Articulatable surgical device with rotary driven cutting member

• US 9,492,167 B2
• Filed: 03/14/2013
• Issued: 11/15/2016
• Est. Priority Date: 03/23/2006
• Status: Active Grant

• Current Assignee: Cilag Gmbh International (Johnson & Johnson)
• Original Assignee: Ethicon Endo-Surgery LLC (Johnson & Johnson)
• Inventors: Shelton, Frederick E. IV, Ortiz, Mark S.
• Primary Examiner(s): Weeks, Gloria R
• Application Number:
  US13/803,862
• Publication Number:
  US 20130197556A1
• Time in Patent Office: 1,342 Days
• Field of Search: 227/180.1
• US Class Current: 1/1
• CPC Class Codes: A61B 1/00042 for mechanical operation
• 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 17/068 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 17/32002 with continuously rotating, oscillating or reciprocating cutting instruments
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/0042 with special provisions for gripping
• 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 2017/2919 details of linkages or pivot points
• CPC Class Codes: A61B 2017/2927 the angular position of the head being adjustable with respect to the shaft
• CPC Class Codes: A61B 2017/2947 Pivots
• CPC Class Codes: A61B 2034/306 Wrists with multiple vertebrae
• CPC Class Codes: A61B 2090/372 Details of monitor hardware
• CPC Class Codes: A61B 90/37 Surgical systems with images on a monitor during operation

Abstract

Methods and devices are provided for controlling movement of a working end of a surgical device. In one embodiment, methods and devices are provided for moving an end effector on a distal end of a surgical fastening device. Movement can include rotational movement of the end effector about an axis of the shaft, articulation of the end effector relative to the shaft, and actuation of an end effector, e.g., closing, firing, and/or cutting. In other embodiments, a single cable actuator is provided and is movable between a first position, in which it is effective to rotate an end effector without actuating (i.e., closing and firing) the end effector, and a second position, in which it is effective to actuate the end effector without rotating the end effector. In other aspects, methods and devices are provided for moving a flexible neck formed on a distal end of an accessory channel for use with an endoscope. Movement of the flexible neck can be used to control positioning of a tool extending through the flexible neck.

Claims

1. A surgical device, comprising:

an elongate shaft operably coupled to an actuator arrangement, the elongate shaft defining a shaft axis and including a flexible shaft portion;

a flexible rotary drive member operably supported by the elongate shaft and defining a rotary drive axis, said flexible rotary drive member operably interfacing with a source of rotary actuation motions to selectively rotate said flexible rotary drive member about said rotary drive axis;

a surgical end effector operably coupled to a distal end of the elongate shaft, the surgical end effector comprising a tissue cutting member interfacing with the flexible rotary drive member and being movable within the end effector in response to an application of said rotary actuation motions to the flexible rotary drive member such that rotation of said flexible rotary drive member about said rotary drive axis in a first rotary direction causes said tissue cutting member to move in a distal direction from a proximal starting position toward a distal ending position and rotation of said rotary drive member about said rotary drive axis in a second rotary direction causes said tissue cutting member to move in a proximal direction from said distal ending position toward said proximal starting position; and

a plurality of flexible actuators operably interfacing with the flexible shaft portion such that selective actuation thereof causes articulation of the end effector relative to the shaft axis.

2. The surgical device of claim 1 wherein the end effector further comprises a pair of jaw members selectively movable between open and closed positions in response to an application of at least one actuation motion to at least one of the jaw members.

3. The surgical device of claim 1 wherein the end effector further comprises means for fastening tissue on each side of a cut line formed therein by the tissue cutting member.

4. The surgical device of claim 3 wherein the means for fastening comprises a plurality of surgical staples operably supported in a staple cartridge portion of the end effector.

5. The surgical device of claim 1 wherein the plurality of flexible actuators comprises a plurality of cables extending through the elongate shaft and operably interfacing with the actuator arrangement and the end effector.

6. The surgical device of claim 5 wherein the plurality of flexible actuators comprises:

a first flexible actuator operably coupled to one of the end effector and the flexible shaft portion and a first rotator portion of the actuator arrangement;

a second flexible actuator operably coupled to one of the end effector and the flexible shaft portion and a second rotator portion of the actuator arrangement;

a third flexible actuator operably coupled to one of the end effector and the flexible shaft portion and a third rotator portion of the actuator arrangement; and

a fourth flexible actuator operably coupled to one of the end effector and the flexible shaft portion and a fourth rotator portion of the actuator arrangement.

7. The surgical device of claim 6 wherein:

the first flexible actuator comprises a first actuator cable and wherein the first rotator portion comprises a first spool rotatably supported by the actuator arrangement;

the second flexible actuator comprises a second actuator cable and wherein the second rotator portion comprises a second spool rotatably supported by the actuator arrangement;

the third flexible actuator comprises a third actuator cable and wherein the third rotator portion comprises a third spool rotatably supported by the actuator arrangement; and

the fourth flexible actuator comprises a fourth actuator cable and wherein the fourth rotator portion comprises a fourth spool rotatably supported by the actuator arrangement.

8. The surgical device of claim 1 wherein the actuator arrangement is electrically powered.

9. The surgical device of claim 7 wherein the source of rotary actuation motions comprises a motor.

10. The surgical device of claim 1 wherein the flexible shaft portion of the elongate shaft comprises a flexible neck that is formed on a distal end of the elongate shaft.

11. The surgical device of claim 1 wherein the flexible shaft portion of the elongate shaft comprises a flexible neck formed on a proximal end of the end effector.

12. The surgical device of claim 1 wherein the flexible shaft portion of the elongate shaft comprises a separate flexible neck member located between the elongate shaft and the end effector.

13. The surgical device of claim 2 wherein the elongate shaft further comprises a gear and drive assembly configured to actuate the jaw members.

14. A surgical device, comprising:

an end effector including a tissue cutting member configured to be selectively axially moved within the end effector;

a hollow elongate shaft operably coupled to a handle and the end effector and extending therebetween, the hollow elongate shaft including a flexible shaft portion comprising a plurality of flexing portions and a plurality of restraining portions which cooperate to facilitate selective bending of the flexible shaft portion in two distinct planes; and

a rotary drive shaft extending through the hollow elongate shaft and defining a rotary drive axis, said rotary drive shaft operably interfacing with the tissue cutting member such that rotation of the rotary drive shaft about said rotary drive axis results in the axial movement of the tissue cutting member within the end effector such that rotation of said rotary drive shaft about said rotary drive axis in a first rotary direction causes said tissue cutting member to move from a proximal starting position in a distal direction toward a distal ending position and rotation of said rotary drive shaft about said rotary drive axis in a second rotary direction causes said tissue cutting member to move in a proximal direction from said distal ending position toward said proximal starting position.

15. The surgical device of claim 14 further comprising a plurality of flexible actuators operably interfacing with the flexible shaft portion such that selective actuation thereof causes selective bending of the flexible shaft portion in the two distinct planes.

16. The surgical device of claim 14 wherein the end effector further comprises a pair of jaw members selectively movable between open and closed positions in response to an application of at least one actuation motion to at least one of the jaw members.

17. The surgical device of claim 16 wherein the elongate shaft further comprises a gear and drive assembly configured to actuate the jaw members.

18. The surgical device of claim 14 wherein the end effector further comprises means for fastening tissue on each side of a cut line formed therein by the tissue cutting member.

19. The surgical device of claim 18 wherein the means for fastening comprises a plurality of surgical staples operably supported in a staple cartridge portion of the end effector.

20. The surgical device of claim 19 wherein the plurality of surgical staples are fired within the end effector as the tissue cutting member is axially advanced within the end effector.