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WO2009046490A1 - Système de commande pour instrument de saisie - Google Patents

Système de commande pour instrument de saisie Download PDF

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Publication number
WO2009046490A1
WO2009046490A1 PCT/AU2008/001492 AU2008001492W WO2009046490A1 WO 2009046490 A1 WO2009046490 A1 WO 2009046490A1 AU 2008001492 W AU2008001492 W AU 2008001492W WO 2009046490 A1 WO2009046490 A1 WO 2009046490A1
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WO
WIPO (PCT)
Prior art keywords
teeth
locking
spring
operating handle
locking lever
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/AU2008/001492
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English (en)
Inventor
John Silady
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Individual
Original Assignee
Individual
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Filing date
Publication date
Application filed by Individual filed Critical Individual
Publication of WO2009046490A1 publication Critical patent/WO2009046490A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B17/2909—Handles
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/0046—Surgical instruments, devices or methods with a releasable handle; with handle and operating part separable
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B17/2909—Handles
    • A61B2017/2912—Handles transmission of forces to actuating rod or piston
    • A61B2017/2919—Handles transmission of forces to actuating rod or piston details of linkages or pivot points
    • A61B2017/292—Handles transmission of forces to actuating rod or piston details of linkages or pivot points connection of actuating rod to handle, e.g. ball end in recess

Definitions

  • the present invention relates to devices for grasping and holding and, more particularly, to control mechanisms for such devices.
  • Laparoscopic surgical procedures include the cutting, holding and cauterising of tissue.
  • a wide range of instruments have been devised operable at the end of an elongate shaft or flexible hollow member.
  • a surgeon is able to activate the instrument at the end of the shaft by a mechanism graspable by the thumb and fingers in a manner similar to the operation of scissors.
  • the instrument at the end of the rod which may take various forms including small cutters and holding jaws or forceps, are very small and easily damaged if excessive force is applied to the pivot pins and other components by the grasping action of the surgeon.
  • a grasping instrument control mechanism said instrument including opposing jaws at an end of an elongate hollow member; said mechanism including a rotatable operating handle acting on a jaws activating element; characterized in that said rotatable operating handle includes an arc of pinion teeth centred on the centre of rotation of said operating handle; said pinion teeth engaging with a rack of teeth along a portion of a cylindrical spring-retaining body communicating with said jaws activating element; said cylindrical spring-retaining body urged into a retracted position by rotation of said operating handle from a non-operating position towards an operating position proximate a fixed handle, wherein rotation of said operating handle past a point of resistance to further closure of said opposing jaws causes partial compression of a compression spring within said cylindrical spring-retaining body without substantial further closure of said opposing jaws.
  • said mechanism is secured within a housing; a base portion of said housing integral with said fixed handle; said operating handle rotatable about a pivot provided in said base portion; said operating handle rotatable between a position maximally distal from said fixed handle and a position proximate said fixed handle; said operating handle passing through said non-operating position.
  • said cylindrical spring-retaining body and a cylindrical pawl-retaining body (44) are slidingly located in a bore of an outer cylindrical body; said outer cylindrical body fixed within said base portion.
  • said cylindrical pawl-retaining body includes a spring compression rod extending from a distal end of said cylindrical pawl-retaining body; said compression spring retained in said cylindrical spring-retaining body between an annular shoulder at a proximate end of said spring- retaining body and a spring compression nut engaged with a threaded portion of said spring compression rod; said spring compression rod extending into, and through substantially the length of said cylindrical spring- retaining body.
  • said cylindrical spring-retaining body abuts said cylindrical pawl-retaining body when said operating handle is in said non-operating position; said compression spring then being in a minimum compressed state.
  • an opposing pair of pawls are retained in a longitudinal slot provided in said cylindrical pawl- retaining body; said pawls shaped at respective proximate ends as jaws so as to close on a ball-end of said jaws activating element; said pawls shaped at respective distal ends to allow symmetrical rotation of one pawl relative to the other between a closed retaining position on said ball- end, and an open disengaging position.
  • said outer cylindrical body is provided with a counterbore at a proximate end of said outer cylindrical body; said counterbore arranged to allow partial protrusion of said opposing pair of pawls from said slot; said protrusion enabled when said proximate ends of said pawls are brought into coincidence with said counterbore by rotation of said operating handle into a position maximally distal from said fixed handle; said pawls rotated into a protruding position through contact of said ball-end of said jaws activating element moving into said proximal direction for disassembly of said instrument from said control mechanism.
  • said opposing pair of pawls are constrained in said closed retaining position when said cylindrical pawl- retaining body is retracted wholly within said bore of said outer cylindrical body by partial rotation of said operating handle towards said fixed handle; said pawls then closed on said ball end of said jaws activating element when said instrument is assembled to said control mechanism.
  • said mechanism further includes a locking lever for releasably retaining said operating handle in a desired operating position in which resistance to further closure of said jaws is accompanied by a degree of compression of said compression spring; said locking lever including first and second teeth for engagement with an arc of locking teeth of said operating handle.
  • said arc of pinion teeth and said arc of locking teeth are substantially arranged at opposing sides of said operating handle and substantially diametrically opposed about said centre of rotation of said operating handle; said locking lever projecting from said housing at a side of said fixed handle distal from said operating handle; said lever arranged for depressing in a direction of said fixed handle by a finger of the hand of a user.
  • said locking lever is an extension of a locking lever plate; said locking lever and said locking lever plate rotating about a pivot provided in said base portion of said housing; said locking lever and locking lever plate biased towards a non-locking position by a spring loaded ball engaging with a hole (88) in said locking lever plate.
  • teeth of said arc of locking teeth of said operating handle are set at angles with respect to radii at respective ones of said teeth; said angles such that said teeth point in a direction opposite to said rotation of said operating handle towards said position proximate said fixed handle.
  • said first and second teeth project from said locking lever plate; said first and second teeth generally angled in an opposite direction to said angles of said teeth of said arc of locking teeth of said operating handle .
  • a first tooth of said first and second teeth is located at greater remove from said pivot of said locking plate than the second tooth of said first and second teeth.
  • said jaws are locked in a said desired operating position by the steps of:
  • said second tooth acts to release said locking position of said locking lever; relative angles of said second tooth and teeth of said arc of locking teeth arranged such that slight rotation of said operating handle towards said fixed handle by slight renewed pressure on said operating handle, acts to release engagement between said first tooth and said meshing teeth of said arc of locking teeth; said spring-loaded ball then acting to return said locking lever to said non-locking position.
  • a said instrument is detachably connected to said control mechanism by an instrument connector element at a proximal end of said mechanism; said connector element comprising an externally threaded cylindrical body; said cylindrical body integral with a disc provided with a finger graspable periphery; said cylindrical body and said disc rotatable around a proximate end portion of said outer cylindrical body; said proximate end portion projecting from said housing.
  • a distal end of said elongate hollow member of a said surgical instrument is provided with a captive nut for threaded engagement with said externally threaded cylindrical body; said distal end provided with a skirt locating within said nut; said skirt clamped to a proximate face of said outer cylindrical body when said captive nut is maximally advanced on said externally threaded cylindrical body, the arrangement being such that said instrument may be rotated 360 degrees relative said control mechanism by means of said finger graspable periphery.
  • said operating handle includes an arcuate segment diametrically opposite said arc of pinion teeth; said mechanism including a conductive path for the transmission of high frequency electric currents for use in diathermy procedures; said path including a cable connector extending from said fixed handle and a spring-loaded conductive rod in contact with an arcuate edge of said arcuate segment.
  • a control mechanism for a grasping instrument comprising an elongate hollow member provided with a tool at an outer end of said elongate hollow member; said mechanism including spring modulation of force applied to an inelastic tool activating element within said elongate hollow member; said force applied by displacement of an operating handle, and wherein said force is limited to the force exerted by said spring when said spring is at a maximum predetermined compression.
  • a retractive force applied to said inelastic tool activating element in a distal direction causes a said tool to change from an inactive state to an activated state .
  • said mechanism is secured within a housing; a base portion of said housing integral with a fixed handle; said operating handle rotatable about a pivot provided in said base portion; said operating handle rotatable between a position proximate said fixed handle and a position distal from said fixed handle.
  • a cylindrical spring-retaining body and a cylindrical pawl-retaining body are slidingly located in a bore of an outer cylindrical body; said outer cylindrical body fixed within said base portion.
  • rotational displacement of said operating handle towards said position proximate said fixed handle is transmitted via an arc of pinion teeth to a rack; said rack provided along a portion of a side of said cylindrical spring-retaining body; rotation of said operating handle towards said position proximate said fixed handle rotating said arc of pinion teeth, thereby urging said cylindrical spring retaining body into a retracting linear motion in said distal direction.
  • said cylindrical pawl-retaining body is provided with a spring compression rod extending from a distal end of said cylindrical pawl-retaining body.
  • said spring is retained in said cylindrical spring-retaining body between an annular shoulder at a proximate end of said spring-retaining body and a spring compression nut; said spring compression nut engaged with a threaded portion of said spring compression rod; said spring compression rod extending into, and through substantially the length of said spring-retaining body.
  • said cylindrical spring-retaining body abuts said cylindrical pawl-retaining body when said operating handle is in a non-force transmitting position; said spring then being in a minimum compressed state.
  • rotation of said operating handle from said non-force transmitting position to a position proximate said fixed handle causes said spring to change from said minimum compressed state to said maximum predetermined compression; said operating handle then biased toward contra-rotation towards said non-force transmitting position.
  • an opposing pair of pawls are retained in a longitudinal slot provided in said cylindrical pawl- retaining body; said pawls shaped at respective proximate ends as jaws so as to close on a ball-end of said inelastic tool activating element; said pawls shaped at respective distal ends to allow symmetrical rotation of one pawl relative to the other between a closed retaining position on said ball-end, and an open disengaging position.
  • said opposing pair of pawls are constrained in said closed retaining position when said cylindrical pawl- retaining body is retracted wholly within said bore of said outer cylindrical body.
  • said outer cylindrical body is provided with a counterbore at a proximate end of said cylindrical body; said counterbore arranged to allow partial protrusion of said opposing pair of pawls from said slot; said protrusion enabled when said proximate ends of said pawls are brought into coincidence with said counterbore by rotation of said operating handle into a position maximally distal from said fixed handle.
  • rotation of said operating handle into said position maximally distal from said fixed handle urges said spring-retaining body and said pawl-retaining body into said position bringing said proximate ends of said pawls into coincidence with said counterbore, thereby allowing assembly and disengagement of a said instrument from said control mechanism.
  • said opposing pair of pawls are rotated into said open releasing position by said ball-end acting against said jaws at said proximate ends of said pawls; said ball-end acting against said jaws as a said instrument is disengaged from said control mechanism.
  • said mechanism further includes a locking lever for releasably retaining said operating handle in a desired said force transmitting position; said locking lever including first and second teeth for engagement with an arc of locking teeth of said operating handle.
  • said arc of pinion teeth and said arc of locking teeth are substantially arranged at opposing sides of said operating handle and substantially diametrically opposed about said pivot.
  • said locking lever projects from said housing at a proximate side of said fixed handle; said lever arranged for depressing in a direction of said fixed handle by a finger of the hand of a user.
  • said locking lever is an extension of a locking lever plate; said locking lever and said locking lever plate rotating about a pivot provided in said base portion of said housing; said pivot passing through a hole in said locking lever plate.
  • said base portion of said housing is provided with a spring-loaded ball; said ball biased towards partly protruding from an inside surface of said housing; protrusion of said ball varying with locking and nonlocking positions of said locking lever and locking lever plate; said ball in a maximum protruded state when said locking lever is in a non-locking position.
  • said locking lever plate is provided with a spring-loaded ball engaging element; said element arranged so that said spring-loaded ball biases said element into a position centred on said ball; said locking lever in said non-locking position when said element is centred on said ball.
  • said engaging element is a hole trough said locking lever plate.
  • teeth of said arc of locking teeth are set at angles with respect to radii at respective ones of said teeth; said angles such that said teeth point in a direction opposite to said rotation of said operating handle towards said position proximate said fixed handle.
  • said first and second teeth project from said locking lever plate; said first and second teeth generally angled in an opposite direction to said angles of said teeth of said arc of locking teeth.
  • a first tooth of said first and second teeth is located at greater remove from said pivot of said locking plate than the second tooth of said first and second teeth.
  • said grasping instrument is locked in a grasping state by movement of said locking lever towards said fixed handle followed by release of pressure by a user on said operating handle; said movement of said locking lever rotating said first and second teeth into meshing engagement with teeth of said arc of locking teeth; and wherein relative angles of said first tooth and meshing teeth of said arc of locking teeth act to lock said first tooth into locked engagement with said meshing teeth by said bias toward contra-rotation of said operating handle.
  • said second tooth acts to release said locking position of said locking lever; relative angles of said second tooth and teeth of said arc of locking teeth arranged such that slight rotation of said operating handle towards said fixed handle by renewed depression of said operating handle, acts to release engagement between said first tooth and said meshing teeth of said arc of locking teeth; said spring-loaded ball then acting to return said locking lever to said non-locking position.
  • said mechanism includes a conductive path for the transmission of high frequency electric currents for use in diathermy procedures; said path including a cable connector extending from said fixed handle and a spring- loaded conductive rod in contact with an arcuate edge of said toothed plate.
  • a said instrument is detachably connected to said control mechanism by an instrument connector element at a proximate end of said mechanism.
  • an instrument connector element comprises a cylindrical body provided with an external thread; said cylindrical body integral with a disc provided with a finger graspable periphery; said cylindrical body and said disc rotatable around a proximate portion of said outer cylindrical body; said proximate portion projecting from said housing.
  • a distal end of said elongate hollow member of a said surgical instrument is provided with a captive nut for threaded engagement with said external thread; said distal end provided with a skirt locating within said nut; said skirt clamped to a proximate face of said outer cylindrical body when said captive nut is maximally advanced on said external thread, the arrangement being such that said instrument may be rotated 360 degrees relative said control mechanism by means of said finger graspable periphery.
  • said housing further includes a cover portion; said cover portion attached to said base portion of said housing by at least one securing fastener; a head portion of said fastener provided with at least one pair of holes for engagement with corresponding pins of a fastener driving tool; said holes arranged so that said tool is able to provide rotational driving force in a tightening direction only; ramp features in said holes forcing disengagement of said tool when rotated in a fastener loosening direction.
  • a method for applying an operating force to a grasping instrument including the steps of: (a) interposing a spring mechanism between an operating handle of a control mechanism of said instrument and an inelastic instrument activating element,
  • a locking system for an operating handle of a control mechanism of a grasping instrument; said locking system including a locking lever operable between a default nonlocking position and an operating handle locking position; said locking lever provided with first and second locking teeth; wherein a first of said locking teeth meshes with teeth of an arc of locking teeth of said operating handle to bias said locking lever in said ' locking position when pressure applied to said operating handle is released; a second of said locking teeth operative in releasing said locking lever from said locking position when a renewed pressure is applied to said operating handle.
  • said locking lever is biased towards said nonlocking position by a spring-loaded ball; said ball biased to protrude from a supporting surface adjacent to a pivot of said lever; said spring-loaded ball engaging edges of a locating element provided in said lever; said lever in said non-locking position when said spring-loaded ball is centred with said locating element.
  • teeth of said arc of locking teeth are set at angles with respect to radii at respective ones of said teeth; said angles such that said teeth point in a direction opposite to rotation of said operating handle in an operating direction.
  • said first and second teeth project from a locking lever plate attached to said locking lever; said first and second teeth generally angled in an opposite direction to said angles of said teeth of said arc of locking teeth.
  • a locking meshing of teeth of said arc of locking teeth and said first tooth of said locking lever is maintained by a biasing of rotation of said operating handle towards a non-operating direction.
  • a leading edge of said first tooth engages with a leading edge of a tooth of said arc of locking teeth to draw said first locking teeth into a maximum meshed position with said arc of locking teeth when said locking lever is moved towards said locking position and pressure is released from said operating handle.
  • a trailing edge of said second tooth is brought into engagement with a trailing edge of a tooth of said arc of locking teeth when renewed pressure is applied to said operating handle in said operating direction; said engagement releasing said first locking teeth from said maximum meshed position; said spring-loaded ball then urging said locking lever to return to said non-locking position.
  • a retaining mechanism for a ball end of an inelastic tool activating element of a grasping instrument including a pair of opposing pawls operating in slots provided in a pawl-retaining cylindrical body; said pawls shaped at distal ends to rotate one against the other between a first closed position and a second open position of said pawls; said pawls provided at respective proximal ends with jaws; said jaws clamping around said ball end when said pawl-retaining cylindrical body is fully retracted into an outer cylindrical body; said jaws opening to release said ball end when said pawl- retaining cylindrical body is advanced proximally within said outer cylindrical body sufficient to bring said proximal ends of -said pawls into- coincidence with a counterbore of said outer cylindrical body.
  • a fastening system for clamping a cover portion to a base portion of a housing of a control mechanism for a grasping instrument; said fastening system comprising at least one threaded fastener provided with a head portion; said head portion provided with at least a pair of elongated arcuate slots in an outer surface of said head portion; each of said slots shaped at one side with a ramped surface extending from said outer surface to the bottom of said slot, and shaped at the other side with a surface substantially normal to said outer surface.
  • Figure 1 is a side view of a control mechanism for a grasping instrument according to a first preferred embodiment of the invention, showing an instrument control mechanism with an example of an attachable surgical instrument,
  • Figure 2 is a side view of the control mechanism with the surgical instrument attached
  • Figure 3 is a sectioned side view of the control mechanism and surgical instrument of Figure 1 with a surgical instrument in a detached position
  • Figure 3B is an enlargement of a portion of the mechanism of Figure 3,
  • Figure 4 is a sectioned side view of the control mechanism and surgical instrument of Figure 1 with the surgical instrument attached but in a non-activated state
  • Figure 4B is an enlargement of a portion of the mechanism of Figure 4,
  • Figure 4C is a further enlargement of portion of Figure 4B
  • Figure 5 is a sectioned side view of the control mechanism and surgical instrument of Figure 1 with the surgical instrument attached in an activated, locked state
  • Figure 5B is an enlargement of a portion of the mechanism of Figure 5,
  • Figures 6A to 6B are enlarged sectioned side views and end views of portions of the mechanism of Figures 1 to 5
  • Figure 7 is a side view of a second preferred embodiment of diathermy instrument control mechanism according to the invention
  • Figure 8 is a sectioned side view of the diathermy control mechanism of Figure 7. DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS First Preferred Embodiment
  • control mechanism 10 comprises a control mechanism 11 to which may be attached for example, any one of a number of surgical instruments for grasping, cutting and cauterizing tissue.
  • An example of such a surgical instrument 12 comprises an elongate hollow member or shaft 14 (as best seen in Figure 3) , at the end of which is the active surgical instrument tool 16 (in this example a pair of grasping forceps) .
  • the instrument is activated by applying retractive force to an inelastic tool activating element, in this instance an activating rod 18 extending from the instrument tool mechanism 20 through shaft 14. This retractive force causes the tool 16 to change from an inactive state to an activated state.
  • Control mechanism 11 comprises a housing 22 made up of a base portion 24 and a cover portion 26. Integrally formed with base portion 24, is a fixed handle 28 extending from base portion 24 and ending in a scissor-like ring 30 for insertion of at least one finger of the hand of a user (not shown) .
  • base portion 24 is provided with a pivot 32 about which an operating handle 34 can rotate from a position proximate fixed handle 28 (as shown in Figure 2) and a position maximally distal from fixed handle 28 (as shown in Figure 3) , and passing through an intermediate non-operating position (as shown in Figure 4) .
  • Operating handle 34 is likewise provided with a scissor-like ring 36 for insertion of the thumb of a user, so that the two handles may be operated with the one hand in similar fashion to the manner of use of a pair of scissors.
  • a spring compression rod 46 extending into, and substantially the length of spring- retaining body 42, when the distal end of pawl-retaining body 44 abuts the proximate end of spring-retaining body 42 (as shown in Figure 6A) .
  • Spring compression rod 46 is threaded at its distal end and provided with a spring compression nut 48.
  • a compression spring 50 is retained between compression nut 48 and annular shoulder 52 at the proximate end of the cylindrical spring-retaining body 42.
  • Cylindrical pawl-retaining body 44 is provided with a longitudinal slot 49. Retained within longitudinal slot 49 are opposing pawls 54 and 55 shaped at their proximate ends as jaws to close on a ball end 56 of the inelastic activating rod 18. As best seen in the enlarged views of Figures 6A to 6C, the distal ends of pawls 54 and 55 are shaped so as to allow rotation one against the other between the open position of Figure GA and the closed positions of Figures 6B and 6C.
  • a portion of the side of the distal end of cylindrical spring-retaining body 42 is machined to provide a toothed rack 58 which engages with an arc of pinion teeth 60.
  • Arc of pinion teeth 60 is part of a toothed plate 62 rigidly attached to, or integral with operating handle 34, and provided with a hole 33 for pivot 32.
  • Also part of toothed plate 62 is an arc of locking teeth 64, substantially diametrically opposite to the arc of pinion teeth 60, with both arcs of teeth centred on pivot 32.
  • control mechanism 11 is provided with an instrument connector element 65 which comprises an externally threaded cylindrical body 66.
  • Cylindrical body 66 is integral with a disc 68 provided with a finger graspable periphery.
  • the cylindrical body and the disc are rotatable around the proximate end portion 40 of the outer cylindrical body 38, projecting from housing 22.
  • Each instrument 12 which may be attached to the control mechanism 11, is provided with a captive nut 69 at the distal end of elongate hollow shaft 14, for threaded engagement with the external thread of the instrument connector element 65.
  • the distal end of elongate hollow shaft 14 is provided with a skirt 70 arranged for clamping to a proximate face 72 of the externally threaded cylindrical body 66.
  • control mechanism 11 of this embodiment of the invention is provided with a locking mechanism 80 as shown in Figures 3 to 5.
  • Locking mechanism 80 is arranged to hold the operating handle 34 in any of a number of possible incremental positions in which at least some additional compressive force has been applied to spring 50 as a result the of retraction of cylindrical spring-retaining body 42 relative to the pawl retaining body; that is, by the rotation of operating handle 34 in the proximate, or operating direction and when further closure of the jaws 16 is impeded. It will be understood that when such an additional force (in addition to the minimum installed spring force) is present, spring 50 will act to urge contra-rotation of operating handle 34 towards the distal, non-operating position.
  • locking mechanism 80 provides interaction between locking teeth 84 of a locking lever 82 and the arc of locking teeth 64 provided on the toothed plate 62 described above.
  • locking lever 82 includes a locking lever plate 83 provided with first and second locking teeth 84A and 84B. Locking lever plate 83 and locking lever 82 pivot about locking lever pivot 86 between the unlocked position shown in Figures 3B and 4B, the intermediate engaging position of Figure 4C, and the fully locked position of Figure 5B.
  • the teeth of the arc of locking teeth 64 are set at angles with respect to radii at respective ones of the teeth, such that the teeth point in a direction opposite to the rotation of the operating handle 34 for applying compressive force to spring 50, that is, towards fixed handle 28.
  • the pair of locking teeth 84A and 84B of locking lever 82 are also angled but in the opposite direction. It can be seen from a comparison of Figures 4B, 4C and 5B, that a first depressing of the locking lever 82 into the locking position of Figure 5B, brings the locking teeth 84A and 84B projecting from locking lever plate 83, into meshing engagement with teeth of the arc of locking teeth 64.
  • leading edges of teeth 84A and 84B are set at different angles. This is partly to accommodate the angular difference of the locking teeth 64 with which these two teeth mesh, but also because they are functionally distinct, with tooth 84A being the active tooth in establishing the locking engagement of the teeth, and tooth 84B being active in disengagement.
  • first tooth 84A (which is at greater remove from pivot 86) and the leading edge of a tooth of the arc of locking teeth 64 with which it engages, are both at the same angle relative the rotation centres o.f pivot 86 of locking lever plate 83 and pivot 32 of toothed plate 62.
  • This angle is such that the biased tendency of the operating lever to contra-rotate towards the distal, non-operating position, acts to pull tooth 84B into the maximum meshed position shown in Figure 5B.
  • This meshing is initiated by a user, having applied the desired clamping force to an item such as a piece of tissue for example, as follows: (a) applying sufficient additional pressure to the operating handle to induce at least some additional compression of the spring 50, (b) simultaneously moving the locking lever in towards the fixed handle 28, and (c) immediately releasing the force he or she is applying to the operating handle 34.
  • Base portion 24 of housing 22 is provided with a spring-loaded ball 90, which is biased towards partly protruding from an inside surface 92 of the base portion 24.
  • the protrusion of ball 90 varies with the locking and non-locking positions of locking lever 82, with the ball in a maximum protruded state when the locking lever is in the non-locking position shown in Figures 3, 3B, 4 and 4B.
  • the arrangement is shown in the enlargements of Figures 3B, 4B and 4C.
  • Locking lever plate 83 is provided with a spring- loaded ball engaging element, which in this instance is a hole 88 through the plate.
  • Hole 88 is arranged so that the spring-loaded ball 90 biases the hole (and thus the locking lever plate and lever) into the non-locking position in which the hole is centred on the ball (as is the situation in Figures 3, 3B, 4 and 4B) .
  • ball 90 is partially depressed but still partially intruding into hole 88, thus biasing the plate and lever back to the position in which the hole 88 is centred on the ball, that is in the position of Figures 3, 3B and 4B.
  • a user In use, a user is able to apply a desired closing force to the tool of a surgical instrument for example, without risk of damage to the instrument, or to some fragile item such as tissue.
  • a desired clamping force can be instantly retained by the relatively short throw of the locking lever, and almost instantly released by applying an insignificant brief additional pressure to the operating handle when in the locking position.
  • any of a number of interchangeable tools for cutting and gripping tissue or other items may be rapidly attached and detached by means of the novel pawl mechanism incorporated in the control mechanism.
  • a diathermy laparoscopic control mechanism 100 again comprises a control mechanism
  • surgical instrument 112 is identical to the exemplary surgical instrument 12 shown for the first embodiment above and is attached to the control mechanism
  • the force provided for a procedure at the tool (forceps 116 in this instance) is modulated and limited by the spring-loaded mechanism described in detail above.
  • the control mechanism 110 of this embodiment is provided with a cable connector 102 projecting from fixed handle 128. Current is passed via compression spring 104 to conductive rod 106. Inner tip 107 of conductive rod 106 is urged into conducting contact with toothed plate 162, affixed to operating handle 134.
  • toothed plate 162 is provided with a smooth arcuate edge 164 substantially diametrically opposite the arc of teeth 160.
  • toothed plate 162 is conductive so that the conductive path between cable connector 102 and the tool of the surgical instrument is completed via toothed plate 162, cylindrical spring-retaining body 142 and spring 150, the cylindrical pawl-retaining body 144, pawls 154 and 155 and activating rod 118.
  • the base portion and cover portion of the housing for the control mechanism may be fastened together by at least one, preferably two fasteners as can be seen in Figures 1, 2 and 7.
  • these fasteners are arranged to allow tightening only with a suitable tool, and are resistant to unscrewing.
  • a threaded fastener 119 is includes a head portion 120 in which is provided at least a pair of elongated arcuate slots 121 in an outer surface of the head portion.
  • Each of these slots 121 is shaped at one side with a ramped surface 122 extending from the outer surface of the head portion to the bottom 123 of the slot, and shaped at the other side with a surface substantially normal to the outer surface.
  • the slots allow the insertion of a driving tool with projecting pins, which when rotated against the surfaces normal to the outer surface of the head portion urge the fastener to rotate, but when rotated in the opposite direction force the tool to disengage without inducing rotation.

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Engineering & Computer Science (AREA)
  • Ophthalmology & Optometry (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

L'invention concerne un mécanisme de commande pour un instrument de saisie ; ledit instrument comporte un élément creux allongé pourvu d'un outil à une extrémité externe dudit élément creux allongé ; ledit mécanisme comprend une modulation par ressort de la force appliquée à un élément d'activation d'outil non élastique à l'intérieur dudit élément creux allongé ; ladite force est appliquée par déplacement d'une poignée d'actionnement, et ladite force est limitée à la force exercée par ledit ressort lorsque ledit ressort est à une compression prédéterminée maximale.
PCT/AU2008/001492 2007-10-09 2008-10-09 Système de commande pour instrument de saisie Ceased WO2009046490A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
AU2007221906A AU2007221906B1 (en) 2007-10-09 2007-10-09 Control System for A Grasping Instrument
GB2007221906 2007-10-09

Publications (1)

Publication Number Publication Date
WO2009046490A1 true WO2009046490A1 (fr) 2009-04-16

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Family Applications (1)

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PCT/AU2008/001492 Ceased WO2009046490A1 (fr) 2007-10-09 2008-10-09 Système de commande pour instrument de saisie

Country Status (2)

Country Link
AU (1) AU2007221906B1 (fr)
WO (1) WO2009046490A1 (fr)

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EP2510888A1 (fr) * 2011-04-11 2012-10-17 Karl Storz GmbH & Co. KG Dispositif de manipulation pour un instrument de chirurgie micro-invasive
GB2490151A (en) * 2011-04-20 2012-10-24 Surgical Innovations Ltd Surgical instrument insert and surgical instrument system
WO2013079340A1 (fr) * 2011-12-02 2013-06-06 Aesculap Ag Poignée chirurgicale et instrument chirurgical à tige tubulaire doté d'une poignée chirurgicale
EP2612609A3 (fr) * 2012-01-04 2013-09-18 Karl Storz GmbH & Co. KG Instrument médical
US10555770B2 (en) 2013-10-29 2020-02-11 Aesculap Ag Electrosurgical tubular shaft, surgical instrument grip and electrosurgical tubular shaft instrument
JP2021534862A (ja) * 2018-08-20 2021-12-16 エシコン エルエルシーEthicon LLC 漸進的ジョー閉鎖構成を有する外科用器具
US11350957B2 (en) * 2019-03-27 2022-06-07 Gyms Acmi, Inc. Laparoscopic forceps assembly for gripping and dissection
US11944299B2 (en) 2006-01-31 2024-04-02 Cilag Gmbh International Surgical instrument having force feedback capabilities
US11957795B2 (en) 2010-09-30 2024-04-16 Cilag Gmbh International Tissue thickness compensator configured to redistribute compressive forces
US11957345B2 (en) 2013-03-01 2024-04-16 Cilag Gmbh International Articulatable surgical instruments with conductive pathways for signal communication
US11963680B2 (en) 2017-10-31 2024-04-23 Cilag Gmbh International Cartridge body design with force reduction based on firing completion
US11986183B2 (en) 2008-02-14 2024-05-21 Cilag Gmbh International Surgical cutting and fastening instrument comprising a plurality of sensors to measure an electrical parameter
US11992208B2 (en) 2007-06-04 2024-05-28 Cilag Gmbh International Rotary drive systems for surgical instruments
US11998206B2 (en) 2008-02-14 2024-06-04 Cilag Gmbh International Detachable motor powered surgical instrument
US11998194B2 (en) 2008-02-15 2024-06-04 Cilag Gmbh International Surgical stapling assembly comprising an adjunct applicator
US12004741B2 (en) 2014-10-16 2024-06-11 Cilag Gmbh International Staple cartridge comprising a tissue thickness compensator
US12023026B2 (en) 2021-03-22 2024-07-02 Cilag Gmbh International Staple cartridge comprising a firing lockout
US12053176B2 (en) 2013-08-23 2024-08-06 Cilag Gmbh International End effector detention systems for surgical instruments
US12059154B2 (en) 2011-05-27 2024-08-13 Cilag Gmbh International Surgical instrument with detachable motor control unit
US12076017B2 (en) 2014-09-18 2024-09-03 Cilag Gmbh International Surgical instrument including a deployable knife
US12082806B2 (en) 2007-01-10 2024-09-10 Cilag Gmbh International Surgical instrument with wireless communication between control unit and sensor transponders
US12178434B2 (en) 2006-10-03 2024-12-31 Cilag Gmbh International Surgical stapling system including control circuit to monitor clamping pressure
US12178432B2 (en) 2010-09-30 2024-12-31 Cilag Gmbh International Tissue thickness compensator comprising laterally offset layers
US12185946B2 (en) 2016-12-21 2025-01-07 Cilag Gmbh International Articulatable surgical stapling instruments
US12213666B2 (en) 2010-09-30 2025-02-04 Cilag Gmbh International Tissue thickness compensator comprising layers
US12213671B2 (en) 2008-02-14 2025-02-04 Cilag Gmbh International Motorized system having a plurality of power sources
US12290261B2 (en) 2011-05-27 2025-05-06 Cilag Gmbh International Robotically-driven surgical instrument with E-beam driver
US12369911B2 (en) 2012-06-28 2025-07-29 Cilag Gmbh International Firing system lockout arrangements for surgical instruments
US12433584B2 (en) 2006-01-31 2025-10-07 Cilag Gmbh International Robotically-controlled end effector
US12440208B2 (en) 2015-03-06 2025-10-14 Cilag Gmbh International Powered surgical instrument
US12446877B2 (en) 2017-06-28 2025-10-21 Cilag Gmbh International Surgical instrument having articulation lock actuated by closure tube displacement

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DE102012022573A1 (de) 2012-11-20 2014-05-22 Karl Storz Gmbh & Co. Kg Medizinisches Instrument
CN115653246B (zh) * 2022-12-28 2023-03-21 中建材佳星玻璃(黑龙江)有限公司 一种玻璃成品组装设备
DE102023122453A1 (de) * 2023-08-22 2025-02-27 Aesculap Ag Demontagemechanismus zwischen Schaftbaugruppe und Handgriff
DE102023122449A1 (de) * 2023-08-22 2025-02-27 Aesculap Ag Chirurgischer Pistolen-Handgriff sowie chirurgisches Instrument mit Pistolen-Handgriff

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Cited By (44)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US12433584B2 (en) 2006-01-31 2025-10-07 Cilag Gmbh International Robotically-controlled end effector
US11944299B2 (en) 2006-01-31 2024-04-02 Cilag Gmbh International Surgical instrument having force feedback capabilities
US12178434B2 (en) 2006-10-03 2024-12-31 Cilag Gmbh International Surgical stapling system including control circuit to monitor clamping pressure
US12082806B2 (en) 2007-01-10 2024-09-10 Cilag Gmbh International Surgical instrument with wireless communication between control unit and sensor transponders
US12023024B2 (en) 2007-06-04 2024-07-02 Cilag Gmbh International Robotically-controlled shaft based rotary drive systems for surgical instruments
US11992208B2 (en) 2007-06-04 2024-05-28 Cilag Gmbh International Rotary drive systems for surgical instruments
US12213671B2 (en) 2008-02-14 2025-02-04 Cilag Gmbh International Motorized system having a plurality of power sources
US11998206B2 (en) 2008-02-14 2024-06-04 Cilag Gmbh International Detachable motor powered surgical instrument
US11986183B2 (en) 2008-02-14 2024-05-21 Cilag Gmbh International Surgical cutting and fastening instrument comprising a plurality of sensors to measure an electrical parameter
US11998194B2 (en) 2008-02-15 2024-06-04 Cilag Gmbh International Surgical stapling assembly comprising an adjunct applicator
US12178432B2 (en) 2010-09-30 2024-12-31 Cilag Gmbh International Tissue thickness compensator comprising laterally offset layers
US11957795B2 (en) 2010-09-30 2024-04-16 Cilag Gmbh International Tissue thickness compensator configured to redistribute compressive forces
US12213666B2 (en) 2010-09-30 2025-02-04 Cilag Gmbh International Tissue thickness compensator comprising layers
EP2510888A1 (fr) * 2011-04-11 2012-10-17 Karl Storz GmbH & Co. KG Dispositif de manipulation pour un instrument de chirurgie micro-invasive
US10582941B2 (en) 2011-04-11 2020-03-10 Karl Storz Se & Co. Kg Handling device for a micro-invasive surgical instrument
US9387003B2 (en) 2011-04-11 2016-07-12 Karl Storz Gmbh & Co. Kg Handling device for a micro-invasive surgical instrument
GB2490151B (en) * 2011-04-20 2018-03-28 Surgical Innovations Ltd Surgical instrument insert and surgical instrument system
GB2490151A (en) * 2011-04-20 2012-10-24 Surgical Innovations Ltd Surgical instrument insert and surgical instrument system
US12059154B2 (en) 2011-05-27 2024-08-13 Cilag Gmbh International Surgical instrument with detachable motor control unit
US12290261B2 (en) 2011-05-27 2025-05-06 Cilag Gmbh International Robotically-driven surgical instrument with E-beam driver
JP2015502792A (ja) * 2011-12-02 2015-01-29 アエスキュラップ アーゲー 外科用ハンドグリップ、及び、外科用ハンドグリップを備えた外科用管状シャフト器具
AU2012344102B2 (en) * 2011-12-02 2016-07-21 Aesculap Ag Surgical handgrip and surgical tubular shaft instrument with a surgical handgrip
WO2013079340A1 (fr) * 2011-12-02 2013-06-06 Aesculap Ag Poignée chirurgicale et instrument chirurgical à tige tubulaire doté d'une poignée chirurgicale
US9561047B2 (en) 2011-12-02 2017-02-07 Aesculap Ag Surgical hand grip and a surgical tubular shaft instrument with a surgical hand grip
US8876805B2 (en) 2012-01-04 2014-11-04 Karl Storz Gmbh & Co. Kg Medical instrument
EP2612609A3 (fr) * 2012-01-04 2013-09-18 Karl Storz GmbH & Co. KG Instrument médical
US12369911B2 (en) 2012-06-28 2025-07-29 Cilag Gmbh International Firing system lockout arrangements for surgical instruments
US11957345B2 (en) 2013-03-01 2024-04-16 Cilag Gmbh International Articulatable surgical instruments with conductive pathways for signal communication
US12053176B2 (en) 2013-08-23 2024-08-06 Cilag Gmbh International End effector detention systems for surgical instruments
US10555770B2 (en) 2013-10-29 2020-02-11 Aesculap Ag Electrosurgical tubular shaft, surgical instrument grip and electrosurgical tubular shaft instrument
US12076017B2 (en) 2014-09-18 2024-09-03 Cilag Gmbh International Surgical instrument including a deployable knife
US12004741B2 (en) 2014-10-16 2024-06-11 Cilag Gmbh International Staple cartridge comprising a tissue thickness compensator
US12440208B2 (en) 2015-03-06 2025-10-14 Cilag Gmbh International Powered surgical instrument
US12185946B2 (en) 2016-12-21 2025-01-07 Cilag Gmbh International Articulatable surgical stapling instruments
US12446877B2 (en) 2017-06-28 2025-10-21 Cilag Gmbh International Surgical instrument having articulation lock actuated by closure tube displacement
US11963680B2 (en) 2017-10-31 2024-04-23 Cilag Gmbh International Cartridge body design with force reduction based on firing completion
JP7504870B2 (ja) 2018-08-20 2024-06-24 エシコン エルエルシー 漸進的ジョー閉鎖構成を有する外科用器具
US12262888B2 (en) 2018-08-20 2025-04-01 Cilag Gmbh International Surgical instruments with progressive jaw closure arrangements
JP2021534862A (ja) * 2018-08-20 2021-12-16 エシコン エルエルシーEthicon LLC 漸進的ジョー閉鎖構成を有する外科用器具
EP3714814B1 (fr) * 2019-03-27 2024-09-11 Gyrus ACMI, Inc. D.B.A. Olympus Surgical Technologies America Ensemble forceps laparoscopique pour la préhension et la dissection
EP4461242A3 (fr) * 2019-03-27 2025-01-22 Gyrus ACMI, Inc. D.B.A. Olympus Surgical Technologies America Ensemble forceps laparoscopique pour la préhension et la dissection
US11350957B2 (en) * 2019-03-27 2022-06-07 Gyms Acmi, Inc. Laparoscopic forceps assembly for gripping and dissection
US12419659B2 (en) 2019-03-27 2025-09-23 Gyrus Acmi, Inc. Laparoscopic forceps assembly for gripping and dissection
US12023026B2 (en) 2021-03-22 2024-07-02 Cilag Gmbh International Staple cartridge comprising a firing lockout

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