Sealer-divider-dissector and related methods

Abstract

To provide a sealer-divider-dissector and related methods. [Solution] The surgical instrument includes a pair of jaws for processing tissue placed between them, a housing, a hemostatic forceps gripping mechanism, an elongated shaft positioned between the housing and the pair of jaws and defining a longitudinal axis, and a pull tube at least partially located within the elongated shaft. The hemostatic forceps gripping mechanism includes a link system configured to move the jaws between an open position and a close position, the link system comprising a first shank having a distal end rotatably coupled to the housing at a first fixed pivot point and a proximal end coupled to a first finger grip, a second shank having a distal end rotatably coupled to the housing at a second fixed pivot point and a proximal end coupled to a second finger grip, and a slider link operationally coupled to the first and second shanks.

Description

Technical Field

[0001] 〔Cross - Reference to Related Applications〕 This application claims the benefit under 35 U.S.C. § 119 to U.S. Provisional Patent Application No. 63 / 180782, filed on Apr. 28, 2021, the disclosure of which is incorporated herein by reference in its entirety.

[0002] The present invention relates to surgical instruments. Specifically (but not intending to limit the present invention), embodiments of the present invention relate to surgical instruments for sealing tissue in a surgical procedure.

Background Art

[0003] Surgeons perform procedures in small or narrow spaces, such as in the head / neck or other parts of the body, such as, for example, thyroidectomy, parathyroidectomy, and / or other excisions. Small and narrow areas within the body are tightly packed with structures such as nerves, arteries, the thyroid gland, the esophagus, muscles, and / or other narrow spaces that impede the surgeon's ability to operate during a surgical procedure (e.g., open, general, or laparoscopic).

[0004] Currently, available medical instruments that can potentially cause injury to the patient are used in surgical procedures. For example, FIG. 1 shows a hemostatic forceps - type sealer - divider used in open surgery. However, the hemostatic forceps - type sealer - divider of FIG. 1 is not suitable for laparoscopic procedures because of its large scissor - type arms. Further, the hemostatic forceps - type sealer - divider is difficult to use in certain open procedures, such as in dense body spaces that further limit the surgeon's field of view. Further, when using the device shown in FIG. 1, the maximum opening of Joe is limited by the size of the surgeon's hand.

[0005] As a further example, surgeons can use sealer-dividers with a pistol grip, as shown in Figure 2. While sealer-dividers with a pistol grip enable laparoscopic procedures, the pistol grip can be unstable, especially when the surgeon is opening and closing the end effector during the surgical procedure. For example, instability can arise when pistol-grip instruments are used in opening procedures because they require greater hand / finger movement to reach the actuator, which can lead to the surgeon inadvertently touching a nerve. Many pistol-grip instruments also include a ratchet mechanism that engages when the jaws are closed (to optimize pressure on the tissue during tissue sealing), and after each sealing, the surgeon must "click" the closed handle to release the ratchet mechanism and open the jaws, which further introduces instability during the surgical procedure. Such instability increases the risk of injury to the patient, especially when working in confined spaces (e.g., the head and neck).

[0006] Some patient injuries occur when surgical instruments inadvertently strike nerves and / or when electrical energy, such as that applied during tissue sealing procedures, spreads beyond the intended target tissue. Minimizing patient injury requires minimizing secondary burns and unnecessary contact with sensitive tissues during surgical procedures, but achieving this presents many challenges, especially when working in confined spaces such as the head and neck, and when using currently available equipment.

[0007] The embodiments described herein address these and / or other problems by providing a multifunctional instrument that minimizes instrument instability during surgical procedures, improves surgeon control, increases the surgeon's field of view at the distal end of the instrument, reduces instrument size while increasing jaw opening, and / or reduces the time required for surgical procedures. Some or all of these contribute to smaller patient wounds and improved surgical outcomes. Another advantage of the embodiments described herein is the ability of the instrument's jaws to open wide, which is advantageous during tissue incision regardless of the surgeon's hand size. [Overview of the project]

[0008] In one embodiment, the surgical instrument comprises: a distal portion having a pair of jaws configured to move between an open position and a close position to process tissue placed between them; a proximal portion having a housing and a hemostatic forceps gripping mechanism, wherein the hemostatic forceps gripping mechanism includes a first finger grip and a second finger grip; an elongated shaft positioned between the proximal and distal portions, wherein the elongated shaft defines a longitudinal axis; and a pull tube at least partially disposed within the elongated shaft. The hemostatic forceps grip mechanism of the surgical instrument comprises a link system configured to move a pair of jaws between an open position and a close position, the link system comprising a first shank having a distal end rotatably coupled to a housing at a first fixed pivot point and a proximal end coupled to a first finger grip, a second shank having a distal end rotatably coupled to a housing at a second fixed pivot point and a distal end coupled to a second finger clip, and a slider link operationally coupled to the first and second shanks. The pull tube of the surgical instrument comprises a proximal end coupled to the slider link and a distal end coupled to the pair of jaws, the pull tube configured to move between a first position and a second position proximal to the first position in response to the operation of the first shank and / or the second shank, thereby moving the pair of jaws between an open position and a close position.

[0009] In some embodiments, the link system is a seven-bar link system comprising a first shank, a second shank, a housing, and a slider link. The link system further comprises a first lever link rotatably coupled to the first shank at a first floating pivot point and each of the slider links, a second lever link rotatably coupled to the second shank at a second floating pivot point and the slider link, and a slide track link fixed to or defined by the housing and configured to restrict the slider link to longitudinal movement relative to the housing.

[0010] In some embodiments, the first and second shanks, the second lever link, and the first and second floating links are configured together to vary the mechanical advantage between the open and close positions. In some embodiments, the mechanical advantage arises when the first and second shanks move from the open to the close position in the stroke, and the pair of jaws have a greater stroke distance in the first half of the stroke than in the second half of the stroke. Furthermore, the mechanical advantage arises when the compressive force required to move the first and second grips closer together decreases as the pair of jaws approach the close position.

[0011] In some embodiments, the first and second floating pivot points are configured to move outward from the longitudinal axis defined by the elongated shaft as the pull tube moves distally. Conversely, the first and second floating pivot points are configured to move inward from the longitudinal axis defined by the elongated shaft as the pull tube moves proximal.

[0012] In these embodiments, the link system is configured to prevent the pair of jaws from locking in close proximity. Optionally, the first and second floating pivot points are configured to lock the pair of jaws in close proximity when the first shank and the first lever link form an angle of approximately 180 degrees between them.

[0013] In some embodiments, the slider link comprises a spring housing that accommodates a load-limiting spring, which is configured to limit the tensile force on the pull tube when the pair of jaws are in the close position. The load-limiting spring is configured to disengage from the pull tube when the pair of jaws move from the close position to the open position.

[0014] The surgical instrument further comprises an electrode actuator and a tissue sealing system having a first electrode positioned on the first jaw of a pair of jaws and a second electrode positioned on the second jaw of a pair of jaws. The first and second electrodes are configured to seal tissue positioned between the pair of jaws in response to proximal movement of either one of the electrode actuators, and the electrode actuators move in response to a force applied to either one of the electrode actuators parallel to a longitudinal axis defined by an elongated shaft. The electrode actuators are positioned along and laterally offset from the longitudinal axis defined by the elongated shaft.

[0015] In some embodiments, the link system is configured to vary the mechanical advantage between an open position and a close position. In some embodiments, the mechanical advantage arises when the first and second shanks of the link system move from the open position to the close position during the stroke, so that the pair of jaws have a greater stroke distance in the first half of the stroke than in the second half of the stroke. In this embodiment, the mechanical advantage decreases throughout the stroke. In some embodiments, the mechanical advantage arises when the compressive force required to move the first and second finger grips decreases as the pair of jaws approach the close position.

[0016] In another embodiment, a surgical instrument configured for processing tissue is disclosed. The surgical instrument comprises a handle operably coupled to an end effector by a link system and an elongated shaft, the handle comprising a first shank and a second shank, and the end effector comprising opposing jaws selectively movable between an open position and a close position when the handle is actuated. The link system is configured such that the stroke of the handle moves the opposing jaws to the close position and engages with tissue located between them by moving the first shank and the second shank closer together, the mechanical advantage of which varies during the stroke, and the opposing jaws have a greater stroke distance in the first half of the stroke than in the second half of the stroke.

[0017] In some embodiments, the link system is configured to rotate the first shank around a first fixed pivot of the link system and rotate the second shank around a second fixed pivot of the link system by moving the first and second shanks.

[0018] Optionally, the first and second fixed pivots are offset laterally from the longitudinal axis defined by the elongated shaft.

[0019] In some embodiments, the surgical instrument further comprises one or more electrode actuators, each having a contact surface for a user's finger, wherein at least one of the electrode actuators is positioned along a longitudinal axis defined by an elongated shaft and offset laterally therefrom. At least one contact surface of the actuator is radially offset by a first distance from the longitudinal axis, and a fixed pivot point is radially offset by a second distance greater than the first distance from the longitudinal axis.

[0020] In some embodiments, the surgical instrument further comprises a projection coupled to a slider link, at least a portion of which is slidably positioned within a guide member, and the projection and guide member are configured to prevent rotation of the slider link.

[0021] In yet another embodiment, a method for operating a surgical instrument for processing tissue is disclosed. The surgical instrument used by the operating method comprises a handle operably coupled to an end effector by a link system and an elongated shaft, the handle comprising a first shank and a second shank, and the end effector comprising opposing jaws that are selectively movable between an open position and a close position using the handle. The method involves moving the opposing jaws to the close position by moving the first and second shanks closer together to engage with tissue located between them, varying the mechanical advantage as the opposing jaws move to the close position. Moving the first and second shanks comprises rotating the first shank around a first fixed pivot and rotating the second shank around a second fixed pivot. The first and second fixed pivots are offset laterally from the longitudinal axis defined by the elongated shaft.

[0022] In some embodiments of a method for operating a surgical instrument, the instrument further comprises a load-limiting spring, and the method further includes engaging the load-limiting spring when the pair of jaws is in the close position and disengaging the load-limiting spring when the pair of jaws approaches the open position. The method further includes moving the pair of jaws between the open position and the close position without locking the pair of jaws in the close position.

[0023] In other embodiments, a method of operating an instrument having a hemostatic forceps-type grip mechanism mechanically coupled to a pair of jaws to open and close the pair of jaws is disclosed. The pair of jaws includes electrodes electrically coupled to an actuator disposed at a proximal portion of the instrument and configured to selectively activate the electrodes. The method includes activating the electrodes by applying a compressive force to the actuator parallel to the longitudinal axis of the instrument. In embodiments where the actuator has an outer surface that is radially offset from the longitudinal axis by a predetermined distance, the method further includes rotating a first shank and a second shank about respective pivot points, the pivot points being radially offset from the longitudinal axis by a first distance, the outer surface of the actuator being radially offset from the longitudinal axis by a second distance, and the second distance being greater than the first distance.

Brief Description of the Drawings

[0024] The drawings illustrate the design and utility of the embodiments, and like elements are provided with common reference numerals. These drawings are not necessarily to scale. A more detailed description of the embodiments illustrated in the accompanying drawings is presented below so that it may be better understood how the above and other advantages and objects are achieved. Since these drawings are merely exemplary embodiments, they should not be construed as limiting the scope of the claims.

[0025] [Figure 1] FIG. 1 is a perspective view of a typical device (prior art). [Figure 2] FIG. 2 is a perspective view of another typical device (prior art). [Figure 3] FIG. 3 is a perspective view of a sealer-divider-dissector according to an embodiment of the present invention. [Figure 4] FIG. 4 is a first side view of the device of FIG. 3. [Figure 5] FIG. 5 is a second side view of the device of FIG. 3. [Figure 6] FIG. 6 is a perspective view of some components of the device of FIG. 3. [Figure 7]FIG. 7 is a cross-sectional view of a first side of some components of FIG. 3, overlaid with a schematic view of the link component of FIG. 8. [Figure 8] FIG. 8 is a schematic view of a first side of the link component of FIG. 6. [Figure 9] FIG. 9 is a first side view of the device of FIG. 3, with some components removed for clarity. [Figure 10] FIG. 10 is a second side view of the device of FIG. 3, with some components removed for clarity. [Figure 11] FIG. 11 is an exploded perspective view of the device of FIG. 3, with some components removed for clarity. [Figure 12] FIG. 12 is a first side view of some components of the device of FIG. 3, with some features removed for clarity. [Figure 13] FIG. 13 is a perspective view of the distal end of the device of FIG. 3 grasping tissue. [Figure 14] FIG. 14 is a side view of the distal end of the device of FIG. 3 grasping tissue, with some components removed for clarity. [Figures 15A-15E] FIGS. 15A - 15E show a schematic of the differences between the devices of FIGS. 1 - 3. [Figure 16] FIG. 16 is a flowchart of a typical method of use of the device of FIG. 3.

DETAILED DESCRIPTION OF THE INVENTION

[0026] For the terms defined below, the following definitions apply unless otherwise defined in the claims or elsewhere in the specification.

[0027] All numerical values are assumed to be modified by "about" herein, whether or not explicitly indicated. "About" means a range of numbers that are considered equivalent (i.e., having the same function or result) to the recited value by one of ordinary skill in the art. In many cases, "about" can include numbers rounded to the nearest significant digit.

[0028] A numerical range mentioned by the final point includes all numbers within that range (for example, 1-5 includes 1, 1.5, 2, 2.75, 3, 3.80, 4, and 5).

[0029] In this specification and in the claims, the singular form includes the plural form unless otherwise specified. In this specification and in the claims, "or" includes "and / or" unless otherwise specified.

[0030] Hereafter, various embodiments will be described with reference to the drawings. The drawings are not necessarily to scale, and the relative scale of selected elements may be exaggerated for clarity. Elements having similar structure or function are indicated by the same reference number throughout the drawings. Furthermore, the drawings are for the sole purpose of facilitating the description of embodiments and are not intended to be an exhaustive description of the invention or to limit its scope. The scope of the invention is defined solely by the claims and their equivalents. Moreover, the exemplary embodiments do not necessarily include all of the forms or advantages presented. Forms or advantages described in relation to a particular embodiment are not necessarily limited to that embodiment and can be implemented in any other embodiment that is not so exemplary.

[0031] Those skilled in the art will understand that, as described herein, “tissue dissection” means the procedure of puncturing tissue with the jaws closed or brought close together, and then separating the tissue by opening the jaws of the instrument or separating the jaws from each other. In contrast, “tissue splitting” means, as described herein, the procedure of cutting tissue fixed between the jaws of the instrument.

[0032] Figures 3-5 are perspective, first side, and second side views, respectively, of a sealer-divider-dissector device 100 according to an embodiment of the present invention. The device 100 comprises a proximal portion 102, a distal portion 104, and a body portion 103 positioned between them. The proximal portion 102 allows a user (e.g., a surgeon, clinician) to grasp, handle, and operate the device 100 with one hand. The proximal portion 102 includes an actuator, such as a handle. The distal portion 104 is configured to grasp, hold, and / or process tissue. The distal portion 104 is further configured to seal, divide, and / or incise tissue when the device 100 is operated, as will be further described below. The body portion 103 includes an elongated shaft 118 configured to transmit the surgeon's operation (e.g., translation and / or rotation) of the proximal portion 102 of the device 100 to the distal portion 104 of the device 100. The elongated shaft 118 and / or distal portion 104 can be made rotatable relative to the proximal portion 102 of the device 100.

[0033] The distal portion 104 of the device 100 comprises an end effector 105 having a pair of jaws (i.e., a first jaw 114 and a second jaw 116). The jaws 114 and 116 are configured to move between an open position (Figures 3-5) and a close position (Figures 13 and 14). The close position is defined as the position in which the jaws 114 and 116 are closed when they grasp, hold, and / or restrain tissue placed between them. Those skilled in the art will understand that the close position is determined by the thickness of the tissue, which may change during surgical procedures such as tissue sealing and incision. One or both sides of the jaws 114 and 116 (e.g., a first electrode 136 and a second electrode 138) are provided with one or more non-conductive stopper elements 115 (Figure 14) in a manner familiar to those skilled in the art, which prevent direct contact between the surfaces of the jaws 114 and 116 and avoid electrical short circuits.

[0034] The proximal portion 102 of the device 100 comprises a housing 160 and a hemostatic forceps grip mechanism, a handle, or an actuator 162. The housing 160 and / or the hemostatic forceps grip mechanism / actuator 162 can be formed from one or more components. The hemostatic forceps grip mechanism is defined as a mechanism configured for the user to grip, similar to the hemostatic forceps device in Figure 1 (i.e., different from the pistol grip device in Figure 2).

[0035] As shown in Figure 3, one or more wires 320 extend from a power source 350, such as a radio frequency generator, through the housing 160 to the end effector 105. The wires 320 are configured to deliver energy to the end effector 105. In another embodiment, the wires 320 may extend from the actuator 162 to the end effector 105. In some embodiments, the connection of the equipment 100 to the power source 350 is wireless (not shown). The energy delivered can be radio frequency (RF) energy or energy suitable for sealing, dividing, and cutting tissue.

[0036] As shown in Figures 3-5, the proximal portion 102 of the device 100 further comprises a first shank 112 and a second shank 108, and a link system 120 (Figures 7 and 8) for acting the jaws 114 and 116 to the open and / or close (closed) positions. The first shank 112 is coupled to a first finger grip 110, and the second shank 108 is coupled to a second finger clip 106. Although the finger grips 110 and 106 are shown as rings in the figures, those skilled in the art will see that the finger grips 110 and 106 may include any suitable configuration to ensure a secure grip on the device 100, such as concave / wavy, notched, and / or recessed areas on one or both shanks 112 or 108.

[0037] The proximal portion 102 of the device 100 further includes a finger wheel 128 coupled to an elongated shaft 118. The finger wheel 128 is configured to rotate the elongated shaft 118 and / or jaws 114, 116 relative to the proximal portion 102 of the device 100 (e.g., the housing 160) in response to the operation of the finger wheel 128. In some embodiments, the proximal portion 102 of the device includes a power actuator 132 and a knife actuator 146 on one side (Figures 3 and 4), and an electrode actuator 134 and a knife actuator 148 on the other side (Figure 5). The electrode and knife actuators are described in more detail below.

[0038] Figure 6 is a perspective view of the device 100 with some features removed for clarity. Specifically, Figure 6 shows the hemostatic forceps grip mechanism 162 of the proximal portion 102 of the device 100, which is coupled to the elongated shaft 118 of the main body portion 103, and the end effector 105 of the distal portion 104. The hemostatic forceps grip mechanism 162 includes and / or is coupled to a link system 120 for moving a pair of jaws 114, 116 between an open position and a close position.

[0039] Figures 7 and 8 show details of the link system 120 of the device 100. In particular, Figure 8 is a schematic diagram of the link system 120. The schematic diagram in Figure 8 is superimposed on the device 100 shown in Figure 7. As shown in Figures 6-8, the link system 120 comprises a first shank 112 and a second shank 108. Each shank 112 and 108 has its respective distal ends 113 and 109. The distal ends 113 and 109 of the shanks 112 and 108 are rotatably coupled to the housing 160 (Figure 7). A finger grip 106 is located on or near the proximal end 117 of the shank 108, and a finger grip 110 is located on or near the proximal end 111 of the shank 112 (Figure 6). The link system 120 further comprises a first lever link 124 and a second lever link 122. The first lever link 124 is rotatably coupled to the first shank 112 and the cartridge spring housing 156, while the second lever link 122 is rotatably coupled to the second shank 108 and the cartridge spring housing 156. The cartridge spring housing 156 is restricted to longitudinal movement relative to the housing 160. The cartridge spring housing 156 includes a load limiting spring 158. The rotational movement of the shanks 112 and 108 around their respective distal ends 113 and 109 is configured to be transmitted to the cartridge spring housing 156 and the tubular member 126, so that the tubular member 126 rotates the jaws 114 and 116. In some embodiments, the tubular member 126 is a hollow pull tube or rod. The link system 120 can be operationally coupled to the jaw link system 300 (Figure 13) or to the jaws 114 and 116. The link system 120 is configured to move the jaws 114 and 116 in response to the operation of the shanks 112 and 108.

[0040] As shown in Figures 6-8, the link system 120 comprises a seven-bar link system configured to convert the rotational movement of shanks 112 and 108 into longitudinal movement of the pull tube 126. To facilitate the disclosure of the link system 120, the links are described from right to left (not in numerical order) in the order shown in Figure 8. The link system 120 comprises a base link 1 fixedly coupled to or defined by a housing 160. The base link 1 may be a feature 161 in or fixed to the housing 160. The base link 1 comprises a first fixed pivot point 410 and a second fixed pivot point 420, each of which pivot points 410 and 420 is fixed to the housing (i.e., there is no rotation or translation of the pivot points). The link system 120 further comprises a link 2 and a link 7. Link 2 may be the first shank 112 and link 7 may be the second shank 108. The link system 120 comprises link 3 and link 6. Link 3 can be a first lever link 124 and link 6 can be a second lever link 122. The first lever link 124 is rotatably coupled to the first shank 112 at a first floating pivot point 430, and the second lever link 122 is rotatably coupled to the second shank 108 at a second floating pivot point 440. The floating pivot points 430 and 440 are configured to allow movement of links 3 and 6 relative to their respective coupling links 2 and 7 in response to user movement of shanks 112 and 108, as indicated by the arrows in Figure 8. Thus, the first floating pivot point 430 and the second floating pivot point 440 are configured to move outward from the longitudinal axis of the device 100 when the pull tube 126 moves distally, and further configured to move inward from the longitudinal axis of the device 100 when the pull tube 126 moves proximal.

[0041] The link system 120 further comprises a slider link 5 coupled to links 3 and 6. The slider link 5 may be a cartridge spring housing 156. The cartridge spring housing 156 is coupled to the first lever link 124 and the second lever link 122 via their respective pivot points 450 and 460. The cartridge spring housing 156 is configured to translate in response to the movement of the lever links 124 and 122, as indicated by the arrows in Figure 8. The link system 120 also comprises a slide track link 4. The slide track link 4 is a feature within the housing 160 or is fixed thereto. The slide track link 4 may include one or more flange faces 171, 173 (Figures 6-8 and 11-12) configured to allow longitudinal movement of the slider link 5 or the cartridge spring housing 156 relative to the housing 160.

[0042] Optionally, the cartridge spring housing 156 may be provided with a projection (not shown) on which at least a portion of the projection may be configured to slidably engage with or be slidably positioned within the guide member 480. The guide member 480 includes a complementary groove, track, or other suitable guiding mechanism (not shown) configured to receive and slidably engage with the projection of the cartridge spring housing 156. The guide member 480 and the projection are configured to guide the movement of the cartridge spring housing 156, thereby limiting the movement to two degrees of freedom (i.e., allowing translation along the x-axis and preventing rotation of the cartridge spring housing 156 in the housing 160 of the device 100). As shown in Figure 7 and the schematic diagram of the link system 120 in Figure 8, the guide member 480 is slidably coupled to the cartridge spring housing 156 and is shown on the opposite side of the slide track link 4. The guide member 480 is positioned laterally on the cartridge spring housing 156 and / or rotates clockwise in the XZ plane (Figure 4) of the device 100 so that the guide member 480 is positioned below the cartridge spring housing 156 or in other suitable position that restricts the movement of the cartridge spring housing to translation along the x-axis.

[0043] It should be seen that the length of the links can be varied to change the lever action of the link system 120 and increase the mechanical advantage of the device 100. The link system 120 is configured to give controlled motion to the jaws 114 and 116.

[0044] To operate the link system 120, the user can move the cartridge spring housing 156 proximal (for example, within and / or proximal to the housing) by moving the shanks 112 and 108 closer together (for example, to the closed or close position). Furthermore, the user can move the cartridge spring housing 156 distal (within and / or distal to the housing) by moving the shanks 112 and 108 apart from each other (for example, to the open position). The cartridge spring housing 156 is coupled to the pull tube 126 such that the proximal movement of the cartridge spring housing 156 results in the proximal translation of the pull tube 126, which brings the jaws 114 and 116 into the close position (for example, closed) (Figures 7 and 10). Conversely, distal movement of the cartridge spring housing 156 causes the pull tube 126 to translate distally, which opens the jaws 114 and 116. Therefore, moving the shanks 112 and 108 away from each other (open position) opens the jaws 114 and 116. As shown in Figure 6, the pull tube 126 has a proximal end 126a connected to the cartridge spring housing 156 and a distal end 126b connected to the jaws 114 and 116.

[0045] In some embodiments, the link system 120 is configured to provide an optimal mechanical advantage at the end of the closing stroke, such as when the shanks 112, 108 are brought closer to each other (for example, toward the housing 160). For example, the mechanical advantage of the device 100 arises when the first and second shanks 112, 108 of the link system 120 move from an open position to a close position during the stroke, and the pair of jaws 114, 116 have a greater stroke in the first half of the stroke than in the second half of the stroke. The jaws 114, 116 are considered to be in the close position when they grasp, hold and / or impound the tissue 200 (Figure 13). The close position is determined by the thickness of the tissue 200 between the jaws 114, 116. When the jaws 114 and 116 are in proximity, the pull tube 126 is prevented from moving further proximal, so that further proximity of the shanks 112 and 108 causes the cartridge spring housing 156 to engage with the load limiting spring 158 in a manner known to those skilled in the art. As the tissue 200 between the jaws 114 and 116 is dehydrated, dried, or melted, the tissue 200 tends to become thinner, which redefines the proximity positions of the jaws 114 and 116, allowing the pull tube 126 and the cartridge spring housing 156 to move proximal during the process. In some embodiments, the load limiting spring 158 can be configured to limit the tensile force on the pull tube 126 to about 40 pounds (18.14 kilograms) or less, or about 35 pounds (15.88 kilograms) or less, or about 30 pounds (13.6 kilograms) or less.

[0046] Those skilled in the art will see that at least a portion of the pull tube 126 can be positioned inside the elongated shaft 118 (Figures 9 and 10). The pull tube 126 can be operationally coupled to the link system 120 and / or the cartridge spring housing 156. The pull tube 126 is configured to slide or move between a first position and a second position relative to the elongated shaft 118. The first position of the pull tube 126 responds to the movement of the shanks 112 and / or 108 (e.g., close or closed position), and the second position of the pull tube 126 responds to the movement of the shanks 112 and / or 108 (e.g., open position). The movement of the pull tube 126 engages with the jaw link system 300 (Figure 13) of the end effector 105 at the distal portion 104 of the device 100, causing the pair of jaws 114, 116 to move between the open and close positions. The jaw link system 300 comprises links 302 and 304, which are similar to jaw link systems for operating jaws 114 and 116 known to those skilled in the art. Bringing shanks 112 and 108 closer together brings jaws 114 and 116 closer together. Releasing shanks 112 and 108 releases jaws 114 and 116. Thus, both jaws 114 and 116 move in response to the movement of shanks 112 and 108, as shown in the embodiments disclosed herein. In another embodiment, one of the jaws (112 or 108) moves relative to the other jaw (not shown).

[0047] Figures 9-12 are detailed exploded perspective views of a device 100 according to an embodiment of the present invention. The end effector 105 of the device 100 comprises a cutting mechanism or knife 152 slidably positioned between the jaws 114, 116. In some embodiments, at least a portion of the knife 152 is located within an elongated shaft 118 and is translationally movable with respect to it. The knife 152 is translationally movable between a first position (e.g., a retracted position away from or proximal to the jaws as shown in Figures 9-10 and 14) and a second position (e.g., an active position between the jaws or distally, not shown). The knife 152 moves to the second position in response to operation of either of the knife actuators 146, 148 by the user. The knife actuators 146, 148 are configured to move the knife 152 distally to the second position in response to the proximal movement of the knife actuators 146, 148. The second position of the knife 152 (e.g., the active distal position) is configured to cut, incise, and / or separate tissue 200 grasped, held, and / or restrained between the jaws 114, 116. The device 100 may further include a biasing mechanism, such as a knife spring 154, for biasing the knife 152 toward the first position (e.g., retracted or proximal). The knife tube 150 may be coupled to the knife 152 or formed integrally with the knife. The knife tube allows the knife 152 to be moved by knife actuators 146, 148. The knife tube 150 is configured to allow the knife 152 to be moved regardless of the rotation and / or orientation of the proximal end 102 of the device 100 relative to the housing 160, or vice versa.

[0048] In some embodiments, the pair of jaws 114, 116 have a shape (not shown) for cutting tissue located between the pair of jaws in response to the opening movement of the first shank 112 and the second shank 108.

[0049] The end effector 105 of the device 100 comprises a first electrode 136 located in a first jaw 114 and a second electrode 138 located in a second jaw 116 (Figures 6 and 9-11). The device 100 further comprises a first electrode actuator 132 (Figures 4 and 12) and a second electrode actuator 134 (Figure 5). The first and second electrodes 136, 138 are configured to deliver sealing energy to the grasped, held and / or constrained tissue 200 between the jaws 114, 116 (Figure 13) in response to movement (e.g., proximal direction) of either the electrode actuators 132, 134. The electrode actuators 132, 134 may be or include a switch 130 (Figure 12) for electrically activating the electrodes 136, 138. Those skilled in the art will see that conductive wires 320 connect the electrodes 136, 138 to a power source 350, such as a generator (Figure 3). The generator is described in U.S. Patent No. 1,0342599, issued on 9 July 2019 (which is incorporated herein by reference in its entirety). Those skilled in the art will further see that the sealing system may include features disclosed in U.S. Patent No. 9,144455, issued on 29 September 2015 (which is incorporated herein by reference in its entirety). The teachings of U.S. Patent No. 1,0765471, issued on 8 September 2020, are also incorporated herein by reference in their entirety.

[0050] The sealing system can be configured as a low-power sealing system having a maximum power of 60 watts and 2.5 amps to seal tissue placed, grasped, held and / or restrained between jaws 114, 116, and can be configured to seal tissue in 1 second or less.

[0051] In some embodiments, the knife actuators 146 and 148 are positioned proximal to the electrode actuators 132 and 134, which can improve the stability of the device due to the position of the user's hand during patient treatment. In some embodiments, the knife actuators 146 and 148 are coupled to the knife trigger yoke 144 and / or knife tube 150 to move the knife 152 (Figure 9).

[0052] In some embodiments, the electrode actuators 132 and 134 are positioned along an axis defined by the elongated shaft 118 (e.g., the X-axis in Figure 4) and offset laterally from it. Positioning the electrode actuators 132 and 134 on a plane intersecting this axis minimizes movement of the distal portion 104 of the instrument 100 during surgical procedures, thereby improving the stability of the instrument. For example, as shown in the coordinate system of Figure 4, the electrode actuator 132 is configured to move parallel to the longitudinal X-axis defined by the elongated shaft 118, thereby increasing the stability of the instrument 100 in use. Positioning the electrode actuators 132 and 134 close to the X-axis of the instrument 100 (Figure 4) is achieved by using the seven-bar link system 120 described above (Figures 6-8). The link system 120 is configured to provide adequate clearance or space in the center of the housing 160 for positioning the electrode actuators 132 and 134 (Figure 12), etc. In prior art devices, the electrode actuators are actuated by applying pressure substantially offset from the X-axis of the device and / or perpendicular to the device shaft, resulting in undesirable movement of the distal end of the device when the electrodes are actuated by the user. Undesirable movement (e.g., small tremors) of the distal end of the prior art device near vulnerable body parts (e.g., thin aortic wall, intestinal tract, etc.) may cause unintended rupture, tear, and damage to these sensitive areas. Therefore, the link system 120 allows for the favorable positioning of the electrode actuators 132 and 134 in the device 100 so that the stability of the device 100 (e.g., jaw stability) is relatively greater during use when the electrode actuators 132 and 134 are actuated by the user. Furthermore, the positioning of the electrode actuators 132 and 134 (e.g., symmetrically arranged with respect to the X-axis of the device 100) is ergonomically suitable for right-handed or left-handed users.

[0053] In the disclosed embodiment, the instrument 100 does not have a jaw lock. Those skilled in the art will see that a jaw lock includes a ratchet or other type of pore that holds the jaws closed or close after the user closes and releases the handle. Often, to unlock the jaw lock, the user must perform another operation of the instrument, such as clicking the handle to unlock the jaw lock. By omitting the jaw lock in the disclosed embodiment, the amount of unintended movement of the instrument 100 during treatment is reduced. The omission of the jaw lock in this design also allows for rapid and repeated cutting, grasping, sealing, and splitting of tissue without changing tools and / or inducing unintended movement of the instrument 100 and / or tissue.

[0054] In another embodiment, the link system 120 may be configured to include jaw closing lock in the proximity position. For example, when pivot points 410, 430, and 450 are collinear with respect to each other, pivot points 420, 440, and 460 are collinear with respect to each other (not shown). Thus, the device 100 (e.g., the first and second floating links 430 and 440) may be configured to lock the jaws in the closed and / or proximity position when the first shank 112 and the first lever link 124 form an angle of about 180 degrees between them.

[0055] In the disclosed embodiment, the link system 120 (combined with the increasing force of the load limiting spring 158 as the jaws 114, 116 approach their close position) is configured such that the user's force to hold the shanks 112, 108 (and therefore the jaws 114, 116) in the close position is reduced. That is, the force on the grip mechanism 162 is reduced at the end of the close movement, eliminating the need for jaw closure lock, improving user control and feedback, and reducing user fatigue (by reducing the force required to keep the jaws closed during tissue sealing). The link system 120 is configured to reduce the pushback to the user's hand when the jaws 114, 116 are in the close position compared to the pushback the user's hand receives just before reaching the close position. The reduction in pushback to the user's hand is made possible by having seven bars in the link system 120, as described above. The seven-bar link system 120 is configured to provide a mechanical advantage when the device 100 reaches the close-range position, so that the compressive force applied by the user to the finger clips 106, 110 is less than the force required to reach the close-range position, minimizing user hand fatigue at the close-range position.

[0056] To improve user feedback, such as indicating that jaws 114 and 116 are in close proximity, audible and / or tactile feedback, such as a click board 174 (Figure 12), can be provided. The click board 174 is configured to produce an audible click sound to indicate that jaws 114 and 116 are in close proximity or closed.

[0057] It should be seen that the proximity positions of jaws 114 and 116 can be variable. For example, when tissue 200 is placed, grasped, held and / or constrained between jaws 114 and 116, the tissue 200 prevents jaws 114 and 116 from contacting each other, but jaws 114 and 116 are positioned in proximity or closed (Figures 13 and 14). Further examples are a) when no tissue 200 is placed between jaws 114 and 116, or b) when a very thin tissue 200 is placed between jaws 114 and 116, and jaws 114 and 116 are closed or positioned in proximity (not shown). Jaws 114 and 116 are provided with one or more nonconductive stopper members 115 that prevent direct contact between the surfaces of jaws 114 and 116, thus avoiding short-outs in a manner known to those skilled in the art, but jaws 114 and 116 are positioned in close or proximity as shown in Figure 14.

[0058] In several embodiments, the device 100 can be configured to apply pressure to tissue grasped, held, and / or restrained between the jaws 114 and 116 when the jaws 114 and 116 are in close proximity. In some embodiments, the pressure is approximately 100 pounds per square inch (approximately 689 kilopascals) to approximately 120 pounds per square inch (approximately 827 kilopascals). In some embodiments, the pressure is approximately 50 pounds per square inch (approximately 345 kilopascals) to approximately 180 pounds per square inch (approximately 1241 kilopascals).

[0059] Figures 15A-15E are schematic diagrams of the jaw movement between currently available prior art devices and device 100 according to embodiments of the present invention. Figure 15A is a schematic diagram of the handle opening angle θ of the prior art hemostatic forceps-type sealer-divider of Figure 1. In the case of the device of Figure 1, the jaw opening angle θ' is the same as or substantially the same as the handle opening angle θ. In order to open the jaws widely, such as to cut tissue, the user must spread the handles very wide, resulting in a distance T between the handles. The 1:1 correlation of the opening angles (θ:θ') is problematic for users with small hands. Furthermore, the view is obstructed when working in a confined space using the device of Figure 1. Figures 15B-15C are schematic diagrams of the opening jaw angles of the prior art sealer-divider with a pistol grip (Figure 2). Users of the device of Figure 2 can open the jaws more freely to a wider angle (e.g., angle α or angle β) compared to the angle θ' of the device of Figure 1. The jaw angles α and β are obtained with smaller movement of the pistol grip of the instrument in Figure 2 (angles a and b, respectively). However, the pistol grip causes instability, especially when used in open surgical procedures. Sealer-dividers with pistol grips typically require a jaw closing lock, which further destabilizes the instrument when unlocked.

[0060] Figure 15D is a schematic diagram of the open jaws of a device 100 according to an embodiment of the present invention. Device 100 addresses the aforementioned problems of prior art devices. As shown in Figure 15D, the jaws of device 100 in the schematic diagram open to a wide angle α, which is comparable to the angle α of a pistol-grip type device (Figure 15D), but the distance A between the handles is much smaller than the distance T of a hemostatic forceps type device (Figure 15A). In other words, the distance A between the handles of device 100 is significantly smaller than the distance T between the handles of a hemostatic device when the jaw open angle α of device 100 is equal to the jaw open angle θ of a hemostatic forceps type device. Thus, device 100 disclosed herein is more stable than hemostatic forceps type devices, has better visibility than pistol-grip devices, and has a larger jaw opening. Figure 15E is a comparison of the handle distance or distal grip angle and the respective jaw opening angles in Figures 15A-15D.

[0061] Figure 16 shows a method 1100 using a sealer-divider-dissector according to an embodiment of the present invention. The apparatus 100 is configured to be used in the manner, operation and / or steps described in method 1100. Method 1100 may include engaging a first finger grip with the thumb of the user's first hand 1104. Method 1100 may include engaging a second finger grip with the middle, ring, or little finger of the user's first hand 1106.

[0062] Optionally, method 1100 may include manipulating the first and second shanks 1108. Manipulation 1108 may include manipulating the first shank using the user's thumb and manipulating the second shank using at least one of the user's middle, ring, or little fingers of the same hand to move the pair of jaws between an open position and a closed or close position. Manipulating the first and second shanks 1108 may include applying an opening motion to the first and second shanks using the user's thumb and at least one of the ring or little fingers of the first hand to move the pair of jaws toward the open position, and applying a close motion to the first and second shanks using the user's thumb and at least one of the ring or little fingers of the first hand to move the pair of jaws toward the close position.

[0063] Optionally, method 1100 may include using at least one of the index, middle, or ring fingers of the user's first hand to move the electrode actuator 1110 (for example, proximal) to activate the first and second electrodes.

[0064] Optionally, method 1100 may include using at least one of the index or middle finger of the user's first hand to move the knife actuator 1112 to move the knife distally (for example, proximal).

[0065] Furthermore, method 1100 may include moving the electrode actuator parallel to (e.g., proximal) the axis defined by the elongated shaft 118 using the middle finger of the user's first hand, and moving the knife actuator (e.g., proximal) using the index finger of the user's first hand.

[0066] Furthermore, method 1100 may include releasing the load limiting spring when the pair of jaws approaches the open position and engaging the load limiting spring when the pair of jaws is in the closed or close position.

[0067] Furthermore, method 1100 may include moving a pair of jaws between an open position and a closed or close position multiple times without engaging the jaw closing lock.

[0068] While specific embodiments have been illustrated and described herein, those skilled in the art will see that this invention is not intended to limit the scope of the invention, and it will be apparent to those skilled in the art that various changes, substitutions, and modifications (e.g., different dimensions of parts, combinations of parts) can be made without departing from the scope of the invention. The scope of the invention is defined by the following claims and their equivalents. The specification and drawings should therefore be considered illustrative and not restrictive. The various embodiments illustrated and described herein are intended to encompass alternatives, modifications, and equivalents of the disclosed invention, which may be included in the claims. This disclosure also includes the following aspects: [Aspect 1] Surgical instrument (100), A distal portion (104) having a pair of jaws (114, 116) configured to move between an open position and a close position to process tissue (200) located between them, A proximal portion (102) having a housing (160) and a hemostatic forceps-type grip mechanism (162), wherein the hemostatic forceps-type grip mechanism includes a first finger grip (110) and a second finger grip (106), An elongated shaft (118) positioned between the proximal portion (102) and the distal portion (104), wherein the elongated shaft (118) defines a longitudinal axis, A pull tube (126) is at least partially disposed within the elongated shaft (118), Equipped with, The hemostatic forceps grip mechanism (162) comprises a link system (120) configured to move the pair of jaws (114, 116) between the open position and the close position, wherein the link system (120) comprises a first shank (112) having a distal end rotatably coupled to the housing (160) at a first fixed pivot point (410) and a proximal end coupled to the first finger grip (110), a second shank (108) having a distal end rotatably coupled to the housing (160) at a second fixed pivot point (420) and a proximal end coupled to the second finger grip (106), and slider links (5, 156) operationally coupled to the first shank (112) and the second shank (108), The pull tube (126) comprises a proximal end (126a) coupled to the slider links (5, 156) and a distal end (126b) coupled to the pair of jaws (114, 116), and the pull tube (126) is configured to move between a first position and a second position proximal to the first position in response to the operation of the first shank (112) and / or the second shank (108), thereby causing the pair of jaws (114, 116) to move between the open position and the close position. Surgical equipment (100). [Aspect 2] The link system (120) is a seven-bar link system comprising a first shank (2, 112), a second shank (7, 108), a housing (160), and slider links (5, 156), wherein the link system (120) further comprises a first lever link (3, 124) rotatably coupled to the first shank (112) at a first floating pivot point (430) and each of the slider links (5, 156), and a second floating pivot point (440) A surgical instrument (100) according to embodiment 1, comprising: a second lever link (6, 122) rotatably coupled to the second shank (7, 108) in the slider link (5, 156); and a slide track link (4, 160, 171, 173) fixed to or defined by the housing (160) and configured to restrict the slider link (5, 156) to longitudinal movement relative to the housing (160). [Aspect 3] The surgical instrument (100) according to embodiment 2, wherein the first and second shanks (112, 108), the first and second lever links (124, 122), and the first and second floating links (430, 440) are configured to collectively vary the mechanical advantage between the open position and the close position. [Aspect 4] The surgical instrument (100) according to embodiment 3, wherein when the first and second shanks (112, 108) move from the open position to the close position during a stroke, the pair of jaws (114, 116) have a stroke distance greater than the second half of the stalk in the first half of the stroke. [Aspect 5] A surgical instrument (100) according to embodiment 3, wherein the compressive force required to move the first and second finger grips (110, 106) closer together decreases as the pair of jaws (114, 116) approach the proximity position. [Aspect 6] A surgical instrument (100) according to any one of embodiments 2 to 5, wherein the first and second floating pivot points (430, 440) are configured to move outward from the longitudinal axis defined by the elongated shaft (118) when the pull tube (126) moves distally. [Aspect 7] A surgical instrument (100) according to any one of embodiments 2 to 5, wherein the first and second floating pivot points (430 and 440) are configured to move inward from the longitudinal axis defined by the elongated shaft (118) when the pull tube (126) moves proximal. [Aspect 8] A surgical instrument (100) according to any one of embodiments 2 to 6, wherein the first and second floating pivot points (430 and 440) are configured to lock the pair of jaws (114, 116) in the proximity position when the first shank (112) and the first lever link (124) form an angle of about 180 degrees between them. [Aspect 9] A surgical instrument (100) according to any one of embodiments 1 to 8, wherein the slider link (5) comprises a spring housing (156) that houses a load limiting spring (158), and the load limiting spring (158) is configured to limit the tensile force on the pull tube (126) when the pair of jaws (114, 116) are in the proximity position. [Aspect 10] The surgical instrument (100) according to embodiment 9, wherein the load limiting spring (158) is configured to disengage from the pull tube (126) when the pair of jaws (114, 116) move from the close position to the open position. [Aspect 11] The surgical instrument (100) according to embodiments 1 to 7 or 9 to 10, wherein the link system (120) is configured to prevent the pair of jaws (114, 116) from locking when in the proximity position. [Aspect 12] Furthermore, a surgical instrument (100) according to any one of embodiments 1 to 11, comprising a tissue sealing system having an electrode actuator (132 or 134), a first electrode (136) positioned on the first jaw (114) of the pair of jaws, and a second electrode (138) positioned on the second jaw (116) of the pair of jaws (114, 116), wherein the first and second electrodes (136, 138) are configured to seal the tissue positioned between the pair of jaws (114, 116) in response to the proximal movement of either of the electrode actuators (132, 134), and the electrode actuator (132 or 134) moves in response to a force applied to either of the electrode actuators (132 or 134) in a direction parallel to the longitudinal axis defined by the elongated shaft (118). [Aspect 13] The surgical instrument (100) according to embodiment 12, wherein the electrode actuators (132, 134) are arranged along the longitudinal axis defined by the elongated shaft (118) and offset laterally therefrom. [Aspect 14] A surgical instrument (100) according to any of embodiments 1 to 2 and 6 to 13, wherein the link system (120) is configured to vary the mechanical advantage between the open position and the close position. [Aspect 15] A surgical instrument (100) according to embodiment 14, wherein when the first and second shanks (112, 108) of the link system (120) move from the open position to the close position during a stroke, the pair of jaws (114, 116) have a stroke distance greater in the first half of the stroke than in the second half of the stroke. [Aspect 16] The surgical instrument (100) according to embodiment 15, wherein the mechanical advantage is reduced throughout the entire stroke. [Aspect 17] A surgical instrument (100) according to embodiment 14, wherein the compressive force required to move the first and second finger grips (110, 106) decreases as the pair of jaws (114, 116) approach the proximity position. [Aspect 18] A surgical instrument (100) configured to process tissue (200), wherein the surgical instrument (100) A handle (162) operably coupled to an end effector (105) by a link system (120) and an elongated shaft (118), wherein the handle (162) comprises a first shank (112) and a second shank (108), and the end effector (105) comprises opposing jaws (114, 116) that are selectively movable between an open position and a close position when the handle (162) is actuated, Equipped with, The link system (120) is configured such that the stroke of the handle (162) moves the first and second shanks (112, 108) closer together, thereby moving the opposing jaws (114, 116) to a close position and engaging with the tissue (200) located between them, and the mechanical advantage fluctuates during the stroke, so that the opposing jaws (114, 116) have a greater stroke distance in the first half of the stroke than in the second half of the stroke. Surgical equipment (100). [Aspect 19] The surgical instrument (100) according to embodiment 18, wherein the link system (120) is configured such that the movement of the first and second shanks (112, 108) causes the first shank (112) to rotate around the first fixed pivot (410) of the link system (120) and the second shank (108) to rotate around the second fixed pivot (420) of the link system (120). [Aspect 20] The surgical instrument (100) according to embodiment 19, wherein the first and second fixed pivots (410, 420) are offset laterally from the longitudinal axis defined by the elongated shaft (118). [Aspect 21] Furthermore, the surgical instrument (100) according to embodiment 18 comprises one or more electrode actuators (132, 134), each having a contact surface for a user's finger, wherein at least one of the electrode actuators (132, 134) is positioned along the longitudinal axis defined by the elongated shaft (118) and offset laterally therefrom. [Aspect 22] A surgical instrument (100) according to embodiment 20 or 21, wherein at least one of the contact surfaces of the actuators (132, 134) is radially offset from the longitudinal axis by a first distance, and the fixed pivot points (410, 420) are radially offset from the longitudinal axis by a second distance greater than the first distance. [Aspect 23] Furthermore, the surgical instrument (100) according to embodiment 2 further comprises a projection coupled to the slider link (5, 156), at least a portion of the projection slidably disposed within a guide member (480), and the projection and the guide member (480) are configured to prevent rotation of the slider link (5, 156). [Aspect 24] A method for operating a surgical instrument (100) for processing tissue (200), wherein the surgical instrument (100) comprises a handle (162) operably coupled to an end effector (105) by a link system (120) and an elongated shaft, the handle (162) comprising a first shank (112) and a second shank (108), and the end effector (105) comprising opposing jaws (114, 116) and selectively movable between an open position and an approaching position using the handle (162), The method described above is By moving the first and second shanks (112, 108) closer together, the opposing jaws (114, 116) are moved to a proximity position to engage with the tissue (200) located between them, and the mechanical advantage is varied as the opposing jaws (114, 116) move to the proximity position. method. [Aspect 25] The method according to embodiment 24, wherein moving the first shank (112) and the second shank (108) includes rotating the first shank (112) around a first fixed pivot (410) and the second shank (108) around a second fixed pivot (420). [Aspect 26] The method according to embodiment 25, wherein the first fixed pivot (410) and the second fixed pivot (420) are offset laterally from the longitudinal axis defined by the elongated shaft (118). [Aspect 27] The surgical instrument (100) further comprises a load-limiting spring (158), and the method further comprises The load limiting spring (158) is engaged when the pair of jaws (114, 116) are in the proximity position, When the pair of jaws (114, 116) approach the open position, the engagement of the load limiting spring (158) is released. including, The method according to aspect 24. [Aspect 28] Furthermore, the method according to embodiment 24, comprising moving the pair of jaws (114, 116) between the open position and the close position without locking the pair of jaws (114, 116) in the close position. [Aspect 29] A method for operating an instrument (100) having a hemostatic forceps-type grip mechanism (162) mechanically coupled to a pair of jaws (114, 116) for opening and closing a pair of jaws (114, 116), wherein the pair of jaws (114, 116) includes electrodes (136, 138) electrically coupled to actuators (132 or 134) positioned in the proximal portion of the instrument (100) and configured to selectively operate electrodes (136, 138), The method described above is The electrodes (136, 138) are operated by applying a compressive force to the actuator (132 or 134) in a direction parallel to the longitudinal axis of the device (100). Methods that include... [Aspect 30] The actuator (132 or 134) has an outer surface that is radially offset from the longitudinal axis by a predetermined distance, and the method further, This includes rotating the first shank (2, 112) and the second shank (7, 108) around their respective pivot points (410, 420, 430, 440), The pivot points (410, 420, 430, 440) are offset radially from the longitudinal axis by a first distance, and the outer surface of the actuator (132 or 134) is offset radially from the longitudinal axis by a second distance, and the second distance is greater than the first distance. The method described in aspect 29.

Claims

1. Surgical instruments, A distal portion having a pair of jaws configured to move between an open position and a close position to process tissue located in between, A proximal portion having a housing and a hemostatic forceps-type grip mechanism, wherein the hemostatic forceps-type grip mechanism includes a first finger grip and a second finger grip, An elongated shaft positioned between the proximal portion and the distal portion, wherein the elongated shaft defines a longitudinal axis, A pull tube is at least partially disposed within the elongated shaft, Equipped with, The hemostatic forceps grip mechanism comprises a link system configured to move the pair of jaws between the open position and the close position, the link system comprising: a first shank having a distal end rotatably coupled to the housing at a first fixed pivot point and a proximal end coupled to the first finger grip; a second shank having a distal end rotatably coupled to the housing at a second fixed pivot point and a proximal end coupled to the second finger grip; and a slider link operationally coupled to the first shank and the second shank. The pull tube comprises a proximal end coupled to the slider link and a distal end coupled to the pair of jaws, and the pull tube is configured to move between a first position and a second position proximal to the first position in response to the operation of the first shank and / or the second shank, thereby causing the pair of jaws to move between the open position and the close position. The link system is a seven-bar link system comprising a first shank, a second shank, a housing, and a slider link, and the link system further comprises A first lever link rotatably coupled to the first shank at the first floating pivot point and the slider link, A second floating pivot point and a second lever link rotatably coupled to the second shank in the slider link, A slide track link is fixed to or defined by the housing and configured to restrict the slider link to longitudinal movement relative to the housing, The first and second shanks, the first and second lever links, and the first and second floating pivot points are configured together to vary the mechanical advantage between the open position and the close position. The compressive force required to move the first and second finger grips closer together decreases as the pair of jaws approach the proximity position. Furthermore, the slider link is provided with a projection, at least a portion of which is slidably arranged within a guide member, the guide member is fixed to the housing, and the projection and the guide member are configured to prevent rotation of the slider link. Surgical equipment.

2. The surgical instrument according to claim 1, wherein when the first and second shanks move from the open position to the close position during a stroke, the pair of jaws have a stroke of a greater distance in the first half of the stroke than in the second half of the stroke.

3. The surgical instrument according to claim 1, wherein the first and second floating pivot points are configured to move outward from the longitudinal axis defined by the elongated shaft when the pull tube moves distally.

4. The surgical instrument according to claim 1, wherein the first and second floating pivot points are configured to move inward from the longitudinal axis defined by the elongated shaft when the pull tube moves proximal.

5. The surgical instrument according to claim 1, wherein the first and second floating pivot points are configured to lock the pair of jaws in the proximity position when the first shank and the first lever link form an angle of about 180 degrees between them.

6. The surgical instrument according to claim 1, wherein the slider link comprises a spring housing for a load-limiting spring, and the load-limiting spring is configured to limit the tensile force on the pull tube when the pair of jaws are in the proximity position.

7. The surgical instrument according to claim 6, wherein the load limiting spring is configured to disengage from the pull tube when the pair of jaws move from the close position to the open position.

8. The surgical instrument according to claim 1, wherein the link system is configured to prevent the pair of jaws from locking when in the proximity position.

9. Furthermore, the surgical instrument according to claim 1, comprising an electrode actuator, a first electrode positioned on a first jaw of a pair of jaws, and a second electrode positioned on a second jaw of a pair of jaws, wherein the first and second electrodes are configured to seal the tissue positioned between the pair of jaws in response to proximal movement of either one of the electrode actuators, and the electrode actuator moves in response to a force applied to either one of the electrode actuators in a direction parallel to the longitudinal axis defined by the elongated shaft.

10. The surgical instrument according to claim 9, wherein the electrode actuator is positioned along the longitudinal axis defined by the elongated shaft and offset laterally therefrom.

11. The surgical instrument according to claim 1, wherein the link system is configured to vary the mechanical advantage between the open position and the close position.

12. The surgical instrument according to claim 11, wherein when the first and second shanks of the link system move from the open position to the close position during a stroke, the pair of jaws have a stroke of a greater distance in the first half of the stroke than in the second half of the stroke.

13. The surgical instrument according to claim 12, wherein the mechanical advantage is reduced throughout the entire stroke.

14. The surgical instrument according to claim 11, wherein the compressive force required to move the first and second finger grips decreases as the pair of jaws approach the proximity position.

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