Methods and apparatus for on-endoscope instruments having end effectors and combinations of on-endoscope and through-endoscope instruments

• US 6,808,491 B2
• Filed: 05/20/2002
• Issued: 10/26/2004
• Est. Priority Date: 05/21/2001
• Status: Expired due to Fees

• Current Assignee: Is LLC
• Original Assignee: Syntheon LLC
• Inventors: Kortenbach, Juergen A., McBrayer, Michael Sean
• Primary Examiner(s): Leubecker, John P.
• Application Number:
  US10/151,503
• Publication Number:
  US 20020173786A1
• Time in Patent Office: 890 Days
• Field of Search: 600/104, 600/106, 600/153, 600/105, 600/127, 606/139, 606/205, 606/51, 606/142
• US Class Current: 600/104
• CPC Class Codes: A61B 10/06 Biopsy forceps , e.g. with cup-shaped jaws
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/0218 for minimally invasive surgery A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/1227 Spring clips
• CPC Class Codes: A61B 17/1285 for minimally invasive surgery
• 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 2017/00292 mounted on or guided by flexible, e.g. catheter-like, means
• CPC Class Codes: A61B 2017/00296 mounted on an endoscope
• CPC Class Codes: A61B 2017/00464 for use with different instruments with hole for different instruments A61B2017/22072
• CPC Class Codes: A61B 2017/2936 Pins in guiding slots
• CPC Class Codes: A61B 2017/2945 Curved jaws
• CPC Class Codes: A61B 2017/320064 with tissue or sample retaining means
• CPC Class Codes: A61B 2018/00494 Stomach, intestines or bowel
• CPC Class Codes: A61B 2018/00607 Coagulation and cutting with the same instrument
• CPC Class Codes: A61B 2018/00982 combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes
• CPC Class Codes: A61B 2018/1432 curved
• CPC Class Codes: A61B 2018/1495 Electrodes being detachable from a support structure
• CPC Class Codes: A61B 2090/306 using optical fibres
• CPC Class Codes: A61B 2090/3614 using optical fibre

Abstract

A surgical system includes an endoscope, a pair of end effectors provided on the outside of the distal end of a endoscope (“on-scope”), in which one end effector is rotatable or otherwise movable relative to the second end effector and in which such movement is effected via controls elements which do not extend through a lumen of the endoscope, and another instrument extending through the lumen of the endoscope (“through-scope”), and which preferably also has a pair of end effectors. The on-scope device may be clamping jaws, needle passers, clip appliers, cautery devices, staplers, and releasable hemoclips, among other end devices. The through-scope end effectors may be graspers and clip appliers, among other end effectors.

Claims

1. A surgical system for performing surgery on tissue, comprising:

a) an endoscope having a lumen and a distal end;

b) a surgical tool coupled to said distal end of said endoscope in a longitudinally fixed manner, said surgical tool including,

i) a first end effector, and

ii) actuation means for actuating said first end effector; and

c) an instrument extendable through said lumen of said endoscope, wherein said instrument includes a second end effector axially extendable through and beyond said first end effector and adapted to axially pull the tissue between said first end effector for manipulation of the tissue by said first end effector.

2. A surgical system according to claim 1, wherein:

said actuation means actuates said first end effector without passing through the lumen of the endoscope.

3. A surgical system according to claim 1, wherein:

said second end effector includes two effecting elements, at least one of which is movable relative to the other.

4. A surgical system according to claim 1, wherein:

said instrument includes one of a forceps, a biopsy forceps, a snare, and a suction device.

5. A surgical system according to claim 1, wherein:

said surgical tool is coupled externally about said distal end of said endoscope.

6. A surgical system according to claim 5, wherein:

said surgical tool is coupled to said distal end of said endoscope with a collar.

7. A surgical system according to claim 1, wherein:

said first end effector includes two effecting elements, at least one of which is movable relative to the other.

8. A surgical system according to claim 7, wherein:

said two end effecting elements of said first end effector are each movable relative to the other.

9. A surgical system according to claim 7, wherein:

at least one of said effecting elements is movable in a non-longitudinal direction relative to the other.

10. A method of performing a surgical procedure, comprising:

a) providing an endoscope having a lumen, a longitudinal axis, a distal end, and a surgical tool coupled to said distal end, said surgical tool including a first end effector including two effecting elements, at least one of which is movable relative to the other;

b) opening said two effecting elements of said first end effector to provide a passage therebetween, said passage being parallel to said longitudinal axis;

c) extending an endoscopic instrument having a second end effector through said lumen until said second end effector extends through said passage between said effecting elements;

d) grasping a body tissue with said endoscopic instrument;

e) pulling said body tissue axially between said effecting elements of said first end effector of said surgical tool; and

f) manipulating the body tissue with said effecting elements of said first end effector of said surgical tool.

11. A method according to claim 10, wherein:

said surgical tool includes a control element extending from a proximal portion of said endoscope to said end effector of said surgical tool, and said control element does not pass through said lumen of said endoscope, said control element actuated by said operating said effecting elements of said first end effector of said surgical tool.

12. A method according to claim 10, wherein:

said surgical tool further includes a tubular member about said control member, said tubular member being coupled to said endoscope at a distal end of said endoscope and being detached from said endoscope along a portion proximal to said distal end of said endoscope.

13. A method according to claim 10, wherein:

said manipulating of said tissue includes at least one of clamping, cutting, cauterizing, stapling, clipping, and hemostasis application.

14. A method according to claim 10, wherein:

said opening said first end effector includes rotating at least one effecting element relative to the other end effector.

15. A method according to claim 10, wherein:

said opening said first end effector includes moving at least one effecting element in a non-longitudinal direction relative to the other end effector.