A SURGICAL INSTRUMENT

Abstract

A handheld electrosurgical instrument with jaws at a distal end of a shaft. For moving the jaws, the instrument includes a linkage structure with at least three pivots which are movable relative to the housing and with at least pivot which is fixed to the housing. By this arrangement, one of the movable pivots may move as a substitute for movement of the jaws, and the instrument may therefore always have the same limits for handle movement e.g. also if the jaws are prevented from moving. Additionally, a more uniform closure pressure may be ensured independently on the force applied to the handle.

Claims

1. A handheld electrosurgical instrument for cutting, cauterizing, or coagulating tissue, the instrument comprising: a housing forming a fixed grip; a handle movable relative to the fixed grip; a shaft extending in a longitudinal direction from a proximal end to a distal end, the proximal end being attached to the housing; a jaw assembly comprising first and second jaw members attached to the distal end of the shaft at least one of the jaw members being movable relative to the other jaw member between an open position where tissue can be received between the jaw members and a closed position where the tissue can be fixed between the jaw members, the jaw assembly further comprising a rod movably arranged in the shaft and configured for moving the jaws between the open and closed positions; and a linkage structure for transferring force from the handle to the rod; wherein the linkage structure comprises at least a first, a second, and a third floating pivots each being movable relative to the housing, and at least one fixed pivot being attached to the housing; where: the first pivot is connected to the second pivot by a first element; the first pivot is connected to one of the at least one fixed pivots by a second element; the handle connects the second pivot and the third pivot; and the third pivot is connected to a primary one of the fixed pivots by an actuator element which is arranged to move the rod in the shaft upon rotation about the primary fixed pivot.

2. The instrument according to claim 1, further comprising a constraint structure limiting movement of the first pivot such that the jaws, during movement of the handle while the jaws are free to move relative to each other, moves to the closed position before the first pivot moves.

3. The instrument according to claim 1 where the first pivot is movably suspended in the housing in a generally linear track formed in the housing.

4. The instrument according to claim 2, where the constraint structure is configured to increase a release force which is necessary for moving the first pivot relative to the housing such that the release force becomes higher than a closure force which is needed for moving the jaws to the closed position under normal use when nothing is hindering free movement of the jaws relative to each other.

5. The instrument according to claim 2, where the constraint structure comprises a spring-element reversibly deformable between a deformed and a relaxed state.

6. The instrument according to claim 5, where the spring-element is arranged to become deformed at least upon movement of the first pivot relative to the housing.

7. claim 1, where the handle is movable relative to the grip between a first limit and a second limit, the first and second limits being on opposite sides of an intermediate position, and where the first, the second, and the third pivots are positioned along a first straight line when the handle is in the intermediate position.

8. The instrument according to claim 7, where the first and third pivot are positioned along a second straight line when the handle is in the first limit, and the second pivot is at a distance x from the second straight line, where x is in the range of 10-30 mm.

9. The instrument according to claim 7, where the first and third pivot are positioned along a third straight line when the handle is in the second limit, and the second pivot is at a distance y from the third straight line, where y is in the range of 1-10 mm.

10. The instrument according to claim 8, where the ratio x:y is at least 5.

11. The instrument according to claim 7, where at least one of the first, the second and the third straight lines is transverse to the longitudinal direction.

12. The instrument according to claim 11, where the straight line extends at an angle between 25 and 75 degrees to the longitudinal direction.

13. The instrument according to claim 5, where the spring-element is arranged to become deformed when the first, the second, and the third pivots are positioned along the straight line.

14. The instrument according to claim 5, where the spring-element becomes deformed along one of the first, the second and the third straight lines.

15. The instrument according to claim 1, where the first pivot is connected to the primary fixed pivot by the second element.

16. The instrument according to claim 15, where the spring-element is arranged directly adjacent the first pivot to become deformed by contact with the first pivot.

17. The instrument according to claim 1, further comprising a secondary fixed pivot, the first pivot being connected to the secondary fixed pivot by the second element.

18. The instrument according to claim 17, where the spring-element is arranged directly adjacent the second element to become deformed by contact with the second element.

19. The instrument according to claim 1, comprising a trigger movable between a released and an actuated position, and a knife movable in a space between the first and second jaw members upon movement of the trigger, wherein the linkage structure prevents movement of the trigger from the released to the actuated position when the jaws are in the open position.

20. The instrument according to claim 19, where the third pivot prevents movement of the trigger from the released to the actuated position.

21. The instrument according to claim 1, where the actuator element forms a first and a second leg, the first leg extending between the third pivot and the primary one of the fixed pivots, and the second legs comprises at least two oppositely directed projections arranged to cooperate with flanges of the rod to thereby move the rod in the shaft.

22. A method of obtaining a locked position of the at least one movable jaws in a handheld electrosurgical instrument which includes: a housing forming a fixed grip; a shaft extending in a longitudinal direction from a proximal end to a distal end, the proximal end being attached to the housing; a jaw assembly attached to the distal end of the shaft, the jaw assembly comprising first and second jaw members movable relative to each other between an open position where tissue can be received between the jaw members and a closed position where the tissue can be fixed between the jaw members, the jaws being movable by movement of a rod in the shaft; and a handle movable relative to the fixed grip thereby effecting movement of the rod in the shaft; the method comprising providing at least a first, a second and a third floating pivots, the floating pivots being provided such that they are movable relative to the housing; providing at least one pivot being fixed to the housing; connecting the first pivot and the second pivot with a first element connecting the first pivot and the fifth pivot with a second element connecting the second and third pivots with the handle; and arranging a rotatable actuator element such that it can move the rod in the shaft when it rotates.

23. The method of moving a knife out of a space between jaws of an instrument according to claim 19, the method comprising moving the handle distally towards a released position until mechanical contact between an edge of the handle and the trigger is established, continuing the movement of the handle in the distal direction while pressing the trigger distally by the contact with the handle until the trigger is in its released position.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0089] In the following, embodiments of the invention will be described in further details with reference to the drawings in which:

[0090] FIG. 1 illustrates a handheld electrosurgical instrument according to the invention;

[0091] FIGS. 2-8 illustrate an open version of the instrument for visualization of internal parts;

[0092] FIG. 9 illustrates an exploded view of the instrument; and

[0093] FIGS. 10-11 illustrate details of a trigger for a knife.

[0094] It should be understood that the detailed description and specific examples, while indicating embodiments of the invention, are given by way of illustration only, since various changes and modifications within the spirit and scope of the invention will become apparent to those skilled in the art from the detailed description.

[0095] FIG. 1 illustrates a handheld electrosurgical instrument 1 for cutting, cauterizing, or coagulating tissue. The instrument comprises a housing 2 forming an outer surface of the instrument and forming a fixed grip 3. A handle 4 is movable relative to the fixed grip and allows the surgeon to move the jaws 5 of the jaw assembly 6 between open and closed positions. The jaws are positioned at the distal end of the shaft 7. The shaft extends in a longitudinal direction, indicated by the arrow 8, from a proximal end 9, to the distal end 10 at which the jaw assembly 6 is attached. At the proximal end of the shaft, the shaft is attached to the housing.

[0096] FIGS. 2-8 illustrate the instrument in views where the housing and shaft are opened to visualize components inside the instrument. In this view, it can be seen that the jaw assembly further comprises a rod 11. The rod extends from the jaws through the shaft and into the housing. The rod can move in the longitudinal direction inside the shaft. In the distal end, the shaft is attached to the jaws in a joint which facilitate closing of the jaws when the rod moves proximally away from the jaws, and opening of the jaws when the rod moves distally in the direction towards the jaws.

[0097] The linkage structure is enclosed in the housing and arranged to transfer force from the handle to the rod such that the rod moves axially in the shaft when the handle is moved relative to the grip.

[0098] The linkage structure comprises the first pivot 12, which is connected to the second pivot 13 by a first rigid rod shaped element 14. The first pivot is connected to a fixed pivot 15 by a second rigid rod shaped element 16. The fixed pivot 15 is fixed rigidly to the housing 2.

[0099] The handle 4, or rather the bar shaped element 4′ forming part of the handle 4, connects the second pivot 13 and the third pivot 17, and the third pivot 17 is connected to a primary one of the fixed pivots 18 by an actuator element 19. The actuator element 19 can rotate about the primary fixed pivot 18 whereby it moves the rod in the shaft.

[0100] FIG. 2 illustrates the instrument with the handle in a first limit position where the jaws are open.

[0101] FIG. 3 illustrates an enlarged view of the housing and the linkage structure when the jaws are open, c.f. the configuration illustrated in FIG. 2. In this view, details of the linkage structure become clearer.

[0102] The pivots 15 and 18 are fixed to the housing and the housing thereby forms a rigid element between these two pivots. The linkage structure is thereby constituted by the bars 14, 16, 4′, 19′, and the bar which is formed by the housing, i.e. the bar existing between the pivots 15 and 18. The bars are linked by the pivots 12, 15, 13, 17, and 18. In the disclosed specific embodiment, the constraint structure is constituted by the spring 24. The spring 24 is compressible and allows movement of the pivot 12 in the handle. When the pivot 12 moves downwards away from the shaft, the movement is against the force from the spring, and when the pivot 12 moves upwards towards the shaft, the movement is supported by the force from the spring 24. The constraint structure, in the form of the spring 24, is shown in any of the FIGS. 2-3 and 5-8. The constraint structure provides resistance against movement of the first pivot. The constraint structure may also be constituted by other structural features whereby movement of the first pivot relative to the housing requires an increased force. As an example, movement of the first pivot may be limited by frictional resistance between the first pivot and the housing, by an elastically deformable coupling between the housing and the first pivot, or by other means. The movement may, correspondingly be limited by similar constraint structures working between one of the first and second elements and the housing, e.g. friction, springs, or other elastically deformable elements between the housing and one of the first and second elements.

[0103] FIG. 4 illustrates further details of the actuator element 19 and its interaction with the rod 11 (the rod 11 is not illustrated in FIG. 4). The actuator element is triangular and forms a first leg between the pivots 17, 18. This leg forms one of the linkages in the 5-bar linkage structure. The actuator element 19 also forms a second leg 19″ extending between the pivot 18 and the tip 19″. This leg is used for manipulating the rod upon rotation of the actuator element 19 about the fixed pivot 18. Near the tip 19′″, and more preferably, more than ⅔ of the distance between the pivot 18 and the tip 19′″ away from the pivot 18, the second leg forms at least one and preferably 2 curved projections 20, 22. The projection 20 pushes against the flange 21 and thereby pushes the rod 11 distally towards the jaws, and the projection 22 pushes against the flange 23 and thereby pushes the rod 11 proximally away from the jaws. The projections 20, 22 are on opposite sides of the second leg, and essentially at equal distance from the line between the pivots 17, 18.

[0104] FIGS. 5 and 6 illustrate the instrument with the handle pressed towards the grip and therefore with the jaws closed.

[0105] The instrument forms an intermediate handle position in which the first, second and third pivots are on a straight line. In this position, the first pivot 12 has moved downwards in the handle away from the third pivot 17, and following that movement, the spring 24 is compressed. In FIG. 5, the handle is in a position before the intermediate position just before the spring becomes compressed, and further depressing of the handle will bring the first, second and third pivots on a straight line.

[0106] FIG. 6 illustrates the instrument with the handle completely depressed, i.e. the handle is in the second limit whereby further movement of the handle towards the grip is prevented by contact between the handle and the housing or by other mechanical stop-means. In this position, the first pivot 12 is returned at least partly towards the original, first, position corresponding to the released handle. Accordingly, the compression force stored in the spring is at least partly released, and movement of the handle back towards the first position will require renewed compression of the spring. Accordingly, a latched position of the handle is obtained by the combination between the floating first pivot 12 and the constraint structure, in this case constituted by the spring 24.

[0107] In use, the handle can be moved from the first limit shown in FIG. 2 towards the second limit shown in FIG. 3. During this movement two different results may be achieved:

[0108] 1. During unhindered movement of the jaws, movement of the handle to the second limit will firstly rotate the actuator element about the primary fixed pivot and thereby move the jaws towards each other, c.f. difference between FIGS. 2, 3 and FIG. 5. When the jaws reach the closed position, continued movement of the handle, c.f. FIG. 6, will move the first pivot against the resistance of the constraint structure. During this movement, the surgeon will feel the resistance of the constraint structure against the movement of the handle, but the movement of the handle may continue. When reaching the intermediate position illustrated in FIG. 3, the spring or similar elastically deformable element is compressed, and further movement of the handle towards the second limit will return the second pivot and thus release at least a part of the compression of the spring. Accordingly, the handle can remain in this position without being held by the surgeon—i.e. a locked handle position is obtained.

[0109] 2. During movement of the handle when the jaws are blocked, e.g. by thick layers of tissue, or blood vessels etc. the jaws move until the closure force which is required to close the jaws exceeds the force required to move the first pivot. At that point, the jaws stop moving, and the first pivot moves as a substitute for the movement of the jaws until the handle reaches the second limit. Accordingly, the surgeon can press the handle as hard as he wishes knowing that the linkage structure and constraint structure will ensure that the jaw force will not become excessive. In fact, the closure force will always be the same no matter how hard the handle is forced towards the grip.

[0110] FIGS. 2 and 3 illustrate the handle in the first limit, and FIG. 6 illustrates the handle in the second limit.

[0111] FIG. 7 illustrates enlarged details of the linkage structure when the handle is in the first limit. The first and third pivots are positioned along a second straight line, illustrated by the dotted line 25. In this position of the handle, the second pivot 13 is at a longest possible distance, illustrated by the dotted line, x, from the second straight line.

[0112] FIG. 8 illustrates an enlarged view of the linkage structure when the handle is pressed towards the second limit. In the illustrated position, the handle has not yet reached the intermediate position in which the first, second and third pivots are on a straight line, but the distance from the second pivot 13 to the dotted line 25 between the first and third pivots 12, 17 has been reduced. The distance x may be as much as 10 mm or more.

[0113] When the handle reaches the second limit, i.e. when it is completely depressed, the second pivot will be on the other side of the dotted line. In this document we refer to the distance on this opposite side between the second pivot 13 and the dotted line with the letter “y”. This distance may e.g. be in the range of 0.01-5 mm, such as in the range of 0.1-2 mm such as in the range of 0.5-1.5 mm.

[0114] Particularly, the ratio of x:y should be larger than 5 or even larger than 10 or even larger than 15.

[0115] FIG. 9 illustrates an exploded view including the linkage structure and the constraint structure.

[0116] The instrument may typically include a bipolar knife, a mono-polar knife, or a non-electrical, mechanically sharpened knife. The knife is used for cutting the tissue after coagulation.

[0117] FIG. 10 illustrates the instrument including a trigger 26 located above the handle 4. The illustrated trigger is in a released position and can be moved in the proximal direction, i.e. away from the jaws, towards an actuated position. Correspondingly, the handle 4 is in the released position and can be moved in the proximal direction, i.e. away from the jaws, towards a completely depressed position.

[0118] The trigger, when moved from the released to the actuated position, translates a pinion 27 which engages a slot 28 in the knife arm 29 and thereby rotates the knife-arm about the knife-pivot 30. By rotation of the knife-arm, the knife-rod 31 is brought forward inside the shaft, and the knife is moved into the space between the jaws.

[0119] FIG. 11 illustrates an enlarged view of the trigger 26. The trigger is illustrated in a cross-section in which it can be seen that the trigger forms a slot 32 and that the trigger is arranged about the handle 4, or rather about the bar shaped element 4′ of the handle. In the cross-section, the slot 32 has no cross-hatching whereas the trigger, where the slot ends, has cross-hatching to illustrate the cross-section.

[0120] The slot forms, in its closed end, an edge 33 which abuts the handle 4, or which at least would come in contact with the handle 4 if the trigger was moved to the actuated position while the handle is in the released position. The mechanical contact between the edge 33 and the handle 4 thereby prevent the trigger to be actuated and the knife to be moved distally into the space between the jaws unless the handle is depressed and the jaws therefore are in the closed position. This increases safety and prevents injury with unintended cutting with the knife.

[0121] Once the handle is moved to the depressed position, the trigger can be moved to the actuated position.

[0122] When the trigger is released, it is brought back to the released position and the knife is pulled out of the space between the jaws by use of a spring. If the knife sticks to the tissue, and therefore does not return out of the space between the jaws, the handle 4 can be moved to force the trigger to the released position by a solid handgrip. For this purpose, the handle may preferably be shaped with a first face 34 being used for depressing the handle, and with a second face 35 being useful for pulling the handle back to the released position, and thereby, if necessary for pulling the trigger to the released position.

Numbered Embodiments

[0123] 1. A handheld electrosurgical instrument (1) for cutting, cauterizing, or coagulating tissue or vessels, the instrument comprising: [0124] a housing (2) forming a fixed grip (3); [0125] a handle (4) movable relative to the fixed grip; [0126] a shaft (7) extending in a longitudinal direction from a proximal end (9) to a distal end (10), the proximal end being attached to the housing; [0127] a jaw assembly (6) comprising first and second jaw members (5) attached to the distal end of the shaft and being movable relative to each other between an open position where tissue can be received between the jaw members and a closed position where the tissue can be fixed between the jaw members, the jaw assembly further comprising a rod (11) movably arranged in the shaft and configured for moving the jaws between the open and closed positions; [0128] a bar element (14) connected to the handle and to a point in the housing; [0129] an actuator element (19) configured to move the rod in the shaft

[0130] The actuator element is configured to move the rod inside the shaft when the actuator element is rotated around the pivot (18),

[0131] the handle (4) is rotationally connected to the actuator element in a pivot (17), and in a different point in the handle rotationally connected to the bar element (14), the bar element (14), extending between a first pivot and a rotational connection (13) between the first element and the handle, and where the first pivot (12) is movably suspended on the housing to enable traveling of the first pivot (12) relative to the housing during activation of the handle, such that the distance of the travel depends on the closure of the jaws.

[0132] 2. An instrument according to embodiment 1, where the first pivot is suspended from the housing by an element (16) that in the one end is connected to the first pivot and in the second end is connected to the housing by an additional pivot (15).

[0133] 3. An instrument according to embodiment 1 or 2, where the first pivot is movably suspended in the housing in a generally linear track formed in the housing.