Surgical instrument for endoscopic and general surgery

• US 5,817,119 A
• Filed: 06/25/1996
• Issued: 10/06/1998
• Est. Priority Date: 07/21/1993
• Status: Expired due to Term

• Current Assignee: Charles H. Klieman
• Original Assignee: Charles H. Klieman
• Inventors: Schena, Bruce M., Stiggelbout, John M., Klieman, Charles H.
• Primary Examiner(s): Thaler, Michael H.
• Application Number:
  US08/671,820
• Time in Patent Office: 833 Days
• Field of Search: 606/205-208, 606/174, 606/170, 128/751
• US Class Current: 606/174
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 17/2909 Handles
• CPC Class Codes: A61B 17/320016 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 2017/00398 using powered actuators, e.g. stepper motors, solenoids
• CPC Class Codes: A61B 2017/0046 with a releasable handle; with handle and operating part separable
• 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
• CPC Class Codes: A61B 2017/2931 with releasable head
• CPC Class Codes: A61B 2017/2932 Transmission of forces to jaw members
• CPC Class Codes: A61B 2017/2937 with flexible part
• CPC Class Codes: A61B 2017/2938 Independently actuatable jaw members, e.g. two actuating rods
• CPC Class Codes: A61B 2017/2939 Details of linkages or pivot points
• CPC Class Codes: A61B 2017/2943 Toothed members, e.g. rack and pinion
• CPC Class Codes: A61B 2034/742 Joysticks
• CPC Class Codes: A61B 34/71 Manipulators operated by drive cable mechanisms

Abstract

A surgical instrument having a handle, barrel and working end effector tip is provided. The barrel is generally tubular, with one end being releasably connected to the handle. The end effector is moveably attached to the other end of the barrel, and may be positioned and operated independently through multiple linkage members connected to a motive power source housed in or attached to the handle. The instrument is operated and controlled by a microprocessor and multidimensional controller or electrical contacts included in the handle. In the preferred embodiment, the end effector is scissor-like, but other end effectors such as graspers, clamps, dissectors or needle drivers, with appropriate operating and linkage members, may be attached to the handle.

Claims

1. A surgical apparatus comprising:

a tubular member with no joints and having a distal end and a proximal end;

an end effector attached directly to the distal end of said tubular member at an attachment point, the end effector comprising a first pivotable working portion and a second pivotable working portion, the two working portions each extending from the attachment point and forming an operating angle therebetween;

a handle attached to the proximal end of the tubular member, the handle comprising;

an elongated grip portion having a longitudinal axis that extends at an angle relative to the longitudinal axis of the tubular member, wherein the grip portion is permanently fixed with respect to the longitudinal axis of the tubular member and grippable by a single hand;

an actuating control; and

a pivot control, the actuating and pivot controls being actuable by the same hand which grips the grip portion; and

linkage extending through the tubular member, the linkage operably connecting the actuating control and the pivot control with the first and second end effector working portions, wherein;

in response to the actuating control being actuated, the linkage acts on the end effector to alter the operating angle; and

in response to the pivot control being actuated while the actuating control is not being actuated, the linkage acts on the end effector to pivot the working portions simultaneously in the same direction about the attachment point while maintaining a substantially constant operating angle.

2. The surgical apparatus of claim 1, wherein the handle further comprises a rotate control for rotating the end effector relative to the handle.

3. The surgical apparatus of claim 2, wherein the pivot control and the rotate control include an electric motor driven by stored electrical energy.

4. The surgical apparatus of claim 3, wherein the pivot control and the rotate control include a microprocessor.

5. The surgical apparatus of claim 4, wherein said altering of the operating angle of the end effector working portions is manually controlled.

6. The surgical apparatus of claim 3, wherein the source of the stored electrical energy is associated with the handle.

7. The surgical apparatus of claim 2, wherein the end effector is rotatable 360°

relative to the axis of the tubular barrel and is operational in any position relative to the axis.

8. The surgical apparatus of claim 1, wherein the linkage includes two lengths of high-modulus tensile cords.

9. The surgical apparatus of claim 8, wherein said two cords are operably coordinated to provide said altering of the operating angle and said simultaneous pivoting of the end effector working portions.

10. The surgical apparatus of claim 9, wherein the linkage further includes two additional cords for opening the end effector portions relative to one another.

11. The surgical apparatus of claim 1, wherein the tubular member is removeably coupled to the handle.

12. The surgical apparatus of claim 1, wherein the first and second end effector working portions are pivotable through and functional in a 360°

included angle.

13. The surgical apparatus of claim 1, wherein the end effector is a scissors.

14. A surgical instrument for use in endoscopy comprising:

a tubular member with no joints and having a proximal end and a distal end;

an end effector attached directly to the distal end of the tubular member at an attachment point, the end effector comprising a first pivotable working portion and a second pivotable working portion, the two working portions each extending from the attachment point and forming an operating angle therebetween;

a handle releasably and rotatably attached to the proximal end of the tubular member, the handle comprising;

an elongated grip portion having a longitudinal axis that extends at an angle relative to the longitudinal axis of the tubular member, wherein the grip portion is permanently fixed with respect to the longitudinal axis of the tubular member and grippable by a single hand;

an actuating control; and

a pivot control, the actuating and pivot controls being actuable by the same hand which grips the grip portion; and

linkage extending through the tubular member, the linkage operably connecting the actuating control and the pivot control with the first and second end effector working portions, wherein;

in response to the actuating control being actuated, the linkage acts on the end effector to alter the operating angle; and

in response to the pivot control being actuated while the actuating control is not being actuated, the linkage acts on the end effector to pivot the working portions simultaneously in the same direction about the attachment point while maintaining a substantially constant operating angle.

15. The instrument according to claim 14, wherein the linkage comprises elongated, flexible members.

16. A surgical instrument comprising:

a handle with an elongated grip portion grippable by a single hand;

a generally tubular barrel with no joints and having a first end and a second end, the first end being rotatably and releasably coupled to the handle, the grip portion of the handle having a longitudinal axis that extends at an angle relative to the longitudinal axis of the tubular member, wherein the grip portion is permanently fixed with respect to the longitudinal axis of the tubular barrel;

a scissor-like working end effector tip having two pieces, each piece being pivotally connected directly to the second end of the barrel at a common attachment point and having a working portion extending generally distally from the attachment point and a lever portion extending generally proximally from the attachment point;

elongated linkage members extending generally toward the handle, the linkage members including;

a first linkage member attached to the first end effector piece and crossing around the lever portion of the first end effector piece to the lever portion of the second end effector piece and over a pulley on one side of the two end effector pieces; and

a second linkage member attached to the second end effector piece and crossing around the lever portion of the second end effector piece to the lever portion of the first end effector piece and over a second pulley on the opposite side of the two end effector pieces;

an actuating control carried by the handle and actuable by the same hand which grips the grip portion, wherein actuation of the actuating control translates both the first and the second linkage members simultaneously in the same direction to pivot the end effector working portions relative to one another; and

a pivot control carried by the handle and actuable by the same hand which grips the grip portion, wherein actuation of the pivot control translates both the first and the second linkage members simultaneously in opposite directions to pivot the end effector working portions simultaneously in the same direction about the attachment point, and wherein, a substantially constant angle between the end effector working portions is maintained during the actuation of the pivot control if the actuating control is not also being actuated.

17. The surgical instrument according to claim 16, wherein the pivot control includes a microprocessor, logic and an electrically powered motor.

18. The surgical instrument according to claim 16, wherein the actuating control includes a trigger.

19. The surgical instrument according to claim 16, wherein said end effector is connected to said tubular member so that said end effector may pivot 360°

with respect to said tubular member.

20. The surgical instrument according to claim 19, wherein said elongated members are tensile.

21. A surgical apparatus comprising:

a tubular member having a distal end and a proximal end, an end effector movably attached to the distal end and a handle attached to the proximal end;

means for rotating, pivoting and closing the end effector in any orientation relative to the tubular member including lengths of high-modulus tensile cords, a slidable, rotatable shaft with right- and left-handed threaded portions, said shaft being slidable and rotatable relative to the tubular member, two nuts operably received on the shaft and being slidable and non-rotating relative to the tubular member, and means for retracting the shaft in the proximal direction; and

means for controlling said means for rotating, pivoting and closing.

22. The surgical apparatus according to claim 21, said means for controlling including a microprocessor.

23. The surgical apparatus according to claim 21, wherein said means for rotating, pivoting and closing includes two of said cords and wherein said cords are operably coordinated to provide said rotating, pivoting and closing.

24. The surgical apparatus according to claim 21, wherein said pivoting and closing takes place about a single pivot point.

25. A surgical instrument comprising:

a handle;

a generally tubular barrel having a first end and a second end, the first end being moveably and releasably coupled to the handle;

a scissor-like working end effector tip pivotally coupled to the second end of the barrel and having two blades pivotally connected to the second end, each blade having a distal end and a proximal portion, the blades crossing over one another at a pivot point generally between the distal end and the proximal portion;

elongated linkage members including a first linkage member attached to the first blade and crossing around the proximal portion of the first blade to the proximal portion of the second blade and over a pulley on one side of the two blades, and a second linkage member attached to the second blade and crossing around the proximal portion of the second blade to the proximal portion of the first blade and over a second pulley on the opposite side of the two blades, said linkage members extending generally toward the handle;

a shaft received in the tubular barrel and being threaded in one direction adjacent to one end and in the opposite direction adjacent to the other end, two nuts received on the shaft, one of the nuts received on each threaded portion of the shaft, the nuts being constrained from rotating and slideable inside the barrel, one of said linkage members being connected to one nut, the second linkage member being connected to the second nut; and

actuating means carried by the handle for operating the blades, said linkage members operably coupled to the actuating means.

26. The surgical instrument according to claim 25, wherein the length of the threaded portions of the shaft exceed the travel of the linkage members.

27. The surgical instrument according to claim 26, each proximal portion of the blades carrying a groove to receive a tensile member.

28. The surgical instrument according to claim 27 and a compression spring generally between and biasing the blades apart.

29. The surgical instrument according to claim 28, wherein pulling one of the linkage members while releasing the other pivots the blades in unison, wherein pulling the linkage members simultaneously closes the blades, and wherein rotating the tubular barrel relative to the handle rotates the blades and linkage members.

30. The surgical instrument according to claim 29, wherein said end effector is connected to said tubular member so that said end effector may pivot 360°

with respect to said tubular member.

31. The surgical instrument according to claim 30, wherein said elongated members are tensile.

32. A surgical apparatus comprising:

a tubular member with no joints and having a distal end and a proximal end;

an end effector attached directly to the distal end of the tubular member at an attachment point, the end effector comprising a first pivotable working portion and a second pivotable working portion, the two working portions each extending from the attachment point and forming an operating angle therebetween;

a handle attached to the proximal end of the tubular member, the handle comprising;

an elongated grip portion having a longitudinal axis that extends at an angle relative to the longitudinal axis of the tubular member, wherein the grip portion is permanently fixed with respect to the longitudinal axis of the tubular member and grippable by a single hand to maintain stability of the surgical apparatus during its operation;

an actuating control; and

a pivot control, the actuating and pivot controls being independent of one another and further being actuable by the same hand which grips the grip portion; and

linkage extending through the tubular member, the linkage operably connecting the actuating control and the pivot control to the first and second end effector working portions, wherein;

in response to the actuating control being actuated, the linkage acts on the end effector to alter the operating angle; and

in response to the pivot control being actuated while the actuating control is not being actuated, the linkage acts on the end effector to pivot the end effector working portions about the attachment point simultaneously in the same direction while maintaining a substantially constant operating angle.

33. The surgical apparatus of claim 32, wherein, in response to the actuating control being actuated, the linkage pivots both of the end effector working portions either toward one another or apart from one another.

34. The surgical apparatus of claim 32, wherein the handle further comprises a rotate control actuable by the same hand which grips the grip portion, the rotate control for rotating the end effector relative to the handle.