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WO2014149313A1 - Instrument chirurgical ayant une section d'articulation renforcée - Google Patents

Instrument chirurgical ayant une section d'articulation renforcée Download PDF

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Publication number
WO2014149313A1
WO2014149313A1 PCT/US2014/017091 US2014017091W WO2014149313A1 WO 2014149313 A1 WO2014149313 A1 WO 2014149313A1 US 2014017091 W US2014017091 W US 2014017091W WO 2014149313 A1 WO2014149313 A1 WO 2014149313A1
Authority
WO
WIPO (PCT)
Prior art keywords
link
spring
lockout
positioning
illustrates
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/US2014/017091
Other languages
English (en)
Inventor
Gregory A. Trees
Patrick J. Minnelli
Alex W. KITURKES
William A. CRAWFORD
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.)
Ethicon Endo Surgery Inc
Original Assignee
Ethicon Endo Surgery Inc
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by Ethicon Endo Surgery Inc filed Critical Ethicon Endo Surgery Inc
Publication of WO2014149313A1 publication Critical patent/WO2014149313A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B18/1442—Probes having pivoting end effectors, e.g. forceps
    • A61B18/1445—Probes having pivoting end effectors, e.g. forceps at the distal end of a shaft, e.g. forceps or scissors at the end of a rigid rod
    • 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
    • A61B2017/2946—Locking means
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B18/1442—Probes having pivoting end effectors, e.g. forceps
    • A61B2018/1452—Probes having pivoting end effectors, e.g. forceps including means for cutting
    • A61B2018/1455—Probes having pivoting end effectors, e.g. forceps including means for cutting having a moving blade for cutting tissue grasped by the jaws

Definitions

  • the present disclosure relates to the field of medical instruments and in particular, although not exclusively, to electrosurgical instruments.
  • the present disclosure is also directed to lockout mechanisms and related user interfaces and methods for such medical instruments.
  • Figure 1 illustrates the form of an electrosurgical medical instrument that is designed for minimally invasive medical procedures, according to one form.
  • Figure 2 illustrates another view of the electrosurgical medical instrument shown in Figure 1 .
  • Figure 3 illustrates another view of the electrosurgical medical instrument shown in Figure 1 .
  • Figure 4a illustrates a sectional view of the electrosurgical medical instrument illustrating elements thereof contained within a housing, according to one form.
  • Figure 4b illustrates a partial sectional view of the lockout mechanism of Figure 4a in a locked out position to prevent the actuation of the control lever, according to one form.
  • Figure 4c illustrates a slide linkage of a lockout mechanism of Figure 4a, according to one form.
  • Figure 5 illustrates a partial sectional view of the electrosurgical medical instrument wherein the first member of the slide linkage has disengaged the extension member, according to one form.
  • Figure 6 illustrates a partial sectional view of the electrosurgical medical instrument in a full stroke position, according to one form.
  • Figure 7 illustrates the electrosurgical medical instrument comprising a case boss and a pinch wedge, according to one form.
  • Figure 8 is an assembled view of the case boss and pinch wedge as shown in Figure 7, according to one form.
  • Figure 9 illustrates a sectional view of a lockout positioning assembly, according to one form.
  • Figure 10 illustrates a partial view various components of a lockout positioning assembly, according to one form.
  • Figure 1 1 illustrates a partial view various components of a lockout positioning assembly, according to one form.
  • Figure 12 illustrates a perspective view of a spring link bracket of a lockout positioning assembly, according to one form.
  • Figure 13 illustrates a partial view of various components of a lockout positioning assembly, according to one form.
  • Figure 14 illustrates a perspective view of a spring link bracket of a lockout positioning assembly, according to one form.
  • Figure 15 illustrates a partial view of various components of a lockout positioning assembly, according to one form.
  • Figure 16 illustrates a perspective view of a spring link bracket of a lockout positioning assembly, according to one form.
  • Figure 17 illustrates a perspective view of a spring link bracket of a lockout positioning assembly, according to one form.
  • Figure 18 illustrates a partial view of various components of a lockout positioning assembly, according to one form.
  • Figure 19 illustrates a partial view of various components of a lockout positioning assembly, according to one form.
  • Figure 20 illustrates a partial view of various components of a lockout positioning assembly, according to one form.
  • Figure 21 illustrates a partial view of various components of a lockout positioning assembly, according to one form.
  • Figure 22 illustrates a perspective view of a spring link bracket, according to one form.
  • Figure 23 illustrates a partial view of various components of a lockout positioning assembly, according to one form.
  • Figure 24 illustrates a partial view of various components of a lockout positioning assembly, according to one form.
  • Figure 25 illustrates a perspective view of a spring link bracket, according to one form.
  • Figure 26 illustrates a partial view of various components of a lockout positioning assembly, according to one form.
  • Figure 27 illustrates a partial view of various components of a lockout positioning assembly, according to one form.
  • Figure 28 illustrates a partial view of various components of a lockout positioning assembly, according to one form.
  • Figure 29 illustrates a partial view of various components of a lockout positioning assembly, according to one form.
  • Figure 30 illustrates a perspective view of a spring link bracket, according to one form.
  • Figure 31 illustrates a partial view of various components of a lockout positioning assembly, according to one form.
  • the present disclosure is directed generally to medical instruments and in particular, although not exclusively, to electrosurgical instruments. Additionally, the present disclosure is directed to lockout mechanisms and related user interfaces and initialization techniques and methods for such surgical instruments.
  • proximal and distal are defined herein relative to a surgeon grasping the electrosurgical instrument.
  • the term 'proximal refers the position of an element closer to the surgeon and the term “distal” refers to the position of an element further away from the surgeon.
  • Many surgical procedures require cutting or ligating blood vessels or other vascular tissue. With minimally invasive surgery, surgeons perform surgical operations through a small incision in the patient's body. As a result of the limited space, surgeons often have difficulty controlling bleeding by clamping and/or tying-off transected blood vessels. By utilizing electrosurgical forceps, a surgeon can cauterize,
  • clamp arms electrosurgical energy applied through jaw members of the electrosurgical forceps, otherwise referred to as clamp arms.
  • Figure 1 illustrates the form of an electrosurgical medical instrument 100 that is designed for minimally invasive medical procedures, according to one form.
  • the instrument 100 is a self contained device, having an elongate shaft 102 that has a housing 1 12 with a handle 104 connected to the proximal end of the shaft 102 and an end effector 106 connected to the distal end of the shaft 102.
  • the end effector 106 comprises medical forceps 108 having a movable jaw member and a cutting blade or knife (not shown) coupled to an extendable member, e.g., an inner sheath (not shown), located within the shaft 102 that are controlled by the user manipulating a control lever 1 10 (e.g., hand trigger) portion of the handle 104.
  • the control lever 1 10 e.g., hand trigger
  • the control lever 1 10 is in the form of a hook (e.g., shepherd's hook) having a curved front portion and a rear portion where the rear portion extends below the front portion.
  • the curved front portion and the rear portion define an aperture therebetween to receive the user's hand to operate the control lever 1 10.
  • the shaft 102 is inserted through a trocar to gain access to the patient's interior and the operating site.
  • the surgeon will manipulate the forceps 108 using the handle 104, the control lever 1 10, and rotation knob 1 16 until the forceps 108 are located around the vessel to be cauterized.
  • the rotation knob 1 16 is coupled to the shaft 102 and the end effector 106. Rotation of the rotation knob 1 16 causes rotation of the shaft 102 and the end effector 106.
  • the shaft 102 is continuously rotatable greater than 360° using the rotation knob 1 16.
  • the activation button 1 14 has a partial activation position and a full activation position.
  • the handle 104 houses batteries and the housing houses control electronics for generating and controlling the electrical energy required to perform the cauterization.
  • the instrument 100 is self contained in the sense that it does not need a separate control box and supply wire to provide the electrical energy to the forceps 108.
  • the instrument 100 also comprises a first visual feedback element 1 18a on the proximal end of the housing 1 12 to indicate that the device is ready for use and functioning normally, that there are a limited number of transections remaining, that RF energy is being delivered, that an alert condition or fault exists, that the initialization clip was removed, among other indications.
  • the first visual feedback element 1 18a is a light emitting diode (LED), without limitation.
  • the first visual feedback element 1 18a is a tri-color LED.
  • the instrument 100 comprises an integral generator and a non-reusable battery.
  • Figure 2 illustrates another view of the electrosurgical medical instrument 100 shown in Figure 1 .
  • the instrument 100 comprises a second visual feedback element 1 18b located on the proximal end of the housing 1 12.
  • the second visual feedback element 1 18b performs the same function as the first visual feedback element 1 18a.
  • the second visual feedback element 1 18b is an LED, without limitation.
  • the second visual feedback element 1 18b is a tri-color LED.
  • FIG 3 illustrates another view of the electrosurgical medical instrument 100 shown in Figure 1 .
  • the instrument 100 comprises a disposal button 120 located on the bottom of the handle 104, for example.
  • the disposal button 120 is used to deactivate the instrument 100.
  • the instrument 100 may be deactivated by pushing and holding the disposal button 120 for a predetermined period.
  • the instrument 100 may be deactivated by pushing and holding the disposal button 120 for about four seconds.
  • the instrument 100 will automatically deactivate after a predetermined period. For example, the instrument 100 will automatically deactivate either eight or 10 hours after completion of the first cycle.
  • An aperture 1 15 formed in the handle 104 provides a path for audio waves or a means for sound generated by an audio feedback element such as a piezoelectric buzzer to escape, for example, from within the handle 104.
  • the piezoelectric buzzer operates at 65 dBa at one meter at a frequency between about 2.605 kHz to 2.800 kHz, for example.
  • the aperture 1 15 enables the sound to escape the handle 104 so that it is comfortably audible to the surgeon while operating the medical instrument 100.
  • Figure 4a illustrates a sectional view of the electrosurgical medical instrument 100 illustrating elements thereof contained within the housing 1 12, according to one form.
  • the instrument 100 comprises a knife lockout mechanism 200 to prevent the advancement of an extendable member 202 (see Figure 4), which in some forms may comprise an inner sheath, coupled to a blade (not shown) portion of the medical forceps 108.
  • the medical forceps 108 having a movable jaw member that is pivotally movable to clamp down on a vessel when the control lever 1 10 is squeezed proximally in the direction of arrow 122.
  • the cutting blade or knife (not shown) portion of the medical forceps 108 also advances distally when the control lever 1 10 is squeezed proximally.
  • the cutting blade sometime referred to as the knife, is for cutting the vessel after it has been cauterized.
  • a knife lockout mechanism 200 prevents the control lever 1 10 from being squeezed and thus prevents the blade from being advanced until the activation button 1 14 is fully engaged and a suitable amount of RF energy is applied to the vessel to properly cauterize it.
  • the knife lockout mechanism 200 ensures that the activation button 1 14 is fully depressed to activate the RF energy source such that energy is delivered to the vessel prior to cutting.
  • the knife lockout mechanism 200 enables the control lever 1 10 to be squeezed proximally in the direction of arrow 122. This action advances the extendable member 202 distally to close the jaw members of the electrosurgical forceps 108 while the cutting blade is
  • electrosurgical energy is applied to the vessel through the jaw members of the electrosurgical forceps 108 before the cutting blade advances.
  • the integral energy source 128 may be a non- replaceable DC energy source such as a battery 128 that fits within the handle portion 104 of the housing 1 12.
  • a non- replaceable DC energy source such as a battery 128 that fits within the handle portion 104 of the housing 1 12.
  • One form of the energy source 128 is described in more detail hereinbelow.
  • the battery 128 is a l OOOmAh, triple-cell Lithium Ion Polymer battery, Lithium battery, among others.
  • the battery 128 will be fully charged prior to Ethylene Oxide (EtO) sterilization, and will have a fully charged voltage of about 12V to about 12.6V.
  • the battery 128 will have two 20A fuses fitted to the substrate which connects the cells, one in line with each terminal.
  • the battery capacity may be greater than 10OOmAh, such as, up to about 3000mAh, for example.
  • the minimum distance between terminals of the battery 128 may be about 3mm such that sparking conditions require an atmosphere with a dielectric breakdown of ⁇ 4200V/m. Even at the lowest pressures encountered in an EtO cycle, for a condition of pure EtO, across a 3mm gap the breakdown voltage is approximately 450V. This is more than an order of magnitude greater than the maximum battery voltage, and this is further mitigated by the use of a Nitrogen blanket during the sterilization process.
  • an electronics system 130 may include and electronics circuit device 131 .
  • the electronics system 130 comprises an RF generation circuit to generate an RF drive signal and to provide the RF drive signal to the at least one electrical contact where the RF generation circuit also includes a resonant circuit.
  • the electronics system 130 also comprises control elements such as one or more than one microprocessor (or micro-controller) and additional digital electronic elements to control the logical operation of the instrument 100.
  • control elements such as one or more than one microprocessor (or micro-controller) and additional digital electronic elements to control the logical operation of the instrument 100.
  • One form of the electronics system 130 is described hereinbelow.
  • the electronics system 130 including the RF generation circuit is supported by the housing 1 12.
  • RF generation circuit to generate an RF drive signal is integral to the housing 1 12 and the battery 128 is non-reusable.
  • a lockout mechanism comprises a rigid, yet elegant solution to controlled lockout of a handheld surgical instrument.
  • many surgical procedures require cutting or ligating blood vessels or other internal tissue.
  • Many surgical procedures are performed using minimally invasive techniques where a handheld instrument is used by the surgeon to perform the cutting or ligating.
  • Handheld instruments generally require significant manual manipulation during use. Much of this manipulation is preferably preformed without end effector activation or articulations. For example, without RF activating energy being applied to tissue.
  • Some compliant lockout mechanisms include lockout stops that must be adjusted in a manner that moves the knife more proximate than desired when in the lockout. Some lockout mechanisms may also require higher than desired force to release the knife.
  • lockout mechanisms however, handheld instruments are preferably small, which makes robust lockout mechanisms difficult to design.
  • lockout mechanism may merely indirectly lockout the operation.
  • the rigidity eliminates the need for extra safety buffers.
  • the lockout mechanism may comprise a logical lockout mechanism 134, in accordance with one form and as disclosed in U.S. Pat. App. No. 13/658,786, the contents of which are hereby incorporated by reference in their entirety.
  • the logical lockout mechanism works in cooperation with an initialization clip as disclosed in prevent operation of the instrument 100 until it is removed. In either case, the lockout mechanism is configured to lockout advancement or linear travel of the extendable member 202 until the lockout
  • Figure 4b illustrates a magnified representation of a mechanical portion of the lockout mechanism 200 of the electrosurgical medical instrument 100 of Figure 4a in a locked out position to prevent the actuation of the control lever 1 10, according to one form.
  • the control lever 1 10 comprises a trigger lever 212 portion that is configured to rotate about a trigger pivot 214 when the control lever 1 10 is squeezed in the direction of arrow 122 ( Figure 4a), unless the instrument 100 is in locked out mode.
  • the trigger lever 212 portion of the control lever 1 10 is prevented from rotating about the trigger pivot 214 because an engagement surface 218 of a first link 220 of slide link 222 engages an engagement surface 226 of the extendable member 202.
  • the first link 220 is coupled to a second link 228 of the slide link 222 via a pin 230 that extends through an elongate pin slot 232.
  • the elongate pin slot 232 is configured to allow pin 230 to slidably move through the elongate pin slot 232.
  • the first link 220 may comprise an elongate pin slot 232 and the second link 228 may comprise the pin 230.
  • the first link 220 is configured to pivot about a first fixed pivot 236 at slot 247.
  • the second link 228 is configured to pivot about a second fixed pivot 240 at slot 245.
  • the second link 228 further comprises projection 242.
  • Projection 242 is structured to engage projection 244, which is operably coupled to release lever 246.
  • Release lever 246 is pivotable about release pivot 248.
  • Figure 5 illustrates the lockout mechanism 200 in an open position, for example, when release lever 246 has been moved proximally.
  • activation button 1 14 Figures 1 -4a
  • the release lever 246 pivots such that projection 244 engages projection 242 to urge the second link 228 to pivot clockwise from a locked position as in Figure 4b to an open position as shown in Figure 5, in the direction of 250.
  • the rotation causes the elongate slot 232 to move proximally relative to the pin 230 such that pin 230 moves distally within the elongate slot 232, e.g., from a proximal portion 254 to a distal portion 256 of the elongate slot 232, to pull the first link 220 such that the first link 220 pivots in a clockwise direction from a locked position as shown in Figure 4 to an open position, in direction of 250, disengaging engagement surface 218 from engagement surface 226 positioned on collar 225.
  • Figure 6 illustrates a partial sectional view of the lockout mechanism 200 in a full stroke position.
  • pivoting of the release lever 246 about release pin 248 engages projection 244 with projection 242, urging the second link 228 of slide link 222 to pivot in direction 250, thereby pivoting the first link 220 in direction 250 such that surface 218 disengages surface 228.
  • the extendable member 202 may move distally in direction 258 ( Figure 5) from a home position (as shown in Figure 5) to the full stroke position.
  • control lever 1 10 ( Figures 1 -4a) may cause trigger lever 212 to pivot about trigger pivot 214.
  • a trigger lever coupling portion comprising a pin 262 pivotally coupled to the control arm 216 moves through slot 264 in direction 266 from a retracted to a full stroke position.
  • the control arm 216 is operably coupled to a retaining member 268 of the extendable member 202 via tab 270 ( Figures 4b, 5). Movement of the pin 262 through slot 264 in direction 266 rotates control arm 216 generally distally to advance the extendable member 202 distally in direction 258. For example, distally advancing the extendable member 202 may move a knife or sheath coupled thereto forward.
  • the lockout mechanism comprises a lockout positioning assembly 300. It will be appreciated that certain features described with respect to Figures 1 -6 may be the same or similar for purposes of the following descriptions of the various forms. Thus, similar features may be identified by similar reference number and, for the sake of brevity, may not be repeated or describe in similar detail. It is to be appreciated that those having skill in the art will recognize after reading the present disclosure that the various features and forms have application beyond the environmental features described herein. That is, the present disclosure is not limited to the environmental aspects, which are provided for the benefit of the reader to assist in understanding the inventive aspects herein disclosed.
  • the lockout positioning assembly 300 comprises a case boss 301 for receiving a pinch wing 31 1 , 313 pinchable in directions "A" and "B", respectively and coupled to a positioning spring 315 via base 333.
  • the case boss 301 design allows only one-way insertion.
  • the case boss 301 comprises a key slot 317 wherein at least a portion of the key slot 317 defines a complementary shape for fittably receiving the pinch wing 31 1 , 313 on positioning spring 315 in only one orientation, generally as illustrated in the drawing and along path "M".
  • the key slot 317 comprises a general u-shape for receiving the pinch wing 31 1 , 313 on positioning spring 315.
  • Figure 8 illustrates the positioning spring 315 extending from the case boss 301 through key slot 317 following insertion of the pinch wing 31 1 , 313 on positioning spring 315.
  • the positioning spring is mounted perpendicular to the first link 320.
  • the positioning spring 315 may be configured to engage a surface 351 of the first link 320 when the first link 320 pivots about fixed pivot 336 from the locked position to the unlocked position.
  • the positioning spring 315 is configured to engage the first link 320 along surface 341 when the first link is in the locked position and the unlocked position.
  • the positioning spring 315 may provide a biasing force to position the first link 320 in the locked position when the control arm 216 (see Figure 5) is in the home position.
  • the positioning spring 315 applies a force biased against the open position such that the positioning spring 315 at least partially assists in maintaining the first link 320 in the locked position, and hence the lockout mechanism in the locked mode, as well as returning the first link 320 to the locked position when the user releases the trigger 1 10 (see Figures 1 -4a) and/or the extendable member 202 is withdrawn proximally such that the collar 225 extends past the first link 320.
  • the location, thickness, extension, and material of the positioning spring 315 should be selected such that the nominal deflection, measured by the distance the positioning spring 315 are preferably caused to deflect when the first link is in the open position, does not exceed the yield strength of the positioning spring 315.
  • preferred materials include copper beryllium alloys, for example.
  • Figure 9 illustrates a form of a lockout positioning assembly 400 comprising a mounted spring link bracket 401 .
  • the mounted spring link bracket 401 comprises a mounting body 417 coupled to positioning spring 415.
  • the positioning spring 415 extends to a slot 421 defined by a housing 423.
  • the mounting body 417 is rotationally coupled to the first link 420 such that when the first link 420 pivots about fix pivot point 436 from the locked position to the open position, the lockout mechanism is disengaged and the mounting body 417 pivots with the first link 420.
  • the mounting body 417 is fixed to the first link 420 by laser welding or other manner of fixation known in the art, such as adhesives, rivets, or the like.
  • the positioning spring 415 deflects downward with the first link 420 while a portion of the positioning spring 415 is retained in the slot 421 defined by the housing 423.
  • a length of the positioning spring 415 is retained within the slot 421 extends out of the slot 421 when the first link 420 pivots to the open position to allow the positioning spring 415 to deflect with the first link 420.
  • the biasing force provided by the positioning spring 415 is therefore overcome by the pivoting force initiated by actuation of the activation button 1 14 (see Figures. 1 -4a), as described above.
  • the positioning spring 415 applies a force biased against the open position such that the positioning spring 415 at least partially assists in maintaining the first link 420 in the locked position, and hence the lockout mechanism in the locked mode, as well as returning the first link 420 to the locked position when the user releases the trigger 1 10 (see Figures 1 -4a).
  • the release lever 246 pivots to engage surfaces 244 and 242 such that the second link 228 pivots to pivot the first link 220 and disengages the lockout mechanism.
  • a spring 415 comprising a bias may engage a surface 451 of the first link 420 at a spring surface 441 .
  • the second link 228 must typically overcome the bias provided by the spring 415 to pivot the first link 220 and disengage the lockout mechanism.
  • the spring 441 may be at least initially deflected.
  • the spring 415 may bias the first link 420 immediately toward the locked position such that when the extendable member 202, e.g., knife, is withdrawn proximally, the collar 425 of the extendable member slides past the first link 220 and the first link 420 is urged toward the extendable member 202 to catch projection 426 of collar 425.
  • the collar 425 may at least partially deflect the spring 415 when the extendable member 202 is retracted and collar 425 contacts the top surface 427 of the first link 429.
  • the location, thickness, extension, and material of the positioning spring 415 are preferably selected such that the nominal deflection of the positioning spring 415 when the first link 424 is in the open position does not exceed the yield strength of the positioning spring 415.
  • preferred materials include copper beryllium alloys, for example.
  • Figure 10 illustrates a lockout mechanism similar to those described above wherein the second link (see Figures 4b-6) is removed to expose fixed pins 534, 538 associated with fixed pivots 436, 440 comprising the fixed points about which the first and second links 524, 228 (see Figures 4b-6) respectively pivot.
  • FIGS 1 1 -12, and in further reference to Figures 10 and 17, illustrate one form of a lockout positioning assembly 500a comprising a pin mounted spring link bracket 501 a.
  • the bracket 501 a comprises a base portion 533a having three extensions.
  • the first extension comprise a horizontally oriented member 537a defining a first vertically oriented side proximal to the base portion 533a and extending to a first attachment flange 529a dimensioned to receive fixed pin 534a.
  • the second extension comprises a positioning spring member 515a extending from an upper portion of the base portion 533a.
  • the positioning spring 515a is configured to extend through a slot 521 a defined in a housing 523a and defines a deflectable surface 541 a configured to engage a surface 551 a of the first link 520a. In various forms, the positioning spring 515a is configured to extend at least partially under the first link 520a to provide a biasing force against an open position of the first link 520a.
  • the third extension comprises a vertically oriented member 539a extending to a second attachment flange 531 a dimensioned to receive fixed pin 538a.
  • FIG. 13-14 illustrate one form of a lockout positioning assembly 500b comprising a pin mounted spring link bracket 501 b.
  • the bracket 501 b comprises a base portion 533b having three extensions.
  • the first extension comprise a vertically oriented member 537b extending to a first attachment flange 529b dimensioned to receive fixed pin 534b.
  • the second extension comprises a positioning spring member 515b extending from an upper portion of the base portion 533b.
  • the positioning spring 515b is configured to extend through a slot 521 b defined in a housing 523b and defines a deflectable surface 541 b configured to engage a surface 541 bof the first link 520b.
  • the positioning spring 515b is configured to extend at least partially under the first link 520b to provide a biasing force against an open position of the first link 520b.
  • the third extension comprises a vertically oriented member 539b extending to an attachment flange 531 b dimensioned to receive fixed pin 538b.
  • FIGS 15-16, and in further reference to Figures 10 and 17, illustrate one form of a lockout positioning assembly 500c comprising a pin mounted spring link bracket 501 c.
  • the bracket 501 c comprises a base portion 533c having three extensions.
  • the first extension comprise a horizontally oriented member 537c extending to an
  • the second extension comprises a positioning spring member 515c extending from a lower portion of the base portion 533c.
  • the positioning spring 515c is configured to extend through a slot 521 c defined in a housing 523c and defines a deflectable surface 541 c configured to engage a surface 551 c of the first link 520c.
  • the positioning spring 515c is configured to extend at least partially under the first link 520c to provide a biasing force against an open position of the first link 520c.
  • the third extension comprises a vertically oriented member 539c extending to an attachment flange 531 c dimensioned to receive fixed pin 538c.
  • Figure 17 illustrates a preferred positioning of first and third extensions 537, 539 of a pin mounted lockout positioning assembly 500.
  • the assembly 500 is shown with the positioning spring 515 extending from the base 533 toward the first link assembly 520.
  • the positioning spring 515 comprises a surface 541 configured to engage a surface 551 of the first link 524.
  • the positioning spring 515 extends at least partially under the first link to provide a biasing force against an open position of the first link 524.
  • the first extension 537 is vertically oriented and extends to a first attachment flange 531 .
  • the first extension may be horizontally oriented and/or vertically oriented in a similar manner as first extensions 537a and 537c.
  • the third extension 539 is vertically oriented and extends to an attachment flange 531 x/y.
  • attachment flange 531 x/y is positioned offset from attachment flange 529, e.g., at position 531 y, to thereby provide clearance for the proximal rotation of the control arm 216 (see Figures 4b-6).
  • the positioning spring 515 deflects in response to the pivoting force of applied by the first link 520.
  • the biasing force provided by the positioning spring 515, 515a, 515b, 515c is therefore overcome by the pivoting force initiated by actuation of the activation button 1 14 (see Figures. 1 -4a), as described above.
  • the positioning spring 515, 515a, 515b, 515c applies a force biased against the open position such that the positioning spring 515, 515a, 515b, 515c at least partially assists in maintaining the first link 520 in the locked position, and hence the lockout mechanism in the locked mode, as well assisting in returning the first link 520 to the locked position when the user releases the trigger 1 10 (see Figures 1 -4a).
  • the location, thickness, extension, and material of the positioning spring 515, 515a, 515b, 515c should be selected such that the nominal deflection of the positioning spring 515, 515a, 515b, 515c when the first link 524 is in the open position does not exceed the yield strength of the positioning spring 515, 515a, 515b, 515c.
  • preferred materials include copper beryllium alloys, for example.
  • Figures 18-19 illustrate one form of a lockout positioning assembly 600 comprising a spring bracket 601 comprising a positioning spring 615 coupled to the release pivot 648.
  • the positioning spring 615 may be coupled to the release lever 646 to provide increased bias when the first link 620 is in the open or locked position.
  • the positioning spring 615 comprises a surface 641 configured to engage a proximate surface 651 of the first link assembly 620.
  • Positioning spring 615 may deflect in direction 675 when the first link 620 pivots from the locked position to the open position.
  • the positioning spring 615 applies a force biased against the open position such that the positioning spring 615 at least partially assists in maintaining the first link 620 in the locked position, and hence the lockout mechanism in the locked mode, as well as returning the first link 620 to the locked position when the user releases the trigger 1 10 (see Figures 1 -4a).
  • the location, thickness, extension, and material of the positioning spring 615 should be selected such that the nominal deflection of the positioning spring 615, indicated by arrow 675, does not exceed the yield strength of the positioning spring 615 when the when the first link 620 is in the open position.
  • preferred materials include copper beryllium alloys, for example.
  • Figures 20-26 illustrate various forms of lockout positioning assemblies 700, 800, 900 comprising spring positioning brackets 701 , 801 , 901 coupled to fixed pivot point 736, 836, 936.
  • FIG. 20 illustrates a lockout positioning assembly 700 comprising a spring positioning bracket 701 coupled to fixed pivot 736.
  • the bracket 701 comprises first and second flanged bracket portions 729, 731 configured to receive fixed pivot 736.
  • the first and second flanged bracket portions 729, 731 extend to base 733.
  • Base 733 is positioned to constrain the positioning spring 715 along a portion of the length of the spring 715.
  • the base 733 may comprise a length of the spring 715 and/or be aligned with the spring 715.
  • the spring may be constrained by attachment flanges 729, 731 that may be positioned on two or more sides of the length of the spring, representing fixed constraints.
  • the spring 715 may be constrained by the first attachment flange 729 and the second attachment flange 731 on at least two sides of the spring 715.
  • the first and second flanges 729, 731 are each fixably coupled to the fixed pivot point 736.
  • the first link is pivotally coupled to the fixed pivot 736 such that the first link 720 may pivot between the locked position and the open position.
  • the release lever 746 pivots to engage projections 744 and 742 such that the second link 728 pivots to pivot the first link 720 and disengages the lockout mechanism.
  • the spring 715 comprises a bias and engages a surface 751 of the first link 720 at a spring surface 741 .
  • the second link 728 must overcome the bias of the spring 715 to pivot the first link 720 and disengage the lockout mechanism.
  • the spring 715 may be at least initially deflected. Depending on the configuration, the spring 715 may bias the first link 720 toward the locked position such that when the knife is withdrawn proximally after use, the collar 725 of extendable member slides past the first link 720 and the first link 720 is urged toward the extendable member 702 to catch projection 726 of collar 725. In various forms, the collar 725 may at least partially deflect the spring 715 when the extendable member 702 is retracted and collar 725 contacts the top surface 727 of the first link 729.
  • Figure 21 illustrates a lockout positioning assembly 700a comprising a spring positioning bracket 701 a coupled to fixed pivot 736a.
  • the bracket 701 a comprises first and second flanged bracket portions 729a, 731 a configured to receive fixed pivot 736a.
  • the first and second flanged bracket portions 729a, 731 a extend to base 733a.
  • Base 733a is positioned to constrain the positioning spring 715a along a portion of the length of the spring 715a.
  • the base 725a may comprise a length of the spring 715a and/or be aligned with the spring 715a.
  • the spring when the base comprises the spring or is aligned with the spring, the spring may be constrained by attachment flanges that may be positioned on two or more sides of the length of the spring 715a, representing fixed constraints.
  • the spring 715a may be constrained by the first attachment flange 729a and the second attachment flange 731 a on at least two sides of the spring 715a.
  • the spring 715a or base 733a may be pressed between the pivot 736a and a mounting structure 749a.
  • Figures 21 -22 illustrate a lockout positioning assembly 800 comprising a spring positioning bracket 801 coupled to fixed pivots 836.
  • the bracket 801 comprises first and second flanged bracket portions 829, 831 configured to receive fixed pivot 836.
  • the first and second flanged bracket portions 829, 831 extend to base 833.
  • Base 833 is positioned in a fixed orientation with relative to the fixed pivot 836.
  • the first and second flanged bracket portions or the base may be fixed to a mounting structure 849 to maintain a fixed position.
  • the base 833 may be welded, adhered, or otherwise fixed to mounting structure 849.
  • the spring 815 is formed to extend away from the base at less than a 90 degree angle in the non- deflected position, as generally shown in Figure 21 .
  • Figure 22 illustrates the deflection of the spring with respect to the base 833 and bracket portions 829, 831 wherein the pivoting of the first link from the lockout position to the open position to disengage the lockout mechanism, at least initially, deflects the spring 815 in the direction of arrow 875 to define a larger angle with respect to the base 833.
  • the spring is positioned generally parallel to the links 820, 828.
  • FIGS 23-26 illustrate a form of a lockout positioning assembly 900 wherein the spring 915 is positioned generally parallel to the links 920, 928.
  • a lockout positioning assembly 900 comprising a spring positioning bracket 901 is coupled to fixed pivot 936.
  • the bracket 901 comprises first and second flanged bracket portions 929, 931 configured to receive fixed pivot 936.
  • the first and second flanged bracket portions 929, 931 extend to base 933.
  • Base 933 is positioned between the first and second and second flanged bracket portions 929, 931 .
  • the first and second flanged bracket portions 929, 931 may constrain the spring 915 through base 933.
  • the first and second flanged bracket portions 929, 931 may be rotatably coupled to the fixed pivot 936.
  • the spring comprises an anti-rotation tab 976 and a rib 977.
  • Figures 27-28 illustrate a form of a lockout positioning assembly 1000.
  • the lockout positioning assembly 1000 comprises a spring positioning bracket 1001 wherein the spring 1015 is positioned parallel to the link 1020 and is disposed proximally to the first link 1020.
  • Figure 27 illustrates lever arm of control arm 1016 retracted such that the extendable member 1002 is in the fully retracted position.
  • a boss case 1080 as shown in a semi isolation view in Figure 29, is disposed proximal to the first link 1020 and retains a spring 1015 extending toward the first link 1020.
  • the spring 1015 comprises a distal angled portion 1081 positioned to engage the first link 1020.
  • the spring 1015 biases the first link 1020 toward the extendable member 1002 and may be deflected via pivoting of the second link 1028 as shown in Figure 28. For example, a user may depress an activation button to pivot the first link 1020 to an open position.
  • the spring positioning bracket 1001 comprising two flanged portions 1029, 1031 , and a base portion 1033. The spring 1015 extends from the base 1033 at about a right angle to engage the first link 1020.
  • FIGs 30-32 illustrate a form of a lockout positioning assembly 1 100.
  • the assembly comprises a spring positioning bracket 1 101 wherein the bracket 1 101 may be positioned about the trigger pivot 1 1 14.
  • the trigger pivot may be utilized to operation an activation lockout.
  • the bracket 1 101 may comprise a ring having thereon disposed a spring 1 1 15 forming an arcuate folded extension.
  • the bracket 1 101 defines two flange portions 1 185, 1 186 and a slot 1 187 for receiving fixed pivot 1 140 to prevent rotation of the bracket 1 101 .
  • the flange portions 1 185, 1 186 extend from a base 1 133.
  • the spring 1 1 15 extends to engage the first link in the locked position, as shown in Figure 32.
  • endoscopic should not be construed to limit the present invention to an instrument for use only in conjunction with an endoscopic tube (e.g., trocar).
  • endoscopic tube e.g., trocar
  • the present invention may find use in any procedure where access is limited to a small incision, including but not limited to laparoscopic procedures, as well as open procedures.

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biomedical Technology (AREA)
  • Otolaryngology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Plasma & Fusion (AREA)
  • Physics & Mathematics (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 verrou d'instrument médical, qui comprend une liaison pouvant coulisser ayant un premier maillon et un second maillon, et un premier pivot fixe et un second pivot fixe. Le second maillon peut pivoter autour du second pivot fixe pour faire pivoter le premier maillon autour du premier pivot fixe. Le pivotement du second maillon autour du second pivot fixe peut désaccoupler le premier maillon d'un élément extensible. Un ressort peut être positionné pour solliciter le premier maillon contre l'élément extensible pour verrouiller l'instrument. Le ressort peut être dévié par le premier maillon lorsque le second maillon pivote autour du second pivot fixe pour désaccoupler le verrou.
PCT/US2014/017091 2013-03-15 2014-02-19 Instrument chirurgical ayant une section d'articulation renforcée Ceased WO2014149313A1 (fr)

Applications Claiming Priority (2)

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US201361801932P 2013-03-15 2013-03-15
US61/801,932 2013-03-15

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WO2014149313A1 true WO2014149313A1 (fr) 2014-09-25

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Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5184625A (en) * 1992-04-16 1993-02-09 Cordis Corporation Biopsy forceps device having improved handle
WO1994004084A1 (fr) * 1992-08-21 1994-03-03 Microsurge, Inc. Mecanisme de prehension ameliore destine a des instruments manuels
US6322578B1 (en) * 1997-07-14 2001-11-27 Heartport, Inc. Endoscopic microsurgical instruments
WO2005112792A2 (fr) * 2004-05-14 2005-12-01 Evalve, Inc. Mecanismes de verrouillage pour dispositifs de fixation et methodes de fixation de ces dispositifs a un tissu
WO2012058213A2 (fr) * 2010-10-29 2012-05-03 Carefusion 207, Inc. Instruments articulés pour coelioscopie

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5184625A (en) * 1992-04-16 1993-02-09 Cordis Corporation Biopsy forceps device having improved handle
WO1994004084A1 (fr) * 1992-08-21 1994-03-03 Microsurge, Inc. Mecanisme de prehension ameliore destine a des instruments manuels
US6322578B1 (en) * 1997-07-14 2001-11-27 Heartport, Inc. Endoscopic microsurgical instruments
WO2005112792A2 (fr) * 2004-05-14 2005-12-01 Evalve, Inc. Mecanismes de verrouillage pour dispositifs de fixation et methodes de fixation de ces dispositifs a un tissu
WO2012058213A2 (fr) * 2010-10-29 2012-05-03 Carefusion 207, Inc. Instruments articulés pour coelioscopie

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