Endoscopic surgical instrument with a handle that can articulate with respect to the shaft

• US 9,289,225 B2
• Filed: 06/22/2010
• Issued: 03/22/2016
• 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.
• Primary Examiner(s): ROANE, AARON F
• Application Number:
  US12/820,820
• Publication Number:
  US 20100305552A1
• Time in Patent Office: 2,100 Days
• Field of Search: 606/1, 606 49- 52, 606/205, 606/206
• 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 said 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, the trocar having an insertion end portion and a proximal end portion;

an elongated shaft assembly coupled to said end effector, said elongated shaft assembly defining a longitudinal axis, said elongated shaft assembly having a distal portion adjacent to said end effector for insertion into the trocar with said end effector, 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 midpoint;

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

a rotary drive shaft assembly configured to actuate said end effector, wherein said rotary drive shaft assembly is rotatable along said longitudinal axis with respect to said control handle and said end effector, said drive shaft assembly comprising;

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

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

a non-translatable articulation joint comprising a torsion cable coupled between said non-contourable distal drive shaft portion and said non-contourable proximal drive shaft portion to enable said non-contourable proximal drive shaft portion to articulate relative to said non-contourable distal drive shaft portion when said handle is articulated relative to said elongated shaft assembly, wherein said non-translatable articulation joint is positioned proximally with respect to said midpoint of said elongated shaft assembly and proximally with respect to the proximal end of the trocar, and wherein said non-translatable articulation joint is configured to permit said control handle to pivot with respect to said non-contourable distal drive shaft portion.

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; and

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, wherein said non-translatable articulation joint is 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 non-translatable articulation joint comprises:

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

a first lower tab protruding from said first 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 portion of said distal shaft segment;

a second lower tab protruding from said second proximal end portion 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 4 wherein said elongated shaft assembly has an elongated shaft axis and wherein said non-translatable articulation joint is constructed to permit said distal shaft segment to pivot about at least one pivot axis relative to said proximal shaft segment.

6. The surgical instrument of claim 5 wherein said first upper pin and said first lower pin are aligned to define a first pivot axis 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 transverse to said elongated shaft axis.

7. The surgical instrument of claim 2 wherein said torsion cable is located within said non-translatable articulation joint coupling said proximal shaft segment to said distal shaft segment.

8. The surgical instrument of claim 7 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 non-contourable 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 non-contourable distal drive shaft portion therein.

9. The surgical instrument of claim 8 wherein said non-translatable 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 non-contourable distal drive shaft portion and a distal end of said non-contourable proximal drive shaft portion;

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

10. The surgical instrument of claim 8 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.

11. The surgical instrument of claim 10 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.

12. The surgical instrument of claim 11 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.

13. The surgical instrument of claim 1 wherein said non-translatable articulation joint comprises a universal joint.

14. The surgical instrument of claim 1 wherein said non-translatable articulation joint comprises:

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

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

15. 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.

16. The surgical instrument of claim 15 wherein said non-translatable articulation joint comprises:

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

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

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

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

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

19. A surgical instrument, comprising:

an end effector sized to be inserted through a trocar, the trocar having an insertion end portion and a proximal end portion;

a 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, 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 midpoint; and

means for controlling said end effector articulatably coupled to said proximal portion of said elongated shaft assembly, said means for controlling comprising a non-contourable distal drive shaft configured to apply at least one rotary control motion to the end effector, said non-contourable distal drive shaft operably coupled to a non-contourable proximal drive shaft by a torsion cable configured to transmit rotary control motions from the non-contourable proximal drive shaft to the non-contourable distal drive shaft while facilitating selective articulation of the non-contourable distal drive shaft relative to the non-contourable proximal drive shaft, wherein said means for controlling said end effector is positioned proximally with respect to said midpoint of said elongated shaft assembly and proximally with respect to the proximal end of the trocar, and wherein said means for controlling said end effector comprise a non-translatable pivot axis.

20. 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 rigid 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 rigid 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 rigid 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 rigid proximal hollow shaft segment;

a first lower tab protruding from said first distal end of said rigid 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 rigid distal hollow shaft segment;

a second lower tab protruding from said second proximal end of said rigid 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 rigid proximal hollow shaft segment and protruding from said first distal end thereof;

a distal spine segment extending through said rigid 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 rigid distal hollow shaft segment such that said rigid distal hollow shaft segment can be selectively axially moved relative to said distal spine segment;

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

a non-contourable 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 torsion cable coupled between said non-contourable distal drive shaft portion and said non-contourable proximal drive shaft portion to enable said non-contourable proximal drive shaft portion to articulate relative to said non-contourable distal drive shaft portion about a non-translatable pivot axis when said control handle is articulated relative to said distal shaft segment.

21. The surgical instrument of claim 20 further comprising a drive shaft articulation joint, 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 non-contourable distal drive shaft portion and a distal end of said non-contourable proximal drive shaft portion;

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

22. The surgical instrument of claim 20 further comprising a non-translatable drive shaft articulation joint, wherein said non-translatable drive shaft articulation joint comprises a universal joint.

23. The surgical instrument of claim 20 further comprising means supported on said instrument for selectively locking said rigid proximal hollow shaft segment in a desired position relative to said rigid distal hollow shaft segment.

24. A surgical instrument, comprising:

an end effector sized and configured to be inserted through a trocar, the trocar comprising an insertion end, a proximal end, and a trocar length extending between the insertion end and the proximal end;

a rotatable drive shaft configured to actuate said end effector, said rotatable drive shaft defining a longitudinal axis, wherein said rotatable drive shaft is rotatable along said longitudinal axis with respect to said end effector, said rotatable drive shaft comprising;

a non-contourable distal end, wherein said end effector extends from said non-contourable distal end; and

a non-articulating portion comprising a non-articulating shaft length which is at least as long as the trocar length;

a handle configured to operate said end effector; and

a non-translatable articulation joint, wherein said handle is rotatably connected to said shaft about said articulation joint.