Surgical instrument guide device

• US 7,842,028 B2
• Filed: 10/03/2005
• Issued: 11/30/2010
• Est. Priority Date: 04/14/2005
• Status: Active Grant

• Current Assignee: Endobotics, LLC
• Original Assignee: Cambridge Endoscopic Devices Inc.
• Inventors: Lee, Woojin
• Primary Examiner(s): Johnson, III; Henry M
• Assistant Examiner(s): ROANE, AARON F
• Application Number:
  US11/242,642
• Publication Number:
  US 20070021737A1
• Time in Patent Office: 1,884 Days
• Field of Search: 600/114, 600/137, 600/141, 600/142, 600/146, 600/149, 606/1
• US Class Current: 606/1
• CPC Class Codes: A61B 1/00154 using guiding arrangements for insertion
• CPC Class Codes: A61B 1/0052 Constructional details of control elements, e.g. handles
• CPC Class Codes: A61B 1/0057 Constructional details of force transmission elements, e.g. control wires
• CPC Class Codes: A61B 17/00 Surgical instruments, devices or methods, e.g. tourniquets A61B18/00 takes precedence; contraceptive devices, pessaries, or applicators therefor A61F6/00; eye surgery A61F9/007; ear surgery A61F11/00
• 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 17/062 Needle manipulators
• CPC Class Codes: A61B 17/068 Surgical staplers , e.g. containing multiple staples or clampsstaplers containing only one staple A61B17/10; magazines or containers for staples A61B17/105; for performing anastomosis A61B17/115; staplers in general B25C5/00
• CPC Class Codes: A61B 17/1285 for minimally invasive surgery
• CPC Class Codes: A61B 17/22 Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for dilators A61M29/00
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 17/2909 Handles
• CPC Class Codes: A61B 17/3403 Needle locating or guiding means guides for suture needles A61B17/0482; guiding or tracking by nuclear magnetic resonance G01R33/285
• CPC Class Codes: A61B 17/3417 Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating syringe needles A61M5/32; dilators A61M29/00
• CPC Class Codes: A61B 17/3423 Access ports, e.g. toroid shape introducers for instruments or hands access sites for liquids A61M39/0247
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/00309 Cut-outs or slits
• CPC Class Codes: A61B 2017/00367 Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
• CPC Class Codes: A61B 2017/00469 for insertion of instruments, e.g. guide wire, optical fibre
• CPC Class Codes: A61B 2017/0225 flexible, e.g. fabrics, meshes, or membranes
• 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
• 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 2017/3445 : used as instrument channel for multiple instruments
• CPC Class Codes: A61B 2017/3447 : Linked multiple cannulas
• CPC Class Codes: A61B 34/70 : Manipulators specially adapted for use in surgery
• CPC Class Codes: A61B 34/71 : Manipulators operated by drive cable mechanisms

Abstract

An instrument guide device comprises an elongated guide shaft having proximal and distal ends and including an instrument lumen for receiving therethrough a manually operated instrument having an instrument shaft. A distal bendable member is disposed at the distal end of the guide shaft and a proximal bendable member is disposed at the proximal end of the guide shaft. Actuation means extends between the distal and proximal bendable members and provides a bending of the distal bendable member controlled from the proximal bendable member. The proximal bendable member is controlled from the manually operated instrument to cause a corresponding bending of said distal bendable member.

Claims

1. A surgical instrument assembly comprising:

an elongated instrument shaft having proximal and distal ends;

an end effector coupled from the distal end of the instrument shaft;

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

said elongated instrument shaft, end effector and control handle defining a manually operated instrument having inserted and withdrawn positions;

a guide member for receiving the manually operated instrument and including;

a guide shaft having respective proximal and distal ends;

a distal bendable member at the distal end of said guide shaft and having at least a distal end;

a proximal bendable member at the proximal end of said guide shaft and having a proximal end and a distal end;

an adaptor coupled between the distal end of the proximal bendable member and the proximal end of the guide shaft;

said adaptor receiving and supporting the distal end of the proximal bendable member;

a grip, separate from the manually operated instrument, receiving and supporting the proximal end of the proximal bendable member;

a lumen through which the manually operated instrument is inserted distally through at least the grip, proximal bendable member, guide shaft and distal bendable member;

said lumen terminating at a distal port at the distal end of the distal bendable member and at a proximal port at the grip; and

actuation cabling extending between said distal and proximal bendable members;

said end effector extending from the distal port of the lumen at an operative site and the control handle extending from the proximal port of the lumen when the manually operated instrument is inserted through the lumen;

whereby any deflection of said proximal bendable member caused by manipulation of said manually operated instrument causes a corresponding deflection of said distal bendable member for control of said distal bendable member, and in turn, said end effector.

2. The surgical instrument assembly of claim 1 wherein said distal bendable member and said proximal bendable member are moveable in any direction, and wherein the manually operated instrument in the inserted position is received in and engaged with internal walls that form the lumen.

3. The surgical instrument assembly of claim 2 wherein said proximal bendable member comprises a unitary slotted structure having a plurality of discs separated by slots and further including a plurality of ribs interconnecting adjacent discs, said ribs being disposed at intervals about the member of less than 90 degrees.

4. The surgical instrument assembly of claim 1 including a fastener for securing the manually operated instrument to the grip.

5. The surgical instrument assembly of claim 4 wherein said grip is formed as two pieces including a grip portion and a rotation knob and said grip and knob portions are supported for relative rotation therebetween.

6. The surgical instrument assembly of claim 1 including a fastening member for securing the manually operated instrument to the grip, and selected from a locking screw and catch.

7. The surgical instrument assembly of claim 6 wherein the fastening member comprises a locking screw mounted on the grip and engaging with the manually operated instrument.

8. The surgical instrument assembly of claim 6 wherein the manually operated instrument has a distal annular groove for receiving the fastening member whereby there is no linear motion of the manually operated instrument relative to the guide member, but there is rotation of the manually operated instrument relative to the guide member.

9. The surgical instrument assembly of claim 8 wherein the fastening member comprises a releasable catch.

10. The surgical instrument assembly of claim 1 wherein the grip has a wall defining opposite cavities, that include a more distal cavity receiving the proximal end of the proximal bendable member therein and a more proximal cavity for receiving the manually operated instrument therein.

11. The surgical instrument assembly of claim 10 wherein the cabling terminates at the grip wall.

12. The surgical instrument assembly of claim 11 including a fastening member mounted on the grip and engaging with the manually operated instrument.

13. The surgical instrument assembly of claim 1 wherein the grip is formed as two pieces including a grip portion and a rotation knob portion, the rotation knob portion defining a cavity for receiving the distal end of the proximal bendable member.

14. The surgical instrument assembly of claim 13 including retention means between the grip and rotation knob portions that enable rotation of rotation knob portion relative to the grip portion.

15. The surgical instrument assembly of claim 14 wherein the rotation knob portion has an end wall that in part defines the cavity, and the cabling terminates at the end wall of the rotation knob portion.

16. The surgical instrument assembly of claim 1 wherein the adaptor includes a funnel shaped portion for transitioning between the elongated guide shaft and proximal bendable member of the guide member.

17. The surgical instrument assembly of claim 16 wherein the funnel shaped portion transitions from a smaller diameter guide shaft to a larger diameter proximal bendable member.

18. The surgical instrument assembly of claim 1 wherein the relative position between the proximal and distal bendable members is locked.

19. The surgical instrument assembly of claim 1 wherein only the manually operated instrument includes an instrument tool.

20. The surgical instrument assembly of claim 1 wherein the guide member is absent any tool.

21. The surgical instrument assembly of claim 1 wherein the diameter of the distal bendable member is different than the diameter of the proximal bendable member.

22. The surgical instrument assembly of claim 21 wherein the proximal bendable member has a diameter greater than the diameter of the distal bendable member.

23. The surgical instrument assembly of claim 1 wherein the maximum transverse cross-sectional dimension of the distal bendable member is different than the maximum transverse cross-sectional dimension of the proximal bendable member.

24. The surgical instrument assembly of claim 23 wherein the proximal bendable member has a maximum transverse cross-sectional dimension that is greater than the maximum transverse cross-sectional dimension of the distal bendable member.

25. The surgical instrument assembly of claim 1 including a pair of proximal bendable members and a pair of distal bendable members.

26. The surgical instrument assembly of claim 25 wherein the pair of proximal bendable members are connected in series and the pair of distal bendable members are connected in series.

27. A manually controlled medical instrument that is operable in combination with a guide member by virtue of the insertion of the manually controlled medical instrument through a continuous lumen of the guide member that extends between open ports at opposite ends of the guide member,

the manually controlled medical instrument including an instrument shaft that interconnects between a manual instrument control handle and a manual instrument tool, the manually controlled medical instrument also including a an actuation member operable from the manual instrument control handle for operating the manual instrument tool,

the guide member including an elongated guide shaft having proximal and distal ends, a distal bendable member disposed at the distal end of the guide shaft, a proximal bendable member having a proximal end and a distal end that is coupled with the proximal end of the guide shaft, and cabling extending between the distal and proximal bendable members and providing a bending of the distal bendable member controlled from and responsive to the bending of the proximal bendable member,

a grip, separate from the manually controlled medical instrument, receiving and supporting the proximal end of the proximal bendable member, the continuous lumen also extending through the grip for accommodation of the manually controlled medical instrument shaft,

the manually controlled medical instrument constructed and arranged for insertion through the lumen of the guide member and grip so as to dispose the manual instrument control handle extending proximally of the proximal bendable member of the guide member and the manual instrument tool extending distally of the distal bendable member of the guide member;

and a fastening member for securing the manually controlled medical instrument to the grip so that there is no linear motion of the manually controlled medical instrument relative to the guide member, once secured,

said manually controlled medical instrument, once inserted into the guide member, by deflection thereof controlling a bending at the proximal bendable member of the guide member that is, in turn, transferred to the distal bendable member to, in turn, control the positioning of the distally extending manual instrument tool.

28. The combination of claim 27 wherein the grip is a two-piece grip.

29. The combination of claim 27 wherein the manually controlled medical instrument is capable of being rotated relative to the guide member.

30. The combination of claim 27 wherein the fastening member comprises one of a locking screw and catch.

31. The combination of claim 27 wherein the manual instrument tool has a longitudinal distal tool axis, the rotation of the manual instrument tool is about its longitudinal distal tool axis, and providing a control member at the proximal end of the manually controlled medical instrument for controlling the rotation about the distal tool axis.

32. The combination of claim 27 including a funnel shaped portion for transitioning between the elongated guide shaft and proximal bendable member of the guide member.

33. The combination of claim 27 wherein the grip is formed as two pieces including a grip portion and a rotation knob portion and the grip and knob portions are supported for relative rotation therebetween.

34. The combination of claim 27 wherein the proximal bendable member comprises a unitary slotted structure having a plurality of discs separated by slots and further including a plurality of ribs interconnecting adjacent discs, said ribs being disposed at intervals about the bendable member of less than 90 degrees.

35. The combination of claim 27 including a pair of proximal bendable members and a pair of distal bendable members.

36. The combination of claim 35 wherein the pair of proximal bendable members are connected in series and the pair of distal bendable members are connected in series.

37. The combination of claim 27 wherein the relative position between the proximal and distal bendable members is locked.

38. The combination of claim 27 wherein only the manually controlled medical instrument includes an instrument tool.

39. The combination of claim 27 wherein the guide member is absent any tool.

40. The combination of claim 27 wherein the diameter of the distal bendable member is different than the diameter of the proximal bendable member.

41. The combination of claim 40 wherein the proximal bendable member has a diameter greater than the diameter of the distal bendable member.

42. The combination of claim 27 wherein the maximum transverse cross-sectional dimension of the distal bendable member is different than the maximum transverse cross-sectional dimension of the proximal bendable member.

43. The combination of claim 42 wherein the proximal bendable member has a maximum transverse cross-sectional dimension that is greater than the maximum transverse cross-sectional dimension of the distal bendable member.

44. The combination of claim 27 wherein the manually controlled medical instrument includes a proximal bendable element that is disposed between the manual instrument control handle and manual instrument shaft, a distal bendable element that is disposed between the manual instrument tool and manual instrument shaft, and actuation cables that extend between the proximal and distal bendable elements.

45. The combination of claim 44 including a rotation knob for supporting the proximal bendable element of the manually controlled medical instrument.

46. The combination of claim 27 wherein the grip has a wall defining opposite cavities, that include a more distal cavity receiving the proximal end of the proximal bendable member therein and a more proximal cavity for receiving the manually controlled medical instrument therein.

47. The combination of claim 46 wherein the cabling terminates at the grip wall.

48. The combination of claim 47 wherein the fastening member comprises a locking screw mounted on the grip and engaging with the manually controlled medical instrument.

49. The combination of claim 27 wherein the grip is formed as two pieces including a grip portion and a rotation knob portion, the rotation knob portion defining a cavity for receiving the distal end of the proximal bendable member.

50. The combination of claim 49 including retention means between the grip and rotation knob portions that enable rotation of rotation knob portion relative to the grip portion.

51. The combination of claim 50 wherein the rotation knob portion has an end wall that in part defines the cavity, and the cabling terminates at the end wall of the rotation knob portion.

52. The combination of claim 50 wherein the fastening member comprises a locking screw mounted on the grip and engaging with the manually controlled medical instrument.

53. The combination of claim 27 wherein the manually controlled medical instrument has a distal annular groove for receiving the fastening member whereby there is no linear motion of the manually controlled medical instrument relative to the guide member, but there is rotation of the manually controlled medical instrument relative to the guide member.

54. The combination of claim 53 wherein the fastening member comprises a releasable catch.

55. The combination of claim 27 including an adaptor coupled between the distal end of the proximal bendable member and the proximal end of the guide shaft, said adaptor receiving and supporting the distal end of the proximal bendable member.

56. The combination of claim 55 wherein the adaptor includes a funnel shaped portion for transitioning between the elongated guide shaft and proximal bendable member of the guide member.

57. The combination of claim 56 wherein the funnel shaped portion transitions from a smaller diameter guide shaft to a larger diameter proximal bendable member.