Surgical instrument with multiple rotatably mounted spreadable end effectors

• US 5,954,731 A
• Filed: 07/29/1997
• Issued: 09/21/1999
• Est. Priority Date: 07/29/1997
• Status: Expired due to Fees

• Current Assignee: Inbae Yoon
• Original Assignee: Inbae Yoon
• Inventors: Yoon, InBae
• Primary Examiner(s): Buiz, Michael
• Assistant Examiner(s): Woo, Julian W.
• Application Number:
  US08/902,311
• Time in Patent Office: 784 Days
• Field of Search: 606/144, 606/145, 606/147, 606/148, 606/139, 606/205, 606/206
• US Class Current: 606/144
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/0491 Sewing machines for surgery
• CPC Class Codes: A61B 17/062 Needle manipulators
• 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 2217/005 with suction drainage system
• CPC Class Codes: A61B 2217/007 with irrigation system

Abstract

An instrument for performing a surgical procedure includes a housing, an elongate shaft having a proximal end mounted by the housing and a distal end with a peripheral edge, a first end effector assembly protruding from the distal end of the elongate shaft and having an end effector at a distal end, and a second end effector assembly protruding from the distal end of the elongate shaft and having an end effector at a distal end. Distal portions of the first and second end effector assemblies extend laterally outward at an angle from first and second longitudinal axes of the elongate shaft to positions where at least a portion of the corresponding end effectors are spaced laterally outward of the peripheral edge of the elongate shaft. In addition, the end effector assemblies are rotatable about the first and second longitudinal axes of the elongate shaft to cause the corresponding end effectors to move along first and second arcuate paths. When inserting the surgical instrument through a portal in an endoscopic procedure, the first and second end effector assemblies are preferably moved to undeployed positions where their end effectors are spaced laterally inward of the peripheral edge of the elongate shaft, for example by rotating the end effector assemblies inwardly or drawing the end effectors proximally into the elongate shaft so that they are straightened. In use, the end effectors can be moved from their undeployed positions to deployed positions disposed laterally outward of the peripheral edge due to the angled configuration of the distal portions of the end effector assemblies.

Claims

1. A surgical instrument for use in open and endoscopic surgery comprising

a housing;

an elongate shaft having a proximal end mounted by said housing and a distal end with a peripheral edge;

a first end effector assembly protruding from said distal end of said elongate shaft and having an end effector at a distal end; and

a second end effector assembly protruding from said distal end of said elongate shaft and having an end effector at a distal end;

wherein a distal portion of said first end effector assembly extends laterally outward at an angle from a first longitudinal axis of said elongate shaft to a position where at least a portion of said corresponding end effector is spaced laterally outward of said peripheral edge of said elongate shaft; and

wherein said first end effector assembly is rotatable about said first longitudinal axis of said elongate shaft to cause said corresponding end effector to move along a first arcuate path having a center of curvature coaxial with said first longitudinal axis.

2. A surgical instrument as recited in claim 1 wherein said end effector of said first end effector assembly is movable between an undeployed position where said end effector is spaced laterally inward of said peripheral edge of said elongate shaft and a deployed position where at least a portion of said end effector is disposed laterally outward of said peripheral edge.

3. A surgical instrument as recited in claim 2 wherein said first end effector assembly includes an elongate proximal portion extending at least partly through said shaft in coaxial alignment with said first longitudinal axis.

4. A surgical instrument as recited in claim 3 wherein said first end effector assembly is longitudinally movable relative to said elongate shaft between an axially extended position where said distal portion of said first end effector assembly bends outwardly in a lateral direction relative to said first longitudinal axis and an axially retracted position where said distal portion of said first end effector assembly is drawn laterally inward toward said first longitudinal axis.

5. A surgical instrument as recited in claim 4 wherein said end effector of said first end effector assembly is proximally spaced from said distal end of said shaft in said retracted position.

6. A surgical instrument as recited in claim 1 wherein said second end effector assembly extends laterally outward at an angle from a second longitudinal axis of said elongate shaft to a position where at least a portion of said corresponding end effector is spaced laterally outward of said peripheral edge of said elongate shaft.

7. A surgical instrument as recited in claim 6 wherein said second end effector assembly is rotatable about said second longitudinal axis of said elongate shaft to cause said corresponding end effector to move along a second arcuate path having a center of curvature coaxial with said second longitudinal axis.

8. A surgical instrument as recited in claim 6 wherein said end effector of said second end effector assembly is movable between an undeployed position where said end effector is spaced laterally inward of said peripheral edge of said elongate shaft and a deployed position where at least a portion of said end effector is disposed laterally outward of said peripheral edge.

9. A surgical instrument as recited in claim 8 wherein said second end effector assembly includes an elongate proximal portion extending at least partly through said shaft in coaxial alignment with said second longitudinal axis.

10. A surgical instrument as recited in claim 9 wherein said second end effector assembly is longitudinally movable relative to said elongate shaft between an axially extended position where said distal portion of said second end effector assembly bends outwardly in a lateral direction relative to said second axis of rotation and an axially retracted position where said distal portion of said second end effector assembly is drawn inwardly toward said second axis of rotation.

11. A surgical instrument as recited in claim 10 wherein said end effector of said second end effector assembly is proximally spaced from said distal end of said shaft in said retracted position.

12. A surgical instrument as recited in claim 1 and further comprising an operating channel defined through said elongate shaft to provide access to the operative site from outside the body.

13. A surgical instrument as recited in claim 1 and further comprising a plurality of operating channels defined through said elongate shaft in laterally spaced relation to provide access to the operative site from outside the body.

14. A surgical instrument as recited in claim 12 wherein said operating channel extends through said housing to define a longitudinal channel along the length of said instrument, and further comprising a coupling at a proximal end of said channel.

15. A surgical instrument as recited in claim 12 wherein said operating channel extends through said housing to define a longitudinal channel along the length of said instrument, and further comprising a valve disposed along said longitudinal channel to control passage of fluids and instruments therethrough.

16. A surgical instrument as recited in claim 1 wherein an operating channel is defined through one of said end effector assemblies to provide access to the operative site from outside the body.

17. A surgical instrument as recited in claim 16 wherein said end effector assembly having an operating channel defined therethrough includes an elongate proximal portion extending through said elongate shaft and wherein said operating channel terminates distally at an opening adjacent the junction between said proximal and distal portions of said end effector assembly.

31. A surgical instrument as recited in claim 1, further comprising an operating mechanism coupled to said first arm and said second arm for creating synchronized movement of said end effectors and a push button for actuating said ope rating mechanism.

33. A surgical instrument as recited in claim 1, wherein said end effector of said first arm is movable between an undeployed position where said end effector is spaced laterally inward of said peripheral edge of said elongate shaft and a deployed position where at least a portion of said end effector of said first arm is disposed laterally outward of said peripheral edge.

34. A surgical instrument as recited in claim 2, wherein said first arm is coupled to an elongate proximal member extending at least partly through said shaft in coaxial alignment with said first longitudinal axis.

35. A surgical instrument as recited in claim 3, wherein said first arm is longitudinally movable relative to said elongate shaft between an axially extended position where said first arm extends outwardly in a lateral direction relative to said first longitudinal axis and an axially retracted position where said first arm is moved laterally inward toward said first longitudinal axis.

36. A surgical instrument as recited in claim 4, wherein said end effector of said first arm is proximally spaced from said distal end of said shaft in said retracted position.

37. A surgical instrument as recited in claim 1, wherein said second arm extends laterally outward at an angle from a second longitudinal axis within said elongate shaft to a position where at least a portion of said end effector of said second arm is spaced laterally outward of said peripheral edge of said elongate shaft.

38. A surgical instrument as recited in claim 6, wherein said second arm is rotatable about said second longitudinal axis to cause said end effector of said second arm to move along a second arcuate path having a center of curvature coaxial with said second longitudinal axis.

39. A surgical instrument as recited in claim 6, wherein said end effector of said second arm is movable between an undeployed position where said end effector is spaced laterally inward of said peripheral edge of said elongate shaft and a deployed position where at least a portion of said end effector is disposed laterally outward of said peripheral edge.

40. A surgical instrument as recited in claim 8, wherein said second arm is coupled to an elongate proximal member extending at least partly through said shaft in coaxial alignment with said second longitudinal axis.

41. A surgical instrument as recited in claim 9, wherein said second arm is longitudinally movable relative to said elongate shaft between an axially extended position where said distal portion of said second arm extends outwardly in a lateral direction relative to said second longitudinal axis and an axially retracted position where said distal portion of said second end effector assembly is moved inwardly toward said second longitudinal axis.

42. A surgical instrument as recited in claim 10, wherein said end effector of said second arm is proximally spaced from said distal end of said shaft in said retracted position.

43. A surgical instrument as recited in claim 1 and further comprising an operating channel defined through said elongate shaft to provide access to an operative site in a patients'"'"' body into which the distal end of the elongate shaft is inserted.

44. A surgical instrument as recited in claim 1 and further comprising a plurality of operating channels defined through said elongate shaft in laterally spaced relation to provide access to an operative site in a patients'"'"' body into which the distal end of the elongate shaft is inserted.

45. A surgical instrument as recited in claim 12 further comprising a coupling at a proximal end of said operating channel.

46. A surgical instrument as recited in claim 12 and further comprising a valve disposed along said operating channel to control passage of fluids and instruments therethrough.

47. A surgical instrument as recited in claim 1, wherein an operating channel is defined through one of said arms to provide access to an operative in a patients'"'"' body into which the distal end of the elongate shaft is inserted.

48. A surgical instrument as recited in claim 16, wherein said arm having an operating channel defined therethrough is coupled to an elongate proximal member extending through said elongate shaft and wherein said operating channel terminates distally at an opening adjacent the junction between said arm and said proximal member.

18. A surgical instrument for use in open and endoscopic procedures comprising

a housing;

an elongate shaft having a proximal end mounted by said housing and a distal end with a peripheral edge;

a first end effector assembly having a proximal portion extending at least part way through said elongate shaft along a first longitudinal axis, a distal portion extending laterally outward from said proximal portion at an angle, and a end effector mounted on said distal portion, said proximal portion of said first end effector assembly being rotatably mounted within said elongate shaft to move said end effector of said first end effector assembly along a first arcuate path having a center of curvature coaxial with said first longitudinal axis; and

a second end effector assembly having a proximal portion extending at least part way through said elongate shaft along a second longitudinal axis laterally spaced from said first longitudinal axis, a distal portion extending laterally outward from said proximal portion at an angle, and a end effector mounted on said distal portion, said proximal portion of said second end effector assembly being rotatably mounted within said elongate shaft to move said end effector of said second end effector assembly along a second arcuate path having a center of curvature coaxial with said second longitudinal axis;

wherein said first arcuate path has a radius of curvature causing at least a portion of said end effector of said first end effector assembly to extend outwardly of said peripheral edge of said elongate shaft.

19. A surgical instrument as recited in claim 18 wherein said second arcuate path has a radius of curvature causing at least a portion of said end effector of said second end effector assembly to extend outwardly of said peripheral edge of said elongate shaft.

20. A surgical instrument as recited in claim 18 wherein said respective end effectors of said first and second end effector assemblies are movable between undeployed positions where said end effectors are spaced laterally inward of said peripheral edge of said elongate shaft and deployed positions where at least a portion of each of said end effectors is disposed laterally outward of said peripheral edge.

21. A surgical instrument as recited in claim 18 wherein said first and second end effector assemblies are longitudinally movable relative to said elongate shaft between respective axially extended positions where respective distal portions of said first and second end effector assemblies bend outwardly in a lateral direction relative to said first and second longitudinal axes, respectively, and respective axially retracted positions where said distal portions are drawn inwardly toward said first and second longitudinal axes, respectively.

22. A surgical instrument as recited in claim 21 wherein said end effectors of said first and second end effector assemblies are proximally spaced from said distal end of said elongate shaft in said respective retracted positions.

50. A surgical instrument as recited in claim 18, wherein said first and second end effector assemblies are longitudinally movable relative to said elongate shaft between respective axially extended positions where respective distal arm portions of said first and second end effector assemblies bend outwardly in a lateral direction relative to said first and second longitudinal axes, respectively, and respective axially retracted positions where said distal arm portions are drawn inwardly toward said first and second longitudinal axes, respectively.

23. A method of performing a surgical procedure in an anatomical cavity comprising the steps of

introducing a surgical instrument having an elongate shaft into the anatomical cavity, the surgical instrument including first and second end effector assemblies protruding distally from the distal end of the elongate shaft, the first end effector assembly including a distal portion extending laterally outward at an angle from a first longitudinal axis of the elongate shaft to an end effector disposed at least partly outside a peripheral edge of the elongate shaft;

and

operating on tissue within the anatomical cavity by rotating the first end effector assembly about the first longitudinal axis.

24. A method of performing a surgical procedure as recited in claim 23 and further comprising, prior to said operating step, the step of

moving the first end effector assembly laterally outward from an undeployed position spaced laterally inward of the peripheral edge of the elongate shaft to a deployed position spaced laterally outward of the peripheral edge of the elongate shaft.

25. A method of performing a surgical procedure as recited in claim 23 and further comprising, prior to said operating step, the step of

moving the first end effector assembly distally relative to the elongate shaft from an axially retracted position within the elongate shaft to an axially extended position protruding from the distal end of the elongate shaft.

26. A method of performing a surgical procedure as recited in claim 23 wherein the second end effector assembly includes a distal portion extending laterally outward at an angle from a second longitudinal axis of the elongate shaft to an end effector disposed at least partly outside a peripheral edge of the elongate shaft and further comprising the step of operating on the tissue by rotating the second end effector assembly about the second longitudinal axis of the elongate shaft.

27. A method of performing a surgical procedure as recited in claim 23 and further comprising the step of operating on the tissue by moving the second end effector assembly axially relative to the first end effector assembly.

28. A method of performing a surgical procedure as recited in claim 23 and further comprising the step of operating on the tissue by moving the first end effector assembly axially relative to the second end effector assembly.

29. A method of performing a surgical procedure as recited in claim 23 and further comprising the step of operating on the tissue by rotating the shaft.

30. A method of performing a surgical procedure as recited in claim 26 wherein said steps of operating on the tissue are conducted simultaneously.

52. A method of performing a surgical procedure as recited in claim 23 and further comprising, prior to said operating step, the step of:

moving the first arm laterally outward from an undeployed position spaced laterally inward of the peripheral edge of the elongate shaft to a deployed position spaced laterally outward of the peripheral edge of the elongate shaft.

53. A method of performing a surgical procedure as recited in claim 23 and further comprising, prior to said operating step, the step of:

moving the first arm distally relative to the elongate shaft from an axially retracted position within the elongate shaft to an axially extended position protruding from the distal end of the elongate shaft.

54. A method of performing a surgical procedure as recited in claim 23, wherein the second arm extends laterally outward at an angle from a second longitudinal axis within the elongate shaft and has an end effector disposed thereon at least partly outside a peripheral edge of the elongate shaft and further comprising the step of operating on the tissue by rotating the second arm about the second longitudinal axis of the elongate shaft.

55. A method of performing a surgical procedure as recited in claim 23 and further comprising the step of operating on the tissue by moving the second arm axially relative to the elongate shaft.

56. A method of performing a surgical procedure as recited in claim 23 and further comprising the step of operating on the tissue by moving the first arm axially relative to the elongate shaft.

32. A surgical instrument for use in open and endoscopic procedures, comprising:

an elongate shaft having a proximal end and a distal end with a peripheral edge;

a handle coupled to said proximal end of said shaft;

a first arm protruding from said distal end of said elongate shaft and having an end effector at a distal end; and

a second arm protruding from said distal end of said elongate shaft and having an end effector at a distal end;

wherein said first arm extends laterally outward at an angle from a first longitudinal axis within said elongate shaft to a position where at least a portion of said end effector of said first arm is spaced laterally outward of said peripheral edge of said elongate shaft; and

wherein said first arm is rotatable about said first longitudinal axis to cause said end effector of said first arm to move along a first arcuate path having a center of curvature coaxial with said first longitudinal axis.

49. A surgical instrument for use in open and endoscopic procedures, comprising:

an elongate shaft having a proximal end and a distal end with a peripheral edge;

a handle coupled to said proximal end of said shaft;

a first end effector assembly having a proximal portion extending at least part way through said elongate shaft along a first longitudinal axis, a distal arm portion extending laterally outward from said proximal portion at an angle, and a end effector mounted on said distal arm portion, said proximal portion of said first end effector assembly being rotatably mounted within said elongate shaft to move said end effector of said first end effector assembly along a first arcuate path having a center of curvature coaxial with said first longitudinal axis;

a second end effector assembly having a proximal portion extending at least part way through said elongate shaft along a second longitudinal axis laterally spaced from said first longitudinal axis, a distal arm portion extending laterally outward from said proximal portion at an angle, and an end effector mounted on said distal arm portion, said proximal portion of said second end effector assembly being rotatably mounted within said elongate shaft to move said end effector of said second end effector assembly along a second arcuate path having a center of curvature coaxial with said second longitudinal axis; and

wherein said first arcuate path has a radius of curvature causing at least a portion of said end effector of said first end effector assembly to extend outwardly of said peripheral edge of said elongate shaft.

51. A method of performing a surgical procedure in an anatomical cavity, comprising the steps of:

introducing a surgical instrument having an elongate shaft into the anatomical cavity, the surgical instrument including first and second arms protruding distally from the distal end of the elongate shaft, the first arm extending laterally outward at an angle from a first longitudinal axis within the elongate shaft and having an end effector thereon disposed at least partly outside a peripheral edge of the elongate shaft; and

operating on tissue within the anatomical cavity by rotating the first arm about the first longitudinal axis.