MULTI-FUNCTION SURGICAL INSTRUMENTS
20210161585 · 2021-06-03
Inventors
Cpc classification
Y10T74/18928
GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
F16H21/10
MECHANICAL ENGINEERING; LIGHTING; HEATING; WEAPONS; BLASTING
A61B18/1445
HUMAN NECESSITIES
A61B2017/293
HUMAN NECESSITIES
A61B2017/2929
HUMAN NECESSITIES
A61B2018/1455
HUMAN NECESSITIES
A61B2017/2908
HUMAN NECESSITIES
F16H21/44
MECHANICAL ENGINEERING; LIGHTING; HEATING; WEAPONS; BLASTING
A61B2017/2912
HUMAN NECESSITIES
A61B2018/1475
HUMAN NECESSITIES
A61B18/1442
HUMAN NECESSITIES
International classification
A61B18/12
HUMAN NECESSITIES
Abstract
A surgical instrument including housing having a shaft extending distally therefrom, an outer sleeve disposed about the shaft and selectively translatable relative to the shaft, a first drive shaft disposed within the shaft and translatable relative to the shaft independently of the outer sleeve, a second drive shaft disposed within the first drive shaft and coupled to the outer sleeve to translate in conjunction with the outer sleeve, and a rotatable nose wheel. The rotatable nose wheel is mounted about a distal end of the housing and is rotatably coupled to each of the outer sleeve, the shaft, the first drive shaft, and the second drive shaft such that rotation of the rotatable nose wheel effects corresponding rotation of the outer sleeve, the shaft, the first drive shaft, and the second drive shaft in conjunction with one another and relative to the housing.
Claims
1-20. (canceled)
21. A surgical instrument, comprising: a housing; a shaft extending distally from the housing; an end effector assembly disposed at a distal end portion of the shaft; an outer deployable member disposed externally about the shaft, the outer deployable member configured to longitudinally translate relative to the end effector assembly between a retracted position and a deployed position; an inner drive shaft disposed within the shaft and operably coupled to the end effector assembly, the inner drive shaft configured to longitudinally translate relative to the end effector assembly between an un-actuated position and an actuated position to manipulate the end effector assembly; and a rotatable wheel associated with the housing, the rotatable wheel operably coupled to each of the shaft, the outer deployable member, and the inner drive shaft such that rotation of the rotatable wheel relative to the housing effects rotation of the shaft, the end effector assembly, the outer deployable member, and the inner drive shaft in conjunction with one another and relative to the housing.
22. The surgical instrument according to claim 21, wherein the rotatable wheel is a nose wheel rotatably mounted about a distal end portion of the housing.
23. The surgical instrument according to claim 21, further comprising a first actuator associated with the housing and operably coupled to the outer deployable member such that actuation of the first actuator relative to the housing longitudinally translates the outer deployable member from the retracted position to the extended position.
24. The surgical instrument according to claim 23, wherein the outer deployable member is rotatable independently of the first actuator such that the first actuator remains rotationally stationary upon rotation of the rotation wheel relative to the housing.
25. The surgical instrument according to claim 23, further comprising an inner deployable member disposed within the shaft, the inner deployable member operably coupled to the first actuator such that actuation of the first actuator relative to the housing longitudinally translates the inner and outer deployable members from the retracted position to the extended position.
26. The surgical instrument according to claim 21, further comprising a second actuator associated with the housing and operably coupled to the inner drive shaft such that actuation of the second actuator relative to the housing longitudinally translates the inner drive shaft between the un-actuated position and the actuated position.
27. The surgical instrument according to claim 26, wherein the inner drive shaft is rotatable independently of the second actuator such that the second actuator remains rotationally stationary upon rotation of the rotation wheel relative to the housing.
28. A surgical instrument, comprising: a housing; a shaft extending distally from the housing; an end effector assembly supported by the shaft; an outer deployable member disposed externally about the shaft, the outer deployable member configured to longitudinally translate relative to the end effector assembly; an inner drive shaft disposed within the shaft and operably coupled to the end effector assembly, the inner drive shaft configured to longitudinally translate relative to the end effector assembly to manipulate the end effector assembly; and a rotatable wheel associated with the housing, the rotatable wheel operably coupled to each of the shaft, the outer deployable member, and the inner drive shaft such that rotation of the rotatable wheel relative to the housing rotates the shaft, the end effector assembly, the outer deployable member, and the inner drive shaft relative to the housing.
29. The surgical instrument according to claim 28, wherein the rotatable wheel is a nose wheel rotatably mounted about a distal end portion of the housing.
30. The surgical instrument according to claim 28, further comprising a first actuator associated with the housing and operably coupled to the outer deployable member such that actuation of the first actuator relative to the housing longitudinally translates the outer deployable member from a retracted position to an extended position.
31. The surgical instrument according to claim 30, wherein the outer deployable member is rotatable independently of the first actuator such that the first actuator remains rotationally stationary upon rotation of the rotation wheel relative to the housing.
32. The surgical instrument according to claim 30, further comprising an inner deployable member disposed within the shaft, the inner deployable member operably coupled to the first actuator such that actuation of the first actuator relative to the housing longitudinally translates the inner and outer deployable members.
33. The surgical instrument according to claim 28, further comprising a second actuator associated with the housing and operably coupled to the inner drive shaft such that actuation of the second actuator relative to the housing longitudinally translates the inner drive shaft.
34. The surgical instrument according to claim 33, wherein the inner drive shaft is rotatable independently of the second actuator such that the second actuator remains rotationally stationary upon rotation of the rotation wheel relative to the housing.
35. A surgical instrument, comprising: a housing; a shaft extending distally from the housing, the shaft defining a longitudinal axis; an end effector assembly supported by the shaft; an outer deployable member disposed externally about the shaft, the outer deployable member configured to longitudinally translate relative to the end effector assembly between a retracted position and a deployed position; an inner drive shaft disposed within the shaft and operably coupled to the end effector assembly, the inner drive shaft configured to longitudinally translate relative to the end effector assembly between an un-actuated position and an actuated position to manipulate the end effector assembly; and a rotatable wheel associated with the housing, the rotatable wheel configured to rotate about the longitudinal axis, the rotatable wheel operably coupled to each of the shaft, the outer deployable member, and the inner drive shaft such that rotation of the rotatable wheel relative to the housing simultaneously rotates the shaft, the end effector assembly, the outer deployable member, and the inner drive shaft relative to the housing.
36. The surgical instrument according to claim 35, wherein the rotatable wheel is a nose wheel rotatably mounted about a distal end portion of the housing.
37. The surgical instrument according to claim 35, further comprising a first actuator associated with the housing and operably coupled to the outer deployable member such that actuation of the first actuator relative to the housing longitudinally translates the outer deployable member from the retracted position to the extended position.
38. The surgical instrument according to claim 37, wherein the outer deployable member is rotatable independently of the first actuator such that the first actuator remains rotationally stationary upon rotation of the rotation wheel relative to the housing.
39. The surgical instrument according to claim 37, further comprising an inner deployable member disposed within the shaft, the inner deployable member operably coupled to the first actuator such that actuation of the first actuator relative to the housing longitudinally translates the inner and outer deployable members from the retracted position to the extended position.
40. The surgical instrument according to claim 35, further comprising a second actuator associated with the housing and operably coupled to the inner drive shaft such that actuation of the second actuator relative to the housing longitudinally translates the inner drive shaft between the un-actuated position and the actuated position.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0022] Various aspects of the present disclosure are described herein with reference to the drawings wherein like reference numerals identify similar or identical elements:
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DETAILED DESCRIPTION
[0038] Referring now to
[0039] Continuing with reference to
[0040] Referring to
[0041] End effector assembly 100 is designed as a unilateral assembly, i.e., where jaw member 120 is fixed relative to outer fixed shaft 12 and jaw member 110 is movable relative to outer fixed shaft 12 and fixed jaw member 120. More specifically, jaw member 110 is operably coupled to a drive shaft 142 (
[0042] With continued reference to
[0043] Referring again to
[0044] With continued reference to
[0045] Handle assembly 30 includes a movable handle 40 and a fixed handle 50. Fixed handle 50 is integrally associated with housing 20. Movable handle 40 includes a lever 42 defining a finger hole 43 and a bifurcated arm 46 extending upwardly from lever 42 and into housing 20. Arm 46 is bifurcated to define first and second spaced-apart flanges that are pivotably coupled to opposed sides of housing 20 via a fixed split pivot 45. Movable handle 40 is pivotable about split pivot 45 and relative to fixed handle 50 between an initial position, wherein movable handle 40 is spaced from fixed handle 50, and a compressed position, wherein movable handle 40 is approximated relative to fixed handle 50. The flanges of arm 46 are each coupled to a distal end of a drive linkage 48 via a first movable pivot 52 that is longitudinally spaced from fixed spit pivot 45. The proximal ends of drive linkages 48, in turn, are pivotably coupled to the free ends of legs 145 of spring cartridge 144 of drive assembly 140 via a second movable pivot 53.
[0046] Drive assembly 140 includes a spring cartridge 144 slidably disposed within housing 20, and a drive shaft 142. Drive shaft 142 is coupled to and extends distally from spring cartridge 144, through outer fixed shaft 12 of forceps 10, ultimately coupling to jaw member 110 of end effector assembly 100, as described above. Spring cartridge 144 houses a biasing member (not explicitly shown) that serves to bias drive shaft 142 distally and movable handle 40 towards the initial position, thus biasing jaw members 110, 120 towards the spaced-apart position. Spring cartridge 144 defines a lumen (not explicitly shown) extending longitudinally therethrough that is configured to slidably receive knife drive shaft 182. Spring cartridge 144 further includes a pair of spaced-apart legs 145, which extend proximally from spring cartridge 144. The proximal ends of drive linkages 48, as mentioned above, are pivotably coupled to the free ends of legs 145 of spring cartridge 144. Thus, as movable handle 40 is moved from the initial position towards the compressed position, the flanges of arm 46 urge drive linkages 48 proximally which, in turn, urges legs 145, spring cartridge 144, and drive shaft 142 proximally such that jaw member 110 is pivoted towards the approximated position relative to jaw member 120. Fixed split pivot 45 and first and second movable pivots 52, 53 further cooperate to define an over-center configuration for locking jaw members 110, 120 in the approximated position once movable handle 40 has been sufficiently compressed towards fixed handle 30, e.g., once first movable pivot 52 is disposed above the line segment extending between fixed split pivot 45 and second movable pivot 53.
[0047] Trigger assembly 60, as mentioned above, is coupled to knife assembly 180 such that trigger 62 is selectively actuatable from an un-actuated position to an actuated position to advance knife 184 from a storage position (
[0048] Trigger assembly 60 includes a trigger 62 having a toggle member 63 and a bifurcated arm 66 extending upwardly from toggle member 63 and into housing 20. Trigger 62 is pivotably coupled to housing 20 via pivot 65, which extends through an intermediate portion 64 of trigger 62. Arm 66 is bifurcated to define a pair of spaced-apart flanges disposed about spring cartridge 144 of drive assembly 140. A pin 69 pivotably couples each flange of arm 66 of trigger 62 to a connector 68. Connectors 68 extends proximally through housing 20 to the base of connectors 68. The base of connectors 68 is coupled to proximal end 183a of knife drive shaft 182 of knife assembly 180 on either side thereof. The coupling of the base of connectors 68 to knife drive shaft 182 also permits rotation of knife drive shaft 182 relative to connectors 68, the importance of which will become more apparent below. Upon pivoting of trigger 62 about pivot pin 65 and relative to housing 20 from the un-actuated position towards the actuated position, arm 66 is rotated to pull connectors 68 distally such that knife drive shaft 182 is pushed distally to translate knife 184 from the storage position towards the extended position. Return of trigger 62 towards the un-actuated position, on the other hand, pivots arm 66 to push connectors 68 proximally such that knife drive shaft 182 is pulled proximally to translate knife 184 back towards the storage position. A biasing member (not shown) may be provided for biasing trigger 62 towards the un-actuated position, thereby biasing knife 184 towards the retracted position.
[0049] Referring briefly to
[0050] Referring again to
[0051] Lever assembly 80 is disposed within a recess 24 defined on an exterior side surface of housing 20 (although lever assembly 80 may also be positioned at any other suitable location) and includes a lever 82 that is rotatable about a pivot 84 between a first position, wherein free end 86 of lever 82 is disposed at a proximal end 25 of recess 24, and a second position, wherein free end 86 of lever 82 is disposed at a distal end 27 of recess 24. As will be described in greater detail below, movement of lever 82 between the first and second positions effects movement of monopolar assembly 200 between the retracted and deployed positions, respectively. Further, a dimple 28 formed within recess 24 of housing 20 may be provided adjacent distal end 27 thereof for receiving a corresponding protrusion (not explicitly shown) extending from an inwardly-facing surface of lever 82 such that, upon movement of lever 82 to the second position, the protrusion (not shown) of lever 82 is engaged within dimple 28 of recess 24 to retain lever 82 in the second position, thereby retaining monopolar assembly 200 in the deployed position. A biasing member (not shown) may be provided for biasing lever 82 towards the first position and, thus, monopolar assembly 200 towards the retracted position, in the absence of lever 82 being locked in the second position via the above-described dimple-protrusion engagement. Other suitable locking mechanisms are also contemplated. In configurations where lever assembly 80 defines a symmetrical configuration, a pair of levers 82 are provided on either side of housing 20, each of which is similar to that described above and is coupled to one end of pivot 84. Pivot 84 extends through housing 20 to operably couple lever 82 to the internal components of lever assembly 80, as will be described below.
[0052] Lever assembly 80 includes a pair of spaced-apart lever linkages 87 disposed within housing 20. Lever linkages 87 are coupled at the first ends thereof to pivot 84 such that rotation of lever 82 effects rotation of pivot 84 and, thus, lever linkages 87 in a similar direction. Lever linkages 87 are disposed on either side of knife drive shaft 182 and between legs 145 of spring cartridge 144 of drive assembly 140. Lever linkages 87 are pivotably coupled to a first elongated linkage 88a at the second ends thereof via pivot 89a. First elongated linkage 88a extends distally though housing 20 and is pivotably coupled to a second elongated linkage 88b via a pivot 89b. Second elongated linkage 88b extends further distally through housing 20 and into rotatable nose wheel 72, wherein second elongated linkage 88b couples lever 82 to both outer insulative sleeve 210 and inner shaft 226 of monopolar assembly 200, as will be described in greater detail below. As a result of this configuration, rotation of lever 82 from the first position to the second position rotates lever linkages 87 which, in turn, urge first and second elongated linkages 88a, 88b, respectively, to translate distally though housing 20, thereby moving monopolar assembly 200 from the retracted position to the deployed position.
[0053] Forceps 10 further includes a rotatable member 150 operably disposed between second elongated linkage 88b and spring cartridge 144 for moving jaw members 110, 120 to the approximated position (if not already disposed in the approximated position) prior to deployment of monopolar assembly 200 to inhibit unintended interference between end effector assembly 100 and monopolar assembly 200 due to. Rotatable member 150 is rotatably coupled to housing 20 via pivot 152 and includes first and second ends 154, 156, respectively, extending in substantially opposite directions from pivot 152. Rotatable member 150 may be biased, e.g., via a torsion spring (not explicitly shown) or any other suitable biasing member, towards the position shown in
[0054] Second elongated linkage 88b defines an expanded body portion 158a compared to distal tip 158b thereof. As a result, with second elongated linkage 88b in the proximal-most position, e.g., with monopolar assembly 200 in the fully retracted position, distal tip 158b of second elongated linkage 88b is positioned adjacent, but spaced-apart from, rotatable member 150. Thus, rotatable member 150 is maintained in the position shown in
[0055] With continued reference to
[0056] As best shown in
[0057] Fixed shaft 12, which secures fixed jaw member 120 at distal end 14 thereof, is disposed within insulative sleeve 210. More specifically, fixed shaft 12 is rotatably coupled to housing 20 at proximal end 16 thereof and extends through nose wheel 72 and insulative sleeve 210 to fixed jaw 120. Fixed shaft 12 defines a pair of opposed longitudinal slots 18 towards proximal end 16 thereof that are configured to receive pin 217 of bushing 216 therethrough, thus permitting outer sleeve 210 to translate relative to fixed shaft 12. Fixed shaft 12 further defines an aperture 19 configured to receive transverse bar 76 of nose wheel 72 to rotatably fix fixed shaft 12 relative to nose wheel 72 and insulative sleeve 210.
[0058] Drive shaft 142 is slidably disposed within fixed shaft 12 and, as mentioned above, is selectively translatable to effect movement of jaw members 110, 120 between the spaced-apart and approximated positions upon actuation of movable handle 40. Drive shaft 142 defines a pair of opposed longitudinal slots 148 that are configured to receive both pin 217 of bushing 216 and transverse bar 76 of nose wheel 72, thus allowing translation of drive shaft 142 and insulative sleeve 210 relative to one another and nose wheel 72, and rotatably securing drive shaft 142 to nose wheel 72. In other words, drive shaft 142 is independently translatable relative to insulative sleeve 210, fixed shaft 12, and nose wheel 72, but is rotatably coupled thereto to rotate in concert therewith.
[0059] Inner shaft 226, which supports energizable rod member 220 at the distal end thereof, is slidably disposed within drive shaft 142. Inner shaft 226 includes a pair of opposed apertures 228 defined towards the proximal end thereof and a pair of opposed longitudinal slots 229 disposed towards the proximal end thereof distally of apertures 228. Apertures 228 are configured to receive pin 217 of bushing 216 to fix inner shaft 226 in both rotation and translation relative to outer insulative sleeve 210 and such that movement of second elongated linkage 88b effects corresponding movement of outer insulative sleeve 210 and inner shaft 226. Slots 229 are configured to receive transverse bar 76 to rotatably fix inner shaft 226 relative to nose wheel 72 while still permitting relative translation therebetween.
[0060] Knife drive shaft 182 is disposed within inner shaft 226 and is independently translatable relative to inner shaft 226, drive shaft 142, fixed shaft 12, outer insulative sleeve 210, and nose wheel 72, but is rotatably coupled to each via engagement of transverse bar 76 within slots 188 defined within opposed sides of knife drive shaft 182. As can be appreciated in view of the above, rotatable nose wheel 72 is rotatable in either direction about longitudinal axis “X-X” and relative to housing 20 to effect corresponding and cooperative rotation of outer fixed shaft 12 (and the internal components therein), end effector assembly 100, and monopolar assembly 200, without comprising the independent relative movements therebetween.
[0061] Turning now to
[0062] With continued reference to
[0063] Insulative sleeve 210′ extends through nose wheel 720 and includes a pair of opposed apertures 212′ defined therethrough towards the proximal end of insulative sleeve 210′. A bushing 216′ is engaged about insulative sleeve 210′ via a pin 217′ extending through apertures 212′ of insulative sleeve 210′. Bushing 216′ defines an annular groove 218′ configured to receive distal engagement end 219′ of second elongated linkage 88b′. Bushing 216′ further includes a pair of flanges 240′ extending in opposite radial directions from bushing 216′. Flanges 240′ are configured for receipt within tracks 780 of nose wheel 720 to rotatably fix sleeve 210′ relative to nose wheel 720 but permitting sleeve 210′ to translate relative to nose wheel 720, e.g., via translation of flanges 240′ along tracks 780.
[0064] Fixed shaft 12′ is rotatably coupled to housing 20′ and defines a pair of opposed longitudinal slots 18′ configured to receive pin 217′ of bushing 216′ to rotatably fix fixed shaft 12′ relative to nose wheel 720. Drive shaft 142′ is slidably disposed within fixed shaft 12′ and likewise defines a pair of opposed longitudinal slots 148′ configured to receive pin 217′ of bushing 216′, thus allowing independent translation of drive shaft 142′ relative to fixed shaft 12′ and insulative sleeve 210′, while rotatably coupling drive shaft 142′ to nose wheel 720. Inner shaft 226′ is slidably disposed within drive shaft 142′ and defines a pair of opposed apertures 228′ configured to receive pin 217′ to fix inner shaft 226′ in both rotation and translation relative to outer insulative sleeve 210′. Knife drive shaft 182′ is longitudinally movable but rotatably coupled to each of the above shafts and sleeves via engagement of pin 217′ within slots 188′ defined within opposed sides of knife drive shaft 182′.
[0065] As a result of the above-described configuration, rotation of rotatable nose wheel 720 about longitudinal axis “X-X” and relative to housing 20 urges flanges 240′ of bushing 216′ to rotate similarly, thereby effecting corresponding and cooperative rotation of outer insulative sleeve 210′, fixed shaft 12′, drive shaft 142′, inner shaft 226′, and knife drive shaft 182′ without interfering with the independent relative movements of these various shafts and sleeves of forceps 10′.
[0066] Turning again to
[0067] In the bipolar mode, monopolar assembly 200 remains disposed in the retracted position, as shown in
[0068] As shown in
[0069] With respect to the monopolar mode of operation, movable handle 40 is first depressed relative to fixed handle 50 to pivot jaw member 110 relative to jaw member 120 from the spaced-apart position to the approximated position. However, this step is not a necessity since, as described above, housing 20 includes a rotatable member 150 disposed therein and configured to move jaw members 110, 120 to the approximated position upon deployment of monopolar assembly 200. Once jaw members 110, 120 are disposed in the approximated position, monopolar assembly 200 is translated from the retracted position (
[0070] With monopolar assembly 200 disposed in the deployed position, as shown in
[0071] At the completion of tissue treatment, e.g., dissection, monopolar assembly 200 may be returned to the retracted position (
[0072] From the foregoing and with reference to the various figure drawings, those skilled in the art will appreciate that certain modifications can also be made to the present disclosure without departing from the scope of the same. 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. 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 and spirit of the claims appended hereto.