A multi-mode surgical instrument

ES 2 308 317 T3

DESCRIPTION

Multimode surgical instrument.

Background of the invention

1. - Field of the invention

The invention relates generally to the field of surgical instruments for use in performing minimally invasive surgical procedures.

2. - Description of the prior art

Endoscopic surgery relies on miniature scopes and video cameras that allow viewing of internal organs through miniature incisions. This provides the surgeon with a clear image, either on a video screen above the operating table or on a video screen attached to the head. The surgeon then performs operative tissue and organ measurements (i.e. moving, cutting, coagulating, manipulating, etc.) while operating a series of endoscopic surgical hand instruments that are inserted via small incisions and viewed, during the operation, through the scope or video camera.

Current endoscopic surgical instruments can be divided into three categories; intended life and use; electrosurgical instruments; and inert instruments. For intended life and use, the instruments can be a single-use instrument that is disposable, a multipurpose instrument that is reusable, or a reusable instrument of limited duration that is semi-disposable. In the limited life reusable instrument, the instrument is intended to be reusable, but crucial items can be substituted, such as inserts on the tips, blades, and insulation.

Electrosurgical instruments are those in which the instrument can provide an electrocautery feature in conjunction with a mechanical feature, such as cutting with scissors and dissecting with dissectors. Subcategories for electrosurgical instruments are monopolar instruments, bipolar instruments, and DC instruments. A monopolar instrument includes a positive conductor that delivers current to the patient to cut or cauterize the anatomy of the patient's body that comes into contact with the monopolar instrument. The current leaves the patient through an earth connection in contact with the patient's body. In a bipolar instrument, a positive lead and a negative lead are each in contact with the anatomy of the patient. The positive conductor sends current to the patient and the negative conductor returns the electrical current back to the power source, through the instrument. The anatomy is cut or cauterized in the selected area of ​​the anatomy between the positive and negative leads. In a direct current instrument, a positive conductor and a negative conductor are used in the same way to cut or cauterize the selected area of ​​the anatomy between the positive and negative conductors.

An example of a surgical instrument is described in US Patent No. 5,282,800 issued to Foshee et al. (The '800 patent). The '800 patent discloses a handle assembly that includes an actuator for creating motion to grasp animal anatomy. A source of electrical power is provided in the handle assembly. A cartridge movably supports a pair of clamping members. The cartridge includes an electrical conductor that extends to the pinch members and to a drive for transmitting motion to the pair of pinch members. The handle assembly includes a docking station for removably supporting the cartridge. The host station has an electrical contact and an interface. The electrical contact is to transmit energy from the source to the electrical conductor in the cartridge. The interface is for transmitting movement from the actuator to the transmission in the cartridge. The receiving station includes a lid that can be moved between an open position, to receive the cartridge, and a closed position, to retain the cartridge.

An example of a cartridge for use in surgery is described in US Patent No. 5,913,874 issued to Berns et al. (The 874 patent). The '874 patent discloses a cartridge for placement in a handle assembly receiving station according to the preamble of claim 1. The cartridge includes an end-extending housing to be supported by the handle assembly. The cartridge also includes a pair of clamping members that are movably supported at the end of the housing. An anchor is disposed on the housing to prevent relative movement between the housing and the handle assembly. A transmission extends through the housing to transmit rectilinear motion from an interface, at the host station, to the clamping members.

Based on the above, it is easy to relate it to the current realities of operating rooms where a large inventory of specific instruments must be maintained at a high cost. Even managing and maintaining this inventory is expensive and complex. Disposable instruments are an added direct cost for each surgery, while maintenance of reusable and reusable instruments of limited duration requires trained personnel and specific facilities and powers to sterilize.

ES 2 308 317 T3

Summary and advantages of the invention

The present inventions provide multimode surgical instruments each comprising a handle assembly to be grasped by medical personnel and a source of electrical power. The handle assembly includes a primary actuator and a take-up station. The primary actuator creates motion to displace a pair of clamping members to clamp animal anatomy. The host station receives any one of several cartridges, each of which supports a pair of such gripper members. The host station has a first electrical contact, a first interface, and a second interface. The first electrical contact transmits electrical energy from the electrical power source through a first cartridge to a first pair of clamping members. The first interface transmits movement from the actuator to the first pair of gripper members. The second interface transmits movement from the actuator to a second pair of clamping members of a second independent cartridge.

By incorporating at least two types of interfaces, which are activated by the same actuator, there can be more than one type of cartridge within the receiving station of the surgical instrument. Therefore, the possibility of using more than one type of cartridge, with the same handle, each with a different type of interface, provides flexibility for surgery and inventory maintenance. Furthermore, by providing the handle assembly with the actuator and electrical contacts, if the surgical cartridge is intended to be desirable, the material that is ultimately discarded can be minimized.

Brief description of the drawings

Other advantages of the present inventions will be readily appreciated, as they are better understood with reference to the following detailed description when considered in conjunction with the accompanying drawings, in which:

Figure 1 is a perspective view of the surgical instrument of the subject inventions being used in a surgical setting;

Figure 2 is an exploded perspective view of the handle assembly and of a bipolar surgical cartridge with a dissecting blade;

Figure 3a is a partial cross-sectional view of a monopolar surgical cartridge for use in the surgical instrument;

Figure 3b is a partial cross-sectional view of a monopolar surgical cartridge for use in the surgical instrument;

Figure 3c is a partial cross-sectional view of a monopolar surgical cartridge for use in the surgical instrument;

Figure 3d is a partial cross-sectional side view of a handle assembly for use in the surgical instrument;

Figure 4 is a partial cross-sectional side view of a handle assembly with the trigger relaxed;

Figure 5 is a partial cross-sectional side view of a handle assembly with the trigger pulled toward the handle;

Figure 6 is a partial cross-sectional side view of a surgical instrument having a bipolar surgical cartridge inserted into the handle assembly with the clamping members in the open position and the dissecting blade in the retracted position;

Figure 7 is a partial cross-sectional side view of a surgical instrument having a bipolar surgical cartridge inserted into the handle assembly with the clamping members in the closed position and the dissecting blade in the extended position;

Figure 8 is a partial cross-sectional side view of a surgical instrument having a monopolar surgical cartridge inserted into the handle assembly with the clamping members in the open position;

Figure 9 is a partial cross-sectional side view of a surgical instrument having a monopolar surgical cartridge inserted into the handle assembly with the clamping members in the closed position;

Figure 10 is a front view of a handle assembly with no cartridge inserted into the handle;

Figure 11 is a partially sectional side view of a second interface for the handle assembly;

Figure 12 is a front view of the second interface of Figure 11 for the handle assembly;

Figure 13 is a partially sectional side view of a seat for the handle assembly biasing device;

Figure 14 is a front view of the seat of Figure 13 for the handle assembly biasing device;

Figure 15 is a front view of a first interface for the handle assembly;

Figure 16 is a cross-sectional side view of the first interface of Figure 15 for the handle assembly;

Figure 17 is a side view of a trigger for the handle assembly;

Figure 18 is a front view of the trigger of Figure 17 for the handle assembly;

Figure 19 is a side view of a handle for the handle assembly ;

Figure 20 is a front view of the handle of Figure 19 for the handle assembly;

Figure 21 is a side view of a reactor for the handle assembly;

Figure 22 is a front view of the reactor of Figure 21 for the handle assembly;

Figure 23 is a top plan view of the reactor of Figures 21 and 22 for the handle assembly;

Figure 24 is an inside side view of one half of the handle assembly housing; and Figure 25 is a partial cross-sectional side view of a handle assembly for use with a surgical cartridge having a cap and five electrical contacts, including the contacts for DC instrumentation.

Detailed description of the preferred embodiment

Referring to the figures, in which like numbers indicate like parts throughout the various views throughout the document, a multimode surgical instrument for performing electrosurgical procedures is shown at 40. Surgical instrument 40 performs various cutting and cautery procedures on animal anatomy, primarily with the use of electrical current. Animal anatomy can include, but is not limited to, human or animal tissues, muscles, blood vessels, and tendons. The electrical current can be monopolar, bipolar, or direct current and is supplied by connecting the surgical instrument 40 to a power source 42, as shown in Figure 1. It is preferable, for safety reasons, that current is supplied only from power source 42 to surgical instrument 40 when a switch, such as a foot pedal 44, is depressed by medical personnel using surgical instrument 40.

Surgical instrument 40 includes a handle assembly 46 to be grasped by medical personnel, and a source 48 of electrical power. Handle assembly 46 receives various types of surgical cartridges 50, 52 that are either bipolar 50 or monopolar 52. However, it will be appreciated that other types of surgical cartridges 50, 52 are also possible, such as a DC surgical cartridge.

Each type of surgical cartridge 50, 52 is rotatably supported on handle assembly 46 and comprises a housing 54, a pair of clamping members 56, 58, an anchor 60, a transmission 62, and at least one electrical conductor 72, 74. Housing 54, which is tubular, extends to a distal end of handle assembly 46. Anchor 60, which is a radial ring 140, is disposed on housing 54 and prevents relative longitudinal movement between housing 54 and handle assembly 46 when ring 140 is engaged with handle assembly 46. The clamping members 56, 58 may be of any shape to facilitate clamping of the anatomy, such as clamps 56 or staples 58. However, the clamping members 56, 58 are not limited to clamps 56 and staples 58, but can also be scissors or probes. Furthermore, the type of clamping members 56, 58 is not limited to the type of energy or current supplied to the surgical cartridge 50, 52. Therefore, it will be appreciated that a bipolar cartridge may incorporate staples 58 or any other type of clamping member. Similarly, the monopolar surgical cartridge may incorporate clamps 56 or any other type of clamping member.

Transmission 62 includes a shaft 64 that is supported by housing 54 movably, and connected to a disk 66 at one end and pinch members 56, 58 at the other end. Disc 66 extends radially from shaft 64 and is rectilinearly movable relative to housing 54 when in position.

ES 2 308 317 T3 engaged with handle assembly 46. Shaft 64 surrounds and is slidably supported 102 around, or slidable 102 within, tubular housing 54 to transmit rectilinear motion relative to housing 54 to open or close pair of pinch members 56, 58.

A rotatable dial 86 may surround housing 54 or transmission 62 to allow rotation of cartridge 50, 52 within handle assembly 46. In addition, a port 70 may be formed, to flush and sterilize the interior of the surgical cartridge 50, 52, through the dial 68 and the housing. Alternatively, if surgical cartridge 50, 52 does not have a quadrant 68, port 70 can only be formed through housing 54.

A first electrical conductor 72 is provided in housing 54 for a monopolar surgical cartridge 52. For a bipolar surgical cartridge 50, a first and a second electrical conductor 72, 74 are disposed in the housing.

Additionally, surgical cartridge 50 may also include a dissecting blade 76. In this configuration, a stem 78 is supported within tubular housing 54 for rectilinear movement between a retracted position, as shown in Figure 7, and an extended position, as shown in Figure 8, between a pair of members. 56 clamping. Stem 78 extends from tubular housing 54 and a fitting 80 extends radially from stem 78 for actuation when engaged with handle assembly 46. Dissecting blade 76 may extend from one end of stem 78 to perform dissection during use of surgical instrument 40. Although, the use of the stem 78 and dissecting blade 76 is illustrated with the bipolar surgical cartridge 50, it will be appreciated that the dissecting blade 76 is not limited to this configuration, and can be used with other types of surgical cartridges.

Handle assembly 46 includes a handle 82, a primary actuator 84, a receiving station 86, a support saddle 88, and electrical connectors 90, 92. The handle 82 is to be grasped by medical personnel. The primary actuator 84 includes a trigger 94 to be displaced relative to, in reaction to, the grip of the handle 82 and to create a movement to displace a pair of clamping members 56, 58 to clamp the anatomy.

The host station 86 is provided to receive any one of several cartridges 50, 52. The host station 86 has a housing 96, a first and a second interface 98, 100, electrical contacts 101, 103, and a cover 102. The Host station 86 has a front wall 105 defining a clamp 104 of a fixed diameter. More specifically, clamp 104 is between housing 96 and cover 102. Each surgical cartridge 50, 52 has a cylindrical neck 106 with a diameter equal to the diameter of the clamp 104 of the host station 86. Therefore, when a surgical cartridge 50, 52 is inserted into the receiving station 86, the neck 106 of the surgical cartridge 50, 52 is rotatably supported by the neck 106.

When a surgical cartridge 50, 52 is inserted into the receiving station 86, the anchor 60 is inserted into the support saddle 88 to prevent relative movement between the anchor 60 and the handle assembly 46. Support saddle 88 is semicircular to allow radial rotation of anchor 60 within support saddle 88. The first and second interfaces 98, 100 are intended to receive the disk 66 of the transmission 62, and are located on each side of the support saddle 88, within the housing 96. Like the support saddle 88, each interface 98, 100 has a semi-circular profile not only to receive disk 66, but to allow radial rotation of disk 66 within interface 98, 100. If, for example, the surgical cartridge 50, 52 is a monopolar surgical cartridge 52, the disc 66 may be inserted into the second interface 100. When a bipolar surgical cartridge 50 is inserted into the host station 86, the disc 66 can be inserted into the first interface 98. To provide additional structure for surgical cartridges 50, 52, a plurality of holders 108 are formed in the housing 96. Each bracket 108 has a semi-circular profile to seat transmission 62 and / or housing 54 and allow radial rotation.

The trigger 94 of the primary actuator 84 is connected to the first and second interfaces 98, 100. Trigger 94 is operatively connected to first interface 98 to transmit motion from primary actuator 84 to a pair of pinch members 56, 58. Link 110 connects trigger 94 to second interface 100 to transmit motion from primary actuator 84 to a pair of clamping members 56,58 when a surgical cartridge 50, 52 is received at host station 86. When trigger 94 is pulled toward handle 82, first, and second interfaces 98, 100 slide straight away from support saddle 88 in opposite directions.

In addition, a reactor 112 is disposed in the housing 96 of the host station 86 to resist movement that displaces the clamping members 56, 58 when a disk 66 of a surgical cartridge 50 is disposed in engagement with the first interface 98. The Reactor 112 includes a compression spring 114 that reacts against front wall 105 of housing 96. When the disk 66 of the transmission 62 of the bipolar surgical cartridge 50 is disposed at the first interface 97, a radial edge 117 extending from the disk 66 engages the reactor 112. Therefore, when the trigger 94 is pulled toward the handle 82, reactor 112 reacts against front wall 105 of housing 96, creating a "spring loaded" feel when trigger 94 is actuated. Because edge 116 is radial, disc 66 of bipolar surgical cartridge 50 remains engaged with reactor 112 even if bipolar surgical cartridge 50 is rotated within handle assembly 46. When the disk 66 of the transmission 62 of the monopolar surgical cartridge 52 is disposed in the second interface 100, the reactor 112 is not engaged.

The housing 96 of the host station 86 also includes an additional actuator 118 and a biasing device 120. Additional actuator 118 includes a pivotally supported lever 122 adjacent to handle 82. With the

In order to provide a surgical instrument 40 that is conductive for left or right hand use, lever 122 rests on both sides of handle 82. The additional actuator 118 creates movement, in response to the pivoting action of the lever 122, to move the stem 78 that is supported, for a rectilinear movement, between a retracted position, as shown in Figure 6, and an extended position. , as shown in FIG. 7, between the clamping members 56. The biasing device 120 includes a coupling 124, an extension spring 126, and a seat 128. Coupling 124 connects lever 122 and seat 128. Seat 128 receives accessory 80 from stem 78. When lever 122 is rotated, additional actuator 118 and stem 78 slide straight in the direction of rotation of lever 122 Extension spring 126 connects coupling 124 to receiving station 86 to bias additional actuator 118 and stem 78 to the retracted position when lever 122 is released.

The receiving station 86 includes a cap 102 movable between an open position to receive a cartridge 50, 52 within the housing 96, and a closed position to retain the cartridge 50, 52 within the housing 96. The cover 102 includes a first electrical connector 90 for receiving a first type of electrical power and for transmitting the first type of electrical power to the first electrical contact 101, and a second electrical connector 92 for receiving a second type of electrical power and for transmitting the second type of electrical energy to the second electrical contact 103. The electrical contacts 101, 103 bear on the cap 102 and include a piston device 132, such as a ball piston, requested to engage with the cartridge 50, 52 when a cartridge 50, 52 is in the receiving station 86 and the lid is closed. However, it can be appreciated that other types of contacts 101, 103 can be used as long as they maintain constant contact with cartridge 50, 52, as cartridge 50, 52 rotates within host station 86.

Additionally, housing 96 defines a semi-circular opening 134 in the front wall of host station 86. A rib 136 protrudes from cover 102, near the front wall of host station 86. When cap 102 is in the closed position, semicircular opening 134 and rib 136 cooperate to define clamp 104 to support neck 106 of surgical cartridge 50, 52. When surgical cartridge 50, 52 is inserted into receiving station 86 and cap 102 is in the closed position, rib 136 is tangential to neck 106 to provide rotational support for surgical cartridge 50, 52. It can be appreciated, however, that other types of cartridge holder 50, 52 can also be used.

Electrical contacts 101, 103 bear on cap 102. First electrical contact 101 is for transmitting electrical energy from the power source through a surgical cartridge 50, 52 to a pair of clamping members 56, 58. The second electrical contact 103 is for transmitting electrical energy from the pair of clamping members 56, 58 to the power source. Preferably, surgical instrument 40 is configured to have electrical contacts 101, 103 that support bipolar and monopolar surgery. Accordingly, the handle assembly 46 can provide two first electrical contacts 101 and a single second electrical contact 103. When a bipolar surgical cartridge 50 is inserted into host station 86, cartridge 50 contacts one of each of first and second electrical contacts 101, 103. Similarly, when a monopolar surgical cartridge 52 is inserted into the host station 86, the cartridge 52 contacts only the first electrical contact 101. Insulation 138 is provided in the portions of the surgical cartridge 50, 52 to prevent unwanted contact between the electrical conductors 72, 74 of the surgical cartridge 50, 52 and other components enclosed in the host station 86. For example, in bipolar surgical cartridge 50, housing 54 is a multi-lumen extrusion having a vinyl extrusion that surrounds and insulates electrical conductors 72, 74.

When a monopolar surgical cartridge 52 is inserted into the host station 86, the first electrical conductor 72 contacts the first electrical conductor 101 for electrical coupling. The first electrical conductor 72 receives energy from the first electrical contact 101 and extends to the pair of clamping members 56, 58 to conduct electrical energy through anatomy when an anatomy is disposed between the pair of clamping members 58.

When the bipolar surgical cartridge 50 is inserted into the host station 86, the first and second electrical leads 72, 74 come into contact with the first and second electrical contacts 101, 103, respectively, for electrical coupling. The first electrical conductor 72 receives energy from the first electrical contact 101 and extends to the clamping members 56. The second electrical conductor 74 sends energy from the clamping members 56 to the second electrical contact 101. Therefore, conductors 72, 74 extend to a pair of clamping members 56 to carry electrical energy through anatomy when an anatomy is disposed between the pair of clamping members 56.

In bipolar surgical cartridge 50, for example, each of the first electrical conductors 72 may include a corresponding ring 140, which surrounds the housing 54, to maintain engagement with the first electrical contact 101 during rotation of the housing in the station. 86 host. In addition, the diameter of ring 140 may be greater than the diameter of housing 54 to allow clamping members 56, housing 54, and / or transmission 62 of surgical instrument 40 to be of any desired diameter to perform surgery. For example, the instrument can accommodate a surgical instrument 40 up to 10mm in diameter. If a surgical instrument 40 with a diameter of 5 mm is inserted into the host station 86, the diameter of the ring 140 would still be 10 mm to allow continuous contact with the electrical contacts 101, 103. Furthermore, the neck 106 would also have a diameter of 10 mm to ensure that the surgical cartridge 50, 52 is firmly retained in the host station 86. If the neck 106 surrounds the transmission 62, which travels rectilinearly in response to the actuation of the

ES 2 308 317 T3 actuator, the neck 106 would have a sufficient length to remain within the clamp 104 during the rectilinear travel of the transmission 62 and the clamp 104.

Many modifications and variations of the present invention are possible within the scope of the claims. Furthermore, reference numbers in the claims are given for convenience only and are not to be construed as limiting.