Abstract
An automated control, a switch and automated actuator for spring-based end effectors of a medical instrument to be used by a single operator without assistance for multiple biopsy, clipping, clamping, grasping, snaring, cutting, dissecting or other operative functions with electrical connections for cautery or hot biopsy used independently or combined with a rigid or flexible endoscope of any size. The actuator may be a spring(s), gear(s), electrical solenoid or motor, air or hydraulic pressure activated piston or a combination thereof. Automated action may be initiated by a voice, hand or foot operated switch. The actuator may be disposable, attached to or separable from the end effector or permanently attached to be reusable. The actuator and end effector may be disposable, attached to or separable from the endoscope or permanently attached to be reusable. The automated device may be incorporated into an endoscope or attached to the outside.
Claims
1. An automated operative instrument, comprising: an endoscope having a shaft with an instrument channel; a handle on one end of the endoscope; a spring-based end effector for biopsy, clipping, clamping, grasping, snaring, dissecting or cutting, said end effector being connected to the endoscope and being disposed outside the endoscope; and an automated control comprising a switch and actuator device connected to the end effector and being adapted to operate the end effector without an assistant or the use of the operator's hands; wherein operating the switch causes the actuator device to cause the spring arms or housing to move the spring arms out of a housing and open the spring arms, or to bring the spring arms within the housing by moving the spring arms or housing, which causes the spring arms to be pushed closed by interior walls of the housing.
2. The operative instrument according to claim 1, further comprising a removable and replaceable shaft, wherein the switch and automated actuator device are connected to said end effector through said removable and replaceable shaft.
3. The operative instrument according to claim 1, wherein the actuator device is separable from the endoscope and the end effector, and is reusable.
4. The operative instrument according to claim 1, wherein the end effector is separable from the automated actuator or endoscope and is replaceable.
5. The operative instrument according to claim 1, wherein the actuator device and/or spring based end effector is attached to a cover of the endoscope and is removable and replaceable, and wherein the switch and actuator device are connected to the end effector by an actuator wire passing down an exterior of the endoscope shaft to the end effector.
6. The operative instrument according to claim 1, wherein the end effector is connected to the automated control device via an actuator wire running through the endoscope shaft.
7. The operative instrument according to claim 1, wherein the automated actuator device is incorporated into a distal section of the endoscope.
8. The operative instrument according to claim 1, wherein the actuator is attached to an outside of the endoscope.
9. The operative instrument according to claim 1, wherein the switch mechanism is selected from the group consisting of a foot switch, a switch on the shaft or handle, and a voice activated switch.
10. The operative instrument according to claim 1, further comprising a removable and replaceable biopsy cassette mounted within the spring based end effector such that biopsies collected by the end effector are automatically fed into the biopsy cassette in the order of acquisition.
11. The operative instrument according to claim 1, wherein the actuator device is selected from the group consisting of a spring(s), electrical solenoid, electric motor, air or hydraulic pressure activated piston, gear(s), and a combination thereof.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0028] Other objects and features of the present invention will become apparent from the following detailed description considered in connection with the accompanying drawings. It is to be understood, however, that the drawings are designed as an illustration only and not as a definition of the limits of the invention.
[0029] FIG. 1 shows a side view of one embodiment of an end effector assembly according to the invention;
[0030] FIG. 2 shows an exploded view of the end effector assembly shown in FIG. 1;
[0031] FIG. 3 shows a longitudinal view of a spring-based multiple biopsy end effector assembly with the jaws fully extended to the actuator stop for biopsy;
[0032] FIG. 3a shows the end effector assembly of FIG. 3 capturing multiple biopsies and placing them in a removable biopsy cassette;
[0033] FIG. 4 shows a longitudinal view of a spring-based multiple biopsy end effector assembly fully retracted to the housing stop to move the specimen(s) into the storage housing;
[0034] FIG. 5 shows a longitudinal view of an endoscope with an automated switch and actuator device connected outside the endoscope handle and of a disposable replaceable multiple biopsy end effector passed through an endoscopic operative device instrument channel;
[0035] FIG. 6 shows a longitudinal view of an automated switch and actuator mechanism connected to the distal segment of an endoscope via a separate shaft to operate a removable replaceable multiple biopsy end effector that is disposed outside the endoscope;
[0036] FIG. 7 shows a longitudinal view of the endoscope having an automated switch and actuator mechanism disposed within the handle with a separable shaft and a removable replaceable spring-based end effector;
[0037] FIG. 8 shows a longitudinal view of an endoscope with an switch and electrical connection in the endoscope handle passing within the endoscope shaft to operate an automated actuator device and end effector in the distal segment of an endoscope;
[0038] FIG. 9 shows the distal end of an endoscope shaft with the end effector assembly disposed outside the endoscope shaft;
[0039] FIG. 10 shows the distal end of an endoscope shaft with the end effector assembly disposed on the cover of the shaft and connected via a separate external actuating shaft;
[0040] FIG. 11 shows an endoscope with an automated actuator mechanism in the distal segment of an endoscope and an external switch and removable replaceable spring-based end effector attached to the outside of the endoscope end;
[0041] FIG. 12a shows a longitudinal view of a blade anvil open biased spring based cutting tool extended from the shaft housing;
[0042] FIG. 12b shows a longitudinal view of an open biased spring based detachable clip extended from the shaft housing;
[0043] FIG. 12c shows a longitudinal view of an open biased spring based clamp with cautery extended from the shaft housing;
[0044] FIG. 12d shows a longitudinal view of an open biased spring based dissecting tool with cautery extended from the shaft housing;
[0045] FIG. 12e shows a longitudinal view of an open biased spring based snare extended from the housing to capture a polyp;
[0046] FIG. 12f shows a longitudinal view of a snare partially closed after capturing a polyp; and
[0047] FIG. 12g shows a longitudinal view of an open biased spring based grasper with ratchet extending from the shaft housing.
DETAILED DESCRIPTION OF THE EMBODIMENTS
[0048] The device shown in FIGS. 1-4 comprises a spring-based biopsy end effector generally designated as 1 with an actuator wire 60a connected to spring arms 40 in a housing 50. A cable or other spacer 42 connected to the housing 50 keeps spring arms 40 in the correct position relative to the housing 50 as shown in FIGS. 3 and 3a until actuator wire 60a is pulled to retract arms 40 within housing 50, to capture a biopsy 100, as shown in FIGS. 3a and 4. As shown in the exploded view in FIG. 2, there is an extension stop 60 and spacer that prevents overextension of spring arms 40, and a housing stop 50a which prevents over-retraction by the actuator wire 60a.
[0049] According to the present invention, the pulling and releasing of wire 60a takes place via an automated actuator mechanism 65 that is actuated by an automated switch device 66, shown in FIGS. 3 and 4. Actuator mechanism 65 can comprise any suitable automatic force generator that can pull and push the actuator wire. Suitable but not limiting examples are spring(s), an electric solenoid, an electric motor such as a stepper motor, an air or hydraulic pressure activated piston, gear(s), or a combination thereof. Connected to actuator mechanism 65 is a switch device 66 for turning the actuator mechanism on and off to pull and push actuator wire 60a. Switch device 66 can be a mechanical switch, a foot pedal, or a voice-activated switch connected to actuator mechanism 65. In this embodiment, switch device 66 is shown as a mechanical switch. Any other suitable type of switching device could also be used.
[0050] FIG. 5 shows a longitudinal view of another embodiment of the invention, in which the biopsy device is incorporated into an operative instrument such as an endoscope 20. Endoscope 20 has a handle 2 and an automated proximal actuator device 65 through which actuating wire 3 passes via shaft 9 to spring arms 5 of multiple biopsy end effector 10. A removable replaceable biopsy cassette 4 is disposed at a distal end of shaft 9 for receiving biopsies captured by spring arms 5 in the order of collection. Automated actuator mechanism 65 is connected to wire 3 via an external tube 7. Automated actuator mechanism 65 generates a force for pushing the wire 6 to open spring arms 5 and pulling wire 3 to cause spring arms 5 to capture a biopsy and move it in to cassette 4. Automated actuator mechanism 65 is connected to a switching device 67, which in this embodiment is a foot pedal, but could also be a hand or voice activated switch mechanism for turning automated actuator mechanism on and off.
[0051] FIG. 6 shows a longitudinal view of endoscope 20 with automated external proximal actuator mechanism 65 connected to spring arms 5 via a wire 3 through a separate actuating shaft 21. Automated actuator mechanism 65 is connected to a voice activated switch 68 in this embodiment, but foot pedals or mechanical hand-activated switches could also be used. As discussed above, automated actuator mechanism 65 can be any suitable mechanism for generating a motive force, such as a stepper motor, solenoid, hydraulic or pneumatic piston, etc. Speaking the required command in the vicinity of switch 68 causes actuator mechanism 65 to pull the wire 3, causing spring arms 5 to retract into shaft 9 and deposit biopsies into cassette 4. As shown in FIG. 6, shaft 21 is detachable from endoscope 20 so that the actuator mechanism 65 can be used on other endoscopes as well.
[0052] FIG. 7 shows a longitudinal view of endoscope 20 in which automated actuator mechanism 65 is incorporated into handle 2 of endoscope 20. The switching device 66 is disposed on the exterior of handle 2 for actuation by the user. Switching device 66 could also be a voice activated switch incorporated in the handle, or a foot pedal connected to actuator mechanism 65. Automated actuator mechanism 65 is connected via wire 3 to spring arms 5 of the device. Shaft 9 and the entire end effector mechanism 10 are removable and replaceable.
[0053] FIG. 8 shows a longitudinal view of endoscope 20 with switching device 66 incorporated in handle 2, and automated actuator mechanism 65 disposed in a distal end of the endoscope shaft 9, adjacent the end effector assembly 10 with spring arms 5. Electrical connection 37 connects actuator mechanism 65 with switching device 66 through the endoscope shaft 9. Shaft 9 and end effector assembly 10 are removable and replaceable.
[0054] FIG. 9 shows the distal end of endoscope shaft 9 having end effector assembly 10 disposed outside the endoscope shaft 9 and connected to the automated actuator mechanism via wire 3. Automated actuator mechanism 65 can be incorporated into the endoscope handle as shown in FIG. 8 or can be disposed outside of the endoscope 20 as shown in FIGS. 5 and 6.
[0055] FIG. 10 shows the distal end of endoscope shaft 9 in which end effector assembly 10 is mounted to the exterior or cover of shaft 9, and has an wire extending through shaft 21 for connection to the automated actuator mechanism. Automated actuator mechanism 65 can be incorporated into the endoscope handle as shown in FIG. 8 or can be disposed outside of the endoscope 20 as shown in FIGS. 5 and 6.
[0056] FIG. 11 shows the endoscope 20 having an automated actuator mechanism 65 attached to the distal segment of the endoscope 20 and to an external removable replaceable spring based end effector assembly 10 having spring arms 5 attached to the outside of the endoscope end. Actuating shaft 21 connects automated actuator mechanism 65 to switching device 66 with an electrical connection.
[0057] The embodiments shown in FIGS. 12a-12g show different variations of end effector assembly 10. Other variations could also be used. FIG. 12a shows a longitudinal view of a blade anvil spring based cutting tool 51 extended from housing 50.
[0058] FIG. 12b shows a longitudinal view of a detachable clip 52 extended from housing 50.
[0059] FIG. 12c shows a longitudinal view of a clamp 53 with cautery extended from housing 50.
[0060] FIG. 12d shows a longitudinal view of a dissecting tool 54 with cautery extended from housing 50.
[0061] FIG. 12e shows a longitudinal view of a snare 55 extended from housing 50 to capture a polyp, and FIG. 12f shows a longitudinal view of a snare 55 partially closed after capturing a polyp.
[0062] FIG. 12g shows a longitudinal view of a grasper 56 with a ratchet extending from housing.
[0063] The present invention provides a novel way for an operator to cut and collect biopsies without requiring an assistant, even while using an endoscope.
[0064] Accordingly, while only a few embodiments of the present invention have been shown and described, it is obvious that many changes and modifications may be made thereunto without departing from the spirit and scope of the invention.
