Articulation locking mechanisms for end effectors

Abstract

To solve one or more problems in performing more and more complicated treatments on a patient.SOLUTION: Provided is a medical device, including: an end effector at a distal end of the medical device; an actuator coupled to a proximal end of the end effector; and a swing arm that is swingably coupled to the end effector distal to the proximal end of the end effector and swings the end effector in response to actuation of the actuator. The swing arm includes a first opening in the proximal end, a second opening in a sidewall, and a lumen extending from the first opening to the second opening. The actuator extends through each of the first opening, the lumen, and the second opening.SELECTED DRAWING: Figure 1

Description

[Technical field]

[0001] The present disclosure relates to minimally invasive (e.g., endoscopic and / or laparoscopic) medical devices and associated methods of use. In embodiments, the present disclosure relates to one or more locking mechanisms for end effectors, e.g., tissue fixation devices such as stapler devices, among other aspects, and associated methods of use. [Background technology]

[0002] Advances in technology have allowed users of medical systems, devices, and methods to perform increasingly complex procedures on patients. For example, grasping and / or joining of tissue within a patient's body may be performed by a surgical device that, for example, grasps or clamps the tissue between opposing jaw structures and then fixes or cuts the tissue. Shortcomings of these systems may include, for example, maintaining a desired orientation of the jaws of the end effector during a procedure, such as a stapling procedure, a cutting procedure, and / or an additional medical procedure. For example, to access tissue, the end effector may be articulated about a pivot point. During the cutting or fixation step, actuation of the cutting and / or fixation device may cause the end effector to swing from a selected orientation to another undesirable direction. Thus, tissue may not be properly stapled and / or cut, which may increase treatment time and / or cost, cause undesirable or incomplete fixation of tissue, and / or require additional treatment / intervention at the target site. This disclosure may solve one or more of these problems or other problems in the art. However, the scope of the disclosure is defined by the appended claims, rather than the ability to solve any particular problem. Summary of the Invention

[0003] According to one aspect, a medical device includes an end effector at a distal end of the medical device, an actuator coupled to a proximal end of the end effector, and a swing arm swingably coupled to the end effector distal to the proximal end of the end effector. Actuation of the actuator causes the end effector to swing relative to the swing arm. A lock is provided on the end effector and the swing arm. The lock has a first state that allows the end effector to swing relative to the swing arm and a second state that restricts the end effector from swinging relative to the swing arm.

[0004] The end effector may include a first jaw and a second jaw hingedly connected to the first jaw and configured to move between an open position and a closed position. The locking mechanism may include a plurality of teeth on a distal end of the swing arm, the plurality of teeth may define a plurality of spaces, and a tab connected to the end effector, the tab may engage one of the spaces in the second state.

[0005] When the pair of jaws is in an open position, the lock is in a first state and when the pair of jaws is in a closed position, the lock is in a second state. The end effector can be configured to oscillate independently of relative movement of the first jaw relative to the second jaw.

[0006] The locking mechanism may include a sprocket connected to the swing arm, the sprocket may include a plurality of teeth defining a plurality of spaces, and the locking mechanism may include a pawl swingably connected to a proximal end of the end effector and configured to engage the plurality of spaces.

[0007] The medical device may further include a wire connected to the pawl and extending proximally, the pawl may be biased into engagement with a plurality of spaces in the sprocket, and moving the wire proximally may be configured to rock the pawl away from the sprocket and move the pawl away from the plurality of spaces.

[0008] The sprocket may be arcuate in shape and a convex arrangement of the spaces of the sprocket may face proximally. The locking mechanism may include a ball nose spring plunger.

[0009] The ball nose spring plunger may include a spring coupled to a first end of the end effector, the spring extending from the first end and configured to be compressed along a compression axis, the ball nose spring plunger may include a plurality of detents secured to the swing arm and a ball bearing connected to the spring and selectively engaging each of the plurality of detents, the ball bearing configured to move along the compression axis.

[0010] The ball bearing may be configured to move from a first of the plurality of detents to an adjacent second of the plurality of detents as the end effector swings about the swing arm, and the spring may be configured to be compressed from the first position to the second position and configured to expand back to the first position as the ball bearing moves from the first detent to the second detent.

[0011] The medical device may further include an actuation wire secured to a proximal end of the end effector, actuation of the actuation wire configured to move the end effector between the open and closed positions.

[0012] The swing arm can include a first opening at a proximal end of the swing arm, a second opening in a sidewall of the swing arm, and a lumen extending from the first opening to the second opening. The actuator can be configured to extend through each of the first opening, the lumen, and the second opening.

[0013] The medical device may further include a handle assembly configured to actuate the end effector and the locking mechanism, and a proximal end of the actuator may be connected to a distal end of the handle assembly, and the medical device may include a catheter, which may include at least one lumen and may extend distally from the handle assembly, the actuator may extend through the at least one lumen, and the swing arm may be secured to the distal end of the catheter.

[0014] A swing angle can be defined between a longitudinal axis of the end effector and a longitudinal axis of the swing arm, and distal movement of the actuator can be configured to increase the swing angle and proximal movement of the actuator can be configured to decrease the swing angle.

[0015] According to another aspect, a medical device includes an elongate member, an end effector connected to a distal end of the elongate member and which may include a tab, and a catheter including a plurality of spaces at its distal end, where the tab may be configured to selectively engage the plurality of spaces to prevent oscillation of the end effector.

[0016] The elongate member may extend through an opening in the catheter near the distal end of the catheter, and the end effector may be pivotally coupled to the catheter distal to the opening. According to another aspect, a medical method includes advancing an end effector and a swing arm to a target site within a patient, swinging the end effector relative to the swing arm about a swing axis until a desired orientation of the end effector is achieved, locking the orientation of the end effector relative to the swing arm, and performing a manipulation via the end effector.

[0017] The end effector may include a first jaw and a second jaw pivotally attached to the first jaw, and the end effector may include an open configuration and a closed configuration, wherein a distance between a distal end of the first jaw and the second jaw is greater in the open configuration than a distance between the distal end of the first jaw and the second jaw in the closed configuration.

[0018] When the end effector is in the closed configuration, the end effector can be locked relative to the swing arm, and when the end effector is in the open configuration, the end effector can be unlocked relative to the swing arm.

[0019] The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate various exemplary embodiments of the present disclosure and, together with the description, serve to explain the principles of the disclosure. [Brief description of the drawings]

[0020] [Figure 1] 1 is a schematic diagram of a tissue fixation device according to one embodiment. [Figure 2A] 2 is a diagram of an end effector of the fastening device of FIG. 1 according to one embodiment. [Figure 2B] 2 is a diagram of an end effector of the fastening device of FIG. 1 according to one embodiment. [Figure 2C] FIG. 2C is a diagram of a swing arm of the end effector of FIGS. 2A and 2B. [Figure 3A] 2 is a diagram of an end effector of the fastening device of FIG. 1 according to one embodiment. [Figure 3B] 2 is a diagram of an end effector of the fastening device of FIG. 1 according to one embodiment. [Figure 4A] 2 is a view of an end effector of the fastening device of FIG. 1 according to another embodiment. [Figure 4B] 2 is a view of an end effector of the fastening device of FIG. 1 according to another embodiment. [Figure 5A] 2 is a view of an end effector of the fastening device of FIG. 1 according to another embodiment. [Figure 5B] FIG. 5B is a diagram of a locking mechanism for the end effector of FIG. 5A. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0021] The present disclosure is described with reference to exemplary medical systems and medical tools for accessing a target site, for example, to grasp, cut, and / or staple tissue. This may provide improved medical tool capabilities and / or assist medical professionals to improve tissue cutting and / or fixation. However, it should be noted that references to specific devices and / or specific procedures are provided for convenience only and are not intended to limit the disclosure. Those skilled in the art will recognize that the concepts underlying the disclosed devices and application methods may be utilized in any suitable procedure, medical or otherwise. The present disclosure can be understood with reference to the following description and the accompanying drawings, in which like elements are referred to with the same reference numerals.

[0022] For ease of description, portions of the disclosed devices and / or their components are referred to as proximal and distal portions. It should be noted that the term "proximal" is intended to refer to the portion of the device closer to the user, and the term "distal" is used herein to refer to the portion away from the user. Similarly, "distally extending" indicates that a component extends in a distal direction, and "proximally extending" indicates that a component extends in a proximal direction. Furthermore, as used herein, the terms "about," "approximately," and "substantially / generally" indicate a range of values ​​within ±10% of the stated or implied value. Furthermore, terms indicating the geometry of components / surfaces refer to exact and approximate shapes.

[0023] The embodiments of the present disclosure may be used to cut and / or fix tissue in an intraluminal space or to facilitate the process. According to one example, the fixation device may be a tissue stapling device. The tissue stapling device may include a cutting or cutting mechanism (e.g., an integrated knife) and a stapling mechanism (e.g., a stapler). The fixation device may be delivered to a target tissue site through a working channel of an endoscope. All or a portion of the fixation device may be metal (such as stainless steel, titanium, or cobalt chrome), plastic (such as polyetheretherketone (PEEK)). Alternatively, all or a portion of the fixation device may include a shape memory metal (such as Nitinol), a shape memory polymer, a polymer, or any combination of materials. Although fixation devices are mentioned herein, the described locking members may be used with any device that is pivotally connected to the distal end of a catheter, sheath, tube, or the like. The locking member may prevent the pivoting motion of an end effector or other device that is pivotally connected to the distal end of, for example, a catheter. This may improve the operation of the end effector. For example, preventing the stapler from pivoting during stapling may improve the fixation between adjacent tissue.

[0024] 1 illustrates an apparatus 10 according to an example of the present disclosure. The apparatus 10 may be a surgical stapling device configured to engage body tissue and apply a plurality of fasteners during a minimally invasive procedure, such as a laparoscopic or endoscopic procedure. In some embodiments, the apparatus 10 may be a suturing device for delivering sutures for tissue closure during a minimally invasive surgical procedure. Although the apparatus 10 may be used to apply sutures, clips, or other fasteners, it will be described primarily in the context of grasping tissue in preparation for performing additional procedures on the tissue, such as stapling and / or cutting the tissue.

[0025] As shown in FIG. 1 , the device 10 includes a handle assembly 30 at a proximal end, an end effector 100 at a distal end, and an elongate body 50 (e.g., a catheter, etc.) connecting the distal end of the handle assembly 30 to the proximal end of the end effector 100 (which may include a stapler device 110, as described herein). The elongate body 50 may extend any length suitable for an endoscopic or laparoscopic procedure and may be configured to be disposed within a working channel of an endoscope. Alternatively, the elongate body 50 may extend along an exterior surface of the endoscope, for example, if the endoscope includes only a single lumen and / or if the diameter of the endoscope's lumen is too small to accommodate the elongate body 50. The elongate body 50 may be removable from the handle assembly 30 to facilitate insertion of the elongate body 50 into the working channel of an endoscope or into a channel of another device, for example, by backloading the elongate body 50 into the working channel. In some examples, the elongated body 50 may be flexible, steerable, and / or rotatable about its axis. The elongated body 50 may include a lumen (or multiple lumens) for placing actuation wires therein, for actuating the end effector 100 via the handle assembly 30, or for actuating other portions of the device 10. The elongated body 50 may be configured to receive multiple actuation wires or a single actuation wire. In some examples, the elongated body 50 may be fixedly coupled to the end effector 100, and in other examples, the elongated body 50 may be removably or releasably coupled to the end effector 100. Unless otherwise stated, any wires or actuation devices described herein may extend from the handle assembly 30 to the end effector 100 via a lumen in the elongated body 50. Alternatively or additionally, one or more of these actuation wires or devices may extend from the handle assembly 30 to the end effector 100 outside of (e.g., adjacent to) the elongated body 50. A catheter 55 (or any other sheath) including a lumen may extend distally from the distal end of the handle assembly 30. The elongated body 50 may be disposed within the lumen of the catheter 55 and may move relative to the catheter 55.1 with curved regions, catheter 55 may be a straight sheath (e.g., a hypotube, etc.) having sufficient stiffness to move proximally and distally within the body. Additionally, Figures 2A-2C, 3A, 3B, 4A, 4B, 5A, and 5B may be shown without catheter 55 attached to the proximal end of swing arm 60 for ease of understanding (e.g., to show elongated body 50).

[0026] The handle assembly 30 may include a handle 32 and a body 34. The handle 32 may include a fixed portion 32a and an actuator portion 32b. The fixed portion 32a of the handle 32 may be fixedly coupled to the body 34. The actuator portion 32b may include a circular or oval portion or ring for placing a user's finger therein, which may assist the user in holding the handle assembly 30. In some examples, the actuator portion 32b of the handle 32 may be an actuator that is pivotally coupled to the body 34 and may be movable relative to the fixed portion 32a of the handle 32. In some examples, the actuator portion 32b of the handle 32 may be coupled to a proximal portion of an actuation wire, such as the actuation wire 40a, via an adjustable coupler 36, as described herein. The anvil 120 of the stapler apparatus 110 may be actuated via the actuation wire 40a extending between the stapler apparatus 110 and the handle assembly 30. In other examples, actuator portion 32b of handle 32 may be configured to control any other mechanism of device 10, such as operating an articulation lock of end effector 100, actuating the deployment of staples from stapler device 110, etc. It will be appreciated that wire 40a may have sufficient stiffness to be pushed distally and pulled proximally.

[0027] In some examples, the handle assembly 30 may include a movable cover 38 pivotally coupled to the housing 34 at a pivot point 38b. In FIG. 1, the cover 38 is shown in an open position, exposing an interior portion of the body 34. The cover 38 may be coupled to a proximal portion of the body 34 and may cover the interior components of the handle assembly 30 when disposed in a closed configuration, e.g., when a distal-most end 38a of the cover 38 faces a surface 34a of the body 34. The cover 38 may be disposed to cover the interior components of the body 34 (e.g., in a closed configuration) by a coupling mechanism, such as a snap-fit ​​mechanism, between a distal portion of the cover 38 and a distal portion of the handle assembly 30. When in the closed configuration, the cover 38 may form a pair of slots in the body 34 (not shown). When the distal portion of the cover 38 is separated from the distal portion of the body 34, a user may rotate or swing the cover 38 at the pivot point 38b to access the interior components of the handle assembly 30.

[0028] The handle assembly 30 may include one or more adjustable couplers 36, 39, which may be configured to receive a portion of an actuation wire, such as the actuation wire 40a. Any of the adjustable couplers 36, 39 may be movable vices to clamp the actuation wire 40a and fixedly couple the actuation wire 40a to the adjustable coupler 36, 39. In some examples, the adjustable couplers 36, 39 are movable by a screw to adjust the coupler 36, 39 and couple or uncouple the actuation wire 40a from the coupler 36, 39. The couplers 36, 39 may be used to move additional wires as described herein.

[0029] The adjustable coupler 39 may be coupled to the longitudinal actuator 31 and may be longitudinally movable via a horizontally moving longitudinal actuator 31 within the body 34. The longitudinal actuator 31 may be partially disposed within the housing 34 and may be longitudinally slidable within two slots formed when the cover 38 is disposed over the internal components of the handle assembly 30. The longitudinal actuator 31 may include a pair of opposing circular or elliptical portions or rings, each circular portion defining an opening for a user to place a respective finger therein. In some examples, the longitudinal actuator 31 may be coupled to an actuation wire (not shown), such as via the adjustable coupler 39 or via a different coupler within the body 34, and may be configured to control staple deployment from the stapler device 110. In other examples, the longitudinal actuator 31 may be configured to control any other mechanism of the device 10, such as actuation of the anvil 120 of the stapler device 110, actuation of a locking mechanism associated with the end effector 100, etc.

[0030] With continued reference to FIG. 1 , the end effector 100 includes a stapler device 110 that may be pivotally coupled to a distal end of an elongated body 50. For example, a connector 52 at the distal end of the elongated body 50 may be pivotally attached to a proximal end of the stapler device 110 via a pin 52a or the like. A swing arm 60 may be pivotally attached to a side of a body 130 of the stapler device 110 via a pin 60a. For example, one or more protrusions 131 may extend from a side of the body 130 and receive the pin 60a through an opening in the protrusion 131, thereby securing the pin 60a relative to the protrusion 131. The pin 60a defines a swing axis of the stapler device 110 relative to the swing arm 60. The pin 60a may also be received in an opening 66 ( FIG. 2C ) at the distal end of the swing arm 60, thereby allowing the stapler device 110 to swing relative to the swing arm 60. Swing arm 60 may be fixedly attached to the distal end of catheter 55 by ultrasonic welding, adhesive, crimping, etc. This may prevent swing arm 60 from moving when elongate member 50 moves relative to catheter 55 and / or swing arm 60, as described herein. For ease of understanding, catheter 55 is only shown in FIG.

[0031] As shown in FIG. 2A, the swing arm 60 may include an opening 62 at a proximal end. The opening 62 may connect to a lumen that extends from the proximal end to the distal end of the arm 60. A slot 65 (e.g., an opening) (FIG. 2C) may be formed in a side of the swing arm 60 and may connect to the lumen of the swing arm 60. The slot 65 may be oval, rectangular, or any other suitable shape. The opening 62, the lumen of the swing arm 60, and the slot 65 may be sized and shaped to receive a portion of the elongated body 50 such that the elongated body 50 may enter the swing arm 60 through the opening 62 and extend out of the slot 65. As described herein, movement of the elongated body 50 relative to the swing arm 60 may cause the stapler apparatus 110 to rotate relative to the swing arm 60. The swing arm 60 shown in FIG. 2C, or an embodiment of the swing arm 60 including the slot 65, may be used with any end effector described herein. Although the swing arm 60 is shown as a rectangular prism, the swing arm 60 may be any shape including a cylinder, a rectangular prism with rounded edges, and the like.

[0032] The anvil 120 may be rotatably or pivotally coupled to the body 130 via a pin 120a (which may define a pivot axis). The anvil 120 and the body 130 may be collectively referred to as jaws, gripping elements, and / or opposing members. The anvil 120 may extend distally from the pin 120a toward a distal end of the stapler apparatus 110. In some examples, the anvil 120 may be rotatably biased about the pin 120a and biased to an open configuration. For example, the distal end 124 of the anvil 120 may be biased away from the body 130 using a spring or the like, thereby creating a space between the distal end 124 of the anvil 120 and a distal portion of the body 130. The anvil 120 may be rotated about the pin 120a and may contact or approach the body 130 in a closed position, for example, to hold tissue between the anvil 120 and the body 130. In some examples, the body 130 can include a channel that supports a cartridge of staples or other fastening devices (not shown). The closed position of the anvil 120 can provide a surface against which the staples can be pressed as they are ejected from the cartridge of the stapler apparatus 110. The cartridge can include a plurality of surgical fasteners, such as staples, which can be deployed from the cartridge when under the influence of a driving force applied by an actuation sled or other actuation mechanism. A suitable stapler and associated actuation mechanism is described in commonly owned U.S. Provisional Patent Application No. 62 / 812,538, filed March 1, 2019, the complete disclosure of which is incorporated herein by reference.

[0033] 2A and 2B, the pin 120a may extend from a side of the anvil 120, and the pin 120a may be disposed within a slot 136 in the side of the body 130. For example, the slot 136 may be disposed in an upper extension of the body 130. In addition to rocking about the pin 120a, the anvil 120 may move longitudinally by means of the pin 120a and the slot 136. For example, the pin 120a of the anvil 120 may move within the slot 136, which is generally oval and extends longitudinally along a longitudinal axis. The slot 136 may be any shape or may be a hole that fixes the longitudinal position of the pin 120a. 2A and 2B, when pin 120a is disposed at the distal end of slot 136, anvil 120 may be disposed in an open configuration, and when pin 120a is disposed at the proximal end of slot 136, anvil 120 may be in a closed position. Wire 40a may be attached to the proximal end 122 of anvil 120 by attachment mechanism 122a. Proximal movement of wire 40a may move anvil 120 proximally, which may cause anvil 120 to rotate about pin 120a to the closed position. Distal movement of wire 40a may move anvil 120 distally, which may cause anvil 120 to rotate about pin 120a to the open position.

[0034] 2B shows a top view of the end effector 100 in the open configuration. The locking tab 126 is connected to the anvil 120 via pin 120a and a second pin 120b distal to pin 120a. Through their connection, the locking tab 126 moves with the anvil 120. It will be understood that the locking tab 126 may be connected to the anvil 120 by any other mechanism known in the art. According to one example, the pin 120b may engage a second slot distal to the slot 136 in the closed configuration, which may lock the anvil 120 in the closed configuration.

[0035] The swing arm 60 may include a swing head 64 at its distal end. The swing head 64 may include a plurality of teeth 64a defining a plurality of spaces 64b therebetween. As described herein, the locking tab 126 may engage the spaces 64b. The teeth 64a and spaces 64b may be radially spaced about the circumference of the swing head 64 (FIG. 2C) such that the stapler apparatus 110 may be locked at an angle relative to the swing arm 60. For example, an angle α may be defined as the angle between a longitudinal axis AA of the stapler apparatus 110 and a longitudinal axis BB of the swing arm 60. When α is 0 degrees, the swing arm 60 may be approximately parallel to the stapler apparatus 110 (axis AA and axis BB are approximately parallel), and when α is 90 degrees, the swing arm 60 may be approximately perpendicular to the stapler apparatus 110 (axis AA and axis BB are approximately perpendicular). The teeth 64a and spaces 64b may be spaced apart such that the stapler device 110 may be locked at an angle relative to the swing arm 60 such that α may be any one of about 0 degrees, about 30 degrees, about 60 degrees, and about 90 degrees. It will be understood that α is not limited to these angles. The number and spacing of the teeth 64a and spaces 64b may determine various angles α of the locked stapler device 110 relative to the swing head 64. For example, the teeth 64a may be positioned on the swing head 64 to change the angle of α. Furthermore, the number of teeth 64a is not limited to the three teeth 64a shown in FIGS. 2A and 2B and may be selected based on the number of designed locking angles.

[0036] 3A and 3B show the anvil 120 in a closed configuration. In the closed configuration, the anvil 120 is rotated about pin 120a such that the distal end 124 of the anvil 120 is closer to the body 130 than in the open configuration. As shown in FIG. 3B, the locking tab 126 can cooperate with teeth 64a in the closed position to prevent relative rotational or rocking motion between the stapler apparatus 110 and the swing arm 60. For example, a proximal portion of the locking tab 126 can be disposed between adjacent teeth 64a in the closed configuration, thereby preventing the stapler apparatus 110 from rotating relative to the swing arm 60.

[0037] A method of operating the end effector 100 will now be described. The end effector 100 may be advanced to a target site in the body through an incision or natural opening. The end effector 100 is advanced in a closed configuration and then opened via actuation of the actuation wire 40a. In the open configuration, tissue at the target site may be positioned between the anvil 120 and the body 130 (e.g., jaws) of the stapler device 110 by any suitable method. To properly orient the stapler device 110, a user may push the elongated body 50 distally or pull the elongated body 50 proximally to swing the stapler device 110 about an axis defined by the pin 60a until the stapler device 110 reaches a desired orientation relative to the swing arm 60 (e.g., a desired angle α). The desired positioning / orientation of the stapler device 110 may be aided, for example, by an imaging device associated with an endoscope through which the device 10 is inserted. After reaching the desired orientation, the user may, for example, use the handle assembly 30 to move the wire 40a proximally (e.g., by pulling the wire 40a), thereby moving the anvil 120 to the closed configuration. As the anvil 120 moves to the closed configuration, the locking tab 126 may engage the space 64b in the locked position and prevent rotation of the stapler apparatus 110 about the axis defined by the pin 60a. While in this locked position, the user may perform additional procedures on the tissue, such as stapling, cutting, or other procedures. Once the procedure is complete, the user may move (e.g., push) the wire 40a distally, which may move the anvil 120 to the open position, thereby disengaging the locking tab 126 from the space 64b. The user may then rotate the stapler apparatus 110 relative to the swing arm 60 to a new, different orientation. If necessary, the user can relock the stapler device 110 in a new orientation by repeating this process, or the user can remove the device from the body.

[0038] Another example locking mechanism for an end effector 100' is shown in FIGS. 4A and 4B. The end effector 100' may be similar to the end effector 100 and may include a stapler device 110 pivotally connected to the swing arm 60. The locking mechanism may include a pawl 66' and a sprocket 64' having a plurality of teeth 64a'. A space 64b' is defined between adjacent teeth 64a'. The sprocket 64' may be rigidly connected to the swing arm 60 and may have an arc shape with a convex surface facing the proximal end of the end effector 100. The pawl 66' may be pivotally attached to the body 130 of the end effector 100 by a pin 66a'. A biasing member, e.g., a spring, may bias the pawl 66' in a distal direction, e.g., toward the sprocket 64'. Pawl 66' can engage spaces 64b' to lock stapler apparatus 110 in a desired orientation relative to swing arm 60. For example, pawl 66' can seat in any of spaces 64b' between adjacent teeth 64a'. Actuation wire 40b can be attached to an opposite end of pawl 66' to the end of pawl 66' connected to pin 66a'. Actuation wire 40b can be similar to wire 40a and can be moved proximally (e.g., pulled) and distally (e.g., pushed) to cause pawl 66' to pivot about pin 66a'.

[0039] Similar to the end effector 100, the end effector 100' can be locked such that the orientation of the stapler device 110 relative to the swing arm 60 is locked in one or more positions based on the number of teeth 64a' and spaces 64b' and the spacing of the teeth 64a' and spaces 64b'. For example, when α is 0 degrees, the swing arm 60 can be parallel to the end effector 100' (axes AA and BB are approximately parallel), and when α is 90 degrees, the swing arm 60 can be perpendicular to the end effector 100' (axes AA and BB are approximately perpendicular). It will be understood that the angle α is not limited to these angles. Furthermore, the number of teeth 64a' and spaces 64b' are not limited to the number shown in FIGS. 4A and 4B. The number of teeth 64a' and spaces 64b' can be selected based on the number of possible positions in which the stapler device 110 can be locked relative to the swing arm 60. For example, teeth 64a' define seven spaces 64b' that provide different angles α between axes AA and BB. More or fewer spaces 64b' at different intervals can provide different angular adjustments of stapler apparatus 110.

[0040] A method of operating the end effector 100' will now be described. The end effector 100' may be introduced into the body and advanced to a target site in a manner similar to the end effector 100. The pawls 66' engage with the spaces 64b' upon insertion such that the angle α is approximately 0 degrees. Once the end effector 100' is adjacent to the target site, a user may move the actuation wire 40b proximally, for example, by pulling on the actuation wire 40b. Proximal movement of the actuation wire 40b may cause the pawls 66' to rotate about the pins 66a' and disengage the pawls 66' from the spaces 64b' and teeth 64a' of the sprocket 64'. After the pawl 66' disengages from the space 64b' and the teeth 64a', the user may orient the stapler device 110 as desired relative to the tissue and / or target site in a manner similar to orienting the stapler device 110 as described with reference to FIGS. 2A and 2A, for example, by moving the elongate body 50 proximally or distally, thereby changing the angle α. Once the stapler device 110 is properly oriented, the user may release and / or push the actuation wire 40b distally. For example, if the pawl 66' is biased toward the sprocket 64', releasing the actuation wire 40b may cause the pawl 66' to engage the space 64b' between the teeth 64a'. Alternatively or additionally, a distal force applied to the actuation wire 40b may be required for such engagement. Once the pawl 66' engages the space 64b' between the teeth 64a', the stapler device 110 may be locked in a selected orientation and the user may perform an additional procedure. The user can then move the anvil 120 from the open configuration to the closed configuration, for example, by moving the actuation wire 40a in a proximal direction, and / or perform additional medical procedures on tissue, such as stapling, cutting, or other procedures. To change the orientation of the stapler device 110 relative to the swing arm 60, the pawl 66' can again be disengaged from the teeth 64a' and the stapler device 110 can be rotated about the axis defined by the pin 60a as described herein. The locking mechanism 64' of Figures 4A and 4B allows for the locking of the stapler device 110 relative to the swing arm 60, regardless of whether the anvil 120 is open or closed.

[0041] Another example locking mechanism of end effector 100'' is described with reference to FIGS. 5A and 5B. End effector 100'' is similar to end effector 100 and 100' and may include, for example, a stapler device 110 and a swing arm 60. The locking mechanism may include a ball nose spring plunger 64'' including a housing 150 secured to a body 130 of stapler device 110. Ball nose spring plunger 64'' may include a detent 64c'' (notch) disposed at a distal end of swing arm 60, a biasing member 64a'' (e.g., a spring, a threaded housing with a spring and a ball bearing, or a plunger, or any other biasing member) disposed within (or on) housing 150 and configured to extend from a proximal end of housing 150, and a ball bearing 64b. The ball bearing 64b'' is inserted within the biasing member 64a'' such that the ball bearing 64b'' is retained by and rotates relative to the biasing member 64a'', and protrudes from the end of the biasing member 64a''.

[0042] As described herein, movement of elongate body 50 relative to swing arm 60 can rotate end effector 100'' about an axis defined by pin 60a. Distal movement of elongate body 50 can increase angle α and compress biasing member 64a'' within housing 150. For example, as angle α increases, stapler apparatus 110 can rotate about an axis defined by pin 60a, which can cause protruding material (teeth) between detents 64c'' to press against ball bearing 64b'', thereby compressing biasing member 64a'' into housing 150. Biasing member 64a'', ball bearing 64b'', and detents 64c'' can cooperate to lock stapler apparatus 110 at different orientation angles α relative to swing arm 60. For example, frictional forces hold ball bearing 64b'' within corresponding detents 64c''. As the stapler apparatus 110 rotates about the axis defined by the pin 60a, the biasing member 64a'' is compressed until the frictional force between the detent 64c'' and the ball bearing 64b'' is overcome. Once this frictional force is overcome, the ball bearing 64b'' moves from the first detent 64c'' to a second detent 64c'' adjacent the first detent 64c''. As the ball bearing 64b'' moves to the second detent 64c'', the biasing member 64a'' returns to its original length / position. Further distal movement of the elongate body 50 may cause the stapler apparatus 110 to pivot about the pivot axis defined by the pin 60a and the biasing member 64a'' to be compressed again. As the biasing member 64a'' is compressed, the ball bearing 64b'' moves from the second detent 64c'' to a third detent 64c'' adjacent the second detent 64c''. Continued distal movement of elongate body 50 increases angle α between axes AA and BB. Alternatively, or additionally, the distal end of end effector 100'' may be pressed against tissue to provide additional leverage and assist in changing angle α.

[0043] To decrease angle α, a force (e.g., a pulling force) applied proximally to elongate body 50 must be sufficient to overcome the frictional force between ball bearing 64b'' and detent 64c''. Once the frictional force is overcome, stapler apparatus 110 moves relative to swing arm 60 such that angle α is decreased. The number of detents 64c'' and the spacing between adjacent detents 64c'' can be selected based on the number of possible positions in which stapler apparatus 110 can be locked relative to swing arm 60. Smaller ball bearings and smaller detents allow for finger adjustment of angle α, providing more options for angle α.

[0044] A method of operating the end effector 100'' will now be described. The end effector 100'' may be introduced into the body and advanced to a target site in a manner similar to end effectors 100 and 100'. The end effector 100 is advanced to the target site in a closed position and opened by actuation of the actuation wire 40a. During insertion, the ball bearing 64b'' may engage the first detent 64c'' such that the angle α is approximately 0 degrees, e.g., the axes AA and BB are approximately parallel. Once the end effector 100'' is adjacent the target site, the user may rotate the stapler apparatus 110 about the pivot axis defined by the pin 60a by pushing the elongated member 50 distally. Distal movement of the elongated member 50 may increase the angle α and cause the biasing member 64a'' to compress within the housing 150. As biasing member 64a'' is compressed into housing 150 from its original length, a second detent 64c'' adjacent to first detent 64c'' engages ball bearing 64b'' and biasing member 64a'' expands to its original length. The frictional force between ball bearing 64b'' and second detent 64c'' locks stapler apparatus 110 relative to swing arm 60. The user may continue to push elongate member 50 distally until a desired orientation of stapler apparatus 110 relative to swing arm 60, e.g., a desired angle α, is achieved.

[0045] To decrease the angle α, the elongate member 50 can be pulled proximally. Such movement compresses the spring 64b'' within the housing 150 and moves the ball bearing 64b'' from, for example, the second detent 64c'' to the first detent 64c''. In this manner, the orientation of the stapler device 110 relative to the swing arm 60 can be selected and locked. The locking mechanism 64'' of FIGS. 5A and 5B allows for the locking and unlocking of the stapler device 110 relative to the swing arm 60, independent of the opening and closing of the anvil 120.

[0046] It will be appreciated that any of the locking mechanisms described herein may be used alone or in combination with one or more of the other locking mechanisms described herein. Although different medical systems have been described, it will be understood that the particular configuration of elements in these fixation systems is not limited. Furthermore, the size, shape, and / or material of the fixation system is not limited. As described herein, various locking mechanisms are included to maintain the orientation of the fixation device of the end effector. For example, the performance of various medical procedures may be improved by ensuring the proper orientation of the end effector relative to the endoscope, and thus the target site / tissue, during a particular procedure.

[0047] It will be apparent to those skilled in the art that various modifications and variations can be made to the disclosed apparatus without departing from the scope of the present disclosure. Other embodiments of the present disclosure will be apparent to those skilled in the art from consideration of the specification and practice of the invention disclosed herein. It is intended that the specification and examples be considered as exemplary only, with a true scope and spirit of the invention being indicated by the following claims.

Claims

1. 1. A medical device, comprising: the medical device comprises an end effector at a distal end of the medical device; The medical device includes an actuator coupled to a proximal end of the end effector; The medical device includes a swing arm swingably coupled to the end effector distal to a proximal end of the end effector, and actuation of the actuator swings the end effector relative to the swing arm; The medical device includes a lock provided on the end effector and the swing arm, the lock having a first state that allows the end effector to swing relative to the swing arm and a second state that restricts the end effector from swinging relative to the swing arm; The lock is a plurality of teeth at a distal end of the swing arm defining a plurality of spaces; a tab connected to the end effector and configured to be disposed within one of the spaces in the second state; and 23. A medical device comprising:

2. The medical device of claim 1 , wherein the end effector includes a first jaw and a second jaw pivotally mounted to the first jaw and configured to move between an open position and a closed position.

3. 1. A medical device, comprising: the medical device comprises an end effector at a distal end of the medical device; The medical device includes an actuator coupled to a proximal end of the end effector; The medical device includes a swing arm swingably coupled to the end effector distal to a proximal end of the end effector, and actuation of the actuator swings the end effector relative to the swing arm; The medical device includes a lock provided on the end effector and the swing arm, the lock having a first state that allows the end effector to swing relative to the swing arm and a second state that restricts the end effector from swinging relative to the swing arm; The end effector includes a first jaw and a second jaw pivotally mounted to the first jaw and configured to move between an open position and a closed position; a medical device, wherein the lock is in the first state when the first jaw and the second jaw are in the open position, and wherein the lock is in the second state when the first jaw and the second jaw are in the closed position.

4. The medical device of claim 2 , wherein the end effector is configured to oscillate independently of movement of the first jaw relative to the second jaw.

5. 1. A medical device, comprising: the medical device comprises an end effector at a distal end of the medical device; The medical device includes an actuator coupled to a proximal end of the end effector; The medical device includes a swing arm swingably coupled to the end effector distal to a proximal end of the end effector, and actuation of the actuator swings the end effector relative to the swing arm; The medical device includes a lock provided on the end effector and the swing arm, the lock having a first state that allows the end effector to swing relative to the swing arm and a second state that restricts the end effector from swinging relative to the swing arm; The lock is a sprocket connected to the swing arm and including a plurality of teeth defining a plurality of spaces; a pawl pivotally connected to a proximal end of the end effector and configured to engage the plurality of spaces; 23. A medical device comprising:

6. 6. The medical device of claim 5, further comprising a wire connected to the pawl and extending proximally, the pawl being biased into engagement with the plurality of spaces in the sprocket, and configured such that moving the wire in the proximal direction swings the pawl away from the sprocket, disengaging the pawl from the plurality of spaces.

7. 7. The medical device of claim 5 or 6, wherein the sprocket is arcuate in shape, and the convex arrangement of the spaces of the sprocket faces proximally.

8. 1. A medical device, comprising: the medical device comprises an end effector at a distal end of the medical device; The medical device includes an actuator coupled to a proximal end of the end effector; The medical device includes a swing arm swingably coupled to the end effector distal to a proximal end of the end effector, and actuation of the actuator swings the end effector relative to the swing arm; The medical device includes a lock provided on the end effector and the swing arm, the lock having a first state that allows the end effector to swing relative to the swing arm and a second state that restricts the end effector from swinging relative to the swing arm; The medical device, wherein the lock comprises a ball nose spring plunger.

9. The ball nose spring plunger is a spring coupled to a first end of the end effector, extending from the first end and configured to be compressed along a compression axis; a plurality of detents secured to the swing arm; a ball bearing connected to the spring and configured to selectively engage each of the plurality of detents and move along the compression axis; The medical device of claim 8 .

10. 10. The medical device of claim 9, wherein the ball bearing is configured to move from a first one of the plurality of detents to an adjacent second one of the plurality of detents as the end effector swings about the swing arm, and the spring is configured to compress from a first position to a second position and expand back to the first position as the ball bearing moves from the first detent to the second detent.

11. 11. The medical device of claim 1, further comprising an actuation wire secured to a proximal end of the end effector, actuation of the actuation wire configured to move the end effector between an open position and a closed position.

12. 1. A medical device, comprising: the medical device comprises an end effector at a distal end of the medical device; The medical device includes an actuator coupled to a proximal end of the end effector; The medical device includes a swing arm swingably coupled to the end effector distal to a proximal end of the end effector, and actuation of the actuator swings the end effector relative to the swing arm; The medical device includes a lock provided on the end effector and the swing arm, the lock having a first state that allows the end effector to swing relative to the swing arm and a second state that restricts the end effector from swinging relative to the swing arm; The swing arm is a first opening at a proximal end of the swing arm; a second opening in a side wall of the swing arm; a lumen extending from the first opening to the second opening; The medical device, wherein the actuator is configured to extend through each of the first opening, the lumen, and the second opening.

13. 1. A medical device, comprising: the medical device comprises an end effector at a distal end of the medical device; The medical device includes an actuator coupled to a proximal end of the end effector; The medical device includes a swing arm swingably coupled to the end effector distal to a proximal end of the end effector, and actuation of the actuator swings the end effector relative to the swing arm; The medical device includes a lock provided on the end effector and the swing arm, the lock having a first state that allows the end effector to swing relative to the swing arm and a second state that restricts the end effector from swinging relative to the swing arm; a handle assembly configured to actuate the end effector and the lock, the actuator having a proximal end connected to a distal end; a catheter including at least one lumen and extending distally from the handle assembly; Further equipped with The medical device, wherein the actuator extends through at least one lumen and the swing arm is fixed to a distal end of the catheter.

14. 14. The medical device of claim 1, wherein a swing angle is defined between a longitudinal axis of the end effector and a longitudinal axis of the swing arm, and distal movement of the actuator is configured to increase the swing angle and proximal movement of the actuator is configured to decrease the swing angle.

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