JAW APERTURE POSITION SENSOR FOR ELECTROSURGICAL FORCEPS
20170215944 · 2017-08-03
Inventors
Cpc classification
A61B18/1445
HUMAN NECESSITIES
A61B90/06
HUMAN NECESSITIES
International classification
Abstract
A surgical instrument including a housing, a shaft, and end effector, and a sensor. The shaft extends distally from the housing. The end effector is disposed at a distal end of the shaft and includes first and second jaw members that are moveable relative between first and second configurations. The first and second jaw members are spaced relative to one another in the first configuration and are closer to one another for approximating tissue in the second configuration. A gap distance is defined between the first and second jaw members. The sensor is positioned within the housing and operable to determine the size of the gap distance. The first and second jaw members configured to be electrical activated to treat tissue between the first and second jaw members when the size of the gap distance is within an acceptable range.
Claims
1. A surgical instrument, comprising: a housing; a shaft extending distally from the housing; an end effector disposed at a distal end of the shaft and including first and second jaw members moveable relative to one another from a first configuration wherein the first and second jaw members are spaced relative to one another, to a second configuration wherein the first and second jaw members are closer to one another for approximating tissue, the first and second jaw members defining a gap distance therebetween; and a sensor positioned within the housing, the sensor operable to determine the size of the gap distance, wherein, if the size of the gap distance is within an acceptable range, the first and second jaw members are configured to be electrically activated to treat tissue between the first and second jaw members.
2. The surgical instrument according to claim 1, wherein the elongated shaft defines a longitudinal axis and is translatable along the longitudinal axis to move the first and second jaw members between the first and second configurations.
3. The surgical instrument according to claim 2, wherein a proximal end of the elongated shaft is longitudinally translatable within the housing, wherein the sensor is positioned adjacent the proximal end of the elongated shaft, and wherein the sensor detects the position of the proximal end of the elongated shaft relative to the housing to determine the size of the gap distance.
4. The surgical instrument according to claim 2, further comprising a drive assembly disposed within the housing and operatively associated with a moveable handle to longitudinally translate the elongated shaft.
5. The surgical instrument according to claim 4, wherein the drive assembly includes a tube having a distal end coupled to the proximal end of the elongated shaft and a proximal end positioned proximal to the moveable handle, the sensor positioned adjacent the proximal end of the tube and configured to detect the position of the proximal end of the tube relative to the housing to determine the size of the gap distance.
6. The surgical instrument according to claim 1, further comprising a drive rod slidably disposed within the elongated shaft and extending into the housing to a proximal end thereof, the drive rod defining a longitudinal axis and is translatable along the longitudinal axis to move the first and second jaws between the first and second configurations.
7. The surgical instrument according to claim 6, wherein the sensor is positioned adjacent the proximal end of the drive rod, the sensor detecting the position of the proximal end of the drive rod relative to the housing to determine the size of the gap distance.
8. The surgical instrument according to claim 6, further comprising a moveable handle operably associated with the drive rod to longitudinally translate the drive rod, the drive rod including a proximal drive plate and a distal drive plate, the moveable handle positioned between the proximal and distal drive plates.
9. The surgical instrument according to claim 8, wherein the sensor is positioned adjacent the proximal drive plate, the sensor detecting the position of the proximal drive plate relative to the housing to determine the size of the gap distance.
10. The surgical instrument according to claim 8, wherein the sensor is positioned adjacent the distal drive plate, the sensor detecting the position of the distal drive plate relative to the housing to determine the size of the gap distance.
11. The surgical instrument according to claim 1, wherein the sensor is configured to provide feedback of the size of the gap distance.
12. The surgical instrument according to claim 1, wherein the first and second jaw members are configured to deliver electrosurgical energy to tissue between the first and second jaw members, and wherein the sensor is configured to provide feedback when the size of the gap distance is suitable for applying electrosurgical energy to tissue.
13. The surgical instrument according to claim 1, wherein the sensor is at least one of optical, magnetic, inductive, or mechanical.
14. A method of determining the size of a gap distance of a surgical instrument, the method comprising: positioning the first and second jaw members of the surgical instrument over tissue such that the tissue is positioned between the first and second jaw members; determining the size of the gap distance of the surgical instrument with a sensor positioned remote to the first and second jaw members; and activating the first and second jaw members to deliver electrosurgical energy to the tissue positioned between the first and second jaw members when the size of the gap distance is in an acceptable range.
15. The method according to claim 14, further comprising pivoting a first handle of the surgical instrument towards a second handle of the surgical instrument to move the first and second jaw members towards one another.
16. The method according to claim 14, wherein determining the size of the gap distance includes detecting the position of a proximal end of a shaft relative to a housing of the surgical instrument with the sensor, the shaft extending distally from the housing with the first and second jaw members positioned at a distal end of the shaft, the sensor being positioned within the housing.
17. The method according to claim 14, wherein determining the size of the gap distance includes detecting the position of a drive rod within a housing of the surgical instrument, the drive rod extending through and slidably within an elongated shaft extending distally from the housing, the first and second jaw members positioned at a distal end of the elongated shaft.
18. The method according to claim 17, wherein detecting the position of the drive rod within the housing of the surgical instrument includes detecting a position of a proximal end of the drive rod relative to the housing with the sensor, the sensor positioned within the housing adjacent the proximal end of the drive rod.
19. The method according to claim 14, further comprising providing feedback when the size of the gap distance is suitable for delivering electrosurgical energy to the tissue between the first and second jaw members of the surgical instrument.
20. The method according to claim 14, further comprising optically, magnetically, inductively, or mechanically detecting a position of a component of the surgical instrument remote to the first and second jaw members to determine the size of the gap distance with the sensor.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0025] Various aspects of the present disclosure are described hereinbelow with reference to the drawings, which are incorporated in and constitute a part of this specification, wherein:
[0026]
[0027]
[0028]
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[0036]
DETAILED DESCRIPTION
[0037] Embodiments of the present disclosure are now described in detail with reference to the drawings in which like reference numerals designate identical or corresponding elements in each of the several views. As used herein, the term “clinician” refers to a doctor, a nurse, or any other care provider and may include support personnel. Throughout this description, the term “proximal” refers to the portion of the device or component thereof that is closest to the clinician and the term “distal” refers to the portion of the device or component thereof that is farthest from the clinician.
[0038] This disclosure relates generally to position sensors positioned in or on the body of an electrosurgical forceps to determine a gap distance or jaw aperture defined between jaw members of the electrosurgical forceps. The position sensor may sense the position of a closure tube that correlates to the jaw aperture, may sense the position of a push rod, or may sense the position or angle of a flag attached adjacent a distal end of the electrosurgical forceps to determine the jaw aperture. The position sensor may also provide feedback (e.g., audible, tactile, or visual) to a clinician when the gap distance between jaw members is in an acceptable range suitable for sealing tissue between the jaw members with electrosurgical energy. The acceptable range for the gap distance to seal tissue is about 0.001 inches to about 0.006 inches. In addition, the position sensor may be in communication with an energy activation circuit to prevent delivery of electrosurgical energy when the gap distance is beyond a predetermined limit (i.e., above the acceptable range).
[0039] Referring now to
[0040] The forceps 10 includes a shaft 12 that defines a longitudinal axis “A-A” of the forceps 10 and has a proximal end 14 (
[0041] Forceps 10 also includes an electrosurgical cable 18 that connects the forceps 10 to a source of electrosurgical energy, e.g., a generator 19. The source of electrosurgical energy provides electrosurgical energy to the end effector 70 of the forceps 10. It is also contemplated that the forceps 10 may include an energy source (e.g., a battery (not shown)) and an electrosurgical generator (not shown) positioned on or within the housing 20 to provide electrosurgical energy to the forceps 10.
[0042] Referring to
[0043] The moveable handle 34 has an upper end 35 that is pivotally secured within the housing 20 and engaged with a drive assembly 40 of the forceps 10. The drive assembly 40 includes a tube 42, a proximal drive plate 44, and a distal drive plate 46. The tube 42 has a proximal end 43a that passes through the proximal and distal drive plates 44, 46 and a distal end 43b that passes through the rotating assembly 50. The distal end 43b of the tube 42 is coupled to the proximal end 14 of the shaft 12 to translate the shaft 12 along the longitudinal axis “A-A”.
[0044] The proximal drive plate 44 is coupled to the proximal end 43a of the tube 42 to translate the tube 42 along the longitudinal axis “A-A”. A first biasing member 45 is positioned between the proximal drive plate 44 and the housing 20 to urge the proximal drive plate 44 distally such that the first and second jaw members 72, 74 of the end effector assembly 70 are biased in the open configuration (
[0045] With additional reference to
[0046] The first and second biasing members 45, 47 are calibrated to limit closure force of the first and second jaw members 72, 74 of the end effector assembly 70. When a small vessel, or amount of tissue, or a large compressible vessel, or amount of tissue, is positioned within a jaw aperture 75 (i.e., between the first and second jaw members 72, 74), a closure force of the first and second jaw members 72, 74 is small such that the handle force is greater than or equal to the clamping force to allow the first and second jaw members 72, 74 to move to an activatable configuration as shown in
[0047] With reference to
[0048] With particular reference to
[0049] Referring now to
[0050] A drive assembly 140 of the forceps 110 includes a drive rod 142, a proximal drive plate 144, and a distal drive plate 146. The drive rod 142 is translatable along the longitudinal axis “A-A” defined by a shaft 112 to move first and second jaw members 172, 174 of an end effector assembly 170 between an open configuration (
[0051] The proximal drive plate 144 is coupled to the drive rod 142 adjacent the proximal end 143a of the drive rod 142. The distal drive plate 146 is coupled to the drive rod 142 distal of the proximal drive plate 144. A moveable handle 134 includes a plunger 136 (
[0052] As the moveable handle 134 is pivoted towards an approximated or closed position (
[0053] As gap distance is reduced, the first and second jaw members 172, 174 engage a vessel or tissue positioned therebetween. As the first and second jaw members 172, 174 engage a vessel or tissue, the vessel or tissue resists movement of the first and second jaw members 172, 174 towards an activatable configuration such that a closure force is required to move the first and second jaw members 172, 174 towards the activatable configuration. The clamping force is the sum of the closure force exerted by tissue positioned within the jaw aperture 175 and mechanical resistance to moving the first and second jaw members 172, 174 towards an activatable configuration. If the clamping force is less than the handle force, the proximal drive plate 144 is moved proximally to translate the drive rod 142 proximally and to move the first and second jaw members 172, 174 towards an activatable configuration until the moveable handle 134 is in the approximated or closed position and the first and second jaw members 172, 174 are in an activatable configuration as shown in
[0054] With continued reference to
[0055] In a fully open configuration of the first and second jaw members 172, 174 (
[0056] With particular reference to
[0057] With reference to
[0058] Referring now to
[0059] The pivot 260 passes through the shafts 221, 241 between the handles 224, 244 and the jaw members 228, 248. The first member 220 includes an electrosurgical cable 18 that connects the forceps 210 to a source of electrosurgical energy. Additionally or alternatively, the second member 240 may include an electrosurgical cable (not shown) that connects the forceps 210 to a source of electrosurgical energy.
[0060] The shafts 221, 241 are designed to transmit a particular closure force to the jaw members 228, 248 as the shafts 221, 241 are pivoted towards the closed configuration. In particular, the shafts 221, 241 effectively act together in a spring-like manner (i.e., bending that behaves like a spring) such that the length, width, height, and deflection of the shafts 221, 241 directly effects the closure force imposed by jaw members 228, 248. The jaws 228 and 248 are more rigid than the shafts 221, 241 such that strain energy stored in the shafts 221, 241 provides a constant closure force between the jaw members 228, 248 in response to a handle force applied to the handles 224, 244.
[0061] With additional reference to
[0062] Continuing to refer to
[0063] When the handles 224, 244 are in the approximated or closed position, the amount of flexation of the shaft 241 correlates to the gap distance between the jaw members 228, 248. The flexation of the shaft 241 is measurable by determining a change in a distance D between a fixed point 280 on the proximal end portion 242 of the second member 240 and the free end 274 of the flag 270 in the open configuration and a distance D′ or D″ between the fixed point 280 and the free end 274 in the approximated configuration.
[0064] As shown in
[0065] When a large amount of tissue is positioned within the jaw aperture 266, the shaft 241 of the second member 240 flexes as the handles 224, 244 are moved to the approximated or closed position and the jaw members 228, 248 remain in a generally open configuration such that a distance D″ is defined between the fixed point 280 and the free end 274 in response to the handle force and the closure force as shown in
[0066] Similar to the forceps 10 and 110 detailed above, when the jaw members 228, 248 are in an activatable configuration (
[0067] Continuing to refer to
[0068] As shown, the deflection flag 270 is substantially linear between the first and second ends 272, 274; however, the deflection flag 270 may be curved or have non-linear portion between the fixed end 272 and the free end 274.
[0069] The various embodiments disclosed herein may also be configured to work with robotic surgical systems and what is commonly referred to as “Telesurgery.” Such systems employ various robotic elements to assist the surgeon and allow remote operation (or partial remote operation) of surgical instrumentation. Various robotic arms, gears, cams, pulleys, electric and mechanical motors, etc. may be employed for this purpose and may be designed with a robotic surgical system to assist the surgeon during the course of an operation or treatment. Such robotic systems may include remotely steerable systems, automatically flexible surgical systems, remotely flexible surgical systems, remotely articulating surgical systems, wireless surgical systems, modular or selectively configurable remotely operated surgical systems, etc.
[0070] The robotic surgical systems may be employed with one or more consoles that are next to the operating theater or located in a remote location. In this instance, one team of surgeons or nurses may prep the patient for surgery and configure the robotic surgical system with one or more of the instruments disclosed herein while another surgeon (or group of surgeons) remotely control the instruments via the robotic surgical system. As can be appreciated, a highly skilled surgeon may perform multiple operations in multiple locations without leaving his/her remote console which can be both economically advantageous and a benefit to the patient or a series of patients.
[0071] The robotic arms of the surgical system are typically coupled to a pair of master handles by a controller. The handles can be moved by the surgeon to produce a corresponding movement of the working ends of any type of surgical instrument (e.g., end effectors, graspers, knifes, scissors, etc.) which may complement the use of one or more of the embodiments described herein. The movement of the master handles may be scaled so that the working ends have a corresponding movement that is different, smaller or larger, than the movement performed by the operating hands of the surgeon. The scale factor or gearing ratio may be adjustable so that the operator can control the resolution of the working ends of the surgical instrument(s).
[0072] The master handles may include various sensors to provide feedback to the surgeon relating to various tissue parameters or conditions, e.g., tissue resistance due to manipulation, cutting or otherwise treating, pressure by the instrument onto the tissue, tissue temperature, tissue impedance, etc. As can be appreciated, such sensors provide the surgeon with enhanced tactile feedback simulating actual operating conditions. The master handles may also include a variety of different actuators for delicate tissue manipulation or treatment further enhancing the surgeon's ability to mimic actual operating conditions.
[0073] Referring initially to
[0074] Each of the robot arms 1002, 1003 may include a plurality of members, which are connected through joints, and an attaching device 1009, 1011, to which may be attached, for example, a surgical tool “ST” supporting an end effector 1100, in accordance with any one of several embodiments disclosed herein, as will be described in greater detail below.
[0075] Robot arms 1002, 1003 may be driven by electric drives (not shown) that are connected to control device 1004. Control device 1004 (e.g., a computer) may be set up to activate the drives, in particular by means of a computer program, in such a way that robot arms 1002, 1003, their attaching devices 1009, 1011 and thus the surgical tool (including end effector 1100) execute a desired movement according to a movement defined by means of manual input devices 1007, 1008. Control device 1004 may also be set up in such a way that it regulates the movement of robot arms 1002, 1003 and/or of the drives.
[0076] Medical work station 1000 may be configured for use on a patient 1013 lying on a patient table 1012 to be treated in a minimally invasive manner by means of end effector 1100. Medical work station 1000 may also include more than two robot arms 1002, 1003, the additional robot arms likewise being connected to control device 1004 and being telemanipulatable by means of operating console 1005. A medical instrument or surgical tool (including an end effector 1100) may also be attached to the additional robot arm. Medical work station 1000 may include a database 1014, in particular coupled to with control device 1004, in which are stored, for example, pre-operative data from patient/living being 1013 and/or anatomical atlases.
[0077] While several embodiments of the disclosure have been shown in the drawings, it is not intended that the disclosure be limited thereto, as it is intended that the disclosure be as broad in scope as the art will allow and that the specification be read likewise. Any combination of the above embodiments is also envisioned and is within the scope of the appended claims. Therefore, the above description should not be construed as limiting, but merely as exemplifications of particular embodiments. Those skilled in the art will envision other modifications within the scope of the claims appended hereto.