VESSEL SEALING INSTRUMENT WITH SUCTION SYSTEM

Abstract

The present disclosure is directed to a forceps having an end effector assembly including first and second jaw members. At least one of the jaw members is movable relative to the other between a spaced-apart position and an approximated position for grasping tissue therebetween. Each jaw member includes an electrically-conductive tissue-contacting surface adapted to connect to a source of energy to treat tissue grasped between the jaw members. A suction system is disposed proximate the first and second jaw members and is configured to apply suction to a surgical site upon activation thereof.

Claims

1-15. (canceled)

16. A surgical system, comprising: a forceps including an elongated shaft having a proximal portion and a distal portion and a longitudinal axis defined therethrough; an end effector coupled to the distal portion of the elongated shaft; a tube selectively slideable along the longitudinal axis of the elongated shaft between a proximal position and a distal position; a fluid source configured to selectively supply irrigation fluid to the end effector through the tube; and a low pressure source configured to selectively suction fluid from the end effector through the tube.

17. The surgical system of claim 16, wherein the end effector includes: a first jaw member; and a second jaw member, wherein at least one of the first jaw member or the second jaw member is movable relative to the other jaw member between a spaced-apart position and an approximated position for grasping tissue therebetween.

18. The surgical system according to claim 17, wherein each of the first jaw member and the second jaw member includes an electrically-conductive tissue-contacting surface adapted to connect to a source of electrical energy to apply energy to the tissue upon activation thereof.

19. The surgical system according to claim 16, further comprising a suction activator configured to activate the low pressure source.

20. The surgical system according to claim 19, wherein the suction activator is at least one of a handswitch or a footswitch.

21. The surgical system according to claim 19, wherein the low pressure source is activated after the suction activator is held in a predetermined position for a predetermined period of time.

22. The surgical system according to claim 16, further comprising a locking mechanism configured to lock the tube in the proximal position.

23. A surgical forceps comprising: an elongated shaft having a proximal portion and a distal portion; an end effector coupled to the distal portion of the elongated shaft, the end effector including a first jaw member and a second jaw member; and a tube extending within or along the elongated shaft and selectively movable relative to the end effector between a first position and a second position, the tube radially offset from at least one of the first or second jaw members; wherein the tube is configured enable at least one of irrigation or suction therethrough.

24. The surgical forceps of claim 23, wherein the tube is adapted to connect to a low pressure source configured to provide suction from the end effector through the tube.

25. The surgical forceps of claim 24, wherein the tube is adapted to connect to a fluid source configured to supply irrigation fluid to the end effector through the tube.

26. The surgical forceps of claim 23, wherein the tube is adapted to connect to a fluid source configured to supply irrigation fluid to the end effector through the tube.

27. The surgical forceps according to claim 23, wherein at least one of the first jaw member or the second jaw member is movable relative to the other jaw member between a spaced-apart position and an approximated position for grasping tissue therebetween.

28. The surgical forceps according to claim 27, wherein each of the first jaw member and the second jaw member includes an electrically-conductive tissue-contacting surface.

29. The surgical forceps according to claim 28, wherein at least one of the electrically-conductive tissue-contacting surfaces of the first or second jaw members is adapted to connect to an electrosurgical generator configured to supply electrical energy thereto.

26. The surgical forceps according to claim 23, further comprising an actuator disposed in the elongated shaft and operably coupled to the tube, the actuator slidable between an unactuated position and an actuated position to slide the tube between the first position and the second position.

27. The surgical forceps according to claim 23, wherein in the second position, a distal portion of the tube is distal of the end effector.

28. The surgical forceps according to claim 23, further comprising an actuator configured to slide the tube between the first position and the second position via at least one of a button, a handle, a mechanical deployment system, an electro-mechanical deployment system, a lever, or a slide.

29. The surgical forceps according to claim 24, wherein the low pressure source is a vacuum pump.

30. A surgical device, comprising: a shaft having a proximal portion and a distal portion; an end effector coupled to the distal portion of the shaft; a tube disposed within or along the shaft and slidable relative to a longitudinal axis of the shaft between a proximal position and a distal position, the tube adapted to couple to a low pressure source configured to apply suction through the tube; and a suction activator configured to activate the low pressure source to apply suction through the tube.

31. The surgical device of claim 30, wherein the suction activator includes an actuator coupled to the tube, the actuator transitionable between an unactuated position and an actuated position to slide the tube between the first position and the second position.

32. The surgical device of claim 31, wherein, when the actuator is transitioned from the unactuated position towards the actuated position, suction is simultaneously applied through the tube.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

[0017] The above and other aspects, features, and advantages of the present disclosure will become more apparent in light of the following detailed description when taken in conjunction with the accompanying drawings in which:

[0018] FIG. 1A is a perspective view of an embodiment of a medical device in accordance with one embodiment of the present disclosure;

[0019] FIG. 1B is a partial, perspective view of the embodiment of FIG. 1, shown with the jaw members in a closed position and a suction tube in a retracted position;

[0020] FIG. 1C is a partial, perspective view of the embodiment of FIG. 1, shown with the jaw members in a closed position and a suction tube in a deployed position;

[0021] FIG. 1D is a partial, cross-sectional, side view of an embodiment of the medical device in accordance with the present disclosure, shown with the jaw members in an open position and the suction tube in a partially retracted position;

[0022] FIG. 1E is a partial, cross-sectional, side view of an embodiment of the medical device of FIG. 1D, shown with the jaw members in an open position and a suction tube in a fully deployed position;

[0023] FIG. 1F is an enlarged, perspective view of the jaw members shown in an open position with the suction tube in a partially deployed position in accordance with the present disclosure.

[0024] FIG. 2 is a perspective view of an open medical device in accordance with another embodiment the present disclosure;

[0025] FIG. 3A is an enlarged, perspective view of the jaw members shown engaging tissue with the suction tube in a retracted position; and

[0026] FIG. 3B is an enlarged, perspective view of the jaw members shown disengaged from tissue and with the suction tube in a deployed position.

DETAILED DESCRIPTION

[0027] Particular embodiments of the present disclosure are described hereinbelow with reference to the accompanying drawings; however, the disclosed embodiments are merely examples of the disclosure and may be embodied in various forms. Well-known functions or constructions are not described in detail to avoid obscuring the present disclosure in unnecessary detail. Therefore, specific structural and functional details disclosed herein are not to be interpreted as limiting, but merely as a basis for the claims and as a representative basis for teaching one skilled in the art to variously employ the present disclosure in virtually any appropriately detailed structure. Like reference numerals may refer to similar or identical elements throughout the description of the figures.

[0028] Referring now to FIGS. 1A and 2, FIG. 1A depicts a forceps 10 for use in connection with endoscopic surgical procedures and FIG. 2 depicts an open forceps 10′ contemplated for use in connection with traditional open surgical procedures. For the purposes herein, either an endoscopic device, e.g., forceps 10, an open device, e.g., forceps 10′, or any other suitable surgical device may be utilized in accordance with the present disclosure. Different electrical and mechanical connections and considerations may apply to each particular type of device, however, the aspects and features of the present disclosure remain generally consistent regardless of the particular device used.

[0029] Turning now to FIG. 1A, an endoscopic forceps 10 is shown including a housing 20 having a shaft 12 that extends therefrom and defines a longitudinal axis “X-X” therethrough, a handle assembly 30, and an end effector assembly 100. Additionally, forceps 10 may be configured to include a rotating assembly 70 and a trigger assembly 80, as shown in FIG. 1.

[0030] Forceps 10 further includes a shaft 12 having a distal end 14 configured to mechanically engage end effector assembly 100 and a proximal end 16 that mechanically engages housing 20. Forceps 10 also includes cable 8 that connects forceps 10 to an energy source, e.g., a generator “G”, or other suitable power source, although forceps 10 may alternatively be configured as a battery-powered device. Cable 8 includes a wire or wires (not shown) extending therethrough that has sufficient length to extend through shaft 12 in order to provide energy to at least one of tissue-contacting surfaces 112, 122 (FIG. 1F) of jaw members 110, 120, respectively. An activation switch 200 may be provided on housing 20 for selectively supplying energy to jaw members 110, 120.

[0031] With continued reference to FIG. 1A, handle assembly 30 includes fixed handle 50 and a moveable handle 40. Fixed handle 50 is integrally associated with or rigidly attached to housing 20 and handle 40 is moveable relative to fixed handle 50.

[0032] Moveable handle 40 is ultimately connected to a drive assembly (not shown in FIG. 1A) that, together, mechanically cooperate to impart movement of jaw members 110 and 120 between a spaced-apart position and an approximated position to grasp tissue disposed between jaw members 110, 120. As shown in FIG. 1A, moveable handle 40 is initially spaced-apart from fixed handle 50 and, correspondingly, jaw members 110, 120 are disposed in the spaced-apart position. Moveable handle 40 is compressible from this initial position to a compressed position corresponding to the approximated position of jaw members 110, 120.

[0033] Rotating assembly 70 is rotatable in either direction about longitudinal axis “X-X” to rotate end effector assembly 100 about longitudinal axis “X-X.” Housing 20 houses the internal working components of forceps 10.

[0034] Forceps 10 may also include a ratchet assembly 31 for selectively locking the jaw members 110 and 120 relative to one another at various positions during pivoting. Ratchet assembly 31 may include graduations or other visual markings that enable the user to easily and quickly ascertain and control the amount of closure force desired between the jaw members 110 and 120.

[0035] In order to effectively “seal” tissue or vessels, two predominant mechanical parameters should be accurately controlled: 1) the pressure or closure force applied to the vessel or tissue; and 2) the gap distance between the conductive tissue contacting surfaces (electrodes).

[0036] Tissue pressures within a working range of about 3 kg/cm2 to about 16 kg/cm2 and, advantageously, within a working range of 7 kg/cm2 to 13 kg/cm2 have been shown to be effective for sealing arteries and vascular bundles.

[0037] In some embodiments, one of the jaw members, e.g., 120, includes at least one stop member 175 (see FIG. 1F) disposed on the inner facing surface of the electrically conductive sealing surface 122 (and/or 112). The stop member(s) is designed to facilitate gripping and manipulation of tissue and to define a gap “g” between opposing jaw members 110 and 120 during sealing (See FIG. 3A). In some embodiments, the separation distance during sealing or the gap distance “g” is within the range of about 0.001 inches (about 0.03 millimeters) to about 0.006 inches (about 0.016 millimeters).

[0038] With reference to FIG. 1F, end effector assembly 100 of forceps 10 (FIG. 1A) is shown. End effector assembly 100 may similarly be used in conjunction with forceps 10′ (FIG. 2), or any other suitable surgical device. For purposes of simplicity, end effector assembly 100 is described herein as configured for use with forceps 10 (FIG. 1).

[0039] Each jaw member 110, 120 of end effector assembly 100 includes a proximal flange portion 111a, 121a, a distal jaw portion 111b, 121b, an outer insulative jaw housing 117, 127 and a tissue-contacting plate 112, 122, respectively. Proximal flange portions 111a, 121a of jaw members 110, 120 are pivotably coupled to one another about a pivot 103 for moving jaw members 110, 120 between the spaced-apart and approximated positions. Distal jaw portions 111b, 121b of jaw members 110, 120 are configured to support jaw housings 117, 127, and tissue-contacting plates 114, 124, respectively, thereon. Further, one of the jaw members, e.g., jaw member 120, may include an energy-based cutting member (not shown) disposed thereon, or a channel 115 for allowing a mechanical cutting member (not shown), e.g., a knife assembly as described above, to pass therethrough. Trigger 82 of trigger assembly 80 is operably coupled to the knife assembly (shown in FIGS. 1D-1F) for selectively translating a knife blade 134 (FIGS. 1D-1F and 3A-3B) through a knife channel 115 (FIG. 1F) defined within one or both of jaw members 110, 120 to cut tissue disposed between jaw members 110, 120. The knife assembly (shown in FIGS. 1D-1F) is configured for longitudinal translation through channel 115 of jaw members 110, 120, e.g., upon activation of a trigger 82 operably coupled to the knife assembly (shown in FIGS. 1D-1F), to mechanically cut tissue grasped between jaw members 110, 120. Knife assembly (shown in FIGS. 1D-1F) may be configured for mechanical cutting, or may be energizable, e.g., via electrical coupling to generator “G” (FIG. 1A) via the one or more wires (not shown) of cable 8 (FIG. 1A), for electro-mechanically cutting tissue.

[0040] In embodiments having an electrical cutting member, the electrical cutting member can be similarly coupled to trigger 82 (FIG. 1A) and generator “G” (FIG. 1A) such that energy, e.g., electrosurgical energy, may be selectively supplied to cutting member and conducted through tissue disposed between jaw members 110, 120 to either or both of tissue-contacting plates 112, 122 to cut tissue in a second mode of operation. A first insulating member may surround electrical cutting member to insulate tissue-contacting plate 122 and electrical cutting member from one another. A second insulating member (not shown) may be disposed within a longitudinal slot defined within tissue-contacting plate 112 of jaw member 110 that opposes electrical cutting member to insulate electrical cutting member from tissue-contacting plate 112 of jaw member 110 when jaw members 110, 120 are disposed in the approximated position.

[0041] Tissue-contacting plates 112, 122 are formed from an electrically conductive material for conducting electrical energy therebetween for treating tissue, although tissue-contacting plates 112, 122 may alternatively be configured to conduct any suitable energy through tissue grasped therebetween for energy-based tissue treatment, e.g., tissue sealing. In embodiments having an energy-based cutting member (not shown), the energy-based cutting member may be formed from an electrically conductive material for conducting electrical energy between energy-based cutting member and one or both of tissue-contacting plates 112, 122 for electrically cutting tissue. Energy-based cutting member may alternatively be configured to conduct any suitable energy through tissue for electrically cutting tissue.

[0042] Tissue-contacting plates 112, 122 are coupled to an activation switch such as trigger 82 (FIG. 1A) and generator “G” (FIG. 1A) or other suitable source of energy, e.g., via the wires (not shown) extending from cable 8 (FIG. 1A) through forceps 10, such that energy, e.g., electrosurgical energy, may be selectively supplied to tissue-contacting plate 112 and/or tissue-contacting plate 122 and conducted therebetween and through tissue disposed between jaw members 110, 120 to treat, e.g., seal, tissue in a first mode of operation. In embodiments where the electrical or mechanical cutting mechanisms and the tissue contacting plates are both activated via trigger 82, tissue may be simultaneously sealed and cut.

[0043] Referring now to FIGS. 1A-1F, a suction system is configured for use with forceps 10 (FIG. 1A). The suction system as described herein may also be configured for use with open forceps 10′ as shown in FIG. 2. However, for purposes of brevity, the suction system will be described in detail herein configured for use with forceps 10 (FIG. 1A).

[0044] As shown, the suction system includes one or more tubes 113 connected to a low pressure source “L” via piping 9. Low pressure source “L” may be any device capable of providing a suction flow in tube 113, such as, but not limited to, a vacuum pump. The tube 113 may be contained within shaft 12 as shown in FIGS. 1A-1F, or may alternatively be attached externally to shaft 12. Tube 113 may also be used for irrigation by connecting tube 113 to a source of fluid such as, but not limited to, saline solution. In this instance the suction system may be designed for positive or negative flow.

[0045] In some embodiments, tube 113 may be disposed on or within forceps 10 in a fixed manner such that tube 113 may not slide longitudinally and is thus positioned at a fixed extension from shaft 12. However, as shown, tube 113 is slidably disposed within the forceps 10 and is selectively extendable via an actuator 199 such that movement of the actuator 199 from an un-actuated position to an actuated position causes tube 113 to translate between a retracted position and a deployed position. Actuator 199 may include one or more buttons, a handle, a mechanical deployment system, an electro-mechanical deployment system, a lever, or a slide, all configured to move the tube between the retracted and deployed position.

[0046] At least part of the tube 113 is offset relative to or disposed proximate the first and second jaw 110, 120 members and is configured to apply suction to the area proximate the first and second jaw members 110, 120. Tube 113 may be disposed underneath/above (radially offset) relative to one or both of the jaw members 110, 120. Alternatively, tube 113 may be disposed in any other suitable manner, such as, but not limited to, within a jaw member 120.

[0047] As shown in FIG. 1B, the tube 113 is shown in a retracted position such that the tube 113 does not extend past the grasping range of the jaw members but still partially extends from shaft 12. Tube 113 may also be fully enclosed by the shaft 12 when in the retracted position. FIG. 1D shows the tube 113 partially extended below jaw member 120. In some embodiments, a locking mechanism (not shown) may be included to hold the tube 113 in the retracted position until a user unlocks the tube 113 for selective movement in order to prevent accidental deployment of tube 113. The locking mechanism may be automatically activated (such as by a spring-loaded latch) or manually activated (such as by a finger switch or knob) upon transitioning the tube 113 to the retracted position.

[0048] FIGS. 1C and 1E show tube 113 in a fully deployed position extending at least partially beyond end effector 100. In some embodiments, the fully deployed position of the tube 113 may not extend beyond the end effector 100. In some embodiments, a locking mechanism may be included to hold the tube 113 in the deployed position until a user unlocks the tube 113 for selective movement in order to prevent accidental retraction of tube 113 during a procedure. The locking mechanism may be automatically activated (such as by a spring-loaded latch) or manually activated (such as by a finger switch or knob) upon the tube 113 reaching the deployed position.

[0049] A suction valve, suction activator, or the like (not shown) may be included on or integrated with the housing 20 such that activation of a suction flow through tube 113 may be easily effected by a user by using, e.g., a handswitch. In some embodiments, the suction activator may be separate from the housing 20, such as a footswitch. In some embodiments, the actuator 199, as described above, also acts as a suction valve or the like such that when the actuator 199 is moved from the un-actuated position (FIG. 1B) to the actuated position (FIG. 1C), the actuator simultaneously activates suction flow through tube 113. The suction flow may begin when the actuator 199 reaches the fully actuated position (FIG. 1C), or at some predetermined position prior to the fully actuated position. In some embodiments, the user may be required to hold the actuator 199 in the actuated position (FIG. 1C) for a preset time period to begin suction. In other embodiments, a button or contact (not shown) may be disposed at the end of the path of movement of actuator 199 such that when actuator 199 is moved to the actuated position (FIG. 1C), the button or electrical contact initiates suction.

[0050] While the actuator 199 is shown to operate in a parallel linear fashion along with tube 113, the actuator 199 may be configured in any desired mechanical format to accommodate a desired ergonomic instrument layout to facilitate activation.

[0051] Referring now to the embodiment of FIG. 2, open forceps 10′ is shown including two elongated shafts 12a and 12b, each having a proximal end 16a and 16b, and a distal end 14a and 14b, respectively. Similar to forceps 10 (FIG. 1A), forceps 10′ is configured for use with end effector assembly 100. More specifically, end effector assembly 100 is attached to distal ends 14a and 14b of shafts 12a and 12b, respectively. As mentioned above, end effector assembly 100 includes a pair of opposing jaw members 110 and 120 that are pivotably connected about pivot 103. Each shaft 12a and 12b includes a handle 17a and 17b disposed at the proximal end 16a and 16b thereof. Each handle 17a and 17b defines a finger hole 18a and 18b therethrough for receiving a finger of the user. As can be appreciated, finger holes 18a and 18b facilitate movement of the shafts 12a and 12b relative to one another which, in turn, pivots jaw members 110 and 120 from an open position, wherein the jaw members 110 and 120 are disposed in spaced-apart relation relative to one another, to a closed position, wherein the jaw members 110 and 120 cooperate to grasp tissue therebetween.

[0052] A ratchet assembly 30′ may be included for selectively locking the jaw members 110 and 120 relative to one another at various positions during pivoting. Ratchet assembly 30′ may include graduations or other visual markings that enable the user to easily and quickly ascertain and control the amount of closure force desired between the jaw members 110 and 120.

[0053] With continued reference to FIG. 2, one of the shafts, e.g., shaft 12a, includes a proximal shaft connector 19 which is designed to connect the forceps 10′ to a source of energy, e.g., generator “G”. Proximal shaft connector 19 secures an electrosurgical cable 8′ to forceps 10′ such that the user may selectively apply energy to jaw members 110 and 120, as needed. One of the shafts, e.g., shaft 12a, includes an activation switch 90′ for selectively supplying energy to jaw members 110, 120.

[0054] Forceps 10′ includes a suction system disposed proximate the first and second jaw members and configured to apply suction to an area proximate the first and second jaw members. The suction system includes a tube 113′, similar to tube 113 as described above, that is connected to a suction source “L” as described herein. Tube 113′ may be slidably disposed within at least one of the shaft members 12a, 12b and selectively extendable from an opening defined proximally of the end effector 100. Tube 113′ may also be connected to an actuator 199′, similar to actuator 199 as described above, such that movement of actuator 199′ between an un-actuated position and an actuated position causes movement of tube 113′ between the retracted position and the deployed position.

[0055] Further disclosed is a method for performing a surgical procedure including the steps of providing a vessel sealing device such as forceps 10, open forceps 10′, or other medical instrument having two opposable jaw members operably connected to a shaft, at least one of the jaw members configured to move relative to the other between an open position and a clamped position A suction system is included proximate one or both of the jaw members.

[0056] Referring now to FIGS. 3A and 3B, the method further includes the step of grasping a vessel or tissue “T” between the two jaw members and applying electrosurgical energy to seal tissue “T”. Before or after sealing, bodily fluids “B” may form at the surgical site. To remove the bodily fluids “B”, the user activates the suction system to remove bodily fluids “B” from the surgical site (FIG. 3B).

[0057] As described herein, the tube 113 may be slidably disposed in forceps 10, and the method may also include the step of deploying the tube 113 from the retracted position to the deployed position to remove fluid and debris from the surgical site. The method may also include the step of retracting the tube 113 after use.

[0058] 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 in the operating room 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.

[0059] 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 controls 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.

[0060] 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 the herein described forceps (e.g., end effectors, suction systems, knifes, 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).

[0061] 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, suction strength/pressure drop, 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.

[0062] It should be understood that the foregoing description is only illustrative of the present disclosure. Various alternatives and modifications can be devised by those skilled in the art without departing from the disclosure. Accordingly, the present disclosure is intended to embrace all such alternatives, modifications, and variances. The embodiments described with reference to the attached drawings are presented only to demonstrate certain examples of the disclosure. Other elements, steps, methods, and techniques that are insubstantially different from those described above and/or in the appended claims are also intended to be within the scope of the disclosure.