Surgical instruments including adapter assemblies and articulated surgical loading units

Abstract

An adapter assembly includes: a cam housing defining a proximal cam groove and a distal cam groove; a first elongated shaft; and a second elongated shaft. The first elongated shaft has a proximal portion received in the proximal cam groove and a distal portion configured to be coupled to a surgical loading unit. The second elongated shaft has a proximal portion received in the distal cam groove and a distal portion configured to be coupled to the surgical loading unit. The first and second elongated shafts are configured to move in opposite longitudinal directions in response to rotation of the cam housing to hinge the surgical loading unit.

Description

Technical Field

[0001] This disclosure generally relates to surgical instruments for use with endoscopes, and more specifically, to surgical instruments comprising adapter assemblies with articulated surgical loading units. Background Technology

[0002] Various types of surgical instruments for treating tissues via endoscopy are known in the art and are commonly used, for example, to close tissues or organs during transection, resection, and anastomosis; to occlude organs in thoracic and abdominal surgeries; and to fuse or seal tissues in electrosurgery.

[0003] An example of such surgical instruments is a surgical suture instrument. Typically, a surgical suture instrument includes: an end effector having an anvil assembly and a cartridge assembly for supporting an array of surgical suture staples; a proximity mechanism for approaching the cartridge assembly and the anvil assembly; and a firing mechanism for ejecting the surgical suture staples from the cartridge assembly.

[0004] During laparoscopic or endoscopic surgery, access to the surgical site is achieved through a small incision or by inserting a narrow cannula through a small incision in the patient. Due to the limited area available for access to the surgical site, many endoscopic instruments include an end effector for hinged relative to the body of the instrument to improve access to the tissue to be treated. Additionally, some end effectors have a blade axis that translates through the end effector to tissue gripped by the jaws of the end effector. During hinged end effector engagement, the blade axis is subjected to bending moments and / or shear forces that may unintentionally drive the blade axis forward. Summary of the Invention

[0005] In one aspect of this disclosure, an adapter assembly includes: a cam housing defining a first cam groove; an outer tube extending distally from the cam housing; and a first elongated shaft. The outer tube has a distal portion configured to be coupled to a surgical loading unit. The first elongated shaft has a proximal portion received in the first cam groove of the cam housing and a distal portion configured to be coupled to the surgical loading unit, such that the first elongated shaft translates in response to rotation of the cam housing to hinge the surgical loading unit. The outer tube is configured to translate relative to the cam housing during rotation.

[0006] In some aspects, the adapter assembly may further include a second elongated shaft having a proximal portion received in a second cam groove defined by the cam housing and a distal portion configured to engage with the surgical loading unit. The first and second elongated shafts may be configured to move in opposite first and second longitudinal directions in response to rotation of the cam housing to hinge the surgical loading unit.

[0007] In some respects, the first cam groove and the second cam groove are configured to translate the first elongated shaft and the second elongated shaft at different rates from each other.

[0008] In some aspects, the adapter assembly may further include a pivot joint pivotally coupled to the distal portion of the outer tube. The pivot joint is configured to be coupled to the surgical loading unit such that the pivot joint and the surgical loading unit translate together with the outer tube.

[0009] In some aspects, the adapter assembly may further include a first link and a second link. The first link may have a proximal portion pivotally connected to a distal portion of the first elongated shaft and a distal portion pivotally connected to a first side of the pivot joint. The second link may have a proximal portion pivotally connected to a distal portion of the second elongated shaft and a distal portion pivotally connected to a second side of the pivot joint, such that the first link and the second link are hinged to the pivot joint relative to the outer tube.

[0010] In some respects, the first cam groove may have one of a right-handed helical configuration or a left-handed helical configuration, and the second cam groove may have the other of the right-handed helical configuration or the left-handed helical configuration.

[0011] In some aspects, the first elongated shaft may have a pin extending laterally from its proximal portion into the first cam groove. The second elongated shaft may have a pin extending laterally from its proximal portion into the second cam groove.

[0012] In some respects, the first cam groove may be a proximal cam groove, and the second cam groove may be a distal cam groove.

[0013] In some respects, each of the proximal cam groove and the distal cam groove may have a helical configuration.

[0014] In some aspects, the proximal cam groove may have a proximal section with a first spacing and a distal section with a second spacing. The distal cam groove may have a distal section with the first spacing and a proximal section with the second spacing.

[0015] In some respects, the second spacing may be greater than the first spacing.

[0016] According to another aspect of this disclosure, a surgical instrument includes a surgical loading unit and an adapter assembly. The surgical loading unit has an end effector and a blade shank that can be translated via the end effector. The adapter assembly has: a housing configured to be coupled to a handle assembly; a cam tube supported within the housing; an outer tube extending distally from the housing; and a first elongated shaft and a second elongated shaft. The cam tube has a first cam groove and a second cam groove. The outer tube has a distal portion configured to be coupled to the surgical loading unit. The first elongated shaft has a proximal portion received in the first cam groove of the cam tube and a distal portion configured to be coupled to the surgical loading unit. The second elongated shaft has a proximal portion received in the second cam groove of the cam housing and a distal portion configured to be coupled to the surgical loading unit. The first and second elongated shafts are configured to move in opposite first and second longitudinal directions in response to rotation of the cam housing to hinge the surgical loading unit. The outer tube is configured to translate relative to the cam tube and together with the tool holder when the cam housing rotates.

[0017] In some respects, the surgical loading unit can be axially constrained by the outer tube, such that the outer tube and the surgical loading unit move together and relative to the cam tube. Attached Figure Description

[0018] This document discloses, with reference to the accompanying drawings, an embodiment of a surgical instrument including the currently disclosed adapter assembly, wherein:

[0019] Figure 1A It is a perspective view of a surgical instrument including an adapter assembly and a surgical loading unit, wherein the staple cartridge body and the scalpel bar of the surgical loading unit are shown being removed from the surgical loading unit;

[0020] Figure 1B yes Figure 1A A perspective view of surgical instruments, in which the staple cartridge body of the surgical loading unit is shown as installed;

[0021] Figure 2 yes Figure 1A A perspective view of the internal components of the adapter assembly;

[0022] Figure 3 yes Figure 2 The diagram shows a perspective view of the internal components of the adapter assembly, with parts removed.

[0023] Figure 4 yes Figure 1A A side perspective view of the adapter assembly, showing the cam housing and outer tube;

[0024] Figure 5 It is a demonstration Figure 4 A side perspective view of the internal components of the adapter assembly, where the parts are separated;

[0025] Figure 6 yes Figure 4 A longitudinal cross-sectional view of the adapter assembly;

[0026] Figure 7 yes Figure 4 A side perspective view of the cam housing, partially shown in dashed lines;

[0027] Figure 8A yes Figure 4 A side perspective view of the adapter assembly, in which the pivot joint is shown in the non-hinged position;

[0028] Figure 8B yes Figure 4 A side perspective view of the adapter assembly, in which the pivot joint is shown in a semi-hinged position; and

[0029] Figure 8C yes Figure 4 A side perspective view of the adapter assembly, in which the pivot joint is shown in its fully hinged position. Detailed Implementation

[0030] Those skilled in the art will understand that the adapter assembly and surgical loading unit specifically described herein and illustrated in the accompanying drawings are non-limiting exemplary embodiments. It is conceivable that elements and features shown or described in connection with one exemplary embodiment may be combined with elements and features of another exemplary embodiment without departing from the scope of this disclosure. Furthermore, those skilled in the art will understand additional features and advantages of this disclosure based on the described embodiments. Therefore, this disclosure should not be limited to what has been specifically shown and described except as indicated by the appended claims.

[0031] As used herein, the term "distal" refers to the portion of a surgical instrument furthest from the clinician, while the term "proximal" refers to the portion of a surgical instrument closest to the clinician. Additionally, as used herein, the term "clinician" refers to a medical professional, including doctors, nurses, and support staff.

[0032] This disclosure relates to a surgical instrument comprising: an adapter assembly configured to be actuated by a handheld actuator or a surgical robot system; and a surgical loading unit coupled to the adapter assembly. The adapter assembly includes a hinge mechanism that drives the surgical loading unit to hinge relative to the adapter assembly. The hinge mechanism includes a cam housing defining a pair of cam slots, each of the cam slots receiving a corresponding pin of a pair of elongated shafts. When the cam housing rotates, the cam slots drive opposing longitudinal movements of the pair of elongated shafts hinged to the surgical loading unit. The cam slots are shaped such that the pair of elongated shafts translate at slightly different rates to apply a net proximal force or a net distal force to the surgical loading unit, thereby translating the surgical loading unit relative to the cam housing. In this way, when the blade of the surgical loading unit is unintentionally translated during the hinge of the surgical loading unit, the surgical loading unit will also translate with it to eliminate any relative translation between the surgical loading unit and the blade. Further advantages of the surgical instruments and their components disclosed herein are described below.

[0033] Figure 1A and 1B A surgical instrument 10 is shown, comprising a handle assembly 12, an adapter assembly 20 configured to be coupled to the handle assembly 12, and a surgical loading unit 30 pivotally coupled to the adapter assembly 20. While the depicted surgical instrument 10 can be configured to fire suture staples, it is contemplated that the surgical instrument 10 can be adapted to fire any other suitable fasteners, such as clamps and two-piece fasteners. Furthermore, although the figures depict a linear surgical suture instrument 10, it is contemplated that certain components described herein can be adapted for use in other types of endoscopic surgical instruments, including nonlinear surgical suture loading units, endoscopic forceps, grippers, dissecters, other types of surgical suture instruments, powered vascular sealing and / or cutting devices, etc.

[0034] Typically, the adapter assembly 20 of the surgical instrument 10 includes a housing 21 and an outer tube 24 extending distally from the housing 21. The housing 21 includes a knob housing 22 and a coupling mechanism 25 extending proximally from the knob housing 22 and configured to be operably coupled to a handle assembly 12 or a surgical robot system (not shown) responsible for actuating the surgical instrument 10. The outer tube 24 has a proximal portion 24a slidably disposed within the distal portion of the knob housing 22. In other embodiments, the outer tube 24 may be rotatable relative to and within the knob housing 22. A surgical loading unit 30 is adapted to attach to the distal portion 24b of the outer tube 24 of the adapter assembly 20 and may be configured for single use or for multiple uses. Pivot joint 26 ( Figure 4 The pivot joint 26 is pivotally connected to and axially restricted to the distal portion 24b of the outer tube 24. The pivot joint 26 is configured to support the collar 32 of the surgical loading unit 30 thereon, such that the outer tube 24 and the surgical loading unit 30 can be translated together with respect to the outer casing 21 as an integrated unit.

[0035] The surgical loading unit 30 includes an end effector 34 supported on a collar 32. The end effector 34 includes an anvil plate 36 non-rotatably coupled to the collar 32 and a staple cartridge assembly 37 disposed relative to the anvil plate 36. The staple cartridge assembly 37 has a base 38 pivotally coupled to the collar 32 and a staple cartridge body 40 configured to be removably housed in a channel 42 within the base 38. A scalpel bar 41 is translatable through the end effector 34 to cut tissue disposed therebetween. The scalpel bar 41 is also configured to selectively open and close the end effector 34 and to fire staples from it as it translates through the end effector 34.

[0036] For a detailed description of the handle assembly 12, reference can be made to U.S. Patent No. 9,918,713, filed November 21, 2014, and U.S. Patent Application Publication No. 2016 / 0310134, filed April 12, 2016, the entire contents of each of which are incorporated herein by reference.

[0037] refer to Figure 2 and 3 The hinge mechanism of the adapter assembly 20 will now be described. The adapter assembly 20 includes a hinged input shaft 50, a firing input shaft 52, and a rotary input shaft 54, each input shaft being rotatably supported on the housing 21. Figure 1AIn the connecting mechanism 25, the articulated input shaft 50 has a proximal portion 50a, which is configured to be drivably coupled to a corresponding drive member 13 of the handle assembly 12 to achieve rotation of the articulated input shaft 50. The articulated input shaft 50 has a distal portion 50b, which has a gear 56 (e.g., a spur gear) fixed therearound.

[0038] The adapter assembly 20 includes a ring gear 58 operably coupled to the articulated input shaft 50 and non-rotatably coupled to the cam housing 60. The ring gear 58 has an inner surface defining gear teeth 62 that engage with the gear teeth of a first gear 64a of a spur gear set 64. The spur gear set 64 has a second gear 64b fixed to and disposed adjacent to the first gear 64a, and having a diameter larger than that of the first gear 64a. The second gear 64b of the spur gear set 64 engages with a gear 56 non-rotatably fixed about the distal portion 50b of the articulated input shaft 50. Therefore, rotation of the articulated input shaft 50 causes rotation of the first gear 64a and the second gear 64b of the spur gear set 64, which in turn drives the ring gear 58 and the coupled cam housing 60 to rotate.

[0039] refer to Figure 4-7 The cam housing 60 of the adapter assembly 20 is rotatably supported within the knob housing 22. The cam housing 60 can be pinned to the ring gear 58. Figure 2 and 3 This causes the cam housing 60 to rotate with the rotation of the ring gear 58. The cam housing 60 defines a longitudinally extending channel 70 therethrough, the dimensions of which are designed to accommodate the various components of the hinge mechanism and firing mechanism of the adapter assembly 20, thereby allowing for a more compact design of the adapter assembly 20.

[0040] The cam housing 60 defines a proximal cam groove 72a communicating with the channel 70 and a distal cam groove 72b located on the distal side of the proximal cam groove 72a and communicating with the channel 70. The proximal cam groove 72a and the distal cam groove 72b are longitudinally spaced from each other and surround a central longitudinal axis “X” defined by the channel 70 of the cam housing 60. Figure 7 The cam groove 72a and the distal cam groove 72b each have opposite helical configurations. For example, the proximal cam groove 72a may have a left-handed helical configuration, while the distal cam groove 72b may have a right-handed helical configuration, or vice versa. The proximal cam groove 72a has a proximal section 73 with a first spacing and a distal section 75 with a second spacing greater than the first spacing. The distal cam groove 72b has a distal section 77 with a first spacing and a proximal section 79 with a second spacing. In all respects, the proximal section 73 and the distal section 77 may have the second spacing, and the distal section 75 and the proximal section 79 may have the first spacing.

[0041] The adapter assembly 20 further includes a pair of first axially movable elongated shafts 74 and a second axially movable elongated shaft 76, and a pair of first hinge links 86 and a second hinge link 88. The first elongated shafts 74 and the second elongated shafts 76 are positioned on opposite sides of the central longitudinal axis “X” of the cam housing 60. Each of the first elongated shafts 74 and the second elongated shaft 76 has proximal portions 74a, 76a disposed within the knob housing 22 and distal portions 74b, 76b disposed within the outer tube 24. The proximal portion 74a of the first elongated shaft 74 has a radially outwardly extending protrusion or pin 82 received within a proximal cam groove 72a. The proximal portion 76a of the second elongated shaft 76 has a radially outwardly extending protrusion or pin 84 received within a distal cam groove 72b. Because the proximal cam groove 72a and the distal cam groove 72b of the cam housing 60 have opposite helical configurations (e.g., right-hand thread versus left-hand thread), the rotation of the cam housing 60 drives the first elongated shaft 74 and the second elongated shaft 76 in opposite longitudinal directions. Furthermore, because the different segments 73, 75, 77, and 79 of the cam grooves 72a and 72b are spaced differently, the proximal cam groove 72a and the distal cam groove 72b translate the first elongated shaft 74 and the second elongated shaft 76 at different rates, as will be described in further detail below.

[0042] The first articulated link 86 of the surgical instrument 10 has a proximal portion 86a pivotally connected to the distal portion 74b of the first elongated shaft 74, and the second articulated link 88 has a proximal portion 88a pivotally connected to the distal portion 76b of the second elongated shaft 76. In various respects, the first and second articulated links can be connected to the first and second elongated shafts 74 and 76 via intermediate shafts 81 and 83. The first link 86 and the second link 88 each have distal portions 86b and 88b pivotally connected to opposite sides of the collar 32 of the surgical loading unit 30. Therefore, the opposing longitudinal movements of the first and second elongated shafts 74 and 76 caused by the rotation of the cam housing 60 push and pull the corresponding first link 86 and second link 88 to articulate the surgical loading unit 30 relative to the adapter assembly 20.

[0043] In operation, to articulate the surgical loading unit 30, the articulated input shaft 50 is rotated by the actuation of the handle assembly 12. The articulated input shaft 50 transfers rotational motion about its fixed gear 56 to the ring gear 58 via the spur gear set 64. Since the cam housing 60 is fixed to the ring gear 58, the cam housing 60 rotates together with the ring gear 58 about the central longitudinal axis "X". As the cam housing 60 rotates, the proximal cam groove 72a of the cam housing 60 drives the pin 82 of the first elongated shaft 74 through the proximal cam groove 72 in the proximal direction, and the distal cam groove 72b of the cam housing 60 drives the pin 84 of the second elongated shaft 76 through the distal cam groove 72b in the distal direction.

[0044] Since the first hinge link 86 acts as a pivotable connection between the first elongated shaft 74 of the adapter assembly 20 and the first side of the surgical loading unit 30, and the second link 88 acts as a pivotable connection between the second elongated shaft 76 of the adapter assembly 20 and the second side of the surgical loading unit 30, the proximal movement of the first elongated shaft 74 and the distal movement of the second elongated shaft 76 are caused by... Figure 8A Arrow "A" indicates the hinge of the surgical loading unit 30 driven to the left. It can be envisioned that rotation of the cam housing 60 in the opposite direction causes the surgical loading unit 30 to hinge to the right.

[0045] During some periods of use, because the surgical loading unit 30 is hinged relative to the outer tube 24, the shank 41 (FIG. 1) may be unintentionally driven distally. This can be undesirable, as if the shank 41 advances, it may cut tissue and / or prematurely drive suture staples into the tissue. However, due to the contours of the proximal cam groove 72a and distal cam groove 72b of the cam housing 60, the surgical loading unit 30 (together with the outer tube 24) is driven distally at the same rate as the shank 41 during hinge.

[0046] For example, when the surgical loading unit 30 is connected to the outer tube 24 ( Figure 8A Coaxially hinged to approximately 40 degrees ( Figure 8B ) and about 70 degrees ( Figure 8C When the distal segment 75 of the proximal cam groove 72a is positioned relative to the proximal segment 79 of the distal cam groove 72b, the larger distance causes the right slender shaft 76 to translate distally slightly faster than the left slender shaft 74 to translate proximally. Therefore, the right slender shaft 76 exerts a net distal force on the surgical loading unit 30 (and the attached outer tube 24), as... Figure 8B and 8CThe space “S” shown demonstrates the distal translation of the surgical loading unit 30 (and the attached outer tube 24) relative to the cam housing 60. Because the surgical loading unit 30 translates relative to the cam housing 60, the accompanying translation of the end effector 30 in the same direction cancels out any unintentional translation of the shank 41. Therefore, no relative motion is achieved between the shank 41 and the end effector 30.

[0047] Those skilled in the art will understand that the adapter assemblies and methods specifically described herein and illustrated in the accompanying drawings are non-limiting exemplary embodiments. It is conceivable that elements and features shown or described in connection with one exemplary embodiment may be combined with elements and features of another exemplary embodiment without departing from the scope of this disclosure. Furthermore, those skilled in the art will understand additional features and advantages of this disclosure based on the foregoing embodiments. Therefore, this disclosure should not be limited to what has been specifically shown and described, except as indicated by the appended claims.

Claims

1. An adapter assembly comprising: A cam housing that defines a first cam groove; An outer tube extends distally from the cam housing and has a distal portion configured to be coupled to a surgical loading unit; A first elongated shaft having a proximal portion received in a first cam groove in the cam housing and a distal portion configured to be coupled to the surgical loading unit, such that the first elongated shaft translates in response to rotation of the cam housing to hinge the surgical loading unit, wherein the outer tube is configured to translate relative to the cam housing when the cam housing rotates. as well as A second elongated shaft having a proximal portion received in a second cam groove defined by the cam housing and a distal portion configured to be coupled to the surgical loading unit, wherein the first elongated shaft and the second elongated shaft are configured to move in opposite first and second longitudinal directions in response to rotation of the cam housing to hinge the surgical loading unit; The first cam groove has one of a right-handed helical configuration or a left-handed helical configuration, and the second cam groove has the other of the right-handed helical configuration or the left-handed helical configuration.

2. The adapter assembly of claim 1, wherein the first cam groove and the second cam groove are configured to translate the first elongated shaft and the second elongated shaft at different rates from each other.

3. The adapter assembly of claim 1, further comprising a pivot joint pivotally coupled to the distal portion of the outer tube, wherein the pivot joint is configured to be coupled to the surgical loading unit such that the pivot joint and the surgical loading unit are translatable together with the outer tube.

4. The adapter assembly of claim 3, further comprising: A first link having a proximal portion pivotally connected to a distal portion of the first elongated shaft and a distal portion pivotally connected to a first side of the pivot joint; as well as The second link has a proximal portion pivotally connected to the distal portion of the second elongated shaft and a distal portion pivotally connected to a second side of the pivot joint, such that the first link and the second link are hinged to the pivot joint relative to the outer tube.

5. The adapter assembly of claim 1, wherein the first elongated shaft has a pin extending laterally from its proximal portion into the first cam groove, and the second elongated shaft has a pin extending laterally from its proximal portion into the second cam groove.

6. The adapter assembly of claim 1, wherein the first cam groove is a proximal cam groove and the second cam groove is a distal cam groove.

7. The adapter assembly of claim 6, wherein each of the proximal cam groove and the distal cam groove has a helical configuration.

8. The adapter assembly of claim 7, wherein the proximal cam groove has a proximal section with a first spacing and a distal section with a second spacing, and the distal cam groove has a distal section with the first spacing and a proximal section with the second spacing.

9. The adapter assembly of claim 8, wherein the second spacing is greater than the first spacing.

10. A surgical instrument comprising: Surgical loading unit, comprising: End effector; as well as A tool holder, which is capable of translation via the end effector; as well as Adapter assembly, comprising: A housing configured to be attached to a handle assembly; A cam housing, which is supported within the outer housing and defines a first cam groove and a second cam groove; An outer tube extends distally from the outer casing and has a distal portion configured to be coupled to the surgical loading unit; A first elongated shaft has a proximal portion housed in a first cam groove in the cam housing and a distal portion configured to be coupled to the surgical loading unit. as well as A second elongated shaft having a proximal portion received in a second cam groove of the cam housing and a distal portion configured to be coupled to the surgical loading unit, wherein the first and second elongated shafts are configured to move in opposite first and second longitudinal directions in response to rotation of the cam housing to hinge the surgical loading unit, wherein the outer tube is configured to translate relative to the cam housing and together with the scalpel bar when the cam housing rotates; The first cam groove has one of a right-handed helical configuration or a left-handed helical configuration, and the second cam groove has the other of the right-handed helical configuration or the left-handed helical configuration.

11. The surgical instrument of claim 10, wherein the first cam groove and the second cam groove are configured to translate the first elongated shaft and the second elongated shaft at different rates from each other.

12. The surgical instrument of claim 10, wherein the surgical loading unit is axially constrained by the outer tube such that the outer tube and the surgical loading unit together translate relative to the cam housing.

13. The surgical instrument of claim 10, wherein the first elongated shaft has a pin extending laterally from its proximal portion into the first cam groove, and the second elongated shaft has a pin extending laterally from its proximal portion into the second cam groove.

14. The surgical instrument of claim 10, wherein the first cam groove is a proximal cam groove and the second cam groove is a distal cam groove.

15. The surgical instrument of claim 14, wherein each of the proximal cam groove and the distal cam groove has a helical configuration.

16. The surgical instrument of claim 15, wherein the proximal cam groove has a proximal section with a first spacing and a distal section with a second spacing, and the distal cam groove has a distal section with the first spacing and a proximal section with the second spacing.

17. The surgical instrument of claim 16, wherein the second spacing is greater than the first spacing.

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