disrupting the ability of said driver member to operate said surgical tool.

21. The instrument of claim 20 wherein said stationary member comprises a tube, and wherein said rotatable member includes a generally rigid tube, said means for allowing including means for holding said driver member substantially rotationally stationary with respect to said bend region as said surgical tool rotates.

22. The instrument of claim 15 wherein said stationary member includes an open distal end, said stationary member supporting said surgical tool distally of said distal end, and further comprising means for axially securing said surgical tool to said distal end without interfering with rotatable member changing said rotational orientation or said driver member operating said surgical tool.

23. The instrument of claim 22 wherein said axially securing means includes a collar threadably received by said distal end for capturing at least a portion of said surgical tool, said collar axially securing said surgical tool to said distal end and permitting said tool to rotate within said collar.

24. A surgical instrument comprising

a stationary member disposed generally along an axis and including a bend region that angularly offsets a distal region of said stationary member from said axis,

a surgical tool disposed at said distal region, and

a movable member supported by said stationary member, said movable member having a generally rigid distal region coupled to said surgical tool, a generally rigid proximal region disposed at a proximal region of said instrument, and a flexible intermediate region disposed in said bend region,

said flexible region including an axially elongated strip of material rigidly interconnected at either end to said generally rigid distal region and said generally rigid proximal region, said strip of material being circumferentially bounded by an axially elongated opening disposed between said generally rigid distal region and said generally rigid proximal region, said strip of material being sufficiently axially stiff to transmit to axial force applied to said proximal region of said movable member through said bend region of said stationary member to operate said tool, said movable member being disposed to slide within said stationary member in response to said applied axial force.

25. The instrument of claim 24 wherein said movable member comprises a hollow tube, a portion of said tube being relieved to provide said elongated opening and axially elongated strip of material.

26. A surgical instrument comprising

a stationary member disposed generally along an axis and including a bend region that angularly offsets a distal region of said stationary member from said axis,

a surgical tool disposed at said distal region, and

a movable member supported by said stationary member, said movable member having a generally rigid distal region coupled to said surgical tool, a generally rigid proximal region disposed at a proximal region of said instrument, and a flexible intermediate region disposed in said bend region,

said flexible region including an axially elongated strip of material rigidly interconnected at either end to said generally rigid distal region and said generally rigid proximal region, said strip of material being circumferentially bounded by an axially elongated opening disposed between said generally rigid distal region and said generally rigid proximal region, said strip of material being sufficiently axially stiff to transmit an axial force applied to said proximal region of said movable member through said bend region of said stationary member to operate said tool, said axially elongated strip of material having a length selected so that said generally rigid distal and proximal regions of said movable member disposed adjacent to said flexible remain substantially outside of said bend region during operation of said tool.

27. A surgical instrument comprising

a stationary member disposed generally along an axis and including a bend region that angularly offsets a distal region of said stationary member from said axis,

a surgical tool disposed at said distal region, and

a tubular movable member supported by said stationary member, said movable member having a generally rigid distal region coupled to said surgical tool, a generally rigid proximal region disposed at a proximal region of said instrument, and a flexible intermediate region disposed in said bend region,

said flexible region including an axially elongated strip of material rigidly interconnected at either end to said generally rigid distal region and said generally rigid proximal region, said strip of material being circumferentially bounded by an axially elongated opening disposed extending radially into said tubular moveable member by a selected amount and disposed between said generally rigid distal region and said generally rigid proximal region, said strip of material being sufficiently axially stiff to transmit an axial force applied to said proximal region of said movable member through said bend region of said stationary member to operate said tool.

28. The instrument of claim 27 wherein said elongated opening radially extends over at least 60% of a diameter of said tube.

29. The instrument of claim 27 wherein said elongated opening radially extends over at least 75% of a diameter of said tube.

30. A surgical instrument comprising

a stationary member disposed generally along an axis and including a bend region that angularly offsets a distal region of said stationary member from said axis,

a surgical tool disposed at said distal region, and

a movable member supported by said stationary member, said movable member having a generally rigid distal region coupled to said surgical tool, a generally rigid proximal region disposed at a proximal region of said instrument, and a flexible intermediate region disposed in said bend region,

said flexible region including an axially elongated strip of material rigidly interconnected at either end to said generally rigid distal region and said generally rigid proximal region, said strip of material being circumferentially bounded by an axially elongated opening disposed between said generally rigid distal region and said generally rigid proximal region, and said strip of material being sufficiently axially stiff to transmit an axial force applied to said proximal region of said movable member through said bend region of said stationary member to operate said tool, said elongated opening having a length selected so that said generally rigid distal and proximal regions of said tube disposed adjacent to said elongated opening remain substantially outside of said bend region during operation of said surgical tool.

31. A surgical instrument comprising

a stationary member disposed generally along an axis and including a bend region that angularly offsets a distal region of said stationary member from said axis,

a surgical tool disposed at said distal region, and

a movable member supported by said stationary member, said movable member having a generally rigid distal region coupled to said surgical tool, a generally rigid proximal region disposed at a proximal region of said instrument, and a flexible intermediate region disposed in said bend region,

said flexible region including an axially elongated strip of material rigidly interconnected at either end to said generally rigid distal region and said generally rigid proximal region, said strip of material being circumferentially bounded by an axially elongated opening disposed between said generally rigid distal region and said generally rigid proximal region, said strip of material being sufficiently axially stiff to transmit an axial force applied to said proximal region of said movable member through said bend region of said stationary member to operate said tool,

a passage defined at least in part by one of said stationary member or movable member for transporting body material severed by said surgical tool from said distal region to said proximal region of said instrument in response to suction applied at said proximal region.

32. The instrument of claim 31 wherein said passage is disposed in said movable member.

33. A surgical instrument comprising

a first member having a distal end coupled to a surgical tool and a region relieved with a first opening pattern to render it relatively flexible,

a second member carried by said first member and movable with respect to said first member, said second member having a distal end coupled to said surgical tool and a region relieved with a second opening pattern different from said first opening pattern to render it relatively flexible,

a stationary member disposed generally along an axis, said stationary member carrying said first member and said second member and having a bend region that angularly offsets a distal region of said stationary member from said axis, said first member being disposed inside said stationary member with the relieved region of said first member being disposed within said bend region.

34. The surgical instrument of claim 33 wherein said second member is disposed inside said first member with the relieved region of said second member being disposed within said bend region.