Surgical instrument with rotatable shaft

• US 6,352,539 B1
• Filed: 01/26/1999
• Issued: 03/05/2002
• Est. Priority Date: 05/02/1997
• Status: Expired due to Fees

• Current Assignee: Scilogy Corporation
• Original Assignee: Scilogy Corporation
• Inventors: Avellanet, Francisco J.
• Primary Examiner(s): Smith, Jeffrey A.
• Assistant Examiner(s): Priddy, Michael B.
• Application Number:
  US09/237,420
• Time in Patent Office: 1,134 Days
• Field of Search: 605/110, 605/113, 605/114, 605/47
• US Class Current: 606/113
• CPC Class Codes: A61B 17/32056 Surgical snare instruments for removing or smashing calculi A61B2017/2212; tonsillotomes A61B17/26
• CPC Class Codes: A61B 18/14 Probes or electrodes therefor
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 18/1815 using microwaves
• CPC Class Codes: A61B 2018/0091 Handpieces of the surgical instrument or device
• CPC Class Codes: A61B 2018/1407 Loop
• CPC Class Codes: A61B 2018/141 Snare
• CPC Class Codes: A61B 2018/1861 with an instrument inserted into a body lumen or cavity, e.g. a catheter
• CPC Class Codes: A61F 2/2403 with pivoting rigid closure members check valves with hinged closure members in general F16K15/03
• CPC Class Codes: A61F 2/86 Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
• CPC Class Codes: A61F 2210/0019 operated at only one temperature whilst inside or touching the human body, e.g. constrained in a non-operative shape during surgery, another temperature only occurring before the operation
• CPC Class Codes: B21C 1/02 Drawing metal wire or like flexible metallic material by drawing machines or apparatus in which the drawing action is effected by drums
• CPC Class Codes: B21C 37/045 Manufacture of wire or bars with particular section or properties
• CPC Class Codes: C02F 1/20 by degassing, i.e. liberation of dissolved gases degasification of liquids in general B01D19/00; arrangement of degassing apparatus in boiler feed supply F22D
• CPC Class Codes: C02F 1/42 by ion-exchange ion-exchange in general B01J
• CPC Class Codes: C02F 1/46104 Devices therefor; Their operating or servicing
• CPC Class Codes: C02F 2201/4611 Fluid flow
• CPC Class Codes: C02F 2209/42 Liquid level
• CPC Class Codes: C02F 2301/066 Overpressure, high pressure
• CPC Class Codes: C25B 1/04 by electrolysis of water
• CPC Class Codes: C25B 15/08 : Supplying or removing reactants or electrolytes; Regeneration of electrolytes
• CPC Class Codes: H01B 13/0292 : After-treatment
• CPC Class Codes: H01B 5/08 : Several wires or the like stranded in the form of a rope
• CPC Class Codes: H01B 5/10 : stranded around a space, insulating material, or dissimilar conducting material
• CPC Class Codes: H01B 7/0009 : Details relating to the conductive cores
• CPC Class Codes: Y02E 60/36 : Hydrogen production from non-carbon containing sources, e.g. by water electrolysis

Abstract

A surgical snare instrument includes an elongated tubular sheath having proximal and distal ends, a flexible torqueable shaft having proximal and distal ends extending through and axially movable relative to the sheath, a snare loop at the distal end of the shaft, and a handle coupled to the proximal ends of the sheath and shaft for moving the shaft relative to the sheath and for rotating the shaft relative to the sheath so that the snare loop, when extended beyond the distal end of the sheath, is rotatable relative to the distal end of the sheath. The shaft is preferably a multifilament twisted and drawn cable. The filaments of the multifilament twisted and drawn cable are preferably either stainless steel, nickel-titanium alloy, or a combination of the two. Such a shaft has been demonstrated to provide the high torqueability necessary for controlled rotation of the snare loop.

Claims

1. A surgical instrument, comprising:

a) an elongated flexible tubular sheath having proximal and distal ends;

b) a flexible shaft having proximal and distal ends extending through and axially and rotationally movable relative to said sheath, with a snare loop being provided at said distal end of said flexible shaft; and

c) a handle assembly comprising a thumb ring and two finger rings which is adapted to move said shaft and said sheath axially and rotationally relative to each other.

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

said handle assembly includes means for applying a cautery current to said flexible shaft.

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

said handle assembly includes a first member and a second member axially movable relative to said first member, said first member being coupled to said sheath, and said second member being coupled to said flexible shaft.

4. A surgical instrument according to claim 3, further comprising:

d) a second shaft relatively stiffer than said flexible shaft, said second shaft having a proximal end coupled to said second member and a distal end coupled to said flexible shaft.

5. A surgical instrument according to claim 4, further comprising:

e) a relatively stiff sleeve provided over said proximal end of said sheath.

6. A surgical instrument according to claim 3, wherein:

said sheath is rotatably coupled to said first member of said handle assembly.

7. A surgical instrument according to claim 6, wherein:

said sheath is provided with a means for manually assisting rotation of said sheath relative to said flexible shaft.

8. A surgical instrument according to claim 1, wherein:

said handle assembly includes a first member, a second member coupled to said proximal end of said flexible shaft and axially movable relative to said first member, and a third member coupled to said proximal end of said sheath, said first and second members being rotationally movable relative to said third member.

9. A surgical instrument according to claim 8, wherein:

said third member has a means for applying a cautery current to said flexible shaft.

10. A surgical instrument comprising:

a) an elongated flexible tubular sheath having proximal and distal ends;

b) a flexible shaft having proximal and distal ends extending through and axially and rotationally movable relative to said sheath, with a snare loop being provided at said distal end of said flexible shaft; and

c) a handle assembly which is adapted to move said shaft and said sheath axially and rotationally relative to each other;

wherein;

said flexible shaft is constructed so that when said proximal end of said flexible shaft is rotated a first degree relative to said proximal end of said sheath, said snare loop at said distal end of said flexible shaft is rotated approximately said first degree relative to said distal end of said sheath.

11. The instrument of claim 10, wherein said handle assembly is adaptable for being operated single-handedly.

12. The instrument of claim 10, wherein said handle assembly is adaptable for being operated with more than one hand.

13. A surgical instrument comprising:

a) an elongated flexible tubular sheath having proximal and distal ends;

b) a flexible shaft having proximal and distal ends extending through and axially and rotationally movable relative to said sheath, with a snare loop being provided at said distal end of said flexible shaft; and

c) a handle assembly which is adapted to move said shaft and said sheath axially and rotationally relative to each other;

wherein;

said flexible shaft is constructed of a resilient material having the torqueability of a multifilament twisted and drawn or twisted and swaged or twisted and rolled cable.

14. A surgical instrument according to claim 13, wherein:

said multifilament twisted and drawn or swaged cable includes at least one of a steel filament and a nickel-titanium alloy filament.

15. The instrument of claim 13, wherein said handle assembly is adaptable for being operated single-handedly.

16. The instrument of claim 13, wherein said handle assembly is adaptable for being operated with more than one hand.

17. A surgical instrument comprising:

a) an enlongated flexible tubular sheath having proximal and distal ends;

b) a flexible shaft having proximal and distal ends extending through and axially and rotationally movable relative to said sheath, with a snare loop being provided at said distal end of said flexible shaft; and

c) a handle assembly which is adapted to move said shaft and said sheath axially and rotationally relative to each other;

wherein;

said handle assembly includes a first member and a second member axially relative to said first member, said second member being coupled to said sheath, and said second member being coupled to said flexible shaft; and

further comprising;

d) a second shaft relatively stiffer than said flexible shaft, said second shaft having a proximal end coupled to said second member and a distal end coupled to said flexible shaft;

wherein;

said second shaft is provided with a pinion, and second member of said handle assembly is provided with a rack which engages said pinion, said second member being movable relative to said second shaft,

wherein when said second member is moved relative to said second shaft, said rack causes rotation of said pinion and said flexible shaft.

18. A surgical instrument according to claim 17, wherein:

said second member is pivotably movable relative to said second shaft.

19. A surgical instrument according to claim 17, wherein:

said second member is pivotably movable relative to said second shaft.

20. A surgical instrument comprising:

a) an elongated flexible tubular sheath having proximal and distal ends;

b) a flexible shaft having proximal and distal ends extending through and axially and rotationally movable relative to said sheath, with a snare loop being provided at said distal end of said flexible shaft; and

c) a handle assembly which is adapted to move said shaft and said sheath axially and rotationally relative to each other;

wherein;

said handle assembly includes a first member and a second member axially relative to said first member, said first member being coupled to said sheath, and said second member coupled to said flexible shaft; and

futher comprising;

d) a second shaft relatively stiffer than said flexible shaft, said second shaft having a proximal end coupled to said second member and a distal and coupled to said flexible shaft;

wherein;

said second shaft is provided with a roller, and second member of said handle assembly is provided with a surface which frictionally engages said roller, said second member being movable relative to said second shaft,

wherein when said second member is moved relative to said second shaft, movement of said surface relative to said roller causes rotation of said roller and said flexible shaft.

21. A surgical instrument, comprising:

a) an elongated flexible tubular sheath having proximal and distal ends;

b) a flexible shaft having proximal and distal ends extending through and axially movable relative to said sheath, a surgical assembly being provided at said distal end of said shaft; and

c) a handle assembly for controllably moving said shaft and said sheath axially and rotationally relative to each other,

wherein said flexible shaft is constructed so that when said proximal end of said flexible shaft is rotated a first degree relative to said proximal end of said sheath, said surgical assembly at said distal end of said flexible shaft is rotated approximately said first degree relative to said distal end of said sheath.

22. A surgical instrument according to claim 21, wherein:

said handle assembly includes means for applying a cautery current to said flexible shaft.

23. A surgical instrument according to claim 21, further comprising:

d) a second shaft relatively stiffer than said flexible shaft, said second shaft having a proximal end and a distal end and being provided with a pinion,

said handle assembly including a first member and a second member axially movable relative to said first member, said second member being provided with a rack which engages said pinion of said second shaft and said second member being movable relative to said second shaft,

said first member being coupled to said sheath, said second member being coupled to said proximal end of said second shaft, and said proximal end of said flexible shaft being coupled to said distal end of said second shaft,

wherein when said second member is moved relative to said second shaft, said rack causes rotation of said pinion and said flexible shaft.

24. A surgical instrument according to claim 23, wherein:

said second member is pivotably movable relative to said second shaft.

25. The instrument of claim 21, wherein said handle assembly is adaptable for being operated single-handedly.

26. The instrument of claim 21, wherein said handle assembly is adaptable for being operated with more than one hand.

27. A surgical instrument comprising:

a) an enlongated tubular sheath having proximal and distal ends;

b) a shaft made of resilient material having the torqueability of a multifilament twisted and drawn or twisted and swaged or twisted and rolled cable having proximal and distal ends extending through and axially movable relative to said sheath, a surgical assembly being provided at said distal end of said shaft; and

c) a handle assembly coupled to said shaft and said sheath and which is adapted to move said shaft and said sheath axially relative to each other.

28. A surgical instrument according to claim 27, wherein:

said handle assembly includes means for moving said shaft and sheath rotationally relative to each other.

29. A surgical instrument according to claim 27, wherein:

said multifilament twisted and drawn or swaged cable shaft includes at least one of a stainless steel filament and a nickel-titanium alloy filament.

30. A surgical instrument according to claim 27, wherein:

said handle assembly means includes means for applying a cautery current to said flexible shaft.

31. The instrument of claim 27, wherein said handle assembly is adaptable for being operated single-handedly.

32. The instrument of claim 27, wherein said handle assembly is adaptable for being operated with more than one hand.

33. A surgical instrument, comprising:

a) an elongated tubular member having proximal and distal ends;

b) an elongated control member extending through and axially and rotationally movable relative to said tubular member, a surgical assembly being provided at said distal end of said control member and a pinion being provided at or adjacent said proximal end; and

c) a handle assembly including a first member and a second member axially movable relative to said first member, said second member being provided with a rack which engages said pinion of said control member and said second member being movable relative to said control member,

said first member being coupled to said tubular member and said second member being coupled to said proximal end of said control member,

wherein when said second member is moved relative to said control member, said rack causes rotation of said pinion and said control member.

34. A surgical instrument according to claim 33, wherein:

said second member is pivotably movable relative to said control member.

35. A surgical instrument, comprising:

a) an elongated tubular member having proximal and distal ends;

b) an elongated control member extending through and axially and rotationally movable relative to said tubular member, a surgical assembly being provided at said distal end of said control member and a roller being provided at or adjacent said proximal end of said control member; and

c) a handle assembly including a first member and a second member axially movable relative to said first member, said second member being provided with a surface which frictionally engages said roller of said control member and said second member being movable relative to said control member,

said first member being coupled to said tubular member and said second member being coupled to said proximal end of said control member,

wherein when said second member is moved relative to said control member, said surface moves relative to said roller and causes rotation of said roller and said control member.

36. A surgical instrument according to claim 35, wherein:

said second member is pivotably movable relative to said control member.