REUSABLE SURGICAL INSTRUMENT FOR MINIMALLY INVASIVE PROCEDURES

Abstract

Disclosed is a reusable surgical instrument (1) with an articulated end-effector (3), such as a dissector, scissor or grasper, to enhance a surgeon's performance during various surgical procedures. The longitudinal axis of the instrument is defined by a shaft (2), comprising an internal structural element (2″) covered by an external tube (2′), which may be inserted through a surgical incision into the body of a patient, optionally through a trocar. The articulated end-effector (3) is mounted on the distal extremity of the shaft's internal structural element and comprises a plurality of links interconnected by a plurality of joints, whose movements are remotely actuated by the surgeon's hands. This remote actuation is accomplished via mechanical transmission (5, 6, 7), mainly composed of flexible elements, which are able to deliver motion from a set of actuation elements, placed at a proximal extremity of the shaft (2), to the instrument's articulated end-effector (3). The external tube (2′) can be easily and individually detached from the shaft (2) after each procedure, so that the instrument (1) can be more effectively cleaned and sterilized.

Claims

1. A reusable surgical instrument comprising: an articulated end-effector, mounted on a distal extremity of the reusable surgical instrument, comprising one or more end-effector links; a proximal hub mounted on the proximal extremity of the reusable instrument comprising one or more rotating elements configured to actuate the end-effector links; mechanical transmission elements configured to transmit motion from the proximal hub to the articulated end-effector; and a shaft which defines the longitudinal axis of the instrument, comprising one or more internal structural elements incorporating the mechanical transmission elements and an external tube configured to protect the internal structural elements and prevent the passage of air through the reusable instrument to maintain insufflation of a body cavity.

2. The reusable surgical instrument of claim 1, wherein the external tube can be dis-attached from the shaft.

3. The reusable surgical instrument of claim 2, wherein the external tube can be dis-attached from the shaft without the need to disassemble any other components of the reusable surgical instrument.

4. The reusable surgical instrument of claim 2, wherein the external tube can be re-attached to the shaft after a cleaning or sterilization procedure is performed on the instrument.

5. The reusable surgical instrument of claim 1, wherein the external tube can be dis-attached from the shaft and re-attached to the shaft for multiple use cycles of the instrument.

6. The reusable surgical instrument of claim 2, wherein at least one transversal element is mounted on the one or more internal structural elements to improve the air-tightness of the reusable instrument.

7. The reusable surgical instrument of claim 6, wherein the at least one transversal element comprises one or more small channels through which the mechanical transmission elements can pass.

8. The reusable surgical instrument of claim 7, wherein the external tube is in contact with at least one sealing element, which fills a gap between an internal surface of the external tube and the transversal elements.

9. The reusable surgical instrument according to claim 1, wherein the external tube is in contact with at least one sealing element, which fills a gap between an internal surface of the external tube and the internal structural element.

10. The reusable surgical instrument according to claim 1, wherein the mechanical transmission elements comprise flexible mechanical elements, selected from the group consisting of wires, chains, ropes and belts.

11. The reusable surgical instrument of claim 10, wherein the tension on the mechanical transmission elements can be released after use to facilitate effective cleaning and sterilization procedures.

12. The reusable surgical instrument of claim 1, wherein the rotating elements are placed on a proximal articulated handle configured to be directly controlled by a hand of a user, so that the user's movements are transmitted to the articulated end-effector.

13. The reusable surgical instrument according to claim 1, wherein its proximal hub is configured to be attached to a mechanical platform comprising a master-slave telemanipulator, such that motion is transmitted from a proximal articulated handle of the master-slave telemanipulator to the rotating elements.

14. The reusable surgical instrument of claim 13, wherein its proximal extremity can be easily attached and detached from the mechanical platform, so that it is removably integrated as part of the master-slave telemanipulator.

Description

BRIEF DESCRIPTION OF THE FIGURES

[0011] The invention will be better understood according to the following detailed description of several embodiments with reference to the attached drawings, in which:

[0012] FIG. 1 shows a perspective view of a reusable surgical instrument according to an embodiment of the invention;

[0013] FIG. 2 shows a perspective view of a reusable surgical instrument according to an embodiment of the present invention with a schematic cutout of the external tube of the instrument shaft, through which is it possible to see the internal structural elements passing through the instrument shaft;

[0014] FIG. 3 shows a perspective view of a reusable surgical instrument according to an embodiment of the present invention with a schematic cutout of the external tube of the instrument shaft, through which is it possible to see different mechanical transmission elements;

[0015] FIG. 4 shows a perspective view of an articulated end-effector of a reusable surgical instrument according to an embodiment of the invention;

[0016] FIG. 5 shows an articulated end-effector according to an embodiment of the present invention in a first active position;

[0017] FIG. 6 shows an articulated end-effector according to an embodiment of the present invention in a second active position;

[0018] FIG. 7 shows an articulated end-effector according to an embodiment of the present invention in a third active position;

[0019] FIG. 8 shows an articulated end-effector according to an embodiment of the present invention in a fourth active position;

[0020] FIG. 9 shows an articulated end-effector according to an embodiment of the present invention in a fifth active position;

[0021] FIG. 10 shows actuation topology for a first distal end-effector link according to an embodiment of the present invention;

[0022] FIG. 11 shows actuation topology for a second distal end-effector link according to an embodiment of the present invention;

[0023] FIG. 12 shows actuation topology for a proximal end-effector link according to an embodiment of the present invention;

[0024] FIG. 13 shows a perspective view of proximal hub with different proximal rotating elements according to an embodiment of the present invention;

[0025] FIG. 14 shows a simplified path of a flexible transmission element actuating a distal articulation of an end-effector according to an embodiment of the present invention;

[0026] FIG. 15 shows a procedure through which an external tube of an instrument shaft can be assembled and disassembled on a reusable surgical instrument according to an embodiment of the present invention;

[0027] FIG. 16 shows a detailed perspective view of sealing and transversal elements mounted on an internal structural element according to an embodiment of the present invention.

DETAILED DESCRIPTION OF THE INVENTION

[0028] A reusable surgical instrument 1 for minimally invasive surgical procedures, with a detachable external tube 2′, constructed in accordance with an embodiment of the present invention, is described herein, and is seen generally in FIG. 1. This instrument 1 includes a main shaft 2, a distal articulated end-effector 3 and a proximal hub 4. Referring to FIG. 2, the shaft 2 is composed of two different elements: an internal structural element 2″ and an external tube 2′. The internal structural element 2″ provides a stable positioning to the end-effector 3 and to allow the passage of the different mechanical elements 5, 6, 7 that are able to deliver motion to the different end-effector links 8, 9, 10 from the proximal hub 4 at the proximal extremity of the instrument (FIGS. 3 and 4). The external tube 2′ protects the internal elements on the shaft 2 when passing through the incision and avoids the passage of air through the instrument 1, in order to maintain the inflation of the body cavity where the instrument 1 is operating.

[0029] Referring still to FIG. 4, the end-effector 3 is connected to the internal structural element 2″ by a proximal joint, which allows the rotation of the proximal end-effector link 8 about the proximal axis 11 in such a manner that the orientation of the proximal end-effector link 8 with respect to the main shaft axis 12 can be changed. The distal end-effector links 9, 10 are rotatably connected to the proximal end-effector link 8 by two distal joints, having coincident axes of rotation, which are represented by the distal axis 13. This distal axis 13 is substantially perpendicular and non-intersecting with the proximal axis 11 and substantially intersects the main shaft axis 12. FIGS. 5 to 9 show the surgical instrument 1 with different angular displacements at the end-effector joints. FIGS. 10 to 12 show the connection between the transmission element 5, 6, 7 and the end-effector links 8, 9, 10.

[0030] With reference to FIGS. 13 and 14, the movement is transmitted to each one of the three distal articulations of the instrument 1 by a rotating element 14, 15, 16, which is able to rotate about an axis 17 and is connected to a transmission element 5, 6, 7. As a result, when the rotating element 14, 15, 16 rotates a certain angle θ1, θ2, θ3 about the axis 17, a rotation α1, α2, α3 is transmitted to the respective end-effector member 8, 9, 10.

[0031] The external tube 2′ can be easily and individually detached and attached to the instrument 1 after each procedure. Referring to FIG. 15, the internal structural element 2″ is fixed directly to the proximal hub 4 and the external tube 2′ can be connected and disconnected from the internal structural element 2″ at the threaded surfaces 18a and 18b. Therefore, with this architecture, the external tube 2′ can be removed from the instrument 1, without the need to disassemble other parts of the system, like the articulated end-effector 3 or the mechanical transmission elements 5, 6, 7, which remain completely operational from a mechanical perspective without the external tube 2′. This feature facilitates the effective cleaning and sterilization of the instrument 1, which can easily be performed by the hospital staff.

[0032] Towards a more distal region of the instrument shaft 2, the external tube 2′ is in contact with a sealing element 19, which fills the gap between the internal surface of the external tube 2′ and the two transversal elements 20a, 20b that are mounted on the internal structural element 2″. These two transversal elements 20a, 20b have small channels 21a, 21b, 21c, 21d, 21e, 21f through which the transmission elements 5, 6, 7 can pass, guaranteeing the air-tightness of the instrument 1.

[0033] In some embodiments of the present invention, the mechanical transmission elements 5, 6, 7 may comprise ropes, whose tension can be released after each procedure, so that the cleaning and sterilization procedures become easier. By releasing the tension on the ropes, the blood and tissue infiltrated amongst the strands of the ropes can be more easily removed. In addition, areas of contact between the ropes and other mechanical elements (like pulleys, end-effector links 8, 9, 10 or rotating elements 14, 15, 16) can be more easily accessed.

[0034] While this invention has been shown and described with reference to particular embodiments thereof, it will be understood by those skilled in the art that various changes in form and details may be made therein without departing from the spirit and scope of the invention as defined by the appended claims. For instance, the external tube 2′ can be made out of different parts and can be attached to the proximal hub 4. In another embodiment, the internal structural element 2″ can also be composed of different parts and can assume different geometries with diverse cross sections, namely tubular (with openings) or U-shaped.

[0035] It will also be easily understood by one of skill in the art that the invention can easily be deployed in the context of other micro-manipulation tasks where complex instruments are used, but regular cleaning and/or sterilization of internal elements of an instrument shaft is desirable. Solely by way of example, micro-manipulation tasks are performed in contaminated environments, wherein thorough cleaning of instrument elements is required after each use. In this context, a detachable outer shaft allowing access to internal elements may be desirable.