Electrosurgical device

Abstract

Surgical instrument (1) comprising: a handle (10) with a longitudinal axis which generally defines a front and a rear direction, such that the handle (10) has a front end and a rear end, wherein the handle (10) also has a top and a bottom direction, an elongated shaft (12) extending from the front end of the handle (10) and extending along the longitudinal axis, an end effector (14) positioned at the rear end of the elongated shaft (12)', a hand switch (26) in the form of a push button, the actuation of which causes the state of the end effector (14) to change, and a rotatable adjusting wheel (28) arranged on the handle (10), wherein a rotation of the adjusting wheel (28) causes a corresponding rotation of the elongated shaft (12), and a trigger (24) for actuating a mechanical cutting mechanism, characterized in that the hand switch (26) is arranged on the handle (10) in a position directly above the adjusting wheel (28) and spaced apart in a direction orthogonal to the longitudinal axis from the adjusting wheel (28), and the trigger (24) is arranged on the handle (10) in a position in front of the hand switch (26) and the rotatable adjusting wheel (28) along the longitudinal axis in the front direction, wherein the hand switch (26) lies directly on a vertical axis that is orthogonal to the longitudinal axis and passes through the control wheel (28), wherein the adjusting wheel (28) is arranged along the longitudinal axis between a front edge and a rear edge of the hand switch (26), wherein the adjusting wheel (28) is aligned on the vertical axis below the hand switch (26) such that the center of the adjusting wheel (28) is below the center of the hand switch (26).

Description

Field of invention

[0001] Embodiments of the present invention described herein relate to an electrosurgical device and in particular an electrosurgical forceps, wherein a mechanical blade provides a tissue cutting function in combination with electrosurgical electrodes which provide a tissue coagulation or sealing effect. Background of the invention and prior art

[0002] Electrosurgical instruments offer advantages over conventional surgical instruments because they can be used for tissue coagulation and sealing. Such an arrangement is known from US 2015 / 223 870 A1, which describes an endoscopic bipolar forceps comprising a housing and a shaft. The shaft has an electrosurgical end-effector assembly at its distal end, comprising two clamping jaws for grasping tissue between them. Each clamping jaw is suitable for connection to an electrosurgical power source, enabling the sealing of tissue held between the clamping jaws. A control arrangement is incorporated in the housing to move the clamping jaws.A movable handle is also present, so that a movement of the handle actuates the control mechanism to move the clamping jaw elements relative to each other. A knife channel is part of the end effector to allow a blade to move forward and backward within the channel, thus enabling the cutting of fabric.

[0003] EP 2 853 220 A1 discloses a surgical instrument having the features of the preamble of claim 1. Further arrangements according to the prior art include the following: US 531 311 S, US 2011 / 0 046 623 A1, US 5 730 740 A, US 5 104 397 A, US 4 800 880 A, WO 98 / 14 124 A1, US 2012 / 0 109 186 A1, US 5 352 235 A, WO 2014 / 074 807 A1, US 7 846 161 B2, WO 2008 / 024 911 A2, US 5 776 130 A, US 6 039 733 A, US 6 179 834 B1, US 7 131 971 B2, US 7 766 910 B2, EP 2 628 459 A2, US 2014 / 0 221 999 A1, US 7 083 618 B2, US 2009 / 0 248 020 A1, US 2015 / 0 209 103 A1, US 5,797,938 A and US 7,101,373 B2. Brief description of the invention

[0004] Embodiments of the invention provide a surgical instrument with an end effector arranged at the end of a rotatable shaft, the shaft projecting from the handle. To ensure easy control of the shaft rotation, an adjustment wheel is provided at the proximal end of the handle, which controls the rotation of the shaft and thus the rotational orientation of the end effector. The end effector is capable of performing several different operations, including grasping, cutting, sealing, and / or coagulating tissue, one of which is controlled by a switch located on the upper surface of the proximal end of the handle.In particular, the switch is positioned on the handle such that it is generally located above the adjustment wheel in a relative position to the wheel that both the adjustment wheel and the switch can be activated by the user's thumb without requiring the user to reposition their other fingers on the handle. In one embodiment of the invention, the switch is therefore positioned vertically above the adjustment wheel. This configuration provides an ergonomic arrangement that enhances the user's ease of use.

[0005] In light of the above explanations, one aspect provides a surgical instrument which includes: a handle with a longitudinal axis that generally defines a front and a rear direction, such that the handle has a front end and a rear end, and the handle also has a top and a bottom direction, an elongated shaft extending from the front end of the handle and along the longitudinal axis, an end effector positioned at the distal end of the elongated shaft, a manual switch in the form of a push button, the actuation of which causes the state of the end effector to change, and a rotatable adjusting wheel arranged on the handle, wherein a rotation of the adjusting wheel causes a corresponding rotation of the elongated shaft, and a trigger to activate a mechanical cutting mechanism, characterized in that the hand switch is arranged on the handle in a position directly above the adjusting wheel and spaced apart in a direction orthogonal to the longitudinal axis of the adjusting wheel, and The trigger is located on the handle in a position in front of the hand switch and the rotating control wheel along the longitudinal axis in the front direction.

[0006] As explained above, such an arrangement ensures ease of use for the user and allows the hand switch and the control wheel to be operated by the user's thumb. In particular, in one embodiment, the hand switch lies directly on an axis that is orthogonal to the longitudinal axis and runs through the control wheel.

[0007] In one embodiment, the handle comprises a front section, which generally extends along the longitudinal axis, and a rear section, which extends at an angle to the longitudinal axis. The adjusting wheel is located towards the rear end of the front section. Additionally, in some embodiments, the outer surface of the adjusting wheel is provided with a notched surface featuring a plurality of notches suitable for receiving the fingers and thumb of a user operating the wheel. These features contribute to the ergonomic design of the handle and thus to its ease of use.

[0008] In one embodiment, the hand switch has a push button, for example, to activate a function of the end effector. The instrument may be designed for use with an electrosurgical generator, and the end effector may comprise one or more electrodes, the instrument including electrical connections capable of connecting it to an electrosurgical generator. In such a case, actuating the hand switch can cause the electrosurgical generator to supply electrosurgical energy to the one or more electrodes.

[0009] In addition to the hand switch, embodiments of the invention may also include an actuating mechanism that is movable between a first position and a second position. In these embodiments, moving the actuating mechanism from its first position to its second position causes the end effector to move from a first state to a second state. For example, it may cause the end effector to move from an open position to a tissue-grasping position.

[0010] With regard to the latter, in some embodiments the end effector has a pair with a first and an opposing second clamping jaw, wherein a movement of the actuating mechanism from its first position to its second position causes at least one of the clamping jaws to move relative to the other from a first open position, in which the clamping jaws are arranged in a spaced-apart relationship relative to each other, to a second closed position, in which the clamping jaws cooperate to grasp intervening tissue.

[0011] In a further development, the actuating mechanism has a first and a second handle, wherein at least one of the handles is movable relative to the other between an open position, in which the handles are spaced apart, and a closed position, in which the handles are brought closer together. Such an arrangement results in a tweezer-like instrument that offers the user a familiar activation mode.

[0012] In some designs, the actuation mechanism can be located directly below the control wheel. This results in a compact instrument with improved ergonomics, as it means the actuation mechanism can be operated by one or more fingers of the user on the same hand as the thumb, which operates the control wheel and / or hand switch.

[0013] To facilitate easy operation of the hand switch, in some embodiments the switch is dimensioned to extend laterally across the upper surface of the instrument over more than 50% of its width, and in some cases over a larger area of ​​more than 80%, or alternatively more than 90%. This allows for a relatively large hand switch that is easy for the user to operate and also accommodates users with different hand sizes who may grip the instrument differently. A hand switch of this size can accommodate virtually any hand size. In some embodiments, the hand switch has a textured upper surface designed to allow the user's thumb to activate the switch without slipping.Such a feature, in turn, improves the ergonomics of the instrument.

[0014] Another arrangement described herein provides a surgical instrument which a handle with a longitudinal axis that generally defines a front and a rear direction, wherein the handle also has a top and a bottom direction, as well as an elongated shaft extending from the front end of the handle, an end effector positioned at the distal end of the elongated shaft, a hand switch, the actuation of which causes a change in the state of the end effector, and a rotatable adjusting wheel arranged on the handle, wherein a rotation of the adjusting wheel causes a corresponding rotation of the elongated shaft, characterized in that the hand switch on the handwheel is arranged in a relative position to the adjusting wheel, such that in use both the adjusting wheel and the switch can be activated by the user's thumb without the user having to change their grip on the handle with their other fingers.

[0015] To achieve the above, the switch is positioned vertically above the dial in most arrangements. Such an arrangement provides an ergonomically improved surgical instrument that is easier to use.

[0016] According to another aspect, embodiments of the invention also provide an electrosurgical system comprising an electrosurgical generator and a surgical instrument, wherein the surgical instrument comprises a handle with a longitudinal axis which generally defines a front and a rear direction, such that the handle has a front end and a rear end, and the handle also has a top and a bottom direction, an elongated shaft extending from the front end of the handle and along the longitudinal axis, an end effector located at the distal end of the elongated shaft, a manual switch in the form of a push button, the actuation of which causes the electrosurgical generator to supply electrosurgical energy to the end effector, and a rotatable adjusting wheel arranged on the handle, wherein a rotation of the adjusting wheel causes a corresponding rotation of the elongated shaft, and a trigger to activate a mechanical cutting mechanism, characterized in that the hand switch is arranged on the handle in a position directly above the adjusting wheel and spaced in a direction orthogonal to the longitudinal axis of the adjusting wheel, and The trigger is located on the handle in a position in front of the hand switch and the rotating control wheel along the longitudinal axis in the front direction. Brief description of the drawings

[0017] Embodiments of the invention will now be described only as examples and with reference to the accompanying drawings, wherein similar reference numerals in the drawings refer to similar parts and wherein: Fig. 1 a side view of an electrosurgical instrument according to an embodiment of the present invention; Fig. 2 a side view of a handle of the electrosurgical instrument according to the embodiment of the present invention; Fig. 3 an exploded view of an electrosurgical instrument according to the embodiment of the present invention; Fig. 4 a cross-sectional view of the clamping mechanism of the electrosurgical instrument Fig. 3 shows in an open arrangement; Fig. 5a a cross-sectional view of the clamping mechanism of the electrosurgical instrument made of Fig. 3 shows in a closed arrangement; Fig. 5b a cross-sectional view of the clamping mechanism of the electrosurgical instrument Fig. 3 shows in a closed arrangement with tissue trapped inside; Fig. 6 a cross-sectional view of part of the clamping mechanism of the electrosurgical instrument made of Fig. 3 shows; Fig. 7 a perspective view of the clamping mechanism of the electrosurgical instrument from Fig. 3 shows; Fig. 8a-f the assembly of a part of the electrosurgical instrument from Fig. 3 show; Fig. 9a-b Cross-sectional views of a part of the electrosurgical instrument made of Fig. 3 are; Fig. 10a-c a blade guide part of the electrosurgical instrument made of Fig. 3 show; Fig. 11 a locking part of the electrosurgical instrument made of Fig. 3 shows; Fig. 12 a blade angle alignment part of the electrosurgical instrument made of Fig. 3 shows; Fig. 13a-b Cross-sectional views of the blade angle alignment part of the electrosurgical instrument made of Fig. 3 show; Fig. 14a-b a blade angle control wheel part of the electrosurgical instrument made of Fig. 3 show; Fig. 15a-b the rotary movement of the blade angle control wheel of the electrosurgical instrument from Fig. 3 show; Fig. 16a-d the rotary motion of the end effector of the electrosurgical instrument from Fig. 3 show; Fig. 17 a cross-sectional view of the electrosurgical instrument from Fig. 3 shows and illustrates a wiring path; Fig. Figures 18a-b show details of an electrical wiring path used in the electrosurgical instrument made of Fig. 3 is used; Fig. 19 further details of an electrical wiring path shown in the electrosurgical instrument made of Fig. 3 is used; Fig. 20a-b Side views of part of the cutting mechanism of the electrosurgical instrument made of Fig. 3 are; Fig. 21 a cross-sectional view of part of the cutting mechanism of the electrosurgical instrument made of Fig. 3 is; Fig. 22 a cross-sectional view of another part of the cutting mechanism of the electrosurgical instrument Fig. 3 shows; Fig. 23 a partially transparent perspective view of the cutting mechanism of the electrosurgical instrument from Fig. 3 is; Fig. 24a-c the assembly of a part of the cutting mechanism of the electrosurgical instrument from Fig. 3 show; Fig. 25a-c Cross-sectional views of the cutting mechanism and the clamping mechanism of the electrosurgical instrument from Fig. 3 show; Fig. 26a-f are cross-sectional views showing the operation of the locking mechanism of the electrosurgical instrument. Fig. 3 illustrate; Fig. 27. A diagram is shown that illustrates the cutting mechanism of the electrosurgical instrument. Fig. 3 illustrated; Fig. 28a-b are line drawings that illustrate the cutting mechanism of the electrosurgical instrument. Fig. 3 illustrate; Fig. 29a-b a blade angle alignment part of the electrosurgical instrument made of Fig. 3 show; Fig. 30 a perspective view of part of the clamping mechanism of the electrosurgical instrument Fig. 3 is; Fig. 31 a partial cross-sectional view of the cutting mechanism and the clamping mechanism of the electrosurgical instrument from Fig. 3 is; Fig. 32 a partial cross-sectional view of the cutting mechanism and the clamping mechanism of the electrosurgical instrument from Fig. 3 is; Fig. 33 the blade angle control wheel part and the electrode control switch of the electrosurgical instrument Fig. 3 shows; Fig. 34 the blade angle control wheel part of the electrosurgical instrument made of Fig. 3 shows; Fig. Figures 35a-b show the handle of the electrosurgical instrument from Fig., held by users with different sized hands; Fig. 36a-c the rotational movement of the end effector of the electrosurgical instrument from Fig. 3 show; Fig. 37 the rotational movement of the blade angle control wheel of the electrosurgical instrument from Fig. 3 shows; Fig. 38 is a schematic perspective view of an example of an end effector; Fig. 39 an enlarged perspective view of part of the end effector from Fig. 38 is; Fig. 40 a schematic cross-sectional view of a part of the end effector made of Fig. 38 is; Fig. 41 is a schematic perspective view of an alternative end effector; Fig. 42 an enlarged perspective view of part of the end effector from Fig. 41 is, Fig. 43 a schematic cross-sectional view of part of the end effector made of Fig. 41 is, Fig. 44 is a schematic cross-sectional view of part of another alternative end effector; Fig. 45 is a representation of an electrosurgical system comprising a generator and an instrument according to the embodiments of the invention; Fig. 46 furthermore a locking part of the electrosurgical instrument made of Fig. 3 shows and Fig. 47a-e the distal end of the electrosurgical instrument Fig. 3 cutting blades used are illustrated. Description of the embodiments

[0018] One embodiment of the invention will now be described. First, a brief overview of the entire embodiment will be given, followed by detailed descriptions of certain aspects thereof. 1. Overview of the instrument's structure

[0019] Fig. Figure 1 shows an electrosurgical instrument 1 according to an example of the present invention. The instrument 1 comprises a proximal handle section 10, an outer shaft 12 extending distally from the proximal handle section 10, and a distal end-effector assembly 14 attached to a distal end of the outer shaft 12. The end-effector assembly 14 can, for example, be a set of opposing jaws arranged to open and close, comprising one or more electrodes arranged on or formed by their opposing inner surfaces, and which, when in use, have connections for receiving a radiofrequency (RF) electrosurgical signal for sealing or coagulating tissue. The jaws are further provided with a slot or other opening in their opposing inner surfaces through which the electrodes can be inserted.which may protrude a mechanical cutting blade or similar element when activated by the user. During application, the handle 10 is activated by the user in two ways: firstly, to clamp tissue between the jaws 14, and secondly, to supply the electrodes with RF current to coagulate the tissue. The jaws 14 may be curved so that the active elements of the instrument 1 are always visible. This is important in vessel sealing devices used to operate on body regions that obstruct the user's view of the device during application. The handle 10 can be activated by the user in a third way to cause the blade to protrude between the jaws 14, thereby cutting the trapped tissue. After completing the required cutting and sealing, the user can release the tissue from the jaws 14.

[0020] The handle 10 includes, as in Fig. Figure 2 shows a housing 20 made of two shell-shaped parts 300, 302, which accommodates all the components required for actuating and rotating the clamping jaws 14, coagulating, and cutting tissue. The shell-shaped parts in the assembled device are ultrasonically welded after the internal components have been arranged inside them. The handle 10 comprises a clamping grip 22 for clamping tissue between the clamping jaws 14, a trigger 24 for cutting the tissue, a switch 26 for activating and deactivating the RF supply to the electrodes in the clamping jaws 14 for tissue coagulation, and a rotary knob 28 for rotating the clamping jaws 14 to access tissue at different angles. The handle 10 is designed so that the instrument 1 and all its functions can be operated with just one hand, with all operating mechanisms easily accessible.

[0021] Fig. Figure 3 shows all the features of instrument 1 required to perform its functions, including those incorporated in the two shell molded parts 300, 302 of the housing 20. To clamp tissue between the clamping jaws 14, a clamping mechanism is actuated using the clamping handle 22. The clamping handle 22 further comprises a collar ring 304, which includes a joint 306 that acts as a pivot point about which the clamping handle 22 rotates. The joint 306 can, for example, consist of two outwardly facing pins that engage in corresponding molded parts 308, which are integrally formed with the shell molded parts 300, 302, thus providing an anchor point about which the clamping handle 22 rotates. The clamping mechanism further comprises a collar ring molded part 310, a spring 312, and an inner molded part 314, as shown in Figure 3. Fig. Figures 4 to 7 are illustrated, with each of these arranged along a drive shaft 316.

[0022] The collar ring 304 includes a through-opening 318 in which the collar ring component 310 is received. The opening 318 has a larger diameter at the top than at the bottom, with the collar ring component 310 being arranged to be received in the lower part of the opening 318, as Fig. Figure 8a illustrates this. When assembled, the collar ring component 310 easily fits through the larger part of the opening 318, so that the collar ring 304 is held between two flanges 800, 802, as shown. Fig. 8b-c show how Fig. As shown in Figure 8d, the collar ring 304 is then pushed upwards to engage the smaller part of the through-opening 318 with the collar ring component 310. Once the joint 306 is connected to the joint components 308 inside the housing 20, the collar ring component 310 is held in the lower part of the opening 318, where it can rotate freely within the opening 318.

[0023] The collar ring component 310, the spring 312 and the inner component 314 are, as in Fig. As shown in Figure 6, the protruding elements 600 and 602 are held between them such that they cannot move axially beyond these protruding elements. In this respect, the protruding elements 602 at the proximal end of the drive shaft 316 are compressible to allow the drive shaft 316 to pass through a channel 604 in the proximal end of the inner molded part 314. The drive shaft 316 is pushed through the channel 604 until it reaches an opening 606, at which point the protruding elements 602 are no longer compressed so that they lie flush against the walls of the drive shaft 316. Instead, the protruding elements 602 fan out and press against the walls of the opening 606, so that the width of the protruding elements 602 extends beyond the diameter of the channel 604. Consequently, the drive shaft 316 cannot be retracted through the channel 604 and is locked in place.

[0024] The distance between the foregoing elements 600, 602 is chosen such that the spring 312 is at least partially compressed between the collar ring molding 310 and the inner molding 314. This pre-compression is essential to ensure that the correct clamping load is applied when the clamping mechanism is activated, as described in more detail below. Both the collar ring molding 310 and the inner molding 314 include cavities 608, 610 into which the spring 312 extends. In particular, a substantial portion of the length of the collar ring molding 310 accommodates the spring 312. This arrangement allows for a longer spring 312, which is important to ensure that the spring 312 never reaches its full length during use.

[0025] The main body of the drive shaft 316 lies within the outer shaft 12, with the distal end of the drive shaft 316 connected to both the distal end of the outer shaft 12 and to the clamping jaws 14. The drive shaft 316 moves axially within the outer shaft 12, and this axial movement moves the clamping jaws 14 from an open to a closed position, as shown in the figure. Fig. 4 and Fig. 5a. The drive shaft 316 is coupled to the clamping jaws 14, for example, by a drive pin 400 in a cam slot 402, the movement of the drive pin 400 in the cam slot 402 moving the clamping jaws 14 between the open and closed positions. The connection between the drive shaft 316, the outer shaft 12, and the clamping jaws 14 is such that a rotary movement of the drive shaft 316 is transmitted to the outer shaft 12 and the clamping jaws 14.

[0026] The outer shaft 12 and the drive shaft 316 are connected at another point by a shaft component 320. The shaft component 320 is received in a socket 322 of the housing 20 and thus connects the outer shaft 12 to the housing 20. The outer shaft 12 is fastened to the shaft component 320 by any suitable means, such as by detent projections 900 that interact with corresponding grooves 902 in the shaft component 320, as shown in Fig. Figure 9b shows that the drive shaft 316 is guided through the body of the shaft form part 320 through an opening (not shown) adapted to the T-shaped cross-section of the drive shaft 316, as shown by Fig. Figure 10a illustrates this. The shaft component 320 is arranged so that it can rotate freely in the socket 322. The shaft component 320 can, for example, comprise cylindrical flange elements 904, 906 that rotate in concentric mating surfaces 908, 910 provided in the shell components 300, 302. Thus, the shaft component 320 rotates with the drive shaft 316, which in turn transmits this rotational movement to the outer shaft 12 and the clamping jaws 14. The shaft component 320 therefore acts as a rotational guide and axial guide for the drive shaft 316.

[0027] The clamping handle 22 comprises a snap-in element 324 arranged to interact with a snap-in component 326 located in the proximal end 328 of the housing 20. The snap-in component 326 can be engaged by any suitable means, such as a component pin 330 formed integrally with one of the shell components 300, 302, as shown in Fig. 3 shown, or simply by the molded part walls 1100, which are formed integrally with the shell molded part 300, as in Fig. 11 is shown, to be held in its place.

[0028] When the clamping handle 22 is driven towards the housing 20 to close the clamping jaws 14, the locking element 324 enters the housing 20 through an opening 1102 and engages with the locking element 326 to hold the clamping handle 22 in this position. As shown from Fig. As shown in Figures 26a to 26f, the snap-fit ​​component 326 comprises a two-way spring 1104 and a cam path 1106 along which the snap-fit ​​element 324 moves. As shown in Fig. As shown in Figure 46, the latching mechanism can also include an override component 4600 to allow the user to manually release the latching element 324 if it becomes stuck, and a locking component 4602 to completely disable the latching mechanism. The override component 4600 and the locking component 4602 can be provided on the latching mold 326 or integrated into the interior of the housing 20.

[0029] As described above, the handle 10 further comprises a rotary knob 28, the rotary knob 28 being arranged to engage the inner molded part 314. For this purpose, the rotary knob 28 and the inner molded part 314 have interlocking elements 1200, 1202, as shown in the figure. Fig. 12 emerges. These interlocking elements 1200, 1202 connect in such a way that the rotary wheel 28 and the inner molded part 314 rotate together, while furthermore allowing axial movement of the inner molded part 314 within the rotary wheel 28, as shown in Fig. as shown in Figures 13a-b. Thus, a rotation of the rotary wheel 28 causes the inner molded part 314 to rotate, which in turn sets the drive shaft 316 and the collar ring molded part 310 into rotation. For stability reasons, the rotary wheel 28 comprises cylindrical surfaces 1204 that slide rotatingly on inner counter surfaces (not shown), which are formed integrally with the shell molded parts 300, 302.

[0030] To allow a user to rotate the clamping jaws 14, the housing 20 has two openings 332, 334 through which notched sections 336 of the rotary knob 28 extend. The two openings 332, 334 are opposite each other on either side of the handle and are trapezoidal. In particular, the trapezoidal openings have parallel sides that are perpendicular to the longitudinal axis of the handle, and one of the parallel sides may be longer than the other, with the longer side at the front end of the opening and the shorter side at the rear end of the opening. The notched sections 336 are chamfered appropriately so that they fit well to the user's thumb or fingers. For this purpose, the notched sections 336 are cut at an angle to the plane of rotation, as shown in Fig. 14a-b is shown. In particular, the angle of the chamfered part of the notched sections should substantially correspond to the angle of the outer casing in the area of ​​the rotary wheel 28.

[0031] The rotary wheel 28 also includes at least one stop element 1500 for limiting the degree of rotation, as in Fig. Figure 15a-b illustrates this. The stop element 1500 interacts with stop parts 1502, 1504, which are integrally formed with the housing 20. When the rotary knob 28 is turned, the stop element 1500 is blocked by the stop parts 1502, 1504, thus preventing further rotation. The stop parts 1502, 1504 can, for example, limit the rotation of the rotary knob to 270°. Similarly, the shaft-shaped part 320 also includes a stop element 1600, which interacts with stop parts 1602, 1604, which are integrally formed with the housing 20, as shown in Figure 15a-b. Fig. Figures 16a-d show that the stop element 1600 of the shaft-shaped part 320 and its corresponding stop parts 1602, 1604 are aligned with respect to the stop element 1500 of the rotary wheel 28 and its corresponding stop parts 1502, 1504 such that the rotation is restricted to the same extent. This means that when the rotary wheel 28 is rotated, the radial point at which the stop element 1500 is blocked on the rotary wheel 28 coincides with the radial point at which the stop element 1600 is blocked on the shaft-shaped part 320. Fig. 15b and Fig. 16a, for example, the clamping jaws 14 were removed from a neutral orientation (which in Fig. (as shown in Figure 16b) is rotated 90° counterclockwise. This freedom of rotation means that the user can capture tissue from different angles without having to rotate the entire instrument 1.

[0032] As described above, the switch 26 is provided to activate or deactivate the RF signal supplied to the electrodes in the clamping jaws 14 via a suitable circuit, such as two tamper-proof switches on a small printed circuit board (PCB) 338. As shown from Fig. As can be seen in Figure 17, the PCB 338 is connected to a connecting cable 1700 to receive the RF output signal from a generator (not shown), and to electrical leads 1702 and 1704 to supply the RF current to the electrodes in the clamping jaws 14, for example, with one lead for the active electrode and one lead for the counter electrode. As shown in Fig. 17 and Fig. As shown in Figure 18ab, the conductors 1702 and 1704 are wound below and around the shaft form 320 before entering a guide slot 1800 in the inner cavity 1802 of the shaft form 320 and running down the outer shaft 12. Wrapping the shaft form 320 with the conductors 1702 and 1704 in this way keeps them in a compact arrangement, allowing for easy assembly and simultaneous rotation of the drive shaft 316. As the drive shaft 316 rotates, the conductors 1702 and 1704 are unwound and rewound. In addition, one of the shell-shaped parts 300 also includes two shaped compartments 1900, 1902, which are arranged successively to accommodate the line contacts 1904, 1906, which connect the active lines and return lines 1702, 1704 to the wiring 1908, 1910 of the intrusion-protected switches 338.The opposite shell-shaped part 302 includes corresponding rib sections (not shown) to hold the contacts 1904, 1906 in the compartments 1900, 1902. Consequently, the two conductor contacts 1904, 1906 are separated longitudinally such that only one contact can pass through each compartment 1900, 1902, thus providing a physical barrier between each compartment 1904, 1906 and each conductor. This prevents the risk of damage to the insulation of one of the conductors caused by the contacts 1904, 1906 and simultaneously protects the contacts 1904, 1906 themselves from fluids that may run along the outer shaft 12 and into the housing 20.

[0033] With reference to the cutting mechanism, a blade 340 is provided for cutting fabric clamped between the jaws 14 in a central path 342 along the length of the drive shaft 316. The mechanism for actuating the blade 340 along the path 342 and between the jaws 14 is actuated via the trigger 24. The trigger 24 actuates a drive assembly consisting of a trigger component 344, a blade drive component 346, a blade collar ring component 348, a tension spring 350, and a blade component 352. The drive assembly is arranged between the shaft component 320 and the handle collar ring 304 of the clamping mechanism. As shown in Fig. As shown in Figures 20a-b, the drive arrangement functions as an offset push-crank mechanism, by which the force exerted by the user on the trigger 24 is converted into an axial movement of the blade shape 352 along the drive shaft 316, which in turn drives the attached blade 340.

[0034] As from Fig. 21, Fig. 22 and Fig. As can be seen from Figure 23, the blade component 352 is arranged to be received in the blade collar ring component 348. Fig. As shown in Figure 22, the blade collar ring molding 348 includes a lip rim 2200 that engages in a recess 2202 that runs around the circumference of the blade molding 352. Fig. Figure 23 shows that the blade molding 352 has a T-shaped opening 2300 for receiving the drive shaft 316 and the blade 340. The blade molding 352 also includes an inner cutout 2100, as shown. Fig. Figure 21 shows the proximal end of the blade 340, wherein the end of the blade 2102 is shaped to fit the inner cutout 2100 of the blade mold 352 to allow easy assembly, as shown in Fig. Figures 24a-c illustrate this. The blade component 352 is independently rotatable relative to the blade collar ring component 348, allowing the two components to rotate concentrically. Consequently, the blade component 352 is able to rotate with the drive shaft 316.

[0035] The clamping jaws 14 can be curved, as described above. To allow the blade 340 to be pushed around the curve while retaining sufficient cutting capability, the frictional force of the cutting blade 340 in the curved path must be minimized. The frictional force is a product of the coefficient of friction of the blade 340 in the path 342 and the force exerted on the walls of the path 342 by bending the blade 340. This frictional force can be reduced, for example, by adding a friction-reducing coating to both sides of the blade and / or, preferably, by weakening the blade 340 to reduce the flexibility of the distal end of the blade so that it can bend along the path 342 while remaining rigid in the cutting force direction. The preferred weakening can be achieved, for example, by providing one or more openings 354 in the distal end, as shown in Fig. 3 and Fig. 47a-c, or by a gradation of the thickness of the blade 340, as in Fig. 47d shown. Alternatively, as in Fig. 47e shows that structured laser cutouts 4712 or chemical etching can be applied in the distal end to adjust the bending stiffness along the blade length, the spacing of such cutouts being constant or increasing stepwise from the distal to the proximal end.

[0036] During use, blood and tissue can accumulate at the distal end of the instrument 1. In particular, blood and tissue can cause the blade 340 to become stuck inside the drive shaft 316. Therefore, the distal end of the drive shaft 316 may include cut-out sections 1000 to reduce the surface area of ​​the drive shaft 316 to which blood and tissue can adhere, as shown in Fig. Figures 10b-c illustrate the cut-out sections. For example, the distal end may comprise two side walls without a base, or the distal end may comprise a base with forked side walls. 2. Operating the instrument

[0037] Following a description of the overall structure of the device, the complete operation of electrosurgical instrument 1 during use will now be explained. This will be followed by a more detailed description of the structure and operation of specific aspects of the device.

[0038] As explained above, the handle 10 of the electrosurgical instrument is configured to i) clamp tissue between a set of jaws 14, ii) lock the jaws into place (if desired by the user), iii) deliver an RF signal to electrodes in the jaws 14 to coagulate the clamped tissue, and iv) move a blade 340 between the jaws 14 to cut the clamped tissue. The handle 10 can also rotate the jaws 14 to allow the user to clamp tissue at different angles without having to rotate the entire handle 10. Consequently, the clamped tissue can be sealed using the same electrosurgical instrument before or during cutting. Furthermore, this effect can be achieved by the instrument with one-handed operation by the surgeon. 2.1 Clamping mechanism

[0039] To clamp tissue between the clamping jaws 14, the user pushes the clamping handle 22 towards the proximal end 328 of the housing 20 until the locking element 324 engages with the locking form 326 inside the housing 20. This movement causes the drive handle 22 to pivot about its joint 306, as shown in Fig. 8e-f shown, and pushes the edge of the collar ring 304 against the flange 800 to displace the collar ring molding 310, the spring 312 and the inner molding 314 along the drive shaft 316 in the proximal direction, as shown in Fig. 4 and Fig. Figure 5a shows that, as described above, the inner molded part 314 is attached to the drive shaft 316 by means of projecting elements 602. When the inner molded part 314 is axially retracted, the drive shaft 316 is also axially moved, causing the pin 400 to move into the cam slot 402 of the clamping jaws 14, thus closing the clamping jaws 14. In this way, the force from the drive handle 22 is transmitted to the drive shaft 316 via the spring mechanism of the collar ring molded part 310, spring 312, and inner molded part 314.

[0040] If fabric is clamped between the clamping jaws 14, as in Fig. As shown in Figure 5b, the spring 312 limits the force acting on the fabric. Once the axial movement of the collar ring component 310, spring 312, and inner component 314 is complete, and the collar ring 304 continues to press against the flange 800, the threshold compression force of the spring 312 is reached, causing the spring 312 to begin compressing between the collar ring component 310 and the inner component 314. As the spring 312 continues to compress, the drive handle 22 can be moved into the engaged position without exerting any further force on the clamped fabric. This means that the force of the drive handle 22 is no longer transmitted to the drive shaft 316 but is effectively absorbed by the spring 312. Thus, the spring 312 ensures that the correct force is transmitted to the clamping jaws 14.Without the spring 312, actuation of the drive handle 22 causes a continued increase in the force transmitted to the drive shaft 316 and consequently to the clamping jaws 14 and the fabric. This could cause mechanical damage to the fabric if the user continues to press the drive handle 22 to engage it with the locking element 324.

[0041] As explained above, the cavities 608 and 610 in the collar ring molding 310 and the inner molding 314 work together to allow for a larger spring 312. This enables a greater spring stroke, so that the spring 312 is not compressed to its compression length during use. If the spring 312 were to reach its compression length, it would no longer absorb the force exerted by the drive handle 22, and the force would again be transmitted to the clamping jaws 14. 2.2 Locking mechanism

[0042] If fabric is clamped between the clamping jaws 14, the clamping jaws 14 can be locked in a closed position by engaging the locking element 324 on the drive handle with the locking element 326 inside the housing 20, as shown in Fig. Figures 26a-f illustrate this. Upon entry of the locking element 324 into the housing 20 through the opening 1102, the locking element 324 engages with the locking form 326, thereby pushing the form 326 downwards within the housing 20 and thus extending the spring 1104. As shown in Fig. As shown in Figures 26b-c, the detent element 324 moves upwards along the side of the cam path 1106 until it reaches its maximum position. At this point, the drive handle 22 can no longer be compressed, and the spring 1104 pulls the detent element 326 back upwards inside the housing 20, so that the detent element 324 is inserted into the V-shaped recess of the cam path 1106 to hold the drive handle 22 in the compressed position and the clamping jaws 14 in the closed position, as shown in Figure 26b-c. Fig. 26d shown.

[0043] In this locked position, the user's hand is free to operate the other functions of Instrument 1, as explained below.

[0044] To release the locking element 324 from the housing 20 and open the clamping jaws 14, the user must push the drive handle 22 towards the housing 20 to release the locking element 324 from the compartment of the cam path 1106, as shown in Fig. 26e. The force of the spring 1104 pulls the detent element 326 further upwards into the housing 20, so that the detent element 324 moves downwards in the opposite direction on the side of the cam path 1106, as shown in Fig. 26e-f is shown, and moved back out of the opening 1102. The snap-fit ​​component 326 then returns to its initial position inside the housing 20. 2.3 Cutting mechanism

[0045] When the clamping jaws 14 are in a closed position, the user may wish to cut the fabric clamped between them. To cut the fabric, a blade 340 is advanced between the clamping jaws 14 by actuating the drive mechanism.

[0046] The drive assembly is a three-pivot arrangement that functions as a push-pull mechanism. When the user pulls the trigger 24 back towards the housing 20, as shown in Fig. As shown in Figures 25b-c, the trigger mold part 344 is levered about a pivot point A, which is anchored to the housing 20, for example in the form of outwardly directed pins 358, which are connected to corresponding mold parts 356, which are integrally formed with the shell mold parts 300, 302. Fig. The three components are connected. This causes the pivot point B, which connects the trigger component 344 and the drive component 346, to move beyond its central position, thereby moving the blade collar ring 348, the blade component 352, and the blade 340 along the drive shaft 316 with a force sufficient for the blade 340 to cut the trapped tissue. In this context, the force exerted on the trigger 24 is transmitted via the trigger component 344 and the drive component 346 to the blade collar ring 348 and the blade component 352. As the pivot point B moves beyond its center point into its advanced position, the speed at which the blade collar ring 348 and the blade component 352 are moved along the drive shaft 316 increases, thereby increasing the force acting on the blade 340.This increases the force with which the blade 340 cuts into the tissue without the user exerting additional force on the trigger 24.

[0047] The shaft-shaped part 320 acts as a stop point for the blade collar ring 348 and the blade-shaped part 352. Consequently, the pivot point B always remains above the other two pivot points A and C with respect to the drive shaft 316.

[0048] During actuation of the trigger 24, the force exerted on the trigger 24 is sufficiently high to overcome the compression force of the tension spring 350, causing it to extend along the same plane as the drive shaft 316, thus allowing axial movement of the blade collar ring 348 and the blade form 352. Upon release of the trigger 24, the tension spring 350 is compressed again to retract the drive assembly to its initial position. The tension of the tension spring 350 is sufficiently high to retract the blade 340 through thick fabric without user intervention. 2.4 Shaft rotation

[0049] During use, the user may need to access tissue from different angles without having to move the entire instrument 1. For this reason, the clamping jaws 14 are advantageously rotatable relative to the handle 10 by means of the rotary knob 28. This is particularly advantageous when the clamping jaws 14 are located on a curved surface, as in Fig. Figures 16a-d illustrate this. As explained above, the rotary wheel 28 is connected to the inner molded part 314 via interlocking elements 1200, 1202, so that the inner molded part 314 rotates with the rotary wheel 28. Since the end of the drive shaft 316 is connected to the inner molded part 314, the drive shaft 316 also rotates, which consequently also rotates the clamping jaws 14 at their opposite end.

[0050] To enable this rotational movement without impairing the function of the clamping mechanism, the collar ring component 310 is independently rotatable within the handle collar ring 304, so that the collar ring component 310 also rotates with the drive shaft 316. Similarly, the blade component 352 is independently rotatable within the blade collar ring 348 to allow the rotation of the drive shaft 316 without impairing the function of the cutting mechanism.

[0051] To transmit the rotational movement to the outer shaft 12, the shaft component 320 is rotatable in its socket 322. As described above, the shaft component 320 acts as a rotation guide to control the rotational movement with respect to the shaft 316 along the entire length of the instrument 1. Additionally, the active and return leads 1702 and 1704 are arranged within the housing 20 to prevent damage to these leads 1702 and 1704 by the rotating components. As described above, the leads 1702 and 1704 are wound around the shaft component 320 to allow for the degree of rotation of the drive shaft 316. Consequently, the leads 1702 and 1704 are unwound and rewound around the shaft component 320 as it rotates. 2.5 Electrode activation

[0052] When the clamping jaws 14 are in a closed position, the user may wish to coagulate and seal the tissue clamped between them. For this purpose, the user initiates electrode activation using the switch 26 on the housing 20, which is conveniently positioned for easy access while operating the device with one hand. This delivers an RF signal to the electrodes in the clamping jaws 14 to coagulate and seal the tissue. The RF signal can have a pure or mixed waveform, depending on the desired effect.

[0053] Following an overview of the structure and operation of the entire device, further detailed descriptions of the structure and operation of specific aspects of it will now follow. 3. Construction and operation of the clamping mechanism

[0054] As described above, the proximal handle section 10 of the electrosurgical instrument 1 includes a first mechanism for actuating one aspect of a distal end-effector assembly 14, such that the end-effector assembly 14 switches between a first and a second state. The end-effector assembly 14 may, for example, be a set of opposing clamping jaws 14 arranged to open and close. The mechanism used to trigger the movement of these clamping jaws 14 is the so-called clamping mechanism, which comprises a drive handle 22 and two barrel-shaped components 310, 314 with a compressed spring 312 between them, all elements being arranged along an elongated rod 316 extending between the clamping jaws 14 and the handle 10, as shown in Fig. 4 and Fig. 5a-b shown.

[0055] As from Fig. As shown in Figure 8a, the drive handle 22 comprises a collar ring 304 in which the collar ring component 310 is received. The collar ring 304 includes an opening 318 shaped like a keyhole or the number 8. The opening 318 consists of two adjacent openings 804, 806, the upper opening 804 having a larger diameter than the lower opening 806.

[0056] The collar ring component 310 is a cylindrical or barrel-shaped component with two flange sections 800, 802, spaced apart longitudinally. The diameter of the proximal flange 800 is larger than that of the upper and lower openings 804, 806. The diameter of the distal flange 802 is smaller than that of the upper opening 804, but larger than that of the lower opening 806.

[0057] During assembly, the collar ring component 310 is first inserted through the upper opening 804, as shown in Fig. Figures 8b-c illustrate this. Since the distal flange 802 is smaller than the upper opening 804, it easily passes through it, while the proximal flange 800 is large enough to prevent the collar ring fitting 310 from being fully advanced through the upper opening 804. As shown in Figures 8b-c, Fig. As shown in 8d, the collar ring 304 is then pushed upwards to engage the lower opening 806 with the collar ring molded part 310.

[0058] After assembly, the collar ring component 310 remains within the lower opening 806 of the collar ring 304 and is arranged such that its two flanges 800, 802 are located on both sides of the collar ring 304, as shown in the figure. Fig. 8e. Since the lower opening 806 has a smaller diameter than both flanges 800, 802, the collar ring fitting 310 cannot be removed by simply pushing it through the lower opening 806. In contrast, the body of the collar ring fitting 310 has a slightly smaller diameter between the two flanges 800, 802 than the lower opening 806. Thus, the collar ring fitting 310 is held loosely enough in the lower opening 808 to allow rotational movement.

[0059] As from Fig. As can be seen from Figure 8e, the longitudinal distance between the two flanges 800, 802 is only slightly greater than the thickness of the collar ring 304, so that it fits precisely between the flanges 800, 802. This ensures that the movement of the drive handle 22 is transmitted directly to the collar ring component 310 and consequently to the other components of the clamping mechanism. This is particularly important to ensure that the clamping jaws 14 react to the movement of the drive handle 22 and that there is no delayed response between actuation of the drive handle 22 and the movement of the clamping jaws 14.

[0060] Once the collar ring component 310 and the drive handle 22 are joined together, the remaining components can be assembled.

[0061] The drive shaft 316 is an elongated rod with one or more projecting elements 602 arranged at its proximal end, as shown in Fig. Figure 6 shows the projecting elements 602 as flexible extensions that fan out from the surface of the drive shaft 316. This means that the projecting elements 602 are deformable enough to be pressed flush against the surface of the drive shaft 316, but return to their original position when relieved by a counterforce. This allows the drive shaft 316 to be easily slid through all components of the clamping mechanism during assembly, as described below.

[0062] The collar ring component 310 has an internal cavity divided into two parts. The first part is a narrow channel or slot 607 for receiving the drive shaft 316, the distal end of the collar ring component 310 comprising an opening 311 as shown in Fig. Figure 3 shows the T-shaped cross-section of the drive shaft 316. The diameter of the channel 607 is only slightly larger than that of the drive shaft 316 to provide a tight fit for improved stability. When the drive shaft 316 is inserted, the protruding elements 602 are flattened to allow the drive shaft to be pushed through completely.

[0063] The second part is a chamber 608, which is sufficiently large to accommodate one end of the spring 312. The chamber 608 can extend over any suitable portion of the length of the collar ring component 310. For example, the length of the chamber 608 can be approximately 25% to 75% of the length of the collar ring component 310.

[0064] The chamber 608 is significantly larger than the collar ring molding channel 607, so that the drive shaft 316 is pushed through the collar ring molding 310, and the protruding elements 602 extend outwards again into their original structure when they reach the chamber 608.

[0065] The collar ring assembly 310 and drive handle 22 is pushed along the drive shaft 316 until the collar ring assembly 310 reaches a second set of projecting elements 600. These projecting elements 600 are wider than the opening 311 on the collar ring assembly 310 in order to form an obstacle that prevents the collar ring assembly 310 from moving further along the drive shaft 316. For this purpose, the projecting elements 600 must be sufficiently rigid so that the collar ring assembly 310 cannot be pushed past them by applying force or by pushing the projecting elements 600 inwards.

[0066] The drive shaft 316 is then pushed through the center of the spring 312. The spring 312 preferably has a diameter that is only slightly larger than that of the drive shaft 312 in order to provide a tighter fit between the spring 312 and the drive shaft 316. The spring 312 is then pushed along the drive shaft 316 until the end of the spring 312 fills the collar ring forming chamber 608.

[0067] The inner molded part 314 is a cylindrical or barrel-shaped component with an inner cavity divided into two sections. The first section is a chamber 610 in which one end of the spring 312 is received such that the spring 312 is partially enclosed by the collar ring molded part 310 and the inner molded part 314. The second section is a narrow channel or slot 603 for receiving the proximal end of the drive shaft 316. The channel 603 is divided into two parts 604 and 606. The first part of the channel 604 is shaped to allow the drive shaft 316 to pass through, flattening the flexible extensions 602 in the process. For this purpose, the diameter of the first channel part 604 is only slightly larger than that of the drive shaft 316 to provide a tight fit.The tight fit of the drive shaft 316 in both the collar ring molding channel 607 and the channel 603 of the inner molding means that the drive shaft 316 is held firmly in place. This increases the stability of the drive shaft 316 in the housing 20, which is particularly important for ensuring maximum control of the end effector 14.

[0068] The second part of the channel 606 provides a shoulder 605 into which the projecting elements 602 can extend. When the drive shaft 316 passes through the channel 604 and into the second channel part 606, the flattened projecting elements 602 fan out again to their original, uncompressed position. Once the projecting elements 602 have engaged with the shoulder 605 of the second channel part 606, the drive shaft 316 cannot be retracted through the first channel part 604 and is thus held in the inner molded part 314. For this to occur, the diameter of the second channel part 606 must be sufficiently wide so that the projecting elements 602 extend beyond the diameter of the first channel part 604. To create this snap-fit ​​connection, a projecting element 602 is only required on one side of the drive shaft 316.

[0069] This snap-fit ​​connection is designed such that any axial movement of the inner molded part 314 is transmitted to the drive shaft 316. Similarly, any rotational movement of the inner molded part 314, for example by the rotary wheel 28 formed around the inner molded part 314, is also transmitted to the drive shaft 316.

[0070] To complete the assembly of the clamping mechanism, the drive shaft 316 is simply pushed through the collar ring molded part 310, the spring 312 and finally the inner molded part 314 until the protruding elements 602 snap into the second channel part 606.

[0071] After being arranged along the drive shaft 316, the collar ring component 310, the spring 312, and the inner component 314 are positioned such that the spring 312 is partially enclosed by the collar ring component 310 and the inner component 314. By providing the collar ring component chamber 608 and the inner component chamber 610, in which a substantial portion of the spring 312 can be accommodated, a longer spring 312 can be used without requiring additional space in the handle 10. The larger the collar ring forming chamber 608 and the chamber 610 of the inner forming part, the longer the spring 312. Furthermore, the distance between the protruding elements 600, 602 means that the ends of the spring 312 are compressed by the end walls 612, 614 of the collar ring forming chamber 608 and the chamber 610 of the inner forming part, respectively, so that the spring 312 undergoes an initial pre-compression during installation.This is important to ensure that when the handle 22 is actuated to activate the clamping mechanism, the correct force is applied to the clamping jaws 14.

[0072] In addition, the inner molded part 314 can be accommodated in another barrel-shaped molded part, such as the rotary wheel 28, as shown in Fig. Figures 13a-b show that the inner molded part 314 rotates with the rotary wheel 28, but is free to move axially within the inner cavity 1300 of the rotary wheel 28 between a first position, as shown in Fig. 13a shown, and a second position, as in Fig. As shown in Figure 13b, the rotation of the wheel 28 rotates the inner molded part 314, which in turn rotates the drive shaft 316 and the clamping jaws 14.

[0073] After all components have been assembled, the drive handle 22 can be installed in the housing 20. For this purpose, the drive handle 22 is connected to the housing at its joint 306. The joint 306 can, for example, consist of two outwardly extending pins that fit together with corresponding joint components 308, which are integrally formed with the shell components 300, 302. This provides an anchor point around which the drive handle 22 can rotate.

[0074] Thus, the arrangement described above provides a mechanism for actuating the end effector arrangement 14, which can be assembled easily and safely without any additional components.

[0075] During use, the user pushes the drive handle 22 towards the proximal end 328 of the housing 20, causing the drive handle 22 to rotate about its joint 306. This presses the collar ring 304 against the proximal flange 800, causing the collar ring component 310 to move longitudinally. This longitudinal movement moves the spring 312, the inner component 314, and the drive shaft 316 back towards the proximal end of the handle section 10, as shown in the figure. Fig. 5a. Since the drive shaft 316 is connected to the clamping jaws 14, for example by an arrangement of pin 400 and cam slot 402, the clamping jaws 14 are moved from the open to the closed position. The force from the drive handle 22 is transmitted to the drive shaft 316 via the spring mechanism of collar ring component 310, spring 312 and inner component 314. This spring mechanism is particularly important because it limits the force acting on any tissue that may be clamped between the clamping jaws 14.

[0076] When the drive handle 22 is pressed, the collar ring component 310, the spring 312, and the inner component 314 continue their axial movement until either the inner component 314 reaches its outermost proximal position, so that the clamping jaws 14 are completely closed, as shown in Fig. 5a shown, or the clamping jaws 14 cannot be closed further due to tissue 500 trapped between them, as shown in Fig. 5b is shown, in which case the drive handle 22 is not fully actuated, so that it is held in place by the detent element 324. If the user continues to press the drive handle 22 and the collar ring 304 continues to press against the flange 800, the threshold compression force of the spring 312 is finally reached, so that the spring 312 begins to be compressed between the collar ring molded part 310 and the inner molded part 314, as shown in Fig. 5b can be seen.

[0077] If the spring 312 is compressed further, the drive handle 22 can be moved into the engaged position without exerting any further force on the clamped fabric 500. This means that the force of the drive handle 22 is no longer transmitted to the drive shaft 316, but is effectively absorbed by the spring 312. The spring 312 thus ensures that the correct force is transmitted to the clamping jaws 14. Without the spring 312, actuating the drive handle 22 would continuously increase the force exerted on the drive shaft 316 and consequently on the clamping jaws 14 and the fabric 500. This could lead to mechanical damage to the fabric 500 if the user presses the drive handle 22 to engage it with the locking element 324.

[0078] For this reason, pre-compression of the spring 312 is important to ensure that the spring 312 absorbs the force of the handle 22 as soon as the inner molded part 314 reaches its axial end position. Similarly, a longer spring 312 allows for a greater spring stroke, so that the spring 312 is not fully compressed to its block length during use. If the spring 312 were to reach its block length, it would no longer absorb the force exerted by the drive handle 22, and the force would again be transmitted to the clamping jaws 14.

[0079] To hold the clamping jaws 14 in their closed position, the locking element 324 on the drive handle 22 must engage with the locking element 326 inside the proximal end 328 of the housing 20, as shown in Fig. 26a-f is shown.

[0080] Fig. Figure 11 shows that the snap-fit ​​component 326 is a single, one-piece molded component comprising a body section 1108, a spring element 1104, and a cam path 1106. The proximal end 328 of the housing 20 has parallel walls 1100 that define a channel 1110 in which the body section 1108 is received. The width of the channel 1110 is selected such that the body section 1108 is held in the channel 1110 but is nevertheless able to slide up and down in the channel 1110 during use, as described below. For this purpose, the snap-fit ​​component 326 is preferably made of a low-friction material, such as polytetrafluoroethylene (PTFE), to allow the body section 1108 to slide easily in the channel 1110 without sticking.For further stability in the channel 1110, a shaped pin 330 can be provided in the housing 20, which engages with a cam slot 331 provided on the body section 1108, as shown in . Fig. 46 shown.

[0081] The spring 1104 is positioned at the end of the body section 1108 and is arranged to bias the body section 1108 upwards in the channel 1110 towards the distal end of the housing 20. The spring 1104 can have any suitable configuration; for example, the spring 1104 can have a curved shape or a loop shape, as shown in Fig. Figure 11 shows the cam path 1106 as a projecting molded part formed on the body section 1108. The cam path 1106 comprises a first cam surface 1112, a groove 1114 and a second cam surface 1116 to form a V-shaped molded part.

[0082] The locking element 324 consists of an arm 1118 extending from the base of the drive handle 22. The arm 1118 has a pin 1120 located at its end, which is capable of moving along the cam path 1106.

[0083] During application, the snap-in element 324 is inserted into the housing 20 through an opening 1102. The pin 1120 engages with the snap-in part 326, so that the body section 1108 is pulled downwards in the channel 1110, thereby extending the spring 1104. As in Fig. As shown in Figures 26b-c, the pin 1120 moves along the side of the first cam surface 1112 until it reaches the upper part of the “V”. At this point, the drive handle 22 can no longer be depressed, and the spring 1104 pulls the body section 1108 back up in the channel 1110, so that the pin 1110 engages in the groove 1114, thereby holding the drive handle 22 in the depressed position and the clamping jaws 14 in the closed position, as shown in Figure 26b-c. Fig. 26d shown.

[0084] To engage the drive handle 22, the user simply needs to activate the drive handle in the fully depressed position, wait until the pin 1110 engages in the groove 1114, and then release the drive handle 22. In this engaged position, the user's hand is free to perform other functions of the instrument 1, such as actuating the cutting mechanism using the trigger 24, rotating the clamping jaws 14 using the rotary knob 28, or actuating the electrodes in the clamping jaws 14 using the switch 26.

[0085] To release the locking element 324 from the housing 20 and open the clamping jaws 14, the user must push the drive handle 22 towards the housing 20 once more. This releases the pin 1120 from the groove 1114, as shown in Fig. 26e shown. When the pin 1120 exits the groove 1114, the force of the pre-tensioned spring 1104 pulls the body section 1108 back upwards in the channel 1110, so that the pin moves along the side of the second cam surface 1116, as shown in Fig. Figures 26e-f show that when the pin 1120 reaches the bottom of the second cam surface 1116, it pushes the body section 1108 further upwards in the channel 1110, allowing the pin 1120 to exit the opening 1102 again. The body section 1108 can then return to its original position in the channel 1110.

[0086] To release the drive handle 22, the user simply needs to push the drive handle 22 towards the proximal end of the housing 20 and then allow the drive handle 22 to return to its original open position.

[0087] Furthermore, the snap-fit ​​component 324 can include an override button 4600, which is formed integrally on the body section 1108, as shown in Fig. Figure 46 shows the override knob 4600 being engaged such that the position of the cam path 1106 changes likewise, causing the pin 1120 to automatically disengage from the groove 1114 and release the drive handle 22. Consequently, if the locking mechanism were to fail for any reason, the user would be able to release the drive handle 22 to open the clamping jaws 14.

[0088] The body section 1108 can further be provided with an integrated locking bar 4602 to allow the user to release the entire locking mechanism. The locking bar 4602 is movable between a first and a second position to manually move the body section 1108 in the channel 1110. When the locking bar 4602 is in the first position, the body section 1108 is in its normal position, so the locking mechanism operates as described above. The user can then move the locking bar 4602 to its second position, which moves the body section 1108 upwards in the channel 1110 so that the pin 1120 can only pass over the second cam surface 1116, thus preventing it from engaging with the groove 1114.

[0089] Such a locking mechanism is also suitable for many end effector arrangements. For example, such a locking element can be provided on the trigger 24 for the cutting mechanism to hold the cutting blade 340 in the activated position.

[0090] When the locking element 324 is released, the drive handle 22 can be moved back to its original position. This releases the collar ring 304 from the load exerted on the proximal flange 800, and it presses against the distal flange 802, thereby pulling the collar ring component 310 back into its original axial position. Consequently, the spring 312, the inner component 314, and the drive shaft 316 are also retracted axially, which in turn returns the clamping jaws 14 to their open configuration. 4. Arrangement and operation of the cutting mechanism

[0091] Several features and aspects relating to the structure and operation of the cutting mechanism will now be described. As described above, the proximal handle section 10 of the electrosurgical instrument 1 includes a second mechanism for actuating another aspect of a distal end-effector assembly 14. For example, the end-effector assembly 14 may be a set of opposing clamping jaws 14 and a blade 340, with the distal end of the blade 340 positioned to slide between the clamping jaws 14 in order to cut tissue clamped between these jaws 14. The mechanism used to trigger movement of the blade 340, which is arranged in a central track 342 of the drive shaft 316, is called the cutting mechanism.The cutting mechanism comprises a drive arm 2000, a blade drive molding 346, a blade collar ring molding 348, a blade molding 352 and a tension spring 350, all coupled together to form a 3 pivot point push-crank mechanism, as shown in . Fig. 20a-b as well as Fig. 31 and Fig. 32 shown.

[0092] The drive arm 2000 is formed from a trigger 24 and the trigger component 344, wherein the trigger 24 is a finger-gripping element for triggering the cutting mechanism and the trigger component 344 is a collar ring with a C-shaped side profile and an opening 364 through which the drive shaft 316 is inserted. The point where the trigger 24 and the trigger component 344 meet forms a pivot point A around which the drive arm 2000 is rotated. This first pivot point A is anchored to the housing 20, for example by means of outwardly facing pins 358, which are connected to corresponding components 356 that are integrally formed with the shell components 300, 302.

[0093] The distal end of the drive arm 2000, that is, the end of the trigger fitting 344, is pivotally connected to the blade drive fitting 346 to form a second pivot point B. The blade drive fitting 346 is an H-shaped frame with two parallel arms and an intermediate strut. Thus, the parallel arms of the blade drive fitting 346 are pivotally connected at one end to the trigger fitting 344, for example, by means of outwardly facing pins 366 and mating connectors 368. At the opposite end, the parallel arms of the blade drive fitting 346 are also pivotally connected to the blade collar ring fitting 348 to form a third pivot point C, for example, by means of outwardly facing pins 372 and corresponding connectors 370.

[0094] As in Fig. As shown in Figures 21 to 23, the blade collar ring-shaped component 348 is a cylindrical or barrel-shaped component with a chamber 2104 in which the blade-shaped component 352 is seated, the blade-shaped component 352 being a cylindrical or barrel-shaped component with a body 362 that fits into the chamber 2104 of the blade collar ring-shaped component 348. The blade-shaped component 352 further comprises a flange 360 ​​with a diameter larger than that of the chamber 2104, such that the flange 360 ​​abuts the distal lip 2200 of the blade collar ring-shaped component 348, as shown in Figures 21 to 23. Fig. 22 shown. Subsequently, the flange 360 ​​ensures that the correct end of the blade fitting 352 is inserted into the blade collar ring fitting.

[0095] The body 362 is provided with a small groove 2202 around its circumference to provide a shoulder that engages with the distal nose 2200, so that the blade mold 352 and the blade collar ring mold 348 are connected to each other via a snap-fit ​​connection. The distal lip 2200 fits into the groove 2202 to hold the blade mold 352 in the blade collar ring mold 348, while the blade mold 352 can rotate freely in the chamber 2104. Thus, the blade mold 352 and the blade collar ring mold 348 are free to rotate concentrically.

[0096] Once the blade collar ring molded part 348 and the blade molded part 352 are assembled, the blade 340 can be used as shown in Fig. 24a-c shown. In this respect, the blade fitting 352 includes a T-shaped opening 2300 extending along its length and shaped to accommodate both the blade 340 and the drive shaft 316, as shown in Fig. 23 shown.

[0097] The proximal end of the blade 340 includes an engagement element 2102 that extends further than the general profile of the remaining part of the blade 340, that is, it does not lie in the same axial plane. As shown in Fig. As shown in Figure 24c, the body 362 further comprises a recess 2100 in which the engagement element 2102 is held. To permit this arrangement, the proximal end of the blade 340 is cut off at a first point opposite the engagement element 2102 to provide a beveled edge 2400, and is cut out at a second point adjacent to the engagement element 2102 to provide a recessed section 2402. Thus, the proximal end of the blade 340 has an L-shaped profile.

[0098] To arrange the blade 340 in the arrangement of blade molding 352 and blade collar ring molding 348, the blade 340 is aligned at an angle to the longitudinal axis of the instrument 1 relative to the T-shaped opening 2300 such that the engagement element 2102 and the inclined edge 2400 can be inserted into the inner cavity 2404 of the blade molding 352, as shown in Fig. 24a-b shown. Then the blade 340 is pulled downwards in line with the longitudinal axis to press the engagement element 2102 into the recess 2100, as shown in Fig. 24c shown. Thus, the engagement element 2102 is effectively hooked with the shoulder 2406 of the blade shape 352, thereby holding the proximal end of the blade 340 in the inner cavity 2404.

[0099] The drive shaft 316 can then be inserted through the T-shaped opening 2300, with the blade 340 being received in the central track 342, as shown by Fig. 22 and Fig. 23 shown. Thus, by a longitudinal movement of the arrangement of blade collar ring form part 348 and blade form part 352 along the drive shaft 316, the blade 340 is displaced along the path 342.

[0100] To complete the blade-release arrangement, a tension spring 350 extends between the blade collar ring molding 348 and the drive arm 2000, for example by means of hooks 2002, 2004.

[0101] During application, the user pulls the trigger 24 back to the housing 20, as shown in Fig. 25b-c shows that the drive arm 2000 pivots about the first pivot point A. This pushes the second pivot point B distally forward, causing the drive component 346 to push the arrangement of blade collar ring component 348 and blade component 352 along the drive shaft. The load applied to the trigger 24 is therefore transmitted via the trigger component 344 and the drive component 346 to the blade collar ring component 348 and the blade component 352. Since the proximal end of the blade 340 is held in the blade mold 352, as described above, the blade 340 slides along the central track 342 with the arrangement of blade collar ring mold 348 and blade mold 352. Because the blade mold 352 is independently rotatable in the blade collar ring mold 348, the drive shaft 316 can be rotated without affecting the operation of the cutting mechanism.

[0102] The mechanism's operation is optimized to provide good force transmission at the beginning of the blade 340's travel, when the user's finger is extended and less powerful, and also at the end of the blade 340's travel, where more forces act against the blade's travel, such as the force of the spring 350, friction within the track 342, and the force required to penetrate thick tissue. As demonstrated by Fig. As can be seen in Figure 27, the user exerts a constant force on the trigger 24. The mechanism transforms this trigger force into a high output force of the blade 340, which decreases as the blade 340 is moved along the track 342 and increases again when the blade 340 reaches the clamping jaws 14. When the pivot point B moves from its retracted position to its advanced position, as shown in Figure 27, the blade 340 is pressed into place by the user. Fig. As shown in Figures 28a-b, such that β > 90°, the speed at which the blade collar ring 348 and the blade shape 352 are moved along the drive shaft 316 is increased, thereby increasing the force of the blade 340. Thus, the mechanism is able to drive the blade 340 with sufficient force to effectively cut the fabric clamped between the jaws 14 without the user having to apply additional force to the trigger 24.

[0103] Furthermore, it may be necessary for the cutting mechanism to slide the blade 340 along a curved set of clamping jaws 14, which increases the frictional forces opposing the movement of the blade 340. The frictional force is the product of the coefficient of friction of the blade 340 within the track 342 and the force that the blade 340 exerts on the walls of the track 342 as a result of the bending.

[0104] To reduce this frictional force, the lateral flexibility of the distal end of the blade can be graduated. Such graduated flexibility can be achieved, for example, preferably by weakening the blade 340 so that it is able to bend along the path 342 while remaining rigid in the direction of the cutting force. A preferred weakening can be achieved, for example, by providing one or more openings or one or more slots 354 in the distal end, as shown in Fig. 47a. Such openings can be of constant or varying size or shape, depending on the required degree of flexibility. For example, in Fig. 47b Two adjacent openings 4702, 4704 of different sizes are provided, the larger opening 4702 providing a higher degree of flexibility than the smaller opening 4704. As a further example, in Fig. 47c provides three openings 4706, 4708, 4710 of varying size and shape, with the largest opening 4706 being located most distally to provide increased flexibility in this region. A preferred weakening can further be achieved by grading the thickness of the blade 340 so that the distal end of the blade 340 is beveled 4700, as shown in Fig. 47d shown.

[0105] Alternatively, patterned laser cuts 4712 or chemical etching can be applied to the distal end to control the flexural strength over a length of the blade 340, as in Fig. 47e shows that the distance between such sections can be constant or can increase gradually from the distal to the proximal end.

[0106] Preferably, the blade 340 is divided into at least three regions of varying flexibility, for example, a distal region, a middle region, and a proximal region, wherein the distal region has greater lateral flexibility than the middle region, and the middle region has greater flexibility than the proximal region. For example, the distal region may be formed by a beveled end 4700 to provide the greatest degree of flexibility; the middle region may be formed with an opening 354 to provide a relatively lower degree of flexibility; and the proximal region may be formed by a rigid bar to provide even less flexibility, as in Fig. 47a shown. In another, in Fig. In the example shown in Figure 47b, the distal region has a large opening 4702 to provide the greatest degree of flexibility; the middle region includes a smaller opening 4704 to provide reduced flexibility; and the proximal region is again a rigid bar with the least degree of flexibility. The distal, middle, and proximal regions can be obtained using any suitable combination of the preferred weakening described above.

[0107] Another way to reduce the frictional force resulting from the curved path is to apply a low-friction coating to at least one side of the distal end of the blade 340. For example, the blade can be coated, for example using physical vapor deposition (PVD) or chemical vapor deposition (CVD) processes, with a low-friction or non-adherent material, such as a PTFE composite or other low-friction polymer composite. 5. Drainage openings

[0108] Several further features and aspects regarding the structure of the drive shaft 316 will now be described. As described above, the drive shaft 316 is an elongated rod with a T-shaped cross-section, as shown in Fig. Figure 10a shows that the drive shaft 316 includes a slot or track 342 along its length, which is suitable for receiving another elongated element, such as the cutting blade 340 used in the cutting mechanism described above. In application, the cutting blade 340 is caused to slide along the length of the drive shaft 316 to move its distal end between the clamping jaws 14 in order to cut tissue clamped therein.

[0109] Over time, blood and tissue can accumulate at the distal end of the instrument 1, particularly along the outer shaft 12 and the drive shaft 316. This accumulation of blood and tissue can cause the blade 340 to stick in the drive shaft 316, impairing the functionality of the instrument 1, especially its cutting mechanism. To prevent this, sections of the distal end of the drive shaft 316 have been cut away, thus reducing the contact area between the drive shaft 316 and the blade 340, and consequently the surface area to which blood and tissue can adhere.

[0110] These cut-out sections can create openings, such as those in Fig. The elongated windows 1000 shown in Figures 10b-c are such that the distal end of the drive shaft 316 comprises a supporting base with forked sidewalls. The cut-out sections can also extend to the base of the drive shaft 316, so that the distal end comprises forked sidewalls and an open bottom. To maximize the amount of drainage provided by these openings 1000, the openings preferably constitute more than 50% of the depth of the drive shaft 316.

[0111] Thus, these openings provide 1000 drainage openings between the central track 342 and the outer surface of the drive shaft 316. 6. Rotary knob and switch

[0112] Several further features and aspects regarding the operation of the adjusting wheel 28 (here also referred to as the rotary wheel) will now be described. The adjusting wheel 28 is designed to allow the user to rotate the outer shaft 12 on which the end effector assembly 14 is mounted. To reduce the required space and thus create a more compact instrument, the internal volume 1300 of the adjusting wheel 28 is also used to provide a space for movement for the inner molded part 314, which forms part of the clamping mechanism described above. With such an arrangement, a more compact mechanism can be obtained.

[0113] In detail, the rotary knob 28 (also referred to here as the adjusting knob) comprises a toothed plastic wheel with a multitude of notched sections 336 arranged around its outer diameter. The adjusting knob 28 has the appearance of a gear, with the notched cutout sections arranged to ergonomically accommodate a user's thumb. In this regard, and as in Fig. 13a, Fig. 13b, especially in Fig. As shown in Figure 14a, the notched sections are positioned at an angle to the plane of rotation of the adjustment wheel during use, so that, in general, the adjustment wheel or rotary knob 28 has a slightly frustoconical shape, wider at the end furthest from the user than at the end closer to the user. The notched sections 336 each extend from the distal edge of the adjustment wheel to the proximal edge and are curved or saddle-shaped to accommodate a user's thumb during use. As detailed in Fig. As shown in Figure 14a, the angular shape of the notched sections 336 is suitable for achieving the truncated cone shape of the rotary wheel 28, generally corresponding to the angle of the instrument body. Fig. Figure 14a illustrates the angular shape of the notches 336 around the edge of the wheel 28, which can be viewed as tangential in the distal direction to the angle of the outer walls of the instrument at the point around the wheel, and in particular to the section of the outer walls of the instrument immediately in front of the wheel. Such an arrangement, in which the angled notches of the outer edge of the rotating wheel fit the angle of the wall of the instrument around the wheel, provides a comfortable and ergonomic shape that is easy for the surgeon to use.

[0114] Regarding the number of notched sections 336 around the outer diameter of the wheel 28, as shown in one embodiment, eight notched sections are evenly spaced around the outer diameter of the wheel. In other embodiments, a smaller or larger number of notched sections may be used, for example, only six or seven, or even nine or ten. If a larger wheel 28 is to be used, a larger number of notched sections 336 may be provided, and conversely, if a smaller wheel is to be used, the number of sections may be smaller. In this respect, the actual size of each notched section 336 should typically remain the same, since the notched sections have been ergonomically selected to comfortably accommodate a user's thumb.

[0115] Regarding the positioning of the adjusting wheel 28 within the instrument, as shown in Fig. As shown in Figure 2, the rotary or adjusting wheel 28 is positioned vertically below the switch 26 and spaced from the adjusting wheel in a direction orthogonal to a longitudinal axis, which is defined, for example, by the longitudinal direction of the drive shaft 316. In particular, the hand switch 26 lies directly on an axis orthogonal to this longitudinal axis, which also passes through the adjusting wheel 28. Furthermore, as shown in Fig. 14a and Fig. As shown in Figure 14b, the switch 26 is relatively large and extends across the dial from one side of the instrument's upper surface to the other. The switch 26 is curved to generally conform to the curved upper surface of the instrument's outer wall and has ridges, grooves, or other raised projections on its outer surface to assist the user in gripping the switch for pressing with their thumb. The surface area of ​​the switch 26 is relatively large, namely more than 3 cm². 2 or even 5 cm 2This provides a large surface area to allow for ergonomic activation by the user. The vertical orientation of the switch 26 directly above the control wheel 28 also allows for ergonomic activation. As explained elsewhere, when activated, the switch 26 serves to supply an RF coagulation signal to the end effector 14 for coagulation of any tissue located therein.

[0116] Regarding the ergonomics of the switch and the dial, Fig. 35a and Fig. Figure 35b shows two corresponding illustrations of different users with hands of different sizes. As shown, the switch 26, because it has a relatively large surface area, is easy for users with different hand sizes to operate while simultaneously operating the clamping handle 22 (and the blade release 24, if desired).

[0117] Back to Fig. As previously described, the adjusting wheel 28 has an inner cavity 1300 which, when used, is received in the inner molded part 314. As previously described, the inner molded part 314 comprises an inner molded chamber 610 and has a T-shaped cut section 1208 therein, through which the drive shaft 316 is received and secured, as previously described. The inner molded part 314 is engaged in the inner cavity of the wheel 28, and flanges 1206 are provided, as shown in Fig. 12 as well Fig. 29a and Fig. Figure 29b shows that the inner part 314 is provided around the outer edge of the cylindrical inner cavity 1300 of the adjusting wheel 28 to hold it in place within the cavity once it is inserted. The inner cavity 1300 of the adjusting wheel 28 is further provided with locking elements 1200 that interact with corresponding locking elements 1202 provided around the outer circumference of the inner cylindrical part 314. The respective locking elements 1200 and 1202 comprise corresponding raised stepped sections that fit side by side circumferentially around the inner surface of the cavity 1300 when the adjusting wheel 28 and the inner cylindrical part 314 are in the correct rotational alignment relative to each other. The respective locking elements 1200 and 1202 are provided in such a way that, during application, the inner cylindrical molded part 314 can slide from side to side within the inner cavity of the wheel 28, but cannot rotate in the wheel 28.Instead, the interacting locking elements 1202 and 1200 act such that the inner molded part 314 rotates with the rotary wheel 28 when the latter is rotated. In this way, any torque applied to the rotary wheel 28 by the user 28 is transferred to the inner molded part 314 and then to the drive shaft 316 to rotate the drive shaft, which carries the end effector 14. Fig. 29a and Fig. Figure 29b shows the inner molded part 314, which is inserted into the inner cavity of the adjusting wheel 28, and illustrates how the inner molded part 314 can slide axially within the inner cavity 1300 of the wheel 28.

[0118] Fig. 13a and Fig. Figure 13b further shows in more detail how the inner molded part 314 is able to move within the inner cavity 1300 of the wheel 28. As described above, the drive shaft 316 passes through the T-shaped opening 1208 in the inner molded part 314 and is secured therein by means of protruding snap-lock or detent elements 602 provided on the end of the drive shaft. The detent or lock elements 602 are in the form of spring metal tabs, which are also able to pass through the T-shaped opening 1208 in the inner molded part 314 and are then received in a second channel section 606 of the inner molded part, which forms a cavity that allows the spring tabs to spring apart, thereby securing the drive shaft within the inner molded part. The inner molded part 314 is then pressed into the inner cavity of the adjusting wheel 1208 and held in place by the detent projections 1206, as described above.The inner molded part can move axially within the inner cavity 1300 to come into contact with the inner surface of the distal wall of the wheel 28, as shown in . Fig. 13a shown, or, at its opposite end, to come into contact with the engagement elements 1206 at the distal edge of the wheel. Thus, the inner molded part 314 is provided with a degree of axial sliding movement within the cavity of the adjusting wheel 28, which is required as part of the mechanism to control the force exerted by the user on material contained within the clamping jaws, as described above.

[0119] The locking mechanism of the inner molded part 314 in the inner cavity of the adjusting wheel 28 greatly improves the assembly of the device, making it significantly easier and therefore cheaper. To position the adjusting wheel in the housing, as shown in Fig. As shown in Figure 33, the outer distal wall 1310 of the adjusting wheel 28 is concentric and thus aligned with an inner support wall 1320, which is provided as a projection by the housing of the device. This also allows for easy and precise assembly and positioning of the wheel 28 within the housing. 7. Rotation control of the drive shaft

[0120] As explained above, the shaft 12 with the end effector 14 mounted on it is rotatable, allowing the end effector 14 to be moved into desired rotational positions for cutting and coagulating tissue. However, to prevent excessive stress on the cable connections to the end effector 14 caused by excessive rotation of the shaft in one direction—which could lead to the wiring becoming coiled, twisted, or subjected to excessive strain—a mechanism for controlling the rotation of the shaft 12 is required, particularly to limit the degree of rotation and thus prevent excessive stress on the wiring. Furthermore, positive control of the shaft 12's rotation improves the ergonomic experience of the instrument during use and the user's perception of quality.

[0121] To provide rotational control of the shaft, one embodiment uses an arrangement which is Fig. 15a and Fig. 15b as well Fig. shown in 16a to 16d. Regarding Fig. In Figure 15, the adjusting wheel 28 with notched sections 36 on its proximal surface (i.e., the rear surface facing the user) is provided with a ring 1506 that projects slightly from the proximal surface, which is aligned concentrically with the axis of the wheel 28. When in use, the ring 1506 rests on guide stop elements 1502 and 1504, which are projections on the inner surface of the outer housing that extend to contact the outer circumference of the ring 1506. Due to their positioning on the housing relative to the axis of the ring, the stop element 1502 is smaller than the stop element 1504, but both stop elements 1502 and 1504 have angled upper guide surfaces 1510 and 1512, respectively (see Figure 1502). Fig. 15a), which are in contact with the outer circumferential surface of the ring 1506, which forms part of the adjusting wheel, and help to support and guide the adjusting wheel during its rotation.

[0122] In addition to providing a guiding function, the stop elements 1502 and 1504 also act as stop elements to prevent the rotation of the adjusting wheel beyond the angular position of the stop elements. For this purpose, the ring 1506 is provided with a rectangular stop projection 1500 extending radially from it. When the adjusting wheel 28 is rotated, the stop projection 1500 comes into contact with corresponding stop surfaces 1514 and 1516 of the stop elements 1502 and 1504. The stop surfaces are angled to be parallel to the rectangular stop projection 1500 when the stop position is at an angle to rest against it.

[0123] The stop elements 1502 and 1504, arranged as described above, are positioned and of such length that they provide a known rotation dimension of the wheel 28 from the stop element 1500 to the stop element 1502. In the presently described and in Fig. 15a and Fig. In the arrangement shown in Figure 15b, the stop elements 1502 and 1504 are positioned on the housing at a distance from each other to allow the adjusting wheel to rotate 270° from stop to stop. The degree of rotation can be easily varied by increasing or decreasing the distance between the stop elements, adjusting the length and angle of the guide and stop surfaces accordingly so that they essentially engage the wheel and the stop elements perpendicularly. For example, the stop elements can be positioned and shaped to provide an angular rotation of the wheel between 250° and 300°.

[0124] The above describes the rotation control that is applied to the adjusting wheel (and then, via the adjusting wheel, the shaft). Fig. Figures 16a to 16d show another rotation control mechanism applied to the shaft at the opposite end of the shaft using the shaft molding 320. Here, the shaft molding is provided with a rectangular stop element 1600 projecting from it. The inner surface of the outer housing is further provided with corresponding shaped stop elements 1602 and 1604, which are shown as a stepped part providing corresponding stop surfaces that offer parallel stop surfaces to the rectangular stop element 1600 at corresponding angular positions of the shaft molding 320. In the example shown, the shaped stop elements are positioned on the housing and provide corresponding stop surfaces to the stop element 1600 to allow a 270° rotation of the shaft 12, which moves the end effector from stop to stop.In further embodiments, the shaped stop parts 1602 and 1604 can be positioned to provide stop surfaces to the stop element 1600 in other rotation angle positions of the shaped part 320 in order to provide a larger or smaller degree of rotation, for example from 180° to 360°, or preferably from 250° to 300°, or most preferably 270°.

[0125] The corresponding rotation control mechanisms provided in the adjusting wheel 28 and in the shaft component 320 can be provided independently of one another; that is, they do not both need to be provided in a given embodiment, but only one or the other can be provided to provide rotation control of the shaft. However, it is advantageous with regard to the operation and perceived quality of the device if both rotation control mechanisms are provided in one device and oriented such that they stop the rotation at the same points in both directions of rotation. Such an arrangement means that the rotation of the shaft is stopped independently at both ends of the handle section 10, and it becomes very difficult for a user to force further unwanted rotation of the shaft beyond the permissible limits defined by the stops.

[0126] An alternative rotation control mechanism is in Fig. 36 and Fig. 37 shown. Fig. Figure 36 again shows the shaft-shaped part 320, but here the part is provided with a ring 3220 on which a primary rectangular stop element 3202 extending radially from it and secondary position marking elements 3204, 3206 and 3208 are mounted, which are arranged essentially, preferably in orthogonal positions, at equal angles around the ring. The secondary position marking elements 3204, 3206 and 3208 form small raised projections that are not large enough to come into contact with the stop surfaces 3212 and 3214.

[0127] The stop surfaces 3212 and 3214 are provided as integral parts with the outer housing and are positioned here to allow the shaft component 320 to rotate 180°. In this respect, the stop element 320 comes into contact with the stop surfaces 3212 and 3214 at the ends of the rotation range to prevent further rotation of the shaft component. Thus, as described in Fig. Figures 36a to 36c show the shaft form part 320, which carries the shaft 12, being rotated over 180° to allow rotational positioning of the end effector as desired.

[0128] Also provided is a resilient projection 3216, which includes a plastic projection with an essentially triangular cross-section extending upwards from the molded part-forming stop surface 3214, such that its tip contacts an outer circumferential surface of the ring 3220. The secondary position markers in the form of small, raised projections press against the tip of the resilient projection when the shaft molded part 320 rotates, causing the tip of the resilient projection to move from its rest position so that the corresponding projection can move past the tip.The effect of this process is to provide user feedback, as the user must exert more force to move the mechanism beyond the rotational positions where the raised protrusions contact the tip of the spring-loaded protrusion. Sufficient force must be applied to flex the tip of the spring-loaded protrusion, allowing the protrusion to move past it. As a result, the user perceives an increase in the force required to rotate the shaft beyond the rotational positions of the raised protrusions, thus providing an intuitive indication of the shaft's rotational position and, consequently, the end effector's position. This haptic feedback mechanism therefore allows for user-friendly and simple operation of the device.

[0129] Fig. Figure 37 shows the corresponding adjusting wheel 28 for the mechanism in Fig. 36. Here, the adjusting wheel is also provided with small stops 3222, which are arranged orthogonally around the adjusting wheel at 90° intervals. A similar mechanism can be provided for the spring-loaded projection 3216, which extends from the housing to provide similar haptic feedback as in the case of the shaft-shaped part 320. In such an arrangement, haptic feedback on the rotational position of the shaft is provided from both ends of the handle, thus improving the user's perception of the device. 8. Cabling

[0130] At this point, further features and aspects relating to the wiring within the handle 2 will be described. As described above, the switching knob 26 is provided to activate and deactivate the RF signal for operating the electrodes in the end effector assembly 14 via a suitable circuit, for example, via two tamper-proof switches on a small circuit board (PCB) 338. As in Fig. As shown in Figure 17, the PCB 338 is connected to a connecting line 1700 for receiving the RF output from a generator (not shown) and electrical wiring 1702, 1704 for providing the RF current to the electrodes in the clamping jaws 14, for example a cable for the active electrode and one for the counter electrode.

[0131] In the arrangement, the wiring 1702, 1704 is led from the electrodes down the outer shaft 12, along the drive shaft 316 and up to the shaft molding part 320, as described by Fig. 17 shown. As in Fig. As shown in Figure 9b, the shaft component 320 is a cylindrical or barrel-shaped component with an opening 912 at its distal end to receive the outer shaft 12. The outer shaft 12 is attached to the shaft component 320, for example, by detent projections 900 that engage with corresponding grooves 902 in the shaft component 320. Consequently, when the shaft component 320 rotates, the outer shaft 12 rotates with it. The shaft component 320 further comprises another opening 914 at its proximal end, the opening 914 being T-shaped to receive the drive shaft 316, the drive shaft 316 extending through the inner cavity 1802 of the shaft component 320 and down the length of the outer shaft 12. Thus, the drive shaft 316 is able to slide within the shaft molding part 320 and the outer shaft 12, but any rotational movement of the drive shaft 316 is transferred to the shaft molding part 320 and subsequently to the outer shaft 12.

[0132] As in Fig. As shown in Figure 18a, the electrode cables 1702, 1704 are led from the inner cavity 1802 through an opening 1800 in the wall of the shaft-shaped part 320 before being wound over and around the body 1804 of the shaft-shaped part 320. This winding of the cables 1702, 1704 around the shaft-shaped part 320 holds the cables 1702, 1704 in a compact arrangement to prevent them from interfering with the assembly of the rest of the instrument 1. Furthermore, winding the cables 1702, 1704 around the shaft-shaped part 320 means that when the shaft-shaped part 320 rotates with the drive shaft 316, the cables 1702, 1704 unwind and rewind with the rotation without being overstretched and thus short-circuited. In particular, winding the cables 1702, 1704 in this special way allows up to 270° of rotation, as described in relation to Fig. 15ab and Fig. described in sections 16a-d.

[0133] The electrical wiring 1702, 1704 is then routed along the top of the housing 20. For this purpose, one of the molded shells 300 is provided with two compartments 1900, 1902, arranged side by side to accommodate the cable contacts 1904, 1906, which connect the active and return cables 1702, 1704 to the wiring 1908, 1910 of the intrusion-resistant switches 338. All electrical cables 1702, 1704, 1908, 1910 are routed into and around the compartments 1900, 1902, so that only one contact 1904, 1906 is accommodated in each compartment 1900, 1902. The routing of the cables can be facilitated by guide sections 1912, 1014, 1916, which guide a set of cables 1702, 1910 around the outside of compartments 1900, 1902. In each compartment, the respective active cable 1702 is aligned longitudinally with cable 1908, and the return cable 1704 is aligned longitudinally with cable 1910.

[0134] Consequently, the two cable contacts 1904, 1906 are separated longitudinally, so that only one contact can pass through each compartment 1900, 1902, thus providing a physical barrier between each contact 1904, 1906 and the wiring. This eliminates the risk of damage to the insulation of one of the cables by the contacts 1904, 1906 themselves.

[0135] The cables 1702, 1704, 1908, 1708 are all inserted into their respective compartments 1900, 1902 through small openings 1918, 1920, 1922, 1924 in the walls of the compartments. Preferably, the dimensions of the openings 1918, 1920, 1922, 1924 are such that only one electrical cable can pass through. The opposing shell-shaped part 302 also includes corresponding rib elements (not shown) to hold the contacts 1904, 1906 in the compartments 1900, 1902, thus forming a substantially sealed housing. This is important to minimize the permeability of the compartments 1900, 1920, in order to protect the contacts 1904, 1906 from any fluid that could penetrate along the outer shaft 12 and into the housing 20, which would cause a short circuit of the contacts 1904, 1906. 9. End effector arrangements

[0136] Exemplary end effector arrangements that can be used with the device are now described. The examples to be described are mentioned only for the sake of completeness, and it is clear that other end effector designs can be used with the instrument, provided they are capable of being driven by the drive shaft 316. That is to say, embodiments of the invention are not limited to the specific end effectors described here, but other end effector designs can also be used.

[0137] Fig. Figures 38 to 44 show exemplary instruments in which electrically conductive stop elements are arranged on one or both of the sealing electrodes. With regard to Fig. 38 comprises an end effector, generally designated 3801, an upper clamping jaw 3802 pivotably connected to a lower clamping jaw 3803 about a pivot point 3804. Flanges 3805 are present at the proximal end of the upper clamping jaw 3802, while flanges 3806 are present at the proximal end of the lower clamping jaw 3803. The flanges 3805 and 3806 each have slots 3807 through which a drive pin 8 extends, such that a proximal and distal movement of the drive pin 3808 (by means of a drive mechanism (not shown)) causes the clamping jaws 3802, 3803 to pivot between an open and a closed position.

[0138] A metallic clamping element 3809 is present on the inner surface of the upper clamping jaw 3802, while a metallic clamping element 3810 is present on the inner surface of the lower clamping jaw 3803. When the clamping jaws 3802 and 3803 pivot into their closed position, the metallic clamping elements 3809 and 3810 come into close contact to grip fabric (not shown) between them.

[0139] The upper clamping piece 3809 has a generally planar surface, with the exception of an elongated recess (in Fig. 38 (not shown), which runs along its length. The lower clamping piece 3810 has a corresponding recess 3811, wherein the recesses in the clamping pieces 3809, 3810 accommodate the longitudinal movement of a cutting blade (not shown). The lower clamping piece 3810 is further provided with a plurality of metallic stop elements 3812, which are arranged along the length of the clamping piece and on both sides of the recess 3811. The stop elements 3812 are now to be described with reference to Fig. 39 and Fig. 40 will be described in more detail.

[0140] Each metallic stop element 3812 consists of the upper projection of a stop element 3813, which is received in an insulating element 3814, so that it encloses the stop element, isolating it from the rest of the clamping piece 3810. Each insulating element 3814 and stop element 3813 is arranged in a corresponding opening 3851 provided in the clamping piece 3810, such that the upper section of the insulating element forms an insulating ring 3816 around each stop element 3812.

[0141] When the clamping jaws 3802, 3803 are moved into their closed position (as in Fig. (as shown in Figure 40), the stop elements 3812 contact the upper clamping piece 3809, maintaining a distance between the upper and lower clamping pieces of between 20 µm and approximately 350 µm (0.00079 in to approximately 0.014 in). During application, an electrosurgical coagulation voltage is applied between the clamping pieces 3809 and 3810, and the distance between the clamping pieces ensures effective sealing of tissue captured between the clamping jaws 3802 and 3803. At the same time, an electrical short circuit between the clamping pieces is prevented because the stop elements 3812 are electrically insulated, so that they do not carry the same electrical potential as the rest of the clamping piece 3810.The metallic stop elements 3812 are rigid, which allows a consistent separation of the surfaces of the clamping pieces, while it is feasible to monitor the electrical potential of the stop elements 3813 to detect when they touch the upper clamping piece 3809 to indicate the closing of the clamping jaws.

[0142] Fig. Figures 41 to 43 show an alternative arrangement in which the metallic stop elements 3812 are mounted directly on the lower clamping piece 3810, without the insulating elements surrounding the stop elements. In this arrangement, insulating elements 3817 are provided on the upper clamping piece 3809, corresponding to each of the stop elements. In this way, the insulating elements 3817 ensure that when the clamping jaws 3802, 3803 are closed, there is no electrical short circuit between the upper clamping piece 3809 and the lower clamping piece 3810. The metallic stop elements 3812 ensure that the appropriate separation of the clamping jaws is maintained during the application of electrosurgical energy to seal tissue captured between the clamping jaws.

[0143] Fig. Figure 44 shows a further alternative in which the metallic stop elements 3812 are again mounted directly on the lower clamping piece 3810. In this arrangement, a metallic counterholder 3818 is positioned opposite each stop element, with each metallic counterholder 3818 being surrounded by an insulating element 3819 to insulate it from the rest of the upper clamping piece 3809. When the clamping jaws are closed, metal-to-metal contact occurs between the stop elements 3812 and the metallic counterholders 3818, with the insulation of the counterholders ensuring that an electrical short circuit between the clamping pieces 3809 and 3810 is again prevented. Here too, the electrical potential of each of the metallic counterholders can be monitored to detect when it assumes the potential of the lower clamping piece, indicating that the clamping jaws are closed. 10. Electrosurgical System

[0144] With reference to Fig. 45 It is provided that, when used, the instrument 1 is connected to an electrosurgical generator 4500, which includes a controllable radio frequency (RF) source (not shown) that, when applied via the electrodes of the end effector of the instrument 1, generates an RF coagulation signal that coagulates or seals tissue. The electrosurgical generator 4500 includes control input switches 4504 and 4502 to allow the generator to be switched on and off, respectively, and to allow control of the power of the RF coagulation signal supplied to the instrument 1. In this respect, the electrosurgical generator 4500 is a conventional one.

[0145] During use, Instrument 1 is connected to Generator 4500 by a control and power supply line 4506, which contains separate electrical leads to allow the supply of an RF signal to the end effector of Instrument 1 via the internal wiring described above, and furthermore to allow the reception of a control signal from Switch 26 of Instrument 1 to cause the electrosurgical generator to output an RF coagulation signal to Instrument 1. During use, the surgeon activates the generator via an on / off switch 4504 and selects the coagulation or sealing signal strength to be generated by the internal RF source using knobs 4502.During a surgical procedure with the instrument, when a sealing or coagulation RF signal is required at the end effector, the surgeon activates the generator to produce such a signal by pressing switch 26 on the instrument. The generated RF signal is then transmitted to the end effector via electrical leads 4506. In other words, pressing switch 26 during use delivers an RF coagulation or sealing signal to the appropriate electrodes located in the end effector. 11. Summary

[0146] In light of the above, embodiments of the invention provide an advanced electrosurgical forceps instrument that allows for simple and ergonomic one-handed operation by the user, offers rotational flexibility of the end effector, controls the force applied by the end effector to the grasped tissue to prevent excessive force, and allows for convenient mechanical cutting of the grasped tissue while simultaneously providing electrosurgical coagulation or sealing of the tissue. Furthermore, the instrument was designed for easy and cost-effective assembly, while also being compact thanks to the efficient use of available space in the internal activation mechanism.

[0147] Various further modifications of the embodiments described above, whether by adding, eliminating or replacing, will be apparent to those skilled in the art in order to provide additional embodiments, each and in their entirety within the scope of protection of the attached claims.

Claims

[1] Surgical instrument (1) comprising: a handle (10) having a longitudinal axis generally defining a front and a rear direction, such that the handle (10) has a front end and a rear end, the handle (10) also having an upper and a lower direction, an elongated shaft (12) extending from the front end of the handle (10) and extending along the longitudinal axis, an end effector (14) positioned at the rear end of the elongated shaft (12), a hand switch (26) in the form of a push button, the actuation of which causes the state of the end effector (14) to change, and a rotatable adjusting wheel (28) arranged on the handle (10), wherein a rotation of the adjusting wheel (28) causes a corresponding rotation of the elongated shaft (12), and a trigger (24) for actuating a mechanical cutting mechanism, characterized bythat the hand switch (26) is arranged on the handle (10) in a position directly above the adjusting wheel (28) and spaced apart from the adjusting wheel (28) in a direction orthogonal to the longitudinal axis, and the trigger (24) is arranged on the handle (10) at a position in front of the hand switch (26) and the rotatable adjusting wheel (28) along the longitudinal axis in the front direction, wherein the hand switch (26) lies directly on a vertical axis which is orthogonal to the longitudinal axis and passes through the adjusting wheel (28), wherein the adjusting wheel (28) is arranged along the longitudinal axis between a front edge and a rear edge of the hand switch (26), wherein the adjusting wheel (28) is aligned on the vertical axis below the hand switch (26) such that the center of the adjusting wheel (28) lies below the center of the hand switch (26). [2] A surgical instrument according to claim 1, wherein the handle (10) has a front portion extending generally along the longitudinal axis and a rear portion extending at an angle to the longitudinal axis, and wherein the adjusting wheel (28) is arranged towards the rear end of the front portion. [3] A surgical instrument according to claim 1 or 2, wherein the outer surface of the adjusting wheel (28) is provided with a notched surface having a plurality of notches (336) adapted to receive the fingers and thumbs of a user operating the adjusting wheel (28). [4] A surgical instrument according to any one of the preceding claims, wherein the end effector (14) comprises one or more electrodes, and the surgical instrument (1) comprises electrical connections capable of connecting the surgical instrument (1) to an electrosurgical generator (4500). [5] The surgical instrument of claim 4, wherein actuation of the handset (26) causes the electrosurgical generator (4500) to provide electrosurgical energy to the one or more electrodes. [6] A surgical instrument according to any one of the preceding claims, comprising an actuating mechanism (22) movable between a first position and a second position, wherein moving the actuating mechanism (22) from its first position to its second position causes the end effector (14) to move from a first state to a second state. [7] A surgical instrument according to claim 6, wherein the end effector (14) comprises a pair of first and opposite second jaws, wherein moving the actuating mechanism (22) from its first position to its second position causes at least one of the jaws to move relative to the other from a first open position in which the jaws are arranged in a spaced-apart relationship relative to each other to a second closed position in which the jaws cooperate to engage intervening tissue. [8] A surgical instrument according to claim 6 or 7, wherein the actuating mechanism (22) comprises a first and a second handle, at least one of the handles being movable relative to the other handle between an open position in which the handles are spaced apart from each other and a closed position in which the handles are brought closer together. [9] Surgical instrument according to one of claims 6 to 8, wherein the actuating mechanism (22) is arranged directly below the adjusting wheel (28). [10] Surgical instrument according to one of the preceding claims, wherein the handset (26) is dimensioned to extend laterally across the upper surface of the surgical instrument (1) over more than 50% of the width of the surgical instrument (1). [11] Surgical instrument according to claim 10, wherein the handset (26) is dimensioned to extend laterally across the upper surface of the surgical instrument (1) over more than 80% of the width of the surgical instrument (1). [12] Surgical instrument according to claim 10 or 11, wherein the hand switch (26) is dimensioned such that it extends laterally over the upper surface of the surgical instrument (1) over more than 90% of the width of the surgical instrument (1). [13] A surgical instrument according to any one of the preceding claims, wherein the handset (26) has a textured upper surface adapted to allow a user's thumb to activate the handset (26) without slipping. [14] A surgical instrument according to any one of the preceding claims, wherein the cutting mechanism comprises a blade assembly, the trigger (24) being movable between a first position and a second position, wherein movement of the trigger (24) from its first position to its second position causes longitudinal movement of the blade assembly to cause advancement of a blade (340) longitudinally relative to the end effector (14). [15] An electrosurgical system comprising an electrosurgical generator (4500) and a surgical instrument (1) according to any one of claims 1 to 14. [16] An electrosurgical system according to claim 15, wherein actuation of the handset (26) causes the electrosurgical generator (4500) to provide electrosurgical energy to the end effector (14).

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