Surgical instrument

• US RE38,335 E1
• Filed: 03/28/2000
• Issued: 11/25/2003
• Est. Priority Date: 05/24/1994
• Status: Expired due to Term

• Current Assignee: Zimmer Spine, Inc. (Zimmer Biomet Holdings, Inc.)
• Original Assignee: Endius Incorporated (Zimmer Biomet Holdings, Inc.)
• Inventors: Taylor, Timothy E., Aust, Gilbert M.
• Primary Examiner(s): Milano, Michael J.
• Assistant Examiner(s): DAVIS, DANIEL J
• Application Number:
  US09/538,856
• Time in Patent Office: 1,337 Days
• Field of Search: 606/1, 606/51, 606/52, 606/174, 606/205-210, 600/564
• US Class Current: 606/170
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 17/2909 Handles
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/00314 Separate linked members
• CPC Class Codes: A61B 2017/2905 flexible
• CPC Class Codes: A61B 2017/2927 the angular position of the head being adjustable with respect to the shaft
• CPC Class Codes: A61B 2017/2929 with a head rotatable about the longitudinal axis of the shaft
• CPC Class Codes: A61B 2017/2939 Details of linkages or pivot points
• CPC Class Codes: A61B 2017/3445 used as instrument channel for multiple instruments catheters A61B2017/22072
• CPC Class Codes: A61B 34/70 Manipulators specially adapted for use in surgery
• CPC Class Codes: A61B 34/71 Manipulators operated by drive cable mechanisms
• CPC Class Codes: A61M 2025/015 Details of the distal fixation of the movable mechanical means
• CPC Class Codes: A61M 25/0138 having flexible regions as a result of weakened outer material, e.g. slots, slits, cuts, joints or coils
• CPC Class Codes: A61M 25/0147 with movable mechanical means, e.g. pull wires

Abstract

A surgical instrument includes a handle, a first stem section having a longitudinal axis and extending from the handle, and a tissue engaging member for engaging tissue. A second stem section, connected between the first stem section and the tissue engaging member, has a portion which is bendable and supports the tissue engaging member for movement between a plurality of orientations relative to the axis and to the first stem section. The surgical instrument includes a system for bending the bendable portion of the second stem section to change the orientation of the tissue engaging member relative to the axis and to the first stem section from a first orientation to a second orientation. The bendable portion of the second stem section includes a member for enabling bending movement of the bendable portion to locate the tissue engaging member at the same angle relative to the longitudinal axis of the first stem section at more than one location along the length of the bendable portion.

Claims

1. A surgical instrument comprising:

a manually engageable handle;

a first stem section having a longitudinal axis and extending from said handle;

tissue engaging means for engaging tissue, said tissue engaging means including at least a first tissue engaging member;

a second stem section connected between said first stem section and said tissue engaging means, said second stem section having at least a portion which is bendable, said second stem section supporting said tissue engaging means for movement between a plurality of orientations relative to said axis and to said first stem section;

means for supporting said first tissue engaging member on said bendable portion of said second stem section; and

means for bending said bendable portion of said second stem section to change the orientation of said tissue engaging means relative to said axis and to said first stem section from a first orientation to a second orientation;

said bendable portion of said second stem section comprising means for enabling bending movement of said bendable portion to locate said tissue engaging means at the same angle relative to said longitudinal axis of said first stem section at more than one location along the length of said bendable portion.

2. A surgical instrument as set forth in claim 1 wherein said bendable portion of said second stem section comprises means for enabling bending movement of said bendable portion to locate said tissue engaging means at an angle of 90°

relative to said longitudinal axis of said first stem section at more than one location along the length of said bendable portion.

3. A surgical instrument as set forth in claim 1 wherein said bendable portion of said second stem section comprises a plurality of independently movable links and said means for enabling bending movement comprises a plurality of pivot joints, each one of said pivot joints defining a respective pivot axis, each one of said pivot joints interconnecting a pair of adjacent ones of said plurality of links for relative pivotal movement about a respective pivot axis, all of said pivot axes extending generally parallel to each other.

4. A surgical instrument as set forth in claim 3 wherein each one of said links comprises a rigid member having at least one pivot pin which is received in a socket of an adjoining link, said pivot pins and said sockets defining said pivot joints.

5. A surgical instrument as set forth in claim 3 further comprising a tubular stabilizing member extending axially within said links, said means for bending comprising means extending along said tubular stabilizing member and connected with said tissue engaging means for transmitting force to said tissue engaging means to change the orientation of said tissue engaging means relative to said axis and to said first stem section.

6. A surgical instrument as set forth in claim 5 wherein said tubular stabilizing member comprises a coil spring.

7. A surgical instrument as set forth in claim 5 wherein said tubular stabilizing member comprises a metal tube.

8. A surgical instrument as set forth in claim 7 wherein said metal tube is made from a superelastic nickel-titanium alloy.

9. A surgical instrument as set forth in claim 5 wherein said tubular stabilizing member is made from metal and further comprising a cylindrical plastic tube which is coaxially extensive with and disposed radially outwardly of said metal tubular stabilizing member.

10. A surgical instrument as set forth in claim 3 further comprising a tubular plastic stabilizing member extending axially within said links, said means for bending comprising at least one deflection control wire which is disposed radially outward of said tubular plastic member.

11. A surgical instrument as set forth in claim 1 wherein said handle includes a first member which is manually engageable to transmit force to said bendable portion of said second stem section to bend said bendable portion and a second member which is manually engageable to transmit force to said tissue engaging means to engage tissue with said tissue engaging means.

12. A surgical instrument as set forth in claim 11 wherein said handle has a pistol-grip configuration.

13. A surgical instrument as set forth in claim 11 wherein said handle has a screwdriver-grip configuration.

14. A surgical instrument as set forth in claim 1 wherein said tissue engaging means comprises a curet.

15. A surgical instrument as set forth in claim 1 wherein said tissue engaging means comprises a probe.

16. A surgical instrument as set forth in claim 1 wherein said tissue engaging means comprises a knife.

17. A surgical instrument as set forth in claim 1 wherein said tissue engaging means comprises platform means for interchangeably receiving a selected one of a plurality of removable tools such as a curet, a probe, or a knife.

18. A surgical instrument as set forth in claim 1 wherein said tissue engaging means comprises a second tissue engaging member which is pivotally movable relative to said first tissue engaging member to engage tissue between said first and second tissue engaging members when said tissue engaging means is in an orientation between 0°

and 180°

to said longitudinal axis of said first stem section at any selected location along the length of said bendable portion.

19. A surgical instrument as set forth in claim 17 wherein said tissue engaging means comprises a pituitary rongeur.

20. A surgical instrument as set forth in claim 18 wherein said tissue engaging means comprises a tool selected from the group consisting of scissors, forceps, and basket cutter.

21. A surgical instrument as set forth in claim 1 wherein said means for enabling bending movement comprises means for selectively providing a predetermined first degree of bending resistance of said bendable portion at a first location along the length of said bendable portion and for selectively providing a predetermined second degree of bending resistance of said bendable portion at a second location along the length of said bendable portion, said second degree of bending resistance being greater than said first degree of bending resistance.

22. A surgical instrument as set forth in claim 1 wherein said bendable portion of said second stem section comprises a tubular plastic body portion having surface indentations located at predetermined locations spaced apart along the length of said plastic body portion for decreasing the bending resistance of said plastic body portion at said predetermined locations.

23. A surgical instrument as set forth in claim 22 wherein said tubular plastic body portion has an inner peripheral surface defining an axially extending central passage, said bendable portion of said second stem section further comprising a resilient metal tube longitudinally co-extensive with said plastic body portion and disposed within said central passage in said plastic body portion.

24. A surgical instrument as set forth in claim 23 wherein said metal tube is made from a superelastic nickel-titanium alloy.

25. A surgical instrument as set forth in claim 22 wherein said surface indentations comprise at least a first set of surface indentations having a first configuration for providing a first degree of bending resistance at the location of said first set of surface indentations and a second set of surface indentations having a second configuration different from said first configuration for providing a second degree of bending resistance at the location of said second set of surface indentations, said second degree of bending resistance being greater than said first degree of bending resistance.

26. A surgical instrument as set forth in claim 1 wherein said bendable portion comprises a tubular plastic member having an inner side surface defining an axially extending central passage and having an outer side surface, a first resilient metal tube overlying said outer side surface of said tubular plastic member, and a second resilient metal tube disposed within said central passage in said tubular plastic member.

27. A surgical instrument as set forth in claim 26 wherein said each one of said first and second resilient metal tubes is made from a superelastic nickel-titanium alloy.

28. A surgical instrument as set forth in claim 27 wherein said second resilient metal tube defines a passage extending along said longitudinal central axis of said surgical instrument, said surgical instrument further comprising means extending through said passage in said second resilient metal tube and connected with said tissue engaging means for transmitting force to said tissue engaging means to engage tissue with said tissue engaging means.

29. A surgical instrument as set forth in claim 27 further comprising control wire means extending within said first resilient metal tube and connected with said tissue engaging means for transmitting force to said tissue engaging means to change the orientation of said tissue engaging means relative to said axis and to said first stem section.

30. A surgical instrument as set forth in claim 1 wherein said bendable portion of said second stem section comprises:

a tubular plastic body portion having an outer side surface and an axially extending central passage; and

a resilient metal tube overlying said outer side surface of said plastic body portion, said resilient metal tube being configured as a helical coil spring.

31. A surgical instrument as set forth in claim 30 wherein said resilient metal tube is made from a superelastic nickel-titanium alloy.

32. A surgical instrument as set forth in claim 30 wherein said helical coil spring is made from an elongate metal member having a rectangular cross sectional configuration.

33. A surgical instrument as set forth in claim 30 wherein said resilient metal tube comprises means for providing a first degree of bending resistance of said resilient metal tube at a first location along the length of said bendable portion of said second stem section and for providing a second degree of bending resistance of said resilient metal tube at a second location along the length of said bendable portion of said second stem section, said second degree of bending resistance being greater than said first degree of bending resistance.

34. A surgical instrument as set forth in claim 1 wherein said bendable portion of said second stem section comprises a tubular plastic body portion having an outer side surface and a resilient metal tube overlying said outer side surface of said plastic body portion, said means for enabling bending movement comprising a series of slots which are formed in said resilient metal tube and which divide said resilient metal tube member into a series of link portions which are spaced along the length of said bendable portion of said second stem section.

35. A surgical instrument as set forth in claim 34 wherein said series of slots comprises at least a first set of slots having a first configuration for providing a first degree of bending resistance of said resilient metal tube at the location of said first set of slots and a second set of slots having a second configuration different from said first configuration for providing a second degree of bending resistance of said resilient metal tube at the location of said second set of slots, said second degree of bending resistance being greater than said first degree of bending resistance.

36. A surgical instrument as set forth in claim 35 wherein each one of said first set of slots has a first predetermined extent along the length of said bendable portion of said second stem section and each one of said second set of slots has a second predetermined extent along the length of said bendable portion of said second stem section which is less than said first predetermined extent.

37. A surgical instrument as set forth in claim 34 wherein said link portions have predetermined different lengths along the length of said bendable portion of said second stem section to vary the bending resistance of said resilient metal tube.

38. A surgical instrument as set forth in claim 1 further comprising a pull wire extending in a passage through said first stem section and said second stem section, said pull wire transmitting force from said handle to said tissue engaging means to engage tissue with said tissue engaging means.

39. A surgical instrument as set forth in claim 1 further comprising a push rod extending in a passage through said first stem section and said second stem section, said push rod transmitting force from said handle to said tissue engaging means to engage tissue with said tissue engaging means.

40. A surgical instrument comprising:

a manually engageable handle;

a first stem section having a longitudinal axis and extending from said handle;

tissue engaging means for engaging tissue, said tissue engaging means including at least a first tissue engaging member;

a second stem section connected between said first stem section and said tissue engaging means, said second stem section having at least a portion which is bendable, said second stem section supporting said tissue engaging means for movement between a plurality of orientations relative to said axis and to said first stem section;

means for supporting said tissue engaging means on said bendable portion of said second stem section; and

means for bending said bendable portion of said second stem section to change the orientation of said tissue engaging means relative to said axis and to said first stem section from a first orientation to a second orientation, said means for bending including a plurality of elongate control members extending axially along said first and second stem sections;

said movable portion of said second stem section comprising;

a resilient inner tubular member defining a central passage in said second stem section through which said elongate actuator member extends, said inner tubular member being made from a superelastic metal;

a flexible outer tubular member coaxial with and disposed radially outward of said inner tubular member; and

passage means for defining a plurality of control member passages disposed radially between said inner tubular member and said outer tubular member, said elongate control members extending through said control member passages.

41. A surgical instrument comprising:

a manually engageable handle;

a first stem section having a longitudinal axis and extending from said handle;

tissue engaging means for engaging tissue, said tissue engaging means including at least a first tissue engaging member;

a second stem section connected between said first stem section and said tissue engaging means, said second stem section having at least a portion which is bendable, said second stem section supporting said tissue engaging means for movement between a plurality of orientations relative to said axis and to said first stem section;

means for supporting said first tissue engaging member on said bendable portion of said second stem section; and

means for bending said bendable portion of said second stem section to change the orientation of said tissue engaging means relative to said axis and to said first stem section from a first orientation to a second orientation;

said movable portion of said second stem section comprising a plurality of independently movable link portions and a plurality of pivot joints, each pivot joint defining a respective pivot axis, each pivot joint interconnecting a pair of adjacent ones of said plurality of link portions for relative pivotal movement about its respective pivot axis, all of said pivot axes extending generally parallel to each other.

42. A surgical instrument comprising:

a manually engageable handle;

a first stem section having a longitudinal axis and extending from said handle;

tissue engaging means for engaging tissue, said tissue engaging means including at least a first tissue engaging member;

a second stem section connected between said first stem section and said tissue engaging means, said second stem section having at least a portion which is bendable, said second stem section supporting said tissue engaging means for movement between a plurality of orientations relative to said axis and to said first stem section;

means for supporting said first tissue engaging member on said bendable portion of said second stem section; and

means for bending said bendable portion of said second stem section to move said tissue engaging means through an arcuate path between a plurality of orientations relative to said axis and to said first stem section;

said bendable portion of said second stem section comprising means for enabling bending movement of said bendable portion of said second stem section to move said tissue engaging means through a plurality of arcuate paths which are of different lengths and which are spaced apart from each other along said longitudinal axis.

43. A surgical instrument as set forth in claim 42 wherein said means for enabling bending movement comprises a plurality of joints which are spaced along the length of said bendable portion and at which said bendable portion is bendable to locate said tissue engaging means at the same angle relative to said longitudinal axis of said first stem section, at each one of said joints, each joint being bendable independently of the other said joint.

44. A surgical instrument as set forth in claim 43 wherein said joints comprise pivot joints interconnecting a plurality of links which form said bendable portion of said second stem section, each one of said pivot joints being bendable independently of the other ones of said pivot joints.

45. A surgical instrument as set forth in claim 43 wherein said joints comprise slots formed in a tubular outer member which is axially coextensive with said bendable portion of said second stem section.

46. A surgical instrument as set forth in claim 43 wherein said joints comprise recessed portions formed in a polymeric member which is axially coextensive with said bendable portion of said second stem section.

47. A surgical instrument as set forth in claim 42 wherein said means for enabling bending movement comprises means for enabling movement of said bendable portion of said second stem section, at more than one location along the length of said bendable portion, into a condition in which said bendable portion has a first segment extending parallel to said axis and a second segment which extends at an angle relative to said axis and to said first stem section.