Multifunctional device and method for minimally invasive surgery

Abstract

The multifunction device for MIS includes a handle (200), a shaft (700), a multifunction head assembly (300), and an articulation joint (800). The head assembly (300) includes a suturing unit (1100) / (1400), and upper and lower gripper units (400) that are located in the plane above and below the suturing unit. Each gripper unit (400n) is configured to rotate about an axis (414) in the plane of the gripper unit (400) to grip tissue or suture, and to rotate about an axis (412) perpendicular to the plane of the gripper unit (400) to tension the gripped suture to tighten the knot. The configuration of the head assembly (300) allows the loose end of the suture, when gripped by the gripper unit (400), to be located within the circular zone of the needle, allowing the needle portion of the suture to be looped around the loose end.

Description

[Technical field]

[0001] The present disclosure relates to the field of surgical instruments. In particular, the present disclosure relates to devices for minimally invasive surgery that include the functions of grasping, suturing, ligating, knot tightening, cutting, and cauterizing during surgery. [Background technology]

[0002] The Background Discussion includes information that may be useful in understanding the present invention. This section is not an admission that any of the information provided herein is prior art or relevant to the present claimed invention, or that any publication referenced, expressly or impliedly, is prior art.

[0003] In the last two decades of the twentieth century, one of the most significant advances in surgical technology was represented by the introduction of minimally invasive surgery (MIS).

[0004] Minimally invasive surgery, commonly known as laparoscopic or endoscopic surgery, is performed by making 4-5 small incisions of 5-12 mm in size in the patient's abdomen to insert various devices / instruments and access the surgical site. The entire surgical procedure is performed by manipulating tool handles from outside the patient's body without direct contact with the diseased tissue or direct visualization of the surgical site. The surgical field is visualized by a laparoscope (a small camera) inserted into the abdominal cavity through one of the incisions in the abdominal wall. The laparoscopic view of the surgical site is captured by a small camera in the laparoscope and displayed to the surgeon on a 2D video monitor.

[0005] With the gradual replacement of traditional open approaches with MIS techniques, patient benefits such as less tissue trauma, less scarring, minimal blood loss, less pain, faster recovery time, and earlier hospital discharge remain consistent findings. Minimally invasive surgery (MIS) has become commonplace in an ever-increasing number of surgical procedures and can replace almost all open surgery.

[0006] Laparoscopic surgery is an amazing technology that solves all of the patient's concerns, but it places increased demands on surgeons who do not have the necessary equipment. Despite advances in surgical technology and the availability of new surgical tools, the complexity of laparoscopic suturing and ligation continues to be a barrier to widespread adoption of MIS procedures, depriving patients of the benefits that laparoscopic surgery can provide.

[0007] During MIS, the surgeon faces the technical challenge of performing all procedures with long and rigid instruments. Depending on each application, the surgeon must use specific instruments and keep changing instruments throughout the surgical procedure. For grasping, a laparoscopic grasper is used, for cutting tissue, laparoscopic scissors are used, and for cauterizing tissue, the surgeon must insert a cautery and operate the cautery with a foot paddle. For intracorporeal suturing, the surgeon must first insert a needle into the abdominal cavity and then complete the suturing using a laparoscopic grasper and needle holder. This causes the surgeon's limbs to be occupied with all the different instruments.

[0008] Most of the operation time is spent changing various instruments, and the surgeon's concentration is affected by the need to constantly change instruments. This increase in operation time requires an increased amount of anesthesia for the patient, making them more susceptible to complications due to prolonged anesthesia.

[0009] Also, because the tissue is not in direct contact with the surgeon's hands and it is a 2D vision, the surgeon cannot perceive the depth and thickness of the tissue. Without the necessary experience, large forces can cause the tissue to break.

[0010] Laparoscopic intracorporeal suturing refers to the approximation of tissues within the body using suture material. A laparoscopic needle holder and grasper and a needle with a suture are used to tie a series of knots within the body. This technique requires the manipulation of the needle and passing it from one needle holder to the next to tie the series of knots.

[0011] Laparoscopic intracorporeal suturing is the preferred method because it is flexible, flexible, economical, and uses commercially available instruments. Laparoscopic suturing is the most basic, but also the most difficult to perform and learn. This is considered a major barrier to widespread use of laparoscopic surgery. Laparoscopic suturing is performed using a suture needle, a laparoscopic needle holder, and a grasping device.

[0012] Intracellular suturing is considered to begin with grasping the tissue with a grasping device, followed by a repetition of grasping the suture needle by the needle holder, driving the needle across the anastomotic end of the tissue, readjusting the needle holder, grasping the other end of the tissue and driving the needle across the other anastomotic end, tying three knots, pulling both ends of the suture thread to tighten the knots, and finishing by cutting the thread.

[0013] Ideally, the needle should be oriented so that the directions of (1) the needle tip and (2) the needle driving force are the same, with the optimal orientation for both being 90° square to the tissue resistance. The tissue should be gripped before suturing to tension the tissue so that the needle can be inserted easily without significant resistance. If the tissue is not gripped and the needle is inserted, the tissue may tear and the needle path may be altered.

[0014] Intracellular suturing requires repetitive bimanual coordinated movements in a limited degree of freedom environment for each step of suturing. During suturing, the surgeon must constantly reorient the needle to find the proper position. Continuous gripping and releasing motions are required to accurately align the needle. Due to the construction of standard needle holders, the orientation of the needle during intracellular suturing is not fully controllable and multiple gripping and releasing motions are required to position the needle before the execution of each stitch. This requires training and can result in extended operative time. Without the necessary experience and practice, these constraints increase the surgeon's efforts leading to physical fatigue, resulting in increased levels of errors and poor suturing quality, while mental stress results in increased operative time and anesthesia usage. These factors make laparoscopic surgery ergonomically demanding.

[0015] Currently, there is no device on the market that can assist the surgeon with all of the above functions using a single instrument.

[0016] One promising solution is single incision laparoscopic surgery (SILS), a type of minimally invasive surgery in which one incision is made and multiple instruments are inserted through this single incision. It was developed primarily to reduce the number of abdominal incisions and speed up recovery. Despite this development, SILS is not commonly performed due to the increased complexity of the surgery, which is caused by the surgeon having to insert all instruments through a single inlet and repeatedly replace them for the desired function. In view of the above, conventional devices are outdated and inefficient, as the tip of the instrument moves in the opposite direction to the surgeon's hand, making it a very laborious operation, as the surgeon must position and orient the needle under conditions of poor needle control and limited degrees of freedom. This drawback makes the process very tedious and exhausting, requiring a steep learning curve.

[0017] Thus, there is a need for an improved laparoscopic surgical device that overcomes the shortcomings of conventional laparoscopic surgical devices and that can facilitate, among other things, grasping, cutting, cauterizing, suturing, and ligating during laparoscopic surgery.

[0018] All publications herein are incorporated by reference to the same extent as if each individual publication or patent application was specifically and individually indicated to be incorporated by reference. If a definition or usage of a term in an incorporated reference contradicts or is contrary to the definition of that term set forth herein, the definition of the term set forth herein shall apply and the definition of the term in the reference shall not apply.

[0019] As used throughout this description and the claims that follow, the meanings of "a," "an," and "the" include plural references unless the context clearly indicates otherwise. Also, as used throughout this description, the meaning of "in" includes "in" and "on," unless the context clearly indicates otherwise.

[0020] The recitation of ranges of values ​​herein is merely intended to serve as a shorthand way of referring individually to each individual value within the range. Unless otherwise indicated herein, each individual value is incorporated herein as if it were individually set forth herein. All methods described herein may be performed in any suitable order unless otherwise indicated herein or otherwise clearly contradicted by context. Any examples or exemplary language (e.g., "such as") provided for specific embodiments herein are intended merely to clarify the invention and do not impose limitations on the scope of the claimed invention. No language in the specification should be construed as indicating any non-claimed element essential to the practice of the invention.

[0021] Groups of alternative elements or embodiments of the invention disclosed herein are not to be construed as limitations. Each group element may be referenced and claimed individually or in any combination with other elements of the group or other elements present herein. One or more elements of a group may be included in or deleted from a group for reasons of convenience and / or patentability. When such inclusion or deletion occurs, the specification is deemed to satisfy the description of all Markush groups used in the appended claims, including the group as modified. Summary of the Invention [Problem to be solved by the invention]

[0022] A general object of the present disclosure is to overcome the shortcomings of conventional surgical devices.

[0023] It is an object of the present disclosure to provide a single device for laparoscopic surgery that facilitates, among other things, grasping, cutting, cauterizing, suturing, ligating and tying knots during laparoscopic surgery.

[0024] Another object of the present disclosure is to provide a laparoscopic surgical device that allows most laparoscopic functions to be performed with a single instrument, thereby eliminating the need to switch instruments for each function.

[0025] Another object of the present disclosure is to provide a laparoscopic surgical device that includes feedback-based tissue grasping that allows for control of grasping force.

[0026] Another object of the present disclosure is to provide a laparoscopic surgical device that includes a mechanism for detecting the presence of blood vessels in grasped tissue to prevent inadvertent damage to the blood vessels.

[0027] Another object of the present disclosure is to provide a laparoscopic surgical device that encompasses six degrees of freedom in space with respect to movement of the head assembly.

[0028] Another object of the present disclosure is to provide a laparoscopic surgical device that automates the entire process of intracorporeal suturing, ligation, and knot tightening into a single process.

[0029] Another object of the present disclosure is to provide a laparoscopic surgical device that avoids multiple needle grasp and release movements during the intracorporeal suturing process.

[0030] Another object of the present disclosure is to provide a laparoscopic surgical device that can be easily integrated into a surgical robotic system.

[0031] Another object of the present disclosure is to provide a laparoscopic device capable of assisting a surgeon in single-site laparoscopic surgery.

[0032] Other objects and advantages of the present invention will become apparent from the following description when read in conjunction with the accompanying drawings, which are incorporated by way of illustration of preferred embodiments of the invention and are not intended to limit the scope of the invention. [Means for solving the problem]

[0033] Aspects of the present disclosure relate to surgical instruments, and in particular to minimally invasive surgical devices (hereinafter also referred to as laparoscopic surgical devices) incorporating grasping, suturing, ligating, knot tightening, tissue cutting, and cauterizing functions / mechanisms.

[0034] In an embodiment, the proposed device for minimally invasive surgery includes a handle, a shaft coupled to a distal end of the handle, and a multi-function head assembly configured at the distal end of the shaft via an articulation joint such that the articulation joint allows the head assembly to rotate in two degrees of freedom relative to the shaft. The head assembly includes a suturing unit and a pair of gripper units including an upper gripper unit located in a plane above the suturing unit and a lower gripper unit located in a plane below the suturing unit. Each of the upper and lower gripper units includes a pair of grippers configured to rotate in the plane of the corresponding gripper unit to grip tissue or suture and to rotate perpendicular to the plane of the gripper unit to tension the gripped suture and tighten the knot.

[0035] At least one of the grippers of the upper and lower gripper units may include a cutting blade configured to slide within the gripper, and in an operative position, a cutting edge of the cutting blade protrudes through a slit in the gripping surface of the gripper for use of the gripper unit as scissors.

[0036] The shaft may include an outer tubular casing and an inner tube coupled to the head assembly via an articulation joint. The inner tube may be coupled to a rotation knob located at a distal end of the handle such that rotation of the rotation knob by a user rotates the head assembly about the longitudinal axis of the shaft.

[0037] The articulation joint may be coupled to a manipulator mounted on the handle via a pair of manipulator ropes. The manipulator may be located on the handle such that a joystick of the manipulator is operable by a user's thumb. Side-to-side and up-down movement of the joystick causes the articulation joint to rotate the head assembly about two mutually perpendicular axes that are perpendicular to the longitudinal axis of the shaft, thereby providing the head assembly with three rotational degrees of freedom.

[0038] The manipulator includes upper and lower gimbals disposed one on top of the other and coupled to a joystick for rotation about two mutually perpendicular axes, each gimbal may be coupled to a pulley for pulling a respective manipulator rope coupling the manipulator to an articulation joint.

[0039] The manipulator may include a lock button along with the joystick configured to press a set of stops against the gimbals, urging the gimbals towards each other to lock the manipulator in any position. Pressing the lock button again disengages the stops from the gimbals, allowing movement of the gimbals to operate the articulation joints.

[0040] Each of the grippers may include a front body and a rear body. The front body may be pivotally coupled to the rear body for rotation about an axis parallel to the plane of the corresponding gripper unit. The rear body may be coupled to a pinion, rotation of the pinion causing rotation of the gripper about an axis perpendicular to the plane of the corresponding gripper unit.

[0041] Each of the grasper units may include a rack that engages with a pinion of a corresponding grasper, such that pulling the rack proximally moves the two graspers toward each other to grasp tissue or suture. The rack of each grasper unit may be coupled to a corresponding pulley in the handle by a grasper rope, such that rotation of the pulley pulls the grasper rope to move the grasper to grasp tissue or suture. Movement of the rack may be controlled based on feedback such that the force of closing the graspers is controlled.

[0042] The pulleys may be coupled to corresponding bevel gears and gripper actuation knobs having a cam mechanism such that a first depression of the gripper actuation knob causes the corresponding bevel gears to move inwardly into engagement with an input bevel gear coupled to the motor, and a second depression of the gripper actuation knob causes the bevel gears to move outwardly out of engagement with the input bevel gear.

[0043] The gripper actuation knob may include a built-in locking mechanism for locking the corresponding gripper unit in an actuated position by locking the corresponding pulley, and the locking mechanism is configured such that pulling the gripper actuation knob outward unlocks the pulley and causes the gripper unit to return the gripper to the open position by a biasing force.

[0044] In another embodiment of a multi-function device for minimally invasive surgery, the device includes a handle, a shaft coupled to a distal end of the handle, and a head assembly configured at the distal end of the shaft. The head assembly includes at least one grasper unit having a pair of graspers for grasping at least tissue. Each of the graspers of the at least one grasper unit includes a cutting blade configured to slide within the grasper, and in an activated position, a cutting edge of the cutting blade protrudes from a slit in a grasping surface of the grasper for use of the grasper unit as scissors. The blade can be configured to have either a direct current or an alternating current flow therethrough for the blade to function as a cautery.

[0045] In another embodiment of a multi-function device for minimally invasive surgery, the device includes a handle, a shaft coupled to a distal end of the handle, and a head assembly configured on the distal end of the shaft. The head assembly includes at least one grasper unit having a pair of graspers for grasping at least tissue. The grasper unit includes a set of infrared and pressure sensors configured on the graspers to provide feedback regarding the thickness of the tissue being grasped and the pressure applied to the tissue during grasping to control actuation of the grasper unit to prevent damage to the grasped tissue.

[0046] In another embodiment of a multi-function device for minimally invasive surgery, the device includes a handle, a shaft coupled to a distal end of the handle, and a head assembly configured on the distal end of the shaft. The head assembly includes at least one gripper unit having a pair of grippers for gripping at least tissue. The at least one gripper unit includes a set of infrared sensors configured on the grippers, and the device includes a controller to detect the presence of a blood vessel in the gripped tissue based on pulsations in a signal from the infrared sensors, the signal indicating the presence of a blood vessel in the gripped tissue. The controller is further configured to issue an alert to a user of the device if a blood vessel is detected.

[0047] An embodiment of the present disclosure provides a method for suturing, ligating tissue and tightening knots during minimally invasive surgery, the method including providing a device for minimally invasive surgery having a suturing unit, an upper gripper unit located in a plane above the suturing unit, and a lower gripper unit located in a plane below the suturing unit, each of the upper and lower gripper units configured to rotate in the plane of the corresponding gripper unit and perpendicular to the plane of the gripper unit and move away from the suturing unit. The method further includes the steps of grasping tissue with the upper and lower gripper units by moving corresponding grippers in the plane of the respective gripper units; piercing the grasped tissue with the needle of the suturing unit so that a suture secured to the suture needle penetrates and crosses the tissue; releasing the grasped tissue; grasping a free end of the suture with one of the upper or lower gripper units so that the free end is located within a circular zone defined by the movement of the needle; moving the needle at least 360 degrees and wrapping the suture around the free end of the suture to create a loop and repeating depending on the type of knot; grasping the needle portion of the suture with the other of the upper and lower gripper units; and moving the grippers of the upper and lower gripper units perpendicular to the plane of the respective gripper units to tighten the knot.

[0048] In yet another embodiment, the present disclosure provides a suturing unit for minimally invasive surgery having a housing with a pair of larger than semicircular circular tracks with upper and lower tracks, a needle track, a suture needle disposed in the needle track for movement along the needle track, and a puck engaging with either the upper track or the lower track at a given time. When engaged with the lower track, the puck is pressed against the suture needle such that movement of the puck results in movement of the suture needle, and when engaged with the upper track, the puck lifts off the suture needle and moves without causing movement of the suture needle. The suturing unit further includes a drive mechanism for moving the puck along the upper and lower tracks. The upper and lower tracks are connected to each other at both ends such that when the puck moves to the end of the lower track, it moves upward to engage with the upper track, and when the puck moves in the reverse direction to the end of the upper track, it moves downward to engage with the lower track.

[0049] The drive mechanism of the suturing unit may be a Scotch yoke mechanism, and the upper track, lower track, and needle track may be configured on either the inner or outer periphery of the housing.

[0050] In another embodiment of a suturing unit for minimally invasive surgery, the suturing unit includes a housing having a needle track configured around an outer periphery of the housing, a suturing needle disposed within the needle track for movement along the needle track, and a belt configured around an outer periphery of the housing and pressed against the suturing needle for moving the needle along the needle track as the belt moves. A plurality of pulleys are positioned to move the belt around the outer periphery of the housing. One of the plurality of pulleys is coupled to a motor by a flexible rotatable shaft to drive the belt.

[0051] Various objects, features, aspects and advantages of the present subject matter will become apparent from the following detailed description of preferred embodiments, taken in conjunction with the accompanying drawings in which like numerals represent like elements.

[0052] The accompanying drawings are included to provide a further understanding of the present disclosure, and are incorporated in and form a part of this specification. The drawings illustrate exemplary embodiments of the present disclosure, and together with the description, serve to explain the principles of the present disclosure. [Brief description of the drawings]

[0053] [Figure 1A] 1A-1D show exemplary left side, right side, and top views, respectively, of a disclosed device for minimally invasive surgery, according to an embodiment of the present disclosure. [Figure 1B] 1A-1D show exemplary left side, right side, and top views, respectively, of a disclosed device for minimally invasive surgery, according to an embodiment of the present disclosure. [Figure 1C] 1A-1D show exemplary left side, right side, and top views, respectively, of a disclosed device for minimally invasive surgery, according to an embodiment of the present disclosure. [Diagram 2] 1 illustrates an exemplary perspective view of a handle of a device according to an embodiment of the present disclosure, showing various components therein. [Diagram 3] 1 illustrates an exemplary exploded view of a head assembly of a device, according to an embodiment of the present disclosure. [Figure 4A] 1 illustrates an exemplary exploded view of a gripper unit of a head assembly of a device, according to an embodiment of the present disclosure. [Figure 4B] 1 illustrates an exemplary top view of a grasper unit of a head assembly of a device, illustrating grasping of tissue by a pair of graspers, according to an embodiment of the present disclosure. [Figure 5A] 1 illustrates an exemplary diagram of a gripper of a gripper unit, showing features that enable the scissor function of the gripper unit, according to an embodiment of the present disclosure. [Figure 5B] 1 illustrates an exemplary diagram of a gripper of a gripper unit, showing features that enable the scissor function of the gripper unit, according to an embodiment of the present disclosure. [Figure 5C] 1 illustrates an exemplary diagram of a gripper of a gripper unit, showing features that enable the scissor function of the gripper unit, according to an embodiment of the present disclosure. [Figure 6] FIG. 1 illustrates an exemplary block diagram of a device showing various elements enabling various functions of the head assembly according to an embodiment of the present disclosure. [Figure 7A] 1 shows an exemplary view of a shaft of a device according to an embodiment of the present disclosure. [Figure 7B] 1 shows an exemplary view of a shaft of a device according to an embodiment of the present disclosure. [Figure 8A] 1A and 1B illustrate exemplary top and perspective views, respectively, of an articulation joint that couples a head assembly to a shaft in accordance with an embodiment of the present disclosure. [Figure 8B] 1A and 1B illustrate exemplary top and perspective views, respectively, of an articulation joint that couples a head assembly to a shaft in accordance with an embodiment of the present disclosure. [Figure 9] 1 illustrates an exemplary exploded view of a manipulator of a device, according to an embodiment of the present disclosure. [Figure 10] 13A-13D show exemplary perspective views of arrangements for coupling motors to the drive mechanisms and knot tightening actuation knobs of the various gripper units of the device, according to embodiments of the present disclosure. [Figure 11A] 13 illustrates details of a suturing unit of a device according to an embodiment of the present disclosure. [Figure 11B] 13 illustrates details of a suturing unit of a device according to an embodiment of the present disclosure. [Figure 11C] 13 illustrates details of a suturing unit of a device according to an embodiment of the present disclosure. [Figure 12] 1 illustrates an exemplary diagram of a suturing needle for use with a suturing unit, according to an embodiment of the present disclosure; [Figure 13A] 13 illustrates the function of a suturing unit according to an embodiment of the present disclosure. [Figure 13B] 13 illustrates the function of a suturing unit according to an embodiment of the present disclosure. [Figure 13C] 13 illustrates the function of a suturing unit according to an embodiment of the present disclosure. [Figure 13D] 13 illustrates the function of a suturing unit according to an embodiment of the present disclosure. [Figure 14A]13A-13C show exemplary exploded views of alternative embodiments of the suturing unit; [Figure 14B] 13A-13C show exemplary exploded views of alternative embodiments of the suturing unit; [Figure 15A] 13A-13D show exemplary views of a head assembly illustrating ligation and knot tightening according to an embodiment of the present disclosure. [Figure 15B] 13A-13D show exemplary views of a head assembly illustrating ligation and knot tightening according to an embodiment of the present disclosure. [Figure 16] FIG. 13 is an exemplary method flow diagram for a method for suturing, ligating, and tightening knots with a head assembly of the disclosed device, in accordance with an embodiment of the present disclosure. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0054] The following is a detailed description of the embodiments of the present disclosure, as illustrated in the accompanying drawings. The embodiments are detailed to clearly communicate the present disclosure. However, the degree of detail provided is not intended to limit the variations of the embodiments anticipated, but on the contrary, is intended to encompass all modifications, equivalents, and alternatives falling within the spirit and scope of the present disclosure as defined by the appended claims.

[0055] Each of the following claims defines a separate invention and is recognized for infringement purposes as including equivalents to the various elements or limitations set forth in the claims. Depending on the context, any reference below to "the present invention" may in some cases refer to specific embodiments only. In other instances, it is recognized that a reference to "the present invention" may refer to the subject matter set forth in one or more, but not necessarily all, of the claims.

[0056] Various terms are used herein. If a term used in the claims is not defined, it should be given the broadest definition that one of ordinary skill in the art would give that term, as reflected in publications and issued patents at the time of filing.

[0057] The embodiments described herein relate to a multifunctional minimally invasive surgical device with functions for grasping, cutting, cauterizing, suturing, ligating, and tightening knots. The device is based on a unique multifunctional head assembly including a suturing unit and a pair of gripper units with an upper gripper unit located in a plane above the suturing unit and a lower gripper unit located in a plane below the suturing unit. Each of the gripper units includes a pair of grippers with the ability to rotate about two different axes, one of which is on a plane to move the gripper perpendicular to the plane of the gripper unit and the other of which is perpendicular to the plane to rotate the gripper perpendicular to the plane of the gripper unit.

[0058] Movement of the gripper in the plane of the gripper unit allows for gripping of tissue and suture, while movement perpendicular to the plane of the gripper unit allows for tensioning of the gripped suture to tighten the knot.

[0059] Although the disclosed devices are described with multiple structural features and functions, it should be understood that the devices can be configured in different configurations having different combinations of features and functions depending on the needs and applications, and all such variations are within the scope of the present disclosure, without any limitation.

[0060] 1A-1C, which respectively disclose left, right and top views of the disclosed laparoscopic surgical device, the device 100 may include a handle 200, a shaft 700 coupled to the handle 200 at a distal end thereof, and a multi-function head assembly 300 coupled to the distal end of the shaft 700 by an articulation joint 800.

[0061] The articulation joint 800 may enable the head assembly 300 to rotate about two mutually perpendicular axes that are perpendicular to the longitudinal axis of the shaft 700 using a manipulator 900 provided on the handle 200. The head assembly can also be rotated about the longitudinal axis of the shaft 700 by rotating a rotation knob 206 provided on the handle 200. Thus, the head assembly has three rotational degrees of freedom, facilitating a surgeon to remotely manipulate the head assembly 300 using the manipulator 900 and rotation knob 206 during laparoscopic surgery.

[0062] The diameter of the head assembly 300, articulation joint 800 and shaft 700 may range from 8-12 mm and the length of the device may range from 250 mm to 400 mm, selected depending on the nature of the procedure, making it suitable for all types of minimally invasive surgical procedures, and may also be used for other types of surgical procedures with appropriate modifications that will be apparent to those skilled in the art.

[0063] The head assembly 300 includes a suturing unit, an upper gripper unit that lies in a plane above the suturing unit, and a lower gripper unit that lies in a plane below the suturing unit, as shown in Figure 3. By having two gripper units, one on either side of the suturing unit, and by having grippers on the gripper units that rotate in the plane of the corresponding gripper unit and rotate perpendicular to the plane of the gripper unit, the device 100 allows for a unique way of handling multiple surgical steps, such as tissue gripping, suturing, ligating, knot tightening, cutting, and cauterizing, all accomplished with a single handheld device that can be switched between functions using a function shift button 204 on the handle 200. Thus, the previously standard use of multiple devices and multiple gripping and release movements during an endoscopic surgical process is avoided, making endoscopic surgery more efficient.

[0064] The device also provides easy access for the surgeon to reach complex anatomical locations with six degrees of freedom (DoF), which are the 3 DoF mentioned above plus two linear motions including longitudinal linear motion of the shaft 700 and lateral and up-down motion of the head assembly 300 by manipulating the entire device 100. The surgeon can rotate the head assembly using a joystick 908 of the manipulator 900 on the handle. The joystick 908 can be moved in four directions, namely left-right and up-down, in a corresponding slot. When the joystick 908 is moved to the right, the head assembly 300 moves to the right and vice versa. Similarly, when the joystick 908 is moved up, the head assembly 300 moves up and vice versa. The joystick 909 is positioned to be reachable by the surgeon's thumb. The rotation knob 206 can rotate the head assembly 360 degrees around the longitudinal axis of the shaft 700.

[0065] FIG. 2, with reference to FIGS. 1A-1C, shows further details of the handle 200. The handle 200 has gun ergonomics so that the surgeon can easily grip and manipulate the handle. The handle has five surfaces, including a top, bottom, back, right, and left side. The top surface of the handle 200 includes a knot tightening actuation knob 214 and a function shift button 204. Also included on the top surface is a rotation knob 206 for rotating the head assembly 300. The knot tightening actuation knob 214 may be used to actuate the tightening of the knot. The function shift button 204 may be a slide switch that may be used to switch functions between grasping, cutting, knot tightening, cauterizing, and suturing.

[0066] The rear surface of the handle 200 that joins with the top surface includes a joystick 908 of a manipulator 900 for manipulating the head assembly 300 by rotating it up and down and left and right. The manipulator 900 includes a locking mechanism for locking the head assembly 300 in a desired orientation. The location of the joystick 908 is ergonomically designed so that it can be easily used by the surgeon with his thumb and can be locked by simply letting go of the joystick 908.

[0067] The underside of the handle 200 includes two gun-style triggers, one main trigger 208 and one minor trigger 210. The main trigger is used to drive the needle of a suturing unit incorporated into the head assembly 300, and the minor trigger 210 can be used to perform any one of grasping, cutting, cauterizing, and tightening knots after the function shift button 204 is moved to the appropriate position.

[0068] The right side of the handle 200 may include a scissor activation button 222 (see FIG. 1B), which may be a sliding button. Sliding the scissor activation button 222 to a scissor position may convert the gripper unit of the head assembly into scissors by protruding blades from slits in the gripping surfaces of the gripper units of the gripper units. Activating the scissors may then cut tissue at the gripped location. Additionally, when the function shift button 204 is in the cauterization position, the blades may receive AC or DC current for cauterization.

[0069] The left side of the handle 200 includes a gripper actuation knob 212L for the lower gripper unit, and the right side of the handle 200 includes a gripper actuation knob 212R for the upper gripper unit. The gripper actuation knobs 212L and 212R are configured as toggle buttons such that a first depression of the gripper actuation knobs 212L / 212R (individually / collectively referred to as the gripper actuation knob(s) 212) engages a drive means, e.g., a motor 218, with the corresponding gripper unit, and a second depression of the gripper actuation knob 212 disengages the motor 218 from the corresponding gripper unit. The gripper actuation knob 212 can also be manually rotated to fine-tune the gripping force. Once the motor is engaged with the selected gripper unit and the function shift button 204 is moved to the gripping position, depressing the small trigger activates the corresponding gripper unit to grip tissue or suture, as the case may be.

[0070] The grasper actuation knobs 212 have a built-in locking mechanism to hold the corresponding grasper unit in the grasping position, and when the grasper actuation knobs 212 are pulled out, the corresponding grasper unit is unlocked and the grasper releases the grasped tissue or suture by moving to an open position with the grasper unit's biasing force against the grasper.

[0071] The top surface of the handle 200 includes a knot tightening actuation knob 214 that functions similarly to the gripper actuation knob 212. Specifically, when the knot tightening actuation knob 214 is depressed, a motor 218 is coupled to both the upper and lower gripper units and moves both grippers of both gripper units perpendicular to the plane of the gripper units in order to tension the gripped thread and tighten the knot.

[0072] 2 and further illustrated in FIG 10, each of the gripper actuation knob 212 and the knot tightening actuation knob 214 is coupled to a bevel gear, e.g., bevel gears 1002-1, 1002-2, and 1002-3, which move inward and engage an input bevel gear 1004 coupled to a motor 218 when the corresponding knob 212 / 214 is depressed. As a result of the bevel gear 1002 coupling to the input bevel gear 1004, rotation of the motor 218 is transmitted to corresponding pulleys, such as first pulleys 1006-1 and 1006-2 coupled to the gripper actuation knob 212 and a second pulley 1006-3 coupled to the knot tightening actuation knob (hereinafter individually / collectively referred to as pulley(s) 1006). The pulleys 1106 have respective ropes wound around them which, when pulled by the rotation of the pulley 1106, actuate the gripper units for a corresponding function.

[0073] The primary trigger 208 may be coupled to the suture pulley 216 such that depression of the primary trigger 208 rotates the suture pulley 216 and pulls the suture rope 220 wound around the suture pulley 216. The suture rope 220 may be coupled to a drive mechanism of the suturing unit of the head assembly 300. The primary trigger 208, the suture pulley 216, and the drive mechanism of the suturing unit may be configured such that one full depression of the primary trigger 208 rotates the suture needle of the suturing unit 180 degrees. A second depression of the primary trigger 208 may rotate the needle an additional 180 degrees for one full rotation after the primary trigger 208 is released from the first depression and returns to the start / release position. In different embodiments, a mechanized means for actuating the suturing unit may be provided and the motor 218 may be used to drive the pulley to pull the suture rope 220 in the same manner as the gripping unit.

[0074] 3 shows an exploded view of head assembly 300 having suturing unit 1100 / 1400, an upper gripper unit, such as gripper unit 400-1, located in a plane above suturing unit 1100 / 1400, and a lower gripper unit, such as gripper unit 400-2, located in a plane below suturing unit 1100 / 1400 (hereinafter individually / collectively referred to as gripper unit(s) 400). The two gripper units 400 may be generally similar in structure, i.e., one may be a mirror image of the other.

[0075] 4A shows an exploded view of a gripper unit 400 that may include a pair of grippers, such as gripper 402-1 and gripper 402-2 (individually / collectively referred to as gripper(s) 402). Each gripper 402 may include a front body 404 and a rear body 406. The front body 404 may be pivotally coupled to the rear body 406, such as by a hinge joint, for rotation about an axis 412 parallel to the plane of the corresponding gripper unit 400. The rear body 406 of each gripper 402 may be coupled to a pinion 408 such that rotation of the pinion 408 causes the gripper 402 to rotate about an axis 414 perpendicular to the plane of the gripper unit 400.

[0076] According to an embodiment, each of the gripper units 400 may include a double-sided rack 410. Both sides of the rack may engage with pinions 408 of the two grippers 402 of the gripper unit 400 such that pulling the rack 410 proximally causes the two grippers 402 to move toward each other to grip tissue 450 or suture, as shown in FIG.

[0077] Each rack 410 of the gripper unit may be coupled by a gripper rope to a corresponding first pulley 1006-1 and 1006-2 of the motor and gear drive mechanism 1000 (see FIG. 10 ) of the handle 200 such that rotation of the pulley pulls the gripper rope and moves the gripper 402 to grip tissue or suture.

[0078] According to an embodiment, the front bodies 404 of the two grippers of each of the gripper units 400 can be coupled to the second pulley 1006-3 of the handle 200 (see FIG. 10 ) by the knot pulling rope 416 such that rotation of the second pulley 1006-3 pulls the knot pulling rope 416, moving the front bodies of the grippers of the two gripper units away from each other perpendicular to the corresponding plane to pull both ends of the suture for tightening the knot, as shown in FIG. 15B .

[0079] According to an embodiment, the gripper unit 400 may include a set of infrared sensors 452 and pressure sensors 454 located on the gripping surfaces of the grippers 402, as shown in FIG. 5B. A pair of infrared sensors 452 located on opposing grippers 402 may be operatively coupled to the device's controller to determine the thickness of the gripped tissue 450. One of the two infrared sensors 452 provided on the opposing surfaces of the two grippers 402 of the gripper unit 400 may be a light emitting sensor, and the other may be a receiving sensor that receives the infrared radiation emitted by the light emitting sensor after passing through the gripped tissue 450. The loss of intensity of the infrared radiation due to passing through the tissue 450 may be used by the controller to estimate the thickness of the gripped tissue. The estimated thickness of the tissue 450 may be used by the controller for controlled actuation of the motor 218 during gripping.

[0080] Furthermore, a pressure sensor 454 may be provided on the tip of the gripper 402, precisely on the front body 404 of the gripper 402, to provide feedback to the controller during operation of the gripper unit 400. Specifically, the controller may stop further rotation of the motor 218 when the sensed pressure exceeds a predefined pressure value. This may prevent the gripped tissue 450 from being damaged by crushing during gripping. However, if for some reason the user feels the need to grip the tissue with a higher pressure, the corresponding gripper actuation knob 212 may be rotated to increase the gripping pressure on the gripped tissue 450.

[0081] According to an embodiment, the infrared sensor 452 may also be used to detect the presence of blood vessels in the grasped tissue. This may be important when the grasper unit 400 is used as a scissor or cautery. A controller coupled to the infrared sensor 452 may be configured to detect blood flow in the grasped tissue 450. Pulsations in the determined blood flow value may be interpreted as the presence of blood vessels. Upon detecting a blood vessel, the controller may issue a warning to the user, for example by a buzzer. The placement of the infrared sensor 452 may also be used to distinguish between healthy tissue and diseased tissue with reduced blood perfusion.

[0082] 5A-5C show features of the front body 404 of the gripper 402 of the gripper unit 400 that allow the gripper unit 400 to be converted into a scissors or cautery. As shown in FIG. 5A, the front body 404 may include a slit 504 located on the gripping surface 502 of the front body 404. FIG. 5B shows a blade 506 configured to be slidable within the front body 404 protruding from the slit 504. The blade 506 may be made to protrude from the slit 504 by actuating a pair of cams, such as, for example, cams 552-1 and 552-2 (collectively referred to as cams 552), as shown in FIG. 5C. The cams 552 may be pivotally fixed to the guide plate 554 such that one cam 552 is on the upper surface of the guide plate 554 and the other cam 552 is on the lower surface of the guide plate 554, and may engage two legs of the Y-shaped blade 506 between which the guide plate is located, as shown in Figure 5C. There may be a spring 556 to bias the blade 506 inwardly to the retracted position.

[0083] The cam 552 may be coupled to the scissor actuation button 222 of the handle 200 via one or more scissor ropes 508, as shown in Figure 5B. As can be appreciated, the blades 506 of both grippers 402 need to be extended in order for the gripper unit 400 to function as scissors, and therefore the scissor ropes of both grippers 402 need to be coupled to the scissor actuation button 222 for pulling simultaneously.

[0084] According to an embodiment, the blade 506 can also be connected to a current source for the gripper unit 400 to function as a cautery device. This function can be activated by shifting the function shift button 204 to a cautery mode, after which when the small trigger 210 is pressed, the controller completes a circuit through the blade 506 of the gripper unit 400 such that an AC or DC current flows through tissue held therebetween.

[0085] FIG. 6 is a block diagram of the control mechanism of the device 100, showing various elements that enable various functions of the device. As shown, the controller 600 of the device may be operably coupled to the function shift button 204, the small trigger 210, and the motor 218 on the handle 200. The controller may also be operably coupled to the sensors 452, 454 and the blade 506 of the gripper unit 400. The controller may be embodied in an electronic circuit board that may also include a processor and memory. The memory may store a look-up table, for example, to estimate the thickness of the grasped tissue based on the signal of the infrared sensor 452. Based on the position of the function shift button 204, the controller 600 may activate the appropriate elements of the device to achieve the selected function when the small trigger 210 is pressed. For example, if the function shift button 204 is in a cauterization mode, the controller 600 may provide a current for cauterization to the blade 506 of the gripper unit 400 when the small trigger 210 is pressed. Similarly, when the function shift button 204 is in the gripping mode, the controller may receive feedback from the infrared sensor 452 to determine the thickness of tissue between the grippers of the activated gripper unit 400 and activate the motor 218 to rotate the required angle of rotation. The controller may also receive feedback from the pressure sensor 454 to stop rotation of the motor 218 when the sensed pressure exceeds a predetermined pressure value to prevent the tissue 450 from being crushed and damaged.

[0086] 7A and 7B show two different views of a shaft 700. The shaft 700 may include an outer casing 702 and an inner tube 704 coaxially disposed within the outer casing 702. The proximal end of the inner tube 704 may be fixed to the rotation knob 206 and the distal end may be fixed to the proximal end of the articulation joint 800. The inner tube 704 may carry various ropes from the handle to the head assembly 300 via the articulation joint 800. The annular space between the outer casing 702 and the inner tube 704 may be used to supply irrigation fluid to the abdominal cavity of a patient during surgery. The irrigation fluid may be supplied through an irrigation port 706 provided in the outer casing 702, as shown in FIG. 7B.

[0087] 8A and 8B show top and perspective views, respectively, of an articulation joint 800. The articulation joint 800 may include a first yoke 802, a second yoke 804, and an intermediate yoke 806 that each couples the first yoke 802 to the second yoke 802 by a pivot joint. The axes of the two pivots are perpendicular to each other to provide two degrees of freedom in two mutually perpendicular axes. Each pivot axis may have a pulley, such as pulley 808, to couple the articulation joint 800 to a manipulator 900 via a manipulator rope 810.

[0088] As shown in FIG. 8B, yokes 802, 804, and 806 may include holes 850 for threading various ropes, such as, for example, scissor rope 508, from shaft 700 to head assembly 300 as shown.

[0089] 9 shows an exploded view of a manipulator 900. The manipulator includes two curved gimbals, e.g., gimbals 902-1 and 902-2 (collectively and individually referred to as gimbal(s) 902), arranged one on top of the other for sliding. Each gimbal 902 may have a slot, e.g., slot 906-1 in gimbal 902-1 and slot 906-2 in gimbal 902-2 (collectively and individually referred to as slot(s) 906). A joystick 908 engages with the slot 906 to move the gimbal 902 in the direction of the slot 906. The gimbals incorporate gears 904-1 and 904-2 that engage with corresponding gears to which pulleys 912-1 and 912-2 (hereinafter collectively and individually referred to as pulley(s) 912) are coupled. The pulley may carry a manipulator rope 810 for coupling the manipulator 900 to the articulation joint 800.

[0090] The manipulator includes a lock button 910 telescopically coupled to a joystick 908. The lower end of the lock button, which protrudes from the joystick 908, includes a stopper 914 supported on the lower gimbal 902. The lower end of the joystick 908 also carries a stopper that engages with the upper gimbal 902. The lock button is biased upwards, whereby the two stops 914 press the gimbals 902 together to lock the gimbals in any position, thereby locking the manipulator in any position. Depressing the lock button 910 moves the stopper 914 away from the gimbals 902, thereby allowing the gimbals 902 to move relative to each other. The movement of the gimbals 902 is transferred to the respective pulleys 912 via the respective gears 904.

[0091] FIG. 10 is a diagram of a motor and gear drive mechanism 1000 for moving the grippers 402 of the two gripper units 400 during a gripping and knot tightening operation that functions as described above.

[0092] 11A-11C show details of an embodiment of a suturing unit of a head assembly 300. The suturing unit 1100 for minimally invasive surgery may include a housing 302 having a pair of tracks arranged in parallel in a circle larger than a semicircle, including an upper track 304 and a lower track 306, and a needle track 310. The needle track 310 may be configured to accommodate a suturing needle, such as, for example, a suture needle 1200 (also referred to simply as needle 1200, and the two terms are used interchangeably herein), for moving the suture needle 1200 along the needle track 310, as shown in FIG. 12. The upper track 304, the lower track 306, and the needle track 310 may be coaxially arranged on different surfaces of the housing 302. 11A and 11C, the upper track 304 and the lower track 306 may be on the inner circumference of the housing 302, and the needle track 310 may be on a flat plane perpendicular to the axes of the upper and lower tracks 304 and 306. Alternatively, as shown in FIG.

[0093] The suturing unit 1100 may further include a puck 312 that engages with one of the upper track 304 and the lower track 306 at any given time. When the puck 312 is engaged with the lower track 306, it engages and presses against the suturing needle 1200, such that movement of the puck 312 results in movement of the suturing needle 1200 along the needle track 310, and when the puck 312 is engaged with the upper track 304, it lifts off of the suturing needle 1200 and moves without causing movement of the suturing needle 1200.

[0094] The suturing unit 1100 may further include a drive mechanism, such as, for example, drive mechanism 350 shown in FIG. 11C , for moving the puck 312 along the upper track 304 and the lower track 306. A link 314 of the drive mechanism 350 may be coupled to the puck 312 for driving the puck 312.

[0095] The upper track 304 and the lower track 306 may be connected to each other at their ends via angled tracks, such as angled track 308 shown in FIG. 11A , such that as the puck 312 moves to the end of the lower track 306, the puck 312 moves upward to engage with the upper track 304, and as the puck 312 moves back to the end of the upper track 304, the puck 312 moves downward to engage with the lower track 306. The drive mechanism 350 may be coupled to the primary trigger 208 via the suture rope 220.

[0096] In an embodiment, the drive mechanism 350 may be a Scotch yoke mechanism, as shown in Figure 11C, although other mechanisms are within the scope of this disclosure.

[0097] FIG. 12 shows an exemplary diagram of a suture needle 1200 for use with a suturing unit. The suture needle 1200 may be a circular needle, larger than a semicircle, with a circumference angle A in the range of 240-270 degrees. In a preferred embodiment, the circumference angle A of the suture needle 1200 may be 240 degrees, or 250 degrees, or 260 degrees, or 270 degrees. The suture needle may have a sharp tip and a trailing end. A suture 1202 may be secured to the trailing end of the suture needle 1200.

[0098] 13A-13D show the function of the suturing unit. Starting from the starting position of the suturing needle 1200 shown in FIG. 13A, where the puck 312 is engaged with the lower track 306, the user presses the primary trigger 208, which rotates the coupled suturing pulley 216, pulling the suture rope 220 and driving the drive mechanism 350. Pressing the primary trigger 208 once rotates the suturing needle 1200 180 degrees, as shown in FIG. 13B. At this point, the puck 312 reaches the end of the lower track 306 and moves to the upper track 304. Now, when the primary trigger is released, the puck 312 moves in the opposite direction, engaged with the upper track 304, without driving the needle 1200. Thus, the needle remains in the same position as shown in FIG. 13C, and the puck 312 reaches the end of the upper track 304 and moves again to the lower track 306. A second depression of the primary trigger 208 causes the suturing needle 1200 to rotate an additional 180 degrees once, and releasing the primary trigger 208 can return the puck 312 to the starting position, as shown in FIG. 13D.

[0099] In an alternative embodiment of the suturing unit shown in FIGS. 14A and 14B, the suturing unit 1400 may be based on the suturing needle 1200 being driven by a belt instead of a puck as in the suturing unit 1100. The suturing unit 1400 may include a housing 1402 having a needle track 1404 configured on the outer periphery of the housing 1402. The suturing needle 1200 may be disposed within the needle track 1404 for movement along the needle track 1404. The suturing unit may further include a belt 1406 configured around the outer periphery of the housing 1402, the belt 1406 being pressed against the suturing needle 1200 to move the needle 1200 along the needle track 1404 with the movement of the belt 1406. There may be multiple pulleys, such as pulley 1408, for example, to move the belt 1406 around the outer periphery of the housing 1402. In an embodiment, one of the pulleys, such as pulley 1408, can be coupled to a motor (not shown) by a flexible rotating shaft 1450, shown in FIG. 14B, to drive belt 1406. Suturing unit 1400 can be mechanized driven by a motor instead of manually depressing main trigger 208.

[0100] 15A and 15B are views of the head assembly showing ligation and tightening of the knot, respectively. After the needle 1200 pierces the grasped tissue, the grasped tissue can be released by releasing the grasper unit, for example by pulling the grasper actuation knob 212 outward. Now, the head assembly 300 can be operated to grasp the free end of the suture 1202 by one of the upper or lower grasper units 400, so that the loose end of the suture 1202 is located within a circular zone defined by the movement of the needle 1200 due to the configuration of the head assembly 300. Now, the needle 1200 can be moved one revolution, i.e., 360 degrees, or more depending on the type of knot required, to wrap the suture around the free end of the suture to make one loop and repeat depending on the type of knot. The other grasper unit 400 can then be used to grasp the needle side portion of the suture 1202. Once both sides of the suture 1202 have been gripped by the two gripper units 400, as shown in FIG. 15B, the two gripper units 400 may be actuated to move perpendicular to the plane of the gripper units 400 to pull on each end of the suture 1202 to tighten the knot. In particular, the tightening of the knot may be actuated by depressing the knot tightening actuation knob 214 and then depressing the small trigger 210.

[0101] 16 is a method flow diagram of a method for suturing, ligating, and tightening knots using the head assembly 300 of the disclosed device 100. The method 1600 may include, at step 1602, providing a device for minimally invasive surgery, such as the device 100 shown in FIGS. 1-15B. The method 1600 may include, at step 1604, gripping tissue, such as tissue 450 shown in FIG. 4B, by upper and lower gripper units, such as the gripper units 400 shown in FIGS. 4A and 4B, by moving corresponding grippers, such as the gripper 402 shown in FIG. 4A, in the plane of the respective gripper units 400. Step 1606 of method 1600 may be piercing the grasped tissue with a needle, such as needle 1200 shown in FIG. 12 , of a suturing unit, such as suturing units 1100 or 1400 shown in FIGS. 11A-11C and 14A-14B, respectively, so that a suture, such as thread 1202 shown in FIG. 12 , secured to suturing needle 1200, penetrates and traverses tissue 450.

[0102] Step 1608 of method 1600 may be releasing the grasped tissue 450, and step 1610 may be grasping the free end of the suture 1202 by one of the upper and lower gripping device units 400 such that the free end of the suture is located within a circular zone defined by the movement of the needle 1200.

[0103] 15A, the method 1600 may include moving the needle 1200 at least 360 degrees to wrap the suture around the free end of the suture to make one loop and repeat depending on the type of knot. In step 1614, the method 1600 may include gripping a needle portion of the suture 1202 by the other of the upper and lower gripper units 400, and in step 1616, the grippers 402 of the two gripper units 400 may be moved perpendicular to the plane of the respective gripper units 400 to tighten the knot of the suture 1202.

[0104] Thus, the present disclosure provides a multi-function device 100 for minimally invasive surgery, including functions of grasping, cutting, cauterizing, suturing, ligating, and tightening knots, among others, during laparoscopic surgery. Thus, the disclosed device 100 overcomes the shortcomings of conventional procedures for minimally invasive surgery that require multiple devices, thereby eliminating the need for multiple instruments and multiple grasping and releasing movements during the process. Because the various functions are mechanized, i.e., motorized, the device can also be modified for integration with a surgical robot, after modifications that will be obvious to those skilled in the art.

[0105] While the above describes various embodiments of the present invention, other and further embodiments of the invention may be devised without departing from the basic scope thereof. The scope of the invention is determined by the claims that follow. The invention is not limited to the described embodiments, versions, or examples, which, when combined with information and knowledge available to those skilled in the art, are included to enable those skilled in the art to make and use the invention. Advantages of the Invention

[0106] The present disclosure provides an improved laparoscopic surgical device that overcomes the shortcomings of conventional methodologies for grasping, suturing, ligating and tightening knots during minimally invasive surgery.

[0107] The present disclosure provides a single device for laparoscopic surgery that facilitates, among other things, grasping, cutting, cauterizing, suturing, ligating and tying knots during laparoscopic surgery.

[0108] The present disclosure provides a laparoscopic surgical device that can perform most laparoscopic functions with a single instrument, thereby eliminating the need to switch instruments for each function.

[0109] The present disclosure provides a laparoscopic surgical device that includes a feedback mechanism during tissue grasping for force control.

[0110] The present disclosure provides a laparoscopic surgical device that includes a mechanism for detecting the presence of blood vessels in grasped tissue to prevent inadvertent damage to the blood vessels.

[0111] The present disclosure provides a laparoscopic surgical device that encompasses six degrees of freedom in space for movement of the head assembly.

[0112] The present disclosure provides a laparoscopic surgical device that automates the entire process of intracorporeal suturing, ligation, and knot tightening into a single process.

[0113] The present disclosure provides a laparoscopic surgical device that avoids multiple grasp and release movements during the process of intracorporeal suturing.

[0114] The present disclosure provides a laparoscopic surgical device that can be easily integrated into a surgical robotic system.

[0115] The present disclosure provides a laparoscopic device capable of assisting a surgeon in single-incision laparoscopic surgery.

Claims

1. A multi-function device for minimally invasive surgery, comprising: The handle and a shaft coupled to a distal end of the handle; a multi-function head assembly configured on the distal end of the shaft via an articulation joint, the multi-function head assembly being capable of rotating with two degrees of freedom relative to the shaft by the articulation joint, a suture unit; an upper gripping device unit located in a plane above the suture unit; a lower gripping device unit located in a plane below the suture unit; a multi-function head assembly comprising: wherein each of the upper and lower gripper units comprises a pair of grippers configured to rotate in the plane of the corresponding gripper unit to grasp tissue or suture, and to rotate perpendicular to the plane of the gripper unit to tension the grasped suture and tighten a knot.

2. the gripper of at least one of the upper and lower gripper units includes a cutting blade configured to slide within the gripper, and in an operative position, a cutting edge of the cutting blade protrudes through a slit in a gripping surface of the gripper for use of the gripper unit as scissors; the gripping device includes a set of cams that engage the corresponding blade, the set of cams being coupled by a scissor rope to a scissor actuation button on the handle, such that moving the scissor actuation button to a cutting mode position pulls the scissor rope and rotates the set of cams, causing the blade to protrude from the slit, and moving the scissor actuation button from the cutting mode position releases the scissor rope and returns the set of cams, allowing a set of springs to move the blade within the slit; and The device of claim 1 , wherein the blade is configured to pass either direct current or alternating current so that the blade functions as a cautery.

3. The shaft comprises an outer tubular casing and an inner tube coupled to the head assembly via the articulated joint; the inner tube is coupled to a rotation knob located at a distal end of the handle, and when a user rotates the rotation knob, the head assembly rotates about the longitudinal axis of the shaft; the articulation joint is coupled to a manipulator via a pair of ropes, the manipulator being positioned on the handle such that a joystick of the manipulator is operable by a user's thumb, and sideways and upward and downward movement of the joystick causes the articulation joint to rotate the head assembly about two mutually perpendicular axes that are perpendicular to the longitudinal axis of the shaft, thereby providing the head assembly with three rotational degrees of freedom; the manipulator comprises upper and lower gimbals disposed one on top of the other and coupled to the joystick for rotation about two mutually perpendicular axes, each gimbal coupled to a pulley for a respective rope connecting the manipulator to the articulation joint; the manipulator includes a lock button configured, together with the joystick, to press a set of stops against the gimbals, urging the gimbals toward each other to lock the manipulator in any position, and depression of the lock button disengages the stops from the gimbals to allow movement of the gimbals to operate the articulation joint; each gripper comprises a front body and a rear body, the front body pivotally coupled to the rear body for rotation about an axis parallel to the plane of the corresponding gripper unit, the rear body coupled to a pinion, rotation of the pinion resulting in rotation of the gripper about an axis perpendicular to the plane of the corresponding gripper unit; each of the gripper units includes a rack that engages the pinion of the corresponding gripper, and pulling the rack proximally moves the two grippers toward each other to grip tissue or suture; the rack of each of the grasper units is coupled by a first rope to a first pulley on the handle, and rotation of the pulley pulls the rope to move the grasper to grasp tissue or suture; the front bodies of the two grippers of each of the gripper units are coupled by a second rope to a second pulley on the handle, and rotation of the second pulley pulls the second rope to move the grippers of the two gripper units away from each other perpendicular to the corresponding plane to pull both ends of the suture and tighten the knot; the two first pulleys and the second pulley are respectively coupled to corresponding bevel gears and corresponding gripper actuation knobs and knot tightening actuation knobs, the actuation knobs having a cam mechanism such that a first depression of the actuation knob causes the corresponding bevel gears to move inward and engage with an input bevel gear coupled to a motor, and a second depression of the actuation knob causes the bevel gears to move outward and disengage from the input bevel gear; the actuation knob includes a built-in locking mechanism for locking the corresponding pulley to lock the corresponding gripper unit in an actuated position, the locking mechanism being configured such that pulling the actuation knob outward unlocks the pulley and causes the gripper unit to return the gripper to the corresponding rest position; the upper and lower gripper units each include a set of infrared and pressure sensors configured on the gripper; the device comprises a controller operably coupled to the set of infrared sensors and the pressure sensors and to the motor, the controller configured to provide feedback regarding a thickness of the grasped tissue based on signals from the infrared sensors, and further configured to stop further rotation of the motor when the sensed pressure exceeds a predetermined pressure value based on feedback from the pressure sensors; 10. The device of claim 1, wherein the controller is configured to detect the presence of a blood vessel in the grasped tissue based on a pulsation in the signal from the infrared sensor, the signal being indicative of blood flow in the grasped tissue, and the controller is further configured to issue an alert to a user of the device if a blood vessel is detected.

4. The device of claim 1, wherein the handle includes a main trigger for actuating the suturing unit, the main trigger coupled to the suture pulley such that when the main trigger is depressed, the suture pulley rotates and pulls a suture rope wrapped around the suture pulley, the suture rope being coupled to a drive mechanism of the suturing unit, and the main trigger, the suture pulley, and the drive mechanism of the suturing unit are configured such that a single full depression of the main trigger causes the suture needle of the suturing unit to rotate 180 degrees, and a second depression of the main trigger causes the suture needle to rotate an additional 180 degrees to complete one revolution after the main trigger is released from the first depression and returns to a starting position.

5. The device described in claim 1, wherein the handle includes a function shift button and a small trigger operably coupled to a controller of the device, the function shift button configured to select between a grasping action, a cutting action, a knot tightening action, a cauterizing action, and a suturing action, and the controller activates the selected function based on the position of the function shift button when the small trigger is pressed.

6. A multi-function device for minimally invasive surgery, comprising: The handle and a shaft coupled to a distal end of the handle; a head assembly configured on the distal end of the shaft, the head assembly including at least one grasper unit including a pair of graspers for grasping at least tissue; wherein each of the grippers of the at least one gripper unit comprises a cutting blade configured to slide within the gripper, and in an active position, a cutting edge of the cutting blade protrudes from a slit in a gripping surface of the gripper for use of the gripper unit as scissors.

7. The device described in claim 6, wherein the blade is configured to allow either direct current or alternating current to flow through it so that the blade functions as a cauterizer.

8. The device of claim 6, wherein the at least one gripping device unit comprises a set of infrared sensors, and the device comprises a controller for detecting the presence of blood vessels in the grasped tissue based on pulsations in signals from the infrared sensors, the signals indicating the presence of blood in the grasped tissue, and the controller is further configured to issue an alert to a user of the device if a blood vessel is detected.

9. A multi-function device for minimally invasive surgery, comprising: The handle and a shaft coupled to a distal end of the handle; a head assembly configured on the distal end of the shaft, the head assembly including at least one grasper unit including a pair of graspers for grasping at least tissue; wherein the grasper unit comprises a set of infrared and pressure sensors configured on the grasper to provide feedback regarding the thickness of the tissue being grasped and the pressure exerted on the tissue during grasping to control actuation of the grasper unit to prevent damage to the grasped tissue.

10. A multi-function device for minimally invasive surgery, comprising: The handle and a shaft coupled to a distal end of the handle; a head assembly configured on the distal end of the shaft, the head assembly including at least one grasper unit including a pair of graspers for grasping at least tissue; Equipped with the at least one gripper unit comprises a set of infrared sensors arranged on the gripper; A multi-function device, the device comprising a controller for detecting the presence of a blood vessel in the grasped tissue based on a pulsation in a signal from the infrared sensor, the signal indicating the presence of blood in the grasped tissue, the controller further configured to issue an alert to a user of the device if a blood vessel is detected.

11. A suturing unit for minimally invasive surgery, comprising: a housing having a needle track configured on a periphery of the housing; a suture needle disposed within the needle track for movement along the needle track; a belt configured around the outer periphery of the housing, the belt pressing against the needle to move the needle along the needle track as the belt moves; a plurality of pulleys for moving the belt around the outer periphery of the housing; Equipped with A suturing unit, wherein one of the plurality of pulleys is coupled to a motor by a flexible rotating shaft for driving the belt.

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