ENDOSCOPIC SURGICAL INSTRUMENT WITH A HANDLE THAT CAN ARTICULATE WITH RESPECT TO THE SHAFT

• US 20160192918A1
• Filed: 03/11/2016
• Published: 07/07/2016
• Est. Priority Date: 01/31/2006
• Status: Active Grant

• Current Assignee: Cilag Gmbh International (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery LLC (Johnson & Johnson)
• Inventors: Shelton, Frederick E. IV, Swayze, Jeffrey S., Ortiz, Mark S., Fugikawa, Leslie M.
• Granted Patent: US 10,743,849 B2
• Time in Patent Office: Days
• US Class Current: 1/1
• 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 17/07207 the staples being applied sequentially
• CPC Class Codes: A61B 17/2812 with a single pivotal connection A61B17/29 takes precedence
• CPC Class Codes: A61B 2017/0069 with universal joint, cardan joint
• CPC Class Codes: A61B 2017/291 the position of the handle being adjustable with respect to the shaft
• CPC Class Codes: A61B 2017/2919 details of linkages or pivot points

Abstract

A surgical instrument particular suited to endoscopic use is disclosed. Various embodiments include an end effector that is sized to be inserted through a trocar. An elongated shaft assembly is coupled to the end effector and a control handle. The elongated shaft assembly has a distal portion that is adjacent to the effector for insertion into the trocar. The elongated shaft assembly further has a proximal portion that is remote from the distal portion such that the proximal portion protrudes from the trocar when the end effector and distal portion are inserted therethrough. The control handle is articulatably coupled to the proximal portion of said elongated shaft assembly to enable the surgeon to move the handle portion to a more ergonomically comfortable position while carrying out the endoscopic procedure. Various articulation joint embodiments and locking arrangements are disclosed.

Claims

1. A surgical instrument, comprising:

an end effector sized to be inserted through a trocar;

an elongated shaft assembly coupled to said end effector, said elongated shaft assembly having a distal portion adjacent to said end effector for insertion into the trocar with said end effector and a proximal portion remote from said distal portion such that said proximal portion protrudes from the trocar when the end effector and distal portion are inserted therethrough; and

a control handle articulatably coupled to said proximal portion of said elongated shaft assembly.

2. The surgical instrument of claim 1, wherein said proximal portion of said elongated shaft assembly comprises:

a proximal shaft segment having a first distal end and a first proximal end, said first proximal end coupled to said control handle;

a distal shaft segment having a second distal end portion coupled to said end effector and a second proximal end portion sized to protrude out of the trocar when said end effector is inserted through the trocar; and

an articulation joint assembly attached to said first distal end of said proximal shaft segment and said second proximal end portion of said distal shaft segment.

3. The surgical instrument of claim 2, wherein said proximal shaft segment is rotatably coupled to said control handle for selective rotation relative to said control handle.

4. The surgical instrument of claim 2, wherein said articulation joint assembly comprises:

a first upper tab protruding from said distal end of said proximal shaft segment;

a first lower tab protruding from said distal end of said proximal shaft segment and in spaced relation to said first lower tab;

a second upper tab protruding from said second proximal end of said distal shaft segment;

a second lower tab protruding from said second proximal end of said distal shaft segment in spaced relation to said second upper tab;

an upper double pivot link sized to span between said first and second upper tabs, said upper double pivot link having a first upper pin pivotally coupled to said first upper tab and a second upper pivot pin pivotally coupled to said second upper tab; and

a lower double pivot link sized to span between said first and second lower tabs, said lower double pivot link having a first lower pin pivotally coupled to said first lower tab and a second lower pin pivotally coupled to said second lower tab.

5. The surgical instrument of claim 1, further comprising:

a rotatable drive shaft assembly supported within said elongated shaft assembly, said rotatable drive shaft assembly comprising;

a distal drive shaft portion operably coupled to an actuator shaft in said end effector;

a proximal drive shaft portion operably coupled to a motor supported in said control handle; and

a drive shaft articulation joint coupled between said distal drive shaft portion and said proximal drive shaft portion to enable said proximal drive shaft portion to articulate relative to said distal drive shaft portion when said handle is articulated relative to said elongated shaft assembly.

6. The surgical instrument of claim 5, wherein said drive shaft articulation joint comprises a universal joint.

7. The surgical instrument of claim 5, wherein said drive shaft articulation joint comprises a torsion cable.

8. The surgical instrument of claim 5, wherein said drive shaft articulation joint comprises:

a central bevel gear rotatably supported between a proximal end of said distal drive shaft portion and a distal end of said proximal drive shaft portion;

a first distal bevel gear coupled to said proximal end of said distal drive shaft portion and in meshing engagement with said central bevel gear; and

a first proximal bevel gear coupled to said distal end of said proximal drive shaft portion and in meshing engagement with said central bevel gear.

9. The surgical instrument of claim 1, further comprising a locking system cooperating with said elongated shaft assembly and control handle to selectively lock said control handle in desired positions relative to said elongated shaft assembly.

10. The surgical instrument of claim 2, wherein said elongated shaft has an elongated shaft axis and wherein said articulation joint is constructed to permit said distal closure tube segment to pivot about at least one pivot axis that is substantially transverse to said elongated shaft axis relative to said proximal shaft segment.

11. The surgical instrument of claim 10, wherein said first upper pin and said first lower pin are aligned to define a first pivot axis that is substantially transverse to said elongated shaft axis and wherein said second upper pin and said second lower pin are aligned to define a second pivot axis that is substantially transverse to said elongated shaft axis.

12. The surgical instrument of claim 2, further comprising:

a distal drive shaft portion operably coupled to an actuator shaft in said end effector and operably supported within said distal shaft segment;

a proximal drive shaft portion operably coupled to a motor supported in said control handle and operably supported within said proximal shaft segment; and

a drive shaft articulation joint coupled between said distal drive shaft portion and said proximal drive shaft portion to enable said proximal drive shaft portion to articulate relative to said distal drive shaft portion when said control handle is articulated relative to said distal shaft segment, said drive shaft articulation joint located within said articulation joint assembly coupling said proximal shaft segment to said distal shaft segment.

13. The surgical instrument of claim 12, further comprising:

a proximal spine tube segment attached to said control handle and received in said proximal shaft segment, said proximal spine tube segment operably supporting a portion of said proximal drive shaft portion therein; and

a distal spine tube segment pivotally coupled to said proximal spine tube segment and supported in said distal shaft segment and attached to said end effector, said distal spine tube segment operably supporting said distal drive shaft portion therein.

14. The surgical instrument of claim 13, wherein said drive shaft articulation joint comprises:

a central bevel gear rotatably affixed to a distal end of said proximal spine tube segment and supported between a proximal end of said distal drive shaft portion and a distal end of said proximal drive shaft portion;

a first distal bevel gear coupled to said proximal end of said distal drive shaft portion and in meshing engagement with said central bevel gear; and

a first proximal bevel gear coupled to said distal end of said proximal drive shaft portion and in meshing engagement with said central bevel gear.

15. The surgical instrument of claim 9, wherein said universal joint comprises:

a proximal yoke member attached to a distal end of said proximal drive shaft portion;

a distal yoke member attached to a proximal end of said distal drive shaft portion; and

a central joint body pivotally coupled to said proximal and distal yoke members.

16. The surgical instrument of claim 15, wherein said central body member is pivotally pinned to said proximal yoke member for pivotal travel about a proximal pivot axis that is substantially transverse to an elongated shaft axis and wherein said central body is pivotally pinned to the distal yoke axis for pivotal travel about a distal axis that is substantially transverse to said elongated shaft axis.

17. The surgical instrument of claim 16, wherein said proximal pivot axis is substantially transverse to said distal pivot axis.

18. The surgical instrument of claim 13, further comprising a locking system cooperating with said elongated shaft assembly and control handle to selectively lock said control handle in desired positions relative to said elongated shaft assembly.

19. The surgical instrument of claim 18, wherein said locking system comprises an actuator assembly operably supported on said instrument and movable between a locked position and an unlocked position, said actuator assembly communicating with said distal spine segment such that when said actuator assembly is in said locked position, said proximal spine tube assembly is prevented from articulating relative to said distal spine tube assembly and when said actuator assembly is in said unlocked position, said proximal spine tube segment can articulate with respect to said distal spine tube segment.

20. The surgical instrument of claim 19, wherein said actuator assembly comprises:

a push button assembly movably supported within a housing supported on the control handle, said push button assembly comprising;

a push button portion;

a yoke portion attached to said push button portion, said yoke portion supporting said proximal end of said proximal shaft segment therein, said proximal end of said proximal shaft segment supporting said proximal spine tube segment therein, said yoke portion having a first gear attached thereto;

a cable wheel rotatably supported in said proximal spine tube segment that is supported within said proximal end of said proximal shaft segment supported within said yoke portion, said cable wheel having a second gear attached thereto for selective meshing engagement with said first gear;

a right tension cable attached to said cable wheel and a right side of a proximal end of said distal spine segment;

a left tension cable attached to said cable wheel and a left side of said proximal end of said distal spine segment; and

a biaser between said housing and said push button assembly to bias said first gear into meshing engagement with said second gear, when said push button is not activated and to permit said second gear to unmesh with said first gear upon application of an activation force to said push button portion.

21. A surgical instrument, comprising:

an end effector sized to be inserted through a trocar;

an elongated shaft assembly coupled to said end effector, said elongated shaft assembly having a distal portion adjacent to said end effector for insertion into the trocar with said end effector and a proximal portion remote from said distal portion such that said proximal portion protrudes from the trocar when the end effector and distal portion are inserted therethrough; and

means for controlling said end effector articulatably coupled to said proximal portion of said elongated shaft assembly.

22. A surgical instrument, comprising:

an end effector sized to be inserted through a trocar;

a control handle operably supporting at least one drive motor therein;

a proximal hollow shaft segment having a first proximal end rotatably coupled to said control handle for selective rotation about an elongated shaft axis and a first distal end;

a distal hollow shaft segment having a second distal end portion operably coupled to said end effector for selective actuation thereof by axial movement along said elongated shaft axis, said distal hollow shaft segment having a second proximal end portion sized to protrude out of the trocar when said end effector is inserted through the trocar;

a first upper tab protruding from said first distal end of said proximal hollow shaft segment;

a first lower tab protruding from said first distal end of said proximal hollow shaft segment and in spaced relation to said first lower tab;

a second upper tab protruding from said second proximal end of said distal hollow shaft segment;

a second lower tab protruding from said second proximal end of said distal hollow shaft segment in spaced relation to said second upper tab;

an upper double pivot link sized to span between said first and second upper tabs, said upper double pivot link having a first upper pin pivotally coupled to said first upper tab and a second upper pivot pin pivotally coupled to said second upper tab;

a lower double pivot link sized to span between said first and second lower tabs, said lower double pivot link having a first lower pin pivotally coupled to said first lower tab and a second lower pin pivotally coupled to said second lower tab;

a proximal spine segment attached to said control handle and extending through said proximal hollow shaft segment and protruding from said first distal end thereof;

a distal spine segment extending through said distal hollow shaft segment and having a proximal end adjacent a distal end of said proximal spine segment, said distal spine segment having a distal end attached to said end effector and being supported within said distal hollow shaft segment such that said distal hollow shaft segment can be selectively axially moved relative to said distal spine segment;

a distal drive shaft portion operably supported in said distal spine segment and being coupled to an actuator shaft in said end effector;

a proximal drive shaft portion operably coupled to one of said at least one drive motors in said control handle and operably supported within said proximal spine segment; and

a drive shaft articulation joint coupled between said distal drive shaft portion and said proximal drive shaft portion to enable said proximal drive shaft portion to articulate relative to said distal drive shaft portion when said control handle is articulated relative to said distal shaft segment.

23. The surgical instrument of claim 22, wherein said drive shaft articulation joint comprises:

a central bevel gear rotatably affixed to a distal end of said proximal spine segment and supported between a proximal end of said distal drive shaft portion and a distal end of said proximal drive shaft portion;

a first distal bevel gear coupled to said proximal end of said distal drive shaft portion and in meshing engagement with said central bevel gear; and

a first proximal bevel gear coupled to said distal end of said proximal drive shaft portion and in meshing engagement with said central bevel gear.

24. The surgical instrument of claim 22, wherein said drive shaft articulation joint comprises a universal joint.

25. The surgical instrument of claim 22, wherein said drive shaft articulation joint comprises a torsion cable.

26. The surgical instrument of claim 22, further comprising means supported on said instrument for selectively locking said proximal hollow shaft segment in a desired position relative to said distal hollow shaft segment.