Surgical instruments

Abstract

To provide a surgical instrument that enables joint motions in multiple directions without needing to use two hands and prevents an operation of an effector jaw due to carelessness.SOLUTION: A surgical instrument 10 includes effector jaws 18 and 20 attached to a holding tool 16 fixed to a distal end of a slender trunk part 14. A handle 12 includes: a grip 22 for opening / closing the effector jaws 18 and 20; a joint motion knob 24 for causing the holding tool 16 to execute joint motions; a trunk part rotation knob 26 for rotating the trunk part; and a safety mechanism for automatically preventing an operation of the grip 22 due to carelessness. The jaws 18 and 20 make a pivotal movement around a pin, and are operated by a rod engaged with the grip 22. A lever 124 is pivotally attached to the handle 12, and includes a latch for blocking the movement of the grip 22 so that the lever 12 does not make a pivotal movement in a proximal direction against energization of a spring.SELECTED DRAWING: Figure 1

Description

[Technical field]

[0001] The present invention relates generally to surgical instruments and, more specifically, to devices for applying ligation clips. [Background technology]

[0002] During laparoscopic and endoscopic surgical procedures, surgeons must often terminate the flow of blood or other fluids through one or more blood vessels or ducts. Ligation clips have been applied to blood vessels or ducts to prevent the flow of bodily fluids through the vessels or ducts. Endoscopic clip application surgical instruments have been used to apply ligation clips, such as polymeric ligation clips as disclosed in U.S. Patent Application Publication No. 2017-0311954 A1, which is incorporated herein by reference in its entirety. Such ligation clips are typically fabricated from biocompatible materials and are usually clamped over the vessel or duct. Once applied to the vessel or duct, the clamped clip terminates the flow of fluids through the vessel or duct.

[0003] Clip application surgical instruments typically included an effector jaw at the distal end of a barrel and a handle portion at the proximal end of the barrel. A safety mechanism for actuating the effector jaw was located near the proximal end. [Prior art documents] [Patent documents]

[0004] [Patent Document 1] US Patent Application Publication No. 2017 / 0311954 Summary of the Invention [Problem to be solved by the invention]

[0005] Endoscopic or laparoscopic surgery is often performed remotely from the incision. As a result, application of ligation clips must be accomplished through a restricted field of view or with fewer tactile responses for the surgeon. It would therefore be desirable to improve the manipulation of surgical instruments by providing instruments that have improved dexterity, allow the surgeon to articulate in multiple directions without the need for the use of two hands, and prevent inadvertent actuation of the effector jaws. [Means for solving the problem]

[0006] An improved surgical instrument for procedures such as applying polymeric ligation clips is configured for enhanced maneuverability and one-handed operation. The surgical instrument includes a body with an effector jaw attached to a retainer secured to a distal end thereof. A handle portion is disposed at a proximal end of the body. The handle portion includes a grip for opening and closing the effector jaw. The handle portion also includes a knob for articulating the retainer, a knob for rotating the body, and a safety mechanism for automatically preventing inadvertent actuation of the grip.

[0007] From the foregoing review it will be appreciated that one aspect of the present invention is to provide an improved surgical instrument of the general characteristics set forth above without suffering from the aforementioned disadvantages of the predecessors of the invention.

[0008] It is a feature of the present invention to provide an improved surgical instrument of the general characteristics described above which facilitates the application of ligation clips.

[0009] One consideration of the present invention is to provide an improved surgical instrument of the general characteristics described above which will enable the surgeon to ligate the vessel wall without undue manipulation.

[0010] Another aspect of the present invention is to provide an improved surgical instrument of the general characteristics described above which is suitably adapted for use with conventional ligation clips.

[0011] A further feature of the present invention is to provide an improved surgical instrument of the general characteristics set forth above which is well suited for economical mass production manufacture.

[0012] A further consideration of the present invention is to provide an improved surgical instrument of the general characteristics set forth above with improved maneuverability.

[0013] It is another aspect of the present invention to provide an improved surgical instrument of the general attributes described above that can be articulated in multiple directions without the need for the practitioner to use two hands.

[0014] One consideration of the present invention is to provide an improved surgical instrument of the general characteristics described above including a handle portion having a grip for actuating the effector jaws and a safety mechanism for automatically locking the grip to prevent inadvertent actuation.

[0015] A further feature of the present invention is to provide an improved surgical instrument of the general characteristics described above including a handle portion having a grip for actuating an effector jaw attached to a retainer secured to the distal end of the barrel, a knob for articulating the retainer, a knob for rotating the barrel, and a catch for locking the grip.

[0016] A further feature of the present invention is to provide an improved surgical instrument of the general characteristics described above comprising an elongated body, a retainer secured to a distal end of the body, effector jaws attached to the retainer, a rod disposed within the body, a distal end of the rod operatively connected to the effector jaws for opening and closing the effector jaws, a handle at a proximal end of the body, and a proximal end of the rod secured to a ball, the handle including a linear drive, the linear drive having a socket and a slot, the ball received within the socket, the handle further including a pivotally mounted grip, the grip including main legs, the main legs received in the slots, whereby pivoting of the grip effects linear movement of the rod and movement of the effector jaws relative to one another.

[0017] Another aspect of the invention is to provide an improved surgical instrument of the general characteristics described above comprising an elongated body having an effector jaw attached to a retainer fixed to a distal end of the body, a bifurcated tip sleeve at the distal end of the body, and a handle at a proximal end of the body, the tip sleeve having a pair of spaced apart walls, the retainer having a grooved flange at its proximal end, the grooved flange pivotally joined to the spaced apart walls of the tip sleeve at an axis of rotation, an axially movable tappet carried within the body, the tappet including a tappet foot pivotally joined to the grooved flange at a point offset from the axis of rotation, whereby axial movement of the tappet articulates the retainer relative to the body about the axis of rotation.

[0018] One consideration of the present invention is to provide an improved surgical instrument of the general characteristics described above having an elongated body, an effector jaw disposed near a distal end of the body, a rod disposed within the body, a distal end of the rod operatively connected to the effector jaw for opening and closing the effector jaw, a handle at a proximal end of the body, the handle operatively connected to the proximal end of the rod, and a safety mechanism for automatically preventing inadvertent operation of the handle, the safety mechanism including a lever rotatable from a locked position in which the handle is prevented from rotating in a proximal direction to an unlocked position in which the handle is not prevented from rotating in the proximal direction, the mechanism further including a spring element biasing the lever to the locked position, and a cam rotatable to bear against a surface of the lever to hold the lever in the unlocked position against the bias of the spring element.

[0019] Other aspects, features and considerations of the present invention will be in part obvious and in part pointed out hereinafter.

[0020] With these objects in view, or with reference to the accompanying drawings, it will be seen that the invention comprises embodiments in various combinations of elements, arrangements of parts, and sequences of steps, by which the above-mentioned aspects, features, and considerations, as well as any other aspects, features, and considerations, are accomplished, the scope of which will be more particularly pointed out and defined in the appended claims.

[0021] In the accompanying drawings, various possible exemplary embodiments of the present invention are shown. [Brief description of the drawings]

[0022] [Figure 1] 1 is a schematic diagram of a surgical instrument constructed in accordance with and illustrating the invention, showing a pair of effector jaws attached to a retainer at a distal end of the barrel and a handle portion at a proximal end of the barrel. [Diagram 2] FIG. 2 is an exploded view of the components for closing and opening the effector jaws. [Diagram 3] FIG. 1 is a fragmentary cross-sectional view of a portion of a surgical instrument showing the effector jaws in an open position. [Figure 4] This is a side view. [Diagram 5] FIG. 1 is a fragmentary cross-sectional view of a portion of a surgical instrument showing the effector jaws in a closed position. [Figure 6] FIG. 1 is a side view with the jaws in a closed position. [Figure 7] FIG. 1 is an exploded view of the components of the handle for closing and opening the effector jaws with the safety mechanism oriented to automatically prevent inadvertent actuation of the effector jaws. [Figure 8] FIG. 1 is an exploded view of the components of the handle for closing and opening the effector jaws with the safety mechanism in an unlocked orientation allowing repeated actuation of the effector jaws. [Figure 9] FIG. 13 is an exploded view of the components for articulation of the retainer. [Figure 10]FIG. 5 is a fragmentary cross-sectional view similar to FIG. 4 taken through a portion of the surgical instrument showing a retainer coaxial with the barrel. [Figure 11] FIG. 1 is a fragmentary cross-sectional view through a portion of the surgical instrument showing the retainer in an articulated position. [Figure 12] FIG. 1 is an exploded view of the components for axial rotation of the barrel. [Figure 13] FIG. 1 is a fragmentary side view of a surgical instrument with the safety mechanism in an automatically locking position. [Figure 14] FIG. 14 is an enlarged view of the circled area in FIG. 13. [Figure 15] FIG. 1 is a fragmentary side view of a surgical instrument with the safety mechanism unlocked. [Figure 16] FIG. 16 is an enlarged view of the circled area in FIG. 15. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0023] The present invention will now be described in detail with reference to the drawings, which are provided as illustrative examples of the present invention to enable those skilled in the art to practice the present invention. In particular, the following drawings and examples are not meant to limit the scope of the present invention to a single embodiment, and other embodiments are possible through the replacement of some or all of the elements described or shown.

[0024] Applicant does not intend any unusual or special meaning to any term in the specification or claims unless expressly so stated. Moreover, the present invention includes present and future known equivalents to the known components illustrated herein.

[0025] Referring now to the drawings, reference numeral 10 indicates a surgical instrument constructed in accordance with and usable for procedures such as applying polymeric ligation clips, illustrating the present invention. The instrument 10 includes a handle portion 12 at a proximal end, a hollow cylindrical main body 14 extending along a longitudinal axis 15, and a retainer 16 which holds a pair of effector jaws 18, 20. The handle portion 12 includes a grip 22, a handle 23, an articulation knob 24, and a handle rotation knob 26, all of which are positioned in close proximity to one another for one-handed operation, such as for squeezing and releasing the grip 22 by the practitioner's fingers and for rotation of the knobs 24 and 26 by the practitioner's thumb and / or index finger with the practitioner's palm resting against the handle 23.

[0026] With reference to FIG. 2, it will be noted that the jaws 18, 20 are actuated through a terminal clevis 30 which is connected to the end of a rod 32 by means of a link 29 similar to a single link of a roller chain. A journal 41 projects from the distal end of the rod 32 through a proximal hole in a pair of side plates 35, and a pin 43 extends through a distal hole in the side plates 35 and through a hole in a clevis flange 45. A further pin 34 extends through opposing faces of the clevis 30 and engages curved cam slots 36, 37 in each of the jaws 18, 20. Linear movement of the clevis 30 and rod 32 causes the jaws 18, 20 to pivot about a pin 38 which extends through a yoke 40 of the retainer 16 as shown in FIG. 9. A portion of the jaws 18, 20 is received inside the yoke 40.

[0027] The proximal end of rod 32 is secured to the distal end of drawbar 42, which includes a ball 44 at its proximal end. A cylindrical linear drive 46 is inserted into a hollow casing 47 of handle portion 12 and further includes a socket 48 for receiving ball 44 therein. A primary leg 50 of handgrip 22 comprises a welded laminate of three plates 150, 152 and 154 and a cam surface 54, the primary leg 50 being received in a slot 52 of linear drive 46. With reference to FIG. 7, it will be noted that as handgrip 22 is pulled towards handle 23, primary leg 50 pivots about a pin 56 secured in a hole 62 in handgrip 12, compressing return spring 60 and moving linear drive 46 and ball 44 in a proximal direction along axis 15.

[0028] Simultaneously, the drawbar 42, rod 32 and terminal clevis 30 move proximally, moving the effector jaws 18, 20 from the normally open position shown in FIG. 3 to the closed position shown in FIG.

[0029] 9, the articulation components of the retainer 16 are illustrated as including a reduced thickness proximal channel flange 64 having spaced parallel plates 65 that are received between parallel spaced walls 63 of a channel 66 formed in a distal sleeve 68. A journal 70 projects from each of the plates 65 and fits within a hole 72 in the channel walls 63. The distal sleeve 68 is received within the distal end of the body 14.

[0030] Articulation of the retainer 16 about an axis of rotation 71 concentric with the journal 70 is provided through reciprocal axial movement of a hollow tappet 74 extending through the body 14. The ends of legs 75 extending from the distal ends of the tappets 74 are received between the plates 65. A pin 73 extends through an offset hole 79 in the plates 65 and through the ends of the legs 75. Thus, axial movement of the tappets 74 provides articulation of the retainer 16 about the journal 70. Extending through the hollow tappet 74 is a drawbar 42, and a pair of gasket seals 45 are provided between the drawbar 42 and the tappet 74.

[0031] As shown in Figure 9, rotation of the articulation knob 24 leads to axial movement of the tappet 74 via turning a cylindrical cam 76 having a helical groove 77. The cam 76 is mounted over a collar 78 that is fitted onto the distal end of the linear drive 46. The collar 78 is fitted over a ring 80 that is secured to the tappet 74 against relative axial movement by a pair of retaining rings 82 that fit into corresponding retaining ring grooves 84. A pair of diametrically opposed cam followers 86 are secured to the ring 80 and engage the helical groove 77 of the cam 76.

[0032] The follower 86 also extends into a pair of diametrically opposed grooves 87 in the collar 78. Thus, through engagement between the cam follower 86 and the cylindrical cam 76, rotation of the articulation knob 24 causes axial movement of the tappet 74 and pivotal movement of the retainer 16 about the axis of the journal 70.

[0033] Housed within the articulation knob 24 is an internal gear 88 which rotates with the knob 24. As the knob 24 rotates, the teeth of the gear 88 engage a pair of ball detent catches 90 housed in diametrically opposed sockets in the collar 78, providing incremental rotation with yieldable and audible limit stops.

[0034] Ideally, the dimensions of the effector jaws 18, 20 and retainer 16 are minimized for ease of maneuverability within the body cavity. By way of example, the length of each effector jaw from its distal tip to the center of the pivot pin 38 is approximately 29 mm, and with the retainer 16 articulated to a maximum offset angle of 50 degrees, as shown in FIG. 10, the distance from the center of the retainer pivot pin 70 to the distal tip of the effector jaws 18, 20 in the open position is approximately 50 mm.

[0035] 12, received and secured to the proximal end of the barrel 14 is a reduced diameter projection 94 of the stepped collar 92. A shoulder of the intermediate diameter section 96 abuts the proximal end of the barrel 14. A larger diameter proximal section 98 of the collar 92 is received within the inner diameter of a main sleeve 100. Also disposed within the inner diameter of the main sleeve is a transition sleeve 102 with a gasket 104 abutting the proximal end of the collar 92 and a further gasket 106 disposed on the sleeve 102. When assembled, a flushing flow path is provided through aligned openings 108, 110 and 112 in the barrel knob 26, stepped collar 92 and main sleeve 100, respectively. A flushing outlet assembly 115 fits within the barrel knob opening 108.

[0036] Housed within the proximal end of the main sleeve inner diameter 100 are a gasket 114, a ring gear 118, and an end collar 120. It should be noted that the end collar 120 and ring gear 118 remain stationary as the barrel rotation knob 26, stepped collar 92, and main sleeve 100 rotate in unison. As the main sleeve 100 rotates, the teeth of the ring gear 118 engage a ball detent catch 122 housed in a socket 119 in the main sleeve 100, incrementally rotating the barrel 14 with yieldable and audible limit stops.

[0037] Consistent with the present invention, a safety mechanism is provided to ensure against unintentional actuation of the effector jaws 18, 20. Referring to Figure 7, where the grip 22 of the handle portion 12 is shown in the automatically locked position, the lock / unlock lever 124 includes a pair of knurled finger bars 126 at the distal end of an integral arm 127. An upper portion of the lock / unlock lever 124 is received within a hollow portion of the handle 23. The lock / unlock lever 124 is configured to pivot about a pin 128 that extends through the handle 23.

[0038] Projecting distally from the top of the lock / unlock lever 124 is an integral catch 130 with a concave abutment end 132. Joining the arm 127 and catch 130 together is a curved portion 134 with a distal surface 136 and a proximal surface 176. It should be noted that the plate 154 includes a proximally projecting strike leg 156 with an abutment end 158.

[0039] A left toggle arm 160 and a right toggle arm 162 are fixed to opposite ends of a cam shaft 164 for rotation along opposite faces of the handle portion 12 between an automatic locking position, shown in FIG. 14, and an unlocked position, shown in FIG. 16. The inner face of each toggle arm includes a recess 166 which receives a ball detent 168. The ball detent 168 seats within a detent 170 in the locked position and within a detent 172 when the toggle arms are in the unlocked position. A locking pin 173 prevents further rotation of the toggle arms once the ball detent seats within the detent 170.

[0040] 14, with the toggle arms 160, 162 in the self-locking position, the handle 22 is prevented from moving proximally by abutting contact between the respective abutment ends 132 and 158. A spring-loaded ball assembly 174 is housed in the proximal end of the handle portion 12 and bears against the proximal face 176 of the curved portion 134, while a cam 178 fixed to the cam shaft 164 bears against the distal face 136 of the curved portion 134.

[0041] The surgeon can grasp the knurled finger bar 126 and pull the lock / unlock lever 124 proximally against the bias of the spring-loaded ball assembly 174, causing the lock / unlock lever 124 to rotate about the pin 128 so that the strike foot 156 is no longer aligned with the catch 130, unlocking the grip 22. The grip 22 can then be pulled proximally to open the effector jaws 18, 20, for example, to install or remove a ligation clip. When the knurled finger bar 126 is released, the lock / unlock lever 124 returns to its FIG. 14 position by the bias of the spring and ball assembly 174 against the proximal surface 176.

[0042] In FIG. 16, the components of the safety mechanism are shown disengaged so that the grip 22 can be pulled without having to rotate the lock / unlock lever 124. To disengage the safety mechanism, the toggle arms 160, 162 along with the cam shaft 164 are rotated approximately 90 degrees counterclockwise (as viewed in FIGS. 13-15) until the ball catch 168 seats in the detent 172 as shown in FIG. 16. Rotation of the cam shaft 164 causes the cam 178 to bear against the distal face 136, rotating the lock / unlock lever 124 counterclockwise against the bias of the spring and ball assembly 174 to its FIG. 16 position where the strike foot 156 is no longer aligned with the catch 130 and the grip 22 is free to be repeatedly actuated throughout the surgical procedure.

[0043] The specific combinations of elements and features in the embodiments detailed above are illustrative only, and the interchangeability and substitution of these teachings with other teachings in this application is expressly contemplated. As those skilled in the art will recognize, variations, modifications, and other implementations of what is described herein may occur to those of ordinary skill in the art without departing from the spirit and scope of the invention as set forth in the claims.

[0044] Having described preferred embodiments of the present invention, it will now be apparent to one of ordinary skill in the art that other embodiments embodying the present concepts may be used. Moreover, one of ordinary skill in the art will appreciate that the embodiments of the present invention described herein may be modified to accommodate and / or conform to changes and improvements in the applicable art and standards referenced herein.

[0045] Variations, modifications, and other implementations of what is described herein may occur to those of ordinary skill in the art without departing from the spirit and scope of the invention as set forth in the appended claims. It is understood, therefore, that these embodiments should not be limited to disclosed embodiments, but rather should be limited only by the spirit and scope of the appended claims.

[0046] Having thus described the invention, we now claim it as new and as claimed to be secured by Letters Patent.

Claims

1. 1. A surgical instrument comprising: an elongated body; a retainer secured to a distal end of the body; an effector jaw attached to the retainer; a rod or cable disposed within the body; a distal end of the rod or cable operatively coupled to the effector jaw for opening and closing the effector jaw; and a handle at a proximal end of the body, the handle comprising a linear drive, the proximal end of the rod or cable operatively connected to the linear drive, the linear drive having a slot, the handle further comprising a pivotally mounted grip, the grip comprising main legs, the main legs received in the slots, whereby pivoting of the grip controls linear movement of the rod or cable and the effector jaws relative to one another.

16. The surgical instrument of claim 15, further comprising a handle for rotating the barrel knob and a main sleeve, the handle further comprising a barrel rotation knob and a main sleeve, the barrel rotation knob, the barrel and the main sleeve coupled to rotate in unison, a ring gear received within the main sleeve, the ring gear remaining stationary as the barrel rotation knob, the barrel and the main sleeve rotate in unison, the handle further comprising a stopper with a ball detent mechanism extending radially through the main sleeve, the stopper with the ball detent mechanism engaging the ring gear, whereby rotation of the barrel rotation knob increments the rotation with an audible limit stop as the ball detent mechanism urges the stopper against the ring gear.

2. The surgical instrument of claim 1 , wherein the handle comprises a retainer articulation tab and a safety mechanism to prevent the effector jaws from closing upon inadvertent manipulation of the grip.

3. 3. The surgical instrument of claim 2, wherein the safety mechanism comprises a lever rotatable from a locked position in which the grip is prevented from rotating to an unlocked position in which the grip is not prevented from rotating, the safety mechanism further comprising a spring element biasing the lever to the locked position.

4. 2. The surgical instrument of claim 1, wherein each effector jaw comprises a cam slot and a pin operably connected to the distal end of the rod or cable, the pin extending transversely through the cam slot such that linear movement of the rod or cable moves the effector jaws relative to one another.

5. The surgical instrument of claim 4, wherein the distal end of the rod or cable is connected to a terminal link and the pin extends through opposing faces of the terminal link.

6. 10. The surgical instrument of claim 1, further comprising a return spring biasing the linear drive to urge the linear drive and the rod or cable distally such that the effector jaws are normally open.

7. The surgical instrument of claim 1 , wherein the main leg comprises a stack of plates including cam surfaces, the cam surfaces being received in the slots.

8. The surgical instrument of claim 1 , wherein the barrel, the barrel rotation knob, the main sleeve and the ring gear are coaxial.

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