Surgical instrument

• US 7,708,758 B2
• Filed: 11/28/2006
• Issued: 05/04/2010
• Est. Priority Date: 08/16/2006
• Status: Active Grant

• Current Assignee: Endobotics, LLC
• Original Assignee: Cambridge Endoscopic Devices Inc.
• Inventors: Chamorro, Andres, Ross, Richard, Lee, Woojin
• Primary Examiner(s): Manahan; Todd E
• Assistant Examiner(s): BLATT, ERIC D
• Application Number:
  US11/605,694
• Publication Number:
  US 20080046000A1
• Time in Patent Office: 1,253 Days
• Field of Search: 403/90, 606139-149, 606205-209
• US Class Current: 606/205
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/2905 flexible
• CPC Class Codes: A61B 2017/291 the position of the handle being adjustable with respect to the shaft
• CPC Class Codes: A61B 2017/292 connection of actuating rod to handle, e.g. ball end in recess

Abstract

The surgical instrument includes a distal tool, an elongated shaft that supports the distal tool, and a proximal handle or control member, where the tool and the handle are coupled to the respective distal and proximal ends of the elongated shaft via distal and proximal bendable motion members. Actuation means extends between said distal and proximal members whereby any deflection of said control handle with respect to said elongated instrument shaft causes a corresponding bending of said distal motion member for control of said working member. The proximal bendable member comprises a ball and socket assembly supported between the handle and instrument shaft and constructed and arranged for three dimensional motion.

Claims

1. A medical instrument comprising:

a proximal control handle;

a distal work member;

a proximal movable member controlled from said proximal control handle;

a distal movable member controlled from said proximal movable member to provide controlled movement of said distal work member via said proximal and distal movable members;

an instrument shaft that intercouples said proximal and distal movable members;

and actuation means coupled between said movable members;

a ball and socket assembly that includes a ball member pivotally retained by a socket defined in said proximal control handle and constructed and arranged for three dimensional motion relative to the socket;

said proximal movable member controlled by the ball member for three dimensional motion therewith;

said movable members both comprising bendable members and further including a rotation knob coupled to at least one of the proximal bendable member and the instrument shaft;

said rotation knob controlling the rotation of the proximal bendable member and, in turn, the instrument shaft, distal bendable member and distal work member;

wherein the internal cavity of the ball member comprises a conical cavity that provides a conical space in which the proximal bendable member is pivotable to enable the three dimensional motion.

2. The medical instrument of claim 1 further including a locking member supported from said proximal control handle and having locked and unlocked states;

said locking member in said unlocked state enabling control of said distal work member from said proximal bendable member; and

said locking member, in said locked state, holding said bendable members in a desired fixed position.

3. The medical instrument of claim 2 wherein said locking member, in the locked state, fixes the position of the proximal bendable member by locking the ball member in the socket.

4. The medical instrument of claim 1 wherein both said distal and proximal bendable members comprise a uni-body structure forming respective distal and proximal bendable members.

5. The medical instrument of claim 1 including first bearing means for rotatably supporting a proximal end of the proximal bendable member relative to the ball member.

6. The medical instrument of claim 5 including second bearing means for rotatably supporting the instrument shaft relative to the proximal control handle.

7. The medical instrument of claim 5 wherein said rotation knob is secured to the proximal bendable member with the first bearing means disposed therebetween.

8. The medical instrument of claim 6 wherein said rotation knob is secured to said instrument shaft distally of the second bearing means.

9. The medical instrument of claim 1 wherein a said proximal bendable member has a distal end connected to the instrument shaft and a proximal end rotatably and pivotally supported by the ball member.

10. The medical instrument of claim 9 including an actuation lever for controlling the distal work member mounted at the proximal control handle and an actuation cable controlled from the actuation lever and extending through at least the instrument shaft and bendable members.

11. The medical instrument of claim 10 including a bell crank mechanism that couples between the actuation lever and the actuation cable, responsive to operation of the actuation lever to control the actuation cable.

12. The medical instrument of claim 1 including a locking member and wherein the rotation knob and proximal bendable member are rotatably supported in the proximal control handle to enable rotation even when the instrument position is locked.

13. The medical instrument of claim 1 wherein said actuation means comprises a set of cables that couple between said bendable members, said cables terminate at one end at the proximal end of the proximal bendable member.

14. The medical instrument of claim 1 wherein said handle comprises a pistol grip handle that includes a base and a top section in which is defined the socket, said socket being a spherical socket that supports the ball member, said ball member supporting the proximal end of the proximal bendable member.

15. The medical instrument of claim 1 wherein said rotation knob is controlled for rotating the proximal bendable member and, in turn, the instrument shaft, distal bendable member and distal work member and for controlling the pivoting of the ball member in the socket.

16. A medical instrument having a proximal control handle and a distal tool that are intercoupled by an elongated instrument shaft that is meant to pass internally of an anatomic body, proximal and distal bendable members that respectively intercouple said proximal control handle and said distal tool with said instrument shaft, cable actuation means extending through the proximal and distal bendable members for coupling motion of the proximal bendable member to the distal bendable member, and a pivot ball, said control handle comprising a base and a top section that defines an at least partially spherical socket that supports the pivot ball for three dimensional pivoting therein, said proximal bendable member constructed and arranged for mounting in the pivot ball, said pivot ball being supported relative to the socket for three dimensional pivoting in the socket.

17. The medical instrument of claim 16 including a control element connected to the pivot ball for manipulating the pivot ball in the socket.

18. The medical instrument of claim 17 wherein the control element comprises a rotation knob supported in line with said proximal bendable member for controlling the three dimensional pivoting.

19. The medical instrument of claim 18 wherein said rotation knob controls the three dimensional pivoting, as well as a rotation relative to the pivot ball about a longitudinal axis of said proximal bendable member so as to control the rotation of said distal tool about a distal tool axis.

20. The medical instrument of claim 17 further including bearing means for rotatably supporting the control element in the pivot ball, a proximal end of said proximal bendable member rotatably supported in a cavity of the pivot ball.

21. The medical instrument of claim 20 wherein said bearing means has the control element connected thereto and the proximal end of the proximal bendable member is supported opposite to the control element from the bearing means.

22. The medical instrument of claim 17 including a locking means that is manually operable by a user and that locks the ball in the socket.

23. In a medical instrument having a proximal control handle and a distal tool that are intercoupled by an elongated instrument shaft that is meant to pass internally of an anatomic body, proximal and distal bendable members that respectively intercouple said proximal control handle and said distal tool with said instrument shaft, and cable actuation means extending through the proximal and distal bendable members for coupling motion of the proximal bendable member to the distal bendable member, a method of controlling the tool from the handle by means of a control element comprising;

pivoting the control element in three dimensions to control the positioning of the tool in three dimensions, rotating the control element to control the rotational orientation of the tool by rotating the instrument shaft and mounting the proximal bendable member at least partially in a ball that is supported for three dimensional pivoting by means of the control element in a socket in the control handle.

24. The method of claim 23 including having the control element, not only pivot the ball in the socket, but also rotate the ball and, in turn, the instrument shaft, distal bendable member and distal tool about a longitudinal distal tool axis.

25. The method of claim 23 including constructing the control element as a single control knob that is attached to the ball.

26. The method of claim 23 including connecting the control element to the instrument shaft for rotating the instrument shaft and, in turn, the distal bendable member and tool.

27. The method of claim 25 including connecting the control element to the proximal bendable member for rotating the instrument shaft and, in turn, the distal bendable member and tool.

28. The method of claim 25 wherein the step of pivoting the control element in three dimensions includes pivoting a proximal end of the proximal bendable member in three dimensions.

29. The method of claim 28 including mounting a proximal end of the proximal bendable member in the ball so that the control element pivots the ball in the socket to bend the proximal bendable member while enabling a rotation of the proximal bendable member relative to the ball to, in turn, rotate the instrument shaft about a longitudinal axis thereof.

30. The method of claim 26 including using the control element as a rotation knob with the dual purpose of being able to firstly rotate the rotation knob to, in turn, rotate the instrument shaft and tool and to secondly pivot the rotation knob to enable the three dimensional positioning.

31. The method of claim 26 including using the control element as a rotation knob attached to the instrument shaft for the purpose of rotating the instrument shaft and, in turn, the distal bendable member and tool.

32. The method of claim 24 wherein the step of rotating the control element includes rotating the instrument shaft relative to the control handle to, in turn, rotate the distal bendable member to, in turn, rotate the tool about the longitudinal distal tool axis [P].

33. The method of claim 23 including locking the ball to the socket.

34. In a medical instrument having a proximal control handle and a distal tool that are intercoupled by an elongated instrument shaft that is meant to pass internally of an anatomic body, proximal and distal bendable members that respectively intercouple said proximal control handle and said distal tool with said instrument shaft, and cable actuation means extending through the proximal and distal bendable members for coupling motion of the proximal bendable member to the distal bendable member, a method of controlling the tool from the handle by means of a control element comprising;

pivoting the control element in three dimensions to control the positioning of the tool in three dimensions, rotating the control element to control the rotational orientation of the tool by rotating the instrument shaft, constructing the control element as a single control knob, wherein the step of pivoting the control element in three dimensions includes pivoting a proximal end of the proximal bendable member in three dimensions, mounting the proximal end of the proximal bendable member in a rotation ball that is supported for three dimensional pivoting in a socket in the control handle and rotatably supporting the proximal bendable member in the ball.

35. The method of claim 34 including rotatably supporting the instrument shaft in the control handle.

36. A surgical instrument comprising:

an elongated instrument shaft having proximal and distal ends;

a tool disposed from the distal end of the instrument shaft;

a control handle disposed at the proximal end of the instrument shaft;

a distal bendable member for coupling the distal end of the elongated instrument shaft to the tool and including proximal and distal ends;

a proximal bendable member for coupling the proximal end of the elongated instrument shaft with the handle and including proximal and distal ends;

and actuation means extending between said distal and proximal bendable members so that any bending of the proximal bendable member causes a corresponding bending of the distal bendable member for controlling the positioning of the tool;

said control handle including first means for rotatably supporting the instrument shaft relative to the control handle and second means for pivotally supporting the proximal end of the proximal bendable member relative to the control handle and in three dimensions;

said second means comprising a ball member mounted in an at least partially spherical socket defined in the control handle;

said ball member defining a conical cavity that provides a conical space in which the proximal bendable member is pivotable to enable the three dimensional motion.

37. The surgical instrument of claim 36 wherein at least one of said bendable members comprise a single unitary slotted structure that is readily capable of bending in any direction and wherein said slotted structure is comprised of a plurality of separately disposed noncontiguous slots.

38. The surgical instrument of claim 36 wherein the first means comprises first bearing means supported at a flange of the control handle and rotatably engaging the instrument shaft.

39. The surgical instrument of claim 38 wherein the second means comprises second bearing means for rotatably supporting the proximal bendable member in the ball member.

40. The surgical instrument of claim 39 including a control element connected to the second bearing means and for controlling the pivoting of the ball member in the socket.

41. The surgical instrument of claim 40 wherein the proximal end of the proximal bendable member is supported at the second bearing means so as to be rotatably with both the second bearing means and control element.

42. The surgical instrument of claim 41 including an actuator cable at the control handle and a tool actuation assembly at the second bearing means for controlling the actuator cable.

43. The surgical instrument of claim 36 wherein a proximal end of the proximal bendable member is supported in the ball member with the distal end of the proximal bendable member extending into the conical cavity.

44. The surgical instrument of claim 43 including a rotation knob rotatably attached to the ball member to control the positioning of the ball member and, in turn, the proximal bendable member.

45. The surgical instrument of claim 43 including a rotation knob attached to the instrument shaft for enabling rotation thereof.

46. The surgical instrument of claim 36 including rotation means adjacent the control handle for rotating the instrument shaft.

47. The surgical instrument of claim 46 wherein the rotation means comprises a rotation knob with the dual purpose of being able to firstly rotate the rotation knob to, in turn, rotate the instrument shaft and tool and to secondly pivot the rotation knob in three dimensions to enable the three dimensional positioning of the tool.

48. The surgical instrument of claim 36 including an actuation lever for controlling the tool mounted at the control handle and an actuation cable controlled from the actuation lever and extending through at least the instrument shaft and bendable members.

49. The surgical instrument of claim 48 including a bell crank mechanism that couples between the actuation lever and the actuation cable, responsive to operation of the actuation lever to control the actuation cable and, in turn, the tool.

50. The surgical instrument of claim 36 including a lock means for fixing the position of the proximal bendable member relative to the control handle.

51. The surgical instrument of claim 50 including a bearing means for supporting the proximal bendable member in the socket in the control handle.

52. The surgical instrument of claim 51 wherein the lock means comprises a locking lever mounted in the control handle and for selective engagement with the ball member.

53. A surgical instrument comprising:

a control handle;

an instrument shaft that extends from the control handle;

a tool disposed from the distal end of the instrument shaft and controlled from the handle as to actuation and positioning thereof;

said control handle having a first section for supporting an actuation element for controlling the actuation of the tool, and a second section for supporting a positioning element for controlling the positioning of the tool;

a distal bendable member for coupling the distal end of the instrument shaft to the tool;

a proximal bendable member for coupling the proximal end of the instrument shaft to the control handle;

cable actuation means extending through the proximal and distal bendable members for coupling motion of the proximal bendable member to the distal bendable members;

said actuation element including actuation means extending at least between the distal and proximal bendable members for controlling the actuation of the tool;

said positioning element including a manually manipulated control element that is both pivotal in three dimensions to control the positioning of the tool in three dimensions and rotatable to control the rotational orientation of the tool by rotating the instrument shaft;

and means for mounting a proximal end of the proximal bendable member in a rotation ball that is supported for three dimensional pivoting in a socket in the control handle.

54. The surgical instrument of claim 53 wherein said means for mounting includes bearing means.

55. The surgical instrument of claim 53 wherein the positioning element comprises a first control knob extending from the control handle and capable of both rotation about an axis and pivoting relative to the control handle in three dimensions.

56. The surgical instrument of claim 55 including a second control knob and means for connecting the second control knob to the instrument shaft for rotating the instrument shaft and, in turn, the tool.

57. The surgical instrument of claim 53 including means for locking the ball to the socket to hold the position of the tool.

58. The surgical instrument of claim 53 including means for rotatably supporting the proximal bendable member in the ball.

59. The surgical instrument of claim 58 including bearing means for rotatably supporting the instrument shaft in the control handle.

60. The surgical instrument of claim 53 wherein the positioning element comprises a single control knob extending from the control handle and further using the rotation knob with the dual purpose of being able to firstly rotate the rotation knob to, in turn, rotate the instrument shaft and tool and to secondly pivot the rotation knob to enable the three dimensional positioning.

65. The surgical instrument of claim 60 including a control element extending from the handle and attached to the pivot element for controlling the positioning of the pivot element in three dimensions.

66. The surgical instrument of claim 65 wherein the pivot element comprises a ball and the control element comprises a control knob.

67. The surgical instrument of claim 66 including an actuating lever mounted on the handle for controlling the actuation of the tool, a tool actuation cable and a transfer mechanism mounted between the control knob and the proximal end of the proximal bendable member controlled from the transfer mechanism for actuating the tool actuation cable.

68. The surgical instrument of claim 67 wherein the transfer mechanism comprises a pivot crank and a transfer disc, the actuation lever controlling the pivot crank and the transfer disc controlling the tool actuation cable.

61. A surgical instrument comprising:

a control handle;

an instrument shaft that extends from the control handle;

a tool disposed from the distal end of the instrument shaft and controlled from the handle as to actuation and positioning thereof;

a distal bendable member for coupling the distal end of the instrument shaft to the tool;

a proximal bendable member for coupling the proximal end of the instrument shaft to the control handle;

cable actuation means extending between the distal and proximal bendable members for coupling motion of the proximal bendable member to the distal bendable member for controlling the positioning of the tool;

and a pivot element mounted by the handle;

a proximal end of the proximal bendable member being mounted to the pivot element for movement therewith;

wherein the pivot element comprises a ball member arranged in an at least partial spherical shaped socket in the handle and capable of three dimensional pivoting therein;

and wherein the socket defines a conical cavity in which the proximal bendable member is pivotable to enable the three dimensional motion.

62. The surgical instrument of claim 61 wherein said control handle has a first section for supporting an actuation element for controlling the actuation of the tool, and a second section for supporting the pivot element used for controlling the positioning of the tool.

63. The surgical instrument of claim 62 wherein the actuation element comprises an actuation lever, a handle control cable controlled from the actuation lever, a pivot mechanism controlled by the handle control cable and a tool actuation cable controlled by the pivot mechanism to control the actuation of the tool.

64. The surgical instrument of claim 63 wherein the pivot mechanism includes a bell crank mechanism and a transfer disc assembly controlled from the bell crank mechanism and for retaining a proximal end of the tool actuation cable.

69. The surgical instrument of claim 61 wherein at least one of said bendable members comprise a single unitary slotted structure that is readily capable of bending in any direction and wherein said slotted structure is comprised of a plurality of separately disposed non-contiguous slots.

70. The surgical instrument of claim 61 wherein the pivot element comprises a ball member that has an outer at least partially spherical shaped surface arranged in a spherical shaped socket in the handle and capable of three dimensional pivoting therein.

71. The surgical instrument of claim 70 wherein the socket defines a conical cavity in which the proximal bendable member is pivotable to enable the three dimensional motion.

72. The surgical instrument of claim 71 wherein the proximal end of the proximal bendable member is fixedly supported in the ball member with the distal end of the proximal bendable member extending into the conical cavity and bendable by pivoting of the ball member in the socket.

73. The surgical instrument of claim 72 including a rotation knob rotatably attached to the ball member to control the positioning of the ball member and, in turn, the proximal bendable member.

74. The surgical instrument of claim 72 including a rotation knob attached to the instrument shaft for enabling rotation thereof.

75. The surgical instrument of claim 61 including rotation means adjacent the control handle for rotating the instrument shaft.

76. The surgical instrument of claim 75 wherein the rotation means comprises a rotation knob with the dual purpose of being able to first rotate the rotation knob to, in turn, rotate the instrument shaft and tool and to second pivot the rotation knob in three dimensions to enable the three dimensional positioning of the tool.

77. The surgical instrument of claim 61 including a lock mechanism for fixing the position of the proximal bendable member relative to the control handle.

78. The surgical instrument of claim 77 wherein the lock mechanism comprises a locking lever mounted on the control handle and for selective engagement with the ball member.

79. In a medical instrument having a proximal control handle and a distal tool that are intercoupled by an elongated instrument shaft that is meant to pass internally of an anatomic body, proximal and distal movable members that respectively intercouple said proximal control handle and said distal tool with said instrument shaft, and cable actuation means extending through the proximal and distal bendable members for coupling motion of the proximal bendable member to the distal bendable member, a method of controlling the position of the tool from the handle comprising;

rotating a first control member to control the rotational position of the tool, actuating a second control member for locking the position of the tool at a fixed position, constructing the movable members as bendable members, supporting the proximal bendable member in a support member that is disposed within the handle and supporting the second control member between the support member and handle so as to selectively lock the position of the tool.

80. The method of claim 79 including pivoting the first control member in three dimensions to control the positioning of the tool in three dimensions and wherein the rotating of the first control member controls the rotational orientation of the tool by rotating the instrument shaft.

81. The method of claim 79 wherein the step of supporting the proximal bendable member in a support member includes providing a ball and socket and controlling the position of the ball so as to pivot the ball relative to the socket.

82. The method of claim 80 including constructing the first control member as a single control knob.

83. The method of claim 80 including connecting the first control member with the proximal bendable member for rotating the instrument shaft and, in turn, the tool.

84. In a medical instrument having a proximal control handle and a distal tool that are intercoupled by an elongated instrument shaft that is meant to pass internally of an anatomic body, proximal and distal movable members that respectively intercouple said proximal control handle and said distal tool with said instrument shaft, and cable actuation means extending through the proximal and distal bendable members for coupling motion of the proximal bendable member to the distal bendable member, a method of controlling the position of the tool from the handle comprising;

rotating a first control member to control the rotational position of the tool, actuating a second control member for locking the position of the tool at a fixed position, providing a ball and socket and controlling the position of the ball so as to pivot the ball relative to the socket, constructing the movable members as bendable members, constructing the first control member as a single control knob and mounting a proximal end of the proximal bendable member in the ball that is supported for three dimensional pivoting in the socket.

85. The method of claim 84 including supporting the second control member between the ball and handle so as to selectively lock the position of the tool.

86. A surgical instrument comprising:

a control handle;

an instrument shaft that extends from the control handle;

a tool disposed from the distal end of the instrument shaft and controlled from the handle as to actuation and positioning thereof;

said control handle having a first section for supporting a first actuation element for controlling the actuation of the tool, and a second section for supporting a second actuation element for controlling the positioning of the tool between locked and unlocked positions;

a distal bendable member for coupling the distal end of the instrument shaft to the tool;

a proximal bendable member for coupling the proximal end of the instrument shaft to the control handle;

cable actuation means extending between the distal and proximal bendable members for coupling motion of the proximal bendable member to the distal bendable member for controlling the positioning of the tool;

a ball and socket structure supported by the control handle responsive to the second actuation element for locking the relative position between the ball and socket;

and means for mounting the proximal end of the proximal bendable member in the ball.

87. The surgical instrument of claim 86 including means for manually controlling the position of the ball in the socket.

88. The surgical instrument of claim 86 wherein said second actuation element includes a locking lever for locking the ball to the socket to hold the position of the tool.