Method for operating a surgical instrument

• US 5,626,587 A
• Filed: 05/17/1995
• Issued: 05/06/1997
• Est. Priority Date: 10/09/1992
• Status: Expired due to Term

• Current Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery, Inc. (Johnson & Johnson)
• Inventors: Gutierrez, Jorge, Hibner, John A., Conlon, Sean P., Bishop, Gregory D., Okorocha, Livyn O., Rhad, Edward, Paul, Michel A., Sambi, Narinderjit
• Primary Examiner(s): Tucker, Guy V.
• Assistant Examiner(s): RASCHE, PATRICK WILLIAM
• Application Number:
  US08/442,783
• Time in Patent Office: 720 Days
• Field of Search: 227/177, 227/19, 227/175.1, 227/176, 227/178, 227/179, 227/180, 606/143, 606/167, 606/170, 606/171, 606/180, 606/205-209, 606/1
• US Class Current: 606/143
• CPC Class Codes: A61B 17/0682 for applying U-shaped staples or clamps, e.g. without a forming anvil
• CPC Class Codes: A61B 17/0684 having a forming anvil staying above the tissue during stapling
• CPC Class Codes: A61B 17/3421 Cannulas
• CPC Class Codes: A61B 2017/2903 transferring rotary motion
• CPC Class Codes: A61B 2017/2923 Toothed members, e.g. rack and pinion
• CPC Class Codes: A61B 2017/2927 the angular position of the head being adjustable with respect to the shaft
• CPC Class Codes: A61B 2017/2929 with a head rotatable about the longitudinal axis of the shaft

Abstract

Various mechanisms, and a method of operating them, are provided for use in a surgical instrument. A shaft and an engaged lost motion operating knob are provided for rotation relative to a handle portion. A latch system prevents rotation of the shaft unless the shaft is rotated by means of the knob. A cartridge is provided for rotation at the distal end of the shaft. Engaging structures are provided for preventing rotation of the cartridge relative to the shaft when axial forces are applied to the cartridge. A loading tool is provided for engaging the cartridge to install the cartridge on the instrument. The cartridge includes a washer for engaging a carrier on which the cartridge is mounted so as to prevent rotation of the washer. The washer is adapted to engage a fastener advancing member in a first angular orientation and is disengaged when the cartridge is rotated to establish a second relative angular orientation. In the first angular orientation, the fastener advancing member is restrained against longitudinal movement to assist in installation of the cartridge onto the instrument. The distal end of the instrument can be articulated, and a helical gear operator is provided for effecting the articulation. The helical gear pitch decreases in a direction such that the mechanical advantage is increased as the articulation angle increases.

Claims

1. A method for operating a surgical instrument wherein said instrument has (1) a frame having a pistol handle grip which is fixed relative to said frame and which is adapted to be held in the palm of the hand while the fingers of the hand extend around one side of the grip and the thumb of the hand extends around another side of the grip, (2) an elongated shaft mounted to said frame for rotation relative thereto, (3) a rotatable first knob on said shaft located adjacent said frame;

(4) a support defining a longitudinal axis and movably mounted to said shaft for movement to an angled orientation relative to said shaft, (5) a rotatable second knob on said frame spaced proximally of said first knob and operatively engaged with said support for effecting pivoting of said support, (6) an end effector mounted to said support for rotation about said longitudinal axis, (7) a rotatable third knob on said frame operatively engaged with said end effector for effecting rotation of said end effector on said support, and (8) a trigger lever mounted distally of said handle grip on said frame for pivotal movement toward and away from said handle grip and operatively engaged with said end effector for effecting operation of said end effector, said method comprising the steps of;

(A) engaging said first knob with a digit of said hand to turn said first knob and rotate said shaft to a selected orientation;

(B) moving a digit of said hand to engage said second knob without extending said digit to and adjacent said first knob, and turning said second knob with said digit to move said support to a selected orientation while said digit is free of engagement with said first knob;

(C) engaging said third knob with a digit of said hand to turn said third knob and rotate said end effector to a selected orientation; and

(D) after performing steps (A), (B), and (C) in any desired sequence, pulling said trigger lever proximally toward said handle grip with a digit of said hand to operate said end effector.

2. The method in accordance with claim 1 in which

step (A) includes engaging said first knob with the index finger of said hand;

step (B) includes engaging said second knob with the thumb of said hand; and

step (C) includes engaging said third knob with the thumb of said hand.

3. The method in accordance with claim 1 in which step (B) is effected before step (A), and step (C) is effected after step (A).

4. The method in accordance with claim 1 in which said support is pivotally mounted to said shaft and in which step (B) includes turning said second knob to pivot said support to a selected orientation.

5. A method for operating a surgical instrument wherein said instrument has (1) a frame having a pistol handle grip which is fixed relative to said frame and which is adapted to be held in the palm of the hand while the fingers of the hand extend around one side of the grip and the thumb of the hand extends around another side of the grip, (2) an elongated shaft mounted to said frame for rotation relative thereto, (3) a first knob on said shaft located adjacent said frame and rotatable about a longitudinal axis;

(4) a support extending along said longitudinal axis and movably mounted to said shaft for movement to an angled orientation relative to said shaft, (5) a second knob on said frame spaced proximally of said first knob and engaged operatively with said support for effecting pivoting of said support, said second knob being rotatable about a transverse axis perpendicular to said longitudinal axis, (6) an end effector mounted to said support for rotation about said longitudinal axis, (7) a rotatable third knob on said frame spaced proximally of said second knob and operatively engaged with said end effector for effecting rotation of said end effector on said support, and (8) a trigger lever mounted distally of said handle grip on said frame for pivotal movement toward and away from said handle grip and operatively engaged with said end effector for effecting operation of said end effector, said method comprising the steps of;

(A) engaging said first knob with a digit of said hand and turning said first knob about said longitudinal axis to rotate said shaft to a selected orientation;

(B) moving a digit of said hand to engage said second knob with said digit of said hand and turning said second knob about said transverse axis to move said support to a selected orientation;

(C) engaging said third knob with a digit of said hand and turning said third knob about said longitudinal axis to rotate said end effector to a selected orientation; and

(D) after performing steps (A), (B), and (C) in any desired sequence, pulling said trigger lever proximally toward said handle grip with a digit of said hand to operate said end effector.