Surgical instruments with articulating shafts

• US 10,335,182 B2
• Filed: 07/18/2016
• Issued: 07/02/2019
• Est. Priority Date: 06/29/2012
• Status: Active Grant

• Current Assignee: Cilag Gmbh International (Johnson & Johnson)
• Original Assignee: Ethicon, LLC (Johnson & Johnson)
• Inventors: Stulen, Foster B., Huang, Zhifan F., Weizman, Patrick A., Smolik, Steven P., Draginoff, Jr., Carl J.
• Primary Examiner(s): Stransky, Katrina M
• Assistant Examiner(s): Mendoza, Michael G
• Application Number:
  US15/212,742
• Publication Number:
  US 20160374712A1
• Time in Patent Office: 1,079 Days
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• 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 17/320092 with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw
• CPC Class Codes: A61B 18/1447 wherein sliding surfaces cause opening/closing of the end effectors
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/00398 using powered actuators, e.g. stepper motors, solenoids
• CPC Class Codes: A61B 2017/22015 with details of the transmission member
• CPC Class Codes: A61B 2017/22018 segmented along its length
• CPC Class Codes: A61B 2017/2927 the angular position of the head being adjustable with respect to the shaft
• CPC Class Codes: A61B 2017/2932 Transmission of forces to jaw members
• CPC Class Codes: A61B 2017/294 Connection of actuating rod to jaw, e.g. releasable
• CPC Class Codes: A61B 2017/320069 for ablating tissue
• CPC Class Codes: A61B 2017/320071 with articulating means for working tip
• CPC Class Codes: A61B 2017/320075 single edge blade, e.g. for cutting
• CPC Class Codes: A61B 2017/320078 Tissue manipulating surface
• CPC Class Codes: A61B 2017/320089 node location
• CPC Class Codes: A61B 2017/320093 additional movable means performing cutting operation
• CPC Class Codes: A61B 2017/320094 additional movable means performing clamping operation
• CPC Class Codes: A61B 2017/320095 with sealing or cauterizing means
• CPC Class Codes: A61B 2018/00196 reciprocating lengthwise
• CPC Class Codes: A61B 2018/00589 : Coagulation
• CPC Class Codes: A61B 2018/00595 : Cauterization
• CPC Class Codes: A61B 2018/00607 : Coagulation and cutting with the same instrument
• CPC Class Codes: A61B 2018/0063 : Sealing
• CPC Class Codes: A61B 2018/00642 : with feedback, i.e. closed loop control
• CPC Class Codes: A61B 2018/00702 : Power or energy
• CPC Class Codes: A61B 2018/00875 : Resistance or impedance
• CPC Class Codes: A61B 2018/0091 : Handpieces of the surgical instrument or device
• CPC Class Codes: A61B 2018/00994 : combining two or more different kinds of non-mechanical energy or combining one or more non-mechanical energies with ultrasound
• CPC Class Codes: A61B 2018/1452 : including means for cutting A61B2018/146 takes precedence
• CPC Class Codes: A61B 34/30 : Surgical robots

Abstract

Various embodiments are directed to articulatable surgical instruments and surgical systems comprising articulatable surgical instruments. Some embodiments comprise an end effector to treat tissue, where the end effector comprises an ultrasonic blade. A hollow shaft may extend proximally from the end effector along a longitudinal axis. A waveguide may extend through the hollow shaft and may be acoustically coupled to the ultrasonic blade. The waveguide may comprise a distally positioned flange positioned within the hollow shaft proximally from the ultrasonic blade and may be held stationary at a first pivot point positioned within the hollow shaft proximally from the flange. A reciprocatable wedge may be configured to interact with the flange to cause the ultrasonic blade to pivot about the first pivot point in a first direction.

Claims

1. An articulatable surgical instrument, comprising:

an end effector to treat tissue, wherein the end effector comprises an ultrasonic blade;

a hollow shaft extending proximally from the end effector along a longitudinal axis;

a waveguide extending through the hollow shaft and acoustically coupled to the ultrasonic blade, wherein the waveguide comprises a distally positioned flange positioned within the hollow shaft proximally from the ultrasonic blade, and wherein the waveguide is held stationary at a pivot point positioned within the hollow shaft proximally from the distally positioned flange; and

a reciprocatable wedge configured to interact with the distally positioned flange to cause the ultrasonic blade to pivot about the pivot point in a first direction.

2. The articulatable surgical instrument of claim 1, wherein the waveguide comprises a bendable portion proximal to the ultrasonic blade and distal to the pivot point.

3. The articulatable surgical instrument of claim 1, further comprising a translatable component coupled to and extending proximally from the reciprocatable wedge, wherein the translatable component is arranged to reciprocate the reciprocatable wedge distally and proximally.

4. The articulatable surgical instrument of claim 1, wherein the pivot point is positioned at a first node of the waveguide at a resonant frequency of the waveguide and the distally positioned flange is positioned at a second node of the waveguide at the resonant frequency of the waveguide.

5. The articulatable surgical instrument of claim 1, wherein an interior wall of the hollow shaft defines a longitudinally directed slot, and wherein at least a portion of the reciprocatable wedge is positioned within the longitudinally directed slot.

6. The articulatable surgical instrument of claim 1, wherein the distally positioned flange defines at least one notch, wherein the reciprocatable wedge comprises a step corresponding to each of the at least one notch, and wherein each step is configured to ride within its corresponding notch as the reciprocatable wedge is reciprocated distally and proximally.

7. The articulatable surgical instrument of claim 1, wherein the reciprocatable wedge defines:

a first wedge portion comprising a first slope, wherein the first wedge portion is configured to pivot the ultrasonic blade about the pivot point by a first amount when the reciprocatable wedge is translated distally to a first position;

a flat portion comprising substantially no slope, wherein the flat portion is positioned proximally from the first wedge portion, and wherein the flat portion is configured to maintain the pivot of the ultrasonic blade about the pivot point by the first amount when the reciprocatable wedge is translated distally from the first position to a second position; and

a second wedge portion comprising a second slope, wherein the second wedge portion is configured to pivot the ultrasonic blade about the pivot point by an additional amount when the reciprocatable wedge is translated distally from the second position to a third position.

8. The articulatable surgical instrument of claim 1, wherein the reciprocatable wedge is a first reciprocatable wedge, and wherein the articulatable surgical instrument further comprises:

a second reciprocatable wedge positioned opposite the first reciprocatable wedge, wherein the second reciprocatable wedge is configured to interact with the distally positioned flange to cause the ultrasonic blade to pivot about the pivot point in a second direction.

9. A surgical system, comprising:

an articulatable surgical instrument, comprising;

an end effector to treat tissue, wherein the end effector comprises an ultrasonic blade;

a cylindrical shaft extending proximally from the end effector along a longitudinal axis;

a waveguide extending through the cylindrical shaft and acoustically coupled to the ultrasonic blade, wherein the waveguide comprises a distal flange positioned proximal to the ultrasonic blade, and wherein the waveguide is held stationary at a pivot point positioned proximal to the distal flange; and

at least one reciprocatable member configured to interact with the distal flange to cause the ultrasonic blade to pivot about the pivot point away from the longitudinal axis, wherein one or more of the at least one reciprocatable member comprises a reciprocatable component including at least one longitudinal slope; and

an instrument mounting portion coupled to and extending proximally from the cylindrical shaft, wherein the instrument mounting portion is configured to reciprocate the at least one reciprocatable member distally and proximally.

10. The surgical system of claim 9, wherein the waveguide comprises a bendable portion proximal to the ultrasonic blade and distal to the pivot point.

11. The surgical system of claim 9, wherein the reciprocatable component including the at least one longitudinal slope comprises a wedge.

12. The surgical system of claim 9, wherein each of the at least one longitudinal slope is configured to pivot the ultrasonic blade about the pivot point by a respective amount.

13. The surgical system of claim 9, wherein the pivot point comprises a proximal flange positioned within the cylindrical shaft proximal to the distal flange.

14. The surgical system of claim 13, wherein the at least one reciprocatable member comprises a second cylindrical shaft, wherein a wall of the second cylindrical shaft defines a longitudinally directed slot, and wherein at least a portion of the distal flange is positioned within the longitudinally directed slot.

15. The surgical system of claim 13, wherein the proximal flange is positioned at a first node of the waveguide at a resonant frequency of the waveguide and the distal flange is positioned at a second node of the waveguide at the resonant frequency of the waveguide.

16. The surgical system of claim 9, wherein the instrument mounting portion is arranged to translate at least one translatable component to reciprocate the at least one reciprocatable member.

17. The surgical system of claim 16, wherein the instrument mounting portion comprises a drive mechanism to differentially translate the at least one translatable component.

18. The surgical system of claim 17, wherein the drive mechanism comprises at least one of a rack and pinion gear mechanism, a worm gear mechanism, or a double cam mechanism.

19. A surgical system, comprising:

a surgical instrument, comprising;

an end effector comprising an ultrasonic blade;

a hollow shaft extending proximally from the end effector along a longitudinal axis;

a waveguide extending through the hollow shaft and acoustically coupled to the ultrasonic blade, wherein the waveguide comprises a distal flange positioned within the hollow shaft proximally from the ultrasonic blade, wherein the waveguide is held stationary at a pivot point positioned within the hollow shaft proximally from the distal flange, and wherein the waveguide comprises a bendable portion proximal to the ultrasonic blade and distal to the pivot point;

at least one reciprocatable component configured to interact with the distal flange to cause the ultrasonic blade to pivot about the pivot point away from the longitudinal axis, wherein each of the at least one reciprocatable components comprises a tapered face portion; and

a translatable member coupled to and extending proximally from each of the at least one reciprocatable components, wherein the translatable member is arranged to reciprocate its respective reciprocatable component distally and proximally, and

an instrument mounting portion coupled to and extending proximally from the hollow shaft, wherein the instrument mounting portion comprises a drive mechanism to differentially translate each translatable member.

20. The surgical system of claim 19, wherein the drive mechanism comprises at least one of a rack and pinion gear mechanism, a worm gear mechanism, or a double cam mechanism.