Organ collection tool

Abstract

A surgical instrument for harvesting an organ includes a surgical tool and a handle. The handle includes an actuator rotatable about an actuator pivot pin and a cam connected to the actuator and rotatable in cooperation with the actuator. The surgical instrument also includes an actuator rod having a distal end connected to the surgical tool and a proximal end connected to the cam. The cam defines a slot that captures a portion of the actuator rod. A portion of the actuator rod that is captured in the slot may slide within the slot as the cam rotates. Sliding of the portion of the actuator rod in the slot actuates the surgical tool.

Description

[0001] Cross - reference to related applications

[0002] This application claims priority to U.S. Provisional Patent Application No. 63 / 410,943, filed on September 28, 2022, the entire content of which is incorporated herein by reference. Technical Field

[0003] The present disclosure relates to a surgical instrument and, more particularly, to an organ harvesting device. Background Art

[0004] In endoscopic vein harvesting (EVH) surgery, a slender surgical instrument can be advanced into an access path near the saphenous vein in a patient's leg, and the blood vessel can be separated from adjacent tissue along the saphenous vein, and collateral blood vessels can be severed along the route of the blood vessel to be harvested. Similar techniques can also be used to harvest the radial artery or other target structures.

[0005] Vascular harvesting devices typically include a surgical tool located at the distal end of the harvesting device and a handle having a controller for operating the surgical tool. The handle is typically held in the operator's hand, and the controller is actuated by the bending of the operator's thumb or finger that pulls the trigger. The harvesting process typically requires repeated bending of the thumb or finger, which can cause operator fatigue. For example, for a single vascular harvesting procedure, the controller may need to be actuated 20 to 60 times with a force of 6 to 7 pounds per actuation. To compensate for fatigue, the operator may adopt hand positions, which results in inefficient use of the surgical tool and potential damage to the harvesting device and the patient's tissue / organs.

[0006] Symmetrical control configurations often make the use of prior art devices non - intuitive. For example, such a controller can be moved in the proximal direction to activate an electrode at or in the surgical tool and can be moved in the distal direction to deactivate the electrode. If the controller is symmetrical with respect to the operating direction, the operator may become confused as to whether he / she is activating or deactivating the electrode. Summary of the Invention

[0007] In view of the above problems, there is a need for a device and a method for the device that are intuitive to operate and that do not easily cause operator fatigue.

[0008] Embodiments of the present invention relate to a surgical instrument for harvesting an organ, including a surgical tool and a handle. The handle includes an actuator rotatable about an actuator pivot pin and a cam connected to the actuator and capable of co-rotating with the actuator. The surgical instrument further includes an actuator rod having a distal end connected to the surgical tool and a proximal end connected to the cam. The cam defines a slot that captures a portion of the actuator rod. The portion of the actuator rod captured in the slot is slidable within the slot when the cam rotates. The sliding of the portion of the actuator rod in the slot actuates the surgical tool.

[0009] In some embodiments, the slot defines a proximal recess and a distal recess. Moving the button of the actuator in the proximal direction causes the portion of the actuator captured in the slot to slide toward the proximal recess. Moving the button of the actuator in the distal direction causes the portion of the actuator captured in the slot to slide toward the distal recess.

[0010] In some embodiments, the surgical tool includes a main jaw and a secondary jaw. The sliding of the portion of the actuator rod in the slot causes the main jaw and the secondary jaw to open or close relative to each other.

[0011] In some embodiments, the handle further includes one or more biasing elements configured to bias the actuator toward a zero position, at which the portion of the actuator rod captured in the slot is positioned between the proximal recess and the distal recess of the slot.

[0012] In some embodiments, the one or more biasing elements include one or more springs disposed in a guide channel of the handle.

[0013] In some embodiments, the surgical tool includes a conductive element. The handle further includes a switch for supplying current from a power source to the conductive element and a switch link pivotally connected to the actuator or the cam and configured to actuate the switch. At the zero position of the actuator, the switch link does not actuate the switch. Rotation of the actuator about the actuator pivot pin beyond the zero position by a distance greater than a predetermined distance causes the switch link to actuate the switch.

[0014] In some embodiments, the surgical tool includes a main jaw and a secondary jaw. At the zero position of the actuator, the main jaw and the secondary jaw are closed relative to each other.

[0015] In some embodiments, the one or more biasing elements include a first compression spring and a second compression spring, and the first compression spring and the second compression spring are configured to bias the switch link toward a balanced position where the force applied by the first compression spring balances the force applied by the second compression spring. The balanced position corresponds to the zero position of the actuator.

[0016] In some embodiments, the slot in the cam is non-linear.

[0017] In some embodiments, the actuator rod is flexible.

[0018] Other embodiments of the present invention relate to a surgical instrument for harvesting an organ. The surgical instrument includes: a handle that includes an actuator; and a surgical tool that includes a main jaw and a secondary jaw, and the main jaw and the secondary jaw are configured to open and close relative to each other in response to movement of the actuator. The main jaw includes a support structure, a conductive element having a distal shank, and a retaining insert disposed at a distal end of the support structure and defining a cavity for receiving the distal shank of the conductive element.

[0019] In some embodiments, the main jaw further includes an insulating material applied around the support structure and between the support structure and the conductive element.

[0020] In some embodiments, the distal shank of the conductive element is bent toward the support structure.

[0021] In some embodiments, the handle further includes a switch for supplying current from a power source to the conductive element.

[0022] In some embodiments, the retaining insert is made of a non-conductive material and isolates the distal shank from the support structure.

[0023] In some embodiments, the main jaw further includes a raised marker to indicate the position of the surgical tool to an operator.

[0024] In some embodiments, the raised marker extends at least partially around an outer surface of the main jaw.

[0025] In some embodiments, the raised marker has a generally semi-circular cross-section.

[0026] In some embodiments, the raised marker is integrally formed with the insulating material of the main jaw.

[0027] In some embodiments, the secondary jaw includes a raised marker to indicate the position of the surgical tool to an operator.

[0028] The further details and advantages of the various examples described in detail herein will become apparent after reading the following detailed description of the various examples in conjunction with the accompanying drawings. BRIEF DESCRIPTION OF THE DRAWINGS

[0029] Figure 1 is a perspective view of a surgical instrument according to an embodiment of the present disclosure;

[0030] Figure 2 is Figure 1 a partial side view of the surgical instrument of

[0031] Figure 3 is Figure 1 a side view of the surgical instrument of

[0032] Figure 4 is Figure 1 a perspective view of the surgical tool of , showing the surgical tool in an open position;

[0033] Figure 5 is Figure 4 a perspective view of the surgical tool of , showing the surgical tool in a closed position;

[0034] Figure 6 is Figure 4 a perspective view of the surgical tool of , with the insulation cover removed for clarity;

[0035] Figure 7 is Figure 6 a top view of the main jaws of the surgical tool of ;

[0036] Figure 8 is Figure 5 a perspective cross-sectional view of the surgical tool of ;

[0037] Figure 9 is Figure 5 a cross-sectional view of the surgical tool of cauterizing a blood vessel during a surgical procedure;

[0038] Figure 10 is Figure 4 a perspective view of the surgical tool of , with the insulation layer shown transparently for clarity;

[0039] Figure 11 is Figure 4 a side perspective view of the surgical tool of , with the insulation layer shown transparently for clarity;

[0040] Figure 12 is Figure 1 a partial exploded view of the surgical tool of ;

[0041] Figure 13 is Figure 1Side cross-sectional view of the handle of the surgical instrument;

[0042] Figure 14 is Figure 1 Electrical schematic diagram of the switch and associated components of the surgical instrument;

[0043] Figure 15 is Figure 14 Electrical schematic diagram of the switch and cable;

[0044] Figure 16 is Figure 1 Perspective view of the actuator, internal circuit and associated components of the surgical instrument;

[0045] Figure 17 is Figure 1 Left side view of the actuator of the surgical instrument; and

[0046] Figure 18 is Figure 17 Right side view of the actuator. Detailed Description

[0047] For the purposes of the description hereinafter, the terms "up", "down", "right", "left", "vertical", "horizontal", "top", "bottom", "lateral", "longitudinal" and their derivatives will refer to the present invention as oriented in the accompanying drawings.

[0048] Spatial or directional terms such as "left", "right", "in", "out", "up", "down", etc. should not be considered limiting, since the present invention may assume various alternative orientations.

[0049] All numbers used in the specification and claims should be understood to be modified in all instances by the term "about". The terms "about", "approximately" and "substantially" refer to a range of plus or minus 10% of the stated value.

[0050] As used herein, the term "at least one of" is synonymous with "one or more of". For example, the phrase "at least one of A, B, and C" means any one of A, B, and C, or any combination of any two or more of A, B, and C. For example, "at least one of A, B, and C" includes one or more of A alone; or one or more of B alone; or one or more of C alone; or one or more of A and one or more of B; or one or more of A and one or more of C; or one or more of B and one or more of C; or one or more of all A, B, and C. Similarly, as used herein, the term "at least two of" is synonymous with "two or more of". For example, the phrase "at least two of D, E, and F" means any combination of any two or more of D, E, and F. For example, "at least two of D, E, and F" includes one or more of D and one or more of E; or one or more of D and one or more of F; or one or more of E and one or more of F; or one or more of all D, E, and F.

[0051] It should also be understood that the specific devices and processes shown in the drawings and described in the following specification are merely exemplary examples of the present disclosure. Accordingly, the specific dimensions and other physical characteristics related to the embodiments disclosed herein should not be considered limiting.

[0052] When used in relation to a component of a surgical instrument, the term "proximal" refers to the portion of the component that is furthest from the surgical access site of the patient. When used in relation to a component of a surgical instrument, the term "distal" refers to the portion of the component that is closest to the patient or inserted into the patient's body.

[0053] As used herein, the term "surgical tool" refers to any device or assembly that can be used to manipulate tissue (e.g., process, manipulate, respond to, hold, cut, heat, or energize tissue, etc.).

[0054] Referring now to the drawings, in which like reference numerals represent like components, embodiments of the present invention relate to a surgical instrument, particularly for use in endoscopic vessel harvesting (EVH) surgery. First, referring to Figures 1 to 3 , a surgical instrument 9 according to an embodiment of the present disclosure includes a handle 11, an elongate body 13 having a proximal end 10 and a distal end 12, and a surgical tool 14 located at the distal end 12 of the elongate body 13. The proximal end 10 of the elongate body 13 is coupled to the distal end 16 of the handle 11. The elongate body 13 can be rigid or flexible. The handle 11 includes an actuator 15 that passes through an actuator rod 36 (see Figure 12)Coupled to the surgical tool 14 for controlling the operation of the surgical tool 14. The actuator rod 36 can be one or more cables, shafts, gears, or any other suitable mechanical means. The handle 11 and the actuator 15 can be made of an insulating material such as plastic.

[0055] Continuing to refer to Figures 1 to 3 And further referring to Figures 4 to 9 , the surgical tool 14 includes a pair of opposing jaws, namely, a main jaw 21 and a secondary jaw 23, for clamping, cutting, and sealing blood vessels. The main jaw 21 includes a conductive element 40 facing the secondary jaw 23. Alternatively or additionally, the secondary jaw 23 may include a conductive element facing the main jaw 21. The conductive element 40 can be in the form of an electrode and is configured to selectively transfer heat during use. As used in this specification, the term "electrode" refers to a component for delivering energy (such as thermal energy) and should not be limited to a component for delivering any particular form of energy. In different embodiments, the conductive element 40 can be made of nickel-chromium, stainless steel, or other metals or alloys. The jaws 21, 23 are configured to close in response to actuation of the actuator 15 (e.g., pressing, pulling, or pushing, etc.), thereby clamping a blood vessel during the performance of a surgical procedure. The actuator 15 can be a two-stage actuator such that actuation (e.g., pressing, pulling, or pushing, etc.) initially closes the jaws 21, 23, and further actuation (e.g., further pressing, further pulling, or further pushing, etc.) causes the conductive element 40 to provide (e.g., emit) heat, thereby cutting and sealing the clamped blood vessel. In particular, when the actuator 15 is further actuated, the conductive element 40 is electrically coupled via a cable 29 to a direct current (DC) source 30 (see Figure 1 ), which supplies current to the conductive element 40 and thereby heats the conductive element 40. After the blood vessel is cut and sealed, the actuator 15 can be deactuated to stop delivering current to the conductive element 40, and can be further deactuated to open the jaws 21, 23. In other embodiments, the source 30 can be other types of energy sources and does not need to be a DC source. The cable 29 can include a plug-type connector 31, which helps to simply and user-friendly connect the surgical instrument 9 to the source 30. In some embodiments, the cable 29 can include three wires, and the connector 31 can include three pins corresponding to the three wires of the cable 29.

[0056] Continuing to refer to Figures 1 to 12, the actuator rod 36 that mechanically couples the jaws 21, 23 to the actuator 15 can be electrically insulated, for example, by silicone rubber, ceramic, plastic heat shrink material, or other suitable non-conductive material. This ensures that energy is safely conducted along the wires housed within the elongate body 13 to the conductive element 40 (and / or the conductive element of the secondary jaw 23) at the primary jaw 21. In other embodiments, the elongate body 13 may not include wires for coupling to the conductive element 40. Alternatively, the actuator rod 36 can be conductive and used to transfer energy to the conductive element 40.

[0057] Now referring to Figures 6 to 12 , the surgical tool 14 is shown in more detail, and in particular a pair of jaws 21, 23 is shown in more detail. The conductive element 40 disposed on the surface of the primary jaw 21 includes two outer portions 50, 52 and an inner (intermediate) portion 48. The outer portions 50, 52 have respective outer terminals 44, 46 at their ends, and the intermediate portion 48 has an inner terminal 42 at its ends. Thus, the outer portions 50, 52 and the inner portion 48 form an electrical heater circuit between the inner terminal 42 and the outer terminals 44, 46. In the embodiment shown in the drawings, the outer portions 50, 52 and the inner portion 48 of the conductive element 40 serve as electrodes that are configured to be able to transfer heat for operating on blood vessels. Specifically, the terminal 42 of the electrode 40 is electrically coupled to the first terminal of the DC source 30 (see Figure 1 ), and the outer terminals 44, 46 of the electrode 40 are electrically coupled to the second terminal of the DC source 30, thereby allowing the electrode 40 to receive and conduct DC energy to cut and / or weld tissue. The conductive element 40 can be formed using a single flat sheet of a conductive material (e.g., a nickel-chromium alloy such as stainless steel in the outer layer and nickel-chromium in the inner layer). This structure has reliability, manufacturing, and cost advantages. It also reduces the likelihood of tissue accumulation and entrapment during use by minimizing the crevices into which tissue can migrate.

[0058] During use, from the DC source 30 (see Figure 1) The current passes through the internal terminal 42 and flows in the internal portion 48 of the conductive element 40, and concurrently flows through the dual external portions 50, 52 of the conductive element 40 to the external terminals 44, 46. Thus, for the internal portion 48 and the external portions 50, 52 of equal thickness and equal width, in response to an electrical signal (such as a voltage) applied between the internal terminal 42 and the external terminals 44, 46, the current density in the internal portion 48 is twice as high as the current density in each of the external portions 50, 52. Of course, the current densities in the internal portion 48 and the external portions 50, 52 can be changed (e.g., by changing the relative widths of the internal portion 48 and / or the external portions 50, 52, by selecting different materials to change the resistance, by changing the width and resistance, etc.) to change the operating temperatures of the internal portion 48 and the external portions 50, 52. In operation, the external portions 50, 52 can operate at a temperature sufficient to weld an organizational structure (such as a blood vessel) clamped between the jaws 21, 23, and the internal portion 48 can operate at a higher temperature sufficient to cut the clamped organizational structure in the middle of the welded section.

[0059] Now referring to Figure 8 and 9 , a partial cross-sectional view of the jaws 21, 23 is shown, which shows the arrangement of the internal portion 48 and the external portions 50, 52. The main jaw 21 includes a structural support 64, and the secondary jaw 23 includes a structural support 66. In some embodiments, the structural supports 64, 66 can be made of a conductive material that allows the supports 64, 66 to be used as electrical wires (e.g., for transmitting current). For example, the structural supports 64, 66 can be made of stainless steel. The structural supports 64, 66 are covered by one or more layers of electrically insulating material 67, such as rubber, polymer, silicone, polycarbonate, ceramic, or other suitable insulating materials. The insulating material 67 can be molded separately and bonded to the corresponding structural supports 64, 66. Alternatively, the insulating material 67 can be overmolded onto the structural supports 64, 66. For example, each of the structural supports 64, 66 can have one or more openings to allow the insulating material 67 to flow therethrough during the overmolding process. A base material (such as a silicone base) can be applied to the structural supports 64, 66 before applying and / or molding the insulating material 67 to improve the adhesion of the insulating material 67 to the structural supports 64, 66. Thus, during the use of the surgical instrument 9, the base material reduces the occurrence of separation of the insulating material 67 and the conductive element 40.

[0060] Continuing to refer to Figure 8, the secondary jaw 23 includes surface protrusions or projections 54 that are substantially aligned with the inner (middle) portion 48 of the primary jaw 21 to increase the compressive force applied to the tissue structure clamped by the jaws 21, 23 and in contact with the middle portion 48. The projections 54 facilitate more effective tissue cutting, while the adjacent regions 56, 58 of the surface projections 54 on the secondary jaw 23 that are aligned with the outer portions 50, 52 of the conductive element 40 introduce a smaller compressive force suitable for welding the clamped tissue.

[0061] Now refer to Figures 7 to 9 , the cross-sections of the respective jaws 21, 23 may not be symmetric. Instead, the primary jaw 21 may have a projection 60, and the secondary jaw 23 may have a projection 62. Each of the projections 60, 62 extends substantially perpendicular to the support structures 64, 66 of the respective jaws 21, 23 to properly space the surgical tool 14 from the patient's main blood vessel 142 during a surgical procedure. Specifically, during the process of removing the main blood vessel 142 by cutting the branch blood vessel 140, the projections 60, 62 abut against the main blood vessel 142 such that the jaws 21, 23 are spaced from the main blood vessel 142 by a specified or predetermined distance D, as Figure 9 shown. For example, the predetermined distance D can be at least 1 mm, more preferably at least 1.5 mm. However, the predetermined distance D can be any value sufficient to prevent or minimize the thermal diffusion from the conductive element 40 to the main blood vessel 142. In this way, the projections 60, 62 help prevent or minimize the thermal diffusion to the main blood vessel 142 due to the cutting and sealing of the branch blood vessel 140, thereby maintaining the integrity of the harvested main blood vessel 142. Moreover, the projections 60, 62 eliminate the need for the operator to guess whether the cutting of the branch blood vessel 140 is far enough from the main blood vessel 142 (e.g., beyond a minimum specified spacing). Instead, the operator simply places the projections 60, 62 of the surgical tool 14 against the main blood vessel 142, and the projections 60, 62 will automatically position the jaws 21, 23 relative to the branch blood vessel 140 such that the branch blood vessel 140 is cut at a predetermined distance D from the main blood vessel 142. In some cases, if the surgical instrument 9 is used to cut other types of tissue, such as nerves, organs, tendons, etc., the projections 60, 62 also provide the same benefits, namely, maintaining the integrity of the tissue adjacent to the cut and eliminating the need for the operator to guess the proper edge and / or position of the surgical tool 14.

[0062] As Figure 9As shown, the protrusions 60, 62 can diverge or taper from the branch blood vessel 140. Such a configuration allows the portion of the branch blood vessel 140 adjacent to the main blood vessel 142 not to be clamped by the jaws. As a result, the severed end of the branch blood vessel 140 will fall off once it is severed. In other embodiments, the surgical instrument 9 need not include two protrusions 60, 62. Alternatively, the surgical instrument 9 may include only one of the protrusions 60 or 62. Such a configuration allows the device at the distal end of the surgical instrument 9 to have a smaller profile, thereby allowing the operator to effectively manipulate the surgical tool 14 under tight tissue conditions. As Figure 9 shown, the outer portion 52 may extend laterally along the outer edges of the closed jaws 21, 23.

[0063] Continuing to refer to Figures 6 to 9 , the main jaw 21 may have a concave side 130 and a convex side 132. In one method of use, when the jaws 21, 23 are used to cut the branch blood vessel 140, the main jaw 21 is oriented such that the concave side 130 faces the main blood vessel 142. An endoscope or viewing device may be placed near the jaws 21, 23, where the endoscope or viewing device views the concave side 130 of the main jaw 21. This allows the operator to better observe the ends of the jaws 21, 23. The configuration of the concave side 130 and the convex side 132 also provides a safety benefit by allowing the operator to know where the ends of the jaws 21, 23 are located during the blood vessel cutting process. As Figure 9 shown, the protruding section of the outer portion 52 is located on the convex side 132 of the main jaw 21, while the protrusions 60, 62 are located on the concave side 130 of the main jaw 21. The concave structure of the concave side 130 provides additional spacing to further protect the main blood vessel 142 when the branch blood vessel 140 is clamped. In addition, the exposed outer portion 52 on the convex side 132 creates a protrusion that makes it easier to contact the access wall in the patient's body through the protruding section of the outer portion 52 to handle bleeding. In other embodiments, the protrusions 60, 62 may be located on the convex side 132 of the jaw assembly, while the protruding section of the outer portion 52 is located on the concave side 130. In this case, during use, the convex side 132 of the jaws 21, 23 will be oriented towards the main blood vessel 142, thereby ensuring that the ends of the jaws 21, 23 do not inadvertently contact the main blood vessel 142, thereby preventing the jaws 21, 23 from damaging the main blood vessel 142.

[0064] Now refer to Figure 10, the main jaw 21 may include a retaining insert 65 for securing the distal shank 43 of the conductive element 40. The retaining insert 65 may be disposed at the distal end of the structural support 64. The distal shank 43 of the conductive element 40 may be bent towards the structural support 64 so as to extend into the retaining insert 65. The retaining insert 65 may be a high-temperature resistant polymer applied to the structural support 64 prior to overmolding or otherwise forming the insulating material 67 onto the structural support 64. In this way, the retaining insert 65 can be mechanically held in place between the structural support 64 and the insulating material 67. The retaining insert 65 may define a cavity 69 for receiving the distal shank 43 of the conductive element 40, thereby preventing the distal end 41 of the conductive element 40 from separating from the main jaw 21. The insulating material 67 may include an opening corresponding to the cavity 69 of the retaining insert 65 through which the distal shank 43 of the conductive element 40 may pass into the cavity 69. The retaining insert 65 may isolate the distal shank 43 of the conductive element 40 from the support structure 64 and may be made of a non-conductive material such that the distal shank 43 does not short-circuit with the support structure 64.

[0065] Continuing to refer Figure 10 and further referring Figure 11 , the insulating material 67 of the main jaw 21 may include raised markings 61 that indicate the position and / or orientation of the conductive element 40 to assist the operator in positioning the jaws 21, 23 for cutting. The insulating material 67 of the secondary jaw 23 may likewise include raised markings 61 to assist the operator in positioning the jaws 21, 23 for cutting. The markings 61 on each jaw 21, 23 may be in the form of ridges that project radially from their respective jaws 21, 23. Each marking 61 may have a substantially semi-circular cross-section and may extend at least partially around the outer surface of the jaws 21, 23. Alternatively, the markings 61 may have other cross-sectional profiles, such as rectangular, triangular, circular, polygonal, etc. The markings 61 may be formed integrally with the insulating material 67, for example, during an overmolding process in which the insulating material 67 is applied to the jaws 21, 23. The markings 61 may be reflective to improve the visibility for the operator.

[0066] Now referring Figure 12 , the components of the jaw operating mechanism of the surgical tool 14 may be supported in a rod housing 68 that includes a sliding pin 70 and an attachment pin 72, all of which are covered by an insulating cover 100. The insulating cover 100 may be made of a flexible material such as silicone rubber, plastic heat shrink material, etc. to shield / protect adjacent tissue from the moving parts of the surgical tool 14 and the electrical energy within the surgical instrument 9. The insulating cover 100 may also hold the sliding pin 70 and the attachment pin 72 in place, obviating the need for more complex fasteners and mechanisms.

[0067] Continuing to refer Figure 12, shows an exploded view of the components forming the surgical tool 14, as well as an exploded view of the components attached to the distal end of the elongate body 13. Specifically, the conductive element 40, which includes an inner portion 48 and outer portions 50, 52, is attached to the main jaw 21. Both the main jaw 21 and the secondary jaw 23 are pivotally attached to the rod housing 68 via insulating material U-clamps 85, 87 and jaw pins 77. The jaws 21, 23 pivot on the U-clamps 85, 87 such that the jaws 21, 23 can be kept electrically insulated from the jaw pins 77, which hold the inner terminals 42 of the conductive element 40 against the surface of the main jaw 21. This configuration prevents the structural supports 64, 66 of the jaws 21, 23, which may be metallic, from contacting the jaw pins 77, thereby avoiding an electrical short circuit. The sliding pin 70 is arranged to slide within an alignment slot 79 in the housing 68 and within mating inclined slots 81, 83 in the main jaw 21 and the secondary jaw 23, respectively. Movement of the sliding pin 70 relative to the jaw pin 77 effects a scissor-like movement of the jaws 21, 23 between an open position (e.g., as shown in Figure 4 and 6 ) and a closed position (e.g., as shown in Figure 5 ). The actuator rod 36 is linked to the sliding pin 70, for example, via a yoke attached to the distal end of the actuator rod 36. Axial movement of the actuator rod 36 in one direction will cause the sliding pin 70 to move towards the jaw pin 77, thereby opening the jaws 21, 23. Axial movement of the actuator rod 36 in the opposite direction will cause the sliding pin 70 to move away from the jaw pin 77, thereby closing the jaws 21, 23.

[0068] Continuing to refer to Figure 12 , the electrical conductor 88 is connected to the inner terminal 42 of the conductive element 40, and the outer terminals 44, 46 are commonly electrically connected to the electrical conductor 91. The electrical conductor 88 or the electrical conductor 91 extends through the elongate body 13 such that the electrical conductors 88, 91 can be accessed from the proximal end of the elongate body 13, as shown in Figure 16 . In other embodiments, if the actuator rod 36 is conductive, the electrical conductor 88 and / or the electrical conductor 91 may be coupled to the actuator rod 36. In such embodiments, during use, the actuator rod 36 will be electrically coupled to one terminal of the DC source 30 or to the contact 95 of the switch 78 (see Figure 16 ). During use, the electrical conductors 88, 91 may be electrically coupled to the terminals of the DC source 30, which supplies current to heat the inner portion 48 and the outer portions 50, 52 of the conductive element 40. The central inner portion 48 is configured to be capable of cutting blood vessels (e.g., the branch blood vessel 140), while the outer portions 50, 52 are configured to be capable of welding (sealing) blood vessels. In some embodiments, the components of the surgical tool 14 may be insulated by an insulating cover 100 to isolate certain components from biological tissue and fluids.

[0069] Now referring toFigures 13 to 18 , which shows the internal components of the handle 11. The handle 11 can be formed by two half-sections to facilitate the assembly of the surgical instrument 9. Figure 13 Shows the components mounted in one half-section of the handle 11. Complementary half-sections (not shown) snap together with the shown half-section or are otherwise attached to the shown half-section to enclose the components within the handle 11. The handle 11 can be formed of a plastic material that provides electrical insulation, ergonomics, and durability. In some cases, the material used to construct the handle 11 is selected to provide the handle 11 with sufficient strength to withstand the forces of the mechanism and the forces of the operator interacting with the instrument 9 during a surgical procedure.

[0070] The electrical switch 78 is mounted in the handle 11 to operate at least partially with the actuator 15 to control the electrical energy supplied to the internal portion 48 and the external portions 50, 52 of the conductive element 40. The actuator 15 is rotatably mounted to the handle 11 by an actuator pivot pin 89 such that the actuator 15 is pivotable relative to the handle 11. Now referring to Figures 13 to 16 , the switch 78 can be a normally open switch that closes the circuit when engaged by a portion of the actuator 15 to supply electrical energy to the conductive element 40 via the cable 29 from a DC source 30 (see Figure 1 ). In particular, the cable 29 can be electrically connected to a connector 99 disposed in the handle 11, and at least one conductor 95 of the cable 29 is interrupted by the switch 78. The connector 99 is attached to wires 96, 97 that supply electrical energy to electrical conductors 88, 91 connected to the conductive element 40. In the unengaged position, as Figure 13 shown, the button 150 of the actuator 15 is in the zero position and the switch 78 is disengaged. Thus, the circuit controlled by the switch 78 is open and no electrical energy is supplied to the electrical conductors 88, 91 connected to the conductive element 40. Moving the button 150 proximally closes the switch 78, which will be described in more detail below, thereby supplying electrical energy to the conductive element 40 from the cable 29.

[0071] Continuing to refer to Figure 13 , the actuator 15 extends through a slot 90 in the handle 11. When the operator applies a proximal or distal force to the button 150 of the actuator 15, the actuator 15 can rotate about the actuator pivot pin 89. Inside the handle 11, a cam 110 is attached to the actuator 15 and rotates in concert with the actuator 15 about the actuator pivot pin 89. The cam 110 defines a slot 111 that captures a portion of the actuator rod 36, such as the barrel 93 of the actuator rod 36, thereby mechanically linking the actuator rod 36 to the actuator 15. The barrel 93 can slide within the slot 111 as the cam 110 rotates about the actuator pivot pin 89. The slot 111 of the cam 110 defines a proximal recess 112 and a distal recess 113. In the zero position of the actuator 15, asFigure 13 As shown, the cylinder 93 is positioned between the proximal recess 112 and the distal recess 113 of the slot 111 such that the button 150 of the actuator 15 can be moved distally or proximally. If the button 150 of the actuator 15 is pushed distally by an operator, the rotation of the actuator 15 and the cam 110 guides the cylinder 93 of the actuator rod 36 into the distal recess 113 of the slot 111, thereby causing the actuator rod 36 to translate in the distal direction. The distal translation of the actuator rod 36 opens the jaws 21, 23, as described herein in connection with Figure 12 As described. Similarly, if the button 150 of the actuator 15 is pulled proximally by an operator, the rotation of the actuator 15 and the cam 110 guides the cylinder 93 of the actuator rod 36 into the proximal recess 112 of the slot 111, thereby causing the actuator rod 36 to translate in the proximal direction. The proximal translation of the actuator rod 36 closes the jaws 21, 23, as described in connection with Figure 12 As described.

[0072] Continuing to refer to Figures 13 to 16 , the actuator 15 can be mechanically coupled to the switch 78 to control the electrical energy supplied to the inner portion 48 and the outer portions 50, 52 of the conductive element 40, as previously noted. In particular, the switch link 115 can be connected to the actuator 15 and / or the cam 110 by a pivot pin 116. When the button 150 of the actuator 15 is pulled proximally to close the jaws 21, 23, the switch link 115 is pulled proximally by the actuator 15. Thus, the proximal end of the switch link 115 engages the contact pad 119 formed in the handle 11. The contact pad 119 guides the switch link 115 to the lever 94 of the switch 78. Continuing to pull the button 150 of the actuator 15 proximally causes the switch link 115 to press the lever 94 of the switch 78. When the lever 94 is pressed by the switch link 115, a complete circuit is formed and current is supplied to the conductive element 40 via the switch 78. Conversely, when the button 150 of the actuator 15 is pushed distally to open the jaws 21, 23, the switch link 115 is pulled distally by the actuator 15 and releases the lever 94 of the switch 78 to interrupt the current to the conductive element 40. As described herein in connection with Figures 1 to 3 As described, the actuator can have a two-stage operation, wherein an initial proximal pull of the actuator 15 beyond the zero position by less than a predetermined distance (or degree of rotation) holds the jaws 21, 23 in a closed position relative to each other but does not supply electrical energy to the heating element 40. To provide the two-stage operation, the geometry of the actuator 15, the cam 110, and the switch link 115 is such that the actuator 15 can be pulled proximally far enough to close the jaws 21, 23 while the switch link 115 does not press the lever 94 of the switch 78. If the actuator 15 is subsequently pulled proximally beyond the predetermined distance, the jaws 21, 23 remain closed while the switch link 115 moves further proximally to press the lever 94 and supply current to the conductive element 40.

[0073] Continuing to refer to Figure 13 and 16 , the actuator 15 can be biased toward the zero position such that when no force is applied to the button 150, the actuator 15 automatically returns to the zero position. At the zero position, the switch 78 is open so that no electrical energy is supplied to the conductive element 40, and the jaws 21, 23 are closed to allow the surgical tool 14 to easily navigate through the surgical access site of the patient. Since the actuator 15 is automatically biased toward the zero position, the operator does not have to apply any energy to keep the jaws 21, 23 closed and the conductive element 40 de-energized during positioning of the surgical tool 12 within the patient. To bias the actuator 15 toward the zero position, the handle 11 can include one or more springs or other biasing elements. In Figure 13 and 16 the illustrated embodiment, the handle 11 defines spring guide channels 117 that receive a pair of opposing compression springs 120a, 120b. The compression springs 120a, 120b engage opposite faces of spring tabs 118 of the switch linkage 115 to bias the spring tabs 118 to a balanced position where the force applied by the first of the compression springs 120a is balanced by the force applied by the second of the compression springs 120b. The balanced position of the spring tabs 118 corresponds to the zero position of the actuator 15 such that when the compression springs 120a, 120b move the spring tabs 118 of the switch linkage 115 to the balanced position, the switch linkage 115 in turn moves the actuator 15 to the zero position.

[0074] Referring to Figure 13 , 16 , 17 and 18, the geometry of the cam 110 can be selected to reduce the force required for the operator to move and hold the jaws 21, 23 in the open position and / or the closed position. In some embodiments, the cam 110 can produce an over-center action that helps the operator move the actuator 15 and hold the actuator 15 in either direction of travel from the zero position. In particular, the slot 111 can be non-linear, such as S-shaped, such that when the button 150 is pulled proximally beyond the zero position, the barrel 93 of the actuator rod 36 is guided toward the proximal recess 112 of the slot 111, thereby reducing the force that needs to be applied to the button 150. Similarly, when the button 150 is pushed distally beyond the zero position, the barrel 93 of the actuator rod 36 is guided toward the distal recess 113 of the slot 111, thereby reducing the force that needs to be applied to the button 150. In some embodiments, the geometry of the actuator 15 and the cam 110 can reduce the force required to open or close the jaws 21, 23 to approximately 2 pounds.

[0075] Referring to Figures 1 to 18, when the actuator 15 is pushed distally to open the jaws 21, 23, the opened jaws 21, 23 can be used to surround a target tissue (e.g., a branched blood vessel 140 as shown in Figure 9 ). When the jaws 21, 23 are placed around the target tissue, the actuator 15 can be pulled proximally to close the jaws 21, 23, thereby clamping the target tissue. If desired, the actuator 15 can be further pulled proximally such that the switch link 115 presses the lever 94 of the switch 78, thereby supplying DC electrical energy from the DC source 30 to the conductive element 40. As previously described, the switch 78 does not close and thus does not supply DC electrical energy until the actuator 15 moves proximally beyond a zero position by a predetermined distance. In this way, the DC electrical energy for cutting and / or cauterizing the target tissue is not supplied until after the jaws 21, 23 have clamped the tissue and the operator has further pulled the actuator 15. This prevents the conductive element 40 of the jaws 21, 23 from being prematurely supplied with electrical energy. By pushing the actuator 15 distally (or simply by releasing the button 150 such that the actuator 15 returns to the zero position under the influence of the compression springs 120a, 120b), the switch link 115 is disengaged from the lever 94 of the switch 78, and the DC electrical energy delivery can be stopped.

[0076] During use of the surgical instrument 9, the elongate body 13 advances along a blood vessel to be harvested (e.g., the main blood vessel 142 as shown in Figure 9 ). In some cases, the surgical instrument 9 can be placed in the instrument channel of a cannula that includes an observation device such as an endoscope for allowing the operator to see the distal end of the surgical instrument 9 within the patient's body. Examples of suitable cannulas that can be used with the surgical instrument 9 are described in U.S. Provisional Patent Application No. 63 / 415,104, filed on September 28, 2022, attorney docket number CS.917, entitled “Cannula for Use With an Endoscopic Vessel Harvesting Device,” the disclosure of which is incorporated herein by reference in its entirety. When a branched blood vessel 140 (or other target tissue) is encountered, the jaws 21, 23 can be used to grip and compress the branched blood vessel 140 in response to manipulation of the actuator 15. Then, the DC source 30 is used to supply electrical energy to the inner portion 48 and the outer portions 50, 52 of the conductive element 40 (which act as resistive elements that heat in response to the delivered direct current) to effect tissue welding at the tissue in contact with the outer portions 50, 52 and tissue cutting at the tissue in contact with the inner portion 48.

[0077] During vascular harvesting, if the operator notices bleeding in the surrounding tissue (e.g., from the wall of a surgical cavity), the operator can use the conductive element 40 to cauterize the bleeding tissue. The conductive element 40 serves as a DC electrode to electrocauterize any tissue (e.g., vascular tissue or surrounding tissue) clamped between the jaws 21, 23. Alternatively, the protruding section of the outer portion 52 of the conductive element 40 that protrudes from the side of the main jaw 21 (as Figure 9 shown) can be used to cauterize the bleeding area. In this case, the jaws 21, 23 can be closed or not closed, and any tissue can be clamped or not clamped. For example, in some embodiments, the operator can refrain from using the jaws 21, 23 to clamp or cut tissue. However, if the operator notices bleeding at or near the surgical site, the operator can use the protruding section of the outer portion 52 of the conductive element 40 to cauterize the bleeding area. In particular, the protruding section of the outer portion 52 serves as a DC electrode to electrocauterize tissue. For example, the side or end of the outer portion 52 that extends beyond the profile of the main jaw 21 can be used for spot cauterization by direct heat conduction. In this case, the outer portion 52 can be heated, and the protruding section can be used to contact the tissue desired to be cauterized.

[0078] As shown in the above embodiments, the surgical instrument 9 allows heat to be delivered to a remote surgical site for welding and severing blood vessels. The embodiments of the surgical instrument 9 also eliminate the need to repeatedly insert a separate bleeding control device into the patient to control bleeding during vascular harvesting and to remove such a bleeding control device from the patient. Thus, the embodiments of the surgical instrument 9 described herein handle bleeding more easily and effectively.

[0079] Although the above embodiments have been described with reference to the surgical tool 14 as a pair of jaws for clamping, cutting, and sealing blood vessels (e.g., saphenous vein, artery, or any other blood vessel), in other embodiments, the surgical tool 14 can have a different configuration and different functions. For example, in other embodiments, the surgical tool 14 can be a clip applicator or a clamping jaw. In further embodiments, the bleeding control feature can be incorporated into any type of laparoscopic / endoscopic surgical tool or any type of tool for open surgery. Additionally, in any of the embodiments described herein, the surgical instrument 9 can be used in any endoscopic surgery that requires dissecting or transecting tissue to control bleeding.

[0080] Moreover, although the above-described embodiments have been described with reference to a surgical instrument having a hemostasis feature, in other embodiments, such a hemostasis feature is optional. Additionally, in any of the embodiments described herein, the surgical tool 14 located at the distal end of the surgical instrument 9 need not include all of the features described herein. For example, in some embodiments, the surgical tool 14 does not include the outer portions 50, 52 of the conductive element 40. Alternatively, the surgical tool 14 may include an electrode strip for cutting or sealing tissue (corresponding to the intermediate electrode portion 48 of the conductive element 40 described herein). Additionally, in other embodiments, the secondary jaw 23 may not have the surface protrusion 54. Alternatively, the secondary jaw 23 may have a flat surface for contacting the inner portion 48 and the outer portions 50, 52 of the conductive element 40. Additionally, in further embodiments, the jaws 21, 23 may not include respective protrusions 60, 62. Alternatively, the cross-section of the jaws 21 / 23 may have a symmetric configuration. In other embodiments, protrusions may be provided on both sides of the jaw assembly (e.g., one or more protrusions located at the recessed side 130 of the jaws 21, 23 and one or more protrusions located at the convex side 132 of the jaws 21, 23). Such a configuration provides cushioning on both sides of the surgical tool 14 and allows for the correct placement of the surgical tool 14 regardless of which side (recessed side 130 or convex side 132) of the surgical tool 14 faces the main blood vessel 142 during use. In additional embodiments, instead of a curved configuration, the jaws 21, 23 may be straight. Additionally, in any of the embodiments described herein, instead of or in addition to using the conductive element 40 to control bleeding, the conductive element 40 may be used to dissect or transect tissue, such as the fat and connective tissue encountered during a vascular harvesting procedure.

[0081] While examples of organ harvesting devices have been provided in the foregoing description, those skilled in the art may make modifications and variations to these examples without departing from the scope and spirit of the present disclosure. Accordingly, the foregoing description is illustrative rather than restrictive. The above-described disclosure is defined by the appended claims, and all changes that fall within the meaning and scope of the equivalents of the claims are included within their scope.

Claims

1. A surgical instrument for harvesting an organ, comprising: a surgical tool; a handle, comprising: an actuator that is rotatable about an actuator pivot pin; and a cam that is connected to the actuator and is rotatable in concert with the actuator; an actuator rod having a distal end connected to the surgical tool and a proximal end connected to the cam, wherein the cam defines a slot that captures a portion of the actuator rod, wherein the portion of the actuator rod captured in the slot is slidable within the slot as the cam rotates, and wherein the sliding of the portion of the actuator rod within the slot actuates the surgical tool.

2. The surgical instrument according to claim 1, wherein the slot defines a proximal recess and a distal recess, wherein moving the button of the actuator in the proximal direction causes the portion of the actuator captured in the slot to slide toward the proximal recess, and wherein moving the button of the actuator in the distal direction causes the portion of the actuator captured in the slot to slide toward the distal recess.

3. The surgical instrument according to claim 1, wherein the surgical tool comprises: a main jaw; and a secondary jaw, wherein the sliding of the portion of the actuator rod within the slot opens or closes the main jaw and the secondary jaw relative to each other.

4. The surgical instrument according to claim 2, wherein the handle further comprises one or more biasing elements configured to bias the actuator toward a zero position, at which the portion of the actuator rod captured in the slot is positioned between the proximal recess and the distal recess of the slot.

5. The surgical instrument according to claim 4, wherein the one or more biasing elements comprise one or more springs disposed in a guide channel of the handle.

6. The surgical instrument according to claim 4, wherein the surgical tool comprises a conductive element, wherein the handle further comprises: a switch for supplying current from a power source to the conductive element; and a switch linkage connected to the actuator or the cam via a pivot pin and configured to actuate the switch, wherein at the zero position of the actuator, the switch linkage does not actuate the switch, and wherein rotation of the actuator about the actuator pivot pin beyond the zero position by more than a predetermined distance causes the switch linkage to actuate the switch.

7. The surgical instrument according to claim 6, wherein the surgical tool comprises: a main jaw; and a secondary jaw, wherein at the zero position of the actuator, the main jaw and the secondary jaw are closed relative to each other.

8. The surgical instrument according to claim 6, wherein The one or more biasing elements include a first compression spring and a second compression spring, the first compression spring and the second compression spring being configured to bias the switch link toward a balanced position at which the force applied by the first compression spring balances the force applied by the second compression spring, and wherein the balanced position corresponds to the zero position of the actuator.

9. The surgical instrument according to claim 1, wherein, the slot in the cam is non-linear.

10. The surgical instrument according to claim 1, wherein, the actuator rod is flexible.

11. A surgical instrument for harvesting an organ, comprising: a handle including an actuator; a surgical tool including a main jaw and a secondary jaw, the main jaw and the secondary jaw being configured to open and close relative to each other in response to movement of the actuator, wherein the main jaw includes: a support structure; a conductive element having a distal shank; and a retaining insert disposed at a distal end of the support structure and defining a cavity for receiving the distal shank of the conductive element.

12. The surgical instrument according to claim 11, wherein, the main jaw further includes an insulating material applied around the support structure and between the support structure and the conductive element.

13. The surgical instrument according to claim 11, wherein, the distal shank of the conductive element is bent toward the support structure.

14. The surgical instrument according to claim 11, wherein, the handle further includes a switch for supplying current from a power source to the conductive element.

15. The surgical instrument according to claim 11, wherein, the retaining insert is made of a non-conductive material and isolates the distal shank from the support structure.

16. The surgical instrument according to claim 11, wherein, the main jaw further includes a raised marker to indicate the position of the surgical tool to an operator.

17. The surgical instrument according to claim 16, wherein, the raised marker extends at least partially around an outer surface of the main jaw.

18. The surgical instrument according to claim 16, wherein, the raised marker has a generally semi-circular cross-section.

19. The surgical instrument according to claim 16, wherein, the raised marker is integrally formed with the insulating material of the main jaw.

20. The surgical instrument according to claim 11, wherein, the secondary jaw includes a raised marker to indicate the position of the surgical tool to an operator.

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